(1) Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law establishes, under the Medi-Cal program, the Family Planning, Access, Care, and Treatment (Family PACT) Program. If Family PACT becomes inoperative, existing law requires all persons who have received, or are eligible to receive, comprehensive clinical family planning services pursuant to Family PACT to receive family planning services under other specified provisions of the Medi-Cal program or under the State-Only Family Planning Program, which is also established within the department for purposes of family planning services. This bill would require the department, subject to an appropriation, to develop a new program or to expand any existing state-only-funded health programs, in order to provide to Medi-Cal beneficiaries certain services or benefits that are otherwise covered under the Medi-Cal program but for any lack of, elimination of, reduction in, or limitation on, federal financial participation. For purposes of the expansion above, the bill would require the department to determine the services or benefits, which may include, but are not limited to, abortion and gender-affirming care, based on the levels of federal financial participation, as specified. (2) This bill would, subject to an appropriation, require the California Health and Human Services Agency to develop a new program, or to expand an existing state program, as applicable, to provide certain services or benefits that are otherwise covered under the Medi-Cal program but for any lack of, elimination of, reduction in, or limitation on, federal financial participation. Under the bill, these services or benefits would not be limited to the population of Medi-Cal beneficiaries. The bill would require the agency to determine the services or benefits, which may include, but are not limited to, abortion, family planning, and gender-affirming care, based on the needs of target populations and the levels of federal financial participation, as specified. The bill would create the Health Care Maintenance and Expansion Fund for purposes of distributing funding, if appropriated, for these services or benefits. The bill would authorize the agency to receive private donations, for deposit into the fund, to support implementation. (3) The bill would authorize modification and expansion of the State-Only Family Planning Program, subject to an appropriation, to facilitate implementation of the provisions described in paragraphs (1) and (2) , as specified.
Existing law establishes the California Health and Human Services Agency, which includes departments charged with the administration of health, social, and other human services. Under existing law, the Legislature finds that state government has an affirmative role in alleviating problems related to the inappropriate use of alcoholic beverages and other drug use and that its major objective is protection of the public health and safety, particularly where problems related to inappropriate alcohol use and other drug use are likely to cause harm to individuals, families, and the community. The agency convened the Behavioral Health Task Force to inform its work on behavioral health issues across the state. This bill, the California Overdose Death and Addiction Reduction Act of 2025, would require the California Health and Human Services Agency, on or before January 1, 2028, to direct the task force, or a successor group, to create a set of recommendations to support an implementation plan for reducing alcohol- and drug-related addiction deaths by 50% on or before 5 years from the date the task force provides the recommendations to the agency, but no later than January 1, 2033. The bill would authorize the task force to include additional members as deemed appropriate by the agency, including representatives from specified entities, experts, and providers, among others. The bill would require the agency to adopt the recommendations provided by the task force and require the agency to consider specified information, including quality and performance measures to establish minimum standards for effective delivery of services. The bill would require the agency, on or before July 1, 2033, to provide the Governor and the Legislature a report of the findings and recommendations related to the extent that the 2033 goal was met and how effective the recommendations of the task force were, and recommendations for beyond 2033 that will continue to reduce overdose deaths and addiction. The bill would also make related findings and declarations.
Existing law authorizes a county to establish a homeless adult and family multidisciplinary personnel team, as defined, with the goal of facilitating the expedited identification, assessment, and linkage of homeless individuals to housing and supportive services within that county and to allow provider agencies to share confidential information for the purpose of coordinating housing and supportive services to ensure continuity of care. This bill would authorize a county to also establish a behavioral health multidisciplinary personnel team, as defined, with the goal of facilitating the expedited identification, assessment, and linkage of a justice-involved person, as defined, diagnosed with a mental illness to supportive services within that county while incarcerated and upon release from county jail and to allow provider agencies and members of the personnel team to share confidential information, as specified, for the purpose of coordinating supportive services to ensure continuity of care. The bill would require the sharing of information permitted under these provisions to be governed by protocols developed in each county, as specified. This bill would authorize a behavioral health multidisciplinary personnel team to designate a qualified person to be a member of the team for a particular case and would require a member who receives information or records regarding a justice-involved person in their capacity as a member of the team to be under the same privacy and confidentiality obligations and subject to the same confidentiality penalties as the person disclosing or providing the information or records. The bill would also require the information or records to be maintained in a manner that ensures the maximum protection of privacy and confidentiality rights.
