Asm. Joaquin Arambula

Existing law establishes the Department of Health Care Access and Information to oversee various aspects of the health care market, including oversight of hospital facilities and community benefits plans. Existing law requires a private, not-for-profit hospital to adopt and update a community benefits plan that describes the activities the hospital has undertaken to address identified community needs within its mission and financial capacity, including health care services rendered to vulnerable populations. Existing law defines the term "community" as the service areas or patient populations for which the hospital provides health care services, defines "vulnerable populations" for these purposes to include a population that is exposed to medical or financial risk by virtue of being uninsured, underinsured, or eligible for Medi-Cal, Medicare, California Children's Services Program, or county indigent programs, and defines "community benefit" to mean the hospital's activities that are intended to address community needs, such as support to local health departments, among other things. Existing law requires a hospital to conduct a community needs assessment to evaluate the health needs of the community and to update that assessment at least once every 3 years. Existing law requires a hospital to annually submit a community benefits plan to the department not later than 150 days after the hospital's fiscal year ends. Existing law authorizes the department to impose a fine not to exceed $5,000 against a hospital that fails to adopt, update, or submit a community benefits plan, and requires the department to annually report on its internet website the amount of community benefit spending and list those that failed to report community benefit spending, among other things. This bill would require the department to define the term "community" by regulation within certain parameters, would redefine the term "community benefit" to mean services rendered to those eligible for, but not enrolled in the above-described programs, the unreimbursed costs as reported in specified tax filings, and the support to local health departments as documented by those local health departments, among other things, and would redefine the term "vulnerable populations" to include those eligible for, but not enrolled in the above-described programs, those below median income experiencing economic disparities, and certain socially disadvantaged groups, such as those who are incarcerated. The bill would require that a community needs assessment include the needs of the vulnerable populations and include a description of which vulnerable populations are low or moderate income, coordination with a local health department, and require that it be updated at least once every 2 years. The bill would require that a community benefits plan demonstrate alignment with the State Health Improvement Plan and the Community Health Improvement Plan, include the proportion and amount of community benefit spending on vulnerable populations, and include measurable objectives that outline equity benchmarks. The bill would additionally require a hospital to annually submit a copy of a specified Internal Revenue Service form to the department. The bill would increase the maximum fine for failure to adopt, update, or submit, a community benefits plan to $25,000 and would authorize the department to impose a maximum fine of $50,000 for a hospital's failure to demonstrate implementation of a community benefits plan. The bill would require the department to include in its annual report the amount of community benefits spending attributable to public health needs and a list of hospitals that fail to comply with specified requirements.

Existing law prohibits the State Energy Resources Conservation and Development Commission (Energy Commission) from certifying a nuclear fission thermal powerplant, except for specified powerplants, and provides that a nuclear fission thermal powerplant, except those specified powerplants, is not a permitted land use in California, unless certain conditions are met regarding the existence of technology for the construction and operation of nuclear fuel rod processing plants and of demonstrated technology or means for the disposal of high-level nuclear waste, as specified. This bill would exempt small modular reactors, as defined, from those provisions. Existing law vests the Public Utilities Commission (PUC) with regulatory authority over electrical corporations and gas corporations. Under existing law, it is the policy of the state that eligible renewable energy resources and zero-carbon resources supply 100% of all retail sales of electricity to California end-use customers and 100% of electricity procured to serve all state agencies by December 31, 2045. Existing law requires the PUC, the Energy Commission, and all other state agencies to incorporate that policy into all relevant planning. This bill would require the PUC, on or before January 1, 2026, to adopt a plan to increase the procurement of electricity generated from nuclear facilities and to phase out the procurement of electricity generated from natural gas facilities.

Existing law, the California Safe Drinking Water Act, requires the State Water Resources Control Board to administer provisions relating to the regulation of drinking water to protect public health. The act requires the state board to establish a grant program, in consultation with the State Department of Education, to award grants to local educational agencies for the purposes of improving access to, and the quality of, drinking water in public schools serving kindergarten or any of grades 1 to 12, inclusive, and preschools and child daycare facilities located on public school property. This bill would require a community water system that serves a schoolsite, as defined, to test for lead in the potable water system outlets of the schoolsite before January 1, 2027, except as provided. The bill would require the community water system to report its findings to the applicable schoolsite or local educational agency and to the state board. The bill would require the local educational agency or schoolsite, if the lead level exceeds a specified level at a schoolsite, to notify the parents and guardians of the pupils who attend the schoolsite, take immediate steps to make inoperable and shut down from use all potable water system outlets where the excess lead levels may exist, and work to ensure that a lead-free source of drinking water is provided for pupils, as specified. The bill would require a community water system to test a potable water system outlet that replaces an outlet that is found to have excess levels of lead. The bill would require a community water system to prepare a sampling plan for each schoolsite where lead sampling is required under these provisions, as specified. The bill would require the schoolsite, local educational agency, and state board to make the results of schoolsite lead sampling publicly available by posting the results on its internet website. The bill would require a schoolsite and a local educational agency, if an internet website is not maintained, to provide the results upon request. By imposing additional duties on local 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.

