BILL ANALYSIS �
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|SENATE RULES COMMITTEE | AB 808|
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THIRD READING
Bill No: AB 808
Author: Skinner (D), et al.
Amended: 8/6/12 in Senate
Vote: 21
SENATE LABOR & INDUSTRIAL RELATIONS COMM. : 5-0, 6/27/12
AYES: Lieu, DeSaulnier, Leno, Padilla, Yee
NO VOTE RECORDED: Wyland, Runner
SENATE APPROPRIATIONS COMMITTEE : 5-2, 8/16/12
AYES: Kehoe, Alquist, Lieu, Price, Steinberg
NOES: Walters, Dutton
ASSEMBLY FLOOR : 75-0, 5/26/11 (Consent) - See last page for
vote
SUBJECT : Workers compensation: hospital employers:
presumption
SOURCE : California Nurses Association
DIGEST : This bill provides, 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 skin
infection) that develops or manifests itself during the
period of the person's employment with the hospital. This
bill creates a presumption that MRSA skin infection arises
out of and in the course of the person's employment if MRSA
skin infection develops or manifests as specified. This
CONTINUED
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bill prohibits attributing MRSA skin infection that
develops or manifests in those cases to any disease or skin
infection existing prior to that development or
manifestation.
ANALYSIS : Existing law establishes a workers'
compensation system that provides benefits to an employee
who suffers from an injury or illness that arises out of
and in the course of employment, irrespective of fault.
This system requires all employers to secure payment of
benefits by either securing the consent of the Department
of Industrial Relations to self-insure or by securing
insurance against liability from an insurance company duly
authorized by the state.
Existing law creates a series of disputable presumptions of
an occupational injury for peace and safety officers for
the purposes of the workers' compensation system. These
presumptions include:
Heart disease;
Hernias;
Pneumonia;
Cancer;
Meningitis;
Tuberculosis;
MRSA skin infection; and
Bloodborne infectious disease.
The compensation awarded for these injuries must include
full hospital, surgical, medical treatment, disability
indemnity, and death benefits, as provided by workers
compensation law. These presumptions tend to run for 5 to
10 years commencing on their last day of employment,
depending on the injury and the peace officer
classification involved.
Existing law provides that the presumptions listed above
are disputable and may be controverted by evidence.
However, unless controverted, the Workers' Compensation
Appeals Board must find is accordance with the presumption.
This bill provides, with respect to hospital employees who
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provide direct patient care in an acute care hospital, that
the term "injury" includes MRSA skin infection that
develops or manifests itself during the period of the
person's employment with the hospital. This bill creates a
presumption that MRSA skin infection arises out of and in
the course of the person's employment if MRSA skin
infection develops or manifests as specified. This bill
prohibits attributing MRSA skin infection that develops or
manifests in those cases to any disease or skin infection
existing prior to that development or manifestation.
Comments
Methicillin-Resistant Staphylococcus aureus .
Staphylococcus aureus, often referred to simply as "staph,"
are bacteria commonly carried on the skin or in the nose of
healthy people. Approximately 25% to 30% of the population
is colonized (when bacteria are present, but not causing an
infection) in the nose with staph bacteria. Staph bacteria
are one of the most common causes of skin infections in the
United States. Most of these skin infections are minor and
occur through direct physical contact of the staphylococci
with a break in the skin (cut or scrape). The staph can be
spread by the infected person to someone else or to an
object. 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. Now, in most communities in the
U.S., over half of the staph causing skin infections are
resistant to commonly used antibiotics, and the infections
often return in spite of apparently successful initial
treatment.
MRSA is Staphylococcus aureus that is resistant to the
penicillin. 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 that causes boils, abscesses, and
other soft tissue infections that are not linked to
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previous antibiotic use. It is called community-associated
MRSA. It is generally believed that the
community-associated MRSA strains did not originate from
the strains of MRSA that cause infections in hospitals and
other healthcare facilities. However, individuals seeking
treatment for community-associated MRSA would likely seek
treatment in a hospital due to the risks involved.
