This Senate Resolution highlights the importance of medically supportive food and nutrition services, often called "food as medicine," in improving health outcomes and reducing healthcare costs for Californians. It notes that these services, which include medically tailored meals and groceries, are already a key part of the state's Medi-Cal program and have been shown to lower emergency room visits and hospitalizations. The resolution emphasizes the value of these programs in addressing diet-related health issues and encourages continued collaboration among healthcare providers and community organizations to expand access. Additionally, it supports sourcing food from local farms to benefit the economy and environment while ensuring high-quality, culturally relevant care for patients.
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.
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.
Existing law provides for the licensure and regulation of health facilities, including general acute care hospitals and skilled nursing facilities, by the State Department of Public Health. A violation of these provisions is generally a crime. Under existing law, if a person dies in a hospital, convalescent hospital, or board and care facility without known next of kin, the person in charge of the hospital or facility is required to give immediate notice of that fact to the public administrator of the county in which the hospital or facility is located, and if the person in charge fails to do so, the hospital or facility is liable for the cost of internment, as specified, and specified losses incurred by the estate or beneficiaries as a result of the failure to notify. This bill would instead require the licensee in charge of a general acute care hospital or a skilled nursing facility to make a reasonable attempt to notify any known next of kin, as specified. The bill would state that this requirement is met if a skilled nursing facility notifies the person's resident representative or has the body transferred to a hospital after death, or if the person notified the hospital or facility, prior to death and in writing, that they do not want their known next of kin to be notified of their presence or death. The bill would require, if a reasonable attempt is made or the person expressed a desire that next of kin not be notified, as specified, that the hospital or facility give notice to the public administrator as described above. The bill would make a hospital or facility that fails to notify any known next of kin liable for a continuing civil penalty of $200 per day, up to a maximum of $50,000, measured from the time it would take to make a reasonable attempt to notify the next of kin until the actual knowledge by the next of kin of the decedent's death. The bill would also make a hospital or facility that fails to notify the county public administrator, as specified, liable for a continuing civil penalty of up to $200 per day, up to a maximum of $50,000, measured from the 5th business day following a person's death until the county public administrator is notified. The bill would authorize a licensee that disputes the assessment of a civil penalty to, within 10 working days of the notification of the penalty, request a hearing pursuant to specified law.
Existing law, the California Health Facilities Financing Authority Act, establishes the California Health Facilities Financing Authority, which has authority to, among other things, make secured or unsecured loans to, or purchase secured or unsecured loans of, any participating health institution in accordance with an agreement between the authority and the participating health institution to refinance indebtedness incurred by that participating health institution, as specified, in connection with projects undertaken, for health facilities acquired, or for working capital. Existing law also authorizes the authority to award grants to eligible clinics and health facilities, as specified. Existing law establishes the California Health Facilities Financing Authority Fund, a continuously appropriated fund, to carry out the purposes of the act. This bill, the Medical Debt Relief Act of 2026, would establish the medical debt relief program, which would be administered by the authority. The bill would require the authority to enter into an interagency agreement with the Department of Health Care Access and Information to implement the program. The bill would require the authority and department to convene a stakeholder advisory group, as specified, no later than July 1, 2027, to advise on the development, implementation, and administration of the program. The bill would require the stakeholder advisory group, on or before January 1, 2028, to develop recommendations for the authority and department, including, among others, criteria for the ranking and priority of eligible recipients to receive discharge of their medical debt. This bill would authorize the authority, in consultation with the department, to, among other things, contract with a medical debt relief coordinator, as defined, for purposes of acquiring medical debt of eligible recipients either directly from a providing health institution or from a debt buyer, as specified. The bill would require the authority to, among other things, maintain books and records of all the medical debt acquired and canceled. The bill would require the authority to maintain a public internet website for information about the program. This bill would create the California Medical Debt Relief Program Account within the California Health Facilities Financing Authority Fund and would make all moneys in the account available, upon appropriation by the Legislature, to the authority for carrying out the purposes of the Medical Debt Relief Act of 2026. The bill would require the authority, in consultation with the department, to provide a report to the Legislature and Governor by January 1 of each year, starting January 1, 2028. Existing law requires a hospital to report specified financial and utilization data to the Department of Health Care Access and Information, including, among other things, total operating expenses, and deductions from revenue, such as bad debts and charity care. This bill would require a hospital to report to the department outstanding medical debt owed to the hospital, including debt amount, bill adjustments, source of coverage, whether charity care or discount was provided, demographic data, ZIP Code, and whether the debt led to litigation or wage garnishment.
