Health and Safety Code

§ 1 This act shall be known as the Health and Safety Code. (Enacted by Stats. 1939, Ch. 60.) § 2 The provisions of this code in so far as they are substantially the same as existing statutory provisions relating to the same subject matter shall be construed as restatements and continuations, and not as new enactments. (Enacted by Stats. 1939, Ch. 60.) § 3 All persons who, at the time this code takes effect, hold office under any of the acts repealed by this code, which offices are continued by this code, continue to hold them according to their former tenure. (Enacted by Stats. 1939, Ch. 60.) § 4 Any action or proceeding commenced before this code takes effect, and any right accrued, is not affected by this code, but all procedure thereafter taken therein shall conform to the provisions of this code as far as possible. (Enacted by Stats. 1939, Ch. 60.) § 5 Unless the provision or the context otherwise requires, these definitions, rules of construction, and general provisions shall govern the construction of this code. (Enacted by Stats. 1939, Ch. 60.) § 6 Division, part, chapter, article, and section headings do not in any manner affect the scope, meaning, or intent of the provisions of this code. (Enacted by Stats. 1939, Ch. 60.) § 7 Whenever a power is granted to, or a duty is imposed upon, a public officer, the power may be exercised or the duty may be performed by a deputy of the officer or by a person authorized, pursuant to law, by the officer, unless this code expressly provides otherwise. (Enacted by Stats. 1939, Ch. 60.) § 8 Writing includes any form of recorded message capable of comprehension by ordinary visual means. Whenever any notice, report, statement, or record is required or authorized by this code, it shall be made in writing in the English language unless it is expressly provided otherwise. (Enacted by Stats. 1939, Ch. 60.) § 9 Whenever reference is made to any portion of this code or of any other law of this State, the reference applies to all amendments and additions now or hereafter made. (Enacted by Stats. 1939, Ch. 60.) § 10 “Section” means a section of this code unless some other statute is specifically mentioned. Subdivision means a subdivision of the section in which that term occurs unless some other section is expressly mentioned. (Enacted by Stats. 1939, Ch. 60.) § 11 The present tense includes the past and future tenses; and the future, the present. (Enacted by Stats. 1939, Ch. 60.) § 12 The masculine gender includes the feminine and neuter. (Enacted by Stats. 1939, Ch. 60.) § 12.2 “Spouse” includes “registered domestic partner,” as required by Section 297.5 of the Family Code. (Added by Stats. 2016, Ch. 50, Sec. 51. (SB 1005) Effective January 1, 2017.) § 13 The singular number includes the plural, and the plural the singular. (Enacted by Stats. 1939, Ch. 60.) § 14 “County” includes city and county. (Enacted by Stats. 1939, Ch. 60.) § 15 Unless expressly otherwise provided, any notice required to be given to any person by any provision of this code may be given by mailing notice, postage prepaid, addressed to the person to be notified, at his residence or principal place of business in this State. The affidavit of the person who mails the notice, stating the facts of such mailing, is prima facie evidence that the notice was thus mailed. (Enacted by Stats. 1939, Ch. 60.) § 16 “Shall” is mandatory and “may” is permissive. (Enacted by Stats. 1939, Ch. 60.) § 17 “Oath” includes affirmation. (Enacted by Stats. 1939, Ch. 60.) § 18 “Signature” or “subscription” includes mark when the signer or subscriber can not write, such signer’s or subscriber’s name being written near the mark by a witness who writes his own name near the signer’s or subscriber’s name; but a signature or subscription by mark can be acknowledged or can serve as a signature or subscription to a sworn statement only when two witnesses so sign their own names thereto. (Enacted by Stats. 1939, Ch. 60.) § 19 “Person” means any person, firm, association, organization, partnership, business trust, corporation, limited liability company, or company. (Amended by Stats. 1994, Ch. 1010, Sec. 151. Effective January 1, 1995.) § 20 “State department” or “department” means State Department of Health Services. Commencing July 1, 2007, any reference to the former State Department of Health Services regarding a function vested by Chapter 2 (commencing with Section 131050) of Part 1 of Division 112, in the State Department of Public Health is deemed to, instead, refer to the State Department of Public Health, and any reference to the former State Department of Health Services regarding a function not vested by Chapter 2 (commencing with Section 131050) of Part 1 of Division 112, in the State Department of Public Health, is deemed to, instead, refer to the State Department of Health Care Services. (Amended by Stats. 2006, Ch. 241, Sec. 8. Effective January 1, 2007. Operative July 1, 2007, by Sec. 37 of Ch. 241.) § 21 “Director” means “State Director of Health Services.” Commencing July 1, 2007, any reference to the former State Director of Health Services regarding a function vested by Chapter 2 (commencing with Section 131050) of Part 1 of Division 112, in the State Department of Public Health is deemed to, instead, refer to the State Public Health Officer. (Amended by Stats. 2006, Ch. 241, Sec. 9. Effective January 1, 2007. Operative July 1, 2007, by Sec. 37 of Ch. 241.) § 22 “Board” or “State Board of Public Health” means “State Department of Health Services,” with respect to regulatory functions heretofore performed by the State Board of Public Health or the “Advisory Health Council” with respect to all other functions heretofore performed by the board. (Amended by Stats. 1977, Ch. 1252.) § 23 “State” means the State of California, unless applied to the different parts of the United States. In the latter case, it includes the District of Columbia and the territories. (Enacted by Stats. 1939, Ch. 60.) § 24 If any provision of this code, or the application thereof to any person or circumstance, is held invalid, the remainder of the code, or the application of such provision to other persons or circumstances, shall not be affected thereby. (Enacted by Stats. 1939, Ch. 60.) § 25 Wherever, pursuant to this code, any state department, officer, board, agency, committee, or commission is authorized to adopt rules and regulations, such rules and regulations which are building standards, as defined in Section 18909 of the Health and Safety Code, shall be adopted pursuant to the provisions of Part 2.5 (commencing with Section 18901) of Division 13 of the Health and Safety Code unless the provisions of Sections 18930, 18933, 18938, 18940, 18943, 18944, and 18945 of the Health and Safety Code are expressly excepted in the provision of this code under which the authority to adopt the specific building standard is delegated. Any building standard adopted in violation of this section shall have no force or effect. Any building standard adopted prior to January 1, 1980, pursuant to this code and not expressly excepted by statute from such provisions of the State Building Standards Law shall remain in effect only until January 1, 1985, or until adopted, amended, or superseded by provisions published in the State Building Standards Code, whichever occurs sooner. (Added by Stats. 