AHEAD AND GET STARTED WITH OUR
MEETING HERE TODAY.
BECAUSE I GUESS IT.
AND GO AHEAD AND GET STARTED
HERE TODAY THANK YOU.
.
WE WILL BE HEARING TO WITNESSES
PER SIDE. TODAY.
WITH A LIMIT OF THREE MINUTES
EACH
ADDITIONAL WITNESSES AYE WEST TO
STATE THEIR NAME AND
ORGANIZATION FOR THE RECORD.
THERE WILL BE ONE EXCEPTION TO
THAT.
LATER ON DURING THE DAY.
WE HAVE A BILL THAT'S CAN BE
COMBINED TO AUTHORS AND SO WE
WILL ALLOW A LITTLE ADDITIONAL
TESTIMONY WILL WILL WILL BRING
THAT HAPPEN AT TIME COMES.
WE HAVE A COUPLE NEW MEMBERS
WITH US TODAY WE HAVE A.
MISTER A VICE SO THANK YOU THANK YOU TO THE
NEW MEMBERS AND THANK YOU TO THE
TO MEMBERS WHO ARE NOT ON THE
COMMITTEE AT THIS TIME SO. WE DO
HAVE A THREE BILLS PROPOSED FOR
CONSENT.
ITEM NUMBER FIVE AB TWENTY ONE
SEVENTY FOUR BY MISS WALDRON.
I AND ITEM NUMBER NINE AT AB
TWENTY THREE NINETY THREE A
COMMITTEE BILL.
ITEM NUMBER TEN.
AB TWENTY FOUR NINETY.
BY MISTER CHU AND THEN I'D
NEVER THIRTEEN AB TWENTY SIX
CITY EIGHT MISTER ALLEN HAS BEEN
PULLED FROM TODAY'S COUNTER AT
THE REQUEST OF THE MEMBER AT THE
AUTHOR SELF.
AT THIS POINT.
WE DO NOT HAVE A QUORUM BUT WE
WILL GO AHEAD AND PROCEED IN OUR
FIRST AUTHOR IS MISTER STEINORTH.
STEINORTH WILL BE PRESENTING AB
SEVENTEEN SEVENTY SIX.
OF FREEDOM IN AMERICA.
THANK YOU MR STEINER.
GOOD MORNING MISTER CHAIR
MEMBERS.
AB SEVENTEEN SEVENTY SIX SIX TO
CLARIFY.
SIX TO CLARIFY LIVE EXISTING
LINE ORDER TO ALLOW FOR INJURED
LAW ENFORCEMENT CANINES TO BE
TRANSPORTED TO A VETERINARY
HOSPITAL USING AN AMBULANCE.
THANKFULLY THIS ISN'T ALL TOO
COMMON ISSUE BUT WHEN OUR LAW
ENFORCEMENT ANIMALS ARE INJURED
THE CURRENT PRACTICE IS TO SCOOP
AND RUN WITH THE ANIMAL BY
PUTTING THEM IN A POLICE CAR.
UNFORTUNATELY THIS ISN'T
PRACTICAL OR ADVISE BECAUSE THE
ANIMAL CAGES AND POLICE CARS ARE
TOO CRAMPED FOR THE ENTERTAINING
AND THEIR HANDLER TO FIT AT THE
SAME TIME. WHILE THE HAMMER
PROVIDES LIFESAVING MEDICAL
ATTENTION.
I'M ACCEPTING THE COMMITTEE
AMENDMENTS ON PAGE FOR THE
ANALYSIS.
AS NOTED IN THE ANALYSIS THE
BILL IS SUPPORTED BY A VARIETY
OF LAW ENFORCEMENT AND PUBLIC
SAFETY ASSOCIATIONS AND THERE IS
NO FORMAL OPPOSITION. I AM
JOINED TODAY BY OFFICER SCOTT
MARTIN AND OFFICER JARED AND
FELLOW FROM THE REDONDO BEACH
POLICE DEPARTMENTS CANINE UNIT
WHO FIRST BROUGHT THIS ISSUE TO
OUR ATTENTION BACK IN DECEMBER.
I'M ARE GOING TO BE.
I'VE BEEN A CANINE HAMLET FOR
SEVEN YEARS TO OUR PARTNER BY
THE NAME RUGER.
I HAVE BEEN PUT IN MANY
DANGEROUS SITUATIONS BUT MORE
IMPORTANTLY AFTER MY DOG AND IF
EXTREMELY DANGEROUS SITUATIONS.
WHERE THE SUSCEPTIBILITY TO
INJURY TO HIM AS HIGH?
AND IN THE COURSE OF MY CAREER
I'VE SEEN A LOT OF THAT.
POLICE DOGS INJURED AND KILLED
IN THE LINE OF DUTY AND.
SINCE TAKING MET TACK COURSES
TOWARDS LIFESAVING TECHNIQUES
TOWARDS.
SAVING POLICE CANINES I'VE
REALIZED THAT SOME OF THE.
OBSTACLES I WOULD RUN INTO IS MY
SIZE BEING A TWO HUNDRED SEVENTY
POUND POLICE OFFICER WITH AN
EIGHTY POUND DOG IF SOMETHING
HAPPENED TO HIM WHERE IF.
REQUIRED.
MEDICAL.
FIRST AID RESPONSE I HAVE A
DIFFICULT TIME GETTING.
HIM TO SEE.
SURVIVED THE INJURIES AND THEN
TRANSPORTING INTO A VETERINARY.
.
A SILLY WHERE HE COULD RISK
RECEIVE. ADVANCE MEDICAL CARE SO
THAT IS.
WHY THIS WAS PROPOSED TO
ASSEMBLYMAN STEINORTH?
IT WITH ANYONE ELSE.
BEACON SUPPORT OF THE BILL.
SEEM NO ONE ANYBODY IN
OPPOSITION.
I'M SORRY I'M SORRY I WAS TOO
FAST ON THE.
ESOS IN MIND THAT WE PLAY HOUSE
PUBLIC AFFAIRS ON BEHALF OF
SOCIAL COMPASSION IN LEGISLATION
HERE IN SUPPORT OF ABOUT.
I THINK IT'S.
IS THERE ANYONE IN OPPOSITION TO
THE BILL.
SEEING NO BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS ANYONE.
OKAY YET MISTER BIGELOW.
THIS IS JUST BECAUSE I HAVE ONE
OF THE SPACE.
Y. WANT TO KNOW WHERE THE
FUNDING IS GOING TO COME FROM
THAT YOU CAN HELP US.
ADDRESS THAT PARTICULAR
QUESTION OTHER NOT LIKE YOU.
YES I'M WELL THANK YOU VERY MUCH
I APPRECIATE THAT NOW MY
UNDERSTANDING IS FOR THE FUNDING
WE'RE GONNA BE LOOKING AT THE
EXISTING AMBULANCE SERVICES AS
THEY ARE. AND.
YOU KNOW JUST ALLOWING THIS SO
THAT WE WOULD HAVE THE AUTHORITY
TO USE THOSE AYE I DON'T
ANTICIPATE WHAT THE COST IS ON
THIS.
WELL I'LL I'LL WORK WITH YOU ON
THAT BUT I THINK IF YOU.
ANYONE ELSE.
KENDALL SEEMS HE NO ONE WOULD
LIKE TO CLOSE MISTER SENT I
RESPECTFULLY ASK YOUR AYE VOTE
OKAY WHEN WE DO NOT HAVE A
QUORUM SO WE WILL WILL BRING IT
UP AT THAT POINT AND I
APPRECIATE COULD SHE BE HERE
OFFICER. THANK THANK YOU VERY
MUCH THANK YOU THANK MEMBERS
TIME COURSE.
MISTER CHAU.
FIRST.
FIRST BILL UP WITH BEING BE
NINETEEN STE EXHIBIT TWENTY ONE
SIXTY SEVEN.
THANK YOU VERY MUCH MISTER
CHAIRMAN AND MEMBERS SAW.
AB TWENTY ONE SIXTY SEVEN WHAT
THE IMPLEMENT REASONABLE
REGULATIONS FOR THE USE OF
DIGITAL HEALTH FEEDBACK SYSTEMS.
INCLUDING ITEMS ALSO KNOWN AS
STITCHED OAK HILLS.
WHILE TECHNOLOGY STANDS TO
IMPROVE HOW HEALTH CARE IS THE
LIVER. DECENT VANCE MEANS DO NOT
COME WITH THE RISK.
HEALTH AND MEDICAL INFORMATION
IS BY ITS VERY NATURE ON.
DEEPLY PERSONAL AND SENSITIVE.
NEW TECHNOLOGY MAKES MEDICAL
INFORMATION EASILY AND QUICKLY
ACCESSIBLE. VIA APPS AND
WEBSITES
IN CALIFORNIA HAS ENSURE THAT
MEDICAL INFORMATION HELD BY
MOBILE DEVICES IS PROTECTED.
UNDER ALL PRIVACY LAWS.
HOWEVER IN ORDER TO BE CONSIDER
MEDICAL INFORMATION THIS
INFORMATION GENERALLY NEEDS TO
BE GENERATED BY A HEALTHCARE
PROVIDER INFORMATION THAT IS
GENERATED BY DIGITAL HEALTH
FEEDBACK SYSTEM MEANING. AT THE
PATIENT LEVEL AND OUTSIDE OF A
MEDICAL FACILITY WILL NOT
NECESSARILY BE CAPTURE UNDER THE
EXISTING DEFINITION OF MEDICAL
INFORMATION.
ARE SEVERAL FORMS OF DIGITAL
PILLOWS THAT'S.
SEND INFORMATION FROM PLACES
LIKE THAT DIGESTIVE TRACT WILL
BLOOD STREAM OF BEING DEVELOPED.
WITH A FEW ALREADY IN USE.
THESE THAT DIGITAL PILLS WHICH
CUT COMBINED IN JUST ABOUT A
MICROCHIP SENSORS WITH A
PHARMACEUTICAL WAS CAN OPERATE
IN A NUMBER OF WAYS.
THEY CAN CONTROL AND MONITOR THE
RELEASE OF ACTIVE THOU
PHARMACEUTICAL INGREDIENTS. ARE
AFTER THE GESTION WE CAN ALSO
RECORD HOW WHETHER WHEN WHERE
AND IN WHAT QUANTITIES A DRUG IS
BEING RELEASED.
AS WELL AS INFORMATION ABOUT THE
PHYSICAL SPEED OF THE PERSON
TAKING THE DRUG SUCH AS
TEMPERATURE ACTIVE ACTIVITY
LEVELS HEART RATE AND
RESPIRATION.
THIS INFORMATION ABOUT WHETHER A
PATIENT HOPE HIS OR HER
MEDICATION AND HOW THAT IT. AYE
MEDICATION INTERACTIVE INTO
BODIES IS UNQUESTIONABLY OF A
MEDICAL NATURE.
SO IT IS IMPERATIVE THAT THE
INFORMATION GENERATED BY DIGITAL
HEALTH FEEDBACK SYSTEMS IS
CLASSIFIED AS MEDICAL
INFORMATION. AND DEVELOPERS AND
OPERATORS OF HARDWARE SOFTWARE
AND APPLICATIONS USED IN
CONJUNCTION WITH THE CHILL
PILLOWS ARE ALREADY PROHIBITED.
OFF FROM SHARING THIS
INFORMATION WITHOUT THE
PATIENT'S INFORMED CONSENT.
THIS BILL AB TWENTY ONE SIX
SEVEN WHAT DO. DIGITAL HEALTH
FEEDBACK SYSTEM TO INCLUDE ITEMS
SUCH AS DIGITAL PILLS AND ENSURE
THAT THE CONFIDENTIALITY OF
MEDICAL INFORMATION ACT WAS
CM I A.. APPLIES TO INFORMATION
DERIVED FROM OR IN THE
POSSESSION OF THE SYSTEMS
THE BILL THE BILL WOULD FURTHER
REQUIRE THAT MANUFACTURERS
EQUIPPED. ADDITIONAL HEALTH A
FEEDBACK SYSTEMS WITH REASONABLE
AND APPROPRIATE THE SECURITY
FEATURES OF THE BILL HAS NO
REGISTER.
OPPOSITION AND WAS WITH AYE I
RESPECTFULLY ASK FOR YOUR
SUPPORT AND I'VE.
WE CARRY MUCH.
IF THE OTHER WITNESSES.
OKAY ANYONE EVER OTHERS IN
SUPPORT.
ANYONE IN OPPOSITION.
SEEING NO ONE WILL BRING BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS
QUESTIONS.
I'D JUST ONE COMMENT AND THAT IS.
.
WHILE WE ARE LOOKING AT AT THIS
SPECIFIC TECHNOLOGY WHAT ON MY
HOPE IS THAT YOU MIGHT CONSIDER
LANGUAGE AT SOME POINT. TO BE A
LITTLE BROADER SO THAT.
AS WE MOVE FORWARD ON AN ISSUE
LIKE THIS WE'RE NOT WE'RE NOT
DOING A SPECIFIC BILL FOR A
SPECIFIC PRODUCT OR.
IT WILL LOOK IN ANY CATEGORY OR
LESSON ON ON SOMEBODY'S AND IT'S
JUST IT'S JUST ASK THAT YOU
CONSIDER THAT.
.
MAYBE IT'LL BE WHO KNOWS WHAT
WILL BE NEXT YEAR I DON'T I
DON'T KNOW AND AND AND MAYBE THE
LANGUAGE CAN BE SUCH A WAY THAT
THAT.
THAT CAN ACTUALLY HAPPEN BUT IN
MAY THAT'S TOO MUCH TO ASK
PORTANTINO TECHNOLOGY CHANGES
RAPIDLY HAVE SILLY BUT.
BUT SOMETHING SOMETHING TO
CONSIDER IS A THE MOST WORK
POINT WELL TAKEN OUT DEFINITELY
GOT IN SCHOOL INTEGRATION THANK
YOU VERY MUCH YOU AS YOU CAN SEE
WE STILL DON'T HAVE A QUORUM. A
ALSO WILL BUT YOU HAVE SECOND
BILL I DO HAVE A SECOND BILL AND
THAT IS.
TWENTY NINE THIRTY FIVE LOS.
THANK YOU AGAIN MISTER CHAIRMAN
AND MEMBERS ARE AB THIRTY TWENTY
NINE THIRTY FIVE WOULD PROHIBIT
THE OPERATOR OF A COMMERCIAL.
HEALTH MONITORING PROGRAM FROM
INTENTIONALLY SHARING WITH
DISCLOSING IS CONSUMERS ARE
INDIVIDUALLY IDENTIFY. FIABLE
HEALTH MONITORING INFORMATION
WITH A THIRD PARTY FIRST WITHOUT
FIRST OBTAINING THE CONSUMER'S
CONSENT THESE ARE WHAT WE CALL
FIFTY IT'S.
AND DEVICES ARE SIMILAR TO NOT.
ON PROTECTION OF MENTAL HEALTH
INFORMATION IS AN ESTABLISHED
RIGHT WITHIN OUR COUNTRY AT THE
FEDERAL LEVEL THE HEALTH
INSURANCE PORTABILITY AND
ACCOUNTABILITY ACT OF NINETEEN
NINETY SIX ALSO KNOWN AS HIPAA.
PLACES STRICT REQUIREMENTS ON
THE SECURING OF PROTECTED HEALTH
INFORMATION AND ALSO PROVIDES
PROTECTION TO CONSUMERS BY
GIVING THEM THE RIGHT TO KNOW
HEALTH INFORMATION.
CALIFORNIA HAS THIS.
ADDITIONALLY ESTABLISHED THE
CONFIDENTIALITY OF MEDICAL
INFORMATION AKKA.
CMI ES IN SHORT IN ORDER TO
PROTECT THE INDIVIDUAL'S MEDICAL
INFORMATION FROM UNAUTHORIZED
DISCLOSURE. OF HEALTH MONITORING
PROGRAMS HAVE INCREASED IN
POPULARITY THE LAST COUPLE YEARS
AND THESE DEVICES ARE MOST
COMMONLY WORN ON ICQ A
CONSUMER'S RISK. ARM AND ARE
CAPABLE OF PERFORMING
CONSIDERABLE HEALTH MONITORING
INCLUDING THE TRACKING OF THE
CONSUMERS TO HEART RATE BLOOD
GLUCOSE AND SLEEPING HABITS.
ADDITIONALLY SOME I ENCOURAGE
CHAU USERS TO EVEN SHARE
INFORMATION ABOUT THEIR MOODS AS
WELL AS OUR SEXUAL ACTIVITY.
WHILE HIPPER AND CMI EIGHT
PROVIDE STRONG PROTECTIONS FOR
MEDICAL HEALTH INFORMATION
THERE'S NOT A SIMILARLY ROBUST
FRAMEWORK OF PROTECTIONS FOR
HEALTH DATA WHICH IS GENERATED
OUTSIDE. OF THE MEDICAL SETTING.
IN THIS VOID OPERATORS OF
COMMERCIAL HEALTH MONITORING
PROGRAMS ARE GENERALLY ABLE TO
SHARE AND OR SELL CONSUMERS
PERSONAL. OF PERSONALLY
IDENTIFIABLE HEALTH DATA TO
THIRD PARTIES.
WITH THAT IN MIND ALL THIS BILL
AB TWENTY NINE THIRTY FIVE WOULD
ESTABLISHED OUT IN ORDER OF TO
SHARE A CONSUMERS. ARE PERSONAL
PERSONALLY IDENTIFIABLE HEALTH
MONITORING INFORMATION THAT'S A
MOUTHFUL. THE OPERATOR OF A
COMMERCIAL HEALTH MONITORING
PROGRAM MUST FIRST OBTAIN A
CONSUMER'S AFFIRMATIVE CONSENT
THAT FULFILLS THE FOLLOWING
REQUIREMENTS
ONE THE REQUEST MUST BE SEPARATE
FROM ALL OTHER. AUTHORIZATIONS
OR AGREEMENT TO THE CONSENT
REQUEST MUST ALSO INCLUDE THE
NAME OF A THIRD PARTY AND THE.
REASON FOR THE REQUEST AND
FINALLY IT MUST BE MAKE CLEAR
HOW THAT CONSUMERS REFUSAL TO
SHARE THAT INFORMATION WILL NOT.
PROHIBIT OR LIMIT THEIR ABILITY
TO USE A.
COMMERCIALLY HEALTH MONITORING
PROGRAM AND FINALLY THIS BILL
WILL PROVIDE THAT A WAIVER OF
ANY A LEGAL RIGHTS A PENALTY
REMEDY FLORA OR ENFORCEMENT.
MECHANISMS PRESENTED TO THE
CONSUMER IN A CONTENT DESCRIBED
IS UNENFORCEABLE AND VOID AS A
MATTER OF LAW SO WE GOT I
RESPECTFULLY ASK YOUR YOUR A
SUPPORT AGAIN AND TELL YOU I
DON'T.
VERY MUCH.
.
IN SUPPORT OTHERS IN SUPPORT.
NO ONE IS THERE ANYONE IN
OPPOSITION.
SEE KNOWN AND BRING IT BACK TO
COMMITTEE FOR QUESTIONS OR
COMMENTS ANYTHING.
CHáVEZ.
I WAS CHAO JUST I DON'T WANT TO
THANK YOU FOR BRINGING THIS
FORWARD WHEN I WAS GOING THROUGH
THIS.
THAT THE ANALYSIS OF THIS AND
ACTUALLY.
I GOT
SCARED THINKING ABOUT THIS I
GUESS I'D NO IDEA THAT THOSE WHO
HAVE FITBIT'S.
I THAT THE AMOUNT OF INFORMATION
HAS BEEN COLLECTED CAN BE
DISTRIBUTOR TO THIRD PARTIES I
THINK OF FRIENDS OF MINE THAT.
THAT THAT HAVE THEM AND HAVE
SHOWN ME HEY LOOK HERE'S MY
SLEEP NOT PATTERNS.
AND IT DOESN'T TAKE MUCH
INDUCTIVE BUT DATA REASONING TO
BE ABLE TO FIGURE OUT OTHER
PROBLEMS AND WHILE IT'S.
IT'S HEALTH RELATED NOT MEDICAL
RELATED A YOU CAN DERIVE A LOT
OF INFORMATION FROM THAT AND I
DON'T THINK THAT CONSUMERS KNOW
THAT WHEN THEY'RE. ACQUIRING IT
SO I WHILE I UNDERSTAND SOME OF
YOU DO SOME OPPOSITION SOME
LANGUAGE OPPOSITION.
IT SEEMS TO ME THAT.
THAT THE PURPOSE AND INTENT OF
YOUR BILL IT IS IS.
OF THAT I KNOW I'M AS A WORKS
THE PROCESS THERE'S PROBABLY
MORE OPPOSITION WITH SOME
LANGUAGE AND I'M SURE YOU'LL BE
WORKING. WITH SOME OF THOSE
STAKEHOLDERS UP BUT I WITH THE
INTENT OF WHAT YOU'RE AIMING FOR
I'M IN FULL SUPPORT. THANK YOU
VERY MUCH FOR YOUR KIND AND AND
I WILL BE. A WORKING WITH THE
OPPOSITION OF FROM THIS POINT ON
AS WELL I THINK IT'S YOU JACK
REYES SOCIETY* AND CONCERNED
ABOUT ARBITRATION CLAUSE THERE'S
NO INTENTION ON OUR PART TO DO
AWAY WITH. ATTRITIONAL HALL AT
ALL SO WILL WORK WITH THEM TO US
YOU KNOW ON FIGHTING THIS BILL
THANK YOU VERY MUCH.
IT'S VERY VERY MUCH.
WALDRON.
THANK YOU MISTER CHAIR.
YES I AGREE AND.
THERE'S SO MANY OTHER DEVICES
THAT ARE COMING OUT NOW ON THOSE
THAT WANT TO CAN REMOVE THE NAME
OF IT FOR PEOPLE TO MONITOR
THEIR HEART THAT WITH THEIR.
FINGERS ON AYE IN THIS YOU KNOW
WITHOUT HAVING THE RUSHED TO THE
EMERGENCY ROOM.
I'M SURE THINGS LIKE THAT WOULD
BE COVERED ALSO UNDER YOUR.
YOUR BILL ON THE MORE WE USE
TECHNOLOGY THE MORE WE ALLOW FOR
THAT KIND OF ACCESS TO HELP
PEOPLE WHO YOU KNOW ESPECIALLY
IN RURAL AREAS OF CAN'T JUST RUN
TO A CLINIC IN FIVE MINUTES AND
ALL THOSE THINGS ARE GOING TO BE
THE WAVE OF THE FUTURE. DIGITAL
HEALTH A LOT OF THINGS LIKE THAT.
ON ONE OF THE THINGS THAT'S
INTERESTING IS I HAVE A FITBIT
THAT AWARE SOMETIMES BUT. A LOT
OF THE INFORMATION ISN'T REALLY
NECESSARILY THAT SCIENTIFIC
BECAUSE I FROM IF YOU JUST MOVE
YOUR ARM IF GIVES YOU STEPS AND
THINGS LIKE THAT SO CLUB WHEN I
HEAR YOU SHOULD TRY. ANYWAY.
SO I THINK YOU'RE GOING ON THE
RIGHT TRACK AND I'M SURE THERE'S
NO BUMPS IN THE ROAD THEY HAVE
TO WORK THROUGH BUT YOU KNOW ALL
THE SUPPORT OF TODAY. THANK YOU
VERY MUCH APPRECIATE.
VERY GOOD AND ANYONE ELSE.
I WAS WANTED NEVER WHY.
YOU CAN HAVE. A AS AS YOU CAN
SEE WE ARE WE'RE STILL COUPLE.
PEOPLE SHY OF A.
QUORUM BUT WITH YOU BUT YOU
WOULD LIKE TO CLOSE ANY OTHER
FOR THE CLOSING I RESPECTFULLY
ASK ARRIVAL THANK YOU VERY MUCH
FOR YOUR TIME THINK SO MUCH
FASTER CHAO PRESENTED.
AND WE COULD USE SOME AUTHORS.
MISS WALDRON.
PLEASE GO AHEAD.
AND AFTER HIS WALDRON WE COULD
USE MARKERS.
SO MISS WALDRON WILL BE
PRESENTING AB NINETEEN SIXTY
THREE
.
WE THANK YOU MISTER CHAIR.
I THINK LOU MISSING ONE OF OUR
WITNESSES BUT WE CAN STILL
PROCEED.
.
I'M HERE TO TODAY TO PRESENT A.
B. NINETEEN SIXTY THREE THE
OPIOID TREATMENT CERTIFICATION
ACT.
HAS YOU KNOW OPIOID DEPENDENCE
IS A LEADING FORM OF DRUG ABUSE.
IN THE WORLD.
AND AS THE NUMBER ONE CAUSE OF
ACCIDENTAL DEATHS IN THE U. S..
MEDICATION ASSISTED TREATMENT
ARE MAD AT ME T. IS AN
INNOVATIVE TREATMENT PROGRAM
THAT USES MEDICATIONS WITH
COUNSELING AND BEHAVIORAL
THERAPIES TO TREAT SUBSTANCE
ABUSE DISORDERS.
THIS TREATMENT.
PROGRAM HAS SHOWN TO BE MORE
EFFECTIVE IN SIGNIFICANTLY
CHEAPER THAN.
EXCLUSIVELY IN PATIENT
TREATMENTS DESPITE INCREASING
SUCCESS OF MATT.
FOR OPIOID ABUSE LESS THAN TWO
PERCENT OF CALIFORNIA MEDICAL
PROVIDERS.
OUR CERTIFIED TO PRESCRIBE
BICU PANEL FOR IN THE LOCKS ON
TREATMENT AND EVEN LESS A
CERTIFIED TO ADMINISTER
NALTREXONE.
PROVIDING ACCESS TO MEDICATION
TO SIT ASSISTED TREATMENT DRUGS
IN RURAL AREAS IS PIVOTAL IN
MANAGING AN OPIOID EPIDEMIC.
HOWEVER THE NUMBER OF CERTIFIED
PROVIDERS IN CALIFORNIA IS FAR
LESS THAN WHAT WE NEED.
A COMBAT OPIOID ABUSE SO
INCREASE ACCESS TO THIS
TREATMENT CALIFORNIA NEEDS TO
INCENTIVIZE MEDICAL PROVIDERS TO
BECOME CERTIFIED PRESCRIBERS.
IN AN EFFORT TO INCENTIVIZE MORE
MEDICAL PROVIDERS TO BECOME
CERTIFIED PRESCRIBERS OF MATT.
THIS BILL WOULD INCREASE THE
REIMBURSEMENT RATE FOR PROVIDERS
WHO ARE CERTIFIED TO PRESCRIBE
MEDICATION ASSISTED TREATMENT
DRUGS.
WE'VE BEEN WORKING WITH
STAKEHOLDERS TO FIND THE PROPER
PERCENTAGE TO INCREASE THE
REIMBURSEMENT RATE WILL KEEP THE
COMMITTEE A PRIZE WHEN THE
NUMBER HAS BEEN DECIDED UPON.
WITH ME TODAY.
I HAVE TOM RUN FREE FROM COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION. AND JOHN WALESA WHO
IS HERE TO HELP OUT WITH
TECHNICAL QUESTIONS THANK YOU.
THANK YOU MISTER CHAIR MEMBERS I
TOM RENT FREE WITH COUNTY BE
ABLE HEALTH DIRECTORS
ASSOCIATION.
THE.
AS AS.
THE ASSEMBLY MEMBER WALDRON HAS
SAID THAT THE.
.
LESSON TWO PERCENT OF
CALIFORNIA'S MEDICAL PROVIDERS
ARE A CERTIFIED TO PRESCRIBE
THESE MEDICATIONS AND WE KNOW I
MEAN. WE'RE ALL AWARE THAT WE
ARE IN THE MIDDLE OF AN OPIOID.
EPIDEMIC WHICH IS A PUBLIC
HEALTH CRISIS AND THERE'S REALLY
DEMONSTRATED SUCCESS OF THESE
MEDICATIONS IN TREATING PEOPLE
WITH SUBSTANCE USE DISORDERS.
I'M THERE'S ALSO A SEVERE
SHORTAGE OF PROVIDERS ESPECIALLY
IN RURAL AREAS BOUT.
HALF OF THE.
RULE COUNTIES HAVE NO NARCOTIC
TREATMENT PROGRAM OF PROVIDERS
AT ALL AND YET IN SOME OF THESE
COUNTIES.
THAT SAYS YOU'VE PROBABLY SEEN
ON THE NEWS THERE ARE MORE
OPIOID PRESCRIPTIONS BEING
WRITTEN IN THERE ARE PEOPLE IN
THE COUNTY SO THIS IS A HUGE
NEED. OBVIOUS THESE MEDICATIONS
WHEN COMBINED WITH BEHAVIORAL
HEALTH THERAPIES ARE.
ON HOLD PERSON TREATMENT
APPROACH.
TO TREATING SUBSTANCE USE
DISORDERS BUT TO INCREASE ACCESS.
AND TO EXPAND OUR NARCOTIC
TREATMENT PROGRAMS AND
INCENTIVIZE MEDICAL PROVIDERS TO
BECOME CERTIFIED PROVIDERS
A PUPIL NORTH VIENEN SUBOXONE
ARE WE HAVE TO INCREASE THE
HISTORICALLY LOW MEDI CAL
PROVIDER REIMBURSEMENT RATES FOR
THE SERVICES AND.
A FOR THESE REASONS WE ARE
SUPPORT.
THIS BILL THANK YOU.
MISTER CHAIRMAN AND MEMBERS JOHN
VALENCIA HERE ON BEHALF OF ALL
KERN IS INCORPORATED DEL KERMES
MANUFACTURERS AND ADDITIONAL
MEDICATION ASSISTED TREATMENT
LONG ACTING INJECTABLE
NALTREXONE. WHICH IS A ONE
HUNDRED PERCENT ANTAGONISED
VERSION WE'RE FULLY SUPPORTIVE
OF ASSEMBLY MEMBER WALDRON'S
HOLISTIC APPROACH ON MAKING. ALL
MEDICATION ASSIST THE TREATMENTS
AVAILABLE TO THE RIGHT PATIENT.
IN THE RIGHT CIRCUMSTANCE AT THE
RIGHT TIME SO WE APPRECIATE HER
APPROACH ON THE MEASURE WE FULLY
SUPPORT IT THANK YOU.
OTHER SUPPORT.
THANK YOU MISTER CHAIR AND
MEMBERS MAKING ALREADY BEHALF OF
THE CALIFORNIA MEDICAL
ASSOCIATION.
GLAD TO SUPPORT THIS BILL WE
HAVE REALLY BEEN. WORKING WITH
OTHERS AND I AM OUR POSITIONS ON
THE MEMBERS TO LOOK TOWARDS I
HAVE PREVENTION. AND TREATMENT
NOW THAT WE HAVE AND WE ARE IN
THIS PLACE REEKS OF MADE SOME
GREAT CHANGES THAT ARE
PRESCRIBING AND WANT TO LOOK
FORWARD TO. HOW WE'RE GOING TO?
DEAL WITH THE POPULATION THAT
HAS.
FALLING VICTIM SUBSTANCE USE
DISORDER AND AND SURE THAT
TREATMENT IS AVAILABLE TO THEM.
AND SO I THINK THAT
INCENTIVIZING WRITERS IS THE
BEST WAY TO DO THAT WE WANT TO
MAKE SURE THAT THEY ARE ABLE TO
PROVIDE THIS CARE.
AND.
.
AND.
I HAVE.
WE FULLY SUPPORT THE BILL AND
THE FORGE OF MOVING FORWARD.
WE GET HOMELESS FOR SUPPORT.
IF YOU. OTHERS IN SUPPORT JUST
TO NAME AN ORGANIZATION SHERRY
DAILY WITH THE CALIFORNIA
CONSORTIUM OF ADDICTION PROGRAMS
AND PROFESSIONALS AND SUPPORT
THANK YOU.
RENTAL HAGER FOR THE CALIFORNIA
PSYCHIATRIC ASSOCIATION IN
SUPPORT.
MR JOHNSON ON BEHALF OF
CALIFORNIA'S AT PHARMACISTS
ASSOCIATION IN SUPPORT THANK YOU.
MAX PARA CALIFORNIA KARAMEA
FILLING POSITIONS IN SUPPORT.
WHERE TOP ON BEHALF OF BY A
COMMON SUPPORT?
ALL OF IRAQ GRAY CALIFORNIA LIFE
SCIENCES ASSOCIATION IN SUPPORT.
DOUG CHIP PET ON BEHALF OF THE
UNION OF AMERICAN PHYSICIANS AND
DENTISTS IN SUPPORT ONE COPY AT
OUR LAST YEAR IN THE BUDGET BILL.
THERE IS A PROVISION THAT
ESSENTIALLY MANDATED.
MEDICATION TREATMENT FOR
INDIVIDUALS WHO ARE SUFFERING
FROM ADDICTION. AND PUBLIC
SECTOR VENUES SUCH AS I
INCARCERATED SETTINGS LIKE THE
DOCTORS THAT I REPRESENT.
THERE'S NO TRAINING THAT'S
PROVIDED AND I WILL ONLY CAUTION
ANYTHING THAT'S.
BEING MANDATED SHOULD HAVE
SUFFICIENT TRAINING BECAUSE
WE'VE STRUGGLED.
.
AS THE A COMET ALLUDED TO
EARLIER IS ONLY TWO PERCENT
THE PHYSICIANS ARE TRAINED IN
THIS SO UNFORTUNATELY IN THE
PUBLIC SECTOR WAS MANDATE ON US.
WE DON'T HAVE SUFFICIENT
TRAINING AND WE ARE WRAPPING UP
I WOULD NOT WANT TO SEE THE SAME
THING HAPPENED PRIVATE SECTOR
BUT OF COURSE WE SUPPORT BILL
THANK YOU.
ANYONE NEED OPPOSITION.
SCENE NUMBER BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS.
AND WOULD YOU LIKE TO CLOSE THAT
WOULD YOU WE STILL WE'RE STILL
ONE TRAVEL QUORUM UNFORTUNATELY
YOU KNOW.
THANK YOU MISTER CHAIRMAN
COMMITTEE.
AND FOR YOUR WORK WITH ME ON
THIS BILL.
THE GOAL IS TO GET PROVIDER
CERTIFIED AND TRAINED AND TO GET
THEM OUT TO HELP OUR FOLKS
ESPECIALLY IN THE RURAL AREAS
THE MOST NEED THEM. FIRED YOUR
EYES AYE VOTE THANK YOU
WHEN WE HAVE A QUORUM.
WE WILL PUT UP AND.
THINK THAT'S PROMOTION AND IT
DOESN'T YOU AND IT DOES ENJOY A
DO PASS RECOMMENDATION THINKS
THANK YOU MISS WALDRON SO.
SEE DOCTOR ARAMBULA ARE YOU
READY.
COME ON UP SIR.
PRESENTING AB TWENTY FOUR NINETY
NINE.
THANK YOU MISTER. CHAIRMAN AND.
WELCOME MR VICE CHAIR AS WELL
AS OTHER MEMBERS.
TODAY I AM HERE TO PRESENT ON AB
TWENTY FOUR NINETY NINE WHICH
IMPROVES ON OUR STATE'S EXISTING
MEDICAL LOSS RATIO STANDARDS.
AND PRESERVES HOW THESE RATIOS
ARE CALCULATED WHICH GUARANTEES
A HIGHER PERCENTAGE OF THE
PREMIUM DOLLARS IS SPENT ON CARE.
CURRENTLY THE AFFORDABLE CARE
ACT PROVIDED MILLIONS OF
CALIFORNIANS WITH HEALTH
COVERAGE FOR THE FIRST TIME IN
THEIR LIVES.
THROUGH MEDICAL EXPANSION AND BY
MAKING PRIVATE COVERAGE MORE
AFFORDABLE.
MILLIONS OF CALIFORNIANS BENEFIT
FROM STRONG A CA CONSUMER
PROTECTIONS THAT MAKE SURE THAT
HEALTH PLAN SPEND A MINIMUM
PORTION OF THE PREMIUMS ON CARE.
COVER ESSENTIAL HEALTH BENEFITS
HAVE NO ANNUAL OR LIFETIME
LIMITS ON BENEFITS
CAP ANNUAL OUT OF POCKET COSTS
AND OFFER COVERAGE ON A
GUARANTEED ISSUE BASIS
REGARDLESS.
