Community paramedicine is a locally designed, community-based, collaborative model of care that leverages the skills of paramedics and emergency medical services (EMS) systems to take advantage of collaborations between EMS and other health care and social service providers. Community paramedics receive specialized training in addition to general paramedicine training and work within a designated program under local medical control as part of a community-based team of health and social services providers.

The resources below provide an overview of this emerging field in California and cover the following topics:

• Overview of Community Paramedicine in California
• In the Field
• Evaluation of Pilot Programs
• Impact on State Budget
• In the News
• Moving Forward

Overview of Community Paramedicine in California

Community Paramedicine: A Promising Model for Integrating Emergency and Primary Care
A brief history of EMS systems and paramedicine in California, a broad overview of the development of community paramedicine in other states and countries, a summary of current perspectives on CP in the state based on interviews with key stakeholders, and a discussion of the barriers to implementing CP programs in California. (California Health Care Foundation)

How California Community Paramedicine Became a Priority for CHCF
Sandra Shewry, CHCF’s vice president of External Engagement, explains the foundation’s support for the community paramedicine pilot projects to demonstrate how CP reduces demand for ED visits and hospital admissions. (California Health Care Foundation)

National Consensus Conference on Community Paramedicine: Summary of an Expert Meeting (PDF)
Report from a federally sponsored meeting of more than 400 EMS officials from across the nation identified areas of consensus on important policy and practice issues and clarified the role of research in advancing CP. (University of Washington)

Sacramento Briefing — Community Paramedicine in California
In this Sacramento Briefing, hosted by CHCF and the California Emergency Medical Services Authority in January 2017, speakers discussed the results from the first year of pilot project operations. Presentation slides and a video recording of the event are available online. (California Health Care Foundation)

In the Field

Community Paramedicine: San Francisco Pilots Sobering Center as ED Alternative
Through close collaboration, trained paramedics in San Francisco successfully diverted patients from the emergency department to the San Francisco Sobering Center. (California Health Care Foundation)

Community Paramedics Team Up with Hospitals to Reduce Readmissions
In five pilot projects, community paramedics check in on patients recently discharged from the hospital, reducing their likelihood of readmission. (California Health Care Foundation)

Community Paramedics Hit the Streets in Stanislaus County: An Early Look
Paramedics can help people in crisis without a ride to the emergency department (ED). Stanislaus County’s community paramedics show the challenges they overcome to deliver effective mental health care. (California Health Care Foundation)

Introduction to Community Paramedicine
California Emergency Medical Services Authority (EMSA) overview of 13 community paramedicine pilot projects in a dozen California locations. (California Emergency Services Authority)

City of Alameda’s New Community Paramedics Use Compassion to Deliver Results
The Alameda Fire Department launched its community paramedicine project in 2015 with two key goals: easing unnecessary hospital readmissions and reducing 911 calls for nonemergencies — especially those that come frequently from the same patients. (California Health Care Foundation)

How Community Paramedics Rescue People from San Diego’s Streets
Community paramedics in a San Diego pilot project provide care and referrals to needed services like behavioral health, transportation, and housing for homeless people — without taking them to hospitals. This approach has not only proved to be lifesaving, it has also enhanced quality of life for many. (California Health Care Foundation)

Rescuing Hospice Patients
When someone in Ventura County calls 911 to obtain help for a hospice patient, community paramedics work with the patient, the family, and the hospice team to care for the patient’s immediate needs in the comfort of their own home. (California Health Care Foundation)

Evaluation of Pilot Programs

Community Paramedicine Delivers Better Care at Lower Cost
Highlights of UCSF’s 2017 evaluation of community paramedicine pilot programs in 13 California locations. (California Health Care Foundation)

Evaluation of California’s Community Paramedicine Pilot Projects
A team of researchers from the Healthforce Center at UCSF and the Philip R. Lee Institute for Health Policy Studies at UCSF are serving as the external evaluators for these pilot projects. (University of California, San Francisco)

Impact on State Budget

EMSA Paramedicine Pilots: Estimating Statewide Medi-Cal Savings (PDF)
The results of an analysis of California’s Community Paramedicine Pilot program with the aim of estimating the potential for Medi-Cal program savings if the services provided under the pilots were expanded more broadly throughout the state. (California Health Policy Strategies, May 11, 2018)

In the News

Give Paramedics the Power to Make Better Choices on Behalf of Vulnerable People
This opinion piece discusses an assembly bill (AB 1795), which would extend to specially trained paramedics the authority to assess whether people would be better treated at designated sobering centers or behavioral health facilities. (Los Angeles Times, April 24, 2018)

Community Paramedics Improve Patients’ Quality of Life and Reduce Health Care Costs
Coverage of San Bernardino County Fire Department’s participation as 1 of 13 pilot projects aimed at studying the value of community paramedicine. (Fontana Herald News)

Pilot Paramedic Program Aims to Reduce Repeat 911 Callers
NBC 7 covers the pilot program in San Diego, which pairs frequent 911 callers with paramedics, giving patients an alternative to calling the emergency lines when things go wrong. (NBC 7 San Diego)

Moving Forward

Beyond 911: State and Community Strategies for Expanding the Primary Care Role of First Responders
A report on state and community strategies for expanding the primary care role of first responders. (National Conference of State Legislatures)