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. Under existing law, home- and community-based services (HCBS) approved by the United States Department of Health and Human Services are covered for eligible individuals to the extent that federal financial participation is available for those services under the state plan or waivers granted in accordance with certain federal provisions. Existing law authorizes the Director of Health Care Services to seek waivers for any or all approvable HCBS. Existing law sets forth provisions for the implementation of the Nursing Facility/Acute Hospital Transition and Diversion Waiver, which is the predecessor of the Home and Community-Based Alternatives (HCBA) Waiver, for purposes of providing care management services to individuals who are at risk of nursing facility or institutional placement, subject to federal cost neutrality. Existing law authorizes the director to propose that the waiver provide for achievement of annual cost neutrality in the aggregate to allow enrollment and authorization of waiver services based on medical necessity, and to require care management contractors to enroll at least 60% of all total annual enrollments from certain health care settings or populations. Existing law additionally sets forth provisions authorizing the director to expand the number of waiver slots up to 5,000 additional slots. This bill would recast the above-described waiver provisions to refer to the HCBA Waiver. The bill would authorize the director, beginning January 1, 2027, to semiannually evaluate the populations receiving the priority enrollment described above, and to designate additional populations to receive priority enrollment based on this evaluation, subject to applicable cost-neutrality requirements. The bill would delete the provision relating to the 5,000 slots. The bill would instead require the department, beginning in 2027, and for the HCBA Waiver period, to increase the total number of waiver slots by 5,000, in addition to any planned expansion of waiver slots federally approved as of January 1, 2026, as specified, consistent with the above-described requirements.
(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. Existing law requires a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2002, to provide coverage for an annual cervical cancer screening test upon the referral of the patient's health care provider. This bill would require a health care service plan contract or health insurance policy, except for a vision-only, dental-only, or Medicare supplement contract or policy, issued, amended, or renewed on or after January 1, 2027, to provide coverage without cost sharing for cervical cancer screening, including the United States Food and Drug Administration (FDA) -authorized or cleared self-collected cervical screening kits, when ordered or provided by an in-network provider and consistent with specified recommendations published by the State Department of Public Health. For health savings account-eligible plans or policies, the bill would require the above-described coverage only to the extent the plan is a high deductible health plan under specified federal law. Because a willful violation of the bill's requirements relative to health care service plans would be a crime, the bill would impose a state-mandated local program. (2) Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and under which health care services are provided to low-income individuals pursuant to a schedule of benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. An annual cervical cancer test for screening or diagnostic purposes, upon the referral of a patient's physician, is a covered benefit under the Medi-Cal program to the extent required or permitted by federal law. This bill would instead include cervical cancer tests for screening that are ordered by a patient's health care provider and consistent with specified recommendations published by the State Department of Public Health as a covered benefit under the Medi-Cal program on or after January 1, 2027. The bill would additionally include FDA-authorized or cleared cervical cancer home test kits for screening that are ordered by a patient's health care provider and consistent with specified recommendations published by the State Department of Public Health and Medi-Cal policies as a covered benefit under the Medi-Cal program on or after January 1, 2027, without cost sharing, to the extent that federal financial participation is available and not otherwise jeopardized and any necessary federal approvals have been obtained. (3) 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 authorizes a school district, county office of education, or charter school to provide emergency stock albuterol inhalers, as specified, to school nurses or trained personnel who have volunteered, and authorizes school nurses or trained personnel to use an emergency stock albuterol inhaler to provide emergency medical aid to persons suffering, or reasonably believed to be suffering, from respiratory distress, as provided. Existing law authorizes a prescription for emergency stock albuterol inhalers to be filled by local or mail order pharmacies or stock albuterol inhaler manufacturers. This bill would revise and recast that latter provision by making its provisions also apply to a childcare program, as defined, that is operated by or contracts with a school district, county office of education, or charter school, as provided. This bill would explicitly authorize a pharmacy to furnish stock albuterol inhalers to a local educational agency pursuant to a written order from an authorized prescriber. The bill would authorize a prescription for emergency stock albuterol inhalers also to be filled by stock albuterol wholesalers or distributers. The bill, for purposes of these provisions, would change references from the Superintendent of Public Instruction to the Education Commissioner in order to implement changes made by AB 181 of the 2025–26 Regular Session.
