BILL ANALYSIS �
AB 297
Page 1
Date of Hearing: April 23, 2013
ASSEMBLY COMMITTEE ON HEALTH
Richard Pan, Chair
AB 297 (Chesbro) - As Amended: March 19, 2013
SUBJECT : Primary care clinics.
SUMMARY : Authorizes a primary care clinic to submit
verification of certification from the National Committee for
Quality Assurance (NCQA) or the Accreditation Association for
Ambulatory Health Care (AAAHC) to the Licensing and
Certification (L&C) Division of the Department of Public Health
(DPH) for purposes of data collection and extraction for
licensing and certification fee calculations.
EXISTING LAW :
1)Defines a clinic as 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.
2)Provides that primary care clinics such as community clinics,
free clinics, and specified specialty clinics are eligible for
licensure by DPH.
3)Authorizes primary care clinics to submit verification of
Joint Commission on Accreditation of Healthcare Organization
(JCAHO) certification to the L&C Division within DPH for entry
into the electronic Licensing Management System for purposes
of data collection and extraction for licensing and
certification fee calculations.
FISCAL EFFECT : None.
COMMENTS :
1)PURPOSE OF THIS BILL . The California Primary Care Association
(CPCA) is the sponsor of this bill. According to the author
and CPCA, this is a technical cleanup bill to reflect current
practice. Adopting verification from these entities in lieu
of DPH site inspections expedites the process and reduces
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state costs that otherwise would be required for the site
inspections and data collection. The fees are collected
annually, and re-inspection is required every three years.
2)BACKGROUND . Primary care clinics are required to be licensed
through the authority of the DPH. Community clinics and free
clinics are two types of primary care clinics. Examples of
community clinics are federally qualified health centers
(FQHCs) and rural health centers. DPH utilizes standards
defined in state and federal law and regulations to evaluate
health facility compliance. The licensing and certification
process is intended to both ensure public safety at community
clinics, and to prevent fraud and abuse of the Medi-Cal and
Medicare billing systems. There are numerous regulations that
clinics must meet regarding physical plant and facility
building standards, pharmaceutical storage and administration,
data reporting, basic services, and staffing in order to
obtain and maintain a primary care clinic license. The clinic
must have the following documents: clinic operational policies
and procedures, transfer agreements, service agreements,
written administrative policies, employee records, employee
health examinations and health records, emergency management
plans, and a quality assurance evaluation policy. The
California Health and Safety Code, the California Code of
Regulations, and other state and federal regulations contain
specific requirements for primary care clinics.
Currently DPH licenses FQHCs that comply with state safety
standards. DPH conducts site inspections and compiles
information to verify and certify compliance with those safety
standards, and also to determine the appropriate calculation
of the DPH's licensing and certification fees. Existing law
provides that in lieu of a DPH site inspection, an FQHC can
submit certification from JCAHO verifying that the FQHC was
inspected by JCAHO and is in compliance with the state's
safety standards. Since the statute was enacted, DPH accepts
verification of compliance from an additional accreditation
entity, the AAAHC. Accrediting entities are independent
non-profit organizations. Accreditation is not required for
an FQHC to operate, but it does certify that the FQHC has met
state standards to assure quality services and facilities.
FQHCs contract with an accrediting entity for inspection and
verification of compliance with state standards.
3)AUTHOR'S TECHNICAL AMENDMENTS . The author would like to
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delete from the bill reference to the NCQA since NCQA does not
certify FQHCs.
REGISTERED SUPPORT / OPPOSITION :
Support
California Primary Care Association
Opposition
None on file.
Analysis Prepared by : Rosielyn Pulmano / HEALTH / (916)
319-2097