California 2021-2022 Regular Session

California Senate Bill SB637 Compare Versions

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1-Amended IN Assembly August 25, 2022 Amended IN Assembly September 03, 2021 Amended IN Assembly July 15, 2021 Amended IN Senate April 21, 2021 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Senate Bill No. 637Introduced by Senator Newman Ochoa Bogh(Coauthor: Senator Hertzberg)February 19, 2021An act to amend Section 1276 of, and to add Section 1275.9 to, the Health and Safety Code, relating to health facilities. An act to amend Sections 19962 and 19963 of the Business and Professions Code, relating to gambling.LEGISLATIVE COUNSEL'S DIGESTSB 637, as amended, Newman Ochoa Bogh. Health facility reporting: staffing. Gambling: local moratorium. Existing law, the Gambling Control Act, establishes the California Gambling Control Commission, which is responsible for licensing and regulating various gambling activities and establishments. Existing law requires the Department of Justice to investigate any violations of, and to enforce, the act. Under the act, a city, county, or city and county may authorize controlled gambling consistent with state law. Existing law prohibits, until January 1, 2023, the governing body or the electors of a city, county, or city and county that has not authorized legal gaming within its boundaries prior to January 1, 1996, from authorizing legal gaming. Existing law also prohibits, until January 1, 2023, an ordinance in effect on January 1, 1996, that authorizes legal gaming within a city, county, or city and county from being amended to expand gaming in that jurisdiction beyond that permitted on January 1, 1996.This bill would extend those prohibitions until January 1, 2024.Existing law also prohibits, until January 1, 2023, the commission from issuing a gambling license for a gambling establishment that was not licensed to operate on December 31, 1999, except as specified. This bill would also extend that prohibition until January 1, 2024.(1)Existing law provides for the licensure and regulation of certain health facilities, including general acute care hospitals, by the State Department of Public Health.This bill would require a general acute care hospital to report specified information to the department on a form and schedule determined by the department, and would require the department to publicly post the information on a weekly basis during any health-related state of emergency in California proclaimed by the President of the United States or by the Governor, and on a monthly basis at all other times. The bill would require that the reports contain information on staffing, including, until January 1, 2025, or the end of the declared COVID-19 emergency, whichever comes first, on matters relating to COVID-19 cases.If the hospital fails to comply with the above requirement, the bill would authorize the department to impose fines or other penalties, and to suspend, revoke, or refuse to renew the license of, the hospital, as specified.(2)Existing law requires certain building standards and regulations to prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served. Existing law requires the regulations to permit program flexibility using alternate methods, procedures, or other specified means, based on a written request and supporting evidence submitted by the applicant or licensee to the department.This bill would require a health facility to post any approval for program flexibility granted by the department immediately adjacent to the facilitys license and on the facilitys internet website, as specified.(3)This bill would incorporate additional changes to Section 1276 of the Health and Safety Code proposed by AB 1422 to be operative only if this bill and AB 1422 are enacted and this bill is enacted last.(4)Existing law generally makes a violation of the licensure provisions for health facilities a misdemeanor.By expanding the scope of a crime under the above paragraphs, this bill would impose a state-mandated local program.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.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESNO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 19962 of the Business and Professions Code is amended to read:19962. (a) Neither the The governing body nor or the electors of a county, city, or city and county that has not authorized legal gaming within its boundaries prior to January 1, 1996, shall not authorize legal gaming.(b) An ordinance in effect on January 1, 1996, that authorizes legal gaming within a city, county, or city and county may shall not be amended to expand gaming in that jurisdiction beyond that permitted on January 1, 1996.(c) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.SEC. 2. Section 19963 of the Business and Professions Code is amended to read:19963. (a) In addition to any other limitations on the expansion of gambling imposed by Section 19962 or any provision of this chapter, the commission may shall not issue a gambling license for a gambling establishment that was not licensed to operate on December 31, 1999, unless an application to operate that establishment was on file with the department prior to September 1, 2000.(b) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.SECTION 1.Section 1275.9 is added to the Health and Safety Code, to read:1275.9.(a)A general acute care hospital, as defined in subdivision (a) of Section 1250, shall report information, including, but not limited to, staffing, including staffing shortages, bed counts, and patient census, to the department on a form and schedule determined by the department.(b)The department shall publicly post information received pursuant to this section and update it on a weekly basis during a statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, and on a monthly basis at all other times.(c)Notwithstanding any other law, the department may, without taking any regulatory action pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, require general acute care hospitals to submit data by means of an All Facilities Letter (AFL). Except in the case of an emergency or other circumstance when delay may impact patient health and safety, when using the AFL process to require specified data submission, the department will do so in consultation with stakeholders.(d)This section does not limit the departments ability to request or require hospitals to report additional information not listed in this section or on a more frequent schedule.(e)Pursuant to subdivision (a), a general acute care hospital shall report the following information regarding staffing:(1)Whether the hospital is experiencing staffing shortage of nurses since the last time of reporting. (2)Whether the hospital experienced any layoffs of nurses since the time of last reporting and, if so, how many nurses and on what calendar day were they laid off.(3)Whether the hospital experienced any furloughs of nurses since the time of last reporting and if so, how many nurses were furloughed and on what calendar day were they furloughed.(4)Whether the hospital experienced any repeated cancellation of shifts of nurses since the time of last reporting. Repeated cancellation means more than two shifts canceled by the employer within a one-calendar-month period. Reports of cancelled shifts shall include information regarding the unit the nurses were scheduled to work in and the reason for the cancellation.(f)Until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, pursuant to subdivision (a), a general acute care hospital shall also report the following information regarding staffing:(1)Numeric total of COVID-19-positive staff, including the total number of staff and facility personnel who have tested positive for COVID-19, whether by laboratory confirmation or clinical diagnosis. Reports of COVID-19-positive staff shall include the numbers of COVID-19-positive staff for each reporting period and as a total number since the first report.(2)Numeric total of newly suspected COVID-19-positive staff, including the total number of staff and facility personnel routinely scheduled to work at the hospital, but not necessarily present at the time of data entry, who are being managed as though they have COVID-19 but who do not have a positive laboratory test result.(3)Numeric total of new COVID-19-related deaths of staff, including the total number of deaths of staff and facility personnel routinely scheduled to work at the hospital and with suspected or laboratory-confirmed COVID-19, that occurred on the previous calendar day.(g)If a general acute care hospital fails to comply with this section, the department may impose fines or other penalties on, and may suspend, revoke, or refuse to renew the license of, the hospital in accordance with any applicable provisions of this chapter.(h)For purposes of this section, the following definitions apply:(1)COVID-19 means the 2019 novel coronavirus disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).(2)General acute care hospital has the same meaning as defined in subdivision (a) of Section 1250.SEC. 2.Section 1276 of the Health and Safety Code is amended to read:1276.(a)The building standards published in the California Building Standards Code by the Department of Health Care Access and Information, and the regulations adopted by the department shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b)These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department or the Department of Health Care Access and Information, as applicable. The approval of the department or the Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or the Department of Health Care Access and Information, regarding the exception, as applicable.(c)While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the department expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d)(1)The department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the department for program flexibility in the prescribed manner. After the department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2)A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e)Notwithstanding any other law or regulation, the department shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.SEC. 2.5.Section 1276 of the Health and Safety Code is amended to read:1276.(a)The building standards published in the California Building Standards Code by the Department of Health Care Access and Information, and the regulations adopted by the State Department of Public Health shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b)These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the State Department of Public Health or the Department of Health Care Access and Information, as applicable. The approval of the department or the Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or Department of Health Care Access and Information regarding the exception, as applicable.(c)While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the State Department of Public Health expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d)(1)The department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the department for program flexibility in the prescribed manner. After the department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2)A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e)To the extent that an application by a health facility for program flexibility, or for an extension of program flexibility, includes a request to allow the health facility to designate a bed or multiple beds in a critical care unit as requiring a lower level of care, including, but not limited to, the level of care provided in an intermediate care, step-down, telemetry, medical-surgical, specialty care, or pediatric services unit, that application shall be referred to as a critical care unit program flexibility request. This subdivision and subdivision (f) do not confer on the department any new or additional authority to modify staffing ratios.(f)(1)The department shall require, as support for a critical care unit program flexibility request, the applicant or licensee to submit supporting evidence that includes documentation establishing the need for program flexibility and that the proposed alternative will not jeopardize the health, safety, and well-being of patients and is needed for increased operational efficiency.(A)Any critical care unit program flexibility request, including supporting evidence submitted with the request, shall be posted on the departments publicly accessible internet website within five calendar days of receipt by the department.(B)The department, at the time it posts a health facilitys critical care unit program flexibility request, shall provide a method to electronically collect public comment specifically on the application for a period of 30 days.(C)The 60-day timeframe provided for in subdivision (d) shall not commence until a facilitys critical care unit program flexibility request and supporting evidence have been posted on the departments internet website.(2)(A)A health facility that makes a critical care unit program flexibility request shall comply with both of the following requirements:(i)Conspicuously post the critical care unit program flexibility request form and a notice next to its license stating that a critical care unit program flexibility request and supporting evidence have been submitted to the department.(ii)Immediately make its best effort to notify affected employees and employee representatives of the critical care unit program flexibility request and direction to where to find the request and supporting evidence, and where to provide public comment.(B)A facilitys critical care unit program flexibility request will not be deemed complete for purposes of the 60-day timeframe pursuant to subdivision (d) until the facility has complied with this paragraph.(3)In no event shall the department approve a health facilitys critical care unit program flexibility request for a period of more than one year.(4)Any approval of a health facilitys critical care unit program flexibility request may be revoked by the department at any time, including on the grounds that there is no longer a need for program flexibility, that the approved alternative jeopardizes the health, safety, and well-being of patients, or that the approved alternative does not adequately protect patient safety.(5)(A)The 30-day comment period required by subparagraph (B) of paragraph (1) shall not apply when a hospital submits a critical care unit program flexibility request due to a health care emergency. Critical care unit program flexibility requests approved pursuant to this paragraph shall not be effective for more than 90 days, and any request to extend the term of critical care unit program flexibility that was approved pursuant to this paragraph shall be subject to the regular process provided for in this subdivision.(B)For purposes of this paragraph, health care emergency means an unpredictable or unavoidable occurrence at unscheduled or unpredictable intervals relating to health care delivery requiring immediate medical interventions and care.(6)This subdivision shall become operative on January 1, 2023. (g)Notwithstanding any other law or regulation, the State Department of Public Health shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.(h)On or before February 1, 2023, the department shall post all of the following information on its internet website:(1)A list of applicants for critical care unit program flexibility and the date of the application.(2)A list of health facilities with approved critical care unit program flexibility and the effective start and end date of the approval.(3)If approved, the notification of approval for critical care unit program flexibility, which shall include the application for critical care unit program flexibility; the regulation or regulations impacted; beds, units, or departments affected; and any conditions placed on the approval.(4)A department contact for the public to submit a complaint related to an approved critical care unit program flexibility.SEC. 3.Section 2.5 of this bill incorporates amendments to Section 1276 of the Health and Safety Code proposed by both this bill and Assembly Bill 1422. That section of this bill shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2022, (2) each bill amends Section 1276 of the Health and Safety Code, and (3) this bill is enacted after Assembly Bill 1422, in which case Section 2 of this bill shall not become operative.SEC. 4.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.
