SMCMA Physician

California's New Healthcare Laws

The California Legislature had an active year in 2018, passing many new laws affecting health care. In particular, there was a strong focus on health care coverage, drug prescribing, public health, and mental health issues. On the following pages you will find highlights of the most significant health laws of interest to physicians for 2019.

 

ALLIED HEALTH PROFESSIONALS

AB 2281 (Irwin) – Clinical laboratories: licensed medical laboratory technicians

CMA Position: Support

Exempts blood smear reviews other than manual leukocyte differentials, microscopic urinalysis, and blood typing of moderate complexity such as automated ABO/Rh testing and antibody screen testing from the prohibition of licensed medical laboratory technicians from performing microscopic analysis or immunohematology procedures.

AB 2423 (Holden) – Physical therapists: direct access to services 

CMA Position: Neutral

Provides physical therapists with an exemption from the provision in the Physical Therapy Practice Act that prohibits the physical therapist from continuing treatment beyond 45 calendar days or 12 visits, whichever occurs first, without receiving specified doctor approval of the physical therapist’s plan of care to enable them to provide services within their scope of practice under the federal Individuals with Disabilities Act (IDEA) under a school-developed Individualized Education Program (IEP) or an Individualized Family Service Plan (IFSP).

AB 2589 (Bigelow) – Controlled substances: human chorionic gonadotropin

Current law lists human chorionic gonadotropin (hCG) as a Schedule III controlled substance under the California Uniform Controlled Substances Act. This bill exempts hCG from being subject to the reagent regulations of the Controlled Substances Act when possessed by, sold to, purchased by, transferred to, or administered by a licensed veterinarian, or a licensed veterinarian’s designated agent, exclusively for veterinary use.

SB 762 (Hernandez) – Optometry: administration of immunizations

Requires training programs for certification of optometrists to administer immunizations to be endorsed by the Accreditation Council for Pharmacy Education in addition to the federal Centers for Disease Control and Prevention.

SB 1003 (Roth) – Respiratory therapy

CMA Position: Neutral

Prohibits any state agency, as defined, except for the Respiratory Care Board of California, from defining or interpreting respiratory care for those licensed under the Respiratory Care Practice Act, or from developing standardized procedures or protocols, unless authorized by these provisions or specifically required by state or federal statute.

 

CONSENT 

AB 3189 (Cooper) – Consent by minors to treatment for intimate partner violence

Authorizes a minor who is 12 years of age or older and who states he or she is injured as a result of intimate partner violence, as defined, to consent to medical care related to the diagnosis or treatment of the injury and the collection of medical evidence with regard to the alleged intimate partner violence. 

 

DEATH AND ORGAN DONATION

AB 2096 (Frazier) – Personal income taxes: voluntary contributions: Organ and Tissue Donor Registry Voluntary Tax Contribution Fund

Allows a taxpayer to designate an amount in excess of personal income tax liability to be transferred into the Organ and Tissue Donor Registry Voluntary Tax Contribution Fund, which the bill creates. 

SB 1163 (Galgiani) – Postmortem examination or autopsy

Makes various changes to provisions regarding postmortem examination or autopsies of unidentified bodies or remains, including to provisions regarding dental examinations, tomography scans, and retention of tissue and bone samples. Authorizes an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration or decomposition, where the circumstances surrounding the death afford a reasonable basis to suspect that the death was caused by or related to the criminal act of another, to perform the exhumation in consultation with a board-certified forensic pathologist. Authorizes a board-certified forensic pathologist to suggest to the agency tasked with an exhumation to consider retaining the services of an anthropologist, as specified.

 

DRUG PRESCRIBING AND DISPENSING

AB 315 (Wood) – Pharmacy benefit management

CMA Position: Sponsor

Requires a pharmacy in inform a customer at the point of sale for a covered prescription drug whether the retail price is lower than the applicable cost-sharing amount for the prescription drug unless the pharmacy automatically charges the customer the lower price. If the customer pays the retail price, the bill requires the pharmacy to submit the claim to the plan or insurer in the same manner as if the customer had purchased the prescription drug by paying the cost-sharing amount when submitted by the network pharmacy.

