Massachusetts lawmakers are considering a bill that would test alternatives to ambulances and police for transporting behavioral health patients, which supporters say could help reduce strains on emergency medical services and lower costs.
Filed by North Attleboro Democratic Rep. Adam J. Scanlon, the bill would establish five regional pilot programs geographically dispersed across the state to test alternative transport models. The Executive Office of Health and Human Services would work with hospitals and MassHealth to manage care and provide reimbursement to pilot participants, according to the bill.
“I filed H. 2234 after hearing from doctors in emergency rooms, as well as those who treat patients for mental and behavioral health issues, that the current system of transporting patients is not working for either side,” said Scanlon in an interview.
He said that due to high demand and low reimbursement rates, ambulance providers cannot satisfy the needs of all behavioral health patients, who often end up boarding in emergency rooms.
“There are usually a few hundred such cases at any particular time, and this is not the right setting for them, nor does it help with efficiency in our hospital emergency rooms which are meant for acute health emergencies,” said Scanlon.
Scanlon added that transportation to an appropriate health facility is often done by using hospital-based ambulances—sometimes occupying an ambulance for hours to travel outside its usual service area. These diversions can lead to longer wait times for patients in all settings, delaying care and increasing the risk of hospital readmission.
“With this bill, we can give behavioral health patients treatment in a system that is designed for them—including a calmer and more therapeutic environment than an ambulance or ER—and free up our hospital and ambulance resources at the same time,” said Scanlon.
Scanlon said that other states have already developed specialized behavioral health transport systems so ambulances and emergency rooms can function more efficiently. In Virginia, the Department of Behavioral Health and Developmental Services uses secure and unmarked vehicles with trained, unarmed drivers who wear plain clothes to create an experience focused on recovery and engagement. This past July, Colorado’s Behavioral Health Administration launched LIFTS, a streamlined network of services, including behavioral crisis, substance use and mental health support.
In Massachusetts, the share of patients with behavioral health needs who had to wait in the emergency room for a bed rose from 31.1% of visits in 2020 to 38.8% in 2024, according to the Health Policy Commission.
Sen. Paul Feeney, D-Foxboro, said in an interview that he sponsored the bill to address the ongoing behavioral health emergency in Massachusetts, which has been compounded by hospital closures and the Steward Health Care crisis.
The HPC, alongside the Center for Health Information and Analysis and the Executive Office of Health and Human Services, will collect data to evaluate the pilots’ effectiveness, focusing on transfer times, nonjudgmental patient treatment, cost-effectiveness and resource use compared to traditional ambulance transport, according to the senator’s office.
“The ways in which patients are transported to receive care in Massachusetts matter. While many health care reforms provide new support for individuals with mental or behavioral health diagnoses, gaps remain—particularly in our emergency services system,” said Feeney.
Newton-Wellesley Hospital does not currently use the ambulance system this bill would apply to. The Newton Fire and Police Department said they do not handle patient transports, but utilize a third-party contractor, Coastal Medical Transportation Services, as the EMS provider for the city.