BILL ANALYSIS                                                                                                                                                                                                    



                                                                AB 911
                                                                Page  1

        CONCURRENCE IN SENATE AMENDMENTS
        AB 911 (Lieu)
        As Amended September 4, 2009
        Majority vote
         
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        |ASSEMBLY:  |45-31|(June 3, 2009)  |SENATE: |32-3 |(September 9,  |
        |           |     |                |        |     |2009)          |
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         Original Committee Reference:   HEALTH  

         SUMMARY  :  Requires every licensed general acute care (GAC) hospital  
        with an emergency department (ED) to assess ED crowding conditions  
        every four or eight hours, as well as develop and implement  
        full-capacity protocols that address staffing, procedures, and  
        operations.

         The Senate amendments  :

        1)Delete the requirement to calculate a National Emergency  
          Department Overcrowding Scale known as the NEDOCS score and  
          instead require calculation of a crowding score using the modified  
          formula in 2) below.

        2)Modify the formula to calculate ED crowding conditions by  
          clarifying and refining terms used in the calculation, and  
          deleting the cap of 200 on the calculated crowding score.

        3)Modify the six categories into which crowding scores are divided  
          by removing prescriptive ranges for each category and instead  
          requiring each GAC hospital to determine the range of scores  
          appropriate for each category.

        4)Allow a GAC hospital with fewer than 14,000 ED visits annually to  
          calculate crowding scores daily between 4 p.m. and 8 p.m., instead  
          of every four or eight hours.

        5)Add a January 1, 2014 sunset date.

         AS PASSED BY THE ASSEMBLY  , this bill was substantially similar to  
        the version passed by the Senate.

         FISCAL EFFECT  :  According to the Senate Appropriations Committee:









                                                                AB 911
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        1)Minor and absorbable costs to the California Department of Public  
          Health to check for hospital compliance with the provisions of  
          this bill.

        2)Minor and absorbable costs to the Office of Statewide Health  
          Planning and Development to accept and file full-capacity  
          protocols developed by hospitals.

        3)Unknown, potentially significant costs or savings to Medi-Cal,  
          Healthy Families, and other publicly-funded health programs, to  
          the extent ED efficiencies reduce wait times, resulting in more  
          publicly-funded patients being served and/or having improved  
          health outcomes.


         Analysis Prepared by  :    Joyce Iseri / HEALTH / (916) 319-2097        
             
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