Existing law requires that, as a condition of parole, a prisoner who has a severe mental health disorder be treated by the State Department of State Hospitals if the prisoner meets certain requirements, including, among others, that the person in charge of treating the prisoner and a practicing psychiatrist or psychologist from the State Department of State Hospitals have evaluated the prisoner and that a chief psychiatrist of the Department of Corrections and Rehabilitation certify to the Board of Parole Hearings that by reason of the prisoner's severe mental health disorder, the prisoner represents a substantial danger of physical harm to others. Existing law allows a prisoner to request a hearing before the Board of Parole Hearings for the purpose of proving that they meet the criteria to be treated by the State Department of State Hospitals. Existing law authorizes a prisoner who disagrees with the determination of the Board of Parole Hearings to file a petition in court in the county in which they are incarcerated or are being treated for a hearing on whether they met the criteria. This bill would require a psychiatrist or psychologist, when determining whether a prisoner represents a substantial danger of physical harm to others, to consider, among other things, the prisoner's history of violence that was related to their severe mental health disorder. The bill would also authorize the court, upon stipulation of the petitioner, prosecuting attorney, and defense counsel in the county of commitment to state prison, to conduct a hearing in the county of commitment to state prison.
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 law sets forth a schedule of benefits covered under the Medi-Cal program, including acupuncture, but only to the extent that federal matching funds are provided for acupuncture. Under this bill, acupuncture would instead be a covered Medi-Cal benefit subject to utilization controls and the availability of federal financial participation. The bill would, if federal financial participation is not available for coverage of acupuncture services, make acupuncture a covered benefit subject to an appropriation and utilization controls. This bill would incorporate additional changes to Section 14132 of the Welfare and Institutions Code proposed by AB 1949 and AB 350 to be operative only if this bill and either or both AB 1949 and AB 350 are enacted and this bill is enacted last.
Existing law requires the State Department of Public Health to conduct a program of epidemiological assessments of the incidence of cancer. Existing law requires specified entities providing specified services to cancer patients, including hospitals, practitioners, and laboratories, to report each case of cancer to the department, as specified. This bill would require a hospital or other facility that provides therapy to a cancer patient within an area designated as a cancer reporting area to post a sign, developed by the department, in a conspicuous location that contains an advisement about cancer data reporting and a quick response code that links to the California Cancer Registry internet website.
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 law requires a health care service plan or health insurer to reimburse a complete claim or a portion thereof within 30 calendar days after receipt of the claim, or, if a claim or portion thereof does not meet the criteria for completeness, to notify the claimant no later than 30 calendar days after receipt that the claim or portion thereof is contested or denied. This bill would grant a claimant no less than 90 calendar days to submit a corrected claim after a health care service plan or health insurer denies a claim or portion thereof or sends a notice of overpayment for a claim based on a defect that may be remedied by submitting a corrected claim. The bill would prohibit a plan or insurer from denying a corrected claim on the grounds that the claim was not submitted within another applicable claim filing deadline. Under the bill, a dispute related to a corrected claim would be required to be eligible for submission to the plan's or insurer's fast, fair, and cost-effective dispute resolution mechanism. 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.
(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, the Community Assistance, Recovery, and Empowerment (CARE) Act, authorizes specified persons, including a person with whom the respondent resides, family members, and first responders, among others, to petition a civil court to create a voluntary CARE agreement or a court-ordered CARE plan and implement services, to be provided by county behavioral health agencies, to provide behavioral health care, including stabilization medication, housing, and other enumerated services, to adults who are currently experiencing a severe mental illness and have a diagnosis identified in the disorder class schizophrenia and other psychotic disorders, and who meet other specified criteria. This bill would authorize a first responder to contact the county behavioral health agency in the county in which the individual resides or is found to request the agency file a petition to commence the CARE process. The bill would require the agency to review the request and determine whether to file a petition within 30 business days. The bill would require the agency, upon completion of the review, to notify the first responder that made the referral of specified information, including whether or not a petition was filed. Because the bill would require a higher level of service from county agencies, this bill would create a state-mandated local program. This bill would require the department to create a referral form to be used by the first responders and would require the department to issue guidance on the procedure to request that the agency file a petition to commence the CARE process. The bill would also require the agency to include specified data in their annual report to the department. 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 creates the California Health Benefit Exchange (Exchange) , also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under the federal Patient Protection and Affordable Care Act. Existing law requires the Exchange to enroll an individual in the lowest cost silver plan or another plan, as specified, upon receiving the individual's electronic account from an insurance affordability program. Existing law requires enrollment to occur before coverage through the insurance affordability program is terminated and prohibits the premium due date from being sooner than the last day of the first month of enrollment. This bill would, commencing July 1, 2027, additionally authorize the Exchange to enroll an individual in the plan in which other members of the individual's household are enrolled, as specified, or the lowest cost plan available to an Indian who is eligible for specified reduced cost sharing, as determined by the Exchange, and would require the Exchange to enroll an individual in any of the plans described above upon receipt of a complete application for an insurance affordability program submitted through the Statewide Automated Welfare System. The bill would require the Exchange to enroll the individual either before coverage through the insurance affordability program is terminated as described above or upon the receipt of a complete application for an insurance affordability program through the Statewide Automated Welfare System as described above. Existing law requires the Exchange to provide an individual who is enrolled in a plan described above with a notice that includes specified information, including a statement that services received during the first month of enrollment will only be covered by the plan if the premium is paid by the due date. This bill would require the Exchange to provide the notice described above prior to the individual's effective date of coverage, and to provide, instead of the statement described above, instructions on how to effectuate coverage in the selected plan, including by paying the premium on or before the due date, or, if there is no premium due, instructions on how to opt into the selected plan. 