GOOD MORNING WE ARE
CONVENING ARE BUDGET SUB
COMMITTEE SIX HEARING ON
PUBLIC HEALTH REPORTING
IN THE CAL READY SYSTEM
I JUST WANT TO READ A COUPLE
INSTRUCTIONS ON THOSE REPETITIVE
FOR ALL OF YOU WHO'VE ATTENDING
ARE COMMITTEES BUT WE JUST HAVE
TO READ OF FOR PROTOCOL PURPOSES
-- FOR ANY PUBLIC IN ROOM
FORTY TWO -- TWO WERE HAVING
TO PHYSICALLY DISTANT HEARING
EVEN THOUGH THE ROOM IS LARGE
ENOUGH EVEN THOUGH THE ROOMS
THE LARGEST HEARING ROOM IN THE
CAPITOL WE CAN ONLY ACCOMMODATE
A FEW MEMBERS WITH MINIMAL
STAFF WE'RE FOLLOWING VERY
STRICT PHYSICAL AND DISTANCING
PROTOCOLS FOR THE PUBLIC TO
ENTER ONLY THE CAPITAL IF
ANY PUBLIC DO COME FOR THE
HEARING WE DO ASK THEM TWO ONE
THREE FIVE TESTIFIED TO PLEASE
LEAVE THE ROOM AND THE ROOM --
THERE'S ONE MINUTE FOR PUBLIC
COMMENTS WE ARE NOT TAKING
ANY BOTH SAY THIS IS JUST A
PURELY INFORMATIONAL HEARING
THE PANELISTS ON THE AGENDA
AND THE LEGISLATIVE ANALYST'S
OFFICE ARE PEERING REMOTELY
-- AND WITH VERY SET UPS IN
THE CAPITAL THERE ARE PUBLIC
STATIONS AVAILABLE ACROSS
CALIFORNIA TO ALLOW THE PUBLIC
TO COMMENT THOSE ARE POSTED
ON THE AGENDA IF ANY
TROUBLE FINDING THOSE LOCATIONS
YOU CAN FEEL FREE TO CALL THE
BUDGET OFFICE AT NINE ONE SIX
THREE ONE NINE TWO OH NINE
NINE ALSO IF YOU HAVE ANY
-- FEEDBACK ON THE HEARING OR
JUST WONDER REGISTER COMMENT
FEEL FREE TO EMAIL US AT
BUDGET SUB S. U. B.
AND THE NUMBER SIX AD A. S. M.
DOT CA DOT GOV
AGAIN TODAY WE'RE HAVING A
VERY IMPORTANT HEARING TO
HEAR HOW PUBLIC HEALTH DATA
SHAPES GUIDANCE AT THE STATE
AND COUNTIES ARE PROVIDING
CALIFORNIA'S DURING THE COLD IT
NINETEEN OUTBREAK WE'RE VERY
PLEASED TO HAVE OUR ACTING
PUBLIC HEALTH DIRECTOR DR PAN
HERE WITH US TODAY TO PROVIDE
AN OVERVIEW OF THE STATE
RATING SYSTEM AND HOW OLD WAS
DETERMINED AND COMMUNICATED
WELL SORRY ABOUT THE CHALLENGES
THE STATE HAD WITH THE CAL
READY SYSTEM IN COVERT NINETEEN
REPORTING IN AUGUST AND DOUBT
-- GIVEN UPDATE ON REALLY
THE RELIABILITY OF THE DATA
I WANT TO THANK MY COLLEAGUE
FROM BAKERS FEEL FOR ME REALLY
REQUESTED THE HEARING AND --
ASKING US TO FOCUS ON DATA
WE THINK OBVIOUSLY DATA IS
EXTRAORDINARILY IMPORTANT IT'S
VERY IMPORTANT THAT WE ARE
COLLECTING AND DISTRIBUTING
ACCURATE INFORMATION TO THE
PUBLIC HAVING SAID THAT I
KNEW WE WERE WE ARE STILL IN A
PANDEMIC I KNOW THAT WE ARE
CONTINUING TO LEARN ABOUT
THE DISEASE AND CONTINUING TO
REALLY DO THINGS THAT WE REALLY
HAVEN'T HAD TO DO ON A SCALE
THAT WE'VE NEVER HAD TO DO
SO KNOWING THAT I KNOW THAT
IT IS VERY DIFFICULT FOR OUR
OFFICES OF TECHNOLOGY AS WELL AS
OUR -- VARIOUS AGENCIES TO
AGAIN BE RUNNING A RESPONSE
TO A PANDEMIC AT THE SAME
TIME BUILDING TECHNOLOGIES
THEY HAVEN'T REALLY BILL
DISTRIBUTING INFORMATION THAT
REALLY HASN'T BEEN IN NEARLY
AS MUCH DEMAND AS AS IT IS NOW
SO AGAIN -- LET ME --
LET ME START TO SEE FIFTH
MEMBERS HAVE ANY OPENING
COMMENTS THE MEMBERS WANT
TO MAKE A COMMENT AS FAR
-- I JUST WANTED I JUST
PUBLIC THANK THE CHAIR FOR THIS
-- HEARING AS YOU KNOW A NUMBER
OF MEMBERS HAVE ASKED -- TO
TO HAVE THIS HEARING INTERVIEW
GOING TO OUR DATA SYSTEMS IN
AND OF COURSE THE IMP HAS WERE
MALE THIS PANDEMIC THE GOAL
IS TO PROVIDE NOT ONLY DECISION
MAKERS BUT OUR COUNTY PUBLIC
HEALTH OFFICERS AND DEPARTMENTS
-- TIMELY AND ACCURATE DATA
SO THAT WE CAN -- WE CAN ADDRESS
THIS PANDEMIC AND AND AND GET
COVERED NINETEEN UNDER CONTROL
SO I JUST WANNA PUBLIC THANK
THE CHAIR FOR THIS IS A VERY
IMPORTANT AND I COMMEND YOU
FOR YOUR LEADERSHIP THANK YOU
VERY MUCH ANY OTHER COMMENTS DR
RANDALL THANK YOU AND
-- I DO WANT TO APPRECIATE --
THE OPPORTUNITY TO BE ABLE TO
ADDRESS US NOW IN THE MIDST OF
WHAT TOO MANY OF US HAVE CALLED
THE PANDEMIC OF THE CENTURY
AND IF I COULD I WANT TO SHARE
A BIT WE HAVE AN OPPORTUNITY
TO NOW COMMUNICATE AND I WANNA
TALK ABOUT A PODCAST THE SPEAKER
HAS ASKED ME TO LISTEN TO ONE
THAT HAD ELIZABETH OUTCOME ON
IT IN THE MIDDLE OF JUNE -- ONE
PODCAST LOOKS AT THE EFFECT
THAT THE PREVIOUS PANDEMIC
OF THE CENTURY THAT OCCURRED
IN NINETEEN EIGHTEEN ON FIRST
AND ELIZABETH OUTCOME WROTE A
BOOK CALLED THE BIBLE MODERNIST
SPOKE ABOUT WHAT THE CURRENT
AND OFTENTIMES WHAT HAPPENS IN
THE MIDST OF THESE PANDEMICS
AS WE GET FROM A TEST WE GET
FOCUSED ON THE NUMBERS WE GET
FOCUSED ON HOW MANY PEOPLE HAVE
DIED AND YES THERE ARE FIFTEEN
THOUSAND SIX HUNDRED AND EIGHT
WHO HAVE DIED FLOOR IN THE STATE
OF CALIFORNIA BECAUSE OF THIS
PANDEMIC BUT WE FORGET WHAT
OCCURS WITH EACH LIFE AND SO
I JUST WANT TO TAKE A MOMENT AT
THE START OF THIS TO ACTUALLY
APPRECIATE THE ADMINISTRATION
FOR WHAT OCCURRED YESTERDAY
FOR WE ARE WATCHING SOMEONE WHO
WILL HAVE LEAST THOSE SWITCHES
ON THEIR MASK AND I WISH TO
SPEAK ABOUT THAT CAMPAIGN AND
SPEAK ABOUT WHAT I SAW YESTERDAY
BECAUSE THE ADMINISTRATION AND
OUR STATE HAS BEEN PREPARING
NOT INHERENTLY FOR PANDEMICS BUT
FOR EMERGENCIES AND HAVING BEEN
AN EMERGENCY ROOM DOCTOR WANTS
TO APPRECIATE WHAT ACTUALLY
