BILL ANALYSIS �
AB 2616
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Date of Hearing: May 7, 2014
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
AB 2616 (Skinner) - As Amended: April 29, 2014
Policy Committee: InsuranceVote:8-5
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill extends to hospital employees who provide direct
patient care the presumption that methicillin-resistant
Staphylococcus aureus (MRSA) infections are job-related. It
also requires workers' compensation benefits to include payment
for medical treatment, including hospital and surgical care,
disability indemnity, and death benefits.
FISCAL EFFECT
1)Presumptions generally lead to an increase in accepted claims
and over-time costs for the workers' compensation system.
2)This bill would apply to several state-run facilities, namely,
state hospitals, developmental centers, and correctional
treatment facilities that are all funded through GF dollars.
The number of additional MRSA cases among state-employed
direct care nursing staff is as a result of the presumption is
likely to be small. However, if even one additional
MRSA-related workers' compensation claims was filed and
approved as a result of this presumption, the cost could
easily be in excess of $200,000 GF.
COMMENTS
1)Purpose . The author states that MRSA is a work-related
contact hazard for hospital employees. Although infection
control measures help slow the spread of MRSA, the author
states, they do not eliminate this job-related hazard. Given
this, the author asserts these employees are entitled that
these infections be presumed related to work.
AB 2616
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2)Background . Existing law establishes a rebuttable presumption
for front-line public safety officers that MRSA infections,
among other injuries and conditions, are job-related.
Data from the Centers for Disease Control and Prevention (CDC)
data show that 78% of MRSA cases are from health facility
settings, with the rest considered community-associated (CA).
People with weak immune systems are more likely to become
infected with CA-MRSA. The distinction between the two types
has been blurred as CA-MRSA has become more prevalent, but the
great majority of infections are still healthcare-acquired.
The bill extends the concept of presumptions in two novel
respects: it applies presumptions to a broad class of private
sector employees, and to non-public safety employees.
Presumptions in current law apply generally to front-line
public safety officers, with very minor and limited
exceptions.
3)Support . The California Nurses Association (CNA) is the
sponsor of this bill. CNA believes a MRSA presumption is
justifiable for direct care workers due to the high-risk
environment in which they work.
4)Opposition . The California Hospital Association (CHA) and the
University of California (UC) oppose this bill, citing
increased costs and a lack of necessity. The UC also points
out workers are often employed by multiple facilities and it
could be difficult to determine which employer may be
responsible for a workers' compensation claim with such
presumptions. Additionally, they are concerned that language
in AB 2616 may eliminate the ability for the apportionment of
a workers' compensation claim for MRSA. Finally, they argue
state employees in a variety of occupations face inherent
employment risks, and that the current workers' compensation
system is a fair standard that is applied to all injuries for
all other employees.
UC provided data indicating the success rate of workers
compensation claims for contagious disease are between 96% and
98% over the last four years, which UC asserts illustrates the
existing workers' compensation system is functioning as
intended and that injured employees are receiving benefits for
these injuries when evidence demonstrates that the injury
arises out of their employment.
AB 2616
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5)Related Legislation . AB 2052 (Gonzalez) extends existing
presumptions for public safety officers to all peace officers,
as defined. AB 2052 is pending on the Suspense File of this
committee.
6)Prior Legislation .
a) AB 664 (Skinner), 2009 and AB 1994 (Skinner), 2010,
proposed including nurses in the full range of presumptions
afforded safety officers. AB 664 and AB 1994 were held on
this committee's Suspense File.
b) AB 375 (Skinner), 2011, initially was similar to AB 664
and AB 1994, but was narrowed to include fewer of the
presumptions. It failed passage on the Senate Floor.
c) AB 808 (Skinner), 2012, was identical to AB 2616 and was
held on the Senate inactive file.
1)Staff Comments . Data are not available to reliably estimate
the difference in the number or success rate of claims under a
scenario where MRSA among direct care workers is presumed
job-related, versus the status quo. Anecdotally, proponents
argue hospitals actively discourage workers from filing claims
and many MRSA infections are likely not considered serious
enough by employees to provoke a claim, especially given
direct care workers are likely to have comprehensive health
insurance and personal doctors through which they can seek
treatment. A presumption would likely encourage more
legitimate claims, and also may encourage a larger proportion
of lower-cost claims, given the burden of proof would no
longer rest with the employee.
It is indisputable that MRSA infection among direct patient
care workers are likely to be job- related; however, it is
unclear whether workers who acquire MRSA have difficulty
pursuing benefits through the normal workers' compensation
process. There are other inherently risky professions that
rely on the workers' compensation system to establish whether
injuries are work-related. The rationale for granting the
presumption in this bill logically implies that private
employees with specific job-related injury risks should
instead be granted blanket presumptions for such risks.
AB 2616
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Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081