BILL NUMBER: SB 1058 AMENDED
BILL TEXT
AMENDED IN SENATE FEBRUARY 25, 2008
INTRODUCED BY Senator Alquist
JANUARY 7, 2008
An act to add Sections 1255.8 and 1569.39
120141 to the Health and Safety Code, relating to health.
LEGISLATIVE COUNSEL'S DIGEST
SB 1058, as amended, Alquist. Health and care
facilities: bacterial infections.
Existing law provides for the licensure and regulation of health
facilities by the State Department of Public Health and of
residential care facilities for the elderly by the State Department
of Social Services . A violation of these provisions is a
crime.
This bill would establish the Medical Facility Infection Control
and Prevention Act, which would require each health facility
and residential care facility for the elderly to implement
certain procedures for the screening, prevention, and reporting of
specified health facility and residential care facility for
the elderly acquired infections. The bill would also
require that each laboratory licensed by the state to perform
specified microbiological testing relating to the identification of
bacterial species and the antibiotic resistance patterns of those
species to also report any information obtained by that laboratory on
the incidence of any facility acquired infections within 5 working
days after obtaining the information. This bill would require the
State Department of Health Care Services and the State
Department of Social Services department to
carry out certain duties in order to implement the bill. Because a
violation of the health facility and residential care
facility for the elderly provisions would be
is a crime, the bill would impose a
state-mandated local program.
Existing law permits the State Department of Public Health to take
various actions to prevent and control the spread of infectious
diseases in this state.
This bill would require the department to take various measures to
prevent, control, and monitor the spread of infectious diseases,
including the sponsoring of local and regional training and the
provision of assistance to local health departments, as prescribed.
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. The Legislature finds and declares all of the
following:
(a) (1) The protection of patients in California health facilities
is of paramount importance to the citizens of this state.
(2) During the past two decades health care facility associated
infections, especially those that are acquired in health
care settings and that are resistant to commonly used
antibiotics, have increased dramatically.
(3) The State Department of Public Health and the State
Department of Social Services need needs to
develop a better, more efficient system to monitor and report the
incidence of antibiotic-resistant and other infections
that are acquired by patients in health facilities and
residential care facilities for the elderly .
(4) These departments need The department
needs to establish and maintain a comprehensive inspection and
reporting system for health facilities and residential care
facilities for the elderly that will ensure that those
facilities comply with state laws and regulations designed to reduce
the incidence of facility associated infections.
(b) It is, therefore, the intent of the Legislature to enact
legislation that will do all of the following:
(1) Ensure that California's standards for protecting patients
from exposure to pathogens associated with in
health facilities and residential care facilities for the
elderly, including Methicillin-resistant Staphylococcus aureus (MRSA)
are adequate to reduce the incidence of antibiotic-resistant
infection acquired by patients in these facilities.
(2) Require that licensed health facilities and residential care
facilities for the elderly report specified health care associated
pathogens to the State Department of Public Health and the State
Department of Social Services, respectively.
(3)
(2) Require these departments to develop and implement
an Internet-based public reporting system that provides updated
information regarding the incidence of infections caused by
health care , including associated pathogens
found acquired in health facilities
and residential care facilities for the elderly .
(4)
(3) Ensure that health facilities and
residential care facilities for the elderly implement
improved procedures intended to maintain sanitary standards in these
facilities, avoid transmission of health care facility
associated pathogens that cause infection , and
provide adequate training to health care professionals regarding the
prevention and treatment of MRSA and other infections in
these facilities.
SEC. 2. This act shall be known, and may be cited as, the Medical
Facility Infection Control and Prevention Act.
SEC. 3. Section 1255.8 is added to the Health and Safety Code, to
read:
1255.8. (a) For purposes of this section, the following terms
have the following meanings:
(1) "Colonized" means that the a
pathogen is present on the patient's body, but is not causing any
signs or symptoms of an infection.
(2) "Health facility acquired infection" means any
a localized or systemic condition resulting from
an exposure adverse reaction to the
presence of an infectious agent or toxin that occurs during
the time a person is a patient of a not present or
incubating at the time of admission to the health facility.
