BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 196|
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UNFINISHED BUSINESS
Bill No: SB 196
Author: Corbett (D), et al
Amended: 7/9/09
Vote: 21
SENATE VOTES NOT RELEVANT
ASSEMBLY FLOOR : 49-27, 9/1/09 - See last page for vote
SUBJECT : Emergency Medical Services
SOURCE : Author
DIGEST : This is a new bill. As this bill left the
senate it dealt with Health care coverage and provides
contracts. These provisions were deleted in the Assembly.
This bill now (1) increases and extends notification
requirements of hospitals with emergency medical services
that are reducing or eliminating services; (2) extends
notification requirements from 30 days to 60 days prior to
eliminating a supplemental service or closing a hospital;
(3) extends from 90 days to 120 days notification
requirements prior to a planned reduction or elimination of
hospital emergency medical services; (4) requires all
hospital employees to be notified of service changes; (5)
requires a health facility to hold a minimum of three
public meetings and requires a status update at the second
public meeting; and (6) requires a facility to make
reasonable efforts to advertise the change, solicit media
CONTINUED
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coverage, and inform patients about changes.
ANALYSIS :
Existing law:
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.
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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
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 percent 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.
This bill 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.
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FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Assembly Appropriations Committee
analysis, absorbable workload to the DPH to continue
oversight of hospitals and current law requirements
regarding hospital closures.
Unknown, likely absorbable increased costs to hospitals to
complete requirements established by this bill. Public
hospitals, including the University of California, are less
likely to experience such cost increases. County and UC
hospitals are mission-driven, safety net providers of last
resort and are therefore less likely to close than
non-profit or for-profit counterparts.
OPPOSITION : (Verified 9/2/09)
California Hospital Association
ARGUMENTS IN SUPPORT : According to the author's office,
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's office 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.
ARGUMENTS IN OPPOSITION : 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
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that a financial solution is virtually impossible in these
economic times.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Arambula, Beall, Block, Blumenfield,
Brownley, Caballero, Carter, Chesbro, Coto, Davis, De La
Torre, De Leon, Eng, Evans, Feuer, Fong, Fuentes,
Furutani, Hall, Hayashi, Hernandez, Hill, Huber, Huffman,
Jeffries, Jones, Krekorian, Lieu, Bonnie Lowenthal, Ma,
Mendoza, Monning, Nava, John A. Perez, V. Manuel Perez,
Portantino, Ruskin, Salas, Saldana, Skinner, Solorio,
Swanson, Torlakson, Torres, Torrico, Yamada, Bass
NOES: Anderson, Bill Berryhill, Tom Berryhill, Blakeslee,
Conway, Cook, DeVore, Duvall, Emmerson, Fletcher, Fuller,
Gaines, Garrick, Gilmore, Hagman, Harkey, Knight, Logue,
Miller, Nestande, Niello, Nielsen, Silva, Smyth, Audra
Strickland, Tran, Villines
NO VOTE RECORDED: Buchanan, Charles Calderon, Galgiani,
Vacancy
CTW:RJG:do 9/2/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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