BILL NUMBER: AB 491	AMENDED
	BILL TEXT

	AMENDED IN SENATE  AUGUST 24, 2012
	AMENDED IN SENATE  JULY 6, 2012
	AMENDED IN ASSEMBLY  MAY 10, 2011
	AMENDED IN ASSEMBLY  APRIL 15, 2011
	AMENDED IN ASSEMBLY  APRIL 5, 2011

INTRODUCED BY   Assembly Member  Miller   Ma

    (   Coauthors:   Assembly Members 
 Garrick   and Miller   ) 
    (   Coauthor:   Senator   Wyland
  ) 

                        FEBRUARY 15, 2011

    An act to add and repeal Section 969.7 of the Streets and
Highways Code, relating to public roads.   An act to
amend Section 1255 of the Health and Safety Code, relating to health
facilities, and declaring the urgency thereof, to take effect
immediately. 



	LEGISLATIVE COUNSEL'S DIGEST


   AB 491, as amended,  Miller   Ma  .
 Public roads: fire suppression.   General acute
care hospitals: cardiac catheterization.  
   Existing law provides for the licensure and regulation of health
facilities, including general acute care hospitals, administered by
the State Department of Public Health. A violation of these
provisions is a crime.  
   Existing law authorizes the department to approve, as prescribed,
a general acute care hospital to offer specified special services,
including, but not limited to, cardiac catheterization laboratory
services, in addition to the basic services offered under the
facility's license.  
   This bill would authorize the expansion of a cardiac
catheterization laboratory service under specified circumstances.
Because this bill would expand the definition of a crime, it would
impose a state-mandated local program.  
   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.  
   This bill would declare that it is to take effect immediately as
an urgency statute.  
   Existing law authorizes a county board of supervisors, after
adopting a resolution, as specified, determining that the general
county interest demands the improvement or repair of a privately
owned road, to improve or repair that road and to pay for those
improvements or repairs in a like manner as improvements or repairs
of county highways.  
   This bill, until January 1, 2017, would grant a board of
supervisors the same authority with respect to improvement and repair
of a public road that is not a county highway or part of the county
maintained system, if necessary for purposes of fire suppression.

   Vote:  majority   2/3  . Appropriation:
no. Fiscal committee:  no   yes .
State-mandated local program:  no   yes  .


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

   SECTION 1.    Section 1255 of the   Health
and Safety Code   is amended to read: 
   1255.   (a)    In addition to the basic services
offered under the license, a general acute care hospital may be
approved in accordance with subdivision (c) of Section 1277 to offer
special services, including, but not limited to, the following:

