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