AHEAD AND GET STARTED WITH OUR
HEALTH COMMITTEE HERE MEETING
HERE THIS AFTERNOON.
SO AS YOU GUYS SO.
WE HAVE SOME ANNOUNCEMENTS
BEFORE WE BEGAN.
FIRST OF ALL -- AS HIS ART ARE
STANDING POLICY THE COMMITTEE WE
WILL HEAR TWO WITNESSES PER SIDE.
WITH A TIME LIMIT OF THREE
MINUTES EACH ADDITIONAL
WITNESSES WILL BE ASKED TO STATE
ON THEIR NAME AN ORGANIZATION --
ONLY FOR THE FOR THE RECORD AND
FOR THE ASKED FOR THE POSITION
OBVIOUSLY WE HAVE SOME BILLS A
PROPOSED FOR THE CONSENT
CALENDAR TODAY.
A PROPOSED FOR CONSENT ARE ITEMS
NUMBER ONE SB ONE TWENTY NINE BY
DR PAN ITEM NUMBER FIVE SB TWO
EIGHTY NINE BY SENATOR ARCHULETA.
ITEM NUMBER SIX SB THREE TWENTY
FIVE BY A SENATOR HILL ITEM
NUMBER SEVEN SB THIRTY THREE
THIRTY ONE BY SENATOR HER TADO.
ITEM NUMBER TEN SB THREE EIGHTY
NINE I BY SENATOR HERTZBERG AND
ITEM NUMBER FOURTEEN SB FIVE
EIGHTY THREE BY SENATOR
JACKSON'S SO WE WITH INSPIRED
THAT WE ACTUALLY DO HAVE BILLS
TO HEAR.
SO -- WILL GO AHEAD AT THIS ONCE
WE HAVE AN AUTHOR -- WE WILL --
CALLING ALL SENATE AUTHORS.
WE WILL WAS SAYS WE HAVE A
SENATE AUTHOR WE WILL CONFIRM
CAN -- CAN BE WITH THE HEARING
THANK YOU
WE HAVE A SWIM A
QUORUM COULD YOU MIND COURT
CALLING THE ROLE PLEASE.
WHAT HERE MAYES?
AGUIAR-CURRY YEAH BIGELOW HERE
BONTA.
BURKE CARRILLO.
FLORA LIMóN OWN.
MCCARTY NAZARIAN RAMOS.
RODRIGUEZ [inaudible]
SANTIAGO [inaudible]
WALDRON.
SO WE DO HAVE A QUORUM -- WE DO
HAVE A CONSENT CALENDARS IF
ANYBODY'S -- WILLING TO MOVE THE
CONSENT CALENDAR CAN SET -- SO
WE HAVE A MOTION BY I DON'T KNOW
WHO IN A SECOND BY AND I DON'T.
MISS CARILLO MISC AG MISS.
WITH WHAT GIVE MISS CARILLO ONE
WILL GIVE MISTER TO GO THE OTHER.
ALL RIGHT SO -- SO THE CONSENT
CALENDAR CONSISTS OF ITEM NUMBER
ONE SB ONE TWENTY NINE PAN AT
THAT NUMBER FIVE SB TWO EIGHTY
NINE OR TO LEAD A ITEM NUMBER
SIX SB THREE TWENTY FIVE HILL.
I DON'T NUMBER SEVEN SB THREE
THIRTY ONE HER TADO I REMEMBER
TEN SB THREE EIGHTY NINE
HERTZBERG AND ITEM NUMBER.
FOURTEEN SB FIVE EIGHTY THREE
JACKSON MADAM SECRETARY PLEASE
CALL THE ROLL.
WOULD.
WOULD AYE MAYES.
AGUIAR-CURRY AGUIAR-CURRY I
BIGELOW BIGELOW AYE BONTA
[inaudible]
BURKE.
CARILLO.
CARILLO AYE FLORA FLORA AYE
LIMóN.
MCCARTY MCCARTY AYE NAZARIAN.
FROM MOST PROBLEMS I RODRIGUEZ.
SANTIAGO.
WALDRON.
WALDRON AYE.
SO I HAD EIGHT VOTES -- THE
SECOND IS PASSED AND WE'LL JUST --
WAIT FOR SENATOR SO DIFFICULT
IT'S ANYONE
[inaudible]
AND THREE WE HAVE A COUPLE OF
BILLS BEFORE US ITEM NUMBER
THREE TWENTY TWO TWENTY SEVEN IS
TO TAKE THAT ONE FIRST.
OKAY THANK YOU VERY MUCH.
ALL RIGHTS WILL GOOD AFTERNOON
MISTER CHAIR AND MEMBERS I WOULD
FIRST LIKE TO TAKE THANK YOU AND
YOURSELF FOR YOUR WORK ON THIS
BILL IS MUCH APPRECIATED -- I
WILL BE ACCEPTING THE COMMITTEE
AMENDMENTS SUGGESTED ON PAGE
EIGHT OF THE COMMITTEE AND
ALICE'S.
AS YOU REMEMBER MAY REMEMBER
SEVERAL OF YOU SAW A SIMILAR
VERSION OF THIS BILL LAST YEAR
SB TWELVE EIGHTY EIGHT WHICH WAS
UNFORTUNATELY VETOED BY THE
GOVERNOR.
NURSE TO PATIENT RATIOS ARE
CRITICALLY IMPORTANT FOR BOTH
THE COUNT WAS PATIENTS WHO SEE
KAREN HOSPITALS AS WELL AS THE
NURSES WHO WORK HERE IN
CALIFORNIA.
SB TWO TWO SEVEN EMPOWERS THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH.
CD PH.
I'M TO ENSURE PATIENT SAFETY BY
ENFORCING MANDATED LONGSTANDING
NURSE TO PATIENT RATIOS AND
FINING HOSPITALS THAT REPEATEDLY
BREAK THE STANDARDS.
FROM 200-082-2000 SEVENTEEN
THERE WERE A TOTAL OF SIX
HUNDRED AND THIRTY FOUR OUT OF
RATIO DEFICIENCY ALLEGATIONS
REPORTED TO C. T. CD PH.
UNFORTUNATELY THE DEPARTMENTS
PRESENT ENFORCEMENT MEASURES ARE
SIMPLY NOT ENOUGH CURRENTLY THE
DEPARTMENT CONDUCTS S. M.
INSPECTIONS EVERY THREE YEARS.
TO ENSURE THE HOSPITALS ARE
COMPLYING WITH THE LAW THIS
PERIODIC CHECK AS FAR TOO
INFREQUENT AND ALLOWS HOSPITALS
TO PREPARE BEFORE TWO CD PH
OFFICIALS CONDUCT THEIR
INSPECTIONS.
SB TWO TWO SEVEN WOULD ADDRESS
THIS PROBLEM BY REQUIRING THAT
THE DEPARTMENT CONDUCT
UNANNOUNCED VISITS TO INSPECT
FOR COMPLIANCE WITHIN THEIR
STAFFING RATIOS.
THIS MEASURE WOULD ALSO EMPOWER
THE DEPARTMENT TO ENFORCE THE
STAFFING REQUIREMENTS WITH FINES
IN CASES WHERE THOSE RATIOS HAVE
BEEN VIOLATED.
SB TWO TWO SEVEN IS CRITICALLY
IMPORTANT SO THAT WE CAN PROTECT
PATIENT SAFETY.
AND THE SAFETY HEARING
CALIFORNIA HERE WITH ME IN
SUPPORT IS GILBERT TEASED THE
PRESIDENT OF SEIU LOCAL ONE TWO
ONE ARE IN.
MARK WINDOWS OF WITH SCA YOU AND
FAITH CONCEPCION WITH UNIACKE.
THAT RIGHT.
OKAY VERY GOOD.
THANK YOU SO IT TOTAL SIX SHE OF
ALL THREE PLANNING TO SPEAK OUT
OF TOTAL SIX MINUTES OKAY TOTAL
OF SIX MINUTES.
OKAY OKAY OKAY THANK YOU.
THANK YOU MISTER CHAIRMAN AND
MEMBERS -- AS JUST SAID MY
NAME'S GILBERTESE AND I'M THE
PRESIDENT OF SEIU LOCAL ONE TO
ONE OR IN A UNION REPRESENTS
REGISTERED NURSES THROUGHOUT
SOUTHERN CALIFORNIA.
I'M ALSO AN OPERATING ROOM NURSE
AT NORTHRIDGE HOSPITAL MEDICAL
CENTER AND IT BECAME A NURSE
THIRTY SIX YEARS AGO BECAUSE I
WANTED TO HELP.
THE SICK TO CARE FOR THE SICK
AND THE RUNNABLE.
WHEN I STARTED WORKING AS A
NURSE'S AIDE THE PRIMARY FOCUS
OF HOSPITALS WAS PATIENT CARE?
TODAY IT SEEMS THAT THEIR
PRIMARY FOCUS IS PROFIT.
HOSPITALS ARE NOTORIOUS FOR
BREAKING THE LAW IN ORDER TO
SAVE A BUCK.
CALIFORNIA IS THE ONLY STATE IN
THE NATION WITH NURSE TO PATIENT
RATIOS LAW.
AND YET HOSPITAL'S ALWAYS
BREAKING IT EACH TIME THEY PUT A
NURSE OUT OF RACIAL NOT ONLY ARE
THE BREAKING THE LAW.
BUT MORE IMPORTANTLY THEY ARE
PUTTING PATIENT SAFETY AT RISK.
EVEN THOUGH THE NURSE TO PATIENT
RATIO LAW WAS PASSED IN NINETEEN
NINETY NINE THERE HAS NEVER BEEN
AN ENFORCEMENT MECHANISM
MECHANISM.
IMPLEMENTED FOR IT.
AND THAT IS WHY SOME HOSPITALS
HAVE GONE SO FAR AS TO SAY TITLE
TWENTY TWO IS A GUIDELINE OUR
SUGGESTION.
BUT NOT ACTUAL ALL.
IN FACT SOME HAVE BEEN BOLD
ENOUGH TO ASK NEW HIRES IF THEY
WOULD BE WILLING TO GO OUT A
RACIAL.
I EQUATE THE RATIOS TO SPEAK.
IF WE DON'T HAVE PENALTIES FOR
VIOLATING SPEED LIMITS DRIVERS
WOULD HAVE NO INCENTIVE TO
FOLLOW THEM.
AND THEN THEY'LL CONTINUE TO
SPEED UNTIL ONE DAY SOMEONE GETS
INJURED OR WORSE DICE.
SO IF WE HAVE SPEEDING LAWS WHEN
FORCE BUT MECHANISMS THAT
PROTECT THE PUBLIC AGAINST
RECKLESS DRIVERS.
WHY DON'T WE HAVE THE SAME TO
HOLD HOSPITALS ACCOUNTABLE FOR
BREAKING THE LAW?
THE NURSE TO PATIENT RATIO
[inaudible]
KAT CURRENTLY.
WHAT IS THE VIOLATED A NURSE TO
PATIENT LAWS ARE NEARLY
NONEXISTENT?
IN FACT MOST OF THE TIME WHEN A
HOSPITAL IS FOUND TO BE IN
VIOLATION OF THE NURSE TO
PATIENT RATIOS.
CITY PH GIVES THEM CITATIONS
KNOWN AS PLANS OF CORRECTION.
SURPRISINGLY THERE IS NO LIMIT
ON HOW MANY PLANS OF CORRECTION
A HOSPITAL CAN GET.
THESE RATIOS AND ARE INTENDED TO
KEEP OUR PATIENTS SAFE AND
PRODUCE THE MOST OPTIMAL HEALTH
OUTCOMES FOR THEM.
AND THAT IS WHY I'M HERE TODAY
TO ASK FOR YOUR AYE VOTE ON SB.
TWO TWO SEVEN THE NURSESHERE
TODAY THAT WILL SPEAK IN SUPPORT
OF THIS MEASURE WILL ALSO ATTEST
TO THE IMPORTANCE OF STAFFING
RATIOS.
AND HOW THEY PROTECT THE HEALTH
AND SAFETY OF PATIENTS.
CALIFORNIA NEEDS TO PROTECT OUR
PATIENTS BETTER AND ENSURE THEY
RECEIVE THE HIGHEST QUALITY OF
CARE.
IN FACT I HAVE RECENTLY RECEIVED
AN EMAIL FROM A NURSE WHO WORKS
IN THE NICK YOU.
NEONATAL INTENSIVE CARE UNIT
WHICH IS THE NEWBORNS.
MAKING US FOR HELP.
THESE NURSES THAT CARE FOR THE
MOST VULNERABLE OF THE
VULNERABLE PATIENTS SICK BABIES.
THERE ARE TIMES THAT THE
HOSPITAL SO OUT OF RATIO THAT A
NURSE IN THAT UNIT HAS ONE TO
FOR A ONE TO SIX WHEN PATIENTS
ARE IT SHOULD BE.
AT THE MOST WANTED.
TO BUT WHAT OUT ACTUAL PENALTY
PENALTIES THE HOSPITAL WILL
CONTINUE TO PUT THESE BABIES AT
RISK [inaudible]
IMAGINE.
THAT WAS YOUR DAUGHTER YOUR SON
YOUR NIECE OF YOUR NEPHEW OR
YOUR GRANDCHILD AND THAT I SEE
YOU.
SB TWO TWO SEVEN WOULD CREATE A
GREATER DISINCENTIVE BY
INSTITUTING REPEAT OFFENDER
LANGUAGE HOSPITALS THAT WILL
FULLY AND CONSTANTLY VIOLATE
NURSE TO PATIENT RATIOS.
WOULD NOW FACE FINES DEPENDING
ON HOW OFTEN THEY VIOLATE TITLE
TWENTY TWO REGULATIONS LASTLY.
SB TWO TWO SEVEN WOULD ALLOW
CITY PH INVESTIGATORS TO CONDUCT
UNANNOUNCED VISITS SO THAT THESE
REPEAT OFFENDERS WON'T BE ABLE
TO SKIRT THE LAW BEFORE THE
STATE CAN INVESTIGATE VIOLATIONS.
AS THE NURSES WE TOOK IN -- TO
PROTECT AN ADVOCATE FOR OUR
PATIENTS.
AS I HELD SENATE COMMITTEE
HEARING THE HOSPITAL ASSOCIATION
BLAME NURSES FOR BEING OUT OF
RACIAL BECAUSE THEY WERE STUCK
IN TRAFFIC OR BECAUSE THE NURSE
LEAVES THE FLOOR TO GO TO THE
BATHROOM OR TO LACTATE.
AS A NURSE MYSELF I CAN TELL YOU
FIRSTHAND IF THE NURSES RUNNING
LIKE THE CURRENT NEWS CAR CARING
FOR THE PATIENT WILL WHITE.
WE DON'T JUST LEAVE THAT'S CALL
PATIENT ABANDONMENT AND WE TOOK
AN OATH AGAINST OUT.
SB TWO TWO SEVEN IS SOUND POLICY
OUTLINES WHAT ARE OPEN.
IN ADDITION I'M NOT SURE OF THE
HOSPITAL'S AWARE BUT NURSES ARE
HUMAN BEINGS.
TO AND WE NEED TO USE THE
RESTROOM JUST LIKE ANYONE ELSE.
IN FACT BY LAW A HOSPITAL IS
SUPPOSED TO ACCOUNT FOR THIS IN
THEIR DAILY STAFFING PLAN ON
BEHALF.
OF ALL THE NURSES OF S. YEAH YOU
WANT TO ONE ARE AND AND THE
ROUTE CALIFORNIA I RESPECTFULLY
URGE YOU TO PASS.
SB TWO TWO SEVEN TO PROTECT
PATIENTS THANK YOU -- GOT TWO
MINUTES [inaudible]
SORRY.
GOOD AFTERNOON CHAIRMAN WOULD IN
MEMBERS OF THE HEALTH COMMITTEE
I WANT TO THANK YOU FOR THE
OPPORTUNITY SPEAK TO YOU TODAY
IN SUPPORT OF SENATE BILL.
TWO TWO SEVEN MY NAME IS FAITH
CONCEPCION I WORK IN CRITICAL
CARE I AM A REGISTERED NURSE.
I'M ALSO A MEMBER OF THE UNITED
NURSES ASSOCIATION OF CALIFORNIA
IN THE I SEE YOU MY PATIENTS ARE
CRITICALLY ILL AND OFTEN DEALING
WITH EXTENSIVE INJURIES OR LIFE
THREATENING DISEASES.
OUR WORK ENVIRONMENT IS FAST
PACED IT'S INTENSE AND IT'S
STRESSFUL AS A NURSE AND I SEE
YOU -- WERE REQUIRED TO BE
HIGHLY VIGILANT OF OUR PATIENTS
MONITORING FOR ANY CHANGES
BIGGER SMALL THAT COULD
POTENTIALLY AFFECT THEIR OUTCOME.
THIS IS ALSO THE SAME SENTIMENT
NURSES IN OTHER UNITS HAVE FOR
THEIR PATIENTS MANY TIMES WE
FACE SITUATIONS THAT MAKE IT
DIFFICULT FOR US TO SPEND TIME
WITH THEIR PATIENTS DUE TO THE
HOSPITAL'S UNDERSTAFFED BEING.
LET ME GIVE YOU AN EXAMPLE WE
COME IN WITH THE EXPECTED RATIO
OF TWO PATIENTS PER NURSE OR
EVEN ONE PATIENT PER NURSE A
PENDING ON THE SEVERITY OF THEIR
ILLNESS.
BUT ALMOST EVERY DAY WE STRUGGLE
TO HAVE THE PROMISED BREAK OF
THIRTY MINUTES AND TWO TEN
MINUTE BREAKS ONE IN THE MORNING
AND ONE IN THE EVENING.
DUE TO UNDER STAFFING SOMETIMES
WERE ASKED TO COVER ONE ANOTHER.
PATIENTS WHILE THE OTHER NURSE
GOES TO THEIR BREAK IN ADDITION
THERE ARE SITUATIONS.
WHERE A NURSE WILL COVER TO
NURSES MEANING FOR PATIENTS SO
HE'S COVERING FOR PATIENTS
PUTTING HIM OR HER AT FOR
PATIENTS THIS IS DANGEROUS
ESPECIALLY NICE YOU AND ANYTHING
CAN HAPPEN IN TEN MINUTES LET
ALONE THIRTY MINUTES?
THIS IS DANGEROUS FOR ME AS A
NURSE AND FOR THE PATIENTS AND
SIGNIFICANTLY IMPACT THE QUALITY
OF CARE THAT I'M ABLE TO PROVIDE
TO MY PATIENTS.
THIS IS A STORY NURSES KNOW TOO
WELL BE SURE STAFF AND
ULTIMATELY BEING FORCED TO
SACRIFICE QUALITY OF CARE
HOSPITALS ON ACCIDENTALLY SHORT
STAFF IT'S A CALCULATED RISK THE
ADMINISTRATION TAKES HOPING NO
SERIOUS HARM HAPPENS. TO THE
PATIENT BECAUSE ONLY THEN CAN A
HOSPITAL BE FINE.
CURRENTLY CALIFORNIA DOESN'T
HAVE A PENALTY FOR HOSPITALS WHO
VIOLATE OUR STATE RACIAL ALL
HOSPITALS KNOW THIS FACT TO WELL
AN UNDERSTAFFED CONTINUOUSLY.
SO WHEN THIS HAPPENS WE SIR
BREAKS WE MISS OUR LUNCH WE
MISSED AN OPPORTUNITY BREATHING
COMPOSE OURSELVES IN A STRESSFUL
ENVIRONMENT.
AND IT'S NOT FAIR THAT WE COME
TO WORK AND GIVE IT 1100% IN
HOSPITALS ON STAFF 1100%.
SO WE WANT -- TO SEE STAFFING
EVERYWHERE IN SB TWO TWO SEVEN
IS THE FIRST STEP IN THE RIGHT
DIRECTION WE RESPECTFULLY ASK
YOU TO VOTE YES.
THANK YOU VERY MUCH SO OTHER
WITNESSES IN SUPPORT JUST YOUR
NAME AND ORGANIZATION PLEASE.
MARY MILLER SERVICE LIKE MANY
HOSPITAL AT FACILITY AND I
STRONGLY SUPPORT THIS BILL THANK
YOU.
JENNIFER LAURIE ARE IN KINDRED
HOSPITAL OF SOUTH BAY.
I SUPPORT THIS BILL THANK YOU.
MONIQUE NICOLE HERNANDEZ
RIVERSIDE COMMUNITY HOSPITAL ACA
AND I STRONGLY SUPPORT THIS BILL
THANK YOU.
CAR WORRY REGISTERED NURSE --
LEC USC MEDICAL CENTER I
STRONGLY SUPPORT THIS BILL THANK
YOU THANK YOU.
ROXANNE GOAL REPRESENTING THE
AMERICAN NURSES ASSOCIATION
CALIFORNIANS SUPPORT THANK YOU.
THANK YOU MISTER CHAIRMAN VERS
MEGAN SUPERS ON BEHALF OF THE
CALIFORNIA PROFESSIONAL
FIREFIGHTERS AND SUPPORT THANK
YOU.
MISTER CHAIR MEMBER SERRA FLOCKS
CALIFORNIA LABOR FEDERATION IN
SUPPORT THANK YOU.
MISTER CHAIR MEMBERS MATT BROWN
BE AFTER THE TEAMSTERS AND
ENGINEERS AND SCIENTISTS OF
CALIFORNIANS SUPPORT THANK YOU
THANK YOU.
LOCAL BURGER CLOSE REGISTERED
NURSE I'M A MEMBER OF THE UNITED
YOURS IS ASSOCIATION OF
CALIFORNIA IN SUPPORT OF TWO TWO
SEVEN THANK YOU.
STEVEN WEBER AND UP CALIFORNIA
ASKS ME WE SUPPORT THIS BILL.
