EMS One-Stop

• Growing the next generation of changemakers in rural EMS

  In this special crossover edition of EMS One-Stop and The Bridge Podcast from the Kentucky Office of Rural Health, host Amelia Holliday leads the conversation, joined by Scott Helle, rural project manager at KORH; and Rob Lawrence, host of EMS One-Stop and EMS leader. Recorded live at the 2025 Kentucky EMS Leadership Academy, this episode explores the evolution, design and impact of the Leadership Academy on Kentucky’s rural EMS landscape. The discussion dives into the Academy’s origins, structure, statewide reach and its mission to prepare the next generation of EMS leaders in some of the most resource-challenged communities in the country. From the realities of low-volume, underfunded rural services, to the inspiring stories of leadership growth and resilience, this episode offers a thoughtful examination of the challenges facing EMS in Kentucky and beyond. Rob reflects on leadership principles drawn from his military and EMS career, while Scott provides a blueprint for how to build and sustain EMS talent in small communities. Together with Amelia’s thoughtful moderation, this episode highlights how mentorship, structured learning and network-building are transforming rural EMS leadership — one cohort at a time. Additional resources The Bridge Podcast (Contains additional discussion) Center of Excellence in Rural Health: Established to address health disparities in rural Kentucky Asking the big questions: Industry leaders weigh in on celebrating EMS Week amidst the forces shaping the EMS landscape Cultivating the next generation of EMS: Leadership development, emotional intelligence and the importance of mentorship Memorable quotes “We’re promoting people above their level of competency — not because they’re not good, but because we haven’t prepared them for what’s next.” — Rob Lawrence “We saw early on that EMS professionals were great at clinical care, but we were missing the leadership piece.” — Scott Helle “Effective communication is the core of good leadership. You can’t lead without it.” — Amelia Holliday “My six principles: pride, integrity, learning, humor, service and courage. They guide everything I do.” — Rob Lawrence “It costs money to build people. That’s why we provide this Academy at no cost to participants.” — Scott Helle “It’s hard to run EMS in a state where many counties don’t even have a tax base to support it.” — Scott Helle “You’re always leading. Once you start, it never stops. People are always watching and listening.” — Rob Lawrence “We’re not just building leaders — we’re building mentors, networks and future change-makers.” — Scott Helle “Nobody becomes a good leader because they want power. The best leaders are those who understand the responsibility.” — Amelia Holliday Episode timeline 00:18 – Introduction to the Kentucky Leadership Academy and crossover with The Bridge Podcast 02:29 – How the Academy was formed and why it was needed 05:00 – Structure of the Academy, application process and regional representation 08:11 – EMS 2050, developing next-gen leaders, and avoiding the Peter Principle 11:00 – The importance of non-clinical leadership education 13:36 – Funding challenges in rural EMS, tax base realities and sustainable operations 17:41 – Rural EMS dynamics, local politics and the true cost of readiness 21:25 – Hospital closures and extended transport times — national rural EMS challenges 24:11 – Leadership is constant: visible, energetic and principle-driven 28:14 – Rob’s military leadership values and the weight of being observed 32:35 – Leadership as service and the power of building trust within teams 34:58 – Rob’s group dynamics “icebreaker” exercise and lessons on leadership styles 39:33 – Mentorship benefits both ways: mentees gain confidence, mentors renew purpose 44:49 – Academy success stories and graduates becoming leaders elsewhere in EMS 46:44 – Closing comments and podcast wrap-up with Amelia and Rob Rate and review the EMS One-Stop podcast Enjoying the show? Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

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• From info overload to instant clarity: Lifeline EMS puts AI to work

