GOOD MORNING
AND WELCOME EVERYONE WHO IS
PARTICIPATING OR VIEWING
ASSEMBLY BUDGET SUB COMMITTEE
NUMBER ONE OVERSIGHT HEARING ON
THE ADMINISTRATION'S LONG TERM
CARE AT HOME PROPOSAL. AND
SKILLED NURSING FACILITY COBIT
NINETEEN MERCHANTS A RESPONSE.
I AM ALSO VERY PLEASED THAT WE
HAVE INVITED THE CHAIRS OF THE
ASSEMBLY STANDING POLICY
COMMITTEES AND BUDGET HUMAN
SERVICES AND AGING AND LONG
TERM CARE COMMUNITIES
COMMITTEES. AS WITH ALL OF OUR
HEARINGS DURING THE PANDEMIC
ERA I'VE BEEN ASKED TO READ
SOME DIRECTIONS REGARDING
PUBLIC PARTICIPATION IN TODAY'S
HEARINGS TO HELP INSURE THE
SAFETY OF EVERYONE HERE TODAY
WHILE ALLOWING FULL PUBLIC
ACCESS TO THE DISCUSSION. DUE
TO THE STATE WIDE STAY AT HOME
ORDER AND GUIDANCE ON PHYSICAL
DISTANCING SEATING FOR THIS
HEARING WILL BE VERY LIMITED.
ALL WILL BE ENCOURAGED TO WATCH
THIS HEARING ON OUR WEBSITE AS
WE HAVE SEEN HERE TODAY. A
MODEL FOR MODERATED TELEPHONE
LINE WILL BE AVAILABLE TO
ASSIST WITH PUBLIC
PARTICIPATION. AFTER WITNESSES
HAVE CONCLUDED AND AFTER THE
CONCLUSION OF THE MEMBER
QUESTIONS THE PUBLIC MAY
PROVIDE PUBLIC COMMENT BY
CALLING THE FOLLOWING TOLL FREE
NUMBER. 977-692-8957 ACCESS
CODE. ONE THREE ONE FIVE FOUR
TWO OH TWO. IF YOU ENCOUNTER
ANY TECHNICAL PROBLEMS WITH
ACCESSING THE PUBLIC COMMENT
PHONE LINE PLEASE CONTACT THE
ASSEMBLY BUDGET COMMITTEE AT.
916-319-2090 NINE. AND A STAFF
MEMBER WILL ASSIST YOU OR YOU
CAN EMAIL AT BUDGET. SUB ONE AT
ASM DOT CA DOT GOV. NOW IF I
CAN. I'D LIKE TO ADDRESS OUR
PANELISTS WHO WILL ALL BE ROOM.
IN REMOTELY TODAY VIA EITHER A
WITNESS VIDEO ROOM OR HERE AT
THE STATE CAPITOL VIA A
TELEPHONE CONFERENCE CALL. WITH
STAFF ASSISTING SO THAT THE
PANEL CAN CONVERSE WITH MEMBERS
WHO ARE HERE IN THE ROOM.
SHOULD WE EXPERIENCE ANY
TECHNICAL DIFFICULTIES WE ASK
YOU TO PLEASE BE PATIENT WE'RE
ASKING ALL OF OUR PANELISTS TO
TURN THE SOUND OFF OF THEIR
LOCATION AND USE YOUR PHONES OF
POSSIBLE TO REDUCE FEEDBACK. A
FEW NOTES ABOUT THE AGENDA
TODAY. AFTER MY OPENING REMARKS
I WELCOME ALL MEMBERS TO MAKE
OPENING REMARKS AS WELL AND
THEN WE WILL TURN THE PANEL ONE.
PANELISTS WILL ADDRESS THE
COMMITTEE AN AGENDA ORDER. ONCE
PANEL ONE IS CONCLUDED WE WILL
HAVE MEMBER QUESTIONS AND
DIALOGUE. WITH THE PANELISTS.
THEN WE WILL GO TO PANEL TO AND
GO THROUGH THE SAME FORMAT AND
SO ON FOR PANELS THREE AND
FOUR. AGAIN PANELISTS WILL
ADDRESS THE COMMITTEE AN AGENDA
ORDER AND THEN WE'LL GO TO
MEMBER QUESTIONS AND ANSWERS
AFTER EACH PANEL. FINALLY ONCE
THE MEMBER QUESTIONS HAVE
CONCLUDED FOR PANEL FOR I WILL
OPEN THE HEARING UP FOR PUBLIC
COMMENT. I WILL FIRST TAKE
PUBLIC COMMENT FROM THOSE IN
THE ROOM AGAIN ASKING FOR YOU
TO RAISE YOUR HANDS AND
DIRECTING YOU TO THE MIKE
INDIVIDUALLY. I WILL THEN OPEN
IT UP TO THE PUBLIC ON THE
PHONE. NOW I WOULD LIKE TO ASK
OUR COMMITTEE CONSULTANTS TO
PLEASE CALL ROLE. HERE MATHIS
WE'RE- RAMOS YEAH HEAR WHAT
YOU'RE. I HAVE A FEW BRIEF
OPENING REMARKS AS WE BEGIN
THIS HEARING. GIVEN ALL OF OUR
CHALLENGES AS A CALIFORNIA AND
THE WORLD COMMUNITY DEALS WITH
KOPET NINETEEN PANDEMIC WE HAVE
LIMITED OPPORTUNITIES TO HOLD
SOMEONE HEARINGS. TODAY'S
HEARING IS ON A CRITICAL
SUBJECT THAT WE PUSHED HARD TO
CONVENE THIS GROUP OF LAWMAKERS
TO DISCUSS. THE ADMINISTRATION
IS DEVELOPING A PROPOSAL THAT
COULD MEAN DRAMATIC CHANGES IN
OUR MEDIC CAL LONG TERM
LANDSCAPE. WE DON'T KNOW THE
SETTLED DETAILS OF THE PROPOSAL
AND THIS IS A MAJOR REASON WHY
ARE WE WHY WE ARE ASKING FOR A
TWENTY TWENTY ONE. FORMAL
PUBLIC AND DELIBERATIVE PROCESS
TO PROPERLY VET WHAT AT WHAT
EVER COMES FORWARD FROM THE
pADMINISTRATION. THIS IS KEY AS
A PROPOSAL NOT AS A SETTLED
PIECE OF POLICY THAT THE
ADMINISTRATION MOVES FORWARD TO
IMPLEMENT WITHOUT US. THE
CONTENT OF ANY NEW BENEFIT IS
CRITICAL OF COURSE. BY THE
DEFINITION OF VULNERABLE
POPULATIONS OF OUR CALIFORNIA
ELDERLY AND DISABLED THAT IT
WILL IMPACT. BUT THE PROCESS TO
ACHIEVE ANY POLICY OUTCOME IS
THE SEED AND ROOT OF THAT
POLICY. AND IF WE DON'T HAVE A
PROCESS OUTLINED FOR THIS THAT
IS ACCEPTABLE. AGAIN A MAJOR
GOAL OF THIS HEARING IS TO
UNDERSTAND THE ADMINISTRATION'S
POSITION ON THIS AT THIS TIME
AND TO EMPHASIZE THAT WE WANT A
PUBLIC LEGISLATIVE PROCESS FOR
ANYTHING THAT HAS DECIDED IN
THIS AREA. NOW WE KNOW THAT
PEOPLE ARE AT RISK AND DYING
TODAY IN NURSING HOMES AND
OTHER CONGREGATE SETTINGS WE
NEED ACTION FROM THE STATE NOW
TO SAVE LIVES. THE LONG TERM
SERVICES AND SUPPORT SUB
COMMITTEE OF THE MASTER PLAN
FOR AGING IS A GROUP OF WELL
RESPECTED LEADERS ACROSS THE
AGING CONTINUUM OF CARE. THESE
LEADERS HAVE PUT FORWARD
RECOMMENDATIONS FOR ACTIONS
THAT WE UNDERSTAND THE
ADMINISTRATION IS TAKING
SERIOUSLY. WE APPLAUD THAT WORK
AND WOULD ASK FOR MORE FOCUS
AND ATTENTION AND INVESTMENT
THERE. IT IS CRITICAL THAT OUR
CORE PROGRAMS IN HOME
SUPPORTIVE SERVICES OR IT TEST
SAYS COMMUNITY BASED ADULT
SERVICES SEABASS MULTI PURPOSES
SENIOR SERVICES PROGRAM MSSP
AND CARE GIVER RESOURCE CENTERS
ARE STRENGTHENED AND THAT THEIR
CAPACITY IS EXPANDED. IF WE ARE
BY DESIGN TRYING TO ENSURE THAT
MORE OF OUR OLDER ADULTS IN
NEED ARE STAYING AT HOME AND IN
THAT THEIR COMMUNITIES.
AVOIDING CONGREGATE SETTINGS
LIKE NURSING HOMES DURING THE
COPA NINETEEN CRISIS WE HAVE TO
RECOMMIT TO THESE CORE PROGRAMS.
BEFORE I ASK OTHER MEMBERS TO
HAVE OPENING REMARKS I WANT TO
BE CLEAR ABOUT THE PURPOSE OF
THIS OVERSIGHT HEARING. WE WANT
A PUBLIC PROCESS IN TWENTY
TWENTY ONE FOR THE PURPOSE AND
CONSIDERATION OF ANY PROPOSAL
THAT COMES FORWARD ON LONG TERM
CARE AT HOME AND WE'RE ASKING
FOR CONTINUE CONTINUED SERIOUS
ENGAGEMENT ON THE STAKEHOLDER
CRISIS RECOMMENDATIONS. THAT
HAVE BEEN PUT FORWARD TO REDUCE
PRESSURE ON NURSING HOMES AND
TO KEEP OLDER ADULTS WITH
CHRONIC NEEDS SAFE AND IN THEIR
COMMUNITIES. WE ARE BEING VERY
DIRECT ABOUT THESE OBJECTIVES
WE ARE ASKING TO HEAR CLARITY
AND RESPONSE FROM THE EXECUTIVE
BRANCH. I'M GOING TO ASK NOW IF
OTHER MEMBERS WOULD LIKE TO
MAKE OPENING REMARKS BEFORE WE
BEGAN TO LISTEN TO OUR PANELS
I'D LIKE TO WELCOME THE CHAIR
OF OUR BUDGET COMMITTEE.
CHAIRED TEAM AS WELL AS CHAIR
NECESSARY IN OF AGING AND CHAIR
RAILS OF HUMAN SERVICES I'D
LIKE TO START BY OFFERING TO
SEE IF ANY MEMBERS HAVE OPENING
COMMENTS. COURAGEOUS. THANK IN
THIS HEARING. I APPRECIATE THE
OPPORTUNITY TO PARTNER WITH MY
COLLEAGUES ON THE BUDGET
SUBCOMMITTEE AS WE ASSESS THE
LONG TERM CARE AT HOME BENEFIT.
POSTAL AN IMMEDIATE NEEDS FOR
OUR POPULATION IN SKILLED
NURSING FACILITIES. THE
DISCUSSION THAT WE'RE HAVING
TODAY AFFECTS THE LIVES OF SOME
OF OUR MOST VULNERABLE
POPULATIONS ARE ELDERLY AND LOW
INCOME POPULATIONS AND WE HAVE
TO SEEK SOLUTIONS TO THE ISSUES
THAT THEY'RE FACING. THE
CURRENT CODE NINETEEN PANDEMIC
HAS MADE IT CLEAR THAT NEW
SOLUTIONS ARE NECESSARY TO CARE
FOR THOSE ALREADY IN SKILLED
NURSING FACILITIES AND THOSE
WHO WOULD TRANSITION INTO
SKILLED NURSING FACILITIES.
WHAT IS ALSO BEEN MADE CLEAR IS
THAT WE NEED BOTH IMMEDIATE
SOLUTIONS THAT ADDRESS CONCERNS
RELATED TO THE CURRENT PANDEMIC
AND WE ALSO NEED TO DEVELOP
LONG TERM STRATEGIES TO HELP
PEOPLE TRANSITION FROM A
FACILITY TO THE COMMUNITY. AS
THE CHAIR OF THE HUMAN SERVICES
COMMITTEE I WANT TO ACKNOWLEDGE
THE MANY PEOPLE IN THESE
POPULATIONS. AND WANT TO INSURE
THAT THEY RECEIVE SERVICES FROM
MULTIPLE PROGRAMS INCLUDING
THOSE INSOCIAL SERVICES AND WE
MUST BE MINDFUL THAT ANY
SOLUTIONS THAT ARE FORMULATED
DO NOT DISRUPT THE SERVICES
THAT ARE ALREADY BEING RECEIVED.
I WOULD LIKE TO THANK THE
ADMINISTRATION FOR THEIR
COMMITMENT TO OUR OLDER ADULTS
AND PEOPLE WITH DISABILITIES
THROUGHOUT THE CURRENT CRISIS.
I WOULD LIKE TO URGE THAT WE
CONTINUE TO HAVE ONGOING
DIALOGUE AND INPUT FROM THE
PUBLIC OUR STAKEHOLDERS AND THE
LEGISLATURE SO THAT WE CAN WORK
TOGETHER TO DEVELOP
COMPREHENSIVE WELL VETTED
STRATEGIES. DURING THE HEARING
I LOOK FORWARD TO LEARNING MORE
ABOUT THE STRUCTURE OF THE LONG
TERM BENEFIT LONG TERM CARE
BENEFITS. AND STRATEGIES TO
MITIGATE THE CURRENT CRISIS THE
PENTOMIC HAS CREATED. I ALSO
LOOK FORWARD TO HEARING ABOUT
THE PUBLIC INVOLVEMENT THAT HAS
OCCURRED THUS FAR AND PLANS FOR
FUTURE INVOLVEMENT WITH
STAKEHOLDERS AND THE
LEGISLATURE. AGAIN I WANT TO
THANK YOU FOR THIS INVITATION
THANK ALL WHO HAVE JOINED US
TODAY. THIRTEEN THE VICTIM IS A
TO REALLY VERY MUCH APPRECIATE
THIS HEARING IT WE KNOW THAT
THIS IS A- THIS IS A ANOTHER
HEARING IN A SERIES OF HEARINGS
THAT WE'VE HAD ON THIS ISSUE
AND THE REASON THAT. THIS
COMMITTEE IS SO FOCUSED ON THE
ISSUE IS. WE'VE SEEN THAT. IN
RELATION TO COPE WITH GAS TO OF
THE MAJOR CAUSES OF COBIT
DASHED AND INFECTIONS HAD BEEN
WITHIN- DIRECT PURVIEW OF THE
STATE. ONE IS OUR CORRECTION
SYSTEM THOSE ARE VERY WELL
PUBLICIZED AS TO- VERY MUCH FOR
DECISIONS THAT WERE MADE THAT
INCREASE THE NUMBER OF
INFECTIONS ACROSS OUR
CORRECTION SYSTEMS. AND ANOTHER
IS REALLY OVER THE REGULATION
OF OUR SKILLED NURSING
FACILITIES WITH THE STATE LEVEL
AND WALL THESE ARE MOSTLY
PRIVATE- ORGANIZATIONS AND
PRIVATE COMPANIES. THE STATE
HAS DIRECT PURVIEW OVER THE
REGULATION OF THESE
ORGANIZATIONS IN AS MUCH- WE
ARE ONE OF THE PRIMARY FUNDERS
BECAUSE MANY OF THE RESIDENTS
OF THESE FACILITIES ARE EITHER
A MEDIC CAL OR MEDICARE- THEY
ARE RECEIVING A PUBLIC
SUBSIDIES. AND SO- WELL WE'RE
NOT RUNNING THESE FACILITIES WE
ARE PAYING FOR THESE FACILITIES
I THINK WHAT'S BEEN MOST-
DISCOURAGING IS. THE ATTITUDE
OF THE ADMINISTRATION IN TERMS
OF- THE PUBLIC INPUT AS WELL AS
LEGISLATIVE INPUT OR LACK
THEREOF- I THINK IT IS. I THINK
IT IS GOOD THAT THE
ADMINISTRATION SEEMS TO BE
WORKING WITH THE ASSOCIATION OF
SKILLED NURSING FACILITIES AND
WORKING WITH THE PROVIDERS
WHICH IS. I BELIEVE VERY
APPROPRIATE BUT WHAT HAS BEEN
MISSING IS THE VOICE OF THE
CUSTOMERS YOU HEAR HOW FAMILY
MEMBERS CAN'T GET ANSWERS
EITHER FROM THE FACILITIES OR
FROM THE ADMINISTRATION AT
TIMES- AND IN TERMS OF
LEGISLATIVE PROPOSALSI THINK
WE- HAVE PUT FORWARD A VARIETY
OF PROPOSALS THAT. HAVEN'T BEEN
AGREED UPON OR WE HAVE TO
FIGURE OUT HOW TO. WORK
TOGETHER. AND I THINK THIS IS
WHY- ARE BUDGET SUB COMMITTEE
SAID IN A SERIES OF HEARINGS WE
HAVE ONE ON EDT AGAIN LATER
THIS WEEK. THE TERM URGE THE
VARIOUS DEPARTMENTS TO. SEEK A
MORE COOPERATIVE. STANCE WITH
THE LEGISLATURE PARTICULAR. AND
I THINK THE PUBLIC AS WELL. WE
KNOW THAT THIS- THIS CALL THE
PANDEMIC IS EXTRAORDINARILY
TOUGH- WE DON'T IMAGINE THAT
ANYBODY HAS ALL THE RIGHT
SOLUTIONS ARE THAT EVEN. THAT
WE'RE GONNA BE MAKING ALL THE
RIGHT DECISIONS- AT ANY
PARTICULAR TIME. BUT THE KEY IS
TO BE MAKING THOSE DECISIONS
TOGETHER. TO BE DOING THEM IN A
COLLABORATIVE MANNER. TO BE
REALLY WORKING TOGETHER AND I
THINK THAT'S REALLY. OUR
MESSAGE TODAY- WELL WE HAVE
QUESTIONS. IT IS NOT TO-
QUESTION- WILL ONLY WITH THE
STATE IS DOING BUT REALLY TO.
WORK TO FIND WAYS THAT WE CAN
TAKE RESPONSIBILITY GATHERED
THAT WE CAN WORK COOPERATIVELY.
YEAH I THINK WE- WE DID GOT
TOGETHER IN OUR BUDGET PROCESS
WE WERE ABLE TO CRAFT A BUDGET
THAT ALL OF THE MINISTRATION
THE LEGISLATURE CAME TOGETHER
ON. AND WE WANT TO VERY MUCH
COULD SURE THAT. WE ARE
CONTINUING TO HELP AND TAKE
CARE OF OUR MOST VULNERABLE-
SOME OF THOSE PROTECTIONS THAT
WE WERE PROUD TO DO IN THE
BUDGET WAS TO ENSURE THAT
CRITICAL PROGRAMS. FOR SENIORS
LIKE IN HOME SUPPORT SERVICES.
C. BASS AS WELL AS M. S. S. P.
WE'RE NOT CUT BECAUSE OTHER
CRITICAL PROGRAMS. THAT SENIORS
RELY ON. SO TODAY I'M JUST VERY
MUCH WANT TO THANK. CHEN
ARAMBULA I KNOW CHAIR WOULD HAS
ALSO CONVENE HEARINGS AS WELL
BUT TO CONTINUE TO DO OUR JOB
TO PROVIDE THE PROPER PUBLIC
OVERSIGHT OVER. THE THIS AGENCY
BUT ALSO OVER THE NETWORK OF
SKILLED NURSING FACILITIES THAT
AGAIN THE STATE IS PRIMARILY
FUNDING. I THINK IT'S ACTUALLY
APPROPRIATE IN AGAIN TO URGE
THAT THESE FACILITIES AND- IN
THE VARIOUS AGENCIES CONTINUE
TO. TRY TO FIND WAYS TO WORK
BETTER WITH THE LEGISLATURE AND
TO TRY TO WORK BETTER WITH THE
PUBLIC IN AGAIN TO TRY TO THINK
DOCTOR RAMBLER FOR. CONVENING
THIS AND VERY MUCH LOOK FOR TO
HEAR. THANK YOU DOCTOR WOULD.
THANK YOU DOCTOR REGULAR AND
THANK YOU FOR PUTTING THIS
HEARING TOGETHER I THINK IT'S
ABSOLUTELY CRITICAL- I
COMPLETELY CONCUR THAT- WE
WOULD LIKE TO BE A PROCESS
ACTUALLY WE'RE WE'RE REQUESTING
TO BE A PROBLEM A PART OF A
PROCESS IN TWENTY TWENTY ONE TO
REALLY DIVE INTO THIS- SOME
PEOPLE MAY REMEMBER- THERE WAS
A LOT OF FRUSTRATION THAT ARE
MAY REVISE HEARING WHEN WE
HEARD THAT MSSP AND SEA BASS
AND- WE'RE GOING TO BE
ELIMINATED- WITH NO BRIDGE WITH
NO AND THEN. A FEW DAYS LATER
WITH THIS NEW PLAN ROLLED OUT
WHICH WE KNEW NOTHING ABOUT.
AND THAT'S THE KIND OF LACK OF
COMMUNICATION WITH US THAT WE
FINDING EXTREMELY FRUSTRATING
AND- WHILE IT YOU KNOW THERE
ARE THINGS I THINK THIS NEW
BENEFIT COULD BE A REAL WIN FOR
EVERYONE- THERE ARE STILL LOTS
OF QUESTIONS AND FOR ME ONE OF
THOSE QUESTIONS WILL WILL
REMAIN AT THE TOP OF THE LIST.
IS IF WE ACTUALLY ARE ABLE TO
DO THIS HOW DO WE TRANSITION-
HOW DO WE MAKE THIS WORK FOR
PEOPLE- AND- IT IS I GUESS WHAT
YOU'RE HEARING PROBABLY THE
MOST IS FRUSTRATION OVER
PROCESS. LESS ABOUT THE CONTENT
AND SO- WE WILL CONTINUE IN OUR
OVERSIGHT ROLE TO PUSH ON THIS-
BECAUSE WE BELIEVE IT IS OUR
RESPONSIBILITY AS THIS
COMMITTEE AS CHAIRS OF THE
COMMITTEES- AND PEOPLE SERVE ON
THESE COMMITTEES TO LOOK OUT
FOR THE PEOPLE THAT WE
REPRESENT- AND MAKE SURE THAT
THEY'RE GETTING THE BEST
POSSIBLE OUTCOMES AND SERVICES
SO- I'LL HAVE. LOTS OF
QUESTONS TODAY AND SOME OF
THEM WILL BE PRETTY DIRECT
WHICH IS KIND OF MY NATURE. BUT
BUT IT COMES FROM A PLACE OF
REALLY WANTING TO DO THE BEST
WE CAN FOR THE PEOPLE THAT WE
REPRESENT- THERE IS HUGE
FRUSTRATION- AND CONCERN OVER
WHAT'S HAPPENED IN SKILLED
NURSING FACILITIES THERE IS
HUGE FRUSTRATION AND CONCERN
WHAT'S HAPPENED WITH CDC ARE-
THIS IS NOT ACCEPTABLE- WE CAN
DO BETTER. WE HAVE TO DO
BETTER. AND I LOOK FORWARD TO
BEING A PART OF THE PROCESS
THAT ENSURES THAT WE DO BETTER.
THANK YOU MISTER CHAIR.
ASSEMBLY MEMBER MATHIS THANK
YOU MISTER CHAIR- DOCTOR GRAHAM
YEAH THANK YOU FOR HOLDING THIS
HEARING- AND INVITING THE OTHER
CHAIRS HERE I THINK IT'S VERY
VITAL IS ALREADY BEEN SAID
THAT- WE TAKE A DEEP DIVE
ESPECIALLY WHEN WE TALK ABOUT
TRANSITIONING FROM ONE. PROGRAM
AND JUST GETTING RID OF IT OVER
TO SOMETHING ELSE THAT HASN'T
BEEN FULLY DISCUSS INCOMPLETELY
VETTED OUT- YOU KNOW IN MY
DISTRICT WE GOT HIT VERY HARD
WITH COVIDIEN ESPECIALLY IN OUR
NURSING HOMES. AND I THINK ONE
OF THE BIGGEST FRUSTRATIONS WAS
THAT IT WAS STATE CONTROLLED.
IN THAT ARE COUNTIES. WHO ARE
THE ONES TRYING TO DEAL WITH
AND MAKE DECISIONS STARK COUNTY
HEALTH DEPARTMENTS AND.
EVERYTHING THAT THEY HAVE TO GO
THROUGH. I FELT COMPLETELY
HELPLESS IN REGARDS TO THESE
CARE FACILITIES THE STATE
CONTROLLED FACILITIES AND I
THINK PART OF THIS PROCESS-
MIGHT BE TO GIVE OUR LOCAL
CONTROL A LITTLE BIT MORE
TEETH. IN DEALING WITH BAD
FACILITIES THAT WE THEY HAVE A
MECHANISM BECAUSE THEY'RE THE
ONES THAT HERE. REALLY FROM THE
FAMILIES OF THOSE THAT ARE IN
THESE NURSING HOMES- THERE ON
THE GROUND MORE. AND I THINK
YOU KNOW I GOTTA AGREE WITH OUR
BUDGET CHAIR MISTER TEAM IN
REGARDS TO THAT FACT THAT THE
VOICES OF THOSE ON THE HOMES
AND THE VOICES OF THOSE FAMILY
MEMBERS DEFINITELY NEED TO BE
HEARD IN NEED TO BE FELT
ESPECIALLY BUYER EXECUTIVE
BRANCH AND I AGREE WITH DR
WOODS THAT. YOU KNOW THE
PURPOSE OF THESE HEARINGS IS TO
SHOW THAT TRANSPARENCY TO SHOW
THE PUBLIC THAT. YOU KNOW WE
ARE DOING OUR JOBS AS
LEGISLATORS WE WANT TO MAKE
SURE THAT THE EXECUTIVE BRANCH
ISN'T JUST WHIPPING THE PAN
WITH YET ANOTHER EXECUTIVE
ORDER. TO CHANGE THE WAY
FAMILIES ARE TAKEN CARE OF HERE
IN CALIFORNIA. THAT EVERYTHING
IS BALANCED THAT. THE INTENT IS
TO ENSURE BETTER CARE FOR. OUR
SENIORS FOR OUR FAMILY MEMBERS
FOR GRANDMA AND GRANDPA THAT
ARE IN THESE FACILITIES ARE MOM
AND DAD. THEN WE CAN DO BETTER
BECAUSE WHAT HAPPENED IN MARCH
AND HAS HAPPENED TO OUR SENIORS
IN THESE HOMES IS. HORRIBLE
AND- WE'VE SEEN THAT WITH THE
STRIKE TEAMS GOING DOWN AND
SPECIALLY IN OUR SOUTH VALLEY
AREA- DR EMIL I KNOW YOU HAVE A
LOT OF THE SAME CONCERNS WE
LOSING THE STRIKE TEAMS COME IN.
BUT WE HAVEN'T SEEN RESULTS
TURN AROUND QUITE AS QUICKLY AS
I THINK WE WOULD ALL HOPE. SO
I'M SURE HE WILL HAVE A VERY
DELIBERATE DISCUSSION WITH LOTS
OF QUESTIONS- AND I DO
APPRECIATE A DOCTOR WOULD VERY
POINTED THREE FOUR QUESTIONS AS
WELL SO I LOOK FOR TO THE
HEARING AND THANK YOU FOR
PUTTING IT TOGETHER. AND THE
FINAL MEMBER OPENING REMARKS
TRINITARIANS. THANK YOU CHEN
ARAMBULA- A VERY MUCH
APPRECIATE YOU CALLING ALL OF
US TOGETHER AND BRINGING
ATTENTION TO THIS IMPORTANT AND
TIMELY MATTER- AND QUITE
FRANKLY. AND OVERLOOKED ISSUE
FOR MANY DECADES- THAT'S JUST
BEEN EXASPERATED EXACERBATED
BECAUSE OF THE CURRENT PANDEMIC.
TO BRING US ALL TOGETHER SO
THAT WE CAN- CONTINUE-
PROVIDING THE OVERSIGHT
NECESSARY WHETHER IT WAS
THROUGH THE POLICY COMMITTEE
HEARING THAT WE HAD A COUPLE OF
MONTHS AGO ARE NOW THROUGH THE
BUDGET PROCESS AS WELL. SO
COUPLE OF POINTS THAT I JUST
WANTED TO MAKE- SENIORS HAVE
BEEN THE AGING COMMUNITY HAS
BEEN OVERLOOKED- FOR MUCH TOO
LONG AND IT SEEMS THAT NOW THAT
WE'VE BEEN PUTTING SOME
ATTENTION. WITH WITH THE- OF
LONG TERM PLAN AND- VARIOUS
BUDGETARY MOVEMENTS WE'VE TRIED
TO TAKE STEPS TO ADDRESS SOME
OF THE NEEDS BUT- IT'S STILL A
PATCHWORK. THAT HASN'T BEEN
SYSTEMATIZED AND WHEN YOU LOOK
AT HOW WE CAN CREATE A CATCH
ALL DIRECTORY A PATH OR BEING
WORKING ON THE PATH OF NO WRONG
DOOR OR MAKING SURE THAT THE
SYSTEM OF- SENIOR AND DISABLED
KEREN SERVICES WORKS RATHER
THAN. ADD YET ONE MORE PROGRAM
WHICH WE WILL KNOW EXACTLY
WHERE IT WOULD FIT IN. WE'RE
WE'RE NOW LOOKING AT A WHOLE
NEW PROGRAM WITHOUT A LOT OF-
DEPTH OR OR DETAIL. SO I DURING
THIS HEARING I'M GONNA BE
LOOKING AT SOME QUESTIONS
HAVING TO DO WITH DATA
COLLECTION. SPECIFICALLY
FINDING OUT. WHAT IS THE DATA
THAT'S EVEN DRIVING US TO GET
TO THIS POINT WHAT IS IT THAT
WE'RE TRYING TO ACHIEVE. AND
WHY IS IT WHAT IS IT THAT WE'RE
TRYING TO OVERCOME AND BASED ON
WHAT DATA. IF WE'RE NOT EVEN
SEEING THOSENUMBERS I'M JUST
WONDERING HOW SOME OF THESE
DECISIONS ARE. BEING DETERMINED
NEXT IS THE BENEFIT FRAMEWORK
AND TARGET POPULATION AGAIN
HAVING TO DO WITH THE CRITERIA-
CURRENT NEEDS WHICH ALSO IS
GOING TO BE BASED ON DATA
COLLECTION. AND THEN THE
OVERSIGHT AND LEGISLATIVE ROLE
SO THESE ARE THE AREAS THAT I'M
GONNA BE LOOKING AT CAREFULLY
AND I WILL. CONTINUE TO WORK
WITH THE ALL OF YOU HERE AS
WELL SO THANK YOU. THANK YOU
MEMBERS WITH THAT I WANT TO
BEGIN OUR FIRST PANEL WHO ARE
WAITING FOR US AND THE WITNESS
VIDEO ROOM. ANDFOR THE
DEPARTMENT OF FINANCE
REPRESENTATIVE JACOB LAMB WHO
IS ON THE DL LAUGH WHEN THIS
VIDEO RUN. OUR FIRST PANEL WILL
CONSIST OF WILL LIGHT BORN
DIRECTOR OF THE DEPARTMENT OF
HEALTH CARE SERVICES. KIM MCCOY
WADE DIRECTOR OF THE CALIFORNIA
DEPARTMENT OF AGING AND JACOB
LAMB PRINCIPLE PROGRAM BUDGET
ANALYST WITH THE DEPARTMENT OF
FINANCE. MORNING IN. I WILL
LIKE TO WARN AND THE DIRECTOR
OF THE DEPARTMENT OF HEALTH
CARE SERVICES. AND DR ARAMBULA
IT IS A REAL PLEASURE TO BE
WORKING WITH YOU ONCE AGAIN.
TICKET COMMITTEE MEMBERS AS
WELL- AND SURE WAS VERY ANCIENT
RENTS. AND LOOK FORWARD TO. OUR
WORKING RELATIONSHIP WE BEEN
ASKED NOT TO. ESPECIALLY PRISON
THE LONG TERM AT HOME PROPOSED
BENEFIT. BUT RATHER RESPOND TO
THE SERIES OF QUESTIONS ABOUT
SO I. START FROM THE ASSUMPTION
THAT THE COMMITTEE ON AND THE
CHERISHED I'VE HAD THE
OPPORTUNITY TO READ OUR- ARMED
CENTURY VERSION TO DOCUMENT
THIS IN THE ASSEMBLY PACKAGE-
OF JUST A NOTE ON THERE WILL BE
A VERSION THREE DOCUMENT IN
SEPTEMBER WHICH AGAIN RESPONSE
TO THE- INPUT FROM STAKEHOLDERS
AND THE- DOZENS AND DOZENS OF.
MEETINGS ARE HOLDING AROUND
THIS AND I ANTICIPATE THAT THE
FOLLOWING OF. SCHERING THAT
DOCUMENT WITH STAKEHOLDERS WITH
OUR PROVIDER COMMUNITY CENTER.
AT ALL WE WILL. HAVE A FOURTH
DOCUMENT PROBABLY LET'S WAS
SEEMING THAT THE DETERMINATION
TO THE PROPOSED BENEFIT IS
FEASIBLE- IT WOULD BE A DESIGN
DOCUMENT THAT WOULD BE
ULTIMATELY SUBMITTED ON A
HOUSE- NINETEEN FIFTY NINETEEN
FIFTEEN I- STATE PLAN AMENDMENT
OF THE DODD TO GET TO WE DEEP
AT THE POINT OF DOING IT AS A
STATE PLAN AMENDMENT. IS THAT
IS AN UNCAPPED BENEFIT THAT IS
CAN BE MADE AVAILABLE ON
STATEWIDE AT THE PACE AT WHICH
ALL CAPACITY IS DEVELOPED ALL
SO WITH THAT SORT OF. THING
MINIMAL OF THE OF THE GOLD LET
ME. ADDRESS THE QUESTIONS IN.
BOTH BY THE COMMITTEE STAFF ON.
FIRST BEING HOW DOES THIS
RESPOND TO THE COPIOUS NINETEEN
AND DUMPED ALL IN VERY LARGE
PART THIS WAS MOTIVATED BY THE
NEED TO REDUCE- OUR POPULATION
IN SKILLED NURSING BOTH BY
MAKING IT POSSIBLE FOR PEOPLE
WHO COULD EXIT. ALONG WITH A
STRONG BLEND OF SOCIAL CARE
SERVICES LIKE I'VE JUST S. PLUS
SKILLED MEDICAL CARE ALONG TO.
EXIT THE SKILLED NURSING
FACILITIES FOR NOT GO INTO
SKILLED NURSING FACILITIES-
FOLLOWING HOSPITAL DISCHARGE OR
ALL HEALTH DETERIORATION WHILE
LIVING IN COMMUNITY THE GOAL OF
COURSE IS TO. MAKE IT POSSIBLE
FOR PEOPLE TO BE LIVING AT HOME
LIVING IN COMMUNITY
PARTICIPATING FULLY ALL BUT
HAVING THEIR- REAL NEEDS MET SO
THAT THEY ARE SAFELY DOING SO.
AMONG THE. THIS QUESTION WAS
POSED TO US WOULD BUT JUST GO
BACK TO THE FIRST QUESTION
WHILE THAT WAS THE INITIAL BE
CERTAINLY BE ORIGINATING IN THE
IMPETUS FOR THE DEVELOPMENT OF
THE BENEFIT. ON LONG TERM CARE
HOME WILL PROVIDE THE MISSING
PIECE IN THE CARE CONTINUUM DOT
ON CERTAINLY THE HUMAN
SERVICES. SOCIAL WORK
PROFESSIONALS LONG LOOKED FOR
WHICH IS YOU KNOW THE UP THE
ABILITY NOT TO HAVE PEOPLE HAVE
TO CHOOSE. WELL I HAVE NO
CHOICE AND TO WIND UP IN A
SKILLED NURSING FACILITY IF
THAT IS NOT WHAT THEY WANT
AGAIN THIS IS NOT A- IN ANY
SENSE A MANDATORY PROGRAM FOR
ANYONE BUT- IT WILL POVIDE.
THE OPTION FOR. ALL WHO PREFER
TO LIVE WITH SERVICES BROUGHT
INTO THEIR HOME AND INTO THE
COMMUNITY. HELLO D. R. SECOND
QUESTION WAS POSED BY THE- OF
THE STOCK WAS IS THIS PROPOSAL
ABOUT COST CONTAINMENT THE
ANSWER IS NO I MEAN IT IS.
INTENDED AS I SENT TO BOTH
DECOMPRESS- THE SKILLED NURSING
POPULATION AT THE TIME OF AN
INFECTION RATES ARE DANGEROUSLY
AUDIENCEARE AND THEN YOU NO
LONGER TERM TO HAVE THE-
ALTERNATIVE GOING INTO. THE
FUTURE. FOUR OUR PEOPLE TO BE
ABLE TO MAKE HOICES ON IT IS
OBVIOUSLY BE THE METHOD BY
WHICH IS FINANCED IS. MEDIC CAL
RATES FOR SKILLED NURSING CARE
WHICH YOU KNOW DEPENDING ON THE
TYPE OF FACILITY RANGE BETWEEN
ABOUT TWO THOUSAND TWO HUNDRED
AND THIRTY DOLLARS PER DAY TO
FOUR HUNDRED AND EIGHTY DOLLARS
A DAY- SO THERE'S YOU KNOW.
THERE THE ABILITY TO CREATE A-
PER DIEM RATE FOR LONG TERM
CARE TOLL EXISTS WITHIN THAT.
THE FACT THAT COST FRAMEWORK.
THE THIRD QUESTION WE'VE BEEN
ASKED TO ADDRESS IS THE FACT
THAT THIS PROGRAM WOULD HAVE ON
ALL MAJOR BASED SERVICES LIKE
MSSP C. BASS C. C. T. IT'S R.
O. FRANKLY THAT THERE ISN'T A
DIRECT EFFECT IN. THOSE CASES-
IT WAS NEVER INTENDED TO BE OF
A SEA BASS OR NEMESIS P.
REPLACEMENT YOU KNOW THE-
TIMING IS EVERYTHING I SUPPOSE
AND THE FACT THAT THE PROPOSAL
EMERGED WHEN IT DID. I THINK
HAS BEEN ASSOCIATED IN PEOPLE'S
MINDS WITH SOMETHING THAT WAS
THAT IS NOT THE
ADMINISTRATION'S ATTENTION WELL.
AGAIN IT'S INTENDED AS A NEW
OPTION THAT NONE OF THOSE CAN
FULLY SERVE TODAY. NOW IN TERMS
OF WHAT I SEE IN THIS
ANTICIPATE WE WILL SEE AS WE
IMPLEMENT LONG TERM CARE TO ALL
SHIPPING FEES. IS THAT A NUMBER
pMAY ACTUALLY BE PROVIDERS IN
THE LONG TERM CARE BENEFIT
STRUCTURE I MEAN IF YOU THINK I
MEAN CERTAINLY I OBSESS
CONTINUES TO BE A- TOP
PROVIDER. ON PARTICULARLY IF
YOU THINK OF PROGRAMS LIKE THE
PACE ORGANIZATIONS ALL WHO DO
ALL ON A SMALL SCALE VERY MUCH
ON WHAT LONG TERM CARE HOME IS
ON THE THAT IS. ALMOST SIMPLY
RICK REQUIRES ANOTHER LINE OF
BUSINESS FOR THEM THE SAME I
THINK IT'S TRUE OF SEA BASS ON
BUT THEY ARE VERY LIKELY TO BE
PROVIDERS IN IT FOR CARE
COORDINATION PURPOSES. MSSP MAY
HAVE A ROLE AGAIN IN EACH
INSTANCE THOUGH. THEY WOULD
HAVE TO BE DOING A SLIGHTLY
DIFFERENT LINE OF BUSINESS THAN
THEY'RE DOING NOW BECAUSE THE-
PARTICIPANTS COULD NOT BE IN.
BOTH A WAIVER PROGRAM AND THE-
STATE PLAN PROGRAM AT THE SAME
TIME SO ON BUT IN OUR
CONVERSATIONS WITH OF THE
PROVIDER NETWORK SO CARAPACE OF
PHOTOGRAPHY I THINK THERE'S YOU
KNOW. A COMPLETE APPRECIATION
OF THE FACT THAT THEY'RE THEY
THEY HAVE A SIGNIFICANT ROLE TO
PLAY IN THIS MOVING FORWARD.
THE FOURTH QUESTION WE WERE
ASKED TO. ADDRESS IT. AND
HIGHLIGHTED THIS MORNING IN AN
OPENING REMARKS IS WHETHER THE
ADMINISTRATION IS WILLING TO
DELAY THE PROPOSAL TO NEXT YEAR
SO THAT IT CAN BE- CHARACTER
WITH A POLICY BUDGET BILL
PROSPECTS. ALL DEPARTMENT
HEALTHCARE SERVICES HAS ALREADY
AS YOU KNOW ALL DEBATE THE FLOW
OF THE OF THE PROCESS PRECISELY
SO AS TO. GET MORE ROBUST.
ENGAGEMENT WITH STAKEHOLDERS
CONSUMER REPRESENTATIVE GROUPS
ETCETERA ALL AND THE WE FULLY
INTEND TO. INCORPORATE THAT IN
PUT THAT AWARENESS INTO THE-
INTIMIDATED A PROGRAM DESIGNED
THE BENEFIT DESIGN AS IT GOES
FORWARD- WE'RE CERTAINLY. ARE
YOU OPEN TO- CONTINUING TO
INFORM THE LEGISLATURE CUTS OFF
THE LEGISLATURE ON COME BACK IN
BUDGET HEARINGS REPORT ON
PROCESS ALONE INFORMED JAIL BE
SEAT BEFORE THEY OF. STATE PLAN
AMENDMENT IS ESTIMATED SO LONG.
I'M GOING TO DEFER AUSTIN FIVE
ON WHICH IS THE FISCAL- TO THE
DEPARTMENT OF FINANCE. CHECK A
BLANK- FOR. GOOD MORNING
CHAIRING COMMITTEE MEMBERS
JACOB ONE PARMA FINANCEIN
REGARDS TO YOUR FIFTH QUESTION
ABOUT THE FISCAL ANALYSIS THE
PROPOSAL I THINK DIRECTOR LIKE
PORN IS NOT A GOOD JOB
EXPLAINING WHAT THE GENESIS OF
THE PROPOSAL WAS AND HOW IT'S
AIMED AT TRANSITIONING
INDIVIDUALS OUT OF A SKILLED
NURSING FACILITY INTO THE
COMMUNITY IDENTIFYING
INDIVIDUALS WHO ARE
TRANSITIONING OUT OF THE
HOSPITAL AND POTENTIALLY INTO A
SKILLED NURSING FACILITY AND
INTERCEPTING INDIVIDUALS WERE
IN THE COMMUNITY AND LIKELY TO
END UP IN A SKILLED NURSING
FACILITY. AT THIS TIME WE DON'T
HAVE A SPECIFIC FISCAL ANALYSIS
TO SHARE WITH YOU BUT BASED OFF
THE TRANSITION OF INDIVIDUALS
FROM SKILLED NURSING FACILITIES
TO THE COMMUNITY WE THINK THAT
WILL HAVE A NET SAVINGS AFFECT
ON THE STATE EXPENDITURES. FOR
THIS PROGRAM. WHEN WE GO TO THE
FEDERAL GOVERNMENT TO ASK FOR
APPROVAL FOR BENEFITS SUCH AS
THIS WE NEED TO DEMONSTRATE
COST NEUTRALITY. AND THE WAY I
DESCRIBE IT WOULD SHOW THIS
FEDERAL GOVERNMENT THAT. IT IS
ON AVERAGE LESS EXPENSIVE TO
PROVIDE SERVICES IN THE
COMMUNITY THAT IS TO PROVIDE
SERVICES AND SKILLED NURSING
FACILITY. OBVIOUSLY ANY SAVINGS
GENERATED FROM THIS PROPOSAL
WOULD NEED TO BE. WHAT HAVE TO
OFFSET ANY STATE OPERATION
COSTS OR COST TO PROVIDE THIS
BENEFIT IN THE COMMUNITY. AS A
STAKEHOLDER PROCESS CONTINUES
TO DEVELOP AND THE FINAL
BENEFIT DESIGN THIS PACKAGE
WILL HAVE A MUCH BETTER IDEA OF
WHAT THOSE POTENTIAL COSTS
WOULD BE AND WHAT THOSE
POTENTIAL SAVINGS WOULD BE.
AGAIN THE DIFFICULT PART FOR
THIS IS IDENTIFYING WHAT
PORTION OF THE POPULATION IS
MOVING DIRECTLY OUT OF A
SKILLED NURSING FACILITY INTO
THE COMMUNITY. VERSUS THE- THE
COST AVOIDANCE THAT WE WHICH
WHAT IS SHE FROM INDIVIDUALS
MOVING OUT OF. FROM INDIVIDUALS
MORE FROM THE COMMUNITY INTO A
SKILLED NURSING FACILITY. SO
THOSE ARE THE TYPESOF
QUESTIONS THAT WE'RE LOOKING
INTO RIGHT NOW I'M TRYING TO.
PIN DOWN SO WE CAN HAVE A MUCH
MORE SPECIFIC FISCAL ANALYSIS
FOR YOU ALL AND WE WILL BE
HAPPY TO SHARE THAT WITH YOU AS
THE BENEFIT. DESIGN IS
FINALIZED THROUGH THE
STAKEHOLDER PROCESS. THANKS. SO
BEING BACK TO THE MAIN
QUESTIONS OF THE PROPOSED ON.
FIFTY UNDERLYING QUESTION OF
COURSE IS WHAT ARE THE- SHORT
TERM IMMEDIATE THINGS THAT CAN
BE DONE- TO HELP. ADDRESS
ISSUES OF CROWDING IN
FACILITIES SUTTER AND- WE
SHARED WITH THE LEGISLATURE
LATE LAST WEEK- DHS'S SORT OF
ACTION PLAN FOR ADDRESSING THE
PARTICULAR URGENCY IN THE
CENTRAL VALLEY- AS YOU KNOW THE-
SIGNIFICANT INCREASE IN CASES
AND- JAMES CARVILLE SAID MADERA
FRESNO STANISLAUS ANIMAL
KINGDOM TOMORROW ON HAS BEEN A-
MAJOR FOCUS OF THE
ADMINISTRATION TO TRY TO ALONG
I HAVE ON THE GROUND RESPONSES.
ALL IN THE- PROGRAMS THAT DH CS
IT HAS A RESPONSIBILITY FOR ONE
WE ARE GOING TO BE WORKING WITH
FEDERAL STATE AND LOCAL
PARTNERS UP TO PURSUE YOU ALL
ACTION ITEMS THAT LEVERAGE OUR
EGGS EXISTING HOME COMMUNITY
BASED SERVICES. ALONG TO REDUCE
AND AVOID NURSING HOME.
POPULATIONS AND WHAT WHAT I'M
GOING TO DESCRIBE RIGHT NOW ARE
THE THINGS THAT ALONG OR WITHIN
OUR EXISTING PROGRAMS ALREADY
ALONG AND WITHIN THE TWENTY
TWENTY BUDGET ACT ALL. BECAUSE
WE WOULD BE APPROACHING THESE
HAS ON DISASTER. THE EMERGENCY
WAIVER REQUEST TO CMS WE
BELIEVE WE CAN SUBMIT THEM
PROBABLY HAVE. COMPLETED VERY
QUICKLY ARM THE THERE ARE FOUR
THINGS I'M GOING TO QUICKLY RUN
THROUGH THAT WE ARE DOING THE
FIRST IS ALL OF A CENTURY
SETTING UP A SORT OF A RAPID
RESPONSE INTENSIVE CASE
MANAGEMENT SYSTEM ALMOST SORT
OF A ROAD TO HOME IN WHICH-
WE'RE WORKING WITH THE MANAGED
CARE PLANS WELL AND THE H. C.
B. S. ROVIDERS IN THE CENTRAL
VALLEY COUNTIES ALL TO. QUICKLY
IDENTIFY PEOPLE WHO ARE IN
MOVEMENT BETWEEN STAGES OF CARE
TO TRY TO ENSURE ABOUT ALL TO
THE GREATEST EXTENT POSSIBLE
THE EXISTING PROGRAMS PARENT
WITH THE CHANGES ALL AT THE
MOMENT- CAN BE LINKED TO THEM.
AVOID ALL. BLENDING IN WINDING
UP IN THE S. ALL. THE NEXT OF
THESE OF BEGINS PROCESS OF
EXPANDING THE CAPACITY OF.
EDITED BEGINS FIRST BY
EXPANDING THE ABILITY OFF THE-
INSTITUTIONAL TRANSITIONS TO BE
RE PRIORITIZED COVERS THE ALL.
OUR TIES ASIAN REQUIREMENTS
THAT EXIST FOR THE- IT SHOULD
BE S. R. PROVIDERS PARTICULARLY
ALL THE- ASSISTED LIVING WAIVER
PROGRAMS CENTER IS THAT IT MUST
BE PEOPLE WHO HAVE BEEN IN
INSTITUTIONAL SETTINGS FOR
GREATER THAN SIXTY DATES ON IN
FACT THE OPPORTUNITY TO MOVE
QUICKLY MAY BE OFFER PEOPLE
WORK BUT THEY'RE SHORT PERIODS
OF TIME. AND SO THAT IS ONE OF
THE THINGS WE WILL ALL BE
MOVING ALL QUICKLY TO TRY TO DO
ALL. FOR THE ASSISTED LIVING
WAIVER ON. SLOT CAPACITY IS
LIMITED BUT. IT IS STILL
AVAILABLE I MEAN THEY'RE THE
IT'S NOT EXHAUSTED- HOWEVER IN
THE CENTRAL VALLEY THE WAIVER
IS ONLY AVAILABLE IN FRESNO
KERN AND SAN JOAQUIN SO TO
ADDRESS THE NEEDS OF RESIDENTS
AND OTHER OF CENTRAL VALLEY
COUNTIES. WE WOULD HAVE TO.
