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's requirements a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires health care service plans and health insurers, as specified, within 6 months after the relevant department issues specified guidance, or no later than March 1, 2025, to require all of their staff who are in direct contact with enrollees or insureds in the delivery of care or enrollee or insured services to complete evidence-based cultural competency training for the purpose of providing trans-inclusive health care for individuals who identify as transgender, gender diverse, or intersex. This bill would prohibit a subscriber, enrollee, policyholder, or insured from being excluded from enrollment or participation in, being denied the benefits of, or being subjected to discrimination by, any health care service plan or health insurer licensed in this state, on the basis of race, color, national origin, age, disability, or sex. The bill would define discrimination on the basis of sex for those purposes to include, among other things, sex characteristics, including intersex traits, pregnancy, and gender identity. The bill would prohibit a health care service plan or health insurer from taking specified actions relating to providing access to health programs and activities, including, but not limited to, denying or limiting health care services to an individual based upon the individual's sex assigned at birth, gender identity, or gender otherwise recorded. The bill would prohibit a health care service plan or health insurer, in specified circumstances, from taking various actions, including, but not limited to, denying, canceling, limiting, or refusing to issue or renew health care service plan enrollment, health insurance coverage, or other health-related coverage, or denying or limiting coverage of a claim, or imposing additional cost sharing or other limitations or restrictions on coverage, on the basis of race, color, national origin, sex, age, disability, as specified. Because a violation of the bill's requirements 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, 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 coverage by health care service plans and health insurers for various screening and treatment services with respect to cancer. This bill would require a large group health care service plan contract or health insurance policy that is issued, amended, or renewed on and after January 1, 2027, to provide coverage for scalp cooling, when prescribed by a health care provider to reduce the incidence or severity of alopecia before, during, or after chemotherapy in which alopecia-inducing chemotherapeutic agents are used. The bill would define scalp cooling for these purposes. Because a violation of these provisions with respect to a health care service plan would be a crime, this bill would impose a state-mandated local program. Existing law also provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services pursuant to a schedule of benefits, including various cancer screenings and benefits relating to cancer treatment. Subject to the extent that federal financial participation is available and not otherwise jeopardized, and any necessary federal approvals have been obtained, this bill would expand the Medi-Cal schedule of benefits to include scalp cooling, when prescribed by a health care provider to reduce the incidence or severity of alopecia before, during, or after chemotherapy in which alopecia-inducing chemotherapeutic agents are used. The bill would subject scalp cooling to utilization controls and medical necessity. 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, the Nursing Practice Act, establishes the Board of Registered Nursing within the Department of Consumer Affairs, until January 1, 2027, and sets forth its powers and duties regarding the licensure and regulation of registered nurses. Existing law creates the Board of Registered Nursing Fund and makes all moneys in the fund available upon appropriation by the Legislature. A violation of the act is a crime. Existing law requires the board, until January 1, 2027, to appoint an executive officer to perform the duties delegated by the board and to be responsible to the board for the accomplishment of those duties, as specified. Existing law requires the board, for the purpose of transacting its business, to meet at least once every 3 months, at times and places it designates by resolution, and requires those meetings to be held in northern and southern California. This bill would extend those dates until January 1, 2031. The bill would remove the above-described location requirements for meetings held by the board, and, instead, require the board to meet at least once every 3 months in locations that are, to the extent practicable, geographically diverse. (2) Existing law specifies that an approved school of nursing, or an approved nursing program, is one that, among other things, gives a course of instruction approved by the board, as specified. Existing law requires the board to prepare and maintain a list of approved schools of nursing whose graduates are eligible to apply for a license to practice nursing, as provided. Existing law requires the board, through its executive officer, to inspect all schools of nursing in the state at the times the board deems necessary, as specified. This bill would require the board to make the list of approved schools of nursing available on its internet website. The bill would require the inspection criteria to be consistent with the 2020 Nursing Education Approval Guidelines established by the National Council of State Boards of Nursing, or its successor, as specified. Existing law requires an approved school of nursing or a nursing program to meet a minimum of 500 direct patient care clinical hours in a board-approved clinical setting, as specified, and requires additional clinical hours required by the program for nursing education preparation in each nursing area as specified by the board to be identified and documented in the curriculum plan for each area. The bill would require