BILL NUMBER: SB 442	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 15, 2009

INTRODUCED BY   Senator Ducheny

                        FEBRUARY 26, 2009

   An act to amend Sections 1200,  1207, 1212, 1213, 1214,
1216,   1213, 1214,  1219,  and 1221
  1229, and 1266  of, and to add Section 1212.5 to,
the Health and Safety Code, relating to clinics.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 442, as amended, 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  require the department to annually  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 that provides direct medical, surgical,
dental, optometric, or podiatric advice, services, or treatment to
patients who remain less than 24 hours, and 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). A place,
establishment, or institution 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 that advice, counseling, information, or referral does
not constitute the practice of medicine, surgery, dentistry,
optometry, or podiatry, shall not be deemed a clinic for purposes of
this chapter.
   (b) For purposes of this chapter:
   (1) "Primary care clinics" means all the types of clinics
specified in subdivision (a) of Section 1204, including community
clinics and free clinics.
   (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
  that  are required to be licensed under Section
1205,  including a   that may include one or
more  mobile health care  unit   units
required to be  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.   1765.101)) and
operated as primary care clinics, or one or more primary care clinics
and one or more mobile health care units. 
   (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 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) 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.   SEC. 2.   Section 1212.5 is
added to the Health and Safety Code, to read:
   1212.5.  (a)  The department, upon   Upon
 application of a clinic corporation  that meets the
requirements of Section 1212 and other applicable requirements of
licensure,   that operates more than one primary care
clinic, as defined in paragraphs (1) and (2) of subdivision (a) of
Section 1240, the department  shall issue a single consolidated
license to  a   the  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)).
  if the clinics included in the single consolidated
license applica   tion meet the requirements of Section 1212
and other applicable requirements for licensure.  
   (b) In addition to primary care clinics, as described in
subdivision (a), a clinic corporation may include, in its application
for a single consolidated license, one or more mobile health care
units that meet the requirements under the Mobile Health Care
Services Act (Chapter 9 (commencing with Section 1765.101)). 

   (c) Upon application of a clinic corporation that operates more
than one mobile health care unit and only operates mobile health care
units, the department shall issue a single consolidated license to
the clinic corporation if the mobile health care units included in
the single consolidated license application meet the requirements
under the Mobile Health Care Services Act (Chapter 9 (commencing with
Section 1765.101)). 

    (b) 
    (d)  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. 
    (1) A completed application for a single consolidated license
has been submitted and the associated license fee has been paid.

    (2) The corporate officers, as specified in Section 5213 of
the Corporations Code, are the same for each primary care clinic or
mobile unit included in the single consolidated license. 
    (3) The clinic corporation's nonprofit board of directors
both owns and operates each primary care clinic or mobile unit
included in the single consolidated license. 
    (4) The clinic corporation has submitted evidence to the
department establishing compliance with the minimum construction
standards of adequacy and safety for physical plant, pursuant to
subdivision (b) of Section 1126, for each primary care clinic
included in the single consolidated license. 
    (2) 
    (5)  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. 
    (e) For purposes of this section there is a presumption that
all primary care clinics included in the application for the single
consolidated license that are separately licensed and in good
standing at the time of application for a single consolidated
license, meet the requirements of subdivision (a) and paragraph (4)
of subdivision (d). 
    (f) For purposes of this section there is a presumption that
all mobile units included in the application for the single
consolidated license that are separately licensed or approved by the
department and in good standing at the time of application for a
single consolidated license, meet the requirements of subdivision
(b). 
    (g) The department shall issue a single consolidated license
under this section within 30 days of receipt of a completed
application or within seven days of the date the central application
unit approves the application for a single consolidated license,
whichever is sooner. If the department determines that an applicant
does not meet the criteria for a single consolidated license as set
forth in subdivision (d), it shall identify, in writing and with
particularity, the grounds for that determination and shall, instead,
process the application under this chapter as if the application was
submitted on the date the denial was released. 
    (h) Upon application to the department, clinic corporation
that is issued a single consolidated license pursuant to this section
may add a clinic, including a mobile health care unit, to the single
consolidated license, or remove a clinic, including a mobile health
care unit, from the single consolidated license, at any time during
the license period. For every primary care clinic or mobile health
care unit added to the single consolidated license before the next
renewal date, the clinic corporation shall pay a license fee, if
applicable, equivalent to the fee for one primary care clinic
included in a single consolidated license set pursuant to subdivision
(d) of Section 1266, prorated based on the effective date of the
addition of the clinic. 
    (i) The department shall develop a single-page application
form for adding a clinic between renewal periods that includes all of
the following information: 
    (1) The name and address of the clinic corporation. 
    (2) The name and address of the clinic or mobile health unit
to be added or removed. 
    (3) The days and hours of operation and the services provided
at each clinic site added. 
    (4) A self-attestation that each clinic site added meets the
requirements of Section 1212, including minimum construction
standards for adequacy and safety of physical plant, pursuant to
subdivision (b) of Section 1226. 
    (5) Evidence of appropriate and sufficient fire clearance.

