BILL ANALYSIS
AB 664
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Date of Hearing: May 20, 2009
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Kevin De Leon, Chair
AB 664 (Skinner) - As Amended: April 30, 2009
Policy Committee: InsuranceVote:7-3
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill establishes several workers' compensation presumptions
for more than 500,000 employees at hospitals statewide,
including workers at private and non-profit hospitals.
Specifically, this bill establishes a presumption that back or
neck injuries and methicillin-resistant Staphylococus aureus
(MRSA, staph) infections are job-related during and after a
period of employment at a hospital, and requires the following
workers' compensation benefits to be provided:
a) Full hospital
b) Surgical
c) Medical treatment
d) Disability indemnity
e) Death benefits
FISCAL EFFECT
1)Increased costs to all hospitals statewide of more than $400
million to $800 million for the payment of full hospital,
surgical, medical treatment, disability indemnity, and death
benefits for presumptions of back and neck injuries and staph
infections. Public hospitals are self-insured for workers'
compensation claims, rather than paid through premiums.
Payments are treated in a pay-as-you-go manner. Therefore, any
increase in costs has a direct impact on public and often GF
funds.
2)This bill fails to define hospital or specify professional
classification or hospital ownership type. Legislation about
workers' compensation presumptions usually addresses public
sector employees, not private sector workers or employers, and
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usually is framed around specific exposures routinely
encountered in the course of employment.
3)Due to lack of specificity, this bill applies to:
a) Public, private, and non-profit facilities.
b) All care settings: county, state, psychiatric, long-term
care facilities for the elderly and developmentally
disabled, correctional treatment centers, and outpatient
surgery centers
c) All employees, regardless of professional role.
4)This bill applies to more than 500,000 workers in hospital
settings, including clerical staff, financial officers,
groundskeepers, and numerous other professionals with no
patient interaction or specific presumed work exposure.
Employees without access to good medical care may seek
treatment in the workers' compensation arena for back and neck
trouble, common ailments for individuals, regardless of
work-related risk.
5)While some medical professionals are at higher risk of MRSA
exposure, hundreds of thousands of employees addressed by this
bill have higher risk of MRSA infection outside of work. Staph
infections are increasingly common across a range of
individuals in the community. In many cases, because MRSA
results in a relatively short and less serious infection,
costs may not be incurred. However, in many other cases,
serious illness and death may result. Hospital payments in
these cases would be substantial and often not attributable to
a work exposure.
6)This bill creates tremendous health care cost pressures
statewide and may exacerbate hospital closures that have
accelerated in recent years. Since 1996, 90 hospitals have
closed across California, with more than 25 closing in the
past five years. In addition, the Workers' Compensation
Insurance Rating Bureau (WCIRB) recently recommended a 24%
increase in premiums. Most of this sharp increase has been
attributed to health care cost escalation in the workers'
compensation system.
COMMENTS
1)Rationale . This bill is sponsored by the California Nurses
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Association to establish workers' compensation presumptions
for employees at hospitals. Workers' compensation
presumptions, limited to the public sector, have been
established to account for increased risk of certain work as
well as public sector employees' need to respond to distinct
hazards and emergencies that are less common in private
sectorand non-profit work.
2)Concerns . Dozens of business, health care, and local
government groups, including the Chamber of Commerce, the
California Hospital Association, and the California
Association of Counties oppose this bill.
In addition, a notable group in opposition to this bill is the
Association of Occupational Health Professionals in Healthcare
(AOHP), a group of physicians, nurses, and nurse practitioners
established specifically to promote employee health and safety
and to provide occupational health education. AOHP indicates
there is no justification for extending workers' compensation
presumptions to private sector workers, or to remove the
burden of proof for all hospital employees, regardless of
function. In addition, AOHP specifies that numerous hospital
policies and procedures are available to reduce workers risk
as well as confirm exposures and provide support to workers'
compensation claims.
3)Related Legislation . AB 586 (Huber), also being heard in this
committee today, expands workers' compensation presumptions
for cancer, hernia, pneumonia, heart trouble, tuberculosis,
blood-borne infectious diseases, meningitis, and MRSA
infections to UC and CSU peace officers.
AB 128 (Coto), pending on the Suspense File of this committee,
establishes a life-time workers' compensation cancer
presumption for public safety professionals (e.g.: fire
firefighters, police officers, highway patrol) with
substantial years of service credit.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081