Bill Text: CA SB1311 | 2013-2014 | Regular Session | Amended

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

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Bill Title: Hospitals: antimicrobial stewardship.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Passed) 2014-09-29 - Chaptered by Secretary of State. Chapter 843, Statutes of 2014. [SB1311 Detail]

Download: California-2013-SB1311-Amended.html

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BILL NUMBER: SB 1311	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 10, 2014

INTRODUCED BY   Senator Hill
   (Coauthor: Assembly Member Mullin)

                        FEBRUARY 21, 2014

   An act to  amend Section 120130 of   add
Section 128   8.85 to  the Health and Safety Code,
relating to  disease.   public health. 


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1311, as amended, Hill.  Reporting of antibiotic
resistant disease.  Public health: antimicrobial
stewardship.  
   Existing law provides for the licensure and inspection of health
facilities, including general acute care hospitals, by the State
Department of Public Health. Existing law requires a general acute
care hospital to develop a process for evaluating the judicious use
of antibiotics, the result of which is required to be monitored by
appropriate representatives and committees involved in quality
improvement activities. Under existing law, a violation of the
provisions governing health facilities constitutes a misdemeanor
punishable by a fine not to exceed $1,000, by imprisonment in a
county jail, or by both that fine and imprisonment.  
   This bill would require all general acute care hospitals, as
defined, to adopt and implement, by July 1, 2015, an antimicrobial
stewardship policy in accordance with guidelines established by the
federal government and professional organizations. The bill would
require a general acute care hospital to develop a physician
supervised multidisciplinary antimicrobial stewardship committee,
subcommittee, or workgroup, and to appoint at least one physician or
pharmacist to that committee, subcommittee, or workgroup who has
attended training specifically on antimicrobial stewardship,
including, but not limited to, a training program offered by the
federal Centers for Disease Control and Prevention. The bill would
also require a general acute care hospital to report antimicrobial
stewardship program activities to each appropriate hospital committee
undertaking clinical quality improvement activities.  
   By expanding the scope of an existing crime, this bill 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.  
   Existing law requires the State Department of Public Health to
establish a list of reportable communicable and noncommunicable
diseases and conditions, including, but not limited to, diphtheria,
listeria, salmonella, shigella, and streptococcal infection in food
handlers or dairy workers, and typhoid. Existing law requires local
health officers to report to the department any disease or condition
on the list as specified by the department. Violation of these
provisions is a crime.  
   This bill would require the list created by the department to
include antibiotic resistant infections and would require the
department to consider adding antibiotic resistant infections listed
in a prescribed federal Centers for Disease Control and Prevention
(CDCR) report. The bill would require the department, in updating the
list, to consider adding resistant infections listed in updates to
the CDCR report. The bill would authorize the department to share the
information gathered on antibiotic resistant infection with the
federal CDCR. By adding to the list of diseases for which
nonreporting is a crime, this bill 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. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


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

   SECTION 1.    Section 1288.85 is added to the 
 Health and Safety Code   ,  immediately following
Section 1288.8  , to read:  
   1288.85.  Each general acute care hospital, as defined in
subdivision (a) of Section 1250, shall do all of the following by
July 1, 2015:
   (a) Adopt and implement an antimicrobial stewardship policy in
accordance with guidelines established by the federal government and
professional organizations.
   (b) Develop a physician supervised multidisciplinary antimicrobial
stewardship committee, subcommittee, or workgroup.
   (c) Appoint to the physician supervised multidisciplinary
antimicrobial stewardship committee, subcommittee, or workgroup, at
least one physician or pharmacist who has attended training
specifically on antimicrobial stewardship, including, but not limited
to, a continuing education training program offered by the federal
Centers for Disease Control and Prevention, the Society for
Healthcare Epidemiology of America, or similar recognized
professional organizations, or post graduate training with a
concentration in antimicrobial stewardship.
   (d) Report antimicrobial stewardship program activities to each
appropriate hospital committee undertaking clinical quality
improvement activities. 
   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.  
  SECTION 1.    Section 120130 of the Health and
Safety Code is amended to read:
   120130.  (a) The department shall establish a list of reportable
diseases and conditions. For each reportable disease and condition,
the department shall specify the timeliness requirements related to
the reporting of each disease and condition, and the mechanisms
required for, and the content to be included in, reports made
pursuant to this section. The list of reportable diseases and
conditions may include both communicable and noncommunicable
diseases. The list may include those diseases that are either known
to be, or suspected of being, transmitted by milk or milk-based
products. The list shall include antibiotic resistant infections. The
department shall consider adding all urgent, serious, and concerning
resistant infections listed in the federal Centers for Disease
Control and Prevention (CDCR) report entitled "Antibiotic Resistance
Threats in the United States, 2013."
   (b) (1) The list may be modified at any time by the department,
after consultation with the California Conference of Local Health
Officers. When modifying the list, the department shall consider any
updates that have been made to the federal CDCR report identified in
subdivision (a).
   (2) Modification of the list shall be exempt from the
administrative regulation and rulemaking requirements of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code, and shall be implemented without being adopted
as a regulation, except that the revised list shall be filed with the
Secretary of State and printed in the California Code of Regulations
as required pursuant to subdivision (e). Those diseases listed as
reportable shall be properly reported as required to the department
by the health officer.
   (c) The department shall establish a list of communicable diseases
and conditions for which clinical laboratories shall submit a
culture or a specimen to the local public health laboratory. The list
shall set forth the conditions under which the culture and specimen
shall also be submitted to the State Public Health Laboratory. The
list may be modified at any time by the department, in consultation
with appropriate local public health stakeholders, including, but not
limited to, local health officers and public health laboratory
directors. Both establishment and modification of the list shall be
exempt from the administrative regulation and rulemaking requirements
of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division
3 of Title 2 of the Government Code, and shall be implemented
without being adopted as a regulation, except that the initial list
and any modifications shall be filed with the Secretary of State and
printed in the California Code of Regulations as required pursuant to
subdivision (f).
   (d) The department may from time to time adopt and enforce
regulations requiring strict or modified isolation, or quarantine,
for any of the contagious, infectious, or communicable diseases, if
in the opinion of the department the action is necessary for the
protection of the public health.
   (e) The health officer may require strict or modified isolation,
or quarantine, for any case of contagious, infectious, or
communicable disease, when this action is necessary for the
protection of the public health.
   (f) The lists established pursuant to subdivisions (a) and (b) and
any subsequent modifications shall be published in Title 17 of the
California Code of Regulations.
   (g) Notwithstanding any other provision of law, no civil or
criminal penalty, fine, sanction, or finding, or denial, suspension,
or revocation of licensure for any person or facility may be imposed
based upon a failure to provide the notification of a reportable
disease or condition or to provide the submission of a culture or
specimen that is required under this section, unless the name of the
disease or condition that is required to be reported, or for which a
culture or specimen is required to be submitted, was printed in the
California Code of Regulations and the department notified the person
or facility of the disease or condition at least six months prior to
the date of the claimed failure to report or submit.
   (h) Commencing July 1, 2009, or within one year of the
establishment of a state electronic laboratory reporting system,
whichever is later, a report generated pursuant to this section, or
Section 121022, by a laboratory shall be submitted electronically in
a manner specified by the department. The department shall allow
laboratories that receive incomplete patient information to report
the name of the provider who submitted the request to the local
health officer.
   (i) The department may, through its Internet Web site and via
electronic mail, advise out-of-state laboratories that are known to
the department to test specimens from California residents of the new
reporting requirements.
   (j) To the extent allowed by law, the department may share the
information gathered on antibiotic resistant infection with the
federal CDCR.  
  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.