text:
(a) The department shall expand eligibility for grants for single- and two-story general acute care hospitals located in rural areas with fewer than 80 general acute care beds and general acute care hospital revenue of seventy-five million dollars ($75,000,000) or less, as reported to the department pursuant to Section 128740 in 2020.

(b) (1) Grants pursuant to this chapter shall provide general acute care hospitals described in subdivision (a) with funds to secure an SPC-4D assessment for purposes of planning for, and estimating the costs of, complying with Section 130065.

(2) The department shall conduct outreach to general acute care hospitals described in subdivision (a) regarding the availability of these grants and provide technical assistance to hospitals applying for the grants.

(3) A general acute care hospital receiving a grant for an assessment pursuant to this subdivision shall provide the estimated cost of SPC-4D compliance to the department.

(c) (1) Subject to paragraphs (2) and (3), general acute care hospitals that have received a grant for an assessment pursuant to subdivision (b) may apply for a grant for purposes of complying with Section 130065.

(2) Subject to paragraphs (2) and (3), for general acute care hospitals that already have an SPC-4D assessment approved by the department, the department may award the general acute care hospital grant money for purposes of complying with Section 130065.

history: (History: Added by Stats. 2024, Ch. 801, Sec. 4. (AB 869) Effective January 1, 2025.)


kind: section

code: HSC

text:
(a) If state funds are appropriated to the Small and Rural Hospital Relief Fund in the future for the purpose of complying with Section 130065, before being awarded state funds, a hospital that qualifies for assessment grants under this chapter shall submit financial information to the department, on a form as required by the department, related to all of the following:

(1) Whether the hospital has attempted to secure other methods of funding for SPC-4D compliance, including federal funding, and if not, the reason why.

(2) The accuracy of the hospital’s SPC-4D cost estimates and confirmation that the estimated costs are only for purposes of SPC-4D compliance.

(3) The hospital’s need for assistance due to financial hardship and lack of ability to finance the required improvements, in order to access state funds.

(b) In awarding grants, the department shall have the authority to deny any costs from the assessment completed pursuant to this chapter that the department determines are not necessary to comply with SPC-4D requirements.

history: (History: Added by Stats. 2024, Ch. 801, Sec. 5. (AB 869) Effective January 1, 2025.)

division: 107. HEALTH CARE ACCESS AND INFORMATION

path: 107. HEALTH CARE ACCESS AND INFORMATION > 7. FACILITIES DESIGN REVIEW AND CONSTRUCTION > 1.5. Small and Rural Hospital Relief Program


text: The department may adopt regulations necessary to implement this chapter.

history: (History: Added by Stats. 2021, Ch. 489, Sec. 2. (SB 395) Effective January 1, 2022.)

part: 7. FACILITIES DESIGN REVIEW AND CONSTRUCTION

chapter: 1.5. Small and Rural Hospital Relief Program


text:
There is hereby created a program in the state for the purposes of promoting, supporting, and improving the early development of children from the prenatal stage to five years of age. These purposes shall be accomplished through the establishment, institution, and coordination of appropriate standards, resources, and integrated and comprehensive programs emphasizing community awareness, education, nurturing, child care, social services, health care, and research.

(a) It is the intent of this act to facilitate the creation and implementation of an integrated, comprehensive, and collaborative system of information and services to enhance optimal early childhood development and to ensure that children are ready to enter school. This system should function as a network that promotes accessibility to all information and services from any entry point into the system. It is further the intent of this act to emphasize local decisionmaking, to provide for greater local flexibility in designing delivery systems, and to eliminate duplicate administrative systems.

(b) The programs authorized by this act shall be administered by the California Children and Families Commission and by county children and families commissions. In administering this act, the state and county commissions shall use outcome-based accountability to determine future expenditures.

(c) This division shall be known and may be cited as the “California Children and Families Act of 1998.”

history: (History: Amended by Stats. 2002, Ch. 245, Sec. 1. Effective January 1, 2003. Note: This section was added on Nov. 3, 1998, by initiative Prop. 10.)

division: 108. CALIFORNIA CHILDREN AND FAMILIES PROGRAM


text:
The California Children and Families Trust Fund is hereby created in the State Treasury.

(a) The California Children and Families Trust Fund shall consist of moneys collected pursuant to the taxes imposed by Section 30131.2 of the Revenue and Taxation Code.

(b) All costs to implement this act shall be paid from moneys deposited in the California Children and Families Trust Fund.

(c) The State Board of Equalization shall determine within one year of the passage of this act the effect that additional taxes imposed on cigarettes and tobacco products by this act has on the consumption of cigarettes and tobacco products in this state. To the extent that a decrease in consumption is determined by the State Board of Equalization to be the direct result of additional taxes imposed by this act, the State Board of Equalization shall determine the fiscal effect the decrease in consumption has on the funding of any Proposition 99 (the Tobacco Tax and Health Protection Act of 1988) state health-related education or research programs in effect as of November 1, 1998, and the Breast Cancer Fund programs that are funded by excise taxes on cigarettes and tobacco products. Funds shall be transferred from the California Children and Families Trust Fund to those affected programs as necessary to offset the revenue decrease directly resulting from the imposition of additional taxes by this act. These reimbursements shall occur, and at any times, as determined necessary to further the intent of this subdivision.

(d) Moneys shall be allocated and appropriated from the California Children and Families Trust Fund as follows:

(1) Twenty percent shall be allocated and appropriated to separate accounts of the state commission for expenditure according to the following formula:

(A) Six percent shall be deposited in a Mass Media Communications Account for expenditures for communications to the general public utilizing television, radio, newspapers, and other mass media on subjects relating to and furthering the goals and purposes of this act, including, but not limited to, methods of nurturing and parenting that encourage proper childhood development, the informed selection of child care, information regarding health and social services, the prevention and cessation of tobacco, alcohol, and drug use by pregnant women, the detrimental effects of secondhand smoke on early childhood development, and to ensure that children are ready to enter school. Any funds not needed in this account may be transferred to the Unallocated Account described in subparagraph (F), upon approval by the state commission.

(B) Five percent shall be deposited in an Education Account for expenditures to ensure that children are ready to enter school and for programs relating to education, including, but not limited to, the development of educational materials, professional and parental education and training, and technical support for county commissions in the areas described in subparagraph (A) of paragraph (1) of subdivision (b) of Section 130125. Any funds not needed in this account may be transferred to the Unallocated Account described in subparagraph (F), upon approval by the state commission.

(C) Three percent shall be deposited in a Child Care Account for expenditures to ensure that children are ready to enter school and for programs relating to child care, including, but not limited to, the education and training of child care providers, the development of educational materials and guidelines for child care workers, and other areas described in subparagraph (B) of paragraph (1) of subdivision (b) of Section 130125. Any funds not needed in this account may be transferred to the Unallocated Account described in subparagraph (F), upon approval by the state commission.

(D) Three percent shall be deposited in a Research and Development Account for expenditures to ensure that children are ready to enter school and for the research and development of best practices and standards for all programs and services relating to early childhood development established pursuant to this act, and for the assessment and quality evaluation of those programs and services. Any funds not needed in this account may be transferred to the Unallocated Account described in subparagraph (F), upon approval by the state commission.

(E) One percent shall be deposited in an Administration Account for expenditures for the administrative functions of the state commission. Any funds not needed for the administrative functions of the state commission may be transferred to the Unallocated Account described in subparagraph (F), upon approval by the state commission.

(F) Two percent shall be deposited in an Unallocated Account for expenditure by the state commission for any of the purposes of this act described in Section 130100 provided that none of these moneys shall be expended for the administrative functions of the state commission.

(G) In the event that, for whatever reason, the expenditure of any moneys allocated and appropriated for the purposes specified in subparagraphs (A) to (F), inclusive, is enjoined by a final judgment of a court of competent jurisdiction, then those moneys shall be available for expenditure by the state commission for mass media communication emphasizing the need to eliminate smoking and other tobacco use by pregnant women, the need to eliminate smoking and other tobacco use by persons under 18 years of age, and the need to eliminate exposure to secondhand smoke.

(H) Any moneys allocated and appropriated to any of the accounts described in subparagraphs (A) to (F), inclusive, that are not encumbered or expended within any applicable period prescribed by law shall (together with the accrued interest on the amount) revert to and remain in the same account for the next fiscal period.

(2) Eighty percent shall be allocated and appropriated to county commissions in accordance with Section 130140.

(A) The moneys allocated and appropriated to county commissions shall be deposited in each local Children and Families Trust Fund administered by each county commission, and shall be expended only for the purposes authorized by this act and in accordance with the county strategic plan approved by each county commission.

