BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Elaine K. Alquist, Chair


          BILL NO:       AB 911                                       
          A
          AUTHOR:        Lieu                                         
          B
          AMENDED:       July 2, 2009                                
          HEARING DATE:  July 15, 2009                                
          9
          CONSULTANT:                                                 
          1
          Tadeo/                                                      
          1
                                        

                                     SUBJECT
                                         
                         Emergency rooms: overcrowding

                                     SUMMARY  

          Requires, until January 1, 2014, every licensed general  
          acute care hospital to assess the condition of its  
          emergency department, using an overcrowding score, every  
          four hours, and to develop and implement capacity protocols  
          based on an overcrowding scale.  Requires the capacity  
          protocols to be filed with the Office of Statewide Health  
          Planning and Development.

                             CHANGES TO EXISTING LAW  

          Existing law:
          Provides for the licensing and regulation of health  
          facilities, including general acute care hospitals, acute  
          psychiatric hospitals, and special hospitals by the  
          Department of Public Health (DPH).

          Establishes the Office of Statewide Health Planning and  
          Development (OSHPD) to analyze California's health care  
          infrastructure, provide information about health care  
          outcomes, assure the safety of buildings used in providing  
          health care, insure loans to encourage the development of  
          health care facilities, and facilitate development of  
                                                         Continued---



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          sustained capacity for communities to address local health  
          care issues.

          This bill:
          Requires every licensed general acute care hospital with an  
          emergency department to calculate and record an  
          overcrowding score every four hours to assess the condition  
          of the emergency department, with exemptions as specified. 

          Defines an overcrowding score as a score calculated to  
          measure emergency department and hospital overcrowding,  
          with an equation, as specified, using the following  
          variables: 
                 Number of patients within the emergency department;
                 Total number of beds staffed in the emergency  
               department, not to exceed the number of licensed beds;
                 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:
                 Total number of patients in the emergency  
               department admitted to the intensive care unit;
                 The longest admit time, in hours, including,  
               transfers; and, 
                 The wait time for the last patient waiting the  
               longest in the waiting room, in hours.  

          Defines overcrowding scale to mean a range of scores that  
          are divided into the following categories: not busy; busy;  
          extremely busy; overcrowded; severely overcrowded; and,  
          dangerously overcrowded. 

          Requires every licensed general acute care hospital with an  
          emergency department to determine the range of overcrowding  
          scores that constitute each category of the overcrowding  
          scale for its emergency department.

          Requires by January 1, 2011, every licensed general acute  
          care hospital to develop and implement, in consultation  
          with its emergency department staff, a full capacity  
          protocol for each of the categories of the overcrowding  
          scale that addresses the following factors, where  
          applicable: 




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                 Notification of hospital administrators, nursing  
               staff, medical staff, and ancillary services of  
               category changes on the overcrowding scale;
                 Bed utilization;
                 Diversion;
                 Elective admissions;
                 Transfers;
                 Triage;
                 Responsibilities of inpatient medical staff and  
               specialty service operations for rounds, discharges,  
               coordination with the emergency department, and  
               emergency consults for emergency department patients;
                 Hospital unit operations;
                 Nursing services;
                 Supplies;
                 Calling in additional medical staff; and,
                 Space utilization, including alternate care sites.

          Requires every licensed general acute care hospital to file  
          its full-capacity protocols with OSHPD, and annually report  
          any revisions to its protocols. 

          Allows licensed general acute care hospitals with emergency  
          departments that do not have an overcrowding score over 60  
          for the pervious 30 days to calculate and record an  
          overcrowding score every eight hours instead of four.

          Requires a licensed general acute care hospital that is  
          calculating an overcrowding score every eight hours instead  
          of four that scores over 60 to again calculate and record  
          an overcrowding score every four hours. 

          Repeals its provisions on January 1, 2014.
           
                                 FISCAL IMPACT

           Unknown.  According to the Assembly Appropriations  
          Committee analysis of a previous version of AB 911, annual  
          General Fund costs and $1 million to the University of  
          California and county-operated medical centers to comply  
          with the National Emergency Department Over Crowding Scale  
          (NEDOCS) reporting every three hours. (Amendments now  
          require the reporting every four hours, and deletes the use  
          of the NEDOCS score in favor of a different, although  
          similar, overcrowding score tool).  




