California Health Care Minimum Wage: Facility Rates and Exemptions

California’s healthcare minimum wage ranges from $19.28 to $25 per hour as of July 1, 2026, with the exact rate depending on the type of facility you work at. Every rate on the schedule sits well above California’s general minimum wage of $16.90 per hour.¹ The law reaches further than most workers assume, covering janitors, food service staff, schedulers, and gift shop employees at qualifying facilities, not just clinicians. Which schedule applies to your employer is what determines your current pay floor.

Which Facilities Are Covered

The law covers a broad slice of California health care. Licensed general acute care hospitals, acute psychiatric hospitals, and psychiatric health facilities are in. So are skilled nursing facilities owned or controlled by a hospital or integrated system, licensed home health agencies, and residential care facilities for the elderly affiliated with an acute care provider.²

Outpatient sites are covered too: dialysis clinics, Medicare-certified surgical centers, urgent care, rehabilitation clinics, and psychology clinics. Non-license-exempt community clinics, intermittent clinics, and rural health clinics are covered on their own schedule. Teaching clinics and clinics run by a city, county, or the University of California qualify. When a hospital system controls affiliated clinics, physician groups, or care sites, those connected sites come in as part of the system. County mental health and county correctional facilities providing health care are included, and physician groups with 25 or more physicians qualify on their own.²

Which Workers Are Covered

You don’t need to touch a patient to qualify. The law covers anyone employed at a covered facility who provides health care services or supports the delivery of health care. That includes janitorial, housekeeping, groundskeeping, security, food service, laundry, medical coding and billing, call center and warehouse work, scheduling, and gift shop work.² If your role keeps a covered facility running, you are almost certainly protected.

Contracted and subcontracted workers are covered under narrower conditions. Your employer must contract with the health care facility to provide health care services or support services. On top of that, the facility must act as a joint employer by controlling your wages, hours, or working conditions, or you must spend more than 50 percent of your work time in a given week at the covered facility.² This closes the outsourcing loophole.

Two narrow on-site carve-outs apply. Delivery workers and waste collection workers at a covered facility are excluded, provided their employer does not own or operate any covered facility. Medical transportation workers moving patients in and out of a facility are excluded on the same condition.³

Wage Schedules by Facility Type

The law sorts covered employers into categories based on size, payer mix, and type of care. Each category has its own path to $25 per hour. Most annual rate changes take effect on July 1, not January 1.

Large Health Systems and Dialysis Clinics

Hospitals and integrated systems with 10,000 or more full-time equivalent employees, and all dialysis clinics regardless of size, are on the fastest track. These facilities started at $23 per hour on October 16, 2024, moved to $24 on July 1, 2025, and reach $25 on July 1, 2026.² County-run facilities in counties with more than five million residents (effectively Los Angeles County) follow the same accelerated schedule, starting January 1, 2025.⁴

Safety Net Hospitals and Small County Facilities

Safety net hospitals get the longest runway. A hospital qualifies as safety net if more than 90 percent of its patients are covered by Medicare or Medi-Cal, or if it is an independent hospital where that share exceeds 75 percent. Rural independent facilities are also in this group.²

These facilities started at $18 per hour and receive 3.5 percent annual increases each July 1 until they hit $25 on July 1, 2033.⁴ That puts the rate at $19.28 per hour as of July 1, 2026. County-run facilities in small counties (under 250,000 residents) follow the same slow schedule to $25 in 2033.²

Community Clinics, Rural Health Clinics, and Urgent Care Clinics

Community clinics, intermittent clinics, rural health clinics, and urgent care clinics associated with community or rural health clinics are on a mid-range schedule:

Through June 30, 2026: $21 per hour
July 1, 2026 to June 30, 2027: $22 per hour
July 1, 2027 onward: $25 per hour

This track reflects the thinner operating margins at clinics serving underserved populations.²

All Other Covered Facilities

Covered facilities that don’t fit any of the above categories, and are not county-run, follow this schedule:

Through June 30, 2026: $21 per hour
July 1, 2026 to June 30, 2028: $23 per hour
July 1, 2028 onward: $25 per hour

Medium county facilities (counties with between 250,000 and five million residents) run on this schedule, starting January 1, 2025.²

What Happens After $25

The rate doesn’t freeze once a category reaches $25 per hour. Each August, the Director of Finance calculates an annual adjustment equal to the lesser of 3.5 percent or the change in the U.S. Consumer Price Index. The new rate takes effect the following January 1.⁴

Who Is Not Covered

Several categories fall outside the law. A worker at an excluded facility has no claim to the healthcare minimum wage even if the person doing the same job at the hospital next door does.

Health care facilities owned, controlled, or operated by the State of California.
Skilled nursing facilities that are not owned or controlled by a hospital or integrated system. These stay excluded until the Legislature passes a separate patient care minimum spending requirement, and no such law currently exists.
Physician practices with fewer than 25 physicians, unless they otherwise qualify under another category.
Congregate living health facilities, which are entirely excluded.
Independent practice associations, unless they fit within another covered facility category.
Outpatient private practice physical therapy clinics providing only physical therapy, as long as they are not owned or controlled by a covered facility.

The standalone skilled nursing exclusion is the one that most often surprises workers. CNAs and care aides at unaffiliated nursing homes frequently assume they are covered, but the law’s protection turns on whether the facility is tied to a hospital system.²

Exempt Salary Threshold

The healthcare minimum wage also raises the salary floor for classifying a worker as exempt from overtime. An exempt employee at a covered facility must earn a salary of at least 1.5 times the applicable healthcare minimum wage or two times the state minimum wage, whichever is greater, and must meet the standard executive, administrative, or professional duties test.²

At a large hospital system paying $25 per hour as of July 2026, the exempt threshold is $37.50 per hour, roughly $78,000 a year for full-time work. At a facility still at $21 per hour, 1.5 times $21 is $31.50, but two times the state minimum of $16.90 is $33.80, so $33.80 controls. Misclassifying a salaried worker below these thresholds exposes the employer to unpaid overtime on top of any minimum wage shortfall.

If You’re Being Underpaid

You have three ways to recover unpaid wages. File an individual wage claim with the Labor Commissioner’s Wage Claim Adjudication Unit through the Division of Labor Standards Enforcement (no lawyer required), sue in court, or, if your employment agreement requires it, go to arbitration. You can also file a Report of Labor Law Violation with the Labor Commissioner’s Bureau of Field Enforcement. That route doesn’t pursue your individual claim, but it can prompt an investigation that helps every worker at the facility.²

A worker who wins is entitled to the unpaid wages, interest, and liquidated damages equal to the amount of unpaid wages. Liquidated damages can be reduced or denied if the employer proves it acted in good faith with reasonable grounds, but that defense is hard to sustain when a published wage schedule exists.⁵

Retaliation is separately illegal. An employer may not fire, demote, suspend, or otherwise punish you for filing a wage claim, complaining about unpaid wages, or taking part in an investigation. Adverse action within 90 days of your protected activity is presumed retaliatory, and the employer has to prove otherwise. A worker who proves retaliation can recover reinstatement, lost wages and benefits, and a civil penalty of up to $10,000 per violation, whether or not the underlying wage claim succeeds.⁶

1
Department of Industrial Relations. Minimum Wage
2
Department of Industrial Relations. Health Care Worker Minimum Wage Frequently Asked Questions
3
LegiScan. Bill Text CA SB525 2023-2024 Regular Session Chaptered
4
California Legislative Information. California Labor Code 1182.14
5
California Legislative Information. California Labor Code 1194.2
6
California Legislative Information. California Labor Code 98.6