Bill Text: CA SB275 | 2019-2020 | Regular Session | Amended

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

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Bill Title: Health Care and Essential Workers: personal protective equipment.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Passed) 2020-09-29 - Chaptered by Secretary of State. Chapter 301, Statutes of 2020. [SB275 Detail]

Download: California-2019-SB275-Amended.html

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Amended  IN  Assembly  August 30, 2020

Amended  IN  Assembly  August 25, 2020

Amended  IN  Assembly  August 24, 2020

Amended  IN  Assembly  July 27, 2020

Amended  IN  Assembly  June 17, 2020

Amended  IN  Assembly  February 13, 2020

Amended  IN  Assembly  January 06, 2020

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Senate Bill

No. 275

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Introduced by Senators Pan and Leyva
(Coauthor: Assembly Member Gonzalez)

February 13, 2019

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An act to add Section 12098.12 to the Government Code, to add Section 131021 to the Health and Safety Code, and to add Section 6403.1 to, and to add and repeal Section 6403.2 of, to the Labor Code, relating to personal protective equipment, and making an appropriation therefor. equipment.

LEGISLATIVE COUNSEL'S DIGEST

SB 275, as amended, Pan. Health Care and Essential Workers Protection Act: Workers: personal protective equipment.

Existing law establishes the State Department of Public Health to implement various programs throughout the state relating to public health, including licensing and regulating health facilities and control of infectious diseases.

This bill, the Health Care and Essential Workers Protection Act, bill would require the State Department of Public Health to and the Office of Emergency Services, in coordination with other state agencies, to, upon appropriation and as necessary, establish a personal protective equipment (PPE) stockpile to ensure an adequate supply of new PPE for health care workers and essential workers, as defined, and would require the stockpile to be at least sufficient for a 45-day pandemic or other health emergency. stockpile. The bill would require the department to establish guidelines for the procurement of the PPE stockpile, procurement, management, and distribution of PPE, taking into account, among other things, the amount of each type of PPE that would be required for all health care workers and essential workers in the state during the a 90-day pandemic or other health emergency, which would represent the amount of PPE to be maintained in the stockpile. emergency.

Existing law requires every employer to furnish and use safety devices and safeguards, and to adopt and use practices that are reasonably adequate to render the employment and place of employment safe and healthful.

The bill would would, commencing January 1, 2023, or one year after the adoption of specified regulations, whichever is later, require health care employers, including clinics, health facilities, and home health agencies, to maintain an inventory of new, unexpired PPE for use in the event of a declared state of emergency and would require the inventory to be at least sufficient for 30 or 45 days of surge consumption, as defined, according to specified deadlines. determined by regulation, as specified. The bill would also specify the surge consumption requirements for health care employers that are safety net providers, as defined. The bill would assess a civil penalty on a health care employer, including a safety net provider, employer who violates that requirement, as specified. The bill would declare a health care employer’s failure to ensure its health care workers use the PPE supplied to them and to provide PPE to its health care workers upon request to be an independent violation of the bill’s requirements. The bill would authorize the Department of Industrial Relations to exempt a health care employer from the above-required civil penalties if the department determines that supply chain limitations make meeting the mandated level of supplies for a specific type of PPE infeasible and the health care employer has made a reasonable attempt to obtain PPE, as specified. On or before January 15, 2021, the bill would require a health care employer to report to the Department of Industrial Relations under penalty of perjury its highest 7-day consecutive average consumption of PPE during the 2019 calendar year. By expanding the scope of the crime of perjury, the bill would impose a state-mandated local program. PPE, or if the health care employer has made a showing that they are not in possession of the mandated level of supplies due to reasons beyond their control, as specified.

The bill would require the Department of Industrial Relations to adopt regulations, in consultation with the State Department of Public Health, setting forth requirements for determining 45-day surge capacity levels, as specified, for a health care employer’s PPE inventory, and would authorize the Department of Industrial Regulations to incorporate by reference existing guidance from the department and from the federal Occupational Safety and Health Administration regarding standards for PPE usage. The bill would require the department to establish similar surge capacity requirements for safety net providers. inventory.

