Bill Text: CA AB2348 | 2023-2024 | Regular Session | Amended
Bill Title: Emergency medical services.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced) 2024-04-29 - Re-referred to Com. on APPR. [AB2348 Detail]
Download: California-2023-AB2348-Amended.html
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Amended
IN
Assembly
April 25, 2024 |
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Amended
IN
Assembly
April 01, 2024 |
CALIFORNIA LEGISLATURE—
2023–2024 REGULAR SESSION
Assembly Bill
No. 2348
| Introduced by Assembly Member Rodriguez |
February 12, 2024 |
An act to amend Sections 1797.103, 1797.120, 1797.225, and 1797.254 of, and to add Sections 1797.235 and 1797.255 to, the Health and Safety Code, relating to emergency medical services.
LEGISLATIVE COUNSEL'S DIGEST
AB 2348, as amended, Rodriguez.
Emergency medical services.
Existing law, the Emergency Medical Services System and the Prehospital Emergency Medical Care Personnel Act, governs local emergency medical services (EMS) systems. The act establishes the Emergency Medical Services Authority (authority), which is responsible for the coordination and integration of all emergency medical services. Existing law authorizes each county to develop an emergency medical services program and requires a county that does so to designate a local EMS agency (LEMSA). Existing law authorizes a LEMSA to create exclusive operating areas in the development of a local EMS plan. Existing law makes a violation of the act or regulations adopted pursuant to the act punishable as a misdemeanor.
Existing law requires the authority to develop
planning and implementation guidelines for emergency medical services systems that address specified components, including the assessment of hospital and critical care centers and data collection and evaluation.
This bill would require the authority to develop planning and implementation guidelines for response times and exemptions. This bill would require the authority to develop a statewide standard methodology for calculation and reporting by a LEMSA of response times for emergency ambulance service providers operating in exclusive operating areas. providers. The bill would require the authority to ensure the guidelines include a list of specified standardized terminology for a LEMSA to use when granting exemptions or when modifying original response time data for required
public reporting of 911 response time. The bill would require a LEMSA to report emergency ambulance services provider response times to the authority in a data dispatch form, as specified. The bill would require an emergency ambulance services provider to report response times to the LEMSA that has jurisdiction over the provider. The bill would require the LEMSA to post emergency ambulance services provider response times monthly on the LEMSA’s internet website in specified formats.
Existing law authorizes a LEMSA to adopt policies and procedures for calculating and reporting ambulance patient offload times.
This bill would make adoption of those policies and procedures mandatory.
Existing law requires a LEMSA to annually submit an EMS plan for the EMS area to the authority according to systems, standards, and guidelines established by the authority.
This bill would require a LEMSA to include in an EMS plan the LEMSA’s annual budget, a list of administrative exemptions and a list of administrative modifications relating to response time that were approved by the LEMSA, and any exemptions granted by the LEMSA in the previous calendar year. The bill would require a LEMSA to make its plan accessible on its internet website, and would require the authority to make each EMS plan submitted to the authority accessible on the authority’s internet website, as specified. The bill would require a LEMSA to use the above-described standardized terminology developed by the authority to the extent possible.
Because the bill would create new requirements within the act, thereby expanding the scope of an existing 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.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 1797.103 of the Health and Safety Code is amended to read:1797.103.
The authority shall develop planning and implementation guidelines for emergency medical services systems which address the following components:(a) Manpower and training.
(b) Communications.
(c) Response and transportation, including response times and exemptions.
(d) Assessment of hospitals and critical care centers.
(e) System organization and management.
(f) Data collection, evaluation, and quality improvement.
(g) Public information and education.
(h) Disaster medical response.
SEC. 2.
Section 1797.120 of the Health and Safety Code is amended to read:1797.120.
(a) The authority shall develop, using input from stakeholders, including, but not limited to, hospitals, local EMS agencies, and public and private EMS providers, and, after approval by the commission pursuant to Section 1799.50, adopt a statewide standard methodology for the calculation and reporting by a local EMS agency of response times for all emergency ambulance services provided(b) The standard statewide methodology developed and
adopted by the authority under this section shall use a fractal reporting format report that includes, at a minimum, a 90th percentile benchmark.
(c) For the purposes of this section, “ambulance patient offload time” means the interval between the arrival of an ambulance patient at an emergency department and the time that the patient is transferred to an emergency department gurney, bed, chair, or other acceptable location and the emergency department assumes responsibility for care of the patient.
(d) For purposes of this division, “response time” means the interval between the point in time when the address or location is received by the responding EMS provider’s dispatch center and the point in time that the transporting ambulance unit arrives at the provided
address or location.
(e) The authority shall ensure the EMS system planning and implementation guidelines for response times comply with all of the following requirements:
(1) The guidelines shall include a list of standardized terminology for local emergency medical services agencies to use when granting exemptions or when modifying original response time data for any publicly reported 911 response times required by this section. The list of standardized terminology shall include the following terms and definitions:
(A) “Cancelled calls” means an EMS response in which the responding unit is notified and begins the response, but the response is terminated prior to responding to the EMS unit arrival on
scene using predefined objective criteria.
(B) “Do not count” means an EMS response generated within the computer-aided dispatch (CAD) incident data that, upon review, does not satisfy the criteria for an EMS response that is subject to compliance monitoring using predefined objective criteria.
(C) “Exemption” means an EMS response where the incident data is administratively excluded from the CAD data used to calculate response interval compliance using predefined objective criteria.
(D) “Time correction” means an EMS response where defined points in time in the CAD incident data are administratively modified from the original CAD incident data using predefined objective criteria.
