CA SB 324
in committeeMedi-Cal: enhanced care management and community supports.
California · 2025-2026 Regular Session · upper
Quick answers
Did CA SB 324 pass?
Not yet. CA SB 324 is in committee as of 2025-08-29 and has not come to a final vote. Latest recorded action (2025-08-29): August 29 hearing: Held in committee and under submission.
What is CA SB 324 about?
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law, subject to implementation of the California Advancing and Innovating Medi-Cal (CalAIM) initiative, requires the department to implement an enhanced care management (ECM) benefit designed to address the clinical and nonclinical needs on a whole-person-care basis for certain target populations of Medi-Cal beneficiaries enrolled in Medi-Cal managed care plans. Under existing law, target populations include, among others, high utilizers with frequent hospital admissions, short-term skilled nursing facility stays, or emergency room visits, and individuals experiencing homelessness. Existing law, subject to CalAIM implementation, authorizes a Medi-Cal managed care plan to elect to cover community supports, as specified. Under existing law, community supports that the department is authorized to approve include, among others, housing transition navigation services and medically supportive food and nutrition services. This bill would require a Medi-Cal managed care plan, for purposes of covering the ECM benefit, or if it elects to cover a community support, to contract with community providers, as defined, that can demonstrate that they are capable of providing access and meeting quality requirements in accordance with Medi-Cal guidelines. In determining which community providers to contract with, the bill would authorize Medi-Cal managed care plans to take into consideration whether those providers are available in the respective county and have experience in providing the applicable ECM or community support. The bill would require the department, for purposes of enforcing these provisions, to require Medi-Cal managed care plans to set goals every other year for the level of contracting and utilization of community providers and local entities, as defined. The bill would require these goals to be established in consultation with the department, as specified. If a community provider contracted to provide ECM services or community supports submits a referral or authorization request for the applicable service on behalf of an eligible member, the bill would require a Medi-Cal managed care plan to assign the member to the contracted referring provider if the plan determines that the provider can appropriately meet the needs of the member. The bill would prohibit the above-described provisions from being construed to limit the department's authority to grant eligibility for presumptive authorization for categories of ECM providers that have extensive experience and expertise in serving certain ECM populations of focus. Existing law requires the department to develop, in consultation with Medi-Cal managed care plans and other appropriate stakeholders, a monitoring plan and reporting template for the implementation of ECM or community supports. Existing law requires the department to annually publish a public report on reported ECM or community support utilization data, populations served, and demographic data, stratified by age, sex, race, ethnicity, and languages spoken, to the extent that statistically reliant data are available. This bill would expressly include providers of ECM or community supports within the consultation process. The bill would require the department to publish the public report on a quarterly basis instead and would require additional demographic data. The bill would also require the department to develop standardized and streamlined templates to be used by Medi-Cal managed care plans or their contracted providers, as specified, and to develop guidance to allow community providers to act as a primary subcontractor with Medi-Cal managed care plans and to subcontract with other community providers as a 3rd-tier subcontractor, as specified.
Who sponsors CA SB 324?
Menjivar is the primary sponsor of CA SB 324, joined by 2 cosponsors.
Description
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law, subject to implementation of the California Advancing and Innovating Medi-Cal (CalAIM) initiative, requires the department to implement an enhanced care management (ECM) benefit designed to address the clinical and nonclinical needs on a whole-person-care basis for certain target populations of Medi-Cal beneficiaries enrolled in Medi-Cal managed care plans. Under existing law, target populations include, among others, high utilizers with frequent hospital admissions, short-term skilled nursing facility stays, or emergency room visits, and individuals experiencing homelessness. Existing law, subject to CalAIM implementation, authorizes a Medi-Cal managed care plan to elect to cover community supports, as specified. Under existing law, community supports that the department is authorized to approve include, among others, housing transition navigation services and medically supportive food and nutrition services. This bill would require a Medi-Cal managed care plan, for purposes of covering the ECM benefit, or if it elects to cover a community support, to contract with community providers, as defined, that can demonstrate that they are capable of providing access and meeting quality requirements in accordance with Medi-Cal guidelines. In determining which community providers to contract with, the bill would authorize Medi-Cal managed care plans to take into consideration whether those providers are available in the respective county and have experience in providing the applicable ECM or community support. The bill would require the department, for purposes of enforcing these provisions, to require Medi-Cal managed care plans to set goals every other year for the level of contracting and utilization of community providers and local entities, as defined. The bill would require these goals to be established in consultation with the department, as specified. If a community provider contracted to provide ECM services or community supports submits a referral or authorization request for the applicable service on behalf of an eligible member, the bill would require a Medi-Cal managed care plan to assign the member to the contracted referring provider if the plan determines that the provider can appropriately meet the needs of the member. The bill would prohibit the above-described provisions from being construed to limit the department's authority to grant eligibility for presumptive authorization for categories of ECM providers that have extensive experience and expertise in serving certain ECM populations of focus. Existing law requires the department to develop, in consultation with Medi-Cal managed care plans and other appropriate stakeholders, a monitoring plan and reporting template for the implementation of ECM or community supports. Existing law requires the department to annually publish a public report on reported ECM or community support utilization data, populations served, and demographic data, stratified by age, sex, race, ethnicity, and languages spoken, to the extent that statistically reliant data are available. This bill would expressly include providers of ECM or community supports within the consultation process. The bill would require the department to publish the public report on a quarterly basis instead and would require additional demographic data. The bill would also require the department to develop standardized and streamlined templates to be used by Medi-Cal managed care plans or their contracted providers, as specified, and to develop guidance to allow community providers to act as a primary subcontractor with Medi-Cal managed care plans and to subcontract with other community providers as a 3rd-tier subcontractor, as specified.