AB 1751 (Low) – CURES database: Interstate data sharing

CMA Position: Oppose Unless Amended

Requires the Department of Justice, no later than July 1, 2020, to adopt regulations regarding the access and use of the information within CURES by consulting with stakeholders, and addressing certain processes, purposes, and conditions in the regulations. Authorizes the department, once final regulations have been issued, to enter into an agreement with any entity operating an interstate data sharing hub, or any agency operating a prescription drug monitoring program in another state, for purposes of interstate data sharing of prescription drug monitoring program information, as specified.

AB 1753 (Low) – Controlled substances: Security form

CMA Position: Neutral

Authorizes the Department of Justice to reduce or limit the number of approved security printers for controlled substance prescription forms to 3, as specified and requires prescription forms for controlled substance prescriptions to have a uniquely serialized number, in a manner prescribed by the department, and requires a printer to submit specified information to the department for all prescription forms delivered.

AB 2037 (Bonta) – Pharmacy: automated patient dispensing systems

Provides an alternative program to authorize a pharmacy located in the state to provide pharmacy services to the patients of covered entities, as defined, that are eligible for discount drug programs under federal law, as specified, through the use of an automated patient dispensing system, as defined. Provides that the responsibility of the operation, maintenance, and security of the automated patient dispensing system would be the responsibility of the pharmacy and requires that the drugs dispensed from the system be labeled in accordance to existing law. Requires the pharmacy to compete an annual self-assessment. 

AB 2086 (Gallagher) – Controlled substances: CURES database

CMA Position: Support

Allows prescribers to access the Controlled Substance Utilization Review and Evaluation System (CURES) database for a list of patients for whom that prescriber is listed as a prescriber in the CURES database.

AB 2256 (Santiago) – Law enforcement agencies: opioid antagonist

CMA Position: Support

Authorizes a pharmacy, wholesaler, or manufacturer to furnish naloxone hydrochloride or other opioid antagonists to a law enforcement agency, as provided.

AB 2487 (McCarty) – Physicians and surgeons: continuing education: opiate-dependent patient treatment and management

CMA Position: Neutral

Authorizes a physician and surgeon to complete a one-time continuing education course of 12 credit hours on opiate-dependent patient treatment and management, including eight hours of training in buprenorphine treatment as an alternative to the mandatory continuing education course on pain management and the treatment of terminally ill and dying patients.

AB 2760 (Wood) – Prescription drugs: prescribers: naloxone hydrochloride and other FDA-approved drugs

CMA Position: Neutral

Requires a prescriber, as defined, to offer a prescription for naloxone hydrochloride or another drug approved by the United States Food and Drug Administration for the complete or partial reversal of opioid depression to a patient when certain conditions are present and to provide education on overdose prevention and the use of naloxone hydrochloride or another drug to the patient and specified others, except as specified. Subjects a prescriber to referral to the licensing board charged with regulating his or her license for the imposition of administrative sanctions, as that board deems appropriate, for violations of these provisions.

AB 2783 (O’Donnell) – Controlled substances: hydrocodone combination products

Reclassifies specified hydrocodone combination products as Schedule II controlled substances under the California Uniform Controlled Substances Act. 

AB 2789 (Wood) – Prescriptions: electronic data transmission

CMA Position: Oppose

Requires, on and after January 1, 2022, health care practitioners authorized to issue prescriptions to have the capability to transmit electronic data transmission prescriptions and would require pharmacies to have the capability to receive those transmissions. Mandates electronic prescribing, unless specified exceptions are met.

SB 212 (Jackson) – Solid waste: pharmaceutical and sharps waste stewardship

CMA Position: Support

Establishes a stewardship program, under which a manufacturer or distributor of covered drugs or sharps, or other entity defined to be covered by the bill, is required to establish and implement, either on its own or as part of a group of covered entities through membership in a stewardship organization, a stewardship program for covered drugs or for sharps, as applicable. Imposes various requirements on a covered entity or stewardship organization that operates a stewardship program, including submitting a proposed stewardship plan, an initial stewardship program budget, an annual budget, annual report, and other specified information to CalRecycle.

