Bill Text: CA AB173 | 2025-2026 | Regular Session | Chaptered

California Assembly Bill 173

Bill Title: Health.

Sponsorship: Committee Bill

Status: (Passed) 2026-09-18 - Chaptered by Secretary of State - Chapter 252, Statutes of 2026. [AB173 Detail]

Download: California-2025-AB173-Chaptered.html

Assembly Bill No. 173

CHAPTER 252

An act to amend Sections 53123.1.5, 53123.2, 53123.3, and 53123.4 of, and to add Sections 53123.7 and 53123.8 to, the Government Code, to amend Sections 1280.3, 32121, and 120956 of, to add Section 130206 to, and to add Chapter 3.5 (commencing with Section 131325) to Part 1 of Division 112 of, the Health and Safety Code, to amend Sections 41030, 41031, 41135, and 41136 of the Revenue and Taxation Code, and to amend Sections 14005.11, 14005.36, 14007.5, 14007.8, 14043.2, 14043.27, 14043.28, 14043.36, 14043.55, 14107.11, 14132.26, and 14184.201 of the Welfare and Institutions Code, relating to health, and making an appropriation therefor, to take effect immediately, bill related to the budget.

[ Approved by Governor September 18, 2026. Filed with Secretary of State September 18, 2026. ]

LEGISLATIVE COUNSEL'S DIGEST

AB 173, Committee on Budget. Health.

(1) Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is in part governed by, and funded pursuant to, federal Medicaid program provisions.

Existing law sets forth qualifications and procedures for the enrollment of providers in the Medi-Cal program, including the completion of a provider agreement and disclosure of certain information as required in federal Medicaid regulations or by the department. Under existing law, failure to disclose the required information, or the disclosure of false information, results in denial of the application for enrollment or makes the provider subject to temporary suspension from the Medi-Cal program, as specified.

This bill would require the department, subject to receipt of necessary federal approvals, to deny an application for enrollment or to terminate the enrollment of a provider if the applicant or provider discloses an affiliation within the previous 5 years with any person or entity that has experienced a disclosable event, as defined, if the department determines that the affiliation poses an undue risk of fraud, waste, or abuse to the Medi‑Cal program. The bill would require the department to apply certain factors set forth in federal regulations for purposes of the risk determination. The bill would authorize the department to take action, regardless of a disclosure, if the affiliation poses the above-described undue risk.

Existing law sets forth various provisions relating to the termination of provisional provider status that is granted to an applicant or provider.

This bill would also apply those provisions to an applicant or provider that is granted preferred provisional provider status or full-enrollment status. The bill would make conforming changes to related provisions. The bill would change existing criteria, and would impose additional criteria, for compliance and grounds for denial, suspension, or termination.

Under existing law, if it is discovered that a provider is under investigation by the department or any state, local, or federal government law enforcement agency for fraud or abuse, the provider is subject to temporary suspension from the Medi-Cal program.

This bill would remove the qualification that the agency be a law enforcement agency and would specify that the provision applies to any local, state, or federal program, at the department’s discretion.

Existing law requires the Director of Health Care Services to notify the provider of the temporary suspension and deactivation of the provider’s number, which takes effect 15 days from the date of the notification.

This bill would instead make the temporary suspension and deactivation effective on the date the department sends the notification. The bill would set forth certain procedures based on the notification delivery method.

Existing law authorizes the department to implement a 180-day moratorium, with potential extensions, on the enrollment of providers, with an exception for certain clinics, health facilities, or natural persons licensed or certified as certain health care professionals, when the director determines that this action is necessary to safeguard public funds or to maintain the fiscal integrity of the program.

This bill would remove the above-described exception for the specified providers. The bill would require the department to provide written notice to the Joint Legislative Budget Committee, and to provide a new notification every 180 days that a moratorium is in effect, as specified.

The bill would make other changes to related provisions regarding verification of a credible allegation of fraud.

(2) Existing law requires the department to develop a program that requires a waiver of federal law to test the efficacy of providing an assisted living benefit to beneficiaries under the Medi-Cal program, as specified.

This bill would authorize the department to implement those provisions through all-county letters or similar instructions, without taking any further regulatory action.

(3) Existing law requires the department to standardize applicable covered Medi-Cal benefits provided by Medi-Cal managed care plans under comprehensive risk contracts with the department on a statewide basis and across all models of Medi-Cal managed care, in accordance with the Terms and Conditions of the California Advancing and Innovating Medi-Cal (CalAIM) initiative. Existing law requires that Community-Based Adult Services (CBAS) continue to be available as a capitated benefit for a qualified Medi-Cal beneficiary under a comprehensive risk contract with an applicable Medi-Cal managed care plan.

This bill would require the department and the California Department of Aging to collaborate with certain entities to understand CBAS center closures. The bill would require the department, on or before March 1, 2029, to update the Legislature and the Legislative Analyst’s Office on CBAS center closures, as specified.

(4) Under existing law, until October 1, 2026, an individual who is not a citizen or a national of the United States who has a specified immigration status is eligible for the full scope of Medi-Cal benefits. Under existing law, beginning October 2, 2026, and until June 30, 2027, that individual is eligible for the full scope of Medi-Cal state-funded benefits, subject to certain service limitations relating to dental care.

This bill would restructure those provisions and would state that, beginning October 1, 2026, the above-described individual would only be eligible for the full scope of Medi-Cal benefits if that individual meets any of certain criteria. The bill would specify that, beginning October 1, 2026, and through June 30, 2027, the individual, if not described in certain federal provisions, would be eligible for the full scope of Medi-Cal state-funded benefits. The bill would exempt, from the above-described service limitations relating to dental care, individuals who are pregnant or entitled to postpartum medical assistance. The bill would make conforming changes or other technical changes to various Medi-Cal provisions. To the extent that the bill would create new duties for counties relating to Medi-Cal eligibility, the bill would impose a state-mandated local program.

Under the bill, effective October 1, 2026, for certain individuals under restricted-scope Medi-Cal, maintenance dialysis services medically necessary for the treatment of chronic dialysis and end-stage renal disease, as specified, would be covered services regardless of whether the treatment meets the definition of an emergency medical condition. To the extent that federal financial participation is unavailable for those services, the bill would require the department to fund those services subject to an appropriation, as specified.

The bill would require the department to issue guidance to Medi-Cal fee-for-service providers implementing these provisions.

(5) Existing law provides for the licensure and regulation of various health facilities, including general acute care hospitals, acute psychiatric hospitals, and special hospitals, by the State Department of Public Health. If the department determines that any of those specified facilities has violated a certain regulation relating to nurse-to-patient ratios, existing law requires the department to assess an administrative penalty, as specified. Under existing law, a general acute care hospital is not subject to that penalty if the hospital demonstrates to the satisfaction of the department certain criteria, including that prompt efforts were made to maintain required staffing levels.

This bill would extend that penalty exemption to acute psychiatric hospitals.

(6) Under existing law, all rebates collected from drug manufacturers on drugs purchased through the AIDS Drug Assistance Program and interest earned on those moneys are deposited in the continuously appropriated AIDS Drug Assistance Program Rebate Fund exclusively to cover costs related to any of certain expenditures. Among those expenditure categories is, to the extent that funding is available, housing support for individuals living with HIV who are eligible for the Housing Opportunities for Persons with AIDS program based on income, but are otherwise ineligible for the program, and are current residents of California.

For purposes of the above-described category, this bill would qualify the program eligibility of the population as being based on income and HIV status.

(7) Existing law establishes, within the California Health and Human Services Agency, the Center for Data Insights and Innovation to ensure the enforcement of state law mandating the confidentiality of medical information.

This bill would make all personal information obtained or maintained by the center confidential. Under the bill, among other privacy protections, personal information collected by the center from other state entities would generally be exempt from the disclosure requirements of the California Public Records Act. The bill would prohibit the use of any collected or obtained information for determinations regarding individual patient care or treatment or for any individual eligibility or coverage decisions or similar purposes.

(8) Existing law, the Local Health Care District Law, authorizes the organization and incorporation of local health care districts and specifies the powers of those districts, including, among other things, the power to establish, maintain, and operate, or provide assistance in the operation of, one or more health facilities or health services.

Existing law authorizes a local health care district to transfer, at fair market value, any part of its assets to one or more corporations to operate and maintain the assets, subject to voter approval for transfers of 50% or more of the district’s assets, as specified. Existing law also authorizes a local health care district to transfer its assets to one or more nonprofit corporations to operate and maintain the assets for the benefit of the communities served by the district without adequate consideration upon specified conditions being satisfied, subject to voter approval for transfers of 50% or more of the district’s assets.

This bill, notwithstanding those provisions, would authorize Palomar Health District to transfer its assets to the Palomar UC San Diego Health Authority if certain conditions are satisfied, including that the board of directors of Palomar Health District adopts a resolution approved by a majority of the board authorizing the execution, delivery, and performance of the operative agreements necessary for the transfer of Palomar Health District assets to the authority and that related agreements contain enforceable covenants requiring that the authority operate and maintain the transferred assets for the provision of health care services for not less than 10 years from the effective date of the transfer of the assets, as specified. The bill would make this authorization apply retroactively to any transfer of Palomar Health District assets to the authority that was approved by the board on or after January 1, 2025, and that, at the time of the board’s approval, would have satisfied specified conditions. If Palomar Health District does not execute a transfer agreement with the authority on or before December 31, 2028, the bill would make the authorization to enter into a transfer agreement expire on December 31, 2028.

The bill would prohibit the authority from transferring, selling, leasing, or otherwise conveying all or substantially all of the assets transferred to it pursuant to these provisions by Palomar Health District without the prior approval of the board of directors. At least 30 days prior to the transfer of all or substantially all of its assets pursuant to these provisions, the bill would require the authority to hold at least 2 public hearings, as specified. Within 30 days of any transfer of Palomar Health District assets, the bill would require Palomar Health District to report to the Attorney General specified information, including, among other things, a description of the assets transferred and a summary of the consideration received.

The bill would make legislative findings and declarations as to the necessity of a special statute for Palomar Health District.

(9) Existing federal law, the National Suicide Hotline Designation Act of 2020, designates the 3-digit telephone number “988” as the universal number within the United States for the purpose of the national suicide prevention and mental health crisis hotline system operating through the 988 Suicide & Crisis Lifeline.

Existing law, the Miles Hall Lifeline and Suicide Prevention Act, requires, among other things, the California Health and Human Services Agency (agency) to create, no later than December 31, 2024, a set of recommendations to support a 5-year implementation plan for a comprehensive 988 system. Existing law requires the agency to convene a state 988 advisory group for purposes of advising the agency on the set of recommendations and requires the recommendations to include specified information. Existing law requires the advisory group to meet at least once per quarter until December 31, 2024. Existing law authorizes the agency to disband the advisory group on or after January 1, 2025. Existing law requires the agency, until December 31, 2029, to post regular updates, no less than annually, regarding the implementation of 988 on its public internet website.

This bill would require the advisory group to meet at least once per quarter until December 31, 2029. The bill would authorize the agency to disband or reconvene the advisory group on or after January 1, 2030. The bill would require the above-described regular updates to include, among other things, the progress toward implementing an interoperable solution between 988 and 911. The bill would require the agency, subject to an appropriation, to maintain a 988 System Governance Board to provide cross-agency coordination and oversight related to implementation of the 988 system until January 1, 2030. The bill would require the State Department of Health Care Services (DHCS) to be responsible for oversight of 988 center and designated 988 center operations, among other things. The bill would require the Emergency Medical Services Authority (authority) to establish statewide training and protocol standards for specified personnel.

Existing law requires the Office of Emergency Services (office) to establish and convene the State 988 Technical Advisory Board for purposes of advising the office on, among other things, recommendations on the feasibility and plan for sustainable interoperability between 988, 911, and behavioral health crisis services. Existing law requires the advisory board to meet no less than quarterly until December 31, 2028. Existing law, after December 31, 2028, authorizes the office to disband the advisory board. Existing law requires the office to appoint a 988 system director to implement and oversee the policy and regulatory framework for the technology infrastructure, coordination, and transfer of calls between 988, 911, and behavioral health crisis services.

This bill would require the advisory board to meet no less than quarterly until December 31, 2029, and thereafter, would authorize the office to disband or reconvene the advisory board. The bill would delete the requirement for the office to appoint a 988 system director. The bill, on or before December 31, 2029, would require the office to procure and implement an interoperable solution, as defined. No later than January 1, 2028, the bill would require the authority to develop and adopt voluntary statewide protocols governing the transfer of calls and communications between 911 public safety answering points and 988 centers or designated 988 centers and mobile crisis team dispatch points, as specified.

Existing law establishes the 988 State Suicide and Behavioral Health Crisis Services Fund and provides that 988 surcharge revenue in the fund is used solely for the operations of the 988 centers and mobile crisis teams. Existing law requires an entity seeking available funds to annually file an expenditure and outcomes report.

This bill would require the 988 surcharge revenue to be used solely for the operations of the 988 centers, until December 31, 2029, designated 988 centers, and mobile crisis teams. The bill would require DHCS to develop and update, as necessary, a 2-year statewide funding estimate for 988 centers, until December 31, 2029, designated 988 centers, and state administrative costs to be used to inform the Legislature’s appropriation from the 988 State Suicide and Behavioral Health Crisis Services Fund, as specified. The bill would require an entity seeking available funds to annually file an expenditure, revenues, and outcomes report. The bill would require DHCS to review and either approve or deny the report. If the report is not approved, the bill would require DHCS to provide technical assistance to the entity to correct and resubmit the report for approval. The bill would require the agency to develop recommendations for a system of funding for the operation of mobile crisis teams.

The bill would require DHCS, no sooner than October 1, 2027, to establish a process for entities to apply for approval by DHCS as a designated 988 center, standards to ensure that a designated 988 center provides quality services, and standards for the oversight and monitoring of designated 988 centers. The bill would impose various requirements on a designated 988 center, including furnishing all information, records, and documentation requested by DHCS and submitting and complying with an approved corrective action plan as required by DHCS. The bill would require DHCS, beginning on January 1, 2028, to make specified information publicly available on its internet website, including any corrective action plans, suspensions, or revocations imposed upon a designated 988 center. The bill would require a 988 center to obtain approval as a designated 988 center from DHCS by December 31, 2029, after which a 988 center that is not approved as a designated 988 center may no longer receive funds.

The bill would require the State Department of Public Health, in consultation with DHCS, to implement public awareness strategies to assist in the implementation of the 988 Suicide & Crisis Lifeline in the state, as specified.

The bill would require the agency to annually determine whether an adequate specialized LGBTQ+ suicide prevention hotline is activated by the federal government under 988. When making this determination, the bill would require the agency to consider specified factors. The bill would authorize the agency to request the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to allow the state to implement the press 3 function at the state level for calls originating in the State of California, which would allow callers to dial “988” and press “3” to be automatically routed to a specialized 988 center. The bill would require the office and the agency, no later than 12 months following the approval by SAMHSA, to ensure that press 3 function technologies are available.

The bill would require the agency, no later than 12 months following approval by SAMHSA, to identify and contract with a qualified entity or entities that specialize in LGBTQ+ suicide prevention services. The bill would require the agency to determine the eligibility criteria, establish an application process, and administer funds to the qualified entity, as specified. The bill would require a qualified entity to comply with various requirements, including having a primary objective of reducing suicide rates or addressing mental health crises.

Existing law requires the office to determine annually, on or before October 1, to be effective on January 1 of the following year, surcharge amounts, as specified, that it estimates will produce sufficient revenue to fund the current fiscal year’s 911 and 988 costs. Existing law requires the office, at least 30 days before determining the surcharge, to prepare a summary of the calculation of the proposed surcharge amounts and make it available to, among others, relevant departments.

This bill would specify that relevant departments, for purposes of the above requirement, include DHCS. The bill would make conforming changes to related provisions.

(10) Existing constitutional provisions require that a statute that limits the right of access to the meetings of public bodies or the writings of public officials and agencies be adopted with findings demonstrating the interest protected by the limitation and the need for protecting that interest.

This bill would make legislative findings to that effect.

(11) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

(12) This bill would appropriate $105,611,000, $5,975,000, and $1,229,000 from the Federal Trust Fund to the State Department of Health Care Services, to be made available for encumbrance or expenditure through June 30, 2027, to expend State Opioid Response Grant funds and Substance Abuse Prevention and Treatment Block Grant funds, as specified.

(13) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.

Vote: MAJORITY Appropriation: YES Fiscal Committee: YES Local Program: YES

The people of the State of California do enact as follows:

SECTION 1.

Section 53123.1.5 of the Government Code is amended to read:

53123.1.5.

For purposes of this article, the following definitions shall apply:

(a) “988” means the three-digit telephone number designated by the Federal Communications Commission for the purpose of connecting individuals experiencing a behavioral health crisis with the national suicide prevention and mental health crisis hotline system in accordance with Section 52.200 of Title 47 of the Code of Federal Regulations.

(b) “988 center” means a center operating on a county or regional basis in California and participating in the National Suicide Prevention Lifeline network to respond to statewide or regional 988 calls.

(d) “Behavioral health crisis services” means the continuum of services to address crisis intervention, crisis stabilization, and crisis residential treatment needs of those with a mental health or substance use disorder crisis that are wellness, resiliency, and recovery oriented. These include, but are not limited to, crisis intervention, including counseling provided by 988 centers, designated 988 centers, mobile crisis teams, and crisis stabilization services.

(e) “Designated 988 center” means a center that has applied for and obtained approval from the State Department of Health Care Services to operate a designated 988 center on a county or regional basis in California, participate in the National Suicide Prevention Lifeline network to respond to statewide or regional 988 calls, and receive funding from the 988 State Suicide and Behavioral Health Crisis Services Fund.

(f) “Interoperable solution” means a preprogrammed function capable of facilitating real-time communication between 911 public safety answering points and 988 centers or designated 988 centers, including, but not limited to, call merging and warm handoffs.

(g) “Mobile crisis team” means a multidisciplinary behavioral health provider team that meets the standards and requirements to provide community-based mobile crisis response services under the Medi-Cal program and other requirements as set forth by the State Department of Health Care Services.

