Trust and Sovereignty

The Paramedic Foundation is a national organization that works to strengthen emergency medical services and rural health systems in communities across the United States. Much of this work takes place on the homelands of sovereign Tribal nations whose governments, communities, and connection to these lands continue today. The Foundation recognizes the inherent sovereignty and self-determination of each nation, and it does not speak for, represent, or oversee any nation or its people. Where the Foundation supports work in a specific region, it does so on a government-to-government basis, at the invitation and direction of the nations whose lands and communities are involved.

What sovereignty means

Long before the United States existed, this land was home to many nations of Native people. Those nations are still here today. A nation is a real government. It has leaders, laws, courts, schools, and in many places its own ambulances and paramedics. These nations governed themselves then, and they govern themselves now. That right of a people to run their own affairs is called sovereignty.

When the United States was formed, it made agreements, called treaties, with these nations, one government to another. Those treaties are part of American law. Recognizing them is not taking a political side. It is telling the truth about our history and keeping promises the country made. A promise between governments still counts, no matter how long ago it was made.

Sovereignty also means a nation runs the programs that affect its own people. Many nations operate their own clinics, health programs, and emergency medical services, and decide for themselves how care is delivered on their lands. The right to lead those decisions is called self-determination. It matters a great deal in emergency care, because the people closest to a community are usually the ones who know best how to care for it. When the Foundation works in these communities, the community leads the work, and the Foundation helps with what the community asks for.

The Foundation's acknowledgement

The Paramedic Foundation works to strengthen emergency medical services and rural health systems in communities across the United States. This work takes place on lands that are the homelands of sovereign Tribal nations, whose governments, communities, and relationship to these lands continue today. The Foundation recognizes the inherent sovereignty and self-determination of these nations as a standing fact that exists independent of, and prior to, any acknowledgement the Foundation might offer.

The Foundation's rural and frontier work extends across many states and several regions of the country, and the lands within these service areas are the homelands of many distinct nations. The Foundation does not attempt to name every nation across every region, since responsible naming follows from concrete engagement and from the invitation of the nations involved. Where its work is directed at a specific region, the Foundation names the nations whose lands and communities are part of that work, in partnership with them.

The Foundation does not grant, oversee, or speak for any nation. Where it contributes to health and emergency medical services priorities, it does so on a government-to-government basis, at the invitation and direction of each nation, and in support of priorities those nations define and lead. Its role is to support tribally led work, not to direct it. The Foundation also recognizes that respectful practice is to develop and affirm this acknowledgement together with Tribal partners rather than to author it in isolation, and it welcomes correction and guidance from the nations and communities with whom it works.

How the Foundation works, and what it commits to

An acknowledgement means little on its own. It carries weight only when it is matched by how an organization actually behaves. These are the commitments that turn the words above into practice.

• The Foundation comes as a guest. It begins work only when a community invites it, and it follows that community's lead and timeline. It supports the priorities a community sets, rather than arriving with its own plan and asking the community to fit into it.
• It adds to local care, and never replaces it. Where a community already has its own paramedics, health workers, or care system, the Foundation's job is to strengthen that system, not to compete with it, supervise it, or take it over. Success is never measured by replacing what a community has already built.
• The community decides what success looks like. What counts as good care, and how it is measured, is defined together with the community and reflects how that community understands health and wellbeing. It is not a checklist brought in from outside.
• Care is safe only when the person receiving it says so. Whether care is respectful and culturally safe is judged by the patient and the community, not by the provider. The Foundation treats this as a starting requirement, and treats honest self-examination and learning as lifelong work, never a box to check.
• A community's information belongs to the community. Health and community data gathered in this work belong to the people they describe. The Foundation collects, holds, and reports such information only on terms the community agrees to, and shares only what the community has agreed to share.
• This is a living promise, kept with partners. The Foundation develops and revises this language together with the nations and communities it works with, and welcomes their correction. It is a commitment the Foundation expects to be held to, not a statement made once and filed away.

What this is, and what it is not

This page does not give any land away, and it does not take any away. It is not a slogan. It is the truth said plainly: these are the homelands of nations that are still here and still govern themselves, and The Paramedic Foundation works beside them as a partner and helper, never as a boss. Telling that truth is the first step. Acting on it, in the ways listed above, is what gives it meaning.

Reconciliation is a long word for a simple idea: repairing trust by being honest about the past and fair in the present. Honesty by itself does not repair trust. It has to be matched by how we act. Saying this plainly, teaching it honestly to the next generation, and holding the Foundation to the commitments above are all part of that repair.

Whose homelands are you on?

The map below comes from Native Land Digital, an Indigenous-led project that maps the homelands, languages, and treaties of Native nations across North America and beyond. To see the nations connected to your own town, open the full searchable map and enter your address.

Open the full searchable map