Bill Text: CA SB442 | 2009-2010 | Regular Session | Amended
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Clinic corporation: licensing.
Spectrum: Strong Partisan Bill (Democrat 10-1)
Status: (Passed) 2010-09-29 - Chaptered by Secretary of State. Chapter 502, Statutes of 2010. [SB442 Detail]
Download: California-2009-SB442-Amended.html
Bill Title: Clinic corporation: licensing.
Spectrum: Strong Partisan Bill (Democrat 10-1)
Status: (Passed) 2010-09-29 - Chaptered by Secretary of State. Chapter 502, Statutes of 2010. [SB442 Detail]
Download: California-2009-SB442-Amended.html
BILL NUMBER: SB 442 AMENDED
BILL TEXT
AMENDED IN SENATE JANUARY 26, 2010
AMENDED IN SENATE JANUARY 12, 2010
AMENDED IN SENATE MAY 6, 2009
AMENDED IN SENATE APRIL 28, 2009
AMENDED IN SENATE APRIL 15, 2009
INTRODUCED BY Senator Ducheny
(Principal coauthor: Assembly Member Chesbro)
(Coauthor: Senator Wiggins)
(Coauthors: Assembly Members Block, Blumenfield, Evans, Fletcher,
Monning, and Salas)
FEBRUARY 26, 2009
An act to amend Sections 1200, 1213, 1214, 1216, 1229, 1245, and
1266 of, and to add Section 1212.5 to, the Health and Safety Code,
relating to clinics.
LEGISLATIVE COUNSEL'S DIGEST
SB 442, as amended, Ducheny. Clinic corporation: licensing.
Under existing law, the State Department of Public Health is
responsible for the licensing and regulation of clinics, as defined.
A violation of these provisions is a crime.
This bill would define "clinic corporation" as a nonprofit
organization that owns one or more primary care clinics, or mobile
health care units as defined, and would provide for a single
consolidated license for clinic corporations, as specified.
Existing law provides for a fee to be paid for an initial license,
renewal license, license upon change of ownership, or special permit
set at specified amounts.
This bill would require the department to annually set the fee for
a clinic corporation. The bill would also make conforming changes to
the licensing provisions. Because this bill would create a new
crime, it would impose a state-mandated local program.
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.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) California's primary care clinics are essential partners with
the state in providing a health care safety net for underserved,
uninsured, and underinsured populations in a cost-effective manner.
(b) California's primary care clinics generate significant savings
to the state and to local communities in both of following ways:
(1) By providing primary and preventive care that responds to
patients' needs before medical problems become serious or life
threatening.
(2) By reducing the reliance of patients, including uninsured and
underinsured patients, on costly emergency room care, inpatient
treatment, and specialty care.
(c) The need for primary care clinics continues to grow
dramatically due to the continuing increase of uninsured and
underinsured patients in California, the escalating unemployment
rate, and a severely depressed economy.
(d) The current system for licensing primary care clinics is
inefficient and not consistent with industry practices. Requiring a
nonprofit corporation that operates primary care clinics to apply for
a license for every clinic site and to repeatedly submit the same
information on the primary care clinic license application places a
significant burden on community clinics to meet outdated bureaucratic
requirements and results in a significant waste of taxpayer and
community resources that could otherwise be devoted to patient care.
(e) Streamlining administrative processes through a consolidated
application for licensure of new and continuing primary care clinics
will result in substantial cost savings to the state and improved
access to health care for underserved populations.
SEC. 2. Section 1200 of the Health and Safety Code is amended to
read:
1200. (a) As used in this chapter, "clinic" means an organized
outpatient health facility that provides direct medical, surgical,
dental, optometric, or podiatric advice, services, or treatment to
patients who remain less than 24 hours, and that may also provide
diagnostic or therapeutic services to patients in the home as an
incident to care provided at the clinic facility. Nothing in this
section shall be construed to prohibit the provision of nursing
services in a clinic licensed pursuant to this chapter. In no case
shall a clinic be deemed to be a health facility subject to the
provisions of Chapter 2 (commencing with Section 1250). A place,
establishment, or institution that solely provides advice,
counseling, information, or referrals on the maintenance of health or
on the means and measures to prevent or avoid sickness, disease, or
injury, where that advice, counseling, information, or referral does
not constitute the practice of medicine, surgery, dentistry,
optometry, or podiatry, shall not be deemed a clinic for purposes of
this chapter.