INDIVIDUALS WOULD HAVE TO BE
WILLING TO SORT OF RELOCATE
AND- RECEIVE THEIR SERVICES IN
KAREN FRESNO STOCKTON OR OR
BAKERSFIELD. ALL RIGHT THIS IS
SOMETHING UP MENTION PROBABLY A
COUPLE OF TIMES MORE ALONG WITH
THE EXISTING- HOME COMMITTEE
BASED SERVICES ON THERE ARE NOT
STATEWIDE FOOTPRINTS IN ALL OF
THE WHICH IS ONE OF THE THINGS
THAT BE. OF LONG TERM CARE
HOMES IN NINETEEN FIFTEEN I
PROGRAM WOULD ULTIMATELY BE
STATEWIDE- BENEFIT SYSTEM. FOR
THE. MSSP PROGRAM. WE'RE
WORKING WITH THE CALIFORNIA
DEPARTMENT ON AGING DIRECTOR
WAIT FOLLOW ME HERE- ON THE
TRUTH IDENTIFIED ON USED MSSPS
LOTS OF AND OF. TO THE EXTENT
THERE IS CAPACITY TO OPERATE
THEM TO MOVE THOSE INTO THE
HIGH IMPACT COUNTIES. ALL AND
THEN WE'RE WORKING VERY CLOSELY
WITH ALL TO PARTNER WITH THE
PACE ORGANIZATIONS ARM TO GET
SOME MODIFICATIONS IN THE
REGULATIONS THAT GOVERN HOW
THEY CAN FUNCTION ON TROOP TO
ALLOW THEM TO RESPOND MORE
READILY- SO. WORKING ON THE
SORT OF IT. THE CONNECTION
BETWEEN PACE AND OF COMMUNITY
CARE TWENTY COULD. CALIFORNIA
CONTINUITY TRANSITIONS ON
PROGRAM WHICH OF COURSE IS THE-
CORRECT. TRANSACTION SERVICES
THAT CAN SUPPORT OF HOME BASED
MODIFICATIONS AND- I DON'T LIKE
THAT- PARTNERING WITH- TASTE TO
REDUCE THE ASSISTED LIVING WAIT
LIST- BY FACILITATING TARGETED
MAILERS TO INDIVIDUALS ALL OF
TO. WORK WITH THEM AND WITH
ASSISTED LIVING FACILITIES AND
WORKING WITH CMS TO OBTAIN
WHAT'S CALLED A BENEFITS
IMPROVEMENT AND PROTECTION ACT
WAIVER CURRENTLY. UNDER THE
BENEFITS IMPROVEMENT PROTECTION
ACT PACE ORGANIZATIONS CANNOT
RECRUIT FOR CLIENTS THEY CAN'T
ADVERTISE ON WHAT WE WILL BE
DOING IS SEEKING A WAIVER FROM.%
CMS SO THAT THE PACE
ORGANIZATIONS THAT HAVE
CAPACITY CAN. B. DIRECTLY
WORKING WITH HOSPITAL DISCHARGE
SYSTEMS AS WELL- SKILLED
NURSING OF SYSTEMS TO MOVE
PEOPLE INTO THE EXISTING PACE
KERA TOLD SYSTEMS OF SERVICE.
WITH THAT I THINK I'LL CONCLUDE
MY- RESPONSES TO THE QUESTIONS
AND DOES. I BELIEVE WE'RE GOING
TO GO DIRECTLY TO THE DIRECTOR
OF WADE THROUGH. TO RESPOND.
THANK YOU MEMBERS AND SHARE. I
THANK YOU MOST OF ALL FOR
CONVENING THIS FORUM TO FOCUS
ON OUR OLDEST RESIDENTS AND
PEOPLE DISABILITIES WHO ARE
BEARING THE BRUNT OF THE KIND
OF VIRUS PANDEMIC A WE ARE VERY
MINDFUL THAT THIS IS A VERY
IMPORTANT TOPIC WORTH GRATEFUL
FOR THE HEARING ASSEMBLY MEMBER
WOULD CALL TWO WEEKS AGO AND
CALL US BCK TO CONTINUE THIS
CONVERSATION. AND REALLY
BROUGHT IN THE LANDS TO LOOK
BOTH AT WHAT WE CAN DO WITHIN
THE FOUR WALLS OF THE SKILLED
NURSING FACILITIES AND I'M GLAD
YOU'VE ALSO CALLED MY COLLEAGUE
FROM THE PRIVATE PUBLIC HEALTH
TO SPEAK TO ALL THE EFFORTS
THERE WE ARE EXTRAORDINARILY
MINDFUL OF THE LOSS OF LIFE THE
THIRTY SEVEN HUNDRED PLUS
PEOPLE WHO HAVE DIED IN
RESIDENTIAL FACILITIES. AND THE
HUNDRED THIRTY PLUS- WORKERS
WHO HAVE DIED AS WELL SO THIS
IS TOP OF MIND FOR ALL OF US IN
THE ADMINISTRATION AND THERE
ARE MULTIPLE STRATEGIES- A PACE
UP WITHIN THE FOUR WALLS DOUBLE
TALK ABOUT MORE IN THE SECOND
PANEL BUT ALSO HOW DO WE KEEP
PEOPLE HOME THE COMMUNITY AS
THEY WISH HOW DO WE SUPPORT
THEIR FAMILIES. THEIR HOUSING
NEEDS THEIR ISOLATION NEEDS
THEIR HEALTHCARE NEEDS HAVE ALL
BEEN TOP OF MIND SO I'LL SPEAK
BRIEFLY TO QUESTION SIX AND
SEVEN SO WE CAN THEN OPEN. THE
FORM. AS I MENTIONED THE
IMMEDIATE ACTIONS ON WITHIN
SNIFFS OF COURSE ARE WITHIN
CITY PH AND THEY WILL. SPEAK
MORE TO THE INFECTION CONTROL
THE ENFORCEMENT THE TESTING AND
THE DATA STRATEGIES THAT THEY
HAVE BEEN DEPLOYING AND
CONTINUE TO DEPLOY. BUT IT'S
EIGHTY EIGHT WOULD BE LOOKED UP
THREE THINGS THAT WE HAVE
FOCUSED ON. OF COURSE BECAUSE
THE LONG TERM CARE- LET'S WE
WILL ALSO HEAR FROM THE
ASSOCIATION LATER TODAY. BUT
OUR PRIMARY FOCUS RIGHT NOW IS
ONE. CONTINUING TO RECEIVE.
COMPLAINTS AND CALLS AND
CONCERNS AND INVESTIGATING BY
TELEPHONE AND BY VIRTUAL. A
FOLLOW UP BUT JUST AS IMPORTANT
AS RE ENTRY. GUIDANCE WAS
ISSUED IN JUNE PROVIDING FOR
SPECIFIC PROTOCOLS FOR REENTRY
BUT- WE ARE ALL STRUGGLING TO
GET MORE EYES AND EARS INTO THE
FACILITIES AND OUR- DOCTOR
EXPLORING NEW PILOTS
PARTICULARLY THE CENTRAL VALLEY
POSSIBLY LOS ANGELES COUNTY. TO
TRY TO GET MORE OF OUR OWN BUT-
AND ALLIED STAFF. INTO
FACILITIES FOR EYES AND YOUR
WELLNESS CHECKS ISOLATION
CHECKS- WE KNOW THE VIRTUAL- IS
WORKING BUT WE ALSO KNOW WE
NEED TO DO MORE. ON THE SECOND
THING THAT WE ARE DOING IS. A
HEARING MORE FROM ALL THE
EXPERTS ON CONGREGATE CARE CDA
WAS. UNFORTUNATE WITH AGENCY TO
CONVENE A BRIEFING IN JULY.
APPLY SURELY TERRINGTON FROM
UCSF AND OTHER ACADEMICS WHO
HAD. PROPOSED MULTIPLE
RECOMMENDATIONS TO THE
ADMINISTRATION. AND SINCE THEN
WE'VE STARTED AWEEKLY
GERIATRIC ADVISORY CIRCLE WITH
UCSF AND USC EXPERTS TO. BE
THAT SOUNDING BOARD TO THE
ADMINISTRATION. AND WE ALSO
JUST CONVENE- A GROUP OF TEN
EXPERT STAKEHOLDERS
REPRESENTING FAMILIES.
RESIDENTS STAFF AND OPERATORS I
WILL BE BE CONVENING THEM AGAIN
AND- AGAIN FOR THAT CONTINUED
COLLABORATION PROBLEM. SOLVING
IN THIS CRISIS MOMENT. AND THEN
AGAIN AS YOU OF IN OTHER FORMS
WE HAVE TO CONTINUE TO LIFT UP
IS OUR HOME AND COMMUNITY BASED
SERVICES. DEPARTMENT OF AGING
LIKE ALL ACROSS AND THE
ADMINISTRATION HAVE BEEN
REDESIGNED TO MEET THE MOMENT.
A COMMUNITY BASED ADULT
SERVICES HAVE GONE REMOTE AND
DOORSTEP. I'M M. S. S. P. AGAIN
ON MAKING ORE PHONE CALLS
ARRANGING FOR MORE DELIVERY OF
MEDICINE AND DELIVERY OF FOOD-
ENGAGING IN MORE ISOLATION
PREVENTION ACTIVITIES. ALL TO
MAKE SURE THAT THE SERVICES
CONTINUE AND THEN WITH THE
pSPENDING EXPAND. TO MEET NEW
AND DEEPER NEEDS AND LIKE
EVERYONE IN THE ADMINISTRATION
WHAT WE ARE WORKING STATEWIDE
WE ARE ALSO FOCUSING MORE ON
THE CENTRAL VALLEY AND OF
CONVENE. ON GROUPS FROM OUR
AREA AGENCIES ON AGING- BUT OUR
MSSP INTERCITY BUS PROVIDERS
AND CENTRAL VALLEY TO HEAR WHAT
THEIR PROBLEMS ARE AND TO TRY
TO. PROBLEM SOLVE WITH THEM AS
QUICKLY AS POSSIBLE. THE OTHER
THING I WANT TO SPEAK TO A
QUESTION SEVEN ABOUT HOW WE CAN
DO MORE TO ENSURE THE FOLKS ARE
AGING. IN PLACE SAFELY DURING
THE COVER CRISIS AS MUCH AS
POSSIBLE. ASSEMBLY MEMBER
NAZARIAN SAID IF PASSED WOULD
BE OPEN TO HEARING AND TALKED
ABOUT THE PATCHWORK OF AGING
SERVICES WHICH IS WHY THE
GOVERNOR CALLED. FOR A MASTER
PLAN FOR AGING IN THE EXECUTIVE
ORDER LAST YEAR. THAT PATCHWORK
HAS MANY MANY BRIGHT SPOTS BUT
IT IS NOT A COORDINATED
INTEGRATED SYSTEM. THAT WE NEED
FOR THE FUTURE AND THAT WE NEED
FOR THIS MOMENT. AND SO THE
MASTER PLAN FOR AGING IS EVEN
MORE IMPORTANT THAN EVER AND
THAT WORK CONTINUES APACE WITH
HUNDREDS OF RECOMMENDATIONS
FROM STAKEHOLDERS PRESENTED
LAST TUESDAY'S. MEETING BUT
WE'RE NOT JUST PLANNING WE'RE
DOING OP PLANNING WILL NOT FEET
PEOPLE AND KEEP PEOPLE SAFE
RIGHT NOW SO WE ARE DOING. ON
ADDITION TO ALL THE HOME
COMMUNITY SERVICES WE JUST
SPOKE ABOUT WERE ALSO LIFTING
UP OUR WORK ON ISOLATION. AS
OLDER ADULTS STAY HOME THE
LONGEST I'M PROBABLY WILL BE
HOME THE LONGEST- GIVEN WHAT WE
KNOW ABOUT PUBLIC HEALTH. SO
WITH CHECKING CAMPAIGNS
POSTCARD MAILINGS WITH A. R. P.
TO THE TWO MILLION PEOPLE OVER
EIGHTY IN OUR STATE. THE TWENTY
FOUR SEVEN FRIENDSHIP LINE TO
CALL ANY TIME WHEN YOU'RE
ADULTS. AND NEW ISOLATION WORK
WITH DIGITAL DIVIDE THE
GOVERNOR'S EXECUTIVE ORDER ON
FRIDAY SPECIFICALLY CALLING OUT
OLDER ADULTS. AND THE NEED TO
BRIDGE THE DIGITAL DIGITAL
DIVIDE THERE AND AGAIN MORE
CARE SPENDING GOING. SO MORE
HAS BEEN HAPPENING MORE IS
COMING BUT THERE'S STILL MORE
TO BE DONE WE LOOK FORWARD TO
THE CONVERSATION. TODAY WITH
YOU ABOUT THAT THANK YOU. THANK
YOU. DIRECTOR TO ONE OF SEE IF
JACOB LAMB WHO. ANY BEFORE WE
WENT TO MEMBER QUESTIONS. AND
NO ADDITIONAL COMMENTS AT THIS
TIME THANK YOU. DO MEMBERS HAVE
QUESTIONS OF THIS PANEL. DOCTOR
WHAT THANK YOU THANK YOU VERY
MUCH TO THE PANEL- APPRECIATED-
I GUESS THE FIRST QUESTION I
HAD WOULD BE FOR DIRECTOR
LIGHTFOOT AND THAT WAS- BECAUSE
I WILL BE HONEST WITH YOU IT
WASN'T REALLY CLEAR US WHEN
THIS BEGAN TO ROLL OUT THIS
FELT LIKE THIS WAS GOING TO BE
A REPLACEMENT FOR A LOT OF
PROGRAMS BUT WHAT I HEARD
DIRECTOR LIFE WOULD SAY WAS
THAT THIS IS ANOTHER. OPTION
PART LIGHT LIGHT POOR EXCUSE ME
I'M SORRY I'M THINK YEAH. MY
APOLOGIES DIRECTOR LIKE FOREIGN.
I ANSWER LIGHT ANYTHING. HI
IT'S NOT INTENDED AS A
REPLACEMENT- IT AND IT WOULDN'T
DO THE SAME THINGS THAT THOSE
PROGRAMS ARE DOING- THE SORT OF
KNOWLEDGE ON TIMELINESS PERHAPS
ITS EMERGENCE BUT- I WOULD
REALLY LIKE TO EMPHASIZE THAT
THIS IS NOT INTENDED AS A
REPLACEMENT FOR. THE EXISTING
HOME COMMUNITY BASED SERVICES.
SO I UNDERSTAND THAT- YOU'RE
STILL CONSIDERING WHETHER OR
NOT TO INCLUDE THE DUAL
ELIGIBLES IN THIS WITH TWO
THIRDS OF MEDICAL RESEARCH
SENIORS THE RECIPIENTS BEING
DUAL ELIGIBLES WHERE ARE YOU IN
THAT PROCESS. I THINK THAT THAT
DECISION HAS BEEN TAKEN THAT WE
WILL DEFINITELY BE INCLUDING
THE DO A LOT OF TROUBLES- AND
THE- YEAH IF IT WAS AMBIGUOUS
AND VERSION TWO. ALL IT WILL BE
UNAMBIGUOUS AND VERSION THREE
SO THERE WILL BE A SAVINGS TO
THE FEDERAL GOVERNMENT DO WE
GET A SHARE OF THAT. WELL WE'RE
GOING TO HAVE TO WORK WITH. THE
FEDERAL GOVERNMENT TO DEFINE
HOW- THE MEDICARE. BENEFIT
INTERACTS WITH OF THIS AYE AYE
I HONESTLY DON'T HAVE THE
ANSWER YET. SO AND THEN SO WHO
IS GONNA BE PROVIDING THE
SERVICES BECAUSE BY IN THE
ORIGINAL PROPOSAL- THERE WAS
GOING TO BE A LICENSURE
REQUIREMENTS AND NOW WITH THE
WITH THE SPA. YOU'RE GONNA BE
ABLE TO BY PASS THAT SO I HAVE
A COUPLE CONCERNS WHO'S GONNA
BE BY THE SERVICES AND THEN
WHERE IS THE OVERSIGHT AND
ENFORCEMENT OF REGULATIONS. ON
ON THOSE PEOPLE BECAUSE IF IT
DOESN'T GO THROUGH THE
LEGISLATIVE PROCESS AND DOESN'T
GO THROUGH REGULATION- THE
FEELS LIKE YOU COULD HAVE A
BUNCH OF PEOPLE RIDING SERVICES
WITH NO OVERSIGHT. SO CAN YOU
HELP ME UNDERSTAND THAT ONE.
THE PROVIDERS THAT WE ARE
ANTICIPATING BEING INVOLVED IN
THIS ARE ALREADY SORT OF
INCENSE LICENSED AND
CREDENTIALED ALL IN. THE SPACE
OF HOME HEALTH AND IN THE CASE
OF THE H. BE US ALL PROGRAMS
ALL. IN THEIR SPECIALITIES IN
THE MEDICAID MANAGED CARE.
REQUIREMENT ALONG WITH THE OF
COURSE LOOKING TO THE- PLANS TO
PLAY THE SORT OF THE
COORDINATOR. OF AN OVERSIGHT
ROLE IN THE FEE FOR SERVICE
ARENA THOSE BE DIRECT
RELATIONSHIPS AND CONTRACTS
BETWEEN DH CS AND ALL PROVIDERS
IN. EACH LOCALITY THAT WERE
CARRYING IT OUT. SO I GUESS AND
THEN THE FINAL QUESTION IS. AND
THE PART THAT SEEMS TO BE THE
MOST VAGUE TO US IS WHAT ARE
THE BENEFITS- AND YOU KNOW HOW
ARE THEY GOING TO BE YOU KNOW
DIFFERENT FROM WHAT'S CURRENTLY
PROVIDED THROUGH- OTHER
PROGRAMS. THE BENEFITS LET ME
BE CLEAR OUR BLEND OF BOTH. ALL
SOCIAL CARE SERVICES THAT ALL.
I JUST S. AND ATTENDANT CARE
ASSISTANCE WITH DAILY LIVING
ALL OF ALL MODIFICATIONS THOSE
SORTS OF SERVICES. WILL THE
AVAILABILITY OF SKILLED MEDICAL
CARE WHICH IS NOT AVAILABLE IN
MOST INSTANCES CURRENTLY HAVING
THE AVAILABILITY OF PHYSICIANS
TO SORT OF REFER INTO THE LONG
TERM CARE AT. HAS EIGHT OF.
NEXT STEP SORT OF REFERRAL
PROGRAM AND SO HAVING THE CARE
SERVICES THEN BUNDLED FOR THAT
PERSON- THERE WOULD BE AN
ELEMENT OF SPECIFIC OF. CARE
MANAGEMENT FORMING THAT WOULD
BE PERSON CENTRED ALONG WITH IT
WOULD NOT BE A SORT OF A
UNIVERSAL ALL THE BACKGROUND
DOCUMENT IN THE WHICH IS SORT
OF THE FIRST TO DOCUMENT IN
THE- COMMITTEE BINDER. ALL
DESCRIBE YOUR DESCRIBES SOME OF
THE- KINDS OF MEDIC SERVICES
THAT WOULD BE MADE AVAILABLE
ALL THE ONLY SORT OF SERVICES
THAT WOULD REALLY SORT OF NOT
BE. FOR A MEDICAL PERSPECTIVE
ALL. INCLUDED WITHIN THE
PACKAGE WOULD BE HOSPICE
SERVICES IF. AND IF SORT OF.
END OF LIFE PLANNING WAS
OCCURRING THEN THE HOSPICE
BENEFIT WOULD REPLACE THE LONG
TERM CARE HOME AND BUT THE
EXPECTATION OF THE SYSTEM THE
COMBINATION OF SERVICES UNDER.
A LONG TERM CARE AT HOME BOTH
ENABLE LIVING AT HOME. BUT ALSO
NOT NOT JUST WE DON'T WANT
PEOPLE TO BE CAPTIVE PORTAL-
THE GOAL IS TO HAVE THE KINDS
OF SERVICES THAT MAKE IT
POSSIBLE FOR THEM TO
PARTICIPATE IN COMMUNITY HOME
IS WHERE THEY WILL RECEIVE.
CARE BUT COMMUNITIES WHERE
HOPEFULLY THERE WITH LIPS. AND
I APOLOGIZE I DID HAVE ONE
FINAL FINAL QUESTION AND THANK
YOU THANK YOU FOR THE THIS THIS
IS HELPFUL I AM CURIOUS YOU YOU
MENTIONED IN YOUR COMMENTS THAT
YOU. YOU KNOW YOU'RE WILLING TO
INFORM AND CONSULT WITH THE
LEGISLATURE. SO WE'RE GETTING
INFORMATION BUT I'M NOT FEELING
THE CONSULTATION PART OF IT
QUITE FRANKLY- AND- AND THE
INFORMATION. YOU KNOW HEADS TO
DATE HAS BEEN MORE. ABOUT US
PRODDING IN ASKING FOR IT
RATHER THAN IT BEING
NECESSARILY YOU KNOW.
FORTHCOMING AND SO THERE
ANALYZE PART OF THE PROBLEM. A
HUGE PART OF THE PROBLEM FOR
US. BECAUSE WHEN THE ORIGINALLY
WE HEARD ABOUT THE PROPOSAL. IT
WAS A ALMOST A MONTH BEFORE
LANGUAGE CAME OUT- ON JUNE
TWELFTH. THAT LANGUAGE HAS BEEN
WITHDRAWN TRAILER BILL LANGUAGE
HAS BEEN WITHDRAWN WE'VE GONE
THROUGH VARIOUS ITERATIONS. AND
I GUESS WHAT. YOU KNOW WHAT WE-
WE FEEL LIKE WE'RE REACTING AND
NOT A PART OF THE PROCESS YET.
THIS IS A HUGE ISSUE FOR US IN
THE LEGISLATURE AND- SO WHAT
IS. YOUR VISION OF INFORM AND
CONSULT. BECAUSE WE HAVE A VERY
DIFFERENT VISION BASED ON WHAT
WE'RE SEEING RIGHT NOW. WELL
LET ME BEGIN BY- SORT OF.
OBSERVING THAT AT THE TIME THAT
THE BENEFIT WAS BEING DISCUSSED
DESIGNED WITH AND INSTRUCTIONS
BEFORE I WAS HERE BUT I CAUGHT
UP ON THE HISTORY ON IT THERE
WAS A REAL SENSE OF URGENCY TO.
MOVES QUICKLY AS POSSIBLE GIVEN
THE- INSPECTION RATES IN
SKILLED NURSING FACILITIES AND
STATE AND SO IF IN FACT.
URGENCY THERE WAS A LACK OF
COMMUNICATION OR A LACK OF OPEN
STREAMS ALL IT CERTAINLY NO ONE
TOOK TIME TO TALK TO KEEP
PEOPLE IN THE DARK. AND NOT
SIMPLY BECAUSE I'M HERE BUT I
THINK IT'S THE DEPARTMENT'S
COMMITMENT NEW CONSTRUCTION
COMMITMENT TO CONSULT HOUSE
WIDELY COMPLETELY AND FULLY
WITH EVERYONE. AS POSSIBLE AND
OBVIOUSLY DEFINITELY INCLUDES
ALL OF THE INTERESTED
LEGISLATORS. ON THE- AT AT THE
SAME SAME. ALL THE AMOUNT OF
WORK THAT WE HAVE DO TO MOVE
THIS INTO BEING A- NOT KNOWING
WHETHER IT IS A PHYSICAL. FAST
AND HAVING FOR DISCIPLINE
BENEFIT WELL IS IT IS IT IS IN
OUR HOUSE AND THE- IF ONE LOOKS
SORT OF THE LIST OF THE
STAKEHOLDER MEETINGS AND-
CONVERSATIONS THAT I'VE ALREADY
OCCURRED. AND THE- I MEAN FOR
THE NEXT THREE OR FOUR MONTHS
OF IT IT IS. ONE THREE- THERE'S
A BILL HE WORKED ON AND
CERTAINLY THROUGHOUT ALL OF
THAT WE WILL BE SHARING ALL
SORT OF GENERATIONS OF
DOCUMENTS AND THEY WILL CHANGE
I WANT TO EMPHASIZE TO SOME
EXTENT THERE'S BEEN A BIT OF
CRITICISM OVER THAT CHANGED.
BUT THAT'S WHAT CONSULTING DOT
COM IT. IT THIS CHANGE THE
DEPARTMENT IS BY ALL. OF MUCH
ANY RACING THOSE TO. ALL THERE.
THAT WILL CONTINUE I HATE IT IF
WE'RE POINT WHERE WE THINK WE
HAVE A FEASIBLE. OF BETTER
DECIDE THEN PERHAPS OKAY SERVE
REPORTED OUT ALONE AND OF
NOTIFY THE LEGISLATION THE
LEGISLATURE UNANSWERED
QUESTIONS PEOPLE HAVE. SIX
AUSTIN POLICE TO HAPPEN. THANK
YOU. KERN IS THERE M. FOLLOWED
BY ASSEMBLYMEMBER MAP. THANK
YOU SIR MISTER CHAIR- THANK YOU
FOR THE LAST LINE OF
QUESTIONING I WANTED TO FOLLOW
UP A LITTLE BIT GIVEN THE
QUESTION THE LAST QUESTION.
DOCTOR WHAT HAD ON OVERSIGHT
AND CONSULTATION. THE LANGUAGE
GIVES THE DEPARTMENT DO THIRTY
TO MODIFY ANY REQUIREMENTS
SPECIFIED TO THE EXTENT IT
DEEMS NECESSARY SO HOW WILL THE
LEGISLATURE PROVIDE OVERSIGHT.
IN IN. GIVEN THE CONSULTATION
ASPECT OF WANTING TO WORK
TOGETHER ON THIS. IT THE
LEGISLATURE WILL BE. AS I SAID
WE WILL BE COMMUNICATING SOLELY
COMPLETELY IS CONSTANTLY AS
POSSIBLE IN. OKAY IN COURT
CONCERNS WILL BE ADDRESSED
COMPLETELY ALL TOOK TOOK TO THE
NTH DEGREE- SO I THAT'S I WOULD
I WOULD SUGGEST THAT IN SOME OF
THE LEGISLATURE WILL WILL
INFORM THE OVERSIGHT THAT THE
DEPARTMENT IS RESPONSIBLE FOR
ALL OF THEM UNDER THE MEDICAID
PLAN. OKAY OKAY SO. WE'LL COME
BACK TO THAT AT SOME POINT AT
NOW GOING BACK TO A COMMENT YOU
HAD MADE EARLIER ABOUT THE NEED
TO REDUCE NUMBERS AND SNAPS AND
THAT THIS WAS OF URGENT MATTER.
THAT WE ADDRESS. IT SEEMS THAT
AND I WANTED I WAS GONNA SAY I
FEEL BUT IT ALSO SEEMS I. THINK
MOST OF MY COLLEAGUES WOULD
AGREE THAT IF WE WERE GONNA
TAKE URGENT STEPS FORWARD ONE
OF THE THINGS WE WOULD TRY TO
IMPLEMENT AS QUICKLY AS
POSSIBLE WAS THE TESTING OF THE
STAFF AT. SKILLED NURSING
FACILITIES. DURING THE HEARING
FROM SEVERAL WEEKS AGO THAT THE
PROPOSAL WAS THAT IT WOULD BE A
CERTAIN SEGMENT OF EMPLOYEES
EVERY CERTAIN NUMBER OF WEEKS
AGO I THINK IT WAS EVERY OTHER
WEEK. OR MAYBE IT WAS EVEN
MONTHLY. AND A- WHERE ARE WE
WITH THAT. B. UP WHY IS IT. WHY
IS THE RATE OF FREQUENCY SO OF
LOW MILEAGE WISE AND IT ON A
WEEKLY BASIS WISE AND IT WEEKLY
BASIS OF ALL STAFF. C. WE'RE
SEEING A LOT OF DELAYS NOW. AND
WHY ARE IN SKILLED NURSING
FACILITIES STAFF AT THE LEVEL
OF IMPORTANCE AND RAPID
RESPONDING TO TESTING AS
HOSPITAL STAFF. FOR CHERNOW'S
ARE AND WORK WITH RESPECT OR
COULD I ACTUALLY HAVE TO THE
FOR A RESPONSE TO OF THE
DEPARTMENT OF PUBLIC HEALTH
WELL IT THIS IS NOT WITHIN THE
AMBIT OF BOTH THE DEPARTURE
HEALTHCARE. IS. OKAY THEY'LL
DENTAL OKAY YOU'RE RIGHT I
WILL- I'LL COME BACK ON THIS
QUESTION LATER ON IT JUST AS WE
WERE TALKING ABOUT. FOCUSING ON
NUMBERS AND REDUCING THE
INDIVIDUALS AND SNIFFS I JUST
WOULD THINK THAT THE FIRST
THING THAT WE WOULD DO AND
SNIFFS WOULD BE TO ACTUALLY
ADDRESS THE ISSUE OF HOW.
SNIFFS WERE CONTAMINATED IN THE
FIRST PLACE WE KNOW THAT IT WAS
EMPLOYEES. AND SO WHY AVEN'T
WE BEEN MORE AGGRESSIVE IN
TESTING THE EMPLOYEES BUT- BUT
THAT'S TRUE I NEED TO ASK THIS
QUESTION- THE REITERATE THIS
QUESTION LATER ON AS WELL. YEAH.
I WOULD DIRECTOR WADE WANNA
STEP IN AND RESPOND TO THAT.
LET ME DEFERRED. ASSEMBLY
MEMBER NAZARIAN I WOULD ONLY
ASSURE THAT THAT HAS THE ISSUE
OF TESTING AND SNIFF TEST IS A
TOP PRIORITY AND HAS COME TO US
FROM THE STAKEHOLDERS FROM THE
GERIATRICIANS AND I DO THINK
THAT THE DIRECTOR SIGNED OF
COURSE THE BEST ONE TO ANSWER
THAT QUESTION AND SHE IS HERE
FOR THE SECOND PANEL OUT SECOND
TOPIC FOR THE PANEL WHEN YOU'RE
READY. OKAY IF SHE'S THERE NOW
SHE CAN ANSWER IT NOW INSTEAD
OF WAITING FOR THE PANEL
PRESENTATION. WE WILL ASK HER
TO COME TO THE FRONT MISTER
CHAIRMAN YOU DON'T MIND ME
TAKING THINGS OUT OF ORDER. ALL
RIGHT. BUT LATER ON IT JUST AS
WE WERE TALKING ABOUT. FOCUSING
ON NUMBERS AND REDUCING. THAT I
COULD WE THINK THAT THE FIRST
pTHING THAT WE WOULD DO. NEXT
WOULD BE. ACTUALLY ADDRESS THE
ISSUE OF HOW. IF WORKING IN THE
FIRST PLACE. WE KNOW THAT IT
WAS. SO WHY THE MOST INTEGRITY
OF BUT- HI GOOD. THE I'M HEIDI
STEIN OCCUR EVERY DRAW OF THE
CAL DEPARTMENT OF PUBLIC AND-
EVEN THOUGH. I WILL BE
AVAILABLE FOR MORE QUESTIONS ON
ME AND PRESENTATION REGARDING
SOME OF THE QUESTIONS I
RECEIVED- I WILL GO AHEAD IN
ANSWER ANY QUESTIONS THAT YOU
WOULD LIKE DONE AT THIS POINT
AT THE HEARING AS WELL. SHOULD
I BELIEVE THAT THAT J. REPEAT
THE QUESTION OR- I KNOW THAT'S
OKAY IF I CAN BY MAY I
UNDERSTAND THE CONCERN IS
AROUND TIME THE FREQUENCY OF
TESTING THE PRIORITIZATION OF
TESTING PARTICULARLY IN SKILLED
NURSING HOMES- WE HAVE- SENSE-
BUT MAY WE ASK THAT ALL. AND
SNIFFS TO THEIR BASELINE
TESTING THEY SUBMITTED THEIR
BASELINE TESTING SO ALL SNIFFS
DID- TEST ALL RESIDENTS AND
STAFF INTO THEIR BASELINE
TESTING. AND ALL OF THOSE WE
HAD ABOUT TWO POINT 9% OF
BASELINE TESTING OF THE HEALTH
CARE WORKERS WERE POSITIVE AND
ABOUT 7% OF THE RESIDENTS WERE
POSITIVE BASED OFF OF THE
BASELINE TESTING. IT WAS A
FACILITY THAT HAD A SINGLE
POSITIVE THEN THEY WENT INTO
WHAT'S CALLED RESPONSE TESTING
WHERE THEY DO RESPONSE TESTING
EVERY WEEK THEY TEST ALL OF
THEIR NEGATIVES IN ORDER TO BE
ABLE TO COPE PART BECAUSE OF
COURSE THE KEY WHAT TESTING
ISN'T THE ACTUAL TEST ITSELF
SINCE THAT'S A POINT IN TIME.
BUT THE MOST IMPORTANT PIECE OF
THAT TEST IS THAT YOU HAVE THE
RESULTS AVAILABLE TO BE ABLE TO
ACTION ON THEM AND TO BE ABLE
TO COHORT PROPERLY WITHIN A
FACILITY. UP THEN IF YOU WERE A
FACILITY WHO HAD ZERO HOSTAS
YOU HAD BOTH FOR YOUR PRESENCE
AND YOUR STAFF YOU WENT INTO
WHAT'S CALLED SURVEILLANCE
TESTING WHERE WE TEST- 25% OF
THE HEALTH CARE WORKERS EVERY.
WEEK AND SO YOU'RE YOU'RE
CONSTANTLY HAVING THAT CADENCE
OF- OF RESPONSE TENSING IRK
SURVEILLANCE TESTING WEEKLY-
AND THAT WAS BASED OFF OF- SOME
OF OUR AND OUR EXPERT GUIDANCE
FROM OUR INFECTION CONTROL
TEAMS ON WHAT WOULD BE THE
PROPER CADENCE FOR- FOR
SURVEILLANCE TESTING- AND WE DO
KNOW THAT THERE HAVE BEEN- IN
THE PAST WHEN WE UPPED THAT
AMOUNT OF TESTING IN THE TATE.
THERE WAS AN ISSUE WITH HAVING
ENOUGH- THREE ANTIGENS THERE IS
ENOUGH ISSUE WITH HAVING
TESTING KIT SUPPLIES AND- SWAPS
AT SOME POINT WHICH. IS WHY WE
WERE SEEING SOME DELAYS WE WERE.
ON THE DEPARTMENT PUBLIC HEALTH
WORKING IN HAND WITH THE
GOVERNOR'S TESTING TASK FORCE-
HOME SOME OF OUR STAFF SERVE ON
THAT IN THAT CAPACITY- SO WE'VE
BEEN WORKING WITH THE TESTING
TASK FORCE TO ENSURE THAT-
THEY'RE CONSTANTLY ADDING. MORE
ADDITIONAL OPTIONS FOR TESTING-
AS WELL AS MORE LABS WE DO HAVE
A TESTING TASK FORCE WEBSITE
THE LAB LIST IT'S CONSTANTLY
BEING UPDATED. TO MATCH THE
INFORMATION THAT'S NEEDED TO BE
ABLE TO MATCH FACILITY. WITH
THOSE LABS WE KEEP ON STRESSING
TO LAB TO MAKE SURE THAT YOU'RE
GOING BEYOND JUST YOUR REGION
OR YOUR COUNTY. AND LOOKING AT
OTHER PRIVATE LABS OR OTHER
OPTIONS BECAUSE WE FOUND THAT
THERE ARE SOME LABS. THAT
REALLY WERE BEING UNDER
UTILIZED AND HAD A LOT OF
CAPACITY STILL- BUT THEY MIGHT
BE IN A FARTHER DISTANCE SPACE
WE'VE NOW ADDED. THANK YOU
SENATOR SO THAT THEY CAN BE
ABLE TO KNOW HOW MANY THANK
YOU. LET ME LET ME LET ME GET
TO THE HEART OF THE ISSUE AGAIN.
RIGHT NOW OUR SKILLED NURSING
FACILITIES DO THEY FALL DOES
THEIR TESTING FALL WITHIN THE
SAME TRACK. OF EXPEDITED
RESPONSE AS HOSPITALS DO. SO
THEY ARE ASKED TO BE
PRIORITIZED ARE HELL ARE
SKILLED NURSING FACILITIES ARE
ASKED TO BE PRIORITIZED AND I
DO KNOW THAT THE TESTING TASK
FORCE DID RECENTLY RELEASE NEW-
PRIORITIZE ATION GUIDELINES.
AND I BELIEVE THAT THEY HAD
PLACED HOSPITAL- THEN SKILLED
NURSING FACILITY THAN OTHER
TYPES OF COMMUNITY AND WHETHER
WAS A SYMPTOMATIC SYMPTOMATIC
SPRATT- SO THERE IS NEW TESTING
GUIDANCE AND PRIVATIZATION BUT
THEY ARE PRIORITIZED AND WE'RE
ASKING. LAPS TO PRIORITIZE
THOSE TESTS TO GIVEN THE
URGENCY OF WHAT WE'VE SEEN AND
SKILLED NURSINGFACILITIES AND
I APOLOGIZE MISTER CHAIR I HOPE
YOU DON'T MIND ME- WHY WOULD.
THE TESTING AND SNIFFS NOT BE A
PRIORITY RIGHT NOW. WHY IS IT.
I WOULD ASSUME AGAIN GOING BACK
TO SOME OF THE COMMENTS THAT
HAVE BEEN MADE ABOUT THE LEVEL
OF URGENCY. AND WE'RE URGENTLY
TRYING TO PUT TOGETHER A WHOLE
NEW PROGRAM HERE BUT WHEN IT
COMES TO ACTUALLY ADDRESSING
WHAT'S KILLING PEOPLE. RIGHT
NOW THE TESTING IS STILL NOT
THE PRIORITY THAT IT SHOULD
HAVE BEEN AND WE DISCUSSED
ABOUT THIS JUST A COUPLE MONTHS
AGO. SO WHY IS IT NOT EVEN
ABOVE AND BEYOND WHERE
HOSPITALS ARE BEING RANKED
RIGHT PRIOR TASTE RIGHT NOW. SO
I CAN'T SPEAK TO THAT BUT I
WILL TAKE THAT INFORMATION BACK
TO THE TESTING TASK FORCE.
ABOUT THAT PRIORITIZATION NO
BUT THIS IS NOT ABOUT YOU
TAKING SOMETHING BACK THIS IS
ABOUT THE LEADERSHIP THAT E
NEED TO PROVIDE. AS AN
ADMINISTRATION AND AS ELECTED
OFFICIALS. AGAIN I DO NOT HAVE
THE- THEY DID NOT PROVIDE INPUT
INTO THAT DOCUMENT I DO NOT-
BUT I CAN DEFINITELY TAKE THAT
INFORMATION BACK TO THE TESTING
TASK FORCE WHO WAS RESPONSIBLE
FOR THAT PRIORITIZATION LIST
BUT I DO KNOW THAT ARE SKILLED
NURSING FACILITIES ARE- RIGHT
UP AT THE TOP AND THEY ARE NOT-
CURRENTLY YOU'RE ABSOLUTELY
RIGHT THAT WHEN I LOOKED AT
THAT LAST DOCUMENT LAST YEAR
ABSOLUTE RIGHT THAT GENERAL Q.
CARE HOSPITAL- STAFF ARE LISTED
ON ONE. OF HIS FIRST AND
SKILLED NURSING ONE WAS SECOND
ON THAT LIST- BUT I WILL
DEFINITELY TAKE THAT
INFORMATION BACK TO SO
LITERALLY TWO MONTHS AFTE
WE'VE HAD OUR FIRST HEARING.
THE RESPONSE WE'RE GETTING IS
THAT SNIFFS TESTING IS STILL.
SECOND RANKED EVEN THOUGH
THEY'VE PRODUCED OVER 40% OF
THE DEATHS DURING THIS PANDEMIC.
TITISEE YES THAT THAT ISN'T IT.
WELL I DON'T KNOW WHAT ELSE I
CAN SAY AT THIS POINT- WHAT WE
CAN SAYWHAT YOU CAN SEE IS
THAT. WE HEARD THE LEGISLATURE
AND WE'RE GOING TO PRIORITIZE
IT. SO THAT BY THE THIRD
HEARING WE HAVE AND I DO HOPE
THAT ALL OF OUR CHURCH
TOGETHER. COME TOGETHER AND WE
HAVE A THIRD HEARING MAYBE IN
SEPTEMBER. MAYBE IN OCTOBER IT
SEEMS LIKE WE NEED TO DO IT ON
A MONTHLY BASIS. TO PLACE A
CERTAIN LEVEL OF FIRE BEHIND
EVERYONE SO THAT WE CAN GET TO
THE RESULT THAT WE'RE ASKING
FOR. TO THE RIGHT ANSWER WOULD
BE YES THIS IS A PRIORITY AND
WE ARE URGENTLY MAKING SURE
THAT THE TESTING IS HAPPENING.
THAT'S WHAT I'D LIKE TO HEAR
THAT I THINK THAT'S WHAT
EVERYONE WOULD LIKE TO HEAR.
ABSOLUTELY HERE THAT ABSOLUTELY
FREE WITH THAT AND AGAIN I WILL
TAKE THAT BACK TO THE TESTING
TASK FORCE WHO WAS RESPONSIBLE
FOR MAKING. THOSE CHOICES AND I
WILL DEFINITELY LETTER
ADMINISTRATION NO- I THINK
OBVIOUSLY SKILLED NURSING
FACILITIES ARE A HUGE PRIORITY
AND WANT TO MAKE SURE THAT THAT
IS EVIDENT IN ALL OF OUR
DOCUMENTS. THANK YOU MISTER
CHAIR. WITH THE FOLLOW UP WE
HAVE CHURTON. I DO AND I
APOLOGIZE I WANNA LIVE IN
THIRTY MINUTES IN THE STOMACH
OR ONE- BUT BEFORE YOU LEAVE.
QUICK FOLLOW UP THERE HAVE SOME
QUESTIONS FOR THE DIRECTORS-
EITHER THERE WAS AN ARTICLE IN
THE BE- TALKING ABOUT THE I
BELIEVE YOU HAVE A STRIKE TEAM
THAT VISITS THE FACILITIES-
WHEN THERE ARE SITUATIONS IS
THAT CORRECT AND I DON'T KNOW
IF THEY'RE THAT THEY'RE UNDER
YOUR EMPLOYEE OR THEY'RE UNDER.
DIRECTOR WAITING FOR YOU. I'D I
BELIEVE THE STRIKE TEAMS
REFERRING TO OUR INFECTION
CONTROL OUR HAI STRIKE TEAMS
AND THEN WE ALSO HAVE. OUR AND
SURVEYORS ARE LICENSE AND
CERTIFICATION SURVEYORS I HAVE
BEEN OUT OF FACILITIES- SO. YES
THAT THAT IS UNDER- CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH GOT
IT. THE ORDER ARTICLE MENTIONED
THAT- DID THE STAFF THAT. DOES
THE SITE VISITS DOESN'T. GET
TESTED IS HAS NOT BEEN
ADDRESSED. YES SO WE DO TEST
OUR STAFF- WE ACTUALLY
SUBMITTED THE SAME WEEK THAT WE
SUBMITTED TO THE- ALL
FACILITIES LETTER TO ALL OF THE
SKILLED NURSING FACILITIES THE
FIRST WEEK OF JUNE. THAT
REQUESTED- OR THAT SET OUT THE
TESTING PLAN FOR ALL OF OUR
SKILLED NURSING FACILITIES WITH
THE SAME WEEK THAT WE
SUBMITTED- ARE TESTING STRATEGY
THAT MERE STAFFER OWN STAFF
THROUGH OUR CAL HR PROCESSES. I
DID TAKE SOME DELAY THROUGH OUR
REGULAR HR BARGAINING UNIT AND
LABOR PROCESSES BUT WE WERE
ABLE TO COMPLETE THAT POLICY
THAT REQUIRES ALL OF OUR STAFF
TO DO THAT SEEM TESTING KIT. SO
HOW OFTEN ARE THEY GETTING
TESTED NOW. SO ALL OF OUR STAFF
HAVE TO BE TESTED- THE SAME
CADENCE WHICH IS THAT 25% EVERY
WEEK- AND- WE DO HAVE-
OBVIOUSLY THERE AT THE OTHER
STATE HEALTH INSURANCE BUT THEN
WE ALSO- HAVE CONTRACTED WITH
OTHER- TESTING LABS AS WELL TO
MAKE SURE THAT THEY HAVE ACCESS
TO TESTING. GAGAN IT SO THEN IF
THEY IF THEY TEST POSITIVE THEN
THEY'RE NOT ALLOWED TO VISIT
THE FACILITIES. THAT'S CORRECT.
OKAY THANK YOU. HI I JUST I
JUST HAD- SOME FOLLOW UP WITH
DIRECTOR LIKE PORN. IT'S GOOD
TO SEE AGAIN DIRECTOR CAN CAN
YOU JUST REFRESH THE
COMMITTEES- MEMORY I KNOW
YOU'RE NEW TO THIS POSITION BUT
HOW LONG YOU'VE BEEN WORKING.
FOR THE STATE AS HEAD OF D. E.
S. S. WELL I WAS THERE FOR.
EIGHT YEARS BOTH OF. JONES
TURNS ME ON THANK YOU FOR YOUR
SERVICE VERY MUCH APPRECIATE
THAT I DON'T. YOU ARE YOU YOU
SAID YOU ARM FAMILIARIZE
YOURSELF WITH THE HISTORY
AROUND THE LONG TERM CARE. AT
HOME THE PROPOSAL SO LAW YOU
WEREN'T INVOLVED- WITH THAT-
YOU YOU'RE FAMILIAR WITH. YEAH
SO WHAT POINT WAS THE YOU YOU
GET A MY COLLEAGUE DR WOULD
MENTION THE SORT OF A LACK OF.
CONSULTATION WITH THE
LEGISLATURE WHICH YOU- SAID IF
IT IF AT ANY POINT WAS
ACCIDENTAL- BUT I GUESS EVEN
AFTER THE POINT WAS MADE. THERE
HAS BEEN NO- NO DISCUSSION OR
REALLY NO PROPOSAL TO COME
FORWARD TO ACTUALLY NOT JUST
CONSULT WITH THE LEGISLATURE
BUT TO REALLY WORK WITH THE
LEGISLATURE TO CRAFT A PROPOSAL
IS THAT. CORRECT. HE BOTH THE
SORT OF ORIGINAL WHAT I'M HER
FRIEND WAS VERSION OF ONE OF
PROGRAM DESIGN WAS SHARED WITH
ALL. STAKEHOLDERS INCLUDING YOU
KNOW LEGISLATIVE STAFF- VERSION
TWO DOCUMENT BY THAT POINT I
KNEW I WAS ON BOARD AND MEMBER
I'M SORRY I GUESS I WAS SAYING
LEGISLATE TORS. SO I MEAN I
MEAN THIS IS YOUR FIRST TIME AT
A- BUDGET HEARING IN RECENT
HISTORY BUT- I TRIED TO- THE
PUBLIC LOOKS AT LEGISLATORS
DIFFERENTLY THAN LEGISLATIVE
STAFF. SO WHEN WE SAY
LEGISLATIVE CONSULTATION I
DON'T. UNTIL YOU'VE CONSULTED
ME I DON'T REALLY COUNT MY
STAFF BUT OTHER PEOPLE OTHER
LEVEL OF THE LEGISLATURE SPEAK
FOR THEMSELVES. BUT AT LEAST
FOR ME. I'M STILL WAITING FOR
MY CALL. ALL RIGHT. WHAT WAS
GOING TO SAY IT'S IRONIC
BECAUSE FREQUENTLY WHEN THE
STUFFS BECAUSE THEY SAY ON
BEHALF OF OUR MEMBER BUT- LET'S
NOT GO THERE- NO I TO SPEAK FOR
MYSELF SO IF YOU WANT TO KNOW
WHAT I THINK YOU CAN ASK ME TO
GREAT I'D BE HAPPY TO COME BY
AND- WHAT DO YOU THROUGH THE
DETAILS AS WE GO THROUGH
VERSION TWO VERSION THREE
VERSION FOR BECAUSE I DIDN'T
NOTICES THERE WAS. YOU WHEN YOU
MENTION. STAKEHOLDERS I DIDN'T
HEAR ANY. LEGISLATOR INVOLVED
IN THAT STAKEHOLDER PROCESS AND
I'D LIKE TO HEAR MORE ABOUT
WHAT STAKEHOLDERS ARE INVITED.
THE LARGE LARGELY THE-
POPULATIONS THAT HAVE BEEN IN
THE- FORMAL MEETINGS HAVE BEEN
A LONG TERM SERVICES AND
SUPPORTS COMMITTEE OF THE
MASTER PLAN ON AGING IF SERVED
IN AN EXPANDED WAY BECAUSE AT
THE LAST CALLED WE DID I THINK
WE HAD THREE HUNDRED OR FOUR
HUNDRED PEOPLE ON THE LINE.
THIS WAS MY RECOLLECTION
INCLUDING- ADVOCACY GROUPS ALL
LATER ALL. THE OF PROFESSIONAL
ASSOCIATIONS THAT CENTER- IF
YOU IF ANY MEMBER OF THE
LEGISLATURE WOULD LIKE TO BE
INCLUDED ON THE ACT OF CALL
GROUP I'D HAPPILY DO SO BUT
MORE IMPORTANTLY I OFFERED THAT
TO. BE HAPPY TO SEE MYSELF IN
THE MEDICAID DIRECTOR WHO
UNFORTUNATELY IS OUT OF TOWN TO
THE STATE TODAY LONG AND CAN
SPEAK MUCH FOR ELOQUENTLY TO
THIS- BUT WE'D BE HAPPY TO COME
AND MEET WITH ANY OF INTERESTED
PARTIES IN THE LEGISLATURE AND
I TAKE THE DIFFERENCE LEGISLATE
TORE. VERSUS STOP. SO I THINK
YOU WOULD YOU FROM FROM MY
COLLEAGUE DR WHAT EARLIER THAT
THEY WERE JUST- YOU KNOW NOT
ONLY HAS THERE NOT BEEN
ENGAGEMENT THAT THAT THERE'S
BEEN ONLY INVOLVEMENT WHEN
WE'VE SORT OF ASKED TO BE
INVOLVED. ALSO AS VICE CHAIR
OF. THE JOINT LEGISLATIVE
BUDGET COMMITTEE I WOULD JUST.
CAUTION YOU USING THAT PROCESS
THAT PROCESS IS REALLY MEANT
FOR- WHAT I WOULD SAY VERY
TECHNICAL CHANGES TO- CURRENT
BUDGET AUGMENTATIONS AS YOU
KNOW THAT THIS IS. THERE WAS NO
BUDGET PROPOSAL THERE WAS NO.
TRAILER BILL THERE IS NO-
LANGUAGE- THIS IS STILL- IT'S A
IT'S A PROPOSAL BUT IT'S NOT A-
WHAT I WOULD SAY IT'S NOT A-
TRADITIONAL STATE PROPOSAL AS
AS YOU'RE WELL AWARE. IF
SOMETHINGS ARE A REAL PROPOSAL
WE SEE IT IN TRAILER BILL OR
RECEIPT IN LEGISLATIVE LANGUAGE
INCIDENT THE LEGISLATIVE BILL.
TO BE DELIBERATED BY THE PUBLIC
TO BE- VIEWED AND DISCUSSED BY
OUR CONSTITUENTS AND TO REALLY
HAVE A- ROBUST PUBLIC PROCESS
AND I THINK THAT. I THINK IS
THAT IS SORT OF WHAT'S LACKING
AT THIS POINT IN MY OPINION.
