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.
SB 297, the Valley Fever Screening and Prevention Act of 2025, creates a statewide framework to identify and respond to regions with elevated valley fever incidence. The bill directs the State Department of Public Health to annually analyze surveillance data, designate high-incidence regions by March 1, 2027, provide local health departments with infection data and screening protocols, distribute training materials, and report to the Legislature every two years on the program’s effectiveness. It also requires local health departments in those regions to conduct public and provider outreach and to report confirmed cases to the state.
The bill would also change clinical and insurance coverage rules in high-incidence regions. Beginning January 1, 2028, adult primary care patients in those areas would have to be offered valley fever screening, subject to specified exceptions such as emergencies, lack of consent capacity, or prior screening when the provider does not believe repeat screening is warranted. If screening suggests further testing, providers must offer diagnostic testing and, if positive, follow-up care or referral. The bill states that providers who, in their professional judgment, decide screening or testing is not appropriate are not subject to discipline or civil/criminal liability for that decision.
On the coverage side, the bill requires most health care service plan contracts and health insurance policies issued, amended, delivered, or renewed on or after June 1, 2027, to cover valley fever screening tests in high-incidence regions without cost sharing, with limited exceptions for specialized plans and certain high-deductible health plans where federal law would be implicated. It also adds valley fever screening tests as a Medi-Cal covered benefit, contingent on federal approval and federal financial participation. The bill further amends the existing Valley Fever Education, Early Diagnosis, and Treatment Act and creates a new screening and prevention chapter in the Health and Safety Code.
The overall sentiment reflected in the bill’s progress is strongly supportive. Committee votes were unanimous at each recorded stage, and the measure advanced through the Senate and Assembly committees without recorded opposition in the provided history. The bill’s framing emphasizes public health protection, early detection, and reducing medical and economic burdens in high-risk regions, which likely contributed to its broad support.
The main points of contention are practical and fiscal rather than ideological. The bill imposes new duties on local health departments and health care providers, creates a state-mandated local program, and may affect insurance and Medi-Cal costs, which explains its referral to Appropriations and suspense file consideration. Another issue is implementation complexity: the Department of Public Health must define high-incidence regions using available data, providers must follow screening and referral requirements, and the bill must be harmonized with federal rules for high-deductible plans and Medi-Cal financing.
SB 297 would expand California public health law by creating a new screening-and-prevention program for valley fever, adding duties for the State Department of Public Health and local health departments, and requiring the state to identify high-incidence regions and distribute screening guidance. It would also amend health care provider obligations in primary care settings within those regions, require insurance coverage for screening without cost sharing in most plans, and add valley fever screening to Medi-Cal as a covered benefit subject to federal approval. The bill would impose a state-mandated local program and could trigger reimbursable local costs if the Commission on State Mandates so determines.
The bill appears to have enjoyed broad support in committee and on the floor, with unanimous recorded votes at each listed stage and no recorded dissent in the provided history. The discussion context suggests a public-health-oriented measure viewed as preventive and targeted rather than controversial, with support likely driven by concern over valley fever in high-risk regions and the value of earlier diagnosis and treatment.
The main areas of concern are implementation burden, cost, and legal/administrative complexity. Local health departments would have new outreach and reporting duties, providers would need to offer screening and follow-up care in designated regions, and insurers would need to adjust coverage rules, all of which can create fiscal and operational impacts. There is also some tension between mandatory screening/coverage and provider discretion, which the bill addresses by shielding clinicians from discipline or liability when they determine screening or testing is not appropriate. Finally, the bill must be aligned with federal requirements for high-deductible plans and Medi-Cal financing, which could limit or complicate implementation.