How nurse triage line added to Stanislaus County 911 system will free up ambulances
American Medical Response has begun using a nurse navigation line in Stanislaus County, intended for 911 callers who have less critical medical needs.
The national ambulance company is partnering with two other entities and the Stanislaus County Emergency Medical Services Agency, which will monitor the program that’s bringing change to the EMS system.
The proponents said poor access to healthcare providers is driving an increase in 911 calls in the Modesto area from people who don’t have a critical medical emergency.
With the new program, if a caller has a nonemergency medical need, the dispatcher gives that person the option to talk with a specially trained nurse about other options, such as telemedicine or an Uber ride to an urgent care clinic, instead of an ambulance trip to a crowded hospital.
An AMR news release said the nurse line connects patients with appropriate care and ensures ambulances are available for critical emergencies.
AMR said the caller can say no and ask for an ambulance, in which case emergency responders can be dispatched. A nurse may also determine a higher level of care is needed.
“A lot of ambulances go to low-acuity calls,” said Daniel Iniguez, regional director for AMR. “This gives those patients a different option instead of tying up an ambulance.”
AMR operates the dispatch center for ground ambulances in this area. Initial 911 calls are handled at the Stanislaus Regional dispatch center and emergency medical calls are transferred to AMR’s Valley Regional Communications Center for ambulance service.
Iniguez said in the news release that more than 33% of residents don’t have a local doctor. In Stanislaus County, officials have been dissatisfied with gaps in ambulance service and slow responses to emergencies. So the new program began Wednesday as an attempt to improve the 911 system.
Iniguez said nurse lines have been successful in other counties across the state. The Modesto program is one of the first in the Central Valley. The company is getting ready to launch the program in Merced and San Joaquin counties, he said.
Stanislaus officials approved the program because of the demand on emergency resources and AMR’s ability to show results from other jurisdictions. The county EMS Agency is responsible for monitoring and oversight.
Chad Braner, the agency’s executive director, said it will start with strict oversight every week and then progress to monthly, quarterly and annual reviews.
He said he expects a quarterly review process after the program clears one year of scrutiny. All calls on the nurse line are audited.
County Supervisor Buck Condit, who has a fire service background, said in theory, the program can be a benefit but the public needs to be educated. His main concern is residents who don’t have a doctor might call 911 just to talk with a nurse.
“We want to make sure the 911 lines stay open for emergencies,” Condit stressed.
Each program is different
Iniguez said every program launch is a learning process. The program in each county looks different, depending on the types of options for patients. As an example, some counties might have urgent care clinics or mental health facilities as options for patients.
Community outreach is important to educate the public about the nurse line.
Iniguez said it takes time for the program to mature. By the third year, about 10% to 12% of calls are taken out of the 911 system, he said, adding, “It might not seem like a lot, but it’s enough to improve 911 efficiencies.”
AMR’s nurse navigation line doesn’t have a spotless record. Seattle’s 911 system has been under review since the death of a woman who was routed to the nurse triage line and waited 10 hours for an ambulance ordered by a nurse. The woman reportedly called 911 for her severe knee pain.
Two other partners in the Stanislaus program are Valley Regional Communications Center and Global Medical Response, the holding company of AMR.
Dr. Gerad Troutman, GMR’s associate chief medical officer, said in the news release that many hospital emergency department visits can be safely handled in another care setting. “Nurse navigation modernizes emergency response by matching patients with the right level of care from the very first call,” Troutman said.
This story was originally published June 26, 2026 at 12:05 PM.
