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<ns0:Id>20250AB__228299INT</ns0:Id>
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<ns0:Action>
<ns0:ActionText>INTRODUCED</ns0:ActionText>
<ns0:ActionDate>2026-02-19</ns0:ActionDate>
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<ns0:SessionYear>2025</ns0:SessionYear>
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<ns0:AuthorText authorType="LEAD_AUTHOR">Introduced by Assembly Member Alanis</ns0:AuthorText>
<ns0:Authors>
<ns0:Legislator>
<ns0:Contribution>LEAD_AUTHOR</ns0:Contribution>
<ns0:House>ASSEMBLY</ns0:House>
<ns0:Name>Alanis</ns0:Name>
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<ns0:Title> An act to add Section 1251.7 to the Health and Safety Code, relating to health facilities.</ns0:Title>
<ns0:RelatingClause>health facilities</ns0:RelatingClause>
<ns0:GeneralSubject>
<ns0:Subject>Health facilities: emergency medical services.</ns0:Subject>
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<html:p>Existing law requires the State Department of Public Health to license and regulate various health facilities, including general acute care hospitals. Existing law requires the department to issue a special permit, in addition to a license, to a health facility to offer one or more special services, such as an emergency center, if specified requirements are met, including that the department finds that the standards of care and services are adequate and appropriate.</html:p>
<html:p>Existing law requires the department to issue a special permit to allow a general acute care hospital to offer emergency stabilization services at a location that is neither inside nor contiguous to the applicant hospital if the hospital provides satisfactory evidence to the department that, among other things, the hospital has a written transfer agreement with the hospital closest to
the location where emergency stabilization services will be provided and satisfactory evidence to the department that this location meets certain requirements, including that the location is in the town of Paradise within the County of Butte and serves the same area previously served by Feather River Hospital.</html:p>
<html:p>This bill would require the department to issue a special permit, as specified, similar to the one issued above to allow a general acute care hospital to offer emergency stabilization services at a location that is neither inside nor contiguous to the applicant hospital if the hospital provides satisfactory evidence to the department that, among other things, the hospital has a written transfer agreement with the hospital closest to the location where emergency stabilization services will be provided and satisfactory evidence to the department that this location meets certain requirements, including that the location is in the City of Patterson in the County
of Stanislaus and serves the same general population as is served by Del Puerto Health Care District.</html:p>
<html:p>This bill would make legislative findings and declarations as to the necessity of a special statute for the City of Patterson in the County of Stanislaus.</html:p>
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<ns0:FiscalCommittee>YES</ns0:FiscalCommittee>
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<ns0:Preamble>The people of the State of California do enact as follows:</ns0:Preamble>
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<ns0:Num>SECTION 1.</ns0:Num>
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Section 1251.7 is added to the
<ns0:DocName>Health and Safety Code</ns0:DocName>
, to read:
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<ns0:Num>1251.7.</ns0:Num>
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<html:p>
(a)
<html:span class="EnSpace"/>
The Legislature finds and declares all of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
Del Puerto Health Care District serves the residents of the City of Patterson and surrounding west side communities in the County of Stanislaus, providing essential health care services, including primary care, urgent care, ambulance services, and other outpatient and community-based services.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Residents of Patterson and neighboring communities are largely rural and may have limited access to transportation and to health care resources located outside the district’s service area, making local access to timely emergency and stabilization services particularly important.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
The community served by Del Puerto Health Care District includes a significant number of individuals with coverage under the federal Medicare Program and the Medi-Cal program, as well as uninsured and underinsured residents, for whom delays in access to appropriate levels of care can result in worsened health outcomes.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
Del Puerto Health Care District is planning and developing a health care campus in the City of Patterson that will include an ambulance and administration center, primary and behavioral health services, and, in later phases, higher acuity services such as skilled nursing and an acute care hospital, in order to meet current and future community health needs.
</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
During the period in which the district is planning, developing, and constructing new facilities and expanded services, it is necessary to
ensure that residents of the City of Patterson and surrounding communities have access to emergency stabilization services close to home, including services that can appropriately receive and stabilize patients prior to transport to a general acute care hospital when clinically indicated.
</html:p>
<html:p>
(6)
<html:span class="EnSpace"/>
Therefore, it is the intent of the Legislature in enacting this section to permit a general acute care hospital, as defined in subdivision (a) of Section 1250, in collaboration with Del Puerto Health Care District, to provide emergency stabilization services at a location that is neither inside nor contiguous to the applicant hospital, in order to ensure that residents of the City of Patterson and the surrounding communities have access to emergency stabilization services during the development and implementation of the district’s long-term health care campus plans.