1+Amended IN Assembly September 03, 2021 Amended IN Assembly July 15, 2021 Amended IN Senate April 21, 2021 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Senate Bill No. 637Introduced by Senator Newman(Coauthor: Senator Hertzberg)February 19, 2021 An act to amend Section 1276 of, and to add, repeal, and add Section 1275.9 of, to, the Health and Safety Code, relating to health facilities.LEGISLATIVE COUNSEL'S DIGESTSB 637, as amended, Newman. Health facility reporting: staffing.(1) Existing law provides for the licensure and regulation of certain health facilities, including general acute care hospitals, by the State Department of Public Health.This bill would require a general acute care hospital to report specified information to the department on a form and schedule determined by the department, and would require the department to publicly post the information on a weekly basis during any health-related state of emergency in California proclaimed by the President of the United States or by the Governor, and on a monthly basis at all other times. The bill would require that the reports contain information on staffing, including, until January 1, 2025, or the end of the declared COVID-19 emergency, whichever comes first, on matters relating to COVID-19 cases. The bill would require the department to publicly post the information and update it based on the same timeframes.If the hospital fails to comply with the above requirement, the bill would authorize the department to impose fines or other penalties, and to suspend, revoke, or refuse to renew the license of, the hospital, as specified.(2) Existing law requires certain building standards and regulations to prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served. Existing law requires the regulations to permit program flexibility using alternate methods, procedures, or other specified means, based on a written request and supporting evidence submitted by the applicant or licensee to the department.This bill would require a health facility to post any approval for program flexibility granted by the department immediately adjacent to the facilitys license and on the facilitys internet website, as specified.(3)This bill would incorporate additional changes to Section 1276 of the Health and Safety Code proposed by AB 1422 to be operative only if this bill and AB 1422 are enacted and this bill is enacted last.(3)(4) Existing law generally makes a violation of the licensure provisions for health facilities a misdemeanor.By expanding the scope of a crime under the above paragraphs, this bill would impose a state-mandated local program.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.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 1275.9 is added to the Health and Safety Code, to read:1275.9.(a)During any statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, a general acute care hospital shall report the information described in subdivision (c) to the department on a weekly basis. At all other times, the general acute care hospital shall report that information to the department on a monthly basis.(b)The department shall publicly post information received pursuant to this section and update it on a weekly basis during the state of emergency described in subdivision (a) and on a monthly basis at all other times.(c)1275.9. (a) A general acute care hospital, as defined in subdivision (a) of Section 1250, shall report information, including, but not limited to, staffing, including staffing shortages, bed counts, and patient census, to the department on a form and schedule determined by the department.(b) The department shall publicly post information received pursuant to this section and update it on a weekly basis during a statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, and on a monthly basis at all other times.(c) Notwithstanding any other law, the department may, without taking any regulatory action pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, require general acute care hospitals to submit data by means of an All Facilities Letter (AFL). Except in the case of an emergency or other circumstance when delay may impact patient health and safety, when using the AFL process to require specified data submission, the department will do so in consultation with stakeholders.(d) This section does not limit the departments ability to request or require hospitals to report additional information not listed in this section or on a more frequent schedule.(e) Pursuant to subdivision (a), a general acute care hospital shall report the following information regarding staffing:(1) Whether the hospital is experiencing staffing shortage of nurses since the last time of reporting. (2) Whether the hospital experienced any layoffs of nurses since the time of last reporting and, if so, how many nurses and on what calendar day were they laid off.(3) Whether the hospital experienced any furloughs of nurses since the time of last reporting and if so, how many nurses were furloughed and on what calendar day were they furloughed.(4) Whether the hospital experienced any repeated cancellation of shifts of nurses since the time of last reporting. Repeated cancellation means more than two shifts canceled by the employer within a one-calendar-month period. Reports of cancelled shifts shall include information regarding the unit the nurses were scheduled to work in and the reason for the cancellation.(f) Until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, pursuant to subdivision (a), a general acute care hospital shall also report the following information regarding staffing:(5)(1) Numeric total of COVID-19-positive staff, including the total number of staff and facility personnel who have tested positive for COVID-19, whether by laboratory confirmation or clinical diagnosis. Reports of COVID-19-positive staff shall include the numbers of COVID-19-positive staff for each reporting period and as a total number since the first report.(6)(2) Numeric total of newly suspected COVID-19-positive staff, including the total number of staff and facility personnel routinely scheduled to work at the hospital, but not necessarily present at the time of data entry, who are being managed as though they have COVID-19 but who do not have a positive laboratory test result.(7)(3) Numeric total of new COVID-19-related deaths of staff, including the total number of deaths of staff and facility personnel routinely scheduled to work at the hospital and with suspected or laboratory-confirmed COVID-19, that occurred on the previous calendar day.(d)(g) If a general acute care hospital fails to comply with this section, the department may impose fines or other penalties on, and may suspend, revoke, or refuse to renew the license of, the hospital in accordance with any applicable provisions of this chapter.(e)(h) For purposes of this section, the following definitions apply:(1) COVID-19 means the 2019 novel coronavirus disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).(2) General acute care hospital has the same meaning as defined in subdivision (a) of Section 1250.(f)This section shall remain in effect only until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, and as of that date is repealed.SEC. 2.Section 1275.9 is added to the Health and Safety Code, to read:1275.9.(a)During any statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, a general acute care hospital shall report the information described in subdivision (c) to the department on a weekly basis. At all other times, the general acute care hospital shall report that information to the department on a monthly basis.(b)The department shall publicly post information received pursuant to this section and update it on a weekly basis during the state of emergency described in subdivision (a) and on a monthly basis at all other times.(c)Pursuant to subdivision (a), a general acute care hospital shall report the following information regarding staffing:(1)Whether the hospital is experiencing staffing shortage of nurses since the last time of reporting.(2)Whether the hospital experienced any layoffs of nurses since the time of last reporting and, if so, how many nurses and on what calendar day were they laid off.(3)Whether the hospital experienced any furloughs of nurses since the time of last reporting and, if so, how many nurses were furloughed and on what calendar day were they furloughed.(4)Whether the hospital experienced any repeated cancellation of shifts of nurses since the time of last reporting. Repeated cancellation means more than two shifts canceled by the employer within a one-calendar-month period. Reports of cancelled shifts shall include information regarding the unit the nurses were scheduled to work in and the reason for the cancellation.(d)If a general acute care hospital fails to comply with this section, the department may impose fines or other penalties on, and may suspend, revoke, or refuse to renew the license of, the hospital in accordance with any applicable provisions of this chapter.(e)For purposes of this section, general acute care hospital has the same meaning as defined in subdivision (a) of Section 1250.(f)This section shall become operative on January 1, 2025.SEC. 3.SEC. 2. Section 1276 of the Health and Safety Code is amended to read:1276. (a) The building standards published in the California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the department shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office the Department of Health Care Access and Information, regarding the exception, as applicable.(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the department expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d) (1) The department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the department for program flexibility in the prescribed manner. After the department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e) Notwithstanding any other law or regulation, the department shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.SEC. 2.5. Section 1276 of the Health and Safety Code is amended to read:1276. (a) The building standards published in the State California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the state department State Department of Public Health shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department State Department of Public Health or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office Department of Health Care Access and Information regarding the exception, as applicable.(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the state department State Department of Public Health expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d) (1) The state department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the state department for program flexibility in the prescribed manner. After the state department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e) To the extent that an application by a health facility for program flexibility, or for an extension of program flexibility, includes a request to allow the health facility to designate a bed or multiple beds in a critical care unit as requiring a lower level of care, including, but not limited to, the level of care provided in an intermediate care, step-down, telemetry, medical-surgical, specialty care, or pediatric services unit, that application shall be referred to as a critical care unit program flexibility request. This subdivision and subdivision (f) do not confer on the department any new or additional authority to modify staffing ratios.(f) (1) The department shall require, as support for a critical care unit program flexibility request, the applicant or licensee to submit supporting evidence that includes documentation establishing the need for program flexibility and that the proposed alternative will not jeopardize the health, safety, and well-being of patients and is needed for increased operational efficiency.(A) Any critical care unit program flexibility request, including supporting evidence submitted with the request, shall be posted on the departments publicly accessible internet website within five calendar days of receipt by the department.(B) The department, at the time it posts a health facilitys critical care unit program flexibility request, shall provide a method to electronically collect public comment specifically on the application for a period of 30 days.(C) The 60-day timeframe provided for in subdivision (d) shall not commence until a facilitys critical care unit program flexibility request and supporting evidence have been posted on the departments internet website.(2) (A) A health facility that makes a critical care unit program flexibility request shall comply with both of the following requirements:(i) Conspicuously post the critical care unit program flexibility request form and a notice next to its license stating that a critical care unit program flexibility request and supporting evidence have been submitted to the department.(ii) Immediately make its best effort to notify affected employees and employee representatives of the critical care unit program flexibility request and direction to where to find the request and supporting evidence, and where to provide public comment.(B) A facilitys critical care unit program flexibility request will not be deemed complete for purposes of the 60-day timeframe pursuant to subdivision (d) until the facility has complied with this paragraph.(3) In no event shall the department approve a health facilitys critical care unit program flexibility request for a period of more than one year.(4) Any approval of a health facilitys critical care unit program flexibility request may be revoked by the department at any time, including on the grounds that there is no longer a need for program flexibility, that the approved alternative jeopardizes the health, safety, and well-being of patients, or that the approved alternative does not adequately protect patient safety.(5) (A) The 30-day comment period required by subparagraph (B) of paragraph (1) shall not apply when a hospital submits a critical care unit program flexibility request due to a health care emergency. Critical care unit program flexibility requests approved pursuant to this paragraph shall not be effective for more than 90 days, and any request to extend the term of critical care unit program flexibility that was approved pursuant to this paragraph shall be subject to the regular process provided for in this subdivision.(B) For purposes of this paragraph, health care emergency means an unpredictable or unavoidable occurrence at unscheduled or unpredictable intervals relating to health care delivery requiring immediate medical interventions and care.(6) This subdivision shall become operative on January 1, 2023. (e)(g) Notwithstanding any other provision of law or regulation, the State Department of Health Services Public Health shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.(h) On or before February 1, 2023, the department shall post all of the following information on its internet website:(1) A list of applicants for critical care unit program flexibility and the date of the application.(2) A list of health facilities with approved critical care unit program flexibility and the effective start and end date of the approval.(3) If approved, the notification of approval for critical care unit program flexibility, which shall include the application for critical care unit program flexibility; the regulation or regulations impacted; beds, units, or departments affected; and any conditions placed on the approval.(4) A department contact for the public to submit a complaint related to an approved critical care unit program flexibility.SEC. 3. Section 2.5 of this bill incorporates amendments to Section 1276 of the Health and Safety Code proposed by both this bill and Assembly Bill 1422. That section of this bill shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2022, (2) each bill amends Section 1276 of the Health and Safety Code, and (3) this bill is enacted after Assembly Bill 1442, in which case Section 2 of this bill shall not become operative.SEC. 4. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
22
3- Amended IN Assembly August 25, 2022 Amended IN Assembly September 03, 2021 Amended IN Assembly July 15, 2021 Amended IN Senate April 21, 2021 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Senate Bill No. 637Introduced by Senator Newman Ochoa Bogh(Coauthor: Senator Hertzberg)February 19, 2021An act to amend Section 1276 of, and to add Section 1275.9 to, the Health and Safety Code, relating to health facilities. An act to amend Sections 19962 and 19963 of the Business and Professions Code, relating to gambling.LEGISLATIVE COUNSEL'S DIGESTSB 637, as amended, Newman Ochoa Bogh. Health facility reporting: staffing. Gambling: local moratorium. Existing law, the Gambling Control Act, establishes the California Gambling Control Commission, which is responsible for licensing and regulating various gambling activities and establishments. Existing law requires the Department of Justice to investigate any violations of, and to enforce, the act. Under the act, a city, county, or city and county may authorize controlled gambling consistent with state law. Existing law prohibits, until January 1, 2023, the governing body or the electors of a city, county, or city and county that has not authorized legal gaming within its boundaries prior to January 1, 1996, from authorizing legal gaming. Existing law also prohibits, until January 1, 2023, an ordinance in effect on January 1, 1996, that authorizes legal gaming within a city, county, or city and county from being amended to expand gaming in that jurisdiction beyond that permitted on January 1, 1996.This bill would extend those prohibitions until January 1, 2024.Existing law also prohibits, until January 1, 2023, the commission from issuing a gambling license for a gambling establishment that was not licensed to operate on December 31, 1999, except as specified. This bill would also extend that prohibition until January 1, 2024.(1)Existing law provides for the licensure and regulation of certain health facilities, including general acute care hospitals, by the State Department of Public Health.This bill would require a general acute care hospital to report specified information to the department on a form and schedule determined by the department, and would require the department to publicly post the information on a weekly basis during any health-related state of emergency in California proclaimed by the President of the United States or by the Governor, and on a monthly basis at all other times. The bill would require that the reports contain information on staffing, including, until January 1, 2025, or the end of the declared COVID-19 emergency, whichever comes first, on matters relating to COVID-19 cases.If the hospital fails to comply with the above requirement, the bill would authorize the department to impose fines or other penalties, and to suspend, revoke, or refuse to renew the license of, the hospital, as specified.(2)Existing law requires certain building standards and regulations to prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served. Existing law requires the regulations to permit program flexibility using alternate methods, procedures, or other specified means, based on a written request and supporting evidence submitted by the applicant or licensee to the department.This bill would require a health facility to post any approval for program flexibility granted by the department immediately adjacent to the facilitys license and on the facilitys internet website, as specified.(3)This bill would incorporate additional changes to Section 1276 of the Health and Safety Code proposed by AB 1422 to be operative only if this bill and AB 1422 are enacted and this bill is enacted last.(4)Existing law generally makes a violation of the licensure provisions for health facilities a misdemeanor.By expanding the scope of a crime under the above paragraphs, this bill would impose a state-mandated local program.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.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESNO
3+ Amended IN Assembly September 03, 2021 Amended IN Assembly July 15, 2021 Amended IN Senate April 21, 2021 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Senate Bill No. 637Introduced by Senator Newman(Coauthor: Senator Hertzberg)February 19, 2021 An act to amend Section 1276 of, and to add, repeal, and add Section 1275.9 of, to, the Health and Safety Code, relating to health facilities.LEGISLATIVE COUNSEL'S DIGESTSB 637, as amended, Newman. Health facility reporting: staffing.(1) Existing law provides for the licensure and regulation of certain health facilities, including general acute care hospitals, by the State Department of Public Health.This bill would require a general acute care hospital to report specified information to the department on a form and schedule determined by the department, and would require the department to publicly post the information on a weekly basis during any health-related state of emergency in California proclaimed by the President of the United States or by the Governor, and on a monthly basis at all other times. The bill would require that the reports contain information on staffing, including, until January 1, 2025, or the end of the declared COVID-19 emergency, whichever comes first, on matters relating to COVID-19 cases. The bill would require the department to publicly post the information and update it based on the same timeframes.If the hospital fails to comply with the above requirement, the bill would authorize the department to impose fines or other penalties, and to suspend, revoke, or refuse to renew the license of, the hospital, as specified.(2) Existing law requires certain building standards and regulations to prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served. Existing law requires the regulations to permit program flexibility using alternate methods, procedures, or other specified means, based on a written request and supporting evidence submitted by the applicant or licensee to the department.This bill would require a health facility to post any approval for program flexibility granted by the department immediately adjacent to the facilitys license and on the facilitys internet website, as specified.(3)This bill would incorporate additional changes to Section 1276 of the Health and Safety Code proposed by AB 1422 to be operative only if this bill and AB 1422 are enacted and this bill is enacted last.(3)(4) Existing law generally makes a violation of the licensure provisions for health facilities a misdemeanor.By expanding the scope of a crime under the above paragraphs, this bill would impose a state-mandated local program.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.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES
44
5- Amended IN Assembly August 25, 2022 Amended IN Assembly September 03, 2021 Amended IN Assembly July 15, 2021 Amended IN Senate April 21, 2021
5+ Amended IN Assembly September 03, 2021 Amended IN Assembly July 15, 2021 Amended IN Senate April 21, 2021
66
7-Amended IN Assembly August 25, 2022
87 Amended IN Assembly September 03, 2021
98 Amended IN Assembly July 15, 2021
109 Amended IN Senate April 21, 2021
1110
1211 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION
1312
1413 Senate Bill
1514
1615 No. 637
1716
18-Introduced by Senator Newman Ochoa Bogh(Coauthor: Senator Hertzberg)February 19, 2021
17+Introduced by Senator Newman(Coauthor: Senator Hertzberg)February 19, 2021
1918
20-Introduced by Senator Newman Ochoa Bogh(Coauthor: Senator Hertzberg)
19+Introduced by Senator Newman(Coauthor: Senator Hertzberg)
2120 February 19, 2021
2221
23-An act to amend Section 1276 of, and to add Section 1275.9 to, the Health and Safety Code, relating to health facilities. An act to amend Sections 19962 and 19963 of the Business and Professions Code, relating to gambling.
