BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair


          SB 1318 (Wolk) - Health facilities: influenza vaccinations
          
          Amended: April 11, 2012         Policy Vote: Health 6-0, Labor 
          4-1
          Urgency: No                     Mandate: Yes
          Hearing Date: May 7, 2012       Consultant: Brendan McCarthy
          
          This bill does not meet the criteria for referral to the 
          Suspense File.
          
          
          Bill Summary: SB 1318 would require clinics and hospitals to 
          require all employees, contractors, volunteers, and medical 
          staff members to either receive an annual influenza vaccination 
          or wear a mask in patient areas during influenza season.

          Fiscal Impact: 
              Potential increased costs to review compliance by clinics, 
              up to $150,000 (Licensing and Certification Fund). The 
              Department may need additional resources to review hospital 
              and clinic records of vaccinations by employees and others. 
              Because the Department already performs periodic inspections 
              of health facilities as part of its licensing program, total 
              additional costs to gather this information is not likely to 
              be significant.

          Background: Current law requires hospitals to offer no-cost 
          influenza vaccinations to all employees. Hospital employees are 
          required to receive the vaccine or sign a form indicating they 
          have declined vaccination. Hospitals are also required to 
          develop and implement plans to limit the spread of influenza.

          According to the Department of Public Health, the overall 
          vaccination rate for healthcare personnel (including employees 
          and non-employees) was just over 60 percent in 2010-11. However, 
          in hospitals that had mandatory vaccination policies, 
          vaccination rates were over 90 percent.

          For the 2011-12 influenza season, public health officers in 
          Sacramento, San Francisco, and Yolo counties have ordered all 
          healthcare workers in inpatient facilities to either receive the 
          influenza vaccine or wear a mask in patient areas for the 








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          duration of the influenza season.

          Proposed Law: 
              SB 1318 would require clinics and hospitals to require all 
              employees, contractors, volunteers, and medical staff 
              members to either receive an annual influenza vaccination or 
              wear a mask in patient areas during influenza season.
              The bill would require clinics to provide no-cost influenza 
              vaccination to employees.
              The bill specifies that it does not preclude hospitals or 
              clinics from taking additional steps to increase vaccination 
              rates or reduce infection rates.
              The bill's provisions would go into effect on July 1, 2013.


          Related Legislation: 
              AB 2064 (V.M. Perez) would require health plans and 
              insurers that cover childhood immunizations to reimburse 
              physicians for the costs of vaccines. That bill is in the 
              Assembly Appropriations Committee.
              AB 2109 (Pan) would specify requirements for parents that 
              seek an exemption from school-aged children vaccination 
              requirements. That bill is on the Assembly Floor.
              SB 739 (Speier) Chapter 526 of 2006 requires hospitals to 
              offer no-cost influenza vaccination to employees and 
              requires employees to receive the vaccine or declare that he 
              or she is refusing.

          Staff Comments: According to a literature review by researchers 
          at George Washington University, each year 23 percent of health 
          care workers contract a case of influenza but experience 
          symptoms mild enough that they continue to work. In these cases 
          the health care worker can still infect other health care 
          workers or patients. The researchers also found that every 
          dollar spent vaccinating health care workers saved $2.58 in 
          through reduced absenteeism.

          According to the California Department of Public Health, 
          hospitals that currently meet the Centers for Disease Control 
          and Prevention's goal of 90 percent vaccination of health care 
          workers were more likely to have mandatory vaccination policies 
          with multiple enforcement strategies.

          The only mandates imposed on local governments by the bill 








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          relate to misdemeanor penalties, and are thus non-reimbursable 
          under the constitution.