BILL ANALYSIS �
-----------------------------------------------------------------
|SENATE RULES COMMITTEE | AB 2616|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
-----------------------------------------------------------------
THIRD READING
Bill No: AB 2616
Author: Skinner (D)
Amended: 8/18/14 in Senate
Vote: 21
SENATE LABOR & INDUSTRIAL RELATIONS COMMITTEE : 5-0, 6/25/14
AYES: Hueso, Wyland, Leno, Padilla, Mitchell
SENATE APPROPRIATIONS COMMITTEE : 5-0, 8/14/14
AYES: De Le�n, Hill, Lara, Padilla, Steinberg
NO VOTE RECORDED: Walters, Gaines
ASSEMBLY FLOOR : 48-26, 5/28/14 - See last page for vote
SUBJECT : Workers compensation: hospital employers:
compensation
SOURCE : California Nurses Association
DIGEST : This bill extends the presumption that
methicillin-resistant Staphylococcus aureus (MRSA) infections
are presumed to be job related to certain hospital employees in
an acute care hospital.
ANALYSIS : Existing law establishes a workers' compensation
system that provides benefits to an employee who suffers from an
injury or illness that arises out of and in the course of
employment, irrespective of fault. This system requires all
employers to secure payment of benefits by either securing the
consent of the Department of Industrial Relations to self-insure
CONTINUED
AB 2616
Page
2
or by securing insurance against liability from an insurance
company duly authorized by the state.
Existing law creates a series of disputable presumptions of an
occupational injury for peace and safety officers for the
purposes of the workers' compensation system. These
presumptions include:
Heart disease;
Hernias;
Pneumonia;
Cancer;
Meningitis;
Tuberculosis;
MRSA skin infections; and
Bloodborne infectious disease.
The compensation awarded for these injuries must include full
hospital, surgical, medical treatment, disability indemnity, and
death benefits, as provided by workers compensation law. These
presumptions tend to run for 5 to 10 years commencing on their
last day of employment, depending on the injury and the peace
officer classification involved.
Existing law provides that the presumptions listed above are
disputable and may be controverted by evidence. However, unless
controverted, the Workers' Compensation Appeals Board must find
is accordance with the presumption.
This bill extends the presumption that MRSA infections are
presumed to be job related to certain hospital employees in an
acute care hospital. Specifically, this bill:
1.Contains findings and declarations concerning the incidence of
MRSA in health care settings that impact nurses.
2.Specifies that the term "injury" as used in the workers'
compensation law with respect to specified hospital employees
shall include MRSA that develops or manifests itself during a
person's employment at a hospital.
3.Specifies that the presumption applies only to hospital
employees who provide direct patient care at a general acute
care hospital.
CONTINUED
AB 2616
Page
3
4.Provides that this infection shall be presumed to arise out of
and in the course of employment.
5.Extends this presumption for a period of 60 days after the
employee has terminated employment with the hospital.
6.Allows the employer to dispute the presumption by requiring
the employer to prove by evidence that the disease or
condition is not related to employment.
7.Prevents MRSA presumptions from apportionment permanent
disability.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
This bill results in increased costs related to disability
benefits for impacted state health care employees. The costs
would be a minimum of $33,000 to $65,000 per industrial
disability benefit (up to one year), and up to $53,000 per
additional temporary disability benefit (up to one additional
year). Thus, costs could range from $33,000 to $118,000 per
individual.
Potentially major benefit and medical costs if a MSRA injury
results in permanent disability.
SUPPORT : (Verified 8/18/14)
California Nurses Association (source)
American Federation of State, County and Municipal Employees,
AFL-CIO
BD
California Applicants' Attorneys Association
California Labor Federation, AFL-CIO
California Professional Firefighters
Consumer Federation of California
LIUNA Locals 777 & 792
Union of Health Care Professionals
United Nurses Association of California
Voters Injured at Work
CONTINUED
AB 2616
Page
4
OPPOSITION : (Verified 8/18/14)
Acclamation Insurance Management Services
Adventist Health
AIA Insurance
Allied Managed Care Incorporated
American Insurance Association
California Association of Joint Powers Authorities
California Chamber of Commerce
California Coalition on Workers' Compensation
California Grocers Association
California Hospital Association
California Manufacturers and Technology Association
California Retailers Association
California Special Districts Association
California State Association of Counties
California State Association of Counties Excess Insurance
Authority
County of Los Angeles
Golden Oak Cooperative
Loma Linda University Medical Center
National Association of Mutual Insurance Companies
National Federation of Independent Business
Republic Indemnity
Rural County Representatives of California
Safeway
Sedgwick Claims Management
The Association of California Healthcare Districts
The University of California
ARGUMENTS IN SUPPORT : Proponents bring attention to the fact
that the worker's compensation system already provides certain
types of public safety employees a rebuttal presumptive
eligibility for heart trouble, hernia, pneumonia, HIV, low back
impairment, and more recently MRSA. Proponents argue that
registered nurses and hospital workers by the nature of their
work, which involves ill patients, contagious diseases and
medical equipment, are in constant danger of being exposed to a
variety of illnesses and becoming injured by the use of medical
equipment. Proponents maintain that because of the nature of
patient care, combined with rising patient acuity and obesity,
more work related injuries and higher levels of exposure to
infectious disease are occurring.
