Health FacilitiesOther Services
Section § 1315
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.
Section § 1316
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.
Section § 1316.5
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.
Section § 1316.6
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.
Section § 1316.7
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.
Section § 1317
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.
Section § 1317.1
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.
Section § 1317.2
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.
Section § 1317.2
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.
Section § 1317.3
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.
Section § 1317.4
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.
Section § 1317.4
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.
Section § 1317.4
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.
Section § 1317.5
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.
Section § 1317.5
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.
Section § 1317.6
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.
Section § 1317.7
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.
Section § 1317.8
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.
Section § 1317.9
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.
Section § 1317.10
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.
Section § 1318
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.
Section § 1319
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.
Section § 1320
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.
Section § 1321
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.
Section § 1322
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.
Section § 1323
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.
Section § 1323.1
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.