BILL ANALYSIS Ó
SB 402
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SENATE THIRD READING
SB 402 (De León)
As Amended June 18, 2013
Majority vote
SENATE VOTE :38-0
HEALTH 19-0 APPROPRIATIONS 15-2
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|Ayes:|Pan, Logue, Ammiano, |Ayes:|Gatto, Harkey, Bocanegra, |
| |Atkins, Bonilla, Bonta, | |Bradford, Ian Calderon, |
| |Chesbro, Gomez, Roger | |Campos, Eggman, Gomez, |
| |Hernández, Gonzalez, | |Hall, Holden, Linder, |
| |Maienschein, Mansoor, | |Pan, Quirk, Wagner, Weber |
| |Mitchell, Nazarian, | | |
| |Nestande, | | |
| |V. Manuel Pérez, Wagner, | | |
| |Wieckowski, Wilk | | |
|-----+--------------------------+-----+--------------------------|
| | |Nays:|Bigelow, Donnelly |
| | | | |
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SUMMARY : Requires, by January 1, 2025, all general acute care
hospitals and special hospitals that have a perinatal unit to adopt
the "Ten Steps to Successful Breastfeeding," as adopted by
Baby-Friendly USA, or an alternative process adopted by a health
care service plan, or the Model Hospital Policy Recommendations
approved by the Department of Public Health (DPH). Specifically,
this bill :
1)Requires all general acute care hospitals and special hospitals,
that have a perinatal unit to adopt by January 1, 2025, the United
Nations Children's Fund and World Health Organization's "Ten Steps
to Successful Breastfeeding," as adopted by Baby-Friendly USA, per
the Baby Friendly Hospital Initiative (BFHI), or an alternate
process adopted by a health care service plan that includes
evidenced-based policies and practices and targeted outcomes, or
the Model Hospital Policy Recommendations, as currently approved
by DPH.
2)Defines "perinatal unit" to be a maternity or newborn service of a
hospital for the provision of care during pregnancy, labor,
delivery, and postpartum and neonatal periods with appropriate
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staff, space, equipment, and supplies.
EXISTING LAW :
1)Establishes DPH, which among other things licenses and regulates
hospitals and promotes child and maternal health. Requires DPH to
include in its public service campaign, the promotion of mothers
breastfeeding their infants.
2)Establishes the Women, Infants and Children program (WIC),
administered by DPH to provide nutritional food supplements to
low-income pregnant women, low-income postpartum and lactating
women, and low-income infants and children under five years of
age, who have been determined to be at nutritional risk.
Establishes the "Breastfeeding Peer Counseling Program" at local
agency WIC sites to increase the rate of breastfeeding for WIC
participants.
3)Establishes the Hospital Infant Feeding Act which requires all
general acute care and special hospitals that have a perinatal
unit to have an infant-feeding policy and to clearly post the
policy and routinely communicate the policy to perinatal unit
staff.
4)Requires the infant-feeding policy to promote breastfeeding,
utilizing guidance provided by the BFHI or the DPH Model Hospital
Policy Recommendations.
FISCAL EFFECT : According to the Assembly Appropriations Committee,
negligible state costs.
COMMENTS : According to the author, evidence indicates that early
infant feeding practices can affect later growth and development in
children, while significantly reducing their risk for infections and
chronic diseases such as diabetes, asthma, and obesity. Although
nearly 90% of California mothers enter the hospital intending to
breastfeed, only about 50% leave the hospital breastfeeding
exclusively.
The author asserts that this disparity is a health equity issue
since many of the hospitals that have low or very low exclusive
breastfeeding rates are in areas that serve low-income women.
Exclusive breastfeeding rates increase when hospitals keep mothers
and babies together; encourage feeding shortly after birth; provide
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staff with education for breastfeeding support; and, avoid
unnecessary formula supplementation.
Baby-Friendly USA provides technical assistance to the facility to
create a plan for achieving Baby-Friendly guidelines. All plans are
reviewed and feedback is provided by Baby-Friendly USA.
Baby-Friendly USA offers a sliding fee schedule to hospitals seeking
a Baby-Friendly designation based on the size of the hospital and
the number of births per year.
According to the California WIC Association (CWA), some 58 of the
approximately 260 perinatal hospitals in California have implemented
comprehensive policies, and become certified as Baby-Friendly, and
approximately 40 hospitals are planning to begin the certification
process, leaving nearly 162 perinatal hospitals that still must
become certified.
The CWA is the sponsor of this bill and writes that the "Ten Steps"
will increase exclusive breastfeeding rates in California, improve
health outcomes for moms and kids, and ultimately save millions in
unnecessary health care costs. The California Hospital Association
also supports this bill, stating, this bill further promotes the
breast feeding support provided to new mothers in our hospitals and
allows each hospital to select from an array of options to provide
that support. Hospitals throughout the state have demonstrated this
commitment by leading the nation with over 60 hospitals voluntarily
achieving the prestigious "Ten Steps to Successful Breastfeeding"
Baby-Friendly Hospital designation status.
The American Academy of Pediatrics writes in support that the
importance of addressing the issue of the impact of hospital
practices and policies on breastfeeding outcomes is highlighted by
the decision of The Joint Commission to adopt the rate of exclusive
breast milk feeding as a Perinatal Care Core Measure. As such, the
rate of exclusive breastfeeding during the hospital stay has been
confirmed as a critical variable when measuring the quality of care
provided.
Analysis Prepared by : Lara Flynn / HEALTH / (916) 319-2097
FN: 0001459
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