CaliforniaSB 8622025-2026 Regular SessionSenateWALLET

Health.

Sponsored By: Sponsor information unavailable

Signed by Governor

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Bill Overview

Analyzed Economic Effects

26 provisions identified: 18 benefits, 1 costs, 7 mixed.

Complex rehab and wheelchair supplier rules

Medi-Cal suppliers of complex rehabilitation technology must meet Medicare-like supplier standards, enroll in Medi-Cal, and be accredited. Each location must employ a qualified rehab technology professional (W‑2). Suppliers must keep parts and repair services and be present (in person or remotely) for evaluation and final fitting. A prescriber must do a physical exam and sign a certificate of medical necessity for power wheelchairs or scooters. The state may add extra reviews, and these rules apply only if needed federal approvals and funding are in place.

Hospitals must tell you about charity care

Hospitals must give you a written notice about discount and charity care policies at the visit or discharge. If not, they must mail it within 72 hours. Notices must be posted on‑site and online, in English and other languages. Emergency departments must give a paper copy. The notice must include the Health Consumer Alliance website and Covered California and Medi‑Cal information.

More services, housing help, and youth care

After prevention spending, the rest of the money goes to county programs that serve people with severe mental illness. Services can include housing assistance. Counties must also include services for youth ages 16 to 25 and consider the needs of transition‑age foster youth.

Pilot funds for school health services

The state provides a one‑time $5 million to start the School Health Demonstration Project. The pilot expands health and mental health services for public school pupils. It also helps districts use Medi‑Cal and other funding sources.

School health pilot grants and support

By June 30, 2022, the Superintendent selected up to three consortia to give two years of hands‑on help to school districts. By September 1, 2022, the state selected up to 25 districts for a two‑year pilot. Each selected district can get up to $100,000 per year, up to $200,000 total, to expand school health services. The health department seeks federal Medicaid funding for this work.

Easier path to nurse assistant jobs

By December 31, 2025, the state seeks vendors to offer the nurse assistant exam in Spanish. By July 1, 2029, the state posts and updates twice a year a list of all approved programs, pass rates by test language for the past two years, and how many were trained. Programs must keep a two‑year average pass rate of at least 60% or risk removal, with a path to reinstatement after fixes. Online programs must meet the same standards and arrange clinical training at a licensed facility.

Patient safety plans at health facilities

Health facilities must run a patient safety plan with a safety committee, incident reporting (including anonymous), team reviews like root‑cause analysis, ongoing safety training, and steps to address racism and discrimination. Starting January 1, 2026 and every two years, facilities must submit the plan to the state; there is an automatic 60‑day extension. The department may fine up to $5,000 for not adopting, updating, or submitting a plan. The department posts all plans online.

Safer baby food: testing and QR results

Starting January 1, 2024, baby food makers must test monthly for toxic elements like arsenic, cadmium, lead, and mercury at a proficient lab. From January 1, 2025, they must post each batch’s test results online for the product’s shelf life plus one month. Labs must be ISO/IEC 17025:2017 accredited and meet strict sensitivity and proficiency standards. From January 1, 2025, labels must include a QR code linking to test results and the FDA, and say: "For information about toxic element testing on this product, scan the QR code."

Counties must plan full mental health services

Each county adopts a three-year program and spending plan with yearly updates and sends it to the state within 30 days. Plans must cover prevention and early intervention, services for children, adults, and seniors, innovation, and technology and facility needs. County plans for children must include wraparound services or show why that is not feasible. If a plan uses restrictive facilities, the county must show why less restrictive, more integrated options will not meet the need. Counties must list workforce shortages and needed training support.

Grants and funding priorities for counties

This part operates only as money is appropriated. First, funds keep existing adult system of care programs running. Next, counties with many adults who have serious mental health conditions and are homeless or at risk get priority. The Director of Health Care Services sets a grant award method and forms an advisory committee with state, county, veterans, housing, law enforcement, and provider members.