The bill would also establish the Personal Protective Equipment Advisory Committee (committee) to be composed of 18 or more members, as specified, appointed by the Secretary of Labor. The bill would require the Department of Industrial Relations to submit a report to the Legislature, on or before May 30, 2021, including, among other recommendations, recommendations regarding the type and amount of PPE needed by health care employers to ensure compliance with public health and safety standards and would require the committee to provide recommendations to the department necessary for the report. The bill would require the Department of Industrial Relations to submit an additional report to the Legislature, on or before January 1, 2031, on the effectiveness of the health care employer inventory requirement. Committee, consisting of representatives from skilled nursing facilities, physicians, and labor organizations that represent health care workers, among other groups, to make recommendations for the development of guidelines for the procurement, management, and distribution of PPE, as specified.

Existing law establishes the Made in California Program within the Governor’s Office of Business and Economic Development, to encourage consumer product awareness and to foster purchases of high-quality products made in California. Existing law creates the Made in California Fund within the State Treasury, consisting of donations and other moneys to be used for the purposes of the Made in California Program, as specified.

This bill would require the office, as a part of the Made in California Program, to encourage in-state production of PPE in order to assist the State Department of Public Health and providers in complying with the bill’s requirements. The bill would create the Health Care Workforce Protection Account within the Made in California Fund, consisting of donations and other moneys, for the exclusive purpose of promoting the production of PPE. The bill would continuously appropriate the donated moneys in the account for the purpose of implementing those provisions, thereby making an appropriation. The bill would require any other funds deposited and maintained in the account to be available for the same purpose, upon appropriation by the Legislature. The bill would declare that its provisions are severable.

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.

Digest Key

Vote: MAJORITY   Appropriation: YESNO   Fiscal Committee: YES   Local Program: YESNO  

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Bill Text

The people of the State of California do enact as follows:

SECTION 1.

This act shall be known, and may be cited, as the Health Care and Essential Workers Protection Act.

SEC. 2.Section 12098.12 is added to the Government Code, to read:

12098.12.

(a)(1)As part of the Made in California Program, the office shall encourage the in-state production of personal protective equipment, (PPE) in order to assist the State Department of Public Health in complying with Section 131021 of the Health and Safety Code and to assist providers in complying with Section 6403.1 of the Labor Code.

(2)For purposes of this section, “personal protective equipment” and “providers” have the same meanings as defined in subdivision (c) of Section 131021 of the Health and Safety Code.

(b)The office may accept monetary donations or other donations from businesses, nonprofit organizations, or individuals for the purpose of implementing this section. These donations shall be deposited in the account established in subdivision (c).

(c)The Health Care Workforce Protection Account is hereby created within the Made in California Fund established by subdivision (h) of Section 12098.10. Moneys deposited into the account shall be used exclusively for the promotion of in-state production of PPE for the purposes described in this section, Section 131021 of the Health and Safety Code, and Section 6403.1 of the Labor Code. The office shall use funds deposited into the account to provide grants, loans, loan guarantees, and other incentives for projects that increase capacity for the in-state manufacturing of PPE. Notwithstanding Section 13340, funds deposited and maintained in the account that were donated pursuant to subdivision (b) are continuously appropriated, without regard to fiscal years, to the director for the purposes of implementing this section. Any other funds deposited and maintained in the account shall be available, subject to appropriation by the Legislature, for purposes of implementing this section.

SEC. 3.SECTION 1.

 Section 131021 is added to the Health and Safety Code, to read:

131021.

 (a) The Legislature finds that having access to a statewide stockpile of personal protective equipment in the event of a pandemic or other health emergency is vital to the health and safety of its health care and essential workers, as well as the general population, which both relies on this workforce and is susceptible to disease transmission should members of this workforce needlessly be infected with transmissible disease. Moreover, the Legislature finds that having in-state production capacity for personal protective equipment is vital to ensuring access to that equipment in the event of a pandemic or other health emergency, in light of likely national and global supply chain disruption.