  In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with Danielle Thomas, chief operating officer, Lifeline EMS of Los Angeles, to explore how her team is harnessing “actual intelligence” — through a proprietary, closed-source AI platform called InCheck — to solve a perennial EMS headache: information overload. Thomas explains how embedding agency-specific protocols, an 800-page policy manual and multi-language translation into a single voice-activated app gives every crew member a “mentor in their pocket,” shrinking cognitive load, sharpening clinical decision-making and smoothing onboarding during the critical first 80 hours of employment. | More: From 73 to 33 minutes: How Sacramento reinvented patient offload times  The conversation ranges from her move from Boston to California and the regulatory culture shock that followed, to Lifeline’s recent CAAS accreditation push and the wider potential of AI-driven tools to boost recruitment, retention, compliance and patient safety. In the second half, Rob and Danielle expanded the conversation from tools to leadership strategy, focusing on how EMS agencies can better support staff in high-pressure, multi-jurisdictional environments. Thomas shares how her team tackled issues like protocol confusion, inconsistent policy knowledge and language barriers — not by adding more training sessions, but by rethinking how information is delivered, accessed and retained on the front lines. She emphasizes the importance of aligning education with the way today’s workforce learns, communicates and engages — especially during the critical first days of employment. The episode closes with a preview of Danielle’s upcoming AAA conference presentation with Carly Strong, which challenges perceptions of gender in EMS leadership and spotlights the untapped potential of inclusive, thoughtful organizational development. Memorable quotes “If you can, as the leader in an EMS organization, figure out how to enhance not only that first 80 hours, but that team member experience.” — Danielle Thomas “As everybody listening knows, I'm sure that every new policy probably has somebody's secret name attached to it because of what happened.” — Rob Lawrence “It honestly solves our recruitment and retention issues because they want to come to work.” — Danielle Thomas “I happen to believe that [AI is] an on-the-train or under at the moment kind of thing … we now have to move forward. It's part of our life. We have to embrace it and we have to employ it.” — Rob Lawrence “The left coast is more highly regulated and so I was not used to the labor laws in California and I was not used to the way that the local EMS authorities work.” — Danielle Thomas “I think every company I've worked at that that was a thing and so we had to create a solution to the problem we had, which was information overload.” — Danielle Thomas Episode timeline 01:25 – Welcome to Danielle Thomas 02:56 – East-to-West move and California’s regulatory maze 4:12 – Lifeline EMS footprint across Los Angeles, Orange and Riverside Counties 6:27 – The policy-overload dilemma in multi-county operations 10:01 – InCheck: turning 800 pages into actionable intel 14:53 – From AI skeptic to evangelist — programming county-specific protocols 18:30 – Five operating modes explained (Rampart, Angel, Nova, L-Chat Narrative) 28:00 – 100-language instant translation with Nova 34:51 – Building the tool in-house; cost and compliance advantages 38:43 – Preview of AAA Conference session, “Just one of the guys” 41:33 – Final takeaways: enhancing the first 80 hours and keeping crews engaged 42:44 – Closing remarks Rate and review the EMS One-Stop podcast Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

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• Paramedics without borders: Celebrating global unity on International Paramedic Day

  In this international edition of the EMS One-Stop podcast, host Rob Lawrence welcomes Lewis Andrews, the chief operating officer of the United Kingdom’s College of Paramedics, for an insightful discussion on two major topics shaping global paramedicine. First up is International Paramedic Day, taking place on July 8, 2025. Now in its third year, the day honors the contribution of paramedics across the world and draws its inspiration from the birthday of Dominique-Jean Larrey, the father of battlefield ambulance care. Lewis explains how the day has grown from 50 initial partners to over 150 global organizations, with this year’s theme being “Unity and community.” The day aims to raise awareness of the profession, share innovations and bring together the global paramedic community. MORE | How community paramedicine is thriving in the UK: Dr. Linda Dykes and Rom Duckworth discuss trans-Atlantic lessons in emergency management In the second half of the show, Lewis delves into the structure and significance of the College of Paramedics, which represents nearly half of the UK’s registered paramedics. He describes how the UK paramedic profession is regulated and protected by law, with a rigorous educational pathway that now includes the potential for prescribing paramedics and direct-to-primary-care tracks. Rob and Lewis explore how paramedics in the UK are increasingly working beyond emergency ambulances — in GP surgeries, urgent care centers and academic roles. Their conversation offers a rich comparison point for U.S. EMS leaders seeking to elevate paramedicine through autonomy, education and broader clinical roles. Memorable quotes “This is not a commercial platform — this is about us celebrating us.” — Lewis Andrews, on the ethos of International Paramedic Day “Let’s not reinvent the wheel, but let’s look at what the wheel is for the environment that it’s required to roll in.” — Lewis Andrews, on global EMS collaboration “The title ‘paramedic’ is protected by law in the UK — you can’t simply do a first aid course and call yourself one.” — Rob Lawrence “Autonomy — in a word — that’s what makes a prescribing paramedic.” — Lewis Andrews, on expanding paramedic roles “We’re also promoting the profession to those who don’t yet know they want to be in the profession.” — Lewis Andrews, on recruitment and professional identity “We have a career framework … that actually shows that you can develop from that day one newly qualified right through to a consultant paramedic, chief paramedic, director, professor.” — Lewis Andrews Episode timeline 00:55 – Introduction to International Paramedic Day (IPD) and its origins 02:17 – Why July 8 was chosen: Dominique-Jean Larrey’s birthday 03:02 – Growth of IPD from 50 to over 150 partners 05:06 – 2025 theme: “Unity and community” and sub-objectives 06:45 – How to participate: share stories, use hashtags (#UnityAndCommunity and #IPD2025), connect globally 08:58 – The global nature of IPD and U.S. partners’ involvement 11:25 – Promoting awareness and the importance of celebrating paramedics 12:50 – Part 2 — The role of the College of Paramedics 14:09 – Overview of College functions: CPD, representation, research, advocacy 18:15 – Registration with HCPC, protected title and the regulator’s role 21:12 – Paramedic education in the UK: degree pathways, demand and cost 23:46 – Discussion on streaming directly into primary care roles 27:09 – Career framework: from graduate paramedic to chief paramedic/professor 30:16 – Prescribing paramedics: autonomy and improved patient experience 33:08 – Recap and call to action: visit www.internationalparamedicsday.com 34:17 – Like, subscribe and engage ADDITIONAL RESOURCES International Paramedics Day Resources UK College of Paramedics The standards of proficiency for paramedics RATE & REVIEW Enjoying the show? Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

