Amended in Assembly June 29, 2015

Amended in Senate May 5, 2015

Amended in Senate April 22, 2015

Amended in Senate April 14, 2015

Senate BillNo. 396


Introduced by Senator Hill

February 25, 2015


An act to amend Section 805.5begin delete of, and to add Section 2216.5 to,end deletebegin insert ofend insert the Business and Professions Code, to amend Section 12529.7 of the Government Code, and to amend Sectionsbegin delete 1204,end delete 1248.15, and 1248.35 of the Health and Safety Code, relating to health care.

LEGISLATIVE COUNSEL’S DIGEST

SB 396, as amended, Hill. Health care: outpatient settings and surgical clinics: facilities: licensure and enforcement.

begin delete

Existing law provides for the licensure and regulation of clinics by the State Department of Public Health. A violation of those provisions is a misdemeanor. Existing law provides that certain types of specialty clinics, including surgical clinics, as defined, are eligible for licensure. Existing law excludes from the definition of surgical clinic any place or establishment owned or leased and operated as a clinic or office by one or more physicians or dentists in individual or group practice. Existing law requires a surgical clinic that is licensed or seeking licensure to comply with federal certification standards for an ambulatory surgical clinic until the department adopts regulations relating to the provision of services by a surgical clinic.

end delete
begin delete

This bill would provide that a surgical clinic that has met the federal certification standards and requirements for an ambulatory surgical clinic is eligible for licensure by the department regardless of physician, podiatrist, or dentist ownership. The bill would provide that a surgical clinic is deemed to have met the licensure requirements under the chapter upon presenting documentation that the surgical clinic has met the federal certification requirements for an ambulatory surgical clinic in the 3 years prior to applying for licensure.

end delete

The Medical Practice Act provides for the licensure and regulation of physicians and surgeons by the Medical Board of California. Existing law provides that it is unprofessional conduct for a physician and surgeon to perform procedures in any outpatient setting except in compliance with specified provisions. Existing law prohibits an association, corporation, firm, partnership, or person from operating, managing, conducting, or maintaining an outpatient setting in the state unless the setting is one of the specified settings, whichbegin delete includesend deletebegin insert includeend insert, among others, an ambulatory surgical clinic that is certified to participate in the Medicare program, a surgical clinic licensed by the State Department of Public Health, or an outpatient setting accredited by an accreditation agency approved by the Division of Licensing of the Medical Board of California.

Existing law provides that an outpatient setting that is accredited shall be inspected by the accreditation agency and may be inspected by the Medical Board of California. Existing law requires that the inspections be conducted no less often than once every 3 years by the accreditation agency and as often as necessary by the Medical Board of California to ensure quality of care provided.

begin delete

This bill would require that all subsequent inspections after the initial inspection for accreditation be unannounced. This bill would require an outpatient setting accredited by the division and a facility certified to participate in the federal Medicare program as an ambulatory surgical center to pay certain fees and to comply with certain data submission requirements.

end delete
begin insert

This bill would authorize the accrediting agency to conduct unannounced inspections subsequent to the initial inspection for accreditation, if the accreditation agency provides specified notice of the unannounced routine inspection to the outpatient setting.

end insert

Existing law requires members of the medical staff and other practitioners who are granted clinical privileges in an outpatient setting to be professionally qualified and appropriately credentialed for the performance of privileges granted and requires the outpatient setting to grant privileges in accordance with recommendations from qualified health professionals, and credentialing standards established by the outpatient setting.begin insert A willful violation of these provisions is a crime.end insert

This bill would additionally require that each licensee who performs procedures in an outpatient setting that requires the outpatient setting to be accredited be peer reviewed, as specified, at least every 2 years, by licensees who are qualified by education and experience to perform the same types of, or similar, procedures. The bill would require the findings of the peer review to be reported to thebegin delete accreditingend deletebegin insert governingend insert bodybegin delete whoend deletebegin insert, whichend insert shall determine if the licensee continues to be professionally qualified and appropriately credentialed for the performance of privileges granted. By expanding the scope of a crime, this bill would impose a state-mandated local program.