22+ An act to amend Section 1276 of, and to add, repeal, and add Section 1275.9 of, to, the Health and Safety Code, relating to health facilities.
2423
2524 LEGISLATIVE COUNSEL'S DIGEST
2625
2726 ## LEGISLATIVE COUNSEL'S DIGEST
2827
29-SB 637, as amended, Newman Ochoa Bogh. Health facility reporting: staffing. Gambling: local moratorium.
28+SB 637, as amended, Newman. Health facility reporting: staffing.
3029
31-Existing law, the Gambling Control Act, establishes the California Gambling Control Commission, which is responsible for licensing and regulating various gambling activities and establishments. Existing law requires the Department of Justice to investigate any violations of, and to enforce, the act. Under the act, a city, county, or city and county may authorize controlled gambling consistent with state law. Existing law prohibits, until January 1, 2023, the governing body or the electors of a city, county, or city and county that has not authorized legal gaming within its boundaries prior to January 1, 1996, from authorizing legal gaming. Existing law also prohibits, until January 1, 2023, an ordinance in effect on January 1, 1996, that authorizes legal gaming within a city, county, or city and county from being amended to expand gaming in that jurisdiction beyond that permitted on January 1, 1996.This bill would extend those prohibitions until January 1, 2024.Existing law also prohibits, until January 1, 2023, the commission from issuing a gambling license for a gambling establishment that was not licensed to operate on December 31, 1999, except as specified. This bill would also extend that prohibition until January 1, 2024.(1)Existing law provides for the licensure and regulation of certain health facilities, including general acute care hospitals, by the State Department of Public Health.This bill would require a general acute care hospital to report specified information to the department on a form and schedule determined by the department, and would require the department to publicly post the information on a weekly basis during any health-related state of emergency in California proclaimed by the President of the United States or by the Governor, and on a monthly basis at all other times. The bill would require that the reports contain information on staffing, including, until January 1, 2025, or the end of the declared COVID-19 emergency, whichever comes first, on matters relating to COVID-19 cases.If the hospital fails to comply with the above requirement, the bill would authorize the department to impose fines or other penalties, and to suspend, revoke, or refuse to renew the license of, the hospital, as specified.(2)Existing law requires certain building standards and regulations to prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served. Existing law requires the regulations to permit program flexibility using alternate methods, procedures, or other specified means, based on a written request and supporting evidence submitted by the applicant or licensee to the department.This bill would require a health facility to post any approval for program flexibility granted by the department immediately adjacent to the facilitys license and on the facilitys internet website, as specified.(3)This bill would incorporate additional changes to Section 1276 of the Health and Safety Code proposed by AB 1422 to be operative only if this bill and AB 1422 are enacted and this bill is enacted last.(4)Existing law generally makes a violation of the licensure provisions for health facilities a misdemeanor.By expanding the scope of a crime under the above paragraphs, this bill would impose a state-mandated local program.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.
32-
33-Existing law, the Gambling Control Act, establishes the California Gambling Control Commission, which is responsible for licensing and regulating various gambling activities and establishments. Existing law requires the Department of Justice to investigate any violations of, and to enforce, the act.
34-
35-Under the act, a city, county, or city and county may authorize controlled gambling consistent with state law. Existing law prohibits, until January 1, 2023, the governing body or the electors of a city, county, or city and county that has not authorized legal gaming within its boundaries prior to January 1, 1996, from authorizing legal gaming. Existing law also prohibits, until January 1, 2023, an ordinance in effect on January 1, 1996, that authorizes legal gaming within a city, county, or city and county from being amended to expand gaming in that jurisdiction beyond that permitted on January 1, 1996.
36-
37-This bill would extend those prohibitions until January 1, 2024.
38-
39-Existing law also prohibits, until January 1, 2023, the commission from issuing a gambling license for a gambling establishment that was not licensed to operate on December 31, 1999, except as specified.
40-
41-This bill would also extend that prohibition until January 1, 2024.
30+(1) Existing law provides for the licensure and regulation of certain health facilities, including general acute care hospitals, by the State Department of Public Health.This bill would require a general acute care hospital to report specified information to the department on a form and schedule determined by the department, and would require the department to publicly post the information on a weekly basis during any health-related state of emergency in California proclaimed by the President of the United States or by the Governor, and on a monthly basis at all other times. The bill would require that the reports contain information on staffing, including, until January 1, 2025, or the end of the declared COVID-19 emergency, whichever comes first, on matters relating to COVID-19 cases. The bill would require the department to publicly post the information and update it based on the same timeframes.If the hospital fails to comply with the above requirement, the bill would authorize the department to impose fines or other penalties, and to suspend, revoke, or refuse to renew the license of, the hospital, as specified.(2) Existing law requires certain building standards and regulations to prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served. Existing law requires the regulations to permit program flexibility using alternate methods, procedures, or other specified means, based on a written request and supporting evidence submitted by the applicant or licensee to the department.This bill would require a health facility to post any approval for program flexibility granted by the department immediately adjacent to the facilitys license and on the facilitys internet website, as specified.(3)This bill would incorporate additional changes to Section 1276 of the Health and Safety Code proposed by AB 1422 to be operative only if this bill and AB 1422 are enacted and this bill is enacted last.(3)(4) Existing law generally makes a violation of the licensure provisions for health facilities a misdemeanor.By expanding the scope of a crime under the above paragraphs, this bill would impose a state-mandated local program.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.
4231
4332 (1) Existing law provides for the licensure and regulation of certain health facilities, including general acute care hospitals, by the State Department of Public Health.
4433
45-
46-
47-This bill would require a general acute care hospital to report specified information to the department on a form and schedule determined by the department, and would require the department to publicly post the information on a weekly basis during any health-related state of emergency in California proclaimed by the President of the United States or by the Governor, and on a monthly basis at all other times. The bill would require that the reports contain information on staffing, including, until January 1, 2025, or the end of the declared COVID-19 emergency, whichever comes first, on matters relating to COVID-19 cases.
48-
49-
34+This bill would require a general acute care hospital to report specified information to the department on a form and schedule determined by the department, and would require the department to publicly post the information on a weekly basis during any health-related state of emergency in California proclaimed by the President of the United States or by the Governor, and on a monthly basis at all other times. The bill would require that the reports contain information on staffing, including, until January 1, 2025, or the end of the declared COVID-19 emergency, whichever comes first, on matters relating to COVID-19 cases. The bill would require the department to publicly post the information and update it based on the same timeframes.
5035
5136 If the hospital fails to comply with the above requirement, the bill would authorize the department to impose fines or other penalties, and to suspend, revoke, or refuse to renew the license of, the hospital, as specified.
5237
53-
54-
5538 (2) Existing law requires certain building standards and regulations to prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served. Existing law requires the regulations to permit program flexibility using alternate methods, procedures, or other specified means, based on a written request and supporting evidence submitted by the applicant or licensee to the department.
56-
57-
5839
5940 This bill would require a health facility to post any approval for program flexibility granted by the department immediately adjacent to the facilitys license and on the facilitys internet website, as specified.
6041
42+(3)This bill would incorporate additional changes to Section 1276 of the Health and Safety Code proposed by AB 1422 to be operative only if this bill and AB 1422 are enacted and this bill is enacted last.
6143
62-
63-(3)This bill would incorporate additional changes to Section 1276 of the Health and Safety Code proposed by AB 1422 to be operative only if this bill and AB 1422 are enacted and this bill is enacted last.
44+(3)
6445
6546
6647
6748 (4) Existing law generally makes a violation of the licensure provisions for health facilities a misdemeanor.
6849
69-
70-
7150 By expanding the scope of a crime under the above paragraphs, this bill would impose a state-mandated local program.
72-
73-
7451
7552 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.
