BILL ANALYSIS Ó AB 2053 Page 1 Date of Hearing: March 29, 2016 ASSEMBLY COMMITTEE ON HEALTH Jim Wood, Chair AB 2053 (Gonzalez) - As Introduced February 17, 2016 SUBJECT: Primary care clinics. SUMMARY: Requires the Department of Public Health (DPH), upon written notification by a licensed primary care clinic (PCC) that it is adding an additional physical plant maintained and operated on separate premises, to issue a single consolidated license to the PCC. Specifically, this bill: 1)Requires DPH, upon written notification by a PCC, to issue a single consolidated license that includes more than one physical plant maintained and operated on separate premises. 2)Requires the written notification to be provided no less than 60 days prior to adding the additional physical plant, and to include evidence that the PCC is licensed in good standing and meets all necessary requirements. 3)Requires DPH, when issuing the license to specify the location of each physical plant. 4)Allows a PCC that is issued a consolidated license to operate AB 2053 Page 2 under a single National Provider Identification (NPI) number, or separate NPI's for one or more of the facilities subject to the consolidated license. 5)Requires the issuance of a consolidated license to be based on all of the following criteria: a) There is a single governing body for all the facilities maintained and operated by the licensee; b) There is a single administration for all the facilities maintained and operated by the licensee; c) There is a single medical director for all the facilities maintained and operated by the licensee, with a single set of bylaws, rules, and regulations; and, d) Separate physical plants maintained and operated by the licensee covered by a single consolidated license are located not more than 15 miles apart. 6)Exempts from existing application requirements a PCC that modifies or adds a physical plant maintained and operated on separate premises. 7)Applies existing notification and building permit requirements to a PCC that modifies or adds an additional physical plant. EXISTING LAW: AB 2053 Page 3 1)Licenses and regulates clinics, including primary care clinics and specialty clinics, by DPH. 2)Requires a person, firm, association, partnership, or corporation desiring a license for a clinic or a special permit for special services, to file an application with DPH on forms furnished by DPH which contain, among other things: a) Evidence satisfactory to DPH that the applicant is of reputable and responsible character, and has the ability to comply with rules and regulations promulgated by DPH; b) The class of clinic to be operated, the character and scope of advice and treatment to be provided, and a complete description of the building, its location, facilities, equipment, apparatus, and appliances to be furnished and used in the operation of the clinic; c) The name and address of the professional licentiate responsible for the professional activities of the clinic and the licentiate's license number and professional experience; and, d) The initial license fee to be charged and any other information DPH deems necessary, including, but not limited to, evidence that the clinic has a written policy relating to the dissemination of information to patients regarding current laws requiring child passenger restraint systems. 3)Specifies that no application is required where a PCC adds a service that is not a special service, or remodels an existing PCC site. Requires a clinic to notify DPH in writing of a change in service or physical plant no less than 60 days prior to adding the service or remodeling an existing PCC site. AB 2053 Page 4 4)Requires, when city, county or state law obligates a PCC to obtain a building permit with respect to remodeling or modification of a PCC, that the PCC must provide DPH a signed certificate or statement from a licensed architect or a written statement from a local building department that the applicable construction, remodeling, alteration, or modification of the physical plant is in compliance with required standards. 5)Specifies that nothing in existing law limits DPH's authority to conduct an inspection at any time in order to ensure compliance with, or to prevent a violation of PCC licensing requirements. 6)Requires all clinics to maintain compliance with licensing provisions, and also specifies that licensing requirements must not prohibit the use of alternate concepts, methods, procedures, techniques, space, equipment, personnel qualifications, or the conducting of pilot projects, provided these exceptions are carried out with provision for safe and adequate patient care and with prior written approval from DPH. FISCAL EFFECT: This bill has not yet been analyzed by a fiscal committee. 1)PURPOSE OF THIS BILL. According to the author, the Patient Protection and Affordable Care Act and California's expansion of Medi-Cal provide a great opportunity for health coverage, but more work must be done to ensure access for communities of color and the working poor throughout our state. The author states this bill offers health centers a streamlined option to consolidate multiple facilities, or open new space near an existing facility, under one license. The author concludes, AB 2053 Page 5 this is a commonsense way to help health centers increase access, which is essential to the successful implementation of increased health coverage. 2)BACKGROUND. a) Community clinics. 