Existing law requires specified entities, including any health care service plan or medical care foundation, to request a report from the Medical Board of California, the Board of Psychology, the Osteopathic Medical Board of California, or the Dental Board of California, prior to granting or renewing staff privileges, to determine if a certain report has been made indicating that the applying physician and surgeon, psychologist, podiatrist, or dentist has been denied staff privileges, been removed from a medical staff, or had his or her staff privileges restricted.

This bill would also require an outpatient setting and a facility certified to participate in the federal Medicare program as an ambulatory surgical center to request that report. By expanding the scope of a crime, this bill would impose a state-mandated local program.

Existing law establishes a vertical enforcement and prosecution model for cases before the Medical Board of California, and requires the board to report to the Governor and the Legislature on that model by March 1, 2015.

This bill would extend the date that report is due to March 1, 2016.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

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

P4    1

SECTION 1.  

Section 805.5 of the Business and Professions
2Code
is amended to read:

3

805.5.  

(a) Prior to granting or renewing staff privileges for
4any physician and surgeon, psychologist, podiatrist, or dentist, any
5health facility licensed pursuant to Division 2 (commencing with
6Section 1200) of the Health and Safety Code, any health care
7service plan or medical care foundation, the medical staff of the
8institution, a facility certified to participate in the federal Medicare
9program as an ambulatory surgical center, or an outpatient setting
10accredited pursuant to Section 1248.1 of the Health and Safety
11Code shall request a report from the Medical Board of California,
12the Board of Psychology, the Osteopathic Medical Board of
13California, or the Dental Board of California to determine if any
14report has been made pursuant to Section 805 indicating that the
15applying physician and surgeon, psychologist, podiatrist, or dentist
16has been denied staff privileges, been removed from a medical
17staff, or had his or her staff privileges restricted as provided in
18Section 805. The request shall include the name and California
19license number of the physician and surgeon, psychologist,
20podiatrist, or dentist. Furnishing of a copy of the 805 report shall
21not cause the 805 report to be a public record.

22(b) Upon a request made by, or on behalf of, an institution
23described in subdivision (a) or its medical staff the board shall
24furnish a copy of any report made pursuant to Section 805 as well
25as any additional exculpatory or explanatory information submitted
26electronically to the board by the licensee pursuant to subdivision
27(f) of that section. However, the board shall not send a copy of a
28report (1) if the denial, removal, or restriction was imposed solely
29because of the failure to complete medical records, (2) if the board
30has found the information reported is without merit, (3) if a court
31finds, in a final judgment, that the peer review, as defined in
32Section 805, resulting in the report was conducted in bad faith and
33the licensee who is the subject of the report notifies the board of
34that finding, or (4) if a period of three years has elapsed since the
35report was submitted. This three-year period shall be tolled during
36any period the licentiate has obtained a judicial order precluding
37 disclosure of the report, unless the board is finally and permanently
38precluded by judicial order from disclosing the report. If a request
P5    1is received by the board while the board is subject to a judicial
2order limiting or precluding disclosure, the board shall provide a
3disclosure to any qualified requesting party as soon as practicable
4after the judicial order is no longer in force.

5If the board fails to advise the institution within 30 working days
6following its request for a report required by this section, the
7institution may grant or renew staff privileges for the physician
8and surgeon, psychologist, podiatrist, or dentist.

9(c) Any institution described in subdivision (a) or its medical
10staff that violates subdivision (a) is guilty of a misdemeanor and
11shall be punished by a fine of not less than two hundred dollars
12($200) nor more than one thousand two hundred dollars ($1,200).

begin delete
13

SEC. 2.  

Section 2216.5 is added to the Business and Professions
14Code
, to read:

15

2216.5.  