PRE EXISTING CONDITIONS AND MANY
OTHERS.
MUCH OF OUR STATE LAWS THAT
IMPLEMENTED THE ACA ACTUALLY
EXCEEDED AND IMPROVED UPON THESE
HERE.
THIS HAS MADE CALIFORNIA A
LEADER IN HEALTH CARE REFORM
ACROSS THE NATION.
OUR CONSUMER CENTERED POLICY
DECISIONS HAVE ALSO LED TO
RELATIVELY STABLE AND SUCCESSFUL
INSURANCE MARKETS.
IMPROVING ON THE MEDICAL LOSS
RATIO STANDARDS THREW AB TWENTY
FOUR NINETY NINE IS ANOTHER WAY
THAT OUR STATE CAN LEAD AND MAKE
THE ACA BETTER FOR OUR CONSUMERS.
RISING HEALTHCARE COSTS
ESPECIALLY HEALTH INSURANCE
PREMIUMS CONTINUE TO BE A
CONCERN FOR CONSUMERS.
THE AMIL OUR STANDARDS HAVE
HELPED TO CURVE.
EXCESSIVE HEALTH INSURER PROFITS
AND ADMINISTRATIVE COSTS BY
CAPPING THESE EXPENSES.
WHILE AT THE SAME TIME
GUARANTEEING THAT AT LEAST
EIGHTY TO EIGHTY FIVE PERCENT OF
PREMIUMS GO TOWARDS ACTUAL
MEDICAL CARE AND QUALITY
IMPROVEMENT ACTIVITIES.
AT THE SAME TIME.
WE CONTINUE TO SEE HEALTH PLANS
AND INSURERS MAKE BILLIONS OF
PROFITS.
EVEN WITH THE STANDARD.
WE ALSO HAVE DATA SHOWING THAT
MOST HEALTH PLANS AND INSURERS
MEET AND WILL EXCEED THE CURRENT
AND ALL OUR STANDARDS.
BOTH OF THESE DEMONSTRATE.
THAT CALIFORNIA CAN DO BETTER
AND SHOULD IMPROVE THE STANDARDS.
AT THE SAME TIME CALIFORNIA
SHOULD ALSO PRISONER PRESERVE
HOW AMMO OURS ARE CALCULATED.
SO THAT MORE OF OUR PREMIUM.
DOLLARS ARE SPENT ON ACTUAL CARE
AND LESS ON INSURANCE COMPANY
PROFITS AND OVERHEAD.
AS A PHYSICIAN I AM COMMITTED TO
ENSURING THE MOST OF OUR PREMIUM
DOLLARS GO TOWARDS MEDICAL CARE
AND NOT ON ADMINISTRATIVE
OVERHEAD.
WITH ME TO TESTIFY AND SUPPORT
HER MARRIED JUNE FLOREZ FROM
HEALTH ACCESS AS WELL AS JIM
FLORI FROM THE WESTERN CENTER OF
LONG POVERTY.
GOOD AFTERNOON MISTER CHAIR AND
MEMBERS MY NAME IS MARY JANE
FLOORS AND ON BEHALF OF HEALTH
ACCESS CALIFORNIA. THE STATE
WIDE HEALTH CARE CONSUMER
ADVOCACY COALITION WORKING ON
AFFORDABLE AND QUALITY
HEALTHCARE FOR ALL CALIFORNIANS
WE ARE PROUD TO SPONSOR AND
SUPPORT. AB TWENTY FOUR NINETY
NINE WHICH WOULD RAISE OUR
STATE'S MEDICAL LOSS RATIO
SANDERS IN THE INDIVIDUAL AND
LARGE GROUP MARKETS AND ALSO
CODIFY OBAMA ERA REGULATIONS IN
OUR STATUTES.
EVERY OTHER ACA RELATED LAW THAT
CALIFORNIA HAS PASSED HAS BEEN
MORE PROTECTIVE AND MORE
CONSUMER CENTRIC.
THE STATE'S MLR STANDARD IS ONE
OF THE FEW THINGS THAT WE
CAPTAIN REFERRED TO FEDERAL
RULES WHICH THAT THE FLOOR.
SIMILAR TO NATIONAL DATA MOST
CALIFORNIA HEALTH PLANS AND
INSURERS HAVE EXCEEDED THE AMONG
OUR STANDARDS AND RESET TWENTY
SIXTEEN FINANCIAL DATA THAT PLAN
SUBMITTED TO THE DAMAGE THE.
SHOW ABOUT ALL OF THE PLANS
OFFERING COVERAGE IN THE
INDIVIDUAL MARKET MATT AND
EXCEEDED THE EIGHTY TWENTY MLR.
NOW THAT WE HAVE A FEW YEARS
WORTH OF EXPERIENCE IN DATA WE
CAN IMPROVE UPON THESE MINIMUM
MEDICAL LOSS RATIOS AND ACTUALLY
RAISE THEM. ADDITIONALLY IT IS A
POINT TO CODIFY OBAMA HERE RULES
ON HOW AND MILLERS ARE CATCHY
LESION POPULATED WHICH IS WHAT
THE STATE HAS USED FOR YEARS.
FINAL ELEMENTS THAT WERE
CONSIDERED IN THE CALCULATIONS
WENT THROUGH A RIGOROUS PROCESS
AT THE FEDERAL LEVEL AND NOW
THEY ARE THEY ARE AT RISK OF
BEING CHANGED DUE TO THE TRUMP
ADMINISTRATION. LASTLY WE ARE
AWARE AND SO I ANALYZE THE IN A
RECENT FIVE HUNDRED PAGE FEDERAL
RULE THAT WAS JUST PUBLISHED
YESTERDAY THAT PROVIDES GUIDANCE
TO THE STATE. SPECIFICALLY ON
MEDICAL LOSS RATIO. DESPITE
FEDERAL ACTIONS LET'S KEEP
CALIFORNIA AT THE FOREFRONT AND
LEADER IN IMPROVING UPON THE ACA.
I RESPECTFULLY ASK FOR YOUR AYE
VOTE THINK YOU.
GOOD AFTERNOON AND GEN FLOOR
WITH WESTERN CENTER ON LAW AND
POVERTY STATEWIDE LEGAL SERVICES
SUPPORT CENTER AND A MEMBER OF
THE HEALTH CONSUMER ALLIANCE
THAT SERVES CALIFORNIA CONSUMERS
WHO NEED HELP WITH THEIR
HEALTHCARE.
WHILE THE MAJORITY OF
CALIFORNIANS LOW INCOME
CONSUMERS NOW USE MEDICARE HOW
MANY DO YOU HAVE EMPLOYER
SPONSORED COVERAGE OR HAVE TO
PURCHASE THEIR OWN THROUGH
COVERED CALIFORNIA OR ON THE
INDIVIDUAL MARKET. AND ARE THUS
PAYING AT LEAST A PORTION IF NOT
ALL OF THEIR PREMIUM.
ADDITIONALLY SOME LOW INCOME
CALIFORNIANS STILL DO NOT
QUALIFY FOR HELP THE MEDI CAL
THE COVER CALIFORNIA WEATHER
BECAUSE OF THEIR IMMIGRATION
STATUS OR BECAUSE OF FEDERAL
REGULATION THAT CREATED A
PROBLEM KNOWN AS THE FAMILY
GLITCH.
FEDERAL REGULATIONS ONLY LOOK TO
THE COST OF EMPLOYER COVERAGE
PROVIDED TO THE EMPLOYEE WHEN
LOOKING AT WHETHER EMPLOYER
COVERAGE IS AFFORDABLE. THIS
MEANS SOME SPOUSES AND CHILDREN
OF EMPLOYEES ARE OFFERED
COVERAGE THAT IS TOO EXPENSIVE
FROM AN EMPLOYER BUT THEY ALSO
CANNOT GET EXTRA HELP BUYING
INSURANCE FROM COVER CALIFORNIA.
FOR EXAMPLE ONE OF OUR PARTNERS
IN THE INLAND EMPIRE HELPED A
CLIENT WHO IS OFFERED KAISER
COVERAGE FROM HIS RESTAURANT
EMPLOYER FOUR HUNDRED AND FOUR
DOLLARS A MONTH.
HOWEVER THE COVERAGE FOR HIS
SPOUSE TO JOIN HIS POLICY WOULD
THAT COST AN ADDITIONAL FIVE
HUNDRED AND SIXTY FOUR DOLLARS A
MONTH.
THIS FAMILIES TOTAL INCOME IS
TWO THOUSAND FOUR HUNDRED AND
TWENTY FOUR DOLLARS A MONTH.
SO THAT'S WELL OVER A THIRD OF
THEIR INCOME.
BECAUSE HUSBAND'S COVERAGE WAS
CONSIDERED AFFORDABLE SEES.
THAT IS CONSIDERED AFFORDABLE IF
SHE WOULD NOT BE ELIGIBLE TO
RECEIVE PREMIUM ASSISTANCE FROM
COVER CALIFORNIA. HER ONLY OTHER
OPTION WOULD BE TO PURCHASE AN
UNSUBSIDIZED POLICY AND THE
CHEAPEST POLICIES IN HER REGION
STARTED AROUND FOUR HUNDRED
DOLLARS THERE WITH A SIXTY THREE
HUNDRED DOLLAR DEDUCTIBLE.
LEAVING THIS FAMILY LESSEN TWO
THOUSAND A MONTH TO PAY FOR ALL
OTHER EXPENSES SUCH AS RENT
TRANSPORTATION UTILITIES AND
FOOD AND STILL BE EXPOSED TO
HIGH MEDICAL EXPENSES.
SHOULD THE MEDICAL LOSS STAND
RATIO STANDARDS BE LOWERED OR
NOT ENFORCED BY THE FEDERAL
GOVERNMENT THESE CALIFORNIANS
WILL BE COMPLETELY BLOCKED OUT
OF THE MARKET.
CALIFORNIANS WHO HAVE TO PAY FOR
THEIR PREMIUMS WHETHER THROUGH
EMPLOYER COVERAGE OR ON THEIR
OWN ARE EXTREMELY SENSITIVE TO
ANY INCREASE IN INSURANCE
PREMIUMS.
HOWEVER FROM TWO THOUSAND ELEVEN
TO TWENTY SEVENTEEN HEALTH PLAN
PREMIUMS HAVE INCREASED ON
AVERAGE OF NINE PERCENT A YEAR
YET WAGES TO NOT INCREASED BY
THE SAME AMOUNT.
WHILE OTHER COST CONTAINMENT
MEASURES ARE NEEDED THE MEDICAL
LOSS RATIO REQUIREMENTS ARE AN
IMPORTANT PIECE AND KEEPING
PREMIUMS DOWN KEEPING HEALTH
PLANS ACCOUNTABLE AND KEEPING
HEALTH COVERAGE AND REACH FOR
ALL CALIFORNIANS.
WE WOULD LIKE TO THINK THE
AUTHOR THE SPONSORS FOR THEIR
LEADERSHIP ON THIS ISSUE AND
RESPECTFULLY REQUEST YOUR AYE
VOTE.
IF YOU THINK YOU VERY MUCH WE'RE
GONNA TAKE A ROLE HERE OF THIS
WE HAVE A QUORUM SO MADAM
SECRETARY PLEASE TAKE THE ROLE
WHAT HERE. MASS.
ANGER CURRY. BIGELOW.
BONTA.
BURKE.
CARILLO. FLORA.
LIMON.
MCCARTY NAZARIAN RODRIGUEZ
SANTIAGO THURMOND WALDRON.
YOU HAVE A QUORUM SO WE WOULD.
NOW THIS POINT OTHERS IN
SUPPORT JUST YOUR NAME AND
ORGANIZATION PLEASE TO.
RAINY HICKS CALIFORNIA'S FOR
DISABILITY RIGHTS CALIFORNIA
ALLIANCE RETIRED AMERICANS IN
STRONG SUPPORT IQ.
KIMBERLY GILL THE CALIFORNIA
BENEFIT HEALTH THAT WORK IN
SUPPORT.
MICHELLE HAVE DATA WITH A CA YOU
CALIFORNIANS SUPPORT.
CHRIS KILEY ON WITH A CALIFORNIA
IMMIGRANT POLICY CENTER IN
SUPPORT.
BRENT IN MARCH YOU WITH THE
CALIFORNIA MEDICAL ASSOCIATION
ALSO IN SUPPORT.
ALTAMONTE INCIDENT WITH THE
AMERICAN CANCER SOCIETY CANCER
ACTION NETWORK ALSO IN SUPPORT.
MAX PARA CALIFORNIA KARAMEA
FILLING POSITIONS ALSO IN
SUPPORT.
EIGHTY ONE REPRESENTING MERTON
KENNETH PEDIATRICS HALL
CALIFORNIA DIVISION IN SUPPORT.
SIR FLOCKS CALIFORNIA LABOR
FEDERATION IN SUPPORT.
Q..
KRISTIN HER LURKING CALIFORNIA
RHEUMATOLOGY ALLIANCE IN SUPPORT.
IF YOU.
DOUGLAS CHIA PET ON BEHALF OF
THE UNION OF AMERICAN PHYSICIANS
AND DENTISTS WOULD ASK ME IN
STRONG SUPPORT THANK YOU.
YOU VERY MUCH.
ANYONE ELSE.
NO ONE.
.
MISSION.
IS THERE ANY OPPOSITION TO THIS
BILL.
THANK YOU MISTER CHAIR AND
MEMBERS NICK LOUISE US ON BEHALF
OF THE CALIFORNIA ASSOCIATION OF
HEALTH PLANS.
WERE STRONGLY OPPOSED TO
ASSEMBLY BILL TWENTY FOUR NINETY
NINE. WHICH PLACES A NEW IN
EXCESS OF MEDICAL LOSS RATIO
REQUIREMENT ON HEALTH PLANS THAT
EXCEEDS IN CONFLICTS WITH
REQUIREMENTS OF EXISTING LAW AND
REGULATIONS.
INCLUDING THOSE UNDER THE OBAMA
ADMINISTRATION.
THIS BILL WILL HAVE THE EFFECT
OF DESTABILIZING CALIFORNIA'S
MARKET. AND DOES NOTHING TO
LOWER MEDICAL ADMINISTRATIVE
COSTS
IT ALSO DOES NOTHING TO COVER
EVEN ONE ADDITIONAL UNINSURED
CALIFORNIAN.
NOW BY WAY OF BACKGROUND HEALTH
PLANS CONTINUE TO BE COMMITTED
TO MAKING THE AFFORDABLE CARE
ACT WORKING CALIFORNIA. IN OUR
COLLECTIVE EFFORTS OF HAVE
PRODUCED SOME PRETTY SOLID
RESULTS.
COVERED CALIFORNIA FOR INSTANCES
PERFORMING MUCH BETTER THAN THE
FEDERALLY BASED EXCHANGES.
WHEN IT COMES TO PLAN
PARTICIPATION LEVELS AND
PREMIUMS.
THIS RELATIVE STABILITY IS DO TO
A BROAD BASE OF ENROLLMENT. AND
CONSUMER CHOICE IN MOST AREAS OF
THE STATE.
HAVING SAID THIS A RASH OF
FEDERAL POLICIES.
MOST RECENTLY THE ELIMINATION OF
THE OF INEFFECTIVE INDIVIDUAL
MANDATE WILL CHALLENGE OUR
COLLECTIVE SUCCESSES.
WHILE THESE CHALLENGES CAN BE
OVERCOME.
ADDING AN ALMOST IMPOSSIBLE MLR
REQUIREMENT WILL TAKE IS
DECIDEDLY IN THE WRONG DIRECTION.
AND WILL CREATE ITS OWN
DESTABILIZING AFFECT.
THIS BILL DOES NOT SEND A
REASSURING SIGNAL TO THE MARKET
AT A TIME OF UNCERTAINTY.
SOME HEALTH PLANS MAY DETERMINE
THAT THE NEW REQUIREMENTS WILL
LEAD TO THE TYPE INANCIAL
LOSSES THAT ARE UNSUSTAINABLE.
AT THE VERY TIME WE NEED TO
ENSURE CONSUMERS HAVE CHOICE.
THIS OUTCOME WOULD BE
PARTICULARLY BAD NEWS IN AREAS
OF THE STATE THAT ARE CURRENTLY
SERVED BY ONLY ONE OR TWO HEALTH
PLANS.
WE HAVE TO KEEP IN MIND THAT THE
NUMBER OF ISSUERS OFFERING
COVERAGE OF YOUR COVERED
CALIFORNIA HAS DECLINED OVER
TIME.
THIS BILL IS NOT HELPFUL IF WE
HOPE TO REVERSE THAT TREND.
FEDERAL MEDICAL LOSS RATIO
REGULATIONS ENACTED UNDER THE
OBAMA ADMINISTRATION WISELY
ANTICIPATE THE POTENTIAL FOR
MARKET IMPACTS.
STIPULATING THAT BEFORE STATES
IT'S A HIGHER MINIMUM MLR. THE
STATE QUOTE MUST SEEK TO ENSURE
ADEQUATE PARTICIPATION BY HEALTH
INSURER CHURNS ISSUERS.
AND COMPETITION IN THE HEALTH
INSURANCE MARKET IN THE STATE.
AMONG OTHER THINGS.
NEW REGULATIONS RELEASED
YESTERDAY CLARIFY THAT A STATE
SUBMITTING A REQUEST FOR AN
ADJUSTMENT TO THE INDIVIDUAL
MARKET. MEDICAL LOSS RATIO
STANDARD MUST SUBMIT DATA FOR
EACH ISSUE WHERE THEY'RE
ACTIVELY OFFERS COVERAGE IN THE
INDIVIDUAL MARKET IN THE STATE.
AND BROKEN DOWN INTO SPECIFIED
CATEGORIES INCLUDING WHETHER THE
ISSUE WERE OR NEW ENTRANT HAS
PROVIDED NOTICE.
ABOUT WHETHER IT'LL BE OFFERING
COVERAGE IN CERTAIN GEOGRAPHIC
AREAS OR IN THE ENTIRE.
OR THROUGHOUT THE ENTIRE STATE.
ACCORDING TO THESE REGULATIONS
IT DOES NOT APPEAR THAT A STATE
CAN AUTOMATICALLY OR REPLACE THE
MINIMUM FEDERAL AND ALL OUR
REQUIREMENTS.
AND IN ANY CASE MARKET
STABILIZATION IS KIND OF THE
NEXUS THERE.
BUT THE PROPONENTS OF TWENTY FOR
NINETY NINE ARE WORRIED THAT THE
TRUMP ADMINISTRATION SEEKING TO
MAKE IT EASIER FOR STATES TO
LOWER THE MLR. FIRST I
PERSONALLY FIND IT VERY
DIFFICULT TO SEE CALIFORNIA
RUSHING TO LOWER ITS MLR BECAUSE
THE CURRENT ADMINISTRATION SAID
IT COULD.
AND WE DON'T BELIEVE THIS WILL
HAPPEN SECOND IF THAT'S THE
CONCERN WE ARE HAPPY TO SIT DOWN
WITH THE AUTHOR TO.
WORK ON WAYS TO PROTECT OUR
CURRENT MEDICAL LOSS RATIO
STANDARDS I'M FROM FEDERAL I'M
FEDERAL INCURSIONS.
I'M ENCLOSING WE BELIEVE THEY'RE
MORE PRODUCTIVE ACTIONS OF
CALIFORNIA CAN TAKE TO STABILIZE
OUR MARKET. ACTIONS ARE MUCH
LESS HARMFUL THIS BILL AND.
WE HAVE WE'RE HOPING TO HAVE
THOSE CONVERSATIONS INSTEAD OF
THIS.
Y. WE'D ASK VOTE NOW THANK YOU.
THANK YOU I SEE TO ADDITIONAL
WITNESSES ARSES ONE OKAY THANK
YOU ARCTIC.
MISTER CHAIR AND MEMBERS STATE
PLANE OR JUST ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF HEALTH
UNDERWRITERS WE APPRECIATE THE
AUTHOR'S AMENDMENTS OUTLINED AT
THE ANALYSIS AND FEEL THAT IT'S
A STEP IN THE RIGHT DIRECTION.
HOWEVER WE BELIEVE THAT THE
PROPOSED INCREASE IN AND ALL I
WOULD HAVE DEVASTATING IMPACTS
ON THE COST AND STABILITY OF THE
LARGE. AN INDIVIDUAL MARKETS.
WE'RE PROUD OF OUR AGENTS ROLE
IN MAKING CALIFORNIA'S EXCHANGE
THE MOST SUCCESSFUL IN THE
COUNTRY. WHERE ONE OF THE FEW
STATES WITH MARKET STABILITY AND
CHOICE WHICH HAS BEEN A HUGE
PART OF THAT SUCCESS?
WE WOULD ECHO THE MARKET IS
STABILIZATION COMMENT SHARED BY
THE PLANS AND WELL MARKET
DESTABILIZATION SEEMS TO BE A
DISTANT TERM IT'S VERY REAL FOR
AGENTS ON THE FRONT LINES. WHO
NEED TO HELP INDIVIDUALS AND
FAMILIES WHO ARE JUST TOLD THEIR
INSURER IS NO LONGER SERVING
THEIR REACH?
THIS WAS RECENTLY THE CASE LAST
YEAR WHEN AT THE BLUE CROSS OF
CALIFORNIA WITH YOUR FROM
SIXTEEN.
OF CALIFORNIA'S NINETEEN PRICING
REGIONS AND HUNDRED AND THIRTY
THREE THOUSAND PEOPLE LOST THEIR
HEALTH CARE.
THIS COMMITTEE IS LOOKING AT
OTHER LEGISLATION RELATING TO
THE DETRIMENTAL EFFECTS OF
MARKET CONSOLIDATION AND A LACK
OF ACCESS IN RURAL AREAS. PLEASE
ALSO CONSIDER THE CIRCUMSTANCES
IN REVIEWING THIS LEGISLATION AS
WELL.
WE WOULD RESPECTFULLY URGE A NO
VOTE AT THIS TIME THAT WE REMAIN
COMMITTED TO PARTNERING WITH THE
AUTHOR. AND HIS COMMENDABLE
EFFORTS TO REDUCE THE COST OF
HEALTH CARE AND IMPROVE ACCESS.
STEPHANIE WATKINS ON BEHALF OF
THE ASSOCIATION COMPANY LIKE AND
HOW.
HE'S A.
JOHN WHEN YOU'RE ON BEHALF
AMERICA'S HEALTH INSURANCE PLANS
AN ANTHEM BLUE CROSS WOULD A
LINER COMETS OF CAP.
SHERRI MCCUE REPRESENTING THE
CALIFORNIA CHAMBER OF COMMERCE
IN OPPOSITION.
KEVIN DE DUTTY REPRESENTING
AETNA WERE OPPOSED THANK YOU.
THE IN CHECK WITH HEALTH THAT IN
OPPOSITION THANK YOU.
AARON NORWOOD ON BEHALF OF THE
INDEPENDENT INSURANCE AGENTS AND
BROKERS OF CALIFORNIA ALSO AND.
ANYONE ELSE.
SEEN KNOWN A BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS.
MISS WALDRON.
SERVER MAYBE A CLARIFICATION
FROM THE OPPOSITION.
THE TOKEN.
.
THE CENTERS FOR MEDICARE AND
MEDICAID SERVICES ARE
REGULATIONS GOVERNING MLR
REQUIREMENTS OF THE ACA.
STIPULATE THAT BEFORE STATE SETS
A HIGHER MINIMUM MLR THE STATE
MUST SEEK TO ENSURE ADEQUATE
PARTICIPATION BY HEALTH INSURERS.
COMPETITION IN THE HEALTH
INSURANCE MARKET IN THE STATE
AND VALUE FOR CONSUMERS SO THAT
PREMIUMS ARE USE FOR CLINICAL
SERVICES OF QUALITY.
IMPROVEMENTS.
IN OTHER WORDS A SAY CAN
AUTOMATICALLY REPLACE THE
FEDERAL OF FOR ALL OUR
REQUIREMENTS CAN YOU SPEAK TO
THE. MOON MAYBE EXPAND ON IT BUT.
RIGHT SO.
.
BEFORE STATE CAN MAKE
ADJUSTMENTS TO THE MEDICAL LOSS
RATIO CERTAIN THINGS HAVE TO
HAPPEN.
AT LEAST THAT'S ACCORDING TO
OUR READ OF EXISTING FEDERAL
REGULATIONS
NOW OF THEIR NEW REGULATIONS ARE
WE SHE JUST YESTERDAY'S OR STILL
TAKING A LOOK AT THOSE. BUT
CLEARLY THE PROCESS FOR MAKING
AN ADJUSTMENT TO THE M. L. ARE.
REQUIRES THAT A STATES TAKE
CERTAIN ACTION INCLUDING MAKING
MARKET IMPACT.
SOME WILL BE AND IT REQUIRES THE
STATE TO.
BASICALLY SURVEY.
THE STATE'S.
HEALTH INSURANCE PLANS.
TO DETERMINE WHAT THE POTENTIAL.
MARKET IMPACTS COULD BE.
RELATIVE TO EACH SPECIFIC ISSUE
WERE.
AND SO.
THAT IS A PROCESS THAT HAS TO
PLAY OUT. OUR READERS THAT THE
STATE WOULD HAVE TO PETITION THE
FEDERAL GOVERNMENT IN ORDER TO
MAKE THOSE ADJUSTMENTS.
IT'S STILL EARLY WE'RE TAKING A
LOOK AT THOSE RAGS.
THAT THERE WERE JUST ISSUED
YESTERDAY BUT AS YOU SAID
CLEARLY UNDER THE.
ABOUT THE OBAMA ADMINISTRATION
WOULD YOU SHOULD THE INITIAL
MEDICAL LOSS RATIO REGULATIONS
THE STATE HOUSE TO MAKE FINDINGS
ABOUT WHAT THE MARKET IMPACT
WILL BE. BEFORE IT.
IT BEFORE TO JUST THEM MEDICAL
LOSS RATIO HIGHER AND THAT
REGULATION THAT YOU ARE CITED
ASSEMBLY MEMBER WALDRON IS
SPECIFIC TO ADJUSTMENTS MAKING
THEM MEDICAL LOSS RATIO HIGHER.
ANYONE ELSE.
DOCTOR REGULAR.
FIRST OF ALL HAVE YOU IT DID YOU
HAVE ACCEPT OUR AMENDMENTS YES
YOU DID OKAY THREATENS OTIS MY
APOLOGIES OKAY.
.
THIS WILL SAVE YOU KNOW I DO.
FOR FOR A. LET YOU.
CLOSE I WANT IS MY SAVED WE WE
RECOGNIZE THAT.
THE.
FEDERAL GOVERNMENT RECENTLY.
CAME OUT WITH A FIVE HUNDRED
PAGE RULE.
WITCHES
FASCINATING IS ALRIGHT BUT.
.
IT WHICH INCLUDE A DISCUSSION OF
WITH REALART REGARDS HIM ALL ARE
AND SO WE WILL BE LOOKING
CLOSELY AT THAT AS WELL. AND AS
I SUSPECT THE AUTHOR WILL BE
MOVING FORWARD SO.
APPRECIATE PRECEDED THAT HAS
COME UP MULTIPLE TIMES HERE.
.
I DO SUPPORT MOVIE FOR WITH
BUILT THIS POINT AND.
.
WE WILL.
ASK IF. ANYONE IS GOING TO BE.
ABLE TO MAKE A MOTION.
THE BILL AFTER YOU CLOSE.
GREAT THANK YOU MISTER CHAIR.
AND IF I MAY I'D REALLY WANTED
TO ADDRESS ONE POINT FROM THE
OPPOSITION.
WHICH WAS.
THAT WE WOULD BE SETTING UP AN
ALMOST IMPOSSIBLE AND MILLAR'S
THEIR QUOTE.
AND I'D LIKE TO POINT OUT THAT
RIGHT NOW A MAJORITY OF THE
HEALTH PLANS ARE CURRENTLY
EXCEEDING. THE PROPOSED
INCREASED AMOUNT.
THREE OUT OF THE ELEVEN.
INDIVIDUAL MARKET PLANTS WOULD
NOT MEET BASED ON OUR CURRENT
ANALYSIS.
AND OLD MAJORITY OF THE PLANTS
WOULD EXCEED THAT IN THE LARGE
GROUP.
THEY'RE DOING THAT TODAY.
WHAT I'M ASKING THIS COMMITTEE
IS TO CODIFY OUR CURRENT OBAMA
ERA?
M. O. LARS AND TO CONSIDER THE
POSSIBILITY OF INCREASING THE
MEDICAL LOSS RATIO.
BASED OFF OF THE HISTORICAL
PERFORMANCE ON THE INSURANCE
COMPANIES
WITH THAT I HUMBLY ASK FOR AN
AYE VOTE.
WE FOR PART OF LOOKING LOOKING
FOR A MOTION.
THE MOTION BY MISTER HIS AIRINA
SECOND BY MR MCCARTY.
MADAM SECRETARY THAT NOTION IS
TO PASS AS AMENDED TO
PREPARATIONS SPENT SECRETARY
PLEASE CALL THE ROLL WHAT I
WOULD AYE MAYES. MAYES NO AGAR
CURRY. ANCHOR CURRY AYE BILBO.
BIGELOW NO BONTA.
BURKE.
CARILLO.
FLORA.
FLORA KNOW. THE MONTH. MOAN AYE
MCCARTY. MCCARTY AYE MISSOURIAN.
NAZARIAN AYE RODRIGUEZ.
SANTIAGO. BERMAN. WALDRON.
WALDRON NO.
THAT'S IT'S A FIVE TO FOUR AND
WILL. COME BACK TO THAT WE HAVE
MORE MEMBERS THINKING STRAIGHT
EVERY MUCH TALKED ARAMBULA.
MISTER GREGG.
MR GREY WILL BE PRESENTING AB
TWENTY TWO OH THREE.
GOOD AFTERNOON MISTER CHAIRMAN.
MEMBERS.
THANK YOU.
FOR THE OPPORTUNITY PERCENT AB%
TWENTY TWO OH THREE HERE TODAY.
OF THIS MEASURE SEEKS TO CODIFY
AND MAKE PERMANENT.
THE AFFORDABLE CARE ACT'S
MEDICAID FEE BOMB WHICH
CALIFORNIA ALLOWED TO EXPIRE AT
THE END OF TWENTY FOURTEEN.
MORE THAN THIRTEEN MILLION
CALIFORNIANS NEARLY A THIRD OF
THE STATE'S POPULATION IS SERVED
BY MEDICARE.
WITH NEARLY FIVE MILLION GAINING
COVERAGE SINCE THE AFFORDABLE
CARE ACT TOOK EFFECT.
WE THE MEDI CAL PATIENTS.
POPULATION LARGER THAN THE
POPULATION OF PENNSYLVANIA
CALIFORNIA HAS MADE SIGNIFICANT
FINANCIAL COMMITMENTS.
TO EXPAND ENROLLMENT THE PROGRAM
WITHOUT ADDRESSING THE
INADEQUACIES
THAT EXIST ONCE ENROLLEES SEEK
TO ACCESS CARE.
THIRTY FOUR PERCENT OF MEDI CAL
BENEFICIARIES REPORT WERE
REPORTED.
I DIFFICULTY FINDING A
HEALTHCARE PROVIDER THIS IS
COMPARED TO JUST THIRTEEN
PERCENT OF PEOPLE WITH OTHER
FORMS OF COVERAGE.
IN TWENTY FIFTEEN UCSF FOUND
THAT THE PERCENTAGE OF POSITIONS
SERVING MEDI CAL PATIENTS
DECREASED BY FIVE PERCENT OVER
JUST TWO YEARS.
THE REASONS FOR THESE ACCESS
CHALLENGES ARE MULTIFACETED. BUT
ONE OF THE GLARING WEAKNESSES
IN MEDI CAL IS THE UNACCEPTABLE
REIMBURSEMENT RATES.
IN TWENTY ELEVEN MEDICARE
PAYMENT RATES TO REVISE WERE CUT
BY TEN PERCENT TO BALANCE THE
STATE'S BUDGET.
DESPITE THE ECONOMIC RECOVERY
SINCE THE RECESSION POSITIONS
PAYMENTS HAVE NOT BEEN RESTORED.
EVEN BEFORE THE TWENTY ELEVEN
CUTS CALIFORNIA PROVIDE ONE OF
THE LOWEST REIMBURSEMENT RATES
OF ANY STATE RANKING FORTY
SEVENTH IN THE NATION FOR
TRADITIONAL FEE FOR SERVICE
PAYMENTS.
MEDICARE REIMBURSES JUST
EIGHTEEN DOLLARS FOR A VISIT TO
THE DOCTOR'S OFFICE.
LESS THAN HALF OF THE MEDICARE
RATE OF FORTY FIVE DOLLARS.
NOT ONLY DO LOW REIMBURSEMENT
RATES.
DISINCENTIVE EYES DOCTORS FROM
PRACTICING IN THE AREAS OF THE
STATE MOST IN NEED OF THEIR
SERVICES. THEY ALSO RESTRICT THE
ABILITY OF EXISTING DOCTORS XIN
ACCEPTING MEDICAL PATIENTS IN
THE FIRST PLACE.
CONGRESS AND THE OBAMA
ADMINISTRATION RECOGNIZE THE LOW
REIMBURSEMENT RATES ARE PRIMARY
BECAUSE OF ACCESS TO CARE ISSUES.
THE ACA MANDATED FUNDED THE
MEDICAID FEE BOP.
WHICH BROUGHT MEDICARE
REIMBURSEMENT RATES FOR PRIMARY
CARE.
IN LINE WITH MEDICARE.
WHEN CALIFORNIA. ALLOWED THE
HIGHER RATES TO EXPIRE IN TWENTY
FIFTEEN.
CALIFORNIA DOCTOR SERVING MEDI
CAL PATIENTS SAW THEIR PAYMENTS
DROPPED BY ALMOST SIXTY PERCENT.
AB TWENTY TWO OR THREE RESTORED
THESE HIGHER RATES FOR PRIMARY
CARE SERVICES.
AS CALIFORNIA CONTINUES TO MAKE
EXPANDING HEALTH CARE COVERAGE
PRIORITY WE MUST ALSO
ACKNOWLEDGE THAT OUR WORK DOES
NOT AND WITH COVERAGE.
MEDI CAL IS NO LONGER JUST A
SAFETY NET PROGRAM IS THE
PRIMARY FORM HEALTH INSURANCE
FOR A THIRD OF OUR POPULATION.
IN ORDER ENSURE THEY RECEIVE
CARE WE MUST PRIORITIZE OUR MEDI
CAL. TO THE SAME DEGREE
THE FEDERAL GOVERNMENT
PRIORITIZE AS MEDICARE.
AB TWENTY TWO OR THREE IS
SUPPORTED BY THE CALIFORNIA
LABOR FEDERATION AND HEALTHAXIS
CALIFORNIA. WE'VE HAD NO
OPPOSITION UP TO THIS POINT ON A
PERSONAL NOTE MEMBERS.
IN MY HOME COUNTY OF MERCED OVER
HALF THE POPULATIONS ON MEDICARE.
AND IT IS.
HYPOCRITICAL.
FOR THIS INSTITUTION.
AND OUR GOVERNMENT BOAT HERE IN
THE STATE AT THE FEDERAL LEVEL
TO CLAIM.
THAT WERE.
GETTING COVERAGE TO FOLKS
WITH THE AFFORDABLE CARE ACT
WHEN PEOPLE IN COMMITTEES LIKE
MINE CAN GET IN TO SEE A DOCTOR.
WE'RE PATTON OURSELVES ON THE
BACK IS IF WE'VE DONE SOMETHING
TO ACTUALLY BRING CARE TO PEOPLE
IN THE REALITIES THEY CAN'T GET
IN TO SEE HIM.
IT'S TIME TO PUT OUR MONEY WHERE
OUR MOUTH IS.
AND SUPPORT A BILL THAT WILL
ACTUALLY ALLOW FOLKS IN RURAL
CALIFORNIA AND ALL CALIFORNIANS
TO ACCESS THESE MEDI CAL.
SERVICES SO MARROW WITH THAT
WHICH SHALL RESPECT LAST YEAR I
DON'T.
