RNs to Call for Passage of Bills on Patient Choice, Safety, Workplace Violence Prevention  
 
Up to 500 California registered nurses will gather in Sacramento Monday, May 12 to press the call for passage in Sacramento of essential legislation that would enhance patient safety, increase access to care, and promote workplace violence prevention and other safety measures.
 
The RNs, members of the California Nurses Association/National Nurses United, will convene at 9:30 a.m. and continue until 11:30 a.m. at the Sacramento Convention Center, after which the RNs will hold a colorful march to the State Capitol before going to meet with individual legislators.
 
The event is part of a global day of action organized by Global Nurses United and its U.S. affiliate, NNU.
 
In the opening session Monday morning, the RNs, joined by several legislators, will describe some of the dramatic changes underway in our state and nation’s health care system, including the effects of the Affordable Care Act on bedside care – and highlight some emerging problems.
 
CNA’s unique package of sponsored bills takes on many of those problems directly to improve the quality of patient care, increase access to patient services, and promote safer workplaces for RNs, other workers, patients, family members, and visitors. Key bills include:
 
AB 2533 – Helps Patients Get Care from the Medical Provider of their Choice
 
AB 2533, introduced by Assembly member Tom Ammiano, would substantially crack down on the practice of insurers and hospitals imposing higher out-of-pocket costs for patients who get medical care outside their insurance provider “network.”
 
The bill would require health insurers to arrange for enrollees who go outside their “approved” list of doctors or hospitals to obtain needed medical care in a timely manner be charged the same out-of-pocket costs as they would pay for getting care within their network.
 
That tackles what CNA Co-President Deborah Burger, RN notes is “a gaping hole in the health insurance system that either limits patient choice, forces patients to travel long distances to find a provider within their ‘network’ or exposes patients and families to excessively high bills that can lead to financial ruin.”
 
Campaign for a Healthy California is among the supporters of the bill. It passed the Assembly Health Committee in April.
 
SB 1299 – Requires Workplace Violence Prevention Programs at All Hospitals
 
SB 1299, by Sen. Alex Padilla, directs the California Occupational Safety and Health Standards Board to adopt standards requiring hospitals to establish workplace violence prevention plans to protect health care workers and other facility personnel from aggressive and violent behavior, and document and report incidents of violence to Cal-OSHA. The bill is awaiting action in Assembly Appropriations.
 
Hospitals would be required to provide education and training programs for recognizing and responding to violence, and would be prohibited from retaliation against employees who seek help from law enforcement. The bill, which has won approval from two Senate committees, has gained added prominence with recent incidents of violence in several California hospitals.
 
SB 1269 – Improved safety in ‘observation units’
 
SB 1269, authored by Sen. Jim Beall, takes on a growing abuse by some California hospitals that place   patients in “observation” beds within hospital settings that are not subject to the same oversight and public protection as inpatient units.  Some patients are placed in “observation units” within a hospital setting for prolonged periods of time up to 72 hours or more. Senate Health has approved the bill.
 
CNA charges that those hospitals engage in these practices specifically to avoid admitting patients in need of more specialized hospital care, in part to avoid new federal penalties for patients who are frequently re-admitted to hospital care after discharge; the same penalties do not apply for a patient re-admitted after discharge from an observation unit.  Additionally, patients sent from a hospital to a nursing facility must have been counted as an inpatient for three days in a row to qualify for Medicare coverage; observation status is not counted toward those three days.
 
AB 503 – Holding Hospitals Accountable on Charity Care and Community Benefit Programs
 
AB 503, jointly authored by Assembly member Bob Wieckowski of Fremont and Assembly member Rob Bonta of Oakland, addresses what CNA calls a rampant abuse of what the hospitals report in how they provide charity care and community benefit programs in exchange for maintaining their tax exempt status.  The Greenlining Institute and the California Rural Legal Assistance Foundation are co-sponsors.
 
A 2012 CNA report found that California non-profits were accumulating nearly $2 billion a year in public subsidies, tax exempt benefits, beyond what they were returning in charity care – while rolling up record profits and paying scores of top executives pay packages in excess of $1 million a year. The California State Auditor’s office has also expressed concern in two reports in recent years over the lack of consistent reporting requirements.
 
AB 503 would clearly define what constitutes charity care, which must be the direct provision of care to the uninsured or underinsured, not promotional activities, marketing, cost containment, or other activities more intended to generate profit, set restrictions on the definition of “community benefit” programs, and improve reporting requirements for greater transparency.
 
Children’s hospitals, county hospitals, other public facilities, and small rural hospitals are exempted. Hearings on the bill are expected in June.
 
AB 2616 – Help for RNs, other staff, exposed to MRSA infections
 
Assembly Bill 2616 by Assembly member Nancy Skinner would extend presumptive eligibility for worker’s comp for any hospital employees who contract the aggressive, especially virulent antibiotic resistance staph infection commonly known as MRSA.
 
An estimated 200,000 MRSA occur in California hospitals every year, of which 12,000 result in deaths, according to the State Department of Public Health. RNs are particularly vulnerable to exposure because of the personal nature of the care they provide.
 
Under current law, a number of workplace injuries qualify for presumption of eligibility for workers’ comp for public safety personnel. But only for police, firefighters and some other safety personnel who are predominantly male. AB 2616 would extend that eligibility to RNs and other hospital employees who are predominantly women. The bill has passed one hurdle and is on to Assembly Appropriations.