An outpatient setting accredited pursuant to Section
161248.1 of the Health and Safety Code and a facility certified to
17participate in the federal Medicare program as an ambulatory
18surgical center are subject to the requirements of the following
19provisions: Section 1216, subdivision (f) of Section 127280,
20Section 127285, and Section 128737 of the Health and Safety
21Code. Any fees collected pursuant to subdivision (f) of Section
22127280 of the Health and Safety Code shall not exceed the
23reasonable costs incurred by the Office of Statewide Health
24Planning and Development in collecting and managing the data
25reported by the outpatient setting and the facility.

end delete
26

begin deleteSEC. 3.end delete
27begin insertSEC. 2.end insert  

Section 12529.7 of the Government Code is amended
28to read:

29

12529.7.  

By March 1, 2016, the Medical Board of California,
30in consultation with the Department of Justice and the Department
31of Consumer Affairs, shall report and make recommendations to
32the Governor and the Legislature on the vertical enforcement and
33prosecution model created under Section 12529.6.

begin delete
34

SEC. 4.  

Section 1204 of the Health and Safety Code is amended
35to read:

36

1204.  

Clinics eligible for licensure pursuant to this chapter are
37primary care clinics and specialty clinics.

38(a)  (1)  Only the following defined classes of primary care
39clinics shall be eligible for licensure:

P6    1(A)  A “community clinic” means a clinic operated by a
2tax-exempt nonprofit corporation that is supported and maintained
3in whole or in part by donations, bequests, gifts, grants, government
4funds or contributions, that may be in the form of money, goods,
5or services. In a community clinic, any charges to the patient shall
6be based on the patient’s ability to pay, utilizing a sliding fee scale.
7No corporation other than a nonprofit corporation, exempt from
8 federal income taxation under paragraph (3) of subsection (c) of
9Section 501 of the Internal Revenue Code of 1954 as amended, or
10a statutory successor thereof, shall operate a community clinic;
11provided, that the licensee of any community clinic so licensed on
12the effective date of this section shall not be required to obtain
13tax-exempt status under either federal or state law in order to be
14eligible for, or as a condition of, renewal of its license. No natural
15person or persons shall operate a community clinic.

16(B)  A “free clinic” means a clinic operated by a tax-exempt,
17nonprofit corporation supported in whole or in part by voluntary
18donations, bequests, gifts, grants, government funds or
19contributions, that may be in the form of money, goods, or services.
20In a free clinic there shall be no charges directly to the patient for
21services rendered or for drugs, medicines, appliances, or
22apparatuses furnished. No corporation other than a nonprofit
23corporation exempt from federal income taxation under paragraph
24(3) of subsection (c) of Section 501 of the Internal Revenue Code
25of 1954 as amended, or a statutory successor thereof, shall operate
26a free clinic; provided, that the licensee of any free clinic so
27licensed on the effective date of this section shall not be required
28to obtain tax-exempt status under either federal or state law in
29order to be eligible for, or as a condition of, renewal of its license.
30No natural person or persons shall operate a free clinic.

31(2)  Nothing in this subdivision shall prohibit a community
32clinic or a free clinic from providing services to patients whose
33services are reimbursed by third-party payers, or from entering
34into managed care contracts for services provided to private or
35public health plan subscribers, as long as the clinic meets the
36requirements identified in subparagraphs (A) and (B). For purposes
37of this subdivision, any payments made to a community clinic by
38a third-party payer, including, but not limited to, a health care
39service plan, shall not constitute a charge to the patient. This
40paragraph is a clarification of existing law.

P7    1(b)  The following types of specialty clinics shall be eligible for
2licensure as specialty clinics pursuant to this chapter:

3(1)  (A) A “surgical clinic” means a clinic that is not part of a
4hospital and that provides ambulatory surgical care for patients
5who remain less than 24 hours. A surgical clinic does not include
6any place or establishment owned or leased and operated as a clinic
7or office by one or more physicians, podiatrists, or dentists in
8individual or group practice, regardless of the name used publicly
9to identify the place or establishment.

