AND LONG TERM CARE COMMITTEE
HEARING ON THE KOBE NINETEEN
OUTBREAK IN SKILLED NURSING
FACILITIES AND THE STATE'S
RESPONSE DO TO STAY AT HOME
ORDER WE ARE PRACTICING FISCAL
DISTANCING HERE IN THE HEARING
ROOM. THROUGHOUT THE CAPITOL
BUILDING SO WE ARE ONLY ABLE TO
HAVE A LIMITED NUMBER OF PEOPLE
WATCH AND PARTICIPATE IN PERSON
WITH YOU AT THE DIFFERENT
OPTIONS FOR PUBLIC COMMENT
TODAY- FORD DON'T MEMBERS IN
THE CHAMBER IN THE PUBLIC OF
THE PUBLIC IN THE ROOM TODAY IN
THE CHAMBER WE ARE ABBAS. VISIT
IN PERSON HEARING IN THIS SPACE
WE CAN ONLY ACCOMMODATE THIRTY
MEMBERS MINIMAL CONTINGENCY ARE
FROM A LIMITED NUMBER PUBLIC
MEDIA CONTAIN MAINTAIN A SIX
FEET DISTANCE OF SPACE AND-
THEY'RE ALSO STRICT PHYSICAL-
DISTANCING PROTOCOL FOR THE
PUBLIC TO ENTER IN KAPLAN FOR
THOSE HERE AND TODAY TH HERE.
REMEMBER THE PUBLIC IN THE ROOM
WOULD LIKE TO SPEAK DURING
PUBLIC COMMENT WE LAST DIRECTOR
HAN LASTED APPROACH THE
MICROPHONE AT APPROACH TIME. I
WOULD NOT THE MY- NEXT. YOU
HAVE TO PROVIDE PUBLIC COME AND
HERE'S PLEASE BE SURE TO HIS
DISTANCE UPON THE CAP INCLUDING
ELEVATOR USED TO ONE PERSON AT
A TIME FOR MEMBERS OF THE
PUBLIC CALLING IN WE ARE ALSO
USING A MODERATED TELEPHONE
SERVICE THROUGH WHICH ANY
MEMBER THE PUBLIC CAN PROVIDE
COMMENTARY WHICH WE CAN GET TO
THE POINT WITH WHEN WE GET TO
THAT POINT IN THE AGENDA. THE
CALL ENOUGH FOR THIS YEAR.
EIGHT SEVEN SEVEN. SIX NINE
TWO. EIGHT NINE FIVE SEVEN AND
THE ACCESS CODE IS TWO FOUR
TWO. SIX TWO THREE SEVEN. YOU
CAN ALSO FIND THIS NUMBER ON
THE ASSEMBLY HEALTH COMMITTEE
ON- WEBSITE. AND THE ASSEMBLY-
AGING AND LONG TERM CARE-
WEBSITE. AS WELL AS ON YOUR TV
SCREEN. IF YOU ARE CALLING IN
THE OPERATOR ON THE LINE GIVE
YOU INSTRUCTIONS ON HOW TO BE
PLACED IN THE QUEUE. PLEASE BE
SURE TO ELIMINATE ALL
BACKGROUND BASIS INCLUDES
MUTINEER LIVESTREAM BROADCAST.
IN YOUR SMART DEVICES TO REDUCE
THIS DISTORTION. ONCE PLACE IN
THE QUEUE YOU ALSO NEED TO MUTE
SELF. UNTIL YOU'RE CALLED ON TO
pPROBLEMS WITH THE MODERATED
PHONE SERVICE PLEASE CALL THE
COMMITTEE AT NINE ONE SIX.
THREE ONE NINE. TWO ZERO NINE
SEVEN. MY STEP WILL BE THERE TO
HELP. ALSO WANT TO KNOW IF WE
ARE ACTING WRITTEN PUBLIC
COMMENT TO THE HEALTH
COMMITTEES PUBLIC EMAIL. THAT
IS A H. E. A DOT COMMITTEE. AT
ASSEMBLY DOT C. A. DOT G. O. V.
WHICH IS POSTED ON OUR WEBSITE.
THANK YOU VERY FOR BEARING THIS
AS WE IMPLEMENT METHODS TO
CONTINUE TO SERVE THE PEOPLE OF
CALIFORNIA WHILE ALSO BEING
MINDFUL AND RESPECTFUL OF THE
PUBLIC HEALTH CONCERNS WE ALL
FACE. IN ADDITION TO BEING ABLE
TO PROCESS BAY FROM INSIDE THE
HEARING ROOM WE HAVE SOME OUT
PANELISTS MAKING USE OF OUR
WITNESS VIDEO CONFERENCING
ROOMS WHICH ARE LOCATED HERE IN
THE CAPITAL THOSE INDIVIDUALS
WHO APPEAR ON THE SCREEN SO
MEMBERS CAN WATCH THEIR
TESTIMONY LIVE FROM OUTSIDE OF
THE HEARING ROOM HAVE A
DISCUSSION WITH AND ASK
QUESTIONS OF THE WITNESS THIS.
I DO WANT TO NOTE WE WILL HAVE
CARDS ELEVEN THIS MORNING AND
WE WILL BEGIN OUR PUBLIC
COMMENTS PROBABLY AROUND TEN
FORTY FIVE THE LATEST BUT IT
MAY BE LIMóN SO WE NOT BE ABLE
TO GET TO EVERYONE TODAY THE
REASON FOR THAT HIGH TO. IS
THAT. ASSEMBLY ARE GOING TO BE.
THAT'S THE- OBSERVING EIGHT
MINUTES IN FORTY SIX SECONDS.
OF SILENCE IN MEMORY OF GEORGE
FLOYD SO WE WILL BE- HARD STOP
ELEVEN AM. AND ANYBODY WHO HAS
COMMENTS THAT PUBLIC COMMENTS
THAT WE ARE NOT ABLE TO GET TO-
TO AUDIO. IS WELCOME TO SUBMIT
THOSE THROUGH OUR WEBSITE AND I
ABSOLUTELY PROMISE YOU WE WILL
READ THOSE AND RESPOND- I'D
LIKE TO START THIS HEARING BY
SAYING. THAT I UNDERSTAND HOW
HARD THE ADMINISTRATION IS
WORKING. TO RESPOND TO THE KOBE
NINETEEN CRISIS. HOWEVER VERY
CONCERNED. LET OUR MOST
VULNERABLE CITIZENS DOWN. FAR
TOO MANY SKILLED NURSING
FACILITY RESIDENTS HAVE LOST
THEIR LIVES TO COOPER DIED
NINETEEN AND I KNOW WE CAN DO
BETTER. THE MOST RECENT DATA ON
THE DEPARTMENT OF PUBLIC HEALTH
WEBSITE SHOWS THAT ONE THOUSAND
NINE HUNDRED AND EIGHTY FIVE
SKILLED NURSING FACILITY
RESIDENTS HAVE DIED. ONE IS TOO
MANY. BUT THAT REMINDS US THAT
EVERYONE OF THOSE DEATHS FROM
REPRESENTS MORE GRIEVING FAMILY
MEMBERS AND FRIENDS THAT
DEVASTATING NUMBER REPRESENTS
ALMOST HALF THE DEATHS IN THE
STATE DO THIS PANDEMIC. THESE
FRAIL SENIORS ARE IN A NURSING
HOME BECAUSE THEY MUST RELY ON
OTHERS FOR THEIR CARE AND
SAFETY AND BECAUSE OF THEIR
CLOSE LIVING CONDITIONS THEIR
VULNERABILITY REQUIRES US TO
MAKE SURE THESE FACILITIES ARE
SAFE AS SAFE AS POSSIBLE AND AS
WERE HERE TODAY. DR PLEA TO ACT
IMMEDIATELY ABOUT WHAT WE CAN
DO TO PROTECT THEM.
ASSEMBLYMEMBER ARIAN ARE AGING
AND LONG TERM CARE COMMITTEE
CHAIR AND I HAVE BROUGHT
TOGETHER STATE REGULATORS. THE
NURSING HOME INDUSTRY AND
NURSING HOME ADVOCATES TO TALK
ABOUT WHAT HAS WORKED. WHAT IS
NOT. AND HOW BEST WE CAN MOVE
FORWARD. EACH PARTICIPANT WILL
HAVE THREE TO FOUR MINUTES TO
MAKE OPENING REMARKS
ASSEMBLYMEMBER NEWTON IS AARON
AND I WILL MODERATED DISCUSSION
AND I ENCOURAGE EVERYONE
PANELISTS AS WELL TO ASK
QUESTIONS. OF EACH OTHER.
ASSEMBLYMAN IT NEEDS AREA WOULD
LIKE TO WOULD YOU LIKE TO MAKE
SOME OPENING REMARKS. SURE.
THANK YOU TO MY FRIEND AND
COLLEAGUE- DOCTOR WOULD- THIS
OVERSIGHT IS- THIS OVERSIGHT
HEARING IS NECESSARY AND
TODAY'S OUT CRIMES OUTCOMES
CAN. HOPEFULLY LEAD TO- SAVING
LIVES AGAIN THANK YOU TO MY
COLLEAGUES TO JOIN ME TODAY
FROM THE ASSEMBLY HEALTH AND
AGING AND LONG TERM CARE
COMMITTEES. THE HEALTH AND WELL
BEING OF OUR SENIORS AND THE
DISABLED ARE OF HIGH IMPORTANCE
TO ALL OF US IN THIS ROOM AS
COMMITTEE MEMBERS AND I WOULD
ALSO LIKE TO THINK- BUDGET
CHAIRS AND COLLEAGUES ASSEMBLY
MEMBER STAINED. AND ARAMBULA
FOR JOINING US TODAY AS WELL
AS- SOME OF OUR OTHER
COLLEAGUES FROM OUR- COMMITTEES.
FROM THE EARLIEST DAYS OF KOBE
NINETEEN WE KNEW. IT HAS THE
GREATEST IMPACT ON SENIORS AND
THE DISABLED. THIS WAS EVIDENT
IN THE OUTBREAKS IN CHINA
SPREADING TO EUROPE AND IN THE
STATE'S HIT HARDEST EARLY ON IN
THE US. AND YET OUR POLICIES
AND RECOMMENDATIONS RELATING TO
KEEPING OUR MOST VULNERABLE
SENIORS SAFE. DO NOT SEEM TO
USE LESSONS LEARNED. WE HAVE
CONTINUED TO USE RHETORIC TO
ADDRESS THIS ISSUE. WORDS
CANNOT KEEP SENIORS IN SKILLED
NURSING SAFE. INFLECTION CANNOT
KEEP CARE GIVERS SAFE OR
EFFECTIVELY TRAIN EXISTING
STAFF TO ADDRESS THE INFECTION
PROTOCOLS WE RECOMMEND. WE NEED
MORE THAN SPEECHES SAYING WE
CARE WE NEED ACTION. WE NEED TO
DEMAND BETTER. SKILLED NURSING
FACILITIES ARE FILLED WITH OUR
MOTHERS AND FATHERS AND GRAND
PARENTS AND SIBLINGS THESE
PATIENTS HAVE FOUGHT WARS TO
DEFEND OUR FREEDOMS LIVE DURING
AND CAME OUT OF THE GREAT
DEPRESSION AND BUILT OUR
ECONOMY AND THE DESERVE BETTER.
WE ARE BRINGING THIS VIRUS TO
THEM WE ARE TRADING AND SHARING
THIS VIRUS WITH THEIR CARE
GIVERS. WE UNDERSTAND HOW THIS
VIRUS SPREADS AND YET WE HAVE
ISOLATED THE SENIOR SENIORS AND
THEY'RE DYING ALONE BECAUSE WE
ARE NOT DOING ENOUGH. PERHAPS
IN REFLECTION WE CAN FINALLY
ACKNOWLEDGE COVERT NINETEEN
DIDN'T CAUSE THESE PROBLEMS BUT
DRAMATICALLY REVEALED THE
SHORTCOMINGS IN CALIFORNIA'S
LONG TERM SUPPORT SERVICES
SYSTEM. INCLUDING THE
LONGSTANDING PERVASIVE
CHALLENGES FACING CALIFORNIA'S
LICENSED FACILITIES. THE FIVE
HUNDRED EIGHTY FIVE THOUSAND
RESIDENTS OF SKILLED NURSING
FACILITY AND RESIDENTIAL CARE
FACILITIES FOR THE ELDERLY ARE
AMONG THE MOST VULNERABLE TO
THE VIRUS YET WE HAVE SEEN
SIGNIFICANT ISSUES ARISE
INCLUDING LACK OF ACCESS TO
PERSONAL PROTECTIVE EQUIPMENT.
LACK OF CONSISTENT TESTING OF
RESIDENTS AND STAFF CHALLENGES
WITH INFECTION CONTROL AND LACK
OF AN OVERALL STATEWIDE
STRATEGY. THE BROADER ISSUE IS
UNFORTUNATELY NOT A NEW ONE IT
IS ROOTED IN OUR COLLECTIVE
FAILURE TO MAKE IT A PRIORITY
TO TRANSFORM THE SYSTEM OF CARE
FOR OLDER ADULTS AND PEOPLE
WITH DISABILITIES. WE HAVE
UNDER VALUED AND UNDER PAID THE
DIRECT CARE WORK FORCE. WE HAVE
PROVIDED INCONSISTENT OVERSIGHT
OF OUR INSTITUTIONAL AND
RESIDENTIAL CARE SETTINGS. AND
WE LACK SUFFICIENT COMMUNITY
BASED ALTERNATIVES FOR PEOPLE
WHO WOULD PREFER TO REMAIN AT
HOME. THE LITTLE HOOVER
COMMISSION'S. NINETEEN NINETY
SIX REPORT ON CALIFORNIA'S LONG
TERM CARE SYSTEM. CALLED OUT
MANY OF THESE SAME ISSUES SOME
TWENTY FOUR YEARS AGO. THE
STATE'S CURRENT OVERSIGHT
STRUCTURE IS TOO FRAGMENTED TO
ALLOW EFFECTIVE COORDINATION
AND INTEGRATION OF LONG TERM
CARE SERVICES THE STATE'S
POLICIES FAVOR EXPENSIVE
INSTITUTIONALIZATION AT THE
EXPENSE OF HOME AND COMMUNITY
BASED SERVICES PERFORMED A
PREFERRED BY CONSUMERS
CONSUMERS CONTINUE. TO TAKE
ISSUE WITH THE QUALITY OF CARE
AND SKILLED NURSING FACILITIES
AND REGULATORY CHANGE HAS NOT
KEPT PACE WITH THE CHANGING
DEMANDS PLACED ON RESIDENTIAL
CARE FACILITIES. ALL SEEM TO
COMMON THESE DAYS AS WELL. SO
WHY HASN'T MUCH HAPPENED FOR
OVER TWENTY FOUR YEARS
UNFORTUNATELY OUR FAILURE TO
ACT STEMS FROM A MUCH LARGER
PROBLEM ROOTED IN PERVASIVE
SOCIETAL AGEISM AND ABLE ISM
THAT HAS NOT PRIORITIZE THE
NEEDS OF CALIFORNIANS OLDER
ADULTS PEOPLE WITH DISABILITIES
AND CARE GIVERS. WE SHOULD ADD
TO THIS ALSO THE DRIVE OF
PROFITEERING. AS A BODY WE NEED
TO PRIORITIZE THESE ISSUES AND
INVEST IN INNOVATION. AND WE
NEED TO CHANGE THE CULTURE OF
AGEISM. IF WE ARE NOT USING
THIS TIME TO DEMAND CHANGE THEN
WHEN. PRIOR TO COVERT NINETEEN
WE DISCUSSED THE NEEDS OF THE
GROWING POPULATION OF SENIORS
AND WHAT THAT WILL LOOK LIKE IN
TEN YEARS. BUT OUR INACTION AND
WEAK FOUNDATIONS RELATING TO
SENIORS AND THE DISABLED
COMPOUNDED WITH COVERT NINETEEN
WILL CONTINUE TO DECREASE THE
NUMBERS OF SENIORS. IN OUR
STATE AND NATION AT A TIME WHEN
THERE'S GONNA BE HISTORICAL
GROWTH OF THAT AGE POPULATION.
THE MAY REVISED IS AN EXAMPLE
OF AGEISM. IT ON FAIRLY
BALANCED CALIFORNIA'S BUDGET ON
THE SHOULDERS OF OUR FRAIL
ELDERLY ELDERLY AND DISABLED.
IT IS A PROPOSAL THAT IS UNJUST
AND UNFAIR. I'M PROUD OF THE
LEGISLATIVE PROPOSAL WE WILL BE
VOTING ON WITHIN A WEEK. OUR
VALUES ARE CLEAR WE WILL NOT
FURTHER HARM SENIORS AND THE
DISABLED IT IS SIMPLY
UNACCEPTABLE. AS THIS OVERSIGHT
HEARING CONTINUES I LOOK
FORWARD TO HEARING FROM ALL OF
YOU YOUR PERSPECTIVES ARE
UNIQUE AND IMPORTANT TO THIS
CONVERSATION WE MUST DO BETTER
BECAUSE IN THE END WHO IS
HARMED MOSTLY BY ALL OF THIS.
WE ALL ARE THE RESIDENTS OF
THESE HOMES ARE FAMILIES. AND
IT'S TIME FOR A CHANGE THANK
YOU. THANK YOU VERY MUCH
ASSEMBLY MEMBER IN HIS AREA AND
I'D I DO WANT TO KNOW- WE HAVE
DOCTOR JOAQUIN ARAMBULA HERE
ARE THE BUDGET CHAIR FOR HEALTH
AND HUMAN SERVICES OR SUB
COMMITTEE CHAIR- THE MYSTERY
SOUTH WOULD LIKE TO MAKE ANY
COMMENTS. I'M SORRY WOULD YOU
LIKE TO MAKE A COMMON STOCK
REGULAR. I'LL LET YOU GUYS DO
IT OUT NOW WHAT WE'LL GO WITH
HIM FIRST MY APOLOGIES THAT WAS.
THANK YOU DOCTOR WOULDN'T THANK
YOU- MISTER NAZARIAN FOR
HOSTING THIS HEARING TODAY AND
FOR WRITING ME AS CHAIR OF A
JOINT LEGISLATIVE AUDIT
COMMITTEE- TO PARTICIPATE-
OBVIOUSLY WITH THE NEWLY
RELEASED DATA WE'VE SEEN- THAT
NEARLY TWENTY SIX THOUSAND
NURSING HOME RESIDENTS OF DIED
FROM COVERT NINETEEN IN MORE
THAN SIXTY THOUSAND OF FALLEN
ILL. IN CALIFORNIA DATA FROM
FROM THE PUBLIC HEALTH SURE
THAT AT LEAST NINE THOUSAND
SEVEN HUNDRED NURSING HOME
RESIDENTS THIS. AND STAFF OF
CONTRACTED- COVERT NINETEEN AND
ONE THOUSAND EIGHT HUNDRED
SEVEN AT DIED- THUS FAR. BUT
LET ME TELL YOU IN KERN COUNTY
WE'VE ACTUALLY SEEN AN OUTBREAK
IN NURSING FACILITIES IN THIS
KIND OF HITS VERY CLOSE TO
HOME. BECAUSE OF MY UNCLE WAS
ACTUALLY AT ONE OF THESE
NURSING FACILITIES. BREAKS OF.
LEVEL WE WERE FIRST LOOKING AT
THIS- I WAS GETTING THESE
FRANTIC CALLS AND TAX BECAUSE
THEY WERE HAVING A HARD TIME
GETTING THEIR STAFF TO EVEN
SHOW UP AND THE RESPONSE FROM
THE STATE'S SEEM VERY SLOW WHEN
THEY WERE- PLEADING PLEADING
FOR HELP BECAUSE THEY DIDN'T
HAVE THE STAFF SHOWING UP TO
EVEN HELP PEOPLE GET OUT OF BED
OR TO. ASSIST THEM IN THEIR
DAILY LIVES AND DAILY FUNCTIONS
AND SO I'M REALLY LOOKING
FORWARD TO TODAY'S HEARING-
WHAT DID THE WHAT WAS THE
STATE'S RESPONSE HOW WERE WE
MEETING PP- WHAT WERE YOU DOING
TO THE FAMILY LOOK AT YOU AS A
FAMILY MEMBER WE WERE REALLY
SEARCHING FOR ANSWERS AND WE
REALLY SEARCHING FOR SOME
GUIDELINES OF CLARITY WHAT IS
BEING DONE WHAT CAN BE DONE.
BUT WILL ONLY HEARING FROM IN
CASE MY UNCLE WAS SAYING YOU
KNOW WHAT NOBODY SHOWED UP FOR
THE PAST TWELVE HOURS OR TWENTY
FOUR HOURS AND IT'S NOT JUST ME
THE ENTIRE FACILITY AND- THANK
YOU FOR HAVING THIS HEARING I'M
LOOKING FOR TO SOME REAL
ANSWERS IN REAL TRYING TO THEN
WE WERE FROM PAST PERIODS AS
WEATHER WAS WITH THINGS LIKE
MERCY. WHY WE DON'T HAVE
SPECIFIC GUIDELINES IN PLACE.
WHY DON'T WE IS IN PLACE I WHY
ARE WE FOR THESE TYPES OF
INCIDENCES AND THESE OUTBREAKS
IN WHAT. WERE WAS A- WHERE WAS
THE HELP. IF WE KNEW SOMETHING
LIKE THIS WAS COMING IN
ESPECIALLY WHEN WE SEE ONE OUT
OF EVERY FIVE NURSING FACILITY
IS HAS HAD SOME INCIDENTS WITH
THE CORONAVIRUS AND WITH KOVIN
SO THANK YOU FOR ALLOWING ME TO
BE HERE TODAY AND I LOOK
FORWARD TO TODAY SIR THANK YOU
VERY MUCH ATTRACT ARAMBULA.
THANK YOU MISTER CHAIR AND- WE
START BY TAKING THAT OFF IF I
MAY AND MAY REMIND OUR
COLLEAGUES TO PUT THEM BACK ON
AFTER WE CITY AND SO- FIRST I
WANT TO SPEAK FOR WHY I CARE SO
MUCH ABOUT THE ELDERLY AND I'VE
SHARED THIS WITH YOU BEFORE
MISTER CHAIR BUT- AND IT'S NOT.
INHERENTLY BECAUSE MY MOTHER
BECAME ELDERLY THIS YEAR AT THE
AGE OF SIXTY FIVE BUT AS A
LEGAL AID LAWYER FOR A NUMBER
OF YEARS SHE STOOD UP FOR THOSE
WHO WERE ELDERLY AND DISABLED
AND LACKING SUFFICIENT ACCESS
TO HEALTH CARE SERVICES AND SO
I SHARE YOUR CONCERN MISTER
CHAIR FOR THE MOST. IT'S THE
REASON WHY I'VE BEEN CARING FOR
THINGS LIKE THE SENIOR PENALTY
AND WHAT I WANTED TO COME TO
TODAY'S HEARING TO MAKE SURE
THAT. WE HAD A VERY IMPORTANT
DISCUSSION TODAY IN THE MOMENT
ABOUT HOW WE RISE OUT OF THIS
PANDEMIC STRONGER THAN WE WENT
IN. BECAUSE I ALSO WANT TO
AGREE WITH CHAIR IN THIS AREA
AND WHEN HE SAID THAT WE HAVE
NOT HAD SUFFICIENT OVERSIGHT.
