BILL NUMBER: AB 2886	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Nakanishi

                        FEBRUARY 22, 2008

   An act to add and repeal Section 1288.65 of the Health and Safety
Code, relating to hospitals.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 2886, as introduced, Nakanishi. Hospitals: sepsis reduction
pilot program.
   Existing law provides for the licensure and regulation by the
State Department of Public Health of health facilities, including
general acute care hospitals, as defined. Existing law requires
health facilities to implement various measures to protect against
the spread of infection in health facilities. Existing law also
requires the department, by July 1, 2007, to appoint a Healthcare
Associated Infection Advisory Committee, composed of specified
members, that is required to make recommendations related to methods
of reporting cases of hospital acquired infections occurring in
general acute care hospitals, as provided.
   This bill would require the department, in conjunction with the
committee, to plan and implement a pilot program, until January 1,
2011, to reduce sepsis-related deaths in no more than 20 qualified
general acute care hospitals in geographically diverse regions of the
state. The bill would require each qualified hospital to receive
specified funding upon meeting certain criteria, require the
department to prepare a report regarding the efficacy of the program,
and would specify that the pilot program would be implemented only
to the extent that funding is made available from prescribed sources.

   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


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

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) Sepsis with acute organ dysfunction, commonly referred to as
severe sepsis, is the leading cause of death in patients in
noncoronary intensive care units, with mortality rates ranging from
28 to 50 percent or more.
   (b) More than 750,000 Americans develop severe sepsis each year,
with a mortality rate of more than 200,000 people each year in the
United States.
   (c) The blood pressure of a patient who has severe sepsis drops
precipitously, which results in shock, and the major organs and
systems of the patient, including, but not limited to, the kidneys,
liver, lungs, and central nervous system, cease to function normally.

   (d) The number of cases of severe sepsis is expected to increase
because of the number of patients with compromised immune systems,
the use of invasive medical procedures, the number of resistant
microorganisms, and the growth of the elderly population.
   (e) Early goal directed therapy (EGDT), a bundled sepsis
management approach developed by Dr. Manny Rivers, has been proven to
reduce mortality by nearly 25 percent when used in the first six
hours of sepsis presentation as recommended by the 2008 International
Sepsis Guidelines.
   (f) A reduction of 20 percent in sepsis-related deaths would save
an estimated $800,000 per hospital per year.
   (g) Despite increased understanding, there is a lack of
centralized information and use of the EGDT protocol in California.
  SEC. 2.  Section 1288.65 is added to the Health and Safety Code, to
read:
   1288.65.  (a) The department, in conjunction with the Healthcare
Associated Infection Advisory Committee, shall plan and implement a
two-year pilot program to reduce sepsis-related deaths in general
acute care hospitals by encouraging the implementation of early goal
directed therapy protocols. The goal of the program is to reduce
sepsis-related deaths by at least 20 percent.
   (b) The pilot program shall be implemented in no more than 20
qualified hospitals in geographically diverse regions of the state.
   (c) Each qualified hospital chosen to participate in the pilot
program shall receive twenty-five thousand dollars ($25,000) upon
receipt of the application and verification of eligibility. Hospitals
shall be given an additional twenty-five thousand dollars ($25,000)
if they do both of the following:
   (1) Implement early goal directed therapy protocols as adopted by
the Surviving Sepsis Campaign and published by the Society of
Critical Care Medicine.
   (2) Subject to Section 56.10 of the Civil Code regarding
confidential patient information, collect and submit data to the
department and to the Surviving Sepsis Campaign data clearinghouse
for use in international clinical outcome studies.
   (d) As used in this section, "qualified hospital" means a general
acute care hospital, as defined in subdivision (a) of Section 1250,
which meets all of the following requirements:
   (1) Is located in California.
   (2) Has not yet implemented early goal directed therapy protocols.

   (3) At least 25 percent of the patients are covered by Medi-Cal.
   (e) The department shall prepare a report on the effect of the
pilot program on the incidence of sepsis and sepsis-related deaths,
as well as estimates of costs avoided, to be submitted to the
Legislature and the Governor's Office on or before January 1, 2011.
   (f) This section shall be implemented only to the extent that
advance funding sufficient to pay the total cost of the pilot program
is received in the form of gifts, grants, and donations from
individuals, private organizations, foundations, or governmental
units other than the state, or an appropriation is made for this
purpose in the annual Budget Act or other statute.
   (g) This section shall remain in effect only until January 1,
2012, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2012, deletes or extends
that date.