SB 828: Minimum wages: health care workers: delay.
- Session Year: 2023-2024
- House: Senate
- Latest Version Date: 2024-05-31
Current Status:
Passed
(2024-05-31: Chaptered by Secretary of State. Chapter 12, Statutes of 2024.)
Introduced
In Committee
First Chamber
In Committee
Second Chamber
Enacted
Existing law requires, for any covered health care facility employer, as defined, with 10,000 or more full-time equivalent employees (FTEE), as defined, any covered health care facility employer that is a part of an integrated health care delivery system or a health care system with 10,000 or more FTEEs, a covered health care facility employer that is a dialysis clinic or is a person that owns, controls, or operates a dialysis clinic, or a covered health facility owned, affiliated, or operated by a county with a population of more than 5,000,000 as of January 1, 2023, the minimum wage for covered health care employees to be $23 per hour from June 1, 2024, to May 31, 2025, inclusive, $24 per hour from June 1, 2025, to May 31, 2026, inclusive, and $25 per hour from June 1, 2026, and until as adjusted, as specified.
Existing law requires, for any hospital that is a hospital with a high governmental payor mix, an independent hospital with an elevated governmental payor mix, a rural independent covered health care facility, or a covered health care facility that is owned, affiliated, or operated by a county with a population of less than 250,000 as of January 1, 2023, as those terms are defined, the minimum wage for covered health care employees to be $18 per hour from June 1, 2024, to May 31, 2033, inclusive, and $25 per hour from June 1, 2033, and until as adjusted, as specified.
Existing law requires, for specified clinics that meet certain requirements, the minimum wage for covered health care employees to be $21 per hour from June 1, 2024, to May 31, 2026, inclusive, and $22 per hour from June 1, 2026, to May 31, 2027, inclusive, and $25 from June 1, 2027, and until as adjusted, as specified.
Existing law requires, for all other covered health care facility employers, the minimum wage for covered health care employees to be $21 per hour from June 1, 2024, to May 31, 2026, inclusive, $23 per hour from June 1, 2026, to May 31, 2028, inclusive, and $25 per hour from June 1, 2028, and until as adjusted, as specified.
Existing law also separately requires, for a licensed skilled nursing facility, as described, in specified circumstances the minimum wage for certain other covered health care employees, as described, to be $21 per hour from June 1, 2024, to May 31, 2026, inclusive, $23 per hour from June 1, 2026, to May 31, 2028, inclusive, and $25 per hour from June 1, 2028, and until as adjusted, as specified.
This bill would delay the minimum wage adjustments above by one month.
This bill would make legislative findings and declarations as to the necessity of a special statute for health care workers.
This bill would declare that it is to take effect immediately as an urgency statute.
Existing law requires, for any covered health care facility employer, as defined, with 10,000 or more full-time equivalent employees (FTEE), as defined, any covered health care facility employer that is a part of an integrated health care delivery system or a health care system with 10,000 or more FTEEs, a covered health care facility employer that is a dialysis clinic or is a person that owns, controls, or operates a dialysis clinic, or a covered health facility owned, affiliated, or operated by a county with a population of more than 5,000,000 as of January 1, 2023, the minimum wage for covered health care employees to be $23 per hour from June 1, 2024, to May 31, 2025, inclusive, $24 per hour from June 1, 2025, to May 31, 2026, inclusive, and $25 per hour from June 1, 2026, and until as adjusted, as specified.
Existing law requires, for any hospital that is a hospital with a high governmental payor mix, an independent hospital with an elevated governmental payor mix, a rural independent covered health care facility, or a covered health care facility that is owned, affiliated, or operated by a county with a population of less than 250,000 as of January 1, 2023, as those terms are defined, the minimum wage for covered health care employees to be $18 per hour from June 1, 2024, to May 31, 2033, inclusive, and $25 per hour from June 1, 2033, and until as adjusted, as specified.
Existing law requires, for specified clinics that meet certain requirements, the minimum wage for covered health care employees to be $21 per hour from June 1, 2024, to May 31, 2026, inclusive, and $22 per hour from June 1, 2026, to May 31, 2027, inclusive, and $25 from June 1, 2027, and until as adjusted, as specified.
Existing law requires, for all other covered health care facility employers, the minimum wage for covered health care employees to be $21 per hour from June 1, 2024, to May 31, 2026, inclusive, $23 per hour from June 1, 2026, to May 31, 2028, inclusive, and $25 per hour from June 1, 2028, and until as adjusted, as specified.
Existing law also separately requires, for a licensed skilled nursing facility, as described, in specified circumstances the minimum wage for certain other covered health care employees, as described, to be $21 per hour from June 1, 2024, to May 31, 2026, inclusive, $23 per hour from June 1, 2026, to May 31, 2028, inclusive, and $25 per hour from June 1, 2028, and until as adjusted, as specified.
This bill would delay the minimum wage adjustments above by one month.
This bill would make legislative findings and declarations as to the necessity of a special statute for health care workers.
This bill would declare that it is to take effect immediately as an urgency statute.
Existing law requires, for any covered health care facility employer, as defined, with 10,000 or more full-time equivalent employees (FTEE), as defined, any covered health care facility employer that is a part of an integrated health care delivery system or a health care system with 10,000 or more FTEEs, a covered health care facility employer that is a dialysis clinic or is a person that owns, controls, or operates a dialysis clinic, or a covered health facility owned, affiliated, or operated by a county with a population of more than 5,000,000 as of January 1, 2023, the minimum wage for covered health care employees to be $23 per hour from June 1, 2024, to May 31, 2025, inclusive, $24 per hour from June 1, 2025, to May 31, 2026, inclusive, and $25 per hour from June 1, 2026, and until as adjusted, as specified.
Existing law requires, for any hospital that is a hospital with a high governmental payor mix, an independent hospital with an elevated governmental payor mix, a rural independent covered health care facility, or a covered health care facility that is owned, affiliated, or operated by a county with a population of less than 250,000 as of January 1, 2023, as those terms are defined, the minimum wage for covered health care employees to be $18 per hour from June 1, 2024, to May 31, 2033, inclusive, and $25 per hour from June 1, 2033, and until as adjusted, as specified.
Existing law requires, for specified clinics that meet certain requirements, the minimum wage for covered health care employees to be $21 per hour from June 1, 2024, to May 31, 2026, inclusive, and $22 per hour from June 1, 2026, to May 31, 2027, inclusive, and $25 from June 1, 2027, and until as adjusted, as specified.
Existing law requires, for all other covered health care facility employers, the minimum wage for covered health care employees to be $21 per hour from June 1, 2024, to May 31, 2026, inclusive, $23 per hour from June 1, 2026, to May 31, 2028, inclusive, and $25 per hour from June 1, 2028, and until as adjusted, as specified.
Existing law also separately requires, for a licensed skilled nursing facility, as described, in specified circumstances the minimum wage for certain other covered health care employees, as described, to be $21 per hour from June 1, 2024, to May 31, 2026, inclusive, $23 per hour from June 1, 2026, to May 31, 2028, inclusive, and $25 per hour from June 1, 2028, and until as adjusted, as specified.
This bill would delay the minimum wage adjustments above by one month.
This bill would make legislative findings and declarations as to the necessity of a special statute for health care workers.
This bill would declare that it is to take effect immediately as an urgency statute.
Existing law establishes the Department of Corrections and Rehabilitation and sets forth its powers and duties regarding the administration of correctional facilities and the care and custody of inmates. Existing law establishes the Pre-Release Construction Trades Certificate Program within the department to increase employment opportunities in the construction trades for inmates upon release. Existing law requires the department to establish a joint advisory committee to implement the program and specifies the duties of the committee, including exploring the prerelease award of formal credit for apprenticeship hours recognized by joint apprenticeship training programs and the Division of Apprenticeship Standards, among other things.This bill would require the department to provide a report to the Legislature, on or before January 1, 2026, on the above-described exploratory findings of the joint advisory committee. The bill would repeal this provision on January 1, 2030.Existing law establishes the Department of Corrections and Rehabilitation and sets forth its powers and duties regarding the administration of correctional facilities and the care and custody of inmates. Existing law establishes the Pre-Release Construction Trades Certificate Program within the department to increase employment opportunities in the construction trades for inmates upon release. Existing law requires the department to establish a joint advisory committee to implement the program and specifies the duties of the committee, including exploring the prerelease award of formal credit for apprenticeship hours recognized by joint apprenticeship training programs and the Division of Apprenticeship Standards, among other things.
This bill would require the department to provide a report to the Legislature, on or before January 1, 2026, on the above-described exploratory findings of the joint advisory committee. The bill would repeal this provision on January 1, 2030.
Existing law authorizes a sheriff or other official in charge of a county correctional facility to provide for the vocational training and rehabilitation of incarcerated individuals, as specified.This bill would declare the intent of the Legislature to enact legislation relating to vocational training for incarcerated individuals.Existing law authorizes a sheriff or other official in charge of a county correctional facility to provide for the vocational training and rehabilitation of incarcerated individuals, as specified.
This bill would declare the intent of the Legislature to enact legislation relating to vocational training for incarcerated individuals.
(a)The Legislature finds and declares as follows:
(1)Workers in the health care industry, including workers at general acute care hospitals, acute psychiatric hospitals, medical offices and clinics, behavioral health centers, and residential care centers provide vital health care services to California residents, including emergency care, labor and delivery, cancer treatments, and primary and specialty care. Similarly, dialysis clinics provide life-preserving care to patients with end-stage renal disease and are part of the continuum of kidney care that also includes hospitals and health systems. Residents and visitors to the state rely on access to this high-quality health care.
(2)Higher wages are an important means of retaining an experienced workforce and attracting new workers. A stable workforce benefits patients and improves quality of care.
(3)Employers across multiple industries are raising wages. The health care sector in California must offer higher wages to remain competitive.
(4)Members of the health care team such as certified nursing assistants, patient aides, technicians, and food service workers, among many others, are essential to both routine medical care and emergency response efforts.
(5)Even before the COVID-19 pandemic, California was facing an urgent and immediate shortage of health care workers, adversely impacting the health and well-being of Californians, especially economically disadvantaged Californians. The pandemic has worsened these shortages. Higher wages are needed to attract and retain health care workers to treat patients, including being prepared to provide necessary care in an emergency.
(6)The Legislature finds and declares that laws that establish, require, impose, limit or otherwise relate to wages, salary, or compensation affect access to quality health care for all residents of, and visitors to, the state provided by licensed health care facilities, which serve as a critical part of the states ability to respond to catastrophic emergencies. The Legislature also finds and declares that the time limitations and other provisions established by this section are necessary to stabilize the health care system following the state and federal public health emergencies related to COVID-19, the closure and bankruptcy of licensed health care facilities, and the reduction in vital services by licensed health care facilities due to financial distress and the health care workforce crisis that has resulted in staffing shortages and strain for health care workers. The Legislature further finds and declares that access to quality health care and the stability of the health care system is a matter of statewide concern and is not a municipal affair as that term is used in Section 5 of Article XI of the California Constitution. Therefore, this section occupies the whole field of wages, salary, or compensation for covered health care facility employees, and applies to all cities and counties, including charter cities, charter counties, and charter cities and counties during the stabilization period provided by this section.
(b)As used in this section:
(1)Adjusted patient days means the total gross patient revenue, divided by gross revenue provided for inpatient services, multiplied by the number of patient days.
(2)(A)Covered health care employee means any of the following:
(i)An employee of a health care facility employer who provides patient care, health care services, or services supporting the provision of health care, which includes, but is not limited to, employees performing work in the occupation of a nurse, physician, caregiver, medical resident, intern or fellow, patient care technician, janitor, housekeeping staff person, groundskeeper, guard, clerical worker, nonmanagerial administrative worker, food service worker, gift shop worker, technical and ancillary services worker, medical coding and medical billing personnel, scheduler, call center and warehouse worker, and laundry worker, regardless of formal job title.
(ii)A contracted or subcontracted employee described in subparagraph (B).
(B)Covered health care employee includes a contracted or subcontracted employee, if all of the following apply:
(i)The employees employer contracts with the health care facility employer, or with a contractor or subcontractor to the health care facility employer, to provide health care services, or services supporting the provision of health care.
(ii)The health care facility employer directly or indirectly, or through an agent or any other person, exercises control over the employees wages, hours or working conditions. However, covered health care employee includes all employees performing contracted or subcontracted work primarily on the premises of a health care facility to provide health care services or services supporting the provision of health care.
(C)Notwithstanding subparagraph (A), covered health care employee does not include:
(i)Employment as an outside salesperson.
(ii)Any work performed in the public sector where the primary duties performed are not health care services.
(iii)Delivery or waste collection work on the premises of a covered health care facility, provided that the delivery or waste collection worker is not an employee of any person that owns, controls, or operates a covered health care facility.
(iv)Medical transportation services in or out of a covered health care facility, provided that the medical transportation services worker is not an employee of any person that owns, controls, or operates a covered health care facility.
(3)(A)Covered health care facility means any of the following:
(i)A facility or other work site that is part of an integrated health care delivery system.
(ii)A licensed general acute care hospital, as defined in subdivision (a) of Section 1250 of the Health and Safety Code, including a distinct part of any such hospital.
(iii)A licensed acute psychiatric hospital, as defined in subdivision (b) of Section 1250 of the Health and Safety Code, including a distinct part of any such hospital.
(iv)A special hospital, as defined in subdivision (f) of Section 1250 of the Health and Safety Code.
(v)A licensed skilled nursing facility, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, if owned, operated, or controlled by a hospital or integrated health care delivery system or health care system.
(vi)A patients home when health care services are delivered by an entity owned or operated by a general acute care hospital or acute psychiatric hospital.
(vii)A licensed home health agency, as defined in subdivision (a) of Section 1727 of the Health and Safety Code.
(viii)A clinic, as defined in subdivision (b) of Section 1204 of the Health and Safety Code, including a specialty care clinic, or a dialysis clinic.
(ix)A psychology clinic, as defined in Section 1204.1 of the Health and Safety Code.
(x)A clinic as defined in subdivision (d), (g), or (l) of Section 1206 of the Health and Safety Code.
(xi)A licensed residential care facility for the elderly, as defined in Section 1569.2 of the Health and Safety Code, if affiliated with an acute care provider or owned, operated, or controlled by a general acute care hospital, acute psychiatric hospital, or the parent entity of a general acute care hospital or acute psychiatric hospital.
(xii)A psychiatric health facility, as defined in Section 1250.2 of the Health and Safety Code.
(xiii)A mental health rehabilitation center, as defined in Section 5675 of the Welfare and Institutions Code.
(xiv)A community clinic licensed under subdivision (a) of Section 1204 of the Health and Safety Code, an intermittent clinic exempt from licensure under subdivision (h) of Section 1206 of the Health and Safety Code, or a clinic operated by the state or any of its political subdivisions, including, but not limited to, the University of California or a city or county that is exempt from licensure under subdivision (b) of Section 1206 of the Health and Safety Code.
(xv)A rural health clinic, as defined in paragraph (1) of subdivision (l) of Section 1396d of Title 42 of the United States Code.
(xvi)An urgent care clinic.
(xvii)An ambulatory surgical center that is certified to participate in the Medicare Program under Title XVIII (42 U.S.C. Sec. 1395 et seq.) of the federal Social Security Act.
(xviii)A physician group.
(xix)A county correctional facility that provides health care services.
(xx)A county mental health facility.
(B)Covered health care facility does not include either of the following:
(i)A hospital owned, controlled, or operated by the State Department of State Hospitals.
(ii)A tribal clinic exempt from licensure under subdivision (c) of Section 1206 of the Health and Safety Code, or an outpatient setting conducted, maintained, or operated by a federally recognized Indian tribe, tribal organization, or urban Indian organization, as defined in Section 1603 of Title 25 of the United States Code.
(4)Employ means to engage, suffer, or permit to work.
(5)Employee means any person employed by an employer.
(6)Employer means a person who directly or indirectly, or through an agent or any other person, employs or exercises control over the wages, hours, or working conditions of any person. Employer includes the state, political subdivisions of the state, the University of California, and municipalities.
(7)Full-time equivalent employee means the total paid hours at a covered health care facility, including an integrated health care delivery system, as of January 1, 2022, as per Department of Health Care Access and Information guidance, divided by 2,080.
(8)Health care services means patient care-related services including nursing; caregiving; services provided by medical residents, interns, or fellows; technical and ancillary services; janitorial work; housekeeping; groundskeeping; guard duties; business office clerical work; food services; laundry; medical coding and billing; call center and warehouse work; scheduling; and gift shop work; but only where such services support patient care.
(9)Health care worker minimum wage means the minimum wage rate established by this section.
(10)Health care system means a parent entity that owns, controls, or operates two or more separately licensed hospitals.
(11)Hospital with a high governmental payor mix means a licensed acute care hospital, as defined in subdivision (a) or (b) of Section 1250 of the Health and Safety Code, where the combined Medicare and Medi-Cal payor mix is 90 percent or greater, as determined by using the adjusted patient days from the Department of Health Care Access and Information annual financial disclosure report, as recorded and calculated as of January 1, 2022, as per the Department of Health Care Access and Information guidance. A hospital shall qualify pursuant to this paragraph only if the combined payor mix of both the hospital and the health care system to which it belongs, if any, is 90 percent or greater.
(12)Independent hospital with an elevated governmental payor mix means all of the following:
(A)A hospital, as defined in subdivision (a) or (b) of Section 1250 of the Health and Safety Code, where the combined Medicare and Medi-Cal payor mix is 75 percent or greater, as determined by using the adjusted patient days from the Department of Health Care Access and Information annual financial disclosure report, as recorded and calculated as of January 1, 2022, as per the Department of Health Care Access and Information guidance.
(B)The hospital is not owned, controlled, or operated by any parent entity with two or more separately licensed hospitals.
(13)Integrated health care delivery system means an entity or group of related entities that includes both of the following: (A) one or more hospitals and (B) one or more physician groups, health care service plans, medical foundation clinics, other health care facilities, or other entities, providing health care or supporting the provision of health care, where the hospital or hospitals and other entities are related through one of the following:
(A)Parent and subsidiary relationships, joint or common ownership or control, common branding, or common boards of directors and shared senior management.
(B)A contractual relationship in which affiliated covered physician groups or medical foundation clinics contract with a health care service plan, hospital or other part of the system, all operating under a common trade name.
(C)A contractual relationship in which a nonprofit health care service plan provides medical services to enrollees in a specific geographic region of the state through an affiliated hospital system, and contracts with a single covered physician group in each geographic region of the state to provide medical services to a majority of the plans enrollees in that region.
(14)Physician group means a medical group practice, including a professional medical corporation, as defined in Section 2406 of the Business and Professions Code, another form of corporation controlled by physicians and surgeons, or a medical partnership, provided that the group includes a total of 25 or more physicians.
(15)Rural independent covered health care facility means a hospital that is not part of an integrated health care delivery system and is not owned, controlled, or operated by any parent entity with two or more separately licensed hospitals and any of the following:
(A)A hospital that is located in a county that is not designated as a metropolitan core-based statistical area.
(B)A small and rural hospital, as defined in Section 124840 of the Health and Safety Code.
(C)A rural general acute care hospital, as described in Section 1250 of the Health and Safety Code.
(16)Urgent care clinic means a facility or clinic that provides immediate, nonemergent ambulatory medical care to patients, including, but not limited to, facilities known as walk-in clinics or centers or urgent care centers.
(c)(1)For any covered health care facility employer with 10,000 or more full-time equivalent employees, any covered health care facility employer that is a part of an integrated health care delivery system or health care system with 10,000 or more full-time equivalent employees, any covered health care facility employer that is a dialysis clinic as defined in subdivision (b) of Section 1204 of the Health and Safety Code or that is a person that owns, controls, or operates a dialysis clinic, or a covered health facility owned, affiliated, or operated by a county with a population of more than 5,000,000 as of January 1, 2023, the minimum wage for all covered health care employees shall be as follows:
(A)From July 1, 2024, to June 30, 2025, inclusive, twenty-three dollars ($23) per hour.