HISTORICALLY AND TRADITIONALLY-
CHARTING ALONG WITH HIM THE-
STATE MEDICAID PLAN. THE
PROCESS OF- CONSULTATION HAS
BEEN A LONG BOTH OF. ORGANIZED
BY THE DEPARTMENT WITH KNOWN
INTERESTED PARTIES ANYONE WHO
EXPRESSES INTEREST WE HAVE A
STAKEHOLDER ADVISORY COMMITTEE
FOR THE WHOLE DEPARTMENT THAT
BEHAVIORAL HEALTH STAKEHOLDER
VISOR COMMITTEE FOR LONG TERM
CARE HOME GOT A STAKEHOLDER
ADVISORY COMMITTEE ALL. WHEN A
PLAN WHAT A PLAN AMENDMENT
DESIGN IS. AT THE POINT WHERE
THE DEPARTMENT FEELS IT IS
IMPLEMENTABLE IT IS THEN POSTED
FOR PUBLIC COMMENT ON IT IT IS
WHAT THE DOCTOR IS A REQUIRED
PART OF THE C. S. PROCESS.
ALONG AND HOWEVER THE- IF THERE
IS NO STATUTE NEEDED TO
IMPLEMENT. THEN THE PRACTICES
BETTER SO LONG AS IT IS.
OPERATING WITH IN THE BUDGET
CONSTRAINTS THAT ALREADY
ADOPTED THAT THE DEPARTMENT
PROCEEDS OBVIOUSLY WITH
GUIDANCE FROM AGES FROM THE
HEALTH AND HUMAN SERVICES
AGENCY IN THE GOVERNOR'S OFFICE
ALL ADD IN CONSULTATION WITH.
ALL INTERESTED PARTIES THE
DEPARTMENT PROCEEDS- TO
IMPLEMENT ALL THE PRODUCT OF
THE BENEFITS HAVE BEEN CHANGED
NUMEROUS TIMES HELLO IN THIS
WAY- THIS IS UNUSUAL. ARE
EXCEPT THAT THIS IS UNUSUAL AND
IT IS UNUSUAL BECAUSE FOR SOME
PEOPLE BECAUSE THE LINKED IN
OUR MINDS WITH OTHER PROGRAMS
AND THIS OVER FOR TO PUT
DIRECTOR LET'S JUST BECAUSE I
MEAN. LET'S NOTLUMP ALL THESE
THINGS TOGETHER. RIGHT I MEAN
YOU ARE LOOK I THINK WE YOU ARE
DISCUSSING IN GENERAL IN MY
OPINION AND ALL DISTRICT
RESIDENTS WE ARE ARE FAIRLY
TECHNICAL CHANGES THAT I
UNDERSTAND YOU HAVE A
STAKEHOLDER PROCESS. WHICH IS
VERY GOOD AND WE THINK FOR THE
MOST PART IT WORKS BUT THIS
TYPE OF CHANGE IS A FAIRLY
LARGE SIGNIFICANT CHANGE. AND I
THINK EVEN AFTER THERE WAS
LEGISLATIVE CONCERN THAT WAS
RAISED IN IN MY OPINION THIS IS
JUST ONE ONE LEGISLATORS
OPINION. THAT THAT CONCERN WAS
IGNORED- AND WAS LARGELY
DISMISSED AND EVEN IN YOUR
OPENING REMARKS. IT WAS
DISMISSED THE SENSE THAT YOU
SAID THE WAY YOU WERE GOING TO
INFORM THE LEGISLATURE WAS A
LETTER. TO JAIL BC. IT AND
AGAIN THAT IS NOT THE PROCESS
WHEN THERE WAS A MAJOR MAJOR
CHANGE. USUALLY WHEN THERE IS A
SIGNIFICANT CHANGE THE PROCESS
EITHER GOES THROUGH THE BUDGET
PROCESS OR IT GOES THROUGH THE
LEGISLATIVE PROCESS. THIS IS
NOT EXCUSE GIVE ME I'M NOT DONE.
IT'S NOT DONE IN SECRET IT IS
NOT DONE WITHOUT PUBLIC INPUT
AND I THINK YOU WHAT YOU'RE
HEARING FROM. MYSELF AND THE
NUMBER OF MY COLLEAGUES IS THE
CONCERN OF REALLY WHAT YOUR
INTENTION IS AROUND THIS
PROCESS AND RELEASE CIRCUMVENT
LEGISLATURE. YOU'LL RECALL
CHARGING THAT WHAT I SAID AT
THE OUTSET OF WAS WE WOULD ARM
BE HAPPY TO REPORT OUT THE
BRIEF- IN BUDGET HEARINGS.
AFTER THE GENTLEMAN BUDGET- AND
THEN PRIOR TO SUBMISSION. OF A
STATE PLAN AMENDMENT IF IT
WOULD BE. OF ANY SORT OF USE OR
VALUE BECAUSE YOU KNOW NOTIFY
GENTLY SEE IF IT'S AND IF
THAT'S NOT NEEDED FIVE. DOT COM
THIS IS AN ATTEMPT TO EVADE I
MEAN THIS IS NOT BEEN CARRIED
OUT SECRET THIS IS THE MOST
PUBLIC SECRET I'VE EVER SEEN-
THE- WHAT WHAT IF WE'RE GOING
TO PURSUE THIS IT IS AN
ENORMOUS LEFT AN ENORMOUS
AMOUNT OF WORK THAT HAS TO TAKE
PLACE OVER THE NEXT FEW MONTHS.
THAT REALITY IF WHAT I
CHARACTER COULD THAT SORT OF
WORK. ON A POSSIBLE THAT AT
SOME FUTURE POINT. THERE MAY BE
IT MAY BE PROVED BASED ON WHAT
HAPPENS TO SOME OTHER PROGRAM.
CENTRALLY WHAT THE LANGUAGE
THAT CAME OVER. ALL FROM BUDGET
STAFF IMPLIED. I CAN'T DO THAT
I MEAN IF YOU KNOW. WE CAN'T WE
CAN'T COMMIT THAT SORT OF
RESOURCE. WHAT WHAT ONE OF MY
COLLEAGUES DID WANT ME TO ASK
YOU FAR FAR- STAFF COULD BE
PART OF THAT WORKING PROCESS
BECAUSE I THINK THERE'S BEEN
SOME. DISCUSSION BUT THEY HAVE
NOT REALLY BEEN A DIRECTLY
INVOLVED. ABSOLUTELY AND I
FRANKLY THOUGHT THAT I HAD
HEARD THEM ON SOME OF THE CALLS
BUT IF THE PROBLEM WRONG MY DAD
AND WE WILL DEFINITELY. THANK
YOU- WERE. WHAT I WOULD SAY IS
AGAIN. PERHAPS YOU FEEL LIKE
THIS HAS BEEN A FAIRLY PUBLIC
PROCESS BUT THERE IS ONE BRANCH
OF GOVERNMENT THAT IS
DISAGREEING WITH YOU. SO I
THINK LET'S JUST REITERATE THAT
AT THAT PERHAPS IT'S A MATTER
OF PERCEPTION. BUT AGAIN IN IN
THIS IN THIS ROUND WE OFTEN
KNOW THAT PERCEPTION IS REALITY.
JUST A QUICK QUESTION BECAUSE I
AFTER- APOLOGIZE I'VE TO GO TO
A MEETING YOU YOU MENTIONED
THAT. DATE DH CS ACTION PLAN OF
THE CENTRAL VALLEY IS NOT
SOMETHING THAT YOU HAVEN'T BEEN
WRITING BECAUSE I KNOW THAT.
THERE WAS A PHONEOUR STAFF BUT
WE HAVE NOT SEEN ANYTHING IN
WRITING. HI FORGIVE ME I
THOUGHT THAT AGENCY CENTERED
OVER. ON FRIDAY THURSDAY OR
FRIDAY YEAH WE WILL GO AND
DOUBLE CHECK THAT BUT OKAY BUT
IF FOR ANY REASON IT WASN'T MY
APOLOGIES AND WE'RE WE WILL
RESET IT BUT NO IT. I BELIEVE
IT WAS SENT. ASSEMBLY MEMBER
MATHIS. THANK YOU MISTER CHAIR.
SOMANY- QUESTIONS THE TO GO
OFF OF BUT I THINK I'LL PICK UP
WHERE. MR TING LEFT OFF.
DIRECTOR LABOR AND THAT'S
CORRECT LATE ONE YES- YOU YOU
DO STATED THAT- HISTORICALLY.
THAT IF THERE'S NOT A STATUE
YOU WON'T INFORM US AND AS
NOTED EARLIER BY MY COLLEAGUE-
MISTER NAZARIAN- UNDER THE
CURRENT PROPOSAL THERE ISN'T A
STATUTE. THAT REQUIRES YOU ALL
TO BRING THAT INFORMATION BACK
TO THE LEGISLATIVE BODY AND I
THINK GAS. PART OF THE PROBLEM.
THAT THE LEGISLATIVE BODY IS
HAVING AS STATED BY. SHARE
TíNH IS THAT. WE ARE BEING
CONSULTED ON BUT YET WHERE THE
BODY THAT IS DESIGNED TO MAKE
PUBLIC POLICY AND WHAT WE'RE
SEEING HERE. IS POLICY BEING
DONE BY THE EXECUTIVE BRANCH
THROUGH THE BUDGET WITH
MECHANISMS PUT IN PLACE WHERE
THERE ARE NO STATUTES TO THEN
BRING THAT POLICY BACK. THROUGH
A POLICY COMMITTEE HEARING
PROCESS SO WALL YOU MIGHT BE
ABLE TO POST THE INFORMATION
PUBLICLY ANNOUNCE FOR PUBLIC
COMMENT WE'RE COMPLETELY GOING
AROUND THAT PUBLIC PROCESS
THROUGH THE POLICY HEARINGS IN
HAVING TESTIMONY HAVING.
COMMUNITIES AND PUBLIC BE ABLE
TO COMMAND HEARING ALL SIDES IN
HAVING OPEN DISCUSSIONS. LAW
WHICH IS A HUGE PART OF WHAT
THE LEGISLATIVE BODIES DESIGNED
TO DO. SO IT AGAIN IS. SHARE
TEAM JUST STATED YOU KNOW I
KNOW I'M NOT THE ONLY ONE IN.
THE FRANKLY I'D LIKE TO REMIND
YOURSELF AND THE. EXECUTIVE
BRANCHES IN THE ADMINISTRATION
THAT THERE ARE. TWO PARTIES
HERE IN SACRAMENTO EVEN THOUGH
THERE MIGHT BE A MAKE A
MAJORITY BUT- THE VICE CHAIRS
IN THE REPUBLICAN CAUCUS AND
ALSO HAS INPUT AS WELL. AND YOU
KNOW REALLY. THIS HASN'T BEEN
PUBLIC WE DON'T NEED CONSULTED
TO. OUR FRANKLY WE ARE THE
POLICY MAKERS AND- A I BELIEVE
THAT'S THE MAJOR FRUSTRATION
HERE SIR IS THAT. INSTEAD OF
GOING THROUGH A SHARING PROCESS
WHERE WE CAN ALL WORK TOGETHER
COMMUTATIVE. TO LOOK AT WHAT'S
BEST FOR OUR NON. POPULATION
WHAT'S BEST TO DO WITH THESE
NURSING HOMES IN THESE
OUTBREAKS WHAT WE'VE SEEN IS
THE EXECUTIVE BRANCH GO THROUGH
THE BUDGET PROCESS AN INJURY
RAMROD WHAT THEY WANT. AND IT.
WITH NO ILL INTENT BULLETS THE
PROCESS AND THE PROCESS HERE
MATTERS BECAUSE THERE ARE
THINGS THAT ARE CLEARLY BEING
MESSED ON AS STATED WITH YOU
KNOW WE ARE 40% OF THE
OUTBREAKS HAPPENING ON OUR
NURSING HOMES WE GET THEIR
STAFF FOR TIER TWO WITH TESTING
TO GET A RESULT WE'RE SEEING
THESE THINGS OVER AND OVER
AGAIN. IN YOU KNOW DIRECTOR WE
NEED TO FIX THAT AND THAT FIX
IS GOING TO COME FROM YOUR SIDE.
AND I WANNA HEAR WHAT YOU
INTEND TO DO. BESIDES JUST
CONSULT FOR US BECAUSE WHEN YOU
SAY CONSULTA SAID. IT MIGHT
JUST BE THIS LEGISLATORS OF
OPINION BUT IT FEELS LIKE- YOUR
YOUR PATENT CHILD ON THE HEAD
SAYING IT'S OKAY ALL THAT YOU
NOW. BUT THAT'S NOT THE WAY IT
WORKS IN YOU KNOW STARTED
HAVING THAT CONVERSATION WITH
OUR STAFF IT IS HAVING A TRUE
POLICY CONVERSATION TO ENSURE.
A FULL IN PLACE SO WHAT WHAT IS
YOUR PLAN MOVING FORWARD
BESIDES JUST THE CONSULTING IN
REGARDS TO THIS. WILL SOMEONE
AYE I WOULD CONSIDER THAT THE
SHARING THAT WE'RE HAVING TODAY
IS ALL AN ACT OF LEGISLATIVE
OVERSIGHT ON THE- WAS NOT A
REQUEST FOR A SORT OF A DEEP
DIVE INTO THE- DETAILS OF A OF
A PLAN BENEFIT BUT I'M HAPPY TO
COME BACK AT ANY TIME. I'M
PERFECTLY BRING ALONG MY
MEDICAID. TO DO THE DEEP DIVE
WHATEVER WELCOME SO PLEASE
DON'T DON'T BELIEVE THAT THE
WEEK THAT WE COME HERE
RELUCTANTLY ALL NOT AT ALL OF
THIS IS A PARTNERSHIP WE WILL.
WE WILL IMPROVE WHAT WE ARE
GOING TO DO BY THE DIALOGUES
ALONE BUT IT'S- GOING TO IT ON
A- KEEPS MOVING FOR. ON SO LONG
AS THE BROUGH OF A DIFFERENT
OFFICE WE STILL I MEAN UP.
THAT'S QUITE. MALHAM I'M GLAD
HEAR THAT AND DO UNDERSTAND THE
EX SO. WITH A PANDA. OTHER THAT
I HAVE FOR YOU. YOU TALKED
ABOUT HOW- FOR THE NEW PROGRAM
WE'RE GOING TO DO CONTRACTS
WITH PROVIDERS- TO PROVIDE THE
IN HOME CARE SERVICE- AS YOU
ALL ARE LOOKING AT HOW THOSE
CONTRACTS ARE GOING TO BE PUT
TOGETHER ARE YOU LOOKING AT
LESONS LEARNED- THROUGH OTHER
IN HOME CARE. PROVIDERS IN THE
ISSUES THAT HAVE BEEN GIVEN
THEIR- LOOKING AT ISSUES WITH
THE- HOW THESE CONTRACTS WORK
IN THE PAST. WITH OTHER
PROVIDER RELATIONSHIPS WE'VE
ALWAYS HEARD FROM THE PUBLIC.
THAT YOU KNOW WE HAVE GREAT
PROVIDERS WE HAVE GREAT
SERVICES BUT KEEPING. THE STAFF
THERE ENSURING THAT THEY'RE
PAID WELL ENOUGH TO EVEN BE
ABLE TO DO THE COMMUTE-
EXPRESSLY IN A REMOTE AREAS-
WHAT WHAT ARE YOU LOOKING AT AS
FAR AS LESSONS LEARNED- TO
ENSURE THAT AS WE MOVE FORWARD.
ON THAT PATH- THAT THE
PROVIDERS AND THE FOLKS THAT
WORK FOR THEM. WE'RE ACTUALLY
GOING TO BE ABLE TO BE THERE
BECAUSE WHEN WE'RE LOOKING AT-
IN HOME CARE WE'RE LOOKING AT
FOLKS WITH ALZHEIMER'S REALLY
GONNA FOCUS A LOT ON THE
DIFFERENT ISSUES. AND AGAIN
THOSE RELATIONSHIPS WITH THAT
PROVIDER ARE EXTREMELY
IMPORTANT THIS IS SOMETHING WE
LOOK AT A LOT WITH OUR ON.
DISABLED COMMUNITY ON A IN
ASSURING THEIR ART RELAPSES AND
THINGS LIKE THAT SO WHAT IS THE
DEPARTMENT LOOKING AT AS FAR AS
ENSURING THAT AS THEY MOVE
FORWARD WITH THOSE CONTRACTS
ARE ACTUALLY GONNA HAVE PEOPLE
THERE IN THAT THEY'RE ACTUALLY
GONNA STICK. IN THOSE JOBS AND
CAREERS. IT'S AN EXCELLENT
QUESTION. ALL THE ALL AND FOR
MOTOR DON'T I'M NOT GOING TO
SIT. ACROSS THEIN HOME
SERVICES PROGRAM. ISSUES
BECAUSE THAT'S AND- MY
DEPARTMENT SOCIAL SERVICES BUT-
AS WE LOOK AT THE SORT OF THE
NON FINANCIAL SO PORTION OF THE-
LONG TERM CARE TOOL. THE SORTS
OF LESSONS I THINK WE WANT TO
DRAW. AND REALLY. ON AND LIFT
UP. ON THE GREAT EXAMPLE OR THE-
WHERE. OR WHO REALLY DON'T. TO
IN OF PUTTING TOGETHER THE IN.
SO CRY. DISCIPLINARY TEAMS.
THAT MAKE IT POSSIBLE FOR TO
LIVE SAFELY COME. AT HOME FOR
YOU KNOW. ALMOST ARE A LOT ALL.
THOSE ARE THE KINDS OF ALL AND
I THINK WE DEFINITELY WILL TO
THE BILL UPON THIS WEEK AS WE-
FOR. ALL OUR. IT OUR EXT. IN
SORT OF THE ALL RIGHT HER HOME
COMMUNITY BASED. OF SUPPORT
SYSTEM. A SORT OF A- PER DIEM
FEE FOR SERVICE OF PAINT ON THE
ABILITY TO REIMBURSE PROVIDERS
AT A REASONABLE LEVEL ALL IS
BUILT INTO IT ALL AND THE YOU
KNOW I THINK IT WILL TAKE
AWHILE FOR THE CAPACITY TO
TRULY COME UP STATEWIDE. THIS
IS NOT GONNA HAPPEN OVERNIGHT
OF BIG BANG EVERYWHERE BUT HOME
AS THAT CAPACITY IS BUILT OF
ICE I THINK IT CAN BE AN
ENGINEERING AND STRONG. BECAUSE
WE'VE SEEN ALL THE LOCATIONS OF
THE COMPARABLE SEARCH PROGRAMS.
OKAY AND THEN- ONE LAST
QUESTION FOR YOU TALKED ABOUT.
SLOTS FOR THE ASSISTED LIVING
WAIVER AND HOW THEIR LIMITED-
ESPECIALLY IN THE- SAN JOAQUIN
VALLEY YOU NOTED FRESNO
STOCKTON BAKERSFIELD- MY
DISTRICT HAPPENS TO BE KINDA
RIGHT RIGHT BETWEEN THE-
BAKERSFIELD AND FRESNO AREA
GOING ALL THE WAY OUT TO INYO
COUNTY- IN EVEN THE PORTIONS
THAT I HAVE OF KERN ARE YOU
KNOW ONE HOUR AWAY. FROM
BAKERSFIELD WHAT ARE WE DOING
FOR GETTING SLOTS FOR OUR RURAL
AREAS. TO ENSURE THAT YOU KNOW
THE THESE ARE POPULATIONS THAT
ARE OUT THERE AWAY. ON
OFTENTIMES HOURS AWAY FROM
LOCAL HOSPITALS. ND YET THE
PROBLEMS STILL PERSIST IN AS
WE'VE SEEN- COVERED HAS A WAY
KIND OF GETTING AROUND
EVERYWHERE. SO WHAT ARE WE
LOOKING AT- FOR ENSURING THAT
WE'RE ABLE TO GET TO THOSE
AREAS AND NOT LEAVE- A
PATCHWORK OF- PLACES ESPECIALLY
IN OUR HARD HIT AREAS OF LEFT.
OPEN TO KOBE. BECAUSE WHERE
WE'RE DOING ALL THESE EFFORTS
ARE DOING THESE THINGS BUT- WE
STILL HAVE POPULATIONS THAT ARE
ARE HOURS AND HOURS AWAY FROM
ANA. THESE AREAS THAT ARE
GETTING HELP SO ON ON THE NEWS
ARE PEOPLE REALLY GREAT YOU
KNOW WE'RE READING FIFTY TWO
MILLION WERE GETTING STRIKE
TEAMS WERE GETTING ALL OF THIS.
BOY IN FACT THERE ARE. LARGE
SWATHS OF HUGE POPULATION
CENTERS- THAT ARE DEEMED RURAL.
ALI VICE CELLULAR TULARE- WE
HAVE AN OUTBREAK IN THE INDICT
NUBA. YOU KNOW WHAT WHAT'S
BEING DONE IN THESE AREAS SO
THAT WAY THEY'RE NOT GETTING
LEFT BEHIND. NO I SO
UNFORTUNATE REALITY IS THAT
THAT'S WHY WOULD HAVE SORT OF
MAKING MY COMMENTS ABOUT THE
REQUESTS THERE STILL BEING
AVAILABLE CAPACITY BUT IT WOULD
REQUIRE A LONG. JUST TO MOVES
TO AND ACCEPT SERVICE IN FRESNO
BAKERSFIELD ALL SAN JOAQUIN
THERE ARE ACTORS THE PROBLEM IS
THAT A LOT OF THESE PEOPLE IN
THESE RURAL AREAS CAN'T AFFORD
TO JUST PICK UP AND MOVE. WANT
IN AND HE HAD A PROBLEM WITH
THIS IS THAT. AND I THINK FOR
ME. WE FIRST NOTED ISSUES
WITHIN OUR NURSING FACILITIES
BACK IN MARCH. AND WE ASK FOR
STRIKE TEAMS TO COME AND I KNOW
I HAVE THOSE PERSONAL
CONVERSATIONS WITH THE
DEPARTMENTS WITH THE GOVERNOR'S
OFFICE. ASKING BEGGING FOR
STRIKE TEAMS TO COME IN. AND
HERE WE ARE MONTHS LATER. AND
OKAY STRICTLY IN OLD PEOPLE
READ THE NEWS SECTION TO COME
THE SILICON VALLEY. BUT
DIRECTOR YOU SAID WE NEED TO
ASK PEOPLE TO MOVE TO DIFFERENT
AREAS THAT'S NOT. EXACTLY I
MEAN I'M NOT AGAIN I MEAN. I'M
A BROKEN RECORD BUT THAT IS
WHY. THE IMPORTANCE OF DOING
LONG TERM CARE HOME AS A
MEDICAID STATE PLAN BENEFIT
MEANS IT'S AVAILABLE EVERYWHERE
IT'S NOT HAS. NOT BEEN BUILT ON
INDIVIDUAL WAIVER PROGRAMS ONE
OF WHICH IS HERE AND THEN ONE
OF WHICH IS SIXTY MILES OVER
THERE IN THE NEXT ONCE YOU.
BACK BEHIND US YOU KNOW IT
THERE'S A POINT AT WHICH WHAT
WE WHAT WE MUST HAVE IS A STATE
WIDE. CAPACITY TO SERVE PEOPLE.
AND TOOK. PLACE THEY THE
WAIVER. PROGRAMS BECAUSE THOSE
ARE HIGHLY SPECIALIZED VERY
CAPABLE THEY DO WHAT THEY DO
BUT TO. BUILD A SORT OF A
DEEPER BENCH BEHIND TOWARD IT
AND I AGREE THAT THE THAT WE
NEED TO LOOK AT THAT PROGRAM.
AND WHAT ARE WE DOING RIGHT NOW
IN THE IMMEDIATE WHAT ARE WE
DOING TO. ENSURE ACCESS TO CARE.
SPECIFICALLY FOR MIKE. IN THIS
RURAL AREA- WHILE WE WAIT FOR.
EVERYTHING ELSE TO GO ALONG. IT
PROBABLY AT THIS POINT THE MOST
RELIABLE EFFORT WE CAN DO IS
THE- INTENSIVE CASE MANAGEMENT
BETWEEN THE MANAGED CARE PLANS
AND THE H. CPA IT'S DBS
PROVIDERS WHERE THEY ARE ALL
BUT THAT IS LIMITED TO WHERE
THEY EXIST AND HAVE CAPACITY
THEY'RE NOT GOING TO. SPROUT UP
THE NEW ALL IN THE SHORT TERM I
MEAN I'M SORRY FOR THAT ANSWER
THE TRUTH. WHAT DO YOU SEE IS A
WAY TO HELP. EXPEDITE THAT
THEY'LL BECAUSE WE KNOW WE
CAN'T JUST WAVE A WAND AND HAVE
THESE AREAS SPROUT UP BUT WHAT
WHAT IS IT THAT THE STATE CAN
DO THAT THE DEPARTMENTS CAN DO
THAT THE GOVERNOR CAN DO WITH
HIS EXECUTIVE POWERS. TO MOVE
FORWARD TO GET. IT AND NOT JUST
MY HAIR I KNOW DOCTOR WOODS IS.
VERY RURAL AND- WE HAVE AREAS
HE EVEN IN LA THAT ARE OFTEN
FORGOTTEN. SO WHAT IS IT THAT
CAN BE DONE ADMINISTRATIVELY.
JOINT HELP GAIN ACCESS TO GET
MORE SLOTS TO GET THESE FOLKS
TAKEN CARE OF. WELL YOU KNOW
WHAT I SKIPPED OVER- SHOULDN'T
BUT I WAS TRYING TO STAY PRETTY.
STARTING THE SPRING OF THE
DEPARTED HEALTHCARE SERVICES
PRESS YOU. A RAFT OF DISASTER
WAIVERS WITH THE FEDERAL
GOVERNMENT. ALL TO MAKE IT
POSSIBLE TO FLEXIBLY PROVIDE
SERVICES ON IN COMMUNITY IN
HOMES. AND SO FOR ALL OF THE.
WAIT FOR PERSONAL CARE SERVICES
WHICH IS SORT OF AN INTENSIVE
HOME CARE PROGRAM FOR THE
ASSISTED LIVING WAIVER C. BASS
FOR MSSP FOR PACE ALL OF THEM
RECEIVE WAIVERS STOPS AT RAREST
PIECE IN THE PAST FOR EXAMPLE
IS PROVIDING SERVICES AND THEN
A CENTER AND SO WAS SEABASS NOW
IT IS BEING PROVIDED IN HOMES
THAT CAN BE EXTENDED. TO TRUE.
SORT OF. B. R. THE SORT OF
WALLS IF YOU THINK ABOUT OF
SYSTEM CAPACITY SO THOSE ARE
THE- THINGS WE CAN DO
IMMEDIATELY ADDED TO A MEDIA
AND- THE PROVIDERS. OF IT'S A
QUESTION OF THE REACH REALLY I
MEAN I'S BUT- THE ASSISTED
LIVING WAIVER IS THE ONE WHICH
PARTICULARLY IS. LOCATION BASED
ON THE SO THAT ONE. IT IT IT.
IT'S A AWFUL THING TO SAY BUT
THAT THE SITUATION OF THE
PERSON MOVING TO THE PLACE NOT
THE THINGS INTO THE FIRST ALL
THE REST THOUGH. SORT OF
RECEIVE WAIVERS THAT I THINK
GIVE THEM OF UNUSUAL DEGREE OF
FLEXIBILITY NOW THIS IS
FLEXIBILITY NOT ONLY. LASTS
WHILE THE PUBLIC HEALTH
EMERGENCY CONTINUES UP. AS A
FEDERALLY DECLARED A PUBLIC
HEALTH EMERGENCY ALL. CURRENTLY
THAT IS I BELIEVE THROUGH
OCTOBER TWENTY SIX TWENTY SEVEN
OF ONE US ALL HOPE THAT IT IS
TO BE EXTENDED ALL BOOKED.IT
THERE THAT'S PROBABLY A VARIETY
OF LOCAL. CALCULATIONS WHAT ARE
NOT ARMED. THE SO EVERYTHING
THAT WE'RE SORT OF TRYING TO
LOOK AT WHAT WE PUT IN PLACE
GOING FORWARD HAS TO BE THINGS
THAT ARE NOT RELYING ON THESE
DISASTER WAIVERS BUT RATHER
THINGS THAT WE CAN DO THROUGH
THE STATE MEDICAID PLAN.
BECAUSE WE CONTROL THAT AND
WITH CMS APPROVAL OF
MODIFICATION ALL THAT'S WE CAN
SERVE OUR PUBLIC AS FULLY AS
POSSIBLE. OR IN DIRECTOR
LASTING ARE YOU DOING COMMUTE.
TO THE PUBLIC USE ELIGIBLE- FOR
THESE OPTIONS AND WHAT WHAT IS
THE DEPARTMENT DOING TO LET
THEM KNOW THAT HE HERE ARE YOUR
OPTIONS. AND I THINK THAT'S-
ANOTHER REASON WHY THE
PARTNERSHIP WITH YOUR
LEGISLATIVE BODY. COMES INTO
PLAY TO ELIMINATE ITS HOW THIS
MESSAGE GETTING DOWN TO-
EVERYBODY BACK HOME BECAUSE-
WHEN I GET PHONE CALLS AND-
HALF THE PEOPLE I TALK TO
HAVEN'T EVEN HEARD OF ANY OF
THIS AND WE'RE GOING TO YOU
KNOW THE LENGTHY PROCESS OF.
YOU KNOW. STATE I HAVE NO
PROBLEM HAVING MY STAFF TO USE
CONSTITUENT SERVICES WE DO ALL
THE TIME BUT IT'S IF THE
INFORMATION IS THERE AND IT
MAKES MORE SENSE AND IT'S BEING
COMMUNICATED. TO FAMILIES. I
HELP THEM UNDERSTAND WHAT THEIR
OPTIONS ARE SO WHAT IS THE
DEPARTMENT DOING TO GET THAT
MESSAGE OUT. THE SHORT TERM IS
THE SORT OF. INTENSIFIED CASE
MANAGEMENT COORDINATION THERE
WE'RE DIRECTING THE MANAGED
CARE PLANS TO CONVENE. ON
SERVICE PROVIDERS IN THE AREA
SO THAT THE. MEDICAL PROVIDERS
THROUGH THE PLANS AND THE H. C.
B. S. PEOPLE ARE CLEARLY
TALKING ON SOMETHING WHICH WAS
NOT IN YOUR BACKGROUND PACKAGE
ALSO SHORT JUST FOR A SECOND
BECAUSE IT I THINK IT HELPS
EXPLAIN WE DIDN'T CHART PUTS
THE CONTINUUM OF ALL OF THE- HE
BASED SERVICES. AND IS THIS
BILL WILDERNESS SOME
BEWILDERING NETWORK THAT PEOPLE
READ IT AND SAID WELL YOU KNOW
I'M A- FRESHMAN I'M NOT SURE I
COULD WORK MY WAY THROUGH THIS.
ALL AND THAT IS A PROBLEM AND
SO AGAIN. BACK. TO THE
ADVANTAGE TO DOING A- MEDICAL
PLAN IS THAT IT THEN BECOMES
EIGHT WIDELY ACCESSIBLE EASILY
AFTER SYSTEM IN WHICH THERE
SERVICES ARE. DEVELOPED ON UP
ON A PERSON CENTRED BASE. BOTH
SOCIAL SERVICES PARENT HEALTH
SERVICES THANK IS DIRECTLY
LINKED FOR ANSWERING THE
QUESTIONS I KNOW ON. AT LEAST
IN MY TENURE BEING IN THE
LEGISLATIVE BODY'S BEEN ASKING
FOR A STREAMLINED MAPPING A
USED TO GET CRITICISM FOR
SAYING WHERE WHERE'S THE APP
FOR THAT AND HOW CAN WE HELP
PEOPLE GO TO OURAPP AND- GET
THINGS DONE AND HAVE A LESS
CONFUSING AND NOW WITH ELVIS
SEEMS LIKE EVERYBODY'S GONE
WELL WHERE'S THAT HAPPEN. WE
ASK FOR IT YEARS AGO SO LET'S
SEE WHERE WE GO NOW. THANK YOU.
CORRECT. THANK YOU DIRECTOR
LIFE FORM. FIRST THE WHOLE
CONCEPT OF KEEPING PEOPLE AT
HOME KEEPING THEM IN THEIR
COMMUNITY YOU'RE GOING TO GET
SUPPORT FROM ALL OF US ON THAT
OUR LONG TERM CARE AT HOME IT'S
A WONDERFUL IDEA I REMEMBER
WITH OUR AGING A LONG TERM CARE
COMMITTEE. CHAIR NAZARIAN HAD A
HEARING SPECIFICALLY ON THE
ISSUE. SO THE CONCEPT. IS A
GREAT CONCEPT. AND JUSTICE
CHAIR. OURHEALTH CHAIR HAD
MENTIONED IT'S THE PROCESS. WE
DO EED TO BE THAT NOT JUST
CONSULTED PARTNERS IN THIS
WHOLE PROCESS WE DO HAVE A
VOICE AND WE REPRESENT A NUMBER
OF PEOPLE WHO LOOK TO US AND
EXPECT US TO TELL THEM WHAT IS
HAPPENING I KNOW THERE'S BEEN
SOME CON. PART OF WHAT HAS BEEN
SAID IS THAT IN CONSULTATION
WITH BUT IT IS CLEAR THAT THIS
ENTIRE PROCESS HAS NOT BEEN
DONE IN CONSULTATION WITH. THE
LEGISLATURE I DO WANT TO ALSO
SAY THAT IN THE DOCUMENT THAT
WE RECEIVED. IT IS NOT JUST A
CENTRAL VALLEY THAT HAS THE HOT
SPOTS BUT THE INLAND EMPIRE
THAT I REPRESENT. AND I WANT TO
BE SURE THAT WE DON'T FORGET
THE INLAND EMPIRE THAT IS
SUFFER TREMENDOUSLY- I ON A
PERSONAL NOTE I LOST MY UNCLE.
HE'S ONE OF THOSE STATISTICS.
AND FOR MY UNCLE HE IT BECOMES
A STATISTIC BUT IT'S VERY
PERSONAL FOR MYSELF AND EVERY
SINGLE ONE OF THOSE PEOPLE.
IT'S PERSONAL FOR THEM THEIR
FAMILIES AND THEIR LOVED ONES.
ONE OF THE THINGS THAT I THINK
HAS BEEN MISSING AND I KNOW
THAT WILL HAVE BEEN ONE OF THE
OTHER PANELS IS THE PEOPLE THAT
WILL BE WORKING AND- MY
COLLEAGUE MENTIONED A LITTLE
BIT ABOUT THIS. WE KNOW THERE'S
BEEN THERE'S BEEN A SHORTAGE IN
SOME OF THE HEARINGS WE'VE
HEARD FROM S. YEAH YOU YOU D.
W. THEY'RE THE ONES PROVIDING
SO MUCH OF THE- IN HOME.
SUPPORT SERVICES. THEY'RE THE
ONES HELPING KEEPING HELPING TO
KEEP PEOPLE AT HOME. YET
THEY'VE BEEN STRUGGLING TO GET
BENEFITS AT A PROPER RATE.
PROPER BENEFITS BENEFITS FOR
THEMSELVES. AND THAT'S
SOMETHING THAT WE CLEARLY NEED
TO ADDRESS IN ALL OF THIS AND
I'M NOT SURE. FROM WHAT I HAVE
READ. THAT THAT HAS BEEN
ADDRESSED. SO I WANT TO BEGIN
WITH THAT IS. THOSE WHO ARE
EXPECTED. TO HELP PEOPLE STAY
AT HOME AND IN THEIR
COMMUNITIES. WHAT SPECIFICALLY
IS BEING DONE TO MAKE SURE THAT
WE ADDRESS THEIR NEEDS. WITH
RESPECT CHAU REYES ALL THE
RIGHT TO SUCH PROGRAMS YOU KNOW
IS PART OF THE DEPARTMENT OF
SOCIAL SERVICES NOT PART OF THE
DEPARTMENT HEALTHCARE SERVICES
ON HOWEVER I'M OBVIOUSLY VERY
FAMILIAR WITH THE PROGRAM
SERVED OVER THERE FOR A NUMBER
OF YEARS ALL. THE I THINK OVER
THE YEARS WE HAVE SEEN A
STRENGTHENING OF. IN MANY
RESPECTS THE WAY OF
RIGHTEOUSNESS PROGRAM OF
EXTENDED STANDARDS CARE GIVING.
WORKFORCE ALL HAS BEEN
RECOGNIZED ALL. COLLECTIVE
BARGAINING RIGHTS PUBLIC
AUTHORITY STRUCTURE SYSTEMS ALL
THE YOU KNOW. WHETHER
INADEQUATE WAGE INCREASES THE
ALL RIGHT AHEAD OF MINIMUM WAGE
INCREASES SO THE- ALL OF THAT
ONE HOPES CONTINUES GOOD LUCK
WITH YOUR JOB THAT'S NOT ONE
THAT I'M SORT OF ON THE THAT I
HAVE THE I HAVE THE DIAL. ON
WHAT RAISING IT I THINK POINTS
TO. ONE OF MY BIG CONCERNS AS
WE MOVE FORWARD IF THE LONG
TERM CARE HOME BENEFIT GETS
LINKED. CONCEPTUAL TO RESOLVING
EVERY OTHER OUTSTANDING ISSUES.
THAT CAN BE RAISED MANY OF
STATUS IS THE CAMPAIGN RAISED
THEM WE SHOULD ABANDON IT NOW
BECAUSE WE CAN'T POSSIBLY.
RECONCILE WITH WE CAN'T CARRY
ALL ON THIS. ON THE STREETS OF
THE THERE ARE MANY OTHER
SETTINGS WHERE ALL THE
BARGAINING RIGHTS OF I'VE JUST
SUCH WORKERS. WILL BE.
CONSIDERED DEBATED IN BUDGET
SETTINGS THAT ARE NOT IN MY
DEPARTMENT- BUT I HAVE TO BE
POINTED. EVEN A LITTLE
AGGRESSIVE IN DE LINKING ISSUES
THAT IF LINK. SENSUALLY TAKE A
LONG TERM CARE HOME PROPOSAL
AND TAKEN HOSTAGE TO OTHER
SHIPS DIRECTOR IF I MADE THEM
WHO ARE THE WORKERS THAT ARE
GOING TO HELP KEEP OUR PEOPLE
AT HOME AND IN THEIR COMMUNITY.
IN THE IN A LARGE PART OF THE
PROGRAM THAT WILL SERVE THE
SYSTEM DATE. ACTIVITIES OF
DAILY LIVING ALL WILL BE THE
IHS US WORKS AND I HOPE AND
THEY WILL COLLECTIVELY BARGAIN
AND GET ALL MY HOPE GOOD WAGES
AND HEALTH BENEFITS NOW IT IS
YOU KNOW THOSE VERY FROM COUNTY
TO COUNTY. THERE ARE MADE
COUNTY THAT I LOST SERVED AT
SANTA CLARA COUNTY WE PROVIDED
FULL HEALTH COVERAGE FULL
DENTAL COVERAGE ANY COUNTY CAN
DO. THAT PLEASE TALK TO THE
ACCOUNTING. I RECOGNIZE WHAT
YOU'RE SAYING BUT BECAUSE THOSE
ARE THE VERY PEOPLE WERE GOING
TO DEPEND ON WE DO HAVE WE
CANNOT D. LINK THEM I DON'T SEE
HOW WE COULD POSSIBLY DO LINK
THEM THEY HAVE TO BE PART OF
THIS ENTIRE CONVERSATION BUT I
JUST I WANT TO IT I KNOW YOU
SAID YOU KNOW THIS BECAUSE YOU
CAN SEE THIS ON THE SCREEN. BUT
THIS IS WHY THIS IS SO
IMPORTANT WE'RE SO GLAD THAT
CHAIRMAN ARAMBULA CALLED THIS
SPECIFIC HEARING YEAH THE PAST
CHAIR OF HUMAN SERVICES YOU OF
THE PRESENT CHAIR OF HUMAN
SERVICES YOU HAVE THE CHAIR OF
OUR HEALTH YOU THE CHERUBAGING
LONG TERM CARE THE CHAIR BUDGET
YOU HAVEN'T WON THE SERIES
ADVOCATES OF DISABILITIES AND
OF COURSE TO THE SHARE OF SUB
ONE. THIS IS HOW IMPORTANT THIS
IS THAT A SONOS CHEER ARAMBULA
TOLD US HE WAS CONVENING THIS
HEARING WE ALL WANTED TO BE
HERE WE WANT TO KNOW WHAT IS
HAPPENING SO THAT WE CAN THEN
PROVIDE INPUT AND BE INVOLVED.
IN THIS AND BE MORE THAN JUST.
CONSULTED AT WITH ANOTHER
QUESTION IF I MAY. IS THAT ONE
OF THE THINGS THAT WE WOULD
WITNESS DURING THE PANDEMIC IS
THE CEAR INTERSECTION BETWEEN%
OUR STATE SOCIAL SERVICES
PROGRAMS AND NURSING FACILITIES.
HOW DO YOU SEE THIS BENEFIT
IMPACTING THOSE PROGRAMS SUCH
AS MS US P. C. BELLS I HSS AND
IN THE FUTURE. WITH THE
POSSIBILITY OF THE RECESSION IN
THE NEXT FEW YEARS. RIGHT NOT
TO PREDICT WHAT I CAN'T CONTROL
ALL OF THE- LET ME REITERATE
WHAT I WAS SAYING EARLIER IN
THE PRESENTATION OF. THE LONG
TERM CARE HOME. BENEFIT WOULD
NOT AFFECT MSSP SEA.
HYDROCEPHALUS. WELL DONE
RECIPROCAL ST BECAUSE I JUST S.
IS A BIT DIFFERENT ARTISTS AS
BENEFIT CAN BE PART OF LONG
TERM CARE TO HELP PEOPLE D.
CLIENTS WHO SOMEONE CHOOSES
LONGER GERITOL IT'S A CHOICE.
COULDN'T CAN ALSO WILL.
PROBABLY ALSO HAVE OUR JUSTICE
BENEFITS IN ORDER AND SERVICES
PROVIDE. WITH C. BOSTON MSSP
DOC BECOMES BECAUSE THERE.
RELATED PROGRAM BECAUSE THEY'RE
WITHIN THE SAME FUNDING STREAM.
PEOPLE COPYING BOOKS SO-
BENEFICIARY WOULD HAVE TO
CHOOSE WHAT THEY- WANT TO BE IN
A SPEECH OR TO THE ONE FIFTY
BASS OR DO THEY WANT TO BE A
LONG TERM CARE TAL. NOPE AS FAR
AS IT THE IMPACT ON THE
EXISTING SEA BASS AND ALSO
SPEAK PROGRAMS. I DON'T SEE AN
IMPACT OLDER THEN ALL STEP.
DAUGHTER FOR SOME REASON THE
SOME CONSUMER CHOOSE NOT TO USE
THEM ALL. VERSUS LONG TERM CARE
TALK THAT MARCH QUESTION I
DON'T KNOW WE CAN GET INTO WELL
CERTAINLY FOR. THOSE PROGRAMS
AND PACE WHAT SORT OF THE
BEGINNING I OULD BE SHOCKED IF
WE DIDN'T SEE THOSE PROVIDERS
STARTING TO SORT OF SPECIALIZED
A- NEW BRANCH OF THEIR SERVICES
BECAUSE THEY'RE GOOD IT SHOULD
ACTUALLY BE PART OF THE
CONTRACTORS FOR THE LONG TERM
CARE HOME SO IN FACT ASSIST I.
SEE THAT IT'S LIKELY TO BE AN
EXPANSION OF THEIR- THERE MODEL
HOME BUT IT WOULD BE AGAINST
THEIR TRUCKS I MEAN WE'RE NOT.
MAKING IT BUT IT IS NOT
INTENDED TO REPLACE THEM IN ANY
FASHION. THE IF I COULD JUST I
APPRECIATE WHAT YOU SAIDWHEN
YOU TALKED ABOUT THE COMMITMENT
ALL THE PEOPLE ON THE-
LEGISLATIVE DíAS TODAY ON THE
COMMITTEE SAID ONE LITTLE BIT
ABOUT MY- DISTRICT WHEN I
STARTED OUT IN THE FIELD IT WAS
A LONG LONG TIME AGO IN THE
EARLY NINETEEN SEVENTIES. IN
SAN FRANCISCO WHEN I WORKED FOR
CATHOLIC CHARITIES AND I WORKED
IN IN THE AGING SIDE OF THE
FIELD AND WE DID HOUSING FOR
THE ELDERLY YOU HAVE YOUR OTHER
CATHOLIC NURSING HOMES FOR THE
ELDERLY SYSTEMS OUT WHAT THERE
NEVER WAS THAT WE HAD WE NEVER
SUCCEEDED. IN FINDING OUT HOW
TO HOLD PROGRAM THAT COULD
REALLY KEEP PEOPLE WHO HAVE
BEEN MEDICALLY SIGNIFICANT
MEDICAL. IN THEIR HOMES AND
THAT'S WHAT THEY WANTED UNTIL I
SAW. IN CHINATOWN OF DOCTOR G.
O. CREATE. WHAT WAS THAT IT WAS
STILL CALL UNLOCK WHICH REALLY
WHAT'S THE FIRST OF THE PACE
PROGRAMS AND IT WORKED. IT WAS
AN ENORMOUS SUCCESS. AND SO
FROM MY PERSPECTIVE THIS IS
FULFILLING GOSH WHAT A SIGNAL
MOST FORTY FIVE PLUS YEARS OF
WHAT I. WANTED TO SEE HAPPEN
ALL. BUT AVAILABLE. IN THE
MEDICAID PROGRAM FOR PEOPLE WHO
ARE YOU KNOW DEDICATED MEDICAL
MEDICAID MEDICARE WORKS AS WELL
ALL. THE WHOLE BENEFIT SO THE
BLOCKS. IF I SEEM A LITTLE
IMPASSIONED AND NOT WILLING TO
STOP A SLOWDOWN. THERE'S A BOAT
SO LET ME LET ME EXPRESS MY
PASSION IN THIS ALSO. THE
REASON THAT I ASK THAT IS THAT
THERE WAS A PROPOSAL
SPECIFICALLY TO ELIMINATE SEA
BASS AND MSSP WITH A NO BRIDGE.
YOU'RE SAYING THIS PROGRAM IS
NOT. INTENDED TO ELIMINATE THEM
SO IMAGINE OUR CONCERN WITH
THIS AND THE FACT THAT WE
AREN'T INCLUDED IN THIS
PROCESS- AND ALL OF THESE
PROPOSALS ARE ARE. BEING
PROPOSED. AND THEY HAVE GREAT
IMPACT ON THE VERY PEOPLE WE
REPRESENT YEAH WE DON'T GET TO%
GIVE OUR INPUT WE WOULD WE
AREN'T CONSULTED WE AREN'T
PARTNERED WITH- THIS IS A
REALLY BIG DEAL. AND I RETURN
TO WHAT I SAID I'VE IDENTIFIED
THE PEOPLE WHO ARE HERE WHO ARE
ABSOLUTELY COMMITTED TO MAKING
SURE THAT THIS IS THE BEST
PROGRAM POSSIBLE. NOTE THAT
THERE HAVE BEEN SOME. SOME SOME
DISCUSSIONS ABOUT HOUSE
DIVIDING IT INTO DOING THE
URGENCY- ISSUES NOW RELATED TO
COVE IT AND THEN HAVING THE
STAKEHOLDER- MEETINGS AND THE
LEGISLATORS MEETINGS AND
CONSULTATIONS TRUE
CONSULTATIONS ARE PROVIDING FOR
TRUE TRANSPARENCY SO THAT IN
TWENTY IT NEXT YEAR WE THEN PUT
TOGETHER THE BEST PROGRAM
POSSIBLE WITH TRUE INPUT IS
THAT STILL A POSSIBILITY. SEE
IT IT'S NOT A BINARY CHOICE
IT'S NOT ANY THE ROLE I MEAN
WE'RE GOING TO PURSUE THOSE
SHORT TERM OF ITEMS THAT I
DESCRIBED EARLIER. HOPEFULLY
WITH SOME PEOPLE FIND THE
DOCUMENTS WERE SENT OVER ON THE
DESCRIBES THEM ALL THAT JUST
HAPPENED SPENT AND TO YOUR
POINT ABOUT THE INLAND EMPIRE
OUR INTENTION IS TO SORT OF.
USE IT AS A TEMPLATE AND THEN.
SUMIT WE SEE SOME SUCCESS FROM
IT MOVE INTO OTHER AREAS. OF IN
YOUR HIGH IMPACT ON. AT THE
SAME TIME PARALLEL TRACK IS.
THIS PROCESS WITH LONG TERM
CARE HOME WHICH AS I SAID I'M
HAPPY TO COME BACK HERE. EVERY
MONDAY- BUT I'LL BRING THE
TECHNICAL STUFF NEXT ON AND-
CLICK THROUGH THE DETAILS WITH
INTERESTED LEGISLATORS ON CHILL
EVERY TIRE HAS BEEN KICKED. ALL
WHAT A CHARACTER. IS AMID ALL
OF THAT WORK ALL OF THAT
STAKEHOLDERS STILL ALL THAT
SYSTEM DESIGNED TO BAN. HOWEVER
WELL MAYBE YES MAYBE NO
DECISION. AFTER THE AFTER
JANUARY ALL WHICH AS WE JUST
FOUND OURSELVES TALKING ABOUT A
FEW MOMENTS AGO CAN SO EASILY
GET LINKED TO OTHER ISSUES THAT
ARE. NOT INHERENTLY CENTRAL TO
IT SO. I HOPE I'M BEING HONEST
AND CLEAR ABOUT THIS OF. I'D
LIKE I MEAN IT WHEN I SAY IT
WILL COME BACK EVERY MONDAY. I
DON'T. I DON'T QUESTION YOUR
YOUR YOUR HONESTY YOUR RECIPE I
DON'T QUESTION THAT ONE BIT. I
THINK THOUGH THAT- JUST AS
YOU'RE NEW TO THAT POSITION.
THERE MAYBE SOMEBODY ELSE IS
NEW TO THE POSITION WILL FORGET
WHAT IT IS YOU TOLD US YOU
WOULD YOU'D BE DOING EVERY
MONDAY. SO WHAT CAN BE PUT INTO
THE PROPOSAL TO ENSURE THAT
THERE IS SPECIFIC OVERSIGHT
FROM THE LEGISLATURE. L. AS THE
PROCESS GOES FORWARD AS THE
DEVELOPMENT OF THE DETAILS. OF
THE BENEFIT TO CONTINUE- I
THINK THAT THE TIMELINE FOR
THIS PROPOSAL HAS BEEN SO
RAPID. THAT THE CHANNELS OF
COMMUNICATION THE CHANNELS OF
FEEDBACK THIS CHANNELS OF A
CONSULTATION- HAVE BEEN- THAT
HAVE NOT BEEN THE- HAVE NOT
BEEN UTILIZED COMPLETELY OR
PROPERLY. SO WHAT IS IT THAT
YOU CAN PROPOSE SHOULD THIS
MOVE FORWARD. WHAT IS IT YOU
CAN PROPOSED TO ENSURE THAT THE
LEGISLATURE OVERSIGHT IS PART
OF THE PROCESS. IN WRITING. I
DON'T HAVE AN ANSWER FOR THE.
WILL YOU WILL YOU GIVE SOME
THOUGHT TO THAT- AND IN YOUR
DISCUSSION AS PART. I PROJECT
BORDERS AS I DON'T THINK THERE
IS AN ANSWER TO THE OUT OF
HOME. IT'S I JUST COMMITTED TO.