(3) "Methicillin-resistant Staphylococcus aureus (MSRA) infection"
means an infection caused by a strain of Staphylococcus aureus
bacteria that is resistant to those antibiotics known as
beta-lactams, including, but not limited to, methicillin,
amoxicillin, and penicillin.
(3) "MRSA" means Methicillin-resistant Staphylococcus aureus.
(b) (1) Each health facility shall develop, implement, and
periodically evaluate procedures for identifying patients who are
colonized by, or infected with, a health facility acquired
toxin or pathogen. MRSA.
(2) Each health facility shall, in accordance with subdivision
(d), implement a procedure to test screen
each patient who is scheduled to undergo an inpatient
orthopedic or cardiac or outpatient surgery, or
who is admitted to an intensive care unit, burn unit, or other unit
at high risk for the presence of the MRSA bacterium.
MRSA.
(c) Each patient who is admitted to a general acute care hospital
shall be tested screened for MRSA
, in accordance with subdivision (d), in the
following cases:
(1) The patient presents with an open, nondraining wound,
cellulitis, dermatological lesions, or a pressure ulcer on the skin.
(2) The patient has been previously discharged from a general
acute care hospital within 30 days prior to the current hospital
admission.
(3) The patient will be admitted to an intensive care unit of the
hospital.
(4) The patient will receive receives
inpatient or outpatient dialysis treatment.
(5) The patient is being transferred from a rehabilitation or
skilled nursing facility or other acute care health
facility, is homeless, or is being admitted directly from a homeless
shelter.
(6) The patient has
recently received invasive treatment in an oncology, hematology,
transplant, or other specialty care unit of a hospital within 30 days
prior to admission to the hospital. skilled nursing
facility.
(6) The patient is homeless or is being admitted directly from a
homeless shelter.
(7) The patient is being admitted directly from prison.
(7)
(8) The patient is a hospital roommate of another
patient who has tested positive for MRSA.
(8) The patient will be admitted to the hospital for a period of
time that will exceed seven days.
(9) The patient has a prior history of MRSA infection.
(10) The patient is an intravenous drug user.
(d) (1) A patient tested for MRSA pursuant to paragraph (2) of
subdivision (b) or subdivision (c) may be tested during a period of
up to two weeks prior to the patient's admission to the facility.
(2) The patient tested, in accordance with paragraph (1) shall
(d) A patient screened in accordance
with subdivision (c) shall again be tested for MRSA immediately
prior to his or her discharge from the facility. A patient who tests
positive for the MRSA bacterium MRSA
pursuant to this paragraph shall not be discharged from the facility
until an appropriately licensed medical professional determines that
the patient's infection can be controlled and does not pose a threat
to the health and safety of others.
(e) Each health facility shall take all reasonable measures to
maintain a clean, sanitary, and pathogen-free environment, that, at a
minimum, shall include all of the following:
(1) Regular disinfection of all restrooms, countertops, furniture,
televisions, telephones, bedding, office equipment, and surfaces in
patient rooms, nursing stations, and storage units.
(2) Regular removal of accumulations of bodily fluids and
intravenous substances, and cleaning and disinfection of all movable
medical equipment, including point-of-care testing devices such as
glucometers, and transportable medical devices such as cardiac
monitors, gurneys, feeding pumps, storage containers, and medication
dispensing devices.
(3) Regular cleaning and disinfection of all surfaces in common
areas in the facility such as elevators, meeting rooms, and lounges.
(f) (1) Each health facility shall maintain an adequate number of
staff responsible for the implementation of infection control
programs, in accordance with the following requirements:
(A) One infection control staff person shall be employed by the
facility for every 100 occupied beds at the facility.
(B) One infection control staff person shall be employed by the
facility for every 200 outpatient visits per day at the facility.
(2) An infection control staff person required to be employed by a
health facility pursuant to subparagraph (A) shall be a properly
licensed registered nurse or other appropriately qualified and
licensed medical professional.
(g) Each health facility shall regularly report to the department
on the number of all cases of a health
facility acquired infection, including MRSA, that exceeds a
baseline level of two or more cases at the facility in a seven-day
period. The report shall be in both written and electronic form, and
the identification of the pathogen causing each
infection. The department shall make those statistics
pertaining to health facility acquired infection rates at specified
health facilities available on its Internet Web site. This
information shall be public and shall include the rate of infections
caused by MRSA and other pathogens.
