AB 2673

Bill Subjects

Abstract

The California Hospice Licensure Act of 1990 (act) requires a person, political subdivision of the state, or other governmental agency to obtain a license from the State Department of Public Health to provide hospice services to an individual who is experiencing the last phase of life due to a terminal disease, as defined, and their family, except as provided. The act also provides for the renewal of a license. The act imposes criminal penalties on any person who violates any provision of the act or any rule or regulation promulgated under the act. Existing law prohibits any person, political subdivision of the state, or other governmental agency from establishing, conducting, maintaining, or representing itself as a hospice unless a license has been issued under the act. This bill would additionally prohibit a person or entity described above that is issued a license to establish a hospice, from transferring the license to another person, political subdivision of the state, or other governmental agency within 5 years of issuance. The bill would provide an exception to that prohibition for extenuating circumstances upon a finding that a transfer is necessary to ensure continuity of care for existing patients. Because a violation of this requirement would be a misdemeanor, the bill would impose a state-mandated local program. Existing law requires an applicant for a hospice license to satisfy certain conditions, and to satisfy the definition of a hospice and provide specified services in order to be licensed as a hospice. Existing law authorizes the department to deny an application for licensure, or suspend or revoke any license issued to provide hospice services for various reasons, including, but not limited to, violation by the applicant or licensee of the act or related rules and regulations promulgated by the department. Existing law authorizes the department to conduct a survey of an accredited hospice to ensure that the accreditation requirements are met. This bill would additionally require an applicant who has not previously qualified for a hospice license to, as a condition of licensure, demonstrate and provide evidence of an unmet need of hospice services in the geographic region the hospice would serve. The bill would require the department to review the history of compliance and complaints for an applicant that has previously qualified for a hospice license. The bill would add to the reasons for denial, suspension, or revocation of a license to include, among others, improperly certifying a patient as eligible for hospice care. The bill would require the department to conduct annual surveys of 5% of accredited hospices to ensure that the accreditation requirements are met, using a selective sample basis, and would authorize the department to survey an accredited hospice not included as part of the required surveys. The bill would establish a procedure for a person to request an investigation of an accredited hospice by making an oral or written complaint alleging a violation of the requirements applicable to hospices. The bill would require the department to make a preliminary review and to make an onsite inspection within 10 days after receiving the complaint, except as specified. The bill would require the department to notify the complainant in writing of its determination as a result of the investigation within 10 business days of completing the investigation. Existing law imposes a moratorium on the department issuing a new license to provide hospice services, except as specified. Existing law requires the moratorium to end on the earlier of 365 days from the date that the California State Auditor publishes a report on hospice licensure or on January 1, 2027, when the moratorium provisions are repealed. This bill would require the department, by January 1, 2024, to adopt emergency regulations to implement the recommendations in a specified report of the California State Auditor. The bill would require the department to maintain the general moratorium on new hospice licenses until the department adopts the regulations. The bill would require the regulations, among other things, to establish guidelines for assessing the appropriateness of a hospice agency's ratio of patients to nurses, require hospice management personnel to have hospice-specific training or experience, and to establish requirements for conducting initial licensing site visits, after transfer of a license, and followup visits, as specified. The bill would require the moratorium to end on the earlier of 2 years from the date that the California State Auditor publishes a report on hospice licensure, or the date the emergency regulations are adopted. The bill would exempt licensed hospice facilities, as defined, from the moratorium. Existing constitutional provisions require that a statute that limits the right of access to the meetings of public bodies or the writings of public officials and agencies be adopted with findings demonstrating the interest protected by the limitation and the need for protecting that interest. This bill would make legislative findings to that effect. 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.