diff --git a/examples/python-us-core/fhir_types/example_folder_structures/profiles/bundle_example_typed_bundle.py b/examples/python-us-core/fhir_types/example_folder_structures/profiles/bundle_example_typed_bundle.py
index 55a50a19..277ac369 100644
--- a/examples/python-us-core/fhir_types/example_folder_structures/profiles/bundle_example_typed_bundle.py
+++ b/examples/python-us-core/fhir_types/example_folder_structures/profiles/bundle_example_typed_bundle.py
@@ -11,7 +11,7 @@
 from fhir_types.hl7_fhir_r4_core.organization import Organization
 from fhir_types.hl7_fhir_r4_core.patient import Patient
 from fhir_types.hl7_fhir_r4_core.resource import Resource
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     build_resource, ensure_profile, get_array_slice, get_array_slices, set_array_slice, set_array_slices, \
     validate_slice_cardinality
 )
diff --git a/examples/python-us-core/fhir_types/hl7_fhir_r4_core/profiles/observation_observation_vitalsigns.py b/examples/python-us-core/fhir_types/hl7_fhir_r4_core/profiles/observation_observation_vitalsigns.py
index 4eb3b6ca..4501a68b 100644
--- a/examples/python-us-core/fhir_types/hl7_fhir_r4_core/profiles/observation_observation_vitalsigns.py
+++ b/examples/python-us-core/fhir_types/hl7_fhir_r4_core/profiles/observation_observation_vitalsigns.py
@@ -8,7 +8,7 @@
 
 from fhir_types.hl7_fhir_r4_core.observation import Observation
 from fhir_types.hl7_fhir_r4_core.base import CodeableConcept, Period, Reference
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     apply_slice_match, build_resource, ensure_profile, ensure_slice_defaults, get_array_slice, matches_value, \
     set_array_slice, strip_match_keys, validate_choice_required, validate_enum, validate_must_support, validate_reference, \
     validate_required, validate_slice_cardinality
diff --git a/examples/python-us-core/fhir_types/hl7_fhir_r4_core/profiles/profile_helpers.py b/examples/python-us-core/fhir_types/hl7_fhir_r4_core/profiles/profile_helpers.py
deleted file mode 100644
index ac498839..00000000
--- a/examples/python-us-core/fhir_types/hl7_fhir_r4_core/profiles/profile_helpers.py
+++ /dev/null
@@ -1,502 +0,0 @@
-"""
-Runtime helpers for generated FHIR profile classes.
-
-This file is copied verbatim into every generated Python output and imported by
-profile modules. It provides:
-
-- **Slice helpers** – match, get, set, and default-fill array slices defined by
-  a FHIR StructureDefinition.
-- **Extension helpers** – read complex (nested) FHIR extensions into plain dicts.
-- **Choice-type helpers** – wrap/unwrap polymorphic ``value[x]`` fields so
-  profile classes can expose a flat API.
-- **Validation helpers** – lightweight structural checks that profile classes
-  call from their ``validate()`` method.
-- **Misc utilities** – deep-match, deep-merge, path navigation.
-
-The helpers operate on plain ``dict`` / ``list`` structures. Profile classes
-own a Pydantic resource instance (``self._resource``); when a helper needs the
-underlying data, the profile passes ``self._resource.model_dump(by_alias=True,
-exclude_none=True)`` or accesses model fields directly. All ``validate_*``
-functions return ``list[str]`` so a profile's ``validate()`` can concatenate
-them into a single errors / warnings list.
-"""
-
-from __future__ import annotations
-
-import copy
-from typing import Any, Iterable, Mapping, MutableMapping, MutableSequence, Sequence, TypeVar
-
-T = TypeVar("T")
-
-# ---------------------------------------------------------------------------
-# General utilities
-# ---------------------------------------------------------------------------
-
-
-def is_record(value: Any) -> bool:
-    """True when ``value`` is a non-None mapping (dict-like, not a list)."""
-    return isinstance(value, Mapping)
-
-
-def ensure_path(root: MutableMapping[str, Any], path: Sequence[str]) -> MutableMapping[str, Any]:
-    """Walk ``path`` from ``root``, creating intermediate dicts (or using the
-    first element of an existing list) as needed. Returns the leaf mapping.
-
-    Used by extension setters to reach a nested target inside a resource dict.
-    """
-    current: MutableMapping[str, Any] = root
-    for segment in path:
-        nxt = current.get(segment)
-        if isinstance(nxt, list):
-            if len(nxt) == 0:
-                nxt.append({})
-            current = nxt[0]
-        else:
-            if not isinstance(nxt, MutableMapping):
-                nxt = {}
-                current[segment] = nxt
-            current = nxt  # type: ignore[assignment]
-    return current
-
-
-# ---------------------------------------------------------------------------
-# Deep match / merge
-# ---------------------------------------------------------------------------
-
-
-def merge_match(target: MutableMapping[str, Any], match: Mapping[str, Any]) -> None:
-    """Deep-merge ``match`` into ``target``, mutating ``target`` in place."""
-    for key, match_value in match.items():
-        if is_record(match_value):
-            existing = target.get(key)
-            if is_record(existing):
-                merge_match(existing, match_value)  # type: ignore[arg-type]
-            else:
-                target[key] = dict(match_value)
-        else:
-            target[key] = match_value
-
-
-def apply_slice_match(input_obj: Mapping[str, Any], match: Mapping[str, Any]) -> dict[str, Any]:
-    """Shallow-clone ``input_obj`` then deep-merge ``match`` on top, returning
-    a complete slice element ready for insertion."""
-    result: dict[str, Any] = dict(input_obj)
-    merge_match(result, match)
-    return result
-
-
-def _get_key(obj: Any, key: str) -> Any:
-    """Retrieve ``key`` from a dict-like or Pydantic-model-like object."""
-    if is_record(obj):
-        return obj.get(key)
-    return getattr(obj, key, None)
-
-
-def _model_get(value: Any, key: str) -> Any:
-    """Get an attribute from a Pydantic model by Python name or field alias.
-
-    Pydantic stores fields as snake_case attributes but slice match dicts use
-    camelCase aliases (e.g. ``resourceType``). Try the direct attribute first;
-    fall back to scanning ``model_fields`` for a matching alias.
-    """
-    direct = getattr(value, key, None)
-    if direct is not None:
-        return direct
-    model_fields = getattr(type(value), "model_fields", None)
-    if model_fields:
-        for field_name, field_info in model_fields.items():
-            if field_info.alias == key or field_info.serialization_alias == key:
-                return getattr(value, field_name, None)
-    return None
-
-
-def matches_value(value: Any, match: Any) -> bool:
-    """Recursively test whether ``value`` structurally contains everything in
-    ``match``. Lists use "every match item has a corresponding value item"
-    semantics; mappings are matched key-by-key; primitives use ``==``.
