Bill Text: CA AB899 | 2019-2020 | Regular Session | Amended


Bill Title: Clinic licensing.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2019-03-13 - Re-referred to Com. on HEALTH. [AB899 Detail]

Download: California-2019-AB899-Amended.html

Amended  IN  Assembly  March 12, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill No. 899


Introduced by Assembly Member Wood

February 20, 2019


An act to amend Sections 1204, 1226, and 1226.2 of the Health and Safety Code, relating to health care facilities.


LEGISLATIVE COUNSEL'S DIGEST


AB 899, as amended, Wood. Clinic licensing.
(1) Existing law provides for the licensure and regulation of clinics by the State Department of Public Health, including primary care clinics, as defined.
This bill would authorize a licensed primary care clinic with a license in good standing with the department for the preceding 5 years to acquire ownership or control of an outpatient setting or a previously licensed primary care clinic. The bill would provide that a licensed primary care clinic that acquires another facility pursuant to this provision be deemed compliant with the minimum standards of adequacy and safety required for the acquired facility. The bill would require a facility acquired by a licensed primary care clinic pursuant to this provision to be deemed compliant with the minimum standards of adequacy and safety required for the acquiring primary care clinic. The bill would require the acquired facility to be added to the existing license of the acquiring primary care clinic immediately following notice to the department by the acquiring primary care clinic.
(2) Existing law establishes the Community Clinics Advisory Committee, which is required to be comprised of at least 15 individuals who are employed by, or under contract to provide service to, a community clinic on a full-time basis, as specified. Existing law requires that committee members be appointed by the 3 statewide primary care clinic associations in California that represent the greatest number of community or free clinic sites. Existing law requires the Office of Statewide Health Planning and Development, in consultation with the Community Clinics Advisory Committee, to prescribe minimum construction standards of adequacy and safety for the physical plant of clinics, as specified.
This bill would require the Community Clinics Advisory Committee to be empaneled on or before January July 1, 2020. The bill would also require that the minimum construction standards of adequacy and safety prescribed for primary care clinics be developed in consideration of the unique and distinct needs of clinics in contrast to health facilities, as defined.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: NO   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 1204 of the Health and Safety Code is amended to read:

1204.
 Clinics eligible for licensure pursuant to this chapter are primary care clinics and specialty clinics.
(a) (1) Only the following defined classes of primary care clinics shall be eligible for licensure:
(A) A “community clinic” means a clinic operated by a tax-exempt nonprofit corporation that is supported and maintained in whole or in part by donations, bequests, gifts, grants, government funds or contributions, that may be in the form of money, goods, or services. In a community clinic, any charges to the patient shall be based on the patient’s ability to pay, utilizing a sliding fee scale. No corporation other than a nonprofit corporation, exempt from federal income taxation under paragraph (3) of subsection (c) of Section 501 of the Internal Revenue Code of 1954 as amended, or a statutory successor thereof, shall operate a community clinic; provided, that the licensee of any community clinic so licensed on the effective date of this section shall not be required to obtain tax-exempt status under either federal or state law in order to be eligible for, or as a condition of, renewal of its license. No natural person or persons shall operate a community clinic.
(B) A “free clinic” means a clinic operated by a tax-exempt, nonprofit corporation supported in whole or in part by voluntary donations, bequests, gifts, grants, government funds or contributions, that may be in the form of money, goods, or services. In a free clinic there shall be no charges directly to the patient for services rendered or for drugs, medicines, appliances, or apparatuses furnished. No corporation other than a nonprofit corporation exempt from federal income taxation under paragraph (3) of subsection (c) of Section 501 of the Internal Revenue Code of 1954 as amended, or a statutory successor thereof, shall operate a free clinic; provided, that the licensee of any free clinic so licensed on the effective date of this section shall not be required to obtain tax-exempt status under either federal or state law in order to be eligible for, or as a condition of, renewal of its license. No natural person or persons shall operate a free clinic.
(2) Nothing in this subdivision shall prohibit a community clinic or a free clinic from providing services to patients whose services are reimbursed by third-party payers, or from entering into managed care contracts for services provided to private or public health plan subscribers, as long as the clinic meets the requirements identified in subparagraphs (A) and (B). For purposes of this subdivision, any payments made to a community clinic by a third-party payer, including, but not limited to, a health care service plan, shall not constitute a charge to the patient. This paragraph is a clarification of existing law.
(3) A licensed primary care clinic with a license in good standing with the department for the preceding five years may acquire ownership or control of an outpatient setting or a previously licensed primary care clinic. A licensed primary care clinic that acquires another facility pursuant to this paragraph shall be deemed compliant with the minimum standards of adequacy and safety required for the acquired facility. A facility acquired by a licensed primary care clinic pursuant to this paragraph shall be deemed compliant with the minimum standards of adequacy and safety required for the acquiring primary care clinic. The acquired facility shall be added to the existing license of the acquiring primary care clinic immediately following notice to the department by the acquiring primary care clinic.
(b) The following types of specialty clinics shall be eligible for licensure as specialty clinics pursuant to this chapter:
(1) A “surgical clinic” means a clinic that is not part of a hospital and that provides ambulatory surgical care for patients who remain less than 24 hours. A surgical clinic does not include any place or establishment owned or leased and operated as a clinic or office by one or more physicians or dentists in individual or group practice, regardless of the name used publicly to identify the place or establishment, provided, however, that physicians or dentists may, at their option, apply for licensure.
(2) A “chronic dialysis clinic” means a clinic that provides less than 24-hour care for the treatment of patients with end-stage renal disease, including renal dialysis services.
(3) A “rehabilitation clinic” means a clinic that, in addition to providing medical services directly, also provides physical rehabilitation services for patients who remain less than 24 hours. Rehabilitation clinics shall provide at least two of the following rehabilitation services: physical therapy, occupational therapy, social, speech pathology, and audiology services. A rehabilitation clinic does not include the offices of a private physician in individual or group practice.
(4) An “alternative birth center” means a clinic that is not part of a hospital and that provides comprehensive perinatal services and delivery care to pregnant women who remain less than 24 hours at the facility.

