Existing law requires any person, firm, association, partnership, or corporation desiring a license for a clinic or a special permit for special services to file with the State Department of Public Health a verified application on forms prescribed and furnished by the department. A clinic corporation, on behalf of a primary care clinic that has held a valid, unrevoked, and unsuspended license for at least the immediately preceding 5 years, with no demonstrated history of repeated or uncorrected violations of specified provisions that pose immediate jeopardy to a patient, and that has no pending action to suspend or revoke its license, is authorized to file an affiliate clinic application to establish a primary care clinic at an additional site or a mobile health care unit. The department, upon receipt of the completed affiliate clinic application submitted by the clinic corporation, is required to approve a license for the affiliate clinic, without the necessity of first conducting an initial onsite survey, if specified conditions are satisfied.

This bill would require the centralized application unit to publish on the departments Internet Web site current checklists and instructions concerning how to complete an application for a new affiliate clinic license, as well as how to report changes to an existing affiliate primary care clinic. The bill would also delete obsolete provisions.

Existing law requires any person, firm, association, partnership, or corporation desiring a license for a clinic or a special permit for special services to file with the State Department of Public Health a verified application on forms prescribed and furnished by the department. A clinic corporation, on behalf of a primary care clinic that has held a valid, unrevoked, and unsuspended license for at least the immediately preceding 5 years, with no demonstrated history of repeated or uncorrected violations of specified provisions that pose immediate jeopardy to a patient, and that has no pending action to suspend or revoke its license, is authorized to file an affiliate clinic application to establish a primary care clinic at an additional site or a mobile health care unit. The department, upon receipt of the completed affiliate clinic application submitted by the clinic corporation, is required to approve a license for the affiliate clinic, without the necessity of first conducting an initial onsite survey, if specified conditions are satisfied.

This bill would require the centralized application unit to publish on the departments Internet Web site current checklists and instructions concerning how to complete an application for a new affiliate clinic license, as well as how to report changes to an existing affiliate primary care clinic.

ASSEMBLY THIRD READING

ATR Bill Id:AB 1947

Author:(Chiu)

As Amended Ver:April 7, 2016

Majority vote

SUMMARY: Requires the centralized application unit of the Licensing and Certification Division in the California Department of Public Health (DPH) to publish current checklists and instructions on how to complete an application for a new affiliate clinic license, and how to report changes to an existing affiliate clinic, on the DPH Web site.

EXISTING LAW: Allows a clinic corporation on behalf of a primary care clinic that has held a valid, unrevoked, and unsuspended license for at least the immediately preceding five years, with no history of violations, to file an affiliate clinic application to establish a primary care clinic at an additional site, or a mobile health care unit, also known as affiliate clinics.

FISCAL EFFECT: According to the Assembly Appropriations Committee, negligible state fiscal effect.

COMMENTS: According to the author, the licensure process for health facilities can be a complicated and time-intensive process. The author notes, in order to assist organizations that operate multiple primary care clinics, which serve the state's safety net population, get through this process more quickly, the Legislature approved a streamlined, fast-tracked affiliate primary care clinic licensure process that is intended to permit clinics to open and begin serving the public as soon as possible.

The author states this bill simply would require DPH to publish on its website an updated affiliate primary care clinic license application checklist for new clinics, and a uniform checklist explaining what existing licensees must do to report changes for existing affiliate primary care clinics. The author concludes that this bill is aimed at ensuring that California's safety net providers, such as affiliate primary care clinics, are able to efficiently open up and not have to face unnecessary burdens.

In 2015 the Legislature passed, and Governor Brown signed AB 1177 (Gomez), Chapter 704, Statutes of 2015, which prohibits a primary care clinic, notwithstanding current regulations or any other law, from being required to enter into a written transfer agreement with a nearby hospital as a condition of licensure, and requires DPH to repeal the regulation requiring primary care clinics to enter into transfer agreements, no later than July 1, 2016. However, the checklist published on DPH's Web site still indicates the transfer agreement is a required element of the application. According to DPH, the Web site and clinic application checklists are in the process of being updated to reflect the changes, and are anticipated to be completed by the end of April 2016. DPH states that an All Facility Letter was published informing clinics about the law change, and that the regulations will be repealed by July 1, 2016, per the provisions of AB 1177.

Planned Parenthood Affiliates of California (PPAC) is the sponsor of this bill and states that it will significantly improve the licensure process by providing applicants with accurate and current information about the requirements to obtain an affiliate primary care clinic license. PPAC notes that DPH has not updated the affiliate primary license application checklist since 2011, leaving their Web site with potentially misleading and contradictory information.