CATHERINE USE REGISTERED NURSE
DIRECTOR OF SCA UNIVERSAL LINES
OF CALIFORNIANS SUPPORT THANK
YOU.
THE ONE CALIFORNIA SCHOOL NURSES
AND SUPPORT.
THANK YOU VERY MUCH [inaudible]
ANYONE ELSE. THREE ONE IN
OPPOSITION TO THE BILL.
GET AFTERNOON CATHERINE'S CARBON
IN THE CALIFORNIA HOSPITAL
ASSOCIATION WE ARE IN OPPOSITION
TO THE BILL IMPRINT AND ARE
REVIEWING THE AMENDMENTS HOWEVER --
OUR HOSPITALS DO WORK DAILY TO
MEET THE RATIOS AND WORK WITH
OUR NURSES I'M TO MEET THE NEEDS
OF THE PATIENTS.
THE LAW IS AN OUT ALL TIMES LAW
AND WE DO STRUGGLE WITH THAT AT
ALL TIMES BECAUSE IT'S BASED ON
THE PATIENTS ACUITY.
AND A CUTIE FOR PATIENT CAN
CHANGE AT ANY GIVEN TIME IT'S A
DYNAMIC SITUATION ON THE FLOOR.
AND AS WE MOVE NURSES TO MEET
THE REQUIREMENTS -- THERE ARE
TIMES WHEN WE'RE STRUGGLING TO
GET THERE AT ALL TIMES BUT WE
PUT THE PATIENT FIRST -- AS OUR
NURSES DO AS WELL -- ARE NURSES
TO CALL IN SICK WE HAVE ABOUT A
ONE IN FIVE TWO ONE IN FOR
INSTANCE WHETHER COLIN SICK AND
WE DO HAVE FLOW POOLS AND ACTION
NURSES AND BREAK NURSES.
AND THEY'RE STILL SITUATIONS
WHERE -- WE MAY FIND OURSELVES
OUT OF RATIO IN AN EFFORT TO PUT
A PATIENT FIRST WE MAY NOT BE
ABLE TO GET A BREAK -- IN SOME
CIRCUMSTANCES EVEN WITH THE
VARIOUS BACKUP POOLS ARE
HOSPITALS EMPLOY.
I'M WHEN WE LOOK AT THE BILL AND
NOW THE ANALYSIS STATED -- OVER
THE LAST TEN YEARS CD PH HAS --
HAD WHAT ABOUT 1% OR LESS THAN
1% OF VIOLATIONS WE THINK ABOUT
THE THIRTY FIVE MILLION HOURS
THAT HAVE BEEN WORKED OVER THE
LAST TEN YEARS -- BUT WE ARE
LOOKING AT THIS BILL -- AND THE
AMENDMENT OFFERED BY THE
COMMITTEE -- TO SEE IF THEY
ADDRESS THE DYNAMIC SITUATIONS
WE'VE BEEN TALKING THROUGH -- I
THINK OUR CONCERN IS IS THAT --
HOUSE WE PUT THE PATIENTS FIRST
AND HOURS ARE HOSPITAL'S WORK IN
GOOD FAITH -- TO DO THAT THAT
THEY'RE NOT IN TURN PENALIZED AT
RATES THAT ARE SIMILAR TO OR OR
BELOW THE RATE WRITTEN WHICH WE
CURRENTLY HAVE THE SYSTEM --
WHICH USES PATIENT HARM SO FOR
EXAMPLE IF YOU HAD A MEDICATION
AIR -- AS STATED THE ANALYSIS IT
WOULD BE A SEVENTY FIVE THOUSAND
DOLLAR PENALTY -- BUT IF YOU HAD
A NURSE THAT NEEDED TO ADDRESS A
PATIENT'S ACUITY -- AND WE THEN
WERE HAD A GAP IN THAT RATIO
WOULD BE A THIRTY THOUSAND
DOLLAR PENALTY SO AS WE LOOK AT
FOR THE SECOND VIOLATION OF THE
LOOK AT THIS BILL WE THINK ABOUT
THE CURRENT SYSTEM.
WHERE THERE'S TO PUT DUPLICATION
IN THE SYSTEM I'M IN THE CURRENT
SYSTEM AND IN THIS BILL AND THEN
HOW WE ADDRESS THAT FINE --
AMOUNT SO WE ARE LOOKING AT THE
AMENDMENTS TO IT TOO I'M SEE IF
THEY ADDRESS THE CONCERNS OF THE
DYNAMIC ENVIRONMENTS IN WHICH WE
WORK AND WILL CONTINUE.
TO ADDRESS THE THOSE CONCERNS.
THANK YOU VERY MUCH.
OTHERS IN OPPOSITION.
AND HOW THEY GOT IS ALSO WITH
KAISER PERMANENTE HEY WE'RE
REVIEWING THE AMENDMENTS AS WELL
BUT AT THIS POINT WE REMAIN IN
OPPOSITION THANK YOU THANK YOU.
JONATHAN CLAY ABOUT THE SCRIPTS
HELP STUDIO -- RETURNING THE
MINUTES AND THEN OPPOSITION
STILL THANK YOU.
I AM WORKING WITH THE
ASSOCIATION OF CALIFORNIA
HEALTHCARE DISTRICTS IN THE SAME
POSITION WHERE REVIEWING THE
AMENDMENTS THAT REMAIN OPPOSED
THANK YOU.
MEGAN OVER ON BEHALF THE UNITED
POSSIBLE ASSOCIATION DID OUT TO
THE POSITION OF MY COLLEAGUES
THANK YOU.
KAREN CIRCUITS YOU CAL CHAMBER
AND WITH THE SAME SAME POSITION
OR POST.
MAYOR MARTIN WITH THE CALIFORNIA
CHILDREN'S HOSPITAL CESSATION
SAME WE ARE OPPOSED IN LOOKING
AT THE AMENDMENTS THANKS THANK
YOU. TWENTY DELGADO I'M WE HAVE
THE DISTRICT HOSPITAL LEADERSHIP
FORUM SAME POSITION LOOKING AT A
MINIMUM THANK YOU.
THANK YOU.
MY SHEPHERD ON BEHALF OF
STANFORD HEALTHCARE SAME AND IN
OPPOSITION THANK YOU.
AARON TAYLOR ABOUT THE MEMORIAL
CARE HEALTH SYSTEMS ALSO IN
OPPOSITION AND REVIEWING THE
AMENDMENTS.
MANUALLY ON BEHALF OF SUTTER
HEALTH IN OPPOSITION
[inaudible]
ANYONE ELSE.
SONORA BRING BACK TO THE
COMMITTEE QUESTIONS OR COMMENTS
FROM THE COMMITTEE [inaudible]
MISS KOREA.
THANK YOU SENATOR LEYVA FOR
BRINGING -- THIS BILL BACK TO
BACK TO LIFE I'M PROUD TO JOIN
AS A CO AUTHOR -- TO SHARE VERY
QUICKLY -- A YEAR OR SO AGO MY
GRANDMOTHER WAS VERY SICK AND
CONSTANT VISITS TO THE
HOSPITAL'S TO ACTUALLY IN MY
DISTRICT.
WHERE I SAW NURSES RUN AROUND --
WHAT APPEARED TO BE A LACK?
OF STAFF -- AS WE TRY TO ASK
QUESTIONS THEY WERE VERY
SUPPORTIVE AND HELPFUL.
BUT I ALSO FELT THAT -- THEY
NEEDED A LITTLE BIT MORE SUPPORT --
I'M GLAD.
THAT THE HOSPITALS ARE IN
COMMITTEE ARE IN DISCUSSION AS
TO HOW TO ADDRESS THESE ISSUES.
I THINK EVERYONE IN THE ROOM
WANTS TO KNOW THAT THE SAFETY.
OF OUR FAMILY MEMBERS WHETHER
IT'S FAMILY MEMBERS OR OUR
SELVES IS THE PRIORITY.
BUT THAT CAN'T HAPPEN IF NURSES
ARE OVER WORKED.
AND IF THERE'S AN UNDERSTAFFED
THE STAFF.
SO I HOPE THAT THERE'S A
RESOLUTION I HOPE THAT WE CAN
COME TOGETHER TO REALLY FULLY --
GET TO WHERE WE NEED TO BE ON
THIS BILL SO THAT THE GOVERNOR
SIGNED SAID AND ULTIMATELY.
NURSES HAVE -- A NURSE TO
PATIENT RATIO THAT IS -- TO THE
CORE OF WHAT NURSES DO WHICH IS
TAKE CARE OF PATIENTS.
AND MAKE SURE THAT THE FAMILY
MEMBERS THAT ARE THERE WITH
THEIR WITH THE PATIENTS HAVE THE
RESOURCES AND OPPORTUNITIES TO
DISCUSS THE CASES.
OF THE FAMILY MEMBERS SO THAT WE
FEEL SECURE.
THAT THEY ARE BEING TAKEN CARE
OF AND I THINK THE HOSPITAL'S
PLAYED A CRITICAL ROLE.
IN MAKING SURE THAT THAT
HAPPENED SO I'M I'M GLADLY
SUPPORTING THIS BILL AND I HOPE
THAT IT MOVES FORWARD AND YOU
COME TO A RESOLUTION.
THANK YOU.
THANK YOU MISTER MCCARTY.
THANK YOU DOCTOR WOULD -- I I
SUPPORT THE BILL AYE AYE BUT IT
FOR LAST YEAR THERE IS ONE WHEN
ISSUE I KNOW THAT -- THE
REPRESENTATIVES I'M NOT SURE IF
IT'S BEEN ADDRESSED BY THE
AMENDMENTS THAT YOU TOOK.
LAST YEAR.
THERE WAS AN ELEMENT WITH THE
PENALTIES CORRECT THEIR WEIGHT
THERE WE TOOK OUT BEFORE IT WENT
TO THE GOVERNOR.
AND HE VETOED IT.
AND IS THE VERSION THAT WE'RE
PRESENTING TODAY EVEN WITH THE
COMMITTEE AMENDMENTS TO THAT
STILL HAVE THAT PIECE IN THERE.
IT DOESN'T IT DOESN'T IT THIS IS
IT WE'VE LOWERED SIGNIFICANTLY
THE PENALTY AMOUNT THOSE PART OF
THE AMENDMENTS THAT WE TOOK SO
IT'S FIFTEEN THOUSAND AND THIRTY
THOUSAND FOR A SECOND VIOLATION --
AND I DON'T KNOW WHAT THE NEW
GOVERNOR WILL DO THAT'S PART OF
THE REASON WE RE INTRODUCED IT.
ARE YOU ARE YOU PROPOSING ARE
WILLING TO TO GO TO THE
THRESHOLD YOU HAD AT THE BILL
THAT YOU SENT TO THE GOVERNOR
LAST YEAR WERE AT THAT NOW.
WE ARE YES OKAY.
AND THAT'S WITH THE AMENDMENTS
YOU TOOK TODAY THAT IS CORRECT
OKAY.
ALRIGHT THANK YOU YOU'RE WELCOME
[inaudible]
ANYONE ELSE.
SEE NO ONE WOULD YOU LIKE TO
CLOSE CENTER YES THANK YOU VERY
MUCH THANK YOU FOR THE
DISCUSSION I JUST WANT TO POINT
OUT TWO THINGS THAT THE
OPPOSITION RAISED.
I DON'T KNOW IF THE SIX HUNDRED
AND THIRTY FOUR OUT OF RATIO
DEFICIENCIES THAT I MENTIONED
EQUAL THE 1% THAT THEY WERE
TALKING ABOUT.
BUT WHAT I WOULD SAY IS SIX
HUNDRED AND THORPE THIRTY FOUR
OUT OF RATIO DEFICIENCIES THAT'S
A MINIMUM OF SIX HUNDRED AND
THIRTY FOUR PATIENTS SO
SOMETIMES WE LOOK AT THINGS THAT
WE THINK 1% 2% IT SEEMS VERY LOW.
BUT TO ME THOSE ARE SIX HUNDRED
AND THIRTY FOUR LIVES AT A
MINIMUM THAT WERE AFFECTED BY
THOSE OUT OF RATIO --
DEFICIENCIES AND THEN THE SECOND
IS TO ASSEMBLYMEMBER MCCARTY'S
ABOUT THE THE VIOLATIONS YOU
KNOW NGUYEN DOCTOR WOULDN'T I
TALKED ABOUT -- REDUCING THE
AMOUNT ONE OF THE THINGS THAT I
MENTIONED TO HIM WAS I WORRIED
THAT FIFTEEN THOUSAND DOLLARS
WAS NOT ENOUGH AND THAT I WAS
WORRIED THAT HOSPITALS WOULD SEE
IT AS A COST OF DOING BUSINESS.
SO WE FEEL LIKE WE ARE IN A
POSITION WHERE THIS WILL BE SOME
SORT OF A PENALTY THAT WILL THEY
WILL WAKE UP AND NOT WORK A
LITTLE HARDER.
ON MAKING SURE THEY'RE NOT OUT
OF RATIO SOMETHING ELSE THAT WE
TOOK -- ANOTHER AMENDMENT THAT
WE TOOK THAT I THINK IS VERY
IMPORTANT.
IS AN EXEMPTION FOR WHEN NURSES
ARE SIX UNEXPECTEDLY INJURED OR
LATE IT NOW SAYS OF A HOSPITAL
CAN DEMONSTRATE THAT THERE WERE
PROBLEMS EFFORTS MADE. TO
REPLACE THE NURSE AND MAINTAIN
THE REQUIRED STAFFING LEVELS
SUCH AS EXHAUSTING THEY'RE ON
CALL LISTS AND UTILIZING THE
CHARGE NEW NURSE THEN THE
HOSPITAL WOULD NOT BE PENALIZED.
SO I THINK THOSE ARE AMENDMENTS
THAT I HOPE WILL GO A LONG WAY
IN ALLEVIATING THE FEARS OF THE
OPPOSITION AT THE END OF THE DAY
WERE LOOKING TO TAKE CARE OF
PATIENTS. FOR ALSO LOOKING TO
TAKE CARE OF OUR NURSES AS MANY
OF YOU HAVE HEARD ME SAY --
PEOPLE WHO BECOME NURSES DON'T
DO IT NECESSARILY FOR THE MONEY
THEY DO BECAUSE THEY TRULY CARE
ABOUT PEOPLE AND THEY WILL SKIP
BREAKS THEY WILL SKIP LUNCHES
BECAUSE THEY'RE WORRIED ABOUT
THE SAFETY OF THEIR PATIENTS.
SO WE HOPE THAT THIS BILL WILL
MAKE THINGS BETTER FOR EVERYONE
AND WITH THAT I RESPECTFULLY ASK
FOR AN AYE VOTE.
THANK YOU VERY MUCH AND THANK
YOU FOR WORKING WITH US --
SENATOR MY PLEASURE THE BILL
DOES ENJOY DO PASS
RECOMMENDATION.
AND LOOKING FOR A MOTION A
MOTION BY MISS CARILLO THANK YOU.
DURING THE SECOND THE SECOND BY
MISTER MCCARTY.
THE MOTION IS TO PASS AS AMENDED
TO APPROPRIATIONS -- OUT OF
SECRETARY PLEASE CALL THE ROLL
WHAT I WOULD AYE MAYES
[inaudible]
AGUIAR-CURRY.
AGUIAR-CURRY AYE BIGELOW.
BONTA.
BURKE CARILLO.
CARILLO AYE FLORA.
LIMóN.
MCCARTY.
MCCARTY I'D NAZARIAN.
SORRY SINCE I CAME IN LATE I
JUST WANTED TO SAY AT LEAST I'M
HAPPY TO SUPPORT IT NOW BUT I'M
LOOKING FORWARD TO SEEING.
HOW MUCH MORE WE CAN WORK WITH
THE OPPOSITION BECAUSE OF THE
TENUOUS MISS NATURE OF HOW
SOMETIMES HOSPITALS CAN?
BE PAYING FOR SOMETHING THAT --
THAT THAT THAT.
HE IS OUTSIDE OF THEIR CONTROL
SO.
I FOR NOW AND I APOLOGIZE BUT
THANK YOU FOR THE OPPORTUNITY TO
SAY THAT THANK YOU.
IS THERE AND I RAMOS.
RAMOS NOT VOTING RODRIGUEZ
SANTIAGO.
WALDRON.
YOU HAVE FIVE VOTES WILL LEAVE
THE ROLE OPEN FOR OTHER WILL BE
THE BILL ON CALL EXCUSE ME FOR
FOR OTHER MEMBERS TO ADD ON SO.
SO THANK YOU THANK YOU VERY MUCH
WE HAVE THIS YEAR ANOTHER BILL.
THE SECOND BEST BE [inaudible]
FIVE SEVENTY FOUR PLEASE.
GOOD AFTERNOON AGAIN MR CHAIRMAN
MEMBERS I AM HAPPY TO BE HERE TO
PRESENT YOU SB FIVE SEVENTY FOUR
AND I DO WANT TO THANK THE CHAIR
AND THE COMMITTEE AGAIN FOR YOUR
HARD WORK ON THIS VERY IMPORTANT
BILL. FOR SEVERAL MONTHS --
WE'VE HAD GOOD FAITH
NEGOTIATIONS WITH THE BILL'S
SPONSORS AN OFFICE OPPOSITION
AND WE HAVE REACHED A COMPROMISE.
WHICH I HAVE TO SAY I'M VERY
PROUD OF EVERYONE WHO'S BEEN
WORKING ON THIS AS WE KNOW IN
THIS -- BUILDING IT'S NOT ALWAYS
EASY TO REACH A COMPROMISE SO I
APPRECIATE THE SPIRIT IN WHICH A
COMPROMISE WAS REACHED.
AND HOW HARD EVERYONE HAS WORKED
TO GET THERE.
WITH THE SPORT THE SUPPORT THE
CHAIR I AM OFFERING THE
FOLLOWING AMENDMENTS TODAY.
DELETE THE DEFINITION OF
INTENTIONALLY ADDED INGREDIENT
WITH NO ADDITIONAL CHANGES TO
THE FRAGRANCE AND FLAVOR
INGREDIENT DEFINITIONS.
THIS THE MAIN AMENDMENT WILL
ALIGN THE DEFINITION OF
INGREDIENTS WITH EXISTING LAW
AND REMOVE ANY CONCERNS OF OVER
REACHING OR IMPRACTICAL.
DISCLOSURE OF INGREDIENTS
COMPONENTS. TO EXTEND THE
IMPLEMENTATION DATE AND
REPORTING FOR COMPLYING WITH THE
BILL'S DISCLOSURE REQUIREMENTS
TO JANUARY.
ONE TWENTY TWENTY ONE THIS
AMENDMENT PROVIDES ADDITIONAL
TIME TO REPAIR FOR
IMPLEMENTATION COMPLAINTS AND
PRODUCT REFORMULATION WITH.
THANKS SIR WITH THESE AMENDMENTS
THE IN THE LEAD INDUSTRY
ORGANIZATIONS HAVE MOVED TO
NEUTRAL. TO DATE WE HAVE WORKED
WITH INDUSTRY TO TAKE TWENTY
SEVEN SIGNIFICANT AMENDMENTS
PLUS TWO ADDITIONAL AMENDMENTS
WHICH I MENTIONED EARLIER.
MEMBERS SB FIVE SEVENTY FOURS A
BALANCED MEASURE THAT EMPOWERS
CONSUMERS PROVIDES APPROPRIATE
BUSINESS PROTECTION AND ADVANCES
PUBLIC HEALTH SPECIFICALLY FIVE
SEVENTY FOUR REQUIRES THE
DISCLOSURE FRAGRANCE AND FLAVOR
INGREDIENTS.
AND PERSONAL CARE PRODUCTS THAT
APPEAR ON DESIGNATED AND
AUTHORITY OF HAZARD CHEMICAL
LIST TO THE DEPARTMENT OF PUBLIC
HEALTH.
THIS BILL VERY IMPORTANTLY DOES
NOT BAN ANY PRODUCT IN GREEN NOR
DOES IT REQUIRE ADDITIONAL
PRODUCT LABELING I THINK THOSE
ARE VERY IMPORTANT ASPECTS.
SB FIVE SEVENTY FOUR PROTECTS
TRADE SECRETS INCLUDING PRODUCT
INGREDIENT FORMULAS SO THAT
WE'RE PROTECTING VALUABLE
RECIPES AND FORMULATIONS.
MEMBERS TODAY IN CALIFORNIA THE
PUBLIC KNOWS MORE ABOUT THE
FRAGRANCE INGREDIENTS AND
CLEANING PRODUCTS THAN THOSE WE
USE TO CLEAN AND SENT OUR BODIES.
PUT ANOTHER WAY WE ACTUALLY KNOW
MORE ABOUT THE FRAGRANCES AND
FLOOR CLEANERS AND DISTRICT THE
DISINFECTANTS THEN OUR SHAMPOOS
DEODORANTS AND BODY SPRAYS.
WE ALSO KNOW VERY LITTLE ABOUT
THE FLAVORS IN CHAPSTICK
MOUTHWASH AND LIP CLASSES I
BROUGHT MY LITTLE FAVORITE
STRAWBERRY FIZZ LIP GLOSS I
WOULD LOVE TO KNOW WHAT.
MAKES IT STRAWBERRY FIELDS.
CURRENTLY.
CURRENTLY NO STATE OR FEDERAL
LAW REQUIRES THE DISCLOSURE OF
FRAGRANCE OR FLAVOR INGREDIENTS
TO CONSUMERS A REGULATORY
AGENCIES NOT EVEN THE FTA.
THIS LOOPHOLE RICK RESULTS AND
LITTLE REGULATORY OVERSIGHT OF
THE SAFETY OF THOSE INGREDIENTS
AND NO WAY TO IDENTIFY THE
CHEMICALS THAT ARE BEHIND THE
WORD FRAGRANCE OR FLAVOR ON THE
LABEL OF BEAUTY AND PERSONAL
CARE PRODUCTS.
