Section § 1315

Explanation

This law allows dentists and dental hygienists, who are licensed in California, to provide dental services in health facilities. Dentists can provide dental care, while registered dental hygienists can offer dental hygiene services specifically in long-term care facilities. Additionally, these hygienists are allowed to train facility staff on oral health care. However, this law does not interfere with a doctor's ability to perform medical tasks.

(a)CA Health & Safety Code § 1315(a) Dental services, as defined in the Dental Practice Act, may be provided to a patient in a health facility licensed under this chapter. Those services shall be provided by a person licensed by the State of California pursuant to Section 1611 of the Business and Professions Code.
(b)Copy CA Health & Safety Code § 1315(b)
(1)Copy CA Health & Safety Code § 1315(b)(1) Dental hygiene services, as defined in the Dental Practice Act, may be provided to a patient in a long-term health care facility, as defined in Section 1418, that is licensed under this chapter, by a person licensed by the State of California as a registered dental hygienist in alternative practice pursuant to Section 1922 of the Business and Professions Code, practicing in accordance with those provisions.
(2)CA Health & Safety Code § 1315(b)(2) A person licensed as a registered dental hygienist by the State of California pursuant to Section 1917, 1917.1, 1918, or 1922 of the Business and Professions Code, practicing in accordance with those provisions, may provide oral health inservice training to staff in a long-term health care facility licensed under this chapter.
(c)CA Health & Safety Code § 1315(c) This section shall not limit or restrict the right of a licensed physician and surgeon to perform any acts authorized under the Medical Practice Act.

Section § 1316

Explanation

This law ensures that health facilities must allow podiatrists to use their services and have staff privileges without being discriminated against based on their degree, whether it's a medical doctor (M.D.), doctor of osteopathy (D.O.), or doctor of podiatric medicine (D.P.M.). Facilities must give all qualified practitioners full clinical and surgical privileges, and any limitations should be based solely on demonstrated competency.

Health facilities shouldn't discriminate in providing services they already offer, regardless of the practitioner's degree. However, teaching hospitals can require faculty appointments for podiatrists seeking staff privileges.

Any violations of this law by health facilities can lead to legal action initiated by the district attorney upon a complaint.

(a)CA Health & Safety Code § 1316(a)  The rules of a health facility shall include provisions for use of the facility by, and staff privileges for, duly licensed podiatrists within the scope of their respective licensure, subject to rules and regulations governing such use or privileges established by the health facility. Such rules and regulations shall not discriminate on the basis of whether the staff member holds a M. D., D.O., or D.P.M. degree, within the scope of their respective licensure. Each health facility shall establish a staff comprised of physicians and surgeons, podiatrists, or any combination thereof, which shall regulate the admission, conduct suspension, or termination of the staff appointment of the podiatrists while using the facilities. No classification of health facilities by the state department, nor any other classification of health facilities based on quality of service or otherwise, by any person, body, or governmental agency of this state or any subdivision thereof shall be affected by a health facility’s provision for use of its facilities by duly licensed podiatrists, nor shall any such classification be affected by the subjection of the podiatrists, to the rules and regulations of a staff comprising podiatrists, physicians and surgeons, or any combination thereof, which govern the podiatrists’ use of the facilities. No classification of health facilities by any governmental agency of this state or any subdivision thereof pursuant to present law or laws passed hereinafter for the purposes of ascertaining eligibility for compensation, reimbursement, or other benefit for treatment of patients shall be affected by a health facility’s provision for use of its facilities by duly licensed podiatrists, nor shall any such classification be affected by the subjection of the podiatrists and dentists to the rules and regulations of a staff comprising podiatrists, physicians and surgeons, or any combination thereof, which govern the podiatrists’ use of the facilities.
With regard to the practice of podiatry in health facilities throughout this state, medical staff status shall include and provide for the right to pursue and practice full clinical and surgical privileges for holders of M.D., D.O., and D. P.M. degrees within the scope of their respective licensure. Such rights and privileges shall be limited or restricted only upon the basis of an individual practitioner’s demonstrated competence. Such competence shall be determined by health facility rules, regulations, and procedures which are necessary and are applied in good faith, equally and in a nondiscriminatory manner, to all practitioners regardless of whether they hold a M.D., D.O., or D.P.M. degree.
Nothing in this section shall be construed to require a health facility to offer a specific health service or services not otherwise offered. If a health service is offered, the facility shall not discriminate between persons holding M.D. , D.O., or D.P.M. degrees who are authorized by law to perform such services.
This subdivision shall not prohibit a health facility which is a clinical teaching facility owned or operated by a university operating a school of medicine from requiring that a podiatrist have a faculty teaching appointment as a condition for eligibility for staff privileges for that facility.
(b)CA Health & Safety Code § 1316(b)  The rules of a health facility which include provisions for use of the facility by, and staff privileges for, medical staff shall not discriminate on the basis of whether the staff member holds a M.D., D.O., or D.P.M. degree, within the scope of their respective licensure. The health facility staff processing, reviewing, evaluating, and determining qualifications for staff privileges for medical staff shall include, if possible, staff members that hold M.D., D.O., and D.P.M. degrees.
(c)CA Health & Safety Code § 1316(c)  Any violation by a health facility of the provisions of this section may be enjoined in an action brought in the name of the people of the State of California by the district attorney of the county in which the health facility is located, upon receipt of a complaint by an aggrieved physician and surgeon or podiatrist.

Section § 1316.5

Explanation

This section mandates that state-owned health facilities must establish fair rules for granting membership and clinical privileges to clinical psychologists based on their licensure, without discrimination compared to other medical professionals. Health facilities need to ensure psychologists can pursue full clinical privileges as long as they demonstrate competence. The section covers both state and non-state-owned facilities, emphasizing nondiscrimination against psychologists. This law clarifies that facilities are not obliged to offer services beyond their scope but must treat licensed psychologists and other doctors equally if they do. State-owned clinical teaching facilities may require psychologists to have a faculty appointment for staff privileges. It also ensures that psychologists' inclusion won't alter a facility's classification or reimbursement eligibility. A clinical psychologist, as defined here, must have a doctorate in psychology and meet certain experience criteria. The law does not aim to expand psychologists' licensure scope.

(a)Copy CA Health & Safety Code § 1316.5(a)
(1)Copy CA Health & Safety Code § 1316.5(a)(1) Each health facility owned and operated by the state offering care or services within the scope of practice of a psychologist shall establish rules and medical staff bylaws that include provisions for medical staff membership and clinical privileges for clinical psychologists within the scope of their licensure as psychologists, subject to the rules and medical staff bylaws governing medical staff membership or privileges as the facility shall establish. The rules and regulations shall not discriminate on the basis of whether the staff member holds an M.D., D.O., D.D.S., D.P.M., or doctoral degree in psychology within the scope of the member’s respective licensure. Each of these health facilities owned and operated by the state shall establish a staff comprised of physicians and surgeons, dentists, podiatrists, psychologists, or any combination thereof, that shall regulate the admission, conduct, suspension, or termination of the staff appointment of psychologists employed by the health facility.
(2)CA Health & Safety Code § 1316.5(a)(2) With regard to the practice of psychology in health facilities owned and operated by the state offering care or services within the scope of practice of a psychologist, medical staff status shall include and provide for the right to pursue and practice full clinical privileges for holders of a doctoral degree of psychology within the scope of their respective licensure. These rights and privileges shall be limited or restricted only upon the basis of an individual practitioner’s demonstrated competence. Competence shall be determined by health facility rules and medical staff bylaws that are necessary and are applied in good faith, equally and in a nondiscriminatory manner, to all practitioners, regardless of whether they hold an M.D., D.O., D.D.S., D.P.M., or doctoral degree in psychology.
(3)CA Health & Safety Code § 1316.5(a)(3) Nothing in this subdivision shall be construed to require a health facility owned and operated by the state to offer a specific health service or services not otherwise offered. If a health service is offered in such a health facility that includes provisions for medical staff membership and clinical privileges for clinical psychologists, the facility shall not discriminate between persons holding an M.D., D.O., D.D.S., D.P.M., or doctoral degree in psychology who are authorized by law to perform the service within the scope of the person’s respective licensure.
(4)CA Health & Safety Code § 1316.5(a)(4) The rules and medical staff bylaws of a health facility owned and operated by the state that include provisions for medical staff membership and clinical privileges for medical staff and duly licensed clinical psychologists shall not discriminate on the basis of whether the staff member holds an M.D., D.O., D.D.S., D.P.M., or doctoral degree in psychology within the scope of the member’s respective licensure. The health facility staff of these health facilities who process, review, evaluate, and determine qualifications for staff privileges for medical staff shall include, if possible, staff members who are clinical psychologists.
(b)Copy CA Health & Safety Code § 1316.5(b)
(1)Copy CA Health & Safety Code § 1316.5(b)(1) The rules of a health facility not owned or operated by this state may enable the appointment of clinical psychologists on the terms and conditions that the facility shall establish. In these health facilities, clinical psychologists may hold membership and serve on committees of the medical staff and carry professional responsibilities consistent with the scope of their licensure and their competence, subject to the rules of the health facility.
(2)CA Health & Safety Code § 1316.5(b)(2) Nothing in this subdivision shall be construed to require a health facility not owned or operated by this state to offer a specific health service or services not otherwise offered. If a health service is offered by a health facility with both licensed physicians and surgeons and clinical psychologists on the medical staff, which both licensed physicians and surgeons and clinical psychologists are authorized by law to perform, the service may be performed by either, without discrimination.
(3)CA Health & Safety Code § 1316.5(b)(3) This subdivision shall not prohibit a health facility that is a clinical teaching facility owned or operated by a university operating a school of medicine from requiring that a clinical psychologist have a faculty teaching appointment as a condition for eligibility for staff privileges at that facility.
(4)CA Health & Safety Code § 1316.5(b)(4) In any health facility that is not owned or operated by this state that provides staff privileges to clinical psychologists, the health facility staff who process, review, evaluate, and determine qualifications for staff privileges for medical staff shall include, if possible, staff members who are clinical psychologists.
(c)CA Health & Safety Code § 1316.5(c) No classification of health facilities by the department, nor any other classification of health facilities based on quality of service or otherwise, by any person, body, or governmental agency of this state or any subdivision thereof shall be affected by a health facility’s provision for use of its facilities by duly licensed clinical psychologists, nor shall any classification of these facilities be affected by the subjection of the psychologists to the rules and regulations of the organized professional staff. No classification of health facilities by any governmental agency of this state or any subdivision thereof pursuant to any law, whether enacted prior or subsequent to the effective date of this section, for the purposes of ascertaining eligibility for compensation, reimbursement, or other benefit for treatment of patients shall be affected by a health facility’s provision for use of its facilities by duly licensed clinical psychologists, nor shall any classification of these facilities be affected by the subjection of the psychologists to the rules and regulations of the organized professional staff which govern the psychologists’ use of the facilities.
(d)CA Health & Safety Code § 1316.5(d) “Clinical psychologist,” as used in this section, means a psychologist licensed by this state who meets both of the following requirements:
(1)CA Health & Safety Code § 1316.5(d)(1) Possesses an earned doctorate degree in psychology from an educational institution meeting the criteria of subdivision (b) of Section 2914 of the Business and Professions Code.
(2)CA Health & Safety Code § 1316.5(d)(2) Has not less than two years clinical experience in a multidisciplinary facility licensed or operated by this or another state or by the United States to provide health care, or, is listed in the latest edition of the National Register of Health Service Providers in Psychology, as adopted by the Council for the National Register of Health Service Providers in Psychology.
(e)CA Health & Safety Code § 1316.5(e) Nothing in this section is intended to expand the scope of licensure of clinical psychologists. Notwithstanding the Ralph C. Dills Act (Chapter 10.3 (commencing with Section 3512) of Division 4 of Title 1 of the Government Code), the Public Employment Relations Board is precluded from creating any additional bargaining units for the purpose of exclusive representation of state psychologist employees that might result because of medical staff membership and/or privilege changes for psychologists due to the enactment of provisions by Assembly Bill No. 3141 of the 1995–96 Regular Session.

