BILL ANALYSIS Ó AB 1129 Page 1 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 | | | | | | | | | | | | ----------------------------------------------------------------- AB 1129 Page 2 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 AB 1129 Page 3 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 AB 1129 Page 4 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 AB 1129 Page 5