10(B) A physician, podiatrist, or dentist may, at his or her option,
11apply for licensure. A surgical clinic shall be eligible for licensure
12by the department regardless of physician, podiatrist, or dentist
13ownership. A surgical clinic that has met the federal certification
14standards and requirements for an ambulatory surgical clinic, as
15specified in Part 416 of Title 42 of the Code of Federal Regulations,
16shall be eligible for licensure by the department pursuant to this
17chapter.

18(C) Until the department adopts regulations relating to the
19provision of services by a surgical clinic pursuant to Section 1225,
20a surgical clinic is deemed to have met the licensure requirements
21under this chapter upon presenting documentation that the surgical
22clinic has met the federal certification standards for an ambulatory
23surgical clinic in the three years prior to applying for licensure.

24(2)  A “chronic dialysis clinic” means a clinic that provides less
25than 24-hour care for the treatment of patients with end-stage renal
26disease, including renal dialysis services.

27(3)  A “rehabilitation clinic” means a clinic that, in addition to
28providing medical services directly, also provides physical
29rehabilitation services for patients who remain less than 24 hours.
30Rehabilitation clinics shall provide at least two of the following
31rehabilitation services: physical therapy, occupational therapy,
32social, speech pathology, and audiology services. A rehabilitation
33clinic does not include the offices of a private physician in
34individual or group practice.

35(4)  An “alternative birth center” means a clinic that is not part
36of a hospital and that provides comprehensive perinatal services
37and delivery care to pregnant women who remain less than 24
38hours at the facility.

end delete
P8    1

begin deleteSEC. 5.end delete
2begin insertSEC. 3.end insert  

Section 1248.15 of the Health and Safety Code is
3amended to read:

4

1248.15.  

(a) The board shall adopt standards for accreditation
5and, in approving accreditation agencies to perform accreditation
6of outpatient settings, shall ensure that the certification program
7shall, at a minimum, include standards for the following aspects
8of the settings’ operations:

9(1) Outpatient setting allied health staff shall be licensed or
10certified to the extent required by state or federal law.

11(2) (A) Outpatient settings shall have a system for facility safety
12and emergency training requirements.

13(B) There shall be onsite equipment, medication, and trained
14personnel to facilitate handling of services sought or provided and
15to facilitate handling of any medical emergency that may arise in
16connection with services sought or provided.

17(C) In order for procedures to be performed in an outpatient
18setting as defined in Section 1248, the outpatient setting shall do
19one of the following:

20(i) Have a written transfer agreement with a local accredited or
21licensed acute care hospital, approved by the facility’s medical
22staff.

23(ii) Permit surgery only by a licensee who has admitting
24privileges at a local accredited or licensed acute care hospital, with
25the exception that licensees who may be precluded from having
26admitting privileges by their professional classification or other
27administrative limitations, shall have a written transfer agreement
28with licensees who have admitting privileges at local accredited
29or licensed acute care hospitals.

30(iii) Submit for approval by an accrediting agency a detailed
31procedural plan for handling medical emergencies that shall be
32reviewed at the time of accreditation. No reasonable plan shall be
33disapproved by the accrediting agency.

34(D) The outpatient setting shall submit for approval by an
35accreditation agency at the time of accreditation a detailed plan,
36standardized procedures, and protocols to be followed in the event
37of serious complications or side effects from surgery that would
38place a patient at high risk for injury or harm or to govern
39emergency and urgent care situations. The plan shall include, at a
40minimum, that if a patient is being transferred to a local accredited
P9    1or licensed acute care hospital, the outpatient setting shall do all
2of the following:

3(i) Notify the individual designated by the patient to be notified
4in case of an emergency.

5(ii) Ensure that the mode of transfer is consistent with the
6patient’s medical condition.

7(iii) Ensure that all relevant clinical information is documented
8and accompanies the patient at the time of transfer.

9(iv) Continue to provide appropriate care to the patient until the
10transfer is effectuated.

11(E) All physicians and surgeons transferring patients from an
12outpatient setting shall agree to cooperate with the medical staff
13peer review process on the transferred case, the results of which
14shall be referred back to the outpatient setting, if deemed
15appropriate by the medical staff peer review committee. If the
16medical staff of the acute care facility determines that inappropriate
17care was delivered at the outpatient setting, the acute care facility’s
18peer review outcome shall be reported, as appropriate, to the
19accrediting body or in accordance with existing law.

