Healthcare

Existing law, the Emergency Medical Services System and the Prehospital Emergency Medical Care Personnel Act (act) , establishes the Emergency Medical Services Authority, which is responsible for the coordination of various state activities concerning emergency medical services (EMS) . The act authorizes a county to develop an EMS program by designating a local EMS agency. Existing law also requires the Commission on Emergency Medical Services to review and approve regulations, standards, and guidelines to be developed by the authority. Existing law generally makes a violation of the act a misdemeanor. This bill would require, by January 1, 2027, a public safety agency that provides "911" call processing services for emergency medical response to provide prearrival medical instructions to "911" callers requiring medical assistance, including, among other things, airway and choking medical instructions for infants, children, and adults and administration of naloxone for narcotics overdoses. The bill would require prearrival medical instructions to be approved by the local EMS agency medical director and implemented consistent with the medical protocols and procedures adopted by the public safety agency. By expanding the scope of a crime, and to the extent that the bill would create new duties for a public safety agency, 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.

Existing law, the Nurse Anesthetists Act, provides for the certification and regulation of nurse anesthetists by the Board of Registered Nursing. Existing law requires the utilization of a nurse anesthetist to provide anesthesia services in an acute care facility to be approved by the acute care facility administration and the appropriate committee, as defined, and at the discretion of the physician, dentist, or podiatrist. Existing law makes a nurse anesthetist who is not an employee of an acute care facility subject to the bylaws of the facility. This bill would expressly provide that a nurse anesthetist is authorized to perform anesthesia services. The bill would define "anesthesia services" for purposes of the act to mean, among other things, preoperative, intraoperative, and postoperative care and pain management provided by a nurse anesthetist for patients receiving anesthesia pursuant to an order by a physician, dentist, or podiatrist for anesthesia services. Under the bill, an order by a physician, dentist, or podiatrist for anesthesia services for a specific patient would be deemed the authorization for the nurse anesthetist to select and implement the modality of anesthesia for the patient and to abort or modify the modality of anesthesia during the course of care. The bill would provide that the selection and administration of medication by a nurse anesthetist for preoperative, intraoperative, and postoperative care and for pain management purposes pursuant to an order by a physician, dentist, or podiatrist shall not constitute a prescription as that term is defined in a specified provision of federal law. The bill would state that the provisions of the Nurse Anesthetists Act are declaratory of existing law and of an advisory opinion, including specified case law.

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 and funded by federal Medicaid program provisions. Existing law generally imposes penalties on a person who negligently, willfully, or maliciously discloses the results of a human immunodeficiency virus (HIV) test to a third party in a manner that identifies or provides identifying characteristics of the person to whom the test results apply, as specified. Existing law, notwithstanding the above-described restrictions, authorizes the recording of the HIV test results by the physician who ordered the test in the test subject's medical record and authorizes other disclosure of the results without written authorization of the test subject, or the subject's representative, to the test subject's providers of health care, excluding a regulated health care service plan, for purposes of diagnosis, care, or treatment of the patient. This bill would authorize a provider of health care to disclose the results of an HIV test that identifies or provides identifying characteristics of a Medi-Cal beneficiary without written authorization of the test subject, or the subject's representative, to the Medi-Cal managed care plan to which the beneficiary is assigned, if applicable, and to external quality review organizations conducting external quality reviews of Medi-Cal managed care plans, for the purpose of administering quality improvement programs, including, but not limited to, value-based payment programs and healthy behavior incentive programs, designed to improve HIV care for Medi-Cal beneficiaries. Under the bill, HIV test results that do not identify or provide identifying characteristics of the test subjects would be authorized for disclosure without written authorization by the Medi-Cal managed care plan to departmental staff for the above-described purpose. The bill would make certain clarifying or declaratory statements with regard to related provisions.