OCCURRED YESTERDAY BUT WE DID
FIFTY MILLION DOLLARS INVESTMENT
INTO EMERGENCY PREPAREDNESS
SO THAT OUR FOOD BANKS ARE
BETTER ABLE TO DEAL WITH ISSUES
LIKE THIS PANDEMIC AS A PUBLIC
SERVANT HAVE BEEN ON THE FRONT
LINES AND I'VE SEEN THE NEED
FROM SO MANY WHO ARE IN OUR
COMMUNITY AND OFTEN TIMES AS
OUR ECONOMY HAS BEEN RAVAGED
WELL WE ARE ALSO FOCUSED ON OUR
PEOPLE WHO WEREN'T ABLE TO PUT
FOOD ON THEIR OWN TABLES THIS
EMERGENCY PREPAREDNESS DOLLARS
HELPED OUR COMMUNITY AND OUR
CENTRAL CALIFORNIA FOOD BANK
TO BE ABLE TO MAKE INVESTMENTS
SO THAT THEY COULD HAVE COLD
STORAGE SO THAT WE COULD
ACTUALLY MAKE SURE THAT THE
GOODS WERE GETTING TO COMMUNITY
WHO NEEDED IT AND ONE OF THE
THINGS THAT THEY TALKED ABOUT
YESTERDAY IF I COULD BECAUSE
THEY THERE WERE TWO WOMEN CEOS
NATALIE CABLES AND KENDYL NINE
WHO WERE PROMOTED DURING THE
MIDST OF THIS PANDEMIC WHO
HAVE MET THIS MOMENT WHO ARE
DOING THINGS IN THE CENTRAL
VALLEY THAT ARE MAKING THINGS
IMPROVED BUT WHAT THEY TALKED
ABOUT WAS THE CONTINUED NEED FOR
INFRASTRUCTURE INVESTMENTS AS
WELL AS OUTREACH THAT THEY ARE
DOING INNOVATIVE PROGRAMS SUCH
AS CURBSIDE TO GO FOR PEOPLE
TO BE ABLE TO RECEIVE GOODS
AND NEEDS BUT THAT THEY WEREN'T
INHERENTLY DOING THIS IN A
CULTURAL AND LINGUISTICALLY
WAY AND WE'RE HAVING TO USE
SOME OF THEIR PHILANTHROPIC
DOLLARS AND SO I'M WONDERING
IF AND AS WE'RE HAVING THIS
DISCUSSION ABOUT PUBLIC HEALTH
AND DATA AND INDIVIDUALS THAT
WE ALSO HAVE A CHANCE TO TALK
ABOUT HOW WE MAKE SURE WE ARE
DOING AN OUTREACH AND INVESTING
IN PROGRAMS THAT ARE MAKING
A DIFFERENCE RIGHT NOW BUT I
WOULD JUST BE REMISS NOT TO TALK
ABOUT MY REGION I'VE BEEN A BIT
OUTSPOKEN WANTING TO MAKE SURE
THAT FRESNO IS MOVING FORWARD
AND WE HAVE AN OPPORTUNITY TODAY
TO RECEIVE INFORMATION WHETHER
OR NOT WE MOVE FROM PURPLE INTO
RED WE HAVE A GLIMMER OF HOPE
BUT I WOULD JUST WANT US TO BE
VIGILANT AND MAKE SURE THAT THIS
IS NOT THE CALM BEFORE THE STORM
BECAUSE IF WE DO GROUND OURSELF
IN THIS AS THE PANDEMIC OF THE
CENTURY WE WILL ALSO LOOK BACK
TO NINETEEN EIGHTEEN AND REALIZE
THAT THE MOST THE HIGHEST
MORTALITY CAME FROM SEPTEMBER
TO DECEMBER OF NINETEEN EIGHTY
THAT IT IS THESE MONTHS THAT
ARE CRUCIAL THAT WE NEED TO BE
VIGILANT AND MAKING SURE WE'RE
DOING EVERYTHING WE CAN TO
SUPPORT OUR STATE AND TO ME
TO THIS MOMENT AND SO I DO
APPRECIATE THE OPPORTUNITY TO
HAVE THIS DISCUSSION I THINK
IT'S OUR RESPONSIBILITY TO
HAVE OVERSIGHT OVER THE PURSE
STRINGS AND TO MAKE SURE WE'RE
ASKING THESE TOUGH QUESTIONS
OF THE ADMINISTRATION I JUST
WANNA THANK YOU MISTER THANK
YOU MR CHAIRMAN SO WE HAVE
FIRST DR ERICA PANDAS ARE ACTING
STATE PUBLIC HEALTH OFFICER DR
GOOD MORNING EVERYONE
ASSEMBLYMEMBER TING AND --
COMMITTEE TO PLEASURE TO BE
HERE THIS MORNING TO PRESENT
TO YOU AND -- I WANT ACTUALLY
IS TO ACKNOWLEDGE -- SOME SOME
WORDS ATTRACT REGULAR JUST SAT
AROUND THIS IS OUR MOMENT AND
WE HAVE MADE GREAT PROGRESS
OVER THE LAST SEVERAL WEEKS
AND CALIFORNIA WITH A LOT
OF IMPROVEMENTS AND MOVEMENT
THROUGH THIS BLUEPRINT OF
THAT TIER CAN WORK AND I CAN
EXPLAIN TO YOU BUT BUT AS ALSO
MENTIONED IT'S VERY IMPORTANT
WE DO NOT LET OUR GUARD DOWN
THIS IS A TIME WHERE -- FLU
SEASON IS AROUND THE CORNER
AND ALL OF THEM INTERVENTIONS
GIRL DOING THIS PHYSICALLY
DISTANCING WEARING AMOUNTS
ARE INCREDIBLY IMPORTANT AND
-- AS WE SLOWLY AND SAFELY
WHICH WILL BE THE THEME OF
MY PRESENTATION TO ALLOW FOR
THINGS RE OPEN WE CANNOT LET
OUR GUARD DOWN SO THAT WE CAN
MAINTAIN OUR PROGRESS WE HAVE
SEEN IN THE LAST FEW DAYS IN THE
ASEAN SECRETARY GALA IS PRESS
CONFERENCE ON FRIDAY THAT WE
ARE SEEING SOME PLATEAUS AND
WE AGAIN WANT TO GO SLOWLY AND
SAFELY SO -- AGAIN WE CANNOT
LET OUR GUARD DOWN BUT WE ALSO
WANT ALLOWED THINGS RESUME
SO WITH THAT I WILL TALK TO YOU
ABOUT OUR CALIFORNIA BLUEPRINT
FOR SAFER ECONOMY AND IT'S
A PLAN ESSENTIALLY TOO SLOWLY
WE LUNCH ON AUGUST THIRTY
FIRST TO GRADUALLY ALLOW FOR
LOOSENING -- BUT ALSO HOW IT
WOULD IMPACT ITS RESTRICTIVE
THINGS VARIOUS SECTORS AND
ACTIVITIES IN THE STATE
HELLO TO ALLOW RE OPENING OF
ACTIVITIES AND BUSINESSES AFTER
THE STAY AT HOME ORDER THAT
STARTED IN MARCH IN IN JULY
EVERY COUNTY IN CALIFORNIA IS
COLOR CODED AND BASED ON A RADIO
TEST POSITIVITY IS THAT THE
NUMBER OF POSITIVE TESTS OVER
ALL THE TESTS THAT ARE DONE
TEST POSITIVITY AND CASE RATES
SO THE CASE RATE IS ESSENTIALLY
THE NUMBER OF CASES IN EACH
COUNTY DEVIDED BY IT'S A PER
CAPITA NUMBER AND THEN THERE
ISN'T JUSTICE AND WE'RE LOOKING
AT THOSE PER DAY SO THE CASE
RATE OF PEOPLE THREE HUNDRED
THOUSAND PER DAY AND THEN WE
JUST NOT PROTESTING VOLUME AND
THE REASON FOR THAT IS WE WANT
TO MAKE SURE COUNTIES ARE DOING
EVERYTHING THEY CAN TO CONTINUE
TO TEST AND DO WHAT WE CALL
CASE FINDING AND YOU FIND MORE
CASES ARE GOING TO INCREASE YOUR
CASE RIGHT SO AS COUNTIES ARE
DOING A LOT OF TESTING WE HAVE
SOME ADJUSTMENTS AROUND THAT TO
ALLOW FOR THAT AN INCREASE IN
TESTING SO THE OVERALL GOALS
