Amended in Senate June 25, 2013

Amended in Assembly April 16, 2013

Amended in Assembly April 1, 2013

California Legislature—2013–14 Regular Session

Assembly Bill No. 852

Introduced by Assembly Member Quirk

February 21, 2013

An act to amend Section 129785 of, and to add Section 129788 to, the Health and Safety Code, relating to health facilities, and making an appropriation therefor.

LEGISLATIVE COUNSEL’S DIGEST

AB 852, as amended, Quirk. Skilled nursing facility construction, alteration, or addition: review.

Existing law, the Alfred E. Alquist Hospital Facilities Seismic Safety Act of 1983, requires design and construction standards for hospital buildings that house patients who have less than the capacity of normally healthy persons to protect themselves. Existing law also requires that those standards specify that hospitals must be reasonably capable of providing services to the public after a disaster.

Existing law requires the Office of Statewide Health Planning and Development (OSHPD) to approve or reject all plans for the construction or alteration of a hospital building. Existing law specifically requires the office, contingent upon an appropriation in the annual Budget Act, to establish a program for training fire and life safety officers to facilitate the timely performance of the office’s duties and responsibilities relating to the review of plans and specifications pertaining to the design and observation of construction of hospital buildings, as specified. Existing law authorizes the office to establish other training programs as necessary to ensure that a sufficient number of qualified persons are available to facilitate the timely performance of the office’s duties and responsibilities, as specified.

Existing law authorized the office to determine and assess an application fee not to exceed 2% of the project’s estimated construction costs for certain hospital facilities, and not to exceed 1.5% of the estimated construction costs for prescribed skilled nursing facilities or intermediate care facilities. Existing law establishes the Hospital Building Fund, requires deposit of these fees into the fund, and begin delete continously end delete begin insert continuously end insert appropriates the moneys in the fund for the purposes of administration of these provisions.

This bill would increase the maximum fee assessed to those skilled nursing facilities or intermediate care facilities to 2% of the project’s estimated construction costs. By increasing the amounts to be deposited into a continously appropriated fund, this bill would make an appropriation.

This bill would require OSHPD, except as prescribed, to develop, with stakeholders, reasonable timeframes for review and approval of skilled nursing facility construction, alteration, or addition projects and would authorize the office begin insert , until January 1, 2019, end insert to assess a reasonable fee for this review, as specified. The bill would require documents submitted for review to include the name and contact information of a project coordinator. The bill would begin insert , until January 1, 2019, end insert require the office to designate begin insert a end insert professional staff begin delete to review the projects and to complete the review within the timeframes end delete begin insert member to conduct a peer review of projects relating to skilled nursing facility construction or alteration end insert . The bill would authorize the office to seek outside assistance through contracts with qualified professional architectural or engineering firms to meet those begin delete review turnaround times end delete begin insert timeframes end insert . The bill would begin delete require OSHPD to monitor document submissions related to new or comparable design concepts meeting approval requirements and, end delete begin insert authorize OSHPD to, end insert when feasible, publish standard requirements begin insert for design concepts end insert for use by stakeholders begin insert when submitting plans for new construction, renovation, or replacement end insert . The bill would require OSHPD to work with stakeholders to establish education and outreach programs directed at reducing document submission error rates and turnaround times. The bill would require begin delete the office end delete begin insert OSHPD, if resources are available, end insert to publish the timeframes begin insert and other requirements end insert on its Internet Web site.

Vote: majority. Appropriation: yes. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

SECTION 1.  

The Legislature finds and declares all of the
following:

(a) A variety of factors have contributed to making health care
construction costs in California among the highest in the nation.
The costs are driven by the escalating price of raw materials, high
demand for skilled labor, and the complexity of design, plan
review, and approval of skilled nursing facility construction.

(b) Skilled nursing facilities are licensed health care facilities
that care for the state’s most fragile and vulnerable citizens.

(c) The physical infrastructure and related systems of these
licensed health facilities are governed by building and fire and life
safety code requirements regulated by the Office of Statewide
Health Planning and Development, the Office of the State Fire
Marshal, and the State Department of Public Health.

