AB 1130: Clinics: licensing: hours of operation.
- Session Year: 2015-2016
- House: Assembly
- Latest Version Date: 2015-10-01
Under existing law, the State Department of Public Health licenses and regulates clinics, as defined. Under existing law, specified types of clinics are exempted from these licensing provisions, including a clinic operated by a licensed primary care community or free clinic, that is operated on separate premises from the licensed clinic, and that is open for limited services of no more than 20 hours a week. Existing law makes it a misdemeanor to violate any provision related to the licensure and regulation of clinics.
This bill would increase the number of hours that a clinic may be open under this licensure exemption provision to 30 hours a week. The bill would also require a licensed primary care community or free clinic to report to the department, when renewing its license, whether it is currently operating an intermittent clinic, the location of any intermittent clinic, and the estimated hours of operation of any intermittent clinic.
This bill would incorporate additional changes to Section 1206 of the Health and Safety Code proposed by AB 941 that would become operative if this bill and AB 941 are chaptered and this bill is chaptered last.
By expanding the scope of an existing crime, this bill 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.
Under existing law, the State Department of Public Health licenses and regulates clinics, as defined. Under existing law, specified types of clinics are exempted from these licensing provisions, including a clinic operated by a licensed primary care community or free clinic, that is operated on separate premises from the licensed clinic, and that is open for limited services of no more than 20 hours a week. Existing law makes it a misdemeanor to violate any provision related to the licensure and regulation of clinics.
This bill would increase the number of hours that a clinic may be open under this licensure exemption provision to 30 hours a week. The bill would also require a licensed primary care community or free clinic to report to the department, when renewing its license, whether it is currently operating an intermittent clinic, the location of any intermittent clinic, and the estimated hours of operation of any intermittent clinic.
This bill would incorporate additional changes to Section 1206 of the Health and Safety Code proposed by AB 941 that would become operative if this bill and AB 941 are chaptered and this bill is chaptered last.
By expanding the scope of an existing crime, this bill 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.
Under existing law, the State Department of Public Health licenses and regulates clinics, as defined. Under existing law, specified types of clinics are exempted from these licensing provisions, including a clinic operated by a licensed primary care community or free clinic, that is operated on separate premises from the licensed clinic, and that is open for limited services of no more than 20 hours a week. Existing law makes it a misdemeanor to violate any provision related to the licensure and regulation of clinics.
This bill would increase the number of hours that a clinic may be open under this licensure exemption provision to 30 hours a week. The bill would also require a licensed primary care community or free clinic to report to the department, when renewing its license, whether it is currently operating an intermittent clinic, the location of any intermittent clinic, and the estimated hours of operation of any intermittent clinic. By
This bill would incorporate additional changes to Section 1206 of the Health and Safety Code proposed by AB 941 that would become operative if this bill and AB 941 are chaptered and this bill is chaptered last.
By expanding the scope of an existing crime, this bill 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.
Under existing law, the State Department of Public Health licenses and regulates clinics, as defined. Under existing law, specified types of clinics are exempted from these licensing provisions, including a clinic operated by a licensed primary care community or free clinic, that is operated on separate premises from the licensed clinic, and that is open for limited services of no more than 20 hours a week. Existing law makes it a misdemeanor to violate any provision related to the licensure and regulation of clinics.
This bill would increase the number of hours that a clinic may be open under this licensure exemption provision to 30 hours a week. The bill would also require a licensed primary care community or free clinic to report to the department, when renewing its license, whether it is currently operating an intermittent clinic, the location of any intermittent clinic, and the estimated hours of operation of any intermittent clinic. By expanding the scope of an existing crime, this bill 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.
Under existing law, the State Department of Public Health licenses and regulates clinics, as defined. Under existing law, specified types of clinics are exempted from these licensing provisions, including a clinic operated by a licensed primary care community or free clinic, that is operated on separate premises from the licensed clinic, and that is open for limited services of no more than 20 hours a week.
This bill would increase the number of hours that a clinic may be open under this licensure exemption provision to 30 hours a week.
This chapter does not apply to the following:
(a)Except with respect to the option provided with regard to surgical clinics in paragraph (1) of subdivision (b) of Section 1204 and, further, with respect to specialty clinics specified in paragraph (2) of subdivision (b) of Section 1204, any place or establishment owned or leased and operated as a clinic or office by one or more licensed health care practitioners and used as an office for the practice of their profession, within the scope of their license, regardless of the name used publicly to identify the place or establishment.
(b)Any clinic directly conducted, maintained, or operated by the United States or by any of its departments, officers, or agencies, and any primary care clinic specified in subdivision (a) of Section 1204 that is directly conducted, maintained, or operated by this state or by any of its political subdivisions or districts, or by any city. Nothing in this subdivision precludes the state department from adopting regulations that utilize clinic licensing standards as eligibility criteria for participation in programs funded wholly or partially under Title XVIII or XIX of the federal Social Security Act.
(c)Any clinic conducted, maintained, or operated by a federally recognized Indian tribe or tribal organization, as defined in Section 450 or 1601 of Title 25 of the United States Code, that is located on land recognized as tribal land by the federal government.
(d)Clinics conducted, operated, or maintained as outpatient departments of hospitals.
(e)Any facility licensed as a health facility under Chapter 2 (commencing with Section 1250).
(f)Any freestanding clinical or pathological laboratory licensed under Chapter 3 (commencing with Section 1200) of Division 2 of the Business and Professions Code.
(g)A clinic operated by, or affiliated with, any institution of learning that teaches a recognized healing art and is approved by the state board or commission vested with responsibility for regulation of the practice of that healing art.
(h)A clinic that is operated by a primary care community or free clinic and that is operated on separate premises from the licensed clinic and is only open for limited services of no more than 30 hours a week. An intermittent clinic as described in this subdivision shall, however, meet all other requirements of law, including administrative regulations and requirements, pertaining to fire and life safety.
(i)The offices of physicians in group practice who provide a preponderance of their services to members of a comprehensive group practice prepayment health care service plan subject to Chapter 2.2 (commencing with Section 1340).
(j)Student health centers operated by public institutions of higher education.
(k)Nonprofit speech and hearing centers, as defined in Section 1201.5. Any nonprofit speech and hearing clinic desiring an exemption under this subdivision shall make application therefor to the director, who shall grant the exemption to any facility meeting the criteria of Section 1201.5. Notwithstanding the licensure exemption contained in this subdivision, a nonprofit speech and hearing center shall be deemed to be an organized outpatient clinic for purposes of qualifying for reimbursement as a rehabilitation center under the Medi-Cal Act (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code).
(l)A clinic operated by 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, that conducts medical research and health education and provides health care to its patients through a group of 40 or more physicians and surgeons, who are independent contractors representing not less than 10 board-certified specialties, and not less than two-thirds of whom practice on a full-time basis at the clinic.
(m)Any clinic, limited to in vivo diagnostic services by magnetic resonance imaging functions or radiological services under the direct and immediate supervision of a physician and surgeon who is licensed to practice in California. This shall not be construed to permit cardiac catheterization or any treatment modality in these clinics.
(n)A clinic operated by an employer or jointly by two or more employers for their employees only, or by a group of employees, or jointly by employees and employers, without profit to the operators thereof or to any other person, for the prevention and treatment of accidental injuries to, and the care of the health of, the employees comprising the group.
(o)A community mental health center, as defined in Section 5667 of the Welfare and Institutions Code.
(p)(1)A clinic operated by 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, as an entity organized and operated exclusively for scientific and charitable purposes and that satisfied all of the following requirements on or before January 1, 2005:
(A)Commenced conducting medical research on or before January 1, 1982, and continues to conduct medical research.
(B)Conducted research in, among other areas, prostatic cancer, cardiovascular disease, electronic neural prosthetic devices, biological effects and medical uses of lasers, and human magnetic resonance imaging and spectroscopy.
(C)Sponsored publication of at least 200 medical research articles in peer-reviewed publications.
(D)Received grants and contracts from the National Institutes of Health.
(E)Held and licensed patents on medical technology.
(F)Received charitable contributions and bequests totaling at least five million dollars ($5,000,000).
(G)Provides health care services to patients only:
(i)In conjunction with research being conducted on procedures or applications not approved or only partially approved for payment (I) under the Medicare program pursuant to Section 1359y(a)(1)(A) of Title 42 of the United States Code, or (II) by a health care service plan registered under Chapter 2.2 (commencing with Section 1340), or a disability insurer regulated under Chapter 1 (commencing with Section 10110) of Part 2 of Division 2 of the Insurance Code; provided that services may be provided by the clinic for an additional period of up to three years following the approvals, but only to the extent necessary to maintain clinical expertise in the procedure or application for purposes of actively providing training in the procedure or application for physicians and surgeons unrelated to the clinic.
(ii)Through physicians and surgeons who, in the aggregate, devote no more than 30 percent of their professional time for the entity operating the clinic, on an annual basis, to direct patient care activities for which charges for professional services are paid.
(H)Makes available to the public the general results of its research activities on at least an annual basis, subject to good faith protection of proprietary rights in its intellectual property.
(I)Is a freestanding clinic, whose operations under this subdivision are not conducted in conjunction with any affiliated or associated health clinic or facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as affiliated only if it directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, a clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as associated only if more than 20 percent of the directors or trustees of the clinic are also the directors or trustees of any individual clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). Any activity by a clinic under this subdivision in connection with an affiliated or associated entity shall fully comply with the requirements of this subdivision. This subparagraph shall not apply to agreements between a clinic and any entity for purposes of coordinating medical research.
(2)By January 1, 2007, and every five years thereafter, the Legislature shall receive a report from each clinic meeting the criteria of this subdivision and any other interested party concerning the operation of the clinics activities. The report shall include, but not be limited to, an evaluation of how the clinic impacted competition in the relevant health care market, and a detailed description of the clinics research results and the level of acceptance by the payer community of the procedures performed at the clinic. The report shall also include a description of procedures performed both in clinics governed by this subdivision and those performed in other settings. The cost of preparing the reports shall be borne by the clinics that are required to submit them to the Legislature pursuant to this paragraph.
SEC. 1.5.Section 1206 of the Health and Safety Code is amended to read:1206.This chapter does not apply to the following:
(a)Except with respect to the option provided with regard to surgical clinics in paragraph (1) of subdivision (b) of Section 1204 and, further, with respect to specialty clinics specified in paragraph (2) of subdivision (b) of Section 1204, any place or establishment owned or leased and operated as a clinic or office by one or more licensed health care practitioners and used as an office for the practice of their profession, within the scope of their license, regardless of the name used publicly to identify the place or establishment.
(b)Any clinic directly conducted, maintained, or operated by the United States or by any of its departments, officers, or agencies, and any primary care clinic specified in subdivision (a) of Section 1204 that is directly conducted, maintained, or operated by this state or by any of its political subdivisions or districts, or by any city. Nothing in this subdivision precludes the state department from adopting regulations that utilize clinic licensing standards as eligibility criteria for participation in programs funded wholly or partially under Title XVIII or XIX of the federal Social Security Act.
(c)(1)Any clinic conducted, maintained, or operated by a federally recognized Indian tribe or tribal organization, as defined in Section 450 or 1603 of Title 25 of the United States Code, that is located on land recognized as tribal land by the federal government.