CONTINUED
AB 2616
Page
5
Proponents argue that the potential for acquiring MRSA is a
constant work related hazard for healthcare workers -and
increasingly, hospital acquired MRSA is infecting hospital
workers and their patients. Proponents note that according to
the State Department of Public Health, healthcare associated
infections (HAIs) are the most common complication of hospital
care and are listed among the top ten leading cause of death in
the United States. Proponents also note that according to the
Office of Statewide Health and Planning and Development, in 2007
there were 52,000 cases of MRSA-infected patients across the
state and according to the CDPH in 2012 there were 728 cases of
severe hospital acquired MRSA bloodstream infections reported by
California's acute care hospitals. Proponents argue that
although infection control measures help to stop the spread of
MRSA and diseases, they do not eliminate the job related threat
of contracting MRSA or other diseases completely.
Proponents argue that data from the CWCI and WCRIB illustrate
that despite the large number of MRSA infections in California's
acute care hospitals, infections of all types are a very small
portion of the worker's compensation system. Further, proponents
argue that the presumption for MRSA will reduce the litigation
over these cases and therefore save the workers' compensation
system money.
ARGUMENTS IN OPPOSITION : Opponents argue that there is no
clinical or scientific data which supports the need for this
presumption under AB 2616. Opponents note that much of the data
referenced pertains only to hospitalized patients and that there
is a lack of data to support the idea that healthcare workers
following accepted infection prevention behaviors are at risk
for developing MRSA skin infections as a result of their
occupation. Opponents contend that the fact that hospital
employees face specific types of risks in the workplace is not a
justification for altering the legal standard for determining
what is or is not an industrial injury. Opponents maintain there
is no statistical evidence that has proven that worker's
compensation claims by hospital employees for exposure to MRSA
are being inappropriately delayed or declined by employers or
insurers or any sort of demonstration that hospital employees
are negatively impacted by the current legal standard. Opponents
argue that AB 2616 establishes a costly precedent by creating
the first such presumption to private sector employees.
CONTINUED
AB 2616
Page
6
Opponents also argue that while AB 2616 is a rebuttable
presumption, a hospital could only overcome the presumption by
proving the complete absence of a relationship to work, which
given the realities of the workplace and worker's compensation
system would be incredibly difficult. Opponents also note that
AB 2616 explicitly prohibits consideration of a pre-existing
condition which creates a new, strict liability standard.
Opponents bring attention to the impact AB 2616 could have on
hospitals. Opponents argue that since a large percentage of
direct patient care workers are employed by two or more
hospitals, the bill could substantially increase litigation
among hospitals to determine which should be responsible for the
claims. Lastly, opponents note that since approximately 75
percent of California's public and private hospitals are
self-insured, under law they must reserve for the worst case
scenario on each claim for their employee's life expectancy.
Opponents argue that any increase in worker's compensation costs
will have a direct impact on the hospital's budget and the
amount of resources available for patient care.
ASSEMBLY FLOOR : 48-26, 5/28/14
AYES: Ammiano, Bloom, Bonilla, Bonta, Bradford, Brown, Buchanan,
Ian Calderon, Campos, Chau, Chesbro, Dababneh, Dickinson,
Eggman, Fong, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gray,
Hall, Roger Hern�ndez, Holden, Jones-Sawyer, Levine,
Lowenthal, Medina, Mullin, Nazarian, Pan, Perea, John A.
P�rez, V. Manuel P�rez, Quirk, Quirk-Silva, Rendon,
Ridley-Thomas, Rodriguez, Salas, Skinner, Stone, Ting, Weber,
Wieckowski, Williams, Yamada, Atkins
NOES: Achadjian, Allen, Bigelow, Ch�vez, Conway, Cooley, Dahle,
Donnelly, Fox, Beth Gaines, Gorell, Grove, Hagman, Harkey,
Jones, Linder, Logue, Maienschein, Mansoor, Melendez,
Nestande, Olsen, Patterson, Wagner, Waldron, Wilk
NO VOTE RECORDED: Alejo, Bocanegra, Daly, Frazier, Muratsuchi,
Vacancy
PQ:nl 8/18/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
CONTINUED
AB 2616
Page
7
**** END ****
CONTINUED