BILL ANALYSIS
AB 2153
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Date of Hearing: April 21, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 2153 (Lieu) - As Introduced: February 18, 2010
Policy Committee: Health Vote:18-1
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill requires each acute care hospital with an emergency
department to record an emergency department overcrowding score
by specified intervals and requires hospitals to develop a full
capacity protocol by January 1, 2012. This bill specifies the
overcrowding score calculation and exempts smaller emergency
departments from the overcrowding score provision.
FISCAL EFFECT
Unknown, likely minor costs to hospitals to periodically
calculate the overcrowding score and to implement the full
capacity protocol. This bill generally describes current
practice and policies for hospital emergency services. Many busy
emergency departments must assess capacity and patient flow
frequently to determine whether they should go on diversion, for
example, during which ambulances are redirected to other
hospitals.
COMMENTS
1)Rationale . This bill is sponsored by the American College of
Emergency Physicians, California Chapter (CalACEP) to increase
information about and hospital focus on strategies to relieve
overcrowding in California emergency departments. Hospitals
that have implemented similar protocols have seen a reduction
in overcrowding by focusing attention throughout a hospital on
moving patients to the most appropriate level of care in a
timely fashion and implementing varied strategies depending on
the seriousness of overcrowding.
2)Background . Emergency department boarding, a particular
problem and a contributor to crowding, occurs when a physician
has decided to admit a patient, but hospital units are unable
to admit the patient due to delays in discharges, testing, or
AB 2153
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other barriers to moving a patient to admission in a timely
way. The reasons for overcrowding are varied, including health
access problems of insured populations, lack of care for other
patients, the aging of the population, and frequent users of
health care. This bill requires hospitals to measure patient
volumes and wait times, to focus professionals throughout the
hospital on patient flow, and requires hospitals to plan
accordingly with respect to full capacity protocols.
3)Related Legislation . AB 911 (Lieu) in 2009 and AB 2207 (Lieu)
in 2007 were both similar to this bill. AB 911 was vetoed due
to concern it would provide no relief to overcrowded emergency
departments. AB 2207 was held on the Suspense File of this
committee. AB 2153, as currently in print, provides hospitals
with greater flexibility than either AB 911 or AB 2207
contained when heard in this committee.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081