7653
77-
78-
7954 This bill would provide that no reimbursement is required by this act for a specified reason.
80-
81-
8255
8356 ## Digest Key
8457
8558 ## Bill Text
8659
87-The people of the State of California do enact as follows:SECTION 1. Section 19962 of the Business and Professions Code is amended to read:19962. (a) Neither the The governing body nor or the electors of a county, city, or city and county that has not authorized legal gaming within its boundaries prior to January 1, 1996, shall not authorize legal gaming.(b) An ordinance in effect on January 1, 1996, that authorizes legal gaming within a city, county, or city and county may shall not be amended to expand gaming in that jurisdiction beyond that permitted on January 1, 1996.(c) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.SEC. 2. Section 19963 of the Business and Professions Code is amended to read:19963. (a) In addition to any other limitations on the expansion of gambling imposed by Section 19962 or any provision of this chapter, the commission may shall not issue a gambling license for a gambling establishment that was not licensed to operate on December 31, 1999, unless an application to operate that establishment was on file with the department prior to September 1, 2000.(b) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.SECTION 1.Section 1275.9 is added to the Health and Safety Code, to read:1275.9.(a)A general acute care hospital, as defined in subdivision (a) of Section 1250, shall report information, including, but not limited to, staffing, including staffing shortages, bed counts, and patient census, to the department on a form and schedule determined by the department.(b)The department shall publicly post information received pursuant to this section and update it on a weekly basis during a statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, and on a monthly basis at all other times.(c)Notwithstanding any other law, the department may, without taking any regulatory action pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, require general acute care hospitals to submit data by means of an All Facilities Letter (AFL). Except in the case of an emergency or other circumstance when delay may impact patient health and safety, when using the AFL process to require specified data submission, the department will do so in consultation with stakeholders.(d)This section does not limit the departments ability to request or require hospitals to report additional information not listed in this section or on a more frequent schedule.(e)Pursuant to subdivision (a), a general acute care hospital shall report the following information regarding staffing:(1)Whether the hospital is experiencing staffing shortage of nurses since the last time of reporting. (2)Whether the hospital experienced any layoffs of nurses since the time of last reporting and, if so, how many nurses and on what calendar day were they laid off.(3)Whether the hospital experienced any furloughs of nurses since the time of last reporting and if so, how many nurses were furloughed and on what calendar day were they furloughed.(4)Whether the hospital experienced any repeated cancellation of shifts of nurses since the time of last reporting. Repeated cancellation means more than two shifts canceled by the employer within a one-calendar-month period. Reports of cancelled shifts shall include information regarding the unit the nurses were scheduled to work in and the reason for the cancellation.(f)Until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, pursuant to subdivision (a), a general acute care hospital shall also report the following information regarding staffing:(1)Numeric total of COVID-19-positive staff, including the total number of staff and facility personnel who have tested positive for COVID-19, whether by laboratory confirmation or clinical diagnosis. Reports of COVID-19-positive staff shall include the numbers of COVID-19-positive staff for each reporting period and as a total number since the first report.(2)Numeric total of newly suspected COVID-19-positive staff, including the total number of staff and facility personnel routinely scheduled to work at the hospital, but not necessarily present at the time of data entry, who are being managed as though they have COVID-19 but who do not have a positive laboratory test result.(3)Numeric total of new COVID-19-related deaths of staff, including the total number of deaths of staff and facility personnel routinely scheduled to work at the hospital and with suspected or laboratory-confirmed COVID-19, that occurred on the previous calendar day.(g)If a general acute care hospital fails to comply with this section, the department may impose fines or other penalties on, and may suspend, revoke, or refuse to renew the license of, the hospital in accordance with any applicable provisions of this chapter.(h)For purposes of this section, the following definitions apply:(1)COVID-19 means the 2019 novel coronavirus disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).(2)General acute care hospital has the same meaning as defined in subdivision (a) of Section 1250.SEC. 2.Section 1276 of the Health and Safety Code is amended to read:1276.(a)The building standards published in the California Building Standards Code by the Department of Health Care Access and Information, and the regulations adopted by the department shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b)These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department or the Department of Health Care Access and Information, as applicable. The approval of the department or the Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or the Department of Health Care Access and Information, regarding the exception, as applicable.(c)While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the department expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d)(1)The department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the department for program flexibility in the prescribed manner. After the department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2)A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e)Notwithstanding any other law or regulation, the department shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.SEC. 2.5.Section 1276 of the Health and Safety Code is amended to read:1276.(a)The building standards published in the California Building Standards Code by the Department of Health Care Access and Information, and the regulations adopted by the State Department of Public Health shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b)These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the State Department of Public Health or the Department of Health Care Access and Information, as applicable. The approval of the department or the Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or Department of Health Care Access and Information regarding the exception, as applicable.(c)While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the State Department of Public Health expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d)(1)The department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the department for program flexibility in the prescribed manner. After the department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2)A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e)To the extent that an application by a health facility for program flexibility, or for an extension of program flexibility, includes a request to allow the health facility to designate a bed or multiple beds in a critical care unit as requiring a lower level of care, including, but not limited to, the level of care provided in an intermediate care, step-down, telemetry, medical-surgical, specialty care, or pediatric services unit, that application shall be referred to as a critical care unit program flexibility request. This subdivision and subdivision (f) do not confer on the department any new or additional authority to modify staffing ratios.(f)(1)The department shall require, as support for a critical care unit program flexibility request, the applicant or licensee to submit supporting evidence that includes documentation establishing the need for program flexibility and that the proposed alternative will not jeopardize the health, safety, and well-being of patients and is needed for increased operational efficiency.(A)Any critical care unit program flexibility request, including supporting evidence submitted with the request, shall be posted on the departments publicly accessible internet website within five calendar days of receipt by the department.(B)The department, at the time it posts a health facilitys critical care unit program flexibility request, shall provide a method to electronically collect public comment specifically on the application for a period of 30 days.(C)The 60-day timeframe provided for in subdivision (d) shall not commence until a facilitys critical care unit program flexibility request and supporting evidence have been posted on the departments internet website.(2)(A)A health facility that makes a critical care unit program flexibility request shall comply with both of the following requirements:(i)Conspicuously post the critical care unit program flexibility request form and a notice next to its license stating that a critical care unit program flexibility request and supporting evidence have been submitted to the department.(ii)Immediately make its best effort to notify affected employees and employee representatives of the critical care unit program flexibility request and direction to where to find the request and supporting evidence, and where to provide public comment.(B)A facilitys critical care unit program flexibility request will not be deemed complete for purposes of the 60-day timeframe pursuant to subdivision (d) until the facility has complied with this paragraph.(3)In no event shall the department approve a health facilitys critical care unit program flexibility request for a period of more than one year.(4)Any approval of a health facilitys critical care unit program flexibility request may be revoked by the department at any time, including on the grounds that there is no longer a need for program flexibility, that the approved alternative jeopardizes the health, safety, and well-being of patients, or that the approved alternative does not adequately protect patient safety.(5)(A)The 30-day comment period required by subparagraph (B) of paragraph (1) shall not apply when a hospital submits a critical care unit program flexibility request due to a health care emergency. Critical care unit program flexibility requests approved pursuant to this paragraph shall not be effective for more than 90 days, and any request to extend the term of critical care unit program flexibility that was approved pursuant to this paragraph shall be subject to the regular process provided for in this subdivision.(B)For purposes of this paragraph, health care emergency means an unpredictable or unavoidable occurrence at unscheduled or unpredictable intervals relating to health care delivery requiring immediate medical interventions and care.(6)This subdivision shall become operative on January 1, 2023. (g)Notwithstanding any other law or regulation, the State Department of Public Health shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.(h)On or before February 1, 2023, the department shall post all of the following information on its internet website:(1)A list of applicants for critical care unit program flexibility and the date of the application.(2)A list of health facilities with approved critical care unit program flexibility and the effective start and end date of the approval.(3)If approved, the notification of approval for critical care unit program flexibility, which shall include the application for critical care unit program flexibility; the regulation or regulations impacted; beds, units, or departments affected; and any conditions placed on the approval.(4)A department contact for the public to submit a complaint related to an approved critical care unit program flexibility.SEC. 3.Section 2.5 of this bill incorporates amendments to Section 1276 of the Health and Safety Code proposed by both this bill and Assembly Bill 1422. That section of this bill shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2022, (2) each bill amends Section 1276 of the Health and Safety Code, and (3) this bill is enacted after Assembly Bill 1422, in which case Section 2 of this bill shall not become operative.SEC. 4.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.
60+The people of the State of California do enact as follows:SECTION 1. Section 1275.9 is added to the Health and Safety Code, to read:1275.9.(a)During any statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, a general acute care hospital shall report the information described in subdivision (c) to the department on a weekly basis. At all other times, the general acute care hospital shall report that information to the department on a monthly basis.(b)The department shall publicly post information received pursuant to this section and update it on a weekly basis during the state of emergency described in subdivision (a) and on a monthly basis at all other times.(c)1275.9. (a) A general acute care hospital, as defined in subdivision (a) of Section 1250, shall report information, including, but not limited to, staffing, including staffing shortages, bed counts, and patient census, to the department on a form and schedule determined by the department.(b) The department shall publicly post information received pursuant to this section and update it on a weekly basis during a statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, and on a monthly basis at all other times.(c) Notwithstanding any other law, the department may, without taking any regulatory action pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, require general acute care hospitals to submit data by means of an All Facilities Letter (AFL). Except in the case of an emergency or other circumstance when delay may impact patient health and safety, when using the AFL process to require specified data submission, the department will do so in consultation with stakeholders.(d) This section does not limit the departments ability to request or require hospitals to report additional information not listed in this section or on a more frequent schedule.(e) Pursuant to subdivision (a), a general acute care hospital shall report the following information regarding staffing:(1) Whether the hospital is experiencing staffing shortage of nurses since the last time of reporting. (2) Whether the hospital experienced any layoffs of nurses since the time of last reporting and, if so, how many nurses and on what calendar day were they laid off.(3) Whether the hospital experienced any furloughs of nurses since the time of last reporting and if so, how many nurses were furloughed and on what calendar day were they furloughed.(4) Whether the hospital experienced any repeated cancellation of shifts of nurses since the time of last reporting. Repeated cancellation means more than two shifts canceled by the employer within a one-calendar-month period. Reports of cancelled shifts shall include information regarding the unit the nurses were scheduled to work in and the reason for the cancellation.(f) Until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, pursuant to subdivision (a), a general acute care hospital shall also report the following information regarding staffing:(5)(1) Numeric total of COVID-19-positive staff, including the total number of staff and facility personnel who have tested positive for COVID-19, whether by laboratory confirmation or clinical diagnosis. Reports of COVID-19-positive staff shall include the numbers of COVID-19-positive staff for each reporting period and as a total number since the first report.(6)(2) Numeric total of newly suspected COVID-19-positive staff, including the total number of staff and facility personnel routinely scheduled to work at the hospital, but not necessarily present at the time of data entry, who are being managed as though they have COVID-19 but who do not have a positive laboratory test result.(7)(3) Numeric total of new COVID-19-related deaths of staff, including the total number of deaths of staff and facility personnel routinely scheduled to work at the hospital and with suspected or laboratory-confirmed COVID-19, that occurred on the previous calendar day.(d)(g) If a general acute care hospital fails to comply with this section, the department may impose fines or other penalties on, and may suspend, revoke, or refuse to renew the license of, the hospital in accordance with any applicable provisions of this chapter.(e)(h) For purposes of this section, the following definitions apply:(1) COVID-19 means the 2019 novel coronavirus disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).(2) General acute care hospital has the same meaning as defined in subdivision (a) of Section 1250.(f)This section shall remain in effect only until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, and as of that date is repealed.SEC. 2.Section 1275.9 is added to the Health and Safety Code, to read:1275.9.(a)During any statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, a general acute care hospital shall report the information described in subdivision (c) to the department on a weekly basis. At all other times, the general acute care hospital shall report that information to the department on a monthly basis.(b)The department shall publicly post information received pursuant to this section and update it on a weekly basis during the state of emergency described in subdivision (a) and on a monthly basis at all other times.(c)Pursuant to subdivision (a), a general acute care hospital shall report the following information regarding staffing:(1)Whether the hospital is experiencing staffing shortage of nurses since the last time of reporting.(2)Whether the hospital experienced any layoffs of nurses since the time of last reporting and, if so, how many nurses and on what calendar day were they laid off.(3)Whether the hospital experienced any furloughs of nurses since the time of last reporting and, if so, how many nurses were furloughed and on what calendar day were they furloughed.(4)Whether the hospital experienced any repeated cancellation of shifts of nurses since the time of last reporting. Repeated cancellation means more than two shifts canceled by the employer within a one-calendar-month period. Reports of cancelled shifts shall include information regarding the unit the nurses were scheduled to work in and the reason for the cancellation.(d)If a general acute care hospital fails to comply with this section, the department may impose fines or other penalties on, and may suspend, revoke, or refuse to renew the license of, the hospital in accordance with any applicable provisions of this chapter.(e)For purposes of this section, general acute care hospital has the same meaning as defined in subdivision (a) of Section 1250.(f)This section shall become operative on January 1, 2025.SEC. 3.SEC. 2. Section 1276 of the Health and Safety Code is amended to read:1276. (a) The building standards published in the California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the department shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office the Department of Health Care Access and Information, regarding the exception, as applicable.(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the department expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d) (1) The department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the department for program flexibility in the prescribed manner. After the department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e) Notwithstanding any other law or regulation, the department shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.SEC. 2.5. Section 1276 of the Health and Safety Code is amended to read:1276. (a) The building standards published in the State California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the state department State Department of Public Health shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department State Department of Public Health or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office Department of Health Care Access and Information regarding the exception, as applicable.(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the state department State Department of Public Health expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d) (1) The state department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the state department for program flexibility in the prescribed manner. After the state department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e) To the extent that an application by a health facility for program flexibility, or for an extension of program flexibility, includes a request to allow the health facility to designate a bed or multiple beds in a critical care unit as requiring a lower level of care, including, but not limited to, the level of care provided in an intermediate care, step-down, telemetry, medical-surgical, specialty care, or pediatric services unit, that application shall be referred to as a critical care unit program flexibility request. This subdivision and subdivision (f) do not confer on the department any new or additional authority to modify staffing ratios.(f) (1) The department shall require, as support for a critical care unit program flexibility request, the applicant or licensee to submit supporting evidence that includes documentation establishing the need for program flexibility and that the proposed alternative will not jeopardize the health, safety, and well-being of patients and is needed for increased operational efficiency.(A) Any critical care unit program flexibility request, including supporting evidence submitted with the request, shall be posted on the departments publicly accessible internet website within five calendar days of receipt by the department.(B) The department, at the time it posts a health facilitys critical care unit program flexibility request, shall provide a method to electronically collect public comment specifically on the application for a period of 30 days.(C) The 60-day timeframe provided for in subdivision (d) shall not commence until a facilitys critical care unit program flexibility request and supporting evidence have been posted on the departments internet website.(2) (A) A health facility that makes a critical care unit program flexibility request shall comply with both of the following requirements:(i) Conspicuously post the critical care unit program flexibility request form and a notice next to its license stating that a critical care unit program flexibility request and supporting evidence have been submitted to the department.(ii) Immediately make its best effort to notify affected employees and employee representatives of the critical care unit program flexibility request and direction to where to find the request and supporting evidence, and where to provide public comment.(B) A facilitys critical care unit program flexibility request will not be deemed complete for purposes of the 60-day timeframe pursuant to subdivision (d) until the facility has complied with this paragraph.(3) In no event shall the department approve a health facilitys critical care unit program flexibility request for a period of more than one year.(4) Any approval of a health facilitys critical care unit program flexibility request may be revoked by the department at any time, including on the grounds that there is no longer a need for program flexibility, that the approved alternative jeopardizes the health, safety, and well-being of patients, or that the approved alternative does not adequately protect patient safety.(5) (A) The 30-day comment period required by subparagraph (B) of paragraph (1) shall not apply when a hospital submits a critical care unit program flexibility request due to a health care emergency. Critical care unit program flexibility requests approved pursuant to this paragraph shall not be effective for more than 90 days, and any request to extend the term of critical care unit program flexibility that was approved pursuant to this paragraph shall be subject to the regular process provided for in this subdivision.(B) For purposes of this paragraph, health care emergency means an unpredictable or unavoidable occurrence at unscheduled or unpredictable intervals relating to health care delivery requiring immediate medical interventions and care.(6) This subdivision shall become operative on January 1, 2023. (e)(g) Notwithstanding any other provision of law or regulation, the State Department of Health Services Public Health shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.(h) On or before February 1, 2023, the department shall post all of the following information on its internet website:(1) A list of applicants for critical care unit program flexibility and the date of the application.(2) A list of health facilities with approved critical care unit program flexibility and the effective start and end date of the approval.(3) If approved, the notification of approval for critical care unit program flexibility, which shall include the application for critical care unit program flexibility; the regulation or regulations impacted; beds, units, or departments affected; and any conditions placed on the approval.(4) A department contact for the public to submit a complaint related to an approved critical care unit program flexibility.SEC. 3. Section 2.5 of this bill incorporates amendments to Section 1276 of the Health and Safety Code proposed by both this bill and Assembly Bill 1422. That section of this bill shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2022, (2) each bill amends Section 1276 of the Health and Safety Code, and (3) this bill is enacted after Assembly Bill 1442, in which case Section 2 of this bill shall not become operative.SEC. 4. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
8861
8962 The people of the State of California do enact as follows:
9063
9164 ## The people of the State of California do enact as follows:
9265
93-SECTION 1. Section 19962 of the Business and Professions Code is amended to read:19962. (a) Neither the The governing body nor or the electors of a county, city, or city and county that has not authorized legal gaming within its boundaries prior to January 1, 1996, shall not authorize legal gaming.(b) An ordinance in effect on January 1, 1996, that authorizes legal gaming within a city, county, or city and county may shall not be amended to expand gaming in that jurisdiction beyond that permitted on January 1, 1996.(c) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.