- Introduced
- 2025-02-11
- Latest action
- 2025-08-29 — August 29 hearing: Held in committee and under submission.
- Bill type
- bill
- Last updated
- —
Subjects
Sponsors
- Menjivarauthor
- McGuireprincipal coauthor
- Calozacoauthor
Committees
Not provided by source.
Action timeline
2025-02-11
Introduced. Read first time. To Com. on RLS. for assignment. To print.
introduction,reading-1,referral-committee
2025-02-12
From printer. May be acted upon on or after March 14.
2025-02-19
Referred to Com. on HEALTH.
referral-committee
2025-03-17
Set for hearing April 2.
2025-03-24
From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.
amendment-passage,committee-passage,reading-1,reading-2,referral-committee
2025-04-03
From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 11. Noes 0. Page 636.) (April 2).
amendment-passage,committee-passage,committee-passage-favorable,referral-committee
2025-04-07
Read second time and amended. Re-referred to Com. on APPR.
amendment-passage,reading-1,reading-2,referral-committee
2025-04-08
Set for hearing April 21.
2025-04-21
April 21 hearing: Placed on APPR. suspense file.
2025-05-16
Set for hearing May 23.
2025-05-23
From committee: Do pass. (Ayes 6. Noes 0. Page 1196.) (May 23).
committee-passage,committee-passage-favorable
2025-05-23
Read second time. Ordered to third reading.
reading-1,reading-2,reading-3
2025-05-27
Read third time. Passed. (Ayes 39. Noes 0. Page 1252.) Ordered to the Assembly.
passage,reading-1,reading-3
2025-05-28
In Assembly. Read first time. Held at Desk.
reading-1
2025-06-05
Referred to Com. on HEALTH.
referral-committee
2025-06-18
From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.
amendment-passage,committee-passage,reading-1,reading-2,referral-committee
2025-07-02
From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 15. Noes 0.) (July 1).
amendment-passage,committee-passage,committee-passage-favorable,referral-committee
2025-07-03
Read second time and amended. Re-referred to Com. on APPR.
amendment-passage,reading-1,reading-2,referral-committee
2025-08-20
August 20 set for first hearing. Placed on APPR. suspense file.
2025-08-29
August 29 hearing: Held in committee and under submission.
Versions
Documents
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Votes
Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations]
2025-04-02 · pass · 11-0
Member-level votes (11)
- Gonzalez: yes
- Valladares: yes
- Weber Pierson: yes
- Rubio: yes
- Durazo: yes
- Grove: yes
- Menjivar: yes
- Padilla: yes
- Wiener: yes
- Limón: yes
- Richardson: yes
Placed on suspense file
2025-04-21 · pass · 6-0
Member-level votes (7)
- Grayson: yes
- Wahab: yes
- Richardson: yes
- Cabaldon: yes
- Caballero: yes
- Seyarto: yes
- Dahle: other
Do pass
2025-05-23 · pass · 6-0
Member-level votes (7)
- Caballero: yes
- Seyarto: yes
- Wahab: yes
- Cabaldon: yes
- Richardson: yes
- Grayson: yes
- Dahle: other
3rd Reading SB324 Menjivar et al.
2025-05-27 · pass · 39-0
Member-level votes (40)
- Cabaldon: yes
- Wahab: yes
- Pérez: yes
- Padilla: yes
- Allen: yes
- Seyarto: yes
- Weber Pierson: yes
- Grove: yes
- Archuleta: yes
- Laird: yes
- Umberg: yes
- Stern: yes
- Limón: yes
- Grayson: yes
- McGuire: yes
- Jones: yes
- McNerney: yes
- Ochoa Bogh: yes
- Caballero: yes
- Ashby: yes
- Rubio: yes
- Cortese: yes
- Arreguín: yes
- Richardson: yes
- Hurtado: yes
- Smallwood-Cuevas: yes
- Cervantes: yes
- Wiener: yes
- Alvarado-Gil: yes
- Gonzalez: yes
- Valladares: yes
- Menjivar: yes
- Durazo: yes
- Becker: yes
- Strickland: yes
- Blakespear: yes
- Dahle: yes
- Choi: yes
- Niello: yes
- Reyes: other
Do pass as amended and be re-referred to the Committee on [Appropriations]
2025-07-01 · pass · 15-0
Member-level votes (16)
- Bonta: yes
- Chen: yes
- Caloza: yes
- Mark González: yes
- Sanchez: yes
- Schiavo: yes
- Aguiar-Curry: yes
- Flora: yes
- Celeste Rodriguez: yes
- Patel: yes
- Stefani: yes
- Krell: yes
- Addis: yes
- Carrillo: yes
- Sharp-Collins: yes
- Patterson: other
Related bills
No related bills recorded for this bill.
Official source
Attribution
Data from openstates_bulk_csv, retrieved 2026-07-24T01:34:27.960412Z
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