BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Elaine K. Alquist, Chair


          BILL NO:       AB 2153                                      
          A
          AUTHOR:        Lieu                                         
          B
          AMENDED:       As Introduced                               
          HEARING DATE:  June 16, 2010                                
          2
          CONSULTANT:                                                 
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          Tadeo                                                       
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                          3                              
                                     SUBJECT
                                         
                            Emergency room crowding

                                     SUMMARY  

          Requires, until January 1, 2015, every licensed general  
          acute care hospital to assess the condition of its  
          emergency department (ED), using a crowding score, every  
          four or eight hours, and to develop and implement capacity  
          protocols for overcrowding.  Requires, by January 1, 2012,  
          every licensed general acute care hospital that operates an  
          ED, to develop and implement full capacity protocols.   
          Requires the full capacity protocols to be filed with the  
          Office of Statewide Health Planning and Development.

                             CHANGES TO EXISTING LAW  

          Existing law:
          Provides for the licensing and regulation of health  
          facilities, including general acute care hospitals, acute  
          psychiatric hospitals, and special hospitals by the  
          Department of Public Health (DPH).

          Defines a general acute care hospital as a health facility  
          having a duly constituted governing body with overall  
          administrative and professional responsibility and an  
          organized medical staff that provides 24-hour inpatient  
                                                         Continued---



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          care, including medical, nursing, surgical, anesthesia,  
          laboratory, radiology, pharmacy and dietary services.

          Permits hospitals to provide emergency medical services,  
          under specified circumstances.

          Establishes the Office of Statewide Health Planning and  
          Development (OSHPD) to analyze California's health care  
          infrastructure, provide information about health care  
          outcomes, assure the safety of buildings used in providing  
          health care, insure loans to encourage the development of  
          health care facilities, and facilitate development of  
          sustained capacity for communities to address local health  
          care issues.

          

          This bill:
          Requires, until January 1, 2015, every licensed general  
          acute care hospital with an emergency department (ED) to  
          assess ED overcrowding every four or eight hours, as well  
          as develop and implement full-capacity protocols that  
          address staffing, procedures, and operations when an ED is  
          overcrowded.  

          Defines "crowding score" as the score calculated to measure  
          ED and hospital overcrowding, with an equation, as  
          specified, using the following variables:
                 Total number of patients within the ED;
                 Total number of staffed beds in the ED, not to  
               exceed the number of licensed beds;
                 Total number of admissions waiting in the ED,  
               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;
                 Total number of patients in the ED admitted to the  
               intensive care-critical care unit;
                 The longest admit time, in hours, including  
               transfers; and,
                 The wait time for the last patient waiting the  
               longest in the waiting room, in hours.

          Defines "crowding scale" as the range of crowding scores  




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          that are divided into six categories of which level one  
          represents the lowest level of crowding and level six  
          represents the highest.

          Requires every licensed general acute care hospital that  
          operates an ED to determine a range of crowding scores that  
          constitutes each category of the crowding scale for its ED.

          Requires every licensed general acute care hospital that  
          operates an ED to assess the condition of its ED by  
          calculating and recording a crowding score a minimum of  
          every four hours or, if after calculating and recording a  
          crowding score less than level four for the previous thirty  
          days, calculating and recording a crowding score a minimum  
          of every eight hours.

          Provides that every licensed general acute care hospital  
          that has an ED and a census of 14,000 visits annually to  
          calculate and record the crowding score daily between 4:00  
          p.m. and 8:00 p.m.

          Requires, by January 1, 2012, every licensed general acute  
          care hospital that operates an ED, to develop and  
          implement, in consultation with its ED staff, a  
          full-capacity protocol for each of the categories of the  
          crowding scale that addresses all of the following factors:
                 Notification of hospital administrators, nursing  
               staff, medical staff, and ancillary services of  
               category changes on the scale;
                 Hospital operations, including bed utilization,  
               transfers, elective admissions, discharges, supplies,  
               and additional staffing;
                 Emergency department operations, including  
               diversion, triage, and alternative care sites; and,
                 Planned response, if the organized medical staff by  
               the hospital for rounds discharges, coordination with  
               the ED and emergency consults for ED patients.