1979, Ch. 1152.) § 27 For purposes of this code: (a) “Communicable Disease Prevention and Control Act” means Sections 104730, 104830 to 104860, inclusive, 113150, 113155, Part 1 (commencing with Section 120100) of, Chapter 1 (commencing with Section 120325, but excluding Section 120380) of Part 2 of, Part 3 (commencing with Section 120500) of, and Part 5 (commencing with Section 121350) of, Division 105. (b) “Hereditary Disorders Act” means Article 1 (commencing with Section 124975) of Chapter 1 of Part 5 of Division 106, and Sections 125050, 125055, 125060, and 125065. (c) “Maternal and Child Health Program Act” means Section 120380, Chapter 4 (commencing with Section 103925) of Part 2 of Division 102, Article 4 (commencing with Section 116875) of Chapter 5 of Part 12 of Division 104, Article 1 (commencing with Section 123225) of Chapter 1 of Part 2 of Division 106, Article 2 (commencing with Section 125000) of Chapter 1 of Part 5 of Division 106, and Sections 125075 to 125110, inclusive. (d) “Miscellaneous Food, Food Facility, and Hazardous Substances Act” means Chapter 4 (commencing with Section 108100), Chapter 6 (commencing with Section 108675), and Chapter 7 (commencing with Section 108750) of Part 3 of, Chapter 3 (commencing with Section 111940), Chapter 4 (commencing with Section 111950), Chapter 5 (commencing with Section 112150), Chapter 6 (commencing with Section 112350), Chapter 7 (commencing with Section 112500), Chapter 8 (commencing with Section 112650), Chapter 9 (commencing with Section 112875), Chapter 10 (commencing with Section 113025), and Article 3 (commencing with Section 113250) of Chapter 11, of Part 6 of, and Chapter 4 (commencing with Section 113700) of Part 7 of, Division 104. (e) “Primary Care Services Act” means Chapter 1 (commencing with Section 124400), Chapter 2 (commencing with Section 124475), Chapter 3 (commencing with Section 124550), Chapter 4 (commencing with Section 124575), Chapter 5 (commencing with Section 124600), Chapter 6 (commencing with Section 124800), and Article 1 (commencing with Section 124875) of Chapter 7 of, Part 4 of Division 106. (f) “Radiologic Technology Act” means Sections 106965 to 107115, inclusive, and Chapter 6 (commencing with Section 114840) of Part 9 of Division 104. (Amended by Stats. 2023, Ch. 42, Sec. 11. (AB 118) Effective July 10, 2023.) § 28 For the purposes of this code, “recycled water” or “reclaimed water” has the same meaning as recycled water as defined in subdivision (n) of Section 13050 of the Water Code. (Added by renumbering Section 27 (as added by Stats. 1995, Ch. 28) by Stats. 1996, Ch. 1023, Sec. 105. Effective September 29, 1996.) § 135 Division 1, Part 0.5 If a department within the California Health and Human Services Agency has received approval of an operational state plan by a federal agency, or has applied and has been approved for a waiver from a federal law or federal regulation, the department shall make any and all approved plans and waivers available to the public by publishing a hyperlink to that information on the homepage of the department’s Internet Web site. (Added by Stats. 2015, Ch. 296, Sec. 1. (AB 294) Effective January 1, 2016.) § 137 Division 1, Part 1, Chapter 1.3 (a) The State Department of Public Health shall develop a coordinated state strategy for addressing the health-related needs of women, including implementation of goals and objectives for women’s health. (b) The approved programmatic costs associated with this strategy shall be the responsibility of the State Department of Public Health unless otherwise provided by law. (Amended by Stats. 2012, Ch. 23, Sec. 8. (AB 1467) Effective June 27, 2012.) § 138.4 Division 1, Part 1, Chapter 1.3 (a) The State Department of Public Health shall place priority on providing information to consumers, patients, and health care providers regarding women’s gynecological cancers, including signs and symptoms, risk factors, the benefits of early detection through appropriate diagnostic testing, and treatment options. (b) In exercising the powers under this section, the State Department of Public Health shall consult with appropriate health care professionals and providers, consumers, and patients, or organizations representing them. (c) The duties of the State Department of Public Health pursuant to this section are contingent upon the receipt of funds appropriated for this purpose. (d) The State Department of Public Health may adopt any regulations necessary and appropriate for the implementation of this section. (Amended by Stats. 2012, Ch. 23, Sec. 10. (AB 1467) Effective June 27, 2012.) § 138.6 Division 1, Part 1, Chapter 1.3 (a) The State Department of Public Health shall include in any literature that it produces regarding breast cancer information that shall include, but not be limited to, all of the following: (1) Summarized information on risk factors for breast cancer in younger women, including, but not limited to, information on the increased risk associated with a family history of the disease. (2) Summarized information regarding detection alternatives to mammography that may be available and more effective for at-risk women between the ages of 25 and 40 years. (3) Information on Internet Web sites of relevant organizations, government agencies, and research institutions where information on mammography alternatives may be obtained. (b) The information required by subdivision (a) shall be produced consistent with the department’s protocols and procedures regarding the production and dissemination of information on breast cancer, including, but not limited to, the following factors: (1) Restrictions imposed by space limitation on materials currently produced and distributed by the department. (2) Future regular production and replacement schedules. (3) Translation standards governing the number of languages and literacy levels. (4) The nature, content, and purpose of the material into which this new information will be incorporated. (c) It is the intent of the Legislature that subdivisions (a) and (b) apply to information that is distributed by any branch of the department, including, but not limited to, the Cancer Detection Section and the Office of Health Equity. (Amended by Stats. 2012, Ch. 23, Sec. 11. (AB 1467) Effective June 27, 2012.) § 140 Division 1, Part 1, Chapter 1.3 (a) The California Reproductive Justice and Freedom Fund (RJ Fund) is hereby established. The goal of the RJ Fund is to dismantle historic and standing systemic reproductive and sexual health inequities through medically accurate, culturally congruent education and outreach, as well as to create innovative strategies that meaningfully address and function to eliminate root causes of reproductive oppression. (b) Upon appropriation by the Legislature, the State Department of Public Health shall award grants from the RJ Fund to eligible community-based organizations over a three-year period. (1) On or before July 1, 2023, the department shall post the grant application on its internet website and solicit applications. (2) On or before December 31, 2023, the department shall award grants to selected entities based on the eligibility criteria. (c) Notwithstanding paragraphs (1) and (2) of subdivision (b), any civil penalties deposited in the RJ Fund pursuant to Section 1798.99.92 of the Civil Code shall be awarded by the State Department of Public Health in the