(b) For purposes of this chapter:
(1) "Primary care clinics" means all the types of clinics
specified in subdivision (a) of Section 1204, including community
clinics and free clinics.
(2) "Specialty clinics" means all the types of clinics specified
in subdivision (b) of Section 1204, including surgical clinics,
chronic dialysis clinics, and rehabilitation clinics.
(3) "Clinic corporation" means a nonprofit organization that
operates one or more primary care clinics, as defined in paragraph
(1) of subdivision (a) of Section 1204, that are required to be
licensed under Section 1205, one or more mobile health care units
required to be licensed or approved pursuant to the Mobile Health
Care Services Act (Chapter 9 (commencing with Section 1765.101)) and
operated as primary care clinics, or one or more primary care clinics
and one or more mobile health care units.
(4) "Department" means the Licensing and Certification Division of
the State Department of Public Health, or its successor.
(5) "Centralized applications unit" means the centralized
applications unit in the Licensing and Certification Division of the
department, or a successor entity.
SEC. 3. Section 1212.5 is added to the Health and Safety Code, to
read:
1212.5. (a) Upon submission of a complete application for a
single consolidated license by an eligible clinic corporation, the
centralized application unit shall issue a single consolidated
license to the clinic corporation when the centralized applications
unit has done all of the following:
(1) Determined each primary care clinic that is on the application
for the single consolidated license and separately licensed to be in
good standing at the time of the application.
(2) Determined each mobile health care unit that is on the
application for the single consolidated license and separately
licensed to be in good standing at the time of the application.
(3) Deemed each primary care clinic that is included on the
application for the single consolidated license and that is not
separately licensed at the time of the application to meet the
requirements of Section 1212 by virtue of the primary care clinic
being included on the application for the single consolidated
license.
(4) Deemed each mobile health care unit that is included on the
application for the single consolidated license and that is not
separately licensed or approved by the department at the time of the
application to meet the requirements of Mobile Health Care Services
Act (Chapter 9 (commencing with Section 1765.101)) by virtue of the
mobile health care unit being included on the application for the
single consolidated license.
(5) Determined compliance with the minimum construction standards
of adequacy and safety of the physical plant, pursuant to subdivision
(b) of Section 1226, for each primary care clinic that is included
on the application for the single consolidated license and that is
not separately licensed at the time of the application.
(b) No primary care clinic or mobile health care unit included on
a single consolidated license application shall be required to submit
a separate application for licensure.
(c) (1) Each primary care clinic that is included on the single
consolidated license issued by the centralized applications unit
shall be deemed to be licensed pursuant to Section 1205.
(2) Each mobile health care unit that is included on the single
consolidated license issued by the centralized applications unit
shall be deemed to be licensed pursuant to Section 1765.125.
(d) Eligibility for a single consolidated license shall be based
on the following criteria:
(1) The clinic corporation applying for the single consolidated
license shall, at the time of application for the single consolidated
license, have been a known entity to the department, have been in
existence for not less than five years, and have operated one or more
primary care clinics or one or more mobile health care units that
hold a valid, unrevoked, and unsuspended license for, at a minimum,
the immediately preceding five years, with no demonstrated history of
repeated or uncorrected violations of this chapter, or any
regulation adopted pursuant to this chapter, that pose immediate
jeopardy to a patient, as defined in subdivision (d) of Section
1218.1, and have no pending action to suspend or revoke its license.
(2) A completed application for a single consolidated license has
been submitted and the associated license fee has been paid.
(3) The corporate officers, as specified in Section 5213 of the
Corporations Code, are the same for each primary care clinic or
mobile health care unit included on the single consolidated license.
(4) The clinic corporation both owns and operates each primary
care clinic or mobile health care unit included on the single
consolidated license under a single board of directors.
(5) There are one or more medical directors operating under a
single set of policies, procedures, and standards for all the primary
care clinics and mobile health care units owned and operated by the
clinic corporation.
