AMENDED IN ASSEMBLY JULY 7, 2025
AMENDED IN SENATE APRIL 10, 2025
AMENDED IN SENATE APRIL 2, 2025
CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION
96
Introduced by Senator Hurtado
February 10, 2025
An act to amend Section 122475 of, to add Sections 1316.8 and 1367.57 to, to add the heading of Chapter 1 (commencing with Section 122475) to Part 7.7 of Division 105 of, and to add Chapter 2 (commencing with Section 122480) to Part 7.7 of Division 105 of, the Health and Safety Code, and to add Section 10123.25 to the Insurance Code, and to add Section 14132.13 to the Welfare and Institutions Code, relating to public health.
Vote: majority Appropriation: no Fiscal committee: yes Local program: yes
LEGISLATIVE COUNSEL’S DIGEST
(1) Existing law establishes the State Department of Public Health to, among other things, implement and administer various programs relating to public health. Existing law, the Valley Fever Education, Early Diagnosis, and Treatment Act, states the intent of the Legislature to raise awareness of the symptoms, tests, and treatments for valley fever among the general public, primary health care providers, and health care providers who care for persons at higher risk for getting valley fever.
This bill, the Valley Fever Screening and Prevention Act of 2025, would require the department to annually analyze and identify regions with high rates of valley fever using public health surveillance data.
department, in consultation with subject matter experts, to the extent feasible and using available data and resources, including public health surveillance data, to annually analyze and identify regions with elevated rates of valley fever. The bill would require the department to publish its first list of high-incidence regions for valley fever on or before March 1, 2027. The bill would require the department to provide local health departments in high-incidence regions with detailed infection data and standardized screening protocols that align with the current national clinical practice recommendations for valley fever. The bill would require the department, on or before January 1, 2030, and every 2 years thereafter, to evaluate the effectiveness of the valley fever screening and prevention program and report its findings to the Legislature.
This bill would require local health departments in high-incidence areas to conduct outreach to health care providers and the general public to raise awareness of valley fever risks, symptoms, and prevention strategies. The bill would require local health departments to annually report the number of confirmed cases of valley fever to the department, as specified. By imposing duties on local health departments, this bill would impose a state-mandated local program.
(2) Existing law provides for the licensure and regulation of health facilities and clinics by the State Department of Public Health. A violation of these provisions is a crime.
This bill, commencing January 1, 2028, would require an adult patient receiving primary care services in a facility, clinic, unlicensed clinic, center, office, or other setting, and in a high-incidence region for valley fever,
to be offered a valley fever screening test, as specified. screened for valley fever, to the extent the services are covered under the patient’s health insurance, unless specified circumstances exist. If the results of a screening suggest that testing should be considered, the bill would require the health care provider to offer the patient diagnostic testing. If the test result is positive, the health care provider shall offer care, as specified, for valley fever management. The bill would prohibit a health care provider who fails to comply with these provisions who, based on their professional judgment, determines it is not appropriate to screen, offer
to screen, or consider or offer a patient testing for valley fever from being subject to any disciplinary action related to their licensure or certification, or to
any civil or criminal liability for that failure. licensure, certification, or privileges in relation to that determination. The bill would also prohibit a violation of these provisions from being the basis of civil or criminal liability.
By expanding the scope of a crime applicable to the health care settings described above, this bill would impose a state-mandated local program.
(3) Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance.
This bill would require prohibit a health care service plan contract or health insurance policy, except as specified, that is issued, amended, delivered, or
renewed on or after June 1, 2027, to cover, without cost sharing, from imposing a deductible, coinsurance, copayment, or other requirement on a valley fever screening or test, as specified, in high-incidence regions for valley fever, as identified by the State Department of Public Health. fever. Because a violation of this requirement relative to health care service plans would be a crime, the bill would impose a state-mandated local program.
(4) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason.
With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
The people of the State of California do enact as follows:
SECTION 1.
This act is known, and may be cited, as the Valley Fever Screening and Prevention Act of 2025.