THESE THE PRODUCTS YOU USE EVERY
DAY IN THE MORNING AND IN THE
EVENING THOUSANDS OF CHEMICALS
ARE USED TO CREATE THE
FRAGRANCES AND FLAVORS THAT
COMPRISE THE BEAUTY.
AND PERSONAL CARE PRODUCTS SOME
OF THESE CHEMICALS HAVE BEEN
LEAD TO NEGATIVE HEALTH IMPACTS
RANGING FROM ALLERGIC REACTIONS
TO REPRODUCTIVE HARM AND
INCREASED RISK OF BREAST CANCER.
SB FIVE SEVENTY FOUR ONE POWER
CONSUMERS TO MAKE EDUCATED DISS
DECISIONS ABOUT WHICH PRODUCTS
TO USE WITH THEMSELVES THEIR
CHILDREN AND THEIR FAMILIES.
SB FIVE SEVENTY FOUR WILL ENSURE
THAT CALIFORNIA CONTINUES TO BE
A NATIONAL AND GLOBAL LEADER ON
PUBLIC HEALTH.
THIS BILLS BROADLY SUPPORTED BY
LABOR PUBLIC HEALTH
ENVIRONMENTAL MULTI ETHNIC AND
CANCER PREVENT PREVENTION
ORGANIZATIONS.
THIS MEASURE MEASURE IS ALSO
SUPPORTED BY DOZENS OF
BUSINESSES THAT ARE FINDING
SUCCESS IN DISCLOSING FRAGRANCE
AND FLAVOR INGREDIENTS INCLUDING
UNILEVER THE SECOND LARGEST
BEAUTY AND PERSONAL CARE
PRODUCTS.
IN THE WORLD.
HERE WITH ME IN SUPPORT.
IS DOCTOR MEGAN SCHWARTZMAN A
PHYSICIAN AN ENVIRONMENTAL
HEALTH SCIENTIST AT UC
BERKELEY'S UP SCHOOL OF PUBLIC
HEALTH AND AN ADDITIONAL
SUPPORTER WHOSE NAME I DON'T
HAVE A VERY SORRY [inaudible]
PLEASE.
MY NAME IS JANET MIDDLEMAN ON
ONE OF THE BILL'S SPONSORS
BREAST CANCER PREVENTION
PARTNERS AND I'M JUST HERE TO
ANSWER TECHNICAL QUESTIONS AND
DOCTOR SCHWARTZMAN IS GOING TO
TAKE THE FULL FIVE TO SIX
MINUTES.
THAT'S OKAY.
OKAY OR LESS IF YOU.
GOOD AFTERNOON ASSEMBLY MEMBER
WOULD AND MEMBERS OF THE HEALTH
COMMITTEE.
MY NAME IS DOCTOR MEGAN TOWARDS
MEN I AM A FAMILY PHYSICIAN AND
AN ENVIRONMENTAL HEALTH
SCIENTIST IN UC BERKELEY SCHOOL
OF PUBLIC HEALTH.
I PRACTICE REPRODUCTIVE HEALTH
CARE AND MY RESEARCH AND
TEACHING FOCUSES ON THE HEALTH
EFFECTS OF CHEMICAL EXPOSURES.
I WORKED ON CALIFORNIA CHEMICALS
POLICY FOR A DECADE I SERVE ON
CALLIE PEES GREEN RIBBON SCIENCE
PANEL AND I CHAIR THE BY
MONITORING SCIENTIFIC ANNE'S
PANEL SO.
I'M HERE TODAY TO SUPPORT SB
FIVE SEVENTY FOUR REQUIRING
COMPANIES TO DISCLOSE THE
PRESENCE OF HAZARDOUS CHEMICALS.
IN THERE -- FRAGRANCE AND
FLAVORING -- FORMULATIONS AND
PERSONAL CARE PRODUCTS.
THIS IS NOT A SMALL CATEGORY OF
CHEMICALS AS YOU'VE ALREADY
HEARD FRAGRANCE AND FLAVOR
CHEMICALS APPEAR IN THE GREAT
MAJORITY OF PERSONAL CARE
PRODUCTS.
AND OUT OF THE THREE THOUSAND
FRAGRANCE CHEMICALS THAT WERE
IDENTIFIED BY THE INTERNATIONAL
FRAGRANCE ASSOCIATION IN.
TWO THOUSAND FIFTEEN FULLY A
THIRD OF THEM ABOUT TWELVE
HUNDRED OVER TWELVE HUNDRED
CHEMICALS HAVE BEEN FLAGGED AS
KNOWN OR POTENTIAL HAZARD --
CHEMICALS OF CONCERN BECAUSE
THEY APPEAR ON ONE OR MORE
SORTED OF LISTS OF HAZARDOUS
CHEMICALS.
THESE AUTHORITATIVE LISTS
INCLUDE CHEMICALS LINKED TO
CANCER BIRTH DEFECTS
REPRODUCTIVE TOXICITY.
ENDOCRINE DISRUPTION AND
ALLERGIC SENSITIZATION.
SOME OF THE HAZARDOUS CHEMICALS
FOUND IN FRAGRANCE.
FORMULATIONS INCLUDE PHTHALATES
LINK TO REPRODUCTIVE TOXICITY
THE VOLATILE ORGANIC COMPOUND
ACETALDEHYDE WHICH IS A
CARCINOGEN ON THE PROP SIXTY
FIVE LIST.
AND THE COMPOUND STYRENE WHICH
HAS BOTH CARCINOGENIC AND
ENDOCRINE DISRUPTING AFFECTS.
YET AS WE'VE HEARD NO FEDERAL
LAW REQUIRES THE DISCLOSURE OF
THESE INGREDIENTS NOT TO
CONSUMERS BUT ALSO NOT TO
PRODUCT MANUFACTURERS OR THE FDA.
THIS MEANS THAT WELL RECOGNIZED
CHEMICAL HAZARDS CAN HIDE BEHIND
THE TERM FRAGRANCE OR FLAVOR
LISTED ON A PRODUCT LABEL.
I BELIEVE THAT CONSUMERS AND
WORKERS HAVE A RIGHT TO KNOW.
AND PHYSICIANS SCIENTISTS AND
REGULATORS HAVE A NEED TO KNOW
ABOUT THE PRESENCE OF TOXIC
CHEMICALS IN PERSONAL CARE
PRODUCTS.
WHY ARE THESE EXPOSURES RELEVANT?
MAYBE THERE'S ONLY A TINY AMOUNT
OF THIS HAZARDOUS CHEMICAL IN A
PRODUCT.
THERE ARE THREE IMPORTANT POINTS
ABOUT THIS THE FIRST IS THAT THE
EXPOSURES AREN'T TINY MY OWN
ANALYSIS OF THE MOST RECENT CARP
CONSUMER CONSUMER PRODUCT SURVEY
DATA.
SHOWS THAT THE EMISSIONS OF
VOLATILE ORGANIC COMPOUNDS FROM
FRAGRANCES IN PERSONAL PRODUCT
CARE PRODUCTS ALONE TOTALED SIX
TONS A DAY IN CALIFORNIA.
THIS GIVES YOU A SENSE OF THE
VOLUME OF THESE CHEMICALS IN
COMMERCE.
SECOND EXPOSURES TO EVEN VERY
LOW DOSES OF HORMONALLY ACTIVE
CHEMICALS TURNED OUT TO BE
PARTICULARLY SIGNIFICANT FOR
PREGNANT WOMEN INFANTS AND
CHILDREN WHOSE DEVELOPING BODIES
AND BRAINS ARE HIGHLY SENSITIVE
TO SMALL FLUCTUATIONS IN
HORMONAL SIGNALS.
AND FINALLY WE'RE NOT EXPOSED TO
THESE CHEMICALS IN ISOLATION
WERE EXPOSED TO COMPLEX MIXTURES
FROM A MULTIPLE PRODUCTS.
WE NOW KNOW UNEQUIVOCALLY THAT
EXPOSURE TO EVEN VERY LOW DOSES
OF SOME CHEMICALS PARTICULARLY
DURING DEVELOPMENT.
MAY INCREASE THE RISK OF BREAST
AND PROSTATE CANCERS.
NEURO DEVELOPMENTAL AND NARROW
DEGENERATIVE DISEASES LIKE ADHD
AND PARKINSON'S.
METABOLIC DISORDERS LIKE OBESITY
AND DIABETES AND REPRODUCTIVE
PROBLEMS SUCH AS INFERTILITY AND
MALE GENITAL BIRTH DEFECTS.
IN ADDITION TO THESE CHRONIC
HEALTH EFFECTS SOMEWHERE BETWEEN
TWO AND 11% OF THE GLOBAL
POPULATION SUFFERS FROM
FRAGRANCE ALLERGIES.
WHICH MEANS THAT HUNDREDS OF
MILLIONS OF PEOPLE LACK THE
INFORMATION TO AVOID THE
SUBSTANCES THAT TRIGGER THEIR
ALLERGIC REACTION.
WHO IS EXPOSED GIVEN THE SIX
TONS OF FRAGRANCE CHEMICALS
EMITTED EVERY DAY FROM PERSONAL
CARE PRODUCTS IN CALIFORNIA WE
ALL ARE?
BUT THE HIGHEST USERS A
FRAGRANCE PRODUCTS ARE WOMEN AND
GIRLS PRECISELY THE POPULATION
MOST AT RISK FOR HEALTH EFFECTS
FROM THOSE CHEMICALS.
ON AVERAGE US WOMEN USE TWELVE
DIFFERENT PERSONAL CARE PRODUCTS
EVERY DAY.
AND INDUSTRY MARKET RESEARCH
INDICATES THAT NEARLY 40% OF
GIRLS AGE SIX TO EIGHT USE
PERFUME OR BODY SPRAY. FOR THE
MORE THE WORK PLACES WITH SOME
OF THE HIGHEST EXPOSURES TO
FRAGRANCE TO PERSONAL CARE
PRODUCTS ARE DOMINATED BY WOMEN
OF CHILDBEARING AGE.
NAIL AND HAIR SALON SPECIFICALLY
WHERE WORKERS HAVE NEARLY FIVE
FOLD ELEVATED RISK OF FRAGRANCE
ALLERGIES COMPARED TO OTHER
OCCUPATIONS FOR THOSE WORKERS.
EXPOSURE TO PERSONAL CARE
PRODUCTS IS NOT ACTUALLY A
PERSONAL CHOICE.
FINALLY CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH REPORTED THAT
NEARLY THREE HUNDRED CASES OF
WORK RELATED ASTHMA ARE
ATTRIBUTABLE TO THE USE OF
FRAGRANCE PRODUCTS IN THE
WORKPLACE.
THESE ARE COMPLETELY PREVENTABLE.
FORTUNATELY AS WE'VE HEARD
HUNDREDS OF COSMETIC COMPANIES
ARE NOW VOLUNTARILY FULLY
DISCLOSING THEIR FRAGRANCE
INGREDIENTS INCLUDING INDUSTRY
GIANTS LIKE UNILEVER AND PROCTER
AND GAMBLE.
RETAILERS ARE ALSO BECOMING PART
OF THE SOLUTION TARGET WILL
REQUIRE ITS NATIONAL BRANDS TO
DISCLOSE FRAGRANCE INGREDIENTS
BY.
TWENTY TWENTY THIS SHOWS THAT
IT'S POSSIBLE.
BUT WE SHOULDN'T RELY ON
VOLUNTARY ACTION ALONE TO SET
PUBLIC POLICY WE NEED A
REGULATORY FLOOR REQUIRING AT
THE VERY LEAST DISCLOSURE OF
KNOWN HAZARDOUS INGREDIENTS IN
PERSONAL CARE PRODUCTS
FRAGRANCES AND FLAVORS.
SB FIVE SEVENTY NINE FOUR IS NOT
ABOUT AGAINST FRAGRANCE IT'S
ABOUT THE RIGHT TO KNOW.
EVEN CONSUMERS AND WORKERS THE
INFORMATION THEY NEED.
AS AN ADDED BENEFIT WE'VE
LEARNED FROM OTHER RIGHT TO KNOW
LAWS AT BOTH THE FEDERAL AND
STATE LEVEL THAT THE SIMPLE ACT
OF HAVING TO DISCLOSE THE USE OF
HAZARDOUS CHEMICALS.
PROMPTS MANUFACTURERS TO REDUCE
THEIR RELIANCE ON THOSE
CHEMICALS.
I RESPECTFULLY URGE YOU TO
SUPPORT SB FIVE SEVENTY FOUR AND
GIVE CALIFORNIANS THE POWER OF
INFORMATION.
THANK YOU.
VERY MUCH SO -- OTHERS IN
SUPPORT -- JUST YOUR NAME AND
ORGANIZATION PLEASE OUR LADY ONE
REPRESENTING OUR CAN GET ANY
PEDIATRICS CALIFORNIA DIVISION
IN SUPPORT THANK YOU.
ARMONK IN SMITH WITH THE
AMERICAN CANCER SOCIETY CANCER
ACTION NETWORK ALSO IN SUPPORT
THANK YOU -- TOO MUCH JOANNA MY
REPRESENTING ON THE AMERICAN
LUNG ASSOCIATION AND I STRONGLY
SUPPORT THIS THANK YOU -- OVER
CAL WITH COURAGE CAMPAIGN WE
STRONGLY SUPPORT THIS THANK YOU.
RENTS SPENCER WITH AMERICAN
COLLEGE OBGYN IS DISTRICT NINE
IN SUPPORT THANK YOU.
ANOTHER SACRAMENTO WITH THE
BLACK WOMEN FOR HONEST ACTUAL
PROJECT.
IN SUPPORT ALSO AS AN EXPECTING
MOM.
THANK YOU.
CATHERINE BATES -- UNILEVER
SEVEN GENERATION CALIFORNIA BABY --
PRODUCTS AND BEAUTY COUNTER AND
SUPPORT THANK YOU.
MOLLY WATSON WITH COURAGE
CAMPAIGN ALSO AS A MOTHER AND
SUPPORT THANK YOU.
HAVE MORE YOU CLEAN UP BEHALF OF
WOMEN'S VOICES FOR THE EARTH
PHYSICIANS FOR SOCIAL SOCIAL
RESPONSIBILITY SAN FRANCISCO AND
LOS ANGELES.
AND AMERICAN ACADEMY OF
PEDIATRICS AND SUPPORT THANK YOU.
EVIL LIVINGSTON WITH BLACK WOMEN
FOR WELLNESS IN SUPPORT THANK
YOU.
READ ADDISON BEHALF OF
ENVIRONMENTAL JUSTICE ALLIANCE
IN THE COALITION FOR CLEAN AIR
IN SUPPORT THANK YOU.
SHARON JOHNSON ON BEHALF OF
BLACK WOMEN HEALTH AND YOU ONLY
CARE WORKSHOP IN SUPPORT.
PERSECUTORS HERE ON BEHALF OF
NATIONAL STEWARDSHIP ACTION
COUNCIL AND CALL FOR PRODUCTS TO
CHIP -- COUNCIL IN SUPPORT THANK
YOU.
K. CATS REPRESENTING BLACK ONE
FOR WELLNESS AND I SUPPORT.
MELISSA ROMERO AT THE CALIFORNIA
LEAGUE OF CONSERVATION VOTERS
AND SUPPORT THANK YOU.
THE SHERIN MCGEE WITH BLACK
WOMEN FOR WELLNESS AND UNIQUE
CARE WORKSHOP IN SUPPORT.
SALLY LIEBER FOR CARDIO CENTER
FOR WOMEN IN VERY STRONG SUPPORT
THANK YOU SUSAN LITTLE WITH THE
ENVIRONMENTAL WORKING GROUP IN
SUPPORT THIS IS NEEDED
ESPECIALLY SINCE THE FDA DOESN'T
HAVE ANY KIND OF RECALL OF FORTY
TO PROVIDE PROTECTIONS.
THANK YOU THANK YOU JUST YOUR
NAME AND ORGANIZATION PLEASE SIR
FLOCKS CALIFORNIA LABOR
FEDERATION IN SUPPORT.
ANDREA VENTURA WITH CLEAN WATER
ACTION IN SUPPORT THANK YOU.
POLLY MARSHALL FROM BREAST
CANCER OVER TIME WE'RE AN
ORGANIZATION OF BREAST CANCER
SURVIVORS FOR THIS IS FOR US
THIS IS NOT JUST RIGHT TO KNOW
IT'S A RIGHT TO PROTECT
OURSELVES AND OUR FAMILIES.
I'M ALSO IF YOU'RE LOOKING AT A
PART NAME AN ORGANIZATION PLEASE
OKAY THANK YOU.
THANK YOU I'M NOT.
THERE IS A FLAT BLACK LOOK
ALANIS STRONG SPONSORS OF THE
BILL IN SUPPORT THANK YOU.
THE TERRACE ON BEHALF OF THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK IN THE HAVING OUR C.
COALITION IN STRONG SUPPORT
THANK YOU.
MERCER CHAN WITH CALIFORNIANS
FOR HEALTHY AND GREEN ECONOMY IN
MR CHAIRMAN MEMBERS POET PAUL
YODER ON BEHALF OF THE CITY AND
COUNTY SAN FRANCISCO AND I'VE
ALSO BEEN ASKED TO SUPPORT THE
BILL ON BEHALF OF CALIFORNIA
HEALTH.
HEALTHY NAIL SALON COLLABORATIVE
WORK SAFE CONSUMER FEDERATION OF
CALIFORNIAN THE NRDC STRONG
SUPPORT THANK YOU THANK YOU.
KINGSLEY TONI AT THE NO WAY HIJA
CAMARA AND A LEASE THAT CAUSE ME
WITH THE PRACTICE PROJECT IN
STRONG SUPPORT THANK YOU.
ANYONE ELSE TO SUPPORT.
HI ANYONE IN OPPOSITION.
PLEASE PLEASE COME FORWARD.
MISTER CHAIR MEMBERS MEDIALLY ON
BEHALF OF THE PERSONAL CARE
PRODUCTS COUNCIL NOT IN
OPPOSITION ACTUALLY JUST WANTED
TO CONVEY TO THE COMMITTEE THAT
WE ARE REMOVING OUR OPPOSITION
BASED ON THE AMENDMENTS THAT THE
AUTHOR JUST.
TOOK TO REMOVE THE DEFINITION OF
INTENTIONALLY ADDED INGREDIENT
AND TO EXTEND -- THE DATE TO
JANUARY ONE TWENTY TWENTY ONE WE
APPRECIATE WORKING WITH THE
AUTHOR AND THE SPONSORS ON THIS
AND OFFICIALLY REMOVED
OPPOSITION.
NICOLE CAN UNITS ON BEHALF OF
THE FRIGGIN CREATORS ASSOCIATION
ALSO OFFICIALLY NEUTRAL ON THE
BILL THANK YOU.
THANK YOU.
THANK YOU MISTER CHAIR MEMBERS
DON KHAKI MCCUE CAP CAN
ASSOCIATES ON BEHALF OF THE
CALIFORNIA MANUFACTURERS AND
TECHNOLOGY ASSOCIATION ALSO
PLEASE REMOVE OPPOSITION THANK
YOU FOR WORKING WITH US Q..
CAPTION CHAIR MEMBERS ADAM RIGHT
LET ME HAVE THE CALIFORNIA
CHAMBER OF COMMERCE ONE I THINK
THE OFF THERE WERE MOVING TO A
NEUTRAL POSITION AS WELL THANK
YOU.
THANK YOU [inaudible]
ANYONE ELSE.
A BRING BACK TO THE COMMITTEE
QUESTIONS OR COMMENTS FROM THE
COMMITTEE [inaudible]
THE SAME.
SEEN SEEN THEN WE HAVE A MOTION
I BELIEVE IT WAS MISTER NAZARIAN
AND SECULAR RESTAURANTS THEY
FIGURED THAT ONE RIGHT FOR THE
FIRST TIME.
IN AWHILE.
SO -- AT MASS.
MADAM SENATOR WHICH LIKE TO
CLOSE RESPECTFULLY AS FOR NAY
VOTE THANK YOU VERY MUCH THE
BILL DOESN'T THE JOY DO PASS
RECOMMENDATION THE MESS MOTION
IS TO PASS -- AS AMENDED -- TO
OF THESE -- THAT'S HARD TO PASS
THE SALT THE SAFETY AND TOXIC
MATERIALS.
ENVIRONMENTAL SAFETY OF THOSE
PEOPLE -- YEAH THAT COMMITTEE --
SO IT IS TO PASS TO TO THOSE TO
THAT CAN MAKE.
MATT OF SEXUAL PLEASE CALL THE
ROLL BEFORE I SCREW ANYTHING
ELSE A WHAT.
ALL RIGHT WHEN I MAYES
AGUIAR-CURRY AGUIAR-CURRY AYE
BIGELOW.
BIGELOW NOT VOTING BONTA.
BURKE CARILLO [inaudible]
FLORA.
WHEN OWN?
MCCARTY.
MCCARTY I IN THIS AREA.
NAZARIAN AYE RAMOS.
RAMOS I RODRIGUEZ.
SANTIAGO.
WALDRON. FIVE THAT'S FIVE VOTES
WILL BE THE BILL ON CALL AND
WILL HAVE OTHER MEMBERS AT SOME
POINT LATER TODAY THANK YOU
MISTER CHAIR THANK YOU MEMBERS
THANK YOU SENATOR.
SENATOR PORTANTINO.
SENATOR YOU HAVE SP ONE SIXTY
THREE BEFORE US TODAY.
THANK YOU MISTER CHAIR AND
MEMBERS BEFORE BEGIN I WANT TO
THANK THE CHAIR OF THE COMMITTEE
STAFFER THERE WERE.