(B)From July 1, 2025, to June 30, 2026, inclusive, twenty-four dollars ($24) per hour.
(C)From July 1 2026, and until adjusted pursuant to subdivision (d), twenty-five dollars ($25) per hour.
(2)For any hospital that is a hospital with a high governmental payor mix, an independent hospital with an elevated governmental payor mix, a rural independent covered health care facility, or a covered health care facility that is owned, affiliated, or operated by a county with a population of less than 250,000 as of January 1, 2023, the minimum wage for all covered health care employees shall be as follows:
(A)From July 1, 2024, to June 30, 2033, inclusive, eighteen dollars ($18) per hour, with 3.5 percent increases annually.
(B)From July 1, 2033, and until adjusted pursuant to subdivision (d), twenty-five ($25) per hour.
(3)(A)For any health care facility specified in clauses (i) to (iv), inclusive, the minimum wage for all covered health care employees shall be as set forth in subparagraph (B).
(i)A clinic as defined in subdivision (h) of Section 1206 of the Health and Safety Code, that is not operated by or affiliated with a clinic described in subdivision (b) of Section 1206 of the Health and Safety Code.
(ii)A community clinic licensed under subdivision (a) of Section 1204 of the Health and Safety Code, and any associated intermittent clinic exempt from licensure under subdivision (h) of Section 1206 of the Health and Safety Code.
(iii)A rural health clinic, as defined in paragraph (1) of subdivision (l) of Section 1396d of Title 42 of the United States Code, that is not license-exempt.
(iv)An urgent care clinic that is owned by or affiliated with a facility defined in clause (ii) or (iii).
(B)(i)From July 1, 2024, to June 30, 2026, inclusive, twenty-one dollars ($21) per hour.
(ii)From July 1, 2026, to June 30, 2027, inclusive, twenty-two dollars ($22) per hour.
(iii)From July 1, 2027, and until adjusted by subdivision (d), twenty-five dollars ($25) per hour.
(4)For all other covered health care facility employers, the minimum wage for all covered health care employees shall be as follows:
(A)From July 1, 2024, to June 30, 2026, inclusive, twenty-one dollars ($21) per hour.
(B)From July 1, 2026, to June 30, 2028, inclusive, twenty-three dollars ($23) per hour.
(C)From July 1, 2028, and until adjusted pursuant to subdivision (d), twenty-five dollars ($25) per hour.
(5)Notwithstanding any other provision of this subdivision, a covered health care facility that is county owned, affiliated, or operated shall not be required to comply with this subdivision before January 1, 2025. Commencing January 1, 2025, a covered health care facility that is county owned, affiliated, or operated shall comply with the appropriate schedule described in this subdivision.
(d)(1)Following the implementation of the minimum wage increase specified in subparagraph (C) of paragraph (1), subparagraph (B) of paragraph (2), clause (iii) of subparagraph (B) of paragraph (3), or subparagraph (C) of paragraph (4) of subdivision (c), on or before August 1 of the following year, and on or before each August 1 thereafter, the Director of Finance shall calculate an adjusted minimum wage. The calculation shall increase the health care worker minimum wage by the lesser of 3.5 percent or the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted United States Consumer Price Index for Urban Wage Earners and Clerical Workers (U.S. CPI-W). The result shall be rounded to the nearest ten cents ($0.10). Each adjusted health care worker minimum wage increase calculated under this subdivision shall take effect on the following January 1.
(2)If the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted U.S. CPI-W is negative, there shall be no increase or decrease in the health care worker minimum wage pursuant to this subdivision on the following January 1.
(e)The health care worker minimum wages shall constitute the state minimum wages for covered health care employment for all purposes under this code and the Wage Orders of the Industrial Welfare Commission.
(f)A health care worker minimum wage shall be enforceable by the Labor Commissioner or by a covered worker through a civil action, through the same means and with the same relief available for violation of any other state minimum wage requirement.
(g)For covered health care employment where the compensation of the employee is on a salary basis, the employee shall earn a monthly salary equivalent to no less than 150 percent of the health care worker minimum wage or 200 percent of the minimum wage, as described in Section 1182.12, whichever is greater, for full-time employment in order to qualify as exempt from the payment of minimum wage and overtime under the law of this state, including where the employer is the state, a political subdivision of the state, the University of California, or a municipality.
(h)(1)On or before January 31, 2024, the Department of Health Care Access and Information shall publish the following information on their internet website:
(A)A list of all covered health care facility employers with 10,000 or more full-time equivalent employees, or covered health care facility employers that are a part of an integrated delivery system or health care system with 10,000 or more full-time equivalent employee, as defined in this section.
(B)A list of all hospitals that qualify as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility.
(2)If a covered health care facility believes that they were inappropriately excluded from the list of hospitals that qualify as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility, the health facility may file a request with the Department of Health Care Access and Information to be classified as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility. The requesting hospital shall provide the following:
(A)The physical location of the requesting hospital.
(B)The payor mix of the requesting hospital, including the percent of uninsured patients and patients covered by Medi-Cal and Medicare.
(C)Any other information as determined necessary by the Department of Health Care Access and Information.
(3)The Department of Health Care Access and Information shall classify a requesting hospital as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility if they meet the definitions provided under this section.
(4)The rules and regulations process described in paragraph (6) shall require the Department of Health Care Access and Information to consider input by stakeholders including health care employees, their representatives, consumers, and health care employers as to the accuracy of the classification of covered health care facility employers according to the numbers of full-time equivalent employees, system affiliation, payor mix, and any other relevant information.
(5)The Department of Health Care Access and Information shall not accept any requests for classification as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility after January 31, 2025.
(6)Until January 1, 2025, any necessary rules and regulations for the purpose of implementing this section may be adopted as emergency regulations in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). The adoption of emergency regulations pursuant to this section shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, or general welfare.
(i)(1)No later than March 1, 2024, the Department of Industrial Relations shall, in collaboration with the State Department of Health Care Services and the Department of Health Care Access and Information, develop a waiver program for covered health care facilities described in clauses (i) to (iv), inclusive, of subparagraph (A) of paragraph (3) of subdivision (c), which would authorize a covered health care facility to apply for and receive a temporary pause or alternative phase in schedule of the health care minimum wage requirements in this section. The issuance of the terms of the pause or alternative phase in schedule pursuant to this subdivision shall be solely and exclusively within the authority of the Department of Industrial Relations, and the authority regarding whether the covered health care facility demonstrates the inability to continue as a going concern pursuant to paragraphs (2) and (3) shall be solely and exclusively within the authority of the State Department of Health Care Services. A waiver issued pursuant to this subdivision shall be for a term of one year from the date of issuance.
(2)In order to obtain a waiver, a covered health care facility shall demonstrate that compliance with this section would raise doubts about the covered health care facilitys ability to continue as a going concern under generally accepted accounting principles. The evidence must include documentation of the covered health care facilitys financial condition, as well as the condition of any parent or affiliated entity, and evidence of the actual or potential direct financial impact of compliance with this section.
(3)Consideration of a covered health care facilitys ability to continue as a going concern shall include the following factors regarding the covered health care facility or any affiliated entity:
(A)Actual or likely closure of the covered health care facility or any affiliated entity.
(B)Actual or likely closure of patient services or programs.
(C)Actual or likely loss of jobs.
(D)Whether the covered health care facility is small, rural, frontier, or serves a rural catchment area.
(E)Whether closure of the covered health care facility would significantly impact access to services in the region or service area.
(F)Whether the covered health care facility is in financial distress that results or is likely to result in the closure of the covered health care facility or any affiliated entity, closure of patient services or programs, or loss of jobs. Factors to consider in determining financial distress include, but are not limited to, the covered health care facilitys prior and projected performance on financial metrics, including the amount of cash on hand, and whether the covered health care facility has, or is projected to experience negative operating margins.
(4)Requests for a waiver pursuant to this subdivision shall be submitted in writing to the Department of Industrial Relations.
(5)The Department of Industrial Relations shall coordinate with the State Department of Health Care Services for consideration of the waiver request pursuant to the authorities described in paragraph (1)
(6)The Department of Industrial Relations shall notify the covered health care facility of the decision on the waiver request in writing.
(7)A covered health care facility may apply to renew a waiver issued pursuant to this subdivision at any time no less than 180 days before the expiration of the existing waiver. The process for consideration and issuance of a waiver renewal shall follow the process described in paragraphs (4) to (6), inclusive.
(8)A waiver issued pursuant to this subdivision shall not exempt a covered health care facility from complying with any and all federal, state, or local laws and regulations, except to the extent that such local laws and regulations are preempted in accordance with subdivision (j).
(9)Notwithstanding paragraph (3) of subdivision (b), for purposes of this subdivision only, covered health care facility shall mean the clinics described in clauses (i) to (iv), inclusive, of subparagraph (A) of paragraph (3) of subdivision (c).
(j)(1)An ordinance, regulation, or administrative action applicable to a covered health care facility, as defined in this section, that establishes, requires, imposes, limits, or otherwise relates to wages or compensation for covered health care facility employees, as defined in this section, shall not be enacted or enforced in or by any city, county, city and county, including charter cities, charter counties, and charter cities and counties.
(2)Any ordinance, regulation, or administrative action taken by any city, county, or city and county, including charter cities, charter counties, and charter cities and counties, that is enacted or takes effect after September 6, 2023, related to covered health facilities, that establishes, requires, imposes, limits, or otherwise relates to wages, salaries, or compensation for covered health care facility employees, as defined in this section, is void.
(3)This subdivision does not preclude any employer, including a city, county, city and county, including charter cities, charter counties, and charter cities and counties, that employs health care employees, from establishing higher wage, salary, or compensation rates for its employees or contracted or subcontracted employees.
(4)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties from establishing a minimum wage that would apply uniformly to all employees across all industries and sectors and not exclusively to employees employed by covered health care facilities.
(5)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties, from establishing or enforcing a minimum wage applicable to covered health care facility employees, as defined in this section, after January 1, 2034. Any such ordinance, regulation, or administrative action shall be evaluated under ordinary preemption principles.
(6)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties, from enacting an ordinance or regulation, or taking administrative action, limiting or otherwise relating to compensation for covered health care facility employees, as defined in this section, after January 1, 2030. Any such ordinance, regulation, or administrative action shall be evaluated under ordinary preemption principles.
(7)This subdivision shall be effective only if the provisions of this section that require health care worker minimum wages take effect.
SEC. 2.Section 1182.15 of the Labor Code is amended to read:1182.15.(a)The Legislature finds and declares as follows:
(1)Workers in the health care industry, including workers at general acute care hospitals, acute psychiatric hospitals, medical offices and clinics, behavioral health centers, and residential care centers provide vital health care services to California residents, including emergency care, labor and delivery, cancer treatments, and primary and specialty care. Similarly, dialysis clinics provide life-preserving care to patients with end-stage renal disease and are part of the continuum of kidney care that also includes hospitals and health systems. Residents and visitors to the state rely on access to this high-quality health care.
(2)Higher wages are an important means of retaining an experienced workforce and attracting new workers. A stable workforce benefits patients and improves quality of care.
(3)Employers across multiple industries are raising wages. The health care sector in California must offer higher wages to remain competitive.
(4)Members of the health care team such as certified nursing assistants, patient aides, technicians, and food service workers, among many others, are essential to both routine medical care and emergency response efforts.
(5)Even before the COVID-19 pandemic, California was facing an urgent and immediate shortage of health care workers, adversely impacting the health and well-being of Californians, especially economically disadvantaged Californians. The pandemic has worsened these shortages. Higher wages are needed to attract and retain health care workers to treat patients, including being prepared to provide necessary care in an emergency.
(6)The Legislature finds and declares that laws that establish, require, impose, limit or otherwise relate to wages, salary, or compensation affect access to quality health care for all residents of, and visitors to, the state provided by licensed health care facilities, which serve as a critical part of the states ability to respond to catastrophic emergencies. The Legislature also finds and declares that the time limitations and other provisions established by this section are necessary to stabilize the health care system following the state and federal public health emergencies related to COVID-19, the closure and bankruptcy of licensed health care facilities, and the reduction in vital services by licensed health care facilities due to financial distress and the health care workforce crisis that has resulted in staffing shortages and strain for health care workers. The Legislature further finds and declares that access to quality health care and the stability of the health care system is a matter of statewide concern and is not a municipal affair as that term is used in Section 5 of Article XI of the California Constitution. Therefore, this section occupies the whole field of wages, salary, or compensation for covered health care facility employees, and applies to all cities and counties, including charter cities, charter counties, and charter cities and counties during the stabilization period provided by this section.
(b)As used in this section:
(1)(A)Covered health care employee means any of the following:
(i)An employee of a health care facility employer who provides patient care, health care services, or services supporting the provision of health care, which includes, but is not limited to, employees performing work in the occupation of a nurse, physician, caregiver, medical resident, intern or fellow, patient care technician, janitor, housekeeping staff person, groundskeeper, guard, clerical worker, nonmanagerial administrative worker, food service worker, gift shop worker, technical and ancillary services worker, medical coding and medical billing personnel, scheduler, call center and warehouse worker, and laundry worker, regardless of formal job title.
(ii)A contracted or subcontracted employee described in subparagraph (B).
(B)Covered health care employee includes a contracted or subcontracted employee, if all of the following apply:
(i)The employees employer contracts with the health care facility employer, or with a contractor or subcontractor to the health care facility employer, to provide health care services, or services supporting the provision of health care.
(ii)The health care facility employer directly or indirectly, or through an agent or any other person, exercises control over the employees wages, hours or working conditions. However, covered health care employee includes all employees performing contracted or subcontracted work primarily on the premises of a health care facility to provide health care services or services supporting the provision of health care.
(C)Notwithstanding subparagraph (A), covered health care employee does not include:
(i)Employment as an outside salesperson.
(ii)Any work performed in the public sector where the primary duties performed are not health care services.
(iii)Delivery or waste collection work on the premises of a covered health care facility, provided that the delivery or waste collection worker is not an employee of any person that owns, controls, or operates a covered health care facility.
(iv)Medical transportation services in or out of a covered health care facility, provided that the medical transportation services worker is not an employee of any person that owns, controls, or operates a covered health care facility.
(2)(A)Covered health care facility means a licensed skilled nursing facility, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, that is not covered by Section 1182.14.
(B)Covered health care facility does not include either of the following:
(i)A skilled nursing facility owned, controlled, or operated by the state.
(ii)A tribal clinic exempt from licensure under subdivision (c) of Section 1206 of the Health and Safety Code, or an outpatient setting conducted, maintained, or operated by a federally recognized Indian tribe, tribal organization, or urban Indian organization, as defined in Section 1603 of Title 25 of the United States Code.
(3)Employ means to engage, suffer, or permit to work.
(4)Employee means any person employed by an employer.
(5)Employer means a person who directly or indirectly, or through an agent or any other person, employs or exercises control over the wages, hours, or working conditions of any person.
(6)Health care services means patient care-related services including nursing; caregiving; services provided by medical residents, interns, or fellows; technical and ancillary services; janitorial work; housekeeping; groundskeeping; guard duties; business office clerical work; food services; laundry; medical coding and billing; call center and warehouse work; scheduling; and gift shop work; but only where such services support patient care.
(7)Health care worker minimum wage means the minimum wage rate established by this section.
(c)For any covered health care facility employer covered by this section, the minimum wage for all covered health care employees shall be as follows:
(1)From July 1, 2024, to June 30, 2026, inclusive, twenty-one dollars ($21) per hour.
(2)From July 1, 2026, to June 30, 2028, inclusive, twenty-three dollars ($23) per hour.
(3)From July 1, 2028, and until adjusted pursuant to subdivision (d), twenty-five dollars ($25) per hour.
(d)(1)Following the implementation of the minimum wage increase specified in subdivision (c), on or before August 1 of the following year, and on or before each August 1 thereafter, the Director of Finance shall calculate an adjusted minimum wage. The calculation shall increase the health care worker minimum wage by the lesser of 3.5 percent or the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted United States Consumer Price Index for Urban Wage Earners and Clerical Workers (U.S. CPI-W). The result shall be rounded to the nearest ten cents ($0.10). Each adjusted health care worker minimum wage increase calculated under this subdivision shall take effect on the following January 1.
(2)If the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted U.S. CPI-W is negative, there shall be no increase or decrease in the health care worker minimum wage pursuant to this subdivision on the following January 1.
(e)The health care worker minimum wages shall constitute the state minimum wages for covered health care employment for all purposes under this code and the Wage Orders of the Industrial Welfare Commission.
(f)A health care worker minimum wage shall be enforceable by the Labor Commissioner or by a covered worker through a civil action, through the same means and with the same relief available for violation of any other state minimum wage requirement.
(g)For covered health care employment where the compensation of the employee is on a salary basis, the employee shall earn a monthly salary equivalent to no less than 150 percent of the health care worker minimum wage or 200 percent of the minimum wage, as described in Section 1182.12, whichever is greater, for full-time employment in order to qualify as exempt from the payment of minimum wage and overtime under the law of this state, including where the employer is the state, a political subdivision of the state, the University of California, or a municipality.
(h)(1)An ordinance, regulation, or administrative action applicable to a covered health care facility, as defined in this section, that establishes, requires, imposes, limits, or otherwise relates to wages or compensation for covered health care facility employees, as defined in this section, shall not be enacted or enforced in or by any city, county, city and county, including charter cities, charter counties, and charter cities and counties.
(2)Any ordinance, regulation, or administrative action taken by any city, county, or city and county, including charter cities, charter counties, and charter cities and counties, that is enacted or takes effect after September 6, 2023, related to covered health facilities, that establishes, requires, imposes, limits, or otherwise relates to wages, salaries, or compensation for covered health care facility employees, as defined in this section, is void.
(3)This subdivision does not preclude any employer, including a city, county, city and county, including charter cities, charter counties, and charter cities and counties, that employs health care employees, from establishing higher wage, salary, or compensation rates for its employees or contracted or subcontracted employees.
(4)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties from establishing a minimum wage that would apply uniformly to all employees across all industries and sectors and not exclusively to employees employed by covered health care facilities.
(5)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties, from establishing or enforcing a minimum wage applicable to covered health care facility employees, as defined in this section, after January 1, 2034. Any such ordinance, regulation, or administrative action shall be evaluated under ordinary preemption principles.
(6)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties, from enacting an ordinance or regulation, or taking administrative action, limiting or otherwise relating to compensation for covered health care facility employees, as defined in this section, after January 1, 2030. Any such ordinance, regulation, or administrative action shall be evaluated under ordinary preemption principles.
(7)This subdivision shall take effect only if subdivision (c) takes effect.
(i)This section shall only take effect when a patient care minimum spending requirement applicable to skilled nursing facilities, as covered in this section, is in effect.
SEC. 3.The provisions of this act are severable. If any provision of this act or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application.
SEC. 4.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 the urgent and immediate shortage of health care workers.
SEC. 5.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the California Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to ensure employers are able to accurately implement the acts minimum wage requirements, it is necessary that this act take effect immediately.
(a)The Legislature finds and declares as follows:
(1)Workers in the health care industry, including workers at general acute care hospitals, acute psychiatric hospitals, medical offices and clinics, behavioral health centers, and residential care centers provide vital health care services to California residents, including emergency care, labor and delivery, cancer treatments, and primary and specialty care. Similarly, dialysis clinics provide life-preserving care to patients with end-stage renal disease and are part of the continuum of kidney care that also includes hospitals and health systems. Residents and visitors to the state rely on access to this high-quality health care.
(2)Higher wages are an important means of retaining an experienced workforce and attracting new workers. A stable workforce benefits patients and improves quality of care.
(3)Employers across multiple industries are raising wages. The health care sector in California must offer higher wages to remain competitive.
(4)Members of the health care team such as certified nursing assistants, patient aides, technicians, and food service workers, among many others, are essential to both routine medical care and emergency response efforts.
(5)Even before the COVID-19 pandemic, California was facing an urgent and immediate shortage of health care workers, adversely impacting the health and well-being of Californians, especially economically disadvantaged Californians. The pandemic has worsened these shortages. Higher wages are needed to attract and retain health care workers to treat patients, including being prepared to provide necessary care in an emergency.
