Article 2. Administration of California Health And Safety Code >> Division 2. >> Chapter 1. >> Article 2.
(a) Any person, firm, association, partnership, or
corporation desiring a license for a clinic or a special permit for
special services under the provisions of this chapter, shall file
with the department a verified application on forms prescribed and
furnished by the department, containing the following:
(1) Evidence satisfactory to the department that the applicant is
of reputable and responsible character. If the applicant is a firm,
association, partnership, trust, corporation, or other artificial or
legal entity, like evidence shall be submitted as to the members,
partners, trustees or shareholders, directors, and officers thereof
and as to the person who is to be the administrator of, and exercise
control, management, and direction of the clinic for which
application is made.
(2) If the applicant is a partnership, the name and principal
business address of each partner, and, if any partner is a
corporation, the name and principal business address of each officer
and director of the corporation and name and business address of each
stockholder owning 10 percent or more of the stock thereof.
(3) If the applicant is a corporation, the name and principal
business address of each officer and director of the corporation, and
where the applicant is a stock corporation, the name and principal
business address of each stockholder holding 10 percent or more of
the applicant's stock and, where any stockholder is a corporation,
the name and principal business address of each officer and director
of the corporate stockholder.
(4) Evidence satisfactory to the department of the ability of the
applicant to comply with the provisions of this chapter and rules and
regulations promulgated under this chapter by the department.
(5) The name and address of the clinic, and if the applicant is a
professional corporation, firm, partnership, or other form of
organization, evidence that the applicant has complied with the
requirements of the Business and Professions Code governing the use
of fictitious names by practitioners of the healing arts.
(6) The name and address of the professional licentiate
responsible for the professional activities of the clinic and the
licentiate's license number and professional experience.
(7) The class of clinic to be operated, the character and scope of
advice and treatment to be provided, and a complete description of
the building, its location, facilities, equipment, apparatus, and
appliances to be furnished and used in the operation of the clinic.
(8) Sufficient operational data to allow the department to
determine the class of clinic that the applicant proposes to operate
and the initial license fee to be charged.
(9) Any other information as may be required by the department for
the proper administration and enforcement of this chapter,
including, but not limited to, evidence that the clinic has a written
policy relating to the dissemination of the following information to
(A) A summary of current state laws requiring child passenger
restraint systems to be used when transporting children in motor
(B) A listing of child passenger restraint system programs located
within the county, as required by Section 27360 or 27362 of the
(C) Information describing the risks of death or serious injury
associated with the failure to utilize a child passenger restraint
(b) (1) No application is required where a licensed primary care
clinic adds a service that is not a special service, as defined in
Section 1203, or any regulation adopted thereunder, or remodels or
modifies an existing primary care clinic site. However, the clinic
shall notify the department, in writing, of the change in service or
physical plant no less than 60 days prior to adding the service or
remodeling or modifying an existing primary care clinic site. Nothing
in this subdivision shall be construed to limit the authority of the
department to conduct an inspection at any time pursuant to Section
1227, in order to ensure compliance with, or to prevent a violation
of, this chapter, or any regulation adopted under this chapter.
(2) Where applicable city, county, or state law obligates the
primary care clinic to obtain a building permit with respect to the
remodeling or modification to be performed by the clinic, the primary
care clinic shall provide a signed certification or statement as
described in Section 1226.3 to the department within 60 days
following completion of the remodeling or modification project
covered by the building permit.
(c) In the course of fulfilling its obligations under Section
1221.09, the department shall ensure that any application form
utilized by a primary care clinic, requiring information of the type
specified in paragraph (1), (4), (8), or (9) of subdivision (a), is
consistent with the requirements of Section 1225, including the
requirement that rules and regulations for primary care clinics be
separate and distinct from the rules and regulations for specialty
clinics. Nothing in this section shall be construed to require the
department to issue a separate application form for primary care
A person, firm, association, partnership, corporation, or
other legal entity desiring a license for a clinic shall be exempt
from the requirements of Chapter 2 (commencing with Section 16000) of
Each application under this chapter for an initial license,
renewal license, license upon change of ownership, or special permit
shall be accompanied by a Licensing and Certification Program fee, as
(a) For all primary care clinics licensed pursuant to this
chapter, the annual fee shall be set in accordance with Section 1266.