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          Additionally, the Assembly Appropriations Committee  
          analysis of a previous version of AB 911 also reports  
          one-time fee-supported special fund costs of $170,000 to  
          DPH to establish regulations and maintain oversight of  
          requirements of this bill during the licensure and  
          certification processes. 

                            BACKGROUND AND DISCUSSION
                                         
          According to the author, California emergency departments  
          are dangerously overcrowded and have reached a crisis  
          level, ranking last in the nation in the number of  
          emergency rooms available to its residents.  The author  
          states that California provides only six emergency rooms  
          for every one million persons.  The author argues that the  
          common misconception surrounding emergency department  
          overcrowding links congestion with non-urgent patients and  
          the uninsured, when the real reason for this congestion is  
          that hospitals keep patients who need hospitalization in  
          the emergency room until a hospital bed becomes available,  
          a practice known as boarding a patient.  

          The author states that there are reported cases in which  
          patients have been boarded in hallways or waiting rooms for  
          up to 24 hours before they are admitted into the inpatient  
          unit of the hospital.  The author further states that, the  
          use of an overcrowding score known as the NEDOCS score,  
          similar to the overcrowding score proposed in AB 911,  and  
          a subsequent full capacity protocol plan, at LAC/USC  
          Medical Center have significantly reduced wait times and  
          patient boarding.  The author contends that this approach  
          would work on a statewide level, and that AB 911 does not  
          require the same full capacity protocol plan for all  
          hospitals; instead, each facility would come up with a plan  
          that works for that particular hospital.  

          A 2003 U.S. General Accounting Office analysis of emergency  
          department overcrowding (GAO report), reported that  
          overcrowding is a problem that has reached historic levels  
          and can be attributed to a number of factors.  The report  
          found that the single most common variable linked to  
          emergency room overcrowding was the growing problem of  
          boarding patients who were already screened and stabilized  
          by emergency staff, until inpatient beds were available.   




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          The GAO report maintains that when emergency departments  
          saturate because of patients waiting for beds and nurses to  
          become available on inpatient units, emergency waiting  
          rooms become overcrowded, wait times increase, and there is  
          a greater risk for poor health outcomes.  According to the  
          GAO report, this leads to temporary closure of crowded  
          emergency departments to inbound ambulance traffic, a  
          process known as diversion, which increases travel time as  
          ambulance drivers seek other hospitals to which they can  
          transport their patients.

          According to a 2007 Institute of Medicine report,  
          "Hospital-Based Emergency Care:  At the Breaking Point"  
          (IOM report), despite the lifesaving feats performed every  
          day by emergency departments and ambulance services, the  
          nation's emergency medical system as a whole is  
          overburdened, underfunded, and highly fragmented.  As a  
          result, according to the IOM report, ambulances are turned  
          away from emergency departments once every minute on  
          average, and patients in many areas may wait hours or even  
          days for a hospital bed.  Moreover, the IOM report  
          maintains, the system is ill prepared to handle surges from  
          disasters such as hurricanes, terrorist attacks, or disease  
          outbreaks.  

          According to information posted on the American Academy of  
          Emergency Medicine website, the Joint Commission issued an  
          important guideline on emergency department overcrowding,  
          in 2004.  The website states that the Joint Commission  
          guidelines recognize the link between overcrowding and  
          quality.  While the guidelines do not call for hospitals to  
          have explicit policies to alleviate overcrowding, they do  
          call for hospitals to have a plan for surge capacity in  
          place, and to provide a level of service to boarded  
          patients comparable to that which they would receive in an  
          inpatient unit.  

          The IOM report called for the strengthening of The Joint  
          Commission standards that address emergency department  
          overcrowding, boarding, and diversion.
           
          Overcrowding score 
          The overcrowding score calculation in AB 911 is a mechanism  
          that was developed by a stakeholder group consisting of the  
          California Chapter of the American College of Emergency  




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          Physicians, the California Emergency Nurses Association,  
          and the California Hospital Association, based on the  
          National Emergency Department Over Crowding Scale (NEDOCS)  
          score.  The overcrowding score is designed to measure  
          emergency department and hospital overcrowding.  The  
          following variables are used in the calculation of an  
          overcrowding score: 
                 Number of patients within the emergency department;
                 Total number of beds staffed in the emergency  
               department, not to exceed the number of licensed beds;
                 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;
                 Total number of patients in the emergency  
               department admitted to the intensive care unit;
                 The longest admit time, in hours, including,  
               transfers; and, 
                 The wait time for the last patient waiting the  
               longest in the waiting room, in hours.  

