Senate approves bill allowing EMS transport to facilities other than emergency departments


STATE HOUSE – The Senate today approved legislation sponsored by Senate Health and Human Services Committee Chairman Joshua Miller to allow emergency medical services to transport patients to facilities other than hospital emergency departments, such as behavioral health centers, community health clinics, urgent care facilities or the person’s primary care provider.

The bill (2023-S 0576A) authorizes emergency medical service agencies approved by the Department of Health to participate in a mobile integrated healthcare/community paramedicine program, allowing the agencies to transport individuals to alternative facilities based on the individual’s need of emergency medical services. It also requires insurance policies that provide coverage for EMS to cover such transport.

Currently, EMS agencies are generally unable to get reimbursed for services unless they transport to a hospital emergency department.

“Emergency departments are not always the appropriate venue for treatment of every health issue for which a person might call 911,” said Chairman Miller, who in 2013 co-chaired a Senate commission that studied ways to reduce ER visits. “For example, once EMS personnel administer Narcan to a person experiencing an overdose, they may not need the services provided at a hospital. But they may very well need and be willing to go to a behavioral health facility to help them with rehab, and there’s a high likelihood that they won’t go if someone doesn’t bring them right away. This is effective use of resources that ensures that people go to the health care facility that is best suited to their needs.”

In particular, Chairman Miller noted, this law needs to be enacted ahead of the impending opening of certified community behavioral health clinics in Rhode Island. CCBHCs are clinics that provide a comprehensive range of mental health and substance use services. In the 2023 state budget bill passed last year, lawmakers authorized the Executive Office of Health and Human Services to seek federal approval to establish CCBHCs, and to cover all behavioral health services at CCBHCs through a bundled payment methodology that is specific to each provider organization’s anticipated costs.

CCBHCs are ideal places to provide treatment for substance use or mental health issues, and those who experience behavioral or mental health emergencies are most likely to use and benefit from their services if they are brought there immediately, Chairman Miller said.

Under the bill, an EMS agency would be allowed to transport patients to alternative facilities only after the Department of Health approves its plans for doing so.

The bill now goes to the House, where Rep. Rebecca Kislak (D-Dist. 4, Providence) is sponsoring companion legislation (2023-H 5873).