BILL NUMBER: AB 1177 CHAPTERED
BILL TEXT
CHAPTER 749
FILED WITH SECRETARY OF STATE OCTOBER 10, 1995
APPROVED BY GOVERNOR OCTOBER 9, 1995
PASSED THE ASSEMBLY SEPTEMBER 6, 1995
PASSED THE SENATE SEPTEMBER 1, 1995
AMENDED IN SENATE AUGUST 24, 1995
AMENDED IN SENATE JULY 21, 1995
AMENDED IN SENATE JULY 6, 1995
AMENDED IN SENATE JUNE 19, 1995
AMENDED IN ASSEMBLY MAY 23, 1995
AMENDED IN ASSEMBLY APRIL 25, 1995
AMENDED IN ASSEMBLY MARCH 30, 1995
INTRODUCED BY Assembly Member Cunneen
FEBRUARY 23, 1995
An act to amend Section 650.01 of the Business and Professions
Code, to add Section 1542.1 to the Civil Code, to add Article 5
(commencing with Section 827) to Chapter 1 of Part 2 of Division 3 of
Title 1 of, and to add Sections 6254.14 and 12511.5 to, the
Government Code, to amend Sections 1250 and 1250.1 of the Health and
Safety Code, to amend Sections 5007.5 and 5023 of the Penal Code, and
to add Section 14165.11 to the Welfare and Institutions Code,
relating to health care, and declaring the urgency thereof, to take
effect immediately.
LEGISLATIVE COUNSEL'S DIGEST
AB 1177, Cunneen. Inmate health care.
(1) Existing law, the Physician Ownership and Referral Act of
1993, prohibits a licensee, that is defined to include physicians and
surgeons among other health care practitioners, from referring a
person for certain health care services if the licensee has a
financial interest, as defined, with the person or entity that
receives the referral.
Existing law exempts from this prohibition, a licensee or a payer
to the extent the licensee or payer is subject to similar
prohibitions on referrals for health care services paid pursuant to
the provisions governing workers' compensation.
This bill would make a clarifying change by revising this
exemption to instead exempt referrals that are subject to the similar
prohibitions on referrals for services covered pursuant to the law
governing workers' compensation.
Existing law requires a physician who refers a person to, or seeks
consultation from, an organization in which the licensee has a
financial interest that is not otherwise prohibited, as defined, to
disclose this financial interest to that patient, or parent or legal
guardian of the patient.
This bill would instead provide that if the physician is acting
pursuant to a contract with, the Department of Corrections, or the
California Youth Authority, and the patient is an inmate or parolee
of either department, the physician would instead be required to
disclose any financial interest to the appropriate department.
(2) Existing law requires that public records, as defined, be open
to inspection at all times during the office hours of the state or
local agency and every person has a right to inspect any public
record, with certain exceptions, including certain records related to
prescribed health care service and insurance coverage contracts.
However, under existing law these contracts are open to inspection by
the Joint Legislative Audit Committee.
This bill would also make these contracts open to inspection by
the Bureau of State Audits.
This bill would exempt records of the Department of Corrections
relating to health care services contract negotiations, as specified,
from the public inspection requirements.
(3) Existing law requires a correctional treatment center, as
defined, to provide certain prescribed health services, and
authorizes it to provide other prescribed health services, under
certain conditions. Existing law requires the State Department of
Mental Health to adopt regulations specifying acute and nonacute
levels of 24-hour care for certain correctional treatment centers
that provide psychiatric and psychological services provided by
county mental health agencies in local detention facilities.
Existing law provides that these provisions regarding correctional
treatment centers shall remain operative only until January 1, 1997.
This bill would delete this provision.
(4) Existing law authorizes the Director of Corrections to charge
a $5 fee for each inmate-initiated medical visit of an inmate, and
requires that the moneys received be transferred to the General Fund.
This bill would delete this provision regarding the transfer of
the funds to the General Fund, and would provide that, upon
appropriation by the Legislature, the funds so received be expended
to reimburse the department for direct provision of inmate health
care services.
(5) Existing law authorizes the California Medical Assistance
Commission to negotiate contracts that are binding on the Department
of Corrections for the provision of acute inpatient hospital services
for the care of inmates of the Department of Corrections. Existing
law also requires the department to enter into contracts with
hospitals and provides that it is bound by the rates, terms and
conditions negotiated by the commission.
