Amended in Senate July 10, 2013

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 BillNo. 852


Introduced by Assembly Member Quirk

February 21, 2013


An act tobegin delete amend Section 129785 of, and toend delete addbegin insert and repealend insert Section 129788begin delete to,end deletebegin insert ofend insertthe 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 continuously appropriates the moneys in the fund for the purposes of administration of these provisions.

This billbegin delete wouldend deletebegin insert would, until January 1, 2019,end insert increase the maximum fee assessed tobegin delete thoseend deletebegin insert certain of thoseend insert skilled nursing facilities or intermediate care facilities to 2% of the project’s estimated construction costs. By increasing the amounts to be deposited into abegin delete continouslyend deletebegin insert continuouslyend insert appropriated fund, this bill would make an appropriation.

This bill would requirebegin delete OSHPD, except as prescribed,end deletebegin insert OSHPDend insert to develop, with stakeholders,begin insert and would require the Facilities Development Division of OSHPD to meet,end insert reasonable timeframes for review and approval of skilled nursing facilitybegin insert and intermediate care facilityend insert construction, alteration, or additionbegin delete projects and would authorize the office, until January 1, 2019, to assess a reasonable fee for this review, as specified.end deletebegin insert projects, except as prescribed.end insert The bill would require documents submitted for review to include the name and contact information of a project coordinator. The bill wouldbegin delete, until January 1, 2019,end delete require the office to designate a professional staff member tobegin delete conduct a peer review ofend deletebegin insert provide consultation on the review ofend insert projects relating to skilled nursing facilitybegin insert and intermediate care facilityend insert construction or alteration. The bill would authorize the office to seek outside assistance through contracts with qualified professional architectural or engineering firms to meet those timeframes. The bill would authorize OSHPD to, when feasible, publish standard requirements for design concepts for use bybegin delete stakeholdersend deletebegin insert skilled nursing and intermediate care facilitiesend insert when submitting plans for new construction, renovation, or replacement. 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 OSHPD, if resources are available, to publish the timeframes and other requirements on its Internet Web site.begin insert The bill would provide that these provisions shall be operative until January 1, 2019.end insert

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

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

P3    1

SECTION 1.  

The Legislature finds and declares all of the
2following:

3(a) A variety of factors have contributed to making health care
4construction costs in California among the highest in the nation.
5The costs are driven by the escalating price of raw materials, high
6demand for skilled labor, and the complexity of design, plan
7review, and approval of skilled nursing facilitybegin insert and intermediate
8care facilityend insert
construction.

9(b) Skilled nursing facilitiesbegin insert and intermediate care facilitiesend insert are
10licensed health care facilities that care for the state’s most fragile
11and vulnerable citizens.

12(c) The physical infrastructure and related systems of these
13licensed health facilities are governed by building and fire and life
14safety code requirements regulated by the Office of Statewide
15Health Planning and Development, the Office of the State Fire
16Marshal, and the State Department of Public Health.

17(d) As the industry moves to update the aging health care
18infrastructure, incorporate advances in medical technology,
19implement a modern health care delivery system, and improve
20electronic medical records systems, health care construction activity
21will increase to unseen levels, creating additional economic
22pressure on the skilled nursingbegin insert, intermediate care,end insert and construction
23begin delete industry.end deletebegin insert industries.end insert

24(e) Licensed health care facilities are required to go through a
25building application and plan check process under the jurisdiction
26of the Office of Statewide Health Planning and Development.

27(f) This process is bureaucratically efficient, but is subject to
28 inherent delays impacting timely approvals of projects. Although
29the Office of Statewide Health Planning and Development has
30developed internal policies that set timeframes for plan review and
P4    1approval, these policies are targets rather than enforceable
2requirements.

3(g) Improving the efficiency of health care building plan review
4and construction efforts will not only reduce the time to design,
5review, and complete facility construction, but also lower the cost
6of the project and reduce overall cost pressures on the health care
7system, allowing more resources to be directed to direct patient
8services.

