BILL NUMBER: AB 1177 AMENDED
BILL TEXT
AMENDED IN SENATE AUGUST 24, 2015
AMENDED IN SENATE JULY 16, 2015
AMENDED IN SENATE JULY 8, 2015
INTRODUCED BY Assembly Members Gomez, Burke, and Low
FEBRUARY 27, 2015
An act to add and repeal Section 1204.2 of the Health and Safety
Code, relating to primary care clinics.
LEGISLATIVE COUNSEL'S DIGEST
AB 1177, as amended, Gomez. Primary care clinics: written transfer
agreements.
Existing regulations require primary care clinics to maintain a
written transfer agreement with one or more nearby hospitals and
other facilities as appropriate to meet medical emergencies. Existing
law authorizes certain clinics to request that the State Department
of Public Health waive this requirement.
This bill would provide that a licensed primary care clinic is not
required to enter into a written transfer agreement pursuant to
those provisions as a condition of licensure, except as provided for
a primary care clinic where anesthesia is used in compliance
with the community standard of practice, in doses that, when
administered, have the probability of placing a patient at risk for
loss of the patient's life-preserving protective reflexes. The bill
would exempt a primary care clinic from the above-referenced hospital
transfer agreement requirement if the clinic submits to the State
Department of Public Health competent evidence, as defined, that
documents its attempt to obtain a written transfer agreement from at
least 2 local hospitals, except as provided. The bill would impose
similar requirements upon an alternative birth center
licensed as a primary care clinic, as specified. The bill would
require a primary care clinic, except as specified, to send with each
patient at the time of transfer, or in the case of an emergency, as
promptly as p ossible, copies of all medical records
related to the patient's transfer, and would require the medical
records to inclu de, among other things, current medical
findings and a brief summary of the course of treatment provided
prior to the patient's transfer. The bill would require the
department to amend repeal its
regulations to conform to these changes.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1204.2 is added to the Health and Safety Code,
to read:
1204.2. (a) (1)
Notwithstanding any other law, including, but not limited to, Section
75047 of Title 22 of the California Code of Regulations, and except
as provided in paragraph (2), subdivision
(c), a primary care clinic described in subdivision (a) of
Section 1204 that is licensed pursuant to this chapter shall not be
required to enter into a written transfer agreement with a nearby
hospital as a condition of licensure.
(2) (A) A primary care clinic where anesthesia is used in
compliance with the community standard of practice, in doses that,
when administered, have the probability of placing a patient at risk
for loss of the patient's life-preserving protective reflexes, shall
have a written transfer agreement with a local accredited or licensed
general acute care hospital.
(B) A primary care clinic described in subparagraph (A) is exempt
from the requirements of subparagraph (A) if that clinic submits to
the department any competent evidence that documents its attempt to
obtain a written transfer agreement from at least two local hospitals
that have elected not to enter into a transfer agreement with that
primary care clinic. If the primary care clinic determines that there
are not two hospitals that are reasonably accessible by road travel
for purposes of providing patients with emergency medical care, the
primary care clinic shall only be required to submit competent
evidence to the department that documents its attempt to obtain a
written transfer agreement from one local hospital.
(C) For the purposes of this section, "competent evidence" means
evidence that is relevant and of such a nature that it can be
received by a court of law, and includes, but is not limited to, an
affidavit of someone with the legal authority to bind the clinic
operation.
(b) (1) A primary care clinic shall send with each patient at the
time of transfer, or in the case of an emergency, as promptly as
possible, copies of all medical records related to the patient's
transfer. To the extent practicable and applicable to the patient's
transfer, the medical records shall include current medical findings,
diagnoses, laboratory results, medications provided prior to
transfer, a brief summary of the course of treatment provided prior
to transfer, ambulation status, nursing and dietary information, name
and contact information for the treating physician at the clinic,
and as appropriate, pertinent administrative and demographic
information related to the patient, including name and date of birth.
(2) The requirements in paragraph (1) shall not apply if the
primary care clinic has entered into a written transfer agreement
with a local hospital that provides for the transfer of medical
records.
(D)
(c) An alternative birth center that is licensed under
this chapter as a primary care clinic, as a condition of licensure,
shall be required to maintain a written transfer agreement with a
local hospital. The transfer agreement shall include provisions for
communication and transportation to meet medical emergencies.
