Bill Text: CA SB455 | 2013-2014 | Regular Session | Enrolled
Bill Title: General acute care hospitals: nurse-to-patient ratios.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Vetoed) 2014-09-29 - In Senate. Consideration of Governor's veto pending. [SB455 Detail]
Download: California-2013-SB455-Enrolled.html
BILL NUMBER: SB 455 ENROLLED
BILL TEXT
PASSED THE SENATE AUGUST 27, 2014
PASSED THE ASSEMBLY AUGUST 19, 2014
AMENDED IN ASSEMBLY AUGUST 6, 2014
AMENDED IN ASSEMBLY JUNE 25, 2013
AMENDED IN ASSEMBLY JUNE 10, 2013
AMENDED IN SENATE APRIL 16, 2013
INTRODUCED BY Senator Hernandez
FEBRUARY 21, 2013
An act to amend Section 1279 of, and to add Section 1276.45 to,
the Health and Safety Code, relating to health facilities.
LEGISLATIVE COUNSEL'S DIGEST
SB 455, Hernandez. General acute care hospitals: nurse-to-patient
ratios.
Existing law establishes the State Department of Public Health and
sets forth its powers and duties, including, but not limited to, the
licensing and regulation of health facilities, as defined.
Existing law requires the department to adopt regulations
governing the operation of a health facility, including, but not
limited to, regulations that require prescribed health facilities to
meet minimum nurse-to-patient ratios, and to assign additional staff
according to a documented patient classification system for
determining nursing care requirements. Violation of these provisions,
or willful or repeated violation of the rules or regulations, is a
crime.
This bill would, with respect to this patient classification
system, require that a committee for each general acute care hospital
review the reliability of this system for validating staffing
requirements at least annually to determine whether the system
accurately measures patient care needs. The bill would require that
at least 50% of the committee members be registered nurses who
provide direct patient care. The bill would require that these nurses
be appointed by the bargaining agent of the registered nurses, if
any, and in the absence of a bargaining agent, by the nursing
administrator. The bill would require the remaining members of the
committee to be appointed by the nursing administrator. By changing
the definition of an existing crime, this bill would impose a
state-mandated local program.
This bill would state that it is the Legislature's intent in
enacting these provisions to supersede specified provisions of a
certain regulation, and not to affect any other law.
Existing law requires the department to periodically inspect
every licensed health facility for compliance with state law and
regulations.
This bill would require the department, during its periodic
inspection of a general acute care hospital, to inspect for
compliance with the minimum nurse-to-patient ratios established
pursuant to existing law.
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.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1276.45 is added to the Health and Safety Code,
immediately following Section 1276.4, to read:
1276.45. (a) With respect to the patient classification system
referenced in subdivision (b) of Section 1276.4, a committee for each
general acute care hospital shall review the reliability of this
system for validating staffing requirements at least annually to
determine whether or not the system accurately measures patient care
needs.
(b) (1) At least 50 percent of the committee members shall be
registered nurses who provide direct patient care. These registered
nurses shall be appointed by the bargaining agent of the registered
nurses, if any, and in the absence of a bargaining agent, shall be
appointed by the nursing administrator.
(2) The remaining members of the committee shall be appointed by
the nursing administrator.
SEC. 2. Section 1279 of the Health and Safety Code is amended to
read:
1279. (a) Every health facility for which a license or special
permit has been issued shall be periodically inspected by the
department, or by another governmental entity under contract with the
department. The frequency of inspections shall vary, depending upon
the type and complexity of the health facility or special service to
be inspected, unless otherwise specified by state or federal law or
regulation. The inspection shall include participation by the
California Medical Association consistent with the manner in which it
participated in inspections, as provided in Section 1282 prior to
September 15, 1992.
(b) Except as provided in subdivision (c), inspections shall be
conducted no less than once every two years and as often as necessary
to ensure the quality of care being provided.
(c) For a health facility specified in subdivision (a), (b), or
(f) of Section 1250, inspections shall be conducted no less than once
every three years, and as often as necessary to ensure the quality
of care being provided.
(d) During the inspection, the representative or representatives
shall offer advice and assistance to the health facility as they deem
appropriate.
(e) For acute care hospitals of 100 beds or more, the inspection
team shall include at least a physician, registered nurse, and
persons experienced in hospital administration and sanitary
inspections. During the inspection, the team shall offer advice and
assistance to the hospital as it deems appropriate.
(f) The department shall ensure that a periodic inspection
conducted pursuant to this section is not announced in advance of the
date of inspection. An inspection may be conducted jointly with
inspections by entities specified in Section 1282. However, if the
department conducts an inspection jointly with an entity specified in
Section 1282 that provides notice in advance of the periodic
inspection, the department shall conduct an additional periodic
inspection that is not announced or noticed to the health facility.
(g) (1) Notwithstanding any other law, the department shall
inspect for compliance with state law and regulations during a state
periodic inspection or at the same time as a federal periodic
inspection, including, but not limited to, an inspection required
under this section. If the department inspects for compliance with
state law and regulations at the same time as a federal periodic
inspection, the inspection shall be done consistent with the guidance
of the federal Centers for Medicare and Medicaid Services for the
federal portion of the inspection.
(2) During every periodic state inspection of a general acute care
hospital, the department shall inspect for compliance with the
nurse-to-patient ratios established pursuant to Section 1276.4.
(h) The department shall emphasize consistency across the state
and its district offices when conducting licensing and certification
surveys and complaint investigations, including the selection of
state or federal enforcement remedies in accordance with Section
1423. The department may issue federal deficiencies and recommend
federal enforcement actions in those circumstances where they provide
more rigorous enforcement action.
SEC. 3. It is the intent of the Legislature in enacting Section
1276.45 of the Health and Safety Code to supersede subdivisions (e)
and (f) of Section 70217 of Title 22 of the California Code of
Regulations, and not to affect any other law.
SEC. 4. 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.
