BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      AB 1129


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          ASSEMBLY THIRD READING


          AB  
          1129 (Burke)


          As Amended  May 4, 2015


          Majority vote


           ----------------------------------------------------------------- 
          |Committee       |Votes |Ayes                |Noes                |
          |                |      |                    |                    |
          |                |      |                    |                    |
          |----------------+------+--------------------+--------------------|
          |Health          |16-0  |Bonta, Maienschein, |                    |
          |                |      |Burke, Chávez,      |                    |
          |                |      |Chiu, Gomez,        |                    |
          |                |      |Gonzalez, Lackey,   |                    |
          |                |      |Nazarian,           |                    |
          |                |      |Patterson,          |                    |
          |                |      |Ridley-Thomas,      |                    |
          |                |      |Rodriguez,          |                    |
          |                |      |Santiago, Thurmond, |                    |
          |                |      |Waldron, Wood       |                    |
          |                |      |                    |                    |
          |----------------+------+--------------------+--------------------|
          |Privacy         |11-0  |Gatto, Wilk, Baker, |                    |
          |                |      |Calderon, Chang,    |                    |
          |                |      |Chau, Cooper,       |                    |
          |                |      |Dababneh, Dahle,    |                    |
          |                |      |Gordon, Low         |                    |
          |                |      |                    |                    |
          |                |      |                    |                    |
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                                                                      AB 1129


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          SUMMARY:  Requires an emergency medical services (EMS) provider,  
          when collecting and submitting data to with a local emergency  
          medical services agency (LEMSA), to use a system compatible with  
          California Emergency Medical Services Information System (CEMSIS)  
          and National Emergency Medical Services Information System  
          (NEMSIS) standards, as specified, and includes those data elements  
          that are required by the LEMSA.  Prohibits a LEMSA from mandating  
          that an EMS provider use a specific system to collect and share  
          this data.


          FISCAL EFFECT:  None


          COMMENTS:  According to the author, current law authorizes LEMSAs  
          to plan, implement, and oversee day-to-day EMS in California.  In  
          order to monitor local EMS providers and services, LEMSAs collect  
          data from those providers.  The author further states, as local  
          providers have shifted to electronic patient records; the  
          potential for better analysis of EMS has increased.  LEMSAs are  
          able to provide the data they collect from EMS providers to the  
          Emergency Medical Services Authority (EMSA) through CEMSIS  
          compatible software.  Although the software and hardware must be  
          compatible with CEMSIS, there are many different systems in use  
          and many more available.  The author explains that without  
          guidelines in law, LEMSAs are able to require EMS providers in  
          their jurisdiction to purchase specific software or hardware for  
          data collection.  Requiring providers that cover multiple counties  
          or contract with multiple LEMSAs to purchase specific software  
          and/or hardware can be an unnecessary and costly burden.  The  
          author asserts existing law is silent on whether or not a LEMSA  
          can require a specific hardware or software provider for EMS  
          providers in their jurisdiction.




          NEMSIS was formed in 2001 by the National Association of State EMS  








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          Directors, in conjunction with the National Highway Traffic Safety  
          Administration and the Trauma/EMS Systems program of the Health  
          Resources and Services Administration's Maternal Child Health  
          Bureau, in order to develop a national EMS database.  NEMSIS is  
          the national repository that will be used to potentially store EMS  
          data from every state in the nation, and was developed to help  
          states collect more standardized elements to allow submission to  
          the national database.




          According to EMSA, CEMSIS is a demonstration project for improving  
          EMS data analysis across California. CEMSIS offers a secure,  
          centralized data system for collecting data about individual EMS  
          requests, patients treated at hospitals, and EMS provider  
          organizations.  EMSA states that at least 14 of California's 33  
          LEMSAs currently send a variety of local data collections to  
          CEMSIS on a voluntary basis, and in return, these local agencies  
          gain access to digital tools for running comprehensive reports on  
          their own data at no cost.




          EMSA states when fully operational with 100% local participation,  
          it is estimated that CEMSIS will catalogue more than 3 million EMS  
          events per year.  According to EMSA, it will use the data to  
          develop and coordinate high quality emergency medical care in  
          California through activities such as healthcare quality programs  
          that monitor patient care outcomes, agency collaboration across  
          jurisdictional boundaries, and public health surveillance.




          On October 1, 2014, the NEMSIS Technical Advisory Committee  
          announced that California was the first state to successfully  
          transmit NEMSIS Version 3 EMS data to the national repository  








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          using field and state level software "certified compliant".   
          NEMSIS Version 3, provides a set of tools that EMS professionals  
          can use to integrate EMS patient care data with electronic medical  
          records at hospitals, leading to better patient outcomes and a  
          smarter system of care.


          The California Ambulance Association, the sponsor of this bill,  
          along with the Los Angeles County Ambulance Association, and  
          several ambulance providers write in support of this bill.   
          Supporters state that the growing practice of LEMSAs to direct or  
          require EMS providers in their region to purchase and employ  
          specific software vendors undermines the purpose of a universal  
          standard allowing providers to use whatever system is most  
          efficient and effective for their area of operation, so long as it  
          complies with the universal standard.  Supporters write that there  
          are numerous programs and vendors compatible with NEMSIS standards  
          that can facilitate the exchange of healthcare information between  
          the state and federal data repositories.


          The Emergency Medical Services Administrators Association of  
          California and the EMS Medical Directors Association of California  
          are both opposed to this bill, unless it is amended.  The  
          opposition writes that although they are supportive of the concept  
          of the use of electronic EMS data, they are opposed to the  
          prohibition of LEMSAs mandating specific data collection systems.   
          According to the opposition, while it is uncommon for a LEMSA to  
          require a single system-wide patient care record system, such an  
          approach could be in the best interest of patients to assure the  
          transfer and continuity of patient care data from prehospital  
          providers, receiving hospitals, and specialty care centers.




          Analysis Prepared by:                                               
                          Patty Rodgers / HEALTH / (916) 319-2097  FN:  
          0000322








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