Health and care facilities: licensing during emergencies or disasters.

RCFEs are now only encouraged (rather than required) to provide a copy of their emergency and disaster plan to the medical health operational area coordinator for local disaster coordination purposes.

Skilled nursing facilities must now 'review' (rather than 'update') their external disaster and mass casualty program plan at least once per year, slightly narrowing the obligation.

The 'disaster suspension of active license' mechanism was removed from the bill. The enrolled version relies solely on the 'inactive license status' framework for facilities made nonoperational by emergencies or disasters.

The legislative counsel's digest no longer identifies the RCFE plan-sharing provision as imposing a state-mandated local program, consistent with its downgrade from mandatory to encouraged.

The specific reference to entities 'destroyed in a fire' as a condition for fee waivers was removed, broadening the fee waiver provision to any entity that is nonoperational and being rebuilt for the same purpose.

Specific transition deadlines (May 1, 2026 and October 1, 2026) requiring existing inactive license holders to resubmit requests were removed from Section 1596.8535.

The document was reformatted from a formal chaptered legislative document (with page numbers, running headers like 'Ch. 546', and official state markings) into a web-based bill text page with navigation menus, search tools, and sidebar links. No changes to the legal text or policy provisions were made.

Added residential care facilities for persons with chronic life-threatening illnesses and home care organizations to the entities covered by the bill's disaster licensing provisions.

Added a general inactivity provision effective January 1, 2028, allowing licensees of community care facilities (adults), RCFEs, medical foster homes for veterans, residential care facilities for chronic life-threatening illness, and child daycare facilities to request inactive license status for any period of inactivity, not just disaster-related closures.

Added an exemption for facilities owned or operated by the Department of Corrections and Rehabilitation from the skilled nursing facility external disaster and mass casualty program plan requirements.

Created a new 'inactive license status' mechanism for community care facilities (children and adults), RCFEs, medical foster homes for veterans, child daycare facilities, residential care facilities for chronic life-threatening illness, and home care organizations. This is distinct from the existing 'disaster suspension of active license' and requires notification within 90 days of a proclamation or declaration.

Changed the requirement that RCFEs 'shall provide' a copy of their emergency and disaster plan to the MHOAC to 'is encouraged to provide,' making it voluntary rather than mandatory.

Changed skilled nursing facility external disaster plan language from 'updated at least once per year' to 'reviewed at least once per year,' softening the obligation.

Added provisions allowing alcohol or other drug recovery or treatment facilities and programs to request inactive license status from DHCS, with a 90-day notification deadline and a 15-working-day response requirement for the department.

Removed the requirement for DPH/DSS to waive in-person or daily attendance requirements for CBAS programs during emergencies. Replaced with a requirement for DHCS to require Medi-Cal managed care plans to presume conditions are met for Emergency Remote Services in CBAS programs for 30 days following a proclamation.

Added provisions in Section 1596.8535 limiting child daycare inspections to one hour before or after normal business hours (with exceptions for safety complaints) and prohibiting inspections during periods of inactive license status.

Expanded fee waiver authority to cover 'annual or biennial' state licensing fees (previously only annual) and extended it to entities approved for inactive license status, not just those with a disaster suspension.

Added authorization for DPH to continue exercising existing authority during emergencies, including suspending a facility's beds, services, or license to assist facilities rendered nonoperational by a declared disaster.

Added transition deadlines for child daycare facilities with existing inactive status: those granted before December 31, 2023 must re-request by May 1, 2026; those granted between January 1, 2024 and December 31, 2025 must re-request by October 1, 2026.

Section 1796.85 was restructured into subsections (a) and (b). Subsection (b) extends the waiver of in-person or daily attendance requirements for childcare programs from 30 calendar days to 90 calendar days following a proclamation or declaration.

New requirement added in Section 1796.85(a): the State Department of Health Care Services must require Medi-Cal managed care plans to presume that conditions are met for Emergency Remote Services in Community-Based Adult Services (CBAS) programs for the first 30 calendar days following a proclamation or declaration, for entities made nonoperational.

The childcare attendance waiver is now handled separately from the CBAS waiver, with a longer 90-day period for childcare versus the 30-day period for CBAS programs, reflecting the different recovery timelines needed by these two types of facilities.

Removed the requirement for skilled nursing facilities to submit a separate evacuation plan to the MHOAC, maintain it with the county medical and health disaster plan, and incorporate MHOAC-recommended revisions. These were former subsections (b), (c), and (d) of new Section 1418.23.

