Amended in Senate May 27, 2015

Amended in Assembly April 16, 2015

California Legislature—2015–16 Regular Session

Assembly Bill No. 614

Introduced by Assembly Member Brown

February 24, 2015

An act to amend begin delete Section end delete begin insert Sections 1254.5 and end insert 1275 of the Health and Safety Code, relating to health facilities.

LEGISLATIVE COUNSEL’S DIGEST

AB 614, as amended, Brown. Health care standards of practice.

Existing begin insert law provides for the licensure and regulation of health facilities by the State Department of Health Care Services. A violation of these provisions is a crime. Existing end insert law authorizes the begin delete State Department of Public Health end delete begin insert department end insert to promulgate rules and regulations regarding health facilities, in accordance with the provisions of the Administrative Procedure Act.

This bill would authorize the department to use a streamlined administrative process to update regulatory references to health care standards of practice adopted by a state or national association when outdated standards are already referenced in the California Code of Regulations. The procedure created by this bill would, among other things, require the department to post the update on the department’s Internet Web site, notify stakeholders of the proposed change, submit notice of the proposed change to the Office of Administrative Law for publication in the California Regulatory Notice Register, accept comments, and consider those comments prior to the adoption of the new standards. The bill would require, if a member of the public requests a public hearing, that the department hold a hearing and consider any comments. The bill would, if comments are submitted in opposition to the proposed change, require the department to instead follow the procedures provided for by the Administrative Procedure Act.

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Existing law requires inpatient treatment of eating disorders to be provided only in state licensed hospitals. Existing law defines “eating disorders” for these purposes as anorexia nervosa and bulimia as defined in the 1980 Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association.

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This bill would instead define “eating disorders” to have the meaning of the term as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, as published by the American Psychiatric Association. By changing the definition of a crime applicable to health facilities, this bill would create a state-mandated local program.

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The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

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This bill would provide that no reimbursement is required by this act for a specified reason.

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Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program:  begin delete no end delete begin insert yes end insert .

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

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begin insert SECTION 1. end insert   

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begin insert Section 1254.5 of the end insert begin insert Health and Safety Code end insert begin insert is
amended to read: end insert

1254.5.  

(a)  The Legislature finds and declares that the disease
of eating disorders is not simply medical or psychiatric, but
involves biological, sociological, psychological, family, medical,
and spiritual components. In addition, the Legislature finds and
declares that the treatment of eating disorders is multifaceted, and
like the treatment of chemical dependency, does not fall neatly
into either the traditional medical or psychiatric milieu.

(b)  The inpatient treatment of eating disorders shall be provided
only in state licensed hospitals, which may be general acute care
hospitals as defined in subdivision (a) of Section 1250, acute
psychiatric hospitals as defined in subdivision (b) of Section 1250,
or any other licensed health facility designated by the State
Department of Health begin insert Care end insert Services.

(c)  “Eating disorders,” for the purposes of this section, begin delete means
anorexia nervosa and bulimia end delete begin insert shall have the meaning of the term end insert
as defined begin delete by end delete begin insert in end insert the begin delete 1980 end delete Diagnostic and Statistical Manual of
Mental begin delete Disorders (DSM-III) end delete begin insert Disorders, as end insert published by the
American Psychiatric Association.

begin delete SECTION 1. end delete
begin insert SEC. 2. end insert   

Section 1275 of the Health and Safety Code is amended
to read:

1275.  

(a) (1) The department shall adopt, amend, or repeal,
in accordance with Chapter 3.5 (commencing with Section 11340)
of Part 1 of Division 3 of Title 2 of the Government Code and
Chapter 4 (commencing with Section 18935) of Part 2.5 of Division
13, any reasonable rules and regulations as may be necessary or
proper to carry out the purposes and intent of this chapter and to
enable the state department to exercise the powers and perform
the duties conferred upon it by this chapter, not inconsistent with
any other law including, but not limited to, the California Building
Standards Law, Part 2.5 (commencing with Section 18901) of
Division 13.