AGAIN OR TO CONTINUE TO AGAIN
SLOWLY AND STRINGENTLY ALLOW
THE THE OPENING OF THE ECONOMY
BUT ALSO MAINTAIN A REDUCE
TRANSMISSION SO AS MENTIONED
YOU KNOW OUR WINTER IS COMING
-- A LOT OF THE SEEMS TO SEE AS
I TALK ABOUT THE SECTORS THAT
ARE ALLOWED OR NOT ALLOWED ARE
UP -- IT'S SAFER TO HAVE THINGS
OUTDOORS WITH THIS VIRUS BUT WE
KNOW THAT SOON WILL BE FORCED
TO DO MORE THINGS INDOORS AND
JUST THAT'S A NATURAL THING
TO DO AND OF COURSE WE'VE
SEEN SOME OF THOSE CHALLENGES
WITH THE RECENT WILDFIRES
AND AIR QUALITY IN HEAT --
AND AGAIN THE IMPACT IS TO
SEASON TYPICALLY WILL STRESS
OUR HEALTH CARE SYSTEM EVEN
JUST FLEW A LOAN WITH A BAD
FLU SEASON CAN REALLY STRESS
OUR SYSTEM AND WE'RE REALLY
WORRIED ABOUT WHAT WE'RE
CONCERNED ABOUT A POTENTIAL
TO ENDEMIC OR HAVE FLU AND CO
THE NINETEEN CASES FILLING OUR
HOSPITALS THIS WINTER SO BI
LINE IS PHASED IN RE OPENING
THAT HAS VARIOUS CHANGES IN
SECTORS AND THINKING ABOUT THAT
SECTOR'S POTENTIAL CONTRIBUTION
TO DISEASE TRANSMISSION WE
CAME UP WITH THIS FRAMEWORK
TO -- HAVE DIFFERENT GOALS
FOR COUNTIES AND BENCHMARKS
THAT THEY COULD SEE TO
ACHIEVE TO MOVE FORWARD SO
AGAIN THE BENCHMARK HAS WE
MOVE FROM WIDESPREAD JUST THE
PURPLE TIER TWO SUBSTANTIAL
JUST THE RED TIER TRANSMISSION
AND THEN MODERATE IS ORANGE AND
MINIMAL IS YELLOW AND EACH
COUNTY AGAIN WAS A SIGN ON
AUGUST THIRTY FIRST ONE OF THOSE
COLORS BASED ON THE THE CASE
REYES AND SEVENTY IN EACH COUNTY
AND -- I JUST WANTED
TO MENTION THAT OF COURSE LIKE
EVERYTHING ELSE AND WE ALL
LEARNED SO MUCH IN THE LAST
NINE MONTHS OF THIS PANDEMIC
-- AND IT CONTINUES OF ALL
A LOT OF THE LEARNING WE'VE DONE
WAS PUT INTO THIS FRAMEWORK AND
AS THINGS OF ALL WILL CONTINUE
TO REASSESS THESE METRICS AND
THRESHOLDS WITH THE DATA WE HAVE
BOTH IN THE STATE AND LOOKING
NATIONALLY AND GLOBALLY SO WHAT
THIS RUMOR DID WAS REPLACE THE
PREVIOUS COUNTY DATA MONITORING
THIS WHICH WAS REALLY AN HONOR
OFFICE HE COUNTY'S READER ON
THE LIST ARE OFF THE LIST AND
THEN MANY THINGS WERE EVEN OPEN
OR CLOSED SO WE REALLY WANT TO
COME OUT WITH A PAYMENT AGAIN
THAT HAS TEARS AND PHASES OF
PEOPLE COULD SORT OF SLOWLY
AND SAFELY MARCHED THROUGH
THEM AND ALSO THE DIFFERENT
SECTORS POTENTIALLY START TO
OPEN CAREFULLY AT A SMALLER
CAPACITY OR START OUTDOORS
AND THEN GRADUALLY MOVED
INDOORS YOU'LL SEE THAT THEME
AND DIFFERENT PARTS OF THE
WHAT'S ALLOWED IN DIFFERENT
SECTORS AND DIFFERENT TIERS
AS OF SUIT AGAINST KIND
OF REVIEW THE RULES OF THIS
REMARK SO AGAIN WE ASSIGNED
ALL THE COUNTIES TO IT HERE ON
AUGUST THIRTY FIRST AND WHAT WE
LOOKED AT WAS -- WE LOOKED AT
SEVEN DAY CASE REYES AND SEVENTY
TEST POSITIVITY AND WE LOOK AT
THOSE WITH THE SEVEN DAY LAG
BECAUSE IT DOES TAKE A LITTLE
BIT OF TIME THAT'S DEFINITELY
IMPROVED OUR TURNAROUND TIME NOW
THE STATE IS AN AVERAGE OF ONE
POINT TWO DAYS BUT IT DOES TAKE
TIME BETWEEN THE TIME THE PERSON
IS TESTED THE TEST RESULTS COME
AND THAT WE RECEIVE THAT DATA
AT THE STATE HEALTH DEPARTMENT
SO WE GET THE MOST ACCURATE
-- BALANCE OF ACCOUNTING FOR
TIME DELAYS IN GETTING THE TEST
RESULTS BUT ALSO NOT BEING TO
BEHIND AND LOOKING AT OUR TRENDS
THAT THE SEVEN DAY LACKS -- WE
LOOK AT THOSE WEEKLY WE RUN A
DATA EVERY MONDAY AND THEN WE
LET THE LOCAL HEALTH DEPARTMENTS
NO ON MONDAY AFTERNOON TO
GET A BARGAIN LIST OF WHERE
THEY'RE SAYING IT'S GOING TO
BE AND THEN ON TUESDAYS SO AT
NOON TODAY WILL BE ANNOUNCING
WHERE THE DIFFERENT COUNTIES
ARE GOING TO MOVE TO SO SOME
OF THE OTHER BASELINE RULES
ARE AGAIN AS IN THE SPIRIT OF
MOVING SLOWLY EVERY COUNTING
IS V. AND A CERTAIN TEAR FOR
AT LEAST THREE WEEKS SO AGAIN
IDEAS AND YOU LOOK AT MODELING
OF THE IMPACT OF OPENING THINGS
OR ARE PEOPLE INTERACTING
MORE AND MIXING MORE IT TAKES
TYPICALLY TWO TO FOUR WEEKS TO
SEE THE IMPACT OF THAT BASED ON
THE COMMISSION PARENT OF THIS
VIRUS SO AGAIN THE RULES EVERY
COUNTY HAS TO BE IN A PHASE
FOR THREE WEEKS -- ALSO
THE COUNTY SAY YOU'RE IN PURPLE
AND YEAR TESTING POSITIVITY
IN YOUR CASE RATE IMPROVE VERY
QUICKLY HERE SOMEHOW AN ORANGE
YOU CANNOT SKIP RIGHT YOU
STILL HAVE TO GO NEXT TO RED
HAT TO BE THREE WEEKS AND READ
BEFORE YOU CAN DO SO AGAIN WE
WANT TO DO THIS SAFELY SLOWLY
AND ALSO THE OTHER RULES ARE
THAT IF THE COUNTY HAS AGAIN
SAY YOU'RE IN PURPLE AND THEN
-- YOU HAVE THAT TEST POSITIVITY
AND READ BUT YOU'RE TO HIS
GREATEST ON PURPLE YOU STILL
REMAIN AT THE MORE RESTRICTIVE
COLOR CODE THANK YOU DON'T YOU
CAN HAVE A TO RENTAL BOTH YOUR
CASE RATE AND A TEST POSITIVE
HERE AND LESS RESTRICTIVE TEAR
DURING THE WEEKLY SAY
ASSESSMENTS -- WE LOOK AT AGAIN
LOOK AT THE THE PRIOR WEEK AND
THE WEEK BEFORE SO IN ORDER TO
MOVE FORWARD AFTER THREE WEEKS
YOU HAVE TO MEET TWO WEEKS
OF CRITERIA OF BEING THE LESS
RESTRICTIVE HERE SO IF YOU'RE
IN PURPLE NOW THAT LAST WEEK YOU
MIGHT READ IT AND WEEP FOR YOU
THAT RIGHT THEN YOU CAN GO CHECK
THAT TODAY SO THAT'S AGAIN SO
YOU HAVE TO STAY IN ONE PLACE
