BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
AB 808 (Skinner) - Workers' compensation: hospital employees:
presumption.
Amended: August 6, 2012 Policy Vote: L&IR 5-0
Urgency: No Mandate: No
Hearing Date: August 6, 2012 Consultant:
Bob Franzoia
This bill meets the criteria to be referred to the Suspense
File.
Bill Summary: AB 808 would provide, with respect to hospital
employees who provide direct patient care in an acute care
hospital, that the term "injury" includes methicillin-resistant
Staphylococcus aureus (MRSA) that develops or manifests itself
during the period of the person's employment with the hospital.
Fiscal Impact: Minimum $33,000 to $65,000 for industrial
disability benefit (up to one year), up to $53,000 for
additional temporary disability benefit (up to one additional
year).
Potentially major benefit and medical costs if a MSRA
injury results in permanent disability.
Background: MRSA is a bacterium responsible for
difficult-to-treat infections. MRSA are by definition strains
of Staphylococcus aureus that are resistant to a large group of
antibiotics including penicillins and cephalosporins. Under
this bill, if a hospital employee who provides direct patient
care in an acute care hospital develops a MRSA skin infection,
it is presumed the injury arose out of and in the course of
employment and is therefore, compensable.
The MRSA presumption shall be extended to a hospital employee
following termination of service for a period of 60 days
commencing with the last day worked.
The state has seven general acute care hospitals operated by the
California Department of Corrections and Rehabilitation (3) and
the Department of Development Services (4).
AB 808 (Skinner)
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Most state employees receive industrial disability leave, which
is full gross pay less the amount deducted for taxes for the
first month and two-thirds of full gross pay thereafter. There
is no maximum on industrial disability leave and can be received
for up to one year. State hospital employees are eligible to
supplement their industrial disability leave benefits with any
paid leave credits they have to bring the amount up to their
regular earnings amount. After one year, the state employee is
eligible for up to one year of temporary disability benefits.
Non state hospital employees may receive temporary disability
benefits for up to 104 weeks. In 2011, a year of workers'
compensation temporary disability benefits for an employee may
be up to $51,307.88, increasing to $52,546.00 ($1,010.55 x 52
weeks) in 2012.
If a licensed vocational nurse or registered nurse (several job
classifications are involved in providing direct patient care)
working in a state acute care hospital contracts MRSA, the cost
could range from approximately $33,000 to $65,000 for up to one
year of industrial disability leave benefits. The employee
would be eligible for up to 52 weeks of temporary disability
benefits after exhausting the industrial leave benefits or
$52,546.00 (in 2012).
Staff notes there are potentially thousands of state employees
who provide direct patient care in settings other than acute
care hospitals. For example, in 2009, of the 3,891registered
nurses in Bargaining Unit 17, roughly two-thirds are "level of
care" nurses providing or supervising direct patient care in
mental health hospitals, youth and adult correctional
institutions, developmental centers, and the state's veterans'
homes.
Most persons recover from job injuries but some continue to have
medical problems. Permanent disability is any lasting disability
that results in a reduced earning capacity after maximum medical
improvement is reached. If a person's injury or illness results
in permanent disability the person is entitled to permanent
disability benefits, even if he or she is able to return to
work. Permanent disability benefits are limited. If a person
loses income, permanent disability benefits may not cover all
the income lost and if the person experiences losses unrelated
to ability to work, permanent disability benefits will not cover
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those losses.
A doctor makes the determination if an injury or illness caused
permanent disability. The doctor also determines if any of the
disability was caused by something other than the work injury
(for example, a previous injury or other condition) in a process
known as apportionment. The disability is stated as a
percentage which equals a specific dollar amount, depending on
the date of the injury and the person's average weekly wages at
the time of injury. If the person was injured on or after Jan.
1, 2005, the permanent disability award may be increased or
decreased by 15 percent, depending on whether the person worked
for an employer with 50 or more employees and the employer
offers a salary continuation program and the person accepts or
declines regular, alternative or modified work. Permanent
disability benefits are normally paid when temporary disability
benefits end and a doctor has indicated the person has some
permanent effects from a workplace injury. A person with a
disability rating of less than 70 percent would receive $230
weekly. A person with a disability rating of more than 70
percent would receive $270 weekly. These amounts have not
changed since 2006.
In addition to temporary and permanent disability benefits, a
person could incur medical costs. According to one estimate,
the cost to treat a MRSA infection can range from $1,000 to
$7,500 or more if extensive hospitalization is required.
This bill may result in increased Medi-Cal costs in non-contract
hospitals, because the allowable costs of hospital cost reports
include workers' compensation expenditures. Any increase may be
minor as the state is moving toward a diagnosis-related system
for reimbursing hospitals and is not negotiating any new
contracts and costs would be spread across all payors. This bill
could increase costs to the University of California which
operates five hospitals. There are an estimated 385 non-state
acute care hospitals and 140,000 full time employees subject to
the bill. In general, the cost for a state hospital employee
and a non state hospital employee with a MRSA presumption would
be in the first year cost difference between industrial
disability leave benefits and temporary disability benefits.
The state and UC would likely appropriate additional funding for
increased workers' compensation costs and private employers
would likely experience higher workers' compensation premiums.
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Existing presumptions (see Labor Code Sections 3212 to 3213.2)
are extended to an employee following termination of service for
a period of three calendar months for each full year of the
requisite service, but not to exceed 60 months (120 months for a
cancer presumption for police and firefighters) in any
circumstance, commencing with the last date actually worked in
the specific capacity. AB 2754 (Bass) Chapter 684/2008 added
Labor Code 3212.8 to provide this presumption for members of a
sheriff's office, or police or fire departments of cities,
counties, districts, or other public or municipal corporations
or political subdivisions and active firefighting members of the
Department of Forestry and Fire Protection or any other county
forestry or firefighting department or unit. Most law
enforcement and firefighting personnel are covered under Labor
Code 4800 and receive benefits equal to their full salary.
From 1992-93 to 2007-08, the peace officer cancer presumption
and the firefighter presumption have total program costs (local
mandate) of $28,994,178 and $40,054,104 respectively.
Related Legislation: AB 375 (Skinner) 2011, which proposed the
term "injury" included a blood borne infectious disease, as well
as MSRA, failed passage on the Senate Floor 20 to 15 (granted
reconsideration) and 20 to 16.