(e) Section 1219 shall not be applicable to a single consolidated
license issued under this section or to a primary care clinic or a
mobile health care unit that is included on a single consolidated
license.
(f) (1) The centralized applications unit shall issue a single
consolidated license under this section within 30 days of receipt of
a completed application for a single consolidated license or within
seven days of the date the centralized applications unit approves the
application for a single consolidated license, whichever is earlier.
(2) (A) If the centralized applications unit determines that an
applicant for a single consolidated license does not meet the
eligibility criteria for a single consolidated license, as set forth
in subdivision (c), it shall identify, in writing and with
particularity, the grounds for that determination, and shall,
instead, process the application for the clinic to be added to the
single consolidated license as an individual clinic on its own in
accordance with the time specified in Section 1218.
(B) A clinic corporation that is denied an application for a
single consolidated license may appeal the denial pursuant to Section
1220.
(3) The centralized applications unit shall issue a single
consolidated license without the necessity of an initial onsite
survey of the primary care clinics and mobile health care units
included on the single consolidated license.
(4) (A) A single consolidated license issued by the centralized
applications unit shall specify the name and location of each primary
care clinic and mobile health care unit included on the single
consolidated license.
(B) The centralized applications unit shall issue an original
single consolidated license to the clinic corporation. The clinic
corporation shall photocopy and distribute identical copies of the
original single consolidated license to each primary care clinic and
mobile health care unit included on the single consolidated license.
The copies of the single consolidated license shall be posted at each
clinic site and in each mobile health care unit.
(g) (1) Upon application to the centralized applications unit, a
clinic corporation with a valid, unrevoked, unsuspended single
consolidated license may, at any time during the license period, do
the following:
(A) Add a primary care clinic or a mobile health care unit to the
single consolidated license.
(B) Relocate a primary care clinic or mobile health care unit that
is already on the single consolidated license.
(C) Delete a primary care clinic or a mobile health care unit from
the single consolidated license.
(2) The centralized applications unit shall add a primary care
clinic or mobile health care unit to, or delete a primary care clinic
or mobile health care unit from, the single consolidated license
within 30 days of receipt of a completed form for the addition or
deletion.
(3) The centralized applications unit shall add a primary care
clinic or a mobile health care unit to, or allow the relocation of a
primary care clinic or mobile health care unit that is already on,
the single consolidated license without the necessity of conducting
an initial onsite survey.
(4) For every primary care clinic or mobile health care unit added
to the single consolidated license before the next renewal date, the
clinic corporation shall pay a license fee, if applicable,
equivalent to the fee for one primary care clinic included in a
single consolidated license set pursuant to subdivision (d) of
Section 1266, prorated based on the effective date of the addition of
the clinic.
(5) (A) A primary care clinic that is deleted from a single
consolidated license for reasons other than noncompliance with this
chapter or Chapter 7 (commencing with Section 75001) of Division 5 of
Title 22 the California Code of Regulations may independently apply
for a primary care clinic license pursuant to Section 1218.1.
(B) A mobile health care unit that is deleted from a single
consolidated license for reasons other than noncompliance with the
Mobile Health Care Services Act (Chapter 9 (commencing with Section
1765.101)) may independently apply for a license or approval pursuant
to the Mobile Health Care Services Act.
(h) (1) The department shall develop a single-page form for the
following:
(A) Adding a primary care clinic or a mobile health care unit to
the single consolidated license.
(B) Relocating a primary care clinic or mobile health care unit
that is already on the single consolidated license.
(C) Deleting a primary care clinic or a mobile health care unit
from the single consolidated license.
(2) The form shall request all of the following information:
(A) The name and address of the clinic corporation's
administrative offices and the name and contact information of the
clinic corporation's chief executive officer or executive director.
(B) The name and address of the primary care clinic site or
location of the mobile health care unit and the name and contact
information of the manager at each primary care clinic site or mobile
health unit to be added, relocated, or deleted.
(C) The type and the manufacturer of the mobile health care unit
to be added, relocated, or deleted.
(D) The expected days and hours of operation and the services
provided at each primary care clinic site or mobile health care unit
added or relocated.
