National Nurses United

10 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G A P R I L | M AY 2 0 1 4 NEWS BRIEFS CALIFORNIA T he california Nurses Associa- tion is sponsoring a number of important bills during this 2014 legislative session that aim to close health insurance industry loop- holes not addressed by the Patient Protection and Affordable Care Act, hold healthcare corporations more accountable for providing charity care, improve safety for patients in outpatient and observation settings, and protect hospital healthcare workers from workplace violence. In April, stabbings of nurses at two Southern California hospitals highlighted the need for the organization's proposed workplace violence prevention bill, catapulting the issue into the spotlight. AB 503 (Wieckowski-Bonta) Charity Care The bill would clearly define what constitutes charity care, which must be direct provision of care to the uninsured or underinsured, not promotional activities, marketing, cost containment, or other activities more intend- ed to generate profit. Sets similar restrictions on the definition of "community benefit" programs. Improves reporting requirements for greater public transparency in how hospi- tals are meeting their charity care obligation, with financial penalties for hospitals that fail to meet reporting requirements. AB 2533 (Ammiano) Patient Choice This bill requires plans and insurers to arrange care from out-of-network providers at no extra cost to enrollees if the enrollees are unable to obtain medically necessary covered services in a timely manner in their network. The bill would also require California Department of Insurance (CDI) to promulgate timely access regulations and to review and update the regulations every three years to determine if updates are necessary. The bill further requires healthcare service plans and insurers to annually report denials of care and complaints regarding timely access to Depart- ment of Managed Health Care (DMHC) and to CDI and post reports on their website. AB 2616 (Skinner) Seeks to establish a rebuttal presumption for workers' compen- sation when an acute-care hospital employ- ee who provides direct patient care contracts a methicillin-resistant Staphylococcus aureus (MRSA) skin infection and presumes these ailments were contracted through employment. AB 2616 seeks to cover MRSA skin infections and covers employees post- employment for 60 days. CNA feels strongly that registered nurses and healthcare work- ers must be protected after providing critical services to their communities. We believe this can best be accomplished by providing these workers with rebuttal presumption for workers' compensation for healthcare work- ers who contract MRSA skin infections. SB 1005 (Lara) Expanding Medi-Cal to Income-Qualified Undocumented Immigrants Expands Medi-Cal benefits to undocumented immigrants who would otherwise not qualify. SB 1269 (Beall) Observation Services Stan- dards This bill would limit the period of time a patient may be placed in observation to 24 hours, making it consistent with time limita- tions imposed on other outpatient settings. It would require hospitals to obtain approval from the state to provide care in "observation units" which would have to meet the same staffing standards, including licensed nurse- to-patient ratios, as emergency rooms. Addi- tionally, it would require hospitals to provide notice to patients that observation services are "outpatient" services and third-party reimbursement may be impacted, and require hospitals to report observation serv- ices to the Office of Statewide Health Plan- ning and Development. SB 1182 (Leno) Expanding Rate Review of Insurance Premium Increases to Large Groups Mandates that large-group health insurance plans (self-insured or HMOs) file rate infor- mation with the Department of Insurance (self-insured plans), or the Department of Managed Health Care (HMOs) at least 60 days prior to implementing a rate increase that exceeds 5 percent of the prior year's rate. Insurers must give large-group purchasers their utilization data, if asked. SB 1299 (Padilla) Workplace Violence To address the growing problem of workplace violence in California hospitals, this bill would direct Cal/OSHA to develop a regula- tory standard on workplace violence requir- ing hospitals establish workplace violence prevention plans that include strong provi- sions to protect healthcare workers and other facility personnel from aggressive and violent behavior, including interactive personnel education and training; systems to assess and improve factors that contribute to violence in the hospital, including sufficiency of security and staffing; provisions protect- ing an employee's right to seek help from law enforcement; and, requirements for hospi- tals to document and report incidents of violence to Cal/OSHA. The bill would also require Cal/OSHA to post a report on its website containing information regarding violent incidents at hospitals and to make recommendations on how to prevent violent incidents at hospitals. —Staff report California legislative update

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