BILL ANALYSIS Ó
AB 1947
Page 1
Date of Hearing: March 29, 2016
ASSEMBLY COMMITTEE ON HEALTH
Jim Wood, Chair
AB 1947
(Chiu) - As Introduced February 12, 2016
SUBJECT: Health facilities: affiliate clinic: licensing.
SUMMARY: Requires the centralized application unit of the
Licensing and Certification Division in the California
Department of Public Health (DPH) to publish current checklists
and instructions on how to complete an application for a new
affiliate clinic license, and how to report changes to an
existing affiliate clinic, on the DPH Website.
EXISTING LAW:
1)Allows a clinic corporation on behalf of a primary care clinic
that has held a valid, unrevoked, and unsuspended license for
at least the immediately preceding five years, with no history
of violations, to file an affiliate clinic application to
establish a primary care clinic at an additional site, or a
mobile health care unit, also known as affiliate clinics.
2)Requires DPH, upon receipt of the completed affiliate clinic
application, to approve the application without first
conducting an initial onsite survey, if all of the following
conditions are met:
AB 1947
Page 2
a) The clinic corporation that operates the existing
licensed primary care clinic (hereafter, the parent clinic)
has submitted a completed affiliate clinic applications and
the associated application fee;
b) The parent and affiliate clinics' corporate officers are
the same;
c) The parent ad affiliate clinics are owned and operated
by the same nonprofit organization with the same board of
directors; and,
d) The parent and affiliate clinics have the same medical
director or directors and medical policies, procedures,
protocols, and standards.
3)Requires the affiliate clinic application to consist solely of
a simple form and supporting documents which provide the
following information:
For a mobile health care unit:
a) The name and address of the clinic corporation's
administrative office, the name and contact information of
the clinic corporation's chief executive officer or
executive director;
b) The name and address of the new affiliate primary care
clinic site or the location of the new affiliate mobile
health care unit, and the name and contact information of
AB 1947
Page 3
the administrator of the new clinic site or mobile health
care unit;
c) The expected days and hours of operation and the
services to be provided at the new affiliate primary care
clinic site or mobile health care unit; and,
d) The type and manufacturer of the new affiliate mobile
healthcare unit and the proposed area or areas where the
mobile health care unit will be providing services.
For a new affiliate clinic site:
a) Evidence of compliance with the minimum construction
standards for adequacy and safety of the new affiliate
clinics physical plant pursuant to the requirements of the
most recent version of the Office of Statewide Health
Planning and Development's California Building Code
applicable to clinics;
b) Evidence of fire clearance for the new affiliate clinic
site;
c) A copy of the transfer agreement between the new
affiliate clinic and a local hospital; and,
d) A current list of clinic corporation board members.
1)Requires the affiliate clinic application to be signed by an
officer of the clinic corporation's board of directors or the
clinic corporation's chief executive officer or executive
AB 1947
Page 4
director.
2)Requires DPH to issue a clinic license within 30 days of
receipt of the completed affiliate clinic application.
Requires, if DPH determines that an applicant does not meet
the requirements of licensure, that DPH identify in writing
the grounds for that determination, and to instead process the
application within 100 days of the filing of the application.
FISCAL EFFECT: This bill has not been analyzed by a fiscal
committee.
COMMENTS:
1)PURPOSE OF THIS BILL. According to the author, the licensure
process for health facilities can be a complicated and
time-intensive process. The author notes, in order to assist
organizations that operate multiple primary care clinics,
which serve the state's safety net population, get through
this process more quickly, the Legislature approved a
streamlined, fast-tracked affiliate primary care clinic
licensure process that is intended to permit clinics to open
and begin serving the public as soon as possible.
The author states this bill simply would require DPH to
publish on its website an updated affiliate primary care
clinic license application checklist for new clinics, and a
uniform checklist explaining what existing licensees must do
to report changes for existing affiliate primary care clinics.
The author concludes that this bill is aimed at ensuring
that California's safety net providers, such as affiliate
primary care clinics, are able to efficiently open up and not
have to face unnecessary burdens.
2)BACKGROUND. In 2015 the Legislature passed, and Governor
Brown signed AB 1177 (Gomez), Chapter 704, Statutes of 2015,
AB 1947
Page 5
which prohibits a primary care clinic, notwithstanding current
regulations or any other law, from being required to enter
into a written transfer agreement with a nearby hospital as a
condition of licensure, and requires DPH to repeal the
regulation requiring primary care clinics to enter into
transfer agreements, no later than July 1, 2016. However, the
checklist published on DPH's Website still indicates the
transfer agreement is a required element of the application.
According to DPH the Website and clinic application checklists
are in the process of being updated to reflect the changes,
and are anticipated to be completed by the end of April 2016.
DPH states that an All Facility Letter was published informing
clinics about the law change, and that the regulations will be
repealed by July 1, 2016, per the provisions of AB 1177.
3)SUPPORT. Planned Parenthood Affiliates of California (PPAC)
is the sponsor of this bill and states that it will
significantly improve the licensure process by providing
applicants with accurate and current information about the
requirements to obtain an affiliate primary care clinic
license. PPAC notes that DPH has not updated the affiliate
primary license application checklist since 2011, leaving
their Website with potentially misleading and contradictory
information.
4)OPPOSITION. The California Right to Life Committee opposes
this bill, stating they are already very concerned about the
health of women who seek services in these facilities due to a
previous bill that changed the building code standards and
that now women are at double risk with the removal of the
requirement for a hospital transfer agreement.
5)RELATED LEGISLATION. AB 2053 (Gonzalez) requires DPH, upon
written notification by a licensed primary care clinic that
they are adding an additional physical plant maintained and
operated on separate premises, to issue a single consolidated
AB 1947
Page 6
license to such clinic.
6)PREVIOUS LEGISLATION.
a) AB 941 (Wood), Chapter 502, Statutes of 2015, expands
the exemption from licensure by DPH to certain clinics
operated by a federally recognized tribe or tribal
organization.
b) AB 1130 (Gray), Chapter 412, Statutes of 2015, extends
the limit on the hours of operation for an intermittent
primary care community or free clinic, from 20 hours a week
to 30 hours a week; requires licensed clinics, as part of
their biennial license renewal, to report to DPH as to
whether they are currently operating any intermittent
clinics, the location of these clinics, and the estimated
hours of operation.
c) AB 1177 prohibits a primary care clinic, notwithstanding
current regulations or any other law, from being required
to enter into a written transfer agreement with a nearby
hospital as a condition of licensure, and requires DPH to
repeal the regulation requiring primary care clinics to
enter into transfer agreements, no later than July 1, 2016.
7)POLICY COMMENT. If DPH completes the required updates on the
timeline noted in the background, this bill will not be
necessary.
REGISTERED SUPPORT / OPPOSITION:
AB 1947
Page 7
Support
Planned Parenthood Affiliates of California (sponsor)
Planned Parenthood Action Fund of the Pacific Southwest
Planned Parenthood Advocacy Project Los Angeles
Planned Parenthood Advocates Pasadena and San Gabriel Valley
Planned Parenthood Mar Monte
Planned Parenthood Northern California Action Fund
Planned Parenthood of Orange and San Bernardino Counties
Opposition
California Right to Life Committee, Inc.
Analysis Prepared by:Lara Flynn / HEALTH / (916) 319-2097