(6)The Legislature finds and declares that laws that establish, require, impose, limit or otherwise relate to wages, salary, or compensation affect access to quality health care for all residents of, and visitors to, the state provided by licensed health care facilities, which serve as a critical part of the states ability to respond to catastrophic emergencies. The Legislature also finds and declares that the time limitations and other provisions established by this section are necessary to stabilize the health care system following the state and federal public health emergencies related to COVID-19, the closure and bankruptcy of licensed health care facilities, and the reduction in vital services by licensed health care facilities due to financial distress and the health care workforce crisis that has resulted in staffing shortages and strain for health care workers. The Legislature further finds and declares that access to quality health care and the stability of the health care system is a matter of statewide concern and is not a municipal affair as that term is used in Section 5 of Article XI of the California Constitution. Therefore, this section occupies the whole field of wages, salary, or compensation for covered health care facility employees, and applies to all cities and counties, including charter cities, charter counties, and charter cities and counties during the stabilization period provided by this section.
(b)As used in this section:
(1)Adjusted patient days means the total gross patient revenue, divided by gross revenue provided for inpatient services, multiplied by the number of patient days.
(2)(A)Covered health care employee means any of the following:
(i)An employee of a health care facility employer who provides patient care, health care services, or services supporting the provision of health care, which includes, but is not limited to, employees performing work in the occupation of a nurse, physician, caregiver, medical resident, intern or fellow, patient care technician, janitor, housekeeping staff person, groundskeeper, guard, clerical worker, nonmanagerial administrative worker, food service worker, gift shop worker, technical and ancillary services worker, medical coding and medical billing personnel, scheduler, call center and warehouse worker, and laundry worker, regardless of formal job title.
(ii)A contracted or subcontracted employee described in subparagraph (B).
(B)Covered health care employee includes a contracted or subcontracted employee, if all of the following apply:
(i)The employees employer contracts with the health care facility employer, or with a contractor or subcontractor to the health care facility employer, to provide health care services, or services supporting the provision of health care.
(ii)The health care facility employer directly or indirectly, or through an agent or any other person, exercises control over the employees wages, hours or working conditions. However, covered health care employee includes all employees performing contracted or subcontracted work primarily on the premises of a health care facility to provide health care services or services supporting the provision of health care.
(C)Notwithstanding subparagraph (A), covered health care employee does not include:
(i)Employment as an outside salesperson.
(ii)Any work performed in the public sector where the primary duties performed are not health care services.
(iii)Delivery or waste collection work on the premises of a covered health care facility, provided that the delivery or waste collection worker is not an employee of any person that owns, controls, or operates a covered health care facility.
(iv)Medical transportation services in or out of a covered health care facility, provided that the medical transportation services worker is not an employee of any person that owns, controls, or operates a covered health care facility.
(3)(A)Covered health care facility means any of the following:
(i)A facility or other work site that is part of an integrated health care delivery system.
(ii)A licensed general acute care hospital, as defined in subdivision (a) of Section 1250 of the Health and Safety Code, including a distinct part of any such hospital.
(iii)A licensed acute psychiatric hospital, as defined in subdivision (b) of Section 1250 of the Health and Safety Code, including a distinct part of any such hospital.
(iv)A special hospital, as defined in subdivision (f) of Section 1250 of the Health and Safety Code.
(v)A licensed skilled nursing facility, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, if owned, operated, or controlled by a hospital or integrated health care delivery system or health care system.
(vi)A patients home when health care services are delivered by an entity owned or operated by a general acute care hospital or acute psychiatric hospital.
(vii)A licensed home health agency, as defined in subdivision (a) of Section 1727 of the Health and Safety Code.
(viii)A clinic, as defined in subdivision (b) of Section 1204 of the Health and Safety Code, including a specialty care clinic, or a dialysis clinic.
(ix)A psychology clinic, as defined in Section 1204.1 of the Health and Safety Code.
(x)A clinic as defined in subdivision (d), (g), or (l) of Section 1206 of the Health and Safety Code.
(xi)A licensed residential care facility for the elderly, as defined in Section 1569.2 of the Health and Safety Code, if affiliated with an acute care provider or owned, operated, or controlled by a general acute care hospital, acute psychiatric hospital, or the parent entity of a general acute care hospital or acute psychiatric hospital.
(xii)A psychiatric health facility, as defined in Section 1250.2 of the Health and Safety Code.
(xiii)A mental health rehabilitation center, as defined in Section 5675 of the Welfare and Institutions Code.
(xiv)A community clinic licensed under subdivision (a) of Section 1204 of the Health and Safety Code, an intermittent clinic exempt from licensure under subdivision (h) of Section 1206 of the Health and Safety Code, or a clinic operated by the state or any of its political subdivisions, including, but not limited to, the University of California or a city or county that is exempt from licensure under subdivision (b) of Section 1206 of the Health and Safety Code.
(xv)A rural health clinic, as defined in paragraph (1) of subdivision (l) of Section 1396d of Title 42 of the United States Code.
(xvi)An urgent care clinic.
(xvii)An ambulatory surgical center that is certified to participate in the Medicare Program under Title XVIII (42 U.S.C. Sec. 1395 et seq.) of the federal Social Security Act.
(xviii)A physician group.
(xix)A county correctional facility that provides health care services.
(xx)A county mental health facility.
(B)Covered health care facility does not include either of the following:
(i)A hospital owned, controlled, or operated by the State Department of State Hospitals.
(ii)A tribal clinic exempt from licensure under subdivision (c) of Section 1206 of the Health and Safety Code, or an outpatient setting conducted, maintained, or operated by a federally recognized Indian tribe, tribal organization, or urban Indian organization, as defined in Section 1603 of Title 25 of the United States Code.
(4)Employ means to engage, suffer, or permit to work.
(5)Employee means any person employed by an employer.
(6)Employer means a person who directly or indirectly, or through an agent or any other person, employs or exercises control over the wages, hours, or working conditions of any person. Employer includes the state, political subdivisions of the state, the University of California, and municipalities.
(7)Full-time equivalent employee means the total paid hours at a covered health care facility, including an integrated health care delivery system, as of January 1, 2022, as per Department of Health Care Access and Information guidance, divided by 2,080.
(8)Health care services means patient care-related services including nursing; caregiving; services provided by medical residents, interns, or fellows; technical and ancillary services; janitorial work; housekeeping; groundskeeping; guard duties; business office clerical work; food services; laundry; medical coding and billing; call center and warehouse work; scheduling; and gift shop work; but only where such services support patient care.
(9)Health care worker minimum wage means the minimum wage rate established by this section.
(10)Health care system means a parent entity that owns, controls, or operates two or more separately licensed hospitals.
(11)Hospital with a high governmental payor mix means a licensed acute care hospital, as defined in subdivision (a) or (b) of Section 1250 of the Health and Safety Code, where the combined Medicare and Medi-Cal payor mix is 90 percent or greater, as determined by using the adjusted patient days from the Department of Health Care Access and Information annual financial disclosure report, as recorded and calculated as of January 1, 2022, as per the Department of Health Care Access and Information guidance. A hospital shall qualify pursuant to this paragraph only if the combined payor mix of both the hospital and the health care system to which it belongs, if any, is 90 percent or greater.
(12)Independent hospital with an elevated governmental payor mix means all of the following:
(A)A hospital, as defined in subdivision (a) or (b) of Section 1250 of the Health and Safety Code, where the combined Medicare and Medi-Cal payor mix is 75 percent or greater, as determined by using the adjusted patient days from the Department of Health Care Access and Information annual financial disclosure report, as recorded and calculated as of January 1, 2022, as per the Department of Health Care Access and Information guidance.
(B)The hospital is not owned, controlled, or operated by any parent entity with two or more separately licensed hospitals.
(13)Integrated health care delivery system means an entity or group of related entities that includes both of the following: (A) one or more hospitals and (B) one or more physician groups, health care service plans, medical foundation clinics, other health care facilities, or other entities, providing health care or supporting the provision of health care, where the hospital or hospitals and other entities are related through one of the following:
(A)Parent and subsidiary relationships, joint or common ownership or control, common branding, or common boards of directors and shared senior management.
(B)A contractual relationship in which affiliated covered physician groups or medical foundation clinics contract with a health care service plan, hospital or other part of the system, all operating under a common trade name.
(C)A contractual relationship in which a nonprofit health care service plan provides medical services to enrollees in a specific geographic region of the state through an affiliated hospital system, and contracts with a single covered physician group in each geographic region of the state to provide medical services to a majority of the plans enrollees in that region.
(14)Physician group means a medical group practice, including a professional medical corporation, as defined in Section 2406 of the Business and Professions Code, another form of corporation controlled by physicians and surgeons, or a medical partnership, provided that the group includes a total of 25 or more physicians.
(15)Rural independent covered health care facility means a hospital that is not part of an integrated health care delivery system and is not owned, controlled, or operated by any parent entity with two or more separately licensed hospitals and any of the following:
(A)A hospital that is located in a county that is not designated as a metropolitan core-based statistical area.
(B)A small and rural hospital, as defined in Section 124840 of the Health and Safety Code.
(C)A rural general acute care hospital, as described in Section 1250 of the Health and Safety Code.
(16)Urgent care clinic means a facility or clinic that provides immediate, nonemergent ambulatory medical care to patients, including, but not limited to, facilities known as walk-in clinics or centers or urgent care centers.
(c)(1)For any covered health care facility employer with 10,000 or more full-time equivalent employees, any covered health care facility employer that is a part of an integrated health care delivery system or health care system with 10,000 or more full-time equivalent employees, any covered health care facility employer that is a dialysis clinic as defined in subdivision (b) of Section 1204 of the Health and Safety Code or that is a person that owns, controls, or operates a dialysis clinic, or a covered health facility owned, affiliated, or operated by a county with a population of more than 5,000,000 as of January 1, 2023, the minimum wage for all covered health care employees shall be as follows:
(A)From July 1, 2024, to June 30, 2025, inclusive, twenty-three dollars ($23) per hour.
(B)From July 1, 2025, to June 30, 2026, inclusive, twenty-four dollars ($24) per hour.
(C)From July 1 2026, and until adjusted pursuant to subdivision (d), twenty-five dollars ($25) per hour.
(2)For any hospital that is a hospital with a high governmental payor mix, an independent hospital with an elevated governmental payor mix, a rural independent covered health care facility, or a covered health care facility that is owned, affiliated, or operated by a county with a population of less than 250,000 as of January 1, 2023, the minimum wage for all covered health care employees shall be as follows:
(A)From July 1, 2024, to June 30, 2033, inclusive, eighteen dollars ($18) per hour, with 3.5 percent increases annually.
(B)From July 1, 2033, and until adjusted pursuant to subdivision (d), twenty-five ($25) per hour.
(3)(A)For any health care facility specified in clauses (i) to (iv), inclusive, the minimum wage for all covered health care employees shall be as set forth in subparagraph (B).
(i)A clinic as defined in subdivision (h) of Section 1206 of the Health and Safety Code, that is not operated by or affiliated with a clinic described in subdivision (b) of Section 1206 of the Health and Safety Code.
(ii)A community clinic licensed under subdivision (a) of Section 1204 of the Health and Safety Code, and any associated intermittent clinic exempt from licensure under subdivision (h) of Section 1206 of the Health and Safety Code.
(iii)A rural health clinic, as defined in paragraph (1) of subdivision (l) of Section 1396d of Title 42 of the United States Code, that is not license-exempt.
(iv)An urgent care clinic that is owned by or affiliated with a facility defined in clause (ii) or (iii).
(B)(i)From July 1, 2024, to June 30, 2026, inclusive, twenty-one dollars ($21) per hour.
(ii)From July 1, 2026, to June 30, 2027, inclusive, twenty-two dollars ($22) per hour.
(iii)From July 1, 2027, and until adjusted by subdivision (d), twenty-five dollars ($25) per hour.
(4)For all other covered health care facility employers, the minimum wage for all covered health care employees shall be as follows:
(A)From July 1, 2024, to June 30, 2026, inclusive, twenty-one dollars ($21) per hour.
(B)From July 1, 2026, to June 30, 2028, inclusive, twenty-three dollars ($23) per hour.
(C)From July 1, 2028, and until adjusted pursuant to subdivision (d), twenty-five dollars ($25) per hour.
(5)Notwithstanding any other provision of this subdivision, a covered health care facility that is county owned, affiliated, or operated shall not be required to comply with this subdivision before January 1, 2025. Commencing January 1, 2025, a covered health care facility that is county owned, affiliated, or operated shall comply with the appropriate schedule described in this subdivision.
(d)(1)Following the implementation of the minimum wage increase specified in subparagraph (C) of paragraph (1), subparagraph (B) of paragraph (2), clause (iii) of subparagraph (B) of paragraph (3), or subparagraph (C) of paragraph (4) of subdivision (c), on or before August 1 of the following year, and on or before each August 1 thereafter, the Director of Finance shall calculate an adjusted minimum wage. The calculation shall increase the health care worker minimum wage by the lesser of 3.5 percent or the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted United States Consumer Price Index for Urban Wage Earners and Clerical Workers (U.S. CPI-W). The result shall be rounded to the nearest ten cents ($0.10). Each adjusted health care worker minimum wage increase calculated under this subdivision shall take effect on the following January 1.
(2)If the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted U.S. CPI-W is negative, there shall be no increase or decrease in the health care worker minimum wage pursuant to this subdivision on the following January 1.
(e)The health care worker minimum wages shall constitute the state minimum wages for covered health care employment for all purposes under this code and the Wage Orders of the Industrial Welfare Commission.
(f)A health care worker minimum wage shall be enforceable by the Labor Commissioner or by a covered worker through a civil action, through the same means and with the same relief available for violation of any other state minimum wage requirement.
(g)For covered health care employment where the compensation of the employee is on a salary basis, the employee shall earn a monthly salary equivalent to no less than 150 percent of the health care worker minimum wage or 200 percent of the minimum wage, as described in Section 1182.12, whichever is greater, for full-time employment in order to qualify as exempt from the payment of minimum wage and overtime under the law of this state, including where the employer is the state, a political subdivision of the state, the University of California, or a municipality.
(h)(1)On or before January 31, 2024, the Department of Health Care Access and Information shall publish the following information on their internet website:
(A)A list of all covered health care facility employers with 10,000 or more full-time equivalent employees, or covered health care facility employers that are a part of an integrated delivery system or health care system with 10,000 or more full-time equivalent employee, as defined in this section.
(B)A list of all hospitals that qualify as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility.
(2)If a covered health care facility believes that they were inappropriately excluded from the list of hospitals that qualify as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility, the health facility may file a request with the Department of Health Care Access and Information to be classified as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility. The requesting hospital shall provide the following:
(A)The physical location of the requesting hospital.
(B)The payor mix of the requesting hospital, including the percent of uninsured patients and patients covered by Medi-Cal and Medicare.
(C)Any other information as determined necessary by the Department of Health Care Access and Information.
(3)The Department of Health Care Access and Information shall classify a requesting hospital as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility if they meet the definitions provided under this section.
(4)The rules and regulations process described in paragraph (6) shall require the Department of Health Care Access and Information to consider input by stakeholders including health care employees, their representatives, consumers, and health care employers as to the accuracy of the classification of covered health care facility employers according to the numbers of full-time equivalent employees, system affiliation, payor mix, and any other relevant information.
(5)The Department of Health Care Access and Information shall not accept any requests for classification as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility after January 31, 2025.
(6)Until January 1, 2025, any necessary rules and regulations for the purpose of implementing this section may be adopted as emergency regulations in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). The adoption of emergency regulations pursuant to this section shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, or general welfare.
(i)(1)No later than March 1, 2024, the Department of Industrial Relations shall, in collaboration with the State Department of Health Care Services and the Department of Health Care Access and Information, develop a waiver program for covered health care facilities described in clauses (i) to (iv), inclusive, of subparagraph (A) of paragraph (3) of subdivision (c), which would authorize a covered health care facility to apply for and receive a temporary pause or alternative phase in schedule of the health care minimum wage requirements in this section. The issuance of the terms of the pause or alternative phase in schedule pursuant to this subdivision shall be solely and exclusively within the authority of the Department of Industrial Relations, and the authority regarding whether the covered health care facility demonstrates the inability to continue as a going concern pursuant to paragraphs (2) and (3) shall be solely and exclusively within the authority of the State Department of Health Care Services. A waiver issued pursuant to this subdivision shall be for a term of one year from the date of issuance.
(2)In order to obtain a waiver, a covered health care facility shall demonstrate that compliance with this section would raise doubts about the covered health care facilitys ability to continue as a going concern under generally accepted accounting principles. The evidence must include documentation of the covered health care facilitys financial condition, as well as the condition of any parent or affiliated entity, and evidence of the actual or potential direct financial impact of compliance with this section.
(3)Consideration of a covered health care facilitys ability to continue as a going concern shall include the following factors regarding the covered health care facility or any affiliated entity:
(A)Actual or likely closure of the covered health care facility or any affiliated entity.
(B)Actual or likely closure of patient services or programs.
(C)Actual or likely loss of jobs.
(D)Whether the covered health care facility is small, rural, frontier, or serves a rural catchment area.
(E)Whether closure of the covered health care facility would significantly impact access to services in the region or service area.
(F)Whether the covered health care facility is in financial distress that results or is likely to result in the closure of the covered health care facility or any affiliated entity, closure of patient services or programs, or loss of jobs. Factors to consider in determining financial distress include, but are not limited to, the covered health care facilitys prior and projected performance on financial metrics, including the amount of cash on hand, and whether the covered health care facility has, or is projected to experience negative operating margins.
(4)Requests for a waiver pursuant to this subdivision shall be submitted in writing to the Department of Industrial Relations.
(5)The Department of Industrial Relations shall coordinate with the State Department of Health Care Services for consideration of the waiver request pursuant to the authorities described in paragraph (1)
(6)The Department of Industrial Relations shall notify the covered health care facility of the decision on the waiver request in writing.
(7)A covered health care facility may apply to renew a waiver issued pursuant to this subdivision at any time no less than 180 days before the expiration of the existing waiver. The process for consideration and issuance of a waiver renewal shall follow the process described in paragraphs (4) to (6), inclusive.
(8)A waiver issued pursuant to this subdivision shall not exempt a covered health care facility from complying with any and all federal, state, or local laws and regulations, except to the extent that such local laws and regulations are preempted in accordance with subdivision (j).
(9)Notwithstanding paragraph (3) of subdivision (b), for purposes of this subdivision only, covered health care facility shall mean the clinics described in clauses (i) to (iv), inclusive, of subparagraph (A) of paragraph (3) of subdivision (c).
(j)(1)An ordinance, regulation, or administrative action applicable to a covered health care facility, as defined in this section, that establishes, requires, imposes, limits, or otherwise relates to wages or compensation for covered health care facility employees, as defined in this section, shall not be enacted or enforced in or by any city, county, city and county, including charter cities, charter counties, and charter cities and counties.
(2)Any ordinance, regulation, or administrative action taken by any city, county, or city and county, including charter cities, charter counties, and charter cities and counties, that is enacted or takes effect after September 6, 2023, related to covered health facilities, that establishes, requires, imposes, limits, or otherwise relates to wages, salaries, or compensation for covered health care facility employees, as defined in this section, is void.
(3)This subdivision does not preclude any employer, including a city, county, city and county, including charter cities, charter counties, and charter cities and counties, that employs health care employees, from establishing higher wage, salary, or compensation rates for its employees or contracted or subcontracted employees.
(4)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties from establishing a minimum wage that would apply uniformly to all employees across all industries and sectors and not exclusively to employees employed by covered health care facilities.
(5)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties, from establishing or enforcing a minimum wage applicable to covered health care facility employees, as defined in this section, after January 1, 2034. Any such ordinance, regulation, or administrative action shall be evaluated under ordinary preemption principles.
(6)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties, from enacting an ordinance or regulation, or taking administrative action, limiting or otherwise relating to compensation for covered health care facility employees, as defined in this section, after January 1, 2030. Any such ordinance, regulation, or administrative action shall be evaluated under ordinary preemption principles.