(b)The department shall establish a personal protective equipment (PPE) stockpile to ensure an adequate supply of PPE for health care workers and essential workers in the state that is at least sufficient for a 45-day pandemic or other health emergency. PPE in the stockpile shall be new and not previously worn or used.

(c)

(b) The following definitions apply for purposes of this section:

(1) “Department” means the State Department of Public Health.

(2) “Office” means the Office of Emergency Services.

(2)

(3) “Essential workers” means primary and secondary school workers, workers at detention facilities, as defined in Section 9500 of the Penal Code, in-home support providers, childcare providers, government workers whose work with the public continues throughout the crisis, and workers in other positions that the department, in its sole discretion, State Public Health Officer or the Director of the Office of Emergency Services deems vital to public health and safety, as well as economic and national security.

(3)

(4) “Health care worker” means any worker who provides direct patient care and services directly supporting patient care, including, but not limited, to physicians, pharmacists, clinicians, nurses, aides, technicians, janitorial and housekeeping staff, food services workers, and nonmanagerial administrative staff.

(4)

(5) “Personal protective equipment” or “PPE” means protective equipment for eyes, face, head, and extremities, protective clothing, respiratory devices, and protective shields and barriers, including, but not limited to, N95 and other filtering facepiece respirators, elastomeric air-purifying respirators with appropriate particulate filters or cartridges, powered air purifying respirators, disinfecting and sterilizing devices and supplies, medical gowns and apparel, face masks, surgical masks, face shields, gloves, shoe coverings, and the equipment identified by or otherwise necessary to comply with Section 5199 of Title 8 of the California Code of Regulations.

(5)

(6) “Provider” means a licensed clinic, as described in Chapter 1 (commencing with Section 1200), an outpatient setting, as described in Chapter 1.3 (commencing with Section 1248) of, a health facility as described in Chapter 2 (commencing with Section 1250) of, or a county medical facility, as described in Chapter 2.5 (commencing with Section 1440) of, Division 2, a home health agency, a physician’s office, a professional medical corporation, a medical partnership, a medical foundation, a rural health clinic, as defined in Section 1395x(aa)(2) of Title 42 of the United States Code, or a federally qualified health center, as defined in Section 1395x(aa)(4) of Title 42 of the United States Code, and any other entity that provides medical services in California.

(6)

(7) “Stockpile” means the personal protective equipment stockpile created pursuant to subdivision (b). (c).

(c) Within one year of the effective date of this section, the department and office, in coordination with other state agencies, shall establish a PPE stockpile, upon appropriation and as necessary.

(d)  The department shall consider the recommendations of the Personal Protective Equipment Advisory Committee created in Section 6403.2 of the Labor Code and establish guidelines for procurement of PPE for the stockpile. also establish guidelines for procurement, management, and distribution of PPE from the department. The department and office shall consider the recommendations of the Personal Protective Equipment Advisory Committee created pursuant to subdivision (f) in developing these guidelines. At a minimum, the guidelines shall take into account all of the following:

(1) The various types of PPE that may be required during a pandemic or other health emergency.

(2) The shelf life of each type of PPE to be obtained for the stockpile that may be obtained from the department and how to annually restock a portion of each type of PPE to ensure the stockpile consists procurements consist of unexpired PPE.

(3) The amount of each type of PPE that would be required for all health care workers and essential workers in the state during a 45-day 90-day pandemic or other health emergency, which shall be the amount of PPE maintained in the stockpile. emergency.

(4) Lessons learned from previous pandemics and state emergencies, including but not limited to, supply procurement, management, and distribution.

(5) Guidance on how to define essential workers based upon different hazards.

(6) Geographical distribution of PPE storage.

(7) Guidance on how to establish policies and standards for PPE surge capacity to ensure that workers have access to an adequate supply of PPE during a pandemic or other health emergency.

(8) The policies and funding that would be required for the state to establish a PPE stockpile.