(E) The proposed area or areas where the added mobile health care
unit will be providing services.
(F) A self-attestation of the following:
(i) Each added or relocated primary care clinic site meets the
requirements of Section 1212 and provides evidence that each clinic
site meets minimum construction standards of adequacy and safety of
the physical plant, pursuant to subdivision (b) of Section 1226.
(ii) Each added or relocated mobile health care unit meets the
requirements of the Mobile Health Care Services Act (Chapter 9
(commencing with Section 1765.101)).
(G) Evidence of appropriate and sufficient fire clearance for each
added or relocated primary care clinic site.
(H) For relocation of a primary care clinic or mobile health care
unit, the new address where the primary care clinic or mobile health
care unit will be located.
(i) A clinic corporation that is issued a single consolidated
license may consolidate the administrative functions, as specified in
Section 1218.2, for all primary care clinics and mobile health care
units that are on the single consolidated license.
(j) The department shall transmit to a clinic corporation that has
been issued a single consolidated license a renewal fee invoice for
a single consolidated license at least 45 days prior to the
expiration date of the existing single consolidated license. Timely
application for renewal shall be deemed equivalent to renewal of the
license and special permits, if any, where the department is unable
to issue a renewal license or special permit on or before the
expiration date.
(k) When the centralized applications unit issues a single
consolidated license pursuant to this section, the department, except
as limited by Section 1229 and Article 5 (commencing with Section
1240), may take any action authorized by this chapter, including, but
not limited to, action specified in Article 5 (commencing with
Section 1240) with respect to a primary care clinic or a mobile
health care unit including, special services provided in a primary
care clinic or mobile health care unit that is included on the single
consolidated license.
(l) (1) Each primary care clinic and mobile health care unit
included on the single consolidated license shall be deemed to be
licensed for the purposes of enrollment as a provider in the Medi-Cal
program, pursuant to subdivision (c) of Section 14043.15 of the
Welfare and Institutions Code, or any program specified in Section
1222. The process for enrollment shall be the same process as
required under Section 1222.
(2) Each primary care clinic or mobile health care unit may
separately enroll as a provider in the Medi-Cal program or other
health care programs using the business address of the primary care
clinic site, or, for a mobile health care unit, the business address
of the clinical corporation's administrative offices.
(3) Any action taken against a provider pursuant to Chapter 7
(commencing with Section 14000) of Part 3 of Division 9 of the
Welfare and Institutions Code, or its successor, shall be an action
taken against the individually enrolled primary care clinic site or
mobile health care unit only, as applicable, and not against the
clinic corporation as a whole.
(m) Nothing in this section shall affect the method for
calculating prospective payment system rates under Section 14132.100
of the Welfare and Institutions Code for rural health clinics and
federally qualified health centers that are included on a single
consolidated license and individually enrolled in the Medi-Cal
program.
(n) (1) Nothing in this section shall affect the requirements for
obtaining a clinic license from the California State Board of
Pharmacy pursuant to Chapter 9 (commencing with Section 4000) of
Division 2 of the Business and Professions Code.
(2) Each primary care clinic site or mobile health care unit that
is included on the single consolidated license shall be deemed to be
licensed as a primary care clinic for the purpose of obtaining a
pharmacy license.
(3) Any action taken by the California State Board of Pharmacy
pursuant to Chapter 9 (commencing with Section 4000) of Division 2 of
the Business and Professions Code, including an action to suspend or
revoke a pharmacy license pursuant to Article 19 (commencing with
Section 4300) of Chapter 9 of Division 2 of the Business and
Professions Code, or its successor, shall be an action taken against
the individual primary care clinic site or mobile health care unit
that holds that pharmacy license, and not against the clinic
corporation as a whole.
(o) (1) Nothing in this section shall affect the requirements for
obtaining a clinical laboratory registration or license pursuant to
Section 1265 of the Business and Professions Code.
(2) Each primary care clinic or mobile health care unit that is
included on the single consolidated license shall be deemed to be
licensed as a primary care clinical for the purpose of obtaining a
clinical laboratory license or registration.