          Requires every licensed general acute care hospital that  
          operates an ED to file its full-capacity protocols with the  
          Office of Statewide Health Planning and Development  
          (OSHPD), and annually report any revisions to its  
          protocols.
                                         
                                 FISCAL IMPACT  




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          According to the Assembly Appropriations Committee analysis  
          of AB 2153, the fiscal impact of this bill is unknown.  The  
          analysis states that AB 2153 would likely create minor  
          costs to hospitals to periodically calculate the  
          overcrowding score and to implement the full capacity  
          protocol; but that this bill generally describes current  
          practice and policies for hospital emergency services.  The  
          analysis points out that many busy EDs 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.

                            BACKGROUND AND DISCUSSION  

          According to the author, California emergency departments  
          are dangerously overcrowded and have reached a crisis  
          level, ranking last in the nation in the number of  
          emergency rooms available to its residents.  The author  
          states that California provides only six emergency rooms  
          for every one million persons.  The author argues that the  
          common misconception surrounding emergency department  
          overcrowding links congestion with non-urgent patients and  
          the uninsured, when the real reason for this congestion is  
          that hospitals keep patients who need hospitalization in  
          the emergency room until a hospital bed becomes available,  
          a practice known as boarding a patient.  

          The author states that there are reported cases in which  
          patients have been boarded in hallways or waiting rooms for  
          up to 24 hours before they are admitted into the inpatient  
          unit of the hospital.  The author further states that, the  
          use of an overcrowding score known as the NEDOCS score,  
          similar to the crowding score proposed in this bill, and a  
          subsequent full capacity protocol plan, at LAC/USC Medical  
          Center have significantly reduced wait times and patient  
          boarding.  The author contends that this approach would  
          work on a statewide level, and that AB 2153 does not  
          require the same full capacity protocol plan for all  
          hospitals; instead, each facility would come up with a plan  
          that works for that particular hospital.  

          The crowding tool proposed in AB 2153 was developed by the  
          American College of Emergency Physicians, State Chapter of  
          California (CAL/ACEP), sponsor of the bill, the California  




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          Hospital Association (CHA), and the California Emergency  
          Nurses Association.  According to CHA, the three  
          organizations hosted an online forum in April  to educate  
          hospitals about the use of this innovative tool and to seek  
          their participation in a three-month pilot to evaluate its  
          efficacy.  CHA will be evaluating results of the pilot to  
          identify if this tool can assist hospitals in objectively  
          determining the amount of ED crowding and assist in the  
          development of full capacity protocols. 


          A 2003 U.S. General Accounting Office analysis of emergency  
          department overcrowding (GAO report), reported that  
          overcrowding is a problem that has reached historic levels  
          and can be attributed to a number of factors.  The report  
          found that the single most common variable linked to  
          emergency room overcrowding was the growing problem of  
          boarding patients who were already screened and stabilized  
          by emergency staff, until inpatient beds were available.   
          The GAO report maintains that when emergency departments  
          saturate because of patients waiting for beds and nurses to  
          become available on inpatient units, emergency waiting  
          rooms become overcrowded, wait times increase, and there is  
          a greater risk for poor health outcomes.  According to the  
          GAO report, this leads to temporary closure of crowded  
          emergency departments to inbound ambulance traffic, a  
          process known as diversion, which increases travel time as  
          ambulance drivers seek other hospitals to which they can  
          transport their patients.

