BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1621
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          ASSEMBLY THIRD READING
          AB 1621 (Lowenthal and Rodriguez)
          As Amended May 23, 2014
          Majority vote 

           HEALTH              19-0        APPROPRIATIONS      17-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Pan, Maienschein,         |Ayes:|Gatto, Bigelow,           |
          |     |Ammiano, Chau, Bonilla,   |     |Bocanegra, Bradford, Ian  |
          |     |Bonta, Ch�vez, Chesbro,   |     |Calderon, Campos,         |
          |     |Gomez, Gonzalez, Roger    |     |Donnelly, Eggman, Gomez,  |
          |     |Hern�ndez, Lowenthal,     |     |Holden, Jones, Linder,    |
          |     |Waldron, Nazarian,        |     |Pan, Quirk,               |
          |     |Nestande, Patterson,      |     |Ridley-Thomas, Wagner,    |
          |     |Ridley-Thomas, Wagner,    |     |Weber                     |
          |     |Wieckowski                |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Requires the Emergency Medical Services Authority  
          (EMSA) to develop regulations and standards for the electronic  
          collection of pre-hospital emergency medical services (EMS) data  
          area to determine statewide coordination and effectiveness of  
          EMS services.  Specifically,  this bill  :

          1)Requires, on or before July 1, 2016, EMSA to adopt minimum  
            standards for the collection of information regarding  
            prehospital care using the existing California Emergency  
            Medical Services Data and Information System (CEMSIS) to  
            determine and monitor the quality and effectiveness of the  
            statewide emergency medical system, compliant with the most  
            current National Emergency Medical Services Information System  
            (NEMSIS) standards.

          2)Requires EMSA to develop regulations and standards for  
            electronic patient care record systems used by local emergency  
            medical services agencies (LEMSAs) and local pre-hospital EMS  
            providers to ensure compatibility with CEMSIS.

          3)Requires a LEMSA that upgrades or purchases an electronic  
            patient care system on or after the date EMSA issues final  
            guidance to ensure the system complies with standards of that  
            guidance.









                                                                  AB 1621
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          4)Makes the enactment of this bill contingent upon an  
            appropriation in the annual State Budget.

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee:

          1)One-time information technology costs in the range of  
            $300,000.  The requirements of the system are not specified in  
            detail, and would be elucidated through the regulatory  
            process.

          2)One-time administrative costs to EMSA in the range of $300,000  
            to develop standards and regulations, and minor ongoing  
            administrative costs.

           COMMENTS  :  According to the author, the mission of EMSA is to  
          ensure quality patient care by administering an effective,  
          statewide system of coordinated emergency medical care, injury  
          prevention, and disaster medical response.  One of EMSA's goals  
          is to ensure that data systems in EMS are positioned for the  
          electronic capture of data and transmission to the hospital in  
          real time.  In 2012, EMSA received a grant from the California  
          HealthCare Foundation (CHCF) to increase the accessibility and  
          accuracy of pre-hospital data for public, policy, academic and  
          research purposes to facilitate system evaluation and  
          improvement.  The CHCF-funded projected revealed that the  
          existing CEMSIS system had a number of weaknesses that made it  
          difficult for EMSA to validate information, the variability in  
          methodology limited its usefulness, and the lack of hospital  
          outcome data limited the ability of LEMSAs to obtain universal  
          outcome data.

          The American Federation of State, County and Municipal Employees  
          writes in support of this bill because it would provide  
          important statewide data on the quality and effectiveness of EMS  
          services, allow policymakers, EMS providers, and the public to  
          access information, and to ultimately improve patient care.   
          American Medical Response, also in support, states this bill  
          will provide important data needed to assess existing systems  
          and establish performance indicators and quality initiatives  
          across the state.  The California Hospital Association states in  
          support that EMS providers must be prepared at all times for the  
          unexpected and patient handoff communication from the ambulances  
          to the emergency departments is one of the most critical  








                                                                  AB 1621
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          information-dependent components of the process.

          The Emergency Medical Services Administrators Association of  
          California, California State Association of Counties, and County  
          Health Executives Association of California all write in  
          opposition to this bill.  The opposition is supportive of  
          expanding the use of electronic EMS data, but not the costly  
          regulatory mandate on counties and EMS providers.  The American  
          Civil Liberties Union, Electronic Frontier Foundation, and the  
          Consumer Federation of California all write that they are  
          opposed to this bill, unless it is amended to include crucial  
          language about privacy and security of sensitive medical data. 
           

          Analysis Prepared by  :    Patty Rodgers / HEALTH / (916) 319-2097  



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