Amended in Senate May 5, 2015

Amended in Senate April 22, 2015

Amended in Senate April 14, 2015

Senate BillNo. 396


Introduced by Senator Hill

February 25, 2015


An act to amend Section 805.5 of, and to add Section 2216.5 to, the Business and Professions Code, to amend Section 12529.7 of the Government Code, and to amend Sections 1204, 1248.15, and 1248.35 of the Health and Safety Code, relating to health care.

LEGISLATIVE COUNSEL’S DIGEST

SB 396, as amended, Hill. Health care: outpatient settings and surgical clinics: facilities: licensure and enforcement.

Existing law provides for the licensure and regulation of clinics by the State Department of Public Health. A violation of those provisions is a misdemeanor. Existing law provides that certain types of specialty clinics, including surgical clinics, as defined, are eligible for licensure. Existing law excludes from the definition of surgical clinic any place or establishment owned or leased and operated as a clinic or office by one or more physicians or dentists in individual or group practice. Existing law requires a surgical clinic that is licensed or seeking licensure to comply with federal certification standards for an ambulatory surgical clinic until the department adopts regulations relating to the provision of services by a surgical clinic.

This bill would provide that a surgical clinic that has met the federal certification standards and requirements for an ambulatory surgical clinic is eligible for licensure by the department regardless of physician, podiatrist, or dentist ownership. The bill would provide that a surgical clinic is deemed to have met the licensure requirements under the chapter upon presentingbegin delete documentation, within a 3-year period,end deletebegin insert documentationend insert that the surgical clinic has met the federal certification requirements for an ambulatory surgicalbegin delete clinic.end deletebegin insert clinic in the 3 years prior to applying for licensure.end insert

The Medical Practice Act provides for the licensure and regulation of physicians and surgeons by the Medical Board of California. Existing law provides that it is unprofessional conduct for a physician and surgeon to perform procedures in any outpatient setting except in compliance with specified provisions. Existing law prohibits an association, corporation, firm, partnership, or person from operating, managing, conducting, or maintaining an outpatient setting in the state unless the setting is one of the specified settings, which includes, among others, an ambulatory surgical clinic that is certified to participate in the Medicare program, a surgical clinic licensed by the State Department of Public Health, or an outpatient setting accredited by an accreditation agency approved by the Division of Licensing of the Medical Board of California.

Existing law provides that an outpatient setting that is accredited shall be inspected by the accreditation agency and may be inspected by the Medical Board of California. Existing law requires that the inspections be conducted no less often than once every 3 years by the accreditation agency and as often as necessary by the Medical Board of California to ensure quality of care provided.

This bill would require that all subsequent inspections after the initial inspection for accreditation be unannounced. This bill would require an outpatient setting accredited by the division and a facility certified to participate in the federal Medicare program as an ambulatory surgical center to pay certain fees and to comply with certain data submission requirements.

Existing law requires members of the medical staff and other practitioners who are granted clinical privileges in an outpatient setting to be professionally qualified and appropriately credentialed for the performance of privileges granted and requires the outpatient setting to grant privileges in accordance with recommendations from qualified health professionals, and credentialing standards established by the outpatient setting.

This bill would additionally require that each licensee who performs procedures in an outpatient setting that requires the outpatient setting to be accredited be peer reviewed, as specified, at least every 2 years, by licensees who are qualified by education and experience to perform the same types of, or similar, procedures. The bill would require the findings of the peer review to be reported to the accrediting body who shall determine if the licensee continues to be professionally qualified and appropriately credentialed for the performance of privileges granted. By expanding the scope of a crime, this bill would impose a state-mandated local program.

Existing law requires specified entities, including any health care service plan or medical care foundation, to request a report from the Medical Board of California, the Board of Psychology, the Osteopathic Medical Board of California, or the Dental Board of California, prior to granting or renewing staff privileges, to determine if a certain report has been made indicating that the applying physician and surgeon, psychologist, podiatrist, or dentist has been denied staff privileges, been removed from a medical staff, or had his or her staff privileges restricted.

This bill would also require an outpatient setting and a facility certified to participate in the federal Medicare program as an ambulatory surgical center to request that report. By expanding the scope of a crime, this bill would impose a state-mandated local program.

Existing law establishes a vertical enforcement and prosecution model for cases before the Medical Board of California, and requires the board to report to the Governor and the Legislature on that model by March 1, 2015.

This bill would extend the date that report is due to March 1, 2016.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

P3    1

SECTION 1.  

