SLS 16RS-2660 ORIGINAL
2016 Regular Session
SENATE CONCURRENT STUDY REQUEST NO. 2
BY SENATOR GATTI
HEALTH CARE. Requests the Senate Health and Welfare Committee and the House Health
and Welfare Committee to convene for a hearing to study the SR 29 of 2014 work group
report on strategies to decrease primary care utilization in emergency rooms in hospitals
across Louisiana.
1 A CONCURRENT STUDY REQUEST
2 To request the Senate Committee on Health and Welfare and the House Committee on
3 Health and Welfare meet and function as a joint committee to study and hear
4 testimony on the Senate Resolution No. 29 of the 2014 Regular Session of the
5 Legislature work group report on strategies to decrease primary care utilization in
6 emergency rooms and hospitals across Louisiana.
7 WHEREAS, in the 2014 regular session of the legislature, Senate Bill No. 493 was
8 filed to prohibit advertising of emergency room wait times by a hospital, as defined in R.S.
9 40:2102; and
10 WHEREAS, in an attempt to reach a compromise on this matter, the author filed
11 Senate Resolution No. 29, directing the Department of Health and Hospitals to create a work
12 group to develop strategies to decrease primary care utilization in emergency rooms; and
13 WHEREAS, the department established an "ER is for Emergencies" work group,
14 consisting of representatives of the Louisiana Hospital Association, Bayou Health plans,
15 Louisiana Behavioral Health Partnership Statewide Management Organization, Louisiana
16 Health Care Quality Forum, Louisiana Nursing Home Alliance, Louisiana Chapter of the
17 American College of Emergency Physicians, Louisiana State Medical Society, Louisiana
18 Chapter of the American Academy of Pediatrics, Louisiana Ambulance Alliance and
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SLS 16RS-2660 ORIGINAL
1 Louisiana Association of Health Plans; and
2 WHEREAS, the work group met weekly from April 23, 2014, through the fall of
3 2014; and
4 WHEREAS, in February 2015, on behalf of the work group, the department
5 submitted a report to the legislature that included five strategies that the membership agreed
6 upon to decrease primary care utilization in hospital emergency departments; and
7 WHEREAS, the five strategies were:
8 (1) Establish an electronic ED Visit Registry to provide timely notification
9 of Medicaid members' ED use to Bayou Health plans.
10 (2) Develop and implement a communications plan to educate patients on the
11 appropriate use of hospital EDs and alternate access points to care.
12 (3) Develop and issue prescribing recommendations to discourage narcotic
13 seeking in hospital EDs.
14 (4) Promote use of the Louisiana Board of Pharmacy's Prescription
15 Monitoring Program to identify potential narcotic seekers in the ED.
16 (5) Develop baseline and progress measures for quarterly reporting on the
17 implementation of agreed upon strategies. These measures are hospital participation
18 in the ED Visit Registry, the completeness of data reported to the ED Visit Registry,
19 accuracy of Medicaid member identification from the ED Visit Registry, pre-ED
20 visit primary care contact rate, post-ED visit follow up rate, and the number of ED
21 visits per 1,000 member months; and
22 WHEREAS, in its closing paragraph, the department reported being "optimistic about
23 the potential for the strategies developed by the SR 29 Working Group to reduce ED
24 demands and constrain Medicaid expenditure growth"; and
25 WHEREAS, it has been more than two years since the work group first convened and
26 it is unclear whether these strategies have been implemented or, if implemented, what the
27 outcomes have been; and
28 WHEREAS, primary care use of the emergency department continues to be a
29 significant problem, with some hospitals now even offering website links or apps to
30 "check-in" or book your emergency room visits in advance; and
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SLS 16RS-2660 ORIGINAL
1 WHEREAS, this emergency room misuse translates into inappropriate and more
2 costly care at a time when the state budget is already strapped; and
3 WHEREAS, Senate Bill No. 38 of the 2016 Regular Session of the Legislature was
4 filed to address the reimbursement rate for emergency room treatment for non-emergency
5 services; and
6 WHEREAS, it is appropriate to conduct a hearing so that the parties who developed
7 and agreed upon the Senate Resolution No. 29 strategies could present an update to the
8 committees on the status of implementation of each strategy, explain any impediments to
9 implementation, and offer any constructive alternatives to address this critical issue.
10 THEREFORE, the Legislature of Louisiana requests that the Senate Committee on
11 Health and Welfare and the House Committee on Health and Welfare meet and function as
12 a joint committee to hear testimony on the Senate Resolution No. 29 work group report on
13 strategies to decrease primary care utilization in emergency rooms and hospitals across
14 Louisiana; and that the joint committee report its findings to the legislature prior to July 1,
15 2016.
16 A copy of this Study Request shall be transmitted to the Department of Health and
17 Hospitals, Louisiana Hospital Association, Bayou Health plans, Louisiana Behavioral Health
18 Partnership Statewide Management Organization, Louisiana Health Care Quality Forum,
19 Louisiana Nursing Home Alliance, Louisiana Chapter of the American College of
20 Emergency Physicians, Louisiana State Medical Society, Louisiana Chapter of the American
21 Academy of Pediatrics, Louisiana Ambulance Alliance and Louisiana Association of Health
22 Plans.
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Christine Arbo Peck.
DIGEST
SCSR 2 Original 2016 Regular Session Gatti
Requests the Senate Committee on Health and Welfare and the House Committee on Health
and Welfare to meet and function as a joint committee to study and hear testimony on the
SR 29 of 2014 work group report on strategies to decrease primary care utilization in
emergency rooms and hospitals across Louisiana.
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