(1) Existing law provides for the licensure and regulation of various healing arts practitioners by boards within the Department of Consumer Affairs. Existing law provides an exemption from these requirements for a health care practitioner licensed in another state who offers or provides health care for which the practitioner is licensed during a state of emergency, as defined, and upon request of the Director of the Emergency Medical Services Authority, as specified. This bill would exempt health care practitioners licensed in another state, territory, or country from certain healing arts licensure, certification, or registration requirements, as described above, while providing professional services at Olympic and Paralympic activities, as defined, if the health care practitioner has been invited by the Los Angeles Organizing Committee for the 2028 Olympic and Paralympic Games to provide those services and the committee provides specified information to the Director of Consumer Affairs. The bill would specify that the exemption applies while the health care practitioner is providing professional services at the invitation of the committee and only during the time sanctioned by the committee. This bill would authorize the official team representative who is responsible for any member participating in Olympic and Paralympic activities to give consent to the furnishing of professional services to a team member who, due to age, disability, or injury, is not able to personally consent in the event the consent of a parent, guardian, or legal representative of a team member cannot be obtained. The bill would specify that in the case of emergency, the consent of the parent, guardian, or legal representative of the team member would not be necessary in order to authorize the performance of professional services. (2) Existing law sets forth various powers and responsibilities for the State Department of Public Health concerning communicable disease prevention and control, in relation to persons, animals, and places, as necessary to protect or preserve the public health. This bill would require that the list of immunizations, items, and services that were recommended by the United States Preventive Services Task Force (USPSTF) , the federal Advisory Committee on Immunization Practices (ACIP) , and the federal Health Resources and Services Administration (HRSA) that were in effect on January 1, 2025, serve as a baseline of recommendations and would authorize the State Department of Public Health, notwithstanding the rulemaking provisions of the Administrative Procedure Act, to modify or supplement those baseline recommendations, as specified. The bill would require the department to publish recommendations and any updates, modifications, or supplements. (3) Existing law authorizes various healing arts licensees, including dentists, doctors of podiatric medicine, optometrists, and pharmacists, to independently prescribe, initiate, or administer specified immunizations approved or authorized by the United States Food and Drug Administration in compliance with specified recommendations, including those by the ACIP. This bill would instead authorize those licensees to prescribe, initiate, or administer specified immunizations in a manner consistent with a recommendation made by the State Department of Public Health, as specified. (4) Existing law provides for the licensure, registration, and regulation of clinical laboratories and various clinical laboratory personnel by the State Department of Public Health. Existing law requires the fees or charges accompanying an application for the issuance or renewal of these licenses, among others, to be adjusted annually by the percentage change printed in the Budget Act and determined by dividing the General Fund appropriation to Laboratory Field Services in the current state fiscal year by the General Fund appropriation to Laboratory Field Services in the preceding state fiscal year. Commencing January 1, 1995, upon establishment of the Clinical Laboratory Improvement Fund, existing law requires this annual adjustment to be determined by dividing the current fiscal year appropriation to the Clinical Laboratory Improvement Fund by the General Fund appropriation to Laboratory Field Services of the department in the preceding fiscal year. Existing law also requires these fees and charges to be adjusted annually by a percentage determined by dividing the total amount of federal funds available for all programs in Laboratory Field Services of the department during the federal fiscal year ending on September 30 of the year immediately preceding the effective date of the change in fees, as specified. This bill would delete the above provisions pertaining to the annual adjustment of fees or charges and replace them with a requirement that the annual adjustment be done by the department to cover the estimated licensing program costs. Existing law requires a tissue bank, as defined, to have a current and valid tissue bank license. Under existing law, the application and annual renewal fee for a tissue bank license is $950, adjusted annually by a percentage listed in the Budget Act. This bill would adjust the fees or charges for a tissue bank license annually pursuant to the provision above requiring the annual adjustment be done by the department to cover the estimated licensing program costs. This bill would additionally revise the application, registration, and license fees for clinical laboratories and clinical laboratory personnel. (5) Existing federal law, the Patient Protection and Affordable Care Act (PPACA) , requires each state to establish an American Health Benefit Exchange to facilitate the purchase of qualified health benefit plans by qualified individuals and qualified small employers. PPACA defines a "qualified health plan" as a plan that, among other requirements, provides an essential health benefits package. Existing state law creates the California Health Benefit Exchange, also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under PPACA. Existing law establishes the Health Care Affordability Reserve Fund to be used, upon appropriation by the Legislature, for health care affordability programs operated by the Exchange. If a qualified health plan is required to cover state-mandated gender-affirming care benefits determined to be in addition to essential health benefits, this bill would require the Exchange to provide payments to issuers of qualified health plans to defray the costs of offering those benefits for plan years beginning on or after January 1, 2026, subject to an appropriation by the Legislature. The bill would authorize the Health Care Affordability Reserve Fund to be used, upon appropriation by the Legislature, for these payments. (6) Existing law establishes the State Department of Public Health and sets forth its powers and duties, including, but not limited to, duties relating to the licensing and regulation of various entities, including clinics. Existing law exempts specified clinics from these licensure requirements, including, among others, certain federal clinics, clinics maintained as outpatient departments of hospitals, and student health centers operated by public institutions of higher education. This bill would exempt from the above-described licensure requirements a clinic approved by, and that provides health care services at locations designated or sanctioned by, the Los Angeles Organizing Committee for the 2028 Olympic and Paralympic Games from May 15, 2028, to September 15, 2028, inclusive. (7) Existing law, the Emergency Medical Services System and the Prehospital Emergency Medical Care Personnel Act, establishes the Emergency Medical Services Authority, which is responsible for the coordination of various state activities concerning emergency medical services (EMS) , including, among others, establishing minimum standards and promulgating regulations for the training and scope of practice for an Emergency Medical Technician I and II (EMT-I and EMT-II) and Emergency Medical Technician-Paramedic (EMT-P) . Existing law requires the authority to have a chief medical officer who is required to provide clinical leadership and oversight concerning treatment, education, and other matters involving medical decisionmaking and delivery of patient care. This bill, notwithstanding any other law, would exempt from the EMS licensure, certification, or accreditation requirements of this state an EMT-I, EMT-II, EMT-P, or similar EMS provider, as defined, licensed or certified in another state or territory of the United States, who provides EMS for which they are licensed, if they are authorized by the chief medical officer of the authority to provide EMS at sites in this state sanctioned by the Los Angeles Organizing Committee for the 2028 Olympic and Paralympic Games and associated with the 2028 Olympic and Paralympic Games. The bill would require the chief medical officer to authorize those EMS personnel based on system needs and informed by committee needs, qualifications of the emergency medical services personnel, and public safety considerations. The bill would prohibit EMS providers authorized by the chief medical officer from being liable for any act or omission taken in good faith while providing authorized services. The bill would require authorization pursuant to these provisions to be valid from May 15, 2028, to September 15, 2028, inclusive, or until authorization is otherwise withdrawn by the chief medical officer. (8) Existing law requires the State Department of Health Care Services (DHCS) to annually report to certain legislative committees, and publicly post, a summary of outcome and expenditure data with regard to outcome measures for alcohol and drug program services, as specified. This bill would repeal the above-described reporting and publication provisions. (9) Existing law requires DHCS to provide certain legislative committees with biannual updates on caseload, estimated expenditures, and related program monitoring data for the Every Woman Counts (EWC) Program, as specified. Existing law requires that expenditures for the EWC Program included in the department's budget for services provided on or after July 1, 2017, be charged against the appropriation for the fiscal year in which the billing is paid. This bill would delete the above-described requirements relating to the EWC Program. (10) Existing law establishes the public policy of the state that pupils are advised to adhere to current immunization guidelines, as recommended by, among other entities, the ACIP. Existing law prohibits the governing authority of a school or other institution from unconditionally admitting any person as a pupil unless, before the person's admission to that institution, the person has been fully immunized against various diseases, including any disease deemed appropriate by the State Department of Public Health, taking into consideration recommendations of various entities, including the ACIP. Existing law requires a medical exemption form and the appeal process for revocation of a medical exemption to be consistent with specified guidelines, including those by the ACIP. This bill would delete certain references to the ACIP and replace other references to the ACIP with the State Department of Public Health. Some of these provisions would be operative beginning July 1, 2026. To the extent that this bill imposes new duties on a local education agency, the bill would impose a state-mandated local program. (11) Existing law, from October 1 to the following April 1, inclusive, of each year, requires specified health facilities to offer immunizations for influenza and pneumococcal disease to residents or inpatients 65 years of age or older who are receiving services at the facility, based upon the latest recommendations of specified entities, including the ACIP. This bill would replace those references to ACIP with the State Department of Public Health. Existing law requires the State Department of Public Health to post on its internet website educational information regarding influenza in accordance