-
-    Works with both plain dicts and Pydantic model instances.  When ``match``
-    is a record and ``value`` is a list, returns ``True`` if any element in
-    ``value`` satisfies the record match (handles nested array fields in FHIR
-    discriminator patterns).
-
-    Core discriminator check used to identify which array element belongs to a
-    given FHIR slice.
-    """
-    if isinstance(match, list):
-        if not isinstance(value, list):
-            return False
-        return all(any(matches_value(item, m_item) for item in value) for m_item in match)
-    if is_record(match):
-        if value is None:
-            return False
-        # Record match against a list: check any element matches
-        if isinstance(value, list):
-            return any(matches_value(item, match) for item in value)
-        # Plain dict
-        if is_record(value):
-            for key, m_val in match.items():
-                if not matches_value(value.get(key), m_val):
-                    return False
-            return True
-        # Pydantic model (or any object with attributes) — use alias-aware lookup
-        if hasattr(value, "__dict__"):
-            for key, m_val in match.items():
-                if not matches_value(_model_get(value, key), m_val):
-                    return False
-            return True
-        return False
-    return value == match
-
-
-def is_extension(value: Any, url: str | None = None) -> bool:
-    """True when ``value`` looks like a raw FHIR Extension (has a ``url``).
-    When ``url`` is given, also checks the URL matches.
-    Works with both plain dicts and Pydantic model instances."""
-    ext_url = _get_key(value, "url") if (is_record(value) or hasattr(value, "__dict__")) else None
-    if ext_url is None:
-        return False
-    return url is None or ext_url == url
-
-
-def get_extension_value(ext: Any | None, field: str) -> Any:
-    """Read a single typed value field from an Extension dict or Pydantic model,
-    returning ``None`` when the extension itself is absent or the field is not set."""
-    if ext is None:
-        return None
-    return _get_key(ext, field)
-
-
-def push_extension(target: Any, ext: Any) -> None:
-    """Push an extension onto ``target.extension`` (Pydantic model) or
-    ``target['extension']`` (dict), creating the list if absent. ``ext`` may
-    be either a dict-like mapping or a Pydantic model instance — mappings are
-    shallow-copied, Pydantic models are stored as-is so attribute access and
-    nested model instances are preserved."""
-    lst = getattr(target, "extension", None) if hasattr(target, "__dict__") else target.get("extension")
-    if not isinstance(lst, list):
-        lst = []
-    if hasattr(ext, "model_dump"):
-        lst.append(ext)
-    else:
-        lst.append(dict(ext))
-    if hasattr(target, "__dict__"):
-        setattr(target, "extension", lst)
-    else:
-        target["extension"] = lst
-
-
-# ---------------------------------------------------------------------------
-# Extension helpers
-# ---------------------------------------------------------------------------
-
-
-def extract_complex_extension(
-    extension: Any | None,
-    config: Sequence[Mapping[str, Any]],
-) -> dict[str, Any] | None:
-    """Read a complex (nested) FHIR extension into a plain key/value dict.
-
-    Each entry in ``config`` describes one sub-extension by ``name`` (URL),
-    ``valueField`` (e.g. ``"valueString"``), and ``isArray``.
-
-    Works with both plain dicts and Pydantic model instances.
-    """
-    if extension is None:
-        return None
-    sub_exts = _get_key(extension, "extension")
-    if not isinstance(sub_exts, list):
-        return None
-    result: dict[str, Any] = {}
-    for entry in config:
-        name = entry["name"]
-        value_field = entry["valueField"]
-        is_array = bool(entry["isArray"])
-        matched = [e for e in sub_exts if _get_key(e, "url") == name]
-        if is_array:
-            result[name] = [_get_key(e, value_field) for e in matched]
-        elif matched:
-            result[name] = _get_key(matched[0], value_field)
-    return result
-
-
-# ---------------------------------------------------------------------------
-# Slice helpers
-# ---------------------------------------------------------------------------
-
-
-def strip_match_keys(slice_obj: Mapping[str, Any], match_keys: Sequence[str]) -> dict[str, Any]:
-    """Remove discriminator keys from a slice element, returning only the
-    user-supplied portion."""
-    result = dict(slice_obj)
-    for key in match_keys:
-        result.pop(key, None)
-    return result
-
-
-def wrap_slice_choice(input_obj: Mapping[str, Any], choice_variant: str) -> dict[str, Any]:
-    """Wrap a flat input dict under a choice-type key. No-op when ``input_obj``
-    is empty."""
-    if len(input_obj) == 0:
-        return dict(input_obj)
-    return {choice_variant: dict(input_obj)}
-
-
-def unwrap_slice_choice(
-    slice_obj: Mapping[str, Any],
-    match_keys: Sequence[str],
-    choice_variant: str,
-) -> dict[str, Any]:
-    """Inverse of :func:`wrap_slice_choice`: strip discriminator keys, then
-    hoist the value inside ``choice_variant`` up to the top level."""
-    result = dict(slice_obj)
-    for key in match_keys:
-        result.pop(key, None)
-    variant_value = result.pop(choice_variant, None)
-    if is_record(variant_value):
-        for k, v in variant_value.items():  # type: ignore[union-attr]
-            result[k] = v
-    return result
-
-
-def ensure_slice_defaults(items: MutableSequence[Any], *matches: Mapping[str, Any]) -> MutableSequence[Any]:
-    """Ensure that every required slice has at least a stub element in the
-    array. If no existing item satisfies a ``match``, a deep clone of the
-    pattern is appended."""
-    for match in matches:
-        if not any(matches_value(item, match) for item in items):
-            items.append(copy.deepcopy(dict(match)))
-    return items
-
-
-def build_resource(resource_cls: type[T], /, **fields: Any) -> T:
-    """Instantiate a Pydantic resource class from kwargs, dropping ``None``
-    values so optional fields don't appear in the dump.
-
-    Centralises construction so generators don't need to import every model.
-    """
-    cleaned = {k: v for k, v in fields.items() if v is not None}
-    return resource_cls(**cleaned)  # type: ignore[call-arg]
-
-
-def ensure_profile(resource: Any, canonical_url: str) -> None:
-    """Add ``canonical_url`` to ``resource.meta.profile`` if not already
-    present. Works on both Pydantic models and plain dicts; creates ``meta``
-    and ``profile`` when missing."""