(7)This subdivision shall be effective only if the provisions of this section that require health care worker minimum wages take effect.
SEC. 2.Section 1182.15 of the Labor Code is amended to read:1182.15.(a)The Legislature finds and declares as follows:
(1)Workers in the health care industry, including workers at general acute care hospitals, acute psychiatric hospitals, medical offices and clinics, behavioral health centers, and residential care centers provide vital health care services to California residents, including emergency care, labor and delivery, cancer treatments, and primary and specialty care. Similarly, dialysis clinics provide life-preserving care to patients with end-stage renal disease and are part of the continuum of kidney care that also includes hospitals and health systems. Residents and visitors to the state rely on access to this high-quality health care.
(2)Higher wages are an important means of retaining an experienced workforce and attracting new workers. A stable workforce benefits patients and improves quality of care.
(3)Employers across multiple industries are raising wages. The health care sector in California must offer higher wages to remain competitive.
(4)Members of the health care team such as certified nursing assistants, patient aides, technicians, and food service workers, among many others, are essential to both routine medical care and emergency response efforts.
(5)Even before the COVID-19 pandemic, California was facing an urgent and immediate shortage of health care workers, adversely impacting the health and well-being of Californians, especially economically disadvantaged Californians. The pandemic has worsened these shortages. Higher wages are needed to attract and retain health care workers to treat patients, including being prepared to provide necessary care in an emergency.
(6)The Legislature finds and declares that laws that establish, require, impose, limit or otherwise relate to wages, salary, or compensation affect access to quality health care for all residents of, and visitors to, the state provided by licensed health care facilities, which serve as a critical part of the states ability to respond to catastrophic emergencies. The Legislature also finds and declares that the time limitations and other provisions established by this section are necessary to stabilize the health care system following the state and federal public health emergencies related to COVID-19, the closure and bankruptcy of licensed health care facilities, and the reduction in vital services by licensed health care facilities due to financial distress and the health care workforce crisis that has resulted in staffing shortages and strain for health care workers. The Legislature further finds and declares that access to quality health care and the stability of the health care system is a matter of statewide concern and is not a municipal affair as that term is used in Section 5 of Article XI of the California Constitution. Therefore, this section occupies the whole field of wages, salary, or compensation for covered health care facility employees, and applies to all cities and counties, including charter cities, charter counties, and charter cities and counties during the stabilization period provided by this section.
(b)As used in this section:
(1)(A)Covered health care employee means any of the following:
(i)An employee of a health care facility employer who provides patient care, health care services, or services supporting the provision of health care, which includes, but is not limited to, employees performing work in the occupation of a nurse, physician, caregiver, medical resident, intern or fellow, patient care technician, janitor, housekeeping staff person, groundskeeper, guard, clerical worker, nonmanagerial administrative worker, food service worker, gift shop worker, technical and ancillary services worker, medical coding and medical billing personnel, scheduler, call center and warehouse worker, and laundry worker, regardless of formal job title.
(ii)A contracted or subcontracted employee described in subparagraph (B).
(B)Covered health care employee includes a contracted or subcontracted employee, if all of the following apply:
(i)The employees employer contracts with the health care facility employer, or with a contractor or subcontractor to the health care facility employer, to provide health care services, or services supporting the provision of health care.
(ii)The health care facility employer directly or indirectly, or through an agent or any other person, exercises control over the employees wages, hours or working conditions. However, covered health care employee includes all employees performing contracted or subcontracted work primarily on the premises of a health care facility to provide health care services or services supporting the provision of health care.
(C)Notwithstanding subparagraph (A), covered health care employee does not include:
(i)Employment as an outside salesperson.
(ii)Any work performed in the public sector where the primary duties performed are not health care services.
(iii)Delivery or waste collection work on the premises of a covered health care facility, provided that the delivery or waste collection worker is not an employee of any person that owns, controls, or operates a covered health care facility.
(iv)Medical transportation services in or out of a covered health care facility, provided that the medical transportation services worker is not an employee of any person that owns, controls, or operates a covered health care facility.
(2)(A)Covered health care facility means a licensed skilled nursing facility, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, that is not covered by Section 1182.14.
(B)Covered health care facility does not include either of the following:
(i)A skilled nursing facility owned, controlled, or operated by the state.
(ii)A tribal clinic exempt from licensure under subdivision (c) of Section 1206 of the Health and Safety Code, or an outpatient setting conducted, maintained, or operated by a federally recognized Indian tribe, tribal organization, or urban Indian organization, as defined in Section 1603 of Title 25 of the United States Code.
(3)Employ means to engage, suffer, or permit to work.
(4)Employee means any person employed by an employer.
(5)Employer means a person who directly or indirectly, or through an agent or any other person, employs or exercises control over the wages, hours, or working conditions of any person.
(6)Health care services means patient care-related services including nursing; caregiving; services provided by medical residents, interns, or fellows; technical and ancillary services; janitorial work; housekeeping; groundskeeping; guard duties; business office clerical work; food services; laundry; medical coding and billing; call center and warehouse work; scheduling; and gift shop work; but only where such services support patient care.
(7)Health care worker minimum wage means the minimum wage rate established by this section.
(c)For any covered health care facility employer covered by this section, the minimum wage for all covered health care employees shall be as follows:
(1)From July 1, 2024, to June 30, 2026, inclusive, twenty-one dollars ($21) per hour.
(2)From July 1, 2026, to June 30, 2028, inclusive, twenty-three dollars ($23) per hour.
(3)From July 1, 2028, and until adjusted pursuant to subdivision (d), twenty-five dollars ($25) per hour.
(d)(1)Following the implementation of the minimum wage increase specified in subdivision (c), on or before August 1 of the following year, and on or before each August 1 thereafter, the Director of Finance shall calculate an adjusted minimum wage. The calculation shall increase the health care worker minimum wage by the lesser of 3.5 percent or the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted United States Consumer Price Index for Urban Wage Earners and Clerical Workers (U.S. CPI-W). The result shall be rounded to the nearest ten cents ($0.10). Each adjusted health care worker minimum wage increase calculated under this subdivision shall take effect on the following January 1.
(2)If the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted U.S. CPI-W is negative, there shall be no increase or decrease in the health care worker minimum wage pursuant to this subdivision on the following January 1.
(e)The health care worker minimum wages shall constitute the state minimum wages for covered health care employment for all purposes under this code and the Wage Orders of the Industrial Welfare Commission.
(f)A health care worker minimum wage shall be enforceable by the Labor Commissioner or by a covered worker through a civil action, through the same means and with the same relief available for violation of any other state minimum wage requirement.
(g)For covered health care employment where the compensation of the employee is on a salary basis, the employee shall earn a monthly salary equivalent to no less than 150 percent of the health care worker minimum wage or 200 percent of the minimum wage, as described in Section 1182.12, whichever is greater, for full-time employment in order to qualify as exempt from the payment of minimum wage and overtime under the law of this state, including where the employer is the state, a political subdivision of the state, the University of California, or a municipality.
(h)(1)An ordinance, regulation, or administrative action applicable to a covered health care facility, as defined in this section, that establishes, requires, imposes, limits, or otherwise relates to wages or compensation for covered health care facility employees, as defined in this section, shall not be enacted or enforced in or by any city, county, city and county, including charter cities, charter counties, and charter cities and counties.
(2)Any ordinance, regulation, or administrative action taken by any city, county, or city and county, including charter cities, charter counties, and charter cities and counties, that is enacted or takes effect after September 6, 2023, related to covered health facilities, that establishes, requires, imposes, limits, or otherwise relates to wages, salaries, or compensation for covered health care facility employees, as defined in this section, is void.
(3)This subdivision does not preclude any employer, including a city, county, city and county, including charter cities, charter counties, and charter cities and counties, that employs health care employees, from establishing higher wage, salary, or compensation rates for its employees or contracted or subcontracted employees.
(4)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties from establishing a minimum wage that would apply uniformly to all employees across all industries and sectors and not exclusively to employees employed by covered health care facilities.
(5)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties, from establishing or enforcing a minimum wage applicable to covered health care facility employees, as defined in this section, after January 1, 2034. Any such ordinance, regulation, or administrative action shall be evaluated under ordinary preemption principles.
(6)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties, from enacting an ordinance or regulation, or taking administrative action, limiting or otherwise relating to compensation for covered health care facility employees, as defined in this section, after January 1, 2030. Any such ordinance, regulation, or administrative action shall be evaluated under ordinary preemption principles.
(7)This subdivision shall take effect only if subdivision (c) takes effect.
(i)This section shall only take effect when a patient care minimum spending requirement applicable to skilled nursing facilities, as covered in this section, is in effect.
SEC. 3.The provisions of this act are severable. If any provision of this act or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application.
SEC. 4.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 the urgent and immediate shortage of health care workers.
SEC. 5.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the California Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to ensure employers are able to accurately implement the acts minimum wage requirements, it is necessary that this act take effect immediately.
(a)The Legislature finds and declares as follows:
(1)Workers in the health care industry, including workers at general acute care hospitals, acute psychiatric hospitals, medical offices and clinics, behavioral health centers, and residential care centers provide vital health care services to California residents, including emergency care, labor and delivery, cancer treatments, and primary and specialty care. Similarly, dialysis clinics provide life-preserving care to patients with end-stage renal disease and are part of the continuum of kidney care that also includes hospitals and health systems. Residents and visitors to the state rely on access to this high-quality health care.
(2)Higher wages are an important means of retaining an experienced workforce and attracting new workers. A stable workforce benefits patients and improves quality of care.
(3)Employers across multiple industries are raising wages. The health care sector in California must offer higher wages to remain competitive.
(4)Members of the health care team such as certified nursing assistants, patient aides, technicians, and food service workers, among many others, are essential to both routine medical care and emergency response efforts.
(5)Even before the COVID COVID-19 pandemic, California was facing an urgent and immediate shortage of health care workers, adversely impacting the health and well-being of Californians, especially economically disadvantaged Californians. The pandemic has worsened these shortages. Higher wages are needed to attract and retain health care workers to treat patients, including being prepared to provide necessary care in an emergency.
(6)The Legislature finds and declares that laws that establish, require, impose, limit or otherwise relate to wages, salary, or compensation affect access to quality health care for all residents of, and visitors to, the state provided by licensed health care facilities, which serve as a critical part of the states ability to respond to catastrophic emergencies. The Legislature also finds and declares that the time limitations and other provisions established by this section are necessary to stabilize the health care system following the state and federal public health emergencies related to COVID-19, the closure and bankruptcy of licensed health care facilities, and the reduction in vital services by licensed health care facilities due to financial distress and the health care workforce crisis that has resulted in staffing shortages and strain for health care workers. The Legislature further finds and declares that access to quality health care and the stability of the health care system is a matter of statewide concern and is not a municipal affair as that term is used in Section 5 of Article XI of the California Constitution. Therefore, this section occupies the whole field of wages, salary, or compensation for covered health care facility employees, and applies to all cities and counties, including charter cities, charter counties, and charter cities and counties during the stabilization period provided by this section.
(b)As used in this section:
(1)Adjusted patient days means the total gross patient revenue, divided by gross revenue provided for inpatient services, multiplied by the number of patient days.
(2)(A)Covered health care employee means any of the following:
(i)An employee of a health care facility employer who provides patient care, health care services, or services supporting the provision of health care, which includes, but is not limited to, employees performing work in the occupation of a nurse, physician, caregiver, medical resident, intern or fellow, patient care technician, janitor, housekeeping staff person, groundskeeper, guard, clerical worker, nonmanagerial administrative worker, food service worker, gift shop worker, technical and ancillary services worker, medical coding and medical billing personnel, scheduler, call center and warehouse worker, and laundry worker, regardless of formal job title.
(ii)A contracted or subcontracted employee described in subparagraph (B).
(B)Covered health care employee includes a contracted or subcontracted employee, if all of the following apply:
(i)The employees employer contracts with the health care facility employer, or with a contractor or subcontractor to the health care facility employer, to provide health care services, or services supporting the provision of health care.
(ii)The health care facility employer directly or indirectly, or through an agent or any other person, exercises control over the employees wages, hours or working conditions. However, covered health care employee includes all employees performing contracted or subcontracted work primarily on the premises of a health care facility to provide health care services or services supporting the provision of health care.
(C)Notwithstanding subparagraph (A), covered health care employee does not include:
(i)Employment as an outside salesperson.
(ii)Any work performed in the public sector where the primary duties performed are not health care services.
(iii)Delivery or waste collection work on the premises of a covered health care facility, provided that the delivery or waste collection worker is not an employee of any person that owns, controls, or operates a covered health care facility.
(iv)Medical transportation services in or out of a covered health care facility, provided that the medical transportation services worker is not an employee of any person that owns, controls, or operates a covered health care facility.
(3)(A)Covered health care facility means any of the following:
(i)A facility or other work site that is part of an integrated health care delivery system.
(ii)A licensed general acute care hospital, as defined in subdivision (a) of Section 1250 of the Health and Safety Code, including a distinct part of any such hospital.
(iii)A licensed acute psychiatric hospital, as defined in subdivision (b) of Section 1250 of the Health and Safety Code, including a distinct part of any such hospital.
(iv)A special hospital, as defined in subdivision (f) of Section 1250 of the Health and Safety Code.
(v)A licensed skilled nursing facility, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, if owned, operated, or controlled by a hospital or integrated health care delivery system or health care system.
(vi)A patients home when health care services are delivered by an entity owned or operated by a general acute care hospital or acute psychiatric hospital.
(vii)A licensed home health agency, as defined in subdivision (a) of Section 1727 of the Health and Safety Code.
(viii)A clinic, as defined in subdivision (b) of Section 1204 of the Health and Safety Code, including a specialty care clinic, or a dialysis clinic.
(ix)A psychology clinic, as defined in Section 1204.1 of the Health and Safety Code.
(x)A clinic as defined in subdivision (d), (g), or (l) of Section 1206 of the Health and Safety Code.
(xi)A licensed residential care facility for the elderly, as defined in Section 1569.2 of the Health and Safety Code, if affiliated with an acute care provider or owned, operated, or controlled by a general acute care hospital, acute psychiatric hospital, or the parent entity of a general acute care hospital or acute psychiatric hospital.
(xii)A psychiatric health facility, as defined in Section 1250.2 of the Health and Safety Code.
(xiii)A mental health rehabilitation center, as defined in Section 5675 of the Welfare and Institutions Code.
(xiv)A community clinic licensed under subdivision (a) of Section 1204 of the Health and Safety Code, an intermittent clinic exempt from licensure under subdivision (h) of Section 1206 of the Health and Safety Code, or a clinic operated by the state or any of its political subdivisions, including, but not limited to, the University of California or a city or county that is exempt from licensure under subdivision (b) of Section 1206 of the Health and Safety Code.
(xv)A rural health clinic, as defined in paragraph (1) of subdivision (l) of Section 1396d of Title 42 of the United States Code.
(xvi)An urgent care clinic.
(xvii)An ambulatory surgical center that is certified to participate in the Medicare Program under Title XVIII (42 U.S.C. Sec. 1395 et seq.) of the federal Social Security Act.
(xviii)A physician group.
(xix)A county correctional facility that provides health care services.
(xx)A county mental health facility.
(B)Covered health care facility does not include either of the following:
(i)A hospital owned, controlled, or operated by the State Department of State Hospitals.
(ii)A tribal clinic exempt from licensure under subdivision (c) of Section 1206 of the Health and Safety Code, or an outpatient setting conducted, maintained, or operated by a federally recognized Indian tribe, tribal organization, or urban Indian organization, as defined in Section 1603 of Title 25 of the United States Code.
(4)Employ means to engage, suffer, or permit to work.
(5)Employee means any person employed by an employer.
(6)Employer means a person who directly or indirectly, or through an agent or any other person, employs or exercises control over the wages, hours, or working conditions of any person. Employer includes the state, political subdivisions of the state, the University of California, and municipalities.
(7)Full-time equivalent employee means the total paid hours at a covered health care facility, including an integrated health care delivery system, as of January 1, 2022, as per Department of Health Care Access and Information guidance, divided by 2,080.
(8)Health care services means patient care-related services including nursing; caregiving; services provided by medical residents, interns, or fellows; technical and ancillary services; janitorial work; housekeeping; groundskeeping; guard duties; business office clerical work; food services; laundry; medical coding and billing; call center and warehouse work; scheduling; and gift shop work; but only where such services support patient care.
(9)Health care worker minimum wage means the minimum wage rate established by this section.
(10)Health care system means a parent entity that owns, controls, or operates two or more separately licensed hospitals.
(11)Hospital with a high governmental payor mix means a licensed acute care hospital, as defined in subdivision (a) or (b) of Section 1250 of the Health and Safety Code, where the combined Medicare and Medi-Cal payor mix is 90 percent or greater, as determined by using the adjusted patient days from the Department of Health Care Access and Information annual financial disclosure report, as recorded and calculated as of January 1, 2022, as per the Department of Health Care Access and Information guidance. A hospital shall qualify pursuant to this paragraph only if the combined payor mix of both the hospital and the health care system to which it belongs, if any, is 90 percent or greater.
(12)Independent hospital with an elevated governmental payor mix means all of the following:
(A)A hospital, as defined in subdivision (a) or (b) of Section 1250 of the Health and Safety Code, where the combined Medicare and Medi-Cal payor mix is 75 percent or greater, as determined by using the adjusted patient days from the Department of Health Care Access and Information annual financial disclosure report, as recorded and calculated as of January 1, 2022, as per the Department of Health Care Access and Information guidance.
(B)The hospital is not owned, controlled, or operated by any parent entity with two or more separately licensed hospitals.
(13)Integrated health care delivery system means an entity or group of related entities that includes both of the following: (A) one or more hospitals and (B) one or more physician groups, health care service plans, medical foundation clinics, other health care facilities, or other entities, providing health care or supporting the provision of health care, where the hospital or hospitals and other entities are related through one of the following:
(A)Parent and subsidiary relationships, joint or common ownership or control, common branding, or common boards of directors and shared senior management.
(B)A contractual relationship in which affiliated covered physician groups or medical foundation clinics contract with a health care service plan, hospital or other part of the system, all operating under a common trade name.
(C)A contractual relationship in which a nonprofit health care service plan provides medical services to enrollees in a specific geographic region of the state through an affiliated hospital system, and contracts with a single covered physician group in each geographic region of the state to provide medical services to a majority of the plans enrollees in that region.
(14)Physician group means a medical group practice, including a professional medical corporation, as defined in Section 2406 of the Business and Professions Code, another form of corporation controlled by physicians and surgeons, or a medical partnership, provided that the group includes a total of 25 or more physicians.
(15)Rural independent covered health care facility means a hospital that is not part of an integrated health care delivery system and is not owned, controlled, or operated by any parent entity with two or more separately licensed hospitals and any of the following:
(A)A hospital that is located in a county that is not designated as a metropolitan core-based statistical area.
(B)A small and rural hospital, as defined in Section 124840 of the Health and Safety Code.
(C)A rural general acute care hospital, as described in Section 1250 of the Health and Safety Code.
(16)Urgent care clinic means a facility or clinic that provides immediate, nonemergent ambulatory medical care to patients, including, but not limited to, facilities known as walk-in clinics or centers or urgent care centers.
(c)(1)For any covered health care facility employer with 10,000 or more full-time equivalent employees, any covered health care facility employer that is a part of an integrated health care delivery system or health care system with 10,000 or more full-time equivalent employees, any covered health care facility employer that is a dialysis clinic as defined in subdivision (b) of Section 1204 of the Health and Safety Code or that is a person that owns, controls, or operates a dialysis clinic, or a covered health facility owned, affiliated, or operated by a county with a population of more than 5,000,000 as of January 1, 2023, the minimum wage for all covered health care employees shall be as follows:
(A)From June July 1, 2024, to May 31, June 30, 2025, inclusive, twenty-three dollars ($23) per hour.
(B)From June July 1, 2025, to May 31, June 30, 2026, inclusive, twenty-four dollars ($24) per hour.