SB 1021 (Wiener) – Prescription drugs

Extends existing provisions related to formularies for outpatient prescription drugs by health care service plans or health insurers and cost-sharing for covered outpatient prescription drugs until January 1, 2024. Prohibits, until January 1, 2024, a drug formulary maintained by a health care service plan or health insurer from containing more than 4 tiers, as specified. Requires a prescription drug benefit to provide that an enrollee or an insured is not required to pay more than the retail price for a prescription drug if a pharmacy’s retail price is less than the applicable copayment or coinsurance amount, and the payment rendered by an enrollee or insured would constitute the applicable cost-sharing. Extends until January 1, 2023, coverage requirement to antiretroviral drug treatments that are medically necessary for the prevention of AIDS/HIV. 

SB 1109 (Bates) – Controlled substances: Schedule II drugs: opioids

CMA Position: Support

Requires training and continuing education under the Medical Practice Act, Nursing Practice Act, Physician Assistant Practice Act, Dental Practice Act, Osteopathic Act, and the Optometry Practice Act to include risks of addiction associated with the use of Schedule II drugs. Requires pharmacy or practitioner dispensing an opioid to a patient for outpatient use to display a notice on the label or container that warns of the risk of overdose and addiction as specified. Requires a prescriber to discuss specified information with the minor, the minor’s parent or guardian or other adult authorized to consent to the minor’s medical treatment before directly dispensing or issuing for a minor the first prescription in a single course of treatment for a controlled substance containing an opioid. Requires youth sports organizations to distribute specified Opioid Factsheet for Patients to each athlete and requires each athlete and their parent to sign a document acknowledging receipt. 

SB 1254 (Stone) – Hospital pharmacies: medication profiles or lists for high-risk patients

CMA Position: Neutral

Requires a pharmacist at a hospital pharmacy to obtain an accurate medication profile or list for each high-risk patient upon admission of the patient under specified circumstances. Authorizes an intern pharmacist or a pharmacy technician to perform the task of obtaining an accurate medication profile or list for a high-risk patient if certain conditions are satisfied. Requires the hospital to establish criteria regarding who is a high-risk patient for purposes of the bill’s provisions and determine a timeframe for completion of the medication profile or list, based on the populations served by the hospital. 

 

EMERGENCY SERVICES

AB 2576 (Aguiar-Curry) – Emergencies: health care

CMA Position: Support if Amended

Authorizes a pharmacist or a community clinic to furnish a dangerous drug or device in reasonable quantities without a prescription during a declared emergency. Requires the Pharmacy Board to allow for the use of a mobile pharmacy or clinic during an emergency if certain conditions are met. Authorizes the Governor, during a state of emergency, to direct all state agencies to utilize, employ, and direct state personnel, equipment, and facilities for the performance of any and all activities that are designed to allow community clinics and health centers to provide and receive reimbursement for services provided during or immediately following the emergency, including directing DHCS to seek federal approvals to allow community clinics and health centers to provide and be reimbursed for Medi-Cal or other services that are provided either telephonically, or to patients at a shelter or other location within the geographical boundaries of the emergency as stated in the proclamation declaring the state of emergency

 

END-OF-LIFE

AB 282 (Jones-Sawyer D) – Aiding, advising or encouraging suicide: exemption from prosecution

Prohibits a person whose actions are compliant with the End of Life Option Act from being prosecuted for deliberately aiding, advising, or encouraging suicide.

AB 3211 (Kalra) – Advance health care directives

Revises the language of the form for written advance health care directives created under the Health Care Decisions Law to allow a person to authorize an agent to consent to any temporary medical procedures necessary to maintain organs, tissues, and/or parts for the purpose of donation. 

 

HEALTH CARE COVERAGE

AB 595 (Wood) – Health care service plans: mergers and acquisitions

CMA Position: Support if Amended

Requires a health care service plan that intends to merge or consolidate with, or enter in an agreement resulting in its purchase, acquisition, or control by, any entity, as defined, including another health care service plan or a licensed health insurer, to give notice to, and secure prior approval from, the Director of the Department of Managed Health Care. Requires a health care service plan subject to these provisions to meet specified requirements and to provide information necessary for the director to make the determination to approve, conditionally approve, or disprove the transaction or agreement, as specified. Requires health care services plans subject to these provisions to pay specified fees and to reimburse the director for specified costs related to making a decision on whether to approval, conditionally approve, or disapprove the transaction

