BILL NUMBER: AB 1544	INTRODUCED
	BILL TEXT


INTRODUCED BY   Committee on Health (Jones (Chair), Fletcher (Vice
Chair), Adams, Ammiano, Block, Carter, Conway, De La Torre, Emmerson,
Hayashi, Hernandez, Bonnie Lowenthal, Nava, V. Manuel Perez, Salas,
and Audra Strickland)

                        MARCH 4, 2009

   An act to add Section 1253.6 to the Health and Safety Code,
relating to health facilities.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1544, as introduced, Committee on Health. Health facilities:
licensure.
   Existing law provides for the licensure of health facilities,
including general acute care hospitals, acute psychiatric hospitals,
and special hospitals, as defined, by the State Department of Public
Health. Violation of these provisions is a misdemeanor.
   Existing law requires that, upon the issuance or renewal of a
general acute care, acute psychiatric, or special hospital license,
the department separately identify on the license each supplemental
service, including the address of where each outpatient service is
provided and the type of services provided at each outpatient
location.
   Existing law authorizes licensed general acute care hospitals and
acute psychiatric hospitals to provide in any alternative setting
health care services and programs that may be provided by any other
provider of health care outside of a hospital building or which are
not otherwise specifically prohibited by provisions of existing law
regulating these facilities. It also requires the state department
and the Office of Statewide Health Planning and Development to adopt
and enforce standards which permit these health facilities to use its
space for alternative purposes.
   This bill would, among other things, require the department to
approve a completed application by a licensed general acute care
hospital, acute psychiatric hospital, or a special hospital that
meets specified requirements to add or modify an outpatient service
as a supplemental service, add the outpatient service to the hospital
license, and issue a new license, within 30 days of receipt of the
completed application, unless the applicant does not meet specified
requirements. The bill would require the outpatient service that is
the subject of the application to provide primary health care service
to patients who remain in the outpatient clinic for less than 24
hours. The bill would also prohibit the outpatient service that is
the subject of the application from providing chronic dialysis
treatment or alternative birthing services or performing outpatient
surgeries that are provided by a surgical clinic. By creating a new
crime, this bill would impose a state mandated local program.
   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:

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) Hospitals in California are essential partners with the state
in providing a health care safety net for underserved, uninsured, and
underinsured populations in a cost-effective manner.
   (b) The need for primary care is growing dramatically due to
changes in the delivery of health care, demands of the market, and
the continuing increase of uninsured and underinsured patients in
California, an escalating unemployment rate, physician shortage, and
a severely depressed economy.
   (c) The current system of approving new hospital-based outpatient
services that provide primary care causes delays in timely access to
care and results in a significant and unnecessary waste of taxpayer
and community resources that could otherwise be devoted to patient
care.
   (d) Administrative streamlining of the approval process, without
compromising patient health and safety, will avoid unnecessary burden
to the state's scarce resources and improve access to vital
community health care services in California.
  SEC. 2.  Section 1253.6 is added to the Health and Safety Code, to
read:
   1253.6.  (a) Upon receipt of an initial application by a licensed
general acute care hospital, acute psychiatric hospital, or a special
hospital that meets the requirements of subdivision (c) to add a new
or modify an existing outpatient service as a supplemental service,
the department shall, within 30 days of receipt of the initial
application, review the entire application, determine whether the
application is missing information or has insufficient information,
and, on the basis of this determination, provide the hospital with
guidance on how to provide the missing information.
   (b) Within 30 days after receipt of a completed application by a
licensed general acute care hospital, acute psychiatric hospital, or
a special hospital that meets the requirements of subdivision (c) to
add or modify an outpatient service as a supplemental service, the
department shall approve the additional or modified outpatient
service, add it to the hospital license, and issue a new license,
unless the applicant does not meet the requirements of this section.
Notwithstanding any other law, the issuance of a new license pursuant
to this section shall not require an initial onsite survey. If the
department determines that the applicant does not meet the
requirements of this section, the department shall provide the
hospital, in writing, the particular basis for this determination.
   (c) A hospital qualifies to submit an application pursuant to this
section only if both of the following conditions are met:
   (1) The hospital has held for the five years immediately preceding
the submission of the completed application, a valid, unrevoked or
unsuspended license, does not have a demonstrated history of repeated
or uncorrected violations of state licensing or federal
certification requirements that pose immediate jeopardy to a patient,
and does not have any pending actions against it to suspend or
revoke the license or terminate Medicare or Medi-Cal certification.
   (2) The hospital owns and operates the outpatient service that is
the subject of the application.
   (d) A completed application for purposes of this section shall
include all of the following:
   (1) The appropriate forms, fees, and documentation, as determined
by the department.
   (2) A description of the type of outpatient service to be
operated, the character and scope of the service to be provided, and
a complete description of the building, its location and proximity to
the main hospital building, facilities, equipment, apparatus, and
appliances to be furnished and used in the operation of the
outpatient service.
   (3) A description of and sufficient evidence that the outpatient
service has written policies and procedures governing the operation
of the service and its reporting relationship to the applicant.
   (4) Evidence of the hospital's compliance with applicable building
standards and possession of a fire clearance.
   (e) The outpatient service that is the subject of the application
shall provide primary health care service to patients who remain in
the outpatient clinic for less than 24 hours.
   (f) The outpatient service that is the subject of the application
shall not provide chronic dialysis treatment or alternative birthing
services or perform outpatient surgeries that are provided by a
surgical clinic.
   (g) Nothing in this section shall prohibit the department from
conducting a licensing inspection or complaint investigation after
receipt of the completed application.
  SEC. 3.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.