Existing law establishes the California Community Colleges, under the administration of the Board of Governors of the California Community Colleges. Existing law establishes community college districts throughout the state, under the administration of community college district governing boards, and authorizes these districts to provide instruction at the community college campuses they operate. Existing law establishes a statewide baccalaureate degree program that authorizes up to a total of 30 baccalaureate degree programs at community college districts to be approved per academic year, as provided. This bill would require the office of the Chancellor of the California Community Colleges to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community college districts to offer a Bachelor of Science in Nursing degree. The bill would limit the pilot program to 10 community college districts statewide and would require the chancellor's office to identify and select eligible community college districts based on specified criteria. The bill would require the chancellor's office to develop a process designed to assist community college districts with nursing programs that are applying for national accreditation for the purpose of qualifying for the pilot program, as provided. The bill would require each participating community college district to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that community college district. The bill would require the Legislative Analyst's Office to conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program, as specified, to be submitted to the Legislature on or before July 1, 2033. The bill would repeal these provisions as of January 1, 2035.

(1) Existing law, the Pharmacy Law, requires the California State Board of Pharmacy within the Department of Consumer Affairs to license and regulate the practice of pharmacy, including pharmacists, pharmacy technicians, and pharmacies. Existing law authorizes the board, with the approval of the Director of Consumer Affairs, to appoint an executive officer to exercise certain powers and to perform certain duties delegated by the board, as specified. Existing law repeals the provisions establishing the board and authorizing the appointment of an executive officer on January 1, 2026, rendering the board subject to review by the appropriate policy committees of the Legislature. This bill would provide that the board has exclusive authority to administer and enforce the Pharmacy Law related to the practice of pharmacy and the licensing of pharmacists and pharmacies, and would specify that its provisions do not prohibit the board from evaluating or acting regarding unlicensed activity, as provided. The bill would extend the repeal date of the above-described provisions to January 1, 2030. The bill would additionally require the board to establish a Pharmacy Technician Advisory Committee to advise and make recommendations to the board, as specified. Existing law specifies the fees for issuance or renewal of licenses issued pursuant to the Pharmacy Law, including, among others, pharmacy licenses. This bill would require the board to waive the application fee for a pharmacy operating a physical location in a medically underserved area, as defined, and would authorize the board to waive the fee for the annual renewal of a license if the licensee provides the board with certification of continued operation in the medically underserved area. (2) Existing law authorizes a pharmacist to perform various procedures and functions, including those related to dispensing or furnishing drugs or devices, as specified. Existing law generally requires a pharmacist's dispensing or furnishing drugs to be done pursuant to a valid prescription, except as provided in specified circumstances. Those exceptions include furnishing an FDA-approved opioid antagonist, emergency contraception drug therapy, self-administered hormonal contraceptives, nicotine replacement products, certain medications for individuals traveling outside of the United States, and certain HIV medications, as specified. Existing law requires certain conditions to be met for a pharmacist to authorize the initiation of a prescription under certain of those exceptions or to otherwise provide clinical advice, services, information, or patient consultation. This bill would revise and recast the above-described provisions to authorize a pharmacist to, among other things, furnish dangerous devices, to furnish FDA-approved or authorized medications as part of preventative health care services that do not require a diagnosis, as specified, and to complete missing information on a prescription for a noncontrolled medication if there is evidence to support the change. The bill would require that a pharmacist provide those and other specified services or activities consistent with the accepted standard of care, defined to mean the degree of care a prudent and reasonable pharmacist licensed under the Pharmacy Law, with similar education, training, experience, resources, and setting, would use in a similar situation. The bill would make nonsubstantive, conforming changes. Existing law requires the clinical advice, services, information, or patient consultation that a pharmacist provides to be provided to a health care professional or to a patient. This bill would authorize a pharmacist to provide the clinical advice, services, information, or patient consultation to a patient's agent. Existing law, until January 1, 2026, authorizes a pharmacist to furnish COVID-19 oral therapeutics, as defined, following a positive test for SARS-CoV-2, the virus that causes COVID-19, in accordance with specified requirements. This bill would delete the January 1, 2026, repeal date, thereby extending this authorization indefinitely. Existing law prohibits a dangerous drug from being refilled without the authorization of the prescriber, except under