THAT WE LACK SUFFICIENT
COMMUNITY SETTINGS FOR US TO BE
ABLE TO AGE IN PLACE WITH
DIGNITY. AND OUR SYSTEM IS TOO
FRAGMENTED. WE HAVE TWELVE
HUNDRED SKILLED NURSING
FACILITIES WE HAVE ROUGHLY A
HUNDRED AND NINETEEN THOUSAND
PEOPLE WHO WORK IN THOSE
FACILITIES. I CHALLENGE US AS A
LEGISLATURE TO COME UP WITH THE
SYSTEM THAT WORKS FOR OUR AGING
POPULATION FOR THE STATE OF
CALIFORNIA. AND I BELIEVE THAT
WE CAN MEET THAT CHALLENGE AND
THINK THAT PART OF IT MUST BE A
DISCUSSION ABOUT FINANCING. I
THINK WE HAVE TO MAKE SURE THAT
OUR PRIORITIES AS A STATE ARE
PUT FRONT AND CENTER AND THAT
WE STAND UP FOR OUR MOST
VULNERABLE. FOR OUR ELDERS AND
FOR THOSE WHO CANNOT BE E
FIGHT ON THIS FLOOR TODAY.
THANK YOU MISTER CHAIR. VERY
MUCH WITH. ANY OTHER MEMBERS OF
LIKE TO SPEAK THIS HAVE ANY
OPENING COMMENTS BEFORE WE
START. OKAY SEEMS TO SEE NO ONE
THEN WHAT WE WILL DO IS WE WILL
TURN TO OUR PANELISTS- WE WILL
ASK EACH PANELIST IS WILL THEY
WILL HAVE EACH THREE TO FOUR
MINUTES FOR OPENING REMARKS
ALASKAN TO SELF INTRODUCED AND
WHAT I'VE MY PLAN IS TO GO
THROUGH BOTH PANELS JUST
STRAIGHT THROUGH. THEY WILL-
ALLOW MEMBERS TO- ASKED SOME
QUESTIONS BUT THIS IS A LITTLE
DIFFERENT APPROACH ANY HEARING
I WANT THE PANELISTS TO ASK
QUESTIONS OF ONE ANOTHER AS
WELL. ONCE AFTER WE HAVE SOME
QUESTIONS- AND- I THINK THAT
WILL BE A VERY INTERESTING
DISCUSSION AND- AND HOPEFULLY A
VERY FREE FLOWING DISCUSSION
SO. AT THIS POINT I'D LIKE TO
TURN OVER TO OUR FIRST OUR
FIRST PANELIST. AND ASK THEM TO
SELF INTRODUCE AND GIVE US
THREE FOUR MINUTES IN YOUR OPEN
REMARKS. GOOD MORNING I'M HEIDI
SIDE OF HER AND THE DEPUTY
DIRECTOR OVER AT C. PH OVER THE
CENTER FOR HEALTH CARE QUALITY.
WHICH IS RESPONSIBLE BOTH FOR
THE LICENSURE AND CERTIFICATION
SURVEYORS- WHO ARE OVER THE
OVERSIGHT OF THESE FACILITIES
AS WELL AS- THE HEALTHCARE
ASSOCIATED INFECTIONS- STRIKE
TEAMS OF PEOPLE THEY ARE
INFECTION DISEASE- SPECIALIST
WHO GO INTO FACILITIES TO TRY
TO MINUTE. TO MINIMIZE
OUTBREAKS. OF I FIRST CAME TO
THE STATE DECEMBER TWENTY
EIGHTEEN I ACTUALLY CAME ALL
THE WAY OVER FROM GERMANY. SO
THAT I COULD BE PART OF A
SYSTEM TO REFORM HOW CALIFORNIA
DOES THEIR QUALITY AND SAFETY
OVERSIGHT. I'M I'M A FIRM
BELIEVER THAT WE ARE THE FIFTH
LARGEST ECONOMY IN THE WORLD
AND THEREFORE WE SHOULD BE
THINKING BIGGER AND
DIFFERENTLY. ON THE ENTIRE
NATION HAS BEEN HIT BY THIS
PANDEMIC. THE ENTIRE NATION ALL
FIFTY STATES USE THE SAME EXACT
CMS MODEL. WHICH IS THAT YOU GO
INTO A FACILITY ONCE A YEAR. OR
IF IT'S A HOSPITAL THREE TIMES
YEAR BUT IN THE CASE OF LONG
TERM FACILITIES THE CMS MODEL
ACROSS ALL FIFTY STATES. IF YOU
DO ONE SURVEY ONCE A YEAR AND
THEN OTHER THAN THAT IT'S ABOUT
IN INVESTIGATIONS FOR
COMPLAINTS AND- THE RIVER
INSTANCE. AND I AM HERE TO SAY
THAT IT'S NOT. AND I THINK IF
ANYTHING THIS PANDEMIC IS
HIGHLIGHTED NOT ONLY THE
INEQUITIES IN OUR HEALTH CARE.
ALSO THE DIVISION THAT DOES
WITH THE NATIONAL HEALTH
QUALITY SAFETY OVER LIKE
SYSTEMS. EVERY SINGLE STATE HAS
BEEN LOOKING AT PP EVERY STATE
HAS FOCUSED ON STAFFING AND
INFECTION CONTROL. AND WE HAVE
DONE SO MUCH IN CALIFORNIA TO
PROVIDE THOSE SERVICES HERE.
WHETHER IT WAS IN ACTING OUR
MEDICAL HEALTH COORDINATION
CENTER ON JANUARY TWENTY FOURTH
WHERE WE HAVE ALL BEEN WORKING
SEVEN DAYS A WEEK- TWENTY FOUR
SEVEN- FOR RESPONSE. OF EFFORTS
TO MAKE SURE THAT EVERYONE HAS
THE TOOLS AND RESOURCES THEY
NEED. BUT MORE IMPORTANTLY THEN
WE START TO DO IMMEDIATE
OUTREACH WITH ALL OF OUR
FACILITIES JANUARY TWENTY
EIGHTH WE STARTED A WEEKLY ALL
FACILITIES CALL FOR ALL LETTER
THOUSAND. BUILDINGS THAT WE
OVERSEE FOR Q. AND TO BE ABLE
TO PROVIDE REAL TIME GUIDED.
WE'VE ISSUED OVER SIXTY PIECES
OF GUIDANCE- AND POLICIES
ACROSS ALL OF OUR FACILITIES.
TO JACK TO PUT MORE NORMAL YEAR
YOU NORMALLY SPEND ABOUT MAYBE
TWENTY TO THIRTY. WE'VE GOT
SIXTY IN ABOUT THREE MONTHS-
BUT WE GUYS WASN'T ENOUGH WE
NEEDED ON SITE VISIT PRESENT
NOT. BE PHYSICAL. IT IS STILL.
TO BE ABLE INSPECTION BE ABLE
TO. KIND OF THE- SO IN FEBRUARY
WE WENT AHEAD AND WE READER ALL
SIX OF SERVER INTO FACILITIES
DID YOU SEE HIM IN FACT CONTROL.
AS WELL AS TO BE ABLE TO
PROVIDE TECHNICAL ASSISTANCE
AND TRY TO PREVENT- TRY TO GIVE
EDUCATION THIS IS THE ARENA
WHERE WE KNEW THAT THERE WAS A
LACK OF EDUCATION THERE IS A
HIGH TURNOVER RATE OF STAFF.
AND THERE ARE A LOT A LOT OF
INFORMATION LIKE DONNING AND
DOFFING AND PEOPLE BEING
COMFORTABLE WITH THOSE
PROCESSES SO WE DID A LOT OF
PREVENTION A LOT OF WEBINARS
ONE OF ON ON ON SITE VISITS AT
THAT TIME. WE ALSO THEN TRIPLED
THE SAUCE. OR HEALTH CARE AT-
ACQUIRED INFECTIONS TEAM BY
REDIRECTING SOME OF OUR NURSES
AND TRAINING THEM AND I KEEP
PRACTICES. THAT THEY COULD BE
PART OF THE STRIKE TEAMS THAT
GO IN AFTER IT. THERE IS ONE
CASE THAT WE CAN BE ABLE TO
START TO MINIMIZE THE OUTBREAK
AS FAST AS POSSIBLE BY DOING
CONTACT TRACING EXPOSURES
WORKING LOCAL PUBLIC HEALTH FOR
TESTING. BUT AGAIN AS TIME AND
TIME WERE ON WE REALIZED THAT
PP STAFFING EDUCATION GOING ON
SITE. IT JUST SIMPLY WASN'T A
NOT PEOPLE WERE STILL HAVING
CASES. PEOPLE WERE STILL DYING.
AND SO THAT IS WHY THE OF
RELEASED- NOW A STATEWIDE SIX
STRATEGY PLAN FOR CALIFORNIA.
ONLY AN ACT OF THIS PLAN BACK
IN MAY SOME OF THESE STRATEGIES
ARE THINGS THAT WE HAD BEEN
WORKING ON OVER THE LAST YEAR
BUT HAVE BEEN ABLE TO EXPEDITE
THEM THROUGH THE EXISTING YOU
KNOW PROCESS. AND SOME OF THESE
THINGS ARE NEW AND BRAND NEW
NOT ONLY TO CALIFORNIA BUT
THERE WILL BE A BRAND NEW TO
THE NATION. I A PROPOSED THESE
SIX STRATEGIES TO SEE EN MASSE
THEY ARE VERY INTERESTED AS
WELL BECAUSE THEY ALSO
RECOGNIZE. IT AS A NATION THERE
IS TO DO. SO THE STRATEGY THAT
I WANTED OVER FIRST AND FOR
TESTING WE HAVE TO BE ABLE TO
KNOW WHERE IT IS AT ALL TIMES.
SO WE HAVE REQUIRED ALL OF OUR
FACILITIES TO DO BASELINE
TESTING WHICH MEANS. ALL STAFF
ALL RESIDENTS MUST BE TESTED BY
JUNE THIRTIETH. AND THEY HAVE
TO REPORT THOSE TESTING RESULTS
TO US AND WE POST THEM ON OUR
WEBSITE THEN AFTER THAT THERE
IS A POSITIVE CASE JUST ONE
POSITIVE CASE THE WILL DO
REPEAT TESTING FOR EVERYONE
THAT FACILITY EVERY WEEK. UP IF
THEY HAVE ZERO POSITIVES THAN
THEY WILL DO SURVEILLANCE
TESTING OF ALL THE HEALTHCARE
WORKERS 25% A WEEK UNTIL YOU
HAVE ALL OF THE HEALTHCARE
WORKERS ONCE A MONTH GETTING
TESTED. UP THE SECOND STRATEGY
IS REALLY ABOUT FAXING
PREVENTION WORK FORCE- SO WE
REALIZE THAT. MANY FACILITIES
ONLY HAVE A PART TIME I KEY. IN
THERE- IN THEIR SKILLED NURSING
FACILITY WHICH IS NOT ENOUGH
AND MANY OF THEM HAVE MULTIPLE
HATS WHAT ROLES THEY HAVE TO
KERRY. SO WE ALSO ISSUED AN AFL
THAT STATES THAT EVERY SNAP IN
CALIFORNIA MUST HAVE A FULL
TIME INFECTION PREVENTION THIS.
OF WHETHER THEY HAVE TWO PEOPLE
TOGETHER OF THAT ARE THEN
TRAINED EITHER BY OUR STAFF
WE'VE OFFERED TRAINING TO BE
ABLE TO DO THAT TO GET THEM
SOME COMPETENCY TESTING. OF BUT
THAT IS A MUST. OF THE THIRD
STRATEGY THAT WE ARE WORKING ON
OPERATIONALLY SCENE IS JUST
SHEER EDUCATION NOT ONLY RE
EDUCATING ALL OF OUR SURVEYORS
ON. PARTICULAR I. T. OF HIGH
INFECTIOUS DISEASES BUT ALSO
WORKING WITH ALL OF THE AN ACE
LPN. RN OUT THERE IN THESE
FACILITIES. OF FOR. IS
SOMETHING THAT IS BRAND NEW TO
THE NATION AND THIS IS
COMPLETELY CHANGING AND
REFORMING HOW WE WOULD DO
QUALITY SAFETY OVERSIGHT. SO IN
LIEU OF. OR IN ADDITION TO THAT
ONCE A YEAR CMS CERTIFICATION.
SURVEY IN ADDITION OUR STATE
WHAT ALSO A SIGN TO THREE.
FACILITIES TO EACH ONE OUR
SERVER. THEY HAVE TO HELP.
SHIFT EVERY SINGLE YEAR. SB
WHEN WE- TO CHECK DALY PART OF
QUALITY SAFETY OVER GROUP THE
BE ABLE TO TRAIN STAFF IF TO BE
ON SITE EVERY WEEK AND WE
BELIEVE THAT THAT PRESENCE WILL
MAKE A DIFFERENCE BECAUSE
ALREADY IN THIS PANDEMIC WE
HAVE BEEN MORE ON SITE THAN WE
EVER HAVE BEFORE IN HERE
ALREADY NOTICING A BIG
DIFFERENCE IN THE B. P. PLACES
THAT WERE GOING AS WELL AS WERE
NOTICING A DIFFERENCE THE
ABILITY TO- MINIMIZE THE AMOUNT
OF DEATH IN CASE IT. UP THE
FIFTH ONE IS QUALITY AND SAFETY
OVERSIGHT ACT. SO THIS IS THE
STATE WHERE ALL STATES ACTUALLY
HAVE BEEN DOING MOST OF THE
LICENSING AND CERTIFICATION. BY
PAPER AND MANUAL PROCESSES IT'S
TWENTY TWENTY WE NEED TO BE
ABLE TO HAVE REAL TIME DATA AS
WELL AS- BE ABLE TO HAVE
FACILITIES AND TRANSPARENCY TO
BE ABLE EVERYONE TO BE ABLE TO
SEE WHAT WERE SEEN. WHAT
RECITING. WHAT THE PLANS ARE
CORRECTION ARE AND ONCE WE HAVE
THIS MOBILE APP WHERE TO A
PORTAL SYSTEM CLOUD BASED
SYSTEM THAT WE BE ABLE TO THAT.
IMMEDIATELY POST THE RESULTS
THE FACILITY WOULD BE ABLE TO
IMMEDIATELY ENTER THEIR PLANS A
CORRECTION. ALL OF THAT WOULD
BE TRANSPARENT FOR OUR
STAKEHOLDERS AS WELL. AND LAST
BUT NOT LEAST PREDICTIVE
ANALYTICS. LICENSING AND
CERTIFICATION ACROSS THE NATION
TENDS TO BE A VERY REACTIVE
TYPE OF WORK. YOU GO AND ONCE A
YEAR ON A SCHEDULE. YOU GO IN
WHEN THERE IS A REACTION TO
EITHER CMPLAINTS. OR INCIDENT.
AND WHAT WE WANT TO DO IS
CREATE MORE OF A PROACTIVE
APPROACH AND SO WHAT WE STARTED
TO DO IN THESE LAST COUPLE OF.
MONTHS IT STARTED TO GATHER
DATA. NOT ONLY DATA FROM. HIM
COMPLAINTS HISTORY IN THE PAST.
BUT ALSO. SELECTING DATA FROM
THE DAILY REPORTING THAT WE'RE
REQUIRING ALL OF THE FACILITIES
TO PROVIDE AT. WE TAKE ALL THAT
DATA AND COME UP WITH THE HIGH
RISK LIST EVERY DAY. IF YOU'RE
A FACILITY AND UP ON THE HIGH
RISK LIST THEY GET AN IMMEDIATE
PHONE CALL REACH OUT AND THEN
WE ALSO GO ON SITE. THAT WEEK
TO BE ABLE. TO SEE WHAT'S GOING
ON. AND SO TRYING TO LOOKING.
INDICATORS AND A ESTABLISHED
KIND OF A PROJECT OF. I THINK
IT. MAY BE. WITH STAFF SHE-
WHERE MIGHT BE A- SECTION
CONTROL ISSUES THAT'S ALLOWING
US TO BE WAY MORE PROACTIVE
THAN ANY OTHER STATE AND SO ALL
OF THIS IS BRAND NEW. IT'S
DEFINITELY LEANING FORWARD. AND
SO FAR WHAT I WAS HAPPY TO SEE
IT AS WE STARTED TO- ROLL OUT
SOME OF THESE INITIATIVES AND
SOME OF THESE OTHER INITIATIVES
OLD ROLL OUT THIS SUMMER AND
FALL. OF WE WERE HAPPY TO SEE
THAT AT LEAST TO SEE A MASK THE
CMS DATA CAME OUT LAST WEEK.
SHOWED THAT. DESPITE THE FACT
THAT CALIFORNIA HAS. MORE
SKILLED NURSING FACILITIES AS
WELL AS SKILLED NURSING SKILLED
NURSING FACILITY RESIDENTS. WE
HAVE TWELVE HUNDRED TWENTY
FOUR. HOWEVER WE ARE TWENTY
THIRD IN THE AVERAGE DEATH RATE
AND WE ARE BY FAR. LOWER THAN
THE NATIONAL AVERAGE AVERAGE IN
EVERY KEY INDICATOR. WHETHER
THAT'S CASES BUT THAT THAT
STAFF. BUT THE STAFF RESIDENTS
WE ARE BY FAR LOWER THAN ANY
OTHER STATE. AND I THINK THAT'S
BECAUSE OF THE WORK THAT WE'VE
BEEN DOING ON SITE BECAUSE THE
OTHER SET OF DATA THAT CMS
RELEASED LAST WEEK. WITH THE
AMOUNT OF TIME. THAT SURVEYORS
HAVE PHYSICALLY BEEN ON SITE.
AND YOU CAN SEE A DIRECT
CORRELATION. BETWEEN CALIFORNIA
WOULD BEEN ON SITE TO OLDER
FACILITIES. EXCEPT FOR A FEW
WHICH WE ARE ACTUALLY FINISHING
UP THIS MONTH. BUT ALL OF THOSE
FACILITIES DIRECTLY CORRELATES
TO READ THEN YOU SEE THE CASES
BY DEATH RATE. AND THEN YOU
LOOK AT OTHER STATES THAT WERE
ON THEIR 30% OF THE TIME 20% OF
THE TIME AND YOUR SEEN A HUGE
HUGE IMPACT. IN IN THEIR DEATH
RIGHT AND SO WE DID. THAT
ISSUES ME TO PLEASE YES I ARE
NOW ALMOST AT TEN MINUTES WE
HAVE FIVE MORE PANELISTS AND I
APPRECIATE EVERYTHING YOU'RE
SAYING BUT WE REALLY WANT TO
HAVE A DISCUSSION SO IF YOU
WOULDN'T MIND WOULD YOU PLEASE
WRAP UP. WE CAN'T HAVE ALL
RIGHT PANELISTS GO TEN MINUTES
THAT'S NOT GOING TO WORK FOR
SO. SORRY MY APOLOGIES. NOW
THAT'S FINE I JUST WANTED TO
SAY THAT THERE'S A CORRELATION
WE SEE THAT THERE'S AN- ADD.
WELCOME THAT CHANGE. AND I WANT
TO BE. THIS CONVERSATION SO I
APPRECIATE THAT YOU YOU PUT
TOGETHER ALL THE STAKEHOLDERS
TODAY. SO THAT WE CAN BE ABLE
TO COME UP WITH SOLUTIONS
TOGETHER. THANK YOU IT WILL BE
HARD TO CUT HAVE A CONVERSATION
IF EVERYBODY DOES A TEN MINUTE-
PRESENTATION HERE SO. THANK YOU
FOR YOUR PRESENTATION- WILL
MOVE ON NEXT TO OUR NEXT
PANELIST CAME ACCORDING. GOOD
MORNING. AND THANK YOU TO THE
ASSEMBLY FOR FOCUSING TODAY ON
CALIFORNIANS WHO LIVE IN
SKILLED NURSING THEIR FRIENDS
AND FAMILY WHO LOVE THEM. AND
THE STAFF WHO WORK THERE. AND
THANK YOU FOR INCLUDING THE
CALIFORNIA DEPARTMENT OF AGING-
THIS IS A VERY VERY TOUGH TIME.
FOR THE PHYSICAL HEALTH AND THE
MENTAL HEALTH OF ALL RESIDENTS
OF SENIOR LIVING AND WE'RE
GRATEFUL FOR THIS OPPORTUNITY
AND I WILL BE BRIEF. CDA HAS
THREE ROLES AS REGARDS PEOPLE
IN SENIOR LIVING FIRST WE HOUSE
THE OFFICE OF LONG TERM CARE.
LET'S WHICH IT DEPENDED
ADVOCATE FOR. BY PUBLIC
INFORMATION TO FRIENDS AND
FAMILY AROUND AGING AND
DISABILITY. AND HAVE TRIED VERY
HARD TO KEEP FAMILY AND FRIENDS
INFORMED. AND THIRD REALLY THE
MASTER PLAN FOR AGING WHICH IS
HELPING CHART THE WAY FORWARD.
IF WE- ALL STRATEGIES FIRST FOR
THE AMBIANCE AS- A BELIEVE
ASSEMBLY WELL KNOWS THE OFFICE
HAS BEEN BANNED FROM ALL
FACILITIES SINCE MARCH
THIRTEENTH NATIONWIDE DUE TO
INFECTION CONTROL. THIS HAS
MEANT TO PEOPLE THAT TO WORK
DOUBLE TIME TO CONNECT OVER
TELEPHONE AND INTERNET AND
OTHER WAYS TO TRY TO GET.
COMPLAINTS AND QUESTIONS OF
CALLS ANSWERED. ARE THE TOP
LINE KNOW HOWEVER IS THAT WITH
A 43% DECLINE IN ABUSE CALLS
COMING IN. WHICH ARE DOES RAISE
QUESTIONS AND CONCERNS AND WE
ARE WORKING DOUBLE TIME WITH
THE V. P. H. TO FIGURE OUT HOW
WE CAN STRENGTHEN THOSE
CONNECTIONS AND GET. INTO
FACILITIES AS SOON AS SAFE AS
POSSIBLE BUT IN THE MEANTIME
MAKES YOUR TELEPHONE AND
INTERNET IS WORKING FOR US.
SECOND WE HAVE TRIED TO ENGAGE
THE PUBLIC THERE'S MORE
INFORMATION ON OUR ENGAGE CA
DOT ORG SITE. FAQS IN ENGLISH
SPANISH MANFORD WE'VE HAD
CONFERENCE CALLS WITH FAMILIES
AND FRIENDS ABOUT CARE GIVING
FROM AFAR ABOUT ADVANCE CARE
PLANNING. ABOUT GRIEF AND LOSS.