(d) As the industry moves to update the aging health care
infrastructure, incorporate advances in medical technology,
implement a modern health care delivery system, and improve
electronic medical records systems, health care construction activity
will increase to unseen levels, creating additional economic
pressure on the skilled nursing and construction industry.

(e) Licensed health care facilities are required to go through a
building application and plan check process under the jurisdiction
of the Office of Statewide Health Planning and Development.

(f) This process is bureaucratically efficient, but is subject to
inherent delays impacting timely approvals of projects. Although
the Office of Statewide Health Planning and Development has
developed internal policies that set timeframes for plan review and
approval, these policies are targets rather than enforceable
requirements.

(g) Improving the efficiency of health care building plan review
and construction efforts will not only reduce the time to design,
review, and complete facility construction, but also lower the cost
of the project and reduce overall cost pressures on the health care
system, allowing more resources to be directed to direct patient
services.

(h) Therefore, it is the intent of the Legislature to codify the
timeframes and due dates for completion by the Office of Statewide
Health Planning and Development of the review of facility
construction documents and to require the office to notify
applicants of the anticipated date the review will be completed and
returned to them.

SEC. 2.  

Section 129785 of the Health and Safety Code is
amended to read:

129785.  

(a)  (1)  The office shall determine an application
filing fee that will cover the costs of administering this chapter.
For a hospital facility, as defined in subdivision (a), (b), or (f) of
Section 1250, and for a skilled nursing or intermediate care facility,
as defined in subdivision (c), (d), (e), or (g) of Section 1250, the
fee shall not exceed 2 percent of a project’s estimated construction
cost. Application filing fees shall be established in accordance
with applicable procedures established in Article 5 (commencing
with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of Title
2 of the Government Code.

(2)  Notwithstanding paragraph (1), the minimum application
filing fee in any case shall be two hundred fifty dollars ($250).

(b)  The office shall issue an annual permit upon submission of
an application, pursuant to Section 129765, for one or more projects
of a hospital facility, as defined in subdivision (a), (b), or (f) of
Section 1250, if the total estimated construction cost is fifty
thousand dollars ($50,000) or less per fiscal year. The fee for the
annual permit shall be five hundred dollars ($500) and shall be in
lieu of an application filing fee. The annual permit shall cover all
projects undertaken for a particular hospital facility up to a total
estimated construction cost of fifty thousand dollars ($50,000)
during the state fiscal year in which the annual permit is issued.
If a hospital facility chooses not to apply for an annual permit to
cover a project or projects costing fifty thousand dollars ($50,000)
or less in total, the hospital facility may instead submit the project
or projects for review and approval as otherwise specified in this
chapter, including paying the application filing fee determined
under subdivision (a).

(c)  The office shall issue an annual permit upon submission of
an application, pursuant to Section 129765, for one or more projects
of a skilled nursing or intermediate care facility, as defined in
subdivision (c), (d), (e), or (g) of Section 1250, if the total estimated
construction cost is twenty-five thousand dollars ($25,000) or less
per fiscal year. The fee for the annual permit shall be two hundred
fifty dollars ($250) and shall be in lieu of an application filing fee.
The annual permit shall cover all projects undertaken for a
particular skilled nursing or intermediate care facility up to a total
estimated construction cost of twenty-five thousand dollars
($25,000) during the state fiscal year in which the annual permit
is issued. If a skilled nursing or intermediate care facility chooses
not to apply for an annual permit to cover a project or projects
costing twenty-five thousand dollars ($25,000) or less in total, the
skilled nursing or intermediate care facility may instead submit
the project or projects for review and approval as otherwise
specified in this chapter, including paying the application filing
fee determined under subdivision (a).