(h) “National Suicide Prevention Lifeline” or “988 Suicide & Crisis Lifeline” means the national network of local crisis hotline centers that provide free and confidential support to people in suicidal crisis or other behavioral health crisis 24 hours per day, seven days per week via a toll-free telephone hotline number that receives calls made through the 988 system. The toll-free telephone number is maintained by the Assistant Secretary for Mental Health and Substance Use under Section 520E-3 of the Public Health Service Act, Section 290bb-36c of Title 42 of the United States Code.

(i) “Office” means the Office of Emergency Services.

(j) “Substance Abuse and Mental Health Services Administration” means that agency of the United States Department of Health and Human Services.

SEC. 2.

Section 53123.2 of the Government Code is amended to read:

53123.2.

(a) No later than July 16, 2022, the Office of Emergency Services shall verify that technology that allows for transfers between 988 centers, as well as between 988 centers and 911 public safety answering points, is available to 988 centers and 911 public safety answering points throughout California.

(b) (1) No later than 90 days after the passage of this act, the office shall establish and convene the State 988 Technical Advisory Board for purposes of advising the office on both of the following:

(A) Recommendations on the feasibility and plan for sustainable interoperability between 988, 911, and behavioral health crisis services, including the identification of any legal or regulatory barriers to the transfer of 911 calls.

(B) The development of technical and operational standards for the 988 system that allow for coordination with California’s 911 system.

(2) The board shall meet no less than quarterly until December 31, 2029. Following that date, the board may be disbanded or reconvened at the discretion of the office.

(3) The board shall consist of a representative from the California Health and Human Services Agency and expert representatives, including, but not limited to, those from 988 centers, designated 988 centers, 911, county behavioral health agencies, and behavioral health crisis service providers.

(c) On or before December 31, 2029, the office, in consultation with the State Department of Health Care Services, shall procure and implement an interoperable solution, as defined in Section 53123.1.5.

(d) The office shall consult with the National Suicide Prevention Lifeline and the Substance Abuse and Mental Health Services Administration on any technology requirements for 988 centers and designated 988 centers.

(e) The office shall retain responsibility for an interoperable solution, including telecommunications coordination and related technology functions.

(f) (1) No later than January 1, 2028, the Emergency Medical Services Authority, in consultation with the Commission on Peace Officer Standards and Training, the California Health and Human Services Agency, the State Department of Health Care Services, and the office, shall develop and adopt voluntary statewide protocols governing the transfer of calls and communications between 911 public safety answering points and 988 centers or designated 988 centers and mobile crisis team dispatch points, including county behavioral health mobile crisis dispatch points. The voluntary protocols shall include all of the following:

(A) Criteria for transfers between 911, mobile crisis team dispatch, including county behavioral health mobile crisis dispatch, and 988.

(B) Procedures, protocols, and policies for warm handoffs.

(D) Coordination standards between 988 centers, designated 988 centers, emergency medical services providers, mobile crisis teams, including county behavioral health mobile crisis teams, public safety agencies, and other first responders.

(2) The Emergency Medical Services Authority shall confer with county behavioral health agencies, 988 centers until December 31, 2029, designated 988 centers, 911 public safety answering points, public safety agencies, and other first responders on the development of these protocols.

SEC. 3.

Section 53123.3 of the Government Code is amended to read:

53123.3.

(a) (1) No later than December 31, 2024, the California Health and Human Services Agency shall create a set of recommendations to support a five-year implementation plan for a comprehensive 988 system.

(2) The California Health and Human Services Agency shall convene a state 988 advisory group for purposes of advising the California Health and Human Services Agency on the set of recommendations to support the five-year implementation plan. The recommendations shall specify what can be accomplished pursuant to existing administrative authority and what will require additional legislation for implementation.

(3) The advisory group shall include, but is not limited to, the State Department of Health Care Services, the office, the State Department of Public Health, the Emergency Medical Services Authority, representatives of counties, representatives of employees working for county behavioral health agencies and agencies who subcontract with county behavioral health agencies who provide these services, health plans, emergency medical services, law enforcement, consumers, families, peers, 988 centers, designated 988 centers, and other local and statewide public agencies.

(4) The advisory group shall meet at least once per quarter until December 31, 2029.

(5) The advisory group may be disbanded or reconvened at the discretion of the California Health and Human Services Agency, but shall not be disbanded before January 1, 2030.

(b) The California Health and Human Services Agency and the advisory group shall make recommendations on all of the following:

(1) Federal Substance Abuse and Mental Health Services Administration requirements and national best practices guidelines for operational and clinical standards, including training requirements and policies for transferring callers to an appropriate specialized center, or subnetworks, within or external to, the National Suicide Prevention Lifeline network.

(2) Maintenance of an active agreement with the administrator of the National Suicide Prevention Lifeline for participation within the network.

(3) Compliance with state technology requirements or guidelines for the operation of 988.

(4) A state governance structure to support the implementation and administration of behavioral health crisis services accessed through 988.

(5) 988 infrastructure, staffing, and training standards that will support statewide access to crisis counselors through telephone call, text, and chat, 24 hours per day, seven days per week.

(6) Access to crisis stabilization services and triage and response to warm handoffs from 911 and 988 centers and designated 988 centers.

(7) Resources and policy changes to address statewide and regional needs in order to meet population needs for behavioral health crisis services.

(8) Statewide and regional public communications strategies informed by the National Suicide Prevention Lifeline and the Substance Abuse and Mental Health Services Administration to support public awareness and consistent messaging regarding 988 and behavioral health crisis services.

(9) Recommendations to achieve coordination between 988 and the continuum of behavioral health crisis services. Recommendations shall address strategies for verifying that behavioral health crisis services are coordinated for a timely response to clearly articulated suicidal or behavioral health contacts made or routed to 988 services as an alternative to a response from law enforcement, except in high-risk situations that cannot be safely managed without law enforcement response and achieving statewide provision of connection to mobile crisis services, when appropriate, to respond to individuals in crisis in a timely manner.

(10) Quantifiable goals for the provision of statewide and regional behavioral health crisis services, which consider factors such as reported rates of suicide attempts and deaths.

(11) A process for establishing outcome measures, benchmarks, and improvement targets for 988 centers and the behavioral health crisis services system. This may include recommendations regarding how to measure, the feasibility of measuring 988 system performance, including capacity, wait time, and the ability to meet demand for services for 988 State Suicide and Behavioral Health Crisis Services Fund fund recipients. This may also include recommendations for how to determine and report the amount billed to and reimbursed by Medi-Cal or other public and private health care service plans or insurers related to 988 services.

(12) Findings from a comprehensive assessment of the behavioral health crisis services system that takes into account infrastructure projects that are planned and funded. These findings shall include an inventory of the infrastructure, capacity, and needs for all of the following:

(A) Statewide and regional 988 centers.

(B) Mobile crisis team services, including mobile crisis access and dispatch call centers.

(D) Crisis stabilization services.

(13) Procedures for determining the annual operating revenues, expenditures, and 988 operational budget for the purposes of establishing the rate of the 988 surcharge and how revenue will be disbursed to fund the 988 system consistent with Section 53123.4 and Section 251a of Title 47 of the United States Code.

(14) Strategies to support the behavioral health crisis service system is adequately funded, including mechanisms for reimbursement of behavioral health crisis response pursuant to Sections 1374.72 and 1374.721 of the Health and Safety Code, including, but not limited to:

(A) To the extent that any necessary federal approvals are obtained and federal financial participation is available and is not otherwise jeopardized, seeking to maximize all available federal funding sources for the purposes of behavioral health crisis services and administrative activities related to 988 implementation, including federal Medicaid reimbursement for services; federal Medicaid reimbursement for administrative expenses, including the development and maintenance of information technology; and federal grants.

(B) Coordinating with the Department of Insurance and Department of Managed Health Care to verify reimbursement to 988 centers or designated 988 centers for behavioral health crisis services by health care service plans and disability insurers, pursuant to Section 1374.72 of the Health and Safety Code and Section 10144.5 of the Insurance Code and consistent with the requirements of the federal Mental Health Parity and Addiction Equity Act of 2008 (29 U.S.C. Sec. 1185a).

(c) Until December 31, 2029, the California Health and Human Services Agency shall post regular updates, no less than annually, regarding the implementation of 988 on its public internet website. The updates shall additionally include all of the following:

(1) Progress toward implementing an interoperable solution between 988 and 911.

(2) Progress toward statewide integration between 988 centers and mobile crisis teams, including behavioral health mobile crisis teams.

(3) Statewide answer rates for call, text messages, and chats.

(d) (1) The California Health and Human Services Agency shall, subject to an appropriation, maintain a 988 System Governance Board to provide cross-agency coordination and oversight related to implementation of the 988 system until January 1, 2030.

(2) The board shall include representatives from, at minimum, the California Health and Human Services Agency, the State Department of Health Care Services, the Emergency Medical Services Authority, the State Department of Public Health, the Department of Managed Health Care, the Department of Insurance, and the office.

(e) The State Department of Health Care Services shall be responsible for all of the following:

(1) Oversight of 988 center and designated 988 center operations.

(2) Beginning July 1, 2027, administration of the 988 State Suicide and Behavioral Health Crisis Services Fund established pursuant to Section 53123.4, except for technical interoperability functions retained by the office pursuant to Section 53123.2.

(3) Establishment of statewide standards and protocols to support least restrictive responses to behavioral health crises, including behavioral health or medical responses in lieu of law enforcement response whenever safe and appropriate.

(f) (1) The Emergency Medical Services Authority shall establish, in accordance with subdivision (f) of Section 53123.2, statewide training and protocol standards, in alignment with national best practices and California’s specific needs, for personnel involved in the following:

(A) Transfer of calls between 911 public safety answering points and 988 behavioral health crisis services.

(B) Medical triage.

(2) The Emergency Medical Services Authority may implement a quality monitoring program to oversee the effectiveness of the activities under paragraph (1) for medical and behavioral health calls. The authority may assess the quality of care and report on the system’s effectiveness to the California Health and Human Services Agency and the State Department of Health Care Services annually. System participants, including, but not limited to, state and local agencies, public safety answering points, 988 centers, and designated 988 centers, may provide the authority with the data necessary to perform the assessments as specified by the authority in regulations.

(3) The Emergency Medical Services Authority may adopt regulations, in accordance with Section 1797.107 of the Health and Safety Code, to implement this subdivision.

(g) This section does not prohibit 988 centers and designated 988 centers from coordinating with other behavioral health crisis response entities, including city-operated or locally operated mobile crisis teams.

SEC. 4.

Section 53123.4 of the Government Code is amended to read:

53123.4.

(a) The 988 State Suicide and Behavioral Health Crisis Services Fund is hereby established in the State Treasury.

(b) (1) The fund shall consist of the revenue generated by the 988 surcharge assessed on users under Section 41020 of the Revenue and Taxation Code, which revenue shall be used in compliance with subdivision (c) of Section 53123.7, solely for the operations of the 988 centers until December 31, 2029, or designated 988 centers and mobile crisis teams, which may include any expenditures authorized pursuant to Section 251a of Title 47 of the United States Code and any applicable rules or regulations adopted by the Federal Communications Commission, including, but not limited to, state administration expenditures, including personnel and other related costs. The fund shall also consist of any other appropriations made to it by the Legislature. The Legislature may consider additional uses for the revenue generated by the 988 surcharge based on recommendations made by the California Health and Human Services Agency and the advisory group pursuant to subdivision (b) of Section 53123.3.

(2) The revenue generated by the 988 surcharge shall, to the extent not prohibited by Section 251a of Title 47 of the United States Code and any applicable rules or regulations adopted by the Federal Communications Commission and in compliance with subdivision (b) of Section 41136 of the Revenue and Taxation Code, be prioritized to fund the following:

(A) First, the 988 centers, until December 31, 2029, and designated 988 centers, including the efficient and effective routing of telephone calls, personnel, and the provision of acute behavioral health services through telephone call, text, and chat to the 988 number.

(B) Second, the operation of mobile crisis teams accessed via telephone calls, texts, or chats made to or routed through 988 as specified under Section 4(a)(2)(B) of Public Law 116-172.

(3) Money in the fund shall not be subject to transfer to another fund or to transfer, assignment, or reassignment for another use or purpose outside of those specified in this article.

(4) 988 surcharge revenue in the fund shall be available, upon appropriation by the Legislature, for the purposes specified in this article.

(5) The revenue generated by the 988 surcharge shall be used to supplement, not supplant, federal, state, and local funding for 988 centers, designated 988 centers, and behavioral health crisis services.

(6) The revenue generated by the 988 surcharge may only be used to fund service and operation expenses that are not reimbursable through Medicaid federal financial participation, Medicare, health care service plans, or disability insurers.

(c) (1) The State Department of Health Care Services shall develop and update, as necessary, a two-year statewide funding estimate for 988 centers, until December 31, 2029, designated 988 centers, and state administrative costs. The annual statewide funding estimate may be used to inform the Legislature’s appropriation from the 988 State Suicide and Behavioral Health Crisis Services Fund for the operations of 988 centers, until December 31, 2029, designated 988 centers, and state administrative costs.

(2) The statewide funding estimate shall be developed through a public process with input from stakeholders, including, but not limited to, representatives of 988 centers, until December 31, 2029, designated 988 centers, and mobile crisis response teams, including county behavioral health agencies.

(3) Commencing with the 2027–28 fiscal year, and each fiscal year thereafter, the State Department of Health Care Services shall project an annual statewide funding estimate for the next fiscal year prior to the enactment of the annual Budget Act for the next fiscal year.

(4) The statewide funding estimate shall consider factors, including, but not limited to, all of the following:

(A) Anticipated statewide call, text, and chat volume.

(B) Staffing and workforce levels necessary to meet projected demand.

(D) Geographic equity and statewide access needs, including rural access.

(E) Surge capacity and disaster readiness.

(F) Federal performance standards and national best practices.

(G) Preliminary assessment of the impact to the surcharge associated with the estimate.

(H) Compliance with the voluntary protocols established pursuant to subdivision (f) of Section 53123.2.

(d) The State Department of Health Care Services shall require an entity seeking funds available through the 988 State Suicide and Behavioral Health Crisis Services Fund to annually file an expenditure, revenues, and outcomes report in a form and manner as determined by the State Department of Health Care Services. The expenditure, revenues, and outcomes report shall include, but is not limited to, the following:

(1) The total budget.

(2) Number and job classification of personnel.

(3) The number of individuals served.

(4) The outcomes for individuals served, if known.

(5) The net revenues, expenditures, and sources of revenues for 988, including county behavioral health or other noncounty contracted or directly provided mobile crisis response, by the entity seeking funds.

(6) Beginning July 1, 2025, to the extent feasible and consistent with paragraph (11) of subdivision (b) of Section 53123.3, measures of system performance, including capacity, wait times, and the ability to meet demand for services and warm handoffs.

(7) Beginning January 1, 2030, to the extent feasible and consistent with paragraph (11) of subdivision (b) of Section 53123.3 the amount billed to and reimbursed by Medi-Cal or other public and private health care service plans or insurers.

(8) The number of individuals who used the service and self-identified as veterans or active military personnel, if known.

(9) Beginning on January 1, 2029, compliance with voluntary protocols pursuant to subdivision (f) of Section 53123.2.

(e) (1) The State Department of Health Care Services shall review and either approve or deny the annual expenditure, revenues, and outcomes report.

(2) If an entity’s annual expenditure, revenues, and outcomes report is not approved, the State Department of Health Care Services shall provide technical assistance to the entity to correct and resubmit the report for approval.

(f) The State Treasurer shall report annually to the office and the State Department of Health Care Services on fund deposits and expenditures.

(g) The California Health and Human Services Agency, in consultation with the office, the Department of Managed Health Care, the State Department of Health Care Services, the Department of Insurance, the Emergency Medical Services Authority, and relevant stakeholders, shall, subject to an appropriation, develop recommendations for a system of funding, which includes funding sources outside of the state General Fund, for the operation of mobile crisis teams in accordance with this article.

SEC. 5.

Section 53123.7 is added to the Government Code, to read:

53123.7.

(a) For purposes of this section, “department” means the State Department of Health Care Services.

(b) No sooner than October 1, 2027, the department shall establish a process for entities to apply for approval by the department as a designated 988 center, as defined in Section 53123.1.5. The framework approval process shall include, but not be limited to, all of the following:

(1) Eligibility criteria for approval of a designated 988 center.

(2) The duration of an entity’s approval as a designated 988 center.

(3) An application process for an entity to request approval as a designated 988 center or renewal as a designated 988 center.

(4) An application review process, including criteria for the department to approve or deny an entity’s application as a designated 988 center or an entity’s application for renewal as a designated 988 center.

(d) A 988 center that is not approved as a designated 988 center may only receive funds available through the 988 State Suicide and Behavioral Health Crisis Services Fund, as described in subdivision (a) of Section 53123.4, until December 31, 2029.

(e) No sooner than October 1, 2027, the department shall establish standards to ensure that a designated 988 center provides quality services. The standards shall include, but are not limited to, the following:

(1) Staffing requirements.

(2) Designated 988 center training requirements.

(3) Clinical and triage protocols for behavioral health services.

(4) Measures to assess the quality of services rendered by a designated 988 center.

(5) Performance requirements for designated 988 centers and counselor services.

(f) No sooner than October 1, 2027, the department shall establish standards for the oversight and monitoring of designated 988 centers.

(g) (1) A designated 988 center shall furnish all information, records, and documentation to the department for oversight and monitoring purposes, in a form and manner specified and requested by the department, to the extent allowed by applicable state and federal confidentiality and privacy laws. A designated 988 center shall preserve and provide any information, including books, records, papers, accounts, documents, video, and any writing, as defined in Section 250 of the Evidence Code, that the department deems necessary to review in compliance with applicable laws. A designated 988 center shall provide any information that the department deems necessary within 15 calendar days from the date of the department’s request unless an extension is granted.

(2) All personal information obtained or maintained under paragraph (1) shall be confidential pursuant to all applicable state and federal confidentiality and privacy laws.

(3) All policies and procedures developed in implementing paragraph (1) shall provide that the privacy, security, and confidentiality of consumers’ personal information is protected, as required by the Information Practices Act of 1977 (Chapter 1 (commencing with Section 1798) of Title 1.8 of Part 4 of Division 3 of the Civil Code), and consistent with state and federal health privacy laws, including the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Public Law 104-191) and the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code).

(4) Unless otherwise specified in this subdivision, personal information collected shall be exempt from the disclosure requirements of the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1), and shall not be made available except pursuant to paragraph (1).

