Around the country, the role of paramedics is changing. In various states, they're receiving extra training to provide more primary and preventive care and to take certain patients to urgent care or mental health clinics rather than more costly emergency rooms. Ramsdell and others in his program, for instance, spent 150 hours in the classroom and with clinicians learning how to provide ongoing care for patients. The changes are driven by the 2010 health law, which aimed to cut spending, expand patient access and improve quality of care. The federal government is funding the Nevada project and others in Arizona, Connecticut, Washington state and elsewhere.