(3) Any action taken by the department pursuant to Chapter 3
(commencing with Section 1200) of Division 2 of the Business and
Professions Code, including an action to suspend or revoke a clinical
laboratory license or registration under Article 7 (commencing with
Section 1320) of Chapter 7 of Division 2 of the Business and
Professions Code, or its successor, shall be an action taken against
the individual primary care clinic site or mobile health care unit
that holds the clinical laboratory license or registration, and not
against the clinic corporation as a whole.
(p) (1) Nothing in this section shall require a clinic corporation
to apply for a single consolidated license.
(2) Nothing in this section shall require a clinic corporation to
include on an application for a single consolidated license all
primary care clinics or mobile health care units owned and operated
by the clinic corporation.
(q) (1) All primary care clinics included on a single consolidated
license shall be subject to the requirements of this chapter and
Chapter 7 (commencing with Section 75001) of Division 5 of Title 22
of the California Code of Regulations, as applicable.
(2) All mobile health units included on a single consolidated
license shall be subject to the requirements of the Mobile Health
Care Services Act (Chapter 9 (commencing with Section 1765.101)), as
applicable.
(r) Nothing in this section shall prohibit a clinic corporation
from requesting program flexibility pursuant to Section 1231 for some
or all primary care clinics or mobile health care units included on
the single consolidated license.
(s) No new primary care clinic regulations shall be required to
implement this section.
SEC. 4. Section 1213 of the Health and Safety Code is amended to
read:
1213. A person, firm, association, partnership, corporation, or
other legal entity desiring a license for a clinic shall be exempt
from the requirements of Chapter 2 (commencing with Section 16000) of
Division 12.5.
SEC. 5. Section 1214 of the Health and Safety Code is amended to
read:
1214. Each application under this chapter for an initial license,
renewal license, license upon change of ownership, or special permit
shall be accompanied by a Licensing and Certification Program fee,
as follows:
(a) For all primary care clinics licensed pursuant to this
chapter, the annual fee shall be set in accordance with Section 1266.
(b) For all specialty clinics licensed pursuant to this chapter,
the annual fee shall be set in accordance with Section 1266.
(c) For all rehabilitation clinics, the annual fee shall be set in
accordance with Section 1266.
(d) For all clinic corporations issued a single consolidated
license pursuant to this chapter, the annual fee shall be set in
accordance with Section 1266.
SEC. 6. Section 1216 of the Health and Safety Code is amended to
read:
1216. (a) Every clinic holding a license or that is included
within a single consolidated license of a clinic corporation shall,
on or before the 15th day of February each year, file with the Office
of Statewide Health Planning and Development upon forms to be
furnished by the office, a verified report showing the following
information relating to the previous calendar year:
(1) Number of patients served and descriptive information,
including age, gender, race, and ethnic background of patients.
(2) Number of patient visits by type of service, including all of
the following:
(A) Child health and disability prevention screens, treatment, and
followup services.
(B) Medical services.
(C) Dental services.
(D) Other health services.
(3) Total clinic operating expenses.
(4) Gross patient charges by payer category, including Medicare,
Medi-Cal, the Child Health Disability Prevention Program, county
indigent programs, other county programs, private insurance,
self-paying patients, nonpaying patients, and other payers.
(5) Deductions from revenue by payer category, bad debts, and
charity care charges.
(6) Additional information as may be required by the office or the
department.
(b) In the event a clinic fails to file a timely report, the
department may suspend the license of the clinic until the report is
completed and filed with the office.
(c) In order to promote efficient reporting of accurate data, the
office shall consider the unique operational characteristics of
different classifications of licensed clinics, including, but not
limited to, the limited scope of services provided by some specialty
clinics, in its design of forms for the collection of data required
by this section.
(d) For the purpose of administering funds appropriated from the
Cigarette and Tobacco Products Surtax Fund for support of licensed
clinics, clinics receiving those funds may be required to report any
additional data the office or the department may determine necessary
to ensure the equitable distribution and appropriate expenditure of
those funds. This shall include, but not be limited to, information
about the poverty level of patients served and communicable diseases
reported to local health departments.
(e) This section shall apply to all primary care clinics.
