1. Secretary – The California Secretary of Health and Human Services (appointed by the Governor) must possess a Medical Degree or Public Health Nurse Degree and a Doctorate or Masters in Public Health Degree or equivalent professional and academic experience.
2. Director – Executive officer (appointed by Governor) who directs the eleven (11) Departments that comprise the Health and Human Services Agency.
3. Board – The designated twenty-nine (29) person CALTCHA Board, a body representing the broadest cross-section of California society and policy expertise. The Board will administer the Trust Fund and is comprised of the Secretary among four (4) politically appointed members, three (3) Local Public Health Officers and twenty-two (22) public organization and community representatives, each for staggered (initial) two (2) or four (4) year terms
4. Trust Fund – The independent CALTCHA Trust Fund, revenue depository account that contains 100% of all local, philanthropic, state, and federal health dollars derived from tax appropriations and reimbursements slated to include, but not be limited to, Federal Medicare, Medicaid/MediCal, Child Health Insurance Program (CHIP) and Child Health & Disability Prevention Program (CHDP) funds, Community Health Center, employer health payroll deductions, and all applicable taxes and any legal, philanthropic contributions within CA that together replace all insurance premiums, deductibles, co-payments, fees, and all current expenditures of the public for health and health-related services.
5. CA Professional and Technical Health Care Advisory Council – The twenty-one (21) person body shall include the eleven (11) directors of the CA HHS Agency Departments and ten (10) members appointed by the Board that advises the Board in its deliberations and operations. The Advisory Council comprises professional experts from but not limited to fields of public health, medicine, nursing, social work, law, conflict-free business, economics, epidemiology, research sciences, public health, medicine, nursing, social work, law, conflict-free business, economics, epidemiology, research sciences, public hospital leadership, sociology, voluntary and philanthropic associations, and faith-based organizations.
6. Assembly – (Local Neighborhood Health Care Assembly) representative civil society bodies, derived from new or existing democratically-elected or appointed, contiguous population neighborhood bodies (specifically defined below to reflect organizational civic, class, and language differences) from within each of California’s fifty-eight (58) Counties, three (3) cities, (or joint powers areas). Members shall s erve for two (2) or four (4) year terms.
7. CA Neighborhood Health Assembly Association - An organization containing representative members of the Local Neighborhood Assemblies established by the CALTCHA Board to provide a cross-section of these bodies to advise the Board on statewide and regional policy and operational matters that exceed the scope of work at individual local levels.
8. Local Public Health Liaison Office (LPHLO) - Qualified new professionally staffed unit within each Local Public Health Department. The LPHLO will gather health data every three years through surveys and research assessments, including face-to-face interviews conducted in conjunction with individual Neighborhood Health Assemblies. From these assessments, the LPHLO and Assemblies produce a prioritized and budgeted plan to be submitted to the Local Health Officer and the Board to fulfill the operations and purposes of this Act.
9. Local Professional and Technical Health Care Advisory Council - The twenty-one (21) person appointed body, selected by the County Board of Supervisors, to represent their diverse population make up, which shall advise the County Health Officer, Local Public Health Liaison Office, and the Assemblies in their deliberations and work that should reflect the same spectrum of expert members as the CA Professional and Technical Health Care Advisory Council
10. Local (County) Health Officer – The county appointed health department executive physician must possess an MD and Doctorate of Public Health or Masters in Public degree, or three (3) years of senior policy level experience in public health organization administration of executive management and planning among California’s fifty-eight (58) county health departments and 3 city health departments. In addition to traditional roles and responsibilities, the local health officer shall administer the Trust Fund Budget allocated to the population of the County Health Officer and the Assemblies in its area. The Local Health Officer shall hire a Deputy Health Officer, who shall be a qualified public health nurse with executive administrative competencies.
11. Provider – Any CA-licensed health care professional including, but not limited to, a physician, nurse, dentist, physician assistant, nurse practitioner, psychologist, social worker, chiropractor, acupuncturist, and other paraprofessional health workers employed as a team member in a multidisciplinary supervised setting including, but not limited to, any specialty therapist, in-home service and supports (IHSS) worker, complementary health care specialist, marriage and family therapists (or counselors), occupational therapist, physical therapist, rehabilitation engineer, sanitation engineer, case manager, epidemiologist, community home visitor and others that provide direct and indirect health-related services.
12. Cultural Competence/Sensitivity – Cultural and linguistic competence/sensitivity is a set of behaviors, attitudes, and policies that enable an individual, organization, or system to work effectively in cross-cultural situations. “Culture” refers to integrated patterns of human behavior that include language fluency, communications, actions, customs, beliefs, values, and institutional awareness of racial, ethnic, disability, gender identity/orientation, religious, and other demographic, social groups. “Competence” implies having the skills and awareness to function effectively as an individual or as an organization, here within the context of California’s heterogeneous cultures to maximize mutual understanding, respect, and trust to achieve positive health outcomes.
13. California Health Service Corps – Post graduate students who receive CALTCHA tuition assistance for their health-related training degrees or accreditation shall be required to provide paid professional clinical service in rural and urban underserved communities for one (1) year in exchange for every one (1) year of tuition subsidy and will become a member of this state public service organization while fulfilling that obligation.
