More on Policy and Legislation

California passes nation's first bill requiring hospitals to keep a 45-day supply of PPE

The law is meant to ensure that healthcare doesn't buckle under the weight of any future pandemics or public health crises.

Jeff Lagasse, Associate Editor

The California state legislature this week passed the nation's first law requiring healthcare facilities – including hospitals, medical groups, skilled nursing facilities and dialysis clinics – to maintain a 45-day supply of personal protective equipment at pandemic levels to be prepared for future healthcare emergencies.

The law also sets the stage for the state of California to create a 90-day supply of PPE for healthcare and other essential workers.

While the law was spurred by the COVID-19 pandemic, it's meant to ensure that healthcare in the state doesn't buckle under the weight of any future pandemics or public health crises.

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The bill was conceived and backed by SEIU-United Healthcare Workers West and was sponsored by Sens. Dr. Richard Pan (D-Sacramento) and Connie M. Leyva (D-Chino). In addition to the 45-day requirement for healthcare facilities, the legislation also creates a state PPE advisory committee to guide California on the creation of a state stockpile of PPE and procurement guidelines to work toward a 90-day pandemic level supply for all essential workers. 

Labor and industry will each have four seats on the 15-member advisory committee, with seven others appointed by the state.

The bill requires employers to provide unexpired PPE upon request to all healthcare workers, whether they are performing direct patient care or supporting patient care, such as environmental services workers and lab, transport and dietary employees.

Under the new law, hospitals, skilled nursing facilities, dialysis clinics and medical practices that are part of an integrated health system are required to build a 45-day surge-level PPE stockpile. The PPE must be "new and not previously worn or used," and the stockpiles must be established by January 1, 2023.

Providers are subject to fines up to $25,000 for each violation for failing to maintain the stockpile, and failing to provide an inventory of equipment to California's Division of Occupational Safety and Health.


PPE has been in high demand since the coronavirus began to spread, and this demand is reflected in its market outlook. The PPE industry is likely to generate close to triple its 2019 revenue by 2027.

A June report from Allied Market Research estimates that the PPE market will reach $33.4 billion globally by 2027, up from just $12.9 billion in 2019, at a compound annual growth rate (CAGR) of 12.4%. Based on end-user, the hospital segment accounted for the largest share in 2019, holding more than two-fifths of the global healthcare PPE market share, and is expected to maintain the largest share throughout the forecast period.

The rise in investment from public and private players in the production of healthcare PPE kits to meet the increasing demand is also fueling the growth of the market.

Because of the demand, however, PPE has been circulating that comes from legally dubious origins. Shortly after the pandemic began, hospitals were using about 10 times their usual amount of PPE products, and up to 15 times the usual amount of N95 respirators in the hardest-hit areas. While previously these items were used only for known infectious respiratory illnesses during surgery, hospitals were now using them as universal precautions for all patients. 

This created a perfect storm, allowing unscrupulous actors to operate in a "gray market" selling counterfeit products to strapped hospitals.


"Too many healthcare and other essential workers have gotten sick and needlessly died because we did not have the supplies of PPE we desperately needed to treat COVID-19 patients," said Jessica Rodriguez, an emergency department technician at Kaiser Oakland. "Many lives will be saved because of this new law."

Twitter: @JELagasse
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