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• How ‘One big beautiful bill’ could break EMS

  In this vital episode of EMS One-Stop, host Rob Lawrence is joined by Matt Zavadsky and attorney Doug Wolfberg of Page, Wolfberg & Wirth for a deep-dive into three financial flashpoints currently impacting EMS. First, the trio unpack the launch of the new PWW|AG/EMS|MC EMS Financial Index, a quarterly report leveraging billing and revenue cycle data from over 1,500 agencies nationwide. This unprecedented benchmarking tool allows EMS leaders to measure performance against regional and national trends, uncovering actionable insights into billing strategies, reimbursement rates, payer mixes and the economics of service delivery. It’s a critical step in helping agencies justify their value and improve their financial sustainability. Next, the discussion turns to MedPAC — the Medicare Payment Advisory Commission — and its controversial response to cost data submitted by ambulance services under the CMS Ground Ambulance Data Collection System. Doug Wolfberg explains how MedPAC discarded over half of the data, labeling higher-cost services — often rural or government-run — as outliers. This move could justify lower or stagnant Medicare fee increases, potentially devastating many providers. Finally, attention shifts to the “One Big Beautiful Bill” moving through Congress and now on its way to the Senate that would eliminate or severely restrict enhanced Medicaid funding mechanisms, such as supplemental payments and provider taxes. If passed, this legislation would reduce reimbursement for millions of transports, triggering funding crises across EMS systems — particularly in states like California and Illinois. The episode delivers a clear message: EMS leaders must prepare, advocate and act now. Episode timeline 00:41 – Rob introduces the three main topics: the PWW|AG/EMS|MC EMS Financial Index, MedPAC’s response to ambulance data and a major federal bill impacting Medicaid 01:59 – Part 1 — PWW|AG/EMS|MC Financial Index 03:37 – Matt explains that the index is built using data from over 1,500 EMS agencies via EMS|MC 05:43 – The importance of regional benchmarking 08:22 – First major finding: dramatic variation in ALS billing rates across regions 09:30 – Key insight: agencies that bill more tend to collect more revenue — agencies are encouraged to determine their true cost of service and align billing accordingly 12:37 – Collection percentage is debunked as a misleading metric; focus should be on dollars collected 15:36 – ALS vs. BLS billing levels explained, with a look ahead to Q2’s emergency-only data set 18:48 – How EMS agencies can better engage with insurers to cover non-transport and MIH services 20:46 – Part 2 — MedPAC 22:24 – Doug outlines how MedPAC discarded over half of the reported ambulance cost data 25:00 – Explanation of which data was discarded and why — primarily high-cost, rural and government-based services 28:22 – Doug asserts MedPAC is using cherry-picked data to suppress reimbursement increases 30:10 – Rob and Doug emphasize that EMS gave MedPAC quality input, but MedPAC is producing garbage output 32:08 – Doug outlines what MedPAC will do next and what EMS leaders must do in response 34:40 – Strong call to action: educate Congress, use real CMS data and don’t accept MedPAC’s narrative 36:59 – Doug emphasizes the importance of evidence-based deployment strategies for financial sustainability 37:31 – Part 3 — “One Big Beautiful Bill” 38:19 – Matt outlines how the bill would drastically limit Medicaid supplemental payments 39:43 – Federal/state Medicaid match rates explained with California as an example 42:51 – The looming reckoning: local governments may have to pay to maintain current EMS service levels 46:02 – Matt warns that the bill could trigger PAYGO cuts to Medicare as well 47:16 – Agencies are urged to plan now, talk to their communities and adjust operations 48:06 – Doug adds that pressure on U.S. senators, especially in red states, could still influence the bill 51:26 – Close and call to action Final takeaway This episode underscores that EMS cannot remain reactive — leaders must proactively use data, engage legislators and educate their communities on the true cost of care. The EMS Financial Index, the MedPAC dismissal, and the pending bill all point to a critical need for informed, strategic advocacy.