(B) Any moneys allocated and appropriated to any of the county commissions that are not encumbered or expended within any applicable period prescribed by law shall (together with the accrued interest on the amount) revert to and remain in the same local Children and Families Trust Fund for the next fiscal period under the same conditions as set forth in subparagraph (A).

(e) All grants, gifts, or bequests of money made to or for the benefit of the state commission from public or private sources to be used for early childhood development programs shall be deposited in the California Children and Families Trust Fund and expended for the specific purpose for which the grant, gift, or bequest was made. The amount of any such grant, gift, or bequest shall not be considered in computing the amount allocated and appropriated to the state commission pursuant to paragraph (1) of subdivision (d).

(f) All grants, gifts, or bequests of money made to or for the benefit of any county commission from public or private sources to be used for early childhood development programs shall be deposited in the local Children and Families Trust Fund and expended for the specific purpose for which the grant, gift, or bequest was made. The amount of any such grant, gift, or bequest shall not be considered in computing the amount allocated and appropriated to the county commissions pursuant to paragraph (2) of subdivision (d).

history: (History: Amended by Stats. 2009, Ch. 157, Sec. 1. (AB 1422) Effective September 22, 2009. Note: This section was added on Nov. 3, 1998, by initiative Prop. 10.)

path: 108. CALIFORNIA CHILDREN AND FAMILIES PROGRAM


text:
(a) There is hereby established a California Children and Families Commission, which may also be known as First 5 California, composed of seven voting members and two ex officio members.

(b) The voting members shall be selected, pursuant to Section 130115, from persons with knowledge, experience, and expertise in early child development, child care, education, social services, public health, the prevention and treatment of tobacco and other substance abuse, behavioral health, and medicine (including, but not limited to, representatives of statewide medical and pediatric associations or societies), upon consultation with public and private sector associations, organizations, and conferences composed of professionals in these fields.

(c) The Secretary of the California Health and Human Services Agency and the Secretary for Education, or their designees, shall serve as ex officio nonvoting members of the state commission.

history: (History: Amended by Stats. 2003, Ch. 378, Sec. 1. Effective January 1, 2004. Note: This section was added on Nov. 3, 1998, by initiative Prop. 10.)


text: The Governor shall appoint three members of the state commission, one of whom shall be designated as chairperson. One of the Governor’s appointees shall be either a county health officer or a county health executive. The Speaker of the Assembly and the Senate Rules Committee shall each appoint two members of the state commission. Of the members first appointed by the Governor, one shall serve for a term of four years, and two for a term of two years. Of the members appointed by the Speaker of the Assembly and the Senate Rules Committee, one appointed by the Speaker of the Assembly and the Senate Rules Committee shall serve for a period of four years with the other appointees to serve for a period of three years. Thereafter, all appointments shall be for four-year terms. No appointee shall serve as a member of the state commission for more than two four-year terms.

history: (History: Added November 3, 1998, by initiative Proposition 10. Effective (by Sec. 7 of Prop. 10) on date election results were certified.)


text: The state commission shall, within three months after a majority of its voting members have been appointed, hire an executive director. The state commission shall thereafter hire such other staff as necessary or appropriate. The executive director and staff shall be compensated as determined by the state commission, consistent with moneys available for appropriation in the Administration Account. All professional staff employees of the state commission shall be exempt from civil service. The executive director shall act under the authority of, and in accordance with the direction of, the state commission.


text:
The powers and duties of the state commission shall include, but are not limited to, the following:

(a) Providing for statewide dissemination of public information and educational materials to members of the general public and to professionals for the purpose of developing appropriate awareness and knowledge regarding the promotion, support, and improvement of early childhood development.

(b) Adopting guidelines for an integrated and comprehensive statewide program of promoting, supporting, and improving early childhood development that enhances the intellectual, social, emotional, and physical development of children in California.

(1) The state commission’s guidelines shall, at a minimum, address the following matters:

(A) Parental education and support services in all areas required for, and relevant to, informed and healthy parenting. Examples of parental education shall include, but are not limited to, prenatal and postnatal infant and maternal nutrition, education and training in newborn and infant care and nurturing for optimal early childhood development, parenting and other necessary skills, child abuse prevention, and avoidance of tobacco, drugs, and alcohol during pregnancy. Examples of parental support services shall include, but are not limited to, family support centers offering an integrated system of services required for the development and maintenance of self-sufficiency, domestic violence prevention and treatment, tobacco and other substance abuse control and treatment, voluntary intervention for families at risk, and any other prevention and family services and counseling critical to successful early childhood development.

(B) The availability and provision of high quality, accessible, and affordable child care, both in-home and at child care facilities, that emphasizes education, training and qualifications of care providers, increased availability and access to child care facilities, resource and referral services, technical assistance for caregivers, and financial and other assistance to ensure appropriate child care for all households.

(C) The provision of child health care services that emphasize prevention, diagnostic screenings, and treatment not covered by other programs; and the provision of prenatal and postnatal maternal health care services that emphasize prevention, immunizations, nutrition, treatment of tobacco and other substance abuse, general health screenings, and treatment services not covered by other programs.

(2) The state commission shall conduct at least one public hearing on its proposed guidelines before they are adopted.

(3) The state commission shall, on at least an annual basis, periodically review its adopted guidelines and revise them as may be necessary or appropriate.

(c) Defining the results to be achieved by the adopted guidelines, and collecting and analyzing data to measure progress toward attaining these results.

(d) Providing for independent research, including the evaluation of any relevant programs, to identify the best standards and practices for optimal early childhood development, and establishing and monitoring demonstration projects.

(e) Soliciting input regarding program policy and direction from individuals and entities with experience in early childhood development, facilitating the exchange of information between these individuals and entities, and assisting in the coordination of the services of public and private agencies to deal more effectively with early childhood development.

(f) Providing technical assistance to county commissions in adopting and implementing county strategic plans for early childhood development.

(g) Reviewing and considering the annual audits and reports transmitted by the county commissions and, following a public hearing, adopting a written report that consolidates, summarizes, analyzes, and comments on those annual audits and reports.

(h) Applying for gifts, grants, donations, or contributions of money, property, facilities, or services from any person, corporation, foundation, or other entity, or from the state or any agency or political subdivision thereof, or from the federal government or any agency or instrumentality thereof, in furtherance of a statewide program of early childhood development.

(i) Entering into any contracts and allocating funds to county commissions as necessary or appropriate to carry out the provisions and purposes of this act.

(j) Making recommendations to the Governor and the Legislature for changes in state laws, regulations, and services necessary or appropriate to carry out an integrated and comprehensive program of early childhood development in an effective and cost-efficient manner.

history: (History: Amended by Stats. 2002, Ch. 245, Sec. 3. Effective January 1, 2003. Note: This section was added on Nov. 3, 1998, by initiative Prop. 10.)


text: Procedures for the conduct of business by the state commission not specified in this act shall be contained in bylaws adopted by the state commission. A majority of the voting members of the state commission shall constitute a quorum. All decisions of the state commission, including the hiring of the executive director, shall be by a majority of four votes.

history: (History: Added November 3, 1998, by initiative Proposition 10. Efective (by Sec. 7 of Prop. 10) on date election results were certified.)


text: Voting members of the state commission shall not be compensated for their services, except that they shall be paid reasonable per diem and reimbursement of reasonable expenses for attending meetings and discharging other official responsibilities as authorized by the state commission.


text:
Any county or counties developing, adopting, promoting, and implementing local early childhood development programs consistent with the goals and objectives of this act shall receive moneys pursuant to paragraph (2) of subdivision (d) of Section 130105 in accordance with the following provisions:

(a) For the period between January 1, 1999, and June 30, 2000, county commissions shall receive the portion of the total moneys available to all county commissions equal to the percentage of the number of births recorded in the relevant county (for the most recent reporting period) in proportion to the entire number of births recorded in California (for the same period), provided that each of the following requirements has first been satisfied:

(1) The county’s board of supervisors has adopted an ordinance containing the following minimum provisions:

(A) The establishment of a county children and families commission. The county commission shall be appointed by the board of supervisors and shall consist of at least five but not more than nine members.

(i) Two members of the county commission shall be from among the county health officer and persons responsible for management of the following county functions: children’s services, public health services, behavioral health services, social services, and tobacco and other substance abuse prevention and treatment services.

(ii) One member of the county commission shall be a member of the board of supervisors.

(iii) The remaining members of the county commission shall be from among the persons described in clause (i) and persons from the following categories: recipients of project services included in the county strategic plan; educators specializing in early childhood development; representatives of a local child care resource or referral agency, or a local child care coordinating group; representatives of a local organization for prevention or early intervention for families at risk; representatives of community-based organizations that have the goal of promoting nurturing and early childhood development; representatives of local school districts; and representatives of local medical, pediatric, or obstetric associations or societies.

