Existing law, the Pharmacy Law, establishes the California State Board of Pharmacy for the licensure and regulation of pharmacists and pharmacies. Existing law authorizes a prescriber to dispense a dangerous drug, including a controlled substance, to an emergency room patient if specified requirements are met, including that the dangerous drug is acquired by the hospital pharmacy. This bill would, notwithstanding any other law, authorize a prescriber to dispense an unused portion of a dangerous drug acquired by the hospital pharmacy to an emergency room patient upon discharge if certain conditions are satisfied, including that the dangerous drug is not a controlled substance and that dispensing the unused portion of the dangerous drug is required to continue treatment of the patient. Existing law requires an automated drug delivery system (ADDS) that is installed, leased, owned, or operated in California to be licensed by the board. Existing law exempts an automated unit dose system (AUDS) , a type of ADDS, from licensure if the AUDS is used solely to provide doses administered to patients while in a licensed general acute care hospital facility or a licensed acute psychiatric hospital facility if the licensed hospital pharmacy owns or leases the AUDS and owns the dangerous drugs and dangerous devices in the AUDS. This bill would also exempt from licensure an AUDS that is used to dispense dangerous drugs to emergency room patients in accordance with specified requirements.
(1) Existing law, the Lanterman Developmental Disabilities Services Act, requires the State Department of Developmental Services to contract with regional centers for the provision of services and supports for persons with developmental disabilities and their families. Under existing law, the services and supports are contained in an individual program plan (IPP) , as specified. Existing law requires the department to implement a statewide Self-Determination Program, available in every regional center catchment area to provide participants and their families, within an individual budget, with increased flexibility and choice, and greater control over decisions, resources, and needed and desired services and supports to implement their IPP. Existing law prescribes the process for allocating funds to, and within, the participant's individual budget. This bill would make various changes to the Self-Determination Program, including, among others, establishing the participants' individual budget generally based on the services authorized instead of being based on purchase of service expenditures, requiring a regional center to certify that participants' spending plans satisfy certain criteria, and requiring the department to establish statewide standardized processes and procedures for the program, with community input, no later than March 1, 2027. (2) Under existing law, contracts between the department and regional centers require regional centers to maintain specified service coordinator-to-consumer ratios and have expertise in certain topics in order to serve consumers. Existing law requires the department, through contracts, to require regional centers to implement implicit bias training, as specified. Existing law authorizes the training to be procured by the department or by a regional center that has obtained prior approval by the department. This bill would make the departmental training requirements subject to an appropriation by the Legislature for that purpose. The bill would also state the intent of the Legislature that regional centers continue to implement the implicit bias training to the extent they are able to, in the absence of a state appropriation. (3) Existing law required the department, between April 1, 2022, and January 1, 2025, to incrementally implement rate reform to increase rates paid to developmental service providers. Existing law requires, in conjunction with the rate reform, the department to implement a quality incentive program that includes the development of a quality incentive payment structure for providers meeting quality measures or benchmarks, or both. This bill would require, beginning in the 2026–27 fiscal year, a provider to be compliant with electronic visit verification, home- and community-based services rules, and applicable annual fiscal reviews and audit requirements as a condition of eligibility for the quality incentive program. Existing law requires the department to implement a hold harmless policy, as specified, for providers whose rates exceed rate model recommendations, to freeze a provider's existing rates until June 30, 2026, and to subsequently adjust the provider's rates to equal the rates for other providers in the provider's service category and region. Existing law requires the department, beginning January 1, 2025, to implement a similar hold harmless policy for providers whose rates in effect on January 1, 2023, exceed 90% of the rate model. This bill would shift the expiration date of the rate freezes to February 28, 2026. Existing law requires that regional centers receive specialized funding allocations to facilitate applications for payments authorized to protect the health and safety of consumers, as specified, for non-English-speaking individuals served. This bill would make that requirement subject to an appropriation by the Legislature. (4) Existing law requires the department to assess a monthly fee to parents of children under 18 years of age who are receiving 24-hour out-of-home care services through a regional center or who are residents of a state hospital when the family's gross income is above 200% of the federal poverty level, as specified. This bill would repeal those provisions relating to the monthly parental fee. The bill would also make technical, conforming changes. (5) Existing law requires a regional center consumer to be referred to a provider of habilitation services if they are determined to be in need of habilitation services, among other factors. Existing law authorizes a regional center to vendor a new work activity or supported employment program after determining the capacity of the program to deliver effective services and assessing the ability of the program to comply with the requirements of CARF, the Rehabilitation Accreditation Commission, as