Section § 1316.6

Explanation

In simple terms, this law says that a health facility can reduce or take away a healthcare practitioner's privileges if they break the facility's rules or procedures. This action must be fair, honest, and apply equally to everyone working there.

Notwithstanding any other provision of this chapter, the exercise of privileges in any health facility may be limited, restricted, or revoked for the violation of such health facility’s rules, regulations, or procedures which are applied, in good faith, in a nondiscriminatory manner to all practitioners in such health facility exercising such privileges or entitled to exercise such privileges.

Section § 1316.7

Explanation

This law mandates that adults receiving primary care should be offered tests for hepatitis B and C if covered by their health insurance, with certain exceptions like emergency situations. If the tests are positive, patients must be given follow-up care or referred to other providers for such care.

The tests should be culturally and linguistically appropriate. Providers have no legal consequences if they don't comply with this requirement. 'Follow-up health care' involves medical management and antiviral treatment based on current national guidelines.

(a)CA Health & Safety Code § 1316.7(a) An adult patient who receives primary care services in a facility, clinic, unlicensed clinic, center, office, or other setting where primary care services are provided, shall be offered a hepatitis B screening test and a hepatitis C screening test, to the extent these services are covered under the patient’s health insurance, based on the latest screening indications recommended by the United States Preventive Services Task Force, unless the health care provider reasonably believes that one of the following conditions applies:
(1)CA Health & Safety Code § 1316.7(a)(1) The patient is being treated for a life-threatening emergency.
(2)Copy CA Health & Safety Code § 1316.7(a)(2)
(A)Copy CA Health & Safety Code § 1316.7(a)(2)(A) The patient has previously been offered or has been the subject of a hepatitis B screening test or hepatitis C screening test.
(B)CA Health & Safety Code § 1316.7(a)(2)(A)(B) This paragraph does not apply if the health care provider determines that one or both of the screening tests should be offered again.
(3)CA Health & Safety Code § 1316.7(a)(3) The patient lacks capacity to consent to a hepatitis B screening test or hepatitis C screening test, or both.
(4)CA Health & Safety Code § 1316.7(a)(4) The patient is being treated in the emergency department of a general acute care hospital, as defined in subdivision (a) of Section 1250.
(b)Copy CA Health & Safety Code § 1316.7(b)
(1)Copy CA Health & Safety Code § 1316.7(b)(1) If a patient accepts the offer of the hepatitis B screening test and the test is hepatitis B surface antigen (HBsAg) positive, a health care provider shall offer the patient followup health care or refer the patient to a health care provider who can provide followup health care.
(2)CA Health & Safety Code § 1316.7(b)(2) If a patient accepts the offer of the hepatitis C screening test and the test is positive, the health care provider shall offer the patient followup health care or refer the patient to a health care provider who can provide followup health care. The followup health care shall include a hepatitis C diagnostic test (HCV RNA).
(c)CA Health & Safety Code § 1316.7(c) The offering of a hepatitis B screening test and hepatitis C screening test under this section shall be culturally and linguistically appropriate.
(d)CA Health & Safety Code § 1316.7(d) This section shall not affect the scope of practice of any health care provider or diminish any authority or legal or professional obligation of any health care provider to offer a hepatitis B screening test, hepatitis C screening test, or both, or a hepatitis C diagnostic test, or to provide services or care for the patient of a hepatitis B screening test, hepatitis C screening test, or both, or a hepatitis C diagnostic test.
(e)CA Health & Safety Code § 1316.7(e) A health care provider that fails to comply with the requirements of this section shall not be subject to any disciplinary actions related to their licensure or certification, or to any civil or criminal liability, because of the health care provider’s failure to comply with the requirements of this section.
(f)CA Health & Safety Code § 1316.7(f) For purposes of this section, the following definitions apply:
(1)CA Health & Safety Code § 1316.7(f)(1) “Followup health care” includes providing medical management and antiviral treatment for chronic hepatitis B or hepatitis C according to the latest national clinical practice guidelines recommended by the American Association for the Study of Liver Diseases.
(2)CA Health & Safety Code § 1316.7(f)(2) “Hepatitis B screening test” includes any laboratory tests or tests that detect the presence of hepatitis B surface antigen (HBsAg) and provides confirmation of whether the patient has a chronic hepatitis B infection.
(3)CA Health & Safety Code § 1316.7(f)(3) “Hepatitis C diagnostic test” includes any laboratory test or tests that detect the presence of the hepatitis C virus in the blood and provides confirmation of whether the patient has an active hepatitis C virus infection.
(4)CA Health & Safety Code § 1316.7(f)(4) “Hepatitis C screening test” includes any laboratory screening test or tests that detect the presence of hepatitis C virus antibodies in the blood and provides confirmation of whether the patient has ever been infected with the hepatitis C virus.

Section § 1317

Explanation

Health facilities with emergency departments must provide necessary emergency care to anyone in life-threatening situations without discrimination based on personal characteristics like ethnicity or insurance status. Care should be given regardless of the patient's ability to pay, and financial arrangements can be made afterward. If a facility can't provide the needed care due to lack of resources, it must help direct the person to a suitable location.

Health professionals and facilities are not liable if they, using reasonable judgment, decide that no emergency condition exists or that appropriate services are not available. Likewise, rescue teams acting in good faith while resuscitating patients aren't held liable for their actions.

Hospitals can't require individuals to be held under specific legal custody for a transfer if they voluntarily seek care. A rescue team is a specially trained group designated to perform resuscitation in emergencies. Health facilities still have responsibilities, like training rescue teams and maintaining proper equipment.

(a)CA Health & Safety Code § 1317(a) Emergency services and care shall be provided to any person requesting the services or care, or for whom services or care is requested, for any condition in which the person is in danger of loss of life, or serious injury or illness, at any health facility licensed under this chapter that maintains and operates an emergency department to provide emergency services to the public when the health facility has appropriate facilities and qualified personnel available to provide the services or care.
(b)CA Health & Safety Code § 1317(b) In no event shall the provision of emergency services and care be based upon, or affected by, the person’s ethnicity, citizenship, age, preexisting medical condition, insurance status, economic status, ability to pay for medical services, or any other characteristic listed or defined in subdivision (b) or (e) of Section 51 of the Civil Code, except to the extent that a circumstance such as age, sex, preexisting medical condition, or physical or mental disability is medically significant to the provision of appropriate medical care to the patient.
(c)CA Health & Safety Code § 1317(c) Neither the health facility, its employees, nor any physician and surgeon, dentist, clinical psychologist, or podiatrist shall be liable in any action arising out of a refusal to render emergency services or care if the refusal is based on the determination, exercising reasonable care, that the person is not suffering from an emergency medical condition, or that the health facility does not have the appropriate facilities or qualified personnel available to render those services.
(d)CA Health & Safety Code § 1317(d) Emergency services and care shall be rendered without first questioning the patient or any other person as to his or her ability to pay therefor. However, the patient or his or her legally responsible relative or guardian shall execute an agreement to pay therefor or otherwise supply insurance or credit information promptly after the services are rendered.
(e)CA Health & Safety Code § 1317(e) If a health facility subject to this chapter does not maintain an emergency department, its employees shall nevertheless exercise reasonable care to determine whether an emergency exists and shall direct the persons seeking emergency care to a nearby facility that can render the needed services, and shall assist the persons seeking emergency care in obtaining the services, including transportation services, in every way reasonable under the circumstances.
(f)CA Health & Safety Code § 1317(f) A general acute care hospital or acute psychiatric hospital shall not require a person who voluntarily seeks care to be in custody pursuant to Section 5150 of the Welfare and Institutions Code as a condition of accepting a transfer of that person after his or her written consent for treatment and transfer is documented or in the absence of evidence of probable cause for detention, as defined in Section 5150.05 of the Welfare and Institutions Code.
(g)CA Health & Safety Code § 1317(g) An act or omission of a rescue team established by a health facility licensed under this chapter, or operated by the federal or state government, a county, or by the Regents of the University of California, done or omitted while attempting to resuscitate a person who is in immediate danger of loss of life shall not impose any liability upon the health facility, the officers, members of the staff, nurses, or employees of the health facility, including, but not limited to, the members of the rescue team, or upon the federal or state government or a county, if good faith is exercised.
(h)CA Health & Safety Code § 1317(h) “Rescue team,” as used in this section, means a special group of physicians and surgeons, nurses, and employees of a health facility who have been trained in cardiopulmonary resuscitation and have been designated by the health facility to attempt, in cases of emergency, to resuscitate persons who are in immediate danger of loss of life.
(i)CA Health & Safety Code § 1317(i) This section does not relieve a health facility of any duty otherwise imposed by law upon the health facility for the designation and training of members of a rescue team or for the provision or maintenance of equipment to be used by a rescue team.

