Asm. Dawn Addis

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 a crime. Existing law provides for the regulation of disability insurers by the Department of Insurance. Existing law generally authorizes a health care service plan or disability insurer to use prior authorization and other utilization review or utilization management functions, under which a licensed physician or a licensed health care professional who is competent to evaluate specific clinical issues may approve, modify, delay, or deny requests for health care services based on medical necessity. This bill, upon communication of a decision by a health care service plan or health insurer delaying, denying, or modifying a health care service based in whole or in part on medical necessity, would authorize a provider to request review of the decision by a licensed physician, or a licensed health care professional under specified circumstances, who is competent to evaluate the specific clinical issues involved in the health care service being requested, and is of the same or similar specialty as the requesting provider. The bill would authorize a licensed health care professional to be the reviewer if the provider requesting peer-to-peer review is not a physician. The bill, notwithstanding any other law, would require these reviews to occur within 2 business days, or if an enrollee or insured faces an imminent and serious threat to their health, within a timely fashion appropriate for the nature of the enrollee's or insured's condition, as specified. If a health care service plan or health insurer fails to meet those timelines, the bill would deem the request for the health care service as approved and supersede any prior delay, denial, or modification. Because a violation of these provisions by a health care service plan would be a crime, this 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 no reimbursement is required by this act for a specified reason.

Existing law authorizes the governing board of a school district that determines during a fiscal year that its revenues are less than the amount necessary to meet its current year expenditure obligations to request an emergency apportionment through the Superintendent of Public Instruction, subject to specified requirements. Existing law authorizes emergency apportionments to be provided through an interim loan from the General Fund and lease financing made available by the California Infrastructure and Economic Development Bank, which is authorized to issue bonds for purposes of the emergency apportionments and related costs, or as an alternative to lease financing, as an emergency apportionment from the General Fund. Existing law prescribes the financing conditions on emergency apportionments, including the calculation of the interest rate. Existing law, notwithstanding any other law, authorizes the Inglewood Unified School District, through the State Department of Education, to request cashflow loans from the General Fund for a total of up to $55,000,000 for emergency operational purposes, as provided. Existing law requires the interest on these loans to be charged at the annual rate of return of the Pooled Money Investment Account, plus an additional 2%. This bill, notwithstanding any other law, and once the Inglewood Unified School District has successfully repaid at least 10 years of a General Fund cashflow loan made pursuant to those provisions, would authorize the school district to seek, and would require the Department of Finance to grant, a waiver of interest on that loan for the next succeeding fiscal year if specified conditions are met, including, among other conditions, that the Los Angeles County Superintendent of Schools, in consultation with the County Office Fiscal Crisis and Management Assistance Team, determines that the school district is making substantial progress towards fiscal solvency and that a waiver of interest would help the school district to exit receivership, as provided. In each subsequent fiscal year, the bill would authorize the school district to seek, and would require the Department of Finance to grant, a subsequent waiver of interest for the applicable fiscal year if the school district again meets those same requirements. To the extent the bill would impose additional duties on the Los Angeles County Superintendent of Schools, 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 the Inglewood Unified School District. 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 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. For a specified plan or insurer offering coverage for dental services, existing law requires urgent dental appointments to be offered within 72 hours of a request, nonurgent dental appointments to be offered within 36 business days of a request, and preventive dental care appointments to be offered within 40 business days of a request, as specified. Existing law requires a contract between a health care service plan and health care provider to ensure compliance with network adequacy standards and to require reporting by providers to plans to ensure compliance. 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. If a health care service plan or health insurer pays a contracting dental provider directly for covered services, this bill would require the plan or insurer to pay a noncontracting dental provider directly for covered services if the noncontracting provider submits to the plan or insurer a written assignment of benefits form signed by the enrollee or insured. The bill would require the plan or insurer to provide a predetermination or prior authorization to the dental provider and to reimburse the provider for not less than that amount, except as specified. The bill would require the plan or insurer to notify the enrollee or insured that the provider was paid and that the out-of-network cost may count towards their annual or lifetime maximum. The bill would require a noncontracting dental provider to make specified disclosures to an enrollee or insured before accepting an assignment of benefits. This bill would require specified plans and insurers that cover dental services to offer urgent dental appointments within 48 hours of a request, nonurgent dental appointments within 18 business days of a request, and preventive dental care appointments within 20 business days of a request, as specified. The bill would subject dentists to the relevant department's regulatory geographic accessibility standards. The bill would require plans and insurers to report comprehensive information regarding the networks that each dental provider serves. The bill would require the Department of Managed Health Care or the Department of Insurance to review the adequacy of an entire dental provider network, including the portions of the network serving plans and insurers not regulated by the respective department. Because a willful violation of the above-described provisions by a health care service plan would be a crime, this 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 no reimbursement is required by this act for a specified reason.

