Medi-Cal ABA Agencies Must Background-Check Patient-Facing Staff by July 1, 2027

SB 874, signed September 27, requires every enrolled Medi-Cal BHT provider to run state and national criminal checks on employees who interact with patients. It also opens a DHCS review of hours, supervision ratios and center-based care.

Governor Newsom signed SB 874 on September 27 as Chapter 655, Statutes of 2026. It adds Welfare and Institutions Code §14132.561. By July 1, 2027, about nine months away, any entity enrolled as a Medi-Cal provider that provides BHT paid for by Medi-Cal must run “a state and national criminal background check on its employees who interact with patients,” or have a third party run it.

Providers must keep documentation showing compliance and produce it “upon request or in the event of a state or federal audit.”

The turn: the check is the small part

The background check is the only hard deadline in the bill. The larger change is the list of topics DHCS must take stakeholder input on before it rewrites Medi-Cal BHT coverage and billing policy:

  • clinical guidelines, including independent assessment and reauthorization;
  • treatment plans, including “the number of hours”;
  • center-based services compared with home, school and other natural settings, “to ensure that only services that qualify as BHT services are billed”;
  • supervision: hours required, where the supervisor is, and how many unlicensed staff one professional may supervise;
  • standardizing plan documentation and credentialing;
  • whether to require fingerprint-based checks.

DHCS can put the resulting changes in place through plan letters and bulletins “without taking any further regulatory action.” By January 1, 2029, it must publish BHT utilization data and a summary of what changed.

Why now

The Senate floor analysis cites the federal OIG's ABA audits and a January 27, 2026 CMS letter to Newsom. That letter named early intensive behavioral intervention a “high-risk” service. The bill first required DOJ fingerprinting. Assembly amendments changed that to a state and national check and made fingerprinting a question for the stakeholder process.

CalABA, the California Association of Health Plans, the California Medical Association and Local Health Plans of California supported the bill. The Doogri Institute, an autistic-led group, opposed it unless amended. It objected to including ABA providers as stakeholders.

The limits

The statute doesn't say who counts as an “employee” for contractors, which vendors or databases qualify, or what happens to an agency that misses July 1. DHCS hasn't issued guidance yet, and no date is set for the stakeholder forums.

What you must know or do

  • Owners: list everyone on payroll who interacts with patients, not only RBTs and BCBAs. Check whether your current hiring check covers both state and national records.
  • HR: set up one retrievable record per employee: date of check, vendor, scope. An auditor will ask for that under (b)(2).
  • If you use 1099 clinicians, the text says “employees.” Get written direction from DHCS or your plans before assuming contractors are out.
  • Clinical directors: the supervision-ratio and center-based topics will set your staffing model. Take part in DHCS's stakeholder forums, directly or through CalABA.