CA AB 164

Description

(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 federal law, H.R. 1 (Public Law 119-21) , enacted in 2025, sets forth various Medicaid eligibility changes for implementation at different stages of a certain timeline, including changes applied to beneficiaries between 19 and 64 years of age, inclusive, with income up to 138% of the federal poverty level, commonly known as Medicaid expansion adults. Federal H.R. 1 generally requires a Medicaid expansion adult to undergo an eligibility redetermination once every 6 months, instead of an annual redetermination. The federal law generally requires a Medicaid expansion adult to demonstrate community engagement through any of certain methods for the corresponding month, including a minimum of 80 hours of work or community service or a minimum of half-time enrollment in an educational program. The federal law reduces the period of retroactive coverage prior to the date of Medicaid application from 3 months to one month for Medicaid expansion adults and to 2 months for other Medicaid beneficiaries. The federal law requires the state to provide for a process to regularly obtain beneficiary address information from reliable data sources, and to utilize a system to prevent an individual from being simultaneously enrolled under Medicaid state plans or waivers of multiple states. This bill would make various changes to related state provisions, or would add new provisions, conforming them to the above-described changes under federal H.R. 1. The bill would require a county to accept specified methods of signatures for renewal forms. Federal H.R. 1 restricts the scope of certain categories of immigrants who qualify for Medicaid eligibility. This bill would make conforming changes to related state provisions. The bill would also modify provisions regarding individuals with certain immigration statuses, so that they would be eligible for the full scope of Medi-Cal state-funded benefits, subject to certain service limitations. Existing law requires an individual without satisfactory immigration status, as specified, who is eligible for full-scope Medi-Cal to enroll in a Medi-Cal managed care plan. This bill would instead specify that an individual without satisfactory immigration status who is eligible for the Medi-Cal program is eligible for services in the Medi-Cal fee-for-service delivery system. The bill would make conforming changes to related provisions. Existing law requires the department to develop an application for insurance affordability programs, including Medi-Cal, for use by all entities authorized to make an eligibility determination for those programs. Existing law authorizes the department to develop and require use of supplemental forms to collect additional information needed to determine eligibility. This bill would make various changes to those provisions, relating to user testing, accuracy, readability, and the work or community engagement requirements under federal H.R. 1. The bill would require the department to undertake efforts to conduct outreach regarding the changes made under federal H.R. 1, and to establish a data dashboard. Under the bill, beneficiary outreach and education would be coordinated across public social services programs to help minimize barriers to administrative disenrollments. The bill would incorporate federal H.R. 1 requirements into county outreach efforts, as specified. By creating new duties for counties regarding Medi-Cal eligibility determinations, procedures, and outreach, the bill would impose a state-mandated local program. (2) Existing law, beginning no sooner than July 1, 2027, requires certain individuals who do not have satisfactory immigration status to pay a monthly premium of $30 as a condition of eligibility for the full scope of Medi-Cal benefits, subject to certain exceptions. This bill would require, no sooner than May 14, 2027, the Governor's 2027–28 May Revision to include the level of the monthly premiums, to be set at no less than $30 and no greater than $50 per beneficiary. Under existing law, no sooner than July 1, 2026, the above-described individuals who are 19 years of age or older are not eligible for dental services under the Medi-Cal program, except as specified. This bill would delay the ineligibility for dental services to a period no sooner than July 1, 2027. (3) Under existing law, to the extent that federal financial participation is available, federally qualified health center (FQHC) services and rural health clinic (RHC) services are covered Medi-Cal benefits. Under existing law, FQHC and RHC services are reimbursed on a per-visit basis, as defined. Under existing law, commencing on July 1, 2026, that reimbursement is conditioned on the services being eligible for federal financial participation. This bill would instead apply that condition commencing on July 1, 2027. (4) Existing law, the California Advancing and Innovating Medi-Cal (CalAIM) Act, subject to receipt of any necessary federal approvals, establishes the CalAIM initiative in order to, among other things, improve quality outcomes, reduce health disparities, and transition and transform the Medi-Cal program to a more consistent and seamless system by reducing complexity and increasing flexibility. Under existing law, the CalAIM initiative ends on December 31, 2026. Existing law appropriates to the department certain amounts of federal financial participation that the department is authorized to claim for expenditures associated with the designated state health programs identified in the CalAIM Terms and Conditions. Existing law appropriates to the Health Care Deposit Fund, a continuously appropriated fund, an amount of General Fund moneys equal to the federal financial participation for use by the department for CalAIM implementation purposes. Existing law also continuously appropriates moneys from the Medi-Cal County Behavioral Health Fund to the department for purposes of implementing certain behavioral health provisions within