-    if isinstance(resource, MutableMapping):
-        meta = resource.get("meta")
-        if not isinstance(meta, MutableMapping):
-            meta = {}
-            resource["meta"] = meta
-        profiles = meta.get("profile")
-        if not isinstance(profiles, list):
-            profiles = []
-            meta["profile"] = profiles
-        if canonical_url not in profiles:
-            profiles.append(canonical_url)
-        return
-    # Pydantic model path
-    meta = getattr(resource, "meta", None)
-    if meta is None:
-        # Try to construct a Meta from the model's annotation
-        meta_field = type(resource).model_fields.get("meta") if hasattr(type(resource), "model_fields") else None
-        if meta_field is not None and meta_field.annotation is not None:
-            try:
-                import types as _types
-                import typing as _typing
-                ann = meta_field.annotation
-                # Unwrap Optional[T] / Union[T, None] / T | None to get the actual class
-                origin = getattr(ann, "__origin__", None)
-                if origin is _typing.Union or isinstance(ann, _types.UnionType):
-                    args = [a for a in ann.__args__ if a is not type(None)]
-                    if args:
-                        ann = args[0]
-                meta = ann(profile=[canonical_url])  # type: ignore[call-arg]
-                resource.meta = meta  # type: ignore[attr-defined]
-                return
-            except Exception:
-                pass
-        # Fallback: shouldn't happen for FHIR resources
-        return
-    profiles = getattr(meta, "profile", None)
-    if profiles is None:
-        meta.profile = [canonical_url]  # type: ignore[attr-defined]
-    elif canonical_url not in profiles:
-        profiles.append(canonical_url)
-
-
-def set_array_slice(lst: MutableSequence[Any], match: Mapping[str, Any], value: Any) -> None:
-    """Find or insert a slice element. If an element matching ``match``
-    already exists it is replaced in place; otherwise ``value`` is appended."""
-    for i, item in enumerate(lst):
-        if matches_value(item, match):
-            lst[i] = value
-            return
-    lst.append(value)
-
-
-def get_array_slice(lst: Sequence[Any] | None, match: Mapping[str, Any]) -> Any:
-    """Return the first element in ``lst`` that satisfies ``match``."""
-    if lst is None:
-        return None
-    for item in lst:
-        if matches_value(item, match):
-            return item
-    return None
-
-
-def get_array_slices(lst: Sequence[Any] | None, match: Mapping[str, Any]) -> list[Any]:
-    """Return all elements in ``lst`` that satisfy ``match``."""
-    if lst is None:
-        return []
-    return [item for item in lst if matches_value(item, match)]
-
-
-def set_array_slices(
-    lst: MutableSequence[Any],
-    match: Mapping[str, Any],
-    values: Sequence[Any],
-) -> None:
-    """Remove all elements matching ``match``, then append ``values``."""
-    indices = [i for i, item in enumerate(lst) if matches_value(item, match)]
-    for i in reversed(indices):
-        del lst[i]
-    lst.extend(values)
-
-
-# ---------------------------------------------------------------------------
-# Validation helpers
-#
-# Each function returns a list of human-readable error strings (empty = ok).
-# Profile classes concatenate them all into a single list inside validate().
-# ---------------------------------------------------------------------------
-
-
-def _get_field(res: Any, field: str) -> Any:
-    if isinstance(res, Mapping):
-        return res.get(field)
-    return getattr(res, field, None)
-
-
-def validate_required(res: Any, profile_name: str, field: str) -> list[str]:
-    """Checks that ``field`` is present (not ``None``)."""
-    return (
-        [f"{profile_name}: required field '{field}' is missing"]
-        if _get_field(res, field) is None
-        else []
-    )
-
-
-def validate_must_support(res: Any, profile_name: str, field: str) -> list[str]:
-    """Checks that a must-support field is populated (warning, not error)."""
-    return (
-        [f"{profile_name}: must-support field '{field}' is not populated"]
-        if _get_field(res, field) is None
-        else []
-    )
-
-
-def validate_excluded(res: Any, profile_name: str, field: str) -> list[str]:
-    """Checks that ``field`` is absent."""
-    return (
-        [f"{profile_name}: field '{field}' must not be present"]
-        if _get_field(res, field) is not None
-        else []
-    )
-
-
-def validate_fixed_value(res: Any, profile_name: str, field: str, expected: Any) -> list[str]:
-    """Checks that ``field`` structurally contains the expected fixed value."""
-    actual = _get_field(res, field)
-    return (
-        []
-        if matches_value(actual, expected)
-        else [f"{profile_name}: field '{field}' does not match expected fixed value"]
-    )
-
-
-def validate_slice_cardinality(
-    res: Any,
-    profile_name: str,
-    field: str,
-    match: Mapping[str, Any],
-    slice_name: str,
-    min_count: int,
-    max_count: int,
-) -> list[str]:
-    """Checks that the number of array elements matching ``match`` falls
-    within ``[min_count, max_count]``. Pass ``max_count = 0`` for unbounded."""
-    items = _get_field(res, field) or []
-    if not isinstance(items, Iterable):
-        items = []
-    count = sum(1 for item in items if matches_value(item, match))
-    errors: list[str] = []
-    if count < min_count:
-        errors.append(
-            f"{profile_name}.{field}: slice '{slice_name}' requires at least {min_count} item(s), found {count}"
-        )
-    if max_count > 0 and count > max_count:
-        errors.append(
-            f"{profile_name}.{field}: slice '{slice_name}' allows at most {max_count} item(s), found {count}"
-        )
-    return errors
-
-
-def validate_choice_required(res: Any, profile_name: str, choices: Sequence[str]) -> list[str]:
-    """Checks that at least one of the listed choice-type variants is present."""
-    if any(_get_field(res, c) is not None for c in choices):
-        return []
-    return [f"{profile_name}: at least one of {', '.join(choices)} is required"]
-
-
-def validate_enum(res: Any, profile_name: str, field: str, allowed: Sequence[str]) -> list[str]:
-    """Checks that the value of ``field`` has a code within ``allowed``.
-    Handles plain strings, Coding, and CodeableConcept."""
-    value = _get_field(res, field)
-    if value is None:
-        return []
-    if isinstance(value, str):
-        return (
-            []
-            if value in allowed
-            else [f"{profile_name}: field '{field}' value '{value}' is not in allowed values"]
-        )
-    # Coding
-    code = _get_field(value, "code")
-    system = _get_field(value, "system")
-    if isinstance(code, str) and system is not None:
-        return (
-            []
-            if code in allowed
-            else [f"{profile_name}: field '{field}' code '{code}' is not in allowed values"]
-        )
-    # CodeableConcept
-    coding = _get_field(value, "coding")
-    if isinstance(coding, list):
-        codes = [_get_field(c, "code") for c in coding]
-        codes = [c for c in codes if isinstance(c, str)]
-        if any(c in allowed for c in codes):
-            return []
-        return [f"{profile_name}: field '{field}' has no coding with an allowed code"]
-    return []
-
-
-def validate_reference(res: Any, profile_name: str, field: str, allowed: Sequence[str]) -> list[str]:
-    """Checks that a Reference field points to one of the ``allowed`` resource
-    types. Extracts the type from the ``reference`` string (the part before
-    the first ``/``)."""