66+SECTION 1. Section 1275.9 is added to the Health and Safety Code, to read:1275.9.(a)During any statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, a general acute care hospital shall report the information described in subdivision (c) to the department on a weekly basis. At all other times, the general acute care hospital shall report that information to the department on a monthly basis.(b)The department shall publicly post information received pursuant to this section and update it on a weekly basis during the state of emergency described in subdivision (a) and on a monthly basis at all other times.(c)1275.9. (a) A general acute care hospital, as defined in subdivision (a) of Section 1250, shall report information, including, but not limited to, staffing, including staffing shortages, bed counts, and patient census, to the department on a form and schedule determined by the department.(b) The department shall publicly post information received pursuant to this section and update it on a weekly basis during a statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, and on a monthly basis at all other times.(c) Notwithstanding any other law, the department may, without taking any regulatory action pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, require general acute care hospitals to submit data by means of an All Facilities Letter (AFL). Except in the case of an emergency or other circumstance when delay may impact patient health and safety, when using the AFL process to require specified data submission, the department will do so in consultation with stakeholders.(d) This section does not limit the departments ability to request or require hospitals to report additional information not listed in this section or on a more frequent schedule.(e) Pursuant to subdivision (a), a general acute care hospital shall report the following information regarding staffing:(1) Whether the hospital is experiencing staffing shortage of nurses since the last time of reporting. (2) Whether the hospital experienced any layoffs of nurses since the time of last reporting and, if so, how many nurses and on what calendar day were they laid off.(3) Whether the hospital experienced any furloughs of nurses since the time of last reporting and if so, how many nurses were furloughed and on what calendar day were they furloughed.(4) Whether the hospital experienced any repeated cancellation of shifts of nurses since the time of last reporting. Repeated cancellation means more than two shifts canceled by the employer within a one-calendar-month period. Reports of cancelled shifts shall include information regarding the unit the nurses were scheduled to work in and the reason for the cancellation.(f) Until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, pursuant to subdivision (a), a general acute care hospital shall also report the following information regarding staffing:(5)(1) Numeric total of COVID-19-positive staff, including the total number of staff and facility personnel who have tested positive for COVID-19, whether by laboratory confirmation or clinical diagnosis. Reports of COVID-19-positive staff shall include the numbers of COVID-19-positive staff for each reporting period and as a total number since the first report.(6)(2) Numeric total of newly suspected COVID-19-positive staff, including the total number of staff and facility personnel routinely scheduled to work at the hospital, but not necessarily present at the time of data entry, who are being managed as though they have COVID-19 but who do not have a positive laboratory test result.(7)(3) Numeric total of new COVID-19-related deaths of staff, including the total number of deaths of staff and facility personnel routinely scheduled to work at the hospital and with suspected or laboratory-confirmed COVID-19, that occurred on the previous calendar day.(d)(g) If a general acute care hospital fails to comply with this section, the department may impose fines or other penalties on, and may suspend, revoke, or refuse to renew the license of, the hospital in accordance with any applicable provisions of this chapter.(e)(h) For purposes of this section, the following definitions apply:(1) COVID-19 means the 2019 novel coronavirus disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).(2) General acute care hospital has the same meaning as defined in subdivision (a) of Section 1250.(f)This section shall remain in effect only until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, and as of that date is repealed.
9467
95-SECTION 1. Section 19962 of the Business and Professions Code is amended to read:
68+SECTION 1. Section 1275.9 is added to the Health and Safety Code, to read:
9669
9770 ### SECTION 1.
9871
99-19962. (a) Neither the The governing body nor or the electors of a county, city, or city and county that has not authorized legal gaming within its boundaries prior to January 1, 1996, shall not authorize legal gaming.(b) An ordinance in effect on January 1, 1996, that authorizes legal gaming within a city, county, or city and county may shall not be amended to expand gaming in that jurisdiction beyond that permitted on January 1, 1996.(c) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.
100-
101-19962. (a) Neither the The governing body nor or the electors of a county, city, or city and county that has not authorized legal gaming within its boundaries prior to January 1, 1996, shall not authorize legal gaming.(b) An ordinance in effect on January 1, 1996, that authorizes legal gaming within a city, county, or city and county may shall not be amended to expand gaming in that jurisdiction beyond that permitted on January 1, 1996.(c) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.
102-
103-19962. (a) Neither the The governing body nor or the electors of a county, city, or city and county that has not authorized legal gaming within its boundaries prior to January 1, 1996, shall not authorize legal gaming.(b) An ordinance in effect on January 1, 1996, that authorizes legal gaming within a city, county, or city and county may shall not be amended to expand gaming in that jurisdiction beyond that permitted on January 1, 1996.(c) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.
72+1275.9.(a)During any statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, a general acute care hospital shall report the information described in subdivision (c) to the department on a weekly basis. At all other times, the general acute care hospital shall report that information to the department on a monthly basis.(b)The department shall publicly post information received pursuant to this section and update it on a weekly basis during the state of emergency described in subdivision (a) and on a monthly basis at all other times.(c)1275.9. (a) A general acute care hospital, as defined in subdivision (a) of Section 1250, shall report information, including, but not limited to, staffing, including staffing shortages, bed counts, and patient census, to the department on a form and schedule determined by the department.(b) The department shall publicly post information received pursuant to this section and update it on a weekly basis during a statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, and on a monthly basis at all other times.(c) Notwithstanding any other law, the department may, without taking any regulatory action pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, require general acute care hospitals to submit data by means of an All Facilities Letter (AFL). Except in the case of an emergency or other circumstance when delay may impact patient health and safety, when using the AFL process to require specified data submission, the department will do so in consultation with stakeholders.(d) This section does not limit the departments ability to request or require hospitals to report additional information not listed in this section or on a more frequent schedule.(e) Pursuant to subdivision (a), a general acute care hospital shall report the following information regarding staffing:(1) Whether the hospital is experiencing staffing shortage of nurses since the last time of reporting. (2) Whether the hospital experienced any layoffs of nurses since the time of last reporting and, if so, how many nurses and on what calendar day were they laid off.(3) Whether the hospital experienced any furloughs of nurses since the time of last reporting and if so, how many nurses were furloughed and on what calendar day were they furloughed.(4) Whether the hospital experienced any repeated cancellation of shifts of nurses since the time of last reporting. Repeated cancellation means more than two shifts canceled by the employer within a one-calendar-month period. Reports of cancelled shifts shall include information regarding the unit the nurses were scheduled to work in and the reason for the cancellation.(f) Until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, pursuant to subdivision (a), a general acute care hospital shall also report the following information regarding staffing:(5)(1) Numeric total of COVID-19-positive staff, including the total number of staff and facility personnel who have tested positive for COVID-19, whether by laboratory confirmation or clinical diagnosis. Reports of COVID-19-positive staff shall include the numbers of COVID-19-positive staff for each reporting period and as a total number since the first report.(6)(2) Numeric total of newly suspected COVID-19-positive staff, including the total number of staff and facility personnel routinely scheduled to work at the hospital, but not necessarily present at the time of data entry, who are being managed as though they have COVID-19 but who do not have a positive laboratory test result.(7)(3) Numeric total of new COVID-19-related deaths of staff, including the total number of deaths of staff and facility personnel routinely scheduled to work at the hospital and with suspected or laboratory-confirmed COVID-19, that occurred on the previous calendar day.(d)(g) If a general acute care hospital fails to comply with this section, the department may impose fines or other penalties on, and may suspend, revoke, or refuse to renew the license of, the hospital in accordance with any applicable provisions of this chapter.(e)(h) For purposes of this section, the following definitions apply:(1) COVID-19 means the 2019 novel coronavirus disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).(2) General acute care hospital has the same meaning as defined in subdivision (a) of Section 1250.(f)This section shall remain in effect only until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, and as of that date is repealed.
10473
10574
10675
107-19962. (a) Neither the The governing body nor or the electors of a county, city, or city and county that has not authorized legal gaming within its boundaries prior to January 1, 1996, shall not authorize legal gaming.
108-
109-(b) An ordinance in effect on January 1, 1996, that authorizes legal gaming within a city, county, or city and county may shall not be amended to expand gaming in that jurisdiction beyond that permitted on January 1, 1996.
110-
111-(c) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.
112-
113-SEC. 2. Section 19963 of the Business and Professions Code is amended to read:19963. (a) In addition to any other limitations on the expansion of gambling imposed by Section 19962 or any provision of this chapter, the commission may shall not issue a gambling license for a gambling establishment that was not licensed to operate on December 31, 1999, unless an application to operate that establishment was on file with the department prior to September 1, 2000.(b) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.
114-
115-SEC. 2. Section 19963 of the Business and Professions Code is amended to read:
116-
117-### SEC. 2.
118-
119-19963. (a) In addition to any other limitations on the expansion of gambling imposed by Section 19962 or any provision of this chapter, the commission may shall not issue a gambling license for a gambling establishment that was not licensed to operate on December 31, 1999, unless an application to operate that establishment was on file with the department prior to September 1, 2000.(b) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.
120-
121-19963. (a) In addition to any other limitations on the expansion of gambling imposed by Section 19962 or any provision of this chapter, the commission may shall not issue a gambling license for a gambling establishment that was not licensed to operate on December 31, 1999, unless an application to operate that establishment was on file with the department prior to September 1, 2000.(b) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.
122-
123-19963. (a) In addition to any other limitations on the expansion of gambling imposed by Section 19962 or any provision of this chapter, the commission may shall not issue a gambling license for a gambling establishment that was not licensed to operate on December 31, 1999, unless an application to operate that establishment was on file with the department prior to September 1, 2000.(b) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.
76+(a)During any statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, a general acute care hospital shall report the information described in subdivision (c) to the department on a weekly basis. At all other times, the general acute care hospital shall report that information to the department on a monthly basis.
12477
12578
12679
127-19963. (a) In addition to any other limitations on the expansion of gambling imposed by Section 19962 or any provision of this chapter, the commission may shall not issue a gambling license for a gambling establishment that was not licensed to operate on December 31, 1999, unless an application to operate that establishment was on file with the department prior to September 1, 2000.
80+(b)The department shall publicly post information received pursuant to this section and update it on a weekly basis during the state of emergency described in subdivision (a) and on a monthly basis at all other times.
12881
129-(b) This section shall remain in effect only until January 1, 2023, 2024, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2023, deletes or extends that date. repealed.
82+
83+
84+(c)
85+
86+
87+
88+1275.9. (a) A general acute care hospital, as defined in subdivision (a) of Section 1250, shall report information, including, but not limited to, staffing, including staffing shortages, bed counts, and patient census, to the department on a form and schedule determined by the department.(b) The department shall publicly post information received pursuant to this section and update it on a weekly basis during a statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, and on a monthly basis at all other times.(c) Notwithstanding any other law, the department may, without taking any regulatory action pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, require general acute care hospitals to submit data by means of an All Facilities Letter (AFL). Except in the case of an emergency or other circumstance when delay may impact patient health and safety, when using the AFL process to require specified data submission, the department will do so in consultation with stakeholders.(d) This section does not limit the departments ability to request or require hospitals to report additional information not listed in this section or on a more frequent schedule.(e) Pursuant to subdivision (a), a general acute care hospital shall report the following information regarding staffing:(1) Whether the hospital is experiencing staffing shortage of nurses since the last time of reporting. (2) Whether the hospital experienced any layoffs of nurses since the time of last reporting and, if so, how many nurses and on what calendar day were they laid off.(3) Whether the hospital experienced any furloughs of nurses since the time of last reporting and if so, how many nurses were furloughed and on what calendar day were they furloughed.(4) Whether the hospital experienced any repeated cancellation of shifts of nurses since the time of last reporting. Repeated cancellation means more than two shifts canceled by the employer within a one-calendar-month period. Reports of cancelled shifts shall include information regarding the unit the nurses were scheduled to work in and the reason for the cancellation.(f) Until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, pursuant to subdivision (a), a general acute care hospital shall also report the following information regarding staffing:(5)(1) Numeric total of COVID-19-positive staff, including the total number of staff and facility personnel who have tested positive for COVID-19, whether by laboratory confirmation or clinical diagnosis. Reports of COVID-19-positive staff shall include the numbers of COVID-19-positive staff for each reporting period and as a total number since the first report.(6)(2) Numeric total of newly suspected COVID-19-positive staff, including the total number of staff and facility personnel routinely scheduled to work at the hospital, but not necessarily present at the time of data entry, who are being managed as though they have COVID-19 but who do not have a positive laboratory test result.(7)(3) Numeric total of new COVID-19-related deaths of staff, including the total number of deaths of staff and facility personnel routinely scheduled to work at the hospital and with suspected or laboratory-confirmed COVID-19, that occurred on the previous calendar day.(d)(g) If a general acute care hospital fails to comply with this section, the department may impose fines or other penalties on, and may suspend, revoke, or refuse to renew the license of, the hospital in accordance with any applicable provisions of this chapter.(e)(h) For purposes of this section, the following definitions apply:(1) COVID-19 means the 2019 novel coronavirus disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).(2) General acute care hospital has the same meaning as defined in subdivision (a) of Section 1250.(f)This section shall remain in effect only until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, and as of that date is repealed.
