Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is in part governed by, and funded pursuant to, federal Medicaid program provisions. Existing federal law generally requires, commencing in 2027, Medicaid beneficiaries between 19 and 64 years of age, inclusive, with income up to 138% of the federal poverty level, commonly known as Medicaid expansion adults, to demonstrate community engagement as a condition of Medicaid eligibility. Existing state law sets forth various provisions to conform to that federal requirement. Existing law requires, no sooner than January 1, 2027, as specified, an applicable individual to demonstrate work or community engagement. Existing law sets forth the mechanisms for an applicable individual to comply with that requirement on a monthly basis, including, among others, a minimum of 80 hours of work, community service, or participation in a work program, or a minimum of half-time enrollment in an educational program. This bill would make changes to the definitions of "applicable individual," "work program," and "educational program," and to some of the compliance mechanisms regarding monthly income, for purposes of the above-described provisions. When there is a conflict in reliable data sources that adversely impacts the eligibility of an applicant or beneficiary, the bill would require the county to request the applicant or beneficiary to confirm information before taking any adverse action on the application or renewal. Existing law requires a county, if it is unable to verify that an applicable individual either has met the requirement to demonstrate work or community engagement or was deemed to have demonstrated work or community engagement, to provide the individual with a notice of noncompliance, as specified, and to continue to provide the individual with Medi-Cal services during a 30-calendar-day period if the individual is enrolled in the Medi-Cal program. This bill would require the county to notify applicable individuals enrolled in the Medi-Cal program of the requirement to demonstrate work or community engagement based on certain delivery formats. For an applicable individual renewing their Medi-Cal enrollment during a 6-month redetermination period and who otherwise meets all other eligibility criteria, the bill would require the county to maintain active eligibility pending verification of work or community engagement until at least the last day of the month of the 30-calendar-day period. Under the bill, an applicable individual would be deemed to have received the notice of noncompliance 5 days after the date on the notice. Under the bill, self-attestation that the individual did not receive a timely notice would constitute good cause for not providing a satisfactory showing within the 30-calendar-day period. If no satisfactory showing is made after the 30-calendar-day period, the bill would require the department to consider all other bases of eligibility for medical assistance under the Medi-Cal state plan prior to denying coverage at application or determining that an individual is ineligible. The bill would authorize the department to defer implementation of any of the above-described changes if the change would result in a fiscal impact that would require an additional appropriation and that additional appropriation has not been made, as specified. By creating new duties for counties relating to Medi-Cal eligibility determinations with regard to work or community engagement, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Existing law establishes the California Children's Services (CCS) program, which is administered by the State Department of Health Care Services and counties, to provide medically necessary services, based on financial eligibility, for persons under 21 years of age who have certain medical conditions, including, among others, cystic fibrosis or hemophilia. Existing law provides for the Medi-Cal program, which is administered by the department, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law authorizes the department to establish a Whole Child Model program, under which managed care plans served by a county organized health system or Regional Health Authority in designated counties provide CCS treatment services to Medi-Cal eligible CCS children and youth. In implementing the program, existing law requires the department to, among other things, establish a statewide Whole Child Model program stakeholder advisory group and to consult with that advisory group on the implementation of the Whole Child Model program, as specified. Existing law terminates the advisory group on December 31, 2026. This bill would rename the statewide Whole Child Model program stakeholder advisory group to the California Children's Services (CCS) advisory group. The bill would require the advisory group to have specified membership, including no more than 6 representatives of CCS clients not enrolled in a managed care plan or enrolled in a managed care plan, but not on a family advisory committee, former CCS clients, and caregivers of former CCS clients, among others. The bill would also require the department to consult with the advisory group on the implementation of the CCS Classic program and to consider the recommendations of the advisory group in developing monitoring processes and outcome measures for the CCS program. The bill would require the department to publish two summary reports on its internet website by specified dates that describe the department's progress and actions on specified matters relating to the CCS program. The bill would delete the December 31, 2026, sunset date, and would instead make the provisions relating to the stakeholder advisory group and the related reporting requirement inoperative on January 1, 2037. This bill would make conforming changes to reflect the renaming of the advisory group.
