Will EMTs Soon Be Allowed To Take Patients To Sobering Centers?

By Keri Blakinger 04/09/18

A new California bill is pushing to empower EMTs, help patients get the best care, and ease the overcrowding of ERs.

EMT team prepping a stretcher in the back of an ambulance

A proposed piece of legislation in California could open the door for paramedics to bring patients to sobering centers and mental health clinics, a shift some see as a “common sense” option not permitted under current law. 

“If people like you and I can take an individual to a sobering center or a mental health urgent care center,” said Los Angeles County Supervisor Janice Hahn, “why can't a highly trained medical professional do the same?" 

As of now, though, they can’t. Current state law allows police to take intoxicated patients or people in a mental health crisis to clinics instead of booking them into jail. That way, they get a chance to sober up or receive on-the-spot help without facing any charges. 

But paramedics are only allowed to take patients to the emergency room. That’s not always the best—or most cost-effective—alternative, and it can be logistically challenging when hospitals are full. 

"Our mental health urgent care centers and the sobering center at Skid Row were designed to provide humane, compassionate care, tailored to meet the needs of their patients," Hahn said, according to the Patch. "This change is common sense. Our paramedics' hands are tied by an outdated state law."

To make that a reality, Hahn planned a trip to Sacramento to advocate for Assembly Bill 1795, which is sponsored by Assemblyman Mike Gipson. The bill would allow local emergency medical services agencies to lay out plans to transport patients who meet specific criteria to designated behavioral health facilities or sobering centers that meet specific standards.

Though the bill doesn’t seem to have garnered much media attention, Gipson penned an op-ed in February in defense of the measure.

“No one will deny that our emergency rooms are drastically over-crowded,” he wrote in the Compton Herald. “Although they may be well-equipped to handle trauma, disasters or emergency physical health conditions—they are not as well-equipped to serve patients who have mental health care needs or substance abuse problems.”

“This measure may not solve the emergency room gridlock,” Gipson wrote, “but it’s a step in the right direction.”

The California Ambulance Association (CAA) supports the bill but only if it is amended to address compensation for the services the ambulances provide. 

The California Ambulance Association issued the following statement about the bill to The Fix:

The CAA supports the programs to be authorized by this proposed law, but we can only support this bill if it is amended to include provisions for reimbursement of the services. Under existing law and regulations, ambulances must transport patients to acute care hospitals to qualify for payment for ambulance service. Transports to alternate destinations such as psychiatric facilities or sobering centers are typically not eligible for reimbursement. These transports being conducted as part of the pilot programs are generally conducted for free. This is not sustainable.

Therefore, the CAA supports AB 1795 contingent upon its amendment to address compensation for the services provided. In order to make the concept of alternate destinations viable and sustainable for the long-term, it must be made clear in this bill that ambulance transports to psychiatric facilities or sobering centers will be paid by State programs (i.e. Medi-Cal, workers compensation, prison contracts, etc.) and all insurance plans and managed care plans at the same rate paid for ambulance transport to an acute care hospital.

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Keri Blakinger is a former drug user and current reporter living in Texas. She covers breaking news for the Houston Chronicle and previously worked for the New York Daily News and the Ithaca Times. She has written about drugs and criminal justice for the Washington Post, Salon, Quartz and more. She loves dogs and is not impressed by rodeo food. Find Keri on LinkedIn and Twitter.