SEC. 2.

 Section 1226 of the Health and Safety Code is amended to read:

1226.
 (a) The regulations shall prescribe the kinds of services which may be provided by clinics in each category of licensure and shall prescribe minimum standards of adequacy, safety, and sanitation of the physical plant and equipment, minimum standards for staffing with duly qualified personnel, and minimum standards for providing the services offered. These minimum standards shall be based on the type of facility, the needs of the patients served, and the types and levels of services provided.
(b) The Office of Statewide Health Planning and Development, in consultation with the Community Clinics Advisory Committee, shall prescribe minimum construction standards of adequacy and safety for the physical plant of clinics as found in the California Building Standards Code. The minimum construction standards shall be developed in consideration of the unique and distinct needs of clinics in contrast to health facilities, as defined in Section 1250.
(c) A city or county, as applicable, shall have plan review and building inspection responsibilities for the construction or alteration of buildings described in paragraph (1) and paragraph (2) of subdivision (b) of Section 1204 and shall apply the provisions of the latest edition of the California Building Standards Code in conducting these plan review responsibilities. For these buildings, construction and alteration shall include conversion of a building to a purpose specified in paragraphs (1) and (2) of subdivision (b) of Section 1204.
Upon the initial submittal submission to a city or county by the governing authority or owner of these clinics for plan review and building inspection services, the city or county shall reply in writing to the clinic whether or not the plan review by the city or county will include a certification as to whether or not the clinic project submitted for plan review meets the standards as propounded by the office in the California Building Standards Code.
If the city or county indicates that its review will include this certification it shall do all of the following:
(1) Apply the applicable clinic provisions of the latest edition of the California Building Standards Code.
(2) Certify in writing, to the applicant within 30 days of completion of construction whether or not these standards have been met.
(d) If upon initial submittal, submission, the city or county indicates that its plan review will not include this certification, the governing authority or owner of the clinic shall submit the plans to the Office of Statewide Health Planning and Development who shall review the plans for certification whether or not the clinic project meets the standards, as propounded by the office in California Building Standards Code.
(e) When the office performs review for certification, the office shall charge a fee in an amount that does not exceed its actual costs.
(f) The office of the State Fire Marshal shall prescribe minimum safety standards for fire and life safety in surgical clinics.
(g) Notwithstanding subdivision (c), the governing authority or owner of a clinic may request the office to perform plan review services for buildings described in subdivision (c). If the office agrees to perform these services, after consultation with the local building official, the office shall charge an amount not to exceed its actual costs. The construction or alteration of these buildings shall conform to the applicable provisions of the latest edition of the California Building Standards Code for purposes of the plan review by the office pursuant to this subdivision.
(h) Regulations adopted pursuant to this chapter establishing standards for laboratory services shall not be applicable to any clinic that operates a clinical laboratory licensed pursuant to Section 1265 of the Business and Professions Code.

SEC. 3.

 Section 1226.2 of the Health and Safety Code is amended to read:

1226.2.
 The Community Clinics Advisory Committee provided for in subdivision (b) of Section 1226 shall meet on an ad hoc basis and shall be comprised of at least 15 individuals who are employed by, or under contract to provide service to, a community clinic on a full-time basis, either directly or as a representative of a clinic association. Members of the committee shall be appointed by the three statewide primary care clinic associations in California that represent the greatest number of community or free clinic sites. The committee shall be empaneled on or before January July 1, 2020.

feedback