Existing law requires the State Department of Public Health to license and regulate various health facilities, including general acute care hospitals. Existing law requires the department to issue a special permit, in addition to a license, to a health facility to offer one or more special services, such as an emergency center, if specified requirements are met, including that the department finds that the standards of care and services are adequate and appropriate. Existing law requires the department to issue a special permit to allow a general acute care hospital to offer emergency stabilization services at a location that is neither inside nor contiguous to the applicant hospital if the hospital provides satisfactory evidence to the department that, among other things, the hospital has a written transfer agreement with the hospital closest to the location where emergency stabilization services will be provided and satisfactory evidence to the department that this location meets certain requirements, including that the location is in the town of Paradise within the County of Butte and serves the same area previously served by Feather River Hospital. This bill would require the department to issue a waiver, as specified, to a publicly owned and operated general acute care hospital, in collaboration with Del Puerto Health Care District, to operate one rural emergency stabilization care unit and waive designated general acute care hospital licensure requirements if specified conditions are met. The bill would limit the term of the waiver based on prescribed factors, including the completion of a hospital build within a 5-mile radius of the emergency stabilization care unit or within 10 years from the initial issuance of the waiver, except as specified. This bill would make legislative findings and declarations as to the necessity of a special statute for Del Puerto Health Care District.
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.
This measure would call on Medi-Cal managed care plans operating across the state of California to sustain and expand medically supportive food and nutrition services offerings to Medi-Cal patients through federal In Lieu of Services (ILOS) authority until these services can become permanent Medi-Cal benefits.
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 that provides prescription drug benefits and maintains one or more drug formularies to meet certain criteria for its formularies and the placement of drugs on formularies. This bill would prohibit a health care service plan or health insurer that provides prescription drug benefits and maintains one or more drug formularies from making changes to a formulary during a plan or policy year, except in specified circumstances. If a plan or insurer implements a formulary change requiring an enrollee or insured to change to a different drug in the same drug class during the plan year, the bill would authorize the individual to remain on the previously covered drug for the rest of the plan year if the drug was previously approved for coverage for the individual's medical condition, is appropriately prescribed, and is considered safe and effective for treating that condition, and would require the plan or insurer to notify the individual and their provider no less than 90 days before the change is implemented. The bill would require a plan or insurer, or its pharmacy benefit manager, to report to the appropriate department any changes made to a formulary during a plan or policy year within 30 days of the change being made. The bill would authorize the departments to investigate and take enforcement action against a plan or insurer for noncompliance with the above-described requirements and to impose, after notice and the opportunity for a hearing, administrative penalties, as specified, for a violation of these provisions. The bill would authorize the departments to conduct audits related to these provisions. Because a willful violation of the bill's provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program. Existing law requires a health care service plan that provides prescription drug benefits to maintain an expeditious process by which prescribing providers may obtain authorization for a medically necessary nonformulary prescription drug. This bill would define "expeditious process" for the above-described purpose to require a plan to approve authorization within 72 hours for nonurgent requests, or within 24 hours if exigent circumstances exist, of a request for approval of a drug prescription. If the plan fails to meet those requirements, the bill would authorize an enrollee to request, and would require the plan to provide, 90 days of transitional coverage to the enrollee for the previously covered drug. The bill would require the Department of Managed Health Care to utilize existing data and its existing authority to collect data from plans and annually publish on its internet website and submit to the Legislature an aggregated report on information related to requests for approval of a nonformulary drug as described above. 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, administered by the State Department of Health Care Services, under which health care services are provided to qualified, low-income persons. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law authorizes a county board of supervisors to establish a commission to negotiate an exclusive contract with the department to provide, or arrange for the provision of, health care services under the Medi-Cal program. Pursuant to the authority described above, the County of Orange established a commission and existing law established the governance of that commission, known as the Orange County Health Authority or CalOptima, to provide health care services under the Medi-Cal program. Existing law prescribes who can serve on the 10-member governing body of the commission and requires each member to serve a 4-year term, except as described. This bill, for terms commencing after January 1, 2027, would impose one-, 2-, and 4-year terms of office, as specified. The bill would also prohibit specified voting members from serving more than two consecutive terms and from serving in that capacity for more than 10 consecutive years. The bill would require the governing body of the Orange County Health Authority to authorize and pay for an independent external audit of its governance procedures and practices, including the roles and responsibilities of the governing body, executive leadership, and staff, among others. The bill would require the audit to be completed by July 1, 2027, and would require that a copy of the report be provided to the Legislature and made public. Because this bill would impose a unique requirement on how services are provided on a local government and would require additional duties of county authorities, the bill would impose a state-mandated local program. This bill would make legislative findings and declarations as to the necessity of a special statute for County of Orange. Existing constitutional provisions require that a statute that limits the right of access to the meetings of public bodies or the writings of public officials and agencies be adopted with findings demonstrating the interest protected by the limitation and the need for protecting that interest. This bill would make legislative findings to that effect. 