(C)From June 1, July 1 2026, and until adjusted pursuant to subdivision (d), twenty-five dollars ($25) per hour.
(2)For any hospital that is a hospital with a high governmental payor mix, an independent hospital with an elevated governmental payor mix, a rural independent covered health care facility, or a covered health care facility that is owned, affiliated, or operated by a county with a population of less than 250,000 as of January 1, 2023, the minimum wage for all covered health care employees shall be as follows:
(A)From June July 1, 2024, to May 31, June 30, 2033, inclusive, eighteen dollars ($18) per hour, with 3.5 percent increases annually.
(B)From June July 1, 2033, and until adjusted pursuant to subdivision (d), twenty-five ($25) per hour.
(3)(A)For any health care facility specified in clauses (i) to (iv), inclusive, the minimum wage for all covered health care employees shall be as set forth in subparagraph (B).
(i)A clinic as defined in subdivision (h) of Section 1206 of the Health and Safety Code, that is not operated by or affiliated with a clinic described in subdivision (b) of Section 1206 of the Health and Safety Code.
(ii)A community clinic licensed under subdivision (a) of Section 1204 of the Health and Safety Code, and any associated intermittent clinic exempt from licensure under subdivision (h) of Section 1206 of the Health and Safety Code.
(iii)A rural health clinic, as defined in paragraph (1) of subdivision (l) of Section 1396d of Title 42 of the United States Code, that is not license-exempt.
(iv)An urgent care clinic that is owned by or affiliated with a facility defined in clause (ii) or (iii).
(B)(i)From June July 1, 2024, to May 31, June 30, 2026, inclusive, twenty-one dollars ($21) per hour.
(ii)From June July 1, 2026, to May 31, June 30, 2027, inclusive, twenty-two dollars ($22) per hour.
(iii)From June July 1, 2027, and until adjusted by subdivision (d), twenty-five dollars ($25) per hour.
(4)For all other covered health care facility employers, the minimum wage for all covered health care employees shall be as follows:
(A)From June July 1, 2024, to May 31, June 30, 2026, inclusive, twenty-one dollars ($21) per hour.
(B)From June July 1, 2026, to May 31, June 30, 2028, inclusive, twenty-three dollars ($23) per hour.
(C)From June July 1, 2028, and until adjusted pursuant to subdivision (d), twenty-five dollars ($25) per hour.
(5)Notwithstanding any other provision of this subdivision, a covered health care facility that is county owned, affiliated, or operated shall not be required to comply with this subdivision before January 1, 2025. Commencing January 1, 2025, a covered health care facility that is county owned, affiliated, or operated shall comply with the appropriate schedule described in this subdivision.
(d)(1)Following the implementation of the minimum wage increase specified in subparagraph (C) of paragraph (1), subparagraph (B) of paragraph (2), clause (iii) of subparagraph (B) of paragraph (3), or subparagraph (C) of paragraph (4) of subdivision (c), on or before August 1 of the following year, and on or before each August 1 thereafter, the Director of Finance shall calculate an adjusted minimum wage. The calculation shall increase the health care worker minimum wage by the lesser of 3.5 percent or the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted United States Consumer Price Index for Urban Wage Earners and Clerical Workers (U.S. CPI-W). The result shall be rounded to the nearest ten cents ($0.10). Each adjusted health care worker minimum wage increase calculated under this subdivision shall take effect on the following January 1.
(2)If the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted U.S. CPI-W is negative, there shall be no increase or decrease in the health care worker minimum wage pursuant to this subdivision on the following January 1.
(e)The health care worker minimum wages shall constitute the state minimum wages for covered health care employment for all purposes under this code and the Wage Orders of the Industrial Welfare Commission.
(f)A health care worker minimum wage shall be enforceable by the Labor Commissioner or by a covered worker through a civil action, through the same means and with the same relief available for violation of any other state minimum wage requirement.
(g)For covered health care employment where the compensation of the employee is on a salary basis, the employee shall earn a monthly salary equivalent to no less than 150 percent of the health care worker minimum wage or 200 percent of the minimum wage, as described in Section 1182.12, whichever is greater, for full-time employment in order to qualify as exempt from the payment of minimum wage and overtime under the law of this state, including where the employer is the state, a political subdivision of the state, the University of California, or a municipality.
(h)(1)On or before January 31, 2024, the Department of Health Care Access and Information shall publish the following information on their internet website:
(A)A list of all covered health care facility employers with 10,000 or more full-time equivalent employees, or covered health care facility employers that are a part of an integrated delivery system or health care system with 10,000 or more full-time equivalent employee, as defined in this section.
(B)A list of all hospitals that qualify as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility.
(2)If a covered health care facility believes that they were inappropriately excluded from the list of hospitals that qualify as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility, the health facility may file a request with the Department of Health Care Access and Information to be classified as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility. The requesting hospital shall provide the following:
(A)The physical location of the requesting hospital.
(B)The payor mix of the requesting hospital, including the percent of uninsured patients and patients covered by Medi-Cal and Medicare.
(C)Any other information as determined necessary by the Department of Health Care Access and Information.
(3)The Department of Health Care Access and Information shall classify a requesting hospital as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility if they meet the definitions provided under this section.
(4)The rules and regulations process described in paragraph (6) shall require the Department of Health Care Access and Information to consider input by stakeholders including health care employees, their representatives, consumers, and health care employers as to the accuracy of the classification of covered health care facility employers according to the numbers of full-time equivalent employees, system affiliation, payor mix, and any other relevant information.
(5)The Department of Health Care Access and Information shall not accept any requests for classification as a hospital with a high governmental payor mix, independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility after January 31, 2025.
(6)Until January 1, 2025, any necessary rules and regulations for the purpose of implementing this section may be adopted as emergency regulations in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). The adoption of emergency regulations pursuant to this section shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, or general welfare.
(i)(1)No later than March 1, 2024, the Department of Industrial Relations shall, in collaboration with the State Department of Health Care Services and the Department of Health Care Access and Information, develop a waiver program for covered health care facilities described in clauses (i) to (iv), inclusive, of subparagraph (A) of paragraph (3) of subdivision (c), which would authorize a covered health care facility to apply for and receive a temporary pause or alternative phase in schedule of the health care minimum wage requirements in this section. The issuance of the terms of the pause or alternative phase in schedule pursuant to this subdivision shall be solely and exclusively within the authority of the Department of Industrial Relations, and the authority regarding whether the covered health care facility demonstrates the inability to continue as a going concern pursuant to paragraphs (2) and (3) shall be solely and exclusively within the authority of the State Department of Health Care Services. A waiver issued pursuant to this subdivision shall be for a term of one year from the date of issuance.
(2)In order to obtain a waiver, a covered health care facility shall demonstrate that compliance with this section would raise doubts about the covered health care facilitys ability to continue as a going concern under generally accepted accounting principles. The evidence must include documentation of the covered health care facilitys financial condition, as well as the condition of any parent or affiliated entity, and evidence of the actual or potential direct financial impact of compliance with this section.
(3)Consideration of a covered health care facilitys ability to continue as a going concern shall include the following factors regarding the covered health care facility or any affiliated entity:
(A)Actual or likely closure of the covered health care facility or any affiliated entity.
(B)Actual or likely closure of patient services or programs.
(C)Actual or likely loss of jobs.
(D)Whether the covered health care facility is small, rural, frontier, or serves a rural catchment area.
(E)Whether closure of the covered health care facility would significantly impact access to services in the region or service area.
(F)Whether the covered health care facility is in financial distress that results or is likely to result in the closure of the covered health care facility or any affiliated entity, closure of patient services or programs, or loss of jobs. Factors to consider in determining financial distress include, but are not limited to, the covered health care facilitys prior and projected performance on financial metrics, including the amount of cash on hand, and whether the covered health care facility has, or is projected to experience negative operating margins.
(4)Requests for a waiver pursuant to this subdivision shall be submitted in writing to the Department of Industrial Relations.
(5)The Department of Industrial Relations shall coordinate with the State Department of Health Care Services for consideration of the waiver request pursuant to the authorities described in paragraph (1)
(6)The Department of Industrial Relations shall notify the covered health care facility of the decision on the waiver request in writing.
(7)A covered health care facility may apply to renew a waiver issued pursuant to this subdivision at any time no less than 180 days before the expiration of the existing waiver. The process for consideration and issuance of a waiver renewal shall follow the process described in paragraphs (4) to (6), inclusive.
(8)A waiver issued pursuant to this subdivision shall not exempt a covered health care facility from complying with any and all federal, state, or local laws and regulations, except to the extent that such local laws and regulations are preempted in accordance with subdivision (j).
(9)Notwithstanding paragraph (3) of subdivision (b), for purposes of this subdivision only, covered health care facility shall mean the clinics described in clauses (i) to (iv), inclusive, of subparagraph (A) of paragraph (3) of subdivision (c).
(j)(1)An ordinance, regulation, or administrative action applicable to a covered health care facility, as defined in this section, that establishes, requires, imposes, limits, or otherwise relates to wages or compensation for covered health care facility employees, as defined in this section, shall not be enacted or enforced in or by any city, county, city and county, including charter cities, charter counties, and charter cities and counties.
(2)Any ordinance, regulation, or administrative action taken by any city, county, or city and county, including charter cities, charter counties, and charter cities and counties, that is enacted or takes effect after September 6, 2023, related to covered health facilities, that establishes, requires, imposes, limits, or otherwise relates to wages, salaries, or compensation for covered health care facility employees, as defined in this section, is void.
(3)This subdivision does not preclude any employer, including a city, county, city and county, including charter cities, charter counties, and charter cities and counties, that employs health care employees, from establishing higher wage, salary, or compensation rates for its employees or contracted or subcontracted employees.
(4)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties from establishing a minimum wage that would apply uniformly to all employees across all industries and sectors and not exclusively to employees employed by covered health care facilities.
(5)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties, from establishing or enforcing a minimum wage applicable to covered health care facility employees, as defined in this section, after January 1, 2034. Any such ordinance, regulation, or administrative action shall be evaluated under ordinary preemption principles.
(6)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties, from enacting an ordinance or regulation, or taking administrative action, limiting or otherwise relating to compensation for covered health care facility employees, as defined in this section, after January 1, 2030. Any such ordinance, regulation, or administrative action shall be evaluated under ordinary preemption principles.
(7)This subdivision shall be effective only if the provisions of this section that require health care worker minimum wages take effect.
SEC. 2.Section 1182.15 of the Labor Code is amended to read:1182.15.(a)The Legislature finds and declares as follows:
(1)Workers in the health care industry, including workers at general acute care hospitals, acute psychiatric hospitals, medical offices and clinics, behavioral health centers, and residential care centers provide vital health care services to California residents, including emergency care, labor and delivery, cancer treatments, and primary and specialty care. Similarly, dialysis clinics provide life-preserving care to patients with end-stage renal disease and are part of the continuum of kidney care that also includes hospitals and health systems. Residents and visitors to the state rely on access to this high-quality health care.
(2)Higher wages are an important means of retaining an experienced workforce and attracting new workers. A stable workforce benefits patients and improves quality of care.
(3)Employers across multiple industries are raising wages. The health care sector in California must offer higher wages to remain competitive.
(4)Members of the health care team such as certified nursing assistants, patient aides, technicians, and food service workers, among many others, are essential to both routine medical care and emergency response efforts.
(5)Even before the COVID COVID-19 pandemic, California was facing an urgent and immediate shortage of health care workers, adversely impacting the health and well-being of Californians, especially economically disadvantaged Californians. The pandemic has worsened these shortages. Higher wages are needed to attract and retain health care workers to treat patients, including being prepared to provide necessary care in an emergency.
(6)The Legislature finds and declares that laws that establish, require, impose, limit or otherwise relate to wages, salary, or compensation affect access to quality health care for all residents of, and visitors to, the state provided by licensed health care facilities, which serve as a critical part of the states ability to respond to catastrophic emergencies. The Legislature also finds and declares that the time limitations and other provisions established by this section are necessary to stabilize the health care system following the state and federal public health emergencies related to COVID-19, the closure and bankruptcy of licensed health care facilities, and the reduction in vital services by licensed health care facilities due to financial distress and the health care workforce crisis that has resulted in staffing shortages and strain for health care workers. The Legislature further finds and declares that access to quality health care and the stability of the health care system is a matter of statewide concern and is not a municipal affair as that term is used in Section 5 of Article XI of the California Constitution. Therefore, this section occupies the whole field of wages, salary, or compensation for covered health care facility employees, and applies to all cities and counties, including charter cities, charter counties, and charter cities and counties during the stabilization period provided by this section.
(b)As used in this section:
(1)(A)Covered health care employee means any of the following:
(i)An employee of a health care facility employer who provides patient care, health care services, or services supporting the provision of health care, which includes, but is not limited to, employees performing work in the occupation of a nurse, physician, caregiver, medical resident, intern or fellow, patient care technician, janitor, housekeeping staff person, groundskeeper, guard, clerical worker, nonmanagerial administrative worker, food service worker, gift shop worker, technical and ancillary services worker, medical coding and medical billing personnel, scheduler, call center and warehouse worker, and laundry worker, regardless of formal job title.
(ii)A contracted or subcontracted employee described in subparagraph (B).
(B)Covered health care employee includes a contracted or subcontracted employee, if all of the following apply:
(i)The employees employer contracts with the health care facility employer, or with a contractor or subcontractor to the health care facility employer, to provide health care services, or services supporting the provision of health care.
(ii)The health care facility employer directly or indirectly, or through an agent or any other person, exercises control over the employees wages, hours or working conditions. However, covered health care employee includes all employees performing contracted or subcontracted work primarily on the premises of a health care facility to provide health care services or services supporting the provision of health care.
(C)Notwithstanding subparagraph (A), covered health care employee does not include:
(i)Employment as an outside salesperson.
(ii)Any work performed in the public sector where the primary duties performed are not health care services.
(iii)Delivery or waste collection work on the premises of a covered health care facility, provided that the delivery or waste collection worker is not an employee of any person that owns, controls, or operates a covered health care facility.
(iv)Medical transportation services in or out of a covered health care facility, provided that the medical transportation services worker is not an employee of any person that owns, controls, or operates a covered health care facility.
(2)(A)Covered health care facility means a licensed skilled nursing facility, as defined in subdivision (c) of Section 1250 of the Health and Safety Code, that is not covered by Section 1182.14.
(B)Covered health care facility does not include either of the following:
(i)A skilled nursing facility owned, controlled, or operated by the state.
(ii)A tribal clinic exempt from licensure under subdivision (c) of Section 1206 of the Health and Safety Code, or an outpatient setting conducted, maintained, or operated by a federally recognized Indian tribe, tribal organization, or urban Indian organization, as defined in Section 1603 of Title 25 of the United States Code.
(4)(3)Employ means to engage, suffer, or permit to work.
(5)(4)Employee means any person employed by an employer.
(6)(5)Employer means a person who directly or indirectly, or through an agent or any other person, employs or exercises control over the wages, hours, or working conditions of any person.
(7)(6)Health care services means patient care-related services including nursing; caregiving; services provided by medical residents, interns, or fellows; technical and ancillary services; janitorial work; housekeeping; groundskeeping; guard duties; business office clerical work; food services; laundry; medical coding and billing; call center and warehouse work; scheduling; and gift shop work; but only where such services support patient care.
(8)(7)Health care worker minimum wage means the minimum wage rate established by this section.
(c)For any covered health care facility employer covered by this section, the minimum wage for all covered health care employees shall be as follows:
(1)From June July 1, 2024, to May 31, June 30, 2026, inclusive, twenty-one dollars ($21) per hour.
(2)From June July 1, 2026, to May 31, June 30, 2028, inclusive, twenty-three dollars ($23) per hour.
(3)From June July 1, 2028, and until adjusted pursuant to subdivision (d), twenty-five dollars ($25) per hour.
(d)(1)Following the implementation of the minimum wage increase specified in subdivision (c), on or before August 1 of the following year, and on or before each August 1 thereafter, the Director of Finance shall calculate an adjusted minimum wage. The calculation shall increase the health care worker minimum wage by the lesser of 3.5 percent or the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted United States Consumer Price Index for Urban Wage Earners and Clerical Workers (U.S. CPI-W). The result shall be rounded to the nearest ten cents ($0.10). Each adjusted health care worker minimum wage increase calculated under this subdivision shall take effect on the following January 1.
(2)If the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted U.S. CPI-W is negative, there shall be no increase or decrease in the health care worker minimum wage pursuant to this subdivision on the following January 1.
(e)The health care worker minimum wages shall constitute the state minimum wages for covered health care employment for all purposes under this code and the Wage Orders of the Industrial Welfare Commission.
(f)A health care worker minimum wage shall be enforceable by the Labor Commissioner or by a covered worker through a civil action, through the same means and with the same relief available for violation of any other state minimum wage requirement.
(g)For covered health care employment where the compensation of the employee is on a salary basis, the employee shall earn a monthly salary equivalent to no less than 150 percent of the health care worker minimum wage or 200 percent of the minimum wage, as described in Section 1182.12, whichever is greater, for full-time employment in order to qualify as exempt from the payment of minimum wage and overtime under the law of this state, including where the employer is the state, a political subdivision of the state, the University of California, or a municipality.
(h)(1)An ordinance, regulation, or administrative action applicable to a covered health care facility, as defined in this section, that establishes, requires, imposes, limits, or otherwise relates to wages or compensation for covered health care facility employees, as defined in this section, shall not be enacted or enforced in or by any city, county, city and county, including charter cities, charter counties, and charter cities and counties.
(2)Any ordinance, regulation, or administrative action taken by any city, county, or city and county, including charter cities, charter counties, and charter cities and counties, that is enacted or takes effect after September 6, 2023, related to covered health facilities, that establishes, requires, imposes, limits, or otherwise relates to wages, salaries, or compensation for covered health care facility employees, as defined in this section, is void.
(3)This subdivision does not preclude any employer, including a city, county, city and county, including charter cities, charter counties, and charter cities and counties, that employs health care employees, from establishing higher wage, salary, or compensation rates for its employees or contracted or subcontracted employees.
(4)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties from establishing a minimum wage that would apply uniformly to all employees across all industries and sectors and not exclusively to employees employed by covered health care facilities.
(5)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties, from establishing or enforcing a minimum wage applicable to covered health care facility employees, as defined in this section, after January 1, 2034. Any such ordinance, regulation, or administrative action shall be evaluated under ordinary preemption principles.
(6)This subdivision does not preclude a city, county, city and county, including charter cities, charter counties, and charter cities and counties, from enacting an ordinance or regulation, or taking administrative action, limiting or otherwise relating to compensation for covered health care facility employees, as defined in this section, after January 1, 2030. Any such ordinance, regulation, or administrative action shall be evaluated under ordinary preemption principles.
(7)This subdivision shall take effect only if subdivision (c) takes effect.
(i)This section shall only take effect when a patient care minimum spending requirement applicable to skilled nursing facilities, as covered in this section, is in effect.
SEC. 3.The provisions of this act are severable. If any provision of this act or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application.
SEC. 4.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 the urgent and immediate shortage of health care workers.
SEC. 5.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the California Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to ensure employers are able to accurately implement the acts minimum wage requirements, it is necessary that this act take effect immediately.
SECTION 1.Section 2716.7 is added to the Penal Code, to read:2716.7.(a)On or before January 1, 2026, the Department of Corrections and Rehabilitation shall report to the Legislature the exploratory findings of the joint advisory committee, regarding the feasibility of awarding formal credit for apprenticeship hours to inmates prior to their release, as described in paragraph (6) of subdivision (b) of Section 2716.5.(b)(1)A report to be submitted pursuant to subdivision (a) shall be submitted in compliance with Section 9795 of the Government Code.(2) Pursuant to Section 10231.5 of the Government Code, this section is repealed on January 1, 2030.(a)On or before January 1, 2026, the Department of Corrections and Rehabilitation shall report to the Legislature the exploratory findings of the joint advisory committee, regarding the feasibility of awarding formal credit for apprenticeship hours to inmates prior to their release, as described in paragraph (6) of subdivision (b) of Section 2716.5.