Essential personal, health, and medical information shall either
accompany the patient upon transfer or be transmitted immediately by
telephone to the receiving facility. This section does not modify or
supersede the requirements imposed on alternative birth centers
described in Section 1204.3.
(b) This section does not require a primary care clinic to have a
hospital transfer agreement with a local hospital, if that clinic
provides only the following types of analgesia and sedation services:
(1) Local anesthesia.
(2) Peripheral nerve blocks.
(3) A combination of both local anesthesia and peripheral nerve
blocks.
(4) Conscious sedation, as defined in Section 1647.1 of the
Business and Professions Code.
(c)
(d) The State Department of Public Health, no later
than July 1, 2016, shall amend repeal
Section 75047 of Chapter 7 of Division 5 of Title 22 of the
California Code of Regulations to be consistent with this
section. Regulations.
(d)
(e) This section shall remain in effect only until
January 1, 2018, and as of that date is repealed, unless a later
enacted statute, that is enacted before January 1, 2018, deletes or
extends that date.
SEC. 2. Section 1204.2 is added to the Health and Safety Code, to
read:
1204.2. (a) (1)
Notwithstanding any other law, and except as provided in
paragraph (2), subdivision (c), a primary care
clinic described in subdivision (a) of Section 1204 that is licensed
pursuant to this chapter shall not be required to enter into a
written transfer agreement with a nearby hospital as a condition of
licensure.
(2) (A) A primary care clinic where anesthesia is used in
compliance with the community standard of practice, in doses that,
when administered, have the probability of placing a patient at risk
for loss of the patient's life-preserving protective reflexes, shall
have a written transfer agreement with a local accredited or licensed
acute general care hospital.
(B) A primary care clinic described in subparagraph (A) is exempt
from the requirements of subparagraph (A) if it submits to the
department any competent evidence that documents its attempts to
obtain a written transfer agreement from at least two local hospitals
that have elected to not enter into a transfer agreement with that
primary care clinic. If the primary care clinic determines that there
are not two hospitals that are reasonably accessible by road travel
for purposes of providing patients with emergency medical care, the
primary care clinic shall only be required to submit competent
evidence to the department that documents its attempt to obtain a
written transfer agreement from one local hospital.
(C) For the purposes of this section, "competent evidence" means
evidence that is relevant and of such a nature that it can be
received by a court of law, and includes, but is not limited to, an
affidavit of someone with the legal authority to bind the clinic
operation.
(b) (1) A primary care clinic shall send with each patient at the
time of transfer, or in the case of an emergency, as promptly as
possible, copies of all medical records related to the patient's
transfer. To the extent practicable and applicable to the patient's
transfer, the medical records shall include current medical findings,
diagnoses, laboratory results, medications provided prior to
transfer, a brief summary of the course of treatment provided prior
to transfer, ambulation status, nursing and dietary information, name
and contact information for the treating physician at the clinic,
and as appropriate, pertinent administrative and demographic
information related to the patient, including name and date of birth.
(2) The requirements in paragraph (1) shall not apply if the
primary care clinic has entered into a written transfer agreement
with a local hospital that provides for the transfer of medical
records.
(D)
(c) An alternative birth center that is licensed under
this chapter as a primary care clinic, as a condition of licensure,
shall be required to maintain a written transfer agreement with a
local hospital. The transfer agreement shall include provisions for
communication and transportation to meet medical emergencies.
Essential personal, health, and medical information shall either
accompany the patient upon transfer or be transmitted immediately by
telephone to the receiving facility. This section does not modify or
supersede the requirements imposed on alternative birth centers
described in Section 1204.3.
(b) This section does not require a primary care clinic to have a
hospital transfer agreement with a nearby hospital, if that clinic
provides only the following types of analgesia and sedation services:
(1) Local anesthesia.
(2) Peripheral nerve blocks.
(3) A combination of both local anesthesia and peripheral nerve
blocks.
(4) Conscious sedation, as defined in Section 1647.1 of the
Business and Professions Code.
(c) This section shall become operative on January 1, 2018.
(d)
____ CORRECTIONS Text--Page 6.
____