(B) The manner of appointment, selection, or removal of members of the county commission, the duration and number of terms county commission members shall serve, and any other matters that the board of supervisors deems necessary or convenient for the conduct of the county commission’s activities, provided that members of the county commission shall not be compensated for their services, except they shall be paid reasonable per diem and reimbursement of reasonable expenses for attending meetings and discharging other official responsibilities as authorized by the county commission.

(C) The requirement that the county commission adopt an adequate and complete county strategic plan for the support and improvement of early childhood development within the county.

(i) The county strategic plan shall be consistent with, and in furtherance of the purposes of, this act and any guidelines adopted by the state commission pursuant to subdivision (b) of Section 130125 that are in effect at the time the plan is adopted.

(ii) The county strategic plan shall, at a minimum, include the following: a description of the goals and objectives proposed to be attained; a description of the programs, services, and projects proposed to be provided, sponsored, or facilitated; and a description of how measurable outcomes of such programs, services, and projects will be determined by the county commission using appropriate reliable indicators. No county strategic plan shall be deemed adequate or complete until and unless the plan describes how programs, services, and projects relating to early childhood development within the county will be integrated into a consumer-oriented and easily accessible system.

(iii) The county commission shall, on at least an annual basis, be required to review its county strategic plan and to revise the plan as may be necessary or appropriate.

(iv) The county commission shall measure the outcomes of county funded programs through the use of applicable, reliable indicators and review that information on a periodic basis as part of the public review of its county strategic plan.

(D) The requirement that the county commission conduct at least one public hearing on its proposed county strategic plan before the plan is adopted.

(E) The requirement that the county commission conduct at least one public hearing on its periodic review of the county strategic plan before any revisions to the plan are adopted.

(F) The requirement that the county commission submit its adopted county strategic plan, and any subsequent revisions thereto, to the state commission.

(G) The requirement that the county commission prepare and adopt an annual audit and report pursuant to Section 130150. The county commission shall conduct at least one public hearing prior to adopting any annual audit and report.

(H) The requirement that the county commission conduct at least one public hearing on each annual report by the state commission prepared pursuant to subdivision (b) of Section 130150.

(I) Two or more counties may form a joint county commission, adopt a joint county strategic plan, or implement joint programs, services, or projects.

(2) The county’s board of supervisors has established a county commission and has appointed a majority of its members.

(3) The county has established a local Children and Families Trust Fund pursuant to subparagraph (A) of paragraph (2) of subdivision (d) of Section 130105.

(b) Notwithstanding any provision of this act to the contrary, no moneys made available to county commissions under subdivision (a) shall be expended to provide, sponsor, or facilitate any programs, services, or projects for early childhood development until and unless the county commission has first adopted an adequate and complete county strategic plan that contains the provisions required by clause (ii) of subparagraph (C) of paragraph (1) of subdivision (a).

(c) In the event that any county elects not to participate in the California Children and Families Program, the moneys remaining in the California Children and Families Trust Fund shall be reallocated and reappropriated to participating counties in the following fiscal year.

(d) For the fiscal year commencing on July 1, 2000, and for each fiscal year thereafter, county commissions shall receive the portion of the total moneys available to all county commissions equal to the percentage of the number of births recorded in the relevant county (for the most recent reporting period) in proportion to the number of births recorded in all of the counties participating in the California Children and Families Program (for the same period), provided that each of the following requirements has first been satisfied:

(1) The county commission has, after the required public hearings, adopted an adequate and complete county strategic plan conforming to the requirements of subparagraph (C) of paragraph (1) of subdivision (a), and has submitted the plan to the state commission.

(2) The county commission has conducted the required public hearings, and has prepared and submitted all audits and reports required pursuant to Section 130150.

(3) The county commission has conducted the required public hearings on the state commission annual reports prepared pursuant to subdivision (b) of Section 130150.

(4) The county commission, in a public hearing, has adopted policies that are consistent with the following state laws:

(A) With regard to conflict of interest of the commission members, the county commission’s policies shall be consistent with Article 4 (commencing with Section 1090) of Chapter 1 of Division 4 of Title 1 of the Government Code, Article 4.7 (commencing with Section 1125) of Chapter 1 of Division 4 of Title 1 of the Government Code, and Chapter 7 (commencing with Section 87100) of Title 9 of the Government Code.

(B) With regard to contracting and procurement, the county commission’s policies shall be consistent with Article 7 (commencing with Section 54201) of Chapter 5 of Part 1 of Division 2 of Title 5 of the Government Code, Chapter 2 (commencing with Section 2000) of Part 1 of Division 2 of the Public Contract Code, Section 3410 of the Public Contract Code, and Chapter 3.5 (commencing with Section 22150) of Part 3 of Division 2 of the Public Contract Code.

(5) The county commission, in a public hearing, has adopted a limit on the percentage of the county commission’s operating budget that may be spent on administrative functions, pursuant to guidelines issued by the state commission that define administrative functions.

(6) The county commission has adopted, in a public hearing, policies and processes establishing the salaries and benefits of employees of the county commission. Salaries and benefits shall conform with established county commission or county government policies.

(e) In the event that any county elects not to continue participation in the California Children and Families Program, any unencumbered and unexpended moneys remaining in the local Children and Families Trust Fund shall be returned to the California Children and Families Trust Fund for reallocation and reappropriation to participating counties in the following fiscal year.

(f) For purposes of this section, “relevant county” means the county in which the mother of the child whose birth is being recorded resides.

history: (History: Amended by Stats. 2006, Ch. 111, Sec. 1. Effective January 1, 2007. Note: This section was added on Nov. 3, 1998, by initiative Prop. 10.)


text:
(a) In the event a county elects to participate in the California Children and Families Program, and satisfies the requirements set forth in Section 130140, the county may establish a county commission that is either of the following:

(1) A legal public entity separate from the county.

(2) An agency of the county with independent authority over the strategic plan described in Section 130140 and the local trust fund established pursuant to subparagraph (A) of paragraph (2) of subdivision (d) of Section 130105.

(b) In the event a county elects to establish a county commission as specified in paragraph (1) of subdivision (a), the following conditions shall apply:

(1) The county commission shall be considered a legal public entity separate from the county, and shall file a statement as required by Section 53051 of the Government Code.

(2) The powers, duties, and responsibilities of the county commission shall include, but shall not be limited to, the following:

(A) The power to employ personnel and contract for personal services required to meet its obligations.

(B) The power to enter into any contracts necessary or appropriate to carry out the provisions of this division.

(C) The power to acquire, possess, and dispose of real or personal property, as necessary or appropriate to carry out the provisions and purposes of this division.

(D) The power to sue or be sued.

(3) The county commission shall be deemed to be a public agency that is a unit of local government for purposes of all grant programs and other funding and loan guarantee programs.

(4) Any obligations of the county commission, statutory, contractual, or otherwise, shall be obligations solely of the commission.

(5) All claims or actions for money or damages against a county commission shall be governed by Part 3 (commencing with Section 900) and Part 4 (commencing with Section 940) of Division 3.6 of Title 1 of the Government Code, except as provided by other statutes or regulations that expressly apply to county commissions.

(6) The county commission, its members, and its employees are protected by the immunities applicable to public entities and public employees governed by Part 1 (commencing with Section 810) and Part 2 (commencing with Section 814) of Division 3.6 of Title 1 of the Government Code, except as provided by other statutes or regulations that apply expressly to the county commissions.

(7) If a county board of supervisors elects not to continue the county’s participation in the California Children and Families Program, the board shall adopt an ordinance terminating the county commission.

(A) In terminating its county commission, the board of supervisors shall allow, to the extent possible, an appropriate transition period to allow for the county commission’s then-existing obligations to be satisfied.

(B) In event of termination, any unencumbered and unexpended moneys remaining in the local Children and Families Trust Fund shall be distributed pursuant to subdivision (e) of Section 130140.

(C) Prior to the termination of the county commission, the board of supervisors shall notify the state Children and Families Commission of its intent to terminate the county commission.

(D) The liabilities of the county commission shall not become obligations of the county upon either the termination of the county commission or the liquidation or disposition of the county commission’s remaining assets.

(c) If a county elects to establish a county commission as provided in paragraph (2) of subdivision (a), the county commission shall be deemed to be an agency of the county with independent authority over the strategic plan described in Section 130140 and the local Children and Families Trust Fund established pursuant to subparagraph (A) of paragraph (2) of subdivision (d) of Section 130105.

(d) Any county commission established prior to the effective date of this section that substantially complies with the provisions of either subdivision (b) or (c) shall be deemed to be in compliance with this section.

