Rural EMS · Community paramedicine · EMS workforce
Keeping emergency care within reach of rural communities, and supporting the people who provide it.
The Paramedic Foundation works with state agencies, regional EMS organizations, counties, and hospital systems, and with the paramedics, EMTs, nurses, and physicians who make up those organizations, to strengthen rural EMS, build community paramedicine, and support the EMS workforce. TPF helps turn local challenges into practical plans that can be staffed, funded, and sustained.
Where to start
What would you like to improve?
Choose the challenge closest to yours. Each page describes the work in more detail and how TPF approaches it.
Keep EMS available in your community
Coverage, regional governance, funding, and planning for the future of local EMS, with the statutory, Medicaid and financial work that lets a plan survive a budget.
Rural health systems and policyBring more care to patients
Community paramedicine, mobile integrated healthcare, treatment in place, and transport to alternate destination, with payment arrangements that outlast the start-up funding.
Community paramedicine and new care modelsSupport and develop your team
Recruitment and retention, leadership and field training officer development, education, and the certification standards the profession runs on.
Workforce, education and certificationPrepare for care in challenging settings
Wilderness, search and rescue and wildfire medicine; event and expedition medicine; and tactical, military interface and disaster medicine.
Austere and operational medicineUnderstand what is working
Performance measures, coverage modeling, dashboards, and program evaluation that show leaders what to keep and what to change.
Data, evaluation and researchSee how the work is organized
The eight service areas TPF contracts under, how they map to these five areas of work, and the practitioners who lead each.
All service areasWhy the work matters
Good care depends on more than what happens during a call.
It also depends on people being available to respond, on services that can keep operating, and on options that fit what a patient needs. In much of rural America those conditions are fragile: call volume is low, coverage areas are large, and EMS is funded per transport rather than for readiness. TPF works with agencies and the clinicians inside them on those conditions, so that local care is built to last.
Selected engagements
Work TPF has carried out
Three examples of what TPF contributed and what the work produced. Outcomes are stated only where a deliverable documents them.
Ohio Department of Health, State Office of Rural Health and Primary Care
Since 2016 TPF has served as the office’s rural EMS consulting partner under the federal Medicare Rural Hospital Flexibility program. The first contract delivered a statewide rural EMS needs assessment, community health needs assessments with Ohio’s Critical Access Hospitals, five regional stakeholder meetings, and two final reports. Across both contracts the work has included county EMS system assessments, statewide workforce surveys, community paramedicine protocol development, and rural EMS sustainability consulting.
Rural health systems work →Community EMS in frontier Wyoming
For the Wyoming Department of Health, working with the state’s Office of Emergency Medical Services and Office of Rural Health, TPF developed and implemented Community Emergency Medical Services pilot programs in Hulett and Newcastle in 2018 and 2019. Three further Department of Health contracts followed, the last closing in 2024.
Community paramedicine work →Evaluating four community paramedicine programs
For the South Carolina Office of Rural Health, TPF evaluated four community paramedicine programs, documented their impact, and contributed the analysis to the state’s community paramedicine blueprint. The study is Community Paramedic Impact Study: An Analysis of Four Programs (Stephen, Herbert, Wingrove, Nudell, and Craig, 2023).
Evaluation and research work →Rural Health Transformation Program
Planning rural health improvements under RHTP
TPF supports state agencies and the organizations they fund with rural EMS system design, community paramedicine, workforce development, and program evaluation under the Rural Health Transformation Program. TPF is prime contractor to the Nebraska Department of Health and Human Services, Division of Public Health, for RHTP community paramedicine and regional EMS technical assistance.
Free tools and resources
Tools for the work in front of you
Every TPF resource is free to use, and none requires registration.
Model staffing and schedules
Test shift configurations, unit-hour utilization, and staffing requirements against call volume and coverage targets. Runs in the browser with nothing to download.
Open the staffing calculator →Find implementation guidance and evidence
More than 750 reference documents collected from agencies, researchers, and governments, including a 46-page, 12-step community paramedic implementation toolkit and the IRCP meeting archive.
Browse the document library →Learn from the people who built the field
Recorded Community Paramedicine Insights Forum and IRCP sessions from 2010 to 2020, with machine-generated transcripts for every audio session.
Open the archive →Programs
Programs TPF administers
International Roundtable on Community Paramedicine
Founded in 2005 in Halifax. Practitioner-led and TPF-administered, the IRCP held its twenty-second forum in Regensburg, Germany, in October 2026.
About the IRCPCommunity Paramedic training and education
CommunityParamedic.org is TPF’s training and education resource site, and the route by which colleges and universities request the Community Paramedic curriculum from TPF.
CommunityParamedic.orgUltra-Endurance Sports Science & Medicine
A TPF program that funds and facilitates research on ultra-endurance sports, shares what that research finds, and works to improve the health and safety of the people who take part.
UESSM.orgThe TPF team
The people behind the work
TPF’s work is carried out by practicing professionals: a core leadership team, a management team, and consultant subject matter experts whose backgrounds span paramedicine, nursing, medicine, public health, health economics, research, and technology. The Paramedic Foundation was incorporated in Minnesota in 2013. Its founding principals have worked together in rural EMS consulting and policy since 2005.
Meet the full team →Common questions
Questions about working with TPF
Who does The Paramedic Foundation work with?
TPF works with state agencies, regional EMS organizations, county governments, hospital systems, legislative partners, and federal program partners, and concentrates that work in rural, frontier, and Tribal communities. Those organizations are made up of paramedics, EMTs, nurses, physicians, and the leaders who manage them. TPF’s free tools and resources are open to anyone working in EMS.
What kinds of challenges can TPF help address?
TPF works on five kinds of problems: keeping EMS available in rural communities through system design, regional governance, and funding; bringing more care to patients through community paramedicine, mobile integrated healthcare, treatment in place, and transport to alternate destinations; recruiting, developing, and retaining the EMS workforce; preparing for care in austere and operational settings; and measuring what is working through data, evaluation, and applied research. The capabilities page maps that work to the eight service areas TPF contracts under and names the practitioners who lead each.
What is community paramedicine and how does it differ from standard EMS?
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.
Where can I find free tools and resources?
The resources page collects them: an EMS staffing and schedule modeling calculator, a document library of more than 750 reference documents, and an archive of recorded community paramedicine sessions. All are free, and none requires registration. The Community Paramedic curriculum is available to accredited colleges and universities by institutional request through CommunityParamedic.org.
How do I start a conversation with TPF, and what does it cost?
Use the contact page. Initial consultations are always free and without obligation. Engagements are scoped to the specific work and system at hand, and costs vary accordingly. TPF is a Minnesota nonprofit corporation and a tax-exempt charity under Section 501(c)(3) of the Internal Revenue Code, and its 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.
Can a public agency contract with The Paramedic Foundation through a cooperative purchasing program?
Yes. TPF holds a national cooperative contract for Consulting Services under PSAI RFB 2026-03, available to public agencies nationwide through Public Safety Association Inc. (PSAI) and Savvik Buying Group. A registered Participating Public Agency can procure under the Master Agreement’s established terms and pricing rather than running its own competitive solicitation, subject to its own state and local procurement law. The about page has the cooperative contract detail.
Is The Paramedic Foundation hiring?
TPF posts open positions on its careers page, with the full position description for each role.