form of grants, subject to the criteria specified in subdivisions (d) to (h), inclusive. (d) A grant recipient shall use any grant funds awarded pursuant to this section to implement a program or fund an existing program that provides and promotes medically accurate, comprehensive reproductive and sexual health education. (e) A program funded pursuant to this section shall do all of the following: (1) Promote reproductive justice. (2) Provide medically accurate, culturally congruent reproductive and sexual health education that is inclusive of information on abortion rights, care, and services. The education or outreach provided by a program shall include information on how to obtain an abortion or provide abortion referrals, especially upon request. (3) Be targeted at communities that have experienced or continue to experience high reproductive or sexual health inequities or disparities. This includes communities that have experienced reproductive or sexual health inequities or disparities because of historic and systemic oppression, including based on their race and ethnicity, immigration status, sexual orientation, gender expression, foster youth status, or disability. (f) A grant recipient may use a portion of grant funds to pay for costs associated with carrying out grant activities. An assessment of associated costs shall contemplate the community-based organization, the community served, and the nature of services it provides, and may include all of the following: (1) Building staff capacity. (2) Development and dissemination of materials. (3) Travel costs. (g) The department shall not spend more than 5 percent of the funds appropriated for the purposes of this section on administrative costs. (h) For purposes of this section: (1) “Community-based organization” means a public or private not-for-profit organization that provides education, resources, or services and is representative of a disparately impacted community or significant segments of a community or has demonstrated status as a trusted part of the community that it serves. (2) “Culturally congruent education” means education that takes account of the cultural beliefs, values, norms, patterns, way of life, or practices of the target audience to provide appropriate and meaningful education. Culturally congruent education and outreach fits a person’s or community’s lifestyle, values, and systems of meaning. It requires acknowledgment, respect, and adaptation of information to the cultural needs of the communities served. Additionally, it contemplates sociocultural and situational factors into education. (3) “Medically accurate” means factual information, verified or supported by research conducted in compliance with scientific methods, published in peer-reviewed journals, if appropriate, and recognized as accurate and objective by the relevant professional organizations. (4) “Racial equity” means the condition achieved when race can no longer be used to predict life outcomes and when conditions for all groups are improved. Racial equity includes transforming the behaviors, institutions, and systems that harm disparately impacted communities, including by increasing access to power, redistributing and providing additional resources, and eliminating barriers to opportunity, in order to empower Black, Indigenous, and communities of color to thrive and realize their full potential. (5) “Reproductive health” means the state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. “Reproductive health” implies that a person is able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when, and how often to do so. (6) “Reproductive justice” means the human right to control our sexuality, our gender, our work, and our reproduction, which can only be achieved when all people, particularly women and girls, have the complete economic, social, and political power and resources to make healthy decisions about their bodies, their families, and their communities in all areas of their lives. At the core of “reproductive justice” is the belief that all people have the right to have children, the right to not have children, and the right to parent the children they have with dignity and respect, in safe and sustainable communities. (7) “Sexual health” means the state of physical, emotional, mental, and social well-being in relation to sexuality, and not merely the absence of disease, dysfunction, or infirmity. “Sexual health” requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence. (Amended by Stats. 2025, Ch. 134, Sec. 6. (AB 45) Effective January 1, 2026.) § 152 Division 1, Part 1, Chapter 1.5 (a) The State Department of Public Health Office of Health Equity shall do all of the following: (1) Perform strategic planning to develop departmentwide plans for implementation of goals and objectives to close the gaps in health status and access to care among the state’s diverse racial and ethnic communities, women, persons with disabilities, and the lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQQ) communities. (2) Conduct departmental policy analysis on specific issues related to multicultural health. (3) Coordinate projects funded by the state that are related to improving the effectiveness of services to ethnic and racial communities, women, and the LGBTQQ communities. (4) Identify the unnecessary duplication of services and future service needs. (5) Communicate and disseminate information and perform a liaison function within the department and to providers of health, social, educational, and support services to racial and ethnic communities, women, persons with disabilities, and the LGBTQQ communities. The department shall consult regularly with representatives from diverse racial and ethnic communities, women, persons with disabilities, and the LGBTQQ communities, including health providers, advocates, and consumers. (6) Perform internal staff training, an internal assessment of cultural competency, and training of health care professionals to ensure more linguistically and culturally competent care. (7) Serve as a resource for ensuring that programs collect and keep data and information regarding ethnic and racial health statistics, including those statistics described in reports released by Healthy People 2020, and information based on sexual orientation, gender identity, and gender expression, strategies and programs that address multicultural health issues, including, but not limited to, infant and maternal mortality, cancer, cardiovascular disease, diabetes, human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), child and adult immunization, osteoporosis, menopause, and full reproductive health, asthma, unintentional and intentional injury, and obesity, as well as issues that impact the health of racial and ethnic communities, women, and the LGBTQQ communities, including substance abuse, mental health, housing, teenage pregnancy, environmental disparities, immigrant and migrant health, and health insurance and delivery systems. (8) Encourage innovative responses by public and private entities that are attempting to address multicultural health issues. (9) Provide technical assistance to counties, other public entities, and private entities seeking to obtain funds for initiatives in multicultural health, including identification of funding sources and assistance with writing grants. (b) Notwithstanding Section 10231.5 of the Government Code, the State Department of Public Health shall biennially prepare and submit a report to the Legislature on the status of the activities required by this chapter. This report shall be included in the report required under paragraph (1) of subdivision (d) of Section 131019.5. (Amended by Stats. 