with the latest recommendations of the ACIP. This bill would replace the reference to ACIP with the State Department of Public Health. (12) Existing law, the Hereditary Disorders Act, requires the State Department of Public Health to license genetic counselors and temporary genetic counselors who meet specified requirements. Existing law prohibits the license fee from exceeding $200 for an original license, license renewal, or temporary license. Existing law requires all moneys collected by the department under the act to be deposited in the Genetic Disease Testing Fund, which is continuously appropriated to the department to carry out the purposes of the act. This bill would instead set the fee for an original license, license renewal, and temporary license at $300. The bill would authorize the department to adjust those fees to an amount not to exceed $500. The bill would require the department to solicit input from affected stakeholders before raising these fees. By authorizing additional moneys to be deposited into a continuously appropriated fund, the bill would make an appropriation. (13) 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 specified health care service plan contracts, or specified disability or health insurance policies, to cover an evidence-based item, service, or immunization that has in effect a specified rating in the recommendations of the USPSTF or an immunization that has in effect a recommendation from specified entities, including the ACIP. Existing law also requires specified health care service plans or disability insurers to offer benefits for the comprehensive prevention care of children consistent with the most current version of the Recommended Childhood Immunization Schedule/United States, jointly adopted by various entities, including the ACIP. This bill would require those health care service plan contracts or disability or health insurance policies to cover an evidence-based item, service, or immunization that had in effect on January 1, 2025, a specified rating in the recommendations of USPSTF. The bill would replace references to the ACIP with the State Department of Public Health. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program. (14) Existing federal law, the Patient Protection and Affordable Care Act (PPACA) , requires each state to establish an American Health Benefit Exchange to facilitate the purchase of qualified health benefit plans by qualified individuals and qualified small employers. Existing state law creates the California Health Benefit Exchange (Exchange) , also known as Covered California, for this purpose. PPACA generally prohibits the use of federal funds for abortion services, but if a qualified health plan provides abortion coverage, PPACA requires the issuer of the plan to collect specified amounts from each enrollee and deposit those funds into a segregated account to be used to pay for abortion services. Under state law, the Exchange makes those payments to qualified health plans on behalf of enrollees. Existing state law requires a health care service plan that provides a qualified health plan through the Exchange to report to the Director of the Department of Managed Health Care the total amount of funds maintained in a segregated account. This bill would establish the Abortion Access Fund, a continuously appropriated fund, to provide funding for abortion services, including for abortion services funded through grants to provide abortion access. The bill would authorize the Department of Health Care Access and Information to distribute moneys in the fund through grants and contracts. Under the bill, contracts, grants, and related information would be exempt from public disclosure. From the 2025–26 fiscal year to the 2028–29 fiscal year, inclusive, the bill would require the Director of the Department of Managed Health Care to order a health care service plan that provides a qualified health plan through the Exchange to transfer to the Abortion Access Fund up to the total amount previously funded by the Exchange, not to exceed a specified percentage of the ending balance in its segregated account, and would require a plan to complete the transfer. Because a willful violation of the bill's requirements relative to health care service plans would be a crime, the bill would impose a state-mandated local program. (15) Under existing law, the Breast Cancer Fund consists of the Breast Cancer Research Account and the Breast Cancer Control Account. Under existing law, revenues from a specified cigarette tax are deposited into the fund and divided equally between the 2 accounts, to be allocated upon appropriation. Existing law requires any entity funded by the Breast Cancer Control Program to collect data and maintain records that are determined by the State Department of Public Health to be necessary to facilitate the department's ability to monitor and evaluate the effectiveness of the entities and the program. Existing law requires the department to submit an annual report to the Legislature and any other appropriate entity. This bill would switch the jurisdiction from the State Department of Public Health to DHCS for purposes of the above-described and other related provisions. The bill would make certain changes to the required contents of the report. Existing law requires the State Department of Public Health to provide for breast cancer screening services at the level of funding budgeted from state and other resources during the fiscal year in which the Legislature has appropriated funds to the department for this purpose, with administrative or indirect costs not exceeding certain limits. This bill would delete those provisions. (16) Existing law establishes the Children and Youth Behavioral Health Initiative, administered by the California Health and Human Services Agency and its departments, as applicable. Under existing law, the purpose of the initiative is to transform the state's behavioral health system into an innovative ecosystem in which all children and youth 25 years of age and younger, regardless of payer, are screened, supported, and served for emerging and existing behavioral health needs. Existing law requires DHCS, or a contracted vendor, to provide competitive grants to qualified entities to build partnerships, capacity, and infrastructure supporting ongoing school-linked behavioral health services, among other purposes, for children and youth 25 years of age and younger. For these purposes, existing law requires the department to develop and maintain a school-linked statewide fee schedule for outpatient mental health or substance use disorder treatment provided to a student who is 25 years of age or younger at a schoolsite. Existing law requires the department to develop and maintain a school-linked statewide provider network of schoolsite behavioral health counselors. Existing law authorizes the department to contract with an entity to administer the school-linked statewide behavioral health provider network. Existing law requires that administrator to, among other things, create and administer a process for the submission and reimbursement of eligible claims. This bill would require the department to convene a working group twice each year of specified stakeholders, including, among others, behavioral health providers and local educational agencies, to discuss the status of, and receive feedback regarding, the implementation of the fee schedule. The bill would require a contracted administrator to automate the matching of student records with health plan enrollment information and to reimburse claims pursuant to claim payment deadlines, as specified. The bill would require the California Health and Human Service Agency to publish a manual to assist a local educational agency with navigating certain federal laws. (17) Existing law, the California Work Opportunity and Responsibility to Kids (CalWORKs) program, requires all applicants for or recipients of CalWORKs to ensure and provide documentation that each child in the assistance unit who is not required to be enrolled in school has received all age-appropriate immunizations. Existing law requires all applicants and recipients to be given notice of that obligation and for the notice to include specified recommended childhood immunization schedules, as approved by various entities, including the ACIP. This bill would remove the reference to the ACIP and replace it with the State Department of Public Health, as specified. (18) Existing law establishes the Medi-Cal program, which is administered by DHCS 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 sets a schedule of benefits that are covered by the Medi-Cal program. This bill would require that vaccines and immunizations are covered in accordance with a recommendation from ACIP, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, and any modification or supplement to a recommendation adopted by the State Department of Public Health. The bill would make the implementation of this provision contingent to the extent that federal financial participation is available and any necessary federal approvals are obtained. (19) Existing law prohibits the use of an assets or resources test for individuals whose income eligibility for Medi-Cal is determined based on the application of a modified adjusted gross income (MAGI) . Existing law prohibits, until January 1, 2026, the use of resources to determine Medi-Cal eligibility for applicants or beneficiaries whose eligibility is not determined using the MAGI-based financial methods, subject to receipt of any necessary federal approvals. Under existing law, operative on January 1, 2026, for those applicants or beneficiaries whose eligibility is not determined using the MAGI-based financial methods, DHCS is required to seek federal approval to implement a disregard of $130,000 in nonexempt property for a case with one member and $65,000 for each additional household member, up to a maximum of 10 members. Existing law requires that provision to be implemented only after the Director of Health Care Services determines that systems have been programmed for the disregards and they communicate that determination in writing to the Department of Finance. This bill would additionally specify that the above-described implementation condition occur no sooner than January 1, 2026. (20) Existing law sets forth provisions for the transition of certain children from the former Healthy Families Program to the Medi-Cal program. Existing law requires DHCS to provide monthly status reports to certain legislative committees on the transition, with a final comprehensive report provided within 90 days after completion of the last phase of transition. This bill would delete the above-described reporting requirement. (21) Existing law establishes a program, known as the 250% Working Disabled Program (250% WDP) , under which certain working persons with disabilities are eligible for Medi-Cal benefits based on a net countable income of less than 250% of the federal poverty level and other specified criteria. Existing law requires DHCS to report to the Governor and the Legislature any information that DHCS gathers that may explain the low participation rates in 250% WDP and any recommendations on increasing participation, as specified. This bill would repeal the above-described reporting provision. (22) The federal Medicaid program prohibits payment to a state for medical assistance furnished to an alien who is not lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law. Existing state law extends Medi-Cal eligibility for the full scope of Medi-Cal benefits to individuals who do not have satisfactory immigration status if they are otherwise eligible for those benefits, with the exception of specified dental benefits for individuals who are 19 years of age or older. Existing law makes an individual who is 19 years of age or older, who does not have satisfactory immigration status, and who applies for Medi-Cal on or after January 1, 2026, eligible only for pregnancy-related services and emergency medical treatment. Existing law, beginning