WE HAVE. EXPANDED STATEWIDE THE
FRIENDSHIP LINE SO THAT ANYONE
SENIOR LIVING AT HOME CAN CALL
AND TALK IF YOU'RE LONELY. AND
ISOLATED WE ARE WELL AWARE OF
THE DESPAIR. IMPACTING TOO MANY
PEOPLE I FEATURED IN A
WONDERFUL ARTICLE BY DOCTOR
LOUISE ERRANT'S AND THE NEW
YORK TIMES YESTERDAY. I HOPE
THAT FRENCH WINE TO BE ONE
SMALL PART OF ADDRESSING THE
DESPAIR. AND WE'RE WORKING ON
DIGITAL DIVIDE STRATEGIES TO
HELP OLDER ADULTS AND PEOPLE
WHO LOVE THEM STAY ONLINE GET
ONLINE GO MORE ALONG. FROM HER.
WITH NEW FUNDING AND PRIVATE
PHILANTHROPY. APPROACH FIRST
AND FOREMOST MASTER PLAN FOR
EATING IS DRIVEN BY EQUITY. AND
FORMED AN EQUITY WORKGROUP IN
FEBRUARY IS VERY CONCERNED
ABOUT THE RACIAL DISPARITIES
THAT ARE SHOWING UP AND DEATHS.
ALL ACROSS THE STATE INCLUDING
SENIOR LIVING AND SOME EMERGING
NEW RESEARCH ABOUT. OF THE
COMPOSITION OF THE MIX OF
PEOPLE WHO ARE LIVING AT HOME
AND THE CONNECTION TO RATES AND
THERE'S A LOT TO DO THEIR TO
UNDERSTAND AND ADDRESS THE
DISPARITIES. AND AS YOU MAY
WELL KNOW THE LONG TERM
SERVICES AND SUPPORTS
SUBCOMMITTEE RELEASED THEIR
REPORT THE RECOMMENDATIONS TO
THE ADMINISTRATION'S ON MAY
TWENTY EIGHTH. COMPREHENSIVE
DOCUMENT ADDRESSING THE ENTIRE
CONTINUUM OF CARE. REALLY
UNDERSTAND HOMES TALKS ABOUT HE
ISSUES SUCH AS THE WORK FORCE
PUBLIC INFORMATION ON QUALITY
STATE OVERSIGHT AND AGAIN
STRONG ALTERNATIVES FOR HOME
AND COMMUNITY BASED SERVICES SO
MORE OFTEN LIVE AT HOME IN THE
HOMES OF OUR CHOOSE ONE TENTH
OF OUR CHOICE LASTLY ARE YOU
MAY HAVE HEARD THE
ADMINISTRATION A PARTNERSHIP
WITH US THE H. C. F. ANNOUNCED
A NEW LONG TERM CARE AT HOME
BENEFIT. WILL BE RECONVENING
THE MASTER PLAN FOR LONG TERM
SERVICES AND SUPPORTS COMMITTEE
SHORTLY TO BEGINNING GAUGING
WITH THERE'S A POTENTIAL
ALTERNATIVE OUGHT TO NURSING
HOME AS PART OF THE OVERALL
STRATEGY WITH THAT HOW COULD MY
REMARKS AND LOOK FOR DISCUSSION
PERFECT THANK YOU SO MUCH.
MISTER CORNET. YES THANK YOU
CHAIRMAN WOULD IN GERMAN IS
THERE ANY MEMBERS MY NAME'S
CRAIG CORNET ON THE PRESIDENT
AND CEO OF THE CALIFORNIA
ASSOCIATION OF HEALTH
FACILITIES. I WANTED THE REASON
I'M HERE TODAY IS TO AS AS THE
PRESIDENT CEO OF THIS
ASSOCIATION. IS TO EXPRESS TO
YOU THE VERY VERY SIGNIFICANT.
AND COULD CONCERN WE HAVE ABOUT
THIS ISSUE AND HOW SERIOUSLY
THE PROFESSION. TAKES OF IT
NINETEEN AND HAS TAKEN THIS
ISSUE. UP I WANT TO TELL YOU
FROM THE BEGINNING RIGHT OFF
THE TOP. THE MORE THE VICTIMS
OF THIS PANDEMIC WE MORE THE
RESIDENTS AND HAITIANS IN OUR
FACILITIES WHO ARE PASSED FROM.
NINETEEN WE MORE THE DEDICATED
STAFF OF OUR FACILITIES. AND
ALL OF THEIR FAMILIES. KOBE
NINETEEN HAS BEEN DESTRUCTIVE
IT HAS BEEN DESTRUCTIVE TO OUR
RESIDENTS IT HAS BEEN
DESTRUCTIVE. TO FAMILIES IT HAS
BEEN DISTRACTED CHARACTER
GIVERS ANTI THAT MINISTRY. THE
ENEMY HERE HAS BEEN THIS VIRUS.
NOT FROM THE PERSPECTIVE OF
THIS PROFESSION THE TWELVE
HUNDRED- NURSING HOME
FACILITIES IN CALIFORNIA THAT
SERVER THAT SERVE ROUGHLY FOUR
HUNDRED THOUSAND PEOPLE YEAR
WITH ALMOST A HUNDRED FIFTY
THOUSAND EMPLOYEES. I WANTED TO
GIVE YOU SIX POINTS THAT WE
HAVE SEEN SO FAR. FIRST NUMBER
ONE KOBE NINETEEN WAS NOTHING.
NOTHING LIKE WE HAVE EVER SEEN
IN TERMS OF THAT AND DAMMIT
TERMS OF THE DISEASE- NOT JUST
IN NURSING HOMES BUT ANYWHERE
WORLDWIDE. NUMBER TWO. THE
INFORMATION AND WHAT WE'VE
LEARNED ABOUT THIS VIRUS
CHANGED IT CHANGED A LOT IT
CHANGED FREQUENTLY. JUST FOR
EXAMPLE AT THE VERY BEGINNING-
THERE WAS NOT THERE'S REALLY
NOT CLEAR THAT A SYMPTOMATIC
PEOPLE POLLUTING OUR RESIDENTS
ARE VISITORS ARE CARE GIVERS.
WHEN THEY WERE A SYMPTOMATIC
THAT THEY COULD HAVE THE VIRUS
AND COULD BE SPREADING IT
WITHOUT SHOWING ANY SIGNS. THIS
IS A. DEVASTATING THANK BEAT B.
S. OF OPERATE. NUMBER THREE IT
WAS ESSENTIALLY AT A LATEST ON
THE IN A AND NOW ALSO ALL
TOGETHER BY THE TIME EVERYONE
ANYONE KNEW WHAT THE GOING ON
IT HAD A SPREAD MANY OF THE AND
MANY PARTS OF THE A CAL AND IN
ORDER HOME BEFORE WE EVEN
REALLY KNEW WAS GOING. NUMBER
AND THIS ONE I CANNOT EMPHASIZE
ENOUGH. ONE OF THE WE HAVE HAD
THE PROBLEMS THAT WE HAVE HAD
SO FOR THAT'S FOR. IS THE WE
HAD AN ATTIC. PERSONAL PER
EQUIPMENT RPP. FOR MONTHS.
SKILLED NURSING FACILITIES IN
CALIFORNIA WE'RE SHORT ON
SUPPLIES. AND THOSE SUPPLIES
MASK CLUBS DOWN SHE- THERE WERE
AS TO. THE SPREAD OF THE
DISEASE. NUMBER FIVE AND THIS
ONE I THINK ALSO CANNOT
EMPHASIZE ENOUGH. UNTIL FAIRLY
RECENTLY THERE HAS BEEN TOTALLY
INADEQUATE TEST. THIS WAS A
GARGANTUAN EFFORT AND A
HERCULEAN EFFORT I THINK THAT
THE STATE HAS HAD TO UNDERGO.
TO BRING TESTING TESTING- UP.
BUT AS IF YOU KNOW ANY. HEALTH
KNOWING ASSEMBLY POPULAR AND IN
WITH THE- IS CRITICAL TO BE
ABLE TO ACT. AND NUMBER SIX
THIS ONE POINT TO BE VERY CLEAR
ABOUT AS WELL. SKILLED NURSING
WERE REALLY NOT HAPPY.
BEGINNING OF THIS PAN I THINK I
THINK ANYONE WHO AT THIS STORE
WILL. THAT AT IT JUST TO SAVE
M. THAT'S WHERE NO CAST KNOWS
BIRD I DON'T BELIEVE BECAUSE I
THINK. THE ENTIRE SOCIETY
FEDERAL GOVERNMENT STATE
GOVERNMENT LOCAL GOVERNMENT
EVERYONE WAS MUCH MORE FOCUSED
INITIALLY ON THE HOSPITAL'S
KNOWING THAT WE MIGHT BE FORTY
THOUSAND HOSPITAL BIT SHORT.
SNIFFS WE'RE NOT AT THE
BEGINNING OF THE LINE AND SO
CONSEQUENCES THAT. BEING
SECONDARY I THINK I HAVE HAD TO
HAVE A DEVASTATING AFFECTS. UP
IN ADDITION WE'VE HAD
CONFLICTING STANDARDS AND
GUIDANCE THAT HAS HAMPERED OUR
EFFORTS AS I SAID THE GUIDANCE
IS CHANGED FROM STATE AND FROM
THE FEDERAL GOVERNMENT OVER
TIME. WE STILL HAVE CONFLICTING
GUIDANCE AT THE LOCAL LEVEL.
WHAT THE WHAT THE COUNTIES ARE
REQUIRING THREE NOW SOME CITIES
ACTUALLY INVOLVED AS WELL IT IS
CONFLICTING WITH WHAT THE STATE
BACK SOMETIMES TELLS. SO THOSE
ISSUES OUT WHERE DO WE GO FROM
HERE AND THIS IS A- VERY OF I
THANK YOU DIRECT SOON. YES
THANK THANK YOU UP I SAY THAT
THERE ARE THREE FOUR THINGS
THAT WE REALLY NEED RIGHT NOW.
WE NEED CORD MAY. COLLABORATION
COMMUNICATION AND CONSISTENCY
FROM THERE AN FROM FROM FROM
ALL EVERYONE IN THE STATE OF
SAY WE ARE WRAPPING UP TESTING
EFFORTS THEY WILL BE DONE.
BASELINE TESTING WILL BE DONE
THE END OF THIS MONTH. AND WHAT
CAN THE- I WOULD SAY. I WOULD
SAY IF YOU GET WITH SUPPORT.
THIS IS THIS IN SOME THIS. WITH
FINANCE RESOURCE WE ARE ALMOST
A 100% GOVERNMENT HEY THE MEDI
CAL RATES FOR NURSING HOMES
HAVE HISTORICALLY BEEN VERY
INADEQUATE. SUPPORT US WITH UP
PP AND TESTING. AND FINE AND
WORKFORCE DEVELOPMENT AND
FINALLY THE LAST POINT I WOULD
MAKE IS PLEASE SUPPORT OUR CARE
GIVERS. IT'S BEEN A GREAT DEAL
OF SUPPORT EXPRESSED FOR DIRECT
LINE- AT HOSPITAL WORKERS OF
FRONT LINE HEALTH CARE WORKERS.
PLEASE DON'T FORGET THE HUNDRED
FIFTY THOUSAND. OF PEOPLE WHO-
DO WHO WROTE QUIRK IN OUR
NURSING HOMES EVERY SINGLE DAY-
AND AT AND- I LOST LAST POINT
OF SAY WE ARE ALSO NOW. WORK
DILIGENTLY TO COME UP WITH NEW
STRATEGIES TO BE OPEN
FACILITIES FOR VISITATION THAT
IS THAT IT REALLY DEVASTATING
THING AS WELL TO NOT HAVE
FAMILIES INSIDE. AND. WELL
THANK YOU VERY NUMBER MOVE ON
TO OUR NAY THE PANEL DOCTOR
MICHAEL WASSERMAN. PUSHING
MEMBERS OF THE CAN SAYING YOU
FOR THIS OP. JOHN KENNEDY
QUOTED THIS TOYNBEE. ASIDE
CA DURABILITY CAN BE
MEASURED BY THE RESPECTIVE CARE
GIVING TO TELL THEIR WE SAW.
HOW DO I. SOCIETY AFTER THIS
PAN. IF WE TAKE NAY BY AND PLAN.
WE FINE. BETTER STATE LOCAL. AS
WELL AS OF HAVE USE ANY OF THE
WORDS. WORD HELP GEORGE CHEN.
EIGHTY YEAR OLD MAN WHO DIED OF
HER CALLED NINETY ON APRIL
TWENTY SECOND GEORGE'S SON FIND.
WHAT TO KNOW IF IT'S DEATH WE
PREVENTABLE. BE ON CANCER IS
YES. THE WORDS INDUSTRY BECAUSE
EXPECTS WATCH HAVE NOT SAVED
ABOUT FLY. WE NEEDED AT THE
TYPE OF ACTION IT IS AN TAKE
FOR THE REST OF OUR. AND BEING
THE FORMER CEO OF THE LARGEST
NURSING HOME CHAIN IN
CALIFORNIA. I WANT TO RECOGNIZE
IT THANK YOU INCREDIBLE PEOPLE
WHO SERVE ON THE FRONT LINES IN
NURSING HOMES THEY ARE
CURRENTLY KERRY AND
COMPASSIONATE HUMAN BEING. MANY
OF HOPE BARELY MAKE A LIVING
WAGE. MEDIA ACCOUNTS OF NURSING
HOME CARE OFTEN FOR THEIR
EFFORTS. TOO MANY HAVE GIVEN
THEIR LIVES DUE TO THE LACK OF
IMMEDIATE AND EFFECTIVE ACTION
ON THE PART OF THE FEDERAL
GOVERNMENT THE STATE THE
COUNTIES IN THE NURSING HOME
INDUSTRY. OPEN NINETEEN. WILL
MAKE ITS WAY. TO CLOSE NURSING
HOMES. WHAT MATTERS IS HOW THE
FACILITY IS PREPARED AND HOW IT
RESPONDS. OUR QUADRUPLE EIGHT
STARTS WITH A G. FOR EVERY
NURSING HOME TO HAVE AN
ABUNDANCE OF PP. THE STATE AND
REGIONAL OPERATORS HAVE
STRUGGLED WITH PANDEMIC RELATED
SUPPLY CHAIN DYNAMICS. THE REAL
ESTATE ALL MEMBERS IN WEEKS
BEHIND THE NURSING HOME
INDUSTRY HAPPY ABILITY TO
LEVERAGE ASSETS TO ACQUIRE PP.
AT THE COMMISSION I DON'T CARE
WHO TAKES RESPONSIBILITY FOR
THE ACQUISITION OF PP. WITHOUT
PP COPE WITH NINETEEN CANNOT BE
STOPPED. THE GOVERNMENT
INDUSTRY MUCH TRANSACTION ALL
THE OBSTACLES AND ASSURE AND A
BUNCH OF PP FOR NURSING HOMES.
NURSING HOMES ARE MANY
HOSPITALS BUT WITH FAR FEWER
RESOURCES. ERICA BORDER POST
ACUTE LONG TERM CARE BENEFIT
PROVIDES THE CERTIFICATION-
SHOULD HELP MEDICAL DIRECTORS
BUT ONLY A FRACTION OF
CALIFORNIA'S NURSING HOME
MEDICAL DIRECTORS HAVE THE CFE
CERTIFICATION. MAJORITY OF
MEDICAL DIRECTORS OF PERSONAL
THROUGHOUT THE STATE UNDER SURE
THE FINAL. WE FEATURE WITH YOUR
FACILITY LEADERSHIP TEAM.
NEGATIVE IMPACT OF THIS HAS
BEEN AMPLIFIED BY COVERT
NINETY. THE STATE OF CALIFORNIA
SHOULD REQUIRE ALL PERSONAL TO
HAVE ENGAGED CERTIFIED MEDICAL
DIRECTOR. MEDICAL RECORDS MUST
ALSO BE ALLOWED TO PERFORM
THEIR DUTIES WITHOUT UNDUE
INFLUENCE FOR PERSONAL
OWNERSHIP. SB NO QUID PRO QUO
RELATED TO ADMISSIONS AND
MEDICAL DIRECTORS SHOULD BE
FREE TO PROVIDE CRITICAL
LEADERSHIP WITHOUT FEAR OF
LOSING THEIR POSITION. THE
GOVERNMENT INDUSTRY FULLY
ENGAGE EXPERTS IN GERIATRICS OF
WHAT TRUMPCARE BENEFIT TO
PROTECT OUR LOCAL ELDERS AS
THIS PANDEMIC WORKS OF COURSE.
YOU MUST BE SURE THAT WE HAVE
WE ARE ACTIVE PARTICIPANTS IN
THE POLICY. PROCESS USE THAT
IMPACT THE LIVES OF OLDER
ADULTS IN OUR STATE. IF THE
CRITICAL EXPERTS HAVE BEEN
ENGAGED FOR THE BEGINNING OF
THIS PANDEMIC OR LIVES COULD
HAVE BEEN SAVED. THANK YOU
AGAIN FOR COMPLETING THIS PANEL
I LOOK FORWARD TO ANSWERING
YOUR QUESTIONS. THANK THANK YOU
VERY MUCH- OUR NEXT PANELIST
PAT MCGINNIS. THANK CHAIRMAN
WHAT THIS AREA TO MEMBERS THANK
YOU FOR THE OPPORTUNITY TO
TESTIFY AT THIS IMPORTANT
HEARING. I'M THE EXECUTIVE
DIRECTOR OF CALIFORNIA HAVE A
FIX FOR NURSING HOME REFORM THE
NONPROFIT ADVOCACY GROUP BASED
IN SAN FRANCISCO AND SERVING
LONG TERM CARE CONSUMERS IN
CALIFORNIA. THIRTY SEVEN YEARS
WITH ADVOCATING FOR ADEQUATE
STAFFING IN NURSING BETTER CARE
FOR RESIDENTS BETTER OVERSIGHT
BY THE DEPARTMENT OF PUBLIC
HEALTH AND PROTECTION OF
RESIDENTS FROM THE COLLECTED
DATA. I THINK THE FEE FOR A
NUMBER OF OUR MATERIALS
INCLUDING WHAT STEPS SHOULD BE
TAKEN IF WE WANT TO CHANGE THE
COURSE. OF CARE FOR NURSING
HOME RESIDENTS AND SOME OF THE
MATERIALS REGARDING THE SPREAD
OF THE VIRUS IN NURSING HOMES
ARE EMERGENCY PLANS WHICH WE
FIRST SENT TO THE DEPARTMENT
EARLY APRIL. WHAT WORKS WITH
NOT MUCH FROM THE BEGINNING OF
THE DECLARATION OF A STATE OF
EMERGENCY. I WE WERE WELL AWARE
THAT NURSING HOMES WOULD BE THE
PERFECT INCUBATORS FOR THE
VIRUS. AND THAT NOTHING WAS
DONE MANY RESIDENTS AND STAFF
WOULD BECOME THE SECOND
INFECTED WOULD DIE. NOW TWO
THOUSAND PLUS AND IT'S RISING
EVERY DAY- THOUSANDS OF NURSING
HOME STAFF TODAY WE NOTED SIXTY
EIGHT NURSING HOME STAFF HAVE
DIED. AND THERE'S NO DOUBT THAT
WHILE OF THESE DEATHS WERE
NEVER. MANY OF THEM IN THE IN.
WERE PREVENTIVE. THEY DIRECT
RESULT OF THE PER POLICIES THE
INADEQUATE OVERSIGHT OF THE
AGENCIES APPOINTED TO PROTECT
NURSING HOME RESIDENTS IN
CALIFORNIA. AND OF COURSE THE
DIRECT RESULT OF THE IN DEPTH
IN THE GLASS. OF CALIFORNIA'S
NURSING YOUR- YOUR OF
CALIFORNIA NURSING HER WERE AND-
EVEN PRIOR THE CONDEMNED. THE
DEPARTMENT OF PUBLIC GRANTED
STAFFING WEIGHBRIDGE. HUNDREDS
OF NURSING HOMES THE FUTURE
DELUDE DIDN'T EVEN HAVE TO MAKE
A VERY MINIMAL STAFFING
REQUIREMENTS. THEY CONTINUE TO
HAVE A BACKLOG OF THOUSANDS AND
THOUSANDS OF COMPLEX. SO IT'S
NO SURPRISE THAT THE NURSING
HOMES WITH THE WORST RECORD TO
CARE WITH PREVIOUS INFECTION
CONTROL DEFICIENCIES. AT THE
HIGHEST NUMBER OF DEATHS AND
SUFFERING. OF THE 50% THE
FISCAL AND NURSING HOMES HAD
DEFICIENCIES AND AFFECTION
CONTROL AND PREVENTION WITHIN
THE PAST TWO YEARS. MOST THE
PHILLIES DIDN'T HAVE A FULL
TIME INFECTION CONTROL
SPECIALIST IF THEY HAVE THEM AT
ALL. AND FAILED TO TRAIN STAFF.
CAROLINE CONVENTION. YOU DELETE
THAT THE BISHOP PERSONAL
PROTECTIVE EQUIPMENT- IN IN
TERMS OF SO THE STAFFER TOLD TO
SHOW UP TO WORK TO RISK GETTING
FIRED. THERE WAS NO TESTING IT
ON THE FIRST COUPLE OF MONTHS
AND EVEN OUT THREE PLUS MONTHS
THIS CRISIS. CASTING A SPORADIC
BINGE. ONE OF THE THIRD OFFICE
BUILDINGS OTHER OUT BY PARK WAS
TO ALL. FOR NURSING. NO FAMILY
NO AND UP. NO LONGER CARE AND
BURKE AND BOTH MEN AND NO NURSE
THE VALUATIONS BEGINNING. I
DON'T THINK ANY VALUE WAIT
REMOTELY AND YET THERE WERE NO
LIMITS PLACED THE NURSING STAFF
THE WALK TO WORK TWO JOBS JUST
TO MAKE A LIVING WAGE- OF
MISCONDUCT REFERRED TO THE-
ARCHITECT INFECTION CONTROL
SURVEYS AND ENGAGE THEY GET DO
SOME OF THOSE INFECTION CONTROL
SURVEYS- WE LOOKED OVER MANY
UP. HUNDREDS OF THEM ONE OF THE
TARGETED OBJECTION TO TRAVEL
SURVEYS TOOK PLACE IN EARLY
APRIL. THE BILL YOUR REHAB AND
NURSING CENTER IN RIVERSIDE
THEY RECEIVED A CLEAN SURVEY
WITH NO INFECTION CONTROL
DEFICIENCIES. LATER LIKE. THREE
DAYS LATER. EIGHTY FOUR OF ITS
RESIDENTS WERE EVACUATED DUE TO
ANNOUNCE ABOUT BREAK IN EXTREME
STAFFING CRISIS. IN YEAH THEIR
INFECTION CONTROL SURVEY DATED
APRIL SEVENTH DAY BUT NO YEAH A
CLEAN BILL OF HEALTH. FOUND
THAT TIME AND TIME AGAIN FORTY.
