Section 1182.14.
Cal. Labor Code - LAB § 1182.14.
in effect(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 state’s 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.
(7)
The Legislature finds and declares that it is the intent of the Legislature that subclause (I) of clause (ii) of subparagraph (B) of paragraph (2) of subdivision (b) is declarative of existing law.
(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 clauses (i) and (ii) apply:
(i)
The employee’s employer contracts with the covered health care facility employer, or with a contractor or subcontractor to the covered health care facility employer, to provide health care services, or services supporting the provision of health care.
(ii)
(I)
Consistent with the definitions of “employ” and “employer” in the Industrial Welfare Commission wage orders, the covered health care facility employer directly or indirectly, or through an
agent or any other person, engages, suffers, or permits an employee to work, or exercises control over the employee’s wages, hours or working conditions, or
(II)
The employee performs contracted or subcontracted work primarily on the premises of a covered health care facility. For purposes of this subparagraph, “primarily” means more than one-half of the employee’s work time during a workweek.
(iii)
A contracted or subcontracted employee shall be paid the applicable minimum wage in this section for all hours worked providing patient care, 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 by a public employee where the public employee is not primarily engaged in services described in clause (i) of subparagraph (A) performed for a covered health care facility. For purposes of this subparagraph, “primarily” means more than one-half of the employee’s work time during a workweek.
(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 patient’s 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 any political subdivisions of the state, including 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, that is not license exempt.
(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)
Any health care facility described in subparagraph (A) that is owned, controlled, or operated by the state or any state agency of the executive branch. As used in this subparagraph, “state agency” includes every state office, officer, department, division, bureau, board, and commission under the executive branch, including any constitutional offices or officers, California State University, or California Community College, but does not include a health care district or the University of California.
(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 political subdivisions of the state, health care districts, 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,, divided by 2,080. The number of full-time equivalent employees shall be determined as follows:
(A)
The number of full-time equivalent employees shall be as detailed in the Department of Health Care Access and Information’s 2021 Pivot Table – Hospital Annual Selected File (April 2023 Extract) and published online at https://data.chhs.ca.gov/dataset/hospital-annual-financial-data-selected-data-pivot-tables. For purposes of determining the number of full-time equivalent employees under this subparagraph, published data in the pivot table shall be aggregated to determine the total full-time equivalent employees for an integrated health care delivery system or health system. As provided by paragraph (1) of
subdivision (c), any covered health care facility employer that is part of these systems shall be subject to the minimum wage schedule described in paragraph (1) of subdivision (c).
(B)
Any covered health care facility employer that does not report the data referenced in subparagraph (A), but had 10,000 or more full-time equivalent employees as of January 1, 2022, shall be subject to the minimum wage schedule described in paragraph (1) of subdivision (c). For the purposes of this paragraph, “full-time equivalent employees” means the total number of paid hours at a nonreporting covered health care facility employer divided by 2,080. This subparagraph does not apply to county entities, except as counties that are specifically covered in subdivision (c).
(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 plan’s 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 as of March 2020.
(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 the following portions of subdivision (c): subparagraph (C) of paragraph (1), subparagraph (B) of paragraph (2), clause (iii) of subparagraph (B) of paragraph (3), or subparagraph (C) of paragraph (4), 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)
(1)
A health care worker minimum wage shall be enforceable by the Labor Commissioner through the procedures set forth in Section 98, 98.1, 98.2, 98.3, 98.7, 98.74, or 1197.1, 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.
(2)
(A)
The Department of Industrial Relations shall amend, supplement, and republish the Industrial Welfare Commission’s wage orders to be consistent with this section. The Department of Industrial Relations shall not make other changes to the wage orders of the Industrial Welfare Commission that are in existence on the effective date of this section. The Department of Industrial Relations shall meet the requirements set forth in Section 1183.
(B)
Every employer that is subject to this section shall comply with both of the following:
(i)
Post a copy of the order as amended, supplemented and republished by the Department of Industrial Relations under this section and keep it posted in a conspicuous location frequented by employees during the hours of the workday, as required by Section 1183.
(ii)
Provide to each employee on the effective date of the earliest minimum wage increase pursuant to subdivision (c), a written notice, in the language the employer normally uses to communicate employment-related information to the employee, indicating the paragraph of subdivision (c) that applies to the employer and the health care worker minimum wage schedule applicable to the employee.
(C)
Notwithstanding paragraph (6) of subdivision (h), any amendment,
supplement, and republication pursuant to this section shall be exempt from the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), and from the procedures set forth in Sections 1177, 1178.5, 1181, 1182, and 1182.1.
(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 a political subdivision of the state, a health care district, 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 health care delivery system or health care system with 10,000 or more full-time equivalent employees. This list shall only include those covered health care facility employers included in the Department of Health Care Access and Information’s 2021 Pivot Table – Hospital Annual Selected File (April 2023 Extract) and published online at https://data.chhs.ca.gov/dataset/hospital-annual-financial-data-selected-data-pivot-tables. For purposes of determining the number of full-time equivalent employees under this subparagraph,
published data in the pivot table shall be aggregated to determine the total full-time equivalent employees for an integrated health care delivery system or health system.
(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. This list shall only include those covered health care facility employers included in the Department of Health Care Access and Information’s 2021 Pivot Table – Hospital Annual Selected File (April 2023 Extract) and published online at https://data.chhs.ca.gov/dataset/hospital-annual-financial-data-selected-data-pivot-tables. For purposes of determining the number of full-time equivalent employees under this subparagraph, published data in the pivot table shall be aggregated to determine the total full-time equivalent employees for an integrated health care delivery system
or health system.
