STAND. COM. REP. NO. 542

Honolulu, Hawaii

RE: S.B. No. 417

S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirtieth State Legislature

Regular Session of 2019

State of Hawaii

Sir:

Your Committees on Commerce, Consumer Protection, and Health and Human Services, to which was referred S.B. No. 417 entitled:

"A BILL FOR AN ACT RELATING TO HEALTH,"

beg leave to report as follows:

The purpose and intent of this measure is to:

(1) Require Medicaid and private insurance coverage of ambulance services;

(2) Authorize Medicaid programs and require private insurers to pay for ambulance services if the patient was treated in a county with a population of two hundred thousand or more, even if the patient is not transported; and

(3) Appropriate funds for Medicaid coverage of ambulance services.

Your Committees received testimony in support of this measure from the Department of Health, Department of Public Safety, Hawai‘i Fire Department of the County of Hawai‘i, O‘ahu County Committee on Legislative Priorities of the Democratic Party of Hawai‘i, American Medical Response, and two individuals. Your Committees received comments on this measure from the Department of the Attorney General, Department of Commerce and Consumer Affairs, Department of Human Services, and Hawaii Medical Service Association.

Your Committees find that in 2018, emergency medical service providers treated and transported 89,770 patients. Emergency medical service providers also responded to 21,473 calls, representing over fourteen percent of all emergency medical service responses, where the patient was treated but not transported. Data shows there has been a consistent increase each year in the proportion of patients who are treated but not transported. Historically, however, the State has billed for patients transported to hospitals. This measure will help recoup operational costs by providing reimbursement for services when a patient is treated but not transported and will help break the cycle of dependence on the emergency care system.

Your Committees further find that as the cost of quality health care continues to increase, alternatives to the traditional provision of health care are required. Community paramedicine is an emerging and innovative model of care that uses emergency medical technicians and paramedics to provide care to underserved populations. Moreover, community paramedicine is an effective approach to serving patients with complex medical and social conditions and has the potential to decrease emergency department use and decrease hospitalizations. A unified statewide community paramedicine program will preserve and enhance emergency medical services, can help provide the right care by the right provider at the right time and place, and reduce wasted healthcare dollars. Your Committees note that this measure is not a new mandate, rather, it expands access to care.

Your Committees have amended this measure by:

(1) Clarifying that the State's Medicaid programs may pay for statewide community paramedicine services rendered by emergency medical technicians or paramedics;

(2) Clarifying that each policy of accident and health or sickness insurance or hospital or medical service plan contract shall provide coverage for statewide community paramedicine services rendered by emergency medical technicians or paramedics;

(3) Removing language that would have limited coverage to services provided within a county with a population of two hundred thousand or more; and

(4) Making technical, nonsubstantive amendments for the purposes of clarity and consistency.

As affirmed by the records of votes of the members of your Committees on Commerce, Consumer Protection, and Health and Human Services that are attached to this report, your Committees are in accord with the intent and purpose of S.B. No. 417, as amended herein, and recommend that it pass Second Reading in the form attached hereto as S.B. No. 417, S.D. 1, and be referred to your Committee on Ways and Means.

Respectfully submitted on behalf of the members of the Committees on Commerce, Consumer Protection, and Health and Human Services,

________________________________ RUSSELL E. RUDERMAN, Chair

________________________________ ROSALYN H. BAKER, Chair