BILL ANALYSIS Ó
AB 1177
Page 1
ASSEMBLY THIRD READING
AB
1177 (Gomez, et al.)
As Introduced February 27, 2015
Majority vote
-----------------------------------------------------------------
|Committee |Votes |Ayes |Noes |
| | | | |
| | | | |
|----------------+------+--------------------+--------------------|
|Health |14-5 |Bonta, Maienschein, |Chávez, Lackey, |
| | |Bonilla, Burke, |Patterson, |
| | |Chiu, Gomez, |Steinorth, Waldron |
| | |Gonzalez, Roger | |
| | |Hernández, | |
| | |Nazarian, | |
| | |Ridley-Thomas, | |
| | |Rodriguez, | |
| | |Santiago, Thurmond, | |
| | |Wood | |
| | | | |
|----------------+------+--------------------+--------------------|
|Appropriations |12-5 |Gomez, Bloom, |Bigelow, Chang, |
| | |Bonta, Calderon, |Gallagher, Jones, |
| | |Daly, Eggman, |Wagner |
| | |Eduardo Garcia, | |
| | |Holden, Quirk, | |
| | |Rendon, Weber, Wood | |
| | | | |
| | | | |
-----------------------------------------------------------------
AB 1177
Page 2
SUMMARY: Requires the Department of Public Health (DPH) to repeal
the regulation requiring primary care clinics to enter into a
written transfer agreement with a nearby hospital as a condition
of licensure, no later than July 1, 2016.
EXISTING STATE REGULATIONS: Require primary care clinics, as a
condition of licensure, to have a written transfer agreement with
a nearby hospital. Allow all licensed clinics, except for those
providing abortion services or birthing services, to request that
DPH waive the requirement to maintain a written transfer
agreement, if the clinic can show that no hospital would agree to
enter into a transfer agreement.
EXISTING FEDERAL LAW: The Emergency Medical Treatment and Active
Labor Act, (EMTALA) is an act of the United States Congress,
passed in 1986 as part of the Consolidated Omnibus Budget
Reconciliation Act. It requires hospitals that accept payments
from Medicare to provide emergency health care treatment to anyone
needing it regardless of citizenship, legal status, or ability to
pay. There are no reimbursement provisions. Participating
hospitals may not transfer or discharge patients needing emergency
treatment except with the informed consent or stabilization of the
patient or when their condition requires transfer to a hospital
better equipped to administer the treatment. EMTALA applies to
"participating hospitals." The statute defines participating
hospitals as those that accept payment from the Department of
Health and Human Services, Centers for Medicare and Medicaid
Services under the Medicare program. Because there are very few
hospitals that do not accept Medicare, the law applies to nearly
all hospitals.
FISCAL EFFECT: According to the Assembly Appropriations
Committee, negligible state fiscal effect.
COMMENTS:
AB 1177
Page 3
1)PURPOSE OF THIS BILL. According to the author, under current
California law, clinics are obliged to obtain a hospital
transfer agreement (HTA) from a nearby hospital as a condition
of licensure in order to begin performing services. DPH
regulations allow clinics who cannot get an HTA from a nearby
hospital to apply for a waiver to this requirement. However,
clinics that provide abortions or birthing services are not
allowed to apply for a waiver, even if a local hospital won't
agree to enter into an HTA. The author states that this
effectively allows a hospital that does not want to enter into
an HTA to prevent an abortion clinic from opening. The author
notes that if this bill is enacted, this regulation will be
repealed and unenforceable, and will give Californians equal
access to reproductive services and the ability to choose.
2)BACKGROUND. As required by California Code of Regulations Title
22, Division 5, Chapter 7, Article 6, primary care clinics must
have an HTA with a local hospital as a condition of licensure.
Should a patient undergoing a procedure at a clinic require
transport to the hospital, an HTA facilitates the timely
transfer of the patient between the hospital and the facility.
The agreements delineate the responsibilities of both the clinic
and the hospital, including the required sharing of vital
information such as the current medical findings regarding the
patient, diagnoses, and the transfer of medical records.
3)SUPPORT. Planned Parenthood Affiliates of California (PPAC) are
the sponsors of this bill and they state by requiring hospital
transfer agreements as a condition of licensure, DPH has
essentially delegated some of its licensure authority to the
hospitals, because any hospital corporation with either a moral
objection or desire to secure a competitive edge can refuse to
sign a transfer agreement and bring a clinic's license
application to a halt. PPAC notes they believe the decision of
whether to grant a clinic a license should rest exclusively with
the state. PPAC also notes the existing transfer agreement
requirement acts as a targeted restriction on abortion
AB 1177
Page 4
providers, or TRAP law, because only abortion clinics and
birthing centers are ineligible to receive a waiver from the
requirement, even in the event that they are unable to secure a
transfer agreement.
4)OPPOSITION. The California Chapter of the American College of
Emergency Physicians is opposed to this bill unless it is
amended to make all clinics equal by allowing community clinics
providing birthing or abortion services to apply for an
exemption.
The California Right to Life Committee, Inc. (CRCL) is opposed
to this bill because it would remove the necessity of having a
written transfer agreement with one or more nearby hospital when
a primary care clinic seeks licensure. CRLC believes this would
be a very serious regulation change and would threaten the
physical safety of patients at these primary care clinics.
Analysis Prepared by:
Lara Flynn / HEALTH / (916) 319-2097 FN: 0000363