Relevant Enacted Legislation

Legislation in California related to care for the seriously ill has progressed and changed significantly throughout the years.

Below is a timeline of relevant California legislation enacted from 2000 to present day. Bills marked with an asterisk (*) were sponsored by the Coalition for Compassionate Care of California.

2025

SB-250 (Ochoa Bogh) Medi-Cal: provider directory: skilled nursing facilities 
Requires, in the provider directory that lists accepted Medi-Cal managed care plans, through the Medi-Cal Managed Care Health Care Options internet website and any other applicable mechanisms, that the directory include skilled nursing facilities as one of the available searchable provider types. Requires [DHCS to] annually update that provider directory to ensure that information is accurate and readily accessible to the public.

 SB-387 (Rubio) Physicians and surgeons: special faculty permits: comprehensive cancer centers
Modifies the requirements for a National Cancer Institute-designated comprehensive cancer center to qualify as an academic medical center by, instead, requiring the facility to train 25 resident or fellow physicians annually and exempting the facility from the Western Association of Schools and Colleges accreditation requirement.

SB-403 (Blakespear) End of Life Option Act 
Repeals the January 1, 2031, expiration date of the act, thereby extending the operation of the act indefinitely. 

SB-590 (Durazo) Paid family leave: eligibility: care for designated persons
Commencing July 1, 2027, expands eligibility for benefits under the paid family leave program to include individuals who take time off work to care for a seriously ill designated person; defines "designated person" to mean any individual related by blood or whose association with the claimant is the equivalent of a family relationship; authorizes the claimant to identify the designated person when they file a claim for benefits.

AB-489 (Bonta) Health care professions: deceptive terms or letters: artificial intelligence
Prohibits the use by AI technology of certain terms, letters, or phrases that indicate or imply that the advice or care being provided through AI is being provided by a natural person with the appropriated health care license or certificate.

AB-583 (Pellerin) Death certificates
C
ommencing July 1, 2026, authorizes the medical and health section data and the time of death on a death certificate to be completed and attested to by a licensed nurse practitioner in the case where a patient is in a skilled nursing or intermediate care facility [AND] adds NPs to individuals required to notify the coroner when they have knowledge of a death under certain specified circumstances [AND] adds NPs to those provisions [in existing law related to death certificates for a fetal death] for purposes of preparing and depositing or delivering a certificate of fetal death [AND] authorizes an NP to use [a specified] procedure to file a declaration to amend a record of death, fetal death, or live birth. 

AB-960 (Pellerin) Patient visitation
Requires, with limited exceptions, a general acute care hospital to allow a patient with physical, intellectual, or developmental disabilities, a patient with cognitive impairment, including dementia, and a patient with another disability, as specified, to have a family or friend caregiver with them as needed, including outside standard visiting hours, unless specified conditions are met.


2024

AB 1005  (Alvarez) In-home Supportive Services: Terminal Illness Diagnosis
Requires that a Medi-Cal beneficiary diagnosed with a terminal illness be provided with certain information about the In-Home Supportive Services (IHSS) program, by the hospital discharge planner or case manager, prior to being discharged from a hospital, and communicate the beneficiary's interest in receiving IHSS to their primary care physician to support timely completion of an application.

SB 639  (Limón) Medical Professionals: Course Requirements
Amends the Medical Practice Act: All general internists and family physicians who have a patient population of which over 25% are 65 years of age or older shall complete at least 20% of all mandatory continuing education hours in a course in the field of geriatric medicine, the special care needs of patients with dementia, or the care of older patients. Also requires nurse practitioners who provide primary care to a patient population of which over 25% are 65 years of age or older to certify that they have completed at least 20% of all existing mandatory continuing education hours in a course in the field of gerontology, the special care needs of patients with dementia, or the care of older patients at the time of renewal. In establishing standards for continuing education, the [nursing] board shall consider including a course in the special care needs of individuals and their families, including, but not limited to, all of the following: (1) Pain and symptom management, including palliative care. (2) The psychosocial dynamics of death. (3) Dying and bereavement. (4) Hospice care. New requirements for education for nurses include 1 hour of direct participation in an implicit bias course offered by a continuing education provider approved by the board. Any nurse practitioner who provides primary care to a patient population of which over 25% are 65 years of age or older shall certify that they have completed at least 20% of all existing mandatory CE hours in a course in the field of gerontology, the special care needs of patients with dementia, or the care of older patients at the time of renewal. Same for physician assistants. 


2023

SB 696 (Portantino) Notaries Public – Remote, Online Notarization
This bill establishes a framework for licensed California notaries to conduct remote online notarizations, including provisions for the licensure of remote online notarization platforms by the Secretary of State and requirements relating to data security and privacy in online notarial transactions.