(h) The department may conduct performance and compliance audits of designated 988 centers.

(1) The department may conduct onsite visits as part of the designation or redesignation process.

(2) The department may conduct onsite visits at any time at any designated 988 center to evaluate compliance with any applicable requirements.

(3) The department may enter and inspect any building, or portion thereof, that contains a designated 988 center and its records, at a reasonable time, with or without notice, to secure information regarding compliance with, or to prevent a violation of, any applicable laws.

(i) The department may require a designated 988 center to take specified actions to correct any noncompliance. As required by the department, the designated 988 center shall submit a corrective action plan to the department for approval and shall comply with an approved corrective action plan. The department may specify timeframes and deadlines for submission of a corrective action plan and for correction of noncompliance.

(j) The department may suspend or revoke a designation issued under this article to operate a designated 988 center, or deny an application for a designation issued under this article to operate a designated 988 center, upon any of the following grounds:

(1) Violation of any provision of this article, regulations or guidance adopted pursuant to this article, or any applicable laws.

(2) Misrepresentation of any material fact in obtaining a designation, including, but not limited to, providing false information or documentation to the department.

(3) Refusal by a designated 988 center or applicant to respond to a request pursuant to subdivision (g), or to allow the department entry into the facility to determine performance or compliance with the requirements of this article, regulations or guidance adopted pursuant to this article, or any applicable laws.

(4) Failure to implement a corrective action plan as mandated by the department to achieve compliance with any of the provisions of this article, regulations or guidance adopted pursuant to this article, or any applicable laws.

(k) A designated 988 center that has had its designation suspended or revoked shall not receive funds available through the 988 State Suicide and Behavioral Health Crisis Services Fund and shall cease operations as a designated 988 center. A designated 988 center that has had its designation suspended shall not resume operations until its designation is reinstated. A designated 988 center that has had its designation revoked shall not resume operations unless it applies for and receives approval for a new designation.

(l) Beginning on January 1, 2028, the department shall make the following publicly available on its internet website:

(1) A list of 988 centers, as defined in Section 53123.1.5.

(2) A list of designated 988 centers, as defined in Section 53123.1.5.

(3) Any corrective action plans, suspensions, or revocations imposed upon a designated 988 center.

SEC. 6.

Section 53123.8 is added to the Government Code, to read:

53123.8.

(a) It is the intent of the Legislature to continue its long history of advancing policies that support suicide prevention efforts and further the initiative to address our youth mental health crisis. Young LGBTQ+ Californians have benefited from the 988 Suicide & Crisis Lifeline’s LGBTQ+ Youth Specialized Services program since 2022. It is the intent of the Legislature to reinstate this program in California.

(b) (1) Notwithstanding subdivision (f), the California Health and Human Services Agency shall annually determine whether an adequate specialized LGBTQ+ suicide prevention hotline is activated by the federal government under 988.

(2) When determining the adequacy of the federal press 3 option pursuant to this subdivision, the agency shall consider all of the following factors:

(A) All individuals identifying as LGBTQ+ may access the press 3 option.

(B) Federal guidance does not limit or discourage any individual identifying as LGBTQ+ from accessing the press 3 option.

(C) LGBTQ+ specialized organizations that have historically served, or may serve, LGBTQ+ individuals are not prohibited from operating or supporting the press 3 option.

(D) Any other factor the agency considers relevant to evaluating the adequacy of press 3 operations.

(c) If the agency has determined that a specialized LGBTQ+ suicide prevention hotline has not been activated by the federal government, as determined pursuant to subdivision (b), both of the following apply:

(1) No later than six months after the agency determines that an adequate specialized LGBTQ+ suicide prevention hotline has not been activated by the federal government under 988, the agency may request the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to allow the state to implement the press 3 function at the state level for calls originating in the State of California. A press 3 function shall allow callers to dial “988 ” and press “3” to be automatically routed to a specialized 988 center or designated 988 center, as set forth in subdivision (e).

(2) No later than 12 months following the approval of the request pursuant to paragraph (1) by SAMHSA or its contracted 988 Suicide & Crisis Lifeline Administrator, the agency and the Office of Emergency Services shall ensure that press 3 function technologies described in paragraph (1) are available.

(d) No later than 12 months following approval of the request submitted pursuant to paragraph (1) of subdivision (c), the agency shall identify and contract with a qualified entity or entities, as set forth in subdivision (e), that specialize in LGBTQ+ suicide prevention services. The agency shall determine the eligibility criteria, establish an application process, and administer funds to the qualified entity pursuant to this article. The agency shall also take into consideration whether the applicant is or was previously a part of the 988 Suicide & Crisis Lifeline network. The agency shall prioritize applicants that primarily service LGBTQ+ populations.

(e) A qualified entity shall comply with all of the following:

(1) Become a “988 center” and, by December 31, 2029, a “designated 988 center” as those terms are defined in Section 53123.1.5. As a 988 center, the qualified entity shall be eligible for funding until December 31, 2029, and shall be subject to the requirements under this article. A 988 center shall obtain designation from the State Department of Health Care Services by December 31, 2029, pursuant to Section 53123.7.

(2) Maintain policies that comply with the Confidentiality of Medical Information Act (CMIA) (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Public Law 104-191), and all other applicable state laws governing the protection of sensitive personal and medical information.

(3) Have a primary objective of reducing suicide rates or addressing mental health crises.

(4) Demonstrate that its mission includes serving the LGBTQ+ population or that it employs staff or volunteers who have completed extensive training in responding to LGBTQ+ crisis contacts in a culturally competent manner. The qualified entity shall ensure that trained staff or volunteers are available to respond to those contacts through an established routing system.

(f) This section shall only be implemented subject to an appropriation made by the Legislature and if both of the following occur:

(1) The agency obtains and maintains the necessary federal approvals to enable a press 3 function for calls.

(2) The agency, in consultation with the State Department of Health Care Services, determines that other federal funding sources, including grants issued by SAMHSA, are not jeopardized.

SEC. 7.

Section 1280.3 of the Health and Safety Code is amended to read:

1280.3.

(a) Commencing on the effective date of the regulations adopted pursuant to this section, the director may assess an administrative penalty against a licensee of a health facility licensed under subdivision (a), (b), or (f) of Section 1250 for a deficiency constituting an immediate jeopardy violation as determined by the department up to a maximum of seventy-five thousand dollars ($75,000) for the first administrative penalty, up to one hundred thousand dollars ($100,000) for the second subsequent administrative penalty, and up to one hundred twenty-five thousand dollars ($125,000) for the third and every subsequent violation. An administrative penalty issued after three years from the date of the last issued immediate jeopardy violation shall be considered a first administrative penalty so long as the facility has not received additional immediate jeopardy violations and is found by the department to be in substantial compliance with all state and federal licensing laws and regulations. The department shall have full discretion to consider all factors when determining the amount of an administrative penalty pursuant to this section.

(b) Except as provided in subdivision (c), for a violation of this chapter or the rules and regulations promulgated thereunder that does not constitute a violation of subdivision (a), the department may assess an administrative penalty in an amount of up to twenty-five thousand dollars ($25,000) per violation. This subdivision shall also apply to violation of regulations set forth in Article 1 (commencing with Section 127400) of Chapter 2.5 of Part 2 of Division 107 or the rules and regulations promulgated thereunder.

The department shall promulgate regulations establishing the criteria to assess an administrative penalty against a health facility licensed pursuant to subdivision (a), (b), or (f) of Section 1250. The criteria shall include, but need not be limited to, the following:

(1) The patient’s physical and mental condition.

(2) The probability and severity of the risk that the violation presents to the patient.

(3) The actual financial harm to patients, if any.

(4) The nature, scope, and severity of the violation.

(5) The facility’s history of compliance with related state and federal statutes and regulations.

(6) Factors beyond the facility’s control that restrict the facility’s ability to comply with this chapter or the rules and regulations promulgated thereunder.

(7) The demonstrated willfulness of the violation.

(8) The extent to which the facility detected the violation and took steps to immediately correct the violation and prevent the violation from recurring.

(d) The regulations shall not change the definition of immediate jeopardy as established in this section.

(e) The regulations shall apply only to incidents occurring on or after the effective date of the regulations.

(f) (1) Notwithstanding subdivision (a), if the department determines that a health facility licensed under subdivision (a), (b), or (f) of Section 1250 has violated a regulation adopted pursuant to Section 1276.4, the department shall assess an administrative penalty of fifteen thousand dollars ($15,000) for the first violation and thirty thousand dollars ($30,000) for the second and each subsequent violation. For purposes of this subdivision, multiple violations found on the same inspection survey shall constitute a single violation for purposes of determining whether the violation was a first, second, or subsequent violation. For purposes of this subdivision, the department shall treat violations on separate days as separate violations.

(2) A violation occurring more than three years after the date of the last violation shall be treated as a first violation.

(3) Notwithstanding any other law, the department may, without taking any regulatory actions pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, implement, interpret, or make specific this subdivision by means of an All Facilities Letter (AFL) or similar instruction.

(4) (A) Notwithstanding paragraph (1), a general acute care hospital or acute psychiatric hospital shall not be subject to an administrative penalty under that paragraph if the hospital demonstrates to the satisfaction of the department all of the following:

(i) That any fluctuation in required staffing levels was unpredictable and uncontrollable.

(ii) Prompt efforts were made to maintain required staffing levels.

(iii) In making those efforts, the hospital immediately used and subsequently exhausted the hospital’s on-call list of nurses and the charge nurse. For purposes of this paragraph, an “on-call list” shall be comprised of nurses who are scheduled to be on call for the shift and unit where an alleged violation occurred, or nurses who are assigned to a regularly scheduled float pool shift to cover any shortages across one or more specified units. A hospital contacting, or attempting to contact, licensed nurses who are not scheduled to be on call and who are not assigned to a float pool for the unit and shift where an alleged violation occurred shall not be considered as exhausting an on-call list for purposes of this paragraph.

(B) This paragraph does not affect the obligation of a general acute care hospital to maintain proper staffing levels as prescribed in Section 70217 of Title 22 of the California Code of Regulations.

(5) This section does not prohibit the department from issuing an administrative penalty for a staffing violation pursuant to this section and an administrative penalty for any resulting harm pursuant to subdivision (a).

(g) If the licensee disputes a determination by the department regarding the alleged deficiency or alleged failure to correct a deficiency, or regarding the reasonableness of the proposed deadline for correction or the amount of the penalty, the licensee may, within 10 working days, request a hearing pursuant to Section 131071. Penalties shall be paid when all appeals have been exhausted and the department’s position has been upheld.

(h) For purposes of this section, “immediate jeopardy” means a situation in which the licensee’s noncompliance with one or more requirements of licensure has caused, or is likely to cause, serious injury or death to the patient.

(i) In enforcing subdivision (a) and paragraph (1) of subdivision (f), the department shall take into consideration the special circumstances of small and rural hospitals, as defined in Section 124840, in order to protect access to quality care in those hospitals.

SEC. 8.

Section 32121 of the Health and Safety Code is amended to read:

32121.

Each local health care district shall have and may exercise all of the following powers:

(a) To have and use a corporate seal and alter it at its pleasure.

(b) To sue and be sued in all courts and places and in all actions and proceedings whatever.

(c) To purchase, receive, have, take, hold, lease, use, and enjoy property of every kind and description within and without the limits of the district, and to control, dispose of, convey, and encumber the same and create a leasehold interest in the same for the benefit of the district.

(d) To exercise the right of eminent domain for the purpose of acquiring real or personal property of every kind necessary to the exercise of any of the powers of the district.

(e) To establish one or more trusts for the benefit of the district, to administer any trust declared or created for the benefit of the district, to designate one or more trustees for trusts created by the district, to receive by gift, devise, or bequest, and hold in trust or otherwise, property, including corporate securities of all kinds, situated in this state or elsewhere, and where not otherwise provided, dispose of the same for the benefit of the district.

(f) To employ legal counsel to advise the board of directors in all matters pertaining to the business of the district, to perform the functions in respect to the legal affairs of the district as the board may direct, and to call upon the district attorney of the county in which the greater part of the land in the district is situated for legal advice and assistance in all matters concerning the district, except that if that county has a county counsel, the directors may call upon the county counsel for legal advice and assistance.

(g) To employ any officers and employees, including architects and consultants, the board of directors deems necessary to carry on properly the business of the district.

(h) To prescribe the duties and powers of the health care facility administrator, secretary, and other officers and employees of any health care facilities of the district, to establish offices as may be appropriate and to appoint board members or employees to those offices, and to determine the number of, and appoint, all officers and employees and to fix their compensation. The officers and employees shall hold their offices or positions at the pleasure of the boards of directors.

(i) To do any and all things that an individual might do that are necessary for, and to the advantage of, a health care facility and a nurses’ training school, or a child care facility for the benefit of employees of the health care facility or residents of the district.

(j) (1) To establish, maintain, and operate, or provide assistance in the operation of, one or more health facilities or health services, including, but not limited to, outpatient programs, services, and facilities; retirement programs, services, and facilities; chemical dependency programs, services, and facilities; or other health care programs, services, and facilities and activities at any location within or without the district for the benefit of the district and the people served by the district.

(2) “Health care facilities,” as used in this subdivision, means those facilities defined in subdivision (b) of Section 32000.1 and specifically includes freestanding chemical dependency recovery units. “Health facilities,” as used in this subdivision, may also include those facilities defined in subdivision (d) of Section 15432 of the Government Code.

(k) To do any and all other acts and things necessary to carry out this division.

(l) To acquire, maintain, and operate ambulances or ambulance services within and without the district.

(m) To establish, maintain, and operate, or provide assistance in the operation of, free clinics, diagnostic and testing centers, health education programs, wellness and prevention programs, rehabilitation, aftercare, and any other health care services provider, groups, and organizations that are necessary for the maintenance of good physical and mental health in the communities served by the district.

(n) To establish and operate in cooperation with its medical staff a coinsurance plan between the health care district and the members of its attending medical staff.

(o) To establish, maintain, and carry on its activities through one or more corporations, joint ventures, or partnerships for the benefit of the health care district.

(p) (1) To transfer, at fair market value, any part of its assets to one or more corporations to operate and maintain the assets. A transfer pursuant to this paragraph shall be deemed to be at fair market value if an independent consultant, with expertise in methods of appraisal and valuation and in accordance with applicable governmental and industry standards for appraisal and valuation, determines that fair and reasonable consideration is to be received by the district for the transferred district assets. Before the district transfers, pursuant to this paragraph, 50 percent or more of the district’s assets to one or more corporations, in sum or by increment, the elected board shall, by resolution, submit to the voters of the district a measure proposing the transfer. The measure shall be placed on the ballot of a special election held upon the request of the district or the ballot of the next regularly scheduled election occurring at least 88 days after the resolution of the board. If a majority of the voters voting on the measure vote in its favor, the transfer shall be approved. The campaign disclosure requirements applicable to local measures provided under Chapter 4 (commencing with Section 84100) of Title 9 of the Government Code shall apply to this election.

(2) To transfer, for the benefit of the communities served by the district, in the absence of adequate consideration, any part of the assets of the district, including, without limitation, real property, equipment, and other fixed assets, current assets, and cash, relating to the operation of the district’s health care facilities to one or more nonprofit corporations to operate and maintain the assets.

(A) A transfer of 50 percent or more of the district’s assets, in sum or by increment, pursuant to this paragraph shall be deemed to be for the benefit of the communities served by the district only if all of the following occur:

(i) The transfer agreement and all arrangements necessary thereto are fully discussed in advance of the district board decision to transfer the assets of the district in at least five properly noticed open and public meetings in compliance with Section 32106 and the Ralph M. Brown Act (Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code).

(ii) The transfer agreement provides that the health care district shall approve all initial board members of the nonprofit corporation and any subsequent board members as may be specified in the transfer agreement.

(iii) The transfer agreement provides that all assets transferred to the nonprofit corporation, and all assets accumulated by the corporation during the term of the transfer agreement arising out of, or from, the operation of the transferred assets, are to be transferred back to the district upon termination of the transfer agreement, including any extension of the transfer agreement.

(iv) The transfer agreement commits the nonprofit corporation to operate and maintain the district’s health care facilities and its assets for the benefit of the communities served by the district.

(v) The transfer agreement requires that any funds received from the district at the outset of the agreement or any time thereafter during the term of the agreement be used only to reduce district indebtedness, to acquire needed equipment for the district health care facilities, to operate, maintain, and make needed capital improvements to the district’s health care facilities, to provide supplemental health care services or facilities for the communities served by the district, or to conduct other activities that would further a valid public purpose if undertaken directly by the district.

(vi) The transfer agreement includes the appraised fair market value, from an independent consultant with expertise in methods of appraisal and valuation and in accordance with applicable governmental and industry standards for appraisal and valuation, of any asset transferred pursuant to this paragraph.

(vii) The appraisal that is used to determine the fair market value that is included within the transfer agreement is performed within the six months preceding the date on which the district approves the transfer agreement.

(B) A transfer of 10 percent or more but less than 50 percent of the district’s assets, in sum or by increment, pursuant to this paragraph shall be deemed to be for the benefit of the communities served by the district only if both of the following occur:

(i) The transfer agreement and all arrangements necessary thereto are fully discussed in advance of the district board decision to transfer the assets of the district in at least two properly noticed open and public meetings in compliance with Section 32106 and the Ralph M. Brown Act (Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code).

(ii) The transfer agreement meets all of the requirements of clauses (iii) to (v), inclusive, of subparagraph (A).

(C) Before the district transfers, pursuant to this paragraph, 50 percent or more of the district’s assets to one or more nonprofit corporations, in sum or by increment, the elected board shall, by resolution, submit to the voters of the district a measure proposing the transfer. The resolution shall identify the asset proposed to be transferred, its appraised fair market value, and the full consideration that the district is to receive in exchange for the transfer. The appraisal shall be performed by an independent consultant with expertise in methods of appraisal and valuation and in accordance with applicable governmental and industry standards for appraisal and valuation within the six months preceding the date on which the district approves the resolution. The measure shall be placed on the ballot of a special election held upon the request of the district or the ballot of the next regularly scheduled election occurring at least 88 days after the resolution of the board. If a majority of the voters voting on the measure vote in its favor, the transfer shall be approved. The campaign disclosure requirements applicable to local measures provided under Chapter 4 (commencing with Section 84100) of Title 9 of the Government Code shall apply to this election.