defined. Existing law also defines additional terms relating to habilitation services, including group services to mean job coaching in a group supported employment placement at a job coach-to-consumer ratio of not less than 1 to 3 nor more than 1 to 8 where services to a minimum of 3 consumers are funded by specified entities. This bill would update the definition of CARF to mean the Commission on Accreditation of Rehabilitation Facilities. The bill would also update the definition of group service to include a coach-to-consumer ratio of not less than 1 to 2 instead of 1 to 3 and would also instead require a minimum of 2 consumers to be funded by specified entities. Existing law authorizes regional centers to purchase habilitation services only from providers who are accredited community nonprofit agencies that provide work activity services or supported employment services, or both, and that have been vendored according to the provisions listed above. This bill would remove the requirement that the providers be accredited community nonprofit agencies that provide work activity services or supported employment services, or both. Existing law sets the hourly rate for supported employment services provided to consumers receiving individualized services and for group services at $36.57 and requires job coaching hours for group services to be allocated on a prorated basis between a regional center and the Department of Rehabilitation when consumers are served in the same group. Existing law also requires that a new work activity program receive the statewide average rate, as determined by the department. This bill would remove the hourly rate for both supported employment services and group services and would instead require the department to set a rate and post the rate to its internet website. The bill would also remove the requirements that job coaching hours for group services be allocated on a prorated basis and that a new work activity program receive the statewide average rate, and would instead require that the program receive the rate posted on the department's internet website. (6) Existing law authorizes a consumer to choose a tailored day service or vouchered community-based training service, in lieu of, or in conjunction with, any other regional center vendored day program, look-alike day program, supported employment program, or work activity program. Existing law requires the hourly rate for the tailored day service option to be calculated in a specified manner. Existing law requires that hourly rate to remain in effect pending the department's review, as specified, and requires the review to be completed by June 30, 2024. This bill would end use of the above-described calculation methodologies on June 30, 2025, and, commencing on July 1, 2025, would require the hourly rate for the tailored day service option for vendored programs to be set by the department and posted on its internet website. (7) Existing law requires the Secretary of California Health and Human Services, in coordination with the department, to lead the development and implementation of the Master Plan for Developmental Services for the state. Existing law requires the secretary to solicit input through the Master Plan for Developmental Services Committee and submit to the Governor and the Legislature an initial report summarizing the recommended components of the master plan, as specified. Existing law requires the secretary and the Director of Developmental Services to work with other state agencies, as necessary, to identify policies, efficiencies, and strategies necessary to implement the master plan. Existing law requires the secretary to annually submit master plan implementation updates to the Governor and the Legislature, as specified. This bill would require the Master Plan for Developmental Services Committee to meet at least 2 times each year, as specified, and would set forth the information to be included in the initial report and recommendation updates, including, among other things, a narrative summary of the master plan committee meetings. (8) This bill would appropriate $2,789,000 from the General Fund to the State Department of Developmental Services for project planning activities at regional centers associated with the Life Outcomes Improvement System. Under the bill, these funds would be available for encumbrance or expenditure through June 30, 2026. (9) 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.
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. Under existing law, home- and community-based services (HCBS) approved by the United States Department of Health and Human Services are covered for eligible individuals to the extent that federal financial participation is available for those services under the state plan or waivers granted in accordance with certain federal provisions. Existing law authorizes the Director of Health Care Services to seek waivers for any or all approvable HCBS. Existing law sets forth provisions for the implementation of the Nursing Facility/Acute Hospital Transition and Diversion Waiver, which is the predecessor of the Home and Community-Based Alternatives (HCBA) Waiver, for purposes of providing care management services to individuals who are at risk of nursing facility or institutional placement. This bill would recast those provisions to refer to the HCBA Waiver. The bill would delete a provision authorizing the expansion of the number of waiver slots up to 5,000 additional slots, and would instead require the enrollment of all eligible individuals who apply for the HCBA Waiver. The bill would require the department, by March 1, 2026, to seek any necessary amendments to the waiver to ensure that there is sufficient capacity to enroll all eligible individuals who are currently on a waiting list for the waiver, as specified. The bill would require the department, by March 1, 2026, to submit a rate study to the appropriate fiscal and policy committees of the Legislature addressing the sustainability, quality, and transparency of rates for the HCBA Waiver. The bill would require that the study include an assessment of the effectiveness of the methods used to pay for services under the waiver, with consideration of certain factors. The bill would make related legislative findings.
