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 violation of the act by a health care service plan a misdemeanor. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law defines "unreasonable rate increase," for these purposes, to have the same meaning as in the federal Patient Protection and Affordable Care Act, which is that an unreasonable rate increase exists when the federal Centers for Medicare and Medicaid Services makes a determination that a rate increase is excessive, unjustified, or unfairly discriminatory, among other things. This bill would instead define "unreasonable rate increase," for the above-described purposes, to mean a rate increase that the Director of the Department of Managed Health Care or the Insurance Commissioner, as applicable, determines is excessive, unjustified, unfairly discriminatory, or otherwise unreasonable. Existing law requires a health care service plan or health insurer to submit rates to their regulating entity for review and to demonstrate the impact of any changes in the rate of growth of health care costs resulting from health care cost targets. This bill would instead require a health care service plan or health insurer to demonstrate the impact of health care cost targets and to demonstrate whether a health care service plan's or health insurer's annual rate growth exceeds or will exceed the cost target for the rating period. The bill would require, if a health care service plan's or health insurer's rate growth is expected to exceed the cost target for a rating period, the health care service plan or health insurer to include specified information in its rate filing, including, among other things, a detailed list of any proactive steps it is taking, or plans to take, for annual rate growth to meet the cost targets. 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. Existing law requires the director or the commissioner, as applicable, in determining if a rate is unreasonable or not justified for purposes of the above-described review, to consider the impact on changes in health care costs as a result of the health care cost targets described above. This bill would delete those provisions and instead require the Department of Managed Health Care and the Department of Insurance to report on if rates, by plan or policy and in aggregate, meet the affordability standard, as defined, for an individual, a couple, and a family of four. The bill would require the report to include the annual change in premiums and cost sharing for the prior 5 years. The bill would, as part of the existing rate submission process, require a health care service plan or health insurer to provide information on premiums, deductibles, cost sharing, and any other factors specified by the department as necessary to complete the reports. 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 generally provides for the regulation of law enforcement agencies and requires specified law enforcement agencies to maintain policies on, among other things, use of force, hate crimes, and gun violence restraining orders. Existing law requires the Commission on Peace Officer Standards and Training to establish and keep updated a field training officer course relating to competencies of the field training program and police training program that addresses how to interact with persons with certain conditions. This bill would make it unlawful for a law enforcement officer to deny, delay, obstruct, or fail to facilitate access to medical evaluation or treatment for an individual under law enforcement control, but who is not in the custody of, or detained by, the Department of Corrections and Rehabilitation, if it is safe and reasonable to provide access to treatment and a medical professional has been requested or is present and is willing to render care to the individual. If access to medical evaluation or treatment is denied or delayed when a medical professional is present and is willing to assist, the bill would require law enforcement to document the basis of the denial within 72 hours of the incident, as specified. The bill would authorize administrative discipline, including suspension or termination, against a law enforcement officer who violates those provisions. By creating a new crime and by increasing the duties on local law enforcement relating to reporting, 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 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.
(1) Existing law provides for the licensure and regulation of health facilities, clinics, home health agencies, and hospice agencies, as defined, by the State Department of Public Health. Existing law provides for the certification of nurse assistants and home health aides by the department. A violation of these provisions by a licensee is a crime. Existing law authorizes the department to deny an application for, initiate an action to suspend or revoke a certificate for, or deny a training and examination application for a nurse assistant or home health aide under specified circumstances. Existing law requires, with some exceptions, the department to deny a training and examination application and deny, suspend, or revoke a certificate if the applicant or certificate holder has been convicted of a violation of or attempted violation of one or more specified crimes. This bill would instead authorize the department to deny an application for, a certificate for, or a training and examination application for, a nurse assistant or home health aide for various reasons, including if an applicant has been convicted of a crime, as specified, within the preceding 7 years from the date of the application that is directly and adversely related to the qualifications, functions, or duties of a certified nurse assistant or home health aide, regardless of whether the applicant was incarcerated for that crime, as specified, and if the applicant has been subjected to formal discipline by the department or a licensing board in or outside California within the preceding 7 years from the date of the application for professional misconduct that would have been cause for discipline, as specified, and that is directly and adversely related to the qualifications, functions, or duties of a certified nurse assistant or home health aide, as specified. The bill would authorize an applicant or certificate holder whose application to be a nurse assistant or home health aide was denied or certificate was suspended or revoked on the basis of a criminal conviction to, during a period of 2 years after