BILL NUMBER: SB 1318	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 11, 2012

INTRODUCED BY   Senator Wolk

                        FEBRUARY 23, 2012

   An act to amend  , repeal, and add  Section 1288.7 of
 , and to   add Section 1228.5 to,  the Health and
Safety Code, relating to infectious diseases.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1318, as amended, Wolk. Health facilities: influenza
vaccinations.
   Existing law imposes on the State Department of Public Health
various duties and responsibilities regarding the regulation of 
clinics and  health facilities, including general acute care
hospitals, as defined.
   Existing law requires a general acute care hospital to annually
offer onsite influenza vaccinations, if available, to all hospital
employees. Existing law requires a general acute care hospital to
require its employees to be vaccinated, or if the employee elects not
to be vaccinated, to declare in writing that he or she declined the
vaccination. A violation of these provisions is punishable as a
misdemeanor.
   This bill would  extend these vaccination provisions to
  require, commencing July 1, 2013, each clinic and
health facility to annually offer onsite influenza vaccinations to
its employees and to require its employees,  contractors,
students, volunteers,  persons with privileges on the medical
staff,  and other onsite health care workers affiliated with the
 hospital,   clinic or health facility, 
as defined  , to be vaccinated. This bill would require each of
the above-listed persons who has received a vaccination from another
health facility to present verification to the clinic or he 
 alth facility  . This bill would require  one of
these parties   each of the above-listed persons 
who elects not to be vaccinated  or does not provide proof of
vaccination  to wear a  hospital-provided  
clinic- or health facility-provided  protective mask, as
specified, while serving his or her duties at the  hospital
  clinic or health facility during the influenza season
 . By expanding the definition of a crime, this bill would
impose a state-mandated local program. 
   This bill would also require, on and after July 1, 2013, each
clinic and health facility to develop policies to ensure nonmedical
staff, as defined compliance with vaccination requirements. This bill
would require, on and after that date, the medical staff to develop
separate policies to ensure compliance with vaccination requirements.

   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.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
   
  SECTION 1.    Section 1288.7 of the Health and
Safety Code is amended to read:
   1288.7.  The department shall require that each general acute care
hospital, in accordance with the Centers for Disease Control
guidelines, take all of the following actions:
   (a)  Annually offer onsite influenza vaccinations, if available,
to all hospital employees, contractors, students, volunteers, and all
other onsite health care workers affiliated with the hospital at no
cost to the employee, contractor, student, volunteer, or other onsite
health care worker affiliated with the hospital. Each general acute
care hospital shall require its employees, contractors, students,
volunteers, and other onsite health care workers affiliated with the
hospital to be vaccinated, or if an employee, contractor, student,
volunteer, or other onsite health care worker affiliated with the
hospital elects not to be vaccinated, to declare in writing that he
or she has declined the vaccination. An employee, contractor,
student, volunteer, or other onsite health care worker affiliated
with the hospital who declines the vaccination shall wear a
hospital-provided surgical or procedural mask, or other mask that
covers the mouth and nose area of the face in order to prevent the
spread of infectious diseases, while serving his or her duties at the
hospital.
   (b) Institute respiratory hygiene and cough etiquette protocols,
develop and implement procedures for the isolation of patients with
influenza, and adopt a seasonal influenza plan.
   (c) Revise an existing or develop a new disaster plan that
includes a pandemic influenza component. The plan shall also document
any actual or recommended collaboration with local, regional, and
state public health agencies or officials in the event of an
influenza pandemic.
   (d) For purposes of this section, "health care worker affiliated
with the hospital" means a person who is either a volunteer or is
employed by, paid by, receives credit from, or any other form of
compensation from the acute care hospital. Health care workers
include, but are not limited to, physicians, nurses, nursing
assistants, therapists, technicians, emergency medical service
personnel, dental personnel, pharmacists, laboratory personnel,
autopsy personnel, students and trainees, contractual staff not
employed by the health care facility, and persons not directly
involved in patient care but potentially exposed to infectious agents
that can be transmitted to and from health care workers and
patients. 
   SECTION 1.    Section 1228.5 is added to the 
 Health and Safety Code   , to read:  
   1228.5.  (a) A clinic shall annually offer its employees onsite
influenza vaccinations, if available, at no cost to the employee.
   (b) A clinic shall require all employees, contractors, students,
volunteers, persons with privileges on the medical staff, and all
other onsite health care workers affiliated with the clinic to either
annually receive an influenza vaccination or, as an alternative to
the annual influenza vaccination, wear a clinic-provided surgical or
procedural mask, or other mask that covers the mouth and nose area of
the face while this person is performing his or her duties in any
patient care area of the clinic during the influenza season, as
defined by the State Health Officer or a local health officer, or
both.
   (c) In meeting the requirements of subdivision (b), the clinic
shall maintain influenza vaccination records of employees,
contractors, students, volunteers, persons with privileges on the
medical staff, and all other onsite health care workers affiliated
with the clinic who were vaccinated onsite or offsite. If the clinic
does not have records of a worker being vaccinated onsite, the clinic
shall require the worker to either provide documentation of an
offsite vaccination or documentation that he or she refused the
vaccination.
   (d) Each clinic shall develop policies to ensure its employees,
contractors, students, volunteers, and other onsite health care
workers affiliated with the clinic, not including medical staff, are
in compliance with the vaccination requirements imposed by this
section. The medical staff shall develop policies independent of the
policies established by the clinic to ensure that persons who have
privileges on the medical staff are in compliance with the
vaccination requirements of this section.
   (e) Nothing in this section shall be construed to prevent a clinic
from instituting additional measures to maximize influenza
vaccination rates and to prevent health care workers affiliated with
the clinic from contracting and transmitting the influenza virus.
   (f) For purposes of this section, the following definitions shall
apply:
   (1) "Health care worker affiliated with the clinic" means a person
who is either a volunteer or is employed by, paid by, or receives
credit or any other form of compensation from the clinic. Health care
worker affiliated with the clinic includes, but is not limited to,
physicians, nurses, nursing assistants, therapists, technicians,
emergency medical service personnel, dental personnel, pharmacists,
laboratory personnel, autopsy personnel, students and trainees, and
contractual staff not employed by the clinic.
   (2) "Medical staff" means professional medical personnel who are
approved and given privileges to provide health care to patients in a
clinic and who are responsible for the adequacy and quality of care
rendered to patients. Medical staff include physicians and surgeons,
and, where dental or podiatric services are provided, dentists or
podiatrists.
   (g) This section shall become operative on July 1, 2013. 
   SEC. 2.    Section 1288.7 of the   Health
and Safety Code   is amended to read: 
   1288.7.  By July 1, 2007, the department shall require that each
general acute care hospital, in accordance with the Centers for
Disease Control  and prevention  guidelines, take all of the
following actions:
   (a)  Annually offer onsite influenza vaccinations, if available,
to all hospital employees at no cost to the employee. Each general
acute care hospital shall require its employees to be vaccinated, or
if the employee elects not to be vaccinated, to declare in writing
that he or she has declined the vaccination.
   (b) Institute respiratory hygiene and cough etiquette protocols,
develop and implement procedures for the isolation of patients with
influenza, and adopt a seasonal influenza plan.
   (c) Revise an existing or develop a new disaster plan that
includes a pandemic influenza component. The plan shall also document
any actual or recommended collaboration with local, regional, and
state public health agencies or officials in the event of an
influenza pandemic. 
   (d) This section shall become inoperative on July 1, 2013, and, as
of January 1, 2013, is repealed, unless a later enacted statute,
that becomes operative on or before January 1, 2013, deletes or
extends the dates on which it becomes inoperative and is repealed.

