More nurses, PPE stockpiles: New California laws aimed at shortages amid pandemic
Gov. Gavin Newsom signed several bills last month that seek to address increasing shortages of equipment and health care workers that have become even more evident as the coronavirus pandemic enters its seventh month.
The new laws make it mandatory for the state as well as hospital employers to stockpile personal protective equipment, or PPE, and is aimed at helping to increase the availability of nurses during such emergencies.
A third law aims to take away some of the barriers facing nurse practitioners with or without a public health crisis.
Here's a guide to California's new legislation related to health :
Revised clinical experience requirements
Effective immediately, Assembly Bill 2288 by Assemblymember Evan Low, D-Campbell, allows nursing programs to revise certain clinical experience requirements for students by submitting a request to a board nursing education consultant.
This will last until the end of the 2020-2021 academic year as well as whenever the governor declares a state of emergency in the same county where an agency or facility used by the approved nursing program is located.
This is meant to help students displaced from clinical experiences because of the pandemic and future state of emergencies, according to the bill's text, and not to increase student enrollment.
Nurse practitioners work apart from doctors
Assembly Bill 890, a controversial bill first introduced by Assemblymember Jim Wood, D-Santa Rosa, gives nurse practitioners a path to practice independently without supervision by a physician, but it comes with many restrictions.
Nurse practitioners must obtain additional certifications and work under physician supervision for at least three years before practicing on their own. They must also tell patients that they're not doctors.
While supporters say this law will help bring more health care access to underserved and rural communities, opponents say that it won't necessarily lead more nurse practitioners to work in these communities and that it will lower the quality of care in such places.
Nurse practitioners are permitted to perform "full practice" duties — evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances — in 22 states and Washington D.C., according to the American Association of Nurse Practitioners (AANP).
Currently, the AANP lists California as one of the most restrictive states when it comes to the work that nurse practitioners are allowed to do and under what supervision.
Beginning Jan. 1, 2023, this new law will allow qualified nurse practitioners to perform more procedures, including prescribing and administering controlled substances and, after meeting the additional requirements, will allow them practice independently.
Acute care hospitals to provide employee PPE
Under Assembly Bill 2537 by Assemblymember Freddie Rodriguez, D-Pomona, public and private employers of workers in general acute care hospitals are required to supply employees handling patient care with appropriate PPE and require such employees to use it.
"Although over 102 million N95 respirators have been distributed in the State of California since March 2020, nurses and other health care workers have not seen the impact of this distribution in their units," reads the Legislature's findings. "In many cases, employers have locked up or rationed N95 respirators, leaving nurses and other health care workers unprotected.
"In some cases," the Legislature continued, "nurses have been disciplined for bringing their own personal protective equipment or demanding that appropriate personal protective equipment be provided when treating COVID-19 positive patients."
By Jan. 15, 2021, general acute care hospitals must be prepared, upon request, to report their highest seven-day consecutive daily average consumption of PPE during 2019 to the Department of Industrial Relations. General acute care hospitals run by the California Department of State Hospitals will report to the Division of Occupational Safety and Health.
Employers will also need to establish and implement effective procedures for keeping track of this inventory.
Beginning April 1, 2021, the new law will also require these employers to maintain a three-month supply of PPE. This list includes N95 filtering facepiece respirators, powered air-purifying respirators with high-efficiency particulate air filters, elastomeric air-purifying respirators and appropriate particulate filters or cartridges, surgical masks, isolation gowns, eye protection and shoe coverings.
Each violation for not maintaining this stockpile could result in a civil penalty of $25,000.
State required to help build PPE stockpiles
Senate Bill 275 by Senator Richard Pan, D-Sacramento, aims to help build a stockpile of PPE. It requires the State Department of Public Health and the Office of Emergency Services, in coordination with other state agencies, to establish a stockpile and develop guidelines for how it will be distributed.
Beginning Jan. 1, 2023, or one year after the adoption of specified regulations, this law also requires health care employers including clinics, health facilities and home health agencies, to maintain an inventory of new, unexpired PPE for use in a declared state of emergency.
The inventory needs to be sufficient for at least 45 days of "surge consumption."
The bill also establishes the Personal Protective Equipment Advisory Committee — comprising representatives from associations representing skilled nursing facilities and physicians, and labor organizations that represent health care workers, and other groups — that will make recommendations for the development of guidelines for the procurement, management, and distribution of PPE.
Maria Sestito covers aging and the senior population in Coachella Valley for The Desert Sun. She is also a Report for America corps member and new to the desert. Please say "hello" via email@example.com or @RiaSestito.