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 federal law, the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) , requires group health plans and health insurance issuers that provide both medical and surgical benefits and mental health or substance use disorder benefits to ensure that financial requirements and treatment limitations applicable to mental health or substance use disorder benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical and surgical benefits. Existing state law requires an individual, small group, or large group health care service plan contract or health insurance policy to provide covered mental health and substance use disorder benefits in compliance with the MHPAEA and specified federal rules, regulations, and guidance. This bill would require the above-described contracts and policies to provide covered mental health and substance use disorder benefits in compliance with specified federal rules, regulations, and guidance as they existed on January 1, 2025. Because a violation of these requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program. The bill would also require the departments to review provisions of the bill that conflict with or materially differ from federal regulations and collaborate with each other to issue guidance on compliance. 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.
The electors of a county may propose an ordinance to the county board of supervisors by submitting an initiative petition containing signatures by registered voters in the county in an amount equal to 10% of the number of votes cast within the county for all candidates for Governor at the preceding gubernatorial election. If the county elections official certifies that an initiative petition has been signed by at least that number of voters, the county board of supervisors is required to either adopt the ordinance or submit it to the voters at the next statewide election occurring not less than 88 days later. This bill would require any Fresno County initiative petition that has been certified as sufficient by the Fresno County Registrar of Voters on or before July 8, 2026, to be submitted, without alteration, to the voters at the November 3, 2026, statewide general election. This bill would make legislative findings and declarations as to the necessity of a special statute for the County of Fresno. This bill would declare that it is to take effect immediately as an urgency statute.
Existing law requires the State Department of Public Health to conduct a program of epidemiological assessments of the incidence of cancer. Existing law requires specified entities providing specified services to cancer patients, including hospitals, practitioners, and laboratories, to report each case of cancer to the department, as specified. This bill would require a hospital or other facility that provides therapy to a cancer patient within an area designated as a cancer reporting area to post a sign, developed by the department, in a conspicuous location that contains an advisement about cancer data reporting and a quick response code that links to the California Cancer Registry internet website.
Existing law requires that, as a condition of parole, a prisoner who has a severe mental health disorder, as specified, be treated by the State Department of State Hospitals, if the prisoner meets certain requirements, including, among others, that the person in charge of treating the prisoner and a practicing psychiatrist or psychologist from the State Department of State Hospitals have evaluated the prisoner and that a chief psychiatrist of the Department of Corrections and Rehabilitation certify to the Board of Parole Hearings that by reason of the prisoner's severe mental health disorder, the prisoner represents a substantial danger of physical harm to others. This bill would require that certain factors be considered in determining whether an offender poses a substantial danger of physical harm to others, including, but not limited to, a history of violent behavior and prior history of state hospital commitment. Existing law allows a prisoner to request a hearing before the Board of Parole Hearings for the purpose of proving that the prisoner meets the criteria to be treated by the State Department of State Hospitals. Existing law allows a prisoner who disagrees with the determination of the Board of Parole Hearings to file a petition in court for a hearing on whether they met the criteria and, if the court reverses the determination of the Board of Parole Hearings, existing law authorizes the court to require the parties to return to court to ensure that the entities involved in the release of the prisoner have coordinated an exit plan for the prisoner. This bill would require that an exit plan include the submission of an application for Medi-Cal benefits and a recommendation, as appropriate, to the supervising county's behavioral health department by a licensed behavioral health professional, as specified, supervising the treatment of, or treating, the prisoner for a mental health disorder for certain resources and programs, including substance use disorder treatment, assisted outpatient treatment, and early psychosis intervention services. Existing law, the Mental Health Services Act (MHSA) , an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, funds a system of county mental health plans for the provision of mental health services, as specified. The MHSA establishes the Mental Health Services Fund, a continuously appropriated fund, which is administered by the State Department of Health Care Services (department) , to fund specified county mental health programs. Existing law, the Behavioral Health Services Act (BHSA) , a