EIGHT TWENTY NINE STAFF OR
EXPECTED IT AND MANY PATIENTS
THAT. THERE ARE HUNDREDS OF
SURVEYS WITH NOTIFICATION
BECAUSE THE SURVEYOR ONE STRUCK
DID NOT TO FIGHT UNTIL THESE
BUT TO COLLABORATE WITH THEM.
MEANWHILE THOUSANDS OF NURSING
HOME RESIDENTS. SUFFERED AND
DIED ALONE. A SIMPLE THAT'S
THAT EVERYONE. CHILD IT'S JUST
THE WARNING BEHAVIOR. YET WE
CAN. TO REWARD NOT SURE THAT
THE STATE. THE SUNSET SUNSET
CHAIR AND- A FULL TWO BILLION A
LOT ANGELES WITH THE- RECORD
THAT AND CAL. AND MANY WERE.
RESIDENT HAVE DONE OF CODE OR
BECAUSE IN FACT. ARE NOW
DOESN'T HOPE DESIGNATED
FACILITIES MEANING THEY CANNOT
RECEIVE SIX TO EIGHT HUNDRED
FIFTY DOLLARS A DAY OUR CO THE
PATIENT. EITHER. ONE AND TWO
STAR FACILITIES FOR THE MOST
PART. A CRIME DOESN'T PAY.
BECAUSE THE NEED TO FILL THESE
WORDS IN. ONE GRAD PARKER.
THREE SIX RESIDENTS SIDE OF THE
CODE NINETEEN CAUSES NEARLY A
HUNDRED RESIDENTS AND STAFF
WERE AFFECTED AND THEY ARE NOW
OPPOSED THE DESIGNATED NURSING
HOMES THANK TO REAP THE
BENEFITS OF INFECTING THEIR
RESIDENTS AND STAFF. HOLLYWOOD
PREMIER HEALTH CARE CENTER
ANOTHER OF THE DEDICATED SO
THAT NINETEEN YEAH. WE'RE
NINETEEN RESIDENTS DIED FROM CO
THE CAUSES AND ANOTHER NINETY
RESIDENTS AND STAFF WERE
INFECTED. OR NOT SENATE'S READ.
THE WEBSITE IS NOT. DOING AN
ALTERNATIVE BUSINESS MODELS BY
BECOMING THE DESIGNATED
FACILITY SO THE MORE PEOPLE YOU
KILL THE MORE PEOPLE YOU GET
INFECTED THE MORE MONEY YOU CAN
GET PER PATIENT PER DAY. THE
GOVERNOR'S BUDGET PROPOSAL
INTENDS TO REWARD THE NURSING
HOME INDUSTRY ONCE AGAIN WITH
BILLIONS MORE IN THAT ACCOUNT
DOLLARS WITH NO ASSURANCE THAT
ANY OF THOSE FUNDS WILL GO TO
IMPROVE STAFF. STAFFING RATIOS
INFECTION CONTROL OR QUALITY OF
CARE. WHAT HAPPENED
CALIFORNIA'S NURSING HOMES IS A
TRAGEDY AND SOME NOT FROM WHAT
PEOPLE AVOIDABLE IF OUR
GOVERNMENT AGENCY HAD THE
COURAGE TO BE A CONSUMER
PROTECTION AGENCY INSTEAD OF A
PROVIDER PROTECTION AGENCY.
MEANWHILE FAMILY MEMBERS ARE
PROHIBITED FROM VISITING THEIR
MOTHERS AND FATHERS THEIR
BROTHERS AND SISTERS THEY
REMAIN WITHOUT ANY RIGHT. BUT
HAVE NO VISITORS AND NO ONE TO
ENSURE THEIR SAFETY SO WE OF
BEAUTY SHOPS BARS. OPEN NURSING
HOME RESIDENTS AGAIN EITHER ONE
DOESN'T CAN. WE HAVE SAM'S TO.
AN AND TO DIE ALONE AND-
KITCHEN. WE HAVE AN OF
RECOMMEND. FOR I JUST TO THE
COMMITTEE. WE NEED TO KEEP
RESIDENTS OUT OF NURSING AND WE
HAVE TO FIND REAL. YOU MAY
BASED. THANK YOU TO BAN SHARED
ROOMS AND- THE IDEA THANK YOU
NIGHT THE LATE ONE. THANK YOU
WOULD LIKE TO CHAT IT THANK YOU
VERY THEIR THANK SOME WE WHAT
TO GO ON OF WELL PAST THE FOUR
MINUTES BUT- WE APPRECIATE YOUR
TESTIMONY AND- I THINK YOU
THANK YOU FOR YOUR PASSION AS
WELL.I'D LIKE TO MOVE ON TO
OUR OUR NEXT- ARE FOR THE NEXT
AND FINAL PANELIST AT LISA
COLEMAN. PLEASE GO AHEAD WHEN
YOU'RE READY LISA. MORNING
THANK YOU ASSEMBLYMEMBERS FOR
THIS OPPORTUNITYAND THESE
DEPLOYMENT AND THE SECOND
DIRECTOR FOR THE CALIFORNIA
LONG TERM CARE OMBUDSMAN
ASSOCIATION. I WANT TO START BY
SAYING I APPRECIATE THIS TIME
TO HAVE A DISCUSSION AND WE
NEED TO BE VERY CAREFUL THAT
WE'RE NOT VILIFYING THIS
INDUSTRY. IT IS. NONE OF US
HAVE THE ABILITY TO SAY WITH
ANY CERTAINTY THAT WE WILL NOT
ULTIMATELY END UP IN A SKILLED
NURSING FACILITY OR SOMETHING
THAT WE LOVE WILL NEED THIS
KIND OF CARE AND SO REFERRING
TO THESE FACILITIES AS DEATH
TRAPS ARE GIVING THE IMPRESSION
THAT LIFE IS JUST NOT WORTH
LIVING IF IT'S GONNA BE LIVED
IN A SKILLED NURSING FACILITY
DOESN'T HELP THE NARRATIVE IN
ANY WAY. IF ANYTHING IT COME IT
COMPOUNDS THE GUILT AND THE
ANXIETY THAT THE RESIDENTS
EXPERIENCE AND THOSE WHO LOVE
THEM SO WHAT I'M HERE TODAY TO
SAY IS WE NEED TO BE FLOODING
THESE FACILITIES WITH RESOURCES
AS WELL AS HOLDING THEM
ACCOUNTABLE FOR THE PROBLEM FOR
THAT FOR CARE THAT THEY ARE
MANDATED TO PROVIDE. SO UNDER
THE GUISE OF RESOURCES THE FOR
ONE WE NEED TO GET THE
OMBUDSMAN'S BACK IN THE
BUILDING- I'M NOT SUGGESTING
THAT WE DO THIS **** NILLY I'M
SUGGESTING THAT IS DONE
THOUGHTFULLY AND WITH. A
PROTECTIVE EQUIPMENT
APPROPRIATE. I CAN ASSURE YOU.
EVERY LOCAL OMBUDSMAN PROGRAM
IS INTIMATELY AWARE OF THE
FACILITIES THAT STRUGGLE TO
PROVIDE GOOD CARE PRIOR TO THE
NINETEEN. AND IT IS THOSE
FACILITIES THAT OUR GREATEST
RISK THAT THE OMBUDSMAN'SARE
ANXIOUS TO GET BACK IN AND LOOK
BEHIND THE CURTAIN. THE SECOND
RESOURCE. THE STATE NEEDS TO
ADDRESS THE ISSUE. SHAMEFUL
PRACTICE WITH VERY FEW
EXCEPTIONS. OF PAYING CNA IS A
POVERTY WAGE. YEAR AFTER YEAR
WE HEAR THE INDUSTRY LIMIT THAT
THEY CAN'T KEEP STAFF. AND
RATHER THAN ADDRESSING THE
ISSUE THE NEED TO PAY A
PROFESSIONAL WAGE. FACILITY
UNDER SEEK THE DEPARTMENT'S
PERMISSION TO UTILIZE STAFF
SHORTAGE WAIVERS. I WALKED CARE
STAFF BY AND LARGE ARE VERY
CARING DEDICATED INDIVIDUALS WE
CAN'T BE SO NAIVE AS TO THINK
THAT THEY'RE WORKING SIXTY TO
EIGHTY HOURS A WEEK IN MULTIPLE
FACILITIES BECAUSE THEY LOVE
WHAT THEY DO. THEY WORK THESE
KINDS OF OURS BECAUSE THAT'S
WHAT'S REQUIRED TO COVER THE
RENT. EVEN DURING A PANDEMIC
BOTH INDUSTRY AND DEPARTMENT
LEADERS JUSTIFIED THE
CONTINUING UTILIZATION OF CARE
STAFF WORKING IN MULTIPLE
FACILITIES. WITH SEEMINGLY NO
REGARD TO THE FACT THAT CARE
STAFF WITH NO MALICE INTENT ON
THEIR PART. WE'RE SPREADING OF
THE NINETEENTH FROM FACILTY TO
FACILITY AND ACROSS COUNTY
LINES. INDUSTRY DEPARTMENT
LEADERS STATED PUBLICLY THEIR
FEARS THAT IF FACILITIES DIDN'T
YOU STAFF THAT WORKED IN
MULTIPLE FACILITIES THEY
WOULDN'T BE ABLE TO COVER THEIR
BE SHIPPED. AND WHILE TARGET
AND SAFE WAY. FOUND A WAY TO
PAY HAS A DIFFERENTIAL THIS
INDUSTRY REFUSES TO LET THE
GENIE OUT OF THE BOTTLE. AND I
BELIEVE IT'S BECAUSE THEY KNOW
THAT IF THEY DID PAY A SALARY
WORTHY OF THE HARD WORKING
PROFESSIONAL JOB OF CARING. FOR
ELDERLY AND FRAIL RESIDENTS
THEY WOULD NO LONGER BE ABLE TO
POINT TO THE HIGH TURNOVER OF
STAFF. FOR MANY SKILLED NURSING
FACILITIES IT'S MORE THAN 60%
EVERY YEAR AS THE REASON WHY
TAKE CARE WHY THEY'RE
CHRONICALLY OPERATE SHORT
STAFFED. AND WHY THEY CAN'T GET
A HANDLE ON FACILITY COMPLIANCE
ISSUES LIKE INFECTION
PREVENTION CONTROL. I DO HAVE A
PROPOSAL FOR THE LEGISLATURE.
COUNTY HEALTH LOCAL PUBLIC
HEALTH OFFICES OF EMERGENCY
SERVICES MAILBOX ALL OF THESE
TEAMS NEED A LOCAL LONG TERM
CARE EXPERT ON THEIR TEAM.
IDEALLY AN OMBUDSMAN. THEY NEED
THE PERSON ON THE TEAM. A
PERSON THAT KNOWS THE CARE
NEEDS OF LONG TERM CARE
RESIDENTS AND IS CONSIDERED
WHEN PLANTING REGIONAL PLANNING
EFFORTS. NO ONE KNOWS CARE
FACILITIES BETTER THAN THE LONG
TERM CARE OMBUDSMAN. IT WAS
ESPECIALLY FRUSTRATING FOR
THESE ADVOCATES TO LEARN OF
FACILITY OUTBREAKS VIA SOCIAL
MEDIA OR ON THE LOCAL NEWS. AND
WHILE IT IT DOESN'T MATTER NOW.
THE VERY FIRST DATA IN A
SKILLED AT IN A IT'S AN
ASSISTED LIVING FACILITY AND
NOT SOUTH SACRAMENTO OCCURRED
WALL OMBUDSMAN'S WERE STILL
MAKING VISITS INTO THESE
FACILITIES WITHOUT PP AND
DISABILITY KNEW ABOUT IT AND
THE LICENSING AGENCY KNEW ABOUT
IT BUT THEY HAD NOT YET THAT
INFORMATION WITH THE OMBUDSMAN.
THIS INDUSTRY CAN DO BETTER.
THE FIST THE RESIDENTS WHO LIVE
IN THESE FACILITIES NEED US TO
DO THAT AND THE LOCAL LONG TERM
CARE OMBUDSMAN PROGRAM STAND AS
WORKING PARTNERS READY TO HELP
IT BE BETTER. THANK YOU. THANK
YOU VERY MUCH- I'D LIKE TO THIS
POINT. TURN OVER TWO OF THE
MEMBERS FOR QUESTIONS AND I
WANT TO SAY I WANNA LET THE
QUESTIONS GO TO ABOUT TEN
TWENTY FIVE AND THEN WHAT I'D
LIKE TO DO IS I'D LIKE TO ASK
OUR LAST THREE PANELISTS TO
PREPARE A QUESTION FOR. OUR
STATE REGULATORS OR- THE
FACILITIES- TO ASK FOR YOU TO
ASK THEM DIRECTLY A QUESTION
PUBLICLY- THAT YOU MIGHT LIKE
TO HAVE ANSWERED AND WE WILL.
CONTINUE IN THAT VEIN UNTIL TEN
FORTY FIVE- WE HAVE WILL TAKE
PART COMMON NOT SAY AGAIN THAT
OUR PUBLIC COMMENT WILL BE
LIMITED FOR FIFTEEN MINUTES AND
I APOLOGIZE FOR THAT BUT WE
WILL BE WE HAVE A HARD STOP AT
ELEVEN AM. AND ANY OTHER PUT A
PUBLIC COMMENT WE WOULD BE
HAPPY TO RECEIVE IN WRITING AND
I PROMISE YOU THAT WE WILL- WE
WILL READ IT AND WE WILL
RESPOND SO AT THIS POINT LIKE
TO OPEN AND TO MEMBERS WHO WHO
HAVE QUESTIONS. ALSO LIKE TO
WELCOME. WITH ROOM THE RACE
HERE THE CHAIR OF OUR HUMAN
SERVICES COMMITTEE. MISTER
RAMOS- ALSO UNDER BUDGET
SUBCOMMITTEE ON HEALTH
COMMITTEE TASHA BOERNER HORVATH.
ARE YOU AN HAVE HUMAN SERVICES
ON LONG TERM CARE THANK YOU AND
THEN MR LACKEY AS WELL- LONG
TERM CARE THANK YOU. SO
QUESTIONS AND MISTER A DOCTOR
RAMYA EXCUSE ME. THANK YOU
MISTER CHAIR AND- IF I MAY I
FIRST WANT TO START WITH THE
HEIDI STAN OCCURRED DEPUTY
DIRECTOR OF DEPARTMENT OF
PUBLIC HEALTH JUST SO SHE CAN
COME TO THE MICROPHONE. BUT I
WANTED TO TALK IF I COULD
BECAUSE I'VE BEEN QUITE
IMPRESSED HAS YOU'VE SPOKEN
ABOUT YOUR SIX STRATEGIES TO
HELP IN THIS AREA. AND WANTED
TO SPEAK DIRECTLY IF I COULD
ABOUT THE ANALYTICS YOUR FINAL
POINT THAT YOU SPOKE ABOUT HOW
WE CAN BE MORE PROACTIVE VERSUS
REACTIVE. AND WANTED TO ASK YOU
DIRECTLY IF WE AS A STATE ARE
LOOKING TOWARDS SOME OF THE
BENCHMARKS THAT WERE SETTING UP
FOR COUNTIES. AS WERE
TRANSITIONING INTO PHASES AND
WHETHER OR NOT WE'RE LOOKING AT
THOSE BENCHMARKS AS AREAS IN
WHICH WHERE WE CAN DIRECTOR
STRIKE TEAMS. SO SPECIFICALLY.
COUNTIES THAT ARE STARTING TO
EXPERIENCE GREATER THAN 8%
POSITIVE. RATES WITHIN. THERE
ARE COUNTIES ARE WE DIRECTING
STRIKE TEAMS TO THOSE COUNTIES
AND THE SKILLED NURSING
FACILITIES. DUE TO THOSE HIGHER
THAN. NORMAL ELEVATED RATES.
GREAT QUESTION THANK YOU FOR
THAT NO WE DO HAVE A COUNTING
WATCH REPORT THAT COMES OUT
EVERY NIGHT- SO WE HAVE THAT
COUNTY WATCH REPORT WE SEND
THAT OUT TO ALL OF OUR DISTRICT
OFFICES IN OUR SURVEYOR SO THAT
THEY'RE AWARE- IN ADDITION IN
THE MORNING ANYTHING THAT SHOWS
ON THAT HIGH RISK LIST WHETHER
THAT IS IN ONE OF THOSE OF.
THOSE HIGH RISK COUNTIES OF
THOSE COUNTIES THAT ARE OPENING
UP OR IF IT'S JUST A FACILITY
AS- YOU KNOW I BELIEVE PATH TO
GET AS HAD SAID THAT YOU KNOW
THERE ARE SOME FACILITIES THAT
WE ARE WE'RE DEFINITELY
WATCHING BECAUSE OF THAT PAST
COMPLAINTS HISTORY SO BOTH
CASES WHETHER IT'S ON THE
COUNTY WATCH REPORT OR IF IT'S
ON THE- PREDICTIVE ANALYTICS
LIST. THE HIGH RISK LIST THAT
WE GO AND- WE CONTACT THEM UP
THAT NEXT DAY. I WOULD ASK IF I
COULD HAVE SOME FOLLOW UP AS
PRESIDENT COUNTY IS ONE OF
THOSE COUNTIES THAT HAS
RECENTLY GONE ABOVE 8%
POSITIVE- TEST. PERCENTAGE AS
WELL AS TULARE COUNTY WHICH IS
IN THE CENTRAL BANK. MY NEXT
QUESTION IS FOR CHEMICAL A WAY
TO AND- YOU KNOW I WANT JUST TO
START A FIGHT COULD WELL YOU'RE
COMING TO THE MICROPHONE TO SAY
THAT JUST BECAUSE WE HAVE A
DECREASE IN TELEPHONE
COMPLAINTS. DOES NOT MEAN
THERE'S OT A NEED FOR US TO
HAVE THE OVERSIGHT AND
ACCOUNTABILITY. TO ENSURE THAT
THERE'S NOT. ABUSE OR NEGLECT
OCCURRING WITHIN OUR SKILLED
NURSING FACILITIES. AND SO
THANK THAT. WE DO NEED TO
FIGURE OUT HOW WE RECTIFY THE-
SITUATION WITH LONG TERM CARE
OMBUDSMAN AS SOON AS POSSIBLE.
AS THEY- HAVE BEEN OUR
REPRESENTATIVES AND ADVOCATES
WITHIN THESE FACILITIES AND-
BELIEVE THAT THEY'RE THE EYES
AND EARS THAT ARE NEEDED IN
THIS MOMENTS TO ENSURE THAT- WE
HAVE THAT. TRANSPARENCY THAT I
WANTED TO ASK YOU IF I COULD
NOW. SINCE YOU MENTIONED THE
LONG TERM CARE BENEFIT. WHAT
DOES THE TRANSITION LOOK LIKE.
WHAT WHAT WHAT ACTUALLY DOES
COMMUNITY SERVICE LOOK LIKE IN
YOUR MIND GOING FORWARD AND HOW
DO WE ENSURE THAT ARE FRAIL AND
ELDERLY WHO RELY UPON THE SEA
BASS AND ASSESS PO. ARE TAKEN
CARE DURING- THESE- POTENTIAL
TIMES JUST TO MAKE ASK YOUR
THOUGHTS ON THAT. THANK YOU AND
ABSOLUTELY AGREE ABOUT THE LONG
TERM CARE OFF OF THAT NEED TO
GET BACK IN A MEANINGFUL WAY
WORKABLE ALL THE CAMPUS WILL
STICK. TO FIGURE OUT THE SAFE
WAY TO DO THAT AS QUICKLY AS
POSSIBLE SO 100% AGREE ON LONG
TERM CARE AT HOME YOU KNOW IF I
WOULD TAKE A PAGE FROM THE
MASTER PLAN LONG TERM. SERVICES
AND SUPPORTS SUBCOMMITTEE FIRST
YOU HAVE THAT VISION THAT IT'S
IMPORTANT THAT PEOPLE WHO WANT
TO STAY HOME CAN'T STAY HOME
AND HAVE THAT CHOICE WITHOUT
ANY IS VERSIONS ON THE NEEDS
FOR SKILLED NURSING A PART OF A
CONTINUUM OF CARE. THAT
CALIFORNIA'S LONG HAD A VISION
FOR SUPPORTING LIVING INVOLVED
WHETHER THAT DISABILITIES UP
PEOPLE ENOUGH FOSTER CARE WE'VE
RECENTLY MOVED FROM GROUP HOMES
TO INDIVIDUAL HOMES- WE BELIEVE
IN HOME LIVING AND SO WE NEED A
VISION ABOUT WE NEED A DATA
DRIVEN. MEASURE RAPIDLY TOWARDS
THAT GOAL AND. SERVICES EVERY.
THAT THINGS LIKE YOUR- THAT
DOES. THINGS LIKE DAY. AT THE
TIME. IN HOME HOW. THAT DOES
INCLUDE TRANCE. IN IN AND OUT
OF SAID. AS MAYBE THE- AND OF
COURSE THAT TO BE A FOR. BUT I
GOT MEDICAL OR- THAT THE ONE
BACK MAKERS FOR ALL THREE. SO
HOW DO WE- THAT THE IS ONE OF
THE GOALS OF THE MASK PLAN. I'M
EXTREMELY SHORT TERM CHALLENGES
WITH THE BUDGET PICTURE BUT
THERE'S ALSO CREDIBLE MEDIUM TO
LONG TERM OPPORTUNITIES THAT
WE'RE GONNA LOOK AT WHAT THE
LONG TERM CARE HOME PROPOSAL
WITH RBC OF PARTNERS- AS WELL
AS ALL STAKEHOLDERS. I LAND AND
PASS A BACK TO YOU YOU MISTER
CHAIR BUT WANTED TO ACKNOWLEDGE
LEASE A COLEMAN WHO HAS BEEN A
LONGTIME ADVOCATE AND- WAS A
WONDERFUL SPEAKER ON THIS
PANEL. THINK SHE- IDENTIFIED AN
ISSUE THAT MANY OF US FOR.
YEARS HAVE BEEN TALKING ABOUT
WHICH IS A- LACK OF ADEQUATE
WORK FORCE WITHIN THIS AREA.