9(h) Therefore, it is the intent of the Legislature to codify the
10timeframes and due dates for completion by the Office of Statewide
11Health Planning and Development of the review of facility
12construction documents and to require the office to notify
13applicants of the anticipated date the review will be completed and
14returned to them.

begin delete
15

SEC. 2.  

Section 129785 of the Health and Safety Code is
16amended to read:

17

129785.  

(a)  (1)  The office shall determine an application
18filing fee that will cover the costs of administering this chapter.
19For a hospital facility, as defined in subdivision (a), (b), or (f) of
20Section 1250, and for a skilled nursing or intermediate care facility,
21as defined in subdivision (c), (d), (e), or (g) of Section 1250, the
22fee shall not exceed 2 percent of a project’s estimated construction
23cost. Application filing fees shall be established in accordance
24with applicable procedures established in Article 5 (commencing
25with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of Title
262 of the Government Code.

27(2)  Notwithstanding paragraph (1), the minimum application
28filing fee in any case shall be two hundred fifty dollars ($250).

29(b)  The office shall issue an annual permit upon submission of
30an application, pursuant to Section 129765, for one or more projects
31of a hospital facility, as defined in subdivision (a), (b), or (f) of
32Section 1250, if the total estimated construction cost is fifty
33thousand dollars ($50,000) or less per fiscal year. The fee for the
34annual permit shall be five hundred dollars ($500) and shall be in
35lieu of an application filing fee. The annual permit shall cover all
36projects undertaken for a particular hospital facility up to a total
37estimated construction cost of fifty thousand dollars ($50,000)
38during the state fiscal year in which the annual permit is issued.
39If a hospital facility chooses not to apply for an annual permit to
40cover a project or projects costing fifty thousand dollars ($50,000)
P5    1or less in total, the hospital facility may instead submit the project
2or projects for review and approval as otherwise specified in this
3chapter, including paying the application filing fee determined
4under subdivision (a).

5(c)  The office shall issue an annual permit upon submission of
6an application, pursuant to Section 129765, for one or more projects
7of a skilled nursing or intermediate care facility, as defined in
8subdivision (c), (d), (e), or (g) of Section 1250, if the total estimated
9construction cost is twenty-five thousand dollars ($25,000) or less
10per fiscal year. The fee for the annual permit shall be two hundred
11fifty dollars ($250) and shall be in lieu of an application filing fee.
12The annual permit shall cover all projects undertaken for a
13particular skilled nursing or intermediate care facility up to a total
14estimated construction cost of twenty-five thousand dollars
15($25,000) during the state fiscal year in which the annual permit
16is issued. If a skilled nursing or intermediate care facility chooses
17not to apply for an annual permit to cover a project or projects
18costing twenty-five thousand dollars ($25,000) or less in total, the
19skilled nursing or intermediate care facility may instead submit
20the project or projects for review and approval as otherwise
21specified in this chapter, including paying the application filing
22fee determined under subdivision (a).

23(d)  If the actual construction cost exceeds the estimated
24construction cost by more than 5 percent, a further fee shall be
25paid to the office, based on the above schedule and computed on
26the amount that the actual cost exceeds the amount of the estimated
27cost. If the estimated construction cost exceeds the actual
28construction cost by more than 5 percent, the office shall refund
29the excess portion of any paid fees, based on the above schedule
30and computed on the amount that the estimated cost exceeds the
31amount of the actual cost. A refund is not required if the applicant
32did not complete construction or alteration of 75 percent of the
33square footage included in the project, as contained in the approved
34drawings and specifications for the project. In addition, the office
35shall adopt regulations specifying other circumstances when the
36office shall refund to an applicant all or part of any paid fees for
37projects submitted under this chapter. The regulations shall include,
38but not be limited to, refunds of paid fees for a project that is
39determined by the office to be exempt or otherwise not reviewable
40under this chapter, and for a project that is withdrawn by the
P6    1applicant prior to the commencement of review by the office of
2the drawing and specifications submitted for the project. All
3refunds pursuant to this section shall be paid from the Hospital
4Building Account in the Architecture Public Building Fund, as
5established pursuant to Section 129795.

end delete
6

begin deleteSEC. 3.end delete
7begin insertSEC. 2.end insert  

Section 129788 is added to the Health and Safety Code,
8to read:

9

129788.  