no sooner than July 1, 2026, or July 1, 2027, as specified, requires individuals who do not have satisfactory immigration status, who are not pregnant, and who are 19 to 59 years of age, inclusive, to pay a monthly premium of $30, subject to certain exceptions. This bill would make certain nonminor dependents and foster youths exempt from the service limitations and monthly premium provisions described above. The bill would require the monthly premium payments described above to begin no sooner than July 1, 2027, and make other technical and conforming changes. (23) Existing law requires DHCS to implement a process that allows applicants and beneficiaries of certain Medi-Cal programs to self-certify the amount and nature of assets and income without the need to submit income or asset documentation. Existing law requires DHCS to implement the process in 2 phases, with the first phase in 2 counties and the 2nd phase statewide, with each county agreeing to meet all federal requirements for income, resource, and other verifications and to perform determinations and verifications in a timely manner. Existing law requires DHCS to promptly provide certain legislative committees with an evaluation of the process and its impact on the Medi-Cal program. This bill would delete certain provisions relating to the 2 phases, including the evaluation requirement. (24) Existing law, under Medi-Cal provisions, requires DHCS to enter into demonstration contracts with manufacturers of medical supplies for 4 items of its own selection of medical supplies existing on the pharmacy claims processing system, for the purpose of establishing rebates or other cost-saving mechanisms and demonstrating cost savings in the purchase of these medical supplies. This bill would repeal those and related provisions. The bill would make conforming changes to other provisions. (25) Existing law requires DHCS to establish a 2-year pilot program to utilize the federal Public Assistance Reporting Information System (PARIS) to identify veterans and their dependents or survivors who are enrolled in the Medi-Cal program and assist them in obtaining federal veteran health care benefits. Existing law requires DHCS to monitor the pilot program, evaluate the outcomes and savings, and provide the fiscal committees of the Legislature with a report on the findings and recommendations. This bill would delete the above-described monitoring, evaluation, and reporting requirements. (26) Existing law, operative until July 1, 2025, requires DHCS to work with stakeholders to conduct a study to identify current requirements for medical interpretation services and make recommendations on strategies that may be employed regarding the provision of medical interpretation services for Medi-Cal beneficiaries who are limited English proficient (LEP) . Existing law requires the department to establish a pilot project to evaluate certain factors, including whether disparities in care are reduced, with respect to LEP Medi-Cal beneficiaries compared with Medi-Cal beneficiaries who are proficient in English. Existing law requires the department to expend up to $5,000,000 for the pilot project pursuant to an appropriation made in the Budget Act of 2019, and makes those funds available for that purpose until June 30, 2025. This bill would extend the operation of these provisions until July 1, 2026, and make those funds available for expenditure, encumbrance, and liquidation until June 30, 2026. By extending the period of time in which previously appropriated funds are available for expenditure, encumbrance, and liquidation, the bill would make an appropriation. (27) Existing law requires the Office of Family Planning within DHCS to submit a biennial report to the Legislature on specified subjects relating to family planning services. This bill would instead require the office to post annual reports on its internet website. (28) Existing law requires the former State Department of Health Services, whose functions were transferred to other departments, to provide certain legislative committees with quarterly updates regarding core activities to improve the Medi‑Cal managed care program and county expansion, as specified. This bill would repeal those reporting provisions. (29) Existing law requires the former State Department of Mental Health, whose functions were transferred to other departments, to provide certain legislative committees with semiannual updates regarding key results and funding for the capital costs associated with development, acquisition, construction, and rehabilitation of permanent supportive housing for individuals with mental illness, as specified. This bill would repeal those reporting provisions. (30) Existing law authorizes the State Public Health Officer, to the extent allowable under federal law, and upon the availability of funds, to expend moneys from the continuously appropriated AIDS Drug Assistance Program (ADAP) Rebate Fund for a program to cover the costs of prescribed ADAP formulary medications for the prevention of HIV infection and other specified costs. Existing law authorizes the State Department of Public Health to spend up to $75,000,000 from the ADAP Rebate Fund to support current or eligible HIV services and programs, as specified. Existing law prescribes the allocation of those funds, including by authorizing up to $65,000,000 of that $75,000,000 to be spent to supplement or fund services, programs, or initiatives for which federal funding has been reduced or eliminated and making $9,000,000 available to fund state and local disease intervention specialists. This bill would make up to $18,000,000 of the above-described $65,000,000 available for state operations and would make up to $1,640,000 of the above-described $9,000,000 available for state operations. By adding to the purposes for which the ADAP Rebate Fund may be spent, the bill would make an appropriation. (31) 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. (32) 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 with regard to certain mandates no reimbursement is required by this act for a specified reason. With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above. (33) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.
Existing law, the Medical Practice Act, establishes the Medical Board of California within the Department of Consumer Affairs and charges it with administrative and enforcement duties related to the provision of medical services under the act. The act makes unprofessional conduct subject to discipline by the board the regular practice of medicine in a specified hospital having 5 or more physicians and surgeons on the medical staff without required provisions governing the operation of the hospital relating to records and to the organization, membership, and self-governance of the medical staff. The act makes unprofessional conduct subject to discipline by the board the regular practice of medicine in a specified hospital having less than 5 physicians and surgeons on the medical staff without required provisions governing the operation of the hospital relating to records and to the membership of the medical staff. The act includes in the organization provisions licensed physicians and surgeons, as specified, and in the membership provisions physicians and surgeons, and other licensed practitioners, as specified. A violation of the act, unless otherwise expressly provided, is a crime. This bill would expand the required provisions related to organization to additionally include dentists, podiatrists, clinical psychologists, nurse practitioners, nurse anesthetists, nurse midwives, and other health care professionals, as specified. The bill would expand the required provisions related to membership of medical staff to additionally include dentists, podiatrists, clinical psychologists, nurse practitioners, nurse anesthetists, and nurse midwives, as specified. By expanding the required provisions, the lack thereof constituting unprofessional conduct, this bill would expand the scope of a crime, and would thereby 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.
(1) Existing law prohibits specified medical professionals, including nurses, not employed in that capacity by the State Department of Health Care Services, and any other person, from being employed or permitted to supervise the health and physical development of pupils unless that person holds a services credential with a specialization in health or a valid credential, as provided. Notwithstanding that provision, existing law authorizes any pupil who is required to take, during the regular schoolday, medication prescribed for them by a physician and surgeon or ordered for them by a physician assistant, to be assisted by the school nurse or other designated school personnel, and to carry and self-administer, prescription auto-injectable epinephrine if the school district receives the appropriate written statements, as specified. This bill would revise and recast that latter provision by authorizing assistance with, and the carrying and self-administration of, emergency epinephrine delivery systems, instead of auto-injectors, and making its provisions also apply to county offices of education and charter schools. Notwithstanding any other law, existing law requires school districts, county offices of education, and charter schools to provide emergency epinephrine auto-injectors, to be stored in an accessible location upon need for emergency use, to school nurses or trained volunteer personnel, and authorizes school nurses and trained personnel to use epinephrine auto-injectors to provide emergency medical aid to persons suffering, or reasonably believed to be suffering, from an anaphylactic reaction, as provided. This bill would revise and recast those provisions by requiring local educational agencies, defined as a school district, county office of education, or charter school, to provide emergency epinephrine delivery systems, instead of auto-injectors, as provided, to be stored at each schoolsite, including at the location of any state or federally subsidized childcare program operated by or under contract with the local educational agency, and by expanding the definition of "volunteer" or "trained personnel" to include certain employees of childcare programs, as provided. To the extent that this bill would impose additional duties on local educational agencies, the bill would impose a state-mandated local program. (2) Existing law authorizes a pharmacy to furnish epinephrine auto-injectors to a school district, county office of education, or charter school for purposes of the requirements described in paragraph (1) above if specified requirements are met, including that the auto-injectors are furnished exclusively for use at a school district site, county office of education, or charter school. This bill would authorize a pharmacy to furnish epinephrine delivery systems, instead of auto-injectors, to those local educational agencies, subject to the same requirements, except that the delivery systems may also be furnished exclusively for use at any state or federally subsidized childcare program operated by or under contract with one of those local educational agencies. (3) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that, 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 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 a specified individual to commence the CARE process, known as the original petitioner. Existing law authorizes the court to dismiss a case without prejudice when the court finds that a petitioner has not made a prima facie showing that they qualify for the CARE process. Existing law requires the court to take prescribed actions if it finds that a prima facie showing has been made, including, but not limited to, setting the matter for an initial appearance on the petition. Existing law requires the court, if it determines the parties have entered or are likely to enter into a CARE agreement, to either approve or modify the CARE agreement and continue the matter at a progress hearing in 60 days, or