California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

Concerns Raised Over Plan To Shift Emergency Services Funding

California hospitals are expressing concern over a plan to transfer funds from the Emergency Medical Services Maddy Fund, a state account that reimburses physicians for treatment of indigent and uninsured patients, the Los Angeles Times reports.

As of fiscal year 2008-2009, the Maddy Fund contained about $95 million.

Lawmakers' Plan

California lawmakers are seeking to address the state's budget deficit in part by shifting $55 million from the Maddy Fund to Medi-Cal, California's Medicaid program. Moving additional funds to Medi-Cal would let the state draw down additional matching federal funds, the Times reports.

According to Mark Hedlund -- spokesperson for Senate President Pro Tempore Darrell Steinberg (D-Sacramento) -- many of the individuals who would have been covered under the fund would be covered by a federal waiver and by a planned Medi-Cal expansion through the national health reform law.

Opponents Weigh In

However, opponents of the plan to shift Maddy funds argue that hospital emergency departments would be negatively affected.

According to Andrea Brault -- an emergency physician at Brotman Medical Center and president of the California chapter of the American College of Emergency Physicians -- moving the funds to Medi-Cal would:

  • Reduce the number of on-call specialists and surgeons at hospitals;
  • Increase ED wait times; and
  • Cause some EDs to close.

Brault added that because health reform does not expand Medi-Cal until 2014 and the federal waiver would cover about 500,000 patients, roughly seven million Californians without insurance would have reduced or no access to emergency health care services.

Hospital Industry Reaction

Some hospital executives said they might pay more to ensure specialists are on call, rather than close EDs. Such a move could increase the burden on private facilities of caring for indigent patients, according to the Times.

Jim Lott -- executive vice president at the Hospital Association of Southern California -- noted that hospitals in low-income areas could be forced to reduce hours or services (Hennessy-Fiske, Los Angeles Times, 3/20).

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