SEC. 2.
The Legislature finds and declares all of the following:
(a) Valley fever is a significant public health concern in California, disproportionately impacting residents of arid regions.
(b) Early detection and intervention are essential to reduce the medical and economic burdens associated with severe cases of valley fever.
(c) Valley fever screening and prevention is necessary to protect the health and well-being of Californians residing in high-risk areas.
(d) Under existing Medi-Cal coverage, skin tests for valley fever are available to Medi-Cal members as part of an office visit for any Medi-Cal member experiencing symptoms. In addition, Medi-Cal covers diagnostic blood tests.
SEC. 3.
Section 1316.8 is added to the Health and Safety Code, to read:
1316.8.
(a) Commencing January 1, 2028, an adult patient who receives primary care services in a facility, clinic, unlicensed clinic, center, office, or other setting where primary care services are provided, and in a high-incidence region for valley fever, as identified by the State Department of Public Health pursuant to Section 122480, shall be offered a valley fever screening test, screened for valley fever, to the extent these services are covered under the patient’s health insurance, based on the latest screening indications recommended by the latest national clinical practice guidelines,
current national clinical practice recommendations, unless the health care provider reasonably believes that one of the following conditions applies:
(1) The patient is being treated for a life-threatening emergency.
(2) (A)The patient has previously been offered or has been the subject of a valley fever screening test. screened or tested for valley fever.
(3) The patient lacks capacity to consent to a valley fever screening test.
(4) The patient is being treated in the emergency department of a general acute care hospital, as defined in subdivision (a) of Section 1250.
(2) Followup health care shall include diagnostic testing and care based on the latest national clinical practice guidelines recommended for valley fever management.
(b) If the result of a valley fever screening suggests that testing should be considered, a health care provider shall offer diagnostic testing, to the extent these services are covered under the patient’s health insurance. If the diagnostic test result is positive, the health care provider shall offer care based on current national clinical practice recommendations for valley fever management or offer to refer the patient to a health care provider who can provide followup health care.
(c) The offering of a valley fever screening test under this section shall be culturally and linguistically appropriate.
(d) This section shall not affect the scope of practice of any health care provider or diminish any authority or legal or professional obligation of any health care provider to offer a screen or test for valley fever screening test,
fever,
or to provide services or care for the patient of a valley fever screening or test.
(e) A health care provider that fails to comply with the requirements of this section who, based upon their professional judgment, determines that it is not appropriate to screen, or offer to screen, a patient for valley fever, or to consider or offer a patient diagnostic testing or care for valley fever, shall not be subject to any disciplinary actions related to their licensure or certification, or to any civil or criminal liability, because of the health care provider’s failure to comply with the requirements of this section.
licensure, certification, or privileges in relation to that determination. A violation of this section shall not be the basis of any civil or criminal liability.
(f) For purposes of this section, the following definitions apply:
(1) “Followup health care” includes providing medical management for valley fever according to the latest current national clinical practice guidelines. recommendations.
(2) “Valley fever screening” means assessing a patient’s clinical presentation to determine if diagnostic testing for coccidioidomycosis should be considered in accordance with current national clinical practice recommendations.
(3) “Valley fever screening test” includes any laboratory test or tests that detect the presence of Coccidioides infection and provides confirmation of whether the patient has been infected.
an active infection.
SEC. 4.
Section 1367.57 is added to the Health and Safety Code, to read:
(a) A health care service plan contract, except for a specialized health care service plan contract, that is issued, amended, delivered, or renewed on or after June 1, 2027, shall cover a valley fever screening test provided pursuant to Section 1316.8 in high-incidence regions for valley fever, as identified by the State Department of Public Health pursuant to Section 122480.
(b) (1)
1367.57.
(a) A health care service plan contract shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided pursuant to this section. a valley fever screening or test provided pursuant to Section 1316.8 in high-incidence regions for valley fever.
