Existing law prohibits the Department of Corrections Rehabilitation from allowing any lack of care that would injure or impair the health of an incarcerated person. Existing law prohibits the department from modifying or canceling the medical treatment of an incarcerated person if a physician certifies that the medical treatment is required to prevent certain violations of law or to prevent serious and imminent harm to the health of an incarcerated person, as specified. This bill would prohibit a supervisor, administrator, or employee of the department from interfering with or refusing to implement prescribed health care, as specified, that results in substantial emotional distress or serious bodily injury, as defined.
Existing law, the Physical Therapy Practice Act, establishes the Physical Therapy Board of California within the Department of Consumer Affairs for the licensure, approval, and regulation of physical therapists and physical therapist assistants. Existing law prescribes specified fees for licenses issued by the board. Existing law authorizes the board to decrease or increase the fee amounts, and establishes specified maximum amounts of license fees. Existing law repeals the board and its authority to employ an executive officer on January 1, 2027. This bill would extend the board's authority to enforce and administer the act and to appoint an executive officer until January 1, 2031. The bill would increase specified fees for licenses issued by the board and would increase the maximum amount to which the board may increase the fees, as specified. The bill would also make nonsubstantive changes to those fee provisions. Existing law authorizes a person whose license has been revoked or suspended, or who has been placed on probation, to petition the board for reinstatement or modification of a penalty after a specified period of time has elapsed. Existing law prohibits the board from considering a petition while the petitioner is under sentence for any criminal offense, including any period of court-imposed probation or parole, or while there is an accusation or petition to revoke probation pending against the petitioner. This bill would further prohibit the board from considering a petition if the applicant is required to register as a sex offender, as specified. The bill would except from this prohibition an applicant whose requirement to register as a sex offender is based solely on a misdemeanor conviction. The bill would also prohibit the board from considering a petition if the conduct underlying the petitioner's conviction involved certain sexual misconduct.
Existing law finds and declares that prenatal and postpartum care, among other things, are essential services necessary to ensure maternal health. Existing law establishes the State Department of Public Health, and vests the department with certain duties relating to maternal health, including maintaining a program of maternal and child health, as provided. This bill would require the department to include on its internet website information advising individuals to discuss pelvic floor concerns with their health care provider during their postpartum care visit.
Existing law establishes the Instructional Quality Commission and requires the commission to, among other things, recommend curriculum frameworks to the State Board of Education. This bill would require the commission, during the next revision of the publication "Health Framework for California Public Schools," to consider including, and recommending for adoption by the state board, specific content related to sexual health instruction to educate pupils about dating abuse and digital violence, as described.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law authorizes the Director of the Department of Managed Health Care to authorize a pilot program in southern California under which approved providers may undertake risk-bearing arrangements with a voluntary employees' beneficiary association with enrollment of more than 100,000 lives, as specified, beginning no earlier than January 1, 2022, to December 31, 2027, inclusive, if certain criteria are met. Existing law requires the association and each participating health care provider to report to the department information regarding cost savings and clinical patient outcomes compared to a fee-for-service payment model. Existing law requires the department to report those findings to the Legislature after the termination of the pilot program and before January 1, 2027. Existing law repeals these provisions on January 1, 2030. This bill would extend that repeal date to January 1, 2031. The bill would extend the end date of the pilot program to December 31, 2030, but would authorize the department to terminate the pilot program for specified reasons and would require the department to terminate the pilot program prior to the pilot program's end date based on any significant negative findings in any report, including if the department identifies any serious deficiencies that could cause enrollee harm. The bill would, instead of requiring the department to report findings to the Legislature after the termination of the pilot program, require the department to submit an interim report of the findings described above and policy recommendations regarding the continuation of the pilot program to the Legislature before January 1, 2029.
Existing law requires the State Department of Health Care Services to license and regulate adult alcohol or other drug recovery or treatment facilities that provide residential nonmedical services, as specified, and further requires the department to certify and regulate alcohol and other drug programs, as specified. This bill would require an alcohol or other drug treatment facility and an alcohol or other drug program to participate in a public consumer protection platform, as defined, designated or designed by the department in order to be licensed or certified. The bill would specify that participation in the public consumer protection platform pursuant to these provisions is only required if the department determines that sufficient funding has been appropriated or otherwise secured to cover the costs of participation in the platform, as specified. The bill would authorize the department to charge a reasonable fee to alcohol or other drug treatment facilities and alcohol or other drug programs required to enroll in the platform, as specified, and would prohibit the administrator of the public consumer protection platform from accepting payment from the entities subject to these provisions. The bill would authorize the department to verify compliance with participation in the public consumer protection platform as part of the certification or licensing process. The bill would prohibit participation in the consumer protection platform from being used as a criterion in evaluating bids, proposals, network participation, reimbursement, or contract performance for publicly funded substance use disorder treatment services. The bill would require the consumer protection platform, if managed by an entity other than the department, to collect and publicly display information from each participating treatment provider on the provider's adoption of evidence-based practices in substance use disorder care, as specified. The bill would authorize the department to implement, interpret, or make specific those provisions by means of provider bulletins, written guidelines, or similar instructions.
