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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2017

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A N   A C T

RELATING TO HEALTH CARE FACILITIES - LICENSING

     

     Introduced By: Representatives Tanzi, McEntee, and Fogarty

     Date Introduced: March 02, 2017

     Referred To: House Finance

     (by request)

It is enacted by the General Assembly as follows:

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     SECTION 1. Section 23-17-2 of the General Laws in Chapter 23-17 entitled "Licensing

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of Health-Care Facilities" is hereby amended to read as follows:

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     23-17-2. Definitions.

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     As used in this chapter:

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     (1) "Affiliate" means a legal entity that is in control of, is controlled by or is in common

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control with another legal entity.

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     (1) (2) "Alzheimer's dementia special-care unit or program" means a distinct living

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environment within a nursing facility that has been physically adapted to accommodate the

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particular needs and behaviors of those with dementia. The unit provides increased staffing;

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therapeutic activities designed specifically for those with dementia; and trains its staff on an

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ongoing basis on the effective management of the physical and behavioral problems of those with

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dementia. The residents of the unit/program have had a standard, medical-diagnostic evaluation

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and have been determined to have a diagnosis of Alzheimer's dementia or another dementia.

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     (2) (3) (i) "Change in operator" means a transfer by the governing body or operator of a

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health-care facility to any other person (excluding delegations of authority to the medical or

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administrative staff of the facility) of the governing body's authority to:

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     (A) Hire or fire the chief executive officer of the health-care facility;

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     (B) Maintain and control the books and records of the health-care facility;

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     (C) Dispose of assets and incur liabilities on behalf of the health-care facility; or

 

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     (D) Adopt and enforce policies regarding operation of the health-care facility.

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     (ii) This definition is not applicable to circumstances wherein the governing body of a

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health-care facility retains the immediate authority and jurisdiction over the activities enumerated

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in subdivisions (2)(i)(A) -- (2)(i)(D) (3)(i)(A) – (3)(i)(D).

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     (3) (4) "Change in owner" means:

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     (i) In the case of a health-care facility that is a partnership, the removal, addition, or

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substitution of a partner that results in a new partner acquiring a controlling interest in the

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partnership;

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     (ii) In the case of a health-care facility that is an unincorporated, solo proprietorship, the

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transfer of the title and property to another person;

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     (iii) In the case of a health-care facility that is a corporation:

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     (A) A sale, lease exchange, or other disposition of all, or substantially all, of the property

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and assets of the corporation; or

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     (B) A merger of the corporation into another corporation; or

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     (C) The consolidation or two (2) or more corporations, resulting in the creation of a new

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corporation; or

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     (D) In the case of a health-care facility that is a business corporation, any transfer of

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corporate stock that results in a new person acquiring a controlling interest in the corporation; or

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     (E) In the case of a health-care facility that is a nonbusiness corporation, any change in

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membership that results in a new person acquiring a controlling vote in the corporation.

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     (4) (5) "Clinician" means a physician licensed under chapter 37 of title 5; a nurse licensed

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under chapter 34 of title 5; a psychologist licensed under chapter 44 of title 5; a social worker

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licensed under chapter 39.1 of title 5; a physical therapist licensed under chapter 40 of title 5; and

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a speech language pathologist or audiologist licensed under chapter 48 of title 5.

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     (5) (6) "Director" means the director of the Rhode Island state department of health.

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     (6) (7) "Freestanding, emergency-care facility" means an establishment, place, or facility

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that may be a public or private organization, structurally distinct and separate from a hospital;

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staffed, equipped, and operated to provide prompt, emergency medical care. For the purposes of

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this chapter, "emergency medical care" means services provided for a medical condition or

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behavioral-health condition that is manifested by symptoms of sufficient severity that, in the

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absence of immediate medical attention, could result in harm to the person or others; serious

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impairment to bodily functions; serious dysfunction of any bodily organ or part; or development

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or continuance of severe pain.