(2) All regulations in effect on December 31, 1973, which were
adopted by the State Board of Public Health, the State Department
of Public Health, the State Department of Mental Hygiene, or the
State Department of Health relating to licensed health facilities
shall remain in full force and effect until altered, amended, or
repealed by the director or pursuant to Section 25 or other
provisions of law.

(b) Notwithstanding this section or any other law, the Office of
Statewide Health Planning and Development shall adopt and
enforce regulations prescribing building standards for the adequacy
and safety of health facility physical plants.

(c) The building standards adopted by the State Fire Marshal,
and the Office of Statewide Health Planning and Development
pursuant to subdivision (b), for the adequacy and safety of
freestanding physical plants housing outpatient services of a health
facility licensed under subdivision (a) or (b) of Section 1250 shall
not be more restrictive or comprehensive than the comparable
building standards established, or otherwise made applicable, by
the State Fire Marshal and the Office of Statewide Health Planning
and Development to clinics and other facilities licensed pursuant
to Chapter 1 (commencing with Section 1200).

(d) Except as provided in subdivision (f), the licensing standards
adopted by the department under subdivision (a) for outpatient
services located in a freestanding physical plant of a health facility
licensed under subdivision (a) or (b) of Section 1250 shall not be
more restrictive or comprehensive than the comparable licensing
standards applied by the department to clinics and other facilities
licensed under Chapter 1 (commencing with Section 1200).

(e) Except as provided in subdivision (f), the state agencies
specified in subdivisions (c) and (d) shall not enforce any standard
applicable to outpatient services located in a freestanding physical
plant of a health facility licensed pursuant to subdivision (a) or (b)
of Section 1250, to the extent that the standard is more restrictive
or comprehensive than the comparable licensing standards applied
to clinics and other facilities licensed under Chapter 1
(commencing with Section 1200).

(f) All health care professionals providing services in settings
authorized by this section shall be members of the organized
medical staff of the health facility to the extent medical staff
membership would be required for the provision of the services
within the health facility. All services shall be provided under the
respective responsibilities of the governing body and medical staff
of the health facility.

(g) (1) Notwithstanding any other law, the department may,
without taking regulatory action pursuant to Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code, update references in the California
Code of Regulations to health care standards of practice adopted
by a recognized state or national association when the state or
national association and its outdated standards are already named
in the California Code of Regulations. When updating these
references, the department shall:

(A) Post notice of the department’s proposed adoption of the
state or national association’s health care standards of practice on
its Internet Web site for at least 45 days. The notice shall include
the name of the state or national association, the title of the health
care standards of practice, and the version of the updated health
care standards of practice to be adopted.

(B) Notify stakeholders that the proposed standards have been
posted on the department’s Internet Web site by issuing a mailing
to the most recent stakeholder list on file with the department’s
Office of Regulations.

(C) Submit to the Office of Administrative Law the notice
required pursuant to this paragraph. The office shall publish in the
California Regulatory Notice Register any notice received pursuant
to this subparagraph.

(D) Accept public comment for at least 30 days after the
conclusion of the 45-day posting period specified in subparagraph
(A).

(2) If a member of the public requests a public hearing during
the public comment period, a hearing shall be held and comments
shall be considered prior to the adoption of the state or national
association’s health care standards of practice.

(3) If no member of the public requests a public hearing, the
department shall consider any comments received during the public
comment period prior to the adoption of the health care standards.

(4) Written responses to public comments shall not be required.
If public comments are submitted in opposition to the adoption of
the proposed standards, or the state or national association named
in the California Code of Regulations no longer exists, the
department shall seek adoption of the standards using the regulatory
process specified in Chapter 3.5 (commencing with Section 11340)
of Part 1 of Division 3 of Title 2 of the Government Code. A state
or national association named in the California Code of Regulations
that has changed its name does not constitute an association that
no longer exists.

(5) If no opposition is received by the department, the
department shall update its Internet Web site to notify the public
that the standard has been adopted and the effective date of that
standard.

(h) For purposes of this section, “freestanding physical plant”
means any building which is not physically attached to a building
in which inpatient services are provided.

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begin insert SEC. 3. end insert   

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No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of
the Government Code, or changes the definition of a crime within
the meaning of Section 6 of Article XIII B of the California
Constitution.

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