specified circumstances. Under those circumstances, existing law requires a pharmacist to make every reasonable effort to contact the prescriber. This bill would remove the above-described requirement that the pharmacist make every reasonable effort to contact the prescriber. Existing law authorizes a pharmacist to dispense not more than a 90-day supply of a dangerous drug other than a controlled substance pursuant to a valid prescription that specifies an initial quantity of less than a 90-day supply followed by periodic refills of that amount if certain requirements are met. Existing law prohibits a pharmacist from dispensing a greater supply pursuant to that provision if the prescriber indicates that there is to be no change to the quantity of the refill, as specified. This bill would remove that prohibition. Existing law authorizes a pharmacy to dispense epinephrine auto-injectors to a prehospital emergency medical care person or lay rescuer for the purpose of rendering emergency care, as specified. This bill would remove the above-described authorization. (3) Existing law authorizes a licensed pharmacist to perform additional functions if the licensee is recognized by the board as "an advanced practice pharmacist" by meeting certain requirements. Those additional functions include, among others, performing patient assessments, ordering and interpreting drug therapy-related tests, and initiating, adjusting, or discontinuing drug therapy, as specified. The requirements for recognition as an advanced practice pharmacist include having completed a combination of specified certifications, postgraduate residencies, or experience under a collaborative practice agreement or protocol with a physician. Existing law also requires an advanced practice pharmacist to complete 10 hours of continuing education in addition to the continuing education otherwise required at the time of a second or subsequent license renewal. This bill would revise those and other related provisions to refer to those licensees as "advanced pharmacist practitioners," instead of as "advanced practice pharmacists." (4) Existing law prohibits any person from furnishing or dispensing any dangerous drug or device on the internet for delivery to any person in California without a prescription issued pursuant to a "good faith prior examination," as provided. This bill would instead refer to that examination as an "appropriate prior examination." (5) Existing law authorizes the board to issue citations containing fines and orders of abatement for violations of specified law, as provided. Existing law authorizes the board to bring an action against a chain community pharmacy under common ownership or management for fines for a violation of the Pharmacy Law that was expressly encouraged by the common owner or manager, as provided. This bill would instead apply those fines for a violation that was expressly encouraged by any owner or manager of the chain community pharmacy. Existing law authorizes the board to bring an action for fines for repeated violations of materially similar provisions of the Pharmacy Law within 5 years by 3 or more pharmacies operating under common ownership or management within a chain community pharmacy, as specified. Existing law provides a pharmacy with a defense if it establishes that the violation was contrary to a written policy that was communicated by the common owner or manager to all employees where the violation occurred. Existing law also provides a defense if the pharmacy establishes that, within 6 months after the violation, the common owner or manager corrected all unlawful policies, communicated the change in policies, and provided the board with proof of abatement of the violation, as specified. This bill would, for the defense that the violation was contrary to a written policy, also require the entity to establish that it has complied with the policy. The bill would revise the above-described corrective-actions defense by allowing those actions to be undertaken by any owner or manager of the pharmacy. The bill would additionally authorize the board to bring an action for fines for repeated violations of materially similar provisions of the Pharmacy Law against a mail order pharmacy, defined as a nonresident pharmacy that dispenses medications and ships them to patients via the postal service or other mail delivery method, as provided. The bill would require the board, in determining the amount of the fine, to consider mitigating and aggregating factors, as specified. (6) Existing law prohibits the board from issuing a pharmacy license to a person who has a shared community or financial interest with a person authorized to prescribe or write a prescription, as provided. This bill would establish an exception to the above-described prohibition under which the applicant and the prescriber would be required to provide statements that the prescriber disavows any community or financial interest in the license and to transmute any interest in the license that is shared community property into the separate property of the applicant, as provided. The bill would prohibit a pharmacy granted a license pursuant to this exception from filling any prescriptions issued or prescribed by a person who shares a community or other financial interest with the licensee or a prescriber at the same place of business as that person if the prescriber owns an interest greater than 10% in the practice issuing the prescription. Existing law authorizes the board to issue a retired license to a licensed pharmacist, as specified. Existing law authorizes the holder of a retired license to restore their license to active status by passing the examination that is required for initial licensure with the board. This bill would instead authorize the holder of a retired license to request to restore their license to active status within 3 years of issuance of the retired license by