any clinical practice hours that are not required to be in direct patient care and are provided using simulation experiences to be based on the best practices published by, among other specified entities, the International Nursing Association for Clinical Simulation and Learning, or based on any equivalent standards approved by the board. Existing law authorizes the director of an approved nursing program, until the end of the 2023–24 academic year, or whenever the Governor declares a state of emergency for a county in which an agency or facility used by an approved nursing program for direct patient care clinical practice is no longer available, to submit to a board nursing education consultant requests to, among other things, allow the program to reduce the required number of direct patient care hours to, among other requirements, 50% in geriatrics and medical-surgical, if certain conditions are met. Existing law prohibits the approval of that request after the 2023–24 academic year and makes an approved request expire at the end of that year. This bill would, instead, authorize a director to submit requests for the approved nursing program to reduce the required number of direct patient care hours to 200 hours in medical-surgical, as specified, if certain conditions are met. The bill would remove the prohibition of the approval of that request after the 2023–24 year and the provision making any an approved request expire at the end of that year. If the board requires the approval of the faculty or directors, as specified, existing law authorizes the board to approve an individual to serve as a member of the faculty, director, or assistant director of an approved school of nursing or nursing program. Existing law makes an individual approval valid for 5 years and authorizes an individual approval to be renewed if the individual demonstrates to the board that they continue to meet the requirements established by the board for faculty, directors, and assistant directors of an approved school of nursing or nursing program. This bill would, instead, make only an individual faculty approval valid for 5 years and authorize only an individual faculty approval to be renewed if the individual demonstrates to the board that they continue to meet the requirements established by the board for faculty of an approved school of nursing or nursing program. If an applicant for approval has a faculty position and does not meet a requirement established by the board for a different position, existing law authorizes the board to accept a remediation plan submitted by an approved school of nursing or nursing program to help the applicant meet the requirement, and if the board accepts the plan, to approve the applicant to instruct in theory under the mentorship and supervision of the content expert identified in the plan for up to one year. If an applicant for approval as an assistant director or director does not have a faculty position and does not meet a requirement established by the board for a different position, the bill would authorize the board to accept a remediation plan submitted by an approved school of nursing or nursing program to help the applicant meet the requirement, and if the board accepts the plan, to approve the applicant to serve in the role of the assistant director under the mentorship of a board-approved director or assistant director while completing the remediation plan for up to one year, as specified. (3) Existing law defines the practice of nursing to include specified activities, including the administration of medications ordered by a physician and surgeon, dentist, podiatrist, or clinical psychologist, as specified. This bill would expand the definition of the practice of nursing to include the administration of medications ordered by a nurse practitioner or certified nurse midwife and the administration of medications as directed by an advanced practice registered nurse to the extent allowable by the advanced practice registered nurse's scope of practice. (4) Existing law requires the board to issue a license as a registered nurse to each applicant who passes the examination and meets all other licensing requirements. Existing law requires all examinations to be written, but authorizes exams in the discretion of the board to be supplemented by an oral or practical examination in subjects the board determines. This bill would remove the requirement that all examinations be written, and the authorization for exams to be supplemented by an oral or practical examination in subjects the board determines. Existing law authorizes a registered nurse under current investigation by the board to request entry into an intervention program by contacting the board. Existing law requires each registered nurse who requests participation in an intervention program to agree to cooperate with the rehabilitation program designed by the intervention evaluation committee and approved by the program manager, as defined. This bill would require the committee, in developing the rehabilitation program, to determine whether a participant is required to practice nursing prior to completion of the program. Existing law requires each person renewing their license as a registered nurse to submit proof satisfactory to the board that, during the preceding 2-year period, they have been informed of the developments in the registered nurse field or in any special area of practice engaged in by the licensee, occurring since the last renewal thereof, either by pursuing a course or courses of continuing education in the registered nurse field or relevant to the practice of the licensee, as specified, or by other means deemed equivalent by the board. This bill would, beginning January 1, 2029, require the board to require each licensee to submit the above-described proof at the time of renewal and require the proof to include, but not be limited to, documentation verifying the completion of the continuing education requirements during the preceding renewal period or the preceding 2 years. Existing law authorizes a registered nurse whose license has been