AND I THINK YOUR IDENTIFICATION
OF HAZARD PAY IS SPOT ON AS WE
ARE NOW ASKING THEM. NEARLY
REQUIRE IT TO THEM. NEW SKILLS
IN INFECTION CONTROL AND
PROTOCOLS AND BELIEVE THAT AS
WE ARE INCREASING THOSE SKILLS
WE SHOULD ALSO BE INCREASING
THEIR PAY. AS THAT WILL HELP US
TO TAKE CARE OF OUR ELDERLY OUR
MOST VULNERABLE IN THESE
FACILITIES. IT'S BEEN LONG
OVERDUE AND I THINK WE AS A
STATE SHOULD LOOK TO FIGURE OUT
HOW TO HAVE THOSE CONVERSATIONS
IN A PRODUCTIVE WAY. SO WE CAN
MEET THE CHALLENGE OF THE
MOMENT THANK YOU. THANK YOU
VERY MUCH AND- WHAT WILL GO
WITH THE BACK WITHOUT A
MYSTERON AND THEN. MR READ-
MISTER SALAS AND THEN MISS
RATES.
HELP THANK. YOU COULD
PROTECT THE MIKE IN THE BACK
THERE. WITH THE WITH THE
WITNESS MIKE. I THINK IT'S ON.
TECHNICAL DIFFICULTIES AND
WE'RE HARD WIRED HERE TOO SO.
BUT TO TRY THE CRUNCHY TRY THE
MIKE IN THE IN THE- BY THE BY
THE BACK THERE. IT WASN'T. IT
WASN'T PLUGGED IN OKAY. THAT'S
A PROBLEM. OKAY. AND I'M
LOOKING AT AS FAR AS-
PREVENTIVE PREVENTIVE- LONG
TERM HEALTH CARE WORKERS THOSE
THAT ARE PROVIDING- HEALTH CARE
TO ELDERLY IN THE HOMES AND
THEN BEING ABLE TO MAKE SURE
THAT THEY'RE PART OF THE
DISCUSSION MOVING FORWARD WE
TALKED A LOT ABOUT PPVS- EARLY
ON IN OUR HEALTH COMMITTEE IN
OUR SUB ONE AND BUDGET IN
GENERAL BUT WE WANNA- MAKE SURE
THAT WE'RE TALKING ABOUT
NURSING HOMES THAT WERE ALSO
TALKING ABOUT THE PRE PRE
ACTIVE- TO MAKING SURE THAT
THOSE THAT ARE ACTUALLY CARING
FOR PEOPLE IN THE HOMES RIGHT
LONG TERM HEALTH CARE WORKERS
THE HOME. ARE ALSO PART OF THE
DISCUSSION AS FAR AS MAKING
SURE THAT WHEN WE TALK ABOUT
PPVS WE TALK ABOUT ADEQUATE
WAGES ALL THESE DIFFERENT
THINGS THAT WERE BRINGING THE
DISCUSSION INTO THE FOR FALL I
UNDERSTAND NOW WE'RE TALKING
ABOUT THE NURSING HOME BUT A
LOT OF THAT COULD BE YOU KNOW
IF WE'RE A TO A THE THINGS THAT
PERHAPS IN THE- TERM. HEALTH
CARE. MORE ONE OF THAT PART OF
THE A AND DISCUSSED THANK YOU
MISTER CHAIR THANK YOU VERY
MUCH MISTER RAMOS- MR SALAS.
THANK YOU RICHARD FIVE TWO
QUICK QUESTIONS I KNOW
INITIALLY WHEN WE WERE LOOKING
AT THIS AND TRYING TO GET SOME
NUMBERS OF THE NUMBERS WERE
ACTUALLY REPORTED AS BEING-
VOLUNTARY AND THEY WERE
VOLUNTARILY COMING IN SO I WAS
WONDERING FROM A STATE
PERSPECTIVE HOW ARE WE MAKING
SURE THAT THE INFORMATION IS
ACCURATE. THIS IS MY FIRST
QUESTION SECONDLY I KNOW MR
AROUND ONE ALLUDED TO THIS AS
WELL IN TERMS OF THE WORK FORCE
WITH THE RESOURCES AND SUPPORT
BECAUSE I CAN TELL YOU THAT.
OUR GOAL THAT THAT WAS THE
BIGGEST PLEA FROM THEM AS THEY
WERE HAVING ISSUES WERE
ADDITIONALLY WHEN WE WERE
DEALING WITH COVERED BY T. WELL
THEY DON'T WANT TO COME AND-
WORK. SO WHAT WAS BEING DONE AT
THAT ARE THEIR GUIDELINES ARE
THERE. RESOURCES FROM THE STATE
WHERE THEY SEND IN STRIKE TEAMS
I THINK EVENTUALLY. WE DID GET
A HOLD OF THE STATE THEY DID-
HELP WITH SOME ASSISTANCE WITH
THAT WASN'T UNTIL MUCH LATER.
SOME TRYING TO FIGURE OUT FROM
THE STATE'S PERSPECTIVE ARE WE
DEVELOPING GUIDELINES NOW TO DO
THIS TO MEET THESE NEEDS.
ANTICIPATING THESE NEEDS
BECAUSE WE'VE SEEN THIS- AND
WHEN YOU LOOK AT THE STATISTICS
I MEAN AT ONE IN EVERY FIVE.
NURSING FACILITY AS SOME OF
CORONAVIRUS INCIDENT. SO TRYING
TO FIGURE OUT THE STATE'S
PERSPECTIVE. FROM THE STATE
DEPARTMENT'S- PERSPECTIVE
PLEASE. THAT QUESTION I BELIEVE
YOU HAD MENTIONED THAT- YOUR
LOVED ONE WAS IN IN KERN COUNTY
AND I'M I'M VERY WELL AWARE OF.
THE OUTBREAKS. WE'VE HAD A KERN
INTO LARRY. AND IN THOSE CASES
IN IN ESPECIALLY IN KERN COUNTY
REMEMBER EARLY ON. WE WOULD
SEND A TEAM WITHIN TWENTY FOUR
HOURS THERE BUT THEY ARE YOU
KNOW SURVEYORS WHO WERE THERE
TO BE ABLE TO PROVIDE
ASSISTANCE OUR SITE. WE ALSO
HAD OR H. I. TEAM THAT WERE
THERE TO BE ABLE TO PROVIDE
INFECTION. BUT THAT DOESN'T
HELP WHEN THERE IS JUST NOT
EVEN STAFF RIGHT AND SO I THINK
THAT WAS THE CASE IN THOSE
PARTICULAR FACILITIES THERE.
YOU'RE JUST NEEDING BODIES THE
STAFF THAT ARE TRAINED TO BE
ABLE TO COME IN AND HELP AND
DO. WORK SO WE HAVE USED A
VARIETY OF DIFFERENT RESOURCES.
REVIEWS HEALTH CORPS. WE HAVE
USED- NATIONAL GUARD IN SOME
CASES- AND IF YOU SOME STEP
CONTRACT AGENCY. AND SO WE'RE
BUILDING. WHAT STAFFING THOSE
THROUGH THEIR CAPPING. THAT
BLOCKED GOES TO THE STATE. OF
WHERE WE'VE BEEN- OF THE WAY
NEED AN UPDATE TO THE- OF A
SENSE SOME OF THOSE OUT CAME ON
IN AS WE START THE MANDATORY
REPORTING- AND INITIALLY THAT
MANDATORY REPORTING THIS IS
BRAND NEW TO ALL TWELVE HUNDRED
FACILITIES TO HALF REPORT EVERY
SINGLE DAY SO INITIALLY WE WERE
CALLING ALL FACILITIES AND
GETTING DATA EVERY DAY. AND
THEN WE SWITCH TO EIGHT APPS IN
EIGHT AND A LINK THEY COULD BE
ABLE TO REPORT EVERY DAY AND
INITIALLY THAT RECORDING WAS
FAIRLY- SPORADIC IN THE SENSE
THAT IT OF. THERE WAS SOME
LEARNING CURVE THERE FOR ALL OF
THESE FACILITIES TO KNOW HOW TO
USE IT. AS WELL AS- WITH THE
NEW TECHNOLOGY OF COURSE MAKING
SURE THAT IT ALSO REPORTED FOR
DIFFERENT MODALITIES WHETHER
SOMEONE REPORTED THROUGH THEIR
PHONE WHETHER THEY REPORTED
THROUGH ON THEIR DESKTOPS THAT
TRACK. SO NOW WE ARE AVERAGING
AROUND 93% OF OUR FACILITIES
ARE REPORTING EACH DAY- WE DO
FOLLOW UP WITH ANYONE WHO WAS A
NON REPORTER ON THAT LIST FROM
THE NIGHT BEFORE. THEY THEN GET
A PHONE CALL THE VERY NEXT DAY
AS WELL- AND WE HAVE DONE SOME
CITATIONS- FOR THAT AS WELL AS
WHEN WE PULLED ALL OF THE
RECENT CMS DATA IN THREE
MONTHS. WE CITED AT OVER THREE
HUNDRED AND- FIFTY- FACILITY
ISN'T DEAD AT A VARIETY OF
DIFFERENT TYPES WAS INFECTION
CONTROL CITATIONS. IMMEDIATE
JEOPARDY SITUATION. AS WELL AS-
SOME NON REPORTING SO- A
VARIETY OF WHAT WERE SEEN
THOUGH IS MUCH TO WHAT YOU'RE
YOU'RE SPEAKING TO IS WE'RE
WORKING WITH- WITH FOLKS WHO
WHO REALLY NEED SOME SOME HELP
WHEN IT COMES TO EDUCATION. ON
INFECTION PREVENTION PREVENT
THAT FEAR RIGHT THAT FEAR OF
HOW. OFTEN AND COMFORTABLE
USING THIS. I'M DOUBLE THE
PUTTING THEMSELVES IN THEIR IN
THEIR FAMILIES AT RISK WE. DID
BE ABLE TO PROVIDE. I'M
STOPPING THE STATE. AS WELL AS
WE- ON FREE HOTELS. FOR HOW
CARE WERE IF THEY WANTED TO GO
TAKE A SHOWER DECONTAMINATE.
TAKE A REST STAY AT HOME STAY
THERE AT THE HOTEL BEFORE GOING
TO THEIR FAMILY. THAT WAS ALL
PROVIDED AS WELL FOR. FOR IT AT
NO COST FOR THESE HEALTH CARE
WORKERS WERE TRYING TO GET
CREATIVE IN TRYING TO FIND AS
MANY WAYS THAT WE CAN WRAP
AROUND SERVICES. AROUND AND THE
STAFF WERE WORKING SO HARD.
THANK YOU VERY MUCH THIS RACE.
THANK YOU THANK YOU VERY MUCH.
A DEAR FRIEND THE SAID TO ME.
THAT IT IS AN UTTER TRAGEDY HOW
OUR SENIORS HAVE BEEN TREATED
IN NURSING HOMES AND THE
DISRESPECT FOR THE PEOPLE WHO
CARE FOR THEM I THINK I HEAR
THIS FROM ALL OF ALL ALL OF MY
COLLEAGUES THAT WE DO HAVE TO
RECOGNIZE THAT. AT SOME POINT
SOME OF US MAY END UP WITH
THESE NURSING HOMES AND IT IS
OUR RESPONSIBILITY TO DO
WHATEVER WE CAN TO MAKE SURE
THAT WHATEVER RULES THEY ABIDE
BY OUR RULES THAT WE PUT ON
THEM NOW. BECAUSE IN THE END IT
IS OUR PARENTS IT IS OUR
GRANDPARENTS IT WILL EVENTUALLY
BE US. WHO WILL BE- BENEFITING
FROM THE VERY RULES WE PUT
TOGETHER. I DO APPRECIATE THE
COMMENTS FROM MY- MY NEIGHBOR
MY COLLEAGUE FROM. SANDRA DINO
WE DO HAVE TO BE CONCERNED
ABOUT THOSE WORKERS. IT'S
REALLY IMPORTANT I APPRECIATE
LOSE A COLEMAN'S- COMMENTS THAT
IT'S RESOURCES AND
ACCOUNTABILITY WHEN WE TALK
ABOUT THE RESOURCES. ONE OF ONE
OF THE SPEAKERS TALKED ABOUT
THE FACT THAT IF YOU HAVE THE
IF YOU'RE THE ONE REASON
RECEIVING THESE COVERT POSITIVE
CO GOOD TO PATIENTS YOU RECEIVE
EXTRA PAY. THE FACILITY DOES.
THERE'S NOTHING TO TELL US THAT
THE WORKERS WHO WORK WITH THOSE
POSITIVE COVE IT- PATIENTS ARE
RECEIVING THE ADDITIONAL PAY.
SO SOMEBODY'S RECEIVING THE
MONEY BUT IT'S NOT THE WORKERS.
AND THERE'S HIGH TURNOVER RATE
HAS TO BE OF GREAT CONCERN FOR
US. BECAUSE IF THEY ARE NOT
BEING PAID ENOUGH IN THERE NOW
HAVING TO GO FROM FACILITY TO
FACILITY. IN ORDER TO PAY THE
RENT AS WAS MENTIONED. THEN
WHAT CAN WE THE STATE DO TO
MAKE SURE THAT WE HELP THAT
PROCESS. THAT HAS TO DO WITH
THE PAY IF WE ARE NOT PAYING
THEM ENOUGH AND BEGINNING AS MY
COLLEAGUE FROM SIMPLE TO DO YOU
KNOW SAID. WHEN THEY ARE IN THE
HOME BEFORE THEY EVER GO TO THE
NURSING HOME NOW IT IN ONE OF
THE DOCUMENTS ALSO THAT WAS
PREPARED IT TALKS ABOUT
PUTTING. THE HOME IN TURNER
SING HOME. THIS BE A HOME MAKE
SURE THAT THAT WE ARE ARE ARE
PROTECTING THOSE SENIORS WHO
ARE NOW BEING PUT IN THESE
NURSING HOMES. IN THE SAME VEIN
THEY ALSO SAY LET'S PUT NURSING
BACK INTO A NURSING HOME LET'S
TAKE CARE OF THOSE SENIORS THAT
ARE IN THOSE FACILITIES. TO
MAKE SURE THAT THEY ARE BEING
TAKEN CARE OF AT A PARTICULAR
STANDARD OF CARE. THE OTHER.
ALL PROMISED THAT I WANTED TO
MAKE WAS. THE RACIAL
DISPARITIES I RECOGNIZE THAT
THERE IS ON PAGE FOUR PAGE NINE
OF OUR DOCUMENTS THEY DO TALK
ABOUT THE RACIAL DISPARITIES
THE AFRICAN AMERICAN LATINOS IN
THE HAWAIIAN PACIFIC ISLANDERS.
BUT AFRICAN AMERICAN
SPECIFICALLY ACCORDING TO THE
DOCUMENT THAT WAS PROVIDED. IS
THE PROPORTION OF KOBE HAD
NINETEEN DEATHS IN AFRICAN
AMERICANS IS APPROXIMATELY
DOUBLE THE POPULATION
REPRESENTATION ACROSS ALL AGE
CATEGORIES. WE READ IT. WE SEE
IT TALK ABOUT IT WE REALLY HAVE
TO HAVE A PLAN. THE NUMBERS ARE
GIVEN REGARDING LATINOS BUT WE
KNOW THAT THE NUMBERS ARE
SIMILAR. THERE THE AFFECT ON
THOSE WHO DON'T HAVE HEALTH
CARE THOSE WHO ARE LIVING IN
POVERTY WHO THEN HAVE TO USE
THE SERVICES. THEY ARE BEING
AFFECTED DISPROPORTION THOSE
WHO LIVE IN THE VERY
COMMUNITIES WHERE THEY THEY
DEVELOP ASTHMA COMMUNITIES LIKE
MINE LIKE MY COLLEAGUE FROM
BAKERSFIELD AND MANY OF THE
REST OF YOU. IF THEY'RE HEALTH
IS BEING COMPROMISED NOW IT
BELOW POVERTY LEVEL THEY'RE NOT
PART OF ONE OF THE RACIAL
GROUPS THERE IS BEING
DISPROPORTIONATELY. AFFECTED BY
COULD NINETEEN NINETY IS JUST
ONE OF MANY HELP HELP IT
AFFECTS. WE HAVE TO HAVE A PLAN
AND I APPRECIATE THAT I SIT IN
THIS HOUSE WITH SOME VERY
COMMITTED VERY COMMITTED TO
MEMBERS AND I THAT'S WHAT I
APPRECIATE ABOUT BEING HERE IS
THAT I KNOW THAT WE WILL LOOK
TO SOMETHING THAT WILL HELP US
IN THE FUTURE. SO MOSTLY I
WANTED TO MAKE THE COMMENTS AND
I WANTED TO SAY HOW MUCH I
APPRECIATE THAT WE'RE HAVING
THIS INFORMATIONAL HEARING
THANK YOU. THANK YOU VERY MUCH
MISS RACE ALSO ONE AND JUST
NOTE WE HAVE OTHER MEMBERS HAVE
A RISE MISTER OVER MISTER
VOEPEL- MISSILE MON- CHAIR
TEEN. OUR BUDGET COMMITTEE
CHAIR- WOULD IN ANY OF YOU HAVE
ANY QUESTIONS ABOUT TO ASK.
COOPER COMMENTS THIS POINT OKAY.
OKAY WILL BRING IT BACK. MR IS
AREA. THANK YOU MISTER CHAIR.
QUITE A FEW QUESTIONS- I
APPRECIATE THAT SEC SEVERAL OF
MY COLLEAGUES HAVE ALREADY
BROUGHT UP THE 10% INCREASE AND
I. THE TEMPORARY 10% RATE
INCREASE- TO COVER COVERT
NINETEEN RELATED EXPENSES AND
I'M INTERESTED TO KNOW IF THE
STATE. OVER SAW HOW THESE WERE
EXPANDED MY COLLEAGUE JUST
RAISE THE ISSUE ABOUT WHETHER
OR NOT THAT WENT TOWARDS- THE
SALARIES SO WAS THERE ANY
MATRIX DID WE KEEP TABS DID WE
TRY TO BE BETTER INFORMED ABOUT
HOW DOES. THAT WERE BEING
EXTENDED- OF. IF. IS THAT A
CRICKETER RESPOND EIGHT
APPRECIATED AND THEN I'D LIKE
TO ALSO ASK A COUPLE OF OTHER
QUESTIONS ON GENERAL OVERSIGHT
AND TESTING. AND WHILE MISS
THAT OCCURS COMING TO THE
MICROPHONE THE MEAT AND GO
AHEAD AND ASK SOMETHING ELSE-
ON OVERSIGHT. YOU STARTED
TALKING ABOUT STRIKE TEAMS. SO
AS WE LEARN MORE ABOUT THE
STRIKE TEAMS GOING INTO THE AND
GET GOING INTO SNIFFS TO ASSIST
WITH INFECTION PROTOCOLS WHAT
IS THE TIMELINE TO KEEP
OVERSIGHT AND CONTINUE
TRAINING. BOARD. I AM HERE NOW
THANK YOU. OF YOUR OF YOUR
FIRST QUESTION ABOUT THE MONEY
IS THAT THE RATE INCREASES THAT
IS THROUGH THE DEPARTMENT OF
HEALTH CARE SERVICES SO I CAN'T
REALLY SPEAK TO SO MUCH-
SPECIFICITY AS FAR AS THE ACS
AND THE FACILITIES BUT I DO
BELIEVE THE CRAIG- CAPITAL. I
CREDIT FROM CAP WANTED TO SPEAK
ON THAT IF THAT'S OKAY BEFORE I
ANSWER YOUR QUESTION OR HOW
WOULD YOU LIKE TO PROCEED. WELL
SINCE YOU'RE HERE WHY DON'T YOU
ANSWER THE SECOND QUESTION
THEM. OKAY OKAY SO I'LL ANSWER
THE QUESTION ABOUT STRIKE TEAM
SO. THAT'S A GREAT QUESTION
WITH THIS RIGHT TEAMS IS THAT
WHEN WE GO AND WE OFTEN IN THE
CASE THAT WAS- USES AN EXAMPLE
LIKE MAGNOLIA. RIGHT HAVE BEEN
THERE ON THE SEVENTH TO DO AN
INFECTION CONTROL INSPECTION.
EVERYTHING MIGHT HAVE LOOKED-
FAIRLY OKAY WE MIGHT HAVE BEEN
ABLE TO DO SOME TRAINING EXCEPT
TRY. AND THEN THINGS CAN CHANGE
IN THE FACILITY VERY VERY
QUICKLY. WHICH IS WHY IN MAY BE
STARTED TO GO TO MORE
PROTECTIVE ANALYTIC MODEL.
BECAUSE GOING INTO A FACILITY
IN TRAINING BUT WHEN IT IS SEEN
IN SOME OF THESE PLACES WE'RE
GOING BACK REPEAT REPEAT REPEAT
AND WHAT WE REPEAT AGO BACK.
WE'RE SEEING THIS IT IS THE
SAME THING BUT WITH A DIFFERENT
SET OF STAFF BECAUSE OF THE
HIGH STAFF TURNOVER. OR
SOMETIMES JUST A GENERAL LACK
LEADERSHIP- IN A LACK OF JUST
HAVING AN INFECTION PREVENTION
OVER BY. WHICH IS WHY. WE
DECIDED TO THEN IN. EARLY MAY
ISSUE OUT OF FELT REQUIRING
THAT ONE HAS A CLUE BUT NINE IN
MITIGATION PLAN. WHICH INCLUDES
THAT THEY MUST HAVE A FULL TIME
IT PRESENT. BECAUSE JUST LIKE
WHAT YOU WERE SPEAKING TO WE
MIGHT BE THERE BUT THE NEED
LEAVE. AND THAT THINGS START TO
TERRY IT AGAIN I WE WERE
NOTICING THAT PATTERN AND
TRYING TO STOP THAT PATTERN IS.
POSSIBLE AS THIS ASK THIS AND
IS BUILT ON. ARE YOU. CON
CHANGE. TO BE ABLE TO CORRECT
THAT IT'S MORE ACTIVE. BECAUSE
OF THIS AREA. SO TO KNOW ABOUT
THESE THE WE'VE KNOWN OF A LOT
OF THESE THE FISH AND THIS IS
AS ONE OF MY ALSO MEANT RIGHT
NOW THIS VIRUS IT COULD HAVE
BEEN ANY OTHER CIRCA ANY FIRE
JUST BIG. AND BROUGHT LIGHT A
OF THE DEFICIENCIES THAT WE'VE
HAD BUT AS YOUR NOW GAINING
INSIGHT INTO WHATEVER'S
HAPPENING EMPLOYEES ARE NOT
COMING TO WORK WELL EMPLOYEES
ARE NOT GOING TO COME TO WORK
IF THEY FEEL THERE'S SOMETHING
TO BE TO BE RISKING RISKS IF
THEY'RE ALSO NOT BEING
COMPENSATED SO YEP WHAT WERE
SOME AS WHAT WE'RE STE THE
STEPS TAKEN BY THE AGENCY TO
MAINTAIN OVERSIGHT SO THAT WEEK
THIRD OF DEMAND FORM WE CAN ASK
FOR MORE WE CAN ASK FOR HIGHER
STANDARD WITH SITE. SINCE BEING
PUT INTO PLACE BE EITHER GIVEN
OUT WAR OR REPRIMANDS BEING
GIVEN OUT AND STAND THIS WAS
ONLY OVER THREE MONTHS YOU DO
WE DO HAVE INSIDE IT'S NOT AS
IF WE'RE STARTING FROM SCRATCH.
