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AB-1895 Public health: maternity ward closures.(2023-2024)

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Date Published: 09/05/2024 04:00 AM
AB1895:v94#DOCUMENT

Enrolled  September 04, 2024
Passed  IN  Senate  August 29, 2024
Passed  IN  Assembly  August 30, 2024
Amended  IN  Senate  August 23, 2024
Amended  IN  Senate  June 24, 2024
Amended  IN  Assembly  May 16, 2024
Amended  IN  Assembly  March 18, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill
No. 1895


Introduced by Assembly Member Weber
(Coauthors: Assembly Members Aguiar-Curry, Berman, and Ortega)

January 23, 2024


An act to add Section 1255.28 to the Health and Safety Code, relating to health facilities.


LEGISLATIVE COUNSEL'S DIGEST


AB 1895, Weber. Public health: maternity ward closures.
Existing law establishes the licensure and regulation of health facilities by the State Department of Public Health, including, among others, general acute care hospitals. A violation of these provisions is a crime. Under existing law, a general acute care hospital is required to provide certain basic services, including medical, nursing, surgical, anesthesia, laboratory, radiology, pharmacy, and dietary services. Existing law authorizes a general acute care hospital to provide various special or supplemental services if certain conditions are met. Existing regulations define a supplemental service as an organized inpatient or outpatient service that is not required to be provided by law or regulation. Existing law requires a health facility to provide 90 days of public notice, with specified requirements, of the proposed closure or elimination of a supplemental service, such as maternity services.
This bill would require an acute care hospital that operates a perinatal unit and expects challenges in the next 6 months that may result in a reduction or loss of perinatal services, to report specified information to the Department of Health Care Access and Information, including, but not limited to, the number of medical staff and employees working in the perinatal unit and the hospital’s prior performance on financial metrics. The bill would require the Department of Health Care Access and Information to forward the provided information to the State Department of Health Care Services and the State Department of Public Health. The bill would require this information to be kept confidential to the extent permitted by law. The bill would require, within 3 months of receiving this notice from the hospital, the Department of Health Care Access and Information, in conjunction with the State Department of Public Health and the State Department of Health Care Services, to conduct a community impact assessment to identify the 3 closest hospitals operating a perinatal unit, their distance from the challenged facility, and whether those hospitals have any restrictions on their reproductive health services. The bill would require the Department of Health Care Access and Information to provide the community impact assessment to specified entities and would require these entities to keep the community impact assessment confidential. If the hospital plans to close its perinatal unit, the bill would require the hospital to provide public notice of the proposed closure, including the results of the community impact assessment, and other specified information on the hospital’s internet website 90 days in advance of the closure. The bill would require the public to be permitted to comment on the closure for 60 days after the notice is given, and would require one noticed public hearing be conducted by the hospital. The bill would also require the hospital to accept written public comment. By creating a new crime, this bill would impose a state-mandated local program.
Existing constitutional provisions require that a statute that limits the right of access to the meetings of public bodies or the writings of public officials and agencies be adopted with findings demonstrating the interest protected by the limitation and the need for protecting that interest.
This bill would make legislative findings to that effect.
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.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

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


SECTION 1.

 Section 1255.28 is added to the Health and Safety Code, to read:

1255.28.
 (a) (1) If a general acute care hospital, as defined in subdivision (a) of Section 1250, that operates a perinatal unit, as defined in Section 70545 of Article 6 of Chapter 1 of Division 5 of Title 22 of the California Code of Regulations, expects challenges in the next six months that may result in a reduction or loss of perinatal services as determined by the hospital after considering the factors described in subdivision (b), the hospital shall report the following information to the Department of Health Care Access and Information:
(A) The number of medical staff and employees working in the perinatal unit.
(B) The number of deliveries per month over the past 12 months in the perinatal unit.
(C) The number of patients served in the perinatal unit over the past 12 months who had commercial insurance.
(D) The number of patients served in the perinatal unit over the past 12 months who had Medi-Cal or Medicare.
(E) The hospital’s prior performance on financial metrics from the past 12 months.
(F) The factors that have caused challenges in the perinatal unit.
(G) What is needed for the perinatal unit to remain open, and whether state intervention is needed.
(2) The Department of Health Care Access and Information shall forward the hospital’s report pursuant to paragraph (1) to the State Department of Health Care Services and the State Department of Public Health. The information provided pursuant to paragraph (1) shall be kept confidential to the extent permitted by applicable law.
(b) When developing its report pursuant to subdivision (a), a hospital shall consider the following factors, including, but not limited to, financial challenges, difficulties finding and retaining qualified workforce members, decreased demand for perinatal services, and birth volume.
(c) Upon receipt of a report from a hospital pursuant to subdivision (a), the Department of Health Care Access and Information, in conjunction with the State Department of Public Health and the State Department of Health Care Services, shall assess the potential impact to the community served of a closure of the hospital’s perinatal unit, develop recommendations for how to resolve the perinatal unit’s challenges, and determine whether state assistance is warranted and feasible. The community impact assessment shall identify the three closest hospitals operating a perinatal unit, their distance from the challenged facility, and whether those hospitals have any restrictions on their reproductive health services. The community impact assessment shall be completed within three months of receipt of the report from the hospital pursuant to subdivision (a). The Department of Health Care Access and Information shall provide the community impact assessment to the hospital, the State Department of Health Care Services, and the State Department of Public Health. Notwithstanding any other law, the community impact assessment shall be kept confidential by all recipients. However, the community impact assessment shall be provided to the public with the public notice described in Section 1255.25 if the hospital later eliminates the perinatal unit supplemental service.
(d) If the hospital plans to close its perinatal unit, it shall provide public notice of the proposed closure in accordance with Section 1255.25 and shall include the results of the community impact assessment described in subdivision (c), and the information required by subdivision (b) of Section 1255.25. The public notice shall be posted on the hospital’s internet website 90 days in advance of the closure. The public shall be permitted to comment on the closure for 60 days after the notice is given, and within this period one noticed public hearing shall be conducted by the hospital. The hospital shall also accept written public comment.
(e) A violation of this section shall not serve as the basis for an administrative penalty pursuant to Section 1280.3.

SEC. 2.

 The Legislature finds and declares that Section 1 of this act, which adds Section 1255.28 of the Health and Safety Code, imposes a limitation on the public’s right of access to the meetings of public bodies or the writings of public officials and agencies within the meaning of Section 3 of Article I of the California Constitution. Pursuant to that constitutional provision, the Legislature makes the following findings to demonstrate the interest protected by this limitation and the need for protecting that interest:
In order to instill confidence in and to avoid unwarranted and unnecessary attention to hospitals that operate a perinatal unit, it is necessary that the community impact assessment remain confidential.

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.