Health care coverage: hearing aids.

All amendments to Welfare and Institutions Code Sections 5008, 5977, 5977.1, 5977.2, 5977.3, and 5977.4 were removed from the bill. These provisions dealt with expanding the 'gravely disabled' definition to include chronic alcoholism (defined as severe alcohol use disorder per DSM criteria), defining 'mental health disorder' by reference to the DSM, and modifying CARE Act court procedures including notice rights for original petitioners and their participation in CARE plan development.

The bill's official title and legislative counsel digest no longer reference substance abuse. The act description was shortened to cover only the addition of hearing aid coverage requirements to the Health and Safety Code and Insurance Code.

The amendment history header was updated to reflect the new August 19, 2026 Assembly amendment date, and minor formatting/whitespace changes were made throughout.

New Section 1367.72 of the Health and Safety Code requires large group health care service plan contracts issued, amended, or renewed on or after January 1, 2027, to include coverage for hearing aids for enrollees under 21 if medically necessary.

New Section 10123.72 of the Insurance Code imposes the same hearing aid coverage requirement on large group health insurance policies issued, amended, or renewed on or after January 1, 2027.

Exemptions are provided for Medicare supplement policies, specialized plans covering only dental or vision benefits, and Medi-Cal managed care plans (which follow separate Medi-Cal requirements under W&I Code Section 14132(l)).

Maximum required coverage is set at $3,000 per individual hearing aid. Enrollees may purchase more expensive aids and pay the difference out of pocket.

Covered hearing aid services must not be subject to deductibles, coinsurance, or copayments, and no dollar limit below $3,000 per aid is permitted. Coverage includes initial assessment, new hearing aids at least once every three years, earmolds, fittings, adjustments, auditory training, and maintenance.

Former Section 5009.5 of the Welfare and Institutions Code, which required the State Department of Health Care Services to establish and implement training guidelines for counties regarding electronic submission of LPS evaluation orders, was removed from the bill.

For children under five years of age, a contracted provider must include a pediatric audiologist.

The fiscal note changed from 'State-mandated local program: no' to 'yes,' indicating the hearing aid coverage requirements create a state-mandated local program because willful violations by health care service plans constitute a crime under existing law.

Assembly Members Bonta, Caloza, Jeff Gonzalez, Patel, and Schiavo were added as coauthors alongside the original Senate coauthors Becker, Dahle, and Niello.

Removed the provision allowing an original CARE Act petitioner to request to maintain their role as petitioner if both the respondent and the county behavioral health agency director consented. The court now must always substitute the county behavioral health agency director or designee as the successor petitioner.

Section 5977(b)(6)(A) changed from a permissive provision (court 'may grant' the original petitioner's request to stay) to a mandatory substitution requirement (court 'shall issue an order relieving the original petitioner and appointing the director').

Section 5977(a)(3)(A)(iv) removed 'the nonsubstituted petitioner' from the list of parties who must receive notice when the county behavioral health agency director is the petitioner, since that category no longer exists.

Removed the phrase 'regardless of the substitution status of the petitioner' from Section 5977(b)(6)(B), since substitution is now always required and there is no longer a scenario where the original petitioner remains in the case.

Chronic alcoholism was removed from the LPS Act definition of 'gravely disabled.' Previously, a person could be found gravely disabled due to impairment by chronic alcoholism; now only mental health disorder, severe substance use disorder, or co-occurring conditions qualify.

A separate provision that had added chronic alcoholism as a basis for grave disability specifically for Articles 2, 3, and 4 of Chapter 2 and Chapter 3 of the LPS Act was deleted entirely, closing a pathway for involuntary commitment based solely on chronic alcoholism.

The standard for an original petitioner to maintain their role as petitioner changed from 'the court may allow unless someone objects' to requiring both the respondent's and the county behavioral health agency director's consent. This makes it harder for family members or others to remain as the active petitioner.

A new provision limits ongoing rights (notice of proceedings, participation in CARE agreement development) to only petitioners described in Section 5974(a) or (b), which covers parents, family members, and persons with whom the respondent resides. All other petitioners are limited to being present and making a statement at the merits hearing only.

For qualifying petitioners (family/residents), participation rights were expanded to explicitly include involvement in developing CARE agreements, CARE plans, and voluntary graduation plans with the county behavioral health agency and the respondent.

All provisions amending the Public Resources Code (Sections 25545 and 25545.14) and adding Section 1003.7 to the Public Utilities Code were removed. These provisions would have expanded CEQA streamlined certification to electrical transmission projects, set a January 1, 2033 application deadline, allowed simultaneous filing with the PUC, and imposed state-mandated local program obligations on the PUC.

The definition of 'gravely disabled' in Section 5008(h)(1)(A) was expanded to include 'chronic alcoholism' as a qualifying condition alongside mental health disorder, severe substance use disorder, and co-occurring conditions. Previously, chronic alcoholism was only addressed in a separate paragraph (2) for specific articles.

New subparagraph (h)(1)(A)(ii) clarifies that 'chronic alcoholism' means 'alcohol use disorder' and qualifies for grave disability only if it meets the diagnostic criteria of 'severe' as defined in the most current edition of the DSM.

The CARE Act petitioner substitution provision was changed: the original petitioner can now only 'request' to maintain their role (rather than having it authorized outright), and the court may grant the request only if both the respondent and the director of the county behavioral health agency consent. Previously the language suggested the petitioner had a stronger right to remain in the role.

The bill now amends multiple Welfare and Institutions Code sections (5008, 5977, 5977.1, 5977.2, 5977.3, 5977.4, 5982, 5983) and adds Section 5009.5, adding an entirely new substance abuse and mental health component alongside the original electricity provisions.

The definition of 'gravely disabled' is expanded to include persons whose inability to provide for basic needs results from a severe substance use disorder or a co-occurring mental health disorder and severe substance use disorder, not just a mental health disorder or chronic alcoholism. A new definition of 'mental health disorder' is added, tying it to the current edition of the Diagnostic and Statistical Manual of Mental Disorders.

Counties may adopt a resolution to defer implementation of changes made by SB 43 (2023-24) to the gravely disabled definition until January 1, 2026, giving local jurisdictions additional time to prepare.

Under the CARE Act, the original petitioner (such as a family member or household member) may now maintain their role as petitioner instead of being automatically substituted by the director of a county behavioral health agency. Substitution only occurs if the respondent objects while present in court and prefers the county agency to take over.

After July 1, 2025, courts must provide ongoing notice of proceedings to the original petitioner throughout CARE proceedings (including continuances and dismissals) unless the court finds it would likely be detrimental to the respondent's treatment or well-being. Before that date, the court may assign notice rights at its discretion.

Nonsubstituted petitioners are now included among those who must receive notice of proceedings, service of documents and reports, and those required to work with county behavioral health agencies to enter into CARE agreements.

Detailed procedural requirements are added for CARE Act proceedings, including timelines for initial appearances (14 court days), hearings on the merits (within 10 days), case management hearings (within 14 days), clinical evaluation hearings (within 21 days), and CARE plan development (within 14 days).

The State Department of Health Care Services is required to establish and implement training guidelines for counties regarding the electronic submission of evaluation orders under the LPS Act (new Section 5009.5).