BILL ANALYSIS Ó
AB 2053
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CONCURRENCE IN SENATE AMENDMENTS
AB
2053 (Gonzalez and Gray)
As Amended August 18, 2016
Majority vote
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|ASSEMBLY: |79-0 |(April 21, |SENATE: |39-0 |(August 23, |
| | |2016) | | |2016) |
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Original Committee Reference: HEALTH
SUMMARY: Requires the Department of Public Health (DPH), upon
written notification by a licensed primary care clinic (PCC) or
an affiliate clinic that it is adding an additional physical
plant maintained and operated on separate premises, to issue a
single consolidated license to the clinic. Specifically, this
bill:
1)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 or affiliate clinic is licensed
in good standing and meets all necessary requirements.
2)Requires DPH, when issuing the license to specify the location
of each physical plant.
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3)Allows a PCC or an affiliate clinic that is issued a
consolidated license to operate under a single National
Provider Identification (NPI) number, or separate NPI's for
one or more of the facilities subject to the consolidated
license.
4)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.
5)Applies existing notification and building permit requirements
to a PCC or an affiliate clinic that modifies or adds an
additional physical plant.
The Senate amendments expand the provisions of this bill to
include affiliate clinics.
FISCAL EFFECT: According to the Senate Appropriations Committee
one-time costs of $110,000 to adopt regulations by DPH
(Licensing and Certification Fund).
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COMMENTS: 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 this is a
commonsense way to help health centers increase access, which is
essential to the successful implementation of increased health
coverage.
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.
Under existing law, a licensed primary care clinic is permitted
to operate an off-site clinic, for up to 30 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 has historically not tracked the number
of intermittent clinics. 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. 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.
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In 2009, SB 442 (Ducheny), Chapter 502, Statutes of 2010, was
introduced with provisions similar in concept to this bill to
allow for a primary care clinic to be issued a consolidated
license to operate facilities at separate locations. However,
it was later amended to streamline provisions related to primary
care clinic affiliate licensure. Under existing law, as amended
by SB 442, a primary care clinic that has held a license for
five years with no history of repeated or uncorrected violations
can apply for an "affiliate clinic" license to establish a
primary care clinic at an additional site. An affiliate license
application does not require an initial onsite survey, and is a
more simplified and streamlined process than applying for a new
stand-alone license. Additionally, primary care clinics
operating under a single corporation utilizing the affiliate
licensing option are entitled to consolidate certain
administrative functions such as billing and related financial
functions, purchasing functions, and offsite storage and
maintenance of certain patient and personnel records.
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 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.
There is no opposition to this bill.
Analysis Prepared by:
Lara Flynn / HEALTH / (916) 319-2097 FN:
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