CalAIM. This bill, subject to receipt of any necessary federal approvals, would extend the CalAIM initiative to December 31, 2031, thereby making an appropriation. The bill would require the department to seek federal approval for implementation of Employment Supports and BridgeCare, the latter of which is to provide home- and community-based services and caregiver supports to individuals enrolled in the federal Medicare Program who meet the near dual eligibility criteria, as specified. Existing law requires an individual county, or counties acting jointly, to provide and administer covered behavioral health Medi-Cal benefits under a single Medi-Cal behavioral health delivery system contract, in accordance with the CalAIM Terms and Conditions. This bill would require the county or counties, if participating in the Drug Medi-Cal organized delivery system, to deliver the behavioral health benefits through a single Prepaid Inpatient Health Plan. (5) Existing law sets forth various requirements and procedures for the enrollment of providers in the Medi-Cal program. This bill, for the period beginning on July 1, 2026, and ending on June 30, 2027, would prohibit the granting of provisional or preferred provisional enrollment status in the Medi-Cal program to an applicant or provider as a result of the department's failure to act within any of specified timeframes. Under those circumstances, the bill would require that the application remain pending unless and until the department issues a written determination consistent with all applicable state and federal Medicaid screening requirements. (6) Existing law prohibits the use of an assets or resources test for individuals whose income eligibility for Medi-Cal is determined based on the application of a modified adjusted gross income (MAGI) . Existing federal law authorizes a state to establish a non-MAGI standard for determining the eligibility of certain populations. Existing law, subject to receipt of any necessary federal approvals, implements a disregard of $130,000 in nonexempt property for a case with one member and $65,000 for each additional household member, up to a maximum of 10 members, as specified. This bill, beginning July 1, 2027, would instead implement a resource limit of $21,000 in nonexempt property for a household with one member, $31,000 for a household with 2 members, and $1,550 for each additional household member, up to a maximum of 10 members, as specified. The bill would make conforming changes to related provisions. By creating new duties for counties relating to the consideration of resources for determining Medi-Cal eligibility, the bill would impose a state-mandated local program. (7) Existing law requires a Medi-Cal managed care plan to comply with a minimum 85% medical loss ratio consistent with certain federal regulations. Under existing law, after the department returns the requisite federal share amounts associated with any remittance funds collected in any applicable fiscal year to the federal Centers for Medicare and Medicaid Services, the remaining amounts remitted by a Medi-Cal managed care plan under these provisions are transferred to the Medi-Cal Loan Repayment Program Special Fund for purposes of the Medi-Cal Physicians and Dentists Loan Repayment Program. This bill instead would deposit the remaining amounts remitted by a Medi-Cal managed care plan into the General Fund. The bill would remove an inoperative provision. (8) Existing law requires the department to establish and maintain a plan, known as the County Administrative Cost Control Plan, whereby costs for county administration of the determination of eligibility for Medi-Cal benefits are effectively controlled within the amounts annually appropriated for that administration. Existing law makes legislative findings that, in order for counties to do the work that is expected of them, it is necessary that they receive adequate funding, including adjustments for reasonable annual cost-of-doing-business increases. Existing law expresses the intent of the Legislature to not appropriate funds for cost-of-doing-business adjustments for the 2024–25 to 2027–28, inclusive, fiscal years, among certain other previous fiscal years. This bill would remove the 2026–27 and 2027–28 fiscal years from the above-described statement of intent regarding the lack of appropriation of funds for the cost-of-doing-business adjustments. (9) Existing law provides for the licensure and regulation of health facilities, including general acute care hospitals and skilled nursing facilities, by the State Department of Public Health. A violation of these provisions is generally a crime. Existing law sets forth various provisions relating to distinct parts of acute care hospitals, including those operating skilled nursing facilities. Existing regulations define "distinct part" as an identifiable unit accommodating beds, including, but not limited to, contiguous rooms, a wing, floor, or building that is approved by the department for a specific purpose. This bill would require a general acute care hospital seeking to provide skilled nursing services in a distinct part, as defined, to submit an application and documentation to the department. If the distinct part meets certain criteria, the bill would authorize the department to approve a hospital's application for a distinct part on a case-by-case basis. The bill would require a skilled nursing distinct part to meet specified conditions, including, among others, being wholly owned by the hospital and being subject to the bylaws and operating decisions of the hospital's governing body. The bill would require a general acute care hospital seeking to add a composite distinct part to its license to submit a proposal to the department, as specified. Under the bill, "composite distinct part" would be defined as a distinct part consisting of 2 or more noncontiguous components that are not located within the same campus. If the department determines that the composite distinct part may