Service pillars · Knowledge domains · Named bench
What The Paramedic Foundation does
TPF is a consulting and policy organization that produces implementation-ready work for rural and frontier EMS systems. Its rural EMS consulting work falls into five pillars. Behind each pillar sits a named bench of practitioners rather than a generalist consulting pool, and every engagement is staffed from that bench according to what the scope actually requires.
How to read these capabilities
TPF maintains two internal records that govern what it will claim about its rural EMS consulting work: a capability statement listing eight service areas, and a roster of the people who anchor fifteen knowledge domains. This page is the public expression of both. Where a pillar has a dedicated page, it is linked. Where it does not yet, the work is still live and the route in is a direct conversation.
One thing this page is not is a menu of everything a client might want. TPF declines work outside these areas rather than staffing it thinly, and it says so at the first meeting.
Pillar one. Rural health systems, governance, and policy
The largest body of TPF’s work, and the one the others usually depend on. It covers statewide and regional EMS system design, regional governance architecture and entity formation, standards of cover and deployment modeling, statutory and regulatory analysis, scope-of-practice modernization, essential service designation, and the legislative and Medicaid pathways that make a system financially viable. It also covers the financial layer that determines whether a governance design survives contact with a budget: rate setting and cost analysis, funding-model design, scenario and cash-flow modeling, and board-facing financial reporting.
This pillar is where the former standalone policy page belongs. Policy work at TPF is not a separate practice; it is the instrument used when a system problem turns out to be a statutory one. Keeping it as an orphan top-level page implied otherwise.
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; strategic planning and implementation.
Rural health systems work · EMS policy and legislative services · RHTP implementation partnership
Pillar two. Innovative care models
Community paramedicine, mobile integrated healthcare, treatment in place, and transport to alternate destination. Program design and implementation, clinical placement infrastructure, integration with the international Community Paramedic curriculum through The Paramedic Network, outcome measurement, and the payment strategy that keeps a program running once start-up funding ends. TPF maintains a controlled vocabulary for these terms and applies it consistently, because the alternative is a program whose statute and evaluation plan describe different things.
Disciplines drawn on: community paramedicine governance and program architecture; clinical protocol and service bundle design; physician medical direction; mobile integrated healthcare and alternative response design; value-based care and payer alignment; health economics and return-on-investment analysis; clinical quality and performance improvement.
Community paramedicine, MIH, and TIP/TAD · International Roundtable on Community Paramedicine
Pillar three. Workforce, education, and professionalization
Workforce needs assessment, recruitment and retention, leadership and field training officer development, volunteer-to-combination transition, behavioral health and peer support program design, curriculum design, accreditation and certification standards, examination development, and preceptor and instructor development. Underneath all of it sits the long arc TPF exists to serve: the recognition of paramedicine as an autonomous health profession with its own credentialing standards and degree pathways.
Professionalization, education, and workforce protection were advertised for some time without a page behind any of them. That gap was the largest single omission on the site, and the pillar page now closes it.
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; clinical education and quality infrastructure; EMS communications and instructional media.
Workforce, education, and certification · Start a conversation about a workforce or education engagement
Pillar four. Austere and operational medicine
High-acuity low-frequency and austere emergency care training, prehospital blood program design, wilderness and mountain medicine, simulation-based instruction, and the operational medicine adjacencies that draw on the same bench. The offerings are wilderness, search and rescue, and wildfire medicine; event and expedition medicine; tactical, military interface, and disaster medicine; and prehospital blood and prolonged field care program design. Each of the first three has its own page, reached from the austere and operational medicine landing.
Austere care is related to rural EMS and it is not the same thing. Rural systems are resource-constrained but connected. Austere settings are those where evacuation is delayed or impossible and the clinician holds the patient. TPF works in both and keeps the distinction, because protocols written for one fail in the other.
Disciplines drawn on: board-certified emergency medicine and EMS medical direction; wilderness and mountain medicine; critical care flight paramedicine; tactical and operational medicine; prolonged field care and prehospital blood program design; austere medical training design.
Pillar five. Data, evaluation, and applied research
EMS performance measure development, NEMSIS and electronic patient care record systems, geospatial analysis and coverage modeling, dashboard and data governance design, logic models, outcome tracking, cost-avoidance and return-on-investment modeling, health services research, and program evaluation designed and reported to the standards a payer or funder will accept. Alongside it sits the technical capability that makes the analysis deliverable: healthcare data standards including FHIR, HL7, and admission-discharge-transfer interfaces; computer-aided dispatch and geographic information system integration; and dashboard platforms.
Information security belongs in this pillar rather than as a footnote. TPF operates a Microsoft 365 environment under Entra ID access controls, maintains organizational alignment with ISO/IEC 27001:2022 through an annual self-audit framework, classifies engagement data under a three-tier taxonomy, and maintains supplementary clause sets for engagements involving criminal justice information systems data or European Economic Area and United Kingdom participants. Agencies increasingly ask about this before they ask about methodology.
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; healthcare data standards and systems integration; dashboard development, data governance, and information security.
