BILL NUMBER: AB 911 ENROLLED
BILL TEXT
PASSED THE SENATE SEPTEMBER 9, 2009
PASSED THE ASSEMBLY SEPTEMBER 10, 2009
AMENDED IN SENATE SEPTEMBER 4, 2009
AMENDED IN SENATE AUGUST 24, 2009
AMENDED IN SENATE JULY 23, 2009
AMENDED IN SENATE JULY 2, 2009
AMENDED IN ASSEMBLY JUNE 1, 2009
INTRODUCED BY Assembly Member Lieu
(Coauthors: Assembly Members Eng and Price)
FEBRUARY 26, 2009
An act to add and repeal Section 1257.10 of the Health and Safety
Code, relating to health facilities.
LEGISLATIVE COUNSEL'S DIGEST
AB 911, Lieu. Emergency room crowding.
Existing law establishes various programs for the prevention of
disease and the promotion of health to be administered by the State
Department of Public Health, including, but not limited to, the
licensure and regulation of health facilities, including general
acute care, hospitals. Violation of these provisions is a crime.
This bill would require every licensed general acute care hospital
with an emergency department to determine the range of crowding
scores, as defined, that constitute each category of the crowding
scale, as provided, for its emergency department. The bill would
require every licensed general acute care hospital with an emergency
department to calculate and record a crowding score every 4 hours,
except as specified, to assess the crowding condition of its
emergency department. The bill would require, by January 1, 2011,
every licensed general acute care hospital with an emergency
department to develop and implement a full-capacity protocol for each
of the categories of the crowding scale.
This bill would require every licensed general acute care hospital
with an emergency department to file its full-capacity protocol with
the Office of Statewide Health Planning and Development, and to
annually report revisions to its protocol.
The bill would repeal its provisions on January 1, 2014.
By changing the definition of an existing crime, this bill would
impose a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1257.10 is added to the Health and Safety Code,
to read:
1257.10. (a) For purposes of this section, a "crowding score"
means the score calculated using the equation as follows: 85.8 (total
number of patients within the emergency department/total number of
staffed beds in the emergency department, not to exceed the number of
licensed beds) + 600 (total number of admissions waiting in the
emergency department, including patients awaiting transfer/total
number of acute inpatient hospital beds routinely in use by the
hospital, excluding beds in the newborn nursery, neonatal intensive
care unit, and obstetrics) + 13.4 (total number of patients in the
emergency department admitted to the intensive care-critical care
unit, with a maximum of four) + .93 (the longest admit time, in
hours, including transfers) + 5.64 (the wait time for the last
patient waiting the longest in the waiting room, in hours) - 20.
(b) For purposes of this section the "crowding scale" means a
range of crowding scores that are divided into six categories of
which level one will be the lowest level of crowding and level six
will be the highest.
(c) Every licensed general acute care hospital, as defined in
subdivision (a) of Section 1250, with an emergency department shall
determine the range of crowding scores that constitute each category
of the crowding scale for its emergency department.
(d) (1) Except as otherwise provided in this subdivision, every
licensed general acute care hospital with an emergency department
shall calculate, and record, a crowding score a minimum of every four
hours to assess the crowding condition of its emergency department.
(2) If, after calculating and recording a crowding score, a
licensed general acute care hospital does not have a crowding score
in level four or higher for the previous 30 days, it may calculate
and record a crowding score every eight hours rather than every four
hours. If the licensed general acute care hospital calculating and
recording a crowding score every eight hours records a score in level
four or higher, it shall again calculate and record a crowding score
every four hours.
(3) Any hospital that has an emergency department census of less
than 14,000 visits annually shall calculate and record the crowding
score daily between 4 p.m. and 8 p.m.
(e) Every licensed general acute care hospital with an emergency
department shall, by January 1, 2011, develop and implement, in
consultation with its emergency department staff, a full-capacity
protocol for each of the categories of the crowding scale that
addresses all of the following factors, as applicable:
(1) Notification of hospital administrators, nursing staff,
medical staff, and ancillary services of category changes on the
crowding scale.
(2) Hospital operations, including bed utilization, transfers,
elective admissions, discharges, supplies, and additional staffing.
(3) Emergency department operations, including diversion, triage,
and alternative care sites.
(4) The planned response of the organized medical staff for
rounds, discharges, coordination with the emergency department, and
emergency consults for emergency department patients.
(f) Every licensed general acute care hospital with an emergency
department shall file its full-capacity protocol with the Office of
Statewide Health Planning and Development and shall annually report
any revisions to its protocol.
(g) This section shall remain in effect only until January 1,
2014, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2014, deletes or extends
that date.
SEC. 2. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.