Health Care -- Regulatory Scheme and Licensure

Health Care -- Regulatory Scheme and Licensure Requirements -- Operating a Health Care Organization

California's licensing process for health care organizations is governed by the State's Health and Safety Code, with responsibility for licensing, licensing, inspecting, regulating and/or certifying shouldered by State and Federal agencies. In a straightforward yet rigorous process aided by online application packets and checklists, these agencies are intent on ensuring compliance with State and Federal laws and regulations.

The process for becoming licensed to operate as a health care organization in California is governed by §1200 -- 1209 of the California Health and Safety Code (California State Legislature, 2003). These code sections broadly deem the term "clinic" or "primary care clinic" to mean an "organized outpatient health facility," whether a community clinic, free clinic, specialty clinic or clinic corporation required to be licensed (California State Legislature, 2003). The requirements and processes outlined in these code sections specifically concern clinics furnishing psychological, podiatric, dental, optometric, medical and surgical advice and services to patients staying in the clinic fewer than 24 hours and related therapy/diagnosis to patients in their homes (California State Legislature, 2003). All such clinics are required to be licensed by the Licensing and Certification Division of the California State Department of Public Health in order to practice within the State (California State Legislature, 2003). The Licensing and Certification Division is responsible for licensing, inspecting, regulating and/or certifying California's health care facilities (California Department of Public Health, 2013). In addition, in the case of health care facilities accepting or intending to accept Medicare and Medi-Cal, the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services (CMS) is also responsible for licensing, inspecting, regulating and/or certifying those health care facilities (California Department of Public Health, 2013).

California's licensing process is straightforward, at least in its basic components. The clinic wishing to be licensed by the State of California must start the process by submitting various documents to the centralized applications unit of California's State Department of Public Health, Division of Licensing and Certification (California State Legislature, 2003). Those documents include a ten-page application packet and checklist (California Department of Public Health, 2012), which consists of a laundry list of ownership, structure, certification and even building requirements. If the clinic began operating after September 26, 1978, it must also submit a "certificate of need," proving that there is a need for the provision of that clinic's services by that clinic in that geographic area (California State Legislature, 2003). The clinic must also submit a verification of certification by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). JCAHO certification is a written acknowledgement that the clinic meets uniform health care standards for structure, management, processes and assessments set by the Joint Commission (Joint Commission on Accreditation of Health Care Organizations, 2012) for Disease-Specific Care, Advanced Disease-Specific Care, Palliative Care or Health Care Staffing Services (Joint Commission on Accreditation of Health Care Organizations, 2013). The clinic may also submit proof of JCAHO accreditation, which is proof of voluntary adherence to high quality standards of care (Joint Commission on Accreditation of Health Care Organizations, 2012) for Ambulatory Health Care, Behavioral Health Care, Hospitals, Critical Access Hospitals, Home Care, Laboratory Services, and Nursing and Rehabilitation Centers (Joint Commission on Accreditation of Health Care Organizations, 2013). Finally, the applicant must submit an application fee determined by the type of health care facility (California Department of Public Health, 2012). Provided the documentation is complete, the Division of Licensing and