Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which health care services are provided to qualified, low-income persons. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law authorizes a county board of supervisors, by ordinance, to establish a commission to negotiate an exclusive contract with the department and to arrange for the provision of health care services under the Medi-Cal program. This system of services provided by or through a county under these provisions is known as a county organized health system. Pursuant to this authority, the County of Orange, by ordinance, established a commission, known as the Orange County Health Authority, or CalOptima, to provide health care services under the Medi-Cal program.
Existing law codifies the establishment of the Orange County Health Authority and vests governance of the authority in a 10-member governing body. Existing law prescribes the membership of the governing body, which includes, among others, 2 members of the Board of Supervisors of the County of Orange, one member who is a current or former hospital administrator, and one member who is a representative of a community clinic. Existing law requires a member of the governing body to serve a 4-year term, except for a member who is a member of the Board of Supervisors of the County of Orange, who is required to serve a one-year term. Existing law prohibits a member of the governing body, except for a member of the Board of Supervisors of the County of Orange, from serving more than 2 consecutive terms.
This bill would prohibit an individual who served a one-year term on the governing body as a member of the board of supervisors from being appointed to serve a 4-year term under any of the other categories within 12 months of the expiration of their one-year term.
Under existing law, the voting members are nominated by the Orange County Health Care Agency and are appointed by a majority vote of the board of supervisors.
This bill would require the board of supervisors to consult with stakeholders in the County of Orange, as specified, for purposes of identifying qualified individuals to be considered as members of the governing body.
Existing law requires members of the governing body to, among other things, strive to improve health care quality, promote prevention and wellness, ensure the provision of cost-effective health and mental health care services, and reduce health disparities.
This bill would require the members of the governing body to ensure the provision of cost-effective behavioral health care services, rather than mental health care services, and would additionally require the members to address the needs of Medi-Cal members who are affected by homelessness and housing instability, improve quality outcomes, and manage the risk and needs of Medi-Cal beneficiaries through whole-person care approaches and addressing social determinants of health.
This bill would require a member of the governing body who has a financial interest in a decision of the governing body to, upon identifying a conflict of interest or a potential conflict of interest, take certain actions, including publicly identifying the financial interest that gives rise to the conflict of interest or potential conflict of interest, recusing the member's own self from discussing and voting on the matter, and leaving the room until after the discussion, vote, and any other disposition of the matter is concluded.
This bill would prohibit members of the governing body, for a period of one year after leaving office, from acting as an agent or attorney for, or otherwise representing, for compensation, any other person, by making any appearance before, or by making any communication to, the commission, as specified, if the appearance or communication is made for the purpose of influencing the commission to take certain actions. The bill would also prohibit specified members of the governing body, for a period of one year after leaving office, from serving as an employee, agent, or attorney for, or otherwise representing, for compensation, the Orange County Health Authority or any other entity that received an expenditure of Medi-Cal funds from the Orange County Health Authority during the prior 5 years, with exceptions, including if the member is returning to or continuing a role they held when appointed to the governing body.
This bill would eliminate the January 1, 2023, repeal date for the authority, thereby extending the authorization for the authority indefinitely. The bill would make other clarifying changes.
This bill would make legislative findings and declarations as to the necessity of a special statute for the County of Orange.

Statutes affected:
09/10/21 - Amended Senate: 31461 GOV
06/13/22 - Amended Senate: 14087.59 WIC, 31461 GOV
06/23/22 - Amended Senate: 14087.59 WIC
08/01/22 - Amended Senate: 14087.59 WIC
08/22/22 - Amended Senate: 14087.59 WIC
09/02/22 - Enrolled: 14087.59 WIC
09/19/22 - Chaptered: 14087.59 WIC