    (j) A clinic corporation that is issued a single consolidated
license may consolidate the administrative functions, as specified
in Section 1218.2, for all clinics that are subject to the single
consolidated license. 
    (k) Upon written notice to the department, a clinic
corporation that has been issued a single consolidated license may
apply for one or more special permits pursuant to Section 1202. A
clinic corporation that is issued one or more special permits may
transfer the special permits from one clinic site to another site
that is included in the single consolidated license. 
    (l) The department shall transmit to the clinic corporation
that is issued a single consolidated license a renewal fee invoice at
least 45 days prior to the expiration date of the single
consolidated license. Failure by the clinic corporation to make
timely payment of the renewal fee shall result in the expiration of
any licenses and special permits. Timely application for renewal
shall be deemed equivalent to renewal of the license and special
permits, if any, where the department is unable to issue a renewal
license or special permit on or before the expiration date. 
    (m) If the department issues a single consolidated license
pursuant to this section, the department, except as limited by
Section 1229 and Article 5 (commencing with Section 1240), may take
any action authorized by this chapter, including, but not limited to,
action specified in Article 5 (commencing with Section 1240 with
respect to a primary care clinic or special services provided in a
clinic that is included in the consolidated license. An action
against one or more clinics included in the consolidated license
shall not be deemed an action against the clinic corporation as a
whole. 
    (n) Nothing is this section shall require the business office
of a clinic corporation to enroll in the Medi-Cal program, pursuant
to subdivision (c) of Section 14043.15 of the Welfare and
Institutions Code, or a program specified in Section 1222, as a
clinic location subject to the single consolidated license. Each
primary care clinic included in the single consolidated license shall
be deemed to be licensed for purposes of enrollment as a provider in
any health care program. Each primary care clinic, including a
mobile health care unit, may separately enroll as a provider in the
Medi-Cal program or other health care program using the business
address of the primary care clinic. 
    (o) Nothing in this section shall affect prospective payment
rate calculations made under Section 14132.100 of the Welfare and
Institutions Code for individual rural health clinics and federally
qualified health centers included in a single consolidated license.

