BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 1544|
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THIRD READING
Bill No: AB 1544
Author: Jones (D) and Fletcher (R), et al
Amended: 9/4/09 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 10-0, 7/15/09
AYES: Alquist, Strickland, Aanestad, Cedillo, Cox,
DeSaulnier, Leno, Negrete McLeod, Pavley, Wolk
NO VOTE RECORDED: Maldonado
SENATE APPROPRIATIONS COMMITTEE : 12-0, 8/17/09
AYES: Kehoe, Cox, Corbett, Denham, Hancock, Leno, Oropeza,
Price, Runner, Walters, Wolk, Yee
NO VOTE RECORDED: Wyland
ASSEMBLY FLOOR : 79-0, 6/1/09 - See last page for vote
SUBJECT : Health facilities: licensure
SOURCE : Author
DIGEST : This bill permits a hospital in good standing to
apply to the Department of Public Health (DPH) to offer an
outpatient service as a supplemental service without a
prior onsite survey by DPH. This bill also requires DPH to
approve the application and to issue or deny a new license
within 100 days of receiving a complete application.
Senate Floor Amendments of 9/4/09 reduce and clarify the
scope of the bill, and modify the procedures and criteria
CONTINUED
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hospitals must meet in order to be approved to offer an
outpatient clinic service.
ANALYSIS : Existing law provides for the licensing and
regulation of health facilities, including hospitals and
primary care clinics, by DPH. 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 DPH
approve an affiliate clinic without the necessity of first
conducting an initial onsite survey if specified conditions
are met.
This bill:
1. Permits a licensed general acute care hospital to apply
to DPH to add a new or modify an existing outpatient
service as a supplemental service.
2. Requires DPH, 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.
3. Requires DPH, upon determining the application is
complete, to investigate the facts set forth in the
application and, if DPH finds that the statements
contained in the application are true, that the
establishment of the operation of the supplemental
service are in conformity with this bill and the rules
and regulations of DPH, DPH shall approve application
and issue a new license.
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4. Specifies that if DPH determines in the course of the
investigation that additional information is needed, the
applicant shall provide the additional information to
DPH upon request.
5. Specifies that if DPH 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 this
bill, or if the applicant fails to provide any
additional information to DPH within 30 days of the
request, DPH shall deny the outpatient clinic services
application.
6. Requires DPH either grant or deny the application for
the outpatient clinic service as a supplemental service
within 100 days of the filing of a completed
application.
7. Specifies that if a licensed general acute care hospital
has previously been approved for an outpatient clinic
service within 30 days after receipt of a completed
application for an additional outpatient clinic service,
DPH shall approve the additional or modified outpatient
clinic service, add it to the hospital license, and
issue a new license, unless the applicant does not meet
the requirements.
8. Specifies that DPH is not required to conduct an onsite
inspection prior to approval of an outpatient clinic
service.
9. Requires a completed application to include all of the
following:
A. The appropriate forms, fees, and documentation.
B. A description of the type of outpatient clinic
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 clinic
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service and evidence satisfactory to DPH that the
hospital owns and will operate the outpatient clinic
service that is the subject of the application.
C. Written policies and procedures governing the
operation of the outpatient clinic service and its
reporting relationship to the applicant.
D. Evidence of the hospital's compliance with
applicable building standards and possession of a
fire clearance for the outpatient clinic service
space.
10.Specifies the outpatient clinic service that is the
subject of the application is to be limited to providing
nonemergency primary health care services in a clinical
environment to patients who remain in the outpatient
clinic for less than 24 hours.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2009-10 2010-11
2011-12 Fund
DPH regulations $70 $120
$0Special*
* DPH Licensing and Certification Program Fund
SUPPORT : (Verified 9/8/09)
California Association of Rural Health Clinics
California Hospital Association
Catholic Healthcare West
Chino Valley Medical Center
Colusa Regional Medical Center
Desert Valley Hospital
Hospital Association of San Diego and Imperial Counties
Montclair Hospital Medical Center
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Palomar Pomerado Health
Private Essential Access Community Hospitals
San Antonio Community Hospital
San Dimas Community Hospital
Scripps Mercy Hospital
Shasta Regional Medical Center
Sierra Kings District Hospital
Victor Valley Community Hospital
ARGUMENTS IN SUPPORT : The California Hospital
Association (CHA) states that hospitals are frustrated at
the amount of time it takes for their clinics to be
approved by DPH. A hospital operated clinic in Reedley had
to wait seven months to be surveyed, during which time it
had to forego 2,800 patient visits. In Modesto, Fairfield,
Clear Lake, and Lodi similar delays have been encountered.
CHA states that hospitals are attempting to respond to the
health care needs of their communities by opening and
expending outpatient primary care clinics, as a means of
relieving overcrowded emergency departments and providing
access to health care services for uninsured and
underinsured patients. CHA argues that the expedited
approval process outlined in the bill will provide
hospitals that are seeking to provide these services parity
with non-hospital based primary care clinics, and will
reduce the amount of time that new and expanded clinics
must wait for surveys before they can commence operations.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Bill
Berryhill, Tom Berryhill, Blakeslee, Blumenfield,
Brownley, Buchanan, Caballero, Charles Calderon, Carter,
Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,
DeVore, Duvall, Emmerson, Eng, Evans, Feuer, Fletcher,
Fong, Fuentes, Fuller, Furutani, Gaines, Galgiani,
Garrick, Gilmore, Hagman, Hall, Harkey, Hayashi,
Hernandez, Hill, Huber, Huffman, Jeffries, Jones, Knight,
Krekorian, Lieu, Logue, Bonnie Lowenthal, Ma, Mendoza,
Miller, Monning, Nava, Nestande, Niello, Nielsen, John A.
Perez, V. Manuel Perez, Portantino, Price, Ruskin, Salas,
Saldana, Silva, Skinner, Smyth, Solorio, Audra
Strickland, Swanson, Torlakson, Torres, Torrico, Tran,
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Villines, Yamada, Bass
NO VOTE RECORDED: Block
RJG/JJA:mw 9/8/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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