20(3) The outpatient setting shall permit surgery by a dentist acting
21within his or her scope of practice under Chapter 4 (commencing
22with Section 1600) of Division 2 of the Business and Professions
23Code or physician and surgeon, osteopathic physician and surgeon,
24or podiatrist acting within his or her scope of practice under
25Chapter 5 (commencing with Section 2000) of Division 2 of the
26Business and Professions Code or the Osteopathic Initiative Act.
27The outpatient setting may, in its discretion, permit anesthesia
28service by a certified registered nurse anesthetist acting within his
29or her scope of practice under Article 7 (commencing with Section
302825) of Chapter 6 of Division 2 of the Business and Professions
31Code.

32(4) Outpatient settings shall have a system for maintaining
33clinical records.

34(5) Outpatient settings shall have a system for patient care and
35monitoring procedures.

36(6) (A)  Outpatient settings shall have a system for quality
37assessment and improvement.

38(B) (i) Members of the medical staff and other practitioners
39who are granted clinical privileges shall be professionally qualified
40and appropriately credentialed for the performance of privileges
P10   1granted. The outpatient setting shall grant privileges in accordance
2with recommendations from qualified health professionals, and
3credentialing standards established by the outpatient setting.

4(ii) Each licensee who performs procedures in an outpatient
5setting that requires the outpatient setting to be accredited shall
6be, at least every two years, peer reviewed, which shall be a process
7in which the basic qualifications, staff privileges, employment,
8medical outcomes, or professional conduct of a licensee is reviewed
9to make recommendations for quality improvement and education,
10if necessary, including when the outpatient setting has only one
11licensee. The peer review shall be performed by licensees who are
12qualified by education and experience to perform the same types
13of, or similar, procedures. The findings of the peer review shall
14be reported to thebegin delete accreditingend deletebegin insert governingend insert bodybegin delete whoend deletebegin insert, whichend insert shall
15determine if the licensee continues to meet the requirements
16described in clause (i).begin insert The process that resulted in the findings of
17the peer review shall be reviewed by the accrediting agency at the
18next survey to determine if the outpatient setting meets applicable
19accreditation standards pursuant to this section.end insert

20(C) Clinical privileges shall be periodically reappraised by the
21outpatient setting. The scope of procedures performed in the
22outpatient setting shall be periodically reviewed and amended as
23appropriate.

24(7) Outpatient settings regulated by this chapter that have
25multiple service locations shall have all of the sites inspected.

26(8) Outpatient settings shall post the certificate of accreditation
27in a location readily visible to patients and staff.

28(9) Outpatient settings shall post the name and telephone number
29of the accrediting agency with instructions on the submission of
30complaints in a location readily visible to patients and staff.

31(10) Outpatient settings shall have a written discharge criteria.

32(b) Outpatient settings shall have a minimum of two staff
33persons on the premises, one of whom shall either be a licensed
34physician and surgeon or a licensed health care professional with
35current certification in advanced cardiac life support (ACLS), as
36long as a patient is present who has not been discharged from
37supervised care. Transfer to an unlicensed setting of a patient who
38does not meet the discharge criteria adopted pursuant to paragraph
39(10) of subdivision (a) shall constitute unprofessional conduct.

P11   1(c) An accreditation agency may include additional standards
2in its determination to accredit outpatient settings if these are
3approved by the board to protect the public health and safety.

4(d) No accreditation standard adopted or approved by the board,
5and no standard included in any certification program of any
6 accreditation agency approved by the board, shall serve to limit
7the ability of any allied health care practitioner to provide services
8within his or her full scope of practice. Notwithstanding this or
9any other provision of law, each outpatient setting may limit the
10privileges, or determine the privileges, within the appropriate scope
11of practice, that will be afforded to physicians and allied health
12care practitioners who practice at the facility, in accordance with
13credentialing standards established by the outpatient setting in
14compliance with this chapter. Privileges may not be arbitrarily
15restricted based on category of licensure.

