BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 832
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          Date of Hearing:   May 20, 2009 

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                     AB 832 (Jones) - As Amended:  May 5, 2009  

          Policy Committee:                              Health Vote:16-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill requires the California Department of Public Health  
          (DPH) to convene a workgroup to develop recommendations  
          regarding the oversight of ambulatory surgical clinics (ASC) to  
          address issues raised in recent litigation, Capen v. Shewry,  
          (155 Cal. App. 4th 378). Findings of Capen have led DPH to  
          conclude the department no longer has the authority to license  
          certain ASC. 

           FISCAL EFFECT  

          One-time GF costs of $50,000 to $100,000 to DPH to convene the  
          workgroup and report to the Legislature by July 2010. 

           COMMENTS  

           1)Rationale  . This bill requires DPH to establish a workgroup to  
            address Capen. According to the author, as a result of the  
            court decision, DPH has concluded that DPH is not authorized  
            to license certain physician-owned ASC, even when clinic  
            licensure is required to meet payment standards of health  
            plans and insurers.  The workgroup established by this bill  
            may reduce confusion or ambiguity generated by current law and  
            Capen. Increased clarity in this area will improve patient  
            safety and clarify DPH oversight. 

           2)DPH Licensing Oversight  . The DPH is responsible for ensuring  
            health and safety standards are met in approximately 7,000  
            public and private health care facilities throughout the  
            state. These facilities include surgical centers, hospitals,  
            skilled nursing facilities (SNF), and home health agencies.  
            SNF and acute care hospitals account for almost 70% of L & C  
            workload. Since Capen, DPH is not renewing or granting any  
            licenses to a surgical clinic with any degree of physician  
            ownership, though the department continues to certify these  





                                                                  AB 832
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            centers for Medicare purposes.

           3)Related Legislation  . AB 543 (Plescia) in 2007 and AB 2122  
            (Plescia) in 2008 required surgical clinics to meet specified  
            operating and staffing standards, including compliance with  
            Medicare conditions of participation. AB 543 was vetoed due to  
            concerns the bill did not fully address patient safety. AB  
            2122 was held on the Suspense File of this committee. AB 2308  
            (Plescia) in 2006 required DPH to convene a workgroup to  
            develop licensure criteria to protect patients receiving care  
            in surgical clinics. AB 2308 was vetoed due to concerns the  
            bill did not meet objectives.

           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081