Evaluation of Community Paramedicine Pilot Projects

In December 2013, the California Emergency Medical Services Authority (EMSA) proposed a pilot project that would assess the feasibility of community paramedicine, a model of care in which paramedics provide care beyond their traditional scope of practice, which is limited to treating persons on the scene of an emergency and transporting them to an emergency department. EMSA proposed to test the following five different community paramedicine concepts at 10 sites across California.

1. Transporting patients with specific, low-acuity conditions to locations other than an emergency department (ED): Stanislaus County, parts of Los Angeles County, Orange County, and San Diego County.
2. Providing short-term, in-home follow-up care for persons recently discharged from a hospital who are at an increased risk of an ED revisit or a hospital readmission: Butte County, San Bernardino County, Solano County, parts of Alameda County, and parts of Los Angeles County. 
3. Addressing the needs of frequent 911 callers or frequent visitors to EDs: parts of Alameda County and parts of San Diego County.
4. Collaborating with hospices to meet the needs of hospice patients when 911 is called: Ventura County.
5. Delivering directly observed therapy (DOT) to persons with tuberculosis: Ventura County.

The Office of Statewide Health Planning and Development approved the project in November 2014. Community paramedics at the 10 pilot sites began providing care in June 2015. 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 the pilot project.