Under existing law, a hunting license grants the privilege to take birds and mammals. Existing law requires the Department of Fish and Wildlife to issue an annual hunting license upon payment of a specified fee that varies in amount depending on the age and residency of the applicant. Under existing law, an annual hunting license is valid for a term of one year beginning on July 1 or for the remainder of the term if issued after July 1. Existing law also requires the department to issue a lifetime hunting license to a resident of the state upon payment of a specified fee that varies in amount depending on the age of the person. This bill would require the department, beginning July 1, 2027, to ensure that every person who purchases a hunting license receives, at minimum, information on certain topics related to firearms, including the safe storage of firearms, liability for parents and guardians who should have known their child could access a firearm at home, basic California firearm laws, and how to legally transfer or relinquish a firearm. The bill would authorize the department, in cooperation with the Department of Justice, to promulgate regulations regarding the implementation of this requirement, and to include additional information to be provided with a hunting license.

Existing law establishes a public school financing system that requires state funding for county superintendents of schools, school districts, and charter schools to be calculated pursuant to a local control funding formula (LCFF) , as specified. Existing law requires funding pursuant to the LCFF to include, among other things, the sum of a base grant, supplemental grant, and concentration grant, if applicable, multiplied by average daily attendance, as provided. Existing law authorizes a school district or charter school to maintain a transitional kindergarten program. Existing law requires a school district or a charter school, as a condition of receipt of apportionment for pupils in a transitional kindergarten program, to ensure that, beginning with the 2025–26 school year, a child who will have their 4th birthday by September 1 of a school year be admitted to a transitional kindergarten program maintained by the school district or charter school. Under existing law, pursuant to the LCFF, school districts and charter schools receive, as funding for transitional kindergarten, the sum of a base grant, a supplemental grant, a concentration grant, if applicable, and a transitional kindergarten add-on, multiplied by transitional kindergarten average daily attendance, as provided. Under existing law, school districts that receive local revenues that exceed the LCFF amount do not receive a specified apportionment of LCFF funds, as provided, and are known as "basic aid school districts" or "excess tax entities." Existing law, notwithstanding those provisions, requires charter schools and school districts, including basic aid districts, to receive a minimum level of state-aid funding, as provided. This bill would, commencing with the 2025–26 fiscal year, require the minimum level of state funding for basic aid districts to include both the above-described sum of the LCFF base, supplemental, and concentration grants for transitional kindergarten, and an unspecified add-on amount for transitional kindergarten, multiplied by transitional kindergarten average daily attendance, as provided. Existing law provides for the funding of necessary small schools and high schools, as specified. Existing law requires that funding to be based on, among other things, the necessary small school's average daily attendance and the number of full-time teachers, as specified. Existing law requires these necessary small school amounts to be added to the LCFF calculations for school districts with necessary small schools, as provided. This bill would, commencing with the 2025–26 fiscal year, and for each fiscal year thereafter, require the Superintendent of Public Instruction to allocate funding for pupils attending transitional kindergarten in certain necessary small schools, as provided. The bill would require this allocation to include, for any average daily attendance generated by pupils attending a transitional kindergarten program in the necessary small school, the sum of the above-described LCFF base grant, supplemental grant, and concentration grant, if applicable, and transitional kindergarten add-on amounts, as provided. The bill would, commencing with the 2025–26 fiscal year, and for each fiscal year thereafter, appropriate the amount of funding necessary to implement the required allocations for the applicable fiscal year from the General Fund to the Superintendent for allocation to necessary small schools under these provisions. Funds appropriated by this bill would be applied toward the minimum funding requirements for school districts and community college districts imposed by Section 8 of Article XVI of the California Constitution.