FOR THREE WEEKS BUT THEN IN
ORDER TO SHOW YOUR PROGRESS AND
STABLE PROGRESS YOU HAVE TO SHOW
YOUR COUNTY IS GOTTEN BETTER
METRICS FOR TWO WEEKS BEFORE YOU
CAN AFFORD INTO THAT TEXTURES AT
TIER -- AND THEN IT'S
ALSO VERY IMPORTANT TO POINT
OUT AND AS A FORMAL LOCAL HEALTH
DEPARTMENT OFFICIAL MYSELF THE
LOCAL HEALTH DEPARTMENT STILL
OF COURSE HAVE THE AUTHORITY
TO BE STRICTER THAN THE STATE
IF THEY CHOOSE TO SO WE HAVE
A LOT OF INFORMATION OUT THERE
ABOUT THE STATE CAN ALLOW AND IN
CERTAIN JURISDICTIONS MAY CHOOSE
TO BE STRICTER SO IT'S JUST
IMPORTANT FOR OUR CITIZENS ALL
SO ANOTHER COMMON QUESTION
IS ABOUT HOW DO WE DETERMINE
WHETHER SECTOR IS LOW MEDIUM
OR HIGH RISK AND WHAT ARE THE
PRINCIPLES THAT WE THINK ABOUT
WE DO THIS SO THE ABILITY TO
ACCOMMODATE FACE COVERINGS ARE
WEARING MASKS IS VERY IMPORTANT
SO THAT'S WHERE PLACES WHERE
PEOPLE ARE EATING OR DRINKING AS
A HIGHER REST BECAUSE YOU CANNOT
BE WEARING YOUR FACE COVERINGS
AVAILABILITY TO PHYSICALLY
DISTANCE BETWEEN INDIVIDUALS
FROM DIFFERENT HOUSEHOLDS THE
ABILITY TO LIMIT THE NUMBER
OF PEOPLE PER SQUARE FOOT SO
AGAIN THE FOR THEIR PART PEOPLE
AREN'T THE SAFER THE ABILITY TO
NUMBER ON THE WAY TO LIMIT THE
DURATION OF EXPOSURE SO LONGER
EXPOSURES ARE CERTAINLY HIGHER
RISKS OR EXPOSURES GOING TO
THE STORE BRIEFLY AND RUNNING
IN GETTING SOMETHING COMING
HOME IS MUCH DIFFERENT THAN
SITTING IN A TWO HOUR EVENT
AND THE ABILITY OF COURSE
ABOUT MIXING YOU WANT TO REALLY
MINIMIZE MIXING PEOPLE ACROSS
AND HOUSEHOLDS AND CERTAINLY
ACROSS DIFFERENT COMMUNITIES
-- AND AGAIN REALLY INVENTED
LIMITING THE AMOUNT OF PHYSICAL
INTERACTIONS OF PEOPLE MIGHT
HAVE THAT ALL WITH OTHERS AND
THEN FINALLY SEVEN LEARNED AGAIN
MORE AND MORE OVER THE LAST
FEW MONTHS THAT THERE'S A MUCH
HIGHER RISK OF THIS VIRUS BEING
TRANSMITTED TO PEOPLE INDOORS
AND VENTILATION IS REALLY
IMPORTANT AND THAT IS WHY VERY
EARLY ON WHEN THERE'S A LOT OF
FLIGHTS FOR DISEASE TRANSMISSION
IT'S MOSTLY OUTDOOR ACTIVITIES
THAT ARE ALLOWED AND NOT
AND THEN THE OTHER THING THAT
REALLY INCREASE SPREAD OR
-- MAKE SPREAD GO FURTHER A
THINGS LIKE SINGING SHOUTING
HEAVY BREATHING SO WHEN YOU'RE
EXERCISING -- AND THEN IF
YOU'RE IN ALLOWED ENVIRONMENT
IT NEEDS ARE MORE LIKELY TO BE
RAISING YOUR VOICE OR SHOUTING
WHICH AGAIN COULD PROPEL THE
DISEASE FURTHER AND IS HIGHER
RISK SETTING -- AND THEN
YOU'LL HEAR A LOT MORE ABOUT
THE THE DATA COLLECTION SYSTEM
BUT JUST BRIEFLY THE WAY IT
WORKS IS THERE ARE OVER EIGHTY
MANDATED REPORTABLE DISEASES
TO LOCAL HEALTH DEPARTMENTS
BY CLINICIANS AND A SHORT
LIST OF THOSE RELAPSE AND CODE
NINETEEN CERTAINLY PART OF
A BOOK BY CLINICIANS AND LAB
SO WE RECEIVE THAT DATA AND A
COUPLE DIFFERENT WAYS WE HAVE
ELECTRONIC LAB REPORTING NOW
COMES IN TO RECOVER THE SYSTEM
WHICH MY COLLEAGUE WILL BE
EXPANDING FURTHER TO YOU AND
THEN THE -- CLINICIANS REPORT
CASES ALSO TO LOCAL DEPARTMENTS
AND THEY ENTERED INTO THE SYSTEM
THAT ALSO GOES TO OUR STATE
HEALTH DEPARTMENT AND THEN
WE JUST -- WE CALCULATE THOSE
ADJUSTED KEY STREETS AND TEST
POSITIVITY AS I WAS EXPLAINING
-- AND THEN ANOTHER COMMON
QUESTION I JUST WANTED TO COVER
IS HOW DOES THIS AFFECT SCHOOLS
SO WHEN WE TRANSITION TO THIS
BLUEPRINT WE WANTED TO MINIMIZE
ANY CHANGES WHAT WE'VE ALREADY
DECLARED ABOUT THE RE OPENING
OF SCHOOLS AND SO THE PURPLE
TEAR WAS BASICALLY VERY SIMILAR
TO THE -- THRESHOLDS FOR THE
COUNTY DATA MINING LIST SO THAT
WAS SORT OF THE HIGHEST LEVEL
AND WE IT'S NOT ALREADY THAT
SCHOOLS COULD BE OPEN ONCE THEY
WERE TWO WEEKS OFF AT THE DATA
MODERN LIST SO THE EQUIVALENT
OF THAT IS ONCE THEY'RE IN THE
RED TERROR AND OUT OF THE PURPLE
TOUR FOR TWO WEEKS OR MORE
SCHOOLS TO RE OPEN SO THAT IS --
AS YOU CAN SEE ACROSS THE STATE
WHAT IS GRADUALLY HAPPENING AS
WELL ONE SCHOOLS ARE OPEN IN
THE RED HERE IF THEY'RE COUNTY
WAS BACK INTO THE PURPLE TEAR IT
DOES NOT NECESSARILY MEAN THEY
NEED TO CLOSE I THINK THERE MAY
BE INCREASED VIGILANCE OF COURSE
AND -- INCREASE POTENTIALLY
INCREASE TESTING -- IN THAT
SETTING BUT WE'VE RECOGNIZE THE
DESTRUCTION OF REAL OPENING AND
CLOSING AND WE REALLY WANT TO
MINIMIZE AGAIN AND SORT OF FLY
THERE SOMEBODY PRINCIPLES THAT
TAKING TIME FOR THERE'S MOVEMENT
SO THEY'RE NOT KIND OF HAVING
A WITH LACKS BETWEEN DIFFERENT
TIERS FINALLY THERE'S A COUNTY
DATA EDUCATION PROCESS WHICH
WE ARE FINALIZING WITH THE
WORKING WITH THEIR LOCAL HEALTH
DEPARTMENT PARTNERS ARE CAN HELP
EXECUTIVES GROUP AND OUR COUNTY
HEALTH OFFICERS ORGANIZATION TO
DEVELOP AN ADJUDICATION PROCESS
OF THAT IF I COUNTY YOU KNOW
AND BACK TO YOUR POINT ABOUT
IF THERE ARE ANY DISCREPANCIES
BETWEEN THE DATA AT THE LOCAL
HEALTH DEPARTMENT SEEING ON
THE GROUND -- AND WHAT WE'RE
SEEING IN THE STATE HEALTH
DEPARTMENT WE WANNA CERTAINLY
-- ACKNOWLEDGE AND RESOLVE ANY
DISCREPANCIES IN THE ACTUAL
DATA AND THEN THERE'S ALSO SOME
CONTEXTUAL IMPORTANCE ABOUT SO
ESPECIALLY IN SOME OF THE SMALL
COUNTIES THERE ARE SITUATIONS
