BILL ANALYSIS
AB 57
Page 1
ASSEMBLY THIRD READING
AB 57 (Price)
As Introduced December 5, 2008
Majority vote
HEALTH 13-6 HIGHER EDUCATION 6-3
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|Ayes:|Jones, Ammiano, Block, |Ayes:|Portantino, Block, Fong, |
| |Carter, De La Torre, | |Galgiani, Ma, Ruskin |
| |De Leon, Hall, Hayashi, | | |
| |Hernandez, Bonnie | | |
| |Lowenthal, Nava, Hill, | | |
| |Salas | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Fletcher, Adams, Conway, |Nays:|Conway, Cook, Huber |
| |Emmerson, Gaines, Audra | | |
| |Strickland | | |
| | | | |
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APPROPRIATIONS 10-5
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|Ayes:|De Leon, Ammiano, Davis, |
| |Fuentes, Hall, John A. |
| |Perez, Price, Skinner, |
| |Solorio, Torlakson |
| | |
|-----+--------------------------|
|Nays:|Nielsen, Duvall, Harkey, |
| |Miller |
| | Audra Strickland |
| | |
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SUMMARY : Requires the Department of Public Health (DPH) to
establish a procedure for collecting and reviewing the written
staffing plans developed by University of California (UC)
hospitals. Specifically, this bill :
1)Requires the collection and review procedure developed by DPH
to include all of the following:
a) Review of the reliability of the patient classification
AB 57
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system for validating staffing requirements;
b) Potential adjustments in the patient classification
system, as specified; and,
c) Staff input about the patient classification system, the
system's required revisions, and the overall staffing plan.
2)Sunsets the provisions of this bill on July 1, 2013.
EXISTING LAW :
1)Establishes for hospitals, pursuant to regulations, minimum
specific nurse-to-patient ratios by licensed nurse
classification and by specified treatment units.
2)Establishes the minimum ratios for hospitals as the minimum
number of registered and licensed nurses that must be
allocated. Requires additional staff to be assigned in
accordance with a documented patient classification system for
determining nursing care requirements, as specified.
3)Requires, pursuant to regulations, a written staffing plan to
be developed by the administrator of hospital nursing
services, based on patient care needs determined by the
patient classification system. Requires the staffing plan to
be developed and implemented for each patient care unit and to
specify patient care requirements and the staffing levels for
registered nurses and other licensed and unlicensed personnel.
FISCAL EFFECT : According to the Assembly Appropriations
Committee analysis, fee-supported special fund cost of
approximately $10,000 to DPH to review staffing plans submitted
by the five UC medical centers. Unknown, likely absorbable
staffing costs to UC to provide DPH with staffing reports and
evidence of patient classification methodologies.
COMMENTS : The sponsor of this bill, the American Federation of
State, County and Municipal Employees (AFSCME), writes that UC
hospitals comprise a crucial component of the state's health
care system and, as such, it is necessary to ensure that these
facilities maintain adequate staffing levels. AFSCME believes
the expanded oversight and review provided by this bill will
allow for appropriate monitoring of staffing levels and patient
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care requirements at UC hospitals while safeguarding public
health.
According to UC, the five medical centers they operate support
the clinical teaching programs of UC's medical and health
sciences schools and provide more than 138,000 inpatient
discharges, 261,000 emergency room visits and more than 3.6
million outpatient visits each year. Collectively, these UC
medical centers comprise one of the largest health care systems
in California and one of the two largest Medi-Cal providers in
the state. The UC health system operates Level I trauma centers
in four of its five regions. A major provider to uninsured and
underinsured patients in Sacramento, San Diego, and Orange
Counties, the UC system also has relationships with more than
100 affiliated veterans, county, and community-based health
facilities throughout California.
Current regulations require hospitals to meet established
nurse-to-patient ratios and to develop a written staffing plan
for registered nurses and other licensed and unlicensed
personnel that reflects patient care needs based on a patient
classification system. Hospitals use various types of
non-nursing professional and technical staff to provide direct
patient care, including respiratory therapists, phlebotomists,
radiology technicians and similar specialists. However,
according to DPH, hospitals may use non-nursing staff only if
they are authorized to provide those services. DPH also
indicates that while it does not review procedures hospitals use
to determine non-nursing staffing levels, it would investigate
complaints related to hospital staffing, including use of
non-nurse personnel. If a patient suffered harm and
understaffing was determined to be a causative factor, DPH
states that it would issue a deficiency notice.
Analysis Prepared by: John D. Miller / HEALTH / (916) 319-2097
FN: 0000638