AB 1860 (Limón) – Health care coverage: cancer treatment

CMA Position: Support

Existing law prohibits, until January 1, 2019, an individual or group health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2015, that provides coverage for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells from requiring an enrollee or insured to pay, notwithstanding any deductible, a total amount of copayments and coinsurance that exceeds $200 for an individual prescription of up to a 30-day supply of a prescribed orally administered anticancer medication, as specified. Existing law authorizes health care service plans to adjust that $200 limit on January 1 of each year, to the extent that adjustment does not exceed the percentage increase in the Consumer Price Index for that year. Raises the limit on copayments and coinsurance to $250 for an individual prescription of up to a 30-day supply of a prescribed orally administered anticancer medication, eliminates provisions authorizing health plans and insurers to adjust this limit, and extends the period the limit remains in effect to January 1, 2024.

AB 2119 (Gloria) – Foster care: gender affirming health care and mental health care

CMA Position: Support if Amended

Makes specified findings and declarations regarding transgender and gender nonconforming children in foster care. Specifies that the rights of minors and nonminors in foster care to be involved in the development of case plan and plan for placement includes the development of case plan elements related to gender affirming health care, with consideration of their gender identity. Provides that the rights of minors and nonminors in foster care to receive medical, dental, vision, and mental health services includes covered gender affirming health care and gender affirming mental health care, as defined, subject to existing consent laws. Requires the Department of Social Services, in consultation with the Department of Health Care Services and other stakeholders, to develop, as specified, guidance and best practices to identify, coordinate, and support foster youth seeking access to gender affirming health care services and gender affirming mental health services.

AB 2499 (Arambula) – Health care coverage: medical loss ratios

CMA Position: Support

Existing law requires a health care service plan or health insurer to provide an annual rebate to each enrollee or insured under that coverage, on a pro rata basis, if the medical loss ratio, calculated as specified, is less than a certain percentage. Existing law excludes all specialized health care service plan contracts and specialized health insurance policies from these requirements. Limits the exemption from annual rebate requirements to specialized health care service plan contracts and specialized health insurance policies that provide only dental or vision services.

AB 2674 (Aguiar-Curry) – Health care service plans: disciplinary actions

CMA Position: Sponsor

Under the Knox-Keene Health Care Service Plan Act of 1975, a health care service plan is prohibited from engaging in an unfair payment pattern, as defined, and allows providers to report instances in which a plan is engaging in an unfair payment pattern to the department. Requires the Department of Managed Health Care to review complaints of unfair payment patterns on or before July 1, 2019, and at least annually thereafter and permits the department to conduct an audit or enforcement action pursuant to existing authority if the review of the complaint data indicates a possible unfair payment pattern.

AB 2863 (Nazarian) – Health care coverage: prescriptions

Requires a pharmacy to inform a customer at the point of sale for a covered prescription drug whether the retail price is lower than the cost-sharing amount for the drug unless the lower price is charged automatically. Limits the amount a health care service plan or health insurer may require an enrollee or insured to pay at the point of sale for a covered prescription to the lesser of the applicable cost-sharing amount or the retail price. Prohibits a health care service plan or health insurer from requiring a pharmacist or pharmacy to charge or collect a cost-sharing amount from an enrollee or insured that exceeds the total retail price for the prescription drug. Provides that the payment rendered by an enrollee or insured constitutes the applicable cost sharing and shall apply to any deductible as well as to the maximum out-of-pocket limit, as specified.

AB 2941 (Berman) – Health care coverage: state of emergency

Requires a health care service plan or health insurer to provide its enrollees or insureds who have been displaced by a state of emergency, as defined, access to medically necessary health care services. Requires a health care service plan or health insurer, within 48 hours of a declaration of emergency by the Governor that displaces or has the immediate potential to displace enrollees or insureds, to file a notification with the regulator containing specified information regarding how the plan or insurer is communicating with and addressing the needs of its enrollees or insureds during the state of emergency.

SB 997 (Monning) – Health care service plans: physician to enrollee ratios

Deletes the repeal date of existing law that would have sunset on January 1, 2019 and requires a health care service plan to ensure that there is at least one full-time equivalent primary care physician for every 2,000 enrollees and authorizes the assignment of up to an additional 1,000 enrollees, as specified, to a primary care physician for each full-time equivalent non-physician medical practitioner, as defined, supervised by that physician. These provisions will operate indefinitely.