(h) Each laboratory licensed by the state to perform
microbiological testing, including, but not limited to, routine
culture and antibiotic resistance testing, or biochemical,
biological, genetic or other assays to determine bacterial species
identification and the antibiotic resistance patterns of those
species shall also report any information obtained by that laboratory
pertaining to the discovery or the incidence of any health facility
acquired infections, including MRSA, within five working days after
obtaining the information.
SEC. 4. Section 1569.39 is added to the Health
and Safety Code, to read:
1569.39. (a) For purposes of this section, the following terms
have the following meanings:
(1) "Colonized," means that the pathogen is present on the patient'
s body, but is not causing any signs or symptoms of an infection.
(2) "Residential care facility for the elderly acquired infection"
means any localized or systemic condition resulting from an exposure
to the presence of an infectious agent or toxin that occurs during
the time a person is a resident of a residential care facility for
the elderly.
(3) "Methicillin-resistant Staphylococcus aureus (MSRA) infection"
means an infection caused by a strain of Staphylococcus aureus
bacteria that is resistant to those antibiotics known as
beta-lactams, including, but not limited to, methicillin,
amoxicillin, and penicillin.
(b) Each residential care facility for the elderly shall develop,
implement, and periodically evaluate procedures for identifying
patients who are colonized by, or infected with, a residential care
facility for the elderly acquired toxin or pathogen.
(c) (1) Each residential care facility for the elderly shall, in
accordance with paragraph (2), implement a procedure to test each
resident of the facility for MRSA prior to admission.
(2) A patient tested for MRSA pursuant to paragraph (1) may be
tested during a period of up to two weeks prior to the patient's
admission to the facility.
(d) Each residential care facility for the elderly shall take all
reasonable measures to maintain a clean, sanitary, and pathogen-free
environment, that, at a minimum, shall include all of the following:
(1) Regular disinfection of all restrooms, countertops, furniture,
televisions, telephones, bedding, office equipment, and surfaces in
patient rooms, nursing stations, and storage units.
(2) Regular removal of accumulations of bodily fluids and
intravenous substances, and cleaning and disinfection of all movable
medical equipment, including point-of-care testing devices such as
glucometers, and transportable medical devices such as cardiac
monitors, gurneys, feeding pumps, storage containers, and medication
dispensing devices.
(3) Regular cleaning and disinfection of all surfaces in common
areas in the facility such as elevators, meeting rooms, and lounges.
(e) Each residential care facility for the elderly shall be
required to employ one infection control staff person for every 100
occupied beds at the facility. The infection control staff person
shall be a properly licensed registered nurse or other appropriately
qualified and licensed medical professional.
(f) Each residential care facility for the elderly shall regularly
report to the department on the number of cases of a residential
care facility for the elderly acquired infection, including MRSA,
that exceeds a baseline level of two or more cases at the facility in
a seven-day period. The report shall be in both written and
electronic form, and the department shall make those statistics
pertaining to a residential care facility for the elderly acquired
infection rates at specified residential care facilities for the
elderly available on its Internet Web site.
(g) Each laboratory licensed by the state to perform
microbiological testing, including, but not limited to, routine
culture and antibiotic resistance testing, or biochemical,
biological, genetic or other assays to determine bacterial species
identification and the antibiotic resistance patterns of those
species shall also report any information obtained by that laboratory
pertaining to the discovery or the incidence of any a residential
care facility for the elderly acquired infections, including MRSA,
within five working days after obtaining the information.
SEC. 4. Section 120141 is added to the
Health and Safety Code , to read:
120141. The department shall take all of the following measures
to prevent, control, and monitor the spread of infectious diseases:
(a) Sponsor local and regional training on basic data analysis to
better prepare local health departments to control and track disease
outbreaks.
(b) Provide local health departments and local health officers
with an inventory of basic electronic disease investigation data
analysis software.
(c) Develop statewide exercises that emphasize the complete cycle
involving communicable disease investigation, including surveillance,
response investigation, disease control and recovery, and that
assist local health officers to enhance, improve, and evaluate the
responses of local health departments to disease outbreaks.
SEC. 5. 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.