paying a renewal fee and successfully completing certain continuing education within the 2 years preceding the request, as specified. If more than 3 years have elapsed since the issuance of the retired license, the bill would require the holder of the retired license to reapply for licensure as a pharmacist, as specified. Existing law authorizes the board to deny a license application if the applicant has been convicted of a crime or subjected to formal discipline that would be grounds for denial of a federal registration to distribute controlled substances. This bill would also authorize the board to deny a license application if the applicant has been convicted of a crime involving fraud in violation of state or federal laws related to health care or involving financial identity theft. Existing law requires certain licensed facilities to perform a self-assessment evaluating compliance with specified provisions of the Pharmacy Law, as provided. This bill would require all licensed facilities to complete a self-assessment every odd-numbered year and within 30 days of certain changes to the license, management personnel, and location, as provided. The bill would require this self-assessment to be signed under penalty of perjury, thereby imposing a state-mandated local program by expanding the crime of perjury. (7) Existing law requires a pharmacy to designate a pharmacist-in-charge and notify the board within 30 days of that designation, as specified. Existing law authorizes the pharmacist-in-charge to, among other things, make staffing decisions and notify store management of dangerous conditions, as specified. This bill would require the pharmacist-in-charge to determine the appropriate pharmacist-to-technician ratio, within prescribed limits, and prohibit anyone else from interfering with the exercise of the pharmacist-in-charge's independent professional judgment in setting this ratio. The bill would additionally require the pharmacist-in-charge to notify the owner or hospital administrator of dangerous conditions, as specified. Existing law provides for the licensing of nonresident pharmacies, as specified. Existing law prohibits a pharmacist at a nonresident pharmacy whose license has been revoked from prescribing a dangerous drug or providing other pharmacy-related services, as specified. This bill would, beginning July 1, 2026, require a nonresident pharmacy, as a prerequisite to registering with the board and ongoing licensure, to identify a California-licensed pharmacist employed and working at the nonresident pharmacy to be proposed to serve as the pharmacist-in-charge. The bill would also require the nonresident pharmacy, within 90 days of designating a pharmacist-in-charge, to notify the board of the identity and license number of that pharmacist and the date they were designated, as specified. The bill would require the nonresident pharmacy, within 90 days, to notify the board of a pharmacist-in-charge ceasing to act as the pharmacist-in-charge and to propose another pharmacist to take over as the pharmacist-in-charge. The bill would additionally, beginning July 1, 2026, prohibit a nonresident pharmacy from permitting a pharmacist-in-charge who is not licensed in California from working at a nonresident pharmacy. The bill would authorize the board to inspect a nonresident pharmacy. The bill would require a nonresident pharmacy to deposit a reasonable amount, as determined by the board, necessary to cover the board's estimated reasonable costs of performing the inspection, as specified. (8) Existing law limits a pharmacy with only one pharmacist to one pharmacy technician performing packaging, manipulative, repetitive, or other nondiscretionary tasks. This bill would increase this limit to 3 pharmacy technicians performing those tasks. (9) Existing law requires a pharmacy to preserve certain records, as provided. This bill would require a pharmacy to additionally maintain records related to prescribed policies and procedures in a readily retrievable format. The bill would also impose requirements related to electronically maintained records. (10) This bill would incorporate additional changes to Section 4064.5 of the Business and Professions Code proposed by SB 418 to be operative only if this bill and SB 418 is enacted and this bill is enacted last. This bill would incorporate additional changes to Section 4076 of the Business and Professions Code proposed by AB 260 to be operative only if this bill and AB 260 are enacted and this bill is enacted last. (11) Because a violation of these provisions 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 California Children's Services (CCS) Program, administered by the State Department of Health Care Services and counties, to provide medically necessary services, based on financial eligibility, for persons under 21 years of age who have any of specified medical conditions, including, among others, cystic fibrosis or hemophilia. Existing law requires the board of supervisors of each county to designate the county department of public health or the county department of social welfare as the designated agency to administer the program. Existing law authorizes counties with a total population under 200,000 persons to administer the county program independently or jointly with the department. Existing law requires counties with a total population in excess of 200,000 persons to administer the county program independently. This bill would authorize counties with a total population under 2,000 persons to designate another county to administer the program, if the other county agrees to the designation and otherwise meets certain CCS standards established by the Director of Health Care Services and if neither county is a Whole Child Model county under certain provisions of the Medi-Cal program. The bill would require the department to adopt regulations necessary to implement these provisions.

