Bill Text: CA SB276 | 2011-2012 | Regular Session | Amended

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Bill Title: General acute care hospitals: special services.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Engrossed - Dead) 2011-09-07 - Re-referred to Com. on RLS. pursuant to Assembly Rule 77.2. [SB276 Detail]

Download: California-2011-SB276-Amended.html

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BILL NUMBER: SB 276	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  SEPTEMBER 2, 2011
	AMENDED IN SENATE  MAY 10, 2011

INTRODUCED BY   Senator  Wright   Corbett 
    (   Principal coauthor:   Assembly Member
  Wieckowski   ) 

                        FEBRUARY 14, 2011

    An act to amend Section 4108 of the Food and Agricultural
Code, relating to expositions and fairs.   An act to
amend Section 1255 of, and to add Section 100923 to, the Health and
Safety Code, relating to health facilities, and declaring the urgency
thereof, to take effect immediately. 


	LEGISLATIVE COUNSEL'S DIGEST


   SB 276, as amended,  Wright   Corbett  .
 Expositions and fairs: California Science Center: police
and security services.   General acute care hospitals:
special services.  
   Existing law provides for the licensure and regulation of health
facilities, including general acute care hospitals, administered by
the State Department of Public Health. A violation of these
provisions is a crime.  
   Existing law authorizes the department to approve, as prescribed,
a general acute care hospital to offer specified special services,
including, but not limited to, cardiac catheterization laboratory
services, in addition to the basic services offered under the
facility's license.  
   This bill would require the department to adopt specified
regulations regarding cardiac catheterization laboratory services.
This bill would permit, until regulations are adopted, a general
acute care hospital that maintains a cardiac surgery service to
provide specified services in its cardiac catheterization laboratory.
This bill would require a general acute care hospital that is
approved to provide cardiac catheterization laboratory service to
develop, maintain, and implement certain policies and procedures.
 
   The bill would also require the department to conduct a 16-month
pilot program to allow any freestanding cardiac catheterization
laboratory to perform both diagnostic and therapeutic procedures, as
specified.  
   Because this bill would expand the definition of a crime, it would
impose a state-mandated local program.  
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.  
   This bill would provide that no reimbursement is required by this
act for a specified reason.  
   This bill would declare that it is to take effect immediately as
an urgency statute.  
   Existing law provides for the Sixth District Agricultural
Association, which is known as the California Science Center, and
requires the California Science Center to establish the position of
Exposition Park Manager to be filled by a person appointed by the
Governor for the purpose of managing, scheduling, and administering
all park-related events, including oversight for the police and
security services of the park. The Exposition Park Manager is
authorized to appoint specified security and safety personnel.
 
   This bill would authorize the Executive Director of the California
Science Center to appoint specified security and safety personnel if
there is no Exposition Park Manager. 
   Vote:  majority   2/3  . Appropriation:
no. Fiscal committee:  no   yes  .
State-mandated local program:  no   yes  .



THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 1255 of the   Health
and Safety Code   is amended to read: 
   1255.   (a)    In addition to the basic services
offered under the license, a general acute care hospital may be
approved in accordance with subdivision (c) of Section 1277 to offer
special services, including, but not limited to, the following:

   (a) 
    (1)  Radiation therapy department. 
   (b) 
    (2)  Burn center. 
   (c) 
    (3)  Emergency center. 
   (d) 
    (4)  Hemodialysis center (or unit). 
   (e) 
    (5)  Psychiatric. 
   (f) 
    (6)  Intensive care newborn nursery. 
   (g) 
    (7)  Cardiac surgery. 
   (h) 
    (8)  Cardiac catheterization laboratory. 
   (i) 
    (9)  Renal transplant. 
   (j) 
    (10)  Other special services as the department may
prescribe by regulation. 
   A 
    (b)     A  general acute care hospital
that exclusively provides acute medical rehabilitation center
services may be approved in accordance with subdivision (b) of
Section 1277 to offer special services not requiring surgical
facilities. 
   The state 
    (c)     The  department shall adopt
standards for special services and other regulations as may be
necessary to implement this section.  For 
    (1)     For  cardiac catheterization
laboratory service, the  state  department shall, at
a minimum, adopt standards and regulations that specify that only
diagnostic services, and what diagnostic services, may be offered by
 an   a general  acute care hospital or a
multispecialty clinic as defined in subdivision (  l  ) of
Section 1206 that is approved to provide cardiac catheterization
laboratory service but is not also approved to provide cardiac
surgery service, together with the conditions under which the cardiac
catheterization laboratory service may be offered. 
   (2) The department shall adopt regulations regarding the types of
diagnostic and therapeutic procedures that can be conducted in the
cardiac catheterization laboratory of a general acute care hospital
that maintains a cardiac surgery service. Until the regulations are
adopted, a general acute care hospital that maintains a cardiac
surgery service may provide diagnostic and therapeutic services in
its cardiac catheterization laboratory within the following
categories:  
   (A) Percutaneous coronary and electrophysiological interventions,
including, but not limited to, emergency and elective coronary stent
insertions.  
   (B) Peripheral angiography, interventional radiology procedures,
neuroangiography, and neurointerventional procedures.  
   (C) Surgical interventions, including, but not limited to,
insertion of permanent pacemakers provided the cardiac
catheterization laboratory meets, at a minimum, the standards
contained in the 1995 California Building Code, or subsequent
edition, for surgery applicable to a cardiac catheterization
laboratory in a general acute care hospital that maintains a cardiac
surgery service, and a safe operating environment consistent with
standards of the Association of periOperative Registered Nurses,
Perioperative Standards and Recommended Practices in effect as of
September 1, 2011.  
   (D) Noncardiac interventions, including, but not limited to,
orthopedic procedures, gastroenterology endoscopy, drainage
procedures, thoracentesis, paracentesis, lumbar punctures,
myelograms, and pain management procedures provided the general acute
care hospital develops, maintains, and implements policies and
procedures for terminal cleaning and other infection control measures
to be used in the laboratory following, during, and after these
interventions.  
   (E) Other diagnostic and therapeutic procedures that can be safely
conducted in a cardiac catheterization laboratory in a general acute
care hospital that maintains a cardiac surgery service, provided the
general acute care hospital first obtains program flexibility in
accordance with the procedures provided in Section 70129 of Title 22
of the California Code of Regulations.  
   (F) A general acute care hospital that is approved to provide
cardiac catheterization laboratory service shall develop, maintain,
and implement policies and procedures governing the following: 

   (i) Use of the cardiac catheterization laboratory under this
section.  
   (ii) Measures to ensure patient safety.  
   (iii) Availability for routine and emergent cardiac situations.
 
   A 
    (d)     A  cardiac catheterization
laboratory service shall be located in a general acute care hospital
that is either licensed to perform cardiovascular procedures
requiring extracorporeal coronary artery bypass that meets all of the
applicable licensing requirements relating to staff, equipment, and
space for service, or shall, at a minimum, have a licensed intensive
care service and coronary care service and maintain a written
agreement for the transfer of patients to a general acute care
hospital that is licensed for cardiac surgery or shall be located in
a multispecialty clinic as defined in subdivision (  l  ) of
Section 1206. The transfer agreement shall include protocols that
will minimize the need for duplicative cardiac catheterizations at
the hospital in which the cardiac surgery is to be performed.

   For 
    (e)     For  purposes of this section,
"multispecialty clinic," as defined in subdivision (  l  )
of Section 1206, includes an entity in which the multispecialty
clinic holds at least a 50-percent general partner interest and
maintains responsibility for the management of the service, if all of
the following requirements are met:
   (1) The multispecialty clinic existed as of March 1, 1983.
   (2) Prior to March 1, 1985, the multispecialty clinic did not
offer cardiac catheterization services, dynamic multiplane imaging,
or other types of coronary or similar angiography.
   (3) The multispecialty clinic creates only one entity that
operates its service at one site.
   (4) These entities shall have the equipment and procedures
necessary for the stabilization of patients in emergency situations
prior to transfer and patient transfer arrangements in emergency
situations that shall be in accordance with the standards established
by the Emergency Medical Services Authority, including the
availability of comprehensive care and the qualifications of any
general acute care hospital expected to provide emergency treatment.