(D) Notwithstanding the other provisions of this paragraph, a health care district shall not transfer any portion of its assets to a private nonprofit organization that is owned or controlled by a religious creed, church, or sectarian denomination in the absence of adequate consideration.

(3) If the district board has previously transferred less than 50 percent of the district’s assets pursuant to this subdivision, before any additional assets are transferred, the board shall hold a public hearing and shall make a public determination that the additional assets to be transferred will not, in combination with any assets previously transferred, equal 50 percent or more of the total assets of the district.

(4) The amendments to this subdivision made during the 1991–92 Regular Session, the amendments made to this subdivision and to Section 32126 made during the 1993–94 Regular Session, and the amendments made to this subdivision during the 2011–12 Regular Session, shall only apply to transfers made on or after the effective dates of the acts amending this subdivision. The amendments to this subdivision made during those sessions shall not apply to either of the following:

(A) A district that has discussed and adopted a board resolution prior to September 1, 1992, that authorizes the development of a business plan for an integrated delivery system.

(B) A lease agreement, transfer agreement, or both between a district and a nonprofit corporation that were in full force and effect as of September 1, 1992, for as long as that lease agreement, transfer agreement, or both remain in full force and effect.

(5) Notwithstanding paragraph (4), if substantial amendments are proposed to be made to a transfer agreement described in subparagraph (A) or (B) of paragraph (4), the amendments shall be fully discussed in advance of the district board’s decision to adopt the amendments in at least two properly noticed open and public meetings in compliance with Section 32106 and the Ralph M. Brown Act (Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code).

(6) Notwithstanding paragraphs (4) and (5), a transfer agreement described in subparagraph (A) or (B) of paragraph (4) that provided for the transfer of less than 50 percent of a district’s assets shall be subject to the requirements of this subdivision when subsequent amendments to that transfer agreement would result in the transfer, in sum or by increment, of 50 percent or more of a district’s assets to the nonprofit corporation.

(7) For purposes of this subdivision, a “transfer” means the transfer of ownership of the assets of a district. A lease of the real property or the tangible personal property of a district shall not be subject to this subdivision, except as specified in Section 32121.4 and as required under Section 32126.

(8) Districts that request a special election pursuant to paragraph (1) or (2) shall reimburse counties for the costs of that special election as prescribed pursuant to Section 10520 of the Elections Code.

(9) (A) Nothing in this section, including subdivision (j), shall be construed to permit a local district to obtain or be issued a single consolidated license to operate a separate physical plant as a skilled nursing facility or an intermediate care facility that is not located within the boundaries of the district.

(B) Notwithstanding subparagraph (A), Eastern Plumas Health Care District may obtain and be issued a single consolidated license to operate a separate physical plant as a skilled nursing facility or an intermediate care facility that is located on the campus of the Sierra Valley District Hospital. This subparagraph shall have no application to any other district and is intended only to address the urgent need to preserve skilled nursing or intermediate care services within the rural County of Sierra.

(C) Subparagraph (B) shall only remain operative until the Sierra Valley District Hospital is annexed by the Eastern Plumas Health Care District. In no event shall the Eastern Plumas Health Care District increase the number of licensed beds at the Sierra Valley District Hospital during the operative period of subparagraph (B).

(10) A transfer of any of the assets of a district to one or more nonprofit corporations to operate and maintain the assets shall not be required to meet paragraphs (1) to (9), inclusive, of this subdivision if all of the following conditions apply at the time of the transfer:

(A) The district has entered into a loan that is insured by the State of California under Chapter 1 (commencing with Section 129000) of Part 6 of Division 107.

(B) The district is in default of its loan obligations, as determined by the Department of Health Care Access and Information.

(C) The Department of Health Care Access and Information and the district, in their best judgment, agree that the transfer of some or all of the assets of the district to a nonprofit corporation or corporations is necessary to cure the default, and will obviate the need for foreclosure. This cure of default provision shall be applicable prior to the office foreclosing on district hospital assets. After the office has foreclosed on district hospital assets, or otherwise taken possession in accordance with law, the office may exercise all of its powers to deal with and dispose of hospital property.

(D) The transfer and all arrangements necessary thereto are discussed in advance of the transfer in at least one properly noticed open and public meeting in compliance with Section 32106 and the Ralph M. Brown Act (Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code). The meeting referred to in this paragraph shall be noticed and held within 90 days of notice in writing to the district by the office of an event of default. If the meeting is not held within this 90-day period, the district shall be deemed to have waived this requirement to have a meeting.

(11) If a transfer under paragraph (10) is a lease, the lease shall provide that the assets shall revert to the district at the conclusion of the leasehold interest. If the transfer is a sale, the proceeds shall be used first to retire the obligation insured by the office, then to retire any other debts of the district. After providing for debts, any remaining funds shall revert to the district.

(12) A health care district shall report to the Attorney General, within 30 days of any transfer of district assets to one or more nonprofit or for-profit corporations, the type of transaction and the entity to whom the assets were transferred or leased.

(13) (A) Notwithstanding paragraphs (1) and (3), and subparagraph (C) of paragraph (2), Palomar Health may transfer all or any part of its assets to the Palomar UCSD Health Authority, provided that all the following conditions are satisfied:

(i) The Palomar Health Board adopts or adopted a resolution approved by a majority of the members of the Palomar Health Board authorizing the execution, delivery, and performance of the operative agreements necessary for the transfer of Palomar Health District assets to the authority, including, but not limited to, the transfer of all or substantially all of Palomar Health District’s remaining assets once authorized to do so by applicable law.

(ii) The authority is formed in furtherance of the provision or support of community hospital and other health care services within, or for the benefit of, the communities served by Palomar Health District, or organized for the purpose of the provision or support.

(iii) The joint exercise of powers agreement governing the authority, the agreements providing for the transfer of the assets to the authority, or one or more other written agreements legally binding upon the authority, contains enforceable covenants requiring that the authority operate and maintain the transferred assets for the provision of health care services for not less than 10 years from the effective date of the transfer of the assets, specifically including commitments to do all of the following:

(I) Ensure that the Palomar hospitals continue to be operated as acute care hospitals.

(II) Ensure that the Palomar hospitals remain certified to participate in the Medicare and Medicaid programs and provide services to Medicare and Medicaid beneficiaries in a nondiscriminatory manner.

(III) Ensure that the Palomar hospitals provide medical care and treatment without regard to insurance status, income, or ability to pay, in a manner consistent with the patient financial assistance policies and procedures adopted by the authority.

(IV) Use commercially reasonable efforts to maintain the services that were provided by the Palomar hospitals immediately prior to the effective date of the transfer.

(B) A transfer pursuant to subparagraph (A) shall be at fair market value as determined by an independent consultant with expertise in methods of appraisal and valuation and in accordance with applicable governmental and industry standards for appraisal and valuation. The appraisal shall be performed within the 12 months of the date on which Palomar Health District executes the transfer agreement.

(D) (i) At least 30 days prior to the transfer of all or substantially all of its assets pursuant to this paragraph, the authority shall hold at least two public hearings, noticed in accordance with the Ralph M. Brown Act (Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code).

(ii) Palomar Health District shall be invited to participate at the public hearings described in clause (i).

(iii) Members of the public shall be entitled to provide at the public hearings described in clause (i) public comment regarding the proposed transfer, the terms of the transfer agreement, and the anticipated effects of the transfer on health care services, employees, and the communities served by Palomar Health District.

(E) Transfers pursuant to this paragraph may be made in one transaction or in successive transactions.

(F) Within 30 days of any transfer of Palomar Health District assets pursuant to this paragraph, Palomar Health District shall report to the Attorney General, in writing, all of the following:

(i) Identity of the authority as the transferee.

(ii) Description of the assets transferred.

(iii) The type of transaction and the date of closing.

(iv) Summary of the consideration received.

(v) Summary of the health care service commitments and employee protections contained in the transfer agreement or related agreements.

(G) This paragraph does not authorize the practice of medicine in violation of Section 2400 of the Business and Professions Code, provided, however, that the transfer of assets to the authority pursuant to this paragraph shall not, standing alone, be deemed to constitute the practice of medicine. A transfer of Palomar Health District assets to the authority, as a public agency, pursuant to this paragraph shall not be construed as a contribution of facilities to a joint venture within the meaning of subdivision (r).

(H) (i) This paragraph shall apply retroactively to any transfer of Palomar Health District assets to the authority that was approved by the Palomar Health Board on or after January 1, 2025, and that, at the time of the board’s approval, would have satisfied the conditions set forth in clauses (i) and (ii) of subparagraph (A).

(ii) With respect to any transfer described in clause (i) that was consummated prior to the effective date of this paragraph, the appraisal requirement set forth in subparagraph (B) shall be deemed satisfied if an independent appraisal of the fair market value of the transferred assets was obtained within 12 months of the date on which the Palomar Health Board approved the operative transfer agreement, notwithstanding the appraisal window otherwise required by this paragraph.

(iii) The retroactive application provided for in this subparagraph shall not affect any final judgment entered prior to the effective date of this paragraph. With respect to any judicial or administrative proceeding that is pending as of the effective date of this paragraph, this paragraph shall be applied to the extent permitted by law.

(iv) The Legislature finds and declares that this subparagraph is intended to provide statutory authorization for, and to remove any procedural impediment or infirmity with respect to, any such previously approved transfer, and that it is in the public interest to apply this paragraph retroactively to ensure the continuity and improvement of health care services within the communities served by Palomar Health District. It is the intent of the Legislature that this paragraph be given the fullest retroactive effect to the extent permitted by law.

(I) Palomar Health District and the authority may enter into ancillary agreements, amendments, and implementation actions that are reasonably necessary to consummate, implement, and administer any transfer authorized by this paragraph, including, but not limited to, transition services agreements, shared services agreements, license agreements, and corrective instruments. Any material amendment to the principal transfer agreement shall be subject to approval by the Palomar Health Board at a public meeting.

(J) (i) The authority shall not transfer, sell, lease, or otherwise convey all or substantially all of the assets transferred to it by Palomar Health District pursuant to this paragraph without the prior approval of the Palomar Health Board and compliance with all applicable provisions of this subdivision.

(ii) Notwithstanding clause (i), transfers or other conveyances expressly permitted by the joint exercise of powers agreement governing the authority, any agreements referenced therein, and the ancillary agreements thereto shall not require any further Palomar Health Board approval or other compliance with this subdivision.

(K) The authorization provided by this paragraph to enter into a transfer agreement shall expire on December 31, 2028, if Palomar Health District does not execute a transfer agreement with the authority on or before December 31, 2028. The expiration of the authorization shall not affect the validity or enforceability of any transfer agreement executed, or any transfer consummated prior to December 31, 2028, and all obligations, commitments, and protections set forth in this paragraph and in any such transfer agreement shall survive the expiration provided by this paragraph and remain in full force and effect in accordance with their respective terms.

(L) For purposes of this paragraph, the following definitions apply:

(i) “Assets” means hospital, health care, and related assets, including, without limitation, real property, personal property, equipment, licenses, permits, contracts, accounts receivable, and other tangible and intangible assets.

(ii) “Palomar Health Board” means the board of directors of Palomar Health District.

(iii) “Palomar Health District” means Palomar Health, the California local health care district organized pursuant to this division that operated the Palomar hospitals.

(iv) “Palomar hospitals” means Palomar Medical Center Escondido and Palomar Medical Center Poway.

(v) “Palomar UCSD Health Authority” or “authority” means Palomar UC San Diego Health Authority, the joint powers authority formed pursuant to Chapter 5 (commencing with Section 6500) of Division 7 of Title 1 of the Government Code by and between Palomar Health District and the Regents of the University of California, a California constitutional corporation organized and existing under Section 9 of Article IX of the Constitution of the State of California, on behalf of the University of California, San Diego Health.

(q) To contract for bond insurance, letters of credit, remarketing services, and other forms of credit enhancement and liquidity support for its bonds, notes, and other indebtedness and to enter into reimbursement agreements, monitoring agreements, remarketing agreements, and similar ancillary contracts in connection therewith.

(r) (1) To establish, maintain, operate, participate in, or manage capitated health care service plans, health maintenance organizations, preferred provider organizations, and other managed health care systems and programs properly licensed by the Department of Insurance or the Department of Managed Care, at any location within or without the district for the benefit of residents of communities served by the district. However, that activity shall not be deemed to result in, or constitute, the giving or lending of the district’s credit, assets, surpluses, cash, or tangible goods to, or in aid of, any person, association, or corporation in violation of Section 6 of Article XVI of the California Constitution.

(2) This section does not authorize activities that corporations and other artificial legal entities are prohibited from conducting by Section 2400 of the Business and Professions Code.

(3) Any agreement to provide health care coverage that is a health care service plan, as defined in subdivision (f) of Section 1345, shall be subject to Chapter 2.2 (commencing with Section 1340) of Division 2, unless exempted pursuant to Section 1343 or 1349.2.

(4) A district shall not provide health care coverage for any employee of an employer operating within the communities served by the district, unless the Legislature specifically authorizes, or has authorized in this section or elsewhere, the coverage.

(5) This section does not authorize any district to contribute its facilities to any joint venture that could result in transfer of the facilities from district ownership.

(s) To provide health care coverage to members of the district’s medical staff, employees of the medical staff members, and the dependents of both groups, on a self-pay basis.

SEC. 9.

Section 120956 of the Health and Safety Code is amended to read:

120956.

(a) The AIDS Drug Assistance Program Rebate Fund is hereby created as a special fund in the State Treasury.

(b) All rebates collected from drug manufacturers on drugs purchased through the AIDS Drugs Assistance Program (ADAP) implemented pursuant to this chapter and, notwithstanding Section 16305.7 of the Government Code, interest earned on these moneys shall be deposited in the fund exclusively to cover costs related to any of the following:

(1) The purchase of drugs and services provided through ADAP and the HIV prevention programs as described in this chapter and in Sections 120972, 120972.1, and 120972.2.

(2) Services related to HIV prevention and care and treatment for individuals living with HIV provided through the programs funded by the Two-Spirit, Transgender, Gender Nonconforming, and Intersex (2TGI) Wellness and Equity Fund as described in Section 150900, to the extent that funds are available for these purposes.

(3) State and local public health department disease intervention and investigation activities and services, as determined by the State Department of Public Health, to the extent that funds are available for these purposes, for any of the following purposes:

(A) HIV.

(B) Sexually transmitted infections.

(D) Mpox.

(E) Other communicable diseases transmitted via sexual or intimate physical contact.

(4) To the extent that funding is available, housing support for individuals living with HIV who are eligible for the Housing Opportunities for Persons with AIDS program based on income and HIV status, but are otherwise ineligible for the program, and are current residents of California.

(5) To the extent that funding is available, services authorized under Part A or B of the Ryan White HIV/AIDS Program.

(6) California Overdose Prevention and Harm Reduction Initiative services and activities, to the extent that funds are available for these purposes.

(c) Notwithstanding Section 13340 of the Government Code, moneys in the fund are continuously appropriated without regard to fiscal year to State Department of Public Health and available for expenditure for those purposes specified under this section.

(d) The department may, in consultation with the Department of Finance, use an alternative local fiscal agent, if necessary, to implement this section.

SEC. 10.

Section 130206 is added to the Health and Safety Code, to read:

130206.

(a) The Legislature finds and declares that the center performs public health activities described in Section 164.512(b) of Title 45 of the Code of Federal Regulations when carrying out activities pursuant to this division. Personal information collected in accordance with this division is necessary to carry out projects with public health purposes.

(b) All personal information obtained or maintained by the center shall be confidential and shall be subject to the following requirements:

(1) Only deidentified and aggregated information shall be included in a publicly available analysis, data product, or research.

(2) All policies and procedures developed in implementing this division shall ensure that the privacy, security, and confidentiality of consumers’ personal information is protected, as required by the Information Practices Act of 1977, and consistent with state and federal health privacy laws, including the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Public Law 104-191) and the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), and data shall not be disclosed until the center has developed a policy regarding the release of data.

(c) Unless otherwise specified in this division, personal information collected by the center from other state entities shall be exempt from the disclosure requirements of the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code), and shall not be made available except pursuant to this division.

(d) Any information collected or obtained shall not be used for determinations regarding individual patient care or treatment and shall not be used for any individual eligibility or coverage decisions or similar purposes.

SEC. 11.

Chapter 3.5 (commencing with Section 131325) is added to Part 1 of Division 112 of the Health and Safety Code, to read:

CHAPTER 3.5. Public Awareness of 988 and Behavioral Health Crisis Services

131325.

(a) The State Department of Public Health, in consultation with the State Department of Health Care Services, shall implement public awareness strategies to assist in the implementation of the 988 Suicide & Crisis Lifeline (Article 6.3 (commencing with Section 53123.1) of Chapter 1 of Part 1 of Division 2 of Title 5 of the Government Code) in the State of California. The purpose of these strategies shall be to increase public awareness in the 988 Suicide & Crisis Lifeline and associated services and conduct statewide evaluation of communication strategies implemented to increase public awareness of the 988 Suicide & Crisis Lifeline.

(b) The State Department of Public Health shall coordinate state behavioral health crisis communications strategies by conducting an assessment of existing communications efforts, developing relevant goals, identifying key audiences, and applying best practices and research-informed resources from community partners. The department shall engage community partners in developing and disseminating behavioral health crisis communications strategies relating to the 988 Suicide & Crisis Lifeline and other support lines and warmlines.

SEC. 12.

Section 41030 of the Revenue and Taxation Code is amended to read:

41030.

(a) The Office of Emergency Services shall determine annually, on or before October 1, to be effective on January 1 of the following year, surcharge amounts pursuant to subdivision (b) that it estimates will produce sufficient revenue to fund the current fiscal year’s 911 and 988 costs.

(b) The surcharge amounts shall be determined annually by dividing the costs, including incremental costs, the Office of Emergency Services estimates for the current fiscal year of the following:

(1) The 911 costs approved pursuant to Article 6 (commencing with Section 53100) of Chapter 1 of Part 1 of Division 2 of Title 5 of the Government Code, less the available balance in the State Emergency Telephone Number Account in the General Fund, by its estimate of the number of access lines to which the surcharge will apply per month for the period of January 1 to December 31, inclusive, of the next succeeding calendar year, but in no event shall the surcharge amount in any month be greater than eighty cents ($0.80) per access line per month.