(9) How distribution from any procurement shall be prioritized in the event that there is insufficient PPE to meet the needs of providers or employers of essential workers, including consideration of the following:

(e)The department shall consider the recommendations of the Personal Protective Equipment Advisory Committee established pursuant to Section 6403.2 of the Labor Code. Based on the committee’s recommendations as to the types of PPE and the determination of how to calculate the appropriate amount of PPE for the state stockpile, the department shall procure 20 percent of the full stockpile three years after enactment of the act that adds this section, only if the Office of Emergency Services determines that prices of PPE have returned to a normal level, adjusted for inflation. The department shall procure an additional 20 percent of the full stockpile in each of the subsequent four years, so that the department has procured 100 percent of the stockpile in five years.

(f)At least 25 percent of PPE in the stockpile shall be manufactured in California. Distribution of the 25 percent required to be manufactured in California shall be exclusively made via resale, whether sold during a state of emergency pursuant to paragraph (1) of, or sold in the normal course of business pursuant to paragraph (2) of, subdivision (g). The Governor shall have the authority to waive this requirement for one year if the Governor determines that the state cannot procure enough PPE to meet the in-state manufacturing requirements. The Governor shall notify the Legislature within 15 days of this determination.

(1)PPE that qualifies as being “substantially made” in California pursuant to Section 12098.10 of the Government Code presumptively counts towards the 25-percent threshold.

(2)PPE manufactured outside of California presumptively counts towards the 25-percent threshold if the following qualifications are met:

(A)The company manufacturing the product has manufacturing facilities in the state.

(B)The company is party to a community benefits agreement related to the in-state manufacturing facilities.

(C)The in-state manufacturing facilities provide services related to the PPE, including, but not limited to, packaging or distribution.

(g)The department shall distribute PPE from the stockpile only under either of the following two circumstances:

(1)If the Governor declares a state of emergency, or a local emergency is declared, for which PPE will be required.

(2)To sell PPE from the stockpile, provided that the department acquires new PPE to offset any shortage resulting from the sale.

(h)The department shall establish guidelines regarding distribution of PPE from the stockpile, including, but not limited to, the timing and amount of PPE distribution and identifying geographic areas in critical need of PPE, as well as the terms of sale should the department determine sale is appropriate. The guidelines shall provide, at a minimum, that in the event there is insufficient PPE to meet needs, the department may consider prioritizing distribution for providers and employers of essential workers that meet any of the following qualifications:

(1)

(A) The provider or employer is in a location with a high share of low-income residents.

(2)

(B) The provider or employer is in a medically underserved area, as designated by the United States Department of Health and Human Services, Health Resources and Services Administration.

(3)

(C) The provider or employer disproportionately serves a medically underserved population, as designated by the United States Department of Health and Human Services, Health Resources and Services Administration.

(4)

(D) The provider or employer is in a county with a high infection rate or high hospitalization rate related to the declared emergency.

(i) Before January 1, 2024, the department shall provide the Department of Finance with an estimate of the cost to fully stock the stockpile and to maintain the stockpile for the subsequent five years. The department shall update these estimates on an annual basis.

(e) The development of the guidelines shall be informed by the recommendations of the Personal Protective Equipment Advisory Committee pursuant to subdivision (f). The guidelines shall not establish policies or standards that are less protective or prescriptive than any federal, state, or local law on PPE standards.

(f) The Personal Protective Equipment Advisory Committee is hereby established. The advisory committee shall consist of the following:

(1) One representative of an association representing multiple types of hospitals and health systems.

(2) One representative of an association representing skilled nursing facilities.

(3) One representative of an association representing primary care clinics.

(4) One representative of a statewide association representing physicians.

(5) Two representatives of labor organizations that represent health care workers.

(6) Two representatives of labor organizations that represent essential workers, as defined by paragraph (3) of subdivision (b).

(7) One representative from the personal protective equipment manufacturing industry.

(8) One consumer representative.

(9) One representative from an association representing counties.

(10) One representative from the State Department of Public Health.

(11) One representative from the Office of Emergency Services.

(12) One representative from the Emergency Medical Services Authority.

(13) One representative from the State Department of Social Services.

