Article 2. Licensure of California Health And Safety Code >> Division 2. >> Chapter 8.5. >> Article 2.
(a) No person, political subdivision of the state, or other
governmental agency, that is not operating a hospice as of January 1,
1991, shall establish or operate a hospice without first obtaining a
license under this chapter.
(b) Any person, political subdivision of the state, or other
governmental agency, that is operating a hospice as of January 1,
1991, may continue to operate the hospice only under the following
(1) The person, political subdivision of the state, or other
governmental agency shall apply to the state department for a license
under this chapter within 60 days after forms for the application of
licensure under this chapter are available from the state
(2) The person, political subdivision of the state, or other
governmental agency shall cease calling or referring to itself as a
hospice upon the final decision of the director upholding the state
department's denial of an application for licensure under this
(c) Nothing in this chapter shall preclude the ongoing use of the
title "volunteer hospice" by those organizations that satisfy all of
(1) They do not provide skilled nursing services.
(2) They do not charge patients or families for hospice services,
and they do not receive third-party insurance payments for services
(3) They satisfy the disclosure requirements specified in
subdivision (c) of Section 1748.
(d) A small and rural hospice is exempt from the licensing
provisions of this chapter and the disclosure requirements of
subdivision (c) of Section 1748. A small and rural hospice may
provide skilled nursing services and may use the title "volunteer
hospice." For purposes of this chapter, a "small and rural hospice"
means a hospice that provides services to less than 50 patients per
year, does not charge for services, does not receive third-party
payment for services rendered, and is not located in a standard
metropolitan statistical area.
A hospice program certified in accordance with federal
Medicare hospice conditions of participation shall be exempt from
subdivision (a) of Section 1747, but shall be subject to Section 1726
unless it elects to apply for hospice licensure. A hospice program
that elects to apply for hospice licensure shall thereafter be
subject to all the hospice licensure requirements set forth in this
Each hospice licensed pursuant to this chapter shall
maintain, and revise as needed, and implement policies regarding the
purchase, storage, furnishing, and transportation of legend devices
that are reviewed annually by a group of professional personnel,
including a physician and surgeon, a pharmacist, and a registered
nurse, and are revised as needed. As used in this section, legend
devices means any device that bears the label "Caution: federal law
restricts this device to sale by or on the order of a ____," or words
of similar meaning.
(a) Except as otherwise provided in subdivision (b) or (d) of
Section 1747, no person, political subdivision of the state, or
other governmental agency shall establish, conduct, maintain, or
represent itself as a hospice unless a license has been issued under
this chapter. Multiple locations need not obtain a separate license.
Multiple locations shall be listed on the license of the parent
agency and each shall pay a licensing fee in the amount prescribed by
subdivision (a) of Section 1750.
(b) Any person, political subdivision of the state, or other
governmental agency desiring a license to establish a hospice shall
file with the state department a verified application on a form
prescribed and furnished by the state department which contains any
information as may be required by the state department for the proper
administration and enforcement of this chapter.
(c) Any hospice that is not required to obtain a license under
this chapter shall disclose in all advertisements and information
provided to the public all of the following information:
(1) It is not required to be licensed and is not regulated by the
(2) Any complaint against the hospice should be directed to the
local district attorney and the state department.
(3) Any complaint against personnel licensed by a board or
committee within the Department of Consumer Affairs and employed by
the hospice should be directed to the respective board or committee.
Any complaint against a certified home health aide or certified nurse
assistant shall be directed to the state department.
The address and phone number of any state agency, board, or
committee which is responsible for addressing complaints shall be
provided by the hospice, upon request, to any patient of the hospice.
(a) To qualify for a license under this chapter, an applicant
shall satisfy all of the following:
(1) Be of good moral character. If the applicant is a franchise,
franchisee, firm, association, organization, partnership, business
trust, corporation, company, political subdivision of the state, or
governmental agency, the person in charge of the hospice for which
the application for a license is made shall be of good moral
(2) Demonstrate the ability of the applicant to comply with this
chapter and any rules and regulations promulgated under this chapter
by the state department.
