BILL NUMBER: AB 510	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  JANUARY 4, 2012
	AMENDED IN ASSEMBLY  MARCH 31, 2011

INTRODUCED BY   Assembly Member Bonnie Lowenthal

                        FEBRUARY 15, 2011

    An act to amend Section 130070 of the Health and Safety
Code, relating to health facilities.   An act to amend
Sections 115111 and 115113 of the Health and Safety Code, relating to
public health. 



	LEGISLATIVE COUNSEL'S DIGEST


   AB 510, as amended, Bonnie Lowenthal.  Hospitals: seismic
safety.   Radiation control: health facilities and
clinics: records.  
   Under existing law, the State Department of Public Health licenses
and regulates health facilities and clinics, as defined. Under
existing law, the Radiation Control Law, the department licenses and
regulates persons that use devices or equipment utilizing radioactive
materials. Under existing law, the department is authorized to
require registration and inspection of sources of ionizing radiation,
as defined. Existing law, commencing July 1, 2012, requires that a
facility using a computed tomography (CT) X-ray system record the
dose of radiation on every CT study produced. Existing law requires
that the displayed dose of radiation be verified annually by a
medical physicist to ensure the accuracy of the displayed dose unless
the facility is accredited. Violations of these provisions are a
crime.  
   This bill would delete the exemption for accredited facilities and
authorize accredited facilities to elect not to annually verify the
displayed dose of radiation, as specified. Because accredited
facilities could now be subject to these provisions, and because a
violation of these provisions is a crime, the bill would impose a
state-mandated local program by expanding the scope of a crime. The
bill also would require the dose to be verified for the facility's
standard adult brain, adult abdomen, and pediatric brain protocols.
 
   Existing law, commencing July 1, 2012, requires a facility to
report the discovery of certain information about an event in which
the administration of radiation results in prescribed occurrences,
within 5 business days of the discovery of the event, to the
department and the patient's referring physician.  
   This bill would instead require that this report be made within 10
business days of the discovery of the event.  
   The bill would also make technical and clarifying changes. 

   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.  
   Existing law provides for the licensure of health facilities,
including general acute care hospitals, by the State Department of
Public Health. 
   Existing law, the Alfred E. Alquist Hospital Facilities Seismic
Safety Act of 1983, establishes, under the jurisdiction of the Office
of Statewide Health Planning and Development, a program of seismic
safety building standards for certain hospitals constructed on and
after March 7, 1973. Existing law requires that, after January 1,
2008, any general acute care hospital building that is determined to
be a potential risk of collapse or pose significant loss of life be
used only for nonacute care hospital purposes, except that the office
may grant specified extensions of that deadline, under prescribed
circumstances.  
   Existing law requires, no later than January 1, 2030, owners of
all acute care inpatient hospitals to either demolish, replace, or
change to nonacute care use all hospital buildings not in substantial
compliance with the regulations and standards developed by the
office pursuant to existing seismic safety laws or seismically
retrofit all acute care inpatient hospital buildings so that they are
in substantial compliance. The office is required to notify the
department of hospital owners that have been notified of a failure to
comply with the above-described deadlines. Unless the notified
hospital places its license in voluntary suspense, the department is
required to suspend or refuse to renew the hospital's license.
 
   This bill would, instead, prohibit a hospital that receives the
above-described notice from providing general acute care inpatient
services in the noncompliant building. It would also require the
department to suspend or refuse to renew the license of a hospital
that does not provide basic general acute care services because of
this bill's requirements. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program:  no  yes  .



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

   SECTION 1.    Section 115111 of the   Health
and Safety Code   is amended to read: 
   115111.  (a) Commencing July 1, 2012, subject to subdivision (e),
a person that uses a computed tomography (CT) X-ray system 
for   dedicated to only diagnostic  human use shall
record the dose of radiation on every CT study produced during a CT
examination  on a system  .
   (b) The facility conducting the study shall electronically send
each CT study and protocol page that lists the technical factors and
dose of radiation to the electronic picture archiving and
communications system.
   (c)  (1)    The displayed dose shall be verified
annually by a medical physicist  for the facility's standard
adult brain, adult abdomen, and pediatr   ic brain
protocols,  to ensure the displayed doses are within 20 percent
of the true measured dose measured in accordance with subdivision (f)
 unless the facility is accredited  .  A

    (2)     A facility that is accredited may
elect not to perform the verification described in paragraph (1).