          Under the scoring system, each level (not busy, busy,  
          overcrowded, dangerously overcrowded, severely overcrowded)  
          corresponds to and necessitates an institutional response  
          with respect to systems, space, and supplies.  

          LAC/USC results
          LAC/USC uses the NEDOCS score, similar to the one required  
          by AB 911, and has developed corresponding full-capacity  
          protocols.  According the LAC/USC Surge Plan, the  
          application of these protocols have freed up treatment  
          areas and staff for the evaluation and treatment of new  
          emergency patients, have increased emergency department  
          capability and resulted in: decreased patient boarding  
          time; decreased emergency department and inpatient loss of  
          services; improved patient safety; improved patient  
          satisfaction; improved morale; and improved resident and  
          student training in both the emergency department and  
          inpatient services.

          LAC/USC reports that this approach works because it  
          mandates accountability; delegates responsibility; defines  
          procedures and protocols, offering uniformity and  




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          standardization; and creates hospital awareness of  
          overcrowding and response thresholds. The LAC/USC  
          protocols, as a part of its standardized procedure, call  
          for conducting a NEDOCS assessment every two hours.  

          Crowding comparisons in the LAC/USC Surge Plan illustrate  
          very little change in the "not busy" and "busy" categories;  
          a rise in the "overcrowded" and "extremely busy" categories  
          and a dramatic decrease in the "severely overcrowded" and  
          "dangerously overcrowded" categories.  LAC/USC reported the  
          following measures for 2007 and 2008:
                 Extremely busy category at 1.2 percent in August,  
               2007, and at 27.8 percent in August, 2008;
                 Overcrowded category at 29.3 percent in August,  
               2007 and at 62 percent in August, 2008;
                 Severely overcrowded category at 31.7 percent in  
               August, 2007 and at 9.6 percent in August, 2008;
                 Dangerously overcrowded category at 37.8 percent in  
               August, 2007 and at 0.3 percent in August, 2008. 

          Prior bills
          AB 2207 (Lieu, 2008) would have required hospitals to  
          assess the condition of an emergency room via the NEDOCS  
          score every three hours and would have authorized hospitals  
          to use hallways, conference rooms, and waiting rooms as  
          temporary patient areas pursuant to hospital full capacity  
          protocols.  This bill was held in the Assembly  
          Appropriations Committee.

          Arguments in support
          The American College of Emergency Physicians, State Chapter  
          of California, sponsor of AB 911 states that, in hospitals  
          that have utilized the approach that this bill proposes,  
          the scoring and assessing of emergency departments as well  
          as the development of a plan to best utilize hospital space  
          and personnel at each level of crowding, has resulted in  
          reduced overcrowding, decreased wait times, and improved  
          patient care.  

          The California Medical Association (CMA) states that AB 911  
          would establish plans for times when hospitals reach  
          capacity, which  is essential to providing consistent and  
          quality emergency care.  CMA further states that AB 911  
          would also provide a way to increase knowledge of the  
          overcrowding problems caused by hospital closures and  




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          consolidations.  
          
          Arguments in opposition
          In reference to a previous version of AB 911, DPH states  
          that there is no evidence that using a NEDOCS score is  
          effective and would work for California.  DPH further  
          states that it has only been used in one hospital in Los  
          Angeles, and will not necessarily help or prevent emergency  
          room overcrowding.  DPH contends that overcrowding  
          assessment in emergency rooms is already done and that  
          there is insufficient evidence to show that AB 911 would  
          have any impact on improving emergency room overcrowding. 

          Concerns
          The California Hospital Association has requested an  
          amendment to allow small volume emergency departments to  
          perform the overcrowding score on a daily basis only,  
          unless their census is one standard deviation above their  
          average daily census, at which time they would have to go  
          back to performing the overcrowding score every four hours.  


                                     COMMENTS

           1)The author may wish to amend AB 911 to change the  
            performance requirements for overcrowding scores  
            conducted at small volume hospitals. 
          
                                  PRIOR ACTIONS

           Assembly Floor:     45-31
          Assembly Appropriations:12-5
          Assembly Health:    11-3

                                    POSITIONS  
                                        
          Support:  California Chapter of the American College of  
          Emergency Physicians 
                            (sponsor) 
                           California Academy of Physician Assistants
                           California Medical Association
                           California Professional Firefighters

          Oppose:   Department of Public Health  (previous version of  
                 the bill) 




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