Existing law provides for the licensing and regulation of health facilities by the State Department of Public Health and generally makes a violation of those provisions a crime. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and generally makes a willful violation of the act a crime. Existing law requires a health facility to provide emergency services and care upon request for any condition in which the person is in danger of loss of life or serious injury or illness. Existing law requires a health care service plan to reimburse providers for emergency services and care. Existing law defines "emergency services and care" for these purposes to mean medical screening, examination, and evaluation by a physician and surgeon, or other appropriate licensed persons under the supervision of a physician and surgeon, to determine if an emergency medical condition or active labor exists and, if it does, the care, treatment, and surgery, if within the scope of that person's license, necessary to relieve or eliminate the emergency medical condition, within the capability of the facility, among other things. This bill would specify that the above-described provisions would not require physician supervision of a licensed nurse-midwife in the labor and delivery unit, obstetric triage, or dedicated emergency obstetric evaluation unit, when the nurse-midwife is providing care to the extent authorized by, and consistent with, specified licensing and certification provisions, or when the nurse-midwife is specifically requested by the treating physician and surgeon to provide obstetric consultation. By changing the scope of a crime, this bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act's requirements a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires health care service plans and health insurers, as specified, within 6 months after the relevant department issues specified guidance, or no later than March 1, 2025, to require all of their staff who are in direct contact with enrollees or insureds in the delivery of care or enrollee or insured services to complete evidence-based cultural competency training for the purpose of providing trans-inclusive health care for individuals who identify as transgender, gender diverse, or intersex. This bill would prohibit a subscriber, enrollee, policyholder, or insured from being excluded from enrollment or participation in, being denied the benefits of, or being subjected to discrimination by, any health care service plan or health insurer licensed in this state, on the basis of race, color, national origin, age, disability, or sex. The bill would define discrimination on the basis of sex for those purposes to include, among other things, sex characteristics, including intersex traits, pregnancy, and gender identity. The bill would prohibit a health care service plan or health insurer from taking specified actions relating to providing access to health programs and activities, including, but not limited to, denying or limiting health care services to an individual based upon the individual's sex assigned at birth, gender identity, or gender otherwise recorded. The bill would prohibit a health care service plan or health insurer, in specified circumstances, from taking various actions, including, but not limited to, denying, canceling, limiting, or refusing to issue or renew health care service plan enrollment, health insurance coverage, or other health-related coverage, or denying or limiting coverage of a claim, or imposing additional cost sharing or other limitations or restrictions on coverage, on the basis of race, color, national origin, sex, age, disability, as specified. Because a violation of the bill's requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services through various delivery systems, including fee-for-service and managed care. The Medi-Cal program is, in part, governed by, and funded pursuant to, federal Medicaid program provisions. Existing law establishes the California Program of All-Inclusive Care for the Elderly (PACE program) to provide community-based, risk-based, and capitated long-term care services as optional services for older individuals under the state's Medi-Cal State Plan and under contracts entered into between the federal Centers for Medicare and Medicaid Services, the department, and PACE organizations. Existing law requires the department to pay capitation rates to health plans participating in the Medi-Cal managed care program using actuarial methods. Existing law requires the department to develop and pay capitation rates to entities contracted pursuant to the PACE program, using actuarial methods consistent with those provisions, with specified exceptions. Existing law requires the department to consult with those contracted entities in developing a rate methodology. This bill would require the department to notify the contracting PACE organization of the proposed rates at least 60 days prior to submission to the federal Centers for Medicare and Medicaid Services (CMS) for approval. The bill would authorize the department to define a reasonable date by which the PACE organization must submit written questions or feedback concerning the proposed rates. The bill would require the department to respond in writing to those questions or feedback by no later than 30 days prior to submitting the rates to CMS.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is in part governed by, and funded pursuant to, federal Medicaid program provisions. Existing law, subject to implementation of the California Advancing and Innovating Medi-Cal (CalAIM) initiative, requires the department to implement an enhanced care management (ECM) benefit designed to address the clinical and nonclinical needs on a whole-person-care basis for certain target populations of Medi-Cal beneficiaries enrolled in Medi-Cal managed care plans. Under existing law, target populations include, among others, high utilizers with frequent hospital admissions, short-term skilled nursing facility stays, or emergency room visits, and individuals experiencing homelessness. This bill would recast the definition of ECM, referring to community-based, high-touch coordination and comprehensive care management services, as specified. The bill would delete certain provisions that designate 2022 or 2023 timelines for commencing ECM coverage, depending on whether or not a Medi-Cal managed care plan operates in a county in which the Whole Person Care pilot program or the Health Home Program was implemented. Existing law, subject to CalAIM implementation, authorizes a Medi-Cal managed care plan to elect to cover community supports. Under existing law, community supports that the department is authorized to approve include, among others, housing transition navigation services and medically supportive food and nutrition services. This bill would require the department to publish and maintain policy guides and all-plan letters on its internet website that define model coverage standards and policy for each community support, to engage stakeholders, to provide ongoing technical assistance, and to establish a standard timeline and process for regular updates to community supports policy guides, as specified. The bill would require a Medi-Cal managed care plan to adopt community supports policies, and to educate its in-network community support providers, as specified. The bill would require the department to publish certain information on ECM and community supports utilization data on the department's internet website on a quarterly basis, to the extent feasible, until January 1, 2032. The bill would require the department, by March 31, 2029, to provide to the legislative committees specified information in writing necessary to inform legislative consideration of transitioning community supports to benefits that are required to be covered under the Medi-Cal program. The bill would make other technical changes to the ECM and community support provisions.