(2)Any clinic conducted, maintained, or operated by a federally recognized Indian tribe or tribal organization, as defined in Section 450 or 1603 of Title 25 of the United States Code, under a contract with the United States pursuant to the Indian Self-Determination and Education Assistance Act (Public Law 93-638), regardless of the location of the clinic, except that if the clinic chooses to apply to the State Department of Public Health for a state facility license, then the State Department of Public Health will retain authority to regulate that clinic as a primary care clinic as defined by subdivision (a) of Section 1204.
(d)Clinics conducted, operated, or maintained as outpatient departments of hospitals.
(e)Any facility licensed as a health facility under Chapter 2 (commencing with Section 1250).
(f)Any freestanding clinical or pathological laboratory licensed under Chapter 3 (commencing with Section 1200) of Division 2 of the Business and Professions Code.
(g)A clinic operated by, or affiliated with, any institution of learning that teaches a recognized healing art and is approved by the state board or commission vested with responsibility for regulation of the practice of that healing art.
(h)A clinic that is operated by a primary care community or free clinic and that is operated on separate premises from the licensed clinic and is only open for limited services of no more than 30 hours a week. An intermittent clinic as described in this subdivision shall, however, meet all other requirements of law, including administrative regulations and requirements, pertaining to fire and life safety.
(i)The offices of physicians in group practice who provide a preponderance of their services to members of a comprehensive group practice prepayment health care service plan subject to Chapter 2.2 (commencing with Section 1340).
(j)Student health centers operated by public institutions of higher education.
(k)Nonprofit speech and hearing centers, as defined in Section 1201.5. Any nonprofit speech and hearing clinic desiring an exemption under this subdivision shall make application therefor to the director, who shall grant the exemption to any facility meeting the criteria of Section 1201.5. Notwithstanding the licensure exemption contained in this subdivision, a nonprofit speech and hearing center shall be deemed to be an organized outpatient clinic for purposes of qualifying for reimbursement as a rehabilitation center under the Medi-Cal Act (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code).
(l)A clinic operated by 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, that conducts medical research and health education and provides health care to its patients through a group of 40 or more physicians and surgeons, who are independent contractors representing not less than 10 board-certified specialties, and not less than two-thirds of whom practice on a full-time basis at the clinic.
(m)Any clinic, limited to in vivo diagnostic services by magnetic resonance imaging functions or radiological services under the direct and immediate supervision of a physician and surgeon who is licensed to practice in California. This shall not be construed to permit cardiac catheterization or any treatment modality in these clinics.
(n)A clinic operated by an employer or jointly by two or more employers for their employees only, or by a group of employees, or jointly by employees and employers, without profit to the operators thereof or to any other person, for the prevention and treatment of accidental injuries to, and the care of the health of, the employees comprising the group.
(o)A community mental health center, as defined in Section 5667 of the Welfare and Institutions Code.
(p)(1)A clinic operated by 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, as an entity organized and operated exclusively for scientific and charitable purposes and that satisfied all of the following requirements on or before January 1, 2005:
(A)Commenced conducting medical research on or before January 1, 1982, and continues to conduct medical research.
(B)Conducted research in, among other areas, prostatic cancer, cardiovascular disease, electronic neural prosthetic devices, biological effects and medical uses of lasers, and human magnetic resonance imaging and spectroscopy.
(C)Sponsored publication of at least 200 medical research articles in peer-reviewed publications.
(D)Received grants and contracts from the National Institutes of Health.
(E)Held and licensed patents on medical technology.
(F)Received charitable contributions and bequests totaling at least five million dollars ($5,000,000).
(G)Provides health care services to patients only:
(i)In conjunction with research being conducted on procedures or applications not approved or only partially approved for payment (I) under the Medicare program pursuant to Section 1359y(a)(1)(A) of Title 42 of the United States Code, or (II) by a health care service plan registered under Chapter 2.2 (commencing with Section 1340), or a disability insurer regulated under Chapter 1 (commencing with Section 10110) of Part 2 of Division 2 of the Insurance Code; provided that services may be provided by the clinic for an additional period of up to three years following the approvals, but only to the extent necessary to maintain clinical expertise in the procedure or application for purposes of actively providing training in the procedure or application for physicians and surgeons unrelated to the clinic.
(ii)Through physicians and surgeons who, in the aggregate, devote no more than 30 percent of their professional time for the entity operating the clinic, on an annual basis, to direct patient care activities for which charges for professional services are paid.
(H)Makes available to the public the general results of its research activities on at least an annual basis, subject to good faith protection of proprietary rights in its intellectual property.
(I)Is a freestanding clinic, whose operations under this subdivision are not conducted in conjunction with any affiliated or associated health clinic or facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as affiliated only if it directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, a clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as associated only if more than 20 percent of the directors or trustees of the clinic are also the directors or trustees of any individual clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). Any activity by a clinic under this subdivision in connection with an affiliated or associated entity shall fully comply with the requirements of this subdivision. This subparagraph shall not apply to agreements between a clinic and any entity for purposes of coordinating medical research.
(2)By January 1, 2007, and every five years thereafter, the Legislature shall receive a report from each clinic meeting the criteria of this subdivision and any other interested party concerning the operation of the clinics activities. The report shall include, but not be limited to, an evaluation of how the clinic impacted competition in the relevant health care market, and a detailed description of the clinics research results and the level of acceptance by the payer community of the procedures performed at the clinic. The report shall also include a description of procedures performed both in clinics governed by this subdivision and those performed in other settings. The cost of preparing the reports shall be borne by the clinics that are required to submit them to the Legislature pursuant to this paragraph.
SEC. 2.Section 1218.4 is added to the Health and Safety Code, to read:1218.4.(a)A licensed primary care community or free clinic shall report to the department, when renewing its license, whether it is currently operating an intermittent clinic, the location of any intermittent clinic, and the estimated hours of operation of any intermittent clinic.
(b)For the purposes of this section intermittent clinic means a clinic described in subdivision (h) of Section 1206.
SEC. 3.Section 1.5 of this bill incorporates amendments to Section 1206 of the Health and Safety Code proposed by both this bill and Assembly Bill 941. It shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2016, (2) each bill amends Section 1206 of the Health and Safety Code, and (3) this bill is enacted after Assembly Bill 941, in which case Section 1 of this bill shall not become operative.
SEC. 4.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
This chapter does not apply to the following:
(a)Except with respect to the option provided with regard to surgical clinics in paragraph (1) of subdivision (b) of Section 1204 and, further, with respect to specialty clinics specified in paragraph (2) of subdivision (b) of Section 1204, any place or establishment owned or leased and operated as a clinic or office by one or more licensed health care practitioners and used as an office for the practice of their profession, within the scope of their license, regardless of the name used publicly to identify the place or establishment.
(b)Any clinic directly conducted, maintained, or operated by the United States or by any of its departments, officers, or agencies, and any primary care clinic specified in subdivision (a) of Section 1204 that is directly conducted, maintained, or operated by this state or by any of its political subdivisions or districts, or by any city. Nothing in this subdivision precludes the state department from adopting regulations that utilize clinic licensing standards as eligibility criteria for participation in programs funded wholly or partially under Title XVIII or XIX of the federal Social Security Act.
(c)Any clinic conducted, maintained, or operated by a federally recognized Indian tribe or tribal organization, as defined in Section 450 or 1601 of Title 25 of the United States Code, that is located on land recognized as tribal land by the federal government.
(d)Clinics conducted, operated, or maintained as outpatient departments of hospitals.
(e)Any facility licensed as a health facility under Chapter 2 (commencing with Section 1250).
(f)Any freestanding clinical or pathological laboratory licensed under Chapter 3 (commencing with Section 1200) of Division 2 of the Business and Professions Code.
(g)A clinic operated by, or affiliated with, any institution of learning that teaches a recognized healing art and is approved by the state board or commission vested with responsibility for regulation of the practice of that healing art.
(h)A clinic that is operated by a primary care community or free clinic and that is operated on separate premises from the licensed clinic and is only open for limited services of no more than 30 hours a week. An intermittent clinic as described in this subdivision shall, however, meet all other requirements of law, including administrative regulations and requirements, pertaining to fire and life safety.
(i)The offices of physicians in group practice who provide a preponderance of their services to members of a comprehensive group practice prepayment health care service plan subject to Chapter 2.2 (commencing with Section 1340).
(j)Student health centers operated by public institutions of higher education.
(k)Nonprofit speech and hearing centers, as defined in Section 1201.5. Any nonprofit speech and hearing clinic desiring an exemption under this subdivision shall make application therefor to the director, who shall grant the exemption to any facility meeting the criteria of Section 1201.5. Notwithstanding the licensure exemption contained in this subdivision, a nonprofit speech and hearing center shall be deemed to be an organized outpatient clinic for purposes of qualifying for reimbursement as a rehabilitation center under the Medi-Cal Act (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code).
(l)A clinic operated by 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, that conducts medical research and health education and provides health care to its patients through a group of 40 or more physicians and surgeons, who are independent contractors representing not less than 10 board-certified specialties, and not less than two-thirds of whom practice on a full-time basis at the clinic.
(m)Any clinic, limited to in vivo diagnostic services by magnetic resonance imaging functions or radiological services under the direct and immediate supervision of a physician and surgeon who is licensed to practice in California. This shall not be construed to permit cardiac catheterization or any treatment modality in these clinics.
(n)A clinic operated by an employer or jointly by two or more employers for their employees only, or by a group of employees, or jointly by employees and employers, without profit to the operators thereof or to any other person, for the prevention and treatment of accidental injuries to, and the care of the health of, the employees comprising the group.
(o)A community mental health center, as defined in Section 5667 of the Welfare and Institutions Code.
(p)(1)A clinic operated by 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, as an entity organized and operated exclusively for scientific and charitable purposes and that satisfied all of the following requirements on or before January 1, 2005:
(A)Commenced conducting medical research on or before January 1, 1982, and continues to conduct medical research.
(B)Conducted research in, among other areas, prostatic cancer, cardiovascular disease, electronic neural prosthetic devices, biological effects and medical uses of lasers, and human magnetic resonance imaging and spectroscopy.
(C)Sponsored publication of at least 200 medical research articles in peer-reviewed publications.
(D)Received grants and contracts from the National Institutes of Health.
(E)Held and licensed patents on medical technology.
(F)Received charitable contributions and bequests totaling at least five million dollars ($5,000,000).
(G)Provides health care services to patients only:
(i)In conjunction with research being conducted on procedures or applications not approved or only partially approved for payment (I) under the Medicare program pursuant to Section 1359y(a)(1)(A) of Title 42 of the United States Code, or (II) by a health care service plan registered under Chapter 2.2 (commencing with Section 1340), or a disability insurer regulated under Chapter 1 (commencing with Section 10110) of Part 2 of Division 2 of the Insurance Code; provided that services may be provided by the clinic for an additional period of up to three years following the approvals, but only to the extent necessary to maintain clinical expertise in the procedure or application for purposes of actively providing training in the procedure or application for physicians and surgeons unrelated to the clinic.
(ii)Through physicians and surgeons who, in the aggregate, devote no more than 30 percent of their professional time for the entity operating the clinic, on an annual basis, to direct patient care activities for which charges for professional services are paid.
(H)Makes available to the public the general results of its research activities on at least an annual basis, subject to good faith protection of proprietary rights in its intellectual property.
