Community Paramedics Bring Mental Health Support to Rural Texas, but Funding Is a Challenge
Public Health Watch and Texas Community Health News by Elissa Jorgensen, July 9, 2025
About a year after Blanco County launched its community health paramedicine program in 2022, paramedic Wesley Patton was referred to a patient in the local jail. The man had been arrested on terroristic threat charges tied to his substance use.
Community paramedicine is largely about being proactive and working with vulnerable people to help improve their health before they need emergency care. So Patton visited the man in jail to talk about options once he was released. Over several months Patton continued meeting with the patient and the man’s family. Once free, the man entered a rehabilitation program, Patton said.
“He has fully turned his life around,” Patton said. “I talked to him the other day, and he said, ‘I finally realized that life is more fun without drugs.’”
Community paramedicine programs started in the U.S. in the 1990s to address the increase in 911 usage and limit emergency department crowding, which can result in delayed service and poor-quality care. Emergency services departments around the country created teams of specially trained paramedics to reach the people most likely to need help and provide more comprehensive care. Much of the work for someone like Patton involves doing outreach, often to people with untreated mental health issues, and directing them to services in the area so they receive help before they’re in crisis. It can also involve providing in-home care to people who lack transportation or are dealing with substance use disorder.
“EMS is no longer just an ambulance or a taxi driver that shows up and takes the patient from location A to location B,” said Dr. Heidi Abraham, the chief deputy medical director for Austin-Travis County EMS and the medical director for the New Braunfels Fire Department and Blanco County EMS. “EMS is able to meet all of these patients where they are and provide them care that is very much tailored to their circumstances and their environment.”
But while the programs have proliferated in major Texas cities, the demand for community paramedicine in rural areas remains unmet. Patton is one of two community health paramedics serving the 13,000 people in Blanco County west of Austin.
Rural communities in Texas overwhelmingly lack mental health resources. This can lead to high levels of crisis care in these communities and costly incarcerations of people with mental illnesses. The Texas Department of State Health Services estimates that providing care to rural Texans experiencing a mental health crisis costs $982 million annually, with $661 million going to ER charges and $248 million to incarceration costs. Suicide rates are higher in Texas’s non-metro areas.
Yet rural health care providers are struggling to find funding for the community paramedicine programs. And unlike other states, Texas has no regulations for CHP programs. Programs vary in structure and the kind of resources they can access. Small cities often struggle to finance their programs, while the ones in bigger cities have higher success rates. The lack of data to prove their effectiveness also makes it hard for community paramedics to advocate for funding.
Read more from Public Health Watch and Texas Community Health News here.