2012, Ch. 23, Sec. 14. (AB 1467) Effective June 27, 2012.) § 416 Division 1, Part 1, Chapter 2, Article 7.5 The Director of Developmental Services may be appointed as either guardian or conservator of the person and estate, or person or estate, of any developmentally disabled person, who is either of the following: (1) Eligible for the services of a regional center. (2) A patient in any state hospital, and who was admitted or committed to such hospital from a county served by a regional center. Any reference in this article to the Director of Health shall be deemed a reference to the Director of Developmental Services. (Amended by Stats. 1977, Ch. 1252.) § 416.10 Division 1, Part 1, Chapter 2, Article 7.5 No appointment of both the Director of Developmental Services and a private guardian or conservator shall be made for the same person and estate, or person or estate. The Director of Developmental Services may be appointed as provided in this article to succeed an existing guardian or conservator upon the death, resignation or removal of such guardian or conservator. (Amended by Stats. 1977, Ch. 1252.) § 416.1 Division 1, Part 1, Chapter 2, Article 7.5 Unless exceptions are expressly made in this article, the provisions of Division 4 (commencing with Section 1400) of the Probate Code shall apply to guardianship and conservatorship appointments made under this article. (Amended by Stats. 1979, Ch. 730.) § 416.11 Division 1, Part 1, Chapter 2, Article 7.5 No costs or fees shall be charged or received by the county clerk for the filing of any conservatorship or guardianship petition as provided in this article, or for any official services performed by him in the course of the proceeding under this article. (Added by Stats. 1968, Ch. 1099.) § 416.12 Division 1, Part 1, Chapter 2, Article 7.5 The Director of Developmental Services shall file an official bond in no event less than twenty-five thousand dollars ($25,000), which bond shall inure to the joint benefit of the several guardianship or conservatorship estates and the State of California, and the Director of Developmental Services shall not be required to file bonds in individual cases. (Amended by Stats. 1978, Ch. 429.) § 416.13 Division 1, Part 1, Chapter 2, Article 7.5 The appointment by the court of the Director of Developmental Services as conservator or guardian shall be by the title of his office. The authority of the Director of Developmental Services as conservator or guardian shall cease upon the termination of his term of office as such Director of Developmental Services and his authority shall vest in his successor or successors in office without further court proceedings. The Director of Developmental Services shall not resign as conservator or guardian unless his resignation is approved by the court. (Amended by Stats. 1977, Ch. 1252.) § 416.14 Division 1, Part 1, Chapter 2, Article 7.5 The Director of Developmental Services shall: (a) Consult with developmentally disabled persons and their families with respect to the services the director offers. (b) Act as adviser for those developmentally disabled persons who request the director’s advice and guidance or for whose benefit it is requested. (c) Accept appointment as guardian or conservator of the person and estate, or person or estate, of those developmentally disabled persons who need the director’s assistance and protection. (Amended by Stats. 1979, Ch. 730.) § 416.15 Division 1, Part 1, Chapter 2, Article 7.5 The Director of Developmental Services, when acting as adviser, may provide advice and guidance to the developmentally disabled person without prior appointment by a court. The provision for such services shall not be dependent upon a finding of incompetency, nor shall it abrogate any civil right otherwise possessed by the developmentally disabled person. (Amended by Stats. 1977, Ch. 1252.) § 416.16 Division 1, Part 1, Chapter 2, Article 7.5 The Director of Developmental Services shall have the same powers and duties as those established for guardians and conservators in Division 4 (commencing with Section 1400) of the Probate Code and shall succeed the State Director of Health as guardian or conservator of developmentally disabled individuals for whom the State Director of Health was appointed guardian or conservator. (Amended by Stats. 1979, Ch. 730.) § 416.17 Division 1, Part 1, Chapter 2, Article 7.5 It is the intent of this article that the director, when acting as guardian or conservator of the person of a developmentally disabled person, shall maintain close contact with the developmentally disabled person no matter where the person is living in this state; shall act as a wise parent would act in caring for the parent’s developmentally disabled child; shall permit and encourage maximum self-reliance on the part of the developmentally disabled person under their protection; and shall work with regional centers and the person, to the greatest extent possible, to develop and implement less restrictive alternatives to conservatorship. (Amended by Stats. 2022, Ch. 894, Sec. 1. (AB 1663) Effective January 1, 2023.) § 416.18 Division 1, Part 1, Chapter 2, Article 7.5 The director shall provide for at least an annual review in writing of the physical, mental, and social condition of each developmentally disabled person for whom he has been appointed conservator or guardian, or for whom he is otherwise acting in his official capacity under this article. These records shall be confidential but may be made available to persons approved by the director or the court. (Amended by Stats. 1973, Ch. 546.) § 416.19 Division 1, Part 1, Chapter 2, Article 7.5 (a) The services to be rendered by the director as adviser or as guardian or conservator of the person shall be performed through the regional centers or by other agencies or individuals designated by the regional centers. (b) No later than January 1, 2024, the Director of Developmental Services shall develop guidelines to mitigate conflicts that may arise when a regional center is acting as the designee of the director for a conservatee, while at the same time is also responsible for service coordination activities pursuant to Section 4647 of the Welfare and Institutions Code for that same person. The guidelines shall also include a process for any conservatee or their legal representative to request assistance from the director or their designee if they are dissatisfied with a regional center’s performance in carrying out its responsibilities under this section. (Amended by Stats. 2022, Ch. 894, Sec. 2. (AB 1663) Effective January 1, 2023.) § 416.20 Division 1, Part 1, Chapter 2, Article 7.5 The director shall receive such reasonable fees for his services as guardian or conservator of the estate as the court allows and such fees shall be paid into the General Fund of the State Treasury. (Added by Stats. 1968, Ch. 1099.) § 416.23 Division 1, Part 1, Chapter 2, Article 7.5 This article does not authorize the care, treatment, or supervision or any control over any developmentally disabled person without the written consent of his parent or guardian or conservator. (Amended by Stats. 