Bill Text: CA AB491 | 2011-2012 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: General acute care hospitals: cardiac catheterization.

Spectrum: Slight Partisan Bill (Republican 3-1)

Status: (Passed) 2012-09-29 - Chaptered by Secretary of State - Chapter 772, Statutes of 2012. [AB491 Detail]

Download: California-2011-AB491-Amended.html

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BILL NUMBER: AB 491	AMENDED
	BILL TEXT

	AMENDED IN SENATE  AUGUST 30, 2012
	AMENDED IN SENATE  AUGUST 29, 2012
	AMENDED IN SENATE  AUGUST 24, 2012
	AMENDED IN SENATE  JULY 6, 2012
	AMENDED IN ASSEMBLY  MAY 10, 2011
	AMENDED IN ASSEMBLY  APRIL 15, 2011
	AMENDED IN ASSEMBLY  APRIL 5, 2011

INTRODUCED BY   Assembly Member Ma
   (Coauthors: Assembly Members Garrick and Miller)
   (Coauthor: Senator Wyland)

                        FEBRUARY 15, 2011

   An act to amend Section 1255 of the Health and Safety Code,
relating to health facilities, and declaring the urgency thereof, to
take effect immediately.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 491, as amended, Ma. General acute care hospitals: cardiac
catheterization.
   Existing law provides for the licensure and regulation of health
facilities, including general acute care hospitals, administered by
the State Department of Public Health. A violation of these
provisions is a crime.
   Existing law authorizes the department to approve, as prescribed,
a general acute care hospital to offer specified special services,
including, but not limited to, cardiac catheterization laboratory
services, in addition to the basic services offered under the
facility's license.
   This bill would authorize the expansion of a cardiac
catheterization laboratory service  under specified
circumstances   if specified requirements are  
met, to apply to no more than two general acute care hospitals 
. Because this bill would expand the definition of a crime, it would
impose a state-mandated local program.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.
   This bill would declare that it is to take effect immediately as
an urgency statute.
   Vote: 2/3. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 1255 of the Health and Safety Code is amended
to read:
   1255.  (a) In addition to the basic services offered under the
license, a general acute care hospital may be approved in accordance
with subdivision (c) of Section 1277 to offer special services,
including, but not limited to, the following:
   (1) Radiation therapy department.
   (2) Burn center.
   (3) Emergency center.
   (4) Hemodialysis center (or unit).
   (5) Psychiatric.
   (6) Intensive care newborn nursery.
   (7) Cardiac surgery.
   (8) Cardiac catheterization laboratory.
   (9) Renal transplant.
   (10) Other special services as the department may prescribe by
regulation.
   (b) A general acute care hospital that exclusively provides acute
medical rehabilitation center services may be approved in accordance
with subdivision (b) of Section 1277 to offer special services not
requiring surgical facilities.
   (c) The department shall adopt standards for special services and
other regulations as may be necessary to implement this section.
   (d) (1) For cardiac catheterization laboratory service, the
department shall, at a minimum, adopt standards and regulations that
specify that only diagnostic services, and what diagnostic services,
may be offered by a general acute care hospital or a multispecialty
clinic as defined in subdivision (  l  ) of Section 1206
that is approved to provide cardiac catheterization laboratory
service but is not also approved to provide cardiac surgery service,
together with the conditions under which the cardiac catheterization
laboratory service may be offered.
   (2) Except as provided in paragraph (3), a cardiac catheterization
laboratory service shall be located in a general acute care hospital
that is either licensed to perform cardiovascular procedures
requiring extracorporeal coronary artery bypass that meets all of the
applicable licensing requirements relating to staff, equipment, and
space for service, or shall, at a minimum, have a licensed intensive
care service and coronary care service and maintain a written
agreement for the transfer of patients to a general acute care
hospital that is licensed for cardiac surgery or shall be located in
a multispecialty clinic as defined in subdivision (  l  ) of
Section 1206. The transfer agreement shall include protocols that
will minimize the need for duplicative cardiac catheterizations at
the hospital in which the cardiac surgery is to be performed.
   (3) Commencing March 1, 2013,  a general acute care hospital
that has applied for program flexibility on or before July 1, 2012,
to expand  cardiac catheterization laboratory services may
