Rural EMS consulting services and how to hire TPF

Area of work 1. Rural health systems, governance, and policy

This is TPF’s largest area of work, and the others usually depend on it. It covers statewide and regional EMS system design. It covers how regional governance is set up and how new regional entities are formed. It includes standards of cover, deployment modeling, analysis of laws and rules, updating scope of practice, and essential service designation. It also covers the legislative and Medicaid paths that let a system pay its way.

Then there is the money side, which decides whether a governance design survives a real budget. That means rate setting and cost analysis, funding models, scenario and cash-flow modeling, and financial reports for boards. When a system problem turns out to be a matter of law, TPF uses policy work as the tool to fix it.

Fire-based EMS. TPF also works with fire-based EMS, where a fire department or fire protection district runs the EMS service. The specialists TPF calls on include people who have served as rural fire and EMS chiefs. They have led moves from volunteer to combination staffing, put protocols in place and secured funding. Others have led an EMS division inside a large fire department, formed a municipal EMS service by joining volunteer rescue squads, and managed grants and federal pandemic-recovery funds for a fire-based service. Some have worked inside a state EMS office or served on national EMS certification and accreditation boards. Others bring fire and EMS consolidation and governance. One analyst is a contract instructor for the National Fire Academy and has taken part in more than 200 fire and EMS agency studies. Physicians TPF calls on give medical direction to fire-based EMS agencies and to a municipal fire and rescue service. Fire department EMS work draws on the same system design described here.

Agency compliance. TPF’s agency compliance support includes controlled substance compliance. The specialists TPF calls on have run that compliance inside EMS agencies. TPF does not give legal opinions. Those rest with counsel.

Disciplines drawn on: EMS governance and institutional design; regional system design and standards of cover; health economics, reimbursement, and payer alignment; nonprofit financial management and board governance; geospatial coverage modeling; fire and EMS consolidation and governance; fire-based EMS division leadership; controlled substance compliance; grant and federal-funds management; strategic planning and implementation; regional EMS and trauma advisory council leadership.

Rural health systems work  ·  EMS policy and legislative services  ·  RHTP implementation partnership

Area of work 3. Workforce, education, and professionalization

This area covers workforce needs, recruitment and retention, and growing leaders and field training officers. It covers the move from a volunteer service to a combination service. It covers behavioral health and peer support programs. It also covers curriculum design, accreditation and certification standards, exam writing, and training for preceptors and instructors.

Training schools and clinical education. The specialists TPF calls on include people who have directed a regional paramedic education program and started an in-house paramedic training school inside an EMS agency. Others have built a skills lab so rural clinicians can practice rare trauma procedures. Some have delivered education on EMS law and the standard of care, and built a documentation framework for patient refusals. That education is for clinicians and agencies. It is not legal advice.

Beneath all of it sits the long-term goal TPF exists to serve. That goal is to see paramedicine recognized as an autonomous health profession, with its own credentialing standards and degree pathways.

Disciplines drawn on: workforce needs assessment and retention; leadership and field training officer development; rural volunteer and combination service operations; curriculum design, accreditation, and higher education pathways; certification standards and examination development; paramedic education program and training school leadership; EMS law and standard-of-care education for clinicians; patient refusal documentation; clinical education and quality infrastructure; nursing and simulation education; EMS communications and instructional media.

Workforce, education, and certification  ·  Start a conversation about a workforce or education engagement

Area of work 5. Data, evaluation, and applied research

This area covers EMS performance measures, the National EMS Information System (NEMSIS) and electronic patient care records, and geospatial analysis and coverage modeling. It covers dashboards, data governance, logic models and outcome tracking. It covers cost-avoidance and return-on-investment models, health services research, and program evaluation. Each evaluation is designed and reported to the standards a payer or funder will accept.

Behind the analysis sits the technical skill that turns it into something usable. That includes healthcare data standards such as Fast Healthcare Interoperability Resources (FHIR), Health Level Seven (HL7) and admission-discharge-transfer interfaces. It also includes linking computer-aided dispatch with geographic information systems, and dashboard platforms.

Information security is part of this area of work. TPF runs a Microsoft 365 environment, with Entra ID controlling access. It aligns with ISO/IEC 27001:2022 through a yearly self-audit. It sorts project data into three tiers. It also keeps extra contract clauses for projects that involve Criminal Justice Information Services (CJIS) data or people in the European Economic Area and the United Kingdom. Agencies increasingly ask about this before they ask about methods.

Disciplines drawn on: EMS performance measure development; geospatial analysis and coverage modeling; health services research and continuous quality improvement; health economics and rural health research; program evaluation design and reporting; qualitative, mixed-methods, and community-engaged research; healthcare data standards and systems integration; dashboard development, data governance, and information security; digital strategy and web development.

Data, evaluation, and research  ·  Publications and commissioned work  ·  Models, calculators, and reference libraries

Roles TPF plays outside its consulting work

TPF also plays three institutional roles that sit apart from its service lines. Mixing them up with consulting work would misrepresent both.

Convening. TPF administers the International Roundtable on Community Paramedicine and still convenes the International Rural and Remote Prehospital Collaborative and the Paramedic G5 meeting. These bodies are led by the people who do the work. TPF supplies their administration, and they are not TPF products.

Custody. TPF is custodian of reference work it does not own or sell. Copyright in the international Community Paramedic curriculum is held by The Paramedic Network. TPF’s role is to ensure it reaches bona fide educational institutions. TPF also maintains open reference standards of its own, including the Paramedic-Narrative documentation standard, published under an open license.

Founding and sustaining organizations. Several bodies in this field exist because TPF founded or funded them, and TPF continues to staff some of them. That history is set out on the partners page.