BILL ANALYSIS Ó AB 2264 Page 1 Date of Hearing: May 14, 2014 ASSEMBLY COMMITTEE ON APPROPRIATIONS Mike Gatto, Chair AB 2264 (Levine) - As Amended: May 6, 2014 Policy Committee: HealthVote:19-0 Urgency: No State Mandated Local Program: No Reimbursable: No SUMMARY This bill requires the Department of Public Health (DPH) to negotiate with any federally recognized tribe for a delegated program under which the tribe assumes responsibility for licensing and regulation of primary care clinics operated by the tribes that meet specified criteria. FISCAL EFFECT 1)One-time costs to DPH, not likely to exceed $150,000 (Licensing and Certification Fund) to execute an agreement that outlines a process under which tribes may enforce state regulation of facilities. 2)Ongoing monitoring costs will likely be minor and absorbable. 3)Minor annual revenue loss to DPH, to the extent facilities regulated by tribes no longer pay approximately $700 per facility in licensing fees per facility. DPH oversight workload should be reduced commensurately with any reduction in licensure fees. COMMENTS 1)Purpose . According to the author, this bill creates a single licensing standard for tribe-operated clinics, by clarifying the exemption from clinic licensing in existing law for clinics operated by federally recognized tribes applies to clinics that are not located within Indian country. The author notes when tribe-operated health programs operate a clinic on federal Indian trust land or in affiliation with an institution of AB 2264 Page 2 higher learning they are exempt from licensure. However, other clinics tribes operate must be licensed. 2)Staff Comments . It appears the intent of the bill is to exempt certain tribe-operated clinics from state licensure requirements. However, this bill does not explicitly exempt the clinics from state licensure. Furthermore, it is unclear whether clinics regulated pursuant to a delegated authority would still pay associated licensure fees. These points should be clarified. Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081