BILL ANALYSIS �
SB 844
Page 1
Date of Hearing: July 5, 2011
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
SB 844 (Price) - As Amended: April 26, 2011
SENATE VOTE : 39-0
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, and the Department
of Public Health (DPH) determines that all applicable statutory
and regulatory standards pertaining to dietary services have
been met.
EXISTING LAW :
1)Provides for the licensing and regulation of health
facilities, including general acute care hospitals, by DPH.
2)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.
3)Requires DPH and the Office of Statewide Health Planning and
Development (OSHPD) to develop regulations that prescribe
standards for the physical plant, staffing, and services of
health care facilities, including general acute care
hospitals.
4)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.
5)Specifies, under DPH regulations, several requirements for
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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.
FISCAL EFFECT : According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS :
1)PURPOSE OF THS BILL . According to the author, Hollywood
Presbyterian Medical Center (HPMC) must temporarily shut down
their dietary services department in order to accommodate
seismic upgrades to the emergency room and other portions of
the hospital. HPMC is seeking the ability to use the dietary
services of Children's Hospital Los Angeles that is
immediately adjacent to HPMC during construction and until
construction is completed. The author explains that HPMC is
landlocked by a street on one side and Children's Hospital Los
Angeles on the other side prohibiting planned construction
activities except inside the hospital itself. Areas of HPMC
scheduled for retrofitting, according to the author, are the
emergency room, the dietary services department, and a number
of floors that provide hospital beds. The only area that is
large enough to accommodate the staging of construction is the
emergency room or the dietary services department, however,
Children's Hospital Los Angeles has the capacity to absorb the
dietary services functions on behalf of HPMC. The author
describes that HPMC and Children's Hospital Los Angeles are
connected by a dedicated walkway that joins the two hospitals.
The author argues that the only other option available to
HPMC is to shut down the emergency room, which would result in
laying-off hospital workers at a time when unemployment in the
county exceeds 13%. Additionally, the author maintains,
without the exemption granted by this bill, there would be a
re-routing of approximately 35,000 emergency room visits
annually, negatively impacting other emergency rooms in the
greater Los Angeles area.
2)BACKGROUND . General acute care hospitals are required to
offer eight basic services: medical, nursing, surgical,
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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.
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.
3)PROGRAM FLEXIBILITY . Health facilities, including hospitals,
are permitted to request "program flexibility" to use
alternate concepts, methods, procedures, techniques,
equipment, and personnel, as long as the hospital meets
statutory requirements and receives prior written approval of
DPH or OSHPD. Under existing law, OSHPD allows flexibility to
hospitals that need to relocate services on an interim basis
as part of its approval plan for compliance with seismic
deadlines. DPH, under existing law, also has the authority to
grant "program flexibility" requests on an interim or
permanent basis for alternative approaches. In both
departments, "program flexibility" is granted on a
case-by-case basis and evaluated to ensure the alternative
proposed meets the intent of the regulatory requirement and
public safety is not compromised. According to DPH and OSHPD,
neither department has received a formal request from HPMC for
"program flexibility" to relocate their dietary services to
Children's Hospital Los Angeles.
4)SUPPORT . The HPMC writes in support that this bill is
essential to meeting state seismic safety standards. HPMC
argues that accommodating the dietary services department
within the existing structure to meet the seismic deadlines
would require closure of their emergency department for an
extended period of time while construction was being
completed. Such a closure, HPMC asserts would put the
community that relies on the emergency room at risk and would
require the dislocation of much of the hospital staff,
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including emergency room personnel.
5)POLICY COMMENT . Considering the options available in existing
law under "program flexibility" through DPH and OSHPD, HPMC
may want to consider exploring the option of applying for
"program flexibility" to accomplish the objectives of this
bill.
REGISTERED SUPPORT / OPPOSITION :
Support
Hollywood Presbyterian Medical Center (sponsor)
Opposition
None on file.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097