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 a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law sets forth specified prior authorization limitations for health care service plans and health insurers. This bill would prohibit a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2027, that provides coverage for physical therapy from imposing prior authorization for the initial 12 physical therapy treatment visits for a new condition. The bill would authorize prior authorization for physical therapy for a recurring condition, as specified. The bill would require a physical therapy provider to verify an enrollee's or an insured's coverage and disclose their share of the cost of care, as specified. The bill would require a physical therapy provider to obtain separate written consent for costs that may not be covered by the enrollee's or insured's plan contract or policy, that includes a written estimate of the cost of care for which the enrollee or insured is responsible if coverage is denied or otherwise not applicable. With respect to health care service plans, the bill would specify that its provisions do not apply to Medi-Cal managed care plan contracts. Because a willful violation of this provision 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 Department of Veterans Affairs. The department, among other services, provides veterans and their dependents and survivors with assistance in processing service-related disability claims, assistance in obtaining affordable housing, and information about health ailments associated with military service. This bill would require the department to establish a program to fund, upon appropriation by the Legislature, an academic study of mental health among women veterans in California, as specified. The bill would require the department to submit a report that summarizes the findings and recommendations of the study to the Legislature no later than June 30, 2029. The bill would repeal these provisions on January 1, 2030.
Existing law establishes the California Interagency Council on Homelessness to oversee the implementation of Housing First guidelines and regulations, and, among other things, identify resources, benefits, and services that can be accessed to prevent and end homelessness in California. Existing law requires a state agency or department that funds, implements, or administers a state program that provides housing or housing-related services to people experiencing homelessness or who are at risk of homelessness to revise or adopt guidelines and regulations to include enumerated Housing First policies. Existing law specifies the core components of Housing First, including services that are informed by a harm-reduction philosophy that recognizes drug and alcohol use and addiction as a part of tenants' lives and where tenants are engaged in nonjudgmental communication regarding drug and alcohol use. This bill would authorize state programs to fund supportive-recovery residences, as defined, that emphasize abstinence under these provisions as long as the state program meets specified criteria, including that at least 90% of program funds awarded to each jurisdiction is used for housing or housing-based services using a harm-reduction model. This bill would specify requirements for applicants seeking funds under these programs and would require the state to perform periodic monitoring of select supportive-recovery residence programs to ensure that the supportive-recovery residences meet certain requirements, including that core outcomes of the supportive-recovery housing emphasize long-term housing stability and minimize returns to homelessness. The bill would also prohibit eviction on the basis of relapse, as specified. The bill would require, if a tenant is no longer interested in living in a supportive-recovery residence with an abstinence focus, is at risk of eviction, or is discharged from the program, the tenant to reside in the supportive recovery residence until the operator secures the tenant a new permanent housing placement option operated with harm-reduction principles that is also permanent housing. The bill would require supportive housing and services to support residents' access to and use of medications to treat behavioral and physical health conditions, as specified, and to provide overdose prevention training and overdose reversal medication to staff and residents, as specified. Existing law establishes the Department of Housing and Community Development and requires it to administer various programs that provide services to homeless individuals. This bill would require the department to adopt the most recent standards approved by the National Alliance for Recovery Residences or other national standards as the minimum standard for supportive-recovery residences that receive public funds under these provisions. The bill would require the department to establish a separate process for determining if the supportive-recovery residence complies with the core components of Housing First. The bill would require the department to verify compliance with the core components of Housing First for residences seeking Housing First certification, as specified. The bill would authorize the department to charge an annual fee to verify that supportive-recovery residences comply with the core components of Housing First in an amount not to exceed the reasonable cost of administering the program, not to exceed $100, and would establish the Supportive-Recovery Residence Program Fund for collection of the fee, to be available upon appropriation by the Legislature.
