BILL ANALYSIS
AB 911
Page 1
GOVERNOR'S VETO
AB 911 (Lieu)
As Amended September 4, 2009
2/3 vote
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|ASSEMBLY: |45-31|(June 3, 2009) |SENATE: |32-3 |(September 9, |
| | | | | |2009) |
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|ASSEMBLY: |79-0 |(September 10, | | | |
| | |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
AB 911
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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:
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.
GOVERNOR'S VETO MESSAGE :
I agree with the author and sponsors that emergency
room overcrowding is a significant crisis facing our
healthcare delivery system in California. Although I
support the intent behind this bill, statute is not
necessary and I do not believe it will provide any
significant improvement to the underlying problem.
Hospitals and emergency room physicians have a strong
and compelling interest to reduce emergency room
overcrowding. I would encourage them to use the
crowding score outlined in this bill and work to
develop full-capacity protocols that best address
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their individual hospital needs.
Analysis Prepared by : Marjorie Swartz / HEALTH / (916)
319-2097
FN: 0003399