legislative act amending the MHSA that was approved by the voters as Proposition 1 at the March 5, 2024, statewide primary election, recast the MHSA by, among other things, renaming the fund to the Behavioral Health Services Fund and reallocating how moneys from that fund may be spent. The BHSA requires each county to establish and administer a full-service partnership program that includes, among other things, outpatient behavioral health services, as specified, and housing interventions. Existing law establishes criteria for an individual with a serious mental illness to be presumptively eligible for a full-service partnership, including, among other things, the person is transitioning to the community after 6 months or more in the state prison or county jail. This bill would add to the criteria for presumptively eligibility for a full-service partnership an individual transitioning to the community after 6 months or more in a state hospital. 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 and funded by federal Medicaid program provisions. Existing law, the California Advancing and Innovating Medi-Cal (CalAIM) Act, supports the stated goals of identifying and managing the risk and needs of Medi-Cal beneficiaries, transitioning and transforming the Medi-Cal program to a more consistent and seamless system, and improving quality outcomes. Existing law makes a qualifying inmate of a public institution eligible, commencing no sooner than January 1, 2023, to receive targeted Medi-Cal services, limited to those services approved in the CalAIM Terms and Conditions for 90 days, as specified. This bill would also make a qualifying inmate of a state hospital eligible to receive targeted Medi-Cal services, as described. By expanding the population receiving benefits under the BHSA and to the extent that the bill would create new duties for counties relating to Medi-Cal eligibility determinations, 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, 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.
(1) Existing federal law requires the Secretary of Health and Human Services to designate health professional shortage areas and requires the secretary, in establishing criteria for the designation of those areas, to consider, among other things, the ratio of available health manpower to the number of individuals in an area or population group and indicators of a need for health services, as specified. Existing state law makes references to federally recognized or designated health professional shortage areas in various contexts, including, among others, the California Physician Corps Program, the California Reproductive Health Services Corps, the Oral Health Program, the Virtual Health Hub for Rural Communities Pilot Program, and health professions planning grants. This bill, until January 1, 2035, would define the term "health professional shortage area" to mean (1) an area determined by the Department of Health Care Access and Information to have a shortage of health professionals, (2) a health professional shortage area currently designated or recognized by the United States Department of Health and Human Services, or (3) an area designated or recognized as a health professional shortage area by the United States Department of Health and Human Services on January 1, 2025, regardless of whether that area remains designated or recognized by the United States Department of Health and Human Services as a health professional shortage area. The bill would authorize the Department of Health Care Access and Information to revoke designations, as specified. (2) Existing law requires specified boards, including the Board of Registered Nursing and the Respiratory Care Board of California, to collect certain workforce data from their respective licensees and registrants for future workforce planning at least biennially. Existing law requires other boards that regulate healing arts licensees or registrants to request workforce data from their respective licensees and registrants for future workforce planning at least biennially. Existing law requires the workforce data collected or requested to include specified information, including, among others, the type of employer or classification of primary practice site, as specified. Existing law prohibits a licensee or registrant from being required to provide the information as a condition for license or registration renewal and prohibits licensees or registrants from being subject to discipline for not providing the information. Existing law requires the boards and the Department of Health Care Access and Information to maintain the confidentiality of licensee and registrant information collected pursuant to these provisions and authorizes release of the information only in aggregate form. Existing law requires each board to provide individual licensee and registrant data to the Department of Health Care Access and Information on a quarterly basis, as specified. This bill would require the workforce data to be collected or requested by boards at the time a license or registration is issued, except as specified. The bill would require the information collected or requested by boards to also include, among other things, the hours worked in inpatient care, hours worked in outpatient care, and whether the licensee or registrant offers a formal sliding fee scale. The bill would instead require each board to provide licensee and registrant data on a monthly basis. (3) 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. (4) This bill would incorporate additional changes to Section 502 of the Business and Professions Code proposed by SB 1271 to be operative only if this bill and SB 1271 are enacted and this bill is enacted last.