1979, Ch. 730.) § 416.5 Division 1, Part 1, Chapter 2, Article 7.5 The director may be nominated by any one of the following to act as guardian or conservator for any developmentally disabled person; (1) who is or may become eligible for the services of a regional center, or (2) who is a patient in any state hospital, and who was admitted or committed to such hospital from a county served by a regional center: (a) A parent, relative or friend. (b) The guardian or conservator of the person or estate, or person and estate, of the developmentally disabled person to act as his successor. (c) The developmentally disabled person. Such nomination shall be in writing and may provide that the authority of the director is to take effect at some date or occurrence in the future that may be fixed in the nomination. The director shall promptly accept or reject such nomination in writing. His acceptance shall be binding upon him and his successors. Any nomination to take effect in the future may be withdrawn by the nominator before its effective date. (Amended by Stats. 1973, Ch. 546.) § 416.6 Division 1, Part 1, Chapter 2, Article 7.5 In every case in which he has agreed to do so, the director may petition for his appointment to act as conservator or guardian of the alleged developmentally disabled person and his estate or his person or estate in the superior court of the county where the main administrative office of the regional center serving such developmentally disabled person is located. (Amended by Stats. 1973, Ch. 546.) § 416.7 Division 1, Part 1, Chapter 2, Article 7.5 If the alleged developmentally disabled person is within the state and is able to attend, he shall be present at the hearing. If he is unable to attend by reason of physical or other inability, such inability shall be evidenced by the affidavit or certificate of a duly licensed medical practitioner as provided in Section 1825 of the Probate Code. Such affidavit or certificate shall be filed no later than 10 days prior to the time of the hearing. (Amended by Stats. 1979, Ch. 730.) § 416.8 Division 1, Part 1, Chapter 2, Article 7.5 In addition to the requirements of Division 4 (commencing with Section 1400) of the Probate Code, the court shall be provided by the regional center with a complete evaluation of the developmentally disabled person for whose protection the appointment is sought. The report shall include a current diagnosis of his physical condition prepared under the direction of a licensed medical practitioner and a report of his current mental condition and social adjustment prepared by a licensed and qualified social worker or psychologist. The evaluation report required by this section shall not be made part of the public record of the guardianship or conservatorship proceedings and shall be open to inspection only by court personnel, the person who is the subject of the proceeding, his parents, guardian or conservator, the attorneys for such parties, and such other persons as may be designated by the court. If an affidavit or certificate has been filed as provided in Section 416.7 evidencing the inability of the alleged developmentally disabled person to be present at the hearing, the psychologist or social worker who assists in preparing the report shall visit the alleged developmentally disabled person and be prepared to testify as to his present condition. (Amended by Stats. 1979, Ch. 730.) § 416.9 Division 1, Part 1, Chapter 2, Article 7.5 The court may appoint the Director of Developmental Services as guardian or conservator of the person and estate or person or estate of a minor or adult developmentally disabled person. The preferences established in Section 1812 of the Probate Code for appointment of a conservator shall not apply. An appointment of the Director of Developmental Services as conservator shall not of itself constitute a judicial finding that the developmentally disabled person is legally incompetent. The petition for the appointment of the Director of Developmental Services as conservator of an adult developmentally disabled person may include a request that the court adjudge the developmentally disabled person to be legally incompetent or such an adjudication may be made subsequently upon a petition made, noticed, and heard by the court in the same manner as a petition for the appointment of the director as conservator. If the Director of Developmental Services is serving as the guardian of an adult developmentally disabled person on December 31, 1980, after that date such appointment shall be deemed to be the appointment of a conservator and the conservatee shall be deemed to have been adjudged to be legally incompetent. (Amended by Stats. 1979, Ch. 730.) § 416.95 Division 1, Part 1, Chapter 2, Article 7.5 Prior to the appointment of the Director of Developmental Services as guardian or conservator of the person or estate of a minor or adult developmentally disabled person, the court shall inform the person of the nature and purpose of the guardianship or conservatorship proceedings and the effect of the proceedings on the basic rights of the person. After communicating the information to the alleged developmentally disabled person and prior to the appointment of the Director of Developmental Services as guardian or conservator, the court shall consult with the person to determine the person’s opinion concerning the appointment. Any adult developmentally disabled person for whom guardianship or conservatorship is sought pursuant to this article shall be informed by a member or designee of the regional center and by the court of the person’s right to counsel; and if the person does not have an attorney for the proceedings the court shall immediately appoint the public defender or other attorney to represent the person. The person shall pay the cost for such legal service if able. If an affidavit or certificate has been filed, as provided in Section 416.7, evidencing the inability of the alleged developmentally disabled person to be present at the hearing, the psychologist or social worker assisting in preparing the report and who is required to visit each person as provided in Section 416.8 shall communicate such information to the person during the visit, consult the person to determine the person’s opinion concerning the appointment, and be prepared to testify as to the person’s opinion, if any. (Amended by Stats. 1979, Ch. 730.) § 425 Division 1, Part 1, Chapter 2, Article 9 The State Department of Health Services shall submit to the State Air Resources Board recommendations for ambient air quality standards reflecting the relationship between the intensity and composition of air pollution and the health, illness, irritation to the senses, and the death of human beings. (Amended by Stats. 1977, Ch. 1252.) § 429.997 Division 1, Part 1, Chapter 2, Article 21 Notwithstanding any provision of state law, and unless prohibited by federal law, a county may eliminate or consolidate any health advisory boards that are required by state law or regulation, or in any existing contract with the department. Where advisory boards are required only by contract between the department and a county, that contract shall be amended by the department, upon written request of the county, to remove a requirement for an advisory board from the contract. (Added by Stats. 