continue the matter for 14 days to allow the parties additional time to enter into an agreement. Existing law prohibits a person from being tried or adjudged to punishment while that person is mentally incompetent. Existing law requires the court to, for a person found mentally incompetent and not charged with certain offenses, among other things, determine whether restoring the person to mental competence is in the interests of justice. Existing law requires the court to, if restoring the person to mental competence is not in the interests of justice, conduct a hearing, as specified, and determine the person's eligibility for diversion. Under existing law, if the court determines, at the first hearing, that the person is ineligible for diversion, the court is required to hold a hearing to determine the person's other options, including the CARE program. Existing law authorizes a court to refer an individual from, among other things, assisted outpatient treatment or conservatorship proceedings, as specified, to CARE Act proceedings. Existing law provides that if the individual is referred from assisted outpatient treatment, the county behavioral health director or their designee shall be the petitioner, whereas if the referral is from conservatorship proceedings, the conservator or proposed conservator is the petitioner. This bill would allow the court to make a prima facie determination without conducting a hearing. The bill, in the first hearing to determine competence to stand trial, would authorize the court to consider the petitioner's eligibility for both diversion and the CARE program. The bill would authorize the court to refer the petitioner to the CARE Act court if the defendant or counsel for the defendant agrees to the referral and the court has reason to believe the petitioner may be eligible for the CARE program. If the petitioner is not accepted into the CARE program or if the CARE Act court refers the petitioner back to criminal court, as specified, the bill would require the criminal court to conduct a hearing to determine whether the petitioner is eligible for a diversion program. The bill would authorize the county behavioral health agency and jail medical providers to share confidential medical records and other relevant information with the court for the purpose of determining likelihood of eligibility for behavioral health services and programs. The bill would authorize the court to call additional progress hearings after 60 days. The bill would also include persons suffering from bipolar I disorder with psychotic features, except for psychosis related to current intoxication, in the disorder class. The bill would additionally authorize a court to refer an individual from felony proceedings, as specified, to the CARE Act program. The bill would authorize a CARE Act court to consider a referral as a petition for participation in the CARE program if certain requirements are met. The bill would make additional technical and conforming changes. Existing law requires the Judicial Council to develop a mandatory form for use to file a CARE process petition with the court, and requires the petition to be signed under penalty of perjury and include either an affidavit of a licensed behavioral health professional, as defined, or evidence that the respondent was detained for a minimum of 2 intensive treatments, as specified. The bill would additionally include a nurse practitioner and physician assistant as a licensed behavioral health professional for purposes of individuals authorized to prepare an affidavit supporting a CARE process petition. By increasing various duties on county behavioral health agencies, 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, 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 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, established the Mental Health Services Oversight and Accountability Commission to oversee the implementation of the MHSA. Existing law specifies the composition of the 16-member commission, including the Attorney General or their designee, the Superintendent of Public Instruction or their designee, specified members of the Legislature, and 12 members appointed by the Governor, as prescribed. Existing law, the Behavioral Health Services Act (BHSA) , an initiative measure enacted by the voters as Proposition 1 at the March 5, 2024, statewide primary election, recast the MHSA by, among other things, renaming the commission to the Behavioral Health Services Oversight and Accountability Commission and changing its composition and duties. This bill would make technical changes to reflect the correct name of the commission. (2) Existing law provides for the licensure and regulation of health facilities by the State Department of Public Health. Existing law requires a health facility to develop, implement, and comply with a patient safety plan to improve the health and safety of patients and to reduce preventable patient safety events. Existing law requires a patient safety plan to contain specified elements, including, but not limited to, a reporting system for patient safety events that allows anyone involved to make a report of a patient safety event to the health facility and a process for a team of facility staff to conduct analyses related to root causes of patient safety events. Existing law, commencing January 1, 2026, and biannually thereafter, requires a health facility to submit a patient safety plan to the department. A violation of these provisions is a crime. This bill would instead require a health facility to submit a patient safety plan to the department biennially. The bill would also make technical corrections to those provisions. (3) Existing law establishes the State Department of Public Health and sets forth its powers and duties to license and administer health facilities, as defined, including skilled nursing facilities and intermediate care facilities. Existing law requires the department to prepare and maintain a list of approved training programs for nurse assistant certification, which are required to include a precertification training program consisting of at least 60 classroom hours of training on basic nursing skills, patient safety and rights, the social and psychological problems of patients, and elder abuse recognition and reporting and at least 100 hours of supervised and on-the-job training clinical practice. Existing law requires at least 2 hours of the 60 hours of classroom training and at least 4 hours of the 100 hours of the supervised clinical training to address the special needs of persons with developmental and mental disorders, including intellectual disability, Alzheimer's disease, cerebral palsy, epilepsy, dementia, Parkinson's disease, and mental illness. A violation of these provisions is a crime. This bill would require that at least 2 of the 60 hours of classroom training address the special needs of persons with Alzheimer's disease and related dementias. By changing the definition of a crime, this bill would impose a state-mandated local program. (4) Existing law requires a hospital, as defined, to maintain an understandable written policy regarding discount payments for financially qualified patients as well as a written charity care policy, and requires a hospital to negotiate the terms of a discount payment plan with an eligible patient, as specified. Existing law requires each hospital to provide patients with written notice, provided at the time of service, about the availability of the hospital's discount payment and charity care policies, and other additional information. This bill would authorize, with the exception of emergency room visits, a hospital to provide the written notice in either hard copy or, if the patient has previously consented to receive electronic communications, using the patient's preferred electronic notification method. The bill would require the written notice related to an emergency room visit to be provided in hard copy. The bill would require, if the notice is provided electronically, the notice to be sent separately from any other electronic communications and to prominently indicate in the subject line that the notice is related to the hospital's discount and charity care policies. (5) Existing law authorizes the State Department of Public Health to develop and administer a syndromic surveillance program and, subject to an appropriation, to either designate an existing system or to create a new system that would be required, at a minimum, to provide public health practitioners access to an electronic health system to rapidly collect, evaluate, share, and store syndromic surveillance data, as specified. This bill would make technical corrections to related provisions. (6) Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires a large group disability insurance policy and a small group disability insurance policy, except as specified, issued, amended, or renewed on or after January 1, 2026, to provide coverage for the diagnosis and treatment of infertility and fertility services, as specified. This bill would instead require a large group health insurance policy and a small group health insurance policy, except as specified, to offer the above-described services. (7) Existing law requires an insurer to provide an insured with an annual written or electronic notice regarding the benefits of a behavioral health and wellness screening, as defined, for children and adolescents 8 to 18 years of age. This bill would make technical changes to those provisions. (8) 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 requires, commencing January 1, 2022, that Community-Based Adult Services (CBAS) continue to be available as a capitated benefit for a qualified Medi-Cal beneficiary under a comprehensive risk contract with an applicable Medi-Cal managed care plan. This bill would make a technical correction to this provision. (9) Existing law, subject to any necessary federal approvals, sets forth various Medi-Cal provisions relating to complex rehabilitation technology (CRT) , which is a form of durable medical equipment, including, but not limited to, complex rehabilitation manual and power wheelchairs. Existing law requires a CRT provider to comply with certain standards, including requiring a qualified rehabilitation technology professional to be physically present for the evaluation. This bill would make a technical correction to this provision. (10) Existing law, the Sherman Food, Drug, and Cosmetic Law, provides for the regulation of various subjects relating to the manufacturing, processing, labeling, advertising, and sale of food, drugs, and cosmetics under the administration and enforcement of the State Department of Public Health. Existing law requires a manufacturer of baby food, as defined, for sale or distribution in this state to test a representative sample of each production aggregate of the manufacturer's final baby food product, at a proficient laboratory meeting certain criteria, for toxic elements, as specified. Existing law defines baby food as food packaged in jars, pouches, tubs, and boxes represented or purported to be specifically for babies and young children less than 2 years of age and excludes infant formula. This bill would clarify that baby food does not include dietary supplements, as defined. (11) 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 Pharmacy Law, establishes, in the Department of Consumer Affairs, the California State Board of Pharmacy to license and regulate the practice of pharmacy. Existing law authorizes a physician and surgeon, nurse practitioner, registered nurse, and specified other health care practitioners acting within the scope of their practice to use a self-screening tool to identify patient risk factors for the use of self-administered hormonal contraceptives by a patient and, after examination, to prescribe, furnish, or dispense self-administered hormonal contraceptives to the patient. This bill would, instead, make those provisions applicable to contraceptives. Existing law authorizes a pharmacist to furnish self-administered hormonal contraceptives in accordance with standardized procedures or protocols developed and approved by both the California State Board of Pharmacy and the Medical Board of California, in consultation with specified other entities. This bill would authorize a pharmacist to also furnish federal Food and Drug Administration-approved nonhormonal contraceptives in accordance with those standardized procedures or protocols. The bill would require a pharmacist, for each federal Food and Drug Administration-approved nonhormonal contraceptives initiated, to provide the recipient with a standardized fact sheet, as specified. Existing law prohibits a pharmacist, pharmacist's employer, or pharmacist's agent from directly charging a patient a separate consultation fee for emergency contraception drug therapy services and requires the pharmacist to disclose the total retail price of the emergency contraception drug therapy. Existing law makes those provisions inoperative for dedicated emergency contraception drugs if these drugs are reclassified as over-the-counter products by the federal Food and Drug Administration. This bill would delete those provisions. Existing law requires a pharmacist to dispense, at a patient's request, up to a 12-month supply of an FDA-approved, self-administered hormonal contraceptive. This bill would, instead, make those provisions applicable to contraceptives. This bill would make related conforming changes.