TIME WORKING WITH US ON THIS
BILL AND I ACCEPT THE PROPOSED
AMENDMENTS -- COMMITTEE MA'AM
IT'S SENATE BILL ONE SIXTY THREE
NOW CALLED LUCAS LAW.
WILL ELIMINATE SIGNIFICANT
ARTIFICIAL BARRIERS IMPOSED BY
HEALTH PLANS BY THE WAY -- LUKA
IS SENATOR STONE'S GRANDDAUGHTER
SO WE MEMORIALIZE THE BILL.
SHE IS SO ARTISTIC AND SO HE
GAVE A PASSIONATE SPEECH AND SO
WE ARE PAYING HIM RESPECT BY --
MEMORIALIZING THE BILL AFTER HIS
GRANDDAUGHTER SO. FOR THOSE OF
YOU WHO ARE INTERESTED -- SO --
SENATE BILL ONE SIXTY THREE WILL
ELIMINATE SIGNIFICAN ARTIFICIAL
BARRIERS IMPOSED BY HEALTH PLANS
THAT ARE PREVENTING FAMILIES
FROM ACCESSING.
BEHAVIORAL HEALTH TREATMENT FOR
CALIFORNIANS WITH AUTISM
RESEARCH HAS CLEARLY SHOWN THAT
CHILDREN.
WITH ASD WHO RECEIVED BEHAVIORAL
HEALTH TREATMENT EARLY CAN SHOW
REMARKABLE PROGRESS THIS BILL
ALSO KHALAF PRODUCT.
CODIFIES REQUIREMENTS FOR A
QUALIFIED AUTISM SERVICE
PROFESSIONAL AND PARA
PROFESSIONAL TO ENSURE HEALTH
INSURANCE COVERAGE STATISTICS
TELL US THAT ONE IN FIFTY NINE
CHILDREN BORN TODAY ARE
DIAGNOSED WITH AUTISM.
EARLY INTERVENTION IS THE KEY TO
HELPING THESE CHILDREN LIVE UP
TO THEIR POTENTIAL AND HEALTH
INSURANCE COVERAGE FOR
BEHAVIORAL HEALTH TREATMENT IS
CRITICAL.
THIS BILL'S GONE THROUGH THIS
COMMITTEE.
BEFORE -- IT'S A GOOD BILL
MEDICALLY NECESSARY DOCTOR
PRESCRIBED TREATMENT SHOULD BE
COVERED TO HELP KIDS DO BETTER I
RESPECTFULLY ASK FOR AN AYE VOTE.
I RESPOND TO THE POSITIVE
PROVIDE WITNESSES CITY.
MY NAME IS JIM WINTRY WITH THE
D. I. R. FLOOR TIME COALITION OF
CALIFORNIA.
THIS IS THE HOPEFULLY THE END OF
A TWENTY YEAR STRUGGLE SINCE
NINETEEN NINETY NINE WHEN THE
LEGISLATURE PASSED MENTAL HEALTH
PARITY ACT WHICH SAID THAT
AUTISM SHOULD BE TREATED THE
SAME AS ANY OTHER PHYSICAL
ELEMENT -- IT'S BEEN A STRUGGLE
WE'VE HAD NUMEROUS PIECES OF
LEGISLATION -- WE'VE HAD
LAWSUITS FROM THE DEPARTMENT OF
MENTAL HEALTH CARE ARE MET
MANAGE HEALTH YOU'RE NOT MENTAL
OUT THERE IN THE DEPARTMENT OF
INSURANCE -- ASSEMBLYMAN IS
ARIAN IS CARRIED ONE OF THOSE
PIECES OF LEGISLATION -- IT'S
BEEN A STRUGGLE EVERY STEP OF
THE WAY TO GET THE THE HEALTH
PLANS TO COVER AUTISM.
AND HOPEFULLY THIS BILL WILL
FINALLY DO THAT THE CHILDREN OF
CALIFORNIA WILL GET THE HELP
THAT THEY NEED TO LIVE THE LIVES
THAT THEY CAN LIVE SO THAT THEY
CAN REACH THEIR FULL POTENTIAL
AND I ASK YOUR AYE VOTE.
THANK YOU VERY MUCH OTHERS IN
SUPPORT. THREE ONE IN OPPOSITION.
I'M SORRY WOMEN TOO QUICK HERE
SO.
OPPOSITION TO THE BILL WE HAVE
SUPPORT SELF.
IN SUPPORT ERIC HARRIS WITH
DISABILITY RIGHTS CALIFORNIA
[inaudible]
ANYWAY.
TRUTH ANDERSON WITH OUR CAN YOU
SEE P. IN SUPPORT THANK YOU.
I HAD A CALL THAT SOMETHING HAVE
THE NATIONAL ASSOCIATION OF
SOCIAL WORKERS CALIFORNIA
CHAPTER IN SUPPORT.
OKAY.
ANYONE ELSE CASEY NO -- ONE
OPPOSITION TO THE BILL.
GOOD AFTERNOON I'M GENERALLY
WITH THE CALIFORNIA ASSOCIATION
HEALTH PLANS I'D LIKE TO THANK
YOU FOR YOUR TIME AN OPPORTUNITY
TO PRESENT ON THIS BILL -- I
JUST WANT TO CLARIFY THE CAP
MEMBERS A CURRENTLY COVER -- OCT
SERVICES FOR THEIR ENROLLEES
WITH AUTISM -- IN TWO THOUSAND
ELEVEN SB NINE FORTY SIX A BILL
AUTHORED BY SENATOR SIGNED BURKE
AT THE TIME MOVED ONTO SOME
COVERAGE OUT OF THE REGIONAL
CENTERS.
AND REQUIRED TO HELP REQUIRED
HEALTH PLANS TO COVER OUR
BEHAVIORAL HEALTH THERAPY FOR
AUTISM -- IN IT WE ALSO HAVE
NETWORK REQUIREMENTS A
SURROUNDING THOSE PROVIDERS AND
SINCE THEN AUTISM SERVICES --
WERE INCLUDED AS PART OF THE
ESSENTIAL HEALTH BENEFITS -- WE
ARE OPPOSED TO THIS BILL -- THIS
BILL AUTHORIZES A SUBSTITUTION
OF EDUCATION AND WORK EXPERIENCE
AND TRAINING QUALIFICATIONS ARE
CURRENT LAW.
WITH ADDITIONAL QUALIFICATIONS
TO MEET THE CRITERIA OF THE FOR
THE AUTISM PROFESSIONALS IMPAIR
PROFESSIONALS.
AND OUR OPPOSITION IS BASED ON
THE FACT THAT WE THINK THIS WILL
DILUTE HE QUALITY OF CARE
CURRENTLY RECEIVED BY OUR
ROWLEY'S -- GENERALLY SPEAKING
HEALTH PLANS CONTRACT WITH
LICENSED PROFESSIONALS TO ENSURE
SERVICES PROVIDES TO THEIR
ENROLLEES ARE ROOTED IN EVIDENCE
BASED TREATMENT -- HEALTH PLAN
COVERAGE DECISIONS ARE ROOTED
ENOUGH EVIDENCE BASED TREATMENT
TO STUDIES -- ONE WITH A SAMPLE
SIZE OF TWENTY TWO YOU KNOW CUT
THAT KIND OF HAVE OUTLINED IT
SOME OF THOSE SERVICES OR THE
MODALITIES THAT WOULD PROVIDE BE
PROVIDED BY.
THE PROVISIONS OF THIS BILL
DON'T MEET THE STANDARD FOR
EVIDENCE BASED TREATMENT -- AND
SO YOU KNOW WE JUST HAVE SOME
SERIOUS CONCERNS REGARDING THE
QUALITY -- THAT WILL BE
PURCHASING ON BEHALF OF OUR AND
RELEASE THANK YOU.
JIM GROSS ON THE BEHALF OF THE
CALIFORNIA ASSOCIATION BEHAVIOR
ANALYSIS WE'VE BEEN SEEKING AN
AMENDMENT TO THE BILL.
THAT CLARIFIES THAT THE TRAINING
STANDARDS THAT APPLY TO BEHAVIOR
ANALYSTS -- ARE NOT AFFECTED BY
THE TRAINING AND SUPERVISION
STANDARDS THAT ARE IN THE BILL
FOR THIS.
NEW GROUP OF INDIVIDUALS BE
PROVIDING SERVICES WE ARE NOT --
OPPOSING THE BILL IN THE MAIN
BUT DO FEEL THAT THESE
AMENDMENTS -- WILL PRESERVE THE
STANDARDS THAT CURRENTLY GOVERN --
ARE PROFESSIONALS -- THERE WAS
SOME CONFUSION EVIDENTLY ABOUT
WHETHER THE BORDER PSYCHOLOGY
HAD CONCERNS ABOUT -- AMENDMENTS
WE HAVE CLARIFIED THAT I DO NOT
BELIEVE THEY HAVE CONCERNS ABOUT
IT SO WE WILL CONTINUE TO WORK
WITH THE AUTHOR BECAUSE AGAIN WE
THINK THESE.
ARE TECHNICAL AMENDMENTS TO
PRESERVE THE STANDARD TO DO
APPLY TO BEHAVIOR ANALYSTS THANK
YOU.
THANK YOU VERY MUCH OTHERS IN
OPPOSITION.
YEAH JOHN WINGER ON BEHALF%
AMERICA'S HEALTH INSURANCE PLANS
WITH ECHO THE CONCERNS OF CAP
THANK YOU.
STEPHANIE WALK INS ON BEHALF OF
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES ALSO IN OPPOSITION Q..
PARENTS ARE KISSING WITH
CALIFORNIA CHAMBER OF COMMERCE
FOR POST ACUTE [inaudible]
ANYONE ELSE.
IN ORDER BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS OR COMMENTS
FROM THE BEGINNING.
MISTER IS THERE IN.
I THINK IT'S A GREAT BILL THANK
YOU FOR BRINGING IT FORWARD
AGAIN WOULD LOVE TO JOIN AS A CO
AUTHOR -- AND JUST JUDGING BY BY
THE THOUGH THE OPPOSITION TELLS
YOU HOW IMPORTANT ISSUE IS TO
THANK YOU.
WE'RE HAPPY TO HAVE YOU ON AS A
CO AUTHOR.
CONSIDER WHICH LIKE TO CLOSE
YEAH I JUST THINK -- YOU KNOW
WE'RE TALKING ABOUT MEDICALLY
NECESSARY TREATMENT THAT'S
PRESCRIBED BY A DOCTOR -- TO
HELP KIDS AND RESPECTFULLY ASK
FOR AN AYE VOTE.
THANK YOU SENATOR THE BILL DOES
ENJOY DO PASS RECOMMENDATION WE
DO HAVE A MOTION BY.
MISTER IS THERE AND THE SECOND
BY MISTAKE YEAR CURRY -- MOTION
IS TO PASS AS AMENDED TO
APPROPRIATIONS LAST MINUTE
SECRETARY PLEASE CALL THE ROLL
WHAT I WHAT I MAYES.
AGUIAR-CURRY AGUIAR-CURRY I
BIGELOW.
BIGELOW NOT VOTING BONTA.
BURKE CARRILLO.
FLORA.
LIMóN.
MCCARTY.
I NAZARIAN.
NAZARIAN AYE RAMOS.
RAMOS I RODRIGUEZ SANTIAGO
WALDRON [inaudible] FIVE YOUR
FIVE VOTES THAT SEEMS TO BE THE
MAGIC NUMBER SO FAR THIS
AFTERNOON BUT IT'S NOT MAGIC YET
BECAUSE YOU NEED EIGHT SO LEAVE
THE BILL ON CALL THANK YOU
MISTER CHAIRMAN THANK YOU SO
MUCH.
CENTER HER TAUGHT OF YOU HAVE A
WAY TO ISSUE.
YOU HAVE ITEM FOR SB TO SIXTY SB
THREE THIRTY ONE IS ALREADY
PASSED ON THE CONSENT CALENDAR
SO.
THANK YOU.
THANK YOU MR CHAIRMAN MEMBERS --
TODAY I'M HERE TO PRESENT SB TWO
SIXTY WHICH AIMS TO HELP EVERY
DAY CALIFORNIANS AVOID COVERAGE%
GAPS AND WHEN THEY UNDERGO LIFE
CHANGES THAT TRIGGER LOSSES IN
COVERAGE -- MANY OF THEM WILL
UNDERGO LIFE EVENTS LIKE GETTING
JOBS ARE EARNING MORE AT THEIR
JOBS WHICH CAN CAUSE THEM TO
LOSE MEDI CAL.
AND BECOME ELIGIBLE FOR COVERED
CALIFORNIA.
THIS BILL ALLOWS COVERED
CALIFORNIA TO EXPEDITE
ENROLLMENT FOR PEOPLE LOSING
MEDI CAL AND CHIP FUNDED
PROGRAMS BY AUTO ASSIGNING.
THEM TO THE PLAN WITH THE MOST
ASSISTANCE WHILE STILL ALLOWING
THEM TO SHOP AROUND.
IT ALSO REQUIRES HEALTH PLANS
AND INSURERS TO TRANSFER A LIST
OF PEOPLE WHO LOSE COVERAGE FOR
ANY REASON TO COVERED CALIFORNIA
SO COVERED CALIFORNIA CAN REACH
OUT TO GET THEM COVERED.
WE'VE A SEPTIC TECHNICAL MOMENTS
FROM THE STAKEHOLDERS AND HAVE
DELAYED IMPLEMENTATION TO JULY
TWENTY TWENTY ONE TO ALLOW
COVERED CALIFORNIA TIME TO SET
UP THE PROGRAM AND TO ENSURE WE
ADDRESS.
ANY OTHER OPERATIONAL QUESTIONS
AND CONCERNS.
THAT THE HEALTH PLANS MAY HAVE.
THIS BILL HAS NO OPPOSITION AND
I RESPECTFULLY ASK FOR AN AYE
VOTE TODAY DON'T HAVE.
THANK YOU.
AND TODAY HAVE CHEN FLORI -- AND
FROM THE WESTERN CENTER ON LAW
AND POVERTY AND MERRY JUNE DS
WITH HEALTH ACCESS IF YOU HAVE
ANY QUESTIONS.
GOOD AFTERNOON MISTER CHAIRMAN
MEMBERS AND JDS HERE ON BEHALF
OF HEALTH ACCESS CALIFORNIA
PROUD TO CO SPONSOR SB TWO SIXTY
WITH THE WESTERN CENTER ON LAW
AND POVERTY.
THIS BILL IS REALLY MEANT TO
MAKE IT EASIER FOR CALIFORNIANS
TO KEEP COVERAGE AND AVOID
COVERAGE GAPS.
EVERY DAY PEOPLE UNDERGO
DIFFERENT TYPES OF LIFE EVENTS
FOR EXAMPLE GETTING MARRIED
GETTING DIVORCE HAVING A BABY
TWENTY TWENTY SIX THAT COULD
TRIGGER A LOSS OF HEALTH CARE
COVERAGE.
AND OUR BILL IS REALLY MEANT TO
MAKE IT EASIER FOR THEM TO GET
ACCESS TO COVERAGE WHETHER IT'S
THROUGH MANY CAL OR COVERED
CALIFORNIA.
THIS BILL BUILDS ON EXISTING
CALIFORNIA AT LAW THE ALREADY
REQUIRES HEALTH PLANS AND
INSURERS TO NOTIFY CONSUMERS OF
THE AVAILABILITY OF COVERAGE AND
MEDI CAL.
OR COVERED CALIFORNIA REGARDLESS
OF WHATEVER FOR WHATEVER REASON
THEY LOST COVERAGE -- I'M GOING
TO TURN IT OVER TO MY COLLEAGUE
CHEN FOR YOU WE'LL TALK MORE
ABOUT THE MEDI CAL TO COVER
CALIFORNIA TRANSITION AND WE
REQUEST YOUR I SUPPORT THANK YOU.
CHEN FLORES THE WESTERN CENTER
ON LAW AND POVERTY YEAH IN SOME
OF THE EARLIEST IMPLEMENTATION.
IMPLEMENTING LEGISLATION THE
AFFORDABLE CARE ACT WE
ENVISIONED A SYSTEM WHERE
SOMEBODY.
WHERE WOULD HAVE NO WHAT'S WRONG
DOOR BASICALLY SOMEONE WOULD
APPLY FOR ONE PROGRAM AND IF
THEY WERE FOUND IN ELIGIBLE FOR
THAT PROGRAM WE DO USE ALL THEIR
INFORMATION TO SEE IF THEY WERE
ELIGIBLE FOR ANY OF?
ANY OTHER PROGRAM.
MOST OF THIS IS WORKING WHEN
SOMEONE'S INCOME GOES UP SUCH
THAT THEY'RE NO LONGER ELIGIBLE
FOR MEDI CAL OR ANOTHER PROGRAM
LIKE AN CAP OR SEE CHIP.
THE COUNTY ELIGIBILITY WORKERS
DO INDEED DETERMINE IF THE
PERSON'S ELIGIBLE FOR COVER
CALIFORNIA BECAUSE THEY ALREADY
HAVE THE NECESSARY INFORMATION.
THEY THEN PUT THAT PERSON INTO
THE ELIGIBILITY SYSTEM IN THE
COVER CALIFORNIA PROGRAM WE KNOW
WHAT THEIR INCOME IS WE KNOW HOW
MUCH FINANCIAL ASSISTANCE ARE
ELIGIBLE.
FOR HOWEVER BECAUSE OF HOW THE
FEDERAL REGULATIONS INVOLVING
PLAN SELECTION OVERLAY WITH OUR
STATE LAW REGARDING TIMELY
NOTICE WE HAVE A SITUATION WHERE
PEOPLEMOVE LOSING THEIR MEDI
CAL OR OTHER PROGRAM OFTEN HAVE
LESS THAN TEN DAYS INCLUDING
WEEKENDS AND HOLIDAYS TO SELECT
A PLAN.
OR THEY FACE A GAP IN COVERAGE.
PLAN SELECTION MAY NOT SEEM LIKE
AN INSURMOUNTABLE BARRIER BUT
PEOPLE OFTEN DON'T KNOW WHERE TO
GET HELP OR UNDERSTAND WHAT THEY
MUST DO TO EFFECTUATE COVERAGE.
THE NETWORKS BETWEEN MEDI CAL
AND CAPS EACH SHIP AND COVER
CALIFORNIA DON'T ALWAYS MATCH.
SADLY WE'VE ALSO SEEN A NUMBER
OF CONSUMERS WHO ENDED UP IN THE
ER DURING THAT GOT PERIOD AND
INCURRED MEDICAL BILLS THEY
COULDN'T PAY AND SOME OF THEM
HAD ALREADY IN FACT AND ROLE AND
COVERED CALIFORNIA.
BUT THEIR COVERAGE WOULDN'T BE
EFFECTIVE UNTIL THE NEXT MONTH.
SB TO SIXTY IS A TECHNICAL FIX
IT THREADS THE NEEDLE BETWEEN
STATE AND FEDERAL LAW BY HAVING
COVER CALIFORNIA START THE
ENROLLMENT PROCESS TO AVOID THE
GAP IN COVERAGE WHILE STILL
ALLOWING CONSUMERS TO CHANGE
PLANS OR FORGO COVERAGE IF THEY
DON'T WANT IT.
WE RESPECTFULLY ASK FOR YOUR
VOTE THANK YOU.
VERY MUCH OTHERS IN SUPPORT.
HELLO HOW TO CONTACT US ON
BEHALF OF THE NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER IN SUPPORT.
OUR MOUNTAINS MATH WITH THE
AMERICAN CANCER SOCIETY CANCER
ACTION NETWORK ALSO IN SUPPORT.
HAS A FEW NANOMETERS NOT TO KNOW
WHAT CHILDREN NOW IN STRONG
SUPPORT.
SIR FLOCKS CALIFORNIA LABOR
FEDERATION IN SUPPORT THANK YOU.
LINDA TENER WITH FOR THE
CALIFORNIA PAN I THINK HEALTH
NETWORK IN SUPPORT THANK YOU.
EXACTLY QUARREL WITH THE
CALIFORNIA DENTAL ASSOCIATION
ALSO IN SUPPORT THANK YOU
[inaudible]
ANYONE ELSE.
THAT MEASURE MEMBERS NICK LOUISE
US ON BEHALF OF THE CALIFORNIA
ASSOCIATION OF HEALTH PLANS --
WE APPRECIATE THE UNDERLYING
INTENT OF THE BILL WE DID ISSUE
A CONCERNS LETTER EARLY ON IN
THE PROCESS BUT WE'VE HAD SOME
VERY MEANINGFUL CONVERSATIONS
WITH THE AUTHOR IN THE SPONSORS.
SOME POSITIVE CHANGES HAVE BEEN
MADE -- WE HAVE THE DOORS -- YOU
KNOW SIT STILL LEFT OPEN FOR US
TO ADDRESS ANY LAST MINUTE
ISSUES SO THANK YOU. SEVENTY
WHAT CAN SOME HAVE A DECISION A
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES WE TOO WOULD
LIKE TO THANK THE AUTHOR AND THE
SPONSOR FOR ALL THE WONDERFUL
WORK THEY'VE BEEN DOING WE'RE
SUPPORT ABOUT THE UNDERLYING
CONCEPT AND WE JUST WANNA MAKE
SURE THAT WE CAN OPERATIONALIZE
IT IN.
A WAY THAT'S MEANINGFUL FOR
CONSUMERS THANK YOU FOR THE
OPPORTUNITY TO CONTINUE WORK ON
THAT.
THANK YOU VERY MUCH ANYONE ELSE.
SEE KNOWN TO BRING BACK TO
COMMITTEE FOR QUESTIONS OR
COMMENTS AND QUESTIONS ARE
COMMISSION COMMITTEE.
