LAFD Advanced Provider Response Unit (APRU)

Health care access

City of Los Angeles (select only if your project has a citywide benefit)

Pilot or new project, program, or initiative (testing or implementing a new idea)

The LAFD responds to over 500,000 emergency medical service (EMS) calls annually, many involving non-life-threatening conditions that strain the city's already overburdened EMS system. These low-acuity calls often result in costly, unnecessary ambulance transports and long emergency room wait times. This cycle diverts critical resources away from life-threatening emergencies and slows citywide response times. A significant portion of these calls involve individuals experiencing homelessness, many of whom face chronic medical, mental health, or substance use issues that aren't resolved through traditional EMS transport. The Advanced Provider Response Unit (APRU) program addresses this issue head-on by treating patients on-site, connecting them with appropriate services, and reducing hospital transports. This model not only improves patient outcomes but also relieves pressure on LAFD personnel, freeing up fire trucks and ambulances to respond more quickly to other emergencies citywide.

With support from LA2050 in 2024, the LAFD Foundation re-equipped the Advanced Provider Response Units (APRUs), helping sustain field operations and demonstrating a successful proof of concept. APRUs pair a paramedic with a nurse practitioner or physician assistant to deliver advanced care directly at the scene of 911 calls. They assess and treat patients on-site, prescribe medications, and connect individuals to services like psychiatric urgent care or sobering centers. Non-emergent but stable patients may be transported via taxi, avoiding unnecessary ER visits and freeing up ambulances.
As of March 2025, the five APRU units operate 10 hours a day, four days a week, with little weekend coverage. They respond to a wide range of calls, including trauma, mass casualty incidents, and mental health crises. The program also helps address the needs of frequent 911 users by offering more sustainable care solutions.
The City has approved the hiring of six new Advanced Providers, allowing the program to expand its reach, but no funding was provided for the additional equipment and supplies needed. This funding would help fill that gap, enabling the Foundation to purchase essential medical tools, replenish supplies, and ensure every unit is fully equipped to deliver high-quality care. This investment will allow the APRU to scale responsibly while continuing to reduce ER congestion and improve EMS response citywide.

If this pilot program continues to be successful, it will help LAFD transform how emergency medical care is delivered in Los Angeles. Patients with non-emergent needs will receive treatment on-site, avoiding unnecessary ER visits and hospital overcrowding. Ambulances and fire trucks will be freed up to respond to critical, life-threatening emergencies, improving citywide response times.
People experiencing homelessness and high-frequency 911 callers will benefit from a more connected care system, receiving support for behavioral health, addiction, and chronic medical needs. The APRU model promotes both efficiency and compassion—delivering care where and when it’s needed, while reducing the strain on first responders. With expansion, Los Angeles will move toward a more equitable, sustainable, and modern approach to emergency medical care, building a stronger and more responsive safety net for all Angelenos.