BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Elaine K. Alquist, Chair


          BILL NO:       SB 212                                       
          S
          AUTHOR:        Florez                                       
          B
          AMENDED:       April 15, 2008                              
          HEARING DATE:  April 29, 2009                               
          2
          CONSULTANT:                                                 
          1
          Moreno/cjt                                                  
          2
                                                                     
                                        
                                     SUBJECT
                                         
                         Health facilities: infections

                                     SUMMARY  

          Permits school districts to provide for the annual cleaning  
          and sterilizing of wrestling equipment, as specified.  
          Requires the Superintendent of Public Instruction to  
          develop information and guidelines regarding the prevention  
          of communicable diseases at school sites, as specified.   
          Requires the California Department of Education (CDE) to  
          post the guidelines on its website.

                             CHANGES TO EXISTING LAW  

          Existing law:
          Requires school districts maintaining high schools to  
          provide for the annual cleaning, sterilizing, and necessary  
          repair of football equipment of their respective schools.

          Requires football equipment that is worn by pupils to be  
          cleaned and sterilized at least once a year and requires  
          football equipment used in spring training to be cleaned  
          and sterilized before it is used in the succeeding fall  
          term.
          
          This bill:
                                                         Continued---



          STAFF ANALYSIS OF SENATE BILL  SB 212 (Florez)Page 2




          Permits school districts to provide for the annual cleaning  
          and sterilizing of wrestling equipment, as specified.

          Requires the Superintendent of Public Instruction to  
          develop information and guidelines regarding the prevention  
          of communicable diseases at school sites and submit it to  
          the State Board of Education for its approval.  Requires  
          the information and guidelines, at a minimum, to address  
          the maintenance of locker rooms, athletic equipment, and  
          synthetic ground covers used for athletic fields and ways  
          to minimize the spread of methicillin resistant  
          Staphylococcus aureus (MRSA) and meningococcal disease.   
          Requires the CDE to post the approved guidelines on its  
          website.

                                         
                                 FISCAL IMPACT  

          Unknown.

                            BACKGROUND AND DISCUSSION  

          According to the author, a 2007 Centers for Disease Control  
          and Prevention (CDC) report included a survey of high  
          school and college athletic trainers of which, 53 percent  
          reported treating MRSA.  School locker rooms and sports can  
          offer a perfect environment for the transmission of MRSA,  
          which can be fatal.  Unfortunately, schools can sometimes  
          provide the perfect transmission for fatal communicable  
          diseases.  The author states that SB 212 will strengthen  
          the public health at our schools.  


          Staphylococcus aureus 

          According to the Department of Public Health (DPH),  
          Staphylococcus aureus (staph) are bacteria commonly carried  
          on the skin or in the nose of healthy people. Approximately  
          25 percent to 30 percent of the population is colonized  
          (when bacteria are present, but not causing an infection)  
          in the nose with staph bacteria. It can also be carried in  
          the armpit, groin, or genital area.  Most of these staph  
          infections are minor (such as pimples and boils) and can be  
          treated without antibiotics.  However, staph also can cause  
          serious infections such as pneumonia, bloodstream  
          infections, and joint infections. Most infections occur  




          STAFF ANALYSIS OF SENATE BILL  SB 212 (Florez)Page 3




          through direct physical contact of the staph with a break  
          in the skin. Susceptibility to infection depends on factors  
          such as immunity and general state of health.  In the past,  
          these staph infections typically have been easy to treat  
          with an inexpensive, short course, usually well-tolerated  
          antibiotics. However, over half of the staph causing skin  
          infections are now resistant to commonly used antibiotics,  
          and the infections often return in spite of apparently  
          successful initial treatment. 


          MRSA 
          According to DPH, MRSA is staph that is resistant to the  
          penicillins, including dicloxacillin or other  
          methicillin-related antibiotics.  Originally, MRSA was  
          confined to hospitals and long-term care facilities.  Many  
          of these hospital-associated MRSA infections caused very  
          serious complications and were resistant to all oral  
          antibiotics. More recently, a newer, more virulent strain  
          of MRSA has emerged in the community (called  
          community-associated MRSA) that causes boils, abscesses,  
          and other soft tissue infections, that is not linked to  
          previous antibiotic use. MRSA is usually transmitted by  
          direct skin-to-skin contact or contact with shared items or  
          surfaces that have come into contact with someone else's  
          infection.  The frequency of infections with  
          community-associated MRSA appears to be higher than those  
          caused by staph in the past, particularly in athletic  
          teams. The reasons for this increase are not known, but it  
          is clear that the community-associated MRSA strains did not  
          originate from the strains of MRSA that cause infections in  
          hospitals and other healthcare facilities.

          Controlling MRSA in schools
          According to the CDC, in general it is not necessary to  
          close schools to disinfect them when MRSA infections occur.  
           MRSA skin infections are transmitted primarily by  
          skin-to-skin contact and contact with surfaces that have  
          come into contact with someone else's infection.   
          Therefore, the CDC recommends that when MRSA skin  
          infections occur, cleaning and disinfection should be  
          performed on surfaces that are likely to contact uncovered  
          or poorly covered infections.  

          Prior legislation
          SB 1058 (Alquist), Chapter 296, Statutes of 2008,  




          STAFF ANALYSIS OF SENATE BILL  SB 212 (Florez)Page 4




          establishes the Medical Facility Infection Control and  
          Prevention Act, which requires hospitals to implement  
          specified procedures for screening, prevention, and  
          reporting specified health care associated infections also  
          known as hospital associated infections (HAIs). Requires  
          hospitals to report positive MRSA and other HAI test  
          results to DPH and requires DPH to make specified  
          information public on its website.

          SB 158 (Florez), Chapter 294, Statutes of 2008, establishes  
          an infection surveillance, prevention, and control program  
          within DPH to provide oversight of hospital prevention and  
          reporting of general acute care hospital-associated  
          infections, expands the responsibilities of DPH's  
          Healthcare Associated Infection Advisory Committee, and  
          requires all hospitals to institute a patient safety plan  
          for the purpose of improving the health and safety of  
          patients and reducing preventable patient safety events.
          
                                   PRIOR VOTES
           
          Senate Education Committee:   5-2

                                     COMMENTS
                                         
          1.Technical amendments.

          On page 2, beginning on line 8
          17578.  The governing board of each district maintaining a  
          high school shall provide for the annual cleaning  and  
          sterilizing of football and wrestling equipment and the  ,  
          sterilizing, and  necessary repair of football equipment of  
          their respective schools pursuant to Sections 17579 and  
          17580  and may provide for the annual cleaning and  
          sterilizing of wrestling equipment  as specified by the  
          Superintendent and the state board pursuant to Section  
          33134.   .
            SEC. 2.  Section 17579 of the Education Code is amended  
          to read:
             17579.  (a) All football equipment actually worn by  
          pupils shall be cleaned and sterilized at least once a  
          year. Football equipment used in spring training shall be  
          cleaned and sterilized before it is used in the succeeding  
          fall term.
             (b) Wrestling equipment used multiple years may be  
          cleaned and sterilized as specified by the Superintendent  




          STAFF ANALYSIS OF SENATE BILL  SB 212 (Florez)Page 5




          and the state board pursuant to Section 33134.
           
                                    POSITIONS  


          Support:  None received.

          Oppose:   None received.


                                   -- END --