In May of this year the National Highway Traffic Safety Administration (NHTSA) conducted a reassessment of emergency medical services in Michigan.  The purpose of this reassessment was to identify key EMS issues, assess the State's progress since the first assessment in 1991, and to make recommendations for improvements to the Michigan EMS system.  A copy of their final report in included for your reference:

2007 NHTSA Reassessment of EMS in Michigan