Senate BillNo. 994


Introduced by Senator Hill

February 10, 2016


An act relating to outpatient health facilities.

LEGISLATIVE COUNSEL’S DIGEST

SB 994, as introduced, Hill. Outpatient health facilities: antimicrobial stewardship.

Under existing law, health facilities, including, among others, general acute care hospitals, skilled nursing facilities, primary care clinics, and specialty clinics, are licensed and regulated by the State Department of Public Health, and a violation of those provisions is a crime. Existing law requires that each general acute care hospital, on or before July 1, 2015, 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. Existing law requires each skilled nursing facility, on or before January 1, 2017, to adopt and implement an antimicrobial stewardship policy consistent with guidelines developed by the federal Centers for Disease Control and Prevention and other specified entities.

This bill would state the intent of the Legislature to enact legislation that would promote the establishment of antimicrobial stewardship programs or policies in outpatient health facilities. The bill makes related findings and declarations.

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

The people of the State of California do enact as follows:

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SECTION 1.  

It is the intent of the Legislature to enact
2legislation that would promote the establishment of antimicrobial
3stewardship programs or policies in outpatient health facilities.

4

SEC. 2.  

The Legislature finds and declares all of the following:

5(a) The overuse and misuse of antibiotics can lead to the
6development of antibiotic-resistant infections, a major public health
7threat.

8(b) The federal Centers for Disease Control and Prevention
9(CDC) estimates that at least 2,000,000 Americans are infected
10with, and at least 23,000 Americans die as a result of,
11antibiotic-resistant infections every year, resulting in at least $20
12billion in direct health care costs and at least $35 billion in lost
13productivity in the United States.

14(c) Antibiotic resistance is a growing threat. A recent study
15commissioned by the United Kingdom determined that by 2050,
16worldwide, more people will die from antibiotic-resistant infections
17than from cancer.

18(d) The overuse and misuse of antibiotics in human medicine
19is a significant factor driving the development of antibiotic
20resistance, and a majority of antibiotics are prescribed in outpatient
21settings, including primary care physician offices, outpatient
22settings where physician assistants and nurse practitioners work,
23dentist offices, and other specialty health care providers.

24(e) According to the CDC, in one year, 262.5 million courses
25of antibiotics are written in outpatient settings. This equates to
26more than five prescriptions written each year for every six people
27in the United States. The CDC estimates that over one-half of the
28antibiotics prescribed in outpatient settings are unnecessary.

29(f) More than 10 million courses of antibiotics are prescribed
30each year for viral conditions that do not benefit from antibiotics.

31(g) Antibiotic stewardship programs, which are already required
32in general acute care hospitals and skilled nursing facilities in the
33state, but not in outpatient settings, are an effective way to reduce
34inappropriate antibiotic use and the prevalence of
35antibiotic-resistant infections.

36(h) The President’s National Action Plan for Combating
37Antibiotic-resistant Bacteria calls for the establishment of antibiotic
P3    1stewardship activities in all health care delivery settings, including
2outpatient settings, by 2020.



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