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 law requires a health care service plan or health insurer to provide an annual enrollment period for individual health benefit plans offered through the Exchange from November 1 of the preceding calendar year to January 31 of the benefit year, inclusive. Existing law specifies that the effective date of coverage for individual health benefit plans offered outside and through the Exchange be no later than January 1 of the benefit year for plan selection made from November 1 to December 31 of the preceding calendar year, inclusive, and be no later than February 1 of the benefit year for plan selection made from January 1 to January 31 of the benefit year, inclusive. This bill would require a health care service plan or health insurer to provide the annual enrollment period and effective dates of coverage described above, except to the extent that those provisions are inconsistent with federal law, as specified. If inconsistent, the bill would require the plan or insurer to provide the annual enrollment period and effective dates of coverage required by federal law. 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. The Medi-Cal program is in part governed by, and funded pursuant to, 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, subject to federal cost neutrality. Existing law authorizes the director to propose that the waiver provide for achievement of annual cost neutrality in the aggregate to allow enrollment and authorization of waiver services based on medical necessity, and to require care management contractors to enroll at least 60% of all total annual enrollments from certain health care settings or populations. Existing law additionally sets forth provisions authorizing the director to expand the number of waiver slots up to 5,000 additional slots. This bill would recast the above-described waiver provisions to refer to the HCBA Waiver. The bill would authorize the director, beginning January 1, 2027, to semiannually evaluate the populations receiving the priority enrollment described above, and to designate additional populations to receive priority enrollment based on this evaluation, subject to applicable cost-neutrality requirements. The bill would delete the provision relating to the 5,000 slots. The bill would instead require the department, beginning in 2027, and for the HCBA Waiver period, to increase the total number of waiver slots by 5,000, in addition to any planned expansion of waiver slots federally approved as of January 1, 2026, as specified, consistent with the above-described requirements.
(1) 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 law requires a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2002, to provide coverage for an annual cervical cancer screening test upon the referral of the patient's health care provider. This bill would require a health care service plan contract or health insurance policy, except for a vision-only, dental-only, or Medicare supplement contract or policy, issued, amended, or renewed on or after January 1, 2027, to provide coverage without cost sharing for cervical cancer screening, including the United States Food and Drug Administration (FDA) -authorized or cleared self-collected cervical screening kits, when ordered or provided by an in-network provider and consistent with specified recommendations published by the State Department of Public Health. For health savings account-eligible plans or policies, the bill would require the above-described coverage only to the extent the plan is a high deductible health plan under specified federal law. Because a willful violation of the bill's requirements relative to health care service plans would be a crime, the bill would impose a state-mandated local program. (2) Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and under which health care services are provided to low-income individuals pursuant to a schedule of benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. An annual cervical cancer test for screening or diagnostic purposes, upon the referral of a patient's physician, is a covered benefit under the Medi-Cal program to the extent required or permitted by federal law. This bill would instead include cervical cancer tests for screening that are ordered by a patient's health care provider and consistent with specified recommendations published by the State Department of Public Health as a covered benefit under the Medi-Cal program on or after January 1, 2027. The bill would additionally include FDA-authorized or cleared cervical cancer home test kits for screening that are ordered by a patient's health care provider and consistent with specified recommendations published by the State Department of Public Health and Medi-Cal policies as a covered benefit under the Medi-Cal program on or after January 1, 2027, without cost sharing, to the extent that federal financial participation is available and not otherwise jeopardized and any necessary federal approvals have been obtained. (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 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. Under existing law, certain vision care benefits are covered under the Medi-Cal program, relating to, among other things, optometric and optician services and eyeglasses, as specified. This bill would require the department, by no later than January 1, 2028, to establish a list of performance measures to ensure that the vision services under the Medi-Cal program meet quality and access criteria. The bill would require that the performance measures be designed to evaluate utilization, access, and availability of Medi-Cal vision services. The bill would require certain information within the performance measures, relating to providers and examinations, among other factors. The bill would require the department, when evaluating performance measures, to consider certain criteria, including trended data and other state performance and quality measures. The bill would require the department to report on each performance measure only to the extent that the department has existing data sources from which to calculate the applicable measure, as specified. The bill would specify a timeline for the posting of performance measures and data on the department's internet website. The bill would also require the department to establish benchmarks for each performance measure and to annually prepare a summary report on complaints and grievances, as specified.