Section 805.5 of the Business and Professions
2Code
is amended to read:

3

805.5.  

(a) Prior to granting or renewing staff privileges for
4any physician and surgeon, psychologist, podiatrist, or dentist, any
5health facility licensed pursuant to Division 2 (commencing with
P4    1Section 1200) of the Health and Safety Code, any health care
2service plan or medical care foundation, the medical staff of the
3institution, a facility certified to participate in the federal Medicare
4program as an ambulatory surgical center, or an outpatient setting
5accredited pursuant to Section 1248.1 of the Health and Safety
6Code shall request a report from the Medical Board of California,
7the Board of Psychology, the Osteopathic Medical Board of
8California, or the Dental Board of California to determine if any
9report has been made pursuant to Section 805 indicating that the
10applying physician and surgeon, psychologist, podiatrist, or dentist
11has been denied staff privileges, been removed from a medical
12staff, or had his or her staff privileges restricted as provided in
13Section 805. The request shall include the name and California
14license number of the physician and surgeon, psychologist,
15podiatrist, or dentist. Furnishing of a copy of the 805 report shall
16not cause the 805 report to be a public record.

17(b) Upon a request made by, or on behalf of, an institution
18described in subdivision (a) or its medical staff the board shall
19furnish a copy of any report made pursuant to Section 805 as well
20as any additional exculpatory or explanatory information submitted
21electronically to the board by the licensee pursuant to subdivision
22(f) of that section. However, the board shall not send a copy of a
23report (1) if the denial, removal, or restriction was imposed solely
24because of the failure to complete medical records, (2) if the board
25has found the information reported is without merit, (3) if a court
26finds, in a final judgment, that the peer review, as defined in
27Section 805, resulting in the report was conducted in bad faith and
28the licensee who is the subject of the report notifies the board of
29that finding, or (4) if a period of three years has elapsed since the
30report was submitted. This three-year period shall be tolled during
31any period the licentiate has obtained a judicial order precluding
32 disclosure of the report, unless the board is finally and permanently
33precluded by judicial order from disclosing the report. If a request
34is received by the board while the board is subject to a judicial
35order limiting or precluding disclosure, the board shall provide a
36disclosure to any qualified requesting party as soon as practicable
37after the judicial order is no longer in force.

38If the board fails to advise the institution within 30 working days
39following its request for a report required by this section, the
P5    1institution may grant or renew staff privileges for the physician
2and surgeon, psychologist, podiatrist, or dentist.

3(c) Any institution described in subdivision (a) or its medical
4staff that violates subdivision (a) is guilty of a misdemeanor and
5shall be punished by a fine of not less than two hundred dollars
6($200) nor more than one thousand two hundred dollars ($1,200).

7

SEC. 2.  

Section 2216.5 is added to the Business and Professions
8Code
, to read:

9

2216.5.  

An outpatient setting accredited pursuant to Section
101248.1 of the Health and Safety Code and a facility certified to
11participate in the federal Medicare program as an ambulatory
12surgical center are subject to the requirements of the following
13provisions: Section 1216, subdivision (f) of Section 127280,
14Section 127285, and Section 128737 of the Health and Safety
15Code. Any fees collected pursuant to subdivision (f) of Section
16127280 of the Health and Safety Code shall not exceed the
17reasonable costs incurred by the Office of Statewide Health
18Planning and Development inbegin delete regulatingend deletebegin insert collecting and managing
19the data reported byend insert
the outpatient setting and the facility.

20

SEC. 3.  

Section 12529.7 of the Government Code is amended
21to read:

22

12529.7.  

By March 1, 2016, the Medical Board of California,
23in consultation with the Department of Justice and the Department
24of Consumer Affairs, shall report and make recommendations to
25the Governor and the Legislature on the vertical enforcement and
26prosecution model created under Section 12529.6.

27

SEC. 4.  

Section 1204 of the Health and Safety Code is amended
28to read:

29

1204.  

Clinics eligible for licensure pursuant to this chapter are
30primary care clinics and specialty clinics.

31(a)  (1)  Only the following defined classes of primary care
32clinics shall be eligible for licensure:

33(A)  A “community clinic” means a clinic operated by a
34tax-exempt nonprofit corporation that is supported and maintained
35in whole or in part by donations, bequests, gifts, grants, government
36funds or contributions, that may be in the form of money, goods,
37or services. In a community clinic, any charges to the patient shall
38be based on the patient’s ability to pay, utilizing a sliding fee scale.
39No corporation other than a nonprofit corporation, exempt from
40 federal income taxation under paragraph (3) of subsection (c) of
P6    1Section 501 of the Internal Revenue Code of 1954 as amended, or
2a statutory successor thereof, shall operate a community clinic;
3provided, that the licensee of any community clinic so licensed on
4the effective date of this section shall not be required to obtain
5tax-exempt status under either federal or state law in order to be
6eligible for, or as a condition of, renewal of its license. No natural
7person or persons shall operate a community clinic.

