BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  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
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            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