This bill would delete these provisions, would require the
department to consult with the commission, and would require the
commission to advise the department so as to assist it in the
planning and negotiating of contracts for the purchase of health care
services. It would authorize the commission to negotiate directly
with providers on behalf of the department, if mutually agreed upon
by the commission and the department.
(6) Under existing law, the Attorney General has charge, as
attorney, of all legal matters in which the state is interested,
except as specified.
This bill would authorize the Attorney General to defend a public
or private provider of health care, as defined, against any claim
that the civil rights of a person in state custody were violated in
the provision of health care services. The bill would condition the
provision of this defense on the provider of health care maintaining
insurance for professional negligence. The bill would add related
provisions with respect to indemnifying any provider of health care,
as defined, or its officers, employees, agents, and subcontractors,
who are defended by the Attorney General, or other legal counsel
provided by the state, and with respect to requiring the health care
provider, as defined, or its officers, employees, agents, or
subcontractors, to release the state and its officers, employees, and
agents, from any claim arising from the defense of the provider of
health care by the Attorney General, or other legal counsel provided
by the state.
(7) Since the bill will impose new duties upon local agencies
operating facilities meeting the definition of a correctional
treatment center, it would impose a state-mandated local program.
Since violation of health facility licensing standards and willful
violation of the regulations adopted for these facilities is a
misdemeanor, this bill would impose a state-mandated local program by
changing the definition of a crime.
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, including the creation of a State Mandates Claims Fund
to pay the costs of mandates that do not exceed $1,000,000 statewide
and other procedures for claims whose statewide costs exceed
$1,000,000.
This bill would provide that with regard to certain mandates no
reimbursement is required by this act for a specified reason.
With regard to any other mandates, this bill would provide that,
if the Commission on State Mandates determines that the bill contains
costs so mandated by the state, reimbursement for those costs shall
be made pursuant to the statutory provisions noted above.
(8) This bill would declare that it is to take effect immediately
as an urgency statute.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 650.01 of the Business and Professions Code is
amended to read:
650.01. (a) Notwithstanding Section 650, or any other provision
of law, it is unlawful for a licensee to refer a person for
laboratory, diagnostic nuclear medicine, radiation oncology, physical
therapy, physical rehabilitation, psychometric testing, home
infusion therapy, or diagnostic imaging goods or services if the
licensee or his or her immediate family has a financial interest with
the person or in the entity that receives the referral.
(b) For purposes of this section and Section 650.02, the following
shall apply:
(1) "Diagnostic imaging" includes, but is not limited to, all
X-ray, computed axial tomography, magnetic resonance imaging nuclear
medicine, positron emission tomography, mammography, and ultrasound
goods and services.
(2) A "financial interest" includes, but is not limited to, any
type of ownership interest, debt, loan, lease, compensation,
remuneration, discount, rebate, refund, dividend, distribution,
subsidy, or other form of direct or indirect payment, whether in
money or otherwise, between a licensee and a person or entity to whom
the licensee refers a person for a good or service specified in
subdivision (a). A financial interest also exists if there is an
indirect financial relationship between a licensee and the referral
recipient including, but not limited to, an arrangement whereby a
licensee has an ownership interest in an entity that leases property
to the referral recipient. Any financial interest transferred by a
licensee to any person or entity or otherwise established in any
person or entity for the purpose of avoiding the prohibition of this
section shall be deemed a financial interest of the licensee. For
purposes of this paragraph, "direct or indirect payment" shall not
include a royalty or consulting fee received by a physician and
surgeon who has completed a recognized residency training program in
orthopedics from a manufacturer or distributor as a result of his or
her research and development of medical devices and techniques for
that manufacturer or distributor. For purposes of this paragraph,
"consulting fees" means those fees paid by the manufacturer or
distributor to a physician and surgeon who has completed a recognized
residency training program in orthopedics only for his or her
ongoing services in making refinements to his or her medical devices
or techniques marketed or distributed by the manufacturer or
distributor, if the manufacturer or distributor does not own or
control the facility to which the physician is referring the patient.