Section § 1317.1

Explanation

This section outlines definitions that help clarify certain medical and emergency services terms used in related laws. "Emergency services and care" includes medical evaluation by doctors or licensed individuals to see if a patient is in an emergency medical situation or active labor, and to provide necessary care. Additionally, it defines psychiatric emergency conditions and the scenarios where they may require admission or transfer to specific psychiatric facilities. The section includes definitions for key terms like "emergency medical condition," "active labor," "hospital," and "medical hazard," among others. Special provisions are made to ensure that these definitions align with other laws, such as the Lanterman-Petris-Short Act and the federal Emergency Medical Treatment and Labor Act, and they clarify that the definitions do not alter the scope of practice for medical personnel.

Unless the context otherwise requires, the following definitions shall control the construction of this article and Section 1371.4:
(a)Copy CA Health & Safety Code § 1317.1(a)
(1)Copy CA Health & Safety Code § 1317.1(a)(1) “Emergency services and care” means medical screening, examination, and evaluation by a physician and surgeon, or, to the extent permitted by applicable law, by other appropriate licensed persons under the supervision of a physician and surgeon, to determine if an emergency medical condition or active labor exists and, if it does, the care, treatment, and surgery, if within the scope of that person’s license, necessary to relieve or eliminate the emergency medical condition, within the capability of the facility.
(2)Copy CA Health & Safety Code § 1317.1(a)(2)
(A)Copy CA Health & Safety Code § 1317.1(a)(2)(A) “Emergency services and care” also means an additional screening, examination, and evaluation by a physician, or other personnel to the extent permitted by applicable law and within the scope of their licensure and clinical privileges, to determine if a psychiatric emergency medical condition exists, and the care and treatment necessary to relieve or eliminate the psychiatric emergency medical condition, within the capability of the facility.
(B)CA Health & Safety Code § 1317.1(a)(2)(A)(B) The care and treatment necessary to relieve or eliminate a psychiatric emergency medical condition may include admission or transfer to a psychiatric unit within a general acute care hospital, as defined in subdivision (a) of Section 1250, or to an acute psychiatric hospital, as defined in subdivision (b) of Section 1250, pursuant to subdivision (k). This subparagraph does not permit a transfer that is in conflict with the Lanterman-Petris-Short Act (Part 1 (commencing with Section 5000) of Division 5 of the Welfare and Institutions Code), or the federal Emergency Medical Treatment and Labor Act (Section 1395dd of Title 42 of the United States Code).
(C)CA Health & Safety Code § 1317.1(a)(2)(A)(C) For the purposes of Section 1371.4, emergency services and care as defined in subparagraph (A) shall not apply to Medi-Cal managed care plan contracts entered into with the State Department of Health Care Services pursuant to Chapter 7 (commencing with Section 14000), Chapter 8 (commencing with Section 14200), and Chapter 8.75 (commencing with Section 14591) of Part 3 of Division 9 of the Welfare and Institutions Code, to the extent that those services are excluded from coverage under those contracts.
(D)CA Health & Safety Code § 1317.1(a)(2)(A)(D) This paragraph does not expand, restrict, or otherwise affect the scope of licensure or clinical privileges for clinical psychologists or other medical personnel.
(b)CA Health & Safety Code § 1317.1(b) “Emergency medical condition” means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in any of the following:
(1)CA Health & Safety Code § 1317.1(b)(1) Placing the patient’s health in serious jeopardy.
(2)CA Health & Safety Code § 1317.1(b)(2) Serious impairment to bodily functions.
(3)CA Health & Safety Code § 1317.1(b)(3) Serious dysfunction of any bodily organ or part.
(c)CA Health & Safety Code § 1317.1(c) “Active labor” means a labor at a time at which either of the following would occur:
(1)CA Health & Safety Code § 1317.1(c)(1) There is inadequate time to effect safe transfer to another hospital prior to delivery.
(2)CA Health & Safety Code § 1317.1(c)(2) A transfer may pose a threat to the health and safety of the patient or the fetus.
(d)CA Health & Safety Code § 1317.1(d) “Hospital” means all hospitals with an emergency department licensed by the state department.
(e)CA Health & Safety Code § 1317.1(e) “State department” means the State Department of Public Health.
(f)CA Health & Safety Code § 1317.1(f) “Medical hazard” means a material deterioration in medical condition in, or jeopardy to, a patient’s medical condition or expected chances for recovery.
(g)CA Health & Safety Code § 1317.1(g) “Board” means the Medical Board of California.
(h)CA Health & Safety Code § 1317.1(h) “Within the capability of the facility” means those capabilities that the hospital is required to have as a condition of its emergency medical services permit and services specified on Services Inventory Form 7041 filed by the hospital with the Department of Health Care Access and Information.
(i)CA Health & Safety Code § 1317.1(i) “Consultation” means the rendering of an opinion or advice, prescribing treatment, or the rendering of a decision regarding hospitalization or transfer by telephone or other means of communication. When determined to be medically necessary, jointly by the treating physician and surgeon, or by other appropriate licensed persons acting within their scope of licensure, under the supervision of a physician and surgeon, and the consulting physician and surgeon, “consultation” includes review of the patient’s medical record, examination, and treatment of the patient in person by a consulting physician and surgeon, or by other appropriate licensed persons acting within their scope of licensure under the supervision of a consulting physician and surgeon, who is qualified to give an opinion or render the necessary treatment in order to stabilize the patient. A request for consultation shall be made by the treating physician and surgeon, or by other appropriate licensed persons acting within their scope of licensure under the supervision of a treating physician and surgeon, provided the request is made with the contemporaneous approval of the treating physician and surgeon. The treating physician and surgeon may request to communicate directly with the consulting physician and surgeon, and when determined to be medically necessary, jointly by the treating physician and surgeon and the consulting physician and surgeon, the consulting physician and surgeon shall examine and treat the patient in person. The consulting physician and surgeon is ultimately responsible for providing the necessary consultation to the patient, regardless of who makes the in-person appearance.
(j)CA Health & Safety Code § 1317.1(j) A patient is “stabilized” or “stabilization” has occurred when, in the opinion of the treating physician and surgeon, or other appropriate licensed persons acting within their scope of licensure under the supervision of a treating physician and surgeon, the patient’s medical condition is such that, within reasonable medical probability, no material deterioration of the patient’s condition is likely to result from, or occur during, the release or transfer of the patient as provided for in Section 1317.2, Section 1317.2a, or other pertinent statute.
(k)Copy CA Health & Safety Code § 1317.1(k)
(1)Copy CA Health & Safety Code § 1317.1(k)(1) “Psychiatric emergency medical condition” means a mental health disorder that manifests itself by acute symptoms of sufficient severity that it renders the patient as being either of the following, regardless of whether the patient is voluntary or involuntarily detained for assessment, evaluation, and crisis intervention, or placement for evaluation and treatment pursuant to the Lanterman-Petris-Short Act (Part 1 (commencing with Section 5000) of Division 5 of the Welfare and Institutions Code):
(A)CA Health & Safety Code § 1317.1(k)(1)(A) An immediate danger to themselves or to others.
(B)CA Health & Safety Code § 1317.1(k)(1)(B) Immediately unable to provide for, or utilize, food, shelter, or clothing, due to the mental health disorder.
(2)CA Health & Safety Code § 1317.1(k)(2) This subdivision does not expand, restrict, or otherwise affect the scope of licensure or clinical privileges for clinical psychologists or medical personnel.
(l)CA Health & Safety Code § 1317.1(l) This section does not expand the scope of licensure for licensed persons providing services pursuant to this section.
(m)CA Health & Safety Code § 1317.1(m) This section does not require a transfer or admission that is in conflict with the Lanterman-Petris-Short Act (Part 1 (commencing with Section 5000) of Division 5 of the Welfare and Institutions Code) or with the requirements of the federal Emergency Medical Treatment and Labor Act (42 U.S.C. Sec. 1395dd).

Section § 1317.2

Explanation

This law states that a person needing emergency medical care cannot be transferred from one hospital to another for nonmedical reasons, like inability to pay, unless specific conditions are met. Firstly, a doctor must evaluate the patient before the transfer. The transferring hospital must ensure the transfer won't pose a medical risk. It also needs consent from a physician at the receiving hospital, confirming they have the required facilities and staff to treat the patient. All relevant medical records must be sent with the patient, including a detailed 'Transfer Summary' signed by the transferring doctor. The transfer must follow state regulations and the patient should be asked about a preferred contact for notification. If that's not possible, the hospital should try to notify next of kin. This law doesn't apply to transfers made for medical reasons or when the patient requests and consents to the transfer.

