Community Paramedicine & Triage to Alternate Destination

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. The Triage to Alternate Destination (TAD) Program offers people who have behavioral health needs, but no emergent medical needs, transport to a mental health crisis center instead of an emergency department (ED) after screening by the Community Paramedic. TAD also offers transport to Sobering Centers in response to 911 calls; people who are acutely intoxicated but do not have acute medical or mental health may receive transport directly to a sobering center for monitoring instead of to an ED.

What is Community Paramedicine?

“Community paramedicine program” means a program developed by a local EMS agency and approved by the Emergency Medical Services Authority to provide community paramedicine services consisting of one or more program specialties, under the direction of medical protocols developed by the local EMS agency that are consistent with the minimum medical protocols established by the authority.

What is Triage to Alternate Destination?

“Alternate destination facility” means a treatment location that is an authorized mental health facility, as defined in Section 1812 of the Health and Safety Code or an authorized sobering center as defined in Section 1813 of the Health and Safety Code.

Questions? Email EMSA's CP and TAD Program Manager

Contact the CP and TAD Program Manager:

Candace Keefauver
Candace.Keefauver@emsa.ca.gov
(916) 969-6669

Program History

Community Paramedicine and Triage to Alternate Destination programs began as pilot projects in 2014, when the Office of Statewide Health Planning and Development’s (OSHPD) Health Workforce Pilot Project Program temporarily waived sections of the Health and Safety Code and approved the CP pilot study. Previously, paramedics were unable to work in any setting other than at the scene of an emergency or while transporting patients. OSHPD’s approval allowed EMSA to test the effectiveness and safety of community paramedicine.

In November of 2023 these programs became fully realized through the approval and implementation of CCR, Title 22: Division 9. Chapter 5: Community Paramedicine and Triage to Alternate Destination.

Pilot Program Video