Existing law prohibits a person from being tried or adjudged to punishment while that person is mentally incompetent. Existing law establishes a process by which a defendant's mental competency is evaluated. Existing law, in the case of a misdemeanor charge in which the defendant is found incompetent, requires the court to hold a hearing to determine if the defendant is eligible for diversion. Existing law requires, if the defendant is not eligible for diversion, the court to hold a hearing to determine whether the defendant will be referred to outpatient treatment, conservatorship, or the CARE program, or if the defendant's treatment plan will be modified. Existing law requires the court to dismiss the case if a defendant does not qualify for the above-described services. Existing law prohibits, except as specified, a person confined in a county jail from being administered any psychiatric medication without prior informed consent. Existing law authorizes a county department of mental health, or other designated county department, to involuntarily administer psychiatric medication to an inmate on a nonemergency basis only after the inmate is provided, among other things, a hearing before a superior court judge, a court-appointed commissioner or referee, or a court-appointed hearing officer. Existing law also provides for the involuntary administration of psychiatric medication to an inmate in an emergency situation. Existing law limits the duration during which an inmate can be involuntarily administered psychiatric medication on an emergency basis and requires that, except as specified, the inmate be provided the same due process protections they would be entitled to when psychiatric medication is involuntarily administered on a nonemergency basis. Existing law specifies that an emergency exists for these purposes when there is a sudden and marked change in an inmate's mental condition so that action is immediately necessary for the preservation of life or the prevention of serious bodily harm to the inmate or others and it is impractical, due to the seriousness of the emergency, to first obtain informed consent. This bill would, if an individual has been found incompetent to stand trial after having been charged with a misdemeanor, additionally authorize the administration of antipsychotic medication to the individual without their prior informed consent on an emergency basis when treatment is necessary to address the emergency condition and the medication is administered in the least restrictive manner, as specified. The bill would specify that a determination made pursuant to these provisions is valid for up to 72 hours if the medication is necessary to address the emergency condition, except as provided. The bill would require the court, prior to issuing an involuntary medication order after hearing, to find by clear and convincing evidence that, among other things, a psychiatrist or psychologist has determined that the individual has a serious mental health disorder that can be treated with antipsychotic medication, and there is no less intrusive alternative to the involuntary administration of antipsychotic medication, and involuntary administration of the medication is in the individual's best interest. The bill would require the court to review that order at least every 60 days and would require the psychiatrist to file an affidavit at that review, as specified. By expanding the crime of perjury, the bill would create a state-mandated local program. The bill would also enumerate certain rights for individuals, prior to the administration of involuntary medication pursuant to these provisions. The bill would make these provisions inoperative and would repeal them on January 1, 2030, subject to a later enacted statute. Existing law provides that if a person in charge of a county jail, city jail, or juvenile detention facility, or a judge, as specified, believes that a person in custody may have a mental health disorder, that person or judge may cause the prisoner to be taken to a facility for 72 hours of treatment and evaluation. The bill would prohibit certain factors, including the person's temporary access to food, clothing, and shelter, while transferred to a 72-hour facility for treatment and evaluation, from being a basis to conclude that the person is able to provide for their basic personal needs. 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 Massage Therapy Act, provides for the certification and regulation of massage professionals by the California Massage Therapy Council, which is a private nonprofit organization governed by a board of directors composed of 13 members. Existing law requires one member to be appointed by the office of the Chancellor of the California Community Colleges, and authorizes the California Association of Private Postsecondary Schools to appoint one member. Existing law requires one member to be a certified massage therapist or a certified massage practitioner who is a California resident who has practiced massage for at least 3 years before appointment and is selected by a specified professional society, association, or other entity the membership of which is composed of massage therapist professionals, and that chooses to participate in the council. This bill would remove the above-described appointment of one member by the office of the Chancellor of the California Community Colleges, and would limit the appointment authority of the California Association of Private Postsecondary Schools by requiring that their appointed member represent an approved massage school. The bill would add an additional member who is a certified massage therapist or a certified massage practitioner who is selected by a specified professional society, association, or other entity, as described above, and would make conforming changes related to that provision. Existing law authorizes the council to take any reasonable actions necessary to carry out the responsibilities and duties set forth in the Massage Therapy Act, including hiring staff. This bill would prohibit the total annual salary for any individual employed or contracted by the council from exceeding the annual salary provided to certain state officers during that fiscal year. Existing law requires the council to issue a certificate to practice massage therapy to