BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           1544 (Jones)
          
          Hearing Date:  8/17/2009        Amended: 8/17/2009
          Consultant: Katie Johnson       Policy Vote: Health 10-0
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          BILL SUMMARY:  AB 1544 would permit a hospital in good standing  
          to apply to the California Department of Public Health (CDPH) to  
          offer an outpatient service as a supplemental service without a  
          prior onsite survey by CDPH. The bill would also require CDPH to  
          approve the application and to issue or deny a new license  
          within 100 days of receiving a complete application.
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                            Fiscal Impact (in thousands)

           Major Provisions         2009-10      2010-11       2011-12     Fund
                                                                  
          CDPH regulations                $70          $120 $0   Special*

          *State Department of Public Health Licensing and Certification  
          Program Fund
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          STAFF COMMENTS: 

          Existing law provides for the licensing and regulation of health  
          facilities, including hospitals and primary care clinics, by the  
          CDPH. Existing law provides for a fee to be paid by a hospital  
          when applying for initial and renewing licensure, as specified.

          Existing regulations define a hospital outpatient service as the  
          rendering of non-emergency health care services to patients who  
          remain in the hospital less than 24 hours.

          Existing law permits a primary care clinic that has held a  
          valid, unrevoked, and unsuspended license for at least the  
          preceding five years to apply to establish another primary care  
          clinic at an additional site, which is referred to as an  
          affiliate clinic. Existing law provides that the CDPH approve an  
          affiliate clinic without the necessity of first conducting an  
          initial onsite survey if specified conditions are met. 











          This bill would permit a hospital to apply to CDPH to offer a  
          new or modify an existing outpatient service without a prior  
          onsite survey by CDPH, provided it has met the following  
          requirements:  

             1)   Has held for the five years immediately preceding the  
               submission of the completed application, a valid, unrevoked  
               or unsuspended license;
             2)   Does not have a history of repeated or uncorrected  
               violations that pose immediate jeopardy to a patient;
             3)   Does not have pending actions against it to suspend or  
               revoke the license or terminate Medicare or Medi-Cal  
               certification;
             4)   Owns and operates the outpatient service that is the  
               subject of the application.
          Page 2
          AB 1544 (Jones)

          This bill would require an applicant hospital to complete all  
          appropriate forms and documentation, pay any necessary fees, and  
          to describe the type of outpatient service and its location and  
          evidence showing that the outpatient service has written  
          policies and procedures governing its operation. This bill would  
          also require CDPH to approve the application and to issue or  
          deny a new license within 100 days of receiving a complete  
          application.

          This bill would limit the outpatient service to providing  
          primary health care service to patients who remain in the  
          outpatient clinic for less than 24 hours and would prohibit the  
          service from providing chronic dialysis treatment, alternative  
          birthing services, and outpatient surgeries that are provided by  
          a surgical clinic.

          This bill would provide that CDPH may conduct a licensing  
          inspection or complaint investigation after the application is  
          approved.

          CDPH would need $70,000 in FY 2009-2010 and $120,000 in FY  
          2010-2011 to promulgate regulations related to this bill.  
          Ongoing costs would be absorbable since hospitals may add  
          supplemental services at any time under existing law.