WHERE MAYBE ONE LARGE AFRICAN
ONE LARGE FAMILY CLUSTER REALLY
CHANGES THEIR TEST POSITIVITY
RATHER CASE RIGHT SO THINGS
LIKE THAT ARE A LARGE OUTBREAK
THAT REALLY IS CONTAINED --
THE HEALTH DEPARTMENT FEELS
COMFORTABLE THAT IT'S ON THE
RIGHT TRENDS THAT THEY THEY
COME TO US AND SAY WOULD LIKE
AN EDUCATION TO DISCUSS WHETHER
OR NOT THIS THIS HAS IMPACTED
OUR METRICS AND MAYBE WE SHOULD
HAVE -- YOU KNOW EITHER MORE
TIME OF POTENTIALLY OR MORE
CONSIDERATION ABOUT WHY WE'RE
MOVING INTO THE NEXT YEAR SO
WE'RE FORMALIZING THE PROCESS
WE'VE HAD SOME INFORMAL --
SITUATIONS OVER OUR FIRST FEW
WEEKS AND WE'RE FORMALIZING THAT
SHOULD BE FINALIZED THIS WEEKEND
POSTED -- THERE'S MORE DETAILS
ON OUR WEBSITE ABOUT HOW THESE
METRICS ARE CALCULATED AND FOR
THE PUBLIC AGAIN TO GET THIS
INFORMATION EVERY TUESDAY WE
UPDATE THE COUNTY MAP ON COVERT
NINETEEN DOT CA DOT GOV AND ANY
INDIVIDUAL CAN CATCH UP PENSION
THEIR COUNTY AND SEE WHAT THE
STATE WILL ALLOW AND THAT COUNTY
BASED ON THE DIFFERENT SECTORS
-- AGAIN THEY ALWAYS DID ALSO
CHECK WITH YOUR LOCAL HEALTH
DEPARTMENT ABOUT WHAT IS A LOT
THAT THAT THAT'S A NICE AND EASY
WAY TO JUST LOOK AT THE MAP AND
SEE WHERE WE ARE AS A STATE AND
WHAT'S ALLOWED IN YOUR COUNTY
SO WITH THAT I WILL PAUSE AND
SEE IF YOU HAVE ANY QUESTIONS
BLACK TO THE TWO KIDS JUST DON'T
HAVE ALL THE PANELISTS SPEAKING
INTO QUESTIONS AT THE END
SHOWS WILL JUST AT THIS POINT
JUST MOVED TO SUSAN FANELLI
OKAY GOOD MORNING TURN MEMBERS
I'M SUSAN VALLEY CHIEF DEPUTY
DIRECTOR OF THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH
I'M HERE TO PROVIDE YOU WITH
BACKGROUND ON THE CALIFORNIA
REPORTABLE DISEASE REPORTING
SYSTEM KNOWN AS CAL READY --
FIRST I WANT TO SAY THAT WE
AS A DEPARTMENT AND AGENCY ARE
COMMITTED TO YOU TIMELY AND
ACCURATE DATA CAL READY IS
THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH'S COMMUNICABLE
DISEASE REPORTING AND
SURVEILLANCE SYSTEM OF RECORD
IS USED BY STATE AND LOCAL
PUBLIC HEALTH OFFICIALS AND
HEALTH CARE PROVIDERS FOR
COMMUNICABLE DISEASE REPORTING
AND SURVEILLANCE CALGARY ALLOWS
PUBLIC HEALTH STAFF TO SECURELY
COLLECT DATA INVESTIGATE CASES
OF COMMUNICABLE DISEASES AND
MANAGE OUTBREAKS THE SYSTEM OF
THE ALLOWS FOR SECURE SHARING OF
DATA BETWEEN THE STATE AND LOCAL
PUBLIC HEALTH STAFF HOWEVER
THE CORE CAL READY SOFTWARE
IS BASED ON TECHNOLOGY THAT IS
TWENTY YEARS OLD LOCAL HEALTH
DEPARTMENTS LABORATORIES AND
HEALTH CARE PROVIDERS ALL ARE
ABLE TO CEMENT COMMUNICABLE
DISEASE INFORMATION TO CAL
READY INFORMATION NOT CAPTURED
AND CAL READY INCLUDES RACE AND
ETHNICITY WITH API SUBGROUPS
ASIAN PACIFIC ISLANDER SEXUAL
ORIENTATION AND GENDER IDENTITY
AGE ADDRESS CLINICAL INFORMATION
DIAGNOSIS INFORMATION AND RISK
FACTOR INFORMATION SO G. DATA
DATA WAS ADDED ON JULY WITH
THE RELEASE OF NEW EMERGENCY
REGULATIONS API INFORMATION
IS DISAGGREGATED TO HELP
IDENTIFY DISTINCT POPULATIONS
MUCH OF THIS INFORMATION IS
COLLECTED BY LOCAL HEALTH
JURISDICTIONS IN CASE REVIEW
BACK TO THE ORIGINAL BUILD OF
THE CAL READY SYSTEM IT WAS
NOT INTENDED TO WITHSTAND THE
VOLUME OF DATA WE ARE CURRENTLY
RECEIVING UNLIKE ALL OTHER
REPORTABLE INFECTIOUS DISEASES
THAT WE'VE DEALT WITH PROVIDERS
AND LABORATORIES ARE ARE
PROVIDED TO PROVIDE NOT ONLY
DOES TEST WITH A POSITIVE RESULT
BUT ALSO ALL NEGATIVE HOUSE
ON THEM FOR AT SIGNIFICANTLY
EXPANDING THE VOLUME OF THAT
DATA BEING COLLECTED AS YOU
KNOW WE HAVE OVER FOURTEEN
POINT FIVE MILLION PASS ALREADY
IF YOU LOOK AT THE DASHBOARD IN
MID JULY THE FIRST YEAR SO
THE PROBLEM WAS AN OUTAGE
IN THE CDPH GATEWAY THE PATH
THAT PROVIDERS USE TO ENTER
INFORMATION ON THE CASE AS THIS
RESULT IN A LARGE BACKLOG OF
THE DATA FLOW INTO CAL READY
ADDITIONALLY DURING THIS TIME
PERIOD THE STATE SECURITY
CERTIFICATE AT THAT CONTROLS
THE CONNECTION BETWEEN THE
CDPH GATEWAY ENTRY INTO THE
SYSTEM AND THE ASSOCIATION OF
PUBLIC HEALTH LABS INFORMATICS
MESSAGING SERVICE SAYS THAT IS
THEY ARE THE INTERMEDIARY THAT
TRANSMITS THE DATA FROM COST
LABORATORIES TO CDPH AS YOU
NO COST AS A LARGE LABORATORY
AND THAT CERTIFICATE EXPIRED
THE RESULT WAS THAT THERE IS
A LARGE NUMBER OF DUPLICATE
CASES IN CAL READY AT THE SAME
TIME THAT CROSS LAB REPORTS
WERE NOT BEING RECEIVED AT
ALL THE CALIFORNIA DEPARTMENT
TECHNOLOGY HAS BEEN EXCELLENT
POCK PARTNER AND IS RESOLVING
THE ISSUE IN RESOLVING THE
ISSUES IN THE SYSTEM AND
THEY'RE HERE TODAY TO SPEAK TO
THE PROJECT MANAGEMENT OF THAT
RESOLUTION IN ORDER TO CREATE
A PERMANENT SOLUTION AND WE ARE
ACCELERATING THE DEVELOPMENT
OF A NEW LABORATORY REPORTING
SYSTEM FOR KOBE IN PARTNERSHIP
WITH THAT AND DEPARTMENT
TECHNOLOGY WE BEGIN THE
PROCUREMENT PROCESS SO WE CAN
IDENTIFY TECHNOLOGY SOLUTION
THAT WILL HELP US COLLECT THE
VOLUME AND COMPLEXITY OF DATA
MOVING FORWARD I'M
C. C. R. S. OR THE CALIFORNIA
COVERT REPORTING SYSTEM WAS
COMPLETED -- AND THIS IS SORT
OF THE INTERMEDIARY STAPP WAS
COMPLETED N. AS IN THE USER