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 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. Existing law authorizes a county, or an agency representing a county, to develop a peer support specialist certification program, subject to departmental approval. Under existing law, these specialists are individuals, at least 18 years of age, who self-identify as having lived experience with the process of recovery from mental illness, substance use disorder, or both, as specified. Existing law requires the department to seek any federal waivers that it deems necessary to establish a demonstration or pilot project for the provision of peer support services in counties that agree to participate. This bill would require the department to require, as a condition of providing ECM, that any ECM provider, whose caseload of members meets certain criteria, maintain an interdisciplinary care team that includes at least one peer support specialist or trainee, as defined, who is integrated into ECM service delivery and available to support ECM members. The bill would set forth the functions of a peer support specialist or trainee for ECM purposes. The bill would require the department to allow an ECM provider to satisfy the requirement through any combination of staffing models, as specified. The bill would require the department to ensure that Medi-Cal managed care plan contracts, policies, and guidance reflect the requirement and to establish monitoring and compliance mechanisms to ensure that ECM providers implement the requirement. The bill would require the department to recognize virtual, telephonic, and technology-enabled peer support service delivery as meeting the integration requirement. Under the bill, an ECM provider subject to these provisions would have until January 1, 2028, to achieve full compliance, as specified. The bill would prohibit the department, a county, a Medi-Cal managed care plan, or a Medi-Cal provider, as applicable, from disqualifying a peer support specialist solely or primarily on the basis of a criminal background check, fingerprint-based background check, or similar screening that is a condition of employment, contracting, certification, credentialing, enrollment, or participation in providing peer support services. Under the bill, this restriction would be implemented to the extent not in conflict with federal law, and the restriction would not prohibit background checks under specified circumstances. The bill would also authorize consideration of an individual's criminal record as part of their overall fitness for the position of peer support specialist if the criminal record has a nexus to that position or its duties. The bill would condition implementation of these provisions on receipt of any necessary federal approvals and the availability of federal financial participation.
(1) Existing law, the Lanterman-Petris-Short (LPS) Act, authorizes the involuntary commitment and treatment of a person, when the person, as a result of a mental health disorder, is a danger to themselves or others, or is gravely disabled. For the purposes of these provisions, existing law defines "gravely disabled" as a condition in which a person, as a result of a mental health disorder, a severe substance use disorder, or a co-occurring mental health disorder and a severe substance use disorder, is unable to provide for their basic personal needs for food, clothing, shelter, personal safety, or necessary medical care. Existing law also authorizes a conservator of a person, estate, or person and the estate to be appointed for a person who is gravely disabled or impaired by chronic alcoholism, subject to specified procedures. Existing law provides the person for whom conservatorship is sought to have the right to demand a court or jury trial on the issue of whether the person is gravely disabled. Existing law prohibits a person from being tried or adjudged to punishment while that person is mentally incompetent, and establishes a process by which a defendant's mental competency is evaluated. This bill would prohibit a court, for purposes of LPS conservatorship, from determining a person's ability to provide for their basic personal needs based solely on the fact that the person has temporary access to those basic personal needs while incarcerated. The bill would also authorize a district attorney to be present and represent public safety interests at any hearing to determine whether an individual is gravely disabled for purposes of the LPS Act. Existing law requires the court to determine the most appropriate placement for a conservatee who is gravely disabled, as defined. Existing law requires the officer providing conservatorship investigation to investigate all available alternatives to conservatorship, as applicable, and to render to the court a comprehensive, written report of the investigation prior to the hearing, as specified. This bill would authorize the district attorney to review all filed documents regarding the investigation, initiation, termination, or modification of, and to be present and represent public safety interests at all hearings that consider, a conservatorship of a person who is gravely disabled, as defined by being found mentally incompetent and meeting the above-described conditions, to provide input to the court about appropriate placement or interim placement by the public conservator. The bill would require a copy of the conservatorship investigation report to be transmitted to the district attorney if the investigation was initiated as part of a determination of mental competence for trial. The bill would authorize the district attorney, if the individual has been appointed a conservator under specified provisions, to challenge the recommendation of the public conservator after the conservatorship investigation for an abuse of discretion in a contested hearing before a judge. The bill would prohibit the district attorney from using the information contained in these reports in subsequent criminal proceedings, except as specified. To the extent the bill imposes a higher level of service on county agencies that prepare and transmit conservatorship investigation reports and on a district attorney to receive those reports, the bill would impose a state-mandated local program. This bill would authorize a county with a population size of 750,000 or greater to consider prioritizing the placement of specified conservatees in a state hospital run by the State Department of State Hospitals if at least 40 of those conservatees are waiting for placement in a state hospital. The bill would also authorize the placement to be on an interim basis at a county detention facility pending acceptance into a facility that achieves the purposes of treatment of the conservatee and protection of the public. The bill would require the conservatee to receive treatment services in accordance with the conservatorship plan within the detention facility pending permanent placement and would require the court to review the conservator's placement efforts every 60 calendar days. 