(b) Notwithstanding paragraph (1), subdivision (a),
if a health care service plan contract is a high deductible health plan as defined in Section 223(c)(2) of Title 26 of the United States Code, the contract shall not impose a deductible, coinsurance, or any other cost sharing on a valley fever screening test, or test for a covered individual that lives, works, or attends school in or that recently visited a high-incidence region for valley fever, unless not applying the deductible, coinsurance, or other cost sharing would conflict with federal requirements for high deductible health plans.
SEC. 5.
The heading of Chapter 1 (commencing with Section 122475) is added to Part 7.7 of Division 105 of the Health and Safety Code, to read:
Chapter 1. General Provisions
SEC. 6.
Section 122475 of the Health and Safety Code is amended to read:
122475.
This chapter shall be known, and may be cited, as the Valley Fever Education, Early Diagnosis, and Treatment Act.
SEC. 7.
Chapter 2 (commencing with Section 122480) is added to Part 7.7 of Division 105 of the Health and Safety Code, to read:
Chapter 2. Screening and Prevention
(a) (1) The State Department of Public Health shall shall, to the extent feasible and using available data and resources, annually analyze and identify regions with high elevated rates of valley fever using based on
public health surveillance data. data and in consultation with subject matter experts. The department may revise its identification criteria over time in response to shifting patterns of disease incidence.
(2) The department shall publish its first list of high-incidence regions for valley fever on or before March 1, 2027.
(b) The department shall provide local health departments in high-incidence regions with detailed infection data and standardized screening protocols that align with the current national clinical practice recommendations for valley fever.
(c) The department shall develop and distribute evidence-based training materials on valley fever screening, detection, diagnosis, and treatment for health care providers.
(a) Local health departments in high incidence areas shall conduct outreach to health care providers and the general public to raise awareness of valley fever risks, symptoms, and prevention strategies.
(b) Local health departments shall annually report to the State Department of Public Health the number of confirmed cases of valley fever.
(a) Notwithstanding Section 10231.5 of the Government Code, on or before January 1, 2030, and every two years thereafter, the department shall evaluate the effectiveness of the valley fever screening and prevention program and report its findings to the Legislature.
(b) A report to be submitted pursuant to subdivision (a) shall be submitted in compliance with Section 9795 of the Government Code.
SEC. 8.
Section 10123.25 is added to the Insurance Code, to read:
(a) A health insurance policy, except for a specialized health insurance policy, that is issued, amended, delivered, or renewed on or after June 1, 2027, shall cover a valley fever screening test provided pursuant to Section 1316.8 of the Health and Safety Code in high-incidence regions for valley fever, as identified by the State Department of Public Health pursuant to Section 122480 of the Health and Safety Code.
(b) (1)
10123.25.
(a) A health insurance policy shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided pursuant to this section. a valley fever screening or test provided pursuant to Section 1316.8 of the Health and Safety Code in high-incidence regions for valley fever for any covered individual that lives, works, or attends school in or that recently visited any
high-incidence region for valley fever.
(b) Notwithstanding paragraph (1), subdivision (a), if a health insurance policy is a high deductible health plan, as defined in Section 223(c)(2) of Title 26 of the United States Code, the policy shall not impose a deductible, coinsurance, or any other cost sharing on a valley fever screening test, unless not applying the deductible, coinsurance, or other cost sharing
would conflict with federal requirements for high deductible health plans.
Section 14132.13 is added to the Welfare and Institutions Code, to read:
14132.13.
(a) Commencing on June 1, 2027, valley fever screening tests in high-incidence regions for valley fever, as identified by the State Department of Public Health pursuant to Section 122480 of the Health and Safety Code, shall be a covered benefit under the Medi-Cal program.
(b) This section shall be implemented only to the extent that any necessary federal approvals are obtained and federal financial participation is available and not otherwise jeopardized.
SEC. 10.SEC. 9.
No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution for certain costs that may be incurred by a local agency or school district because, in that regard, this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
However, if the Commission on State Mandates determines that this act contains other costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.