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<ns0:Id>20250AB__219499INT</ns0:Id>
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<ns0:ActionText>INTRODUCED</ns0:ActionText>
<ns0:ActionDate>2026-02-19</ns0:ActionDate>
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<ns0:SessionYear>2025</ns0:SessionYear>
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<ns0:AuthorText authorType="LEAD_AUTHOR">Introduced by Assembly Member Valencia</ns0:AuthorText>
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<ns0:Legislator>
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<ns0:House>ASSEMBLY</ns0:House>
<ns0:Name>Valencia</ns0:Name>
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<ns0:Title> An act to amend Section 14087.59 of the Welfare and Institutions Code, relating to Medi-Cal. </ns0:Title>
<ns0:RelatingClause>Medi-Cal</ns0:RelatingClause>
<ns0:GeneralSubject>
<ns0:Subject>Medi-Cal: special commissions.</ns0:Subject>
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<html:p>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.</html:p>
<html:p>Pursuant to the authority described above, the County of Orange established a 10-member 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 board and requires each member to serve a 4-year term, except as described.</html:p>
<html:p>This bill would require those terms to be staggered and would require, for the term beginning after January 1, 2027, 3 members to serve 2 years, with a 4-year term beginning thereafter. The bill would also require the commission to provide access to any books, documents, or records that are reasonably necessary to review the conduct of its activities to any authorized representative of the Board of Supervisors of the County of Orange. Because this bill would impose a unique requirement on how services are provided on a local government, the bill would impose a state-mandated local program.</html:p>
<html:p>This bill would make legislative findings and declarations as to the necessity of a special statute for County of Orange.</html:p>
<html:p>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.</html:p>
<html:p>This bill would provide that no reimbursement is required by this act for a specified reason.</html:p>
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<ns0:VoteRequired>MAJORITY</ns0:VoteRequired>
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<ns0:Preamble>The people of the State of California do enact as follows:</ns0:Preamble>
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<ns0:Num>SECTION 1.</ns0:Num>
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Section 14087.59 of the
<ns0:DocName>Welfare and Institutions Code</ns0:DocName>
is amended to read:
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<ns0:Num>14087.59.</ns0:Num>
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(a)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
Notwithstanding subdivision (d) of Section 14087.54, governance of the commission in the County of Orange established pursuant to Section 14087.54, known as the Orange County Health Authority, shall be vested in a governing body consisting of 10 members: 9 voting members and 1 nonvoting member. The nonvoting member shall be the Director of the Orange County Health Care Agency. The nine voting members shall be nominated by the Orange County Health Care Agency and appointed by a majority vote of the Board of Supervisors of the County of Orange and shall consist of the following:
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(A)
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Two members shall each be a member of the Board of Supervisors of the County of Orange, with one additional member of the Board of Supervisors of the
County of Orange to serve as an alternate.
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<html:p>
(B)
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One member shall be a current or former hospital administrator.
</html:p>
<html:p>
(C)
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One member shall be a representative of a community clinic, which may include, but is not limited to, a representative of a federally qualified health center, as defined in Section 1396d(l)(2)(B) of Title 42 of the United States Code.
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<html:p>
(D)
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One member shall be a member of the public who is a legal resident of the County of Orange.
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<html:p>
(E)
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One member shall be a practicing licensed medical provider who is not an owner or officer, or a member of the board of directors, of a contracted independent physician’s association or provider network.
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<html:p>
(F)
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One member shall be a current CalOptima
member or a family member of a current CalOptima member.
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<html:p>
(G)
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One member shall be an accounting or public finance professional, or an attorney who is an active member of the State Bar.
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<html:p>
(H)
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One member shall be a practicing licensed physician who is a representative of a contracted independent physician’s association or provider network.
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<html:p>
(2)
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For purposes of identifying qualified individuals to be considered as members of the governing body, the Board of Supervisors of the County of Orange shall consult with stakeholders in the County of Orange, including, but not limited to, providers who serve CalOptima members, consumers, and advocates.
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<html:p>
(b)
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Each member of the governing body shall reside in, or be employed in, the County of Orange and shall be generally
representative of the diverse backgrounds, interests, and demography of persons residing in the County of Orange. Each member of the governing body shall have a commitment to a health care system that seeks to improve access to high-quality health care for persons served by the commission and that in fact delivers high-quality care and is financially viable. Each member shall possess the requisite skills and knowledge necessary to design and operate a quality publicly assisted health care delivery system.
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<html:p>
(c)
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(1)
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Members of the governing body of the commission shall serve four-year terms, which shall be staggered, except for those members who are members of the Board of Supervisors of the County of Orange who shall serve a one-year term.