(g) The Director of the Office of Emergency Services or their designee shall appoint the representatives from paragraphs (1) through (9), inclusive.

(h) The Personal Protective Equipment Advisory Committee shall make recommendations to the office and department necessary to develop the guidelines required pursuant to subdivision (d).

SEC. 4.SEC. 2.

 Section 6403.1 is added to the Labor Code, to read:

6403.1.

 (a) The Legislature hereby finds that having access to a health care employer-level inventory of personal protective equipment in the event of a pandemic or other health emergency is vital to the health and safety of its health care workforce, as well as the general population, who both rely on the state’s health care workforce for care and are susceptible to disease transmission should members of the health care workforce needlessly be infected with transmissible disease.

(b) For purposes of this section:

(1) “Department” means the Department of Industrial Relations.

(2) (A) “Health care employer” means a licensed clinic, as described in Chapter 1 (commencing with Section 1200) of, an entity described in subdivision (i) or (l) of Section 1206 of, an outpatient setting, as described in Chapter 1.3 (commencing with Section 1248) of, a health facility, as described in Chapter 2 (commencing with Section 1250), with the exception of facilities described in subdivisions (d), (e), (g), (h), and (m) of Section 1250 of, the Health and Safety Code, or a county medical facility, as described in Chapter 2.5 (commencing with Section 1440) of, Division 2 of the Health and Safety Code, a home health agency, a medical practice that is operated or maintained as part of an integrated health system or health facility, a rural health clinic, as defined in Section 1395x(aa)(2) of Title 42 of the United States Code, or a federally qualified health center, as defined in Section 1395x(aa)(4) of Title 42 of the United States Code. a person or organization that employs workers in the public or private sector to provide direct patient care in a general acute care hospital setting as defined in subdivision (a) of Section 1250 of the Health and Safety Code, a health facility as defined in paragraphs (1) and (2) of subdivision (c) of Section 1250 of the Health and Safety Code, a medical practice that is operated or maintained as part of an integrated health system or health facility, or a dialysis clinic licensed in accordance with paragraph (2) of subdivision (b) of Section 1204 of the Health and Safety Code.

(B) “Health care employer” does not include an independent medical practice that is owned and operated, or maintained as a clinic or office, by one or more licensed physicians and used as an office for the practice of their profession, within the scope of their license, regardless of the name used publicly to identify the place or establishment unless the medical practice is operated or maintained exclusively as part of an integrated health system or health facility or is an entity described in subdivision (l) of Section 1206 of the Health and Safety Code.

(3)“Safety net provider” means a health care employer, as described in paragraph (2), that is a licensed clinic, as described in subdivision (a) of Section 1204 of the Health and Safety Code, an intermittent clinic exempt from licensure under subdivision (h) of, or a tribal clinic exempt from licensure under subdivision (c) of, Section 1206 of the Health and Safety Code, or an outpatient setting conducted, maintained, or operated by a federally recognized Indian tribe, tribal organization, or urban Indian organization, as defined in Section 1603 of Title 25 of the United States Code, or a rural health clinic, as defined in Section 1395x(aa)(2) of, or a federally qualified health center, as defined in Section 1395x(aa)(4) of, Title 42 of the United States Code.

(4)

(3) “PPE” and “health care worker” have the same meanings as defined in subdivision (c) of Section 131021 of the Health and Safety Code.

(c) (1)Except as provided in paragraphs (1) and (2) of subdivision (h), a health care employer shall maintain an inventory of unexpired PPE, as specified in this section, for use in the event of a state of emergency declaration by the Governor, or a local emergency for a pandemic or other health emergency. Personal protective equipment in the inventory shall be new and not previously worn or used. Except as provided in paragraph (2), a A health care employer who violates the requirement to maintain an inventory of unexpired personal protective equipment prescribed by this section shall be assessed a civil penalty of up to twenty-five thousand dollars ($25,000) for each violation, as specified in Section 6428.

(2)A safety net provider that violates the requirement to maintain an inventory of unexpired personal protective equipment as specified in this section shall be assessed a civil penalty per violation, in an amount to be determined by the department, not to exceed a total of two thousand five hundred dollars ($2,500) per calendar year.