improve access to care and address a specific unmet need in the geographical area served by the hospital, the bill would authorize the hospital to submit an application for approval of a composite distinct part. The bill would require a freestanding component of a composite distinct part to independently meet all of the licensing requirements applicable to a freestanding skilled nursing facility, including staffing requirements and ratios. The bill would prohibit a hospital from using composite distinct parts to segregate residents by payment source or on a basis other than care needs. The bill would limit the hospital to a maximum of only one licensed skilled nursing distinct part, which may be a composite distinct part, with the hospital and the distinct part or composite distinct part having only one license number. The bill would set forth related identification duties for the department. Existing law requires the department, upon approval, to issue a separate license for the provision of basic services relating to skilled nursing or intermediate care, whenever these basic services are to be provided by an acute care hospital in a separate freestanding facility, whether or not contiguous to the hospital. Existing law sets forth various exemptions to this requirement, including for beds licensed to an acute care hospital and located within the physical structure in which acute care is provided. This bill would exempt, from the above-described requirement, licensed skilled nursing beds in a distinct part located on a general acute care hospital's campus, as specified. Under the bill, a composite distinct part would be exempt only if the hospital's license has a distinct part on its campus approved for skilled nursing. By creating new requirements for general acute care hospitals, distinct parts, and composite distinct parts, the violation of which would be a crime, the bill would impose a state-mandated local program. (10) Existing law requires the State Department of Public Health to develop and maintain a statewide comprehensive community-based perinatal services program, as specified, to deliver services in medically underserved areas or areas with demonstrated need. Existing law requires the department, by July 1, 2026, to establish a 10-year pilot project within up to 5 critical access hospitals to allow participating hospitals, on an application basis, to establish standby perinatal services, as defined. Existing law requires, if qualified, the first 2 hospitals selected to be nonprofit and located in the Counties of Humboldt and Plumas. This bill would require, if qualified, a nonprofit hospital located in the County of Lake to be one of the first 3 hospitals selected. The bill would make various changes to certain criteria, with regard to staff responsibilities and procedures, for a hospital requesting approval to establish a standby perinatal service. Because a violation of these provisions would be a crime, the bill would impose a state-mandated local program. The bill would make legislative findings and declarations as to the necessity of a special statute for the County of Lake. (11) Existing law provides for the licensure and regulation of home health agencies by the State Department of Public Health. Existing law generally makes a violation of those provisions a misdemeanor. Existing law prescribes various requirements for the application for a home health agency license, including a provisional license for an applicant that has not been previously licensed. This bill, except as provided, would require a home health agency to have an administrator, administrator designee, director of patient care services, and director of patient care services designee, and to submit to the department specified information for each individual on an initial application. The bill would require existing agencies to provide this information no later than March 31, 2027. The bill would require the department to verify specified details of home health agency management personnel. The bill, except as provided, would require an applicant for licensure of a home health agency or a branch office to demonstrate an unmet need for home health services in the agency's geographic service area. The bill would specify additional grounds by which the department is authorized to deny an application for, or suspend or revoke, a license. Because a violation of these provisions would be a crime, the bill would impose a state-mandated local program. The bill would prohibit the transfer of a license that is issued pursuant to these provisions. The bill would prohibit the department from approving a change of ownership of a licensed home health agency within 5 years of the date a license was initially issued to the licensee. The bill would authorize the department to make an exception for extenuating circumstances, as specified. The bill, for a specified period of time, would prohibit the department from issuing a new license to operate a home health agency or add a branch office to an existing license. The bill would authorize the department to grant an exception upon a written finding that an applicant for a new license or with a pending application has demonstrated an unmet need for home health services in the area where the applicant proposes to operate. The bill would require the department to update existing home health agency regulations as necessary and adopt regulations that, among other things, clarify the maximum time and distance that home health agency staff may travel to reach patients, as specified. (12) Existing law requires the State Department of Health Care Services to license and regulate alcohol or other drug programs that provide recovery, treatment, or detoxification services or medications for addiction treatment. Under existing law, a licensee is required to provide at least one specified nonmedical service. Existing law requires the department to adopt American Society of Addiction Medicine (ASAM) treatment criteria, or an equivalent