1993, Ch. 64, Sec. 2. Effective June 30, 1993.) § 438 Division 1, Part 1.5 The Office of the Surgeon General is hereby established within the California Health and Human Services Agency. The office shall be responsible for all of the following: (a) Raising public awareness on and coordinating policies governing scientific screening and treatment for toxic stress and adverse childhood events. (b) Advising the Governor, the Secretary of the California Health and Human Services Agency, and policymakers on a comprehensive approach to address health issues and challenges, including toxic stress and adverse childhood events, as effectively and early as possible. (c) Marshalling the insights and energy of medical professionals, scientists, and other academic experts, public health experts, public servants, and everyday Californians to solve our most pressing health challenges, including toxic stress and adverse childhood events. (Added by Stats. 2019, Ch. 38, Sec. 12. (SB 78) Effective June 27, 2019.) § 439 Division 1, Part 1.5 (a) The Surgeon General shall be appointed by the Governor and shall be the director of the Office of the Surgeon General. (b) On and after July 1, 2019, the appointment of the Surgeon General shall be subject to confirmation by the Senate. (c) The salary of the Surgeon General shall be fixed in accordance with state law. (Added by Stats. 2019, Ch. 38, Sec. 12. (SB 78) Effective June 27, 2019.) § 439.900 Division 1, Part 1.6 This act shall be known and may be cited as the Health Research Fairness Act. (Added by Stats. 1991, Ch. 792, Sec. 1.) § 439.901 Division 1, Part 1.6 The Legislature finds and declares all of the following: (a) The National Institutes of Health (NIH), the nation’s major source of funding for medical research conducted in the United States, spends approximately 13 percent of its budget for research on conditions and diseases that are primarily women’s health issues. Although it is true that the great majority of the NIH research funds are expended for studies of diseases that affect both men and women, or for fundamental research that has significance for diseases affecting all segments of our population, women have not been adequately represented in research populations in major NIH-funded studies of diseases which affect both men and women. (b) Today many medical treatments currently used on women are based on studies conducted entirely on men. For example, although cardiovascular illness is the number one cause of death and disability in American women, women have consistently been excluded from major research studies in this area. (c) It is estimated that 175,000 American women will develop breast cancer, and 44,000 women will die from the disease this year. Currently, one in nine women born in the United States will develop breast cancer in her lifetime. (d) Women constitute 11 percent of all reported AIDS cases. Eighty percent of all HIV-infected women are women of color. (e) Osteoporosis, a condition characterized by excessive loss of bone tissue, affects an estimated 24 million Americans and results annually in an estimated $10 billion in direct medical costs. The cost of this disease will continue to escalate as the population ages and the incidence of osteoporosis increases. If current trends continue, the cost of osteoporosis treatment could be as much as $62 billion by the year 2020. (f) Eighty percent of individuals affected by osteoporosis are women. One-half of all women over age 45 years, and 90 percent of all women over age 75 years, suffer from osteoporosis. (g) Nearly one million couples seek medical advice or treatment for infertility. In the last 20 years, the number of infertility-related visits to doctors has nearly quadrupled. The risk of infertility is one and one-half times greater for blacks than for whites. (h) Despite these facts, women’s health issues—which are defined as diseases or conditions that are unique to women, are more prevalent or more serious in women, or for which specific risk factors or interventions differ for women—have received insufficient attention both in terms of funding and research. (i) The best way to treat women’s health problems is to prevent them from occurring, or to catch them in their earliest stages when they are most treatable. Without research into the causes and cures of diseases affecting women, these diseases cannot be effectively treated. (j) On August 24, 1990, the NIH published a revised, strengthened “NIH/ADHMA Policy Concerning Inclusion of Women in Study Populations.” That policy clearly stated that adequate numbers of women must be included in NIH-funded clinical studies, in proportion to the prevalence of the condition under study, unless an appropriate justification is provided. The revised policy also states that NIH will not fund grants that do not comply with its provisions. (k) The majority of biomedical research funded by, or based at, the University of California is fundamental research that investigates basic life processes and disease mechanisms, often at the cellular or molecular level, and that yields benefits for all segments of our population. (Added by Stats. 1991, Ch. 792, Sec. 1.) § 439.902 Division 1, Part 1.6 (a) On or before June 30, 1992, state agencies shall adopt, and it is the intent of the Legislature that the Regents of the University of California adopt, policies based on the publication “NIH/ADHMA Policy Concerning Inclusion of Women in Study Populations,” so that women and members of minority groups are appropriately included as subjects of health research projects carried out by state agencies or University of California researchers. The review of research proposals funded by state agencies or the University of California should include consideration of the appropriateness of the composition of research populations. (b) On or before September 30, 1992, state agencies and the University of California shall transmit to the Legislature copies of the policies adopted pursuant to this section, along with copies of the specific procedures put in place to carry out those policies. (Added by Stats. 1991, Ch. 792, Sec. 1.) § 439.903 Division 1, Part 1.6 State agencies shall, and it is the intent of the Legislature that the University of California: (a) Provide special opportunities for funding research projects devoted to diseases, disorders, or other health conditions of particular concern to women and minorities, or in health research areas in which women and minorities have been traditionally underrepresented. (b) At the same time, ensure that funding will enable researchers to adapt to changing population distribution of diseases. (Added by Stats. 1991, Ch. 792, Sec. 1.) § 439.904 Division 1, Part 1.6 (a) State agencies and the University of California shall report, consistent with available data, on the extent to which state funds administered by those agencies and the University of California are used to support research on diseases, disorders, or other health conditions that meet one or more of the following criteria, as determined by the state agency or the University of California: (1) Are unique to women or minorities, more prevalent in women or minorities, or more serious for women or minorities. (2) For which the risk factors or interventions are different for women or minorities. (b) On or before June 30, 1992, state agencies and the University of California shall adopt procedures for collecting and classifying data on the extent to which state-funded research projects address medical issues of particular concern to women and minorities. On and after June 30, 1993, information concerning the extent to which research supported by particular programs of state agencies and the University of California addresses medical issues of particular concern to women and minorities shall be incorporated into the appropriate periodic program reports required under existing law. (Added by Stats. 