BILL ANALYSIS                                                                                                                                                                                                    



                                                             


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|SENATE RULES COMMITTEE            |                    SB 97|
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                    UNFINISHED BUSINESS
                              

Bill No:  SB 97
Author:   Burton (D), et al
Amended:  6/8/99
Vote:     21

  
  SENATE HEALTH & HUMAN SERV. COMMITTEE  :  6-2, 3/10/99
AYES:  Escutia, Figueroa, Hughes, Polanco, Solis,  
  Vasconcellos
NOES:  Morrow, Mountjoy
NOT VOTING:  Haynes

  SENATE APPROPRIATIONS COMMITTEE  :  8-0, 4/19/99
AYES:  Johnston, Alpert, Bowen, Burton, Karnette, Mountjoy,  
  Perata, Vasconcellos
NOT VOTING:  Escutia, Johnson, Kelley, Leslie, McPherson

  SENATE FLOOR  :  24-14, 5/10/99
AYES:  Alarcon, Alpert, Baca, Bowen, Burton, Chesbro,  
  Costa, Dunn, Escutia, Figueroa, Hayden, Hughes, Johnston,  
  Karnette, Murray, O'Connell, Ortiz, Peace, Perata,  
  Polanco, Schiff, Sher, Speier, Vasconcellos
NOES:  Brulte, Haynes, Johannessen, Johnson, Kelley,  
  Knight, Leslie, Lewis, Monteith, Morrow, Mountjoy,  
  Poochigian, Rainey, Wright
NOT VOTING:  McPherson, Solis

  ASSEMBLY FLOOR  :  46-26, 6/28/99 - See last page for vote
 

  SUBJECT  :    Health facilities:  retaliation against  
            employee or patient with grievance

  SOURCE  :     California Nurses Association
                                                 CONTINUED





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  DIGEST  :    This bill prohibits a health facility from  
discriminating against a patient or employee who presents a  
grievance or cooperates in any investigation against that  
facility.

  Assembly Amendments  add inmates housed in local detention  
facilities including a county jail or a juvenile hall,  
juvenile camp, or other juvenile detention facility to  
those exempted from the provisions of the bill.

  ANALYSIS  :

Existing law prohibits:

1.An employer from retaliating against an employee who  
  provides information to a government or law enforcement  
  agency about the employer's violation of law or  
  regulation.  A violation is considered a misdemeanor and  
  is punishable by (a) imprisonment in the county jail not  
  to exceed one year, (b) a fine not to exceed $1,000, or  
  (c) both.  A corporation may be fined up to $5,000.

2.A long-term health care facility from retaliating or  
  discriminating against an employee or patient, who has  
  filed a grievance, or provided information to a  
  governmental entity relating to care, services, or  
  conditions at that facility.  A violation is subject to a  
  civil penalty of not more than $10,000.
 
This bill:

1.Makes findings and declarations to encourage patients,  
  nurses, and other health care workers to notify  
  government entities of suspected unsafe patient care and  
  conditions.

2.Prohibits any health facility from retaliating or  
  discriminating against an employee or patient, who has  
  filed a grievance or provided information to a  
  governmental entity relating to the care, services, or  
  conditions at that facility.








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3

3.Requires a health facility that violates this provision  
  to be subject to a civil penalty of not more than  
  $25,000.

4.Establishes a "rebuttable presumption" that any  
  discriminatory treatment taken by a health facility is  
  retaliatory if it occurs against (a) a patient within 180  
  days of his/her filing a grievance or complaint or (b) an  
  employee within 120 days of his/her filing a grievance or  
  complaint.

5.Defines "discriminatory treatment of an employee" to  
  include discharge, demotion, suspension, any other  
  unfavorable changes in employment, or the threat of these  
  actions.

6.Establishes a misdemeanor penalty of up to $20,000 for  
  any person who willfully violates the provisions in this  
  bill.

7.Requires that an employee who has been discriminated  
  against, pursuant to this bill, is entitled to  
  reinstatement, reimbursement for lost wages and benefits,  
  and legal costs associated with pursuing the case.

8.Exempts from the above provisions (a) an inmate of either  
  a Department of Youth Authority or Department of  
  Corrections' correctional facility or to an inmate housed  
  in a local detention facility and (b) a long-term health  
  care facility that is subject to existing law.

9.Provides that nothing in the bill abbrogates or limits  
  any other theory of liability or remedy otherwise  
  available in law.

  Comments  

The California Department of Health Services (DHS) reports:

1.An annual average of 11,000 complaints against all types  
  of health facilities, including long-term care facilities  
  and hospitals.  An estimated 7,000 complaints per year  
  are against long-term care facilities.








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2.In fiscal year 1997-98, DHS issued 1,258 citations  
  against long-term care facilities.  One of these  
  citations was against a long-term care facility for  
  retaliation and discrimination against an employee. 

3.DHS staff indicates that they receive a number of  
  retaliation complaints against health care facilities,  
  other than long-term care facilities, but without  
  statutory authority they cannot follow-up on them.

