BILL ANALYSIS Ó
SB 145
Page 1
SENATE THIRD READING
SB
145 (Pan)
As Amended May 5, 2015
Majority vote
SENATE VOTE: 21-15
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Health |13-5 |Bonta, Maienschein, |Chávez, Lackey, |
| | |Bonilla, Burke, Chiu, |Patterson, |
| | |Gomez, Gonzalez, |Steinorth, Waldron |
| | |Roger Hernández, | |
| | |Nazarian, Rodriguez, | |
| | |Santiago, Thurmond, | |
| | |Wood | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Judiciary |8-2 |Mark Stone, Weber, |Wagner, Gallagher |
| | |Alejo, Chau, Chiu, | |
| | |Cristina Garcia, | |
| | |Maienschein, Thurmond | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Appropriations |12-5 |Gomez, Bloom, Bonta, |Bigelow, Chang, |
| | |Calderon, Gordon, |Gallagher, Jones, |
SB 145
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| | |Eggman, Eduardo |Wagner |
| | |Garcia, Holden, | |
| | |Quirk, Rendon, Weber, | |
| | |Wood | |
| | | | |
| | | | |
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SUMMARY: Prohibits a general acute care hospital, acute
psychiatric hospital, or special hospital from transporting a
patient, who in the judgment of the attending physician or other
licensed health care professional is at risk of serious injury
or death as a result of clinical alcohol intoxication, to any
other location including but not limited to, police custody, a
correctional facility, or a county jail, unless the patient is
medically stable or appropriately transferred to another
licensed health facility. Allows the State Department of Public
Health (DPH) to determine if a violation of this bill
constitutes an immediate jeopardy violation and if so, to assess
penalties accordingly. Prohibits anything in this bill from
being construed to contradict any other law related to workplace
violence prevention, including, but not limited to, workplace
violence standards adopted by the Occupational Safety and Health
Standards Board.
FISCAL EFFECT: According to the Assembly Appropriations
Committee, minor and absorbable fiscal impact to DPH, if any.
COMMENTS: According to the author, certain hospitals are
transferring patients admitted to their ER for acute alcohol
poisoning to police departments, corrections facilities, and
county jails by calling 911. The author states this bill stops
a practice that poses a risk to patient safety, prevents the
cost and liabilities of the treating hospitals' emergency
patients from being wrongly shifted to the police and correction
facilities, and preserves 911 calls for true emergencies.
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Blood alcohol concentration. The amount of alcohol in a
person's body is measured by the weight of the alcohol in a
certain volume of blood. This is called the blood alcohol
concentration (BAC). It is illegal to drive with a BAC of 0.08
or higher. A driver also can be arrested with a BAC below 0.08
when a law enforcement officer has probable cause, based on the
driver's behavior. BAC may be affected by age, gender, physical
condition, amount of food consumed, and any drugs or medication.
According to information provided by the author and the Service
Employees International Union - United Healthcare Workers West
(SEIU-UHW), for the first three months of 2014, 124 emergency
calls came from Shasta Regional Medical Center, a Prime
Healthcare hospital in Redding, California, which averages to
about 41 such calls per month. In comparison, a hospital
operated by Dignity Health, about two miles away from Shasta
Regional Medical Center, only made 53 emergency calls in the
first nine months of 2014, or about six per month.
Emergency Medical Treatment and Active Labor Act (EMTALA).
EMTALA is an act of the United States Congress, passed in 1986
as part of the Consolidated Omnibus Budget Reconciliation Act.
It requires hospitals that accept payments from Medicare to
provide emergency health care treatment to anyone needing it
regardless of citizenship, legal status, or ability to pay.
There are no reimbursement provisions. Participating hospitals
may not transfer or discharge patients needing emergency
treatment except with the informed consent or stabilization of
the patient or when their condition requires transfer to a
hospital better equipped to administer the treatment. EMTALA
applies to "participating hospitals." The statute defines
participating hospitals as those that accept payment from the
Department of Health and Human Services, Centers for Medicare
and Medicaid Services under the Medicare program. Because there
are very few hospitals that do not accept Medicare, the law
applies to nearly all hospitals.
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EMTALA was passed to address the problem of hospitals refusing
to treat indigent, uninsured, or Medicaid patients, or "dumping"
these patients by transferring them to county hospitals or other
charity hospitals.
SEIU-UHW writes there is substantial evidence that one of
California's largest hospital chains - Prime Healthcare Services
- is inappropriately and dangerously transferring patients
admitted to the ER for acute alcohol poisoning to police
departments, corrections facilities, and county jails by calling
911. SEIU-UHW states this practice by a for-profit health care
provider poses a risk to patient safety and improperly shifts
costs and liabilities to the police and corrections facilities.
United Nurses Associations of California/Union of Health Care
Professionals (UNAC/UHCP) states that discharging patients with
high blood alcohol levels and transferring them to jail in a
police car is dangerous to patients. Hospitals are required to
provide stabilizing treatment for patients experiencing an
emergency medical condition, and in the case of patients who
require emergency services because of very high BAC levels, the
hospital must stabilize the patient before attempting to make
any transfer. UNAC/UHCP concludes any practice or policy of
transferring patients prior to stabilization is unconscionable.
The California Hospital Association (CHA) is opposed to this
bill and states the current version of this bill restates a
prohibition that is already in both state and federal law. CHA
notes that, initially, this bill would have established
prescriptive clinical criteria that would have overridden the
judgment of physicians, nurses and other medical staff in
California's emergency departments. CHA concludes that the
current version of this bill now creates a duplicative mandate
on hospitals and authorizes DPH to issue penalties it already
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has the authority to impose.
Analysis Prepared by:
Lara Flynn / HEALTH / (916) 319-2097 FN:
0001559