(3) For the purposes of this section, "immediate family" includes
the spouse and children of the licensee, the parents of the licensee,
and the spouses of the children of the licensee.
(4) "Licensee" means a physician as defined in Section 3209.3 of
the Labor Code.
(5) "Licensee's office" means either of the following:
(A) An office of a licensee in solo practice.
(B) An office in which services or goods are personally provided
by the licensee or by employees in that office, or personally by
independent contractors in that office, in accordance with other
provisions of law. Employees and independent contractors shall be
licensed or certified when licensure or certification is required by
law.
(6) "Office of a group practice" means an office or offices in
which two or more licensees are legally organized as a partnership,
professional corporation, or not-for-profit corporation, licensed
pursuant to subdivision (a) of Section 1204 of the Health and Safety
Code, for which all of the following apply:
(A) Each licensee who is a member of the group provides
substantially the full range of services that the licensee routinely
provides, including medical care, consultation, diagnosis, or
treatment through the joint use of shared office space, facilities,
equipment, and personnel.
(B) Substantially all of the services of the licensees who are
members of the group are provided through the group and are billed in
the name of the group and amounts so received are treated as
receipts of the group, except in the case of a multispecialty clinic,
as defined in subdivision (l) of Section 1206 of the Health and
Safety Code, physician services are billed in the name of the
multispecialty clinic and amounts so received are treated as receipts
of the multispecialty clinic.
(C) The overhead expenses of, and the income from, the practice
are distributed in accordance with methods previously determined by
members of the group.
(c) It is unlawful for a licensee to enter into an arrangement or
scheme, such as a cross-referral arrangement, that the licensee
knows, or should know, has a principal purpose of ensuring referrals
by the licensee to a particular entity that, if the licensee directly
made referrals to that entity, would be in violation of this
section.
(d) No claim for payment shall be presented by an entity to any
individual, third party payer, or other entity for a good or service
furnished pursuant to a referral prohibited under this section.
(e) No insurer, self-insurer, or other payer shall pay a charge or
lien for any good or service resulting from a referral in violation
of this section.
(f) A licensee who refers a person to, or seeks consultation from,
an organization in which the licensee has a financial interest,
other than as prohibited by subdivision (a), shall disclose the
financial interest to the patient, or the parent or legal guardian of
the patient, in writing, at the time of the referral or request for
consultation.
(1) If a referral, billing, or other solicitation is between one
or more licensees who contract with a multispecialty clinic pursuant
to subdivision (l) of Section 1206 of the Health and Safety Code or
who conduct their practice as members of the same professional
corporation or partnership, and the services are rendered on the same
physical premises, or under the same professional corporation or
partnership name, the requirements of this subdivision may be met by
posting a conspicuous disclosure statement at the registration area
or by providing a patient with a written disclosure statement.
(2) If a licensee is under contract with the Department of
Corrections or the California Youth Authority, and the patient is an
inmate or parolee of either respective department, the requirements
of this subdivision shall be satisfied by disclosing financial
interests to either the Department of Corrections or the California
Youth Authority.
(g) A violation of subdivision (a) shall be a misdemeanor. The
Medical Board of California shall review the facts and circumstances
of any conviction pursuant to subdivision (a) and take appropriate
disciplinary action if the licensee has committed unprofessional
conduct. Violations of this section may also be subject to civil
penalties of up to five thousand dollars ($5,000) for each offense,
which may be enforced by the Insurance Commissioner, Attorney
General, or a district attorney. A violation of subdivision (c),
(d), or (e) is a public offense and is punishable upon conviction by
a fine not exceeding fifteen thousand dollars ($15,000) for each
violation and appropriate disciplinary action, including revocation
of professional licensure, by the Medical Board of California or
other appropriate governmental agency.
(h) This section shall not apply to referrals for services that
are described in and covered by Sections 139.3 and 139.31 of the
Labor Code.
(i) This section shall become operative on January 1, 1995, or the
operative date of any federal legislation that contains a
self-referral prohibition similar to that contained in the Physician
Ownership and Referral Act of 1993 that applies to all health care
payers including, but not limited to, Medi-Cal, medicare, and private
insurers, that is enacted prior to January 1, 1995, if the Medical
Board of California notifies the Secretary of the Senate that the
federal legislation has been enacted, whichever operative date is
later.