1991, Ch. 792, Sec. 1.) § 439.905 Division 1, Part 1.6 It is the intent of the Legislature to encourage research on the effectiveness of RU-486 (mifepristone) in treating breast and ovarian cancer, meningioma, endometriosis, Cushing’s syndrome, osteoporosis, diabetes, and AIDS. (Added by Stats. 1991, Ch. 792, Sec. 1.) § 439.906 Division 1, Part 1.6 For purposes of this part, “state agency” has the same meaning as defined in Section 11000 of the Government Code. (Added by Stats. 1991, Ch. 792, Sec. 1.) § 440.10 Division 1, Part 1.7 “Health facility,” as used in this chapter, means any general acute care hospital required to be licensed pursuant to Chapter 2 (commencing with Section 1250) of Division 2. (Added by Stats. 1993, Ch. 1049, Sec. 1. Effective January 1, 1994.) § 440.20 Division 1, Part 1.7 Within seven days after completion of the patient’s itemized bill, every health facility shall provide to the primary attending health care practitioner a copy, upon written request specifying the individual patient, of the complete itemized charges for services rendered by the health facility to the health care practitioner’s patient when the primary attending health care practitioner is not employed by the health facility nor is a member of an integrated group practice that provided the health facility services. (Added by Stats. 1993, Ch. 1049, Sec. 2. Effective January 1, 1994.) § 440.30 Division 1, Part 1.7 The primary attending health care practitioner’s written request to the health facility shall specify the records to be copied pursuant to Section 440.20 and shall include a fee to defray the cost of copying, not to exceed twenty-five cents ($0.25) per page, plus any reasonable costs of clerical services incurred in locating and making the records available. (Added by Stats. 1993, Ch. 1049, Sec. 3. Effective January 1, 1994.) § 440.40 Division 1, Part 1.7 The primary attending health care practitioner shall obtain prior written consent from each patient for whom a billing is requested, authorizing the release of the patient’s billing. A copy of this signed patient consent form shall be forwarded to the health care facility as part of the written request for itemized billings. (Added by Stats. 1993, Ch. 1049, Sec. 4. Effective January 1, 1994.) § 440.50 Division 1, Part 1.7 No information, other than the itemized billing set forth in Section 440.20, that is prohibited from being released by any other provision of law shall be made available pursuant to Section 440.20. (Added by Stats. 1993, Ch. 1049, Sec. 5. Effective January 1, 1994.) § 442 Division 1, Part 1.8 For the purposes of this part, the following definitions shall apply: (a) “Actively dying” means the phase of terminal illness when death is imminent. (b) “Disease-targeted treatment” means treatment directed at the underlying disease or condition that is intended to alter its natural history or progression, irrespective of whether or not a cure is a possibility. (c) “Health care provider” means an attending physician and surgeon. It also means a nurse practitioner or physician assistant practicing in accordance with standardized procedures or protocols developed and approved by the supervising physician and surgeon and the nurse practitioner or physician assistant. (d) “Hospice” means a specialized form of interdisciplinary health care that is designed to provide palliative care, alleviate the physical, emotional, social, and spiritual discomforts of an individual who is experiencing the last phases of life due to the existence of a terminal disease, and provide supportive care to the primary caregiver and the family of the hospice patient, and that meets all of the criteria specified in subdivision (b) of Section 1746. (e) “Palliative care” means medical treatment, interdisciplinary care, or consultation provided to a patient or family members, or both, that has as its primary purpose the prevention of, or relief from, suffering and the enhancement of the quality of life, rather than treatment aimed at investigation and intervention for the purpose of cure or prolongation of life as described in subdivision (b) of Section 1339.31. In some cases, disease-targeted treatment may be used in palliative care. (f) “Refusal or withdrawal of life-sustaining treatment” means forgoing treatment or medical procedures that replace or support an essential bodily function, including, but not limited to, cardiopulmonary resuscitation, mechanical ventilation, artificial nutrition and hydration, dialysis, and any other treatment or discontinuing any or all of those treatments after they have been used for a reasonable time. (Added by Stats. 2008, Ch. 683, Sec. 2. Effective January 1, 2009.) § 442.5 Division 1, Part 1.8 (a) When a health care provider makes a diagnosis that a patient has a terminal illness, the health care provider shall do both of the following: (1) Notify the patient of his or her right, or, when applicable, the right of another person authorized to make health care decisions for the patient, to comprehensive information and counseling regarding legal end-of-life options. This notification may be provided at the time of diagnosis or at a subsequent visit in which the provider discusses treatment options with the patient or the other authorized person. (2) Upon the request of the patient or another person authorized to make health care decisions for the patient, provide the patient or other authorized person with comprehensive information and counseling regarding legal end-of-life care options pursuant to this section. When a terminally ill patient is in a health facility, as defined in Section 1250, the health care provider, or medical director of the health facility if the patient’s health care provider is not available, may refer the patient or other authorized person to a hospice provider or private or public agencies and community-based organizations that specialize in end-of-life care case management and consultation to receive comprehensive information and counseling regarding legal end-of-life care options. (b) If a patient or another person authorized to make health care decisions for the patient, requests information and counseling pursuant to paragraph (2) of subdivision (a), the comprehensive information shall include, but not be limited to, the following: (1) Hospice care at home or in a health care setting. (2) A prognosis with and without the continuation of disease-targeted treatment. (3) The patient’s right to refusal of or withdrawal from life-sustaining treatment. (4) The patient’s right to continue to pursue disease-targeted treatment, with or without concurrent palliative care. (5) The patient’s right to comprehensive pain and symptom management at the end of life, including, but not limited