BILL NUMBER: SB 442 INTRODUCED
BILL TEXT
INTRODUCED BY Senator Ducheny
FEBRUARY 26, 2009
An act to amend Sections 1200, 1207, 1212, 1213, 1214, 1216, 1219,
and 1221 of, and to add Section 1212.5 to, the Health and Safety
Code, relating to clinics.
LEGISLATIVE COUNSEL'S DIGEST
SB 442, as introduced, Ducheny. Clinic corporation: licensing.
Under existing law, the State Department of Public Health is
responsible for the licensing and regulation of clinics, as defined.
A violation of these provisions is a crime.
This bill would define "clinic corporation" as a nonprofit
organization that owns one or more primary care clinics, as defined,
and would provide for a single, consolidated license for corporation
clinics, as specified.
Existing law provides for a fee to be paid for an initial license,
renewal license, license upon change of ownership, or special permit
set at specified amounts.
This bill would set the fee for a clinic corporation at a
percentage of the fee for primary care clinics for each clinic site.
The bill would also make conforming changes to the licensing
provisions. Because this bill would create a new crime, it imposes 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.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1200 of the Health and Safety Code is amended
to read:
1200. (a) As used in this chapter, "clinic"
means an organized outpatient health facility which
that provides direct medical, surgical, dental,
optometric, or podiatric advice, services, or treatment to patients
who remain less than 24 hours, and which that
may also provide diagnostic or therapeutic services to
patients in the home as an incident to care provided at the clinic
facility. Nothing in this section shall be construed to prohibit the
provision of nursing services in a clinic licensed pursuant to this
chapter. In no case shall a clinic be deemed to be a health facility
subject to the provisions of Chapter 2 (commencing with Section 1250)
of this division . A place, establishment, or
institution which that solely provides
advice, counseling, information, or referrals on the maintenance of
health or on the means and measures to prevent or avoid sickness,
disease, or injury, where such that
advice, counseling, information, or referrals
referral does not constitute the practice of medicine,
surgery, dentistry, optometry, or podiatry, shall not be deemed a
clinic for purposes of this chapter.
References in this chapter to "primary
(b) For purposes of this chapter:
(1) "Primary care clinics"
shall mean and designate means all the
types of clinics specified in subdivision (a) of Section 1204,
including community clinics and free clinics. References in
this chapter to specialty clinics shall mean and designate all
(2) "Specialty clinics" means all
the types of clinics specified in subdivision (b) of Section 1204,
including surgical clinics, chronic dialysis clinics, and
rehabilitation clinics.
(3) "Clinic corporation" means a nonprofit organization that
operates one or more primary care clinics, as defined in paragraphs
(1) and (2) of subdivision (a) of Section 1204, which are required to
be licensed under Section 1205, including a mobile health care unit
licensed or approved pursuant to the Mobile Health Care Services Act
(Chapter 9 (commencing with Section 1765.101)). "Clinic corporation"
shall not mean a health facility, as described in Section 1250 or
subdivision (b) of Section 32000.1, a health care district, as
described in subdivision (a) of Section 32000.1, or a person or
public or private entity that operates, establishes, manages,
conducts, or maintains clinics that are exempt from licensure
pursuant to Section 1206, except that a clinic corporation may
operate one or more intermittent clinics, as described in subdivision
(b) of Section 1206, in addition to licensed primary care clinics.
Except for Section 1205.5, 1206, 1206.1, or 1218.1, any section in
this chapter that refers to a "primary care clinic," "clinic," or
"licensed clinic" for the purposes of licensing, special permits,
inspection, or data collection shall also apply to a clinic
corporation.
(4) "Department" means the Licensing and Certification Division of
the State Department of Public Health, or its successor.
SEC. 2. Section 1207 of the Health and Safety Code is amended to
read:
1207. The state department shall inspect and
license clinics and clinic corporations , and shall
inspect and approve clinics and clinic corporations to
offer special services. Nothing in this section shall be
interpreted to require a clinic corporation to apply for a single
consolidated license pursuant to Section 1212.5.
SEC. 3. Section 1212 of the Health and Safety Code is amended to
read:
1212. (a) Any A person, firm,
association, partnership, or corporation desiring a license for a
clinic or a special permit for special services under the provisions
of this chapter, shall file with the department a verified
application on forms prescribed and furnished by the department,
containing the following:
(1) Evidence satisfactory to the department that the applicant is
of reputable and responsible character. If the applicant is a firm,
association, partnership, trust, corporation, or other artificial or
legal entity, like evidence shall be submitted as to the members,
partners, trustees or shareholders, directors, and officers thereof
and as to the person who is to be the administrator of, and exercise
control, management, and direction of the clinic for which
application is made.
(2) If the applicant is a partnership, the name and principal
business address of each partner, and, if any partner is a
corporation, the name and principal business address of each officer
and director of the corporation and name and business address of each
stockholder owning 10 percent or more of the stock thereof.