IT VERY MUCH MISTER GRAY.
OTHERS IN SUPPORT.
GOOD AFTERNOON MR CHEN MEMBERS
NEAR ABOUT THAT'S WHAT
HEALTHAXIS CALIFORNIANS SUPPORT.
Q..
I'M SORRY TO.
SORRY DIRTY HEX REPRESENTING THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS AND SUPPORT IT NO HE
WANTED TO GET IT.
TWO MINUTES FOR JUSTICE.
I I MEAN I I DON'T HAVE A LOT TO
ADD TO WHAT OF THE ASSEMBLY
MEMBER ALREADY SPOKE OF I THINK
WE ALL KNOW THAT.
HIGHER MEDICAL RATES
MAKE BETTER OUTCOMES I WOULD
JUST ADD. THAT NATIONAL SAID
AFTER THE ACA IMPLEMENTED THE
THE FEE BOMB THEY DID DO A
NATIONAL STUDY ON SEVERAL STATES
AND IT DID SHOW THAT AND
IMPROVED WAIT TIMES. AND ACCESS
TO CARE DID GET BETTER.
SO WITH THAT WE SUPPORT THANK
YOU.
THE CHAIR MEMBERS SERAPH LOCKS
ON THE CALIFORNIA LABOR
FEDERATION WE ARE ALSO IN
SUPPORT OF THAT PRIMARY CARE BY
UP TO MEDICARE RIGHT. THANK YOU.
GOOD AFTERNOON MISTER CHAIRMAN
MEMBERS MICHELLE BACO AT THE
CALIFORNIA MEDICAL ASSOCIATION.
AYE WE ARE ACTUALLY WE HAVE A
SUPPORTIVE COMMENDED POSITION ON
THE BILL I'M WE STRONGLY SUPPORT
THE INTENT OF THE BILL OBVIOUSLY
BUT.
WE WOULD JUST LIKE TO SEE AN
AMENDMENT THAT WOULD.
ALLOW ALL PHYSICIANS THAT
PROVIDE PRIMARY CARE SERVICES TO
BE ELIGIBLE FOR THE
REIMBURSEMENT INCREASED. AYE WE
ARE.
LOOKING FORWARD TO WORKING
CONTINUE TO WORK WITH THE AUTHOR
ON THIS ISSUE AND THANK YOU AND
I LIKE IT'S IT'S PUT COMMENDED
THINKS.
JUST NAME ORGANIZATION PLEASE UP
WEST SANDS UNITED WAYS OF
CALIFORNIA IN SUPPORT THANK YOU.
MICHELLE CAPITA WITH A CA YOU
CALIFORNIA OUTSIDE SUPPORT.
PATRICIA WENT SO PLAIN OLD
CITIZEN IN SUPPORT. THANK YOU.
A DARK CIPOLLA PLAIN OLD
LOBBYIST FOR THE UNION OF
AMERICAN PHYSICIANS AND DENTISTS.
THOUGH WE HAVE A SUPPORT AMENDED
LIKE OUR COLLEGES CMA WE THINK
REIMBURSEMENT RATES
SHOULD BE ACROSS THE BOARD FOR
PRIMARY CARE SPECIALIST WITH
RESPECT TO MEDICAL MEDICARE.
THANK YOU.
YOU VERY MUCH.
IS THERE ANYONE IN OPPOSITION.
SEEING NO ONE TO BRING BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS.
ITS ABSURDITY.
IT'S BEEN THE MOVE BILL HAS BEEN
MOVED TO. MOVE FIVE MISTER MAYES
SECONDED BY MISTER BIGELOW ICE
ONE SAY THANK YOU FOR BRINGING
THIS BILL FORWARD MISTER GRAY.
LOVE TO BE ADDED AS A CO AUTHOR
OF THAT AT SOME POINT IF YOU.
ALLOW ME THAT.
.
AND IF WE HAVE TO TAKE YOU HAVE
ANY OTHER MEMBERS WE HAVE THE
SAME ISSUES WE HAVE THE SAME
ISSUES AND OUR COMMUNITIES.
COUNTIES WITH NEAR FOR FOR THE
NEAR FIFTY PERCENT OF ON MEDI
CAL HAVING DIFFICULT TIMES
GETTING IN TO SEE DOCTORS.
AND IT IS DIRECTLY ATTRIBUTABLE
TO THE RATES SO SPECIFIED IN THE
FEE FOR SERVICE FOR THE FOR
SERVICE PROGRAMS I THINK YOU FOR
YOUR COMMITMENT. TO RURAL
CALIFORNIA AND I BRING THIS
ISSUE FORWARD THANKS SO MUCH.
BUT THAT WE DO HAVE A MOTION.
AND BY MISTER MAYES A SECOND BY
MISTER BIGELOW IT IS TO PASS
APPROPRIATIONS MADAM SECRETARY
PLEASE CALL THE ROLL. WOULD I
WOULD I MAYES MAYES AYE ACTOR
CURRY. BAKER CURRY AYE BIGELOW.
BIGELOW AYE BONTA.
BURKE. I CARILLO.
FLORA. FLORA I LIVE ON.
LIMON AYE MCCARTY.
ARTIE I KNOW THIS AREA.
RODRIGUEZ SANTIAGO BERMAN
WALDRON.
WALDRON AYE.
NINE ZERO YOUR BILL IS OUT.
THANK YOU MISTER CHAIR THANK YOU
MEMBERS LEAVE IT OPEN FOR OTHERS
TO ADD ON THIS POINT EMINEM.
ACTUALLY MISS FRIEDMAN I
BELIEVE IS NEXT AND THEN WHILE
SHE'S WALKING UP.
WE DO HAVE CONSECUTIVE ANYBODY.
WILLING TO MOVE THE CONSECUTIVE
QUITE SOME OF.
SO THANK YOU VERY MUCH IN MOTION
BY MISS.
AT YOUR CURRY A SECOND BY MISS
BURKE THANK YOU FOR WAITING AT
ME.
THE CONSENT CALENDAR INCLUDES
ITEMS NUMBER FIVE AB TWENTY ONE
SEVENTY FOUR BY MISS WALDRON.
ITEMNUMBER NINE AB TWENTY THREE
NINETY THREE A HEALTH COMMITTEE
BILL ITEM NUMBER TEN.
AB TWENTY FOUR NINETY BY MR
CHIU.
MINUTES SECRETARY PLEASE CALL
THE ROLL WOULD I WOULD I MAYES.
EGGER CURRY ACTOR CURRY AYE
BIGELOW. BIGELOW AYE BONTA.
BURKE. BURKE I CARILLO FLORA.
FLORA EILEMA.
MCCARTY.
PARTY AYE NAZARIAN. RODRIGUEZ
SANTIAGO BERMAN WALDRON.
WALDRON AYE.
SO IT SEVEN WITH THAT WILL BE
THOUGH THAT WOULD BE ON COFFEE.
SO MISS MISS FRIEDMAN YOU HAVE
BEFORE US AB TWENTY SEVENTEEN
THANK YOU MISTER CHAIR AND
MEMBERS EVEN THIS FAMILIES
TRANSITION OUT OF CHO WORKS AS
THEIR INCOME GROWS FROM
EMPLOYMENT. ACCESSING RETAINING
MEANINGFUL HEALTHCARE COVERAGE
IS A CONSIDERABLE CHALLENGE.
THE CHEAPEST COVER CALIFORNIA
PLAN HAS AN INDIVIDUAL
DEDUCTIBLE OF SIXTY THREE
HUNDRED DOLLARS IN A FAMILY
DEDUCTIBLE OF TWELVE THOUSAND
SIX HUNDRED DOLLARS.
THE MAXIMUM CASH ASSISTANCE FOR
A FAMILY UNDER CAO WORKS JUST
SEVEN HUNDRED AND FOURTEEN
DOLLARS A MONTH.
AND A PROGRAM AND THE PROGRAM
WRIST ARM AND PROGRAM
RESTRICTIONS MEAN THAT A FAMILY
CANNOT HAVE MORE THAN TWENTY TWO
HUNDRED FIFTY DOLLARS IN THE
BANK ACCOUNT. EVEN WITH THE TAX
SUBSIDIES AND COST SHARING
REDUCTIONS AVAILABLE TO HELP YOU
COVER CALIFORNIA THE MATH JUST
DOESN'T WORK.
AB TWENTY SEVEN EIGHTEEN
ALLIANCE CALIFORNIA POLICY WITH
WHAT'S ALLOWABLE UNDER FEDERAL
LAW AND SET OF EXISTING SET A
EXISTING SIX MONTH WINDOW PER
TRANSITIONAL MEDICAL COVERAGE AN
OPTION FOR AN ADDITIONAL SIX
MONTH EXTENSION OF THE FAMILY
MAKES INCOME REQUIREMENTS.
FAMILIES LEAVING CAO WORKS WOULD
HAVE TWELVE MONTHS OF
TRADITIONAL MEDICAL COVERAGE.
AS THIS COMMITTEE KNOWS ALL TOO
WELL KEEPING CALIFORNIANS
HEALTHY DEPENDS UPON ACCESS TO
AFFORDABLE QUALITY HEALTHCARE.
FOR FAMILIES STILL STRUGGLING TO
MAKE ENDS MEET AFTER LEAVING HOW
WORKS MEDI CAL PROVIDES A SAFETY
NET OF HEALTHCARE COVERAGE I
RESPECTFULLY ASK FOR AND I WROTE.
MOVE THE BILL.
I'VE A WITNESS HERE TODAY IN
SUPPORT JAN FLOREY PUT THE
WESTERN CENTER OF LAW PARTY.
GOOD AFTERNOON GENTLER WITH
WESTERN CENTER ON LAW AND
POVERTY WHERE STATEWIDE LEGAL
SERVICES SUPPORT CENTER
REPRESENTING LOW INCOME
CALIFORNIANS AND WE FOCUS BOTH
ON THE MEDI CAL AND THE COW
WORKS PROGRAMS. WE'RE PLEASED TO
SUPPORT AB TWENTY SEVEN EIGHTEEN
WHICH WOULD ALLOW FAMILIES
EXITING CAO WORKS TO BE ELIGIBLE
FOR A TWELVE MONTH TRANSITIONAL
MEDI CAL. PERIOD RATHER THAN THE
CURRENT SET UP WHICH IS THE SIX
MONTH PLUS IN INCOME CHECK AND
THEN ANOTHER SIX MONTH PERIOD.
ALLOWING FAMILIES EXITING CAO
WORKS TO KEEP MEDI CAL FOR
TWELVE MONTHS REGARDLESS OF
INCOME WOULD ENABLE MORE
FAMILIES TO MOVE OUT OF POVERTY
BY PRETTY PROVIDING AN
ADDITIONAL BUFFER PERIOD. WHEN
THEY DON'T HAVE TO WORRY ABOUT
PAYING FOR HEALTH CARE PREMIUMS
ARE OUT OF POCKET COSTS.
FAMILIES TO BECOME ELIGIBLE FOR
TAX SUBSIDIES UNCOVER CALIFORNIA
STILL PAY FACE HIGH OUT OF
POCKET COST SUCH AS COPAYS AND
DEDUCTIBLES.
AS MENTIONED THE CHEAPEST COVER
CALIFORNIA PLAN HAS A HIGH
DEDUCTIBLE OF SIXTY THREE
HUNDRED DOLLARS WHEN YOU COMPARE
THIS TO THE ALLOWABLE ASSETS IN
THE CAO WORKS PROGRAM. JUST BY
BEING ON IT THE COW WORKS
PROGRAM FAMILIES ARE NOT ALLOWED
TO HAVE MORE THAN TWENTY TWO
HUNDRED FIFTY DOLLARS IN SAVINGS
SO NO FAMILY EXITING CAO WORKS
IS GOING TO IMMEDIATELY HAVE
SIXTY THREE HUNDRED DOLLARS IN
SAVINGS ON HAND.
ADDITIONALLY WHEN THAT FAMILIES
WHO HAVE BEEN ON CAL WORKS DO
YOU FIND HIGHER PAYING WORK THAT
WOULD MAKE HIM ELIGIBLE FOR MEDI
CAL THEY STILL HAVE EITHER
CONSIDERABLE DEBT TO RESOLVE. OR
CONSIDERABLE UNMET NEEDS.
TO PUT INTO CONTEXT IF A FAMILY
OF THREE CAN ONLY HAVE A CASH
GRANT OF SEVEN HUNDRED FOURTEEN
DOLLARS THAT'S NOT ENOUGH TO PAY
FOR RENT OR OTHER NECESSITIES.
FAMILIES GET BY BY BORROWING
FROM FRIENDS FAMILY MEMBERS OR
PAYDAY LENDERS OR THEY SIMPLY GO
WITHOUT REPLACING BROKEN
APPLIANCES ARE BEING ABLE TO
APPLY BY THEIR CHILDREN
APPROPRIATE. SHOES CLOTHING AND
SCHOOL SUPPLIES OR HAVE RENT AND
OTHER BILLS THAT ARE OVERDUE.
GIVEN THIS DISCREPANCY BETWEEN
THE ASSISTANCE THAT'S AVAILABLE
ON CAL WORKS AND WHAT FAMILIES
ACTUALLY NEED IT CAN TAKE AT
LEAST A YEAR TO RECOVER ONCE
THEY'RE EARNING ENOUGH TO BE
INELIGIBLE FOR COWARDS AND
MEDICARE.
FINALLY. REMOVING THE SIX MONTH
ELIGIBILITY CHECK ALSO ENSURES CRACKS JUST BECAUSE THEY FAILED
TO TURN IN A PIECE OF PAPER.
AB TWENTY SEVEN EIGHTEEN IS A
NECESSARY STEP TO ALLOW FAMILIES
MOVING OFF CAL WORKS TO
STABILIZE OUR INCOME AND STILL
BE ABLE TO ACCESS NEEDED HEALTH
SERVICES.
FOR THE SPIRIT REASONS WE URGE
YOUR AYE VOTE AND WE THINK
ASSEMBLYMAN MEMBER FRIEDMAN FOR
HER LEADERSHIP ON THIS ISSUE.
YOU VERY MUCH
THE OTHERS IN SUPPORT.
MARY VALDEZ WITH HEALTHAXIS
CALIFORNIANS SUPPORT.
YOU VERY MUCH ANYONE ELSE.
SEE NO ONE IS HOME SORRY NEVER
MIND I'M.
OR.
YES SIR.
THEY'VE DONE THIS A LONG TIME
AGO. RAIN HICKS CALIFORNIA
DISABILITY RIGHTS CALIFORNIA
LINES TO RETIRED AMERICANS ITS
STRONG SUPPORT.
ANYONE IN OPPOSITION.
.
QUESTION.
ME BEING A BLEEDING HEART THAT
CONSERVATIVE.
.
BUT DEMOS LOOKING FOR
OPPORTUNITIES
IT'S A TO TRY TO.
TO INCENTIVIZE
WELL FOLKS FROM GETTING OFF OF A
COW WORKS OR OF THEIR INCOME
WORKS TO BE
GET EDUCATION.
A TO PROVIDE ITS I DON'T WANT TO
DIS INCENTIVIZE THEM.
A TO GET OFF OF OF CAL WORKS
AND SO CAN YOU TALK A LITTLE BIT
MORE ABOUT ABOUT THAT BECAUSE
ONE OF THOSE I MEAN LOOKS LIKE
THE COST COULD BE.
AND I KNOW THE SUPPOSED HE
COMMITTEE.
BUT IT LOOKS LIKE THE COST
COULD BE A IN THE MID MILLIONS
OF DOLLARS WE DON'T KNOW WHAT
THAT IS.
AND SO YOU WE WERE TRYING TO
FIGURE OUT WHAT THE BENEFITS ARE
YOU TALK A LITTLE BIT ABOUT THE
DYNAMIC BETWEEN BETWEEN THAT
SURE.
THE COST ACTUALLY WOULDN'T BE
THAT HIGH BECAUSE THE MAJORITY
OF FAMILIES COMING OFF CAL WORKS
ACTUALLY MOVING TO ANOTHER MEDI
CAL PROGRAM UNDER THE MATCH AYE
RUBRIC. SO THERE AT ELIGIBLE
OTHERWISE WHAT THIS DOES IS
CREATES A BUFFER FOR PEOPLE WHO
HAVE STILL GONE ABOVE THAT A
LITTLE MORE SO IT DOES CREATE AN
INCENTIVE TO NOT ONLY FIND A JOB
TO FIND A JOB THAT PAYS WELL.
AND STILL HAVE A YEAR BUFFER
PERIOD IN WHICH YOU CAN
STABILIZE OUR FINANCES AND MOVE
ON WITH YOUR LIFE.
WHEN WE LOOKED AT THE EIGHT
CODES ON ANY GIVEN MONTH THERE'S
ROUGHLY TWENTY SEVEN THOUSAND
PEOPLE IN THE FIRST SIX MONTHS
OF TRANSITIONAL MEDI CAL SO IT'S
NOT HUGE WHEN YOU CONSIDER THE
THIRTEEN AND A HALF MILLION
PEOPLE WE HAVE ON MEDI CAL.
THE PEOPLE THAT MAKE IT TO THAT
SECOND SIX MONTHS THERE'S ONLY
AROUND THREE OR FOUR THOUSAND
PEOPLE A MONTH.
DO WE HAVE A NUMBER.
WE ASSIGN A NUMBER TO THAT THE
WHAT THE COSTS WILL BE.
NO. SOMEBODY CAN'T BUT THAT
WOULD NOT BE ME. MIGHT JUST OUT
THAT THESE ARE PEOPLE THAT ARE
ALREADY ELIGIBLE FOR TWELVE
MONTHS WHAT WE'RE DOING IS
TELLING THEM THAT THEY DON'T
HAVE TO IN SIX MONTHS RE APPLY
AND REQUALIFICATION. SO ASSUMING
THAT THEIR INCOME IS YOU KNOW IS
STABLE THEY MAY OR MAY NOT
QUALIFY ANYWAY FOR THE YEAR.
SO WE'RE TRYING TO MAKE SURE
THAT NOBODY ALSO DOES THAT
CALCULUS AND SAYS WHY DON'T WANT
TO MAKE A LITTLE BIT MORE
BECAUSE I LOSE THIS BENEFIT.
OTHER QUESTIONS.
SEEING NONE.
.
IT'S GONNA TAKE WHICH LIKE THE
CLOSENESS WAS FRIEDMAN I'M AND
DECIDE ASPIRIN I BOWED
RESPECTFULLY GREAT THANK YOU
VERY MUCH FOR BRINGING THIS BILL
FORWARD IT DOESN'T AND CHOI DO
PASS RECOMMENDATION. WE HAVE A
MOTION BY MISTER AGUILAR CURRY A
SECOND BY THE MISS BURKE.
MADAM SECRETARY PLEASE CALL.
WOOD YES WOULD AYE MAYES.
THERE'S NOT VOTING HACKER CURRY.
I CARE CURRY AYE BIGELOW.
BIGELOW NO.
BONTA.
BURKE.
BURKE I CARILLO.
FLORA.
LARA KNOW THE MOST.
MCCARTY.
MCCARTY AYE NAZARIAN AYE
NAZARIAN AYE RODRIGUEZ.
SANTIAGO. BERMAN WALDRON.
S. AS A FIVE TO TWO WE NEED
THREE MORE VOTES WE HAVE SEVERAL
MEMBERS MISSING UMNO WILL BRING
IT BACK TO MAKE THINGS SO MUCH
WAS FRIEDMAN APPRECIATED.
SEEN WE DO NOT HAVE OTHER
AUTHORS PRESIDENT.
MISS AGUILAR CURRY WHICH YOU
LIKE TO PRESENT.
Q..
TO SUBMIT SOME SOME.
FIVE I SEVEN SIX.
THIS ME.
AB TWENTY FIVE SEVENTY SIX
THANK YOU.
YOU'RE WELCOME.
GOOD AFTERNOON MISTER CHAIRMAN
AMBER'S.
AS YOU KNOW WELL THE TWO
THOUSAND SEVENTEEN WHILE FAR
SEASON WAS ONE OF THE WORST IN
CALIFORNIA'S HISTORY.
NEARLY TWO DOZEN COMMUNITY
HEALTH CENTERS WERE IMPACTED BY
THE FIRES PUTTING THOUSANDS OF
PATIENTS CARE IN JEOPARDY.
AB TWENTY FIVE SEVENTY SIX
TAKES THE RECENT EXPERIENCES OF
CLINICS AND HEALTH PROVIDERS
INTO ACCOUNT.
THE PROPOSES CHANGES THAT WILL
PROVIDE IMPROVE CONTINUITY OF
CARE IN THE FACE OF NATURAL
DISASTERS.
THIS BILL WILL CLARIFY THAT
DURING A STATE OF EMERGENCY
PROVIDERS CAN HAVE TELEPHONE
APPOINTMENTS.
WITH PATIENTS PROVIDE HEALTH
CARE SERVICES IN SHELTERS AND
MAKE HOME VISITS WHERE NEEDED.
THE ABILITY TO PROVIDE.
AND BE REIMBURSED FOR THESE
ACTIVITIES.
IT'S CRITICAL TO KEEP PATIENTS
HEALTHY AND AVOID UNNECESSARY
STRAIN ON EMERGENCY RESPONDERS.
FURTHER THIS BILL ALSO SETS OUT
IN XCELERATED PERMITTING PROCESS
FOR TEMPORARY PHARMACY LICENSES.
THIS IS THE SENSUAL WHEN I
HEALTH CENTER HAS BEEN DESTROYED
OR CANNOT OPERATE THE PHARMACY
TO DISPENSE MEDICATION TO
PATIENTS.
I HAVE I BELIEVE TWO WITNESSES
HERE THAT ARE COMING UP.
LORI LYNN HOGAN FROM SANTA ROSA
COMMUNITY HEALTH AND MEGAN
STUDENTS APPLYING FOR.
YOUR BETH WELL LIT THAT MULLIN
SKI ó CALIFORNIA HEALTH PLUS
IF ADVOCATES THANK YOU VERY MUCH
FOR COMING TODAY.
INCLUDES.
THE MICROPHONE IS NOW ON PERFECT
THANK YOU.
MY NAME IS LAURIE THAN HOGAN.
I'M THE COMMUNITY IN DONOR
RELATIONS DIRECTOR A CENTER IS A
COMMUNITY HEALTH A NONPROFIT
FEDERALLY QUALIFIED HEALTH
CENTER. PROVIDING OUTPATIENT
MEDICAL DENTAL AND MENTAL HEALTH
SERVICES. AT ELEVEN CAMPUSES FOR
OVER FIFTY THOUSAND PATIENTS IN
SANTA ROSA.
THANK YOU FOR THE OPPORTUNITY TO
SHARE THE HEALTH CENTER
PERSPECTIVE. ON A. B. TWENTY
FIVE SEVENTY SIX AND THE
IMPORTANT ROLE IT PLAYS IN
SUPPORTING ACCESS TO CARE FOR
DISASTER IMPACTED COMMUNITIES.
OUR WHOLE CENTER IS A PROUD
MEMBER OF BOTH THE CALIFORNIA
PRIMARY CARE ASSOCIATION. AND
THE REDWOOD COMMUNITY HEALTH
COALITION THE CO SPONSORS OF AB
TWENTY FIVE SEVENTY SIX.
TODAY I'LL START BY SHARING MY
HELL CENTERS EXPERIENCE TO THE
TWENTY SEVENTEEN FIRESTORM AND
THEN PROVIDE SOME STATEWIDE
PERSPECTIVE. ON THE NEED FOR
ADDITIONAL POLICY AND REGULATION
TO SUPPORT HEALTH CARE WHEN
DISASTER STRIKES.
ON OCTOBER NINTH TWENTY
SEVENTEEN. CENTER IS A COMMUNITY
HEALTH LARGEST HEALTH CENTER ARE
VISTA CAMPUS.
WAS DESTROYED DUE TO THE EXPENSE
EXTENSIVE FIRE SMOKE HEAT AND
WATER DAMAGE IN THE FIRE STORM
THAT HIT NORTHERN CALIFORNIA.
IN A FEW SHORT HOURS TWENTY FOUR
THOUSAND OF OUR PATIENTS LOST
THEIR MEDICAL HOME WHERE THEY
RECEIVED COMPREHENSIVE PRIMARY
CARE. AND MENTAL HEALTH SERVICES.
WITHOUT THE PROBABILITY TO
PROVIDE THE SERVICES OUR
ORGANIZATIONS SUSTAINABILITY
ENTER COMMUNITIES HEALTH AND
WELL BEING. WAS AND STILL IS AT
RISK.
WHILE THE FIRES ARE STILL RAGING
WHILE OUR PHONE LINES WERE DOWN
IN OUR IT SERVICE WERE DESTROYED.
WHILE WE WERE STILL TRIAGE IN
OUR DAMAGES AND MANAGING
TEMPORARY CLOSURES AT VARIOUS
OTHER CAMPUSES. YOU TO SMOKE IN
CHANGING FIRES OF PATTERNS.
WE NEVER STOPPED PROVIDING
HEALTH CARE PATIENTS NEEDED.
THROUGH SOCIAL MEDIA AND OUR
WEBSITE WE PROVIDED REGULAR
UPDATES TREPIDATIONS AND OUR
COMMUNITY MEMBERS.
ON WHERE THEY CAN GO TO GET CARE.
WE SENT OUR CLINICIANS RESIDENTS
AND HEALTH CARE TEAMS TO
SHELTERS.
WE RAPIDLY CREATED ALTERNATIVE
METHODS TO CONNECT WITH OUR
PATIENTS THAT HAD BEEN EVACUATED
ARE DISPLACED.
WERE SHELTERING IN PLACE OR
WHOSE PRIMARY CARE PLEASE EGGMAN
DESTROYED. ONE OF THE MOST
EFFECTIVE OF THESE WAS PROVIDING
TELEPHONE VISITS.
OFFERING MEDICAL CARE OVER THE
PHONE AS ROAD CLOSURES AIR
QUALITY AN INOPERABLE PUBLIC
TRANSPORTATION SYSTEMS MADE IN
PERSON VISITS BOTH IMPOSSIBLE.
AND UNSAFE.
OUR PRIORITIES REMAIN TO BE SEE
ALL OF OUR PATIENTS WHO NEED
CARE. PROVIDE MEANINGFUL WORK
FOR EMPLOYEES AND SUPPLY SPACE
FOR A NURSE PRACTITIONER AND
FAMILY PRACTICE RESIDENTS TO
CONTINUE THEIR TRAINING.
THIS IS WHY WE NEED AB TWENTY
FIVE SEVENTY SIX.
OVER A THREE MONTH PERIOD ONLY
TWENTY SEVENTEEN TO TWO DOZEN
HEALTH CENTER CORPORATION
SERVING A TEN COUNTY REGION. AND
ROUGHLY EIGHT HUNDRED THOUSAND
PATIENTS WERE IMPACTED BY FIRES
IN CALIFORNIA.
THIS COMPREHENSIVE BILL AIMS TO
PROVIDE THE STATE WITH
ADDITIONAL TOOLS TO ADDRESS THE
FOLLOWING CHALLENGES DURING A
DECLARED EMERGENCY.
TELEPHONE VISITS.
CAROUSEL TEARS.
CARE AT HOME.
THIS BILL WILL QUIRK CLARIFY
STATE LAW TO ENSURE THAT.
IN THESE THREE AREAS.
A PROVIDERS CAN CONDUCT AND BE
PAID FOR THESE KINDS OF VISITS
IN AN EMERGENCY SITUATION.
I LIKE TO THINK LONG AND FOR
THIS IMPORTANT HEARING SUPPORT A
BILL TODAY.
ON BEHALF OF CALIFORNIA
HOPELESS ADVOCATES AND THE
COMPLEX HEALTH CENTERS REPS AND
ACROSS THE STATE.
IMPORTANT MOMENT FOR US TO
REALLY LEARN AND.
MAKE SURE THAT THE EXPERIENCE
OF LAST YEAR AREN'T REPEATED
ACROSS OUR STATE WHEN FUTURE
DISASTERS STRIKE POPULAR ENTRY
TECHNICAL QUESTIONS YOU HAVE
TODAY.
THANK YOU VERY MUCH OF OTHER
SINCE.
OTHER SUPPORT.
WE WERE MOTION BY MISTER MAYES A
SECOND AYE MR BIGELOW. JODY HAD
SOME TO HAVE THE PLANNED
PARENTHOOD AFFILIATES OF
CALIFORNIANS PART. THANK YOU.
REDWOOD COMMUNITY HEALTH
COALITION ON BEHALF SICKENING
HEALTH CENTERS IN MARIN NAPA
SNOW MANILA COUNTIES WE ARE
HONORED CO SPONSOR AND WE
SUPPORT THIS LEGISLATION PICKET.
MICHELLE EVANS OF THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA WE REPRESENT LOCAL
HEALTH DEPARTMENTS THAT ARE STAY
IN SUPPORT.
YOU VERY MUCH.
SIR ANYONE IN OPPOSITION.
TEAM NO ONE WILL BRING BACK THE
COMMITTEE FOR QUESTIONS OR
COMMENTS ANYONE QUESTIONS OR
COMMENTS ON THE TRAIN.
SEE NOW LEGISLATIVE THINK ABOUT
THE THANK YOU FOR BRINGING THE
BILL FORWARD.
OBVIOUSLY THE THE IMPACTS OF OF
THIS DISASTER ON OUR COMMUNITIES
HAS BEEN.
DRAMATIC AND AND AND THE
UNFORESEEN CHALLENGES OF OF SOME
OF THE THINGS WERE FACING AND
DID FACE.
WE HOPE THAT BILLS LIKE THIS
WILL HELP US TO BE IN A BETTER
POSITION STATEWIDE SHOULD
ANOTHER DISASTER LIKE THIS
HAPPENS Y. THANK YOU VERY MUCH
FOR YOUR EFFORTS TO BRING THIS
WAR. WE DO HAVE YOU WOULD LIKE
TO CLOSE.
S. M. YOU KNOW YOU NEVER CAN
IMAGINE A CATASTROPHIC EVENT.
AND AT WHAT TO DO AND HOW TO BE
PREPARED FOR THIS DEVASTATION ON
A TEST THAT AND ON A TEST
ANTICIPATED CHALLENGES. THAT
COME WITH NATURAL DISASTERS.
OF THIS BILL WILL CHANGE.
THAT WILL IMPROVE THE ABILITY
FOR HEALTH CLINICS IN THE
PROVIDERS TO DELIVER TIMELY
ACCESS TO SERVICES AFTER A
DISASTER.
KERRS.
.
TO WATCH THESE BUILDINGS GO DOWN
AND HAVE THESE HEROES MAKE SURE
THAT OUR COMMUNITY STILL HAD
HEALTH COVERAGE.
WAS AMAZING AND SO I ASK YOU
FOR YOUR AYE BUT TODAY.
I CAN I COULDN'T AGREE MORE.
SO MUCH
MADAM SECRETARY UMP THAT DIDN'T
THE MOTION IS TO PASSED TO
BUSINESS AND PROFESSIONS BUT OF
SECRETARY PLEASE CALL THE ROLL
WHAT I WOULD AYE MAYES.
MAYES I AM YOUR VERY. LIFE AGAR
CURRY AYE BIGELOW. BIGELOW AYE
BONTA.
BURKE. BIRD I CARILLO. CARILLO
AYE FLORA.
FLORA AYE AMONG.
MCCARTY. MCCARTY AYE THIS AREA.
SYRIAN AYE RODRIGUEZ.
SANTIAGO. THURMOND WALDRON.
MODERNIZE.
TWO ZERO YOUR BILL IS OUT WHICH
LIKE TO PRESENT YOUR SECOND GO
YEAH I WOULD THINK VERY MATHIS
THREE MUCH.
I DID NUMBER FOURTEEN AB TWENTY
SIX SEVENTY FOUR
.
MISTER CHAIR MEMBERS I'D LIKE TO
START BY THANKING THE COMMITTEE
CONSULTANTS FOR WORKING WITH ME
AND MY STAFF ON THIS BILL.
I WILL BE TAKING THE AMENDED
AMENDMENTS INDICATED THE
ANALYSIS TO CLARIFY APPLICATION
OF THE POLICY AND ADDRESS
CONCERNS FROM THE OPPOSITION.
MEMBERS AS WE STRUGGLED WITH HOW
TO PROVIDE AFFORDABLE QUALITY
HEALTH CARE TO ALL CALIFORNIANS.
REMUS LOOKED FIRST TO ADDRESS
THE COST DRIVERS THAT DO NOT
CONTRIBUTE DIRECTLY TO HEALTH
SERVICES OR PATIENT CARE.
AB TWENTY SIX SEVENTY FORWARD
WILL REQUIRE THAT THE DEPARTMENT
OF MANAGED HEALTHCARE
INVESTIGATE PROVIDER COMPLAINTS.
THAT A HEALTH CARE SERVICE PLAN
HAS UNDERPAID OR FAIL TO PAY
THEM FOR THEIR SERVICES.
IF D. M. AGE SEE DETERMINES
AFTER INVESTIGATING CLAIMS THAT
HEALTH CARE SERVICE PLAN HAS
ENGAGED IN A PATTERN.
UNDERPAYING A PROVIDER THIS BILL
REQUIRED THAT THE DIRECTOR
ASSESSED ADMINISTRATIVE
PENALTIES EQUAL TO THE AMOUNT OF
THE UNDER PAYMENT PLUS INTEREST.
AND TO REIMBURSE THE PROVIDER
FOR THE LOSSES INCURRED PLUS
INTEREST.
THIS CHANGE WILL ESTABLISH A
PENALTY AMOUNT SIGNIFICANT
ENOUGH TO DISCOURAGE FUTURE
VIOLATIONS AND CHANGE UNFAIR
BUSINESS BEHAVIOR.
THESE ARE COSTS THAT IN SEVERAL
INEVITABLY END UP BEING PASSED
ON TO THE CONSUMERS.
REDUCING VIOLATIONS IN THE FIRST
PLACE WILL PROTECT THE
ALLOWING PROVIDERS AND THE STATE
TO INVEST THE ALREADY LIMITED
RESOURCES INPATIENT CARE. RATHER
THAN PAPERWORK.
AB TWENTY SIX SEVENTY FOUR IT
DOES NOT CHANGE EXISTING DUE
PROCESS REQUIREMENTS.
AND WILL NOT DO ANYTHING TO
CHANGE DIEM AGENCIES DISCRETION
TO DETERMINE WHEN A HEALTH CARE
SERVICE PLAN HAS ENGAGED IN A
PATTERN OF VIOLATING THE LAW.
RATHER THE CHANGES PROPOSED IN
THIS BILL WILL ONLY BE IMPOSED
ON A HEALTH PLAN THAT IS FOUND
TO BE HABITUALLY VIOLATING THE
LAW.
I ASK FOR AYE VOTE AND I HAVE
ONE THOMAS FOR THE CALIFORNIA
MEDICAL ASSOCIATION WITH ME HERE
TODAY. AS WELL AS DOCTOR WILLIAM
ABRAM. WILLIAM AVERY.
THANK YOU VERY MUCH.
THANK YOU ASSEMBLY WOMAN ARE
AGGRO OCCURRED.
MISTER CHAIR MEMBERS WANT
THOMAS REPRESENTING THE
CALIFORNIA MEDICAL ASSOCIATION I
TOO WOULD LIKE TO EXTEND MY
GRATITUDE TO THE STAFF AND THE
WORK THEY DID ON THE BILL.
THINK AMENDMENTS MAKE IT A
BETTER PRODUCT.
.
THE SOMEONE DID A GREAT JOB OF
DESCRIBING THE BILL SO I'M JUST
GOING TO TALK A LITTLE BIT ABOUT
WHAT WE LEARNED.
WHEN WE TALK TO OUR MEMBERS SO
YOU KNOW DESPITE THE CALIFORNIA
LEGISLATURE'S ENACTMENT OF AB
FOURTEEN FIFTY FIVE OR LIKE
EIGHTEEN YEARS AGO.
THESE WIDESPREAD.
OPINION ABUSE PRACTICES BY
HEALTH PLANS.