NO ABSOLUTELY SO IN JUST THOSE
THREE MONTHS WHEN I PULLED THE
CMS DATA WEHAD GIVEN OUT OVER
THREE HUNDRED AND FIFTY
CITATIONS. TO OVER A HUNDRED
AND SIXTY DIFFERENT FACILITIES
AND ALL OF THOSE A HUNDRED AND
I THINK THIRTEEN OF THEM IT
JUST THAT WHEN I PULL THE DATA
FROM MARCH FIRST TO JUNE FIRST.
THOSE WERE ALL INFECTION
CONTROL SO HUNDRED THIRTEEN OF
A MORE INFECTION CONTROL LOAN-
SO THAT WAS- AND THAT WAS THE
WAY THEY WERE WE'RE CONTINUING
TO PROVIDE THAT THAT SITE THAT
OVERSIGHT THEY HAVE TO WHATEVER
WE DO A CITATION THEY HAVE TO
THAN TO SUBMIT A PLAN OF
CORRECTION. WE THEN ALSO THEN
GO BACK INTO THE FACILITY TO
CONFIRM THAT THEY DID FIX OUR
PLANET CORRECTION. I'M AND SOME
PLACES RECEIVED MULTIPLE-
CITATIONS BECAUSE WHEN WE KEPT
GOING BACK IN AND WE FOUND MORE
ISSUES. THE OTHER THING THAT
WE'VE NOTICES THE TREND IS-
RECENTLY IS WE MIGHT GO INTO A
FACILITY THERE MIGHT BE AN
INFECTION PREVENTION ISSUE. AT
FIRST. WE FIX THAT BY WORKING
WITH THEM TO GIVE A TRAINING WE
GIVE THEM EDUCATION. BUT WHEN
WE ARE STAYING THERE LONG
ENOUGH THEN. TO SEE QUALITY OF
CARE ISSUES THAT ARE MORE
DAMAGING. AND SO THIS QUALITY
OF CARE ISSUES THAT THOSE END
UP BEING. OF IT'S WHERE IN AN
ACT WE ARE WORKING ON A CLOSURE
OF THE FACILITY THIS WEEK
BECAUSE OF THE QUALITY OF CARE
THAT FOUND THERE. WE WERE. SO.
I AGREE THIS UP. FORWARD EVEN
HOST PANDA WE DON'T WANT TO
BACK TO THE RIGHT SEE MON WHERE
YOU ALL GO IN A YEAR THAT'S AT
YES WE WILL CONTINUE DO THE CMS
PATIENTS ONCE A YEAR YOU WANT
TO ADD AN AUGMENT THOUGHT WITH
THE STATE PROCESS THAT'S MORE
ROBUST AND MORE ON IT AND MORE
SIMILAR TO WHAT WE'RE DOING
NOW. WHICH IS BEING ON SITE. SO
IN ORDER TO KEEP WITH I AM
THANK YOU I APPRECIATE IT I
WANT TO TURN OVER SO THAT
MISTER WHAT DOCTOR WOULD CAN.
ASK SOME OF HIS QUESTIONS BUT I
THINK SOME OF THE THINGS THAT
I'M GOING TO BE VERY INTERESTED
IN LOOKING AT AND- CONTINUE TO
WORK WITH ALL OF OUR COLLEAGUES
HERE AS WELL AS WITH DOCTOR
WOULD. IS JUST SOME OF. SOME OF
THE THINGS THAT AS A BUSINESS
YOU PUT INTO PLACE TO MAKE SURE
THAT. YOU'RE PROTECTING THE
STANDARD THAT YOU'RE PROVIDING
ANY COULD BE IN ANY BUSINESS-
OR OR- OR OR OR- THE CARE FOR
THE INDIVIDUALS THAT YOU'VE
TAKEN RESPONSIBILITY ON- AND
I'M NOT JUST BLAMING THE SNIFFS
HERE- SKILLED NURSING
FACILITIES. IT'S ALSO OUR
RESPONSIBILITY AS GOVERNMENT
OVERSIGHT. OVERSIGHT TO HAVE
TAKEN TO PARTICIPATE IN AN
EFFECTIVE WAY. HAVE SET CERTAIN
STANDARDS. I'M I'M STILL
BAFFLED A LITTLE BIT ABOUT THE
TESTING. AND ABOUT CERTAIN
CIRCUMSTANCES WHERE. WHEN WE
KNEW EARLY ON IN OCTOBER WHEN
WE SHUT DOWN THE FACILITIES
FROM FAMILY AND LOVED ONES
GOING IN. WE KNEW THAT WE WERE
CREATING A SAFE SPACE WELL IN
THAT SAFE SPACE COME CERTAIN
STANDARDS TO MAKE SURE THAT
EMPLOYEES WHO ARE COMING IN AND
OUT. DO NOT TAKE WHAT DO NOT
MIGRATE OR EXPOSE BRING IN
EXPOSURE. AND THE- WHEN YOU SEE
THE BALLOONING OF DEATHS IN A
VERY SHORT PERIOD OF TIME. OF A
I CAN ONLY LOOK TO WHERE WE
FAILED AS GOVERNMENT TO MAKE
SURE WE PUT. AND IMPOSE CERTAIN
STANDARDS- AS WELL AS- AS WELL
AS THE CENTERS NOT BEING AS
CAUTIOUS AS NEEDED. TO MAKE
SURE THAT NOTHING WAS COMING
INTO THE FACILITIES. AND THESE
ARE GOING TO BE CONVERSATIONS
THAT I'M GONNA WANT TO
CONTINUE. THANK YOU MISTER
CHAIR. THE WITNESS THERE THIS
THIS IS THAT RIGHT FROM THE
FROM CAP I FELT PRETTY
SUFFICIENT OF HEALTH FACILITIES
IF I COULD JUST ADD ON TO YOUR
EARLIER QUESTION. ABOUT THE 10%
ADD ON I JUST WANT TO BE VERY
CLEAR ABOUT. A COUPLE OF THINGS
UP THAT THAT TEMPORARY 10%
RIGHT NOW FACILITIES MANY MANY
MANY FACILITIES INCLUDING SOME
I JUST HEARD FROM A FOR THIS
HEARING THIS MORNING. ACROSS
THE STATE ARE PAYING HAVE TO
PAY NOW. THAT THAT IS HAPPENING
IN REAL TIME IT WAS A LEASE
EVERYWHERE IN ADDITION THOUGH
THAT TEMPORARY 10% IN ADDITION
TO BEING USED FOR HAVING A- IT
IS ALSO BEEN USED FOR OVER
TIME. FOR ADDITIONAL- WITH WITH
THE SPLIT STAFF HAVE NOT BEEN
IN THE BUILDING UP BECAUSE THEY
TESTED POSITIVE AND MAYBE OR
MAYBE QUARANTINING AT HOME FOR
A PERIOD- THERE ARE TEMPORARY
WORKERS THAT HAVE TO BE BROUGHT
IN FREQUENTLY. IN ORDER TO HAVE.
IT FACILITIES ALSO HAVE HEY A
PREMIUM. TO FOR. A P. IT HAD A
IN SOME CASES BEEN VERY GAPS TO
TERMS OF THE COST OF THE PP. SO
THAT'S WHERE ALL THAT THAT'S
WHERE THAT THAT'S FOR THIS
FUNDS ARE GOING BUT I WANT TO
EMPHASIZE THAT. THAT THAT MORE
RESOURCES ARE GOING INTO STAFF
AND- COST ALL THE TIME- THAT
THAT'S NECESSARY. THE AST
THING THIS TO YOUR POINT
EARLIER IN THIS IS COME UP
SEVERAL TIMES. I DON'T WANT TO
DIMINISH THE IMPORTANCE OF
INFECTION PREVENTION AND
CONTROL THAT IS ABSOLUTELY
ESSENTIAL. IN FACILITIES BUT I
DO WANT TO MAKE SURE THAT THAT
YOU'RE AWARE THAT THE LATEST
WHAT THE LATEST RESEARCH IS
TELLING US ABOUT HOLD ITS BREAD
AND FACILITIES. THE LATEST
RESEARCH FROM HARVARD FROM THE
UNIVERSITY OF CHICAGO- AND FROM
BROWN. IT'S BASICALLY TELLING
US THAT THAT THAT THAT THE
THERE IS NOT. REALLY A LOT OF
CORRELATION IN TERMS OF THE
QUALITY OF THE BUILDING. AND
THE QUALITY THE HISTORY OF THE
BUILDING IN TERMS OF ITS STAR
RATING. IT'S INFECTION
PREVENTION OR ANY OF THAT. WHAT
IS CORRELATED MORE TOWARD KOBE
IS THE INTENSITY OF COLD IN THE
COMMUNITY. THE SIZE OF THE
BUILDING- AND THINGS MORE THAT
NATURE. SO IF YOU SEEN THE
FIRST WRESTLING AND I STATES
THAT HAD TO COPE WITH DEATH.
WAS A FIVE STAR FACILITY THAT
HAS HAPPENED ALSO HERE IN
CALIFORNIA TO. SO I THINK THAT
THE AGAIN NOT TO DIMINISH THE
IMPORTANCE OF THOSE ISSUES.
JUST TO LET YOU KNOW EVEN IN
THE BEST FACILITIES. THAT THE
ADEQUATE PP ABOUT THE ADEQUATE
TESTING. THEY WERE ALL PRONE TO
THE SITUATION AS PER. I
APPRECIATE THAT AND I DON'T
WANT TO BELIEVE IT THE POINT
BUT OBVIOUSLY. I WAS IN. THE TO
TIM THEN THE MINUTE I AM NOT
WILL. AT WHICH- IS FIVE OR-
IT'S A MATTER OF HOW YOU RUN
THE FIRST. AND WHAT'S THEN YOU
INTO. THAT ENSURES THE SAFETY
SO WITH THAT. THANK YOU EXCUSE
ME CHAIR MAC MAC THIS IS LISA
COLEMAN IF I COULD RESPOND TO
IT ALSO I'M I THINK PART OF
THIS DISCUSSION WE ARE MISSING
A MAJOR COMPONENT AND THAT IS
THE LOCAL PUBLIC HEALTH A LARGE
PART OF THE FRUSTRATION AND
INCONSISTENCIES IN THE
BEGINNING THE SKILLED NURSING
FACILITY WHAT A DIFFERENT
POSITION I DON'T THINK ANYONE
WITH CALVET ACCEPT ONLY PERSONS
THAT HAD NEGATIVE TESTING
EXCEPT PEOPLE WITH CUT- CITY
PERSON OUT BECAUSE THEY FELL
DOWN BUT REQUIRE THAT THEY STAY
IN THE HOSPITAL UNTIL THEY GET
TO TEST TO PROVE THAT THEY
DON'T HAVE IT. IT WAS THAT WAS
THE INCONSISTENCY OF MESSAGING
THAT COSTS SO MUCH PROBLEM IN
THE BEGINNING AND THAT GOES
BACK TO MY LEGISLATIVE REQUEST
THOSE LOCAL PLANNING
ORGANIZATIONS NEED TO HAVE AN
EXPERT IN LONG TERM CARE. LOCAL.
PUBLIC HEALTH. ARE INTIMATE
AWARE OF WHICH SKILLED OR THE-
HISTORICALLY STRUGGLES FROM.
REGULATORY IN COMPLIANCE AND SO
WHEN A HOSPITAL IS JUST
CHARGING A CO THAT POSITIVE
PERSON TO A FACILITY. THAT THAT
SHOULD HAVE BEEN MORE OF A
DECISION THAT WAS MADE BY
EXPERTS OF FACILITY THE PUBLIC
HEALTH AND THE OFFICE MANAGER
AT THE FACILITY RATHER THAN THE
LOCAL PUBLIC HEALTH OF THE
OFFICE OF EMERGENCY SERVICES.
AND ALSO ON THE FUNDING I
WOULDN'T TO POINT OUT THAT
THERE IS ADDITIONAL FUNDING ON
TOP OF THE 10% SKILLED NURSING
FACILITY INTEREST YOU'RE
LOOKING AT TO GET THIS COMING
BUDGET. ABC THIRTEEN TWENTY
NINE IS LOOKING TO GIVE THEM AN
ADDITIONAL NINETY TWO MILLION
IN GENERAL FUND. FOR QUALITY
CARE. AND TO MY KNOWLEDGE THERE
IS NOTHING IN THAT NINETY TWO
MILLION DOLLARS THAT SAYS THEY
HAVE TO PAY A LIVING WAGE. I AM
THRILLED TO HEAR. THAT
FACILITIES ARE PAYING HAZARD
PAY. IT HAS A PAY NEEDS TO BE
ALL THE TIME NOT JUST PHONE
CODE IS RAPID. AND THAT NINETY
TWO MILLION DOLLARS I BELIEVE
THE STATE HAS AN OBLIGATION TO
PUT A LINK. TO STAFFING. FOR
THAT ADDITIONAL MONEY. THANK
YOU. I'M GONNA HAVE THREE BRIEF
QUESTIONS AND THEN WE'RE GOING
TO MOVE TO WHAT OUR CALLER
LIGHTNING ROUND- WE'RE GONNA
HAVE DR WASSERMAN PAT MCGINNIS
AND LISA COLEMAN WE TRAVEL AND
OFTEN ASK. THAT THE OTHER THE
STATE PAN STATE REGULATORS AND
SKILLED NURSING FACILITIES EACH
THAT WE ONE QUESTION- I'D WE
HOPE WOULD HAVE MORE TIME TO DO
THAT BUT HAVE MORE QUESTIONS
BUT IT LOOKS LIKE WILL WILL
HAVE SHORT SHORTER. SO MY FIRST
QUESTION IS GOING TO BE. TO
HIGH I MISSED. AND OCCUR. AND
WHILE YOU'RE WALKING UP- TO THE
TO THE CHAIR THERE- I WANNA I
JUST. AS W AS WE LOOK AT THE
NUMBER OF DEATHS IN SKILLED
NURSING FACILITIES WHICH ARE
ACCOUNT 450% ROUGHLY OF ALL THE
DESPERATE FOR COATED IN THE
ENTIRE STATE- WHAT CAN YOU TELL
ME ABOUT- THAT TRACING- BECAUSE
WE- ARE WE ARE WE PUTTING THE
TRACING ASSETS. THE WORDS OF
ANY PURPOSE IN A PROPORTIONAL
WAY TO TRACK THESE CASES I KNOW
THAT WE ARE. I KNOW THE GOAL
WAS TO HAVE TEN THOUSAND
TRACERS IN PLACE WHERE I THINK
WORD ABOUT THREE THOUSAND- AND
WE SO I THINK WE'RE LAGGING ON
THAT SO HOW ARE WE TREATING
THIS AND COMMUNITIES- WE KNOW
THAT THERE'S A LOT OF SPREAD
BECAUSE OF THE WORKERS
OBVIOUSLY. A MOVIE THE MULTIPLE
FACILITIES BUT HOW MUCH ARE WE
FOCUSING ON TRACING TO HELP
WITH THESE OUTBREAKS. ONE OF
THE NEW EFFORTS THE TRACING IS
GONNA BE SPECIFICALLY FOCUS WAS
SKILLED NURSING FACILITIES SO.
AS I MENTIONED EVERY SKILLED
NURSING FACILITY- THIS MONTH
NEEDS TO COMPLETE THEIR BASED
LIKE TESTING WHICH MEANS
EVERYONE IS TESTED. I'M AT THE
POINT THAT THERE IS EVEN JUST
ONE PERSON. OF WAS POSITIVE.
THEN THE HAVE CONTACT TRACING
GOING ON WITH THAT WITH ANYONE
WHO'S TESTING POSITIVE- SO THAT
WE CAN NOT ONLY BE ABLE TO CO
HORT APPROPRIATELY- SO YOU OF
POSITIVES AND IN ONE AREA.
POTENTIAL EXPOSURES IN ONE AREA
EVEN IF THEY TESTED NEGATIVE ON
THE FIRST TEST. AND THOSE WHO
WEREN'T EXPOSED OVER NEGATIVE
IN ANOTHER AREA. BUT IN
ADDITION TO THAT BEEN THERE
CONTACT TRACING DECEIT. WHETHER
OR NOT WAS IT A HELP WORKERS
WHO WORKED IN ANOTHER FACILITY
BECAUSE THAT IS. THE CASE.
FOCUS ON. WELL UPSET WHEN THEY
DID TO AFTER A- DOES THEIR OF
THEIR BAY LIKE TEN OF THE WILL
THE CONTINUE TO. TESTING AND
EVERYTHING TIME THERE IS THAT
POSITIVE THAT WE WILL THEN
IMMEDIATELY WORK WITH CONTACT
TRACING WITH THAT. SO WE DO
HAVE CONTACT TRACERS THAT WE
ACTUALLY REDEPLOYED OR RE
DIRECTED SOME OF OUR OWN. OF
THE SURVEY OUR STAFF SO WE DO
HAVE SOME SURVEY OR STOP ON OUR
TEAM WHO ARE OVER SIXTY FIVE OR
WHO CAN'T DO- ONSITE. AND FOR
THOSE STAFF WE DEDICATE TO SOME
OF THESE. TAX RATES IN EFFORTS.
SO THAT THEY CAN BEGIN SINCE
THEY ALREADY IN. A RELATIONSHIP
THEY THESE DIFFERENT FACILITIES
THEY CAN BE ABLE TO DO. CONTACT
CRAZY JUST HAPPENED TO BE. AN
INVESTIGATIVE FIRST THE TO CAN
DO. OFF SITE AND SO THE ONE FOR
WAY THAT WHEN YOU'RE TRYING TO.
NOT ONLY JUST GO TOP FROM THE
YOU KNOW THE TEN THOUSAND THAT
YOU HEAR THAT'S REQUIRED FOR
CONTACT RAISING THE STATE. BUT
TRYING TO HAVE A DEDICATED TEAM
OF CONTACT TRACERS. FOR JUST OR
SKILLED NURSING FACILITIES FOR
THIS PURPOSE. OKAY THANK YOU SO
THAT IS THAT. THAT'S HAPPENING
NOW OR IS THAT IN THE- IS THAT
IN THE IN THE FUTURE THAT'S
HAPPENING NOW AS WE'RE GETTING
OUR TESTING RESULTS IN.
EVERYONE WE SPENT ON A I FELT
LAST WEEK REQUIRING ALL
FACILITIES TO BE ABLE TO- TURN
IN ALL OF THEIR TESTING
RESULTS. SO THAT ONCE WE GET
THOSE TESTING RESULTS THEN WE
THEN ON SENT OUT TEAMS TO BE
ABLE TO DO THAT CONTACT TRACY
WE HAVE THE- AND WHERE ARE E
IN THE PROGRESS OF TESTING-
EMPLOYEES OF FACILITIES IN MY
OWN COMMUNITY OF SANTA ROSA. WE
HAVE- HEALTHCARE HEALTHCARE
WORKERS CAN ACTUALLY GO AND GET
YOU TESTED THROUGH DRIVE
THROUGH- THEY CAN GO THEY CAN
GO ONCE EVERY COUPLE OF WEEKS-
I'VE HEARD IT A THOUSAND
REFERENCES IN THE PRESS THAT WE
COULDN'T POSSIBLY TEST
EVERYBODY. WHO NEEDS TO BE
TESTED YET WE'RE OFFERING THAT
IN OUR COMMUNITY SO WHERE ARE
WE IN THAT TESTING- BECAUSE THE
ONCE OF THESE ARE. POINTING TAX
RIGHT SO COULD GO AND GET THE
NEXT WEEK N. N. ANCHOR BACK IN
IN FACT IN FACT PEOPLE IN THE
FACILITY SO- THAT THAT. HAS
BEEN FROM THE VERY BEGINNING
BECAUSE. TESTING FOR HEALTH
CARE WORKERS IN THESE
FACILITIES. SO I DO HAVE A
DOCTOR HERE EIGHTEEN HERE FROM
CITY PA TO WAS ON THE- CO CHAIR
OF THE TESTING TASK FORCE BUT
I'LL GO AHEAD SPEAK TO A LITTLE
BIT OF THIS PIECE THAT WE DO
HAVE AN AGGRESSIVE- TESTING-
PLAN FOR CALIFORNIA ASKING THAT
THEY RETEST EVERY SEVEN DAYS
THAT THEY ARE POSITIVE FOR THE
OUT POPULOUS AS WELL AS THE
SURVEILLANCE TESTING THIS
FOCUSED ON THE HEALTH CARE
WORKERS 25% OF THOSE HEALTHCARE
WORKERS EVERY WEEKS THAT YOU
HAVE A 100% SO IT'S CONSTANT.
OF BUT WE DO HAVE THE CAPACITY
TO TESTING CALIFORNIA WE HAVE
SEVERAL STATE LABS WE HAVE A
LINK WE HAVE PRIVATE LABS WE
HAVE ACADEMIC RESEARCH
HOSPITALS WE ARE RICH WITH LABS
IN IN CALIFORNIA IT'S A MATTER
OF MAKING SURE THAT WE HELP AND
PROVIDE TECHNICAL ASSISTANCE ON
HOW TO GET TESTED. I THINK THE
BIGGEST- UP THERE YOU'RE THAT I
SEEN IS INITIALLY IT'S NOT
OVERWHELMING OF HOW DO I TEST
WELL YOU KNOW TWO HUNDRED-
STAFF IN MY IN MY LOCATION
BECAUSE I THINK REGIONALLY
PEOPLE THINKING CAP OUT LOUD
WHERE THEY WERE THINKING
REGIONALLY AND WE'RE TELLING
NOT LOOK AT THIS WHOLE LIST
HERE'S A LIST OF LABS HERE'S
THE LIST OF TYPES OF ALL OF THE
SERVICES THAT THEY OFFER THAT
LAB. SO DO MOBILE TEAM THAT
WILL GO OUT- AND- DO WITH THE
ROAD MOBILE VAN WE ALSO HAVE
DRIVE THROUGH SEEN WE HAVE
TESTING THAT AVAILABLE- KIND OF
ITS THIS TIME OUT THE SPECIMEN
IS AN AND BRING THAT. RIGHT A
DIFFERENT OPTION JUST ABOUT CAN
SURE THAT EVERYONE HAS A TOOLS
RESOURCES. NOTE TO ACCESS THEM
AND KNOWS HOW TO MAKE SURE THAT
THERE THEY'RE GETTING THAT.
