When the nearest major hospital is an hour away, rural communities rely on emergency medical services (EMS) providers to be the first line of defense against illness or emergencies. EMS providers serve the public in their greatest moments of need, delivering both medical care and peace of mind to rural residents who might not have another option for care in that moment. After the initial assessment and treatment on the scene, rural EMS providers often execute complex transfers to the most appropriate care facility, which may be in an urban healthcare facility. The South Carolina Office of Rural Health works to ensure these providers are well trained to meet a wide spectrum of needs in underserved communities. SCORH is home to the SC Rural EMT Tuition Assistance Program, a competitive scholarship that covers all levels of EMT training and education to those working for rural EMS providers. SCORH also serves as the state leader of the SC Community Paramedic Advisory Committee and advised the state’s first Community Paramedic Pilot and Extended Pilot Programs sponsored by the SC DHEC Bureau of Healthcare Professionals.