ARE CONTINUING THEIR CONTINUING
TO FLOUT THE LAW. IN MARCH A CMA
ALONG WITH THAT'S COUNTY MEDICAL
SOCIETIES AND SEVERAL SPECIALTY
SOCIETIES.
CONDUCT A SURVEY OF PHYSICIANS
TO OBTAIN SOME FEEDBACK ON
HEALTH PLANS ARE ROUTINELY
ENGAGING IN UNFAIR PATTERNS.
IN A PERIOD OF ABOUT NINE DAYS
WE GOT SEVEN HUNDRED FORTY ONE.
OF RESPONSES FROM PHYSICIAN
PRACTICES REPRESENT THOUSANDS OF
PHYSICIANS ACROSS THE STATE WE
HAD RESPONSES FROM FORTY
COUNTIES.
TWENTY SIX PERCENT OF THE
RESPONDENTS WERE FROM RURAL
COUNTIES.
SEVENTY FOUR PER PERCENT OF THE
RESPONDENTS WERE AND PRACTICES
OF FIVE OR LESS SO CLEARLY THIS
IS BEHAVIOR THAT IS IMPACTING.
SMALL PRACTICES PRACTICES THAT
ARE RULE AREAS THAT ARE CUTTING.
INTO.
THEIR ABILITY TO.
PROVIDE MEDICAL CARE AND KEEP
THEIR THEIR DOORS OPEN.
SO YOU KNOW.
AT TWO ADDRESSES WERE
SPONSORING.
AB TWENTY SIX SEVEN FOUR THANK
YOU ASSEMBLY WOMAN I THINK SHE
DID A GREAT JOB DESCRIBING WHAT
THE BILL WOULD DO WE'RE NOT
TRYING TO CHAINS OF THE EXISTING.
PROCESS WE'RE JUST TRYING TO SAY
THAT IN. WHEN THERE'S AN
INVESTIGATION AND DETERMINATION
THAT THERE'S BEEN A PATTERN OF
UNLAWFUL BEHAVIOR THAT THE
PENALTIES NEED TO BE SUCH THAT
IT MITIGATES THIS BEHAVIOR GOING
FORWARD. SO.
THANK YOU AND NOW WE ASK FOR
YOUR VOTE.
DOCTOR EVER THANK YOU AND I'M A.
DUCKBILL A ROMA CARDIOLOGISTS IN
PRIVATE PRACTICE ALIGNED WITH A
LARGE MEDICAL CENTER AND OTHER.
CARDIOLOGISTS AND.
AND DE STE SO THAT THERE'S A
PROCESS.
I IT'S TAKES PLACE CALLED PRE
AUTHORIZATION.
AND WE COMPLY WITH IT.
I IT'S TIME CONSUMING. IN A WAY
WHERE I CAN I HAVE STAFF MEMBERS
EXPLAIN THIS SITUATION AND THE
PATIENT'S DIAGNOSIS WHAT WE'VE
DONE SO FAR WHAT WE NEED TO DO.
THEY BUMP IT UP TO MAYES SO I
CAN TALK TO A CLERK TYPICALLY
AND THEN AFTER I TALKED TO THE
CLERK ASKED TALK TO MEDICAL
DIRECTOR.
AND.
THEN WE GET THAT APPROVED.
AND AND I HAVE THE PATIENT IN
HIS SEVENTIES WHO I DEVELOPED A
SEVERELY NEAR AN. AREA ORDERED
VALVE WHICH POTENTIALLY LIFE
THREATENING.
FIFTY PERCENT MORTALITY WITH
THE ONSET OF SYMPTOMS OF HEART
FAILURE WHICH HE HAS. GOT
APPROVED.
AND THEN WE DID THE PROCEDURE
AND THEN AFTERWARDS DE. DESPITE
HAVING EXPLAINED IT BEFORE AND
GOT THE PRE AUTHORIZATION THEY
SAID.
WE WANT TO SEE ALL THE RECORDS.
SO WE SENT THE RECORDS I SAID
I'M.
THROUGH A FAX I SENT HIM
THROUGH MY ELECTRONIC MEDICAL
RECORDS.
I IMAGE COMMITTEE THAT DOES IT.
AND DIDN'T GET A RESPONSE AND
WHAT HAPPENS IF TIME PASSES THEY
USE THE TIME AS A REASON. TO NOT
PAY.
SO THIS IS A GENTLEMAN WHO IN
THE INTERVENING TIME.
HAD A RUPTURED HIS AORTIC
ANEURYSM AND.
THE MANAGEMENT THAT IS.
IT DELAYED BY THE FACT THAT HE
STILL HAS SEVERE AORTIC STENOSIS
WHEN HE COULD HAVE HAD A TRANS
CATHARINE ORDERED VALVE
REPLACEMENT WHICH IS.
YOU KNOW REDUCE THE MAJORITY
ITALIAN CITIZEN EXAMPLE.
AND IT'S ONE THAT'S CLEAR MY
MIND BECAUSE IT'S RECENT BUT
IT'S A IT'S A HABITUAL PATTERN.
AND I THINK THE SURVEY SHOWS
THAT IT'S NOT JUST MY EXPERIENCE
BUT HUNDREDS OF PHYSICIANS AND
AND FRANKLY PHYSICIANS DON'T
TAKE THEIR TIME TO DO THIS KIND
REPORT AND WE'RE SEEING PATIENTS
OFF THEIR SEVEN HUNDRED THAT
ANSWER THAT THERE'S PROBABLY
SEVEN THOUSAND DIDN'T.
AND SO WHAT THE LAWS ARE THERE
IS YOU'RE SAYING AND. MAYBE THEY
JUST NEED SOME BETTER TEETH.
ANY QUESTIONS I'D BE HAPPY TO
ANSWER WITH MY EXPERIENCE. THANK
YOU VERY MUCH.
OTHERS IN SUPPORT.
KRISTIN HER LOCKED IN CALIFORNIA
RHEUMATOLOGY LINES IN SUPPORT.
KIM.
HOW SOUTHERN OF THE CALIFORNIA
HOSPITAL ASSOCIATIONS?
IF YOU.
TOM REILLY ON BEHALF OF CALDERON
IN SUPPORT.
YOU VERY MUCH.
HE WON OPPOSITION.
WELL I'M SORRY IT DO YOU
YOU'RE READING I.
THANK CALIFORNIA CALUMET FAMILY
PHYSICIANS IN SUPPORT THANK YOU.
THANK YOU MISTER CHAIR AND
MEMBERS NICK LOUISE OWES ON
BEHALF OF THE CALIFORNIA
ASSOCIATION OF HEALTH PLANS ON
IN RESPECTFUL OPPOSITION TO
ASSEMBLY BILL TWENTY SIX.
SEVENTY FOUR.
EVEN WITH THE AMENDMENTS ON
THAT ARE BEING ADOPTED TODAY.
WE BELIEVE THIS WILL IN IN THE
SUIT.
IS MY FIRST DAY OF TESTIMONY OF
THE YEAR SO.
OKAY.
YEAH EXACTLY EXECUTIVE I HAVE
ONE THANK YOU THOUGH.
AB TWENTY SIX EMMY FOR A WERE
OPPOSED WE BELIEVE IT WILL
INCREASE HEALTH PLAN
ADMINISTRATIVE COSTS.
BY ALLOWING PROVIDERSTO
INITIATE REGULATORY ACTION
AGAINST OUR MEMBER HEALTH PLANS
FOR EACH INDIVIDUAL PAYMENT
DISPUTE NO MATTER HOW BIG OR HOW
SMALL.
AND AYE WE WANT TO THINK THE
OFFICE STAFF FOR BRINGING US IN
EARLY AND GIVING US A HEADS UP
ABOUT THE BILL. UNFORTUNATELY WE
HAVE A DISAGREEMENT ABOUT THE
POLICY IN ABOUT WHAT THE BILL
ACTUALLY DOES.
WE BELIEVE THIS BILL PLACES A
HUGE BURDEN ON THE DEPARTMENT OF
MANAGED HEALTHCARE TO ADJUDICATE
WHAT WILL BE.
A LARGE NUMBER OF NEW CLAIMS
THAT LEAD TO HIGHER COSTS IS
MANDATORY FINES ARE LEVIED
AGAINST ARE MET MEMBER HEALTH
PLANS.
INEFFECTIVE THIS BILL IS AN
ACTIVE THE REGULATOR WILL BE
ADJUDICATING ISSUING FINES ON
EVERY DISAGREEMENT BETWEEN
CONTRACTED PARTIES.
WE DON'T BELIEVE THAT THE
AMENDMENTS THAT WERE TAKING.
I TAKE THIS TO A PATTERN OR
PRACTICE MODEL.
IT WE WE BELIEVE IT STILL
APPLIES ON ON AN INDIVIDUAL CASE
BY CASE BASIS.
SO IMPLEMENTING THIS BILL.
FROM OUR PERSPECTIVE IS NOT A
GOOD EXPENDITURE OF RESOURCES
AND WILL DISTRACT THE REGULATOR
FROM ITS FOCUS ON OTHER CONSUMER
ORIENTED ISSUES.
EXISTING LAW WAS HEAVILY
NEGOTIATED.
AND.
WAS NEGOTIATED TO AVOID
UNREALISTIC EXPECTATIONS OF THE
STATE IS GOING TO ACT AS YOU
ULTIMATE JUDGE AND EVERY SINGLE
PAYMENT DISPUTE. AND THE
ANALYSIS.
THAT WAS PREPARED BY STAFF.
GOES OVER THE EXISTING BODY OF
LAW AND IN GOOD DETAIL.
UNDER CURRENT LAW JUST AS A
SUMMARY THE DO YOU MAY SEE IS
ALREADY AUTHORIZED TO
INVESTIGATE COMPLAINTS AND
ASSESS MONETARY PENALTIES ON
HEALTH PLANS FOR UNFAIR PAYMENTS.
AFTERNOON AFTER A PATTERN OF
PRACTICE HAS BEEN ESTABLISHED.
YOU KNOW IF YOU CAN LOOK AT
INDIVIDUAL CLAIMS ON IF THE TEAM
AC DOES MAKE A DETERMINATION
THAT A PLAN DID NOT PAY A FAIR
AMOUNT OF THE PROVIDER. THE PLAN
WOULD BE RESPONSIBLE FOR THE
UNPAID AMOUNT IN THE CALCULATED
INTEREST ON THE UNPAID AMOUNT.
WHICH WOULD BE RETROACTIVE BACK
TO THE ORIGINAL DATE.
THAT THE PLAN RECEIVE THE CLAIM.
WHAT AB TWENTY SIX SEVENTY FOUR
IS ASKING FOR IS AN ADDITIONAL
ADMINISTRATIVE PENALTY ON TOP OF
THAT FOR INDIVIDUAL CLAIMS?
IF THE DEPARTMENT DOT CURRENTLY
IF THE DEPARTMENT RECEIVES A
NUMBER OF REPORTS RELATED TO
PROVIDER DISPUTES THAT YOU MAY
SEE CAN DECIDE TO DO A NON
ROUTINE SERVING ON THE PLANS.
AND YOU AN UNFAIR PAYMENT
PATTERN EMERGING TREND ANALYSIS.
THAT'S EXISTING LAW.
AND PROCESS.
AB TWENTY SIX SEVENTY FOUR
WOULD INSTEAD REMOVE THE DEBATE
SEIZE DISCRETION IN THESE AREAS
AND AND REQUIRE INVESTIGATION
SOME PENALTIES IN EVERY
INDIVIDUAL PAYMENT DISPUTE.
AND AGAIN IF THEY'RE ALREADY
CLEARLY ESTABLISHED RULES FOR
HOW THESE A COMPLAINT SHOULD BE
HANDLED. IN ADDITION TO EXISTING
LAW THE CONTRACT TERMS BETWEEN
PLANS I'M PROVIDERS UNUSUALLY
OUTLINED A PROCESS FOR RESOLVING
THIS DISPUTES.
YOU KNOW BUT BASED ON THE OF
SPONSORS SURVEY IT APPEARS AT A
NUMBER OF.
A LARGE NUMBER OF PROVIDERS ARE
UNAWARE OF THE CURRENT YOU MAY
SEE PROCESS AND WE WOULD SUGGEST
THAT.
PERHAPS.
IT BETTER EDUCATION CAMPAIGN TO
THEIR MEMBERSHIP ON THIS ISSUE
INSTEAD OF.
THE MOVIE FOR WITH THIS BILL.
SO WE ASK FOR NO VOTE.
BUT OTHERS IN OPPOSITION YEAH I
JUGGLING ARAB F. ANTHEM BLUE
CROSS.
ANYONE ELSE.
GREENBACKS COMMITTEE FOR
QUESTIONS OR COMMENTS.
TO ME.
I'M NEW.
TOM SO I GET TO TO PLAY DUMB
LITTLE BETTER BUT. FROM THE
OPPOSITION ARE ARE ARE YOU
SUGGESTING THAT THERE ISN'T A
PROBLEM THAT NEEDS TO BE FIXED.
WE HAVEN'T BEEN.
THE ONLY THING THAT WE'VE BEEN
PRESENTED IS WITH THE.
ASSOCIATION SURVEY BY THE
SPONSORS OF THIS BILL WHICH.
.
BUT YOU KNOW WE DON'T WE DON'T
FIND ANY OTHER SCIENTIFIC
EVIDENCE FOR STUDIES A REPORTS
THAT SUGGESTS THAT THERE'S AN
ISSUE HERE.
ARE WE HAVEN'T BEEN PRESENTED
WITH ONE THAT WE CAN REACT TO AT
LEAST.
AND IT I MEAN IF WE CAN GO BACK
TO THEIR SURVEY ACTUALLY.
.
JUST A COUPLE OF POINTS.
.
IN WHEN THEY DID SURVEY THEIR
MEMBERS I MEAN WE DO HAVE TO
KNOW THAT APPROXIMATELY SEVENTY
ONE PERCENT OF RESPONDENTS
STATED. THAT THEIR APPEALS ROOF
WERE EITHER RESOLVED ALWAYS MOST
OFTEN OR AT LEAST HALF THE TIME
WHEN THEY JUST WENT THROUGH THE
HEALTH PLAN'S INTERNAL DISPUTE
RESOLUTION PROCESS.
SO THAT PROCESS WHICH IS
EXISTING LAW. YOU KNOW ACHIEVES
RESULTS.
YOU KNOW THAT AGAIN I HAVE TO
SAY. THEIR SURVEY ALSO SHOWS A
PROVIDERS ALL OVERWHELMINGLY
FEEL TO USE THE DAMAGE HE'S
PROVIDER COMPLAINTS SYSTEM. AND
WHEN THEY WERE ASKED WHY THEY
DID USE IT A MAJORITY OF THEM SO
THEY DON'T EVEN KNOW ABOUT IT SO.
PERHAPS THAT'S WHERE THE PROBLEM
IS.
WELL IF I COULD GO AHEAD ANSWER.
.
YEAH WELL I THINK THE.
THE WAY WE INTERPRET THAT IS
THAT DO ITS HAS LOW USAGE
BECAUSE RIGHT NOW IT'S
PERMISSIVE THE DM DM EIGHT SEE
PROCESSES PERMISSIVE. ARE THEY
ARE REQUIRED TO INVESTIGATE.
PROVIDER COMPLAINTS.
THEY DO IT.
LIKE WHEN AN ASSOCIATION LIKE
OURS IN OUR MEMBERS.
UP ALERT US AND WE GATHER THE
INFORMATION AND TAKE IT TO
DAMAGE CMA AND THEY DO AN
INVESTIGATION. I THINK.
CLEARLY THAT.
.
WHAT THE LAST DOCTOR ABLE SAID
DOCTORS ARE BUSY SEEING PATIENTS
THE FACT THAT WE GOT SEVEN
HUNDRED FORTY ONE RESPONSES AND
SUCH AMOUNT OF TIME SHOWS
THERE'S A LOT OF INTENSITY
AROUND THIS? THAT THE PROBLEM
CONTINUES EVEN AFTER.
THE LAWS THAT WERE PASSED EIGHT
EIGHTEEN YEARS AGO AND SO WHAT
WE'RE SIMPLY TRYING TO DO IS TO.
PUT ENOUGH TEETH INTO THE LAW
SO THAT HEALTH PLANS AREN'T
ESSENTIALLY MAKING A BUSINESS
DECISION WHERE FOR MONTHS AND
MONTHS AND MONTHS THEY CONTINUE
WITH THIS UNLAWFUL BEHAVIOR. OF
UNDERPAYING DENYING CLAIMS.
TO PROVIDERS.
AND THEN GETTING WHAT IS
ESSENTIALLY AFTER THEY'VE MADE
MILLIONS OF DOLLARS.
RETAINING THIS MONEY OR KEEPING
THE MONEY OUT OF THE HANDS OF
THE PROVIDERS THAT THEY'RE OWED
AND GETTING WHAT'S RELATIVELY A
SMALL.
FINE FOR THAT SO IT SIMPLY
BECOMES A BUSINESS DECISION FOR
THEM TO TAKE THE FINE AND AND
MAKE THE MONEY SO WHAT ALL WE'RE
SAYING IS IS TO ROUTE TO HELP
MITIGATE THIS BEHAVIOR. BY.
GIVING ARE PROVIDING THAT
DEPARTMENTS HEALTH CARE WITH THE
AUTHORITY TO LEVY A MORE SEVERE
FINES.
THE OTHER THING I WANTED TO
ADDRESS RIGHT QUICKLY IS THE
IDEA OF THIS.
.
WHETHER THEY INVESTIGATE
INDIVIDUAL OR PATTERNS
CURRENTLY DIEM MAKE SEE SAYS
THAT ONCE YOU GO THROUGH THE
PLAN'S INTERNAL PROCESS. AND
NOTHING IS RESOLVED AND YOU CAN
USE A DUE TO MAKE SEE PROC
PROCESS AND YOU CAN'T SUBMIT
INDIVIDUAL CLAIMS FOR THEIR
CONSIDERATION. WHAT WE'RE TRYING
TO DO MOVING FORWARD IF THE IF
IF THE LANGUAGE ISN'T TIGHT
ENOUGH IS WE WANT THE ENHANCED
PENALTIES TO APPLY ONLY? TO
PATTERNS OF UNLAWFUL BEHAVIOR
BUT IT SEEMS TO ME THAT IF A
SMALL CLINIC IN A RULE COUNTY OR
IN AN URBAN COUNTY HAS. A TWO
HUNDRED THOUSAND DOLLAR DISPUTE
WITH THE PLAN THAT THEY SHOULD
BE ABLE TO SUBMIT THAT ONE CLAIM
TO BE MADE CNC IF THEY CAN GET
SOME RESOLUTION.
SO.
WHAT WE WOULD LIKE TO DO IS TO
SEE THE ENHANCED PENALTIES APPLY
TO THOSE HEALTH PLANS ARE
BEHAVING UNLAWFULLY? AND A
PATTERN OVER TIME.
ANYONE ELSE.
SO TERM SO I GUESS I'M GONNA A
COUPLE A COUPLE QUESTIONS YOUR
QUESTION.
YEAH PLEASE GO AHEAD WELL FIRST
OF ALL IS THERE SOMEONE FROM
TEAMMATES SEE WHO CAN. COME UP
AND TALK ABOUT THIS.
OKAY SO.
WHY CAN'T BE ADMINISTRATIVELY TO
THIS?
THEY DO HAVE CURRENTLY.
HAVE WITH FORTY TO DO
INVESTIGATIONS AND ASSESS
PENALTIES.
IT'S A BROAD AUTHORITY IT IS SO
THEY CAN PRETTY MUCH DO WHATEVER
THEY WANT THERE'S A.
THERE'S NO SPECIFICS ON WHAT
TYPES OF PENALTIES AND FINES AT
LEAST FROM OUR POINT OF VIEW
THAT THEY SHOULD APPLY. SO
CURRENTLY THEY DO DO THESE AS I
SAID IT'S PERMISSIVE.
SO.
THEY THAT WHICH MEANS THAT THEY
DON'T HAVE THE PEOPLE POWER THE
PEOPLE HOURS IN ORDER TO
INVESTIGATE AN ADEQUATE NUMBER
OF THESE.
PROVIDER COMPLAINTS IN THIS IS
NOT VISIT JUST POSITIONS THAT'S
PROVIDERS ACROSS THE BOARD.
THEY DON'T HAVE THE RESOURCES
TO DO AN ADEQUATE JOB OF
MITIGATING BEHAVIOR.
THAT IS HARMING OF.
PROVIDERS ACROSS THE STATE.
SO ARE THERE ANY EXAMPLES.
VERY FEW.
ARE THERE EXAMPLES OF CASES
WHERE PAYMENT OR SERVICES HAVE
BEEN MISSED THAT HAS BEEN
DETRIMENTAL TO.
THE PATIENT'S LIFE OR ME LIKE I
SAW THE OTHER STATISTICS BUT.
I JUST WANNA UNDERSTAND IF
THERE'S BEEN SOMETHING
SIGNIFICANT THAT'S HAPPENED
THAT'S.
FORCING YOU TO BRING THIS
FORWARD NOW.
I BROUGHT A FOUR BECAUSE ON THE
SECOND ONE TO BE ABOVE THE FOLD.
THERE WAS A SPECIFIC.
OF PROVIDER THAT WAS ABROAD TO
EVERYONE'S ATTENTION. AND IT
AFFECTS MY DISTRICT AS WELL AS
MANY RURAL DISTRICTS AS WELL.
AND IF I COULD.
YET WHEN WE DID THE SURVEY WE
ALSO ASKED FOR EXAMPLES OF OF
HOW. OF THIS BEHAVIOR BY THE
PLANS IMPACTED.
PATIENT CARE IN THEIR ABILITY
TO DO THE PRACTICE I THINK
DOCTOR ABLE PRESENTED ONE AND AN
EXAMPLE MAYBE ONE HERE BUT
DOCTOR EVIL CAN YOU. YEAH
THERE'S A PROCESS SAID THAT WE
COMPLY WITH THAT CALLED PRE
AUTHORIZATION HEALTH PLAN
CONSERVE TRACKS IT OUT TO THIRD
PARTY WHICH IS STAFFED BY.
RADIOLOGISTS WHO YOU KNOW ARE
PRESUMABLY SEEING PATIENTS
BECAUSE THEY'RE THERE TO TAKE
THE PHONE CALLS TYPICALLY.
I HAVE A STAFFER DO THE INITIAL
CALL AND THEY DO THE CALL WITH
PERSON AND I ALSO HAVE COMPUTER
SOFTWARE THAT MATCHES STUFF UP.
SO. THE DATA IS THERE IS TO THE
INDICATION FOR THE PROCEDURE.
I AND DE THE SO THAT THEY DON'T
THEY THE INDICATIONS.
IN THE YOU KNOW PREPARE IN
THESE CASES ARE PRETTY CLEAR
THESE ARE.
BORDERLINE THINGS EITHER THINGS
THAT THEIR SOFTWARE SAYS IT'S
OKAY TO DO.
AND THEN AFTER THE FACT.
SO I'VE USED THIS THIRD PARTY
HAVE GOTTEN APPROVED BY AND. YOU
KNOW IF I NEED TO I GO UP TO A
LICENSED PHYSICIAN A RADIOLOGIST
TYPICALLY.
AND WHO SAN WHO'S HEARD IT AND
SAYS IT'S NECESSARY.
AND THEN.
LATER AFTER THE. CLAIM IS BEEN
POSTED. AND AND.
INSTEAD OF PAYING THE CLAIM THAT
THEY AGREED THAT THEY'RE GONNA
DO BECAUSE THE PATIENT NEEDED IT
FOR THE REASON THAT THEY HAD A
LIFE THREATENING DIAGNOSIS. THEY
SAY SEND US RECORDS.
SO THEY DON'T SAY CENTERS ONE
RECORD DON'T SAY SEND THE TEST
THAT YOU DID THIS AND SEND ALL
THE RECORDS.
SO WE SEND ALL THE RECORDS.
AND THEN WE DON'T GET A RESPONSE
BACK ON THAT.
AND THEN THERE'S A TALK TO A
CLOCK TICKING
IF YOU DON'T GET AND TIME IT'S
DENIED BECAUSE OF TIME.
AND I YOU KNOW I'VE GOT OTHER
THINGS TO DO SO SOMETIMES I MISS
THAT DEADLINE AND YOU KNOW I'D I
DELEGATE AS MUCH OF THIS TO
STAFF AS I CAN.
BUT. IT REALLY SEEMS STRATEGIC
CAM AND DE THERE APPARENTLY THIS
ISN'T JUST MY EXPERIENCE OF
BECAUSE THERE'S NOW A SURVEY.
SHOWING HUNDREDS OF DOCTORS THAT
WERE.
BOTHERED ENOUGH BY THIS THAT
THEY TOOK THE SURVEY.
I'M ALSO ON THE AMERICAN
COLLEGE OF CARDIOLOGY'S.
WHICH IS WHY I'M UP HERE TODAY
AND YOU KNOW IT'S HARD TO GET
DOCKS TO DO THIS IT'S HARD TO
GET HIM TO TAKE TIME TO REPORT
THEIR EXPENSES BECAUSE.
WELL WE LIKE TO DO WAS TAKE CARE
PATIENTS AND YOU KNOW DO THE
THINGS THAT WE'RE TRAINED TO DO
IN THIS ISN'T IT IT REALLY IS.
.
SO I'M I'M
THE CURE IS THIS.
THIS IS THE QUESTIONS YOU
DOCTORS THIS IS THIS UP PATTERN
THAT YOU SEE OF YOU YOU CITED AN
EXAMPLE SO WAS THIS A PATTERN.
IS A PATTERN WITH SPECIFIC PLANS.
THROUGH GOAL IS OPEN TO YOU THE
THE THOUGH YOU KNOW THAT THE.
THE THE PLAN IS IN THE ROOM.
ON THIS ONE SO THAT THEY CAN
THEY CAN MAYBE ANSWER WHETHER
THEY.
.
PLANET THAT WAY I DO I DO THINK
THEY ARE THERE IS SOME TARGETING
THAT GOES ON WITH IT.
SO THIS IS NOT THIS IS NOT AN
ISOLATED INCIDENT YOU YOU'LL DO
PRE AUTHORIZATIONS AND THAT THIS
IS A RECENT EXAMPLE BUT IT'S NOT
A IT'S NOT A IT'S NOT A LOAN
EXAMPLE CORRECT.
THE PRE AUTHORIZATION PROCESS I
I UNDERSTAND AND I I PARTICIPATE
AND YOU KNOW WHAT.
IF IT WAS DONE IN GOOD FAITH YOU
KNOW I THINK IT'S REASONABLE
YEAH YOU DON'T WANT UNNECESSARY
PROCEDURES BEING DONE YOU WANT
YOU KNOW ONE MAKE SURE THAT THE
RIGHT THINGS BEING DONE FOR THE
RIGHT PATIENT.
BUT AFTER THAT AFTER EVERYBODY
AGREES YOU FELT TAKEN THE TIME
TO AGREED THAT THIS IS NECESSARY
TO THEN PULL THE RUG OUT
AFTERWARDS IN AND THEN GO ON
YOUR DEADLINES AND SAVE YOU
DON'T GET THIS. PIECE PAPERBACK
BY THIS TIME.
WE GOT WE GOT YOU.
AND THERE REALLY IS A GOTCHA
KIND OF A PROCESS.
AND I AM I THINK THINK YOU FOR
THANK YOU TO YOU HAPPENING.
THOUGHTS ON THAT MISTER I JUST
YOU KNOW THIS BILL HAS TO DO
WITH PAYMENT DISPUTES.
BETWEEN HOW MUCH A DOCTOR GOT
PAID THIS DOES NOT HAVE TO DO
WITH PRIOR AUTHORIZATION.
Y. THING NUMBER ONES YOU DID
GET PAID.
YEAH THAT'S A PRETTY GOOD IT'S
GOOD HE'S TALKING ABOUT PRIOR
AUTHORIZATION FOR CARE THAT'S A
COMPLETE THAT'S A. THAT SOUNDS
LIKE A DIFFERENT SUBJECT TO ME.
THAT'S NOT THAT'S NOT A DISPUTE
ABOUT THE AMOUNT THAT YOU GOT
PAID.
WHICH IS THE SUBJECT OF THIS
BILL AND TO YOUR POINT MISTER
CHAIR THE DNA THAT YOUMAY SEE
CAN ALREADY LEVY PENALTIES ON
PATTERNS OF PRACTICE.
THROUGH THE CHAIR UMPIRE WHILE.
THE BILL DOES DO YOU MAY SEE THE
ALREADY HAS REGULATIONS ON BY A.
LARGE NUMBER OF BEHAVIORS THAT
THE PLANS WILL DO AND WHAT
DOCTOR ABLE JUST DESCRIBED IS
ONE OF THOSE BEHAVIORS. THAT
NGUYEN DONE IN A PATTERN.
IT WOULD COULD BE AFTER OF
INVESTIGATION DETERMINED TO BE
UNLAWFUL BEHAVIOR OF A PATTERN
OF UNLAWFUL BEHAVIOR SO.
.
THAT'S IN THE REGULATIONS AND
WHAT DR ABEL'S TALK ABOUT IS
ABSOLUTELY ONE ISSUES THAT COULD
BE ADDRESSED BY THE SPELL.
SO QUESTION TO THE AUTHOR IS IS
IT YOUR CONTENTION THAT EVERY
CLAIM BE ADJUDICATED IN THIS WAY.
BECAUSE I WOULD HAVE TO AGREE
THAT IF THAT IS THE CASE THAT IS
AN UNFAIR BURDEN ON DMA SEE IN
THE RESOURCES THEY HAVE.
WE'RE HOPING THAT THROUGH BY
GETTING A SPELL THIS PASSES THAT
WILL WORK DMA.
H. C. ON THE MAKING SURE THAT
WE HAVE ENOUGH STAFF TO MAKE
SURE THESE THINGS GET THROUGH.
AND SO I WOULD WANT THEM TO GO
THROUGH ABSOLUTELY.
.
YES WHISPERED TO TEAR YEAH I AM
AND I THINK.
JUST TO.
PUT A LITTLE MORE.
VERBIAGE AROUND WHAT TO SOMEONE
SAID I THINK ONCE AGAIN IT'S
ALREADY PART OF THEIR. JIM MADE
SEEDS.
A REGULATIONS THAT INDIVIDUAL
DISPUTES CAN BE SUBMITTED TO
THEM FOR CONSIDERATION.
I THINK WHAT WE'RE TRYING TO DO
AN ACCOMPLICE IN THE BILL IS TO
APPLY THE ENHANCED PENALTIES.
TO THOSE PLANS THAT THAT THERE
WOULD THERE'S A PATTERN OF.
UNLAWFUL BEHAVIOR SO I THINK
MOVING FORWARD IF THE IF THE
CURRENT LANGUAGE DOESN'T DO THAT
AND WE'RE GONNA WE'RE HAPPY TO
SIT DOWN WITH. THE OPPONENT'S.
DE MATE SEE AND ANYONE ELSE TO
MAKE SURE THAT THE LANGUAGE IS
WRITTEN IN THE WAY TO ENSURE
THAT.
THE ENHANCED PENALTIES APPLY TO
PATTERNS OF BEHAVIOR.
SO THEN I GUESS MY QUESTION TO
MR LUISA'S SO DO YOU OBJECT TO
ENHANCED PENALTIES FOR PATTERNS
OF BEHAVIOR.
IF THAT'S THAT AS I AS AS
PRESENTED BY THIS. AT THIS POINT
IN TIME WAS PRESENTED WITH OTHER
EVIDENCE WE DON'T BELIEVE THAT
THERE IS A NEED FOR THIS BILL.
.
SO I JUST LEAVE IT THAT WITHOUT
CONFERRING WITH MY MEMBERS.
ALRIGHT.
THAT.
WHICH I CLOSE.
I'M SORRY IF YOU ARE IN THE
QUESTION.
I'M JUST ARE A QUESTION THERE
WAS A PROPOSED AMENDMENT IT
HASN'T BEEN TAKEN I DON'T
BELIEVE AT THIS POINT SHE. DID
ACCEPTED MINIMALISM'S.
DIFFERENT AMENDMENT OKAY WAS AN
AMENDMENT THAT WAS I PRESENTED
TO YOU IN AND SUGGESTED.
SO THAT WOULD TAKE AND I WOMEN
EIGHT OUT IT WOULD JUST SAY.
ELIMINATE BUT NOT LIMITED TO IN
SUBSECTION BE.
TWO OF THE PROPOSED SECTION H.
AS SEE. THIRTEEN EIGHT SIX POINT
FIVE.
I KNOW IT'S A LONG AND IT AND
THAT'S IN THE WEEDS.
I BELIEVE. THAT KIND OF
ADDRESSES THEIR ISSUE. AND THE
CONCERNS THAT ARE BEING RAISED
HERE.
WOULD THAT BE SOMETHING YOU'D BE
WILLING TO ENTERTAIN.
AS THIS BILL MOVES FORWARD.
OKAY.
YES I I'M WILLING TO TAKE THAT.
THAT MAY NOT RESOLVE ALL YOUR
ISSUES BUT I THINK THAT GETS.
A STRONG PERCENTAGE OF YOUR
ISSUE RESOLVED I KNOW YOU
PARTICULAR SECTION BUT I BELIEVE
AS I UNDERSTAND IT.
THAT WOULD THAT WOULD TAKE THAT%
OLD OPEN ENDED COMPONENT THAT
EACH OF THE MEMBERS HERE.
DRESSED VERY IF IF IF I MAY I
MEAN WE WOULD HAVE TO REVIEW
THAT BUT I THINK STRUCTURALLY
THE BILL. JUST JUST THE WAY IT'S
CONSTRUCTED.
.
RELATES TO INDIVIDUAL DISPUTES
JUST BY JUST BY JUST BITES
CONSTRUCTION BUT WHAT WERE HAPPY
TO TAKE A LOOK AT THAT AS THE
BILL MOVES FORWARD BUT. BUT.
TO GIVE OPPOSED IF IF I HAD A
NOD OF AGREEMENT YOU BE WILLING
TO TAKE THAT I'D BE WILLING TO
SUPPORT THIS
TODAY.
THAT WAS A NOT WELL YEAH. THAT
WOULD BE A YES.
OKAY.
THEN I WILL COMMIT TO SEE.
SUPPORTING THIS BILL TODAY
WITHOUT AMENDMENT.
MISTER MISTER CHAIR IN LIGHT OF
OTHER AUTHOR WHEN TO WORK TO
CONTINUE WORK THE STAKEHOLDERS
SOME OF THE BILL.
SECOND.
OKAY WE HAVE A MOTION BUSH'S
SECOND WHICH I CLOSE RECESS YES
THINK YOU'RE A CLOSE I'D LIKE TO
REITERATE THAT THE PROVISIONS OF
AB TWENTY SIX SEVEN FOUR WOULD
ONLY IMPACT THE HEALTH PLAN THAT
HAS BEEN FOUND TO BE HAVING. TO
HAVE ENGAGED IN A PATTERN
UNDERPAYING PROVIDERS FOR THEIR
SERVICES.
AS YOU CAN SEE FROM THE PROPOSED
AMENDMENTS TODAY AND THE ONE
THAT MR ASSEMBLY MEMBER BIGELOW.
PROPOSED I AM COMMITTED TO
WORKING WITH THE OPPOSITION AND
I PLAN TO CONTINUE ENGAGING WITH
ALL STAKEHOLDERS INVOLVED TO
FINE TUNE THIS BILL. I ASK FOR
YOUR AYE VOTE.
WELL THANK YOU VERY MUCH AND
YOUR COMMITMENT TO.
TO THE AMENDMENT.
AS PROPOSED BY MISTER BIGELOW
AND AND WORKING WITH THE AT WORK
WITH ALL PARTIES IN THIS PART
CAN ARE BILL ITSELF WITH THAT WE
HAVE A MOTION BY MISTER BIGELOW
SECOND BY MISTER MEMBERS.
WHATEVER.
ALRIGHT FOR THE RED THE RECORD
STATE WITH THE MOTION WAS BY
MISTER MASON AND THE SECOND BY
MISTER BIGELOW THINKING RIGHT
THAT TYPE. OF.
AND.
WILL HAVE MEDICS SIX HERE
PLEASE CALL THE ROLL THE MOTION
IS TO PASS AS AMENDED TO
APPROPRIATIONS.