revoked or suspended or who has been placed on probation to petition the board for reinstatement or modification of penalty, as specified, subject to specified time periods. This bill would specify that no minimum time period applies if the registered nurse has had their license revoked by default for failure to submit a notice of defense. (5) Existing law requires the board to issue a certificate to practice nurse-midwifery to a person licensed as a registered nurse who meets specified qualifications. Existing law authorizes a certified nurse-midwife to attend cases of low-risk pregnancy and childbirth and to provide certain types of care, including prenatal care. Existing law generally authorizes a certified nurse-midwife to furnish drugs or devices incidentally to the provision of, among other things, the care and services described above. Existing law makes the furnishing or ordering of drugs or devices by a certified nurse-midwife conditional on the issuance by the board of a number to the applicant who has successfully completed certain requirements. Existing law authorizes the board to issue a furnishing number upon initial application and, if approved by the board, prohibits requiring the applicant from having to make a separate application. Existing law authorizes the board to charge an applicant a fee to cover all necessary costs to implement these provisions that is no more than $1,500 for an initial application or $1,000 for a renewal application, and to charge a penalty fee for failure to renew a furnishing number within the prescribed time that is no more than $500. This bill would authorize the board to also issue a furnishing number described above upon renewal application, and would remove the authorization for the board to charge a penalty fee for failure to renew a furnishing number within the prescribed time. The bill would specify that the initial application and renewal application are those for a certificate to practice nurse-midwifery. (6) Existing law, the Nurse Anesthetists Act, which is part of the Nursing Practice Act, requires the board to issue a certificate to practice nurse anesthesia to a person licensed as a registered nurse who meets specified qualifications. Existing law fixes the amounts of fees in connection with the issuance of certificates of nurse anesthetists, including that the fee to be paid upon the filing of an application for a certificate is fixed by the board at not less than $500 and no more than $1,500. This bill would remove the minimum fee amount for the above-described fees. (7) Existing law requires, on and after January 1, 2008, an applicant for initial qualification or certification as a nurse practitioner who has not been qualified or certified as a nurse practitioner in California or any other state to meet certain requirements, including holding a valid and active registered nursing license. Existing law generally authorizes a nurse practitioner to furnish drugs or devices when certain conditions are met, including that the nurse practitioner is functioning pursuant to standardized procedure, as defined, or protocol, as specified. Existing law makes the furnishing or ordering of drugs or devices by a nurse practitioner conditional on the issuance by the board of a number to an applicant who has successfully completed certain requirements. Existing law authorizes the board to issue a furnishing number upon initial application and, if approved by the board, prohibits requiring the applicant from having to make a separate application. Existing law authorizes the board to charge an applicant a fee to cover all necessary costs to implement these provisions that is no more than $1,500 for an initial application or $1,000 for a renewal application, and to charge a penalty fee for failure to renew a furnishing number within the prescribed time that is no more than $500. This bill would authorize the board to also issue a furnishing number described above upon renewal application, and would remove the authorization for the board to charge a penalty fee for failure to renew a furnishing number within the prescribed time. The bill would specify that the initial application and renewal application are those for the qualification or certification as a nurse practitioner. Existing law authorizes a nurse practitioner to perform certain functions, including conducting an advanced assessment, without standardized procedures in accordance with their education and training, as specified, if the nurse practitioner meets certain requirements, including that they have completed a transition to practice in California of a minimum of 3 full-time equivalent years of practice or 4600 hours, as specified. This bill would also authorize the completion of a transition to practice in another state, as described above, for purposes of that requirement. For purposes of a transition to practice completed in another state, the bill would require the board to, among other things, on or before January 1, 2028, identify states where practice experience would meet or exceed the requirements under specified provisions if obtained in this state. (8) Existing law requires a registered nurse applying to be a clinical nurse specialist for the evaluation of their qualifications to use that title to pay a nonrefundable fee of not less than $500 but not exceeding $1,500, and requires a fee to be paid for a temporary certificate to practice as a clinical nurse special to be not less than $30 but no more than $50. Existing law requires a biennial renewal fee to be paid upon submission of an application to renew the clinical nurse specialist certificate, and to be established by the board at no less than $150 and not more than $1,000. Existing law requires the penalty fee for failure to renew a certificate within the prescribed time to be 50% of the renewal fee in effect on the date of the renewal of the license to be not less than $75 and no more than $500. This bill would delete the minimum fee amounts prescribed above. (9) The bill would also make various nonsubstantive changes to various nursing related provisions.
