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How California’s Wedworth-Townsend Paramedic Act Helped Shape the History of EMS

On July 15, 1970, California Gov. Ronald Reagan signed the Wedworth-Townsend Paramedic Act into law. This was the first state-level paramedic act in the United States, and it set in motion a new era for emergency medical services across the country.

“A lot of what we think of as paramedics now didn’t exist; those who worked prehospital care were considered ambulance drivers back then,” says Kristy Van Hoven, director of the National EMS Museum. “The goal in patient care was to get to the hospital as quickly as possible, where a nurse or physician could take care of the patient.”

State law at the time prevented personnel other than physicians and nurses from providing emergency medical care. Prior to this, businesses, funeral homes, hospitals, police, and fire departments operated their own ambulances, but the business was pretty “scoop and scoot,” as any old-timer will tell you.

That changed with the paramedic pilot program. In 1966 the National Academy of Sciences published the seminal white paper Accidental Death and Disability: The Neglected Disease of Modern Society, the results of a three-year study on accidental deaths in the country. It noted that other countries lowered their accident mortality rates by staffing ambulances with physicians who provided care on the scene and en route to the hospital.

In Los Angeles early in 1970, new technology and procedures were implemented around mobile cardiac response. Doctors Walter Graf and J. Michael Criley successfully trained paramedics to deliver prehospital care to cardiac arrest patients without direct physician intervention in the ambulance—known back then as a mobile coronary care unit. They were able to transport patients to the hospital for further treatment and recovery, resulting in increased survival rates.

This new form of prehospital care brought numerous challenges and risks, such as providing narcotics, the need to intubate, crossing jurisdictions, and operational boundaries. Criley and Graf teamed up with Los Angeles County Supervisor Kenneth Hahn to formalize and legalize this new practice. With input from others working in mobile prehospital care, Hahn recruited two state legislators, Sen. James Wedworth and Rep. Larry Townsend, to help draft the first paramedic act in the country. It added provisions to the health and safety code specifically authorizing hospitals to conduct pilot programs relating to mobile intensive care paramedics.

After the act was signed into law, paramedic training began the next month at Freeman Memorial Hospital under Graf’s direction. It was the first nationally accredited paramedic training program in the United States.

“This act was the beginning—the catalyst,” says Van Hoven. “This set in motion the idea of what paramedics do today. It was important because it allowed for more freedom of practice without the fear that if a patient were to die, would someone be criminally liable? Or if they crossed county lines and didn’t report in because they were driving fast to help save a cardiac patient, would there be operational implications? Sometimes people would get in trouble for that and lose their jobs. This removed all these concerns so they could focus on patient care.”

Commemorating the Law

The National EMS Museum, which is dedicated to preserving and sharing the history of the emergency medical services in the United States, planned to install a commemorative in-gallery exhibition to celebrate the impact of the Wedworth-Townsend Act. But given the threat of COVID-19, the commemorative physical exhibition was converted into a digital one that will stay in the virtual museum for years to come.

“It’s really incredible that over the years, we’ve gone from ambulance drivers to fully functioning mobile response hospitals,” says Van Hoven. “It’s just really inspiring that changes in emergency response and critical care can move so quickly and improve so greatly in such a short amount of time. No longer are we just doing ‘scoop and scoot’ or coronary care; we are providing all sorts of lifesaving procedures in the back of an ambulance, essentially a big mobile hospital unit, because of this early legislation.”

The museum, which has four traveling exhibitions touring around the country, is has a virtual presence that allows visitors to explore online exhibits such as the Wedworth-Townsend Paramedic Act of 1970.

“EMS has really developed into a fully functioning honorable profession that really doesn’t get enough credit in the world for innovating as much as it has in medical care and patient care,” adds Van Hoven. “Our museum is going to change that. We are on a mission to share all these great stories.”

To learn more about the National EMS Museum, visit emsmuseum.org.

Daniel Casciato is a freelance writer and social media consultant from Pittsburgh, Pa. He makes his living writing about health, law, social media, and technology. Follow him on Twitter at @danielcasciato

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