BILL NUMBER: AB 911 AMENDED
BILL TEXT
AMENDED IN SENATE JULY 2, 2009
AMENDED IN ASSEMBLY JUNE 1, 2009
INTRODUCED BY Assembly Member Lieu
(Coauthors: Assembly Members Eng and Price)
FEBRUARY 26, 2009
An act to add Section 1257.10 to add and
repeal Section 1257.10 of the Health and Safety Code, relating
to health facilities.
LEGISLATIVE COUNSEL'S DIGEST
AB 911, as amended, Lieu. Emergency rooms: overcrowding.
Existing law establishes various programs for the prevention of
disease and the promotion of health to be administered by the State
Department of Public Health, including, but not limited to, the
licensure and regulation of health facilities. Violation of these
provisions is a crime.
This bill would require every licensed general acute care
hospital with an emergency department to determine the range of
overcrowding scores, as defined, that constitute each category of the
overcrowding scale, as determined by the bill, for its emergency
department. The bill would require every licensed general acute
care hospital with an emergency department to calculate
and record a NEDOCS an overcrowding
score , as defined, every 4 hours, except as
specified, to assess the crowding condition of its emergency
department. The bill would require, by January 1, 2011, every
licensed general acute care hospital with an emergency
department to develop and implement a full-capacity protocol
for each of the categories of the overcrowding scale.
This bill would require every licensed general acute care hospital
with an emergency department to file its full-capacity
protocol with the Office of Statewide Health Planning and
Development, and to annually report revisions to its protocol.
The bill would repeal its provisions on January 1, 2014.
By changing the definition of an existing crime, this bill would
impose a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1257.10 is added to the Health and Safety Code,
to read:
1257.10. (a) For purposes of this section, a "NEDOCS
an "overcrowding score" means the score
calculated using the equation derived from the National
Emergency Department Overcrowding Study and is as follows:
85.8 (total number of patients within the emergency department/total
number of staffed beds in the emergency department ,
not to exceed the number of licensed beds ) + 600
(total number of admissions waiting in the emergency
department/total number of inpatient hospital beds) + 13.4 (total
department, including patients awaiting transfer/total
number of acute inpatient hospital beds routinely in use by the
hospital, excluding beds in the newborn nursery, neonatal intensive
care unit, and obstetrics) + 13.4 (total number of patients
on respirators in the emergency department
admitted to the intensive care unit ) + .93 (the longest admit
time, in hours , including transfers ) + 5.64 (the wait
time for the last patient called from triage
waiting the longest in the waiting room , in hours) - 20.
(b) For purposes of this section the "overcrowding scale" means
the range of NEDOCS a range of overcrowding
scores that are divided into the following categories:
(1) Not busy , which includes NEDOCS scores of 20 and
below .
(2) Busy , which includes NEDOCS scores of 21 to 60,
inclusive .
(3) Extremely busy , which includes NEDOCS scores of 61
to 100, inclusive .
(4) Overcrowded , which includes NEDOCS scores of 101 to
140, inclusive .
(5) Severely overcrowded , which includes NEDOCS scores
of 141 to 180, inclusive .
(6) Dangerously overcrowded , which includes NEDOCS scores
over 180 .
(c) Every licensed general acute care hospital with an emergency
department shall determine the range of overcrowding scores that
constitute each category of the overcrowding scale for its emergency
department.
(c)
(d) Every licensed general acute care hospital
with an emergency department shall calculate, and record,
a NEDOCS an overcrowding score every
four hours to assess the crowding condition of its emergency
department.
(d)
(e) (1) If, after calculating and recording a
NEDOCS an overcrowding score pursuant to
subdivision (c) (d) , a licensed
general acute care hospital does not record a NEDOCS
have an overcrowding score over 60 for the
previous 30 days, it may calculate and record a NEDOCS
an overcrowding score every eight hours rather
than every four hours.
(2) If a licensed general acute care hospital calculating and
recording a NEDOCS an overcrowding score
every eight hours pursuant to this subdivision scores over 60, it
shall again calculate and record a NEDOCS an
overcrowding score every four hours pursuant to
subdivision (c) (d) .
(e)
(f) Every licensed general acute care hospital
with an emergency department shall, by January 1, 2011, develop
and implement, in consultation with its emergency department staff,
a full-capacity protocol for each of the categories of the
overcrowding scale that addresses all of the following factors,
except that if any of these factors do not occur at the hospital, the
hospital may state in its protocol that the factor is not applicable
:
(1) Notification of hospital administrators, nursing staff,
medical staff, and ancillary services of category changes on the
overcrowding scale.
(2) Bed utilization.
(3) Diversion.
(4) Elective admissions.
(5) Transfers.
(6) Triage.
(7) Responsibilities of inpatient medical staff and specialty
service operations for rounds, discharges, coordination with the
emergency department, and emergency consults for emergency department
patients.
(8) Hospital unit operations.
(9) Nursing services.
(10) Supplies.
(11) Calling in additional medical, nursing, and ancillary staff.
(12) Space utilization, including, but not limited to, alternate
care sites.
(f)
(g) Every licensed general acute care hospital shall
file its full-capacity protocol with the Office of Statewide Health
Planning and Development and shall annually report any revisions to
its protocol.
(h) This section shall remain in effect only until January 1,
2014, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2014, deletes or extends
that date.
SEC. 2. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.