BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1544
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          Date of Hearing:   May 20, 2009 

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

            AB 1544 (Committee on Health) - As Introduced:  March 4, 2009 

          Policy Committee:                              HealthVote:17-0

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill addresses current law delays in the licensure of  
          hospital-based outpatient clinics.  Specifically, this bill  
          authorizes a hospital that has been licensed for five years and  
          is in good standing to operate an outpatient clinic without a  
          prior onsite survey by the California Department of Public  
          Health (DPH), under specified conditions. In addition, this bill  
          requires DPH to provide feedback about an application to add to,  
          amend, or modify an existing license within 30 days of receipt. 

           FISCAL EFFECT  

          One-time fee-supported special fund costs of $200,000 to  
          promulgate regulations and establish processes contained in this  
          bill.  Ongoing fee-supported special fund costs of $50,000. 

           COMMENTS  

           1)Rationale  . This bill, supported by the California Hospital  
            Association and several individual hospitals and health  
            systems, increases the ability of hospitals with outpatient  
            clinics to add to or expand outpatient clinic services without  
            a delay experienced under current law. According to the author  
            and supporters, some hospitals wait several months for DPH  
            licensure and certification (L & C) surveyors to finalize  
            licensure activity. During this time, hospitals are unable to  
            meet outpatient demand. Patients therefore have negative  
            health outcomes, sometimes requiring emergency care. This bill  
            increases hospitals' ability to care for patients in a less  
            costly environment and in a more timely way than under current  
            law. 

           2)The L & C Division within DPH  is responsible for ensuring a  
            high standard of medical care in approximately 7,000 public  
            and private health care facilities throughout the state. These  





                                                                  AB 1544
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            facilities include hospitals, clinics, surgical centers,  
            skilled nursing facilities (SNF), and home health agencies.  
            Surveyors from L & C conduct annual reviews of facilities that  
            receive payment under Medicare and Medi-Cal; conduct licensure  
            reviews to ensure compliance with state laws; investigate  
            complaints made related to patient care; and impose sanctions  
            on facilities failing to meet certain requirements. SNF and  
            acute care hospitals accounts for almost 70% of L & C  
            workload.
           
          3)Related Legislation  . AB 2010 (De Saulnier), Chapter 90,  
            Statutes of 2008 exempts affiliate clinics from provisional  
            licensure requirements.  
           
           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081