89+
90+1275.9. (a) A general acute care hospital, as defined in subdivision (a) of Section 1250, shall report information, including, but not limited to, staffing, including staffing shortages, bed counts, and patient census, to the department on a form and schedule determined by the department.(b) The department shall publicly post information received pursuant to this section and update it on a weekly basis during a statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, and on a monthly basis at all other times.(c) Notwithstanding any other law, the department may, without taking any regulatory action pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, require general acute care hospitals to submit data by means of an All Facilities Letter (AFL). Except in the case of an emergency or other circumstance when delay may impact patient health and safety, when using the AFL process to require specified data submission, the department will do so in consultation with stakeholders.(d) This section does not limit the departments ability to request or require hospitals to report additional information not listed in this section or on a more frequent schedule.(e) Pursuant to subdivision (a), a general acute care hospital shall report the following information regarding staffing:(1) Whether the hospital is experiencing staffing shortage of nurses since the last time of reporting. (2) Whether the hospital experienced any layoffs of nurses since the time of last reporting and, if so, how many nurses and on what calendar day were they laid off.(3) Whether the hospital experienced any furloughs of nurses since the time of last reporting and if so, how many nurses were furloughed and on what calendar day were they furloughed.(4) Whether the hospital experienced any repeated cancellation of shifts of nurses since the time of last reporting. Repeated cancellation means more than two shifts canceled by the employer within a one-calendar-month period. Reports of cancelled shifts shall include information regarding the unit the nurses were scheduled to work in and the reason for the cancellation.(f) Until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, pursuant to subdivision (a), a general acute care hospital shall also report the following information regarding staffing:(5)(1) Numeric total of COVID-19-positive staff, including the total number of staff and facility personnel who have tested positive for COVID-19, whether by laboratory confirmation or clinical diagnosis. Reports of COVID-19-positive staff shall include the numbers of COVID-19-positive staff for each reporting period and as a total number since the first report.(6)(2) Numeric total of newly suspected COVID-19-positive staff, including the total number of staff and facility personnel routinely scheduled to work at the hospital, but not necessarily present at the time of data entry, who are being managed as though they have COVID-19 but who do not have a positive laboratory test result.(7)(3) Numeric total of new COVID-19-related deaths of staff, including the total number of deaths of staff and facility personnel routinely scheduled to work at the hospital and with suspected or laboratory-confirmed COVID-19, that occurred on the previous calendar day.(d)(g) If a general acute care hospital fails to comply with this section, the department may impose fines or other penalties on, and may suspend, revoke, or refuse to renew the license of, the hospital in accordance with any applicable provisions of this chapter.(e)(h) For purposes of this section, the following definitions apply:(1) COVID-19 means the 2019 novel coronavirus disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).(2) General acute care hospital has the same meaning as defined in subdivision (a) of Section 1250.(f)This section shall remain in effect only until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, and as of that date is repealed.
91+
92+1275.9. (a) A general acute care hospital, as defined in subdivision (a) of Section 1250, shall report information, including, but not limited to, staffing, including staffing shortages, bed counts, and patient census, to the department on a form and schedule determined by the department.(b) The department shall publicly post information received pursuant to this section and update it on a weekly basis during a statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, and on a monthly basis at all other times.(c) Notwithstanding any other law, the department may, without taking any regulatory action pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, require general acute care hospitals to submit data by means of an All Facilities Letter (AFL). Except in the case of an emergency or other circumstance when delay may impact patient health and safety, when using the AFL process to require specified data submission, the department will do so in consultation with stakeholders.(d) This section does not limit the departments ability to request or require hospitals to report additional information not listed in this section or on a more frequent schedule.
93+
94+1275.9. (a) A general acute care hospital, as defined in subdivision (a) of Section 1250, shall report information, including, but not limited to, staffing, including staffing shortages, bed counts, and patient census, to the department on a form and schedule determined by the department.
95+
96+(b) The department shall publicly post information received pursuant to this section and update it on a weekly basis during a statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, and on a monthly basis at all other times.
97+
98+(c) Notwithstanding any other law, the department may, without taking any regulatory action pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, require general acute care hospitals to submit data by means of an All Facilities Letter (AFL). Except in the case of an emergency or other circumstance when delay may impact patient health and safety, when using the AFL process to require specified data submission, the department will do so in consultation with stakeholders.
99+
100+(d) This section does not limit the departments ability to request or require hospitals to report additional information not listed in this section or on a more frequent schedule.
101+
102+(e) Pursuant to subdivision (a), a general acute care hospital shall report the following information regarding staffing:
103+
104+(1) Whether the hospital is experiencing staffing shortage of nurses since the last time of reporting.
105+
106+(2) Whether the hospital experienced any layoffs of nurses since the time of last reporting and, if so, how many nurses and on what calendar day were they laid off.
107+
108+(3) Whether the hospital experienced any furloughs of nurses since the time of last reporting and if so, how many nurses were furloughed and on what calendar day were they furloughed.
109+
110+(4) Whether the hospital experienced any repeated cancellation of shifts of nurses since the time of last reporting. Repeated cancellation means more than two shifts canceled by the employer within a one-calendar-month period. Reports of cancelled shifts shall include information regarding the unit the nurses were scheduled to work in and the reason for the cancellation.
111+
112+(f) Until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, pursuant to subdivision (a), a general acute care hospital shall also report the following information regarding staffing:
113+
114+(5)
115+
116+
117+
118+(1) Numeric total of COVID-19-positive staff, including the total number of staff and facility personnel who have tested positive for COVID-19, whether by laboratory confirmation or clinical diagnosis. Reports of COVID-19-positive staff shall include the numbers of COVID-19-positive staff for each reporting period and as a total number since the first report.
119+
120+(6)
121+
122+
123+
124+(2) Numeric total of newly suspected COVID-19-positive staff, including the total number of staff and facility personnel routinely scheduled to work at the hospital, but not necessarily present at the time of data entry, who are being managed as though they have COVID-19 but who do not have a positive laboratory test result.
125+
126+(7)
127+
128+
129+
130+(3) Numeric total of new COVID-19-related deaths of staff, including the total number of deaths of staff and facility personnel routinely scheduled to work at the hospital and with suspected or laboratory-confirmed COVID-19, that occurred on the previous calendar day.
131+
132+(d)
133+
134+
135+
136+(g) If a general acute care hospital fails to comply with this section, the department may impose fines or other penalties on, and may suspend, revoke, or refuse to renew the license of, the hospital in accordance with any applicable provisions of this chapter.
137+
138+(e)
139+
140+
141+
142+(h) For purposes of this section, the following definitions apply:
143+
144+(1) COVID-19 means the 2019 novel coronavirus disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
145+
146+(2) General acute care hospital has the same meaning as defined in subdivision (a) of Section 1250.
147+
148+(f)This section shall remain in effect only until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, and as of that date is repealed.
130149
131150
132151
133152
134153
135-(a)A general acute care hospital, as defined in subdivision (a) of Section 1250, shall report information, including, but not limited to, staffing, including staffing shortages, bed counts, and patient census, to the department on a form and schedule determined by the department.
154+
155+
156+(a)During any statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, a general acute care hospital shall report the information described in subdivision (c) to the department on a weekly basis. At all other times, the general acute care hospital shall report that information to the department on a monthly basis.
136157
137158
138159
139-(b)The department shall publicly post information received pursuant to this section and update it on a weekly basis during a statewide health-related state of emergency in California proclaimed by the President of the United States or health-related state of emergency proclaimed by the Governor, and on a monthly basis at all other times.
160+(b)The department shall publicly post information received pursuant to this section and update it on a weekly basis during the state of emergency described in subdivision (a) and on a monthly basis at all other times.
140161
141162
142163
143-(c)Notwithstanding any other law, the department may, without taking any regulatory action pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, require general acute care hospitals to submit data by means of an All Facilities Letter (AFL). Except in the case of an emergency or other circumstance when delay may impact patient health and safety, when using the AFL process to require specified data submission, the department will do so in consultation with stakeholders.
144-
145-
146-
147-(d)This section does not limit the departments ability to request or require hospitals to report additional information not listed in this section or on a more frequent schedule.
148-
149-
150-
151-(e)Pursuant to subdivision (a), a general acute care hospital shall report the following information regarding staffing:
164+(c)Pursuant to subdivision (a), a general acute care hospital shall report the following information regarding staffing:
152165
153166
154167
155168 (1)Whether the hospital is experiencing staffing shortage of nurses since the last time of reporting.
156169
157170
158171
159172 (2)Whether the hospital experienced any layoffs of nurses since the time of last reporting and, if so, how many nurses and on what calendar day were they laid off.
160173
161174
162175
163-(3)Whether the hospital experienced any furloughs of nurses since the time of last reporting and if so, how many nurses were furloughed and on what calendar day were they furloughed.
176+(3)Whether the hospital experienced any furloughs of nurses since the time of last reporting and, if so, how many nurses were furloughed and on what calendar day were they furloughed.
164177
165178
166179
167180 (4)Whether the hospital experienced any repeated cancellation of shifts of nurses since the time of last reporting. Repeated cancellation means more than two shifts canceled by the employer within a one-calendar-month period. Reports of cancelled shifts shall include information regarding the unit the nurses were scheduled to work in and the reason for the cancellation.
168181
169182
170183
171-(f)Until January 1, 2025, or when the Governor declares the end of the COVID-19 emergency, whichever comes first, pursuant to subdivision (a), a general acute care hospital shall also report the following information regarding staffing:
184+(d)If a general acute care hospital fails to comply with this section, the department may impose fines or other penalties on, and may suspend, revoke, or refuse to renew the license of, the hospital in accordance with any applicable provisions of this chapter.
172185
173186
174187
175-(1)Numeric total of COVID-19-positive staff, including the total number of staff and facility personnel who have tested positive for COVID-19, whether by laboratory confirmation or clinical diagnosis. Reports of COVID-19-positive staff shall include the numbers of COVID-19-positive staff for each reporting period and as a total number since the first report.
188+(e)For purposes of this section, general acute care hospital has the same meaning as defined in subdivision (a) of Section 1250.
176189
177190
178191
179-(2)Numeric total of newly suspected COVID-19-positive staff, including the total number of staff and facility personnel routinely scheduled to work at the hospital, but not necessarily present at the time of data entry, who are being managed as though they have COVID-19 but who do not have a positive laboratory test result.
192+(f)This section shall become operative on January 1, 2025.
180193
181194
182195
183-(3)Numeric total of new COVID-19-related deaths of staff, including the total number of deaths of staff and facility personnel routinely scheduled to work at the hospital and with suspected or laboratory-confirmed COVID-19, that occurred on the previous calendar day.
196+SEC. 3.SEC. 2. Section 1276 of the Health and Safety Code is amended to read:1276. (a) The building standards published in the California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the department shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office the Department of Health Care Access and Information, regarding the exception, as applicable.(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the department expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d) (1) The department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the department for program flexibility in the prescribed manner. After the department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e) Notwithstanding any other law or regulation, the department shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.
197+
198+SEC. 3.SEC. 2. Section 1276 of the Health and Safety Code is amended to read:
199+
200+### SEC. 3.SEC. 2.
201+
202+1276. (a) The building standards published in the California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the department shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office the Department of Health Care Access and Information, regarding the exception, as applicable.(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the department expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d) (1) The department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the department for program flexibility in the prescribed manner. After the department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e) Notwithstanding any other law or regulation, the department shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.
203+
204+1276. (a) The building standards published in the California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the department shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office the Department of Health Care Access and Information, regarding the exception, as applicable.(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the department expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d) (1) The department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the department for program flexibility in the prescribed manner. After the department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e) Notwithstanding any other law or regulation, the department shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.
205+
206+1276. (a) The building standards published in the California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the department shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office the Department of Health Care Access and Information, regarding the exception, as applicable.(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the department expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d) (1) The department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the department for program flexibility in the prescribed manner. After the department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e) Notwithstanding any other law or regulation, the department shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.
184207
185208
186209
187-(g)If a general acute care hospital fails to comply with this section, the department may impose fines or other penalties on, and may suspend, revoke, or refuse to renew the license of, the hospital in accordance with any applicable provisions of this chapter.
210+1276. (a) The building standards published in the California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the department shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.
211+
212+(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office the Department of Health Care Access and Information, regarding the exception, as applicable.
213+
214+(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the department expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.
215+
216+(d) (1) The department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the department for program flexibility in the prescribed manner. After the department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.
217+
218+(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.
219+
220+(e) Notwithstanding any other law or regulation, the department shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.
