AB 2194: Medi-Cal: special commissions.

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, 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 vests governance of the commission in a 10-member governing body and requires that 2 of the governing bodys members be members of the Board of Supervisors of the County of Orange, with one additional member from the Board of Supervisors of the County of Orange serving as an alternate. Existing law 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 would instead vest governance of the commission in a 9-member governing body and would require their terms to be staggered for the term beginning after January 1, 2027. The bill would remove the 2 members of the Board of Supervisors of the County of Orange from the governing body and instead require the Director of the Orange County Health Care Agency and the Director of Social Services of the County of Orange to fill those spots. The bill would establish a selection committee and require that members of the governing body be nominated and selected by the selection committee. The bill would prescribe the members of the selection committee and require that it be administered by the commission. require the terms for members of the governing body to be staggered and would require, for the term beginning prior to January 1, 2027, 3 members to serve 2 years, with a 4-year term beginning thereafter. 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, 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.

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.