BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                          AB 1136 (Swanson)
          
          Hearing Date: 8/25/2011         Amended: 8/15/2011
          Consultant: Katie Johnson       Policy Vote: Labor 5-1
          _________________________________________________________________
          ____
          BILL SUMMARY:  AB 1136 would require all general acute care 
          hospitals to maintain a safe patient handling policy and provide 
          trained lift teams or other support staff trained in safe 
          lifting techniques. The bill would also require employers to 
          adopt a patient protection and health care worker back and 
          musculoskeletal injury prevention plan as part of the injury and 
          illness prevention programs required by existing state 
          regulations.
          _________________________________________________________________
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2011-12      2012-13       2013-14     Fund
           Hospital staff, training,         potentially significant, would 
          vary                   General/*
          and purchase of        by hospital                      Federal/
          equipment cost pressure                                 Local
          on all payers                     

          DIR regulations        up to $100 one-time through FY 
          2012-2013Special**

          *See Staff Comments
          **Occupational Safety and Health Fund
          _________________________________________________________________
          ____

          STAFF COMMENTS:  SUSPENSE FILE.
          
          As part of the injury and illness prevention programs required 
          by existing California regulations, or any successor law or 
          regulation, employers would be required to adopt a patient 
          protection and health care worker back and musculoskeletal 
          injury prevention plan. The plan would include a safe patient 
          handling policy component for the protection of patients and 
          health care workers in health care facilities.  This bill would 
          require employers to provide training to health care workers 








          AB 1136 (Swanson)
          Page 1


          that would be required to include the appropriate use of lifting 
          devices and equipment, the five areas of body exposure, and the 
          use of lifting devices to handle patients safely. A registered 
          nurse would be required to be responsible for the observation 
          and direction of patient lifts and mobilization. Every employer 
          in California is required to have an IIPP; in hospitals, a safe 
          patient handling or lift policy may be part of the IIPP.

          This bill would provide that a general acute care hospital would 
          not be required to hire new staff to comprise the lift team so 
          long as direct patient care assignments are not compromised. A 
          "health care worker" would be defined as a lift team member or 
          other staff responsible for assisting in lifting patients.

          There are approximately 420 hospitals in California. This bill 
          would apply to all general acute care hospitals, except that it 
          would specifically exempt those administered by the California 
          Department of Corrections and Rehabilitation and the Department 
          of Developmental Services. 

          Other Hospitals
          To the extent that a hospital does not have a patient handling 
          policy that meets this bill's provisions, there could be 
          increased costs in the low hundreds of thousands of dollars per 
          lift team to hire and train staff. Additionally, if a hospital 
          does not have the necessary lifting equipment, it could incur 
          one-time equipment purchase costs as well. In California, 
          hospitals are paid by a variety of public and private "payers," 
          such as insurers, health care service plans, the state, 
          counties, or individuals. Any additional staffing or equipment 
          costs to hospitals would put cost pressure on all payers of 
          health care coverage, including state payers such as the 
          Medi-Cal program, the Healthy Families Program (Healthy 
          Families), and California Public Employees Retirement System 
          (CalPERS), to cover any increased costs to hospitals that would 
          result from this bill in the rates that they pay to the 
          hospital; state programs do not pay hospitals directly for 
          administrative costs. Medi-Cal costs are shared 50 percent 
          General Fund/other non-federal funds and 50 percent federal 
          funds depending on the private or publicly-owned status of the 
          hospital; Healthy Families costs are shared 35 percent General 
          Fund and 65 percent federal funds; and CalPERS costs are shared 
          approximately 55 percent General Fund and 45 percent other 
          funds. 








          AB 1136 (Swanson)
          Page 2



          There would be costs of up to $100,000 special funds one-time to 
          the Department of Industrial Relations (DIR) for regulations. 
          Occupational Safety and Health Fund monies are capped and 
          annually adjusted by a deflator. This bill would put pressure on 
          those limited funds.

          Previous Legislation
          This bill is similar to several previous bills that were all 
          vetoed by Governor Schwarzenegger:  SB 1151 (Perata, 2008), SB 
          171 (Perata, 2007), AB 371 (Huffman, 2007), SB 1204 (Perata, 
          2006), SB 363 (Perata, 2005), and AB 2532 (Hancock, 2004). In 
          his SB 1151 veto message, the Governor said, "?This bill is 
          unnecessary as current laws and regulations are in place to 
          address the workplace health and safety needs of health care 
          workers. Existing statutes are flexible and allow employers to 
          exercise discretion in determining what combination of lift 
          teams and equipment is necessary to have an effective Injury and 
          Illness Prevention Program?."