June 22, 2006
The Honorable Wilma Chan, Chair
Assembly Health Committee
Sacramento, CA. 95814
RE: Oppose SB 739 (Speier)
Dear Assemblymember Chan:
Consumers Union, nonprofit publisher of Consumer Reports, writes in opposition to SB 739 as amended on June 15, 2006 and urges you to not send it forward. Sen. Speier sponsored a solid hospital infection reporting bill two years ago which Consumers Union strongly supported; unfortunately, that bill was vetoed by the governor. This effort to move California forward on preventing deadly hospital infections is too great a compromise.
Consumers Union launched a multi-state campaign for public disclosure of hospital-acquired infection rates in 2004. Since then, 35 states have debated this issue and 13 have passed laws to provide consumers with this important patient safety information. The campaign has been the catalyst for increased activity around the prevention of hospital infections which will continue to improve only as long as there is assurance that the public can see the results of hospitals’ efforts. Public disclosure provides a strong incentive for hospitals to act against this largely preventable problem that is all too prevalent in America’s hospitals.
A prior version of SB 739 gave the public information about how well their hospital controls infections. It is now a shell of its former self and merely requires hospitals to have policies in place to prevent infections. This adds nothing to current practice as all hospitals in the state currently have policies for preventing infections, but do not consistently follow them. For example, policies for doctors and nurses to clean their hands between patients is at the core of every hospital infection prevention policy today, yet research has repeatedly shown that appropriate hand cleansing occurs only about 50% of the time.
Hospital-acquired infections kill 90,000 Americans every year; two million patients – one in 20 – will get an infection in the hospital, according to the CDC. These infections cost the state hundreds of millions of dollars each year in Medicaid and other state funding for healthcare programs. The Pennsylvania agency that issued the first reports on the frequency of these infections in their state found that 76% of the infections were paid for by Medicare and Medicaid. The cost in lives is horrific and the cost in wasted healthcare dollars is unacceptable, especially considering the great healthcare needs unmet in California. Most of these infections are preventable, as is being demonstrated by hospitals around the country that are implementing strong, consistent infection control efforts.
We know of these successes only when hospitals choose to disclose them- the hospitals that do not have success will not disclose. The public can no longer trust that something is being done — we need accountability and evidence that whatever our hospitals are doing to prevent infections is working. SB 739 gives us nothing in the way of accountability, nor does it even establish the groundwork for more “outcome” information (infection rates) in the future.
SB 739 asks the public to take the word of hospitals that they are following infection prevention guidelines developed by CDC, some of which have been available for hospitals to voluntarily adhere to for more than 20 years. The proponents of this new version of SB 739 claim that the Department of Health Services will check to see that these policies are being followed. However, each California hospital is visited by DHS in a routine inspection only once every three years. In addition, the bill only authorizes the Department to ensure that those policies connected to prevention of surgical infections be monitored.
All the public will be told as a result of SB 739 is whether or not their hospital has policies in place to follow guidelines that are mandated by state law — we will not know how often they actually follow these practices nor will we know whether their policies are resulting in a real reduction in the rate of infection at their facility. Under SB 739, the public will also apparently see some information about preventing surgical site infections — but it comes very late, a year after we will probably see this information on the new federal “Hospital Compare” website. In 2007, Medicare will begin attaching enhanced payment for hospitals reporting the rate at which they conduct surgical infection prevention practices.
The current version of SB 739 does too little and should not pass. It would mislead the public into thinking that something significant will happen in infection control. California can do better. The Legislature should refuse to pass this weak bill and instead come back next year and pass a bill that will give Californians useful information that will truly prod lifesaving industry reform.
If you have any questions, please contact Lisa McGiffert, Consumers Union’s “Stop Hospital Infections” Project Director, at 512-415-5405.
Lisa McGiffert, Project Director
A Project of Consumers Union
Betsy Imholz, Director
West Coast Office
Consumers Union of U.S., Inc.
cc: Assembly Health Committee Members and staff
Senate Jackie Speier