AB 48 (Aguiar-Curry) Nursing Facility Resident Informed Consent Protection Act of 2023
Existing law requires skilled nursing facilities and intermediate care facilities to have written policies regarding the rights of patients. This bill adds to these rights the right of every resident to receive the information that is material to an individual’s informed consent decision concerning whether to accept or refuse the administration of psychotherapeutic drugs, as specified. This bill also adds the right to be free from psychotherapeutic drugs used for the purpose of resident discipline, convenience, or chemical restraint, except in an emergency that threatens to cause immediate injury to the resident or others.

AB 847 (Luz Rivas) Medi-Cal: Pediatric Palliative Care Services
The State Department of Health Care Services (DHCS) established the Pediatric Palliative Care (PPC) Waiver in 2009, upon receiving federal approval in December 2008. After the PPC Waiver ended on December 31, 2018, DHCS implemented a plan in 2019 to transition some PPC services to the Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT) benefit, which is available to Medi-Cal beneficiaries under 21 years of age. This bill extends eligibility for PPC services for those individuals who have been determined eligible for those services prior to 21 years of age until 26 years of age and would extend eligibility for hospice services after 21 years of age. To the extent that these provisions would alter the eligibility of individuals for these services, the bill creates a state-mandated local program. The bill implements these provisions only to the extent that necessary federal approvals are obtained and federal financial participation is not otherwise jeopardized.

AB 1029 (Pellerin) Advance Health Care Directive Form
Existing law establishes the requirements for executing a written advance health care directive that is legally sufficient to direct health care decisions. This bill clarifies that a “health care decision” does not include consent by a patient’s agent, conservator, or surrogate to convulsive treatment, psychosurgery, sterilization, or abortion. The bill confirms that a voluntary, standalone Psychiatric Advance Directive may still be executed and amends the statutory advance health care directive form that the individual’s agent may not consent to placement in a mental health facility, or consent to convulsive treatment, psychosurgery, sterilization, or abortion for the individual. Amendments: Added language that defines “psychiatric advance directive” as a legal document, executed on a voluntary basis by a person who has the capacity to make medical decisions and in accordance with the requirements for an advance health care directive, that allows a person with mental illness to protect their autonomy and ability to direct their own care by documenting their preferences for treatment in advance of a mental health crisis. 

AB 1697 (Schiavo) Uniform Electronic Transactions Act
Amend California’s Confidentiality of Medical Information Act and Uniform Electronic Transactions Act to permit the use of electronic signatures to authorize the sharing of certain medical information. Adds flexibility to authorizations for release of medical information by allowing them to expire when a specified event occurs (rather than on a specified date), and allowing non-electronic authorizations to be handwritten by persons other than the signatory (thereby assisting persons with certain disabilities). Committee amendments added appropriate safeguards, borrowed from federal law, for the use of expiration events as opposed to expiration dates, on such authorizations.

RN 23 09482; AB 118  (Committee on Budget) Health Omnibus | California POLST eRegistry Act
Existing law requires the Secretary of State to maintain an Advance Health Care Directive Registry through which a person may register information regarding their advance directive in a central information center. The California POLST eRegistry Act requires the Emergency Medical Services Authority (EMSA) to establish a statewide electronic POLST registry system to collect a patient’s POLST information and disseminate that information to an authorized user. Existing law requires EMSA to incorporate the Advance Health Care Directive Registry into the POLST eRegistry. AB 118, the health omnibus trailer bill (specifically paragraph (27)), amended Health & Safety Code §1862 to delete the requirement that EMSA incorporate the Advance Health Care Directive Registry into the POLST eRegistry. An agreement was made that the adoption of the trailer bill to remove the requirement to integrate the Directive (AHCD) Registry into the POLST Registry entailed the understanding that EMSA will modify the POLST to allow people to indicate if they have filed their AHCD with the Secretary of State.


2022

AB 2288 (Choi) Advance Directive & Mental Health Treatment
Existing law, the Health Care Decisions Law, authorizes an adult having capacity to give an individual health care instruction. AB 2288 clarifies that health care decisions under those provisions include mental health treatment and revises the statutory advance health care directive form to clarify that a person may include instructions relating to mental health treatment.

AB 2338 (Gipson) Healthcare Decision-Maker Hierarcy
This bill clarifies that if an adult patient lacks the capacity to make health care decisions, the following legally recognized health care decisionmakers may make health care decisions on the patient's behalf, in the following descending order of priority: a) The patient's surrogate chosen by the patient as provided; b) The patient's agent pursuant to an advance health care directive or a power of attorney for health care; c) The conservator or guardian.

