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Table of Contents:
Virginia Paramedicine Programs in Pulaski and Danville Slash Repeat 911 Calls, but Rural Funding Remains a Hurdle
B.C. Paramedics Union Says 76 of 101 Community Paramedic Positions Sit Vacant, Warns Program Is Being Shifted to 911 Response
Region of the Week: Monticello, Indiana
Read Time: 5 minutes
Pulaski County launched its community paramedicine program on Jan. 1, 2026, under paramedic Erika Dalton. By early August it had referred about 70 people to services and closed about 30 cases, and those closed-case patients went from 200 EMS calls in the three months before enrollment to 11 in the three months after.
Pulaski County Administrator Jonathan Sweet backed the program with general fund money, covering roughly $170,000 in startup costs for Dalton's salary, training, and a new vehicle. The county now funds it entirely from its general fund.
The Danville Life Saving Crew's program, led by paramedic Keith Carroll, costs about $200,000 a year. For roughly five years it has relied on a local grant of about $123,000 annually, which expires at the end of 2026, and the agency is looking for a sustainable replacement.
Neither Medicare nor Virginia Medicaid reimburses community paramedicine. In 2025, the Virginia General Assembly introduced legislation with two $50,000 appropriations to the Department of Medical Assistance Services to develop a reimbursement plan.
Only about 15% of Pulaski County's ambulance calls are true emergencies, and 230 people called 911 at least four times in 2025. Vinton First Aid Crew Chief Brandan Arthur says volunteer agencies often lack the staffing and money to launch a program, since the savings don't generate revenue.
Who to Contact:
Erika Dalton, Director of Community Paramedicine, Pulaski County EMS (https://www.linkedin.com/in/erika-dalton-nrp-cp-c-96384129a/)
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The Ambulance Paramedics of BC (APBC), CUPE 873, says B.C. Emergency Health Services (BCEHS) is winding down its preventive community paramedicine program in rural, remote and Indigenous communities, and in areas short on primary care providers, to relieve pressure on the 911 system.
The union says 76 of the 101 community paramedic positions created across the province are unfilled, many for more than two years. It also alleges funding is being diverted elsewhere.
The union says BCEHS recently proposed moving the remaining community paramedics toward more 911 response. APBC President Jason Jackson says the program is meant to prevent 911 calls, not to add another responder to them.
APBC acknowledges that community paramedics already help with serious emergency calls when needed. Its concern is that 911 response would become their main job, at the expense of scheduled home visits, preventive care and relationships with local providers.
The union is asking BCEHS and the Provincial Health Services Authority to pause the proposed changes, restore the vacant positions and consult communities, patients and paramedics first. It also wants the role expanded, not reduced.
Who to contact:
Jason Jackson, President, Ambulance Paramedics of BC (CUPE 873) — [email protected] / 604-273-5722
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Region of the Week: Monticello, Indiana
On Sept. 8, the Monticello (Ind.) Board of Works approved a grant agreement to restart the fire department's Mobile Integrated Health program. The program is contracted with the Indiana Department of Health and secured $880,000 over five years.
The first year, 2026–2027, brings $308,000. The earlier version of the program ran entirely on grant money and shut down when that grant wasn't renewed.
Firefighter Dave Dulin wrote the new grant application. At the same meeting he was promoted to Public Safety 4, and his brother, Firefighter Colin Dulin, was promoted to Public Safety 2.
The board also approved a $220,781 grant to restart Project Sprout, which the fire department supports. In the program, nurse practitioner Leslie Koopman provides free prenatal and short-term postnatal care in White County, which has no birthing center. The grant adds two years of funding.
Project Sprout went six months without a director for lack of funding. It has grown from two or three patients to 17–20, and the fire department, which has eight certified car seat technicians, gives out free car seats and refers families to the program.