November 30, 2023

Governor Newsom met the October 14 deadline to take action on measures approved by the Legislature and delivered to his desk. To keep counties informed of new laws that impact them, CSAC will be publishing a series of articles to spotlight those laws in each policy area. This week, the Health and Human Services policy area provides information on new laws affecting adult protective services, behavioral health, fentanyl misuse prevention and response, foster care, and other HHS programs.

The new laws listed below become effective January 1, 2024, unless otherwise noted.

Adult Protective Services

AB 386 (Nguyen) (Chapter 433, Statutes of 2023) – Supported

This measure, which was sponsored by the County Welfare Directors Association (CWDA) will assist Adult Protective Services (APS) in effectively investigating allegations of abuse by extending the period for which APS can request records. The measure also expands the type of items that APS can request from a bank or financial institution to include information regarding newly issued cards, changes of addresses, and information regarding trusts or Powers of Attorney.

Behavioral Health

SB 35 (Umberg) (Chapter 283, Statutes of 2023)

This urgency measure provides clean-up language to the Community Assistance, Recovery, and Empowerment (CARE) Act and makes necessary clarifications and changes in order for counties and other stakeholders to implement the CARE Act. CSAC joined RCRC and UCC in support of amendments to SB 35, which provide limited authority to county behavioral health agencies to disclose medical and mental health information to the court. As an urgency measure, SB 35 took effect immediately after being signed by the Governor on September 30, 2023.

SB 43 (Eggman) (Chapter 637, Statutes of 2023) – Concerns

This measure expands the definition of “gravely disabled” under the Lanterman-Petris-Short (LPS) Act, which provides for the involuntary detention and/or conservatorship and treatment of individuals, to include individuals with a severe substance use disorder (SUD) condition without a co-occurring mental health diagnosis. The bill authorizes counties, by adoption of a resolution of its governing body, to elect to defer implementation of the changes in SB 43 until January 1, 2026.

SB 280 (Laird) (Chapter 705, Statutes of 2023)

This measure requires, by January 1, 2025, a conservator to file a plan for care, custody, and control of the conservatee within 120 days of appointment by the court and within 10 days before a hearing to continue or terminate an existing conservatorship. The plan, which the court may require to be updated at any point, must include several specified provisions. Judicial Council must develop a mandatory form to be used in preparing the care plan by January 1, 2025.

SB 717 (Stern) (Chapter 883, Statutes of 2023)

This measure requires courts to notify individuals who have been found incompetent to stand trial (IST), and whose misdemeanor charges have been dismissed by the court and are not receiving court directed services, of their need for ongoing mental health services. Additionally, this bill requires the court to provide the individuals with the contact information of the county behavioral health department.

Governor’s Behavioral Health Modernization Package

AB 531 (Irwin) (Chapter 789, Statutes of 2023)

This measure, also known as the Behavioral Health Infrastructure Bond Act of 2024, authorizes $6.38 billion in general obligation bonds to finance the conversion, rehabilitation, and construction of supportive housing and behavioral health housing and treatment settings. Of the total, $1.5 billion in grants is specifically called out to be awarded to counties, cities, and tribal entities, and local jurisdictions are not precluded from applying for additional funds. Specified provisions of this measure and SB 326 will appear before the voters on the March 5, 2024, statewide primary election ballot as Proposition 1. Provisions not being presented to the voters for approval will take effect on January 1, 2024. For example, AB 531 removes the January 1, 2027, sunset date for the Behavioral Health Continuum Infrastructure Program, making the program operational indefinitely.

SB 326 (Eggman) (Chapter 790, Statutes of 2023)

This measure amends the Mental Health Services Act (MHSA) which was approved by the voters as Proposition 63 in 2004, and makes other statutory changes to update the state’s behavioral health system. Among its provisions, SB 326 renames the MHSA to the Behavioral Health Services Act (BHSA), broadens the eligible uses of funds to include the provision of substance use disorder treatment services, revises the funding categories to include a prioritization for housing interventions for those with the most severe needs, including the chronically homeless, and establishes additional oversight and accountability measures. Specified provisions of this measure and AB 531 will appear before the voters on the March 5, 2024, statewide primary election ballot as Proposition 1. Several provisions of SB 326, although not being presented to the voters, only take effect upon approval of Proposition 1. Other provisions of SB 326, an urgency measure, took immediate effect. A listing of the non-ballot provisions of SB 326 is available here. 