Innovation and early psychosis programs

Counties must design innovation programs to reach underserved people, improve outcomes, and may expand permanent supportive housing. Counties may spend innovation funds only after the state oversight commission approves. The law creates the Early Psychosis Intervention Plus (EPI Plus) program, including outreach, psychotherapy, family support, school and job help, medicine, case management, and technology. An advisory committee with county, provider, clinician, primary care, and lived-experience members guides design, selection, and evaluation. Funds for an approved innovation plan do not revert while encumbered or until three years after approval; if voters approved MHSA changes on March 5, 2024, these sections stop July 1, 2026 and are repealed January 1, 2027.

Keeps Medi-Cal mental health in two counties

The state keeps specialty mental health services with the Medi‑Cal plan that handled them on July 1, 2022 in Sacramento and Solano Counties. The freeze stays until transition plans include continuity‑of‑care protections and notices to beneficiaries, and Section 14184.403 is implemented. This protects care during the changeover.

Managed care adds SNF, LTC, transplants

Starting January 1, 2022, donor and recipient organ and bone marrow transplants are covered under managed-care capitation. From 2022 through 2024, plans must pay providers the Medi-Cal fee-for-service (FFS) amount for those transplant services; the state may keep this rule for later contracts. Starting January 1, 2023, skilled nursing facility (SNF) care is in capitation, and from 2023 through 2025 plans must pay SNFs the FFS amount; the state may continue this for 2026 contracts. Starting January 1, 2024, other institutional long-term care is capitated, and from 2024 through 2025 plans must pay the FFS amount; the state may continue this for 2026 contracts. Capitation rates must be actuarially sound and reflect these payment levels. Plans must also pay CBAS providers the FFS amount unless a different rate is agreed.

Medi-Cal benefits standard; CBAS via managed care

Beginning January 1, 2022, Community-Based Adult Services (CBAS) stay covered under managed-care capitation. You must enroll in an applicable Medi-Cal managed care plan to get CBAS, unless you are exempt under CalAIM rules. CBAS must follow state and federal home- and community-based services rules. The Department of Health Care Services makes covered Medi-Cal benefits the same across all managed care plans statewide. The health and developmental services departments also run a workgroup to plan the move of ICF/DD facilities from fee-for-service into managed care.

More oversight and transparency of MHSA funds

The state sets instructions for the Annual MHSA Revenue and Expenditure Report; counties must certify accuracy and submit it electronically. The state and oversight commission post each county’s report online, and by October 1 each year the state lists funds that could revert. If a county is not following its contract, the state can require a correction plan and must post the findings and plan. By July 1, 2018, the state reported amounts subject to reversion before July 1, 2017 and gave counties a way to appeal. Until regulations are adopted, the state may use all‑county letters with public comment to implement rules. Oversight commissioners serve as ex officio members on the statewide planning council during its duties; if voters approved MHSA changes on March 5, 2024, this ends July 1, 2026 and is repealed January 1, 2027.

More training hours for nurse assistants

Approved CNA programs must give at least a 16-hour orientation before any direct care. They must include at least 60 classroom hours and 100 hours of supervised clinical practice. Training must cover developmental and dementia needs. At least 4 clinical hours must address special needs.

County mental health reserves and caps

Counties must keep a prudent reserve so services continue when revenues drop. A county’s reserve is capped at 33% of its five‑year average (25% for counties under 200,000 people). No more than 20% of the five‑year average can go to tech, buildings, HR, and reserves. Planning costs are capped at 5% of yearly revenues. Starting July 1, 2025, up to 2% of annual revenues can improve operations, data, and oversight. Each year, 5% of funds must go to approved innovation projects.

Infertility coverage rules and limits in 2026

Starting January 1, 2026, large‑group health plans must cover infertility diagnosis and treatment, including up to three completed egg retrievals and unlimited embryo transfers when medically appropriate. Small‑group insurers must offer an infertility coverage option, but employers do not have to buy it. Plans cannot impose worse copays, deductibles, or limits on infertility drugs or services, and cannot deny coverage for using donors or gestational carriers. Religious employers are exempt, and PERS plans are exempt until July 1, 2027.