ACCEPTANCE TESTING PHASE THIS
I'M SYSTEM WILL ALLOW ALL LIKE
TRONIC LABORATORY IN COMING
INTO THE STATE THIS SYSTEM ON
CRITICAL GOOD REPORTING SYSTEM
THAT CONSUMES THE DATA FROM
CAL READY LOS ANGELES AND SAN
DIEGO USE DIFFERENT SYSTEMS
ON THE GROUND AND PROVIDED
HOGAN REPORTING DATABASE THAT
IS USED TO DELIVER THE DAILY
PUBLIC METRICS REQUIRED BY THE
GOVERNOR'S DASHBOARD ON THIS
WILL PROVIDE A MORE STABLE
SOLUTION AND ENSURE MORE
CONSISTENT -- ABILITY AND
STABILITY IN THE SYSTEM IN
ADDITION IN ADDITION TO
IDENTIFYING THAT NEW TECHNOLOGY
SOLUTION WE HAVE ESTABLISHED
NEW PROTOCOLS AND NOTIFICATIONS
WHEN ANY SYSTEM CHANGES ARE
MADE WE HAVE MADE UPGRADES TO
OUR SERVERS TO ENSURE THAT WE
HAVE EXTRA CAPACITY WE BUILT
RIGHT DOWN THAT PROCESS USED TO
VALIDATE THE DATA -- ON DATA
REPORTS OF WHAT'S COMING AND
WHAT'S THE SYSTEM IS READING
AND WE STRENGTHEN OVERSIGHT
MONITORING SO CASE DATA ARE
COMPLETE TIMELY INVALIDATE AT
ADDITIONALLY WE'VE CREATED A
TEAM THAT HAS BEEN REACHING
OUT TO A SYSTEM WORK WITH OUR
LOCAL HOUSE JURISDICTIONS IN
PROCESSING THEIR CASES AND
ALSO ARE AT THE STAFF CONTINUES
TO WORK WITH OUR LOCAL HEALTH
JURISDICTIONS TO RESOLVE ANY
DATA ISSUES AND EXPLAIN THE
STATE METHODOLOGY WERE NEED AT
AT THAT TIME WE HELD COUNTY'S
HARMLESS BY RETROACTIVELY
APPLYING THE DATA AND UPDATING
THE COUNTY DATA MONITORING LAST
AS YOU KNOW WE HAVE NOW MOVED
TO THE BLUEPRINT THAT ERICA
JUST TALKED ABOUT THE DATA
ISSUES DID NOT IMPACT COUNTY'S
PLACEMENT IN THAT TIERED SYSTEM
THANK YOU VERY MUCH FOR YOUR
TIME THE CALIFORNIA DEPARTMENT
TOP TECHNOLOGY WILL PROVIDE
INFORMATION ON PROJECT
MANAGEMENT AND OVERSIGHT OVER
THE PROCESS USED TO RESOLVE
THE CONRADIE DATA ISSUES
AND WE HAVE GARY KNOW DEAN
R. I. T. DEPUTY DIRECTOR
HERE TO ANSWER ANY SPECIFIC
POWER ANY QUESTIONS THANK YOU
THANK YOU WE CAN NOW
GO TO RON ROBINETTE
THANK YOU THIRTEEN M. MEMBERS
OF THE COMMITTEE MY NAME IS RON
ROBINETTE I AM I AM A BRANCH
CHIEF OVER PROJECT APPROVALS
AND OVERSIGHT AS DEPARTMENT OF
TECHNOLOGY IN EARLY AUGUST I
COORDINATED INCIDENT MANAGEMENT
AND SUPPORT FOR THE COVER
THE SYSTEM ISSUE I'M GOING
MY TEAM IS PROVIDE PERFORMING
OVERSIGHT AT THE CDPH PROJECT
PORTFOLIO AND ALSO PROVIDING
SYSTEM ADVISORY SUPPORT FOR
OPERATIONS AND MAINTENANCE
ISSUES I AM TWENTY FIVE YEARS
EXPERIENCE IN INFORMATION
TECHNOLOGY TWENTY FOUR WITH THE
STATE OF CALIFORNIA AND I AM
PROJECT MANAGEMENT CERTIFIED BY
THE INTERNATIONALLY RECOGNIZED
PROJECT MANAGEMENT INSTITUTE ON
AUGUST THIRD CDT WAS CONTACTED
BY CDPH IN RESPONSE TO DATA
ISSUES AND CAL READY CDT GOT
ENGAGED IN THE CAPACITY OF
INCIDENT RESPONSE IN MANAGEMENT
SPECIFICALLY WE WERE BROUGHT
IN TO CLEAR THE BACKLOG OF
LAB RESULTS TO PERFORMANCE
OF THE ENTIRE CAR READY
APPLICATION AND ITS ECOSYSTEM
OF REPORTING AND ANALYZE YOUR
AND LONG TERM CAPABILITIES
OF COVERT RECORDING CDT
ASSEMBLED AN INCIDENT RESPONSE
TEAM CONSISTING OF SENIOR
LEVEL EXPERTISE IN ENTERPRISE
TECHNOLOGY DATA MANAGEMENT DATA
POLICY -- MET DATACENTER
ENTERPRISE ARCHITECTURE AND
PROJECT MANAGEMENT WE ALSO
LEVERAGE INDUSTRY PARTNERS
SUCH AS MICROSOFT LINEATED
FOR THE WRAPS THE MESSAGING
JIN AND SUN QUEST FOR THE CAT
READY APPLICATION THE TEAM
PERFORMS ROOT CAUSE ANALYSIS
WHILE SETTING UP INDEPENDENT
VALIDATION PERFORMANCE
DASHBOARDS TO MONITOR INCOMING
MESSAGES TO ENSURE DATA QUALITY
WELL WE CONTINUE PROCESSING
THREE TWENTY HOUR WORK DAYS
OVER A WEEK WITH CITY PH STAFF
AND CITY INCIDENT RESPONSE TEAM
AND VENDORS BY NINE AM SUNDAY
AUGUST NINE WE CLEAR THE BACKLOG
IN INCOMING LAB RESULTS NOW
HAD PARALLEL VALIDATION ENGINES
TO DOUBLE CHECK PROCESSING
THE IMPROVEMENTS RESULTED IN
DATA PROCESSING THROUGHPUT
INCREASES FROM FORTY THREE
HUNDRED TO TWENTY FOUR THOUSAND
PER HOUR A FIVE X. INCREASE
THE END OF THE PROCESS OF
BABBITT TO CASE REPORTING
INCLUDING LOCAL HEALTH
JURISDICTIONS ACCESS TO DATA
WAS ALSO TUNED IN IMPROVE
WITH ADDITIONAL QUALITY
ASSURANCE MEASURES SUCH AS THE
ESTABLISHMENT OF INDEPENDENT
DATA VERIFICATION CHANNEL AS AN
INTERIM SOLUTION AFTER THE
IMMEDIATE ISSUE WAS RESOLVED
CITY CONTINUED TO WORK WITH
THE C. PH TEAM TO STABILIZE
THE ENVIRONMENT FURTHER SYSTEM
RESILIENCE WAS BUILT TO PROVIDE
AN ADDITIONAL DATA FLOW CHANNEL
AND CAN BE USED AS A FAIL
OVER SERVICE YOUR PRODUCTION
SYSTEMS HAVE AN ISSUE AGAIN
RIGOROUS CHANGE MANAGEMENT
PROCESS WAS IMPLEMENTED WITH
APPROVAL REQUIRED FROM BOTH
CDPH SENIOR MANAGEMENT AND
CDT AND WE CONTINUE DAILY
MONITORING FOR DATA AT EVERY
HANDOFF IN TOUCH POINT OF
THE SYSTEM SO ISSUES CAN BE
SPOTTED EARLY AND RESOLVE TIMELY
AS A RESULT OF THE INCIDENT
RESPONSE AND STABILIZATION
SINCE THEN THERE'S BEEN NO
UNPLANNED DOWNTIME ON SYSTEMS
DATA IT'S CHECKED AND VALIDATED
EVERY DAY WITH INDEPENDENT
DASHBOARDS DISCREPANCIES ARE
SPOTTED EARLY AND RESOLVE
TIMELY TO ENSURE DATA INTEGRITY
AT THE HIGHEST POSSIBLE LEVEL
IN ADDITION TO FIXING THE
IMMEDIATE ISSUES CITY TEAM BEGAN
ORGANIZING A PROACTIVE MEASURE