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• Safe streets for all: MVC care funding in action

  In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with returning guest Chief Robbie MacCue of Colonie EMS (New York) to explore the transformative potential of the Safe Streets and Roads for All (SS4A) federal grant program. Funded by the Infrastructure Investment and Jobs Act, SS4A aims to prevent roadway fatalities and enhance post-crash care. With $5 billion available nationwide and $900 million still on the table for FY25, this conversation is a call to action for EMS agencies across the country. Chief MacCue shares the story of how his department, in collaboration with neighboring EMS and police agencies, secured $2.4 million in SS4A funding for a project focused on innovative vehicle alert systems, prehospital health information exchange and groundwork for whole blood deployment. From demystifying the grant application to defining success metrics and compliance reporting, this episode breaks it all down — turning policy into practice, and complexity into impact. Memorable quotes “I was pretty taken back by the statistic that 40% of these patients were alive when EMS arrived and later died. Those are patients that are talking to us that are no longer living after a crash.” — Robbie MacCue “This isn’t free money. It comes with reporting requirements, match funding and responsibility — but there’s help out there, and it’s absolutely worth it.” — Robbie MacCue “Our goal is to go upstream to the source of the problem. How do we stop the bleeding? How do we stop some of these accidents from actually happening?” — Robbie MacCue “We put a two-page narrative together that generated a $3,000,000 regional application … based on simple principles about statistics.” — Robbie MacCue “Post-crash care is definitely a missing element in the Safe System Approach … and EMS needs to be part of the solution, not just the response.” — Robbie MacCue “You don’t have to have all the solutions right away. You just have to have the initiative to get with other like-minded people.” — Robbie MacCue “This project isn’t just for crashes. It will also help us with high-utilizer patients and improve reimbursement accuracy by connecting data silos.” — Robbie MacCue “Somebody emailed me in the week to say that the EMS One-Stop podcast is the podcast that’s able to turn a very complex EMS topic into a car bumper sticker. So there you go. If we’re doing that and we can achieve that, then we’re getting somewhere.” — Rob Lawrence Episode timeline 00:00-02:00 – Intro to SS4A and the scale of available funding ($5B) 02:00-04:00 – Why post-crash care matters: 42% of patients alive at EMS arrival die later 04:00-07:00 – How Colonie EMS discovered and approached the SS4A opportunity 07:00-10:00 – Building a regional grant application and tripling the funding 10:00-13:30 – Overview of the proposed project – transponder tech, health information exchange and whole blood 13:30-17:00 – Specific technology being explored and integration challenges 17:00-20:00 – Working with MPOs, consultants and navigating acronyms 20:00-25:00 – Finding the 20% match, leveraging in-kind contributions and funding timelines 25:00-30:00 – Federal reporting requirements and budgeting with SF-424A 30:00-35:00 – The big goal: Closing the outcome data loop and EMS-hospital data sharing 35:00-40:00 – Measuring success, from whole blood to vehicle alerts 40:00-42:30 – Robbie’s final advice: “Don’t be intimidated — reach out and apply.” ADDITIONAL RESOURCES SS4A Application Portal & Resources: Safe Streets and Roads for All (SS4A) Grant Program | US Department of Transportation NHTSA’s Office of Emergency Medical Services | EMS.gov Lexipol Grants Support Metropolitan Planning Organizations (MPOs) database

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