CONSTANT CONVERSATION ABOUT
SELECT IS NEEDED. OKAY SO
BESIDES CONVERSATION AND THAT
THAT I JUST IF I MAY UM NOT TO
BELABOR THE ISSUE BUT- THIS.
CONVERSATION THIS CONSULTATION
ONLY HAPPENED BECAUSE THE
LEGISLATURE THROUGH CHAIR
ARAMBULA REQUESTED IT AND THIS
ISN'T THE WAY IT SHOULD BE DONE
THANK YOU MISTER DIRECTOR THANK
YOU RICHARD. THANK YOU AND-
SEEING NO FURTHER QUESTIONS I
FIRST JUST WANT TO THANK THE
ASSEMBLY MEMBERS FOR THEIR
THOROUGH QUESTIONS AND AMOUNT
OF DETAIL THAT WE'VE BEEN ABLE
TO FLUSH OUT. AS DIRECTOR LIGHT
BORN TALKED ABOUT HIS HISTORY I
FIRST ONE ACTUALLY THANK HIM
THIS IS THE FIRST MEETING THAT-
I HAVE SEEN YOU PRESENT THAT
AS- YOU IN YOUR CURRENT
POSITION AND I COULDN'T THINK
OF A BETTER PERSON TO SIT IN
THAT SEAT NOW I THINK IT'S
IMPORTANT FOR US TO COMBINE
SOCIAL SERVICES AND HEALTH CARE
SERVICES AND YOUR KNOWLEDGE OF
THE LAST EIGHT YEARS AS
DIRECTOR. YOUR DIPLOMACY AND
YOUR COMMITMENTS TO PROCESS
WILL BE NEEDED TO ENSURE THAT
THE APPROPRIATE POLICIES ARE
BEING PUT FORWARD FOR US AS A
STATE. I DO WANT TO BRING MY
EXPERIENCE IF I CAN TO THE
TABLE AS WELL. BECAUSE I
BELIEVE AS A DOCTOR IN AN
EMERGENCY ROOM DOCTOR ONE OF
THE SKILLS I HAD TO LEARN.
QUICKLY WAS TO TRIAGE. AND IT
APPEARS THAT WHAT I'M SEEING
FROM YOU IS. PUTTING A NEW
OPTION ON THE TABLE. AND I
THINK WHAT I'M TRYING TO MAKE
SURE IS THAT WE ARE DEALING
WITH THE CRISIS THAT WE HAVE AT
HAND WHICH IS COVERED NINETY.
AND THE ORIGINAL PRESENTATION
OF THIS PROPOSAL SEEMED TO LINK
THIS BENEFIT WITH COVERT
NINETEEN. AND I'M NOT. SURE I
CAN GO THERE BECAUSE I BELIEVE
THAT. THIS POLICY NEEDS TO SLOW
DOWN AND IS BEING RUSHED AND
SHOULD NOT BE ALLOWED TO
DIRECTLY TO COVERT NINETEEN.
AND BECAUSE OF THAT I HAVE A I
STRUGGLE A LITTLE BIT WITH
WANTING TO PROVIDE THE URGENCY
THIS YEAR AT ALL. I BELIEVE
THAT WE NEED THE PUBLIC PROCESS
SO THAT WE CAN MAKE SURE WE ARE
ANSWERING ALL THE APPROPRIATE
QUESTIONS. NOW WHAT I DO WANT
TO ACKNOWLEDGE IS YOUR
ASSESSMENT DIRECTOR WHICH IS
THAT WE DO HAVE A PATCHWORK OF
AGING SERVICES THAT WE DO NOT
HAVE A COORDINATED INTEGRATED
SERVICE THAT THERE'S A NEED FOR
US TO TALK ABOUT ET AND
HOSPITAL DISCHARGES AND WHERE
PEOPLE GO AND WHAT TRANSITION
LOOKS LIKE AND THAT WE NEED TO
WORK TOWARDS A STATE WIDE
CAPACITY. I SEE WHERE IT IS
THAT YOU'RE DRIVING TOWARDS
WITH THE NINETEEN FIFTEEN HI
WAIVER LOOKING TO CREATE AN
UNCAPPED BENEFIT BUT I THINK
WHAT I'M TRYING TO MAKE SURE WE
DO IS IN MEDICINE WE ALWAYS
SAID YOU MEASURE TWICE AND CUT
ONCE. AND SO I'M JUST TRYING TO
MAKE SURE THAT WE- ARE DOING
OUR DUE DILIGENCE AND- IF I CAN.
I THINK WHAT CHAIR RAILS WAS
TRYING TO GET TO AND IF I CAN
JUST ASK A DIRECT QUESTION.
GIVEN HOW MUCH THE PROPOSAL IS
CHANGING. CAN THE
ADMINISTRATION COMMITS TO
BRINGING US A STABLE PROPOSAL
FOR CONSIDERATION IN JANUARY OF
TWENTY TWENTY ONE AND ALLOWING
FOR A PUBLIC DELIBERATIVE
PROCESS. IF IN BRINGING A
STABLE OUR FIRST IF IT ISN'T A
STABLE PROPOSAL BY THEN IT WILL
BE BECAUSE FRANKLY. CONCLUDED
THAT IT'S NOT FEASIBLE ALL.
THEREFORE I HAD WHAT I
ANTICIPATE IS THAT BY THE TIME
WE ARE IN JANUARY BUDGET
HEARINGS WILL BE ABLE TO REPORT
OUT EITHER THAT. YES THIS WE
HAVE A STATE PLAN BENEFITS THAT
CAN BE. MADE AS A AS A NINETEEN
FIFTEEN I AM AMENDMENT AWAY FOR
MANY TO THE STATE. ALL OR OR WE
DON'T- THAT IS THE COMMITMENT
ALLIF. PRECISE BECAUSE-
HONESTLY BETWEEN ALWAYS BEEN
IMPORTANT ALL IF THE QUESTION
IS WILL BE WELL I MIGHT BE
SAYING WE WILL BRING UP FOR A
VOTE OF SOME SORT DOWNTURN. NOW
WHEN I WOULD APPRECIATE THAT
THE PROPOSAL THAT'S PUT BEFORE
US IS SOMETHING THAT WE CAN
CONSULT AND CONTINUE TO WASSAN
AND DELIBERATE ON THROUGH THE
NEXT YEAR I JUST AM TRYING TO
ROAD MAP OUT A LITTLE BIT WHAT
SOME OF THOSE NEXT STEPS ARE
AND THEN THAT TEAM I HAVE THREE
FOLLOWING QUESTIONS AND THEN I
MAY MOVE US FROM THE PAST. AND
APPRECIATE THE STAMINA AND
WHICH YOU HAVE GIVEN US BUT IT
BECAUSE WE'RE LOOKING AT A
SOCIAL SERVICES LANDS WHAT
PERSON CENTRED ACCOUNTABILITY
AND OUTCOME MEASURES WILL BE
USED TO SHOW THAT THIS BENEFIT
IS HELPING AND NOT HURTING
AFFECTED MEDICARE RECIPIENTS.
THE EVALUATION IS GOING TO
OCCUR IN AT LEAST TWO OF THE-
ON THAT FIRST IS ON. HEALTH
ACUITY MEASUREMENTS ARE UP OR
PEOPLE STAINED. WELL ARE
BECAUSE THEY'RE HEALTH
STABILIZED ARE THEY- NOT HAVING
TO GO REPEATEDLY TO EMERGENCY
CARE FROM HOME I MEAN WHAT THE
GOAL IS TO HAVE STABLE
HEALTHCARE THIS IS NOT THE SAME
AS SAYING TWENTY FOUR HOUR CARE
IF SOMEBODY NEEDS TWENTY FOUR
HOUR MEDICAL CARE THAT. THIS
PROGRAM WILL WORK FOR THEM THAT
NEED TO BE IN AN INSTITUTIONAL
SETTING BUT ASSUMING THAT THEY
CAN BE MAINTAINED WITH LOOK
LET'S YOU KNOW SORT OF A
REASONABLE AMOUNT OF HOURLY
CARE. ALL OF THAT WILL BE A LOT
OF DAILY HERE ALL THAT THEN
WILL. BE ONE SECOND MEASURES
ALL ARE THE HAPPY. WITH SOME UP
WITH THAT QUESTION WE PEOPLE ON
IF THEY- CAME FROM THE NURSING.
TOOK THE LONG TERM CARE. ARE
THEY MORE SERVICE ARE LESS WITH
THE CIRCUMSTANCES OF THEIR
DAVID. ON IF THEY CHECK IF THEY
MOVED FROM ALL POSSIBLE
DISCHARGE. TO OUR TOTAL IN
THEIR HOMES OR THEY SATISFIED
WITH ARTICULATE CONFIDENT THAT
THEY ARE GETTING AND WILL GET
THE CARE THEY NEED- DOT SO THAT
IT'S GOING TO BE A CRITICAL
PIECE TO IT AND FINE TUNE
WITHIN THOSE TWO ON THE I
REALLY LOOK TO THE YOU KNOW
THE- HAPPINESS PART OF IT HOUSE
TOOK OUR THAT'S WHERE THEIR
SOCIAL CARE IS GOING TO COME
INTO- ARE THEY FEELING THAT.
THEY WERE IN CONTROL OF THEIR
ENVIRONMENT. THEY'RE ALL. OKAY
DAY LIVING IN. SO ABOUT THOSE
LAWS OF THE PORT THOUGHT WERE I
THINK WE- SOCIAL. AND MEDICAL
CARE TO ONE PACKAGE. YOU KNOW
I'M I'M REALLY INTERESTED BY
ONE OF THE COMMENTS YOU HAD
WHICH IS. IF YOU NEED US TO
FOCUS ON THIS NEW OPTION AND
NOT TO FIX ALL THE OTHER ISSUES
WITHIN THE PROGRAMS. AND I
BELIEVE WHY THAT'S IMPORTANT
FIX FOR ME IS TO ACTUALLY SAY
THAT THE CURRENT SYSTEM ISN'T
WORKING FOR ALL PEOPLE. AND
WHERE I GO IS TO THINK BACK TO
MY DAYS ON THE EMERGENCY
DEPARTMENT WHERE IF YOU WERE
JUST CHARGING SOMEONE YOU DON'T
ALWAYS HAVE A STABLE. LACED TO
GO WITH SYSTEM THAT WORKED
WITHIN NOT ONLY JUST YOUR
COUNTY BUT ACROSS COUNTY LINES
WHICH IS. WHY I SEE THE LOGIC
FOR BUILDING THE STATE WIDE
CAPACITY. BUT I WANTED IF YOU
COULD TO HAVE YOU EXPLAIN HOW
THIS BENEFIT THE SHARES A
PROPER AND COORDINATED.
HOSPITAL DISCHARGE AND CASE
IT'S INHERENT TO TOOK THE
DESIGN OF IT I MEAN IF IT'S IF
IT'S THE- INDIVIDUAL. PERSON
THE PERSON WAS THE CENTER OF
ALL THIS IF IT'S YOU KNOW THEIR
DOCTOR IS CONCLUDING THAT
EITHER THEY NEED TO GO TO
SKILLED CARE OR ALTERNATIVELY
HAVE LONG TERM CARE TOLD. AND
THEN. IS MAKING THAT REFERRAL
INTO. WHOEVER IS DOT LOCAL
CONTRACTOR FOR THE LONG TERM
CARE TO PROGRAM ALL WAS THEM
DOING THE INDIVIDUAL WORKING
WITH THE DOCTOR THE PHYSICIAN
DURING THE INDIVIDUALIZED
PERSON CENTERED CASE PLAN ALL
AND THEN SORT OF SAYING WHAT
ARE THESE RANGE OF NEEDS I'M IS
THERE THE NEED FOR WOUND CARE
IS THERE THE NEED FOR GI TO
HAVE MAINTENANCE IS THERE THE
NEED TO. GO DOWN THE LIST AND
THEN COME FROM THE OTHER SIDE
OF IT THE SOCIAL COMES ON TO
SAY AND FOR THE PERSON DOES OR
DOESN'T HAVE EIGHT AVAILABLE
CARE GIVER IN THE WHOLE OF
THEIR THAT CARE GIVERS CAPACITY
IS WALKED OFF IF THEY ARE
WORKING ON. SCHOOL DAY SHIFTS
AND ARE NOT HOME DURING THE DAY.
THAT IS THERE A DEVELOPER OF
ALL OF THREE CARE GIVER.
PRESENCE THE WHOLE AND THEN
WHAT IS REALLY THE- OF THE HOME
CARE GIVERS AND THEY HAVE TO BE
BROUGHT INTO THE CONVERSATION
TO THIS IS WHERE THE CARE GIVER
RESOURCE ALL NETWORKS COME INTO
PLAY ON. IT TOP CONVERSATION
BUT PEOPLE MAY NOT BE TOTALLY
UP FRONT ABOUT WHAT THE TENANT
CARE ACT ASSIST ALL AND THAT
HAS TO BE FACTORED INTO A CARE
PLAN AND IF THEY CARED IF THERE
IF WE CAN'T COME UP WITH AN
ALTERNATIVE CARE GIVER PLAN
THEN IT DOESN'T PROBABLY WORK
FOR THE CLIENT BUT IF WE CAN
EITHER THROUGH THE CARE GIVER
WAS AT HOME WITH SUPPORT OR
ALTERNATIVE CARE GIVER UP THAT
MAYBE IT IS WORKING AND THEN.
THE CCT PROGRAM THEY NEED TO
COME IN TO DO QUALIFICATIONS TO
MAKE MAKE THE PACKAGE WORK
THAT'S THE WAY IN WHICH I THINK
THE WHOLE COMES TOGETHER- BUT
IT'S BECAUSE- ALL THOSE PIECES.
KERN OPERATE. IN AN INTEGRATED
FASHION AS OPPOSED TO THE
PATCHWORK WHERE IF SOMEBODY
LINKS UP WITH ONE PROGRAM
VERSUS ANOTHER PROGRAM TO LOOK
AT SOME OF THAT NEED MET BUT
MAYBE NOT ALL. I'M AND I WILL
COMMAND THE DEPARTMENT FOR
LOOKING FOR FLEXIBILITY
SPECIFICALLY THE ONE REGARDING
GREATER THAN SIXTY DAYS STAYS
WITHIN US WAS AN EASY ONE. FOR
US TO HIGHLIGHT BUT I DO
BELIEVE THERE WERE MULTIPLE
THAT YOU WORKED IN JUST ONE ARE
COMMENDED FOR THAT. NOW I WILL
AND THANK THIS PANEL BUT I DO
WANT TO STATE I'VE- MADE IN MY
LIFE MISSION TO WORK TOWARD
HEALTH EQUITY. AND SO I DO WANT
TO HAVE A LANDS OF AN EQUITY
LINE IS TO ASK THE DEPARTMENT
IF. FOR WHAT POPULATIONS IN
PARTICULAR WOULD THIS AFFECT
AND WITH THIS MAGNIFY RACIAL
AND ETHNIC DISPARITIES THAT ARE
ALREADY WIDE EVEN FURTHER. WELL
WE SHARE THE I ALREADY RUN
HEALTH EQUITY ALL THAT IS SORT
OF MY MANTRA ONE AND EVERYTHING
IN THE PREPARATORY WORK ON
RIGHT. OKAY AND THE DESIGN THAT
WE ARE WORKING TOWARDS HAS TO
ADDRESS THAT ALONG THERE G. E.
O. BEST PART ON AGING LONG TERM
SERVICES AND SUPPORTS HOUSE OF
EQUITY SO GROUP THAT WE'RE IN
DIALOGUE WITH THE STAKEHOLDER
GROUP WE'VE- BROADENED IT TO
INCLUDE VOICES. WHO CAN ALL
SHORTLY POINT US TO PLACES
WHERE IT MAKES A DIFFERENCE THE
PIECES WHERE I THAT I KNOW HAS
WEEKS OF GONE BACK TO LOOK
AFTER. ALL ARE THESE ARE
GETTING THE RIGHT NOTES ON A
LIST OF AT ONE POINT THERE WAS
ALL SORT OF A- AN ASSUMPTION
THAT OF LONG TERM CARE AT HOME
COULD NOT BE PROVIDED IN OF
ASSISTED LIVING SIDE. I THINK
THAT IS NO SORT OF. BEING
REQUESTED PRECISELY BECAUSE
DEPENDING ON- PEOPLE'S INCOME
LEVELS. RESOURCES OUTSIDE. THE
INSTITUTIONAL SETTING ALL. WE
NEED TO BE SENSITIVE TO WHAT IS
A REALISTIC FOR PEOPLE AND I
WAS A LOOK AT THAT I KEEP
PUTTING IT ON THE ICE OFF ARE
THERE. SITUATIONS THAT ARE.
THAT PEOPLE OF COLOR. LOWEST
INCOME RECIPIENTS MAY NOT BE
ABLE TO ACCESS SO WE HAVE TO BE
SURE THAT WE CAN ACCESS. ALL
THAT'S OF. ALL OF THE GATE WHAT
HAPPENED. WITH THAT I WANTED TO
THANK THIS FIRST PANEL AND WE
WILL MOVE ON. TO STAKEHOLDER
REACTION PANEL WE WILL FIRST
HEAR FROM PATTY BERG THE FORMER
STATE ASSEMBLY MEMBER FORMER
CHAIR OF ASSEMBLY BUDGET
COMMITTEE NUMBER ONE AS WELL AS
ASSEMBLY COMMITTEE ON AGING AND
LONG TERM CARE. WE ALSO HAVE
CARING KIESLER THE EXECUTIVE
DIRECTOR OF THE CALIFORNIA
ASSOCIATION OF PUBLIC
AUTHORITIES FOR IHS US AND
TIFFANY WHITTON LONG TERM CARE
DIRECTOR S. CI YOU CALIFORNIA.
MODERATOR IF YOU COULD CONNECT
OUR FIRST PANELIST. PINE IS
OPEN. BURGER BELIEVE YOU THE
FIRST PANELIST YOUR LINE IS
OPEN IN THE SPEECH. ALL CAN YOU
HEAR ME TOO YES YES WE CAN GO
AHEAD ALL GREAT I'M SO SORRY
OKAY GOOD MORNING THANK YOU FOR
THE OPPORTUNITY TO TESTIFY
TUESDAY AND SHARE MY
PERSPECTIVE ON THE
ADMINISTRATION'S LONG TERM CARE
AT HOME PROPOSAL WELL I HAVE
SEVERAL CONCERNS I DO FEEL THAT
THE PROGRAM STATED GOAL TO
PROVIDE A MORE COORDINATED SET
OF MEDICAL AND HOME AND
COMMUNITY BASED SERVICES IT'S A
LOT OF ONE. WE ALL KNOW THAT
OUR LONG TERM CARE SYSTEM IS
BROKEN CALIFORNIA'S OLDER
ADULTS AND PEOPLE WITH
DISABILITIES STRUGGLE TO ACCESS
STREAMLINED COORDINATED CARE
AND BUSINESS DUE TO MANY ISSUES
INCLUDING LACK OF CAPACITY
WORKFORCE CHALLENGES AN
UNDERFUNDED SYSTEM AND
FRAGMENTATION ACROSS SILOS OF
CARE I HAVE WRITTEN AND BEEN
INVOLVED WITH THREE MASTER
PLANS ON AGING FOR THE STATE OF
CALIFORNIA AND MOST RECENTLY AS
A MEMBER OF THE LTSS
SUBCOMMITTEE. THE ISSUE
ADDRESSED IN THIS PROPOSAL
NAMELY THE TRANSITION CARE
BETWEEN HOSPITAL TO HOME A
NURSING HOME TO HOME IT'S NOT A
NEW ONE IN OTH THE TWENTY
FIFTEEN MASTER PLAN AND THE
TWENTY TWENTY LTSS REPORT THE
ISSUE OF CARE TRANSITION TO
WHAT THE DRAFT WITH CONCRETE
RECOMMENDATIONS I HAVE
IDENTIFIED CONCERNS RELATED TO
THIS PROPOSAL MY FIRST CONCERN
RELATES TO QUESTIONS REGARDING
THE TARGET POPULATION
PARTICULARLY MEDICARE
RECIPIENTS WHO NEED LONG TERM
CARE SERVICES. THIS DATA
INDICATES THAT QUOTE NOT ALL
MEDICARE BENEFICIARIES WHO
REQUIRE LONG TERM CARE SERVICES
WILL BE ELIGIBLE FOR THIS
BENEFIT UNQUOTE WHY IS THE
PROGRAM CALLED LONG TERM CARE
AT HOME IF PEOPLE NEEDING LONG
TERM. CARE MIGHT NOT BE
INCLUDED. FURTHER IT UP IN.
THAT QUOTE MANY OF THE LONG
TERM CARE. FOR UNDER THE
BENEFIT. MAY BE AVAILABLE OTHER
AVENUES AND OUR PROGRAMS AND
WELL. THIS SEEMS TO BE
CONFUSING AND APPEARS TO ADD ON
TO THE SIDE OF THE
FRAGMENTATION OF THE CURRENT
SERVICE DELIVERY SYSTEM. WHEN I
LOOK AT THE EXAMPLES LISTED ON
PAGE THREE AND FOUR OF THE
REPORT APPROVAL WOULD BE SERVED
UNDER THIS PROGRAM I HAVE
SERIOUS CONCERNS ABOUT
WORKFORCE SERVICE DELIVERY AND
COST NEEDED TO CARE FOR THAT
POPULATION IN A HOME SETTING.
THIS RELATES TO MY SECOND
CONCERN REGARDING
INFRASTRUCTURE AND ENSURING WE
HAVE THE SERVICE SOMEPLACE
BEFORE TRANSITIONING
INDIVIDUALS HOME. CURRENTLY
CALIFORNIA LACKS A STATEWIDE
INFRASTRUCTURE INCLUDING
WORKFORCE CAPACITY TO ACHIEVE
THE VISION OF THIS PROPOSAL
MULTISPECIALTY IN RURAL AREAS
OF THE STATE LIKE WHERE I LIVE
OUT OF. MY THIRD CONCERN
FOCUSES ON WORKFORCE CAPACITY
AND THE AVAILABILITY OF BOTH
PAID CARE GIVERS AND UNPAID
FAMILY CAREGIVERS WHO WILL BE
ESSENTIAL TO THE SUCCESS OF
THIS PROGRAM. THE PROPOSAL WITH
THREE PRIMARY CATEGORIES HAVE
SKILLED NURSING CARE THAT MAY
BE PROVIDED IN THE HOME ALL OF
THOSE IDENTIFIED IN THESE
CATEGORIES WILL INITIALLY NEED
TWENTY FOUR SEVEN DAYS A WEEK
SHARE BINDING BEST CARE
ESPECIALLY NOW IN THE PANDEMIC
ENVIRONMENT. IS PARTICULARLY
CHALLENGING AND IT'S ALSO VERY
COSTLY. ADDITIONALLY UNPAID
FAMILY OR FRIEND CARE GIVERS
OFTEN FACE SITUATION WHERE THEY
ARE CHALLENGED TO PERFORM
HEALTH MAINTENANCE STAFF FOR
LOVED ONES IN THE HOME.
INCLUDING BUT NOT LIMITED TO
TUBE FEEDINGS VENTILATOR CARE
OSTOMY CARE AND OTHER. IT'S NOT
CLEAR WHETHER FAMILY CARE
GIVERS WILL BE ASKED TO PERFORM
THESE TASKS OR WHETHER NURSES
OR LPNS WILL BE AVAILABLE TO
MEET THEIR NEEDS. UNFORTUNATELY
THERE ARE A NUMBER OF BARRIERS
TO OBTAINING THE SERVICES
INCLUDING WORKFORCE SHORTAGES.
AND COST OF CARE. I FOURTH CAN
CENTER ON BY UP AND EXTRA
HOUSING FOR THE WHO HAVE NO
HOME RETURN TO. THE CURRENT
PROPOSAL LACKS A CLEAR STRATEGY
TO ENSURE THE HOUSING STOCK
WILL BE SUFFICIENT TO MEET OUR
POPULATIONS NEED. BIKE PATH
CONCERN CENTERS ON THE ROLE OF
THE LEGISLATURE IN DEVELOPING A
FRAMEWORK THAT THIS PROPOSAL
AND THEN OVERSEEING ITS
IMPLEMENTATION. WE NEED A
TRANSPARENT PROCESS THAT HAD
BEEN FULLY VETTED BUT ALL
INVOLVED STAKEHOLDERS THAT STOP
FULLY ADDRESSES THE ISSUE. AND
ANSWERS THE QUESTIONS THAT ARE
POSED HERE TO PAY. WE ALL WANT
SOUND PUBLIC POLICY TO COME OUT
OF THIS EFFORT BUT IT CURRENTLY
APPEARS RUSHED FOR
IMPLEMENTATION IN TWENTY TWENTY
ONE. ENCLOSING MY HOPE IS THAT
THE ADMINISTRATION CAN TAKE
MORE TIME TO DEVELOP THIS
PROPOSAL IN CONCERT WITH
STAKEHOLDERS AND CERTAINLY THE
LEGISLATURE. ADDRESS THE
CONCERNS OUTLINED HERE TODAY.
AND BEFORE THE PROGRAM CAN BE
IMPLEMENTED WE NEED AN ADEQUATE
INFRASTRUCTURE IN PLACE.
OTHERWISE WE RISK PUTTING THE
CART BEFORE THE HORSE AND
ENDANGERING LIFE. THANK YOU SO
MUCH. THANK YOU ASSEMBLYMEMBER
MODERATOR IF WE CAN GO TO
MISTER KIESLER. HE FIRED BUT
CALIFORNIA ASSOCIATION OF
PUBLIC AUTHORITIES. I WANT TO
SAY THAT I WANT TO THANK YOU
THE MEMBERS OF THE SUBCOMMITTEE
AND THE LEADERSHIP FOR SAVING
OUR PROGRAMS IN THE LAST UDGET
FIGHT EXACTLY GOVERNOR'S LAND
ON THEIR BUDGET PROPOSAL BUT
YOU DID WAS FALL AND ARE VERY
MUCH APPRECIATED A CONCERN.
THAT I HAVE HERE AND I THINK
MANY OF YOU HAVE COVERAGE SAID
IS ON THE PRICE THAT THE
ADMINISTRATION IS. PARKING IS
CONFLATING TWO DIFFERENT THINGS
ONE IS A CRISIS REACTION TO
KOBE AND THE OTHER IS THE
OVERHAUL OF OUR LONG TERM CARE.
SYSTEM AND THERE'S DIFFERENT
THINKING THAT SHOULD BE APPLIED
TO THOSE TWO DIFFERENT GOAL. IN
MY FORTY YEARS AS AN ADVOCATE
WORKING OF LONG TERM CARE AND
HAVE A LOBBYIST- IN CALIFORNIA
MANY EFFORTS HAVE BEEN MADE TO
REFORM OUR LONG TERM CARE.
SYSTEM VERY FEW BEEN
SUCCESSFUL- LONG TERM CARE-
THERE ISN'T THE COURTS
STAKEHOLDERS VERY MUCH WELCOME
THE DISCUSSION ABOUT THE NEW
BENEFIT THAT HAS THE POTENTIAL
TO HELP PEOPLE AVOID PLACEMENT
AND NURSING HOMES BUT THERE ARE
A LOT OF. CONCERNS THE NUMEROUS
QUESTIONS ABOUT THE CURRENT
PROPOSAL INCLUDING WHY IS THE
ADMINISTRATION DRIVING TO HAVE
A STATE PLAN AMENDMENT.
SUBMITTED BY THE END OF THIS
YEAR- I AM COMPLETELY UNAWARE
OF ANY PARTICULAR DEADLINE THAT
THE ADMINISTRATION IS UP AGAIN.
THAT WOULD BE REQUIRED THAT
THIS STATE PLAN AMENDMENT BE
COMPLETED BY THE END OF THE
YEAR THERE ARE OTHER WAIVERS.
OTHER MEDIC CAL AGREEMENT THAT
THERE ARE TIMELINE BOND I'M NOT
AWARE OF ANYTHING THAT SAYS THE
TASK TO BE DONE BY THE END OF
THE YEAR. GOOD AND LONG LASTING
REFORM WILL FOLLOW GOOD CRISIS
RESPONSE. ON THE OTHER HAND BAD
REFORM. CAN CREATE A NEW CRISIS.
I DIRECTOR MORE SAID THAT CAN
BE DONE IN BY IN. WAY BUT THE
ACT. THREE DIFFERENT THINGS
THAT. WILL PROVIDE THEY COLDER
THERE KIND ABOUT. WANTED CRIED
RESPOND TO THIS ABOUT THE- A
PATH TO MEET REFORM. THE THIRD
THAT WE BURKE. IS THAT THE- RAT
OF THE BUDGET. ARE CLEARLY THIS.
WAS POORLY TIME IN A- IT IN THE
OF THE MAIN. THAT PROPOSED
IMPLEMENT. DEMOCRATS P. THE-
REVIEWS I THANK CARE GIVE READ
CENTERS IN YOUR CHRISTIAN AGE
ON THE- RESOURCE CENTERS AND
BUT SERVICE. IT TOOK ME YEARS
OF EFFORT BUILD UP THE M. OF
THE IS AND OTHER. LONG TERM
CARE PROGRAM IT DOESN'T MAKE
SENSE TO A LEMONADE OR REDUCE
THESE PROGRAMS. THAT HAVE BEEN
A WHOLE AND OURS SO. THAT'S ONE
NOW DURING THE WHOLE BIT- AND
THAT ADMINISTRATION. TOWARDS
COMPLETION OF A STATE PLAN
AMENDMENT BY THE END OF THE
YEAR JUST DOESN'T MAKE SENSE
WHAT WE SHOULD. BE SO FOCUSED
ON. CHRYSLER THREE NOW. TURNING
TO THAT. PROPOSED IT'S NOT
CLEAR AT ALL TRANSIT THIRD.
WOULD WORK AND HOW IT WOULD
WORK WAR HELLO. OR WITH
EXISTING SUCCESSFUL CALIFORNIA
CAN YOU TRENDS. PROGRAM BOB
MANY OF US ALSO BELIEVE THAT IT
WOULD BE A VERY IMPORTANT TOOL
RIGHT NOW WHERE THE DEPARTMENT
OF HEALTH CARE SERVICES TO
AUTHORIZE. THAT CCTV COMMANDING
CARE CALIFORNIA COMMITTEE
TRANSITIONS PROGRAM TWO THIRDS
MEDICARE BENEFICIARY TO OBTAIN
THEM FOR LESS THAN NINETY DAYS
WE KNOW THAT THE VAST MAJORITY
OF. SKILLED NURSING FACILITY
RESIDENTS ARE SHORTER TERM AND
WE SHOULD BE FOCUSED ON
DECOMPRESSION NOW- IT'S
UNDERSTANDABLE WHY THE
ADMINISTRATION WOULD BE
FOCUSING ON CENTRAL VALLEY
CRISIS RESPONSE. BUT I WANT TO
REMIND THE ADMINISTRATION THAT
THE INITIAL THIRDS WITHIN THE
BAY AREA AND WE DON'T KNOW
WHERE THE NEXT CRISIS. IS GOING
TO BE AND THAT E SHOULD BE IN
OUR CRISIS RESPONSE THINKING
ALSO BE FOCUSED ON THE BALLOT
STATEWIDE. ALREADY KNOW TO BE
ABLE TO EFFECT PEOPLE GETTING.
OUT OF NURSING HOME. I WAS
SPECIFICALLY FOR IN HOME
SERVICES PRO DURING COUNTRY NOW
AND POTENTIALLY. OUT THERE
BENEFIT. I AS A WEIGHT
CONSUMERS TO GET MORE HOURS
WHEN WE'RE STILL UNDER THREAT
INSTEAD TO HAVE THE ARE YOU
KEEP THE PROGRAM OUR THREE BY
SEVEN PERCENT. AND THAT HOW DO
THEY LOG YOU TAKE A FACT ON
JULY ON DECEMBER THIRTY FIRST
TWENTY TWENTY IT'S ALSO NOT
CLEAR THE FIFTH COULD MAKE ARE
ALREADY COMPLICATED I JUST THAT
FUNDING MORE COMPLICATED- THE
THAT THE RATE THAT IS BEING
DESCRIBED HERE I THINK THE
BUNDLE EVERYTHING INCLUDING I
CHECKED THAT- IT WOULD BE VERY
IMPORTANT FOR THE- PROPOSAL TO
EXPLICITLY HOLD. COUNTY
HARMLESS AND TO ALSO PROVIDE
ADEQUATE FUNDING FOR THE
ADMINISTRATIVE ACTIVITIES BOTH
OF THE EXISTING PROGRAM AND ANY
POTENTIAL NEW ADMINISTRATIVE
ACTIVITIES AND THEN I WANT TO
CLOSE ALSO AGAIN THEY'RE HERE
ON TIMELINE IT'S NOT REALISTIC
TO IMPLEMENT A STATEWIDE
BENEFIT AND TWENTY TWENTY ONE.
AND CAN DO. THE RIGHT. I
TOTALLY I OF WHAT DID NEED TO
BE BY THE END OF THE YEAR AND
WOULD AFTER THE ADMIN. WILL
PROVIDE MORE INFO ON. ALSO THE
STAKEHOLDER PROCESS IT FELT
SHOULD BE MORE TRANSPARENT
DIRECTOR OF WHITE BORN AND I
APPRECIATE THAT HE SAID THAT
THE BILL BE ISSUING THE PAPER
IN SEPTEMBER AND OF THE
ADDITIONAL. STAKEHOLDER MEETING
BUT FOR THE VAST MAJORITY OF
THE PUBLIC THEY LOOK AT THE
DEPARTMENT OF HEALTH CARE
SERVICES WEBSITE WHERE IT SHOWS
THERE WOULD ONLY BE THREE
MEDIUM AND THAT THOSE THREE
MEETINGS ARE BEHIND US WITH A
LAUGH HAVING DONE. JULY THIRTY
FIRST IT'S VERY IMPORTANT THAT
THEY AND THEY POST INFORMATION
AND KEEP IT UPDATED ON WHAT
THEIR TIME LINE AS TO WHAT THE
PROCESS IS FOR INPUT. THANK YOU
VERY MUCH. THANK YOU MISS
KIESLER. NEXT MISS WOODEN
PLEASE. GENERAL ELECTRIC YOU'RE
A MEMBERS SITTING RIGHT IN LONG
TERM CARE DIRECTOR WITH F. B.
I. CALIFORNIA THANK YOU SO MUCH
FOR THE OPPORTUNITY TO SPEAK
WITH YOU ALL TODAY I'M SPEAKING
ON BEHALF OF SEIU LOCAL TWENTY
FIFTEEN AND UW AFTER THE LOCAL
THIRTY NINE THIRTY COLLECTIVELY
WE REPRESENT OVER FIVE HUNDRED
THOUSAND IN HOME SUPPORTIVE
SERVICES PROVIDERS THROUGHOUT
THE STATE. I WANT TO BEGIN BY
STRONGLY ENCOURAGING THE
ADMINISTRATION AND LEGISLATURE
TO PRIORITIZE AND RESOLVE THE
ONGOING CRISIS AND CONGREGATE
CARE SETTING AS A RESULT OF
PROBATE NINETEEN WHICH OF
COURSE THE RECOMMENDATION OF
THE MASTER PLAN FOR AGING LPS
EXCEPT COMMITTEE. FOR IMMEDIATE
ACTION ITEMS. WITH RESPECT TO
THE- L. AND HOPE IF IT WE URGE
WE HAVE. TO TAKE. DISCUSSION
AROUND THE DESIGN AND
IMPLEMENTATION OF THE NEW
BENEFIT. HI MY AGE SHOULD
EXPERIENCE EXTEND WELL INTO
TWENTY TWENTY ONE AND MUST
INCLUDE LEGISLATIVE
DELIBERATION AND AUTHORITY.
HIGHLIGHTED MOVING AWAY TO
THAT. GIVEN THAT HALF OF ALL
HOPE IT MIGHT MCCARTY
CALIFORNIA OCCUR ENERGY HOMES
WE UNDERSTAND THE STATE.
URGENTLY AND CREATING THE LONG
TERM CARE BENEFIT HELLO. BY
CREATING BENEFIT THAT NEARLY.
BENEFICIARIES OF NOWHERE. OR
ALLOWS THEM BYPASS NEXT.
WITHOUT THE DRESSING UNDER. LAW
LASTING ISSUE. BY THE POUND. DH
WE ARE MOVING OUT. TO TACKLE
DISPARITIES AND THE- OF. THAT
TERM CARE A HOME BENEFIT MUST
PRIORITIZE. EQUITY IN THE- IN
ORDER TO ENJOY THE THIRD TO
HELP. HI METALLIC RATE AND
ACCESS TO SERVICES AND UNDER
THIRD AND UNDERSERVED. WELL ALL
ADDRESSING IS FRIEDMAN LONG
TERM WORK. HELLO DIRECT YOUR
WORK FOR NEEDS TO BE AND DOOR
TO DELIVER. IT CRITICAL EASTER
CHAU. WORKERS OVER WOMEN AFTER
OF COLOR MANY OF WHOM ARE IN.
ARE IN. TO THE COUPLE I THEY
ARE THE ONLY HERO ON THE-
ACCOUNT BY AGAIN COLD IT MAY.
YES THE INDOOR UNDER. WORKING
COULD. ON THE MINIMUM WAGE WE
LITTLE TOO HELP BENEFITS THREE
DAYS OF SICK PAY. AND I CAN GO
ON AND ON. LET YOUR PRIORITIES
WE CAN LOOK TO THE AGENT THAT
THE PRIVATE SECTOR WORKFORCE
RECOMMENDATIONS IN THE MASTER
PLAN ON AGING OUT YET THAT THE
COMMITTEE REPORT MAY TWENTY
TWENTY. I WILL QUICKLY
HIGHLIGHT SOME OF OUR CONCERNS
AND RECOMMENDATIONS AS IT
RELATES TO THE LTC AT HOME
BENEFIT. THE THIRD LONGTIME THE
IMPLEMENTATION OF THE BENEFITS
WHICH HAVE ALREADY BEEN TOUCHED
ON. THE CHOICE OF THE PH OF THE
LICENSING AGENCY. YEAH SHOULD
NOT DESIGNATE DPH AT THE AGENCY
RESPONSIBLE FOR LIKE. IDPH
OTHER HISTORY OF SELLING TO
PERFORM STATUTORILY REQUIRED
OVERSIGHT RESPONSIBILITIES
WORKING NOT ONLY THE SAFETY AND
WELFARE OF RAIL BONOBO
CALIFORNIA RESIDING AND LONG
TERM HEALTH HEALTHCARE
FACILITIES. BUT ALSO FEDERAL
FUNDING FOR THE MEDICAL
PROGRAM. THIRD OF OVERLAPPING
AND DUPLICATIVE SERVICES AND
PROGRAMS WE WOULD ENCOURAGE THE
AGE YOU HAVE TO WORK OFF OF
EXISTING MODELS THAT PARTNER
WITH A DEFECT LIKE THE VC T.
PROGRAM. TO MAXIMIZE CARE FOR
THOSE WHO ARE ELIGIBLE. WE
RECOMMEND CLARIFYING BENEFIT
TARGET POPULATION THAT HAS
ALREADY BEEN TOUCHED ON TODAY-
THE ESTABLISHMENT OF A
STANDARDIZED. ASSESSMENT TOOL
AND FINALLY ENSURING EQUITY.
ACCESS AND AFFORDABILITY. TO
CONCLUDE WE LOOK FOR TO THE
CONTINUED COME. WE WERE THAT
THE LONG TERM CARE AT HOME
BENEFITS. AS WELL WEEK AND ON
BUT THAT WE- IT IS BEYOND THE-
THAT WE TAKE THE TO PAY CLOSE
ATTENTION TO THE GREEK. BEFORE
IMPLEMENTING THE MEDINA. WE
HAVE ABOUT THE ARE YOU A TWENTY
FIFTH AND YOU W. MIDDLE THIRTY
MY THIRTY WE THANK YOU FOR YOUR
CALL IN A BILL TO SHARE YOU ALL.
I WANT TO EXPRESS OUR SINCERE
THANK YOU TO CARE RARE FOR HER
COMMENTS. TO I HAVE PROVIDERS
THANK. THANK YOU MISS OF. MAN
YOU I CAN Mà. I'M GOING TO A
SPRING AND- TURN. LIKE CAR FROM
THE SCAM- INDEPENDENT. ARTISTS
USE ME FROM THE SCAM COMMUNITY
SERVICE- BEFORE ONE O'CLOCK
BECAUSE I UNDERSTAND SHE HAS A
CONFLICT. MODERATOR IF YOU CAN
BRING THIS LIKE ON YOUR- YOUR
LINE IS OPEN. HI THANK YOU VERY
MUCH FOR ACCOMMODATING MY
SCHEDULE THANK YOU ALSO FOR
ALLOWING ME TO SPEAK TODAY
HONORABLE CHAIRMAN AND MEMBERS
IT IS AN HONOR TO BE HERE TODAY
AND TO PARTICIPATE IN THIS.
VERY IMPORTANT DISCUSSION. SO I
AM DENISE LIKE A VICE PRESIDENT
OF INDEPENDENCE AT HOME-
PAKISTAN COMMUNITY SERVICE LOS
ANGELES COUNTY. WE HAVE AN MSSP
PROGRAM AND OTHER SERVICES
THERE TODAY MY COMMENTS WILL
BE- AROUND BOTH MSF P. AND I'M
ALSO REPRESENTING THE BATHS- TO
DAY. IN ORDER TO BRING SOME
COLOR TO THE CONVERSATION.
FIRST FOR THE REACTOR IT'S A TO
ECHO THE- I'D LIKE TO ECHO THE
CONCERNS OF THE HONORABLE
MEMBERS AND PRIOR PANELISTS.
REGARDING THE LTC AT HOME
BENEFIT SOMETHING THAT I WANT
TO POINT OUT HERE IS. THAT THE
INABILITY TO FIND THE ISSUE AT
HAND WILL END WHILE ADDING
FRAGMENTATION OR AN ADDITIONAL
FILO INTO THE EXISTING SYSTEM A
CARE. BY PROPOSING A NEW
PRODUCT TO OVERLAY INSTEAD OF
UNIFYING STRENGTHENING AND
EXPANDING THE CURRENT PROGRAMS.
AND CARE DELIVERY BY COMMUNITY
BASED PROVIDERS WHO HAVE THE
EXPERIENCE AND KNOWLEDGE AND
SKILLS TO DELIVER THE CRITICAL
SERVICES IN COORDINATION
NEEDED. JUST BEAMS BACKWARDS
AND WHAT I APPRECIATE TODAY AND
I KNOW THE NEXT PANEL WHICH
WERE WHERE I WAS SUPPOSED TO BE
ON IS REALLY GOING TO BE
TALKING ABOUT A PATH FORWARD. A
SHORT TERM AND I KNOW THAT THE
LTSS THAT THAT THEY DON'T HAVE
TO SUBCOMMITTEE. SHORT TERM
PLAN THAT THEY HAVE BROUGHT
FORTH TODAY THAT MYCOLLEAGUE
CLLR RAMSEY WILL GO INTO DETAIL
NEXT ON. AND THEN ALSO THE LTFS
SUBCOMMITTEE IS WORKING ON A
LONGER TERM PLAN FORWARD- TO
PROPOSE IN ORDER TO REALLY.
STRENGTHEN AND LIFT UP WHAT WE
ALREADY HAVE PROGRAMS CAN BE
EXPANDED IN CAN BE MADE
STATEWIDE THERE'S A LOT OF WORK
THAT WOULD NEED TO BE DONE FOR
THAT. BUT LET ME TRANSITION TO.
ELEMENT TRANSITION TO THE
MATTER AT HAND TODAY. ON THE
NEXT PANELISTS WILL YOU WILL BE
DESCRIBING TO THE TWELVE
RECOMMENDATIONS I BELIEVE THE
CALLS ON THE BINDER THAT THE
LTSS SUBCOMMITTEE. HAS BROUGHT
FORTH AND UP TO DATE TODAY WHAT
I WOULD LIKE TO SPEAK TO OUR-
SUPPORTING ALL OF THE
RECOMMENDATIONS BUT I'D LIKE TO
SPEAK TO. BOTH EMMA FIFTY AND
THE SEA BASS MODEL OF CARE. I
REALLY DO WANT TO ALSO ECHO- MY
ONE OF MY FORMER BUT ONE OF THE
PANELISTS COMMENT ABOUT
THANKING YOU FOR YOUR- STRENGTH
DURING THE BUDGET CYCLE BECAUSE.
I'M A FIFTY ANTI BASS WERE TO
PRO GRAMS UP FOR ELIMINATION.
BUT I BELIEVE IF WE TAKE A STEP
BACK. FROM THE BUDGETARY CAN.
AND WE WERE LOOK AT VALUE OF
THESE MODELS THERE'S MORE THAN
FORTY YEARS OF DEEP KNOWLEDGE
AND UNDERSTANDING OF THE
POPULATIONS WE SERVE AS- WELL
AS KNOWLEDGE OF THE COMMUNITY
AND THE GROUND LEVEL. WE KEEP
PEOPLE OUT OF SKILLED NURSING
FACILITIES FROM OUR WORK
WHETHER IT'S IN OUR CENTER.
WHETHER IT'S BEEN IN THE HOMES
OR UNDER COPE ITH WHETHER IT'S
BEEN IN THE ADAPTED STYLE WE
HAVE BEEN DELIVERING. WE HAVE
BEEN HELPING PEOPLE FOR YEARS
STAY IN THE COMMUNITY. HEALTH
SAFETY AND WELFARE FOR THOSE
WHOM WE SERVE IS AT THE
FOREFRONT OF BOTH PROGRAMS.
THIS BECAME AN EX EXTREMELY
IMPAIR UP EXTREMELY APPARENT
DURING THE PANDEMIC. WE DO
COMPREHENSIVE ASSESSMENT CARE
PLANS COORDINATION AND SERVICE
DELIVERY WHICH ARE ALL
HALLMARKS OF OUR MODEL. WE ARE
INTENSIVE HIGH TOUCH TO ENSURE
CRITICAL NEEDS ARE MET. TO
ENABLE SUCCESSFUL LIVING IN THE
COMMUNITY. WE ASSESS AND
SUPPORT BOTH THE CLIENT AND THE
CARE GIVER. AND I HEARD
DIRECTOR LIGHT ONE TALK ABOUT
THE NEED FOR STABLE STRONG CARE
GIVING AT HOME IN THE COMMUNITY
AND HE IS ABSOLUTELY RIGHT. AND
WE WORK WITH IHS US AND OTHER
AND THE CARE GIVER RESOURCE
CENTER AS WELL AS TO OUR OWN
STAFF AND THEIR COMPETENCIES TO
HELP SHORE UP THAT CARE GIVING.
AND FOR MSSP IN PARTICULAR
WHERE IS THE GAP WHERE THERE'S
A GAP WE HAVE. THE ABILITY TO
USE WAIVER SERVICES TO PURCHASE
OF THAT GAP AND SEE BASS HAS
THE ABILITY. TO BRING SERVICES
TO HELP WITH THOSE GAPS. EVEN
COVERED WE HAVE PIVOTED EXT.
ARM OF CARE WORKING WITH THE
CHALLENGES OF THE PANDEMIC TO
CONTINUE. TO ENSURE HEALTH
SAFETY AND WELLNESS FOR EXAMPLE
THE BASS IS GOING TO CREATED
THE CENTER WITHOUT WALLS.
THEY'RE DELIVERING SUPPORTIVE
SERVICES THROUGH TELEHEALTH.
EXPANDED PERSON CENTERED CARE
WITH REMOTE AND IN CENTER WORK.
AND THEY'VE BEEN ABLE TO
FURTHER THEIR RELATIONSHIP AND
SUPPORT FOR THEIR FAMILY
CAREGIVERS. FOR MSSP WE'RE ALSO
USING TELEHEALTH TO CONNECT AND
COORDINATE. FREQUENCY OF CALLS
HAVE ALSO INCREASED TO ENSURE
NEEDS ARE MET. AND WE ALSO
AREN'T DO FRONT PORCH VISITS TO
DROP OFF CRITICAL SUPPLIES SUCH
AS FOOD AT THE AS- DIRECTOR
WAITED TALKED ABOUT EARLIER.
ARE WAVERED SERVICES FUND THAT
WHICH IS THE BEST A PORT
COMPONENT OF THE NINETEEN FIFTY
THREE WAIVER FOR MSSP. WE'VE
BEEN ABLE TO USE THAT TO SHIP
TO FILL MAJOR GAPS DURING COPE
AT. SUCH AS PAIN FOR
SUPPLEMENTAL CARE GIVERS GIVING
WHEN THE I JUST WORKER. DIED
JUST CARE GIVER HAS NOT BEEN
AVAILABLE. AND BEING ABLE TO
KEEP THEM AT HOME AND PREVENT
THEM FROM GOING. TO THE
EMERGENCY ROOM BY GETTING THE
CARE THAT THEY NEED. THESE
MODEL ARE PROOF. AND NEEDED
MORE THAN EVER. WE ARE
FOSTERING CONNECTIVITY SECURITY
WHILE COMBATING LONELINESS AND
ISOLATION WHILE DE LEVERAGING
OUR DEEP RELATIONSHIPS THAT IS
FOSTERED BY OUR MODEL CARA
PRINCIPLES. THE LESSON LEARNED
FOR REACHING BEYOND OUR MODEL.
DURING THE COPA CRISIS SHOULD
ALSO BE CONSIDERED PART OF
THESE PROGRAMS MOVING FORWARD.
WE CAN REACH WE CAN REACH
PEOPLE BETTER IN THE
SITUATIONS. AND IT WOULD LEAD
TO THE CONVERSATION OF HOW WE
PUT THESE SERVICES MORE AND
MORE COMMUNITIES THAT NEED US.
WE IN THE PROPOSAL THAT YOU'LL
SEE FROM THE LTFS SUB COMMITTEE
THERE ARE RECOMMENDATIONS
AROUND BOTH THE BATSMEN MSSP TO
CONTINUE TO LEVERAGE THESE
MODELS. IN NEW WAYS AND IT
MOVING FORWARD YOU WILL SEE THE
MSSP WE ARE ASKING FOR RATE
IMMEDIATE RATE STABILIZATION
AND SLOT RESTORATION. FOR THE
IMMEDIATE SHORT TERM. THEREARE
THE NOTE THAT THAT WOULD HELP
US BE ABLE TO BE ABLE TO
CONTINUE TO BE ACTIVE FOR THE
RESPONDING TO COVET AND MAKING
SURE OUR RATES ARE THERE TO PAY
OUR PROVIDERS. S. WE EXPECT
LOOKING FOR EXPEDITED
ENROLLMENT PROCESS AS OUTLINED
IN THE PROPOSAL THAT WILL
ENABLE FASTER ENROLLMENT. CARE
PLANNING AND DELIVERY OF
INTERVENTIONS TO THE COMMUNITY.