8(B)  A “free clinic” means a clinic operated by a tax-exempt,
9nonprofit corporation supported in whole or in part by voluntary
10donations, bequests, gifts, grants, government funds or
11contributions, that may be in the form of money, goods, or services.
12In a free clinic there shall be no charges directly to the patient for
13services rendered or for drugs, medicines, appliances, or
14apparatuses furnished. No corporation other than a nonprofit
15corporation exempt from federal income taxation under paragraph
16(3) of subsection (c) of Section 501 of the Internal Revenue Code
17of 1954 as amended, or a statutory successor thereof, shall operate
18a free clinic; provided, that the licensee of any free clinic so
19licensed on the effective date of this section shall not be required
20to obtain tax-exempt status under either federal or state law in
21order to be eligible for, or as a condition of, renewal of its license.
22No natural person or persons shall operate a free clinic.

23(2)  Nothing in this subdivision shall prohibit a community
24clinic or a free clinic from providing services to patients whose
25services are reimbursed by third-party payers, or from entering
26into managed care contracts for services provided to private or
27public health plan subscribers, as long as the clinic meets the
28requirements identified in subparagraphs (A) and (B). For purposes
29of this subdivision, any payments made to a community clinic by
30a third-party payer, including, but not limited to, a health care
31service plan, shall not constitute a charge to the patient. This
32paragraph is a clarification of existing law.

33(b)  The following types of specialty clinics shall be eligible for
34licensure as specialty clinics pursuant to this chapter:

35(1)  (A) A “surgical clinic” means a clinic that is not part of a
36hospital and that provides ambulatory surgical care for patients
37who remain less than 24 hours. A surgical clinic does not include
38any place or establishment owned or leased and operated as a clinic
39or office by one or more physicians, podiatrists, or dentists in
P7    1individual or group practice, regardless of the name used publicly
2to identify the place or establishment.

3(B) A physician, podiatrist, or dentist may, at his or her option,
4apply for licensure. A surgical clinic shall be eligible for licensure
5by the department regardless of physician, podiatrist, or dentist
6ownership. A surgical clinic that has met the federal certification
7standards and requirements for an ambulatory surgical clinic, as
8specified in Part 416 of Title 42 of the Code of Federal Regulations,
9shall be eligible for licensure by the department pursuant to this
10chapter.

11(C) Until the department adopts regulations relating to the
12provision of services by a surgical clinic pursuant to Section 1225,
13a surgical clinic is deemed to have met the licensure requirements
14under this chapter upon presentingbegin delete documentation, within a
15three-year period,end delete
begin insert documentationend insert that the surgical clinic has met
16the federal certification standards for an ambulatory surgicalbegin delete clinic.end delete
17begin insert clinic in the three years prior to applying for licensure.end insert

18(2)  A “chronic dialysis clinic” means a clinic that provides less
19than 24-hour care for the treatment of patients with end-stage renal
20disease, including renal dialysis services.

21(3)  A “rehabilitation clinic” means a clinic that, in addition to
22providing medical services directly, also provides physical
23rehabilitation services for patients who remain less than 24 hours.
24Rehabilitation clinics shall provide at least two of the following
25rehabilitation services: physical therapy, occupational therapy,
26social, speech pathology, and audiology services. A rehabilitation
27clinic does not include the offices of a private physician in
28individual or group practice.

29(4)  An “alternative birth center” means a clinic that is not part
30of a hospital and that provides comprehensive perinatal services
31and delivery care to pregnant women who remain less than 24
32hours at the facility.

33

SEC. 5.  

Section 1248.15 of the Health and Safety Code is
34amended to read:

35

1248.15.  

(a) The board shall adopt standards for accreditation
36and, in approving accreditation agencies to perform accreditation
37of outpatient settings, shall ensure that the certification program
38shall, at a minimum, include standards for the following aspects
39of the settings’ operations:

P8    1(1) Outpatient setting allied health staff shall be licensed or
2certified to the extent required by state or federal law.

3(2) (A) Outpatient settings shall have a system for facility safety
4and emergency training requirements.