14. County Physician Provider Review Board – A permanent body of twenty-one (21) members and staff, appointed by the County Health Officer, whose members shall include representatives from the local organized physician, dental and nursing communities, and whose role shall be to consult with the County Health Officer to assure quality, cost-effectiveness, accountability and fair reimbursements for health professional directed services.
15. Union & Corporate Pension Health Fund Task Force – A body of twenty-one (21) members, with state-funded staff, whose role shall be to establish a program to compensate justly those who belong to or have belonged to unions (public and private), or are, or have been, employees of a business and that have paid into a public or private union health benefits funds, Taft-Hartley trusts, or a business health care funds, such that health services are maintained or improved, for all residents of California.
16. California Pharmaceutical, Medical Supplies, Assistive Equipment, Regulatory Task Force – CA Secretary appointed body that will advise the Board on establishing and managing California’s comprehensive drug and equipment formulary, including medical supplies and assistive equipment. The task force will assess technology acquisition, distribution, and availability and will also assist the Board in negotiating fair and reasonable prices on pharmaceuticals, supplies, and equipment for the CALTCHA system and report to the public on all its relevant functions.
17. County Health and Wellbeing Coordinating Councils – Each county shall establish a senior professional body to coordinate with relevant local and state agencies and departments on broader social determinants of health.
18. Just Workforce Transition Planning Board – Secretary and the Executive Committee of the Board to appoint this fifteen (15) member body with responsibility to plan and influence the transition of administrative personnel working within the current CA medical and administrative system to maximize alternative reemployment, training and transitional financial support for a period of up to five (5) years as CALTCHA is implemented.
19. California Government Patient Compensation Fund – Public fund to replace most of the current malpractice liability litigation and settlement system. Its goals are to justly compensate injured patients and ensure a sound and ethical professional health practice framework for the state.
20. Global Operating Budget – Each individual hospital, nursing home, community health center (including Federally Qualified Health Centers), and similar programs delivering specialized services for specific categories of patients, public postsecondary health training programs, and other institutional providers of care and education shall be paid with a comprehensive annual budget allocated by the CALTCHA Board and based on community needs assessments and budgeted plans that are triennially submitted. Intended to replace the system of line-item billing with multiple payers.
21. Non-Profit – shall comply with the definition in the IRS 501(c)(3) health corporation regulations.
22. Social Work – Social work is a profession focused on persons and their environments to help individuals and communities cope effectively with their realities and change them when necessary. Professional social workers must hold BSW, MSW, or DSW/Ph.D. in Social Work degrees from an accredited school of social work. Licensed Clinical Social Workers (LCSWs) or Associate Clinical Social Workers (ASWs)- who are in the process of gaining their license in social work - provide direct services or therapy to individuals, guiding people to critical resources and counseling them on life-changing decisions. Social Workers also advocate for policy change to improve social conditions and strengthen the social safety net.
23. Mental Health – Includes home, clinic, hospital, office, and community-based psychiatric, psychological, and counseling professional services focused on helping individuals suffering from disorders of thought or emotion that interfere in their lives. In addition, it includes pediatric prevention and early intervention, diagnostics, short and long term individual, family, or group therapies, crisis intervention, addiction services, case management, and vocational services to address and overcome the sources and manifestations of clinical mental disorganization and achieve freedom from mental or emotional interference to wellbeing.
24. Life Time Care and Community Health – includes the broad resources to sustain wellbeing throughout the span of life, primarily where people live. Community Health includes social determinants of health and wellbeing such as food, transportation, housing, education, employment, health care, and the system of tangible and intangible infrastructure that delivers goods and services to families where they live and focuses on the geographic neighborhood. Community-level health promotes healthy individual living, helps prevent chronic diseases, and brings the greatest health benefits to the greatest number of people in need. According to the Center for Disease Control (CDC), prioritizing community health can help reduce visible and quantifiable health differences in age, gender, disability, race and ethnicity, location, social status, and income. Because it is difficult to be healthy if where we live is unhealthy, the intersection of healthcare, economics, social interaction, and location is vital to guarantee the impact of community health on individuals and households.
25. Navigation/Navigator – Assistive process executed by community health workers (i.e., navigators) to ensure CA residents can access services – including direct health and broader social services - coordinated in a way that fulfills individuals’ needs within the CALTCHA system of care.
26. Uniform Computer Electronic Billing System and Electronic Patient Record System – A secure and unified statewide database that records services provided, facilitates the assessment of the quality of care, population needs, fraud, and documentation of system outcomes that streamlines provider reimbursement.
27. Transition and Implementation Task Force - A body of flexible, effective size and expertise appointed by the Board in coordination with the Secretary, for the first nine (9) months after passage of CALTCHA, and constituted to manage CALTCHA’s initial organization and function, including the gathering of statutorily defined funds necessary to establish the Trust Fund. The completion of this Task Force’s work – when verified by the Secretary - triggers the beginning of CALTCHA permanent operations.