Assembly Bill 3115, authored by Assembly Member Mike Gipson, is pending before Governor Jerry Brown after having passed both houses of the Legislature. AB 3115 would authorize a local emergency medical services agency (LEMSA) to develop community paramedicine and triage to alternate destination programs until 2025.

While community paramedicine is an important program for the EMS industry, this bill is not the right approach and should be vetoed. Among other reasons, this is due to the fact that AB 3115 seeks to restrict the service that the private ambulance industry is allowed to provide, which will ultimately harm the public. The successes of the community paramedic pilot studies have been largely due to the work performed and delivered by the private ambulance companies.

Under current law, there have been a number of pilot programs taking place around the state. The pilot studies conducted over the past two years, as well as the dozens of programs across the nation in other states, have proven the value and benefit of this EMS service. In addition, over 71 percent of the patients served by the pilot projects in California so far have been completed by private ambulance companies and these successful programs have improved the lives of many patients.

From the perspective of the California Ambulance Association, the passage of AB 3115 may result in the termination of many of the existing community paramedicine projects across the state that are in place today and give preference to those run by public agencies. However, these public agencies, who are the intended beneficiaries of AB 3115, cannot sustain the services that would need to be provided because of budgetary constraints.

To make matters worse, the restrictions that are imposed by AB 3115 on private ambulance companies are so burdensome that most, if not all, private companies will be unable to provide community paramedic services if this bill is enacted. AB 3115 implies that public agencies (i.e., fire departments) are best able to provide community paramedic services. There is zero evidence of this assertion. As a result, AB 3115 may likely result in the diminution of community paramedic services in California, rather than increase them.

A section of AB 3115 requires that any new community paramedic program that a local EMS agency wants to initiate be first offered to fire departments.  Only after a public agency refuses the offer would a private ambulance company be eligible to propose a service plan.

Authorization of a community paramedic program should not be about the type of uniform the paramedic wears.  Rather, AB 3115 should be focused on getting the highest quality of care delivered to the residents.  A community paramedic provider should be selected on their proven history and their quality of care – nothing else.  Giving public agencies an edge or right-of-first refusal robs the public of getting the best possible service provider.

AB 3115 also advances the authority and control of fire departments and fire districts, while sacrificing coordinated EMS services for the general public. The Emergency Medical Services Administrators Association of California and the Emergency Medical Directors Association of California state that this bill will erode local medical control of EMS systems and create unnecessary impediments for innovative solutions to the delivery of healthcare by counties and their local EMS agencies. These two groups specifically city the preferential treatment of public agencies over private entities in AB 3115.