BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                       AB 503


                                                                      Page  1





          ASSEMBLY THIRD READING


          AB  
          503 (Rodriguez)


          As Amended  March 23, 2015


          Majority vote


           -------------------------------------------------------------------- 
          |Committee       |Votes |Ayes                   |Noes                |
          |                |      |                       |                    |
          |                |      |                       |                    |
          |----------------+------+-----------------------+--------------------|
          |Health          |17-0  |Bonta, Maienschein,    |                    |
          |                |      |Bonilla, Burke,        |                    |
          |                |      |Chávez, Chiu, Gomez,   |                    |
          |                |      |Lackey, Nazarian,      |                    |
          |                |      |Patterson,             |                    |
          |                |      |Ridley-Thomas,         |                    |
          |                |      |Rodriguez, Santiago,   |                    |
          |                |      |Steinorth, Thurmond,   |                    |
          |                |      |Waldron, Wood          |                    |
          |                |      |                       |                    |
          |----------------+------+-----------------------+--------------------|
          |Appropriations  |16-0  |Gomez, Bigelow, Bonta, |                    |
          |                |      |Calderon, Chang, Daly, |                    |
          |                |      |Eggman, Gallagher,     |                    |
          |                |      |Eduardo Garcia,        |                    |
          |                |      |Holden, Jones, Quirk,  |                    |
          |                |      |Rendon, Wagner, Weber, |                    |
          |                |      |Wood                   |                    |
          |                |      |                       |                    |
          |                |      |                       |                    |
           -------------------------------------------------------------------- 








                                                                       AB 503


                                                                      Page  2







          SUMMARY:  Allows a health facility to release patient-identifiable  
          medical information to an emergency medical services (EMS)  
          provider and to a local emergency medical services agency (LEMSA)  
          when specific data elements are requested for the purpose of  
          quality assessment and improvement.  Requires the Emergency  
          Medical Services Authority (EMSA) to develop minimum standards for  
          the implementation of this data collection system.


          FISCAL EFFECT:  According to the Assembly Appropriations  
          Committee, this bill would have minor staff costs to EMSA to  
          revise existing regulations, estimated at around $20,000 (existing  
          federal grant funds).


          COMMENTS:  According to the author, prehospital providers of  
          emergency medical care or transport, such as ambulance companies,  
          need patient-identifiable outcomes in order to evaluate the  
          effectiveness of their clinical and operational procedures to  
          improve patient care and outcomes.  The author further states that  
          public policy should permit and encourage quality improvement and  
          systems effectiveness between hospitals and prehospital emergency  
          service providers.  The author argues that while federal law  
          allows this to occur, state law does not and this bill would allow  
          such disclosures to occur under state law.


          In 2012, EMSA received a grant from the California HealthCare  
          Foundation (CHCF) to increase the accessibility and accuracy of  
          prehospital data for public, policy, academic and research  
          purposes to facilitate system evaluation and improvement.  The  
          grant included a review of EMSA's existing system, the development  
          of a core measures program, and engagement with LEMSAs to  
          facilitate uniform reporting.  As part of the project, EMSA has  
          begun implementation of the new national data standards and  
          integrating electronic health information systems.









                                                                       AB 503


                                                                      Page  3






          The CHCF-funded projected revealed:  1) that the existing system  
          had a number of weaknesses that made it difficult for EMSA to  
          validate EMS information for reporting, impacting its suitability  
          for statewide sustainability and transition to the new national  
          data standards; 2) that variability in data collection methodology  
          (in some cases related to the use of paper vs. electronic patient  
          records) limited the usefulness of data submitted; and, 3) the  
          lack of hospital outcome data, particularly for cardiac arrest  
          cases limited the ability of LEMSAs to obtain universal outcome  
          data.  The capacity of the current system was also assessed by the  
          Health Services Advisory Group, an External Quality Review  
          Organization network contractor, which found similar weaknesses to  
          those identified in the CHCF core measures project.  The  
          recommendations for EMSA included better standardization of data  
          collection from LEMSAs.


          The sponsor of this bill, the California Hospital Association  
          (CHA), writes in support that prehospital EMS providers, such as  
          ambulance companies, need patient-identifiable outcome information  
          to evaluate the effectiveness of their clinical and operational  
          procedures to improve their patent safety and quality outcomes,  
          particularly for emergency services programs such as trauma,  
          stroke, and STEMI (ST segment elevation myocardial infarction - a  
          type of heart attack).  CHA maintains that public policy should  
          permit and encourage quality improvement activities between  
          providers and hospitals to improve quality and patient safety and  
          ultimately improve emergency patient survival rates.




          Analysis Prepared by:                                               
                          Patty Rodgers / HEALTH / (916) 319-2097  FN:  
          0000178











                                                                       AB 503


                                                                      Page  4