Community Paramedicine in California

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

New models of care delivery are developing to address the growing gap between demand for California health care workers, and the state’s supply of them. There is also a push to ensure that health care resources are spent efficiently and effectively.

Paramedics — a licensed, mobile, round-the-clock health resource — are well-received in streets and homes, and serve as an important part of the health care safety net. Paramedics working in community paramedicine go beyond their traditional response-and-transport roles to facilitate more appropriate use of emergency care resources, reduce repeat hospitalizations, direct patients to the most appropriate site for care, and enhance access to primary care for medically underserved populations.

The California Emergency Medical Services Authority (EMSA), under the auspices of the Office of Statewide Health Planning and Development’s Health Workforce Pilot Project authority, is conducting pilot projects across the state to evaluate whether CP is safe and effective. Each pilot provides a different type of service in a locale where access to care is limited or where a short-term intervention is needed. The projects allow organizations to test and assess CP models that have been customized by first responders and their health care partners to meet local needs. CHCF funded the independent evaluation and training.

In a January 2017 Sacramento briefing held by CHCF and EMSA, speakers discussed the results from the first year of pilot project operations. Speakers included:

  • Howard Backer, MD, MPH, FACEP, director, EMSA
  • Janet Coffman, PhD, MA, MPP, associate professor, UCSF School of Medicine
  • Mark Hartwig, fire chief, San Bernardino County Fire Department, Post Discharge Pilot Project
  • Anne Jensen, resource access program manager, City of San Diego, Frequent 911 User Pilot Project
  • Richard Murdock, executive director, Mountain-Valley EMS Agency, Behavioral Health Pilot Project
  • Sandra Shewry, MPH, MSW, vice president, External Engagement at CHCF

The presentation slides and other handouts from the briefing are available under downloads.