(2) For the 2023 and 2024 calendar years, the 988 surcharge shall be set at eight cents ($0.08) per access line per month.

(3) For determinations that are made applicable to the calendar year beginning on January 1, 2025, and each calendar year thereafter, the 988 surcharge shall be determined by dividing the 988 costs approved pursuant to Article 6.3 (commencing with Section 53123.1) of Chapter 1 of Part 1 of Division 2 of Title 5 of the Government Code, less the available balance in the 988 State Suicide and Behavioral Health Crisis Services Fund, by the Office of Emergency Services’ estimate of the number of access lines to which the surcharge will apply per month for the period of January 1 to December 31, inclusive, of the next succeeding calendar year, but in no event shall the surcharge amount in any month be greater than thirty cents ($0.30) per access line per month.

(c) When determining the 911 surcharge amount pursuant to this section, the Office of Emergency Services shall include the costs it expects to incur to plan, test, implement, and operate Next Generation 911 technology and services, including text to 911 service, and alerts and warnings, consistent with the plan and timeline required by Section 53121 of the Government Code.

(d) (1) Service suppliers shall report the total number of access lines to the Office of Emergency Services, on or before August 1, for the previous period of January 1 to December 31, inclusive.

(2) The total number of access lines required to be reported in paragraph (1) shall include all lines from the categories of wireline communication service line, wireless communication service line, prepaid mobile telephony service line, and VoIP service line. The number of access line figures shall be reported individually for these categories.

(3) Notwithstanding any other law, the Office of Emergency Services, within 45 days of receiving a request from the department, shall provide the department the name and address of each service supplier, each service supplier’s total number of access lines, as provided in paragraph (2) for the prior calendar year, and any other information the department deems necessary to conduct its responsibilities under this part.

(e) The Office of Emergency Services shall perform a validation of the number of access lines using subscription data or other comparable data collected by appropriate federal or state agencies. This subscription data or other comparable data shall be used to validate the access line data required to be reported by service suppliers in subdivision (d).

(f) (1) The Office of Emergency Services shall notify the department of the surcharge amount imposed under this part, determined pursuant to this section on or before October 1 of each year.

(2) The surcharge imposed on the purchase of prepaid mobile telephony services shall be equal to the amount set forth in subdivision (b) for each retail transaction in this state.

(g) (1) At least 30 days prior to determining the surcharge pursuant to subdivision (a), the Office of Emergency Services shall prepare a summary of the calculation of the proposed surcharge amounts and make it available to the public, the Legislature, the California Health and Human Services Agency and relevant departments, including the State Department of Health Care Services, and on its internet website.

(2) For determinations made on or before October 1, 2019, the summary shall contain all of the following:

(A) The prior year revenues to fund 911 costs, including, but not limited to, revenues from prepaid service.

(B) Projected expenses and revenues from all sources, including, but not limited to, prepaid service to fund 911 costs.

(h) For purposes of this section, for the determination made by the Office of Emergency Services on or before October 1, 2019, that is applicable for the calendar year beginning on January 1, 2020, and ending on December 31, 2020, the following definitions shall apply:

(1) “Service supplier” shall mean a person supplying an access line to a service user in this state.

(2) “Service user” means any person that subscribes for the right to utilize an access line in this state who is required to pay a surcharge under the provisions of this part.

SEC. 13.

Section 41031 of the Revenue and Taxation Code is amended to read:

41031.

(a) The Office of Emergency Services shall make its determination of the 911 surcharge amount each year no later than October 1 and shall notify the department of the new amount, which shall be effective with respect to access lines and the purchase of prepaid mobile telephony services on or after January 1 of the next succeeding calendar year.

(b) The Office of Emergency Services, in consultation with the California Health and Human Services Agency and the State Department of Health Care Services, shall make its determination of the 988 surcharge amount each year no later than October 1 and shall notify the department of the new amount, which shall be effective with respect to access lines and the purchase of prepaid mobile telephone services on or after January 1 of the next succeeding calendar year. The Office of Emergency Services shall provide written notice to the California Health and Human Services Agency and the State Department of Health Care Services of the new surcharge amount at least 30 days prior to October 1 each year, or as soon thereafter as is possible.

SEC. 14.

Section 41135 of the Revenue and Taxation Code is amended to read:

41135.

(a) All amounts required to be paid to the state under this part shall be paid to the department in the form of remittances payable to the California Department of Tax and Fee Administration. The department shall transmit the revenues to the State Treasurer to be deposited in the State Treasury to either the credit of the State Emergency Telephone Number Account in the General Fund, or the 988 State Suicide and Behavioral Health Crisis Services Fund, depending on the apportionment of the revenues arising from each surcharge.

(b) The department, in consultation with the State Department of Health Care Services and the Office of Emergency Services, may adopt regulations to implement the apportionment of the revenues from each surcharge.

(c) The department shall submit an annual report to the State Department of Health Care Services and the Office of Emergency Services on revenue generated by the 988 surcharge.

SEC. 15.

Section 41136 of the Revenue and Taxation Code is amended to read:

41136.

(a) From the funds in the State Emergency Telephone Number Account, all amounts of the 911 surcharge collected shall, when appropriated by the Legislature, be spent solely for the following purposes:

(1) To pay refunds authorized by this part.

(2) To pay the department for the cost of the administration of the 911 surcharge under this part.

(3) To pay the Office of Emergency Services for its costs in administration of the “911” emergency telephone number system.

(4) To pay bills submitted to the Office of Emergency Services by service suppliers or communications equipment companies for the installation of, and ongoing expenses for, the following communications services supplied to local agencies in connection with the “911” emergency phone number system:

(A) A basic system, defined as 911 systems, including, but not limited to, Next Generation 911, and the subsequent technologies, and interfaces needed to deliver 911 voice and data information from the 911 caller to the emergency responder and the subsequent technologies, and interfaces needed to send information, including, but not limited to, alerts and warnings, to potential 911 callers.

(B) A basic system with telephone central office identification.

(D) Approved incremental costs.

(5) To pay claims of local agencies for approved incremental costs, not previously compensated for by another governmental agency.

(6) To pay claims of local agencies for incremental costs and amounts, not previously compensated for by another governmental agency, incurred prior to the effective date of this part, for the installation and ongoing expenses for the following communication services supplied in connection with the “911” emergency telephone number system:

(B) A basic system with telephone central office identification.

(D) Approved incremental costs. Incremental costs shall not be allowed unless the costs are concurred in by the Office of Emergency Services.

(b) (1) From the funds in the 988 State Suicide and Behavioral Health Crisis Services Fund, all amounts of the 988 surcharge collected shall be spent for purposes identified in Section 53123.4 of the Government Code. However, before funds are disbursed as provided in Section 53123.4 of the Government Code, funds shall be used for all of the following:

(A) To pay refunds authorized by this part.

(B) To pay the department for the cost of the administration of the 988 surcharge under this part.

(2) The remainder of the revenue shall be disbursed to the State Department of Health Care Services and the Office of Emergency Services for the purposes identified in Section 53123.4 of the Government Code.

SEC. 16.

Section 14005.11 of the Welfare and Institutions Code, as amended by Section 70 of Chapter 27 of the Statutes of 2026, is amended to read:

14005.11.

(a) To the extent required by federal law for qualified beneficiaries enrolled in the federal Medicare Program, the department shall pay the premiums, deductibles, and coinsurance for elderly and disabled persons entitled to benefits under Title XVIII of the federal Social Security Act, whose income does not exceed the federal poverty level and whose resources do not exceed the amount specified in subdivision (a) of Section 14005.62.

(b) The department shall pay, in addition to subdivision (a), applicable additional premiums, deductibles, and coinsurance for drug coverage extended to qualified beneficiaries enrolled in the federal Medicare Program.

(c) The deductible payments required by subdivision (b) may be covered by providing the same drug coverage as offered to categorically needy recipients, as defined in Section 14050.1.

(d) As specified in this section, it is the intent of the Legislature to assist in the payment of Medicare Part B premiums for qualified low-income Medi-Cal beneficiaries who are ineligible for federal sharing or federal contribution for the payment of those premiums.

(e) For a Medi-Cal beneficiary who has a spend down of excess income but who is ineligible for the assistance provided pursuant to subdivision (a), or who is ineligible for any other federally funded assistance for the payment of the beneficiary’s Medicare Part B premium, the department shall pay for the beneficiary’s Medicare Part B premium in the month following each month that the beneficiary’s spend down of excess income has been met.

(f) When a county is informed that an applicant or beneficiary is eligible for benefits under the federal Medicare Program, the county shall determine whether that individual is eligible under the Qualified Medicare Beneficiary program, the Specified Low-Income Medicare Beneficiary program, or the Qualifying Individual program, and shall enroll the applicant or beneficiary in the appropriate program.

(g) (1) The department shall enter into a Medicare Part A buy-in agreement for qualified Medicare beneficiaries with the federal Centers for Medicare and Medicaid Services by submitting a state plan amendment with a proposed effective date in accordance with paragraph (2).

(2) Subject to paragraph (3), the Medicare Part A buy-in agreement described in this subdivision shall be effective on January 1, 2025, or the date the department communicates to the Department of Finance in writing that systems have been programmed for implementation of this subdivision, whichever date is later.

(3) This subdivision shall be implemented only to the extent that any necessary federal approvals are obtained and that federal financial participation is available and is not otherwise jeopardized.

(4) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department, without taking any further regulatory action, may implement, interpret, or make specific this subdivision by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, until the time regulations are adopted.

(5) For purposes of this subdivision, “Medicare Part A buy-in agreement” means an agreement authorized by Section 1395v of Title 42 of the United States Code under which the state shall pay Medicare Part A premiums for qualified individuals who are enrolled in both the Medicare Program and the Medi-Cal program.

(h) This section shall become inoperative on July 1, 2027, and, as of January 1, 2028, is repealed.

SEC. 17.

Section 14005.36 of the Welfare and Institutions Code is amended to read:

14005.36.

(a) (1) (A) The department shall undertake efforts to conduct outreach about work or community engagement requirements, more frequent redeterminations, and changes to retroactive eligibility to impacted Medi-Cal beneficiaries pursuant to changes made under federal H.R. 1 (Public Law 119-21).

(B) The outreach shall include information on how to comply with the work or community engagement requirements, an explanation of the definition of an “applicable individual” as set forth in subsection (xx) of Section 1396a of Title 42 of the United States Code, and those beneficiaries who may be exempted, including any reporting requirements and processes to meet an exemption, and the consequences of noncompliance.

(C) The department shall provide an outreach notice to the beneficiary by mail, or an electronic format if elected by the individual, and by one or more additional formats. Additional formats may include telephone, text message, an internet website, other commonly available electronic means, and other formats that the United States Secretary of Health and Human Services determines appropriate.

(D) Beneficiary outreach and education shall be coordinated across public social services programs to help minimize barriers to administrative disenrollments.

(E) The department shall solicit input from existing department-convened stakeholder workgroup meetings and member advisory boards, to the extent feasible, to help inform member communications and outreach strategies.

(2) (A) The county shall undertake outreach efforts to beneficiaries receiving benefits under this chapter, in order to maintain the most up-to-date home addresses, telephone numbers, and other necessary contact information, and to encourage and assist with timely submission of the annual reaffirmation form, and, when applicable, transitional Medi-Cal program reporting forms and to facilitate the Medi-Cal redetermination process, including the requirements of Public Law 119-21. In implementing this subdivision, a county shall make a good faith effort to collaborate with community-based organizations, provided that confidentiality is protected. A county shall exercise its discretion in determining which community-based organizations are best situated to assist in outreach efforts, particularly in efforts aimed at difficult-to-reach individuals and communities.

(B) The county outreach efforts shall meet cultural and linguistic appropriateness standards, in alignment with the National Standards for Culturally and Linguistically Appropriate Services.

(b) The department shall encourage and facilitate efforts by managed care plans to report updated beneficiary contact information to counties.

(c) (1) The department and each county shall incorporate, in a timely manner, updated contact information received from managed care plans pursuant to subdivision (b) into the beneficiary’s Medi-Cal case file and into all systems used to inform plans of their beneficiaries’ enrollee status. Updated Medi-Cal beneficiary contact information shall be limited to the beneficiary’s telephone number, change of address information, and change of name.

(2) When a managed care plan obtains a beneficiary’s updated contact information, the managed care plan shall provide the beneficiary’s updated contact information to the appropriate county.

(d) The department shall share beneficiary redetermination data, including the date of redetermination, with applicable managed care plans to aid in managed care plans’ efforts to assist beneficiaries with retaining Medi-Cal coverage, including incorporation into the managed care plans’ outreach and education efforts.

(e) This section shall be implemented only to the extent that federal financial participation under Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396 et seq.) is available.

(f) To the extent otherwise required by Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department shall adopt emergency regulations implementing this section no later than July 1, 2015. The department may thereafter readopt the emergency regulations pursuant to that chapter. The adoption and readoption, by the department, of regulations implementing this section shall be deemed to be an emergency and necessary to avoid serious harm to the public peace, health, safety, or general welfare for purposes of Sections 11346.1 and 11349.6 of the Government Code, and the department is hereby exempted from the requirement that it describe facts showing the need for immediate action and from review by the Office of Administrative Law.

SEC. 18.

Section 14007.5 of the Welfare and Institutions Code is amended to read:

14007.5.

(a) Persons who are not citizens or nationals of the United States shall be eligible for Medi-Cal, whether federally funded or state-funded, only to the same extent as permitted under federal law and regulations for receipt of federal financial participation under Title XIX of the federal Social Security Act, except as otherwise provided in this section and elsewhere in this chapter.

(b) (1) Through September 30, 2026, an individual who is not a citizen or a national of the United States who has the immigration status described in Section 1641 of Title 8 of the United States Code shall be eligible for the full scope of Medi-Cal benefits.

(2) Beginning October 1, 2026, an individual described in paragraph (1) shall only be eligible for the full scope of Medi-Cal benefits if that individual meets either of the following criteria:

(A) The individual is described in Section 1396b(v)(5) of Title 42 of the United States Code and is not subject to the limitation described in Section 1613(a) of Title 8 of the United States Code.

(B) The individual receives supplemental security income under Title XVI of the federal Social Security Act.

(c) (1) Beginning October 1, 2026, and through June 30, 2027, an individual described in paragraph (1) of subdivision (b), but not described in Section 1396b(v)(5) of Title 42 of the United States Code, shall be eligible for the full scope of Medi-Cal state-funded benefits.

(2) Beginning July 1, 2027, an individual who has an immigration status described in Section 1641 of Title 8 of the United States Code, but is not described in Section 1396b(v)(5) of Title 42 of the United States Code shall only be eligible for medically necessary pregnancy-related services, and care and services necessary for the treatment of an emergency medical condition and medical care directly related to the emergency, as defined in federal law.

(d) (1) Beginning October 1, 2026, a person who has an immigration status described in paragraph (1) of subdivision (b), but who is subject to the limitation described in Section 1613(a) of Title 8 of the United States Code, shall be eligible for the full scope of Medi-Cal state-funded benefits, subject to the service limitations described in subdivision (p).

(2) An individual who is not described in subdivision (b) or (c), but who is permanently residing in the United States under color of law, shall be eligible for the full scope of Medi-Cal state-funded benefits, subject to the service limitations described in subdivision (p). For purposes of this section, persons who are not citizens or nationals of the United States and who are “permanently residing in the United States under color of law” shall be interpreted to include all persons who are not citizens or nationals of the United States residing in the United States with the knowledge and permission of the United States Department of Homeland Security and whose departure the United States Department of Homeland Security does not contemplate enforcing and with respect to whom federal financial participation is not available under Title XIX of the federal Social Security Act.

(e) Any person who is not a citizen or national of the United States who is otherwise eligible for Medi-Cal services, but who does not meet the requirements under subdivision (b), (c), or (d), shall only be eligible for care and services that are necessary for the treatment of an emergency medical condition and medical care directly related to the emergency, as defined in federal law, except as described in Sections 14007.65, 14007.7, and 14007.8. For purposes of this section, the term “emergency medical condition” means a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following:

(1) Placing the patient’s health in serious jeopardy.

(2) Serious impairment to bodily functions.

(3) Serious dysfunction to any bodily organ or part. It is the intent of this section to entitle eligible individuals to inpatient and outpatient services that are necessary for the treatment of the emergency medical condition in the same manner as administered by the department through regulations and provisions of federal law.

(f) Effective October 1, 2026, for individuals described in paragraph (2) of subdivision (c) and subdivision (e), maintenance dialysis services medically necessary for the treatment of chronic dialysis and end-stage renal disease, and provided in a freestanding outpatient dialysis facility licensed under paragraph (2) of subdivision (b) of Section 1204 of the Health and Safety Code, or a hospital-based dialysis facility licensed under Chapter 2 (commencing with Section 1250) of Division 2 of the Health and Safety Code, are covered services under this section, regardless of whether the treatment meets the definition of an emergency medical condition under subdivision (e) or Section 51056 of Title 22 of the California Code of Regulations. The services covered under this subdivision include medically necessary transportation to and from the facility for the purpose of receiving these services.

(g) To the extent that federal financial participation is unavailable for services described in subdivision (f), the department shall fund those services subject to an appropriation made by the Legislature, and coverage under subdivision (f) shall not be interrupted, reduced, or conditioned on the availability of federal financial participation.

(h) The department shall issue guidance to Medi-Cal fee-for-service providers implementing this section, and shall amend Section 51056 of Title 22 of the California Code of Regulations, or other applicable regulations, as necessary to conform to this section.

(i) (1) (A) No sooner than July 1, 2027, all individuals described in subdivisions (c) and (d), except for those individuals described in subparagraph (B), shall be required to pay a monthly premium as a condition of eligibility for the full scope of Medi-Cal benefits, subject to the service limitations described in subdivision (p), if they are otherwise eligible for benefits under this chapter.

(B) The following individuals are not subject to the monthly premium requirements described in subparagraph (A):

(i) Individuals under 19 years of age.

(ii) Individuals over 59 years of age.

(iii) Individuals who are pregnant or entitled to postpartum medical assistance.

(iv) Individuals enrolled in the county or state Medi-Cal Inmate Eligibility Program.

