The Los Angeles Hospital Leadership Group discussed at its Aug. 14 meeting community paramedicine, a new and evolving community health based program. A stakeholder group of representatives from San Bernardino convened a workgroup that also met regarding this topic. This program would expand the scope of practice and transport for paramedics who undergo enhanced training as it pertains to specific conditions yet to be determined. Basic Life Support (BLS) ambulance volume to a hospital ED will vary depending on the scope of the local pilot project.

The Leadership Group agreed that any alternative patient destination pilot should incorporate a mental health component in order to better manage ED resources, as well as reduce wait-time. Addressing the treatment needs of drug seekers in an outpatient setting is another recommended component for a local pilot. The Leadership Group requested additional information on how the capitated managed care will be tracked and paid.

HASC evaluated the issues outlined by the Leadership Group to the LA County EMS –Stakeholder Group on Paramedicine, which is largely comprised of fire chiefs. Fire chiefs for the most part expressed interest in moving forward with an alternative patient destination option without detailing the scope. Other pilot options being considered include targeting frequent 911-callers and preventive care.

The UCLA Center for Pre-Hospital Care announced that it is working with hospitals and paramedics in Santa Monica and Pasadena to launch an alternative patient destination program. In addition, the Center for Pre-Hospital Care disclosed that it is also working on developing a post-discharge pilot in the Burbank area. The three pilot programs appeared to be the most advanced in terms of identified local support and program development.

These proposals, along with any others that are subsequently being developed, will be reviewed by the LA County EMS - Stakeholder Group on Sept. 23, prior to their submittal to the California Emergency Medical Services Authority.

In San Bernardino, three potential pilot proposals were discussed, including alternate destination, alternate destination with post-discharge follow-up care with specific patients, and post discharge follow-up care for defined patient populations. The tight timeframe has raised concerns about the viability of submitting a comprehensive proposal by the Sept. 30 deadline.

Contact: Jaime Garcia
(213) 538-0702, jgarcia@hasc.org

Inland: Dimitrios Alexiou
(951) 222-2284, dalexiou@hasc.org