BILL ANALYSIS �
AB 1896
Page 1
ASSEMBLY THIRD READING
AB 1896 (Chesbro)
As Amended March 27, 2012
Majority vote
BUSINESS & PROFESSIONS 9-0
-----------------------------------------------------------------
|Ayes:|Hayashi, Bill Berryhill, | | |
| |Allen, Butler, Eng, | | |
| |Hagman, Hill, Ma, Smyth | | |
| | | | |
-----------------------------------------------------------------
SUMMARY : Exempts from California licensure all health care
practitioners employed by a tribal health program as long as
they are licensed in another state. Specifically, this bill :
1)Provides that a person who is licensed as a health care
practitioner in any other state and is employed by a tribal
health program, as defined in federal law, shall be exempt
from any licensing requirement described in California law
governing the healing arts with respect to acts authorized
under the person's license where the tribal health program
performs the services described in the contract or compact of
the tribal health program under the Indian Self-Determination
and Education Assistance Act (ISDEAA).
2)Defines "health care practitioner" to mean any person who
engages in acts that are the subject of licensure or
regulation under the law of any other state.
EXISTING LAW :
1)Licenses and regulates a number of healing arts professionals
under various boards within the Department of Consumer Affairs
(DCA).
2)Allows, until January 1, 2016, a hospital to enter into an
agreement with the Armed Forces of the United States (U.S.) to
authorize a physician and surgeon, physician assistant, or
registered nurse to provide medical care in the hospital under
specified conditions, including that the practitioner holds a
valid license in good standing to provide medical care in the
District of Columbia or any state or territory of the U.S.,
AB 1896
Page 2
and that the practitioner registers with the appropriate
California licensing board, as specified.
3)Authorizes a physician and surgeon who is not licensed in
California but who is a commissioned officer on active duty in
the medical corps of any branch of the Armed Forces of the
U.S. to practice medicine as part of a residency, fellowship,
or clinical training program under specified conditions.
These officers are required to register with the Medical Board
of California, as specified.
4)Authorizes, under federal law, a health care professional, as
defined, to practice his or her health profession in any state
or territory without licensure by that state if he or she has
a current license to practice the health profession and is
performing authorized duties for the Department of Defense.
5)Defines, under federal law, the term "tribal health program"
to mean an Indian tribe or tribal organization that operates
any health program, service, function, activity, or facility
funded, in whole or part, by the Indian Health Service (IHS)
through, or provided for in, a contract or compact with the
IHS under the ISDEAA.
6)Establishes, under the Patient Protection and Affordable Care
Act (PPACA), that licensed health professionals employed by a
tribal health program shall be exempt, if licensed in any
state, from the licensing requirement of the state in which
the tribal health program performs the services described in
the contract or compact of the tribal health program under the
ISDEAA.
FISCAL EFFECT : Unknown. This bill is keyed non-fiscal by the
Legislative Counsel.
COMMENTS : According to the author, "Historically, the Tribal
Health Programs have experienced shortages in doctors, dentists,
nurses and other providers. According to the Indian Health
Service's Workforce report, the vacancy rates range from 10% to
25% depending on the type of provider and this is primarily
attributed to the remoteness of many of the facilities.
"California's 31 Tribal Health Programs operate 57 ambulatory
clinics in primarily rural regions and have substantial
AB 1896
Page 3
difficulty hiring and retaining providers to work in the
facilities. These critically important safety net facilities
serve over 130,000 American Indian/Alaska Native patients and
multiple Medi-Cal patients on an annual basis. This bill is
necessary as it will enable Tribal Health Programs to hire
healthcare providers. The bill will amend the current
California Business and Professions Code to align with Federal
law allowing professionals employed by tribal health programs to
work in states without licensure as long as they hold a license
from another state."
Under current state law, health care practitioners who provide
services at tribal health centers must be licensed by the
appropriate healing arts board under DCA. However,
recently-enacted federal law under the PPACA exempts these
practitioners from licensing requirements of the state in which
they practice if they are licensed in another state. This bill
adds this provision to state law, in conformity with federal
law.
As states revamp their health care systems to prepare for
compliance with PPACA, the sponsors contend that this licensure
exemption should be specified in state law to avoid confusion
and possible litigation. Supporters also assert that this
legislation will assist in filling the shortage of health care
providers at tribal health centers in the state, by removing a
possible barrier for those professionals to practice in
California.
Analysis Prepared by : Angela Mapp / B.,P. & C.P. / (916)
319-3301
FN: 0003254