BILL ANALYSIS Ó
AB 2743
Page 1
Date of Hearing: April 27, 2016
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
AB
2743 (Eggman) - As Amended April 18, 2016
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Urgency: No State Mandated Local Program: NoReimbursable: No
SUMMARY:
This bill requires the California Department of Public Health
(CDPH), on or before July 1, 2017, to establish and administer a
pilot program, in 10 specified contiguous northern California
counties, to create an Internet Web-site based electronic acute
psychiatric bed registry (registry) to collect aggregate data
and display information regarding the availability of acute
psychiatric beds in psychiatric facilities. It also:
AB 2743
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1)Requires specified facilities to report to the registry
regarding availability of beds.
2)Requires CDPH to issue a progress report and an evaluation
plan making recommendations for further implementation to the
Legislature, and sunsets the pilot January, 1, 2022.
FISCAL EFFECT:
1)Estimated one-time cost of $1 million in contract information
technology costs (Licensing and Certification Fund).
2)Annual ongoing contract funding for approximately $100,000 for
maintenance of the registry system, and $100,000 in staffing
costs (Licensing and Certification Fund).
3)Minor GF costs to the Department of State Hospitals for
training staff and reporting to the registry. State hospitals
are licensed as acute psychiatric facilities that would be
subject to the bill's requirements to use the registry.
However, only Napa State Hospital routinely accepts patients
in psychiatric crisis.
COMMENTS:
AB 2743
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1)Purpose. According to the author, a web-based psychiatric bed
registry would improve mental health service access by getting
patients dealing with mental health crises to the appropriate
professionals more quickly and streamlining communication and
reduce patient waiting time.
2)Background. Finding appropriate inpatient psychiatric care is
difficult for those in mental health crisis. According to 2011
OSHPD data analyzed by the California Hospital Association,
California has lost nearly 32%, or nearly 3,000 inpatient
psychiatric beds compared to 1995. California's bed rate is
one bed for every 5,975 people, as of 2011, compared to the
nation's average of one bed for every 4,758 people.
Additionally, 26 of California's 58 counties have no inpatient
psychiatric services. Other states have implemented similar
registries to track availability of inpatient psychiatric
beds, generally on a voluntary basis. Virginia, however,
recently implemented mandatory electronic reporting to such a
registry, which an independent evaluation noted had some
important strengths but also significant challenges and
limited impact in reducing wait times for locating facilities.
3)Support. The California Psychiatric Association (CPA), a
cosponsor of this bill, states California is one of 24 states
that lack a statewide computerized tracking database, or other
electronic system for the tracking of available psychiatric
beds in community-based hospitals. CPA argues that the need
is critical because the loss of about 3,000 California
psychiatric beds in the last two decades has made open beds
more difficult to find. The Steinberg Institute, also a
cosponsor of the bill, the California Chapter of the American
College of Emergency Physicians (Cal/ACEP), and other groups
write in support.
4)Opposition. The California Hospital Association (CHA) and
numerous individual hospitals oppose this bill, contending an
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electronic bed registry would do little to improve the
availability or access to inpatient beds for individuals in
need of emergency inpatient psychiatric care and would
redirect critical staff within the hospitals to administrative
functions and away from patient care. CHA argues that
"real-time" bed registries have been tried in other states
(both on a voluntary and mandated basis) and they have proven
to be very difficult to implement and have not shown
significantly improved efficiencies. CHA concludes that an
electronic registry would not remove the necessity for
professionals to call facilities with available beds to
ascertain appropriateness for the patient, the capability and
capacity of the facility, nor the need to work with the
individual and family to make treatment decisions.
Analysis Prepared by:Lisa Murawski / APPR. / (916)
319-2081