Advanced Provider Response Units (APRU)

FIRE DEPARTMENT

County Spending Category
3.1 Shoring Up LA County's Safety Net
Federal Expenditure Category
Other COVID-19 Public Health Expenses (including Communications, Enforcement, Isolation/Quarantine)
Project Launch Date
02/16/2023
Anticipated End Date
06/30/2025
Interpretation Languages
  • Armenian
  • Farsi
  • Korean
  • Russian
  • Spanish
  • Tagalog/Filipino
  • Thai
  • Mandarin
  • Cantonese
  • Vietnamese
  • Arabic
  • Hindi
  • Japanese
  • ASL
Project Contacts Indicators & Metrics Target Populations Project Description Goals & Objectives

Project Contacts

Indicators & Metrics to Date

  • Number of FTEs responding to COVID-19 supported under this authority
    10.5
  • # patients discharged from EMS care
    2726
  • # low-acuity 911 callers
    7260
  • # re-contacting EMS within 72hours
    97
  • # of patients navigated PUCC
    388
  • Number of APRU services in high and highest-need communities.
    3

Target Populations

  • Systems Impacted Individuals
  • Individuals Experiencing Mental Health Disorders
  • People Experiencing Homelessness

Project Description

The Advanced Provider Response Units (APRU) are special response units that focus on assessing and treating 911 EMS patients with minor to moderate complaints and redirecting them to appropriate levels of care based on their needs. They bring the skills of an Advanced Provider (Nurse Practitioner, Physician Assistant or Physician) directly to the patient, obviating the need to transporting patients to already overcrowded emergency departments. This is most useful in communities with the poorest access to care that use the 911 system and the Emergency Departments more frequently for minor complaints because of a lack of other options. As we learned during the COVID-19 pandemic, the EMS system does not have the capacity to manage the overwhelming number of patients generated by the pandemic. In fact, we know that during the height of the pandemic, the EMS and ED systems were completely saturated which meant many patients were left to wait hours to days in the emergency department waiting rooms when their issue could have been resolved without a visit to the ED. We also know that during the COVID-19 pandemic, patient's lost access to their primary care doctors, urgent cares and specialists however the 911 system continued to be activated in overwhelming numbers. The APRU allows for far more efficient management of patients with COVID-19. By intervening, patients get a better experience, they get connected to appropriate levels of care available in their communities, and Emergency Departments can maintain surge capacity.

Goals & Objectives

Goal Description By June 2025, both increase surge capacity in Emergency Departments for true emergencies and improve health outcomes in areas where patients historically lack access to medical services by providing alternative care options, access to health care services for patients with minor medical needs, and better availability of ambulances and paramedic units in those communities.

Objective Description By June 2025, reduce use of emergency systems for patients with high 911 utilization with low acuity health issues to improve the quality of care and appropriateness of levels of care for patients with behavioral health needs and limited health care access  and increase the efficiency of emergency response to COVID-19 by diverting patients with minor health needs from emergency services.

Activity Description The APRU will add itself to low-acuity 911 calls by monitoring dispatch radio calls for service. The APRU will respond to calls for services when requested by other Los Angeles County Fire Department units. The APRU will respond to calls for service from partnering law enforcement agencies. The APRU will schedule follow-up visits with 911 system high utilizers. The APRU will refer patients with only behavioral health complaints to psychiatric urgent care centers.
Indicators
# Type Name Baseline Target
1 Service Delivery # low-acuity 911 callers 1000.00 1000.00
2 Service Delivery # patients discharged from EMS care 100.00
4 Performance # re-contacting EMS within 72hours 7.00
5 Service Delivery # of patients navigated PUCC 100.00

Outcome Description Ongoing APRU services to existing areas and expansion of two additional service areas in high and highest need communities.
Indicators
# Type Name Baseline Target
1 Program Outcome Total number of patients who receive care from EMS' 1.00 3.00
2 Service Delivery Number of APRU services in high and highest-need communities. 1.00 3.00