THAT WOULD LIKE TO CLOSE SENATOR.
THANK YOU VERY MUCH YOUR ARM THE
BILL DOES ENJOYED YOU PASS
RECOGNITION THANK YOU FOR
BRINGING THIS FORWARD I THINK
CONTINUITY OF OF COVERAGE IS IS
A VERY IMPORTANT ISSUE AND I
APPRECIATE YOUR EFFORTS ON THIS
PART -- WITH THAT WE HAVE A
MOTION BY -- THIS AT YOUR CURRY
THE SECOND BY MISTER IS THERE IN
THE MOTION IS TO PASS TO
APPROPRIATIONS COMMITTEE
SECRETARY PLEASE CALL THE ROLL
WHAT I WOULD AYE MAYES.
MAYES AYE AGUIAR-CURRY
AGUIAR-CURRY I BIGELOW.
BIGELOW AYE BONTA BURKE CARILLO.
FLORA.
LIMóN MCCARTY.
THIS AREA HI NAZARIAN AYE RAMOS
RAMOS I RODRIGUEZ.
SANTIAGO WALDRON. SIX YES SIX
VOTES WILL LEAVE THE BILL ON
CALL THANK YOU THANK YOU SO MUCH
[inaudible]
AND MOVED.
THE BILL WE WE NEED A COUPLE
MORE SENATORS [inaudible]
SO TALK.
DOCTOR PAN CENTER MITCHELL
[inaudible]
PART OF WE CAN OPEN THE ROLE ON
THE CONSENT CALENDAR FOR MEMBERS
TO ADD ON PLEASE OPEN THE ROLE.
MAYES I MAYES AYE BONTA BURKE.
LEVEL.
THIS AREA.
NAZARIAN AYE [inaudible]
RODRIGUEZ SANTIAGO.
ITS TENTH.
SO CAN SECOND HAS TEN VOTES SO
WE'LL LEAVE THAT JOB -- OPEN FOR
OTHER STAT ON
MADAM SECRETARY
CAN YOU OPEN THE ROLE ON ITEM
NUMBER TWO SB [inaudible]
ONE SIXTY THREE COMMITMENTS
BECAUSE LIFT THE CALL EXCUSE ME
ON ITEM NUMBER.
TWO MAYES NOBODY MAYES NOT
VOTING.
BONTA BURKE CARRILLO FLORA
[inaudible]
LIMON.
RODRIGUEZ SANTIAGO WALDRON.
STUFF I COULD STILL FIVE ZERO
AND THEN WILL LIFT THE CALL ON
ITEM NUMBER.
THREE SB TWO TWO SEVEN WITNESS
LABOR.
PLEASE CALDERON SORRY.
MAYES [inaudible]
MAYES NO [inaudible]
BIGELOW [inaudible]
BIGELOW NO.
BONTA BURKE FLORA LOW MOAN
RODRIGUEZ SANTIAGO WALDRON.
THAT SAYS IT FIVE TWO AND THEN --
WITH ITEM NUMBER THIRTEEN WILL --
LIFT THE CALL CALL THE ABSENT
MEMBERS [inaudible]
MAYES.
IT'S NOT VOTING.
BONTA BURKE CARILLO FLORA LOW
HOME FREDERICK IS SANTIAGO
WALDRON.
CAST OF FIVE ZERO THANK YOU.
STILL WAITING FOR SENATORS ARE
.
PLEASE.
BE CENTER.
WE'RE REALLY GLAD TO SEE YOU.
WE WERE GET REALLY BORED VERY SO
YOU SHOULD HAVE COME.
HE SHOULD HAVE SENT THE X. HELP
ME.
THERE'S A LOT OF PEOPLE TO BUILD
IT FEEL THAT WAY ABOUT WHAT'S
GOOD AND JUST IN GENERAL TODAY.
SAY ONE MORE TIME I IS A LOT OF
PEOPLE BUILDING FEEL THE SAME
WAY I'M HERE RIGHT JUST COME.
FROM WHEREVER I AM WHICH BILL
ARE WE TAKING A FIRST HOW ABOUT --
THREE SIXTY ONE WORKS BEAUTIFUL
OKAY.
YOUR MIND SIR.
THE MOTION IN THE SECOND.
I'D LIKE TO BEGIN BY ACCEPTING
THE COMMITTEE MEMBERS AND
THANKING THE COMMITTEE STAFF FOR
THEIR TECHNICAL ASSISTANCE IN
TWENTY THIRTEEN I AUTHORED AB
THREE SIX ONE WHICH AUTHORIZES
THE CREATION OF HEALTH HOMES
PROGRAM IN CALIFORNIA.
THAT WAS SHORTLY AFTER THE
RECESSION IN THE BILL WAS
ALLOWED -- TO THE BILL WILL NOT
WAS ALLOWED TO SUNSET AFTER TWO
YEARS AS YOU KNOW HEALTH PLANS
PROVIDERS READ THIS IS A PILOT
PROGRAM BACK IN THE TWO YEARS
AND ARE LESS LIKELY TO TO FULLY
IMPLEMENT THE PROGRAM.
NOW THAT OUR ECONOMY IS IN A
MUCH BETTER POSITION SB THREE
SIX ONE WHICH IS BEFORE YOU
TODAY WILL ENSURE THAT THE
IMPLEMENTATION OF THE HEALTH
HOMES PROGRAM IS CONSISTENT WITH
THE INTENT.
OF THE ORIGINAL LAW.
YOU KNOW IF MISTER CHAIR AND
MEMBERS THE GOAL OF THE HEALTH
HOMES PROGRAM IS TO HELP MEDI
CAL BENEFICIARIES WHO ARE
HOMELESS.
AND OR LIVE WITH MULTIPLE
CHRONIC HEALTH CONDITIONS --
WITH THEIR ADHERENCE TO
MEDICATION LINK THEM TO PEER
FAMILY SUPPORT SYSTEMS AND
PROVIDE HOUSING TRANSITION
SERVICES AMONG OTHER SERVICES --
I KNOW THAT THERE BEEN SOME
CONCERNS FROM HEALTH PLANS ABOUT
THE TIERED RATES AT THAT.
THE REQUIRED TO PAY -- HEALTH
HOME PROVIDERS AND WE'VE HAD
CONVERSATIONS WITH THE PLANS AND
HAVE YET TO COME TO AN AGREEMENT.
ON THAT WILL ADDRESS THEIR
CONCERNS THAT WOULD PRESERVE OUR
GOAL TO INCREASE PARTICIPATION
AMONG MEMBERS EXPERIENCING
HOMELESSNESS HOWEVER WE ARE
COMMITTED TO CONTINUING TO WORK
WITH THEM.
AND THE DEPARTMENT HEALTH CARE
SERVICES TO COME TO AN AGREEMENT
ON THE LANGUAGE IN THE
REQUIREMENT FOR TIERED PAYMENT
RATES.
I WILL POINT OUT TO FOR YOU TO
HEAR FROM THE CHIU EXPERTS AS WE
WORK SO HARD THAT THE ALL THOSE
YEARS AGO -- AND YOU'LL HEAR
FROM SHARING REPORT AND LINDEN
WAY WITH WESTERN CENTER AND THE
CORPORATION FOR SUPPORT OF
HOUSING RESPECTIVELY.
AND I'LL BE AVAILABLE TO ANSWER
ANY QUESTIONS BUT ASKED FOR AN
AYE VOTE.
THANK YOU VERY MUCH PLEASE GOOD
AFTERNOON CHAIR MEMBERS LED AWAY
WITH WESTERN CENTER ON LAW AND
POVERTY PROUD CO SPONSORS OF
THIS IMPORTANT MEASURE WE
FIRSTLY IT WOULD LIKE TO
APPRECIATE THAN ASSEMBLY MEMBER.
MITCHELL'S LEADERSHIP AND
AUTHORIZING THE STATE TO CREATE
THE HEALTH HOMES PROGRAM AND THE
BIT AND THIS BILL TO ENSURE THE
PROGRAM IS OPERATING AS INTENDED.
FIRSTLY WOULD LIKE TO START WITH
LESSONS LEARNED FROM OTHER
STATES THAT CAN HELP CALIFORNIA
IMPROVE THE PROGRAM SPECIFICALLY
MAIN EVALUATORS REPORTED A
PERCEPTION THAT THE PROGRAM IS
NOT SUSTAINABLE OR PREDICTABLE
BECAUSE OF A POTENTIAL TO YEAR.
END DATE -- WHICH DISCOURAGES
PLANS AND PROVIDERS FROM HIRING
STAFF CALIFORNIA'S EXPERIENCES
THAT'S FAR BEEN CONSISTENT WITH
MAINS.
A FURTHER I THE FEDERAL
GOVERNMENT STATES ON THAT --
INSUFFICIENT DATA AFTER TWO
YEARS TO ASSESS OUTCOMES DUE TO
DATA LACKS AND SO IT DOES TAKE
SOME TIME TO SHOW THAT THIS
PROGRAM IS WORKING.
AND EVALUATORS AT NEW YORK'S
HEALTH HOME PROGRAM RECOMMENDED
TIERED RATES WITH HIGHER RATES
FOR PEOPLE SIR -- FOR A PROVIDER
SERVING INDIVIDUALS EXPERIENCING
HOMELESSNESS A TIERED RATE
STRUCTURE ALLOWS PROVIDERS TO
GET PAID FOR THE TYPE AND
INTENSITY OF SERVICES PROVIDED.
CALIFORNIA'S HOMELESS THIS
CRISIS IS GROWING WHILE
DECLINING BETWEEN TWENTY TEN AND
TWENTY SEVENTEEN CALIFORNIA SAUL
AND 9% OVERALL INCREASE IN
HOMELESSNESS WHILE THE COUNTRY
AS A WHOLE SAW A 13% DECLINE.
UNTIL CALIFORNIA'S ABLE TO
ADDRESS THAT THE BILL WOULD
IMPROVE CARE TO MEDI CAL
ENROLLEES WHO ARE HOMELESS AND
HAVE A CHRONIC CONDITION OR A
SEVERE MENTAL ILLNESS WE ARE
DRIVE VOTE.
ON THIS MEASURE THAT HAS
BIPARTISAN SUPPORT AND NO NO
VOTE.
GOOD AFTERNOON SHARON REPORT
WITH THE CORPORATION FOR SUPPORT
OF HOUSING -- BENEFICIARIES
EXPERIENCING HOMELESSNESS AND
KERR DISPROPORTIONATE MEDI CAL
COSTS WE KNOW THIS FROM DECADES
OF RESEARCH THAT THEIR COSTS
ACTUALLY INCREASE OVER TIME
WHILE THERE HOMELESS EVEN IF
THEY'RE RECEIVING THE BEST CARE
COORDINATION SERVICES.
DECADES OF DATA ALSO SHOW THAT
WHEN YOU CONNECT THESE
BENEFICIARIES TO INTENSIVE
SERVICES TO HELP THEM GET STABLY
HOUSE.
AND TO AT AND ACHIEVE HELL
STABILITY THAT BENEFICIARIES ARE
ABLE TO NOT ONLY IMPROVE THEIR
HEALTH OUTCOMES DRAMATICALLY
THEY SAVE SIGNIFICANT PUBLIC
RESOURCES.
THANKS TO SENATOR MITCHELL'S A.
B. THREE SIXTY ONE THE HEALTH
HOMES PROGRAM IS FUNDING
SERVICES TO HELP PEOPLE
EXPERIENCING HOMELESSNESS.
GET CONNECTED -- TO HOUSING
NAVIGATION SERVICES AND TENANCY
STABILITY SERVICES.
WELL THE DEPARTMENT OF HEALTH
CARE SERVICES REQUIRES HEALTH
HOME PROGRAM PROVIDERS TO OFFER
THESE SERVICES.
THE STATE HAS SOME DISTANCE TO
GO BEFORE THE PROGRAM FOR FILLS
THE ORIGINAL INTENT OF AB.
THREE SIXTY ONE IT HAS THE
POTENTIAL TO SERVE MANY MANY
MORE CALIFORNIANS EXPERIENCING
HOMELESSNESS.
AND TO HAVE GREATER IMPACT ON
THIS POPULATION.
SB THREE SIXTY ONE THAT WILL
ENSURE HEALTH PLANS CAN
DETERMINE WHICH MEMBERS ARE
EXPERIENCING CHRONIC
HOMELESSNESS AT THE MOMENT THEY
HAVE NO WAY OF IDENTIFYING
MEMBERS EXPERIENCING
HOMELESSNESS.
BUT LONG CHRONIC HOMELESSNESS SO
THE BILL WOULD REQUIRE --
PROVIDERS TO OUR REACH TO PEOPLE
ON THE STREETS AND PROVIDE
INCENTIVES TO HEALTH HOME --
PROVIDERS TO SERVE THE
POPULATION CURRENTLY PROVIDERS.
WHO ARE PROVIDING HEALTH HOME
SERVICES?
NOW THAT PROVIDING SERVICES TO
THIS POPULATION IS MORE
DIFFICULT AND MORE EXPENSIVE FOR
THEM AND SO THEY HAVE FEW
INCENTIVES TO TACKLE THE NEEDS
OF THIS -- THESE BENEFICIARIES.
THOUGH PROVIDERS DO NOT HAVE ANY
CURRENT INCENTIVES TO SERVE
PEOPLE EXPERIENCING HOMELESSNESS
THE PLANS AND THE STATE DO -- I
HAD ONE EXAMPLE IS A JOURNAL OF
AMERICAN MEDICAL ASSOCIATION
STUDY THAT SHOWED.
THAT -- A HOMELESS BENEFICIARIES
RECEIVING THESE TYPES OF
SERVICES SAVED TWENTY FIVE
HUNDRED DOLLARS PER MONTH BY
PROVIDING INTENSIVE SERVICES
THAT CONNECT PEOPLE TO HOUSING.
OVER THEIR PREVIOUS COSTS -- TO
MEDICAID.
IN A REPORT TO CONGRESS THE
CENTERS FOR MEDICARE AND
MEDICAID SERVICES EVALUATORS
REPORTED HOUSING INSTABILITY AS
AMONG THE GREATEST REPORTED NEED.
AND THE LACK OF CONNECTION TO
HOUSING IS THE BIGGEST CHALLENGE
TO PROGRAM'S SUCCESS.
PARTICULARLY CONSIDERING HOW
MANY OF THE HIGHEST COST
MEDICAID BENEFICIARIES
EXPERIENCE HOMELESSNESS.
SB THREE SIXTY ONE REMOVE
BARRIERS TO SUSTAINING THE
HEALTH HOMES PROGRAM.
AND EMPLOYMENT TO HOLD HOMES
PROGRAM THAT ADDRESSES THE NEED
FOR SERVICES AMONG MEDI CAL
BENEFICIARIES EXPERIENCING
HOMELESSNESS I URGE YOUR AYE
VOTE THANK YOU.
THANK YOU OTHERS IN SUPPORT.
GOOD AFTERNOON RONALD COLMAN
HERE BEHALF OF HEALTH ACCESS
CALIFORNIANS STRONG SUPPORT
THANK YOU THANK YOU.
GOOD AFTERNOON RUSSIAN THREE
WERE CALIFORNIA STATE
ASSOCIATION OF COUNTIES IN
SUPPORT THANK YOU.
I AM THE CONTACT US ON BEHALF OF
THE NATIONAL ASSOCIATION OF
SOCIAL WORKERS CALIFORNIA
CHAPTER IN SUPPORT.
THANK YOU -- CHILD DISABILITY
RIGHTS CALIFORNIA IN SUPPORT
THANK YOU.
PROSECUTORS HERE WE HAVE A CITY
OF SANTA MONICA IN SUPPORT THANK
YOU.
MEGAN SEWERS ON BEHALF OF
CALIFORNIA HEALTH PLUS ADVOCATES
IN SUPPORT.
LINDA TURNER WHAT'S OF THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK IN SUPPORT.
DAVID SISTER OF HOUSING
CALIFORNIA AND STRONG SUPPORT
THANK YOU THANK YOU.
GOOD AFTERNOON JENNIFER AUTHER
WITH CALIFORNIA ASSOCIATION
HEALTH PLANS WE HAVE A SUPPORT
OF AMENDED POSITION ON ON THE
BILL WILL CONTINUE OUR
DISCUSSIONS WITH THE AUTHORS
OFFICE IN THE SPONSORED WE
APPRECIATE THEIR OPEN DOOR
POLICY SO FAR THIS YEAR THANK
YOU THANK YOU.
SURE JOHNSON FROM FRESNO
CALIFORNIANS SUPPORT THANK YOU
[inaudible]
ANYONE ELSE. THIRTY ONE IN
OPPOSITION.
CNN WILL BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS OR COMMENTS
IN THE WORLD.
THE REQUEST BUT NOT THAT QUICK
SO -- SO WE HAVE -- WILL BRING
IT BACK TO SENATOR MITCHELL
WOULD YOU LIKE TO CLOSE I WOULD
JUST SAY VERY BRIEFLY MISTER
CHAIR THAT HEALTH HOME PROGRAMS
ARE REALLY NOT ACROSS THE
COUNTRY.
AND THESE PROGRAMS HELP ELIGIBLE
THOSE WHO ARE ELIGIBLE FOR
MEDICARE NOW WITH THAT HEARINGS
TO MEDICATION LINK THEM TO PEER
FAMILY SUPPORT SYSTEMS AND
PROVIDE HOUSING TRANSITION
SERVICES AMONG MANY OTHER
SERVICES FOR ALL THOSE REASONS
I'M ASKING FOR AN AYE VOTE.
THANK YOU VERY MUCH SENATOR YOUR
BILL ENJOYS A DO PASS
RECOMMENDATION THANK YOU BRING
IT FORWARD WE HAVE A MOTION BY
MISTER MAYES A SECOND BY MISTER
FLORA -- EMOTIONS TO PASS AS
AMENDED TO APPROPRIATIONS WHEN
WEISSMANN OF SECRETARY PLEASE
CALL THE ROLL WHAT I WOULD I'D
MAYES.
MAYES AYE AGUIAR-CURRY
[inaudible]
BIGELOW.
BONTA BURKE CARILLO.
CARILLO AYE FLORA [inaudible]
THE MOST.
MCCARTY THIS AREA.
RAMOS RAMOS I RODRIGUEZ
RODRIGUEZ AYE SANTIAGO.
WALDRON.
WALDRON AYE.
YES SIX WILL BE BELIEVE THE BILL
ON COLLEGE OF I APPRECIATE THAT
IS TODAY SO.
SO YOUR NEXT BILL SENATOR
MITCHELL.
THANKS.
FOR I LEVIN SP.
FOUR SIXTY FOUR THANK YOU VERY
MUCH MISTER CHAIRMAN AND MEMBERS
THIS VERY IMPORTANT PIECE OF
LEGISLATION ADDRESSES THE
MATERNAL MORTALITY DISPARITY IN
OUR STATE.
I APPRECIATE ONCE AGAIN THE
COMMITTEE STAFFER WORKING WITH
MY TEAM AND WILL BE TAKING THE
MEASUREMENTS REFLECTED ON PAGE
NINE OF YOUR COMMITTEE ANALYSIS.
THE AMERICAN COLLEGE OF
OBSTETRICIANS AND GYNECOLOGISTS
IN THEIR TWENTY SEVENTEEN REPORT
ENTITLED POLICY ON RACIAL BIAS
NOTES QUOTE.
THE RACIAL AND ETHNIC
DISPARITIES IN WOMEN'S HEALTH
CANNOT BE REVERSED WITHOUT
ADDRESSING RACIAL BIAS BOTH
IMPLICIT AND EXPLICIT.
WITHOUT EXAMINING THESE
DISPARITIES THROUGH A LENS THAT
TAKES INTO ACCOUNT RACE GENDER
AND CLASS AND EQUITABLE
HEALTHCARE SYSTEM THAT SERVES
ALL WOMEN CANNOT BE REALIZED IN
QUOTE.
SB FOUR SIX FOUR CALLS FOR THIS
THOROUGH AN INTERSECTIONAL
EXAMINATION OF BIAS.
THE BILL REQUIRES EVERY HOSPITAL
AND ALTERNATIVE BURST CENTER TO
PROVIDE EVIDENCE BASED IMPLICIT
BIAS TRAINING TO ALL PERINATAL
HEALTH CARE PROVIDERS.
THESE TRAININGS WILL CALL
ATTENTION TO THE INTERPERSONAL
INSTITUTIONAL AND STRUCTURAL
BARRIERS TO EQUITABLE CARE IN
ORDER TO CATALYZE A CULTURAL
CHANGE IN HOSPITALS.
SO THAT ALL WOMEN ARE ASSURED A
DIGNIFIED.
EXPERIENCE DURING CHILDBIRTH.
ALTHOUGH OPPOSITION REPORTS THAT
FACILITY BASED TRAININGS ARE NOT
THE APPROPRIATE VEHICLE TO
DELIVER THESE TRAININGS TO
PHYSICIANS RESEARCH SHOWS THAT
IMPLICIT BIAS TRAININGS WORK.
AND DO AND DO SO BEST WHEN THEY
ARE DONE IN PERSON.
IN A GROUP SETTING AND OUR
INTERACTIVE.
SENATE BILL FOUR SIX FOUR
ENCOURAGES IN PLACE TRAINING
WITH ALL PERINATAL STAFF TO
MAXIMIZE THE POTENTIAL OF THE
FACILITIES WIDE IMPACT.
SB FOUR SIX FOUR WILL ALSO
REQUIRE THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH TO
TRACK AND PUBLISH MATERNAL
MORTALITY AND SEVERE MORBIDITY
RATES TO BETTER MONITOR THESE
ISSUES.
