A California Assembly bill takes on frequent emergency services use

Health Care 911, our five-part series with U-T San Diego, has received lots of feedback since its publication last month. Thoughtful comments came from residents and stakeholders alike, all of whom recognized the human and financial toll taken by frequent emergency services use.

A particularly intriguing note came from the Corporation for Supportive Housing, which pointed to efforts to leverage funds from health reform as a way to reduce frequent use of 911.

The Corporation has supported a California-specific proposal, state Assembly Bill 2266, that would create “health teams” – including social service and housing providers to offer coordinated care to frequent users.

It is the kind of help that frequent user Raohl Hursh, profiled in the series, has so far been unwilling to accept. And the type that Joan Kloh, another profiled frequent user, is navigating with success, and setbacks, along the way. Kloh was enrolled in Project 25, an effort by the United Way of San Diego County to provide housing and supportive services to frequent users.

But AB2266 is distinct.

Under its provisions, a funding option embedded in health reform would provide a 90-cent federal match for every dollar a local entity -- such as a county health agency – is investing in comprehensive services for frequent users. A 50-cent match for every dollar invested would be available indefinitely after two years, as long as health officials are able to prove the programs resulted in state taxpayer savings.

“AB 2266 would transform our Medi-Cal system from a ‘treat the illness’ to a ‘treat the person’ approach,” Sharon Rapport, the Corporation’s associate director for California Policy, said in an email.

She is confident that the programs would meet the savings benchmarks required, and then some.

“Overwhelming data on supportive housing, which offers the type of services this bill would fund, show that AB 2266 could save Medi-Cal between $7,500-$29,000 per participant, per year,” she said.

“Most importantly, it would save the lives of potentially thousands of Californians, getting people off the streets, out of hospitals and into decent, appropriate care,” she added.

There is a hitch, however, and if you are guessing it has to do with the current U.S. Supreme Court review of health reform, you are correct.

Funding for AB 2266, sponsored by California Assemblywoman Holly Mitchell, a Democrat representing Los Angeles, can only come after approval from the federal government.

It will likely die on the vine, Rapport said, if the U.S. Supreme Court overturns key provisions of health reform. The opinions are expected in late June.

Needless to say, we will keep a close eye on the Supreme Court decision, and a close eye on AB2266 if it survives.

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