2011 Legislative Report
76th Session of the Nevada Legislature
The 76th Session of the Nevada Legislature concluded on June 7, 2011 at 1:00 a.m. The session was marked primarily by a focus on the budget because of declining revenues and the sunset of taxes were set to expire in July. One other key aspect of the session was on reforms, specifically focused on education reforms. However, the session took a clear turn in its gridlock over the budget and reforms when the Nevada Supreme Court announced their decision that the State of Nevada could not divert the money as it did during the 2010 Special Session from the Clear Water Coalition. This allowed the Governor to reconsider his no new tax pledge and extended the taxes that were scheduled to sunset in July.
UMC had two bills that it actively championed throughout the 2011 Legislative Session to help further the mission of the hospital.
AB29 Signed by Governor Sandoval on June 1, AB 29 has three parts. First, it allows for the board of trustees of a hospital to increase the monthly stipend for members of the hospital advisory board to an amount up to $500. Second, it allows the board of trustees the option to require certain medical staff to be affiliated with University of Nevada School of Medicine (UNSOM)/UNLV Dental School. Third, it allows for the continuation of the study of inter-facility transferred patients between facilities. This bill becomes law July 1, 2011.
SB10 Signed by the Governor on May 30, SB 10 requires the Division of Health to adopt regulations to assess the impact of applicants for new services in five specific areas as well as the affect it would have on existing programs in terms of capacity and program robustness. These five areas include Open-Heart, Trauma Level 1, Burn Care, Organ Transplant, and NICU Level 3. This bill becomes law July 1, 2011 and UMC will continue to monitor its implementation through the regulatory phase.
Other Pertinent Healthcare Legislation
There were a series of bills passed and signed by the Governor that will begin to take effect on or after July 1, 2011 that impact, to some degree, the operations of UMC. These bills are listed under Transparency, Healthcare Facilities and Operations, and Open Meeting Law.
AB280 Hospitals’ Patient Safety Plan Committees must adopt checklists for use by staff to ensure a sanitary room and environment and checklists at discharge to verify that patients received proper instructions on medications and aftercare. Patient safety policies must include: 1) a policy for identifying a patient using at least two personal identifiers including name and date of birth; 2) a policy of nationally recognized standards for protocols relating to hand hygiene; and 3) a policy to comply with patient safety checklists. They must submit an annual report to the Legislative Counsel Bureau to be transmitted to the Legislative Committee on Healthcare regarding development and usage of patient safety checklists.
SB168 Requires hospitals to provide medical records to be made available for physical inspection within five working days after request. It requires physicians to submit a report concerning the occurrence of any sentinel event arising from surgery requiring conscious or deep sedation, or general anesthesia, performed at a facility or office other than a hospital. Hospitals shall report to the Board of Medical Examiners within five days after a change in privileges of a physician, perfusionist, physicians assistant, or respiratory therapist based on an investigation of mental, medical or psychological competency or suspected or alleged substance abuse.
SB209 Requires sentinel event reporting by hospitals on the website maintained by the Division of Health.
SB225 The Division of Health will post a list of those hospitals that submit proof that they are certified as Primary Stroke Centers by the Joint Commission.
SB264 Hospital reports of sentinel events will include rate of occurrence. The Health Division will use discharge data to report by hospital “potentially preventable readmissions” that are not more than 30 days post discharge, are clinically related, and were preventable. Reports will include the total number of readmissions, rate of occurrence, average length of stay, and average billed charges by DRG categories.
SB339 Hospitals must post and provide to patients information relating to facility-acquired infections and related policies. Patients must be informed no later than five days post confirmed diagnosis of a facility-acquired infection. Hospitals shall designate an employee as the Infection Control Officer. The Health Division shall post on its website, each hospital’s safety plan including their infection control program.
SB340 The Health Division (to the extent that money is available) shall for each hospital, report the name of each physician who performed a surgical procedure the total number of procedures by DRG and by principal diagnosis, principal surgical procedure and secondary surgical procedure.
Healthcare Facilities and Professionals
AB36 Pertains to the Indigent Accident Fund and changes the membership of the board who administer the fund, with more participation from county commissions. AB529, another bill that addresses the Indigent Accident Fund, allows the taking of funds to be used for another purpose.
AB98 Establishes the Uniform Emergency Volunteer Health Practitioners Act and sets up a registration process for in-state and out-of-state health practitioners, including veterinarians, to volunteer during emergency situations, consistent with the Federal Division of Emergency Management.
AB146 Expands the authority of the Director of the Governor’s Office for Consumer Health Assistance to adopt regulations to establish procedures for hearing disputes between patients and hospitals regarding billing.
AB160 Increases the reporting requirements for hospitals including expenses for providing community benefits, on the Health Division’s state web-site. Corporate owned hospitals will report services purchased from its corporate home office and the net income of the consolidated corporation (if publicly available).
SB43 Establishes a statewide health information exchange system in accordance with federal law under the Director of the Department of Health and Human Services and directs him to take necessary action to comply with federal law concerning electronic health records.
SB300 Prohibits a hospital from attempting to collect for services provided to the patient from the proceeds of a civil action if the hospital has a contractual agreement with a third party to provide healthcare for the patient.
SB329 The Board of Medical Examiners shall “encourage” physicians to acquire CME regarding patient education for medication management and the ability of the patient to request to have the symptoms or purpose of the medication attached to the container. Physicians shall post in conspicuous locations and in each exam room a formal notice (language proscribed in statute) regarding the right for patients to have symptoms or purpose of medication attached to container.
SB419 Physicians, nurses, and all allied health professionals must submit an attestation having knowledge of and in compliance with the guidelines of the CDC concerning the prevention of transmission of infectious agents through safe and appropriate injection practices as a condition of license or certification renewal.
SB420 Long-term nursing facilities must adopt written policy establishing the number of days the facility will hold the bed of a patient/resident when he or she is transferred temporarily to a hospital and that will provide a means to resume residency if the hospital admission exceeds the time limit, as a bed becomes available.
Open Meeting Law
AB59 Changes open-meeting law requiring certain information to be included on the agenda if the board is found to be in violation of the regulations. It allows the Attorney General to issue subpoenas pertaining to violations. The bill requires certain wording “for possible action” to be placed next to appropriate agenda items. It changes the process for notification if administrative action is to be taken against an individual. It also imposes additional civil penalties up to $500 per violation, against any member who violates open-meeting laws.
AB257 Makes changes to open-meeting law by providing additional public comment periods prior to the discussion of items on the agenda.