Existing law, the Warren-911-Emergency Assistance Act, requires every local public agency to establish within its jurisdiction a basic emergency telephone system that includes, at a minimum, police, firefighting, and emergency medical and ambulance services. Existing law establishes the Office of Emergency Services within the office of the Governor and requires the office to be responsible for the state's emergency and disaster response services, as specified. Existing law requires the office, at specified intervals, to consult with, among others, the State Fire Marshal and the State Department of Public Health in order to review and update technical and operational standards for public agency systems. Existing law requires a public safety agency that provides "911" call processing services for emergency medical response to, by January 1, 2027, provide prearrival medical instructions to "911" callers requiring medical assistance, as specified. This bill would require a public safety agency described above that was not providing prearrival instructions to the "911" callers described above on or before January 1, 2027, to report to their local emergency medical services agency the status of their compliance with the above-described requirement on or before January 31, 2027.
The Child Care and Development Services Act, administered by the State Department of Social Services, establishes a system of childcare and development services for children up to 13 years of age. The Early Education Act requires the Superintendent of Public Instruction, to, among other things, provide an inclusive and cost-effective preschool program. Under both acts, the cost to a provider agency of providing an early childhood mental health consultation service is reimbursable if certain requirements are met, including that the consultation service uses a relationship-based model that includes specified components, including, among others, that, at least twice per program year, early care- and education setting-based mental health assessments are conducted and that there is, with the consent of parents or legal guardians, at least one screening of each enrolled child for adverse childhood experiences and screening for buffering factors. This bill would remove the requirement that the consultation service use a relationship-based model that includes those components in order to be reimbursable and would instead require that, in order to be reimbursable, the consultation service, among other things, uses a relationship-based model that incorporates, at least once per school or program year, an early care and education classroom observation tool that includes measures on the classroom environment, social-emotional learning climate, and teacher and child interactions to guide the specific activities and support the consultant will provide.
(1) Existing law requires the governing board of a school district to give diligent care to the health and physical development of pupils and authorizes the governing board of a school district to employ properly certified persons for this purpose. Existing law requires a school of a school district or county office of education and a charter school to notify pupils and parents or guardians of pupils no less than twice during the school year on how to initiate access to available pupil mental health services on campus or in the community, or both, as provided. Existing law requires the State Department of Education, on or before June 1, 2025, to develop model referral protocols for addressing pupil behavioral health concerns, as provided. This bill would require the department, on or before July 1, 2027, in consultation with appropriate stakeholders, to review and, as necessary, update the model referral protocols to include guidance on providing equity-centered mental health supports in case of a local emergency related to immigration enforcement activities or deportations of pupils or their family members. (2) Existing law requires the governing board or body of a local educational agency that serves pupils in grades 7 to 12, inclusive, before January 31, 2026, to adopt a policy on referral protocols for addressing pupil behavioral health concerns in grades 7 to 12, inclusive, as provided. This bill would require those local educational agencies, on or before July 1, 2028, to review and, as necessary, update that policy to include guidance on providing equity-centered mental health supports in case of a local emergency related to immigration enforcement activities or deportations of pupils or their family members. The bill would authorize an updated policy to either be based on the updated model referral protocols developed by the department or developed in consultation with school and community stakeholders and school-linked behavioral health professionals, and would require the updated policy to, at a minimum, address procedures relating to referrals to behavioral health professionals and support services. By imposing additional duties on local educational agencies, the bill would impose a state-mandated local program. (3) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which health care services are provided to qualified, low-income persons. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law authorizes a county board of supervisors to establish a commission to negotiate an exclusive contract with the department to provide, or arrange for the provision of, health care services under the Medi-Cal program. Pursuant to the authority described above, the County of Orange established a commission and existing law established the governance of that commission, known as the Orange County Health Authority or CalOptima, to provide health care services under the Medi-Cal program. Existing law prescribes who can serve on the 10-member governing body of the commission and requires each member to serve a 4-year term, except as described. This bill, for terms commencing after January 1, 2027, would impose one-, 2-, and 4-year terms of office, as specified. The bill would also prohibit specified voting members from serving more than two consecutive terms and from serving in that capacity for more than 10 consecutive years. The bill would require the governing body of the Orange County Health Authority to authorize and pay for an independent external audit of its governance procedures and practices, including the roles and responsibilities of the governing body, executive leadership, and staff, among others. The bill would require the audit to be completed by July 1, 2027, and would require that a copy of the report be provided to the Legislature and made public. Because this bill would impose a unique requirement on how services are provided on a local government and would require additional duties of county authorities, the bill would impose a state-mandated local program. This bill would make legislative findings and declarations as to the necessity of a special statute for County of Orange. Existing constitutional provisions require that a statute that limits the right of access to the meetings of public bodies or the writings of public officials and agencies be adopted with findings demonstrating the interest protected by the limitation and the need for protecting that interest. This bill would make legislative findings to that effect. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services, including pharmacy services and drugs. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law sets forth a schedule of benefits covered under the Medi-Cal program, including acupuncture, but only to the extent federal matching funds are provided for acupuncture. To the extent federal financial participation is available, this bill would require the Medi-Cal program to cover up to 24 acupuncture visits per beneficiary per calendar year and would state that additional visits per calendar year may be authorized based on medical necessity. This bill would incorporate additional changes to Section 14132 of the Welfare and Institutions Code proposed by AB 350 and SB 944 to be operative only if this bill and either or both AB 350 and SB 944 are enacted and this bill is enacted last. This bill would make certain provisions operative only if both this bill and SB 944 is enacted and takes effect on or before January 1, 2027.
The Donahoe Higher Education Act sets forth, among other things, the missions and functions of California's public and independent segments of higher education and their respective institutions of higher education. The act requests the Regents of the University of California, and requires the Trustees of the California State University, to require each campus in their respective segments to grant students the right to reenroll in their baccalaureate degree program after withdrawing or stopping out, if the student was in good academic standing with the university. This bill, commencing with the 2027–28 academic year, would require a campus of the University of California, the California State University, or the California Community Colleges, a private postsecondary educational institution, or an independent institution of higher education to adopt a written policy to allow a student to take a voluntary medical leave of absence for a period to be determined by the postsecondary educational institution, or for a period of up to one academic year, whichever is longer. The bill would prohibit the leave of absence policy from, among other things, requiring a student who takes a medical leave of absence to submit an official notice of withdrawal to the postsecondary educational institution. The bill would require a postsecondary educational institution, among other things, to post the medical leave of absence policy on the institution's internet website and notify students and faculty of the location of the posted policy on its internet website by sending an email at the beginning of each academic semester or term. These provisions would apply to the University of California only to the extent that the regents, by appropriate resolution, make them applicable. By imposing additional duties on community college districts, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Existing law, the Lesbian, Gay, Bisexual, Transgender, and Intersex Disparities Reduction Act, requires the State Department of Public Health, among other specified state entities, in the course of collecting demographic data directly or by contract as to the ancestry or ethnic origin of Californians, to collect voluntary self-identification information pertaining to sexual orientation, gender identity, and variations in sex characteristics/intersex status (SOGISC) . This bill would define "information pertaining to SOGISC" to mean information pertaining to a person's sexual orientation identity, gender identity, identification as intersex, or identification as possessing sex characteristics that vary from those typically associated with a person's sex assigned at birth. Existing law, the Information Practices Act of 1977, prescribes a set of requirements, prohibitions, and remedies applicable to agencies, as defined, with regard to their collection, storage, and disclosure of personal information, as defined. Under existing law, a person who willfully requests or obtains any record containing personal information from an agency under false pretenses is guilty of a misdemeanor. Existing law establishes the University of California, administered by the Regents of the University of California, the California State University, administered by the Trustees of the California State University, and the California Community Colleges, administered by the Board of Governors of the California Community Colleges, as the 3 segments of public postsecondary education in the state. Existing law requests the Trustees of the California State University, the Regents of the University of California, and the governing board of each community college district to allow the faculty, staff, and students to identify their sexual orientation, gender identity, and gender expression on any forms used to collect specified demographic data and to report that data, as provided. This bill would