    (p) Nothing in this section shall affect the requirements for
obtaining a permit or license from the Board of Pharmacy pursuant to
Chapter 9 (commencing with Section 1480) of Division 2 of the
Business and Professions Code. Each primary care clinic that is
included in the single consolidated license shall be deemed to be
licensed as a primary care clinic for purposes of obtaining a
pharmacy license or permit. 
    (q) Nothing in this section shall affect the requirements for
obtaining a clinic laboratory registration or license pursuant to
Section 1265 of the Business and Professions Code. Each primary care
clinic, including a mobile health care unit, that is included in the
single consolidated license shall be deemed to be licensed as a
primary care clinic for the purpose of obtaining a clinic laboratory
license or registration. 
    (r) Nothing in this section shall require a clinic
corporation to apply for a single consolidated license. 
   SEC. 5.   SEC. 3.   Section 1213 of the
Health and Safety Code is amended to read:
   1213.   Any   A  person, firm,
association, partnership, corporation, or other legal entity desiring
a license for a clinic shall be exempt from the requirements of
Chapter 2 (commencing with Section 16000) of Division 12.5.
   SEC. 6.   SEC. 4.   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  
issued a single consolidated license  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.   set
in accordance with Section 1266.  
  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.   SEC. 5.   Section 1219 of the
Health and Safety Code is amended to read:
   1219.  (a) Except for an affiliate clinic, as defined in Section
1218.1, or a clinic corporation that includes  ,  in its
application for a single consolidated  license a 
 license, one or more  primary care  clinic
  clinics  , including  a  
one or more  mobile health care  unit  
units  , that  was   were  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 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 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, or a successor entity.
   (b) "Clinic" means primary care clinics, nonprofit community
health centers, nonprofit rural health clinics, nonprofit community
clinics, and free clinics. 
   SEC. 6.    Section 1229 of the   Health and
Safety Code   is amended to read: 
   1229.   (a)    The state department shall notify
 any   , in writing, a  clinic of all
deficiencies in its compliance with the provisions of this chapter
 ,  or the rules and regulations adopted hereunder, 
which   that  are discovered or confirmed by
inspection, and the clinic shall agree with the  state
 department  upon   on  a plan of
correction  which   that  shall give the
clinic a reasonable time to correct  such   the
 deficiencies. During  such   the 
allotted time, a list of deficiencies and the plan of correction
shall be conspicuously posted in a clinic location accessible to
public view. If  ,  at the end of the allotted time 
, as  provided in the plan of correction, the clinic has
failed to correct the deficiencies, the  state 
department shall assess the licensee a civil penalty not to exceed
fifty dollars ($50) per day, until the state department finds the
clinic in compliance. In  such   that 
case, the  state  department may also initiate
action against the clinic to revoke or suspend the license. Nothing
in this chapter shall be deemed to prohibit a clinic  which
  that  is unable to correct the deficiencies
 , as  specified in a plan of  corrections,
  correction  for reasons beyond its control from
voluntarily surrendering its license pursuant to Section 1245 prior
to the assessment of  any   a  civil
penalty or the initiation of  any   a 
revocation or suspension proceeding. 
   (b) Notwithstanding subdivision (a), the department shall notify,
in writing, a clinic corporation of all deficiencies in compliance
with the provisions of this chapter, or the rules and regulations
adopted hereunder, that are discovered or confirmed by inspection, in
one or more clinics included in a single consolidated license issued
pursuant to Section 1212.5, and the clinic corporation shall agree
with the department on a plan of correction that gives the clinic
corporation a reasonable time to correct the deficiencies. If, at the
end of the time provided in the plan of correction, the clinic
corporation has failed to correct the deficiencies, the department
shall assess the licensee a civil penalty not to exceed fifty dollars
($50) per day per clinic cited as deficient, until the department
finds the clinic corporation in compliance. The department may also
initiate action against the clinic corporation to remove or suspend
the clinic or clinics that are the subject of the deficiencies from
the single consolidated license. Nothing in this chapter shall be
deemed to prohibit a clinic corporation that is unable, for reasons
beyond its control, to correct the deficiencies specified in the plan
of correction from voluntarily removing a clinic or clinics from its
single consolidated license prior to the assessment of a civil
penalty or the initiation of a removal or suspension proceeding. In
no case shall the department initiate an action to revoke or suspend
the single consolidated license for uncorrected deficiencies outlined
in a written notice of deficiencies, in one or more clinics included
in a single consolidated license, unless each clinic, including a
mobile health care unit, that is included in the single consolidated
license is cited in the notice of deficiencies and the clinic
corporation failed to correct the deficiencies in every clinic within
the allotted time period according to the plan of correction. 
   SEC. 7.    Section 1266 of the   Health and
Safety Code  is amended to read: 
   1266.  (a) The Licensing and Certification Division shall be
supported entirely by federal funds and special funds by no earlier
than the beginning of the 2009-10 fiscal year unless otherwise
specified in statute, or unless funds are specifically appropriated
from the General Fund in the annual Budget Act or other enacted
legislation. For the 2007-08 fiscal year, General Fund support shall
be provided to offset licensing and certification fees in an amount
of not less than two million seven hundred eighty-two thousand
dollars ($2,782,000).
   (b) The Licensing and Certification Program fees for the 2006-07
fiscal year shall be as follows:


  Type of       Facility          Fee
General Acute Care Hospitals   $ 134.10  per bed
Acute Psychiatric Hospitals    $ 134.10  per bed
Special Hospitals              $ 134.10  per bed
Chemical Dependency Recovery
Hospitals                      $ 123.52  per bed
Skilled Nursing Facilities     $ 202.96  per bed
Intermediate Care Facilities   $ 202.96  per bed
Intermediate Care Facilities
- Developmentally Disabled     $ 592.29  per bed
Intermediate Care Facilities
-       Developmentally                  per
Disabled - Habilitative        $1,000.00 facility
Intermediate Care Facilities
- Developmentally Disabled -             per
Nursing                        $1,000.00 facility
Home Health Agencies                     per
                                $2,700.00 facility
Referral Agencies                        per
                                $5,537.71 facility
Adult Day Health Centers                 per
                                $4,650.02 facility
Congregate Living Health
Facilities                     $ 202.96  per bed
Psychology Clinics                       per
                                $ 600.00  facility
Primary Clinics - Community              per
and Free                       $ 600.00  facility
Specialty Clinics - Rehab
Clinics                                  per
  (For       profit)            $2,974.43 facility
  (Nonprofit)                             per
                                $ 500.00  facility
Specialty Clinics - Surgical             per
and Chronic                    $1,500.00 facility
Dialysis Clinics                         per
                                $1,500.00 facility
Pediatric Day Health/Respite
Care                           $ 142.43  per bed
Alternative Birthing Centers             per
                                $2,437.86 facility
Hospice                                  per
                                $1,000.00 facility
Correctional Treatment Centers $ 590.39  per bed


   (c) Commencing February 1, 2007, and every February 1 thereafter,
the department shall publish a list of estimated fees pursuant to
this section. The calculation of estimated fees and the publication
of the report and list of estimated fees shall not be subject to the
rulemaking requirements of Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code.

