Existing law requires the State Department of Public Health (department) to license and regulate each health facility, defined to mean a facility, place, or building that is organized, maintained, and operated for the diagnosis, care, prevention, and treatment of human illness, and includes, among others, a general acute care hospital and an acute psychiatric hospital.
Existing law, the Unruh Civil Rights Act (Unruh Act) , specifies that all persons within the jurisdiction of the state are free and equal, and no matter their sex, race, color, religion, ancestry, national origin, disability, medical condition, genetic information, marital status, sexual orientation, citizenship, primary language, or immigration status are entitled to the full and equal accommodations, advantages, facilities, privileges, or services in all business establishments of every kind.
Existing law requires a health facility that maintains and operates an emergency department to provide emergency services and care, as defined, to any person requesting the services or care for any condition in which the person is in danger of loss of life, or serious injury or illness, as specified. Existing law prohibits the provision of emergency services and care from being based on or affected by, among other characteristics, a person's ethnicity, citizenship, age, preexisting medical condition, insurance status, economic status, or a characteristic identified in the Unruh Act, as specified. Existing law requires a hospital to adopt a policy prohibiting discrimination in the provision of emergency services and care, and to prohibit physicians and surgeons who serve on an "on-call" basis to the hospital's emergency room from refusing to respond to a call, based on the characteristics described above. If a hospital fails to timely adopt the required policies and protocols, in addition to denial or revocation of any of its licenses, existing law subjects the hospital to a fine not to exceed $1,000 for each day after 60 days' written notice from the department that the hospital's policies or protocols are inadequate, as specified.
This bill would increase the fine for a hospital's failure to adopt the policies and protocols required for the provision of emergency services and care to $1,000,000 per day.
Existing law prohibits a hospital, governmental agency, or person from retaliating against, penalizing, or taking other specified actions against a physician or other personnel for reporting in good faith a violation of the requirements governing the provision of emergency services and care, or for refusing to transfer a patient when the physician determines that the transfer or delay caused by the transfer will create a medical hazard to the person, as specified. Existing law subjects a person who violates either of these prohibitions to a civil penalty of no more than $10,000 per violation.
This bill would increase the maximum amount of that civil penalty to $1,000,000 per violation.
Under existing law, a hospital found by the department to have committed or been responsible for a violation of the requirements governing the provision of emergency services and care is subject to a civil penalty in an amount not to exceed $25,000 for each hospital violation, except as specified. A physician and surgeon found by the Medical Board of California to have committed or been responsible for a violation of those requirements is subject to a civil penalty by the board not to exceed $5,000. Existing law establishes a cumulative maximum limit of $30,000 for civil penalties against hospitals assessed under these provisions and under a specified federal provision governing emergency examination and treatment for emergency medical conditions and women in labor. Existing law requires the department, when determining the amount of a penalty for a hospital violation, to take into account factors including, but not limited to, civil fines that have been imposed for violating the federal provisions. Existing law requires the department to return or credit state penalty amounts to a hospital to ensure that the cumulative maximum limit is not exceeded.
This bill would increase the maximum amount of a civil penalty against a hospital or physician and surgeon that violated the above-referenced requirements to $1,000,000, respectively. The bill would delete the provisions requiring the cumulative maximum penalty limit and the requirement that the department consider the above-described civil fines imposed for violating federal provisions.
Existing law authorizes a person who suffers personal harm and any medical facility that suffers financial loss resulting from a violation of the requirements relating to the provision of emergency services and care to recover damages, attorney's fees, and other appropriate relief in a civil action against the transferring or receiving hospital, as specified. Existing law also authorizes a person potentially harmed by the emergency services and care provisions or implementing regulations, or the local district attorney or the Attorney General, to bring a civil action to enjoin the violation, as prescribed.
This bill additionally would authorize the local district attorney or the Attorney General to bring a civil action against an entity that violates an injunction issued according to the above provisions, as specified. The bill would require a court to award a civil penalty of up to $1,000,000, attorney's fees, and litigation costs to the prevailing party.

Statutes affected:
AB 290: 1317 HSC, 1317.3 HSC, 1317.4 HSC, 1317.6 HSC
01/22/25 - Introduced: 1317 HSC, 1317.3 HSC, 1317.4 HSC, 1317.6 HSC
02/18/25 - Amended Assembly: 1317 HSC, 1317.3 HSC, 1317.4 HSC, 1317.6 HSC