(d)(1)On or before January 15, 2021, the department, after consultation with the Office of Emergency Services, shall evaluate and make a determination as to whether there is a significant supply limitation of PPE facing purchasers in California. If the department determines there is not a significant supply limitation, commencing 60 days after this determination, only those health care employers licensed under subdivisions (a), (b), and (c) of Section 1250 of the Health and Safety Code shall maintain an inventory equal to a minimum of six months of daily consumption. For purposes of this subdivision, daily consumption shall be based on the highest seven-day consecutive daily average consumption of PPE in 2019. If the department determines that there is a significant supply limitation, the department shall revisit this determination every 30 days until there is a determination that there is no longer a significant supply limitation, after which employers described in subdivisions (a), (b), and (c) of Section 1250 of the Health and Safety Code shall have 60 days to maintain an inventory equal to a minimum of six months of daily consumption.

(2)The department may determine that a supply limitation only exists for one or more types of PPE, in which case a health care employer shall be required to maintain an inventory only for the types of PPE for which the department has determined there is not a supply limitation.

(3)In evaluating whether a significant supply chain limitation exists, the department shall take into account whether health care employers have made requests through their medical health operational area coordinators to obtain PPE.

(4)If the department determines there is a significant supply limitation, the department shall make findings with applicable evidence that supply chain limitations exist regarding a particular type of PPE. The findings shall be made in writing, submitted to the Legislature and relevant health care employers and relevant health care unions, and posted on the department’s internet website.

(5)For the purposes of paragraph (1), health employers licensed under subdivision (c) of Section 1250 of the Health and Safety Code shall only be required to have a 30-day supply of gloves until regulations are adopted pursuant to subdivision (k).

(e)(1)Commencing January 1, 2022, or 60 days after regulations are adopted pursuant to subdivision (k), health care employers, except as provided in subdivision (f), shall have an inventory at least sufficient for 30 days of surge consumption, as determined by those regulations.

(2)

(d) (1) Commencing January 1, 2023, or 365 days after regulations are adopted pursuant to subdivision (k), (h), whichever is later, health care employers shall have an inventory at least sufficient for 45 days of surge consumption, as determined by those regulations. The regulations shall not establish policies or standards that are less protective or prescriptive than any federal, state, or local law on PPE standards.

(2) A health care employer shall provide an inventory of its PPE to the Division of Occupational Safety and Health upon request. An employer who violates this requirement shall be assessed a civil penalty of up to twenty-five thousand dollars ($25,000) for each violation. This subdivision does not apply to a health care employer that provides services in a facility or other setting controlled or owned by another health care employer that is obligated to maintain a PPE inventory and report that inventory pursuant to this subdivision for all its owned or controlled facilities and settings.

(f)

A safety net provider shall do either of the following, starting six months after regulations established in subdivision (k) are adopted if there is no supply chain limitation on any type of PPE as described in subdivision (i), or January 1, 2023, whichever is later:

(1)Have an inventory at least sufficient for 30 days of surge consumption, as determined by the regulations adopted pursuant to subdivision (k).

(2)Demonstrate to the department that it has entered into a standing contract with a third-party entity that manufactures, maintains, or distributes PPE that ensures timely access to an inventory at least sufficient for 30 days of consumption, as determined by the regulations adopted pursuant to subdivision (k).

(g)On or before January 15, 2021, a health care employer licensed under subdivisions (a), (b), and (c) of Section 1250 of the Health and Safety Code shall report to the department under penalty of perjury its highest seven-day consecutive daily average consumption of PPE during the 2019 calendar year.

(h)

(e) (1) If a health care employer provides services in a facility or other setting controlled or owned by another health care employer who is obligated to maintain a PPE inventory, the health care employer who controls or owns the facility or other setting shall be required to maintain the required PPE for the health care employer providing services in that facility or setting.