Existing law requires school districts, county offices of education, and charter schools to provide emergency epinephrine auto-injectors to school nurses or trained volunteer personnel, and authorizes school nurses and trained personnel to use epinephrine auto-injectors to provide emergency medical aid to persons suffering, or reasonably believed to be suffering, from an anaphylactic reaction, as provided. Existing law requires school districts, county offices of education, and charter schools to, among other things, store those emergency epinephrine auto-injectors in an accessible location upon need for emergency use and include that location in specified annual notices. Existing law authorizes a pupil to carry and self-administer prescription auto-injectable epinephrine if the school district receives specified written statements from a physician and surgeon or a physician assistant, and from the parent, foster parent, or guardian of the pupil, as specified. This bill would replace all references to epinephrine auto-injectors or auto-injectable epinephrine in the above-described provisions with references instead to epinephrine delivery systems, as defined, and would require school districts, county offices of education, and charter schools to instead provide at least one type of United States Food and Drug Administration-approved epinephrine delivery system, as specified. To the extent the bill would impose additional duties on local educational agencies, 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. This bill would declare that it is to take effect immediately as an urgency statute.

Existing federal law provides for the Medicare Program, which is a public health insurance program for persons 65 years of age and older and specified persons with disabilities who are under 65 years of age. Existing federal law specifies parts of Medicare that cover specific services, such as Medicare Part B, which generally covers medically necessary services and supplies and preventive services. 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 a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing federal law additionally provides for the issuance of Medicare supplement policies or certificates, also known as Medigap coverage, which are advertised, marketed, or designed primarily as a supplement to reimbursements under the Medicare Program for the hospital, medical, or surgical expenses of persons eligible for the Medicare Program, including coverage of Medicare deductible, copayment, or coinsurance amounts, as specified. Existing law, among other provisions, requires supplement benefit plans to be uniform in structure, language, designation, and format with the standard benefit plans, as prescribed. Existing law prohibits an issuer from denying or conditioning the offering or effectiveness of any Medicare supplement contract, policy, or certificate available for sale in this state, or discriminating in the pricing of a contract, policy, or certificate because of the health status, claims experience, receipt of health care, or medical condition of an applicant in the case of an application that is submitted prior to or during the 6-month period beginning with the first day of the first month in which an individual is both 65 years of age or older and is enrolled for benefits under Medicare Part B. Existing law requires an issuer to make available specified Medicare supplement benefit plans to a qualifying applicant under those circumstances who is 64 years of age or younger who does not have end stage renal disease. This bill would delete the exclusion of otherwise qualified applicants who have end stage renal disease, thereby making the specified Medicare supplement benefit plans available to those individuals. The bill, on and after January 1, 2027, would prohibit an issuer of Medicare supplement coverage in this state from denying or conditioning the issuance or effectiveness of any Medicare supplement coverage available for sale in the state, or discriminate in the pricing of that coverage because of the health status, claims experience, receipt of health care, medical condition, or age of an applicant, except as specified, if an application for coverage is submitted during an open enrollment period, as specified in the bill. The bill would entitle an individual enrolled in Medicare Part B to a 90-day annual open enrollment period beginning on January 1 of each year, as specified, during which period the bill would require applications to be accepted for any Medicare supplement coverage available from an issuer, as specified. The bill would require the open enrollment period to be a guaranteed issue period. The bill would authorize premium rates offered to applicants during the open enrollment period to vary based on the applicants' age at the time of issue, as specified, but would prohibit the premiums from varying based on age after the contract is issued. Because a violation of the bill's requirements by a health care service plan would be a crime, 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 no reimbursement is required by this act for a specified reason.