A person needing emergency services and care shall not be transferred from a hospital to another hospital for any nonmedical reason (such as the person’s inability to pay for any emergency service or care) unless each of the following conditions are met:
(a)CA Health & Safety Code § 1317.2(a)  The person is examined and evaluated by a physician and surgeon, including, if necessary, consultation, prior to transfer.
(b)CA Health & Safety Code § 1317.2(b)  The person has been provided with emergency services and care so that it can be determined, within reasonable medical probability, that the transfer or delay caused by the transfer will not create a medical hazard to the person.
(c)CA Health & Safety Code § 1317.2(c)  A physician and surgeon at the transferring hospital has notified and has obtained the consent to the transfer by a physician and surgeon at the receiving hospital and confirmation by the receiving hospital that the person meets the hospital’s admissions criteria relating to appropriate bed, personnel, and equipment necessary to treat the person.
(d)CA Health & Safety Code § 1317.2(d)  The transferring hospital provides for appropriate personnel and equipment that a reasonable and prudent physician and surgeon in the same or similar locality exercising ordinary care would use to effect the transfer.
(e)CA Health & Safety Code § 1317.2(e)  All of the person’s pertinent medical records and copies of all the appropriate diagnostic test results that are reasonably available are transferred with the person.
(f)CA Health & Safety Code § 1317.2(f)  The records transferred with the person include a “Transfer Summary” signed by the transferring physician and surgeon that contains relevant transfer information. The form of the “Transfer Summary” shall, at a minimum, contain the person’s name, address, sex, race, age, insurance status, and medical condition; the name and address of the transferring physician and surgeon or emergency department personnel authorizing the transfer; the time and date the person was first presented at the transferring hospital; the name of the physician and surgeon at the receiving hospital consenting to the transfer and the time and date of the consent; the time and date of the transfer; the reason for the transfer; and the declaration of the signor that the signor is assured, within reasonable medical probability, that the transfer creates no medical hazard to the patient. Neither the transferring physician and surgeon nor transferring hospital shall be required to duplicate, in the “Transfer Summary,” information contained in medical records transferred with the person.
(g)CA Health & Safety Code § 1317.2(g)  The transfer conforms with regulations established by the state department. These regulations may prescribe minimum protocols for patient transfers.
(h)CA Health & Safety Code § 1317.2(h) The patient shall be asked if there is a preferred contact person to be notified and, prior to the transfer, the hospital shall make a reasonable attempt to contact that person and alert him or her about the proposed transfer, in accordance with subdivision (b) of Section 56.1007 of the Civil Code. If the patient is not able to respond, the hospital shall make a reasonable effort to ascertain the identity of the preferred contact person or the next of kin and alert him or her about the transfer, in accordance with subdivision (b) of Section 56.1007 of the Civil Code. The hospital shall document in the patient’s medical record any attempts to contact a preferred contact person or next of kin.
(i)CA Health & Safety Code § 1317.2(i) This section shall not apply to a transfer of a patient for medical reasons.
(j)CA Health & Safety Code § 1317.2(j) This section shall not prohibit the transfer or discharge of a patient when the patient or the patient’s representative requests a transfer or discharge and gives informed consent to the transfer or discharge against medical advice.

Section § 1317.2

Explanation

This law section details the responsibilities of hospitals with legal or contractual obligations to provide care for patients, specifically relating to patient transfers. Hospitals must accept patients if they're legally obligated to, unless it creates a medical hazard or they're unable to accept due to lack of resources, in which case they must arrange alternative care. County hospitals have specific rules regarding accepting patients eligible under welfare laws but can manage resources wisely. Third-party payors, like insurers, are responsible for covering the costs according to their obligations, except when patients have to pay for unmet services or deductibles. A hospital failing to provide care as required may have to cover another facility's expenses for the care they should have delivered. Certain provisions don't apply to county obligations under welfare laws, and hospitals aren't required to arrange care for patients they aren't legally obligated to help.

(a)CA Health & Safety Code § 1317.2(a) A hospital that has a legal obligation, whether imposed by statute or by contract, to the extent of that contractual obligation, to any third-party payor, including, but not limited to, a health maintenance organization, health care service plan, nonprofit hospital service plan, insurer, or preferred provider organization, a county, or an employer to provide care for a patient under the circumstances specified in Section 1317.2 shall receive that patient to the extent required by the applicable statute or by the terms of the contract, or, when the hospital is unable to accept a patient for whom it has a legal obligation to provide care whose transfer will not create a medical hazard as specified in Section 1317.2, it shall make appropriate arrangements for the patient’s care.
(b)CA Health & Safety Code § 1317.2(b) A county hospital shall accept a patient whose transfer will not create a medical hazard as specified in Section 1317.2 and who is determined by the county to be eligible to receive health care services required under Part 5 (commencing with Section 17000) of Division 9 of the Welfare and Institutions Code, unless the hospital does not have appropriate bed capacity, medical personnel, or equipment required to provide care to the patient in accordance with accepted medical practice. When a county hospital is unable to accept a patient whose transfer will not create a medical hazard as specified in Section 1317.2, it shall make appropriate arrangements for the patient’s care. The obligation to make appropriate arrangements as set forth in this subdivision does not mandate a level of service or payment, modify the county’s obligations under Part 5 (commencing with Section 17000) of Division 9 of the Welfare and Institutions Code, create a cause of action, or limit a county’s flexibility to manage county health systems within available resources. However, the county’s flexibility shall not diminish a county’s responsibilities under Part 5 (commencing with Section 17000) of Division 9 of the Welfare and Institutions Code or the requirements contained in Chapter 2.5 (commencing with Section 1440).
(c)CA Health & Safety Code § 1317.2(c) The receiving hospital shall provide personnel and equipment reasonably required in the exercise of good medical practice for the care of the transferred patient.
(d)CA Health & Safety Code § 1317.2(d) Any third-party payor, including, but not limited to, a health maintenance organization, health care service plan, nonprofit hospital service plan, insurer, or preferred provider organization, or employer that has a statutory or contractual obligation to provide or indemnify emergency medical services on behalf of a patient shall be liable, to the extent of the statutory or contractual obligation to the patient, for the reasonable charges of the transferring hospital and the treating physicians for the emergency services provided pursuant to this article, except that the patient shall be responsible for uncovered services, or any deductible or copayment obligation. Notwithstanding this section, the liability of a third-party payor that has contracted with health care providers for the provision of these emergency services shall be set by the terms of that contract. Notwithstanding this section, the liability of a third-party payor that is licensed by the Insurance Commissioner or the Director of the Department of Managed Health Care and has a contractual obligation to provide or indemnify emergency medical services under a contract that covers a subscriber or an enrollee shall be determined in accordance with the terms of that contract and shall remain under the sole jurisdiction of that licensing agency.
(e)CA Health & Safety Code § 1317.2(e) A hospital that has a legal obligation to provide care for a patient as specified by subdivision (a) of Section 1317.2a to the extent of its legal obligation, imposed by statute or by contract to the extent of that contractual obligation, which does not accept transfers of, or make other appropriate arrangements for, medically stable patients in violation of this article or regulations adopted pursuant thereto shall be liable for the reasonable charges of the transferring hospital and treating physicians for providing services and care that should have been provided by the receiving hospital.
(f)CA Health & Safety Code § 1317.2(f) Subdivisions (d) and (e) do not apply to county obligations under Section 17000 of the Welfare and Institutions Code.
(g)CA Health & Safety Code § 1317.2(g) This section does not require a hospital to make arrangements for the care of a patient for whom the hospital does not have a legal obligation to provide care.

Section § 1317.3

Explanation

This law requires hospitals to create specific policies and protocols as part of their licensing requirements. Hospitals need to prevent discrimination in emergency care, covering aspects such as ethnicity, age, or ability to pay. They must also ensure that on-call doctors cannot refuse patients based on these characteristics. Before transferring patients, hospitals must inform them or their representatives about the reasons for transfer or refusal of care and their rights to emergency services, posting this information prominently in emergency rooms. If hospitals fail to implement these policies on time, they can be fined $1,000 per day after a 60-day notice. All policies should have been submitted for state approval by December 31, 1988.

(a)CA Health & Safety Code § 1317.3(a) As a condition of licensure, each hospital shall adopt, in consultation with the medical staff, policies and transfer protocols consistent with this article and regulations adopted hereunder.
(b)CA Health & Safety Code § 1317.3(b) As a condition of licensure, each hospital shall adopt a policy prohibiting discrimination in the provision of emergency services and care based on ethnicity, citizenship, age, preexisting medical condition, insurance status, economic status, ability to pay for medical services, or any characteristic listed or defined in subdivision (b) or (e) of Section 51 of the Civil Code, except to the extent that a circumstance such as age, sex, preexisting medical condition, or physical or mental disability is medically significant to the provision of appropriate medical care to the patient. Transfer by a hospital of a patient who requires evaluation for involuntary psychiatric treatment, as determined by the receiving hospital or other receiving health facility, based upon the decision of a professional person duly authorized by law to make that decision, shall not constitute discrimination for the purposes of this section, if the transferring hospital has not been designated as an evaluation facility by a county pursuant to Section 5150 of the Welfare and Institutions Code, and if the transfer is in compliance with Section 1317.2.
(c)CA Health & Safety Code § 1317.3(c) As a condition of licensure, each hospital shall require that physicians and surgeons who serve on an “on-call” basis to the hospital’s emergency room cannot refuse to respond to a call on the basis of the patient’s ethnicity, citizenship, age, preexisting medical condition, insurance status, economic status, ability to pay for medical services, or any characteristic listed or defined in subdivision (b) or (e) of Section 51 of the Civil Code, except to the extent that a circumstance such as age, sex, preexisting medical condition, or physical or mental disability is medically significant to the provision of appropriate medical care to the patient. If a contract between a physician and surgeon and hospital for the provision of emergency room coverage presently prevents the hospital from imposing those conditions, the conditions shall be included in the contract as soon as is legally permissible. Nothing in this section shall be construed as requiring that any physician serve on an “on-call” basis.
(d)CA Health & Safety Code § 1317.3(d) As a condition of licensure, all hospitals shall inform all persons presented to an emergency room or their representatives if any are present and the person is unable to understand verbal or written communication, both orally and in writing, of the reasons for the transfer or refusal to provide emergency services and care and of the person’s right to emergency services and care prior to transfer or discharge without regard to ability to pay. Nothing in this subdivision requires notification of the reasons for the transfer in advance of the transfer where a person is unaccompanied and the hospital has made a reasonable effort to locate a representative, and because of the person’s physical or mental condition, notification is not possible. All hospitals shall prominently post a sign in their emergency rooms informing the public of their rights. Both the posted sign and written communication concerning the transfer or refusal to provide emergency services and care shall give the address of the department as the government agency to contact in the event the person wishes to complain about the hospital’s conduct.
(e)CA Health & Safety Code § 1317.3(e) If a hospital does not timely adopt the policies and protocols required in this article, the hospital, in addition to denial or revocation of any of its licenses, shall be subject to a fine not to exceed one thousand dollars ($1,000) each day after expiration of 60 days’ written notice from the state department that the hospital’s policies or protocols required by this article are inadequate unless the delay is excused by the state department upon a showing of good and sufficient cause by the hospital. The notice shall include a detailed statement of the state department’s reasons for its determination and suggested changes to the hospital’s protocols which would be acceptable to the state department.
(f)CA Health & Safety Code § 1317.3(f) Each hospital’s policies and protocols required in or under this article shall be submitted for approval to the state department by December 31, 1988.

