BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de Le�n, Chair


          SB 455 (Hernandez) - General acute care hospitals: patient  
          classification systems.
          
          Amended: April 16, 2013         Policy Vote: Health 7-1
          Urgency: No                     Mandate: Yes
          Hearing Date: April 29, 2013                            
          Consultant: Brendan McCarthy    
          
          This bill does not meet the criteria for referral to the  
          Suspense File.
          
          
          Bill Summary: SB 455 would codify existing regulatory  
          requirements that acute care hospitals establish and maintain  
          patient classification systems. The bill would require a  
          hospital's patient classification system review committee to  
          include direct care nurses and require those nurses to be  
          appointed by a collective bargaining agent, if there is one.

          Fiscal Impact: 
              Likely one-time costs of about $70,000 for the revision of  
              existing regulations (Licensing and Certification Program  
              Fund). Implementation of this bill will require the revision  
              of an existing regulation (see below). 

          Background: Current law requires acute care hospitals to  
          maintain specified nurse-to-patient ratios. Regulations adopted  
          by the Department of Public Health to implement nurse-to-patient  
          ratios require hospitals to develop and maintain patient  
          classification systems, which are more detailed protocols for  
          establishing staffing levels based on the care need of specific  
          patients. Current law requires the Department to inspect  
          hospitals no less than every three years to review compliance  
          with these and other regulatory requirements.

          Proposed Law: SB 455 would codify existing regulatory  
          requirements that acute care hospitals establish and maintain  
          patient classification systems. 

          The bill would require a hospital's patient classification  
          system review committee to include direct care nurses and  
          require those nurses to be appointed by a collective bargaining  








          SB 455 (Hernandez)
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          agent, if there is one.

          The bill specifies that no new regulations are required or  
          authorized in the bill.

          Related Legislation: SB 1246 (Hernandez, 2012) contained  
          provisions similar to this bill, among other provisions relating  
          to acute care hospitals. That bill was vetoed by Governor Brown.

          Staff Comments: The bill specifies that no new regulations are  
          required or authorized under the bill. Existing regulations  
          requiring patient classification systems require members of the  
          review committee to be appointed by the nursing administration.  
          The requirement in this bill that the collective bargaining  
          agent (if there is one) appoint nurses to that committee  
          conflicts with that requirement. In order to conform the  
          existing regulations to this bill, those regulations will  
          require revision.

          The only local mandates imposed by the bill relate to crimes or  
          infractions and are not reimbursable by the state under the  
          California Constitution.