          According to a 2007 Institute of Medicine report,  
          "Hospital-Based Emergency Care:  At the Breaking Point"  
          (IOM report), despite the lifesaving feats performed every  
          day by emergency departments and ambulance services, the  
          nation's emergency medical system as a whole is  
          overburdened, underfunded, and highly fragmented.  As a  
          result, according to the IOM report, ambulances are turned  
          away from emergency departments once every minute on  
          average, and patients in many areas may wait hours or even  
          days for a hospital bed.  Moreover, the IOM report  
          maintains, the system is ill prepared to handle surges from  
          disasters such as hurricanes, terrorist attacks, or disease  
          outbreaks.  The IOM report called for the strengthening of  
          The Joint Commission standards that address emergency  
          department overcrowding, boarding, and diversion.




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          According to information posted on the American Academy of  
          Emergency Medicine website, the Joint Commission issued an  
          important guideline on emergency department overcrowding,  
          in 2004.  The website states that the Joint Commission  
          guidelines recognize the link between overcrowding and  
          quality.  While the guidelines do not call for hospitals to  
          have explicit policies to alleviate overcrowding, they do  
          call for hospitals to have a plan for surge capacity in  
          place, and to provide a level of service to boarded  
          patients comparable to that which they would receive in an  
          inpatient unit.  

          Prior legislation
          AB 911 (Lieu) of 2009 contained provisions identical to  
          those contained in this bill and was vetoed by Governor  
          Schwarzenegger.  In his veto address the Governor stated,  
          that, although he supports the intent behind the bill, it  
          is not necessary and he does not believe it would  provide  
          any significant improvement to the underlying problem.  The  
          Governor further encouraged hospitals to use the crowding  
          score outlined in the bill and work to develop  
          full-capacity protocols that best address their individual  
          hospital needs.
          
          AB 2207 (Lieu) of 2008  would have required hospitals to  
          assess the condition of an emergency room via the NEDOCS  
          score every three hours and would have authorized hospitals  
          to use hallways, conference rooms, and waiting rooms as  
          temporary patient areas pursuant to hospital full capacity  
          protocols.  This bill was held in the Assembly  
          Appropriations Committee.

          


          Arguments in support
          The American College of Emergency Physicians, California  
          State Chapter (CAL/ACEP), sponsor of this bill states that  
          AB 2153 provides an opportunity to relieve ED overcrowding  
          that is simple, has a proven, successful track record, and  
          doesn't require additional funding from the state or  
          hospitals.  CAL/ACEP notes that LA County/USC hospital,  
          with the largest ED in the state, implemented this approach  
          at no additional cost and experienced a dramatic reduction  




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          in ED overcrowding. 

          Arguments in opposition
          According to the Department of Public Health (DPH), there  
          is currently no evidence that using the crowding score  
          prescribed in this bill is effective or that it would  
          address the causative factors of ED overcrowding.  DPH  
          states that the scoring system would not necessarily  
          prevent ED overcrowding, and would take providers away from  
          patient care, further prolonging wait times.  DPH notes  
          that Governor Schwarzenegger vetoed AB 911 in 2009, which  
          is identical to AB 2153.  

          The San Bernardino County Board of Supervisors (SBCBS)  
          states that there is no evidence that using a scoring tool  
          is effective and would work for California.  The SBCBS  
          notes that overcrowding assessments in EDs are already  
          conducted and that there is insufficient evidence to show  
          that using a scoring tool would have any impact on  
          improving ED overcrowding.  According to SBCBS, Arrowhead  
          Regional Medical Center, San Bernardino County's  public  
          hospital, already employs an effective system to avoid ED  
          overcrowding, and feels the mandated tool in this bill  
          would impose an unnecessary and unfunded state mandate.  


                                  PRIOR ACTIONS

           Assembly Health Committee          18-1
          Assembly Appropriations Committee17-0
          Assembly Floor           68-2


                                    POSITIONS  
                                        
          Support:  American College of Emergency Physicians,  
          California State Chapter 
                                (sponsor) 
                           California Medical Association
                           California Ambulance Association
                           
          Oppose:  Department of Public Health 
                 San Bernardino County Board of Supervisors
                 San Joaquin County Health Care Services
                                




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