BILL ANALYSIS Ó SENATE COMMITTEE ON HEALTH Senator Ed Hernandez, O.D., Chair BILL NO: AB 297 AUTHOR: Chesbro AMENDED: April 29, 2013 HEARING DATE: June 26, 2013 CONSULTANT: Marchand SUBJECT : Primary care clinics. SUMMARY : Permits licensed primary care clinics to submit certification from the Accreditation Association for Ambulatory Health Care to the Department of Public Health for purposes of data collection and extraction for fee calculations, in addition to the existing ability to submit certification from the Joint Commission on the Accreditation of Healthcare Organizations. Existing law: 1.Licenses and regulates various types of clinics, including primary care clinics, by the Department of Public Health (DPH). 2.Permits primary care clinics to submit to DPH verification of certification from the Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) for entry into the electronic Licensing Management System for purposes of data collection and extraction for licensing and certification fee calculations. This bill: Permits primary care clinics to submit verification of certification from the Accreditation Association for Ambulatory Health Care (AAAHC), in addition to the existing ability to submit verification of Joint Commission certification, to DPH for entry into the electronic Licensing Management System for purposes of data collection and extraction for licensing and certification fee calculations. FISCAL EFFECT : This bill has been keyed non-fiscal. PRIOR VOTES : Assembly Health: 18- 0 Assembly Floor: 75- 0 COMMENTS : 1.Author's statement. This bill is a technical, cleanup bill Continued--- AB 297 | Page 2 that would update obsolete language to reflect the current practice in which DPH accepts certification from AAAHC as well as that of the Joint Commission. Adopting verification from these entities in lieu of DPH site inspections expedites the process and reduces 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. According to DPH, the section of law this bill is amending authorizes primary care clinics to submit certification of accreditation for entry into the Electronic Licensing Management System (ELMS), which is the electronic database DPH uses to store information about licensed health facilities. DPH states that there is no requirement for a clinic to be certified by an accrediting organization, and accreditation information is not factored into the calculation of licensure fees. However, DPH waives the periodic licensing inspection requirements for those clinics that are accredited by a recognized accrediting organization. DPH states that it does not approve accrediting organizations, but recognizes those organizations that are approved by the federal Centers for Medicare and Medicaid Services (CMS) as national accreditation organizations. The list of CMS-approved accrediting organizations includes the Joint Commission, as well as AAAHC. 3.Request for amendments. The American Osteopathic Association (AOA) requests that this bill be amended to include AOA's Healthcare Facilities Accreditation Program (AOA/HFAP). AOA states that AOA/HFAP is a nationally recognized accreditation organization conducting accreditation surveys for more than 65 years, and that it meets or exceeds all standards required by CMS to provide accreditation to hospitals and ambulatory care/surgical facilities, and has maintained its deeming authority continuously since the inception of CMS. AOA states that excluding an accrediting organization equipped to accredit an ambulatory care program is providing a disservice to health care facilities within California. 4.Support. This bill is sponsored by the California Primary Care Association (CPCA). This bill is a technical clean-up bill that would update obsolete language to reflect the current practice in which DPH accepts certification from AAAHC, as well as that of the Joint Commission. The Association of California Healthcare Districts states in support that AB 297 | Page 3 adopting verification from these accrediting entities in lieu of DPH site inspections expedites the licensing and certification processes and reduces state costs that otherwise would be required for the site inspections and data collection. 5.Suggested amendment. There is a section of existing law, related to the section being amended by this bill, which, in relevant part, exempts a primary care clinic from DPH inspection requirements if the clinic is "accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Accreditation Association for Ambulatory Health Care (AAAHC), or any other accrediting organization recognized by the department." The author may wish to amend this bill with similar language, so that a clinic could submit certification information from any accrediting organization recognized by DPH. This would reflect current practice by DPH, and may accommodate the request for amendments by AOA. Additionally, the reference in existing law to the "Joint Commission on Accreditation of Healthcare Organizations" is outdated; in 2007, it changed its name to "Joint Commission." While this was not added by this bill, the author may wish to consider an amendment to update this provision of law. SUPPORT AND OPPOSITION : Support: California Primary Care Association (sponsor) Association of California Healthcare Districts Oppose:None received. -- END --