(2) No sooner than May 14, 2027, the Governor’s 2027–28 May Revision shall include the level of monthly premiums imposed under this subdivision, which shall be no less than thirty dollars ($30) and no greater than fifty dollars ($50) per beneficiary.

(3) An individual required to pay premiums pursuant to this subdivision, after no more than 90 days of nonpayment of the monthly premium, is only eligible for medically necessary pregnancy-related services, and care and services necessary for the treatment of an emergency medical condition and medical care directly related to the emergency, as defined in federal law. All outstanding premium balances shall be paid in full as a condition of continued eligibility for the full scope of Medi-Cal benefits.

(4) The monthly premium requirements and service limitations described in paragraphs (1), (2), and (3) shall not apply to nonminor dependents, as defined in Section 11400, and individuals who but for their immigration status are eligible for Medi-Cal pursuant to Section 14005.28. These individuals shall remain eligible for the full scope of Medi-Cal benefits until their 26th birthday.

(j) Pursuant to Section 14001.2, each county department shall require that each applicant for, or beneficiary of, Medi-Cal, including a child, shall provide their social security number account number, or numbers, if they have more than one social security number.

(k) (1) In order to be eligible for benefits under subdivision (b), (c), or (d), an applicant or beneficiary shall present United States Citizenship and Immigration Services registration documentation or other proof of satisfactory immigration status from the United States Citizenship and Immigration Services.

(2) Any person who meets all other program requirements but who lacks documentation of United States Citizenship and Immigration Services registration or other proof of satisfactory immigration status shall be provided a reasonable opportunity to submit the evidence. For purposes of this paragraph, “reasonable opportunity” means 90 days or the time it actually takes the county to process the Medi-Cal application, whichever is longer.

(3) During the reasonable opportunity period under paragraph (2), the county department shall process the applicant’s application for medical assistance in a manner that conforms to its normal processing procedures and timeframes.

(l) (1) The county department shall grant only the Medi-Cal benefits set forth in subdivision (e) of this section or in Section 14007.65, 14007.7, or 14007.8 to any individual who, after 30 calendar days or the time it actually takes the county to process the Medi-Cal application, whichever is longer, has failed to submit documents constituting reasonable evidence indicating a satisfactory immigration status for Medi-Cal purposes, or who is reported by the United States Citizenship and Immigration Services to lack a satisfactory immigration status for Medi-Cal purposes.

(2) If a person who is not a citizen or national of the United States has been receiving Medi-Cal benefits based on eligibility established prior to the effective date of this section and that individual, upon redetermination of eligibility for benefits, fails to submit documents constituting reasonable evidence indicating a satisfactory immigration status for Medi-Cal purposes, the county department shall discontinue the Medi-Cal benefits, except for the care and services set forth in subdivision (e) of this section or in Section 14007.65, 14007.7, or 14007.8. The county department shall provide adequate notice to the individual of any adverse action and shall accord the individual an opportunity for a fair hearing if the individual requests one.

(m) To the extent permitted by federal law and regulations, a person who is not a citizen or national of the United States applying for services under subdivisions (b), (c), or (d) shall be granted eligibility for the scope of services to which they would otherwise be entitled if, at the time the county department makes the determination about their eligibility, the person meets either of the following requirements:

(1) The person has not had a reasonable opportunity to submit documents constituting reasonable evidence indicating satisfactory immigration status.

(2) The person has provided documents constituting reasonable evidence indicating a satisfactory immigration status, but the county department has not received timely verification of the person’s immigration status from the United States Citizenship and Immigration Services.

(3) The verification process shall protect the privacy of all participants. A person’s immigration status shall be subject to verification by the United States Citizenship and Immigration Services, to the extent required for receipt of federal financial participation in the Medi-Cal program.

(n) If a person does not declare status as a lawful permanent resident or person permanently residing under color of law, or as a person legalized under Section 210, 210A, or 245A of the federal Immigration and Nationality Act (Public Law 82-414), Medi-Cal coverage under subdivision (e) of this section or in Section 14007.65, 14007.7, or 14007.8 shall be provided to the individual if they are otherwise eligible.

(o) If a person subject to this section is not fluent in English, the county department shall provide an understandable explanation of the requirements of this section in a language in which the person is fluent.

(p) (1) No sooner than July 1, 2027, all individuals described in subdivisions (d) and (e) who are 19 years of age or older shall not be eligible for dental services set forth in this chapter, except for the treatment of an emergency medical condition and medical care directly related to the emergency, as defined in federal law.

(2) Paragraph (1) shall not apply to nonminor dependents, as defined in Section 11400, and individuals who but for their immigration status are eligible for Medi-Cal pursuant to Section 14005.28. These individuals shall remain eligible for the full scope of Medi-Cal benefits until their 26th birthday.

(3) Paragraph (1) shall not apply to individuals who are pregnant or entitled to postpartum medical assistance.

(q) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the State Department of Health Care Services may implement, interpret, or make specific this section, in whole or in part, by means of plan or county letter, information notices, plan or provider bulletins, or other similar instructions, without taking any further regulatory action.

(r) Subdivisions (d) and (p) shall be implemented only after the director determines, and communicates in writing to the Department of Finance, that systems have been programmed for implementation.

SEC. 19.

Section 14007.8 of the Welfare and Institutions Code is amended to read:

14007.8.

(a) (1) An individual who is 25 years of age or younger, and who does not have satisfactory immigration status or is unable to establish satisfactory immigration status as required by Section 14011.2, shall be eligible for the full scope of Medi-Cal benefits, subject to the service limitations described in subdivisions (b), (c), and (k), if they are otherwise eligible for benefits under this chapter.

(2) (A) After the director determines, and communicates that determination in writing to the Department of Finance, that systems have been programmed for implementation of this subparagraph, but no sooner than May 1, 2022, an individual who is 50 years of age or older, and who does not have satisfactory immigration status or is unable to establish satisfactory immigration status as required by Section 14011.2, shall be eligible for the full scope of Medi-Cal benefits, subject to the service limitations described in subdivisions (b), (c), and (k), if they are otherwise eligible for benefits under this chapter.

(B) After the director determines, and communicates that determination in writing to the Department of Finance, that systems have been programmed for implementation of this subparagraph, but no later than January 1, 2024, an individual who is 26 to 49 years of age, inclusive, and who does not have satisfactory immigration status as required by Section 14011.2, shall be eligible for the full scope of Medi-Cal benefits, subject to the service limitations described in subdivisions (b), (c), and (k), if they are otherwise eligible for benefits under this chapter.

(b) (1) No sooner than January 1, 2026, an individual who is 19 years of age or older, who does not have satisfactory immigration status as required by Section 14011.2, who is otherwise eligible for Medi-Cal services pursuant to subdivision (e) of Section 14007.5, and who applies for Medi-Cal on or after January 1, 2026, shall only be eligible for medically necessary pregnancy-related services, and care and services necessary for the treatment of an emergency medical condition and medical care directly related to the emergency, as defined in federal law.

(2) Notwithstanding paragraph (1), an individual who is 19 years of age or older, who does not have satisfactory immigration status as required by Section 14011.2, who was enrolled in full-scope Medi-Cal and was not pregnant, but loses coverage for full-scope Medi-Cal, shall be eligible to reenroll in full-scope Medi-Cal within three months from the date of disenrollment for full-scope Medi-Cal, pregnancy-only Medi-Cal, or postpartum Medi-Cal. Payment of outstanding premium balances prior to the initiation of the three-month cure period shall be a condition of reenrollment under this subdivision for individuals disenrolled from Medi-Cal due to nonpayment of premiums. For purposes of this paragraph, “full-scope Medi-Cal” means the full scope of Medi-Cal benefits, subject to the service limitations described in subdivision (k).

(3) Paragraphs (1) and (2) shall not apply to nonminor dependents, as defined in Section 11400, and individuals who but for their immigration status are eligible for Medi-Cal pursuant to Section 14005.28. These individuals shall remain eligible for the full scope of Medi-Cal benefits until their 26th birthday.

(c) (1) No sooner than January 1, 2026, if an individual described in subdivision (a) who is 19 years of age or older loses eligibility for full-scope Medi-Cal on or after January 1, 2026, the individual shall only be eligible for medically necessary pregnancy-related services, and care and services necessary for the treatment of an emergency medical condition and medical care directly related to the emergency, as defined in federal law.

(2) No sooner than January 1, 2026, notwithstanding paragraph (1), if an individual described in subdivision (a) who is 19 years of age or older loses eligibility for full-scope Medi-Cal while pregnant, the individual shall remain eligible for the full scope of Medi-Cal benefits, subject to the service limitations described in subdivision (k), throughout the pregnancy and for 12 months after the pregnancy ends.

(d) The department shall provide monthly updates to the appropriate policy and fiscal committees of the Legislature on the status of the implementation of this section.

(e) Effective no sooner than January 1, 2027, to the extent permitted by state and federal law, an individual eligible for the Medi-Cal program pursuant to this section shall be eligible for services in the Medi-Cal fee-for-service delivery system.

(f) (1) The department shall maximize federal financial participation in implementing this section to the extent allowable. For purposes of implementing this section, the department shall claim federal financial participation to the extent that the department determines it is available.

(2) To the extent that federal financial participation is unavailable, the department shall implement this section using state funds appropriated for this purpose.

(g) This section shall be implemented only to the extent it is in compliance with Section 1621(d) of Title 8 of the United States Code.

(h) (1) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department, without taking any further regulatory action, shall implement, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time any necessary regulations are adopted. Thereafter, the department shall adopt regulations in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.

(2) Notwithstanding Section 10231.5 of the Government Code, the department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code, until regulations have been adopted.

(i) In implementing this section, the department may contract, as necessary, on a bid or nonbid basis. This subdivision establishes an accelerated process for issuing contracts pursuant to this section. Those contracts, and any other contracts entered into pursuant to this subdivision, may be on a noncompetitive bid basis and shall be exempt from both of the following:

(1) Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code and any policies, procedures, or regulations authorized by that part.

(2) Review or approval of contracts by the Department of General Services.

(j) (1) (A) No sooner than July 1, 2027, all individuals described in subdivision (a), except for those individuals described in subparagraph (B), shall be required to pay a monthly premium as a condition of eligibility for Medi-Cal benefits, if they are otherwise eligible for benefits under this chapter.

(B) The following individuals are not subject to the monthly premium requirements described in subparagraph (A):

(i) Individuals under 19 years of age.

(ii) Individuals over 59 years of age.

(iii) Individuals who are pregnant or entitled to postpartum medical assistance.

(iv) Individuals enrolled in the county or state Medi-Cal Inmate Eligibility Program.

(3) An individual described in paragraph (1), after no more than 90 days of nonpayment of the monthly premium, will only be eligible for medically necessary pregnancy-related services, and care and services necessary for the treatment of an emergency medical condition and medical care directly related to the emergency, as defined in federal law. All outstanding premium balances shall be paid in full as a condition of continued eligibility for full-scope Medi-Cal coverage, subject to the service limitations described in subdivision (k).

(k) (1) No sooner than July 1, 2027, an individual who is 19 years of age or older, who is eligible for Medi-Cal benefits pursuant to subdivision (a), shall not be eligible for dental services set forth in this chapter, except for the treatment of an emergency medical condition and medical care directly related to the emergency, as defined in federal law.

(3) Paragraph (1) shall not apply to individuals who are pregnant or entitled to postpartum medical assistance.

(l) Subdivisions (b), (c), (j), and (k) shall be implemented only after the director determines, and communicates in writing to the Department of Finance, that systems have been programmed for implementation.

SEC. 20.

Section 14043.2 of the Welfare and Institutions Code is amended to read:

14043.2.

(a) Whether or not regulations for certification are adopted under Section 14043.15, in order to be enrolled as a provider, or for enrollment as a provider to continue, an applicant or provider may be required to sign a provider agreement and shall disclose all information as required in federal Medicaid regulations and any other information required by the department. Applicants, providers, and persons with an ownership or control interest, as defined in federal Medicaid regulations, shall submit their date of birth and their social security number or numbers to the department, to the full extent allowed under federal law. Corporations with an ownership or control interest, as defined in federal Medicaid regulations, shall submit their taxpayer identification number and all business address locations and post office box addresses. The director may designate the form of a provider agreement by provider type. Failure to disclose the required information, or the disclosure of false information, shall result in denial of the application for enrollment or shall make the provider subject to temporary suspension from the Medi-Cal program, which shall include temporary deactivation of the provider’s number or numbers, including all business addresses used by the provider to obtain reimbursement from the Medi-Cal program.

(b) The director shall notify the provider of the temporary suspension and deactivation of the provider’s number or numbers, including all business addresses used by the provider, and the effective date thereof.

(c) (1) In addition to the grounds for denial or temporary suspension described in subdivision (a), the department shall deny an application for enrollment or terminate the enrollment of a provider if the applicant or provider discloses an affiliation, as defined in Section 455.101 of Title 42 of the Code of Federal Regulations, within the previous five years with any person or entity that has experienced a disclosable event, as defined in Section 455.101 of Title 42 of the Code of Federal Regulations, if the department determines that the affiliation poses an undue risk of fraud, waste, or abuse to the Medi‑Cal program.

(2) In determining whether an affiliation poses an undue risk of fraud, waste, or abuse to the Medi-Cal program, the department shall apply the factors set forth in Section 455.107(f) of Title 42 of the Code of Federal Regulations. Legally protected health care activity, as defined in Title 1.81.7 (commencing with Section 1798.300) of Part 4 of Division 3 of the Civil Code, shall not, by virtue of the nature of that activity alone, constitute fraud, waste, or abuse to the Medi-Cal program.

(3) In accordance with Section 455.107(h) of Title 42 of the Code of Federal Regulations, the department may take action under this subdivision, up to and including denial or termination, regardless of whether the provider fully and timely discloses the affiliation, if the affiliation poses an undue risk of fraud, waste, or abuse to the Medi-Cal program.

(4) This section shall be implemented only upon receipt of all necessary federal approvals and only to the extent that federal financial participation is available and not otherwise jeopardized.

(d) Notwithstanding Section 100171 of the Health and Safety Code and Section 14123, proceedings after the imposition of sanctions provided for in subdivision (a) or (c) shall be in accordance with Section 14043.65.

SEC. 21.

Section 14043.27 of the Welfare and Institutions Code is amended to read:

14043.27.

(a) If an applicant or provider is granted provisional provider status, preferred provisional provider status, or full-enrollment status pursuant to Section 14043.26 and, if at any time during the provisional provider status period, preferred provisional provider status period, or full-enrollment status period, the department conducts any announced or unannounced visits or any additional inspections or reviews pursuant to this chapter or Chapter 8 (commencing with Section 14200), or the regulations adopted thereunder, or pursuant to Section 100185.5 of the Health and Safety Code, and discovers or otherwise determines the existence of any ground to deactivate the provider’s number and business addresses or suspend the provider from the Medi-Cal program pursuant to this chapter or Chapter 8 (commencing with Section 14200), or the regulations adopted thereunder, or pursuant to Section 100185.5 of the Health and Safety Code, or if any of the circumstances listed in subdivision (c) occur, the department shall terminate the provisional provider status, preferred provisional provider status, or full-enrollment status of the provider, regardless of whether the period of time for which the provisional provider status or preferred provisional provider status was granted under Section 14043.26 has elapsed.

(b) (1) Termination of provisional provider status, preferred provisional provider status, or full-enrollment status shall include deactivation of the provider’s number, including all business addresses used by the provider to obtain reimbursement from the Medi-Cal program and removal of the provider from enrollment in the Medi-Cal program, except where the termination is based upon a ground related solely to a specific location for which provisional provider status, preferred provisional provider status, or full-enrollment status was granted. Termination of provisional provider status, preferred provisional provider status, or full-enrollment status, based upon grounds related solely to a specific location may include failure to have an established place of business, failure to possess the business or zoning permits or other approvals necessary to operate a business, or failure to possess the appropriate licenses, permits, or certificates necessary for the provider of service category or subcategory identified by the provider in its application package.

(2) Providers shall continuously maintain compliance with all federal, state, and local requirements. The department may request evidence of compliance with established place of business requirements at any time and may conduct site verification activities and unannounced site inspections. Refusal to cooperate or permit access to these sites shall constitute grounds for denial, suspension, or termination. Use of maildrop locations and virtual offices, unless exempted by the department, or nonoperational spaces shall be considered noncompliance with established place of business requirements.

(3) Where the grounds relate solely to a specific location, the termination of provisional provider status, preferred provisional provider status, or full-enrollment status shall include only deactivation of the specific locations that the grounds apply to and shall include removal of the provider from enrollment in the Medi-Cal program only if, after deactivation of the specific locations, the provider does not have any business address that is not deactivated.

(c) The following circumstances are grounds for termination of provisional provider status, preferred provisional provider status, or full-enrollment status:

(1) The provider, persons with an ownership or control interest in the provider, or persons who are directors, officers, or managing employees of the provider have been convicted of any felony, or convicted of any misdemeanor involving fraud or abuse in any government program, related to neglect or abuse of a patient in connection with the delivery of a health care item or service, or in connection with the interference with, or obstruction of, any investigation into health care related fraud or abuse, or have been found liable for fraud or abuse in any civil proceeding, or have entered into a settlement in lieu of conviction for fraud or abuse in any government program.

(2) There is a material discrepancy in the information provided to the department, or with the requirements to be enrolled, that is discovered after provisional provider status, preferred provisional provider status, or full-enrollment status has been granted and that cannot be corrected because the discrepancy occurred in the past.

(3) The provider has provided material information that was false or misleading at the time it was provided.

(4) The provider failed to have an established place of business at the business address for which the application package was submitted at the time of any onsite inspection, announced or unannounced visit, or any additional inspection or review conducted pursuant to this article or a statute or regulation governing the Medi-Cal program, unless the practice of the provider’s profession or delivery of services, goods, supplies, or merchandise is such that services, goods, supplies, or merchandise are rendered or delivered at locations other than the business address and this practice or delivery of services, goods, supplies, or merchandise has been disclosed in the application package approved by the department when the provisional provider status, preferred provisional provider status, or full-enrollment status was granted.

(5) The provider meets the definition of a clinic under Section 1200 of the Health and Safety Code, but is not licensed as a clinic pursuant to Chapter 1 (commencing with Section 1200) of Division 2 of the Health and Safety Code and fails to meet the requirements to qualify for at least one exemption pursuant to Section 1206 or 1206.1 of the Health and Safety Code.