SEC. 2. Section 1542.1 is added to the Civil Code, to read:
1542.1. Notwithstanding Section 1542, a provider of health care,
as defined in Section 56.05, or its officers, employees, agents, or
subcontractors, shall release the state and its officers, employees,
and agents, from any claim arising from the defense of the provider
of health care by the Attorney General, or other legal counsel
provided by the state pursuant to Section 12511.5 of the Government
Code.
SEC. 3. Article 5 (commencing with Section 827) is added to
Chapter 1 of Part 2 of Division 3.6 of Title 1 of the Government
Code, to read:
Article 5. Indemnification of Certain State Agents
827. A provider of health care, as defined in Section 56.05 of
the Civil Code, its officers, employees, agents, and subcontractors,
who are defended by the Attorney General pursuant to Section 12511.5,
or other legal counsel provided by the state, shall be indemnified
in accordance with Section 825, subject to the same conditions and
limitations applicable to state employees, except that no provider of
health care shall be indemnified in a civil rights action unless the
health care provider maintains insurance for professional
negligence. To the extent that negligence constitutes the basis of
liability of the health care provider, the provider's private
insurance shall be the source of recovery.
SEC. 4. Section 6254.14 is added to the Government Code, to read:
6254.14. (a) Except as provided in Sections 6254 and 6254.7,
nothing in this chapter shall be construed to require disclosure of
records of the Department of Corrections that relate to health care
services contract negotiations, and that reveal the deliberative
processes, discussions, communications, or any other portion of the
negotiations, including, but not limited to, records related to those
negotiations such as meeting minutes, research, work product,
theories, or strategy of the department, or its staff, or members of
the California Medical Assistance Commission, or its staff, who act
in consultation with, or on behalf of, the department.
Except for the portion of a contract that contains the rates of
payment, contracts for health services entered into by the Department
of Corrections or the California Medical Assistance Commission on or
after July 1, 1993, shall be open to inspection one year after they
are fully executed. In the event that a contract for health services
that is entered into prior to July 1, 1993, is amended on or after
July 1, 1993, the amendment, except for any portion containing rates
of payment, shall be open to inspection one year after it is fully
executed.
Three years after a contract or amendment is open to inspection
under this subdivision, the portion of the contract or amendment
containing the rates of payment shall be open to inspection.
Notwithstanding any other provision of law, the entire contract or
amendment shall be open to inspection by the Joint Legislative Audit
Committee and the Bureau of State Audits. The Joint Legislative
Audit Committee and the Bureau of State Audits shall maintain the
confidentiality of the contracts and amendments until the contract or
amendment is fully open to inspection by the public.
It is the intent of the Legislature that confidentiality of health
care provider contracts, and of the contracting process as provided
in this subdivision, is intended to protect the competitive nature of
the negotiation process, and shall not affect public access to other
information relating to the delivery of health care services.
(b) The inspection authority and confidentiality requirements
established in subdivisions (q), (v), and (w) of Section 6254 for the
Legislative Audit Committee shall also apply to the Bureau of State
Audits.
SEC. 5. Section 12511.5 is added to the Government Code, to read:
12511.5. The Attorney General may defend a public or private
provider of health care, as defined in Section 56.05 of the Civil
Code, and its officers, employees, agents, and subcontractors against
any claim that the civil rights of a person in state custody were
violated in the provision of health care services, where those
services were provided under contract with, or under the control of,
the Department of Corrections. Defense of the provider of health
care is conditioned upon the provider maintaining insurance for
professional negligence.
SEC. 6. Section 1250 of the Health and Safety Code is amended to
read:
1250. As used in this chapter, "health facility" means any
facility, place, or building that is organized, maintained, and
operated for the diagnosis, care, prevention, and treatment of human
illness, physical or mental, including convalescence and
rehabilitation and including care during and after pregnancy, or for
any one or more of these purposes, for one or more persons, to which
the persons are admitted for a 24-hour stay or longer, and includes
the following types:
(a) "General acute care hospital" means a health facility having a
duly constituted governing body with overall administrative and
professional responsibility and an organized medical staff that
provides 24-hour inpatient care, including the following basic
services: medical, nursing, surgical, anesthesia, laboratory,
radiology, pharmacy, and dietary services. A general acute care
hospital may include more than one physical plant maintained and
operated on separate premises as provided in Section 1250.8. A
general acute care hospital that exclusively provides acute medical
rehabilitation center services, including at least physical therapy,
occupational therapy, and speech therapy, may provide for the
required surgical and anesthesia services through a contract with
another acute care hospital. In addition, a general acute care
hospital that, on July 1, 1983, provided required surgical and
anesthesia services through a contract or agreement with another
acute care hospital may continue to provide these surgical and
anesthesia services through a contract or agreement with an acute
care hospital.