(b) For all specialty clinics licensed pursuant to this chapter,
the annual fee shall be set in accordance with Section 1266.
(c) For all rehabilitation clinics, the annual fee shall be set in
accordance with Section 1266.
Notwithstanding the provisions of Section 1214, each
application for a surgical clinic or a chronic dialysis clinic under
this chapter for an initial license, renewal license, license upon
change of ownership, or special permit shall be accompanied by an
annual Licensing and Certification Program fee set in accordance with
Each application under this chapter for an initial license,
renewal license, license upon change of ownership, or special permit
for a psychology clinic shall be accompanied by a Licensing and
Certification Program fee set in accordance with Section 1266.
Each new license issued pursuant to this chapter shall expire
12 months from the date of its issuance, and each special permit
shall expire on the expiration date of the underlying license. The
state department shall transmit to the licensee a renewal fee invoice
at least 45 days prior to the expiration date of the license.
Failure by the clinic licensee to make timely payment of the renewal
fee shall result in the expiration of the license and special permit,
if any. A renewal license or special permit may be issued for a
period not to exceed two years if the holder of the license or
special permit has not been found to be in violation of any statutory
requirements, regulations, or standards during the preceding license
period. In all other cases, the renewal license or special permit
shall be issued for a period not to exceed one year. Timely
application for renewal, accompanied by the necessary fee, shall be
deemed equivalent to renewal of a license or special permit, where
the department is unable to issue a renewal license or special permit
on or before the expiration date.
(a) Every clinic holding a license shall, on or before the
15th day of February each year, file with the Office of Statewide
Health Planning and Development upon forms to be furnished by the
office, a verified report showing the following information relating
to the previous calendar year:
(1) Number of patients served and descriptive information,
including age, gender, race, and ethnic background of patients.
(2) Number of patient visits by type of service, including all of
(A) Child health and disability prevention screens, treatment, and
(B) Medical services.
(C) Dental services.
(D) Other health services.
(3) Total clinic operating expenses.
(4) Gross patient charges by payer category, including Medicare,
Medi-Cal, the Child Health Disability Prevention Program, county
indigent programs, other county programs, private insurance,
self-paying patients, nonpaying patients, and other payers.
(5) Deductions from revenue by payer category, bad debts, and
charity care charges.
(6) Additional information as may be required by the office or the
(b) In the event a clinic fails to file a timely report, the
department may suspend the license of the clinic until the report is
completed and filed with the office.
(c) In order to promote efficient reporting of accurate data, the
office shall consider the unique operational characteristics of
different classifications of licensed clinics, including, but not
limited to, the limited scope of services provided by some specialty
clinics, in its design of forms for the collection of data required
by this section.
(d) For the purpose of administering funds appropriated from the
Cigarette and Tobacco Products Surtax Fund for support of licensed
clinics, clinics receiving those funds may be required to report any
additional data the office or the department may determine necessary
to ensure the equitable distribution and appropriate expenditure of
those funds. This shall include, but not be limited to, information
about the poverty level of patients served and communicable diseases
reported to local health departments.
(e) This section shall apply to all primary care clinics.
(f) This section shall apply to all specialty clinics, as defined
in paragraph (2) of subdivision (a) of Section 1204 of the Health and
Safety Code that receive tobacco tax funds pursuant to Article 2
(commencing with Section 30121) of Chapter 2 of Part 13 of Division 2
of the Revenue and Taxation Code.
(g) Specialty clinics that are not required to report pursuant to
subdivision (f) shall report data as directed in Section 1216 as it
existed prior to the enactment of Chapter 1331 of the Statutes of
1989 and Chapter 51 of the Statutes of 1990.