(I)Is a freestanding clinic, whose operations under this subdivision are not conducted in conjunction with any affiliated or associated health clinic or facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as affiliated only if it directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, a clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as associated only if more than 20 percent of the directors or trustees of the clinic are also the directors or trustees of any individual clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). Any activity by a clinic under this subdivision in connection with an affiliated or associated entity shall fully comply with the requirements of this subdivision. This subparagraph shall not apply to agreements between a clinic and any entity for purposes of coordinating medical research.
(2)By January 1, 2007, and every five years thereafter, the Legislature shall receive a report from each clinic meeting the criteria of this subdivision and any other interested party concerning the operation of the clinics activities. The report shall include, but not be limited to, an evaluation of how the clinic impacted competition in the relevant health care market, and a detailed description of the clinics research results and the level of acceptance by the payer community of the procedures performed at the clinic. The report shall also include a description of procedures performed both in clinics governed by this subdivision and those performed in other settings. The cost of preparing the reports shall be borne by the clinics that are required to submit them to the Legislature pursuant to this paragraph.
SEC. 1.5.Section 1206 of the Health and Safety Code is amended to read:1206.This chapter does not apply to the following:
(a)Except with respect to the option provided with regard to surgical clinics in paragraph (1) of subdivision (b) of Section 1204 and, further, with respect to specialty clinics specified in paragraph (2) of subdivision (b) of Section 1204, any place or establishment owned or leased and operated as a clinic or office by one or more licensed health care practitioners and used as an office for the practice of their profession, within the scope of their license, regardless of the name used publicly to identify the place or establishment.
(b)Any clinic directly conducted, maintained, or operated by the United States or by any of its departments, officers, or agencies, and any primary care clinic specified in subdivision (a) of Section 1204 that is directly conducted, maintained, or operated by this state or by any of its political subdivisions or districts, or by any city. Nothing in this subdivision precludes the state department from adopting regulations that utilize clinic licensing standards as eligibility criteria for participation in programs funded wholly or partially under Title XVIII or XIX of the federal Social Security Act.
(c)(1)Any clinic conducted, maintained, or operated by a federally recognized Indian tribe or tribal organization, as defined in Section 450 or 1603 of Title 25 of the United States Code, that is located on land recognized as tribal land by the federal government.
(2)Any clinic conducted, maintained, or operated by a federally recognized Indian tribe or tribal organization, as defined in Section 450 or 1603 of Title 25 of the United States Code, under a contract with the United States pursuant to the Indian Self-Determination and Education Assistance Act (Public Law 93-638), regardless of the location of the clinic, except that if the clinic chooses to apply to the State Department of Public Health for a state facility license, then the State Department of Public Health will retain authority to regulate that clinic as a primary care clinic as defined by subdivision (a) of Section 1204.
(d)Clinics conducted, operated, or maintained as outpatient departments of hospitals.
(e)Any facility licensed as a health facility under Chapter 2 (commencing with Section 1250).
(f)Any freestanding clinical or pathological laboratory licensed under Chapter 3 (commencing with Section 1200) of Division 2 of the Business and Professions Code.
(g)A clinic operated by, or affiliated with, any institution of learning that teaches a recognized healing art and is approved by the state board or commission vested with responsibility for regulation of the practice of that healing art.
(h)A clinic that is operated by a primary care community or free clinic and that is operated on separate premises from the licensed clinic and is only open for limited services of no more than 30 hours a week. An intermittent clinic as described in this subdivision shall, however, meet all other requirements of law, including administrative regulations and requirements, pertaining to fire and life safety.
(i)The offices of physicians in group practice who provide a preponderance of their services to members of a comprehensive group practice prepayment health care service plan subject to Chapter 2.2 (commencing with Section 1340).
(j)Student health centers operated by public institutions of higher education.
(k)Nonprofit speech and hearing centers, as defined in Section 1201.5. Any nonprofit speech and hearing clinic desiring an exemption under this subdivision shall make application therefor to the director, who shall grant the exemption to any facility meeting the criteria of Section 1201.5. Notwithstanding the licensure exemption contained in this subdivision, a nonprofit speech and hearing center shall be deemed to be an organized outpatient clinic for purposes of qualifying for reimbursement as a rehabilitation center under the Medi-Cal Act (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code).
(l)A clinic operated by 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, that conducts medical research and health education and provides health care to its patients through a group of 40 or more physicians and surgeons, who are independent contractors representing not less than 10 board-certified specialties, and not less than two-thirds of whom practice on a full-time basis at the clinic.
(m)Any clinic, limited to in vivo diagnostic services by magnetic resonance imaging functions or radiological services under the direct and immediate supervision of a physician and surgeon who is licensed to practice in California. This shall not be construed to permit cardiac catheterization or any treatment modality in these clinics.
(n)A clinic operated by an employer or jointly by two or more employers for their employees only, or by a group of employees, or jointly by employees and employers, without profit to the operators thereof or to any other person, for the prevention and treatment of accidental injuries to, and the care of the health of, the employees comprising the group.
(o)A community mental health center, as defined in Section 5667 of the Welfare and Institutions Code.
(p)(1)A clinic operated by 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, as an entity organized and operated exclusively for scientific and charitable purposes and that satisfied all of the following requirements on or before January 1, 2005:
(A)Commenced conducting medical research on or before January 1, 1982, and continues to conduct medical research.
(B)Conducted research in, among other areas, prostatic cancer, cardiovascular disease, electronic neural prosthetic devices, biological effects and medical uses of lasers, and human magnetic resonance imaging and spectroscopy.
(C)Sponsored publication of at least 200 medical research articles in peer-reviewed publications.
(D)Received grants and contracts from the National Institutes of Health.
(E)Held and licensed patents on medical technology.
(F)Received charitable contributions and bequests totaling at least five million dollars ($5,000,000).
(G)Provides health care services to patients only:
(i)In conjunction with research being conducted on procedures or applications not approved or only partially approved for payment (I) under the Medicare program pursuant to Section 1359y(a)(1)(A) of Title 42 of the United States Code, or (II) by a health care service plan registered under Chapter 2.2 (commencing with Section 1340), or a disability insurer regulated under Chapter 1 (commencing with Section 10110) of Part 2 of Division 2 of the Insurance Code; provided that services may be provided by the clinic for an additional period of up to three years following the approvals, but only to the extent necessary to maintain clinical expertise in the procedure or application for purposes of actively providing training in the procedure or application for physicians and surgeons unrelated to the clinic.
(ii)Through physicians and surgeons who, in the aggregate, devote no more than 30 percent of their professional time for the entity operating the clinic, on an annual basis, to direct patient care activities for which charges for professional services are paid.
(H)Makes available to the public the general results of its research activities on at least an annual basis, subject to good faith protection of proprietary rights in its intellectual property.
(I)Is a freestanding clinic, whose operations under this subdivision are not conducted in conjunction with any affiliated or associated health clinic or facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as affiliated only if it directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, a clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as associated only if more than 20 percent of the directors or trustees of the clinic are also the directors or trustees of any individual clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). Any activity by a clinic under this subdivision in connection with an affiliated or associated entity shall fully comply with the requirements of this subdivision. This subparagraph shall not apply to agreements between a clinic and any entity for purposes of coordinating medical research.
(2)By January 1, 2007, and every five years thereafter, the Legislature shall receive a report from each clinic meeting the criteria of this subdivision and any other interested party concerning the operation of the clinics activities. The report shall include, but not be limited to, an evaluation of how the clinic impacted competition in the relevant health care market, and a detailed description of the clinics research results and the level of acceptance by the payer community of the procedures performed at the clinic. The report shall also include a description of procedures performed both in clinics governed by this subdivision and those performed in other settings. The cost of preparing the reports shall be borne by the clinics that are required to submit them to the Legislature pursuant to this paragraph.
SEC. 2.Section 1218.4 is added to the Health and Safety Code, to read:1218.4.(a)A licensed primary care community or free clinic shall report to the department, when renewing its license, whether it is currently operating an intermittent clinic, the location of any intermittent clinic, and the estimated hours of operation of any intermittent clinic.
(b)For the purposes of this section intermittent clinic means a clinic described in subdivision (h) of Section 1206.
SEC. 3.Section 1.5 of this bill incorporates amendments to Section 1206 of the Health and Safety Code proposed by both this bill and Assembly Bill 941. It shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2016, (2) each bill amends Section 1206 of the Health and Safety Code, and (3) this bill is enacted after Assembly Bill 941, in which case Section 1 of this bill shall not become operative.
SEC. 4.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
This chapter does not apply to the following:
(a)Except with respect to the option provided with regard to surgical clinics in paragraph (1) of subdivision (b) of Section 1204 and, further, with respect to specialty clinics specified in paragraph (2) of subdivision (b) of Section 1204, any place or establishment owned or leased and operated as a clinic or office by one or more licensed health care practitioners and used as an office for the practice of their profession, within the scope of their license, regardless of the name used publicly to identify the place or establishment.
(b)Any clinic directly conducted, maintained, or operated by the United States or by any of its departments, officers, or agencies, and any primary care clinic specified in subdivision (a) of Section 1204 that is directly conducted, maintained, or operated by this state or by any of its political subdivisions or districts, or by any city. Nothing in this subdivision precludes the state department from adopting regulations that utilize clinic licensing standards as eligibility criteria for participation in programs funded wholly or partially under Title XVIII or XIX of the federal Social Security Act.
(c)Any clinic conducted, maintained, or operated by a federally recognized Indian tribe or tribal organization, as defined in Section 450 or 1601 of Title 25 of the United States Code, that is located on land recognized as tribal land by the federal government.
(d)Clinics conducted, operated, or maintained as outpatient departments of hospitals.
(e)Any facility licensed as a health facility under Chapter 2 (commencing with Section 1250).
(f)Any freestanding clinical or pathological laboratory licensed under Chapter 3 (commencing with Section 1200) of Division 2 of the Business and Professions Code.
(g)A clinic operated by, or affiliated with, any institution of learning that teaches a recognized healing art and is approved by the state board or commission vested with responsibility for regulation of the practice of that healing art.
(h)A clinic that is operated by a primary care community or free clinic and that is operated on separate premises from the licensed clinic and is only open for limited services of no more than 30 hours a week. An intermittent clinic as described in this subdivision shall, however, meet all other requirements of law, including administrative regulations and requirements, pertaining to fire and life safety.
(i)The offices of physicians in group practice who provide a preponderance of their services to members of a comprehensive group practice prepayment health care service plan subject to Chapter 2.2 (commencing with Section 1340).
(j)Student health centers operated by public institutions of higher education.
(k)Nonprofit speech and hearing centers, as defined in Section 1201.5. Any nonprofit speech and hearing clinic desiring an exemption under this subdivision shall make application therefor to the director, who shall grant the exemption to any facility meeting the criteria of Section 1201.5. Notwithstanding the licensure exemption contained in this subdivision, a nonprofit speech and hearing center shall be deemed to be an organized outpatient clinic for purposes of qualifying for reimbursement as a rehabilitation center under the Medi-Cal Act (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code).
(l)A clinic operated by 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, that conducts medical research and health education and provides health care to its patients through a group of 40 or more physicians and surgeons, who are independent contractors representing not less than 10 board-certified specialties, and not less than two-thirds of whom practice on a full-time basis at the clinic.
(m)Any clinic, limited to in vivo diagnostic services by magnetic resonance imaging functions or radiological services under the direct and immediate supervision of a physician and surgeon who is licensed to practice in California. This shall not be construed to permit cardiac catheterization or any treatment modality in these clinics.
