BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          AB 2260 (Wood) - Emergency medical services
          
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          |Version: May 27, 2016           |Policy Vote: HEALTH 9 - 0       |
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          |Urgency: No                     |Mandate: No                     |
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          |Hearing Date: August 1, 2016    |Consultant: Brendan McCarthy    |
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          This bill meets the criteria for referral to the Suspense File.

          Bill  
          Summary:  AB 2260 would require the state Emergency Medical  
          Services Authority to determine a single set of data elements to  
          be used by air ambulance providers to submit data to local  
          emergency medical services agencies.


          Fiscal  
          Impact:  
           One-time costs of $130,000 over two years for development of  
            the required data elements, consultation with stakeholders,  
            and adoption of regulations by the Emergency Medical Services  
            Authority (General Fund).

           Potential one-time costs of about $500,000 for information  
            technology system changes, if the Emergency Medical Services  
            Authority adopts set of data elements that would require  
            modification of its information technology systems used to  
            accept data from local emergency medical services authorities  
            and EMS providers (General Fund). Whether or not the Authority  
            will incur significant information technology costs will  
            depend on the specifics of the data elements that are  







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            developed through the required process.

           Unknown reimbursable mandate costs to the state from local  
            emergency medical services agencies who would be required to  
            upgrade their electronic record systems to comply with the  
            data standards adopted by the Emergency Medical Services  
            Authority under the bill (General Fund). Depending on the data  
            elements adopted by the Authority, local agencies may need to  
            make significant upgrades to their electronic record systems  
            to accept the data reported by EMS providers. Depending on the  
            size of the local agency, those costs could be in the tens of  
            thousands for a small agency to over $1 million for a large  
            agency. If significant upgrades are required, those agencies  
            could file a mandate claim with the state. 


          Background:  Under current law, the Emergency Medical Services Authority is  
          required to develop planning guidelines for emergency medical  
          services, including training requirements for emergency medical  
          service personnel. 

          Current law authorizes counties to develop emergency medical  
          services programs and designate a Local Emergency Medical  
          Services Agency to oversee the local system. Current law  
          requires emergency medical services providers to report data to  
          their Local Emergency Medical Services Agency, following  
          specified requirements.


          Proposed Law:  
            AB 2260 would require the state Emergency Medical Services  
          Authority to determine a single set of data elements to be used  
          by air ambulance providers to submit data to local emergency  
          medical services agencies.
          Specific provisions of the bill would:
           Require the Authority to determine a single set of data  
            elements and formatting for air ambulances to submit to local  
            emergency medical services agencies, by January 1, 2018;
           Require the Authority to convene stakeholders regarding the  
            data elements and formatting;
           Require the data elements and formatting to be compatible with  
            both the National EMS Information System (NEMSIS) and the  
            California EMS Information Sharing System (CEMSIS);
           Prohibit the Authority from requiring an air ambulance  








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            provider to use a specific electronic health record system;
           Require air ambulance providers to submit data directly to the  
            Authority, upon request;
           Prohibit local emergency medical services agencies from  
            requiring additional data from air ambulance providers.


          Related  
          Legislation:  
           AB 1129 (Burke, Statutes of 2015) requires emergency medical  
            services providers to use an electronic system compatible with  
            NEMSIS and CEMSIS when reporting data to local emergency  
            medical services agencies.
           AB 1621 (Lowenthal, 2014) would have required the Emergency  
            Medical Services Authority to adopt a single, statewide  
            standard for the collection of data relating to prehospital  
            care and would have required local emergency medical services  
            authorities to submit data to the authority using the  
            standard. That bill was held on this committee's Suspense  
            File.


          Staff  
          Comments:  This bill is not keyed as imposing a mandate on local  
          governments. However, the Emergency Medical Services Authority  
          has statutory authority to develop planning and implementation  
          guidelines for the state's emergency medical services system. To  
          the extent that the Authority adopts the required data elements  
          and formatting through the regulatory process and requires EMS  
          providers to use those data elements to report to local  
          emergency medical services authorities, local agencies may face  
          information technology costs to upgrade their existing systems.  
          Local agencies that experience significant costs to do so are  
          likely to file a reimbursable mandate claim with the Commission  
          on State Mandates.
          Under current law, EMS providers are required to use electronic  
          health record systems that are compliant with state and national  
          standards. The Emergency Medical Services Authority is in the  
          process of working with stakeholders to develop policies and  
          recommendations to improve EMS data collection for all types of  
          EMS services. 











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