SB 1034 (Mitchell) – Health care: mammograms

CMA Position: Neutral

Extends, until January 1, 2025, the operation of existing law that requires a health facility at which a mammography examination is performed to include a prescribed notice on breast density in the summary of the written report that is sent to a patient, if specified circumstances apply. Makes technical and conforming changes.

 

HEALTH CARE FACILITIES AND FINANCING

AB 1953 (Wood) – Skilled nursing facilities: disclosure of interests in business providing services

Requires an organization that operates, conducts, owns, or maintains a skilled nursing facility to additionally report to the office whether the licensee, or a general partner, director, or officer of the licensee, has an ownership or control interest of 5% or more in a related party, as defined, that provides any service to the skilled nursing facility. If goods, fees, and services collectively worth ten thousand dollars ($10,000) or more per year are delivered to the skilled nursing facility, the disclosure shall include the related party’s profit and loss statement, and the Payroll-Based Journal public use data of the previous quarter for the skilled nursing facility’s direct caregivers.

AB 2428 (Gonzalez-Fletcher) – Federally qualified health centers: rural health clinics

Exempts from Medi-Cal provider enrollment a primary care clinic with an additional physical plant added to its consolidated primary care clinic license from the requirement to separately enroll the additional physical plant as a separate provider and from the requirement to submit a complete application package, if the primary care clinic has notified the department of its additional physical plant. Allows an FQHC or RHC adding a new licensed location to its primary care license to elect to have the reimbursement rate for the new location established in accordance with the standard PPS methodology, or to have one PPS rate for all its locations.

AB 2983 (Arambula) – Health care facilities: voluntary psychiatric care

CMA Position: Support

Prohibits a general acute care hospital or an acute psychiatric hospital from requiring a person who voluntarily seeks care to be in custody as a danger to himself or herself or others or gravely disabled as a condition of accepting a transfer of that person after his or her written consent for treatment and transfer is documented or in the absence of evidence of probable cause for detention.

SB 1152 (Hernandez) – Hospital patient discharge process: homeless patients

CMA Position: Oppose Unless Amended

Requires each hospital to include a written homeless patient discharge planning policy and process within the hospital discharge policy. Among other requirements, the policy shall require a hospital to inquire about a patient’s housing status; to connect the patient with available community resources and supportive services; and to identify a post discharge destination for the patient. Requires a hospital to document specified information before discharging a homeless patient, including that the patient has been offered a meal and weather-appropriate clothing. Requires, commencing on July 1, 2019, a hospital to develop a written plan for coordinating services and referrals for homeless patients with the county behavioral health agency, health care and social service agencies in the region, health care providers, and nonprofit social service providers, as available, to assist with ensuring appropriate homeless patient discharge.

SB 1397 (Hill) – Automated external defibrillators: requirement: modifications to existing buildings

CMA Position: Support

Applies the automated external defibrillator (AED) requirements to certain structures that are constructed prior to January 1, 2017, and subject to subsequent modifications, renovations, or tenant improvements, as specified.

 

INSURANCE

SB 910 (Hernandez) – Short-term limited duration health insurance

Prohibits a health insurer from issuing, selling, renewing, or offering a short-term limited duration health insurance policy, as defined, for health care coverage in California. Makes conforming changes.

SB 1008 (Skinner) – Health insurance: dental services: reporting and disclosures

CMA Position: Support

Requires a health care service plan or a health insurer that issues, sells, renews, or offers a health care service plan contract or insurance policy that covers dental services in California to utilize a uniform, specified benefits and coverage disclosure matrix. Requires the Department of Managed Health Care and the Department of Insurance to develop the uniform benefits and disclosure matrix in consultation with stakeholders and to implement the bill’s provisions relating to the benefits and coverage disclosure matrix through emergency regulations, as specified.

