The American College of Paramedics, through its advocacy arm, the American Paramedic Association (APA), is sounding the alarm following the sudden termination of all members of the National EMS Advisory Council (NEMSAC).
In a statement released Aug. 29, the organizations called the move disruptive to EMS policymaking and a setback for clinicians on the front lines. At the same time, they outlined a framework to reconstitute NEMSAC under paramedic-led leadership.
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Background on NEMSAC
NEMSAC was established under the Federal Advisory Committee Act to advise the Secretary of Transportation and the Federal Interagency Committee on EMS. The council provides national needs assessments, formal recommendations and annual reports to the secretaries of Transportation, Health and Human Services, and Homeland Security.
Despite its role, paramedic representation on NEMSAC has been inconsistent. According to the APA, the termination of all members risks destabilizing ongoing work but also presents a “rare opportunity” to rebuild the council with paramedics in every voting seat.
Framework for reconstitution
The APA and the American College of Paramedics proposed a framework that would:
- Make NEMSAC paramedic-led, with all voting seats filled by licensed paramedics (EMTs, advanced EMTs, and paramedics).
- Ensure recommendations remain clinician-focused, prioritizing patient outcomes and workforce needs.
- Include voices from across the EMS system — such as dispatch, fire service, hospitals, finance and patient advocates — through liaison and advisory roles.
- Advance action quickly on priorities like reimbursement, workforce issues, offload delays and data integration.
The groups also recommended shifting EMS governance from the Department of Transportation to a new Office of the Chief Paramedic within the Department of Health and Human Services, while maintaining DOT’s role in roadway safety and vehicle standards.
Guardrails and next steps
To prevent politicization, the framework calls for reaffirming NEMSAC’s nonpartisan mission, resuming predictable meetings and enforcing conflict-of-interest protections.
APA leaders said they are already taking steps, including:
- Convening EMS, nursing, physician and fire service organizations to support a clinician-led reconstitution
- Publishing a clinician-led summary of advisories ready for expedited adoption
- Preparing qualified paramedics to fill every voting seat
“The termination of NEMSAC members is disruptive and serious,” APA Chair Joshua A. Worth Sr. said in the statement. “But if followed by a transparent, paramedic-led reconstitution, it can strengthen EMS governance and deliver measurable improvements in reimbursement, clinician safety, patient outcomes and system performance.”
The statement was also signed by Nick Nudell, chair of the American College of Paramedics, and Gary Wingrove, president of The Paramedic Foundation.