(b)(1)A report to be submitted pursuant to subdivision (a) shall be submitted in compliance with Section 9795 of the Government Code.
(2) Pursuant to Section 10231.5 of the Government Code, this section is repealed on January 1, 2030.
SECTION 1.It is the intent of the Legislature to enact legislation relating to vocational training for incarcerated individuals.It is the intent of the Legislature to enact legislation relating to vocational training for incarcerated individuals.
|
Date
|
Status
|
|---|---|
| May 31, 2024 | Chaptered by Secretary of State. Chapter 12, Statutes of 2024. |
| May 31, 2024 | Approved by the Governor. |
| May 30, 2024 | Enrolled and presented to the Governor at 2:30 p.m. |
| May 30, 2024 | Urgency clause adopted. |
| May 30, 2024 | Assembly amendments concurred in. (Ayes 31. Noes 1. Page 4265.) Ordered to engrossing and enrolling. |
| May 29, 2024 | From committee: That the Assembly amendments be concurred in. (Ayes 4. Noes 0. Page 4255.) |
| May 24, 2024 | From committee: Be re-referred to Com. on L., P.E. & R. pursuant to Senate Rule 29.10(d). (Ayes 5. Noes 0. Page 4205.) Re-referred to Com. on L., P.E. & R. |
| May 24, 2024 | Re-referred to Com. on RLS pursuant to Senate Rule 29.10(d). |
| May 24, 2024 | Set for hearing May 29. |
| May 23, 2024 | In Senate. Concurrence in Assembly amendments pending. |
| May 23, 2024 | Read third time. Urgency clause adopted. Passed. (Ayes 61. Noes 7. Page 5639.) Ordered to the Senate. |
| May 23, 2024 | Read second time. Ordered to third reading. |
| May 23, 2024 | Assembly Rule 63 suspended. |
| May 22, 2024 | From committee: Do pass. (Ayes 7. Noes 0.) (May 22). |
| May 20, 2024 | Ordered to second reading. |
| May 20, 2024 | Withdrawn from committee. |
| May 20, 2024 | Read second time. |
| May 20, 2024 | Re-referred to Com. on L. & E. pursuant to Assembly Rule 77.2. |
| May 20, 2024 | Joint Rule 62(a) suspended. |
| May 20, 2024 | Assembly Rule 96 and 63 suspended. (Ayes 54. Noes 12. Page 5293.) |
| May 20, 2024 | Amended. (Ayes 53. Noes 15. Page 5294.) |
| Jun 21, 2023 | June 27 set for second hearing canceled at the request of author. |
| Jun 5, 2023 | June 13 set for first hearing canceled at the request of author. |
| May 18, 2023 | Referred to Com. on PUB. S. |
| May 11, 2023 | In Assembly. Read first time. Held at Desk. |
| May 11, 2023 | Read third time. Passed. (Ayes 39. Noes 0. Page 1055.) Ordered to the Assembly. |
| May 9, 2023 | Read second time. Ordered to consent calendar. |
| May 8, 2023 | From committee: Be ordered to second reading pursuant to Senate Rule 28.8 and ordered to consent calendar. |
| May 1, 2023 | Set for hearing May 8. |
| Apr 26, 2023 | From committee: Do pass and re-refer to Com. on APPR with recommendation: To consent calendar. (Ayes 5. Noes 0. Page 902.) (April 25). Re-referred to Com. on APPR. |
| Apr 10, 2023 | Set for hearing April 25. |
| Mar 29, 2023 | Re-referred to Com. on PUB S. |
| Mar 22, 2023 | From committee with author's amendments. Read second time and amended. Re-referred to Com. on RLS. |
| Mar 1, 2023 | Referred to Com. on RLS. |
| Feb 21, 2023 | From printer. May be acted upon on or after March 20. |
| Feb 17, 2023 | Introduced. Read first time. To Com. on RLS. for assignment. To print. |
|
Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| May 30, 2024 | Unfinished Business SB828 Durazo Urgency Clause Concurrence | Senate Floor |
Passed |
|
| May 29, 2024 | That the Assembly amendments be concurred in | Senate Standing Committee on Labor, Public Employment and Retirement |
Passed |
|
| May 23, 2024 | SB 828 Durazo Third Reading Urgency By HANEY | Assembly Floor |
Passed |
|
| May 22, 2024 | Do pass. | Assembly Standing Committee on Labor and Employment |
Passed |
|
| May 20, 2024 | SB 828 Smallwood-Cuevas Senate Second Reading By HANEY Amendment Set #1 | Assembly Floor |
Passed |
|
| May 11, 2023 | Consent Calendar SB828 Smallwood-Cuevas | Senate Floor |
Passed |
|
| Apr 25, 2023 | Do pass, but first be re-referred to the Committee on [Appropriations] with the recommendation: To Consent Calendar | Senate Standing Committee on Public Safety |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| Alameda Superior Court | * Support | May 22, 2024 |
| California Hospital Association | * Support | May 29, 2024 |
| Initiate Justice | ** Support | |
| Los Angeles General Medical Center | * Support | May 22, 2024 |
| Mercy General Dignity Health | * Support | May 29, 2024 |
| Sacramento Kaiser Permanente | * Support | May 29, 2024 |
| San Francisco General Hospital | * Support | May 22, 2024 |
| SEIU California | * Support | May 29, 2024 |
| SEIU United Healthcare Workers | * Support | May 29, 2024 |
| South Sacramento Kaiser | * Support | May 29, 2024 |
| Tenet Hospitals | * Indeterminate | May 22, 2024 |
| Tracy Kaiser | * Support | May 29, 2024 |
SENATE RULES COMMITTEE Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | SB 828 |
UNFINISHED BUSINESS
Bill No: SB 828
Author: Durazo (D)
Amended: 5/20/24
Vote: 27 - Urgency
PRIOR SENATE VOTES NOT RELEVANT
SENATE LABOR, PUB. EMP. & RET. COMMITTEE: 4-0, 5/29/24 (Pursuant to Senate Rule 29.10)
AYES: Smallwood-Cuevas, Cortese, Durazo, Laird
NO VOTE RECORDED: Wilk
ASSEMBLY FLOOR: 61-7, 5/23/24 - See last page for vote
SUBJECT: Minimum wages: health care workers: delay
SOURCE: SEIU California
DIGEST:
This bill delays by one month the implementation of health care worker minimum wage increases scheduled to take effect June 1, 2024.
Assembly Amendments struck previous contents of the bill requiring a report to the Legislature on the Pre-Release Construction Trades Certificate Program to instead address the one month delayed implementation of the health care worker minimum wage and replace the author from Senator Smallwood-Cuevas to Senator Durazo.
ANALYSIS:
Existing law:
- Sets California’s minimum wage at $16.00 an hour for all employers and specifies that after January 1, 2023, the minimum wage rate will be adjusted annually for inflation based on the national consumer price index for urban wage earners and clerical workers (CPI-W), as specified. (Labor Code §1182.12)
- Requires, effective April 1, 2024, fast food restaurants, as defined, to pay their employees a minimum wage of $20.00 per hour. (Labor Code §1474-1477)
- Defines, among others and for purposes of the statewide minimum wage for health care workers provisions described below, the following terms:
- “Covered health care employee” to mean either of the following:
- An employee of a health care facility employer who provides patient care, health care services, or supportive services, which includes but is not limited to nurses, physicians, caregivers, medical residents, interns or fellows, patient care technicians, janitors, housekeeping staff persons, groundskeepers, guards, clerical workers, nonmanagerial administrative staff, food service staff, gift shop staff, technical and ancillary services workers, medical coding and billing personnel, schedulers, call center and warehouse workers, and laundry workers, regardless of formal job title.
- A contracted or subcontracted employee if specified criteria is met.
- “Covered health care facility” as any of the following:
- A facility or work site that is part of an integrated health care delivery system.
- A licensed general acute care hospital, as defined, including a distinct part of any such hospital.
- A licensed acute psychiatric hospital, as defined, including a distinct part of any such hospital.
- A special hospital, as defined.
- A licensed skilled nursing facility, as defined, if owned, operated, or controlled by a hospital or integrated health care delivery system or health care system.
- A patient’s home when health care services are delivered by an entity owned or operated by a general acute care or psychiatric hospital.
- A licensed home health agency, as defined.
- A clinic, as defined, including a specialty care, or dialysis clinic.
- A psychology clinic, as defined.
- An outpatient clinic of a hospital.
- A clinic operated by, or affiliated with, any institution of learning that teaches a recognized healing art and is approved by the state board or commission vested with responsibility for regulation of the practice of that healing art.
- A nonprofit clinic that conducts medical research and health education and provides health care to its patients through a group of 40 or more physicians and surgeons, who are independent contractors representing not less than 10 board-certified specialties, and not less than two-thirds of whom practice on a full-time basis at the clinic.
- A licensed residential care facility for the elderly, as defined, if affiliated with an acute care provider or owned, operated or controlled by a general acute care hospital, acute psychiatric hospital, or the parent entity of such.
- A psychiatric health facility, as defined.
- A mental health rehabilitation center, as defined.
- A community clinic, as defined, an intermittent clinic, as specified, or a clinic operated by the state or any of its political subdivisions, including, but not limited to, the University of California or a city or county that is exempt from licensure, as specified.
- A rural health clinic, as defined.
- An urgent care clinic.
- An ambulatory surgical center, as specified.
- A physician group.
- A county correctional facility that provides health care services.
- A county mental health facility.
- “Health care services” as patient care-related services including nursing; caregiving; services provided by medical residents, interns, or fellows; technical and ancillary services; janitorial work; housekeeping; groundskeeping; guard duties; business office clerical work; food services; laundry; medical coding and billing; call center and warehouse work; scheduling; and gift shop work; but only where such services support patient care.
- “Hospital with a high governmental payor mix” means a licensed acute care hospital, as defined, where the combined Medicare and Medi-Cal payor mix is 90% or greater, as determined by using the adjusted patient days from the Department of Health Care Access and Information (DHCAI) annual financial disclosure report as recorded and calculated as of January 1, 2022, as per the DHCAI guidance. A hospital will qualify pursuant to this paragraph only if the combined payor mix of both the hospital and the health care system to which it belongs, if any, is 90% or greater.
- “Independent hospital with an elevated governmental payor mix” means all of the following:
- A hospital, as specified, where the combined Medicare and Medi-Cal payor mix is 75% or greater as determined by using the adjusted patient days from the DHCAI annual financial disclosure report as recorded and calculated as of January 1, 2022, as per the DHCAI guidance.
- The hospital is not owned, controlled, or operated by any parent entity with two or more separately licensed hospitals. (Labor Code §1182.14(b))
- Defines "rural independent covered health care facility" to mean a hospital that is not part of an integrated health care delivery system and is not owned, controlled, or operated by any parent entity with two or more separately licensed hospitals and any of the following:
- A hospital that is located in a county that is not designated as a metropolitan core-based statistical area.
- A small and rural hospital, as defined.
- A rural general acute care hospital, as described in the Health and Safety Code. (Labor Code §1182.14(b))
- “Covered health care employee” to mean either of the following:
- Effective June 1, 2024, requires specified healthcare facility employers to pay their employees on a phased in multi-tiered a statewide minimum wage schedule as follows:
- For a covered health care facility employer with 10,000 or more full-time equivalent (FTE) employees, any covered health care facility employer that is part of an integrated health care delivery system, a health care system with 10,000 or more FTE employees, a dialysis clinic, as defined, or a covered health care facility owned, affiliated, or operated by a county with a population of more than five million people as of January 1, 2023, the minimum wage for covered health care employees shall be:
- $23 per hour from June 1, 2024, to May 31, 2025;
- $24 per hour from June 1, 2025, to May 31, 2026; and
- $25 per hour from June 1, 2026, until adjusted, as specified.
- (Labor Code §1182.14(c) (1))
- For a hospital with a governmental payor mix, as defined, an independent hospital with an elevated government payor mix, as defined, a rural independent covered health care facility, or a covered health care facility that is owned, affiliated, or operated by a county with a population of less than 250,000 as of January 1, 2023, the minimum wage for covered health care employees shall be:
- $18 per hour from June 1, 2024, to May 31, 2033, with 3.5 percent annual increases;
- $25 per hour from June 1, 2033, until adjusted as specified.
- (Labor Code §1182.14(c) (2))
- For a health care facility that is a specified free clinic that is not directly conducted or maintained by a governmental entity, a community clinic and associated intermittent clinic, as defined, a rural health clinic, as defined, and an urgent care clinic, all as defined, the minimum wage for covered health care employees shall be:
- $21 per hour from June 1, 2024, to May 31, 2026;
- $22 per hour from June 1, 2026, to May 31, 2027; and
- $25 from June 1, 2027, until adjusted as specified.
- (Labor Code §1182.14(c) (3))
- For a health care facility that is a licensed skilled nursing facility, as defined, the minimum wage for all covered health care employees shall be:
- $21 per hour from June 1, 2024, to May 31, 2026;
- $23 per hour from June 1, 2026, to May 31, 2028; and
- $25 per hour from June 1, 2028, until adjusted as specified.
- (Labor Code §1182.15(c))
- For all other covered health care facility employers, the minimum wage for all covered health care employees shall be:
- $21 per hour from June 1, 2024, to May 31, 2026;
- $23 per hour from June 1, 2026, to May 31, 2028; and
- $25 per hour from June 1, 2028, until adjusted as specified.
- (Labor Code §1182.14(c) (4))
- For a covered health care facility employer with 10,000 or more full-time equivalent (FTE) employees, any covered health care facility employer that is part of an integrated health care delivery system, a health care system with 10,000 or more FTE employees, a dialysis clinic, as defined, or a covered health care facility owned, affiliated, or operated by a county with a population of more than five million people as of January 1, 2023, the minimum wage for covered health care employees shall be:
- Provides a delayed implementation date of January 1, 2025, for any covered health care facility that is county-owned, affiliated, or operated to implement the applicable wage schedule as set forth above. (Labor Code §1182.14(c) (5))
- Provides that, following the implementation of the minimum wage increases, on or before August 1 of the following year, and on or before each August 1 thereafter, the Director of Finance shall calculate an adjusted minimum wage. The calculation shall increase the health care minimum wage by the lesser of 3.5% or the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted United States Consumer Price Index for Urban Wage Earners and Clerical Workers (U.S. CPI-W). Each adjusted minimum wage increase shall take effect on the following January 1. If the rate of change in the averages is negative, there shall be no increase or decrease in the health care worker minimum wage, as specified. (Labor Code §1182.14(d))
- Requires, by March 1, 2024, the Department of Industrial Relations, in consultation with the State Department of Health Care Services and the Department of Health Care Access and Information, to develop a waiver that would authorize a covered health care facility, as specified, to apply for a one-year temporary pause or alternative phase-in schedule of the minimum wage requirements. In order to obtain a waiver, a covered health care facility shall demonstrate that compliance with the minimum wage requirements would raise doubts regarding its ability to continue operations, as specified. (Labor Code §1182.14(i))
- Provides a 10-year moratorium, beginning September 6, 2023 and expiring January 1, 2034, on an ordinance, regulation, or administrative action applicable to a covered health care facility that establishes, requires, imposes, or otherwise relates to wages or compensation for covered health care facility employees, as specified. (Labor Code §1182.14(j))
- Provides that the health care worker minimum wage shall be enforceable by the Labor Commissioner or by a covered worker through a civil action, through the same means and relief available for violation of any other state minimum wage requirement. (Labor Code §1182.14(f))
This bill:
- Delays by one month the implementation of the health care worker minimum wage increases, and all future wage adjustments, by changing from June 1, 2024 to July 1, 2024, the effective date of its provisions.
- Includes an urgency statute necessary to ensure employers are able to accurately implement the act’s minimum wage requirements.
Background
California's current minimum wage is $16 per hour. Some cities in California have established minimum wages that are higher than the current statewide minimum wage. Since the start of 2022, spearheaded by SEIU-United Health Workers, several California cities have passed or introduced ordinances for a $25 per hour minimum wage for healthcare workers. Some of these ordinances have been challenged and put on hold after petitions for referendum were submitted to put the matter before city voters. An initiative cleared for the November 2024 ballot, The Living Wage Act, would increase the state minimum wage to $18 an hour over several years for employers in all industries.
In 2023, SB 525 (Durazo, Chapter 890, Statutes of 2023) was enacted to, starting on June 1, 2024, (1) phase in a multi-tiered statewide minimum wage increase schedule (reaching up to $25 an hour) for health care workers employed by covered healthcare facilities, as defined; (2) require, following the phased-in wage increases, the minimum wage for health care workers to be adjusted, as specified; (3) provide a temporary waiver of wage increases under specified circumstances; and (4) establish a 10-year moratorium on wage ordinances, regulations, or administrative actions for covered health care facility employees, as specified.
Governor Newsom is seeking some changes to SB 525 provisions as part of the 2024-25 state budget. As noted in the Governor’s budget summary, “Given the overall economic and General Fund revenue outlook and the significant fiscal impact of SB 525 on the state, the Administration is seeking early action in January by the Legislature to add an annual “trigger” to make the minimum wage increases subject to General Fund revenue availability, clarify the exemption for state facilities, and make other implementation clarifications.”[1] This bill, SB 828, would align the healthcare worker minimum wage provisions with the state budget timeline and allows the Legislature and the Governor to continue these discussions.
Comments
According to a UC Berkeley Labor Center report, “California health care minimum wage: New estimates for impacts on workers, patients, and the state budget,” upon implementation of the health care worker minimum wage increase, nearly half a million health care workers in California will enjoy higher pay with an average annual earnings increase of $6,400 in the first year.[2] Additionally, they note that studies show that the majority of workers who will benefit from this increase are women and workers of color.[3] Furthermore, half of the lowest paid health care workers currently rely on state safety net programs such as Medi-Cal, CalFresh and CalWORKS, so raising their wages will lead to lower enrollment in Medi-Cal.[4]
According to the author, “SB 525 provided a historic wage increase to more than 450,000 health care workers mainly women and people of color, who take care of us and keep our health care system functioning. It is clear that these workers need this to help support their families and I appreciate health care employers that recognized this and have begun to increase wages. SB 828 is an urgency measure that moves the start date of the health care minimum wage by one month to July 1, 2024. This aligns SB 525 with the budget year and allows the Legislature to continue discussions with the Administration and technical changes to ensure health care workers get their raises.”
Related/Prior Legislation
AB 610 (Holden, Chapter 4, Statutes of 2024) amended existing fast food worker provisions requiring a $20 an hour minimum wage for fast food workers to exempt specified restaurants from the definition of “fast food restaurant,” including restaurants in airports, hotels, event centers, theme parks, museums and other locations, as prescribed.
SB 525 (Durazo, Chapter 890, Statutes of 2023) enacted the phased in multi-tiered statewide minimum wage increase schedule for health care workers employed by covered healthcare facilities, as specified above under existing law.
AB 1228 (Holden, Chapter 262, Statutes of 2023) required, among other things, the hourly minimum wage for fast food restaurant employees to be twenty dollars ($20) per hour, effective April 1, 2024. The bill repealed, revised and recast provisions of the Fast Food Accountability and Standards Recovery Act (FAST Act) to codify changes that were negotiated and agreed to by both proponents and opponents (seeking a referendum) of AB 257 (Holden, 2022) but only if the referendum was withdrawn by January 1, 2024.
AB 257 (Holden, Chapter 246, Statutes of 2022) enacted the Fast Food Accountability and Standards Recovery Act to, among other things, establish the Fast Food Council within the Department of Industrial Relations, with a sunset date of January 1, 2029, for the purpose of establishing sectorwide minimum standards on wages, working hours, and other working conditions related to the health, safety, and welfare of, and supplying the necessary cost of proper living to, fast food restaurant workers.
SB 3 (Leno, Chapter 4, Statutes of 2016) increased the state minimum wage to $15 per hour, in an incremental timeline from $10 to $15, and indexed the minimum wage to inflation thereafter, as specified, among other things.
FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No
SUPPORT: (Verified 5/28/24)
SEIU California (source)
California Association of Rural Health Clinics
California Hospital Association
OPPOSITION: (Verified 5/28/24)
None received
ARGUMENTS IN SUPPORT: According to SEIU California, “Quality patient care requires strong staffing levels. Setting a pathway for workers to earn a $25 hour minimum wage will bolster efforts to fill the more than 500,000 person shortage of healthcare workers our state is facing by ensuring that health care workers are fairly compensated. This legislation reaffirms the goals of SB 525 while aligning the implementation date with our state’s fiscal calendar.”
ASSEMBLY FLOOR: 61-7, 5/23/24
AYES: Addis, Aguiar-Curry, Alanis, Alvarez, Arambula, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Connolly, Flora, Mike Fong, Friedman, Gabriel, Garcia, Gipson, Grayson, Haney, Hart, Irwin, Jackson, Jones-Sawyer, Kalra, Lee, Low, Lowenthal, Maienschein, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Ortega, Pacheco, Papan, Jim Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Rendon, Reyes, Rodriguez, Santiago, Schiavo, Soria, Ting, Valencia, Villapudua, Waldron, Ward, Weber, Wilson, Wood, Zbur, Robert Rivas
NOES: Davies, Dixon, Vince Fong, Gallagher, Hoover, Joe Patterson, Sanchez
NO VOTE RECORDED: Cervantes, Chen, Megan Dahle, Essayli, Holden, Lackey, Mathis, Luz Rivas, Blanca Rubio, Ta, Wallis, Wicks
Prepared by: Alma Perez-Schwab / L., P.E. & R. / (916) 651-1556
5/29/24 14:37:22
**** END ****
Governor’s Budget Summary, 2024-25. https://ebudget.ca.gov/2024-25/pdf/BudgetSummary/FullBudgetSummary.pdf ↑
Lucia, Laurel, Lopezlira, Enrique, and Jacobs, Ken, “California health care minimum wage: New estimates for impacts on workers, patients, and the state budget,” UC Berkeley Center for Labor Research and Education. February 2024. P. 2. ↑
Ibid. ↑
Ibid. ↑
SENATE COMMITTEE ON LABOR, PUBLIC EMPLOYMENT AND RETIREMENT
Senator Lola Smallwood-Cuevas, Chair
2023 - 2024 Regular
Bill No: SB 828 Hearing Date: May 29, 2024
Author: | Durazo | ||
Version: | May 20, 2024 | ||
Urgency: | Yes | Fiscal: | Yes |
Consultant: | Alma Perez-Schwab | ||
SUBJECT: Minimum wages: health care workers: delay.
KEY ISSUE
This bill delays by one month the implementation of health care worker minimum wage increases scheduled to take effect June 1, 2024.
ANALYSIS
Existing law:
- Sets California’s minimum wage at $16.00 an hour for all employers and specifies that after January 1, 2023, the minimum wage rate will be adjusted annually for inflation based on the national consumer price index for urban wage earners and clerical workers (CPI-W), as specified. (Labor Code §1182.12)
- Effective April 1, 2024, requires fast food restaurants, as defined, to pay their employees a minimum wage of $20.00 per hour. (Labor Code §1474-1477)
- Defines, among others and for purposes of the statewide minimum wage for health care workers provisions described below, the following terms:
- “Covered health care employee” to mean either of the following:
- An employee of a health care facility employer who provides patient care, health care services, or supportive services, which includes but is not limited to nurses, physicians, caregivers, medical residents, interns or fellows, patient care technicians, janitors, housekeeping staff persons, groundskeepers, guards, clerical workers, nonmanagerial administrative staff, food service staff, gift shop staff, technical and ancillary services workers, medical coding and billing personnel, schedulers, call center and warehouse workers, and laundry workers, regardless of formal job title.
- A contracted or subcontracted employee if all of the following apply:
- The employee's employer contracts with the health care facility employer, or with a contractor or subcontractor to the health care facility employer, to provide health care services, or services supporting the provision of health care.
- The health care facility employer directly or indirectly, or through an agent or any other person, exercises control over the employee's wages, hours or working conditions. However, “covered health care employee” includes all employees performing contracted or subcontracted work primarily on the premises of a health care facility to provide health care services or services supporting the provision of health care.
- “Covered health care facility” as any of the following:
- A facility or work site that is part of an integrated health care delivery system.
- A licensed general acute care hospital, as defined, including a distinct part of any such hospital.
- A licensed acute psychiatric hospital, as defined, including a distinct part of any such hospital.
- A special hospital, as defined.
- A licensed skilled nursing facility, as defined, if owned, operated, or controlled by a hospital or integrated health care delivery system or health care system.
- A patient’s home when health care services are delivered by an entity owned or operated by a general acute care or psychiatric hospital.
- A licensed home health agency, as defined.
- A clinic, as defined, including a specialty care, or dialysis clinic.
- A psychology clinic, as defined.
- An outpatient clinic of a hospital.
- A clinic operated by, or affiliated with, any institution of learning that teaches a recognized healing art and is approved by the state board or commission vested with responsibility for regulation of the practice of that healing art.
- A nonprofit clinic that conducts medical research and health education and provides health care to its patients through a group of 40 or more physicians and surgeons, who are independent contractors representing not less than 10 board-certified specialties, and not less than two-thirds of whom practice on a full-time basis at the clinic.
- A licensed residential care facility for the elderly, as defined, if affiliated with an acute care provider or owned, operated or controlled by a general acute care hospital, acute psychiatric hospital, or the parent entity of such.
- A psychiatric health facility, as defined.
- A mental health rehabilitation center, as defined.
- A community clinic, as defined, an intermittent clinic, as specified, or a clinic operated by the state or any of its political subdivisions, including, but not limited to, the University of California or a city or county that is exempt from licensure, as specified.
- A rural health clinic, as defined.
- An urgent care clinic.
- An ambulatory surgical center, as specified.
- A physician group.
- A county correctional facility that provides health care services.
- A county mental health facility.
- “Health care services” as patient care-related services including nursing; caregiving; services provided by medical residents, interns, or fellows; technical and ancillary services; janitorial work; housekeeping; groundskeeping; guard duties; business office clerical work; food services; laundry; medical coding and billing; call center and warehouse work; scheduling; and gift shop work; but only where such services support patient care.
- “Hospital with a high governmental payor mix” means a licensed acute care hospital, as defined, where the combined Medicare and Medi-Cal payor mix is 90% or greater, as determined by using the adjusted patient days from the Department of Health Care Access and Information (DHCAI) annual financial disclosure report as recorded and calculated as of January 1, 2022, as per the DHCAI guidance. A hospital will qualify pursuant to this paragraph only if the combined payor mix of both the hospital and the health care system to which it belongs, if any, is 90% or greater.
- “Independent hospital with an elevated governmental payor mix” means all of the following:
- A hospital, as specified, where the combined Medicare and Medi-Cal payor mix is 75% or greater as determined by using the adjusted patient days from the DHCAI annual financial disclosure report as recorded and calculated as of January 1, 2022, as per the DHCAI guidance.
- The hospital is not owned, controlled, or operated by any parent entity with two or more separately licensed hospitals. Labor Code §1182.14(b)(12).
- Defines "rural independent covered health care facility" to mean a hospital that is not part of an integrated health care delivery system and is not owned, controlled, or operated by any parent entity with two or more separately licensed hospitals and any of the following:
- A hospital that is located in a county that is not designated as a metropolitan core-based statistical area.
- A small and rural hospital, as defined.
- A rural general acute care hospital, as described in the Health and Safety Code.
- “Covered health care employee” to mean either of the following:
(Labor Code §1182.14(b))
- Effective June 1, 2024, requires specified healthcare facility employers to pay their employees on a phased in multi-tiered a statewide minimum wage schedule as follows:
- For a covered health care facility employer with 10,000 or more full-time equivalent (FTE) employees, any covered health care facility employer that is part of an integrated health care delivery system, a health care system with 10,000 or more FTE employees, a dialysis clinic, as defined, or a covered health care facility owned, affiliated, or operated by a county with a population of more than five million people as of January 1, 2023, the minimum wage for covered health care employees shall be:
- $23 per hour from June 1, 2024, to May 31, 2025;
- $24 per hour from June 1, 2025, to May 31, 2026; and
- $25 per hour from June 1, 2026, until adjusted, as specified.
- For a covered health care facility employer with 10,000 or more full-time equivalent (FTE) employees, any covered health care facility employer that is part of an integrated health care delivery system, a health care system with 10,000 or more FTE employees, a dialysis clinic, as defined, or a covered health care facility owned, affiliated, or operated by a county with a population of more than five million people as of January 1, 2023, the minimum wage for covered health care employees shall be:
(Labor Code §1182.14(c) (1))
- For a hospital with a governmental payor mix, as defined, an independent hospital with an elevated government payor mix, as defined, a rural independent covered health care facility, or a covered health care facility that is owned, affiliated, or operated by a county with a population of less than 250,000 as of January 1, 2023, the minimum wage for covered health care employees shall be:
- $18 per hour from June 1, 2024, to May 31, 2033, with 3.5 percent annual increases;
- $25 per hour from June 1, 2033, until adjusted as specified.
- For a hospital with a governmental payor mix, as defined, an independent hospital with an elevated government payor mix, as defined, a rural independent covered health care facility, or a covered health care facility that is owned, affiliated, or operated by a county with a population of less than 250,000 as of January 1, 2023, the minimum wage for covered health care employees shall be:
(Labor Code §1182.14(c) (2))
- For a health care facility that is a specified free clinic that is not directly conducted or maintained by a governmental entity, a community clinic and associated intermittent clinic, as defined, a rural health clinic, as defined, and an urgent care clinic, all as defined, the minimum wage for covered health care employees shall be:
- $21 per hour from June 1, 2024, to May 31, 2026;
- $22 per hour from June 1, 2026, to May 31, 2027; and
- $25 from June 1, 2027, until adjusted as specified.
- For a health care facility that is a specified free clinic that is not directly conducted or maintained by a governmental entity, a community clinic and associated intermittent clinic, as defined, a rural health clinic, as defined, and an urgent care clinic, all as defined, the minimum wage for covered health care employees shall be:
(Labor Code §1182.14(c) (3))
- For a health care facility that is a licensed skilled nursing facility, as defined, the minimum wage for all covered health care employees shall be:
- $21 per hour from June 1, 2024, to May 31, 2026;
- $23 per hour from June 1, 2026, to May 31, 2028; and
- $25 per hour from June 1, 2028, until adjusted as specified.
- For a health care facility that is a licensed skilled nursing facility, as defined, the minimum wage for all covered health care employees shall be:
(Labor Code §1182.15(c))
- For all other covered health care facility employers, the minimum wage for all covered health care employees shall be:
- $21 per hour from June 1, 2024, to May 31, 2026;
- $23 per hour from June 1, 2026, to May 31, 2028; and
- $25 per hour from June 1, 2028, until adjusted as specified.
- For all other covered health care facility employers, the minimum wage for all covered health care employees shall be:
(Labor Code §1182.14(c) (4))
- Provides a delayed implementation date of January 1, 2025, for any covered health care facility that is county-owned, affiliated, or operated to implement the applicable wage schedule as set forth above. (Labor Code §1182.14(c) (5))
- Provides that, following the implementation of the minimum wage increases, on or before August 1 of the following year, and on or before each August 1 thereafter, the Director of Finance shall calculate an adjusted minimum wage. The calculation shall increase the health care minimum wage by the lesser of 3.5% or the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted United States Consumer Price Index for Urban Wage Earners and Clerical Workers (U.S. CPI-W). Each adjusted minimum wage increase shall take effect on the following January 1. If the rate of change in the averages is negative, there shall be no increase or decrease in the health care worker minimum wage, as specified. (Labor Code §1182.14(d))
- Requires, by March 1, 2024, the Department of Industrial Relations, in consultation with the State Department of Health Care Services and the Department of Health Care Access and Information, to develop a waiver that would authorize a covered health care facility, as specified, to apply for a one-year temporary pause or alternative phase-in schedule of the minimum wage requirements. In order to obtain a waiver, a covered health care facility shall demonstrate that compliance with the minimum wage requirements would raise doubts regarding its ability to continue operations, as specified. (Labor Code §1182.14(i))
- Provides a 10-year moratorium, beginning September 6, 2023 and expiring January 1, 2034, on an ordinance, regulation, or administrative action applicable to a covered health care facility that establishes, requires, imposes, or otherwise relates to wages or compensation for covered health care facility employees, as specified. (Labor Code §1182.14(j))
- Provides that the health care worker minimum wage shall be enforceable by the Labor Commissioner or by a covered worker through a civil action, through the same means and relief available for violation of any other state minimum wage requirement. (Labor Code §1182.14(f))
This bill:
- Delays by one month the implementation of the health care worker minimum wage increases by changing from June 1, 2024 to July 1, 2024, the effective date of its provisions.
- Includes an urgency statute necessary to ensure employers are able to accurately implement the act’s minimum wage requirements.
COMMENTS
1. Background:
California's current minimum wage is $16 per hour. Some cities in California have established minimum wages that are higher than the current statewide minimum wage. Since the start of 2022, spearheaded by SEIU-United Health Workers, several California cities have passed or introduced ordinances for a $25 per hour minimum wage for healthcare workers. Some of these ordinances have been challenged and put on hold after petitions for referendum were submitted to put the matter before city voters. An initiative cleared for the November 2024 ballot, The Living Wage Act, would increase the state minimum wage to $18 an hour over several years for employers in all industries.
In 2023, SB 525 (Durazo) was enacted to, starting on June 1, 2024, (1) phase in a multi-tiered statewide minimum wage increase schedule (reaching up to $25 an hour) for health care workers employed by covered healthcare facilities, as defined; (2) require, following the phased-in wage increases, the minimum wage for health care workers to be adjusted, as specified; (3) provide a temporary waiver of wage increases under specified circumstances; and (4) establish a 10-year moratorium on wage ordinances, regulations, or administrative actions for covered health care facility employees, as specified.
Governor Newsom is seeking some changes to SB 525 provisions as part of the 2024-25 state budget. As noted in the Governor’s budget summary, “Given the overall economic and General Fund revenue outlook and the significant fiscal impact of SB 525 on the state, the Administration is seeking early action in January by the Legislature to add an annual “trigger” to make the minimum wage increases subject to General Fund revenue availability, clarify the exemption for state facilities, and make other implementation clarifications.”[1] This bill, SB 828, would align the healthcare worker minimum wage provisions with the state budget timeline and allows the Legislature and the Governor to continue these discussions.
2. Need for this bill?
According to a UC Berkeley Labor Center report, “California health care minimum wage: New estimates for impacts on workers, patients, and the state budget,” upon implementation of the health care worker minimum wage increase, nearly half a million health care workers in California will enjoy higher pay with an average annual earnings increase of $6,400 in the first year.[2] Additionally, they note that studies show that the majority of workers who will benefit from this increase are women and workers of color.[3] Furthermore, half of the lowest paid health care workers currently rely on state safety net programs such as Medi-Cal, CalFresh and CalWORKS, so raising their wages will lead to lower enrollment in Medi-Cal.[4]
According to the author, “SB 525 provided a historic wage increase to more than 450,000 health care workers mainly women and people of color, who take care of us and keep our health care system functioning. It is clear that these workers need this to help support their families and I appreciate health care employers that recognized this and have begun to increase wages.
SB 828 is an urgency measure that moves the start date of the health care minimum wage by one month to July 1, 2024. This aligns SB 525 with the budget year and allows the Legislature to continue discussions with the Administration and technical changes to ensure health care workers get their raises.”
3. Proponent Arguments:
According to SEIU California, “Quality patient care requires strong staffing levels. Setting a pathway for workers to earn a $25 hour minimum wage will bolster efforts to fill the more than 500,000 person shortage of healthcare workers our state is facing by ensuring that health care workers are fairly compensated. This legislation reaffirms the goals of SB 525 while aligning the implementation date with our state’s fiscal calendar.”
4. Opponent Arguments:
None received.
5. Prior/Related Legislation:
SB 525 (Durazo, Chapter 890, Statutes of 2023) enacted the phased in multi-tiered statewide minimum wage increase schedule for health care workers employed by covered healthcare facilities, as specified above under existing law.
AB 610 (Holden, Chapter 4, Statutes of 2024) amended existing fast food worker provisions requiring a $20 an hour minimum wage for fast food workers to exempt specified restaurants from the definition of “fast food restaurant,” including restaurants in airports, hotels, event centers, theme parks, museums and other locations, as prescribed.
AB 1228 (Holden, Chapter 262, Statutes of 2023) requires, among other things, the hourly minimum wage for fast food restaurant employees to be twenty dollars ($20) per hour, effective April 1, 2024. AB 1228 repealed, revised and recast provisions of the Fast Food Accountability and Standards Recovery Act (FAST Act) to codify changes that were negotiated and agreed to by both proponents and opponents (seeking a referendum) of AB 257 (Holden, 2022) but only if the referendum was withdrawn by January 1, 2024.
AB 257 (Holden, Chapter 246, Statutes of 2022) enacted the Fast Food Accountability and Standards Recovery Act to, among other things, establish the Fast Food Council within the Department of Industrial Relations, with a sunset date of January 1, 2029, for the purpose of establishing sectorwide minimum standards on wages, working hours, and other working conditions related to the health, safety, and welfare of, and supplying the necessary cost of proper living to, fast food restaurant workers.
SB 3 (Leno, Chapter 4, Statutes of 2016), among other things, increased the state minimum wage to $15 per hour, in an incremental timeline from $10 to $15, and indexed the minimum wage to inflation thereafter, as specified.
SUPPORT
California Association of Rural Health Clinics
California Hospital Association
SEIU California
OPPOSITION
None received
-- END --
Governor’s Budget Summary, 2024-25. https://ebudget.ca.gov/2024-25/pdf/BudgetSummary/FullBudgetSummary.pdf ↑
Lucia, Laurel, Lopezlira, Enrique, and Jacobs, Ken, “California health care minimum wage: New estimates for impacts on workers, patients, and the state budget,” UC Berkeley Center for Labor Research and Education. February 2024. P. 2. ↑
Ibid. ↑
Ibid. ↑
(Without Reference to File)
SENATE THIRD READING
STR Bill Id:SB 828
Author:(Durazo)
As Amended Ver:May 20, 2024
2/3. Urgency
SUMMARY
Delays by one month the implementation of health care worker minimum wage increases and states that it is an urgency statute.
Major Provisions
See summary above and policy committee analysis for existing law.
COMMENTS
While this bill delays by one month implementation of health care worker wage increases, it maintains the intent of SB 525 (Durazo) Chapter 890. Statutes of 2023 to ultimately establish a $25/hour health care industry minimum wage. Upon implementation, nearly half a million health care workers in California will enjoy higher pay with an average annual earnings increase of $6,400 in the first year.[1] Studies show that the majority of workers who will benefit from this increase are women and workers of color.[2] Furthermore, half of the lowest paid health care workers currently rely on state safety net programs such as Medi-Cal, CalFresh and CalWORKS, so raising their wages will lead to lower enrollment in Medi-Cal.[3] Finally, raising low-wage health care worker pay is critical because it will likely reduce staff turnover and lead to better retention—two issues that many argue desperately need our attention.
According to the Author
"SB 525 provided a historic wage increase to more than 450,000 health care workers mainly women and people of color, who take care of us and keep our health care system functioning. It is clear that these workers need this to help support their families and I appreciate health care employers that recognized this and have begun to increase wages.
SB 828 is an urgency measure that moves the start date of the health care minimum wage by one month to July 1, 2024. This aligns SB 525 with the budget year and allows the Legislature to continue discussions with the Administration and technical changes to ensure health care workers get their raises."
Arguments in Support
SEIU California is in support and states, "Quality patient care requires strong staffing levels. Setting a pathway for workers to earn a $25 hour minimum wage will bolster efforts to fill the more than 500,000 person shortage of healthcare workers our state is facing by ensuring that health care workers are fairly compensated. This legislation reaffirms the goals of SB 525 while aligning the implementation date with our state's fiscal calendar."
