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?."