evidence-based standard, as the minimum standard of care for licensed facilities, and required the department to adopt regulations to implement the ASAM Criteria by January 1, 2023. The ASAM Criteria, 4th Edition, changes the levels of care for substance use treatment and integrates withdrawal management services, formerly referred to as detoxification services, into other care levels. This bill would recast detoxification as withdrawal management and would make conforming changes. The bill would require a licensee to provide recovery and treatment services or recovery, treatment, and withdrawal management services. The bill would require a license to provide detoxification-only services to expire on July 1, 2027. The bill would prohibit a licensee from providing detoxification-only services on and after that date and would prohibit the department from issuing or extending a license for detoxification-only services on or after that date. The bill would require the department to promulgate regulations to implement the ASAM Criteria by January 1, 2030, and in the interim would authorize the department to implement the ASAM Criteria through all-county letters, plan letters, information notices, or similar instructions. On and after July 1, 2027, the bill would require a licensee that provides withdrawal management services to provide those services as required in guidance issued by the department. (13) Existing law imposes certain fair pricing requirements on hospitals, including, among other things, requiring that hospitals provide patients with a written notice containing information about the availability of the hospital's discount payment and charity care policies and restricting the sale of patient debts. Existing law requires the Director of the Department of Health Care Access and Information to impose administrative penalties for each violation against a hospital that fails to comply with these provisions, except as specified. This bill would establish the Hospital Fair Pricing Penalties Fund and would require any moneys collected from the above-described administrative penalties to be deposited into the fund. The bill would, upon appropriation, authorize the department to use moneys from the fund to carry out the above-described fair-pricing provisions. (14) Existing law requires the Center for Data Insights and Innovation to compile an annual quality of care report card and produce an annual report regarding health care consumer or patient assistance help centers. Existing law establishes the Health Plan Improvement Trust Fund and requires moneys in the fund to be used for these purposes, upon appropriation by the Legislature. Existing law sets forth the shares of funding from the Managed Care Fund and Insurance Fund to be deposited into the Health Plan Improvement Trust Fund. Existing law makes personal information obtained or maintained by the center confidential and exempt from other disclosure requirements. This bill would repeal and recast the above-described provisions to be administered by the Department of Health Care Access and Information beginning July 1, 2026. The bill would also make conforming changes. Existing law requires the Department of Health Care Access and Information to establish and implement the California Health and Human Services Data Exchange Framework, which is required to include a single data sharing agreement and common set of policies and procedures that will leverage and advance national standards for information exchange and data content, and that will govern and require the exchange of health information among health care entities and governmental agencies in the state. Existing law generally requires specified entities to execute the data sharing agreement on or before January 31, 2023, and to exchange health information or provide access to health information pursuant to the framework by July 1, 2026. This bill would delay required compliance with the above-described provisions until July 1, 2027, for specified community clinics, intermittent clinics, and rural health clinics. (15) Existing law establishes the California Reproductive Health Equity Program within the Department of Health Care Access and Information to ensure abortion and contraception services are affordable for and accessible to all patients and to provide financial support for safety net providers of these services. Existing law authorizes a Medi-Cal enrolled provider to apply to the department for a grant, and a continuation award after the initial grant, to provide abortion and contraception services if specified criteria are met. Existing law establishes the California Reproductive Health Equity Fund, a continuously appropriated fund, to provide this grant funding. Existing law establishes the Abortion Access Fund, a continuously appropriated fund in the State Treasury, to provide funding for abortion services. This bill would rename the program as the California Reproductive and TGI Health Equity Program, would expand the program's purposes to ensure affordability and access to gender-affirming care, and would make conforming changes. The bill would require the department to develop an application form and begin accepting grant applications on or before January 1, 2027. The bill would authorize the department to use the money in the Abortion Access Fund to provide grant funding to safety net providers for abortion services through the program and would expand the purposes of the California Reproductive Health Equity Fund to include grant funding for gender-affirming care services, thus making an appropriation. The bill would make contracts, grants, and related program information confidential and exempt from disclosure to the public. (16) Existing law, the Medical Practice Act, provides for the licensure and regulation of physicians and surgeons by the Medical Board of California and requires the board to adopt and administer standards for the continuing education of those licensees. Existing law requires the board, in determining its continuing education requirements, to consider including a course in menopausal mental or physical health. Existing law, the Osteopathic Act, provides for the licensure and regulation of osteopathic physicians and surgeons by the Osteopathic Medical Board of California and requires the board to adopt and administer standards for the continuing education of those licensees. Under this bill, beginning July 1, 2027, a qualifying physician and surgeon or osteopathic physician and surgeon who completes continuing medical education courses in perimenopause, menopause, and postmenopausal care would receive 2 hours of credit for each hour completed of that coursework, as specified. The bill would make changes to related provisions regarding course hours for nurse practitioners and physician assistants. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and generally makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. This bill would require a health care service plan contract or health insurance policy, as specified, to include coverage for certain treatments for menopausal symptoms, as medically necessary. The bill would require these contracts and policies to include a program that meets specified criteria to ensure the individuals have access to current menopause information and covered items and services. The bill would require a plan or insurer to base a medical necessity determination or utilization review criteria for the treatment of symptoms resulting from menopause on current generally accepted standards of menopause care. Beginning January 1, 2027, the bill would require a plan or insurer conducting utilization review for the treatment of symptoms resulting from menopause to apply certain criteria and guidelines, as specified. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program. Existing law sets forth a schedule of benefits under the Medi-Cal program. This bill would cover certain treatments for menopausal symptoms under the Medi-Cal program, subject to medical necessity and to the extent that federal financial participation is available. The bill would require the department to establish and maintain a policy to reimburse providers for provision of services related to menopause care. (17) Existing law establishes the Breast Cancer Fund, which consists of 2 accounts, the Breast Cancer Research Account and the Breast Cancer Control Account. Under existing law, revenues from a specified cigarette tax are deposited into the fund and divided between the 2 accounts, to be allocated upon appropriation by the Legislature. Existing law requires 10% of moneys in the Breast Cancer Research Account to be allocated to the Cancer Surveillance Section, as specified. This bill would correct an erroneous reference within the above provisions. (18) Existing law creates the California Health Benefit Exchange, also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under the Patient Protection and Affordable Care Act (PPACA) . Existing law establishes the Health Care Affordability Reserve Fund to be used, upon appropriation, for health care affordability programs operated by the Exchange, among other things. Existing law requires the Exchange, upon appropriation, to provide payments equaling the cost of providing coverage of abortion services for which federal funding is prohibited to individuals enrolled in a qualified health plan through the Exchange in the individual market. Existing law prohibits the payments from being less than $1 per enrollee per month. This bill would require that the Health Care Affordability Reserve Fund be utilized, upon appropriation, for the above-described payments. (19) Existing law, the Mental Health Services Act (MHSA) , an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, creates the Mental Health Service Fund, a continuously appropriated fund, for the purpose of funding a system of county mental health plans for the provision of mental health services. Existing law authorizes the Legislature to clarify procedures and terms of the MHSA by majority vote. Existing law, the Behavioral Health Services Act (BHSA) , a legislative act amending the MHSA that was approved by the voters as Proposition 1 at the March 5, 2024, statewide primary election, recast the MHSA by, among other things, renaming the Mental Health Service Fund as the Behavioral Health Service Fund, expanding the MHSA to include treatment of substance use disorders, changing the county planning process, and expanding services for which counties and the state can use funds. Existing law requires a county to calculate a maximum amount it establishes as the funding level for its prudent reserve for its Local Behavioral Health Services Fund, not to exceed 20% of the average of the total funds distributed to the county, as specified, and requires a county with a population of less than 200,000 to calculate a maximum amount it establishes as the prudent reserve for its Local Behavioral Health Services Fund, not to exceed 25% of the average of the total funds distributed to the county, as specified. This bill would, commencing with the 2029–30 fiscal year and every 3 fiscal years thereafter, require a county to calculate the maximum funding level of its prudent reserve, as specified, and include a plan for the expenditure of funds exceeding the maximum amount funding level in the county's integrated plan. Existing law requires the Controller, on or before the 15th day of each month, to distribute to each Local Behavioral Health Service Fund established by counties all unexpended and unreserved funds on deposit as of the last day of the prior month in the Behavioral Health Services Fund for the provision of behavioral health programs and other related activities pursuant to a methodology provided by the State Department of Health Care Services. This bill, commencing July 1, 2028, would require the department to establish a methodology for determining annual minimum expenditure levels for funds distributed to counties, as described