Existing law requires the State Board of Education to adopt statewide academically rigorous content standards in the core curriculum areas of reading, writing, mathematics, history/social science, and science, as specified. Existing law requires the Instructional Quality Commission to, among other things, recommend curriculum frameworks to the state board and develop criteria for evaluating instructional materials. This bill would require the state board to, on or before January 1, 2028, develop and adopt academically rigorous content standards for ethnic studies instruction in high school. The bill would require the commission, on or before January 1, 2028, to review and recommend to the state board curriculum frameworks and instructional materials for ethnic studies instruction in high school, as specified. The bill would require the state board to provide the commission with evaluation criteria to use in providing its review and recommendations. The bill would state the intent of the Legislature to enact subsequent legislation to establish an advisory committee with a majority of the advisory committee's members being experts in African American studies, Asian American and Pacific Islander studies, Native American studies, and Latino and Chicanx studies, to provide input to the state board on proposed content standards and to the commission on proposed curriculum frameworks and instructional materials for ethnic studies instruction in high school. Existing law requires a pupil to complete designated coursework while in grades 9 to 12, inclusive, in order to receive a diploma of graduation from high school. These graduation requirements include, commencing for pupils graduating in the 2029–30 school year, the completion of a one-semester course in ethnic studies meeting specified requirements. Under existing law, the requirement to complete an ethnic studies course may be fulfilled by the completion of, among others, a course based on the model curriculum developed by the Instructional Quality Commission, an ethnic studies course taught as part of a course that has been approved as meeting the A–G requirements of the University of California and the California State University, or a locally developed ethnic studies course approved by the governing board of a school district or the governing body of a charter school. Existing law requires the curriculum, instruction, and instructional materials for these ethnic studies courses to meet specified requirements, including that they not reflect or promote any bias, bigotry, or discrimination against any person or group of persons on the basis of certain characteristics. Existing law makes these provisions relating to ethnic studies courses operative only upon an appropriation of funds by the Legislature for purposes of these provisions. This bill would require the curriculum, instruction, and instructional materials for any high school ethnic studies course, including ethnic studies courses meeting high school graduation requirements, to meet the above-described requirements, and would require the curriculum, instruction, and instructional materials for all high school ethnic studies courses to additionally, among other things, foster multicultural respect and understanding and focus on the domestic experience and stories of historically marginalized peoples in American society. To the extent that the bill would impose new duties on local educational agencies, the bill would impose a state-mandated local program. The bill would require a school district, county office of education, or charter school to provide, on or before June 30, 2026, the State Department of Education with a copy of all curricula, instruction, and instructional materials in ethnic studies that schools offer or plan to offer to pupils in any of grades 9 to 12, inclusive, and the adoption calendar for curricula, instruction, and instructional materials in ethnic studies proposed for adoption by the governing board or body of the local educational agency for instruction to these pupils. The bill would require a local educational agency that does not have an ethnic studies course in place for its pupils in any of grades 9 to 12, inclusive, on or before June 30, 2026, to provide the department with a copy of all curricula, instruction, and instructional materials in ethnic studies that its schools seek to adopt at least 60 days before being first presented at a public meeting of the governing board or body of the local educational agency for instruction to these pupils. The bill would require the department to post the information received pursuant to these requirements on its internet website. To the extent that the bill would impose new duties on local educational agencies, it would impose a state-mandated local program. The bill would require the department to monitor compliance with the requirements of this bill as part of its annual compliance monitoring of state and federal programs and to provide a report to the relevant policy and fiscal committees of the Legislature summarizing the data collected through compliance monitoring, as specified. 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.