(f) This section shall apply to all specialty clinics, as defined
in paragraph (2) of subdivision (a) of Section 1204 of the Health and
Safety Code that receive tobacco tax funds pursuant to Article 2
(commencing with Section 30121) of Chapter 2 of Part 13 of Division 2
of the Revenue and Taxation Code.
(g) Specialty clinics that are not required to report pursuant to
subdivision (f) shall report data as directed in this section as it
existed prior to the enactment of Chapter 1331 of the Statutes of
1989 and Chapter 51 of the Statutes of 1990.
SEC. 7. Section 1229 of the Health and Safety Code is amended to
read:
1229. (a) The state department shall notify, in writing, a clinic
of all deficiencies in its compliance with the provisions of this
chapter, or the rules and regulations adopted hereunder, that are
discovered or confirmed by inspection, and the clinic shall agree
with the department on a plan of correction that shall give the
clinic a reasonable time to correct the deficiencies. During the
allotted time, a list of deficiencies and the plan of correction
shall be conspicuously posted in a clinic location accessible to
public view. If, at the end of the allotted time provided in the plan
of correction, the clinic has failed to correct the deficiencies,
the department shall assess the licensee a civil penalty not to
exceed fifty dollars ($50) per day, until the state department finds
the clinic in compliance. In that case, the department may also
initiate action against the clinic to revoke or suspend the license.
Nothing in this chapter shall be deemed to prohibit a clinic that is
unable to correct the deficiencies specified in a plan of correction
for reasons beyond its control from voluntarily surrendering its
license pursuant to Section 1245 prior to the assessment of a civil
penalty or the initiation of a revocation or suspension proceeding.
(b) (1) Notwithstanding subdivision (a), the department shall
notify, in writing, a primary care clinic or mobile health care unit
included on a single consolidated license issued pursuant to Section
1212.5, of all deficiencies in its compliance with this chapter, or
the rules and regulations adopted hereunder, that are discovered or
confirmed by inspection. The department shall also notify, in
writing, the clinic corporation of the notice of deficiency. Upon
receiving notification from the department, the primary care clinic
or mobile health care unit shall notify the clinic corporation of its
deficiencies. The deficient primary care clinic or mobile health
care unit shall agree with the department on a plan of correction
that gives the deficient primary care clinic or mobile health care
unit a reasonable time to correct the deficiencies. If, at the end of
the allotted time provided in the plan of correction, the deficient
primary care clinic or mobile health care unit has failed to correct
the deficiencies, the department shall assess the deficient primary
care clinic or mobile health care unit a civil penalty not to exceed
fifty dollars ($50) per day, until the department finds the deficient
primary care clinic or mobile health care unit in compliance. The
department may also
initiate action against the clinic corporation to remove or suspend
the applicability of the single consolidated license to the deficient
clinic or unit pursuant to the procedure in Section 1241.
(2) Prior to the assessment of a civil penalty or the initiation
of a removal or suspension proceeding, the department may accept both
of the following from the clinic corporation in lieu of civil
penalties and action for removal or suspension:
(A) Pursuant to Section 1245, the voluntary surrender of the
portion of the clinic corporation's single consolidated license that
is applicable to the deficient primary care clinic or mobile health
care unit.
(B) The deletion of the deficient primary care clinic or the
mobile health care unit from the clinic corporation's single
consolidated license.
(3) If a primary care clinic or mobile health care unit is no
longer licensed due to a removal, suspension, or voluntary surrender
of its license pursuant to this section, the process for
reinstatement of its license shall be as follows:
(A) The process for reinstatement after voluntary surrender shall
be pursuant to Section 1245.
(B) The process for reinstatement after suspension shall be
pursuant to Section 1242.
(C) The process for reinstatement after revocation shall be
pursuant to Section 1244.
SEC. 8. Section 1245 of the Health and Safety Code is amended to
read:
1245. (a) Any licensee or holder of a special permit may, with
the approval of the department, surrender his or her license or
special permit for suspension by the department for a temporary
period not to exceed 24 consecutive months.