to, adequate pain medication, treatment of nausea, palliative chemotherapy, relief of shortness of breath and fatigue, and other clinical treatments useful when a patient is actively dying. (6) The patient’s right to give individual health care instruction pursuant to Section 4670 of the Probate Code, which provides the means by which a patient may provide written health care instruction, such as an advance health care directive, and the patient’s right to appoint a legally recognized health care decisionmaker. (c) The information described in subdivision (b) may, but is not required to, be in writing. Health care providers may utilize information from organizations specializing in end-of-life care that provide information on factsheets and Internet Web sites to convey the information described in subdivision (b). (d) Counseling may include, but is not limited to, discussions about the outcomes for the patient and his or her family, based on the interest of the patient. Information and counseling, as described in subdivision (b), may occur over a series of meetings with the health care provider or others who may be providing the information and counseling based on the patient’s needs. (e) The information and counseling sessions may include a discussion of treatment options in a culturally sensitive manner that the patient and his or her family, or, when applicable, another person authorized to make health care decisions for the patient, can easily understand. If the patient or other authorized person requests information on the costs of treatment options, including the availability of insurance and eligibility of the patient for coverage, the patient or other authorized person shall be referred to the appropriate entity for that information. (f) The notification made pursuant to paragraph (1) of subdivision (a) shall not be required if the patient or other person authorized to make health care decisions, as defined in Section 4617 of the Probate Code, for the patient has already received the notification. (g) For purposes of this section, “health care decisions” has the meaning set forth in Section 4617 of the Probate Code. (h) This section shall not be construed to interfere with the clinical judgment of a health care provider in recommending the course of treatment. (Amended by Stats. 2015, Ch. 303, Sec. 245. (AB 731) Effective January 1, 2016.) § 442.7 Division 1, Part 1.8 If a health care provider does not wish to comply with his or her patient’s request or, when applicable, the request of another person authorized to make health care decisions, as defined in Section 4617 of the Probate Code, for the patient for information on end-of-life options, the health care provider shall do both of the following: (a) Refer or transfer a patient to another health care provider that shall provide the requested information. (b) Provide the patient or other person authorized to make health care decisions for the patient with information on procedures to transfer to another health care provider that shall provide the requested information. (Amended by Stats. 2014, Ch. 568, Sec. 2. (AB 2139) Effective January 1, 2015.) § 442.9 Division 1, Part 1.8 (a) Before the discharge from an acute care hospital of a Medi-Cal beneficiary diagnosed with a terminal illness, the hospital’s designated case manager or discharge planner shall evaluate the patient’s likely need for posthospital services and their ability to access those services. For patients anticipated to need in-home personal care, the hospital case manager or discharge planner shall ask the patient, or another person authorized to make health care decisions for the patient, if they are interested in receiving information about the in-home supportive services (IHSS) program (Article 7 (commencing with Section 12300) of Chapter 3 of Part 3 of Division 9 of the Welfare and Institutions Code). If the patient or authorized person expresses interest in receiving the IHSS information, the hospital case manager or discharge planner shall provide to the patient or authorized person the information, including how to initiate the application process and the option for a family member to provide care as an IHSS provider subject to the IHSS provider enrollment conditions set forth in that article. (b) If the patient seeks to apply for services under the IHSS program, the hospital case manager or discharge planner shall, as appropriate, communicate to the patient’s primary care physician the patient’s interest in applying for IHSS to support the timely completion of the health care certification form (SOC 873 or its successor), as described in Section 12309.1 of the Welfare and Institutions Code. (Added by Stats. 2024, Ch. 346, Sec. 1. (AB 1005) Effective January 1, 2025.) § 443 Division 1, Part 1.85 This part shall be known and may be cited as the End of Life Option Act. (Added by Stats. 2015, 2nd Ex. Sess., Ch. 1, Sec. 1. (AB 15 2x) Effective June 9, 2016.) § 443.1 Division 1, Part 1.85 As used in this part, the following definitions shall apply: (a) “Adult” means an individual 18 years of age or older. (b) “Aid-in-dying drug” means a drug determined and prescribed by a physician for a qualified individual, which the qualified individual may choose to self-administer to bring about their death due to a terminal disease. (c) “Attending physician” means the physician who has primary responsibility for the health care of an individual and treatment of the individual’s terminal disease. (d) “Attending physician checklist and compliance form” means a form, as described in Section 443.22, identifying each and every requirement that must be fulfilled by an attending physician to be in good faith compliance with this part should the attending physician choose to participate. (e) “Capacity to make medical decisions” means that, in the opinion of an individual’s attending physician, consulting physician, psychiatrist, or psychologist, pursuant to Section 4609 of the Probate Code, the individual has the ability to understand the nature and consequences of a health care decision, the ability to understand its significant benefits, risks, and alternatives, and the ability to make and communicate an informed decision to health care providers. (f) “Consulting physician” means a physician who is independent from the attending physician and who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding an individual’s terminal disease. (g) “Department” means the State Department of Public Health. (h) “Health care provider” or “provider of health care” means any person licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code; any person licensed pursuant to the Osteopathic Initiative Act or the Chiropractic Initiative Act; and any person certified pursuant to Division 2.5 (commencing with Section 1797) of this code. (i) “Health care entity” means any clinic, health dispensary, or health facility licensed pursuant to Division 2 (commencing with Section 1200), including a general hospital, medical clinic, nursing home or hospice facility. A health care entity does not include individuals described in subdivision (h). (j) “Informed decision” means a decision by an individual with a terminal disease to request and obtain a prescription for a drug that the individual may self-administer to end the individual’s life, that is based on an understanding and acknowledgment o