an applicant who meets specified qualifications, including that the applicant has successfully completed at least 500 hours in the curricula in massage and related subjects, as specified, from approved schools. Existing law requires the council to determine whether the school from which an applicant has obtained their education meets the requirement of the Massage Therapy Act. If the council has any reason to question whether or not the applicant received that education from the school or schools that the applicant is claiming, existing law requires the council to investigate the facts to determine that the applicant received the education before issuing the certificate. This bill would authorize, instead of require, the council to conduct that investigation regarding the applicant's education, as described above. The bill would require an applicant who meets all of the other requirements for certification and who received the instruction described above at an approved school that was not under formal investigation at the time at which the applicant began instruction but was subsequently placed under investigation by the council to, as a condition of certification, have the opportunity for an interview or educational hearing, as specified, provided that their application for certification was submitted to the council no more than 90 days from the date of a final decision by the council to revoke the school's approval. The bill would require the council to issue a certificate to any applicant who successfully passes the interview or hearing, provided that the school at which the applicant completed the instruction was a school approved by the council within 90 days from the date the applicant submitted their application for certification and was considered to be in good standing, as specified, at the time the applicant passed the interview or hearing. Existing law, beginning January 1, 2027, also requires an applicant to pass a massage and bodywork competency assessment examination that meets generally recognized psychometric principles and standards and that is approved by the council, as specified. The bill would remove the requirement that an applicant pass a massage and bodywork competency assessment examination as described above, and would require an approved massage school, upon each student's completion of curriculum at the massage school, to provide notice to the student that the massage and bodywork competency assessment examination is not a requirement for certification but may be required for licensure or certification as a massage therapist in any other state. Existing law requires a certificate holder to notify the council within 30 days of any changes in the certificate holder's home address or the address of any massage establishment or other location where the certificate holder provides massage for compensation, except as specified. This bill would also require a certificate holder to notify the council within 30 days of any changes in the certificate holder's legal name. Existing law makes it a violation of the Massage Therapy Act for an applicant or certificate holder to commit certain acts, and makes the commission of those acts grounds for the council to deny an application for a certificate or to impose discipline on a certificate holder. Those acts include being convicted of any felony, misdemeanor, infraction, or municipal code violation, providing massage of female breasts without the written consent of the person receiving the massage and a referral from a licensed California health care provider, and dressing in certain attire or manners while engaged in the practice of massage for compensation, or while visible to clients in a massage establishment as specified. This bill would specify that the council may take action for a conviction, as described above, when the time for appeal has elapsed, the judgment of conviction has been affirmed on appeal, or an order granting probation is made suspending the imposition of sentence. The bill would define a "conviction" for these purposes to mean a judgment following a plea or verdict of guilty, a plea of nolo contendere, or a finding of guilt. The bill would also revise and recast the above-described acts that are considered a violation of the Massage Therapy Act. In this regard, the bill would remove the requirement of a referral from a licensed California health care provider to provide massage of female breasts. The bill would remove the list of prohibited attire or manners of dressing while engaged in the practice of massage for compensation, or while visible to clients in a massage establishment, except that the bill would maintain the prohibition on dressing in a manner that is deemed by the council to constitute unprofessional attire based on the custom and practice of the profession in California. The bill would also include among those specified acts that are considered a violation the determination of being a threat to public safety based on mental health reasons by a medical or mental health professional, or the rendering of a finding of not guilty in a criminal proceeding by reason of insanity. Existing law authorizes a board to deny a license on the grounds that the applicant has been convicted of a crime or was subject to formal discipline within the preceding 7 years from the date of application based on professional misconduct that is substantially related to the qualifications, functions, or duties of the business or profession for which the present application is made, as specified and subject to certain exceptions. This bill would require the denial of an initial certificate to practice massage therapy on the grounds that the applicant has been convicted of a crime or has been subject to formal discipline as provided under the act to be consistent with the above-described provisions authorizing a board to deny a license on certain grounds. Existing law requires the council to follow specified procedures for deciding upon and imposing the denial of a certificate or the discipline of a certificate holder under the Massage Therapy Act. Existing law requires, with certain exceptions, the council to provide an opportunity for the applicant or certificate holder to be heard, orally or in writing, not less than 5 days before the effective date of the denial or discipline, by