(a) An applicant for a license to operate a primary care
clinic, as specified in subdivision (a) of Section 1204 that meets
all requirements for licensure under this chapter, except that it
proposes to operate its clinic out of an existing facility that does
not satisfy all of the applicable building requirements for the
physical plant, other than fire and life safety requirements, shall
be issued a license by the state department if both of the following
requirements are met:
(1) The applicant establishes, by evidence satisfactory to the
state department, that, where possible and feasible, the applicable
building requirements have been met.
(2) The applicant submits a plan of modernization acceptable to
the state department that sets forth the proposed changes to be made,
during a period not to exceed three years from the date of initial
licensure, to bring the applicant's facility into substantial
conformance with applicable building requirements.
(b) Failure to complete the plan of modernization as approved and
within the time allowed shall constitute a basis for revocation or
nonrenewal of the applicant's license unless the applicant earlier
applies for and obtains a waiver from the department. The director
shall waive building requirements for primary care clinics where he
or she determines all of the following conditions are met:
(1) That the requirements cannot be met by an applicant, or that
they can be met only at an unreasonable and prohibitive cost.
(2) That the requirements are not essential to protect the health
and safety of the clinic staff or the public it serves.
(3) That the granting of the waiver applied for is in the public
Upon the filing of an application for a license or for a
special permit, or for renewal of a license or special permit, the
state department shall investigate the facts set forth in the
application and, if the state department finds that the statements
contained in the application are true, that the establishment or the
continued operation of the clinic and any special services it
provides are in conformity with the intent and purpose of this
chapter, and that the applicant is in compliance with the provisions
of this chapter and the rules and regulations of the state
department, the state department shall issue to the applicant the
license or special permit, or renewal thereof, applied for. However,
if the director finds that the statements contained in the
application are not true, or that the establishment or the continued
operation of the clinic, or its special services, is not in
conformity with the intent and purpose of this chapter, or that
applicant is not in compliance with the provisions of this chapter
and the rules and regulations promulgated hereunder, he shall deny
the applicant the license or special permit or renewal thereof
applied for. The state department shall either grant or deny a
license or special permit within 100 days of the filing of a
completed application for such license or special permit.
(a) A clinic corporation on behalf of a primary care clinic
that has held a valid, unrevoked, and unsuspended license for at
least the immediately preceding five years, with no demonstrated
history of repeated or uncorrected violations of this chapter or a
regulation adopted under this chapter that pose immediate jeopardy to
a patient, as defined in subdivision (f), and that has no pending
action to suspend or revoke its license, may file an affiliate clinic
application under this section to establish a primary care clinic at
an additional site or a mobile health care unit, either of which
shall hereafter be referred to as the affiliate clinic. The
department, upon receipt of the completed affiliate clinic
application submitted by the clinic corporation, shall approve a
license for the affiliate clinic, without the necessity of first
conducting an initial onsite survey, if all of the following
conditions are met:
(1) The clinic corporation that operates the existing licensed
primary care clinic, which shall hereafter be referred to as the
parent clinic, has submitted a completed affiliate clinic application
and the associated application fee.
(2) The parent and affiliate clinics' corporate officers, as
specified in Section 5213 of the Corporations Code, are the same.
(3) The parent and affiliate clinics are owned and operated by the
same nonprofit organization with the same board of directors.
(4) The parent and affiliate clinics have the same medical
director or directors and medical policies, procedures, protocols,
(b) The affiliate clinic application shall consist solely of a
simple form and required supporting documents giving the following
(1) The name and address of the clinic corporation's
(2) The name and contact information of the clinic corporation's
chief executive officer or executive director.
(3) The name and address of the new affiliate primary care clinic
site or the location of the new affiliate mobile health care unit.
(4) The name and contact information of the administrator of the
new affiliate primary care clinic site or mobile health care unit.