(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.
(1) Existing law, the Nursing Practice Act, establishes the Board of Registered Nursing to license and regulate the practice of nursing. Existing law requires an applicant for licensure as a registered nurse to comply with specified education and other requirements. This bill would also require an applicant for licensure as a registered nurse to undergo a fingerprint-based state and national criminal history background check, would require the board to submit to the Department of Justice (department) fingerprint images and related information for applicants, and would require the department to provide a state- and federal-level response, as specified. (2) Existing law requires the department to maintain state summary criminal history information, as defined, and to furnish this information to various state and local government officers and officials, as well as other prescribed entities, including, among others, a city, county, city and county, or district, if needed in the course of their duties. Existing law authorizes the Attorney General to furnish state summary criminal history information and, if authorized, federal-level criminal history information, upon a showing of a compelling need, to specified entities, including, among others, peace officers of the United States, other states, or territories or possessions of the United States. Existing law makes it a misdemeanor to furnish criminal history information to a person who is not authorized by law to receive it. This bill would instead make those provisions applicable to a city, county, city and county, or governmental district. The bill would also authorize the Attorney General to provide that information to peace officers of tribes in other states under the same conditions. The bill would prescribe a procedure by which a city, county, city and county, or governmental district submit fingerprint images and related information to the department. The bill would make a release of information by the department under these provisions subject to specified federal regulations. By expanding access to criminal history information, this bill would expand a crime and therefore impose a state-mandated local program. (3) Existing law requires employees, prospective employees, volunteers, contractors, and subcontractors of a criminal justice agency to undergo a fingerprint-based state and national criminal history background check. Existing law requires the department to provide a state- and federal-level response, as specified. This bill would make that provision, with regard to a volunteer, contractor, or subcontractor, only applicable to a volunteer, contractor, or subcontractor who either provides services for the administration of criminal justice or has direct or remote access to the criminal justice agency's systems or unescorted access to a criminal justice agency's facilities. (4) Existing law requires employees of entities that have contracts with a private school or heritage school and provide services, including schoolsite administrative or grounds, landscape maintenance, and instruction, to provide their fingerprints to the department, as specified. Existing law requires employees of an entity that contracts with a local educational agency to complete a criminal background check, as specified. Under existing law, a county, city, city and county, or special district is required to have specified prospective employees or volunteers complete a background check that inquires as to whether the applicant has been convicted of certain offenses. Existing law also requires the submission of fingerprints to the department for certifying a massage professional, licensing a professional fiduciary, registering a tax preparer, confirming the appointment of a humane officer, working for a bank or its affiliates, and licensing an escrow agent, as specified. Existing law requires the department to ascertain whether the individual whose fingerprints were submitted has been arrested or convicted of a crime and notify the employer if the person has been convicted of specified felonies. Existing law authorizes the department to notify specified entities of pending criminal proceedings. This bill would instead require those background checks to be submitted pursuant to the provisions above and would make conforming changes. (5) Existing law authorizes a human resource agency, as defined, or a nonprofit corporation or other organization specified by the Attorney General that employs or uses the services of volunteers in positions in which the volunteer or employee has supervisory or disciplinary power over a child or children to request from the department records of all convictions or any arrest pending adjudication involving specified offenses of a person who applies for a license, employment, or volunteer position in which they would have supervisory or disciplinary power over a minor or any person under their care. This bill would revise and recast those provisions to instead allow a qualified entity, as defined, to require a covered individual, as defined, to undergo a fingerprint-based state and national