   SEC. 3.    Section 1288.7 is added to the  
Health and Safety Code   , to read:  
   1288.7.  (a) A health facility shall annually offer its employees
onsite influenza vaccinations, if available, at no cost to the
employee.
   (b) A health facility shall require all employees, contractors,
students, volunteers, persons with privileges on the medical staff,
and all other onsite health care workers affiliated with the health
facility to either annually receive an influenza vaccination or, as
an alternative to the annual influenza vaccination, wear a health
facility-provided surgical or procedural mask, or other mask that
covers the mouth and nose area of the face while this person is
performing his or her duties in any patient care area of the health
facility during the influenza season, as defined by the State Health
Officer or a local health officer, or both.
   (c) In meeting the requirements of subdivision (b), the health
facility shall maintain influenza vaccination records of employees,
contractors, students, volunteers, persons with privileges on the
medical staff, and all other onsite health care workers affiliated
with the health facilities who were vaccinated onsite or offsite. If
the health facility does not have records of a worker being
vaccinated onsite, the health facility shall require the worker to
either provide documentation of an offsite vaccination or
documentation that he or she refused the vaccination.
   (d) Each health facility shall develop policies to ensure its
employees, contractors, students, volunteers, and other onsite health
care workers affiliated with the health facility, not including
medical staff, are in compliance with the vaccination requirements
imposed by this section. The medical staff shall develop policies
independent of the policies established by the health facility to
ensure that persons who have privileges on the medical staff are in
compliance with the vaccination requirements of this section.
   (e) Nothing in this section shall be construed to prevent a health
facility from instituting additional measures to maximize influenza
vaccination rates and to prevent health care workers affiliated with
the health facility from contracting and transmitting the influenza
virus.
   (f) In addition to other requirements of this section, general
acute care hospitals shall take all of the following actions:
   (1) Institute respiratory hygiene and cough etiquette protocols,
develop and implement procedures for the isolation of patients with
influenza, and adopt a seasonal influenza plan.
   (2) Revise an existing or develop a new disaster plan that
includes a pandemic influenza component. The plan shall also document
any actual or recommended collaboration with local, regional, and
state public health agencies or officials in the event of an
influenza pandemic.
   (g) For purposes of this section, the following definitions shall
apply:
   (1) "Health care worker affiliated with the health facility" means
a person who is either a volunteer or is employed by, paid by, or
receives credit or any other form of compensation from the health
facility. Health care worker affiliated with the health facility
includes, but is not limited to, physicians, nurses, nursing
assistants, therapists, technicians, emergency medical service
personnel, dental personnel, pharmacists, laboratory personnel,
autopsy personnel, students and trainees, and contractual staff not
employed by the health facility.
   (2) "Medical staff" means professional medical personnel who are
approved and given privileges to provide health care to patients in a
health facility and who are responsible for the adequacy and quality
of care rendered to patients. Medical staff include physicians, and,
where dental or podiatric services are provided, dentists or
podiatrists.
   (h) This section shall become operative on July 1, 2013. 
   SEC. 2.   SEC. 4.   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.