(5) The expected days and hours of operation and the services to
be provided at the new affiliate primary care clinic site or mobile
health care unit.
(6) Evidence that the new affiliate mobile health care unit meets
the requirements of the Mobile Health Care Services Act (Chapter 9
(commencing with Section 1765.101)).
(7) The type and the manufacturer of the new affiliate mobile
health care unit and the proposed area or areas where the new
affiliate mobile health care unit will be providing services.
(8) To the extent otherwise required by law, evidence of
compliance with the minimum construction standards for adequacy and
safety of the new affiliate clinic's physical plant, pursuant to the
OSHPD 3 requirements of the most recent version of the California
Building Code applicable to clinics and subdivision (b) of Section
1226. The compliance may be established in the form prescribed by
(9) Evidence of fire clearance for the new affiliate clinic site.
(10) A copy of the lease or purchase agreement for the new
affiliate clinic site.
(11) A copy of the transfer agreement between the new affiliate
clinic and a local hospital.
(12) A current list of clinic corporation board members.
(c) The affiliate clinic application shall be signed by an officer
of the clinic corporation's board of directors or the clinic
corporation's chief executive officer or executive director.
(d) The department shall issue a clinic license under this section
within 30 days of receipt of a completed affiliate clinic
application. If approved, a clinic license shall be issued within
seven days of approval. If the department determines that an
applicant does not meet the conditions stated in subdivision (a), it
shall identify, in writing and with particularity, the grounds for
that determination, and shall instead process the application in
accordance with the time specified in Section 1218.
(e) Nothing in this section shall prohibit the department from
conducting a licensing inspection of the affiliate clinic at any time
after receipt of the completed affiliate clinic application.
(f) For purposes of this section, "immediate jeopardy to a patient"
means a situation in which the clinic's noncompliance with one or
more requirements of licensure has caused, or is likely to cause,
serious injury, harm, impairment, or death to a patient.
Notwithstanding any other provision of law, two or more
primary care clinics that are operated by a single nonprofit
corporation shall be entitled to consolidate their administrative
functions within the State of California without first obtaining the
approval of the department. The department shall have access to
offsite records. Upon request for access by the department, offsite
records shall either be transferred to a clinic or administrative
site or be available at the offsite facility within 48 hours. The
administrative functions are limited to the following:
(a) Offsite storage and maintenance of patient medical records
that have been inactive for at least three years.
(b) Offsite storage and maintenance of personnel records, except
that copies of specific records documenting the employees' date of
hire, general qualifications, proof of current licensure if
applicable, training, and annual health checks shall be kept at the
site at which the employee provides all or a majority of his or her
(c) Billing and related financial functions.
(d) Purchasing functions.
(a) In order to reduce paperwork, eliminate errors, and
streamline communications between the department and licensed primary
care clinics, a clinic corporation that operates one or more
affiliate clinics shall, on behalf of all licensed clinics it
operates, act as the administrative headquarters for purposes of
receiving from and submitting to the department communications
regarding primary care clinic license applications or license
renewals, primary care clinic operations, requests for prior
approval, additions of services, primary care clinic relocations,
required reports of changes in primary care clinic administration and
board of directors, notices of deficiencies, and all communications
from the department to primary care clinics licensed by the
department including communications by mail, e-mail, facsimile, or
any other electronic or telephonic means.
(b) The department shall maintain a complete corporate file
containing information about each clinic corporation operating one or
more affiliate clinics, including all of the following:
(1) A copy of the clinic corporation's articles of incorporation
(2) Unless exempt under paragraph (1) of subdivision (a) of
Section 1204, a copy of the determination letter to show the clinic
corporation's exempt status under paragraph (3) of subsection (c) of
the Internal Revenue Code of 1954, as amended.
(3) A copy of the clinic corporation's organizational chart.
(4) Information identifying the clinic corporation's governing
body, including the clinic corporation's board of directors and
corporate officers and required documents.