   (d) Subject to subdivision (e), the radiology report of a CT study
shall include the dose of radiation by either recording the dose
within the patient's radiology report or attaching the protocol page
that includes the dose of radiation to the radiology report.
   (e) The requirements of this section shall be limited to CT
systems capable of calculating and displaying the dose.
   (f) For the purposes of this section, dose of radiation shall be
defined as one of the following:
   (1) The computed tomography index volume (CTDI vol) and dose
length product (DLP), as defined by the International
Electrotechnical Commission (IEC) and recognized by the federal Food
and Drug Administration (FDA).
   (2) The dose unit as recommended by the American Association of
Physicists in Medicine.
   SEC. 2.    Section 115113 of the   Health
and Safety Code   , as amended by Section 1 of Chapter 139
of the Statutes of   2011, is amended to read: 
   115113.  (a) Except for an event that results from patient
movement or interference, a facility shall report to the department
an event in which the administration of radiation results in any of
the following:
   (1) Repeating of a CT examination, unless otherwise ordered by a
physician or a radiologist, if the following dose values are
exceeded:
   (A) 0.05 Sv (5 rem) effective dose  equivalent  .

   (B) 0.5 Sv (50 rem) to an organ or tissue.
   (C) 0.5 Sv (50 rem) shallow dose  equivalent  to
the skin.
   (2) CT X-ray irradiation of  a body part   an
area of the body  other than that intended by the ordering
physician or a radiologist if  at least  one of the
following dose values are exceeded:
   (A) 0.05 Sv (5 rem) effective dose  equivalent  .

   (B) 0.5 Sv (50 rem) to an organ or tissue.
   (C) 0.5 Sv (50 rem) shallow dose  equivalent  to
the skin.
   (3) CT or therapeutic exposure that results in unanticipated
permanent functional damage to an organ or a physiological system,
hair loss, or erythema, as determined by a qualified physician.
   (4) A CT or therapeutic dose to an embryo or fetus that is greater
than 50 mSv (5 rem) dose  equivalent  , that is a
result of radiation to a known pregnant individual unless the dose to
the embryo or fetus was specifically approved, in advance, by a
qualified physician.
   (5) Therapeutic ionizing irradiation of the wrong individual
 ,  or  the  wrong  non  
overlapping  treatment site.
   (6) The total dose from therapeutic ionizing radiation delivered
differs from the prescribed dose by 20 percent or more. A report
shall not be required pursuant to this paragraph in any instance
where the dose administered exceeds 20 percent of the amount
prescribed in a situation where the radiation was utilized for
palliative care for the specific patient. The radiation oncologist
shall notify the referring physician that the dose was exceeded.
   (b) The facility shall, no later than  five  
10  business days after discovery of an event described in
subdivision (a), provide notification of the event to the department
and the referring physician of the person subject to the event and
shall, no later than 15 business days after discovery of an event
described in subdivision (a) provide written notification to the
person who is subject to the event.
   (c) This section shall become inoperative on the effective date of
the act that added this subdivision, and shall remain inoperative
until July 1, 2012.
   SEC. 3.    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.  
  SECTION 1.    Section 130070 of the Health and
Safety Code is amended to read:
   130070.  The office shall notify the State Department of Public
Health of the hospital owners that have received a written notice of
violation for failure to comply with either Section 130060 or 130065.
Notwithstanding Chapter 2 (commencing with Section 1250) of Division
2, upon receipt of a notice of violation from the office because of
its failure to comply with either Section 130060 or 130065, a
hospital shall not provide general acute care inpatient services in
the building that is the subject of the notice of violation. The
department shall suspend or refuse to renew the license of a hospital
that does not provide basic general acute care services because of
this section. The license shall be reinstated or renewed upon
presentation to the department of a written notice of compliance
issued by the office.