(a) For projectsbegin insert submitted by health facilities licensed
10pursuant toend insert
begin insert subdivisions (c) and (d) of Section 1250 that doend insert not
11begin delete qualifyingend deletebegin insert qualifyend insert for rapid review under Sectionbegin delete 129856,end deletebegin insert 129880,end insert
12 the Facilities Development Division shall meet reasonable
13timeframes developed by the office, in conjunction with
14stakeholders, that include all of the following:

15(1) Preliminary review of documents submitted to the office.

16(2) First review of new projects.

17(3) Backchecks.

18(4) Amended construction documents.

19(b) Documents submitted to the office for new construction of,
20alteration of, or addition to, health facilities licensed pursuant to
21begin delete subdivisionend deletebegin insert subdivisionsend insert (c)begin insert and (d)end insert of Section 1250 shall include
22the name and contact information for an individual designated to
23be the project coordinator and shall be reviewed and approved
24within the timeframes set forth in this section.

25(c) In order to ensure consistency of application of California
26Building Code standards, the office shall designate a professional
27staff member familiar with health facilities providing skilled
28nursing care tobegin delete conduct a peerend deletebegin insert provide consultation on theend insert review
29of projects relating to skilled nursing facilitybegin insert and intermediate
30care facilityend insert
construction or alteration pursuant to this section.

begin delete

31(d) The office shall charge a reasonable fee for the review and
32approval of plans submitted pursuant to this section. This fee shall
33be based on the estimated cost, including costs associated with the
34designated professional staff member, but shall not exceed the
35reasonable cost of the entire phased review and approval process
36for those plans.

end delete
begin delete

37(e)

end delete

38begin insert(d)end insert In order to meet the review timeframes developed pursuant
39to this section, the office may seek outside assistance through
P7    1contracts with qualified professional architectural or engineering
2firms.

begin delete

3(f)

end delete

4begin insert(e)end insert If resources are available, the office may publish standard
5requirements, when feasible, for design concepts for use by
6begin delete stakeholdersend deletebegin insert skilled nursing facilities and intermediate care
7facilitiesend insert
when submitting plans for new construction, renovation,
8orbegin delete replacement.end delete

9begin delete(g)end deletebegin deleteend deletebegin deleteDesign end deletebegin insertreplacement. Design end insertconcepts to be considered begin delete under
10subdivision (f)end delete
may include, but are not limited to, reduction in
11beds; installation and use of new technology, such as electronic
12medical records; space conversion dedicated to changes in care
13delivery models; and common replacement of major infrastructure
14equipment, including roofing, HVAC, generators and emergency
15power systems, water heaters and boilers, and kitchen and laundry
16room equipment.

begin delete

17(h)

end delete

18begin insert(f)end insert The office shall work with stakeholders to receive input for,
19or assistance with, the establishment of education and outreach
20programs directed at reducing document submission error rates
21 and turnaround times. To the extent resources are available, the
22office shall publish on its Internet Web site these requirements,
23including, but not limited to, the timeframes developed pursuant
24to this section.

begin insert

25(g) Notwithstanding subdivision (a) of Section 129785, the
26maximum application filing fee for a skilled nursing or intermediate
27care facility, as defined in subdivision (c) or (d) of Section 1250,
28shall not exceed 2 percent of a project’s estimated construction
29cost.

end insert
begin delete

30(i) Subdivisions (c) and (d) shall cease to be implemented, and
31all related fees shall cease to be assessed, on January 1, 2019.

end delete
begin insert

32(h) This section shall remain in effect only until January 1, 2019,
33and as of that date is repealed, unless a later enacted statute, that
34is enacted before January 1, 2019, deletes or extends that date.

end insert


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