(5) Information identifying the clinic corporation's
administrators, including the chief executive officer or executive
director and medical director.
(c) A clinic corporation shall not be required to resubmit
information, materials, or documents identified in subdivision (b) as
part of an affiliate clinic application, unless the information,
materials, or documents are necessary to complete the corporate file.
(d) A clinic corporation shall submit to the department, on behalf
of all licensed primary care clinics operated by the clinic
corporation, a single report of change that is applicable to all
primary care clinics operated by the clinic corporation, including a
change in a principal officer or general manager of the governing
body, the medical director, and the clinic administrator, as required
(e) A clinic corporation may submit to the department, on behalf
of all licensed primary care clinics operated by the clinic
corporation that are within the same license renewal month, a single
payment for all primary care clinic licensure renewal fees.
(a) A licensed primary care community or free clinic shall
report to the department, when renewing its license, whether it is
currently operating an intermittent clinic, the location of any
intermittent clinic, and the estimated hours of operation of any
(b) For the purposes of this section "intermittent clinic" means a
clinic described in subdivision (h) of Section 1206.
(a) Except for affiliate clinics, as defined in Section
1218.1, if a clinic or an applicant for a license has not been
previously licensed, the department may only issue a provisional
license to the clinic as provided in this section.
(b) A provisional license to operate a clinic shall terminate six
months from the date of issuance.
(c) Within 30 days prior to the termination of a provisional
license, the department shall give the clinic a full and complete
inspection, and, if the clinic meets all applicable requirements for
licensure, a regular license shall be issued. If the clinic does not
meet the requirements for licensure but has made substantial progress
towards meeting such requirements, as determined by the department,
the initial provisional license shall be renewed for six months.
(d) If the department determines that there has not been
substantial progress towards meeting licensure requirements at the
time of the first full inspection provided by this section, or, if
the department determines upon its inspection made within 30 days of
the termination of a renewed provisional license that there is a lack
of full compliance with such requirements, no further license shall
(e) If an applicant for a provisional license to operate a clinic
has been denied by the department, the applicant may contest the
denial by filing a statement of issues, as provided in Section 11504
of the Government Code. The proceedings to review the denial shall be
conducted pursuant to the provisions of Chapter 5 (commencing with
Section 11500) of Part 1 of Division 3 of Title 2 of the Government
(a) The state department may issue a provisional license to
a clinic if:
(1) The clinic and the applicant for licensure substantially meet
the standards specified by this chapter and regulations adopted
pursuant to this chapter.
(2) No violation of this chapter or regulations adopted under this
chapter exists in the clinic which jeopardizes the health or safety
(3) The applicant has adopted a plan for correction of any
existing violations which is satisfactory to the state department.
(b) A provisional license issued under this section shall expire
not later than six months after the date of issuance, or at such
earlier time as determined by the state department at the time of
issuance, and may not be renewed.
Immediately upon the denial of any application for a license
or special permit or a renewal thereof, the state department shall
notify the applicant in writing. Within 15 days after the state
department mails the notice, the applicant may present his written
petition for a hearing to the state department. Upon receipt by the
state department of the petition in proper form, such petition shall
be set for hearing. The proceedings 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, and the state department has all
powers granted therein.
The director may issue a temporary license to operate a community
clinic or free clinic when the director determines that the facility
is in compliance with the provisions of this chapter, except that the
facility has applied for but not yet been granted an exemption from
federal taxation as required by subdivision (a) of Section 1204. In
such cases, the prospective licensee shall submit to the director a
copy of its application for exemption from federal taxation which it
has sent to the federal Internal Revenue Service. The director shall
request the Franchise Tax Board to review the application and to
render an opinion regarding whether it is likely that the exemption
will be granted. If the Franchise Tax Board so determines, the
director may proceed to issue a temporary license. Such temporary
license shall expire 12 months from the date of its issuance or upon
the facility being granted such exemption from federal taxation. The
director shall issue no more than three successive temporary licenses
to one facility.