1317.1
. Unless the context otherwise requires, the following
definitions shall control the construction of this article and
Section 1371.4:
(a) (1) "Emergency services and care" means medical screening,
examination, and evaluation by a physician and surgeon, or, to the
extent permitted by applicable law, by other appropriate licensed
persons under the supervision of a physician and surgeon, to
determine if an emergency medical condition or active labor exists
and, if it does, the care, treatment, and surgery, if within the
scope of that person's license, necessary to relieve or eliminate the
emergency medical condition, within the capability of the facility.
(2) (A) "Emergency services and care" also means an additional
screening, examination, and evaluation by a physician, or other
personnel to the extent permitted by applicable law and within the
scope of their licensure and clinical privileges, to determine if a
psychiatric emergency medical condition exists, and the care and
treatment necessary to relieve or eliminate the psychiatric emergency
medical condition, within the capability of the facility.
(B) The care and treatment necessary to relieve or eliminate a
psychiatric emergency medical condition may include admission or
transfer to a psychiatric unit within a general acute care hospital,
as defined in subdivision (a) of Section 1250, or to an acute
psychiatric hospital, as defined in subdivision (b) of Section 1250,
pursuant to subdivision (k). Nothing in this subparagraph shall be
construed to permit a transfer that is in conflict with the
Lanterman-Petris-Short Act (Part 1 (commencing with Section 5000) of
Division 5 of the Welfare and Institutions Code).
(C) For the purposes of Section 1371.4, emergency services and
care as defined in subparagraph (A) shall not apply to Medi-Cal
managed care plan contracts entered into with the State Department of
Health Care Services pursuant to Chapter 7 (commencing with Section
14000), Chapter 8 (commencing with Section 14200), and Chapter 8.75
(commencing with Section 14590) of Part 3 of Division 9 of the
Welfare and Institutions Code, to the extent that those services are
excluded from coverage under those contracts.
(D) This paragraph does not expand, restrict, or otherwise affect
the scope of licensure or clinical privileges for clinical
psychologists or other medical personnel.
(b) "Emergency medical condition" means a medical condition
manifesting itself by acute symptoms of sufficient severity
(including severe pain) such that the absence of immediate medical
attention could reasonably be expected to result in any of the
following:
(1) Placing the patient's health in serious jeopardy.
(2) Serious impairment to bodily functions.
(3) Serious dysfunction of any bodily organ or part.
(c) "Active labor" means a labor at a time at which either of the
following would occur:
(1) There is inadequate time to effect safe transfer to another
hospital prior to delivery.
(2) A transfer may pose a threat to the health and safety of the
patient or the unborn child.
(d) "Hospital" means all hospitals with an emergency department
licensed by the state department.
(e) "State department" means the State Department of Public
Health.
(f) "Medical hazard" means a material deterioration in medical
condition in, or jeopardy to, a patient's medical condition or
expected chances for recovery.
(g) "Board" means the Medical Board of California.
(h) "Within the capability of the facility" means those
capabilities that the hospital is required to have as a condition of
its emergency medical services permit and services specified on
Services Inventory Form 7041 filed by the hospital with the Office of
Statewide Health Planning and Development.
(i) "Consultation" means the rendering of an opinion or advice,
prescribing treatment, or the rendering of a decision regarding
hospitalization or transfer by telephone or other means of
communication. When determined to be medically necessary, jointly by
the treating physician and surgeon, or by other appropriate licensed
persons acting within their scope of licensure, under the supervision
of a physician and surgeon, and the consulting physician and
surgeon, "consultation" includes review of the patient's medical
record, examination, and treatment of the patient in person by a
consulting physician and surgeon, or by other appropriate licensed
persons acting within their scope of licensure under the supervision
of a consulting physician and surgeon, who is qualified to give an
opinion or render the necessary treatment in order to stabilize the
patient. A request for consultation shall be made by the treating
physician and surgeon, or by other appropriate licensed persons
acting within their scope of licensure under the supervision of a
treating physician and surgeon, provided the request is made with the
contemporaneous approval of the treating physician and surgeon. The
treating physician and surgeon may request to communicate directly
with the consulting physician and surgeon, and when determined to be
medically necessary, jointly by the treating physician and surgeon
and the consulting physician and surgeon, the consulting physician
and surgeon shall examine and treat the patient in person. The
consulting physician and surgeon is ultimately responsible for
providing the necessary consultation to the patient, regardless of
who makes the in-person appearance.
(j) A patient is "stabilized" or "stabilization" has occurred
when, in the opinion of the treating physician and surgeon, or other
appropriate licensed persons acting within their scope of licensure
under the supervision of a treating physician and surgeon, the
patient's medical condition is such that, within reasonable medical
probability, no material deterioration of the patient's condition is
likely to result from, or occur during, the release or transfer of
the patient as provided for in Section 1317.2, Section 1317.2a, or
other pertinent statute.
(k) (1) "Psychiatric emergency medical condition" means a mental
disorder that manifests itself by acute symptoms of sufficient
severity that it renders the patient as being either of the
following:
(A) An immediate danger to himself or herself or to others.
(B) Immediately unable to provide for, or utilize, food, shelter,
or clothing, due to the mental disorder.
(2) This subdivision does not expand, restrict, or otherwise
affect the scope of licensure or clinical privileges for clinical
psychologists or medical personnel.
(l) This section shall not be construed to expand the scope of
licensure for licensed persons providing services pursuant to this
section.