BILL ANALYSIS Ó AB 2260 Page 1 ASSEMBLY THIRD READING AB 2260 (Wood) As Amended May 27, 2016 Majority vote ------------------------------------------------------------------ |Committee |Votes|Ayes |Noes | | | | | | | | | | | | | | | | |----------------+-----+----------------------+--------------------| |Health |19-0 |Wood, Maienschein, | | | | |Bonilla, Burke, | | | | |Campos, Chiu, | | | | |Dababneh, Gomez, | | | | | | | | | | | | | | |Roger Hernández, | | | | |Lackey, Nazarian, | | | | |Olsen, Patterson, | | | | |Ridley-Thomas, | | | | |Rodriguez, Santiago, | | | | |Steinorth, Thurmond, | | | | |Waldron | | | | | | | |----------------+-----+----------------------+--------------------| |Appropriations |20-0 |Gonzalez, Bigelow, | | | | |Bloom, Bonilla, | | | | |Bonta, Calderon, | | | | |Chang, Daly, Eggman, | | | | |Gallagher, Eduardo | | AB 2260 Page 2 | | |Garcia, Roger | | | | |Hernández, Holden, | | | | |Jones, Obernolte, | | | | |Quirk, Santiago, | | | | |Wagner, Weber, Wood | | | | | | | | | | | | ------------------------------------------------------------------ SUMMARY: Requires the Emergency Medical Services Authority (EMSA) to, before January 1, 2018, determine a single set of data elements and formatting for air ambulance providers to submit to local emergency medical services agencies (LEMSAs). Specifically, this bill: 1)Requires EMSA to convene interested stakeholders for the purpose of determining the single set of data elements and formatting. Specifies that the stakeholders include representatives of LEMSAs, air ambulance providers, and EMSA, and allows EMSA to reconvene the stakeholders annually to modify the elements and formatting of the data. 2)Requires the data elements and formatting to comply with the National EMS Information System (NEMSIS) and California EMS Information System (CEMSIS) electronic health record. 3)Prohibits EMSA from requiring an air ambulance provider to use a specific electronic health record system to collect and share data with LEMSAs. 4)Requires air ambulance providers, in addition to submitting data to LEMSAs, to submit data directly to EMSA if requested. AB 2260 Page 3 5)Requires air ambulance providers, when submitting data to the LEMSA, to ensure that the electronic health record system can be integrated with the LEMSA's NEMSIS and CEMSIS compliant data system, so the LEMSA can collect data from the provider. 6)Prohibits a LEMSA from requiring additional data elements or formatting from an air ambulance provider, once the single set of data elements and formatting has been established as described in 1) above. FISCAL EFFECT: According to the Assembly Appropriations Committee, one-time General Fund (GF) cost pressure for staff and consulting costs of $100,000 per year for two years, to support the stakeholder and regulatory process to create standardized data elements. If EMSA's Information Technology (IT) systems need to be modified in order to handle increased data reporting as a result developing standardized data elements specific to air ambulance providers, potential GF cost pressure in the range of $350,000 for IT changes. The current CEMSIS is already compatible with national standards, but may need to be customized to allow additional data elements to be reported. This cost estimate is approximate; the need for IT changes, the extent of changes, and the corresponding costs would depend on the outcome of the data standardization effort required by this bill. COMMENTS: According to the author, air ambulance providers are essential EMS providers who provide services on a regional or statewide basis, crossing county and local EMS authority lines on a regular basis. All pre-hospital providers must submit incident and patient data information to the LEMSA with jurisdiction over each service call. As a result of the multiple LEMSAs, air ambulance providers submit patient data to multiple providers. This can be duplicative, and often the data is not requested or reported in a uniform manner. This duplication places a significant financial burden on air AB 2260 Page 4 ambulance providers, which this bill will ease by requiring the submission of a single data set in a consistent format. EMSA is charged with providing leadership in developing and implementing EMS systems throughout California and setting standards for the training and scope of practice of various levels of EMS personnel. The 33 LEMSAs throughout the state are responsible for planning, implementing, and managing local trauma care systems, including assessing needs, developing the system design, designating trauma care centers, collecting trauma care data, and quality assurance. Air ambulances provide services on a regional or statewide basis. For any given emergency air transport, there may be up to three different LEMSA jurisdictions involved, including the LEMSA where the Air Ambulance is based; the LEMSA where the patient was picked up; and, the LEMSA where the receiving hospital is located. All of these LEMSAs may have a reasonable basis for obtaining and reviewing the electronic health record. A single helicopter base may provide services to and from more than 10 different LEMSAs. A single helicopter provider with multiple bases may, over the course of the year, provide services to and from the majority of the 33 LEMSAs. NEMSIS was formed in 2001 by the National Association of State EMS Directors. 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. 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. 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 AB 2260 Page 5 to digital tools for running comprehensive reports on their own data at no cost. Existing law requires an EMS provider to use an electronic health record system that exports data in a format that is compliant with the current versions of CEMSIS and NEMSIS and includes the data elements that are required by the LEMSA, and specifies that a LEMSA must not mandate that a provider use a specific system to collect and share the data. As noted by the author and sponsors, many LEMSAs have different data reporting requirements. Analysis Prepared by: Lara Flynn / HEALTH / (916) 319-2097 FN: 0003226