Bill Text: CA AB2194 | 2009-2010 | Regular Session | Introduced
Bill Title: Health facilities: program flexibility.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2010-04-13 - In committee: Set, first hearing. Hearing canceled at the request of author. [AB2194 Detail]
Download: California-2009-AB2194-Introduced.html
BILL NUMBER: AB 2194 INTRODUCED
BILL TEXT
INTRODUCED BY Assembly Member Fletcher
FEBRUARY 18, 2010
An act to add and repeal Chapter 2 (commencing with Section
101990) to Part 6 of Division 101 of the Health and Safety Code,
relating to health facilities.
LEGISLATIVE COUNSEL'S DIGEST
AB 2194, as introduced, Fletcher. Health facilities: program
flexibility.
Existing law requires the State Department of Public Health to
administer the licensing of several categories of clinics and health
facilities, including general acute care hospitals. Existing law
requires the building standards published in the California Building
Standards Code and the regulations adopted by the department to
prescribe standards for adequacy, safety, and sanitation of the
physical plant, of appropriate staffing, and of services, based on
the type of health facility and the needs of the persons served.
The bill would require the department to establish the
Acuity-Adaptable Care Delivery Pilot Program to provide not less than
one but not more than 5 general acute care hospitals, as defined,
with the ability to use licensed intensive care beds as stepdown and
medical surgical beds interchangeably, based on the acuity of the
patient, as provided.
The bill would require the participating hospitals to measure
specified outcomes and to undergo an annual review of the outcomes,
including an onsite inspection by the department and independent
evaluations. The bill also would require the department, by January
1, 2015, to prepare and submit a report to the Legislature on the
pilot program. The bill would allow the department to charge a
participating hospital an annual fee that does not exceed the amount
of the direct costs to the department of overseeing and evaluating
the pilot program and does not exceed $25,000 per year.
The bill would make the program inoperative 7 years after the
first patient is admitted to the first pilot program hospital and
would repeal the program on January 1 of the following year.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Chapter 2 (commencing with Section 101990) is added to
Part 6 of Division 101 of the Health and Safety Code, to read:
CHAPTER 2. HEALTH FACILITY INNOVATION
101990. (a) The State Department of Public Health shall establish
the Acuity-Adaptable Care Delivery Pilot Program to provide general
acute care hospitals, as defined in subdivision (a) of Section 1250,
the ability to use licensed intensive care beds as stepdown and
medical surgical beds interchangeably based upon the acuity of the
patient, including the use of technology, equipment, procedures,
techniques, and concepts that support this model of care.
(b) Utilization of technology, equipment, procedures, techniques,
and concepts that supports the acuity-adaptable care delivery model
shall be consistent with the provision of safe, therapeutic,
effective care that promotes patient safety. Deployment of technology
shall not prevent health care providers from following accepted
practice standards, including use of clinical judgment in the
assessment, evaluation, planning, and implementation of care, nor
from acting as a patient advocate.
(c) The department shall identify alternate technology, equipment,
procedures, techniques, and concepts, giving special consideration
to the use of acuity-adaptable nursing units and beds, that will
promote innovation and improvement in services and patient care.
(d) The department shall solicit and accept proposals from general
acute care hospitals to participate in the pilot program to use
licensed intensive care beds as stepdown and medical surgical beds
interchangeably based upon the acuity of the patient, including the
use of technology, equipment, procedures, techniques, and concepts
that support this model of care.
(e) The department shall, by October 1, 2011, authorize not less
than one, but not more than five, general acute care hospitals
identified by the department or proposed by a hospital pursuant to
subdivision (d) to use licensed intensive care beds as stepdown and
medical surgical beds interchangeably based upon the acuity of the
patient, including the use of technology, equipment, procedures,
techniques, and concepts that support this model of care. At least
one authorized general acute care hospital shall be located within
the County of San Diego and shall be associated with a two-hospital
system operated by a health care district.
(f) A general acute care hospital participating in the pilot
program shall measure all of the following patient, caregiver, and
organizational outcomes:
(1) Morbidity.
(2) Hospital acquired infections.
(3) Adverse events.
(4) Patient satisfaction.
(5) Cost per discharge.
(6) Length of stay.
(7) Workplace injuries.
(8) Employee satisfaction.
(9) Staff turnover, by job category.
(g) Measures of program success shall include improvement in any
or all of the outcomes listed in subdivision (f) as compared to
risk-adjusted and like populations. Outcome data shall be stratified
by service line; for example, cardiovascular and neuroscience.
(h) A general acute care hospital participating in the pilot
program shall comply with the staffing requirements for licensed
nurses set forth in Section 1276.4 based on the acuity of the patient
and not the licensed bed category and physical location of the
patient.
(i) (1) Each general acute care hospital, acute psychiatric
hospital, and special hospital, as defined in subdivisions (a), (b),
and (f) of Section 1250, shall ensure that each direct care
registered nurse, including a new hire, casual, per diem, temporary
agency, registry, and traveler staff, shall receive and complete
orientation to the hospital and patient care unit or clinical care
area in which he or she will be working. Each health facility subject
to this section shall adopt written policies and procedures for the
training and orientation of nursing staff.
(2) Each direct care registered nurse shall have current
demonstrated and validated competency required for the specific
individual needs of the patient population admitted to the unit or
clinical area before being assigned to patient care for that unit or
clinical area.
(j) A general acute care hospital participating in the pilot
program shall consult with affected employees, including the
recognized collective bargaining agent or agents, if any, and members
of the hospital medical staff organized pursuant to Section 2282 of
the Business and Professions Code. This consultation may occur
through hospital committees.
(k) A general acute care hospital participating in the pilot
program shall be required to undergo an annual review of the outcomes
of the pilot program, including an onsite inspection by the
department. The department shall also require independent evaluations
by experts, subject to conflict-of-interest requirements, on an
annual basis to evaluate the outcomes in terms of quality and patient
safety as well as worker safety.
(l) The department may charge a general acute care hospital
participating in the pilot program an annual fee that does not exceed
the amount of the direct costs to the department of overseeing and
evaluating the pilot program and does not exceed twenty-five thousand
dollars ($25,000) per year. The moneys collected from this fee shall
be deposited in the State Department of Public Health Licensing and
Certification Program Fund.
(m) As appropriate, a general acute care hospital participating in
the pilot program shall consult with the Office of Statewide Health
Planning and Development if the hospital's physical building is
involved in the use of technology, equipment, procedures, techniques,
and concepts that support the acuity-adaptable care delivery model.
(n) On or before January 1, 2015, the department shall prepare and
submit a report to the Legislature on the results of the pilot
program and its impact upon the quality of service and patient care.
101991. This chapter shall become inoperative seven years after
the first patient is admitted to the first pilot program hospital and
shall be repealed on January 1 of the following year.