criminal history background check and would authorize a qualified entity to get a subsequent arrest notification pursuant to the provisions above. By expanding access to criminal history information, this bill would expand a crime and therefore impose a state-mandated local program. The bill would make any statutory requirement for an entity to conduct a federal criminal history information check for licensing, certification, or employment purposes inapplicable until the Federal Bureau of Investigation authorizes the entity to conduct a federal criminal history information check, as specified. If the Federal Bureau of Investigation authorizes an entity to conduct a federal criminal history information check, the bill would require the entity to require an applicant, licensee, certified individual, or employee who did not previously undergo a federal criminal history information check to resubmit their fingerprints for that purpose. (6) Existing law requires an application used to determine the eligibility to own a firearm to include 2 copies of the applicant's fingerprints. This bill would instead require an applicant for a certificate of eligibility and a dangerous weapons license or permit issued by the department, including, among other weapons, an assault weapon or short-barreled shotgun, to submit to the department fingerprint images and related information for purposes of conducting a state and national criminal history background check, as specified, and for the purpose of determining if the applicant is prohibited by state or federal law from possessing, receiving, owning, or purchasing a firearm. The bill would require the department to retain the fingerprint impressions for subsequent arrest notification, as specified. (7) Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, 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. Existing law requires the State Department of Health Care Services to screen all providers and designate each provider as "limited," "moderate," or "high" categorical risk. For all providers designated as a "high" categorical risk, existing law requires the State Department of Health Care Services, or its designee, to conduct a criminal background check and require specified individuals to submit a set of fingerprints within 30 days of the State Department of Health Care Services's request in a manner specified by the State Department of Health Care Services. This bill would instead add the State Department of Public Health in place of the State Department of Health Care Services's authority to have a designee for these purposes. The bill would require, as an alternative to the State Department of Health Care Services, the State Department of Public Health to prescribe the manner by which a person submits their fingerprints. (8) Existing law requires the State Department of Health Care Services to require that specified applicants, providers, and individuals submit fingerprint images and related information for purposes of a state and federal criminal background check and prescribes a procedure for the State Department of Health Care Services and the department to follow for these purposes. This bill would also add the State Department of Public Health to this requirement and procedure as an alternative to the State Department of Health Care Services and would instead require the information be submitted for specified individuals who are subject to a state and national criminal history background checks. The bill would define "applicant" and "provider" for these purposes. (9) Existing law requires the State Department of Social Services to license and regulate community care facilities, residential care facilities for persons with chronic, life-threatening illness, residential care facilities for the elderly, and childcare centers. Existing law requires the department to obtain a criminal record for all applicants for licenses for these facilities and services and specified other employees and officers of these facilities, including, among others, adults responsible for the administration or direct supervision of staff, a staff person, volunteer, or employee who has contact with clients, and, if the applicant is a firm, partnership, association, or corporation, the chief executive officer or other person serving in a like capacity. This bill would expand the list of individuals to include, among others, an administrator, supervisor, manager, or director of the facility, or an individual acting in those roles, an adult responsible for the operation of the facility, and a person with a 10% or greater financial interest in the applicant. The bill would clarify that a staff person, volunteer, or employee who has direct contact with clients includes adults and minors. The bill would also include limited liability companies in the list of applicant types to which these provisions apply. By expanding access to criminal history information, this bill would expand a crime and therefore impose a state-mandated local program. (10) Existing law authorizes specified governmental entities to require employees, prospective employees, volunteers, contractors, and subcontractors to