Section § 1317.4

Explanation

This law section outlines procedures and responsibilities for hospitals in California related to patient transfers. Hospitals must keep records of transfers for three years and report annual statistics on patient transfers, including reasons and insurance status. Hospitals and medical staff are required to report apparent violations of transfer regulations, and those who report in good faith are protected against retaliation. Hospitals' decisions on patient transfers must prioritize patient safety, and reporting individuals are protected if they refuse a transfer for safety reasons.

Violations of non-retaliation rules can result in fines up to $10,000. Annual reports summarize economic and hazardous transfers and violations, keeping patient identities confidential. If a hospital wants to dispute a proposed fine, they must notify the state department promptly. Disputes can lead to a court hearing or binding arbitration. The state department carries the burden of proving the case in court, and proceedings are expedited. If fines are reduced or dismissed, it must be clearly noted in public records.

(a)CA Health & Safety Code § 1317.4(a)  All hospitals shall maintain records of each transfer made or received, including the “Memorandum of Transfer” described in subdivision (f) of Section 1317.2, for a period of three years.
(b)CA Health & Safety Code § 1317.4(b)  All hospitals making or receiving transfers shall file with the state department annual reports on forms prescribed by the department which shall describe the aggregate number of transfers made and received according to the person’s insurance status and reasons for transfers.
(c)CA Health & Safety Code § 1317.4(c)  The receiving hospital, and all physicians, other licensed emergency room health personnel, and certified prehospital emergency personnel at the receiving hospital who know of apparent violations of this article or the regulations adopted hereunder shall, and the corresponding personnel at the transferring hospital and the transferring hospital may, report the apparent violations to the state department on a form prescribed by the state department within one week following its occurrence. The state department shall promptly send a copy of the form to the hospital administrator and appropriate medical staff committee of the transferring hospital and the local emergency medical services agency, unless the state department concludes that the complaint does not allege facts requiring further investigation, or is otherwise unmeritorious, or the state department concludes, based upon the circumstances of the case, that its investigation of the allegations would be impeded by disclosure of the form. When two or more persons required to report jointly have knowledge of an apparent violation, a single report may be made by a member of the team selected by mutual agreement in accordance with hospital protocols. Any individual, required to report by this section, who disagrees with the proposed joint report has a right and duty to separately report.
A failure to report under this subdivision shall not constitute a violation within the meaning of Section 1290 or 1317.6.
(d)CA Health & Safety Code § 1317.4(d)  No hospital, government agency, or person shall retaliate against, penalize, institute a civil action against, or recover monetary relief from, or otherwise cause any injury to a physician or other personnel for reporting in good faith an apparent violation of this article or the regulations adopted hereunder to the state department, hospital, medical staff, or any other interested party or government agency.
(e)CA Health & Safety Code § 1317.4(e)  No hospital, government agency, or person shall retaliate against, penalize, institute a civil action against, or recover monetary relief from, or otherwise cause any injury to a physician who refused to transfer a patient when the physician determines, within reasonable medical probability, that the transfer or delay caused by the transfer will create a medical hazard to the person.
(f)CA Health & Safety Code § 1317.4(f)  Any person who violates subdivision (d) or (e) of Section 1317.4 is subject to a civil money penalty of no more than ten thousand dollars ($10,000) per violation. The remedy specified in this section shall be in addition to any other remedy provided by law.
(g)CA Health & Safety Code § 1317.4(g)  The state department shall on an annual basis publish and provide to the Legislature a statistical summary by county on the extent of economic transfers of emergency patients, the frequency of medically hazardous transfers, the insurance status of the patient populations being transferred and all violations finally determined by the state department describing the nature of the violations, hospitals involved, and the action taken by the state department in response. These summaries shall not reveal the identity of individual persons transferred.
(h)CA Health & Safety Code § 1317.4(h)  Proceedings by the state department to impose a fine under Section 1317.3 or 1317.6, and proceedings by the board to impose a fine under Section 1317.6, shall be conducted as follows:
(1)CA Health & Safety Code § 1317.4(h)(1)  If a hospital desires to contest a proposed fine, the hospital shall within 15 business days after service of the notice of proposed fine notify the director in writing of its intention to contest the proposed fine. If requested by the hospital, the director or the director’s designee, shall hold, within 30 business days, an informal conference, at the conclusion of which he or she may affirm, modify, or dismiss the proposed fine. If the director or the director’s designee affirms, modifies, or dismisses the proposed fine, he or she shall state with particularity in writing his or her reasons for that action, and shall immediately transmit a copy thereof to the hospital. If the hospital desires to contest a determination made after the informal conference, the hospital shall inform the director in writing within 15 business days after it receives the decision by the director or director’s designee. The hospital shall not be required to request an informal conference to contest a proposed fine, as specified in this section. If the hospital fails to notify the director in writing that it intends to protest the proposed fine within the times specified in this subdivision, the proposed fine shall be deemed a final order of the state department and shall not be subject to further administrative review.
(2)CA Health & Safety Code § 1317.4(h)(2)  If a hospital notifies the director that it intends to contest a proposed fine, the director shall immediately notify the Attorney General. Upon notification, the Attorney General shall promptly take all appropriate action to enforce the proposed fine in a court of competent jurisdiction for the county in which the hospital is located.
(3)CA Health & Safety Code § 1317.4(h)(3)  A judicial action to enforce a proposed fine shall be filed by the Attorney General after a hospital notifies the director of its intent to contest the proposed fine. If a judicial proceeding is prosecuted under the provisions of this section, the state department shall have the burden of establishing by a preponderance of the evidence that the alleged facts supporting the proposed fine occurred, that the alleged facts constituted a violation for which a fine may be assessed under Section 1317.3, 1317.4, or 1317.6, and the proposed fine is appropriate. The state department shall also have the burden of establishing by a preponderance of the evidence that the assessment of the proposed fine should be upheld. If a hospital timely notifies the state department of its decision to contest a proposed fine, the fine shall not be due and payable unless and until the judicial proceeding is terminated in favor of the state department.
(4)CA Health & Safety Code § 1317.4(h)(4)  Action brought under the provisions of this section shall be set for trial at the earliest possible date and shall take precedence on the court calendar over all other cases except matters to which equal or superior precedence is specifically granted by law. Times for responsive pleading and for hearing any such proceeding shall be set by the judge of the court with the object of securing a decision as to subject matters at the earliest possible time.
(5)CA Health & Safety Code § 1317.4(h)(5)  If the proposed fine is dismissed or reduced, the state department shall take action immediately to ensure that the public records reflect in a prominent manner that the proposed fine was dismissed or reduced.
(6)CA Health & Safety Code § 1317.4(h)(6)  In lieu of a judicial proceeding, the state department and the hospital may jointly elect to submit the matter to binding arbitration, in which case, the department shall initiate arbitration proceedings. The parties shall agree upon an arbitrator designated by the American Arbitration Association in accordance with the Association’s established rules and procedures. The arbitration hearing shall be set within 45 days of the parties’ joint election, but in no event less than 28 days from the date of selection of an arbitrator. The arbitration hearing may be continued up to 15 days if necessary at the arbitrator’s discretion. The decision of arbitrator shall be based upon substantive law and shall be binding on all parties, subject to judicial review. This review shall be limited to whether there was substantial evidence to support the decision of the arbitrator.
(7)CA Health & Safety Code § 1317.4(h)(7)  Proceedings by the board to impose a fine under Section 1317.6 shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code.

Section § 1317.4

Explanation

This section of the California Health and Safety Code explains the rules for transferring a patient with a psychiatric emergency to another hospital's psychiatric unit. The decision to transfer must be based on the treating provider's belief that the transfer won't harm the patient's condition.

Hospitals must notify and document the patient's health care plan before transfer, and they must provide details like the patient's name, member ID, and contact info for the next location. If the receiving facility does not have a contract with the patient's health plan, the plan might arrange another transfer to a contracted facility, dependent on the treating provider's assessment of safety.

There is no requirement for hospitals to seek pre-approval for transfers related to psychiatric emergencies, easing the process when urgent care is needed. Communication duties after the transfer are limited to ensuring at least one successful contact with the health care plan.