A "general acute care hospital" includes a "rural general acute
care hospital". However, a "rural general acute care hospital" shall
not be required by the department to provide surgery and anesthesia
services. A "rural general acute care hospital" shall meet either of
the following conditions:
(1) The hospital meets criteria for designation within peer group
six or eight, as defined in the report entitled Hospital Peer
Grouping for Efficiency Comparison, dated December 20, 1982.
(2) The hospital meets the criteria for designation within peer
group five or seven, as defined in the report entitled Hospital Peer
Grouping for Efficiency Comparison, dated December 20, 1982, and has
no more than 76 acute care beds and is located in a census dwelling
place of 15,000 or less population according to the 1980 federal
census.
(b) "Acute psychiatric hospital" means a health facility having a
duly constituted governing body with overall administrative and
professional responsibility and an organized medical staff that
provides 24-hour inpatient care for mentally disordered, incompetent,
or other patients referred to in Division 5 (commencing with Section
5000) or Division 6 (commencing with Section 6000) of the Welfare
and Institutions Code, including the following basic services:
medical, nursing, rehabilitative, pharmacy, and dietary services.
(c) "Skilled nursing facility" means a health facility that
provides skilled nursing care and supportive care to patients whose
primary need is for availability of skilled nursing care on an
extended basis.
(d) "Intermediate care facility" means a health facility that
provides inpatient care to ambulatory or nonambulatory patients who
have recurring need for skilled nursing supervision and need
supportive care, but who do not require availability of continuous
skilled nursing care.
(e) "Intermediate care facility/developmentally disabled
habilitative" means a facility with a capacity of 4 to 15 beds that
provides 24-hour personal care, habilitation, developmental, and
supportive health services to 15 or fewer developmentally disabled
persons who have intermittent recurring needs for nursing services,
but have been certified by a physician and surgeon as not requiring
availability of continuous skilled nursing care.
(f) "Special hospital" means a health facility having a duly
constituted governing body with overall administrative and
professional responsibility and an organized medical or dental staff
that provides inpatient or outpatient care in dentistry or maternity.
(g) "Intermediate care facility/developmentally disabled" means a
facility that provides 24-hour personal care, habilitation,
developmental, and supportive health services to developmentally
disabled clients whose primary need is for developmental services and
who have a recurring but intermittent need for skilled nursing
services.
(h) "Intermediate care facility/developmentally disabled--nursing"
means a facility with a capacity of 4 to 15 beds that provides
24-hour personal care, developmental services, and nursing
supervision for developmentally disabled persons who have
intermittent recurring needs for skilled nursing care but have been
certified by a physician and surgeon as not requiring continuous
skilled nursing care. The facility shall serve medically fragile
persons who have developmental disabilities or demonstrate
significant developmental delay that may lead to a developmental
disability if not treated.
(i) (1) "Congregate living health facility" means a residential
home with a capacity, except as provided in paragraph (4), of no more
than six beds, that provides inpatient care, including the following
basic services: medical supervision, 24-hour skilled nursing and
supportive care, pharmacy, dietary, social recreational, and at least
one type of service specified in paragraph (2). The primary need of
congregate living health facility residents shall be for
availability of skilled nursing care on a recurring, intermittent,
extended, or continuous basis. This care is generally less intense
than that provided in general acute care hospitals but more intense
than that provided in skilled nursing facilities.
(2) Congregate living health facilities shall provide one of the
following services:
(A) Services for persons who are mentally alert, physically
disabled persons, who may be ventilator dependent.