(e) (1) Individually identifiable physical or mental health information, substance abuse information, child care or education information, personnel or employment information, financial information, criminal justice information, or demographic information, regarding a child or a child’s parent, legal guardian, or other family member, that is provided to a county commission by a parent, legal guardian, family member, health care provider, health plan, public health authority, school, law enforcement agency, social services agency, probation agency, or any other source, shall be considered confidential, and may be disclosed only to a person, agency, or entity that receives funding from the county commission, by way of a grant award or contract or as a service provider for the provision of early childhood services, and only to the extent necessary to the provision of services, unless further disclosure is authorized by a written consent of the parent or legal guardian, or where disclosure is required by state or federal law.

(2) Confidential information identified in accordance with this section shall not be subject to disclosure under the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code).

history: (History: Amended by Stats. 2002, Ch. 664, Sec. 153. Effective January 1, 2003.)


text: The state commission and each county commission shall establish one or more advisory committees to provide technical and professional expertise and support for any purposes that will be beneficial in accomplishing the purposes of this act. Each advisory committee shall meet and shall make recommendations and reports as deemed necessary or appropriate.


text:
(a) On or before October 15 of each year, each county commission shall conduct an audit of, and issue a written report on the implementation and performance of, its functions during the preceding fiscal year, including, at a minimum, the manner in which funds were expended, the progress toward, and the achievement of, program goals and objectives, and information on programs funded and populations served for all funded programs.

On or before November 1 of each year, each county commission shall submit its audit and report to the state commission for inclusion in the state commission’s consolidated report required in subdivision (b). Each commission shall submit its report in a format prescribed by the state commission if the state commission approves that format in a public meeting prior to the fiscal year during which it is to be used by the county commissions. The state commission shall develop the format in consultation with the county commissions.

(b) The state commission shall, on or before January 31 of each year, do both of the following:

(1) Conduct an audit and prepare a written report on the implementation and performance of the state commission functions during the preceding fiscal year, including, at a minimum, the manner in which funds were expended and the progress toward, and the achievement of, program goals and objectives.

(2) Prepare a written report that consolidates, summarizes, analyzes, and comments on the annual audits and reports submitted by all of the county commissions and the Controller for the preceding fiscal year. The written report shall include a listing, by category, of the aggregate expenditures on program areas funded by the state and county commissions pursuant to the purposes of this act, according to a format prescribed by the state commission. This report by the state commission shall be transmitted to the Governor, the Legislature, and each county commission.

(3) In the event a county commission does not submit the information prescribed in subdivision (a), the state commission may withhold funds that would otherwise have been allocated to the county commission from the California Children and Families Trust Fund pursuant to Section 130140 until the county commission submits the data as required by subdivision (a).

(c) The state commission shall make copies of each of its annual audits and reports available to members of the general public on request and at no cost. The state commission shall furnish each county commission with copies of those documents in a number sufficient for local distribution by the county commission to members of the general public on request and at no cost.

(d) Each county commission shall make copies of its annual audits and reports available to members of the general public on request and at no cost.

history: (History: Amended by Stats. 2005, Ch. 243, Sec. 1. Effective January 1, 2006. Note: This section was added on Nov. 3, 1998, by initiative Prop. 10.)


text:
(a) In addition to the requirements in Section 130150, the Controller shall issue guidelines for expanded annual audits of each county commission required pursuant to subdivision (b) of Section 130150 and associated quality control functions, subject to funding by the state commission.

(b) The scope of the audits shall address a review of county commission policies and practices with respect to the following elements:

(1) Contracting and procurement policies, to determine whether they are in place pursuant to paragraph (4) of subdivision (d) of Section 130140, whether state and county commissions are operating in accordance with these policies, and whether these policies contain provisions to ensure that the grants and contracts are consistent with the state or county commission’s strategic plan.

(2) Administrative costs, to ensure that the county commission’s definitions comply with the state commission’s guidelines and that the county commission has a process in place to monitor these costs.

(3) Policies and procedures, established pursuant to paragraph (4) of subdivision (d) of Section 130140, designed to assure compliance by the state commission and county commissions with all applicable state and local conflict-of-interest statutes and regulations.

(4) Policies and practices designed to assure that county commissions are adhering to county commission ordinances established pursuant to paragraph (1) of subdivision (a) of Section 130140.

(5) Long-range financial plans, to determine whether state and county commissions have these plans and that the plans have been formally adopted by the commission in a public hearing.

(6) Financial condition of the commission.

(7) Amount commissions spend on program evaluation and the documented results of these expenditures.

(8) Salaries and benefit policies, to determine whether the county commission’s employee salaries and benefits comply with the policies that the county commission adopted pursuant to paragraph (6) of subdivision (d) of Section 130140.

(c) The auditor for the state commission or the county commission shall submit each audit report, upon completion, simultaneously to both the Controller and to the state commission or applicable county commission.

(d) The state commission and each respective county commission shall schedule a public hearing within two months of receipt of the audit to discuss findings within the report and any response to the findings. Within two weeks of the public hearing, the state or county commission shall submit to the Controller a response to the audit findings.

(e) Within six months of the state or county commission’s response pursuant to subdivision (d), the Controller shall determine whether a county commission has successfully corrected its practices in response to the findings contained in the audit report. The Controller may, after that determination, recommend to the state commission to withhold the allocation of money that the county commission would otherwise receive from the California Children and Families Trust Fund until the Controller determines that the county commission has a viable plan and the ability to correct the practices identified in the audit.

(f) The Controller shall prepare a summary report of the final audits and submit the report to the state commission by November 1 of each year for inclusion in the annual report required pursuant to subdivision (b) of Section 130150.

(g) On or before April 30, 2006, the Controller shall present to the state commission in a public meeting the final audit guidelines and implementation plan. When developing the guidelines, the Controller shall consider the reasonableness of the projected costs and administrative burden of the required audit functions.

history: (History: Added by Stats. 2005, Ch. 243, Sec. 2. Effective January 1, 2006.)


text:
The following definitions apply for purposes of this act:

(a) “Act” means the California Children and Families Act of 1998.

(b) “County commission” means each county children and families commission established in accordance with Section 130140.

(c) “County strategic plan” means the plan adopted by each county children and families commission and submitted to the California Children and Families Commission pursuant to Section 130140.

(d) “State commission” means the California Children and Families Commission established in accordance with Section 130110.

history: (History: Amended by Stats. 1999, Ch. 126, Sec. 6. Effective July 14, 1999. Note: This section was added on Nov. 3, 1998, by initiative Prop. 10.)


text: The Children and Families Health and Human Services Fund is hereby established in the State Treasury. The Children and Families Health and Human Services Fund shall be used, upon appropriation by the Legislature, to provide health and human services, including, but not limited to, direct health care services, to children from birth through five years of age.

history: (History: Added by Stats. 2011, Ch. 4, Sec. 2. (AB 99) Effective March 24, 2011.)


text: Notwithstanding paragraph (1) of subdivision (d) of Section 130105, for the 2011–12 fiscal year, fifty million dollars ($50,000,000) from the accounts described in subparagraphs (A) to (F), inclusive, of paragraph (1) of subdivision (d) of Section 130105, including reserve funds, upon approval of the state commission, shall be transferred to and deposited in the Children and Families Health and Human Services Fund to support state health and human services programs for children from birth through five years of age. The state commission shall ensure that these funds are available for the purposes described in this section. To the extent it is necessary or appropriate for the state commission to disencumber existing obligations to meet the requirements of this section, the state commission, including, but not limited to, its representatives, officers, directors, and employees, including its attorneys and other persons, is hereby released from any and all liability, rights, claims, demands, and actions, known and unknown, which any party may have, arising in connection with the disencumbering of funds or obligations in accordance with this section. For purposes of this section, “state health and human services programs” includes, but is not limited to, direct health care services.

history: (History: Added by Stats. 2011, Ch. 4, Sec. 3. (AB 99) Effective March 24, 2011.)


text:
(a) Notwithstanding paragraph (2) of subdivision (d) of Section 130105, for the 2011–12 fiscal year, nine hundred fifty million dollars ($950,000,000) from the combined balances of all the county Children and Families Trust Funds, including reserve funds, as provided for in subparagraphs (A) and (B) of paragraph (2) of subdivision (d) of Section 130105, shall be transferred to and deposited in the Children and Families Health and Human Services Fund, to support state health and human services programs for children from birth through five years of age.

(b) For purposes of this section, “state health and human services programs” includes, but is not limited to, direct health care services and “county commission” includes, but is not limited to, county commissions, account holders for local children and families trust funds, and county government fiscal agents.

(c) The share of the amount specified in subdivision (a) required of each county commission shall be determined in the following manner and subject to the following conditions:

(1) A county commission that received less than six hundred thousand dollars ($600,000) in California Children and Families Trust Fund revenues in the 2009–10 fiscal year is exempt from this section and is not required to deposit funds in the Children and Families Health and Human Services Fund as part of the budget solution described in subdivision (a).