(a)Copy CA Health & Safety Code § 1317.4(a)
(1)Copy CA Health & Safety Code § 1317.4(a)(1) Notwithstanding subdivision (j) of Section 1317.1, a patient may be transferred for admission to a psychiatric unit within a general acute care hospital, as defined in subdivision (a) of Section 1250, or an acute psychiatric hospital, as defined in subdivision (b) of Section 1250, for care and treatment that is solely necessary to relieve or eliminate a psychiatric emergency medical condition, as defined in subdivision (k) of Section 1317.1, provided that, in the opinion of the treating provider, the patient’s psychiatric emergency medical condition is such that, within reasonable medical probability, no material deterioration of the patient’s psychiatric emergency medical condition is likely to result from, or occur during, a transfer of the patient.
(2)CA Health & Safety Code § 1317.4(a)(2) A provider shall notify the patient’s health care service plan, or the health plan’s contracting medical provider of the need for the transfer if identification of the plan is obtained pursuant to paragraph (1) of subdivision (b).
(b)CA Health & Safety Code § 1317.4(b) A hospital that transfers a patient pursuant to subdivision (a) shall do both of the following:
(1)CA Health & Safety Code § 1317.4(b)(1) Seek to obtain the name and contact information of the patient’s health care service plan. The hospital shall document its attempt to ascertain this information in the patient’s medical record. The hospital’s attempt to ascertain the information shall include requesting the patient’s health care service plan member card, asking the patient, the patient’s family member, or other person accompanying the patient if they can identify the patient’s health care service plan, or using other means known to the hospital to accurately identify the patient’s health care service plan.
(2)CA Health & Safety Code § 1317.4(b)(2) Notify the patient’s health care service plan or the health plan’s contracting medical provider of the transfer, provided that the identification of the plan was obtained pursuant to paragraph (1). The hospital shall provide the plan or its contracting medical provider with the name of the patient, the patient’s member identification number, if known, the location and contact information, including a telephone number, for the location where the patient will be admitted, and the preliminary diagnosis.
(c)Copy CA Health & Safety Code § 1317.4(c)
(1)Copy CA Health & Safety Code § 1317.4(c)(1) A hospital shall make the notification described in paragraph (2) of subdivision (b) by either following the instructions on the patient’s health care service plan member card or by using the contact information provided by the patient’s health care service plan. A health care service plan shall provide all noncontracting hospitals in the state to which one of its members would be transferred pursuant to paragraph (1) of subdivision (b) with specific contact information needed to make the contact required by this section. The contact information provided to hospitals shall be updated as necessary, but no less than once a year.
(2)CA Health & Safety Code § 1317.4(c)(2) A hospital making the transfer pursuant to subdivision (a) shall not be required to make more than one telephone call to the health care service plan, or its contracting medical provider, provided that in all cases the health care service plan, or its contracting medical provider, shall be able to reach a representative of the provider upon returning the call, should the plan, or its contracting medical provider, need to call back. The representative of the hospital who makes the telephone call may be, but is not required to be, a physician and surgeon.
(d)CA Health & Safety Code § 1317.4(d) If a transfer made pursuant to subdivision (a) is made to a facility that does not have a contract with the patient’s health care service plan, the plan may subsequently require and make provision for the transfer of the patient receiving services pursuant to this section and subdivision (a) of Section 1317.1 from the noncontracting facility to a psychiatric unit within a general acute care hospital, as defined in subdivision (a) of Section 1250, or an acute psychiatric hospital, as defined in subdivision (b) of Section 1250, that has a contract with the plan or its delegated payer, provided that in the opinion of the treating provider the patient’s psychiatric emergency medical condition is such that, within reasonable medical probability, no material deterioration of the patient’s psychiatric emergency medical condition is likely to result from, or occur during, the transfer of the patient.
(e)CA Health & Safety Code § 1317.4(e) Upon admission, the hospital to which the patient was transferred shall notify the health care service plan of the transfer, provided that the facility has the name and contact information of the patient’s health care service plan. The facility shall not be required to make more than one telephone call to the health care service plan, or its contracting medical provider, provided that in all cases the health care service plan, or its contracting medical provider, shall be able to reach a representative of the facility upon returning the call, should the plan, or its contracting medical provider, need to call back. The representative of the facility who makes the telephone call may be, but is not required to be, a physician and surgeon.
(f)CA Health & Safety Code § 1317.4(f) A provider is not required to seek prior authorization to provide emergency services and care, as defined in paragraph (2) of subdivision (a) of Section 1317.1, or to make a transfer pursuant to subdivision (a) for a patient who has a psychiatric emergency medical condition, as defined in subdivision (k) of Section 1317.1, that is not otherwise required by law.

Section § 1317.4

Explanation

If someone has a psychiatric emergency, certain psychiatric units and hospitals must accept their transfer from another hospital's emergency department, regardless of whether they're there voluntarily or not. This is required when the sending doctor confirms the patient is stable for transfer, the receiving facility has a bed available, and they have the right staff and services to help. However, this rule doesn't apply to county-owned psychiatric facilities or those listed under Section 4100 of the Welfare and Institutions Code.

(a)CA Health & Safety Code § 1317.4(a) A psychiatric unit within a general acute care hospital, as defined in subdivision (a) of Section 1250, a psychiatric health facility of more than 16 beds, as defined in Section 1250.2 and subject to subdivision (d), or an acute psychiatric hospital, as defined in subdivision (b) of Section 1250, shall accept a transfer of a person with a psychiatric emergency medical condition, as defined in subdivision (k) of Section 1317.1, from a health facility licensed under this chapter that maintains and operates an emergency department and the receiving facility shall provide emergency services and care to that person consistent with paragraph (2) of subdivision (a) of Section 1317.1, regardless of whether the person is voluntary or involuntarily detained for assessment, evaluation, and crisis intervention, or placement for evaluation and treatment pursuant to the Lanterman-Petris-Short Act (Part 1 (commencing with Section 5000) of Division 5 of the Welfare and Institutions Code), or whether the facility operates an emergency department, if all of the following requirements are met:
(1)CA Health & Safety Code § 1317.4(a)(1) The treating physician at the sending facility has determined that the patient is medically stable and appropriate for treatment in a psychiatric setting and has included that determination in the patient’s medical record.
(2)CA Health & Safety Code § 1317.4(a)(2) The facility has an available bed.
(3)CA Health & Safety Code § 1317.4(a)(3) The facility has appropriate facilities and qualified personnel available to provide the services or care.
(b)CA Health & Safety Code § 1317.4(b) A facility accepting a transfer of a person with a psychiatric emergency medical condition pursuant to subdivision (a) shall comply with the requirements of subdivisions (b), (d), and (f) of Section 1317.
(c)CA Health & Safety Code § 1317.4(c) This section shall not apply to a facility listed in Section 4100 of the Welfare and Institutions Code.
(d)CA Health & Safety Code § 1317.4(d) This section shall not apply to a psychiatric health facility that is county owned and operated.

Section § 1317.5

Explanation

This law states that any reported violations of this particular article and its regulations will be investigated by the state department. The state department can also allow the local EMS agency to conduct the investigation. The investigation must follow certain procedures and finish within 60 days after the report is received.

Once the investigation is complete, if the violation involves a physician, it must be reported to the Medical Board of California unless the complaint is found to have no reasonable basis.

(a)CA Health & Safety Code § 1317.5(a)  All alleged violations of this article and the regulations adopted hereunder shall be investigated by the state department. The state department, with the agreement of the local EMS agency, may refer violations of this article to the local EMS agency for investigation. The investigation shall be conducted pursuant to procedures established by the state department and shall be completed no later than 60 days after the report of apparent violation is received by the state department.
(b)CA Health & Safety Code § 1317.5(b)  At the conclusion of its investigation, the state department or the local EMS agency shall refer any alleged violation by a physician to the Medical Board of California unless it is determined that the complaint is without a reasonable basis.

Section § 1317.5

Explanation

This section allows emergency departments in certain health facilities to post a notice making it clear that any form of threatening or aggressive behavior towards staff will not be tolerated. The notice warns that assaulting staff may lead to criminal convictions.

A health facility licensed under this chapter that maintains and operates an emergency department may post a notice in a conspicuous place in the emergency department stating substantially the following:
WE WILL NOT TOLERATE any form of threatening or aggressive behavior toward our staff. Assaults and batteries against our staff are crimes and may result in a criminal conviction.

Section § 1317.6

Explanation

If a hospital in California violates certain regulations, the state can fine them up to $25,000 for each violation. The fine considers if the violation was intentional, if it posed a health risk, its severity, and any other fines from federal violations.

For hospitals owned by health care plans, complaints are sent to the Department of Managed Health Care unless unfounded. Physicians may also face fines up to $5,000 for similar reasons. Hospitals and healthcare workers can face legal actions for intentional or repeated violations.

The maximum combined state and federal fines for a hospital’s specific violation can't exceed $30,000, and fines are adjusted to reflect this. Hospitals could lose their emergency service permits for violations.

Administrators who knowingly break the law can face misdemeanor charges. Violations must be reported to hospital accrediting bodies and emergency service agencies. Individuals or facilities harmed by violations can sue for damages or legal fees. These penalties don't apply to county-level requirements.

