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Date Available

4-16-2026

Year of Publication

2026

Document Type

Graduate Capstone Project

Degree Name

Master of Public Health (M.P.H.)

College

Public Health

Department/School/Program

Public Health

Faculty

Paula Arnett

Committee Member

Julia Costich

Faculty

Anne Ray

Abstract

Rural and mixed rural–urban communities face persistent disparities in access to timely emergency medical services (EMS), contributing to preventable morbidity and mortality from time-sensitive conditions such as cardiovascular disease, stroke, and injury. Hardin County, Kentucky, reflects these challenges due to its geographically dispersed population, high burden of chronic disease, and variability in EMS response times. This capstone proposes Hardin Health Link, a Community-Integrated Paramedicine (CIP) program designed to expand the traditional role of EMS providers through in-home health assessments, chronic disease monitoring, post-discharge follow-up, medication reconciliation, and connection to clinical and social services.

Guided by an evidence-informed framework, the program integrates partnerships among the Lincoln Trail District Health Department, Hardin County EMS, the Kentucky Department for Public Health, and the University of Kentucky College of Public Health. A comprehensive management, financing, and operational plan is presented, including a diversified funding strategy and alignment with emerging value-based care models. The proposed program targets high-risk populations, including older adults, individuals with chronic conditions, and frequent EMS utilizers, with the goal of reducing non-emergent EMS use and improving continuity of care.

A mixed-methods evaluation design, guided by the CDC Framework for Program Evaluation, will assess program implementation, service utilization, care coordination outcomes, and participant experiences. Anticipated outcomes include improved chronic disease management, enhanced care transitions, reduced emergency service utilization, and strengthened health equity in rural communities. Hardin Health Link represents a scalable, community-centered model for integrating EMS within broader public health systems to improve population health outcomes and system efficiency.

Funding Information

N/A

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