WHAT WE BOTH THE BATON MSSP ARE
ALSO WELL POSITIONED I HEARD
DIRECTOR LIGHT BORN ALSO TALK
ABOUT. HOW THE MSF PNC BASSES
MAY NEED TO LEVERAGE THEIR
COMPETENCIES AND DIFFERENT WAYS
AND POSSIBLY IT AND NEW
STRUCTURES AS WE MOVE FORWARD
IN TERMS OF SERVING THE STATE.
WHAT THE HE BATH AN MSSP ARE
ALREADY EXPERIENCED TO PROVIDE
RAPID RESPONSE CARE MANAGEMENT
ON THAT IF THE IN TERMS OF THE-
IN THE RECOMMENDATIONS WHERE WE
HAVE OUTLINED- CASE MANAGEMENT-
OPTIONS TO BE ABLE TO BE ABLE
TO DO THE ASSESSMENT AND HELP
DO THE ANY NATIONAL CARE
PLANNING AND GET PEOPLE TO THE
SERVICES THAT THEY NEED. NOT
EVERYBODY MAY NEED THE SERVICES
THAT ARE BEING PRESENTED TODAY
BUT WE CAN HELP IN THAT PROCESS
OF BEING ABLE. TO DO THAT
ASSESSMENT AND MOVE THEM
FORWARD. SO WITH THAT I THANK
YOU AGAIN FOR DEFINITELY
ALLOWING US TO SPEAK AND REMOVE
IN MY TIME SO THAT I COULD
SPEAK TODAY. AND REALLY ASK
THAT YOU CONSIDER THOUGHTFULLY
A PATH FORWARD ESPECIALLY AS WE
GO TOWARDS THE NEXT BUDGETING
TO THE STATEMENT. AND FOR NOW
THE BEST NUMBER TO BE STAND
READY TO HELP THE STATE IN THE
IMMEDIATE RESPONSE ON THE
GROUND. THANK YOU VERY MUCH.
THANK YOU MISSED LIKE OUR I
WOULD LIKE TO ASK IF MEMBERS
HAVE QUESTIONS FOR THIS PANEL.
AND IF THEY DO I WOULD LIKE YOU
TO DIRECT YOUR QUESTION TO A
SPECIFIC PANELISTS. AND FOR THE
PANELISTS PLEASE ON YOU
YOURSELVES WHEN YOUR NAME IS
CALLED AND RE MUTE. ONCE YOU'VE
CONCLUDED. WE THAT. DOCTOR WHAT.
JUST CUT. JUST COMMENTS
PERSONAL THANK YOU VERY MUCH TO
THE PANEL- VERY MUCH APPRECIATE
YOUR PERSPECTIVE AND- SPECIALLY
ONCE A HIGH TO PADDY. OUT THERE.
I KNOW SHE'S UP IN EUREKA HER
HOPE SHE'S UP IN EUREKA BUT-
AND WHO'S A REAL WHO'S BEEN A
REAL EXPERT IN REAL ADVOCATE
FOR- FOR- SENIORS- IT
THROUGHOUT HER ENTIRE CAREER SO
I THINK YOU FOR YOUR INPUT. AND
WE VERY MUCH APPRECIATE THAT WE
ARE TAKING NOTES AND- AND I
SUSPECT OTHERS ARE TAKING NOTES
AS WELL BUT- THANK YOU SO MUCH
FOR THE FOR THE INFORMATION.
AND THE PASSION AND WHAT YOU DO
ALL OF YOU- WE'RE HERE TO
SUPPORT YOU AND- SUPPORT MORE
IMPORTANT TO SUPPORT THOSE
PEOPLE WHO NEED WHO NEED TO THE
SERVICES AND MAKE SURE WE GET
THE BEST WAY POSSIBLE SO THANK
YOU SO MUCH. CARESS I TOO WANT
TO THANK OUR PRESENTERS-
ASSEMBLY MEMBER BURKE IT YOU
ARE VERY SPECIFIC IN YOUR FIVE
CONCERNS SO I THINK THAT THOSE
ARE CONCERNS WE SHARE THANK YOU
FOR PUTTING THEM PUTTING THEM
SOSA SIMPLY- I THINK NUMBER
FIVE OBVIOUSLY IS THE ONE THAT
I'M MOST CONCERNED WITH AND
THAT IS THE ROLE OF THE
LEGISLATURE TO OVERSEE THE
PROCESS SO EXTREMELY IMPORTANT
IN ALL OF THIS. I WANT TO THANK
ALSO KAREN KIESLER- I THINK
YOU'RE RIGHT TO IT'S THE
PROCESS THAT WE HAVE TO LOOK
AT- IT'S LOOKING AT THIS IS TWO
DIFFERENT THINGS THE CRISIS-
THEY WERE DEALING WITH THE NOW
WITH COVERT AND THE OVERHAUL OF
THE ENTIRE SYSTEM- AND- THESE
ARE TWO SEPARATE AND DISTINCT
THINGS AND I THINK THAT WE
SHOULD LOOK AT THEM THAT WAY
AND TIFFANY IT'S ALWAYS GREAT
TO HEAR YOU. AND DO ALWAYS HERE.
THE NUMBER OF PEOPLE YOU SPEAK
FOR FIVE HUNDRED THOUSAND I HSS
WORKERS. I THINK THAT IT IS
EXTREMELY IMPORTANT THAT I WAS
A WE GO THROUGH THIS PROCESS.
THAT I HSS WORKERS BE INCLUDED
IN THESE CONVERSATIONS BECAUSE
IN THE END WE ARE GOING TO RELY
ON ALL OF THOSE WORKERS TO HELP
US IMPLEMENT THIS PROGRAM BUT I
AGREE IS A WONDERFUL PROGRAM.
SOMEBODY'S GOT TO DO THE WORK
AND I KNOW WE'RE GOING TO RELY
ON YOU AND ALL OF YOUR MEMBERS
AND WE'VE GOT TO MAKE SURE YOU
ARE AT THE TABLE WHEN WE'RE
COMING TO DECISIONS REGARDING
IT. SO THANK YOU ALL THREE OF
YOU. THANK YOU CHAIR ASSEMBLY
MEMBER MATHIS. BALLS KEEP IT
SHORT AND SWEET MISTER CHAIR
REALLY LIKE TO THANK THE PANEL
FOR TAKING THE TIME ON THIS
IMPORTANT ISSUE AND I THINK NOT
JUST MYSELF BUT- ALL OF- MY
COLLEAGUES TRULY APPRECIATE
YOUR INPUT AND- THE QUESTIONS
PRESENTED AND THE CONCERNS I
THINK WE ALL SHARE THOSE AND
ARE ALL LOOKING AT THOSE MOVING
FORWARD SO AGAIN. THANK YOU TO
THE PANELISTS. WHAT THANK THANK
YOU THANK YOU UP FOR YOUR
INDULGENCE I POSIT I DO WANT TO
ADD ONE ONE OTHER FACTOR HERE
THAT I THINK IS REALLY REALLY
IMPORTANT- CERTAINLY- ALL
EVERYBODY SITTING UP HERE RIGHT
NOW IS- REPRESENT REPRESENTS
AREAS WHERE THERE ARE HUGE
WORKFORCE SHORTAGE ISSUES- AND-
YOU KNOW CERTAINLY AS A SOMEONE
WHO REPRESENTS A LOT OF A
LARGELY RURAL AREA A LOT OF THE
CHALLENGES THAT WE FACE NOT
JUST WORKFORCE BUT ALL OF THE
OTHER ISSUES- TEND TO GET
MAGNIFIED AND THEN WE WERE
DEALING IN A CRISIS LIKE WE ARE
NOW. IT'S DOUBLY MAN MAGNIFIED
AND SO WE ARE AT THE END OF THE
DAY ONE BE SURE WHATEVER
BENEFIT WE GET IS THAT IT IS
PROPER IT IS PROPORTIONATELY
FAIR FOR EVERY PART OF THE
STATE AND- AND SO THAT WE GET
THE EVERYBODY GETS THEIR FAIR
SHARE RESOURCES AND THAT IS
SOMETHING WE ALWAYS STRUGGLE
WITH IN OUR IN OUR RURAL
COMMUNITIES AND OTHER
COMMUNITIES THAT ARE THAT THAT
DINNER UNDERSERVED SO. SO JUST
WANT TO PUT AN EXCLAMATION
POINT ON THAT PART OF IT AND
THANK YOU AGAIN. THANK YOU TO
WOULD BECAUSE I THINK YOU
ACTUALLY BEAT ME TO- BE ADDED
TO IT BECAUSE- I DO HAVE BEEN.
WANTING TO MAKE SURE WE HAVE
THE WORKFORCE TO DEAL WITH THIS
IN OUR RURAL COMMUNITIES. I
WANT TO FOCUS I WILL HAVE TWO
QUESTIONS FOR THE PANEL AND
THEY WILL BE FOR- FORMER
ASSEMBLYMEMBER BURKE AS WELL
AS- USE KIESLER. AND THEY'RE
GOING TO BE ABOUT THE TIMING OF
THE PROPOSAL. YOU KNOW I'MKIND
OF FOCUSED ON IT I USED TO.
SURGICAL TERM EARLIER IT COULD
HAVE BEEN A CARPENTRY TERM AS
SOMEONE REMINDED ME. BUT I DO
BELIEVE THERE IS THIS IDEA THAT
YOU CAN DO IT RIGHT. YOU CAN DO
IT CHEAP OR YOU CAN DO IT ON
TIME. YOU CAN DO TWO OF THE
THREE. AND I THINK WHAT YOU'RE
HEARING FROM THEM MAJORITY OF
US'S LET'S SLOW DOWN THE
PROCESS SO WE CAN DO IT RIGHT.
AND I BELIEVE AND WOULD LIKE TO
HEAR FROM THE STAKEHOLDERS WHAT
IS OR WHAT ARE YOU REQUESTING
IN TERMS OF TIMING FOR THIS
PROPOSAL. I DON'T IT IS PATTY
BURKE CAN YOU HEAR ME YES MA'AM.
MMHM OKAY I DON'T- I MEAN I
JUST THINK THERE'S A LOT OF
PRELIMINARY WORK THAT HAS TO
HAPPEN FIRST- YOU KNOW THERE
HASN'T BEEN ANY THAT I'M AWARE
OF PRELIMINARY WORK DONE TO
IDENTIFY THE PATIENT POPULATION
THAT WOULD BE ELIGIBLE FOR THIS
BENEFIT NOR WHAT CRITERIA WILL
BE USED TO DECIDE WHICH
PATIENTS COULD BE SAFELY
DISCHARGE. I HAVE TO SAY THAT
I'VE HAD- FORTY SEVEN YEARS
EXPERIENCE WITH SKILLED NURSING
AND CERTAINLY CRAIG CORNET CAN
ADDRESS THAT- IN A GREAT WAY
BUT- I HAD TWO HIP REPLACEMENTS
IF I HADN'T HAD TWENTY FOUR
HOUR CARE AT HOME I WOULD HAVE
HAD TO RUN INTO A SKILLED
NURSING FACILITY AND I'VE
VISITED BROWN TO APPLYING TO
SKILLED NURSING FACILITIES
AFTER HIP REPLACEMENT BECAUSE
THEY DIDN'T HAVE ANYBODY AT
HOME TO PROVIDE THE CARE. AND
THE WORK FORCE ISSUES ARE GOING
TO BE HUGE HERE AND THERE ARE
SO MANY THINGS I MEAN I LOVE
THAT OUR LONG TERM SERVICES AND
SUPPORT SHOP COMMITTEE HAS
DEVELOPED IN THE CONCRETE
RECOMMENDATIONS. FOR YOU AS IT
RELATES TO WHAT WE COULD BEGIN
DOING NOW AND I JUST THINK THAT
THERE IS I THINK THERE LOT OF
WAR OTHERWISE I MEAN I CAN
ABOUT LIABILITY ISSUES I'M
CONCERNED ABOUT GETTING PEOPLE
HOME TOO QUICKLY WITHOUT THE
SUPPORT THAT THEY NEEDED AND-
AND DYING ESSENTIALLY I AM JUST
VERY CONCERNED ABOUT THAT I
JUST THINK WE HAVE TO TAKE WE
REALLY HAVE TO TAKE TIME YOU
HAVE TO UNDERSTAND THE WORK
FORCE. AND THAT IS THAT IT
THAT'S A HUGE ISSUE BOTH THE
UNPAID CAREGIVERS ESPECIALLY AT
IT AS WE'RE DEALING WITH THIS
PANDEMIC AS WELL AS- AS WELL AS
THOSE THAT ARE PAID CARE
GIVERS- AND THERE'S A REAL
SHORTAGE AND CERTAINLY IN RURAL
AREAS WHERE I LIVE SO. I DO
THINK WE HAVE TO GO SLOWLY I
DON'T THINK WE'RE GOING TO HAVE
ANYTHING TO BE ABLE TO OFFER TO
DO ESSENTIALLY THE WORK THE
PRELIMINARY WORK HAS TO BE DONE
NOW AND THEN MAYBE WE CAN HAVE
SOMETHING IN TWENTY TWENTY ONE
I DON'T KNOW ABOUT BUT I BE
TRYING TO RUSH IT WITH OUT THE
LEGISLATURE BEING INVOLVED
EVERY STEP OF THE WAY IS- IT IT
IT JUST FELT. DISASTER
COMMITTEE. I WOULD GUARANTEE
WHAT WHAT CALIFORNIA. OF PUBLIC
AUTHORITIES YOUR SPECIFIC
QUESTION WAS WHAT IS OUR OUR-
SO I TO ONE IS FOR THE- TO A-
WHY. THIRTY FIRST WOULD BE
THERE TIME LINE. THAT YOU
COMPLETE THE DESIGN AND
DEVELOPMENT OF THE PROPOSAL AND
WITH THE MEDICINE FIVE AND THE
SECOND IS FOR THEM TO INCLUDE
THEIR PROPOSAL AND THE
GOVERNOR'S JANUARY BUDGET. FOR
IT YOU GO THROUGH THE REGULAR
BUDGET PROCESS. AND THEN YOU
LOOK AT THE DEVELOPMENT IN THE
OUT YEARS THERE IS NO WAY THAT
WE CAN DEVELOP A RESPONSIBLE
STATEWIDE BENEFITS THAT. WOULD
BE IMPLEMENTED NEXT YEAR. NOW I
HEARD HOW DO I SUPPORT WHAT CAN
JEFF BET AND THE PATTY BURKE
CAN TOTAL SUPPORT THAT WE DON'T
HAVE THAT WE HAVE THE
INFRASTRUCTURE IN PLACE THAT
THAT WAS OUR FIRST- OUR FIRST
OBJECTIVE LOGIC AT THE EVERY
STRUCTURE OF SERVICES IN PLACE
THROUGHOUT THE STATE OF
CALIFORNIA PRIOR TO DOING
TRANSITION I MEAN THIS IS BIG
FOR THE COLD IN THE CALL THAT
CRISIS BUT- IN ADDITION
HAPPENED LATE. IN THE GAME
AFTER WE HAD. SERVICES IN PLACE
AND THAT ALSO INCLUDES
WORKFORCE. THAT'S AN INCREDIBLY
IMPORTANT POINT- MISS BERGEN
ONE THAT'S NOT LOST ON THIS
COMMITTEE IS THAT DESPITE THE
EFFORT. LED BY THE
ADMINISTRATION IMPLEMENTATION
SENATE LAWRENCE AND THAT DOES
NOT APPEAR TO SHOW CAPACITY
WITHIN OUR CURRENT
INFRASTRUCTURE I'M I HAVE
HIGHLIGHTED THE QUESTION MIS
KEYS LEARN TO PLAN ON ASKING
THE ADMINISTRATION UNDER OUR
FOURTH PANEL. AND DO BELIEVE WE
ARE WORKING TOWARDS AS THE
LEGISLATURE MAKING SURE THAT
THIS IS PROPOSED IN THE JANUARY
BUDGET AND THAT WE ACTUALLY
HAVE LANGUAGE TO WORK OFF OF
IT'S VERY DIFFICULT FOR US TO-
PROVIDE OVERSIGHT AND
ACCOUNTABILITY WHEN WE DON'T
HAVE A TRAILER BILL LANGUAGE
ACTUALLY BEFORE US THAT WE CAN
SPEAK TO. SPECIFIC POINTS.
RIGHT WITH THAT I WOULD LIKE
TO. I HAVE MY FINAL QUESTION
FOR THIS PANEL BEFORE MISS
WHITE HOOD AND YOU KNOW I
EARLIER I HAD ASKED- DIRECTOR
LIGHT BORN ABOUT WHAT OUTCOMES
AND METRICS HE BELIEVED NEEDED
TO BE LOOKED AT. AND WANTED TO
SEE IF YOU- HAD ANY SPECIFIC
METRICS AND OUTCOMES THAT YOU
THOUGHT SHOULD BE INCLUDED AS
PART OF A NEW BENEFIT AND JUST
AS A REMINDER DIRECTOR LIGHT
BORN FELT THAT THE TWO PILLARS
WERE HEALTH ACUITY AND ARE THEY
HAPPY AND WANTED TO. BE ABLE TO
SEE- IF YOU HAD ANY METRICS
ARE. YOU THOUGHT WOULD BE
IMPORTANT. THANK YOU SO MUCH
FOR THE QUESTION- RICHARD I
WOULD SAY YES- DIRECTOR LIGHT
GOING HEAD ON TWO PILLARS I
WOULD SAY THOSE ARE PROBABLY
VERY IMPORTANT- TO MAKE SURE
THAT WE CAN SEE IF THEY'RE
HAPPY BUT I ALSO THINK- THAT
THAT IS THE- A LARGER QUESTION.
NEEDS TO BE- I DIRECTED YOU TO
LOOK AT METRICS LIKE- ACCESS.
TO QUALITY CARE YOU NEED TO
LOOK AT YOU ALREADY BUT-
EQUITY- THE EQUITY DEBT. THE
THIRTY BILLION EQUITY SO WE
NEED TO START LOOKING AT
MEASURES THAT WE NEED TO START
LOOKING AT- I THINK THAT CAN
HELP BUILD INDIVIDUAL ACCOUNT
OF ACCOUNTABLE AND MAKING SURE
THAT WE'RE NOT ONLY ASKING ARE
YOU HAPPY BUT ARE YOU THE- FOR
THE SERVICES THAT YOU NEED. ARE
YOU RECEIVING THEM IN A TIMELY
MANNER ARE YOU WHERE ARE YOU
SEE THAT THAT THAT THAT THAT
THAT YOU FELT- ARE NECESSARY
FOR YOUR CONDITION AND NOT JUST
BEING TOLD PEOPLE ARE THEY- I
THOUGHT I WOULD. JACKSON THE
HOST OF QUESTIONS AND METRICS
THAT NEED TO BE APPLIED- WAIT
AND MET WITH SOME
ACCOUNTABILITY TO MAKE SURE
THAT WE ARE- ACTUALLY GETTING
BE CONCERNED WITH THE- QUALITY.
CARE THAT THEY- I AM SURE THE-
WE CAN FOLLOW UP OFF. BUT PART
OF THE A- ACCESS TO. CARE IS
FOR US MAKE SURE WE HAVE. A
WORKFORCE IS. AND BELIEVE THAT
NEEDS TO BE. A LARGE PART OF
THE CONVERSATION TO MAKE SURE
WE CAN. WORK TOWARDS- WHAT IS
CURRENTLYBEING PROPOSED. WITH
THAT I DIDN'T. CHAU ONE FINAL
QUESTION YES FOR MS WHITE AND-
DO YOU FEEL THAT YOU WERE ABLE
TO RECEIVE ADEQUATE FEEDBACK
FROM YOUR FROM THE INDIVIDUALS
YOU REPRESENT WITH THE PROPOSAL
TIMELINE AND HOW DO YOU FEEL
THIS STAKEHOLDER ENGAGEMENT
PROCESS COMPARED TO OTHERS IN
THE PAST. THANK YOU FOR THE-
QUESTION I DO NOT BELIEVE THAT
WE HAD THE ADEQUATE TIME TO
MAKE SURE THAT I CAN'T LOOK AT
A FIVE HUNDRED THOUSAND MEMBERS
SO MAKING SURE THAT WE CAN
CHECK AN EXAMPLE ON THE ON VERY
IMPORTANT TO US. WE LEARNED
ABOUT THE PROGRAM ON THE DAY
THAT IT WAS PUT OUT LIKE THE
DRAFT WE PUT OUT WE WERE TOLD
ABOUT IT SO WE WEREN'T GIVEN
ANY TYPE OF HEADS UP SO THAT WE
CAN HAVE ANY TYPE OF INPUT
HAVING THE LANGUAGE THAT OUR
MEMBERS CAN ACTUALLY TAKE A
LOOK AT TO THE CHECKPOINT WITH
SOMETHING THAT IS VITAL TO THE
DOCTOR COMES IN THAT WE CAN
REFLECT DR- RATHER THAN JUST. A
DRAFT. THANK YOU. WITH THAT I
WANT THE THINGS THIS PANEL
MOVING ON TO PENALTIES THREE
DISC NURSING FACILITY RESPONSE
WE WILL START WITH CLEAR RAMSEY
SENIOR STAFF ATTORNEY FOR
JUSTICE IN AGING WE WILL THEN
HAVE LIZA COLEMAN EXECUTIVE
DIRECTOR FOR THE CALIFORNIA
LONG TERM CARE OMBUDSMAN
ASSOCIATION FOLLOWED BY CRAIG
CORNET CEO AND PRESIDENT OF THE
CALIFORNIA ASSOCIATION OF
HEALTH FACILITIES MODERATOR IF
YOU CAN QUEUE UP OUR FIRST
PANELIST. ONE IS OPEN. THANK
YOU I THANK YOU CHAIRMAN
ARAMBULA COMMITTEE MEMBERS AND
INVITED ASSEMBLYMEMBERS MY NAME
IS CLAIRE RAMSEY AND I'M A
SENIOR STAFF ATTORNEY WITH
JUSTICE IN AGING AND I'M ALSO A
MEMBER OF THE MASTER PLAN FOR
AGING LTSS SUB COMMITTEE I'M
HERE TO DAY TO PRESENT ON THE
TWELVE CRISIS RESPONSE
RECOMMENDATIONS CREATED BY THE
OUTFIT THAT SUBCOMMITTEE. THAT
ARE SPECIFIC TO WHAT WE THINK
CAN BE DONE FOR HOME AND
COMMUNITY SERVICES NOW. HE
CRISIS RESPONSE RECOMMENDATIONS
ARE SPECIFIC RECOMMENDATIONS TO
HELP OLDER ADULTS AND PEOPLE
WITH DISABILITIES AVOID A
NURSING HOME PLACEMENT. ORDER
SUPPORT THEM TO TRANSITION OUT
OF A NURSING HOME. EXITING A
NURSING HOME WITH THE GOAL OF
SAVING LIVES. BY REDUCING
PRESSURE IN NURSING HOMES NOW.
WE CRAFTED THESE
RECOMMENDATIONS THREE MAJOR
CRITERIA IN MIND. FIRST WE
WANTED TO MAKE USE OF OUR
EXISTING HOME AND COMMUNITY
BASED SERVICES INFRASTRUCTURE
WHICH IS ACTUALLY VERY BROAD.
THANK YOU WE WANTED TO BE VERY
PRACTICAL AND CONCRETE NURSING
IN OUR RECOMMENDATIONS. AND TO
CHOOSE RECOMMENDATIONS THAT
COULD BE QUICKLY IMPLEMENTED.
AND THIRD HE WANTED TO HAVE
RECOMMENDATIONS THAT HAD THE
ABILITY TO BE TARGETED. TO
COMMUNITIES WITH THE HIGHEST.
AND WE KNEW THAT IT A LOT OF
SENSE OF THAT MIGHT BE. THAT
MIGHT BE COMMUNITIES BASED IN
PARTICULAR HEALTH DISPARITIES
AND WE THINK THESE
RECOMMENDATIONS CAN BE FLEXIBLE
ENOUGH AND NIMBLE ENOUGH TO
MEET THE NEEDS. AND WE KNOW
THAT CONTAINING COVER NINETEEN
SAVING LIVES IS A COMPLICATED.
AND SERIOUS TASK AND WE KNOW IT
REQUIRES A MULTIFACETED
APPROACH BUT WE BELIEVE TE
TRIAL RECOMMENDATIONS CAN BE
PART OF THE SOLUTION. AND A
CARBON IMMEDIATE SOLUTION THAT
YOU ARE NOW LOOKING FOR. SO I'M
GOING TO QUICKLY WALK THROUGH
ITS RECOMMENDATION. THEY ARE
NOT LISTED IN PRIORITY ORDER
AND WHAT WE BELIEVE THEY DO
BUILD UPON AND STRENGTHEN EACH
OTHER WE BELIEVE THAT DOING A
FEW OR SEVERAL OF THEM. WOULD
ALSO BE IMPORTANT. AND HELP
PEOPLE AND SAVE LIVES. TO BE
GROUP RECOMMEND. INTO THREE
MAJOR CATEGORIES THE FIRST
CATEGORY IS THE VERSION AND
TRANSITION SERVICES. TO THE
FIRST YOU HEARD REFERENCE TO BY
KAREN KIESLER WOULD BE TO
CREATE A CALIFORNIA COMMUNITY
TRANSITION PROGRAM. WE ALREADY
HAVE THE FIFTY P. PROGRAM THAT
IS EXCELLENT. SUCCESSFUL AND
COST SAVING AND WHAT WE THINK
WE CAN ADD TO THAT IT'S
ALLOWING IT TO WORK FOR PEOPLE
WHO HAVE LIVED IN NURSING HOMES
FOR LESS THAN NINETY DAYS. SO
THEY DON'T HAVE TO WAIT THREE
MONTHS. BEFORE THEY CAN GET
TRANSITION BACK HOME. CURRENTLY
THERE IS ACTUALLY A VEHICLE TO
DO THIS SB TWO FOURTEEN WHICH
IS AUTHORED BY SENATOR DODD AND
IS BEING AMENDED. TO MAKE THIS
CHANGE. THANK YOU FOR
RECOMMENDING THE ESTABLISHMENT
OF A COMMUNITY LIVING FUND
WHICH WOULD HAVE THE ABILITY TO
PURCHASE GOODS AND SERVICES TO
PEOPLE CAN STAY IN THEIR HOMES.
AND DO NOT NEED TO GO TO
NURSING HOMES IN THE FIRST
PLACE DEFINED COULD SERVE NON
MEDICAL. AND NON MEDICAL
ELIGIBLE INDIVIDUALS AS WELL AS
THOSE ON MEDI CAL. AND THE
THIRD ARGUMENTATION IN THIS
CATEGORY IS THE RAPID RESPONSE
INTENSIVE CASE MANAGEMENT. I'M
NOT SURE EXACTLY THE SAME AS
WHAT- DIRECTOR LIGHT DURING HAD
PROPOSED BECAUSE I'VE JUST
GOTTEN THAT EMAIL WITH THAT
INFORMATION TODAY. DURING THE
HEARING BY. OUR IS TO BASIC USE
EXISTING PROGRAMS TO FILL A
SPECIFIC ROLE IN H. BE A
CONTINUOUS CARE BASICALLY WORK
WITH HOSPITAL DISCHARGE PLANNER
TO HELP MOVE PEOPLE FROM
HOSPITAL TO HOME AND MAKE SURE
THEY HAVE SERVICES IN THEIR
HOME FROM DAY ONE AND DO NOT
HAVE A GAP WHICH COULD CAUSE
INJURY OR DEATH OR- CONTINUED
ELEMENT. AND WE THINK THIS
COULD BE TARGETED SPECIFICALLY
IT SPECIFIC COMMUNITY SO WOULD
NOT HAVE TO BE THE THING IT
SHOULD BE A PROGRAM USED IN
EACH COMMUNITY. NEXT WE HAVE A
GOOD RECOMMENDATION AROUND
ACCESS TO INCREASING ACCESS TO
H. C. B. S. SERVICES. AND AGAIN
WE WANT TO MAKE SURE THIS IS
VERY CLEAR WE ARE NOT SIMPLY
SUGGESTING THAT JUST SIMPLY
INCREASING WHAT. IS ENOUGH BUT
WE INSTEAD THINK. THAT IF WE
INCREASE FOUGHT AND LEVERAGE
THE FLEXIBILITY AND MAKE THE
ADMINISTRATION SIMPLER AND
FASTER. AND THEN TO TARGET
THESE EFFORTS SPECIFICALLY DID
THE COMMUNITIES THAT NEED THEM
WE CAN HAVE A HUGE IMPACT ON
SLOWING TRANSMISSION OF COBIT
AND KEEPING PEOPLE SAFE IN THE
HOME. THE FIRST YOU WANT TO
PROPOSED. THE ASSISTED LIVING
WAIVER SOUGHT BY TEN THOUSAND
FOUGHT. AND INCREASING THE
NUMBER OF COUNTIES. THAT ARE
SERVED BY THIS PROGRAM SO THAT
PEOPLE DON'T HAVE TO MOVE-FARTHER. YOU GET THE CARE THEY
NEED WE THINK THIS IS THE
QUESTION SPECIALLY NEEDED FOR
THOSE WHO CANNOT LIVE ALONE OR
CANNOT LIVE IN A HOME. WITH ME
AND. WHO DON'T HAVE A HOME TO
RETURN TO. YEAH YOU WANT TO SEE
IN BY FIVE THOUSAND OF THE H.
B. A WAIVER SPOT AND AGAIN WE
CAN BE IN TARGET THE HOT SPOT
AND THOSE PROVIDE VERY HIGH
LEVEL SERVICES FOR PEOPLE
COMING OUT OF NURSING HOMES OR
PEOPLE WHO WOULD BE AT VERY
HIGH RISK OF MOVING IN.
ESPECIALLY BECAUSE THEY CAN
GIVE ADDITIONAL PERSONAL CARE
SERVICES OUR WHICH ARE SO
IMPORTANT FOR PEOPLE. NEXT WE
WOULD LIKE TO SEE INCREASED
USAGE AND PRIORITIZATION OF HFS
IS. RIGHT EXCUSE ME PULMONARY
ASSESSMENT. LEADERS SUBSTANCE
WHICH CAN TAKE PLACE IN
HOSPITALS R NURSING
FACILITIES. AND BASICALLY CAN
ENSURE THAT PEOPLE HAVE AGES
THAT APPROVED SERVICES TO FROM
DAY ONE. OF THE RETURNED HOME.
IT'S ALREADY EXISTS WE JUST
THINK IT NEEDS MORE
PRIORITIZATION AND ADDITIONAL.
FLEXIBILITY ADDED TO IT. FOR
THE RESTORED THOUGHT AND
STABILIZED IN AMATEUR PRO WHICH
TO THE CYCLE RT NINE. NEXT IF
YOU AND FLEXIBILITY AND
STABILIZE FUNDING FIRST
DEVELOPED PROGRAMS WHICH CAN
YOU ALSO TALKED ABOUT. NEXT
WOULD BE TO. INCREASE FOR
CHARACTER. RESOURCE CENTER. SO
THEY CAN PROVIDE ADDITIONAL
RESPITE SERVICES TO HELP
SUPPORT ALL THE UNPAID FAMILY
AND FRIEND CARE GIVERS TOWARD
WORKING SO TIRELESSLY DURING A
PANDEMIC. AND LASTLY WOULD BE A
LOT TO ALLOW FOR RAPID
INVOLVEMENT IN PACE AND TO
PROVIDE FOR SHORT TERM
SUPPLEMENTAL WAIT. WE BELIEVE
THAT COMBINATION CAN REALLY-
BEEN MOBILIZED IN TARGETED WAYS
THROUGHOUT THE STATE AND CAN.
BE USED SPECIFICALLY WHAT COULD
HELP IN PARTICULAR AREAS AND
EVERYTHING DOESN'T HAVE TO BE
AVAILABLE EVERYWHERE. LASTLY
ONE HAVE A GROUP OF CATEGORIES
EXCUSE ME A GROUP OF
pOF INCREASING HEALTH AND
SAFETY. WE WANT TO RECOMMEND
THAT WE REQUIRE HOGAN TESTING
BEFORE SOMEONE MAKE THE
HOSPITAL WHICH IS NOT REQUIRED
RIGHT NOW. WHETHER THEY'RE
ABOUT TO GO HOME OR TO A
FACILITY TO THE PEOPLE WHO ARE
CARING FOR THEM CAN TAKE
CORPORATE PRECAUTION AND THAT
THE PEOPLE LEAVING THE HOSPITAL
CAN BE APPROPRIATELY CARED FOR.
UNLESS WE WANT TO RECOMMEND
INSURING ADEQUATE PP FOR IT
SHOULD BE A PROVIDER. LOOK AT
PEOPLE WHO NEED THE SERVICES
AND THE PEOPLE PROVIDING THE
SERVICES ARE PROTECTED FROM
INFECTION. I KNOW I'VE JUST
COVERED A LOT OF INFORMATION
VERY QUICKLY BUT I'M VERY HAPPY
TO ANSWER SPECIFIC QUESTIONS
ABOUT ANY OF THESE AFTER THE
OTHER PANELISTS HAVE PRESENTED.
AND I THINK LTSS COMMITTEE A
WHOLE JUST WANTED THEY WERE
VERY PROUD TO OPERATE THESE
RECOMMENDATIONS BECAUSE WE DO
THINK THEY HAVE THE CAPACITY.
TO REALLY. BE IMMEDIATE AND TO
HELP PEOPLE RIGHT NOW DURING
THE TOTAL PRICE OF AND TO
REALLY STATEWIDE OF OUR OLDER
CALIFORNIANS AND PEOPLE WITH
DISABILITIES. THANK YOU AND
THAT ALL PASSENGERS ANALYSTS.
THANK YOU MISS RAMSEY IF WE CAN.
OF MISS COLEMAN NEXT. CHEN AND
I'M LEAST ALLMAN WITH CAL ALONG
TO CARE ABOUT SAYS. AND I WANT
TO YOU FOR HAVING THIS. I'M
TRULY WANT TO SAY LINE. OF
THOSE LIVING AND WORKING IN
LONG TERM CARE FACILITIES AND
WE REALLY HAVE TO FOCUS ON
PROVIDING RESOURCES. AND I
WOULD SAY THE FIRST RESOURCES
OMBUDSMEN. I'M INCIDENTS HAPPEN
WILL CONTINUE TO DO AS MUCH
POSSIBLY OVER THE PHONE. THE
FOR ELDER ABUSE INVESTIGATIONS
AND OTHER COMPLAINTS AND IN
PERSON OPTIONS WITH APPROPRIATE
PP SHOULD BE MORE THAN ALLOWED.
HIS VILLAGE THESE VISITS SHOULD
BE ENCOURAGED EIGHT A C. CL THE
STATE OMBUDSMAN OFFICE HAVE
SAID THAT OMBUDSMAN'S CAN
RESUME IN PERSON. VISITS
FOLLOWING SPECIFIC GUIDELINES.
AND I WAS ENCOURAGED TO HEAR-
THIS WAY TALKING ABOUT REACHING
OUT WITH LOCAL PUBLIC HEALTH.
TO ENSURE THAT THAT HAPPENS. I
WOULD ASK THAT BECAUSE LOCAL
PUBLIC HEALTH AUTHORITIES HAVE
VERY VERY VERY DIVERSE MANDATE.
EVEN THOUGH CPCC ALLEN STATE
OMBUDSMAN HAVE SAID OFFICE WE
CAN GO BACK IN THE BUILDINGS
LOCAL PUBLIC HEALTH- HAVE VERY.
DIFFERENT OPINIONS ON THIS AND
I WOULD ASK THAT. THE
LEGISLATURE DIRECT THE CDA AND
AGENCIES TO COMMUNICATE WITH
THE LOCAL PUBLIC HEALTH ON
BEHALF OF THE PROGRAM. IT
SHOULD NOT BE UP TO THE
INDIVIDUAL OMBUDSMAN PROGRAM TO
CONVINCE THE LOCAL PUBLIC
HEALTH OFFICER OF THEIR VITAL
ROLE. SECOND RESOURCE FACILITY
STAFFING. YOU KNOW EVEN DURING
A PANDEMIC BOTH INDUSTRY AND
DEPARTMENT LEADERS JUSTIFIED
THE CONTINUING UTILIZATION OF
CARE STAFF WHO WORK IN MULTIPLE
FACILITIES. WE SEEMINGLY NO
REGARD TO THE FACT THAT CARE
STAFF AT WITH NO WENT MALICE
INTENT. ARE SPREADING CODE
NINETEEN FROM FACILITY TO
FACILITY AND EVEN CROSSING
COUNTY LINES. WE SHOULD REQUIRE
FACILITIES AS THEY ARE
CURRENTLY GETTING HIGHER
REIMBURSEMENT RATES FOR
MEDICARE AND HEALTH PLANS TO
PROVIDE SERVICES TO COVER A
POSITIVE RESIDENTS. THAT THEY
USE THIS MONEY TO INCREASE
STAFFING. FACILITIES NEED TO BE
INCENTIVIZED EXCUSE ME
FACILITIES NEED TO INCENTIVIZE
STAFF TO WORK AT ONE FACILITY
BY PAYING A PROFESSIONAL HEALTH
CARE WGE. AND AUTHORIZING
OVERTIME. THE STATE NEEDS BE RE
FOR PAY ROLLED JOURNAL TO SEE
HOW THE DOLLARS ARE BEING SPENT
ON STAFFING. WE NEED TO PUT
PRESSURE ON CMS TO ROLL BACK
THE HOLIDAY ON DATA
REQUIREMENTS NO MORE ON OUR
SYSTEM OF SELF REPORTING WE
NEED TO KNOW WHAT THE FACTS ARE.
THE THIRD RESOURCE ARE UNPAID
CARE GIVERS WE NEED TO ALLOW
VISITORS TO HELP WITH CARE
THOSE VISITORS WHO CAP WITH
CARE TO RESUME FACILITY VISITS.
I WOULD ARGUE THAT THIS HAS
BEEN THE MOST CRUEL ASPECT OF
OUR WELL INTENDED IN WELL
INTENDED APPROACHES TO MANAGING
COVE IN. THIS MORNING I MADE
THE MISAKE OF ANSWERING THE
PHONE CALL. FROM A WOMAN THE
LACK I WISH I COULD JUST HAVE
BROUGHT YOU HERE I BROUGHT HER
HERE TO SHARE HER STORY ON
MARTHA'S HUSBAND HAS BEEN IN
THE FACILITY FOR A FEW YEARS IT
WASN'T A GREAT FACILITY VPN
LEFT. BUT IT WAS CLOSE TO HER
HOME IT WAS CLOSE TO A PARK IT
WAS CLOSE TO AT A MOVIE THEATER
SHE CAN WIELD THEM TO IN HIS
WHEELCHAIR. A CO THAT HIT AND
OVER THE LAST FEW MONTHS SHE'S
WATCHED FROM A WINDOW. AS HE'S
LOST WEIGHT SHE DOESN'T KNOW
EXACTLY HOW MANY POUNDS BUT SHE
GUESSES OVER TWENTY BECAUSE
SHE'S NOT IN THAT ROOM.
PROMPTING HIM TO EAT
ENCOURAGING HIM WITH TASTY
TREATS AND JUST SPENDING TIME
TALKING TO HIM AS HE EATS HIS
MEAL. SHE HASN'T BEEN IN HIS
ROOM MASSAGING HIS LEGS AND HIS
HANDS THE THIRTY AND FORTY
MINUTES SHE WOULD DO EVERY
SINGLE DAY. AND INSTEAD SHE'S
WATCHED OUTSIDE THE FACILITY.
AS HIS UPPER BODY. THE SIDE
THAT WAS DAMAGED FROM THE
STROKE. IT'S AFTER FAILING TO
THE POINT NOW WHERE SHE DOESN'T
THINK HE'LL EVER BE IN A
WHEELCHAIR AGAIN. WE KNOW THAT.
THERE'S A RISK BRINGING
VISITORS IN. BUT NOT ALLOWING
THEM TO COME IN HASN'T IMPROVED
OF THE RISK AT ALL WHAT WE KNOW
IN JUNE WHEN I HAD THE
OPPORTUNITY TO SPEAK BEFORE THE
HEALTH COMMITTEE. THERE WERE
SEVENTY ONE SKILLED NURSING
FACILITIES IN THE STATE BUT
ALREADY RECORDED TEN OR MORE
DEATHS WE HAVEN'T LET RIGHT WE
HAVEN'T LETTER VISITORS IN AND
YET NOW EIGHT WEEKS LATER WE'RE
AT A HUNDRED AND TWENTY SIX
FACILITIES THAT HAVE GREATER
THAN TEN RESIDENTS OR STAFF
THAT IT DIED FROM CALVET. WE
NEED TO BRING THE HUMANITY OF
BRINGING LOVED ONES BACK INTO
THE BUILDINGS. THESE ON KATE
UNPAID CARE GIVERS NEED PP THEY
NEED PP TRAINING. THEY NEED TO
BE SUBJECTED TO THE SAME KOPET
TESTING AS FOR THE REST OF THE
STAFF. WHICH MEANS WE HAVE TO
INCREASE STAFFING. INCREASE
TESTING. TESTING FOR BOTH THE
OMBUDSMAN PROGRAMS IS ESSENTIAL
WORKERS TESTING FOR UNPAID
CAREGIVERS AND ALSO INCREASING
THE TESTING OF STAFF SO THAT WE
IDENTIFY THE- A SYMPTOMATIC
CARE GIVERS. I WOULD SAY IN
ADDITION MY FINAL SUGGESTION AS
THAT THE DEPARTMENT NEEDS TO
PROVIDE AN APPEAL PROCESS TO
ENSURE THAT VISITORS AND- AND
RESIDENTS WHO WANT TO HAVE
VISITS. THAT THAT PROCESS IS
FAIR AND THAT THERE'S A METHOD
FOR CASE BY CASE REVIEW
ALLOWING FAMILY WISH TO VISIT
WITH THEIR LOVED ONES OR OR
RESIDENTS WHO WISH TO HAVE
VISITORS. IN RESPONSE TO BE
EXPANDING. UP IN HOME PROGRAMS
FOR FOUR YEARS WE'VE BEEN
WORKING TO EXPAND THE ASSISTED
LIVING WAIVER HOW. WHAT WHAT
BETTER POSITION WE WOULD BE IN
TODAY IF WE HAD HAD THAT
PROGRAM EXPANDED ALL OF THE
COUNTIES IN THE ADDITIONAL
SLOTS. AND WITH REGARDS TO THIS
AT HOME BENEFIT ONE OF THE
MAJOR ACTIVITIES THE
OMBUDSMAN'S PLAY REGULARLY IS
ASSISTING RESIDENTS WITH
LEAVING THE FACILITY AND GOING
HOME. AND YET THE OMBUDSMAN
PROGRAM WAS NOT INVITED IN AS A
PART OF THE STAKEHOLDER AND
LEARNED ABOUT THIS PROGRAM WHEN
IT WAS BEING PUBLISHED JUST
LIKE EVERYONE ELSE. SO WE ASK
THAT WE BE INCLUDED IN THE
STAKEHOLDER PROCESS. THIS
INDUSTRY CAN DO BETTER AND THE
RESIDENTS WHO LIVE IN THESE
FACILITIES THEY NEED THEM TO DO
BETTER. THE LOCAL LONG TERM
CARE OMBUDSMAN PROGRAM STANDS
READY AS WORKING PARTNERS TO
HATE TO HELP MAKE IT BETTER.
THANK YOU. THANK YOU MISS
COLEMAN. BUT YOU'VE ALWAYS DONE
A TREMENDOUS JOB OF BRINGING
VOICE FOR THOSE WHO ARE
VULNERABLE. AND THEN NURSING
HOMES AND THANK TODAY WAS NO
EXCEPTION. THANK YOU SIR. MAXTA
MISTER CORNET. THANK YOU ARE
THANK YOU MR CHAIRMAN AND
MEMBERS MY NAME IS CRAIG CORNET
I'M THE CEO OF THE CALIFORNIA
ASSOCIATION OF HEALTH
FACILITIES. PROFESSIONAL TRADE
ORGANIZATION THAT REPRESENTS
OVER NINE HUNDRED SKILLED
NURSING FACILITY AND MORE THAN
FOUR HUNDRED INTERMEDIATE CARE
FACILITY FOR THE
DEVELOPMENTALLY DISABLED
THROUGHOUT CALIFORNIA. I
APPRECIATE THE OPPORTUNITY TO
PROVIDE COMMENT TODAY LIKE
FORMER ASSEMBLYMEMBER BURKE
KAREN KIESLER CLAIRE RAMSEY AND
THE NEEDS LIKE- I AM ALSO A
MEMBER OF THE LTSS SUB
COMMITTEE AND I ENDORSE THE
COMMENTS YOU'VE HEARD EARLIER
ABOUT THAT LONG TERM CARE HOME
PROPOSAL. I'LL IN ADDITION A
LOT OF SHARE CAPTAIN GESTURED
FOR IMMEDIATE ASSISTANCE FOR
SKILLED NURSING FACILITY
PATIENTS EMPLOYEES TO COMBAT.
BOKO THE NINETEEN PANDEMIC. I
LIKE THE FIRST ACKNOWLEDGE THAT
AT THE TREMENDOUS AND HI
COROLLA OF ALL THE LONG CARE.
CARE GIVERS THAT ARE STATE TO
TRY THEIR VERY EVERY DAY TO
KEEP OUR PRATTVILLE ELDERLY
POPULATION SAFE AND PROTECTED.
SKILLED NURSING FACILITIES IN
PARTICULAR PANDEMIC HAS BEEN
NOTHING LIKE WE'VE EVER SEEN
BEFORE IT HAS BEEN DESTRUCTIVE.
IN INSIDE OUR BUILDINGS THAT
HAVE BEEN DESTRUCTIVE TO OUR
RESIDENTS TO OUR FAMILY AND TO
OUR STAFF. IN THE BEGINNING NO
ONE KNEW THE EXTENT TO WHICH IT
WOULD AFFECT PATIENTS AMERICAN.
IN WITH TO DAY ESTATE. ATTEMPT
ON TEMPTED UNDERSTAND THE VIRUS
AND ITS CHARACTERISTICS.
SKILLED NURSING FACILITIES HAVE
STEPPED UP TO THE PLATE AND WE
ARE NOW SEEING SIGNIFICANT
CLIENT I WOULD PROVE DETECTION.
CONTAINMENT AND PREVENTION. BUT
THERE IS STILL MORE WORK TO DO
THAT WILL REQUIRE CONTINUED
STATE SUPPORT FOR THEIR
SUCCESS. I DO APPRECIATE THE
STATE'S GOLDFIELD CREATED WITH
THIS LONG TERM CARE AT HOME
PROPOSAL WHICH ATTEMPTS TO
PROVIDE ADDED OPPORTUNITIES FOR
MEDICARE BENEFICIARIES CAN BE
CARED FOR AT HOME. MY
ORGANIZATION HAS ALWAYS
SUPPORTED THE PROMISED THE
PATIENT SHOULD BE IN THE MOST
APPROPRIATE SETTING POSSIBLE.
TO INSURE THEIR HEALTH AND WELL
BEING. I AM HOW COULD THAT
MOVING TOO QUICKLY ON THE
PROPOSAL AS YOU'VE HEARD. COULD
HAVE IMPACTS THROUGHOUT THE
LONG TERM NEGATIVE IMPACTS
THROUGHOUT THE LONG TERM CARE
CONTINUE. AS THE LEGISLATURE
LOOKS TO CONSIDER A PROPOSAL
LIKE THIS IN THE COMING MONTHS
I WOULD ENCOURAGE YOUR
CONSIDERATION THE FOLLOWING.
FIRST WORKFORCE CHALLENGES IN
THE SECTOR AND THROUGHOUT THE
LONG TERM CARE CONTINUE UP OUR
A BATCH. THE STATE NEEDS TO
STEP UP TO THE PLATE IN
PROVIDING INCENTIVES FINANCIAL
SUPPORT AND STREAMLINING OF
TRAINING. FOR LONG TERM CARE
GIVERS. NUMBER TWO THE STATE
SHOULD EVALUATE HOW IT CONFERS
BETTER SUPPORT AND ENHANCE THE
EXISTING LONG TERM CARE MODELS
THAT ALREADY PROMOTE IN HOME.
HEALTHCARE SERVICES AND
SUPPORTS YOU'VE HEARD THAT FROM
OTHERS. NUMBER THREE THE STATE
SHOULD PRIORITIZE OPTIONS FOR
PATIENT CURRENTLY IN SKILLED
NURSING FACILITIES THAT DO NOT
HAVE GOOD RESIDENTIAL PLACEMENT
DUE TO THEIR MENTAL HEALTH CREE
INCOME NEED. ALLOWED A FOURTH
ITEM HERE WITH A BIG INCREDIBLY
IMPORTANT. THAT IS OVERSIGHT
AND ACCOUNTABILITY AND GOOD
QUALITY CONTROL AND QUALITY
MEASUREMENT SYSTEM. WE STILL
DON'T KNOW HOW THOSE WOULD WORK
IN A LONG TERM CARE HOME
PROPOSAL THEY ARE HOWEVER
ESSENTIAL AND MUST BE AT LEAST
AS STRONG AS WHAT WE. HAVE IN
CONGREGATE CARE SETTING. I
WOULD BE ABLE TO PROTECT IN THE
L. T. S. SUB. DISCUSSION REGARD
THE I'D FOR A MERGER CHEAPEST.
TO THE CURRENT CODE NINETEEN
PANDEMIC. CATHOLIC PORTS WHICH
SUGGESTION THAT YOU'VE HEARD
FROM CLAIRE AND OTHERS TOOK A
MOMENT AGO. AT THAT HAVE BEEN
OUTLINED IN PARTICULAR THOUGH I
WANT TO EMPHASIZE THE FOLLOWING
ITEMS THAT MOST BUT WOULD BE
MOST BENEFICIAL. IS STILL
NURSING FACILITIES FIRST
INCREASING HEALTH AND SAFETY
FOR SKILLED NURSING READ THAT
THROUGH APPROPRIATE TESTING AND
PERSONAL PROTECTIVE EQUIPMENT
FOR HEALTH CARE WORKERS THAT IS
ESSENTIAL. ADDRESSING THE
IMMEDIATE PROBLEM IS MOST
CRUCIAL TO KEEPING OUR NURSING
FACILITY PATIENTS SAFE. IN
ADDITION. YOU HEARD ALREADY
IT'S IMPORTANT AT ALL STATE AND
LOCAL REGULATORS BE SCREENED
AND TESTED IF THEY'RE GOING TO
IT WHATEVER THE INTEREST A
SKILLED NURSING FACILITY THIS
IS AN ISSUE WE TALK TO THE
STATE ABOUT FOR A NUMBER OF
MONTHS. I'M MORE GLAD TO KNOW
THAT THE STATE OF NEW PORT ON
THAT. BUT THIS IS ABSOLUTELY
ESSENTIAL. NUMBER THREE
INCREASING ACCESS TO AN
EXPANDING THE CURRENT HOME AND
COMMUNITY BASED PROGRAMS THAT
CAN PROVIDE HOME BASED HEALTH
SERVICES WITH THE MOST
IMMEDIATE AND EFFECTIVE MEANS.