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 a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2021, to provide coverage for medically necessary treatment of mental health and substance use disorders, as defined, under the same terms and conditions applied to other medical conditions. This bill would generally require a large group health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2026, to reimburse an eligible enrollee or insured for up to 12 visits with a behavioral health provider if the enrollee or insured lives in a county where a local or state emergency has been declared due to wildfires and the enrollee or insured has experienced a loss, trauma, or displacement because of the fire. The bill would prohibit these benefits from being subject to utilization review. The bill would require a health care service plan contract or health insurer to provide notice to all affected enrollees of these provisions, as specified. Because a willful violation of these provisions 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. This bill would declare that it is to take effect immediately as an urgency statute.
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 a crime. Existing law provides for the regulation of disability insurers by the Department of Insurance. Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services, including pursuant to contracts with various types of managed care plans. Existing law generally authorizes a health care service plan, including a Medi-Cal managed care plan, or disability insurer to use utilization review, under which a licensed physician or a licensed health care professional who is competent to evaluate specific clinical issues may approve, modify, delay, or deny requests for health care services based on medical necessity. For a request prior to or concurrent with the provision of health care services, existing law requires utilization review decisions to be made within 5 business days from the plan's or insurer's receipt of the information reasonably necessary and requested by the plan or insurer to make the determination, or within 72 hours if the enrollee or insured faces an imminent and serious threat to their health or the normal timeframe would be detrimental to their life or health, as specified. This bill would change the timeline for prior or concurrent authorization requests to no more than 3 business days from the plan's or insurer's receipt via electronic submission, or 5 business days from receipt via submission that is not electronic, of the information reasonably necessary and requested by the plan or insurer to make the determination. The bill would require a utilization review decision to be made within 24 hours from receipt of a prior or concurrent authorization request via electronic submission, or 48 hours from receipt via submission that is not electronic, if the enrollee or insured faces an imminent and serious threat to their health or the normal timeframe would be detrimental to their life or health. Because a willful violation of this provision by a health care service plan would be a crime, the bill would impose a state-mandated local program. The bill would exclude Medi-Cal managed care plans from the above-described timeline changes. 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.
(1) 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 a crime. Existing law provides for the regulation of health insurers by the Department of Insurance, which is under the control of the Insurance Commissioner. Existing law requires the Department of Managed Health Care and the commissioner to develop and adopt regulations establishing standards and requirements to provide enrollees and insureds with appropriate access to language assistance in obtaining health care services and covered benefits. Existing law requires the Department of Managed Health Care and commissioner, in developing the regulations, to require health care service plans and health insurers to assess the linguistic needs of the enrollee and insured population, and to provide for translation and interpretation for medical services, as indicated. This bill would require a health care service plan or health insurer to take reasonable steps to provide meaningful access to each individual with limited English proficiency, including companions with limited English proficiency, eligible to receive services or likely to be directly affected by its programs and activities. The bill would require a health care service plan or health insurer to offer a qualified interpreter or to utilize a qualified translator when interpretation or translation services are required, as specified. The bill would prohibit a health care service plan or health insurer from requiring an individual with limited English proficiency to provide or pay for the costs of their own interpreter. The bill would require a health care service plan or health insurer to comply with specified requirements when providing remote interpreting services. The bill would make a health care service plan or health insurer that violates these provisions liable for administrative penalties, as specified. (2) Existing law requires certain vital documents containing enrollee- or insured-specific information to include a written notice of the availability of interpretation services in certain threshold languages. Existing law requires a health care service plan or health insurer, upon request, to provide a written translation of those documents within a specified timeframe. For those documents that also relate to expedited plan review of a grievance for a case involving an imminent and serious threat to the health of the patient, existing law authorizes a health care service plan or health insurer to satisfy the requirement by providing notice of the availability of oral interpretation services. This bill would authorize a health care service plan or health insurer to satisfy the notice requirement by taking reasonable steps to inform the enrollee or insured of any required actions, including by providing a sight translation of a document. (3) Existing law requires a health care service plan or health insurer that advertises or markets products in a non-English language, as specified, to