(B) Services for persons who have a diagnosis of terminal illness,
a diagnosis of a life-threatening illness, or both. Terminal
illness means the individual has a life expectancy of six months or
less as stated in writing by his or her attending physician and
surgeon. A "life-threatening illness" means the individual has an
illness that can lead to a possibility of a termination of life
within five years or less as stated in writing by his or her
attending physician and surgeon.
(C) Services for persons who are catastrophically and severely
disabled. A catastrophically and severely disabled person means a
person whose origin of disability was acquired through trauma or
nondegenerative neurologic illness, for whom it has been determined
that active rehabilitation would be beneficial and to whom these
services are being provided. Services offered by a congregate living
health facility to a catastrophically disabled person shall include,
but not be limited to, speech, physical, and occupational therapy.
(3) A congregate living health facility license shall specify
which of the types of persons described in paragraph (2) to whom a
facility is licensed to provide services.
(4) (A) A facility operated by a city and county for the purposes
of delivering services under this section may have a capacity of 59
beds.
(B) A congregate living health facility not operated by a city and
county servicing persons who are terminally ill, persons who have
been diagnosed with a life-threatening illness, or both, that is
located in a county with a population of 500,000 or more persons may
have not more than 25 beds for the purpose of serving terminally ill
persons.
(C) A congregate living health facility not operated by a city and
county serving persons who are catastrophically and severely
disabled, as defined in subparagraph (C) of paragraph (2) that is
located in a county of 500,000 or more persons may have not more than
12 beds for the purpose of serving catastrophically and severely
disabled persons.
(5) A congregate living health facility shall have a
noninstitutional, homelike environment.
(j) (1) "Correctional treatment center" means a health facility
operated by the Department of Corrections, the Department of the
Youth Authority, or a county, city, or city and county law
enforcement agency that, as determined by the state department,
provides inpatient health services to that portion of the inmate
population who do not require a general acute care level of basic
services. This definition shall not apply to those areas of a law
enforcement facility that houses inmates or wards that may be
receiving outpatient services and are housed separately for reasons
of improved access to health care, security, and protection. The
health services provided by a correctional treatment center shall
include, but are not limited to, all of the following basic services:
physician and surgeon, psychiatrist, psychologist, nursing,
pharmacy, and dietary. A correctional treatment center may provide
the following services: laboratory, radiology, perinatal, and any
other services approved by the state department.
(2) Outpatient surgical care with anesthesia may be provided, if
the correctional treatment center meets the same requirements as a
surgical clinic licensed pursuant to Section 1204, with the exception
of the requirement that patients remain less than 24 hours.
(3) Correctional treatment centers shall maintain written service
agreements with general acute care hospitals to provide for those
inmate physical health needs that cannot be met by the correctional
treatment center.
(4) Physician and surgeon services shall be readily available in a
correctional treatment center on a 24-hour basis.
(5) It is not the intent of the Legislature to have a correctional
treatment center supplant the general acute care hospitals at the
California Medical Facility, the California Men's Colony, and the
California Institution for Men. This subdivision shall not be
construed to prohibit the California Department of Corrections from
obtaining a correctional treatment center license at these sites.
(k) "Nursing facility" means a facility that is certified to
participate as a provider of care in the federal medicaid program
under Title XIX of the federal Social Security Act and is licensed as
either of the following:
(1) Skilled nursing facility.
(2) Intermediate care facility.
(l) Regulations defining a correctional treatment center described
in subdivision (j) that is operated by a county, city, or city and
county, the Department of Corrections, or the Department of the Youth
Authority, shall not become effective prior to, or if effective,
shall be inoperative until January 1, 1996, and until that time these
correctional facilities are exempt from any licensing requirements.
SEC. 7. Section 1250.1 of the Health and Safety Code is amended to
read:
1250.1. (a) The state department shall adopt regulations that
define all of the following bed classifications for health
facilities:
(1) General acute care.
(2) Skilled nursing.
(3) Intermediate care-developmental disabilities.
(4) Intermediate care--other.
(5) Acute psychiatric.
(6) Specialized care, with respect to special hospitals only.
(7) Chemical dependency recovery.
(8) Intermediate care facility/developmentally disabled
habilitative.
(9) Intermediate care facility/developmentally disabled nursing.
(10) Congregate living health facility.
(11) Pediatric day health and respite care facility, as defined in
Section 1760.2.
