Assembly Member Bauer-Kahan's emergency services legislation proposes sweeping changes to California's hospital compliance framework, dramatically increasing penalties for violations while modifying anti-discrimination requirements in emergency care settings.

The bill removes citizenship status and pre-existing medical conditions from protected characteristics that hospitals must disregard when providing emergency services, while maintaining prohibitions against discrimination based on other factors like ethnicity, age, and insurance status. These characteristics may only be considered when medically relevant to providing appropriate care.

The legislation's most substantial changes come through enhanced enforcement mechanisms. Maximum daily fines for hospitals failing to maintain proper emergency care policies increase from $1,000 to $1,000,000. Similar million-dollar caps replace existing penalties ranging from $5,000 to $25,000 for violations by physicians and facilities. The bill eliminates current cumulative penalty limits and expands enforcement authority, allowing district attorneys and the Attorney General to pursue civil actions against violators.

Under the modified framework, hospitals must maintain detailed transfer records and submit annual reports documenting patient insurance status and transfer rationales. The legislation preserves existing protections for medical personnel who report violations or refuse transfers that could endanger patients, while strengthening anti-retaliation provisions through heightened penalties. New procedural requirements establish timelines for contesting fines and outline options for binding arbitration to resolve disputes.