GO FORWARD PLAN IN ANTICIPATION
OF AN EVEN LARGER VOLUME OF
PROVIDE SPECIFIC TEST STARTING
IN THE FALL ON AUGUST TWELFTH
A NEW COVERED REPORTING SYSTEM
PROCUREMENT WAS CONDUCTED
VIA COMPETITIVE PROCUREMENT
BIDS WERE DUE AUGUST FOURTEEN
AND OVER TWO HUNDRED VENDORS
ATTENDED THREE BIDDERS
CONFERENCES THIRTY EIGHT
SUBMITTED PROPOSALS AND BE A
FURTHER DEMONSTRATION OF THE
SOLUTION BY TOP CANDIDATES
OPTIM WITH SELECTED AS THE
SOLUTION PROVIDER FOR THE
COVERT REPORTING SYSTEM
ON AUGUST TWENTY FIVE PSE
AND THE GO SHE ASIANS WITHIN
ELEVEN DAYS THE CUPBOARD
REPORTING SYSTEM DOES NOT
REPLACE CAL READY SINCE CAL
READY IS THE SYSTEM OF RECORD
FOR ALL DISEASE IN CALIFORNIA
SUCH AS TUBERCULOSIS SIX ADDRESS
FIFTY NINE WE PROVIDES A
DEDICATED SPACE TO PROCESS
HOPE IT SPECIFIC DATA AT
A VOLUME THAT CAL READY
WAS NOT DESIGNED FOR CDPH
HAS A SEPARATE AN ONGOING
EFFORT TO EVALUATE CAL READY
REPLACEMENT AND CDC'S ROLE IN
THIS NEW SYSTEM IS PROCUREMENT
AND PROJECT OVERSIGHT AND WE
ARE CLOSELY MONITORING AND
WORKING WITH CD P. H. AS THE
COVERED SYSTEM IS ABOUT TO
LAUNCH EARLY OCTOBER THANK YOU
FOR YOUR TIME AND I'M HAPPY TO
ANSWER ANY SPECIFIC INCIDENT
QUESTIONS THAT YOU MAY HAVE
THANK YOU NOW WE HAVE A SENIOR
PATRICK FROM THE LEGISLATIVE
ANALYST'S OFFICE NEXT
HEY CAN YOU HEAR ME
YES WE CAN HEAR YOU FINE
THANK YOU OKAY THANK YOU VERY
MUCH GOOD MORNING MR CHAIRMAN
MEMBERS AND WE WERE ASKED
TO BE HERE TAPE TO ANSWER
ANY QUESTIONS THAT MEMBERS
OF THE SUBCOMMITTEE MAY HAVE
AND I AM HAPPY TO DO SO AT
ANY TIME THANK YOU VERY MUCH
THANK YOU LET'S GO BACK
TO THE COMMITTEE QUESTIONS
MISTER COOPER WITH
THANK YOU MISTER CHAIR
FROM HER MAKESHIFT HOSPITAL
FLAT FACILITIES SHARING AND
TRACKING TESTING RESULTS
NO V. FOR PUBLIC HEALTH
EACH
FOR DEPARTMENT OF PUBLIC HEALTH
IF YOU'RE IN THE ROOM FOR
SOME REASON IT'S NOT COMING I
THINK IF TO START TALKING TO
CAN YOU SEE ME AGAIN NOW
YES THANK YOU I'M SURE AND
CAN YOU REPEAT THE QUESTION
SORRY ABSOLUTELY SO HOW
ARE THE MAKESHIFT HOSPITALS
LAST FACILITIES SHARING AND
TRACKING TESTING RESULTS
SO BASICALLY ALL HEALTHCARE
SYSTEMS IN A LABORATORY TEST
RESULTS ARE SUBMITTED TO --
ALL LABS ARE ACTUALLY MANDATED
TO REPORT THAT DATA TO US
THROUGH OUR ELECTRONIC LAB
CELESTINO SO WAS CALIFORNIA
USING PAPER RECORDS
-- I MEAN THAT IS SOMETHING
WE ARE WORKING VERY ACTIVELY
ON I THINK THE OTHER ISSUE
THAT'S GONNA FALL THIS THESE
POINT OF CARE WILL BE HIGH
ANTIGEN TESTING AND THOSE
ARE POINT OF CARE THEY DON'T
HAVE AN ELECTRONIC WAY TO
DO IT BUT THERE IS A MANDATE
ITS TITLE SEVENTEEN SECTION
TWENTY FIVE OF AYE WHERE OLIVER
TORIES ARE REQUIRED TO DO NOT
SO AS NEW LABS ARE COMING ON
BOARD SOMETIMES THAT'S NOT
THE FIRST THING THEY -- YOU
KNOW I GET A LOT OF WHETHER
EVOLVING WITH THIS PANDEMIC AND
-- SO THEY FIRST GET THEIR
TECHNOLOGY FOR THEIR ACTUAL
LABORATORY TESTING AND THEN
THEY REALIZE THAT THEY HAVE TO
REPORT TO US AND THEY'RE AND
THEY'RE ACTIVELY WORKING ON
DOING THAT BUT I WOULD ALSO SAY
THAT CLINICIANS STILL ARE STILL
SOMETIMES FAXING OR SOMETIMES
LEADS ARE FAXING DATA IS TRUE
TO LOCAL HEALTH DEPARTMENTS SO
THAT IS SOMETHING THAT ON ALL
LEVELS DIFFERENT ORGANIZATIONS
ARE WORKING ON IT BUT THE
CIRCLING BACK IN THIS DAY AND
AGE OBVIOUSLY WITH THE NAVY
SHIP MERCY IN OUR CAREER HERE
IN SACRAMENTO THESE PAPER FILES
WITH ELECTRONIC TRACKING ABILITY
IT'S JUST MIND BOGGLING THAT
WE AREN'T USING ELECTRONIC
RECORDS OR SONY SYSTEMS OUT
THERE OFF THE SHELF SYSTEMS --
IT JUST SEEMS VERY CUMBERSOME
TO HAVE A PAPER SYSTEM
HELLO WHY IS THAT WITH WITH
SO MANY ITEMS OR SOMEBODY
PROGRAMS AVAILABLE I
MEAN I THINK THAT'S A COMMON
QUESTION WE HELLER ARE WANTING
TO TO UPDATE OUR RESOURCES
COLLECTIVELY BUT I GUESS I'M
A PERSON ON THAT BECAUSE THERE
ARE OFF THE SHELF SYSTEMS NOT
I MEAN IT'S NOT A LOT OF MONEY
TO TO GET A SYSTEM LIKE THIS
TO DO ELECTRONICALLY SO -- WHY
HAVEN'T WE DONE THAT YEAH IT'S
REALLY CONNECTING THOSE ON THE
HOSPITAL LABS OR OTHER SYSTEMS
AND COULD YOU COULD YOU SIT DOWN
PLEASE YEAH KINSMEN LABORATORY
INFORMATION MANAGEMENT SYSTEM
SO IT'S THE I. T. CONNECTIVITY
TO THOSE SYSTEMS THAT WE'RE
WORKING ON AND I THINK OUR
NEW SYSTEM THE C. C. R. AS
SYSTEM THAT WE'RE BUILDING WILL
PROVIDE AN EASIER WAY AFTER
A LOT FOR -- SOME OF THESE
HOSPITALS AND LABS TO CONNECT
INTO THE SYSTEM SO WE ARE AWARE
OF THAT WE'RE CONCERNED ABOUT
IT AS WELL AND WORKING WITH
PROVIDERS TO GET THEM AS QUICKLY
ON TO THE SYSTEM AS WE CAN
SO OBVIOUSLY WE'RE YOU KNOW
SEVEN MONTHS INTO THIS -- THE
NAVY SHIP IS GONE ALLEN ARE
KOREANS NOT BEING USED SO HOW
FAR AWAY ARE WE FROM -- BRINGING
THE TRUCK FILES ON BOARD
I THINK FOR THE MOST PART WE
DO HAVE A LOT TRAINING FILES
IT'S AS NEW LABS ARE NEW HEALTH
CARE -- COMES ON BOARD THAT WE
HAVE TO GET THEM CONNECTED AND
SO WE'RE WORKING THROUGH THAT
SYSTEM WE THINK IT'LL BE MUCH
EASIER WITH AND I'LL HAVE I HAVE
R. I. T. FOLKS TALK TO IT BUT
ONE OF THE BENEFITS TO THE C. C.