(a)CA Health & Safety Code § 1317.6(a)  Hospitals found by the state department to have committed or to be responsible for a violation of this article or the regulations adopted pursuant thereto shall be subject to a civil penalty by the state department in an amount not to exceed twenty-five thousand dollars ($25,000) for each hospital violation. In determining the amount of the fine for a hospital violation, the state department shall take into account all of the following:
(1)CA Health & Safety Code § 1317.6(a)(1)  Whether the violation was knowing or unintentional.
(2)CA Health & Safety Code § 1317.6(a)(2)  Whether the violation resulted or was reasonably likely to result in a medical hazard to the patient.
(3)CA Health & Safety Code § 1317.6(a)(3)  The frequency or gravity of the violation.
(4)CA Health & Safety Code § 1317.6(a)(4)  Other civil fines which have been imposed as a result of the violation under Section 1395 of Title 42 of the United States Code.
(b)CA Health & Safety Code § 1317.6(b)  Notwithstanding this section, the director shall refer any alleged violation by a hospital owned and operated by a health care service plan involving a plan member or enrollee to the Department of Managed Health Care unless the director determines the complaint is without reasonable basis. The Department of Managed Health Care shall have sole authority and responsibility to enforce this article with respect to violations involving hospitals owned and operated by health care service plans in their treatment of plan members or enrollees.
(c)CA Health & Safety Code § 1317.6(c)  Physicians and surgeons found by the board to have committed, or to be responsible for, a violation of this article or the regulations adopted pursuant thereto shall be subject to any and all penalties which the board may lawfully impose and may be subject to a civil penalty by the board in an amount not to exceed five thousand dollars ($5,000) for each violation. A civil penalty imposed under this subdivision shall not duplicate federal fines, and the board shall credit any federal fine against a civil penalty imposed under this subdivision.
(d)CA Health & Safety Code § 1317.6(d)  The board may impose fines when it finds any of the following:
(1)CA Health & Safety Code § 1317.6(d)(1)  The violation was knowing or willful.
(2)CA Health & Safety Code § 1317.6(d)(2)  The violation was reasonably likely to result in a medical hazard.
(3)CA Health & Safety Code § 1317.6(d)(3)  There are repeated violations.
(e)CA Health & Safety Code § 1317.6(e)  It is the intent of the Legislature that the state department has primary responsibility for regulating the conduct of hospital emergency departments and that fines imposed under this section should not be duplicated by additional fines imposed by the federal government as a result of the conduct which constituted a violation of this section. To effectuate the Legislature’s intent, the Governor shall inform the Secretary of the federal Department of Health and Human Services of the enactment of this section and request the federal department to credit any penalty assessed under this section against any subsequent civil monetary penalty assessed pursuant to Section 1395dd of Title 42 of the United States Code for the same violation.
(f)CA Health & Safety Code § 1317.6(f)  There shall be a cumulative maximum limit of thirty thousand dollars ($30,000) in fines assessed against hospitals under this article and under Section 1395dd of Title 42 of the United States Code for the same circumstances. To effectuate this cumulative maximum limit, the state department shall do both of the following:
(1)CA Health & Safety Code § 1317.6(f)(1)  As to state fines assessed prior to the final conclusion, including judicial review, if available, of an action against a hospital by the federal Department of Health and Human Services under Section 1395dd of Title 42 of the United States Code (for the same circumstances finally deemed to have been a violation of this article or the regulations adopted hereunder, because of the state department action authorized by this article), remit and return to the hospital within 30 days after conclusion of the federal action, that portion of the state fine necessary to assure that the cumulative maximum limit is not exceeded.
(2)CA Health & Safety Code § 1317.6(f)(2)  Immediately credit against state fines assessed after the final conclusion, including judicial review, if available, of an action against a hospital by the federal Department of Health and Human Services under Section 1395dd of Title 42 of the United States Code, which results in a fine against a hospital (for the same circumstances finally deemed to have been a violation of this article or the regulations adopted hereunder, because of the state department action authorized by this article), the amount of the federal fine, necessary to assure the cumulative maximum limit is not exceeded.
(g)CA Health & Safety Code § 1317.6(g)  Any hospital found by the state department pursuant to procedures established by the state department to have committed a violation of this article or the regulations adopted hereunder may have its emergency medical service permit revoked or suspended by the state department.
(h)CA Health & Safety Code § 1317.6(h)  Any administrative or medical personnel who knowingly and intentionally violates any provision of this article, may be charged by the local district attorney with a misdemeanor.
(i)CA Health & Safety Code § 1317.6(i)  Notification of each violation found by the state department of the provisions of this article or the regulations adopted hereunder shall be sent by the state department to the Joint Commission for the Accreditation of Hospitals, the state emergency medical services authority, and local emergency medical services agencies.
(j)CA Health & Safety Code § 1317.6(j)  Any person who suffers personal harm and any medical facility which suffers a financial loss as a result of a violation of this article or the regulations adopted hereunder may recover, in a civil action against the transferring or receiving hospital, damages, reasonable attorney’s fees, and other appropriate relief. Transferring and receiving hospitals from which inappropriate transfers of persons are made or refused in violation of this article and the regulations adopted hereunder shall be liable for the reasonable charges of the receiving or transferring hospital for providing the services and care which should have been provided. Any person potentially harmed by a violation of this article or the regulations adopted hereunder, or the local district attorney or the Attorney General, may bring a civil action against the responsible hospital or administrative or medical personnel, to enjoin the violation, and if the injunction issues, the court shall award reasonable attorney’s fees. The provisions of this subdivision are in addition to other civil remedies and do not limit the availability of the other remedies.
(k)CA Health & Safety Code § 1317.6(k)  The civil remedies established by this section do not apply to violations of any requirements established by any county or county agency.

Section § 1317.7

Explanation

This law says that counties and other government agencies can set their own rules about emergency care and patient transfers, as long as these rules don't conflict with state regulations. But for patients on Medi-Cal, state Medi-Cal rules take priority. If hospitals and doctors have agreements with local governments that set tougher transfer rules, those agreements must be followed.

However, these rules or agreements cannot delay or stop essential care for patients with psychiatric emergencies, no matter how they are detained, and must adhere to laws concerning mental health treatment.

(a)CA Health & Safety Code § 1317.7(a) This article does not preempt any county or any other governmental agency acting within its authority from regulating emergency care or patient transfers, including the imposition of more specific duties, consistent with the requirements of this article and its implementing regulations. Any inconsistent requirements imposed by the Medi-Cal program shall preempt this article with respect to Medi-Cal beneficiaries. To the extent hospitals and physicians enter into contractual relationships with county or other governmental agencies that impose more stringent transfer requirements, those contractual agreements shall control.
(b)CA Health & Safety Code § 1317.7(b) Notwithstanding subdivision (a), those duties or contractual agreements shall not unreasonably delay or deny the provision of medically necessary care to a patient with a psychiatric emergency medical condition, as defined in subdivision (k) of Section 1317.1, regardless of whether the patient is voluntary or involuntarily detained for assessment, evaluation, and crisis intervention, or placement for evaluation and treatment pursuant to the Lanterman-Petris-Short Act (Part 1 (commencing with Section 5000) of Division 5 of the Welfare and Institutions Code).

Section § 1317.8

Explanation

This law section says that if a part of this article is found to be illegal or goes against the constitution in a court case, the rest of the chapter stays valid and enforceable.

If any provision of this article is declared unlawful or unconstitutional in any judicial action, the remaining provisions of this chapter shall remain in effect.

Section § 1317.9

Explanation

This law makes it clear that it does not change or cancel out another specific law, Section 2400 of the Business and Professions Code.

It also says that doctors can use their best medical judgment, even if it goes against certain regulations, as long as they're following key parts of the health standards (Sections 1317, 1317.1, and specific parts of 1317.2) and if following the regulation would not be in the patient's best interest.

(a)CA Health & Safety Code § 1317.9(a)  This article shall not be construed as altering or repealing Section 2400 of the Business and Professions Code.
(b)CA Health & Safety Code § 1317.9(b)  Nothing in Sections 1317 et seq. and 1798.170 et seq. shall prevent a physician from exercising his or her professional judgment in conflict with any state or local regulation adopted pursuant to Section 1317 et seq. or 1798.170 et seq., so long as the judgment conforms with Sections 1317, 1317.1, and, except for subdivision (g), Section 1317.2, and acting in compliance with the state or local regulation would be contrary to the best interests of the patient.

Section § 1317.10

Explanation

This law section states that Stanford Hospital and Clinics and Lucile Packard Children’s Hospital can operate as a single facility for patients in active labor arriving at Stanford's emergency department, but only if certain conditions are met. First, the hospitals must have an agreement for Lucile Packard to accept and care for all laboring patients, regardless of their insurance or financial status. Second, a qualified medical professional must determine that the patient shows signs of active labor and can safely be transferred to Lucile Packard's labor and delivery, as long as their condition isn't better treated in the emergency room. Third, patients have the right to refuse transfer. Lastly, both hospitals need a plan to quickly transport the patient with a specially trained escort.

Notwithstanding Sections 1317 and 1317.2, Stanford Hospital and Clinics and Lucile Packard Children’s Hospital at Stanford shall be treated as a single licensed facility for purposes of providing emergency services and care to patients with conditions related to active labor presenting to the emergency department at Stanford Hospital and Clinics if all of the following conditions are met:
(a)CA Health & Safety Code § 1317.10(a) The two hospitals have entered into an agreement in which Lucile Packard Children’s Hospital at Stanford accepts and provides emergency services and care to all patients who are in active labor presenting to the emergency department at Stanford Hospital and Clinics, without regard to insurance status, financial status, or other nonclinical factors.
(b)CA Health & Safety Code § 1317.10(b) A physician and surgeon, qualified emergency department registered nurse, or other appropriately licensed personnel under the supervision of a physician and surgeon determines, prior to the transfer, that the patient has signs or symptoms, or both, suggestive of active labor, the patient can be safely transferred from the emergency department at Stanford Hospital and Clinics to the labor and delivery department of Lucile Packard Children’s Hospital at Stanford, and the patient does not have a condition, illness, or injury more appropriately treated in the emergency department.
(c)CA Health & Safety Code § 1317.10(c) The patient has the right to refuse the transfer.
(d)CA Health & Safety Code § 1317.10(d) Each hospital has a prepared plan to promptly transport the patient with an employee escort who has specialized training in transporting women in labor.

Section § 1318

Explanation

This law requires health facilities in California that handle patients' money to have a bond from a surety company. This bond serves as insurance to ensure the facility treats patients’ funds honestly. The bond amount is based on the facility's size but must be at least $1,000.

