AMENDED IN SENATE AUGUST 13, 2026

AMENDED IN SENATE JUNE 22, 2026

AMENDED IN ASSEMBLY APRIL 23, 2026

AMENDED IN ASSEMBLY APRIL 13, 2026

CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION

95

Introduced by Assembly Member Alanis

(Coauthors: Assembly Members Bonta and Flora)

February 19, 2026

An act to add Section 1251.7 to the Health and Safety Code, relating to health facilities.

Vote: majority   Appropriation: no   Fiscal committee: yes   Local program: no

LEGISLATIVE COUNSEL’S DIGEST

Existing law requires the State Department of Public Health to license and regulate various health facilities, including general acute care hospitals. Existing law requires the department to issue a special permit, in addition to a license, to a health facility to offer one or more special services, such as an emergency center, if specified requirements are met, including that the department finds that the standards of care and services are adequate and appropriate.

Existing law requires the department to issue a special permit to allow a general acute care hospital to offer emergency stabilization services at a location that is neither inside nor contiguous to the applicant hospital if the hospital provides satisfactory evidence to the department that, among other things, the hospital has a written transfer agreement with the hospital closest to the location where emergency stabilization services will be provided and satisfactory evidence to the department that this location meets certain requirements, including that the location is in the town of Paradise within the County of Butte and serves the same area previously served by Feather River Hospital.

This bill would require the department to issue a waiver, as specified, to a publicly owned and operated general acute care hospital, in collaboration with Del Puerto Health Care District, to operate one rural emergency stabilization care unit and waive designated general acute care hospital licensure requirements if specified conditions are met. The bill would limit the term of the waiver based on prescribed factors, including the completion of a hospital build within a 5-mile radius of the emergency stabilization care unit or within 10 years from the initial issuance of the waiver, except as specified.

This bill would make legislative findings and declarations as to the necessity of a special statute for Del Puerto Health Care District.

The people of the State of California do enact as follows:

SECTION 1.

Section 1251.7 is added to the Health and Safety Code, to read:

1251.7.

(a) The Legislature finds and declares all of the following:

(1) Del Puerto Health Care District serves the residents of the City of Patterson and surrounding west side communities in the County of Stanislaus, providing essential health care services, including primary care, urgent care, ambulance services, and other outpatient and community-based services.

(2) Residents of Patterson and neighboring communities are largely rural and may have limited access to transportation and to health care resources located outside the district’s service area, making local access to timely emergency and stabilization services particularly important.

(3) The community served by Del Puerto Health Care District includes a significant number of individuals with coverage under the federal Medicare Program and the Medi-Cal program, as well as uninsured and underinsured residents, for whom delays in access to appropriate levels of care can result in worsened health outcomes.

(4) Del Puerto Health Care District is planning and developing a health care campus in the City of Patterson that will include an ambulance and administration center, primary and behavioral health services, and, in later phases, higher acuity services such as skilled nursing and an acute care hospital, in order to meet current and future community health needs.

(5) During the period in which the district is planning, developing, and constructing new facilities and expanded services, including the construction of a full scale general acute care hospital, it is necessary to ensure that residents of the City of Patterson and surrounding communities have access to emergency stabilization services close to home, including services that can appropriately receive and stabilize patients prior to transport to a general acute care hospital when clinically indicated.

(6) Therefore, it is the intent of the Legislature in enacting this section to require the department to provide a waiver for a general acute care hospital, as defined in subdivision (a) of Section 1250, so long as it is publicly owned and operated, in collaboration with Del Puerto Health Care District, to provide emergency stabilization services at a location that is neither inside nor contiguous to the applicant hospital, in order to ensure that residents of the City of Patterson and the surrounding communities have access to emergency stabilization services during the development and implementation of the district’s long-term health care campus plans.

(7) It is further the intent of the Legislature that this waiver be deemed a rural emergency stabilization care unit to provide the highest quality of emergency stabilization services feasible and be staffed by physicians who are board certified in emergency medicine or have equivalent training and experience in emergency care.

(8) It is not the intent of the Legislature to establish a model for a freestanding emergency department, which is currently, and remains, prohibited by state law.

(b) For purposes of this section, the following definitions apply:

(1) “Department” means the State Department of Public Health.

(2) “District” means Del Puerto Health Care District.

(3) “General acute care hospital” has the same meaning as in subdivision (a) of Section 1250.

(4) “Rural emergency stabilization care unit” means a facility operated by the district that is not licensed as a general acute care hospital pursuant to subdivision (a) of Section 1250, is not located inside or contiguous to a general acute care hospital, and provides 24-hour emergency medical screening, stabilization, and triage services for unscheduled patients who present with emergency medical conditions.

(c) Notwithstanding any other law, including Section 1250, the department shall issue a waiver for a general acute care hospital, as defined in subdivision (a) of Section 1250, so long as it is publicly owned and operated, in collaboration with Del Puerto Health Care District, to provide emergency stabilization services at a rural emergency stabilization care unit that is neither inside nor contiguous to the applicant hospital, and shall waive general acute care hospital licensure requirements that, by their terms, require inpatient beds, inpatient nursing units, or other services that cannot be provided onsite but are provided in a noncontiguous setting, if all of the following conditions are met:

(1) The location is within the City of Patterson in the County of Stanislaus and is intended to serve the same general population as is served by Del Puerto Health Care District.

(2) The location meets the regulatory requirements applicable to emergency departments described in subdivisions (a), (b), (d), (e), (f), (g), (h), (i), (k), (l), and (n) of, and paragraph (6) of subdivision (m) of, Section 70413 of, subdivision (a) of Section 70415 of, and Sections 70417, 70419, 70651, 70655, 70657, and 70841 of, Title 22 of the California Code of Regulations.