(3) If the applicant is a corporation, the name and principal
business address of each officer and director of the corporation, and
where the applicant is a stock corporation, the name and principal
business address of each stockholder holding 10 percent or more of
the applicant's stock and, where any stockholder is a corporation,
the name and principal business address of each officer and director
of the corporate stockholder.
(4) Evidence satisfactory to the department of the ability of the
applicant to comply with the provisions of this chapter and rules and
regulations promulgated under this chapter by the department.
(5) The name and address of the clinic, and if the applicant is a
professional corporation, firm, partnership, or other form of
organization, evidence that the applicant has complied with the
requirements of the Business and Professions Code governing the use
of fictitious names by practitioners of the healing arts. If the
applicant is a clinic corporation, the name and address of each
primary care clinic to be included on the license.
(6) The name and address of the professional licentiate
responsible for the professional activities of the clinic and the
licentiate's license number and professional experience.
(7) The class of clinic to be operated, the character and scope of
advice and treatment to be provided, and a complete description of
the building, its location, facilities, equipment, apparatus, and
appliances to be furnished and used in the operation of the clinic.
(8) Sufficient operational data to allow the department to
determine the class of clinic that the applicant proposes to operate
and the initial license fee to be charged.
(9) Any other information as may be required by the department for
the proper administration and enforcement of this chapter,
including, but not limited to, evidence that the clinic has a written
policy relating to the dissemination of the following information to
patients:
(A) A summary of current state laws requiring child passenger
restraint systems to be used when transporting children in motor
vehicles.
(B) A listing of child passenger restraint system programs located
within the county, as required by Section 27360 or 27362 of the
Vehicle Code.
(C) Information describing the risks of death or serious injury
associated with the failure to utilize a child passenger restraint
system.
(b) (1) No application is required where a licensed primary care
clinic adds a service that is not a special service, as defined in
Section 1203, or any regulation adopted thereunder, or remodels or
modifies an existing primary care clinic site. However, the clinic
shall notify the department, in writing, of the change in service or
physical plant no less than 60 days prior to adding the service or
remodeling or modifying an existing primary care clinic site. Nothing
in this subdivision shall be construed to limit the authority of the
department to conduct an inspection at any time pursuant to Section
1227, in order to ensure compliance with, or to prevent a violation
of, this chapter, or any regulation adopted under this chapter.
(2) Where applicable city, county, or state law obligates the
primary care clinic to obtain a building permit with respect to the
remodeling or modification to be performed by the clinic, the primary
care clinic shall provide a signed certification or statement as
described in Section 1226.3 to the department within 60 days
following completion of the remodeling or modification project
covered by the building permit.
(c) In the course of fulfilling its obligations under Section
1221.09, the department shall ensure that any application form
utilized by a primary care clinic, requiring information of the type
specified in paragraph (1), (4), (8), or (9) of subdivision (a), is
consistent with the requirements of Section 1225, including the
requirement that rules and regulations for primary care clinics be
separate and distinct from the rules and regulations for specialty
clinics. Nothing in this section shall be construed to require the
department to issue a separate application form for primary care
clinics.
SEC. 4. Section 1212.5 is added to the Health and Safety Code, to
read:
1212.5. (a) The department, upon application of a clinic
corporation that meets the requirements of Section 1212 and other
applicable requirements of licensure, shall issue a single
consolidated license to a clinic corporation that operates more than
one primary care clinic, as defined in paragraphs (1) and (2) of
subdivision (a) of Section 1204, including any mobile unit licensed
under the Mobile Health Care Services Act (Chapter 9 (commencing with
Section 1765.101)).
(b) Eligibility for the issuance of a single consolidated license
shall be based on the following criteria:
(1) There is a single governing body for all primary care clinics
maintained and operated by the licensee.
(2) There are one or more medical directors operating under a
single set of policies, procedures, and standards for all the primary
care clinics maintained and operated by the licensee.
(c) In issuing the single consolidated license, the department
shall specify the name, location, hours of operation, and services of
each clinic included in the license.
(d) A clinic corporation that is issued a single consolidated
license may, at its discretion, consolidate the administrative
functions set out in Section 1218.2 for all clinics that are subject
to the single consolidated license.
SEC. 5. Section 1213 of the Health and Safety Code is amended to
read:
1213. Any person, firm, association, partnership, corporation
, or other legal entity desiring a license for a clinic
shall be exempt from the requirements of Chapter 1
2 (commencing with Section 15000)
16000) of Division 12.5.
SEC. 6. Section 1214 of the Health and Safety Code is amended to
read:
1214. Each application under this chapter for an initial license,
renewal license, license upon change of ownership, or special permit
shall be accompanied by a Licensing and Certification Program fee,
as follows:
(a) For all primary care clinics licensed pursuant to this
chapter, the annual fee shall be set in accordance with Section 1266.
