BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 442|
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UNFINISHED BUSINESS
Bill No: SB 442
Author: Ducheny (D), et al
Amended: 8/12/10
Vote: 21
SENATE HEALTH COMMITTEE : 11-0, 4/22/09
AYES: Alquist, Strickland, Aanestad, Cedillo, Cox,
DeSaulnier, Leno, Maldonado, Negrete McLeod, Pavley, Wolk
SENATE APPROPRIATIONS COMMITTEE : 9-0, 1/21/10
AYES: Kehoe, Cox, Corbett, Denham, Leno, Liu, Price,
Walters, Yee
SENATE FLOOR : 35-0, 1/28/10
AYES: Aanestad, Ashburn, Calderon, Cedillo, Cogdill,
Corbett, Correa, Cox, Denham, DeSaulnier, Ducheny,
Dutton, Florez, Hancock, Harman, Hollingsworth, Kehoe,
Leno, Liu, Lowenthal, Maldonado, Negrete McLeod, Oropeza,
Padilla, Pavley, Price, Romero, Simitian, Steinberg,
Strickland, Wiggins, Wolk, Wright, Wyland, Yee
NO VOTE RECORDED: Alquist, Huff, Runner, Walters, Vacancy
ASSEMBLY FLOOR : 74-0, 8/16/10 - See last page for vote
SENATE HEALTH COMMITTEE : 7-0, 8/19/10
AYES: Alquist, Strickland, Aanestad, Cedillo, Leno,
Negrete McLeod, Romero
NO VOTE RECORDED: Pavley, Vacancy
SUBJECT : Clinic corporation: licensing
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SOURCE : California Family Health Council
California Primary Care Association
Planned Parenthood Affiliates of California
DIGEST : This bill streamlines administrative processes
for community clinics to apply for affiliate clinic
licensure from the Department of Public Health.
Assembly Amendments delete permissive language and
require an affiliate clinic application to be signed by
an officer of the clinic corporation's board of directors
or the clinic corporation's chief executive officer or
executive director.
ANALYSIS :
Existing law:
1. Provides for the licensing and regulation of health
clinics, including community and free clinics, by the
Department of Public Health (DPH).
2. Provides for a fee to be paid for an initial and annual
renewal license, as specified. Estimated fees are
published every February 1 by DPH.
3. Permits a primary care clinic that has held a valid,
unrevoked, and unsuspended license for at least the
preceding five years to apply to establish another
primary care clinic at an additional site, which is
referred to as an affiliate clinic.
4. Provides that the DPH license an affiliate clinic
without the necessity of first conducting an initial
onsite survey if specified conditions are met and within
30 days of receipt of a completed application or within
seven days of approving it.
This bill:
1. Requires the affiliate clinic application be contained
in a simple form and specifies the contents of the
application form.
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2. Establishes related definitions for terms such as
"clinic corporation".
3. Requires a clinic corporation to act as the
administrative headquarters for communications with DPH.
4. Requires DPH to retain information related to clinic
corporations maintaining affiliate clinic licenses.
Specifies the information DPH is required to maintain.
Specifies a clinic corporation will not be required to
resubmit information maintained by DPH about clinic
corporations when applying for affiliate licensure.
5. Requires a clinic corporation to submit a single report
of change of governance for the clinic corporation and a
single payment for all clinic licensure renewal fees.
Comments
According to the Senate Appropriations Committee analysis:
"CDPH [California Department of Public Health] currently
uses a system of 14 regional offices and a contract with
Los Angeles County and a database that tracks licensees
to oversee all of the health facilities, including
clinics that it licenses and certifies. The department
would likely need to modify the way in which it oversees
clinics since clinics and mobile health care units on a
single consolidated license would no longer be tracked by
an individual license number. Depending on the workload
at a given regional office, an additional program
technician could be needed to oversee a single
consolidated license and to facilitate communication
amongst the regional office that oversees the single
consolidated license and the other regional offices that
will directly oversee each of the clinics on the license.
If each of the offices and LA County needed to hire an
extra full-time staff member, costs could be up to
$600,000 in FY 2010-2011 and $1,000,000 in FY 2011-2012
and ongoing.
"This bill would state that regulations would not be
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necessary to implement these provisions. However, it is
likely that the CDPH would need to promulgate regulations
to implement these provisions where the language is not
explicit in its directions to the department, clinics,
mobile health care units, and clinic corporations. If
CDPH promulgates regulations, it would need approximately
$75,000 in FY 2010-2011 and $125,000 in FY 2011-2012.