-    value = _get_field(res, field)
-    if value is None:
-        return []
-    ref = _get_field(value, "reference")
-    if not isinstance(ref, str):
-        return []
-    slash = ref.find("/")
-    if slash == -1:
-        return []
-    ref_type = ref[:slash]
-    if ref_type in allowed:
-        return []
-    return [
-        f"{profile_name}: field '{field}' references '{ref_type}' but only {', '.join(allowed)} are allowed"
-    ]
diff --git a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_ethnicity_extension.py b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_ethnicity_extension.py
index 81faaf8b..bddfc0db 100644
--- a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_ethnicity_extension.py
+++ b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_ethnicity_extension.py
@@ -9,7 +9,7 @@
 from fhir_types.hl7_fhir_r4_core.base import Extension
 from fhir_types.hl7_fhir_r4_core.base import Extension
 from fhir_types.hl7_fhir_r4_core.base import Coding
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     _get_key, apply_slice_match, build_resource, ensure_slice_defaults, get_array_slice, get_extension_value, \
     is_extension, matches_value, push_extension, set_array_slice, strip_match_keys, unwrap_slice_choice, validate_fixed_value, \
     validate_required, validate_slice_cardinality, wrap_slice_choice
diff --git a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_individual_sex_extension.py b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_individual_sex_extension.py
index febd5f98..c13b2983 100644
--- a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_individual_sex_extension.py
+++ b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_individual_sex_extension.py
@@ -6,7 +6,7 @@
 
 from fhir_types.hl7_fhir_r4_core.base import Extension
 from fhir_types.hl7_fhir_r4_core.base import Coding
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     build_resource, validate_choice_required, validate_fixed_value, validate_required
 )
 
diff --git a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_interpreter_needed_extension.py b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_interpreter_needed_extension.py
index d3b563fa..b13d64cf 100644
--- a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_interpreter_needed_extension.py
+++ b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_interpreter_needed_extension.py
@@ -6,7 +6,7 @@
 
 from fhir_types.hl7_fhir_r4_core.base import Extension
 from fhir_types.hl7_fhir_r4_core.base import Coding
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     build_resource, validate_choice_required, validate_fixed_value, validate_required
 )
 
diff --git a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_race_extension.py b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_race_extension.py
index 539048d9..5e6c7f2c 100644
--- a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_race_extension.py
+++ b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_race_extension.py
@@ -9,7 +9,7 @@
 from fhir_types.hl7_fhir_r4_core.base import Extension
 from fhir_types.hl7_fhir_r4_core.base import Extension
 from fhir_types.hl7_fhir_r4_core.base import Coding
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     _get_key, apply_slice_match, build_resource, ensure_slice_defaults, get_array_slice, get_extension_value, \
     is_extension, matches_value, push_extension, set_array_slice, strip_match_keys, unwrap_slice_choice, validate_fixed_value, \
     validate_required, validate_slice_cardinality, wrap_slice_choice
diff --git a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_tribal_affiliation_extension.py b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_tribal_affiliation_extension.py
index 6934caf3..9cdc7b6e 100644
--- a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_tribal_affiliation_extension.py
+++ b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/extension_uscore_tribal_affiliation_extension.py
@@ -9,7 +9,7 @@
 from fhir_types.hl7_fhir_r4_core.base import Extension
 from fhir_types.hl7_fhir_r4_core.base import Extension
 from fhir_types.hl7_fhir_r4_core.base import CodeableConcept
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     _get_key, apply_slice_match, build_resource, ensure_slice_defaults, get_array_slice, get_extension_value, \
     is_extension, matches_value, push_extension, set_array_slice, strip_match_keys, unwrap_slice_choice, validate_fixed_value, \
     validate_required, validate_slice_cardinality, wrap_slice_choice
diff --git a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/observation_uscore_blood_pressure_profile.py b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/observation_uscore_blood_pressure_profile.py
index d96a712b..2ba389e0 100644
--- a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/observation_uscore_blood_pressure_profile.py
+++ b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/observation_uscore_blood_pressure_profile.py
@@ -11,7 +11,7 @@
     BackboneElement, CodeableConcept, Period, Quantity, Range, Ratio, Reference, SampledData
 )
 from fhir_types.hl7_fhir_r4_core.observation import ObservationComponent
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     apply_slice_match, build_resource, ensure_profile, ensure_slice_defaults, get_array_slice, matches_value, \
     set_array_slice, strip_match_keys, unwrap_slice_choice, validate_choice_required, validate_enum, validate_fixed_value, \
     validate_must_support, validate_reference, validate_required, validate_slice_cardinality, wrap_slice_choice
diff --git a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/observation_uscore_body_weight_profile.py b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/observation_uscore_body_weight_profile.py
index 838ec932..98be19f9 100644
--- a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/observation_uscore_body_weight_profile.py
+++ b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/observation_uscore_body_weight_profile.py
@@ -10,7 +10,7 @@
 from fhir_types.hl7_fhir_r4_core.base import (
     CodeableConcept, Period, Quantity, Range, Ratio, Reference, SampledData
 )
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     apply_slice_match, build_resource, ensure_profile, ensure_slice_defaults, get_array_slice, matches_value, \
     set_array_slice, strip_match_keys, validate_choice_required, validate_enum, validate_excluded, validate_fixed_value, \
     validate_must_support, validate_reference, validate_required, validate_slice_cardinality
diff --git a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/observation_uscore_vital_signs_profile.py b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/observation_uscore_vital_signs_profile.py
index 5ec2556e..4d77df71 100644
--- a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/observation_uscore_vital_signs_profile.py
+++ b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/observation_uscore_vital_signs_profile.py
@@ -10,7 +10,7 @@
 from fhir_types.hl7_fhir_r4_core.base import (
     CodeableConcept, Period, Quantity, Range, Ratio, Reference, SampledData
 )
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     apply_slice_match, build_resource, ensure_profile, ensure_slice_defaults, get_array_slice, matches_value, \
     set_array_slice, strip_match_keys, validate_choice_required, validate_enum, validate_must_support, validate_reference, \
     validate_required, validate_slice_cardinality
diff --git a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/patient_uscore_patient_profile.py b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/patient_uscore_patient_profile.py
index 1ed756fe..f42f19e7 100644
--- a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/patient_uscore_patient_profile.py
+++ b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/patient_uscore_patient_profile.py
@@ -14,7 +14,7 @@
 from .extension_uscore_interpreter_needed_extension import UscoreInterpreterNeededExtension
 from .extension_uscore_race_extension import UscoreRaceExtension
 from .extension_uscore_tribal_affiliation_extension import UscoreTribalAffiliationExtension
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     _get_key, build_resource, ensure_profile, extract_complex_extension, get_extension_value, is_extension, \
     push_extension, validate_must_support, validate_required
 )
diff --git a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/profile_helpers.py b/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/profile_helpers.py
deleted file mode 100644
index ac498839..00000000
--- a/examples/python-us-core/fhir_types/hl7_fhir_us_core/profiles/profile_helpers.py
+++ /dev/null
@@ -1,502 +0,0 @@
-"""
-Runtime helpers for generated FHIR profile classes.