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 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. b) Clinic licensing requirements. Clinic licensing requirements vary widely in California depending on the type of clinic and contain many exceptions. Examples of some of the types of clinics exempt from licensure by DPH include: i) Any establishment that is owned and operated as a clinic by one or more licensed health care practitioners and used as an office for the practice of their profession, with the exception of surgical clinics and specialty clinics; ii) Clinics operated as outpatient departments of hospitals; AB 2053 Page 6 iii) A clinic operated by, or affiliated with, any institution of learning that teaches a recognized healing art and is approved by the state board or commission vested with responsibility for regulation of the practice of that healing art; iv) An intermittent clinic that is open for no more than 20 hours per week, and that is operated by a licensed primary care clinic; and, v) Student health centers operated by public institutions of higher education. Clinics exempt from licensure must comply with all local building and fire safety standards. c) DPH program flexibility. The DPH Licensing and Certification Program (L&C) has no authority to waive laws and regulations, regardless of whether or not they are outdated or obsolete as a result of changes in technology, or procedures. However, in order to serve patients in health care facilities, L&C has a statutorily authorized concept called Program Flexibility, which recognizes that regulations cannot keep pace with modern technology and that often new alternatives, approaches, and techniques which meet the intent of the regulation is preferable to AB 2053 Page 7 strict compliance. Program flexibility allows DPH to provide an exception to regulation upon request and supportive documentation. d) Waivers granted and denied. The proponents of this bill have provided Committee staff with three examples of instances where DPH has approved clinics' requests for waivers similar to what would be allowed under this bill. For example, in 2008 Shasta Community Health Center in Redding was granted a waiver and allowed to operate in additional space across the street under one consolidated license. However, in 2015, Open Door clinic in Fortuna was denied a consolidated license for facilities that are housed in the same shopping center. The clinic was told that it could not have one license cover three separate buildings, and DPH did not suggest they apply for Program Flexibility. It appears that there is no statewide policy on how to approach requests for Program Flexibility with regard to licensing clinics. In some regions, local DPH offices are allowing consolidated licenses with buildings on separate sites, and others are not. According to DPH, Program Flexibility requests are unique and considered on a case-by-case basis by each District Office. 3)SUPPORT. The California Primary Care Association (CPCA) is the sponsor of this bill, and writes that, today, if a licensed health center wants to expand the services it provides and decides to open an additional facility that is located next door, around the corner, or a few stops down the AB 2053 Page 8 bus line, it is required to obtain a separate license to operate the additional facility. CPCA notes because the new facility is independently licensed, it must operate independently, creating challenges related to patient satisfaction, continuity of care, data analytics, billing, supply management, logistics, and more. CPCA states this bill will provide surety and guidance to DPH and its field offices by allowing for a streamlined and consistent process for both DPH and health centers to add facilities under the provisions of this bill. Planned Parenthood Affiliates of California supports this bill stating it will help community health centers expand primary care services and more easily adopt integrated care models by allowing multiple facilities to operate on a single consolidated license. 4)RELATED LEGISLATION. AB 1947 (Chiu) requires the centralized application unit of L&C 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. AB 1947 is set to be heard in this Committee on March 29, 2016. 5)PREVIOUS LEGISLATION. a) AB 941 (Wood), Chapter 502, Statutes of 2015, expands the exemption from DPH licensure 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 AB 2053 Page 9 whether they are currently operating any intermittent clinics, the location of these clinics, and the estimated hours of operation. c) AB 1177 (Gomez), Chapter 704, Statutes of 2015, 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. d) SB 937 (Ducheny), Chapter 602, Statutes of 2003, revises provisions relating to the licensure and operation of primary care clinics. Permits a primary care clinic to add a service or remodel a site without first having to apply for a new license from DPH. Authorizes a primary care clinic with more than one site to consolidate certain administrative functions. Requires DPH to issue a license to a primary care clinic to allow it to open a clinic at an additional site, under specified conditions. 6)TECHNICAL AMENDMENT. In order to correct a drafting error, the bill should be amended as follows: On page 4, line 26, strike "or that has multiple licenses for a single health facility on the same premises" REGISTERED SUPPORT / OPPOSITION: AB 2053 Page 10 Support AIDS Project Los Angeles Health & Wellness AltaMed Health Services Corporation California Primary Care Association (CPCA) Capital Impact Partners Community Clinic Association of Los Angeles County Community Clinic Consortium Family Healthcare Network Mendocino Coast Clinics North Coast Clinics Network Omni Family Health Open Door Community Health Centers Planned Parenthood Action Fund of the Pacific Southwest AB 2053 Page 11 Planned Parenthood Advocacy Project Los Angeles County Planned Parenthood Affiliates of California Planned Parenthood Northern California Action Fund Planned Parenthood of Mar Monte Ravenswood Family Health Center Redwoods Rural Health Center Santa Cruz Community Health Centers Opposition None on file. AB 2053 Page 12 Analysis Prepared by:Lara Flynn / HEALTH / (916) 319-2097