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, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Existing law establishes the California Reproductive and TGI Health Equity Program within the Department of Health Care Access and Information for the purpose of ensuring abortion, contraception, and gender-affirming care are affordable for and accessible to all patients, regardless of their ability to pay, and to provide financial support for safety net providers of these services to offset the costs of providing uncompensated care to patients with low incomes who would otherwise lack access to care. Existing law authorizes a Medi-Cal enrolled provider to apply for a grant, and a continuation award after the initial grant, if they agree to provide abortion, contraception, and gender-affirming care services in accordance with specified requirements, including that the services are provided at no cost or a reduced cost to individuals with a household income at or below 400% of the federal poverty level who are uninsured or have health care coverage that does not include both abortion and contraception or does not include gender-affirming care and are not otherwise eligible to receive both abortion and contraception care at no cost through the Medi-Cal and Family PACT programs or receive gender-affirming care at no cost through the Medi-Cal program. This bill would additionally authorize a Medi-Cal enrolled provider to apply for a grant or a continuation of a grant if they provide the above-described services to patients who are veterans, as defined, who are uninsured or have health care coverage that does not include both abortion and contraception and are not otherwise eligible to receive both abortion and contraception care at no cost through the Medi-Cal and Family PACT programs. The bill would make other conforming changes and would make related findings and declarations. Existing law establishes the Department of Veterans Affairs and vests the department with specified duties related to veterans in the state, including the development of a transition program to assist veterans in successfully transitioning from military to civilian life by providing information related to, among other things, health care programs and services. This bill would require the Department of Veterans Affairs to publish a link to the State Department of Public Health's abortion information internet website on the women veterans resources page of its internet website.
This bill designates the week of May 11 to May 15, 2026, as Student Mental Health Awareness Week throughout California. The measure requires state agencies and institutions to acknowledge this specific timeframe to highlight the importance of student mental well-being. By officially recognizing these dates, the legislation aims to encourage public focus on mental health resources for students during that period. It does not allocate funding or mandate specific programs, but rather serves to raise awareness through formal designation.
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 federal law, enacted on July 4, 2025, sets forth various changes to Medicaid eligibility with regard to community engagement reporting, redeterminations, retroactive coverage, and cost sharing, among other factors, for certain Medicaid populations pursuant to a specified implementation timeline. This bill would require the department to establish a data dashboard that provides data on applications, enrollment, redeterminations, disenrollments, and terminations, with certain objectives in consideration, related to the impact of the above-described federal law on Medi-Cal eligibility and enrollment, as specified. The bill would require the dashboard to track and report on the specific data for work or community engagement requirements and exemptions. The bill would require the department, commencing no later than January 1, 2028, to operationalize the dashboard and to post the information on a monthly basis in a downloadable format. The bill would require the department to undertake efforts to conduct outreach about work or community engagement requirements, more frequent redeterminations, and changes to retroactive eligibility to impacted Medi-Cal beneficiaries, and to conduct listening sessions, as specified. Under the bill, beneficiary outreach and education would be coordinated across public social services programs to help minimize barriers to administrative disenrollments. The bill would require a Medi-Cal managed care plan to establish and conduct an outreach and education plan for its enrollees about the work or community engagement guidelines set forth in federal law based on guidance provided by the department. The bill would require the outreach and education plan to address certain information on Medi-Cal eligibility, the right to appeal or reinstate Medi-Cal coverage, and resources, and to meet certain cultural and linguistic appropriateness standards. Existing law requires a county to undertake outreach efforts to beneficiaries receiving Medi-Cal benefits in order to, in part, facilitate the Medi-Cal redetermination process. Existing law authorizes a county to collaborate with community-based organizations in implementing this provision. This bill would incorporate the requirements of the above-described federal law into the Medi-Cal redetermination facilitation process. The bill would require a county to make a good faith effort to collaborate with community-based organizations, as specified. The bill would require the county outreach efforts to meet cultural and linguistic appropriateness standards. By creating new duties for counties relating to Medi-Cal outreach, the bill would impose a state-mandated local program. Existing law requires the department to encourage and facilitate efforts by managed care plans to report updated beneficiary contact information to counties. When a managed care plan obtains a beneficiary's updated contact information, existing law requires the plan to ask the beneficiary for approval to provide the beneficiary's updated contact information to the appropriate county. If the managed care plan does not obtain that approval, existing law requires the county to attempt to verify that the information that it receives from the plan is accurate, as specified, before updating the beneficiary's case file. This bill would remove the requirement for the managed care plan to ask the beneficiary for approval for purposes of providing the contact information to the county. The bill would remove the requirement for the county to make the verification attempt and would remove a related provision on the method of contact. The bill would require the department to share, or require each county to share, beneficiary redetermination data with applicable managed care plans to aid in managed care plans' efforts to assist beneficiaries with retaining Medi-Cal coverage, as specified. To the extent the bill creates new duties for counties relating to the sharing of Medi-Cal redetermination data, it 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, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