-
-This file is copied verbatim into every generated Python output and imported by
-profile modules. It provides:
-
-- **Slice helpers** – match, get, set, and default-fill array slices defined by
-  a FHIR StructureDefinition.
-- **Extension helpers** – read complex (nested) FHIR extensions into plain dicts.
-- **Choice-type helpers** – wrap/unwrap polymorphic ``value[x]`` fields so
-  profile classes can expose a flat API.
-- **Validation helpers** – lightweight structural checks that profile classes
-  call from their ``validate()`` method.
-- **Misc utilities** – deep-match, deep-merge, path navigation.
-
-The helpers operate on plain ``dict`` / ``list`` structures. Profile classes
-own a Pydantic resource instance (``self._resource``); when a helper needs the
-underlying data, the profile passes ``self._resource.model_dump(by_alias=True,
-exclude_none=True)`` or accesses model fields directly. All ``validate_*``
-functions return ``list[str]`` so a profile's ``validate()`` can concatenate
-them into a single errors / warnings list.
-"""
-
-from __future__ import annotations
-
-import copy
-from typing import Any, Iterable, Mapping, MutableMapping, MutableSequence, Sequence, TypeVar
-
-T = TypeVar("T")
-
-# ---------------------------------------------------------------------------
-# General utilities
-# ---------------------------------------------------------------------------
-
-
-def is_record(value: Any) -> bool:
-    """True when ``value`` is a non-None mapping (dict-like, not a list)."""
-    return isinstance(value, Mapping)
-
-
-def ensure_path(root: MutableMapping[str, Any], path: Sequence[str]) -> MutableMapping[str, Any]:
-    """Walk ``path`` from ``root``, creating intermediate dicts (or using the
-    first element of an existing list) as needed. Returns the leaf mapping.
-
-    Used by extension setters to reach a nested target inside a resource dict.
-    """
-    current: MutableMapping[str, Any] = root
-    for segment in path:
-        nxt = current.get(segment)
-        if isinstance(nxt, list):
-            if len(nxt) == 0:
-                nxt.append({})
-            current = nxt[0]
-        else:
-            if not isinstance(nxt, MutableMapping):
-                nxt = {}
-                current[segment] = nxt
-            current = nxt  # type: ignore[assignment]
-    return current
-
-
-# ---------------------------------------------------------------------------
-# Deep match / merge
-# ---------------------------------------------------------------------------
-
-
-def merge_match(target: MutableMapping[str, Any], match: Mapping[str, Any]) -> None:
-    """Deep-merge ``match`` into ``target``, mutating ``target`` in place."""
-    for key, match_value in match.items():
-        if is_record(match_value):
-            existing = target.get(key)
-            if is_record(existing):
-                merge_match(existing, match_value)  # type: ignore[arg-type]
-            else:
-                target[key] = dict(match_value)
-        else:
-            target[key] = match_value
-
-
-def apply_slice_match(input_obj: Mapping[str, Any], match: Mapping[str, Any]) -> dict[str, Any]:
-    """Shallow-clone ``input_obj`` then deep-merge ``match`` on top, returning
-    a complete slice element ready for insertion."""
-    result: dict[str, Any] = dict(input_obj)
-    merge_match(result, match)
-    return result
-
-
-def _get_key(obj: Any, key: str) -> Any:
-    """Retrieve ``key`` from a dict-like or Pydantic-model-like object."""
-    if is_record(obj):
-        return obj.get(key)
-    return getattr(obj, key, None)
-
-
-def _model_get(value: Any, key: str) -> Any:
-    """Get an attribute from a Pydantic model by Python name or field alias.
-
-    Pydantic stores fields as snake_case attributes but slice match dicts use
-    camelCase aliases (e.g. ``resourceType``). Try the direct attribute first;
-    fall back to scanning ``model_fields`` for a matching alias.
-    """
-    direct = getattr(value, key, None)
-    if direct is not None:
-        return direct
-    model_fields = getattr(type(value), "model_fields", None)
-    if model_fields:
-        for field_name, field_info in model_fields.items():
-            if field_info.alias == key or field_info.serialization_alias == key:
-                return getattr(value, field_name, None)
-    return None
-
-
-def matches_value(value: Any, match: Any) -> bool:
-    """Recursively test whether ``value`` structurally contains everything in
-    ``match``. Lists use "every match item has a corresponding value item"
-    semantics; mappings are matched key-by-key; primitives use ``==``.
-
-    Works with both plain dicts and Pydantic model instances.  When ``match``
-    is a record and ``value`` is a list, returns ``True`` if any element in
-    ``value`` satisfies the record match (handles nested array fields in FHIR
-    discriminator patterns).
-
-    Core discriminator check used to identify which array element belongs to a
-    given FHIR slice.
-    """
-    if isinstance(match, list):
-        if not isinstance(value, list):
-            return False
-        return all(any(matches_value(item, m_item) for item in value) for m_item in match)
-    if is_record(match):
-        if value is None:
-            return False
-        # Record match against a list: check any element matches
-        if isinstance(value, list):
-            return any(matches_value(item, match) for item in value)
-        # Plain dict
-        if is_record(value):
-            for key, m_val in match.items():
-                if not matches_value(value.get(key), m_val):
-                    return False
-            return True
-        # Pydantic model (or any object with attributes) — use alias-aware lookup
-        if hasattr(value, "__dict__"):
-            for key, m_val in match.items():
-                if not matches_value(_model_get(value, key), m_val):
-                    return False
-            return True
-        return False
-    return value == match
-
-
-def is_extension(value: Any, url: str | None = None) -> bool:
-    """True when ``value`` looks like a raw FHIR Extension (has a ``url``).