16(e) The board shall adopt standards that it deems necessary for
17outpatient settings that offer in vitro fertilization.

18(f) The board may adopt regulations it deems necessary to
19specify procedures that should be performed in an accredited
20outpatient setting for facilities or clinics that are outside the
21definition of outpatient setting as specified in Section 1248.

22(g) As part of the accreditation process, the accrediting agency
23shall conduct a reasonable investigation of the prior history of the
24outpatient setting, including all licensed physicians and surgeons
25who have an ownership interest therein, to determine whether there
26have been any adverse accreditation decisions rendered against
27them. For the purposes of this section, “conducting a reasonable
28investigation” means querying the Medical Board of California
29and the Osteopathic Medical Board of California to ascertain if
30either the outpatient setting has, or, if its owners are licensed
31physicians and surgeons, if those physicians and surgeons have,
32been subject to an adverse accreditation decision.

33

begin deleteSEC. 6.end delete
34begin insertSEC. 4.end insert  

Section 1248.35 of the Health and Safety Code is
35amended to read:

36

1248.35.  

(a) Every outpatient setting that is accredited shall
37be inspected by the accreditation agency and may also be inspected
38by the Medical Board of California. The Medical Board of
39California shall ensure that accreditation agencies inspect outpatient
40settings.

P12   1(b) Unless otherwise specified, the following requirements apply
2to inspections described in subdivision (a).

3(1) The frequency of inspection shall depend upon the type and
4complexity of the outpatient setting to be inspected.

5(2) Inspections shall be conducted no less often than once every
6three years by the accreditation agency and as often as necessary
7by the Medical Board of California to ensure the quality of care
8provided. After the initial inspection for accreditation,begin delete allend delete
9 subsequent inspectionsbegin delete shallend deletebegin insert mayend insert be unannounced.begin insert For
10unannounced routine inspections, the accreditation agency shall
11notify the outpatient setting that the inspection will occur within
1260 days.end insert

13(3) The Medical Board of California or the accreditation agency
14may enter and inspect any outpatient setting that is accredited by
15an accreditation agency at any reasonable time to ensure
16compliance with, or investigate an alleged violation of, any
17standard of the accreditation agency or any provision of this
18chapter.

19(c) If an accreditation agency determines, as a result of its
20inspection, that an outpatient setting is not in compliance with the
21standards under which it was approved, the accreditation agency
22may do any of the following:

23(1) Require correction of any identified deficiencies within a
24set timeframe. Failure to comply shall result in the accrediting
25agency issuing a reprimand or suspending or revoking the
26outpatient setting’s accreditation.

27(2) Issue a reprimand.

28(3) Place the outpatient setting on probation, during which time
29the setting shall successfully institute and complete a plan of
30correction, approved by the board or the accreditation agency, to
31correct the deficiencies.

32(4) Suspend or revoke the outpatient setting’s certification of
33accreditation.

34(d) (1) Except as is otherwise provided in this subdivision,
35before suspending or revoking a certificate of accreditation under
36this chapter, the accreditation agency shall provide the outpatient
37setting with notice of any deficiencies and the outpatient setting
38shall agree with the accreditation agency on a plan of correction
39that shall give the outpatient setting reasonable time to supply
40information demonstrating compliance with the standards of the
P13   1accreditation agency in compliance with this chapter, as well as
2the opportunity for a hearing on the matter upon the request of the
3outpatient setting. During the allotted time to correct the
4deficiencies, the plan of correction, which includes the deficiencies,
5shall be conspicuously posted by the outpatient setting in a location
6accessible to public view. Within 10 days after the adoption of the
7plan of correction, the accrediting agency shall send a list of
8deficiencies and the corrective action to be taken to the board and
9to the California State Board of Pharmacy if an outpatient setting
10is licensed pursuant to Article 14 (commencing with Section 4190)
11of Chapter 9 of Division 2 of the Business and Professions Code.
12The accreditation agency may immediately suspend the certificate
13of accreditation before providing notice and an opportunity to be
14heard, but only when failure to take the action may result in
15imminent danger to the health of an individual. In such cases, the
16accreditation agency shall provide subsequent notice and an
17opportunity to be heard.