</html:p>
<html:p>
(7)
<html:span class="EnSpace"/>
It is further the
intent of the Legislature that any such location provide the highest quality of emergency stabilization services feasible and be staffed by physicians who are board certified in emergency medicine or have equivalent training and experience in emergency care.
</html:p>
<html:p>
(8)
<html:span class="EnSpace"/>
It is not the intent of the Legislature to establish a model for a freestanding emergency department, which is currently, and remains, prohibited by state law.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
The department shall issue a special permit, as defined in Section 1251.5, to allow a general acute care hospital, as defined in subdivision (a) of Section 1250, to offer emergency stabilization services at a location that is neither inside nor contiguous to the applicant hospital, including serving as an emergency medical services receiving site if authorized to do so by the medical director of the local emergency medical services agency pursuant to Section
1798.101, if the hospital provides satisfactory evidence to the department that the hospital has a written transfer agreement with the hospital closest to the location where emergency stabilization services will be provided pursuant to this section, and any other hospital necessary to ensure the safe and effective transfer of patients needing services outside the capacity of the closest hospital, and if the applicant hospital submits and has received approval for an application pursuant to subdivision (c) and meets all of the following requirements:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
The location is within the City of Patterson in the County of Stanislaus and is intended to serve the same general population as is served by Del Puerto Health Care District.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
The location meets the regulatory requirements applicable to emergency departments, as described in subdivisions (a), (b), (d), (e), (f), (g), (h), (i),
(k), (l), and (n) of, and paragraph (6) of subdivision (m) of, Section 70413 of, subdivision (a) of Section 70415 of, and Sections 70417, 70419, 70651, 70655, 70657, and 70841 of, Title 22 of the California Code of Regulations.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
The location meets the nurse-to-patient staffing requirements of a basic emergency department, as specified in the regulations adopted pursuant to Section 1276.4.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
The location complies with the hospital’s existing collective bargaining agreements.
</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
The location is open 24 hours a day, 7 days a week.
</html:p>
<html:p>
(6)
<html:span class="EnSpace"/>
The location provides medical, pharmacy, nursing, clinical laboratory, and radiological services onsite in compliance with Article 3 (commencing with Section 70201) of Chapter 1 of Division 5 of Title 22 of the
California Code of Regulations.
</html:p>
<html:p>
(7)
<html:span class="EnSpace"/>
The location provides nutritional services to patients. The location may comply with this paragraph by providing those services directly or by contracting with an outside entity.
</html:p>
<html:p>
(8)
<html:span class="EnSpace"/>
The location complies with the federal Emergency Medical Treatment and Active Labor Act (Section 1395dd of Title 42 of the United States Code) and with Section 1317 of this code.
</html:p>
<html:p>
(9)
<html:span class="EnSpace"/>
The location has informed the local emergency medical services agency about the types of medical conditions and injuries that the facility cannot treat and for which the patient needs to be transported directly to a general acute care hospital emergency department.
</html:p>
<html:p>
(10)
<html:span class="EnSpace"/>
Notwithstanding subdivision (i) of Section 70651 of Title 22 of the California Code of
Regulations, the wording of exterior signs states “EMERGENCY STABILIZATION SERVICES, PHYSICIAN ON DUTY.”
</html:p>
<html:p>
(11)
<html:span class="EnSpace"/>
The location stabilizes for transport or release a patient within 24 hours of registration. The location reports to the department any failure to stabilize a patient for transfer or release of the patient within 24 hours.
</html:p>
<html:p>
(12)
<html:span class="EnSpace"/>
Upon registration, the location provides a patient with a written notice that the patient should consult with their health care coverage carrier about which services may be covered and for which copayments and charges the patient may be responsible.
</html:p>
<html:p>
(13)
<html:span class="EnSpace"/>
The location posts information identifying the three nearest hospitals ranked by estimated driving time from the nearest to the farthest away.
</html:p>
<html:p>
(14)
<html:span class="EnSpace"/>
The location posts a
sign, at or near any public entrance of the location, stating that patients requiring surgery, trauma care, or an inpatient bed will be transported to the nearest hospital.
</html:p>
<html:p>
(15)
<html:span class="EnSpace"/>
The location meets the physical plant requirements and has received clearance from the Department of Health Care Access and Information as appropriate for the setting and services being provided at the location.
