BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 196
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          SENATE THIRD READING
          SB 196 (Corbett)
          As Amended July 9, 2009
          Majority vote 

           SENATE VOTE  :vote not relevant  
           
           HEALTH              14-5        APPROPRIATIONS      12-5        
           
           ----------------------------------------------------------------- 
          |Ayes:|Jones, Adams, Ammiano,    |Ayes:|De Leon, Ammiano,         |
          |     |Block,                    |     |Charles Calderon, Coto,   |
          |     |Carter, De La Torre, De   |     |Davis, Fuentes, Hall,     |
          |     |Leon, Hall,               |     |John A. Perez, Skinner,   |
          |     |Hayashi, Hernandez,       |     |Solorio, Torlakson, Hill  |
          |     |Bonnie Lowenthal, Nava,   |     |                          |
          |     |V. Manuel Perez, Salas    |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Fletcher, Conway,         |Nays:|Conway, Duvall, Harkey,   |
          |     |Emmerson, Gaines, Audra   |     |Miller,                   |
          |     |Strickland                |     |Audra Strickland          |
           ----------------------------------------------------------------- 
          
          SUMMARY  :  Changes the notice requirements for hospital closures.  
           Specifically,  this bill  :

          1)Increases from 90 to 120 days the public notice an acute care  
            hospital must provide prior to closing or downgrading the  
            emergency department (ED).

          2)Adds employees to the list of entities that must be provided  
            with this notice and requires the hospital to hold a minimum  
            of three public meetings related to the proposed changes.

          3)Requires the facility to inform the public of the status at  
            the second public meeting.   

          4)Increases from 30 to 60 days the public notice an acute care  
            hospital must give prior to closing a facility or relocating  
            supplemental services. 

           EXISTING LAW  :









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          1)Establishes the Department of Public Health (DPH) as the state  
            entity responsible for licensing and regulating health  
            facilities, including acute care hospitals.

          2)Requires that any hospital that provides emergency medical  
            services, as soon as possible, but not later than 90 days  
            prior to a planned reduction or elimination of the level of  
            emergency medical services, provide notice of the intended  
            change to DPH, the local government entity in charge of the  
            provision of health services, and all health care service  
            plans or other entities under contract with the hospital to  
            provide services to enrollees of the plan or other entity.

          3)Requires that in addition to the notice required by #2) above,  
            affected hospitals, within the 90 days, provide public notice  
            of the intended change in a manner that is likely to reach a  
            significant number of residents of the community serviced by  
            that facility.

          4)Requires the county in which the closure or downgrade will  
            occur to prepare an impact evaluation that DPH must receive  
            before approving the change.  The impact evaluation must  
            include the impact on community access to emergency care.  The  
            process must include at least one public hearing, meet  
            specified timelines and may be delegated to the local  
            emergency services agency.  

          5)Requires any general acute care hospital not later than 30  
            days prior to a planned closure of the facility or elimination  
            of a supplemental service to provide public notice with  
            specified information, including a description of the planned  
            action and of the three nearest available comparable services  
            in the community.  Requires the hospital to post the notice at  
            the entrance to the facility and provide it to DPH and the  
            county board of supervisors.

          6)Requires, under the Beilenson Act, that, prior to a county  
            health facility closing, eliminating, or reducing the level of  
            medical services provided, or the leasing, selling, or  
            transfer of management, the county board of supervisors  
            provide public notice, including notice posted at the entrance  
            to all county health care facilities, of public hearings to be  
            held by the board of supervisors prior to its decision to  
            proceed.  The notice is required to contain:  a) a list of the  








                                                                  SB 196
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            proposed reductions or changes, by facility and service; b)  
            the amount and type of each proposed change; c) the expected  
            savings; and, d) the number of persons affected.

          7)Allows counties to establish Local Health Care Districts  
            (hospital district) to operate health care facilities,  
            including acute care hospitals.  Hospital districts are  
            required to secure voter approval in the district before  
            transferring or leasing more than 50% of the assets to a  
            private corporation.  

          8)Requires hospitals to meet seismic safety standards by 2008  
            and allows extensions under certain circumstances to 2013 and  
            2020.  

           FISCAL EFFECT  :   According to the Assembly Appropriations  
          Committee, absorbable costs to DPH and unknown, but likely  
          absorbable costs to hospitals. 

           COMMENTS  :   According to the author, when a hospital closes or  
          eliminates a health service, it has a dramatic effect on the  
          availability, quality, and accessibility of care.  This bill  
          adds 30 days to the existing notice requirement for an acute  
          care hospital for a total of 60 days.  It also adds 30 days  
          notice of the closure of an ED, for a total of 120 days, and  
          requires the hospital to hold three public meetings.  This  
          additional notice, the author states, will allow the public to  
          find solutions to keep their emergency rooms open, find a new  
          provider, or increase revenue to keep the local hospital open.   
          This bill also requires a status report at the second public  
          hearing. 

          The California Hospital Association (CHA) opposes this bill and  
          states that hospitals close because of inadequate revenue.   
          According to CHA, it is frequently a choice between closing the  
          emergency department or the entire hospital.  CHA contends that  
          when a closure is announced, staff  begin to look for other  
          opportunities and that adding 90 days and more pubic meetings  
          will "pile on" costs to a troubled hospital.  With regard to the  
          author's assertion that this provides additional time to find  
          solutions, the opponents respond that a financial solution is  
          virtually impossible in these economic times. 










                                                                  SB 196
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           Analysis Prepared by  :    Marjorie Swartz / HEALTH / (916)  
          319-2097 


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