AND HIGHLIGHT THE AREAS AND
DEMOGRAPHICS THAT NEED FURTHER
INTERVENTION -- I'VE GOT HERE --
SOME WITNESSES WHO -- ARE GOING
TO TAKE A MINUTE MISTER CHAIR TO
SHARE VERY PERSONAL STORIES YOU
KNOW WHEN YOU AND I TALKED ABOUT
THIS BILL WE TALKED ABOUT.
THE DISPROPORTIONATE NUMBER OF
BLACK WOMEN WHO HAVE -- I'M ONE
OF THE SPECTRUM NEGATIVE
EXPERIENCES -- WITH THEIR
BIRTHING EXPERIENCE IN HOSPITALS
AND AND ALTERING THE BIRTHING
CENTERS AND ON THE OTHER END OF
THE SPECTRUM LOSE THEIR LIVES
AND SO GIL SCOTT -- IS WILLING
TO SHARE FROM STOCKTON HAS COME
TO TODAY.
TO IN LIGHT NOTHING SHARE HER
PERSONAL STORY SHE'S A COMMUNITY
ADVOCATE FOR SENIORS HEALTH AND
RIGHTS AS WELL AS VICKI
ALEXANDER WHO'S A RETIRED OBGYN.
TRAINED AT UC SAN FRANCISCO ON
AND SHE'S FOUNDER AND BOARD
PRESIDENT OF HEALTHY BLACK
FAMILIES INK IN THE EAST BAY
[inaudible]
THANK YOU -- AFTERNOON EVERYONE
HI MY NAME IS GIL SCOTT -- AND
I'M HERE TODAY TWENTY WITH ALL
THE WOMEN INVOLVED IN THE DIG ME
A PREGNANCY AND CHILDBIRTH HAD.
I'M ALSO HERE TO SHARE A LITTLE
BIT OF MY TESTIMONY -- SO WHAT
TOOK PLACE WITH DORM ONE OF MY
PREGNANCIES.
I'M I WAS ABOUT SIX MONTHS
PREGNANT.
I HAD BEGIN TO NOTICE MINIMAL
MOVEMENT.
IN AND OUT OF THE BABY INSIDE OF
ME.
AND I HAD AN APPOINTMENT THE
NEXT DAY I WENT TO MY REGULAR DO
YOU ARE YOU IN.
WHO WAS NOT THERE WAS NOT
AVAILABLE AND SO I WAS SEE MY
NURSE PRACTITIONER?
THE NURSE THE NURSE PRACTITIONER --
DID EXAMINE ME AND I GAVE HER --
MY CONCERNED OF WHAT WAS GOING
ON WITH ME.
AND SHE EXAMINED ME TOM SHE CAN
HEAR HEART BEAT.
SO WITH THAT I STARTED TO
QUESTION HER AND SHE GAVE ME THE
ANSWER OF COME BACK INTO A
FOLLOW UP WITH YOUR REGULAR.
DOCTOR.
SO I DO GO BACK HOME AND WITH IN
THAT. TO TWO FOUR WEEK PERIOD I
WENT INTO FULL BLOWN LABOR
[inaudible]
I'M.
I'M THANKFUL TODAY BECAUSE THAT
I'M ALIVE TODAY BECAUSE I FOUND
OUT THAT MY BABY WAS STILLBORN.
MY BABY HAD BEEN DEAD INSIDE OF
ME. FOR ALMOST FOUR WEEKS.
I MY WHOLE INTERNAL SYSTEM COULD
HAVE SHUT DOWN COULD BE EMPLOYED
IN AND I COULD HAVE DIED DURING
THAT SITUATION THAT I WENT
THROUGH -- THEN I'LL COME.
I FEEL FROM NOT BEING THOROUGH
FOR ME NOT HAVING THOROUGH
ATTENTION -- I KNOW THAT I
NEEDED SURROUNDING THE NORMAL
FUNCTION OF MY BODY MY BABY.
IN MY BABY IT RESULTED IN ME
HAVING.
TO GIVE THE BABY A NAME GIVE THE
BABY A BURIAL GIVE THE BABY A
FUNERAL.
AND THEY LEFT ME IN A VERY
DEPRESSED STATE.
THANK YOU THANK YOU.
THANK YOU.
THANK YOU FOR IS FIVE WE REALLY
APPRECIATE YOUR TESTIMONY.
GOOD AFTERNOON CHAIRMAN WOULD.
AND MEMBERS OF THE COMMITTEE MY
NAME IS DOCTOR VICKY ALEXANDER.
I HAVE TESTIFIED IN MANY PLACES
LOCAL STATE AS WELL AS FEDERAL
LEVEL AROUND INFANT MORTALITY
FOR THE LAST THREE YEARS -- I'M
TIRED OF TESTIFYING.
ABOUT THE DISPARITIES IN INFANT
MORTALITY IS REALLY A TIME FOR
COURAGEOUS CHANGE AND I THINK
SENATE BILL FOUR SIX FOUR WILL
DO THAT FOR US -- THERE'S JUST
FOUR THINGS I WANT TO COMMENT ON
BRIEFLY.
ON THE BILL.
THE FIRST IS.
WE NEED MORE INFORMATION ABOUT
THE DEATHS OF WOMEN.
AND OF THEIR BABIES OFTENTIMES A
MEDICAL RECORDS ARE NOT COMPLETE.
I DID A FULL AUDIT A ONE OF THE
HOSPITALS IN BERKELEY.
OOPS I GUESS I GAVE IT AWAY FOR
THOSE OF YOU THAT MIGHT KNOW THE
AREA -- I DID A FULL AUDIT TO MY
STAFF DID A FULL ON IT WHEN I
WAS A DIRECTOR MATERNAL CHILD
HEALTH FOR THE CITY OF BERKLEY.
OF ALL THEIR RECORDS FOR ONE
YEAR PERIOD OF TIME ALL THEIR
DELIVERY RECORDS TO SEE WHAT
THERE WERE MANY.
WE DON'T NEED TO GO INTO THAT WE
KNOW THAT WE CAN TELL THAT THERE
ARE BIASES BASED ON INFANT
MORTALITY THAT IS FOUR TIMES
HIGHER -- THREE TWO TIMES HIGHER
AND MATERNAL MORTALITY AS FOUR
TIMES HIGHER IN THE BLACK
COMMUNITY.
WE CAN NO LONGER JUST SIT BACK
BUT YOU KNOW I SAID THAT THIRTY
YEARS AGO.
AND MICKEY LELAND'S HEARING IN
IN IN [inaudible]
WASHINGTON -- BUT WE NEED MORE
INFORMATION ON OUR BIRTH
CERTIFICATES THAT WEEKEND THEN
AUTOMATICALLY NOW IN OUR
ELECTRONIC SYSTEMS.
SHARE WITH THE PHYSICIANS TO
DELIVERED.
THE BABIES THEY DON'T HAVE TO
SHARE THE NAMES BUT THEY SHOULD
KNOW OF ALL THEIR DELIVERIES HOW
MANY OF THESE BABIES ACTUALLY
DIED IN CONGREGATE.
HOW MANY OF THE MOTHERS HAD
PROBLEMS POST PARTUM AND PASSED
AWAY POSTPARTUM?
WE DON'T EVEN KNOW THAT AS OF
THIS POINT THE PHYSICIAN RECORDS
ARE NOT ACCURATE ENOUGH THEY
NEED TO HAVE A CASE.
THERE HAS TO COME FROM THE BIRTH
RECORD.
AND THE PHYSICIANS OFTENTIMES DO
NOT HAVE THAT.
SECONDLY I THINK THERE NEEDS TO
BE AN ACCOUNTABILITY SYSTEM. FOR
THE DOCKS AND THIS WOULD BE ONE
OF THE ACCOUNTABILITY SYSTEMS
THERE'S RIGHT NOW THEY'RE NOT
ACCOUNTABLE TO ANYBODY
[inaudible]
IN REALITY.
THEY'RE NOT ACCOUNTABLE TO
ANYBODY.
EVEN TO SOME OF THE COMMITTEES
IN THE HOSPITALS THEY DON'T HAVE
TO ACTUALLY REPORT ON ALL OF THE
ISSUES THAT HAVE MAY HAVE RISEN
AND WHAT THEY HAVE DONE TO
IMPROVE.
ON THOSE ISSUES.
NEEDLESS TO SAY.
THINGS AROUND IMPLICIT BIAS.
WHICH IS IN THE OLD DAYS YOU
JUST CALLED STRAIGHT UP RACISM.
BASED ON THE COLOR OF A PERSON'S
SKIN AND BY THE WAY WHEN A WOMAN
COMES IN IS AND THE THE NURSES
TO THE DOCK WE GOT A TWENTY FOUR
YEAR OLD BLACK WOMAN.
ALREADY THAT BIASES THERE HASN'T
EVEN SEEN THE PATIENT.
THAT IS REALLY A PROBLEM.
SO WE REALLY NEED TO BE ABLE TO
NOT ONLY TRAIN PEOPLE AROUND
IMPLICIT BIAS BUT ALSO BE ABLE
TO HAVE THEM.
LEARN FROM IT AND TO SEE THEIR
OWN BEHAVIOR AND HOW THEIR
BEHAVIOR -- IN THE DELIVERY
WOULD WORK.
I STRONGLY SUPPORT SENATE BILL
FOUR SIXTY FOUR IS SOMETHING IS
REALLY GOT TO BE DONE -- AND WE
NEED TO GET RID OF THIS ON GOING
IN EQUITY BETWEEN RACES IN THIS
COUNTRY.
THANK YOU VERY MUCH -- OTHERS IN
SUPPORT -- JUST YOUR NAME AND
ORGANIZATION PLEASE -- GAS ON
BEHALF OF MARCH OF DIMES IN
SUPPORT.
THANK YOU.
DOCTOR THE SHAUNA MONET RECS AND
SUPPORT THANK YOU DELYLAH CLAY
ON BEHALF OF LOS ANGELES COUNTY
AND SUPPORT THANK YOU.
LEVINE OF ORANGE SAN FRANCISCO
IN SUPPORT THANK YOU MICHELLE
GIVEN TO THE COUNTY HEALTH
EXECUTIVES ASSOCIATION OF
CALIFORNIANS SUPPORT.
ALEXIS CABINS OAKLAND CALIFORNIA
AND SUPPORT Q. AND A ON THE
CONTENTS ON BEHALF OF THE
NATIONAL ASSOCIATION OF SOCIAL
WORKERS IN SUPPORT THANK YOU.
SHARON JOHNSON FRESNO CALIFORNIA
ON BEHALF OF BLACK WOMEN HEALTHY
ONLY QUE WORKSHOP IN SUPPORT
THANK YOU.
LINDA TOMORROW WHAT'S WITH THE
CALIFORNIA PENITENT HEALTH
NETWORK AND AS WELL AS THE HELP
HAVING OUR SAY COALITION IN
SUPPORT.
DR ERICA MOWER FROM LOS ANGELES
CALIFORNIA IN SUPPORT THANK YOU
ROXANNE GOAL REPRESENTING THE
AMERICAN NURSES ASSOCIATION
CALIFORNIANS SUPPORT THANK YOU
BRIANNA HAAS FOR MAC FROM ANY
GIRLS AND TULARE COUNTY AND WE
SUPPORT.
MOLLY WATSON FROM COURAGE
CAMPAIGN ALSO THE A BLACK MOTHER
OF A SMALL CHILD AND ENDS IN
FULL SUPPORT THANK YOU VERY MUCH
OF A LIVIA CAROLS FROM FULLER
HALLIFORD AND I SUPPORT.
MEGAN SUPERS CALIFORNIA HEALTH
PLUS ADVOCATES IN SUPPORT.
DOESN'T SIMMONS AND TULARE
CALIFORNIA I SUPPORT THANK YOU.
WOULD SOON DAVIS OF THE
CALIFORNIA BUT HEALTH THAT WORK
IN SUPPORT.
GERALDINE IS WILL GO A LONG
FRESNO CALIFORNIA SUPPORT THANK
YOU.
MISTER CHAN ON BEHALF OF BLACK
WOMEN FOR WELLNESS AND TRONG
SUPPORT THANK YOU.
EVIL LEVINGSTON WITH BLACK WOMEN
FOR WELLNESS IN SUPPORT THANK
YOU CATHERINE AGREED ON ON
BEHALF OF FIRST FIVE ELAINE
FIRST HAVE CALIFORNIANS SUPPORT.
THE NEW YES CLOSE CALIFORNIA AND
SUPPORT THANK YOU.
WE NEED FOR WILLIAMS PUBLIC
HEALTH NURSE MATERNITY NURSE.
IN SUPPORT THANK YOU.
K. CATS ON BEHALF OF BLACK WOMEN
FOR WELLNESS ECHO PARK
CALIFORNIA I SUPPORT THANK YOU.
YES MEAN POWERED HEALTH ACCESS
CALIFORNIA AND SUPPORT.
THANK YOU I JOIN JOHNS BLACK
WOMEN FOR WELLNESS LA COUNTY
RESIDENT I SUPPORT THANK YOU.
CHRISTY REASON BOB OF THE
CALIFORNIA HOSPITAL ASSOCIATION
IN SUPPORT.
THANK YOU THE SHERIN MCGEE FROM
FRESNO CALIFORNIA WITH BLACK
WOMEN WOMEN FOR A WELLNESS ANY
ONLY CARE WORKSHOP IN STRONG
SUPPORT.
BRENDA HEARN MOTHER BLACK WOMEN
FOR WELLNESS STRONG SUPPORT
THANK YOU.
ALEX BANKS BLACK WOMEN FOR
WELLNESS LOS ANGELES SUPPORT
THANK YOU.
KIMBERLY ROBINSON WITH BLACK
FROM WOMEN FOR WELLNESS FROM
STOCKTON IN SUPPORT.
JASMINE HALEY STRONG SUPPORT
THANK YOU.
I'D FRESNO BLACK WOMEN FOR
WELLNESS STRONG SUPPORT.
LET'S SAY BROWN LOS ANGELES
COUNTY WERE BLACK WOMEN FOR
WELLNESS STRONG SUPPORT.
CAN I MAKE FAT AND FROM FRESNO
WITH CENTRAL VALLEY URBAN
INSTITUTE STRONG SUPPORT.
MICHELLE POOL OAKLAND CALIFORNIA
STRONG SUPPORT.
I SHOULD HURRY FRESNO CALIFORNIA
WITH CENTRAL VALLEY URBAN
INSTITUTE IN STRONG SUPPORT.
KAELIN TANNER FROM AUSTIN DOES
CALIFORNIA WITH BLACK MORE FOR
WELLNESS STRONG SUPPORT THANK
YOU.
MONEY SHED WORDS ON BEHALF OF
THE CENTRAL VALLEY URBAN
INSTITUTE IN FRESNO CALIFORNIA I
STRONGLY SUPPORT.
DIAMOND LEAST SOUTH LOS ANGELES
RESIDENT RESIDENT STRONG SUPPORT.
TRUCKING LETTERMAN'S
MICHELANGELO STRONG SUPPORT.
I AM CAIT DANIEL SMITH
GOVERNMENTAL I SUPPORT THIS BILL
FOR ME MY MOM MY WAS ALONE.
KINGSLEY TONI AG A TONY GWYNN
AWAY HIJA CAMARA AND A LEASE
THAT CAUSE ME WITH THE PRAXIS
PROJECT IN STRONG SUPPORT THANK
YOU.
WHEN I WAS LIKE A LITTLE BLACK
WOMAN FROM ON THIS ACTION
PROJECT EXPECTING MOM AND STRONG
SUPPORT?
HEATHER BROWN FRESNO ECONOMIC
OPPORTUNITIES COMMISSION IN
STRONG SUPPORT THANK YOU.
PROSECUTORS HERE WE HAVE THE
CITY OF LOS ANGELES IN SUPPORT.
JORDAN PERRY WITH BLACK ONE FOR
WELLNESS FROM A HIGH CALIFORNIA
IN SUPPORT.
VANESSA BANNED FROM LANCASTER
CALIFORNIA IN STRONG SUPPORT
THANK YOU.
DOCTOR CATHERINE MITCHELL.
GRIEVING MOTHER WHO'S LOST HER
SON.
IN STRONG SUPPORT THANK YOU.
SAMANTHA AND TRUMP FROM KOREA
TOWN IN LOS ANGELES I REPRESENT
COLOR OF CHANGE AND WE'RE IN
STRONG SUPPORT THANK YOU.
TIFFANY HER FROM LOS ANGELES
CALIFORNIA I STRONGLY SUPPORT.
JACQUELINE HUGGINS A BLACK WOMAN --
I'M A STRONG SUPPORT OF
FINANCIAL THANK YOU.
CHANEL WILLIAMS COMMUNITY
ORGANIZER AND HEALTH ADVOCATE
FROM SAN FRANCISCO CALIFORNIA
ALSO ELECTED OFFICIAL IN THE
CITY COLLEGE BOARD OF TRUSTEES
IN STRONG SUPPORT.
THANK YOU.
SEMI MUHAMMAD FROM BLACK WOMEN
FOR WELLNESS AND FULL SUPPORT
THANK YOU.
FOUGHT TO MáS SUIT AND I'M CAN
I'M A CHRISTIAN MORE USEPA CURRY
GREEN PARTY PRESIDENTIAL
CANDIDATE LOOKING FORWARD TO
THAT IT TWENTY TWENTY AND ON'T
IN STRONG SUPPORT BLACK WOMEN
FOR WELL THIS.
HI GOOD AFTERNOON SABRINA ASH
AND I AM LEGISLATIVE CHAIR FOR
CALIFORNIA WOMEN LAWYERS AND THE
VICE CHAIR OF PUBLIC POLICY FOR
NATIONAL WOMEN'S POLITICAL
CAUCUS.
THIS BILL IS ON OUR PRIORITY
LIST -- AGENDA FOR THE YEAR WE
STRONGLY ARE IN SUPPORT THANK
YOU THANK YOU.
YOUR BASE A FLAT WITH BLACK LOOK
FLAWLESS AND ON BEHALF OF THE
ABOUT PRO CHOICE CALIFORNIA IT'S
A PART.
THANK YOU.
CHEN FLORES WESTERN CENTER ON
LAW AND POVERTY PROUD CO SPONSOR.
THANK YOU [inaudible]
ANYONE ELSE.
AMERICAN.
HONDA STIR OF SAN FRANCISCO
DEPARTMENT OF PUBLIC HEALTH
MATERNAL CHILD AND ADOLESCENT
HEALTH.
AND FAMILY PLANNING PROGRAM
THANK YOU [inaudible]
ANYONE ELSE.
OKAY IS THERE ANYONE IN
OPPOSITION.
I'LL BE QUICK MORNING CARVALLO
THE CALIFORNIA MEDICAL
ASSOCIATION -- WE HADN'T OPPOSE
UNLESS AMENDED POSITION AND
BELIEVE THAT THE AMENDMENTS THAT
WERE TAKEN TODAY AND COMMITTEE --
MAKE THIS TRAINING VOLUNTEER FOR
PHYSICIANS WERE NOT PLOY BY THE
HOSPITALS -- WE THINK THAT IT
WILL HELP TO ADDRESS OUR
CONCERNS AND LOOK FORWARD TO
SEEING THAT AMENDMENT IN PRINT.
THANK YOU VERY MUCH [inaudible]
ANYONE ELSE.
SAY NO ONE WILL BRING IT BACK TO
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS OR COMMENTS
CAM IN. THREE NINE WE DO HAVE A
MOTION BY MISTER MAYES A SECOND
BY MISS CARILLO CENTER WHICH
WOULD YOU LIKE TO CLOSE I WOULD
VERY MUCH THANK YOU -- AS A T.
SHIRT SAY THAT FEEL GREEN TEA
FOR SINCE SO MANY PEOPLE WHO
TRAVEL -- UP HERE TODAY TO SPEAK
IN SUPPORT AND TELL THEIR
STORIES BLACK WOMEN DO DESERVE
BETTER.
AND WHEN WE RECOGNIZE THAT THE
BLACK MATERNAL MORTALITY RATE IN
CALIFORNIA REMAINS FOUR TIMES
HIGHER THAN THOSE OF OTHER
RACIAL RACIAL ETHNIC GROUPS.
THAT'S WHY THE BILL IS BEFORE
YOU TODAY -- I HAVE TO SAY
MISTER CHAIR YOU KNOW I STAFF
SENATE HEALTH AND HUMAN SERVICES
COMMITTEE.
ALMOST THIRTY YEARS AGO.
WHEN WE DIDN'T HAVE A MOVEMENT
BY AND FOR BLACK WOMEN TO
ADVOCATE ON BEHALF OF THEIR OWN
LIVES AND THEMSELVES?
THIS WOULD GIVE ME GREAT PRIDE
TO STAND HERE TODAY TO SEE A
HEARING ROOM FILLED WITH WOMEN.
WHO ARE CLEAR THAT THEY DO
DESERVE BETTER AND ARE WILLING
TO STEP UP AND ENGAGE IN
ADVOCACY TO MAKE SURE THAT --
BIAS BE IT IMPLICIT OR EXPLICIT --
WILL NO LONGER IMPACT THEIR
ABILITY TO DELIVER A FULL TERM
BABY.
OR TO SURVIVE CHILDBIRTH
THEMSELVES.
THE GOAL OF THIS BEFORE SIX FOR
IS TO DO THAT.
WITH THIS BILL IN THE MOVEMENT
THAT IT IS HELPING TO CREATE --
WHETHER -- A DOCTOR VOLUNTARILY
CHOOSES TO TAKE THE IMPLICIT
IMPLICIT BIAS TRAINING OR NOT.
IT IS OUR HOPE THAT WOMEN WILL
ASK THEIR PROVIDERS.
