BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 2406
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          Date of Hearing:  April 1, 2014

                            ASSEMBLY COMMITTEE ON HEALTH
                                 Richard Pan, Chair
               AB 2406 (Rodriguez) - As Introduced:  February 21, 2014
           
          SUBJECT  :  Emergency Medical Services Authority: abuse of  
          emergency medical services.

           SUMMARY  :  Requires the Emergency Medical Services Authority  
          (EMSA) to prepare and submit a report to the Legislature, no  
          later than December 1, 2015, identifying programs that have been  
          implemented in the state by local emergency medical services  
          agencies (LEMSAs) that address the misuse and abuse of the  
          emergency medical services (EMS) system in California.   
          Specifically,  this bill  :

          1)Requires the report EMSA must submit to include:

             a)   A summary of the different programs implemented by  
               LEMSAs and specific information on the various approaches  
               applied to serve those who frequent EMS system transports,  
               such as:

               i)     Identification and prioritization;

               ii)    Medical assessments;

               iii)   Care management or comprehensive care;

               iv)    Support to the patient and family by directing the  
                 patient and his or her family to available resources such  
                 as health insurance coverage, access to primary care and  
                 mental health services, transportation, and other  
                 relevant social services;

               v)     The financial impact of servicing frequent EMS user  
                 transports, including funding sources and the costs of  
                 providing these services;

               vi)    Best practices; and,

               vii)   Cost-saving measures to offset frequent EMS user  
                 transport expenses.









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             b)   Recommendations for the implementation of a statewide  
               program to address the misuse and abuse of emergency  
               medical services.

          2)Requires EMSA to submit the report to the Legislature no later  
            than December 1, 2015.

          3)Requires EMSA to include in the report and summary an Internet  
            Website where the report can be downloaded and a telephone  
            number to call to order a hard copy of the report and to post  
            the report and summary on EMSA's Internet Website.  

           EXISTING LAW  :  

          1)Establishes EMSA, which is responsible for the coordination  
            and integration of all state activities concerning EMS,  
            including the establishment of minimum standards, policies,  
            and procedures.

          2)Authorizes counties to develop an EMS program and designate a  
            LEMSA responsible for planning and implementing an EMS system.  
             Requires a LEMSA that elects to implement a trauma care  
            system to develop and submit a plan to EMSA prior to the  
            implementation.
          3)Defines "emergency" as a condition or situation in which an  
            individual has a need for immediate medical attention, or  
            where the potential for such need is perceived by emergency  
            medical personnel or a public safety agency.

          4)Specifies that any individual who reports, or causes any  
            report to be made, to any city, county, city and county, or  
            state department, district, agency, division, commission, or  
            board, that an emergency exists, knowing that the report is  
            false, is guilty of a misdemeanor.  Provides that it is a  
            misdemeanor to knowingly report a false emergency, but that  
            this conduct is a felony if the offense results in great  
            bodily injury or death.

          5)Imposes liability for all reasonable costs incurred by any  
            unnecessary emergency response when a person is convicted of  
            use of the 911 emergency line with intent to harass and  
            imposes liability for a person convicted of filing a false  
            emergency report liable for the costs of the emergency  
            response.









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          6)Requires the Legislative Counsel to annually prepare, publish,  
            and maintain an electronic list of all reports that state and  
            local agencies are required or requested by law to prepare and  
            file with the Governor or the Legislature.

           FISCAL EFFECT  :  This bill has not been analyzed by a fiscal  
          committee.

           COMMENTS  :

           1)PURPOSE OF THIS BILL  .  According to the author, several  
            counties and agencies in California have adopted programs that  
            have greatly reduced nonessential use of EMS transportation  
            and emergency department (ED) visits.  These educational and  
            instructional efforts have resulted in tremendous savings to  
            Medi-Cal, hospitals, and other state and local agencies.  The  
            author would like to make available to all LEMSAs the programs  
            that some agencies are undertaking to curb over utilization of  
            EMS transportation and EDs.  The author furthers that these  
            programs not only save scarce health care resources, but also  
            provide humanitarian outreach to a largely vulnerable  
            population of patients by directing them to appropriate  
            services at proper levels of care.  Requiring EMSA to identify  
            programs that have been implemented throughout the state to  
            address EMS frequent users and to prepare and submit a report  
            to the Legislature will provide program information and a  
            format to other counties and agencies to assist them in  
            implementing their own programs to rein in unnecessary medical  
            costs.  The author argues that ambulance transport to a  
            hospital's ED has become the first and only access point to  
            the healthcare system for many Americans.  However, the misuse  
            and abuse of ambulance transportation and EMS services in  
            California by those commonly referred to as frequent flyers  
            cost taxpayers millions of dollars annually and stress already  
            overloaded hospital EDs by unnecessarily transporting  
            non-acutely ill or injured patients there when more  
            appropriate and less costly transport and care settings may be  
            available.