The California Environmental Quality Act (CEQA) requires a lead agency, as defined, to prepare, or cause to be prepared, and certify the completion of an environmental impact report (EIR) on a project that it proposes to carry out or approve that may have a significant effect on the environment or to adopt a negative declaration if it finds that the project will not have that effect. CEQA also requires a lead agency to prepare a mitigated negative declaration for a project that may have a significant effect on the environment if revisions in the project would avoid or mitigate that effect and there is no substantial evidence that the project, as revised, would have a significant effect on the environment. Existing law exempts from CEQA a rezoning that implements the schedule of actions contained in an approved housing element, as specified, except, among other things, a rezoning that would allow for the construction of a distribution center or for oil and gas infrastructure. This bill would instead exempt a rezoning to the extent that it is necessary to implement a schedule of actions contained in an approved housing element, except, among other things, a rezoning that would allow for the construction of a distribution center, for a tourism facility, as defined, or for oil and gas infrastructure. Existing law, for a proposed housing development project, as defined, that would otherwise be exempt from CEQA pursuant to a statutory exemption or specified categorical exemptions, but for a single condition, limits the application of CEQA to the effects upon the environment that are caused by that single condition, except as provided. This bill, for purposes of those provisions, would modify the definition of housing development project to exclude a project that has any portion of the project designated for use as a tourism facility, as defined. To the extent that this would create new duties for a lead agency, this bill would impose a state-mandated local program. Existing law exempts specified projects from CEQA, including a project that consists exclusively of a facility for advanced manufacturing, as defined, if the project is located on a site zoned exclusively for industrial uses. Existing law excludes projects located on natural and protected lands, as defined, from these exemptions, as provided. Existing law includes in the definition of natural and protected lands, lands protected as preserve areas or reserve lands pursuant to an adopted natural community conservation plan or habitat conservation plan, as specified. This bill would instead include, for that portion of the definition of natural and protected lands, lands identified for conservation in an adopted natural community conservation plan, habitat conservation plan, or other adopted natural resource protection plan, as specified. The bill would also expand the definition of natural and protected lands to include habitat for protected species, as specified, fully protected species, or species protected by the federal Endangered Species Act of 1973, the California Endangered Species Act, or the Native Plant Protection Act. The bill would eliminate the exemption from CEQA for advanced manufacturing projects. The bill would instead exempt from CEQA, until January 1, 2030, a project that consists exclusively of a facility for semiconductor manufacturing if the project is located on a site that was zoned exclusively for heavy industrial use on or before August 1, 2025, and meets specified criteria, including, among other things, that the project does not involve the storage, use, or discharge of extremely hazardous gases or chemicals above California's accidental release program reporting thresholds, the project applicant demonstrates high road employment standards and certifies to the lead agency that it will maintain those standards in the development, construction, and operation of the facility, and the project applicant has provided a legally binding commitment to comply with specified labor-related requirements with respect to the initial construction of the facility and subsequent maintenance that is contracted out to a contractor in the construction industry, as specified. Because a lead agency would be required to determine the applicability of this exemption, the bill would impose a state-mandated local program. The bill would require the State Energy Resources Conservation and Development Commission to develop and make available to lead agencies guidelines for evaluating whether a project applicant demonstrates high road employment standards. The bill would require the Office of Land Use and Climate Innovation, on or before January 1, 2029, to report to the Legislature on projects that were exempted from CEQA pursuant to the above exemption, as provided, and require the report to include a list of the projects for semiconductor manufacturing facilities that have been approved for development in the state, as specified. CEQA requires in an action or proceeding to attack, review, set aside, void, or annul certain acts or decisions of a public agency to be commenced according to a specified process and requires the record of proceedings to contain specified information, including all internal agency communications, except as specified. Existing law provides that for those projects that do not include a distribution center or oil and gas infrastructure, internal agency communication does not include staff notes and electronic internal agency communications, including emails, that were not presented to the final decisionmaking body, other than those communications and documents consulted, or reviewed by the lead agency executive or a local agency executive, as provided, thereby limiting what the record of proceeding is required to contain for these projects. This bill would eliminate the above-described limitation on internal agency communication required to be included in the record of proceedings for those projects that do not include a distribution center or oil and gas infrastructure, thereby requiring additional information to be included in the record of proceeding. By imposing new duties on a lead agency in order to comply with this provision, the bill would create 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 no reimbursement is required by this act for a specified reason.

Existing law, the State Civil Service Act, regulates employment with the state and vests in the Department of Human Resources all powers, duties, and authority necessary to operate the state civil service system. Existing law establishes standards for the use of personal services contracts by state agencies. Existing law permits personal services contracting to achieve cost savings when specified conditions are met, including that the contract does not cause the displacement of civil service employees. Existing law establishes the Department of Corrections and Rehabilitation in state government, with jurisdiction over persons committed to the state prison. Existing law also establishes the State Department of State Hospitals within the California Health and Human Services Agency, with jurisdiction over specified facilities for the treatment of persons with mental health disorders. This bill would require the Department of Corrections and Rehabilitation and the State Department of State Hospitals, before entering into a personal services contract to have a contractor fill a budgeted State Bargaining Unit 16 (BU-16) physician position or a State Bargaining Unit 19 (BU-19) psychologist position, to take specified actions. Among others, these actions would include preparing an analysis comparing the hourly cost of a contractor to a civil service BU-16 physician or BU-19 psychologist. The bill would require these departments to submit an annual report detailing certain information about contractors and civil service physicians and psychologists to BU-16, BU-19, and specified legislative committees.