(2) By June 30, 2012, each county commission not exempted by paragraph (1) shall remit for deposit into the Children and Families Health and Human Services Fund, 50 percent of its county commission funding, which includes total reserved, total unreserved-designated, and total unreserved-undesignated local children and families trust funds as of June 30, 2010. No funds other than revenues received pursuant to the California Children and Families Act of 1998 shall be remitted for deposit into the Children and Families Health and Human Services Fund.

(3) Notwithstanding paragraph (2), county commission payments for deposit into the Children and Families Health and Human Services Fund shall not cause any county commission’s fund balance to fall below the amount received by the county commission from the California Children and Families Trust Fund in the 2009–10 fiscal year.

(4) Full payments to the Children and Families Health and Human Services Fund shall be made by county commissions within the 2011–12 fiscal year. Notwithstanding any other provision of law, no 2012–13 allocation to a county commission shall occur prior to the full payment being made.

(5) Notwithstanding paragraphs (1) to (4), inclusive, the total combined remittances from county commissions in the 2011–12 fiscal year shall equal nine hundred fifty million dollars ($950,000,000). To the extent paragraphs (1) to (4), inclusive, result in more than nine hundred fifty million dollars ($950,000,000) being provided by county commissions in total, the difference shall be proportionally returned to all contributing county commissions.

(d) Pursuant to subdivision (c), each county commission, as defined in subdivision (b), shall ensure that the funds for transfer and deposit to the Children and Families Health and Human Services Fund are not encumbered and are available for the purposes described in this section. To the extent that it is necessary or appropriate for a county commission to disencumber existing obligations to meet the requirements of this section, the county commission, including, but not limited to, its representatives, officers, directors, and employees, including its attorneys and other persons, is hereby released from any and all liability, rights, claims, demands, and actions, known and unknown, which any party may have, arising in connection with the disencumbering of funds, or obligations in accordance with this section.

(e) After a county commission’s share of the nine hundred fifty million dollars ($950,000,000) specified in subdivision (a) has been determined pursuant to subdivision (c), that county commission, or appropriate agent or entity, shall remit those funds to the Controller for deposit into the Children and Families Health and Human Services Fund. The entire share of funds for each county commission shall be remitted within the 2011–12 fiscal year, and may be done, in equal amounts, on a monthly basis.

history: (History: Added by Stats. 2011, Ch. 4, Sec. 4. (AB 99) Effective March 24, 2011.)


text: There is hereby established within the California Health and Human Services Agency the Center for Data Insights and Innovation to ensure the enforcement of state law mandating the confidentiality of medical information. The Center for Data Insights and Innovation shall be administered by a director who shall also serve as the California Health and Human Services Chief Data Officer and shall be appointed by the Secretary of California Health and Human Services.

history: (History: Repealed and added by Stats. 2021, Ch. 696, Sec. 11. (AB 172) Effective October 8, 2021.)

division: 109. CENTER FOR DATA INSIGHTS AND INNOVATION


text:
The Legislature finds and declares all of the following:

(a) The California Health and Human Services Agency manages great amounts of valuable data on all aspects of life for Californians, including, but not limited to, health care delivery, business, social services, child welfare, and public health.

(b) California has long recognized that securing individual privacy rights and confidentiality of personal health and medical records is of paramount importance to establishing public confidence in the provision of state services, and that ensuring transparent accountability, governance, and oversight are critical components to maintaining the public’s trust.

(c) Data is a fundamental asset that can be more fully utilized without compromising patient privacy and data security. Improving and streamlining collection practices, interoperability of data and technology, data infrastructure, data security, and data sharing is critical to the improvement of the lives of Californians and will foster person-centered and not program-centered decisionmaking.

(d) When data practices safeguard individual privacy, interpreting and using data improves public programs and policies and enriches the lives of people in many ways, including, but not limited to, all of the following:

(1) Analytics increase efficiency and help target resources to vulnerable and underserved populations.

(2) Data analytics allow for optimal use of existing resources and information assets to drive operational decisions and avoid changes that may result in adverse impacts or negative outcomes for vulnerable and underserved populations.

(3) Health and social services outcomes are improved through use of analytics to identify underserved populations, detect gaps in services, and improve and facilitate access to programs and services.

(4) Demographic and services information can be assessed to identify and address disparities, including racial, ethnic, gender, and geographic disparities, in health and socioeconomic status to advance equity and improve person-centered outcomes.

(e) Information sharing among state departments for integrated health and social services has been hindered by a lack of standardized interpretation and application of health privacy laws throughout the state. State departments often do not share information for integrated health and social services, even when sharing is appropriate, lawful, and permissible to all identifiable individuals. In order to provide efficient and effective health and social services, information should be securely exchanged among state departments in a manner that prioritizes individual privacy and autonomy over access to personal data.

(f) Unmitigated sharing and centralization of personal data relating to individuals presents unique risks to privacy, as that data can be used in concert to produce profiles revealing intimate details of individuals’ personal lives. Any policy related to data sharing, especially among governmental entities, must, therefore, be responsive to potential risks to personal privacy and include safeguards against invasive or excessive sharing of personal information.

(g) Data sharing has the potential to positively affect health and social services outcomes by linking vulnerable populations to services for which they are eligible.

(h) It is the intent of the Legislature to establish the Center for Data Insights and Innovation to do all of the following:

(1) Establish health information sharing guidance that balances the need for patient privacy with the benefits of data sharing to support and encourage integrated care and services to assist California health and social services organizations.

(2) Increase privacy protections by ensuring only required health data is transmitted for purposes and uses consistent with state and federal law.

(3) Administer the State Committee for the Protection of Human Subjects.

(4) Administer the California Health and Human Services Agency Open Data Portal.

(5) Develop and administer the California Health and Human Services Agency Research Data Hub and other future data initiatives.

(6) Improve and strengthen the security of data processes within the departments of the California Health and Human Services Agency.

(7) Identify and guide tangible and program-specific efforts, from the California Health and Human Services Agency leadership perspective, toward enhanced person-centered services that bridge and connect access to all health and social services programs for which an individual may be eligible.

history: (History: Amended by Stats. 2026, Ch. 27, Sec. 50. (SB 164) Effective June 29, 2026.)

path: 109. CENTER FOR DATA INSIGHTS AND INNOVATION


text:
For the purposes of this division, the following definitions apply:

(a) “Bona fide research” has the same meaning as subdivision (f) of Section 820 of Title 11 of the California Code of Regulations.

(b) “Center” means the Center for Data Insights and Innovation.

(c) “Chief Data Officer” means the Director of the Center for Data Insights and Innovation.

(d) “CHHS Open Data Portal” means the California Health and Human Services Agency Open Data Portal.

(e) “Director” means the Director of the Center for Data Insights and Innovation.

(f) “HIPAA” means the federal Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191).

(g) “Research Data Hub” means the California Health and Human Services Agency Research Data Hub or future iterations and names of that product.

(h) “State entities” means all state departments, agencies, boards, commissions, programs, and other organizational units of the executive branch of state government.

(i) “Qualified researcher” means state entities, clinical investigators, including investigators conducting epidemiologic studies, health care research organizations, and accredited public or private nonprofit educational or health care institutions for bona fide research purposes.

history: (History: Added by Stats. 2021, Ch. 696, Sec. 11. (AB 172) Effective October 8, 2021.)


text:
(a) The center shall assume statewide leadership, coordination, policy formulation, direction, and oversight responsibilities for compliance with state and federal health information privacy laws, including, but not limited to, the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), the Information Practices Act of 1977 (Chapter 1 (commencing with Section 1798) of Title 1.8 of Part 4 of Division 3 of the Civil Code), the federal Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191), and the federal Health Information Technology for Economic and Clinical Health Act (Title XIII of the federal American Recovery and Reinvestment Act of 2009 (Public Law 111-5)), and implementing regulations. The center shall exercise full authority relative to state entities to establish policy, provide direction to state entities, provide guidance on data sharing, monitor progress, and report on compliance activities.

(b) Beginning January 1, 2022, the center shall complete an independent security assessment as described in Section 11549.3 of the Government Code at least once every three years and, consistent with subdivision (d) of that section, submit any resulting report and recommendations to the Office of Emergency Services.

(c) All state entities subject to HIPAA shall complete an assessment, in a form specified by the center, to determine the impact of HIPAA on their operations. All state entities shall cooperate with the center to determine whether the state entity is subject to HIPAA, including, but not limited to, providing a completed assessment, as prescribed by the center.

(d) All state entities shall cooperate with the efforts of the center to monitor HIPAA and health information privacy compliance activities and to obtain information on these activities. Information obtained about these activities shall not include personal information, as defined in subdivision (a) of Section 1798.3 of the Civil Code.