WHAT I WOULD AYE MAYES AYE MAYES
AYE ANGER CURRY FIVE AGAR CURRY
AYE BIGELOW? AYE BIGELOW AYE
BONTA. BONTA AYE BURKE.
CARILLO.
CARILLO AYE FLORA FLORA AYE
LIMOS.
MCCARTY.
THIS AREA. NAZARIAN AYE
RODRIGUEZ.
SANTIAGO. THURMOND WATER.
THAT IS A VOTE SO THAT IS OUT.
AND WE WILL LEAVE THE RELEVANT
FOR OTHERS TO ADD ONTO.
MISTER BERMAN.
MISTER BERMAN WILL BE PRESENTING
AB TWENTY NINE FORTY ONE.
THAT.
ON
.
THANK YOU.
CARAMEL.
SECOND.
I APPRECIATE YOUR TIME THIS
AFTERNOON.
AT I'LL TURN IT OVER TO MY.
WITNESSES.
FOR A QUICK EXPLANATION OF WHY
THEY SUPPORT THE BILL.
AND AND A QUICK EXPLANATION OF
THE BILL.
CHAN MEMBERS MAYOR FLORES ON
BEHALF OF HEALTH ACCESS
CALIFORNIA THE STATE WIDE HEALTH
CARE CONSUMER ADVOCACY COALITION
WE ARE AND SUPPORTED. US AB
TWENTY NINE FORTY ONE WHICH
WOULD ENSURE THAT CONSUMERS WHO
ARE DISPLACED BY A STATE OF
EMERGENCY CONTINUE TO RECEIVE.
COVERED HEALTHCARE SERVICES
WHICH WE THINK IS REALLY QUITE
AND WE PESTER I'VE.
THANK YOU.
TRACY RYAN BROKE COUNTY
REPRESENTATIVES OF CALIFORNIA.
ALSO IN SUPPORT WE ARE PRESENT
THIRTY FIVE RURAL COUNTIES. AND
I WE BELIEVE THIS WILL HELP OUR.
COMMUNITIES ACCESS CARE IN THOSE
TIMES OF DISASTERS
THANK YOU.
THANK YOU VERY MUCH OTHERS
OTHERS IN SUPPORT.
GEN FLOOR IN BEHALF OF WESTERN
CENTER ON LAW AND POVERTY IN
SUPPORT.
IS THERE ANYONE IN OPPOSITION
.
STEPHANIE Y. BECAUSE ON BEHALF
OF THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANY IF WE WOULD FIRST LIKE
TO THANK THE AUTHOR AND HIS
STAFF REACHING OUT TO US EARLY.
AND WE THINK THIS IS AN
IMPORTANT PIECE OUR OUR MEMBERS
SEE THEMSELVES AS A STAKEHOLDER
IN THIS PROCESS AS FAR AS WHEN
THEY'RE NATURAL DISASTERS THEY
WERE PART OF THE LARGER PLAN.
WE LOOK FORWARD TO WORKING WITH
THEM AT THIS BILL DOES MOVE FOR
TODAY I THINK WE ARE A LITTLE
CONCERNED. ABOUT THAT CODIFYING
EXISTING PRACTICE
I'M IN STATUTE THAT WHEN THESE
ARE VERY FLUID DYNAMIC
SITUATIONS SOMETIMES IT'S A
SIMPLE EMAIL FROM THE DEPARTMENT
ASKING THE PLANS TO LET THEM
KNOW WHAT THEY'RE DOING
INTERFACE WITH THEIR ENROLLEES
IN INSURANCE. SO WHAT WERE A
LITTLE CONCERNED ABOUT IS A
BUILDING A LITTLE BIT OVERLY
PRESCRIPTIVE ABOUT HOW IT SAYS
THAT TO HAPPEN I THINK OUR PLANS
WOULD PREFER AT PROCESS FOR
WHICH THE DEPARTMENT. NOTIFY
THAN THAT THEY THAT THERE IS AN
ISSUE IN THAT THEY WOULD LIKE
THEM TO INTERFACE WITH THAT
VERSUS HAVING THE PLANS DECIDE
WHEN AND WHERE THEY SHOULD BE
FILING SOMETHING THAT CERTAIN
DISASTERS. WE'VE SEEN NATURAL
DISASTERS I'M THAT ARE DECLARE
THAT DON'T NECESSARILY IMPACT
AND RELEASE YOUR INSURANCE AND
SO WE'RE JUST LOOKING TO BE. A
PART OF THE LARGER PROCESS AND
BUT OUR MEMBERS DO YOU HOPE TO
WORK FORWARD. WITH THE AUTHOR
AND THE SPONSOR'S INCOME DO
RESOLUTION.
IF YOU COULD AFTERNOON I'M
JENNIFER RALLY WITH CALIFORNIA
ASSOCIATION HEALTH PLANS AND WE
TO APPRECIATE THE OFFER ON THEIR
STAFF COMING. TO US EARLY TO
START THE CONVERSATION ON THIS
BILL I'M I'D LIKE TO YOU KNOW A
LINE MY COMMENTS WITH THAT MS
WATKINS AND JUST REALLY.
CONCERNED ABOUT HOW PRESCRIPTIVE
THE BILL IS ON AND THAT SOME OF
THE FLEXIBILITY THAT IS
NECESSARY INFLUENCE SITUATIONS
JUST ISN'T APPARENT IN THAT
STRUCTURE.
GIVE.
VERY MUCH IS THERE ANYONE ELSE
IN OPPOSITION.
SEE NO ONE BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS.
SEEING NONE MISTER BERMAN CHUCK
CLOSE.
YEAH I.
WE APPRECIATE ALL THE COMMENTS
FROM BOTH SIDES AND WHAT IF WE
CONTINUE TO WORK TOGETHER THAT.
I COME UP WITH A SOLUTION THAT'S.
AS THE LEAST BIT PRESCRIPTIVE
AS POSSIBLE BUT STILL PUTTING IN
THE.
YOU KNOW RIGHT YEAH CODIFYING
THAT THE REGULATIONS THAT WE
THINK ARE NECESSARY.
AND ARE YOU ACCEPTING THE
COMMITTEE SOMETIME AND I
SHOULD'VE. ESCAPED EVERYTHING
BLESSED OF SKIP THAT YES I'D
LIKE TO BEGIN BY THANKING THE
COMMITTEE FOR THEIR WORK ON THIS
BILL. WILL BE ACCEPTING THIS IS
JUST A TECHNICAL ASSISTANCE
AMENDMENTS FROM THE DEPARTMENT
OF MANAGED HEALTHCARE DESCRIBED
IN THE ANALYSIS.
WELL THEN MISTER PER YEAR
WELCOME.
WE HAVE A MOTION BY.
FLORA SECOND BY MISTER BIGELOW.
MADAM SECRETARY PLEASE.
THE EVIDENCE.
YOU ARE. OKAY I'VE TALKED TO US
LOOK IT WAS YOU MISTER FOR. IT
WHAT IT WAS CONSIDER MILITANT
ISLAMIC.
YEAH.
IF YOU WAS YOU SECOND OF A LOT
OF THOSE TODAY MISTER MASON WAS.
SO WE HAVE A MOTION BY MISTER
FLORA SECOND BY MISTER MAYES.
MEMSIC TRIP PLEASE CALL THE
ROLL THE MOTION IS TO PASS AS
AMENDED TO.
WHAT I WOULD AYE MAYES? NEEDS
AYE AYE HURRY AYE THANK YOU VERY
AYE BIGELOW.
BONTA. BONTA AYE BURKE.
CARILLO. CARILLO AYE FLORA.
FLORA EILEMA.
MON I MCCARTY.
THIS AREA I'VE MISSOURIAN AYE
RODRIGUEZ.
RODRIGUEZ I.
SO YOUR EGO.
THURMOND.
WALTER.
WELL THEN I.
THAT'S NINE ZERO YOUR BILL
WITHOUT MISTER BERMAN WILL LEAVE
THEIR OPEN FOR OTHERS TO ADD ON
THANK YOU VERY MUCH AT THIS
POINT MR O'DONNELL.
IT'S TRUE DONALD HAS TWO BILLS
FIRST BILL IS DEEPLY TWENTY
NINES
THE ONE.
GOOD AFTERNOON MISTER CHAIR AND
COMMITTEE MEMBERS I AM PLEASED
TO RESENT AB TWENTY NINE SIXTY
ONE WHICH REQUIRES LOCAL
EMERGENCY MEDICAL SERVICES
AGENCIES.
OTHERWISE KNOWN AS LANCE SAYS
TO TRANSMIT AMBULANCE PATIENT
OFF LOAD TIME DATA TO THE
EMERGENCY MEDICAL SERVICES
AUTHORITY.
WHEN EMS PERSONNEL BRING A
PATIENT TO AN EMERGENCY ROOM
THEY'RE REQUIRED BY LAW TO WAIT
WITH THEIR PATIENT UNTIL THAT
PATIENT CAN BE ADMITTED TO THE
HOSPITAL.
FIRE DEPARTMENT'S AMBULANCE
DRIVERS AM LUMPS US ACROSS THE
STATE. CONSISTENTLY REPORT
UNACCEPTABLE DELAYS SOMETIMES
FOR HOURS MANY TIMES ARE. WE
WAITING FOR HOURS.
IN THE OFF LOADING TRANSFER
PATIENTS.
AND LOOK TO THE LOCAL EMERGENCY
DEPARTMENTS.
THESE DELAYS ARE KNOWN AS WALL
TIME THEIR FIREFIGHTERS
PARAMEDICS EMTS LEANING AGAINST
THE WALL THEY'RE JUST STANDING
THERE WAITING FOR THEIR PATIENT
TO BE ACCEPTED TO THE HOSPITAL.
AND THERE'S A VARIETY OF REASONS
THAT THAT MAY OCCUR.
IN TWENTY FIFTEEN I AUTHORED AB
TWELVE TWENTY THREE TO TAKE THE
FIRST STEP IN ADDRESSING THIS
HIGHLY COMPLEX ISSUE. AND I WANT
TO STRESS IT IS A COMPLEX ISSUE.
THAT BILL DIRECTOR THE M. S.
AUTHORITY TO DEVELOP A STANDARD
METHOD. FOR MEASURING AND
REPORTING AMBULANCE PATIENT OFF
LOAD TIMES.
THIS THE BILL ALSO AUTHORIZED
THE DEBT DID NOT REQUIRE LAPSES
TO ADOPT POLICIES FOR REPORTING
WALL TIME TO THE AUTHORITY.
WHILE THE AUTHORITY TO FILL
THEIR RESPONSIBILITY UNDER AB
TWELVE TWENTY THREE REPORTED THE
REPORTING OF ALL TIME DATA BY
LEMP SAYS. HAS BEEN INTERMITTENT
AT BEST.
IN FACT MORE THAN HALF OF THE
THIRTY THREE LANCE'S ACROSS THE
STATE HAVE NOT REPORTED ANY DATA
AT ALL.
THE ABSENCE OF CONSISTENT
STATEWIDE INFORMATION CREATES US
CREATE SIGNIFICANT CHALLENGES
FOR STAKEHOLDERS WORKING TO
DEVELOP POLICIES THAT CAN REDUCE.
OR ELIMINATE OFFLOAD DELAY.
AB TWENTY SIX TWENTY NINE SIXTY
ONE SIMPLY SEEKS TO OBTAIN THIS
INFORMATION VERY REQUIRING
RATHER THAN PERMITTING LAMB SAYS
TERABYTE AMBULANCE PATIENT
OFFLOAD TIME DATA. TO THE
AUTHORITY ON A CONSISTENT BASIS
WITH ME HERE TO TESTIFY IN
SUPPORT ITS CHRISTY BONE WITH A
CALIFORNIA PROFESSIONAL
FIREFIGHTERS.
THE BILL.
BUT CHRISSY MISTER CHAIRMAN
MEMBERS KRISTIE BELL ON BEHALF
OF CALIFORNIA PROFESSIONAL
FIREFIGHTERS PLEASED TO BE
SPONSORS THIS MEASURE.
CONSIDERING THE MOTION THE
SECOND I WOULD JUST SAY THAT NOT
ONLY ARE FIREFIGHTERS ON THE
WALL THERE ALSO RENDERING CARE
THEY'RE LIKE AN EXTENSION OF THE
EMERGENCY DEPARTMENT UNTIL THEY
CAN TRANSFER PATIENT CARE TO THE
HOSPITAL.
OF THERE'S A TREMENDOUS AMOUNT
OF RESOURCES THAT ARE IMPACTED
BY THIS DELAY PRIVATE AND PUBLIC
SECTOR AND EVEN THE PRIVATE
SECTOR RESOURCE. IMPLICATION
FALLS BACK ON COUNTIES OF WHO
ARE CONTRACTING WITH THEM TO
PROVIDE THAT SERVICE SO.
I WILL CLOSE BY SAYING WE
APPRECIATE THE RESEARCH PROVIDED
BY THE HOSPITAL ASSOCIATION AND
THEIR INTEREST IN SOLVING THIS
PROBLEM WITH US. AND THAT IS OUR
INTEREST TO LET'S GET A COMPLETE
SET OF DATA AND THEN TALK ABOUT
WHETHER THESE PROBLEMS ARE A
RESTRICTED TO CERTAIN AREAS.
BASED ON THE DESIGN OF THE IN
THE SYSTEM IN THAT AREA OR
STATEWIDE. A LET'S SOLVE THE
PROBLEM IN A SMART WAY WE ARE TO
SUPPORT.
VERY MUCH OTHERS IN SUPPORT.
NO ONE.
SIR OPPOSITION.
GOOD AFTERNOON MISTER CHAIRMAN
MEMBERS COUNTY DELGADO WITH THE
CALIFORNIA HOSPITAL ASSOCIATION
AND WE APPRECIATE THE AUTHOR'S
INTEREST IN ADDRESSING THIS
ISSUE ARE HOSPITALS HAVE BEEN
WORKING FOR THE PAST FOUR YEARS.
COLLABORATIVELY TO TRY TO
RESOLVE THIS ISSUE AND TAKE A
LOOK AT SOME OF THE.
ISSUES THAT. DRIVE THIS A.
THEY PATIENT OFFLOAD TIME.
HOWEVER WE DO HAVE SOME CONCERNS
WITH THE FACT THAT THIS PROCESS
OF COLLECTION IS STILL IN ITS
INFANCY AND WE DON'T BELIEVE
THAT THE WAY THAT THE
INFORMATION. IS GOING TO BE.
IS COLLECTED THROUGH THE LAMB
SAYS AND AND PROVIDED TO THE
ABSENCE WILL BE IN A WAY THAT
THE DATA WILL BE USEFUL.
BECAUSE WE THINK THAT EACH ONE
OF THOSE.
M. SAYS MAYBE REPORTING IN
DIFFERENT FORMATS.
AS YOU CAN IMAGINE THESE ARE
HUMAN CONDITIONS.
AND EACH CASE IS VERY DIFFERENT
SO TAKING A LOOK AT WHAT THOSE
INDIVIDUAL DRIVERS ARE MAY BE
DIFFICULT TO.
TO GET TO THROUGH JUST STRICT
DATA THIS BILL WOULD REQUIRE
THAT ALL HOSPITALS REPORT
WHETHER OR NOT THEY HAVE EIGHT
PATIENT DELAY SO YOU MIGHT BE
COMPARING HOSPITALS THAT DO HAVE
A LARGE VOLUME TO A HOSPITAL
THAT DOES NOT.
SO FOR THOSE REASONS WE ARE IN
OPPOSITION.
SIR ANYONE ELSE IN OPPOSITION.
I DO HAVE A QUESTION ABOUT THAT
BUT ALSO AND OTHERS OTHERS
QUESTIONS
ANYONE ELSE QUESTIONS OR
COMMENTS FROM THE DANCE.
YEAH MISTER MISTER RODRIGUEZ.
YES FIRST WANT TO THANK THE
AUTHOR FOR BRING THIS BILL
FOREGROUNDS.
I CAN ATTEST MANY TIMES OF I'VE
WAITED.
A WALL ON THE WALL I'M UP TO
EIGHT HOURS AND THE SHIFT THAT
ARE TWENTY FOUR HOUR SHIFTS WE
WORK.
AND FOR NUMBER REASONS ARE YOU
SPECIFIC SANTA.
SUMMER O'DONNELL THAT.
MEMPHIS LEADER DIFFERENT ON WHY
THE WALL TIMES GREATER THAN
OTHERS.
AND ACCURACY SURE YOU THAT EVEN
FROM THE SMALL COMMUNITY
HOSPITALS TO THE LARGE MEDICAL
CENTERS I HAVE WAITED HOURS AND
HOURS AND HOURS.
.
WITH THAT SAID LOOK WHERE DOES
TO PATIENT CARE YOU KNOW IT.
SOMEBODY CALLED NINE ONE ONE.
SEEK EIGHT WE TAKEN TO THE
HOSPITAL AND GUESS WHAT.
DEPENDING ON WHAT HOT SPRING GO
TO WHAT THE SERBS
CIRCUMSTANCES ARE YOUR ARE
SITTING BASICALLY SITTING WITH
THEIR PATIENTS ON THE GURNEY.
FOR HOURS AT A TIME IN THE
HALLWAY.
WHAT DOES THAT DO TO PATIENT
CARE FOR ONE? THE MOST PART WHAT
IT DOES TO A FIRST RESPONDERS
THAT SHOULD BE OUT THERE ON THE
STREETS
AND STATIONS.
READY TO GO OVER THE NEXT
EMERGENCY IN AND AND IN SOME
CASES IT DELAY SERVICE.
TO THEM I WANT SYSTEM BECAUSE
YOU HAVE.
OF THESE INDIVIDUALS THAT ARE
SITTING NEXT TO A PATIENT.
AND OFFICE YOU DO RENDERING AID
IN CARE BECAUSE.
ALWAYS THERE FOR HOURS YOU'RE
STILL MUTTERING THE VITAL SIGNS
ARE STRONG MAKING SURE THE
PATIENT IS OKAY UNTIL THERE'S A
BIT OF ALCOHOL.
SO IT'S IT'S A BIG ISSUE AND
IT'S BEEN GOING ON FOR YEARS IN
MY OVER THIRTY YEARS WORK NOW
MEANS INDUSTRY.
I WOULD SAY HALF OF THAT TIME
HAS BEEN SPENT.
ON WALL TIME.
SO I THOUGHT I JUST WANT THAT
YOU BRING THIS BILL FORWARD I
CAN ATTEST TO YOU ON.
THE SOONER THE BETTER TARGET
DRESSES ISSUES AND GOT OUR FOLKS
OUT THERE BACK ON THE STREET
WHILE MOST IMPORTANT GETTING
THOSE PATIENTS THE CARE THAT
THEY NEED.
AND WHAT THAT SELECT BR AUDIT
ADDED AS A CO AUTHOR IS WHAT
THAT'S POSSIBLE
SO THANK YOU FOR BRINGS BEFORE.
I'M SO I GUESS MY QUESTION MY
QUESTION IS.
SO THIS IS REQUIRING THE
COLLECTION OF DATA SO. WHY ARE
YOU OPPOSED TO THE COLLECTION OF
DATA?
WE BELIEVE THAT A.
THAT THE COMPARISON WILL BE
DIFFICULT TO MAKE IF SOME
HOSPITALS.
REPORT NOTHING AND OTHER
HOSPITALS DO WE JUST AND ALSO
THAT THE WAVE THAT EACH HOSPITAL
REPORTS. TO BE INDIVIDUAL LAMB
SAYS MAYBE USING A DIFFERENT
MECHANISM WHETHER IT'S AN
ELECTRONIC VERSION OR A FORM
VERSION SO WE WE FEEL THAT MAYBE
IT HAD DIFFICULT WAY TO MAKE
COMPARISON WE AS. AS WAS
MENTIONED BY THE AUTHOR AND THIS
IS AN ISSUE THAT OUR HOSPITAL
MEMBERS HAVE BEEN WORKING ON.
THE SHIP COMMENT.
CARE.
TRY MY MIKE MISTER CHAIRMAN I I
BELIEVE UNDER THE BILL THOUGH
PROVIDERS DO THE REPORTING AND
IT'S BASED ON WHETHER IT'S AN
ELECTRONIC PATIENT CARE RECORD
THE ROOK REQUIRED TO MAINTAIN.
OR SOME OTHER METHODOLOGY AS
DETERMINED BY THE LOCALLY AMISS
AGENCY AT THE CORE. OPEN TO.
THE FORMAT TO WHICH THAT TAKES
THAT IT'S HELPFUL DATA BUT THIS
IS ALREADY BEING COLLECTED WHAT
CHRONICALLY. AND I WOULD EVEN
SUGGEST THAT WE LOVE TO GIVE US
THE HOSPITAL GOLD STAR IF THEY.
ARE REPORTED TO HAVE NO WHILE
TIME.
THANK YOU.
ANY OTHER QUESTIONS OR.
THROUGH BIGELOW.
NOT THANK YOU I'M.
I GUESS MY I'M JUST GONNA.
KIND OF LOOK AT IT.
LIKE THE GOOD MEMBER DOWN HERE
SPEAKING BOTH OF US HAPPEN TO BE
ENTITIES WITH WORK ON AMBULANCES
AND SPEND A LOT OF TIME IN
HOSPITALS. WITH OUR PATIENTS AND.
.
SOMETIMES IT'S REALLY
FRUSTRATING IT'S NO SLAM AGAINST%
ANYBODY IS JUST. THERE'S A TON
OF PEOPLE THAT ARE BACKING UP
OUR EMERGENCY ROOMS AND IT'S
VERY DIFFICULT.
IT'S MORE DIFFICULT WHEN YOU
HAVE LIMITED.
COMMUNITIES LIKE THE ONES WE'VE
SERVED IN RURAL AREAS.
THAT HAVE VERY LIMITED.
AMBULANCES AND MEDICS AVAILABLE.
TO RESPOND WHEN YOU'RE TYING
THEM UP IN IN MY PARTICULAR
COUNTIES CASE. WHERE I SERVE?
YOU CAN BE EVERY MEDIC.
LEAVING AN ENTIRE COMMUNITY
WITHOUT ANY ADDITIONAL SUPPORT
OTHER THAN THE MUTUAL AID.
.
AND THE GETS PULLED AND WE HAVE
TO ASK FOR MERCED OR FRESNO OR
MARIPOSA DRAMATIC. ISSUE.
BECAUSE PEOPLE ARE BACKED UP IF
WE COULD LIST. ANALYZES AND THAT
THIS BILL HELPS GET THAT
INFORMATION I'M ALL FOR IT. SO I
THANK YOU FOR DOING THAT I I
HOPE THAT THE HOSPITALS WOULD
LOOK AT THIS IS A POSITIVE AND
AND I'M WILLING TO WORK WITH YOU
TO TRY TO.
SOLVE WHATEVER ISSUE THERE IS.
ON THIS BECAUSE I WANT TO SEE
SOMETHING LIKE THIS HAPPENED I'M
GOING TO SEE THIS INFORMATION
GAINED.
THAT'S TRUE OF EVERY SPOTTERS OF
COURSE I JUST THIS IS NOT THIS
THIS BILL IS NOT INTENDED TO BE
PUNITIVE.
WE FULLY INTEND TO CONTINUE
WORKING WITH THE HOSPITAL
ASSOCIATION WE UNDERSTAND THAT
THEY HAVE LEGITIMATE CONCERNS
AND AGAIN WE WANT TO HELP.
GATHER SOME DATA SO WE CAN SOLVE
A PROBLEM.
AND AND WE WANT TO WORK TOGETHER
THAT'S OUR GOAL HERE TODAY AND
I'M GLAD TO HEAR THAT THAT'S
WHAT I'M.
YOU VERY MUCH.
TAKE CARE FOR YEAH I JUST WANT
TO DATA A DITTO ASSEMBLY MEMBER.
.
OTHER BIG LOT GUY WHO'S YOUR
NAME THE FIVE BIGELOW UP BECAUSE
WE HAVE THE SAME EXACT THING IN
RURAL COMMUNITIES YOU HAVE ONLY
ONE AMBULANCE SERVICE.
AND THEY'RE GONE. AND YOU DON'T
KNOW IF YOU GET ANOTHER
EMERGENCY WE'RE GOING TO DO SO
THE THE DATA ISN'T GOING TO HURT
ANYBODY IN. A SHOW FIGURE OUT A
WAY TO MAKE SURE IT'S.
I EQUAL IN IN A LITTLE WORK FOR
ALL OF A SUDDEN NOT RECEIVING A
FOREIGN I'M CURIOUS TO FIND OUT.
THE TIMING.
IS PUBLIC PERCEPTION IS THAT
WE'RE OUR IS OUR INFLUENCE IN
SMALL TOWNS WHERE
IS THE MOTION IS TO PASS TO
APPROPRIATIONS MOTION WAS MADE
FIVE MISTER RODRIGUEZ SECOND IF
I MAY. FLORA
PLEASE CALL THE ROLL.
WHAT I WOULD AYE MAYES AYE MAYES
AYE AYE CARE CURRY I'M ANCHOR
CURRY AYE BIGELOW?
BIGELOW AYE BONTA. BONTA AYE
BURKE.
CARILLO. REAL AYE FLORA FLORA I
AM AMONG.
MARK I'M MCCARTY.
THIS AREA. SIDE NAZARIAN AYE
RODRIGUEZ JUST RODRIGUEZ AYE
SANTIAGO.
MY WEB SEARCH TURN SOMETHING UP
FOR MISSOURI IN AUGUST.
DATA.
IT'S LIKE.
THURMOND.
I THURMOND AYE WALDRON.
WALDRON AYE.
THAT'S ELEVEN ZERO THAT'S THAT
WHO IS OUT TO.
WHICH YOU LIKE TWO PROHIBITS A DOT AUDIT STANDARDS
ARE BEING APPLIED RETROACTIVELY.
THE MEDI CAL ELLIE A BILLING
PROGRAM PROVIDES FUNDING FOR
CRITICAL SCHOOL BASED HEALTH
SERVICES WHICH SUPPORT THE
HEALTH AND ACADEMICS
EXCESS.
OF CALIFORNIA STUDENTS.
RECENT FEDERAL CHANGES WILL
ALLOW SCHOOLS TO SERVE MANY MORE
STUDENTS THAN THEY HAVE IN THE
PAST.
BUT AT A TIME WHEN CALIFORNIA
SCHOOL SHOULD BE WRAPPING UP
THEIR EFFORTS TO WRITE HEALTH
SERVICES TO MORE STUDENTS.
SOME SCHOOL DISTRICTS HAVE BEEN
ENDING THEIR PARTICIPATION IN
THE PROGRAM TURNING DOWN
MATCHING FUNDS FEDERAL FUNDS TO
PROVIDE THE SERVICES.
THIS IS BECAUSE IN RECENT YEARS
SCHOOL DISTRICTS HAVE EXPERIENCE
DIFFICULTY LOTS OF DIFFICULTY.
RECEIVING CLEAR AND CONSISTENT
GUIDANCE FROM THE STATE ON HOW
TO BILL FOR SERVICES IN A
COMPLIANT MANNER.
IN ADDITION CURRENT AUDIT
STANDARDS HAVE BEEN
RETROACTIVELY APPLIED TO CLAIMS
FOR PRIOR YEARS LEADING TO
DISALLOWANCE IS FOR BUILDING.
WHICH WAS DONE PROPERLY AT THE
TIME.
IN OTHER WORDS CHANGING HISTORY.
CALIFORNIA ALREADY LAGS FAR
BEHIND OTHER STATES IN THE
AMOUNT OF FEDERAL FUNDS WE DRAW
DOWN THESE PROGRAMS THREATEN
HARD TO DISADVANTAGE OUR SCHOOLS
AND STUDENTS EVEN FURTHER.
THE MEDI CAL ELLIE A BILLING
OPTION PROGRAM IS COMPLEX AND
ELEAZAR REQUIRE CLARITY AND
CONSISTENCY IN THE
ADMINISTRATION OF THIS PROGRAM
ACROSS OUR STATE.
AB THIRTY ONE NINETY TWO WILL
HELP MAINTAIN SCHOOL DISTRICT
PARTICIPATION IN THE PROGRAM SO
THAT CALIFORNIA'S STUDENTS.
CAN RECEIVE THE SERVICES THEY
NEED TO BE HEALTHY AND SUCCEED
IN THE CLASSROOM.
WITH ME TODAY AND SUPPORT I HAVE
DIANNE PORTERFIELD DEPUTY
SUPERINTENDENT OF BUSINESS
SERVICES FOR THE SAN MATEO.
COUNTY OFFICE OF EDUCATION AND
ERICA HOFFMAN LEGISLATIVE
ADVOCATE FOR THE CALIFORNIA
SCHOOL BOARDS ASSOCIATION.
THERE.
ORDER FILLED AND I AM THE DEPUTY
SUPERINTENDENT OF BUSINESS
SERVICES FOR THE SAN MATEO
COUNTY OFFICE OF EDUCATION.
I'VE SERVE THERE FOR EIGHT YEARS
SAN MATEO COE RAMMED THE ONLY A
BUILDING OPTION FOR A NUMBER OF
YEARS.
CEMETERY COUNTY OFFICE OF
EDUCATION SUPPORTS THE PREMISE
OF PURPOSE OF A B. THIRTY ONE
NINETY TWO BECAUSE OUR
EXPERIENCE OPERATING THE ELLIOT
BILLING OPTION PROGRAM. AND THE
DIFFICULTIES THAT WE ENCOUNTER.
IN TWO THOUSAND AND SIX THE
DEPARTMENT PROVIDED MINIMAL
GUIDANCE TO ELEAZAR THAT
SERVICES PROVIDED BY TRAIN
HEALTH CARE AIDES. COULD BE
CLAIMED UNDER THE LA A BILLING
OPTIONS.
TRAINED HEALTH CARE AIDES
PROVIDE ASSISTIVE CARE TO
STUDENTS WHICH ARE ESSENTIAL FOR
STUDENTS TO ACCESS THEIR
EDUCATION.
ASSISTED CARE SUCH AS
ADMINISTRATING ADMINISTERING
MEDICATIONS GASTRIC TUBE
FEEDINGS SEIZURE CARE
TRACHEOTOMY TOOK CARE. AND
SECTIONING TO INVEST IN SURE A
STUDENT DOES NOT SUFFOCATE.
WITHOUT THESE SERVICES MANY OF
THE STUDENTS THAT SAN MATEO COE
SERVICE WOULD NOT BE ABLE TO BE
IN THE CLASSROOM WITH THEIR
PEERS.
BASED ON THE DEPARTMENT'S
GUIDELINES AND USING THE
GUIDELINES PROVIDED SAN MATEO CO
WE BECAME CLAIMING FOR SERVICES
BY TRAINED HEALTH CARE AIDES.
BEGINNING WITH.
EIGHT OH NINE SCHOOL YEAR.
HOWEVER IN TWENTY FOURTEEN SAN
MATEO SUEY WAS AUDITED AND
NEARLY ALL OF OUR CLAIMS WORD
UNDER. TRAINS HEALTH CARE AIDES
WERE DISALLOWED.
THE DEPARTMENT STATED THAT THE
REASON THESE CLAIMS WERE
DISALLOWED US BECAUSE WE FAILED
TO PROPERLY DOCUMENT THE
SERVICES THAT WERE PROVIDED.
AT THE TIME OF THAT THESE CLAIMS
ARE SUBMITTED SAN MATEO WAS A
HEARING TO THE CURRENT CLAIMING
GUIDELINES PROVIDED BY THE
DEPARTMENTS. HOWEVER BY THE TIME
WE WERE AUDITED THE DEPARTMENT
HAD PUT OUT NEW GUIDELINES IN
JUNE TWENTY THIRTEEN.
PROCLAIMING FOR TRAINED HEALTH
CARE AIDES AND THESE WERE THE
GUIDELINES OF THE AUDITOR'S USED.
IN TOTAL NINETY EIGHT PERCENT OF
OUR ELLIOT BILLING OPTION CLAIMS
WERE DISALLOWED THIS AMOUNTED TO
FOUR MILLION. IN LOSSES OVER A
FOUR YEAR PERIOD TO SAN MATEO
COUNTY OFFICE OF THAT. THAT
COULD HAVE BEEN REINVESTED IN
HEALTH CARE SERVICES.
SAN MATEO APPEALED THE DECISION
THE DEPARTMENT WAS ALSO THE
APPELLATE BODY USING ANOTHER
ADMINISTRATOR AS THE HEARING
AUDITOR.
AFTER THE DECISION AND SEVERAL
FAILED ATTEMPTS TO GET CLEAR
GUIDANCE ON HOW TO CLAIM. FOR
TRAINED HEALTHCARE IF THEY.
HEALTH CARE AIDES GOING FORWARD
SAN MATEO CO WE DROPPED OUT OF
THE PROGRAM IN THIS COMPLETELY
NOT MADE ANY CLAIMS.
SINCE TWENTY FOURTEEN SCHOOL
YEAR.
ALTHOUGH WE BELIEVE THAT ELLIE
AB OWING OPTION PROGRAM IS OF
VALUABLE TOOL TO HELP STUDENTS
WITH SPECIAL NEEDS ACCESS
EDUCATION. THE LACK OF GUIDANCE
AND AROUND AROUND CLAIMING AND
THE HUGE DISALLOWANCE IS THAT
RESULTED. MADE OUR CONTINUED
PARTICIPATION UNTENABLE.
SINCE SAM MATTEO NO LONGER
PARTICIPATING IN THIS ALL COSTS
FOR TREAT HEALTH CARE AIDES ARE
CHARGED TO SCHOOL DISTRICTS
PARTICIPATING IN OUR PROGRAM.
PULLING MORE FUNDS AWAY FROM
EDUCATION.
I'M HERE SUPPORTING THIS BILL
BECAUSE WE BELIEVE THAT THE
FISCAL IN PROGRAM COMPLIANCE
GUIDE WOULD HELP TO
SIGNIFICANTLY REDUCE THE
AMBIGUITY AROUND CLAIMING. AND
WOULD DECREASE THE NUMBER AND
SIZE OF AUDIT DISALLOWANCE WE
LOOK FORWARD TO THE DAY. THAT WE
CAN RE ENTER THE PROGRAM FOR
THAT REASON WE ASK FOR AN AYE.
ERICA HOPPING ON BEHALF THE
CALIFORNIA SCHOOL BOARDS
ASSOCIATION. ON AS A PROGRAM
ADMINISTRATOR SOMEONE USED TO
ADMINISTER THIS PROGRAM I THINK
IT'S REALLY HARD.
TO FOLLOW THE SAME CEMETERY
COUNTY OFFICE OF EDUCATION I
JUST WANT TO SAY. THIS IS A
PROGRAM THAT PROVIDES FEDERAL
MONEY TO SCHOOLS.
FOR HEALTH CARE SERVICES.
HOWEVER BECAUSE OF THE
INCONSISTENCIES IN AUDIT GUIDES
FROM THE DEPARTMENT OF HEALTH
CARE SERVICES DISTRICTS ARE
DROPPING LIKE FLIES OUT OF THIS
PROGRAM.
AS WE ALL TALK ABOUT THE NEED TO
PROVIDE HEALTH CARE SERVICES TO
ALL STUDENTS. THE NEED TO
PROVIDE MENTAL HEALTH SERVICES
STUDENTS.
THIS IS A BIG HUGE DISINCENTIVE
RIGHT NOW IF WE CAN GET AUDIT
GUIDE THE DISTRICTS COULD FOLLOW.
THAT DISTRICTS KNEW EXACTLY
WHERE THEY NEED TO GO AND HOW
THEY NEEDED TO FILE THEIR CLAIMS.
THAT WOULD BE A TREMENDOUS.
RESOURCE FOR SCHOOL DISTRICTS
AND FOR THOSE REASONS WE VERY
STRONGLY SUPPORT THIS MEASURE
AND WE VERY STRONGLY URGE RIVA
THANK YOU.
THANK YOU VERY MUCH ON OTHERS TO
SUPPORT.
HELEN ROTH DOWDEN TEACHERS FOR
HEALTHY KIDS IN FULL SUPPORT
THIS IS REALLY AN ISSE THAT.
THE LEGISLATURE NEEDS TO WEIGH
IN ON THANK YOU.