TO SUPPORT INCREASES IN HOME
CARE. K. JUST HE WOULD AYE THAT
WE BELIEVE WILL HAPPEN TO ME
POSITIVE AND ON NURSING HOME
PATIENTS. THESE INCLUDE.
GREATER ACCESS FOR NURSING
FACILITIES TO CALL THE NINETEEN
TESTING THAT PROVIDES TIMELY
RESULT. TESTING IS GETTING
BETTER BUT THERE ARE STILL MANY
HURDLES THAT WOULD THAT REMAIN.
I WANTED TO ALSO THANK-%
CHAIRMAN OF DARIAN PLEASE
COMMENT ABOUT THE PRIORITY OF
TESTING. I BEING AT LEAST WHERE
IT IS IN A CUTE KERR HOSPITAL
THIS IS SOMETHING WE'VE BEEN
ADVOCATING FOR QUITE SOME TIME.
AT THIS POINT. NOW THAT WE ARE
SEEING TIMING THE TIME IT TAKES
TO GET TEST RESULTS BACK.
HADN'T HAVE BEEN CREATED LITTLE
TOO LATE AND CASTING THAT WE
CANNOT GET A RESULT BACK WITHIN
FORTY EIGHT HOURS OR. LESS IT'S
REALLY NOT VERY EFFECTIVE.
FEDERAL AND STATE WERE. ARE
OFTEN NOT AND- WE HAVE CMF
PROVIDING CERTAIN- AND FUNDING
FOR POINT OF CARE TESTING
DEVICES RIGHT NOW. WHILE THE
STATE AND SOME COUNTY REQUIRING
LAB TESTING. IN EITHER CASE.
THERE ARE THEY ARE
REIMBURSEMENT QUESTIONS ABOUT
HOW THE HELL WHO WILL COVER
THESE COSTS. ACTUALLY FOR
HEALTHCARE WORKERS. IT'S
IMPORTANT TO ENSURE DEDICATED
TP FIFTY KILLED NURSING
FACILITIES HEALTH CARE WORKERS-
IS AVAILABLE AND ACCESS TO BP
HAS IMPROVED BUT THERE ARE
STILL GAPS AND PRODUCTS
SHORTAGES ON A REGULAR BASIS WE
ARE PARTICULARLY WORRIED ABOUT
THE SITUATION IN THE FALL. WITH
REGARD TO CERTAIN CERTAIN ITEMS
QUICKLY GLOVES. THE STATE COULD
REQUESTED REQUIRE THE STATE
SHOULD REQUIRES- THE ACCOUNT
NEEDS TO HAVE A DESIGNATED
OFFICER INDIVIDUAL THAT
NAVIGATE ALL TRANSFERS FROM
HOSPITAL TO CLOSE TO KEEP. CARE
SETTINGS HELPING TO INFORM THE
HOSPITAL DISCHARGE
TRANSPLANTING APPROPRIATE HOME
BASED ARE IMPATIENT OPTION A CO
GOOD POSITIVE PATIENTLY SPECIAL.
ANOTHER ISSUE THERE SHOULD BE
AT LEAST A SINGLE WEBSITE OUR
PROVIDER PORTAL THATIS A
REPOSITORY FOR ALL PANDEMIC
INFORMATION. WEBSITE SHOULD BE
TRANSPARENT FOR EVERYONE FOR
CARE GIVERS FOR FAMILY TO THE
LEGISLATURE AND THEPRESS. IT
SHOULD INCLUDE ALL COUNTY STATE
AND FEDERAL INFORMATION ON A
SINGLE FIGHT PARTICULARLY THE
DIFFERENT DIFFERENT REGULATORY
STRUCTURES WHICH- FRANKLY AT
THIS POINT ARE VERY UNCLEAR TO
THE PROVIDER- GIVEN THE OVERLAP
AND ALSO TO THE PUBLIC. AS I
MENTIONED EARLIER ALL THE
REGULATORS NEED TO BE TESTED
BEFORE ENTERING AND LASTLY BUT
NO LESS IMPORTANT. THE STATE'S
OING TO HAVE TO PROVIDE SOME
FUNDING FOR NURSING FACILITIES
TO COVER THE COSTS ASSOCIATED
WITH SIGNIFICANTLY INCREASED.
LIABILITY AND COMP WORKER'S
COMPENSATION INSURANCE RATES
DURING THE PANDEMIC. NURSING
HOME FACILITIES- RATES ARE
SKYROCKETING FOR PANDEMIC
COVERAGE AND THAT IS. A THAT IF
YOU COULD SELL EITHER EVEN
LUCKY ENOUGH TO BE ABLE TO GET
ACTUAL COVERAGE WHICH IS AT
QUICKLY NOT EVEN OFFERED
ANYMORE. MORE SLEEP WITH THE
NOT. GUILTY FOR NOT FINDING
CARRIERS WHO WILL COVER THEIR
LIABILITY OF WORKERS COMP RISK
RELATED TO CODE THAT. I WANT TO
THANK YOU FOR GIVING ME THE
OPPORTUNITY TO PARTICIPATE IN
THIS HEARING TODAY I APPRECIATE
THE ASSEMBLY THOUGHTFUL
EXAMINATION. OF HOW THE STATE
CAN MOST SAFELY AND EFFECTIVELY
CARE FOR A VULNERABLE ELDERLY
POPULATION. I LOOK FORWARD TO
THE CONTINUED DISCUSSION. THANK
YOU MISTER CAR. I WILL NOW ASK
FOR. MEMBER TO SEE IF THEY HAVE
QUESTIONS FOR THIS PANEL. AND I
WOULD AGAIN ASK YOU TO DIRECT
THEM TOWARDS A SPECIFIC
PANELISTS. AND FOR THE
PANELISTS TO THEN ON MUTE
YOURSELF ONCE YOU AND THEN WE
MEET YOURSELF ONCE YOU'VE
CONCLUDED. MEMBERS ANY
QUESTIONS. SINAN I WILL. TAKE A
CHANCE IF I CAN ASSEMBLY MEMBER
MATHIS. THANK YOU MISTER
CARROLL ALL THE STATE AGAIN I
DON'T WANT TO THANK THE
PANELISTS FOR POINTING OUT VERY
SPECIFIC THINGS- YOU KNOW.
DISCUSSING THE STAFFING ISSUES-
I KNOW IN MY DISTRICT WE HAD A
LOT OF ISSUES EARLY ON WITH-
STAFF HAVING TO WORK MULTIPLE
JOBS- AND WORKING ON MULTIPLE
FACILITIES IN IN DEALING WITH
THE SPREAD. OF CALVET WHERE
IT'S JUMPING FROM FACILITY TO
FACILITY BECAUSE- STAFF FOR
HAVING TO WORK MULTIPLE JOBS I
THINK THAT GETS TO THE BIGGER
CONVERSATION OF. THE ECONOMY
AND OTHER THINGS BUT- IT
DEFINITELY GETS INTO THE
DISCUSSION OF HOW WELL WE ARE-
PAIN IN TAKING CARE OF THESE
PEOPLE WHO TAKE CARE OF OUR
LOVED ONES- THE CONVERSATION IN
REGARDS TO VISITS- CAN'T TELL
YOU HOW MANY. PHONE CALLS I'VE
HAD FROM CONSTITUENTS THAT ARE
CRYING BECAUSE THEY'RE NOT ABLE
TO VISIT- THEY'RE GIVEN A
WINDOW VISIT WITH A TINTED
WINDOWS. ANOTHER REALLY GOOD
POINT I THINK THAT WAS MADE
MISTER CHAIR. WAS BY MISS
COLEMAN ON THE SELF REPORTING I
THINK THAT'S A BIG ISSUE-
REALLY QUESTION FOR ALL THE
PALACE THAT I WOULD HAVE IS
WHAT WHAT ARE YOUR THOUGHTS ON.
GIVING THE COUNTIES. A LITTLE
MORE TEETH IN REGARDS TO.
OVERSIGHT AND THE ABILITY TO
SHUT DOWN FACILITIES THAT- OR
BAD ACTORS BECAUSE I KNOW SOME
OF THE FACILITIES THAT WE HAD
HAD VERY VERY POOR REPORTS THE
STATE IT HAD GOING IN MULTIPLE
TIMES. TO PROVIDE RETRAINING TO
ADJUST FIRE ON SOME OF THESE
NURSING HOMES AND- WE'RE
ACTUALLY INVESTIGATING ONE OF
THEM. SO YOU KNOW IF THE COUNTY
HAD THAT ABILITY TO GO IN AND
SHUT THEM DOWN OR TO GO IN AND
TAKE CONTROL- OF ON THE IN ANY
OF YOUR OPINIONS DO YOU THINK
THAT THAT WOULD HELP. FOR THOSE
SELECT FEW FACILITIES THAT ARE
THE BAD APPLES THAT OR THE BAD
PLAYERS- THEY AND I COMPLETELY
AGREE WITH THE COMMENTS MADE-
WE'VE ALL DONE A LOT OF WORK TO
INCREASE THE NUMBER OF TESTING
AND TESTING SITES WE'VE HAD.
COMPANIES LIKE CVS EVEN STEP
UP. TO DO DRIVE THROUGH
TESTING. BUT IT REALLY COMES
DOWN TO THIS RESULT BACKLOG
THAT WERE ALL SEEN IN THE FACT
THAT IT'S TAKING TWO TO THREE
WEEKS TO GET RESULTS. AND BY
THE TIME YOU TAKE THETEST TO
GET THE RESULTS YOU COULD'VE
ALREADY GOT IT SOMEWHERE ELSE.
SO BUT I SEE THE HUGE ISSUE
THERE S- BUT AGAIN WITH THE
SELF REPORTING WHAT CHANNELS
WHAT ARE YOUR THOUGHTS. ON
GIVING COUNTIES THAT ABILITY TO
STEP IN WHEN THERE'S A BAD
ACTOR. OF ADMIT THAT IS QUITE
CORNET I WOULD JUST TELL YOU
THAT THAT THEY HAVE THAT
ABILITY NOW ASSEMBLY MEMBER AND
IN MOST CASES THE COUNTY. BOARD
WITHIN COUNTY HEALTH DEPARTMENT
I'M VISITING KRING REGULARLY
UNTIL I AM YEAH THEY THEY DO
NOT HAVE THAT ABILITY BECAUSE
THAT WOULD HAVE BEEN- SOME THAT
WOULD HAVE HAPPENED BACK IN
MARCH WITH ONE OF MY FACILITIES
WE LOOKED INTO THAT AND THEY DO
NOT HAVE THE- POWER TO. TO DO
THAT OR TWO OF REGULATE THEM ON
ANY LEVEL THAT THAT'S BEEN AN
ISSUE THAT WE. DISCOVERED IN
MARCH SO. I WOULD THAT YOU IF
YOU WANT CORRECT THAT THE- BEEN
CUT I'M AWARE OF THAT HAS
HAPPENED IN COUNTY CALIBER. AND
I THINK DOWN IN THE WAY IF YOU
THAT AREA SOME THE RATES. THAT
HAVE IN AND WE KNOW THAT THEY
ARE THEY ARE THEY ARE IN MANY
COUNTIES REGULATE THAT THAT
PUBLIC HEALTH. KERR SO BUT I
GUESS I WOULD SAY T. DO IT ALSO
A LOT THERE'S A LOT MORE
OVERSIGHT NOW THAN THERE HAS
SPENT ALSO THE- CDPH THE
SURVEYORS. ARE NOW VISITING
FACILITIES GOOD SO HE HAD
SUBMIT A MITIGATION PLANS TO
THE STATE IN JUNE- CDPH IS NOW
FOLLOWING UP THEY HAVE TO
APPROVE THE MITIGATION PLANS
AND THEY ARE MAKING. REGULAR
VISITS TO THE FACILITIES TO
MAKE SURE THEY'RE KEEPING BURKE
MITIGATION PLANS ON TRACK.
AGAIN AND MANY COUNTY. AS I AS
I MENTIONED I KNOW I KNOW MANY
CALORIES THE PUBLIC HEALTH
DEPARTMENT BECAUSE THIS THING I
CAN'T. TELL YOU THAT IN EVERY
COUNTY BUT I KNOW THAT ANSWER
QUITE QUITE. GREG VERY
SPECIFICALLY BECAUSE BECAUSE
YOU ARE YOU DO REPRESENT- MANY
OF. THESE FACILITIES. WE WILL
IF WE WERE TO DESIGN A- ANY ANY
KIND OF A FOR THE COUNTY TO
HAVE. ON IS THE PROBLEM THAT
I'VE SEEN IS THAT BY THE TIME
THE STATE RESPONSE IS IT'S JUST
TAKES TOO LONG. AND WITH THE
COUNTY IS BEING RIGHT THERE ON
THE GROUND- OBVIOUSLY THERE
HAVE BETTER ACCESS AND A LOT OF
THE PEOPLE THAT GET THE
COMPLAINTS ARE ARE USUALLY THE
LOCALS- AND BY THE TIME IT GETS
TO THE STATE LEVEL- THERE'S
ALREADY A SERIOUS ISSUE SO.
FROM YOUR FROM YOUR VIEWPOINT
SIR WHAT WOULD YOU SEE IT AS A-
TO GIVE THE COUNTY BETTER
OVERSIGHT TO GIVE THEM ACTUAL
SOME TEETH- TO ENSURE THAT THE
BAD ACTORS THAT. QUITE FRANKLY
SIR MAKE YOUR ORGANIZATION LOOK
BAD- WHAT WOULD THAT BE. WHAT
WHAT OKAY SORRY ASSEMBLY MEMBER
THERE ARE IN SOME COUNTIES. THE
COUNTIES WILL PUT IT MISSION
BAND ON THE FACILITY IF THEY
ARE CONCERNED AND THEY WILL SAY
NO NO ADDITIONAL ADDITION UNTIL
UNTIL- YOU KNOW WE SEE CERTAIN
LEVELS OF IMPROVEMENT THAT
HAPPENED. THAT HAPPENED
DIRECTLY I WILL TELL YOU THE
ONE THE THINGS THAT IS MOST
CONCERNING US ABOUT. IT
FREQUENTLY THE LACK OF
COORDINATION. WE SEE A NORM AS
I MENTIONED EARLIER THERE
THERE'S DIFFERENT GUIDANCE IN
COMBAT ALL OVER THE PLACE AND
FISCALLY FREQUENTLY FIND IT
VERY CONFUSING BECAUSE THEY MAY
BE GETTING ONE SET OF GUIDANCE
FROM THE FEDERAL GOVERNMENT
DIFFERENT THAT TO THE STATE.
AND A DIFFERENT THAT FROM FROM
THE COUNTIES SO ONE CONCERNED
WE'VE HAD FROM THE GET GO IF
THE EQUIPMENT IS THE LACK OF
COORDINATION AT THE DIFFERENT
GOVERNMENTAL LEVELS BUT A LOOK.
AT ASSEMBLY MEMBER MATHIS THIS
THIS IS LISA CALLING MAY I
RESPOND TO THIS YES PLEASE.
YEAH I WOULD ECHO PART OF WHAT
A GREAT JUST SAID ABOUT THE
INCONSISTENCY AND MESSAGING.
AND THAT THAT INCONSISTENCY
BETWEEN THE FEDERAL THE STATE
AND THE LOCAL HAS CAUSED GREAT
FRUSTRATION AND HARDSHIP AND
CONFUSION AND IN SOME. CASES
HAS MADE. HAS MADE THE CITY
WORSE. WE YOU'RE TALKING ABOUT
THIS IS BEING DOWN. THAT THAT'S
THAT'S VERY EXTREME SITUATION
AND WE WOULD HOPE IT WOULD
NEVER GET TO THAT- MY ALL MY
ALWAYS GO TO RESPONSES THAT WE
NEEDED OMBUDSMAN'S IN THESE
BUILDINGS AND THE FACT THAT WE
HAVE SUCH DIVERSE. LOCAL PUBLIC
HEALTH IS IN PART OF THE
PROBLEM AS TO WHY WE HAVEN'T
HAD ON BUT SINCE GOING BACK
INTO THE BUILDINGS BECAUSE THEY
SEE THESE THINGS WHEN IT'S
SMALL. AND THEY ARE DOES I MEAN
THE WHOLE FOCUS IS TO DO
INTERVENTION BEFORE THESE
BECOME BIG PROBLEMS. SO GETTING
THE OMBUDSMAN'S BACK IN I DON'T
KNOW THAT I WOULD SAY GIVING
LOCAL PUBLIC HEALTH MORE TEETH
I WOULD SAY A BETTER
COMMUNICATION OF MESSAGE
BETWEEN. THE AGENCY AND LOCAL
PUBLIC OUT WOULD HELP A LOT. I
I'M I WON'T FIND FAULT WITH
LOCAL PUBLIC HEALTH OFFICERS
WHEN I THINK ABOUT THE SIZE OF
THE POPULATION. WHEN YOU'RE
LOOKING AT WHAT PERCENTAGE IS
IN LONG TERM CARE FACILITIES
IT'S PROBABLY LESS THAN 1% OF
THEIR OVERALL POPULATION AND SO
TO EXPECT THEM TO BE EXPERTS IN
LONG TERM CARE IS PROBABLY AN
UNREALISTIC EXPECTATION. BUT A
GOOD SOLUTION I THINK WOULD BE
TO HAVE A LONG TERM CARE EXPERT
ON THE LOCAL PUBLIC HEALTH
TEAM. AND SAID THAT THEY WOULD
BE ABLE TO PROVIDE. MORE
ACCURATE INPUTS ARE ACCURATE
UNDERSTANDING OF. OF AT. AN
OUTBREAK THIS GOING ON IN A
NURSING HOME. THANK YOU THAT
THAT'S A REALLY GOOD POINT IT'S
I ASK THIS QUESTION BECAUSE WE
HAD A. ONCE IT WAS REPORTED. A
IN REALLY YOU YOU ALL KNOW HOW
THESE THINGS IF YOU KNOW OF
BLOWS UP AND IT'S A NEW STORY
AND ALL OF SUDDEN IT'S LIKE
WHAT HAPPENED HERE. WE FIND OUT
THAT WE HAD A FACILITY THAT.
HAD HORRIBLE GRADES FROM. THE
APARTMENT AT THE STATE LEVEL.
AND THEN YOU ASK THE COUNTY AND
THEY TURN AROUND AGO WELL IT'S
LICENSE THROUGH THE STATE. SO
SOME WOMEN WE NEED YOU TO TAKE
CARE OF IT BECAUSE IT'S AT THE
STATE LEVEL. BECAUSE A LOT OF
OUR OUR COUNTIES LIKE YOU SAID
AREN'T USED TO DEALING WITH
THESE POPULATIONS. AND THEY
LOOK AT OKAY WHO HOLDS THE
LICENSE BECAUSE WHOEVER HOLDS
THE LICENSE HOLDING THE POWER
OVER THEM. AND I WOULD AGREE
HAVING MORE ODD BUT IT'S BEEN
HAVING SOMEBODY THERE. WOULD
DEFINITELY HELP WITH THESE IN I
DON'T MEAN TO YOU KNOW GOING IN
AND SHUT THEM DOWN BECAUSE WE
WANT TO SEE THESE OPEN WE WANT
TO SEE THEM BE GOOD PLAYERS WHO
WANT TO MAKE SURE THAT WE'RE
KEEPING FACILITIES IN OUR
COMMUNITIES ESPECIALLY IN OUR-
COLLECTIVE RURAL. AREAS OF THAT
FOR THIS COMMITTEE REPRESENTS-
BUT WE ALSO NEED TO MAKE SURE
WE HAVE WAYS. WHERE THAT
INFORMATION'S COMING OUT CENTER
WHERE IT'S COMING OUT FASTER.
AND WHERE YOU KNOW IF THERE IS
SOMEBODY WITHIN THE COUNTY
HEALTH DEPARTMENT WHERE WE CAN
SET THE REGULATIONS WHERE EVERY
COUNTY IS DOING IT THE SAME WAY
AND HAS THAT SAME STANDARD OF
CARE THEN THEY CAN ACTUALLY
HAVE THE ABILITY TO TELL THAT
FACILITY HEY HERE'S HERE'S
WHERE YOU'RE MESSING UP THIS IS
WHAT YOU NEED TO DO AND MOVE
FORWARD BECAUSE IT THIS THE
STOP. GAP BETWEEN. THAT
FACILITY IN A RURAL AREA IN
CALIFORNIA. GOING BACK TO THE
STATEMENT COMING BACK DOWN.
IT'S TAKING TOO LONG AND PEOPLE
ARE DYING. BUT I DON'T EVER
WANT TO SEE THAT HAPPEN AGAIN
SO. AND I KNOW THIS HAPPENED IN
MY DISTRICT WHICH IS WHY I CARE
A LOT ABUT IT BECAUSE TO ME
THEY SHOULD NEVER HAPPENED WE
SHOULD HAVE KNOWN THESE PEOPLE
ARE GETTING A RATING OF
LITERALLY A ONE OUT OF FIVE. IN
FRANKLY THAT THEY SUCK AT WHAT
THEY WERE DOING. YET THEY WERE
STILL OPEN. SO I JUST HAVE TO
THINK OF HOW DO WE MAKE THE
SYSTEM BETTER- YOU KNOW WITH
THE LIKE YOU SAID PUTTING ON
BUDGET WITHIN THEIR HAVING THAT
PERSON AT THE COUNTY WOULD HELP
BUT IT COMES INTO. SABALLY HAS
AS WE SEE TOO OFTEN AS
POLICYMAKERS UNLESS THERE'S A
MECHANISM IN THERE. TO CREATE A
AN ACTUAL PENALTY THAT WILL YOU
KNOW GIVE THEM REASON TO
ACTUALLY BE GOOD PLAYERS- SADLY
THERE ARE SOME OUT THERE THAT
WON'T DO IT UNLESS THERE IS A
PUNISHMENT MECHANISM- HANGING
OVER THEIR HEADS. BUT THERE BUT
THERE IS WE DO HAVE THE-
QUALITY ACCOUNTABILITY FUND
THAT IS UP FOR TRAILER BILL
LANGUAGE- THAT. THAT BILL THAT
FUNDING SOURCE PROVIDES A
FINANCIAL CONTRIBUTION. WARD
TWO FACILITIES PROVIDING GOOD
QUALITY CARE WHY DON'T WE DO A
SERIOUS RE WORK OF THAT FUND
AND WE PROVIDE A BONUS TO
FACILITIES THAT ARE DOING A
GREAT JOB THEY DON'T FAIL AT
THINGS LIKE HAND WASHING AND
INFECTION PROTOCOLS THAT WE
REWARD FACILITIES THAT AREN'T
USING CARES. AND PAY A LIVING
HEALTH CARE WAIT AND NOT HAVING
TO UTILIZED A CARE WAIVER THERE
ARE THINGS WITHIN THE STATE'S
PURVIEW TO IMPROVE THE QUALITY
OF CARE IT'S RECEIVED IN
SKILLED NURSING FACILITIES BUT
IT MEANS WE HAVE TO HOLD THESE
FACILITIES ACCOUNTABLE AT THE
LARGE CORPORATE OFFICE LEVEL. I
DON'T WANNA SEE IS GOING IN AND
BERATING A CNA I WANT TO SEE IS
GOING INTO CORPORATE OFFICES
AND TAKING AWAY THEIR JET
AIRPLANES BECAUSE THAT'S WHERE
TAXPAYERS MONEY IS GOING. THERE
ARE SKILLED NURSING FACILITIES
THAT ARE CRYING POOR EVERY DAY
AND YET THEY ARE PROVIDING
GREATER DIVIDENDS TO THEIR
SHAREHOLDERS IN A PANDEMIC THEN
THEY WERE PROVIDED LAST YEAR.
BECAUSE THEY'RE GETTING MORE
MONEY FOR THAT CARE AND THEY
NEED TO BE PROVIDING. HEY TO
STAFF. BECAUSE THEY'RE GETTING
THAT EXTRA MONEY I WOULD AGREE
WITH THAT IN A WITH- HOPEFULLY
WE CAN CREATE SOME TRAILER BILL
LANGUAGE WITH THIS AND THAT.
MAYBE WE CAN PENALIZE THESE-
LARGER CORPORATIONS THAT AREN'T
BEING GOOD PLAYERS AND HAVE
THAT MONEY GO TO- GIVE A BOOST
TO THE GOOD ACTORS. ANYWAY
THANK YOU. WE ARE FIRST GOING
TO GO TO CHAIR WOULD PROFILER
QUESTION AND THEN SHARE REYES
TOOK AWAY LISA PLEASE. THANK
THANK YOU AND I APOLOGIZE I HAD
TO STEP OUT SO I MISSED YOUR
PRESENTATION BUT I DID WANT TO-
AND I APOLOGIZE EVERYBODY FOR
THAT- SO MY UNDERSTANDING FRUIT
FROM DOCTOR REGULARS THAT.
CURRENTLY LONG TERM CARE
OMBUDSMAN REALLY ONLY ABLE TO
ACCESS RESIDENTS BY TELEPHONE
IS THAT. CORRECT YES AND NO
OKAY. YEAH DEPARTMENT PUBLIC
HEALTH CCL AND THE STATE
OMBUDSMAN HAVE COME UP WITH
GUIDELINES FOR OMBUDSMAN'S TO
INTER FACILITIES. SAFELY A VERY
SLOW. AND YET WE'RE BEING- THE
ACCESS TO THESE FACILITIES IS
BEING HAMPERED BY IN CONFLICT
BY INCONSISTENCIESWITH LOCAL
PUBLIC HOUSE SO THE LOCAL
PUBLIC HEALTH SAYS NO THE
OMBUDSMAN CAN'T GO IN IT
DOESN'T MATTER THAT THE STATE
OMBUDSMAN HAS HAS. ESTABLISHED
ALL THESE PROTOCOLS BECAUSE
LOCAL PUBLIC HEALTH TRACKS
EVERYTHING. THAT'S THAT'S
THAT'S TROUBLING OKAY I
UNDERSTAND THAT- AND I WOULD
JUST I GUESS I WOULD JUST SAY
YES I HAVE A I HAVE A RELATIVE
IN A IN AN ASSISTED LIVING
FACILITY. I WILL TELL YOU FROM
PERSONAL EXPERIENCE WITH THAT
RELATIVE WHICH I SPOKE TO A
LOT. LEADING UP TO- THEIR
CHANGE OF RESIDENCE- THE
TELEPHONE BUSINESS JUST DON'T
CUT IT- QUITE FRANKLY BECAUSE
THERE'S NOTHING TO STOP THERE'S
NO SUBSTITUTE FOR A FACE TO
FACE- IN PERSON CONTACT AND I
DON'T MEAN THROUGH A GLASS
EITHER. THEIR SUBTLE BODY
LANGUAGE CHANGES ARE ALL SORTS
OF THINGS THAT HAPPEN BECAUSE
YOU KNOW I WENT FOR A COUPLE OF
YEARS NOT REALIZING THE GRAVITY
OF THE SITUATION THAT MY
RELATIVE WAS IN. BECAUSE THEY
HAD CREATED COPING MECHANISMS
TO BE ABLE TO MAKE IT MAKE ME
FEEL LIKE EVERYTHING WAS OKAY
WHEN IT TRULY WASN'T AND SO I
THINK A LOT OF PEOPLE DON'T
WANT TO LEARN THEIR FAMILY. AND
MAYBE SOME AND MAYBE NOT BE
ABLE TO SPEAK UP BUT I DO WORRY
THAT THIS YOU KNOW THAT THERE
ARE BIGGER PROBLEMS THERE THAT
WE DON'T KNOW BECAUSE WE DON'T
HAVE THE BOOTS ON THE GROUND OR
IN BOOTS IN THE BUILDING SO TO
SPEAK. AND IT REALLY REALLY IS
TROUBLING SO I GUESS I AM I AM
YOU KNOW I I'M DISAPPOINTED
BECAUSE WE TALKED WE TALKED
ABOUT THIS ISSUE. IT WE HAD A
AND R. I THINK WE'VE TALKED
ABOUT THIS AT OUR LAST-
OVERSIGHT HEARING WE DID ON
SKILLED NURSING FACILITIES
WHICH WAS. BACK IN JUNE I
BELIEVE- AND- AND HERE WE ARE
COUPLE MONTHS LATER AND YOU'RE
TELLING ME THAT PROGRESS IS
SLOW AND THAT'S REALLY
FRUSTRATING IN MY HOME COUNTY.
80% OF THE DEATHS FROM KOBE
EIGHTY PERCENT. ARE IN SKILLED
NURSING FACILITIES. AND I THINK
THAT'S INCREDIBLY TROUBLING TO
ME. AND I JUST. EIGHTY YOU GUYS
DO SUCH AMAZING WORK AND IT'S I
JUST. I'M REALLY REALLY
FRUSTRATED THAT WEEK AS A AT
THE STATE LEVEL CANNOT DO
SOMETHING. TO COMPEL LOCAL
PUBLIC HEALTH AGENCIES TO
ALLOW. FOR YOUR PRESENCE IN
THESE FACILITIES PERIOD AND SO.
THAT I DO THINK WE'RE GETTING
THERE AND AS LATE. EARLIER THAT
TO ADD. THE DEPARTMENT IS-
SEEMINGLY MUCH MORE WILLING TO
BE PROACTIVE AND SPEAK ON OUR
BEHALF LOCAL PUBLIC HEALTH- OF
BUT- THIS IS THE BUDGET
COMMITTEE AND I WOULD BE
SHIRKING MY RESPONSIBILITIES IF
I DIDN'T POINT OUT THE FACT
THAT SIXTY PERCENT. OF
OMBUDSMEN CURRENTLY ARE OVER
THE AGE OF SIXTY. SO WHILE THE
MONEY THAT THIS THIS COMMITTEE.
USED TO RESOURCE THE OMBUDSMAN
PROGRAM OVER THE LAST TWO YEARS
STARTED TO SHOW BENEFITS WE
WERE UP HUNDRED VOLUNTEERS AT
THE BEGINNING OF THIS YEAR- I
CAN TELL YOU THAT THE
DECERTIFICATION PROCESS IS
HAPPENING IT'S SLOW BECAUSE
RIGHT NOW WE'RE NOT GOING TO
FACILITIES IN A IN. A LARGE WAY
BUT IT IS GOING TO OCCUR AND
IT'S GOING TO REQUIRE THAT THE
STATE SPEND MONEY TO HAVE STAFF
BECAUSE WE NEED TO HAVE PEOPLE
GOING INTO THESE FACILITIES AND
IF. WE HAVE ONE PARTICULAR
PROGRAM THE AVERAGE AGE OF
STAFF IN THE FIFTH AT THE
AVERAGE AGE FOR THAT STAFF FOR
A PROGRAM. SAYING THIS BADLY.
UP THERE EIGHTY YEARS OLD. WE
HAVE IT WE HAVE AN OMBUDSMAN
HE'S EIGHTY FOUR WITH ANOTHER
OPPORTUNITY SEVENTY NINE YOU
KNOW IT IT IT'SDONE THAT
DOESN'T WORK THEY ARE GREAT
ADVOCATES THEY ARE FEARS THEY
KNOW THE RULES THEY THEY NEED
NO AND HAVE FORGOTTEN MORE THAN
I WILL EVER KNOW. BUT IT DOES
NOT MAKE SENSE TO BRING THEM
INTO A FACILITY SO WE ARE GOING
TO HAVE TO HIRE STAFF. AND THE
GOOD THING IS THE OMBUDSMAN
PROGRAM IS VERY NIMBLE AND-
WHENEVER YOU HAVE GIVEN THE
STAFF GIVEN A RESOURCES IN THE
PAST. WITHIN A YEAR THEY'RE UP
AND RUNNING AND- SO I HAVE
EVERY BELIEVE THAT THAT WILL
HAPPEN AGAIN THIS TIME. AND LET
OMBUDSMAN'S WILL HELP MAKE A
DIFFERENCE IS. WE DO HAVE TO
GET THE EYES AND EARS BACK IN
THESE FACILITIES. WELL THIS
COMMITTEE IS DRUG DONE
EVERYTHING THEY CAN TO MAKE
SURE YOU GUYS WERE FULLY FUNDED
AND WE WILL CONTINUE TO DO
EVERYTHING WE CAN TO ENSURE
THAT YOU GET THE RESOURCES YOU
NEED. FOR THE CRITICAL SERVICES
YOU PROVIDE SO THANK YOU FOR
EVERYTHING. CARESS LISA I'D I
WANT I WANT TO THANK YOU JUST
THE IDEA OF THE OMBUDSMAN
PROGRAM- DOES BRING SOME RELIEF
TO ALL OF US BECAUSE I THINK
IT'S CLEAR WE NEED TO HAVE YOU
THERE WE NEED TO HAVE THE
OMBUDSMAN THERE- BUT WE ALSO
WANT YOU SAFE SO WHEN. ANY OF
YOUR MEMBERS ARE AT RISK WE
DON'T WANT THEM- TO BE EXPOSED-
SO THANK YOU FOR ALWAYS
ADVOCATING I SINCERELY
APPRECIATE TO EARLIER I. AM
SURE THAT MY UNCLE HAD- PASSED
FROM COATED IN HIS FACILITY 50%
OF THE RESIDENTS TESTED
POSITIVE. THERE WERE A NUMBER
OF DEATHS NOT JUST MY UNCLE.
AND BUT I'VE GOT TO TELL YOU
THAT UNTIL THAT TIME. MY UNCLE
WAS SO WELL TAKEN CARE OF WE
VISITED IT REGULARLY AND WE
FELT THAT THEY THEY THEY CARED
FOR HIM THEY TOOK CARE OF HIM
HE WAS ALWAYS A HAPPY GUY SO
EVERYBODY WANTED TO BE AROUND
HIM HE GOT A COUPLE OF
GIRLFRIENDS IN THERE I DON'T
KNOW- BUT JUST. IT SO THE
FACILITY ITSELF I WANT TO GIVE
CREDIT WHERE CREDIT IS DUE THEY
DID A GREAT JOB IN TAKING CARE
OF MY UNCLE BUT ONCE KOBE HAD
ENTERED THE FACILITY. THAT WAS
THE END- BUT WE HAD LOTS OF THE
STAFF MEMBERS ALSO TESTED
POSITIVE NOT 50% BUT A GOOD
NUMBER OF THEM TESTED POSITIVE
FINDING WAYS TO. PROTECT
EVERYBODY AND THERE'S GOING TO
BE EXTREMELY IMPORTANT. HERE I
DO HAVE A QUESTION AFTER ALL OF
THAT I JUST I WANTED TO THANK
YOU. WHAT WE'VE TALKED ABOUT
DIFFERENT RECOMMENDATIONS- AND
MANY OF THESE RECOMMENDATIONS
USE FLEXIBILITY IS WITHIN OUR
CURRENT SUPPORT INFRASTRUCTURE
TO ADDRESS CURRENT ISSUES. CAN
YOU ELABORATE OR OF ANY OF THE
OTHERS WOULD LIKE TO ELABORATE
ON ANY PARTICULAR
RECOMMENDATIONS THAT YOU SEE A
NEED TO PRIORITIZE. IN ORDER TO
ENSURE UNINTERRUPTED CARE FOR
SENIORS AND THOSE IN THE
LIVING- AND THOSE LIVING WITH
WITH DISABILITIES. IF AND WHEN
OUR STATUS IT WITH THE SECOND
WAVE OF COVERT. WELL I HAVE
CONCERNS ABOUT THIS INDUSTRY AS
A WHOLE AND HOW THE LONG TERM
EFFECTS ARE GOING TO BE YOU
KNOW LAST YEAR THERE WERE
PEOPLE THAT FELL AND WENT INTO
A SKILLED NURSING FACILITY AND
GOT GREAT CARE THANK THEY WERE
REHABILITATED ON HOW TO WALK
AGAIN WITH THAT NEW HIP AND
THEY'RE GONNA GET TEN TO
FIFTEEN GOOD YEARS FROM THAT
REHABILITATION AND I AM VERY
CONCERNED THAT THOSE SAME
SENIORS THAT ARE FALLING AND
HAVING YOUR HIPS REPLACED IN A
HOSPITAL ARE NOW SO FEARFUL OF
GETTING CODED THAT THEY'RE
GOING HOME AND THEY'RE BY
PASSING ALL OF THAT GREAT
REHABILITATION. AND THEY'RE NOT
GOING TO GET TEN TO FIFTEEN
GOOD YEARS ON THAT HIT BECAUSE
THEY DIDN'T GET THE BENEFIT
THEY DIDN'T GET THE REHAB AT
THE BEGINNING SO WE DO HAVE TO
MAKE SKILLED NURSING FACILITY
SAFE AGAIN I THINK TESTING
TESTING TESTING PP PP PP I
THINK WE NEED TO HAVE WASHING
STATIONS OUTSIDE OF THE
BUILDING AND WE HAVE BRUNO'S
STANDING OVER THEM MAKING SURE
THAT EVERYBODY ACTUALLY WASHES
THEIR HANDS FOR THE FULL HAPPY
BIRTHDAY TWO TIMES. IF THEY- WE
HAVE TO. WE HAVE TO DO FIT
TESTING WE HAVE TO PROVIDE CARE
INSTRUCTION IN NATIVE LANGUAGE
SO THE CARE GIVERS NOTE TO
THEIR CORE WHY THEY SHOULD BE
WEARING THESE MASKS TOO OFTEN
WE'RE HEARING REPORTS OF CARE
GIVERS THAT WHERE THE MASS
WHILE THE PROVIDING DIRECT CARE
TO THE RESIDENTS BUT THEN THEY
GO BACK TO THEIR BREAK ROOMS
AND THEY'RE NOT WEARING THE
MASKS ANYMORE. THAT THAT'S HOW
WE GET THE SPREAD THAT'S HOW WE
GET THE- NON SYMPTOMATIC PEOPLE
THAT ARE PASSING THIS DISEASE.
SO I WOULD SAY- WHATEVER WE CAN
DO TO INCREASE THE USE OF PP TO
TAKE IT OUT OF THE POLITICAL
REALM AND JUST MAKE IT A PUBLIC
SAFETY. AND HAND WASHING. THE
ANTIBACTERIAL GOO IS GREAT BUT
IT DOES NOT BE A GOOD TWENTY
SECONDS OF HAND WASHING. AND
MARK MY LAST QUESTION IS. HOW
DO YOU OR HOW DID IT HAPPEN HOW
DO WE PLAN TO USE THE
RECOMMENDATIONS TO ENSURE THAT
INDIVIDUALS WHO DO NOT QUALIFY
FOR MEDI CAL HAVE ACCESS TO
NECESSARY HEALTH SERVICES
DURING THE PANDEMIC. SOMEBODY
ELSE WHO CAN ANSWER THAT
BECAUSE I DON'T HAVE A GOOD
ANSWER. ASSEMBLY MEMBER
REGISTERED CLEAR RAMSEY- AND
JUSTICE IN AGING. YEAH I DON'T
HAVE A PERFECT ANSWER THAT
QUESTION I THINK IT'S A VERY.
COMPLEX ANSWER GIVEN THAT YOU
KNOW OUR SYSTEM IS BUILT VERY
HEAVILY ON USING META CAL
DOLLARS FOR- COMMUNITY SERVICES
AND ON- INSTITUTIONAL LONG TERM
CARE. BUT THERE ARE SOME THINGS
FOR EXAMPLE BE- COMMUNITY
LIVING FIND COULD BE USED UP TO
NON MEDICARE HOW RECIPIENTS- WE
COULD LOOK AT WAYS THAT-
MEDICARE COULD HELP PEOPLE
RAPID. RESPONSE INTENSIVE CASE
MANAGEMENT- AND WE ALSO HAVE.
WAYS TO HELP PEOPLE BECOME
ELIGIBLE FOR MEDICARE HEALTH
FOR EXAMPLE THERE'S SOMETHING
CALLED THE SELF. IMPOVERISHMENT
PROVISIONS WHICH ALLOW. OR WHEN.
WOULD NEED LEVEL OF AT A
NURSING HOME BUT THEY COULD BE
FIXED SERVICES IN THEIR HOME
THEY CAN QUALIFY FOR MEDI CAL
WITHOUT HAVING TO SPEND DOWN TO
A LEVEL THAT MEDIC CAL NORMALLY
REQUIRES. I THINK WE HAVE TO
CURRENT. ABILITY TO HELP PEOPLE
BUT I THINK YOU'VE HIT UPON A
MUCH BIGGER PROBLEM WHICH IS.
THAT WE DEPEND SO HEAVILY ON
MEDICARE OUT FOR HOME AND
COMMUNITY BASED SERVICES
PROGRAM. I DO ALSO THINK SO- WE
COULD HELP BY EXPANDING OUR
MEDIC HEALTH PROGRAMS. SO THAT
WE'RE TAKING BURDEN OFF OF IF
SOMEONE CAN GET ON TO MEDICARE
THAN THEY CAN BE SERVED. ON
THERE ARE A LOT OF PEOPLE ON
WAITING LISTS WHO WOULD QUALIFY
BUT DON'T THINK THAT THEY'RE
GOING TO BE ABLE TO GET THE
SERVICES THEY NEED TO DON'T
APPLY. AND THEN HOPEFULLY YOU
KNOW ALLOW SOME- ABILITY FOR
OUR PRIVATE CARE GIVERS TO HAVE
A SMALLER GROUP OF PEOPLE TO
TAKE CARE BECAUSE. MEDIC HELP
TAKING CARE OF THE LARGER GROUP
AND AS- MEMBER CRIED TO ANSWER
YOUR LAST WEEK I KNOW IS. AT
WITH BUT- I'LL JUST SAY THAT I
REALLY HOPE- BECAUSE SHE'D
RECOMMENDATIONS MADE BY CRAIG
AND LISA I TOOK ONE SIDE OF THE
COIN. BECAUSE WE DO NEED SAFETY
IN NURSING HOMES ABSOLUTELY
THERE ARE PEOPLE. WHO NEED TO
THE NURSING HOME BUT IT'S THE
BEST PLACEMENT FOR THEM. RIGHT
NOW AND- THERE'S NO POINT IN
CALLING THEM OUT AND MAKING
THEM ON STAGE IN THE COMMUNITY
HOWEVER. THERE ARE PEOPLE WHO
COULD BE WELL SERVED IN THE
COMMUNITY AND SO WE SEE THE
RECOMMENDATIONS WE PUT FORWARD
AT THE L. TRYPTOPHAN COMMITTEE
THAT OTHER SIDE OF THE COIN. SO
THERE'S A PLACE. FOR PEOPLE TO
GO GO TO- ASSEMBLY MEMBER
MACINNES CONCERNING- IF PUBLIC
HEALTH THOUGHT. THIS PLACE IS
NOT DOING A GOOD JOB WE THINK
OUR SOLUTION COULD BE TARGETED
TO THE LEVEL OF FACILITY THEN
YOU COULD SAY. WE'RE TARGETING
CAPABILITIES THE HIGHEST RATES.
AND WORKING TO GET THE TRUTH
OUT MAKE SURE THE PEOPLE WHO DO
REMAIN. UNDER CONSTRUCTION
CONTROL THAT WE HAVE THE
STATE'S- WE CAN DIFFERENT
PEOPLE. AND SO WE REALLY WANT
TO SEE THE WORKING TOGETHER TO
IMPROVING. OUR SYSTEM FOR OLDER
ADULTS. ALL BOTH. IN THE- AND
HOME SERVER. THANK YOU SO MUCH
AND MISTER CHAIR MATT TAKE A
PERSONAL POINT OF PRIVILEGE-
JUST TO I DO WANT TO THANK ALL
THOSE NURSES WHO TOOK CARE OF
MY UNCLE- AFTER HE WAS
DIAGNOSED WITH COPD AND AS HIS
CONDITION WORSENED- THREE DAYS
BEFORE HIS DEATH WAS HIS
BIRTHDAY. AND IT AND IT
THROUGHOUT THE WHOLE PROCESS
THEY WOULD PUT THE EITHER AN
IPAD OR AN IPHONE SO THAT WE
COULD SEE HIM HE COULD SEE US-
AND WE WERE ABLE TO SING HAPPY
BIRTHDAY TO HIM WITH MONEY THAT
SHE- AND THREE DAYS LATER HE
DID PASS BUT- THE NURSING.
PEOPLE ARE SO IMPORTANT AT ALL
OF THIS AND I THINK. THAT'S WHY
IT IS SO IMPORTANT THAT AS WE-
LOOK TO ANY PROGRAM TO ANY
CHANGES WE HAVE TO BE SURE TO
TAKE CARE OF THE PEOPLE WHO ARE
TAKINGCARE OF THE PATIENTS AND
GOES TO LEASE THOSE- COMMENT
ABOUT MAKING SURE THAT. IT
ISN'T TO THE JETS THAT ARE
BEING- FUNDED BUT IT'S THE
PEOPLE TAKING CARE OF OUR MOST
VULNERABLE OUR MOST PRECIOUS-
PEOPLE THAT THOSE ARE THE ONES
WE NEED TO TAKE CARE OF HIM SO
YOU THROUGHOUT THIS ENTIRE
PROCESS I WILL. ALWAYS BE THE
ADVOCATE FOR THE WORKERS ABOVE
EVERYTHING ELSE BECAUSE THEY
ARE THE ONES PUTTING THEIR
LIVES ON THE LINE. TO TAKE CARE
OF OUR ELDERLY ARE DISABLED AND
WE'VE GOT TO DO EVERYTHING WE
CAN TO PROTECT THEM SO THAT
THEY CAN BE HEALTHY. AND BE
ABLE TO TAKE CARE OF THE VERY
PEOPLE THERE TAKING CARE OF SO
THANK YOU. THANK YOU CHAIR
RAILS FOR BRINGING THE HUMAN
INTO HUMAN SERVICES YOU ALWAYS
REMIND US IT'S ABOUT THE PERSON
AND- NOT THE STATISTICS AND
APPRECIATE THAT TRINITARIAN. IF
YOU HAD A QUESTION I WOULD BE
AN APPROPRIATE TIME IF NOT.
PERFECT THEN I WILL ASK THE
FINAL TWO QUESTIONS ON THIS
PANEL I I MAY- FIRST TO YOU
MISS COLEMAN. ERECTOR LIGHT
BORN EARLIER SAID THAT THERE
WAS A MISSING LINK IN THE
CONTINUUM OF ARE. AND WANTED
TO GET YOUR ASSESSMENT ON
WHETHER OR NOT THAT'S TRUE.
ABSOLUTELY THAT IS TRUE EIGHT
OUT WE. WE HAVE VERY BLANKET
YOU EITHER FIT INTO THIS COLUMN
BECAUSE YOU HAVE FUNDS OR YOU
DON'T HAVE FUNDS AND SO YOU'RE
RELEGATED INTO THIS ARENA WE
ARE TRYING TO COMBINE TO WHAT I
THINK OF IS TWO VERY DIFFERENT
GROUPS WE HAVE OLDER ADULTS WHO
ARE DEAF WHO HAVE DISABILITIES.
AND THEN WE HAVE OLDER ADULTS
WHO HAVE COGNITIVE IMPAIRMENT
AND THOSE TWO GROUPS SHOULD NOT
BE TREATED THE SAME WELL THE
PERSON THAT HAS A SHARP MIND
BUT HAS MEDICAL CONDITIONS
MIGHT BE VERY WELL SUITED IN
HOME UTILIZING CARE GIVERS
BEING ABLE TO COMMUNICATE
SUCCESSFULLY THEIR CARE NEEDS
BEING ABLE TO ANTICIPATE WHEN
THEY'RE GOING TO NEED CARE. AT
AN OLDER ADULT WITH A COGNITIVE
IMPAIRMENT THAT JUST DOESN'T
WORK YOU CAN'T TAKE A PERSON
WITH ADVANCED DEMENTIA AND SAY
WELL I'M GOING TO PROVIDE THEM
WITH CARE AT BREAKFAST AND
SHOWERS AND THEN SOMEONE ELSE
WILL STOP IRAN LUNCH AND THEN
SOMEONE ELSE TO COME AND PUT
HIM TO BED AT NIGHT. THAT WOULD
BE LIKE THE SAME AS SAYING WANT
GET- SIX HOURS A DAY SPREAD OUT
OVER THE COURSE OF THE DAY FOR
MY SIX YEAR OLD TO GET STATE
KERR IT DOESN'T MAKE SENSE AND
WE'RE TRYING TO. USE THESE
PROGRAMS FOR TWO VERY
DISTINCTLY DIFFERENT
POPULATIONS. I KNOW THAT THERE
ARE MANY FAMILIES THAT ARE
STRUGGLING DOING THE VERY BEST
THEY CAN TO KEEP MOM AND DAD AT
HOME SAFE. I ALSO KNOW THERE'S
A LOT OF OLDER ADULTS THAT ARE
EXPERIENCING SUCH SEVERE SOCIAL
ISOLATION. BECAUSE WE'RE
KEEPING THEM AT HOME ALONE.
INSTEAD OF ALLOWING THEM TO
LIVE IN A COMMUNITY ENVIRONMENT
I CAN ASSISTED LIVING FACILITY
WHERE THEY STILL HAVE THEIR OWN
APARTMENT THEY STILL HAVE THEIR
OWN BATHROOM THEY HAVE THEIR
OWN PERSONAL SPACE. BUT THEY
ALSO GET TO BENEFIT FROM HAVING
A COMMUNITY TO BE AROUND THEM.
SO YES I DO THINK THE- DIRECTOR
HAS HIT UPON EIGHT EIGHT EIGHT
DISTINCT PROBLEM IN THE SYSTEM.
WE ARE TRYING TO COVER TOO
WIDE. A POPULATION WITH TOO
NARROW A FRESH. I WILL
APPRECIATE THAT MISS COLEMAN
WE'VE ALWAYS LOOKED TO YOU TO
BE OUR EYES AND EARS WITHIN
SKILLED NURSING FACILITIES AND
THAT THAT- UNDERSTANDING OF HOW
THE SYSTEMS WORK IS INCREDIBLY
IMPORTANT FOR US AS LEGISLATORS
AND- BELIEVE IT ALLOWS US TO.
SEE THAT THERE IS A NEED TO
WORK ON THIS PROBLEM. BUT WE
HAVE TO GET IT RIGHT. AND SO
WITH THAT IF I COULD THE FINAL
QUESTION FOR THIS PANEL IS FOR
MISS RAMSEY. AND YOU KNOW I WAS
QUITE APPRECIATIVE OF THE SUB
COMMITTEE COMING UP WITH TWELVE
RECOMMENDATIONS. BUT I WANTED
TO SEE IF. AND YOU WERE VERY
EXPLICIT NOT TO SAY THAT THEY
WERE PRIORITIZED IN. ANY WAY.
AND IRONICALLY I'M ASKING FOR
YOU NOW TO PRIORITIZE THEM. AND
SEE IF ANY ARE ESPECIALLY
CRUCIAL FOR THE ADMINISTRATION
TO ACT UPON NOW- I WOULD
HIGHLIGHT AND STAND UP-
RECOMMENDATIONS ONE M. ELEVEN
THAT. JUMPED OUT TO ME BUT
WANTED TO SEE IF ANY OTHER
RECOMMENDATIONS MISS RAMSEY- OR
ESPECIALLY CRUCIAL RIGHT NOW.
