H.R. 2936 — Addressing Boarding and Crowding in the Emergency Department

This section expands public health data modernization grants under section 2823(a)(1) of the Public Health Service Act by authorizing awards to appropriate entities for (1) developing state- or region-wide, real-time (or near real-time), accurate, and scalable systems to track hospital bed capacity and its effects on emergency department boarding rates, wait times for treatment, and time emergency medical services personnel spend waiting to offload patients; and (2) establishing or maintaining public-facing dashboards of such information (redacted per applicable privacy laws).

This section requires the Center for Medicare and Medicaid Innovation (CMI) to test two additional payment and service delivery models for Medicare and Medicaid beneficiaries and enrollees (i.e., applicable individuals). (1) The first model promotes research-based improvements to emergency care for older adults, including sufficient interdisciplinary staffing and education, physical infrastructure changes, geriatric-focused policies and metrics, and enhanced coordination with post-acute care facilities such as skilled nursing, assisted living, and independent living facilities. (2) The second model promotes research-based improvements to emergency care for individuals experiencing acute psychiatric crises, including dedicated emergency department units and expedited transfers to post-acute care facilities. (As background, the CMI tests models to reduce Medicare and Medicaid expenditures while preserving or enhancing care quality.)

This section directs the Comptroller General of the United States to conduct a study (1) to determine best practices for developing and maintaining public health data systems for tracking hospital capacity—including systems supported under section 2823(a)(1) of the Public Health Service Act—to ensure state- or region-wide, real-time (or near real-time), accurate, and scalable tracking of emergency departments, adult and pediatric intensive care units, inpatient psychiatric services, skilled nursing facilities, and other facilities, with seamless integration into hospital electronic medical records; and (2) to assess how such systems affect emergency department boarding rates (as measured by Centers for Medicare & Medicaid Services and accreditation entities), wait times for treatment and discharge, and emergency medical services offload times. Not later than one year after enactment, the Comptroller General must complete the study and submit a report to Congress on its results.