"This bill would require the CDPH to annually set the fee
for a single consolidated license. It is estimated that
the CDPH would require an additional Fee Development
Analyst at $60,000 in FY 2009-2010 and $100,000 ongoing
to set the fee annually. Additionally, the CDPH would
need an additional information technology staff person to
modify the department's data systems to include this new
licensure category and create a system that would
accommodate the new way of tracking clinics at $60,000 in
FY 2010-2011 and $110,000 in FY 2011-2012.
"In total, depending on department workload, costs for
regulations, ongoing district office administration, and
database management and clinic tracking would be up to
approximately $800,000 in FY 2010-2011 and $1,300,000 FY
2011-2012, and $1,200,000 ongoing. All costs would be
offset by initial and annual single consolidated license
fees."
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12 2012-13 Fund
DPH administration up to $800 up to $1,300up to
$1,200 Special*
Initial clinic licensing/ unknown, but likely to
provide sufficient Special*
annual renewal fee revenue funds to cover ongoing
program costs
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* DPH Licensing and Certification Program Fund
SUPPORT : (Verified 1/25/10) (Unable to reverify)
California Family Health Council (co-source)
California Primary Care Association (co-source)
Planned Parenthood Affiliates of California (co-source)
Alliance Medical Center
Alliance for Rural Community Health
Alta Med Health Services
Anderson Valley Health Center
Central Valley Health Network
Chinatown Service Center
Clinicas del Camino Real, Incorporated
Clinica de Salud del Valle de Salinas
Clinica Sierra Vista
Community Clinic Association of Los Angeles County
East Community Health Center, Inc.
Eisner Pediatric and Family Medical Center
Family HealthCare Network
Family Health Centers of San Diego
Imperial Beach Health Center
LifeLong Medical Care
Long Valley Health Center
MayView Community Health Center
Mendocino Coast Clinics, Inc.
Mendocino Community Health Clinics, Inc.
Neighborhood Healthcare
North Coast Clinics Network
North County Health Services
Northeast Valley Health Corporation
Open Door Community Health Centers
Petaluma Health Center
Planned Parenthood Mar Monte
Planned Parenthood of San Diego and Riverside Counties
Planned Parenthood of Santa Barbara, Ventura and San Luis
Obispo
Planned Parenthood: Shasta-Diablo
Potter Valley Community Health Center
Redwood Coast Medical Services
Saban Free Clinic
Salud Para La Gente
Shasta Community Health Center
Shasta Consortium of Community Health Centers
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Shingletown Medical Center
Six Rivers Planned Parenthood
Southern Trinity Health Services
UMMA Community Clinic
Venice Family Clinic
West County Health Centers, Inc.
ARGUMENTS IN SUPPORT : The California Primary Care
Association (CPCA) states that this bill eliminates
unnecessary administrative barriers to increasing access to
care by allowing primary care clinics to operate multiple
sites under one consolidated license. CPCA states that
moving to a consolidated licensure will streamline the
licensing process, reduce duplication, and promote
administrative efficiency, and thereby maximize the ability
of safety net providers to meet the growing health care
needs of individuals and families in their communities.
Planned Parenthood Affiliates of California (PPAC) states
that each time a clinic corporation applies for a new
clinic, numerous documents must be submitted to DPH, many
of which are duplications of paperwork already filed with
the department. PPAC states that significant time and
money is expended on these cumbersome licensing activities
that take away from the critical services clinic staff
should be providing. PPAC states that this bill
streamlines and modernizes the current overly burdensome
processes and eliminate duplication.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Tom
Berryhill, Block, Blumenfield, Bradford, Brownley,
Buchanan, Caballero, Carter, Chesbro, Conway, Cook, Coto,
De La Torre, De Leon, DeVore, Eng, Evans, Feuer,
Fletcher, Fong, Fuentes, Fuller, Furutani, Gaines,
Galgiani, Garrick, Gatto, Gilmore, Hagman, Hall, Harkey,
Hayashi, Hernandez, Hill, Huber, Huffman, Jeffries,
Jones, Knight, Lieu, Logue, Bonnie Lowenthal, Ma,
Mendoza, Miller, Monning, Nava, Nestande, Niello,
Nielsen, Norby, V. Manuel Perez, Portantino, Ruskin,
Salas, Saldana, Silva, Skinner, Smyth, Solorio, Audra
Strickland, Swanson, Torlakson, Torres, Torrico, Tran,
Villines, Yamada, John A. Perez
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NO VOTE RECORDED: Bass, Bill Berryhill, Blakeslee, Charles
Calderon, Davis, Vacancy
CTW:mw 8/19/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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