(1) The California Hospice Licensure Act of 1990 requires a person, political subdivision of the state, or other governmental agency to obtain a license from the State Department of Public Health to provide hospice services to an individual who is experiencing the last phase of life due to a terminal disease, as defined, and their family, except as provided. Existing law requires the department, by January 1, 2024, to adopt emergency regulations to implement the recommendations in a specified report of the California State Auditor. Existing law requires the department to maintain the general moratorium on new hospice agency licenses until the department adopts the regulations, but in no event later than March 29, 2024. Existing law requires the moratorium to end on the earlier of 2 years from the date that the California State Auditor publishes a report on hospice agency licensure, or the date the emergency regulations are adopted.
This bill would instead require the moratorium to end on the date the emergency regulations are adopted and would extend the deadline by which the department is required to adopt those regulations to January 1, 2025.
(2) Under existing law, the Department of Health Care Services is responsible for licensing and certifying alcoholism and drug abuse recovery and treatment programs and facilities, including both residential and nonresidential programs. Existing law requires the department to charge a fee for the licensure or certification of these facilities and to evaluate licensing and certification fees annually, taking into consideration the overall cost of specified residential and outpatient licensing and certification activities of the department, plus a reasonable reserve. Existing law requires the department to submit proposed new fees or fee changes to the Legislature for approval, as specified, and prohibits new fees or fee changes without legislative approval. Existing law establishes the Residential and Outpatient Program Licensing Fund, consisting of fees, fines, and penalties collected from residential and outpatient programs.
This bill would require any excess fees remaining in the Residential and Outpatient Program Licensing Fund at the end of each fiscal year to be carried forward and taken into consideration in setting the amount of fees imposed in the immediately subsequent fiscal year. The bill would authorize the department, no sooner than July 1, 2027, to approve a fee increase, up to and including 5 percent on an annual basis, as needed to address the costs of the licensing and certification activities described above. The bill would require the department to submit any proposed new fees or fee increases in excess of 5 percent to the Legislature for approval and would prohibit new fees or fee changes in excess of 5 percent to be implemented without legislative approval. The bill would require the department to develop a process for programs and facilities to apply for a hardship fee waiver and issue a provider bulletin detailing the application process for the hardship fee waiver that includes eligibility requirements for demonstrated need by July 1, 2024.
Existing law requires the department to implement the licensing and certification provisions for alcoholism and drug abuse recovery and treatment programs and facilities through the Administrative Procedure Act. Existing law authorizes the department to implement new fees or fee changes by means of provider bulletins or similar action and to supersede the existing licensing and certification fees until the department amends the regulations. Existing law requires the department to notify and consult with interested parties and appropriate stakeholders regarding new fees or fee changes.
This bill would remove the requirement that the department implement the licensing and certification provisions described above through the Administrative Procedures Act. The bill would additionally authorize the department to implement the hardship fee waiver process by means of provider bulletins or similar action. The bill would remove the authority of the department to supersede the licensing and certification fees described above. The bill would additionally require the department to notify and consult with interested parties and appropriate stakeholders regarding the hardship fee waiver process.
(3) Existing law establishes the Emergency Medical Services Authority and requires the authority to be headed by a director who is appointed by the Governor. Existing law also requires the authority to have a chief medical officer who is appointed by the Governor, upon nomination by the Secretary of California Health and Human Services, who is a physician and surgeon licensed in California, as specified, and who has substantial experience in the practice of emergency medicine or emergency response in California. Existing law requires the chief medical officer to provide clinical leadership and oversight concerning treatment, education, and other matters involving medical decisionmaking and delivery of patient care.
This bill additionally would require the appointment of the director and the chief medical officer to be subject to confirmation by the Senate. The bill would specify that the offices of the director and the chief medical officer are held at the pleasure of the Governor.
(4) Existing law requires the State Department of Public Health to implement and administer a residential lead-based paint hazard reduction program, as specified, including adopting regulations regarding accreditation of providers of health and safety training to employees who engage in or supervise lead-related construction work, as defined, and certification of employees who have successfully completed that training. Existing law, commencing on January 1, 2024, requires a firm and at least one person onsite and employed by a firm, doing renovation, repair, or painting work that will disturb lead-based paint to have a certificate. Existing law, as of July 1, 2023, requires the department to develop and implement an education and outreach program for every person and firm that is required to have a certificate.