(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 revised Annual Disclosure Report pursuant to Section 128755 of the Health and Safety Code that reflects 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)
The Department of Industrial Relations shall, in collaboration with the Department of Health Care Access and Information, administer 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 will allow a covered health care facility to apply for a 12-month delay in schedule of the health care minimum wage requirements in this section. The issuance of waivers pursuant to this subdivision shall be solely and exclusively within the authority of the Department of Industrial Relations pursuant to paragraph (3). The authority regarding whether the covered health care facility demonstrates that it meets the requirements to obtain a waiver, set forth in paragraphs (2) and (3) shall be solely and exclusively within the
authority of the Department of Health Care Access and Information.
(2)
In order to obtain a waiver, a covered health care facility shall demonstrate at the time the waiver application is submitted that it meets the criteria as set forth in subparagraphs (A) and (B) of this paragraph.
(A)
Each request for a waiver shall include the covered health care facility’s, and any parent or affiliated company’s, most recent audited financial statements and year-to-date internally prepared financial statements no older than 45 days prior to the date of submission; examined level forecasting with an attestation from an independent certified public accountant demonstrating that compliance with this section would raise doubt about the covered health care facility’s and its parent company’s ability to maintain a positive cashflow over the next 12 months; and balance sheets showing that the
covered health care facility and its parent company have less than 45 days cash on hand and a current ratio of current assets to current liabilities of one or less.
(B)
The covered health care facility shall provide a declaration verifying that the contents of the documents contained in the waiver request are true and correct. The declaration shall be in a form and manner specified by the Department of Health Care Access and Information and signed by an authorized executive officer of the covered health care facility.
(C)
The Department of Industrial Relations shall make approved information available on its internet website within 15 working days of the issuance of the waiver. The Department of Health Care Access and Information shall make the audited financial information submitted in conjunction with an approved waiver available on its internet website within 15 working days of
the issuance of the waiver.
(3)
If, following review of the documentation submitted pursuant to subparagraphs (A) and (B) of paragraph (2), the Department of Health Care Access and Information determines that the covered health care facility has demonstrated that it meets the criteria for a waiver set forth in subdivision (i), the Department of Industrial Relations shall issue a waiver for the covered health care facility. If a covered health care facility is issued a waiver, all dates in clauses (i) to (iii), inclusive, of subparagraph (B) of paragraph (3) of subdivision (c), or any superseding dates pursuant to a previously issued waiver that are on or after the effective date of the issued waiver, are postponed by 12 months for that covered health care facility.
(4)
Notwithstanding the rulemaking provisions of 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 Department of Industrial Relations and the Department of Health Care Access and Information may implement, interpret, or make specific this subdivision, in whole or in part, by means of information notices or other similar instructions, without taking any further regulatory action.
(5)
If a waiver is issued, any covered health care facility affected by the waiver shall within 10 days of notice from the Department of Industrial Relations:
(A)
Post a copy of the waiver, including the applicable minimum wage, in a conspicuous location frequented by employees during the hours of the workday.
(B)
Provide to each covered health care employee, a written notice, in the language the covered health care facility normally uses to communicate
employment-related information to the covered health care employee, informing the covered health care employee the covered health care facility had applied for and received a one-year waiver of the increase of the minimum wage and stating the applicable minimum wage.
(6)
A covered health care facility may apply for and be issued a waiver pursuant to this subdivision in consecutive years. However, a waiver shall not be available after July 1, 2032, and every covered health care facility described in clauses (i) to (iv), inclusive, of subparagraph (A) of paragraph (3) of subdivision (c) shall pay the adjusted wage required by subdivision (d) beginning July 1, 2033, regardless of whether the facility received any waivers.
(7)
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).
(8)
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.
(k)
For purposes of implementing this section, the Department of Industrial Relations and the Department of Health Care Access and Information may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to this subdivision shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, Part 2 (commencing with
Section 10100) of Division 2 of the Public Contract Code, and the State Administrative Manual, and shall be exempt from the review or approval of any division of the Department of General Services.
References
referencesCal. Health and Safety Code - HSC § 1250.
referencesCal. Health and Safety Code - HSC § 1727.
referencesCal. Health and Safety Code - HSC § 1204.
referencesCal. Health and Safety Code - HSC § 1204.1.
referencesCal. Health and Safety Code - HSC § 1206.
referencesCal. Health and Safety Code - HSC § 1569.2.
referencesCal. Health and Safety Code - HSC § 1250.2.
referencesCal. Welfare and Institutions Code - WIC § 5675.
referencesCal. Business and Professions Code - BPC § 2406.
referencesCal. Health and Safety Code - HSC § 124840.
referencesCal. Government Code - GOV § 11340.
referencesCal. Health and Safety Code - HSC § 128755.
referencesCal. Government Code - GOV § 14825.
referencesCal. Government Code - GOV § 19130.
referencesCal. Public Contract Code - PCC § 10100.
referencesCal. Labor Code - LAB § 5.
referencesCal. Labor Code - LAB § 98.
referencesCal. Labor Code - LAB § 1183.
referencesCal. Labor Code - LAB § 1177.
referencesCal. Labor Code - LAB § 1182.12.
Source: CA Legislative Counsel Bulk DataURL: https://downloads.leginfo.legislature.ca.gov/pubinfo_2025.zipFetched: 6/27/2026