Existing law creates the Vocational Nurse Education Program within the Department of Health Care Access and Information for persons agreeing to serve in an eligible county health facility, state-operated health facility, or a health workforce shortage area, before completing vocational nursing school. Existing law authorizes a person who qualifies for admission to a vocational nursing program to apply for funding under the program, as specified. Existing law establishes the Vocational Nurse Education Fund for the purpose of promoting the education of vocational nurses and related administrative costs. This bill would create the California Nurse-Midwifery Education Fund within the department for the purpose of establishing California-based, master's level, nurse-midwifery education programs within the California State University, the University of California, or both. The bill would require the department to administer the fund, and receive moneys from the General Fund for these purposes upon appropriation by the Legislature. The bill would require the department to establish a competitive application criteria to ensure the optimal sites selection for the education programs within the California State University system or the University of California, would require the department to ensure that a master's degree is an option for students as the culminating degree of the education programs receiving funds, and would require the education programs to meet specified requirements. The bill would also require the fund to support the annual operating costs for the development, operation, and maintenance of the education programs through the graduation of the first cohort of matriculated students, or 5 years, whichever is shorter.
Existing law provides for the licensure of various health facilities, including general acute care hospitals, acute psychiatric hospitals, and special hospitals, by the State Department of Public Health. Existing law requires the department to adopt regulations that establish minimum, specific, and numerical licensed nurse-to-patient ratios by licensed nurse classification and by hospital unit for all general acute care hospitals, acute psychiatric hospitals, and special hospitals. Existing law requires the department to assess an administrative penalty of $15,000 for the first violation and $30,000 for the second and each subsequent violation if the department determines that a specified health facility has violated nurse-to-patient ratios, as specified. Under existing law, an acute general hospital is not subject to this administrative penalty if the hospital demonstrates it has met specified requirements, including that any fluctuation in required staffing levels was unpredictable and uncontrollable, prompt efforts were made to maintain required staffing levels, and the hospital immediately used and subsequently exhausted the hospital's on-call list of nurses and the charge nurse. Existing law specifies that multiple violations found on the same inspection survey constitute a single violation for purposes of determining whether the violation was a first, 2nd, or subsequent violation. This bill would define "on-call list" for the above purpose and would specify that a hospital contacting, or attempting to contact, licensed nurses who are not scheduled to be on call and who are not assigned to a float pool for the unit and shift where an alleged violation occurred is not considered as exhausting an on-call list. The bill would require the department to treat violations on separate days as separate violations.
Existing law requires the Department of Health Care Access and Information, formerly known as the Office of Statewide Health Planning and Development, to establish a program to contract with programs that train certified nurse-midwives and programs that train licensed midwives in accordance with the global standards for midwifery education and the international definition of "midwife" as established by the International Confederation of Midwives in order to increase the number of students receiving quality education and training as a certified nurse-midwife or as a licensed midwife. Existing law requires these provisions to be implemented only upon an appropriation by the Legislature for these purposes in the annual Budget Act or another act. This bill would require the Department of Health Care Access and Information, upon appropriation from the Legislature for this purpose, to administer funding for a statewide study on midwifery education. The bill would require the study to be conducted by an outside consultant familiar with the health care and midwifery landscapes and workforce in California that would, among other things, identify viable education programs that can serve both rural and urban geographic areas. The bill would require the department to submit a report from the study's findings to the Legislature, to post the report on the department's internet website, and to notify all persons in the department's reproductive health and maternity care electronic mailing list, as specified. The bill would define "reproductive health care professionals" as, among others, medical doctors and licensed midwives.
(1) Existing law provides for the licensure and regulation of health facilities, including general acute care hospitals, acute psychiatric hospitals, and special hospitals, by the State Department of Public Health. Existing law requires the department to adopt regulations that establish minimum, specific, and numerical licensed nurse-to-patient ratios by licensed nurse classification and by hospital unit for all general acute care hospitals, acute psychiatric hospitals, and special hospitals. Existing law requires the regulations adopted by the department for acute psychiatric hospitals that are not operated by the State Department of State Hospitals to take into account the special needs of the patients served in the psychiatric units. Existing law generally makes a willful violation of those licensing provisions a crime. Under existing law, on and after July 1, 2015, any acute psychiatric hospital that submits a completed application and is operated by the State Department of State Hospitals may be approved by the State Department of Public Health to offer, as a supplemental service, an Enhanced Treatment Program (ETP) that meets certain conditions, including sufficient and documented evaluation of violence risk of the patient. Existing law requires an ETP to meet certain requirements relating to staffing and patient room features and to implement certain policies and procedures on patient care. Under existing law, those ETP provisions remain in effect for each pilot ETP until January 1 of the 5th calendar year after each pilot ETP site has admitted its first patient, and the provisions are repealed as of January 1 of the 5th calendar year after each pilot ETP site has admitted its first patient. Existing law requires the State Department of State Hospitals to post a declaration on its internet website regarding the timing of that repeal condition. This bill would delete the above-described provisions regarding ETP repeal. The bill would instead repeal those provisions on January 1, 2030, as specified. To the extent that the bill would extend the operation of certain ETP sites, and by extending ETP requirements, the violation of which would be a crime, the bill would impose a state-mandated local program. This bill would specify regulations for acute psychiatric hospitals not operated by the State Department of State Hospitals are deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, and general welfare, and would require the department to adopt emergency regulations for these facilities no later than January 31, 2026, and permanent regulations thereafter, as specified. The bill would authorize the department to readopt the emergency regulations, as specified. The bill would authorize the emergency regulations to include, among other things, staffing standards specific to acute psychiatric hospitals. (2) Existing law requires the State Department of Public Health to use the direct care staffing level data it collects to determine whether a skilled nursing facility has met its nursing hours or direct care service hours per patient per day requirements, as specified. Existing law requires the department to assess specified administrative penalties on skilled nursing facilities that fail to meet these requirements and establishes an administrative process that skilled nursing facilities may use to appeal determinations or assessments made by the department. Existing law continues in the Special Deposit Fund the Skilled Nursing Facility Minimum Staffing Penalty Account and requires the administrative penalties described above to be deposited into that account. Under existing law, the account is continuously appropriated to the department to support the implementation of these provisions. This bill would remove the Skilled Nursing Facility Minimum Staffing Penalty Account from the Special Deposit Fund. The bill would, notwithstanding any other law, authorize the State Controller to use the funds in the Skilled Nursing Facility Minimum Staffing Penalty Account for cash flow loans to the General Fund, as specified. (3) Existing law requires a clinic, health facility, home health agency, or hospice to prevent unlawful or unauthorized access to, and use or disclosure of, patients' medical information, as defined. Existing law requires the clinic, health facility, home health agency, or hospice to report any unlawful or unauthorized access to, or use or disclosure of, a patient's medical information to the State Department of Public Health and to the affected patient or the patient's representative, as specified. Existing law authorizes the department to assess administrative penalties for violation of these provisions and gives the department discretion to consider all factors when determining the amount of a penalty. Existing law requires these and other specified penalty moneys to be deposited into the Internal Departmental Quality Improvement Account, which is established within the Special Deposit Fund. Upon appropriation by the Legislature, existing law requires the moneys in the account to be expended for internal quality improvement activities in the Licensing and Certification Program. This bill would remove the Internal Departmental Quality Improvement Account from the Special Deposit Fund and, notwithstanding specified provisions of law, require all interest earned on the moneys deposited in the account to be retained in the account. The bill would also, notwithstanding any other law, authorize the State Controller