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     (7) (8) "Health-care facility" means any institutional health-service provider, facility, or

 

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institution, place, building, agency, or portion thereof, whether a partnership or corporation,

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whether public or private, whether organized for profit or not, used, operated, or engaged in

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providing health-care services, including, but not limited to: hospitals; nursing facilities; home

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nursing-care provider (which shall include skilled nursing services and may also include activities

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allowed as a home-care provider or as a nursing service agency); home-care provider (which may

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include services such as personal care or homemaker services); rehabilitation centers; kidney

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disease treatment centers; health maintenance organizations; freestanding, emergency-care

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facilities as defined in this section, and facilities providing surgical treatment to patients not

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requiring hospitalization (surgi-centers); hospice care, and physician ambulatory-surgery centers

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and podiatry ambulatory-surgery centers providing surgical treatment. The term "health-care

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facility" also includes organized ambulatory-care facilities that are not part of a hospital but that

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are organized and operated to provide health-care services to outpatients, such as: central-services

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facilities serving more than one health-care facility or health-care provider; treatment centers;

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diagnostic centers; outpatient clinics; infirmaries and health centers; school-based health centers,

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and neighborhood health centers. The term "health-care facility" also includes a mobile, health-

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screening vehicle as defined in this section. The term "health-care facility" shall not apply to

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organized, ambulatory-care facilities owned and operated by professional service corporations as

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defined in chapter 5.1 of title 7, as amended (the "professional service corporation law"), or to a

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private practitioner's (physician, dentist, or other health-care provider) office or group of the

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practitioners' offices (whether owned and/or operated by a hospital or an affiliate of a hospital or

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an individual practitioner, alone or as a member of a partnership, professional service corporation,

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organization, or association); provided, however, notwithstanding any other provision herein or in

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the general laws, any hospital or any affiliate of a hospital that owns and/or operates a

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practitioner's office shall ensure that such practitioner's office complies with licensing or

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accreditation requirements that may be applicable to the practitioner's office. Individual

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categories of health-care facilities shall be defined in rules and regulations promulgated by the

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licensing agency with the advice of the health services council. Rules and regulations concerning

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hospice care shall be promulgated with regard to the "Standards of a Hospice Program of Care",

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promulgated by the National Hospice Organization. Any provider of hospice care who provides

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hospice care without charge shall be exempt from the licensing provisions of this chapter but

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shall meet the "Standards of a Hospice Program of Care." Facilities licensed by the department of

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behavioral healthcare, developmental disabilities, and hospitals and the department of human

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services, and clinical laboratories licensed in accordance with chapter 16.2 of this title, as well as

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Christian Science institutions (also known as Christian Science Nursing Facilities) listed and

 

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certified by the Commission for Accreditation of Christian Science Nursing

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Organizations/Facilities, Inc. shall not be considered health-care facilities for purposes of this

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chapter.

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     (8) (9) "Homemaker", or however else called, means a trained, non-professional worker

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who performs related housekeeping services in the home for the sick, disabled, dependent, or

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infirm, and as further defined by regulation; the director shall establish criteria for training.

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     (9) (10) "Hospital" means a person or governmental entity licensed in accordance with

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this chapter to establish, maintain, and operate a hospital.

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     (10) (11) "Licensing agency" means the Rhode Island state department of health.

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     (11) (12) "Medical services" means any professional services and supplies rendered by,

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or under the direction of, persons duly licensed under the laws of this state to practice medicine,

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surgery, or podiatry that may be specified by any medical service plan. Medical service shall not

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be construed to include hospital services.

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     (12) (13) "Mobile, health-screening vehicle" means a mobile vehicle, van, or trailer that

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delivers primary and preventive health-care screening services, and:

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     (i) Does not maintain active contracts or arrangements with any health insurer subject to

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regulation under chapters 20 or 42 of title 27;

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     (ii) Does not maintain active contracts or arrangements with another licensed health care

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facility as that term is defined within this section; and

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     (iii) Does not provide medical services free of charge.

