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. 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.
Existing law, the Medical Practice Act, establishes the Medical Board of California and sets forth its powers and duties relating to the licensure and regulation of physicians and surgeons. Existing law establishes the Osteopathic Medical Board of California and sets forth its powers and duties relating to the licensure and regulation of osteopathic physicians and surgeons and requires the Osteopathic Medical Board of California to enforce the Medical Practice Act with respect to its licensees, consistent with the Osteopathic Act, as specified. A violation of the Medical Practice Act is a crime. Existing law generally makes the unauthorized practice of medicine a crime. Existing law makes an exception to that criminal provision if a person, before performing services, complies with certain disclosure requirements. Existing law excludes from that exception a list of specified services, including, among others, conducting surgery or any other procedure on another person that punctures the skin or harmfully invades the body. This bill, on and after January 1, 2028, would add the provision of osteopathic manipulative treatment, as defined, to that list of specifically excluded services. By excluding those services from the exception to the unauthorized practice of medicine, the bill would expand the scope of a crime, thereby imposing a state-mandated local program. Existing law, with specified exceptions, makes it a misdemeanor for a person to use the words "doctor" or "physician," the letters or prefix "Dr.," the initials "M.D." or "D.O.," or any other terms or letters indicating or implying that the person is a physician and surgeon, physician, surgeon, or a practitioner under the Medical Practice Act or other law, or to represent or hold themselves out as a physician and surgeon, physician, surgeon, or practitioner under the act or other law without having a valid, unrevoked, and unsuspended certificate as a physician and surgeon under the act. Existing law prohibits a person from using those terms or letters or any other terms or letters indicating or implying that the person is a physician and surgeon, physician, surgeon, or practitioner in a health care setting that would lead a reasonable patient to determine that the person is a licensed "M.D." or "D.O." This bill, on and after January 1, 2028, would also make it a misdemeanor for a person who is not licensed by the Osteopathic Medical Board of California to use the phrase "doctor of osteopathy" or the initials "D.O.," or use the word "osteopath" in a way that implies that they are a licensed osteopath, a licensed doctor of osteopathy, or a physician and surgeon licensed by the board when offering or providing a service to treat a medical or physical condition. By creating a new 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 Board of Behavioral Sciences within the Department of Consumer Affairs and requires the board to regulate licensees and registrants under the Licensed Marriage and Family Therapist Act (LMFTA) , the Educational Psychologist Practice Act (EPPA) , the Clinical Social Worker Practice Act (CSWPA) , and the Licensed Professional Clinical Counselor Act (LPCCA) . Existing law makes a violation of those acts a crime. The LMFTA, the CSWPA, and the LPCCA each contain varying provisions limiting their application to the practice of certain medical and other behavioral science professionals, attorneys, and certain religious personnel, including priests, rabbis, and ministers of the gospel of any religious denomination. This bill would revise and recast those provisions to, among other things, exempt a religious official of any denomination, including those specified above and imams, when providing faith-based counseling services as part of their regular professional duties for an established and legally recognizable faith-based entity if certain criteria are met. The bill would also exempt attorneys and physicians who provide counseling services as part of their professional practice from the LMFTA and the LPCCA. Existing law establishes examination and experiential requirements under the LMFTA, the EPPA, the CSWPA, and the LPCCA to qualify for licensure or registration under those acts and requires an applicant for licensure or registration to have passed certain examinations or obtain specified experience within a certain timeline for it to be accepted by the board. In this regard, existing law generally requires the applicant to gain the required experience no more than 6 years before the board receives the application. For licensed educational psychologists, the EPPA authorizes the board to accept a passing score on a