Community Paramedicine in Rural Areas: State and Local Findings and the Role of the State Flex Program (Policy Brief #35)

Document Type

Policy Brief

Publication Date



paramedicine, rural health, MRHRC, Policy, EMS, emergency medical services, USM Aging Initiative, Health and Wellness


This study examined the evidence base for community paramedicine in rural communities, the role of community paramedics in rural healthcare delivery systems, the challenges faced by states in implementing community paramedicine programs, and the role of the state Flex programs in supporting development of community paramedicine programs. Additionally, the study provides a snapshot of community paramedicine programs currently being developed and/or implemented in rural areas. Another FMT briefing paper describes these same findings in detail.


  • Many rural community paramedicine programs are in pilot stages.
  • Most community paramedics work within an expanded role rather than an expanded scope of practice, the latter requiring legislative or regulatory change.
  • Funding and reimbursement for community paramedicine services are major challenges for the sustainability of community paramedicine programs.
  • Data collection is vital for community paramedicine programs to be able to show value, including shared saving and patient outcomes.
  • Collaboration at local and state levels is essential for buy-in, and partnering with the State Office of Rural Health is especially helpful in the early development and outreach efforts for rural community paramedicine programs.