(b) A clinic corporation with a single consolidated license may,
with the approval of the department, surrender the portion of the
clinic corporation's single consolidated license that is applicable
to a primary care clinic or mobile health care unit that is found to
be deficient pursuant to subdivision (b) of Section 1229, for
suspension by the department for a temporary period not to exceed 24
consecutive months.
(c) (1) A license, special permit, or portion of a clinic
corporation's single consolidated license suspended pursuant to this
section may be reinstated by the department on receipt of an
application and after an inspection showing full compliance with all
applicable licensing requirements.
(2) A clinic corporation may apply for reinstatement of a
deficient primary care clinic or mobile health care unit using the
form described in subdivision (g) of Section 1212.5.
(d) (1) Upon voluntary surrender of a single consolidated license
by a clinic corporation, the department shall issue individual
licenses to each primary care clinic and mobile health care unit
included on the single consolidated license and that are not the
subject of a deficiency pursuant to Section 1229.
(2) The clinic corporation may apply for reinstatement by
submitting a new application for a single consolidated license.
SEC. 9. Section 1266 of the Health and Safety Code is amended to
read:
1266. (a) The Licensing and Certification Division shall be
supported entirely by federal funds and special funds by no earlier
than the beginning of the 2009-10 fiscal year unless otherwise
specified in statute, or unless funds are specifically appropriated
from the General Fund in the annual Budget Act or other enacted
legislation. For the 2007-08 fiscal year, General Fund support shall
be provided to offset licensing and certification fees in an amount
of not less than two million seven hundred eighty-two thousand
dollars ($2,782,000).
(b) (1) The Licensing and Certification Program fees for the
2006-07 fiscal year shall be as follows:
Type of Facility Fee
General Acute Care Hospitals $ 134.10 per bed
Acute Psychiatric Hospitals $ 134.10 per bed
Special Hospitals $ 134.10 per bed
Chemical Dependency Recovery
Hospitals $ 123.52 per bed
Skilled Nursing Facilities $ 202.96 per bed
Intermediate Care Facilities $ 202.96 per bed
Intermediate Care Facilities
- Developmentally Disabled $ 592.29 per bed
Intermediate Care Facilities
- Developmentally Disabled - per
Habilitative $1,000.00 facility
Intermediate Care Facilities
- Developmentally Disabled - per
Nursing $1,000.00 facility
Home Health Agencies per
$2,700.00 facility
Referral Agencies per
$5,537.71 facility
Adult Day Health Centers per
$4,650.02 facility
Congregate Living Health
Facilities $ 202.96 per bed
Psychology Clinics per
$ 600.00 facility
Primary Clinics - Community per
and Free $ 600.00 facility
Specialty Clinics - Rehab
Clinics per
(For profit) $2,974.43 facility
(Nonprofit) per
$ 500.00 facility
Specialty Clinics - Surgical per
and Chronic $1,500.00 facility
Dialysis Clinics per
$1,500.00 facility
Pediatric Day Health/Respite
Care $ 142.43 per bed
Alternative Birthing Centers per
$2,437.86 facility
Hospice per
$1,000.00 facility
Correctional Treatment Centers $ 590.39 per bed
(2) In the first year of licensure for intermediate care
facility/developmentally disabled-continuous nursing (ICF/DD-CN)
facilities, the licensure fee for those facilities shall be
equivalent to the licensure fee for intermediate care
facility/developmentally disabled-nursing facilities during the same
year. Thereafter, the licensure fee for ICF/DD-CN facilities shall be
established pursuant to subdivisions (c) and (d).
(c) Commencing February 1, 2007, and every February 1 thereafter,
the department shall publish a list of estimated fees pursuant to
this section. The calculation of estimated fees and the publication
of the report and list of estimated fees shall not be subject to the
rulemaking requirements of Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code.
(d) Commencing February 1, 2010, 2011,
and every February 1 thereafter, the department shall publish
the estimated fee for a single consolidated license issued under
Section 1212.5 pursuant to this section. The estimated fee for
primary care clinics, for each primary care clinic included in a
single consolidated license shall be included in the report and list
of estimated fees required by subdivisions (c) and (e).
