Healthcare (Substance Abuse)

Existing law requires the State Department of Health Care Services to license and regulate adult alcohol or other drug recovery or treatment facilities that provide residential nonmedical services, as specified, and further requires the department to certify and regulate alcohol or other drug programs, as specified. Existing law requires a licensed facility to take specified actions, including to develop a plan to address when a resident relapses. Existing law requires a certified program to keep all policies and procedures in an operation manual. This bill would require a licensed facility to develop a suicide prevention plan. The bill would authorize the department to implement the above-described requirement by bulletin or all-county or all-provider letter, after stakeholder input, until regulations are promulgated. The bill would require the department to promulgate regulations to implement the requirement no later than January 1, 2031. The bill would require a certified program to include in its operation manual a suicide prevention plan.

Existing law, the Community Assistance, Recovery, and Empowerment (CARE) Act, authorizes specified adult persons to petition a civil court to create a voluntary CARE agreement or a court-ordered CARE plan and implement services, to be provided by county behavioral health agencies, to provide behavioral health care, including stabilization medication, housing, and other enumerated services, to adults who are currently experiencing a severe mental illness and have a diagnosis identified in the disorder class schizophrenia and other psychotic disorders, and who meet other specified criteria. Existing law authorizes specified individuals to file a petition to commence the CARE process, including, but not limited to, a spouse, parent, sibling, child, grandparent, or an individual who stands in loco parentis to the respondent. Existing law requires the court to issue an order relieving the original petitioner if the petitioner is someone other than the director of a county behavioral health agency or their designee and appoint the director or their designee as the successor petitioner. Existing law requires the original petitioner to have specified rights to notice of proceedings if the petitioner is a parent or specified family member or the person with whom the respondent resides. Existing law authorizes the court to allow the original petitioner to participate in the respondent's CARE proceedings to the extent the respondent consents. This bill would authorize the original petitioner to provide specified information regarding the respondent, including the respondent's condition, treatment history, and housing status. The bill would require the CARE team to review specified parts of the provided information, including that relevant to the respondent's care and treatment, and would authorize the court to consider that information in evaluating the respondent's progress and compliance, among other things. The bill would specify that the respondent's consent is not required to receive this information from the original petitioner and that submission of this information does not confer party status on the original petitioner or create a right to direct treatment decisions, obtain discovery, access confidential records, receive protected health information, attend confidential proceedings, or otherwise participate in the proceedings without the respondent's consent, except as expressly provided by law.

This measure would recognize and affirm the important role of artists, arts organizations, creative arts therapists, and arts for health initiatives in supporting behavioral health, promoting recovery, strengthening community resilience, and contributing to public safety. The measure would encourage and recognize exploration, support, and integration of arts and behavioral health within California's health care, behavioral health, and community-based systems.

(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, the Community Assistance, Recovery, and Empowerment (CARE) Act, authorizes specified persons, including a person with whom the respondent resides, family members, and first responders, among others, to petition a civil court to create a voluntary CARE agreement or a court-ordered CARE plan and implement services, to be provided by county behavioral health agencies, to provide behavioral health care, including stabilization medication, housing, and other enumerated services, to adults who are currently experiencing a severe mental illness and have a diagnosis identified in the disorder class schizophrenia and other psychotic disorders, and who meet other specified criteria. This bill would authorize a first responder to contact the county behavioral health agency in the county in which the individual resides or is found to request the agency file a petition to commence the CARE process. The bill would require the agency to review the request and determine whether to file a petition within 30 business days. The bill would require the agency, upon completion of the review, to notify the first responder that made the referral of specified information, including whether or not a petition was filed. Because the bill would require a higher level of service from county agencies, this bill would create a state-mandated local program. This bill would require the department to create a referral form to be used by the first responders and would require the department to issue guidance on the procedure to request that the agency file a petition to commence the CARE process. The bill would also require the agency to include specified data in their annual report to the department. 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, 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 authorizes health care service plans and health insurers that cover prescription drugs to utilize reasonable medical management practices, including prior authorization and step therapy, consistent with applicable law. This bill would prohibit a health care service plan contract or a health insurance policy that is issued, amended, or renewed on or after January 1, 2027, from imposing step therapy as a prerequisite to authorizing coverage of any prescription drug used for the treatment of a serious mental illness or substance use disorder, as those terms are defined, except as specified. The bill would specify that the prohibition on step therapy does not apply when the United States Food and Drug Administration-labeled indications and usage of a drug indicate that some prior medication must be taken. Because a willful violation of this provision by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.