(d)  If the actual construction cost exceeds the estimated
construction cost by more than 5 percent, a further fee shall be
paid to the office, based on the above schedule and computed on
the amount that the actual cost exceeds the amount of the estimated
cost. If the estimated construction cost exceeds the actual
construction cost by more than 5 percent, the office shall refund
the excess portion of any paid fees, based on the above schedule
and computed on the amount that the estimated cost exceeds the
amount of the actual cost. A refund is not required if the applicant
did not complete construction or alteration of 75 percent of the
square footage included in the project, as contained in the approved
drawings and specifications for the project. In addition, the office
shall adopt regulations specifying other circumstances when the
office shall refund to an applicant all or part of any paid fees for
projects submitted under this chapter. The regulations shall include,
but not be limited to, refunds of paid fees for a project that is
determined by the office to be exempt or otherwise not reviewable
under this chapter, and for a project that is withdrawn by the
applicant prior to the commencement of review by the office of
the drawing and specifications submitted for the project. All
refunds pursuant to this section shall be paid from the Hospital
Building Account in the Architecture Public Building Fund, as
established pursuant to Section 129795.

SEC. 3.  

Section 129788 is added to the Health and Safety Code,
to read:

129788.  

(a) For projects not qualifying for rapid review under
Section 129856, the Facilities Development Division shall meet
reasonable timeframes developed by the office, in conjunction
with stakeholders, that include all of the following:

(1) Preliminary review of documents submitted to the office.

(2) First review of new projects.

(3) Backchecks.

(4) Amended construction documents.

(b) Documents submitted to the office for new construction of,
alteration of, or addition to, health facilities licensed pursuant to
subdivision (c) of Section 1250 shall include the name and contact
information for an individual designated to be the project
coordinator and shall be reviewed and approved within the
timeframes set forth in this section.

(c)  begin delete The end delete begin insert In order to ensure consistency of application of
California Building Code standards, the end insert office shall designate begin insert a end insert
professional staff begin insert member end insert familiar with health facilities providing
skilled nursing care to begin insert conduct a peer end insert review begin insert of end insert projects relating
to skilled nursing facility construction or alteration pursuant to
this section.

(d) The office shall charge a reasonable fee for the review and
approval of plans submitted pursuant to this section. This fee shall
be based on the estimated cost, including costs associated with the
designated begin delete qualified end delete professional staff begin insert member end insert , but shall not exceed
the reasonable cost of the entire phased review and approval
process for those plans.

begin delete

(e) The project cost threshold under subdivision (a) of Section
129880, for the purposes of a skilled nursing facility only, shall
be increased to one hundred thousand dollars ($100,000) without
regard to the cost of equipment or other items not related to the
actual repair or construction costs.

end delete begin delete

(f)

end delete

begin insert (e) end insert  In order to meet the review timeframes developed pursuant
to this section, the office may seek outside assistance through
contracts with qualified professional architectural or engineering
firms.

begin delete

(g) The office shall monitor document submissions related to
new or comparable design concepts meeting approval requirements
and, when feasible, publish standard requirements for use by
stakeholders. Design concepts may include new construction,
renovation, or replacement.

end delete begin insert

(f) If resources are available, the office may publish standard
requirements, when feasible, for design concepts for use by
stakeholders when submitting plans for new construction,
renovation, or replacement.

end insert begin delete

(h)

end delete

begin insert (g) end insert  Design concepts to be considered under subdivision begin delete (g) end delete begin insert (f) end insert
may include, but are not limited to, reduction in beds; installation
and use of new technology, such as electronic medical records;
space conversion dedicated to changes in care delivery models;
and common replacement of major infrastructure equipment,
including roofing, HVAC, generators and emergency power
systems, water heaters and boilers, begin delete kitchen, end delete begin insert and kitchen end insert and laundry
room equipment.

begin delete

(i)

end delete

begin insert (h) end insert  The office shall work with stakeholders to begin delete establish end delete begin insert receive
input for, or assistance with, the establishment of end insert education and
outreach programs directed at reducing document submission error
rates and turnaround times. begin delete The end delete begin insert To the extent resources are
available, the end insert office shall publish on its Internet Web site these
requirements, including, but not limited to, the timeframes
developed pursuant to this section.

begin insert

(i) Subdivisions (c) and (d) shall cease to be implemented, and
all related fees shall cease to be assessed, on January 1, 2019.

end insert