Changed the update frequency for the external disaster and mass casualty program plan from at least once every five years to per year (annually). The amendment inserts 'per year' alongside the existing 'every five years' language, indicating a shift to annual updates.

New subsection (b) added to Section 1418.23 requiring skilled nursing facilities to update their external disaster and mass casualty program plan at least once every five years, seek input from county or regional and local planning offices including the MHOAC, incorporate lessons learned from recent major disasters affecting California SNFs, and provide copies of the plan and updates to local or regional emergency planning offices.

Section 1796.83 fee waiver provision broadened: previously applied only to entities 'destroyed in a fire,' now applies to any entity that is nonoperational due to destruction, significant damage, or prolonged closure and is being rebuilt for the same purpose.

Section 1569.695: removed the redundant 'encouraged' subsection (j) regarding local emergency authority review, keeping only the mandatory requirement to provide a copy of the plan to the MHOAC. Fixed duplicate subsection numbering.

Removed redundant phrasing 'by being destroyed due to its destruction' in Sections 1796.82 and 11834.62, simplifying to 'due to its destruction, significant damage, or through a prolonged closure or otherwise.'

New Section 1418.23 requires skilled nursing facilities to submit an evacuation plan to the MHOAC that can be implemented during emergencies, natural disasters, wildfires, or other causes. The plan must be maintained with the county medical and health disaster plan, and the facility must incorporate recommended revisions from the MHOAC to the extent feasible.

Section 1569.695 is amended so that RCFEs must now provide a copy of their emergency and disaster plan to the MHOAC for local disaster coordination. Previously, facilities were only encouraged to have the plan reviewed by local emergency authorities.

The conditions under which entities can obtain a disaster suspension of their active license are expanded from 'destroyed or through a closure' to include 'significant damage' and 'prolonged closure' as qualifying conditions in Sections 1796.82, 1796.83, and 11834.62.

The annual state licensing fee waiver (Section 1796.83) is expanded from applying only to entities destroyed in a fire to also covering entities nonoperational due to significant damage or prolonged closure, broadening who can receive the year-by-year fee waiver.

New Section 6 adds a no-reimbursement clause under Article XIII B of the California Constitution, stating no reimbursement is required because the act only creates or changes crimes within the meaning of Government Code Section 17556.

The bill is now flagged as imposing a state-mandated local program (changed from 'no' to 'yes') and requiring fiscal committee review (changed from 'no' to 'yes'), reflecting the new obligations placed on local MHOACs and emergency coordination entities.

Added a new Chapter 15 (Sections 1796.80-1796.86) to Division 2 of the Health and Safety Code covering disaster licensing for facilities under the State Department of Public Health and State Department of Social Services, including clinics, skilled nursing facilities, intermediate care facilities, hospice, residential facilities, adult day programs, foster family homes, transitional shelters, crisis nurseries, childcare facilities, medical foster homes for veterans, and residential care facilities for the elderly.

Added a new Article 6 (Sections 11834.60-11834.64) to Chapter 7.5 of Part 2 of Division 10.5 of the Health and Safety Code extending similar disaster licensing provisions to alcohol or other drug recovery or treatment facilities under the State Department of Health Care Services.

Established that a facility may obtain a disaster suspension of its active license if it was made nonoperational by destruction, closure, or other means during a covered emergency and notifies the applicable department within 6 months that it intends to become operational again in the same or an alternative location.

Defined four triggering events: a state of emergency proclaimed by the Governor, a federal emergency declaration, a federal major disaster declaration, and a federal fire management assistance declaration approved by FEMA.

Authorized departments to waive annual state licensing fees in whole or in part on a year-by-year basis for entities destroyed in a fire that are being rebuilt for the same purpose and have obtained a disaster suspension.

The fiscal committee designation changed from 'no' to 'yes,' indicating the amended bill now has fiscal implications requiring review.

Required that when an entity is licensed by more than one state department within the California Health and Human Services Agency, the governing departments must coordinate operational steps including concurrent processes.

Required departments to waive in-person or daily attendance requirements for Community-Based Adult Services (CBAS) and childcare programs for the first 30 calendar days following a proclamation or declaration.

Required the State Department of Social Services to collaborate with local building, planning, and permitting officials, the local fire marshal, and local childcare agencies and regional centers to ensure swift inspection and licensing processes for entities being made operational again.

The original single-section intent statement was retained but renumbered as Section 3, and a new findings section (Section 1) referencing the January 7, 2025 Los Angeles wildfires was added at the beginning of the bill.