CA AB1113

Requires federally qualified health centers (FQHCs) to maintain a minimum 90% mission spend ratio, meaning at least 90% of total revenue must be spent on patient services and mission-directed expenses rather than administrative costs, profits, or overhead

Mandates annual reporting to the State Department of Public Health by June 30, 2027, including IRS Form 990 filings and financial documentation, with registration fees to fund oversight activities

Imposes administrative penalties of $5,000 for first reporting violations and $10,000 for each subsequent month of non-compliance, plus penalties equal to the shortfall for FQHCs failing to meet the 90% ratio

Provides a 2-year abatement period allowing FQHCs to avoid paying penalties if they return to compliance and agree with the department on a plan to spend the penalty amount on mission-directed expenses

Exempts FQHCs owned by government entities, tribes, tribal organizations, urban Indian organizations, or those participating in a bona fide labor-management cooperation committee