BILL NUMBER: SB 361	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 14, 2015

INTRODUCED BY   Senator Hill
   (Coauthor: Senator Nielsen)
   (Coauthors: Assembly Members Rodriguez and Waldron)

                        FEBRUARY 24, 2015

   An act to add Section 1275.4 to the Health and Safety Code,
relating to public health, and declaring the urgency thereof, to take
effect immediately.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 361, as amended, Hill. Skilled nursing facilities:
antimicrobial stewardship guidelines.
   Existing law provides for the licensure and regulation of skilled
nursing facilities by the State Department of Public Health. Under
existing law, a violation of the provisions governing skilled nursing
facilities constitutes a crime. Existing law also establishes the
Hospital Infectious Disease Control Program, which requires the
department and general acute care hospitals to implement various
measures relating to the prevention of health care associated
infection. The program requires, by July 1, 2015, that each general
acute care hospital adopt and implement an antimicrobial stewardship
policy, in accordance with guidelines established by the federal
government and professional organizations, that includes a process to
evaluate the judicious use of antibiotics, as specified.
   This bill would require  the department,  
all skilled nursing facilities, as defined,  by no later than
 July 1, 2016, to develop guidelines in accordance with
guidelines established by the federal government and professional
organizations, extending the principles of antimicrobial stewardship
in order to promote the judicious use of antimicrobials in all
skilled nursing facilities, as defined.   January 1,
2017, to adopt and implement an antimicrobial stewardship policy. The
bill would also require each skilled nursing facility, within 3
months of the establishment of antimicrobial stewardship guidelines
by the federal Centers for Disease Control and Prevention or
professional organizations, to amend its policy to be consistent with
those antimicrobial stewardship guidelines. 
   By expanding the scope of an existing crime, this bill would
impose a state-mandated local program.
   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.
   This bill would declare that it is to take effect immediately as
an urgency statute.
   Vote: 2/3. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 1275.4 is added to the Health and Safety Code,
to read: 
   1275.4.  (a) On or before July 1, 2016, the State Department of
Public Health shall develop guidelines in accordance with guidelines
established by the federal government and professional organizations,
extending the principles of antimicrobial stewardship in order to
promote the judicious use of antimicrobials in all skilled nursing
facilities, as defined in subdivision (c) of Section 1250.
   (b) The department shall consult with long-term care
organizations, infection prevention experts, and other interested
stakeholders in the development of these guidelines. 
    1275.4.    (a) (1) On or before January 1, 2017,
each skilled nursing facility, as defined in subdivision (c) of
Section 1250, shall adopt and implement an antimicrobial stewardship
policy.  
   (2) Within three months of the federal Centers for Disease Control
and Prevention (CDC) or professional organizations, including the
Society for Healthcare Epidemiology of America (SHEA), establishing
antimicrobial stewardship guidelines specific to skilled nursing
facilities, each skilled nursing facility shall amend its
antimicrobial stewardship policy to be consistent with those newly
established antimicrobial stewardship guidelines.  
   (c) 
    (b)  All skilled nursing facilities, as defined in
subdivision (c) of Section 1250, shall comply with  the
department guidelines extending the principles of antimicrobial
stewardship   this section  . Failure to comply
with the  department's antimicrobial stewardship guidelines
  requirements of this section  may subject the
facility to the enforcement actions set forth in Section 1423.
  SEC. 2.  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.
  SEC. 3.  This act is an urgency statute necessary for the immediate
preservation of the public peace, health, or safety within the
meaning of Article IV of the Constitution and shall go into immediate
effect. The facts constituting the necessity are:
   In order to protect Californians from the burden and threats posed
by the national security priority of antimicrobial-resistant
infections, it is necessary that this act take effect immediately.