Medi-Cal: special commissions.

Section 14087.59(c)(5) term limitation language was corrected from garbled text ('shall not serve no more than two consecutive terms... 4-year terms and shall not serve in that capacity for more than 10 consecutive years') to clear language: 'shall not serve more than two consecutive 4-year terms and shall not serve in that capacity for more than 10 consecutive years.' This fixes a double negative and removes leftover drafting fragments that could have created ambiguity about whether term limits actually applied.

Subdivision (c) of Section 14087.59 was restructured from a nested format with sub-paragraphs (c)(1), (c)(2), and (c)(3) into a flat structure with paragraphs (1) through (7), improving readability without changing substantive content.

The legislative counsel's digest was cleaned up to remove a redundant and garbled sentence about staggered terms, retaining only the clear statement that the bill imposes one-, 2-, and 4-year terms of office for terms commencing after January 1, 2027.

The selection committee mechanism is entirely removed. Previously, a committee composed of the Senator, Assembly Member, and U.S. Representative with the most CalOptima members (plus other stakeholders) would nominate and select governing body members. Now members are simply nominated by the Orange County Health Care Agency and appointed by a majority vote of the Board of Supervisors.

A new 10-year consecutive service cap is added for governing body members described in subparagraphs (B) through (H). In addition to the existing two-consecutive-term limit, no member may serve in that capacity for more than 10 consecutive years total.

A new 12-month cooling-off period prevents a Board of Supervisors member who served on the governing body under subparagraph (A) from being appointed to any other governing body seat (subparagraphs B through H) within 12 months after their one-year term expires.

The governing body size is clarified as 10 members total: 9 voting members and 1 nonvoting member (the Director of the Orange County Health Care Agency). The prior version had ambiguous language referencing both 'nine members' and '10 members.'

A new Section 4 adds legislative findings under Section 3 of Article I of the California Constitution, justifying the limitation on public access to records related to the external audit. The findings state that confidentiality is necessary to protect proprietary information and prevent retaliation against interviewed staff.

The anti-retaliation protections for staff participating in the independent external audit are strengthened. The new version explicitly states that all information provided by staff will be stripped of identifying information and that staff will not be subject to professional discipline in retaliation for participating in or sharing information during the audit.

The governing body is reduced from 10 members (9 voting + 1 nonvoting) to a single 9-member board. The Director of the Orange County Health Care Agency, previously a nonvoting member, is now one of the nine voting members.

Two Board of Supervisors members and their alternate are removed from the governing body entirely. Their seats are replaced by the Director of the Orange County Health Care Agency and the Director of Social Services for the County of Orange.

New Section 14087.591 requires the governing body to authorize and pay for an independent external audit of governance procedures, including conflict-of-interest policies, separation of governance from operations, contracting and procurement practices, nomination policies, and whether executive leadership can independently conduct contracting. The audit must include staff interviews and anonymous feedback opportunities.

The audit report and any corrective action plan must be made available to the public, consistent with applicable confidentiality and proprietary information requirements.

The independent external audit report must be submitted to the Legislature and the department no later than July 1, 2027. The reporting requirement becomes inoperative on July 1, 2031. The governing body must develop a corrective action plan addressing identified deficiencies.

Term staggering provisions are updated: members in subparagraphs (C), (E), and (G) (rather than the prior (B), (E), and (G)) serve initial two-year terms, reflecting the renumbering after Board of Supervisors seats were removed. The provision barring someone who served a one-year term from being appointed to a four-year term within 12 months is deleted since no one-year terms remain.

References to 'CalOptima Orange County Health Authority member' are changed to 'Orange County Health Authority member' in several places, removing the CalOptima brand name from the statutory text.

The two Board of Supervisors seats on the CalOptima governing body are removed and replaced with the Director of the Orange County Health Care Agency and the Director of Social Services of the County of Orange, shifting governance from elected political officials to appointed administrative directors.

A new selection committee is established to nominate and select members of the governing body by majority vote. The committee includes the state Senator, Assembly Member, and U.S. Representative who each represent the most Medi-Cal beneficiaries enrolled in CalOptima (or their surrogates), plus an Orange County Health Authority member or family representative, an at-large representative, a financial or legal representative, an independent practice physician representative, a hospital representative, and a provider representative.

The term of office for members serving a term beginning after January 1, 2027, shall be determined by lot at the first meeting, providing a mechanism to stagger terms among new appointees.

The Assembly version's requirement that the commission provide access to books, documents, or records to authorized representatives of the Board of Supervisors is removed in the Senate version. The alternate Board of Supervisors member's right of access to records is retained, but the broader oversight access provision for the Board as a whole is eliminated.

References to 'CalOptima member' are updated throughout to 'CalOptima Orange County Health Authority member' for greater specificity and clarity.

The alternate member from the Board of Supervisors of Orange County is now explicitly granted the same right of access as any other governing body member to the commission's books, communications, documents, and records, including confidential materials in connection with closed session items.

The legislative counsel's digest was reorganized to separate existing law (governing body composition, Board of Supervisors membership requirements) from what the bill would newly require (staggered terms, access rights for the alternate member).