written examination administered by the board for a period of 7 years from the date the examination was taken. Under the LMFTA, the CSWPA, and the LPCCA, registrants and applicants for licensure, registration, or a subsequent registration number are required to pass a California law and ethics examination. The LMFTA, the CSWPA, and the LPCCA require an applicant for licensure to pass a clinical examination within 7 years from the initial attempt, unless the applicant obtains a passing score on the current version of the California law and ethics examination. This bill, instead, would require applicants for licensure under the LMFTA, the EPPA, the CSWPA, and the LPCCA, to obtain the relevant experience and to pass the relevant examination within 7 years preceding the date on which the board receives the application. The bill would require those applicants and registrants under the LMFTA, the CSWPA, and the LPCCA who submit applications to the board on and after January 1, 2030, to have passed the California law and ethics examination no more than 7 years before the board receives the application, as specified. Existing law authorizes an associate marriage and family therapist registration, an associate clinical social worker registration, or an associate professional clinical counselor registration to be renewed a maximum of 5 times and prohibits a registration from being renewed beyond 6 years from the last day of the month of issuance. Existing law authorizes an applicant to apply for a subsequent registration number when no renewals are possible if certain requirements are met. Existing law prohibits an applicant who is issued a subsequent associate registration number from being employed or volunteering in a private practice. This bill would increase the maximum number of renewals for those registrations to 6 and would extend the renewal deadline to 7 years from the last day of the month of issuance. The bill would authorize an applicant applying for or holding a subsequent associate registration number to request a 2-year hardship extension of the subsequent associate registration number to allow them to be employed or volunteer at one private practice or professional corporation employer, subject to specified conditions and requirements, including signing an application under penalty of perjury. By expanding the crime of perjury, the bill would impose a state-mandated local program. Existing law requires an associate marriage and family therapist or a marriage and family therapist trainee to disclose to a client or patient that they are unlicensed and to provide specified information to the client or patient. Existing law requires a social work applicant or registrant and a clinical counselor trainee, applicant, or associate to inform each client or patient that they are unlicensed and under supervision, as specified. This bill would instead require a marriage and family therapist applicant or registrant, a social work applicant, registrant, intern, or trainee, or a clinical counselor applicant, associate, or trainee, in addition to disclosing to a client or patient that they are unlicensed and under supervision, to provide the name of their employer or the entity for which they volunteer. Existing law establishes a $20 fee for rescoring a written examination under the LMFTA, the EPPA, the CSWPA, and the LPCCA. This bill would delete that fee. This bill would delete obsolete provisions and make other technical and nonsubstantive changes. This bill would incorporate additional changes to Section 4980.41 of the Business and Professions Code proposed by SB 1445 to be operative only if this bill and SB 1445 are enacted and this bill is enacted last. 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 Maddy Emergency Medical Services (EMS) Fund and authorizes each county to establish an emergency medical services fund for reimbursement of costs related to emergency medical services. Existing law, until January 1, 2027, requires 15% of the fund to be used to, among other things, improve access to, and coordination of, pediatric trauma and emergency services, with specified preferences, and requires the cost of administering money deposited into the EMS Fund to be reimbursed from the money collected, as specified. Existing law, until January 1, 2027, authorizes county boards of supervisors to elect to levy an additional penalty, for deposit into the EMS Fund, in the amount of $2 for every $10 upon fines, penalties, and forfeitures collected for criminal offenses. Existing law, until January 1, 2027, requires 15% of the funds collected pursuant to that provision to be used to provide funding for pediatric trauma centers. This bill would extend the operative date of these provisions until January 1, 2037.
