BILL ANALYSIS Ó
AB 1223
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB
1223 (O'Donnell)
As Amended June 30, 2015
Majority vote
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|ASSEMBLY: | 76-0 | (May 26, |SENATE: |38-0 | (August 31, |
| | |2015) | | |2015) |
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Original Committee Reference: HEALTH
SUMMARY: Requires the Emergency Medical Services Authority
(EMSA) to develop, using input from stakeholders, a statewide
standard methodology for the calculation and reporting of
patient offload time by local emergency medical services (EMS)
agencies. Defines "ambulance patient offload time" as the
interval between the arrival of a patient transported by
ambulance at an emergency department (ED) and the time that the
ED assumes responsibility for care of the patient. Allows a
local EMS agency to adopt policies and procedures for
calculating and reporting ambulance patient offload time, as
specified. Requires, if a local EMS agency adopts a policy for
calculating and reporting ambulance patient offload time, to
establish criteria for the reporting of, and quality assurance
follow-up for, a "nonstandard patient offload time."
The Senate amendments define "nonstandard patient offload time"
as an offload time that exceeds a period of time designated in
AB 1223
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the criteria established by the local EMS agency, but excludes
from this definition instances in which the offload times exceed
the designated period of time due to acts of God, natural
disasters, or manmade disasters.
FISCAL EFFECT: According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS: According to the author this bill provides a
definition for the term "ambulance patient offload time" and
requires EMSA to create a methodology that local EMS agencies
may use to create a policy for the measurement and reporting of
ambulance patient offload time appropriate for their region.
The author states this methodology will be devised using
stakeholder input and flexible enough to meet the unique needs
of each of the state's 33 local EMS agencies. The author argues
that delays in patient offload time are becoming more of a
problem than currently exists. A crucial first step in dealing
with this issue is to properly identify and define what the
issue is. The author concludes, this bill creates a common
definition and a standard way of measuring the problem across
the state, while allowing for the collection of the data needed
address it.
The California Fire Chiefs Association (CFCA), sponsor of this
bill, writes in support that current law requires EMS providers
when responding to 9-1-1 calls to deliver their patients to
licensed EDs. CFCA states that patients suffering from serious
medical conditions and those with only minor issues go through
the same process and are delivered to the same type of facility;
at the same time EDs are busier than ever, this means that EMS
responders are spending more time waiting to offload patients at
EDs and this bill seeks to help alleviate this problem by
requiring the adoption of a methodology to keep track of wait
times. CFCA indicates that it is vital that as EDs and EMS
providers take on a larger role in our healthcare system that
state statutory and regulatory frameworks are updated to reflect
reality. The California Professional Firefighters (CPF) also
write in support that this bill will establish an important
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first step in defining "wall time" within the context of
reducing or altogether eliminating wall time in our EMS system.
CPF further writes that while a patient waits to be admitted to
the hospital, EMS personnel responsible for his or her care
cannot respond to other emergency calls while waiting to
transfer the patient. According to CPF, not only does this
prevent a patient from receiving appropriate and immediate care,
it poses a public safety risk by having fewer qualified EMS
personnel available to respond to other emergencies.
The Riverside County Regional Medical Center and the Urban
Counties Caucus both write in opposition to the prior version of
this bill, that although reducing ambulance waiting times is an
important issue, local EMS agencies are currently working on a
project to try and address one facet of this issue and suggest a
local solution over a statewide construct, which may not work in
all counties.
Analysis Prepared by:
Patty Rodgers / HEALTH / (916) 319-2097 FN:
0001370