BILL NUMBER: AB 491	AMENDED
	BILL TEXT

	AMENDED IN SENATE  AUGUST 29, 2012
	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 Ma
   (Coauthors: Assembly Members Garrick and Miller)
   (Coauthor: Senator Wyland)

                        FEBRUARY 15, 2011

   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, Ma. 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.
   Vote: 2/3. Appropriation: no. Fiscal committee: yes.
State-mandated local program: 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:
   (1) Radiation therapy department.
   (2) Burn center.
   (3) Emergency center.
   (4) Hemodialysis center (or unit).
   (5) Psychiatric.
   (6) Intensive care newborn nursery.
   (7) Cardiac surgery.
   (8) Cardiac catheterization laboratory.
   (9) Renal transplant.
   (10) Other special services as the department may prescribe by
regulation.
   (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.
   (c) The department shall adopt standards for special services and
other regulations as may be necessary to implement this section.
   (d) (1) For cardiac catheterization laboratory service, the
department shall, at a minimum, adopt standards and regulations that
specify that only diagnostic services, and what diagnostic services,
may be offered by 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.
   (2)  A   Except as provided in paragraph (3),
a   cardiac catheterization laboratory service
 of   shall be located in  a general acute
care hospital  shall be   that is  either
licensed to perform cardiovascular procedures requiring
extracorporeal coronary artery bypass  and meet 
 that meets  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
  1276.4  , 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
  paragraph (3)  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.
   (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.
   (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.