Existing law authorizes the department or any local law enforcement agency to enter, inspect, and photograph any premises where abatement, a lead hazard evaluation, or renovation, repair, or painting is being conducted or has been ordered, enter the place of business of any person who conducts abatement, lead hazard evaluations, or renovation, repair, or painting, and inspect and copy any business record of any person who conducts abatement, lead hazard evaluations, or renovation, repair, or painting to determine whether the person is complying with specified certification requirements.
This bill would authorize the department or any local law enforcement agency to enter, inspect, and photograph any premises where abatement, a lead hazard evaluation, or lead-related construction work is being conducted or has been ordered, enter the place of business of any person who conducts abatement, lead hazard evaluations, or lead-related construction work, and inspect and copy any business record of any person who conducts abatement, lead hazard evaluations, or lead-related construction work to determine whether the person is complying with specified certification requirements. The bill would delay the implementation of the provisions requiring a firm to have a certificate until July 1, 2027, and delay the implementation of the education and outreach program until July 1, 2026.
(5) Existing law requires the State Department of Health Care Services to license and establish regulations for psychiatric residential treatment facilities, which are defined as licensed residential facilities operated by a public agency or private nonprofit organization that provide psychiatric services to individuals under 21 years of age in an inpatient setting. Under existing law, an individual's length of stay at the facility is based on specified criteria and must be consistent with an individual plan of care developed by an interdisciplinary team. Under existing law, the interdisciplinary team may include, among others, a nurse practitioner, a mental health professional who has a master's degree in psychology, marriage and family therapy, social work, or counseling and who has been certified by the state, and a social worker.
This bill would revise the membership of the team, including removing the nurse practitioner, replacing the mental health professional with a psychologist who has a master's degree in clinical psychology or who has been certified, as specified, and requiring the social worker to be a psychiatric social worker.
Existing law requires information and records obtained in the course of providing specified mental health and developmental services to be confidential, but allows the disclosure of the information and records under specified circumstances, including, among others, in communications between qualified professional persons in the provision of services or appropriate referrals, or in the course of conservatorship proceedings, with the consent of the patient, or the patient's guardian or conservator, before information or records are disclosed by a professional person employed by a facility to a professional person not employed by the facility who does not have the medical or psychological responsibility for the patient's care.
This bill would authorize, if the patient is a dependent or ward of the juvenile court who has been removed from the physical custody of their parents, legal guardian, or Indian custodian, and who is not under a conservatorship, disclosure of information or records without the consent of the patient or their guardian or conservator to the dependent's or ward's social worker or probation officer for the purposes of ensuring the dependent or ward receives all necessary services or referrals for transition out of a facility to a lower level of care. The bill would also authorize the disclosure of information and records to the department for the purpose of licensing and establishing regulations for the psychiatric residential treatment facilities.
(6) Existing law, the California Affordable Drug Manufacturing Act of 2020, requires the California Health and Human Services Agency (CHHSA) to enter into partnerships, in consultation with other state departments as necessary, to, among other things, increase patient access to affordable drugs.
This bill would authorize CHHSA to enter into partnerships regarding over-the-counter naloxone products to allow the development, manufacturing, or distribution of those products by any entity that is authorized to do so under federal or state law.
(7) Existing law appropriates funds from the Federal Trust Fund to the State Department of Health Care Services to implement federal grants that address the opioid and stimulant epidemics through prevention, treatment, harm reduction, or recovery services.
This bill would additionally appropriate $56,239,000 from the Federal Trust Fund to the State Department of Health Care Services to expend Substance Abuse Prevention and Treatment Block Grant funds.
(8) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.

Statutes affected:
08/27/23 - Amended Senate: 1751.70 HSC, 1753.1 HSC, 1797.101 HSC, 11833.02 HSC, 11833.04 HSC, 105254 HSC, 4081 WIC, 5328 WIC