Under the model, the nurse practitioner and paramedic can conduct advanced clinical assessments, provide treatment and coordinate follow-up care
The Santa Monica City Council has approved the expansion of the city’s Advanced Provider Unit program, adding a second specialized response team to the Fire Department following early results officials say reduced unnecessary hospital transports and eased strain on emergency services.
The council voted to authorize the additional unit, building on the program’s launch in November 2025. The Advanced Provider Unit, or APU, pairs a firefighter-paramedic with a nurse practitioner to respond to complex medical and behavioral health calls, particularly those involving frequent 911 users.
City officials said the expansion is part of Santa Monica’s two-year strategic Realignment Plan, aimed at increasing organizational capacity and improving coordination among fire, police and emergency medical services.
“This is what modern public safety looks like,” Mayor Caroline Torosis said in a statement following the vote. “We’re meeting people where they are, delivering advanced care in the field, reducing strain on our ERs, and keeping ambulances ready for true emergencies.”
According to data released by the city, the first APU responded to more than 130 calls during its first three months of operation. Officials said the team provided what the department classifies as an “advanced level of care” to more than 60 patients, including conducting diagnostic testing, behavioral health screenings and in-home safety assessments.
The city reported that more than 20 patients were treated at the scene and discharged without being transported to a hospital, and that ambulances were freed up for other emergencies more than 50 times because the APU handled calls that did not require traditional transport. In two cases, officials said the unit helped place elderly patients who frequently called 911 into long-term care facilities better suited to manage their medical needs.
Under the model, the nurse practitioner and paramedic can conduct advanced clinical assessments in the field, provide treatment when appropriate and coordinate follow-up care. The unit also conducts follow-up visits with high-risk patients in an effort to manage chronic conditions and reduce repeat emergency calls.
Fire officials said that by diverting non-emergency or lower-acuity cases away from ambulances and emergency departments, the program helps maintain availability of frontline units for time-critical incidents such as fires, cardiac arrests and major trauma.
With the addition of a second unit, the Fire Department plans to expand coverage to seven days a week and increase operating hours from 7 a.m. to 5 p.m., targeting peak demand periods. Officials said the expansion is expected to further reduce avoidable ambulance transports and emergency department use while improving overall system resiliency.
The department anticipates the second APU will be fully staffed and operational by March.
In conjunction with the expansion, the city is recruiting nurse practitioners for part-time, contracted roles within the program. Candidates must have at least one year of full-time experience as a nurse practitioner in an emergency department, urgent care or similar setting. Additional requirements include licensure by the California Board of Registered Nursing, national board certification in a relevant specialty, current life support certifications from the American Heart Association and a valid California driver’s license.
City officials said the APU represents a shift toward mobile integrated health care, blending emergency response with proactive, community-based medical services designed to address complex health and behavioral needs outside traditional hospital settings.