to use the funds in the Internal Departmental Quality Improvement Account for cash flow loans to the General Fund, as specified. (4) Existing law also establishes the Internal Health Information Integrity Quality Improvement Account. Existing law requires all administrative fines assessed by the State Department of Public Health for unlawful disclosures of confidential medical information, as specified, to be deposited in that account. Upon appropriation by the Legislature, existing law requires money in the account to be used for purposes of supporting quality improvement activities of the department. The bill would, effective July 1, 2025, abolish the Internal Health Information Integrity Quality Improvement Account and transfer all moneys in the account to the Internal Departmental Quality Improvement Account. The bill would require all remaining balances, assets, liabilities, and encumbrances of the Internal Health Information Integrity Quality Improvement Account as of July 1, 2025, to be transferred to, and become part of, the Internal Departmental Quality Improvement Account. The bill would require the administrative fines assessed for unlawful disclosures of confidential medical information described above to be deposited in the Internal Departmental Quality Improvement Account. The bill would, upon appropriation by the Legislature, require money in the account to be used for purposes of supporting quality improvement activities of the Licensing and Certification Program. The bill would also, notwithstanding any other provision of law, authorize the State Controller to use the funds in the account for cash flow loans to the General Fund, as specified. (5) Existing law provides for the licensure of long-term health care facilities by the State Department of Public Health. Existing law establishes the State Health Facilities Citation Penalties Account and the Federal Health Facilities Citation Penalties Account in the Special Deposit Fund into which moneys from civil penalties for violations of state and federal law, respectively, are deposited. Existing law requires the moneys in those accounts to be used, upon appropriation by the Legislature, in accordance with state and federal law for the protection of health or property of residents of long-term health care facilities, as specified. This bill would remove the State Health Facilities Citation Penalties Account and the Federal Health Facilities Citation Penalties Account from the Special Deposit Fund. (6) Existing law requires a skilled nursing facility, by January 1, 2026, to have an alternative source of power, as defined, to protect resident health and safety, as defined, for no fewer than 96 hours during any type of power outage. Existing law imposes specific compliance requirements based on whether a skilled nursing facility uses a generator as its alternative source of power, or batteries or a combination of batteries in tandem with a renewable electrical generation facility. This bill would instead require a skilled nursing facility to comply with these provisions on or after January 1, 2026, commencing on the first day of the Medi-Cal skilled nursing facility rate year for which the State Department of Health Care Services publishes a written notice on its internet website that the Legislature has appropriated sufficient funds for the express purpose of providing an add-on to the Medi-Cal skilled nursing facility per diem rate for the projected Medi-Cal cost compliance, as specified. The bill would authorize the State Department of Health Care Services to implement these requirements by means of provider bulletins, policy letters, or other similar instructions, without taking regulatory action. (7) 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 pharmacy benefit manager under contract with a health care service plan to, among other things, register with the Department of Managed Health Care. This bill would instead require a pharmacy benefit manager contracting with a health care service plan or health insurer to secure a license from the Department of Managed Health Care on or after January 1, 2027, or the date on which the department has established the licensure process, whichever is later. The bill would establish application requirements, and would require a pharmacy benefit manager applying for licensure to reimburse the Director of the Department of Managed Health Care for the actual cost of processing the application, including overhead, up to an amount not to exceed $25,000. The bill would require a pharmacy benefit manager to submit financial statements to the department at specified intervals, and would require those statements and other proprietary information to be kept confidential, as specified. The bill would authorize the director to suspend or revoke a pharmacy benefit manager license, but would provide that, once issued, a license remains in effect until revoked or suspended. The bill would authorize a pharmacy benefit manager whose license has been revoked, or suspended for more than one year to petition the director to reinstate the license, and would authorize the director to prescribe a fee, not to exceed $500, for the actual cost of processing the petition. The bill would create the Pharmacy Benefit Manager Fund in the State Treasury, into which fees, fines, penalties, and reimbursements collected from pharmacy benefit managers would be deposited, except fines and administrative penalties for specified acts or omissions would be deposited into the newly created Pharmacy Benefit Manager Administrative Fines and Penalties Fund in the State Treasury. Because a violation of these provisions would be a crime, the bill would impose a state-mandated local program. Existing law requires the Department of Health Care Access and Information to implement and administer the Health Care Payments Data System to learn about and seek to improve public health, population health, social determinants of health, and the health care system. This bill would require a pharmacy benefit manager to provide specified data to the Department of Health Care Access and Information regarding drug pricing, fees, and other information. The bill would require a licensed health care service plan to pay an annual fee for the 2025–26 and 2026–27 fiscal years for the reasonably necessary expenses of the Department of Health Care Access and Information to fund the Health Care Payments Data Program. The bill would also require a licensed pharmacy benefit manager to pay amounts twice per year to fund the actual and reasonably necessary expenses of the department to implement pharmacy benefit manager licensing and the actual and reasonably necessary expenses of the Department of Health Care Access and Information pertaining to data reporting by pharmacy benefit managers. The bill would require the Health Care Payments Data Program advisory committee to include pharmacy benefit managers. (8) Existing law requires large group health care service plan contracts and disability insurance policies issued, amended, or renewed on or after July 1, 2025, to provide coverage for the diagnosis and treatment of infertility and fertility services, including a maximum of 3 completed oocyte retrievals with unlimited embryo transfers, as specified. Existing law also requires small group health care service plan contracts and disability insurance policies issued, amended, or renewed on or after July 1, 2025, to offer coverage for the diagnosis and treatment of infertility and fertility services. This bill would instead require compliance with the above-described provisions by large and small group health care service plan contracts and disability insurance policies issued, amended, or renewed on or after January 1, 2026. The bill would authorize the Director of the Department of Managed Health Care and the Insurance Commissioner to issue guidance regarding these provisions until January 1, 2027, and would require the departments to consult with each other and stakeholders in issuing that guidance. (9) Existing law authorizes the State Public Health Officer, to the extent allowable under federal law, and upon the availability of funds, to expend moneys from the continuously appropriated AIDS Drug Assistance Program (ADAP) Rebate Fund for a program to cover the costs of prescribed ADAP formulary medications for the prevention of HIV infection and other specified costs. Existing law authorizes the State Department of Public Health, to the extent that the activities are an allowable use of funds, to spend up to $23,000,000 from the ADAP Rebate Fund to implement certain programs, including an allocation of $5,000,000 annually for 3 years, beginning on July 1, 2024, to the Transgender, Gender Nonconforming, and Intersex (TGI) Wellness and Equity Fund to fund services related to care and treatment for eligible individuals living with HIV and AIDS. Under existing law, expenditure from the ADAP Rebate Fund also includes an allocation of $5,000,000, in the 2024–25 fiscal year, available until June 30, 2027, to distribute funding to a community-based organization to make internal and external condoms available, if Senate Bill 954 of the 2023–24 Regular Session becomes effective, aimed at preventing the transmission of HIV and sexually transmitted infections. This bill would additionally allow the moneys allocated to the TGI Wellness and Equity Fund to fund services related to HIV prevention, and would have the allocation begin instead on July 1, 2025. With regard to funding for condoms, the bill would remove the condition that Senate Bill 954 become effective, and would authorize the allocation until June, 30, 2028. This bill would authorize the State Department of Public Health to spend up to $75,000,000 from the ADAP Rebate Fund to support current or eligible HIV services and programs, as specified. The bill would specify the allocation of those funds, including by authorizing up to $65,000,000 of that $75,000,000 to be spent to supplement or fund services, programs, or initiatives for which federal funding has been reduced or eliminated. By adding to the purposes of the ADAP Rebate Fund, and by extending the terms of certain allocations, the bill would make an appropriation. (10) Existing law requires the Office of Health Equity within the State Department of Public Health to administer the TGI Wellness and Equity Fund for purposes of funding grants to create programs, or funding existing programs, focused on coordinating trans-inclusive health care for individuals who identify as transgender, gender nonconforming, or intersex. This bill would instead refer only to the State Department of Public Health, without specifying the office, for purposes of administering the fund. Existing law authorizes use of the moneys in the fund, upon appropriation, to fund grants for certain purposes, including grants to TGI-serving organizations for the purpose of facilitating therapeutic arts programs, such as dancing, painting, or writing. This bill would restructure that specific purpose by having the grants be made available to TGI-serving organizations for facilitating evidence-based therapeutic arts programs. The bill would make conforming changes to related provisions. (11) Existing law, the California Affordable Drug Manufacturing Act of 2020, requires the California Health and Human Services Agency (CHHSA) to enter into partnerships, in consultation with other state departments as necessary, to, among other things, increase patient access to affordable drugs. Existing law authorizes CHHSA to enter into partnerships regarding over-the-counter naloxone products to allow the development, manufacturing, or distribution of those products by an entity that is authorized to do so under federal or state law. This bill, subject to an appropriation by the Legislature, would additionally authorize CHHSA to enter into partnerships to increase competition, lower prices, and address supply shortages for generic or brand name drugs to address emerging health concerns, for the development, production, procurement, or distribution of vaccines, as