  Prior legislation
  
AB 3309 (Burton, 1996), which failed passage in the  
Assembly Health Committee.

SB 253 (Burton, 1997), which was vetoed by Governor Wilson  
because "[t]here is no empirical data to indicate that  
health facilities workers require a higher level of  
protection than other employees."  It passed the Senate  
21-15 - Noes:  Brulte, Haynes, Hurtt, Johannessen, Johnson,  
Kelley, Knight, Kopp, Leslie, Lewis, McPherson, Monteith,  
Mountjoy, Rainey and Wright.

  FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
Local:  Yes


According to Senate Appropriations Committee analysis:



                         Fiscal Impact (in thousands)
  
Major Provisions                   1998-99                1999-2000        2000-01   
  Fund  
Civil penalties                 unknown potential penalties

STAFF COMMENTS:

Both state hospitals and University of California (UC)  
hospitals are licensed health facilities owned and operated  
by the state.  Operating departments or UC would be  
responsible for paying any fines if health facility  
supervisors violate these provisions and the civil action  







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5

succeeds against the state.

  SUPPORT  :   (Verified  6/28/99)

California Nurses Association (source)
California School Employees Association
Congress of California Seniors
Health Access
Service Employees International Union (SEIU)
AARP
California Association of Medical Laboratory Technology
Emergency Nurses Association of California
Little Hoover Commission
California Resources for Independent Living
Engineers and Scientists of California
Region 8 States Council of the United Food and Commercial  
Workers
Hotel Employees, Restaurant Employees International Union
California Conference of Machinists
California Labor Federation, AFL-CIO
Older Women's League of California
Consumer Attorneys of California
California Conference Board, Amalgamated Transit Union
American Nurses Association/California
American Federation of State, County and Municipal  
Employees, AFL-CIO

  OPPOSITION  :    (Verified  6/28/99)

California Healthcare Association
Kaiser Permanente Medical Care Program
United Hospital Association
California Dialyses Council
California Association of Catholic Hospitals

  ARGUMENTS IN SUPPORT  :    Supporters argue:

1.The purpose of this bill is to extend to hospital  
  patients and health care workers the same whistleblower  
  protections that currently apply to long-term care  
  facilities.

2.This bill would help protect nurses and patients who  
  complain about possible unsafe patient care in hospitals.







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3.Retaliatory actions against patients, nurses and other  
  health care workers are on the increase.  Nurses working  
  in hospitals and other health care facilities who report  
  unsafe patient care or conditions put their own jobs at  
  risk and, therefore, are afraid to speak out.

4.Existing laws are so vague and general that they do not  
  protect patients and employees in hospitals.

  ARGUMENTS IN OPPOSITION  :    Opponents argue:
  
  1.Retaliation against a whistleblower is already a crime  
  that is subject to penalties.  Employees who are subjects  
  of retaliation can go to the Department of Industrial  
  Relations, Division of Labor Standards Enforcement or to  
  the courts for relief.

2."Rebuttable presumption" is bad public policy.  By  
  creating the legal presumption that a hospital is guilty  
  of retaliation unless it can prove itself innocent, this  
  bill tilts the process in favor of one of the parties in  
  a dispute.  Furthermore, rebuttable presumption in this  
  bill will have an adverse impact on patient care, if  
  swift action cannot be taken against an incompetent  
  employee.

3.This bill encourages an incompetent employee to file a  
  frivolous complaint against a hospital due to the  
  protections provided in this bill.  

4.This bill creates no corresponding penalties for  
  employees who willfully or negligently misuse the process  
  for their own purposes.

  ASSEMBLY FLOOR :
AYES:  Alquist, Aroner, Bock, Calderon, Cardenas, Cardoza,  
  Corbett, Correa, Davis, Dutra, Firebaugh, Florez, Floyd,  
  Gallegos, Havice, Hertzberg, Honda, Jackson, Keeley,  
  Knox, Kuehl, Lempert, Leonard, Longville, Lowenthal,  
  Machado, Mazzoni, Migden, Nakano, Papan, Reyes, Scott,  
  Shelley, Soto, Steinberg, Strom-Martin, Thomson,  
  Torlakson, Vincent, Washington, Wayne, Wesson, Wiggins,  
  Wildman, Wright, Villaraigosa







                                                       SB 97
                                                       Page  
7

NOES:  Aanestad, Ackerman, Ashburn, Baldwin, Bates, Battin,  
  Baugh, Brewer, Briggs, Campbell, Cox, Dickerson,  
  Frusetta, House, Maddox, Maldonado, Margett, McClintock,  
  Olberg, Oller, Robert Pacheco, Pescetti, Runner,  
  Strickland, Thompson, Zettel
NOT VOTING:  Cedillo, Cunneen, Ducheny, Granlund,  
  Kaloogian, Leach, Rod Pacheco, Romero


CP:sl  6/29/99   Senate Floor Analyses 

               SUPPORT/OPPOSITION:  SEE ABOVE

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