Arguments in Opposition
None on file.
FISCAL COMMENTS
Unknown.
VOTES
SENATE FLOOR: 39-0-1
YES: Allen, Alvarado-Gil, Archuleta, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dahle, Dodd, Durazo, Eggman, Glazer, Gonzalez, Hurtado, Jones, Laird, Limón, McGuire, Menjivar, Min, Newman, Nguyen, Niello, Ochoa Bogh, Padilla, Portantino, Roth, Rubio, Seyarto, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk
ABS, ABST OR NV: Grove
ASSEMBLY FLOOR: 53-15-12
YES: Addis, Aguiar-Curry, Alvarez, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Connolly, Mike Fong, Friedman, Garcia, Gipson, Grayson, Haney, Hart, Holden, Irwin, Jackson, Jones-Sawyer, Kalra, Lee, Low, Lowenthal, Maienschein, McCarty, McKinnor, Ortega, Pacheco, Papan, Pellerin, Petrie-Norris, Quirk-Silva, Rendon, Reyes, Santiago, Schiavo, Soria, Ting, Valencia, Villapudua, Ward, Weber, Wicks, Wilson, Wood, Zbur, Robert Rivas
NO: Alanis, Davies, Dixon, Essayli, Flora, Vince Fong, Gallagher, Hoover, Lackey, Jim Patterson, Joe Patterson, Sanchez, Ta, Waldron, Wallis
ABS, ABST OR NV: Arambula, Cervantes, Chen, Megan Dahle, Gabriel, Mathis, Muratsuchi, Stephanie Nguyen, Ramos, Luz Rivas, Rodriguez, Blanca Rubio
ASM LABOR AND EMPLOYMENT: 7-0-0
YES: Ortega, Flora, Alanis, Wendy Carrillo, Lee, Ward, Zbur
UPDATED
VERSION: May 20, 2024
CONSULTANT: Megan Lane / L. & E. / (916) 319-2091 FN: 0003477
Date of Hearing: May 22, 2024
ASSEMBLY COMMITTEE ON LABOR AND EMPLOYMENT
Liz Ortega, Chair
SBPCA Bill Id:SB 828
Author:(Durazo) – As Amended Ver:May 20, 2024
SENATE VOTE: 39-0 (not relevant)
SUBJECT: Health care worker: minimum wage; delay.
SUMMARY: Delays by one month the implementation of health care worker minimum wage increases and states that it is an urgency statute.
EXISTING LAW:
- Defines "covered health care employee" to mean either of the following:
- An employee of a health care facility employer who provides patient care, healthcare services, or services supporting the provision of health care, which includes, but is not be limited to, employees performing work in the occupation of a nurse; physician; caregiver; medical resident, intern, or fellow; patient care technician; janitor; housekeeping staff person; groundskeeper; guard; clerical worker; nonmanagerial administrative worker; food services worker; gift shop worker; technical and ancillary services worker; medical coding and medical billing personnel; scheduler; call center and warehouse worker; and laundry worker, regardless of formal job title.
- A contracted or subcontracted employee if all of the following apply:
- The employee's employer contracts with the health care facility employer, or with a contractor or subcontractor to the health care facility employer, to provide health care services, or services supporting the provision of health care.
- The health care facility employer directly or indirectly, or through an agent or any other person, exercises control over the employee's wages, hours or working conditions. Labor Code §1182.14(b)(2)(A)-(B).
- Provides that all employees performing contracted or subcontracted work primarily on the premises of a health care facility to provide health care services or services supporting the provision of care are also covered health care employees. Labor Code §1182.14(b)(2)(B)(ii).
- Defines a "hospital with a high governmental payor mix" to mean a licensed acute care hospital, as defined, where the combined Medicare and Medi-Cal payor mix is 90% or greater, as determined by using the adjusted patient days from the Department of Health Care Access and Information (DHCAI) annual financial disclosure report as recorded and calculated as of January 1, 2022, as per the DHCAI guidance. A hospital will qualify pursuant to this paragraph only if the combined payor mix of both the hospital and the health care system to which it belongs, if any, is 90% or greater. Labor Code §1182.14(b)(11).
- Defines an "independent hospital with an elevated governmental payor mix" to mean all of the following:
- A hospital, as specified, where the combined Medicare and Medi-Cal payor mix is 75% or greater as determined by using the adjusted patient days from the DHCAI annual financial disclosure report as recorded and calculated as of January 1, 2022, as per the DHCAI guidance.
- The hospital is not owned, controlled, or operated by any parent entity with two or more separately licensed hospitals. Labor Code §1182.14(b)(12).
- Defines "rural independent covered health care facility" to mean a hospital that is not part of an integrated health care delivery system and is not owned, controlled, or operated by any parent entity with two or more separately licensed hospitals and any of the following:
- A hospital that is located in a county that is not designated as a metropolitan core-based statistical area.
- A small and rural hospital, as defined.
- A rural general acute care hospital, as described in the Health and Safety Code. Labor Code §1182.14(b)(15).
- Provides that for any covered health care facility employer with 10,000 or more full time equivalent employees, or any covered health care facility employer that is a part of an integrated health care delivery system or a health care system with 10,000 or more full time equivalent employees, any covered health care facility employer that is a dialysis clinic, as described, or a covered health facility owned, affiliated or operated by a county with a population of more than five million people as of January 1, 2023, the minimum wage for all covered health care employees shall be as follows:
- From June 1, 2024, to May 31, 2025, inclusive, $23 per hour.
- From June 1, 2025, to May 31, 2026, inclusive, $24 per hour.
- From June 1, 2026, and until adjusted, $25 per hour. Labor Code §1182.14(c)(1).
- Provides that for any hospital that is a hospital with a high governmental payor mix, an independent hospital with an elevated governmental payor mix, or a rural independent covered health care facility, or a covered health care facility that is owned, affiliated, or operated by a county with a population of less than 250,000 as of January 1, 2023, the minimum wage for all covered health care employees shall be as follows:
- From June 1, 2024, to May 31, 2033, inclusive, $18 per hour, with 3.5% increases annually.
- From June 1, 2033, and until adjusted, $25 per hour. Labor Code §1182.14(c)(2).
- Provides that for a health care facility that is a specified free clinic that is not directly conducted or maintained by a governmental entity, a community clinic and associated intermittent clinic, as defined, a rural health clinic, as defined, and an urgent care clinic, as defined, the minimum wage for all covered health care employees shall be as follows:
- From June 1, 2024, to May 31, 2026, inclusive, $21 per hour.
- From June 1, 2026, to May 31, 2027, inclusive, $22 per hour.
- From June 1, 2027, and until adjusted, $25 per hour. Labor Code §1182.14(c)(3)(A)-(B).
- Provides that for all other covered health care facility employers, the minimum wage for all covered health care employees shall be as follows:
- From June 1, 2024, to May 31, 2026, inclusive, $21 per hour.
- From June 1, 2026, to May 31, 2028, inclusive, $23 per hour.
- From June 1, 2028, and until adjusted, $25 per hour. Labor Code §1182.14(c)(4).
- Provides a delayed implementation date of January 1, 2025, for any covered health care facility that is county-owned, affiliated, or operated to implement the applicable wage schedule as set forth in 6) through 9), above. Labor Code §1182.14(c)(5).
- Provides that for a health care facility that is a licensed skilled nursing facility, as defined, the minimum wage for all covered health care employees shall be as follows:
- From June 1, 2024, to May 31, 2026, inclusive, $21 per hour.
- From June 1, 2026, to May 31, 2028, inclusive, $23 per hour.
- From June 1, 2028, and until adjusted, $25 per hour. Labor Code §1182.15(c).
- States that the wage schedule in 11), above, shall only take effect when a patient care minimum spending requirement applicable to these skilled nursing facilities is in effect. Labor Code §1182.15(i).
- Provides that, following the implementation of the minimum wage increases, on or before August 1 of the following year, and on or before each August 1 thereafter, the Director of Finance shall calculate an adjusted minimum wage. The calculation shall increase the health care minimum wage by the lesser of 3.5% or the rate of change in the averages of the most recent July 1 to June 30, inclusive, period over the preceding July 1 to June 30, inclusive, period for the United States Bureau of Labor Statistics nonseasonally adjusted United States Consumer Price Index for Urban Wage Earners and Clerical Workers (U.S. CPI-W). Each adjusted minimum wage increase shall take effect on the following January 1. Labor Code §1182.14(d)(1).
FISCAL EFFECT: Unknown
COMMENTS: While this bill delays by one month implementation of health care worker wage increases, it maintains the intent of SB 525 (Durazo) to ultimately establish a $25/hour health care industry minimum wage. Upon implementation, nearly half a million health care workers in California will enjoy higher pay with an average annual earnings increase of $6,400 in the first year.[1] Studies show that the majority of workers who will benefit from this increase are women and workers of color.[2] Furthermore, half of the lowest paid health care workers currently rely on state safety net programs such as Medi-Cal, CalFresh and CalWORKS, so raising their wages will lead to lower enrollment in Medi-Cal.[3] Finally, raising low-wage health care worker pay is critical because it will likely reduce staff turnover and lead to better retention—two issues that many argue desperately need our attention.
According to the author, “SB 525 provided a historic wage increase to more than 450,000 health care workers mainly women and people of color, who take care of us and keep our health care system functioning. It is clear that these workers need this to help support their families and I appreciate health care employers that recognized this and have begun to increase wages.
SB 828 is an urgency measure that moves the start date of the health care minimum wage by one month to July 1, 2024. This aligns SB 525 with the budget year and allows the Legislature to continue discussions with the Administration and technical changes to ensure health care workers get their raises.”
Arguments in Support
SEIU California is in support and states, “Quality patient care requires strong staffing levels. Setting a pathway for workers to earn a $25 hour minimum wage will bolster efforts to fill the more than 500,000 person shortage of healthcare workers our state is facing by ensuring that health care workers are fairly compensated. This legislation reaffirms the goals of SB 525 while aligning the implementation date with our state’s fiscal calendar.”
Arguments in Opposition
None on file.
Prior and Related Legislation
SB 525 (Durazo), Chapter 890, Statutes of 2023 established a health care employee minimum wage with phase-in schedules based on factors such as health care facility size, type of facility, and the governmental payor mix percentage, as described. Provided a process for a specified hospital to appeal exclusion from certain schedules and a waiver process for a clinic to obtain a temporary pause or alternative phase-in schedule.
AB 1228 (Holden) Chapter 262, Statutes of 2023 required, among other things, the hourly minimum wage for fast food restaurant employees to be twenty dollars ($20) per hour, effective April 1, 2024.
REGISTERED SUPPORT / OPPOSITION:
Support
SEIU California
Opposition
None on file.
Analysis Prepared by: Megan Lane / L. & E. /
SENATE RULES COMMITTEE Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | SB 828 |
CONSENT
Bill No: SB 828
Author: Smallwood-Cuevas (D)
Amended: 3/22/23
Vote: 21
SENATE PUBLIC SAFETY COMMITTEE: 5-0, 4/25/23
AYES: Wahab, Ochoa Bogh, Bradford, Skinner, Wiener
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
SUBJECT: Corrections: vocational training
SOURCE: Author
This bill requires the California Department of Corrections and Rehabilitation (CDCR) to report to the Legislature the exploratory findings of the Pre-Release Construction Trades Certificate Program joint advisory committee, regarding the feasibility of awarding formal credit for apprenticeship hours to incarcerated individuals prior to their release.
ANALYSIS:
Existing law:
- Establishes the Pre-Release Construction Trades Certificate Program within CDCR to increase employment opportunities in the construction trades for incarcerated individuals upon release. (Pen. Code, § 2716.5, subd. (a).)
- Requires the department to establish a joint advisory committee for the purpose of implementation of the program. (Pen. Code, § 2716.5, subd. (b).)
- Requires the committee to be composed of representatives from building and construction trades employee organizations, the State Building and Construction Trades Council of California, joint apprenticeship training programs, the Prison Industry Authority, the Division of Apprenticeship Standards, the Labor and Workforce Development Agency, and any other representatives the department determines appropriate. (Pen. Code, § 2716.5, subd. (b).)
- Provides that the responsibilities of the committee include, but are not be limited to, the following:
- Develop guidelines for the participation of incarcerated individuals in preapprenticeship training programs, as described. Requires the guidelines to provide for the integration, for all inmate preapprenticeship training programs in the building and construction trades, of the multicraft core curriculum implemented by the State Department of Education for its California Partnership Academies pilot project and by the California Workforce Development Board and local boards.
- Develop and implement a pre-release construction trades certification that validates that an incarcerated individual completed instruction, skills, and competencies required by and recognized by the participating building and construction trades.
- Ensure compliance with any applicable requirements and regulations of the Division of Apprenticeship Standards.
- Evaluate pre-release on-the-job training opportunities to compare and match competencies with those of registered apprentices in the building and construction trades.
- Explore the feasibility of the electronic tracking of each participating incarcerated individual’s relevant activities to efficiently capture competencies related to the certification.
- Explore the pre-release awarding of formal credit for apprenticeship hours recognized by joint apprenticeship training programs and the Division of Apprenticeship Standards.
- Facilitate the admission of graduates of preapprenticeship programs, after release, into state-approved apprenticeship programs and for apprenticeship programs to evaluate such individuals for admission with advanced standing based on prior coursework and work experience.
(Pen. Code, § 2716.5, subd. (b)(1)-(7).)
This bill:
- Requires CDCR to report to the Legislature the exploratory findings of the joint advisory committee, regarding the feasibility of awarding formal credit for apprenticeship hours to incarcerated individuals prior to their release, as described, on or before January 1, 2026.
- Requires the report to be submitted in compliance with Section 9795 of the Government Code.
- Provides that its provisions are repealed on January 1, 2030.
Background
CDCR provides a variety of job training programs to prepare incarcerated individuals for employment opportunities following release. SB 866 (Committee on Budget and Fiscal Review, Chapter 53, Statutes of 2018) established the Pre-Release Construction Trades Certification Program, a program within CDCR designed to increase employment opportunities in the construction trades for incarcerated individuals upon release. Penal Code Section 2716.5 requires the department to establish a joint advisory committee, made up of relevant stakeholders, for the purpose of implementing the program. The joint advisory committee is tasked with developing guidelines for the participation of incarcerated individuals in pre-apprenticeship training programs, developing and implementing a pre-release construction trades certification, exploring the pre-release awarding of formal credit for apprenticeship hours, and facilitating the admission of graduates of pre-apprenticeship programs into state-approved apprenticeship programs, among other things. Penal Code Section 2716.5 does not contain any provisions requiring the joint advisory committee to report or publish its findings. This bill requires CDCR to report to the Legislature the findings of the joint advisory committee regarding the feasibility of awarding formal credit for apprenticeship hours to incarcerated individuals prior to their release.
FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No
SUPPORT: (Verified 5/8/23)
Initiate Justice
OPPOSITION: (Verified 5/8/23)
None received
Prepared by: Stephanie Jordan / PUB. S. /
5/10/23 15:35:01
**** END ****
SENATE COMMITTEE ON PUBLIC SAFETY
Senator Aisha Wahab, Chair
2023 - 2024 Regular
Bill No: SB 828 Hearing Date: April 25, 2023
Author: | Smallwood-Cuevas | ||
Version: | March 22, 2023 | ||
Urgency: | No | Fiscal: | Yes |
Consultant: | SJ | ||
Subject: Corrections: vocational training
HISTORY
Source: Author
Prior Legislation: SB 866 (Comm. on Budget & Fiscal Rev.), Ch. 53, Stats. 2018
Support: Unknown
Opposition: None known
PURPOSE
The purpose of this bill is to require the California Department of Corrections and Rehabilitation (CDCR) to report to the Legislature the exploratory findings of the Pre-Release Construction Trades Certificate Program joint advisory committee, regarding the feasibility of awarding formal credit for apprenticeship hours to incarcerated individuals prior to their release.
Existing law establishes the Pre-Release Construction Trades Certificate Program within CDCR to increase employment opportunities in the construction trades for incarcerated individuals upon release. (Pen. Code, § 2716.5, subd. (a).)
Existing law requires the department to establish a joint advisory committee for the purpose of implementation of the program. (Pen. Code, § 2716.5, subd. (b).)
Existing law requires the committee to be composed of representatives from building and construction trades employee organizations, the State Building and Construction Trades Council of California, joint apprenticeship training programs, the Prison Industry Authority, the Division of Apprenticeship Standards, the Labor and Workforce Development Agency, and any other representatives the department determines appropriate. (Pen. Code, § 2716.5, subd. (b).)
Existing law provides that the responsibilities of the committee include, but are not be limited to, the following:
- Develop guidelines for the participation of incarcerated individuals in preapprenticeship training programs, as described. Requires the guidelines to provide for the integration, for all inmate preapprenticeship training programs in the building and construction trades, of the multicraft core curriculum implemented by the State Department of Education for its California Partnership Academies pilot project and by the California Workforce Development Board and local boards.
- Develop and implement a pre-release construction trades certification that validates that an incarcerated individual completed instruction, skills, and competencies required by and recognized by the participating building and construction trades.
- Ensure compliance with any applicable requirements and regulations of the Division of Apprenticeship Standards.
- Evaluate pre-release on-the-job training opportunities to compare and match competencies with those of registered apprentices in the building and construction trades.
- Explore the feasibility of the electronic tracking of each participating incarcerated individual’s relevant activities to efficiently capture competencies related to the certification.
- Explore the pre-release awarding of formal credit for apprenticeship hours recognized by joint apprenticeship training programs and the Division of Apprenticeship Standards.
- Facilitate the admission of graduates of preapprenticeship programs, after release, into state-approved apprenticeship programs and for apprenticeship programs to evaluate such individuals for admission with advanced standing based on prior coursework and work experience.
(Pen. Code, § 2716.5, subd. (b)(1)-(7).)
This bill requires CDCR to report to the Legislature the exploratory findings of the joint advisory committee, regarding the feasibility of awarding formal credit for apprenticeship hours to incarcerated individuals prior to their release, as described, on or before January 1, 2026.
This bill requires the report to be submitted in compliance with Section 9795 of the Government Code.
This bill provides that its provisions are repealed on January 1, 2030.
COMMENTS
- Need For This Bill
According to the author:
A key component of California’s reentry programs for formerly incarcerated individuals is finding pathways into stable and long-term employment. One tried and proven method to improve employment outcomes for California’s incarcerated population has been to provide educational opportunities within the prison system so that individuals reentering society have the tools to begin working in skilled and stable jobs as soon as they’re released.
While there have been a number of successful vocational training programs operated in California’s prison system, some approaches have not seen widespread adoption. One option that has yet to be fully explored is awarding apprenticeship credit to incarcerated individuals. SB 828 will require the Department of Corrections and Rehabilitation to report to the Legislature on their existing efforts to determine the feasibility of offering this additional level of job-readiness development. This will help us make the policy changes necessary to provide those that have served their time with the best possible opportunity to successfully reenter society.
- Pre-Release Construction Trades Certificate Program
CDCR provides a variety of job training programs to prepare incarcerated individuals for employment opportunities following release. SB 866 (Comm. on Budget & Fiscal Review, Chapter 53, Statutes of 2018) established the Pre-Release Construction Trades Certification Program, a program within CDCR designed to increase employment opportunities in the construction trades for incarcerated individuals upon release. Penal Code section 2716.5 requires the department to establish a joint advisory committee, made up of relevant stakeholders, for the purpose of implementing the program. The joint advisory committee is tasked with developing guidelines for the participation of incarcerated individuals in pre-apprenticeship training programs, developing and implementing a pre-release construction trades certification, exploring the pre-release awarding of formal credit for apprenticeship hours, and facilitating the admission of graduates of pre-apprenticeship programs into state-approved apprenticeship programs, among other things. Penal Code section 2716.5 does not contain any provisions requiring the joint advisory committee to report or publish its findings. This bill requires CDCR to report to the Legislature the findings of the joint advisory committee regarding the feasibility of awarding formal credit for apprenticeship hours to incarcerated individuals prior to their release.
-- END --
Bill Co-Author(s):