BILL NUMBER: AB 1544 CHAPTERED
BILL TEXT
CHAPTER 543
FILED WITH SECRETARY OF STATE OCTOBER 11, 2009
APPROVED BY GOVERNOR OCTOBER 11, 2009
PASSED THE SENATE SEPTEMBER 9, 2009
PASSED THE ASSEMBLY SEPTEMBER 10, 2009
AMENDED IN SENATE SEPTEMBER 4, 2009
AMENDED IN SENATE AUGUST 17, 2009
AMENDED IN SENATE JULY 23, 2009
INTRODUCED BY Assembly Members Jones and Fletcher
(Coauthors: Assembly Members Adams, Ammiano, Block, Carter,
Conway, De La Torre, Emmerson, Hayashi, Hernandez, Bonnie Lowenthal,
Nava, V. Manuel Perez, Salas, and Audra Strickland)
MARCH 4, 2009
An act to add Section 1253.6 to the Health and Safety Code,
relating to health facilities.
LEGISLATIVE COUNSEL'S DIGEST
AB 1544, Jones. Health facilities: licensure: outpatient clinic
service.
Existing law provides for the licensure of health facilities,
including general acute care hospitals, acute psychiatric hospitals,
and special hospitals, as defined, by the State Department of Public
Health. Violation of these provisions is a misdemeanor.
Existing law requires that, upon the issuance or renewal of a
general acute care, acute psychiatric, or special hospital license,
the department separately identify on the license each supplemental
service, including the address of where each outpatient service is
provided and the type of services provided at each outpatient
location.
Existing law authorizes licensed general acute care hospitals and
acute psychiatric hospitals to provide in any alternative setting
health care services and programs that may be provided by any other
provider of health care outside of a hospital building or which are
not otherwise specifically prohibited by provisions of existing law
regulating these facilities. It also requires the state department
and the Office of Statewide Health Planning and Development to adopt
and enforce standards which permit these health facilities to use its
space for alternative purposes.
This bill would, among other things, require the department to
approve a completed application by a licensed general acute care
hospital that meets specified requirements to add or modify an
outpatient clinic service as a supplemental service, add the
outpatient service to the hospital license, and issue a new license,
within 100 days of receipt of the completed application, unless the
applicant does not meet specified requirements. The bill would limit
the outpatient clinic service that is the subject of the application
to providing only nonemergency primary health care services in a
clinical environment to patients who remain in the outpatient clinic
for less than 24 hours. The bill would define "outpatient clinic
services" for purposes of the bill. By creating a new crime, this
bill would impose a state mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) Hospitals in California are essential partners with the state
in providing a health care safety net for underserved, uninsured, and
underinsured populations in a cost-effective manner.
(b) The need for primary care is growing dramatically due to
changes in the delivery of health care, demands of the market, and
the continuing increase of uninsured and underinsured patients in
California, an escalating unemployment rate, physician shortages, and
a severely depressed economy.
(c) The current system of approving new hospital-based outpatient
services that provide primary care causes delays in timely access to
care and results in a significant and unnecessary waste of taxpayer
and community resources that could otherwise be devoted to patient
care.
(d) Administrative streamlining of the approval process, without
compromising patient health and safety, will avoid an unnecessary
burden to the state's scarce resources and improve access to vital
community health care services in California.
SEC. 2. Section 1253.6 is added to the Health and Safety Code, to
read:
1253.6. (a) This section shall govern applications by general
acute care hospitals for supplemental services approval for
outpatient clinic services.
(b) Upon receipt of an initial application by a licensed general
acute care hospital to add a new or modify an existing outpatient
service as a supplemental service, the department shall, within 30
days of receipt of the initial application, review the entire
application, determine whether the application is missing information
or has insufficient information, and, on the basis of this
determination, provide the hospital with guidance on how to provide
the missing information.
(c) Upon determination by the department that an application for
an outpatient clinic service as a supplemental service is complete
pursuant to subdivision (b), the department shall investigate the
facts set forth in the application and, if the department finds that
the statements contained in the application are true, that the
establishment of the operation of the supplemental service are in
conformity with the intent and purpose of this chapter, and that the
applicant is in compliance with this chapter and the rules and
regulations of the department, the department shall approve the
additional or modified outpatient clinic service, add it to the
hospital license, and issue a new license. However, if the department
determines in the course of the investigation that additional
information is needed to determine whether the statements contained
in the application are true or that the establishment or the
continued operation of the supplemental service are in conformity
with the intent and purpose of this chapter, or that the applicant is
in compliance with this chapter and the rules and regulations of the
department, the applicant shall provide the additional information
to the department upon request. If the department finds that the
statements contained in the application are not true, or that the
establishment of the outpatient service as a supplemental service is
not in conformity with the intent and purpose of this chapter, or if
the applicant fails to provide any additional information to the
department within 30 days of the request, the department shall deny
the outpatient clinic services application. The department shall
either grant or deny the application for the outpatient clinic
service as a supplemental service within 100 days of the filing of a
completed application.
(d) If a licensed general acute care hospital has previously been
approved for an outpatient clinic service within 30 days after
receipt of a completed application for an additional outpatient
clinic service, the department shall approve the additional or
modified outpatient clinic service, add it to the hospital license,
and issue a new license, unless the applicant does not meet the
requirements of this section. Notwithstanding any other law, the
department shall not be required to conduct an onsite inspection
prior to approval of an outpatient clinic service pursuant to this
section. However, nothing shall preclude the department from
conducting an onsite inspection at any time, or denying an
application, in accordance with subdivision (c). If the department
determines that the applicant does not meet the requirements of this
section, the department shall provide the hospital, in writing, the
particular basis for this determination.
(e) A completed application for purposes of this section shall
include all of the following:
(1) The appropriate forms, fees, and documentation, as determined
by the department.
(2) A description of the type of outpatient clinic service to be
operated, the character and scope of the service to be provided, and
a complete description of the building, its location and proximity to
the main hospital building, facilities, equipment, apparatus, and
appliances to be furnished and used in the operation of the
outpatient clinic service and evidence satisfactory to the department
that the hospital owns and will operate the outpatient clinic
service that is the subject of the application.
(3) Written policies and procedures governing the operation of the
outpatient clinic service and its reporting relationship to the
applicant.
(4) Evidence of the hospital's compliance with applicable building
standards and possession of a fire clearance for the outpatient
clinic service space.
(f) The outpatient clinic service that is the subject of the
application shall be limited to providing nonemergency primary health
care services in a clinical environment to patients who remain in
the outpatient clinic for less than 24 hours.
(g) For purposes of this section "outpatient clinic services"
shall have the same meaning as the services that may be provided by a
primary care clinic in accordance with subdivision (a) of Section
1204. Nothing in this section shall be interpreted to mean that
supplemental outpatient services established by a general acute care
hospital pursuant to this section shall be considered primary care
clinics for licensing, regulatory, or enforcement purposes.
SEC. 3. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.