California ACEP 2021 Legislative Review


Written by Valerie Norton, IEPC Member and President-Elect, California ACEP
and Elena Lopez-Gusman, Executive Director – California ACEP

California ACEP had a busy year with critical issues of pandemic, workforce, payment threats, and mental health boarding. Here is a summary of some of the legislative activity that was Valerie Norton IEPC Member and President-Elect, California ACEP Elena Lopez-Gusman Executive Director – California ACEP discussed during an IEPC Speaker Series.

Improve the safety and quality of care for patients across California

• AB 451 Arambula: Requires freestanding psychiatric hospitals to accept patients in transfer under the same rules as other EMTALAbound facilities, without regard to ability to pay. Signed by the Governor.

• AB 685 Maienschein: Would require Emergency Physician review before a health plan or insurer could down code a claim. This is a two-year bill and will be heard in January.

Improve EM practice

• AB 1113 Medina: Gives free college tuition at state schools for children of healthcare workers who died of COVID. We worked with the authors to have independent physicians included, not just hospital employees. Signed by Governor.

• SB 104 McGuire: Would provide a pass-through credit on state and local taxes (SALT) to S corporation physician groups. This bill is held on suspense but was enacted by AB 150 which was a budget trailer bill. While we were hoping to expand the applicability of the passthrough to more EP entities, we were pleased to see this signed into law.

• SB 250 Pan: CMA sponsored bill that would require insurers to collect co-pays and deductibles directly from patients instead of making physicians do that. Will be heard again in January.

• $40 million budget allocation for grants to EDs to provide behavioral health navigation services. This is modeled after the $40 million we successfully got last year for substance use navigators. This was passed and signed and there will be a grant process in 2022 to distribute the additional funds.

Oppose or try to amend legislation that would be detrimental to ED practice

• SB 447 Laird: would allow pain and suffering awards for heirs of decedents who get a malpractice award. Essentially doubles possible MICRA pain and suffering award from $250,000 to $500,000. Signed by the Governor.

• AB 835 Nazarian: Would require all EDs to test for HIV on all patients undergoing a blood draw unless they opted out. After energetic lobbying efforts to oppose different versions of this bill over several years, the current version was kept in the “suspense file” this year due to the cost to the state (Medi-Cal, UC system). It would have been an unfunded mandate for all hospitals.

• SB Roth 806: This bill is an omnibus bill that reauthorizes the CA Medical Board. Among its provisions, it would have continued the post-graduate training license that was established 5 years ago by the medical board reauthorization bill and prevented moonlighting. We worked hard to fix this and were successful. Signed by Governor.

• AB 1204 Wicks: Would have required physicians to report redundant demographic data on their patients already being reported by hospital. We were able to work with the author to have physicians removed.

• AB 1105 Rodriguez: Would have required physician employers to provide COVID testing to their employees, duplicative of hospital testing. We were able to work with the author to remove the requirement for emergency physicians.

• AB 789 Low: Would have required Hepatitis B & C screening in the emergency department when primary care services were being provided. We were able to work with the author to exclude the ED.

• SB 306 Pan: Would have required syphilis screening on patients who delivered in the ED. Worked with author to make this a recommendation rather than a requirement.

• SB 744 Glazier: Would have added housing, address and other demographic patient information to the mandatory reporting already required of physicians for communicable respiratory illnesses. Worked with author so that this is only required to be reported if the information is known.

Work in the regulatory process to implement recent laws in sensible ways that will protect EM and ED patients

• AB 1544 Community Paramedicine: AB 1544 was signed into law in 2020 allowing paramedics to expand their scope of practice in certain settings and to allow paramedics to transport patients to certain alternate destinations (sobering centers and mental health facilities). We serve on the advisory committee drafting regulations to provide guidance to LEMSAs to implement this law.

• AB 890 Wood NP scope of practice: we are engaging with the BRN advisory committee and in process of creating a position statement from California ACEP regarding our opinions about the transition to independent practice in an ED setting, and what additional requirements NPs should have to meet for this.

To view the full November 2021 newsletter click here.