AS WE INTERVIEW DOCTORS AS WE
ALL ARE TAUGHT WHEN WE GO TO THE
TWO OR OF THE BIRTHING CENTER IN
THE OLD BE SO YOU KNOW WHERE YOU
GOING TO DELIVER THE BABY WE'RE
GETTING COURAGE BLACK WOMAN TO
ASK THEIR PROVIDER.
HAVE YOU GONE TO IMPLICIT BIAS
TRAINING I WANT TO INCREASE THE
LIKELIHOOD OF MY SURVIVAL.
OF DELIVERING THIS BABY.
SO WITH ALL THAT I HOPE THAT YOU
WILL JOIN US IN THIS MOVEMENT
AND SUPPORT SENATE BILL FOUR SIX
FOUR I THANK YOU FOR YOUR
PATIENCE.
I THINK YOU CENTER MITCHELL AND
I REALLY WANT TO THANK YOUR
WITNESSES -- FOR SHARING WITH US
TODAY AND ALL THE PEOPLE CAME
HERE TODAY FROM GREAT DISTANCES
TO SUPPORT YOUR BILL -- THE
SCIENCE DOESN'T LIE AND IT'S SAD
THAT WE ARE IN THE STATE THAT --
IN FOR WE'RE COUNTY IN THE AND
THE RISK OF MOTHERS IS MUCH
HIGHER FOR WOMEN OF COLOR -- I
AM PLEASED TO SEE THE CALIFORNIA
HOSPITAL ASSOCIATION IN SUPPORT
OF THIS BILL.
AND I WOULD HOPE THAT THEY WOULD
REQUIRE OF THE DOCTORS -- WHO
DELIVER IN THEIR HOSPITALS TO
UNDERGO THIS TRAINING AS A
CONDITION OF WORKING -- AND
DELIVERING AND THEIR HOSPITALS I
THINK IT'S IMPORTANT -- AND I
APPRECIATE YOUR YOUR YOUR
BRINGING THIS TO OUR ATTENTION
IT'S IMPORTANT THAT EVERYBODY
HAVE THE CHANCE TO HAVE A LIGHT
HEALTHY BABY.
HAD A HEALTHY OUTCOME FOR THE
MOTHER AS WELL WITH THAT -- I
WILL ASK MADAM SECRETARY -- TO
CALL THE ROLL OF THE MOTION IS
TO PASS AS AMENDED TO
APPROPRIATIONS MA'AM SECRETARY
PLEASE CALL THE ROLL.
I WOULD I MAYES [inaudible]
I AGUIAR-CURRY.
BIGELOW.
BIGELOW AYE BONTA.
BURKE [inaudible]
CARILLO.
FLORA.
FLORA AYE LIMóN [inaudible]
MCCARTY [inaudible]
THIS AREA.
RAMOS I PROMISE I RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO WALDRON
[inaudible]
HI [inaudible] SEVEN ALSO.
THE BILL HAS SEVEN WE STILL HAVE --
MEMBERS WHO ARE HERE BELIEVE THE
BILL ON CALL THANK YOU SO MUCH
THANK YOU VERY MUCH.
MISTER CHAIRMAN COMMITTEE
[inaudible]
DOCTOR PAN.
GOOD AFTERNOON.
GOOD AFTERNOON DOCTOR PAN.
GIVE IT JUST A SECOND SIR.
GIVEN THE AMOUNT OF TIME THIS
CAN BE A SPENT WITH ME A READY I
NEVER WANT TO KEEP YOU WAITING
[inaudible]
APPRECIATE THAT [inaudible]
OKAY.
YOU HAVE TO BILLS BEFORE US THE
FIRST ONE WILL BE -- ITEM NUMBER
EIGHT SB THREE FORTY THREE
THAT'S OKAY.
THANK YOU OKAY THANK YOU DOCTOR
CHAIR MEMBERS -- SB THREE FORTY
THREE REMOVES PROVISIONS IN THE
LAW THAT ALLOWS KAISER PERMANENT
TATE REPORTS.
LESS INFORMATION TO REGULATORS
THEN OTHER HEALTH PLANS AND
HOSPITALS.
TRANSPARENCY LAWS LIKE RATE
REVIEW IN HOSPITAL FINANCIAL
DISCLOSURES WERE CREATED TO HELP
PURCHASERS AND REGULATORS MINOR
COSTS THAT DRIVE HEALTH.
INSURANCE PREMIUM RATES AS
HEALTHCARE COSTS CONTINUE TO
RISE POLICYMAKERS PURCHASERS AND
CONSUMERS SHOULD HAVE ACCESS TO
THE SAME INFORMATION ABOUT WHAT
IS DRIVING COST INCREASES AT
KAISER.
THEY HAVE ABOUT EVERY OTHER
HOSPITAL AND HEALTH PLAN.
I RECENTLY AGREED TO AMENDMENTS
TO ADDRESS SOME OF KAISER'S
CONCERNS -- DUE TO KAISER SO
UNIQUE STRUCTURE THEY STATED
THAT THEY WERE UNABLE TO REPORT
BALANCE SHEETS ARE CASH FLOW
STATEMENTS BY EACH INDIVIDUAL
FACILITY.
WE AGREED TO REINSTATE THE
KAISER LANGUAGE FOR THOSE
PORTIONS OF THE HOSPITAL ANNUAL
REPORTS.
ADDITIONALLY BECAUSE OZ PART
WILL BE HALF TO DEVELOP
REGULATIONS TO CHANGE THE WAY
KAISER COMPLETES ANNUAL REPORTS
WE AGREE TO THE LAY CHANGES THE
KAISER AND REPORTING
REQUIREMENTS AND TO OUR SPOT
COMPLETES THE REGULATIONS.
THE MYTH OF THIS ISN'T
EVERYTHING KAISER ASKED FOR BUT
WE ARE AT LEAST.
AT A POINT WHERE WE'RE NOT
ASKING FOR ANYTHING THE KAISER'S
UNABLE TO COMPLY WITH.
NOW GIVEN HOW MANY HOSPITALS
KAISER OPERATES AND HOW MANY
PATIENTS ARE COVERED BY CRISIS
HEALTH PLANS THIS BILL
REPRESENTS A HUGE LEAP FORWARD
IN TRANSPARENCY OF HEALTH CARE
COSTS.
I DO WANT TO RECOGNIZE AND I
THINK HIGHS ARE FOR WORKING WITH
ME AND THE SPONSORS OF THE BILL.
I KNOW WE'RE NOT QUITE THERE YET
BUT I WOULD POINT OUT AND A
LITTLE I GUESS I SHOULD THE
THAT I THINK THAT WERE WE WERE
WE WERE WE ARE ASKED I THINK
IT'S SOMEPLACE THAT'S IN MY MIND
IS -- REASONABLE WE TRY TO BRING
THINGS TOGETHER AND WITH THAT
ASPECT WE ASK FOR AN AYE VOTE MY
MY WITNESSES AND SUPPORT THANK
YOU.
THANK YOU PLEASE GO AHEAD GOOD
AFTERNOON MR CHARITY OR ON
BEHALF OF THE SERVICE EMPLOYEES
INTERNATIONAL UNION ON BEHALF OF
SEVEN HUNDRED THOUSAND MEMBERS
WE ARE THE PROUDSPONSORS OF SB.
THREE FORTY THREE AGAIN A BILL
TO ENSURE THAT OUR HOSPITALS AND
HAVE HEALTH PLANS ON A LIVING
PLATE LEVEL PLAYING FIELD WHEN
IT COMES TO TRANSPARENCY ABOUT
HEALTH CARE COST.
I THINK ALL OF US ARE AWARE
ABOUT THE INCREASING COST OF
HEALTHCARE ACROSS THE STATE OF
CALIFORNIA.
ON BEHALF OF SEVEN HUNDRED
THOUSAND MEMBERS WHO HAVE
EMPLOYER COVERAGE IN HEALTHCARE
THEIR COST CONTINUE TO RISE ON A
DAY TO DAY AND I THINK YOUR
CONSTITUENTS I'M SURE YOU HEAR
IT ON A DAY TO DAY WE HEAR IT
FROM MEMBERS OF SCA YOU.
MEMBERS OUTSIDE OF S. YEAH YOU
THE HUGE RATE OF GROWTH IN
HEALTHCARE COSTS AND THE ONLY
WAY THAT WE CAN TACKLE THIS
PROBLEM IS HAVING INFORMATION I
THINK WE OFTEN HEAR THE TERM
INFORMATION IS POWER IN ORDER
FOR US.
TO BE ABLE TO TACKLE THE PROBLEM
OF HEALTH CARE COSTS WE HAVE TO
ENSURE EVERYONE'S ON A LEVEL
PLAYING FIELD AND THE DATA THAT
WE GET FROM OTHER HOSPITAL
SYSTEMS.
IS CONSISTENT WITH THE DATA THAT
WE GET FROM A KAISER WHO SERVES
OVER 60% OF THE POPULATION IN
CALIFORNIA JUST TO GIVE YOU AN
IDEA OF WHAT OUR MEMBERS ARE
EXPERIENCING -- HEALTHCARE COSTS
HAVE GONE UP SO HIGH IN THE YEAR
OF NINETEEN NINETY NINE EMPLOYER
SPONSORED COVERAGE WAS AT ABOUT
FIVE THOUSAND SEVEN HUNDRED
NINETY ONE DOLLARS.
IN TWENTY SIXTEEN HEALTHCARE
COSTS HAVE GONE UP TO OVER
EIGHTEEN THOUSAND DOLLARS SO I
DON'T HAVE TO EXPLAIN TO ALL OF
YOU HERE ON THE DíAS THE
PROBLEM THEY WERE ATTEMPTING TO
TACKLE IN CALIFORNIA WE ARE
COMMITTED TO HAVING A RICH
CONVERSATION.
WITH THE ALLIES IN FOLKS ACROSS
THE AISLE ABOUT HOW TO TACKLE
THAT BUT IN ORDER TO DO THAT
KAISER HAS TO BE ON THE SAME
LEVEL PLAYING FIELD AS EVERY
OTHER HOSPITAL IN ASSOCIATION IN
CALIFORNIA.
AND MAKE SURE THAT THOSE PRICES
AND THEIR RATES ARE TRANSPARENT
SO WERE ABLE TO IDENTIFY THE
PROBLEM TACKLE THE PROBLEM AND
DO SOMETHING TO ADDRESS THE COST
FOR CONSTITUENTS IN THE FOLKS
THAT WE CARE ABOUT ACROSS THE
STATE [inaudible]
THANK YOU.
GOOD AFTERNOON MISTER CHAIRMAN
MEMBERS YES MEAN PALETTE FOR
HEALTH ACCESS CALIFORNIA THE
STATE WIDE HEALTH CARE CONSUMER
ADVOCACY COALITION HERE IN
SUPPORT OF SB.
THREE FORTY THREE MEMBERS HELP
ACCESS WAS THE SPONSOR OF THE
ORIGINAL RATE REVIEW LEGISLATION
WHICH SB THREE FORTY THREE A
MAN'S WE DRAFTED THE SENTENCE
WHICH ALLOWS KAISER DOCTORS TO
DISCLOSE ACTUAL EXPERIENCE USING
BENEFIT CATEGORIES THAT ARE
SIMILAR TO THOSE USED BY OTHER
PLANS.
THE RATE REVIEW LAW REQUIRES
HEALTH PLANS TO SAY HOW MUCH
THEY SPENT ON TEN CATEGORIES
PHYSICIAN SERVICES INPATIENT
HOSPITAL CARE OUTPATIENT
EMERGENCY CARE LABS AND IMAGING.
MEMBERS DUES DOES KAISER KNOW
HOW MUCH PHYSICIAN SERVICES COST
SEPARATED OUT FROM HOSPITAL
SERVICES DO THEY HAVE A BUDGET
THAT SEPARATES LAB SERVICES FROM
X. RAYS AND CAT SCANS MRI AND
OTHER IMAGING COSTS.
HOW ARE THEY PROVIDING CARE TO
ALMOST NINE MILLION CALIFORNIANS
IF THEY DON'T KNOW HOW MUCH THEY
SPEND ON DOCTORS COMPARED TO
HOSPITALS?
WE KNOW FROM OUR WORK ON OTHER
RATE REVIEW BILLS THAT KAISER
PROVIDES TO LARGE PURCHASERS
MUCH MORE DETAILED INFORMATION
ON UNIT COSTS AND UTILIZATION
FOR TYPES OF CARE.
AND THEY DO IT QUARTERLY YET ON
THE RATE FILINGS KAISER SAYS
THEY CANNOT PUBLICLY EXPLAIN
WHAT THEY SPEND ON DOCTORS
HOSPITALS LABORATORIES AND
IMAGING. FOR THESE REASONS WE
SUPPORT SB THREE FORTY THREE AND
REQUEST YOUR AYE VOTE.
THANK YOU VERY MUCH OTHERS IN
SUPPORT JUST YOUR NAME AND
ORGANIZATION PLEASE.
MY NAME IS STEPHANIE POWER I'M A
PROUD MEMBER OF SEIU S. CI GIVE
YOU H. W. AND I AM IN SUPPORT OF
THIS BILL THANK YOU.
SIR FLOCKS CALIFORNIA LABOR
FEDERATION IN SUPPORT THANK YOU.
MISTER CHAIR MEMBERS MAP BROUGHT
FOR THE TEAMSTERS UNITE HERE
MACHINISTS EIGHTY YOU UTILITY
WORKERS AND ENGINEERS AND
SCIENTISTS OF CALIFORNIANS
SUPPORT THANK YOU THANK YOU.
DINI SALAS SEIU YOU H. W. AND
I'M FROM POMONA CALIFORNIA AND
I'M IN SUPPORT OF THIS BILL.
THANK YOU.
JACKIE BATES M. FROM AS HE ARE
YOU YOU H. W. IN STRONG SUPPORT
OF THIS BILL THANK YOU.
ANDREW WHITE WITH THE CALIFORNIA
PUBLIC EMPLOYEES RETIREMENT
SYSTEM IN SUPPORT THANK YOU.
LISA UNDER WOULD SEIU UNITED
HEALTHCARE WORKERS WEST AND I AM
IN SUPPORT THANK YOU.
LIZ GRIGSBY SEIU YOU H. W. AND
I'M IN SUPPORT.
SHOW BONTA WALLER WITH SEIU U.
S. W. IN STRONG SUPPORT.
THANK YOU.
EVELYN NEVER LET THEIR FROM
MODESTO CALIFORNIA -- SEIU
MEMBER AND I'M IN STRONG SUPPORT
THANK YOU.
LISA FLOYD I'M FROM NORTHRIDGE
CALIFORNIA MY SCA YOU YOU H. W.
MEMBER IN STRONG SUPPORT THANK
YOU.
DOWNEY SHOW BROUGHT IN -- WITH
AS HE I YOU YOU H. W'S OTHER
CALIFORNIA I SUPPORT.
HI URSULA MIRO WITH THIS YEAR
YOU YOU H. W. SANTA ROSA I
SUPPORT THANK YOU.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY IN SUPPORT THANK
YOU [inaudible]
ANYONE ELSE.
SIR ANYONE IN OPPOSITION.
THANK YOU MR CHAIRMAN MEMBERS
THERESA START WITH KAISER
PERMANENTE A WE DO HAVE AN
OPPOSE UNLESS AMENDED POSITION.
ON THE BILL AND WE DO WANT TO
EXPRESS OUR THANKS AND
APPRECIATION TO THE AUTHOR AND
SPONSOR -- FOR WHAT I BELIEVE
HAVE BEEN HOURS AND HOURS OF
CONVERSATION ABOUT THIS BILL --
AND OUR CONCERNS WITH IT IN AND
WE REALLY DO APPRECIATE THAT
THEY HAVE LISTEN TO US AND AS
YOU HEARD FROM SENATOR PAN --
THEY DID MAKE A PRETTY
SIGNIFICANT AMENDMENT TO THE
BILL -- I LAST WEEK WHICH WHICH
WE VERY MUCH APPRECIATE AND DOES
GO -- QUITE A WAYS IN ADDRESSING
OUR CONCERNS SO WE ACTUALLY ARE
REALLY REALLY CLOSE IN BEING
ABLE TO RESOLVE THIS BILL AND
AND COME TO A COMPROMISE A LOT
OF THAT GOING ON IN THE
COMMITTEE TODAY -- THEY THE ONLY
AMENDMENT THAT WE ARE STILL
REQUESTING IT IS SIMILAR TO WHAT
ALREADY WHEN IN THE BILL ON THE
NEW REQUIREMENTS THAT WE HAVE
AGREED TO REPORT.
AT A MORE GRANULAR LEVEL ON THE
ANNUAL -- HOSPITAL REPORTING
REQUIREMENTS TO OSHKOSH WE ARE
SIMPLY LOOKING FOR THE SAME
DELAY -- INTO LAS POD CAN DO
REGULATIONS -- AND GET READY FOR
THIS NEW DATA ON THE QUARTERLY
REPORTING SIDE SO KAISER HAS
AGREED -- TO ALL OF THE NEW DATA
ELEMENTS AT THE FACILITY LEVEL
AT AT THE QUARTERLY REPORTING
BUT WE SIMPLY WOULD ASK FOR A
DELAYED IMPLEMENTATION TO ALLOW.
A KAISER PERMANENTE TO RAMP UP
FOR THAT AND TO GET READY FOR
THAT NEW REQUIREMENT AS WELL AS
TO ALLOW OFSHE TIED TO RAMP UP
AND GET READY FOR THAT SO -- WE
HAVE AGREED TO ALMOST EVERYTHING
IN THIS BILL WE WE ACTUALLY HAVE
MET THE AUTHOR.
A HALF WHERE MORE THAN HALF WAY
ACTUALLY ON IN AND AGAIN DO
APPRECIATE -- ALL OF THAT THE
CONVERSATIONS SENATOR PAN
COMMITTED EARLY ON I IN IN THE
SENATE TO WORK WITH US IN IN TO
ENTERTAIN REASONABLE AMENDMENTS
THAT WOULD ADDRESS OUR CONCERNS
WHICH WE DO APPRECIATE.
I THINK THIS IS THE EPITOME OF A
REASONABLE MAN AND AND JUST TO
ADDRESS THAT THE SPONSORS --
HEALTHCARE COSTS ARE ARE
CONCERNED AS WELL -- WE
ABSOLUTELY SURE THAT CONCERN
WHICH IS ACTUALLY WHY THIS
AMENDMENT IS SO IMPORTANT IS IT.
WILL ALLOW US -- TO HAVE
ADMINISTRATIVELY MORE SIMPLIFIED
WAY OF REPORTING THIS DATA IN
EIGHTEEN MONTHS IF WE WAIT
EIGHTEEN MONTHS -- OFSHE BUT
WILL HAVE UPGRADED THEIR
TECHNOLOGY SO I WON'T HAVE TO
HIRE ADDITIONAL PEOPLE TO DO
THIS THOUSANDS OF FIELD OF
MANUAL DATA ENTRY WHICH IS HOW
WE WOULD HAVE TO DO IT NOW -- WE
THINK IT MAKES MORE SENSE -- AND
IS MORE COST EFFECTIVE TO JUST
ALLOW OURSELVES TO BUILD UP TO
THAT SYSTEM ALLOW OCCUPIED TO
BUILD UP TO THAT AND TO CONTINUE --
TO BE GOOD STEWARDS OF OUR
MEMBER DOLLARS SO --
UNFORTUNATELY WITHOUT THAT A
MINUTE WE WILL HAVE TO CONTINUE
TO OPPOSE THE BILL BUT AGAIN --
EXPRESS OUR APPRECIATION TO THE
AUTHOR IN PARTICULAR HIS STAFF
WHO'S BEEN VERY PATIENT WITH ME
[inaudible]
ANYONE ELSE. TO KNOWN BRING IT
BACK TO COMMITTEE FOR QUESTIONS
MR.
FOR DR PANDERING TO SEE YOU AND
THE FIRST TIME I HEARD THIS BILL
IT HAS COME A LONG WAY SO I MEAN
DESERVE A TIME A CREDIT FOR
WORKING WITH THE OPPOSITION IT'S
ACTUALLY QUITE REMARKABLE HOW
WELL THIS IS COME TOGETHER.
BUT I DO HAVE JUST THAT ONE
QUESTION IN YOUR OPINION WHAT IS
THE CONCERN.
WITH THE LANE IMPLEMENTATION OF
THE QUARTERLY FILINGS.
SO -- I THINK THE CHALLENGES IS
THAT -- WHAT WE THE PURPOSE OF
THE BILL IS TO HAVE KAISER
REPORT -- RECOGNIZING THE KAISER
IS A LITTLE DIFFERENT -- TO HAVE
THAT ESSENTIALLY REPORT THAT
SAME OR SIMILAR DATA -- WITHIN
REASON AS ALL OTHER HOSPITALS
AND HEALTH PLANS RIGHT AND SO.
THE CHALLENGE ON THE QUARTERLY
REPORT RIGHT NOW SO I CERTAINLY --
YOU KNOW KAISER SAID CAN WE WAIT
EIGHTEEN MONTHS BECAUSE I ASK
WHAT'S GOING TO MOVE TO
ELECTRONIC SYSTEM.
AND SO THEREFORE THEY WOULD HAVE
TO FILE THESE REPORTS MANUALLY.
I GUESS THE CHALLENGE WERE FACED
WITH IS THAT.
HOSPITALS ALL THE OTHER
HOSPITALS IN THE STATE.
ARE HAVING TO REPORT THE SAME OR
SIMILAR DATA MANUALLY.
ALREADY RIGHT SO THEY ARE
CURRENTLY DOING IT NOW AND SO I
GUESS THE QUESTION IS IS THAT
AND THERE YOU KNOW I MEAN WE
DON'T WANT TO SUPPOSE EXPECTS
FENCES ON EVERYBODY BUT THEY'RE
ALSO THEY'RE ACTUALLY OCCURRING
THAT EXPENSE OF MANUALLY AND
THINGS THAT THE ONLY WAY TO DO.
