The Paramedic Foundation builds the systems that keep rural communities alive.

The Rural Health Transformation Program (RHTP) is a federal rural health initiative enacted under P.L. 119-21 in July 2025 with $10 billion appropriated for each of fiscal years 2026 through 2030, $50 billion in total. States use the funds for rural health system redesign under plans approved by the Centers for Medicare & Medicaid Services (CMS), and CMS’s award announcement names improved emergency medical services communication and treat-in-place options among the activities states will fund. All 50 states received RHTP awards for FY2026, with state award processes beginning or underway.

Where a state’s plan and solicitation permit, The Paramedic Foundation can serve on RHTP-funded work as a prime contractor, a lead applicant for an eligible state subaward, a subrecipient, or a technical assistance, evaluation, curriculum, or implementation partner. TPF is prime contractor to the Nebraska Department of Health and Human Services, Division of Public Health, for RHTP community paramedicine work and regional EMS technical assistance. TPF’s founding principals have worked together in rural EMS consulting and policy since 2005, including prime contracts with the Ohio Department of Health, the Nebraska Department of Health and Human Services, and the Matanuska-Susitna Borough in Alaska. Work under RHTP includes EMS system design and evaluation, community paramedicine and mobile integrated health program development, CMS outcome reporting infrastructure, financial sustainability planning, and workforce development. Initial consultations are free.

Community paramedicine is a model in which specially trained paramedics provide non-emergency care outside the traditional 911-response context. This includes chronic disease management, post-discharge follow-up, behavioral health navigation, medication reconciliation, preventive health visits, and social determinants of health screening. Unlike standard EMS, which is structured around emergency response and hospital transport, community paramedicine focuses on keeping people out of the emergency department by delivering appropriate care in the home or community setting. Published evaluations have reported reductions in emergency department use in several programs, including Renfrew County, Ontario, and Central Oregon; results vary with program design, population and study method.

In the Maine Rural Health Research Center’s 2023 study led by Yvonne Jonk, an ambulance desert is a populated area whose center lies more than a 25-minute drive from an ambulance station. This is a geographic access measure, not a measured ambulance response time. Using 2020 Census population data and ambulance station locations collected in 2021 and 2022, the study counted about 4.5 million people living in ambulance deserts across the 41 states with available data, about half of them in rural counties. In TPF’s work, the conditions behind ambulance deserts include low call volume, large coverage areas, and an EMS funding model that pays per transport rather than for readiness.

Engagements are scoped to the specific work and system at hand, and costs vary accordingly. Initial consultations are always free and without obligation. TPF is a Minnesota nonprofit corporation and a tax-exempt charity under Section 501(c)(3) of the Internal Revenue Code. Consulting fees are structured to support the mission, not to generate profit. If TPF is not the right fit for what you are working on, TPF says so directly. Reach out through the contact page to start a conversation.

TPF organizes its work into five service pillars for readers and eight service areas for contracting. The eight service areas are EMS Policy and Governance; Regional System Design and Standards of Cover; Workforce Development; Community Paramedicine and TIP/TAD; Medicaid and Payer Alignment; Financial Management and Board Governance; Federal Grant and CMS Program Support; and Data, Performance, and Evaluation. The five pillars are rural health systems, governance and policy; innovative care models; workforce, education and professionalization; austere and operational medicine; and data, evaluation and applied research. The capabilities page maps each service area to its pillar and names the practitioners who anchor it.

TPF posts open positions on its careers page, with the full position description for each role. TPF engages people as employees, as officers, and as independent contractors under its standard Consultant Agreement, and is building a global bench of subject matter