Twelfth initiative qualified for California 2024 ballot: Measure to revise Children’s Services Program

An initiative to change California Children’s Services (CCS) Program eligibility requirements and authorize the program to cover the costs of life-saving specialty drugs qualified for the ballot on June 21. This marks the twelfth initiative to qualify this cycle, the highest number since 2016 when 15 initiatives were certified.

The initiative is sponsored by the California Children’s Hospital Association. The support campaign, Because We Need Affordable Life-Saving Healthcare for our Critically Ill Children, reported nearly $10 million in contributions through March 31.

The California Children’s Services Program was created in 1927 and provides health care coverage for individuals under the age of 21 who are diagnosed with qualifying serious or chronic diseases and meet certain financial criteria. State law lists the following diseases as qualifying for coverage:

• Noninfectious diseases of the central and peripheral nervous system that produce a neurologic impairment that is life-threatening or physically disabling;
• Cerebral palsy manifested by the presence of either rigidity, spasticity, hypotonia, involuntary movements, or ataxia;
• Seizure disorder as a component of or secondary to the CCS-eligible condition or has unknown origin; and
• Congenital anomalies of the nervous system.

Other qualifying diseases are specified by state regulation issued by the state Department of Health Care Services (DHCS).

In addition to a qualifying disease, an individual must meet one of the following conditions:

• family income of $40,000 or less;
• out-of-pocket medical expenses are likely to be more than 20% of the family income;
• was adopted with a known health problem covered by CCS;
• a need for the Medical Therapy Program, which is available to any child regardless of family income; or
• enrolled in Medi-Cal with full benefits.

The initiative would formally specify all qualifying diseases in state law by adopting DHCS’s regulations and guidance as of January 1, 2022. The initiative would also require DHCS to collaborate with stakeholders every five years to determine whether additional diseases should be added to CCS’s qualifying list.

As of December 2023, 13,409 children were enrolled in CCS, and 161,840 qualified through Medi-Cal enrollment.

The initiative would also create a new financial assistance program that covers a portion of medically necessary items and services to treat a qualifying disease regardless of family income level.

The initiative would also increase payments to hospitals by establishing a new grant program administered by DHCS that provides a grant to each hospital. The grant would total $200 times a hospital’s total number of days of inpatient services and the total number of outpatient visits provided to CCS children.

The other nine initiatives slated to appear on the Nov. ballot relate to changes to drug and theft penalties, requiring a personal finance course in high school, pandemic prevention, the state’s minimum wage, remediation for labor violations, local rent control, Medi-Cal RX program regulations, a tax on managed care organizations, and oil and gas well regulations.

Two others were certified but then removed from the ballot. One initiative, a veto referendum related to increasing the minimum wage for fast food workers, was withdrawn by its sponsors after they reached a compromise with the state legislature. A second initiative that would have increased vote requirements for new taxes was removed from the ballot by the state Supreme Court on June 20. The court ruled that the initiative amounted to a revision of the state constitution that would have to be placed on the ballot by the state legislature or a constitutional convention.

The deadline to qualify or withdraw a ballot initiative is June 27. Between 2010 and 2022, an average of 82 initiatives were filed per election cycle with an average of nine initiatives ultimately certified for the ballot. For the 2024 election cycle, 43 ballot initiatives were filed in California.

Additional reading: California 2024 ballot propositions