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     (13) (14) "Non-English speaker" means a person who cannot speak or understand, or has

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difficulty in speaking or understanding, the English language, because he/she uses only, or

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primarily, a spoken language other than English, and/or a person who uses a sign language and

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requires the use of a sign-language interpreter to facilitate communication.

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     (14) (15) "Person" means any individual, trust or estate, partnership, corporation,

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(including associations, joint stock companies, and insurance companies) state, or political

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subdivision or instrumentality of a state.

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     (15) (16) "Physician ambulatory-surgery center" means an office, or portion of an office,

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that is utilized for the purpose of furnishing surgical services to the owner and/or operator's own

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patients on an ambulatory basis, and shall include both single-practice, physician ambulatory-

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surgery centers and multi-practice, physician ambulatory-surgery centers. A "single-practice,

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physician ambulatory-surgery center" is a physician ambulatory center owned and/or operated by

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a physician-controlled professional service corporation as defined in chapter 5.1 of title 7 (the

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"professional service corporation law"), or a physician-controlled limited liability company (as

 

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defined in chapter 16 of title 7 (the "limited liability company act")) in which no physician is an

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officer, shareholder, director, or employee of any other corporation engaged in the practice of the

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same profession, or a private physician's office (whether owned and/or operated by an individual

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practitioner, alone or as a member of a partnership, professional service corporation, limited

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liability company, organization, or association). A "multi-practice, physician ambulatory-surgery

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center" is a physician ambulatory-surgery center owned and/or operated by a physician-controlled

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professional service corporation (as defined in the professional service corporation law) or a

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physician-controlled limited, liability company (as defined in the limited liability company act) in

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which a physician is also an officer, shareholder, director, or employee of another corporation

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engaged in the practice of the same profession, or a group of physicians' offices (whether owned

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and/or operated by an individual practitioner, alone or as a member of a partnership, professional

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service corporation, limited liability company, organization, or association).

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     (16) (17) "Podiatry ambulatory-surgery center" means an office or portion of an office

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that is utilized for the purpose of furnishing surgical services to the owner and/or operator's own

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patients on an ambulatory basis, and shall include both single-practice, podiatry ambulatory-

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surgery centers and multi-practice podiatry ambulatory-surgery centers. A "single-practice

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podiatry ambulatory-surgery center" is a podiatry ambulatory center owned and/or operated by a

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podiatrist-controlled professional service corporation (as defined in chapter 5.1 of title 7 (the

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"professional service corporation law")), or a podiatrist-controlled limited liability company (as

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defined in chapter 16 of title 7 (the "limited liability company act")) in which no podiatrist is an

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officer, shareholder, director, or employee of any other corporation engaged in the practice of

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the same profession, or a private podiatrist's office (whether owned and/or operated by an

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individual practitioner, alone or as a member of a partnership, professional service corporation,

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limited liability company, organization, or association). A "multi-practice, podiatry ambulatory-

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surgery center" is a podiatry ambulatory-surgery center owned and/or operated by a podiatry-

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controlled professional service corporation (as defined in the professional service corporation

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law) or a podiatry-controlled, limited liability company (as defined in the limited liability

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company act) in which a podiatrist is also an officer, shareholder, director, or employee of

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another corporation engaged in the practice of the same profession, or a group of podiatrists'

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offices (whether owned and/or operated by a an individual practitioner, alone or as a member of a

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partnership, professional service corporation, limited liability company, organization, or

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association).

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     (17) (18) "Qualified interpreter" means a person who, through experience and/or training,

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is able to translate a particular foreign language into English, with the exception of sign-language

 

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interpreters who must be licensed in accordance with chapter 71 of title 5.

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     (18) (19) "Qualified, sign-language interpreter" means one who has been licensed in

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accordance with the provisions of chapter 71 of title 5.

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     (19) (20) "School-based health center" means a facility located in an elementary or

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secondary school that delivers primary and preventive health-care services to students on site.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH CARE FACILITIES - LICENSING

***

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     This act would amend the definition of health care facility to allow a hospital or an

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affiliate of a hospital to own and operate ambulatory-care facilities.

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     This act would take effect upon passage.

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