(e) All state entities affected by HIPAA shall comply with the decisions of the director in achieving compliance with HIPAA and other health information privacy laws, including whether a state entity is subject to HIPAA and other state and federal health information privacy requirements.

(f) (1) The center shall assume statewide leadership, coordination, direction, and oversight responsibilities for determining which provisions of state law concerning health information are preempted by HIPAA, or are more protective of individually identifiable health information, pursuant to Section 160.203 of Title 45 of the Code of Federal Regulations. State entities impacted by HIPAA shall, at the direction of the center, do both of the following:

(i) Assist in determining which state laws concerning personal medical information are preempted by HIPAA.

(ii) Conform to all determinations made by the center concerning HIPAA preemption issues.

(2) If the center determines that a state law is preempted by HIPAA, the center shall provide the determination and a recommendation for a solution to the Secretary of California Health and Human Services.

(g) State entities are responsible for ensuring compliance with state and federal health information privacy laws, including, but not limited to, HIPAA. To the extent that funds are appropriated in the annual Budget Act, the center shall do all of the following to assist state entities in complying with health information requirements:

(1) Develop uniform policies on privacy, patient rights, and other matters related to health information requirements that shall be adopted and implemented by all state entities. In developing these policies, the center shall consult with representatives from the private sector, state government, and other public entities, including at least two consumer representatives, at least one of whom shall have expertise in privacy and security of health information.

(2) Specify training and tools, such as protocols for assessment and reporting and any other tools determined by the director, for compliance with health information requirements.

(3) Develop statewide guidance on health information sharing to support integrated health care and social services, including guidance on state and federal health information privacy laws, regulations, and policies. In developing this guidance, the center shall consult with representatives from the private sector, state government, and other public entities relevant to the provision of health care and social services, including privacy advocates, patient rights representatives, and county administrators of health and human services programs and their association representatives.

(4) Represent the State of California in discussions on health data sharing, data interoperability, HIPAA, and substance use disorder information requirements contained in Part 2 of Title 42 of the Code of Federal Regulations with the federal Department of Health and Human Services. The center may review and approve all comments related to data sharing, data interoperability, HIPAA, and substance use disorder information requirements contained in Part 2 of Title 42 of the Code of Federal Regulations that state entities propose for submission to the federal Department of Health and Human Services or any other body or organization.

(5) Coordinate and communicate with other affected entities, including, but not limited to, the Department of Technology and State Chief Data Officer.

(6) Monitor the compliance activities of state entities with state and federal health information requirements and require these entities to report on their activities at times specified by the director, using a format prescribed by the director.

(7) Develop standards for the center’s use in determining the extent of compliance with health information requirements.

(8) Provide technical assistance to state entities on information sharing and compliance with state and federal health information privacy requirements.

(h) (1) (A) Beginning March 1, 2022, and annually thereafter, the center shall provide to the Legislature, and post on its internet website, a written update that outlines its major endeavors, including the challenges encountered, the milestones achieved toward meeting set objectives to achieve a person-centered approach in health and human services, and the data collection and sharing practices employed by the center during the preceding year.

(B) An update to be submitted to the Legislature pursuant to subparagraph (A) shall be submitted in compliance with Section 9795 of the Government Code.

(2) Upon the issuance of the update pursuant to subparagraph (A), the center shall meet with legislative staff representing the health and human services fiscal and policy areas to report on efforts for health and human services to become more person-centered in service delivery. The center shall provide updates on specific major programs serving or attempting to serve populations that are by definition considered underserved and vulnerable, including populations living in poverty and deep poverty, and who may lack access or face limitations due to age, disability, functional impairment, educational level, adverse childhood experiences, and cultural and linguistic challenges. This meeting shall occur through virtual or in-person meetings.


text:
(a) The center shall administer the State Committee for the Protection of Human Subjects, which is California’s institutional review board. Before state information assets subject to the Information Practices Act (Chapter 1 (commencing with Section 1798) of Title 1.8 of Part 4 of Division 3 of the Civil Code) are disclosed for research, the request for data shall be approved by the State Committee for the Protection of Human Subjects in compliance with the process in Section 1798.24 of the Civil Code. In its duties, the State Committee for the Protection of Human Subjects board shall be fully independent in its review of requests for state data, institutional review board activities, and its activities under Section 1798.24 of the Civil Code.

(b) Upon appropriation by the Legislature, the center shall administer the CHHS Open Data Portal, develop and administer the Research Data Hub, and may develop and administer other significant data initiatives for California Health and Human Services Agency and its departments.

(c) The center shall use data to improve processes and provide strategic planning and services to the departments within the California Health and Human Services Agency, consistent with intent identified in subdivision (h) Section 130201.


text:
(a) Effective July 1, 2021, the Center for Data Insights and Innovation Fund is hereby created in the State Treasury, and, upon appropriation by the Legislature, moneys in the fund shall be made available for the purpose of this division. Any moneys in the fund that are unexpended or unencumbered at the end of the fiscal year may be carried forward to the next succeeding fiscal year.

(b) The Center for Data Insights and Innovation Fund is the successor fund to the Office of Health Information Integrity Trust Fund. All the assets and liabilities of the Office of Health Information Integrity Trust Fund shall become assets and liabilities of the Center for Data Insights and Innovation Fund upon establishment of the Center for Data Insights and Innovation Fund.

(c) Notwithstanding Section 16305.7 of the Government Code, all interest earned on moneys that have been deposited in the fund shall be retained in the fund and used for purposes consistent with this division.

(d) The fund shall be administered by the director and moneys in the fund shall be used to pay all costs arising from the implementation of this division and rendering services to state entities as required by this division, including, but not limited to, employment and compensation of necessary personnel and expenses, such as operating and other expenses of the center and costs associated with technical assistance, and to establish reserves. At the discretion of the director, segregated, dedicated accounts within the fund may be established.

(e) The fund shall consist of all of the following:

(1) Moneys appropriated and made available by the Legislature for the purposes of this division.

(2) All revenues received from the services provided for in this division.

(3) Any other moneys that may be made available to the center from any other source, including, but not limited to, the return from investments of moneys by the Treasurer and funds received pursuant to subdivision (g).

(f) The center may collect fee-for-service payments from a nonstate entity for services provided to the nonstate entity by the State Committee for the Protection of Human Subjects.

(g) The center may also solicit funding in any of the following ways:

(1) The center may apply to the United States Secretary of Health and Human Services for federal grants.

(2) To the extent permitted by federal law, the center may seek federal financial participation for assisting beneficiaries of the Medi-Cal program.


text:
The director may adopt regulations to implement this division and the changes made to subdivision (t) of Section 1798.24 of the Civil Code by the act that added this section. Before adopting regulations, the center shall adopt the following standards:

(a) At least 45 days prior to adoption, the center shall post a proposed regulation on its internet website. Public comment shall be accepted by the center for at least 30 days after the proposed regulation is posted. If a member of the public requests a public hearing during the 30-day review period, the hearing shall be held prior to adoption of the regulation. The process described in this subdivision shall apply to the adoption of new regulations and to changes to existing regulations until June 30, 2024.

(b) Adoption of, and changes to, regulations adopted pursuant to this division shall not be subject to the rulemaking requirements of Section 11343.4 of, and Article 5 (commencing with Section 11346) and Article 6 (commencing with Section 11349) of Chapter 3.5, of Part 1 of Division 3 of Title 2 of the Government Code until June 30, 2024.

(c) The director shall file any regulation adopted pursuant to this division with the Office of Administrative Law for filing with the Secretary of State and publication in the California Code of Regulations. Any regulation filed with the Office of Administrative Law pursuant to this subdivision shall include a citation to this section and any other applicable state or federal laws as providing authority for the adoption of the regulation.

(1) Any regulation adopted pursuant to this division shall become effective on the date it is filed with the Secretary of State unless the director prescribes a later date in the regulation or in a written instrument filed with the regulation.

(2) Any regulation adopted pursuant to this division shall expire the date that this division is repealed.


text: The center may contract for the provision of services required to implement this division. The center shall adopt standards for the organizations with which it contracts pursuant to this section to ensure compliance with the privacy and confidentiality laws of this state, conduct privacy trainings as necessary, and regularly verify that the organizations have measures in place to ensure compliance with the adopted standards. The Legislature finds that these contracts are for a new state function and authorizes the performance of this work by independent contractors, pursuant to paragraph (2) of subdivision (b) of Section 19130 of the Government Code.


text:
(a) On or before July 1, 2022, and subject to an appropriation in the annual Budget Act, the California Health and Human Services Agency, along with its departments and offices and in consultation with stakeholders and local partners, shall establish the California Health and Human Services Data Exchange Framework that shall include a single data sharing agreement and common set of policies and procedures that will leverage and advance national standards for information exchange and data content, and that will govern and require the exchange of health information among health care entities and government agencies in California. On or before January 1, 2026, the Department of Health Care Access and Information shall take over the establishment, implementation, and all of the functions related to the California Health and Human Services Data Exchange Framework, including the data sharing agreement and policies and procedures, from the California Health and Human Services Agency.