           2)BACKGROUND  .  According to recent studies published in the  
            Annals of Emergency Medicine, in 2007, an estimated 45.2  
            million adults had one or more ED visits.  A small number are  
            responsible for a disproportionate share of ED visits.  Only  
            8% of users were responsible for 28% of all adult ED visits.   
            Most frequent users had health insurance (84%) and a usual  








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            source of care (81%).  Characteristics associated with  
            frequent use included poor physical health, poor mental  
            health, and family income below the poverty threshold.  In  
            2010, this pattern continued as frequent users comprised  
            between 4.5% and 8% of all ED patients but accounted for 21%  
            to 28% of all visits.  Most frequent ED users are white and  
            insured, disproportionately through public insurance programs.  
             On average, these patients have higher acuity complaints and  
            are at greater risk for hospitalization than occasional ED  
            users.  Frequent users are also heavy users of other parts of  
            the health care system.

           3)FREQUENT USERS  .  According to the American College of  
            Emergency Physicians (ACEP), the definition of a frequent ED  
            user varies and studies show a misconception of frequent users  
            abusing their access to emergency care.  Instead they are  
            coming in for real emergencies including urgent mental health,  
            drug, and alcohol-related issues as opposed to primary  
            care-treatable problems.  ACEP stresses the importance of  
            developing models that integrate medical care of the patient  
            with social services he or she needs.  The City of San Diego  
            defines frequent users as people who have used EMS more than  
            three times in a six month period and represent .08% of the  
            city's population yet account for more than 17% of paramedic  
            and ambulance calls.  In 2012, San Diego had 1,136 frequent  
            users totaling more than $20 million in ambulance and  
            paramedic costs alone.  One of the ways the city is addressing  
            these frequent users is through the San Diego EMS Resource  
            Access Program, a paramedic-based system that intercepts high  
            EMS users to reduce their dependence on EMS by linking them  
            with appropriate resources for their underlying medical,  
            mental health, and social needs.  During the first two years  
            of using this case management approach, the program  
            demonstrated significant improvements for 51 clients and  
            reduced the number of ambulance transports from 736 to 459.   
            The City and County of San Francisco and Alameda County have  
            both used their fire departments to identify frequent users  
            and address the reasons for their high use of EMS.  In San  
            Francisco, a homeless outreach program was established which  
            reduced emergency call volume by 75% in 18 months and has  
            saved the City $12 million.  Alameda County is proposing a  
            local pilot program called the Fire Station Health Care Portal  
            that would offer non-emergency preventive and primary care, ED  
            follow-up, and 911/211 phone advice and response.  The Portals  
            will be staffed by a nurse practitioner, emergency medical  








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            technician, a registered nurse care coordinator, and a patient  
            care technician.

           4)California's EMS system  .  California operates on a two-tiered  
            EMS system.  EMSA is the lead agency and centralized resource  
            to oversee emergency and disaster medical services.  EMSA is  
            charged with providing leadership in developing and  
            implementing LEMSAs throughout California, and in setting  
            standards for the training and scope of practice of various  
            levels of EMS personnel.  California has 32 LEMSAs that  
            provide EMS for California's 58 counties.  (Seven regional EMS  
            systems comprised of 33 counties and 25 single-county agencies  
            provide the services.)  Regional systems are usually comprised  
            of small, rural, less-populated counties, and single-county  
            systems generally exist in the larger and more urban counties.  
             LEMSAs are responsible for planning, implementing, and  
            managing local trauma care systems, including assessing needs,  
            developing the system design, designating trauma care centers,  
            collecting trauma care data, and providing quality assurance.
           5)PROPOSED AMENDMENT  .  The author wishes to make an amendment to  
            the intent language of this bill.

           6)RELATED LEGISLATION  .

             a)   AB 1621 (Lowenthal and Rodriguez) requires EMSA to  
               develop the State Emergency Medical Services Data and  
               Information System (SEMSDIS), and, after approval by the  
               Commission on Emergency Medical Services, adopt minimum  
               standards to implement and maintain SEMSDIS by July 1,  
               2016.  AB 1621 is pending in the Assembly Health Committee.

             b)   ACR 84 (Rodriguez) proclaims May 18, 2014, through May  
               24, 2014, as Emergency Medical Services Week.  ACR 84  
               passed the Assembly Rules Committee on March 20, 2014 with  
               a vote of 9-0.

           7)PREVIOUS LEGISLATION  .

             a)   AB 678 (Pan), Chapter 397, Statutes of 2011, establishes  
               a supplemental payment program for governmental entity  
               providers of Medi-Cal emergency medical transportation  
               services using certified public expenditures to match  
               federal funds.

             b)   AB 1059 (Huffman), Chapter 403, Statutes of 2011, adds  








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               new data elements to the annual report to the Legislature  
               required of each county establishing a Maddy EMS Fund  
               regarding moneys collected and disbursed.

             c)   AB 1988 (Diaz), Chapter 333, Statutes of 2002, requires  
               EMSA to convene a task force to study the delivery and  
               provision of EMS.  Requires the task force, among other  
               things, to develop a plan to ensure that all Californians  
               are served by appropriate coverage areas for emergency and  
               trauma services and that sufficient numbers of EDs and  
               trauma centers exist to serve each area's population.

           REGISTERED SUPPORT / OPPOSITION  :  

           Support 
           
          None on file.

           Opposition 
           
          None on file.

           
          Analysis Prepared by  :    Patty Rodgers / HEALTH / (916) 319-2097