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 require applicants for state homelessness funding for recovery housing, as defined, to demonstrate the availability of a range of interventions, as specified. The bill would require a program that provides recovery housing to meet specified requirements in order to be eligible for state funding, including that the program satisfies the core components of Housing First, relapse is not, unless there is another lease violation, grounds for eviction and residents receive relapse support, the program provides emergency preparedness and overdose prevention and response training to staff and residents and makes overdose reversal medication available and readily accessible to staff and residents onsite, and the program adopts and maintains a written return-to-use policy, as specified. The bill would make related findings and declarations.
Existing law authorizes a school district, county office of education, and charter school to provide emergency naloxone hydrochloride or another opioid antagonist to school nurses and trained personnel who have volunteered, and authorizes school nurses and trained personnel to use naloxone hydrochloride or another opioid antagonist to provide emergency medical aid to persons suffering, or reasonably believed to be suffering, from an opioid overdose. This bill, to be known as the School Safety and Opioid Overdose Prevention Act, and commencing with the 2027–28 school year, would require a school resource officer, as defined, to (1) upon assignment to a schoolsite, and at least every 2 years thereafter, complete an opioid overdose recognition and response training, as specified, and (2) report, on or before July 1, 2028, and annually thereafter until July 1, 2030, to the State Department of Public Health, among other things, the number of times the school resource officer administered an opioid antagonist, and the types of opioid antagonist received and administered, while serving at a schoolsite. The bill would prohibit a school resource officer who administers an opioid antagonist while assigned to a schoolsite, and their employing or contracting entity, from being held liable in a civil action or being subject to criminal prosecution for the school resource officer's acts or omissions, unless those acts or omissions constitute gross negligence or willful and wanton misconduct, as provided. The bill would require the Commission on Peace Officer Standards and Training, in consultation with the State Department of Education, to provide implementation guidance to local educational agencies and law enforcement agencies on accessing opioid antagonists at low or no cost and integrating overdose response into school safety planning. The bill would require the State Department of Public Health, on or before July 1, 2031, to submit a report to the Legislature with the information annually reported by school resource officers, and post specified information on the department's internet website, as provided.
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 also provides for the regulation of health insurers by the Department of Insurance. Existing law requires an individual or small group health care service plan contract or health insurance policy to include, at a minimum, coverage for essential health benefits, as specified. Commencing January 1, 2027, if the United States Department of Health and Human Services approves a new essential health benefits benchmark plan for the state, existing law requires essential health benefits to include an annual hearing exam and one hearing aid per ear every three years. This bill, the Let California Kids Hear Act, would require a large group health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2028, to include coverage for hearing aids, as defined, and related services for enrollees and insureds under 21 years of age, if medically necessary. The bill would authorize a large group health care service plan contract or health insurance policy to limit the dollar coverage for each individual hearing aid device to $3,000, as specified. Because a willful violation of these 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 provides for the licensure and regulation of alcohol or other drug recovery or treatment facilities by the State Department of Health Care Services. Existing law prohibits operating an alcohol or other drug recovery or treatment facility to provide recovery, treatment, or detoxification services within this state without first obtaining a current valid license. If a facility is alleged to be providing those services without a license, existing law requires the department to conduct a site visit to investigate the allegation. Existing law also authorizes the department to conduct announced or unannounced site visits to licensed facilities for the purpose of reviewing them for compliance, as specified. Existing law requires alcohol or other drug programs to be certified by the department, except as specified. Existing law prohibits those programs from operating without a certification. If a program is alleged to be providing services without a certification, existing law requires the department to conduct a site visit to investigate the allegation. Existing law also authorizes the department to conduct announced or unannounced site visits to certified programs for the purpose of reviewing them for compliance, as specified. This bill would require the department to assign a complaint under its jurisdiction regarding a licensed alcohol or other drug recovery or treatment facility or a certified alcohol or other drug program to an analyst for investigation within 10 days of receiving the complaint. If the department receives a complaint that does not fall under its jurisdiction, the bill would require the department, to the extent feasible, to notify the complainant, in writing, that it does not investigate that type of complaint. The bill would require the department to complete an investigation into a complaint regarding a facility within 120 days of assigning the complaint unless the department requires additional resources, as specified, to complete the investigation. Commencing July 1, 2027, and each July 1 thereafter, the bill would require the department to post on its internet website an annual report of the investigations conducted by the department, as specified. The bill would authorize the department to impose a single fee increase for the licensure of facilities and certification of programs, as described above, commensurate with the reasonable cost of preparing and maintaining the report.
