BILL NUMBER: AB 1544 AMENDED
BILL TEXT
AMENDED IN SENATE AUGUST 17, 2009
AMENDED IN SENATE JULY 23, 2009
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 amended, 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
100 days of receipt of the completed application, unless the
applicant does not meet specified requirements. The bill would limit
the outpatient service that is the subject of the application to
providing only 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, performing outpatient surgeries that are provided
by a surgical clinic, or providing other services that are not
consistent with providing primary health care services for patients
who remain in the outpatient clinic for less than 24 hours. 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 shortages , 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 an
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, an 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,
(b) Upon determination by the department that an application for
an outpatient service as a supplemental service is complete pursuant
to subdivision (a), the department shall investigate the facts set
forth in the application and, if the department finds that the
statements contained in the application are true, that the
establishment of the operation of the supplemental service are in
conformity with the intent and purpose of this chapter, and that the
applicant is in compliance with the provision of this chapter and the
rules and regulations of the department, the department shall
approve the additional or modified outpatient service, add it to the
hospital license, and issue a new license. However, if the department
finds that the statements contained in the application are not true,
or that the establishment of the outpatient service as a
supplemental service is not in conformity with the intent and purpose
of this chapter, the department shall deny the applicant the
license. The department shall either grant or deny the application
for the outpatient service as a supplemental service within 100 days
of the filing of a completed application.
(c) If a licensed general acute care
hospital, acute psychiatric hospital, or a special hospital meets the
requirement of subdivision (d) and has been approved for an
outpatient service as a supplemental service in accordance with
subdivision (b), within 30 days after receipt of a completed
application for an additional outpatient 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. However,
nothing shall preclude the department form
from conducting an onsite inspection prior to approving an
application for supplemental services or denying an application if it
finds licensing deficiencies as a result of the inspection. 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)
(d) 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)
(e) 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
documentation 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)
(f) The outpatient service that is the subject of the
application shall be limited to providing primary health care service
to patients who remain in the outpatient clinic for less than 24
hours.
(f)
(g) The outpatient service that is the subject of the
application shall not provide chronic dialysis treatment or
alternative birthing services, perform outpatient surgeries that are
provided by a surgical clinic, or provide other services not
consistent with those described in subdivision (e).
(g)
(h) Nothing in this section shall prohibit the
department from conducting a licensing inspection or complaint
investigation after the application is approved.
(h)
(i) The outpatient service that is the subject of the
application shall comply with applicable standards for outpatient
services, including, but not limited to, requirements applicable to
life safety, building standards, infection control, medical records,
personnel policies, governance, and patient rights.
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.