IT RIGHT NOW.
I THOUGHT IS MOVING TO
ELECTRONIC SYSTEM SO HOPEFULLY
EVERYBODY WILL BE ABLE TO MOVE
AT THE SAME TIME -- IN EIGHTEEN
MONTHS.
BUT I THINK THE CHALLENGES SO
THE QUESTION IS IS THIS IT'S NOT
THAT KAISER CAN'T REPORT THE
DATA [inaudible]
RIGHT.
BUT IT WOULD TAKE SOME EXTRA
EFFORT TO DO THAT BUT EVERY
OTHER HOSPITAL IN THE STATE IS
CURRENTLY REQUIRED BY LAW TO
EXERT THAT EFFORT THEMSELVES TO
DO THAT.
AND SO YOU KNOW THAT THERE'S A
QUESTION IF THERE IF THERE'S A
SO THIS IS LIKE THIS FINAL
LITTLE BIT BUT THERE'S A
QUESTION OF FAIRNESS ABOUT WELL.
IF KAISER DOESN'T HAVE TO DO IT
EVERY OTHER HOSPITAL AND THEY
HAVE BY THE WAY THEY'RE SPENDING
MONEY TRY YOU KNOW PROVIDING
THAT INFORMATION AND THAT
INFORMATION IS USEFUL.
I MEAN IT'S NOT IT'S NOT JUST
LIKE ALWAYS WANT YOU FILL OUT
PAPER JUST STOPPED PAPER.
IT IS IT IS IT USEFUL TO
UNDERSTAND WHAT'S GOING ON YOU
KNOW AT SO YOU KNOW WHAT IT IS
IS IT FAIR TO SAY WELL BECAUSE
YOU HAVE IT WOULDN'T GIVE YOU
EXTRA TIME.
VERSES EVERYONE ELSE TO ACTUALLY
HAVE TO DO IT STILL HAS TO DO IT
RIGHT AND I THINK THAT'S THAT
THAT THAT'S THE BIT WERE
STRUGGLING WITH BECAUSE I
CERTAINLY HEAR WHAT KINDS ARE
SAYING YOU KNOW WE HAVE A DUE TO
WE RAMP UP AND SO FORTH BUT IT'S
NOT.
THAT THEY CAN'T DO IT IT'S JUST
THAT.
THEY SAID YEAH IT DOES TAKE --
SOME EXTRA PEOPLE SOME EXTRA
WORK BUT EVERY OTHER HOSPITAL.
WE'VE ACTUALLY MADE ALSO THEY'RE
READY HAVE MEET THEY HAVE TO
ALSO SPEND THAT EXPENSE DOING IT
AS WELL AND I AM GLAD THAT
OXFORD'S MOVING TO A SYSTEM
THEY'LL ACTUALLY REQUIRE LESS
EFFORT IN EIGHTEEN MONTHS.
BUT UNTIL THEN EVERY OTHER
HOSPITAL CLEAN HOSPITALS IN YOUR
DISTRICT ARE NOT KAISER ARE.
TAKING THE TIME TO DO THAT SO
THAT WE CAN HAVE THE DATA AND WE
NEED TO DO THE OVERSIGHT AND
THAT'S WHY WE'RE HAVING.
THIS YEAH WE DECIDE NOT TO TAKE
THEM AND THAT -- YEAH.
BUT THE FAIRNESS ISSUE THERE.
NO IT IS AND I APPRECIATE THAT
RESPONSE YOU KNOW AND JUST
RIDLEY ALL ALL WRAPPED UP
BECAUSE IT'S BEEN A LONG
COMMITTEE.
IN ON ON THE ON THE STRICTLY
BUSINESS SIDE OF IT YOU KNOW
COMING FROM OUR OUR FAMILY SIDE
A MUCH SMALLER SMALLER SCALE
LIKE WHEN WE IMPLEMENT A NEW
PROCEDURE WHETHER WE HAVEN'T
DONE IT BEFORE.
AND THEN IT'S GOING TO CHANGE IN
EIGHTEEN MONTHS AGAIN IT'S KIND
OF DOUBLE NOT SAYING THAT THEY
SHOULDN'T HAVE DONE IT PRIOR NOT
SEEN ANY OF THAT.
BUT JUST KIND LIKE THIS DOUBLE
WHAMMY SO WHAT KIND OF TEACHING
AN OLD DOG NEW TRICKS TWICE.
YES THAT'S MY ONLY CONCERN WITH
THIS BUT I ACTUALLY -- I RESPECT
YOUR POSITION ON THIS AND I
REALLY APPRECIATE ALL IN CONCERT
YOU'VE TAKEN SO FAR PROJECT OKAY
THANK YOU THANK YOU [inaudible]
ANYONE ELSE.
YOU KNOW I JUST A COMMENT --
ALONG THE SAME LINES -- YOU KNOW
I APPRECIATE WHERE YOU'RE COMING
FROM THERE IT'S THINK KAISER'S
HAD AN EXCEPTION TO THIS FOR
OVER TWENTY YEARS -- THIS
REPORTING REQUIREMENT AND AS WE
HEARD I BELIEVE.
INFORMATION IS POWER AND IS
IMPORTANT I BELIEVE THAT WE HAVE
THAT INFORMATION AS SOON AS
POSSIBLE SO -- GRANTED THERE IS
EXPENSE TO EVERYTHING WE DO AND
THE OTHER HOSPITALS OF
ENCOURAGING THESE EXPENSES FOR
MANY MANY YEARS AND WE'RE
GETTING VALUABLE INFORMATION
FROM THAT.
I THINK AN EIGHTEEN MONTH DELAY
IS IS UNFAIR TO OTHERS IN
CALIFORNIA WE COULD BE
BENEFITING FROM THAT INFORMATION.
AND WHICH IS WHY WE DIDN'T ASK
YOU TO TAKE THAT AMENDMENT.
AND I WOULD HOPE THAT AS BLOOM
WAS FOR THAT WE WE STAY THE
COURSE ON THAT BECAUSE I THINK
THIS INFORMATION IS VERY
IMPORTANT.
SO -- WITH THAT WOULD YOU LIKE
TO CLOSE SENATOR.
I RESPECTFULLY ASK WHEN I THAT
THANK YOU AND I DO WANNA THANK
HIGHS ARE FOR ALL THE WORK
THEY'VE DONE TO US SO WE CAN TRY
TO COME TOGETHER ON THIS THANK
YOU.
THANK YOU -- WE HAVE A MOTION --
FROM THIS YEAR CURRY A SECOND
FROM MISTER IS THERE IN THE
MOTION IS DUE PASSED TO
APPROPRIATIONS MAN SECRETARY
PLEASE CALL THE ROLL WHAT I
WOULD AYE MAYES.
MAYES NOT VOTING AGUIAR-CURRY
[inaudible]
BIGELOW.
BIGELOW NO BONTA [inaudible]
BURKE.
CARILLO.
CARILLO AYE FLORA.
FLORIDA VOTING RAMON.
MCCARTY [inaudible]
NAZARIAN.
RAMOS.
FROM SO I RODRIGUEZ.
RODRIGUEZ I SANTIAGO WALDRON.
GIVE FOUR WORLD WE GOT A LOT OF
MEMBERS ARE MISSING RIGHT NOW.
GIVE SECOND HOMES YES THANK YOU.
SO SB FIVE OH THREE AND SO SB
FIVE A THREE WITH STRENGTH IN
OVERSEAS.
ALRIGHT WELL SB FIVE A THROUGH
STREET IN OVER SENTIENCE FANCY
OF MEDI CAL MANAGED CARE PLANS
USE PLANTS SUBCONTRACT SERVICES
AND DELEGATE RESPONSIBILITIES
SEEMS LIKE YOUR YOU KNOW THE
BILL EXPECT WE ASK FOR AN AYE
VOTE NO BUT THIS IS A SUPPORT.
IF YOU.
COULD EVER SUPPORT GOOD
AFTERNOON CHAIR MEMBERS LED THE
WAY WITH WESTERN CENTER ON LAW
AND POVERTY PROUD TO CO SPONSOR
SB FIVE OH THREE WHICH WOULD
PROVIDE GREATER OVERSIGHT AND
TRANSPARENCY FOR MEDI CAL PLANTS
DELEGATE RESPONSIBILITY TO
SUBCONTRACT CONSIDERING SUPPORT
ON BOTH SIDES.
WE URGE YOUR SUPPORT FOR THIS.
BILL THIS BIPARTISAN BILL WITH I
NO NO VOTES AND HAPPY TO ANSWER
ANY QUESTIONS THANK YOU.
THANK YOU.
GOOD AFTERNOON MISTER CHAIRMAN
BRIDGE JUST COME RAN ON TOP
ACCESS CALIFORNIA STATEWIDE.
CONSUMER ADVOCACY COALITION OF
HERE TODAY IN SUPPORT OF SB.
FIVE OH THREE OVER 80% OF
MEDICAL US THIRTEEN MILLION --
BENEFICIARIES RECEIVE SERVICES
TO MEDI MEDI CAL MANAGED CARE
PLANS THIS BILL MAKES IT CLEAR
THAT THE MEDICAMENTO.
CARE PLANS BARE SPOTS ABILITY
FOR ALL SERVICES PROVIDED TO
BENEFICIARIES REGARDLESS OF
SUBCONTRACTING DELEGATION
INSTABILITY ATION.
THIS BILL WOULD ALSO REQUIRE THE
MEDI CAL MANAGED CARE PLANS TO
CONDUCT IN CEMENT AUDITS OTHER
SUBCONTRACTORS. TO A DEPARTMENT
OF HEALTH CARE SERVICES PATIENT
CARE OFTEN SUFFERS IN THEIR
LAYERS OF SUB DELEGATION --
WITHOUT PROPER TRANSPARENCY AND
OVERSIGHT. FOR THESE REASONS
REPRESENTS PART SB FIVE A THREE
AND ASK FOR YOUR AYE VOTE TODAY
THANK YOU THANK YOU.
OTHERS IN SUPPORT.
DAVE WALRATH REPRESENTING
CALIFORNIA RETIRED TEACHERS
ASSOCIATION AND SUPPORT THANK
YOU [inaudible]
ANYONE ELSE. TWO ONE IN
OPPOSITION -- AT THIS WILL BE
BRIEF GENERALLY WITH CALIFORNIA
ASSOCIATION HEALTH PLANS WE
APPRECIATE -- WE ARE REMOVING
OUR OPPOSITION WE APPRECIATE ALL
THE HARD WORK WITH THE AUTHOR
STAFF AND THE SPONSORS ON COMEY
TOGETHER WITH THE PLANTS ON THIS
ISSUE.
AND IF ANY CHANGES YOU KNOW KERR
THE BILL LATER IN THE PROCESS WE
MAY CONTINUE OUR CONVERSATIONS
BUT RIGHT NOW WE ARE REMOVING
OPPOSITION WE REALLY APPRECIATE
THEIR HARD WORK THANK YOU.
THANK YOU.
ANYONE ELSE SEE NO ONE WILL
BRING IT BACK COMMITTEE.
QUESTIONS OR COMMENTS.
CNN WOULD LIKE CLOSE SENATOR
STRICTLY YES WHEN I BUT THANK
YOU.
VERY MUCH DOCTOR PAN WE HAVE A
MOTION BY MISTER MAYES A SECOND
BY MISTER BIGELOW THIS.
ENJOYS A DO PASS RECOMMENDATION
MOTIONS TO PASS TO PREPARATIONS
MADAM SECRETARY PLEASE CALL THE
ROLL WHAT I WHAT I MAYES.
MAYES AYE AGUIAR-CURRY.
BIGELOW BIGELOW AYE BONTA BURKE
BURKE I CARILLO CARILLO AYE
FLORA FLORA LIMóN.
MCCARTY.
NAZARIAN.
RAMOS RAMOS AYE RODRIGUEZ.
RODRIGUEZ I SANTIAGO
[inaudible]
OLDER.
THANK PAYING WE GET THE FIRST
BILL OUT TODAY [inaudible]
THANK YOU.
BUT LEAVE IT LEAVE THE ROLL UP
AND FOR OTHERS TO ADD ON THANK
YOU VERY MUCH THANK YOU THINK IS
RIGHT THANK YOU.
AND WE'LL ASK OUR MEMBERS WHO TO
COME AND COMPASS -- WITH VOTES
.
OKAY WELL WE'RE WAITING WE'LL
GIVE THE OPTION FOR OTHER
MEMBERS WHO ARE HERE -- TO TO
ADD ON TO THEIR VOTE -- MA'AM
SECRETARY OF FIRST OF ALL WE CAN
OPEN THE ROLE ON THE CONSENT
CALENDAR [inaudible]
AND IT'S LIFT ACTUALLY OPEN THE
ROLL CALL THE ABSENT MEMBERS.
BONTA BURKE BURKE I LIVE ALONE.
RODRIGUEZ RODRIGUEZ I SANTIAGO.
CLOSER THAT'S TWELVE ZERO WHICH
LIKE TO ADD ON TO THE CONSENT
CALENDAR MISTER MOM.
I FOR MALONE I THIRTEEN ZERO
THIRTEEN ZERO WE'LL GO TO THE
TOP OF OUR ORDER AFTER THAT ITEM
NUMBER.
TWO SB ONE SIXTY THREE PLEASE
LIFT THE CALL CALL THE ABSENT
MEMBERS.
BONTA.
BURKE BURKE I CARILLO.
CARILLO AYE FLORA.
FLORA NOT VOTING.
LOW MOAN.
MOAN I RODRIGUEZ.
CRITICIZED AS IAGO.
WALDRON.
THAT'S NINE ZERO THAT BILL WAS
OUR ITEM NUMBER THREE SB TWO TWO
SEVEN SENATOR LEYVA PLEASE LIFT
THE CALL CALL THE ABSENT MEMBERS.
BONTA.
BURKE BURKE I FLORA.
FLORA NO LIMOS.
LIVE ON I PROMISE I'M SORRY --
RODRIGUEZ.
RODRIGUEZ I SANTIAGO WALDRON.
HE THAT HAS EIGHT VOTES THAT
BILL IS NOW BELIEVE THE ROLE
OPEN FOR OTHERS TO ADD ON ITEM
NUMBER FOUR SB TWO SIXTY PLEASE
LIFT THE CALL CALL THE ABSENT
MEMBERS BONTA.
BURKE BURKE I CARILLO.
CARILLO AYE FLORA FLORA I LOW
MOAN.
MOAN AYE MCCARTY.
RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO
[inaudible]
WALDRON.
AND SO ELEVEN THE BILL HAS.
ELEVEN IT IS OUT ITEM NUMBER
EIGHT SB.
THREE FORTY THREE PLACE TO LIFT
THE CALL CALL THE ABSENT MEMBERS
AGUIAR-CURRY.
AGUIAR-CURRY I BONTA AYE BURKE.
BURKE I FLORA.
THE MOST.
I MCCARTY [inaudible]
NAZARIAN.
NAZARIAN AYE SANTIAGO
[inaudible]
WALDRON.
THAT IS NINE VOTES THAT BILL IS
OUT ITEM NUMBER NINE SB THREE
SIXTY ONE MITCHELL PLEASE --
LITTLE LIFT THE CALL CALL THE
ABSENT MEMBERS.
AGUIAR-CURRY AGUIAR-CURRY AYE
BIGELOW.
BONTA AYE BONTA AYE BURKE BURKE
I FLORA.
FLORA I LIVE ON THE PHONE I
MCCARTY [inaudible]
NAZARIAN.
IS THERE AND I SANTIAGO.
CLOSER THAT'S TWELVE ZERO THAT
BILL IS OUT ITEM NUMBER ELEVEN
SP FOUR SIXTY FOUR BIT AFFECT A
PLACE WITH THE CALL CALL THE
ABSENT MEMBERS AGUIAR-CURRY.
AGUIAR-CURRY I BONTA.
BONTA AYE BURKE BURKE I CARILLO.
CARILLO I LIVE ALONE.
LIMóN AYE MCCARTY.
IN THIS AREA.
IN THIS AREA AND I SANTIAGO.
THIRTEEN YEAH THAT IS THIRTEEN
VOTES THAT BILL IS OUT ITEM
NUMBER -- TWELVE SB FIVE OH
THREE PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS AGUIAR-CURRY.
AGUIAR-CURRY I BONTA BONTA AYE.
LIMON.
LOW MOAN AYE MCCARTY.
MCCARTY I NECESSARY IN.
THIS AREA AND I SANTIAGO
[inaudible]
WALDRON. THIRTEEN THIRTEEN ZERO
AND FINALLY SB OTHER ITEM
THIRTEEN I SPEAK FIVE SEVENTY
FOUR PLEASE LIFT THE CALL CALL
THE ABSENT MEMBERS BONTA.
BONTA AYE BURKE.
BURKE I CARILLO.
CARILLO AYE FLORA.
FLORA NOT VOTING.
LIMON.
LOW MOAN AYE RODRIGUEZ.
RODRIGUEZ I SANTIAGO
[inaudible]
WALDRON. TEN ZERO S. NINE VOTES
THAT ATTENDS. TEN ZERO TEN ZERO
SO THAT BILL WAS OUT AS WELL.
SO -- ALL THE BILLS HAVE BEEN --
PAST.
IN COMMITTEE TODAY -- WE WILL
ALLOW OTHER MEMBERS TO ADD ON AS
THEY APPEAR WE'RE GOING TO WAIT
ABOUT FIVE MINUTES SO SO I KNOW
MR BONTA YOU HAVE SOME TO ADD ON
TO MISTER MCCARTY US AND ADD ON
TO IF YOU WANT TO COME UP HERE
WE CAN DO THAT.
UP HERE.
THANK YOU.
GALLAGHER.
SEC COUNTERPART BY.
TOOK A SECOND OWNERS NOW --
FOURTEEN ITEM IN. TO TO ITEM
NUMBER TWO SP ONE SIXTY THREE
BONTA AYE BONTA AYE.
THAT'S TEN ZERO ITEM NUMBER
THREE SB.
TWO TWO SEVEN BONTA AYE BONTA
AYE. NINE TWO NINE TWO THIS ITEM
NUMBER FOUR SB TWO SIXTY BONTA.
AYE BONTA AYE.
MCCARTY AYE MCCARTY AYE. FIFTEEN
MINUTES THIRTEEN ZERO ITEM
NUMBER EIGHT SB THREE FORTY
THREE PM.
MCCARTY AYE MCCARTY AYE. TEN ONE
TEN ONE ITEM NUMBER NINE SB
THREE SIXTY ONE MITCHELL MCCARTY.
AYE MCCARTY AYE. THIRTEEN ZERO
THIRTEEN ZERO ITEM NUMBER -- FOR
TWELVE ELEVEN ELEVEN I FOURTEEN
ZERO I REMEMBER LEVIN ARMS OR
TWELVE SB.
FIVE OH THREE TEN EVERYBODY FOR
THAT.
ONE THIS MCCARTY SON HE'S ON
YEAH FIVE SEVENTY FOUR AS WELL
OKAY.
YOU ARE GOOD.
SO THE ONLY PERSON.
YOU GOT A COUPLE THAT YOU.
YEAH [inaudible]
IT WAS -- SHE'S LOOKING.
SANTIAGO IS ON HIS WAY OKAY --
SB.
THREE SIXTY ONE THAT'S MITCHELL
BILL YES.
FIRST MITCHELL BILL WITH THE
HOME HEALTH PROGRAM YES
[inaudible]
HELLO I SAYS.
FOURTEEN ZERO I THINK THAT WAS
IT I THINK.
THAT WAS A I WAS
.
THE VOTE CHANGE -- SB THREE
FORTY THREE PAN BIGELOW NO.
TWO NOT NOT VOTING TAKE A NOTE
TO NOT VOTING. TEN ZERO SO THAT
IS TEN ZERO THANK YOU
[inaudible]
OKAY [inaudible]
MR SANTIAGO -- WHERE IF YOU'VE
BEEN A BUSY MAN THIS FOR
SANTIAGO SO -- SO -- THE CONSENT
CALENDAR.
SANTIAGO I FIFTEEN ZERO THAT IS
FIFTEEN ZERO ITEM NUMBER TWO SP
[inaudible]
ONE SIXTY THREE SANTIAGO.
SANTIAGO AYE. ELEVEN ELEVEN ZERO
ITEM NUMBER THREE SB TWO TWO
SEVEN LEYVA.
SANTIAGO SANTIAGO AYE.
TEND TO TEND.
TO HAVE A NUMBER FOR SB TO SIXTY
HER TADO.
SANTIAGO SANTIAGO AYE. FOURTEEN
ZERO FOURTEEN ZERO ITEM NUMBER
EIGHT SB THREE FORTY THREE PAN.
SANTIAGO SANTIAGO I ELEVEN ZERO
ITEM NUMBER NINE SB THREE SIXTY
ONE MITCHELL.
SANTIAGO SANTIAGO I FIFTEEN
SEVEN FIFTEEN ZERO ITEM NUMBER
ELEVEN SP FOUR SIXTY FOUR
MITCHELL.
SANTIAGO.
SANTIAGO I FIFTEEN FIFTEEN ZERO
ITEM NUMBER TWELVE SB FIVE OH
THREE PM.
SANTIAGO SANTIAGO AYE FOURTEEN
ZERO FOURTEEN ZERO AND FINALLY
ITEM NUMBER THIRTEEN SB FIVE
SEVENTY FOUR LABOR.
SANTIAGO SANTIAGO RA. ELEVEN
ELEVEN ZERO SO THANK YOU VERY
MUCH.
OF THAT CONCLUDES THE BUSINESS
OF THE HEALTH COMMITTEE THANK
YOU VERY MUCH