1.CARESTAR’s initial grant supported 

the Comprehensive Access and Equity Project. What did that funding make possible that wouldn’t have happened otherwise? 

The CARESTAR grant allowed us to do something that’s often overlooked in systems change work: build a strong foundation before moving to implementation. It gave us the resources to define what equity means in the context of emergency medical services and to begin developing a comprehensive framework for measuring it across a complex, statewide system. 

We were able to convene stakeholders from across California, host statewide discussions, and invest in the data and expertise needed to move from intention to structure. That included early work to identify what data we needed, how to collect it, and how to apply it in a way that could inform policy and practice. We also used this opportunity to begin the organizational change management work necessary to support long-term adoption — aligning partners, building shared understanding, and preparing the system to translate this work into practice. 

2. For those who may be new to it, what is the Statewide Impact Framework—and what makes it different from traditional EMS data efforts? 

The Statewide Impact Framework integrates demographic, clinical, and system-level data to help us measure not just how the EMS system is performing overall, but how it is performing for different communities across California. It brings together data on access, care delivery, and patient outcomes to identify where disparities exist, track progress over time, and support decision-making at the local, state, and partnership level.

While traditional EMS data systems often prioritize volume, response times, or operational efficiency, they don’t tell us whether care is equitable. This Framework does. 

3. How should local EMS agencies or partners start engaging with the framework today? What does “getting started” actually look like? 

We encourage local EMS agencies and partners to explore the framework, understand the key metrics, and begin thinking about how those measures align with their current data systems and priorities. 

Some agencies may begin by reviewing their own data through an equity lens — looking at differences in response, treatment, or outcomes across populations. Others may participate in pilot efforts as we continue to test feasibility, refine metrics, and build reporting standards. 

We’re also working closely with local EMS agencies to provide guidance, technical support, and opportunities for building capacity in a way that reflects the needs of each community. 

4. You’ve emphasized that this work is about turning data into action. Can you share a real-life example of how the framework drives change? 

One example is how the framework can highlight differences in patient outcomes for time-sensitive conditions, such as cardiac or respiratory emergencies, across different communities. When those disparities become visible, agencies can begin to ask more targeted questions: Are there differences in response times? In treatment protocols? In access to appropriate facilities? 

From there, the data can inform specific actions— whether that’s updating clinical protocols, investing in targeted training, improving coordination with hospitals, or addressing gaps in coverage in certain areas. 

With the adoption of the framework and partnerships, we hope to see measurable reductions in racial disparities in access, care, and outcomes.