(2) A health care employer may apply for a waiver of some or all of the PPE inventory requirements of subdivision (e) (d) by writing to the department, which may approve the waiver if the facility has 25 or fewer employees and the employer agrees to close in-person operations during a public health emergency in which increased use of PPE is recommended by the public health officer until sufficient PPE becomes available to return to in-person operations. This provision does not apply to health facilities as described in subdivisions (a), (b), and (c) of Section 1250 of the Health and Safety Code.

(3) If a health care employer’s inventory of a type of PPE dips below the mandated level of supplies as a result of the health care employer’s distribution of that type of PPE to its health care workers or another health care employer’s workers during a state of emergency declared by the Governor or a declared local emergency for a pandemic or other health emergency, the health care employer shall not be subject to the civil penalty established by subdivision (c) for 30 days, provided the health care employer replenishes its inventory to the mandated level within 30 days if the department has determined there is not a supply limitation pursuant to paragraph (4). If the health care employer’s inventory of a type of PPE dips below 75 percent of the mandated requirement, the health care employer shall notify the department in writing if the shortage is due to distribution of that type of PPE to health care workers. Safety net providers shall not be required to notify the department when their inventory goes below the required level. limitation.

(i)

(f) The department may exempt a health care employer from a civil penalty prescribed by subdivision (c) if the department determines that supply chain limitations make meeting the mandated level of supplies infeasible and a health care employer has made a reasonable attempt, in the discretion of the department, to obtain PPE. The department may grant an exemption only until the supply chain limitation has been resolved and the department shall revisit that determination every 30 days. This paragraph shall apply only to the specific type of PPE that is impacted by supply chain limitations. PPE, or if the health care employer makes a showing that meeting the mandated level of supplies is not possible due to issues beyond their control, such as if the equipment was ordered from a manufacturer or distributor but the order was not fulfilled, or if the equipment was damaged or stolen.

(j)(1)

(g) Consistent with existing law, a designated health care employer shall supply appropriate PPE to its health care workers, ensure that its health care workers use the PPE supplied to them, and provide appropriate PPE to its health care workers upon their request. This paragraph is declaratory of existing law.

(2)Each day that a health care employer fails to comply with paragraph (1) shall constitute an independent violation of this section.

(3)Notwithstanding paragraph (2) and existing law, a safety net provider who violates paragraph (1) shall be assessed a civil penalty per violation, in an amount to be determined by the department, not to exceed a total of two thousand five hundred dollars ($2,500) per calendar year.

(k)

(h) (1)The department, by regulation and in consultation with the State Department of Public Health, shall set forth requirements for determining 45-day surge capacity levels for health care employer inventory as required by paragraph (1) of subdivision (e), (d), including, but not limited to, the types and amount of PPE to be maintained by the health care employer based on the type and size of each health care employer, as well as the composition of health care workers in its workforce. The regulations shall require each health care employer to maintain sufficient PPE for all health care workers. The regulations shall consider the recommendations of the Personal Protective Equipment Advisory Committee established pursuant to Section 6403.2. For employers described in subdivision (a), (b), or (c) of Section 1250 of the Health and Safety Code, the requirement to maintain an inventory of at least six months of daily consumption pursuant to subdivision (d) shall be a minimum level, and regulations establishing surge capacity levels shall not require less than this amount. The regulations may incorporate by reference existing guidance of the department and of the federal Occupational Safety and Health Administration regarding standards for PPE usage, including, but not limited to, the guidance at Sections 3380 and 5199 of Title 8 of the California Code of Regulations and Subpart I (commencing with Section 1910.132) of Part 1910 of Title 29 of the Code of Federal Regulations, as in effect on May 19, 2020.

(2)The department, by regulation and in consultation with the State Department of Public Health and the Personal Protective Equipment Advisory Committee, shall set forth requirements for calculating capacity levels for safety net providers’ inventory as required by subdivision (f), including, but not limited to, the types and amount of PPE to be maintained by the health care employer that is a safety net provider, based on anonymized facility information regarding the type and size of each health care employer and its workforce.