-    When ``url`` is given, also checks the URL matches.
-    Works with both plain dicts and Pydantic model instances."""
-    ext_url = _get_key(value, "url") if (is_record(value) or hasattr(value, "__dict__")) else None
-    if ext_url is None:
-        return False
-    return url is None or ext_url == url
-
-
-def get_extension_value(ext: Any | None, field: str) -> Any:
-    """Read a single typed value field from an Extension dict or Pydantic model,
-    returning ``None`` when the extension itself is absent or the field is not set."""
-    if ext is None:
-        return None
-    return _get_key(ext, field)
-
-
-def push_extension(target: Any, ext: Any) -> None:
-    """Push an extension onto ``target.extension`` (Pydantic model) or
-    ``target['extension']`` (dict), creating the list if absent. ``ext`` may
-    be either a dict-like mapping or a Pydantic model instance — mappings are
-    shallow-copied, Pydantic models are stored as-is so attribute access and
-    nested model instances are preserved."""
-    lst = getattr(target, "extension", None) if hasattr(target, "__dict__") else target.get("extension")
-    if not isinstance(lst, list):
-        lst = []
-    if hasattr(ext, "model_dump"):
-        lst.append(ext)
-    else:
-        lst.append(dict(ext))
-    if hasattr(target, "__dict__"):
-        setattr(target, "extension", lst)
-    else:
-        target["extension"] = lst
-
-
-# ---------------------------------------------------------------------------
-# Extension helpers
-# ---------------------------------------------------------------------------
-
-
-def extract_complex_extension(
-    extension: Any | None,
-    config: Sequence[Mapping[str, Any]],
-) -> dict[str, Any] | None:
-    """Read a complex (nested) FHIR extension into a plain key/value dict.
-
-    Each entry in ``config`` describes one sub-extension by ``name`` (URL),
-    ``valueField`` (e.g. ``"valueString"``), and ``isArray``.
-
-    Works with both plain dicts and Pydantic model instances.
-    """
-    if extension is None:
-        return None
-    sub_exts = _get_key(extension, "extension")
-    if not isinstance(sub_exts, list):
-        return None
-    result: dict[str, Any] = {}
-    for entry in config:
-        name = entry["name"]
-        value_field = entry["valueField"]
-        is_array = bool(entry["isArray"])
-        matched = [e for e in sub_exts if _get_key(e, "url") == name]
-        if is_array:
-            result[name] = [_get_key(e, value_field) for e in matched]
-        elif matched:
-            result[name] = _get_key(matched[0], value_field)
-    return result
-
-
-# ---------------------------------------------------------------------------
-# Slice helpers
-# ---------------------------------------------------------------------------
-
-
-def strip_match_keys(slice_obj: Mapping[str, Any], match_keys: Sequence[str]) -> dict[str, Any]:
-    """Remove discriminator keys from a slice element, returning only the
-    user-supplied portion."""
-    result = dict(slice_obj)
-    for key in match_keys:
-        result.pop(key, None)
-    return result
-
-
-def wrap_slice_choice(input_obj: Mapping[str, Any], choice_variant: str) -> dict[str, Any]:
-    """Wrap a flat input dict under a choice-type key. No-op when ``input_obj``
-    is empty."""
-    if len(input_obj) == 0:
-        return dict(input_obj)
-    return {choice_variant: dict(input_obj)}
-
-
-def unwrap_slice_choice(
-    slice_obj: Mapping[str, Any],
-    match_keys: Sequence[str],
-    choice_variant: str,
-) -> dict[str, Any]:
-    """Inverse of :func:`wrap_slice_choice`: strip discriminator keys, then
-    hoist the value inside ``choice_variant`` up to the top level."""
-    result = dict(slice_obj)
-    for key in match_keys:
-        result.pop(key, None)
-    variant_value = result.pop(choice_variant, None)
-    if is_record(variant_value):
-        for k, v in variant_value.items():  # type: ignore[union-attr]
-            result[k] = v
-    return result
-
-
-def ensure_slice_defaults(items: MutableSequence[Any], *matches: Mapping[str, Any]) -> MutableSequence[Any]:
-    """Ensure that every required slice has at least a stub element in the
-    array. If no existing item satisfies a ``match``, a deep clone of the
-    pattern is appended."""
-    for match in matches:
-        if not any(matches_value(item, match) for item in items):
-            items.append(copy.deepcopy(dict(match)))
-    return items
-
-
-def build_resource(resource_cls: type[T], /, **fields: Any) -> T:
-    """Instantiate a Pydantic resource class from kwargs, dropping ``None``
-    values so optional fields don't appear in the dump.
-
-    Centralises construction so generators don't need to import every model.
-    """
-    cleaned = {k: v for k, v in fields.items() if v is not None}
-    return resource_cls(**cleaned)  # type: ignore[call-arg]
-
-
-def ensure_profile(resource: Any, canonical_url: str) -> None:
-    """Add ``canonical_url`` to ``resource.meta.profile`` if not already
-    present. Works on both Pydantic models and plain dicts; creates ``meta``
-    and ``profile`` when missing."""
-    if isinstance(resource, MutableMapping):
-        meta = resource.get("meta")
-        if not isinstance(meta, MutableMapping):
-            meta = {}
-            resource["meta"] = meta
-        profiles = meta.get("profile")
-        if not isinstance(profiles, list):
-            profiles = []
-            meta["profile"] = profiles
-        if canonical_url not in profiles:
-            profiles.append(canonical_url)
-        return
-    # Pydantic model path
-    meta = getattr(resource, "meta", None)
-    if meta is None:
-        # Try to construct a Meta from the model's annotation
-        meta_field = type(resource).model_fields.get("meta") if hasattr(type(resource), "model_fields") else None
-        if meta_field is not None and meta_field.annotation is not None:
-            try:
-                import types as _types
-                import typing as _typing
-                ann = meta_field.annotation
-                # Unwrap Optional[T] / Union[T, None] / T | None to get the actual class
-                origin = getattr(ann, "__origin__", None)
-                if origin is _typing.Union or isinstance(ann, _types.UnionType):
-                    args = [a for a in ann.__args__ if a is not type(None)]
-                    if args:
-                        ann = args[0]
-                meta = ann(profile=[canonical_url])  # type: ignore[call-arg]
-                resource.meta = meta  # type: ignore[attr-defined]
-                return
-            except Exception:
-                pass
-        # Fallback: shouldn't happen for FHIR resources
-        return
-    profiles = getattr(meta, "profile", None)
-    if profiles is None:
-        meta.profile = [canonical_url]  # type: ignore[attr-defined]
-    elif canonical_url not in profiles:
-        profiles.append(canonical_url)
-
-
-def set_array_slice(lst: MutableSequence[Any], match: Mapping[str, Any], value: Any) -> None:
-    """Find or insert a slice element. If an element matching ``match``
-    already exists it is replaced in place; otherwise ``value`` is appended."""