   (a) 
    (1)  Radiation therapy department. 
   (b) 
    (2)  Burn center. 
   (c) 
    (3)  Emergency center. 
   (d) 
    (4)  Hemodialysis center (or unit). 
   (e) 
    (5)  Psychiatric. 
   (f) 
    (6)  Intensive care newborn nursery. 
   (g) 
    (7)  Cardiac surgery. 
   (h) 
    (8)  Cardiac catheterization laboratory. 
   (i) 
    (9)  Renal transplant. 
   (j) 
    (10)  Other special services as the department may
prescribe by regulation. 
    A 
    (b)     A  general acute care hospital
that exclusively provides acute medical rehabilitation center
services may be approved in accordance with subdivision (b) of
Section 1277 to offer special services not requiring surgical
facilities. 
   The state 
    (c)    The  department shall adopt
standards for special services and other regulations as may be
necessary to implement this section.  For 
    (d)     (1)    For 
cardiac catheterization laboratory service, the  state
 department shall, at a minimum, adopt standards and
regulations that specify that only diagnostic services, and what
diagnostic services, may be offered by  an   a
general  acute care hospital or a multispecialty clinic as
defined in subdivision (  l  ) of Section 1206 that is
approved to provide cardiac catheterization laboratory service but is
not also approved to provide cardiac surgery service, together with
the conditions under which the cardiac catheterization laboratory
service may be offered. 
   A 
    (2)     A  cardiac catheterization
laboratory service  shall be located in   of
 a general acute care hospital  that is  
shall be  either licensed to perform cardiovascular procedures
requiring extracorporeal coronary artery bypass  that meets
  and meet  all of the applicable licensing
requirements relating to staff, equipment, and space for service, or
shall, at a minimum, have a licensed intensive care service and
coronary care service and maintain a written agreement for the
transfer of patients to a general acute care hospital that is
licensed for cardiac surgery or shall be located in a multispecialty
clinic as defined in subdivision (  l  ) of Section 1206.
The transfer agreement shall include protocols that will minimize the
need for duplicative cardiac catheterizations at the hospital in
which the cardiac surgery is to be performed. 
   (3) Commencing March 1, 2013, cardiac catheterization laboratory
services may be expanded by a general acute care hospital to include
cardiac catheterization space that is in conformance with applicable
building code standards, including those promulgated by the Office of
Statewide Health Planning and Development, provided that all of the
following occur:  
   (A) The expanded laboratory space is located in the building so
that the space is connected by an enclosed all-weather passageway
that is accessible by staff and patients who are accompanied by
staff.  
   (B) The service performs no more than 25 percent of its procedures
on hospital inpatients.  
   (C) The service complies with all policies and procedures approved
by hospital medical staff, and all standards and regulations
prescribed by the department, including, but not limited to,
applicable nurse-to-patient ratios under Section 1276.5, and with all
standards and regulations prescribed by the Office of Statewide
Health Planning and Development. Emergency regulations allowing a
general acute care hospital to operate a cardiac catheterization
laboratory service shall be adopted by the department and by the
Office of Statewide Health Planning and Development by February 28,
2013.  
   (4) Notwithstanding Section 129885, cardiac catheterization
laboratory services expanded in accordance with this section shall be
subject to all applicable building standards. The Office of
Statewide Health Planning and Development shall review the services
for compliance with the OSHPD 3 requirements of the most recent
version of the California Building Standards Code.  
   For 
    (e)    For  purposes of this section,
"multispecialty clinic," as defined in subdivision (  l  )
of Section 1206, includes an entity in which the multispecialty
clinic holds at least a 50-percent general partner interest and
maintains responsibility for the management of the service, if all of
the following requirements are met:
   (1) The multispecialty clinic existed as of March 1, 1983.
   (2) Prior to March 1, 1985, the multispecialty clinic did not
offer cardiac catheterization services, dynamic multiplane imaging,
or other types of coronary or similar angiography.
   (3) The multispecialty clinic creates only one entity that
operates its service at one site.
   (4) These entities shall have the equipment and procedures
necessary for the stabilization of patients in emergency situations
prior to transfer and patient transfer arrangements in emergency
situations that shall be in accordance with the standards established
by the Emergency Medical Services Authority, including the
availability of comprehensive care and the qualifications of any
general acute care hospital expected to provide emergency treatment.

   Except 
    (f)     Except  as provided  in
this section and  in Sections 128525 and 128530, under no
circumstances shall cardiac catheterizations be performed outside of
a general acute care hospital or a multispecialty clinic, as defined
in subdivision (  l  ) of Section 1206, that qualifies for
this definition as of March 1, 1983.
   SEC. 2.    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. 
   SEC. 3.    This act is an urgency statute necessary
for the immediate preservation of the public peace, health, or safety
within the meaning of Article IV of the Constitution and shall go
into immediate effect. The facts constituting the necessity are:

   In order to improve access to health care for patients requiring
cardiac catheterization services at the earliest possible time, it is
necessary that this act take effect immediately.  
  SECTION 1.   Section 969.7 is added to the Streets
and Highways Code, to read:
   969.7.  (a) A board of supervisors, after it has determined by a
resolution adopted by a four-fifths vote of its membership that the
general county interest demands the improvement or repair of a public
road that is not a county highway and is not in the county
maintained system, may improve or repair the road if the improvements
or repairs are necessary for the purpose of fire suppression. Those
improvements or repairs shall be made and paid for in the same manner
as improvements or repairs of county highways. Proceedings under
this section shall not cause the road to become a county highway.
   (b) This section shall remain in effect only until January 1,
2017, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2017, deletes or extends
that date.