(1) The California Health and Human Services Data Exchange Framework is not intended to be an information technology system or single repository of data, rather it is technology agnostic and is a collection of organizations that are required to share health information using a common set of policies and procedures in order to improve the health outcomes of the individuals they serve.

(2) The California Health and Human Services Data Exchange Framework will be designed to enable and require real-time access to, or exchange of, health information among participants through any health information exchange network, health information organization, or technology that adheres to specified standards and policies.

(3) The California Health and Human Services Data Exchange Framework shall align with state and federal data requirements, including the federal Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191), the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), Sections 827, 10850, and 14100.2 of the Welfare and Institutions Code, and other applicable state and federal privacy laws related to the sharing of data among and between providers, payers, and the government, while also streamlining and reducing reporting burden.

(4) For the purposes of this section, “health information” means:

(A) For hospitals, skilled nursing facilities, clinical laboratories, and physician organizations and medical groups, all electronic health information as defined under federal regulation in Section 171.102 of Title 45 of the Code of Federal Regulations and held by the entity. The information pursuant to this subparagraph shall be at a minimum the information included in Section 171.102 of Title 45 of the Code of Federal Regulations as of April 15, 2025. In accordance with the California Health and Human Services Data Exchange Framework data sharing agreement and policies and procedures, a signatory to the data sharing agreement is not required to share information that is not maintained by the entity.

(B) For health insurers and health care service plans, at a minimum, the data required to be shared under the federal Centers for Medicare and Medicaid Services Interoperability and Patient Access regulations for public programs as contained in United States Department of Health and Human Services final rule CMS-9115-F, 85 FR 25510 as of April 15, 2025.

(b) (1) On or before January 31, 2024, and except as provided in paragraphs (2) to (5), inclusive, the entities listed in subdivision (f) shall exchange health information or provide access to health information to and from every other entity in subdivision (f) in real time as specified by the department pursuant to the California Health and Human Services Data Exchange Framework data sharing agreement for treatment, payment, or health care operations, except that the health care organizations in subparagraph (C) of paragraph (2) of subdivision (f) and paragraph (7) of subdivision (f) shall exchange or provide access to health information by July 1, 2026.

(2) The requirement in paragraph (1) shall not apply to physician practices of fewer than 25 physicians, rehabilitation hospitals, long-term acute care hospitals, acute psychiatric hospitals, critical access hospitals, and rural general acute care hospitals with fewer than 100 acute care beds, and any nonprofit clinic with fewer than 10 health care providers until January 31, 2026.

(3) The requirement in paragraph (1) shall not apply to facilities described in subdivision (a) of Section 1180.2 until January 31, 2029.

(4) The requirement in paragraph (1) shall not apply to the exchange of health information related to abortion, abortion-related services, gender-affirming care, immigration or citizenship status, or place of birth.

(5) The requirement in paragraph (1) shall not apply to health care organizations described in subparagraph (D) of paragraph (2) of subdivision (f) until July 1, 2027.

(c) The California Health and Human Services Agency shall convene a stakeholder advisory group no later than September 1, 2021, to advise on the development, implementation, and administration of the California Health and Human Services Data Exchange Framework. On or before January 1, 2026, the department shall take over the responsibilities of the stakeholder advisory group.

(1) The members of the stakeholder advisory group shall be appointed by the director and shall not have a financial interest, individually or through a family member, related to issues the stakeholder advisory group will advise on. The stakeholder advisory group may consider and vote on recommendations for updates to the data sharing agreement and its policies and procedures that the department may, but is not obligated to, enact.

(2) The director shall appoint to the stakeholder advisory group representatives from health care stakeholders and experts with representation of the following groups:

(A) State departments and other state entities, including signatories of the California Data Exchange Framework data sharing agreement that shall serve as ex officio nonvoting members.

(B) Health care service plans and health insurers.

(C) Physicians, including those with small practices.

(D) Hospitals, including public, private, rural, and critical access hospitals.

(E) Clinics, long-term care facilities, behavioral health facilities, or substance use disorder facilities.

(F) Consumers.

(G) Organized labor.

(H) Privacy and security professionals.

(I) Health information technology professionals.

(J) Community health information organizations.

(K) County health, social services, and public health.

(L) Community-based organizations providing social services.

(M) Skilled nursing facilities.

(N) Physician organizations and medical groups.

(O) Management services organizations.

(3) The stakeholder advisory group shall not exceed 17 voting members and shall maintain a balance of perspectives with not more than 50 percent of voting members who are signatories of the data sharing agreement.

(4) The director shall select a chair from amongst the members.

(5) The stakeholder advisory group shall provide information and advice to the department on health and social services information technology issues, including all of the following:

(A) Identify which data beyond health information as defined in paragraph (4) of subdivision (a), at minimum, should be shared for specified purposes between the entities outlined in this subdivision and subdivision (f).

(B) Identify gaps, and propose solutions to gaps, in the life cycle of health information, including gaps in any of the following:

(i) Health information creation, including the use of national standards in clinical documentation, health plan records, and social services data.

(ii) Translation, mapping, controlled vocabularies, coding, and data classification.

(iii) Storage, maintenance, and management of health information.

(iv) Linking, sharing, exchanging, and providing access to health information.

(C) Identify ways to incorporate data related to social determinants of health, such as housing and food insecurity, into shared health information.

(D) Identify ways to incorporate data related to underserved or underrepresented populations, including, but not limited to, data regarding sexual orientation and gender identity, language, race, and ethnicity.

(E) Identify ways to incorporate relevant data on behavioral health, developmental disabilities, and substance use disorder conditions.

(F) Address the privacy, security, and equity risks of expanding care coordination, health information exchange, access, and telehealth in a dynamic technological, and entrepreneurial environment, where data and network security are under constant threat of attack.

(G) Develop policies and procedures consistent with national standards and federally adopted standards in the exchange of health and social services information, including matters of meaningful and informed consent, privacy, confidentiality, identity management, liability and security, and ensure that health and social services information sharing broadly implements national frameworks and agreements.

(H) Develop definitions of complete clinical, administrative, and claims data consistent with federal policies and national standards.

(I) Identify how all payers will be required to provide enrollees with electronic access to their health information, consistent with rules applicable to federal payer programs.

(J) Assess governance structures to help guide policy decisions and general oversight.

(K) Identify federal, state, private, and philanthropic sources of funding that can support health and social services information exchange.

(6) On or before January 1, 2027, the stakeholder advisory group shall develop recommendations in consultation with signatories, consumer advocates, and racial equity experts for statutory changes, training and technical assistance, and best practices to require the entities listed in subdivision (f) to collect individual-level demographic and health-related social needs data about Californians served.

(7) The stakeholder advisory group shall hold public meetings with stakeholders, solicit input, and set its own meeting agendas. Meetings of the stakeholder advisory group are subject to the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of the Government Code).

(8) The members of the stakeholder advisory group shall serve without compensation, but shall be reimbursed for any actual and necessary expenses incurred in connection with their duties as members of the group.

(d) No later than April 1, 2022, the California Health and Human Services Agency shall submit an update, including written recommendations, to the Legislature based on input from the stakeholder advisory group on the issues identified in paragraph (5) of subdivision (c).

(e) On or before January 31, 2023, the California Health and Human Services Agency shall work with the California State Association of Counties to encourage the inclusion of county health, public health, and social services, to the extent possible, as part of the California Health and Human Services Data Exchange Framework in order to assist both public and private entities to connect through uniform standards and policies. It is the intent of the Legislature that all state and local public health agencies will exchange electronic health information in real time with participating health care entities to protect and improve the health and well-being of Californians.

(f) On or before January 31, 2023, and in alignment with existing federal standards and policies, the following health care organizations shall execute the California Health and Human Services Data Exchange Framework data sharing agreement pursuant to subdivision (a), except that the health care organizations in subparagraph (C) of paragraph (2) and paragraph (7) shall execute the data sharing agreement by July 1, 2026, and health care organizations in subparagraph (D) of paragraph (2) shall execute the data sharing agreement by July 1, 2027:

(1) General acute care hospitals, as defined by Section 1250.

(2) Physician organizations and medical groups, which include any of the following:

(A) A medical group practice, a professional medical corporation, a medical partnership, or any lawfully organized group of physicians and surgeons that provides, delivers, furnishes, or otherwise arranges for health care services.

(B) An independent practice association, to the extent that it maintains electronic health information on behalf of their participating physicians.

