Health.

The bill was transformed from a single-section placeholder into a multi-code omnibus amending Government Code, Health and Safety Code, Revenue and Taxation Code, and Welfare and Institutions Code provisions across at least 13 distinct policy areas.

Palomar Health District: Authorizes transfer of district assets to Palomar UC San Diego Health Authority with conditions including a 10-year covenant to operate for health care services, retroactive application to board approvals on or after January 1, 2025, and expiration if no agreement is executed by December 31, 2028.

Medi-Cal provider enrollment: Requires DHCS to deny or terminate provider enrollment if the applicant has an affiliation within the previous 5 years with a person or entity that experienced a disclosable event, if the department determines the affiliation poses an undue risk of fraud, waste, or abuse. Also makes temporary suspension effective on the date notification is sent rather than 15 days later.

988 Suicide and Crisis Lifeline: Establishes a designated 988 center approval process (DHCS to establish by October 1, 2027), requires all 988 centers to obtain designation by December 31, 2029 or lose funding, extends advisory group meetings through December 31, 2029, requires an interoperable solution between 988 and 911 by December 31, 2029, and creates a 988 System Governance Board until January 1, 2030.

988 funding: Requires DHCS to develop a two-year statewide funding estimate for 988 centers and designated 988 centers, requires annual expenditure/revenues/outcomes reports from fund recipients with DHCS approval or denial authority, and specifies that surcharge revenue supplements rather than supplants other funding sources.

Nurse-to-patient ratio penalties: Extends the existing penalty exemption (for demonstrating prompt efforts to maintain staffing levels) from general acute care hospitals to acute psychiatric hospitals.

LGBTQ+ suicide prevention: Requires the agency to annually determine whether an adequate specialized LGBTQ+ suicide prevention hotline is activated under 988, authorizes requesting SAMHSA approval for a state-level press 3 routing function, and requires contracting with qualified entities specializing in LGBTQ+ suicide prevention within 12 months of SAMHSA approval.

CBAS center closures: Requires DHCS and the Department of Aging to collaborate with certain entities to understand Community-Based Adult Services center closures and requires a report to the Legislature and Legislative Analyst's Office by March 1, 2029.

Non-citizen Medi-Cal eligibility restructured: Beginning October 1, 2026, individuals with specified immigration status are only eligible for full-scope Medi-Cal if they meet certain criteria. Through June 30, 2027, those not described in certain federal provisions remain eligible for full-scope state-funded benefits. Pregnant individuals and those entitled to postpartum care are exempt from dental service limitations.

Maintenance dialysis: Effective October 1, 2026, medically necessary maintenance dialysis for chronic dialysis and end-stage renal disease becomes a covered service under restricted-scope Medi-Cal regardless of whether it meets the emergency medical condition definition, with state funding required where federal financial participation is unavailable.

Appropriates $105,611,000, $5,975,000, and $1,229,000 from the Federal Trust Fund to DHCS for State Opioid Response Grant and Substance Abuse Prevention and Treatment Block Grant funds, available through June 30, 2027.

Adds new definitions in Government Code Section 53123.1.5 for 988, 988 center, designated 988 center, behavioral health crisis services, interoperable solution, mobile crisis team, and other terms supporting the 988 system framework.

Medi-Cal provider moratorium: Removes the existing exception that allowed certain clinics, health facilities, or licensed natural persons to be exempt from a 180-day enrollment moratorium, and requires written notice to the Joint Legislative Budget Committee with renewal every 180 days.