   Except 
    (f)     Except  as provided in
 Sections 128525 and 128530   Article 4
(commencing with Section 100921) of Chapter 4 of Part 1 of Division
101  , under no circumstances shall cardiac catheterizations be
performed outside of a general acute care hospital or a
multispecialty clinic, as defined in subdivision (  l  ) of
Section 1206, that qualifies for this definition as of March 1, 1983.

   SEC. 2.    Section 100923 is added to the  
Health and Safety Code   , to read:  
   100923.  (a) Notwithstanding subdivision (d) of Section 100922,
the department shall conduct a 16-month pilot program to allow any
freestanding cardiac catheterization laboratory licensed pursuant to
Section 100922, to perform both diagnostic and therapeutic procedures
in addition to those authorized in subdivision (d) of that section.
   (b) The department shall consult with the existing freestanding
cardiac catheterization laboratories to determine which procedures to
authorize under the pilot program with the primary goal being
patient safety. The department may monitor these laboratories during
the pilot program. The laboratories shall provide a list of
procedures to the department for approval prior to conducting any
additional procedures, or adding any additional procedures to the
list.
   (c) The laboratories participating in the pilot program shall
report at a minimum to the department after nine months of
participation in the pilot program the number of procedures performed
by type of procedure, the outcome of those procedures, any unusual
occurrences at the laboratory, any adverse events, as defined by the
department, and any other information needed to evaluate the safety
of the pilot program. The laboratory shall report to the department
any event or occurrence that affects the health or safety of the
patients, staff, or visitors within 72 hours of the occurrence. The
department shall use this information to develop any proposed
legislative changes to the licensing requirements of existing
freestanding cardiac catheterization laboratories.
   (d) As a pilot program of limited scope and duration, the
department may set additional standards to ensure patient safety and
to gather necessary information on the pilot program. Accordingly,
any freestanding cardiac catheterization laboratory participating in
the pilot program shall comply with any additional standards required
by the department to ensure patient safety and shall provide any
additional information requested by the department related to this
pilot program. 
   SEC. 3.    No reimbursement is required by this act
pursuant to Section 6 of Article XIII B of the California
Constitution because the only costs that may be incurred by a local
agency or school district will be incurred because this act creates a
new crime or infraction, eliminates a crime or infraction, or
changes the penalty for a crime or infraction, within the meaning of
Section 17556 of the Government Code, or changes the definition of a
crime within the meaning of Section 6 of Article XIII B of the
California Constitution. 
   SEC. 4.    This act is an urgency statute necessary
for the immediate preservation of the public peace, health, or safety
within the meaning of Article IV of the Constitution and shall go
into immediate effect. The facts constituting the necessity are:
 
   California hospitals with cardiac catheterization laboratories
that deliver care in accordance with current standards of practice
for cardiac catheterization laboratories face immediate restriction
in the care that may be rendered in their facilities, due to
ambiguities in California laws and regulations and the interpretation
thereof. As a result, access to critical cardiovascular and other
such services may be unavailable or delayed, jeopardizing patient
health and safety in hospitals throughout California. Enactment of
this measure on an emergency basis will help maintain continuity of,
and access to, state-of-the-art cardiac and vascular catheterization
services.  
  SECTION 1.    Section 4108 of the Food and
Agricultural Code is amended to read:
   4108.  The California Science Center shall establish the position
of Exposition Park Manager to be filled by a person appointed by the
Governor for the purpose of managing, scheduling, and administering
all park-related events, including oversight for the police and
security services of the park.
   (a) The Exposition Park Manager may appoint the following persons:

   (1) The chief and assistant chief of museum security and safety
who shall have the powers of peace officers as specified in Section
830.3 of the Penal Code.
   (2) Other safety officers who shall have the powers of arrest as
specified in Section 830.7 of the Penal Code.
   (b) The officers appointed pursuant to subdivision (a) shall
provide police and security services to keep order and to preserve
the peace and safety of persons and property at the California
Science Center and at Exposition Park on a year-round basis.
   (c) The Executive Director of the California Science Center may
make the appointments listed in subdivision (a) if there is no
Exposition Park Manager.