If an adult patient lacks the capacity to make a health care decision, but does not have one of the above health care decisionmakers, a surrogate may be chosen from any of the following persons: The spouse or domestic partner of the patient; An adult child of the patient; A parent of the patient; An adult sibling of the patient; An adult grandchild of the patient; An adult relative or close personal friend.

SB 1139 (Kamlager) Prison Visitation (serious illness)
This bill requires the Department of Corrections and Rehabilitation (CDCR) to make changes in policy related to prisoners who have been hospitalized due to a serious or critical medical condition, including making emergency phone calls available, providing support for a completing medical power of attorney and other forms, informing persons covered by the medical release of information form of the prisoner's health status, and visitation. 


2021

SB 129 (Skinner): Budget Act of 2021
This budget includes a $10 million appropriation for the California Emergency Medical Services Authority (EMSA) to develop a POLST eRegistry in consultation with the Coalition for Compassionate Care of California (CCCC) and other stakeholders. In addition to the one-time allocation of $10 million for the POLST registry, the budget trailer bill (AB 133) included an additional $750,000 per year in ongoing spending to strengthen the POLST ecosystem and prepare patients and providers for the future registry.

SB 353 (Roth): Extends Hospice Palliative Care 
Extends SB 294 to January 1, 2025. SB 294 (2017) authorizes a licensed hospice to provide palliative care services concurrently with curative treatment to a person who does not have a terminal prognosis or who has not elected to receive hospice services only by licensed and certified hospices.

SB 380 (Eggman) End of Life Option Act Update
Makes significant changes to California’s End of Life Option Act (EoLOA), including reducing the required waiting period between a patient’s oral requests from 15 days to 48 hours. The changes go into effect on January 1, 2022. 


2019

AB 528 (Low): Controlled substances: CURES database
Makes changes to the Controlled Substances Utilization Review and Evaluation System (CURES). Includes exemption for prescriptions for the terminally ill: “(5) If a health care practitioner prescribes, orders, administers, or furnishes a controlled substance to a patient, who is terminally ill, as defined in. subdivision (c) of Section 11159.2.”

AB 714 (Wood) Opioid prescription drugs: prescribers
Clarifies and narrows the application of current law requiring prescribers to offer a prescription for naloxone hydrochloride. Expressly exempts prescriptions for patients in inpatient or outpatient facilities and  terminally ill patients. (Urgency clause effective immediately.)


2018

AB 282 (Jones-Sawyer) – 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 – Organ Donation
Revises the form language on the Advance Health Care Directive to provide a general check-off box to allow, upon death, the donation of all organs, tissue, and body parts to be donated for purposes of transplantation, therapy, research, and education.


 

2017

SB 294 (Hernandez) – Hospice Palliative Care *
Effective January 1, 2018, this bill explicitly allows a licensed hospice to provide palliative care services concurrently with curative treatment to a person who does not have a terminal prognosis or who has not elected to receive hospice services. As signed into law, SB 294 essentially creates a “pilot” to observe and measure the effects of hospice providers offering palliative care services. Sunsets January 1, 2022.


2016

SB 586 (Hernandez) – Children’s services Pediatric palliative care advocacy and education
This bill authorizes the California Children’s Services (CCS) program to establish a Whole Child Model program, under which managed care plans under county organized health systems or Regional Health Authority that elect, and are selected, to participate would provide CCS services under a capitated payment model to Medi-Cal and State Children’s Health Insurance Program (S-CHIP) eligible CCS children and youth.

SCR 117 (Pan) – Relative to palliative care
This resolution encourages the State of California to study the status and importance of coordinated palliative care and to develop solutions, tools, and best practices for providing better patient-centered care and information to individuals with chronic diseases in California.


2015

AB 637 (Campos) – Physician Orders for Life Sustaining Treatment forms *
This bill allows nurse practitioners and physician assistants – under the supervision of a physician and within their scope of practice – to sign POLST forms and make them actionable medical orders. Read the announcement.

SB 19 (Wolk) – Physician Orders for Life Sustaining Treatment form: statewide registry *
This bill requires the California Health and Human Services Agency to establish and operate a statewide registry system, to be known as the California POLST Registry, for the purpose of collecting POLST forms received from health care providers. Read the announcement.

AB 187 (Bonita): Medi-Cal Managed Care: California Children’s Services program
This bill extends the termination of the prohibition against services covered under the California Children’s Services program from being incorporated into a Medi-Cal managed care contract entered into after August 1, 1994, until January 1, 2017.

SR 17 (Jackson) – California Healthcare Decisions Day *
This resolution declared April 16, 2015, as “Healthcare Decisions Day” in California, and urged all Californians to communicate their healthcare preferences and execute an advance healthcare directive. It also urged those who are seriously ill to learn about the Physician Orders for Life Sustaining Treatment (POLST) program. Read the announcement.