-    for i, item in enumerate(lst):
-        if matches_value(item, match):
-            lst[i] = value
-            return
-    lst.append(value)
-
-
-def get_array_slice(lst: Sequence[Any] | None, match: Mapping[str, Any]) -> Any:
-    """Return the first element in ``lst`` that satisfies ``match``."""
-    if lst is None:
-        return None
-    for item in lst:
-        if matches_value(item, match):
-            return item
-    return None
-
-
-def get_array_slices(lst: Sequence[Any] | None, match: Mapping[str, Any]) -> list[Any]:
-    """Return all elements in ``lst`` that satisfy ``match``."""
-    if lst is None:
-        return []
-    return [item for item in lst if matches_value(item, match)]
-
-
-def set_array_slices(
-    lst: MutableSequence[Any],
-    match: Mapping[str, Any],
-    values: Sequence[Any],
-) -> None:
-    """Remove all elements matching ``match``, then append ``values``."""
-    indices = [i for i, item in enumerate(lst) if matches_value(item, match)]
-    for i in reversed(indices):
-        del lst[i]
-    lst.extend(values)
-
-
-# ---------------------------------------------------------------------------
-# Validation helpers
-#
-# Each function returns a list of human-readable error strings (empty = ok).
-# Profile classes concatenate them all into a single list inside validate().
-# ---------------------------------------------------------------------------
-
-
-def _get_field(res: Any, field: str) -> Any:
-    if isinstance(res, Mapping):
-        return res.get(field)
-    return getattr(res, field, None)
-
-
-def validate_required(res: Any, profile_name: str, field: str) -> list[str]:
-    """Checks that ``field`` is present (not ``None``)."""
-    return (
-        [f"{profile_name}: required field '{field}' is missing"]
-        if _get_field(res, field) is None
-        else []
-    )
-
-
-def validate_must_support(res: Any, profile_name: str, field: str) -> list[str]:
-    """Checks that a must-support field is populated (warning, not error)."""
-    return (
-        [f"{profile_name}: must-support field '{field}' is not populated"]
-        if _get_field(res, field) is None
-        else []
-    )
-
-
-def validate_excluded(res: Any, profile_name: str, field: str) -> list[str]:
-    """Checks that ``field`` is absent."""
-    return (
-        [f"{profile_name}: field '{field}' must not be present"]
-        if _get_field(res, field) is not None
-        else []
-    )
-
-
-def validate_fixed_value(res: Any, profile_name: str, field: str, expected: Any) -> list[str]:
-    """Checks that ``field`` structurally contains the expected fixed value."""
-    actual = _get_field(res, field)
-    return (
-        []
-        if matches_value(actual, expected)
-        else [f"{profile_name}: field '{field}' does not match expected fixed value"]
-    )
-
-
-def validate_slice_cardinality(
-    res: Any,
-    profile_name: str,
-    field: str,
-    match: Mapping[str, Any],
-    slice_name: str,
-    min_count: int,
-    max_count: int,
-) -> list[str]:
-    """Checks that the number of array elements matching ``match`` falls
-    within ``[min_count, max_count]``. Pass ``max_count = 0`` for unbounded."""
-    items = _get_field(res, field) or []
-    if not isinstance(items, Iterable):
-        items = []
-    count = sum(1 for item in items if matches_value(item, match))
-    errors: list[str] = []
-    if count < min_count:
-        errors.append(
-            f"{profile_name}.{field}: slice '{slice_name}' requires at least {min_count} item(s), found {count}"
-        )
-    if max_count > 0 and count > max_count:
-        errors.append(
-            f"{profile_name}.{field}: slice '{slice_name}' allows at most {max_count} item(s), found {count}"
-        )
-    return errors
-
-
-def validate_choice_required(res: Any, profile_name: str, choices: Sequence[str]) -> list[str]:
-    """Checks that at least one of the listed choice-type variants is present."""
-    if any(_get_field(res, c) is not None for c in choices):
-        return []
-    return [f"{profile_name}: at least one of {', '.join(choices)} is required"]
-
-
-def validate_enum(res: Any, profile_name: str, field: str, allowed: Sequence[str]) -> list[str]:
-    """Checks that the value of ``field`` has a code within ``allowed``.
-    Handles plain strings, Coding, and CodeableConcept."""
-    value = _get_field(res, field)
-    if value is None:
-        return []
-    if isinstance(value, str):
-        return (
-            []
-            if value in allowed
-            else [f"{profile_name}: field '{field}' value '{value}' is not in allowed values"]
-        )
-    # Coding
-    code = _get_field(value, "code")
-    system = _get_field(value, "system")
-    if isinstance(code, str) and system is not None:
-        return (
-            []
-            if code in allowed
-            else [f"{profile_name}: field '{field}' code '{code}' is not in allowed values"]
-        )
-    # CodeableConcept
-    coding = _get_field(value, "coding")
-    if isinstance(coding, list):
-        codes = [_get_field(c, "code") for c in coding]
-        codes = [c for c in codes if isinstance(c, str)]
-        if any(c in allowed for c in codes):
-            return []
-        return [f"{profile_name}: field '{field}' has no coding with an allowed code"]
-    return []
-
-
-def validate_reference(res: Any, profile_name: str, field: str, allowed: Sequence[str]) -> list[str]:
-    """Checks that a Reference field points to one of the ``allowed`` resource
-    types. Extracts the type from the ``reference`` string (the part before
-    the first ``/``)."""