SB 1375 (Hernandez) – Health insurance: small employer groups

Amends the definition of “eligible employee” for the purpose of determining whether a business is a “small employer” eligible to purchase group coverage by excluding sole proprietors, partners of a partnership, and the spouses of sole proprietors and partners. Prohibits employer group health care service plans and employer group health benefit plans from being issued, marketed, or sold to sole proprietorship or partnership without employees through any arrangement, and requires that only individual health care service plans and individual health benefit plans be sold to any entity without employees.

 

MEDI-CAL

AB 1785 (Nazarian) – Medi-Cal eligibility: assets

Excludes the principal and interest of a 529 savings plan, as defined, from consideration for purposes of any asset or resources test to determine eligibility for certain Medi-Cal benefits, as specified. Excludes qualified distributions from a 529 savings account from consideration for purposes of any income test to determine eligibility for certain Medi-Cal benefits.

AB 2861 (Salas) – Medi-Cal: telehealth: alcohol and drug use treatment

CMA Position: Support

Requires, to the extent federal financial participation is available and any necessary federal approvals have been obtained, that a Drug Medi-Cal certified provider receive reimbursement for individual counseling services provided through telehealth by a licensed practitioner of the healing arts or a registered or certified alcohol or other drug counselor, when medically necessary and in accordance with the Medicaid state plan.

SB 849 (Committee on Budget and Fiscal Review) – Medi-Cal

Establishes, until January 1, 2026, the Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act Program, to be developed by the State Department of Health Care Services to provide loan assistance payments to qualifying, recent graduate physicians and dentists that serve beneficiaries of Medi-Cal and other specified health care programs as specified. Allows the department to authorize a dental integration pilot program in San Mateo County as a component of the Medi-Cal 2020 demonstration project 

SB 1287 (Hernandez) – Medi-Cal: medically necessary services

Revises the Medi-Cal definition of “medically necessary” for purposes of an individual under 21 years of age to incorporate federal standards related to Early and Periodic Screening Diagnostic, and Treatment (EPSDT) services and requires the department and its contractors to update any specified materials to ensure the new medical necessity standard for coverage for individuals under 21 years of age is accurately reflected in all materials.

SB 1423 (Hernandez) – Medi-Cal: oral interpretation services

Modifies the minimum qualifications that an interpreter is required to possess to provide oral interpretation services to limited English-proficient (LEP) Medi-Cal beneficiaries enrolled in either a managed care plan or a mental health plan.

 

MEDICAL CANNABIS

AB 710 (Wood) – Cannabidiol

Provides that, if specified changes in federal law regarding the controlled substance cannabidiol occurs, a physician, pharmacist, or other authorized healing arts licensee who prescribes, furnishes, or dispenses a product composed of cannabidiol, in accordance with federal law, is deemed to be in compliance with state law governing those acts. Excludes from the Medicinal and Adult-Use Cannabis Regulation and Safety Act (MAUCRSA), any medicinal product composed of cannabidiol approved by the federal Food and Drugs Administration and either classified as a Schedule II-V controlled substance or exempted by MAUCRSA. 

AB 1996 (Lackey) – The California Cannabis Research Program

Conforms the name of the Cannabis Research Program as the California Marijuana Research Program hosted by the Center for Medicinal Cannabis Research, throughout the code. Authorizes the program to cultivate cannabis for its use in research, as specified and expands the program to in include the study of naturally occurring constituents of cannabis and synthetic compounds that have effects similar to naturally occurring cannabinoids. Authorizes controlled clinical trials on testing methods for detecting harmful contaminants in cannabis, including mold and bacteria. 

 

MEDICAL RECORDS

AB 2088 (Santiago) – Patient records: addenda

Requires a health care provider to allow a patient, regardless of their age, who inspects their patient records to provide to the health care provider a written addendum with respect to any item or statement in their records that the patient believes to be incomplete or incorrect.

 

MENTAL HEALTH

AB 1968 (Low) – Mental health: firearms

CMA Position: Neutral

Prohibits a person who has been taken into custody, assessed, and admitted to a designated facility because he or she is a danger to himself, herself, or others, as a result of a mental health disorder and who was previously taken into custody, assessed, and admitted one or more times within a period of one year preceding the most recent admittance from owning a firearm for the remainder of his or her life, subject to existing notice and hearing procedures.