a person or body authorized to decide whether the proposed denial or discipline should go into effect. This bill would require the person or body authorized to make that decision to be qualified. The bill would authorize an applicant or certificate holder to request an appeal of a final decision of the council to deny a certificate or discipline a certificate holder by submitting a request in writing within 30 days of the date of the final decision. In this regard, the bill would require a request to appeal a final decision to be considered by a committee of the board of directors within 120 days of the final decision, as specified. If a request to appeal is granted, the bill would require the appeal of the final decision to be heard at the next board of directors meeting, as specified, that is at least 120 days from the date that the request to appeal was granted, except as specified. The bill would require the council to notify the applicant or certificate holder of its right to request an appeal pursuant to these provisions at the time of the final decision. Existing law requires the council to develop policies, procedures, rules, or bylaws governing the requirements and processes for approving, denying approval of, imposing corrective action on, or unapproving schools from which applicants obtain their education, as specified. Existing law requires the council, on or before one year from the date the council receives an initial application for approval as a school, to approve the school, propose to deny approval of the school, or notify the school that corrective action is required, and authorizes the council to deny the application of a school that fails to adequately rectify the deficiencies. Existing law authorizes a school to appeal the council's final decision to deny approval of the school, and requires the appeal to be heard at the next board of directors meeting, as specified. This bill would require the council to notify the school of its right to appeal pursuant to these provisions at the time of the final decision. Existing law states the intent of the Legislature that, among other things, the Massage Therapy Act enables consumers and local government to more easily identify certified massage professionals and provide for consistent statewide certification and oversight of massage professionals. Existing law repeals the Massage Therapy Act on January 1, 2026. This bill would also state the intent of the Legislature that, among other things, both state and local regulation of massage therapy reflect the recognized status of certified massage professionals as health care providers. The bill would instead repeal the act on January 1, 2030. Existing law, the Bagley-Keene Open Meeting Act, requires, with specified exceptions, that all meetings of a state body be open and public and all persons be permitted to attend any meeting of a state body. The act imposes various requirements on a state body holding a meeting subject to the act, including, among other things, requiring the state body to provide notice of its meeting to any person who requests that notice in writing. The Massage Therapy Act requires meetings of the council to be subject to the rules of the Bagley-Keene Open Meeting Act, and authorizes the board to adopt additional policies and procedures that provide greater transparency to certificate holders and the public than required by the act. This bill would, except as otherwise provided in the Massage Therapy Act, require meetings of the council to be governed by either Rosenberg's Rules of Order or Robert's Rules of Order, Newly Revised. The bill would require the council to provide a meaningful opportunity for public participation in the adoption, amendment, or repeal of any policies, procedures, rules, or bylaws that substantially impact the rights, benefits, privileges, duties, obligations, or responsibilities of individuals or entities subject to certification or approval by the council, including, among other things, actions by the council to increase fees. In this regard, the bill would require the council, at a minimum, to publish the complete text of any policies, procedures, rules, or bylaws proposed for adoption, amendment, or repeal along with a summary of the changes being considered for a period of at least 45 calendar days before the adoption, amendment, or repeal, and to accept written public comments during the 45-day period and allow further public comment during a meeting held for these purposes. Existing law, the California Public Records Act, requires state and local agencies to make their records available for public inspection, unless an exemption from disclosure applies. This bill would require the council, beginning July 1, 2027, and to the extent practicable, to make the records of the council available for public inspection in a manner consistent with the California Public Records Act, as specified, and would authorize the council to charge for the direct costs of responding to requests for records, as specified. (2) Existing law establishes the California Private Postsecondary Education Act of 2009, which provides for student protections and regulatory oversight of private postsecondary educational institutions, as defined, in the state. The act is enforced by the Bureau for Private Postsecondary Education within the Department of Consumer Affairs. Existing law requires an institution with an approval to operate under the act that knows that it is being investigated by an oversight entity other than the bureau to report that investigation, as defined, to the bureau in writing within 30 days of the institution's first knowledge of the investigation, and requires an institution with an approval to operate under the act that is the subject of a judgment by, a regulatory action by, increased oversight or monitoring by, or a settlement with, any oversight entity other than the bureau to report it to the bureau within 30 days. Existing law defines "oversight entity" for these purposes to include, among other entities, a governmental agency. This bill would also include any private entity authorized pursuant to any provision of the Business and Professions Code to approve schools or educational programs for purposes of a professional certification as an "oversight entity" for the above-described purposes.