THANK YOU- ASSEMBLY MEMBER-
ARAMBULA I. I THINK. OKAY TWO
THINGS ONE IS I WILL SAY THAT
FOR THE L. TRYPTOPHAN COMMITTEE
DOT GROUP HAS NOT PUT A
PRIORITIZATION UPON THE BOOK SO
I DO WANT TO SAY THAT RIGHT NOW
I'M JUST SPEAKING FOR MYSELF
AND THAT DIFFERENT MEMBERS OF
THAT SUBCOMMITTEE COULD. HAVE
DIFFERENT CENTER PRIVATIZATION
I WOULD SAY WERE I SEE THAT THE
NEED IS TO MAKE SURE THAT THERE
IS. STOCK ACTION TAKEN EACH OF
THE DIFFERENT CATEGORIES SO ARE
YOU GREEN THAT NUMBER ONE
AROUND THE CALIFORNIA COMMUNITY
TRANSITION. IS REALLY VITAL TO
MAKING SURE THAT WE BASICALLY
CAN EXPAND A PROGRAM THAT
ALREADY WORK. AND JUST APPLY IT
TO A LARGER POPULATION AND ONE
THAT WE KNOW MAKES UP THE VAST
MAJORITY OF BURDENS AND
EVERYTHING HOMES. I THINK WE DO
NEED TO FIND A WAY TO DO SOME
INCREASING OF CAPACITY WITHIN
OUR CURRENT H. CBS PROGRAM- I
THINK I JUST GOT TWENTY HOURS-
VERY DOABLE QUICKLY BECAUSE
THAT ALREADY EXISTS AND IT
DOESN'T REQUIRE. A LOT OF
ADDITIONAL. CLICK OR A LOT OF
CHANGES BUT I SAY THAT I. THE
NEED FOR ADDITIONAL. AS WELL-
IF YOU CAN- PUT MONEY INTO THE
INTO THE PROGRAM AND THEN
LASTLY I AGREE WITH YOU ABOUT
NUMBER ELEVEN BECAUSE IT DOES
SEEM. TO BE FAIRLY OUT OF
CONTROL THAT WE MIGHT LET
PEOPLE WHO ARE POSITIVE FOR
KOBE D. GOING INTO NURSING
HOMES TO GOING BACK INTO THEIR
OWN HOME AND INTO THE COMMUNITY
AND WE DON'T EVEN KNOW THAT. SO
I THINK THERE IS. A REAL NEED
IMMEDIATELY FOR TESTING BUT I
WILL SAY THAT NUMBER TWELVE YOU
KNOW WE ARE ASKING PEOPLE TO
TAKE RISKS AND ALL THE FOCUS ON
WORKERS I THINK IT'S BEEN. VERY
IMPORTANT AND THAT TO ME IS-
UNDERLINED BY RECOMMENDATION
TWELVE WHICH IS REALLY SAYING
WE'RE NOT GONNA LET OUR HOME
CARE WORKERS ARE. NURSING HOME
WORKERS ARE COMMUNICATE WORKERS.
DO THE JOB WITHOUT PROPER
PROTECTIVE EQUIPMENT SO- THAT
WOULD BE FOR MY PARTICIPATION
BUT I KNOW THERE MIGHT BE
OTHERS WHO WOULD- WHO MIGHT.
EVEN DIFFERENT WAY. NO THAT'S
INCREDIBLY HELPFUL AND I AGREE
WITH THE APPROACH OF LOOKING
WITHIN THE THREE DIFFERENT
CATEGORIES THAT YOU HAVE- JUST
TO REPEAT IT APPEARS YOU'VE
SAID NUMBER ONE. AND AS I'M
TRACKING IT FOUR FIVE AND SIX
AS WELL AS NORMAL ELEVEN AND
TWELVE- WHICH- A- JUST WANTS TO
APPRECIATE EVEN JUST OPINING
ABOUT THAT IN REAL TIME IT
HELPS US TO- KNOW WHICH ONES
ARE ESPECIALLY CRUCIAL. WITH
THAT I WANTED TO THANK THIS
PANEL AND MOVE ON TO OUR FINAL
PANEL THE ADMINISTRATION
REACTION PANEL WHERE WE WILL
HAVE DIRECTOR LIGHT BORN
DIRECTOR LEAD AS WELL AS-
DEPUTY DIRECTOR STEIN OCCUR AS
WELL AS JACOB LAMB FROM
DEPARTMENT OF FINANCE FOR ANY
QUESTIONS THAT WE MAY HAVE. SO
IF WE CAN INVITE THAT PANEL
BACK AND SE WHAT REACTION THEY
HAVE STARTING WITH DIRECTOR
LEVEL. THANK THANK YOU. IN
TERMS OF THE RECOMMENDATIONS
THAT- THE LONG TERM SERVICES
AND SUPPORTS UP COMMITTEE ARM
DEVELOPED- FIRSTLY JUST SAVE
OUR STUFF INSTEAD OF GOING
THROUGH IN. IN DETAIL TO TRY
TO. BE SURE THAT IN A COUPLE
ALL FOUR CORNERS UNDERSTOOD.
SEVERAL OF THE OF THE
RECOMMENDATIONS OWN REQUIRE NON
EMERGENCY FEDERAL WAIVERS WHICH
ARE LONG. LONG IN GETTING IT
WILL COME QUICKLY. SO IT DOES
PROBABLY YOU KNOW WE WILL HAVE
TO. PUT TO ONE SIDE OTHERS ON.
CANDIDLY FRANKLY MAYBE BUDGET
ISSUES ON THAT IF THEY IF
THEY'RE NOT HELP BUDGET ON
THESE MAY BE THINGS THAT-
SHOULD SHOULD E DOUBLE IF
THEY'RE ALL THESE. THE
ADMINISTRATION AS I SAID
EARLIER WHICH WILL REDUCE OF
EMBARKING ON OR IN THE- THIS
GOT TO EVERYONE ON THE
IMMEDIATE ACTION STEPS FOR
DOING THOSE OF COURSE WERE
COMMITTED TO NOW- WE'LL BE
WORKING WITH. STAKEHOLDERS AND
PARTNERS. OTHERS ARE OR WHAT
CAN BE DONE WITH OTHERS ALL. TO
THE QUESTION OF. WITH IN
SKILLED NURSING FACILITIES MAKE
SURE THAT ALL EMPLOYEES I'M-
THE- THEIR THEIR THEIR NEEDS
ARE BEING MET- YOU WILL RECALL
THAT THE STATE BUDGET OKAY
ALLOWED US TO GIVE A 10% RATE
INCREASE UP TO SKILLED NURSING
ASSOCIATED WITH OF THE PANDEMIC.
WE WILL BE ON THE BACK END OF
IT ALL GOING BACK TO WHAT IT
CALLED THE NURSING HOMES TO BE
SURE THAT THOSE FUNDS ACTUALLY
MADE IT TO SUPPORTING THEIR
WORK FORCES NOT TO. JETS THE
WHATEVER ELSE ON THE PROFIT
LINE. MIGHT'VE BEEN ALMOST B.
SORT OF BROADLY THE RIGHT I
HOPE THAT OUR ALONG EARLIER
PRESENTATION SORT OF TO THE
EXTENT THAT THE GOAL IS TO
CONTINUE ON THE MOST WIDESPREAD
POSSIBLE DIALOGUE ON BOTH
AROUND SUGGESTIONS FOR SHORT
TERM BUT ALSO THE NEED TO.
INCORPORATE STRATEGIES INTO
SORT OF A MORE LASTING. PROGRAM
CONSTRUCTION WILL CONTINUE AND
BY SINCERE APOLOGIES TO THE
LONG TERM CARE OMBUDSMAN GROUP
WE HAD ADDED THEM STAKEHOLDERS
I SOMEHOW THOUGHT THEY WERE ON
THE LTSS. LONG GROUP BUT WE
WILL COURSE BE REACHING OUT TO
THEM WITH THAT ON MAY BE TURNED
OVER TO A DIRECTOR WAY. THANK
YOU SHARE ARAMBULA I WOULD SAY.
COUPLE REFLECTIONS ON AFTER
THIS REALLY- IMPORTANT
INFORMATIVE DISCUSSION TODAY-
CLEARLY WE'RE AT ALL HANDS ON
DECK- MOMENT IN A MOMENT IT'S
GOING TO BE WITH US FOR QUITE
SOME TIME SO- THE PARTNERSHIP
OF THE LEGISLATURE IS MORE
IMPORTANT THAN EVER- AND I
THINK I WANT TO APPRECIATE
PEOPLE'S OF KNOWLEDGE MEANT
THAT IT HAS BEEN AN
OVERWHELMING TIME IT'S BEEN A
FAST MOVING TIME IT IS BEEN A
STRESSFUL TIME PERSONALLY
PROFESSIONALLY FOR SO MANY OF
WILL DO BETTER. I WANT TO THANK
LEGISLATIVE STAFFERS CONTINUE
TO REACH OUT AND WORK THROUGH
THESE VERY DIFFICULT ISSUES AT
ALL KINDS OF OURS AND ALL KINDS
OF A CONVERSATION SO THAT WE
ARE WORKING WALKING FORWARD
HAND IN HAND WE DO NEED ALL OF
OUR HEARTS AND MINDS- WORKING
ON THESE ISSUES. SO JUST LOOKED
UP A COUPLE THAT ARE TOP OF
MIND DEPARTMENT OF AGING. TO GO
BACK TO DIRECTOR LIFE FORMS
WERE WE ARE BOTH- DOING THAT
EMERGENCY CRISIS IMMEDIATE
RESPONSE DAY IN DAY OUT AND-
MOVING US TO THE TRANSFORMATIVE
FUTURE THAT IS CLEARLY
REQUIRED. BY THE CHALLENGES
WE'RE FACING IN THIS RESPONSE.
SO TOP OF MIND FOR US THE
DEPARTMENT OF AGING IS AS LISA
SAID. RE ENTRY INTO THE SKILLED
NURSING AND ASSISTED LIVING
FACILITIES WE DO AGREE WE NEED
OUR EYES AND EARS ON FOLKS. WE
ARE TRYING TO WORK WITH THE ON
WHAT'S TO HELP THEM WITH THE
BARRIERS ARE. A STATE OR LOCAL
OR TRAINING OR PP OR TESTING
WE'VE GOT SOME OF THOSE
BARRIERS AND HAVE INITIATIVES
UNDER WAY BOTH CENTRAL VALLEY
IN LA TO KNOCK THOSE BARRIERS
DOWN. WE ALSO WANNA MAKE SURE
WE'RE USING EVERY SINGLE INCH
OF OUR CAPACITY IN THE M. S. S.
P. SYSTEM THE CBS SYSTEM. AND
THE TRIPLE A SYSTEM WHICH DID
RECEIVE CARE RESPONDING THAT
WENT OUT THE LAST WEEK OF JULY.
WE WANT TO MAKE SURE EVERY
COMMUNITY HAS THAT AND SPENDING
THAT ON THE HOME AND COMMUNITY
SERVICES THE FAMILY CAREGIVER
SUPPORT. THE HOME ALL PART OF
THAT WRAP SERVICES. BUT WE
DON'T WANT TO MISS THIS MOMENT.
TO TRANSFORM WE CANNOT JUST
CONTINUE TO ASK OUR PATCHWORK
QUILT. TO COVER US ALL I DO SO
AN EQUITABLE AND EFFECTIVE WAY
WE REALLY DO NEED TO REIMAGINE
THE FUTURE AND I WANT TO THANK
CRAIG CORNET AND OTHERS WHO
HAVE. IN OUR FIRST ABLE TO
CONVERSATION ABOUT SKILLED
NURSING- SO WE DO NEED TO
CREATE SPACE TO REIMAGINE%
SKILLED NURSING FOR THE FUTURE.
WE DO NEED TO REIMAGINE WHAT
ARE HEALTH CARE THE SECOND HALF
OF OUR LIFE LOOKS LIKE- AND
THAT'S WHY THE MASTER PLAN AND
OTHER STAKEHOLDER ENGAGEMENT
LEGISLATIVE ENGAGEMENT IN LONG
TERM CARE AT HOME IS SO
IMPORTANT. OUT OF THIS TRAUMA
NEEDS TO COME TRANSFORMATION.
AND ONE PIECE THAT YOU- AS IN
GOVERNMENT WILL KNOW. IS THE
NEED FOR HUBS. WHERE IS THAT
ONE STOP THAT PEOPLE WHO ARE
CALLING YOUR OFFICE IS PEOPLE
WHO ARE CALLING OUR OFFICES I
THINK ALL OF OUR PHONES ARE
RINGING OFF THE HOOK WITH
PEOPLE. NEEDING INFORMATION. I
IN GREAT. AS THEY TRY TO OUT
THE BEST THINGS FOR THEM. AND
THEIR FAMILIES SO WE KNOW THE
TIME IS. IS UPON US TO GET OUR
AGING AND DISABILITY SYSTEMS
INTO HUBS. GET OUR LTSS SYSTEMS
INTO HOMES IS DH CS IS. IS
PROPOSING WE HAVE SEVERAL
EXAMPLES OF THIS AROUND THE
STATE IN AROUND PROVIDER
NETWORKS BUT WE DON'T YET HAVE.
THE SYSTEM THAT WE ALL WANT FOR
OURSELVES AND FOR OUR LOVED
ONES- AND SO AGAIN- MOVING
FORWARD ON BOTH FRONTS.
URGENTLY AND IN PARTNERSHIP- WE
WILL BE A DIFFERENT PLACE WE
HAVE TO BE THANK YOU. THANK YOU
DIRECTOR WADE WANTED TO SEE IF
DEPUTY DIRECTOR STEINORTH HER
HEAD IN THE- FINAL. WELL GOOD
MORNING AGAIN OR ACTUALLY I
GUESS WE SHOULD NOW SAY GOOD
AFTERNOON THANK YOU SO MUCH FOR
HAVING THIS FORUM TODAY- THANK
YOU BOTH THE LEGISLATORS AND
OUR PARTNERS- ARE STAKEHOLDERS
WHO HAVE BEEN ENGAGED- YOU
KNOW. CRAIG KARNAD AND LISA
COLEMAN WHO I'VE WORKED WITH-
QUITE EXTENSIVELY THROUGHOUT
THIS PANDEMIC IN PRIOR. THIS
REALLY IS ABOUT THE
COLLABORATION- BOTH- I ECHO
SOME OF THE- COMMENTS THAT WERE
MADE EARLIER ABOUT- SOMETIMES
THOSE FRUSTRATIONS RIGHT
BETWEEN THE FEDERAL THE STATE
AND THE COUNTY- LEVEL ISSUING
GUIDANCE ARE ALL HAVING
DIFFERENT LEVELS OF AUTHORITY.
ON THESE FACILITIES- THAT ARE
IMPACTED. YEAH I ACTUALLY I HAD
THE PLEASURE OF A FLYING DOWN
TO IMPERIAL I'VE SPENT THE LAST
TWO WEEKS ON THE ROAD IN SIX
DIFFERENT COUNTIES IN THE
CENTRAL VALLEY AND I'LL BE IN
KINGS COUNTY LATER THIS WEEK-
BECAUSE THERE IS THAT THAT
NEEDED THAT COLLABORATION FACE
TO FACE- BOTH WALKING THROUGH
THOSE FACILITIES THAT ARE
HARDEST HIT. AS WELL AS WORKING
WITH THE LOCAL PUBLIC HEALTH
OFFICERS- I FOUND OFF IN ONE OF
THOSE STRATEGIES- THAT THAT
IT'S BEEN HELPFUL- IN THAT KIND
OF LEAVING OUT SOME OF THESE
ISSUES AROUND I THINK THAT.
THAT REPRESENTATIVE MATHIS WHO
POINTED OUT AS WELL AS SOME OF
OTHERS ABOUT THAT FRUSTRATION
BETWEEN YOU KNOW WHERE IS THE
COUNTY AUTHORITY THE STATE
AUTHORITY AND THAT THE FEDERAL
CMS WHO ACTUALLY- CERTIFIES
THESE FACILITIES THERE ARE
FORTY. AND SOMETIMES THAT HAS
TO BE A CONVERSATION TOGETHER
WITH THOSE FACILITIES- TEATHER
LEVEL SET OR MAKE SURE THAT
THEY HAVE THAT. THE RESOURCES
NEEDED TO BE SUCCESSFUL A FEW
THINGS THAT I WON TO TOUCH ON.
AS I WAS I. THERE'S A FEW
QUESTIONS PRIOR. BUT YOU KNOW
WHAT ARE SOME LESSONS LEARNED-
WHAT HAVE WE CHANGE NOW WOULD
HAVE BEEN SIX OF SOME
STRATEGIES THAT SEEM TO WORK.
AND WHAT IS THE CURRENT STATUS.
OF ONE OF THE QUICK THINGS THAT
WE FOUND OUT EARLY ON THE
PANDEMIC IS THAT A FACILITY CAN
CHANGE. DRASTICALLY WITHIN
FORTY EIGHT HOURS. THANK
MAGNOLIA- IS A GREAT EXAMPLE OF
THAT THAT HAPPENED IN APRIL
WHERE ARE STATE STAFF IN THERE
TWO DAYS PRIOR TO THE
EVACUATION. AND WHAT WE FOUND
IS THAT. YOU CAN HAVE ALL OF
THE GREAT BEST LAID PLANS IN
PLACE WITH INFECTION PREVENTION%
AND EVERYTHING LOOKING COPA
STATIC. BUT THE MOMENT THAT
THERE IS THAT- IMPACT OF COATED
WE HAVE FOUND VARIOUS DEGREES
OF REACTIONS- IN A FACILITY. IN
UNDERSTANDING THAT STAFFING AND
PP- ARE CRITICAL AND WE
DISCOVERED EARLY ON AND DID A
CASE STUDY ON THIS. AND FOUND
THAT YOU KNOW EVEN THOUGH ALL
FACILITIES HAVE EMERGENCY PLANS
THEY DON'T NECESSARILY-
SPECIFICALLY- TALK ABOUT
CONTINGENCY PLANS WITH HOPE IT.
IN SO THAT'S WHY WE WERE THE
FIRST AND ONLY STATE TO REQUIRE
MITIGATION PLANS OF ALL OF OUR
FACILITIES. AND AS CRAIG HAD
MENTIONED WE'RE NOW ON SITE
MORE THAN EVER IN FACT I THINK
I TRACKED. IN THE THREE MONTHS
BETWEEN. APRIL AND- JULY WE
WERE ON SITE A THOUSAND TIMES
MORE THAN WE WERE IN THE PRIOR
YEAR. AND THAT KIND OF CADENCE
AND OVERSIGHT AND PHYSICALLY
JUST BOOTS ON THE GROUND IN THE
FACILITY I BELIEVE HAS MADE A
DIFFERENCE AND THAT'S EXACTLY
WHY. WHEN WE LOK AT KIND OF
REGULATORY REFORM WE'RE LOOKING
AT WHAT THE CADENCE OF
FREQUENCY THAT WERE IN
FACILITIES. THAT'S WHY THAT'S A
BIG PART OF THE PUSH FOR DPH TO
CONTINUE. THAT GOING FORWARD. I
THE OTHER PIECES WAS. A BIG FAN
HERE IS THAT WHICH WAS
MENTIONED WAS TRANSPARENCY OF
INFORMATION- WE DID JUST
RELEASED A NEW SNIFF WEBPAGE-
WHICH I INVITE ALL OF YOU TO.
TAKE A LOOK AT- THE IT'S MORE
TRANSPARENT THAN EVER AS FAR AS
BEING ABLE TO TAKE INFORMATION
AS FAR AS TESTING WHOSE
TESTING- THE- THE POSITIVES
NEGATIVES. REFUSALS ECCENTRIC
WE HAVE INFORMATION ABOUT JUST
CASE AND DEATH ANNA BUT MORE
IMPORTANTLY WE HAVE INFORMATION
ON. WHERE ARE THE FIST- WHICH
OF THE FACILITIES EACH WEEK WHO
HAVE BEEN DEEMED OKAY- BY THE
FEDERAL GOVERNMENT. TO HAVE
INDOOR VISITATIONS OF PEOPLE
LOVED ONES CAN LOOK AT THAT. AS
A STATE WE DID LEAN VERY
FORWARD AND WENT ON AND STATE
STATED THAT ALL FACILITIES AND-
CALIFORNIA MUST REQUIRE OUTDOOR
VISITATION- IN THE IN ADVANCE
OF WHATEVER CMS GUIDANCE HOT-
AND WE ALSO HAVE INFORMATION ON
THERE ABOUT WHAT WE PHYSICALLY
DOING WHICH I THINK IS MOST
IMPORTANT THAT. IT'S NOT JUST A
FINAL LOVED WHEN I LOOK UP
THERE AND I SEE OKAY THIS IS
THE FACILITY AND THIS IS HOW
MANY CASES AND DEATHS. MORE
IMPORTANTLY WE THEN HAVE
INFORMATION ON THERE AS TO-
WHEN OUR INFECTION CONTROL
STRIKE TEAMS HAVE BEEN WHAT'S
THE LAST TIME THAT WE WENT IN
THERE FOR MITIGATION PLAN
SURVEY WHAT ARE WE PHYSICALLY
DOING IN THOSE FACILITIES AS A
STATE WHETHER THEY BE OUR
SURVEYORS THERE THERE. WERE OUR
STRIKE TEAMS ARE INFECTION
CONTROL STRIKE TEAMS ARE THERE
SO PLEASE TAKE A LOOK AT THAT
AND THAT'S OUR EFFORT TO TRY TO
HAVE THATONE STOP SHOP OF
INFORMATION- FOR THE PUBLIC.
THE OTHER THAT WE- REALLY
LEARNED. OBVIOUSLY WAS THAT.
INFECTION CONTROL IS- ONE OF
THOSE- KIND OF ACHILLES HEELS
GOING INTO COBIT AT SOME OF
THESE FACILITIES. SO WE REALLY
BOLSTERED UP THE TRAINING THE
EDUCATION. I'M DOING STATEWIDE
CALLS THREE TIMES A WEEK
WEBINARS ON ONCE A WEEK. HAVING
THE- ARE H. I. STAFF THE
INCREASED OR H. I. STAFF A
FIFTY PERCENT. WE RE TRAINED
ALL OF OUR SURVEYORS ON H.I.
COMPETENCIES. SO THAT EVERYONE.
HAS THAT ABILITY TO MAKE SURE
THAT THEY HAVE STAFF WHO ARE
COMFORTABLE DONNING AND DOFFING
CORRECTLY. MAKING SURE THAT THE
CO ORDINATES OWN IT CORRECTLY.
I'M AND WORKING A LOT WITH OUR
LOCAL PUBLIC HEALTH AS WELL- TO
BEEF UP THEIR RESOURCES. AND
THEN LAST BUT NOT LEAST ARE
PREDICTIVE ANALYTICS WHICH I
KNOW I'VE TALKED- TO ON THE
LEGISLATURE OF ABOUT BEFORE.
BUT WE ARE FINDING THAT THIS
WAY OF LOOKING AT DATA PULLING
DATA EARLY AND OFTEN COUPLING
IT WITH EARLIER PASSED
COMPLIANCE DATA. COUPLING IT
WITH- ALL OF THE CASE RATES
AND- OUTBREAKS IN A REGION WERE
ABLE TO HAVE A HIGH RISK LIST
IN EACH DAY ON OUR SNIFF
WEBSITE WE DO POST WITH THAT
HIGH RISK LIST IS. AND THEN WE
ALSO DO TO KEEP THAT LIST BY
SHOWING YOU THE NEXT DAY WHAT
DID WE DO IN THE LAST TWENTY
FOUR HOURS AT THAT HIGH RISK OF
TO BE VISIT ON SITE NO- WHAT
DID NEED NATURE I REFERRAL
ETCETERA- IN THAT HAS BEEN
HELPFUL IN JUST GOING. EARLY
AND INTERVENING EARLY TO HELP
MITIGATE- WE HAVE FOUND THAT
DESPITE THE FACT THAT HOSPITAL
LAYS HOSPITALIZATIONS DID PEAK
IN CALIFORNIA- IN LATE SUMMER
AS WELL AS OUR CASES HAVE. BEEN
RISING AND LACE UP LATE SUMMER
I AM HAPPY TO REPORT THAT SOME
OF THESE INTERVENTIONS THAT WE
HAVE PLACED- HAS MADE IT SO
THAT THE- DEATH RATE HAS
DECREASED AND STABILIZED. AS
WELL AS THE- CASE RATE AND ARE
SKILLED NURSING FACILITIES HAS-
STABILIZE FROM THE BEGINNING OF
THE PANDEMIC. SO MORE WORK TO
DO. I BELIEVE THAT DOT TESTING
AT STAFF YOU KNOW THOSE TWO
THINGS THAT ARE REALLY- GONNA
BE INCREMENTAL ESPECIALLY AS WE
GO INTO- FLU SEASON. I CAN TELL
YOU THAT'S WHAT KEEPS ME UP AT
NIGHT IS MAKING SURE THAT WE
HAVE PLANS IN PLACE TO BOLSTER-
TESTING AS WELL AS- STAFFING
WORK FORCE. SO THAT WE ARE
PREPARED GOING INTO- A FLU
SEASON. THANK YOU MISDIAGNOSIS-
I WILL BRING IT BACK NOW FOR
MEMBERS TO ASK QUESTIONS WE
WILL START WITH CHAIR IN THIS
AREA. HANK YOU. THANK YOU SURE
ARAMBULA- I JUST WAS TAKEN BY
THE LAST COMMENT MISTER AND
MISS SENECA STACKER THAT YOU
MADE ABOUT WHAT KEEPS YOU UP AT%
NIGHT. I A- HONESTLY SOMETIMES
FIELD WITH YOUR CALM AND
MEASURED RESPONSES NOT MUCH
KEEPS YOU UP AT NIGHT. WHEN I'M
GONNA CONTINUE HARPING ON THIS
TESTING ISSUE BECAUSE I FEEL
LIKE YOU'VE GIVEN EVERY REASON
YOU'RE EXTREMELY VERBOSE AND
VERY TALENTED AT ARTICULATING
THE VARIOUS STEPS TAKEN. BUT
YOUR RESPONSE IS NOT
COMMENSURATE TO THE INTENSITY
AND URGENCY YOU HAVE HEARD FROM
THE PANELISTS TODAY. AND IF YOU
FAIL TO CONTINUE TO RESPOND
WITH URGENCY THAT WE'RE ASKING
YOU TO I REMEMBER ALSO SPEAKING
TO MISTER CORNET ABOUT. IS ON
MY WAY TO THE FUNERAL OF THE
FORMER MEMBER CUT CHOI CHU HI
JUNE WHEN I WAS ON THE PHONE
THE ENTIRE DRIVE TALKING TO
VARIOUS OPERATORS IN LOS
ANGELES ABOUT. SHUTTING PUT THE
POTENTIAL OF SHUTTING DOWN.
SKILLED NURSING FACILITIES. AND
WORKING WITH THE GOVERNOR'S
ADMINISTRATION AND THAT
HAPPENED IN A RELATIVELY SHORT
PERIOD OF TIME WE THOUGHT IT
WAS A GOOD STEP TO DO THAT. YET
WE NEVER ANTICIPATED THAT WHEN
WE'RE CREATING. A SAFE BUBBLE
THAT THEN WITHIN THAT BUBBLE
THERE WOULD BE CONTAMINATION
AND THERE WOULD BE ALL THESE
CHALLENGES LEADING UP TO
SIGNIFICANT NUMBERS OF DEATH.
SO I HATE I NEED TO HAVE THAT
URGENCY IN RESPONSE FROM YOU IN
KNOWING ALSO WHAT'S GOING ON
YOU BROUGHT UP SURVEYORS ARE
THEY BEING TESTED. YES THEY ARE
HOW WHAT FREQUENCY. SO WE TEST
OUR OUR SURVEYORS THE SAME
FREQUENCY AS WE DO FOR OUR
SKILLED NURSING FACILITIES THAT
WE REGULATE THAT'S NOT WHAT I
FIGURED. THAT IS WHAT WE DO I
CAN SHARE WITH YOU THE POLICY
AND BE HAPPY TO SHARE THAT WITH
YOU. IN FACT. FROM WHAT I'VE
SEEN. SURVEYORS. I AFFECT BEING
TOLD TO BE TESTED. ALONG WITH
THE PUBLIC. SO WE DO HAVE A
TESTING POLICY WE DO HAVE A
CONTRACTED- TESTING- GROUP FOR
OUR SURVEYORS WE ALSO AND I'M
HAPPY TO SHARE ALL OF THAT WITH
YOU I DO KNOW THAT YOU MUST BE
REFERENCING PROBABLY THE LA
TIMES ARTICLE THAT HAPPENED A
FEW WEEKS AGO- BUT WE DID
REQUEST FOR A TESTING POLICY
THE SAME EXACT WEEK THAT WE-
ISSUED OUT OUR TESTING AFL. AND
WE DO HAVE BOTH FAIRLY OPTIM
SERVER WE HAVE SEVERAL OPTIONS
FOR TESTING FOR ALL OF OUR
SURVEYORS SO- I ASSURE YOU WE
SHARE WITH YOU THAT POLICY
WOULD BE HAVE TO DO SO AND YET
SINCE WERE ADDED WHAT ABOUT THE
OMBUDSMAN ARE THEY GETTING
TESTED. SO I CAN'T SPEAK TO-
THAT'S BEEN THAT'S THE
CALIFORNIA DEPARTMENT OF AGING
I'D BE HAPPY TO HAVE DIRECTOR
CAN'T WAIT COME BACK UP HERE-
AND I APOLOGIZE IF MY- IF MY
PROFESSIONAL RESPONSES ARE
MEASURED IN KONG. HOWEVER I CAN
ASSURE YOU THAT THERE IS
DEFINITELY A SENSE OF URGENCY
WHICH IS WHY MANY OF US HAS
BEEN WORKING. TWENTY FOUR SEVEN
FOR SEVEN MONTHS. AND YES THIS
IS ALSO BOTH PERSONAL AND
PROFESSIONAL FACT THAT AWFUL
ALSO LOST A LOVED ONE. IN ONE
OF OUR CONGREGATE SETTINGS IN
CALIFORNIA DO TO COPE IT. SO
PLEASE UNDERSTAND THAT EVEN
THOUGH WE AE COMMON MEASURE IN
OUR RESPONSES TODAY WE ARE
DEFINITELY AND PASSIONATE ABOUT
WHAT WE DO. IT'S NOT JUST ABOUT
TODAY IT'S ABOUT AND I AM SORRY
FOR YOUR- LOSS OF YOUR LOVED
ONE I DON'T WANT THAT TO SLIP
BY. BUT IT'S NOT JUST ABOUT.
YOUR RESPONSES TODAY IT'S BEEN
THE SERIAL RESPONSES IT'S THE
RESPONSE IS GOING BACK TO AS
FAR AS EVEN. OF THE PREVIOUS
HEARING AND CONVERSATIONS
BEFORE THAT WHERE. YOU'VE HEARD
FROM VARIOUS CHAIRS VARIOUS
MEMBERS OF THIS LEGISLATIVE
BODY ASKING FOR THERE TO BE.
ACTION TAKEN FOR AND YET IT'S-
IT. AGAIN YOUR RESPONSE HAS
EITHER BEEN NOT COMMENSURATE TO
THE CHALLENGES THAT WE FEEL
WE'RE DEALING WITH NOR HAS. OF
YOUR ELUSIVENESS OF NOT REALLY.
COLLABORATING WITH US ALLOWED
US TO HAVE BETTER CONFIDENCE IN
KNOWING EXACTLY WHAT'S GOING ON
AGAIN GOING BACK TO WHAT I HAD
BROUGHT UP BEFORE WITH- MR-
LIKE BORN ABOUT- THE DATA. WE
AYE IT'S INTERESTING FOR ME TO
KNOW HOW WE'RE COMING UP WITH A
WHOLE NEW PROGRAM WHEN. WE
DON'T EVEN KNOW WHAT THE DATA
IS BASED ON. AND BY THE WAY I
WAS NOT HERE WHEN MR LIGHT
BOARD HAD TO STEP OUT FOR A
MEETING WITH MY CONSTITUENTS
BUT MR LAPOINTE THIS TALKED
ABOUT- MEDIC CALIFORNIANS SING
AND I WAS INTERESTED TO FIND
OUT A LITTLE BIT MORE ABOUT.
WHETHER THERE IS ANY
DUPLICATION OR OVERLAP OF
MEDICARE FINANCING SO IF-
MISTER LIKE PORN IS STILL THERE
I WOULD APPRECIATE A FOLLOW UP
DOESN'T HAVE TO BE NOW BUT A
FOLLOW UP ON ON THIS TOPIC-
WITH MORE DATA. BUT AS- FOR
YOUR TO JUST COMPLETE MY
COMMENTS UP- MISTER MAKER I
WOULD TO. UP I WOULD EVEN
PROPOSE RIGHT NOW FOR MY
COLLEAGUES IF WE WOULD LIKE TO
AT SOME POINT HAVE A HEARING.
IN SEPTEMBER OCTOBER WHENEVER
WE FEEL APPROPRIATE BUT BUT- AT
LEAST ONE OR TWO MORE. BEFORE
THE END OF THE YEAR SO THAT
THERE IS A CONTINUED.
CONVERSATION ABOUT THIS AND FOR
US TO KNOW EXACTLY WITH WHAT
LEVEL OF URGENCY YOU'RE MEETING
SOME OF THE DEMANDS THAT WE'VE
BEEN ASKING ABOUT. THANK YOU.
THANK YOU. ASSEMBLY MEMBER
MATHIS. THANK YOU CHEN
ARAMBULA- W. DIRECTOR- STANEK-
DON'T KNOW GOING TOO FAR. I'M
HERE YOU'RE YOU'RE STILL IN THE
HOT SEAT. THE QUESTIONS I
REALLY HAVE OR YOU KNOW BACK
WHEN EVERYTHING TOOK OFF IN
MARCH AND- EVEN BEFORE THEN
EMAIL WE'RE WE'RE TO THE POINT
WHERE TALK ABOUT STRIKE TEAMS
EXPRESSLY IN THE- AGAIN IN THE
SOUTHERN SAN JOAQUIN VALLEY
AREA- AND I KNOW I SPECIFICALLY
ASKED THAT WE KEEP- TEAMS AND
BEDDED. WITH THESE COUNTY
OFFICES TO ENSURE THINGS WERE
WE'RE GOING ON BECAUSE I MEAN
THAT THE FACT IS NOBODY'S DEALT
WITH ANYTHING LIKE THIS. IN
THIS LIFETIME EVER. AND SO
THERE IS NO PROFESSIONAL
EXPERIENCE THAT WOULD HAVE
PREPARED ANYBODY FOR THIS. AND
IT'S NOTHING AGAINST ANYBODY
BUT THE FACT IS YOU KNOW YOU
COUNTY NEED ALL HANDS ON DECK
AND- WHEN WE START HAVING THESE
CONVERSATIONS OF. WE KNOW OF I
COUNTY HAS. A SEVERE NEED IN
NEEDS HELP. WHAT IS GOING ON
WITH CAN YOU DRIVE A LITTLE
MORE DEPTH FOR THE MEMBERS ON
WHAT THAT LOOKS LIKE YOU KNOW
WHEN HE SENT A STRIKE TEAM AND
ARE THEY EMBEDDED WITH THE
COUNTY DEPARTMENT OF HEALTH
WHAT IS THEIR ROLE THERE WHAT
ARE THEY DOING THERE- I KNOW WE
ALL JUST YOU KNOW WE HEAR ON
THE NEWS. THEY WERE FINALLY
GETTING THIS FIFTY TWO MILLION
DOLLARS TO GO OUT TO THESE
AREAS BUT I ALSO GET CALLS FROM
CONSTITUENTS WHO ARE CONCERNED
THAT YOU KNOW IT'S IS THIS
MONEY GOING TO HEALTH IS A
GOING TO ACCOUNTING OFFICES IS
IT GOING TO GET MORE PP IS THIS
NURSING AND STAFFING IN THESE
THINGS. OR IS IT. A INCREASE ON
SAY ABC LICENSE GUYS GOING OUT
GOING AFTER SMALL BUSINESSES
THAT ARE OPEN THE THESE ARE THE
PHONE CALLS I GET. AND SINCE I
HAVE YOU IN THE HOT SEAT I'D
LIKE TO NOW- AND SO ON MY
CONSTITUENTS. NO PRESSURE EIGHT
THAT AND- I CAN UNDERSTAND-
PARTICULARLY- THE AREA IN WHICH
YOU REPRESENT- SINCE I'VE SPENT
QUITE A BIT OF TIME THERE
RECENTLY. AS WELL AS I WAS BORN
AND RAISED IN THE CENTRAL
VALLEY O I UNDERSTAND- THAT
THEY WERE HIT HARD VERY EARLY.
AND WHEN WE DO SEND OUT A
STRIKE TEAM WHAT WE OFTEN DO-
IT LOOKS A LITTLE BIT DIFFERENT
DEPENDING ON ON THE LOCAL
PUBLIC HEALTH AND WHAT THEIR
NEEDS ARE. BUT WE DO SEND OUT
STRIKE TEAMS WE DO BOTH STATE-
AT THE FACILITY AND TELL THEIR
STABILIZED- WE USUALLY SEE
FIRSTHAND OUT OUR- OUR
SURVEYORS BECAUSE THEY'RE QUICK
THEY'RE FASTER THEIR THEIR-
THEIR CLOSER PROXIMITY YOU HAD
MENTIONED EARLY ON IN- AND
SOMETHING YOU SAID EARLIER IN
THE HEARING TODAY ABOUT- YOU
KNOW JUST HAVING THAT DISTANCE
AND EVEN TO JUST GET TO A PLACE
ONE ACTION THAT WE HAVE BEEN
TAKING AS SOMETHING AS A TAKE
AWAY. IS THAT POST PANDEMIC-
EVEN DURING POINT DEMOCRAT
FORTY STARTED THIS IS
RECRUITING FOR OUR SURVEYORS IN
OUR STRIKE TEAMS ARE OUR
INFECTION CONTROL SPECIALIST
NOT NECESSARILY NEAR A BRICK
AND MORTAR- HEALTH CARE
FACILITY- A STATE HEALTH CARE
FACILITY BROKEN WATER LOCATION
AND SO- THAT WAS SOMETHING THAT
HAD BEEN DONE FOR YEARS WHERE
WE'D HAVE YOU KNOW WE HAVE
TWELVE DIFFERENT DISTRICT
OFFICES ACROSS THE STATE. AND
PEOPLE WOULD BE GENERALLY
LOCATED NEAR THE DISTRICT
OFFICE AND SOMETIMES HAVETO
DRIVE TWELVE YOU KNOW FOUR TO
FIVE HOURS JUST TO GET TO A
FACILITY. SO NOW WE'RE DOING A
VERY CONCENTRATED EFFORT TO DO
STATEWIDE RECRUITMENT
ESPECIALLY NOW IN THE DAYS THAT
WERE BEING ABLE TO DO OUR OUR
PROCESSES MORE ELECTRONICALLY
SO THEY CAN BE ABLE TO TELL
WORK AND WORK FROM HOME. AND BE
MORE AGILE AND GET TO
FACILITIES MUCH QUICKER THAN
THEY HAD IN THE PAST AND SO I
JUST WANT TO POINT THAT OUT
THAT APPRECIATE YOU- BROUGHT
THAT UP EARLIER ABOUT JUST EVEN
THE GEOGRAPHY. OF GETTING- TWO
LOCATIONS FAST BUT WHEN WE DO
SEND OUT A STRIKE TEAM ARE
USUALLY ARE ARE HEALTHCARE
CHOIR INSPECTIONS EXPERTS WHO
WILL KIND OF GO OVER TECHNICAL
ASSISTANCE AND TRY TO MAKE SURE
THAT. THERE ARE JUST EFFECTIVE
INFECTION CAN TROY MEASURES.
AND THEN ALSO HAVE A REGULAR
TEAM THOSE ARE SURVEYORS. THOSE
ARE ONES THAT ARE GOING OUT FOR
COMPLIANCE- WILL SITE FOR
COMPLIANCE- WE HAVE HAD AN
INCREASE- OVER THE COURSE THE
DURATION WE HAD AN INCREASE OF
UP WHAT WE CALL IMMEDIATE
JEOPARDY. WHICH IS THE- MOST
AGREE JUST FORM. A VIOLATION-
AND THAT HAS NOW TAPER DOWN I
NOTICED IN JULY WE HAD- LESS I
CHASE AND WE DID IN BEIJING-
THAT MAY AND JUNE AND- OF EARLY
JULY SO I. THINK THAT'S IN A
GOOD TREND. THAT WE'RE SEEING
LESS OF THOSE TYPES OF
SITUATIONS- PROBABLY BECAUSE
WE'RE OUT THERE FOR- AND THEN
THERE HAVE BEEN- SOME CASES
WHERE WE STAY AND WE MIGHT. BE
PHYSICALLY BT WE KEEP IN-
PARTNERSHIP WITH THE LOCAL
PUBLIC HEALTH SO KERN COUNTY IS
ONE WHERE I KNOW SOME OF OUR
STAFF HAD DAILY PHONE CALLS-
EVERY DAY GOING OVER THE
DIFFERENT FACILITIES WHAT ARE
THEY SEEN ENTERING FACILITIES
TOGETHER AS BOTH THE STATE. AND
COUNTY PARTNER. ON THAT HAS
BEEN A SUCCESSFUL- OF VENTURE
WHENEVER WE CAN. BE MORE
CLOSELY IN LINE WITH THE LOCAL
PUBLIC HEALTH BETTER. I SEE PRE
PANDEMIC. THE LOCAL PUBLIC
HEALTH OFFICES KIND OF DID
THEIR THING AND THE- CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH
DISTRICT OFFICES. DID THEIR
PIECE BUT THEY RARELY
INTERACTED AND SO THAT'S BEEN A
BIG PIECE OF TRYING TO BRIDGE
THOSE TWO KIND OF SILOS AND
HAVING TO WORK TOGETHER- THAT'S
ROUTE THE PANDEMIC BUT- WHAT
I'D LIKETO SEE IS MORE OF THAT
INTEGRATION EVEN POST PANDEMIC.
I DEFINITELY AGREE WITH THE
FACT OF THE TWO SILOS KIND OF
CRASHING TOGETHER. ON A AS
WE'VE HEARD TODAY- EVERY COUNTY
THIS KIND OF BEEN DOING. WHAT
WORKS FOR THEM AND THEIR COUNTY
AND WILL WORKS FOR THEIR
CONSTITUENTS AND I THINK
THERE'S DEFINITELY A NEED TO
HAVE- SOME CONSENSUS ACROSS THE
BOARD ACROSS THE STATE TO GET
THAT COLLABORATION WORKING
BETTER TOGETHER. ALL THE OTHER
QUESTION I HAVE FOR YOU. AND
OBVIOUSLY YOU GET ASKED A LOT
ABOUT TESTING. BUT I'M GETTING
STORIES ALL THE TIME ABOUT
PEOPLE WHO SIGNED UP TO GO TO A
TESTING SITE FOR WHATEVER
REASON THEY THEY DON'T MAKE IT
AND THEN THEY GET A LETTER IN
THE MAIL THE SAYS THEY TESTED
POSITIVE EVEN THOUGH THEY
DIDN'T SHOW UP. SO I'M I'M
HEARING THINGS LIKE THAT IN
THOSE THOSE ARE. KIND OF THINGS
THAT DRAW CONCERNS. WITH PEOPLE
GETTING LETTERS EVEN THOUGH
THEY AND GET TESTED. AND THEN
THE OTHER THING WHAT ARE WE
DOING AND WE TALK A LOT ON THE
TESTING SITE BOY. I KNOW IN IN
MY DISTRICT WE HAVE A LAB
THAT'S LITERALLY VERIFYING ALL
THE TESTS FOR FOUR OTHER
COUNTIES. PHILLIPS OF THE TEST
COMMAND THEY GO THERE THESE
GUYS GO TROUGH AND GET THE
RESULTS WHAT ARE WE DOING TO
INCREASE. HELP THERE TO REDUCE
THAT BACKLOG ON THAT TESTING SO
WHAT IS BEING DONE. WITH THAT
THAT WE TESTING TURN AROUND-
HAPPENS MUCH MORE EFFICIENTLY.
WELL YOUR FIRST QUESTION I WILL
SAY THAT WHEN I'VE BEEN ON THIS
TRIP THROUGHOUT THE CENTRAL
VALLEY I HAVE HEARD THAT SAME-
RUMOR WHERE PEOPLE ARE SAYING
THAT THEY SIGNED UP FOR A TEST
AND THEN- THEY RECEIVED A FALSE
POSITIVE- A POSITIVE IN THE
MAIL- HOWEVER THEY HAVEN'T YET
BEEN ABLE TO TRACK THAT RUMOR
DOWN. TO AN ACTUAL PERSON YET
AT LEAST OF THE LOCAL PUBLIC
HEALTH OFFICERS THAT I TALKED
TO BECAUSE THAT WAS ALSO VERY
JARRING CONCERNING TO THEM AND
EVERY TIME THAT THEY TRIED TO
TRACK IT DOWN THE END UP BEING
A FRIEND OF A FRIEND OR SISTERS
BROTHERS. YOU KNOW
NEIGHBORWORKS ADDRESS BUT THEY
WERE NEVER ACTUALLY ABLE TO
TRACK DOWN SO IF YOU ARE IF YOU
HAVE YOU KNOW ANY INFORMATION
OF WHEN THAT ACTUALLY HAS
HAPPENED OR SOME SORT OF. PROOF
FOR ACTION PLEASE SEND THAT TO
THE LOCAL PUBLIC HEALTH OF THAT
COUNTY BECAUSE I KNOW THAT THEY
REALLY WANT TO BE ABLE TO TRACK
THAT DOWN TO SEE. IF THERE ARE.
IT EVERY TIME I HEAR ABOUT IT
I'M LIKE. I SAID SAN EMAIL SAID
MADE YOU KNOW SO WE ACTUALLY.
SOMETHING IN SOME HARD EVIDENCE
YEAH- TO VERIFY THESE CLAIMS-
BUT I'M REALLY INTERESTED IN
THE SECOND PART ON. WHAT WE'RE
DOING TO. HANDLE THIS. GETTING
THE ACTUAL RESULTS IN THESE
LABS AND MAKING SURE YOU KNOW
BECAUSE WE'VE WE'VE THROWN
MILLIONS AND MILLIONS OF
DOLLARS AT AT TESTING AND TRACK
AND TRACE AND EVERYTHING ELSE.
AND LITERALLY WERE TO THIS
POINT OF. OKAY NOW YOU CAN YOU
CAN DRIVE THROUGH YOU KNOW CVS
PHARMACY AND GET A TEST. BY
WAITING TWO WEEKS TO GET THE
RESULTS JUST DOESN'T CUT IT.
MMHM I TOTALLY AGREE- I WOULD
SUGGEST THAT WE SHOULD HAVE-
SOMEONE FROM THE GOVERNOR'S
TESTING TASK FORCE BE PART OF
THE NEXT HEARING- TO BE ABLE TO
ANSWER ALL THESE QUESTIONS-
UNFORTUNATELY ALL OF THOSE-
VERY VERY CRITICAL ISSUES
AROUND TESTING TURN AROUND
TIMES IS NOT UNDER MY PURVIEW
AND I WILL I CERTAINLY PARTNER
WITH THE TESTING TASK FORCE
SYMBOL- CAN I DEFINITELY THINK
WE NEED MORE REPRESENTATION
HERE TO ANSWER THOSE QUESTIONS
I'M HONESTLY DON'T HAVE THE
ANSWER I WOULD AGREE WITH THAT-
BUT BUT TO YOUR KNOWLEDGE IS.
IS OUR OTHER THINGS BEING DONE
OUR RESOURCES BEING SENT THAT
DIRECTION IN INTO WHAT YOU KNOW
WHEN YOU CAN SPEAK ON- BUT
WITHOUT STEPPING ON THE FEET OF
THE OTHER OFFICE. DO YOU KNOW
AT TWO YEAR AGAIN TODAY WHAT
WHAT DO YOU SEE BEING DONE. AND
FRANKLY FROM WHERE YOU'RE AT
AS- DEPUTY DIRECTOR WHAT DO YOU
THINK SHOULD BE BEING DONE. SO
I KNOW THEY ARE WORKING
FEVERISHLY- I'M TRYING TO
INCREASE THE TESTING TURNAROUND
TIMES. FROM WHAT I'VE HEARD IN
THE FIELD IN JUST THE LAST
WEEK- THE LONGEST TURNAROUND
TIME- FROM A COUPLE OF WEEKS
AGO WAS UPWARDS UP TO FIFTEEN
DAYS- AND SOME OF THOSE SAME
pVERY LENGTHY TURNAROUND TIMES.
HAVE NOW MADE IT BACK IN TWO
THREE DAYS WHICH IS OBVIOUSLY
MUCH MORE WHAT WE WOULD LIKE TO
SEE SO THAT LEAVES GIVES ME
SOME AMOUNT OF- RELIEF KNOWING
THAT THE TESTING TURN AROUND
TIMES ARE IMPROVING- I THINK
CRAIG WHEN IT ALSO MENTIONS-
CMS'S RECENTLY ON THE FEDERAL
GOVERNMENT HAS AND YOU- ANTIGEN
TESTING- I KNOW THERE'S BEEN A
LOT OF CONTROVERSY AROUND THESE
ANTIGEN TEST BECAUSE- THEY
DON'T HAVE THE SAME ADVOCACY
RATE. AS A TRADITIONAL PCR
TEST- AT THIS POINT THOUGH I
KNOW WE ARE GOING TO BE
REVISING- ARE TESTING AFL-
ARTISTS IN ALL FACILITIES
LETTER THAT WE SENT OUT- IT
BECAUSE WE ARE LOOKING AT THE-
DIFFERENT OPTIONS AND WHAT IS
THE BENEFIT RIGHT IS IT BETTER
TO HAVE A TEST IN A FACILITY
THAT HAS LOW EFFICACY- BUT AT
LEAST YOU HAVE- FASTER
TURNAROUNDS ALL. OR IS IT
BETTER TO WAIT RIGHT WELL WE
OBVIOUSLY WOULD RATHER HAVE THE
GOLD STANDARD TEST FOR THE
SHORTER TURNAROUND. TIME
OBVIOUSLY I THINK. IS GOING TO
BE THEM BOTH CREDIT PIECE OF
THIS. ELEMENT BECAUSE- YOU IN
ORDER TO PROTECT THESE- MOST
VULNERABLE- PEOPLE IN A
FACILITY YOU HAVE TO BE ABLE TO
HAVE THAT INFORMATION SO YOU
CAN QUICKLY QUICKLY- COHORT
THEM APPROPRIATELY AND CONTAIN-
OTHERWISE- YOU'RE ALREADY
YOU'RE ALREADY BEHIND SEVEN
DAYS FOURTEEN DAYS BEHIND- AND
IT COULD SPREAD EVEN FARTHER
THAN YOU DO. THANK YOU. BEFORE
WE TRANSITION TO A CHAIR RAILS
I DID JUST WANT TO MENTION IF I
COULD DR CHAVEZ MAY BE A
RESOURCE THAT WE CAN REACH OUT
TO TOGETHER- HE IS- ONE OF THE
CO CHAIRS- THAT SHE WAS
REFERENCING AND AS AN
EPIDEMIOLOGIST I'VE BEEN
PARTICULARLY IMPRESSED WITH
HIS- LINGUISTIC AND CULTURAL
COMPETENCY THAT I THINK WILL
HELP US BOTH WITHIN THE CENTRAL
VALLEY- I DID WANT TO JUST SAY
OF THE PASSING FOR GOING
THROUGH THE CENTRAL VALLEY AND
TO KINGS COUNTY I JUST. WOULD
BE REMISS NOT TO RECOMMEND A
SUPERIOR DAIRY FOR ICE CREAM.