Real-time health reporting for providers

The health department can set up a statewide syndromic surveillance program, if funded. Entities the department names must send required data electronically as close to real time as possible, following state standards and schedules. An entity may report to its local health department’s system instead if that system can send the data to the state now or by July 1, 2027. The department helps local health departments build automatic transmission by July 1, 2027. No fines, sanctions, or license actions apply unless the rules were printed in the California Code of Regulations and the department gave at least six months’ notice.

Rules for county mental health dollars

Before counties get money, the state may reserve up to 5% of annual revenues for state uses. The state can also reserve up to $36,000,000 for a workforce initiative if the annual budget approves it. Counties must put state behavioral health funds in a local Mental Health Services Fund, and interest earned stays in that fund. Counties must use 20% of key distributions for prevention and early intervention, and may draw on prudent reserves to keep serving the same number of people when allocations drop. If the state finds reserves are adequate and there are no unmet needs, it plans with counties to spend extra balances. Section 5892 starts January 1, 2025 and ends July 1, 2026 if voters approved MHSA changes on March 5, 2024.

Stronger reporting for county mental health

Counties must file yearly MHSA plans and updates that show people served, cost per person, how unspent funds are used, and proposed spending. Counties must follow GAAP rules, use cash basis for capital and tech projects, and report total MHSA spending on veterans. All spending must match the approved plan, and MHSA Medi‑Cal services count toward the county match sent to the state. The department may withhold MHSA funds if a county misses the annual report deadline.

Timeline rules for county mental health funds

Unspent county funds must return to the state after three years, unless in an approved reserve. Money for capital projects, tech, or training can be kept up to 10 years. Small counties (under 200,000 people) have a five‑year window, and approved innovative plans do not revert while funds are encumbered. Funds unspent by July 1, 2020, and some earlier amounts revert on set dates; some pre‑2017 funds are reallocated back to the county for original uses. During July 1, 2020–June 30, 2022, counties could use reserves for prevention, early help, and housing assistance. If voters approved the MHSA changes on March 5, 2024, section 5848 becomes inoperative July 1, 2026 and is repealed January 1, 2027.

Annual notice on child mental health screenings

Health insurers must send a yearly notice about behavioral health and wellness screenings for children ages 8 to 18, including depression and anxiety screening. This rule does not apply to Medi-Cal managed care plans that contract with the state.

Deadlines on old unspent county funds

By July 1, 2018, counties with unspent funds that could revert had to plan to spend them by July 1, 2020 and send the plan to the oversight commission. If a county had not sent a plan by January 1, 2019, it had to send the unspent funds to the State Controller by July 1, 2019.

Schools get body-shaming policy resources

By June 30, 2025, the State Department of Education posts a model body‑shaming policy and resources for K–12 schools. Districts can use the materials to teach staff, parents, and students about body shaming.

Mental health services through county contracts

The state delivers mental health services through contracts with county mental health programs or counties acting together. Contracts may be exclusive and set by geographic area. Two or more counties may agree to deliver or subcontract services together and must spell out duties and fiscal liability. The state reviews each county performance contract at least once every three years, if funding is available.

Sponsors & Cosponsors

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 208 • No: 0

Senate vote • 9/8/2025

Item 176 — Senate SFLOOR

Yes: 39 • No: 0

House vote • 9/3/2025

Item 169 — Assembly AFLOOR

Yes: 79 • No: 0

legislature vote • 7/16/2025

Vote in CX25

Yes: 13 • No: 0

legislature vote • 6/24/2025

Vote in CX08

Yes: 15 • No: 0

Senate vote • 5/29/2025

Item 354 — Senate SFLOOR

Yes: 38 • No: 0

legislature vote • 5/23/2025

Vote in CS61

Yes: 6 • No: 0

legislature vote • 5/12/2025