18(2) If an outpatient setting does not comply with a corrective
19action within a timeframe specified by the accrediting agency, the
20accrediting agency shall issue a reprimand, and may either place
21the outpatient setting on probation or suspend or revoke the
22accreditation of the outpatient setting, and shall notify the board
23of its action. This section shall not be deemed to prohibit an
24outpatient setting that is unable to correct the deficiencies, as
25specified in the plan of correction, for reasons beyond its control,
26from voluntarily surrendering its accreditation prior to initiation
27of any suspension or revocation proceeding.

28(e) The accreditation agency shall, within 24 hours, report to
29the board if the outpatient setting has been issued a reprimand or
30if the outpatient setting’s certification of accreditation has been
31suspended or revoked or if the outpatient setting has been placed
32on probation. If an outpatient setting has been issued a license by
33the California State Board of Pharmacy pursuant to Article 14
34(commencing with Section 4190) of Chapter 9 of Division 2 of
35the Business and Professions Code, the accreditation agency shall
36also send this report to the California State Board of Pharmacy
37within 24 hours.

38(f) The accreditation agency, upon receipt of a complaint from
39the board that an outpatient setting poses an immediate risk to
40public safety, shall inspect the outpatient setting and report its
P14   1findings of inspection to the board within five business days. If an
2accreditation agency receives any other complaint from the board,
3it shall investigate the outpatient setting and report its findings of
4investigation to the board within 30 days.

5(g) Reports on the results of any inspection shall be kept on file
6with the board and the accreditation agency along with the plan
7of correction and the comments of the outpatient setting. The
8inspection report may include a recommendation for reinspection.
9All final inspection reports, which include the lists of deficiencies,
10plans of correction or requirements for improvements and
11correction, and corrective action completed, shall be public records
12open to public inspection.

13(h) If one accrediting agency denies accreditation, or revokes
14or suspends the accreditation of an outpatient setting, this action
15shall apply to all other accrediting agencies. An outpatient setting
16that is denied accreditation is permitted to reapply for accreditation
17with the same accrediting agency. The outpatient setting also may
18apply for accreditation from another accrediting agency, but only
19if it discloses the full accreditation report of the accrediting agency
20that denied accreditation. Any outpatient setting that has been
21denied accreditation shall disclose the accreditation report to any
22other accrediting agency to which it submits an application. The
23new accrediting agency shall ensure that all deficiencies have been
24corrected and conduct a new onsite inspection consistent with the
25standards specified in this chapter.

26(i) If an outpatient setting’s certification of accreditation has
27been suspended or revoked, or if the accreditation has been denied,
28the accreditation agency shall do all of the following:

29(1) Notify the board of the action.

30(2) Send a notification letter to the outpatient setting of the
31action. The notification letter shall state that the setting is no longer
32allowed to perform procedures that require outpatient setting
33accreditation.

34(3) Require the outpatient setting to remove its accreditation
35certification and to post the notification letter in a conspicuous
36location, accessible to public view.

37(j) The board may take any appropriate action it deems necessary
38pursuant to Section 1248.7 if an outpatient setting’s certification
39of accreditation has been suspended or revoked, or if accreditation
40has been denied.

P15   1

begin deleteSEC. 7.end delete
2begin insertSEC. 5.end insert  

No reimbursement is required by this act pursuant to
3Section 6 of Article XIII B of the California Constitution because
4the only costs that may be incurred by a local agency or school
5district will be incurred because this act creates a new crime or
6infraction, eliminates a crime or infraction, or changes the penalty
7for a crime or infraction, within the meaning of Section 17556 of
8the Government Code, or changes the definition of a crime within
9the meaning of Section 6 of Article XIII B of the California
10Constitution.



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