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California health care services 2026

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The document is a letter from the California Department of Health Care Services outlining the 2019 Medi-Cal Privacy and Security Agreement (PSA) for County Welfare Departments. It details the requirements for safeguarding Medi-Cal Personally Identifiable Information (PII), including submission guidelines for signed agreements, privacy and security protocols, personnel controls, technical security measures, and breach notification procedures. The agreement aims to ensure compliance with federal and state laws regarding data privacy and security.

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Click ‘Get Form’ to open the California Health Care Services Agreement in the editor.
Complete the Preamble by entering your county name and department/agency name in the designated fields.
Fill out Section XX with the signatory information, ensuring that the name and title of the signatory are printed or typed clearly.
Modify the Header of the Agreement to include the appropriate Agreement Number, replacing 'XX' with your two-digit county code.
Ensure that two copies of the completed Agreements are prepared, both containing original signatures from an authorized official.
Include a contact name, telephone number, email address, and street address for communication purposes when sending Agreements to DHCS.
Submit all signed Agreements by August 26, 2019, to ensure compliance with submission guidelines.

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