Los Angeles County Approves Motion to Sustain and Expand Advanced Provider Response Unit (APRU) Program

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Los Angeles, CA (January 14, 2025) — Today, the Los Angeles County Board of Supervisors approved a motion introduced by Chair Pro Tem Hilda L. Solis and Supervisor Janice Hahn to secure ongoing funding for the highly successful Advanced Provider Response Unit (APRU) program. The APRU program provides specialized emergency medical services (EMS) to the County’s most vulnerable residents, offering critical care while reducing unnecessary emergency department (ED) visits and preventing avoidable ambulance transports.

The motion, approved by the Board of Supervisors, directs the Los Angeles County Fire Department (LACoFD), the Chief Executive Office, and the Department of Health Services to identify a sustainable funding source or, if needed, one-time bridge funding to maintain and expand the APRU program. The program, which has already made a significant impact on patient care and system efficiency, requires approximately $7 million annually to continue its operations across Supervisorial Districts 1, 2, and 5, as well as to expand into Districts 3 and 4.

Launched in 2019 with Measure B funding, the APRU program deploys emergency medical response vehicles staffed by a LACoFD firefighter/paramedic and an advanced practice provider (nurse practitioner or physician assistant). These units focus on low-acuity EMS calls, providing basic medical care in the field and redirecting patients to the appropriate follow-up care, which helps alleviate the burden on emergency departments and EMS systems, especially during high-demand periods like the COVID-19 pandemic.

Since its inception, the APRU program has responded to more than 23,000 EMS calls, diverting over 8,700 patients from avoidable hospital transports and ED visits, including more than 1,200 mental health patients who were directed to crisis stabilization units. These interventions have led to substantial cost savings, as the program helps reduce the need for expensive ambulance rides and hospital stays, with each ambulance transport in Los Angeles County starting at $2,223 and an average ED visit costing around $3,238.

“The approval of this motion today is a critical step toward ensuring that the APRU program continues to provide compassionate and critical care to those who need it most. This program is about more than just reducing costs. It’s about meeting people where they are and giving them the right care at the right time,” said Chair Pro Tem Solis. “From those experiencing homelessness to individuals struggling with mental health issues or substance use disorders, the APRU units help guide people to the services they need, reducing avoidable emergency department visits and improving their overall well-being. Continuing and expanding this program is not only a fiscal priority but a moral one.”

The motion also outlines the need for continued collaboration between LACoFD, the Departments of Health Services, Mental Health, and Public Health, local health plans, and hospitals to improve care coordination and remove barriers to accessing physical and behavioral health services, especially for those at risk of avoidable emergency room visits.

The funding for the program, which has been supported by the American Rescue Plan Act (ARPA) since 2023, is set to expire by March 2025. To bridge this gap, Chair Pro Tem Solis and Supervisor Hahn have called for immediate action to secure funding through a variety of sources, including potential opioid settlement funds, given the APRU’s work with patients experiencing substance use health emergencies.

With the passage of Measure E, a parcel tax initiative to fund the LACoFD, the APRU program is expected to receive substantial support starting in 2026. However, until that funding becomes available, the APRU program’s future depends on securing interim funding for the remainder of 2025.