In fall 2025, leaders at the Mid-America Regional Council (MARC), which includes city and county governments and the metropolitan planning commission for the Kansas City region, sat down to begin preparing their application for a Safe Streets and Roads for All (SS4A) grant. They already knew that if they were successful, they wanted to use the funds primarily to launch a prehospital blood transfusion program.

MARC’s committee on EMS saw the potential for prehospital blood products to save more patients in both Kansas and Missouri (the council oversees transportation planning for parts of both states). Specifically, they wanted to save patients who’d likely otherwise die from severe hemorrhage, whether in a motor-vehicle crash or from a medical emergency or penetrating trauma.

MARC serves nine counties and 119 cities, including 35 ambulance companies. With a response area that large, leadership believed a regional approach to introducing prehospital transfusion made the most sense, says Jason White, Emergency Medical Services (EMS) Program Manager at MARC. “We’re rolling it out slowly because we know we’re going to learn along the way. We put in for the SS4A grant because we felt that one or two of our progressive EMS agencies could absolutely get started” with the help of more funding.

In December 2025, MARC learned their application for a Planning and Demonstration grant had been approved, and that they’d receive $373,436 for their “Regional Safe Streets Plan Supplement and Demonstration Project: Saving Lives by Improving Post-Crash Care Through Early Use of Whole Blood.”

MARC will use the funds to design and demonstrate a regional prehospital whole-blood program and produce a post-crash care appendix for the region’s FY 2023 Comprehensive Safety Action Plan. Work will include developing protocols and partner agreements (primarily with EMS agencies and hospitals), paramedic training and certification, storage and monitoring of blood products on emergency vehicles, and an evaluation plan to measure whole-blood administration and inform recommendations for the council’s Action Plan recommendations.

Four Tips for a Successful SS4A Application

Every public safety agency will approach their SS4A application process a little differently, but here’s some advice gleaned from MARC’s success:

1. Understand how you want to save more lives and reduce serious injuries on your roadways. While MARC’s committee on EMS was already deeply familiar with their local trauma data, many agencies applying for SS4A funds will need to analyze local patterns and trends to determine where and how blood products or other proposed roadway-safety work can have the greatest impact. This is a critical part of any successful application.
   Trauma data informed MARC’s plans to introduce prehospital blood transfusion and their decision to undertake a regional approach. “The EMS subcommittee [on whole blood] said, ‘we need to get into whole blood; it’ll have a positive impact on the patients we serve,’” explains White, who has worked in EMS since 1979. “We need to do it regionally because [whole blood] is a rare commodity and it’s fragile… So all of those conversations went on before we put pen to paper and said, ‘let’s go after this grant.’”
    
2. Engage, then divide and conquer. The EMS committee meets monthly, which made that a natural time to discuss what was still needed to complete their SS4A application. “The meeting includes surgeons, receiving hospitals, blood managers, EMS medical directors, ambulance services, ER staff and blood banks, so the conversation around the grant was routing through them,” White explains. MARC also reached out to the Kansas and Missouri State Highway Safety Offices to double-check the numbers from these offices that MARC used on their SS4A application.
   Members of the whole blood subcommittee were asked to help complete or assemble much of what was needed for the application, such as the Self-Certification Eligibility Worksheet, Action Plan documents and other supporting documentation.
   If your agency can’t easily gather the contributors needed to finish your SS4A application, consider designating a temporary project manager. This point person can track missing documents and information and ensure they’re received in time to meet the May 26 deadline.
    
3. Find your match. Even the best-laid plans can hit a glitch or two. MARC’s biggest challenge in completing their application was finding matching funds. (The SS4A program requires that 20% of total project funding comes from non-federal sources.) It didn’t help that the council’s service area includes “a state line [between Kansas and Missouri] that runs through the middle of our region,” White says. Fortunately, he adds, “Kansas has a state fund that provides a match and we were able to apportion how much of the grant would be spent in Kansas, and they gave us a 20% match out of state funds.”
   Missouri, though, didn’t have the same resource to draw from—though they did have a health foundation with an applicable program. “There are entities willing to support bringing federal dollars into your community. You just need to go looking for them,” he stresses.
    
4. Watch and learn. White says the MARC team found NHTSA and DOT resources especially helpful in putting their application together. “We jumped on the webinars that were offered and we found value in those, and we picked up the phone and called the Office of EMS,” he explains. You can find recordings of the webinars on applying for an SS4A grant at these links:

EMS Focus: Safe Streets and Roads for All Grants - Preparing a Strong FY26 Post-Crash Care Application  (focused on EMS agencies)

State of 911: Safe Streets and Roads for All Grants - Preparing a Strong FY26 Post-Crash Care Application (focused on 911 centers)

U.S. Department of Transportation: Webinar Series: Safe Streets and Roads for All Grants

Lastly, White recommends reaching out to others who’ve received an SS4A grant to see how they did it. You can find information about organizations who’ve received a grant on the DOT’s SS4A site.

“Everybody in EMS is pretty open and happy to talk to each other,” he says, adding that MARC is now talking to Omaha Fire (part of a separate council of government), which has a prehospital blood program and is currently applying for an SS4A grant themselves. Given the limited blood supply—a situation faced by nearly every community—communication like this can be critical to ensuring regional capacity for blood products isn’t strained to the breaking point.

 

Looking Ahead

MARC is so encouraged by their success in applying for SS4A funds that White says they’re already at work on an application for an Implementation Grant for FY26. (The organization received a previous SS4A Planning and Demonstration Grant in FY23 to develop their Action Plan; the FY25 grant is their first focusing on post-crash care.) “There are a whole lot of smart people that handle highways and bridges and we’re meeting with them this week,” he notes. “We’re hoping for more dollars coming in behind the dollars NHTSA has provided to help with further implementation.”

For now, the first two MARC agencies to have prehospital blood—Kansas City, Kansas Fire Department and ambulance company AMR in Missouri—are primed to start. “We’re ready to procure the refrigerators, the coolers, the monitoring equipment and then we’re hoping to have four to six months of implementation of sites one and two,” White says. “If you look at the research, feeding patients whole blood is the counter to hemorrhagic shock. The impact of this for our patients and communities is going to be huge.”

The Safe Streets and Roads for All (SS4A) grant program was established in late 2021 through the Infrastructure Investment and Jobs Act to fund regional, local and Tribal initiatives that help prevent roadway fatalities and serious injuries.

The final Notice of Funding Opportunity (NOFO) for SS4A prioritizes public safety infrastructure, which includes "physical and digital hardware, software, systems, technologies, equipment, protocols, facilities, and coordination models used by public safety agencies such as 911, EMS, fire services, law enforcement, and trauma system partners to either prevent, respond to, or reduce the severity of roadway crashes. Public safety infrastructure may be permanent, modular, configurable, or interoperable, and may include temporary, pilot, or limited-scale deployments."

Applications are due by May 26, 2026 at 5 p.m. ET. Send questions to: SS4A_NHTSA@dot.gov