The California Right to Life Committee opposes this bill, stating they are already very concerned about the health of women who seek services in these facilities due to a previous bill that changed the building code standards and that now women are at double risk with the removal of the requirement for a hospital transfer agreement.

Analysis Prepared by: Lara Flynn / HEALTH / (916) 319-2097 FN: 0002696

Date of Hearing: April 6, 2016

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez, Chair

ABPCA Bill Id:AB 1947

Author:(Chiu) – As Introduced Ver:February 12, 2016

Urgency: No State Mandated Local Program: No Reimbursable: No

SUMMARY:

This bill requires the California Department of Public Health (CDPH) to publish on their web site current checklists and instructions related to the "affiliate clinic" licensure process.

FISCAL EFFECT:

Negligible state fiscal effect. The Licensing and Certification Division of CDPH indicates they are in the process of updating the information.

COMMENTS:

1. Purpose. This bill, sponsored by Planned Parenthood Affiliates of California, is intended to ensure clinics can access current information on the affiliate clinic license process, in order to reduce administrative burden on clinics applying for and maintaining such licenses. Specifically, they indicate currently available information is erroneous and out-of-date.
2. Background. Affiliate clinics are separate clinic sites operated under a single license. Clinics in good standing may establish an additional clinic site or a mobile health care unit as an affiliate clinic in order to streamline licensure of the additional clinic. Existing law stipulates the affiliate clinic application should be a simple form and specifies the additional minimal information that is required. Chapter 704, Statutes of 2015 (AB 1177, Gomez), prohibits a primary care clinic, notwithstanding current regulations or any other law, from being required to enter into a written transfer agreement with a nearby hospital as a condition of licensure, and requires DPH to repeal the regulation requiring primary care clinics to enter into transfer agreements, no later than July 1, 2016. In spite of the new law prohibiting transfer agreements as a requirement of licensure notwithstanding any other law or regulation, CDPH's website currently states they are required for affiliate clinic licensure.
3. Clarifying amendment suggested. Language in the code section being amended by this bill specifies "a copy of the transfer agreement between the new affiliate clinic and a local hospital" is required for an affiliate clinic license, in spite of language passed last year barring such a requirement, as noted above. Since affiliate clinics are licensed under a primary care clinic, for which transfer agreements are expressly not required notwithstanding any other law, the author may wish to consider clarifying HSC 1218.1 to remove 1218.1(b)(11) in order to align it with existing law.

Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081

Date of Hearing: March 29, 2016

ASSEMBLY COMMITTEE ON HEALTH

Jim Wood, Chair

ABPCA Bill Id:AB 1947

Author:(Chiu) – As Introduced Ver:February 12, 2016

SUBJECT: Health facilities: affiliate clinic: licensing.

SUMMARY: Requires the centralized application unit of the Licensing and Certification Division in the California Department of Public Health (DPH) to publish current checklists and instructions on how to complete an application for a new affiliate clinic license, and how to report changes to an existing affiliate clinic, on the DPH Website.

EXISTING LAW:

1. Allows a clinic corporation on behalf of a primary care clinic that has held a valid, unrevoked, and unsuspended license for at least the immediately preceding five years, with no history of violations, to file an affiliate clinic application to establish a primary care clinic at an additional site, or a mobile health care unit, also known as affiliate clinics.
2. Requires DPH, upon receipt of the completed affiliate clinic application, to approve the application without first conducting an initial onsite survey, if all of the following conditions are met:
   1. The clinic corporation that operates the existing licensed primary care clinic (hereafter, the parent clinic) has submitted a completed affiliate clinic applications and the associated application fee;
   2. The parent and affiliate clinics' corporate officers are the same;
   3. The parent ad affiliate clinics are owned and operated by the same nonprofit organization with the same board of directors; and,
   4. The parent and affiliate clinics have the same medical director or directors and medical policies, procedures, protocols, and standards.
3. Requires the affiliate clinic application to consist solely of a simple form and supporting documents which provide the following information:

For a mobile health care unit:

• 1. The name and address of the clinic corporation's administrative office, the name and contact information of the clinic corporation's chief executive officer or executive director;
  2. The name and address of the new affiliate primary care clinic site or the location of the new affiliate mobile health care unit, and the name and contact information of the administrator of the new clinic site or mobile health care unit;
  3. The expected days and hours of operation and the services to be provided at the new affiliate primary care clinic site or mobile health care unit; and,
  4. The type and manufacturer of the new affiliate mobile healthcare unit and the proposed area or areas where the mobile health care unit will be providing services.