 be expanded by a general acute care hospital to include
  utilize  cardiac catheterization space that is in
conformance with applicable building code standards, including those
promulgated by the Office of Statewide Health Planning and
Development, provided that all of the following  occur
  conditions are met  :
   (A) The expanded laboratory space is located in the building so
that the space is connected  to the general acute care hospital
 by an enclosed all-weather passageway that is accessible by
staff and patients who are accompanied by staff.
   (B) The service performs  cardiac catheterization services on
 no more than 25 percent of  its procedures on hospital
inpatients   the hospital's inpatients who need cardiac
catheterizations  .
   (C) The service complies with  all   the same
 policies and procedures approved by hospital medical staff
 for cardiac catheterization laboratories that are  
located within the general acute care hospital  , and 
all   the same  standards and regulations
prescribed by the department  for cardiac catheterization
laboratories located inside general acute care hospitals  ,
including, but not limited to,  applicable  
appropriate  nurse-to-patient ratios under Section 1276.4, and
with all standards and regulations prescribed by the Office of
Statewide Health Planning and Development. Emergency regulations
allowing a general acute care hospital to operate a cardiac
catheterization laboratory service shall be adopted by the department
and by the Office of Statewide Health Planning and Development by
February 28, 2013. 
   (D) Emergency regulations implementing this paragraph have been
adopted by the department and by the Office of Statewide Health
Planning and Development by February 28, 2013.  
   (E) This paragraph shall not apply to more than two general acute
care hospitals.  
   (4) After March 1, 2014, an acute care hospital may only operate a
cardiac catheterization laboratory service pursuant to paragraph (3)
if the department and the Office of Statewide Health Planning and
Development have adopted regulations in accordance with the
requirements of Chapter 3.5 (commencing with Section 11340) of Part 1
of Division 3 of Title 2 of the Government Code that provide
adequate protection to patient health and safety including, but not
limited to, building standards contained in Part 2.5 (commencing with
Section 18901) of Division 13.  
   (4) 
    (5)  Notwithstanding Section 129885, cardiac
catheterization laboratory services expanded in accordance with
paragraph (3) shall be subject to all applicable building standards.
The Office of Statewide Health Planning and Development shall review
the services for compliance with the OSHPD 3 requirements of the most
recent version of the California Building Standards Code.
   (e) For purposes of this section, "multispecialty clinic," as
defined in subdivision (  l  ) of Section 1206, includes an
entity in which the multispecialty clinic holds at least a 50-percent
general partner interest and maintains responsibility for the
management of the service, if all of the following requirements are
met:
   (1) The multispecialty clinic existed as of March 1, 1983.
   (2) Prior to March 1, 1985, the multispecialty clinic did not
offer cardiac catheterization services, dynamic multiplane imaging,
or other types of coronary or similar angiography.
   (3) The multispecialty clinic creates only one entity that
operates its service at one site.
   (4) These entities shall have the equipment and procedures
necessary for the stabilization of patients in emergency situations
prior to transfer and patient transfer arrangements in emergency
situations that shall be in accordance with the standards established
by the Emergency Medical Services Authority, including the
availability of comprehensive care and the qualifications of any
general acute care hospital expected to provide emergency treatment.
   (f) Except as provided in this section and in Sections 128525 and
128530, under no circumstances shall cardiac catheterizations be
performed outside of a general acute care hospital or a
multispecialty clinic, as defined in subdivision (  l  ) of
Section 1206, that qualifies for this definition as of March 1, 1983.

  SEC. 2.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.
  SEC. 3.  This act is an urgency statute necessary for the immediate
preservation of the public peace, health, or safety within the
meaning of Article IV of the Constitution and shall go into immediate
effect. The facts constituting the necessity are:
   In order to improve access to health care for patients requiring
cardiac catheterization services at the earliest possible time, it is
necessary that this act take effect immediately.