AB 2099 (Gloria) – Mental health: detention and evaluation

CMA Position: Support

Requires that a facility accepting a person taken into custody and placed in a designated facility for up to 72 hours for evaluation and treatment pursuant to existing law, treat a copy of the application stating the circumstances surrounding the event the same as the original.

AB 2193 (Maienschein) – Maternal mental health

CMA Position: Neutral

Requires, by July 1, 2019, health care service plans and health insurers to develop a maternal mental health program, as specified. Requires a licensed health care practitioner who provides prenatal or postpartum care for a patient to offer to screen or to appropriately screen a mother for maternal mental health conditions, subject to specified exceptions. 

AB 2315 (Quirk-Silva) – Pupil health: mental and behavioral health services: telehealth technology: guidelines

CMA Position: Support if Amended

Requires the State Department of Education, in consultation with the State Department of Health Care Services and stakeholders, to, on or before July 1, 2020, develop and post guidelines, as specified, for the use of telehealth technology in public schools, to provide mental health and behavioral health services to pupils on school campuses. 

AB 2325 (Irwin) – County mental health services: veterans

CMA Position: Support

Prevents a county from denying an eligible veteran county mental or behavioral health services while the veteran is waiting for a determination of eligibility for, and availability of, mental or behavioral health services provided by the United States Department of Veterans Affairs. Makes specific findings and declarations about the county’s duty to provide mental and behavioral health services to veterans.

AB 2639 (Berman) – Pupil suicide prevention policies: reviews: updates

CMA Position: Support

Requires the governing board or body of a local educational agency that serves pupils in grades 7 to 12 to review, at minimum every 5th year, its policy on pupil suicide prevention and, if necessary, update its policy. 

AB 3032 (Frazier) – Maternal mental health conditions 

Requires a general acute care hospital or special hospital that has a perinatal unit to develop and implement, a program as specified, relating to maternal mental health conditions including, but not limited to, postpartum depression. 

SB 1004 (Wiener) – Mental Health Services Act: prevention and early intervention

CMA Position: Support

Requires the Mental Health Services Oversight and Accountability Commission to establish priorities for the use of prevention and early intervention funds and to develop a statewide strategy for monitoring implementation of prevention and early intervention services, as specified. Requires the commission to establish a strategy for technical assistance, support, and evaluation to support the successful implementation of the objectives, metrics, data collection, and reporting strategy. Amends the Mental Health Services Act by requiring a portion of funds in the county plan relating to prevention and early intervention focus on the priorities established by the commission. Permits a county to include other priorities, as determined through a stakeholder process

SB 1113 (Monning) – Mental health in the workplace: voluntary standards

CMA Position: Support

Authorizes the Mental Health Services Oversight and Accountability Commission, in consultation with the Labor and Workforce Development Agency, to establish a framework and voluntary standard for mental health in the workplace that serves to reduce mental health stigma, increase public, employee, and employer awareness of the recovery goals of the Mental Health Services Act, and to provide guidance to California’s employer community to put in place strategies and programs, to support the mental health and wellness of employees. 

 

PROFESSIONAL LICENSING AND DISCIPLINE

AB 505 (Caballero) – Medical Board of California: adjudication: expert testimony

CMA Position: Sponsor

Authorizes the administrative law judge to extend the time for the exchange of specified expert witness testimony information with counsel for the other party to be completed, upon a motion based on a showing of good cause, for a period not to exceed 100 calendar days from the current requirement that the exchange of the information to be completed 30 calendar days prior to the commencement date of the hearing or as specified. 

SB 1448 (Hill) – Healing arts licensees: probation status: disclosure

CMA Position: Oppose

Requires, on or after July 2, 2019, the licensing boards for podiatrists, naturopathic doctors, chiropractors, acupuncturists, physicians and surgeons, and osteopaths to provide, before the patient’s first visit, a specified disclosure to a patient or the patient’s representative if the licensee is on probation pursuant to a probationary order made on and after July 1, 2019. Also requires the licensing boards to post specified information related to licensees on probation on their website.

