BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
AB 1136 (Swanson)
Hearing Date: 8/25/2011 Amended: 8/15/2011
Consultant: Katie Johnson Policy Vote: Labor 5-1
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BILL SUMMARY: AB 1136 would require all general acute care
hospitals to maintain a safe patient handling policy and provide
trained lift teams or other support staff trained in safe
lifting techniques. The bill would also require employers to
adopt a patient protection and health care worker back and
musculoskeletal injury prevention plan as part of the injury and
illness prevention programs required by existing state
regulations.
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Fiscal Impact (in thousands)
Major Provisions 2011-12 2012-13 2013-14 Fund
Hospital staff, training, potentially significant, would
vary General/*
and purchase of by hospital Federal/
equipment cost pressure Local
on all payers
DIR regulations up to $100 one-time through FY
2012-2013Special**
*See Staff Comments
**Occupational Safety and Health Fund
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STAFF COMMENTS: SUSPENSE FILE.
As part of the injury and illness prevention programs required
by existing California regulations, or any successor law or
regulation, employers would be required to adopt a patient
protection and health care worker back and musculoskeletal
injury prevention plan. The plan would include a safe patient
handling policy component for the protection of patients and
health care workers in health care facilities. This bill would
require employers to provide training to health care workers
AB 1136 (Swanson)
Page 1
that would be required to include the appropriate use of lifting
devices and equipment, the five areas of body exposure, and the
use of lifting devices to handle patients safely. A registered
nurse would be required to be responsible for the observation
and direction of patient lifts and mobilization. Every employer
in California is required to have an IIPP; in hospitals, a safe
patient handling or lift policy may be part of the IIPP.
This bill would provide that a general acute care hospital would
not be required to hire new staff to comprise the lift team so
long as direct patient care assignments are not compromised. A
"health care worker" would be defined as a lift team member or
other staff responsible for assisting in lifting patients.
There are approximately 420 hospitals in California. This bill
would apply to all general acute care hospitals, except that it
would specifically exempt those administered by the California
Department of Corrections and Rehabilitation and the Department
of Developmental Services.
Other Hospitals
To the extent that a hospital does not have a patient handling
policy that meets this bill's provisions, there could be
increased costs in the low hundreds of thousands of dollars per
lift team to hire and train staff. Additionally, if a hospital
does not have the necessary lifting equipment, it could incur
one-time equipment purchase costs as well. In California,
hospitals are paid by a variety of public and private "payers,"
such as insurers, health care service plans, the state,
counties, or individuals. Any additional staffing or equipment
costs to hospitals would put cost pressure on all payers of
health care coverage, including state payers such as the
Medi-Cal program, the Healthy Families Program (Healthy
Families), and California Public Employees Retirement System
(CalPERS), to cover any increased costs to hospitals that would
result from this bill in the rates that they pay to the
hospital; state programs do not pay hospitals directly for
administrative costs. Medi-Cal costs are shared 50 percent
General Fund/other non-federal funds and 50 percent federal
funds depending on the private or publicly-owned status of the
hospital; Healthy Families costs are shared 35 percent General
Fund and 65 percent federal funds; and CalPERS costs are shared
approximately 55 percent General Fund and 45 percent other
funds.
AB 1136 (Swanson)
Page 2
There would be costs of up to $100,000 special funds one-time to
the Department of Industrial Relations (DIR) for regulations.
Occupational Safety and Health Fund monies are capped and
annually adjusted by a deflator. This bill would put pressure on
those limited funds.
Previous Legislation
This bill is similar to several previous bills that were all
vetoed by Governor Schwarzenegger: SB 1151 (Perata, 2008), SB
171 (Perata, 2007), AB 371 (Huffman, 2007), SB 1204 (Perata,
2006), SB 363 (Perata, 2005), and AB 2532 (Hancock, 2004). In
his SB 1151 veto message, the Governor said, "?This bill is
unnecessary as current laws and regulations are in place to
address the workplace health and safety needs of health care
workers. Existing statutes are flexible and allow employers to
exercise discretion in determining what combination of lift
teams and equipment is necessary to have an effective Injury and
Illness Prevention Program?."