undergo fingerprint-based state and national criminal history background checks. Existing law establishes the Business and Consumer Services Agency, the California Housing and Homelessness Agency, and the Housing Development and Finance Committee. Existing law sets forth the general responsibilities and roles of the California Housing Finance Agency, the California Housing and Homelessness Agency, the Department of Housing and Community Development, and the Housing Development and Finance Committee in carrying out state housing policies and programs. This bill would authorize the Housing Development and Finance Committee to require an employee, prospective employee, volunteer, contractor, or subcontractor to undergo a fingerprint-based state and national criminal history background check, as specified. The bill would require the department to provide a state- and federal-level response. By expanding access to criminal history information, this bill would expand a crime and therefore impose a state-mandated local program. (11) Existing law, the Yacht and Ship Brokers Act, prohibits a person from, among other things, acting as a broker or salesperson for the purchase or sale of a yacht without a license. The act authorizes the issuance of a temporary license to a salesperson under specified conditions. The act requires an applicant for a broker or salesperson license to undergo a fingerprint-based state and national criminal history background check. This bill would authorize a temporary license to be issued to a broker. The bill would also authorize the Deputy Director of Boating and Waterways to extend the term of a temporary license or issue a new temporary license to provide an applicant for a broker or salesperson license time to comply with the criminal history background requirement, as specified. (12) This bill would incorporate additional changes to Section 44237 of the Education Code proposed by SB 685 to be operative only if this bill and SB 685 are enacted and this bill is enacted last. (13) This bill would incorporate additional changes to Section 11105 of the Penal Code proposed by AB 2001 to be operative only if this bill and AB 2001 are enacted and this bill is enacted last. (14) 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. (15) This bill would declare that it is to take effect immediately as an urgency statute.
Existing law establishes the Department of Health Care Access and Information in the Health and Welfare Agency and requires the department to perform specified functions relating to, among other things, health policy and planning, health professions development, and health facility data. This bill would require the department to convene a workgroup to discuss graduate medical education capacity in California, with a focus on access to residency positions. The bill would require the workgroup to be composed of interested stakeholders, as specified. The bill would require the department, in consultation with the Medical Board of California, to prepare and submit a report to the appropriate committees of the Legislature on or before July 1, 2028, that includes, among other information, recommendations for increasing residency capacity in California, improving geographic and specialty distribution, and reducing barriers to entry, including for international medical graduates. The bill would repeal its provisions on January 1, 2030.
Existing law, the Acupuncture Licensure Act, establishes the Acupuncture Board to license and regulate the practice of acupuncture. Existing law requires an applicant for a license to practice acupuncture to furnish satisfactory evidence of completion of an approved educational and training program, unless the applicant satisfies specified other requirements. Existing law defines "approved educational and training program" to mean a school or college that offers education and training in the practice of an acupuncturist that, among other requirements, offers a curriculum that includes at least 3,000 hours, of which at least 2,050 hours are didactic and laboratory training and at least 950 hours are supervised clinical instruction. This bill, on and after January 1, 2032, would require an approved educational and training program to offer a curriculum that confers a doctoral degree in acupuncture and Chinese herbal medicine consisting of not less than 3,300 hours, of which at least 2,220 hours are didactic and laboratory training and at least 1,080 hours are supervised clinical instruction. Existing law makes it unprofessional conduct for an acupuncturist to use the title "Doctor" or the abbreviation "Dr." in connection with the practice of acupuncture unless they possess a license that authorizes that use or they possess a doctoral degree from a specified educational institutions. This bill would make those provisions applicable to the title "Doctor of Acupuncture and Herbal Medicine" or the abbreviation "D.A.H.M." The bill would also prohibit a person from using the title "licensed acupuncturist" or the abbreviation "LAc" unless the person holds a valid, unrevoked, and unsuspended license pursuant to the act. The bill would make conforming changes.
