TO:
Honorable Mayor and Members of the City Council
THROUGH:
Bruce Moe, City Manager
FROM:
Robert Espinosa, Fire Chief
George Gabriel, Management Analyst
SUBJECT:Title
Request by Mayor Howorth to Discuss Assembly Bill 1795 Authorizing a Local Emergency Medical Services Agency to Allow Paramedics to Transport People to a Community Care Facility (Fire Chief Espinosa).
DISCUSS AND PROVIDE DIRECTION
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Recommended Action
RECOMMENDATION:
At the request of Mayor Howorth, staff recommends that City Council discuss and provide direction on submitting a letter to support, oppose, or take no position on Assembly Bill (AB) 1795 (Gipson).
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FISCAL IMPLICATIONS:
There are no fiscal implications associated with the recommended action.
BACKGROUND:
AB 1795 was introduced to the California State Legislature on January 9, 2018 by California Assemblymember Mike A. Gipson (D-Carson).
AB 1795 authorizes local emergency medical services agencies to allow paramedics to transport people to a community care facility, such as a mental health urgent care center or sobering facility. The bill also authorizes local medical services agencies to add community paramedicine to its scope of practice activities necessary for the assessment, treatment, and transport of a patient to a community care facility upon receiving approval from the State Emergency Medical Services Authority.
Under current California State law, only law enforcement personnel are allowed to transport intoxicated patients or patients experiencing mental health episodes to sobering centers or mental health urgent care centers. However, paramedics and Emergency Medical Technicians are barred from doing so by the California Health and Safety Code and must transport intoxicated patients or patients experiencing mental health care episodes to county approved emergency departments.
Proponents of the legislation contend that a patient who is transported to an emergency department could be treated more appropriately if transported directly to a mental health urgent care center or to a sobering center where medically-trained personnel, including nurses and psychiatrists, can provide specialized intensive crisis services and treatment. Additionally, it can reduce the burden on local health care systems that may suffer from hospital overcrowding. AB 1795 allows paramedics to function outside their traditional emergency response and transport roles to help facilitate more appropriate use of emergency department resources.
Currently, AB 1795 has been referred to the Assembly Health Committee and will be heard at a future committee meeting. Thus far, the bill has been supported by the Los Angeles County Division of the League of California Cities, Los Angeles County (co-sponsor), the California Hospital Association (co-sponsor), the California Ambulance Association, the Emergency Medical Services Administrator’s Association of California, and the EMS Medical Directors Association of California.
DISCUSSION:
The City of Manhattan Beach’s Fire Department provides paramedic services. The City’s paramedic services currently operate under Los Angeles County’s Emergency Medical Services (EMS) program. Therefore, if AB 1795 were to be passed by the California State Legislature, Los Angeles County would likely revise the current Emergency Medical Services program allowing paramedics to transport patients that meet specific criteria established by the Los Angeles Emergency Medical Services Agency to a mental health urgent care center or sobering center. At this time it is uncertain what parameters the revised EMS program would create to determine what would make a patient eligible for transportation to a community care facility.
The City’s Fire Department regularly tracks data on the paramedics’ primary impression of a patient’s presentation. In 2017, paramedics determined that 36 patients presented themselves as affected by alcohol, 61 patients presented themselves as in behavioral/psychological crisis, and 64 patients were suspected to have alcohol use.
Depending on the criteria established in the revised EMS program, some patients may be eligible to be taken to a sobering center or mental health care facility. Under current law, patients are taken to emergency rooms where paramedic services await an emergency room nurse to accept the patient. If AB 1795 passes, the City’s paramedic services will be offered an alternative location to transport patients. In the case of emergency room overcrowding, this flexibility offered to paramedics is paramount to ensure efficiency and productivity.
AB 1795 would allow paramedics to transport patients to five mental health urgent care centers and one sobering center in Los Angeles County. The mental health urgent care center closest to the City of Manhattan Beach is the Exodus Urgent Care Center (Westside) at 11444 W. Washington Blvd, Los Angeles, CA. The sobering center closest to the City of Manhattan Beach is Exodus Recovery, Inc. Sobering Center at 640 Maple Avenue, Los Angeles, CA.
While these two locations may require further travel from the City of Manhattan Beach to transport patients, staff believes that the potential wait time in an overcrowded emergency room could be greater than the potential transportation time to one of these care facilities.
Consistent with precedent, City Council may provide a letter of support or opposition on legislation that effects Manhattan Beach residents. If the City Council provides direction to support or oppose legislation, staff will prepare the respective letter for the Mayor’s signature and send it to the Governor, the Assembly Committee on Health, the League of California Cities and California Assemblymember Mike A. Gipson.
PUBLIC OUTREACH/INTEREST:
After analysis, staff determined that public outreach was not required for this issue.
LEGAL REVIEW
The City Attorney has reviewed this report and determined that no additional legal analysis is necessary.
Attachments:
1. Assembly Bill 1795
2. League of California Cities Los Angeles County Division Notice of Support