5(B) There shall be onsite equipment, medication, and trained
6personnel to facilitate handling of services sought or provided and
7to facilitate handling of any medical emergency that may arise in
8connection with services sought or provided.

9(C) In order for procedures to be performed in an outpatient
10setting as defined in Section 1248, the outpatient setting shall do
11one of the following:

12(i) Have a written transfer agreement with a local accredited or
13licensed acute care hospital, approved by the facility’s medical
14staff.

15(ii) Permit surgery only by a licensee who has admitting
16privileges at a local accredited or licensed acute care hospital, with
17the exception that licensees who may be precluded from having
18admitting privileges by their professional classification or other
19administrative limitations, shall have a written transfer agreement
20with licensees who have admitting privileges at local accredited
21or licensed acute care hospitals.

22(iii) Submit for approval by an accrediting agency a detailed
23procedural plan for handling medical emergencies that shall be
24reviewed at the time of accreditation. No reasonable plan shall be
25disapproved by the accrediting agency.

26(D) The outpatient setting shall submit for approval by an
27accreditation agency at the time of accreditation a detailed plan,
28standardized procedures, and protocols to be followed in the event
29of serious complications or side effects from surgery that would
30place a patient at high risk for injury or harm or to govern
31emergency and urgent care situations. The plan shall include, at a
32minimum, that if a patient is being transferred to a local accredited
33or licensed acute care hospital, the outpatient setting shall do all
34of the following:

35(i) Notify the individual designated by the patient to be notified
36in case of an emergency.

37(ii) Ensure that the mode of transfer is consistent with the
38patient’s medical condition.

39(iii) Ensure that all relevant clinical information is documented
40and accompanies the patient at the time of transfer.

P9    1(iv) Continue to provide appropriate care to the patient until the
2transfer is effectuated.

3(E) All physicians and surgeons transferring patients from an
4outpatient setting shall agree to cooperate with the medical staff
5peer review process on the transferred case, the results of which
6shall be referred back to the outpatient setting, if deemed
7appropriate by the medical staff peer review committee. If the
8medical staff of the acute care facility determines that inappropriate
9care was delivered at the outpatient setting, the acute care facility’s
10peer review outcome shall be reported, as appropriate, to the
11accrediting body or in accordance with existing law.

12(3) The outpatient setting shall permit surgery by a dentist acting
13within his or her scope of practice under Chapter 4 (commencing
14with Section 1600) of Division 2 of the Business and Professions
15Code or physician and surgeon, osteopathic physician and surgeon,
16or podiatrist acting within his or her scope of practice under
17Chapter 5 (commencing with Section 2000) of Division 2 of the
18Business and Professions Code or the Osteopathic Initiative Act.
19The outpatient setting may, in its discretion, permit anesthesia
20service by a certified registered nurse anesthetist acting within his
21or her scope of practice under Article 7 (commencing with Section
222825) of Chapter 6 of Division 2 of the Business and Professions
23Code.

24(4) Outpatient settings shall have a system for maintaining
25clinical records.

26(5) Outpatient settings shall have a system for patient care and
27monitoring procedures.

28(6) (A)  Outpatient settings shall have a system for quality
29assessment and improvement.

30(B) (i) Members of the medical staff and other practitioners
31who are granted clinical privileges shall be professionally qualified
32and appropriately credentialed for the performance of privileges
33granted. The outpatient setting shall grant privileges in accordance
34with recommendations from qualified health professionals, and
35credentialing standards established by the outpatient setting.

36(ii) Each licensee who performs procedures in an outpatient
37setting that requires the outpatient setting to be accredited shall
38be, at least every two years, peer reviewed, which shall be a process
39in which the basic qualifications, staff privileges, employment,
40medical outcomes, or professional conduct of a licensee is reviewed
P10   1to make recommendations for quality improvement and education,
2if necessary, including when the outpatient setting has only one
3licensee. The peer review shall be performed by licensees who are
4qualified by education and experience to perform the same types
5of, or similar, procedures. The findings of the peer review shall
6be reported to the accrediting body who shall determine if the
7licensee continues to meet the requirements described in clause
8(i).

9(C) Clinical privileges shall be periodically reappraised by the
10outpatient setting. The scope of procedures performed in the
11outpatient setting shall be periodically reviewed and amended as
12appropriate.

13(7) Outpatient settings regulated by this chapter that have
14multiple service locations shall have all of the sites inspected.