Existing law provides for the licensure and regulation by the State Department of Public Health of health facilities, including general acute care hospitals, as defined. Existing law requires a health facility to allow a patient's domestic partner, the children of the patient's domestic partner, and the domestic partner of the patient's parent or child to visit unless no visitors are allowed, the facility reasonably determines that the presence of a particular visitor would endanger the health or safety of a patient, a member of the health facility staff, or other visitor to the health facility, or would significantly disrupt the operations of a facility, or the patient has indicated to the health facility staff that the patient does not want this person to visit. A violation of this provision is a misdemeanor. This bill would require a general acute care hospital to allow a patient with physical, intellectual, or developmental disabilities, a patient with cognitive impairment, including dementia, and a patient with another disability, as specified, to have a family or friend caregiver with them as needed, including outside standard visiting hours, unless specified conditions are met, including, but not limited to, that the hospital reasonably determines that the presence of a particular visitor would endanger the health or safety of the visitor, a patient, a member of the staff, or other visitor to the hospital, or would significantly disrupt the operations of the hospital. The bill would not prohibit a hospital from otherwise establishing reasonable restrictions upon visitation. The bill would authorize the hospital to impose legitimate health and safety requirements on visitors, as specified. The bill would specify that its provisions do not prohibit restrictions to patient visitation policies implemented during a state of emergency declared by the Governor, a health emergency declared by the State Public Health Officer, or a local health emergency declared by a local health officer, as specified. The bill would specify that its provisions do not create any new civil or criminal liability, including, but not limited to, liability for any illness, infection, or injury experienced by a patient or visitor on the part of a hospital that complies with its requirements. By expanding the scope of a crime, this bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
(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 federal law provides for the Medicare Program, which is a public health insurance program for persons 65 years of age and older and specified persons with disabilities who are under 65 years of age. Existing federal law specifies parts of Medicare that cover specific services, such as Medicare Part B, which generally covers medically necessary services and supplies and preventive services. 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 federal law additionally provides for the issuance of Medicare supplement policies or certificates, also known as Medigap coverage, which are advertised, marketed, or designed primarily as a supplement to reimbursements under the Medicare Program for the hospital, medical, or surgical expenses of persons eligible for the Medicare Program, including coverage of Medicare deductible, copayment, or coinsurance amounts, as specified. Existing law, among other provisions, requires supplement benefit plans to be uniform in structure, language, designation, and format with the standard benefit plans, as prescribed. Existing law prohibits an issuer from denying or conditioning the offering or effectiveness of any Medicare supplement contract, policy, or certificate available for sale in this state, or discriminating in the pricing of a contract, policy, or certificate because of the health status, claims experience, receipt of health care, or medical condition of an applicant in the case of an application that is submitted prior to or during the 6-month period beginning with the first day of the first month in which an individual is both 65 years of age or older and is enrolled for benefits under Medicare Part B. Existing law requires an issuer to make available specified Medicare supplement benefit plans to a qualifying applicant under those circumstances who is 64 years of age or younger who does not have end stage renal disease. This bill would delete the exclusion of otherwise qualified applicants who have end stage renal disease, thereby making the specified Medicare supplement benefit plans available to those individuals. The bill, on and after January 1, 2027, would prohibit an issuer of Medicare supplement coverage in this state from denying or conditioning the issuance or effectiveness of any Medicare supplement coverage available for sale in the state, or discriminate in the pricing of that coverage because of the health status, claims experience, receipt of health care, medical condition, or age of an applicant, except as specified, if an application for coverage is submitted during an open enrollment period, as specified in the bill. The bill would entitle an individual enrolled in Medicare Part B to a 90-day annual open enrollment period beginning on January 1 of each year, as specified, during which period the bill would require applications to be accepted for any Medicare supplement coverage available from an issuer, as specified. The bill would require the open enrollment period to be a guaranteed issue period. The bill would authorize premium rates offered to applicants during the open enrollment period to vary based on the applicants' age at the time of issue, as specified, but would prohibit the premiums from varying based on age after the contract is issued. Because a violation of the bill's requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law, subject to implementation of the California Advancing and Innovating Medi-Cal (CalAIM) initiative, requires the department to implement