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  
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          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  




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            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.

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