(n)A clinic operated by an employer or jointly by two or more employers for their employees only, or by a group of employees, or jointly by employees and employers, without profit to the operators thereof or to any other person, for the prevention and treatment of accidental injuries to, and the care of the health of, the employees comprising the group.
(o)A community mental health center, as defined in Section 5667 of the Welfare and Institutions Code.
(p)(1)A clinic operated by 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, as an entity organized and operated exclusively for scientific and charitable purposes and that satisfied all of the following requirements on or before January 1, 2005:
(A)Commenced conducting medical research on or before January 1, 1982, and continues to conduct medical research.
(B)Conducted research in, among other areas, prostatic cancer, cardiovascular disease, electronic neural prosthetic devices, biological effects and medical uses of lasers, and human magnetic resonance imaging and spectroscopy.
(C)Sponsored publication of at least 200 medical research articles in peer-reviewed publications.
(D)Received grants and contracts from the National Institutes of Health.
(E)Held and licensed patents on medical technology.
(F)Received charitable contributions and bequests totaling at least five million dollars ($5,000,000).
(G)Provides health care services to patients only:
(i)In conjunction with research being conducted on procedures or applications not approved or only partially approved for payment (I) under the Medicare program pursuant to Section 1359y(a)(1)(A) of Title 42 of the United States Code, or (II) by a health care service plan registered under Chapter 2.2 (commencing with Section 1340), or a disability insurer regulated under Chapter 1 (commencing with Section 10110) of Part 2 of Division 2 of the Insurance Code; provided that services may be provided by the clinic for an additional period of up to three years following the approvals, but only to the extent necessary to maintain clinical expertise in the procedure or application for purposes of actively providing training in the procedure or application for physicians and surgeons unrelated to the clinic.
(ii)Through physicians and surgeons who, in the aggregate, devote no more than 30 percent of their professional time for the entity operating the clinic, on an annual basis, to direct patient care activities for which charges for professional services are paid.
(H)Makes available to the public the general results of its research activities on at least an annual basis, subject to good faith protection of proprietary rights in its intellectual property.
(I)Is a freestanding clinic, whose operations under this subdivision are not conducted in conjunction with any affiliated or associated health clinic or facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as affiliated only if it directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, a clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as associated only if more than 20 percent of the directors or trustees of the clinic are also the directors or trustees of any individual clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). Any activity by a clinic under this subdivision in connection with an affiliated or associated entity shall fully comply with the requirements of this subdivision. This subparagraph shall not apply to agreements between a clinic and any entity for purposes of coordinating medical research.
(2)By January 1, 2007, and every five years thereafter, the Legislature shall receive a report from each clinic meeting the criteria of this subdivision and any other interested party concerning the operation of the clinics activities. The report shall include, but not be limited to, an evaluation of how the clinic impacted competition in the relevant health care market, and a detailed description of the clinics research results and the level of acceptance by the payer community of the procedures performed at the clinic. The report shall also include a description of procedures performed both in clinics governed by this subdivision and those performed in other settings. The cost of preparing the reports shall be borne by the clinics that are required to submit them to the Legislature pursuant to this paragraph.
SEC. 1.5.Section 1206 of the Health and Safety Code is amended to read:1206.This chapter does not apply to the following:
(a)Except with respect to the option provided with regard to surgical clinics in paragraph (1) of subdivision (b) of Section 1204 and, further, with respect to specialty clinics specified in paragraph (2) of subdivision (b) of Section 1204, any place or establishment owned or leased and operated as a clinic or office by one or more licensed health care practitioners and used as an office for the practice of their profession, within the scope of their license, regardless of the name used publicly to identify the place or establishment.
(b)Any clinic directly conducted, maintained, or operated by the United States or by any of its departments, officers, or agencies, and any primary care clinic specified in subdivision (a) of Section 1204 that is directly conducted, maintained, or operated by this state or by any of its political subdivisions or districts, or by any city. Nothing in this subdivision precludes the state department from adopting regulations that utilize clinic licensing standards as eligibility criteria for participation in programs funded wholly or partially under Title XVIII or XIX of the federal Social Security Act.
(c)(1)Any clinic conducted, maintained, or operated by a federally recognized Indian tribe or tribal organization, as defined in Section 450 or 1601 1603 of Title 25 of the United States Code, that is located on land recognized as tribal land by the federal government.
(2)Any clinic conducted, maintained, or operated by a federally recognized Indian tribe or tribal organization, as defined in Section 450 or 1603 of Title 25 of the United States Code, under a contract with the United States pursuant to the Indian Self-Determination and Education Assistance Act (Public Law 93-638), regardless of the location of the clinic, except that if the clinic chooses to apply to the State Department of Public Health for a state facility license, then the State Department of Public Health will retain authority to regulate that clinic as a primary care clinic as defined by subdivision (a) of Section 1204.
(d)Clinics conducted, operated, or maintained as outpatient departments of hospitals.
(e)Any facility licensed as a health facility under Chapter 2 (commencing with Section 1250).
(f)Any freestanding clinical or pathological laboratory licensed under Chapter 3 (commencing with Section 1200) of Division 2 of the Business and Professions Code.
(g)A clinic operated by, or affiliated with, any institution of learning that teaches a recognized healing art and is approved by the state board or commission vested with responsibility for regulation of the practice of that healing art.
(h)A clinic that is operated by a primary care community or free clinic and that is operated on separate premises from the licensed clinic and is only open for limited services of no more than 20 30 hours a week. An intermittent clinic as described in this subdivision shall, however, meet all other requirements of law, including administrative regulations and requirements, pertaining to fire and life safety.
(i)The offices of physicians in group practice who provide a preponderance of their services to members of a comprehensive group practice prepayment health care service plan subject to Chapter 2.2 (commencing with Section 1340).
(j)Student health centers operated by public institutions of higher education.
(k)Nonprofit speech and hearing centers, as defined in Section 1201.5. Any nonprofit speech and hearing clinic desiring an exemption under this subdivision shall make application therefor to the director, who shall grant the exemption to any facility meeting the criteria of Section 1201.5. Notwithstanding the licensure exemption contained in this subdivision, a nonprofit speech and hearing center shall be deemed to be an organized outpatient clinic for purposes of qualifying for reimbursement as a rehabilitation center under the Medi-Cal Act (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code).
(l)A clinic operated by 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, that conducts medical research and health education and provides health care to its patients through a group of 40 or more physicians and surgeons, who are independent contractors representing not less than 10 board-certified specialties, and not less than two-thirds of whom practice on a full-time basis at the clinic.
(m)Any clinic, limited to in vivo diagnostic services by magnetic resonance imaging functions or radiological services under the direct and immediate supervision of a physician and surgeon who is licensed to practice in California. This shall not be construed to permit cardiac catheterization or any treatment modality in these clinics.
(n)A clinic operated by an employer or jointly by two or more employers for their employees only, or by a group of employees, or jointly by employees and employers, without profit to the operators thereof or to any other person, for the prevention and treatment of accidental injuries to, and the care of the health of, the employees comprising the group.
(o)A community mental health center, as defined in Section 5601.5 5667 of the Welfare and Institutions Code.
(p)(1)A clinic operated by 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, as an entity organized and operated exclusively for scientific and charitable purposes and that satisfied all of the following requirements on or before January 1, 2005:
(A)Commenced conducting medical research on or before January 1, 1982, and continues to conduct medical research.
(B)Conducted research in, among other areas, prostatic cancer, cardiovascular disease, electronic neural prosthetic devices, biological effects and medical uses of lasers, and human magnetic resonance imaging and spectroscopy.
(C)Sponsored publication of at least 200 medical research articles in peer-reviewed publications.
(D)Received grants and contracts from the National Institutes of Health.
(E)Held and licensed patents on medical technology.
(F)Received charitable contributions and bequests totaling at least five million dollars ($5,000,000).
(G)Provides health care services to patients only:
(i)In conjunction with research being conducted on procedures or applications not approved or only partially approved for payment (I) under the Medicare program pursuant to Section 1359y(a)(1)(A) of Title 42 of the United States Code, or (II) by a health care service plan registered under Chapter 2.2 (commencing with Section 1340), or a disability insurer regulated under Chapter 1 (commencing with Section 10110) of Part 2 of Division 2 of the Insurance Code; provided that services may be provided by the clinic for an additional period of up to three years following the approvals, but only to the extent necessary to maintain clinical expertise in the procedure or application for purposes of actively providing training in the procedure or application for physicians and surgeons unrelated to the clinic.
(ii)Through physicians and surgeons who, in the aggregate, devote no more than 30 percent of their professional time for the entity operating the clinic, on an annual basis, to direct patient care activities for which charges for professional services are paid.
(H)Makes available to the public the general results of its research activities on at least an annual basis, subject to good faith protection of proprietary rights in its intellectual property.
(I)Is a freestanding clinic, whose operations under this subdivision are not conducted in conjunction with any affiliated or associated health clinic or facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as affiliated only if it directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, a clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as associated only if more than 20 percent of the directors or trustees of the clinic are also the directors or trustees of any individual clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). Any activity by a clinic under this subdivision in connection with an affiliated or associated entity shall fully comply with the requirements of this subdivision. This subparagraph shall not apply to agreements between a clinic and any entity for purposes of coordinating medical research.
(2)By January 1, 2007, and every five years thereafter, the Legislature shall receive a report from each clinic meeting the criteria of this subdivision and any other interested party concerning the operation of the clinics activities. The report shall include, but not be limited to, an evaluation of how the clinic impacted competition in the relevant health care market, and a detailed description of the clinics research results and the level of acceptance by the payer community of the procedures performed at the clinic. The report shall also include a description of procedures performed both in clinics governed by this subdivision and those performed in other settings. The cost of preparing the reports shall be borne by the clinics that are required to submit them to the Legislature pursuant to this paragraph.
SEC. 2.Section 1218.4 is added to the Health and Safety Code, to read:1218.4.(a)A licensed primary care community or free clinic shall report to the department, when renewing its license, whether it is currently operating an intermittent clinic, the location of any intermittent clinic, and the estimated hours of operation of any intermittent clinic.
(b)For the purposes of this section intermittent clinic means a clinic described in subdivision (h) of Section 1206.
SEC. 3.Section 1.5 of this bill incorporates amendments to Section 1206 of the Health and Safety Code proposed by both this bill and Assembly Bill 941. It shall only become operative if (1) both bills are enacted and become effective on or before January 1, 2016, (2) each bill amends Section 1206 of the Health and Safety Code, and (3) this bill is enacted after Assembly Bill 941, in which case Section 1 of this bill shall not become operative.
SEC. 3.SEC. 4.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
This chapter does not apply to the following:
(a)Except with respect to the option provided with regard to surgical clinics in paragraph (1) of subdivision (b) of Section 1204 and, further, with respect to specialty clinics specified in paragraph (2) of subdivision (b) of Section 1204, any place or establishment owned or leased and operated as a clinic or office by one or more licensed health care practitioners and used as an office for the practice of their profession, within the scope of their license, regardless of the name used publicly to identify the place or establishment.
(b)Any clinic directly conducted, maintained, or operated by the United States or by any of its departments, officers, or agencies, and any primary care clinic specified in subdivision (a) of Section 1204 that is directly conducted, maintained, or operated by this state or by any of its political subdivisions or districts, or by any city. Nothing in this subdivision precludes the state department from adopting regulations that utilize clinic licensing standards as eligibility criteria for participation in programs funded wholly or partially under Title XVIII or XIX of the federal Social Security Act.
