SECTIONS 1747-1751

1747.  (a) No person, political subdivision of the state, or othergovernmental agency, that is not operating a hospice as of January 1,1991, shall establish or operate a hospice without first obtaining alicense under this chapter. (b) Any person, political subdivision of the state, or othergovernmental agency, that is operating a hospice as of January 1,1991, may continue to operate the hospice only under the followingconditions: (1) The person, political subdivision of the state, or othergovernmental agency shall apply to the state department for a licenseunder this chapter within 60 days after forms for the application oflicensure under this chapter are available from the statedepartment. (2) The person, political subdivision of the state, or othergovernmental agency shall cease calling or referring to itself as ahospice upon the final decision of the director upholding the statedepartment's denial of an application for licensure under thischapter. (c) Nothing in this chapter shall preclude the ongoing use of thetitle "volunteer hospice" by those organizations that satisfy all ofthe following: (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 servicesrendered. (3) They satisfy the disclosure requirements specified insubdivision (c) of Section 1748. (d) A small and rural hospice is exempt from the licensingprovisions of this chapter and the disclosure requirements ofsubdivision (c) of Section 1748. A small and rural hospice mayprovide skilled nursing services and may use the title "volunteerhospice." For purposes of this chapter, a "small and rural hospice"means a hospice that provides services to less than 50 patients peryear, does not charge for services, does not receive third-partypayment for services rendered, and is not located in a standardmetropolitan statistical area.1747.1.  A hospice program certified in accordance with federalMedicare hospice conditions of participation shall be exempt fromsubdivision (a) of Section 1747, but shall be subject to Section 1726unless it elects to apply for hospice licensure. A hospice programthat elects to apply for hospice licensure shall thereafter besubject to all the hospice licensure requirements set forth in thischapter.1747.5.  Each hospice licensed pursuant to this chapter shallmaintain, and revise as needed, and implement policies regarding thepurchase, storage, furnishing, and transportation of legend devicesthat are reviewed annually by a group of professional personnel,including a physician and surgeon, a pharmacist, and a registerednurse, and are revised as needed. As used in this section, legenddevices means any device that bears the label "Caution: federal lawrestricts this device to sale by or on the order of a ____," or wordsof similar meaning.1748.  (a) Except as otherwise provided in subdivision (b) or (d) ofSection 1747, no person, political subdivision of the state, orother governmental agency shall establish, conduct, maintain, orrepresent itself as a hospice unless a license has been issued underthis chapter. Multiple locations need not obtain a separate license.Multiple locations shall be listed on the license of the parentagency and each shall pay a licensing fee in the amount prescribed bysubdivision (a) of Section 1750. (b) Any person, political subdivision of the state, or othergovernmental agency desiring a license to establish a hospice shallfile with the state department a verified application on a formprescribed and furnished by the state department which contains anyinformation as may be required by the state department for the properadministration and enforcement of this chapter. (c) Any hospice that is not required to obtain a license underthis chapter shall disclose in all advertisements and informationprovided to the public all of the following information: (1) It is not required to be licensed and is not regulated by thestate department. (2) Any complaint against the hospice should be directed to thelocal district attorney and the state department. (3) Any complaint against personnel licensed by a board orcommittee within the Department of Consumer Affairs and employed bythe hospice should be directed to the respective board or committee.Any complaint against a certified home health aide or certified nurseassistant shall be directed to the state department. The address and phone number of any state agency, board, orcommittee which is responsible for addressing complaints shall beprovided by the hospice, upon request, to any patient of the hospice.1749.  (a) To qualify for a license under this chapter, an applicantshall satisfy all of the following: (1) Be of good moral character. If the applicant is a franchise,franchisee, firm, association, organization, partnership, businesstrust, corporation, company, political subdivision of the state, orgovernmental agency, the person in charge of the hospice for whichthe application for a license is made shall be of good moralcharacter. (2) Demonstrate the ability of the applicant to comply with thischapter and any rules and regulations promulgated under this chapterby the state department. (3) File a completed application with the state department thatwas prescribed and furnished pursuant to Section 1748. (b) In order for a person, political subdivision of the state, orother governmental agency to be licensed as a hospice it shallsatisfy the definition of a hospice contained in Section 1746, andalso 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 QualityHospice Care, 2003," as available from the California Hospice andPalliative Care Association, until the state department adoptsregulations establishing alternative standards pursuant tosubdivision (e). (d) (1) Notwithstanding any provision of law to the contrary, tomeet the unique needs of the community, licensed hospices mayprovide, in addition to hospice services authorized in this chapter,any of the following preliminary services for any person in need ofthose services, as determined by the physician and surgeon, if any,in charge of the care of a patient, or at the request of the patientor family: (A) Preliminary palliative care consultations. (B) Preliminary counseling and care planning. (C) Preliminary grief and bereavement services. (2) Preliminary services authorized pursuant to this subdivisionmay be provided concurrently with curative treatment to a person whodoes not have a terminal prognosis or who has not elected to receivehospice services only by licensed and certified hospices. Theseservices shall be subject to the schedule of benefits under theMedi-Cal program, pursuant to subdivision (w) of Section 14132 of theWelfare and Institutions Code. (e) The state department may adopt regulations establishingstandards for any or all of the services required to be providedunder subdivision (b). The regulations of the state departmentadopted pursuant to this subdivision shall supersede the standardsreferenced in subdivision (c) to the extent the regulations duplicateor replace those standards.1749.5.  The Legislature recognizes that hospices can apply forcertification for their hospice programs from the federal Medicareprogram. If the department has determined during any combinedlicensing and certification survey that a hospice is in substantialcompliance with a requirement, the department shall not be redundantby also reviewing the similar licensing or certificationrequirements.1750.  (a) Each new and renewal application for a license under thischapter shall be accompanied by an annual Licensing andCertification Program fee set in accordance with Section 1266. (b) All hospices shall maintain compliance with the licensingrequirements. These requirements shall not, however, prohibit the useof alternate concepts, methods, procedures, techniques, space,equipment, personnel qualifications, or the conducting of pilotprojects, necessary for program flexibility. Program flexibilityshall be carried out with provision for safe and adequate patientcare and with prior written approval of the state department. Awritten request for program flexibility and substantiating evidencesupporting the request shall be submitted by the applicant orlicensee to the state department. The state department shall approveor deny the request within 60 days of submission. Approval shall bein writing and shall provide for the terms and conditions under whichprogram flexibility is approved. A denial shall be in writing andshall specify the basis therefor. If after investigation the statedepartment determines that a hospice using program flexibilitypursuant to this section is operating in a manner contrary to theterms or conditions of the approval for program flexibility, thedirector shall immediately revoke that approval. (c) Each hospice shall, on or before March 15 of each year, filewith the Office of Statewide Health Planning and Development (OSHPD),upon forms furnished by OSHPD, a verified report for the precedingcalendar year upon all matters requested by OSHPD. This report mayinclude, but not be limited to, data pertaining to age of patients,diagnostic categories of patients, and number of visits by serviceprovided.1751.  (a) Upon an applicant's filing an application for licensureunder this chapter and compliance with this chapter and the rules andregulations adopted by the state department under this chapter, thestate department shall issue to the applicant a license to operate asa hospice. Any fees required pursuant to Section 1750 shall be paidbefore a license is issued. Licensure also may be denied by the statedepartment as specified in Section 1755. (b) Each license issued under this chapter shall expire 24 monthsfrom the date of its issuance. (c) A biennial application for the renewal of a license,accompanied by any fee required pursuant to subdivision (b) ofSection 1750, shall be filed with the state department no less than30 days prior to the expiration date of the license. The failure tofile an application for renewal within the time required by thissubdivision shall result in the expiration of the license.