If a patient suffers financial harm due to mishandling of their money by the facility, they can sue to collect damages covered by the bond. Failing to maintain this bond or embezzling patient funds could lead to the facility losing its license.

This law doesn't apply to facilities handling small amounts of money, specifically less than $25 per patient and less than $500 for all patients per month. Additionally, certain types of health facilities might be exempt from purchasing this bond, though they are still financially liable for mishandling funds.

(a)CA Health & Safety Code § 1318(a)  The director shall require as a condition precedent to the issuance, or renewal, of any license for a health facility, if the licensee handles or will handle any money of patients within the health facility, that the applicant for the license or the renewal of the license file or have on file with the state department a bond executed by an admitted surety insurer in a sum to be fixed by the state department based upon the magnitude of the operations of the applicant, but which sum shall not be less than one thousand dollars ($1,000), running to the State of California and conditioned upon the licensee’s faithful and honest handling of the money of patients within the health facility.
(b)CA Health & Safety Code § 1318(b)  Every person injured as a result of any improper or unlawful handling of the money of a patient of a health facility may bring an action in a proper court on the bond required to be posted by the licensee pursuant to this section for the amount of damage the person suffered as a result thereof to the extent covered by the bond.
(c)CA Health & Safety Code § 1318(c)  The failure of any licensee under this section to maintain on file with the state department a bond in the amount prescribed by the director or who embezzles any patient’s trust funds shall constitute cause for the revocation of the license.
(d)CA Health & Safety Code § 1318(d)  The provisions of this section shall not apply if the licensee handles less than twenty-five dollars ($25) per patient and less than five hundred dollars ($500) for all patients in any month.
(e)CA Health & Safety Code § 1318(e)  The director may exempt licensed health facilities of the types specified in subdivisions (a), (b), (c), and (f) of Section 1250 from the requirements of this section. However, the exemption from the bond purchase requirements of this section shall not affect the financial liability of such health facilities.

Section § 1319

Explanation

This law allows a health facility to require all its medical staff to carry professional liability insurance as a condition for being part of the staff.

The rules of a health facility may include provisions that require every member of the medical staff to have professional liability insurance as a condition to being on the medical staff of the health facility.

Section § 1320

Explanation

This law states that nursing and intermediate care facilities in California can't force patients to buy their medications, medical supplies, or equipment from a specific pharmacy or supplier.

However, these facilities can require that a patient's chosen pharmacy follows the facility's rules if they're necessary for patient care or compliance with regulations.

Additionally, the facility can insist that any controlled substances, which need regular counting, be provided in specific containers suited for this procedure.

A skilled nursing facility or intermediate care facility shall not require patients to purchase drugs, or rent or purchase medical supplies or equipment, from any particular pharmacy or other source.
This section shall not preclude a skilled nursing facility or intermediate care facility from requiring that the patient’s pharmacy or other source comply with the facility’s policies and procedures reasonably necessary for the care of the patient or policies and procedures required to meet the intent of state or federal regulations. Nothing in this section shall preclude a skilled nursing facility or intermediate care facility from requiring that controlled substances which are periodically counted by the facility on at least a daily basis be dispensed by the patient’s pharmacy in containers suitable for that purpose.

Section § 1321

Explanation

Health facilities are not allowed to promote or claim they offer occupational therapy services unless those services are actually supervised and managed by a qualified occupational therapist or assistant, as defined in another section of the rules.

No health facility shall advertise or represent in any way that it provides occupational therapy services unless such services are provided under the administrative control of the health facility by an occupational therapist or occupational therapy assistant within the meaning of Section 2570 of the Business and Professions Code.

Section § 1322

Explanation

This law makes it illegal for hospitals to decide whether a doctor can work there based on the doctor’s contract with insurance companies or health care plans. In other words, a doctor's involvement with an insurer shouldn't affect their hospital privileges.

A hospital which contracts with an insurer, nonprofit hospital service plan, or health care service plan shall not determine or condition medical staff membership or clinical privileges upon the basis of a physician and surgeon’s or podiatrist’s participation or nonparticipation in a contract with that insurer, hospital service plan, or health care service plan.

Section § 1323

Explanation

This law requires health facilities to inform patients if they have a significant financial interest in an ancillary health service provider. Patients must be notified in writing and advised they have the option to choose a different provider. Similarly, if ancillary health service providers have a significant interest in a health facility, they must also inform their customers. A 'significant beneficial interest' is generally a financial interest of at least 5 percent or $5,000, but certain exceptions apply, such as lease agreements and ownership interests below certain thresholds in publicly held companies. Ancillary health service providers include those offering services like pharmaceuticals, laboratories, and mental health. Disclosures are not necessary if the patient is part of a prepaid health plan.

(a)CA Health & Safety Code § 1323(a)  A health facility, as defined by subdivisions (c) to (g), inclusive, of Section 1250, which has a significant beneficial interest in an ancillary health service provider or which knows that an ancillary health service provider has a significant beneficial interest in the health facility shall disclose that interest in writing to the patients of the health facility, or their representatives, and advise the patients, or their representatives, that they may choose to have another ancillary health service provider provide any supplies or services ordered by a member of the medical staff of the health facility.
(b)CA Health & Safety Code § 1323(b)  If supplies or services are provided on an outpatient basis by an ancillary health service provider which is not on the same site as, or which is not on a site which is adjacent to, a health facility, as defined by subdivision (a) or (b) of Section 1250, which has a significant beneficial interest in the ancillary health service provider, or if the ancillary health service provider has a significant beneficial interest in the health facility, the ancillary health service provider shall disclose that interest in writing to the customers of the ancillary health service provider, or their representatives, and advise the customers, or their representatives, that they may choose to have another ancillary health service provider provide any supplies or services ordered by a member of the medical staff of the health facility.
(c)CA Health & Safety Code § 1323(c)  A health facility, as defined by Section 1250, shall not charge, bill, or otherwise solicit payment from a patient on behalf of, or refer a patient to, another health facility in which the health facility has a significant beneficial interest unless the health facility first discloses in writing to the patient, or his or her representative, that the patient may choose to have another health facility provide any supplies or services ordered by a member of the medical staff of the health facility.
(d)Copy CA Health & Safety Code § 1323(d)
(1)Copy CA Health & Safety Code § 1323(d)(1)  Except as provided in paragraph (2), “significant beneficial interest” means any financial interest that is equal to or greater than the lesser of the following:
(A)CA Health & Safety Code § 1323(d)(1)(A)  Five percent of the whole.
(B)CA Health & Safety Code § 1323(d)(1)(B)  Five thousand dollars ($5,000).
(2)CA Health & Safety Code § 1323(d)(2)  “Significant beneficial interest” does not include any of the following interests:
(A)CA Health & Safety Code § 1323(d)(2)(A)  A lease agreement between a health facility, ancillary health service provider, another health facility, or a parent corporation of the health facility, or any combination thereof.
(B)CA Health & Safety Code § 1323(d)(2)(B)  Any financial interest held by a health facility or ancillary health service provider in the stock of a publicly held health facility or ancillary health service provider, or any parent corporation of a health facility or ancillary health service provider, if that financial interest does not exceed 5 percent of any class of equity securities of the health facility, ancillary health service provider, or parent corporation.
(C)CA Health & Safety Code § 1323(d)(2)(C)  An ownership interest in a health facility or ancillary health service provider if more than three-fourths of the patients of the health facility or ancillary health service provider are members of a prepaid group practice health care service plan, as defined by Section 1345.
(e)Copy CA Health & Safety Code § 1323(e)
(1)Copy CA Health & Safety Code § 1323(e)(1)  “Ancillary health service provider” includes, but is not limited to, providers of pharmaceutical, laboratory, optometry, prosthetic, or orthopedic supplies or services, suppliers of durable medical equipment, home-health service providers, and providers of mental health or substance abuse services.
(2)CA Health & Safety Code § 1323(e)(2)  As used in subdivision (b), “adjacent” means real property located within a 400-yard radius of the boundaries of the site on which the health facility is located.
(f)CA Health & Safety Code § 1323(f)  Neither a health facility nor an ancillary health service provider is required to make any disclosures required by this section to any patients or customers, or their representatives, if the patients or customers are enrolled in organizations or entities which provide or arrange for the provision of health care services in exchange for a prepaid capitation payment or premium.

Section § 1323.1

Explanation

Hospitals must inform patients if a scheduled service in a hospital-based outpatient clinic is available at a non-hospital location, which might be cheaper. The notification should clearly mention that hospital-based clinics can be more expensive and where to check for alternatives.

A 'hospital-based outpatient clinic' refers to facilities not located on the hospital's main campus. However, this rule doesn't apply to certain nonprofit hospitals associated with specific health plans, provided there is no cost difference for patients receiving care at either a hospital-based clinic or a regular medical office.

(a)CA Health & Safety Code § 1323.1(a) A general acute care hospital shall notify each patient scheduled for a service in a hospital-based outpatient clinic when that service is available in another location that is not hospital-based. The notification shall be in substantially the following form:
The location where you are being scheduled to receive services is a hospital-based clinic, and, therefore, may have higher costs. The same service may be available at another location within our health system that is not hospital-based, which may cost less. Check with the [insert name of office] at [insert telephone number] for another location within our health system, or check with your health insurance company, for more information about other locations that may cost less.
(b)CA Health & Safety Code § 1323.1(b) For purposes of this section, a “hospital-based outpatient clinic” means a department of a provider, as defined in Section 413.65(a)(2) of Title 42 of the Code of Federal Regulations, that is not located on the campus of that provider.
(c)CA Health & Safety Code § 1323.1(c) This section shall not apply to a general acute care hospital operated by a nonprofit corporation under common control with a nonprofit health care service plan licensed pursuant to the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340) of Division 2) that exclusively contracts with no more than two medical groups in the state to provide and arrange for medical services for the enrollees of the health care service plan, so long as the cost-sharing design does not vary based on whether the care is provided in a hospital-based clinic or a medical office building.