Sustainable Rural EMS: Navigating Change

November 2021
National Rural Health Resource Center,
SafeTech Solutions

For more than five decades, rural ambulance services across the U.S. have been staffed largely by volunteers. As volunteerism declines and rural ambulance staffing becomes more unpredictable, it would be prudent to ask if your community has an emergency medical services (EMS) problem.

This guide is designed to assist rural communities in navigating a change from unsustainable volunteer EMS and ambulance service models to those that are sustainable. This guide is intended to direct community leaders through change based on a stepped process that has been used in rural communities throughout the U.S. It includes information on how to assess if a community has an EMS problem, the needed ingredients to change, and a six-step process to implement change to a more sustainable model of rural EMS.

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,560,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.