Existing law generally requires county boards of supervisors, city councils, and the governing boards of school districts, community college districts, and other special districts, if those bodies are elected using district-based elections, to adopt new boundaries for the districts following each federal decennial census. Notwithstanding that requirement, existing law authorizes a local jurisdiction other than a charter city to establish an independent redistricting commission to adopt new boundaries for the local jurisdiction's districts. This bill would require a county, general law city, charter city, or charter city and county that contains over 300,000 residents, and a school district or community college district that contains over 500,000 residents, to establish an independent redistricting commission to adopt district boundaries after each federal decennial census. The bill would require a county, general law city, charter city, or charter city or county with over 300,000 residents, and a school district or community college district with over 500,000 residents, that does not enact an ordinance, resolution, or charter amendment establishing an independent redistricting commission by January 1, 2030, and January 1 of every subsequent year ending in 0, to establish a 14-member independent redistricting commission according to specified procedures, including procedures for the random selection of the members of the commission from among applicants meeting certain qualifications. By requiring certain local jurisdictions to establish independent redistricting commissions to adopt district boundaries, the bill would impose a state-mandated local program. The bill would prohibit a member of an independent redistricting commission from communicating with any individual or organization regarding redistricting matters, except as provided. The bill would require the State Auditor to provide the contact information of any applicant to serve on the Citizens Redistricting Commission, which is responsible for adjusting the boundary lines of the congressional, legislative, and State Board of Equalization districts, to any city or county that has established an independent or hybrid redistricting commission, provided that the applicant has consented to share this information and the city or county has requested to receive this information, and to inform those applicants of opportunities to serve on an independent or hybrid redistricting commission. The bill would require the State Auditor to establish a database and create and advertise a process for this exchange of information. Under existing law, independent redistricting commissions have been established for the Counties of Los Angeles, San Diego, Riverside, Fresno, and Kern. The bill would exempt the Counties of Los Angeles, San Diego, Riverside, Fresno, and Kern from the bill's provisions requiring a county with over 300,000 residents to establish an independent redistricting commission, unless the existing law provisions establishing independent redistricting commissions for those counties are repealed or invalidated. The bill also would exempt a charter city with a population of at least 2,500,000 people from the bill's provisions if specified conditions are met, including if both this bill and Senate Bill 52 are enacted and if the city complies with certain provisions in Senate Bill 52 that require such cities to establish independent redistricting commissions. This bill would incorporate additional changes to Section 23003 of the Elections Code proposed by Assembly Bill 764 to be operative only if this bill and Assembly Bill 764 are enacted and this bill is enacted last. The bill would include findings that changes proposed by this bill address a matter of statewide concern rather than a municipal affair and, therefore, apply to all cities, including charter cities. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Existing law establishes the California State University, under the administration of the Trustees of the California State University, as one of the segments of public postsecondary education in the state. This bill would establish the Legislative Internship Program under the administration of the California State University's Center for California Studies to provide paid internship opportunities at offices of the Legislature, to qualified applicants, as provided. The bill would establish the Legislative Internship Program Fund as the initial depository of all moneys appropriated, donated, or otherwise received for the program, and upon appropriation by the Legislature, would require the Center for California Studies to distribute moneys in the fund to program participants, as specified. Existing law requires all appropriations for contingent expenses of the Senate and the Assembly and legislative committees thereof to be available and disbursed, as provided. This bill would prohibit these funds from being used to provide a paid internship position pursuant to the Legislative Internship Program.

Existing law requires the State Department of Social Services to establish and supervise a county- or county consortia-administered program to provide cash assistance for aged, blind, or disabled legal immigrants who are not citizens who, due to their immigration status, are not eligible for the Supplemental Security Income/State Supplementary Program for the Aged, Blind, and Disabled, also known as SSI/SSP benefits. Under existing law, an individual is eligible for this program if their immigration status meets SSI/SSP eligibility criteria but they are not eligible for those benefits solely due to their immigration status, as specified. Existing law also requires any person who is found to be eligible by the department for federally funded SSI to apply for SSI benefits. This bill would expand eligibility for that program to aged, blind, and disabled individuals regardless of immigration status if the individual meets the eligibility criteria for the program and is not eligible solely due to their immigration status. This bill would exempt individuals who are not qualified immigrants, as specified, from having to apply for SSI in order to receive benefits. The bill would also delete several inoperative provisions. The bill would make the implementation of these substantive changes contingent upon an appropriation for its express purposes. By expanding county duties under the program, 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.

