ITUP Blog: 2024 Introduced Legislation

March 14, 2024

By: Sumaira Akbarzada, Akunna Chilaka, Daven Crossland, Indira Galvez, MPA, and Shirley Lam, MPH

2024 Introduced Legislation

Overview: The deadline for introducing legislation for the second year of the 2023-2024 legislative session was February 16, 2024. Legislation introduced this year focuses on improving access to equitable and affordable health care, transforming the health care delivery system with a focus on reproductive, perinatal, behavioral health care, and the future of health with technological innovations.

Summary and Policy Areas: This blog summarizes introduced legislation that proposes solutions relating to ITUP’s three priority policy issues: health care coverage and access, delivery system transformation, and the future of health.

Additionally, we noted with icons which bills address:

Legislative Bill Process Guide: At the end of this blog, we also include important information on the legislative bill process, helpful links, and a timeline that can be used to follow these bills throughout the year.

Note: this is not a comprehensive list of all the health and health care-related bills that were introduced. If you have questions about a bill not listed here, please feel free to contact us at [email protected]

Health Care Coverage and Access

Covered California Expansion: AB 4 (Arambula) expands access to Covered California by allowing all Californians, regardless of immigration status, to purchase health insurance through the marketplace. AB 4 requires Covered California to execute a mirror exchange program on its own to expand coverage to undocumented people under existing federal rules and subsidies if they are available. See ITUP’s Issue Brief on Expanding Health Coverage for California Farmworkers for more details on the impact of AB 4.

Health Care Immigration: AB 1783 (Essayli) removes all taxpayer funding for healthcare benefits for undocumented residents from the California State Budget. See ITUP’s fact sheet reviews existing health care programs for immigrants in California.

Office of Tribal Affairs in Public Health: AB 1965 (Blanco Rubio) establishes the Office of Tribal Affairs within California’s Department of Public Health (CDPH) led by an appointed Tribal Health Liaison to assist in addressing the public health disparities impacting Tribal communities. In addition, the appointed Liaison will serve at the pleasure of the State Public Health Officer and requires regular consults and consideration of input and information by the Liaison.

Health Care Coverage Cost Sharing: AB 2258 (Zbur) prohibits non-grandfathered health care plans or health insurance policies, issued, amended, or renewed on or after January 1, 2025, from charging patients out-of-pocket costs or cost-sharing requirements for preventive care services and screenings. Preventative care services and screenings include home test kits for sexually transmitted diseases, cervical cancer and colorectal cancer screenings, and prophylaxis for HIV infection. In addition, AB 2258 states the violation of this law would constitute a crime and that the Commissioner of the Department of Insurance is responsible for enforcing the implementation of this bill.

Social Determinants of Health Screening and Outreach: AB 2250 (Weber) requires health plans renewed or amended on or after January 1, 2027, provide social determinants of health (SDOH) screenings as a covered benefit for members. In addition, AB 2250 requires health plans to provide primary care physicians who administer SDOH screenings access to peer support specialists, health workers, social workers, or community health workers.

Medi-Cal Nonmedical and Nonemergency Medical Transportation: AB 2043 (Boerner) authorizes the Department of Health Care Services (DHCS) to require Medi-Cal Managed Care Plans (MCPs) to contract with public paratransit service operators for nonemergency medical transportation trips. This allows public paratransit service operators to be reimbursed by MCPs at DHCS’ fee-for-service transportation rate.

Medi-Cal Federally Qualified Health Centers and Rural Health Clinics: SB 282 (Eggman & McGuire) authorizes DHCS to reimburse federally qualified health centers (FQHCs) and rural health centers (RHCs) for a maximum of two same-day in-person and/or telehealth-based visits. Reimbursement for two same-day visits occurs if the Medi-Cal patient endures illness or injury after the first visit that signifies, they need further medical diagnosis or treatment or if the Medi-Cal patient has a medical visit and either a mental health visit, dentist visit, or acupuncture visit. In addition, SB 282 requires DHCS to submit a state plan amendment showcasing these policy changes to the Center for Medicare and Medicaid Services by July 1, 2024.

Health Care Delivery System Transformation

Medi-Cal: Adverse Childhood Experiences Trauma Screenings: AB 2110 (Arambula) expands provider definitions for Adverse Childhood Experiences (ACEs) screenings to include Medi-Cal enrolled community-based organizations (CBOs) and local health jurisdictions who provide services through community health workers, and doulas. This allows these providers to receive Medi-Cal payments for ACEs trauma screenings.