specified, and for the manufacture, purchase, or distribution of medical supplies or medical devices. (12) Existing law requires, when a defendant pleads not guilty by reason of insanity, that a jury determine whether the defendant was sane or insane at the time the offense was committed. Under existing law, if a defendant is found to be not guilty by reason of insanity, the court is required to commit the person to the State Department of State Hospitals or any other appropriate public or private treatment facility, as specified. If a defendant is confined in a state hospital or other treatment facility as an inpatient, existing law requires the medical director of the facility to submit a report, at 6-month intervals, to the court and the community program director of the county of commitment setting forth the status and progress of the defendant. This bill would instead require the above-described report to be submitted every 12 months. (13) Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services, 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 sets forth a schedule of benefits under the Medi-Cal program, including prescribed drugs subject to the Medi-Cal list of contract drugs. Existing law requires a specified health care service plan contract, including a Medi-Cal managed care plan, to cover the costs for COVID-19 diagnostic and screening testing, as provided, regardless of whether the services are provided by an in-network or out-of-network provider. Existing law prohibits this coverage from being subject to copayment, coinsurance, deductible, or any other form of cost sharing. Existing law also prohibits a health care service plan from imposing prior authorization or any other utilization management requirements on COVID-19 diagnostic and screening testing. Existing law requires the State Department of Health Care Services to seek any federal approval it deems necessary to implement those provisions regarding COVID-19. This bill would require a Medi-Cal managed care plan, as defined, to cover COVID-19 screening, testing, immunizations, and therapeutics in accordance with applicable statutes, regulations, all plan letters, the Medi-Cal provider manual, Medi-Cal managed care plan contracts with the department, as specified, and other guidance. The bill would exclude Medi-Cal managed care plans from the above-described prohibitions against cost sharing and utilization management by a health care service plan for COVID-19 diagnostic and screening testing. The bill would remove the above-described requirement on the State Department of Health Care Services to seek federal approval. (14) Existing law sets forth a schedule of benefits covered under the Medi-Cal program, including hospice service that is certified under the federal Medicare Program, subject to utilization controls. Under existing law, coverage is available only to the extent that no additional net program costs are incurred. Under existing law, prior authorization is not required for hospice services, with exceptions in the case of any admission that violates federal law or for inpatient hospice services. This bill would make the above-described restriction on prior authorization inoperative on July 1, 2026, and would repeal it as of January 1, 2027. Under the bill, hospice services would be covered under Medi-Cal in accordance with Medicare requirements and subject to utilization controls, while maintaining the condition on net program costs. The bill would condition implementation of this coverage on the availability of federal financial participation and receipt of any necessary federal approvals. (15) Existing law authorizes the department to enter into contracts with manufacturers of single-source and multiple-source drugs, on a bid or nonbid basis, for drugs from each major therapeutic category. Existing law requires all pharmaceutical manufacturers to provide to the department a state rebate equal to an amount not less than 10% of the average manufacturer price based on Medi-Cal utilization data for any drug products that have been added to the Medi-Cal list of contract drugs under provisions relating to treatment of acquired immunodeficiency syndrome (AIDS) or an AIDS-related condition or to treatment of cancer. Existing law authorizes the department to restrict the availability of the drug products of certain manufacturers by requiring prior authorization when the department has not received a timely rebate payment, but authorizes a beneficiary to continue obtaining those drugs if the beneficiary qualifies for continuing care status. Continuing care status requires a beneficiary to have been taking the drug at the time the manufacturer is placed on prior authorization status and the department to receive a claim for the drug with a date of service that is within 100 days prior to the date the manufacturer was placed on prior authorization status. This bill would delete the above-described provisions on continuing care status and, instead, beginning January 1, 2026, would authorize beneficiaries to continue to receive drugs previously prescribed but subject to prior authorization if their pharmacy provider or prescriber initiates a prior authorization request that is subsequently approved by the department. This bill would, effective January 1, 2026, for pharmaceutical manufacturers renewing or entering new state rebate agreements, require that the rebate amount be in an amount not less than 20% of the average manufacturer price if the federal rebate is less than 50% of that price, or an amount not less than 15% of that price if the federal rebate is 50% or greater of that price. Under existing law, for purposes of the above-described drug products, if the pharmaceutical manufacturer does not enter into a supplemental rebate agreement within 60 days after the addition of the drug to the Medi-Cal list of contract drugs, the manufacturer is required to provide to the department a state rebate equal to not less than 20% of the average manufacturer price, as specified. This bill would increase the state rebate minimum threshold to not less than 25% of the price. The bill would make a conforming change to a related provision. Existing law establishes the Medi-Cal Drug Rebate Fund, into which nonfederal moneys collected by the department under the above-described rebate provisions are deposited. Under existing law, funds deposited into the Medi-Cal Drug Rebate Fund are continuously appropriated to the department for purposes of funding the nonfederal share of health care services for children, adults, seniors, and persons with disabilities enrolled in the Medi-Cal program. By increasing the state rebate minimum threshold for the above-described drug products, the bill would make an appropriation. Existing law requires the department, when it determines that a drug should be removed from the list of contract drugs, to conduct a public hearing to receive comment on the impact of removing the drug. This bill would, instead of a public hearing, require the department to provide individual notice to impacted beneficiaries that the drug is only obtainable through the prior authorization process. The bill would require that the notice include a description of the beneficiary's right to a fair hearing and would encourage the beneficiary to consult a physician. The bill would require the department to also provide provider notice about the removal of the drug, as specified. (16) Existing law requires, with exceptions, the temporary placement of a Medi-Cal provider under payment suspension upon receipt of a credible allegation of fraud for which an investigation is pending under the Medi-Cal program against the provider. Existing law sets forth related provisions regarding the department's collection of overpayments, appeal procedures afforded to the provider, offsetting of the overpayments to satisfy audit or appeal findings if the findings are against the provider, and return of the overpayments if the findings are in favor of the provider, as specified. Existing law authorizes the lifting of a payment suspension upon resolution of an investigation for fraud or abuse. This bill would create the Medi-Cal Anti-Fraud Special Deposit Fund for the deposit of outstanding Medi-Cal payments intercepted as a result of a payment suspension. Under the bill, moneys would be continuously appropriated and allocated, but would remain in the fund until the department lifts the suspension, after which the department would be authorized to return the intercepted Medi-Cal payments to the provider or to offset the payments against any liabilities or restitution owed by the provider to the department. (17) Existing law, the Medi-Cal Long-Term Care Reimbursement Act, requires the department to implement a facility-specific ratesetting system for certain skilled nursing facilities using a cost-based reimbursement rate methodology. Existing law requires the department, subject to any necessary federal approvals, for managed care rating periods that begin between January 1, 2023, and December 31, 2026, inclusive, to establish and implement the Workforce and Quality Incentive Program. Under that program, a network provider furnishing skilled nursing facility services to a Medi-Cal managed care enrollee is authorized to earn performance-based directed payments from the Medi-Cal managed care plan with which they contract, as specified, in addition to other certain payments. Existing law repeals the act on January 1, 2028, as specified. This bill would instead apply the program to managed care rating periods that begin between January 1, 2023, and December 31, 2025, inclusive. The bill would make the provisions relating to the program inoperative on January 1, 2026, and authorize the department to conduct all necessary closeout activities applicable to any managed care rating period before January 1, 2026. The bill would repeal those provisions on January 1, 2027, or on the date that the Director of Health Care Services certifies to the Secretary of State that all necessary closeout activities have been completed, whichever is later, but no later than January 1, 2028. The bill would delete a related provision regarding the supplementation of funds available for payments made under the program, as described above, for the 2026 calendar year. (18) Existing law, subject to an appropriation by the Legislature for this purpose, expands the schedule of benefits to include an annual cognitive health assessment for Medi-Cal beneficiaries who are 65 years of age or older if they are otherwise ineligible for a similar assessment as part of an annual wellness visit under the Medicare Program. Existing law makes a Medi-Cal provider eligible to receive the payment for this benefit only if they comply with certain requirements, including completing cognitive health assessment training, as specified. Existing law requires the department, by January 1, 2024, and every 2 years thereafter, to consolidate and analyze data related to the benefit, and to post information on the utilization of, and payment for, the benefit on its internet website. This bill would delete the requirement that a Medi-Cal provider complete specified cognitive health assessment training to be eligible to receive the payment. The bill would also delete the requirement that the department consolidate and analyze data and post information related to the benefit every 2 years. (19) Existing law authorizes the Director of Health Care Services to terminate a contract or impose sanctions if the director finds that an entity that contracts with the department for the delivery of health care services, known as a contractor, fails to comply with contract requirements, state or federal law or regulations, or the state plan or approved waivers, or for other good cause. Existing law includes various entities as part of the definition of "contractor" for purposes of these provisions, including Medi-Cal managed care plans and Drug Medi-Cal organized delivery systems. This bill would add, to the list of contractors subject to the above-described provisions, entities