BILL ANALYSIS
AB 1994
Page 1
Date of Hearing: May 5, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 1994 (Skinner) - As Amended: March 23, 2010
Policy Committee: Insurance
Vote:8-4
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill establishes several workers' compensation presumptions
for more than 350,000 direct patient care workers at hospitals
statewide, including workers at private and non-profit
hospitals. This bill establishes presumptions that specified
injuries arise from employment for the purposes of workers'
compensation benefits. Specifically, this bill:
1)Requires these injuries to include:
a) Back or neck injuries
b) Methicillin-resistant Staphylococus aureus (MRSA, staph)
infection
c) H1N1 influenza infection
2)Requires the workers' compensation benefits to include payment
for:
a) Full hospital
b) Surgical
c) Medical treatment
d) Disability indemnity
e) Death benefits
3)Requires the presumptions to be in effect until either 90 days
or 180 days after termination of employment.
FISCAL EFFECT
1)Increased costs to hospitals statewide of more than $250
million to $500 million for the payment of full hospital,
AB 1994
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surgical, medical treatment, disability indemnity, and death
benefits for presumptions of back and neck injuries, staph
infections, and influenza-related illness. 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)Legislation about workers' compensation presumptions usually
addresses public sector employees, not private sector workers
or employers, and usually is framed around specific exposures
routinely encountered in the course of employment. This bill
fails to define hospital or specify professional
classification or hospital ownership type.
3)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.
4)This bill codifies a workers' compensation presumption related
to H1N1 influenza. Although H1N1 explained a significant
proportion of the flu in 2009, it is only a subtype of
influenza and in many other years recedes in clinical
significance with regard to morbidity and mortality. It is
unclear why this subtype of influenza was chosen for
codification. In addition, risk of H1N1 infection and other
forms of flu are very common in the general population, aside
of exposure to infection in an inpatient setting.
COMMENTS
1)Rationale . This bill is sponsored by the California Nurses
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 in certain types of
work. The author and sponsor of this bill indicate nurses
should join public safety professionals in having such
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presumptions due to the hazardous nature of their work with
respect to musculoskeletal injuries and infection.
2)Presumptions . California workers' compensation law provides
that workers are provided compensation benefits when an injury
or illness arises out of and in the course of employment.
Current law specifies that certain medical conditions suffered
by public safety officers (e.g., cancer, hernia, heart
trouble, pneumonia, tuberculosis, blood-borne infectious
disease, meningitis, and exposure to biochemical substances)
are presumed to have arisen in the course of employment. The
purpose of these statutory presumptions is to provide
additional compensation benefits to employees who provide
vital and hazardous services by easing their burden of proof
of industrial causation. This bill seeks to establish similar
presumptions for nurses in California hospitals.
3)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.
4)Related Legislation . AB 2253 (Coto), pending on the Suspense
File of this committee, eliminates a five-year cap on a
workers' compensation cancer presumption for public safety
professionals and quadruples the rate at which professionals
accrue the presumption.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081