(3) The location meets the nurse-to-patient staffing requirements of a basic emergency department, as specified in the regulations adopted pursuant to Section 1276.4.

(4) The location complies with the hospital’s existing collective bargaining agreements.

(5) The location is open 24 hours a day, 7 days a week.

(6) The location provides medical, pharmacy, nursing, clinical laboratory, and radiological services onsite in compliance with Article 3 (commencing with Section 70201) of Chapter 1 of Division 5 of Title 22 of the California Code of Regulations.

(7) The location complies with the federal Emergency Medical Treatment and Active Labor Act (Section 1395dd of Title 42 of the United States Code) and with Section 1317.

(8) The location has informed the local emergency medical services agency about the types of medical conditions and injuries that the facility cannot treat and for which the patient needs to be transported directly to a general acute care hospital emergency department.

(9) Notwithstanding subdivision (i) of Section 70651 of Title 22 of the California Code of Regulations, the wording of exterior signs states “EMERGENCY STABILIZATION SERVICES, PHYSICIAN ON DUTY.”

(10) The location stabilizes for transport or release a patient within 24 hours of registration. The location reports to the department any failure to stabilize a patient for transfer or release of the patient within 24 hours.

(11) Upon registration, the location provides a patient with a written notice that the patient should consult with their health care coverage carrier about which services may be covered and for which copayments and charges the patient may be responsible.

(12) The location posts information identifying the three nearest hospitals ranked by estimated driving time from the nearest to the farthest away.

(13) The location posts a sign, at or near any public entrance of the location, stating that patients requiring surgery, trauma care, or an inpatient bed will be transported to the nearest hospital.

(14) The location meets the physical plant requirements and has received clearance from the Department of Health Care Access and Information as appropriate for the setting and services being provided at the location.

(15) The applicant hospital has submitted and received approval on an application that meets the requirements of subdivision (d).

(d) (1) The application shall be submitted pursuant to Section 1265 and shall include all of the following:

(A) A plan of operation that shall, at a minimum, address the location’s plan for patient care, infection control, waste disposal, and linen services.

(B) The policy and procedure that the location will implement for the emergency transportation of patients that cannot be served by the facility. The policy and procedure shall comply with the standards of practice and shall include all of the following:

(i) How the patient will be transported to the nearest general acute care hospital emergency department.

(ii) The timeframe for transfer to the nearest general acute care hospital with an emergency department.

(iii) How the location will ensure patient safety during the transfer.

(C) A written transfer agreement with all hospitals within a 25-mile radius with an emergency department.

(D) A community outreach and education plan to ensure the community is informed of the types of services that the facility is capable of providing. The plan shall include instructions identifying the care that the facility is capable of providing and indicating the types of injuries or conditions for which a patient should be transported directly to the nearest general acute care hospital emergency department.

(E) A triage algorithm that the location developed and will implement in collaboration with the local emergency medical services agency to determine appropriate patients for transport to the location.

(2) Notwithstanding Section 1267, a waiver issued pursuant to this section shall expire two 2 years from the date of its issuance, and may be renewed every two 2 years, for a combined period not to exceed 10 years from the initial date of issuance.

(3) If, prior to expiration of the waiver, the district has submitted complete construction documents to the Department of Health Care Access and Information for review of a general acute care hospital to be located within the district, the department shall extend the waiver until the issuance of a certificate of occupancy for that hospital.

(4) The department may deny a request for approval or renewal of the waiver if the location fails to meet the requirements of this chapter pursuant to Section 1269. The department may suspend or revoke the waiver pursuant to Article 5 (commencing with Section 1294).

(e) A hospital issued a waiver pursuant to this section shall report all of the following:

(1) For purposes of the Annual Report of Hospitals required by regulations adopted pursuant to Section 1250.8, report bed and service utilization data separately by each any facility issued a single consolidated license pursuant to this section.

(2) Hospital reporting requirements specified in Section 1279.1 regarding adverse events and the reporting requirements specified in Section 70737 of Title 22 of the California Code of Regulations.

(3) By March 1 of each year, a detailed report on the types of services, number of patients served, and any adverse patient outcomes during the prior calendar year.

(f) Notwithstanding any other law, the department may, without taking regulatory action pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, implement, interpret, or make specific this section by means of an All Facilities Letter or similar instruction.

(g) This section shall remain operative only until a hospital build is completed within a five-mile radius of the emergency stabilization care unit or within 10 years from the initial issuance of the waiver issued pursuant to this section unless, prior to the expiration of that 10-year period, the district has submitted complete construction documents to the Department of Health Care Access and Information for review of a general acute care hospital or has commenced vertical construction of that hospital, in which case this section shall remain operative until issuance of a certificate of occupancy for that hospital.

SEC. 2.

The Legislature finds and declares that a special statute is necessary and that a general statute cannot be made applicable within the meaning of Section 16 of Article IV of the California Constitution because of all of the following:

(a) Residents, workers, and visitors in the City of Patterson face comparable—and in many cases more burdensome—access conditions to emergency medical services when compared to other designated areas.

(b) Average travel distances from the City of Patterson to the nearest full-service acute care hospital or trauma center are approximately 21 miles, with average drive times of 36 minutes or more.

(c) These access delays are driven by persistent geographic isolation, limited roadway options, agricultural and freight traffic, rail crossings, State Highway 33 congestion, and weather-related disruptions, including fog and flooding.

(d) The access challenges in the City of Patterson reflect structural constraints and ongoing gaps in timely emergency medical services in a rural, medically underserved community, rather than temporary emergencies such as wildfires.