The term of office of members of the governing body described in any of subparagraphs (B) to (H), inclusive, of paragraph (1) of subdivision (a) duly serving prior to January 1, 2027, shall remain unchanged. For the term beginning after January 1, 2027, members of the governing body described in subparagraphs (B), (E), and (G) of paragraph (1) of subdivision (a) shall serve a two-year term. Thereafter, those members shall serve a four-year term and are subject to the limitations provided for in paragraph (2) of this subdivision. Members who are appointed to fill the unexpired term of a vacant seat shall have an initial term that corresponds to the unexpired term of the vacant seat. A vacancy that occurs in the last 90 days of a term shall not be filled until the expiration of the term.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
A member of the governing body described in any of subparagraphs (B) to (H), inclusive, of paragraph (1) of
subdivision (a) shall serve no more than two consecutive terms. An individual who served a one-year term on the governing body as described in paragraph (1) may not be appointed to serve a four-year term under any of subparagraphs (B) to (H), inclusive, of paragraph (1) of subdivision (a) within 12 months of the expiration of their one-year term. The limitations set forth in this paragraph apply only to service for consecutive terms. No other limitation on the number of terms a person may serve is intended.
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<html:p>
(3)
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A member of the governing body of the commission may be removed from the governing body by a vote in favor of that removal of at least two-thirds of the full membership of the Board of Supervisors of the County of Orange.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
The governing body of the commission, subject to a two-thirds vote of the full membership, may increase the number of public members, or the number of
members who are current CalOptima members or family members of current CalOptima members who may serve as a member of the governing body, subject to an affirmative vote by a majority of the Board of Supervisors of the County of Orange, provided, however, that a change in the composition of the governing body under this subdivision shall not result in the elimination of any member described in paragraph (1) of subdivision (a).
</html:p>
<html:p>
(e)
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Each member of the governing body shall have the responsibility and duty to follow the requirements of applicable federal and state laws and regulations, including Section 1090 of the Government Code, the applicable provisions of Sections 87100 to 87500, inclusive, of the Government Code, and Section 14047.6 of this code, to serve the public interest of the members of CalOptima, and to ensure the operational well-being and fiscal solvency of the Orange County Health Authority. Members of the governing body shall
further strive to improve health care quality, promote prevention and wellness, ensure the provision of cost-effective health and behavioral health care services, reduce health disparities, address the needs of Medi-Cal members who are affected by homelessness and housing instability, improve quality outcomes, and manage the risk and needs of Medi-Cal beneficiaries through whole-person care approaches and addressing social determinants of health. The Orange County Health Authority shall work to earn the public’s trust through its commitment to accountability, responsiveness, transparency, reliability, and cooperation.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
A member of the governing body who has a financial interest, within the meaning of Section 87100 of the Government Code, in a decision before the governing body shall, upon identifying a conflict of interest or a potential conflict of interest and immediately prior to the consideration of the matter, do all of the
following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
Publicly identify the financial interest that gives rise to the conflict of interest or potential conflict of interest in detail sufficient to be understood by the public, except that disclosure of the exact street address of a residence is not required.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Recuse the member’s own self from discussing and voting on the matter.
</html:p>
<html:p>
(3)
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Leave the room until after the discussion, vote, and any other disposition of the matter is concluded, unless the matter has been placed on the portion of the agenda reserved for uncontested matters.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
Notwithstanding paragraph (3), the member may speak on the issue during the time that the general public speaks on the issue.
</html:p>
<html:p>
(g)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
A member of the governing body shall not, for a period of one year after leaving office, act as an agent or attorney for, or otherwise represent, for compensation, any other person, by making any formal or informal appearance before, or by making any oral or written communication to, the commission, or any committee, subcommittee, or present member of the commission, or any officer or employee of the commission, if the appearance or communication is made for the purpose of influencing administrative action or influencing any action or proceeding involving the issuance, amendment, awarding, or revocation of a permit, license, grant, or contract, or the sale or purchase of goods or property.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
In addition to paragraph (1), a member of the governing body described in subparagraphs (A) and (G) of paragraph (1) of subdivision (a) shall not, for a period of one year after leaving office, serve as an employee, agent, or attorney, or
otherwise represent, for compensation, the Orange County Health Authority or any other entity that received an expenditure of Medi-Cal funds from the Orange County Health Authority during the prior five years. This paragraph does not apply to expenditures of Medi-Cal funds from the Orange County Health Authority for routine administrative expenses for reimbursement for travel, continuing education costs, routine office expenses, and other ongoing routine administrative expenses. This paragraph does not prevent any member from returning to or continuing the role that they held when they were appointed to the governing body.
</html:p>
<html:p>
(h)
<html:span class="EnSpace"/>
The commission shall provide access to any books, documents, or records that are reasonably necessary to review the conduct of its activities to any authorized representative of the Board of Supervisors of the County of Orange.
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<ns0:Num>SEC. 2.</ns0:Num>
<ns0:Content>
<html:p>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 unique circumstances applicable to the County of Orange with respect to the operation and governance of the Orange County Health Authority, which is a county-organized health system known as CalOptima.</html:p>
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<ns0:BillSection id="id_8E086F89-159D-457F-9551-08E8FED34E25">
<ns0:Num>SEC. 3.</ns0:Num>
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<html:p>
No reimbursement is required by this act pursuant to Section 6 of Article XIII
<html:span class="ThinSpace"/>
B of the California Constitution because the only costs that may be incurred by a local agency or school district are the result of a program for which legislative authority was requested by that local agency or school district, within the meaning of Section 17556 of the Government Code and Section 6 of Article XIII
<html:span class="ThinSpace"/>
B of the California Constitution.
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