221+
222+SEC. 2.5. Section 1276 of the Health and Safety Code is amended to read:1276. (a) The building standards published in the State California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the state department State Department of Public Health shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department State Department of Public Health or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office Department of Health Care Access and Information regarding the exception, as applicable.(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the state department State Department of Public Health expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d) (1) The state department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the state department for program flexibility in the prescribed manner. After the state department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e) To the extent that an application by a health facility for program flexibility, or for an extension of program flexibility, includes a request to allow the health facility to designate a bed or multiple beds in a critical care unit as requiring a lower level of care, including, but not limited to, the level of care provided in an intermediate care, step-down, telemetry, medical-surgical, specialty care, or pediatric services unit, that application shall be referred to as a critical care unit program flexibility request. This subdivision and subdivision (f) do not confer on the department any new or additional authority to modify staffing ratios.(f) (1) The department shall require, as support for a critical care unit program flexibility request, the applicant or licensee to submit supporting evidence that includes documentation establishing the need for program flexibility and that the proposed alternative will not jeopardize the health, safety, and well-being of patients and is needed for increased operational efficiency.(A) Any critical care unit program flexibility request, including supporting evidence submitted with the request, shall be posted on the departments publicly accessible internet website within five calendar days of receipt by the department.(B) The department, at the time it posts a health facilitys critical care unit program flexibility request, shall provide a method to electronically collect public comment specifically on the application for a period of 30 days.(C) The 60-day timeframe provided for in subdivision (d) shall not commence until a facilitys critical care unit program flexibility request and supporting evidence have been posted on the departments internet website.(2) (A) A health facility that makes a critical care unit program flexibility request shall comply with both of the following requirements:(i) Conspicuously post the critical care unit program flexibility request form and a notice next to its license stating that a critical care unit program flexibility request and supporting evidence have been submitted to the department.(ii) Immediately make its best effort to notify affected employees and employee representatives of the critical care unit program flexibility request and direction to where to find the request and supporting evidence, and where to provide public comment.(B) A facilitys critical care unit program flexibility request will not be deemed complete for purposes of the 60-day timeframe pursuant to subdivision (d) until the facility has complied with this paragraph.(3) In no event shall the department approve a health facilitys critical care unit program flexibility request for a period of more than one year.(4) Any approval of a health facilitys critical care unit program flexibility request may be revoked by the department at any time, including on the grounds that there is no longer a need for program flexibility, that the approved alternative jeopardizes the health, safety, and well-being of patients, or that the approved alternative does not adequately protect patient safety.(5) (A) The 30-day comment period required by subparagraph (B) of paragraph (1) shall not apply when a hospital submits a critical care unit program flexibility request due to a health care emergency. Critical care unit program flexibility requests approved pursuant to this paragraph shall not be effective for more than 90 days, and any request to extend the term of critical care unit program flexibility that was approved pursuant to this paragraph shall be subject to the regular process provided for in this subdivision.(B) For purposes of this paragraph, health care emergency means an unpredictable or unavoidable occurrence at unscheduled or unpredictable intervals relating to health care delivery requiring immediate medical interventions and care.(6) This subdivision shall become operative on January 1, 2023. (e)(g) Notwithstanding any other provision of law or regulation, the State Department of Health Services Public Health shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.(h) On or before February 1, 2023, the department shall post all of the following information on its internet website:(1) A list of applicants for critical care unit program flexibility and the date of the application.(2) A list of health facilities with approved critical care unit program flexibility and the effective start and end date of the approval.(3) If approved, the notification of approval for critical care unit program flexibility, which shall include the application for critical care unit program flexibility; the regulation or regulations impacted; beds, units, or departments affected; and any conditions placed on the approval.(4) A department contact for the public to submit a complaint related to an approved critical care unit program flexibility.
223+
224+SEC. 2.5. Section 1276 of the Health and Safety Code is amended to read:
225+
226+### SEC. 2.5.
227+
228+1276. (a) The building standards published in the State California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the state department State Department of Public Health shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department State Department of Public Health or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office Department of Health Care Access and Information regarding the exception, as applicable.(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the state department State Department of Public Health expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d) (1) The state department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the state department for program flexibility in the prescribed manner. After the state department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e) To the extent that an application by a health facility for program flexibility, or for an extension of program flexibility, includes a request to allow the health facility to designate a bed or multiple beds in a critical care unit as requiring a lower level of care, including, but not limited to, the level of care provided in an intermediate care, step-down, telemetry, medical-surgical, specialty care, or pediatric services unit, that application shall be referred to as a critical care unit program flexibility request. This subdivision and subdivision (f) do not confer on the department any new or additional authority to modify staffing ratios.(f) (1) The department shall require, as support for a critical care unit program flexibility request, the applicant or licensee to submit supporting evidence that includes documentation establishing the need for program flexibility and that the proposed alternative will not jeopardize the health, safety, and well-being of patients and is needed for increased operational efficiency.(A) Any critical care unit program flexibility request, including supporting evidence submitted with the request, shall be posted on the departments publicly accessible internet website within five calendar days of receipt by the department.(B) The department, at the time it posts a health facilitys critical care unit program flexibility request, shall provide a method to electronically collect public comment specifically on the application for a period of 30 days.(C) The 60-day timeframe provided for in subdivision (d) shall not commence until a facilitys critical care unit program flexibility request and supporting evidence have been posted on the departments internet website.(2) (A) A health facility that makes a critical care unit program flexibility request shall comply with both of the following requirements:(i) Conspicuously post the critical care unit program flexibility request form and a notice next to its license stating that a critical care unit program flexibility request and supporting evidence have been submitted to the department.(ii) Immediately make its best effort to notify affected employees and employee representatives of the critical care unit program flexibility request and direction to where to find the request and supporting evidence, and where to provide public comment.(B) A facilitys critical care unit program flexibility request will not be deemed complete for purposes of the 60-day timeframe pursuant to subdivision (d) until the facility has complied with this paragraph.(3) In no event shall the department approve a health facilitys critical care unit program flexibility request for a period of more than one year.(4) Any approval of a health facilitys critical care unit program flexibility request may be revoked by the department at any time, including on the grounds that there is no longer a need for program flexibility, that the approved alternative jeopardizes the health, safety, and well-being of patients, or that the approved alternative does not adequately protect patient safety.(5) (A) The 30-day comment period required by subparagraph (B) of paragraph (1) shall not apply when a hospital submits a critical care unit program flexibility request due to a health care emergency. Critical care unit program flexibility requests approved pursuant to this paragraph shall not be effective for more than 90 days, and any request to extend the term of critical care unit program flexibility that was approved pursuant to this paragraph shall be subject to the regular process provided for in this subdivision.(B) For purposes of this paragraph, health care emergency means an unpredictable or unavoidable occurrence at unscheduled or unpredictable intervals relating to health care delivery requiring immediate medical interventions and care.(6) This subdivision shall become operative on January 1, 2023. (e)(g) Notwithstanding any other provision of law or regulation, the State Department of Health Services Public Health shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.(h) On or before February 1, 2023, the department shall post all of the following information on its internet website:(1) A list of applicants for critical care unit program flexibility and the date of the application.(2) A list of health facilities with approved critical care unit program flexibility and the effective start and end date of the approval.(3) If approved, the notification of approval for critical care unit program flexibility, which shall include the application for critical care unit program flexibility; the regulation or regulations impacted; beds, units, or departments affected; and any conditions placed on the approval.(4) A department contact for the public to submit a complaint related to an approved critical care unit program flexibility.
229+
230+1276. (a) The building standards published in the State California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the state department State Department of Public Health shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department State Department of Public Health or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office Department of Health Care Access and Information regarding the exception, as applicable.(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the state department State Department of Public Health expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d) (1) The state department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the state department for program flexibility in the prescribed manner. After the state department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e) To the extent that an application by a health facility for program flexibility, or for an extension of program flexibility, includes a request to allow the health facility to designate a bed or multiple beds in a critical care unit as requiring a lower level of care, including, but not limited to, the level of care provided in an intermediate care, step-down, telemetry, medical-surgical, specialty care, or pediatric services unit, that application shall be referred to as a critical care unit program flexibility request. This subdivision and subdivision (f) do not confer on the department any new or additional authority to modify staffing ratios.(f) (1) The department shall require, as support for a critical care unit program flexibility request, the applicant or licensee to submit supporting evidence that includes documentation establishing the need for program flexibility and that the proposed alternative will not jeopardize the health, safety, and well-being of patients and is needed for increased operational efficiency.(A) Any critical care unit program flexibility request, including supporting evidence submitted with the request, shall be posted on the departments publicly accessible internet website within five calendar days of receipt by the department.(B) The department, at the time it posts a health facilitys critical care unit program flexibility request, shall provide a method to electronically collect public comment specifically on the application for a period of 30 days.(C) The 60-day timeframe provided for in subdivision (d) shall not commence until a facilitys critical care unit program flexibility request and supporting evidence have been posted on the departments internet website.(2) (A) A health facility that makes a critical care unit program flexibility request shall comply with both of the following requirements:(i) Conspicuously post the critical care unit program flexibility request form and a notice next to its license stating that a critical care unit program flexibility request and supporting evidence have been submitted to the department.(ii) Immediately make its best effort to notify affected employees and employee representatives of the critical care unit program flexibility request and direction to where to find the request and supporting evidence, and where to provide public comment.(B) A facilitys critical care unit program flexibility request will not be deemed complete for purposes of the 60-day timeframe pursuant to subdivision (d) until the facility has complied with this paragraph.(3) In no event shall the department approve a health facilitys critical care unit program flexibility request for a period of more than one year.(4) Any approval of a health facilitys critical care unit program flexibility request may be revoked by the department at any time, including on the grounds that there is no longer a need for program flexibility, that the approved alternative jeopardizes the health, safety, and well-being of patients, or that the approved alternative does not adequately protect patient safety.(5) (A) The 30-day comment period required by subparagraph (B) of paragraph (1) shall not apply when a hospital submits a critical care unit program flexibility request due to a health care emergency. Critical care unit program flexibility requests approved pursuant to this paragraph shall not be effective for more than 90 days, and any request to extend the term of critical care unit program flexibility that was approved pursuant to this paragraph shall be subject to the regular process provided for in this subdivision.(B) For purposes of this paragraph, health care emergency means an unpredictable or unavoidable occurrence at unscheduled or unpredictable intervals relating to health care delivery requiring immediate medical interventions and care.(6) This subdivision shall become operative on January 1, 2023. (e)(g) Notwithstanding any other provision of law or regulation, the State Department of Health Services Public Health shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.(h) On or before February 1, 2023, the department shall post all of the following information on its internet website:(1) A list of applicants for critical care unit program flexibility and the date of the application.(2) A list of health facilities with approved critical care unit program flexibility and the effective start and end date of the approval.(3) If approved, the notification of approval for critical care unit program flexibility, which shall include the application for critical care unit program flexibility; the regulation or regulations impacted; beds, units, or departments affected; and any conditions placed on the approval.(4) A department contact for the public to submit a complaint related to an approved critical care unit program flexibility.
231+
232+1276. (a) The building standards published in the State California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the state department State Department of Public Health shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department State Department of Public Health or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office Department of Health Care Access and Information regarding the exception, as applicable.(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the state department State Department of Public Health expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.(d) (1) The state department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the state department for program flexibility in the prescribed manner. After the state department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.(e) To the extent that an application by a health facility for program flexibility, or for an extension of program flexibility, includes a request to allow the health facility to designate a bed or multiple beds in a critical care unit as requiring a lower level of care, including, but not limited to, the level of care provided in an intermediate care, step-down, telemetry, medical-surgical, specialty care, or pediatric services unit, that application shall be referred to as a critical care unit program flexibility request. This subdivision and subdivision (f) do not confer on the department any new or additional authority to modify staffing ratios.(f) (1) The department shall require, as support for a critical care unit program flexibility request, the applicant or licensee to submit supporting evidence that includes documentation establishing the need for program flexibility and that the proposed alternative will not jeopardize the health, safety, and well-being of patients and is needed for increased operational efficiency.(A) Any critical care unit program flexibility request, including supporting evidence submitted with the request, shall be posted on the departments publicly accessible internet website within five calendar days of receipt by the department.(B) The department, at the time it posts a health facilitys critical care unit program flexibility request, shall provide a method to electronically collect public comment specifically on the application for a period of 30 days.(C) The 60-day timeframe provided for in subdivision (d) shall not commence until a facilitys critical care unit program flexibility request and supporting evidence have been posted on the departments internet website.(2) (A) A health facility that makes a critical care unit program flexibility request shall comply with both of the following requirements:(i) Conspicuously post the critical care unit program flexibility request form and a notice next to its license stating that a critical care unit program flexibility request and supporting evidence have been submitted to the department.(ii) Immediately make its best effort to notify affected employees and employee representatives of the critical care unit program flexibility request and direction to where to find the request and supporting evidence, and where to provide public comment.(B) A facilitys critical care unit program flexibility request will not be deemed complete for purposes of the 60-day timeframe pursuant to subdivision (d) until the facility has complied with this paragraph.(3) In no event shall the department approve a health facilitys critical care unit program flexibility request for a period of more than one year.(4) Any approval of a health facilitys critical care unit program flexibility request may be revoked by the department at any time, including on the grounds that there is no longer a need for program flexibility, that the approved alternative jeopardizes the health, safety, and well-being of patients, or that the approved alternative does not adequately protect patient safety.(5) (A) The 30-day comment period required by subparagraph (B) of paragraph (1) shall not apply when a hospital submits a critical care unit program flexibility request due to a health care emergency. Critical care unit program flexibility requests approved pursuant to this paragraph shall not be effective for more than 90 days, and any request to extend the term of critical care unit program flexibility that was approved pursuant to this paragraph shall be subject to the regular process provided for in this subdivision.(B) For purposes of this paragraph, health care emergency means an unpredictable or unavoidable occurrence at unscheduled or unpredictable intervals relating to health care delivery requiring immediate medical interventions and care.(6) This subdivision shall become operative on January 1, 2023. (e)(g) Notwithstanding any other provision of law or regulation, the State Department of Health Services Public Health shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.(h) On or before February 1, 2023, the department shall post all of the following information on its internet website:(1) A list of applicants for critical care unit program flexibility and the date of the application.(2) A list of health facilities with approved critical care unit program flexibility and the effective start and end date of the approval.(3) If approved, the notification of approval for critical care unit program flexibility, which shall include the application for critical care unit program flexibility; the regulation or regulations impacted; beds, units, or departments affected; and any conditions placed on the approval.(4) A department contact for the public to submit a complaint related to an approved critical care unit program flexibility.
