BILL ANALYSIS                                                                                                                                                                                                    �






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

          BILL NO:       AB 2297
          AUTHOR:        Levine
          AMENDED:       April 24, 2014
          HEARING DATE:  June 18, 2014
          CONSULTANT:    Marchand

           SUBJECT  :  Health facilities: reliable alternative clean energy  
          technologies.
           
          SUMMARY  :  Permits health facilities to use reliable alternative  
          clean energy technologies as primary or backup power sources if  
          the technology meets reliability requirements, and requires the  
          Office of Statewide Health Planning and Development to submit  
          building standards for the use of reliable alternative clean  
          energy technologies to be adopted in the next triennial edition  
          of the California Building Standards Code.

          Existing law:
          1.Establishes the Alfred E. Alquist Hospital Facilities Seismic  
            Safety Act of 1983, which requires the Office of Statewide  
            Health Planning and Development (OSHPD) to propose proper  
            building standards for earthquake resistance, and provide an  
            independent review of the design and construction of hospital  
            buildings. 

          2.Establishes the California Building Standards Commission  
            (CBSC), consisting of the Secretary of the State and Consumer  
            Services Agency, and 10 members appointed by the Governor, as  
            specified.

          3.Requires any building standard adopted or proposed by state  
            agencies to be submitted to, and approved or adopted by, the  
            CBSC. Requires building standards adopted by state agencies  
            and submitted to CBSC to be accompanied by an analysis written  
            by the state agency that proposes the standards to justify the  
            approval to the satisfaction of the CBSC.
          
          This bill:
          1.Permits a health facility to use reliable alternative clean  
            energy technologies as primary or backup power sources if the  
            technology meets reliability requirements set forth by federal  
            and state regulators.
             
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          2.Requires OSHPD to submit to the CBSC building standards for  
            the use of reliable alternative clean energy technologies for  
            essential power systems to be adopted in the next triennial  
            edition of the California Building Standards Code.

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, likely minor and absorbable staff costs to OSHPD and  
          CBSC to incorporate building standards specific to clean energy  
          technology for backup power generation in the next revision of  
          the California Building Standards Code.



           PRIOR VOTES  :  
          Assembly Health:         16- 2
          Assembly Appropriations:  13- 4
          Assembly Floor:          66- 10
           
          COMMENTS  :  
           1.Author's statement.  According to the author, AB 2297 simply  
            states that California should explore the various technologies  
            that can be used to power hospitals in the state and asks  
            state regulators to adopt building standards that are  
            technology neutral, rather than being singularly focused on  
            diesel.

          2.OSHPD building standards and the California Building Standards  
            Code. OSHPD is the adopting agency for building standards for  
            health facilities, including clinics.  The CBSC, which is  
            responsible for adopting and publishing the California  
            Building Standards Code, which is updated every three years,  
            accepts building standard recommendations from state adopting  
            agencies related to the types of buildings that fall under  
            their respective jurisdictions.  The 2013 code was recently  
            adopted, and took effect on January 1, 2014. OSHPD states that  
            the deadline for submissions for the next triennial edition  
            has already passed, so that the earliest building standards  
            code that could reflect any changes from this bill is the code  
            that will be published in 2020.

          3.Conflict with federal requirements.  According to OSHPD, there  
            are two required power systems in a hospital. The first is the  
            normal power system, which is the main source of power for a  
            hospital. Alternative energy technologies are sometimes used  
            for this purpose. The second power system is the essential  
            power system used for emergency backup purposes. When OSHPD  




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            proposes new hospital building standards, the submission is  
            required to include a "Nine Point Criteria Analysis" that  
            justifies the approval of the building standard in terms of  
            specified criteria of the CBSC. One of those criteria  
            specifies that "applicable national specification, published  
            standards, and model codes have been incorporated." With  
            regard to power sources, federal Medicare participation  
            requirements for hospitals include requirements that hospitals  
            meet National Fire Protection Association (NFPA) standards,  
            which include requirements on primary and back-up power  
            sources. One of the NFPA requirements specifies that a  
            generator has to be driven by one of the following "prime  
            mover" types: a spark-ignited otto cycle (basically, a  
            4-stroke piston engine similar to what is found on gasoline  
            cars), a diesel cycle, or a gas turbine cycle. Given that this  
            bill does not define "alternative green energy technology," it  
            is conceivable that there is a technology out there that is  
            "green" and that meets this requirement. However, if the  
            intent of this bill is to authorize the use of fuel cell  
            technology for back-up power systems, it does not appear as  
            though this technology would meet federal requirements, and  
            therefore, even if OSHPD proposed permitting this technology  
            to the CBSC, it is unlikely that it would be approved unless  
            NFPA standards changed.

          4.Prior legislation. AB 1863 (Gaines), Chapter 164, Statutes of  
            2010, extended until January 1, 2016 existing requirements  
            that health facilities test diesel backup generators in  
            accordance with standards set by The Joint Commission.

            AB 2216 (Gaines), Chapter 232, Statutes of 2008, extended  
            until January 1, 2011, a requirement that health care  
            facilities meet the most recent standards set by the Joint  
            Commission on the Accreditation of Healthcare Organizations  
            for testing of backup diesel generators, and deleted a  
            requirement that health facility diesel backup generators be  
            started during weeks when the generator is not being tested.  

            AB 390 (Montanez), Chapter 676, Statutes of 2003, reduced the  
            testing frequency for testing diesel backup generators of  
            health facilities.

          5.Support.  Bloom Energy supports this bill and writes that  
            other technologies exist that provide the same electrical  
            back-up capacities and can be significantly cleaner than  




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            current back-up generating technologies. Bloom Energy  
            manufactures distributed fuel cell power systems using a  
            non-combustion process. According to Bloom Energy, the result  
            is a new option for energy infrastructure that combines  
            increased electrical reliability and improved energy security  
            with significantly lower environmental impact. The National  
            Resources Defense Council (NRDC) supports this bill and writes  
            that currently hospitals are required to have diesel back-up  
            generators on-site in case electricity from the grid fails and  
            these backup generators are required to be tested at regular  
            intervals.  NRDC further argues that diesel back-up generators  
            contribute to local air pollution problems and that even  
            though other technologies exist that provide similar  
            electrical back-up capacities and are cleaner than back-up  
            diesel generating technologies, significant regulator  
            impediments exist that prevent hospitals from utilizing these  
            cleaner technologies. The Environmental Defense Fund (EDF)  
            also supports this bill stating that researchers estimate that  
            as many as 60,000 Americans die prematurely each year because  
            of exposure to fine particles and diesel back-up generators  
            emit fine particles at extremely high rates.  EDF states that  
            this bill will help allow for the adoption of less- or  
            non-polluting technologies in many of the areas of California  
            most impacted by localized air pollution.

          6.Suggested amendments.  As discussed in comment 3) above, the  
            requirements in this bill could conflict with federal  
            standards for hospital power systems. While the first  
            provision of this bill only permits health facilities to use  
            alternative clean energy if it meets federal and state  
            reliability requirements, the second provision of the bill  
            requiring OSHPD to propose new standards does not have a  
            similar qualification. To ensure OSHPD is not wasting time and  
            resources proposing new standards that are in conflict with  
            federal law and will not be approved, this bill should be  
            clarified so that OSHPD is only required to submit new  
            building standards for the use of alternative technologies if  
            the new standards would meet federal requirements for hospital  
            power systems.
               
           SUPPORT AND OPPOSITION  :
          Support:  Bloom Energy
                    Environmental Defense Fund
                    Natural Resource Defense Council
                    Sunrun





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          Oppose:   None received

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