(l)A health care employer shall provide an inventory of its PPE to the Division of Occupational Safety and Health upon request. An employer who violates this requirement shall be assessed a civil penalty of up to twenty-five thousand dollars ($25,000) for each violation. This subdivision does not apply to health care employers that are safety net providers or to a health care employer that provides services in a facility or other setting controlled or owned by another health care employer that is obligated to maintain a PPE inventory and report that inventory pursuant to this subdivision for all its owned or controlled facilities and settings.

SEC. 5.Section 6403.2 is added to the Labor Code, to read:

6403.2.

(a)The Personal Protective Equipment Advisory Committee is hereby established. The Secretary of Labor or their designee shall appoint the membership of the advisory committee. The advisory committee shall consist of 18 or more individuals who have experience in health care, public health, workers’ rights, or emergency preparedness and shall consist of the following:

(1)One representative of an association representing multiple types of hospitals and health systems.

(2)One representative of an association representing skilled nursing facilities.

(3)Two representatives of an association representing primary care clinics, with one of those members representing clinics specializing in family planning that are safety net providers.

(4)One representative of a statewide association representing physicians from multiple specialties and modes of practice.

(5)Three representatives of labor organizations that represent health care workers.

(6)Three representatives of labor organizations that represent essential workers, as defined by paragraph (2) of subdivision (c) of Section 131021 of the Health and Safety Code, with one of the members from a labor union representing agricultural workers.

(7)One representative of an association representing home health agencies.

(8)One consumer representative.

(9)One representative from the Department of Industrial Relations.

(10)One representative from the State Department of Public Health.

(11)One representative from the Office of Emergency Services.

(12)One representative from an association representing counties.

(13)One public member with expertise in emergency preparedness and employee health and safety.

(14)One representative from the Department of General Services.

(15)One representative from an association representing ambulatory surgery centers.

(b)The Personal Protective Equipment Advisory Committee shall make recommendations to the department and the State Department of Public Health necessary for the department to provide the report required pursuant to subdivision (c).

(c)On or before May 30, 2021, the department shall submit a report to the Legislature based on the recommendations of the Personal Protective Equipment Advisory Committee. The report shall include recommendations on implementation of the various requirements of the committee and shall include, but not be limited to, recommendations relating to both of the following:

(1)The type and amount of PPE needed by health care employer type, during a public health emergency, to ensure compliance to public health and safety standards.

(2)The type and amount of PPE required for the state stockpile created pursuant to Section 131021 of the Health and Safety Code.

(3)Guidance on best practices for how health care employers may make fit testing available for their workforce to be properly fitted for PPE.

(4)Actions that the state can take to encourage a resilient supply chain and to incentivize in-state production of PPE. The committee shall create an additional working group, made up of interested members of the committee and subject matter experts in supply chain and distribution management or other areas of expertise, to provide guidance on actions the state can take to create a state-run group purchasing organization by 2023.

(5)Guidance on best practices for provider inventory storage.

(6)Strategies to increase transparency for both the state stockpile and health care employers’ inventory.

(7)With regard to health care employers, other than health facilities described in Chapter 2 (commencing with Section 1250) of Division 2 of the Health and Safety Code, the report in this subdivision shall take into consideration the following factors:

(A)Patient volume during a pandemic emergency.

(B)The ability of an employer to utilize telemedicine to minimize in-person contact.

(C)The intent of the Legislature that the inventory required for these employers be composed primarily of PPE that the employer would utilize in the normal course of business.

(d)On or before January 1, 2031, the department and the State Department of Public Health shall submit a report to the Legislature on the effectiveness of the health care employer inventory requirement and make recommendations, if any, that will improve health care worker safety and health care employer preparedness during a pandemic or other health emergency. The report shall also review the effectiveness of the state stockpile.

(1)A report to be submitted pursuant to subdivision (c) or (d) shall be submitted in compliance with Section 9795 of the Government Code.

(2)Pursuant to Section 10231.5 of the Government Code, this section is repealed on January 1, 2035.

SEC. 6.SEC. 3.

 The provisions of this act are severable. If any provision of this act or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application.

SEC. 7.

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.