188233
189234
190235
191-(h)For purposes of this section, the following definitions apply:
236+1276. (a) The building standards published in the State California Building Standards Code by the Office of Statewide Health Planning and Development, Department of Health Care Access and Information, and the regulations adopted by the state department State Department of Public Health shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.
237+
238+(b) These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department State Department of Public Health or the office, Department of Health Care Access and Information, as applicable. The approval of the department or the office Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or office Department of Health Care Access and Information regarding the exception, as applicable.
239+
240+(c) While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the state department State Department of Public Health expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.
241+
242+(d) (1) The state department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the state department for program flexibility in the prescribed manner. After the state department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.
243+
244+(2) A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.
245+
246+(e) To the extent that an application by a health facility for program flexibility, or for an extension of program flexibility, includes a request to allow the health facility to designate a bed or multiple beds in a critical care unit as requiring a lower level of care, including, but not limited to, the level of care provided in an intermediate care, step-down, telemetry, medical-surgical, specialty care, or pediatric services unit, that application shall be referred to as a critical care unit program flexibility request. This subdivision and subdivision (f) do not confer on the department any new or additional authority to modify staffing ratios.
247+
248+(f) (1) The department shall require, as support for a critical care unit program flexibility request, the applicant or licensee to submit supporting evidence that includes documentation establishing the need for program flexibility and that the proposed alternative will not jeopardize the health, safety, and well-being of patients and is needed for increased operational efficiency.
249+
250+(A) Any critical care unit program flexibility request, including supporting evidence submitted with the request, shall be posted on the departments publicly accessible internet website within five calendar days of receipt by the department.
251+
252+(B) The department, at the time it posts a health facilitys critical care unit program flexibility request, shall provide a method to electronically collect public comment specifically on the application for a period of 30 days.
253+
254+(C) The 60-day timeframe provided for in subdivision (d) shall not commence until a facilitys critical care unit program flexibility request and supporting evidence have been posted on the departments internet website.
255+
256+(2) (A) A health facility that makes a critical care unit program flexibility request shall comply with both of the following requirements:
257+
258+(i) Conspicuously post the critical care unit program flexibility request form and a notice next to its license stating that a critical care unit program flexibility request and supporting evidence have been submitted to the department.
259+
260+(ii) Immediately make its best effort to notify affected employees and employee representatives of the critical care unit program flexibility request and direction to where to find the request and supporting evidence, and where to provide public comment.
261+
262+(B) A facilitys critical care unit program flexibility request will not be deemed complete for purposes of the 60-day timeframe pursuant to subdivision (d) until the facility has complied with this paragraph.
263+
264+(3) In no event shall the department approve a health facilitys critical care unit program flexibility request for a period of more than one year.
265+
266+(4) Any approval of a health facilitys critical care unit program flexibility request may be revoked by the department at any time, including on the grounds that there is no longer a need for program flexibility, that the approved alternative jeopardizes the health, safety, and well-being of patients, or that the approved alternative does not adequately protect patient safety.
267+
268+(5) (A) The 30-day comment period required by subparagraph (B) of paragraph (1) shall not apply when a hospital submits a critical care unit program flexibility request due to a health care emergency. Critical care unit program flexibility requests approved pursuant to this paragraph shall not be effective for more than 90 days, and any request to extend the term of critical care unit program flexibility that was approved pursuant to this paragraph shall be subject to the regular process provided for in this subdivision.
269+
270+(B) For purposes of this paragraph, health care emergency means an unpredictable or unavoidable occurrence at unscheduled or unpredictable intervals relating to health care delivery requiring immediate medical interventions and care.
271+
272+(6) This subdivision shall become operative on January 1, 2023.
273+
274+(e)
192275
193276
194277
195-(1)COVID-19 means the 2019 novel coronavirus disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
196-
197-
198-
199-(2)General acute care hospital has the same meaning as defined in subdivision (a) of Section 1250.
200-
201-
202-
203-
204-
205-
206-
207-(a)The building standards published in the California Building Standards Code by the Department of Health Care Access and Information, and the regulations adopted by the department shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.
208-
209-
210-
211-(b)These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the department or the Department of Health Care Access and Information, as applicable. The approval of the department or the Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or the Department of Health Care Access and Information, regarding the exception, as applicable.
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215-(c)While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the department expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.
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219-(d)(1)The department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the department for program flexibility in the prescribed manner. After the department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.
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223-(2)A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.
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227-(e)Notwithstanding any other law or regulation, the department shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.
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235-(a)The building standards published in the California Building Standards Code by the Department of Health Care Access and Information, and the regulations adopted by the State Department of Public Health shall, as applicable, prescribe standards of adequacy, safety, and sanitation of the physical plant, of staffing with duly qualified licensed personnel, and of services, based on the type of health facility and the needs of the persons served thereby.
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239-(b)These regulations shall permit program flexibility by the use of alternate concepts, methods, procedures, techniques, equipment, personnel qualifications, bulk purchasing of pharmaceuticals, or conducting of pilot projects as long as statutory requirements are met and the use has the prior written approval of the State Department of Public Health or the Department of Health Care Access and Information, as applicable. The approval of the department or the Department of Health Care Access and Information shall provide for the terms and conditions under which the exception is granted. A written request plus supporting evidence shall be submitted by the applicant or licensee to the department or Department of Health Care Access and Information regarding the exception, as applicable.
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243-(c)While it is the intent of the Legislature that health facilities shall maintain continuous, ongoing compliance with the licensing rules and regulations, it is the further intent of the Legislature that the State Department of Public Health expeditiously review and approve, if appropriate, applications for program flexibility. The Legislature recognizes that health care technology, practice, pharmaceutical procurement systems, and personnel qualifications and availability are changing rapidly. Therefore, requests for program flexibility require expeditious consideration.
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247-(d)(1)The department shall, on or before April 1, 1989, develop a standardized form and format for requests by health facilities for program flexibility. Health facilities shall thereafter apply to the department for program flexibility in the prescribed manner. After the department receives a complete application requesting program flexibility, it shall have 60 days within which to approve, approve with conditions or modifications, or deny the application. Denials and approvals with conditions or modifications shall be accompanied by an analysis and a detailed justification for any conditions or modifications imposed. Summary denials to meet the 60-day timeframe shall not be permitted.
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251-(2)A health facility shall post any approval by the department granted under this section, or a true copy thereof, immediately adjacent to the health facilitys license and on the facilitys internet website. The department may not waive or flex this requirement and may not permit health facilities to maintain program flexibility approvals only in a binder or other location separate from the location stated in this subdivision.
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255-(e)To the extent that an application by a health facility for program flexibility, or for an extension of program flexibility, includes a request to allow the health facility to designate a bed or multiple beds in a critical care unit as requiring a lower level of care, including, but not limited to, the level of care provided in an intermediate care, step-down, telemetry, medical-surgical, specialty care, or pediatric services unit, that application shall be referred to as a critical care unit program flexibility request. This subdivision and subdivision (f) do not confer on the department any new or additional authority to modify staffing ratios.
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259-(f)(1)The department shall require, as support for a critical care unit program flexibility request, the applicant or licensee to submit supporting evidence that includes documentation establishing the need for program flexibility and that the proposed alternative will not jeopardize the health, safety, and well-being of patients and is needed for increased operational efficiency.
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263-(A)Any critical care unit program flexibility request, including supporting evidence submitted with the request, shall be posted on the departments publicly accessible internet website within five calendar days of receipt by the department.
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267-(B)The department, at the time it posts a health facilitys critical care unit program flexibility request, shall provide a method to electronically collect public comment specifically on the application for a period of 30 days.
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271-(C)The 60-day timeframe provided for in subdivision (d) shall not commence until a facilitys critical care unit program flexibility request and supporting evidence have been posted on the departments internet website.
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275-(2)(A)A health facility that makes a critical care unit program flexibility request shall comply with both of the following requirements:
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279-(i)Conspicuously post the critical care unit program flexibility request form and a notice next to its license stating that a critical care unit program flexibility request and supporting evidence have been submitted to the department.
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283-(ii)Immediately make its best effort to notify affected employees and employee representatives of the critical care unit program flexibility request and direction to where to find the request and supporting evidence, and where to provide public comment.
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287-(B)A facilitys critical care unit program flexibility request will not be deemed complete for purposes of the 60-day timeframe pursuant to subdivision (d) until the facility has complied with this paragraph.
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291-(3)In no event shall the department approve a health facilitys critical care unit program flexibility request for a period of more than one year.
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295-(4)Any approval of a health facilitys critical care unit program flexibility request may be revoked by the department at any time, including on the grounds that there is no longer a need for program flexibility, that the approved alternative jeopardizes the health, safety, and well-being of patients, or that the approved alternative does not adequately protect patient safety.
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299-(5)(A)The 30-day comment period required by subparagraph (B) of paragraph (1) shall not apply when a hospital submits a critical care unit program flexibility request due to a health care emergency. Critical care unit program flexibility requests approved pursuant to this paragraph shall not be effective for more than 90 days, and any request to extend the term of critical care unit program flexibility that was approved pursuant to this paragraph shall be subject to the regular process provided for in this subdivision.
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303-(B)For purposes of this paragraph, health care emergency means an unpredictable or unavoidable occurrence at unscheduled or unpredictable intervals relating to health care delivery requiring immediate medical interventions and care.
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307-(6)This subdivision shall become operative on January 1, 2023.
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311-(g)Notwithstanding any other law or regulation, the State Department of Public Health shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.
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278+(g) Notwithstanding any other provision of law or regulation, the State Department of Health Services Public Health shall provide flexibility in its pharmaceutical services requirements to permit any state department that operates state facilities subject to these provisions to establish a single statewide formulary or to procure pharmaceuticals through a departmentwide or multidepartment bulk purchasing arrangement. It is the intent of the Legislature that consolidation of these activities be permitted in order to allow the more cost-effective use and procurement of pharmaceuticals for the benefit of patients and residents of state facilities.
314279
315280 (h) On or before February 1, 2023, the department shall post all of the following information on its internet website:
316281
317-
318-
319282 (1) A list of applicants for critical care unit program flexibility and the date of the application.
320-
321-
322283
323284 (2) A list of health facilities with approved critical care unit program flexibility and the effective start and end date of the approval.
324285
325-
326-
327286 (3) If approved, the notification of approval for critical care unit program flexibility, which shall include the application for critical care unit program flexibility; the regulation or regulations impacted; beds, units, or departments affected; and any conditions placed on the approval.
328-
329-
330287
331288 (4) A department contact for the public to submit a complaint related to an approved critical care unit program flexibility.
332289
290+SEC. 3. Section 2.5 of this bill incorporates amendments to Section 1276 of the Health and Safety Code proposed by both this bill and Assembly Bill 1422. That section of this bill shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2022, (2) each bill amends Section 1276 of the Health and Safety Code, and (3) this bill is enacted after Assembly Bill 1442, in which case Section 2 of this bill shall not become operative.
333291
292+SEC. 3. Section 2.5 of this bill incorporates amendments to Section 1276 of the Health and Safety Code proposed by both this bill and Assembly Bill 1422. That section of this bill shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2022, (2) each bill amends Section 1276 of the Health and Safety Code, and (3) this bill is enacted after Assembly Bill 1442, in which case Section 2 of this bill shall not become operative.
334293
294+SEC. 3. Section 2.5 of this bill incorporates amendments to Section 1276 of the Health and Safety Code proposed by both this bill and Assembly Bill 1422. That section of this bill shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2022, (2) each bill amends Section 1276 of the Health and Safety Code, and (3) this bill is enacted after Assembly Bill 1442, in which case Section 2 of this bill shall not become operative.
335295
296+### SEC. 3.
336297
337-Section 2.5 of this bill incorporates amendments to Section 1276 of the Health and Safety Code proposed by both this bill and Assembly Bill 1422. That section of this bill shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2022, (2) each bill amends Section 1276 of the Health and Safety Code, and (3) this bill is enacted after Assembly Bill 1422, in which case Section 2 of this bill shall not become operative.
298+SEC. 4. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
338299
300+SEC. 4. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
339301
302+SEC. 4. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
340303
341-
342-
343-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.
304+### SEC. 4.