Health.

The bill expanded from a single-section intent statement to a multi-code omnibus amending Government Code, Health and Safety Code, Revenue and Taxation Code, and Welfare and Institutions Code provisions.

Authorizes Palomar Health District to transfer assets to the Palomar UC San Diego Health Authority with conditions including a 10-year covenant to operate for health care services, public hearings before asset transfers, and reporting to the Attorney General. Applies retroactively to board approvals on or after January 1, 2025. Authorization expires December 31, 2028 if no transfer agreement is executed.

Beginning October 1, 2026, non-citizens with certain immigration statuses lose eligibility for the full scope of Medi-Cal benefits unless they meet specific criteria. Through June 30, 2027, those not covered by certain federal provisions remain eligible for state-funded benefits only. Pregnant individuals and those entitled to postpartum care are exempt from dental service limitations.

Extends the hospital nurse-to-patient ratio penalty exemption (previously only for general acute care hospitals) to acute psychiatric hospitals that demonstrate prompt efforts to maintain required staffing levels.

Medi-Cal providers must disclose affiliations within the previous 5 years with persons or entities that experienced a disclosable event. The department may deny enrollment or terminate a provider if the affiliation poses an undue risk of fraud, waste, or abuse. Temporary suspension becomes effective on the date notification is sent rather than 15 days later.

Removes the exception for certain clinics, health facilities, and licensed professionals from the 180-day provider enrollment moratorium. Requires written notice to the Joint Legislative Budget Committee when a moratorium is in effect, with new notification every 180 days.

Requires the agency to annually determine whether an adequate specialized LGBTQ+ suicide prevention hotline is activated under 988, and authorizes requesting SAMHSA approval for a press-3 routing function to direct California callers to a specialized center. Requires contracting with qualified entities specializing in LGBTQ+ suicide prevention within 12 months of SAMHSA approval.

Appropriates $105,611,000, $5,975,000, and $1,229,000 from the Federal Trust Fund to DHCS for State Opioid Response Grant funds and Substance Abuse Prevention and Treatment Block Grant funds, available through June 30, 2027.

Restructures 988 surcharge fund usage to prioritize 988 centers and designated 988 centers first, then mobile crisis teams second. Requires DHCS to develop a two-year statewide funding estimate starting with the 2027-28 fiscal year to inform legislative appropriations.

Adds definitions for 988, 988 center, designated 988 center, behavioral health crisis services, interoperable solution, mobile crisis team, and National Suicide Prevention Lifeline to Government Code Section 53123.1.5.

Extends the 988 advisory group meeting requirement from December 31, 2024 to December 31, 2029. Requires the Office of Emergency Services to procure and implement an interoperable solution between 988 and 911 by December 31, 2029. Requires voluntary statewide protocols for call transfers by January 1, 2028. Requires DHCS to establish a designated 988 center approval process no sooner than October 1, 2027.

Creates a 988 System Governance Board for cross-agency coordination until January 1, 2030. Assigns DHCS oversight of 988 center and designated 988 center operations. Requires annual expenditure, revenues, and outcomes reports with DHCS approval or denial authority. A 988 center must obtain designated status by December 31, 2029 or lose funding eligibility.