The process that agencies must follow in order to begin participating in EMSTARS is outlined in Section 2 of the EMSTARS Program Manual (522kb,.pdf).
The process framework presented in the EMSTARS Program Manual consists of the major groupings of activities common to most project initiatives that an agency undertakes. The process framework only identifies the required activities, outcomes, and milestones that must be achieved by an agency to begin reporting data to and participating in EMSTARS. This guide does not indicate all activities or timeframes but at a minimum, agencies must complete the specifics outlined in the EMSTARS Program Manual. Agencies may conduct different or additional activities or use other terms but the results or outcomes required for EMSTARS data submission are described in the EMSTARS Program Manual.
Below is a high-level depiction of the process.