For a new affiliate clinic site:

• 1. Evidence of compliance with the minimum construction standards for adequacy and safety of the new affiliate clinics physical plant pursuant to the requirements of the most recent version of the Office of Statewide Health Planning and Development's California Building Code applicable to clinics;
  2. Evidence of fire clearance for the new affiliate clinic site;
  3. A copy of the transfer agreement between the new affiliate clinic and a local hospital; and,
  4. A current list of clinic corporation board members.

1. Requires the affiliate clinic application to be signed by an officer of the clinic corporation's board of directors or the clinic corporation's chief executive officer or executive director.
2. Requires DPH to issue a clinic license within 30 days of receipt of the completed affiliate clinic application. Requires, if DPH determines that an applicant does not meet the requirements of licensure, that DPH identify in writing the grounds for that determination, and to instead process the application within 100 days of the filing of the application.

FISCAL EFFECT: This bill has not been analyzed by a fiscal committee.

COMMENTS:

1. PURPOSE OF THIS BILL. According to the author, the licensure process for health facilities can be a complicated and time-intensive process. The author notes, in order to assist organizations that operate multiple primary care clinics, which serve the state’s safety net population, get through this process more quickly, the Legislature approved a streamlined, fast-tracked affiliate primary care clinic licensure process that is intended to permit clinics to open and begin serving the public as soon as possible.

The author states this bill simply would require DPH to publish on its website an updated affiliate primary care clinic license application checklist for new clinics, and a uniform checklist explaining what existing licensees must do to report changes for existing affiliate primary care clinics. The author concludes that this bill is aimed at ensuring that California’s safety net providers, such as affiliate primary care clinics, are able to efficiently open up and not have to face unnecessary burdens.

1. BACKGROUND. In 2015 the Legislature passed, and Governor Brown signed AB 1177 (Gomez), Chapter 704, Statutes of 2015, which prohibits a primary care clinic, notwithstanding current regulations or any other law, from being required to enter into a written transfer agreement with a nearby hospital as a condition of licensure, and requires DPH to repeal the regulation requiring primary care clinics to enter into transfer agreements, no later than July 1, 2016. However, the checklist published on DPH’s Website still indicates the transfer agreement is a required element of the application. According to DPH the Website and clinic application checklists are in the process of being updated to reflect the changes, and are anticipated to be completed by the end of April 2016. DPH states that an All Facility Letter was published informing clinics about the law change, and that the regulations will be repealed by July 1, 2016, per the provisions of AB 1177.
   
2. SUPPORT. Planned Parenthood Affiliates of California (PPAC) is the sponsor of this bill and states that it will significantly improve the licensure process by providing applicants with accurate and current information about the requirements to obtain an affiliate primary care clinic license. PPAC notes that DPH has not updated the affiliate primary license application checklist since 2011, leaving their Website with potentially misleading and contradictory information.
   
3. OPPOSITION. The California Right to Life Committee opposes this bill, stating they are already very concerned about the health of women who seek services in these facilities due to a previous bill that changed the building code standards and that now women are at double risk with the removal of the requirement for a hospital transfer agreement.
   
4. RELATED LEGISLATION. AB 2053 (Gonzalez) requires DPH, upon written notification by a licensed primary care clinic that they are adding an additional physical plant maintained and operated on separate premises, to issue a single consolidated license to such clinic.
5. PREVIOUS LEGISLATION.
   1. AB 941 (Wood), Chapter 502, Statutes of 2015, expands the exemption from licensure by DPH to certain clinics operated by a federally recognized tribe or tribal organization.
   2. AB 1130 (Gray), Chapter 412, Statutes of 2015, 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; requires 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.
      
   3. AB 1177 prohibits a primary care clinic, notwithstanding current regulations or any other law, from being required to enter into a written transfer agreement with a nearby hospital as a condition of licensure, and requires DPH to repeal the regulation requiring primary care clinics to enter into transfer agreements, no later than July 1, 2016.
      
6. POLICY COMMENT. If DPH completes the required updates on the timeline noted in the background, this bill will not be necessary.
   

REGISTERED SUPPORT / OPPOSITION:

Support

Planned Parenthood Affiliates of California (sponsor)
Planned Parenthood Action Fund of the Pacific Southwest
Planned Parenthood Advocacy Project Los Angeles
Planned Parenthood Advocates Pasadena and San Gabriel Valley
Planned Parenthood Mar Monte
Planned Parenthood Northern California Action Fund
Planned Parenthood of Orange and San Bernardino Counties

Opposition

California Right to Life Committee, Inc.

Analysis Prepared by: Lara Flynn / HEALTH / (916) 319-2097