The California chapter of the American College of Emergency Physicians (CalACEP) is urging the California Legislature to make a budget commitment to drug and alcohol counseling in California Emergency Departments (ED’s) to the tune of $20 million. The funding is requested to create a statewide pilot program that places a certified drug and alcohol counselor in each of the roughly 400 EDs throughout California. Data would be gathered during the pilot to measure the efficacy of treatment and the cost savings to the Medi-Cal program and other payers. The request comes as a result of a successful University of California Davis ED pilot funded through a grant from the Office of the President. The UCD pilot employed a certified drug and alcohol counselor to provide interventions in their ED and results were impressive. Over a 12-month period, the Medi-Cal patients who received a brief intervention and referral to treatment experienced a 60 percent decline in ED utilization. 

On April 12, 2018, Dr. Aimee Moulin, a UC Davis Emergency Room Physician, and newly elected CalACEP President, testified before the Senate Appropriations Budget and Fiscal Review Subcommittee #3 that studies have shown that direct referrals to treatment have increased enrollment rates as high as 50 percent. Dr. Moulin stated that “offering assistance to these patients at a time when they are most vulnerable to their disease proved incredibly effective towards the patient’s acknowledgment of their need for treatment.” Similarly in New Jersey, the newly established Opioid Overdose Recovery Program which provides ED intervention for patients who experience alcohol and opioid overdose, confirmed that over 80 percent of patients accepted bedside intervention, 40 percent of those patients accepted recovery support services, and 45 percent accepted detox, substance use disorder treatment and/or recovery. These results were realized during the first six months of program implementation. Over 60 percent of the overdose patients seen under the Program were Medicaid beneficiaries.

Senator Richard Pan, M.D., Chairman of the Subcommittee, himself a UC Davis physician, encouraged Dr. Moulin and assured members of the Office of Finance and the Legislative Analyst’s Office that, “there are real cost savings here to be realized” and encouraged the organizations to work together to identify ways to report the cost savings. The request made its way through the Senate and is now awaiting a hearing to be affirmed by the State Assembly.

Aimee Moulin, M.D., is an emergency medicine physician with a research interest in Behavioral Health Emergencies and Health Policy. Dr. Moulin has a background in health policy and leadership and is dedicated to addressing disparities in healthcare access for patients with mental illness. She received her graduate degree in Genetics from the University of California at Davis and graduated from both medical school and residency at the University of Southern California. Dr. Moulin is board certified in emergency medicine and is the current President of California ACEP.

Most recently, Dr. Moulin completed a QSCERT postdoctoral fellowship supported by funding from the Agency for Healthcare Quality and Research (AHRQ).
The Quality, Safety, and Comparative Effectiveness Research Training (QSCERT) T32 Program is a multidisciplinary, postdoctoral training program in quality, safety and comparative effectiveness research with an emphasis on training future leaders in surgical, trauma, and urgent/emergency care and other areas of relevant outcomes research.

Dr. Moulin’s complete testimony before the California State Senate Budget and Fiscal Review Subcommittee No. 3 on April 12, 2018 (Part 2), can be found in the California State Senate's Media Archive.