BILL ANALYSIS                                                                                                                                                                                                    �






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                       Senator Ed Hernandez, O.D., Chair


          BILL NO:       SB 844                                      
          S
          AUTHOR:        Price                                       
          B
          AMENDED:       As Introduced                               
          HEARING DATE:  April 13, 2011                              
          8
          CONSULTANT:                                                
          4              
          Hansel                                                     
          4              
                                     SUBJECT
                                         
                Health facilities: general acute care hospitals


                                     SUMMARY  

          Allows, for the purposes of hospital licensing 
          requirements, dietary services to be provided either at the 
          hospital, or in another hospital immediately adjacent to 
          the hospital, as long as dedicated facilities are in place 
          to accommodate the delivery of these services.


                             CHANGES TO EXISTING LAW  

          Existing law:
          Provides for the licensing and regulation of health 
          facilities, including general acute care hospitals, by the 
          Department of Public Health (DPH).

          Requires, under statute and regulations, general acute care 
          hospitals to provide eight basic services:  medical, 
          nursing, surgical, anesthesia, laboratory, radiology, 
          pharmacy, and dietary services, defined as providing safe, 
          satisfying, and nutritionally adequate food for patients 
          with appropriate staff, space, equipment, and supplies.

          Requires DPH and the Office of Statewide Health Planning 
          and Development (OSHPD) to develop regulations that 
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          prescribe standards for the physical plant, staffing, and 
          services of health care facilities, including general acute 
          care hospitals.

          Requires DPH to allow any general acute care hospital 
          facility that needs to relocate services on an interim 
          basis, as part of its approval plan for compliance with 
          hospital building or seismic standards, flexibility in 
          achieving compliance with licensing standards so long as 
          public safety is not compromised.

          Specifies, under DPH regulations, several requirements for 
          dietary services in hospitals, including a requirement that 
          a registered dietician be employed on a full-time or 
          part-time basis, that sufficient dietetic service personnel 
          be employed to provide for the nutritional needs of 
          patients, a requirement that equipment necessary for the 
          proper preparation, serving, and storage of food be 
          provided, and a requirement that food supplies meet certain 
          standards for amount and quality.
          
          This bill:
          Allows, for the purposes of hospital licensing 
          requirements, dietary services to be provided either at the 
          hospital or in another hospital immediately adjacent to the 
          hospital as long as dedicated facilities are in place to 
          accommodate the delivery of these services.


                                  FISCAL IMPACT  

          This bill has not been analyzed by a fiscal committee.


                            BACKGROUND AND DISCUSSION  

          According to the author, SB 844 would provide an exemption 
          to the requirement that general acute care hospitals have 
          dietary services on the hospital property, when dietary 
          services can be accessed by an adjacent building with 
          dedicated facilities to accommodate their delivery.  The 
          author states that this is needed to help Hollywood 
          Presbyterian Hospital, which must temporarily shut down its 
          dietary services department in order to accommodate seismic 
          upgrades to its emergency room. While construction is 




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          occurring, the hospital must use the dietary services from 
          the hospital immediately adjacent until construction is 
          completed.

          The author argues that in the case of Hollywood 
          Presbyterian Hospital, the only other option would be to 
          shut down the emergency room, which would result in laying 
          off hospital workers and require a rerouting of 
          approximately 35,000 emergency room visits per year.

          Hospital licensing requirements
          General acute care hospitals are required to offer eight 
          basic services:  medical, nursing, surgical, anesthesia, 
          laboratory, radiology, pharmacy, and dietary services.  
          They are also permitted to offer several different types of 
          supplemental services, including emergency medical, burn 
          center, psychiatric, intensive care newborn, cardiovascular 
          surgery, chronic dialysis, and radiation therapy services.

          Health facilities, including hospitals, are permitted to 
          request program flexibility to use alternate concepts, 
          methods, procedures, techniques, equipment, personnel, as 
          long as statutory requirements are met, with the prior 
          written approval of DPH or OSHPD.  However, this does not 
          generally extend to the relocation of services outside of 
          the hospital campus, or the sharing of services with other 
          hospitals, as is proposed by this bill.

          DPH regulations outline several requirements for dietary 
          services that hospitals are required to meet, including a 
          requirement that a registered dietician be employed on a 
          full-time or part-time basis, that sufficient dietetic 
          service personnel be employed to provide for the 
          nutritional needs of patients, a requirement that equipment 
          necessary for the proper preparation, serving, and storage 
          of food be provided, and a requirement that food supplies 
          meet certain standards for amount and quality.

          
                                     COMMENTS
                                         
          1.  Flexibility for DPH.  This bill, as drafted, could 
          require DPH to approve location of dietary services in an 
          adjacent location even if the arrangement violates other 
          licensing provisions regarding adequate space, staffing, 




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          and food storage.  By increasing the number of meals 
          prepared in the adjacent facility's dietary service, the 
          arrangement could impact both facilities' ability to meet 
          these requirements.  A suggested amendment would be to 
          additionally require that the arrangement to provide 
          dietary services in an adjacent hospital must meet all 
          applicable requirements pertaining to the provision of 
          dietary services and must not impact the ability of the 
          adjacent facility to meet the requirements on an ongoing 
          basis.


                                    POSITIONS  

          Support:  None received
          
          Oppose:   None received


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