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 law generally authorizes a health care service plan or health 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. Existing law requires a health care service plan or health insurer, including those plans or insurers that delegate utilization review or utilization management functions to medical groups, independent practice associations, or to other contracting providers, to comply with specified requirements and limitations on their utilization review or utilization management functions. Existing law requires the criteria or guidelines used to determine whether or not to authorize, modify, or deny health care services to be developed with involvement from actively practicing health care providers. On or after January 1, 2026, this bill would prohibit a health care service plan or health insurer from requiring a contracted health professional to complete or obtain a prior authorization for any covered health care services if the plan or insurer approved or would have approved not less than 90% of the prior authorization requests they submitted in the most recent completed one-year contracted period. The bill would set standards for this exemption and its denial, rescission, and appeal. The bill would authorize a plan or insurer to evaluate the continuation of an exemption not more than once every 12 months, and would authorize a plan or insurer to rescind an exemption only at the end of the 12-month period and only if specified criteria are met. The bill would require a plan or insurer to provide an electronic prior authorization process. The bill would also require a plan or insurer to have a process for annually monitoring prior authorization approval, modification, appeal, and denial rates to identify services, items, and supplies that are regularly approved, and to discontinue prior authorization on those services, items, and supplies that are approved 95% of the time. Because a willful violation of the bill's requirements relative to health care service plans 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.
Sponsored bills
Existing law, the Mobilehome Parks Act, generally regulates various classifications of mobilehome and related vehicle parks, and imposes enforcement duties on the Department of Housing and Community Development and local enforcement agencies. The act authorizes any person to file an application with the governing body of a city or county for a conditional use permit for a mobilehome park. The act requires a person, before operating a mobilehome park, and each year thereafter, to obtain a valid permit from the enforcement agency in order to operate the park. The act also requires the owner of a mobilehome park to obtain a permit to create, move, shift, or alter park lot lines. This bill would authorize an owner of an existing mobilehome park that is subject to, or intends to qualify for, a valid permit to operate the park, to apply to the enforcement agency to add additional specified spaces to the mobilehome park not to exceed 10% of the previously approved number of spaces in the mobilehome park, if the owner has not been served with a notice of violation that constitutes an imminent threat to health and safety. The bill would exempt the additional spaces from any business tax, local registration fee, use permit fee, or other fee, except those fees that apply to the existing spaces in the park. Existing law, 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 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. CEQA does not apply to the approval of ministerial projects. This bill would prohibit the enforcement agency, city, or county from requiring a conditional use permit, zoning variance, or other zoning approval in order to add the spaces. By requiring a city or county to ministerially approve a project to add the mobilehome park spaces described above, this bill would exempt those projects from CEQA.
The California Constitution provides that the University of California constitutes a public trust, and requires the university to be administered by the Regents of the University of California, a corporation in the form of a board, with full powers of organization and government, subject to legislative control only for specified purposes. The California Native American Graves Protection and Repatriation Act of 2001 requires all agencies and museums, which is defined to include higher education institutions, that receive state funding and have possession or control over collections of California Native American human remains and associated funerary objects to inventory those remains and objects for repatriation to the appropriate California Indian tribes, as specified. As a condition for using state funds to handle and maintain Native American human remains and cultural items, this bill would require the office of the President of the University of California to comply with various requirements regarding repatriation of Native American human remains and cultural items, as provided.