(c)Any clinic conducted, maintained, or operated by a federally recognized Indian tribe or tribal organization, as defined in Section 450 or 1601 of Title 25 of the United States Code, that is located on land recognized as tribal land by the federal government.
(d)Clinics conducted, operated, or maintained as outpatient departments of hospitals.
(e)Any facility licensed as a health facility under Chapter 2 (commencing with Section 1250).
(f)Any freestanding clinical or pathological laboratory licensed under Chapter 3 (commencing with Section 1200) of Division 2 of the Business and Professions Code.
(g)A clinic operated by, or affiliated with, any institution of learning that teaches a recognized healing art and is approved by the state board or commission vested with responsibility for regulation of the practice of that healing art.
(h)A clinic that is operated by a primary care community or free clinic and that is operated on separate premises from the licensed clinic and is only open for limited services of no more than 30 hours a week. An intermittent clinic as described in this subdivision shall, however, meet all other requirements of law, including administrative regulations and requirements, pertaining to fire and life safety.
(i)The offices of physicians in group practice who provide a preponderance of their services to members of a comprehensive group practice prepayment health care service plan subject to Chapter 2.2 (commencing with Section 1340).
(j)Student health centers operated by public institutions of higher education.
(k)Nonprofit speech and hearing centers, as defined in Section 1201.5. Any nonprofit speech and hearing clinic desiring an exemption under this subdivision shall make application therefor to the director, who shall grant the exemption to any facility meeting the criteria of Section 1201.5. Notwithstanding the licensure exemption contained in this subdivision, a nonprofit speech and hearing center shall be deemed to be an organized outpatient clinic for purposes of qualifying for reimbursement as a rehabilitation center under the Medi-Cal Act (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code).
(l)A clinic operated by 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, that conducts medical research and health education and provides health care to its patients through a group of 40 or more physicians and surgeons, who are independent contractors representing not less than 10 board-certified specialties, and not less than two-thirds of whom practice on a full-time basis at the clinic.
(m)Any clinic, limited to in vivo diagnostic services by magnetic resonance imaging functions or radiological services under the direct and immediate supervision of a physician and surgeon who is licensed to practice in California. This shall not be construed to permit cardiac catheterization or any treatment modality in these clinics.
(n)A clinic operated by an employer or jointly by two or more employers for their employees only, or by a group of employees, or jointly by employees and employers, without profit to the operators thereof or to any other person, for the prevention and treatment of accidental injuries to, and the care of the health of, the employees comprising the group.
(o)A community mental health center, as defined in Section 5667 of the Welfare and Institutions Code.
(p)(1)A clinic operated by 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, as an entity organized and operated exclusively for scientific and charitable purposes and that satisfied all of the following requirements on or before January 1, 2005:
(A)Commenced conducting medical research on or before January 1, 1982, and continues to conduct medical research.
(B)Conducted research in, among other areas, prostatic cancer, cardiovascular disease, electronic neural prosthetic devices, biological effects and medical uses of lasers, and human magnetic resonance imaging and spectroscopy.
(C)Sponsored publication of at least 200 medical research articles in peer-reviewed publications.
(D)Received grants and contracts from the National Institutes of Health.
(E)Held and licensed patents on medical technology.
(F)Received charitable contributions and bequests totaling at least five million dollars ($5,000,000).
(G)Provides health care services to patients only:
(i)In conjunction with research being conducted on procedures or applications not approved or only partially approved for payment (I) under the Medicare program pursuant to Section 1359y(a)(1)(A) of Title 42 of the United States Code, or (II) by a health care service plan registered under Chapter 2.2 (commencing with Section 1340), or a disability insurer regulated under Chapter 1 (commencing with Section 10110) of Part 2 of Division 2 of the Insurance Code; provided that services may be provided by the clinic for an additional period of up to three years following the approvals, but only to the extent necessary to maintain clinical expertise in the procedure or application for purposes of actively providing training in the procedure or application for physicians and surgeons unrelated to the clinic.
(ii)Through physicians and surgeons who, in the aggregate, devote no more than 30 percent of their professional time for the entity operating the clinic, on an annual basis, to direct patient care activities for which charges for professional services are paid.
(H)Makes available to the public the general results of its research activities on at least an annual basis, subject to good faith protection of proprietary rights in its intellectual property.
(I)Is a freestanding clinic, whose operations under this subdivision are not conducted in conjunction with any affiliated or associated health clinic or facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as affiliated only if it directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, a clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as associated only if more than 20 percent of the directors or trustees of the clinic are also the directors or trustees of any individual clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). Any activity by a clinic under this subdivision in connection with an affiliated or associated entity shall fully comply with the requirements of this subdivision. This subparagraph shall not apply to agreements between a clinic and any entity for purposes of coordinating medical research.
(2)By January 1, 2007, and every five years thereafter, the Legislature shall receive a report from each clinic meeting the criteria of this subdivision and any other interested party concerning the operation of the clinics activities. The report shall include, but not be limited to, an evaluation of how the clinic impacted competition in the relevant health care market, and a detailed description of the clinics research results and the level of acceptance by the payer community of the procedures performed at the clinic. The report shall also include a description of procedures performed both in clinics governed by this subdivision and those performed in other settings. The cost of preparing the reports shall be borne by the clinics that are required to submit them to the Legislature pursuant to this paragraph.
SEC. 2.Section 1218.4 is added to the Health and Safety Code, to read:1218.4.(a)A licensed primary care community or free clinic shall report to the department, when renewing its license, whether it is currently operating an intermittent clinic, the location of any intermittent clinic, and the estimated hours of operation of any intermittent clinic.
(b)For the purposes of this section intermittent clinic means a clinic described in subdivision (h) of Section 1206.
SEC. 3.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
This chapter does not apply to the following:
(a)Except with respect to the option provided with regard to surgical clinics in paragraph (1) of subdivision (b) of Section 1204 and, further, with respect to specialty clinics specified in paragraph (2) of subdivision (b) of Section 1204, any place or establishment owned or leased and operated as a clinic or office by one or more licensed health care practitioners and used as an office for the practice of their profession, within the scope of their license, regardless of the name used publicly to identify the place or establishment.
(b)Any clinic directly conducted, maintained, or operated by the United States or by any of its departments, officers, or agencies, and any primary care clinic specified in subdivision (a) of Section 1204 that is directly conducted, maintained, or operated by this state or by any of its political subdivisions or districts, or by any city. Nothing in this subdivision precludes the state department from adopting regulations that utilize clinic licensing standards as eligibility criteria for participation in programs funded wholly or partially under Title XVIII or XIX of the federal Social Security Act.
(c)Any clinic conducted, maintained, or operated by a federally recognized Indian tribe or tribal organization, as defined in Section 450 or 1601 of Title 25 of the United States Code, that is located on land recognized as tribal land by the federal government.
(d)Clinics conducted, operated, or maintained as outpatient departments of hospitals.
(e)Any facility licensed as a health facility under Chapter 2 (commencing with Section 1250).
(f)Any freestanding clinical or pathological laboratory licensed under Chapter 3 (commencing with Section 1200) of Division 2 of the Business and Professions Code.
(g)A clinic operated by, or affiliated with, any institution of learning that teaches a recognized healing art and is approved by the state board or commission vested with responsibility for regulation of the practice of that healing art.
(h)A clinic that is operated by a primary care community or free clinic and that is operated on separate premises from the licensed clinic and is only open for limited services of no more than 20 30 hours a week. An intermittent clinic as described in this subdivision shall, however, meet all other requirements of law, including administrative regulations and requirements, pertaining to fire and life safety.
(i)The offices of physicians in group practice who provide a preponderance of their services to members of a comprehensive group practice prepayment health care service plan subject to Chapter 2.2 (commencing with Section 1340).
(j)Student health centers operated by public institutions of higher education.
(k)Nonprofit speech and hearing centers, as defined in Section 1201.5. Any nonprofit speech and hearing clinic desiring an exemption under this subdivision shall make application therefor to the director, who shall grant the exemption to any facility meeting the criteria of Section 1201.5. Notwithstanding the licensure exemption contained in this subdivision, a nonprofit speech and hearing center shall be deemed to be an organized outpatient clinic for purposes of qualifying for reimbursement as a rehabilitation center under the Medi-Cal Act (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code).
(l)A clinic operated by 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, that conducts medical research and health education and provides health care to its patients through a group of 40 or more physicians and surgeons, who are independent contractors representing not less than 10 board-certified specialties, and not less than two-thirds of whom practice on a full-time basis at the clinic.
(m)Any clinic, limited to in vivo diagnostic services by magnetic resonance imaging functions or radiological services under the direct and immediate supervision of a physician and surgeon who is licensed to practice in California. This shall not be construed to permit cardiac catheterization or any treatment modality in these clinics.
(n)A clinic operated by an employer or jointly by two or more employers for their employees only, or by a group of employees, or jointly by employees and employers, without profit to the operators thereof or to any other person, for the prevention and treatment of accidental injuries to, and the care of the health of, the employees comprising the group.
(o)A community mental health center, as defined in Section 5601.5 5667 of the Welfare and Institutions Code.
(p)(1)A clinic operated by 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, as an entity organized and operated exclusively for scientific and charitable purposes and that satisfied all of the following requirements on or before January 1, 2005:
(A)Commenced conducting medical research on or before January 1, 1982, and continues to conduct medical research.
(B)Conducted research in, among other areas, prostatic cancer, cardiovascular disease, electronic neural prosthetic devices, biological effects and medical uses of lasers, and human magnetic resonance imaging and spectroscopy.
(C)Sponsored publication of at least 200 medical research articles in peer-reviewed publications.
(D)Received grants and contracts from the National Institutes of Health.
(E)Held and licensed patents on medical technology.
(F)Received charitable contributions and bequests totaling at least five million dollars ($5,000,000).
(G)Provides health care services to patients only:
(i)In conjunction with research being conducted on procedures or applications not approved or only partially approved for payment (I) under the Medicare program pursuant to Section 1359y(a)(1)(A) of Title 42 of the United States Code, or (II) by a health care service plan registered under Chapter 2.2 (commencing with Section 1340), or a disability insurer regulated under Chapter 1 (commencing with Section 10110) of Part 2 of Division 2 of the Insurance Code; provided that services may be provided by the clinic for an additional period of up to three years following the approvals, but only to the extent necessary to maintain clinical expertise in the procedure or application for purposes of actively providing training in the procedure or application for physicians and surgeons unrelated to the clinic.
(ii)Through physicians and surgeons who, in the aggregate, devote no more than 30 percent of their professional time for the entity operating the clinic, on an annual basis, to direct patient care activities for which charges for professional services are paid.
(H)Makes available to the public the general results of its research activities on at least an annual basis, subject to good faith protection of proprietary rights in its intellectual property.
(I)Is a freestanding clinic, whose operations under this subdivision are not conducted in conjunction with any affiliated or associated health clinic or facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as affiliated only if it directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, a clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). For purposes of this subparagraph, a freestanding clinic is defined as associated only if more than 20 percent of the directors or trustees of the clinic are also the directors or trustees of any individual clinic or health facility defined under this division, except a clinic exempt from licensure under subdivision (m). Any activity by a clinic under this subdivision in connection with an affiliated or associated entity shall fully comply with the requirements of this subdivision. This subparagraph shall not apply to agreements between a clinic and any entity for purposes of coordinating medical research.