Emergency Medical Services

AB 40 (Rodriguez) (Chapter 793, Statutes of 2023)

This measure requires local emergency medical services agencies (LEMSAs), by July 1, 2024, to develop ambulance patient offload time (APOT) standards, not to exceed 30 minutes, 90 percent of the time. This measure requires the Emergency Medical Services Authority, when a hospital has exceeded the adopted APOT standard for the preceding month, to report the exceedance to the LEMSA. The LEMSA must then alert all emergency medical service providers in their jurisdiction, direct the hospital to implement an APOT reduction protocol, and host bi-weekly calls with hospital administrators and other stakeholders.

Fentanyl

AB 33 (Bains) (Chapter 887, Statutes of 2023) – Supported  

This measure establishes the Fentanyl Misuse and Overdose Prevention Task Force, subject to an appropriation by the Legislature, to undertake various duties relating to the assessment of the nature and extent of fentanyl misuse in California and the evaluation of approaches to increase public awareness of fentanyl misuse. Importantly, the bill includes representatives from a local health department, the County Behavioral Health Directors Association (CBHDA), and the County Health Executives Association of California (CHEAC) as members of the task force. As an urgency measure, AB 33 took effect immediately after being signed by the Governor on October 13, 2023.

SB 19 (Seyarto) (Chapter 857, Statutes of 2023) – Supported

Like AB 33, which was also signed by the Governor, this measure establishes a Fentanyl Misuse and Overdose Prevention Task Force. SB 19 also includes local stakeholders, including representatives from a local health department, CBHDA, and CHEAC, as members on the task force.

Foster Care

AB 426 (Jackson) (Chapter 428, Statutes of 2023)

This measure increases the civil penalty amount that the California Department of Social Services (CDSS) can assess for providing unlicensed residential care to children. The penalty will increase from $200 per day to $1,000 per day. AB 426 also requires the CDSS Director to inform the Board of Supervisors and county welfare director in writing if county action is required to remedy a failure to comply with current law. CSAC engaged on prior versions of this legislation.

General Assistance

SB 462 (Wahab) (Chapter 110, Statutes of 2023)

This measure allows the sharing of confidential information for purposes directly connected with the provision of relief and administration of General Assistance/General Relief (GA/GR) programs. AB 1457 aligns privacy protections for the GA/GR program with those of other social services programs.

Homelessness

AB 271 (Quirk-Silva) (Chapter 135, Statutes of 2023)

This measure authorizes counties to establish a homeless death review committee. The purpose of these committees would be to assist local agencies in establishing the root causes of the death of homeless individuals. AB 271 also establishes protections for certain communications and documents reviewed by the committee and procedures for sharing and disclosing certain information.

Minimum Wages for Health Care Workers

SB 525 (Durazo) (Chapter 890, Statutes of 2023) – Dropped Opposition

This measure raises the minimum wage broadly across the health care sector to $25 per hour for hourly workers and increases the salaries of full-time employees to no less than 150% of the health care worker minimum wage or 200% of the state’s applicable minimum wage, whichever is greater. Based on employer size, county population size, and hospital governmental payor mix, this measure utilizes a phased-in approach over several years. Once the $25 per hour is reached, the minimum wage must increase annually by 3.5 % or the United States Consumer Price Index, whichever is lower. See tiers and timeline below. This measure applies to county hospitals, clinics (with county clinics exempted from the clinic provisions in the bill), mental health facilities, and correctional health facilities. Counties can delay implementing these provisions until January 1, 2025.

Social Services Programs

AB 1457 (Ortega) (Chapter 279, Statutes of 2023)

This measure expands the requirements for county social services program eligibility decisions to be made exclusively by county merit or civil service employees. Many county social services programs are currently subject to this requirement and the list of programs will now also include In-Home Supportive Services, Adult Protective Services, the California Food Assistance Program, and the Cash Assistance for Immigrants Program.