(12) Correctional treatment center. For correctional treatment
centers that provide psychiatric and psychological services provided
by county mental health agencies in local detention facilities, the
State Department of Mental Health shall adopt regulations specifying
acute and nonacute levels of 24-hour care. Licensed inpatient beds
in a correctional treatment center shall be used only for the purpose
of providing health services.
(b) Except as provided in Section 1253.1, beds classified as
intermediate care beds, on September 27, 1978, shall be reclassified
by the state department as intermediate care--other. This
reclassification shall not constitute a "project" within the meaning
of Section 437.10 and shall not be subject to any requirement for a
certificate of need under Part 1.5 (commencing with Section 437) of
Division 1, and regulations of the state department governing
intermediate care prior to the effective date shall continue to be
applicable to the intermediate care--other classification unless and
until amended or repealed by the state department.
SEC. 8. Section 5007.5 of the Penal Code is amended to read:
5007.5. (a) The Director of Corrections is authorized to charge a
fee in the amount of five dollars ($5) for each inmate-initiated
medical visit of an inmate confined in the state prison.
(b) The fee shall be charged to the prison account of the inmate.
If the inmate has no money in his or her personal account, there
shall be no charge for the medical visit.
(c) An inmate shall not be denied medical care because of a lack
of funds in his or her prison account.
(d) The medical provider may waive the fee for any
inmate-initiated treatment and shall waive the fee in any
life-threatening or emergency situation, defined as those health
services required for alleviation of severe pain or for immediate
diagnosis and treatment of unforeseen medical conditions that if not
immediately diagnosed and treated could lead to disability or death.
(e) Followup medical visits at the direction of the medical staff
shall not be charged to the inmate.
(f) All moneys received by the Director of Corrections pursuant to
this section shall, upon appropriation by the Legislature, be
expended to reimburse the Department of Corrections for direct
provision of inmate health care services.
SEC. 9. Section 5023 of the Penal Code is amended to read:
5023. (a) It is the intent of the Legislature that the
Department of Corrections operate in the most cost-effective and
efficient manner possible when purchasing health care services for
inmates. To achieve this goal, it is desirable that the department
have the benefit and experience of the California Medical Assistance
Commission in planning and negotiating for the purchase of health
care services.
(b) The Department of Corrections shall consult with the
commission to assist the department in planning and negotiating
contracts for the purchase of health care services. The commission
shall advise the department, and may negotiate directly with
providers on behalf of the department, as mutually agreed upon by the
commission and the department.
SEC. 10. Section 14165.11 is added to the Welfare and Institutions
Code, to read:
14165.11. (a) It is the intent of the Legislature that the
Department of Corrections operate in the most effective and efficient
manner possible when purchasing health care services for inmates.
To achieve this goal, it is desirable that the department have the
benefit of the experience of the California Medical Assistance
Commission in planning and negotiating for the purchase of health
care services.
(b) The commission may work with the Department of Corrections to
assist the department in planning and negotiating contracts for the
purchase of health care services. The commission may either consult
with the department or negotiate directly with providers on behalf of
the department, as mutually agreed upon by the commission and the
department.
SEC. 11. No reimbursement is required by this act pursuant to
Section 6 of Article XIIIB of the California Constitution for certain
costs that may be incurred by a local agency or school district
because in that regard 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 XIIIB of the California Constitution.
However, notwithstanding Section 17610 of the Government Code, if
the Commission on State Mandates determines that this act contains
other costs mandated by the state, reimbursement to local agencies
and school districts for those costs shall be made pursuant to Part 7
(commencing with Section 17500) of Division 4 of Title 2 of the
Government Code. If the statewide cost of the claim for
reimbursement does not exceed one million dollars ($1,000,000),
reimbursement shall be made from the State Mandates Claims Fund.
Notwithstanding Section 17580 of the Government Code, unless
otherwise specified, the provisions of this act shall become
operative on the same date that the act takes effect pursuant to the
California Constitution.
SEC. 12. This act is an urgency statute necessary for the
immediate preservation of the public peace, health, or safety within
the meaning of Article IV of the Constitution and shall go into
immediate effect. The facts constituting the necessity are:
In order for the provisions of the Budget Act of 1994 to be
implemented in a timely and appropriate manner, it is necessary that
this act take effect immediately.