(2)By January 1, 2007, and every five years thereafter, the Legislature shall receive a report from each clinic meeting the criteria of this subdivision and any other interested party concerning the operation of the clinics activities. The report shall include, but not be limited to, an evaluation of how the clinic impacted competition in the relevant health care market, and a detailed description of the clinics research results and the level of acceptance by the payer community of the procedures performed at the clinic. The report shall also include a description of procedures performed both in clinics governed by this subdivision and those performed in other settings. The cost of preparing the reports shall be borne by the clinics that are required to submit them to the Legislature pursuant to this paragraph.
|
Date
|
Status
|
|---|---|
| Jul 13, 2015 | From committee: Be placed on second reading file pursuant to Senate Rule 28.8. |
| Oct 1, 2015 | Chaptered by Secretary of State - Chapter 412, Statutes of 2015. |
| Oct 1, 2015 | Approved by the Governor. |
| Sep 10, 2015 | Enrolled and presented to the Governor at 4 p.m. |
| Sep 1, 2015 | Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 80. Noes 0.). |
| Sep 1, 2015 | Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 80. Noes 0. Page 2743.). |
| Sep 1, 2015 | Assembly Rule 77 suspended. (Page 2729.) |
| Sep 1, 2015 | Assembly Rule 77 suspended. |
| Aug 31, 2015 | Read third time. Passed. Ordered to the Assembly. (Ayes 40. Noes 0. Page 2306.). |
| Aug 31, 2015 | Read third time. Passed. Ordered to the Assembly. |
| Aug 31, 2015 | In Assembly. Concurrence in Senate amendments pending. May be considered on or after September 2 pursuant to Assembly Rule 77. |
| Aug 27, 2015 | Read second time. Ordered to third reading. |
| Aug 26, 2015 | Read third time and amended. Ordered to second reading. |
| Jul 14, 2015 | Read second time. Ordered to third reading. |
| Feb 27, 2015 | Introduced. To print. |
| Jun 29, 2015 | Read second time and amended. Re-referred to Com. on APPR. |
| Jun 25, 2015 | From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 8. Noes 0.) (June 24). |
| Jun 8, 2015 | In committee: Hearing postponed by committee. |
| May 14, 2015 | Referred to Com. on HEALTH. |
| Apr 30, 2015 | Read third time. Passed. Ordered to the Senate. (Ayes 77. Noes 0. Page 1225.) |
| Apr 30, 2015 | Read third time. Passed. Ordered to the Senate. |
| Apr 30, 2015 | In Senate. Read first time. To Com. on RLS. for assignment. |
| Apr 23, 2015 | Read second time. Ordered to Consent Calendar. |
| Apr 22, 2015 | From committee: Do pass. To Consent Calendar. (Ayes 17. Noes 0.) (April 22). |
| Apr 15, 2015 | From committee: Do pass and re-refer to Com. on APPR. with recommendation: To Consent Calendar. (Ayes 16. Noes 0.) (April 14). Re-referred to Com. on APPR. |
| Mar 19, 2015 | Referred to Com. on HEALTH. |
| Mar 2, 2015 | Read first time. |
| Mar 1, 2015 | From printer. May be heard in committee March 31. |
|
Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| Sep 1, 2015 | AB 1130 GRAY Concurrence in Senate Amendments | Assembly Floor |
Passed |
|
| Aug 31, 2015 | Assembly 3rd Reading AB1130 Gray By Pan | Senate Floor |
Passed |
|
| Jun 24, 2015 | Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations] | Senate Standing Committee on Health |
Passed |
|
| Apr 30, 2015 | AB 1130 GRAY Consent Calendar Second Day Regular Session | Assembly Floor |
Passed |
|
| Apr 22, 2015 | Do pass. To Consent Calendar. | Assembly Standing Committee on Appropriations |
Passed |
|
| Apr 14, 2015 | Do pass and be re-referred to the Committee on [Appropriations] with recommendation: To Consent Calendar | Assembly Standing Committee on Health |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| Alameda Health Consortium | ** Support | Aug 31, 2015 |
| Bienvenidos Community Health Center | ** Support | Aug 31, 2015 |
| California Family Health Council Inc. | ** Support | Aug 31, 2015 |
| California Primary Care Association | ** Support | Aug 31, 2015 |
| California School-Based Health Alliance | ** Support | Aug 31, 2015 |
| Camarena Health | ** Support | Aug 31, 2015 |
| Central Valley Health Network | ** Support | Aug 31, 2015 |
| Chinatown Service Center | ** Support | Aug 31, 2015 |
| Clinica Sierra Vista | ** Support | Aug 31, 2015 |
| Clinicas de Salud del Pueblo, Inc. | ** Support | Aug 31, 2015 |
| Coastal Health Alliance | ** Support | Aug 31, 2015 |
| Community Clinic Association of Los Angeles County | ** Support | Aug 31, 2015 |
| Council of Community Clinics | ** Support | Aug 31, 2015 |
| CPCA | * Support | Jun 24, 2015 |
| Dos Palos Memorial Hospital Skilled Nursing Facility | ** Support | Aug 31, 2015 |
| El Dorado Community Health Centers | ** Support | Aug 31, 2015 |
| Family Healthcare Network | ** Support | Aug 31, 2015 |
| Family Purpose | ** Support | Aug 31, 2015 |
| Golden Valley Health Centers | ** Support | Aug 31, 2015 |
| Harmony Health Medical Clinic and Family Resource Center | ** Support | Aug 31, 2015 |
| Hill Country Community Clinic | ** Support | Aug 31, 2015 |
| Inland Behavioral and Health Services, Inc. | ** Support | Aug 31, 2015 |
| James Morehouse Project | ** Support | Aug 31, 2015 |
| La Clinica de la Raza | ** Support | Aug 31, 2015 |
| La Maestra Community Health Centers | ** Support | Aug 31, 2015 |
| Livingston Community Health | ** Support | Aug 31, 2015 |
| Los Angeles Trust for Children's Health | ** Support | Aug 31, 2015 |
| Northeast Valley Health Corporation | ** Support | Aug 31, 2015 |
| Omni Family Health | ** Support | Aug 31, 2015 |
| People Assisting the Homeless | ** Support | Aug 31, 2015 |
| Petaluma Health Center | ** Support | Aug 31, 2015 |
| Planned Parenthood Affiliates Of California | ** Support | Aug 31, 2015 |
| Santa Rosa Community Health Centers | ** Support | Aug 31, 2015 |
| The Children's Partnership | ** Support | Aug 31, 2015 |
| United Health Centers of the San Joaquin Valley | ** Support | Aug 31, 2015 |
| Venice Family Clinic | ** Support | Aug 31, 2015 |
| Wellspace Health | ** Support | Aug 31, 2015 |
| West County Health Centers | ** Support | Aug 31, 2015 |
AB 1130
Page 2
CONCURRENCE IN SENATE AMENDMENTS
AB 1130
(Gray)
As Amended August 26, 2015
Majority vote
ASSEMBLY: |
77-0 |
(April 30, 2015) |
SENATE: |
40-0 |
(August 31, 2015) |
Original Committee Reference: HEALTH
SUMMARY: Extends the limit on the hours of operation for an intermittent primary care community or free clinic, from 20 hours a week to 30 hours a week.
The Senate amendments require licensed clinics, as part of their biennial license renewal, to report to the Department of Public Health as to whether they are currently operating any intermittent clinics, the location of these clinics, and the estimated hours of operation, and incorporate additional changes to Health and Safety Code Section 1206 proposed by AB 941 (Wood) of the current legislative session, that would become operative if this bill and AB 941 are chaptered and this bill is chaptered last.
FISCAL EFFECT: According to the Senate Appropriations Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS: According to the author, the existing limit on hours of operation for intermittent clinics of a maximum of 20 hours was placed in statute 37 years ago, and based on a typical 40 hour work week. The author states that today, full time healthcare centers are open much longer hours, in some cases seven days a week, and continue to adapt in order to meet the needs of every community. The author notes that given the increase in patient population thanks to the Medi-Cal expansion and the Patient Protection and Affordable Care Act, this bill seeks to increase the hours an intermittent clinic may operate so that they may keep up with the demand for service in all areas of California, but particularly in the most underserved regions.
Community clinics and health centers are nonprofit, tax-exempt clinics that are licensed as community or free clinics, and provide services to patients on a sliding fee scale basis or, in the case of free clinics, at no charge to the patients. These include federally designated community health centers, migrant health centers, rural health centers, and frontier health centers. California is home to nearly 1,000 community clinics serving more than 5.6 million patients (or one in seven Californians) annually through over 17 million patient encounters. More than 50% of these patients are Hispanic and 43% speak a primary language other than English.
The Central Valley Health Network and the California Primary Care Association are the cosponsors of this bill and note that many intermittent clinics are operated on school campuses and address the unique needs of school age children and their families. The sponsors point out that others are operated in short- and long-term shelters designed to help people experiencing homelessness and others are embedded in affordable housing communities. The sponsors conclude that in these situations, the intermittent clinics meet the unique healthcare needs of patients who may not have the ability to access a full time health center.
There is no opposition to this bill.
Analysis Prepared by: Lara Flynn / HEALTH / (916) 319-2097 FN: 0001865
AB 1130
Page 5
|
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 |
THIRD READING
Bill No: AB 1130
Amended: 8/26/15 in Senate
SENATE HEALTH COMMITTEE: 8-0, 6/24/15
AYES: Hernandez, Nguyen, Mitchell, Monning, Nielsen, Pan, Roth, Wolk
NO VOTE RECORDED: Hall
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
ASSEMBLY FLOOR: 77-0, 4/30/15 (Consent) - See last page for vote
SUBJECT: Clinics: licensing: hours of operation
SOURCE: California Primary Care Association
Central Valley Health Network
DIGEST: This bill expands the licensure exemption for intermittent clinics that are operated by licensed clinics on separate premises by permitting these intermittent clinics to be open for up to 30 hours per week, instead of only 20 hours per week.
Senate Floor Amendments of 8/26/15 incorporate provisions from AB 941 (Wood) in order to avoid chaptering-out problems.
Existing law:
Licenses and regulates clinics, including primary care clinics and specialty clinics, by the Department of Public Health (DPH).
Defines a primary care clinic as either a “community clinic,” which is required to be operated by a non-profit corporation and to use a sliding fee scale to charge patients based on their ability to pay, or a “free clinic,” which is also required to be operated by a non-profit but is not allowed to directly charge patients for services rendered or for any drugs, medicines, or apparatuses furnished.
Exempts various types of clinics from licensure and regulation by DPH, including clinics operated by the United States or by a federally recognized Indian tribe on tribal land.
Exempts from licensure by DPH an intermittent clinic that is operated by a licensed primary care community clinic on separate premises from the licensed clinic and is only open for limited services of no more than 20 hours each week. However, an intermittent clinic operated under this exemption is still required to meet all other requirements of law, including administrative regulations and requirements, pertaining to fire and life safety.
This bill:
Expands the licensure exemption for intermittent clinics that are operated by licensed clinics on separate premises by permitting these intermittent clinics to be open for up to 30 hours per week, instead of only 20 hours per week.
Requires licensed primary care clinics to report to DPH, when renewing its license, whether it is currently operating an intermittent clinic, the location of any intermittent clinic, and the estimated hours of operation of any intermittent clinic.
Incorporates provisions from AB 941 (Wood), which pertains to tribal clinics, to avoid chaptering-out conflicts.