ANDREA COLEMAN COORDINATOR OF
MEDI CAL PROGRAMS FOR LOS
ANGELES UNIFIED SCHOOL DISTRICT
LAUSD AS A CO SPONSOR AND STRONG
SUPPORTER OF AB THIRTY ONE
NINETY TWO. THANK YOU.
MANY ONE REPRESENT CALIFORNIA
SCHOOL NURSES ORGANIZATION IN
STRONG SUPPORT.
AND YOU GOTTA WATCH SO.
IN ON BEHALF OF MY COLLEAGUE
NANCY LOOK BECAUSE THE COALITION
FOR ADEQUATE FUNDING FOR SPECIAL
EDUCATION IT'S IN SUPPORT.
DELORES DURAN FLORES WITH THE
CALIFORNIA SCHOOL EMPLOYEES
ASSOCIATION WE REPRESENT TWO
HUNDRED AND FIFTY THOUSAND
CLASSIFIED SCHOOL EMPLOYEE THAT
MANY OF WHICH PROVIDE THE
SERVICES THIS BILLS GREATLY
NEEDED. YES WE ARE.
AMENDED ICKY WITH THE CALIFORNIA
COUNTY SUPERINTENDENTS OF
SCHOOLS. ARE COMMON SIR ECHOED
BY AND THIS PARTICULAR COMMENTS
TODAY AND WE URGE YOUR SUPPORT.
IS THERE ANYONE IN OPPOSITION TO
THE BILL.
SEEM NORMAL BRAVE BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS.
SEEING NONE.
WE HAVE A MOTION THAT WHICH I
CLOSE MISTER DOLLOPS THAT'S
RIGHT I DON'T THINK IT.
SO WE HAVE A MOTION BY MISTER
MAYES A SECOND TRIMESTER BERMAN.
AND SECRETARY OF THIS MISSION
IS TO PASS TO APPROPRIATIONS
MADAM SECRETARY PLEASE CALL THE
ROLL WHAT I'VE WHAT I'VE MAYES
MAYES AYE ANGER CURRY. BAKER
CURRY AYE BIGELOW AYE BIGELOW
AYE BONTA AYE BONTA AYE BURKE.
CARILLO. CARILLO AYE FLORA AYE
AYE FLORA AYE LIMON.
I MCCARTY.
THIS AREA. NAZARIAN AYE
RODRIGUEZ. RODRIGUEZ AYE
SANTIAGO.
THURMOND. THURMOND AYE WALDRON.
THAT'S ELEVEN ZERO THAT BILL IS
ALSO OUT OF STRUGGLE THANK YOU
MUCH BELIEVE IT OPEN FOR OTHERS
TO ADD ON THIS LOAN.
MISTER MOM WILL BE PRESENTING.
AB TWENTY ONE SEVENTY EIGHT.
THANK YOU MISTER CHAIR AND
MEMBERS I WANTED TO START
RETHINKING OF THE CHAIR
COMMITTEE STAFF FOR THEIR HARD
WORK ON ASSEMBLY BILL TWENTY ONE
SEVENTEEN.
ACCORDING TO THE CALIFORNIA
ASSOCIATION OF FOOD BANKS ONE
AND OF EVERY CALIFORNIANS DOES
NOT KNOW WHERE THEIR NEXT MEAL
COMES FROM AND ONE IN FIVE
CHILDREN. IN CALIFORNIA GO TO
BED HUNGRY EVERY EACH NIGHT.
CHARITABLE FEEDING ORGANIZATIONS
ARE AT TIMES LIMITED IN THEIR
ABILITY TO FEED THE HUNGRY DUE
TO THE LACK OF ACCESS TO FULLY
PERMITTED FOOD FACILITIES. OR
REQUIREMENTS THAT LIMIT SERVICE
TO THREE EVENTS IN AND NINETY
PERIOD.
THANK YOU WITH ME TODAY I HAVE
US SOME SUPPORTERS I'M IN FAVOR
OF A TWENTY ONE SEVENTY.
THAT
INCREASING NUMBERS ARE MISTER
CHAIR JUST ALONG FOR THE LOCAL
ENVIRONMENT HEALTH DIRECTIVES WE
SPONSORING THE MEASURE WE WANT
TO BRING THIS TO YOU PRO
ACTIVELY TO ADDRESS TWO ISSUES.
THE HUNGRY THAT REALLY NEED MORE
FOOD AND ALSO TO TRY AND OF
BOOKS OF THE TERRIBLE FOOD
WASTAGE YET SO WE ARE PRO
ACTIVELY TRYING TO FIND A WAY.
TO GET MORE FOOD TO HEALTHY
PEOPLE I BROUGHT WITH ME TO
EXPERTS ON THIS THEN EXPLAIN WHY
THE BY THE BILL IS NECESSARY.
YES GOOD AFTERNOON MY NAME IS
MICHAEL VALLEY AND THE DIRECTOR
OF ENVIRONMENTAL HEALTH A MEMBER
OF THE CALIFORNIA ASSOCIATION
ENVIRONMENT HEALTH
ADMINISTRATORS. AND THE DIRECTOR
FOR THE A DEFENSE COUNTY OF
SANTA CLARA AND I JUST WANTED
POINT OUT THAT WE'VE BEEN
WORKING ON THIS WITH SEVERAL
STAKEHOLDERS TO TRY TO IDENTIFY
SOME REASONABLE SOLUTIONS. TO
THE CURRENT CODE WHICH IS VERY
RESTRICTIVE WHEN IT COMES TO
TRYING TO PERMIT THIS TYPE OF
THAT OPERATION AND WE SEE AN
OPPORTUNITY HERE FOR US TO HAVE
A SECONDARY TIER. OF ESSENTIALLY
REGISTRATION THAT WOULD ALLOW
FLEXIBILITY FOR LOCAL AGENCIES
TO BE ABLE TO.
FOLD IN THIS TYPE OF OPERATION
WHICH TYPICALLY IS OCCURRING
OUTSIDE OF REGULATORY AUTHORITY
AND THE FOCUS FOR US IS REALLY
ON. ACCESS IN FOOD SAFETY AND
BEING ABLE TO SERVE AS A
POPULATION THAT DOESN'T HAVE TO
MAKE THE SAME DECISIONS ABOUT
ACCESS TO FOOD THAT YOU AND I DO
EVERYDAY. AND SO WE SEE THIS IS
A GREAT WAY FOR US TO.
SORT OF BRIDGE THE GAP THAT'S
EXISTED FOR MANY MANY YEARS ON
THIS TYPE OF AN OPERATION.
SO IF YOU HAVE ANY QUESTIONS
WOULD BE HAPPY TO OPEN IT UP.
IF YOU ANY ADDITIONAL WITNESSES
IN SUPPORT.
MICHAEL RIGHT AGAIN ON BEHALF
OF THE BOARD OF SUPERVISORS OF
SANTA CLARA COUNTY IN SUPPORT.
THANK YOU.
ANY OTHERS AND SUPPORT.
SEEING NONE.
MANY WITNESSES IN OPPOSITION.
SEEING NONE ANY QUESTIONS OR
COMMENTS FROM THE MEMBERS.
IT'S LIKE CLOTHES ASPECT LAST
MINUTE AYE VOTE.
WE DO HAVE A MOTION AND A SECOND.
THE MOTION IS DUE PASSED
APPROPRIATIONS IS CULTURAL.
WHAT?
MAYES GUY MAYES AYE ANGER CURRY
THANK YOUR CURRY AYE BIGELOW AYE
BIGELOW AYE BONTA.
BURKE AYE BURKE AYE CARILLO.
LARA AND FLORA EILEMA.
I. THOUGHT I. MCCARTY.
THIS AREA. ACT NAZARIAN AYE
RODRIGUEZ. RODRIGUEZ AYE
SANTIAGO THURMAN.
THURMOND AYE WALDRON.
NINE ZERO IT'S OUT
CONGRATULATIONS.
I MISS IN THIS AREA AND YOU
READY.
FOR.
MR CHEN.
BUT.
OKAY.
HE'S WAITING FOR.
I THINK YOU COMING FOR SANTIAGO.
I MISSION IS AARON ALRIGHT THANK
YOU.
OKAY.
AND OF MISTER SANTIAGO'S R. LAST
BILL SO.
YOUR SON HERE WILL BE COMING
SOON.
THANK YOU MISTER CHAIR AND
MEMBERS OF AB TWENTY THREE
TWENTY EIGHT WOULD REQUIRE THE
DEPARTMENT OF HEALTH CARE
SERVICES.
TO DEVELOP REGULATIONS FOR
COMPREHENSIVE CONTINUUM OF
SUBSTANCE USE DISORDER CARE FOR
YOUTH UNDER AGE TWENTY ONE. THE
BILL IDENTIFIES MONEY FROM
PROPOSITION SIXTY FOUR AS A
POTENTIAL SOURCE OF SUPPLEMENTAL
FUNDING FOR THE SYSTEM OF CARE.
RATHER THAN ALLOCATING
PROPOSITION SIXTY FOUR FUNDS IT
THIS BILL SIMPLY RECOGNIZES
MONEY THAT IS ALREADY SUPPOSED
TO BE USED.
FOR THE YOUTH EDUCATION
PREVENTION EARLY INTERVENTION
AND TREATMENT ACCOUNT.
FOR CONTEXT UP TO NINETY PERCENT
OF ADULTS WITH SUBSTANCE USE
DISORDER DEVELOP THE PATTERN OF
ALCOHOL OR DRUG DEPENDENCE
BEFORE EACH EIGHTEEN. AND
UNFORTUNATELY CALIFORNIA HAS NOT
CHOSEN TO INVEST.
AND A ROBUST SYSTEM OF SUBSTANCE
USE DISORDER CARE FOR UNINSURED.
AND MEDICAID ELIGIBLE YOUTHS.
WHILE COUNTIES MANAGE PUBLICLY
FUNDED TREATMENT PROGRAMS THEY
LACK SYSTEMIC GUIDANCE.
SYSTEMATIC GUIDANCE AND
DEDICATED FINANCIAL RESOURCES TO
ESTABLISH A COMPREHENSIVE SET OF
SERVICES FOR THIS VULNERABLE
POPULATION.
ESTABLISHING STATEWIDE STANDARDS
WILL BE A VALUABLE TOOL FOR
YOUTH TREATMENT PROGRAMS.
WITH ME IN SUPPORT.
OUR DOCTOR.
OF WITH BILL WILLIAM ARROYO
FROM THE CALIFORNIA PSYCHIATRIC
ASSOCIATION AND TOM RENT FREE
FROM THE COUNTY BEHAVIORAL
HEALTH DIRECTORS ASSOCIATION AS
WELL AS A MISTER RANDALL HAGAR
MONTH BILL.
ARE GOOD AFTERNOON.
MY NAME IS DOCTOR WILLIAM
ARROYO AND I'M HERE REPRESENTING
THE CALIFORNIA PSYCHIATRIC
ASSOCIATION AS ITS CURRENT
PRESIDENT.
WE REPRESENT THIRTY FIVE
HUNDRED PSYCHIATRISTS.
ACROSS THE STATE I WANT TO THANK
THE.
CHAIRING THE COMMITTEE FOR THIS
OPPORTUNITY I WANT TO START BY.
I DESCRIBING WHAT MY CLINICAL
WORK IN TALES I WORK WITH THAT I
USED TO HAVE HAD. MINOR BRUSHES
WITH THE LAW HAD BEEN REMOVED
FROM THEIR HOMES AND TEMPORARY.
TEMPORARILY PLACED IN A FACILITY
OPERATED BY THE PROBATION
DEPARTMENT LOS ANGELES COUNTY.
THEIR AGE RANGES FROM TWELVE TO
EIGHTEEN IN VIRTUALLY ALL ARE
BLACK.
OR LATINO AT LEAST FIFTY PERCENT
UPSET YOU TAP MODERATE TO SEVERE
SUBSTANCE USE DISORDER PROBLEMS
WHICH INCLUDES ALCOHOL.
IT'S VERY COMMON FOR THE PARENTS
TO REPORT THAT THERE SUBSTANCE
USE IS THEIR PRIMARY CONCERN.
IT SHOULD NOT ONLY BE CONCERNED
THAT THEIR PARENTS BUT ALSO TO
EVERYONE IN THIS HEARING.
MANY OF THESE YOUNG PEOPLE WERE
INTOXICATED WHEN THEY COMMITTED
THEIR FACTS.
THESE YOUNG PEOPLE REPRESENT THE
FUTURE RESIDENTS OF THE STATE IF
THEY LABEL LONG ENOUGH. AND
DON'T DIE PREMATURELY DUE EITHER
TO THEIR DRUG USE OR OTHER RISKY
BEHAVIORS.
IF THEY DON'T DIE AND I'M NOT
HELPED THEY MAY JOIN THE RATS
RANKS
OF THE MUSHROOMING POPULATION OF
HOMELESS YOUNG PEOPLE ACROSS THE
STATE.
MANY OF THESE YOU STILL HAVE THE
POTENTIAL TO BECOME PRODUCTIVE
CITIZENS BUT WITHOUT SUBSTANCE
USE DISORDER TREATMENT. WILL NOT
LIKELY GRADUATE FROM HIGH SCHOOL
AND A RECYCLE JAILS AND PRISONS
THEREBY BECOMING A LIFELONG
BURDEN. TO OUR STATE.
WE KNOW FROM RECENT STUDIES THAT
MARIJUANA ADVERSELY AFFECTS THE
DEVELOPING BRAIN.
IT CONTINUES TO DEVELOP THROUGH
EARLY ADULTHOOD.
SUCH A FAX INCLUDE PROBLEMS WITH
MEMORY ATTENTION AND LEARNING
OFTEN RESULT IN A SCHOOL FAILURE.
A VERY RECENT SCIENTIFIC STUDY
CONCLUDED THAT THE BRAINS OF
YOUNG PEOPLE WHO STARTED
DRINKING ALCOHOL HEAVILY AT AN
EARLY AGE.
HAVE BRAINS WHICH IS A
CONSEQUENCE
OF THIS EARLY DRINKING PATTERN.
FUNCTION DIFFERENTLY FROM THOSE
YOU TO.
DID NOT ENGAGE IN SUCH BEHAVIOR.
AB TWENTY THREE TWENTY EIGHT
PROVIDES OUR STATE ALL OF OUR
COMMUNITIES AND MOST IMPORTANTLY.
YOUNG PEOPLE WITH THAT SECOND
CHANCE TO PURSUE THEIR DREAMS.
SPIKE THE FACT THAT THERE IS AN
ENTITLEMENT
THROUGH THE FEDERAL MEDICARE
PROGRAM TO MEET THEIR NEEDS ARE
HEALTH SYSTEMS HAS.
FAILED THEM AND THEIR FAMILIES.
THE RESTRUCTURE OF SUBSTANCE USE
DISORDER TREATMENT IN CALIFORNIA
IT'S WAY OVERDUE. AND OF COURSE
AS WE JUST MENTIONED PRODUCTS
PROP SIXTY FOUR PROVIDES.
SOME RESOURCES FOR DEVELOPING
AND SUSTAINING THAT CONTINUUM OF
CARE. NECESSARY FOR THESE
YOUNGSTERS TO RESUME A NORMAL
DEVELOPMENT.
PROTECTING YOUNG PEOPLE'S BRAINS
SHOULD NOT BE AN OPTION.
IN ADDITION THERE'S A MAJOR COST
AVOIDANCE BY CARRYING OUT AB
TWENTY THREE TWENTY EIGHT IN
MULTIPLE SECTORS INCLUDING
HEALTH. JUVENILE JUSTICE
CRIMINAL JUSTICE CHILD WELFARE
EDUCATION AMONG OTHERS.
SO LET'S DO THE RIGHT THING AND
IDEA IMPLORE YOU TO.
A PORT AB TWENTY THREE TWENTY
EIGHT THANK YOU. THANK YOU
MISTER CHAIRMAN WAS TOM RENT
FREE WITH THE CALIFORNIA
BEHAVIOR HEALTH DIRECTORS
ASSOCIATION.
ANYONE WHO HAS EVER HAD OCCASION
TO TRY TO FIND.
TREATMENT PROGRAM FOR AN
ADOLESCENT WITH SUBSTANCE USE
DISORDER AN AGE APPROPRIATE
TREATMENT PROGRAM KNOWS HOW
DIFFICULT IT IS THERE ARE VERY
FEW OUR YOUTH A SPECIFIC
PROVIDERS LONG WAITING LISTS.
I MOST YOUTH THE NEED OF AT THE
SUBSTANCE USE DISORDER TREATMENT
DID NOT RECEIVE CARE WITH AN
ESTIMATED TREATMENT RATES AS LOW
AS ONE. NOW IN TEN.
TWENTY YEARS AGO IN NINETEEN
NINETY EIGHT.
THERE WAS A STATUTE PASSED BY
THIS BODY THAT THAT REQUIRED THE
STATE TO ESTABLISH A YOUTH
SUBSTANCE USE DISORDER SYSTEM OF
CARE. THAT WAS NEVER DONE AYE
THERE WERE NO REGULATIONS WERE
WRITTEN THERE WERE NO STANDARDS
DEVELOPED. OUT WE THINK THIS IS
THE TIME TO MAYBE COME BACK NOW
THAT WE HAVE THE ACCESS TO A
POTENTIAL SOURCE OF FUNDING
THROUGH THE USE YOU'VE EDUCATION
PREVENTION.
IT EARLY INTERVENTION AND
TREATMENT ACCOUNT.
WE THINK IT'S TIME TO REALLY I
GET BACK AND FOCUS ON THIS ISSUE
AND GET OUR YOUNG PEOPLE. THAT
NEED THIS HELP THAT THE
TREATMENT THAT THEY NEED SO WE
SUPPORT THIS BILL THANK YOU.
MISTER CHAIRMAN LATER FOR THE
CALIFORNIA PSYCHIATRIC
ASSOCIATION URGING YOUR SUPPORT
HERE FOR ANY QUESTION
THANK YOU I THANK YOU VERY MUCH
OTHERS IN SUPPORT.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY IN SUPPORT.
MELISSA I'M ON BEHALF OF THE
CALIFORNIA ACADEMY OF CHILD AND
ADOLESCENT PSYCHIATRY IN STRONG
SUPPORT.
GOOD OLD PLAIN CITIZEN AGAIN.
PATRICIA WETZEL IN SUPPORT THANK
YOU FOR BEING HERE.
MICHELLE EVANS AT THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA REPRESENTING LOCAL
HEALTH DEPARTMENTS IN SUPPORT.
BECAME.
SO REALLY ONE IN OPPOSITION.
SAY NO ONE WILL BRING BACK THE
COMMITTEE FOR QUESTIONS OR
COMMENTS.
OF TERMS BIGELOW.
THANK YOU TO THE AUTHOR.
MAYBE YOU COULD.
GIVE US AN IDEA OF WHAT YOU
THINK THIS IS GOING TO COST AND.
MAYBE A LITTLE MORE. FOCUSED IN
ON. WHERE WE'RE GONNA FIND FUNDS
TO ACCOMPLISH THE? MUCH NEEDED
RESULTS THAT YOU'RE TALKING
ABOUT HERE TODAY BY THE WAY THIS
IS THIS IS A GOOD BILL WITH GOOD
DIRECTION.
IT'S JUST IT'S.
LACKING IN THIS AREA SO IF YOU
COULD HELP ANSWER THAT I CHERISH
IT SURE. A THANK YOU AND AND
THANKS FOR THE QUESTION THAT AND.
.
WHAT WE KNOW AT A BIG PERCENTAGE?
A PERCENT OF THE FUNDS.
AND PROP SIXTY FOUR ARE GOING TO
BE.
GOING TOWARDS LAW ENFORCEMENT
AND ALSO EARLY INTERVENTION WHEN
IT COMES TO DRUG USE SO.
INSTEAD OF BEING PRESCRIPTIVE
AND SAYING THAT.
EXACTLY WHERE THE MONEY AND HOW
MUCH IT'S GONNA COME WE WERE
TRYING TO KEEP THAT. OPEN SO
THAT WE CAN WORK THROUGH.
CONTINUE WORKING THROUGH IF WE
NEED TO LOOK AT SPECIFICS I'M.
I'M HAPPY TO WORK WITH YOU.
AT THERE'S A TEAM HERE OF
EXPERTS ALSO WHO.
WOULD DEATH BE MORE THAN
WILLING TO TRY TO FIGURE OUT IF
WE NEED TO BE A LITTLE MORE
SPECIFIC.
I GUESS IT'S A PART OF MINE.
JUST.
LEARNING THE EXPERIENCE BEING
THE FIRST TIME ON THE COMMITTEE
TODAY ON.
POLICY IS ONE THING AND YOU HAVE
A GOOD SOLID POLICY DOCUMENT
HERE IS JUST THE LACKING PORT OF
IT PART OF MOVING FORWARD TO THE
APPROPRIATIONS. ELEMENT WOULD BE
THE FUNDING MECHANISM
SO I. I'D LIKE TO ASK THAT
QUESTION SO THAT YOU CAN START.
A CARING FOR THOSE.
ANSWERS.
NOW AND IT WOULD BE GOOD FOR
FOLKS WHO BRING BILLS ALLEN.
IT ALWAYS IDENTIFY WHERE THAT
MONEY'S GOING TO COME FROM
BECAUSE TO OFTEN AND WE'VE SAID
IT HERE TODAY SEVERAL TIMES.
TOO OFTEN.
WE DON'T INCLUDE THAT CARD MORE
PROVE YOUR SOMETHING BLINDLY.
SIR I'M JUST ASKING THE QUESTION.
BECAUSE I DON'T.
I HAVE NO REASON TO OPPOSE THIS
BILL ON A POLICY STANDPOINT.
I JUST WOULD LIKE TO GET
THE FUNDING COMPONENT AND I
APPRECIATE THAT OF BECAUSE THAT
IS AN IMPORTANT POINT. IF
THERE'S.
THE MORE SPECIFIC RESPONSE.
I'M SOME IN BIGELOW SO THE EAP
THE FEDERAL EPA STT MANDATE A
FOR MEDICAID ELIGIBLE YOUTH CAN
COVER.
THE COST FOR THE TREATMENT
COMPONENT AND OF COURSE THAT'LL
HELP DRAW DOWN ALSO MATCHING
FEDERAL FUNDS.
I IS FAR AS BUILDING WE REALLY
NEED TO BUILD A SYSTEM OF CARE
THAT DOESN'T EXIST SO FOR
INFRASTRUCTURE CAPACITY
EXPANSION THAT'S KIND OF WHERE
WE WERE HOPING TO LOOK AT MAYBE
SOME OF THE.
BEING ABLE TO ACCESS.
THE FUNDS AVAILABLE THROUGH THE
YOUTH EDUCATION.
EARLY INTERVENTION TREATMENT A
CALENDAR PROP SIXTY FOUR.
YOU KNOW THERE ARE. FEDERAL
GRANTS THERE MAY BE SOME STATE
GRANT MONEY AVAILABLE THAT WE
CAN ACCESS AS WELL I WOULD I
THINK WHAT WE'RE LOOKING AT IS
PROBABLY MULTIPLE SOURCES OF OF.
FUNDING.
YEAH AND HAVE IF I MAY ADD.
.
THEY'D BE ABLE HEALTH SYSTEM THE
PUBLIC BEHAVIOR HEALTH SYSTEM
CALIFORNIA FRANKLY IS COMPRISED
OF MULTIPLE FUNDING STREAMS IF
WE WERE TO DESIGN IT TODAY WE
WOULD NOT HAVE.
FUNDING STRUCTURES CURRENTLY IN
PLACE FRANKLY.
UP BUT THAT BEING SAID.
WE DON'T BELIEVE THAT AS THIS
INITIATIVE SHOULD IT.
GET THROUGH THE STATE
LEGISLATURE AND SIGNED BY THE
GOVERNOR THAT HE WOULD GO TO
SCALE IN THE FIRST YEAR.
WE FORESEE THAT.
THERE THERE WOULD BE.
.
INCREMENTAL EXPANSIONS OVER A
NUMBER OF YEARS.
AND SO.
WITH THAT IN MIND IT'S IT'S
REALLY HARD TO COME UP WITH.
WHAT EXACTLY WOULD BE THE PRICE
TAG FOR THE FIRST YEAR BUT I I
WOULD?
ALL BUT THE CERTAIN THAT.
.
THAT.
OUT COSTS FOR.
IMPLEMENT THE SERVICE WHAT BUT
BE INCREASED BUT LIKE AND LET'S
KEEP IN MIND THAT THERE IS A
FEDERAL ENTITLEMENT.
SO THAT WE WOULD.
HOPEFULLY DRIVE DOWN SUFFICIENT
FEDERAL DOLLARS TO SUPPORT ITS
INITIATION AS WELL AS SUBSEQUENT
EXPANSION.
SO IN THE.
PEOPLE TO SAY THAT WERE POPULAR.
FORTY MILLION PEOPLE THAT
ONE PERSON.
RELATIONS
WOULD BE IN EFFECT
NUMBER TO USE FOR.
AND THEN YOU CAN GROW FROM THERE.
IF YOU HAD AN AVERAGE OF
SOMEWHERE BETWEEN ONE AND TEN
THOUSAND DOLLARS PER PATIENT.
YOU CAN SEE THIS IS GOING TO BE
A VERY LARGE NUMBER SO THE
CONCERN THAT I'M RAISING.
IS A FAIRLY SIGNIFICANT ONE TO
THE AUTHOR I THINK THE POLICY IS
SOUND IN GOING IN AND IN HIS
DIRECTION I JUST WOULD LIKE TO
WORK THROUGH THIS THAT WE CAN
DEFINE.
WITH AN OPEN SET OF EYES THAT
WE'RE LOOKING AT VERY LARGE BITE
OUT OF THE.
THEY THINK YOU GOT I I'M VERY
COGNIZANT I APPRECIATE YOU
STRESSING THAT POINT AND I'M
GONNA ASK.
DOCTOR ARROYO TO ANSWER IT BUT
ONE POINT THAT I DID FORGET WAS.
WENT ON IT WE WE WERE INITIALLY
TALKING ABOUT THIS CONCEPT AND
THIS IDEA I WAS SHOCKED TO SEE
THAT HOW MUCH FEDERAL DOLLARS
WE'RE NOT TAKING ADVANTAGE OF.
AND IF THERE WAS THE OPPORTUNITY
TO BE ABLE TO NOT TAP INTO
GENERAL FUND BUT USE FUNDS THAT
ARE GOING TO BE COMING IN AND
HOPE. LAW.
EXPANDING OVER TIME.
BECAUSE OF PROP SIXTY FOUR.
IMPLEMENTATION OF OF OF OF. THE
NEW INDUSTRY IN CALIFORNIA.
YOU'RE GONNA BE ABLE TO BE ABLE
TO LEVERAGE THAT AND TAKE
ADVANTAGE OF A LOT OF FEDERAL
DOLLARS AS WELL THAT WAS.
THAT WAS THE MOTIVATING FACTOR.
YEAH IT FIVE FIVE MAY BE FURTHER
INDULGED.
I WOULD SAY THAT.
AS THIS BEGINS TO BE
IMPLEMENTED AND TO EXPAND WE
WILL SEE COST SAVINGS IN OTHER
SECTORS.
SO I IT'S FAR. BETTER ESTIMATING
THE COST IS RATHER CALM
COMPLICATED IN THAT.
WE WOULD HOPE TO SEE COST
SAVINGS.
IN OTHER COMPONENTS OF HEALTH
CARE.
JUVENILE JUSTICE I EDUCATION
AND SO FORTH SO.
ALTHOUGH.
AT AT.
FIRST GLANCE.
THERE WOULD BE A COSTS FOR DATA.
TREATMENT.
BUT IT WOULD BE OFFSET
BY COSTS AND OTHER SECTORS.
DO SOMETHING TO KEEP IN MIND.
HE RICH MISS WALDRON. THANK YOU
MISTER CHAIR.
.
BUT YESTERDAY I HAD THE CHANCE
TO MEET WITH THE FOLKS FROM THIS
THE STANFORD UNIVERSITY
INITIATIVE.
WORKING ON.
SEVERAL DIFFERENT SUBSTANCE
ABUSE DISORDERS ON.
AND ONE OF THE REALLY
INTERESTING FACTS THAT THEY'VE
BEEN DOING SOME STUDIES IN
NEUROSCIENCE.
AND ITS EFFECTS
MUM ASSOCIATED WITH YOU KNOW
WHAT CAUSES PEOPLE TO GET
ADDICTIONS OF ISSUES AND THINGS
LIKE THAT AND I FOUND THAT. WHEN
YOU LOOK AT USE FROM THE AGES OF
ELEVEN TO TWENTY FIVE IS THE
HIGHEST CHANCE THE PEOPLE ARE
GOING TO GET ADDICTED THAT'S
WHEN THE BRAIN IS AT THAT WEIRD
STAGE THAT YOU PROBABLY ALL KNOW
A LOT BETTER THAN I DO AS FAR AS
THE TERMINOLOGY BUT.
THAT'S THIS POINT OF TIME A
WINDOW OF OPPORTUNITY WHERE.
AND THAT IT'S BEEN A FRUSTRATION
BECAUSE WE HAVE FAILED I THINK
IS THE CALIFORNIA. TO PUT MONEY
INTO TREATMENT OF SUBSTANCE USE
AND CO OCCURRING DISORDER MENTAL
HEALTH.
TO THE EXTENT THAT WE ARE STILL
HAVING TO PAY AT THE OTHER END.
SO.
.
THE ANALYSIS ACTUALLY HAD. ONE
THING I STARTED ALL OVER BECAUSE
THAT'S WHEN MY BIGGEST HOME
ISSUES WITH CALIFORNIA'S THAT
THEY JUST HAVE NOT COME TO THE
REALIZATION THAT THEY NEED TO
PUT MONEY TOWARDS OPIOID. ABUSE.
AND TREATMENTS.
AND IT'S IT JUST DOESN'T HEAR
THAT.
COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA ARGUES
THAT EXTENSIVE RESEARCH CONFIRMS
THAT TREATMENT IS A HIGHLY COST
EFFECTIVE WAY TO REDUCE HARM
FROM SUBSTANCE USE DISORDERS
WHILE SAVING MONEY ELSEWHERE IN
THE HEALTH CARE AND CRIMINAL
JUSTICE SYSTEMS WHICH IS THE
OTHER IMPACT.
BUT CALIFORNIA HAS YET TO INVEST
IN DEVELOPING OFF OR FUNDING A
COMPREHENSIVE CONTINUUM OF
SUBSTANCE USE DISORDER SERVICES
FOR UNINSURED AND MEDICAID
ELIGIBLE YOU. SO IT IS A HUGE
ISSUE.
I APPRECIATE YOU BRINGING FORTH.
WE'LL SEE IF WE CAN GET THROUGH
APPROPRIATIONS A WHICH IS WHERE
WE USE IN THE RUN UP. UNTIL WALL
BUT ANYWAY I WISH YOU THE BEST
THANK YOU.
I'D BE HONORED TO HAVE YOU AS A
CO AUTHOR.
YOU'D LIKE TO JOIN.
THANK YOU.
TO ANY ANY OTHER QUESTIONS FOR
MISTER NAZARIAN.
SEEN THEM WOULD YOU LIKE.
JEFF.
WHICH A CLOSENESS USER I
RESPECTFULLY ASK ARRIVAL CAN WE
HAVE A MOTION AND.
FROM MISTER THURMAN A SECOND
FROM MISTER AGUILAR CURRY MOTION
IS TO PASS TO APPROPRIATIONS.
METACRITIC PLEASE CALL THE ROLL
WHERE IF I WOULD AYE MAYES MAYES
AYE ACCURATE VERY.
ACTOR CURRY AYE BIGELOW.
BIGELOW AYE BONTA.
BURKE. BURKE AYE CARILLO.
CARILLO AYE FLORA.
LARA AYE LIMA.
MCCARTY. MCCARTY AYE NAZARIAN
AYE SYRIAN AYE RODRIGUEZ
RODRIGUEZ I SANTIAGO.
SANTIAGO AYE THURMAN.
BERMAN I WALDRON. WALDRON AYE.
THAT'S THIRTEEN ZERO YOUR BILL
WAS OUT MISTER NAZARIAN THANK
YOU VERY MUCH LEAVE IT OPEN FOR
OTHERS. OF MISTER SANTIAGO AND
MR CHEN.
SO MISTER SANTIAGO WILL BE
PRESENTING AND MR CHANNEL BE
PRESENTING A. B. NINETEEN
SEVENTY ONE MISTER CHAN HAS
AGREED TO HOLD HIS SUBSTANTIALLY
SIMILAR BILL. AB TWENTY ONE
FIFTY SIX AND JOIN THIS BILL AS
A AS A AS A PRINCIPLE AS A JOINT
AUTHOR.
WITH.
MISTER SANTIAGO THESE REQUESTED
EQUAL TIME TO PRESENT TO US
WE'VE AGREED TO FOR WITNESSES.
AFTER AT TWO MINUTES EACH
TOTAL FOR THE PRESENTATION OF
THE BILL IN THE OPPOSITION HAS
BEEN HAS BEEN GIVEN EQUAL WILL
WILL BE GIVEN EQUAL TIME SO.
PLEASE PROCEED.
MISTER SANTIAGO AND THEN MR
CHEN.
HERE
NO.
POSSIBLE GIVEN THE THE. BILL. I
LIKE THE FIRST EXCEPT THE
COMMITTEE AMENDMENTS AND I THINK
THE COMMITTEE STOP YOURSELF AND
OTHERS FOR HELPING US TO WORK
THROUGH THIS BILL. AS AMENDED AB
NINETEEN SEVENTY ONE WHICH
CHANGE DEFINITION OF GRAVELY
DISABLED TO INCLUDE MEDICAL
TREATMENT WITH THE INABILITY OR
FAILURE TO RECEIVE MEDICAL
TREATMENT WILL RESULT. IN
DETERIORATING PHYSICAL CONDITION
OR DEATH.
THE LOST THE CURRENT LAW STILL
FAILS TO ADDRESS THE NEEDS OF
THOSE WITH MENTAL ILLNESS AREN'T
TO PROVIDE. A FOR THEIR MEDICAL
FOR THEIR NEEDED MEDICAL
TREATMENT.
OTHER MENTAL ILLNESS AXES A
BARRIER FOR THEM TO ACCEPT SUCH
MEDICAL CARE LEAVING MANY OF
THEM ON THE STREETS AND SEVERELY
ILL.
.
AB NINETEEN SEVENTY ONE WOULD
PROVIDE AWAY TO BRING PEOPLE OFF
THE STREETS AND POTENTIALLY
SAVED OUR LIVES WHILE
MAINTAINING THE STATUTORILY
PROTECTED SAFEGUARDS AND CIVIL
LIBERTIES.
OF MY COLLEAGUE WOULD ALSO.
BE PRESENTING.
THANK YOU MISTER CHAIR COMMITTEE
MEMBERS FIRST AND FOREMOST WHEN
I THINK OF SOMETHING ON MIGUEL
SANTIAGO MORE FREEDOM FROM MOMMY.
PRESENT THIS BILL.
ON I HAD THE DISTINCT PLEASURE
OF BEING THE HEALTH THE MENTAL
DEBT BEFORE FORMER LA COUNTY
SUPERVISOR MIKE ANTONOVICH FOR
ABOUT TEN YEARS.
AND DO THAT TIME WILL NUMBERS
I'VE SEEN THROUGH LOS SO THE LOS
ALTOS HOMELESS HOUSING AUTHORITY.
WAS AT ABOUT SEVENTY PERCENT OF
THE FOLKS ARE CHRONICALLY
HOMELESS.
THE FOLKS THAT YOU SEE ON THE
STREET WITH IT SKID ROW IN
PASADENA.
THOSE FOLKS SUFFER FROM CO
OCCURRING DISORDERS.
MEANING THEY HAVE.
DRUNKEN SUBSIDIES ISSUES
NOW MENTAL HEALTH ISSUES
OFTENTIMES HAVE PRIMARY CARE
ISSUES.
IN ORDER FOR THEM TO TREAT THEM.
PART OF THE PROCESS IS TO MAKE
SURE THAT THIS BILL WAS BEING
PASSED ME CHANGE A TERM GRIP
IT'S STABLE.