under the Home- and Community-Based Alternatives (HCBA) Waiver and the Program of All-Inclusive Care for the Elderly (PACE) , as specified. (20) Under existing law, to the extent that federal financial participation is available, federally qualified health center (FQHC) services and rural health clinic (RHC) services are covered Medi-Cal benefits. Under existing law, FQHC and RHC services are reimbursed on a per-visit basis, as defined. This bill would, commencing July 1, 2026, require reimbursement for FQHC and RHC services that are eligible for federal financial participation. The bill would revise the definition of visit for purposes of this provision to mean a face-to-face encounter between an FQHC or RHC patient and specified health professionals that is eligible for federal financial participation or an encounter between an FQHC or RHC patient and specified health professionals using specified modalities, including, among others, video synchronous interaction, when services delivered through those modalities meet the applicable standard of care and are eligible for federal participation. (21) Existing law requires the department to establish the Nondesignated Public Hospital Intergovernmental Transfer Program to provide supplemental payments to nondesignated public hospitals in a manner that maximizes federal financial participation in the resulting supplemental payments. Existing law authorizes a transferring entity, as defined, to agree to transfer its intergovernmental transfer (IGT) allocation, as defined, to the state in accordance with the program, and requires the state to deposit the transferred funds into the Medi-Cal Inpatient Payment Adjustment Fund, which is a continuously appropriated fund. Existing law authorizes the state to retain 9% of each intergovernmental transfer amount to reimburse the department, or transfer to the General Fund, for the administrative costs of operating the program and for the benefit of Medi-Cal children's health care programs. This bill would require a nondesignated public hospital participating in the program to reimburse the department for specified administrative costs as a condition of receiving the above-described supplemental payments. Beginning with the 2026–27 fiscal year and every fiscal year thereafter, the bill would require the state to retain a percentage of each IGT amount associated with interim supplemental payments such that the total amount retained is equal to the projected administrative cost to the department, as specified. The bill would require the department to project the specified administrative costs each fiscal year to determine the percentage to be retained. To the extent the bill would continuously appropriate additional moneys, the bill would make an appropriation. (22) Existing law establishes the Medi-Cal Hospital/Uninsured Care Demonstration Project Act, which revises hospital reimbursement methodologies under the Medi-Cal program to maximize the use of federal funds consistent with federal Medicaid law and stabilize the distribution of funding for hospitals that provide care to Medi-Cal beneficiaries and uninsured patients. Existing law provides funding, in supplementation of Medi-Cal reimbursement, to various hospitals, including nondesignated public hospitals, in accordance with certain provisions relating to disproportionate share hospitals. Existing law establishes the Nondesignated Public Hospital Supplemental Fund, a continuously appropriated fund, in the State Treasury, and requires all amounts in the fund for a project year in excess of the amount necessary to make specified supplemental payments to be available for negotiation by the California Medical Assistance Commission, as provided. For the 2025–26 fiscal year, this bill would require additional supplemental payments to be made to nondesignated public hospitals that meet certain criteria such that the specified payments made are equal to the prescribed amount transferred from the General Fund plus the applicable amount of federal financial participation that is available for the nonfederal share of payments. The bill would require the remaining amounts in the fund to be used for supplemental payments to nondesignated public hospitals pursuant to a methodology developed by the department, as specified. The bill would make these provisions inoperative on June 30, 2026, abolish the fund effective December 31, 2028, and repeal these provisions on July 1, 2030. The bill would authorize the department to conduct any necessary and remaining duties, as specified, even after these provisions become inoperative. (23) The federal Medicaid program prohibits payment to a state for medical assistance furnished to an alien who is not lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law. Existing state law extends Medi-Cal eligibility for the full scope of Medi-Cal benefits to an individual who does not have satisfactory immigration status if they are otherwise eligible for those benefits, as specified. This bill would instead exclude an individual who is 19 years of age or older and does not have satisfactory immigration status from dental benefits under Medi-Cal, as specified and would, beginning no sooner than July 1, 2027, require individuals who are not pregnant and who are 19 to 59 years of age, inclusive, to pay a monthly premium of $30, subject to certain exceptions. The bill would make an individual who is 19 years of age or older and does not have satisfactory immigration status and who applies for Medi-Cal on or after January 1, 2026, eligible only for pregnancy-related services and emergency medical treatment. The bill would delay the implementation of certain provisions until the director makes specified communications to the Department of Finance. The bill would make other conforming changes. Because counties are required to make Medi-Cal eligibility determinations and this bill would alter Medi-Cal eligibility, the bill would impose a state-mandated local program. (24) Existing law prohibits the use of an assets or resources test for individuals whose income eligibility for Medi-Cal is determined based on the application of a modified adjusted gross income (MAGI) . Existing federal law authorizes a state to establish a non-MAGI standard for determining the eligibility of certain populations. Existing law, subject to receipt of any necessary federal approvals, prohibits the use of resources, including property or other assets, to determine Medi-Cal eligibility for applicants or beneficiaries whose eligibility is not determined using the MAGI-based financial methods. Existing law requires the department to seek federal authority to disregard all resources as authorized by the flexibilities provided pursuant to federal law. This bill would, commencing on January 1, 2026, remove the above-described prohibition on the use of resources for determining Medi-Cal eligibility in non-MAGI cases and implement a disregard of $130,000 in nonexempt property for a case with one member and $65,000 for each additional household member, up to a maximum of 10 members, as specified. As part of conforming changes, the bill would make certain provisions inoperative on January 1, 2026, and would repeal them as of January 1, 2027. The bill would make certain inoperative provisions operative for purposes of reinstating references to resources or assets. The bill would make certain additional changes to the above-described provisions, including modifying the timeline of certain regulations and changing certain reporting requirements. By creating new duties for counties relating to the consideration of resources for determining Medi-Cal eligibility, the bill would impose a state-mandated local program. (25) Existing law establishes the Children and Youth Behavioral Health Initiative, administered by the California Health and Human Services Agency and its departments, with the purpose of transforming the state's behavioral health system into an innovative ecosystem in which all children and youth 25 years of age and younger, regardless of payer, are screened, supported, and served for emerging and existing behavioral health needs. Existing law requires, subject to an appropriation, that the initiative include, among other things, grants to qualified entities to support implementation of the initiative for behavioral health services in schools and investments for behavioral health workforce, education, and training. Existing law authorizes the Department of Health Care Access and Information to award competitive grants to qualified entities and individuals to expand the supply of behavioral health counselors, coaches, peer supports, and other allied health care providers serving children and youth, including those at schoolsites. Existing law defines a "behavioral health coach," for purposes of those provisions, to mean a new category of behavioral health provider who, among other things, (A) is trained specifically to help address the unmet mental health and substance use needs of children and youth, (B) receives appropriate supervision from licensed staff, and (C) has training and qualifications, including psychoeducation, system navigation, crisis deescalation, safety planning, coping skills, and motivational interviewing. This bill would revise these provisions to replace the term "behavioral health coach" with "certified wellness coach." The bill would specify that a certified wellness coach receives appropriate supervision and coordination from staff who are licensed or who hold a pupil personnel services credential or school nurse services credential. The bill would add crisis referral to, and remove crisis deescalation and safety planning from, the list of a certified wellness coach's training and qualifications. (26) Existing law, as a component of the Children and Youth Behavioral Health Initiative, authorizes the State Department of Health Care Services to award competitive grants to entities that it deems qualified to, among other things, expand access to licensed medical and behavioral health professionals, counselors, peer support specialists, community health workers, and behavioral health coaches serving children and youth. This bill would revise that provision to replace the term "behavioral health coaches" with "certified wellness coaches." (27) Existing law establishes a Department of Health Care Access and Information within the California Health and Human Services Agency. Existing law requires the department, on or before July 1, 2023, to develop and approve statewide requirements for community health worker certificate programs and to approve the curriculum required for programs to certify community health workers. Existing law requires the department, on or before July 1, 2023, to review, approve, or renew evidence-based curricula and community-defined curricula for core competencies, specialized programs, and training. Existing law requires an organization that seeks approval or renewal of a community health worker certificate program to submit a community health worker certificate program plan, submit to periodic reviews, and submit annual community health worker certificate program reports, as specified. Existing law authorizes the department, in consultation with stakeholders, to request that an individual who is either enrolled in, or who has completed, a community health worker certificate program submit specified workforce data. Existing law defines "community health worker" to, among other things, include nonlicensed health workers with the qualifications developed pursuant to these provisions. This bill would repeal these provisions. The bill would make conforming changes to provisions defining "community health worker" by cross-reference to the above-described definition. (28) 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. (29) 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 with regard to certain mandates no reimbursement is required by this act for a specified reason. With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above. (30) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.