Existing law establishes the 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 grants the State Department of Health Care Services the sole authority in state government to license adult alcoholism or drug abuse recovery or treatment facilities and authorizes the department to issue a license to specified types of facilities if certain criteria are met. Existing law requires an operator of a licensed alcoholism or drug abuse recovery or treatment facility or certified alcohol or other drug program to include on its internet website and intake form paperwork a disclosure that an individual may check the internet website of the department to confirm whether the facility's license or program's certification has been placed in probationary status, been subject to a temporary suspension order, been revoked, or the operator has been given a notice of operation in violation of law. Existing law requires the disclosure to include a link to the department's internet website that contains the Probationary Status, Temporary Suspension Order, Revoked and Notice of Operation in Violation of Law Program List. This bill would require the department to indicate on its internet website containing the above-described list, in a location and font that is easy to see and read, that notices to recovery residences issued for a specified violation are not included in that list. The bill would also require the department to post on its internet website, in a specified manner, an identification and summary of each violation the department has issued for the above-described facilities and programs. The bill would require the department to implement this requirement to protect the public it serves by providing sufficient information regarding those who violate the state laws it administers without posting information that violates privacy rights and protections provided by state or federal law.

Existing law establishes the California Interagency Council on Homelessness to oversee the implementation of Housing First guidelines and regulations, and, among other things, identify resources, benefits, and services that can be accessed to prevent and end homelessness in California. Existing law requires a state agency or department that funds, implements, or administers a state program that provides housing or housing-related services to people experiencing homelessness or who are at risk of homelessness to revise or adopt guidelines and regulations to include enumerated Housing First policies. Existing law specifies the core components of Housing First, including services that are informed by a harm-reduction philosophy that recognizes drug and alcohol use and addiction as a part of tenants' lives and where tenants are engaged in nonjudgmental communication regarding drug and alcohol use. This bill would authorize state programs to fund supportive-recovery residences, as defined, that emphasize abstinence under these provisions as long as the state program meets specified criteria, including that at least 90% of program funds awarded to each jurisdiction is used for housing or housing-based services using a harm-reduction model. This bill would specify requirements for applicants seeking funds under these programs and would require the state to perform periodic monitoring of select supportive-recovery residence programs to ensure that the supportive-recovery residences meet certain requirements, including that core outcomes of the supportive-recovery housing emphasize long-term housing stability and minimize returns to homelessness. The bill would also prohibit eviction on the basis of relapse, as specified. The bill would require, if a tenant is no longer interested in living in a supportive-recovery residence with an abstinence focus, is at risk of eviction, or is discharged from the program, the tenant to reside in the supportive recovery residence until the operator secures the tenant a new permanent housing placement option operated with harm-reduction principles that is also permanent housing. The bill would require supportive housing and services to support residents' access to and use of medications to treat behavioral and physical health conditions, as specified, and to provide overdose prevention training and overdose reversal medication to staff and residents, as specified. Existing law establishes the Department of Housing and Community Development and requires it to administer various programs that provide services to homeless individuals. This bill would require the department to adopt the most recent standards approved by the National Alliance for Recovery Residences or other national standards as the minimum standard for supportive-recovery residences that receive public funds under these provisions. The bill would require the department to establish a separate process for determining if the supportive-recovery residence complies with the core components of Housing First. The bill would require the department to verify compliance with the core components of Housing First for residences seeking Housing First certification, as specified. The bill would authorize the department to charge an annual fee to verify that supportive-recovery residences comply with the core components of Housing First in an amount not to exceed the reasonable cost of administering the program, not to exceed $100, and would establish the Supportive-Recovery Residence Program Fund for collection of the fee, to be available upon appropriation by the Legislature.