the department receives the criminal record report, provide the department with evidence of good character and rehabilitation or provide the department with evidence that the criminal conviction is no longer grounds for denial, as specified. The bill would prescribe requirements for the department in requesting or acting on a nursing assistant or home health aide applicant's criminal history information, including if the department decides to deny a training and examination application or certificate. The bill would authorize the department to initiate an action to suspend or revoke a certificate for professional misconduct warranting cause for discipline, as specified. Upon a determination to revoke or suspend a certificate, the bill would prescribe the requirements for the department to notify the certificate holder in writing by certified mail, including providing information about the procedure for the certificate holder to challenge the determination or request reconsideration. By expanding the scope of a crime, this bill would impose a state-mandated local program. (2) Existing law governs the certification of a certified nurse assistant in a licensed skilled nursing or intermediate care facility. Existing law requires renewal of that certification to be conditional upon specified occurrences, including that the certificate holder submitted documentation of completion of 48 hours of in-service training every 2 years, as specified. Existing law requires at least 12 of the 48 hours of in-service training to be completed in each of the 2 years. Existing law requires that 24 of the 48 hours may be obtained through a specified online computer training program. In order to renew an unexpired certificate, existing law requires the certificate holder to, on or before the expiration date, apply for renewal on a form provided by the department and to submit documentation of the required in-service training. Existing law authorizes an expired certificate to be renewed at any time within 2 years of its expiration on the filing of an application for renewal on a form provided by the department and documentation of the required in-service education. This bill would additionally authorize the certificate holder to submit documentation of 48 hours of continuing education every 2 years. The bill would require at least 12 of the 48 hours of continuous education or in-service training to be completed in each of the 2 years. The bill would authorize the 48 continuing education or in-service hours to be obtained through in-person instructions, synchronous online instruction, asynchronous online instruction, or other distance learning formats approved by the department. This bill would require, to renew an unexpired certificate, or authorize, to renew an expired certificate within 2 years after expiration, the certificate holder to submit documentation of the continuing education or in-service training. (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 no reimbursement is required by this act for a specified reason.
Existing law defines "sexual orientation change efforts" as practices by mental health providers that seek to change an individual's sexual orientation, as specified. Existing law prohibits a mental health provider, as defined, from engaging in sexual orientation change efforts with a patient under 18 years of age, and provides that such efforts attempted by a mental health provider are considered unprofessional conduct and must subject the mental health provider to discipline by that provider's licensing entity. This bill would define "sexual orientation or gender identity change efforts" as any practices of a licensed mental health provider that seek, during the provision of mental health services, to direct a patient toward a predetermined sexual orientation or gender identity, as specified, and would apply the prohibitions described above to such efforts. The bill would exclude specified practices, including age-appropriate interventions to address unlawful conduct or unsafe practices that do not seek to direct the patient toward a particular sexual orientation or gender identity, from this definition.
Existing law establishes the California Reproductive and TGI Health Equity Program within the Department of Health Care Access and Information for the purpose of ensuring abortion, contraception, and gender-affirming care are affordable for and accessible to all patients, regardless of their ability to pay, and to provide financial support for safety net providers of these services to offset the costs of providing uncompensated care to patients with low incomes who would otherwise lack access to care. Existing law authorizes a Medi-Cal enrolled provider to apply for a grant, and a continuation award after the initial grant, if they agree to provide abortion, contraception, and gender-affirming care services in accordance with specified requirements, including that the services are provided at no cost or a reduced cost to individuals with a household income at or below 400% of the federal poverty level who are uninsured or have health care coverage that does not include both abortion and contraception or does not include gender-affirming care and are not otherwise eligible to receive both abortion and contraception care at no cost through the Medi-Cal and Family PACT programs or receive gender-affirming care at no cost through the Medi-Cal program. This bill would additionally authorize a Medi-Cal enrolled provider to apply for a grant or a continuation of a grant if they provide the above-described services to patients who are veterans, as defined, who are uninsured or have health care coverage that does not include both abortion and contraception and are not otherwise eligible to receive both abortion and contraception care at no cost through the Medi-Cal and Family PACT programs. The bill would make other conforming changes and would make related findings and declarations. Existing law establishes the Department of Veterans Affairs and vests the department with specified duties related to veterans in the state, including the development of a transition program to assist veterans in successfully transitioning from military to civilian life by providing information related to, among other things, health care programs and services. This bill would require the Department of Veterans Affairs to publish a link to the State Department of Public Health's abortion information internet website on the women veterans resources page of its internet website.