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 through fee-for-service or managed care delivery systems. The Medi-Cal program is in part governed by, and funded pursuant to, federal Medicaid program provisions. Existing law provides for the licensure of hospice agencies by the State Department of Public Health to provide hospice services to an individual who is experiencing the last phase of life due to a terminal illness, as defined. Under existing law, hospice services are covered under the Medi-Cal program, subject to utilization controls and the availability of federal financial participation, as specified. The State Department of Health Care Services administratively requires, effective March 2, 2026, a hospice provider to use a certain online attestation form to notify the department when a Medi-Cal fee-for-service member has elected to receive hospice services, as specified. This bill would codify and recast those departmental procedures relating to the online form. The bill would require the hospice provider to submit the online form within 5 calendar days after the member's election to receive hospice services, and to submit the form in conjunction with counseling, receipt of informed consent, and completion of a separate election notice form, as specified. The bill would make these provisions applicable only to the Medi-Cal fee-for-service delivery system. In the case of Medi-Cal managed care, the bill would require a hospice provider to instead follow its assigned Medi-Cal managed care plan's submission requirements, as specified.
Existing law, the Respiratory Care Practice Act, establishes the Respiratory Care Board of California to license and regulate respiratory care practitioners. Existing law authorizes the board to employ an executive office, as specified. Existing law establishes fees for license and examination requirements for respiratory care practitioners, including an initial license fee of no more than $300 and a license renewal fee at $230, as specified. Existing law authorizes the board to increase the license renewal fee, by regulation, to no more than $330. Existing law repeals the existence of the board and the authority for employment of an executive officer on January 1, 2027. This bill would extend the operation of the existence of the board and the executive officer to January 1, 2031, and would delete the initial license fee provision. The bill would increase the license renewal fee to $330 and would authorize the board to increase the license renewal fee, by regulation, to $375. Existing law establishes requirements for licensure as a respiratory care practitioner and generally prohibits an applicant for licensure from being licensed without first successfully passing the National Board for Respiratory Care's Therapist Multiple-Choice Examination, at the cut-off level required to qualify for the Clinical Simulation Examination, and the Clinical Simulation Examination, or any succeeding examinations. This bill would revise the above provision to instead prohibit an applicant from being licensed under these provisions without first successfully passing the National Board for Respiratory Care's Respiratory Therapy Examination, at the cut-off level required to qualify for the Registered Respiratory Therapist credential, or any succeeding examinations. Existing law authorizes the board to order the denial, suspension, or revocation of, or the imposition of probationary conditions upon, a license of a respiratory care practitioner for certain specified acts, including the commission of any fraudulent, dishonest, or corrupt act that is substantially related to the qualifications, functions, or duties of a licensee. Existing law further requires the board to revoke or suspend a license for the conviction of a crime that is substantially related to the qualifications, functions, or duties of a licensee. Existing law deems a crime involving sexual misconduct or attempted sexual misconduct, regardless of whether committed with a patient, to be a substantially related crime and requires the board to revoke a license for sexual contact with a patient or for the commission of, or conviction for, a sex offense, as defined. This bill would additionally require the board to suspend the license of a respiratory care practitioner convicted of specified felonies, regardless of whether the offense was committed in the course of practice, and notwithstanding any other provision. The bill would require the board to revoke the license if the specified conviction becomes final. The bill would authorize the board to decline to impose or to set aside a suspension in the interest of justice and would require the board to rescind a license suspension or revocation if the conviction is overturned, as provided. The bill would authorize a licensee to request a hearing to determine the appropriate level of discipline and would prohibit an administrative law judge from considering expert testimony regarding whether the conviction is substantially related to the practice of respiratory care. The Respiratory Care Practice Act authorizes the board to promulgate regulations defining specified levels of respiratory care, with each requiring a greater degree of