(6) The provider performs clinical laboratory tests or examinations, but it or its personnel do not meet CLIA, and the regulations adopted thereunder, and the state clinical laboratory law, do not possess valid CLIA certificates and clinical laboratory registrations or licenses pursuant to Chapter 3 (commencing with Section 1200) of Division 2 of the Business and Professions Code, or are not exempt from licensure as a clinical laboratory under Section 1241 of the Business and Professions Code.

(7) The provider fails to possess either of the following:

(A) The appropriate licenses, permits, certificates, or other approvals needed to practice the profession or occupation, or provide the services, goods, supplies, or merchandise the provider identified in the application package approved by the department when the provisional provider status, preferred provisional provider status, or full-enrollment status was granted and for the location for which the application was submitted.

(B) The business or zoning permits or other approvals necessary to operate a business at the location identified in its application package approved by the department when the provisional provider status, preferred provisional provider status, or full-enrollment status was granted.

(8) The provider, or if the provider is a clinic, group, partnership, corporation, or other association, any officer, director, or shareholder with a 10 percent or greater interest in that organization, commits two or more violations of the federal or state statutes or regulations governing the Medi-Cal program, and the violations demonstrate a pattern or practice of fraud, abuse, or provision of unnecessary or substandard medical services.

(9) The provider commits any violation of a federal or state statute or regulation governing the Medi-Cal program or of a statute or regulation governing the provider’s profession or occupation and the violation represents a threat of immediate jeopardy or significant harm to any Medi-Cal beneficiary or to the public welfare.

(10) The provider submits claims for payment that subject a provider to suspension under Section 14043.61.

(11) The provider submits claims for payment for services, goods, supplies, or merchandise rendered at a location other than the business address or addresses listed on the application for enrollment, unless the practice of the provider’s profession or delivery of services, goods, supplies, or merchandise is such that services, goods, supplies, or merchandise are rendered or delivered at locations other than the business address and this practice or delivery of services, goods, supplies, or merchandise has been disclosed in the application package approved by the department when the provisional provider status, preferred provisional provider status, or full-enrollment status was granted.

(12) The provider has not paid its fine, or has a debt due and owing, including overpayments and penalty assessments, to any federal, state, or local government entity that relates to Medicare, Medicaid, Medi-Cal, or any other federal or state health care program, and has not made satisfactory arrangements to fulfill the obligation or otherwise been excused by legal process from fulfilling the obligation.

(d) If, during a provisional provider status period or a preferred provisional provider status period, the department conducts any announced or unannounced visits or any additional inspections or reviews pursuant to this chapter or Chapter 8 (commencing with Section 14200), or the regulations adopted thereunder, and commences an investigation for fraud or abuse, or discovers or otherwise determines that the provider is under investigation for fraud or abuse by any other state, local, or federal government agency, including any local, state, or federal program, at the department’s discretion, the provider shall be subject to termination of provisional provider status or preferred provisional provider status, regardless of whether the period of time for which the provisional provider status or preferred provisional provider status was granted under Section 14043.26 has elapsed.

(e) A provider whose provisional provider status, preferred provisional provider status, or full-enrollment status has been terminated pursuant to this section may appeal the termination in accordance with Section 14043.65.

(f) Any department-recovered fine or debt due and owing, including overpayments, that are subsequently determined to have been erroneously collected shall be promptly refunded to the provider, together with interest paid in accordance with subdivision (e) of Section 14171 and Section 14172.5.

(g) Legally protected health care activity, as defined in Title 1.81.7 (commencing with Section 1798.300) of Part 4 of Division 3 of the Civil Code, shall not, by virtue of the nature of that activity alone, result in termination from the Medi-Cal program.

SEC. 22.

Section 14043.28 of the Welfare and Institutions Code is amended to read:

14043.28.

(a) (1) If an application package is denied under Section 14043.26 or provisional provider status, preferred provisional provider status, or full-enrollment status is terminated under Section 14043.27, the applicant or provider shall be prohibited from reapplying for enrollment or continued enrollment in the Medi-Cal program or for participation in any health care program administered by the department or its agents or contractors for a period of three years from the date the application package is denied or the provisional provider status, preferred provisional provider status, or full-enrollment status is terminated, except as provided otherwise in paragraph (2) of subdivision (h), or paragraph (2) of subdivision (i), of Section 14043.26 and as set forth in this section.

(2) If the application is denied under paragraph (2) of subdivision (h) of Section 14043.26 because the applicant failed to resubmit an incomplete application package or is denied under paragraph (2) of subdivision (i) of Section 14043.26 because the applicant failed to remediate discrepancies, the applicant may resubmit an application in accordance with paragraph (2) of subdivision (h) or paragraph (2) of subdivision (i), respectively.

(3) If the denial of the application package is based upon a conviction for any offense or for any act included in Section 14043.36 or termination of the provisional provider status, preferred provisional provider status, or full-enrollment status is based upon a conviction for any offense or for any act included in paragraph (1) of subdivision (c) of Section 14043.27, the applicant or provider shall be prohibited from reapplying for enrollment or continued enrollment in the Medi-Cal program or for participation in any health care program administered by the department or its agents or contractors for a period of 10 years from the date the application package is denied or the provisional provider status, preferred provisional provider status, or full-enrollment status is terminated.

(4) If the denial of the application package is based upon two or more convictions for any offense or for any two or more acts included in Section 14043.36 or termination of the provisional provider status, preferred provisional provider status, or full-enrollment status is based upon two or more convictions for any offense or for any two acts included in paragraph (1) of subdivision (c) of Section 14043.27, the applicant or provider shall be permanently barred from enrollment or continued enrollment in the Medi-Cal program or for participation in any health care program administered by the department or its agents or contractors.

(5) The prohibition in paragraph (1) against reapplying for three years shall not apply if the denial of the application or termination of provisional provider status, preferred provisional provider status, or full-enrollment status is based upon any of the following:

(A) The grounds provided for in paragraph (4), or subparagraph (B) of paragraph (7), of subdivision (c) of Section 14043.27.

(B) The grounds provided for in subdivision (d) of Section 14043.27, if the investigation is closed without any adverse action being taken.

(C) The grounds provided for in paragraph (6) of subdivision (c) of Section 14043.27. However, the department may deny reimbursement for claims submitted while the provider was noncompliant with the federal Clinical Laboratory Improvement Amendments of 1988 (CLIA) (42 U.S.C. Sec. 263a et seq.).

(D) The grounds provided for in subdivision (b) of Section 14043.36 for being terminated or excluded under Medicare or under the Medicaid program or Children’s Health Insurance Program of any other state.

(b) (1) If an application package is denied under subparagraph (A), (B), (D), or (E) of paragraph (4) of subdivision (f) of Section 14043.26, or with respect to a provider described in subparagraph (B) of paragraph (2) of subdivision (h), or subparagraph (B) of paragraph (2) of subdivision (i), of Section 14043.26, or provisional provider status, preferred provisional provider status, or full-enrollment status is terminated based upon any of the grounds stated in subparagraph (A) of paragraph (7), or paragraphs (1), (2), (3), (5), and (8) to (12), inclusive, of subdivision (c) of Section 14043.27, all business addresses of the applicant or provider shall be deactivated and the applicant or provider shall be removed from enrollment in the Medi-Cal program by operation of law.

(2) If the termination of provisional provider status, preferred provisional provider status, or full-enrollment status is based upon the grounds stated in subdivision (d) of Section 14043.27 and the investigation is closed without any adverse action being taken, or is based upon the grounds in subparagraph (B) of paragraph (7) of subdivision (c) of Section 14043.27 and the applicant or provider obtains the appropriate license, permits, or approvals covering the period of provisional provider status, preferred provisional provider status, or full-enrollment status, the termination taken pursuant to subdivision (c) of Section 14043.27 shall be rescinded, the previously deactivated provider numbers shall be reactivated, and the provider shall be reenrolled in the Medi-Cal program, unless there are other grounds for taking these actions.

(c) Claims that are submitted or caused to be submitted by an applicant or provider who has been suspended from the Medi-Cal program for any reason or who has had its provisional provider status, preferred provisional provider status, or full-enrollment status terminated or had its application package for enrollment or continued enrollment denied and all business addresses deactivated may not be paid for services, goods, merchandise, or supplies rendered to Medi-Cal beneficiaries during the period of suspension or termination or after the date all business addresses are deactivated.

(d) Legally protected health care activity, as defined in Title 1.81.7 (commencing with Section 1798.300) of Part 4 of Division 3 of the Civil Code, shall not, by virtue of the nature of that activity alone, result in denial, suspension, or termination from the Medi-Cal program.

SEC. 23.

Section 14043.36 of the Welfare and Institutions Code is amended to read:

14043.36.

(a) The department shall not enroll any applicant that has been convicted of any felony or misdemeanor involving fraud or abuse in any government program, or related to neglect or abuse of a patient in connection with the delivery of a health care item or service, or in connection with the interference with or obstruction of any investigation into health care related fraud or abuse or that has been found liable for fraud or abuse in any civil proceeding, or that has entered into a settlement in lieu of conviction for fraud or abuse in any government program, within the previous 10 years. In addition, the department may deny enrollment to any applicant that, at the time of application, is under investigation by the department or any state, local, or federal government law enforcement agency for fraud or abuse pursuant to Subpart A (commencing with Section 455.12) of Part 455 of Title 42 of the Code of Federal Regulations. The department shall not deny enrollment to an otherwise qualified applicant whose felony or misdemeanor charges did not result in a conviction solely on the basis of the prior charges. If it is discovered that a provider is under investigation by the department or any state, local, or federal government agency for fraud or abuse, including any local, state, or federal program, at the department’s discretion, that provider shall be subject to temporary suspension from the Medi-Cal program, which shall include temporary deactivation of the provider’s number, including all business addresses used by the provider to obtain reimbursement from the Medi-Cal program.

(b) If it is discovered that a provider has been terminated under Medicare or under the Medicaid program or Children’s Health Insurance Program in any other state, the provider shall not be enrolled in, or shall be subject to termination from, the Medi-Cal program, which shall include deactivation of the provider’s enrolled numbers and all business addresses used to obtain reimbursement from the Medi-Cal program.

(c) The director shall notify in writing the provider, by certified mail, of the temporary suspension and deactivation of the provider’s number, which shall take effect on the date the department sends the notification. If the provider has an email address on file with the department, the department shall notify the provider by certified mail and by email, and the temporary suspension and deactivation of the provider’s number shall take effect on the date the department sends the notification to the provider’s email address on file with the department. Notwithstanding Section 100171 of the Health and Safety Code, proceedings after the imposition of sanctions provided for in subdivision (a) shall be in accordance with Section 14043.65.

(d) A temporary suspension may be lifted when a resolution of an investigation for fraud or abuse occurs.

SEC. 24.

Section 14043.55 of the Welfare and Institutions Code is amended to read:

14043.55.

(a) The department may implement a 180-day moratorium on the enrollment of providers in a specific provider of service category, on a statewide basis or within a geographic area, when the director determines this action is necessary to safeguard public funds or to maintain the fiscal integrity of the program. The department shall provide written notice to the Joint Legislative Budget Committee at least 10 calendar days prior to the effective date of the initiation of a moratorium implemented under this subdivision. The department shall provide a new notification every 180 days that a moratorium is in effect. These written notices shall include the rationale for the moratorium or extension of an existing moratorium, as applicable, affected provider categories, and geographic scope. This moratorium may be extended or repeated when the director determines this action is necessary to safeguard public funds or to maintain the fiscal integrity of the program. The authority granted in this section shall not be interpreted as a limitation on the authority granted to the department in Section 14105.3.

(b) If the Secretary of the United States Department of Health and Human Services establishes a temporary moratorium on enrollment as described in federal regulations, the department shall establish a corresponding moratorium covering the same period and provider types, even if those provider types would not ordinarily be subject to a moratorium under this section, unless the department determines that the imposition of the moratorium will adversely impact beneficiaries access to medical assistance. A federal moratorium adopted under this subdivision shall not be subject to the director’s determinations regarding safeguards of public funds and program integrity or other prerequisites that are necessary to implement a state-initiated moratorium.

SEC. 25.

Section 14107.11 of the Welfare and Institutions Code is amended to read:

14107.11.

(a) Upon verification of a credible allegation of fraud by the state, as defined in subdivision (d) and for which an investigation is pending under the Medi-Cal program against a provider as defined in Section 14043.1, or the commencement of a suspension under Section 14123, the provider shall be temporarily placed under payment suspension, unless it is determined there is a good cause exception, as defined in subdivision (g), not to suspend the payments or to suspend them only in part, and the department may do any of the following:

(1) Collect any Medi-Cal program overpayment identified through an audit or examination, or any portion thereof from any provider. Notwithstanding Section 100171 of the Health and Safety Code, a provider may appeal the collection of overpayments under this section pursuant to procedures established in Article 5.3 (commencing with Section 14170). Overpayments collected under this section shall not be returned to the provider during the pendency of any appeal and may be offset to satisfy audit or appeal findings if the findings are against the provider. Overpayments will be returned to a provider with interest if findings are in favor of the provider.

(2) Give notification of the payment suspension for any goods, services, supplies, or merchandise, or any portion thereof. The department shall notify the provider within five days of any payment suspension under this section. The department may delay notification to the provider by 30 days if it is requested to do so in writing by any law enforcement agency, which may be renewed in writing up to two times and in no event may exceed 90 days. The notice to the provider shall do all of the following:

(A) State that the payment suspension is being imposed in accordance with this subdivision and that the payment suspension is for a temporary period and will not continue if it is determined that no credible allegation of fraud remains against the provider or when legal proceedings relating to the allegation are complete.

(B) Cite the circumstances under which the payment suspension will be terminated.

(D) Inform the provider of the right to submit written evidence that would be admissible under the administrative adjudication provisions of Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, for consideration by the department.

(b) Notwithstanding Section 100171 of the Health and Safety Code, a provider may appeal a payment suspension pursuant to Section 14043.65. Payments suspended under this section shall not be returned to the provider during the pendency of any appeal and may be offset to satisfy audit or appeal findings.

(c) A payment suspension may be lifted when a resolution of an investigation for fraud or abuse occurs as defined in subdivision (p) of Section 14043.1.

(d) A credible allegation of fraud has the same meaning as set forth in Section 455.2 of Title 42 of the Code of Federal Regulations.

(e) (1) On a quarterly basis, the Department of Justice, and any other law enforcement agency that has accepted referrals for investigation from the department, shall submit a report to the department listing each referral and stating whether the referral continues to be under investigation and whether it involves a credible allegation of fraud. If the Department of Justice or a law enforcement agency fails to submit a report under this subdivision, the department may request the report from the Department of Justice or the law enforcement agency on no more than a quarterly basis. The Department of Justice or the law enforcement agency, as applicable, shall provide the report within 30 days of the request.

(2) Notwithstanding paragraph (1), no quarterly report shall be required from a law enforcement agency, unless that law enforcement agency has either received a referral from the department or reported an open case to the department and has not yet reported rejection or closure of that referral or open case.

(f) A report, request, or notification submitted under this section shall be exempt from the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code). These records may be disclosed to law enforcement agencies or other government entities that execute an agreement conforming to paragraph (5) of subdivision (c) of Section 7921.505 of the Government Code.

(g) For purposes of this section, all of the following apply:

(1) “Provider” has the same meaning as that term is defined in Section 14043.1.

(2) “Good cause exception” means a reason determined by the department that falls under Section 455.23(e) or (f) of Title 42 of the Code of Federal Regulations.

(3) “Law enforcement agency” includes any agency employing peace officers, as defined in Chapter 4.5 (commencing with Section 830) of Title 3 of Part 2 of the Penal Code.

(h) The director may, in consultation with interested parties, adopt regulations to implement this section as necessary. These regulations may be adopted as emergency regulations in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code) and the adoption of the regulations shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, or general welfare. The director shall transmit these emergency regulations directly to the Secretary of State for filing and the regulations shall become effective immediately upon filing. Upon completion of the formal regulation adoption process and prior to the expiration of the 120-day duration period of emergency regulations, the director shall transmit directly to the Secretary of State the adopted regulations, the rulemaking file, and the certification of compliance as required by subdivision (e) of Section 11346.1 of the Government Code.

SEC. 26.

Section 14132.26 of the Welfare and Institutions Code is amended to read:

14132.26.

(a) The department shall develop a program that requires a waiver of federal law to test the efficacy of providing an assisted living benefit to beneficiaries under the Medi-Cal program. Assisted living benefits shall include, but are not limited to, the care and supervision activities specified in Section 1569.2 of the Health and Safety Code and Section 87101 of Title 22 of the California Code of Regulations, and other health-related services. The program developed pursuant to this section shall be known as the waiver program for purposes of this section. The department shall submit any necessary waiver applications or modifications to the Medicaid state plan to the federal Centers for Medicare and Medicaid Services to implement the waiver program, and shall implement the waiver program only to the extent federal financial participation is available.

(b) The department shall develop the waiver program in conjunction with other state departments, consumers, consumer advocates, housing and service providers, and experts in the fields of gerontology, geriatric health, nursing services, and independent living.

(c) The assisted living benefit shall be designed to provide eligible individuals with a range of services that enable them to remain in the least restrictive and most homelike environment while receiving the medical and personal care necessary to protect their health and well-being. Benefits provided pursuant to this waiver program shall include only those not otherwise available under the state plan, and may include, but are not limited to, medicine management, coordination with a primary health care provider, and case management.

(d) (1) Eligible individuals shall be those who are eligible for the Medi-Cal program and are determined by the department to be eligible for placement in a nursing facility, as defined under subdivisions (c) and (d) of Section 1250 of the Health and Safety Code. Eligibility shall be based on an assessment of an individual’s ability to perform functional and instrumental activities of daily living, as well as the individual’s medical diagnosis and prognosis, and other criteria, including other Medi-Cal services that the beneficiary is receiving, as specified in the waiver.

(2) An eligible individual shall participate in the waiver program only if they are fully informed of the program and the nature of the assisted living benefit and indicates in writing their choice to participate.

(e) (1) The waiver program shall test the effectiveness of providing a Medi-Cal assisted living benefit through two service delivery approaches, as specified in paragraphs (2) and (3).

