BILL ANALYSIS Ó AB 1130 Page 1 Date of Hearing: April 14, 2015 ASSEMBLY COMMITTEE ON HEALTH Rob Bonta, Chair AB 1130 (Gray) - As Introduced February 27, 2015 SUBJECT: Clinics: licensing: hours of operation SUMMARY: Extends the limit on the hours of operation for an intermittent primary care community or free clinic, from 20 hours a week to 30. EXISTING LAW: 1)Requires clinics to be licensed by the Department of Public Health (DPH). Provides for exemptions from these licensing requirements for certain types of clinics, including federally operated clinics, local government primary care clinics, clinics affiliated with an institution of higher learning, clinics conducted as outpatient departments of hospitals, and community or free clinics that are operated on separate premises from the licensed clinic and are only open for limited services of no more than 20 hours a week (also known as intermittent clinics). 2)Requires an intermittent clinic to meet all other requirements of law, including administrative regulations and requirements AB 1130 Page 2 pertaining to fire and life safety. 3)Authorizes DPH to take various types of enforcement actions against a primary care clinic that has violated state law or regulation, including imposing fines, sanctions, civil or criminal penalties, and suspension or revocation of the clinic's license. FISCAL EFFECT: This bill has not been analyzed by a fiscal committee. COMMENTS: 1)PURPOSE OF THIS BILL. According to the author, the existing limit on hours of operation for intermittent clinics of a maximum of 20 hours was placed in statute 37 years ago, and based on a typical 40 hour work week. The author states that today, full time healthcare centers are open much longer hours, in some cases seven days a week, and continue to adapt in order to meet the needs of every community. The author notes that given the increase in patient population thanks to the Medi-Cal expansion and the Patient Protection and Affordable Care Act, this bill seeks to increase the hours an intermittent clinic may operate so that they may keep up with the demand for service in all areas of California, but particularly in the most underserved regions. 2)BACKGROUND. Community clinics and health centers are nonprofit, tax-exempt clinics that are licensed as community or free clinics, and provide services to patients on a sliding fee scale basis or, in the case of free clinics, at no charge to the patients. These include federally designated community health centers, migrant health centers, rural health centers, and frontier health centers. California is home to nearly 1,000 community clinics serving AB 1130 Page 3 more than 5.6 million patients (or one in seven Californians) annually through over 17 million patient encounters. More than 50% of these patients are Hispanic and 43% speak a primary language other than English. 3)SUPPORT. The Central Valley Health Network and the California Primary Care Association are the cosponsors of this bill and, along with numerous other supporters including the Council of Community Clinics, Family Healthcare Network, and People Assisting the Homeless, note that many intermittent clinics are operated on school campuses and address the unique needs of school age children and their families. The supporters point out that others are operated in short- and long-term shelters designed to help people experiencing homelessness and others are embedded in affordable housing communities. The supporters conclude that in these situations, the intermittent clinics meet the unique healthcare needs of patients who may not have the ability to access a full time health center. The California School-Based Health Alliance also supports this bill and states since its introduction some of their school-based health centers have shared that increasing the hours could help many of them transition into stand-alone community health centers that provide services over 30 hours a week, thereby increasing access to care across California. 4)PREVIOUS LEGISLATION. SB 1094 (Schiff), Chapter 673, Statutes of 1998, exempts certain nonprofit clinics from licensure requirements on the basis that they are operated primarily for purposes of conducting medical research and are not operated in conjunction with other health care clinics or facilities. REGISTERED SUPPORT / OPPOSITION: Support AB 1130 Page 4 California Primary Care Association (cosponsor) Central Valley Health Network (cosponsor) California School-Based Health Alliance Council of Community Clinics Family Healthcare Network Family Purpose James Morehouse Project Livingston Community Health People Assisting the Homeless Planned Parenthood Affiliates of California The Children's Partnership Venice Family Clinic Opposition None on file. Analysis Prepared by:Lara Flynn / HEALTH / (916) 319-2097