Existing law, the Lanterman-Petris-Short Act, authorizes the involuntary commitment and treatment of persons with specified mental disorders. Under the act, when a person, as a result of a mental health disorder, is a danger to self or others, or gravely disabled, the person may, upon probable cause, be taken into custody by specified individuals, including, among others, by a peace officer, a designated member of a mobile crisis team, or a professional person designated by the county, and placed in a facility designated by the county and approved by the State Department of Health Care Services for up to 72 hours for evaluation and treatment. Existing law authorizes county behavioral health director to develop procedures for the county's designation and training of professionals who will be designated to perform the above-described provisions. Existing law authorizes the procedures to include, among others, the license types, practice disciplines, and clinical experience of the professionals eligible to be designated by the county. Existing law exempts specified individuals, including a peace officer responsible for the detainment of a person under these provisions from criminal and civil liability for an action by a person who is released at or before the end of the period for which they were detained. This bill would require a county behavioral health director to include an emergency physician, as defined, as one of the practice disciplines eligible to be designated by the county when developing and implementing procedures for the designation and training of those professionals. The bill would also exempt an emergency physician who is responsible for the detainment of a person under those provisions from criminal and civil liability, as specified.

Existing law establishes the California Interagency Council on Homelessness to oversee the implementation of Housing First guidelines and regulations, and, among other things, identify resources, benefits, and services that can be accessed to prevent and end homelessness in California. Existing law requires a state agency or department that funds, implements, or administers a state program that provides housing or housing-related services to people experiencing homelessness or who are at risk of homelessness to revise or adopt guidelines and regulations to include enumerated Housing First policies. Existing law specifies the core components of Housing First, including services that are informed by a harm-reduction philosophy that recognizes drug and alcohol use and addiction as a part of tenants' lives and where tenants are engaged in nonjudgmental communication regarding drug and alcohol use. This bill would authorize state programs to fund supportive-recovery residences, as defined, that emphasize abstinence under these provisions as long as the state program meets specified criteria, including that at least 90% of program funds awarded to each jurisdiction is used for housing or housing-based services using a harm-reduction model. This bill would specify requirements for applicants seeking funds under these programs and would require the state to perform periodic monitoring of select supportive-recovery residence programs to ensure that the supportive-recovery residences meet certain requirements, including that core outcomes of the supportive-recovery housing emphasize long-term housing stability and minimize returns to homelessness. The bill would also prohibit eviction on the basis of relapse, as specified. The bill would require, if a tenant is no longer interested in living in a supportive-recovery residence with an abstinence focus, is at risk of eviction, or is discharged from the program, the tenant to reside in the supportive recovery residence until the operator secures the tenant a new permanent housing placement option operated with harm-reduction principles that is also permanent housing. The bill would require supportive housing and services to support residents' access to and use of medications to treat behavioral and physical health conditions, as specified, and to provide overdose prevention training and overdose reversal medication to staff and residents, as specified. Existing law establishes the Department of Housing and Community Development and requires it to administer various programs that provide services to homeless individuals. This bill would require the department to adopt the most recent standards approved by the National Alliance for Recovery Residences or other national standards as the minimum standard for supportive-recovery residences that receive public funds under these provisions. The bill would require the department to establish a separate process for determining if the supportive-recovery residence complies with the core components of Housing First. The bill would require the department to verify compliance with the core components of Housing First for residences seeking Housing First certification, as specified. The bill would authorize the department to charge an annual fee to verify that supportive-recovery residences comply with the core components of Housing First in an amount not to exceed the reasonable cost of administering the program, not to exceed $100, and would establish the Supportive-Recovery Residence Program Fund for collection of the fee, to be available upon appropriation by the Legislature.