above. The bill would, beginning in the 2028–29 fiscal year, set the minimum expenditure level at the average annual amount of distributed funds for a county in the preceding 3 years. The bill would require a county, commencing with the 2029–30 fiscal year and each fiscal year thereafter, to spend an amount of distributed funds that is equal to or greater than the minimum expenditure level for that fiscal year, as specified. The bill would authorize a county to spend funds from its prudent reserve only during a fiscal year for which the department publishes a revised minimum expenditure level, during any fiscal year in which the amount of distributed funds is less than the minimum expenditure level calculated for that fiscal year, or during a fiscal year in which the county determines that there has been a change in local behavioral health needs or circumstances. Existing law requires each county to prepare and submit an integrated plan and annual updates to the Behavioral Health Services Oversight and Accountability Commission and the department. Existing law requires the integrated plan and annual update to include a budget that includes the county planned expenditures and reserves for the county distributions from the Behavioral Health Service Fund and any other funds allocated to the county to provide specified services and programs. Existing law requires all expenditures for county behavioral health programs to be consistent with a currently approved county integrated plan, annual update, or intermittent update. If a county fails to submit certain data and information or fails to allocate funding as specified, existing law authorizes the department to impose a corrective action plan, monetary sanctions, or temporarily withhold payments to the county. Existing law requires these monetary sanctions to be deposited in the Behavioral Health Services Act Accountability Fund, a continuously appropriated fund, to be allocated and distributed to the county that paid the monetary sanction upon the department's determination that the county has come into compliance. If a county fails to comply with the minimum expenditure requirements described above, this bill would authorize the department to impose a corrective action plan, monetary sanctions, or temporarily withhold payments to the county. Because the monetary sanctions would be a new source of moneys for the Behavioral Health Services Act Accountability Fund, a continuously appropriated fund, this bill would make an appropriation. By creating additional duties for counties, the bill would impose a state-mandated local program. (20) Existing law requires the State Department of State Hospitals to designate a community program director who is responsible for administering community treatment programs for certain committed persons. Existing law establishes the Forensic Conditional Release Program to provide outpatient and community-based treatment to committed persons. Existing law requires the department, until June 30, 2026, to establish a statewide panel of independent evaluators to identify and evaluate state hospital patients who are appropriate for participation in the program. This bill would rename the independent evaluation panel as the independent placement panel. The bill would make certain changes to the designation process for case reviews and placement recommendations. The bill would extend these provisions indefinitely. Existing law prohibits outpatient status for a person who is charged with and found incompetent on a charge of, convicted of, or found not guilty by reason of insanity of, certain crimes until the person has actually been confined in a state hospital or other treatment facility for at least 180 days. Existing law permits outpatient status, without a person first being confined in a state hospital or other treatment facility, in the case of other crimes. Existing law requires the court to consider certain criteria before placing those persons on outpatient status. This bill would modify some of those factors that the court would be required to consider. The bill would also make changes to related provisions regarding procedures for the independent placement panel or designee to submit certain recommendations and for the court to give notice of hearing dates to specified entities. (21) Existing law authorizes the State Public Health Officer, to the extent allowable under federal law, and upon the availability of funds, to expend moneys from the continuously appropriated AIDS Drug Assistance Program (ADAP) Rebate Fund for a program to cover the costs of prescribed ADAP formulary medications for the prevention of HIV infection and other specified costs. This bill would additionally allow moneys from the ADAP Rebate Fund to be used to cover costs related to state and local public health department disease intervention and investigation activities and services for specified communicable diseases, to the extent that funds are available for these purposes. The bill would also allow moneys from the fund to be used to cover costs related to housing support and other programs or initiatives relating to HIV treatment or overdose prevention and harm reduction. The bill would, to the extent deemed an allowable use of the fund, authorize the State Department of Public Health to spend up to $134,840,000 in fiscal year 2026–27, $134,490,000 in fiscal year 2027–28, $126,590,000 in fiscal year 2028–29, and $130,090,000 in fiscal year 2029–30, from the fund to implement specified programs. The bill would authorize the department to spend up to $50,000,000 for related purposes, as specified. By adding to the purposes of the ADAP Rebate Fund, the bill would make an appropriation. (22) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason. With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above. (23) 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. (24) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.

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