(1) Existing law subjects foster care provider applicants, resource family applicants, and certain other adults in those homes, to a criminal records check and requires the applicant or other adult in the applicant's home to obtain a criminal record clearance or criminal record exemption prior to licensure or approval. Existing law prohibits the State Department of Social Services or other approving entity from granting a criminal records exemption, except as specified, to an applicant or other adult in the applicant's home who has been convicted of certain felonies. Existing law authorizes the State Department of Social Services or other approving entity, for the purpose of the resource family approval process described below, to grant an exemption from disqualification for the conviction of a felony for which a criminal record exemption cannot be granted if the applicant is a relative seeking placement of a specific relative child or children, the applicant or other adult living in the home is of present good character necessary to justify granting the exemption, and the applicant or other adult living in the home has not been convicted of certain felonies within the last 5 years. This bill would, among other things, additionally authorize the department, or other approving entity, to grant an exemption under those circumstances to a nonrelative extended family member or an extended family member. (2) Existing law authorizes the court to order temporary placement of the child in the home of a relative, extended family member, or nonrelative extended family member, and requires the court to consider the results of a criminal records check, among other things, before ordering that placement. Existing law also authorizes the placement of a child on an emergency basis in the home of a relative or nonrelative extended family member, and requires the relative or nonrelative extended family member to submit an application for approval as a resource family after the emergency placement. Existing law authorizes the court to place a child after an order of removal, or on a temporary or emergency basis in the home of a relative, regardless of the status of any criminal record exemption or resource family approval if the court finds that the placement does not pose a risk to the health and safety of the child. This bill would also authorize the court to place a child after an order of removal, or on a temporary or emergency basis, in the home of a nonrelative extended family member or an extended family member, regardless of the status of any criminal record exemption or resource family approval or tribally approved home approval if the court finds that the placement does not pose a risk to the health and safety of the child. (3) Existing law establishes the state-funded Kinship Guardianship Assistance Payment Program (Kin-GAP) , which provides aid on behalf of eligible children who are placed in the home of a relative guardian. Existing law requires aid in the form of state-funded Kin-GAP to be provided on behalf of any child under 18 years of age and to any eligible youth under 19 years of age who has had a kinship guardianship established, as described above, and who meets other requirements, including that the child or youth has been adjudicated a dependent child or ward of the juvenile court, has been residing for at least 6 consecutive months in the approved home of the prospective relative guardian, and has had the dependency jurisdiction or wardship terminated, as specified. This bill would also make eligible for state-funded Kin-GAP a child who was subject to an order for placement with a relative regardless of the status of any criminal record exemption or resource family approval or tribally approved home approval, as specified. (4) Existing law establishes the Aid to Families with Dependent Children-Foster Care (AFDC-FC) program, under which counties provide payments to foster care providers on behalf of qualified children in foster care. In order to be eligible for AFDC-FC, existing law requires a child or nonminor dependent to be placed in one of several specified placements, including, among others, the approved home of a relative or a nonrelative extended family member. This bill would also add to that list of eligible placements the home of a nonrelative extended family member or extended family member who has been authorized by the juvenile court and is ineligible for emergency caregiver funding due to the denial of resource family approval or approval as a tribally approved home. (5) Existing law establishes the Approved Relative Caregiver Funding Program (ARC) for the purpose of making the amount paid to relative caregivers for the in-home care of children and nonminor dependents placed with them who are ineligible for AFDC-FC payments equal to the amount paid on behalf of children and nonminor dependents who are eligible for AFDC-FC payments. Existing law requires the ARC to fund the placement of a child with an approved relative caregiver if the placement of the child or nonminor dependent is not eligible for AFDC-FC while placed with the approved relative caregiver because the child or nonminor dependent is not eligible for federal financial participation in the AFDC-FC payment. This bill would also require funding for placement of a child with an approved relative caregiver if the child or nonminor dependent is not eligible for AFDC-FC while placed with the approved relative caregiver because the placement was authorized by the juvenile court. (6) Existing law establishes the Adoption Assistance Program (AAP) , which provides financial aid to the adoptive families of special needs children. Under existing law, AAP payments are provided on behalf of youth between 18 and 21 years of age if the youth meets specified requirements, including that the prospective adoptive parent or any adult living in the prospective adoptive home has completed specified criminal background check requirements. This bill would instead require the criminal background check requirement to be according to the resource family approval requirements, or that the child was subject to an order for placement with a relative, nonrelative extended family member, or extended family member, regardless of the status of any criminal record exemption or resource family approval or tribally approved home approval. (7) Existing law provides for the implementation of the resource family approval process, which replaces the multiple processes for licensing