BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair


          AB 491 (Ma) - General acute care hospitals: cardiac 
          catheterization.
          
          Amended: August 30, 2012        Policy Vote: Health 
          Urgency: Yes                    Mandate: Yes
          Hearing Date: August 29, 2012                          
          Consultant: Brendan McCarthy    
          
          This bill does not meet the criteria for referral to the 
          Suspense File.
          
          
          Bill Summary: AB 491, an urgency measure, would authorize 
          general acute care hospitals to provide cardiac catheterization 
          services in a connected outpatient facility.

          Fiscal Impact: 
              One-time costs up to $150,000 for the Office of Statewide 
              Health Planning and Development to adopt regulations 
              (Hospital Building Fund).

              One-time costs up to $150,000 for the Department of Public 
              Health to adopt regulations (Licensing and Certification 
              Program Fund).

          Background: Under current law, the Office of Statewide Health 
          Planning and Development is responsible for enforcing seismic 
          safety and other facility standards for health care facilities. 
          Also under current law, the Department of Public Health licenses 
          acute care hospitals. 

          Current law requires a cardiac catheterization laboratory 
          service to be located in a general acute care hospital that is 
          either licensed to perform cardiovascular services or has a 
          licensed intensive care service and coronary care service and 
          has an agreement on the transfer of patients to a general acute 
          care hospital that is licensed for cardiac services.

          Proposed Law: AB 491 would authorize general acute care 
          hospitals to provide cardiac catheterization services in a 
          connected outpatient facility.









          AB 491 (Ma)
          Page 1


          Beginning March 1, 2013, the bill would allow cardiac 
          catheterization services to be provided outside an acute care 
          hospital provided the following conditions are met:
              The expanded cardiac catheterization laboratory space must 
              be connected to the hospital by an enclosed, all-weather 
              passageway.
              The service performs no more than 25 percent of its 
              procedures on hospital inpatients.
              The service complies with all policies and procedures 
              approved by hospital medical staff and all standards and 
              regulations prescribed by the Department of Public Health 
              and the Office of Statewide Health Planning and Development.

          The bill requires the Office of Statewide Health Planning and 
          Development and the Department of Public Health to adopt 
          emergency regulations by February 28, 2013.

          The bill requires the Office of Statewide Health Planning and 
          Development to review compliance by any impacted cardiac 
          catheterization laboratory service for compliance with seismic 
          safety standards for outpatient facilities.

          This bill is an urgency measure.

          Related Legislation: SB 276 (Corbett) would require the 
          Department of Public Health to develop regulations regarding the 
          type of medical procedures that can be performed in a cardiac 
          catheterization laboratory. That bill is in the Assembly.

          Recommended Amendments: Staff recommends the bill be amended to 
          limit the bill's authority to two acute care hospitals that have 
          already applied for flexibility to provide these services; 
          clarify that only 25 percent of a hospital's inpatients can be 
          served by the outpatient cardiac catheterization lab; ensure 
          that all statutory and regulatory standards that apply to 
          inpatient cardiac catheterization labs also apply to impacted 
          outpatient labs; and require the Office of State Health Planning 
          and Development and the Department of Public Health to develop 
          regulatory standards for outpatient labs impacted by the bill.