provide specified documents in the same non-English language. This bill would add to the list of documents required to be provided in the advertised or marketed non-English language, (A) notices related to any termination of coverage and change in covered services, (B) complaint forms to file a grievance or appeal, and (C) communications related to costs and payment of covered services, as specified. (4) Existing law requires a health care service plan or health insurer to notify enrollees or insureds, as applicable, and members of the public of nondiscrimination policies, grievance or complaint procedures, as applicable, and the availability of language assistance services and appropriate auxiliary aids and services, as specified. This bill would require a health care service plan or health insurer to also provide the information to persons seeking coverage. The bill would require a health care service plan or health insurer to notify enrollees or insureds, persons seeking coverage, and members of the public that the plan or insurer provides language assistance services and appropriate auxiliary aids and services, as specified. Existing law requires this information to be provided upon initial enrollment, upon renewal, and annually in or with materials that are routinely disseminated. This bill would require a health care service plan or health insurer to also provide the above-described information in clear and prominent physical locations, as specified, and upon request. The bill would require a health care service plan or health insurer to provide information regarding the provision of language assistance services, as described above, in a notice when specified forms or communications are provided, as specified. (5) Existing law requires a health care service plan or health insurer to report to the applicable department on internal policies and procedures relating to cultural appropriateness in specified contexts. This bill would require a health care service plan or health insurer to additionally report to the applicable department on internal policies and procedures relating to language access, as specified. (6) Because a willful violation of these provisions by a health care service plan would be 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 Compassionate Use Act of 1996, an initiative measure enacted by Proposition 215 at the November 6, 1996, statewide general election, declares that its purpose is, among other things, to ensure that seriously ill Californians have the right to obtain and use marijuana for medical purposes, as specified, and exempts from state criminal liability certain patients and their primary caregivers who possess or cultivate marijuana for the personal medical purposes of the patient. The Control, Regulate and Tax Adult-Use of Marijuana Act of 2016 (AUMA) , an initiative measure approved as Proposition 64 at the November 8, 2016, statewide general election, established a comprehensive system to legalize, control, and regulate the cultivation, processing, manufacture, distribution, testing, and sale of nonmedical marijuana. Existing law, the Medicinal and Adult-Use Cannabis Regulation and Safety Act (MAUCRSA) , among other things, consolidates the licensure and regulation of commercial medicinal and adult-use cannabis activities, including the retail sale of medicinal cannabis. MAUCRSA also authorizes specified licensees to provide free medicinal cannabis or medicinal cannabis products to medicinal cannabis patients if specified criteria are met. Existing law, the Medicinal Cannabis Patients' Right of Access Act, prohibits a local jurisdiction from adopting or enforcing any regulation that prohibits the retail sale by delivery within the local jurisdiction of medicinal cannabis to medicinal cannabis patients or their primary caregivers by medicinal cannabis businesses, as defined, or that has the effect of prohibiting the retail sale by delivery within the local jurisdiction of medicinal cannabis to medicinal cannabis patients or their primary caregivers, as specified. This bill, until January 1, 2029, would authorize a licensed microbusiness with an M-license, as defined, whose licensed activities include retail sale, manufacturing, distribution, and outdoor cultivation to directly ship certain medicinal cannabis or medicinal cannabis products to a medicinal cannabis patient in the state, if the licensed microbusiness complies with specified requirements, including that the medicinal cannabis is shipped by a common carrier, as described, the amount shipped to a medicinal cannabis patient in a single day does not exceed specified possession limits, and the package is received and signed for by someone 21 years of age or older. The bill would require the shipment to comply with specified laws and regulations governing cannabis and cannabis products sold by licensed retailers, as provided. If the medicinal cannabis patient is a qualified patient that possesses a valid physician's recommendation, the bill would require the licensed microbusiness to certify in writing that they verified the recommendation and would require the retailer to keep a copy of that certification for no less than 7 years. The bill would amend the Medicinal Cannabis Patients' Right of Access Act to, among other things, prohibit a local jurisdiction from adopting or enforcing any regulation that prohibits the retail sale by delivery within or shipment into the local jurisdiction of medicinal cannabis to medicinal cannabis patients or their primary caregivers by a licensed microbusiness, as specified. The bill would also authorize free medicinal cannabis or medicinal cannabis products provided to medicinal cannabis patients in compliance with MAUCRSA to be shipped to those patients by a licensed microbusiness with an M-license, as provided. To the extent this bill would impose additional duties on local jurisdictions, and to the extent the bill would expand the crime of perjury by requiring the licensed microbusiness to certify verification of physician recommendations, 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 with regard to certain mandates no reimbursement is required by this act for a specified reason. With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