15(8) Outpatient settings shall post the certificate of accreditation
16in a location readily visible to patients and staff.

17(9) Outpatient settings shall post the name and telephone number
18of the accrediting agency with instructions on the submission of
19complaints in a location readily visible to patients and staff.

20(10) Outpatient settings shall have a written discharge criteria.

21(b) Outpatient settings shall have a minimum of two staff
22persons on the premises, one of whom shall either be a licensed
23physician and surgeon or a licensed health care professional with
24current certification in advanced cardiac life support (ACLS), as
25long as a patient is present who has not been discharged from
26supervised care. Transfer to an unlicensed setting of a patient who
27does not meet the discharge criteria adopted pursuant to paragraph
28(10) of subdivision (a) shall constitute unprofessional conduct.

29(c) An accreditation agency may include additional standards
30in its determination to accredit outpatient settings if these are
31approved by the board to protect the public health and safety.

32(d) No accreditation standard adopted or approved by the board,
33and no standard included in any certification program of any
34 accreditation agency approved by the board, shall serve to limit
35the ability of any allied health care practitioner to provide services
36within his or her full scope of practice. Notwithstanding this or
37any other provision of law, each outpatient setting may limit the
38privileges, or determine the privileges, within the appropriate scope
39of practice, that will be afforded to physicians and allied health
40care practitioners who practice at the facility, in accordance with
P11   1credentialing standards established by the outpatient setting in
2compliance with this chapter. Privileges may not be arbitrarily
3restricted based on category of licensure.

4(e) The board shall adopt standards that it deems necessary for
5outpatient settings that offer in vitro fertilization.

6(f) The board may adopt regulations it deems necessary to
7specify procedures that should be performed in an accredited
8outpatient setting for facilities or clinics that are outside the
9definition of outpatient setting as specified in Section 1248.

10(g) As part of the accreditation process, the accrediting agency
11shall conduct a reasonable investigation of the prior history of the
12outpatient setting, including all licensed physicians and surgeons
13who have an ownership interest therein, to determine whether there
14have been any adverse accreditation decisions rendered against
15them. For the purposes of this section, “conducting a reasonable
16investigation” means querying the Medical Board of California
17and the Osteopathic Medical Board of California to ascertain if
18either the outpatient setting has, or, if its owners are licensed
19physicians and surgeons, if those physicians and surgeons have,
20been subject to an adverse accreditation decision.

21

SEC. 6.  

Section 1248.35 of the Health and Safety Code is
22amended to read:

23

1248.35.  

(a) Every outpatient setting that is accredited shall
24be inspected by the accreditation agency and may also be inspected
25by the Medical Board of California. The Medical Board of
26California shall ensure that accreditation agencies inspect outpatient
27settings.

28(b) Unless otherwise specified, the following requirements apply
29to inspections described in subdivision (a).

30(1) The frequency of inspection shall depend upon the type and
31complexity of the outpatient setting to be inspected.

32(2) Inspections shall be conducted no less often than once every
33three years by the accreditation agency and as often as necessary
34by the Medical Board of California to ensure the quality of care
35provided. After the initial inspection for accreditation, all
36subsequent inspections shall be unannounced.

37(3) The Medical Board of California or the accreditation agency
38may enter and inspect any outpatient setting that is accredited by
39an accreditation agency at any reasonable time to ensure
40compliance with, or investigate an alleged violation of, any
P12   1standard of the accreditation agency or any provision of this
2chapter.

3(c) If an accreditation agency determines, as a result of its
4inspection, that an outpatient setting is not in compliance with the
5standards under which it was approved, the accreditation agency
6may do any of the following:

7(1) Require correction of any identified deficiencies within a
8set timeframe. Failure to comply shall result in the accrediting
9agency issuing a reprimand or suspending or revoking the
10outpatient setting’s accreditation.

11(2) Issue a reprimand.

12(3) Place the outpatient setting on probation, during which time
13the setting shall successfully institute and complete a plan of
14correction, approved by the board or the accreditation agency, to
15correct the deficiencies.

16(4) Suspend or revoke the outpatient setting’s certification of
17accreditation.