ABx2 15 (Eggman, Alejo, and Stone) – End of Life Option Act
This bill, until January 1, 2026, would enact the End of Life Option Act authorizing an adult who meets certain qualifications, and who has been determined by his or her attending physician to be suffering from a terminal disease, as defined, to make a request for a drug prescribed pursuant to these provisions for the purpose of ending his or her life. Went into effect June 9, 2016.


2014

AB 2044 (Rodriguez) – CPR in RCFEs
This bill, among other things, requires that Residential Care Facilities for the Elderly (RCFEs) have at least one staff person trained in CPR and first aid on duty and on the premises at all times. The bill clarifies that this requirement shall not be construed to require staff to perform CPR on a resident who has requested to forego resuscitative measures as indicated by a POLST form or other DNR orders.

AB 2139 (Eggman) – End-of-life care: patient notification
Effective January 1, 2015, when a health care provider (an attending physician, surgeon, physician assistant, or nurse practitioner) makes a diagnosis that a patient has a terminal illness, the health care provider is required to notify the patient or, when applicable, another person authorized to make health care decisions for the patient, of the right to receive comprehensive information and counseling regarding legal end-of-life options. This All Facilities Letter (AFL) provides notice of the enactment of Assembly Bill 2139 (Chapter 568, Statutes 2014). Authority: Health and Safety Code (HSC) sections 442.5 and 442.7

SB 1004 (Hernandez) – Palliative and Hospice Care benefit under Medi-Cal *
SB 1004, which passed the legislature in 2014 with overwhelming and bipartisan support, is designed to expand access to palliative care services for beneficiaries of Medi-Cal managed care plans, which serve more than half of all people in the Medi-Cal program.


2013

AB 633 (Salas) – Emergency medical services: civil liability
This bill makes it so people who, in good faith and not for compensation, render emergency medical or nonmedical care or assistance at the scene of an emergency are not liable for civil damages resulting from any act or omission, except as specified.


2012

SB 135 (Hernandez) – Hospice Facilities
This bill creates a specific licensing category for inpatient hospices, known as congregate living health facility-hospices.


2011

AB 507 (Hayashi) – Pain Management
This bill removes legal barriers to pain management and practice in California.

SB 177 (Strickland) – Congregate Living Health Facilities
This bill creates a specific licensing category for inpatient hospices, known as congregate living health facility-hospices.


2008

AB 3000 (Wolk) – Physician Orders for Life-Sustaining Treatment (POLST) *
This bill provides consumers with a new mechanism – Physician Orders for Life-Sustaining Treatment (POLST) – to ensure that their wishes are honored regarding medical treatment towards the end of life.

AB 2747 (Berg) – End-of-Life Care
When a health care provider makes a diagnosis of a terminal illness, the provider shall, upon the patient’s request, provide comprehensive information and counseling regarding legal end-of-life options.

AB 2565 (Eng) – Brain Death
Requires hospitals to adopt a policy for providing family or next of kin with a reasonable period of time in the event a patient is declared brain dead. During this period the hospital is required to continue cardiopulmonary support.

SB 1196 (Runner) – Coroner Inquiries
If a decedent was been attended to by a hospice nurse within 20 days prior to death, the coroner does not have to review the death.


2007

AB 1689 (Leiber) – Revised Uniform Anatomical Gifts Act


2006

AB 1363 (Jones) – Omnibus Conservatorship & Guardianship Reform Act of 2006
AB 1745 (Chan) – Pediatric Palliative Care Benefit

This bill led to the development of the Partners For Children Pediatric Palliative Bare Benefit under Medi-Cal, a program that allows eligible children and their families to receive palliative care services during the course of the child’s illness while concurrently pursuing curative treatment for the child’s life limiting or life threatening medical condition.

This legislation and the resulting program was championed by the Children’s Hospice & Palliative Care Coalition.


2005

AB 1676 (Richman) – Advance Directives and Terminal Illness Decisions


2004

AB 1299 (Daucher) – Hospice Licensure
AB 2352 (Jackson) – Residential care facilities for persons with chronic life-threatening illness
AB 2445 (Canciamilla) – Advance health care directives: registry


2003

AB 1166 (Berg) – Residential Care Facilities and Terminally-ill Residents


2002

AB 1946 (Corbett) – Written materials for patients
AB 1961 (Canciamilla) – Residential care facilities for the elderly; terminally ill persons


2001

AB 1278 (Wayne) – Health Care Decisions
SB 587 (Soto) – Critically or Terminally Ill Patients: Transfers
SB 751 (Speier) – Hospitals: Surrogate Decisionmakers


2000

AB 891 (Alquist) – Advance Directives
AB 892 (Alquist) – Hospice Services