(3) File a completed application with the state department that
was prescribed and furnished pursuant to Section 1748.
(b) In order for a person, political subdivision of the state, or
other governmental agency to be licensed as a hospice it shall
satisfy the definition of a hospice contained in Section 1746, and
also provide, or make provision for, the following basic services:
(1) Skilled nursing services.
(2) Social services/counseling services.
(3) Medical direction.
(4) Bereavement services.
(5) Volunteer services.
(6) Inpatient care arrangements.
(7) Home health aide services.
(c) The services required to be provided pursuant to subdivision
(b) shall be provided in compliance with the "Standards for Quality
Hospice Care, 2003," as available from the California Hospice and
Palliative Care Association, until the state department adopts
regulations establishing alternative standards pursuant to
(d) (1) Notwithstanding any provision of law to the contrary, to
meet the unique needs of the community, licensed hospices may
provide, in addition to hospice services authorized in this chapter,
any of the following preliminary services for any person in need of
those services, as determined by the physician and surgeon, if any,
in charge of the care of a patient, or at the request of the patient
(A) Preliminary palliative care consultations.
(B) Preliminary counseling and care planning.
(C) Preliminary grief and bereavement services.
(2) Preliminary services authorized pursuant to this subdivision
may be provided concurrently with curative treatment to a person who
does not have a terminal prognosis or who has not elected to receive
hospice services only by licensed and certified hospices. These
services shall be subject to the schedule of benefits under the
Medi-Cal program, pursuant to subdivision (w) of Section 14132 of the
Welfare and Institutions Code.
(e) The state department may adopt regulations establishing
standards for any or all of the services required to be provided
under subdivision (b). The regulations of the state department
adopted pursuant to this subdivision shall supersede the standards
referenced in subdivision (c) to the extent the regulations duplicate
or replace those standards.
The Legislature recognizes that hospices can apply for
certification for their hospice programs from the federal Medicare
program. If the department has determined during any combined
licensing and certification survey that a hospice is in substantial
compliance with a requirement, the department shall not be redundant
by also reviewing the similar licensing or certification
(a) Each new and renewal application for a license under this
chapter shall be accompanied by an annual Licensing and
Certification Program fee set in accordance with Section 1266.
(b) All hospices shall maintain compliance with the licensing
requirements. These requirements shall not, however, prohibit the use
of alternate concepts, methods, procedures, techniques, space,
equipment, personnel qualifications, or the conducting of pilot
projects, necessary for program flexibility. Program flexibility
shall be carried out with provision for safe and adequate patient
care and with prior written approval of the state department. A
written request for program flexibility and substantiating evidence
supporting the request shall be submitted by the applicant or
licensee to the state department. The state department shall approve
or deny the request within 60 days of submission. Approval shall be
in writing and shall provide for the terms and conditions under which
program flexibility is approved. A denial shall be in writing and
shall specify the basis therefor. If after investigation the state
department determines that a hospice using program flexibility
pursuant to this section is operating in a manner contrary to the
terms or conditions of the approval for program flexibility, the
director shall immediately revoke that approval.
(c) Each hospice shall, on or before March 15 of each year, file
with the Office of Statewide Health Planning and Development (OSHPD),
upon forms furnished by OSHPD, a verified report for the preceding
calendar year upon all matters requested by OSHPD. This report may
include, but not be limited to, data pertaining to age of patients,
diagnostic categories of patients, and number of visits by service
(a) Upon an applicant's filing an application for licensure
under this chapter and compliance with this chapter and the rules and
regulations adopted by the state department under this chapter, the
state department shall issue to the applicant a license to operate as
a hospice. Any fees required pursuant to Section 1750 shall be paid
before a license is issued. Licensure also may be denied by the state
department as specified in Section 1755.
(b) Each license issued under this chapter shall expire 24 months
from the date of its issuance.
(c) A biennial application for the renewal of a license,
accompanied by any fee required pursuant to subdivision (b) of
Section 1750, shall be filed with the state department no less than
30 days prior to the expiration date of the license. The failure to
file an application for renewal within the time required by this
subdivision shall result in the expiration of the license.