(1) Existing law, the California Healthy Youth Act, requires school districts, defined to include county boards of education, county superintendents of schools, the California School for the Deaf, the California School for the Blind, and charter schools, to ensure that all pupils in grades 7 to 12, inclusive, receive comprehensive sexual health education and human immunodeficiency virus (HIV) prevention education, as specified. This bill would authorize the State Department of Education to monitor compliance with the requirements of the California Healthy Youth Act as part of its annual compliance monitoring of state and federal programs. (2) Existing law establishes the Office of School-Based Health Programs for the purpose of assisting local educational agencies regarding the current health-related programs under the purview of the State Department of Education including, among other duties, coordinating school health program activities with public health, social services, environmental, and local educational agencies, and other public and private entities. This bill would prohibit a local educational agency, as defined, from prohibiting school-based health centers, as defined, that serve schools of the local educational agency from making internal and external condoms available and easily accessible to pupils in any of grades 7 to 12, inclusive, at the school-based health center site and would require a school of a local educational agency to allow condoms to be made available to pupils in any of grades 7 to 12, inclusive, during the course of, or in connection with, educational or public health programs and initiatives, as provided. To the extent the bill imposes additional duties on local educational agencies, the bill would impose a state-mandated local program. (3) Under existing law, the Sherman Food, Drug, and Cosmetic Law, the State Department of Public Health generally regulates the packaging, labeling, advertising, and sale of food, drugs, devices, and cosmetics, in accordance with the Federal Food, Drug, and Cosmetic Act. A violation of those provisions is generally a crime. Existing law sets forth various other provisions relating to the furnishing and health care coverage of certain types of contraception. This bill would, with certain exceptions, prohibit a retail establishment, as defined, from refusing to furnish nonprescription contraception to a person solely on the basis of age by means of any conduct, including, but not limited to, requiring the customer to present identification for purposes of demonstrating their age. Under the bill, a violation of that prohibition would be exempt from the above-described criminal penalty. (4) 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 authorizes designated health care services providers, employees, volunteers, and patients, and individuals who face threats of violence or violence or harassment from the public because of their affiliation with a designated health care services facility, to complete an application to be approved by the Secretary of State for the purposes of enabling state and local agencies to respond to requests for public records without disclosing a program participant's residence address contained in any public record and otherwise provide for confidentiality of identity for that person, subject to specified conditions. Existing law defines "designated health care services" to mean gender-affirming health care services or reproductive health care services. Under existing law, any person who makes a false statement in an application is guilty of a misdemeanor. Existing law prohibits a person, business, or association from knowingly publicly posting or publicly displaying, disclosing, or distributing on internet websites or on social media, the personal information or image of any designated health care services patient, provider, or assistant, or other individuals residing at the same home address, with the intent to incite a third person to cause imminent great bodily harm to the person identified in the posting or display, or to a coresident of that person, as specified, or to threaten the person identified in the posting or display, or a coresident of that person, as specified. Existing law additionally prohibits a person, business, or association from soliciting, selling, or trading on the internet or social media the personal information or image of a designated health care services patient, provider, or assistant with the intent described above. Existing law establishes a cause of action for injunctive or declarative relief for a violation of these prohibitions. Existing law prohibits a person from posting on the internet or social media, with the intent that another person imminently use that information to commit a crime involving violence or a threat of violence against a designated health care services patient, provider, or assistant, or other individuals residing at the same home address, the personal information or image of a reproductive health care services patient, provider, or assistant, or other individuals residing at the same home address. This bill would, commencing October 1, 2027, similarly establish an address confidentiality program for a designated immigration support services provider, employee, or volunteer, as defined, who faces threats of violence or harassment from the public because of their affiliation with a designated immigration support services facility. This bill would additionally prohibit a person, business, or association from soliciting, selling, or trading on the internet the personal information or image of a designated immigration support services provider, employee, or volunteer with the intent described above. The bill would also, among other things, prohibit a person from posting on the internet the personal information or image of a designated immigration support services provider, employee, or volunteer, or other individuals residing at the same home address, with the specific intent that another person imminently use that information to commit a crime involving violence or a threat of violence that is likely to occur against such an individual. The bill would define various terms for these purposes. By imposing new duties on local agencies and creating new crimes, this bill would create a state-mandated local program. 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. 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.
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, also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans offered by participating carriers as required under PPACA. This bill would require a nonprofit health care service plan participating in the Exchange to annually disclose its material investment holdings to the Exchange on or before July 1 of each year, unless otherwise specified by regulation, beginning on July 1, 2027. The bill would require the Exchange to prominently display, and make accessible to the public, those disclosures on its internet website. If a plan fails to comply with the disclosure requirements, the bill would require the Department of Managed Health Care to assess an administrative penalty against the plan, as specified. The bill would require the Exchange to prominently post the plan's noncompliance status on its internet website until compliance is achieved.
