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Legislative Homestretch: Where We Stand

Lawmakers returned from their summer break this week to finish out the legislative session, which ends in four short (or long, depending on how you see it) weeks. By Sept. 13, bills need to be voted on and sent to the Governor, who then has 30 days to act on them.

As we enter the homestretch, here’s where we stand on some of this year’s top priorities:

Nurse Staffing Ratio Penalties – Senate Bill 227 (Leyva, D-Chino) would create punitive fines for hospitals that don’t meet nurse staffing ratios. CHA was able to secure an amendment to provide a structure for the department to consider certain factors when a hospital is reported as out of compliance. CHA remains opposed as we evaluate the political pressures surrounding this legislation.

Rate Setting (Surprise Billing) – Assembly Bill 1611 (Chiu, D-San Francisco) has been paused by its author for this year because of the significant concerns around an unnecessary provision that would set the rate insurance companies pay hospitals for out-of-network emergency care. For now, we’re preparing to continue this fight — we’ll continue to push for a clean policy that protects patients from out-of-network cost sharing, without setting payment rates and giving insurance companies an advantage in contract negotiations over hospitals.

Seismic Compliance – One of CHA’s sponsored bills, Senate Bill 758 (Portantino, D-La Canada) would modernize a 25-year-old building standards law to refocus on hospitals’ capabilities, rather than their facilities, in the event of an earthquake. At our request, the bill has been extended into next year to allow more time to educate lawmakers about disaster preparedness and patient triage generally, and to hammer out the details of how to ensure post-disaster care delivery is efficient and effective.

Independent Contractors – Assembly Bill 5 (Gonzalez, D-San Diego) would prohibit independent contractor status for many health care professionals. With a lobby day next week, and the help of a broad coalition of health care professionals, we’re urging an amendment that would exempt certain health care workers — such as nurse practitioners, physical therapists, certified nurse anesthetists, and others — so they can choose how they wish to be employed. This would also give hospitals the staffing flexibility they need to care for patients when complex workforce issues arise.

Community Benefit – CHA has taken a neutral position on Assembly Bill 204 (Wood, D-Santa Rosa), now that we’ve secured important amendments. The bill would require hospitals to report community benefits at the hospital level rather than the system level, and no longer includes language that defines charity care as a percentage of Medicare reimbursement, limits reportable community benefit programs, or requires the Office of Statewide Health Planning and Development to develop new regulations. 

The sands can shift quickly as bills head to their final outcome at this time of year, so while we’re cautiously optimistic that this will ultimately be a strong session for hospitals, we’re not letting our guard down in these final weeks.

— Carmela