THE EVIDENCE. YOU RECOMMEND
THAT BUT ALL ALSO ON THE READER
DIRECTOR WHEN YOU ARE DOWN IN
THE VALLEY- LET ME KNOW I'D
LOVE TO MEET WITH YOU AND TACK
ALONG WITH YOUR- AND SEE WHAT
YOU GUYS ARE DOING BOOTS ON THE
GROUND SO. WHAT I DO HAVE THOSE
QUESTIONS FROM CONSTITUENTS I
CONCEDE YOU KNOW I I'VE I'VE
ACTUALLY BEEN THERE THAN ON
GROUND WITH THEM. AND IT THAT
WAY I CAN ACTUALLY REPORT BACK
TO THE PUBLIC WHAT'S HAPPENING
BECAUSE I THINK. YOU KNOW THE
IT'S THIS BIG MYSTERY OF WHAT'S
ACTUALLY GOING ON. AND THAT'S
THAT'S WHAT'S LACKING WITH THE
TRANSPARENCY HERE SO OFTEN LOVE
THE OPPORTUNITY TO GO ON THE
FIELD WITH YOU SO I CAN
ACTUALLY REPORT BACK TO
CONSTITUENTS AND LET HIM KNOW
FIRST HAND. WHAT'S GOING ON.
RIGHT TO READ. I WASN'T GOING
TO SAY THAT BUT THAT'S AN
EXCELLENT SUGGESTION MISTER
MATHIS AND THEN WHEN YOU ARE IN
THE INLAND EMPIRE OR AND IF ANY
OF YOUR TEAM IS IN THE INLAND
EMPIRE PLEASE LET ME KNOW AND I
WOULD IMAGINE THAT ANY OF THE
LEGISLATORS ANY OF MY
COLLEAGUES WOULD OFFER THE SAME
THING I THINK FOR ANY OF US TO
BE ABLE TO MEET WITH YOU AS YOU
ARE DOING THE WORK OF THE STATE
IT WOULD HELP US TO ALSO SPEAK
WITH OUR- CONSTITUENTS- IT.
MISTER CHAIR I WANT TO BUY
CLOSING COMMENTS JUST TO THANK.
ALL OF THE SPEAKERS TODAY. BUT
MOST ESPECIALLY WANT TO THANK
YOU. FOR PUTTING THIS HEARING
TOGETHER. OTHERWISE WE WOULD
HAVE LEFT. WITHOUT HAVING.
HEARD EXACTLY WHAT WAS
HAPPENING WITHOUT HAVING
ALLOWED OUR STAKEHOLDERS. AN
OPPORTUNITY FOR THEM TO KNOW
THAT WE HEAR THEM. AND WE WANT
TO MAKE SURE THEY'RE INCLUDED
IN THIS PROCESS- SO I WANT TO
THANK YOU FOR. FOR PUTTING THAT
TODAY'S HEARING TOGETHER THANK
YOU. DR WOULD YES ARMISTEAD
OCCUR I THINK UNFORTUNATELY YOU
LEFT BUT I'D LIKE TO HAVE YOU
BACK IF YOU DON'T. SORRY FOR
THAT I'M HERE THAT'S OKAY
THAT'S OKAY THIS IS- I KNOW
WE'VE TALKED A LOT ABOUT
TESTING AND YOU KNOW WE HAVE A
TASK FOR TESTING TASK FORCE AND
THEN IT WAS SOMEWHAT DISBANDED
NOW WE'VE GOT A NEW TESTING
TASK FORCE AND- IN THE MIDDLE
OF THAT WE'VE HAD CHALLENGES
WITH TESTING IN. AND SO YOU'VE
SAID THAT- THE FACILITIES- THAT
SKILLED NURSING FACILITIES.
TEST 25% OF THEIR STAFF ON A
WEEKLY BASIS. SO WHAT IS THE-
CURRENT TURNAROUND TIME FOR
THOSE STAFF THAT ARE BEING
TESTED- SO EGGS SO THAT FOR
THAT 25% WHEN YOU GET IN THE
RESULTS BACK. FROM IT IS. THE
AVERAGE HAS BEEN ANYWHERE FROM
LAST I LOOKED AT THE AVERAGE AS
IT WAS BETWEEN FIVE AND SEVEN
DAYS BUT AGAIN I'VE SEEN TASKS
THAT HAVE COME BACK WITHIN YOU
KNOW FORTY EIGHT HOURS TO THREE
DAYS AND THEN I'VE SEEN TEST
LIKE I JUST MENTIONED THAT HAVE
BEEN YOU KNOW REALLY A
DEPLORABLE FOURTEEN FIFTEEN
DAYS WHICH IS NOT USEFUL- AND
ALL OF THAT IS BEING TRACKED BY
THE TESTING TASK FORCE AND THAT
ANY INFORMATION THAT I HEAR
FROM THE FIELDER FROM MY STAFF
OUT IN THE FIELD. I THEN OF
COURSE YOU KNOW RAISE THAT UP
OVER- TO THE TESTING TASK FORCE
AS WELL AS I KNOW THAT THEY ARE
TRYING TO WORK FOR WORK WITH
DIFFERENT OPTIONS OUT THERE AND
TRY TO MEET THE CAPACITY ISSUES
THAT ARE THERE ARE GUESS I GET
IT. IF THEN MY- IF YOU CAN GET
NOT GET THERE IS. IF YOU'VE
STILL GOT OUT BUYERS FOR YOU'RE
NOT GETTING RESULTS WITHIN FIVE
TO SEVEN DAYS- FOR THAT TWENTY
FIVE PERCENT. YOU'RE KIND OF
FLYING BLIND IN FACILITIES AND
THAT'S THAT'S THAT'S TROUBLING-
I HAVE HAD NUMEROUS
CONVERSATIONS WITH PEOPLE
PUBLIC HEALTH REGARDING-
TESTING AND THE CHALLENGES OF
TESTING. AND THE FRUSTRATION IS
THAT THERE ARE. CONTINUE TO BE
LABORATORIES THAT HAVE
CAPACITY. THAT ARE GROSSLY
UNDER UTILIZED AND YET ON THE
OTHER HAND WE'VE GOT
LABORATORIES. THAT ARE DOING
THE TESTING RESULTS ARE
PROCESSING THE TESTING RESULTS.
AND THAT ARE BEHIND AND THE
DISCONNECT HERE CONTINUES TO BE
REALLY REALLY TROUBLING- WHEN
WE'VE GOT IN THIS IN THIS CITY.
A LAB THAT HAS IT HAS A
CAPACITY. THAT IS ONLY BEING
USED AT THEIR THEIR THEIR ONLY
RUNNING AT 20% CAPACITY. THAT'S
PRETTY FRUSTRATING- TO KNOW
WHEN WE'VE GOT OTHER COMMERCIAL
LABORATORIES OUT THERE THAT ARE
TAKING SO LONG AND SO I JUST.
I'M KINDA AREA FRUSTRATION NOT
AT YOU BUT IT'S A CONTINUED
FRUSTRATION WITH TESTING IN
GENERAL- THAT CONTINUES TO BE A
PROBLEM- THE AND I DO WONDER
BECAUSE WE HAD THIS HASN'T COME
HAS NOT COME UP. IN THIS IS- I
THINK AN IMPORTANT ISSUE AS
WELL- AND THAT'S THE ISSUE
AROUND CONTACT TRACING SO WHEN
YOU DO HAVE. EMPLOYEES THAT
TEST POSITIVE IN FACILITIES-
HOW VIGOROUS IS THE CONTACT
TRACING OR IS IT HAPPENING AT
ALL BECAUSE IN SO I THINK IN
SOME AREAS THEY'VE KIND OF
THROWN UP THEIR HANDS ON
CONTACT TRACING. BUT OTHERS ARE
STILL BEING MORE VIGOROUS ABOUT
IT SO WHAT IS THE STATUS OF
CONTACT TRACING WHAT IS THE
DEPARTMENT'S POLICY WHAT YOUR
YOUR YOU KNOW WITH RELATION TO-
SKILLED NURSING FACILITIES AND
IS THAT. IS THAT A UNIVERSAL IT
IS IN OTHER WORDS IS BEING DONE
UNIVERSALLY WITH FACILITIES OR
IS IT JUST KIND OF LOOSEY
GOOSEY DEPENDING ON WHAT COUNTY
AROUND. WELL OF THE COMMENT ON
YOUR FIRST- OBSERVATION THAT
YES IT'S NOT SO MUCH A CAPACITY
ISSUE BUT A MATCHING ISSUE
RIGHT WHERE YOU MIGHT HAVE SOME
LABS THAT ARE RUNNING ABOVE AND
BEYOND THEIR CAPACITY- AND THEN
YOU HAVE OTHER LABS THAT ARE
RUNNING BELOW. THE CAN PASS.
AND THAT'S BEEN A LOT OF THE
CONVERSATION I'VE HAD WHEN I
HAVE MY WEEKLY CALLS WITH ALL
OF THE FACILITIES IS. MAKE SURE
THAT YOU ARE LOOKING BEYOND
YOUR REGION YOU MIGHT FIND A
LAB THAT HAS- THE TESTING TURN
AROUND TIME TO BE MUCH MORE IN
YOUR FAVOR. BUT IT MIGHT BE
FRTHER AWAY AND SO I'M ALWAYS
REFERENCING THAT TESTING TASK
FORCE WEBSITE BECAUSE THAT
WEBSITE DOES SHOW THE AVERAGE
TURNAROUND TIMES. AND THE
CAPACITY LEVEL AT THAT FACILITY
SO I AGREE THAT IS A
FRUSTRATION THAT WEEK WE HAVE
CAPACITY IS ABOUT MATCHING- I'M
AS FAR AS CONTACT TRACING AND
THAT'S BEEN PART OF THE REASON
WHY WE'VE BEEN DOING THESE- IN
PERSON VISITS WITH ALL OF THE-
LOCAL PUBLIC HEALTH- BECAUSE
LOCAL LOCAL PUBLIC HEALTH- ARE
THE- ONES WHO ARE THE CONTACT
TRACERS THEY'RE THE ONES THAT
ARE DOING THE BULK OF THE POT
CONTACT TRACING. IN THESE
FACILITIES- I KNOW THAT MANY OF
THEM DO- PRIORITIZE AND HEALTH
CARE WORKERS- FIRST OF ALL.
ABOVE OTHERS WHEN THEY'RE DOING
THEIR CONTACT TRACING I'VE MET
WITH SOME COUNTIES WHO HAVE
BEEN UP TO SPEED WITH ALL THEIR
CONTACT TRACING I'VE BEEN WITH
OTHER COUNTIES WHO SAID THEY
REALLY AVE A BACKLOG WHEN IT
COMES TO THEIR CONTRACT
TRACING. AND SOME OF THE BEST
PRACTICES AND THINGS THAT WE
ARE SEEN ARE YOU SEEN- YOUR
COMMUNITY BASED ORGANIZATIONS
AND REALLY BUILDING OUT YOUR%
LOCAL PUBLIC HEALTH CONTACT
TRACING GROUP. BEYOND JUST THE
GOVERNMENT SO TO SPEAK BECAUSE
THERE'S ALSO A LOT OF
COMMUNITIES OUT THERE WHO IF
YOU GET A CALL FROM SOMEONE
WHO'S FROM ANY KIND OF
GOVERNMENT. WHO ASKED THEM YOU
KNOW WE'RE IF YOU'VE BEEN IN
THE LAST FOURTEEN DAYS YOU'RE
NOT ALWAYS GOING TO GET HONEST
RESPONSES BECAUSE THERE'S THAT
LACK OF TRUST. IN SO THAT'S WHY
WE'VE BEEN TALKING ABOUT WHICH
HAS BEEN POSITIVE MODELS I WANT
TO SEE FRESNO WAS ONE COUNTY
AND WENT TO THAT WAS REALLY
TRYING TO REACH OUT MORE AND DO
MORE WITH A COMMUNITY BASED
ORGANIZATION LEADERS. AND HAVE
THEM REALLY SERVE AS A GREAT
OPORTUNITY OR A GREAT RESOURCE
FOR- CONTACT TRACY. SO THAT
TRUSTED PEOPLE. SHE NEEDS TO BE
ABLE TO GET ACCURATE
INFORMATION THEY'VE SEEN A
VARIETY OF DIFFERENT MODELS
FROM EACH- PUBLIC HEALTH OFFICE
AND- ASK FOR VISITING AND
WORKING AND TALKING WITH EACH
COUNTY- ANYTHING THAT'S A BEST
PRACTICE IN ANY WAY SHAPE OR
FORM WHETHER IT BE BUSINESSES
RE OPENING OR CONTACT TRACING.
WE ARE- PROVIDING ALL THAT
INFORMATION BACK UP- TO THE
EMERGENCY SEARCH TASK FORCE AT
THE STATE OPERATIONS CENTER.
AND YOU FOR THAT. AND THIS.
THIS GOES TO JUST A GENERAL
KIND OF A GENERAL PET PEEVE IS
NOT DIRECTED AT YOU. PLEASE SO
DON'T DON'T TAKE IT THAT WAY-
BUT IT IS- I THINK KIND OF THE
GENESIS OF THIS WHOLE HEARING
IS AROUND COMMUNICATION AND- WE
DON'T REALLY LIKE SURPRISES.
YOU KNOW I MEAN MAYBE GOOD
SURPRISE US BUT WE DON'T LIKE
TO BE CONCORD QUITE FRANKLY-
AND SO I THINK THE WAY THE LONG
TERM CARE HOME THING ROLLED
OUT. WAS A BIG SURPRISE TO US
AND WE DIDN'T WE AND I THINK-
YOU'RE YOU'RE HEARING. IT
HEARING THAT IN GENERAL. WE
REGARD JUST ENJOY THE LACK OF
COMMUNICATION FROM
ADMINISTRATION TO LEGISLATORS-
HAS HAS BEEN EXTREMELY
FRUSTRATING AND THAT'S PART
THAT'S A BIG PART OF THIS
TODAY. BECAUSE WE KNOW OUR
DISTRICTS REALLY WELL AND SO
THE IDEA THAT E COULD REACH
OUT TO COMMUNITY PARTNERS TO
HELP AMPLIFY MESSAGES. THAT
COULD BE HELPFUL. FOR THESE
KINDS OF THINGS HASN'T HAPPENED
VERY MUCH. IT'S STARTING TO
HAPPEN MORE BUT- A LOT OF
THINGS COME OUT. THEY'RE NOT
INTERPRETED CORRECTLY YOU THE
THEIR THEIR VAGUE IN SOME CASES
OR NOT AND IF PEOPLE DON'T KNOW
WHAT'S GOING ON HE GOT FIFTY
EIGHT DIFFERENT COUNTIES IN
FIFTY EIGHT DIFFERENT
INTERPRETATIONS OF THINGS
PEOPLE ARE CONFUSED- AND THEN
YOU HAVE POPULATIONS OF FOLKS
WHO WHO DON'T TRUST A
GOVERNMENT. AND SO THE
INABILITY FOR US TO BE ABLE TO
COMMUNICATE WITH OUR
CONSTITUENTS WHO WE WHO WHO WHO
TRUST US AND PASS ON SOME THESE
MESSAGES HAS IS REALLY
HAMPERING US- I EXPERTS
EXPERIENCES DURING FIRES IN TWO
THOUSAND AND SEVENTEEN- WE'VE
GOT A LOT OF PEOPLE THAT WERE
DISPLACED AND A LOT OF PEOPLE
IN OUR LATINO COMMUNITY BECAUSE
OF THE FEDERAL ADMINISTRATION
AND ICE. WE'RE REALLYRELUCTANT
TO COME AND GET INFORMATION- AT
TOWN HALLS AND SO WE WENT OUT
OF OUR WAY TO SET UP A SEPARATE
KIND OF TOWN HALLS WITH TRUSTED
COMMUNITY PARTNERS TO GET THE
MESSAGES OUT. AND IT JUSTFEELS
LIKE THAT SOMETHING WE SHOULD
HAVE BEEN DOING FROM THE
BEGINNING AND SO AND IT FEELS
LIKE IT'S JUST BEGINNING TO
ROLL ROLL OUT AND THAT'S YOU
KNOW WE'RE MONTHS INTO THIS
NOW. AND. YOU KNOW I JUST URGE.
HOWEVER MY BE ON THEIR LIST. WE
ARE IN WE KNOW OUR DISTRICTS
AND CAN AMPLE THE MESS AND BUT
WE'RE NOT. REALLY BEING ENGAGED
IN THAT WAY AND THAT'S THAT'S
THAT'S A HUGE SOURCE OF
FRUSTRATION. THANK YOU. THANK
YOU CHAIR WOULD SIGNAL MOTHER
MORE QUESTION I MAY DIRECTOR
LIKE BORN UP TO THE MICROPHONE
IF I CAN. WELL WE'RE DOING THAT
I'M I WILL SAY THAT DIRECTOR
STILL OCCUR YOU FOR AND PA.
TRACING I WOULD REMISS NOT TO
THAT WERE OVER A DAYS IN THIS.
AND STILL ARE WAITING FOR. OF
THAT CONTRACT FROM WHAT I
UNDERSTAND AND- I THINK IT
GIVES US A CHANCE TO REALLY
REFLECT AND- AS DIRECTOR WADE
SAID TO FIGURE OUT HOW WE CAN
RISE OUT OF THIS PANDEMIC
STRONGER. AND STILL HELP US TO
REIMAGINE THE FUTURE. I TOO AM
CONCERNED ABOUT THE SILOS AND
ENSURING THAT WE ARE WORKING
TOGETHER. AND IF I CAN I WANT
TO NOW TURN TO WHAT I BELIEVE
WAS- KAREN KIESLER QUESTIONS.
AND SEE IF COULD WHY DOES THE
STATE PLAN AMENDMENT NEED TO
GET DONE BY THE END OF THE YEAR.
JERRY LAI I APOLOGIZE ON BEHALF
OF THE DIRECTOR LIKE PORN HE
HAD A CALL WITH CMS THAT HE HAD
TO TAKE SO- HIS TEAM IS
WATCHING AND WE WILL TAKE THAT
BACK BUT HE HAS TO SEND HIS
REGRETS AT THIS MOMENT WE
APOLOGIZE. GREAT AND I
APPRECIATED I HAVE NOT BEEN
ONE. LIMIT AND TO BELIEVE THAT
PROCESS ALLOWS FOR BETTER
TRANSPARENCY AND SO- THE
HEARING DID AND- USUALLY GOES
LONG BECAUSE I THINK IT NEEDS
TO BE ROBUST AND- DELIBERATIVE-
BUT IF YOU CAN ON THE SECOND
QUESTION AGAIN IS THE ONE I
ASKED IN THE FIRST PANEL. I'M
STILL WAITING TO HEAR A
COMMITMENT TO WORK WITH
STAKEHOLDERS IN THE
LEGISLATURE. AS YOU ENGAGE IN
BOTH SHORT TERM WORK. AND
DEVELOP ANY LONG TERM PROPOSAL
THAT WOULD BE CONSIDERED IN
PART OF THE PUBLIC PROCESS FOR
TWENTY TWENTY ONE. WHICH THE
ABSOLUTELY WE AND I WE TAKE
YOUR POINT AT THAT THE LAW TERM
CARE HOME WHAT OF THE BILL HAD
BEEN UP WITH PLANS FOR NEW NEW
ALSO THERE IS NO ALREADY IN
THAT HAS NOT FULLY COMMUNICATED
WE TAKE THAT AND THEN OF COURSE
TODAY'S ROBUST DISCUSSION ABOUT
HOW TO DEEP IN THE PARTNERSHIP
WITH THE LEGISLATURE SO THERE
ARE NO SURPRISES. THAT'S ALSO
I'VE TAKEN TO HEART AND MORE TO
COME ON THAT FRONT. WITHOUT I
WILL THINK. PANEL AND-
PRESENTATION AND WILL NOW TURN
TO PUBLIC COMMENT. AND AS
MENTIONED AT THE OUTSET OF THE
HEARING WE WILL BE USING A
MODERATED TELEPHONE SERVICE FOR
PUBLIC COMMENT. ARE CALLING
NUMBER TODAY IS ONE EIGHT SEVEN
SEVEN. SIX NINE TWO EIGHT NINE
FIVE SEVEN. AND THE ACCESS CODE
IS ONE THREE ONE. FIVE FOUR TWO
OH TWO. AGAIN ONLY PLEASE TYPE
IN ONE AND ZERO ONCE. AND WITH
THAT I WILL CHECK TO SEE IF THE
MODERATOR HAS ANYONE WHO HAS
STAYED ON THE LINE FOR OUR
FOREIGN A- HALF HOUR HEARING SO
FAR. MODERATOR CERTAINLY AS A
REMINDER TO PUT YOURSELF INTO
THE QUEUE AND RECEIVE YOUR LINE
NUMBER FOR PUBLIC COMMENT
PLEASE PRESS ONE THEN ZERO AT
THIS TIME. WE'RE GOING TO START
WITH LINE NUMBER TWENTY EIGHT
THAT'S TWO EIGHT YOUR LINE IS
OPEN. GOOD AFTERNOON THAT YOU
MEMBERS ON A CHAIRS VERY MODERN
THAT I READ ALL. ON COUNTY ALL
AND POP INDIA. PERCENT COMMENTS
WE TO YOU YOUR TIME TODAY WITH
A THE SYSTEM. HEARING MUCH AT.
IT WE HAVE A LOT CONCERN AND
CONTRARY HARD ALONG WHICH THAT.
TO PROTECT THE FEEDBACK AND HE
ADDS. KRUGERRAND THAT HOW OVER
THE CREWMEN. TO PROTECT OUR
SENIOR AND PEOPLE AND THEIR
SAID AT AS- CARE GIVERS AND
NEEDED ON A BET THAT THAT THEY
NEED. DO YOU BELIEVE THAT COULD
HAPPEN VERY FIRST IS WAY TOO
EARLY AND I NEED TO BE A LOT
MORE STAKEHOLDER ENGAGEMENT- WE
APPRECIATE THAT THE DIRECTOR
COULD BANKRUPT AND LIKELY DID
SAY THAT THIS IS NOT ON A TO
GET TO A PLACE THE BATTERY. HE
BUT WE GET STRONGER COMPLEX THE
LEGISLATURE TO STAY ENGAGED.
BECAUSE WE NEED TO PROTECT THE
PROGRAM AGAIN THEY HAVE A
PROVEN TRACK RECORD OF BEING
VERY BENEFICIAL AND AGAIN THANK
YOU FOR YOUR TIME. AND CRAPPIE
ANSWER QUESTIONS AND THEY GET
YOUR STOP THE CLOCK WHEN I WAS.
WITH THE CLUB. THANK YOU MA'AM.
MEXICO PLEASE. SIX WILL COME MY
NUMBER SEVEN THAT SEVEN YOUR IS
OPEN. GOOD AFTERNOON AND THANK
YOU COMMITTEE WE AND OF TAKING
UP THE- EVEN ISSUE MY NAME IS
GERRY JURIST ALL OF THE
GOVERNMENT AFFAIRS DIRECTOR FOR
THE ALZHEIMER'S ASSOCIATION-
WHILE THE STATE OF DONE MUCH
THEIR DRUG HOLDEN CONGREGATE
LIVING FACILITIES THERE REMAIN
A NUMBER OF CHALLENGES THAT YOU
KNOW ENOUGH WORDS. MY BOOK THE
HIGHLIGHT FOR ISSUES REALLY
QUICKLY FIRST WE NEED UNIFIED
TESTING STANDARDS ACROSS ALL
CRICKET SETTING CURRENTLY THE
STANDARDS FOR MATH AND ART THE
A FEW DIFFERENT MAKE IT
CHALLENGING. FOR THE PUBLIC TO
UNDERSTAND WHAT IS REQUIRED AT
ALL- OVER. EIGHT THOUSAND
FACILITY THROUGHOUT THE STATE.
I CAN'T RECORDING OF KOBE
NINETEEN TO BE CONSISTENT.
ACCEPTABLE THE PUBLIC. SHE
APPEARED SAID THAT BIG JOB
PUBLISHED AND REQUIREMENTS
FIRST. BUT THE DEPARTMENT OF
SOCIAL SERVICES FOR WEEKS OF
NOT HAD ACTIVELY ACCESSIBLE
DATA FOR THE FACILITY THEY
REGULATE AND EITHER DATASET IS
AVAILABLE ON THE PUBLIC FACING.
COVER NINETEEN WEBSITE THAT
THAT THAT THE STATE BEGAN AT
THE BEGINNING OF A PANDEMIC
THIRD STATE GUIDANCE I'M
REQUIRE STOPPING. TERM CARE
TACTICALLY FOR AT LEAST TEN
DAYS PRIOR TO RETURNING TO WORK
RIGHT NOW PAYMENT WOULD NOT
MEET THIS REQUIREMENT MAKES IT
DIFFICULT FOR STAFF. TO CHOOSE
BETWEEN THEIR INCOME AND THEIR
HEALTH AND SAFETY AND THE
HEALTH AND SAFETY OF THE
INDIVIDUAL FROM THAT.
OPPORTUNITY THEN LASTLY. OUR
ASSOCIATION REMAIN CONCERNED
ABOUT THE IMPACT THAT ISOLATION
HAS HAD ON INDIVIDUALS IN LONG
TERM CARE. I INPARTICULAR
THOSE WITH DEMENTIA OUR STATE
MUCH FIND WAYS. PAVE WAY FOR
INDIVIDUALS IN LONG TERM CARE
TO BE ABLE TO FEED AND BILLS
THAT WHAT THEIR LOVED ONES. WE
KNOW THAT THE STATE OR THROUGH
PERFECT OPTIONS AT THIS POINT
BUT WE REMAIN EXTREMELY
CONCERNED ABOUT THE THIS ISSUE
IN PARTICULAR. THANK YOU AND WE
LOOK FORWARD TO- CONTINUE
CONVERSATION. BUT ALL OF THESE
ISSUES. THANK YOU SIR NEXT
CALLER. NEXT CALLER IS MY
NUMBER FORTY A FORCE YOUR LINE
IS OPEN. THANK YOU GOOD
AFTERNOON CHAIRED COMMITTEE
CHAIRS AND MEMBERS AND MY NAME
IS WITH CALL OF ART AND I
REPRESENT MOM'S MEAL. WHICH
DELIVERED HIGH QUALITY
MEDICALLY TAILORED NOW DIRECTLY
TO THE HOMES AND PATIENTS IN
CALIFORNIA INCLUDING MEDICAL
PATIENT. AND WELL IF THE COURT
THE CONCEPTS AS A LONG TERM
CARE I'M BENEFIT AS THE COP
AFFECTED WAY TO KEEP. MEDICARE
BENEFICIARY FAVORITE HOME AND
REDUCE PRESSURE ON SKILLED
NURSING FACILITIES. WE ARE
SURPRISED AND CONCERNED THAT
THAT APARTMENT PROPOSAL DOES
NOT INCLUDE HOME DELIVERED
MEALS IN THE BUNDLE OF
EVERYTHING. AND WE ABSOLUTELY
BELIEVE MORE TIME IS NEEDED TO
EXPLORE QUESTIONS CONTACT THE
POLITICAL AND MANAGE BELIEVE
THE HOME DELIVERED MEAL DURING
ESSENTIAL ELEMENT TO ORDER
USING POPULATION AND DECOMPRESS
HOSPITAL. INCOME NUTRITION IT
MAILED OR DELIVERED DIRECTLY TO
BENEFICIARIES THAT THEIR HOMES
ARE CRITICAL COMPONENTS TO
KEEPING THEM HEALTHY AND FAITH
ESPECIALLY. NOW INCREASE AND
CONGRESS MEAL SITE THERE. BOB
VOLUNTEER ORGAN. IN IT CAN'T
EXTRA TO KEEP WITH BILLION THE
MAN. WHICH IS GULPING A LONG
WAY LIST FOR SERVICE. IN
ADDITION HOME TO MEAL THERE'S
OPEN. IN THE BY HELP TO PREVENT
INSTITUTE INSTITUTE. FOR THE
FIRE TRANSMISSION RENT AND
REDUCE PRESSURE ON THE
HEALTHCARE SYSTEM. MONORAIL
BELIEVE HOME DELIVERED MEAL
VERY URGENTLY NEEDED COMPONENT
THAT MIGHT BE INCLUDED IN THE
BUNDLE OF SERVICES. IN THAT
WHAT PROPOSED LONG TERM CARE AT
HOME BENEFIT AND WE ARE HAPPY
TO REPORT THAT THE LEGISLATURE
HOWEVER POSSIBLE. AS YOU
CONSIDER THE PROPOSAL THANK YOU.
THANK YOU MA'AM. NEXT CALLER
PLEASE. THE COLOURS LINE NUMBER
SIXTY EIGHT THAT SIX EIGHT YOUR
LINE IS OPEN THANK YOU- MARTY
EMOTO A FAMILY MEMBER- MY OLDER
SISTER HAD DEVELOPMENTAL
DISABILITIES AND WAS A MEDI
MEDI WHEN SHE WAS ALIVE- AND
ALSO WITH C. CAN CALIFORNIA
DISABILITY YOU'RE COMING ACTION
NETWORK AND A MEMBER OF THE A
MASTER PLAN FOR AGING LONG TEM
SERVICES AND SUPPORTS
SUBCOMMITTEE APPRECIATE THE
WORK- AND THIS HEARING OF THE
SUBCOMMITTEE- AND ALSO THE OUT
REACH EFFORTS- THAT WOULD MEET
THAT HAVE BEEN MADE BY THE
DEPARTMENT- REGARDING THIS
BENEFIT- BUT STRONGLY SUPPORT
THE- RECOMMENDATIONS. OF THE
ADVOCACY PANEL THAT CALLED FOR
A LONGER TIME LINE MORE
DISCUSSION- BY STAKEHOLDERS AND
ALSO MORE IMPORTANTLY- LOOKING
AT OTHER POSSIBLE SOLUTIONS-
ESPECIALLY THE ISSUE OF
EMPHASIZING THE NEED FOR CRISIS
RESPONSE AND SUPPORTING AND
STRENGTHENING- THE SERVICES
THAT THE SUPPORT OF THE PEOPLE
ON THE FRONT LINES INCLUDING
THREE. AND MISSISSIPPI AND
OTHER PROGRAMS ALSO HOPE THE
SUBCOMMITTEE WILL LOOK AT THE
IMPACT OF ANY BENEFIT ON THE
PEOPLE WITH DEVELOPMENTAL
DISABILITIES- AND THE IMPACT ON
REGIONAL CENTERS AND PROVIDERS
AND- LASTLY- TO THE COMMENTS
MADE BY MR THE VERY AND REALLY
APPRECIATE APPRECIATE THAT ON
TESTING BUT ALSO THAT CASTING
IS VITALLY NEEDED FOR OTHER
PEOPLE ON THE FRONT LINES
INCLUDING IT SERVICE WORKERS
AND WORKERS TO PROVIDE
SUPPORTED LIVING SERVICES.
THANK YOU AGAIN FOR THE SHARING.
THANK YOU SIR. NEXT CALL PLEASE.
COLORS NUMBER SIXTY SEVEN THAT
SIX SEVEN YOUR LINE IS OPEN.
MISTER CHAIRMAN AND MEMBERS
THIS IS QUITE MAIN REPRESENTING
CALCULATES THE PROGRAM FOR ALL
INCLUSIVE. CARE FOR THE ELDERLY
OUT WE WANT TO- THANK GOD. HE
H. S. N. DIRECTOR LIKE CORN FOR
HIGHLIGHTING SOME OF THE-
THINGS THAT PACE IS ABLE TO DO
BEFORE- THE POPULATIONS THAT
ARE FIVE INCH KILLED THEIR SEEN
OUR FACILITIES OR AT THE
ALTERNATIVE TO- A PROVIDING UP
FULLY INTEGRATED CARE TO. ALLOW
INDIVIDUALS TO CONTINUE TO LIVE
IN THEIR COMMUNITIES BUT THEY
ARE NOW- FIFTY EIGHT CENTERS IN
TWENTY EIGHT COUNTY. EIGHT
BILLION THE CENTRAL VALLEY
THERE'S BEEN A TREMENDOUS.
GROWTH ALL THE WAY FROM SAN
JOAQUIN HI TO OUR CURRENT
COUNTY- WE DO WANT TO I SUPPORT
THE RECOMMENDATIONS OF THE
LTSS- COMMITTEE- AND THEN
HIGHLIGHT THAT THE TO THAT
APPLY A PARTICULARLY TO PACE
ORGANIZATIONS- WHICH IS A-
EXPEDITED. A LEVEL OF CARE
DETERMINATION SO THAT
INDIVIDUALS CAN GO FROM A-
SETTING A MILLION TO A PAGE
PROGRAMS RIGHT NOW IT COULD
TAKE UP TO A MONTH. UP FOR THE-
WHAT JUST WORKS BOTH PACE AND
THE DETAIL DHEA. THAT ALSO SOME
ADJUSTMENT FOR THE WAY IN
WHICH- THAT PAYMENT TECHNOLOGY
WORKS SO THAT IF SOMEONE ENTERS
A PACE PROGRAM MID MONTH- THEY
CAN. BE. THE STATE TO BE BILLED
FOR THAT ON. A PER CAP OR SOME
SIMILAR BASIS WE HAVE LOTS OF
CAPACITY AND PACES CONTINUING
TO GROW. THANK YOU VERY MUCH.
THANK YOU SIR NEXT CALLER
PLEASE. THE COLOURS LINE NUMBER
SEVENTY SEVEN ZERO YOUR LINE IS
OPEN. MISTER CHAIR MEMBERS
RANDY MARTIN ON BEHALF OF
ARYANA HEALTH CARE WHICH IS
OPERATING CALIFORNIA'S PRIMERA
HEALTHCARE A MAJOR- HOME HOME
CARE AGENCIES ACROSS THE STATE
OF CALIFORNIA WE OVERALL
SUPPORT THE DIRECTION THAT THE
DEPARTMENT IS TAKING IN THIS
REGARD HOWEVER WE SHARE
CONCERNS ABOUT MOVING TOO
QUICKLY. WE APPRECIATE THE
CAUTION BY THE LEGISLATURE ON
OTHERS I'M THAT WE NEED TO TAKE
THIS IN A IN A IN A MANNER THAT
WILL ENSURE THAT WE GET THE
BEST POSSIBLE PROGRAM OUT OF IT
I'M WE HAVE SUBMITTED. A LETTER
WITH- MULTIPLE PUBLIC COMMENT-
TO THE DEPARTMENT THAT WE HAVE
SHARED WITH YOUR COMMITTEE- I
WON'T REITERATE DOES THAT AT
THIS POINT I WOULD LIKE TO
POINT OUT ONE OVER ARCHING
CONCERN THAT WE HAVE WITH THE
CURRENT ITERATION OF THE
BENEFIT DESIGN AND THAT USED TO
GET RID OF THE SEPARATE LICENSE
YOUR CATEGORY FOR A LONG TERM
CARE AT HOME AGENCY- WE THINK
THAT BANKS TROUBLE- WE THINK
THAT IT BLURS THE LINE BETWEEN
THE LICENSEES CURRENT LICENSE
REQUIREMENTS. AND THE RIGHT NOW
REQUIREMENTS OF A LONG TERM
CARE AT HOME AGENCY WE'RE
CONCERNED THAT THE DEPARTMENT
WOULD BE LESS ABLE TO ENSURE
ACCOUNTABILITY OF EITHER
LICENSE FEE I'M MORE ALSO
FRANKLY CONCERNED THAT- THE
LICENSE HE WILL BE LOOKING OVER
ITS SHOULDER AT ALL TIMES IN
CASE THE EXECUTION OF ITS LONG
TERM CARE HOME SERVICES-
NEGATIVELY IMPACTED UNDERLYING
ONE. UNDERLYING LICENSE OR VICE
VERSA AND WE LOOK FORWARD TO
WORKING WITH THE LEGISLATURE
AND THE DEPARTMENT- AS WE GO
FORWARD- AS WE SAID THIS IS AN
IMPORTANT CHANGE AND BENEFIT
DESIGN I'VE ALWAYS SUPPORT
GOING FORWARD AS. LONG AS IT'S
DONE SMARTLY. THANK YOU. THANK
YOU MIX COLOR. MODERATOR DO WE
HAVE ANY OTHER PUBLIC CONTACT.
ALLERGIES ONCE AGAIN IF YOU'D
LIKE TO PUT YOURSELF IN A QUEUE
YOU MAY PRESS ONE ADVANTAGE
ZERO AT THIS TIME WE HAVE ONE
REMAINING IN Q. WILL GO TO LINE
NUMBER SEVENTY ONE. SEVEN ONE
YOUR LINE IS OPEN. GOOD
AFTERNOON I'M KRISTIN HAYMAN
THE EXECUTIVE DIRECTOR OF THE
CALIFORNIA ASSOCIATION FOR
ADULT DAY SERVICES. THANK YOU
ASSEMBLY MEMBER RANDY LEFT FOR
HOLDING TODAY'S HEARING. AND I
ALSO WANT TO THINK THAT THE
COMMITTEE STAFF FOR THEIR
THOUGHTFUL WORK ON THE HEARING.
ANALYSIS AND FOR DIRECTORS
MIGHT BORN AND WAIT FOR
LISTENING AND SPEAKING. TO THE
LEGISLATURE. AND STAKEHOLDERS
CONCERNS TODAY. I ALSO WANT TO
THANK ALL THE ASSEMBLY MEMBERS
FOR ALL THEIR POIGNANT COMMENTS
TODAY. AND TO MY COLLEAGUE
DENISE BAKER FOR HER TESTIMONY
THIS MORNING. CATHLAMET ARTICLE
POSITION PAPER TO DH. AND ALSO
TO IT THE TOP. SO I JUST WANT
TO TOUCH ON A FEW POINTS TODAY.
THE ADULT DAY HEALTHCARE THE
BATH AND- PROGRAMS ARE COST
EFFECTIVE COMMUNITY BASED
ALTERNATIVES TO PLACEMENT AND
SKILLED NURSING FACILITIES.
THAT THE VERY AFFECTED LTSS
PROGRAM MODEL THE FTP EXPERTISE
IN HELPING INDIVIDUALS THE FOR
ANDROID INSTITUTIONAL
PLACEMENT. EACH PROGRAM
REPRESENTS OVER FORTY YEARS OF
EXPERTISE IN THE PROVISION OF
COMMUNITY BASED ALTERNATIVES TO
SNIFF PLACEMENT. AFTER
LISTENING TO TODAY'S HEARING WE
ARE ENCOURAGED BY THE COMMENTS
MADE BY DIRECTOR LIGHT BORN.
WHERE HE EMPHASIZED THAT THIS
NEW PROGRAM IS NOT INTENDED TO
BE A REPLACEMENT FOR THE
STATE'S EXISTING COMMUNITY
BASED SERVICES. AND WE ARE ALSO
ENCOURAGED BY WHAT WE HEARD
TODAY NOTING THAT ADULT DAY
HEALTH CARE FEEDBACK. COULD BE
REGARDED AS A CONTRACTOR UNDER
THIS NEW PROGRAM. FOR THE PAST
FIVE MONTHS AS DIRECTOR WAIT
SPOKE TO OUR PROVIDERS HAVE
BEEN ABLE TO PROTECT OVER
THIRTY SEVEN THOUSAND
INDIVIDUALS AT HOME. BY
PROVIDING THEM WITH THE
ESSENTIAL CARE AND DIRECT
SUPPORT DURING THE CODEPENDENT
NECK. THEY'VE BEEN PROVIDING
ESSENTIAL SERVICES IN THE
COMMUNITY THAT ASSIST WITH
EXACTLY WHAT THE PROGRAM SEEKS
TO DEAL DECOMPRESSED KILLED
THEIR STATE FACILITIES. WE
CERTAINLY RECOGNIZE THAT THE
PANDEMIC HAS INCREASED THE
URGENCY AND CONCERN ABOUT OUR
STATE'S NURSING FACILITIES
DURING A CRISIS. AND WE AGREE
WITH ASSEMBLY WITH YOUR-
ASSEMBLY MEMBER RANDY LIKE THE
SENTIMENT THAT WE NEED TO
CONTINUE TO TAKE MEASURED AND
THOUGHTFUL APPROACH TOWARD
CREATING A NEW MEDICARE
BENEFITS. ARE PROVIDERS ARE
READY. TO CONTINUE TO ASSIST IN
THE DEVELOPMENT OF THE STATE OR
BENEFIT THAT BUILD ENHANCERS
UPON THE CURRENTLY ESTABLISHED
LTSS PROGRAMS. THAT HAVE BEEN
ESSENTIAL IN PREVENTING
HOSPITALIZATIONS AND LONG TERM
NURSING HOME STATE. AND LASTLY
WE ALSO SUPPORT THE LTSS BUT
COMMITTEES RECOMMENDATIONS.
THAT WERE PRESENTED TO THE
SUBCOMMITTEE TODAY. THANK YOU
FOR YOUR TIME AND CONSIDERATION.
THANK YOU. MODERATOR ANNE.
PUBLIC COMMENTS. WE HAVE THREE
MORE THEY'VE QUEUED UP WE'LL GO
TO LINE NUMBER SEVENTY FOUR
SEVEN FOR YOUR LINE IS OPEN.
GOOD AFTERNOON MY NAME IS
PAULINE SHOULD TARA AND I AM
THE DEPUTY DIRECTOR OF
CALIFORNIA ADVOCATES FOR
NURSING HOME REFORM. CANTOR'S
SUPPORT PROVIDING SAFE
ALTERNATIVES TO
INSTITUTIONALIZATION HOWEVER WE
WANT TO BE ASSURED THAT THE
PROPOSED BENEFIT ONE LAKH COME
AT THE COST OF REDUCING.
EXISTING VITAL HBO PROGRAM.
CANTOR HAS SUBMITTED LETTERS
ABOUT OUR CONCERNS- SOME OF OUR
CONCERNS INCLUDE- THAT NURSING
FACILITIES AND MEDICARE MANAGED
CARE PLAN THANK YOU FOR THE
BENEFIT TO COERCE UNSAFE
DISCHARGES IN ORDER TO MAXIMIZE
PROFIT. THAT IN MANY CASES
THERE MAY BE NO HALTER
PRESIDENT TO GO TO PARTICULARLY
AT THE PROPOSAL DOES NOT
INCLUDE AN ASSISTED LIVING
BENEFIT. THE LACK OF CLARITY
REGARDING FINANCIAL ELIGIBILITY
CRITERIA AND THE APPLICATION OF
BALBOA PARK RICHMOND
PROTECTION. ESPECIALLY GIVEN
THE DEPARTMENT CONTINUED DELAY
OF THE 138% INCREASE AT THE AGE
OF THE TABLE TO FEDERAL POVERTY
LEVEL PROGRAM. THAT THERE WILL
BE AN ADEQUATE OVERSIGHT OF LTC
AT HOME AGENCIES WHICH INCLUDE
FOR PROFIT ORGANIZATION.
FINALLY THE DEATH BENEFIT WILL
FURTHER CONTRIBUTE TO THE
FRAGMENTATION OF A TO BE A TO
DO IT. ELIGIBILITY CRITERIA AND
REQUIREMENTS THAT BENEFICIARIES
NOT BE ENROLLED IN OTHER WE
WERE PROGRAMS. WE THINK THAT
THAT IT HAD THE POTENTIAL TO BE
A VERY POSITIVE CHANGE IN THE
WAY WE DELIVER LONG TERM CARE.
IT COULD ALLOW THE PROPER INPUT
THE TIME NEEDED TO HAVE A
MEANINGFUL VETTING PROCESS AND
I DO WANT TO THANK YOU FOR
HAVING THAT SUPPORT. TODAY
THANK YOU. THANK. YOU MA'AM.
NEXT CALLER PLEASE. NEXT CALL
IS ONE OF SIXTY THAT SIX FOUR
YOUR LINE IS OPEN. GOOD APP
SHARE AND GOT COMMITTEE MEMBERS
AND- MY NAME TERRY AND I AM
FAMILY AT THE I HEAR ABOUT THE
DEPARTMENT OF THE- SERVICES TAP.
AND I'M ALSO AN R&D WITH YOUR
TO HOME CARE AREA. I WANT TO
THANK THE ADMINISTRATION FOR
THIS PROPOSAL A VERY INSIGHTFUL
QUESTIONING OF THE CANADIAN
PANEL MEMBERS. FOCUSING ON THE
IMPROVEMENT OF CURRENT SERVICES
AND THE DEVELOPMENT OF
ADDITIONAL OPTIONS AMERICAN
HEALTHCARE IS VITAL HOWEVER.
SHE DID TO THE CURRENT SYSTEM
MUST START WITH AN ABUNDANCE OF
PRELIMINARY WORK IN PLANNING
THE CLOSURE OF THE STATE
DEVELOPMENTAL CENTERS IS AN
EXAMPLE OF CAREFUL SERVICE
EXPANSION THE FIFTH PICK TO
AFFECT NEEDS. HOWEVER ONE NEED
NOT WELL MATT IS OUT OF ABOUT A
THOUSAND DEVELOPMENTALLY
DISABLED CLIENTS CURRENTLY IN
DIFFERENT NURSING HOME MORE
THAN 20% OF WHOM HAVE TESTED
POSITIVE FOR COVERED NINETEEN
AND WITH FORTY THREE DEATHS
AMONG THEM. PERHAPS THE
PROPOSAL WHEN WE FIND COULD
OTHER OFFER OTHER OPTIONS
BEYOND WORKING ON PLACEMENT FOR
THEM THANK YOU SO. MUCH FOR ALL
YOUR EFFORTS. THANK YOU MAY.
NEXT CALLER PLEASE. NEXT CALL
IN Q. LINE NUMBER SEVENTY THAT
TWO YOU'RE LINUS OPEN. HI MY
NAME IS DR TO ARE THAT'S GOING
TO AND I BEEN AN EXACT LEADER
FOR BOTH AN EIGHT BE A PROGRAM
I WOULD GO TO EVERYONE ON THE
PANEL FOR THE TIME AND EFFORT
YOU PUT INTO DEVELOPING THE
LONG TERM CARE HOME PROPOSAL-
IT'S IMPORTANT TO NOTE THAT
THERE IS SIGNIFICANT OVERLAP
BETWEEN THE LONG TERM CARE HOME
AND IF THE THING CARE MODELS
SUCH A PIECE OF PAPER AND IT
SHOULD BE A PROGRAM- I'D LIKE
TO EMPHASIZE. THAT THE CRITICAL
IMPORTANCE OF CLEARLY DEFINING
THE SERVICE GAP THE LONG TERM
CARE HOME THE DEADLINE TO
ADDRESS- AND RESPECTIVELY TO
DEATH BUT THAT- THAT THAT PANEL
CONSIDER EXPANSION EXISTING
PROGRAMS TO ADDRESS GAPS RATHER
THAN LAYERING ON ADDITIONAL
PROGRAMS THAT ALREADY COMPLEX
SERVICE ENVIRONMENT- AND
RECOMMEND AN EMPHASIS ON.
PROVIDING ACTIVATED ACT WHAT
THE PEOPLE NEED FOR THE AFFAIR
BUT SAYS- AGAIN THANK EVERYONE.
FOR YOUR CONTRIBUTION TODAY.
THANK YOU. NEXT CALLER. WE HAVE
A LOT THE QUEUE A SECOND TIME I
CAN RE PROMPT ONE THEN ZERO TO
PLACE YOUR LINE INTO Q. AND WE
HAVE NO ONE ELSE SHOWING UP AT
THIS TIME. PLEASE CONTINUE
THANK YOU MODERATOR. THIS IS
BEEN AN INCREDIBLY IMPORTANT
CONVERSATION ABOUT CALIFORNIANS
WHO ARE MOST AT RISK. AND THEY
WERE AT RISK PRIOR TO COPE WITH
NINETEEN AND NOW THAT HAS BEEN
COMPOUNDED IN THE CONTINUING
PANDEMIC. I AM GRATEFUL TO HAVE
THIS PUBLIC DISCUSSION ABOUT
THE PENDING PROPOSAL FROM THE
ADMINISTRATION AND TO LISTEN TO
KEY STAKEHOLDERS AS WE ALL TRY
TO GRAPPLE WITH THE QUOTE TWERK
OF THE LONG TERM CARE SERVICES
IN OUR STATE. WE HAVE BIG
PROBLEMS TO ADDRESS IN THE
STATE. RACIAL AND ETHNIC
DISPARITIES ARE WIDE AND DEEP
UNDERSCORED BY THE TERRIBLE
RAVAGES WE'RE SEEING IN OUR
ELDERLY BLACK LATINO AND API
COMMUNITIES. THE ADMINISTRATION
ASSERTS THAT ITS MEETING WITH
STAKEHOLDERS AND LISTENING. I
HOPE THE ADMINISTRATION LISTENS
TO WHAT PEOPLE SAID TODAY THEY
SAID. DON'T DO ANYTHING ABOUT
US WITHOUT US. WE AS LAWMAKERS
ARE SAYING STOP AND BRING US
PROPOSAL THAT WE CAN
COLLABORATE ON TOGETHER IN
TWENTY TWENTY ONE. ADVOCATES
ARE SAYING INVEST IN OUR
CURRENT PROGRAMS AND FIX THE
INFRASTRUCTURE THERE THERE'S
ENOUGH WORK FOR US TO DO TO
REPAIR OUR CURRENT SYSTEM AND
PROVIDE A HIGHER QUALITY OF
SERVICE IN COORDINATION
UTILIZING OUR CURRENT PROGRAMS.
I CERTAINLY HOPE WE CAN GIVE
TIME AND ATTENTION TO THE
IMMEDIATE CRISIS AND A
THOUGHTFUL DELIBERATE LONG TERM
PLANNING EFFORTS FOR AGING. ALL
THE WHILE PRESERVING THE
CURRENT PROGRAMS THAT ARE THE
BEDROCK OF OUR LONG TERM CARE
SYSTEM. I HSS SEABASS AND MSSP.
I LOOK FORWARD TO CLOSE
COLLABORATION WITH THE GOVERNOR
AND OUR ADMINISTRATIVE PARTNERS
AS WE MOVE AHEAD THANK YOU ALL
AND STAY HEALTHY AND SAFE.