foster family homes, certifying foster homes by licensed foster family agencies, approving relatives and nonrelative extended family members as foster care providers, and approving guardians and adoptive families. Existing law requires the child's placement to be funded by ARC if the child-specific approval is granted to a relative who has received a criminal records exemption by showing that the relative is seeking placement of a specific child or children with whom the relative is related, the relative is of present good character necessary to justify granting the exemption pursuant to certain factors, and the relative does not have a felony conviction within the last 5 years for specified crimes. Existing law requires the relative to be ineligible for federal financial participation while the child is placed with them. This bill would also require a nonrelative extended family member or extended family member, who has received the criminal records exemption, to receive funding under AFDC-FC or ARC and to be ineligible for federal financial participation. (8) By expanding the application of the above county-administered funding programs, this bill would impose a state-mandated local program. (9) Existing law continuously appropriates moneys from the General Fund to defray a portion of county costs under the AFDC-FC program. This bill would provide that the continuous appropriation would not be made for purposes of implementing the bill. (10) 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 federal law provides for allocation of federal funds through the federal Temporary Assistance for Needy Families (TANF) block grant program to eligible states. Existing law provides for the California Work Opportunity and Responsibility to Kids (CalWORKs) program under which, through a combination of state and county funds and federal funds received through the TANF program, each county provides cash assistance and other benefits, including allowances for other purposes such as pregnancy, homeless assistance, and recurring special needs, to qualified low-income families. This bill would, beginning April 1, 2025, make a menstruating person who is qualified for aid under the CalWORKs program and between 10 and 55 years of age, inclusive, entitled to $20 per month to assist with menstrual product costs. The bill would require the State Department of Social Services to work with the County Welfare Directors Association of California and the California Statewide Automated Welfare System (CalSAWS) to develop and implement the necessary system changes on or before April 1, 2025. By increasing the duties of counties administering the CalWORKs program, the bill would impose a state-mandated local program. Existing law continuously appropriates moneys from the General Fund to defray a portion of county costs under the CalWORKs program. This bill would instead provide that the continuous appropriation would not be made for purposes of implementing the bill. 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 measure would declare that the Legislature should pass laws that halt the importation of cobalt or any product using cobalt mined in Africa using child slave labor and encourage the production of cobalt and other critical minerals ethically sourced from within the United States.
This measure would designate the plaza at the center of the California State Capitol World Peace Rose Garden in the City of Sacramento as the Chief Justice Rose Elizabeth Bird Justice For All Plaza. The measure would also request the Department of General Services to determine the cost of erecting appropriate plaques and markers showing the designation and, upon receiving donations, to cover the cost to erect signage.
This measure would state the support of the State of California in admitting Washington, D.C. into the Union as a state of the United States of America and urge the members of the United States Congress to enact federal legislation granting statehood to the people of Washington, D.C.
This measure would designate the portion of U.S. Route 101 in the County of San Luis Obispo, from postmile 13.173 to postmile 17.767, as the Katcho Achadjian Memorial Highway. The measure would request the Department of Transportation to determine the cost of appropriate signs showing this special designation and, upon receiving donations from nonstate sources covering that cost, to erect those signs.
Under existing law, known as the public trust doctrine, the state has title as trustee to all tidelands and navigable lakes and streams and is charged with preserving these waterways for navigation, commerce, and fishing, as well as for scientific study, recreation, and as an open space and habitat for birds and marine life. Existing law establishes the State Lands Commission in the Natural Resources Agency. Existing law provides that the commission has exclusive jurisdiction over all ungranted tidelands and submerged lands owned by the state. Existing law authorizes the commission to enter into an exchange, with any person or any private or public entity, of filled or reclaimed tidelands and submerged lands or beds of navigable waterways, or interests in these lands, that are subject to the public trust for commerce, navigation, and fisheries, for other lands or interests in lands, if the commission finds that specified conditions are met. This bill would authorize the commission to convey to the City of Alameda, in trust, as defined, and the bill would authorize the city to accept, any lands to be exchanged into the trust pursuant to an exchange agreement, as defined, to which the city is a party, as provided. The bill would grant the Encinal Terminals public trust lands, as defined, to the city, in accordance with the terms and conditions of the Encinal Terminals exchange agreement, as defined, to be held by the city subject to the terms and conditions of the granting act, as defined, and the public trust, as defined. By adding to the duties of the city with respect to the use and management of trust lands, this bill would impose a state-mandated local program. The bill would require the commission to notify the appropriate committees of the Legislature if the conveyances authorized in the Encinal Terminals exchange agreement have not been completed within the terms of the agreement, as provided. This bill would make legislative findings and declarations as to the necessity of a special statute for the City of Alameda. 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.