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SB-156 Health facilities: emergency medical services.(2019-2020)

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Date Published: 07/05/2019 09:00 PM
SB156:v95#DOCUMENT

Amended  IN  Assembly  July 05, 2019
Amended  IN  Senate  April 30, 2019
Amended  IN  Senate  April 11, 2019
Amended  IN  Senate  March 19, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Senate Bill
No. 156


Introduced by Senator Nielsen
(Principal coauthor: Assembly Member Gallagher)
(Coauthor: Assembly Member Aguiar-Curry)

January 23, 2019


An act to add and repeal Section 1251.6 to of the Health and Safety Code, relating to health facilities.


LEGISLATIVE COUNSEL'S DIGEST


SB 156, as amended, Nielsen. Health facilities: emergency medical services.
Existing law requires the State Department of Public Health to license and regulate various health facilities, including general acute care hospitals. Existing law requires the department to issue a special permit, in addition to a license, to a health facility to offer one or more special services, such as an emergency center, if specified requirements are met, including that the department finds that the standards of care and services are adequate and appropriate. Existing regulations generally require emergency medical services and care to be provided within a hospital. Existing law provides that a special permit issued under these provisions expires on the expiration date of the license, which occurs 12 months from the date of the issuance of the license.
This bill would make legislative findings relating to the impact of the Camp Fire in 2018 on the County of Butte, including the destruction of Feather River Hospital in that county. Pursuant to those provisions, the bill would require the department to issue a special permit to allow a general acute care hospital to offer emergency stabilization services at a location outside of the hospital if the hospital provides satisfactory evidence to the department that that, among other things, the hospital has a written transfer agreement with the hospital closest to the location where emergency stabilization services will be provided, and satisfactory evidence to the department that this location meets certain requirements, including that the location is in the County of Butte and serves the same area previously served by Feather River Hospital. The bill would require this special permit to expire 2 years from the date of its issuance, and would authorize the special permit to be renewed every 2 years, for a combined period not to exceed 6 years from the initial date of issuance. The bill would impose certain requirements on the hospital to renew a special permit under these provisions. The bill would repeal its provisions on January 1, 2028.
This bill would make legislative findings and declarations as to the necessity of a special statute for the County of Butte.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 1251.6 is added to the Health and Safety Code, to read:

1251.6.
 (a) The Legislature finds and declares all of the following:
(1) The Camp Fire in 2018 resulted in the destruction of most of the towns of the eastern part of the County of Butte, including the towns of Paradise, Magalia, and Concow, as well as Feather River Hospital in Paradise operated by Adventist Health.
(2) Feather River Hospital was, by far, the largest employer in Paradise, and was the only acute care hospital service in the northeastern part of the county, including the communities of Paradise, Stirling City, Lovelock, De Sabla, and Magalia.
(3) The community that lived near Feather River Hospital was made up primarily of individuals with coverage under the federal Medicare Program or the Medicaid program, and many had only limited access to transportation. Access to health care and health resources has been greatly exacerbated since the Camp Fire.
(4) As the community begins to rebuild, it will be necessary for some health care services to be available to address potential injuries at work sites worksites and during construction.
(5) Because the destruction of the town of Paradise was so complete, it has created a unique situation in that it is unclear at this time whether and how long it will take for the community to rebuild, which makes it difficult for Adventist Health to determine whether a rebuild of the hospital makes sense at this point.
(6) Therefore, it is the intent of the Legislature in enacting this section to permit Adventist Health to provide emergency stabilization services at the site of the former Feather River Hospital for a limited period of time, to ensure the community of Paradise has access to emergency stabilization services as it begins the rebuilding process. It is further the intent of the Legislature that this is a temporary approach, intended to provide a period of time to assess whether and to what extent the town of Paradise will return and make the construction of a new hospital viable.
(7) It is not the intent of the Legislature to establish a model for a freestanding emergency department, which is currently, and remains, prohibited by state law.
(b) The department shall issue a special permit, as defined in Section 1251.5, to allow a general acute care hospital, as defined in subdivision (a) of Section 1250, to offer emergency stabilization services at a location that is outside of the hospital, including serving as an emergency medical services receiving site if authorized to do so by the medical director of the local emergency medical services agency pursuant to Section 1798.101, if the hospital provides satisfactory evidence to the department that the hospital has a written transfer agreement with the hospital closest to the location where emergency stabilization services will be provided pursuant to this section, and any other hospital necessary to ensure the safe and effective transfer of patients needing services outside the capacity of the closest hospital, and satisfactory evidence to the department that this location meets all of the following requirements:
(1) The location is in the County of Butte and serves the same area previously served by Feather River Hospital.
(2) The location meets the requirements of subdivision (a) of Section 70415 of, and Sections 70651, 70653, 70655, and 70657 of of, Title 22 of the California Code of Regulations.
(3) The location meets the nurse-to-patient staffing requirements of a basic emergency department, as specified in the regulations adopted pursuant to Section 1276.4.
(4) The location complies with the hospital’s existing collective bargaining agreements.
(5) The location is open 24 hours a day, 7 days a week.
(6) The location has a physician who is board certified in emergency medicine on site at all times. provides clinical laboratory and radiological services onsite.
(7) The location complies with the federal Emergency Medical Treatment and Active Labor Act (Section 1395dd of Title 42 of the United States Code) and with Section 1317 of this code.
(c) A hospital issued a special permit pursuant to this section shall, for purposes of the Annual Report of Hospitals required by regulations adopted pursuant to Section 1250.8, report bed and service utilization data separately by each facility issued a single consolidated license pursuant to this section.

(c)

(d) (1) Notwithstanding Section 1267, a special permit issued pursuant to this section shall expire two years from the date of its issuance, and may be renewed every two years, for a combined period not to exceed six years from the initial date of issuance.
(2) Prior to a first renewal of the special permit, the hospital that is issued a special permit pursuant to this section shall perform a community needs assessment. Prior to a second and final renewal of the special permit, the hospital shall have submitted plans for construction of a new hospital for review with the Office of Statewide Health Planning and Development.
(e) This section shall remain in effect only until January 1, 2028, and as of that date is repealed.

SEC. 2.

 The Legislature finds and declares that a special statute is necessary and that a general statute cannot be made applicable within the meaning of Section 16 of Article IV of the California Constitution because of the unique circumstances in the County of Butte, specifically the area previously served by Feather River Hospital in the town of Paradise, resulting from the severe destruction by the Camp Fire in 2018, which makes it unclear whether and how long it will take for the community to rebuild and which makes it difficult to determine whether a rebuild of the hospital is feasible at this point, while emergency stabilization services are needed in that community.