-    value = _get_field(res, field)
-    if value is None:
-        return []
-    ref = _get_field(value, "reference")
-    if not isinstance(ref, str):
-        return []
-    slash = ref.find("/")
-    if slash == -1:
-        return []
-    ref_type = ref[:slash]
-    if ref_type in allowed:
-        return []
-    return [
-        f"{profile_name}: field '{field}' references '{ref_type}' but only {', '.join(allowed)} are allowed"
-    ]
diff --git a/examples/python-us-core/fhir_types/example_folder_structures/profiles/profile_helpers.py b/examples/python-us-core/fhir_types/profile_helpers.py
similarity index 100%
rename from examples/python-us-core/fhir_types/example_folder_structures/profiles/profile_helpers.py
rename to examples/python-us-core/fhir_types/profile_helpers.py
diff --git a/src/api/writer-generator/python/profile.ts b/src/api/writer-generator/python/profile.ts
index 638acc2b..3b5282a4 100644
--- a/src/api/writer-generator/python/profile.ts
+++ b/src/api/writer-generator/python/profile.ts
@@ -234,7 +234,7 @@ const emitModuleImports = (
     for (const [extClassName, info] of [...extProfileImports.entries()].sort(([a], [b]) => a.localeCompare(b))) {
         w.pyImportFrom(`.${info.moduleName}`, extClassName);
     }
-    w.pyImportFrom(".profile_helpers", ...helperImports);
+    w.pyImportFrom(`${w.opts.rootPackageName}.profile_helpers`, ...helperImports);
     w.line();
     w.line();
 };
@@ -480,7 +480,6 @@ export const generateNewProfiles = (
 ): void => {
     if (profiles.length === 0) return;
     w.cd("profiles", () => {
-        w.cp("profile_helpers.py", "profile_helpers.py");
         for (const profile of profiles) {
             const moduleName = pyProfileModuleName(tsIndex, profile);
             w.cat(`${moduleName}.py`, () => {
diff --git a/src/api/writer-generator/python/writer.ts b/src/api/writer-generator/python/writer.ts
index 68a10de0..6c60b64c 100644
--- a/src/api/writer-generator/python/writer.ts
+++ b/src/api/writer-generator/python/writer.ts
@@ -115,11 +115,12 @@ export class Python extends Writer<PythonGeneratorOptions> {
             groupedComplexTypes: groupByPackages(tsIndex.collectComplexTypes()),
             groupedResources: groupByPackages(tsIndex.collectResources()),
         };
-        this.generateRootPackages(groups);
+        const hasProfiles = (this.opts.generateProfile ?? false) && tsIndex.collectSnapshotProfiles().length > 0;
+        this.generateRootPackages(groups, hasProfiles);
         this.generateSDKPackages(tsIndex, groups);
     }
 
-    private generateRootPackages(groups: TypeSchemaPackageGroups): void {
+    private generateRootPackages(groups: TypeSchemaPackageGroups, hasProfiles: boolean): void {
         this.generateRootInitFile(groups);
         if (this.forFhirpyClient) {
             if (this.fieldFormat === "camelCase") {
@@ -128,6 +129,11 @@ export class Python extends Writer<PythonGeneratorOptions> {
                 this.copyAssets(resolvePyAssets("fhirpy_base_model.py"), "fhirpy_base_model.py");
             }
         }
+        // Shared profile runtime helpers live once at the root package and are
+        // imported absolutely (e.g. `from fhir_types.profile_helpers import ...`).
+        if (hasProfiles) {
+            this.copyAssets(resolvePyAssets("profile_helpers.py"), "profile_helpers.py");
+        }
         this.copyAssets(resolvePyAssets("requirements.txt"), "requirements.txt");
     }
 
diff --git a/test/api/write-generator/__snapshots__/python.test.ts.snap b/test/api/write-generator/__snapshots__/python.test.ts.snap
index ac158f5b..303c37ba 100644
--- a/test/api/write-generator/__snapshots__/python.test.ts.snap
+++ b/test/api/write-generator/__snapshots__/python.test.ts.snap
@@ -421,7 +421,7 @@ from typing import Literal
 
 from fhir_types.hl7_fhir_r4_core.observation import Observation
 from fhir_types.hl7_fhir_r4_core.base import CodeableConcept, Period, Quantity, Reference
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     apply_slice_match, build_resource, ensure_profile, ensure_slice_defaults, get_array_slice, matches_value, \\
     set_array_slice, strip_match_keys, validate_choice_required, validate_enum, validate_fixed_value, validate_must_support, \\
     validate_reference, validate_required, validate_slice_cardinality
@@ -585,7 +585,7 @@ from fhir_types.hl7_fhir_r4_core.base import (
     BackboneElement, CodeableConcept, Period, Quantity, Reference
 )
 from fhir_types.hl7_fhir_r4_core.observation import ObservationComponent
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     apply_slice_match, build_resource, ensure_profile, ensure_slice_defaults, get_array_slice, matches_value, \\
     set_array_slice, strip_match_keys, unwrap_slice_choice, validate_choice_required, validate_enum, validate_fixed_value, \\
     validate_must_support, validate_reference, validate_required, validate_slice_cardinality, wrap_slice_choice
@@ -805,7 +805,7 @@ from .extension_uscore_individual_sex_extension import UscoreIndividualSexExtens
 from .extension_uscore_interpreter_needed_extension import UscoreInterpreterNeededExtension
 from .extension_uscore_race_extension import UscoreRaceExtension
 from .extension_uscore_tribal_affiliation_extension import UscoreTribalAffiliationExtension
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     _get_key, build_resource, ensure_profile, extract_complex_extension, get_extension_value, is_extension, \\
     push_extension, validate_must_support, validate_required
 )
@@ -1064,7 +1064,7 @@ from fhir_types.hl7_fhir_r4_core.base import (
     BackboneElement, CodeableConcept, Period, Quantity, Range, Ratio, Reference, SampledData
 )
 from fhir_types.hl7_fhir_r4_core.observation import ObservationComponent
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     apply_slice_match, build_resource, ensure_profile, ensure_slice_defaults, get_array_slice, matches_value, \\
     set_array_slice, strip_match_keys, unwrap_slice_choice, validate_choice_required, validate_enum, validate_fixed_value, \\
     validate_must_support, validate_reference, validate_required, validate_slice_cardinality, wrap_slice_choice
@@ -1462,7 +1462,7 @@ from fhir_types.hl7_fhir_r4_core.observation import Observation
 from fhir_types.hl7_fhir_r4_core.base import (
     CodeableConcept, Period, Quantity, Range, Ratio, Reference, SampledData
 )
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     apply_slice_match, build_resource, ensure_profile, ensure_slice_defaults, get_array_slice, matches_value, \\
     set_array_slice, strip_match_keys, validate_choice_required, validate_enum, validate_excluded, validate_fixed_value, \\
     validate_must_support, validate_reference, validate_required, validate_slice_cardinality
@@ -1706,7 +1706,7 @@ from typing import Any, Literal, overload
 from fhir_types.hl7_fhir_r4_core.base import Extension
 from fhir_types.hl7_fhir_r4_core.base import Extension
 from fhir_types.hl7_fhir_r4_core.base import Coding
-from .profile_helpers import (
+from fhir_types.profile_helpers import (
     _get_key, apply_slice_match, build_resource, ensure_slice_defaults, get_array_slice, get_extension_value, \\
     is_extension, matches_value, push_extension, set_array_slice, strip_match_keys, unwrap_slice_choice, validate_fixed_value, \\
     validate_required, validate_slice_cardinality, wrap_slice_choice