THE HOMELESS ISSUE WITH A MULTI
PRONGED PROBLEM THAT A MULTI
PRONGED SOLUTION.
OF COURSE HOUSING IS PART OF
THAT COMPONENT.
BUT IN ADDITION SHOULD THAT.
WE CAN TAKE THE PROBLEM THAT
WHICH WE SEE ON THE STREET IN
DAYTON GIVEN TO HOUSING. BUT IN
MY OPINION THAT'S CALLED WHERE
HOUSING WITHOUT HEALING. THIS
BILL ATTEMPTS TO ADDRESS THOSE
ISSUES.
WE ALL KNOW A FORMER ELECTED
OFFICIAL MEMBERS ALL AKON.
FORMER LA CITY COUNCIL MEMBER
FORMER MEMBER OF THE SENATE.
AS WE STAND HERE TODAY AND WE
HAVE A DIALOGUE AND DEBATE.
HIS SON IS ON THE STREETS
HOMELESS AS WE SPEAK
HE CERTAINLY HAS THE POLITICAL
INFLUENCE.
AND THE RESOURCES NECESSARY TO
GET HIS HOUSE HIS SON TREATMENT.
UNFORTUNATE BECAUSE THE SUN IS
EIGHTEEN OLD AN ADULT. HE CANNOT
DO THAT.
THIS BILL IS ATTEMPT TO ADDRESS
SOME OF THOSE CONCERNS.
THANK YOU SO MUCH.
CHEN.
I'M SORRY MISTER CHAIR BUT WE
HAVE ONE OF THE OTHER OR JOINT
AUTHORS.
THANK YOU MISTER CHAIRMAN
AMBER'S I WE ALL KNOW THAT WE
HAVE A HOUSING CRISIS AND WE
KNOW THAT SERIOUS MENTAL ILLNESS.
CREATES OFTEN INSURMOUNTABLE
BARRIERS FOR HOMELESS RESIDENTS
IN CALIFORNIA. AND SADLY WE KNOW
THAT WE HAVE PEOPLE DYING IN OUR
STREETS WE SEE IT EVERYDAY IN MY
DISTRICT.
AS NOTED BY MY COLLEAGUE MISTER
SANTIAGO IN LOS ANGELES COUNTY
ALONE OVER EIGHT HUNDRED
HOMELESS INDIVIDUALS DIED ON THE
STREETS LAST YEAR. EIGHT HUNDRED.
FOR ME THAT'S INEXCUSABLE WE
HAVE TO DO MORE TO GET PEOPLE IN
CRISIS THE HELP THAT THEY NEED.
AS YOUR ANALYSIS POINTS OUT
CALIFORNIA HAS PATHWAYS TO THE
COURTS TO REQUIRE INDIVIDUALS TO
GET TREATMENT EVEN WITHOUT THEIR
CONSENT.
HOWEVER THE DEFINITION OF
GRAVELY DISABLED DOESN'T FULLY
TAKE INTO ACCOUNT THE DANGER
MANY PEOPLE STRUGGLING WITH
SEVERE MENTAL ILLNESSES ARE IN.
IT DOESN'T CLEARLY ACCOUNT FOR
THEIR MEDICAL NEEDS AND A DOZEN
MEASURED INDIVIDUALS
UNDERSTANDING OF THEIR OWN
HEALTH.
I UNDERSTAND THE CONCERNS OF THE
OPPOSITION AND I BELIEVE THAT
WE'RE ALL ON THE SAME SIDE WE
WANT CALIFORNIANS IN CRISIS TO
BE ABLE TO ACCESS THE CARE THAT
THEY NEED.
AS A JOINT AUTHORED ON THIS BILL
I CAN ASSURE YOU THAT WE WILL
CONTINUE TO WORK WITH ALL
STAKEHOLDERS AS THE BILL MOVES
FORWARD.
I BELIEVE THAT WE CAN FIND A
MIDDLE GROUND IN WAYS THAT WE
CAN SATISFY THE CONCERNS OF
PEOPLE WHO ARE CURRENTLY OPPOSE
BUT ALSO ADDRESS ARE VERY REAL
AND GROWING CRISIS ON OUR
STREETS.
MY RESIDENTS DO NOT WANT TO WALK
PAST PEOPLE THAT THEY KNOW
WITHOUT INTERVENTION ARE GOING
TO BE DEAD IN A MONTH SIX MONTHS
OR A YEAR. IS JUST
UNCONSCIONABLE THEY WANT US TO
HAVE THE TOOLS TO GET PEOPLE THE
HELP THAT THEY NEED THANK YOU
VERY MUCH FOR YOUR CONSIDERATION.
PLEASE.
JOHN SHARON DIRECTOR OF MENTAL
HEALTH LOS ANGELES COUNTY.
WE I THINK ALL KNOW THAT WE ARE
FAILING AS A SYSTEM ARE MOST.
VULNERABLE.
MENTALLY ILL.
INDIVIDUALS ARE ACROSS THE STATE.
OF THE BOARD OF SUPERVISORS KNOW
LAKE COUNTY. ARE COMPELLED
MYSELF AS WELL AS OUR COUNTY
COUNCIL IS WITH ME TODAY.
TO EVALUATE THE SITUATION AND
GET RECOMMENDATIONS FROM A VERY
BROAD SET OF STAKEHOLDERS WHICH
WE. DID OVER MANY MANY MONTHS.
FROM THAT.
.
EFFORT WE LET WE BECAME TO
CONCLUSIONS THAT YES WE DO NEED
MUCH MORE INTENSIVE PREVENTION
EFFORTS WE NEED MUCH MORE
ACCESSIBLE OUTPATIENT CARE YES
WE NEED MORE RESIDENTIAL CARE.
AND WE NEED MORE HOUSING
PARTICULARLY FOR THOSE WITH
SERIOUS MENTAL ILLNESS BUT IN
ADDITION THAT WE NEEDED MORE
ENGAGEMENT TOOLS AND%
PARTICULARLY ENGAGEMENT TOOLS
FOR THOSE. WHO ARE SUFFERING AND
YOU ARE VERY RESISTANT TO
GETTING CARE AND THAT'S WHAT
THIS BILL? IS ALL ABOUT.
ENGAGEMENT REALLY AT ITS CORE.
AT THE TOP OF THE LIST INVOLVES
A HEART FORWARD APPROACH TO
ENGAGE PEOPLE ARE SUFFERING
BUT FOR THOSE WHO WILL NOT
ENGAGE WE MUST FIGURE OUT WAYS
TO MORE EFFECTIVELY. HELP THEM
AND THAT IN MANY CASES.
FOR THE MOST SEVERELY ILL
REQUIRES SURROGATE DECISION
MAKING.
WE SEE THIS IS A CLARIFICATION
OF LPS LAW.
SPIRIT.
BEING INDIVIDUALS WHO CANNOT
PROVIDE FOR THEIR BASIC NEEDS
INCLUDING FOOD CLOTHING SHELTER
AND SELF CARE.
REQUIRE AND MUST GET FOR HUMANE
REASONS ASSISTANCE IN MAKING.
DECISIONS CRITICAL TO THEIR WELL
BEING.
EXTERIOR RATIONS PHYSICALLY.
IS AN INDICATOR.
UPGRADE DISABILITY.
AND THE FOR ABLE TO RECOGNIZE
THAT AND INCORPORATE THAT INTO
OUR PRACTICE BUT THAT'S FIRST
RESPONDERS.
CLINICIANS AS WELL AS IN THE
COURTS WE WILL BE DOING A GREAT.
JUSTICE TO THOSE WHO ARE
SUFFERING AND MANY DYING IN THE
STREETS IN BIGGER NUMBERS. EVERY
YEAR.
GOOD AFTERNOON MY NAME IS DIANE
XIN STOCK.
JUST AN AVERAGE CITIZEN BUT A
MOTHER OF A THIRTY TWO YEAR OLD
SON WITH A SERIOUS MENTAL
ILLNESS.
ALSO THE MOTHER OF THREE OTHER
ADULT CHILDREN WHO ARE THRIVING
IN DOING WHILE AND WE DON'T
REALLY.
OR HEARTBROKEN ABOUT MY OTHER
SON AND HAS.
PREDICAMENT.
MY SON HAS SUFFERED WITH A
MENTAL ILLNESS SINCE HE WAS A
CHILD HE'S BEEN LABELED
PREDOMINANTLY SCHIZOPHRENIC
COMPLICATED BY SUBSTANCE ABUSE
AND HE LACKS ANY INSIGHT INTO
HIS ILLNESS. HE IS ONE OF THE
RESISTANT. INDIVIDUAL SO IT WAS
JUST TALKED ABOUT.
I'M HE MET CRITERIA FOR GRAVELY
DISABLED FOR SEVEN YEARS.
AND IN TWO THOUSAND THIRTEEN MY
COUNTY SAID HE NO LONGER
QUALIFIED CITING SUBSTANCE ABUSE
IS HIS PRIMARY PROBLEM EVEN
THOUGH THE CALIFORNIA DEFINITION
OF MENTAL ILLNESS DOES NOT
EXCLUDE CO OCCURRING DISORDERS.
SUBSTANCE ABUSE.
AND HE HAD NEVER LOOKED WORSE.
HE BELIEVES HE'S TO PARKS
RECORDINGS OFTEN UNCERTAIN OF
WHO I AM MOSTLY CONVINCED I'M A
CRACK ADDICT WHO WILL NOT GET
OUT OF HIS HOUSE.
HE HAS ANNOUNCEMENT THE LAST
YEAR AND A HALF IN COUNTY JAIL
IN SOLITARY CONFINEMENT FOR HIS
OWN PROTECTION.
FOR SIX CUTTING OFF ANGLE
MONITORS VIOLATIONS OF PROBATION
STEMMING FROM A RESTRAINING
ORDER. THAT I WAS FORCED TO
OBTAIN.
HE DIDN'T COME OUT OF JAIL
BETTER.
THEN WHEN HE WENT IN BUT I SLEPT
BETTER KNOWING THAT HE HAD A
ROOF OVER HIS HEAD TO THE WINNER.
THE FIRST TIME I TOLD MY SON WAS
GRAVELY DISABLED I WAS
DEVASTATED. WAS NOT WHAT I
ENVISION WHEN THEY LEYVA VV IN
MY ARMS THE VERY FIRST TIME.
WHEN THE CONSERVATORSHIP WAS
DROPPED WE SPIRALED INTO THE
DARKEST FOUR YEARS OF OUR LIVES
MY SON CALLED ME SOBBING BEGGING
ME FOR HOW WE COULDN'T
ARTICULATE WHAT THAT HOPE LOOK
LIKE.
NO ONE COULD CONVINCE HIM TO
VOLUNTARILY ENGAGE IN SERVICES.
JAIL ISN'T THE ANSWER NEITHER OF
THE STREETS BUT HE'S NOT WELCOME
AT ANY OF THE CURRENT HOUSING
OPTIONS BECAUSE OF ITS UNTREATED
MENTAL ILLNESS.
THE SYSTEM'S FAILING MY SON AND
HUNDREDS IF NOT THOUSANDS OF
OTHERS JUST LIKE HIM.
CURRENT LAWS ARE NOT INTERPRETED
THE SAME BY COUNTIES PROVIDERS
AND LAW ENFORCEMENT AGENCIES
BECAUSE THE DEFINITION ISN'T
CLEAR.
SO AS YOU CONTEMPLATE YOUR
DECISION TODAY ASK YOURSELVES
WHAT IF THIS WAS YOU. WHAT IF
YOU COULD SEE INTO THE FUTURE
AND SAW THAT NEXT MONTH YOU'D
EXPERIENCES SCHIZOPHRENIC BREAK%
YOU HAVE NO INSIGHT INTO YOUR
ILLNESS AND STUDY FOLLOWED YOUR
DELUSIONAL THINKING?
YOU LOSE YOUR JOB YOUR HOUSE ALL
OF YOUR POSSESSIONS YOUR FAMILY
WHO LOVES YOU. IS AFRAID OF YOU
AND BEGINS TO DISTANCE
THEMSELVES FROM YOU OUT OF FEAR
OF YOUR ERRATIC BEHAVIOR WHEN
YOU'RE LEFT TO FIND A PLACE TO
SLEEP AT NIGHT.
A DOORWAY STAIRWELL UNDER A
BRIDGE
YOU BEG FOR FOOD OR DIG SCRAPS
OUT OF DUMPSTERS.
YOUR NAY DEFECATE ON THE IN
PUBLIC BECAUSE RESTROOMS ARE FOR
CUSTOMERS ONLY.
IN YOUR RIGHT MIND TODAY. WOULD
YOU CHOOSE TO BE LEFT LIKE THAT
WITH ALL YOUR CIVIL RIGHTS
INTACT.
OR WOULD YOU HOPE SOMEONE
INTERVENES ON YOUR BEHALF.
PLEASE SUPPORT THE BILL IT'S A
FIRST STEP REALLY IN
TRANSFORMING A SYSTEM THAT'S
FAILING.
THANK YOU.
GOOD AFTERNOON.
MEMBERS OF THE ASSEMBLY MISTER
CHAIR.
MY NAME IS MICHELLE IS ARC.
AND I'M A RECENTLY RETIRED
POLICE OFFICER WITH TWENTY SIX
YEARS ON THE FORCE.
WITH THE SACRAMENTO POLICE
DEPARTMENT.
I AM ALSO ON THE BOARD OF
DIRECTORS FOR NAMI SACRAMENTO.
THE LAST THREE YEARS OF MY
CAREER I WORKED ON A MOBILE
CRISIS UNIT.
I WAS ON THE ONLY.
MOBILE CRISIS UNIT WITH THE
CITY OF SACRAMENTO.
A ROOM WITH A CLINICIAN AND WE
RESPONDED TO ALL CALLS WITH
MENTAL HEALTH ELEMENT.
I RODE.
I WAS ALSO A CRISIS NEGOTIATE
NEGOTIATOR IN THE PEOPLE ON THE
STREETS NEW ME AS OFFICER
MARSHALL.
I WOULD OFTEN COUNTER PEOPLE WHO
WERE DELUSIONAL.
AND SYMPTOMATIC AND WHO DIDN'T
FIT THE FIFTY ONE FIFTY CRITERIA.
OF BEING A DANGER TO THEMSELVES
OR OTHERS ARE GRAVELY DISABLED.
THEY MAY HAVE BEEN ALERT AND
ORIENTED.
BUT ALERT BUT THEY WERE NOT
ORIENTED.
AND SOME SIMPLE ORIENTATION
QUESTIONS I WOULD GIVE THEM.
THEY WOULD TURN INTO A WORD
SALAD. IN THE ANSWERS REPEAT GO
IN AND THE QUESTIONS ARE GOING
ANSWERED.
THIS WAS TO THE POINT WHERE I
FELT THAT IT DIDN'T MAKE THE
COULD MAKE AN ACCURATE
ASSESSMENT. OF THEIR OWN MENTAL
HEALTH.
I WOULD ALSO LOOK AT OTHER
FACTORS WHETHER THE PERSON
HANDED ME NO MENTAL HEALTH
ISSUES. WHERE THEY WERE USING
DRUGS POSSIBLY POLY DRUG USE OR?
WHETHER THERE ARE SLEEP DEPRIVED
OR THEY HADN'T EATEN WHAT
MULTIPLE DAYS ARE A COMBINATION
OF ALL.
I OFTENTIMES HAD A GOOD RAPPORT
WITH THIS DEMOGRAPHIC IN AND
THEY KNEW WHO I WAS AND I KNEW
WHO THEY WERE IN. AND IT
OFTENTIMES I WOULD KNOW WHAT
THEIR BASELINE WAS.
IN WITH THEIR BEHAVIOR WAS AND
IF THEY WERE DE COME DE
COMPENSATING.
I WOULD LOOK AT THE SITUATION
AND IF THERE WERE F. I WAS ABLE
TO PROVIDE IF THEY WERE ABLE TO
PROVIDE FOOD SHELTER AND
CLOTHING FOR THEMSELVES.
IF THEY WERE ABLE TO PROVIDE
FOOD FOR THEMSELVES.
EVEN IF THEY HAD TO BEG FOR IT
OR GOES THE DUMPSTER.
THEY THEY HAD FOOD THEY'RE
CARRYING A BLANKET THEY WERE
ABLE TO PROVIDE SHELTER. IF THEY
HAD.
IF THEY'RE WEARING CLOTHES IN
THE WERE CLOSED IT IF THEY KNEW
HOW TO GET TO WHERE DAY SHELTER.
THEN THEY DID NOT MEET THE
CRITERIA.
THIS DIDN'T SOLVE THE ISSUE.
OF THE PEOPLE WANDERING AROUND
IN THE MIDST OF THEIR PSYCHOSIS.
IF THEY DIDN'T MEET THE CRITERIA
I OFTEN HAD TO LEAVE THEM TO
DRAFT
AND POTENTIALLY GOING TO SOME
DANGEROUS SITUATIONS.
IF THE BEHAVIOR WAS BIZARRE
INTIMIDATING TO OTHERS IN THEY
WOULDN'T. THEY WOULD NOT BE
ACCEPTED INTO SHELTERS A RESPITE
CENTERS.
SO ABSENT ANY OTHER CHOICES I
HAVE TO LEAVE IT IN THE MIDST OF
THEIR HALLUCINATIONS PARKING AT
CARS HIDING FROM. WOULD BE
SNIPERS BATTLING SPIDERS GREAT
FROM THEIR SKIN.
THESE PEOPLE NEEDED A SAFE PLACE.
TO BE AND WHETHER THEY WERE
DETOXING FORMER DRUG OR THEY
WERE EXPERIENCING MENTAL HEALTH.
ISSUE.
THESE I BELIEVE THAT.
THAT THEY NEEDED HELP.
SO.
IF THAT MEANS MODIFYING THIS
GRAVELY DISABLED BURBAGE
TO GIVE OFFICERS AND HEALTH CARE
WORKERS THE DISCRETIONARY
ABILITY MORE OF A DISCRETIONARY
ABILITY.
TO GET THE PEOPLE TO THE MENTAL
HEALTH.
CENTERS FOR THE MENTAL HEALTH
HELP.
THAT THEY NEED.
AND DESERVE.
THEN I WOULD ASK YOU TO GIVE.
BUT I VOTE.
IF YOU THINK YOU VERY MUCH.
MISTER CHAIRMAN RENTAL HAGER FOR
THE CALIFORNIA PSYCHIATRIC
ASSOCIATION.
I THINK YOU'VE HEARD ALL THE
REASONS THAT YOU NEED HERE TODAY
WHY YOU SHOULD VOTE YES ON THIS
BILL.
BUT LET ME JUST PROVIDE SOME
CONTEXT.
.
NO THE LPS ACTIVES FIFTY ONE
YEARS OLD IT WAS DESIGNED TO
HELP PEOPLE WHO COULD NOT HELP
THEMSELVES.
WE DESIGN CRITERIA DANGER TO
SELF DANGER TO OTHERS GREATLY
DISABLED IN ORDER TO BE ABLE TO
MAKE DISCRIMINATIONS ABOUT SOME
OF THOSE PEOPLE.
BUT AT AT AT AT THE VERY BOTTOM
IT'S REALLY ABOUT HOW TO
EVALUATE OUR RISK OF HARM
FOR INDIVIDUALS.
AND WHEN THE DRAFTERS DID THAT.
THEY ESTABLISHED THREE CRITERIA
FOOD CLOTHING AND SHELTER AS A
CENTRAL HUMAN NEEDS.
AND I'M NOT SURE WHY THEY NEVER
CONSIDERED HEALTH CARE AND
HEALTH NEEDS IN THAT.
ANALYSIS
BUT IT'S VERY VERY CLEAR TODAY
THAT THE ISSUE HERE BEFORE US IS
WHETHER OR NOT HEALTH NEEDS.
OUR ESSENTIAL HUMAN NEEDS JUST
LIKE FOO CLOTHING AND SHELTER.
I THINK THAT'S WHAT THIS BILL
DOES I THINK IT'S REALLY
IMPORTANT.
PSYCHIATRISTS EVERY DAY HAVE TO.
WATCH AS PATIENTS THAT THEY HAD
MET TO SEVENTY TWO HOUR HOLD ARE
THEN RELEASED AT A SUBSEQUENT
FOURTEEN DAY HOLD. BECAUSE
HEARING OFFICERS ARE NOT
ACKNOWLEDGING THAT THE HEALTH
ISSUES WHICH ARE OFTEN DIRE AND
ACUTE FOR SOME OF THOSE PATIENTS
ARE SUFFICIENT GROUNDS TO KEEP
THEM FOR TREATMENT THAT IS BOTH
MENTAL HEALTH AND HEALTH.
SO WITH THAT I THINK I WILL
CLOSE.
I THINK.
.
YOU KNOW ONE OF THE THINGS I WAS
TALKING ABOUT WITH A FRIEND.
THIS WEEKEND WAS A BOOK BY
JOSEPH CAMPBELL A HERO WITH A
THOUSAND FACES.
I THINK YOU HAVE TO THOSE HEROES
RIGHT HERE WITH US HERE ON THE
DYESS.
AS FAMILY MEMBERS AND POLICE
OFFICERS AND I THINK THAT.
THE AUTHORS AND EVERYBODY
INVOLVED IN THIS ARE AS WELL.
THANK YOU VERY MUCH.
OTHERS IN SUPPORT.
CHAIR MEMBERS SAY JOHN ADDRESS
WITH THE STEINBERG INSTITUTE WE
ARE VERY PROUD TO BE CO SPONSORS
OF NINETEEN SEVENTY ONE. WE
BELIEVE IT PROVIDES A CLARITY
NEEDED TO SAVE LIVES.
THINK.
HI AM JOANNA JUERGENS I AM A
MOTHER TO US ON THAT SUFFERS
WITH SERIOUS MENTAL ILLNESS AND
I'M ALSO CURRENTLY ON THE BOARD
OF SACRAMENTO NAMI AND I TOTALLY
SUPPORT THIS IT'S MUCH NEEDED.
THEY DRAIN MAHMOUD WHAT THE
UNION OF AMERICAN PHYSICIANS AND
DENTISTS IN STRONG SUPPORT.
PATRICIA ON SO MOM OF THREE KIDS
WITH MENTAL HEALTH CONDITIONS.
I HAVE BI POLAR DISORDER.
I STRONGLY SUPPORT THIS POSITION.
SO ANYONE IN OPPOSITION
MISTER CHAIR MEMBERS KURT CHILD
DISABILITY RIGHTS CALIFORNIA.
WE'RE HERE ON BEHALF OF A
COALITION OF DISABILITY RIGHTS
CIVIL RIGHTS.
AND HOMELESS ORGANIZATIONS THAT
ARE OPPOSED TO THIS.
THIS LEGISLATION.
ACT A COUPLE OF THINGS I JUST
WANT TO ADD TO BE CLEAR
DISABILITY RIGHTS CALIFORNIA IS
THE LARGEST DISABILITY RIGHTS
ORGANIZATION IN THE COUNTRY.
WE REPRESENT INDIVIDUALS
THROUGHOUT THE STATE OF
CALIFORNIA UP AND DOWN MANY OF
THESE INDIVIDUALS ARE ARE VERY
CLIENTS THAT WE'RE TALKING ABOUT
THAT'S WHY YOU SEE US HERE.
EVERYDAY ADVOCATING ON THE NEED
FOR SERVICES THE NEED FOR
TREATMENT. TO ENSURE THAT
INDIVIDUALS CAN BE.
JUSTICE WERE.
SUGGESTING HERE SUCCESSFUL IN
GETTING OFF THE STREETS AND
LIVING THERE.
HOPEFULLY PRODUCTIVE LIVES.
WHERE WE'RE ALWAYS SKEPTICAL
WHEN WE HEAR ABOUT?
A THE CRISIS.
AS THE NEED TO GO IN A DIRECTION
WHERE WE CUT BACK FROM CIVIL
RIGHTS.
AND WE WOULD SUGGEST THAT'S
EXACTLY WHAT WE'RE DOING.
HERE IS MOVING AWAY FROM THE
PROTECTIONS THAT INDIVIDUALS
HAVE.
TO BE SELF DETERMINED IT TO BE
SELF DIRECTING.
AND WE WOULD SUGGEST CERTAINLY
THAT LPS HAS SERVED FOR DECADES
THAT BALANCE THAT'S BEEN
ESSENTIAL.
BETWEEN INVOLUNTARY CARE AND
TREATMENT AND THE ABILITY OF.
INDIVIDUALS TO LIVE SELF
DIRECTED.
LIVES.
I WOULD LIKE TO NOTE I THINK
THE.
.
CONSULTANT DID AN EXCELLENT JOB
ON THIS ANALYSIS AND I
OFTENTIMES
THESE ARGUMENTS GET LOST HERE
AND.
WHAT CAN BE THE THE EMOTIONS
AND THE WHAT ARE ALWAYS THE
HEART WRENCHING?
STORIES THAT THAT WE HEAR BUT
BUT TO AYE I THINK THE ANALYSIS
DID KEEP THE FOCUS ON EXACTLY
WHAT.
.
LPS DOES WHAT IT HAS
HISTORICALLY DONE AND WHY IT HAS
BEEN LARGELY SUCCESSFUL.
BUT I THINK IT'S ALSO IMPORTANT
TO NOTE THAT THE LEGISLATURE
TOOK A LOOK AT THIS A FEW YEARS
AGO WITH THE ASSISTED OUTPATIENT
TREATMENT DEMONSTRATION PROJECT
THAT'S LAURA'S LAW.
AND THE IN LAURA'S LAW TOOK
SPECIFIC NOTICE OF THE VERY
ISSUES AND CONCERNS THAT ARE
BEING RAISED.
HERE IF I MIGHT JUST MAKE
QUICKLY WE LAID OUT FOR YOU.
IN OUR LETTER TO THE COMMITTEE
WHAT WE THINK ARE THE CORE
QUESTIONS THAT REALLY NEED TO BE
ANSWERED. AND.
RESOLVING AND GETTING.
I THINK SOME CONSENSUS ON THIS
ISSUE WE HAVE NOT HEARD UP FRONT.
HOW MANY PEOPLE WE ARE TALKING
ABOUT THE THE TESTIMONY TODAY
LED US TO BELIEVE THAT WE ARE
TALKING ABOUT A LOT OF
INDIVIDUALS BOTH AND LA AND AND
STATEWIDE?
WE HAVEN'T HEARD WHAT IS
FOLKS ARE BUMPING UP AGAINST.
THAT PRECLUDES
THE.
CONSERVATORSHIP PER INVOLUNTARY
TREATMENT FOR INDIVIDUALS IS AT
THE COURTS WHERE IS THAT BARRIER.
AND AND I THINK WHAT IS MOST
IMPORTANTLY WHAT WE'RE HERE
EVERY DAY SUGGESTING THE PROBLEM
IS ONE THAT THERE IS NOT HOUSING
AND THERE IS NOT ADEQUATE
TREATMENT.
AND WE WOULD SUGGEST THAT THAT'S
WHAT WE SHOULD BE LOOKING AT WE
SHOULD BE FOCUSING ON THE
ASSURING SUPPORTIVE HOUSING FOR
THESE INDIVIDUALS THROUGHOUT THE
STATE WE SHOULD BE LOOKING AT
ENSURING THAT THERE IS.
THE CARE AND TREATMENT WE WOULD
URGE YOUR.
NO VOTE ON THE BILL.
GOOD AFTERNOON JAN FLOREY FROM
THE WESTERN CENTER ON LAW AND
POVERTY.
WE DO BELIEVE THAT AB AND
NINETEEN SEVENTY ONE IS COMING
FROM A GENUINE DESIRE TO
ALLEVIATE THE GROWING CRISIS OF
HOMELESSNESS.
BUT WE BELIEVE IT'S THE WRONG
APPROACH.
YET WE AGREED THAT THERE ARE
PEOPLE DYING ON THE STREET BUT
THEY'RE NOT ALL DYING FOR LACK
OF MEDICAL TREATMENT SOME OF
THEM ARE DYING FOR BASIC
EXPOSURE TO THE ELEMENTS BECAUSE
THEY'RE SIMPLY NOT ENOUGH
HOUSING
PEOPLE COMMENT TO ME ALL THE
TIME THAT THEY SEE MORE.
VERY SICK PEOPLE AROUND
SACRAMENTO FOR EXAMPLE THAT ARE
HOMELESS.
BUT THAT'S DIRECTLY RELATED TO
THE FACT WHEN THE GOLDEN ONE
CENTER WAS BEING BUILT WE CLOSED
A COUPLE OF S. ARROWS.
THOSE TYPES OF RESIDENTIAL
HOTELS ARE A LAST RESORT HOUSING
FOR PEOPLE WHO ARE OFTEN USING
DRUGS PEOPLE WITH FELONIES.
PEOPLE THE HISTORY OF DRUG
ADDICTION PEOPLE THAT CAN'T JUST
GET ANOTHER PLACE AND WHEN
THEY'RE HOUSING CLOSES THEY END
UP ON THE STREET.
SIMILARLY THE MENTAL HEALTH
SERVICES ACT WHICH IS TO PROVIDE
THE FULL SERVICE SUPPORTIVE
HOUSING WITH ADEQUATE MENTAL
HEALTH AND SUBSTANCE USE
TARGET POPULATION NEEDS. HAS
LEFT TWO AND A HALF BILLION IN
UNSPENT FUNDS ON THE TABLE AND
THIS IS AFTER THE MENTAL HEALTH
SERVICES ACT FUNDING REPLACED
ALL OF ITS PREDECESSOR FUNDING
THE AB TWENTY THIRTY FOUR
FUNDING. DESPITE THE LANGUAGE TO
SUPPLEMENT AND NOT SUPPLANT THAT
FUNDING.
FURTHERMORE THE LANGUAGE OF AB
NINETEEN SEVENTY ONE PINNING THE
DEFINITION OF GRAVELY DISABLED
TO THE LACK OF MEDICAL TREATMENT
ALSO IGNORE CISSUS
THE SUPPLY SIDE REALITY THAT
WE'RE IN.
SINCE TWENTY FOURTEEN NEARLY ALL
OF THE HOMELESS POPULATION HAS
BEEN ENTITLED TO AND MOST ARE IN
FACT ENROLLED IN MEDICARE.
SO PEOPLE EXPERIENCING
HOMELESSNESS ARE ACTUALLY ABLE
TO PROVIDE THEIR OWN MEDICAL
CARE HOWEVER PROVIDING HAVING A
MEDICAL CARD DOES NOT IN AND OF
ITSELF GUARANTEE THAT THEY'RE
GETTING THE RIGHT KIND OF CARE.
THAT THEY HAVE THE SUPPORT OF
HOUSING THE NEED WITH A
WRAPAROUND SERVICES THEY NEED
THAT WILL ACTUALLY ENABLE THEM
TO GET BETTER.
ABC NINETEEN SEVENTY ONE DOES
NOT ACTUALLY SUPPLY THE FULL
SERVICE
SUPPORTIVE HOUSING THAT WOULD
SUPPORT SOMEONE THROUGH
SUBSTANCE USE TREATMENT OR AND.
TO LIVE WITH MENTAL ILLNESS
THE SOLUTION PROVIDED IN AB
NINETEEN SEVENTY ONE IS
INVOLUNTARY DETAINMENT.
A SOMEWHAT IRONIC SOLUTION WHEN
MANY PEOPLE IN CALIFORNIA ARE
NOW EXPERIENCING HOMELESSNESS
AND ARE DESPERATELY SEEKING A
PLACE TO LIVE THE ADEQUATELY
MEET SOON NEEDS AND WHAT THEY
CAN AFFORD.
LOCKING PEOPLE UP ONLY
EXACERBATE NOT ALLEVIATE THE
RESOURCE PROBLEM THAT WE
CURRENTLY HAVE AND WE DON'T HAVE
TO SERVICES TO PROVIDE TO THEM.
ONCE THEY ARE LOCKED UP AYE IN
THE CURRENT SITUATION THAT WE
HAVE IF WE WERE IN A SITUATION
WHERE WE SAID WE HAVE BUILT ALL
OUR SUPPORTIVE HOUSING WE HAVE
BEDS THAT ARE OPEN WE HAVE
SERVICES THAT ARE AVAILABLE AND
WE'RE STILL LOOKING AT THIS
PROBLEM. THEN WE MIGHT WANT TO
GO LOOKING AT LPS AGAIN BUT
UNTIL THAT TIME WE NEED TO LOOK
AT THE RESOURCES THAT WE HAVE.
COULD JUST IN FAIRNESS I WE HAD
WE ALLOWED.
TWO MINUTES FOR EACH WITNESS
BEFORE.
THAT WENT PAST THAT DATE WITH
THAT GUY GROUP TOOK TEN MINUTES
TOTAL WERE IN SEVEN MINUTES NOW
WE HAVE TWO WITNESSES.
AND THREE MINUTES SO.
PLEASE. JOURNAL BE VERY BRIEF
KEVIN BACON FOR THE AMERICAN
CIVIL LIBERTIES UNION OF
CALIFORNIA. AND IT'S UNFORTUNATE
THAT WE.
ARE ARE TALKING ABOUT THIS
ISSUE.
IN ONLY THE HEALTH COMMITTEE.
BECAUSE I NEED TO GET A LITTLE
BIT LEGALLY ON YOU.
REALLY TALKING ABOUT POLICY
ISSUES HERE BUT THERE ARE ALSO
IMPORTANT CONSTITUTIONAL ISSUE
WHAT WE'RE TALKING ABOUT IN IN
THIS BILL IS DETAINING AND
CONFINING PEOPLE WHO HAVEN'T
DONE ANYTHING WRONG AND DON'T
MEET THE STANDARD FOR DANGER
THEMSELVES. TO THEMSELVES OR
OTHERS
SO.
.
THERE IS A VERY DIFFICULT IN
HIGH STANDARD FOR THE GOVERNMENT
ALUM TO JUSTIFY THAT KIND OF.
INTERVENTION
AND AND THAT IS THAT IT MUST BE
A COMPELLING GOVERNMENTAL RECENT
AND THAT THERE CAN'T BE LESS.
INTRUSIVE ALTERNATIVES.
ALLEN SO I.
BUT UNFORTUNATELY THIS IS NOT
THE JUDICIARY COMMITTEE AND I'M
SORRY THAT THE BILL I'M WITHOUT
ALSO SENT TO. THE JUDICIARY
COMMITTEE BECAUSE THAT'S
PROBABLY THE PLACE TO HAVE THAT
DISCUSSION BUT THERE ARE
IMPORTANT CONSTITUTIONAL ISSUES.
THAT WE REALLY CONSTRUED RAIN
WHATEVER.
ACTION LEGISLATURE MIGHT WANT
TO TAKE IN THIS AREA ARM AND
THOSE SUFFICIENTLY COMPELLING
GOVERNMENTAL REASONS ARE NOT.
SATISFIED BY.
EVEN A HUMANE IMPULSE OR DESIRE
NOT TO SEE
BUT ON THE STREETS.
AND MY NAME IS RANDY HICKS.
CALIFORNIA'S FOR DISABILITY
RIGHTS BUT I'M NOT SPEAKING OF
CD ARE TODAY MUCH WE CAN AS A
CLIENT.
I BELIEVE THIS GOES TOO FAR FOR
HELPING CLIENTS.
WHAT I BELIEVE NOW IS SET?
IF I WAS SEVERELY MENTALLY ILL.
AND I WAS LIVING ON THE STREETS
I HAVE THE FEELING THAT I WOULD
BE LOCKED AWAY IN A JAIL
SOMEWHERE.
I'M NOT GETTING THE HELP THAT
ARE SUPPOSED TO BE GETTING THIS
DREAMY DISCLOSE A BRIDGE TOO FAR.
NOTED THAT IT SEEMS TO ME THAT.
I'M ON MEDICINE NOW I'M ON
PROZAC IT WORKS FOR ME BUT IT
DOESN'T WORK FOR EVERYBODY AND
PEOPLE DON'T. DE MISDIAGNOSIS
THINGS.
I BEEN THERE. AND I UNDERSTAND
OUT.
AND SO WHAT'S HAPPENED TO ME IS
THE GAME IS SOMETHING DIFFERENT
AND I HAD TERRIBLE SEVERE
REACTIONS TO IT.