</html:p>
<html:p>
(16)
<html:span class="EnSpace"/>
The applicant hospital has submitted and received approval on an application that meets the requirements of subdivision (c).
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
The application shall be submitted pursuant to Section 1265 and shall include all of the following:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
A plan of operation that shall, at a minimum, address the location’s plan for patient care, infection
control, waste disposal, and linen services.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
The policy and procedure that the location will implement for the emergency transportation of patients that cannot be served by the facility. The policy and procedure shall comply with the standards of practice and shall include all of the following:
</html:p>
<html:p>
(i)
<html:span class="EnSpace"/>
How the patient will be transported to the nearest general acute care hospital emergency department.
</html:p>
<html:p>
(ii)
<html:span class="EnSpace"/>
The timeframe for transfer to the nearest general acute care hospital with an emergency department.
</html:p>
<html:p>
(iii)
<html:span class="EnSpace"/>
How the location will ensure patient safety during the transfer.
</html:p>
<html:p>
(C)
<html:span class="EnSpace"/>
A written transfer agreement with the nearest hospital with an emergency department.
</html:p>
<html:p>
(D)
<html:span class="EnSpace"/>
A community outreach and education plan to ensure the community is informed of the types of services that the facility is capable of providing. The plan shall include instructions identifying the care that the facility is capable of providing and indicating the types of injuries or conditions for which a patient should be transported directly to the nearest general acute care hospital emergency department.
</html:p>
<html:p>
(E)
<html:span class="EnSpace"/>
A triage algorithm that the location developed and will implement in collaboration with the local emergency medical services agency to determine appropriate patients for transport to the location.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
The special permit application fee shall be fifteen thousand dollars ($15,000).
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
Notwithstanding Section 1267, a special permit issued pursuant
to this section shall expire 2 years from the date of its issuance, and may be renewed every 2 years, for a combined period not to exceed 10 years from the initial date of issuance.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
If, prior to expiration of the special permit, the district has submitted complete construction documents to the Department of Health Care Access and Information for review of a general acute care hospital to be located within the district, the department shall extend the special permit until the issuance of a certificate of occupancy for that hospital.
</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
The department may deny a request for approval or renewal of a special permit if the location fails to meet the requirements of this chapter pursuant to Section 1269. The department may suspend or revoke a special permit pursuant to Article 5 (commencing with Section 1294).
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
A
hospital issued a special permit pursuant to this section shall report all of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
For purposes of the Annual Report of Hospitals required by regulations adopted pursuant to Section 1250.8, report bed and service utilization data separately by each facility issued a single consolidated license pursuant to this section.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Hospital reporting requirements specified in Section 1279.1 regarding adverse events and the reporting requirements specified in Section 70737 of Title 22 of the California Code of Regulations.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
By March 1 of each year, a detailed report on the types of services, number of patients served, and any adverse patient outcomes during the prior calendar year.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
Notwithstanding any other law, the department may, without
taking regulatory action pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, implement, interpret, or make specific this section by means of an All Facilities Letter or similar instruction.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
This section shall remain in effect only until a hospital build is completed within a five-mile radius of the emergency stabilization location or within 10 years from the initial issuance of the special permit unless, prior to the expiration of that 10-year period, the district has submitted complete construction documents to the Department of Health Care Access and Information for review of a general acute care hospital or has commenced vertical construction of that hospital, in which case this section shall remain operative until issuance of a certificate of occupancy for that hospital.
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<ns0:Num>SEC. 2.</ns0:Num>
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<html:p>The Legislature finds and declares that a special statute is necessary and that a general statute cannot be made applicable within the meaning of Section 16 of Article IV of the California Constitution because of all of the following:</html:p>
<html:p>
(a)
<html:span class="EnSpace"/>
Residents, workers, and visitors in the City of Patterson face comparable—and in many cases more burdensome—access conditions to emergency medical services when compared to other designated areas.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
Average travel distances in the City of Patterson to the nearest full-service acute care hospital or trauma center are approximately 21 miles, with average drive times of 36 minutes or more.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
These access delays are driven by persistent geographic isolation, limited roadway options, agricultural and freight traffic, rail crossings, State Highway 33 congestion, and weather-related disruptions, including fog and flooding.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
The access challenges in the City of Patterson reflect structural constraints and ongoing gaps in timely emergency medical services in a rural, medically underserved community, rather than temporary emergencies such as wildfires.
</html:p>
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