(2) Under the first model, an assisted living benefit shall be provided to residents of licensed residential care facilities. Facility participation in the program shall be determined by the department in conjunction with the State Department of Social Services and in accordance with the criteria for participation specified in the waiver. Under this model the facility operator shall be responsible for the provision of services allowed under the benefit, either directly or through contracts with other provider agencies, as permitted and specified in the waiver. During participation in the waiver program, residential care facilities shall comply with all terms and conditions of the waiver. The department and the State Department of Social Services, may, as determined necessary and appropriate, waive provisions contained in Division 2 (commencing with Section 1200) of the Health and Safety Code, subdivision (h) of Section 14132.95, and Title 22 of the California Code of Regulations for facilities providing services to waiver program participants.

(3) Under the second model, an assisted living benefit shall be provided to residents in publicly funded senior and disabled housing projects. Under this model an independent agency, pursuant to a contract with the department, shall be responsible for the provision of case management and other services to eligible individuals, as specified in the waiver.

(f) The department shall evaluate the effectiveness of the waiver program.

(1) The evaluation shall include, but not be limited to, participant satisfaction, health, and safety, the quality of life of the participant receiving the assisted living benefit, and demonstration of the cost neutrality of the waiver program as specified in federal guidelines.

(2) The evaluation shall estimate the projected savings, if any, in the budgets of state and local governments if the program was expanded statewide.

(3) The evaluation shall be submitted to the appropriate policy and fiscal committees of the Legislature on or before January 1, 2003.

(g) The department shall limit the number of participants in the waiver program during the initial three years of its operation to a number that will be statistically significant for purposes of the program evaluation and that meets any requirements of the federal Health Care Financing Administration, including a request to waive statewide implementation requirements for the waiver program during the initial years of evaluation.

(h) In implementing this section, the department may enter into contracts for the provision of essential administrative and other services. Contracts entered into under this section may be on a noncompetitive bid basis, and shall be exempt from the requirements of Chapter 2 (commencing with Section 10290) of Part 2 of Division 2 of the Public Contract Code.

(i) The department shall not implement the waiver program specified in subdivision (a) if the benefits provided pursuant to the waiver program will result in additional costs to the Medi-Cal program.

(j) The waiver program shall be developed and implemented only to the extent that funds are appropriated or otherwise available for that purpose.

(k) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, in whole or in part, by means of all-county letters, plan letters, provider bulletins, information notices, or other similar instructions, without taking any further regulatory action.

SEC. 27.

Section 14184.201 of the Welfare and Institutions Code is amended to read:

14184.201.

(a) Notwithstanding any other law, the department shall standardize those applicable covered Medi-Cal benefits provided by Medi-Cal managed care plans under comprehensive risk contracts with the department on a statewide basis and across all models of Medi-Cal managed care in accordance with this section and the CalAIM Terms and Conditions.

(b) (1) Notwithstanding any other law, commencing January 1, 2023, subject to subdivision (f) of Section 14184.102, the department shall include, or continue to include, skilled nursing facility services as capitated benefits in the comprehensive risk contract with each Medi-Cal managed care plan.

(2) For contract periods from January 1, 2023, to December 31, 2025, inclusive, during which paragraph (1) is implemented, each Medi-Cal managed care plan shall reimburse a network provider furnishing skilled nursing facility services to a Medi-Cal beneficiary enrolled in that plan, and each network provider of skilled nursing facility services shall accept the payment amount the network provider of skilled nursing facility services would be paid for those services in the Medi-Cal fee-for-service delivery system, as defined by the department in the Medi-Cal State Plan and guidance issued pursuant to subdivision (d) of Section 14184.102. For contract periods commencing on or after January 1, 2026, during which paragraph (1) is implemented, the department may elect to continue the payment requirement described in this paragraph, subject to subdivision (f) of Section 14184.102.

(3) For contract periods during which paragraph (1) is implemented, capitation rates paid by the department to a Medi-Cal managed care plan shall be actuarially sound and shall account for the payment levels described in paragraph (2) as applicable. The department may require Medi-Cal managed care plans and network providers of skilled nursing facility services to submit information that the department deems necessary to implement this subdivision, at the times and in the form and manner specified by the department.

(c) (1) Notwithstanding any other law, commencing January 1, 2024, subject to subdivision (f) of Section 14184.102, the department shall include, or continue to include, institutional long-term care services not described in subdivision (b) as capitated benefits in the comprehensive risk contract with each Medi-Cal managed care plan.

(2) For contract periods from January 1, 2024, to December 31, 2025, inclusive, during which paragraph (1) is implemented, each Medi-Cal managed care plan shall reimburse a network provider furnishing institutional long-term care services not described in subdivision (b) to a Medi-Cal beneficiary enrolled in that plan, and each network provider of institutional long-term care services not described in subdivision (b) shall accept the payment amount that the network provider of institutional long-term care services would be paid for those services in the Medi-Cal fee-for-service delivery system, as defined by the department in the Medi-Cal State Plan and guidance issued pursuant to subdivision (d) of Section 14184.102. For contract periods commencing on or after January 1, 2026, during which paragraph (1) is implemented, the department may elect to continue the payment requirement described in this paragraph, subject to subdivision (f) of Section 14184.102.

(3) For contract periods during which paragraph (1) is implemented, capitation rates paid by the department to a Medi-Cal managed care plan shall be actuarially sound and shall account for the payment levels described in paragraph (2), as applicable. The department may require Medi-Cal managed care plans and network providers of institutional long-term care services to submit information that the department deems necessary to implement this subdivision, at the times and in the form and manner specified by the department.

(4) The department shall convene, in collaboration with the State Department of Developmental Services (DDS), a workgroup to address transition of intermediate care facility/developmentally disabled (ICF/DD) facilities, and Intermediate Care Facility for the Developmentally Disabled-Nursing (ICF/DD-N) and Intermediate Care Facility for the Developmentally Disabled-Habilitative (ICF/DD-H) Homes from the Medi-Cal fee-for-service delivery system to the Medi-Cal managed care delivery system to ensure a smooth transition to CalAIM.

(d) (1) Notwithstanding any other law, commencing January 1, 2022, the department shall include donor and recipient organ transplant surgeries, as described in Section 14132.69 and in the CalAIM Terms and Conditions, and donor and recipient bone marrow transplants, as described in Section 14133.8 and in the CalAIM Terms and Conditions, as capitated benefits in the comprehensive risk contract with each Medi-Cal managed care plan.

(2) For contract periods from January 1, 2022, to December 31, 2024, inclusive, during which paragraph (1) is implemented, each applicable Medi-Cal managed care plan shall reimburse a provider furnishing organ or bone marrow transplant surgeries to a Medi-Cal beneficiary enrolled in that plan, and each provider of organ or bone marrow transplant surgeries shall accept the payment amount that the provider of organ or bone marrow transplant surgeries would be paid for those services in the Medi-Cal fee-for-service delivery system, as defined by the department in the Medi-Cal State Plan and guidance issued pursuant to subdivision (d) of Section 14184.102. For contract periods commencing on or after January 1, 2025, during which paragraph (1) is implemented, the department may elect to continue the payment requirement described in this paragraph, subject to subdivision (f) of Section 14184.102.

(3) For contract periods during which paragraph (1) is implemented, capitation rates paid by the department to a Medi-Cal managed care plan shall be actuarially sound and shall account for the payment levels described in paragraph (2) as applicable. The department may require Medi-Cal managed care plans and providers of organ or bone marrow transplant surgeries to submit information that the department deems necessary to implement this subdivision, at the times and in the form and manner specified by the department.

(e) (1) Notwithstanding any other law, commencing January 1, 2022, Community-Based Adult Services (CBAS) shall continue to be available as a capitated benefit for a qualified Medi-Cal beneficiary under a comprehensive risk contract with an applicable Medi-Cal managed care plan, in accordance with the CalAIM Terms and Conditions.

(2) CBAS shall only be available as a covered Medi-Cal benefit for a qualified Medi-Cal beneficiary under a comprehensive risk contract with an applicable Medi-Cal managed care plan. Medi-Cal beneficiaries who are eligible for CBAS shall enroll in an applicable Medi-Cal managed care plan in order to receive those services, except for beneficiaries exempt from mandatory enrollment in a Medi-Cal managed care plan pursuant to the CalAIM Terms and Conditions and Section 14184.200.

(3) CBAS shall be delivered in accordance with applicable state and federal law, including, but not limited to, the federal home and community-based settings regulations set forth in Sections 441.301(c)(4), 441.530(a)(1), and 441.710(a)(1) of Title 42 of the Code of Federal Regulations, and related subregulatory guidance and any amendment issued thereto.

(4) For contract periods during which paragraph (1) is implemented, each applicable Medi-Cal managed care plan shall reimburse a network provider furnishing CBAS to a Medi-Cal beneficiary enrolled in that plan, and each network provider of CBAS shall accept the payment amount that the network provider of CBAS would be paid for the service in the Medi-Cal fee-for-service delivery system, as defined by the department in guidance issued pursuant to subdivision (d) of Section 14184.102, unless the Medi-Cal managed plan and network provider mutually agree to reimbursement in a different amount.

(5) For contract periods during which paragraph (1) is implemented, capitation rates paid by the department to an applicable Medi-Cal managed care plan shall be actuarially sound and shall account for the payment levels described in paragraph (4) as applicable. The department may require applicable Medi-Cal managed care plans and network providers of CBAS to submit information the department deems necessary to implement this subdivision, at the times and in the form and manner specified by the department.

(6) (A) The department and the California Department of Aging shall, subject to an appropriation made by the Legislature, collaborate with the California Association for Adult Day Services, CBAS providers, and applicable Medi-Cal managed care plans, to understand CBAS center closures.

(B) On or before March 1, 2029, the department shall provide an update to the relevant budget and policy committees in the Legislature and the Legislative Analyst’s Office on CBAS center closures, developed in consultation with the California Department of Aging, the California Association for Adult Day Services, CBAS providers, and applicable Medi-Cal managed care plans. The update shall include, but not be limited to, all of the following:

(i) A summary of the department’s previous and planned engagement with the California Association for Adult Day Services and CBAS providers during the 2026–27 and 2027–28 fiscal years focused on understanding potential options for addressing CBAS center closures, including administrative efficiencies and improvements for eligibility and claims issues.

(ii) Potential options to help mitigate CBAS center closures, administrative challenges, and eligibility and claims issues.

(iii) Any potential options identified that would require legislative action to implement.

(f) Notwithstanding any other law, including, but not limited to, subdivision (a), the department may not transfer responsibility for specialty mental health services in the Counties of Sacramento and Solano from the Medi-Cal managed care plan responsible for those services on July 1, 2022, in those counties until no sooner than all of the following requirements have been met:

(1) The requirements of Section 14184.403 have been implemented.

(2) Each county and Medi-Cal managed care plan has submitted to the department a transition plan that contains provisions for continuity of care or the transfer of care.

(3) Notice has been provided to affected beneficiaries, including the ability of beneficiaries to request continuity of care pursuant to mental health and substance use disorder information notices issued by the department.

(g) For purposes of this section, the following definitions apply:

(1) “Comprehensive risk contract” has the same meaning as set forth in Section 438.2 of Title 42 of the Code of Federal Regulations.

(2) “Institutional long-term care services” has the same meaning as set forth in the CalAIM Terms and Conditions and, subject to subdivision (f) of Section 14184.102, includes at a minimum all of the following:

(A) Skilled nursing facility services.

(B) Subacute facility services.

(D) Intermediate care facility services.

(3) “Network provider” has the same meaning as set forth in Section 438.2 of Title 42 of the Code of Federal Regulations.

SEC. 28.

(a) The Legislature finds and declares all of the following:

(1) Palomar Health, a California local health care district organized under the Local Health Care District Law (Palomar Health District), operated Palomar Medical Center Escondido and Palomar Medical Center Poway, which together serve as essential providers of acute care, emergency, trauma, behavioral health, and other health care services to the communities of northern San Diego County.

(2) Palomar Health District has and continues to face significant financial, operational, and capital challenges, including substantial outstanding bonded indebtedness, workforce recruitment and retention difficulties, and increasing demand for health care services in its service area, which threaten the long-term sustainability of health care delivery to the communities that it serves.

(3) The Palomar UCSD Health Authority is a joint powers authority formed by and between Palomar Health District and the Regents of the University of California, on behalf of the University of California, San Diego Health. The authority was formed for the purpose of operating and maintaining the hospital, health care facilities, and services previously operated and provided by Palomar Health District.

(4) The formation of the authority contemplates a two-phased transfer of Palomar Health District’s hospital and health care assets. In the first phase, Palomar Health District agreed to transfer approximately 49 percent of its assets to the authority, together with a structured transition of all hospital and health care operations to the authority through a series of ancillary agreements, including, without limitation, agreements providing for the leasing of Palomar Health District employees to the authority and the grant to the authority of the right to use and operate those assets not transferred during the first phase. Palomar Health District agreed to transfer all or substantially all of its remaining assets to the authority when authorized by law to do so.

(5) The transfer of Palomar Health District’s hospital and health care assets to the Palomar UC San Diego Health Authority constitutes a transfer between public agencies undertaken for public health care purposes, and is not a privatization of public assets.

(6) The combination of a local health care district’s community hospital system with a University of California academic medical center through a joint powers authority presents a unique governmental structure that is not adequately addressed by the general transfer provisions of Section 32121 of the Health and Safety Code, which were designed primarily to address transfers to private nonprofit corporations and do not contemplate the distinctive governance, operational, regulatory, and public accountability characteristics of a public-to-public transfer of this nature.

(7) The transfer is expected to enhance the quality, scope, and long-term sustainability of health care services available to the communities served by Palomar Health District by integrating those services with the clinical, academic, and research capabilities of the authority, while preserving public ownership and accountability.

(b) It is the intent of the Legislature that the transfer include meaningful protections for the employees of Palomar Health District, including offers of employment, preservation of substantially comparable compensation and benefits, and honoring of existing collective bargaining agreements and relationships.

SEC. 29.

The Legislature finds and declares that a special statute is necessary and that a general statute cannot be made applicable within the meaning of Section 16 of Article IV of the California Constitution because of the following unique circumstances relating to Palomar Health District:

(a) The transaction involves the only local health care district in California that has entered into a joint powers agreement with the Regents of the University of California for the purpose of transferring and operating the district’s hospital and health care assets.

(b) The combination of a community hospital district serving northern San Diego County with an academic medical center through a joint powers authority presents governance, regulatory, financial, and operational circumstances that are materially distinct from those of any other local health care district in the state.

(c) A general statute authorizing all local health care districts to transfer assets to any public agency without the procedural protections of subdivision (p) of Section 32121 of the Health and Safety Code could authorize transactions that have not been subject to equivalent public scrutiny, community protection, or labor safeguards, and could undermine existing voter protections applicable to other districts.

(d) The financial and operational circumstances of Palomar Health District, including its outstanding bonded indebtedness, and the urgent need to stabilize and improve health care delivery in its service area, require a legislative solution tailored to those specific circumstances.

(e) The transaction has been the subject of extensive public deliberation, board action, and community engagement, and retroactive validation of actions already taken in reliance on existing law is necessary to preserve the continuity of health care services and avoid disruption to patients, employees, and the communities served by Palomar Health District.

SEC. 30.

The Legislature finds and declares that Section 5 of this act, which adds Section 53123.7 to the Government Code, imposes a limitation on the public’s right of access to the meetings of public bodies or the writings of public officials and agencies within the meaning of Section 3 of Article I of the California Constitution. Pursuant to that constitutional provision, the Legislature makes the following findings to demonstrate the interest protected by this limitation and the need for protecting that interest:

In order to protect the privacy of individuals utilizing or otherwise mentioned in the provision of emergency response or crisis lifeline services, while also ensuring that the State Department of Health Care Services will have access to the records containing personal information and personal health information necessary to carry out its functions under the act, it is necessary that the act include limitations on public disclosure.

SEC. 31.

The Legislature finds and declares that Section 10 of this act, which adds Section 130206 to the Health and Safety Code, imposes a limitation on the public’s right of access to the meetings of public bodies or the writings of public officials and agencies within the meaning of Section 3 of Article I of the California Constitution. Pursuant to that constitutional provision, the Legislature makes the following findings to demonstrate the interest protected by this limitation and the need for protecting that interest:

The Center for Data Insights and Innovation will have access to personal information and, as such, it is crucial that the information in its possession not be available to the public.

SEC. 32.

If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.

SEC. 33.

The following sums are hereby appropriated from the Federal Trust Fund to the State Department of Health Care Services, to be made available for encumbrance or expenditure through June 30, 2027, for the following set of purposes:

(a) The sum of one hundred five million six hundred eleven thousand dollars ($105,611,000) for augmentation of the amount appropriated in Item 4260-116-0890 of the Budget Act of 2026 (Chapters 19 and 21 of the Statutes of 2026) to expend State Opioid Response Grant funds.

(b) The sum of five million nine hundred seventy-five thousand dollars ($5,975,000) for augmentation of the amount appropriated in Item 4260-116-0890 of the Budget Act of 2026 (Chapters 19 and 21 of the Statutes of 2026) to expend Substance Abuse Prevention and Treatment Block Grant funds.

(c) The sum of one million two hundred twenty-nine thousand dollars ($1,229,000) for augmentation of the amount appropriated in Item 4260-001-0890 of the Budget Act of 2026 (Chapters 19 and 21 of the Statutes of 2026) to expend State Opioid Response Grant funds.

SEC. 34.

This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.

LegiScan Search

View Top 50 Searches

LegiScan Info

2026 Schedules

Price List

Voter Registration

Governor Deadlines &
Effective Dates

LegiScan Trends

View Top 50 National

CA AB387 Nevaeh Youth Sports Safety Act.

CA SB401 Political Reform Act of 1974: filing deadlines: emergency situations.

NJ A5457 Prohibits motor vehicle manufacturer or dealer from requiring subscription...

CA SB1438 Local government: investments and deposits.

CA AB1832 2-1-1 information and referral response system.

CA AB2179 Workplace violence: restraining orders.

CA AB2009 Blood banks and plasma centers.

PA HR623 Recognizing October 9, 2026, as "Ageism Awareness Day" in Pennsylvania...

MI SB0413 Health occupations: psychologists; requirements for practice by limited...

NY A11700 Establishes multidisciplinary personnel teams to ensure prompt, coordinated,...

Main menu