   (d) Commencing February 1, 2010, and every February thereafter,
the department shall publish the estimated fee for a single
consolidated license issued under Section 1212.5 pursuant to this
section. The calculation of the estimated fee shall be based on a
percentage of the fee for primary care clinics, for each primary care
clinic included in a single consolidated license, and shall be
included in the report and list of estimated fees required by
subdivisions (c) and (e).  
   (d) 
    (e)  By February 1 of each year, the department shall
prepare the following reports and shall make those reports, and the
list of estimated fees required to be published pursuant to
subdivision (c), available to the public by submitting them to the
Legislature and posting them on the department's  Internet 
Web site:
   (1) The department shall prepare a report of all costs for
activities of the Licensing and Certification Program. At a minimum,
this report shall include a narrative of all baseline adjustments and
their calculations, a description of how each category of facility
was calculated, descriptions of assumptions used in  any
 calculations, and shall recommend Licensing and
Certification Program fees in accordance with the following:
   (A) Projected workload and costs shall be grouped for each fee
category.
   (B) Cost estimates, and the estimated fees, shall be based on the
appropriation amounts in the Governor's proposed budget for the next
fiscal year, with and without policy adjustments to the fee
methodology.
   (C) The allocation of program, operational, and administrative
overhead, and indirect costs to fee categories shall be based on
generally accepted cost allocation methods. Significant items of
costs shall be directly charged to fee categories if the expenses can
be reasonably identified to the fee category that caused them.
Indirect and overhead costs shall be allocated to all fee categories
using a generally accepted cost allocation method.
   (D) The amount of federal funds and General Fund moneys to be
received in the budget year shall be estimated and allocated to each
fee category based upon an appropriate metric.
   (E) The fee for each category shall be determined by dividing the
aggregate state share of all costs for the Licensing and
Certification Program by the appropriate metric for the category of
licensure. Amounts actually received for new licensure applications,
including change of ownership applications, and late payment
penalties, pursuant to Section 1266.5, during each fiscal year shall
be calculated and 95 percent shall be applied to the appropriate fee
categories in determining Licensing and Certification Program fees
for the second fiscal year following receipt of those funds. The
remaining 5 percent shall be retained in the fund as a reserve until
appropriated.
   (2) (A) The department shall prepare a staffing and systems
analysis to ensure efficient and effective utilization of fees
collected, proper allocation of departmental resources to licensing
and certification activities, survey schedules, complaint
investigations, enforcement and appeal activities, data collection
and dissemination, surveyor training, and policy development.
   (B) The analysis under this paragraph shall be made available to
interested persons and shall include all of the following:
   (i) The number of surveyors and administrative support personnel
devoted to the licensing and certification of health care facilities.

   (ii) The percentage of time devoted to licensing and certification
activities for the various types of health facilities.
   (iii) The number of facilities receiving full surveys and the
frequency and number of follow up visits.
   (iv) The number and timeliness of complaint investigations.
   (v) Data on deficiencies and citations issued, and numbers of
citation review conferences and arbitration hearings.
   (vi) Other applicable activities of the licensing and
certification division. 
   (e) 
    (f)  (1) The department shall adjust the list of
estimated fees published pursuant to subdivision (c) if the annual
Budget Act or other enacted legislation includes an appropriation
that differs from those proposed in the Governor's proposed budget
for that fiscal year.
   (2) The department shall publish a final fee list, with an
explanation of any adjustment, by the issuance of an all facilities
letter, by posting the list on the department's Internet Web site,
and by including the final fee list as part of the licensing
application package, within 14 days of the enactment of the annual
Budget Act. The adjustment of fees and the publication of the final
fee list shall not be subject to the rulemaking requirements of
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code. 
   (f) 
    (g)  (1) No fees shall be assessed or collected pursuant
to this section from any state department, authority, bureau,
commission, or officer, unless federal financial participation would
become available by doing so and an appropriation is included in the
annual Budget Act for that  state  department,
authority, bureau, commission, or officer for this purpose. No fees
shall be assessed or collected pursuant to this section from any
clinic that is certified only by the federal government and is exempt
from licensure under Section 1206, unless federal financial
participation would become available by doing so.
   (2) For the 2006-07 state fiscal year, no fee shall be assessed or
collected pursuant to this section from any general acute care
hospital owned by a health care district with 100 beds or less.

   (g) 
    (h)  The Licensing and Certification Program may change
annual license expiration renewal dates to provide for efficiencies
in operational processes or to provide for sufficient cash flow to
pay for expenditures. If an annual license expiration date is
changed, the renewal fee shall be prorated accordingly. Facilities
shall be provided with a 60-day notice of  any  
a  change in their annual license renewal date.
   SEC. 10.   SEC. 8.   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.