BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1130|
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THIRD READING
Bill No: AB 1130
Author: Gray (D), et al.
Amended: 6/29/15 in Senate
Vote: 21
SENATE HEALTH COMMITTEE: 8-0, 6/24/15
AYES: Hernandez, Nguyen, Mitchell, Monning, Nielsen, Pan,
Roth, Wolk
NO VOTE RECORDED: Hall
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
ASSEMBLY FLOOR: 77-0, 4/30/15 (Consent) - See last page for
vote
SUBJECT: Clinics: licensing: hours of operation
SOURCE: California Primary Care Association
Central Valley Health Network
DIGEST: This bill expands the licensure exemption for
intermittent clinics that are operated by licensed clinics on
separate premises by permitting these intermittent clinics to be
open for up to 30 hours per week, instead of only 20 hours per
week.
ANALYSIS:
Existing law:
1)Licenses and regulates clinics, including primary care clinics
and specialty clinics, by the Department of Public Health
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(DPH).
2)Defines a primary care clinic as either a "community clinic,"
which is required to be operated by a non-profit corporation
and to use a sliding fee scale to charge patients based on
their ability to pay, or a "free clinic," which is also
required to be operated by a non-profit but is not allowed to
directly charge patients for services rendered or for any
drugs, medicines, or apparatuses furnished.
3)Exempts various types of clinics from licensure and regulation
by DPH, including clinics operated by the United States or by
a federally recognized Indian tribe on tribal land.
4)Exempts from licensure by DPH an intermittent clinic that is
operated by a licensed primary care community clinic on
separate premises from the licensed clinic and is only open
for limited services of no more than 20 hours each week.
However, an intermittent clinic operated under this exemption
is still required to meet all other requirements of law,
including administrative regulations and requirements,
pertaining to fire and life safety.
This bill:
1)Expands the licensure exemption for intermittent clinics that
are operated by licensed clinics on separate premises by
permitting these intermittent clinics to be open for up to 30
hours per week, instead of only 20 hours per week.
2)Requires licensed primary care clinics to report to DPH, when
renewing its license, whether it is currently operating an
intermittent clinic, the location of any intermittent clinic,
and the estimated hours of operation of any intermittent
clinic.
Comments
1)Author's statement. According to the author, the existing
limit of 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. Today, full time
healthcare centers are open much longer hours, (in some cases
7 days a week) and continue to adapt in order to meet the
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needs of every community. Given the increase in patient
population thanks to the Medi-Cal expansion and the Affordable
Care Act, this bill simply increases 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)Intermittent clinics. Under existing law, a licensed primary
care clinic is permitted to operate an off-site clinic, for up
to 20 hours per week, without obtaining a separate license for
these off-site locations. While there are a little more than
1,000 licensed primary care clinics, because no license is
required for these off-site locations, DPH does not track the
number of intermittent clinics. The sponsors of this bill
estimate there are approximately 200 intermittent clinics
across the state, ranging from a small one-provider clinic
inside a homeless shelter that is open four hours per week, to
the larger school-based health centers that may operate up to
20 hours per week. There are no regulations specific to
intermittent clinics, and under California statute, these
clinics are only required to meet fire and life safety
requirements of law, which are established by the State Fire
Marshall. As stated by the many supporting organizations,
primary care clinics use these satellite locations to offer
services in communities that might not otherwise support a
full-time licensed clinic, such as school-based health
centers, or in rural or underserved communities.
Related Legislation
AB 941 (Wood, 2015) expands a licensure exemption for tribal
clinics, which are currently exempted if they are located on
tribal land, by exempting tribal clinics regardless of the
location of the clinic, if the clinic is operated under a
contract with the United States pursuant to the Indian
Self-Determination and Education Assistance Act. AB 941 is
currently pending in the Senate Appropriations Committee.
Prior Legislation
AB 2787 (Arambula, 2008) was identical to this bill. AB 2787 was
held on the Assembly Appropriations Committee suspense file.
FISCAL EFFECT: Appropriation: No Fiscal
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Com.:YesLocal: Yes
SUPPORT: (Verified7/14/15)
California Primary Care Association (co-source)
Central Valley Health Network (co-source)
Alameda Health Consortium
Bienvenidos Community Health Center
California Family Health Council
California School-Based Health Alliance
Camarena Health
Chinatown Service Center
Clinica Sierra Vista
Clinicas de Salud del Pueblo, Inc.
Coastal Health Alliance
Community Clinic Association of Los Angeles County
Council of Community Clinics
Dos Palos Memorial Hospital Skilled Nursing Facility
El Dorado Community Health Centers
Family HealthCare Network
Family Purpose
Golden Valley Health Centers
Harmony Health Medical Clinic and Family Resource Center
Hill Country Community Clinic
Inland Behavioral and Health Services, Inc.
James Morehouse Project
La Clinica de la Raza
La Maestra Community Health Centers
Livingston Community Health
Los Angeles Trust for Children's Health
Northeast Valley Health Corporation
Omni Family Health
People Assisting the Homeless
Petaluma Health Center
Planned Parenthood Affiliates of California
Santa Rosa Community Health Centers
The Children's Partnership
United Health Centers of the San Joaquin Valley
Venice Family Clinic
Wellspace Health
West County Health Centers
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OPPOSITION: (Verified7/14/15)
None received
ARGUMENTS IN SUPPORT: This bill is co-sponsored by the
California Primary Care Association (CPCA) and the Central
Valley Health Network (CVHN). According to CPCA and CVHN, by
increasing the number of operating hours for intermittent
clinics, community health centers can meet the growing need for
care, especially among special populations that may not have the
ability to access care in traditional full time health centers.
According to CPCA and CVHN, many intermittent clinics are
operated on school campuses and address the unique needs of
school age children and their families. Others are operated in
short and long-term shelters designed to help people
experiencing homelessness, or are embedded in affordable housing
communities. The California School-Based Health Alliance states
in support that since the introduction of this bill, many
school-based health centers have shared that increasing the
hours they can provide health care services means greater access
to care and increased support for children and their families.
Camarena Health states in support that it is currently
partnering with the largest school district in Madera County to
begin the development of two new school based health center
sites that will deliver medical, dental, behavioral health and
health education services, and is also partnering with a local
grower to establish an on-site clinic that would provide primary
care services to agricultural employees during their work day.
WellSpace Health states in support that just blocks away from
the Capitol there is an intermittent clinic operated in the
Salvation Army shelter, and another embedded in an affordable
housing community, and that increasing the maximum operating
hours will improve a clinic's ability to get services and
resources in the most underserved areas quickly.
ASSEMBLY FLOOR: 77-0, 4/30/15
AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,
Bonilla, Bonta, Brough, Brown, Burke, Calderon, Chang, Chau,
Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd,
Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia,
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Eduardo Garcia, Gatto, Gipson, Gonzalez, Gordon, Gray, Grove,
Hadley, Harper, Roger Hernández, Holden, Irwin, Jones,
Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low,
Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin,
Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea,
Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago,
Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber,
Wilk, Williams, Wood, Atkins
NO VOTE RECORDED: Campos, Chávez, Gomez
Prepared by:Vince Marchand / HEALTH /
7/14/15 16:53:49
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