Language Access: SB 1078 (Min) intends to create an Office of Language Access to provide oversight, accountability, and cross-coordination amongst state agencies to ensure limited-English-proficient Californians have meaningful access to government programs and services. (hE)

Bilingual-Oriented Social Equity Services Grant Program: AB 2155 (Ting) requires, beginning with the 2025-26 fiscal year, the California Department of Social Services (CDSS) to establish the Bilingual-Oriented Social Equity Services Grant Program Fund and administer the Bilingual-Oriented Social Equity Services Grant Program to distribute funds to community-based nonprofit organizations providing equitable language access to social services. In addition, AB 2155 requires CDSS to prioritize funding to organizations who are current state program grantees. AB 2155 requires 40% of funds to be awarded as Multilingual Success Grants to CBOs serving limited-English-proficient Californians whose language communities represent 2% or more of California’s total population. In addition, AB 2155 requires 60% of funds to be awarded as Multilingual Access Grants to CBOs serving limited-English-proficient populations that do not meet that threshold.

Transforming California’s Behavioral Health and Substance Use Disorder System

Prisons Mental Health: AB 2142 (Haney) requires the California Department of Corrections and Rehabilitation (CDCR) to establish a three-year pilot program at two or more institutions to provide access to specified mental health therapy for incarcerated persons. In addition, AB 2142 requires the California Correctional Health Care Services to house treatment records generated under the pilot program. AB 2142 requires CDCR to report information to the fiscal and appropriate policy committees of the Legislature, from March 1, 2025, to March 1, 2027. (MH)

Psychological Associates at Federally Qualified Health Centers and Rural Health Clinics: AB 2703 (Aguiar-Curry) requires DHCS to seek federal approvals that would allow FQHCs and RHCs to bill DHCS for a visit between a psychological associate and a Medi-Cal patient. For this to happen, specific conditions must be met, including that a licensed psychologist supervises the psychological associate and bills for that visit under their name, not the name of the psychological associate. In addition, AB 2703 states that the definition of supervising a psychological associate will change depending upon what is required by the Board of Psychology.

Improving Women’s Health/Reproductive Health Care Delivery

California Dignity in Pregnancy and Childbirth Act: AB 2319 (Wilson & Weber) requires all hospitals providing perinatal or prenatal care to participate in evidence-based implicit bias training, including recognition of intersecting identities and potential associated biases. AB 2319 requires initial basic training for the implicit bias program to be completed by June 1, 2025, for current health care providers, and within six months of their start date for new health care providers. In addition, AB 2319 requires by February 1 of each year, facilities provide CDPH proof of compliance; failure or violation of provisions authorizes CDPH to issue an administrative penalty. AB 2319 requires CDPH to annually share publicly on their website a list of facilities that did not submit timely proof of compliance and have been issued administrative penalties. In addition, AB 2319 vests CDPH with full administrative power, authority, and jurisdiction to implement and enforce the California Dignity in Pregnancy and Childbirth Act.

Future of Health

Broadband

Affordable Internet and Net Equality Act of 2024: AB 1588 (Wilson) requires the California Department of Technology (CDT), in coordination with the California Public Utilities Commission (CPUC) and the California Department of General Services (DGS) to develop and establish the Net Equality Program. In addition, AB 1588 requires the state to only contract with internet service providers (ISPs) offering affordable internet services, costing no more than $40 per month to households participating in certain public assistance programs, or the federal Affordable Connectivity Program (ACP). AB 1588 requires CDT to provide a publicly accessible list of ISPs that meet the requirements on their website.

Affordable Internet and Net Equality Act of 2024: SB 1179 (Durazo) requires CDT, in coordination with the CPUC, and DGS to develop and establish the Net Equality Program. In addition, SB 1179 requires the state to contract with ISPs offering affordable internet service to households participating in certain public assistance programs. SB 1179 defines affordable home internet service as costing no more than $30 per month and that it meets specified minimum speed requirements. In addition, SB 1179 requires ISPs to establish a phone number to sign up eligible households and requires ISPs to advertise the availability of affordable internet service. SB 1179 requires CDT to annually update and provide a list of ISPs that meet the requirements on their website.

Defining Digital Discrimination of Access: AB 2239 (Bonta) intends to adopt the definition of “digital discrimination access” that conforms to the definition adopted by the Federal Communications Commission (FCC) into state law.

Telehealth

Medi-Cal Telehealth: AB 2339 (Aguiar-Curry) expands existing Medi-Cal definitions and exceptions to allow the use of asynchronous telehealth modalities to establish new patient relationships when related to sensitive services and requested by patients. In addition, AB 2339 states that for purposes of Medi-Cal, asynchronous store and forward also includes asynchronous electronic transmission initiated directly by patients, including through mobile telephone applications. AB 2339 removes the option of patients attesting to no video access in audio-only establishment exception.