Individuals at risk for MRSA include workers in a
healthcare setting, individuals visiting patients in a
healthcare setting, athletic facilities, dormitories,
military barracks, correctional facilities, and daycare
centers. However, MRSA is now found throughout the general
community.
Prior Legislation
AB 375 (Skinner, 2011) contained nearly identical
provisions to this bill on Methicillin-Resistant
Staphylococcus aureus (MRSA) skin infections, but also
included bloodborne pathogens. The bill was refused
passage on the Senate Floor.
AB 1994 (Skinner, 2010) proposed similar provisions to AB
375, but also included additional conditions to which the
presumption would apply, such as back and neck injuries.
The bill was held on the Assembly Appropriations Committee
Suspense File.
AB 664 (Skinner, 2009) was similar to AB 1994. AB 664 was
held on the Assembly Appropriations Committee Suspense
File.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
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.
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SUPPORT : (Verified 8/16/12)
California Nurses Association (source)
California Applicants' Attorneys Association
California Labor Federation
California Professional Firefighters
Laborers' Locals 777 & 792
Union of Healthcare Professionals
United Nurses Association of California
OPPOSITION : (Verified 8/16/12)
ALPHA Fund
Association of California Healthcare Districts
Association of California Insurance Companies
California Association for Health Services at Home
California Association of Joint Powers Authorities
California Chamber of Commerce
California Coalition of Workers' Compensation
California Hospital Association
California Special Districts Association
California State Association of Counties
CSAC Excess Insurance Authority
Los Angeles Area Chamber of Commerce
Regional Council of Rural Counties
ARGUMENTS IN SUPPORT : Proponents believe that this bill
will ensure that nurses are appropriately protected from
the pathogenic hazards found in hospitals. Proponents note
that current law provides a presumption of occupational
injury to public safety officers if they contract a
Methicillin-Resistant Staphylococcus aureus (MRSA) skin
infection, but nurses who are exposed to MRSA on a routine
basis are not provided a similar presumption. Proponents
note that while existing procedures have done much to
reduce MRSA exposures, it remains a daily threat to the
health of nurses throughout California. Finally,
proponents note that nurses perform a highly specialized
and key role in ensuring the health and welfare of the
people of California, and they should be able to provide
that service without fighting with an insurance company in
the event of a serious MRSA infection.
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ARGUMENTS IN OPPOSITION : Opponents argue that there is
no rationale to extend the concept of presumptions to
employees who are not in the traditional group - public
safety officers - who have received this special benefit
due to the special dangers of the work they do. Because of
the unique role that public safety officers play in our
society, they have historically received several different
and unique benefits, including enhanced retirement rules,
special disability retirement rules, enhanced temporary
disability rules, and presumptions of compensability.
While these enhanced benefits may be appropriate for public
safety employees, it does not follow that these rules
should be expanded to other classes of employee. Opponents
argue that there is no evidence that the normal rules
governing how injuries or conditions are proven to be
job-related are not working properly with respect to the
employees and the conditions being addressed by the bill.
ASSEMBLY FLOOR : 75-0, 05/26/11
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Beall, Bill
Berryhill, Block, Blumenfield, Bonilla, Bradford,
Brownley, Buchanan, Butler, Charles Calderon, Carter,
Chesbro, Conway, Cook, Dickinson, Donnelly, Eng, Feuer,
Fletcher, Fong, Fuentes, Furutani, Beth Gaines, Galgiani,
Garrick, Gatto, Gordon, Grove, Hagman, Halderman, Hall,
Harkey, Hayashi, Roger Hern�ndez, Hill, Huber, Hueso,
Huffman, Jeffries, Knight, Lara, Logue, Bonnie Lowenthal,
Ma, Mansoor, Mendoza, Miller, Mitchell, Monning, Morrell,
Nestande, Nielsen, Norby, Olsen, Pan, Perea, V. Manuel
P�rez, Portantino, Silva, Skinner, Smyth, Solorio,
Swanson, Torres, Valadao, Wagner, Wieckowski, Williams,
Yamada, John A. P�rez
NO VOTE RECORDED: Campos, Cedillo, Davis, Gorell, Jones
PQ:n 8/20/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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