BILL ANALYSIS �
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THIRD READING
Bill No: AB 974
Author: Hall (D)
Amended: 7/2/13 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 6/26/13
AYES: Hernandez, Anderson, Beall, De Le�n, DeSaulnier, Monning,
Nielsen, Pavley, Wolk
SENATE APPROPRIATIONS COMMITTEE : 5-0, 8/12/13
AYES: De Le�n, Gaines, Hill, Lara, Steinberg
NO VOTE RECORDED: Walters, Padilla
ASSEMBLY FLOOR : 75-0, 5/9/13 (Consent) - See last page for vote
SUBJECT : Patient transfer: nonmedical reasons: notice to
contact person or next of kin
SOURCE : Author
DIGEST : This bill requires a hospital to alert a patients
emergency contact person prior to transferring the patient from
one hospital to another for nonmedical reasons, and requires the
hospital to document any attempts to contact in the patient's
medical record.
ANALYSIS :
Existing law:
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1. Requires hospital emergency departments, under the federal
Emergency Medical Treatment and Active Labor Act as well as
state law, to provide emergency screening and stabilization
services without regard to the patient's insurance status or
ability to pay.
2. Requires a health plan to reimburse providers for emergency
services and care provided to its enrollees until the care
results in stabilization of the enrollee.
3. Prohibits any person needing emergency services and care from
being transferred from a hospital to another hospital for any
nonmedical reason, such as the person's inability to pay for
any emergency service or care, unless specified conditions
are met, including the following:
A. The person is examined and evaluated by a physician
prior to transfer;
B. The person has been provided with emergency services
and care so that it can be determined, within reasonable
medical probability, that the transfer or delay caused by
the transfer will not create a medical hazard to the
person;
C. A physician at the transferring hospital has notified
and obtained the consent to the transfer by a physician at
the receiving hospital;
D. The transferring hospital provides the appropriate
personnel and equipment to effect the transfer, and all
the person's pertinent medical records are transferred
with the person; and,
E. The records transferred with the person include a
"Transfer Summary," signed by the transferring physician,
containing specified relevant information, including the
reason for the transfer and a declaration of the signing
physician that the transfer creates no medical hazard to
the patient.
4. Prohibits anything in the above provisions of law pertaining
to the nonmedical transfer of a person needing emergency
services and care from prohibiting the transfer or discharge
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of a patient when the patient or the patient's representative
requests a transfer or discharge and gives informed consent
to the transfer or discharge against medical advice.
5. Permits a health facility to disclose medical information
about a patient in order to notify a family member or a
personal representative of the patient about the patient's
location, general condition, or death, if specified
procedures are followed.
6. Prohibits, under Title 22 of the California Code of
Regulations, any patient from being transferred or discharged
solely for the purposes of effecting a transfer from a
hospital to another health facility unless certain
requirements have been made, including that the patient or
the person legally responsible for the patient has been
notified, or attempts have been made over the 24-hour period
prior to the patient's transfer and the legally responsible
person cannot be reached.
This bill:
1. Requires that, prior to a transfer of a patient for a
nonmedical reason, the hospital ask the patient if there is a
preferred contact person to be notified, and make a
reasonable attempt to contact and alert him/her about the
proposed transfer.
2. Requires the hospital, if a patient is unable to respond, to
make a reasonable effort to ascertain the identity of the
preferred contact person or the next of kin and alert him/her
about the transfer.
3. Requires that the hospital document any attempts to contact a
preferred contact person or next of kin in the patient's
medical record.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee, potential
costs of $130,000 per year for two years to develop and adopt
implementing regulations by the Department of Public Health
(Licensing and Certification Program Fund). The Department
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indicates that it may need to adopt implementing regulations to
clarify this bill's requirements on hospitals.
SUPPORT : (Verified 8/14/13)
AFSCME
Alzheimer's Association
American College of Emergency Physicians
Brotherhood Crusade
California Advocates for Nursing Home Reform
California Chapter of the American College of Emergency
Physicians
California Senior Legislature
Congress of California Seniors
Consumer Attorneys of California
Health Access California
ARGUMENTS IN SUPPORT : The author's office states that this
bill is in response to an incident involving the elderly mother
in the care of a constituent, who suffered a stroke and was
brought to the closest emergency room which happened to be an
out of network hospital. The patient was then stabilized, and
once she met all the criteria to be eligible for transfer, she
was transferred to an in-network hospital. The transferring
hospital, however failed to notify the daughter who had been
visiting her mother. When she arrived at the hospital she was
shocked and scared to find that her mother's room was empty.
Her first thought was that her mother had died. She was
eventually able to find someone who informed her of the
transfer.
Health Access California states that this bill builds on
existing California law regarding transfer of individuals from
one hospital to another by adding a provision that the hospital
should attempt to contact a family member or emergency contact
person prior to the transfer, and that this seems a simple
measure of human dignity. The Consumer Attorneys of California
state that hospitals are not required to notify the patient's
next of kin or emergency contact that the patient is being
transferred, and that this lack of communication creates
unnecessary confusion and fear in an already stressful time for
family members and friends. The California Chapter of the
American College of Emergency Physicians states that this bill
will reduce the confusion caused by hospital transfers, and that
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it supports ensuring that loved ones are notified when patients
are transferred to another hospital. The Congress of California
Seniors states that this bill aims to end the confusion and
heartache that results when family members do not know where
their relative has gone. California Advocates for Nursing Home
Reform states that for all persons with disabilities and the
elderly, notifying someone about the transfer is essential to
their health and safety. The Alzheimer's Association notes that
without notification of a pending transfer, families of someone
living with Alzheimer's disease could fear that their loved one
has wandered off, when in reality they have been transferred to
another health facility.
ASSEMBLY FLOOR : 75-0, 5/9/13
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,
Blumenfield, Bocanegra, Bonilla, Bonta, Bradford, Brown,
Buchanan, Ian Calderon, Campos, Chau, Ch�vez, Chesbro, Conway,
Cooley, Dahle, Daly, Dickinson, Eggman, Fong, Fox, Frazier,
Beth Gaines, Garcia, Gatto, Gomez, Gordon, Gorell, Gray,
Grove, Hagman, Hall, Harkey, Roger Hern�ndez, Jones,
Jones-Sawyer, Levine, Linder, Lowenthal, Maienschein, Mansoor,
Medina, Melendez, Mitchell, Morrell, Mullin, Muratsuchi,
Nazarian, Nestande, Olsen, Pan, Patterson, Perea, V. Manuel
P�rez, Quirk, Quirk-Silva, Rendon, Salas, Skinner, Stone,
Ting, Torres, Wagner, Weber, Wieckowski, Wilk, Williams,
Yamada, John A. P�rez
NO VOTE RECORDED: Donnelly, Holden, Logue, Waldron, Vacancy
JL:k 8/14/13 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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