(b) For all specialty clinics licensed pursuant to this chapter,
the annual fee shall be set in accordance with Section 1266.
(c) For all rehabilitation clinics, the annual fee shall be set in
accordance with Section 1266.
(d) For all clinic corporations licensed pursuant to this chapter,
the annual fee shall be a percentage of the fee for primary care
clinics set pursuant to subdivision (a) for each clinic site.
Intermittent clinics, as described in subdivision (h) of Section
1206, included in the clinic corporation license shall not be counted
for the purpose of establishing the license fee.
SEC. 7. Section 1216 of the Health and Safety Code is amended to
read:
1216. (a) Every clinic holding a license or included in the
license of a clinic corporation shall, on or before the 15th
day of February each year, file with the Office of Statewide Health
Planning and Development upon forms to be furnished by the office, a
verified report showing the following information relating to the
previous calendar year:
(1) Number of patients served and descriptive information,
including age, gender, race, and ethnic background of patients.
(2) Number of patient visits by type of service, including all of
the following:
(A) Child health and disability prevention screens, treatment, and
followup services.
(B) Medical services.
(C) Dental services.
(D) Other health services.
(3) Total clinic operating expenses.
(4) Gross patient charges by payer category, including Medicare,
Medi-Cal, the Child Health Disability Prevention Program, county
indigent programs, other county programs, private insurance,
self-paying patients, nonpaying patients, and other payers.
(5) Deductions from revenue by payer category, bad debts, and
charity care charges.
(6) Additional information as may be required by the office or
the department.
(b) In the event a clinic fails to file a timely report, the
department may suspend the license of the clinic until the report is
completed and filed with the office.
(c) In order to promote efficient reporting of accurate data, the
office shall consider the unique operational characteristics of
different classifications of licensed clinics, including, but not
limited to, the limited scope of services provided by some specialty
clinics, in its design of forms for the collection of data required
by this section.
(d) For the purpose of administering funds appropriated from the
Cigarette and Tobacco Products Surtax Fund for support of licensed
clinics, clinics receiving those funds may be required to report any
additional data the office or the department may determine necessary
to ensure the equitable distribution and appropriate expenditure of
those funds. This shall include, but not be limited to, information
about the poverty level of patients served and communicable diseases
reported to local health departments.
(e) This section shall apply to all primary care clinics but
shall not apply to intermittent clinics, as defined in subdivision
(h) of Section 1206 .
(f) This section shall apply to all specialty clinics, as defined
in paragraph (2) of subdivision (a) of Section 1204 of the Health and
Safety Code that receive tobacco tax funds pursuant to Article 2
(commencing with Section 30121) of Chapter 2 of Part 13 of Division 2
of the Revenue and Taxation Code.
(g) Specialty clinics that are not required to report pursuant to
subdivision (f) shall report data as directed in Section 1216 as it
existed prior to the enactment of Chapter 1331 of the Statutes of
1989 and Chapter 51 of the Statutes of 1990.
SEC. 8. Section 1219 of the Health and Safety Code is amended to
read:
1219. (a) Except for an affiliate clinics
clinic , as defined in Section 1218.1, or a
clinic corporation that includes in its application for a single
consolidated license a primary care clinic, including a mobile health
care unit, that was licensed and in good standing as of December 31,
2009, if a clinic or an applicant for a license has not been
previously licensed, the department may only issue a provisional
license to the clinic as provided in this section.
(b) A provisional license to operate a clinic shall terminate six
months from the date of issuance.
(c) Within 30 days prior to the termination of a provisional
license, the department shall give the clinic a full and complete
inspection, and, if the clinic meets all applicable requirements for
licensure, a regular license shall be issued. If the clinic does not
meet the requirements for licensure but has made substantial progress
towards meeting such those
requirements, as determined by the department, the initial
provisional license shall be renewed for six months.
(d) If the department determines that there has not been
substantial progress towards meeting licensure requirements at the
time of the first full inspection provided by this section, or, if
the department determines upon its inspection made within 30 days of
the termination of a renewed provisional license that there is a lack
of full compliance with such those
requirements, no further license shall be issued.
(e) If an applicant for a provisional license to operate a clinic
has been denied by the department, the applicant may contest the
denial by filing a statement of issues, as provided in Section 11504
of the Government Code. The proceedings to review the denial shall be
conducted pursuant to the provisions of Chapter 5 (commencing with
Section 11500) of Part 1 of Division 3 of Title 2 of the Government
Code.
SEC. 9. Section 1221 of the Health and Safety Code is amended to
read:
1221. For purposes of this article, the following definitions
shall apply:
(a) "Centralized applications unit" means the centralized
applications unit in the Licensing and Certification Division of the
State Department of Public Health Services
, or a successor entity.
(b) "Clinic" means nonprofit primary care
clinics, nonprofit community health centers, nonprofit rural
health clinics, nonprofit community clinics, and free clinics.
SEC. 10. 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.