California Professional Firefighters

AB 678 - Medi-Cal: Ground Emergency Medical Transport

Assembly Member Richard Pan (D - Sacramento)CPF-sponsored legislation allowing local fire departments to be reimbursed by the federal government for Medi-Cal emergency transport services is on its way to Governor Brown.

AB 678 would allow local fire departments to submit certified public expenditures for unreimbursed Medi-Cal ground emergency medical transportation services to the Department of Health Care Services (DHCS) for reimbursement by the federal government. This bill would further require participating agencies to reimburse DHCS for related administrative expenses. The bill is authored by Assembly Member Richard Pan (D - Sacramento), .

As California's health system continues to deteriorate, the local fire department in its first response capacity participates in transporting Medi-Cal patients at an ever increasing rate. Specifically, ambulance transports have increased 13% from 1997 to 2006 and ambulance transports of Medi-Cal beneficiaries increased 19% from 2006 to 2009. Further, Medicare rates in California were reduced 10% in 2010, representing a reduction of $35 million statewide, thereby straining fire department budgets even more.

California's ambulances will provide approximately 3.1 million transports this year. Nearly 300,000 of those will be Medi-Cal patients, and up to half of whom will be transported by fire departments. Depending on the demographics the percentage of those patients can range from 10% to 35% of a fire department's total transport volume.

Historically, Medi-Cal has not kept up with the cost of inflation or healthcare and current Medi-Cal rates do not cover the operating cost of a typical ambulance transport. These non-reimbursed costs are subsequently absorbed into a fire department's General Fund and paid for by the taxpayers. The California Department of Health Care Services has identified an existing federal program that provides a 50% match of unreimbursed expenses to local agencies who provide Medi-Cal ground emergency medical transportation services.

Federal money is being left on the table. The sooner this voluntary program is up and running, the sooner local fire departments can access much needed fiscal relief and continue providing these critical safety net services.

AB 678 was approved unanimously by the Assembly Health Committee on April 5, 2011. This bill was then referred to the Assembly Appropriations Committee where it was approved unanimously on May 27, 2011. AB 678 was approved on the Assembly Floor 76-1 on June 2, 2011. It was then referred to the Senate Health Committee where it was approved unanimously on June 22, 2011. The measure won final approval in the Senate on September 2nd. On October 2nd, 2011 Governor Brown proudly signed this bill into law effective immediately. 

For questions, contact our Legislative Director, Amy Howard.