 

PUBLIC HEALTH

AB 2370 (Holden) – Lead exposure: child day care facilities: family day care homes

CMA Position: Support

Makes various changes to the California Child Day Care Facilities Act including, but not limited to, requiring, as a condition of licensure, health and safety training in the prevention of lead exposure as a part of the preventive health practices course or courses component and requiring child day care facilities to provide the parent or guardian with written information on the risks and effects of lead exposure, blood lead testing recommendations and requirements, and options for obtaining blood lead testing, as specified. Requires specified child day care centers to have its drinking water tested for lead contamination levels.

AB 2507 (Jones-Sawyer) – County jails: infant and toddler breast milk feeding policy

CMA Position: Support

Requires, on or before January 1, 2020, a county sheriff or the administrator of a county jail to develop and implement an infant and toddler breast milk feeding policy for lactating inmates detained in or sentenced to a county jail that is based on currently accepted best practices. 

 

REPRODUCTIVE HEALTH

AB 2289 (Weber) – Pupil rights: pregnant and parenting pupils

CMA Position: Support

Codifies federal and state regulations that prohibit an educational institution from applying any rule concerning a pupil’s actual or potential parental, family, or marital status that treats pupils differently on the basis of sex. Establishes accommodations for pregnant and parenting pupils including eight weeks of parental leave.

 

WORKFORCE & OFFICE SAFETY ISSUES

AB 1791 (Waldron) – Physicians and surgeons: continuing education

Requires the Medical Board of California, in determining continuing education requirements, to consider including a course in integrating HIV/AIDS pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) medication maintenance and counseling in primary care settings, especially as it pertains to HIV testing, access to care, counseling, high-risk communities, patient concerns, exposure to HIV/AIDS, and the appropriate care and treatment referrals.

AB 1976 (Limón) – Employment: lactation accommodation

CMA Position: Sponsor

Requires an employer to make reasonable efforts to provide an employee with use of a room or other location, other than a bathroom, for an employee to express breast milk in private. An employer shall be deemed in compliance if: (1) the employer is unable to provide a permanent lactation location because of operational, financial, or space limitations; (2) the temporary lactation location is private and free from intrusion while an employee expresses milk; (3) the temporary lactation location is used only for lactation purposes while an employee expresses milk.; and (4) the temporary lactation location otherwise meets the requirements of state law concerning lactation accommodation.

AB 2009 (Maienschein) – Interscholastic athletic programs: automated external defibrillator

CMA Position: Support

If a school district or charter school elects to offer any interscholastic athletic program, require the school district or charter school to: (1) ensure that there is a written emergency action plan in place, and posted as specified, that describes the location and procedures to be followed in the event of sudden cardiac arrest or other medical emergencies related to the athletic program’s activities or events; (2) acquire, commencing July 1, 2019 at least one AED for each school within the school district or the charter school to be available on campus; (3) encourage that the AED or AEDs are available for the purpose of rendering emergency care or treatment, as specified; (4) ensure that the AED or AEDs are available to athletic trainers and coaches and authorized persons at the athletic program’s on campus activities or events; and 5) ensure that the AED or AEDs are maintained and regularly tested, as specified.

AB 2202 (Gray) – U C School of Medicine: San Joaquin Valley Regional Medical Education Endowment Fund

CMA Position: Support

Creates the University of California San Francisco San Joaquin Valley Regional Medical Education Endowment Fund for the purpose of supporting the annual operating costs for the development, operation, and maintenance of a branch campus of the University of California, San Francisco, School of Medicine in the San Joaquin Valley. 

AB 2311 (Arambula) – Medicine: trainees: international medical graduates

CMA Position: Support

Eliminates the reference to the specific courses in clinical instruction authorized to be offered to the international medical graduate participants in the pre-residency training program at the David Geffen School of Medicine of the University of California, Los Angeles.

SB 1348 (Pan) – Postsecondary education: allied health professional clinical programs: reporting

CMA Position: Support

As part of the Strong Workforce Program, requires, beginning in 2019 and in each year thereafter, the Office of the California Community Colleges must report, for each community college program that offers a certificate or degree related to allied health professionals, specified information, including the number of students participating in the clinical training and the license number or employer identification number of each clinical training site, delineated by program and occupation, with multiyear implementation for the reporting.

 

 

These are just a sampling of the new laws impacting health care in 2018 and beyond. For a comprehensive list, see “Significant New California Laws of Interest to Physicians for 2019,” at cmadocs.org/new-laws-2019.