Rural EMS · Community paramedicine · EMS workforce
Keeping emergency care within reach in rural America
In much of rural America, calls are few, distances are long, and emergency medical services (EMS) are paid by the trip instead of for being ready. The Paramedic Foundation (TPF) helps state agencies, counties, regional EMS groups and hospital systems work through those problems. The goal is a plan your community can staff, pay for and keep going.
Where to start
Start with the problem you need to solve
Pick the one closest to yours. Each page explains the work and how TPF goes about it.
Keep EMS available in your community
Coverage, regional governance, funding and long-term planning for local EMS. That includes the legal, Medicaid and budget work a plan needs to last.
Rural health systems and policyBring more care to patients
Community paramedicine and mobile integrated healthcare. Treating patients where they are, or taking them somewhere other than the emergency department. Payment plans that last after the start-up money runs out.
Community paramedicine and new care modelsSupport and develop your team
Hiring and keeping staff, growing leaders and field training officers, education, and the certification standards the profession relies on.
Workforce, education and certificationPrepare for care in challenging settings
Wilderness, search and rescue, and wildfire medicine. Event and expedition medicine. Tactical medicine, the move from military to civilian care, and disaster medicine.
Austere and operational medicineUnderstand what is working
Performance measures, coverage modeling, dashboards and program evaluation. They show leaders what to keep and what to change.
Data, evaluation and researchSee everything TPF does
The eight service areas TPF contracts under, how they fit these five areas of work, and the people who lead each.
All service areasSelected engagements
Work TPF has done for states
Three examples of what TPF did and what came of it.
Ohio Department of Health, State Office of Rural Health and Primary Care
Since 2016, TPF has been the office’s rural EMS consulting partner under the federal Medicare Rural Hospital Flexibility program. The first contract produced a statewide rural EMS needs assessment. It also produced community health needs assessments with Ohio’s Critical Access Hospitals, five regional stakeholder meetings and two final reports. Over both contracts, TPF has also assessed county EMS systems, run statewide workforce surveys, written community paramedicine protocols and advised on keeping rural EMS going.
Rural health systems work →Community EMS in frontier Wyoming
TPF worked for the Wyoming Department of Health with the state’s Office of Emergency Medical Services and Office of Rural Health. In 2018 and 2019, TPF designed and launched Community Emergency Medical Services pilot programs in Hulett and Newcastle. Three more Department of Health contracts followed. The last one closed in 2024.
Community paramedicine work →Evaluating four community paramedicine programs
For the South Carolina Office of Rural Health, TPF evaluated four community paramedicine programs and documented their impact. The analysis became part of 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
Help with the Rural Health Transformation Program
Under the Rural Health Transformation Program (RHTP), TPF helps states and the groups they fund. That help covers rural EMS system design, community paramedicine, workforce development and program evaluation. 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
Free tools for the work in front of you
Every TPF resource is free, and none asks you to register.
Model staffing and schedules
Test shift patterns and staffing needs against your call volume and coverage goals. It runs in your browser, with nothing to download.
Open the staffing calculator →Find implementation guidance and evidence
More than 750 reference documents from agencies, researchers and governments. They include a 46-page, 12-step toolkit for starting a community paramedic program, and the meeting archive of the International Roundtable on Community Paramedicine (IRCP).
Browse the document library →Learn from the people who built the field
Recordings of Community Paramedicine Insights Forum and IRCP sessions from 2010 to 2020. Every audio session has a machine-made transcript.
Open the archive →Programs
Programs TPF administers
International Roundtable on Community Paramedicine
Founded in Halifax in 2005, the IRCP is led by the people who do the work, and TPF administers it. It held its 22nd forum in Regensburg, Germany, in October 2026.
About the IRCPCommunity Paramedic training and education
CommunityParamedic.org is TPF’s training and education site. Colleges and universities use it to request the Community Paramedic curriculum from TPF.
CommunityParamedic.orgUltra-Endurance Sports Science & Medicine
A TPF program that funds and supports research on ultra-endurance sports and shares what it finds. Its aim is to make these events healthier and safer for the people who take part.
UESSM.orgThe TPF team
The people behind the work
Practicing professionals do TPF’s work. They include a core leadership team, a management team and consultant subject matter experts. Their 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 and hospital systems. It also works with legislative partners and federal program partners. Most of that work is in rural, frontier and Tribal communities. These organizations are made up of paramedics, emergency medical technicians (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, bringing more care to patients, supporting the workforce, preparing for care in challenging settings, and measuring what works. The capabilities page shows the eight service areas TPF contracts under and the people who lead each.
What is community paramedicine and how does it differ from standard EMS?
Community paramedicine uses specially trained paramedics to give care that is not an emergency, outside the usual 911 call. Examples include care for long-term illness, a check-in after a hospital stay, help getting behavioral health care, medication checks, preventive visits and screening for social needs. Standard EMS is built around emergency response and the trip to the hospital. Community paramedicine aims to keep people out of the emergency department by giving the right care at home or in the community. Published studies of several programs, including Renfrew County, Ontario, and Central Oregon, have reported fewer emergency department visits. Results depend on how a program is designed, who it serves and how it was studied.
Where can I find free tools and resources?
The resources page has them all: a calculator for EMS staffing and schedules, a library of more than 750 reference documents, and an archive of recorded community paramedicine sessions. All are free, and none asks you to register. Schools can ask for the Community Paramedic curriculum through CommunityParamedic.org. It goes only to bona fide educational institutions.
How do I start a conversation with TPF, and what does it cost?
Start on the contact page. A first conversation is always free, with no obligation. Each project is scoped to the work and the system involved, so costs vary. TPF is a Minnesota nonprofit corporation and a tax-exempt charity under Section 501(c)(3) of the Internal Revenue Code. Its consulting fees support the mission rather than produce a profit. If TPF is not the right fit for your work, TPF will tell you so.
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 each open position, with its full description, on its careers page.