prohibit information pertaining to SOGISC collected pursuant to the Lesbian, Gay, Bisexual, Transgender, and Intersex Disparities Reduction Act, or collected by public postsecondary education institutions in accordance with the above paragraph, from being disclosed in a manner allowing personal identification to any entity outside of California state or local government, or an authorized agency thereof, subject to specified exceptions, and would require information pertaining to SOGISC reported in an identifiable form to be limited to the minimal extent required to meet the applicable exception, and in compliance with the Information Practices Act of 1977. The bill would require state entities under these provisions, after notifying the Legislature that the entity has the necessary automation capabilities, to share information pertaining to SOGISC in accordance with specified requirements when state and federal programs share systems or intake processes and that information is required for federal program participation. The bill would require the State Department of Social Services to comply with these provisions as early as possible following the notification set forth above, but no later than January 1, 2028. The bill would provide that these provisions also apply to information that could reasonably be used to infer a person's transgender or intersex status, as specified, and a that violation of these provisions is subject to penalties described in the Information Practices Act of 1977. By expanding the scope of a crime in the Information Practices Act of 1977, the bill would impose a state-mandated local program. Existing law, the California Public Records Act, requires each state and local agency, as defined, to make its records open to public inspection at all times during office hours, except as specifically exempted from disclosure by law. This bill would provide, subject to specified exceptions, that information pertaining to SOGISC is confidential and shall be exempt from disclosure by specified state entities under the California Public Records Act, unless the information pertaining to SOGISC is deidentified, or disclosed in accordance with the Information Practices Act of 1977. This bill would provide that its provisions are severable. Existing constitutional provisions require that a statute that limits the right of access to the meetings of public bodies or the writings of public officials and agencies be adopted with findings demonstrating the interest protected by the limitation and the need for protecting that interest. This bill would make legislative findings to that effect. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act's requirements a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law prohibits a contract between a plan or insurer and a dentist from requiring a dentist to accept an amount set by the plan or insurer as payment for dental care services provided to an enrollee or insured that are not covered services under the enrollee's contract or the insured's policy. Existing law requires a plan or insurer to make specified disclosures to an enrollee or insured regarding noncovered dental services. Existing law requires a health care service plan or health insurer to comply with specified timely access requirements. Under existing law, a health care service plan is required to annually report to the Department of Managed Health Care on this compliance. Existing law authorizes the Department of Insurance to issue guidance to insurers regarding annual timely access and network reporting methodologies. This bill would require a plan or insurer, including a specialized plan or insurer, covering dental services, to pay a noncontracting dental provider, which includes a registered dental hygienist in alternative practice, directly for covered services rendered to the enrollee or insured in accordance with the benefit provided in the contract or policy when the noncontracting dental provider submits to the plan or insurer an assignment of benefits. The bill would require a noncontracting dental provider to obtain a signed and dated consent to collect an assignment of benefits from an enrollee or insured. The bill would prohibit a noncontracting dental provider collecting an enrollee's or insured's assignment of benefits from charging an enrollee or insured, prior to the plan or insurer payment, more than an estimate of the enrollee's or the insured's cost sharing for the treatment or a deposit that approximates that cost share. Because a willful violation of these provisions relative to health care service plans would be a crime, this bill would impose a state-mandated local program. This bill would require a plan or insurer to certify, under penalty of perjury, that specified information submitted to its regulator regarding network adequacy is true and correct, thus creating a crime and imposing a state-mandated local program. Existing law, the Dental Practice Act, provides for the licensure and regulation of dentists and dental assistants by the Dental Board of California and the licensure and regulation of dental hygienists by the Dental Hygiene Board of California, and defines unprofessional conduct by a licensee, including, among other things, the violation of any provision of the act. Existing law authorizes the respective board to discipline a licensee under the act by placing the licensee on probation under various specified terms and conditions. This bill would require a noncontracting dental provider, including a registered dental hygienist in alternative practice, to make specified disclosures to a patient before collecting the patient's signed and dated consent to an assignment of benefits. The bill would expand the definition of unprofessional conduct under the act to include the failure to comply with that disclosure requirement and the above-described prohibition relating to the charging of a patient more than an estimate of their cost sharing and the failure to maintain a signed and dated copy of the patient's consent. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
