California legislators advance AB 1328 to raise Medi-Cal ambulance reimbursement rates

The California Assembly Health Committee convened on April 22, 2025, to discuss several significant health-related bills aimed at improving care for vulnerable populations and addressing systemic issues within the healthcare system.

One of the primary topics was a proposed bill that seeks to standardize criteria for medical necessity in subacute care for children. Doug Padgett, representing Totally Kids Rehabilitation Hospital, emphasized the importance of this legislation, stating that it would prevent delays in care for medically fragile children. He highlighted that the current system has led to significant delays in admissions, resulting in children remaining in costly NICU beds longer than necessary. The bill aims to hold managed care plans accountable for adhering to established guidelines, which Padgett argued would not only improve patient outcomes but also save the state substantial healthcare costs.

Dr. Joseph De Carlo, a medical director at a Northern California subacute facility, supported Padgett's testimony, explaining that subacute care is essential for patients who are too ill for home care but not sick enough for hospital admission. He noted that delays in transferring patients to subacute facilities can lead to increased costs for the state, as patients remain in higher-cost emergency departments.

The committee also reviewed Assembly Bill 1328, which addresses reimbursement rates for non-emergency ambulance services under Medi-Cal. Currently, these rates have not been updated since 1999, leading to significant financial losses for ambulance providers. Sean Sullivan, CEO of Life's West Ambulance, and Dr. David Duncan, a former EMS authority director, testified that increasing these rates is crucial for ensuring timely patient transport and maintaining the viability of ambulance services across California.

Another significant bill discussed was Assembly Bill 1356, which aims to enhance the investigation process following deaths in drug and alcohol recovery facilities. The bill would require facilities to submit follow-up reports detailing actions taken in response to incidents, thereby increasing accountability and oversight. Brianna Zwabin, an investigator with Jared's Law, shared a personal story highlighting the need for improved safety measures in these facilities, advocating for the bill as a means to prevent future tragedies.

The committee's discussions underscored the ongoing challenges within California's healthcare system, particularly regarding the care of vulnerable populations and the need for regulatory reforms to ensure timely and effective medical services. The bills discussed are set to move forward for further consideration, with the potential to significantly impact healthcare delivery in the state.