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 by, and funded pursuant to, federal Medicaid program provisions. Existing federal law, enacted on July 4, 2025, sets forth various changes to Medicaid eligibility with regard to community engagement reporting, redeterminations, cost sharing, and retroactive coverage, among other factors, for certain Medicaid populations, including beneficiaries between 19 and 64 years of age, inclusive, with income up to 138% of the federal poverty level, commonly known as Medicaid expansion adults. The above-described federal law requires the state, beginning on October 1, 2028, to impose deductions, cost sharing, or similar charges determined appropriate by the state, in an amount greater than $0, with respect to certain care, items, or services furnished to Medicaid expansion adults, with income exceeding 100% and up to 138% of the federal poverty level, as determined by the state. The federal law excludes certain services from these provisions and prohibits the charge from exceeding $35. This bill would, no sooner than October 1, 2028, set a copayment of $0.01 for nonemergency services for the above-described population, as specified. The bill would authorize the provider to collect, retain, or waive the copayment amount. The bill would not apply the copayment requirements to emergency services, family planning services, or any services under certain categories. The bill would prohibit a service provider from denying care or services to an individual solely because of nonpayment of copayment. The bill would create an exemption from a copayment requirement for any visit, service, device, or item for which the Medi-Cal program's payment is $10 or less. The bill would prohibit the total aggregate amount of deductions, cost sharing, or similar charges imposed for all individuals in a family from exceeding 5% of the family income. Existing law requires the department to develop a single, accessible, standardized paper, electronic, and telephone application for insurance affordability programs, including Medi-Cal, for use by all entities authorized to make an eligibility determination for those programs. Existing law authorizes all insurance affordability programs to accept self-attestation for age, date of birth, family size, household income, state residence, pregnancy, work or community engagement activities or exemptions, and any other applicable criteria needed to determine eligibility, to the extent permitted by state and federal law. This bill would instead require those programs to accept self-attestation, to the extent permitted by state and federal law. Existing law requires department, the California Health and Human Services Agency, and the California Health Benefit Exchange (Exchange) board to establish a process for receiving and acting on stakeholder suggestions and concerns regarding the Exchange, as specified. Existing law requires this process to include regular updates on the work to analyze, prioritize, and implement corrections to confirmed defects and proposed enhancements to the eligibility systems and to monitor screening and evaluation for Medi-Cal eligibility. The bill would instead require the establishment of a process for receiving and acting on stakeholder suggestions and concerns regarding the functionality, accuracy, and legally appropriate determination of specified electronic eligibility systems and public internet websites that support Medi-Cal and the Exchange. The bill would also instead require the process to include regular updates on the work to analyze, prioritize, and implement corrections to confirmed defects and proposed enhancements to the eligibility systems and to monitor screening and evaluation for insurance affordability program eligibility. To the extent these provisions expand duties for counties relating to Medi-Cal and insurance affordability program eligibility, 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, 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 State Department of Public Health, headed by the State Public Health Officer, and sets forth its powers and duties, including the administration of provisions relating to the prevention and control of communicable diseases. Existing law authorizes the department to take necessary measures to ascertain the nature and prevent the spread of communicable diseases. Existing law prohibits the governing authority of a school or other institution from unconditionally admitting or advancing to the 7th grade level any person as a pupil of any public or private elementary or secondary school, childcare center, day nursery, nursery school, family daycare home, or development center, unless, prior to their admission or advancement to that institution, they have been fully immunized against various communicable diseases, as provided, subject to any specific age criteria. Existing law requires the governing authority of a school or other institution, on at least an annual basis, to file a written report on the immunization status of new entrants to the school or institution under their jurisdiction with the department and the local health department at times and on forms prescribed by the department. This bill, the Informed Parents, Healthy Schools Act, would require the department to establish, and update as needed, levels of immunization rates needed to prevent the spread of specified communicable diseases. The bill would require the department to establish notification procedures designed to annually inform designated parties, including schools, daycare centers, and county departments of public health, when an immunization rate is determined to fall below the rate established by the department, among other things. The bill would require that the notification be translated into any language, in addition to English, that is spoken by 15% or more of enrolled children. The bill would require the department to apply existing data de-identification standards and methodologies to protect individual privacy, consistent with applicable state and federal law, in implementing these provisions. The bill would require a school or institution, as defined, to distribute the above-described notification to parents or guardians of enrolled children within 10 business days of receiving the notification from the department. The bill would authorize the school or institution to determine the manner of distribution for the notification, consistent with specified requirements. The bill would require the governing authority of the school or institution to cooperate with the department in carrying out these provisions. By requiring school districts to comply with these requirements, 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.