training or skill to perform. Existing law specifies the lowest level as basic services, which are tasks or services that do not require a respiratory assessment and only require manual, technical skills, or data collection. Existing law, the Vocational Nursing Practice Act, limits a licensed vocational nurse to basic respiratory tasks and services, as prescribed. Existing law exempts from the Respiratory Care Practice Act specified tasks performed by a licensed vocational nurse. In this regard, existing law authorizes a licensed vocational nurse to perform respiratory tasks and services under specified circumstances that vary depending on the task or service, the nurse's training, demonstrated competency, and employer, and the setting in which the task or service is performed, as provided. Specifically, existing law authorizes a licensed vocational nurse who is employed by a home health agency to perform respiratory tasks and services identified by the board if, on or before January 1, 2028, the licensed vocational nurse has completed patient-specific training satisfactory to their employer, and, on and after that date, the licensed vocational nurse has completed that training in accordance with guidelines promulgated by the board, in collaboration with the Board of Vocational Nursing and Psychiatric Technicians of the State of California. This bill would expand the respiratory tasks and services a licensed vocational nurse is authorized to perform. In this regard, the bill would remove the above requirement that a licensed vocational nurse be employed by a home health agency to perform respiratory tasks and services identified by the board, and would, instead, authorize a licensed vocational nurse to perform these services in expanded settings, including, among others, congregate living health facilities, group homes, and adult residential facilities. The bill would authorize a licensed vocational nurse to perform certain suctioning tasks, as specified. Existing law specifies that the Respiratory Care Practice Act is not intended to limit, preclude, or otherwise interfere with the practice of other licensed personnel carrying out authorized and customary duties and functions. This bill would provide that certain activities are not considered to be practicing respiratory care, including documenting observations and gathering and reporting data to another health care provider, as specified.
Existing law, the Medical Practice Act, establishes the Medical Board of California and sets forth its powers and duties relating to the licensure and regulation of physicians and surgeons. Existing law establishes the Osteopathic Medical Board of California and sets forth its powers and duties relating to the licensure and regulation of osteopathic physicians and surgeons and requires the Osteopathic Medical Board of California to enforce the Medical Practice Act with respect to its licensees, consistent with the Osteopathic Act, as specified. A violation of the Medical Practice Act is a crime. Existing law generally makes the unauthorized practice of medicine a crime. Existing law makes an exception to that criminal provision if a person, before performing services, complies with certain disclosure requirements. Existing law excludes from that exception a list of specified services, including, among others, conducting surgery or any other procedure on another person that punctures the skin or harmfully invades the body. This bill, on and after January 1, 2028, would add the provision of osteopathic manipulative treatment, as defined, to that list of specifically excluded services. By excluding those services from the exception to the unauthorized practice of medicine, the bill would expand the scope of a crime, thereby imposing a state-mandated local program. Existing law, with specified exceptions, makes it a misdemeanor for a person to use the words "doctor" or "physician," the letters or prefix "Dr.," the initials "M.D." or "D.O.," or any other terms or letters indicating or implying that the person is a physician and surgeon, physician, surgeon, or a practitioner under the Medical Practice Act or other law, or to represent or hold themselves out as a physician and surgeon, physician, surgeon, or practitioner under the act or other law without having a valid, unrevoked, and unsuspended certificate as a physician and surgeon under the act. Existing law prohibits a person from using those terms or letters or any other terms or letters indicating or implying that the person is a physician and surgeon, physician, surgeon, or practitioner in a health care setting that would lead a reasonable patient to determine that the person is a licensed "M.D." or "D.O." This bill, on and after January 1, 2028, would also make it a misdemeanor for a person who is not licensed by the Osteopathic Medical Board of California to use the phrase "doctor of osteopathy" or the initials "D.O.," or use the word "osteopath" in a way that implies that they are a licensed osteopath, a licensed doctor of osteopathy, or a physician and surgeon licensed by the board when offering or providing a service to treat a medical or physical condition. By creating a new 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.