(e) By February 1 of each year, the department shall prepare the
following reports and shall make those reports, and the list of
estimated fees required to be published pursuant to subdivision (c),
available to the public by submitting them to the Legislature and
posting them on the department's Internet Web site:
(1) The department shall prepare a report of all costs for
activities of the Licensing and Certification Program. At a minimum,
this report shall include a narrative of all baseline adjustments and
their calculations, a description of how each category of facility
was calculated, descriptions of assumptions used in calculations, and
shall recommend Licensing and Certification Program fees in
accordance with the following:
(A) Projected workload and costs shall be grouped for each fee
category, including workload costs for facility categories that have
been established by statute and for which licensing regulations and
procedures are under development.
(B) Cost estimates, and the estimated fees, shall be based on the
appropriation amounts in the Governor's proposed budget for the next
fiscal year, with and without policy adjustments to the fee
methodology.
(C) The allocation of program, operational, and administrative
overhead, and indirect costs to fee categories shall be based on
generally accepted cost allocation methods. Significant items of
costs shall be directly charged to fee categories if the expenses can
be reasonably identified to the fee category that caused them.
Indirect and overhead costs shall be allocated to all fee categories
using a generally accepted cost allocation method.
(D) The amount of federal funds and General Fund moneys to be
received in the budget year shall be estimated and allocated to each
fee category based upon an appropriate metric.
(E) The fee for each category shall be determined by dividing the
aggregate state share of all costs for the Licensing and
Certification Program by the appropriate metric for the category of
licensure. Amounts actually received for new licensure applications,
including change of ownership applications, and late payment
penalties, pursuant to Section 1266.5, during each fiscal year shall
be calculated and 95 percent shall be applied to the appropriate fee
categories in determining Licensing and Certification Program fees
for the second fiscal year following receipt of those funds. The
remaining 5 percent shall be retained in the fund as a reserve until
appropriated.
(2) (A) The department shall prepare a staffing and systems
analysis to ensure efficient and effective utilization of fees
collected, proper allocation of departmental resources to licensing
and certification activities, survey schedules, complaint
investigations, enforcement and appeal activities, data collection
and dissemination, surveyor training, and policy development.
(B) The analysis under this paragraph shall be made available to
interested persons and shall include all of the following:
(i) The number of surveyors and administrative support personnel
devoted to the licensing and certification of health care facilities.
(ii) The percentage of time devoted to licensing and certification
activities for the various types of health facilities.
(iii) The number of facilities receiving full surveys and the
frequency and number of followup visits.
(iv) The number and timeliness of complaint investigations.
(v) Data on deficiencies and citations issued, and numbers of
citation review conferences and arbitration hearings.
(vi) Other applicable activities of the licensing and
certification division.
(f) (1) The department shall adjust the list of estimated fees
published pursuant to subdivision (c) if the annual Budget Act or
other enacted legislation includes an appropriation that differs from
those proposed in the Governor's proposed budget for that fiscal
year.
(2) The department shall publish a final fee list, with an
explanation of any adjustment, by the issuance of an all facilities
letter, by posting the list on the department's Internet Web site,
and by including the final fee list as part of the licensing
application package, within 14 days of the enactment of the annual
Budget Act. The adjustment of fees and the publication of the final
fee list shall not be subject to the rulemaking requirements of
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code.
(g) (1) No fee shall be assessed or collected pursuant to this
section from any state department, authority, bureau, commission, or
officer, unless federal financial participation would become
available by doing so and an appropriation is included in the annual
Budget Act for that department, authority, bureau, commission, or
officer for this purpose. No fee shall be assessed or collected
pursuant to this section from any clinic that is certified only by
the federal government and is exempt from licensure under Section
1206, unless federal financial participation would become available
by doing so.
(2) For the 2006-07 state fiscal year, no fee shall be assessed or
collected pursuant to this section from any general acute care
hospital owned by a health care district with 100 beds or less.
(h) The Licensing and Certification Program may change annual
license expiration renewal dates to provide for efficiencies in
operational processes or to provide for sufficient cashflow to pay
for expenditures. If an annual license expiration date is changed,
the renewal fee shall be prorated accordingly. Facilities shall be
provided with a 60-day notice of a change in their annual license
renewal date.
SEC. 10. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because 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 XIII B of the California
Constitution.