DONE OF TESTING WAS OF THE- IN
THE MID. PLAN THAT WERE
REQUIRED FOR ALL OF OUR AND
SKILLED NURSING FACILITIES TO
TURN IN THEIR MEDICATION PLAN
BY JUNE FIRST- WE HAVE A 100%
OF ALL OF OUR NURSING- SKILLED
NURSING FACILITIES TO TURN IN A
MEDICARE. PLAN AND SO NOW OUR
TEAMS ARE GOING THROUGH THOSE
PLANS MAKING SURE THAT THEY'RE
ACTUALLY ACTING ON. THE TESTING
IN THE OTHER ITEMS THAT
REQUIREMENTS IN THERE. BUT I
DON'T OF DOCTOR JEANNIE WHAT'S
THAT ACTUALLY WE'RE WE'RE IND
OF SHORT ON TIME SO I MEAN IT
HAS. A BABY CAN GET THAT IN
WRITING OR SOURCE OF FURTHER
THE CONVERSATION OFFLINE SO I
APOLOGIZE DR DEAN I'M GONNA.
ASK WE WANT OKAY. I DID AND
THIS A COMMENT. AND THEN AND
THEN AS A COMMENT FOR- CAMAGUEY
WEIGHED A JUST IN GENERAL- AND
I WOULD ASK THAT YOU COULD GET
BACK TO US ON THIS. I NEVER DID
REALLY HEAR AN ANSWER TO DOCTOR
RANDY THIS QUESTION ABOUT. HOW
WE'RE GOING TO TRANSITION FROM
PROGRAMS LIKE M. S. S. P. AND
C. BASS IF- ALTHOUGH WE HAVE.
IN THE ASSEMBLY PUSH BACK ON
THAT'S CUTS- BUT I NEVER HEARD
ANYTHING ABOUT WHAT A
TRANSITION PERIOD LOOK LIKE
BECAUSE ACCORDING TO THE
GOVERNOR'S BUDGET. THOSE
PARTIES ARE GOING TO END ON
JULY ONE. WITH SENIORS TO HAVE
NOTHING. AND BUT WITH THERE IS
A PROGRAM THAT MIGHT GET GOING
IN TWENTY TWENTY ONE. BUT THERE
WAS NO COMMENT THERE WAS THERE
REALLY WASN'T AN ANSWER THAT SO
I WOULD REALLY LIKE- AN ANSWER.
TO THAT TO THE- TO THE OUR
BUDGET SUBCOMMITTEE CHAIR- INTO
OUR OFFICE AS WELL. I WOULD SAY
THIS IN GENERAL ON YOUR ON THE
MASTER PLAN ON AGING AS WE'RE
LOOKING AT THAT. TO EMPHASIZE
FLEXIBILITY FOR COMMUNITIES- MY
COMMUNITIES THAT ARE IN THE
DISTRICT I REPRESENT DO NOT
LOOK LIKE. LOS ANGELES- THEY
DON'T LOOK LIKE- SAN FRANCISCO.
THERE SMALL RURAL AND OFTEN
HAVE A VERY LIMITED RESOURCES
AND SO IT'S IMPORTANT AS WE-
LOOK AT THAT WE HAVE ACTUALLY
HAVE FLEXIBILITY- IN IN OUR IN
OUR COMMUNITIES. AND I I'M AND
I APPRECIATE. ALSO THAT YOU
REFERENCED THE IMPORT OF LONG
TERM CARE OMBUDSMAN. BUT IT
WOULD OUT THAT IT WAS ALSO
SUBJECT TO A MAJOR BUDGET CUTS.
AND A AT A TIME WHEN I THINK WE
NEED THAT THE MOST. AND THAT'S
THAT'S PRETTY PRETTY DOES HEART
AND SO. I DO HAVE A FINAL
QUESTION AND THAT IS IN AS FOR.
MR CORNET. AND MOVE ON TO WORK.
WE'RE GONNA HAVE OUR- PANEL.
PAMELA PAM QUESTIONS MISTER.
SAID THAT YOU WE WERE HAMPERED
BY A LATE START NASH.
INTERNATIONALLY STATE- IF
YOU'RE YOU'VE BEEN PLAGUED WITH
INADEQUATE PP TESTING- I WOULD
POINT OUT THAT- ABOUT 67% OF
RESIDENTS OF SKILLED NURSING
FACILITIES ARE ARE MEDI CAL.
THEN ANOTHER 25230% ARE
MEDICARE- AND SO THERE ARE
THERE NOT A HUGE NUMBER OF
PRIVATE PAY. SO THE VAST
MAJORITY OF INCOME TO SKILLED
NURSING FACILITIES IS
GOVERNMENT. AND WITH THAT-
SHOULD IS OVERSIGHT AND THAT'S
WHY WE HAVE DEPARTMENT OF
PUBLIC HEALTH- SO INVOLVED IN
OVERSEE. I AM CONCERNED AND
FRUSTRATED THE FIRST OUTBREAKS
OF CODED OF SIGNIFICANCE WERE
IN LONG TERM CARE FACILITIES IN
WASHINGTON. EARLY EARLY. WHEN
DID YOU BEGAN TO TRY TO ACQUIRE
YOUR OWN PP AND I POINT THIS
OUT BECAUSE THE VAST MAJORITY
OF YOUR SKILLED NURSING
FACILITIES ARE FOR PROFIT AND
THEY'RE MAKING. A LOT OF MONEY.
SO WHEN DID YOU BEGIN TO CA
CHOIR PP WHEN DID YOU BEGIN TO
DO THE- INFECTION CONTROL
PROTOCOLS. AND HOW ARE WE GOING
TO GO FORWARD ON THIS BECAUSE
IT IS YOU ARE FOR PROFIT
ENTITIES COMING WITH YOUR HAND
OUT TO US- TO TAKE CARE OF
THINGS. IN IT IT APPEARS THAT
YOU DID NOT IN SOME CASES DID
NOT HAVE- PLANS IN PLACE DID
NOT HAVE PROTOCOLS IN PLACE.
DID NOT HAVE ADEQUATE STAFF-
BECAUSE OF THE TURNOVER- SO
WHEN DID YOU BEGIN TO TAKE THIS
SERIOUSLY- AND- WHAT IS YOUR
PLAN GOING FORWARD. YEAH THANK
THANK YOU MISTER CHAIRMAN I
WOULD SAY THAT THE THAT THE
PROFESSION TOOK IT SERIOUSLY
FROM THE FROM THE GET GO WHEN-
ON WHAT DATE. IT'S LIKE I CAN'T
SAY THE EXACT DATE BUT I CAN
TELL YOU THAT I WAS ON A CALL
WITH MY COUNTERPART IN THE
STATE OF WASHINGTON THE SAME
WEEK. THAT IT BECAME APPARENT
THAT THERE WAS A AT AND I'M ON
NASH CALLS WITH THE HEALTHCARE.
EVERY WEEK WITH THE STATE
EXECUTIVES IN ALL FIFTY STATES
WE TALK ABOUT THESE ISSUES
SHARE WHAT'S GOING ON AND WE
WERE HEARING ABOUT THIS BILL
TIME. SO THE ISSUE THOUGH WE
WE'VE HEARD ABOUT WE DIDN'T
KNOW AT THAT POINT THEY'LL WITH
HOW THAT MUCH OUT OF HOW
SPREADING- OR ANYTHING ELSE I
WILL ALSO. GIVE. MARCUS HE
STOCKPILE TO A DEGREE BUT
THEY'LL STOP DID NOT LIE IN
ADDITION THEY NOT A EVERY ALL
THE NINETY FIVE MASS OF WHICH
WAS THE IMPORTANT NUMBER YEAH
THING I WOULD POINT IS THERE
ARE TWO MAJOR SUPPLIERS TO OF
PP IN CALIFORNIA BOTH OF THOSE
COMPANIES THAT'S WHY THEY
DIDN'T HAVE THE SUPPLIES- IT
BECAUSE WHAT WAS HAPPENING IN
IN TERMS OF THE PRODUCTION. THE
PRODUCTION CHANGE THE STARTING
IN CHINA- VERY EARLY ON THEY
DIDN'T HAVE SUPPLIES AND THEN
ANY OF THOSE- PROVIDERS THEY WE
TALKED PROVIDE- EVERY WEEK THE
WE TALKED TO THE FTP PROVIDERS
EVERY WEEK THEY WERE TELLING US
WELL WE CAN MAKE 50% OF THE
NORMAL ORDER FOR OUR FOR OUR
CUSTOMERS- THIS NEXT WEEK WE
DON'T KNOW WHAT WE'RE GONNA BE
ABLE TO GET BACK TO THAT BUT
THAT START VERY BUT I WAS THE-
SAY THAT THERE WAS JUST. A
WOULD WE GOT SO HI THIS. THE P.
M. AND ALL BECAUSE AGAIN
BECAUSE WHETHER THINGS TO
MENTIONED LACK TESTING AT. ALL
AS WELL. AND THERE NOT. THIS
THIS PROFESSION MORE THAN ANY
OTHER PART. IT IS HEAVILY IT'S
THE MOST OF MOST IN MEDI CAL
LEAST IS THE MOST. A GOVERNMENT
FUNDED OF ANY PART OF THE
HEALTH CARE STRUCTURE. UP IN
THE MEDI CAL RATES HAVE NEVER
BEEN ADEQUATE THE MEDICARE
RATES ARE BETTER THERE'S NO
QUESTION ABOUT THAT. BUT AT THE
SAME TIME. THE THIS CENSUS THE
CENSUS WAS COMING DOWN ON THE
MEDICARE POPULATION BECAUSE
PEOPLE WERE NOT COMING OUT OF
THE HOSPITAL- THE HOSPITALS
WERE NOT DOING SURGERIES-
ITSELF IS STILL THESE WERE EVEN
MORE SWEET FINANCE. I'D ALSO
POINT OUT TO BY THE WAY THAT
10% INCREASE HAS NOT REALLY
EVEN HIT ANY OF FACILITIES AT
THIS POINT NOT THAT'S OKAY
THERE WASN'T MY QUESTION
ACTUALLY IS YEAH I JUST
APPRECIATEAPPRECIATE THAT SO-
THANK YOU FOR THE QUESTION I
CAN ITS ONE EMPHASIZED- AS SOON
AS WE KNEW WHAT WAS GOING ON I
THINK PEOPLE TRY TO BE ON TOP
OF AS MUCH AS POSSIBLE. GET IT
IS CHANGING THE. GEN WHAT WE
ABOUT THE SYMPTOMS IS. WE
DIDN'TIT DOESN'T TELL IT A-
DEVASTATED KIRKLAND WASH. WE DO
NOT KNOW INITIALLY. THAT THE A
SYMPTOMATIC PEOPLE COULD BE
TRANSFERRED. INTO SKILLED
NURSING FACILITIES SB SPREADING
THE DISEASE- WITHOUT ANY ANY
ANY SYMPTOMS SHOWING AT ALL
THAT WAS THAT WAS LATE
INFORMATION AND THAT WAS
OBVIOUSLY DEVASTATING BECAUSE
MANY PEOPLE WERE TRANSFERRED
FROM HOSPITALS. WHO HAD NOT
BEEN TESTED ON THE THEORY THAT
THEY WERE A SYMPTOMATIC. AND BY
THAT POINT WAS PROBABLY TOO
LATE. THANK YOU- I THINK THIS
THIS ALL OF THIS WHOLE
CONVERSATION BAGS THAT WILL
WILL BE HAVING THIS IS ANOTHER
HEARING ON THIS- BECAUSE AND I
WILL BE SUBMITTING QUESTIONS IN
ADVANCE OF THAT AS I AS I.
SUSPECTED MISTER NAZARIAN WILL
AS WELL I'D LIKE TO MOVE ON
NOW- QUICKLY TO WE HAVE- EACH
EACH OF OUR OTHER PANELISTS TO
ASK A SINGLE QUESTION. YOU PICK
WHO YOU WANT TO ASK YOU TO AND
THEN- I DO WE WILL- THEY WILL
MOVE ON OUR TO OUR PUBLIC
COMMENT SO DR WASSERMAN YOU
HAVE A QUESTION. ANY ANY OF OUR
PANELISTS THERE YEAH. YES I
HAVE A QUESTION FOR MR OCCURRED
I DO WANT TO LET YOU KNOW OUR-
MICHAEL COMMENTS WILL ADDRESS A
LOT OF THE QUESTIONS. SURE
MEMBERS ABOUT. AT I WOULD. SAY
THE TWO WILL BE MARCH THE
EXPERTS YOU JURY AFTER TO MARCH
CARE BEEN. GUEST TRY TO SHARE
OUR EXPERT WITH FEET AGENT. WE
UNDERSTOOD SO LEADERS ON. IN
MORE. WE HONOR A SIM SPREAD I
ACTUALLY HAVE TO DISAGREE WITH
THE COMMENTS MADE ON A
SYMPTOMATIC SPREAD. THE DATA
WOULD BEAR THE EXPERTS KNEW
ABOUT A SYMPTOMATIC SPREAD BY
MID MARCH- IN FACT WE TESTED AT
THE LOS ANGELES JEWISH HOME ALL
OF OUR STAFF AND RESIDENTS. BY
THE END OF MARCH BASED ON THIS
KNOWLEDGE. THE OTHER THING IS
ON MARCH THIRTEENTH WE
RECOMMENDED THAT THE GOVERNOR
MANDATE FULL TIME INFECTION
PREVENTION OF SO. I APPRECIATE
THE MOVEMENT TO IMPROVE SERVICE
PROCESS BUT I THINK IT'S
CRITICAL IT'S CPA CAN GAUGE THE
EXPERTS IN GERIATRICS LONG TERM
CARE. AS WELL AS THE REGULAR.
BUT YOU'D BE ON BUDGET AND IN.
DEVELOPING THIS PROCESS. WE'LL
TALK ABOUT IN A WOODED. BUT
WITH ALL DUE. I AM VERY. H. CAN
COME UP WITH EFFECTIVE
PREDICTIVE ANALYTICS WITHOUT
WERE WITH THE EXPERTS IN AFTER
TO MORE TERM CARE SO WHAT I
WILL TO ASK YOU IS MY
ORGANIZATION. WHAT WAS APPEAR
TO ORGANISE. IS WORKING TO
CONVENE A OF EXPERTS TO DEVELOP
RECOMMENDED ON HOW TO ACTUALLY
IMPROVE THE SURVEY PROCESS WHAT
I'D LIKE TO ASK MR OCCURS
MISSION CONNECT TO A TRUE
COLLABORATIVE PROCESS. IN THE
EXPLOSION GERIATRICS AND LONG
TERM CARE BENEFIT. IN NOT ONLY
GIVING INPUT BUT ACTUALLY BEING
PART OF THE PLANNING PROCESS
AND THE DEVELOPMENT OF THIS NEW
APPROACH. DR WASSERMAN AND IT'S
GOOD TO HEAR YOUR VOICE AS SO
WE SPEAK OFTEN- NOT ONLY JUST
pON A WEEKLY BASIS BUT- OFTEN ON
EVEN OF PRE PANDEMIC SO ALWAYS
APPRECIATE YOUR PARTNERSHIP AND
YOUR EXPERTISE PARTICULARLY
YOUR TEAM AS A WHOLE. SO YES I
WILL OF COURSE CAN BET TO HAVE
YOU AND YOUR TEAM AS WELL AS
OTHER- PARTNERS AT THE TABLE TO
BE PART OF THESE PLANNING
PROCESSES IN FACT- YOU'LL SEE
STRAPS OF THESE- COMING YOUR
WAY. SOON MUCH LIKE I'VE SHARED
SO MANY OTHER ALL FACILITY
LETTER- WITH YOU AND YOUR TEAM
FOR YOUR INPUT. OF I ALSO WANT
TO THINK DOCTOR WALKED IN AND
FIFTEEN FOR BEING PART OF OUR
COLLABORATIVE- AUTHORS EVERY
THURSDAY YOU DO INFECTION
PREVENTION CALL FOR ALL OVER
SKILLED NURSING FACILITIES
ALONG WITH- EIGHT STEP BACK.
AND AS WELL AS WE WANT TO BE
ABLE TO PULL AND OTHER PARTNERS
INTO THIS BUT JUST WANT TO
THANK YOU FOR YOUR WE COMMIT.
WITH US IT WILL TRY TO PROVIDE
A LEADERSHIP AND DIRECTION. TO
THE SKILLED NURSING FACILITY
CAN BE. THANK YOU YOU WELCOME.
THANK YOU MISS ME GET YOU HAVE
A QUESTION FOR ANY OF OUR
PANELISTS. NINETY ONE CONTENT
OF WHERE THIRTY SEVEN YEARS
SINCE I'VE BEEN DOING THIS BUT
HEARD THE NURSING HOME
INDUSTRY. GIVE US MORE MONEY
WILL PROVIDE BETTER CARE AND
HAVEN'T HAPPENED YET HOWEVER I
WANT TO HAVE TO SIGN UP FOR A
COUPLE OF THINGS NUMBER ONE
THOUSAND SURVEYS DONE DURING
THE HEIGHT OF THE PANDEMIC-
INFECTION CONTROL SURVEYS.
NOTED ABSOLUTELY NO
DEFICIENCIES AND SECONDLY IS
THAT CAN BE CORRECTED AND
SECONDLY- WE NEED TO STOP THE-
STAFFING WAIVERS. AND I'M
WONDERING IF THE DEPARTMENT IS
LOOKING AT THAT WE KNOW THAT
THERE'S NOT ENOUGH ARE AND WE
KNOW THAT THERE'S NOT ENOUGH
THAT THE NURSING. AND WE KNOW
THAT IF THE INDUSTRY WOULD GET
STAFF MORE MONEY THERE WOULD BE
MORE STAFF AVAILABLE. NO YOU
SHOW ME THE MONEY AND THEY WILL
COME. HOWEVER I WANT TO KNOW
WHY MY WHERE WHY WE'VE BEEN A
THOUSAND. SERVICE DURING THE
HEIGHT OF THE SANTA LIKE WITH
AFTER NO THE- WHEN THERE WERE
DAYS LATER HE DYING. AND
ACTUALLY. GOING ON WITH THIS
THAT. OTHER THAN STOP OKAY. THE
SENATOR HAD. THANK YOUR
QUESTION. SO YES WE HAVE BEEN
VERY. ACTIVE ACTIVE THAN ANY
OTHER STATE BEING IN ON THESE
FACILITIES. BUT AGAIN IN THESE
FACILITIES IN ADDITION THE
THREE HUNDRED AND FIFTY
CITATIONS THERE ARE MANY- THAT
YOU WOULD NOTED THAT ALSO
DIDN'T HAVE THE SLIGHTEST. BUT
THAT THERE WAS NOT DOESN'T MEAN
THAT THEIR VALUE. I THINK THAT
WE NEED TO REMEMBER THAT IN
ORDER TO HAVE QUALITY AND
SAFETY AND THE FACILITY. IT IS
A MIXTURE BETWEEN PROVIDING THE
TOOLS AND RESOURCES AND
EDUCATION FOR PEOPLE TO BE
SUCCESSFUL. AND OTHER TIMES
THERE ARE THERE ARE PLACES
WHERE YES WE HAVE THE CARROT
AND HAVE TO STICK. WE DO USE.
DO YOU HAVE OF THE CITATIONS ON
ON ON AS WELL I. OVERNIGHT WHEN
WE LOOK AT STAFF. QUESTION
REGARDING STAFFING I DO KNOW
THAT ARE FOR THE- THAT HE HAD A
RICH PUT OUT THERE TO BE ABLE
TO HELP THE HOW AS MUCH LIKE TO
AS POSSIBLE DURING THE PANDEMIC
WE KNOW THAT THOSE WAIVERS DO
EXPIRE OF APPLIED JUNE
THIRTIETH- AND WE WILL BE
WORKING WITH STAKEHOLDERS AND
ASSESSING WHAT THE NEXT STEPS
WOULD SITUATION WILL BE GOING
FOR. NUMBER THANK YOU BUT I'M-
I THINK THEY KIND OF. I'M I'M
SORRY WE'RE GONNA GO AHEAD AND
MOVE ON TO- MISS COLEMAN I WITH
HER FOR HER QUESTION. I'M GONNA
KEEP HIDING IN THE HOT SEAT. MY
REQUEST IS WILL WILL HEIDI
COMMIT TO FORMALIZING THAT THIS
ANALYTICS WILL INCLUDE THE HOT
LESS THAT ARE IDENTIFIED BY THE
LOCAL LONG TERM CARE OMBUDSMAN.
AND THAT THE STRIKE TEAMS THAT
ARE GOING INTO THESE FACILITIES
WELL IT THIS MOMENT OMBUDSMAN'S
CAN'T GO INTO THE FACILITIES
BUT IF THE STRIKE TEAM WOULD
COMMIT TO INFORM ALL IN ALL
FACILITIES LETTER OR IN SOME.
SOME WAY. TO INCLUDING THE
LOCAL OMBUDSMAN IN THAT STRIKE
AS THE LOCAL EXPERT. GREAT
THANK YOU WE AT THE END OF
AGAIN A ANOTHER WONDERFUL AND
PARTNER ON IN THIS- IN THIS
FIGHT DURING THE PANDEMIC UP
LEASE I DO ON AS WE SPOKE
YESTERDAY I ALSO WANTED TO SAY
THANK YOU AGAIN- FOR YOU AND
YOUR PARTNERSHIP IN YOUR TEAMS
AND CERTAINLY I THINK THE
OMBUDSMAN IS- OF ONE OF THE-
GIRLS THAT WE HAVE NOT BEEN
ABLE. HAVE A LONG SILENCE WHICH
AS OF THE HAS HEARD IT SAID I
BELIEVE WE NEED TO HAVE A MAN
THERE AND BE OF THE TEAM AS
WELL AS OF COURSE YES WE WOULD
AS I FOR A POLICE PLEASE GIVE
ME A DOT ANY INFORMATION
INDICATORS THAT YOU'RE TO.
EXPERTS OF NEED I ALSO WANT TO
HIGHLIGHT THAT YOUR IDEA AND
YOU'RE ASKING THE LEGISLATURE
THIS MORNING IN ASKING THAT ON
BUT THE A PART OF THE FABRIC OF
THE LOCAL PUBLIC HEALTH I FULL
IS THE THAT I AND I JUST HOPE
THAT THAT TO WISH. THE YOU VERY
MUCH I DO ONE OF ONCE AGAIN.
KEEP THAT ARE. THAT WE DO HAVE
A HIGH STOP MEDIC AYE IT'S
ELEVEN GONNA GO TO A- OH FOR
I'D- AND I APOLOGIZE FOR THAT
BUT OUR TIME IS VERY. I COMMIT
THAT I DO WANNA LOOK TOWARDS
ANOTHER ANOTHER HEARING-
POSSIBLY- YOU KNOW LATER AND
LATER IN THE SUMMER EARLY FALL.
TO REALLY TALK ABOUT THIS AND
WE WILL BE A QUESTION IS- THAT
WE WOULD LIKE ANSWER BASED ON.