Health Information: AB 1943 (Weber) establishes the identification and collection of telehealth data in the Medi-Cal program to measure individual patient health and population health outcomes. Data elements collected include outcomes, access, effectiveness, and morbidity and mortality and will be used to measure outcomes of the Medi-Cal population for medical care, public health interventions, social determinants, physical environments, genetics, and individual behavior.

Healing Arts Counseling: AB 2566 (Wilson) enters California into the Interstate Counseling Compact (the Compact), an interstate licensing compact legally binding among multiple states facilitating interstate practice of licensed professional counselors. In addition, AB 2566 requires the Compact to establish a joint public agency, the Counseling Compact Commission to provide development, maintenance, operation, and utilization of a coordinated database and reporting system containing licensure, adverse action, and investigative information on all licensed individuals in Member States.

Artificial Intelligence

Artificial Intelligence Disclosure: AB 1824 (Valencia) creates a disclosure requirement for content generated through artificial intelligence (AI).

Artificial Intelligence Training Data Transparency: AB 2013 (Irwin) requires, on or before January 1, 2026, developers of artificial intelligence systems to post on their websites documentation regarding the data used to train the artificial intelligence system or service.

California Interagency AI Working Group: SB 721 (Becker) creates the California Interagency AI Working Group, until January 1, 2030 to deliver a report to the Legislature concerning AI. In addition, SB 721 requires working group members to be Californians with expertise in at least two of the following areas: computer, artificial intelligence, and data privacy. SB 721 requires the report to include a recommendation of a definition of artificial intelligence for use in legislation.

Automated Decision Systems: AB 2058 (Weber) states the intent of the Legislature to enact legislation relating to commercial algorithms and artificial intelligence-enabled medical devices.

Artificial Intelligence Accountability Act: SB 896 (Dodd) requires the Government Operations Agency, CDT, and the Office of Data and Innovation to produce a State of California Benefits and Risk of Generative Artificial Intelligence Report. In addition, SB 896 requires the report to include an examination of the most significant, potentially beneficial uses for deployment of generative artificial intelligence (GenAI) tools by the state and requires those entities to update the report. SB 896 requires the California Cybersecurity Integration Center and the State Threat Assessment Center to perform a joint risk analysis of potential threats posed by the use of GenAI to California’s critical energy infrastructure. In addition, SB 896 requires a state agency that uses GenAI to clearly disclose their use of AI during person interactions, whether through an online platform or telephonically. SB 896 requires an automated decisionmaking system used by a state agency or department to be evaluated for risk potential before adoption.

Artificial Intelligence Services: Safety, Privacy, and Nondiscrimination Standards: SB 892 (Padilla) requires CDT to establish safety, privacy, and nondiscrimination standards for AI services and to report to the Legislature the standards established. In addition, on August 1, 2025, SB 892 prohibits contracts for artificial intelligence unless the provider meets those standards set by CDT.

California Artificial Intelligence Research Hub: SB 893 (Padilla) requires the Government Operations Agency, the Governor’s Office of Business and Economic Development, and CDT, to collaborate and establish the California Artificial Intelligence Research Hub (hub) in the Government Operations Agency. In addition, SB 893 requires the hub to serve as a centralized entity facilitating collaboration across multi-disciplinary partners to advance artificial intelligence research and development that seeks to harness the technology’s full potential for public benefit while safeguarding privacy, advancing security, and addressing risks and potential harms to Californians.

Artificial Intelligence Technology: SB 970 (Ashby) determines the use of synthetic, AI-generated audio, video, and images, is deemed as false personation of a person’s likeness. In addition, SB 970 requires the Judicial Council to develop and implement screening procedures to identify synthetic records. SB 970 requires the Judicial Council to create educational materials to aid in identifying AI-tampered evidence. In addition, SB 970 requires any person or entity selling or providing access to artificial intelligence technology designed to create synthetic images, video, or voice to provide a consumer warning that misuse of such technology may result in civil or criminal liability for the user.