(2) The list of standardized terminology described in paragraph (1) shall include common reasons for granting exemptions from 911 response times in the various emergency medical services areas of the state.
SEC. 3.
Section 1797.225 of the Health and Safety Code is amended to read:1797.225.
(a) A local EMS agency shall adopt policies and procedures for calculating and reporting ambulance patient offload time, as defined in subdivision (c) of Section 1797.120.(b) A local EMS agency that adopts policies and procedures for calculating and reporting ambulance patient offload time pursuant to subdivision (a) shall do all of the following:
(1) Use the statewide standard methodology for calculating and reporting ambulance patient offload time developed by the authority pursuant to Section 1797.120.
(2) Establish criteria for the reporting of, and quality
assurance followup for, a nonstandard patient offload time, as defined in subdivision (c).
(c) (1) For the purposes of this section, a “nonstandard patient offload time” means that the ambulance patient offload time for a patient exceeds a period of time designated in the criteria established by the local EMS agency pursuant to paragraph (2) of subdivision (b).
(2) “Nonstandard patient offload time” does not include instances when the ambulance patient offload time exceeds the period set by the local EMS agency due to acts of God, natural disasters, or manmade disasters.
SEC. 4.
Section 1797.235 is added to the Health and Safety Code, to read:1797.235.
(a) A local EMS agency shall adopt policies and procedures for calculating and reporting of response times, as defined in subdivision (d) of Section 1797.120, for emergency ambulance services(b) (1) A local EMS agency shall use the statewide standard methodology for calculating and reporting response interval performance developed by the authority pursuant to subdivision (a) of Section 1797.120.
(2) When establishing response time compliance requirements, the local EMS agency shall weigh the risk to the safety of the responding crew and public against the severity of the medical emergency when determining what level of response and time allotment to require from an emergency ambulance services provider.
(c) Local EMS agency response times reporting shall include data from all emergency ambulance services providers operating under Section 1797.224 where the annual transport volume of all emergency ambulance transports within an exclusive operating area exceeds 10,000 transports per calendar year within their jurisdiction.
(d) A local EMS agency shall report emergency ambulance services provider response times to the authority in a data dispatch form that is consistent with the California Emergency Medical Services Information System (CEMSIS) and the National Emergency Medical Services Information System (NEMSIS) standards, as specified by the authority, including with the following:
(1) The point in time that the public safety agency dispatch center receives the EMS call.
(2) The point in time that the EMS provider’s dispatch center that is responsible for directly dispatching the ambulance unit receives EMS caller data from a public agency dispatch center.
(3) The point in time that the responding ambulance unit is notified
of EMS caller data by dispatch.
(4) The point in time that the ambulance unit is en route.
(5) The point in time that the ambulance unit arrives on scene.
(e) (1) A local EMS agency shall make response times publicly available monthly on the local EMS agency internet website both in raw form and on a 90th percentile fractal compliance scale. For purposes of this subdivision, “raw form” means the response time prior to administrative exemptions or modification.
(2) The local EMS agency shall include on the local EMS agency’s internet website the response times provided to the local EMS agency by an emergency ambulance services provider
pursuant to subdivisions (c) and (g).
(f) For purposes of this section, “EMS caller data” means the address or location of the emergency.
(g) An emergency ambulance services provider shall report response times to the local EMS agency that has jurisdiction over the provider in the manner described in subdivision (d).
(h) This section does not apply to calls not originating in the 911 system.
(i) This section does not prohibit the local EMS agency from reporting response interval compliance from emergency ambulance services providers that do not satisfy the requirements described in subdivision (c).
(j) This section does not prohibit local EMS agencies from granting exemptions that do not use the terminology established by the authority when the reason for granting the exemption does not meet the definition of a term established by the authority.
(k) This section does not prohibit a local EMS agency, when utilizing standardized terminology to grant exemptions from 911 response times, from including additional information or rationales when granting exemptions.
(l) Nothing in this section supersedes Section 1797.201.
SEC. 5.
Section 1797.254 of the Health and Safety Code is amended to read:1797.254.
(a) Local EMS agencies shall annually submit an emergency medical services plan that includes the local EMS agency’s annual budget for the EMS area to the authority, according to EMS Systems, Standards, and Guidelines established by the authority.(b) The authority shall approve or request changes to the proposed plans within 90 calendar days of receipt.
(c) (1) A local EMS agency shall make the plan accessible on the agency’s internet website within 30 calendar days of approval by the authority.
(2) The authority shall make each local EMS agency plan submitted to the authority accessible on the authority’s internet website within 30 calendar days of approval by the authority.
SEC. 6.
Section 1797.255 is added to the Health and Safety Code, to read:1797.255.
(a) Each local EMS agency shall include in the annual EMS plan required by Section 1797.254 all of the following:(1) The list of administrative exemptions approved by the local EMS agency, if any, relating to 911 response time performance standards.
(2) The list of administrative modifications relating to reported response time performance standards approved by the local EMS agency, if any.
(3) Any exemptions from meeting 911 response times granted by the local EMS agency in the previous calendar year.
(b) For purposes of subdivision (a), when standardized terminology for exemptions is established by the authority pursuant to Section 1797.120, local EMS agencies shall utilize those standardized terms to the extent possible.
(c) This section does not prohibit a local EMS agency from granting exemptions that do not use the terminology established by the authority when the reason for granting the exemption does not meet the definition of a term established by the authority.
(d) This section does not prohibit a local EMS agency, when utilizing standardized terminology to grant exemptions from 911 response times, from including additional information or rationales when granting
exemptions.
