TITLE
Recommendation to authorize City Manager, Fire Department, Health Department and all other appropriate departments to work together and report back in 120 days on the potential costs, benefits and challenges in forming a Long Beach Community Paramedicine Program.
(District 5)
DISCUSSION
Community Paramedicine (CP) is an innovative and evolving model of community-based
healthcare designed to provide more effective and efficient services at a lower cost.
Community Paramedicine allows paramedics to function outside their traditional
emergency response and transport roles to help facilitate more appropriate use of
emergency care resources while enhancing access to primary care for medically
underserved populations.
Community Paramedics are licensed paramedics who have received specialized training
in addition to general paramedicine training and work within a designated Community
Paramedicine program under local medical control as part of a community-based team of
health and social services providers. Paramedics are uniquely positioned for expanded
roles as they are trusted and accepted by the public; are trained to make health status
assessments; recognize and manage life-threatening conditions outside of the hospital;
and operate under medical control as part of an organized, systems approach to care.
In 2015, the California Emergency Medical Services Authority (EMSA), working in
partnership with the California Health Care Foundation (CHCF) conducted 13 Community
Paramedicine pilot projects in a dozen California locations over a two-year period to test
and evaluate new or expanded roles for paramedics along with healthcare delivery
alternatives. The projects focus on providing services where access to healthcare is
limited or when a short-term intervention is needed.
Under the pilot, community paramedics provide:
• Short-term follow-up care after hospital discharge for people with chronic
conditions
• Case management services to frequent users of the emergency medical services
(EMS) system
• Directly observed therapy for people with tuberculosis
• Collaboration with hospice nurses to reduce unwanted transports of hospice
patients to an emergency department
• Transportafionror people with mental health needs to mental health crisis centers
• Transportation for people who are acutely intoxicated to sobering centers
• Transportation for patients with low-acuity medical conditions to urgent care
centers
The Healthforce Center at UC San Francisco conducted an evaluation of the pilot project
and found that community paramedics are collaborating successfully with physicians,
nurses, behavioral health professionals and social workers to fill gaps in the health and
social services safety net.
The evaluation yielded consistent findings for six of the seven community paramedicine
concepts tested. All of the post-discharge, frequent 911 users, tuberculosis, hospice, and
alternate destination - mental health projects have been in operation for at least two and
one half years and have improved patients' well-being. In most cases, they have yielded
savings for payers and other parts of the health care system. Findings regarding
outcomes of a project testing the sixth concept, alternate destination - sobering center,
suggest that this project is also benefitting patients and the health care system over the
course of its first 14 months. The seventh concept, alternate destination - urgent care,
shows potential but further research involving a larger volume of patients is needed to
draw definitive conclusions.
Since the City of Long Beach has its own health department, its own paramedic service,
several hospitals and numerous clinics, a Long Beach Community Paramedicine Program
could potentially create a new model of community healthcare for Long Beach residents
with a more effective and efficient method of service delivery for certain healthcare needs,
especially to our most vulnerable communities, potentially at lower cost.
This matter was reviewed by Budget Manager Grace H. Yoon on March 8, 2019.
FISCAL IMPACT
This recommendation requests a report in 120 days on the potential costs, benefits and
challenges in forming a Long Beach Community Paramedicine Program. Compiling this
report is anticipated to require a moderate level of staff hours beyond normal budgeted
scope of duties and is expected to have a moderate impact on existing City Council
priorities due to strain on staff capacity, the complexity of the issue, and balancing against
other priorities. Any additional fiscal impact of the Community Paramedic Program would
be included in the requested review.
SUGGESTED ACTION
Approve recommendation.
Respectfully Submitted,
STACY MUNGO
COUNCILWOMAN, FIFTH DISTRICT
SUZIE PRICE
COUNCILWOMAN, THIRD DISTRICT
DARYL SUPERNAW
COUNCILMEMBER, FOURTH DISTRICT
REX RICHARDSON
COUNCILMEMBER, NINTH DISTRICT