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AB-1164 Hospitals: emergency departments: crowding score.(2023-2024)

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Date Published: 02/16/2023 09:00 PM
AB1164:v99#DOCUMENT


CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill
No. 1164

Introduced by Assembly Member Lowenthal

February 16, 2023

An act to add Section 1257.10 to the Health and Safety Code, relating to health facilities.


LEGISLATIVE COUNSEL'S DIGEST


AB 1164, as introduced, Lowenthal. Hospitals: emergency departments: crowding score.
Existing law requires the State Department of Public Health to license and regulate health facilities, including general acute care hospitals. A violation of those provisions is generally a crime.
This bill would require a licensed general acute care hospital with an emergency department to determine the range of crowding scores, as defined, that constitute each category of the crowding scale, as provided, for its emergency department. The bill would require the hospital to calculate and record a crowding score at a minimum every 4 hours, except as specified, to assess the crowding condition of the hospital’s emergency department.
The bill would require, by January 1, 2025, the hospital to develop and implement a full-capacity protocol for each of the categories of the crowding scale, as specified. The bill would require the hospital to file its protocol with the Department of Health Care Access and Information and to annually report any revisions to its protocol.
By expanding the scope of a crime, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

The people of the State of California do enact as follows:


SECTION 1.

 Section 1257.10 is added to the Health and Safety Code, immediately following Section 1257.9, to read:

1257.10.
 (a) For purposes of this section, “crowding score” means the score calculated using the following equation: 85.8 (total number of patients within the emergency department/total number of staffed beds in the emergency department, not to exceed the number of licensed beds) + 600 (total number of admissions waiting in the emergency department, 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) + 13.4 (total number of patients in the emergency department admitted to the intensive care-critical care unit, with a maximum of four) + 0.93 (the longest admit time, in hours, including transfers) + 5.64 (the wait time for the last patient waiting the longest in the waiting room, in hours) - 20.
(b) For purposes of this section, “crowding scale” means a range of crowding scores that are divided into six categories of which level one is the lowest level of crowding and level six is the highest.
(c) A licensed general acute care hospital, as defined in subdivision (a) of Section 1250, with an emergency department shall determine the range of crowding scores that constitute each category of the crowding scale for its emergency department.
(d) (1) Except as otherwise provided in this subdivision, a licensed general acute care hospital with an emergency department shall calculate, and record, a crowding score at a minimum every four hours to assess the crowding condition of its emergency department.
(2) If, after calculating and recording a crowding score, the hospital does not have a crowding score in level four or higher for the previous 30 days, it may calculate and record a crowding score every eight hours rather than every four hours. If the hospital that is calculating and recording a crowding score every eight hours records a score in level four or higher, it shall again calculate and record a crowding score at a minimum every four hours.
(3) A licensed general acute care hospital that has an emergency department census of less than 14,000 visits annually shall calculate and record the crowding score daily between 4 p.m. and 8 p.m.
(e) A licensed general acute care hospital with an emergency department shall, by January 1, 2025, develop and implement, in consultation with its emergency department staff, a full-capacity protocol for each of the categories of the crowding scale that addresses all of the following factors, as applicable:
(1) Notification of hospital administrators, nursing staff, medical staff, and ancillary services of category changes on the crowding scale.
(2) Hospital operations, including bed utilization, transfers, elective admissions, discharges, supplies, and additional staffing.
(3) Emergency department operations, including diversion, triage, and alternative care sites.
(4) The planned response of the organized medical staff for rounds, discharges, coordination with the emergency department, and emergency consults for emergency department patients.
(f) A licensed general acute care hospital with an emergency department shall file its full-capacity protocol with the Department of Health Care Access and Information and shall annually report any revisions to its protocol.

SEC. 2.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.