Existing law requires a licensed health care practitioner who provides prenatal, postpartum, or interpregnancy care for a patient to offer to screen or appropriately screen a mother for maternal mental health conditions. For purposes of that requirement, existing law defines "maternal mental health condition" to mean a mental health condition that occurs during pregnancy, the postpartum period, or interpregnancy, as specified. This bill would limit the definition of "maternal mental health condition" to a mental health condition that occurs during the pregnancy or the postpartum period, as specified. The bill would authorize a licensed health care practitioner to satisfy the above-described requirement for maternal mental health screening by referring the patient or client to another licensed health care practitioner who is authorized to screen, evaluate, diagnose, and treat the patient or client for a maternal mental health condition. The bill would require a licensed health care practitioner who provides prenatal, postpartum, or perinatal care for a patient or client who screens positive for a maternal mental health condition to ensure that the patient or client receives appropriate clinical evaluation, and, if the practitioner diagnoses a patient or client with a maternal mental health condition, offer or provide treatment to the patient or client, consistent with the provider's scope of practice. 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 or health insurer to develop a maternal mental health program designed to promote quality and cost-effective outcomes. Existing law requires the program to, among other things, conduct specified maternal mental health screenings during pregnancy and the postpartum period. Existing law requires the program guidelines and criteria to be provided to relevant medical providers, including all contracting obstetric providers. Existing law encourages health care service plans and health insurers to, among other things, improve screening, treatment, and referral to maternal mental health services. For purposes of these provisions, existing law defines "maternal mental health" to mean a mental health condition that occurs during pregnancy or during the postpartum period, as specified. This bill would modify the term to "maternal mental health condition" and define it as a mental health condition that occurs during the pregnancy or the postpartum period, as defined by the most recent clinical guidelines adopted by the American College of Obstetricians, as specified. The bill would instead require the above-described maternal mental health program to include maternal mental health screening to be conducted during pregnancy and one or more mental health screenings to be conducted during the postpartum period in accordance with applicable clinical guidelines and the standards of care appropriate to the provider's scope of practice, as specified. The bill would require program guidelines and criteria to be provided to relevant licensed health care practitioners, as defined, including all contracting obstetric providers. The bill would require a health care service plan or health insurer to provide case management or care coordination for an enrollee or insured who screens positive for a maternal mental health condition in accordance with the plan's or insurer's existing case management and care coordination programs. The bill would encourage health care service plans and health insurers to improve treatment, including through the use of outpatient prescription drugs approved for maternal mental health by the United States Food and Drug Administration. 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.
Existing federal law, the Community First Choice Option (CFCO) program, authorizes states to provide home- and community-based attendant services and supports to eligible Medicaid enrollees, as specified. Existing federal law provides federal financial participation for a state that provides services under the CFCO program. Existing state law establishes the In-Home Supportive Services (IHSS) program, administered by the State Department of Social Services and counties, under which qualified aged, blind, and disabled persons are provided with services in order to permit them to remain in their own homes. Existing law requires the state and counties to share the annual cost of providing IHSS pursuant to a specified cost ratio. Existing law requires all counties to have a rebased County IHSS Maintenance of Effort (MOE) and requires the rebased MOE to be adjusted for the annualized cost of increases in provider wages, health benefits, or other benefits, as prescribed. Existing law, commencing July 1, 2026, requires a county to pay, separate from the rebased County IHSS MOE payment, a 100% share of the enhanced federal financial participation that would have been received if the state ceases to receive that funding for the provision of services due to noncompliance of timely case reassessment for the federal CFCO program. This bill would require the department to, on or before July 1, 2029, prepare and submit to the Legislature a report on the amount of the above-described payments made by counties due to noncompliance of timely case reassessment for the federal CFCO program.
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 to provide coverage for behavioral health treatment for pervasive developmental disorder or autism. Existing law requires this treatment to be provided under a prescribed treatment plan that is reviewed no less than every 6 months by the qualified autism service provider. This bill would prohibit a health care service plan or health insurer from imposing restrictions on the utilization of authorized treatment hours within the treatment plan's 6-month authorization period. The bill would require authorized hours to remain available for use throughout the authorization period if the use of the hours is consistent with the treatment plan and clinical guidelines, and is documented in the treatment plan and progress reports. 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.