Comments
Author’s statement. According to the author, the existing limit of hours of operation for intermittent clinics of a maximum of 20 hours was placed in statute 37 years ago, and based on a typical 40 hour work week. Today, full time healthcare centers are open much longer hours, (in some cases seven days a week) and continue to adapt in order to meet the needs of every community. Given the increase in patient population thanks to the Medi-Cal expansion and the Affordable Care Act, this bill simply increases the hours an intermittent clinic may operate so that they may keep up with the demand for service in all areas of California, but particularly in the most underserved regions.
Intermittent clinics. Under existing law, a licensed primary care clinic is permitted to operate an off-site clinic, for up to 20 hours per week, without obtaining a separate license for these off-site locations. While there are a little more than 1,000 licensed primary care clinics, because no license is required for these off-site locations, DPH does not track the number of intermittent clinics. The sponsors of this bill estimate there are approximately 200 intermittent clinics across the state, ranging from a small one-provider clinic inside a homeless shelter that is open four hours per week, to the larger school-based health centers that may operate up to 20 hours per week. There are no regulations specific to intermittent clinics, and under California statute, these clinics are only required to meet fire and life safety requirements of law, which are established by the State Fire Marshall. As stated by the many supporting organizations, primary care clinics use these satellite locations to offer services in communities that might not otherwise support a full-time licensed clinic, such as school-based health centers, or in rural or underserved communities.
Related Legislation
AB 941 (Wood, 2015) expands a licensure exemption for tribal clinics, which are currently exempted if they are located on tribal land, by exempting tribal clinics regardless of the location of the clinic, if the clinic is operated under a contract with the United States pursuant to the Indian Self-Determination and Education Assistance Act.
Prior Legislation
AB 2787 (Arambula, 2008) was identical to this bill. AB 2787 was held on the Assembly Appropriations Committee suspense file.
FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: Yes
California Primary Care Association (co-source)
Central Valley Health Network (co-source)
Alameda Health Consortium
Bienvenidos Community Health Center
California Family Health Council
California School-Based Health Alliance
Camarena Health
Chinatown Service Center
Clinica Sierra Vista
Clinicas de Salud del Pueblo, Inc.
Coastal Health Alliance
Community Clinic Association of Los Angeles County
Council of Community Clinics
Dos Palos Memorial Hospital Skilled Nursing Facility
El Dorado Community Health Centers
Family HealthCare Network
Family Purpose
Golden Valley Health Centers
Harmony Health Medical Clinic and Family Resource Center
Hill Country Community Clinic
Inland Behavioral and Health Services, Inc.
James Morehouse Project
La Clinica de la Raza
La Maestra Community Health Centers
Livingston Community Health
Los Angeles Trust for Children’s Health
Northeast Valley Health Corporation
Omni Family Health
People Assisting the Homeless
Petaluma Health Center
Planned Parenthood Affiliates of California
Santa Rosa Community Health Centers
The Children’s Partnership
United Health Centers of the San Joaquin Valley
Venice Family Clinic
Wellspace Health
West County Health Centers
OPPOSITION: (Verified 8/27/15)
None received
ARGUMENTS IN SUPPORT: This bill is co-sponsored by the California Primary Care Association (CPCA) and the Central Valley Health Network (CVHN). According to CPCA and CVHN, by increasing the number of operating hours for intermittent clinics, community health centers can meet the growing need for care, especially among special populations that may not have the ability to access care in traditional full time health centers. According to CPCA and CVHN, many intermittent clinics are operated on school campuses and address the unique needs of school age children and their families. Others are operated in short and long-term shelters designed to help people experiencing homelessness, or are embedded in affordable housing communities. The California School-Based Health Alliance states in support that since the introduction of this bill, many school-based health centers have shared that increasing the hours they can provide health care services means greater access to care and increased support for children and their families. Camarena Health states in support that it is currently partnering with the largest school district in Madera County to begin the development of two new school based health center sites that will deliver medical, dental, behavioral health and health education services, and is also partnering with a local grower to establish an on-site clinic that would provide primary care services to agricultural employees during their work day. WellSpace Health states in support that just blocks away from the Capitol there is an intermittent clinic operated in the Salvation Army shelter, and another embedded in an affordable housing community, and that increasing the maximum operating hours will improve a clinic’s ability to get services and resources in the most underserved areas quickly.
ASSEMBLY FLOOR: 77-0, 4/30/15
AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Chang, Chau, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gonzalez, Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams, Wood, Atkins
NO VOTE RECORDED: Campos, Chávez, Gomez
Prepared by: Vince Marchand / HEALTH /
8/27/15 13:49:09
**** END ****
AB 1130
Page 5
|
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 |
THIRD READING
Bill No: AB 1130
Amended: 6/29/15 in Senate
SENATE HEALTH COMMITTEE: 8-0, 6/24/15
AYES: Hernandez, Nguyen, Mitchell, Monning, Nielsen, Pan, Roth, Wolk
NO VOTE RECORDED: Hall
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
ASSEMBLY FLOOR: 77-0, 4/30/15 (Consent) - See last page for vote
SUBJECT: Clinics: licensing: hours of operation
SOURCE: California Primary Care Association
Central Valley Health Network
DIGEST: This bill expands the licensure exemption for intermittent clinics that are operated by licensed clinics on separate premises by permitting these intermittent clinics to be open for up to 30 hours per week, instead of only 20 hours per week.
Existing law:
Licenses and regulates clinics, including primary care clinics and specialty clinics, by the Department of Public Health (DPH).
Defines a primary care clinic as either a “community clinic,” which is required to be operated by a non-profit corporation and to use a sliding fee scale to charge patients based on their ability to pay, or a “free clinic,” which is also required to be operated by a non-profit but is not allowed to directly charge patients for services rendered or for any drugs, medicines, or apparatuses furnished.
Exempts various types of clinics from licensure and regulation by DPH, including clinics operated by the United States or by a federally recognized Indian tribe on tribal land.
Exempts from licensure by DPH an intermittent clinic that is operated by a licensed primary care community clinic on separate premises from the licensed clinic and is only open for limited services of no more than 20 hours each week. However, an intermittent clinic operated under this exemption is still required to meet all other requirements of law, including administrative regulations and requirements, pertaining to fire and life safety.
This bill:
Expands the licensure exemption for intermittent clinics that are operated by licensed clinics on separate premises by permitting these intermittent clinics to be open for up to 30 hours per week, instead of only 20 hours per week.
Requires licensed primary care clinics to report to DPH, when renewing its license, whether it is currently operating an intermittent clinic, the location of any intermittent clinic, and the estimated hours of operation of any intermittent clinic.
Comments
Author’s statement. According to the author, the existing limit of hours of operation for intermittent clinics of a maximum of 20 hours was placed in statute 37 years ago, and based on a typical 40 hour work week. Today, full time healthcare centers are open much longer hours, (in some cases 7 days a week) and continue to adapt in order to meet the needs of every community. Given the increase in patient population thanks to the Medi-Cal expansion and the Affordable Care Act, this bill simply increases the hours an intermittent clinic may operate so that they may keep up with the demand for service in all areas of California, but particularly in the most underserved regions.
Intermittent clinics. Under existing law, a licensed primary care clinic is permitted to operate an off-site clinic, for up to 20 hours per week, without obtaining a separate license for these off-site locations. While there are a little more than 1,000 licensed primary care clinics, because no license is required for these off-site locations, DPH does not track the number of intermittent clinics. The sponsors of this bill estimate there are approximately 200 intermittent clinics across the state, ranging from a small one-provider clinic inside a homeless shelter that is open four hours per week, to the larger school-based health centers that may operate up to 20 hours per week. There are no regulations specific to intermittent clinics, and under California statute, these clinics are only required to meet fire and life safety requirements of law, which are established by the State Fire Marshall. As stated by the many supporting organizations, primary care clinics use these satellite locations to offer services in communities that might not otherwise support a full-time licensed clinic, such as school-based health centers, or in rural or underserved communities.
Related Legislation
AB 941 (Wood, 2015) expands a licensure exemption for tribal clinics, which are currently exempted if they are located on tribal land, by exempting tribal clinics regardless of the location of the clinic, if the clinic is operated under a contract with the United States pursuant to the Indian Self-Determination and Education Assistance Act. AB 941 is currently pending in the Senate Appropriations Committee.
Prior Legislation
AB 2787 (Arambula, 2008) was identical to this bill. AB 2787 was held on the Assembly Appropriations Committee suspense file.
FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: Yes
California Primary Care Association (co-source)
Central Valley Health Network (co-source)
Alameda Health Consortium
Bienvenidos Community Health Center
California Family Health Council
California School-Based Health Alliance
Camarena Health
Chinatown Service Center
Clinica Sierra Vista
Clinicas de Salud del Pueblo, Inc.
Coastal Health Alliance
Community Clinic Association of Los Angeles County
Council of Community Clinics
Dos Palos Memorial Hospital Skilled Nursing Facility
El Dorado Community Health Centers
Family HealthCare Network
Family Purpose
Golden Valley Health Centers
Harmony Health Medical Clinic and Family Resource Center
Hill Country Community Clinic
Inland Behavioral and Health Services, Inc.
James Morehouse Project
La Clinica de la Raza
La Maestra Community Health Centers
Livingston Community Health
Los Angeles Trust for Children’s Health
Northeast Valley Health Corporation
Omni Family Health
People Assisting the Homeless
Petaluma Health Center
Planned Parenthood Affiliates of California
Santa Rosa Community Health Centers
The Children’s Partnership
United Health Centers of the San Joaquin Valley
Venice Family Clinic
Wellspace Health
West County Health Centers
OPPOSITION: (Verified 7/14/15)
None received
ARGUMENTS IN SUPPORT: This bill is co-sponsored by the California Primary Care Association (CPCA) and the Central Valley Health Network (CVHN). According to CPCA and CVHN, by increasing the number of operating hours for intermittent clinics, community health centers can meet the growing need for care, especially among special populations that may not have the ability to access care in traditional full time health centers. According to CPCA and CVHN, many intermittent clinics are operated on school campuses and address the unique needs of school age children and their families. Others are operated in short and long-term shelters designed to help people experiencing homelessness, or are embedded in affordable housing communities. The California School-Based Health Alliance states in support that since the introduction of this bill, many school-based health centers have shared that increasing the hours they can provide health care services means greater access to care and increased support for children and their families. Camarena Health states in support that it is currently partnering with the largest school district in Madera County to begin the development of two new school based health center sites that will deliver medical, dental, behavioral health and health education services, and is also partnering with a local grower to establish an on-site clinic that would provide primary care services to agricultural employees during their work day. WellSpace Health states in support that just blocks away from the Capitol there is an intermittent clinic operated in the Salvation Army shelter, and another embedded in an affordable housing community, and that increasing the maximum operating hours will improve a clinic’s ability to get services and resources in the most underserved areas quickly.
ASSEMBLY FLOOR: 77-0, 4/30/15
AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Chang, Chau, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gonzalez, Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams, Wood, Atkins
NO VOTE RECORDED: Campos, Chávez, Gomez
Prepared by: Vince Marchand / HEALTH /
7/14/15 16:53:49
**** END ****
AB 1130 (Gray) Page 4 of 4
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1130
AUTHOR: |
Gray |
||
VERSION: |
February 27, 2015 |
||
HEARING DATE: |
June 24, 2015 |
|
|
CONSULTANT: |
Vince Marchand |
||
SUBJECT: Clinics: licensing: hours of operation
SUMMARY:
Expands the licensure exemption for intermittent clinics that are operated by licensed clinics on separate premises by permitting these intermittent clinics to be open for up to 30 hours per week, instead of only 20 hours per week.