Data, evaluation, and research · Publications and commissioned work · Models, calculators, and reference libraries
Rural EMS consulting service areas, crosswalked
The table below maps the eight service areas TPF maintains internally to the five pillars above and to the page where each is described. It exists so that a funder or agency comparing this site to a TPF capability statement finds the same eight areas in both places.
| Service area | Pillar | Where it is described |
|---|---|---|
| EMS Policy and Governance | One | Rural health and policy |
| Regional System Design and Standards of Cover | One | Rural health |
| Community Paramedicine and TIP/TAD | Two | Innovative care |
| Medicaid and Payer Alignment | One and Two | Policy and innovative care |
| Workforce Development | Three | Workforce, education and certification |
| Financial Management and Board Governance | One | This page and financial modeling |
| Federal Grant and CMS Program Support | One | RHTP |
| Data, Performance, and Evaluation | Five | Data, evaluation and research |
What sits alongside the pillars
Three things TPF does are not service lines and should not be presented as though they were. They are institutional roles, and conflating them with consulting work misrepresents both.
Convening. TPF administers the International Roundtable on Community Paramedicine and continues to convene the International Rural and Remote Prehospital Collaborative and the Paramedic G5 meeting. These are practitioner-led bodies for which TPF supplies the administrative spine, not TPF products.
Custody. TPF holds custodial responsibility for reference work it neither owns nor sells. 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.
Procurement
How TPF is contracted
Capability is only useful to an agency that can buy it. TPF is contracted four ways, and the right one usually turns on the funding source rather than on the scope of work.
Cooperative contract
TPF holds a national cooperative contract for Consulting Services under PSAI RFB 2026-03 (Electronics, IT Solutions and Consulting Services), available to public agencies nationwide through Public Safety Association Inc. (PSAI) and Savvik Buying Group. A registered Participating Public Agency can procure under established terms and pricing rather than running its own solicitation.
Direct contract with a public agency
A state agency, county, regional body, or hospital system contracts TPF directly, through its own procurement process. TPF holds multi-year prime contracts on this basis, including with the Ohio Department of Health and the Nebraska Department of Health and Human Services.
Federally funded programs
Where federal funds are involved, the awarding agency designates TPF’s role and that designation governs treatment under 2 CFR Part 200. TPF can be a prime contractor, a prime applicant, or a subrecipient. Each engagement states the designation as the agency made it rather than as the flow of funds appears.
Partnership and technical assistance
TPF also works as a technical assistance, evaluation, curriculum, or implementation partner alongside another organization holding the award, and takes on NGO and policy support work that does not carry a consulting fee.
Cooperative purchasing detail, including the Principal Procurement Agency and the registration a Participating Public Agency completes, is on the about page. Whether a cooperative contract satisfies a given agency’s procurement requirements is a determination for that agency and its own counsel.
TPF procurement and commodity codes
Registered NIGP class and item codes, for agencies that source by commodity code. Class titles are given as the NIGP Code states them.
| Code | Item | Class |
|---|---|---|
| 918-12 | Analytical Predictive Studies and Surveys Consulting | 918 Consulting Services |
| 918-21 | Business Consulting | |
| 918-27 | Community Development Consulting | |
| 918-38 | Education and Training Consulting | |
| 918-46 | Feasibility Studies, Consulting | |
| 918-49 | Finance and Economics Consulting | |
| 918-58 | Governmental Consulting | |
| 918-67 | Human Services Consulting, Including Mental Health Consulting | |
| 918-75 | Management Consulting | |
| 918-78 | Medical Consulting | |
| 918-81 | Natural Disasters, Fire, Flood, Wind, Quakes, Consulting | |
| 918-83 | Organizational Development Consulting | |
| 918-90 | Strategic Planning and Consulting | |
| 918-93 | Security and Safety Consulting | |
| 924-19 | Educational Research Services | 924 Educational and Training Services |
| 924-78 | Teaching and Instruction Services: Elementary and Secondary Education, Higher Education and Adult Education | |
| 924-86 | Vocational Training, All Types, Including Vocational Rehabilitation and Technical Education | |
| 948-82 | Research and Science Services, Medical | 948 Health Services |
The eighteen codes track the five service pillars rather than sitting alongside them. Class 918 carries the consulting work across all five. Class 924 carries the workforce, education, and professionalization pillar where TPF is engaged to build or evaluate training rather than to advise on it. Class 948 carries applied research where the deliverable is evidence rather than a recommendation.
The NIGP Code is maintained by the National Institute of Governmental Purchasing and is licensed through Periscope Holdings. Agencies registering TPF in a state or local vendor system should confirm the codes against that system’s own list, because states adopt different editions of the NIGP Code and some maintain their own commodity schemes instead. Montana, for one, uses a four-digit scheme of its own rather than NIGP; TPF is registered there under those codes and they are held in TPF’s registration record rather than published here.
What TPF is not
TPF is not a certification or licensure body; entry-level paramedic credentials are issued by state EMS offices. It is not a professional membership association. It is not a lobbying organization, and it takes no position on pending legislation in the deliverables it produces for public agencies. It is not an academic center, although its work meets academic citation and methodology standards. It is not a staffing firm, and it does not bill by the hour against a utilization target.
Fuller detail on structure, governance, and how engagements are formed is on the about page. Profiles of everyone named on this page are on the team page.
Not sure which pillar your problem sits in?
Most do not sit cleanly in one. A rural service with a staffing crisis, a governance problem, and no reimbursement strategy has a single problem with three faces, and TPF scopes it that way.