WHAT WE'RE LEARNING WHAT WE
HEARD TODAY AND SO ON I WANT TO
THANK ALL OF OUR PANELISTS FOR
BEING WITH US I VERY MUCH
APPRECIATE THAT AND I APOLOGIZE
AND I WAS A LITTLE. CURTAIN
TRYING TO MOVE THINGS ALONG BUT
WE DID HAVE A TIME CONSTRAINT-
AND I DO WANT TO LET YOU KNOW
THAT. THE SHE EXPERT. BEING US
AND- AM. I THINK YOU VERY MUCH
FOR THE INFORMATION DOES WANTED
A DOLLAR THEATER OF THE ACT
WE'VE HAD OTHER MEMBERS IN THE
ROOM AND- BEEN TIME TO REALLY.
THAT IT NOT SAM I'M I'M- FROM
OF COMMITTEE TO SEE. CURRY OUR
BUDGET SO. ON HEALTH AND HUMAN
ARE HUMAN SERVICES HEALTHY MISS
BLANCA RUBIO TIME THANK THEM
FOR BEING HERE WITH US TODAY AS
WELL- WITH THAT DO YOU HAVE
ANY- ANYTHING LIKE THIS. BEFORE
IN ELSE EXCEPT. OKAY AS MUCH
THANK YOU A- WE LEARNED A LOT
THIS IS TO A VERY VERY TRY.
ISSUE FOR US- AND- IN LIGHT OF-
BUDGET CUTS. THAT ARE WOULD
HAVE BEEN PROPOSED- EVEN MORE
TROUBLING- HIGH- HOPE THAT
MOVING FORWARD- THAT WE
ACTUALLY COME UP WITH.
ADDITIONAL PRE PLANNING SO THAT
WE ARE NOT AS REACTIVE IN THE
FUTURE- WHEN IT COMES TO
DEALING WITH THIS- PANDEMICS OR
OTHER KINDS OF PUBLIC HEALTH
EMERGENCIES. I HOPE THAT WE
ULTIMATELY END UP WITH. THAT
STRICT PROTOCOLS AND SUPPLY
CHAINS THAT THAT ARE AVAILABLE
AND A SKILLED WELL PAID WORK
FORCE TO TAKE CARE OF THE MOST
FRAGILE AMONG US- IN WITH THAT
I WOULD LIKE TO- AND- WE DO
HAVE A SKILLED WORKFORCE
SOMEONE MAKE THAT CLEAR. I JUST
WANNA MAKE SURE THEY'RE WELL
PAID- AND THAT WAY I KNOW THAT
THAT WILL HELP WITH THE
TURNOVER. AND I KNOW THAT THAT
WILL HELP WITH THE LONG TERM
CARE OF OUR OF OUR MOST FRAGILE
RESIDENTS. WITH THAT WOULD LIKE
TO OPEN THE PHONE LINES. KEEP
YOUR COMMENTS TO POP UP IN IT
POWER AS AND OTHERS WERE
THERE'S- FORD F. FORTY PEOPLE
IN THE QUEUE. AND I APOLOGIZE
IN ADVANCE BUT WE WILL TAKE. WE
DON'T GET TO YOU. TAKE YOUR CAR
IN RIGHT YOU CAN COME TO. A
EIGHT EIGHT EXCUSE FOR AGAIN. A
H. E. A. DOT COMMITTEE. AT
ASSEMBLY. DOT C. A. DOT G. O.
V. WITH LAST MODERATE TO PLEASE
OPEN THE LINES. THANK YOU IF
YOU WOULD LIKE TO MAKE A
COMMENT PLEASE. ONE AND THEN
ZERO AT THIS TIME. AND OVER THE
LINE OF NUMBER FIFTY SIX PLEASE
GO AHEAD. HI GOOD MORNING AND
THANK YOU FOR TAKING MY CALL
THEM TODAY AND THANK YOU FOR
THE WIDE RANGING COMMENTS ON
THE NURSING HOME ISSUE I MEAN
WHY ARE WHAT WITH A OR P.
CALIFORNIA. WE HAVE CENTER OF
COURSE ARE LONGER COMMENT. TO
ASSEMBLY- AGING A LONG TERM
CARE STAFF. SO ALL THE KIDS
SOME OF THE HIGHLIGHTS THAT
WE'RE LOOKING FOR IN TERMS OF-
PRACTICE PHYSICIAN BUT THE
STATE AT IN THE STATE AS WELL
AS NATIONALLY. I'M FIRST OF ALL
WE ASK THAT THE LEGISLATURE
REJECT THE NURSING HOME
INDUSTRY PROPOSAL TO ALLOW
REDUCE STAFFING HAS WORKED TO
CREATE. BLANKET IMMUNITY FROM
LIABILITY FROM NURSING HOMES.
WE THAT WE DO A BETTER JOB OF
MAKING PUBLIC THE NAMES OF
NURSING FACILITIES WITH
CONFIRMED COMPETE NINETEEN CASE.
ARE WE REQUIRE WE ASK THAT WE
REQUIRE THE FAMILY MEMBERS OF
KOBE NINETEEN POSITIVE
RESIDENTS BE AWARDED OF ANY
PLANS TO TRANSFER THESE
RESIDENTS OTHER FACILITIES WE
WANT TO MAKE SURE THAT WE WANT
TO ENSURE THAT ALL NURSING HOME
TO ADEQUATELY STAFFED TO MEET
CURRENT DEMAND. IN SHORT THAT
NURSING FACILITIES AN ASSISTED
LIVING FACILITIES WHICH I KNOW
WE DON'T DISCUSS TODAY HAVE
ACCESS. TO THE NECESSARY PPA P.
P. P. EFFORT TO START TODAY. TO
PROVIDE SPREAD AMONG. EXPAND
FURTHER EXPAND THE AVAILABILITY
OF TESTING FOR RESIDENTS AND
STAFF. REALLY WORKING TO ENSURE
THAT WHILE PHYSICAL VISITORS
THIS IS THE STILL PROHIBITED
NURSING FACILITIES ALLOW AND
FACILITATE BURKE FOR VISITATION
AND YOUR TELEPHONE
COMMUNICATION BETWEEN RESIDENTS
AND OUR FAMILIES. AND MAKE
PUBLIC THE STANDARD OF CARE
USED BUT WITH THE STATE DURING
THE PERIOD OF CRISIS AS I NOTED
OUR LETTER- GOES INTO FAR
GREATER CAN'T HELP BUT WANT TO
MAKE SURE TO HIT BECAUSE I LIKE
THANK YOU THANK YOU VERY MUCH I
WAS IMMINENT THIRTY SO PLEASE
TRY TO KEEP A TWO MINUTE THANK
YOU. NEXT NEXT CALLER PLEASE.
THANK YOU I'M THIRTY SIX WERE
OPEN. IF ANYONE LOOKED AT THE
END CALIFORNIA ON BEHALF OF
TWENTY THOUSAND I THINK THE
COMMITTEE WORKERS AND TOO MUCH
OF FACILITY I WANT TO BEGIN BY
TAKING THE CHAIR FOR HAVING
THIS HEARING AND WHILE WE
UNDERSTAND THE FOCUS OF THIS
HERE YOU LOOK ON THE PATIENT
AND THE FAMILY WITH THE JUST
ASK WHAT ABOUT THE WORK IN
THEIR FAMILIES THERE WAS
DEFINITELY A LOT OF TALK ABOUT
THE WE'RE GOOD AND WE DO
APPRECIATE THAT. THAT QUESTION
YOUR DAY WORKERS ARE CALLED ON
A DAILY BASIS AND I OFTENTIMES
THE POPULAR BUT IN THE LONG THE
RATE AND TO DATE THERE ARE OVER
FIFTY WAS THE BAD GUY WE'RE
GOING TO WORKING THEN RETURN.
HOME TO THEIR- UNITY. THEY
CONTINUE TO. A LOT. ON THE LINE
DALY FOR THE CARE. PENSION
BECAUSE THERE. DEPEND ON THEM.
ADAPTATION DESERVE. ARE PROVIDE.
THE QUESTION OF THE- BY. HAD
WORD. WHAT HAVE YOU. WORKED
ABOUT TRYING ARE THERE FOR THE
FUTURE. FROM WHAT THE
PROSPECTIVE WHAT HAPPENED. IN
YEAH AS USUAL ARE ABLE TO. GET
OUT OF BACK IN THE- ME. IN A
TIME WHERE IT'S NEEDED. ALL HAS
WORKED. OUR LOOK THE BILL. TO
BE WITH YET CONTINUE TO WORK
TO. THE DAY. CHALLENGE THEY
FACE. WHAT HAPPENED WAS PROVIDE.
ADEQUATE PT. OUT. DISCUSSIONS
IN THE FUTURE LIKE REALLY GET
THE CALL THAT WE WOULD ASK THAT
YOU CONSIDER- THE PERSPECTIVE
OF THE WORKER THANK YOU OKAY
THANK YOU THAT WAS AN ALSO ONE
THIRD ONE THIRTY PLEASE ONE
MINUTE AND I'M SORRY I'M REALLY
SORRY BUT I WILL. I WILL CUT I
WILL HAVE TO STOP YOU AFTER ONE
MINUTE. SO NEXT NEXT CALLER
PLEASE. Q. I'M THIRTY FOUR
PLEASE GO AHEAD. HI THIS IS THE
AMBER CREST ON BEHALF OF
JUSTICE AND EATING AND THANK
YOU FOR THE HEARING WE JUST
HAVE TO MAKE ALL CONGREGATE
SETTING THE PRIORITY AREAS IN
THE LAST LIKE IT'S A LOAN
THERE'S BEEN AN 8% INCREASE IN
REPORTED THAT THE NURSING HOME
BUT CAN NOT BE WHAT WE EXPECT
OVER THE NEXT WEEKS MONTHS OR
YEARS AS A PIRATE RADIO ON.
FIFTEEN WE ABSOLUTELY CANNOT
ACCEPT THE PROPOSED BUDGET
WHICH WILL ONLY EXACERBATE AND
COMPOUND THE CRACKER BY MAKING
CUTS NEARLY ALL PROGRAM THE
MUCH OLDER ADULTS RELY
INCLUDING ELIMINATION OF
PROGRAMS LIKE HE DOESN'T AND
IT'S A P. THAT PROVIDE CARE IN
THE HOME NOT ONLY WOULD BE CUT.
FROM THE BUDGET MEETING THEY'RE
NOT GIVING BUT ALL BUT THEY
WILL ONLY BE TO AND THE MISSION
NURSING HOMES AND I CAN'T TO
DOUBLE RIGHT BALLS AND. OUR
STATE BUDGET RESPONSE
HEALTHCARE. THE PEOPLE WHO ARE
DYING TO BE THE- FIRST AND WE-
ARE YOUR HARD FOR. AND WE STATE
LOCAL EVEN PEOPLE WITH. NOT BE
FOR OKAY. YEAH BUT THE
BACKLIGHT. OF WHAT HAPPENED. I
CALENDAR ALL THE PEOPLE CAN.
WHITE IT. THANK YOU BY THE YOUR
DEVALUING LOTS OF OLDER. PEOPLE
WITH DISABILITIES THEIR CARE.
THANK YOU NEXT COVERED. THANK
YOU I'M NINE PLEASE GO. WELL I
AM THIRTY NINE PLEASE GO AHEAD.
THAT'S LARRY EVERYONE KNEW IT
WAS THE DENTAL TELL THEM THAT
PRESIDENCY OF MAKE AN AGING I
WANT TO THANK CHAIR WITH AND
SHARE MISSOURIAN FOR HOLDING
THIS HEARING AND ALL THAT YOU
HAD THAT SO FAR IN ALL THAT YOU
HAVE QUESTIONS AND ALL THAT
THAT YOU BELIEVE IN AND I AM SO
APPRECIATIVE THAT LITTLE COOPER
COMMISSION HELLO YOU'RE RIGHT.
TWENTY FOUR YEARS AGO WE SAT WE
NEED TO HAVE A COMMUNITY HAS
SUPPORT SERVICES IN IT THE
PEOPLE DON'T GET
INSTITUTIONALIZED IN HERE WITH
HAVING A CONVERSATION AND ONE
AS A LEASE THAT COMMENT
REGARDING- TRYING LOCAL PUBLIC
HEALTH WE'RE DOING IT CONTRA
COPY. BUT MINUTES AT THE AND
THE COUNTY HEALTH SO A PRIEST
AND HAPPY TO HAVE THEM
PARTNERING WITH THE TABLE SO
ONE ALSO THAT GAPPING INCREASE
THE NURSING GREAT TO MEET BE
TIED TO STAFF. I WON TO ECHO TO
MCQUAY WAIT AT FIRST WE HAVE TO
WE AT WHAT ARE IS THE MASTER
PLAN FOR YOU CAN WHICH IS
PEOPLE IN THE- AND THE WAY MUST
CAN TO FUND THE BASS AND THE
HEALTH AND I THINK YOU FOR AND
HE'S VERY NICE THANK YOU FOR
SUPPORT OF. THEY ALSO WORK THAT.
THE SHOPPING BETTER ABOUT THE-
ABILITIES WHEN BILL. THERE'S ON
THEM AND LIVE A BEVERLY. AND WE
ARE. A LOT WAGE TO THE WORKER.
IT OKAY. THANK YOU TO THE- THAT
YOU FOR YOUR SUPPORT NEXT.
THANK VERY MUCH. THANK YOU I
SEVENTY SEVEN GO OUT. OKAY GOOD
AFTERNOON MY NAME IS RICH IN
THIS I'M A RETIRED CIVIL RIGHTS
ATTORNEY WHO HAPPENS TO LIVE IN
THE CONTINUING CARE COMMUNITY
IN SAN FRANCISCO WHICH INCLUDES
A FORTY BED NURSING FACILITY
AND ASSISTED LIVING AND MEMORY
CARE- WANT TO ENDORSE MANY OF
THE RECOMMENDATIONS THAT HAVE
BEEN MADE THIS HEARING AND SET
FOR HOLDING BRING. A PARTICULAR
WOULD LIKE TO ENDORSE THE TEN
POINT PLAN PUT FORWARD BY
CALIFORNIA ASSOCIATION OF
NURSING HOMES WHICH GOES BEYOND
AND BROADER FOR THE NEEDS OF
THIS I ALSO WANT TO- SAY THAT I
WISH EVERYONE HAD THE SAME
SITUATION THAT I HAVE HERE I
HAVE A- FACILITY THAT. HAD
INFECTIOUS COUNTRY STAFFING AND
EVERYTHING WHAT. THE CO THAT
CRY SHUT DOWN THE- TO WE EARLY.
THAN THE CITY DID WE HAVE NO
THAT CASES HERE WE HAVE
ADEQUATE P. P. ADEQUATE
STAFFING. WE ARE VERY FORTUNATE
TO HAVE A WELL MANAGED FACILITY
MOST FACILITIES ARE NOT WELL
MANAGED AND NEED A LOT MORE
SCRUTINY AND OVERSIGHT BY THE
STATE THANK YOU THANK YOU SO
MUCH FOR HAVING THIS THANK YOU
VERY MUCH. NEXT CALLER. YOUR
MIND FORTY FOUR PLEASE GO AHEAD.
HELLO I'M A FAMILY MEMBER IN A
FIRST HAND WITNESS THE TYPE OF
ABUSE NEGLECT INTIMIDATION AND
RETALIATION BETTER FACILITY CAN
INFLICT UPON ITS RESIDENTS AND
FAMILY MEMBERS THEY HE BEHAVE
THIS WAY WE CALLED IT AND NOW I
REFUSED TO NAME THE FACILITY I
DEAL WITH THE PEER RETALIATION.
DUE TO THE COURT CURRENT COVERT
RESTRICTIONS AND BECAUSE I HAVE
A LOVED ONE THAT IN THERE AND
IT'S A CODE BUT IN FACT THE
TOTAL OF THE- AND MIGHT. BE
PRESENT FOR MY LOVED ONE
APPROXIMATELY FORTY HOURS PER
WEEK IN THE LAST SEVEN YEARS.
I'M OF RED. IS IN AGREE
DISPLAYED THAT THE PART OF
HEALTH AND THEIR. WORK
CORPORATION AS THE BILL WITH
YOU ADDRESS OF THE BALL WHAT
LEVEL THE BODY FACILITY AND
REALLY PEOPLE FUNDING YOUR WORK
THE CRIMINAL NEGATIVE WITH A
PART THAT THE THEY MUST ALL THE
CLARA FOR THEIR WORK ACT IN AND
I THE COURT EVERYTHING BUT
AGAIN IT'S THE AT THE FIVE AND
I WILL BE FALL UP AN EMAIL
THANK YOU FOR YOUR THANK THANK
YOU FOR YOUR CALL YOU. NEXT
CALL PLEASE. THANK YOU RIGHT AT
FIVE THREE FOUR. THE MORNING
THIS DIRECTLY EARNERS THAT THAT
THE LIKE DIRECTOR FOR THE TURN
THE CAL. I ALSO TARGETING
COMMON THAT WE PENINSULA WEEK
BUT JUST A FEW ADDITIONAL. I
THE NURSING HOME INDUSTRY SPENT
THE DREAM LOBBYING MUSIC LIVE
IN RATHER THAN A CORRECT URGENT
NEED AND STAGGERING BACK INTO
THE PUBLIC. HELP SHOULD NOT
ALLOW THEM TO HAVE WHY DIDN'T
SHIELD IN A TIME WITH HER
EARNED IN A CONDO. IS OUR MOST
IMPORTANT. MAYBE I'LL GIVE YOU
A THE SURVIVING FAMILY AND HELP.
THE WRITING COULDN'T. THE
SENATOR. AND STATE IS FINDING
ARE THE CLAUSES LIKELY THINK
ABOUT OUR SUPPORT AND SIMPLY
CANNOT GET THEM I'M EVEN THE
CURRENT ABILITY THANK YOU VERY
MUCH THANK YOU VERY THANK YOU.
NEXT CALL YOUR MIND WHEN FIVE
THREE GO AHEAD. HELLO HI MY
NAME IS CARE STORE AND I LOOK
UP AND I REALLY APPRECIATE THAT
TIME CARE THAT YOU ALL GIVING
TO CRITICAL. I'M I'M COMMENTING
ON BEHALF TANDEM WITH THE
MEXICAN NETWORK AND MANY OF OUR
MEMBERS PEOPLE TO THE BILL
OLDER ADULTS FAMILY CARRIER WHO
LONG TERM CARE AND LONG TERM.
SUPPORT AND YEAH COME THAT THAT
THING INCREASE PAPER WORKERS
TIME OFF. AT TREATMENT FOR
RESIDENTS STAFF AND THE PROJECT.
BLOCKING THE GOVERNOR AND MUCH.
WHOLE NURSING HOME. AND NOT
PROVIDE THEM AND UNITY AND I
BELIEVE IN WHAT CRACK
AUTHORIZATION THE- FIFTY SHE OF
HELP WITH. HAVE A LETTER THE
GOVERNOR OUT. COMMUNITIES FOR
NURSING. AND CHILLED THEM. YEAH
THAT HAPPEN ON YOUR WATCH
DURING NINE. I'M AND I TO THE
STATE TO TAKE A QUICK THE TABLE.
AND A CHAIR. FOR ANY AND ON
AGAIN AND WE ALSO ASK THAT YOU
MAKE BUDGET CUTS TO POLICE AND
PRISON NOT I BACK AND CRITICAL
PROGRAM TO PEOPLE CAMBODIA THE
ELDER. THANK YOU VERY MUCH.
TWENTY TWO MORE CALLS IN AND I
POD. TO YOU HAVE TO GO THE
HEARING SO. PLEASE GOING TO. BE
PRETTY GO AHEAD. BUT YOU MY
NAME IS MICHAEL CRY OF PARTNER
IN THE IN THE LAW LAW FIRM IN
YOUR CAN HELP OPEN HUBBLE
COUNTY. AND I WANTED TO ECHO
COMMON PREVIOUS CALLER IT MAY
IN THEIR COMMENTS URGING LET IN
THIS TERMS NOT TO GROW. A
BLANKET A NEW TO THE NURSING
HOME. QUESTION OF MY LAW FIRMS
THE DIFFICULT WHAT. EXPERIENCE
TO SHOW THAT THESE FOR PROPER
CORPORATIONS THEIR BUSINESS
MODEL OF UNDER AND THEN WE CAN
PROFITS ESERVERS OF THAT AT THE
EXPENSE OF THE REST AND
FAMILIES IN NURSING SO. OF LOOK
INTO. IN TO GIVE THEM ONE IT
NEARLY. WOULD BE AN OPERATION
FAMILIES AND RESIDENTS THE.
pSTRONGEST TERMS CANNOT GOING TO
MEET TO THE PEOPLE. IS
CORPORATION. SHOULD BE COUNTED
THE VIA THE COURT SYSTEM IT'S
JUST AT THE WAY TO HOLD WITH TO
MAKE BE FAIR DO THEIR- THANK
YOU THANK YOU MUCH AND THEN OUR
FINAL CALL. THANK YOU I'M
SEVENTY THREE PLEASE GO AHEAD.
HELLO MY NAME'S NICOLE HOW
EXECUTIVE DIRECTOR FOR. THE
OFFICE ONE OF ALAMEDA I WANT TO
THANK THE CHURCH THE HOLDING OF
HEARING TODAY I WANT TO RAISE
UP THE ISSUE AROUND WORKFORCE
AND I'D LIKE TO TIE IT BACK TO
THE REQUIREMENTS FOR TRAINING
FOR CERTIFIED NURSING
ASSISTANT. NOT ONLY WERE THE
REGULATIONS. CHANGED IN DURING
CORBETT AND ALLOWING FACILITY
TO HAVE FRANKLY UNDER SKILLED
LABOR IN THAT BUT ALSO THE
CERTIFIED NURSING ASSISTANT
TRAINING PROGRAM IF PROJECT
PRESCRIBE. AND LEAVE. FORTY A
BASED AND SUPPORT AND PURSUE
UNDER MY LOOK. AND IF WE WANT
FUTURE CARE IT TO COME FROM THE
CORE WORK. AND THIS IS GOVERNOR
BY CAL PART PUBLIC AND THE ONE
THING I ASK THAT THE CHURCH
WOULD DIRECT PH TO LOOK AT POP
INNOVATION. TO THE SEA IN A
CURRICULUM AND WHAT IS
PERMITTED THANK YOU SO MUCH AND
I APPRECIATE YOUR ATTENTION TO
THIS MATTER. THANK YOU VERY
MUCH FOR THAT SUGGESTION AND I
WANT TO THANK EVERYBODY I DO
APOLOGIZE THAT WE WERE NOT ABLE
TO GET INTO EVERY. ALL PUBLIC
COMMENT. OH I'LL HAVE ANOTHER
HERE. AND A- AND WE- MAKE SURE
WE HAVE TWENTY OF TIME FOR
PUBLIC I PROMISE YOU THAT WE
THAT I'M GOING TO THANK MIKE
MIKE COKE CAN HERE- ASSEMBLY
MEMBER IN HIS AREA AND WE WILL
GO AHEAD DURING THE MEETING
THANK YOU ONCE AGAIN FOR
EVERYONE FOR YOUR PARTICIPATION.
RIGHT.