Existing law, the Medical Practice Act, establishes the Medical Board of California and charges it with administrative and enforcement duties related to the provision of medical services under the act. Existing law establishes requirements for the delivery of medical services, including via telehealth by specified health care providers. A violation of the act is a crime. Under existing law, a "health care provider," for purpose of the act, includes a qualified autism service provider that is certified by a national entity or a qualified autism service professional, as specified. This bill would expand that definition of "health care provider" to also include a qualified autism service paraprofessional. By expanding the scope of a crime under the act, 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 requires the Director of Pesticide Regulation to adopt regulations relating to worker health in areas where pesticides are used so that pesticide residue levels are not a significant factor in cholinesterase depression or other health effects. Existing law requires that an employer who has an employee who regularly handles pesticides have an agreement with a medical supervisor who is registered with the Office of Environmental Health Hazard Assessment (OEHHA) . Existing law requires that a laboratory that performs tests ordered by a medical supervisor report specified information to the Department of Pesticide Regulation on, at a minimum, a monthly basis. Existing law requires that the reports be submitted via electronic media and formatted in a manner approved by the director. Existing law requires the Department of Pesticide Regulation to share information from cholinesterase reports with the OEHHA and the State Department of Public Health on an ongoing basis, in an electronic format. Existing law requires the registered medical supervisor ordering a cholinesterase test to note in the test order the name of the medical supervisor and the purpose of the test, and ensure that the person tested and the employer receive a copy of the cholinesterase test results and any recommendations from the medical supervisor based upon those results within 14 days of the medical supervisor's receipt of the results. Existing law requires the medical supervisor to report any worker with cholinesterase depression indicating pesticide exposure to the local health officer within 24 hours. These provisions are operative until January 1, 2027. This bill would extend these provisions until January 1, 2030.
Existing law describes the California Interscholastic Federation (CIF) as a voluntary organization that consists of school and school-related personnel with responsibility for administering interscholastic athletic activities in secondary schools, and sets forth the Legislature's intent regarding the CIF's implementation of certain policies. Existing law requires the CIF, in consultation with the State Department of Education, to develop guidelines, procedures, and safety standards for the prevention and management of exertional heat illness. This bill would require, on or before July 1, 2027, and annually thereafter, the CIF to review and update as necessary the guidelines, procedures, and safety standards, with special consideration for regions of the state with higher average temperatures.
Existing law authorizes the Board of Supervisors of the County of Alameda to establish a hospital authority for the purpose of effecting a transfer of the management, administration, and control of the Alameda Health System. Existing law requires the hospital authority to be governed by a board that is appointed, both initially and continually, by the board of supervisors. Existing law requires the enabling ordinance to specify the membership of the hospital authority governing board, the qualifications for individual members, the manner of appointment, selection, or removal of governing board members, their terms of office, and all other matters that the board of supervisors deems necessary or convenient for the conduct of the hospital authority's activities. Existing law specifies that a hospital authority established pursuant to these provisions, but that does not obtain the administration, management, and control of the medical center or has those duties and responsibilities revoked by the board of supervisors, is not empowered with the powers provided to an independent hospital authority, as specified. This bill would specify that the board of supervisors is authorized to amend the enabling ordinance. The bill would require the enabling ordinance to authorize the membership of the governing board to include, with the approval of the board of supervisors, a representative of any local public entity that contributes financial or other support to the hospital authority, as specified. The bill would authorize, at the board of supervisors' discretion and as specified in the enabling ordinance, the governing board to consist entirely of members of the board of supervisors or to include any number of the members of the board of supervisors or county officers or employees appointed to represent the interests of the county. The bill would prohibit the inclusion of members of the board of supervisors or county employees on the governing board from being a basis to determine that the hospital authority is not an independent entity or that the hospital authority has not obtained the administration, management, and control of the medical center. This bill would also authorize the governing board to delegate day-to-day operational responsibilities to one or more subsidiary bodies it establishes, consisting of members possessing relevant expertise, and requires that delegation to involve reasonable safeguards to ensure that the governing board retains ultimate control over the hospital authority. The bill would authorize the hospital authority to affiliate with, or acquire ownership or control of, additional public or private hospitals, clinics, or programs to further its mission, at the discretion of the governing board. After a hospital authority is created as specified, the bill would authorize the board of supervisors to change the composition of the governing board and to revoke the duties and responsibilities of the hospital authority and transfer the hospital authority back to the county.