AND THEN THEY WOULD GO AND
INEVITABLY GO BACK.
SELECT QUESTION REALLY IS IS
THIS REALLY ABOUT.
PUBLIC SAFETY.
AND NOT ABOUT HOUSING.
THIS IS REALLY ABOUT MAKING SURE
THAT WE DON'T HAVE THOSE PEOPLE
ON THE STREETS AND MARK BECAUSE
YOU DON'T SEE THEM ANYMORE.
OR JUST REALLY ABOUT HELPING
PEOPLE AND IF HE AND AS THE GUY
FROM THE SEAL YOU SAID HE HAD TO
PUT POINT ABOUT HOUSING. WE
DON'T HAVE ENOUGH HOUSING.
THIS IS AGAIN TAKING AWAY
ANOTHER OPPORTUNITY FOR PEOPLE
TO HAVE A HOME TO LIVE IN.
AND.
AND IF WE REALLY WANT TO FIX
TREATMENT WE SHOULD REALLY FIX
THE MENTAL HEALTH SYSTEM.
IT'S A MESS IS IT IS NOW.
PEOPLE ARE NOT GETTING WHAT THEY
NEED BECAUSE THE FACT IS DATA
CAN'T AFFORD IT.
OR I KNOW I WANT TO COUNTY.
AND I STARTED ON GENERAL
ASSISTANCE
BEFORE I WAS WITH MENTAL DID I
THINK WE FOR MENTAL HEALTH.
DID DIAGNOSIS IF I CAN GO TO
WORK.
DID I THINGS WERE TREATMENT.
DOT CAME MUCH MUCH LATER I HAD
TO DO THAT SOMETIMES WE HAVE THE
SELF ADVOCATES CHUBBY THINGS
HAPPEN WE DON'T NEED TO HAVE
FAMILY MERGE GONZALEZ WHAT WE'RE
GOOD WE'RE DOING WRONG. JUST
DAYTONA'S WHAT WE'RE DOING WRONG.
AND THIS BILL HERE THIS BILL
GOES TOO FAR.
TOO FAR FOR A QUITE LIKE ME.
AND I BOTH.
THANK. YOU VERY MUCH.
OTHERS IN OPPOSITION.
KIMBERLY SHOUT THE CALIFORNIA
PEN AT THE CULT THAT WORK IN
OFFICES.
MISTER CHAIR A MEMBER I'M.
IN ONE OF THOSE IN BETWEEN
CATEGORIES HERE NOT SUPPORTING
OR OPPOSING.
TRANSMIT ON BEHALF OF THE STATE
ASSOCIATION OF PUBLIC
ADMINISTRATORS. PUBLIC
CONSERVATISM PUBLIC GUARDIANS
AGAIN WE DON'T HAVE A POSITION
ON THE BILL WE HAVE BEEN IN
DISCUSSIONS WITH THE SPONSORS WE
FIND OURSELVES. KIND OF AGREEING
WITH BOTH SIDES HERE.
FROM A CAUTIONARY NOTE WE ARE
THE PEOPLE PUBLIC CONSERVATORY
THAT IF THIS BILL PASSES.
THE PUBLIC CONSERVE OUR WILL BE
THE ONE WHO TAKES.
THESE CASES ON AND THE
CAUTIONARY NOTE IS THAT IN MOST
COUNTIES WE ARE NOT FUNDED BY
COUNTY ONLY RESOURCES WELL
ENOUGH TO TAKE CARE OF THE
CASELOAD WE HAVE NOW. AND IF
THIS BILL WERE TO PASS.
WE'LL DO OUR BEST BUT WERE
ALREADY IN A TRIAGE MODE WITH
THE CURRENT CASELOAD AND SO
WITHOUT SOME EXTRA FUNDING TO
HELP US. I TAKE ON MORE CASES
IT'S ARE WE JUST HAD TO TELL
PEOPLE BUT THIS PROBABLY ISN'T
GOING TO BE THE SOLUTION TO CARE
THAT WE ALL HOPE FOR. THE OTHER
BIGGER ISSUE AS ONCE WE GET
PEOPLE INTO A CONSERVATORSHIP.
OUR CLIENT OR OUR MEMBERS ARE
NOT ABLE TO FIND PLACES TO PUT
THESE PEOPLE THERE JUST AREN'T
THE MENTAL HEALTH RESOURCES
AVAILABLE. AND SO AGAIN IF YOU
CONSERVE AMIDST DOESN'T MEAN
THAT THEY'RE GOING TO RECEIVE
THAT FOR A FACT THAT THAT THE
TREATMENT THAT WE ALL HOPE THEY
DO SO.
JUST WANTED TO PROVIDE A
CAUTIONARY NOTE FOR EVERYONE AS
YOU DECIDE ON THIS BILL.
DURING MUCH.
.
ANYONE ELSE.
BRING BACK TO THE COMMITTEE FOR
QUESTIONS COMMENTS.
MISTER MISTER RODRIGUEZ.
I DON'T THINK THE AUTHORS FOR
FOR BRINGING THIS BILL FORWARD.
.
SUCH ONE EQUIVOCATION SO.
THE FIFTY ONE FIFTY YOU TALK
ABOUT BEING GRAVELY DISABLED SO
THIS IS GOING TO ADD LANGUAGE
THAT.
IF BY CHANCE YOU FIND SOMEONE
THAT.
IS UNABLE TO PROVIDE CARE FOR
THEMSELVES THAT THEY WOULD BE ON
FIFTY ONE FIFTY OR WAKES
ABANDONMENT TO ADD.
WHAT WHEEL WE WOULDN'T DO THAT
MUCH IF I MAY WHAT WE WOULD DO
IS ADD TO THE DEFINITION OF
GRAVELY DISABLED?
?
THE SOMEBODY WOULD HAVE TO HAVE
MEDICAL NEED TO THAT'S RIGHT NOW
IT'S CLOTHING BUT.
.
HOUSING THEMSELVES.
GLASS WHICH GIVES ME BUT WE
WERE AND MEDICAL NEED TO IT AS
WELL.
YEAH WE'RE JUST CHARACTERS
BECAUSE OVERSEE.
DEALING WITHA LOT OF THEME
FOLKS ARMS ON THE FIFTY ONE
FIFTIES AND THEN.
OFFICES THAT WAS ALWAYS ISSUE IF
YOU'RE GRAVELY DISABLED IF YOU
WANT A LOT KNOWING IT DIDN'T
REALLY MAKE SENSE SO TO SPEAK.
THEY PUT YOU ON THE FIFTY ONE
FIFTY TO GET MENTAL HEALTH CARE
SERVICES.
ARMED SOLDIERS WANTED HER FINE
ADDING THIS OTHER LANGUAGE TO
INCLUDE THESE OTHER INDIVIDUALS.
.
FOR MY NEXT QUESTION TWO IS I
DON'T SEVENTY TWO HOUR HOLD ON
ONE OF SEVEN SEVENTY TWO HOURS
EVEN. LONG ENOUGH MAYBE X.
ANOTHER TWENTY FOUR HOURS NINETY
SIX HOURS TO PROVIDE MORE CARE
FOR THESE FOLKS BECAUSE.
EVERYBODY'S DIFFERENT RIGHT IN
AND MAYBE THREE DAYS MAY NOT BE
GOOD BUT I GUESS THEY CAN RE DO
THAT BUT I JUST WANTED A.
SIMPLIFICATION ON THAT I SEE
WHERE YOU'RE GOING WITH THAT.
IN THE ASSEMBLY HAS JUST TALKED
ABOUT THE NEED FOR MORE BET
SERVICES I MEAN HOW DO WE.
SYSTEM IS KIND OF ALREADY
OVERBURDENED CELS BICU AT MORE
INTERNAL WOULD. MEAN THAT YOU
NEED TO ADD MORE FOR THAT JUST
CLONE THIS PARTICULAR BILL WILL
IT WORK JUST WERE DRESSING ONE
PARTICULAR ISSUE I MEAN I'LL
REMIND YOU THAT THE LEGISLATURE.
HAS TAKEN.
HAS TAKING.
ACTION LAST YEAR WILL BE DUE TO
NO PLACE LIKE HOME GRANTED IT'S.
IT'S IN THAT OCCASION BUT IF YOU
TAKE A LOOK AT OUR STATE BUDGET
IN SOME OF THE THAT WE'VE BEEN
ADVOCATING FOR CERTAINLY FUND.
OF THOSE KIND OF THINGS AND.
IN LA COUNTY.
ALSO REMIND YOU ONE PARTICULAR
COUNTY BUT OTHERS CAN DO THE
SAME THING WE'VE PASS HHH WHICH
IS GOING TO FUND.
SOME OF THESE WRAPAROUND
SUPPORT SERVICES.
LIKEWISE A CITY
IT DOESN'T COVER YOUR AREA BUT.
SEE OF LOS ANGELES DID A EACH.
AND WE'VE DONE A NUMBER OF A
THE BUDGET ASK AND REQUEST I
THAT COULD AUGMENT THIS I MEAN
THERE'S NO DOUBT I'M NOT ARGUING
THAT THERE'S A NEED OF OF.
HOUSING ABSOLUTELY THINK THIS
LEGISLATORS RECOGNIZED IT I
THINK.
OVER THE LAST SEVERAL YEARS OF
CARRY TWO THREE HOUSING BILLS A
YEAR AND CAT AND IN FACT LAST
YEAR WE VOTED TO PUT SOMETHING.
AND IN THE.
NOVEMBER.
NOVEMBER ELECTIONS OF THE
VOTERS CAN DECIDE TO DO THIS I
THINK WE'VE ADDRESSED SOME OF
THOSE ISSUES OF THIS BILL IS
VERY NARROWLY FOCUSED JUST ON
THE DEFINITION OF GRAVELY
GRAVELY DISABLED.
OOPS.
S. RECORDED THAT'S RIGHT.
THANK YOU MISTER CHAIR ON.
I SUPPORT THIS MEASURE AND.
I THINK YOU FOR BRINGING AFFORD
I REALIZE IT'S AN. UNCOMFORTABLE
CONVERSATION THIS IS NOT AN EASY
THING TO TALK ABOUT I THINK
THERE ARE.
LEGITIMATE ISSUES THAT COME UP
WITH PEOPLE'S.
CONSTITUTIONAL RIGHTS.
AND.
THE IMPLEMENTATION OF THIS BUT.
.
I I THINK IT'S IT'S NEEDED AND
CAN THIS DAY AND AGE I I JUST
WANT TO KNOW THAT.
IT IS ABSOLUTELY NOT AS HAS
BEEN MENTIONED A SOLUTION TO
HOMELESSNESS.
THERE ARE INDIVIDUALS WHO ARE
MENTALLY ILL ARE HOMELESS OR
PEOPLE WHO ARE HOMELESS MOMENTS
WE ARE BUT BY NO MEANS. IS THIS
IS THIS THAT THAT'S A SOLUTION
BUT SO I'M.
YOU KNOW THERE ARE TOO MANY
PEOPLE WHO SLIP THROUGH THE
CRACKS WHO DON'T QUALIFY AS
MISTER RODRIGUEZ SAID FOR.
FIFTY ONE FIFTY WHO I'M TO. DATE
THEY DON'T.
QUALIFY. EITHER BECAUSE THEY
DON'T MEET THE THRESHOLD OF THE
COUNTY FOR THE LORD'S LA OR
LOWERS LA MY SENDING IS IN EVERY
COUNTY CORRECT.
TO HAVE A DAHLE IMPLEMENT IT ON
I I KNOW THAT LAURA I KNOW HER
FAMILY.
SHE WAS THAT AMAZING NINETEEN
YEAR OLD WOMAN HERE IN THE
SACRAMENTO AREA.
WAS KILLED TRAGICALLY BY
DERANGED INDIVIDUAL HER PARENTS
NAKED AMANDA WILCOX ARTICLES
SAYING THIS ISSUE AS WELL AS
WORKING ON GUN VIOLENCE ISSUES.
AND DOWN YOU KNOW WE WE WE TRIED
TO TO TO MAKE A DIFFERENCE
WITH THIS BUT WITH WITH THAT
LAURA'S LA BUT IT'S IT'S IT
HASN'T GONE FAR ENOUGH AND. YOU
CAN WALK OUTSIDE OF OUR STATE
CAPITOL FOR TEN FIFTEEN MINUTES
AND.
AND YOU CAN SEE INDIVIDUALS WHO
DON'T QUITE.
QUALIFY MEET THE THRESHOLD A
FIFTY ONE FIFTY BUT AS WE HEARD
FROM.
PERFORMERS SACRAMENTO POLICE
OFFICER WHO DID A PHENOMENAL JOB
MICHELLE. WAS OUR CAT HERE
TESTIFIED EARLIER.
THEY'RE THEY'RE INDIVIDUALS WHO.
YOU KNOW YOU WANT TO HELP THEY
CAN'T THEY'RE NOT QUITE HELPING
THEMSELVES BUT THEY DON'T QUITE.
MEET THAT THRESHOLD OF VIOLENCE
TO SOMEBODY ELSE FOR THEMSELVES.
AND.
I THINK THAT THIS IS SOMETHING
THAT WE OUGHT TO CONSIDER.
I'M NOT SURE IF IT'S SOMETHING
THAT YOU'RE OFFERING. IS A.
THIS IS IS THIS THAT A PILOT
OPPORTUNITY HERE IS A SUNSET.
BECAUSE I KNOW THIS IS THAT I'D
DRAMATIC CHAT DRAMATIC CHANGE
FROM.
THE LAND TO MEANT POLICY YOU
KNOW THE LATE SIXTIES SO I DO
THINK THERE ARE.
IMPLEMENTATION ISSUES WITH WHICH
WE'VE HEARD FROM FROM THE
OPPONENTS BUT.
I THINK THAT IT.
IT IT IS NEEDED AND THAT WOULD
WORK TO TO HELP DEAL WITH OUR
ISSUES TO GET PEOPLE.
THE HELP THAT THEY NEED THE HELP
THAT THEY DESERVES HELP THAT
THEY'RE NOT GETTING FOR WHATEVER
REASON HELP THAT OUR COMMUNITY
WANTS THEM TO GET THE WE CAN'T
PROVIDE.
THANK YOU.
YOU WANNA RESPOND IN THIS MANNER.
CORRECT.
LOOK CLOSER CHECK MADE TO BE
CHANGED IF SOMETHING DOESN'T
WORK IN THE LEGISLATURE FEELS
THAT HE NEEDS TO CHANGE DOWN THE
LINE THEY CAN.
I MEAN IN FACT IF IF IF THIS
DOESN'T WORK I CAN IMAGINE
MYSELF BEING BACK IN HAVING A
DIFFERENT SORT OF CONVERSATION
TIGHTENING OR LOOSENING UP I
MEAN THIS IS WHAT WE DO.
.
BUT BUT IN NINE TO REALIZE THAT
THIS IS A VERY UNCOMFORTABLE
CONVERSATION WAS UNCOMFORTABLE
FOR ME TO APPROACH IT. BUT AT
THE END OF THE DAY IF
YOU WALK DOWN MOST HOMELESS
ENCAMPMENTS.
A PARTICULAR THAT'S THE CASE IN
MY DISTRICT.
YOU HAVE CLOSE TO TEN THOUSAND
PEOPLE WHO WERE LIVING ON THE
STREETS.
YOU CAN MAKE THE ARGUMENT THAT A
GOOD PERCENTAGE OR SOME
PERCENTAGE OF THEM.
HAVE SEVERE MEDICAL NEEDS.
AND. I MEAN.
THAT'S THE HUMANE THING TO DO.
I KNOW I WALK DOWN THE STREET
SOMETIMES YOU'LL SEE THAT
INDIVIDUAL SCRATCH THEMSELVES
WITH WITH THIS DASH.
HOLES IN THEIR SKIN.
TOLD THAT LOOKED LIKE THEY'D
BEEN RUBBED AGAINST THE GROUND
WITH NOTHING LEFT IN.
I REALIZE IT'S UNCOMFORTABLE
CONVERSATION BUT IT IS
ABSOLUTELY INHUMANE TO IGNORE
THAT PERSON WHO YOU CAN GIVE
SOME SORT OF MEDICAL SERVICE TO.
AND AND THIS REALLY STAND UP FOR
THE.
FROM A STORY THAT I HAVE BEEN
IN THE DISTRICT OF A WOMAN WHO I
HONORED.
AS AS WOMAN OF THE YEAR WHO
REALLY BEGIN THIS CONVERSATION
WITH US A YEARS AGO I'M.
JOINTAUTHORS HAVE THEIR OWN
EXPERIENCES IT LET THEM THE TO
THE SAME PATH BUT IT WAS ABOUT
AN INDIVIDUAL WHO STOOD UP IN
FRONT OF BUSINESS. AND SOME A
HIM THIS HAD TO GO AGAINST THE
WALL AND UNTIL IT BLEEDS IN
PERSON JUST LAYS ON THE STUFF
YOU CAN DO ABOUT IT.
TO PREVENT THAT FROM HAPPENING.
AND THOSE A CONSERVATORSHIP.
.
BATTLE IN THAT AREA.
A REGARDING THIS
BUT WHEN WE TOOK A LOOK AT THIS
WERE CERTAINLY NOT TAKE WERE NOT
TAKEN THE APPROACH.
TO REMOVE CIVIL LIBERTIES FROM
EVERY ANYBODY WHO'S DISABLED BUT
WHAT WHEN WE TOOK THE STEP.
PATH
WE WANTED TO PROVIDE MEDICAL
SERVICES.
I TO FROM THE SOMEBODY WHO.
NEEDS IT.
AND AGAIN I WOULD SAY JUST THE
IN HUMANE THING TO JUST KEEP
WALKING DOWN THE STREET WHEN WE
KNOW WE CAN DO SOMETHING ABOUT
IT.
HOUSE.
JUST QUICKLY NO WORKING TOWARDS
IN OF THE DAY.
THIS IS A FANTASTIC BILL WANT
TO THANK YOU FOR THE COURAGE TO
STAND UP AND DO THIS AND NOW
IT'S BEEN TRIED BEFORE.
AND IT'S BEEN DIFFICULT AND THE
LISTENER TO COMMISSION STOCK NAM
AND THE STORY. OF MY HAVE.
IF FAMILY MEMBERS.
WHOSE.
GONE THROUGH THAT EXACT SAME
THING AND IT IS SO DEVASTATING
AND TO BE ABLE TO WATCH.
.
YEAH WE TALK A LOT ABOUT A READ
A LOT OF GOOD AROUND HERE ABOUT
JUSTICE IN.
AND WE TALK ABOUT LIBERTY AND I
LOVE LIBERTY AND WANT MORE OF IT
I DON'T THINK ANYBODY'S LIBERTY.
OF FROM THEM BUT I ALSO THINK
ABOUT THE QUESTION OF WHETHER WE
ARE OUR BROTHER'S KEEPER.
AND THERE ARE THOSE INSTANCES IN
WHICH SOMEBODY NEEDS HELP AND
THAT'S WHAT THIS IS WE'RE
TALKING ABOUT HELPING FOLKS SO
THANK YOU FOR THE COURAGE TO
COME FORWARD. ABOUT SUPPORTING
THE SAID TODAY.
GOOD WORK.
ANY OTHER COMMENTS.
WOULD BE AUTHORS SLIGHT CLOSE.
I RESPECTFULLY ASK FOR MY VOTE
AND THANK YOU.
SO.
WE HAVE THE MOST WE HAVE A
MOTION.
MISTER MAYES A SEGMENT MR
MCCARTY WHEN I THINK THE AUTHORS.
PRITHU THINGS NUMBER ONE BRING
THE BILL FOR.
AND WORKING TOGETHER ON THIS AS.
AS COOPER SO YOU'RE A PRINCE
BURGER JOINT AUTHORS.
AND.
WITHOUT A BIKE HAVE MET
SECRETARY PLEASE HOPE TO SEE SIR.
I JUST WANT TO SAY THINGS CHARGE
WANTED THANK.
SO THAT.
SUMMER MIGUEL SANTIAGO FULLER
BETWEEN AUTHOR NEXT THING IS I
WANT TO COMMEND YOU ON YOUR
STAFF ACCOUNTS SAY NOTHING'S
ABOUT.
YOUR STAFF FOR DOING A
FANTASTIC JOB. A SPECIAL PERSON
TO YOUR RIGHT SHE'S BEEN.
FOR.
A JOINT BECAUSE THANK YOU VERY
MUCH.
SHE HATED.
WITH THAT.
MADAM SECRETARY THAT MOTION IS
TO PASS AS AMENDED TO
APPROPRIATIONS.
MEMSIC TO PLEASE CALL THE ROLL
WHAT I'VE WHAT I'VE MAYES MAYES
AYE AYE CARE CURRY. ACTOR CURRY
AYE BIGELOW.
BIGELOW AYE BONTA AYE PUNCH AYE
BURKE. BURKE I CARILLO. CARILLO
AYE FLORA FLORA I WILL MOST.
MCCARTY AYE MCCARTY AYE NAZARIAN.
RODRIGUEZ. RODRIGUEZ AYE
SANTIAGO AYE TERRIBLE AYE BERMAN.
THERE WHEN I WALDRON.
AUBURN I.
THAT'S THIRTEEN ZERO THE BILL
WAS OUT I WILL BE THERE OLYMPIC
BROTHERS TO ADD ON MY END OF THE
DAY.
AT THIS POINT.
WE HAVE HEARD ALL OF THE BILLS
BUT WE'RE GOING TO. GO BACK TO
THE.
BACK TO THE TOP OF THE ORDER.
I WE HAVE.
.
ITEM NUMBER ONE AB SINCE
SEVENTEEN SEVENTY SIX
THAT NOW HAS A MOTION BY MISTER
BIGELOW AND THE SECOND BY.
MISTER MAYES THE MOTION IS TO
PASSED AS AMENDED TO TO DISH.
AHMED SECRETARY PLEASE CALL THE
ROLL.
ONE I WOULD I'VE MADE. MAYES AYE
AYE CAREFREE.
YEAH I BIGELOW.
HELLO I BONTA BONTA AYE BURKE.
CARILLO. CARILLO AYE FLORA FLORA
AND AMONG.
MCCARTY AYE MCCARTY AYE HAS AREA.
RODRIGUEZ.
MURDER IS NOT VOTING SANTIAGO.
A LOT OF NUMBER ONE SEVENTEEN
SEVENTY SIX STEINORTH.
JERRY WAS I.
CONTACT AYE THURMAN.
BERMAN I WALDRON.
OVER TIME.
THAT IS TWELVE ZERO.
THAT BILL IS OUT.
ITEM NUMBER TWO AB NINETEEN
SIXTY
THREE.
MISS WALDRON BEEN MOTION BY
MONSIEUR HERE CURRY.
SECOND BY MISTER MCCARTY.
MOTION IS TO PASS TO
APPROPRIATIONS AND SECTOR PLEASE
CALL THE ROLL.
WHEN I WENT AYE MAYES MAYES AYE
AGAR CURRY.
ANGER CURRY AYE BIGELOW.
BIGELOW AYE BONTA AYE BONTA AYE
BURKE.
CARILLO.
BROUGH AYE FLORA.
FLORA I LIVE ON.
MCCARTY AYE MCCARTY AYE NAZARIAN.
RODRIGUEZ RODRIGUEZ AYE.
SANTIAGO. SANTIAGO AYE THURMAN
AYE KAREN AYE WALDRON.
WALTER I HER AYE. BURKE AYE.
THAT IS THIRTEEN ZERO.
WE JUST DID A VOTE ON A. B.
NINETEEN SEVENTY ONE SANTIAGO.
SANTIAGO CHEN.
SO WE WILL NOW MOVE TO ITEM
NUMBER FOUR.
MISTER CHAU TWENTY ONE SIXTY
SEVEN ENTER
IN FOR A MOTION SOME.
SO WE HAVE A MOTION BY MISS
MCCARTY SECOND AYE MR RODRIGUEZ
ASSIST TO PASS A PRIVACY
CONTINUE CONSUMER PROTECTION OF
SECRETARY PLEASE CALL THE ROLL.
MAYES I ANCHOR CURRY. THANK YOUR
CURRY AYE BIGELOW.
BIGELOW AYE BONTA. BONTA AYE
BURKE.
BURGER I CARILLO.
CARILLO AYE FLORA. FLORA I
LOANED.
MCCARTY AYE MCCARTY AYE NAZARIAN.
RODRIGUEZ. RODRIGUEZ AYE
SANTIAGO.
I'M SANTIAGO AYE THURMAN. BERMAN
AYE WALDRON.
WALDRON AYE.
THAT'S THIRTEEN ZERO.
THE CONSENT CALENDAR.
IS ON CALL SO.
WILL HAVE AMENDED SECRETARY
OPEN THE ROLL CALL THE ABSENT
MEMBERS GOT SICK CALORIE CLUES
AB TWENTY ONE SEVENTY FOUR ITEM
NUMBER FIVE ITEM NUMBER NINE AB
TWENTY THREE NINETY THREE.
HEALTH COMMITTEE BILL ITEM
NUMBER TEN.
AB TWENTY FOUR NINETY EIGHT
MISTER CHAIR WHEN SECRETARY
PLEASE CALL THE ABSENT MEMBERS
ARE ACTUALLY OVER THE ROLL CALL.
THE MEMBERS.
MAYES.
MAYES I.
BONTA. BONTA AYE CARILLO.
CARILLO EILEMA.
THERE AND.
RODRIGUEZ IVORY ASIDE SANTIAGO.
ONTARIO AYE THURMOND. AYE.
THAT'S THIRTEEN ZERO.
ITEM NUMBER SEVEN.
AB TWENTY TWO OR THREE MISTER
GRAY AS SECRETARY PLEASE OPEN
THE ROLAND CALLED THE ABSENT
MEMBERS.
DID.
SIX I'M SORRY ITEM NUMBER SIX.
AB TWENTY ONE SEVENTY EIGHT.
PLEASE FOR THE ROLL CALL THE
ABSENT MEMBERS.
WHEN I WENT AYE. BONTA.
I CARILLO.
CARILLO AYE SANTIAGO.
I.
TERRY MCCARTY UNITE MCCARTY.
WALDRON.
WALDRON AYE.
FIFTEEN ZERO.
I'D THEN NOW ITEM NUMBER SEVEN
AB TWENTY TWO OR THREE MISTER
GRAY PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS CONTEST.
BONTA AYE CARILLO.
CARILLO AYE NAZARIAN.
.
THE BILL.
TWO VERY.
GREAT I. IS VERY HIGH RODRIGUEZ
AYE RODRIGUEZ AYE SANTIAGO.
I AYE SANTIAGO AYE THURMAN.
THURMOND I.
THAT'S FIFTEENTH ZERO. ITEM
NUMBER.
EIGHT MISTER HIS AREA.
TWENTY THREE TWENTY EIGHT PM
SECRETARY PLEASE OPEN THE ROLE
AND ACTUALLY. GET OPEN THE ROLL
CALL THE ABSENT MEMBERS.
SPONSORS. BONTA AYE REMOTE.
FOURTEEN.
THAT'S FOURTEEN ZERO.
ITEM NUMBER.
ELEVEN.
DR ARAMBULA.
AB TWENTY FOUR NINETY NINE
MADAM SECRETARY PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS.
BONTA BONTA AYE FOR.
BURKE THAT VOTING CARILLO.
REAL AYE.
RODRIGUEZ. RUBIO IF I SANTIAGO.
SANTIAGO AYE THURMOND.
THURMOND I.
THAT IS TEN FOR.
ITEM NUMBER TWELVE I EP AB
TWENTY FIVE SEVENTY SIX MISS
AGUILAR CURRY. AND SECRETARY
PLEASE CALL. THE ROLL CALL THE
ABSENT MEMBERS CONTACT. CONTACT
I AM AMONG.
RODRIGUEZ I PREDICT IF I
SANTIAGO. SANTIAGO AYE THURMOND.
BERMAN I.
THAT IS FOURTEEN FORTY.
IT WERE CAPTURED YEAH IF THAT'S
FOURTEEN ZERO.
ITEM NUMBER.
.
FOURTEEN ITEM NUMBER FOURTEEN
TWENTY SIX SEVENTY FOUR AGUIAR
CURRY ABOUT SECRETARY PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS BURKE.
BURKE AYE THE MONTH.
MCCARTY I MCCARTY AND I.
RODRIGUEZ RHETORIC ASIDE
SANTIAGO. SANTIAGO AYE THURMAN.
THURMOND AYE WALDRON.
WHILE THEY'RE NOT PUTTING.
THAT IS. THIRTEEN THIRTEEN ZERO.
ITEM NUMBER.
.
FIFTEEN.
AB. TWENTY SEVENTEEN.
.
THE ON CALL A ONE OF OPEN THE
ROLE IN A CALL THE ABSENT
MEMBERS.
BONTA. UNTIL I.
KOREA. KOREA BY.
LIMON.
THE MOMENT I.
RODRIGUEZ. RODRIGUEZ AYE.
SANTIAGO. SANTIAGO AYE THURMAN.
THURMOND AYE WALDRON.
WALTER NO.
SORRY.
THAT IS 11-3 THAT BILL IS OUT
ITEM NUMBER SIXTEEN AB TWENTY
NINE THIRTY FIVE MISTER CHAU
WERE IN SEARCH OF A MOTION.
BUT LET AND.
RUSSIA BY MISTAKE AIR CURRY UP
SECOND IN THE CHORUS WILL GIVE
THAT TO MISS CARILLO.
TO PASS THE MOST IS TO PASS TO
CONSUMER GROW BY PRESSING
CONSUMER PROTECTION AND
SECRETARY PLEASE CALL THE ROLL.
WOULD BUY WHEN I MAYES.
THANK YOU ARE CURRY FIGURE CURRY
AYE BIGELOW.
BIGELOW AYE. BONTA.
BONTA AYE BURKE.
CARILLO. CARILLO AYE FLORA.
AMONG. THE MORE AYE MCCARTY AYE
MCCARTY AYE THIS AREA MY LOSER
ANDI RODRIGUEZ. RODRIGUEZ AYE
SANTIAGO. SANTIAGO AYE THURMAN.
BERMAN AYE WILDER.
WELL THEN I.
THAT IS TWELVE ZERO.
ITEM NUMBER SEVENTEEN MR BERMAN
HAVE OPEN THE ROLL CALL THE
ABSENT MEMBERS BIGELOW. AYE
BIGELOW AYE FOR.
MCCARTY. MCCARTY AYE.
RODRIGUEZ AYE PROBING ASIDE FROM
THIAGO.
SANTIAGO AYE TERRIBLE.
THURMOND I.
THAT'S FOURTEEN ZERO AND THEN.
.
ITEM NUMBER EIGHTEEN MISTER
O'DONNELL AB TWENTY NINE SIXTY
ONE.
OPEN THE ROLE YOU'RE GOOD YOU'RE
GOOD.
FIX PACK.
OPEN A ROLL CALL THE ABSENT
MEMBERS PARK.
MCCARTY AYE MCCARTY AYE.
SANTIAGO.
SANTIAGO AYE.
THAT'S THIRTEEN ZERO AND THEN
FINALLY A. B. THIRTY NINE ONE
NINETY TWO.
STIR O'DONNELL OPEN THE ROLL
CALL THE ABSENT MEMBERS FOR.
MCCARTY.
MCCARTY I.
SANTIAGO SANTIAGO AYE WALDRON.
WHILE THERE I.
THAT'S FOURTEEN ZERO SO I KNOW
MISS LOW MOAN HAVE A COUPLE THAT
SHE WANTED TO ADD ON TO SO.
WILL FIND THOSE.
LET ME. OPEN NUMBER IT SURE.
SO. WHERE IT?
ITEM NUMBER ONE AB SEVENTEEN
SEVENTY SIX AND OPEN THE ROLE.
BURKE.
LIMON.
SOME ARE NOT VOTING.
NAZARIAN.
NO SIR AND I.
YEAH. THEIR. THAT'S THIRTEEN
ZERO.
THEN ITEM. TO. TO. THE NINETEEN
SIXTY THREEWALDRON OPEN THE
ROLE. LIMON.
YEAH.
LARA AYE THIS AREA.
I WAS VERY I.
THAT'S FIFTEEN ZERO ITEM THREE
NINETEEN SEVENTY ONE SANTIAGO
LIMA.
LIMON NOT VOTING.
THIS VARIANT.
I WAS VERY AYE QUIRK.
THAT'S FOURTEEN ZERO. ITEM
NUMBER FOUR AB TWENTY ONE SIXTY
SEVEN MISTER CHAN.
BACK TO ITEM NUMBER THREE.
MISS LIMON CHANGES HER VOTE TO.
AND I.
FROM VOTING AYE LEMOND AYE.
FIFTEEN THAT MAKES AT FIFTEEN
ZERO.
I'M NUMBER FOUR TWENTY ONE SIXTY
SEVEN.
NOT.
LAMAR AYE THIS AREA.
PLAY WITH SIXTY SEVEN I. MISS
HEARING AYE FIFTEEN THAT'S
FIFTEEN ZERO.
AB TWENTY ONE SEVENTY FOUR ITEM
NUMBER FIVE LET'S CONSENT
THAT'S CONSENT I'M SORRY CONSENT
EARLY.
MAMA HAD CAMANCHE AYE THIS AREA.
THIS CASSETTE SO IT SO TWENTY
ONE SEVENTY FOUR TWENTY THREE
NINETY THREE TWENTY FOUR NINETY
WESTERN THIS AREA FIFTEEN.
FIFTEEN ZERO ON CONSENT.
TWENTY SEVEN EIGHT TEAM WAS IT
WAS TAKEN OUT MASS.
ITEM NUMBER FIFTEEN.
YEAH LOOK.
COULD KEEP.
SO WE'RE YEAH WE'RE GOING TO
WE'RE GOING THROUGH THAT ORDER
SO TWENTY ONE SEVENTY A I'M
SORRY.
WE WERE ON TWENTY ONE SEVENTY
EIGHT AT FIFTEEN FIFTEEN TWENTY
ONE THIRTY FIFTEEN. TWENTY EIGHT
THE NEXT ONE A GRAZE TWENTY TWO
OR THREE IS FIFTEEN ZERO.
.
TWENTY THREE TWENTY EIGHT A
MISTER NAZARIAN SPELL. LAMONT.
LIMON I.
THAT'S FIFTEEN ZERO.
THEN A TWENTY FOUR NINETY NINE
MISTER ARAMBULA DR ARAMBULA.
RUINS THEIR.
AND THAT IS WHERE.
AND WHERE I GET.
YEAH THE NEXT ONE IS I GET CURRY
ON TWENTY FIVE SEVENTY SIX.
LIMON MUSLIM OWNERS AYE. AYE.
THAT'S FIFTEEN ZERO.
TWENTY SIX.
TWENTY SIX SEVENTY FOUR AFFECT
YOUR CAREER.
MOST. LIMON I.
THAT'S PRETTY FOURTEENTH ZERO.
ITEM NUMBER.
.
TWENTY SEVEN EIGHTEEN IS VOTED
WAS PUT ON TWENTY SEVENTEEN.
OKAY.
ITEM NUMBER A SIXTEEN TWENTY
NINE THIRTY FIVE.
JUST DON'T HAVE ME. HERE
PERMITTING THERE ARE NONE HERE
OKAY.
THAT MISTER BERMAN TWENTY NINE
FORTY ONE.
OKAY AND MISTER O'DONNELL.
FOR.
RODRIGUEZ I REQUEST TO HELP HE
WAS NOT VOTING. WAIT NO ON HIM
WHEN HE WAS AYE SIXTY ONE YES HE
DID VOTE YES OKAY FOURTEEN TO HE
MOVED A BILL THAT'S RIGHT.
THAT IS FOUR. FOURTEEN ZERO.
AND THEN FINALLY AB THIRTY ONE
NINE TWO.
O'DONNELL.
OKAY THAT IS SO FOURTEEN ZERO.
SO WITH THAT WE WILL GO AHEAD
AND THAT.
WELL YES.
I JUST WANTED TO MAKE SURE THAT
WE ALL GOT TO WISH THAT CHAIR
AND I HAVE THREE VERY IF THEY.
HOW IF SUSPEND THIS VERY THING
NO?
KALRA RAFN