Existing law sets forth various programs relating to opioid overdose prevention and treatment, including, among others, standing orders for the distribution of an opioid antagonist, a naloxone grant program, and a grant program to reduce fentanyl overdoses and use throughout the state. 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, the pharmacist service of furnishing naloxone hydrochloride is a covered Medi-Cal benefit. The Medi-Cal program also covers certain medications to treat opioid use disorders as part of narcotic treatment program services, or as part of medication-assisted treatment services within the Drug Medi-Cal Treatment Program, as specified. 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. This bill would make legislative findings relating to the United States Food and Drug Administration (FDA) approving a certain naloxone hydrochloride nasal spray for nonprescription use. Under the bill, prescription or nonprescription naloxone hydrochloride or another drug approved by the FDA for the complete or partial reversal of an opioid overdose would be a covered benefit under the Medi-Cal program. The bill would require a health care service plan contract or health insurance policy that provides coverage for prescription drugs and that is issued, amended, delivered, or renewed on or after January 1, 2025, to cover prescription and nonprescription naloxone hydrochloride and all other drugs or products approved by the FDA for the complete or partial reversal of an opioid overdose. The bill would prohibit a health care service plan contract or health insurance policy that provides coverage for prescription drugs from imposing any cost-sharing requirements for that coverage exceeding $10 per package of medication, as specified, would require point-of-sale coverage for over-the-counter, FDA-approved naloxone hydrochloride or another FDA-approved drug or product for the complete or partial reversal of an opioid overdose at in-network pharmacies, and would prohibit a high deductible health plan from imposing cost sharing, as specified. The bill would repeal these provisions on January 1, 2030. 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. 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, including comprehensive perinatal services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Under existing law, a pregnant individual or targeted low-income child who is eligible for, and is receiving, health care coverage under any of specified Medi-Cal programs is eligible for full-scope Medi-Cal benefits for the duration of the pregnancy and for a period of one year following the last day of the individual's pregnancy. This bill, during the one-year postpregnancy eligibility period, and as part of comprehensive perinatal services under Medi-Cal, would require the department to cover additional comprehensive perinatal assessments and individualized care plans and to provide additional visits and units of services in an amount, duration, and scope that are at least proportional to those available on July 27, 2021, during pregnancy and the initial 60-day postpregnancy period in effect on that date. The bill would require the department, in coordination with the State Department of Public Health, to consider input from certain stakeholders, as specified, in determining the specific number of additional comprehensive perinatal assessments, individualized care plans, visits, and units of services to be covered. The bill would require the department to cover comprehensive perinatal services that are rendered by a nonlicensed perinatal health worker in a beneficiary's home or other community setting away from a medical site, as specified. The bill would also require the department to allow a nonlicensed perinatal health worker rendering those services to be supervised by a community-based organization (CBO) or a local health jurisdiction (LHJ) . For these purposes, the bill would require a CBO or LHJ supervising a nonlicensed perinatal health worker to provide those services under contract with a Comprehensive Perinatal Services Program provider. The bill would condition implementation of the provisions above on receipt of any necessary federal approvals and the availability of federal financial participation. The bill would authorize the department to implement these provisions by all-county letters or similar instructions until regulations are adopted.

(1) Existing law requires specified state agencies, boards, and commissions, in the course of collecting demographic data as to the ancestry or ethnic origin of Californians, to use separate collection categories and tabulations for specified groups. Existing federal law provides for the Supplemental Nutrition Assistance Program, known in California as CalFresh, under which supplemental nutrition assistance benefits allocated to the state by the federal government are distributed to eligible individuals by each county. Under existing law, the State Department of Social Services (department) administers the CalFresh program. Existing law requires the department to publicly report specified information, including certain data specific to students enrolled in an institution of higher learning who receive CalFresh benefits, as specified. This bill would require the department, in the course of collecting demographic data directly or by contract as to the ancestry or ethnic origin of California residents for any report on the CalFresh program, to use separate collection categories and tabulations for each major Latino group, Mesoamerican Indigenous nation, and Mesoamerican Indigenous language group, as specified. Existing law requires specific state agencies, boards, and commissions to report, as specified, data on collection categories and tabulations for specified groups. Existing law requires the collected data to be made available to the public except for personal identifying information, which shall be deemed confidential. This bill would require the department to include the collected data in every demographic report on ancestry or ethnic origins of California residents that the department publishes or releases on or after July 1, 2027. On or before July 1, 2027, and annually thereafter, the bill would require the department to report to the Legislature on the above-described data collection and methods used to collect that data. The bill would require the department to make available to the public the collected data, except for personal identifying information, as specified. The bill would require the department to update its data collection to reflect additional Latino groups, Mesoamerican Indigenous nations, and Mesoamerican Indigenous language groups as they are reported by the United States Census Bureau, as specified. The bill would require the department to comply with the bill's requirements as early as possible, but no later than July 1, 2027. On or after January 1, 2026, the bill would require the State Department of Public Health to comply with the bill's requirements if funding is appropriated for this express purpose, as specified. (2) 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.