BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
SB 1246 (Hernandez) - Health facility staffing.
Amended: April 25, 2012 Policy Vote: Health 5-2
Urgency: No Mandate: Yes
Hearing Date: May 24, 2012 Consultant: Brendan McCarthy
SUSPENSE FILE. AS PROPOSED TO BE AMENDED.
Bill Summary: SB 1246 would require the Department of Public
Health to review compliance by hospitals with existing nurse
staffing ratios and patient classification systems. The bill
would also deem a failure to have a patient classification
system an immediate jeopardy violation.
Fiscal Impact:
Absorbable costs to review compliance with staffing ratios
and patient classification systems as part of ongoing
inspection activities. (Licensing and Certification Program
Fund).
Background: Existing law requires hospitals to maintain
specified nurse-to-patient ratios. Existing regulations require
hospitals to develop and maintain patient classification
systems, which are more detailed protocols for staffing levels
based on specific patient needs. Existing law requires the
Department of Public Health to inspect hospitals no less than
every three years to review compliance with these and other
regulatory requirements.
Existing law also specifies administrative penalties that may be
assessed by the Department, based on the potential harm to
patients.
Proposed Law: SB 1246 would make several changes to the
Department of Public Health's enforcement of existing laws and
regulations relating to hospitals. The bill would:
Explicitly require the Department of Public Health to
review hospitals compliance with nurse-to-patient ratios and
patient classification systems when performing periodic
inspections.
SB 1246 (Hernandez)
Page 1
Codify existing regulations requiring hospitals to develop,
maintain, and annually update patient classification
systems.
Deem the failure to maintain a patient classification
system an immediate jeopardy violation (which under current
law is punishable by fines from $50,000 to $100,000).
Deem the failure to comply with a patient classification
system a non-immediate jeopardy violation.
Require nurses on a hospital's committee to review patient
classification systems to be appointed by the collective
bargaining agent, if any.
Related Legislation: SB 541 (Alquist) Chapter 605 of 2008
modified the existing administrative penalties authorized in
law, making violations risking immediate jeopardy to patients
subject to fines from $50,000 to $100,000. Upon adoption of
regulations implementing SB 541 (which have not yet been
completed), penalties would increase to $75,000 to $125,000.
Staff Comments: Current law requires the Department to inspect
hospitals for compliance with provisions of state law and
regulations. The Department has general authority to impose
administrative penalties based on for deficiencies that threaten
patient safety. The Department has indicated that it does review
hospital compliance with nurse-to-patient ratios (required in
statute) and patient classification systems (required in
regulation) as part of its existing inspection and enforcement
program.
The Department indicates that deeming a failure to maintain a
patient classification an immediate jeopardy violation, which
means a larger fine, would lead to more appeals of those
violations, generating additional workload under the
Department's appeal process.
The only mandates imposed on local governments by the bill
relate to misdemeanor penalties, and are thus non-reimbursable
under the constitution.
Proposed Author Amendments: The proposed amendments would limit
the requirement to maintain patient classification systems to
acute care hospitals and eliminate the provision that makes the
failure to maintain a patient classification system an immediate
SB 1246 (Hernandez)
Page 2
jeopardy violation.