Safe and Secure Innovation for Frontier Artificial Intelligence Systems Act: SB 1047 (Wiener) enacts the Safe and Secure Innovation for Frontier Artificial Intelligence Systems Act to require a developer of a covered model to determine safety regulations for large-scale AI models to ensure they do not cause harm to society. Before training of an AI model starts, SB 1047 requires developers, or people who are responsible for the creation and ownership of an AI model, to make a positive safety determination determining their large AI systems do not have or come close to having hazardous capabilities to harm society. If an AI model does not have a positive safety determination, developers must ensure they know how to fully shut down the AI model, if needed. In addition, SB 1047 establishes the Frontier Model Division within CDT. Developers of AI models that do not have a positive safety determination must submit annual certifications of compliance regarding the harms presented to society and reports describing any safety incidents that occur. SB 1047 requires the Frontier Model Division publicly release reports summarizing the findings of the certifications of compliance. In addition, SB 1047 mandates CDT to create CalCompute, a public cloud computer cluster that aims to spur innovation in researching, developing, and deploying large-scale AI models safely, securely, and equitably. SB 1047 protects whistleblowers who report developers who do not comply with the law and states that the violation of this law constitutes a civil violation that is made enforceable by the California Attorney General.

Health Care Coverage Utilization Review: SB 1120 (Becker) requires health care plans or health insurers to ensure that a licensed physician supervises the use of AI decision making tools used for prior authorization. SB 1120 requires licensed physician oversight when AI tools are used to inform decisions to approve, deny, or modify prior authorization requests.

Data

California Health and Human Services Data Exchange Framework: AB 1331 (Wood) requires the Center for Data Insights and Innovation (CDII), a division of CalHHS to oversee CalHHS DxF on or before January 1, 2025, and establish a CalHHS Data Exchange Board. The Board will review, modify, and approve modifications to the existing Data Sharing Agreement (DSA), which oversees the sharing of health information among health care organizations and government agencies in California. The Board will develop a process for designating qualified health information organizations (QHIOs) and report DSA signatory compliance, consumer experiences with data exchange, and evaluation of technical programs and grants to the legislature annually.  See ITUP’s California Data Exchange Framework 101 Fact Sheet & Policy Toolkit for more information.

Social Care Data Privacy: AB 1011 (Weber) prohibits entities from selling, renting, or otherwise disclosing social care information used within a closed-loop referral system (CLRS), unless required by law. In addition, AB 1011 prohibits the use of social care information stored in CLRSs for any purpose other than the purpose for which the information was collected. AB 1011 defines social care information as any care, services, goods, administrative, or payment information related to an individual’s social needs.

What’s Next: Legislative Process Information

This is a timeline with key events and deadlines useful for tracking legislation. Below, we provide a detailed explanation of the timeline and the California legislative process.

The 2024 Legislative calendars for the California Assembly, and Senate include all deadlines that must be met for bills to be signed into law. The ‘house of origin’ or the ‘first house’ is the branch of the Legislature where the bill was introduced (ABs = Assembly Bills, the Assembly is the first house the bill must pass through; SBs = Senate Bills, the Senate is the first house the bill must pass through). Bills can be amended throughout the process.

Committee Hearings

Policy committees began hearing bills in March 2024. The committees are made up of a subset of assemblymembers or senators to hear bills on a specific policy topic, such as health. The committee chairs set bills for hearing dates throughout March and April, and public hearings are recorded and can be watched live, typically in person, but live stream video is available and was preferred during the public health emergency. Assembly and Senate Health Committee hearing dates, agendas that list the bills being heard, and a link to where you, the public, can watch the hearings are found on each policy committee’s website. The deadline for bills to be discussed in committees is April 26, 2024, for fiscal bills (legislation that has a cost to the state), and May 3, 2024, for non-fiscal bills.

Appropriations Committee Hearings

Once a bill passes in policy committee(s), the next step in the legislative process for most bills is a hearing in the Appropriations Committee. The Appropriations Committee reviews all bills that have a designated fiscal impact, and the deadline for bills to be heard in the House of Origin appropriations committee is May 17, 2024. At this point in the Legislative process, many bills will be ‘held on suspense,’ which effectively means they will not move forward in the process. In the Assembly, any bill that has an annual cost of $150,000 or more, from any fund, gets placed on the suspense file. In the Senate, legislation with an annual cost of $50,000 General Fund or $150,000 federal funds or special funds, gets placed on the suspense file. Like the policy committees, the Appropriations Committees hold public hearings. Most bills get placed on the suspense file and are heard in committee close to the May 17, 2024, deadline.

House of Origin Floor Vote

The last stop for a bill before the opposite house begins to weigh in on the policy is the ‘floor vote’. This is where all Assemblymembers vote on AB bills and all Senators vote on SB bills. The deadline for bills to be voted on the House of Origin floor this year is May 24, 2024.

Following a bill’s successful passage out of its house of origin, the entire process listed above is repeated in the opposite house (Ex. Abs will then go through the Legislative process in the Senate). The last day of this year’s legislative session, and subsequently, the last day a bill can pass through the entire process is August 31, 2024. Bills that successfully passed through the Legislature will either be signed or vetoed by Governor Newsom no later than September 30, 2024.