(C) A medical foundation exempt from licensure pursuant to subdivision (l) of Section 1206.

(D) A community clinic licensed under subdivision (a) of Section 1204, an intermittent clinic exempt from licensure under subdivision (h) of Section 1206, or a rural health clinic, as defined in paragraph (1) of subdivision (l) of Section 1396d of Title 42 of the United States Code.

(E) A specialty clinic, as described in paragraphs (1) to (3), inclusive, of subdivision (b) of Section 1204.

(F) An ambulatory surgical center or accredited outpatient setting.

(3) Skilled nursing facilities, as defined by Section 1250, that currently maintain electronic health records.

(4) Health care service plans and disability insurers that provide hospital, medical, or surgical coverage that are regulated by the Department of Managed Health Care or the Department of Insurance. This section shall also apply to a Medi-Cal managed care plan under a comprehensive risk contract with the State Department of Health Care Services pursuant to Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200) of Part 3 of Division 9 of the Welfare and Institutions Code that is not regulated by the Department of Managed Health Care or the Department of Insurance.

(5) Clinical laboratories, as that term is used in Section 1265 of the Business and Professions Code, and that are regulated by the State Department of Public Health.

(6) Acute psychiatric hospitals, as defined by Section 1250.

(7) Emergency medical services, as defined by Section 1797.72.

(g) Commencing July 1, 2026, unless already required by an existing contract requirement, including any existing contract requirement that extends to subcontractors and delegates, compliance with subdivision (f) shall be required as a condition of continuing, amending, or entering into a new or existing contract for the coverage of or provision of health care services with the Department of Health Care Services, the Public Employees’ Retirement System, and the California Health Benefit Exchange. This subdivision shall not be construed to prevent any future contract requirement that extends this provision to subcontractors and delegates.

(h) The department shall work with experienced nonprofit organizations and entities represented in the stakeholder advisory group in subdivision (c) to provide technical assistance to the entities outlined in subdivisions (e) and (f).

(i) On or before July 31, 2022, the California Health and Human Services Agency shall develop in consultation with the stakeholder advisory group in subdivision (c) a strategy for unique, secure digital identities capable of supporting master person indices to be implemented by both private and public organizations in California.

(j) For purposes of implementing this section, including, but not limited to, hiring staff and consultants, facilitating and conducting meetings, conducting research and analysis, and developing the required reports, the department may enter into exclusive or nonexclusive contracts on a bid or negotiated basis. Contracts entered into or amended pursuant to this section shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, and Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and shall be exempt from the review or approval of any division of the Department of General Services. A person hired or otherwise retained pursuant to this subdivision shall not be permitted to have any financial interest in the California Health and Human Services Data Exchange Framework or shall be, or shall not be affiliated with, any health care organization required to participate in the California Health and Human Services Data Exchange Framework pursuant to subdivisions (b) and (f). The term “person,” as used in this subdivision, means any individual, partnership, joint venture, association, corporation, or any other organization or any combination thereof.

(k) (1) The department shall administer, manage, oversee, and enforce the California Health and Human Services Data Exchange Framework and its data sharing agreement, including its related policies and procedures, governance, and all other materials or initiatives related to the California Health and Human Services Data Exchange Framework. The department shall propose and publish updates to the framework and new policies and procedures of the framework that are necessary to advance the goals of this section. There shall be at least a forty-five-calendar-day public review period to review updates to the framework and new policies and procedures. The department shall publish approved updates in a publicly accessible format 180 calendar days before the effective date of the amendment, except when a shorter time period is necessary to comply with applicable law.

(2) Commencing January 1, 2027, the department shall publish and keep current on its internet website the names of any known entities the department deems not to be in compliance with the requirement to execute the California Health and Human Services Data Exchange Framework data sharing agreement pursuant to subdivision (f). Entities may submit to the department a statement of extenuating circumstances which may impact an entity’s ability to come into compliance. The department shall publish these statements on its internet website. The department may submit information regarding compliance with the requirement in subdivision (f) to relevant state licensing entities.

(3) Upon appropriation and after submission of the report described in paragraph (4), the department may develop enforcement actions subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).

(4) In collaboration with the stakeholder advisory group, the department shall develop and submit a report to the Legislature by July 1, 2027, in compliance with Section 9795 of the Government Code that includes all of the following:

(A) A list of all entities in paragraphs (1), (3), and (4) of subdivision (f) deemed to be required signatories to the California Health and Human Services Data Exchange Framework data sharing agreement per subdivision (f).

(B) The status of each entity’s execution of the data sharing agreement.

(C) The compliance pathway or pathways utilized to meet its contractual requirements under the data sharing agreement, and, where applicable, if the signatory has a contract in place pursuant to subdivision (g).

(D) An evaluation as to the need for an independent governing board for the California Health and Human Services Data Exchange Framework.

(E) An evaluation of the need for technical assistance and other grant programs to support signatories’ legal requirements under the data sharing requirement.

(F) An evaluation of other categories of entities for participation in the California Health and Human Services Data Exchange Framework.

(G) An evaluation of the need for a framework for enforcement and investigation and resolution of disputes between California Health and Human Services Data Exchange Framework participants regarding the data sharing agreement and its policies and procedures.

(H) An assessment of consumer experiences with health and social services information exchange.

(l) Except where otherwise indicated in this section, all actions to implement the California Health and Human Services Data Exchange Framework, including the adoption or development of any data sharing agreement, requirements, policies and procedures, guidelines, subgrantee contract provisions, or reporting requirements, shall be exempt from the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). The department shall release program notices that detail the requirements of the California Health and Human Services Data Exchange Framework.

(m) For purposes of this section, both of the following definitions shall apply:

(1) “Department” means the Department of Health Care Access and Information.

(2) “Director” means the Director of the Department of Health Care Access and Information.

history: (History: Amended by Stats. 2026, Ch. 27, Sec. 55. (SB 164) Effective June 29, 2026.)

division: 109.7. CALIFORNIA HEALTH AND HUMAN SERVICES DATA EXCHANGE FRAMEWORK


text:
(a) No later than July 1, 2026, the department shall establish a process to designate qualified health information organizations as data-sharing intermediaries that have demonstrated their ability to meet requirements of the California Health and Human Services Data Exchange Framework. Health and social service organizations may comply with the data exchange framework by participating in and sharing information with a qualified health information organization.

(b) For purposes of this section, “qualified health information organization” means an entity that has applied for, and satisfied, the process and criteria described in subdivision (a).

history: (History: Added by Stats. 2025, Ch. 325, Sec. 2. (SB 660) Effective January 1, 2026.)

path: 109.7. CALIFORNIA HEALTH AND HUMAN SERVICES DATA EXCHANGE FRAMEWORK


text:
The Legislature finds and declares all of the following:

(a) Over the past three decades, the United States has been a leader in biological research and medicine that describes fundamental biological structures and processes in unprecedented detail and that has led to breakthroughs in therapies and treatments. Advances in information technology and computing have also furthered our ability to gather important data to better understand disease functions. However, we are now at a point where our capacity to collect information has outpaced our capacity to integrate and analyze it and to convert data to new knowledge.

(b) According to a 2011 report from the National Academy of Sciences, entitled “Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease,” the aggregation, integration, and analysis of data from research, clinical, personal, and population health settings are critical to creating a new knowledge network that will enable us to deliver more precise medicine, whether by targeting existing therapies more safely and effectively to patients, or by developing new therapies based on new insights into disease. Precision medicine, which embodies efforts to create this new knowledge network through data infrastructure, technology tools, and diagnostics, holds promise to transform health, health care, and biomedical research.

(c) Precision medicine, particularly in the form of better diagnostic tools for infectious disease, has the potential to alleviate the burdens of pandemics through early detection, faster response, and better countermeasures.

(d) California, with its vast scientific, medical, and technological resources, is positioned to lead advances in the field of precision medicine, which is gaining both national and international prominence. By establishing a California Initiative to Advance Precision Medicine, the state can help coordinate public, private, and nonprofit partners to advance this important intersection between science, research, and medicine, and to foster the creation of new technologies and therapies that can improve the health of Californians. A California Initiative to Advance Precision Medicine will bring together state precision medicine leaders as well as complete projects that demonstrate the power and application of precision medicine to the people of the State of California.

history: (History: Added by Stats. 2024, Ch. 41, Sec. 54. (SB 164) Effective June 29, 2024. Repealed as of June 30, 2029, pursuant to Sec. 130304.)

division: 110. CALIFORNIA INITIATIVE TO ADVANCE PRECISION MEDICINE


text: As used in this division, “California Initiative to Advance Precision Medicine” or “initiative” means the California Initiative to Advance Precision Medicine established in Section 130302.

path: 110. CALIFORNIA INITIATIVE TO ADVANCE PRECISION MEDICINE