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4 Working Nurse l WorkingNurse.com November 9–December 14, 2020 ON THE QUICK Nursing & Healthcare News Taking Aim at PPE Shortages New California laws require hospitals to stockpile personal protective equipment T he Legislature is not happy about ongoing PPE short- ages at some California hospitals. Two new state laws will require facilities to bolster their stockpiles of personal protective equipment. "Nurses Deserve Protection" It's no secret that the pandemic caught some hospitals flat- footed when it came to vital equipment like surgical masks and N95 respirators. While some hospitals had or were able to obtain adequate supplies, other facilities have been forced to ration and reuse single-use PPE. The human cost has been high. By mid-October, there were more than 41,000 confirmed cases of COVID-19 among California healthcare workers, including at least 194 deaths. (More than one-third of those cases and more than half of the reported deaths have been in L.A. County.) Declaring that "[n]urses and healthcare workers deserve protection while doing their jobs," the Legislature passed two bills intended to ensure that California hospitals are better-prepared in the future: A.B.2537 and S.B.275. Governor Newsom signed both bills into law on September 29. Three-Month Supply A.B.2537 reaffirms that acute care hospitals have a legal obligation to provide PPE for staff involved in direct patient care and ensure that employees use that equipment. Those hospitals will also be required to stockpile enough respirators, masks, gowns, eye protection and shoe cover- ings for three months of operations at normal (pre-pan- demic) levels. All single-use equipment in that stockpile must be new; previously used or expired equipment can't be counted toward the requirement. Hospitals will also need to maintain a current inventory of all required PPE supplies and provide that inventory to the Department of Industrial Relations upon request. Surge Stockpile The second law, S.B.275, will require most healthcare employers — not just hospitals — to maintain an emergency stockpile of certain PPE. This emergency stockpile must be sufficient for 45 days of operation under surge conditions, with certain temporary exemptions for employers that transfer their PPE supplies to another facility during a public health emergency or that shut down in-person operations (as many outpatient servic- es did earlier this year) until they can replenish their stocks. Can the Supply Chain Keep Up? Both new laws have teeth: Hospitals that fail to maintain the required inventory levels may face civil penalties of up to $25,000 per violation. Nonetheless, the new rules won't make an immediate difference in local PPE supplies. A.B.2537's three-month supply rule doesn't go into effect until April 1, 2021. The 45- day surge consumption requirements of S.B.275 still have to be defined by regulation, and won't take effect before Jan. 1, 2023. With the pandemic showing no signs of abating, the big question is whether the supply chain will be able to provide enough PPE for hospitals to meet these requirements. Both laws do allow exemptions for hospitals that fall short "due to issues beyond their control" or if the Department of Industrial Relations "determines that supply chain limitations make meeting the mandated level of sup- plies infeasible." However, even then, hospitals must still make "a reason- able attempt" to secure all required supplies. Judging by the past year, that might not be easy — or cheap. WN CRITICAL SHORTAGES The lack of a coordinated federal and state response to the sourcing and distribution of PPE left hospitals to fend for themselves and nurses to improvise — with deadly results.