Community Paramedicine: New Model

The California Emergency Medical Services Authority, reports that “Community Paramedicine” (CP) is a new and evolving model of community-based healthcare where paramedics function outside of their customary emergency response and transport roles. This makes it possible for paramedics to provide better emergency care and to enhance access to primary care for medically underserved populations.

In general, CP programs typically are designed to address specific local problems and take advantage of locally developed linkages and collaborations between emergency medical services and other healthcare and social service providers in the community.

Paramedics can be used to help deliver more efficient care if they are able to operate on a limited basis outside their initial emergency and transport role and work with other team members in the community.

Some of today’s issues in delivering care involve the overuse of the 911 system for social or psychological problems, trying to find alternative means to effectively manage patients who do not require transport to acute care hospital emergency departments, repeat ED visits, hospital readmissions due to gaps in care between hospital and outpatient care, limited or no capacity for short-notice home visits, and the need to supplement primary care shortages in underserved areas.

Currently, the California Health and Safety Code limits paramedic scope of practice to emergency care in the pre-hospital environment. Patients under the care of a paramedic are required to be delivered to a general acute care hospital emergency department.

The paramedic’s scope of practice in the state is somewhat unique as compared to other licensed health professionals in that the code refers to both a set of authorized skills and activities that emergency medical personnel may perform.

Other states in the U.S including North Carolina, Colorado, Minnesota, Maine, and Texas, have implemented variations of Community Paramedicine or a comparable Advanced Practice Paramedic program.

To further the field and to meet training needs, a full Community Paramedic training curriculum has been developed by the Community Healthcare Emergency Cooperative which is a multistate and multinational collaborative and by the North Central EMS Institute in Minnesota.