an enhanced care management (ECM) benefit designed to address the clinical and nonclinical needs on a whole-person-care basis for certain target populations of Medi-Cal beneficiaries enrolled in Medi-Cal managed care plans. Under existing law, target populations include, among others, high utilizers with frequent hospital admissions, short-term skilled nursing facility stays, or emergency room visits, and individuals experiencing homelessness. Existing law, subject to CalAIM implementation, authorizes a Medi-Cal managed care plan to elect to cover community supports, as specified. Under existing law, community supports that the department is authorized to approve include, among others, housing transition navigation services and medically supportive food and nutrition services. This bill would require a Medi-Cal managed care plan, for purposes of covering the ECM benefit, or if it elects to cover a community support, to contract with community providers, as defined, that can demonstrate that they are capable of providing access and meeting quality requirements in accordance with Medi-Cal guidelines. In determining which community providers to contract with, the bill would authorize Medi-Cal managed care plans to take into consideration whether those providers are available in the respective county and have experience in providing the applicable ECM or community support. The bill would require the department, for purposes of enforcing these provisions, to require Medi-Cal managed care plans to set goals every other year for the level of contracting and utilization of community providers and local entities, as defined. The bill would require these goals to be established in consultation with the department, as specified. If a community provider contracted to provide ECM services or community supports submits a referral or authorization request for the applicable service on behalf of an eligible member, the bill would require a Medi-Cal managed care plan to assign the member to the contracted referring provider if the plan determines that the provider can appropriately meet the needs of the member. The bill would prohibit the above-described provisions from being construed to limit the department's authority to grant eligibility for presumptive authorization for categories of ECM providers that have extensive experience and expertise in serving certain ECM populations of focus. Existing law requires the department to develop, in consultation with Medi-Cal managed care plans and other appropriate stakeholders, a monitoring plan and reporting template for the implementation of ECM or community supports. Existing law requires the department to annually publish a public report on reported ECM or community support utilization data, populations served, and demographic data, stratified by age, sex, race, ethnicity, and languages spoken, to the extent that statistically reliant data are available. This bill would expressly include providers of ECM or community supports within the consultation process. The bill would require the department to publish the public report on a quarterly basis instead and would require additional demographic data. The bill would also require the department to develop standardized and streamlined templates to be used by Medi-Cal managed care plans or their contracted providers, as specified, and to develop guidance to allow community providers to act as a primary subcontractor with Medi-Cal managed care plans and to subcontract with other community providers as a 3rd-tier subcontractor, as specified.
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 provides for the licensure and regulation of various types of clinics, including alternative birth centers, by the State Department of Public Health, and makes a violation of those provisions a crime. Existing law defines an alternative birth center as a clinic that is not part of a hospital and that provides comprehensive perinatal services and delivery care to pregnant women who remain less than 24 hours at the facility. Existing law requires a licensed alternative birth center specialty clinic, and a licensed primary care clinic that provides services as an alternative birth center, to meet certain criteria, including, among others, being located in proximity to a facility with the capacity for management of obstetrical and neonatal emergencies, as specified. 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 sets forth certain criteria for Medi-Cal reimbursement to alternative birth centers for facility-related delivery costs. Under existing law, as a criterion under both the licensing provisions and the Medi-Cal reimbursement provisions described above, the facility is required to be a provider of comprehensive perinatal services as defined in the Medi-Cal provisions. This bill would remove, under both sets of criteria, the certification condition of being a provider of comprehensive perinatal services as defined in the Medi-Cal provisions. The bill would require the facility to provide perinatal services that are comprehensive in nature, as specified, consistent with certain standards. The bill would remove the above-described proximity requirement and would instead require a written policy for hospital transfer. The bill would require the policy to include certain requirements relating to, among other things, arrangements for the referral of a complication, arrangements for the transfer of care, provision of medical records, information about the estimated transfer time, and a clear explanation of the facility's overall emergency transfer plan, as specified. The bill would also make a technical change to an obsolete reference within a related provision. By creating new requirements for an alternative birth center or a primary care clinic that provides services as an alternative birth center, the violation of which is a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