Existing law:
Licenses and regulates clinics, including primary care clinics and specialty clinics, by the Department of Public Health (DPH)
Defines a primary care clinic as either a “community clinic,” which is required to be operated by a non-profit corporation and to use a sliding fee scale to charge patients based on their ability to pay, or a “free clinic,” which is also required to be operated by a non-profit but is not allowed to directly charge patients for services rendered or for any drugs, medicines, or apparatuses furnished.
Exempts various types of clinics from licensure and regulation by DPH, including clinics operated by the United States or by a federally recognized Indian tribe on tribal land.
Exempts from licensure by DPH an intermittent clinic that is operated by a licensed primary care community clinic on separate premises from the licensed clinic and is only open for limited services of no more than 20 hours each week. However, an intermittent clinic operated under this exemption is still required to meet all other requirements of law, including administrative regulations and requirements, pertaining to fire and life safety.
This bill: Expands the licensure exemption for intermittent clinics that are operated by licensed clinics on separate premises by permitting these intermittent clinics to be open for up to 30 hours per week, instead of only 20 hours per week.
FISCAL EFFECT:
According to the Assembly Appropriations Committee, this bill has negligible state fiscal effect.
PRIOR VOTES:
Assembly Floor: |
77 - 0 |
Assembly Appropriations Committee: |
17 - 0 |
Assembly Health Committee: |
16 - 0 |
COMMENTS:
Author’s statement. According to the author, the existing limit of hours of operation for intermittent clinics of a maximum of 20 hours was placed in statute 37 years ago, and based on a typical 40 hour work week. Today, full time healthcare centers are open much longer hours, (in some cases 7 days a week) and continue to adapt in order to meet the needs of every community. Given the increase in patient population thanks to the Medi-Cal expansion and the Affordable Care Act, this bill simply increases the hours an intermittent clinic may operate so that they may keep up with the demand for service in all areas of California, but particularly in the most underserved regions.
Intermittent clinics. Under existing law, a licensed primary care clinic is permitted to operate an off-site clinic, for up to 20 hours per week, without obtaining a separate license for these off-site locations. While there are a little more than 1,000 licensed primary care clinics, because no license is required for these off-site locations, DPH does not track the number of intermittent clinics. The sponsors of this bill estimate there are approximately 200 intermittent clinics across the state, ranging from a small one-provider clinic inside a homeless shelter that is open 4 hours per week, to the larger school-based health centers that may operate up to 20 hours per week. There are no regulations specific to intermittent clinics, and under California statute, these clinics are only required to meet fire and life safety requirements of law, which are established by the State Fire Marshall. As stated by the many supporting organizations, primary care clinics use these satellite locations to offer services in communities that might not otherwise support a full-time licensed clinic, such as school-based health centers, or in rural or underserved communities.
Related legislation. AB 941 (Wood) expands a licensure exemption for tribal clinics, which are currently exempted if they are located on tribal land, by exempting tribal clinics regardless of the location of the clinic, if the clinic is operated under a contract with the United States pursuant to the Indian Self-Determination and Education Assistance Act. AB 941 is currently pending in this committee.
Prior legislation. AB 2787 (Arambula, 2008), was identical to this bill. AB 2787 was held on the Assembly Appropriations Committee suspense file.
Support. This bill is co-sponsored by the California Primary Care Association (CPCA) and the Central Valley Health Network (CVHN). According to CPCA and CVHN, by increasing the number of operating hours for intermittent clinics, community health centers can meet the growing need for care, especially among special populations that may not have the ability to access care in traditional full time health centers. According to CPCA and CVHN, many intermittent clinics are operated on school campuses and address the unique needs of school age children and their families. Others are operated in short and long-term shelters designed to help people experiencing homelessness, or are embedded in affordable housing communities. The California School-Based Health Alliance states in support that since the introduction of this bill, many school-based health centers have shared that increasing the hours they can provide health care services means greater access to care and increased support for children and their families. Camarena Health states in support that it is currently partnering with the largest school district in Madera County to begin the development of two new school based health center sites that will deliver medical, dental, behavioral health and health education services, and is also partnering with a local grower to establish an on-site clinic that would provide primary care services to agricultural employees during their work day. WellSpace Health states in support that just blocks away from the Capitol there is an intermittent clinic operated in the Salvation Army shelter, and another embedded in an affordable housing community, and that increasing the maximum operating hours will improve a clinic’s ability to get services and resources in the most underserved areas quickly.
Suggested amendment on reporting intermittent clinics. According to the sponsors, based on a survey of their licensed clinic members, there are approximately 200 intermittent clinics. However, according to DPH, while some licensed clinics do report when they open an intermittent clinic, it is inconsistent, and they do not keep track of this information. Committee staff has worked with the author’s office and sponsors on an amendment to require licensed clinics, as part of their biennial license renewal, to report to DPH as to whether they are currently operating any intermittent clinics, the location of these clinics, and the estimated hours of operation.
SUPPORT AND OPPOSITION:
Support: California
Primary Care Association (co-sponsor)
Central Valley Health
Network (co-sponsor)
Alameda Health Consortium
California
Family Health Council
California School-Based Health Alliance
Camarena Health
Chinatown Service Center
Clinica
Sierra Vista
Clinicas de Salud del Pueblo, Inc.
Coastal
Health Alliance
Community Clinic Association of Los Angeles
County
Council of Community Clinics
Dos Palos Memorial Hospital Skilled Nursing Facility
El Dorado Community Health Centers
Family HealthCare Network
Family Purpose
Golden Valley Health
Centers
Harmony Health Medical Clinic and Family Resource
Center
Hill Country Community Clinic
Inland Behavioral and Health Services, Inc.
James Morehouse Project
La Maestra Community Health
Centers
Livingston Community Health
Los Angeles Trust for Children’s Health
People Assisting the Homeless (PATH)
Planned Parenthood Affiliates of
California
Santa Rosa Community Health Centers
The
Children’s Partnership
United Health Centers of the San Joaquin Valley
Venice Family Clinic
Wellspace Health
West County
Health Centers
Oppose: None received
-- END --
AB 1130
Page 1
Date of Hearing: April 22, 2015
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Jimmy Gomez, Chair
AB 1130
(Gray) – As Introduced February 27, 2015
Policy Committee: |
Health |
Vote: |
16 - 0 |
|
|
|
|
|
|
|
|
Urgency: No State Mandated Local Program: No Reimbursable: No
SUMMARY:
This bill increases the limit on the hours of operation for an intermittent primary care community or free clinic, from 20 hours a week to 30 hours.
FISCAL EFFECT:
Negligible state fiscal effect.
COMMENTS:
Purpose. This bill seeks to increase the hours an intermittent clinic may operate so they may keep up with increased demand for service. The author notes demand has increased because of the Medi-Cal expansion and the federal Patient Protection and Affordable Care Act (ACA). This bill is co-sponsored by the Central Valley Health Network and the California Primary Care Association.
Background. Community clinics and health centers are nonprofit, tax-exempt clinics that are licensed as community or free clinics, and provide services to patients on a sliding fee scale basis or, in the case of free clinics, at no charge to the patients. Current law requires clinics to operate under a license from the California Department of Public Health. So-called intermittent clinics can operate under the auspices of a licensed facility without being licensed themselves, as long as they meet certain standards, including service hours that do not exceed 20 hours a week.
Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081
AB 1130
Page 2
Date of Hearing: April 14, 2015
ASSEMBLY COMMITTEE ON HEALTH
Rob Bonta, Chair
AB 1130
(Gray) – As Introduced February 27, 2015
SUBJECT: Clinics: licensing: hours of operation
SUMMARY: Extends the limit on the hours of operation for an intermittent primary care community or free clinic, from 20 hours a week to 30.
EXISTING LAW:
Requires clinics to be licensed by the Department of Public Health (DPH). Provides for exemptions from these licensing requirements for certain types of clinics, including federally operated clinics, local government primary care clinics, clinics affiliated with an institution of higher learning, clinics conducted as outpatient departments of hospitals, and community or free clinics that are operated on separate premises from the licensed clinic and are only open for limited services of no more than 20 hours a week (also known as intermittent clinics).
Requires an intermittent clinic to meet all other requirements of law, including administrative regulations and requirements pertaining to fire and life safety.
Authorizes DPH to take various types of enforcement actions against a primary care clinic that has violated state law or regulation, including imposing fines, sanctions, civil or criminal penalties, and suspension or revocation of the clinic's license.
FISCAL EFFECT: This bill has not been analyzed by a fiscal committee.
COMMENTS:
PURPOSE OF THIS BILL. According to the author, the existing limit on hours of operation for intermittent clinics of a maximum of 20 hours was placed in statute 37 years ago, and based on a typical 40 hour work week. The author states that today, full time healthcare centers are open much longer hours, in some cases seven days a week, and continue to adapt in order to meet the needs of every community. The author notes that given the increase in patient population thanks to the Medi-Cal expansion and the Patient Protection and Affordable Care Act, this bill seeks to increase the hours an intermittent clinic may operate so that they may keep up with the demand for service in all areas of California, but particularly in the most underserved regions.
BACKGROUND. Community clinics and health centers are nonprofit, tax-exempt clinics that are licensed as community or free clinics, and provide services to patients on a sliding fee scale basis or, in the case of free clinics, at no charge to the patients. These include federally designated community health centers, migrant health centers, rural health centers, and frontier health centers.
California is home to nearly 1,000 community clinics serving more than 5.6 million patients (or one in seven Californians) annually through over 17 million patient encounters. More than 50% of these patients are Hispanic and 43% speak a primary language other than English.
SUPPORT. The Central Valley Health Network and the California Primary Care Association are the cosponsors of this bill and, along with numerous other supporters including the Council of Community Clinics, Family Healthcare Network, and People Assisting the Homeless, note that many intermittent clinics are operated on school campuses and address the unique needs of school age children and their families. The supporters point out that others are operated in short- and long-term shelters designed to help people experiencing homelessness and others are embedded in affordable housing communities. The supporters conclude that in these situations, the intermittent clinics meet the unique healthcare needs of patients who may not have the ability to access a full time health center.
The California School-Based Health Alliance also supports this bill and states since its introduction some of their school-based health centers have shared that increasing the hours could help many of them transition into stand-alone community health centers that provide services over 30 hours a week, thereby increasing access to care across California.
PREVIOUS LEGISLATION. SB 1094 (Schiff), Chapter 673, Statutes of 1998, exempts certain nonprofit clinics from licensure requirements on the basis that they are operated primarily for purposes of conducting medical research and are not operated in conjunction with other health care clinics or facilities.
REGISTERED SUPPORT / OPPOSITION:
Support
California Primary Care Association (cosponsor)
Central Valley
Health Network (cosponsor)
California School-Based Health
Alliance
Council of Community Clinics
Family Healthcare
Network
Family Purpose
James Morehouse Project
Livingston
Community Health
People Assisting the Homeless
Planned
Parenthood Affiliates of California
The Children's
Partnership
Venice Family Clinic
Opposition
None on file.
Analysis Prepared by: Lara Flynn / HEALTH / (916) 319-2097
Discussed in Hearing
38SEC
Assembly Floor
2MIN
Senate Floor
3MIN
Senate Standing Committee on Health
Bill Author
Bill Co-Author(s):
