Bill Text: CA SB455 | 2013-2014 | 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: 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-Amended.html

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BILL NUMBER: SB 455	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  JUNE 10, 2013
	AMENDED IN SENATE  APRIL 16, 2013

INTRODUCED BY   Senator Hernandez

                        FEBRUARY 21, 2013

   An act to add Section  1276.35   1276.45
 to the Health and Safety Code, relating to health facilities.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 455, as amended, Hernandez. General acute care hospitals:
patient classification system.
   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 require the department to require every
general acute care hospital to establish and maintain a patient
classification system for establishing staffing requirements by unit,
patient, and shift, and to establish a review committee to review
the reliability of the system, and review the system at least
annually.   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, as defined. 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-mandate local program. 
   This bill would state that it is the Legislature's intent in
enacting this bill to supersede specified provisions of a certain
regulation, and not to affect any other provision in that regulation.

   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 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
established pursuant to 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.
   (3) For purposes of this subdivision, "direct patient care" means
caring directly for patients for a minimum of 50 percent of the
registered nurse's work time.  
  SECTION 1.    Section 1276.35 is added to the
Health and Safety Code, immediately following Section 1276.3, to
read:
   1276.35.  (a) The State Department of Public Health shall require
every health facility licensed pursuant to subdivision (a) of Section
1250 to do all of the following:
   (1) Establish and maintain a patient classification system for
establishing staffing requirements by unit, patient, and shift.
   (2) Establish a patient classification system review committee to
review the reliability of the patient classification system, as
follows:
   (A) The review committee shall be appointed by the nursing
administration of the facility, except as set forth in subparagraph
(C).
   (B) At least one-half of the membership of the review committee
shall be composed of registered nurses who provide direct patient
care.
   (C) If the registered nurses are represented by a collective
bargaining agent, the registered nurses shall be appointed by the
bargaining agent.
   (3) The patient classification system shall be reviewed at least
annually.
   (b) No new regulations are required or authorized for
implementation of this section. 
   SEC. 2.    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 provision
in that regulation. 
   SEC. 2.   SEC. 3.   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.