18(d) (1) Except as is otherwise provided in this subdivision,
19before suspending or revoking a certificate of accreditation under
20this chapter, the accreditation agency shall provide the outpatient
21setting with notice of any deficiencies and the outpatient setting
22shall agree with the accreditation agency on a plan of correction
23that shall give the outpatient setting reasonable time to supply
24information demonstrating compliance with the standards of the
25accreditation agency in compliance with this chapter, as well as
26the opportunity for a hearing on the matter upon the request of the
27outpatient setting. During the allotted time to correct the
28deficiencies, the plan of correction, which includes the deficiencies,
29shall be conspicuously posted by the outpatient setting in a location
30accessible to public view. Within 10 days after the adoption of the
31plan of correction, the accrediting agency shall send a list of
32deficiencies and the corrective action to be taken to the board and
33to the California State Board of Pharmacy if an outpatient setting
34is licensed pursuant to Article 14 (commencing with Section 4190)
35of Chapter 9 of Division 2 of the Business and Professions Code.
36The accreditation agency may immediately suspend the certificate
37of accreditation before providing notice and an opportunity to be
38heard, but only when failure to take the action may result in
39imminent danger to the health of an individual. In such cases, the
P13   1accreditation agency shall provide subsequent notice and an
2opportunity to be heard.

3(2) If an outpatient setting does not comply with a corrective
4action within a timeframe specified by the accrediting agency, the
5accrediting agency shall issue a reprimand, and may either place
6the outpatient setting on probation or suspend or revoke the
7accreditation of the outpatient setting, and shall notify the board
8of its action. This section shall not be deemed to prohibit an
9outpatient setting that is unable to correct the deficiencies, as
10specified in the plan of correction, for reasons beyond its control,
11from voluntarily surrendering its accreditation prior to initiation
12of any suspension or revocation proceeding.

13(e) The accreditation agency shall, within 24 hours, report to
14the board if the outpatient setting has been issued a reprimand or
15if the outpatient setting’s certification of accreditation has been
16suspended or revoked or if the outpatient setting has been placed
17on probation. If an outpatient setting has been issued a license by
18the California State Board of Pharmacy pursuant to Article 14
19(commencing with Section 4190) of Chapter 9 of Division 2 of
20the Business and Professions Code, the accreditation agency shall
21also send this report to the California State Board of Pharmacy
22within 24 hours.

23(f) The accreditation agency, upon receipt of a complaint from
24the board that an outpatient setting poses an immediate risk to
25public safety, shall inspect the outpatient setting and report its
26findings of inspection to the board within five business days. If an
27accreditation agency receives any other complaint from the board,
28it shall investigate the outpatient setting and report its findings of
29investigation to the board within 30 days.

30(g) Reports on the results of any inspection shall be kept on file
31with the board and the accreditation agency along with the plan
32of correction and the comments of the outpatient setting. The
33inspection report may include a recommendation for reinspection.
34All final inspection reports, which include the lists of deficiencies,
35plans of correction or requirements for improvements and
36correction, and corrective action completed, shall be public records
37open to public inspection.

38(h) If one accrediting agency denies accreditation, or revokes
39or suspends the accreditation of an outpatient setting, this action
40shall apply to all other accrediting agencies. An outpatient setting
P14   1that is denied accreditation is permitted to reapply for accreditation
2with the same accrediting agency. The outpatient setting also may
3apply for accreditation from another accrediting agency, but only
4if it discloses the full accreditation report of the accrediting agency
5that denied accreditation. Any outpatient setting that has been
6denied accreditation shall disclose the accreditation report to any
7other accrediting agency to which it submits an application. The
8new accrediting agency shall ensure that all deficiencies have been
9corrected and conduct a new onsite inspection consistent with the
10standards specified in this chapter.

11(i) If an outpatient setting’s certification of accreditation has
12been suspended or revoked, or if the accreditation has been denied,
13the accreditation agency shall do all of the following:

14(1) Notify the board of the action.

15(2) Send a notification letter to the outpatient setting of the
16action. The notification letter shall state that the setting is no longer
17allowed to perform procedures that require outpatient setting
18accreditation.

19(3) Require the outpatient setting to remove its accreditation
20certification and to post the notification letter in a conspicuous
21location, accessible to public view.

22(j) The board may take any appropriate action it deems necessary
23pursuant to Section 1248.7 if an outpatient setting’s certification
24of accreditation has been suspended or revoked, or if accreditation
25has been denied.

26

SEC. 7.  

No reimbursement is required by this act pursuant to
27Section 6 of Article XIII B of the California Constitution because
28the only costs that may be incurred by a local agency or school
29district will be incurred because this act creates a new crime or
30infraction, eliminates a crime or infraction, or changes the penalty
31for a crime or infraction, within the meaning of Section 17556 of
32the Government Code, or changes the definition of a crime within
33the meaning of Section 6 of Article XIII B of the California
34Constitution.



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