R. S. SYSTEM WILL BE AN EASIER
WAY TO GET IN SOME OF THESE
-- ELECTRONIC FILES BUT BUT
NO TIMELINE RIGHT NOW THE
I'M NOT DEFERRED HER I. T. FOLKS
TO ANSWER THAT TIMELINE ON THE
RAUNER KERRY
THANK YOU MEMBERS APPROPRIATE
QUESTION D. TRONIC
ABILITY FOR THOSE LAPS OR
PROVIDERS THAT HAVE ELECTRONIC
SYSTEMS TO SUBMIT THOSE TO
THE STATE OF CALIFORNIA THAT'S
CURRENTLY AVAILABLE AND WHEN THE
ONE OFF CONTRACTS ARE
USED TO EXPAND ON THAT TESTING
DONE IN THE STATE THAT SAME
MANDATORY REQUIREMENT THAT
THEY SUBMIT INTO THE STATEWIDE
ELECTRONIC PAYMENT SYSTEM
SO THE PROVIDERS THAT ARE
THAT ARE USING THIS AT ONE OP
TESTING FACILITIES THAT'S THAT'S
THEIR OPTION TO UTILIZE
NON ELECTRONIC RECORDS BUT BUT
OTHER STATES HAVE FOUND WAYS TO
HAVE ELECTRONIC HEALTH RECORDS
IN MAKESHIFT HOSPITALS SO I'M
I'M WONDERING IF OTHER STATES
ARE DOING THAT -- A NEW PUBLIC
HEALTH IS A ROBUST IT SYSTEM
-- I FROM WE ARE DOING THAT
IF OTHER STATES CAN DO IT
SORRY ARE YOU ASKING
SPECIFICALLY ABOUT
TEMPORARY HOSPITALS CORRECT
-- WILL AND WE HAVEN'T EVEN
HAVE NOT NOT
ONLY THAT SECONDARY WILL LOOK
INTO THAT WE HAVE BEEN CLEAR --
AND WILL I THINK THAT I COULD DO
THE QUESTION AGAIN OUR MAKESHIFT
HOSPITAL FACILITY SHARING
AND TRACKING TEST RESULTS
OKAY SO YOU'RE RIGHT YEAH I
MEAN YOU'RE CORRECT WE HAVE BEEN
USING AND A FEW HOSPITALS THAT
WE SET UP IN MAKESHIFT WAY I'M
SO WE'LL TAKE THAT BACK AS A
CONSIDERATION AND EXPLORE WHAT
SOME OTHER OPTIONS ARE FOR THOSE
ARCO ARENA TYPE -- SITUATION
SORRY WE WERE ADDRESSING THE
BIGGER QUESTION WITH SOME OF
THE LABS AS THEY COME ON BOARD
AND GETTING THEM INTO THE LOCK
PRODUCTS SYSTEM UNDERSTUDY
MAKESHIFT AND OBVIOUSLY OTHER
STATES ARE DOING IT RIGHT NOW
WITH MAKESHIFT WERE SELECT
WHAT EXETER IF WE DO THAT THAT
WOULD BE GREAT OKAY WE'LL
TAKE THAT BACK AND I THINK YOU
THANK YOU MR FONG
I THINK THIS CHAIR THIS QUESTION
MADE THE FOR SUSAN OR FOR DR
PAM BUT IS IT CORRECT TO SAY
THAT THE THE PATH FOR COUNTIES
AND CITIES TO MOVE THROUGH THE
BLUEPRINT FROM TIER TO TIER
IS BASED ON THE INFORMATION
COLLECTED IN THE CAR READY
SYSTEM A WEEK IS THAT IS
THAT IS THAT THE BASIS OF
THE DATA THAT IS CORRECT
AND THAT DOT ALONG WITH ANY
ADJUDICATION AND ANY WORK
THAT WE DO WITH OUR LOCAL
JURISDICTIONS IF THEY BELIEVE
THEY HAVE DATA THAT IS NOT WELL
REFLECTED AND CAL READY SO WE
HAVE AS ERICA DESCRIBE WE HAVE
AT AND EDUCATION PROCESS WE HAVE
YOU KNOW A COUPLE OF SYSTEMS AND
THERE ARE A COUPLE COUNTIES IN
THE STATE THAT DON'T USE THE CAL
READY SYSTEM IN THE SAME WAY I'M
SO WE WORK WITH UP ON BOTH SAN
DIEGO AND LOS ANGELES SO THEN
GIVE IT SO THEN IS CAL READY
SUPPOSED TO OPERATE IN REAL TIME
AS IF IF THE IF THE BLUEPRINT
IS IS IS BASED ON THE DATA
SYSTEMS OR THE DATA PROVIDING
THE COVERAGE SYSTEM IS CAL
READY SUPPOSED TO BE OPERATING
IN A REAL TIME BASIS I THINK
AS CLOSE TO REAL TIME AS WE CAN
GET IT UNDERSTANDING THAT THERE
ARE LAGS IN TERMS OF LABORATORY
PURPORTING INTO ANY AND SO
WHAT WE USE IN THE BLUEPRINT
AS THAT SEVEN DAY LAG BECAUSE
WE KNOW AS CASES ARE REPORTED
THEY GET BANNED I TOOK IT BACK
TO THE CORRECT DATE -- AND
SO WE USE THAT SEVEN DAY LAG TO
BE AS CLOSE TO REAL TIME WITH
ACCURATE INFORMATION AS WE CAN
BE OKAY THEN I GUESS GOING BACK
TO THE JULY TWENTY FIFTH -- I
AND I THINK IT'S KIND OF GLOSSED
OVER BUT MY UNDERSTANDING AND
CORRECT ME IF I GIVE MY IF MY
UNDERSTANDING WHAT HAPPENED IS
INCORRECT BUT THAT THE SYSTEM TO
CARRY SYSTEM WAS NOT DESIGNED TO
HANDLE THE VOLUME OF DATA AS YOU
INDICATED AND SO THROUGH SOME
CHECK IT WAS SEEN THAT THE
CAVITY SYSTEM WASN'T OPERATING
AT FULL CAPACITY IN WHICH CASE
THE SYSTEM WAS SHUT DOWN IS THAT
CORRECT AND THEN I
I'M NOT SCARED TO INSPECT THE
SYSTEM DID GAP GO DOWN ON JULY
TWENTY FIFTH AND WAS LATER
BROUGHT BACK UP IN AUGUST
GARY TO SPEAK TO THE SPECIFICS
OF WHY THE SYSTEM WENT DOWN
-- THIS IS A VERY NOTING CHAU
FOR PUBLIC HEALTH -- SO IT
WAS SORT OF A COMBINATION OF
EVENTS THAT HAPPEN -- WITH A
LARGE VOLUME MESSAGES COMING
INTO THE FRONT END OF OUR --
-- GATEWAY -- WE NOTICED THERE
WAS A LARGE VOLUMES AND A LOT
OF DUPLICATES AT THAT WERE
FLOWING THROUGH TO THE CARRY
SYSTEM -- THAT CAUSE PROBLEMS
WITHIN THE CAO READY SYSTEM
IN A STARTED TO BACK UP SO
WE OKAY SO I WILL GO AGAIN
IT'S JUST TOO MUCH OUT BUT IT
YET THESE DUPLICATE MESSAGES
BECAUSE SIGNIFICANT BACKLOG
OKAY SO THEN ONCE YOU DISCOVERED
THE THE THE GLITCH I GUESS
IS WHAT WE'RE IT WAS BEING
REFERRED TO THEN THE SYSTEM WAS
TAKEN DOWN OR TO ADDRESS A
DUPLICATION OR WAS IT AS A
SYSTEM WAS BROUGHT BACK ON
AFTER THE GLITCH WAS WAS ADDRESS
THEN THE DUPLICATIONS BECAME A
PROBLEM IN WHICH CASE THAT HAD
TO BE ADDRESSED IS THAT CORRECT
YES YES WE STARTED DRESS IT
AT THE AT THE GATEWAY WHICH IS
IN FRONT OF HOW READY AND --
WE MADE SOME CHANGES TO REDUCE
THE DUPLICATION WHICH AT SIDE
EFFECTS THEMSELVES AND THEN --
THAT CAUSE PROBLEMS WITH THE
GATEWAY AND THEN WE STARTED
WORKING ON HOW COULD WE FIX
THOSE PROBLEMS SEVERAL EIGHT
SO THAT THOSE ARE THE TEMPORARY
FIX THAT WAS USED TO ADDRESS
IT TO THE GOVERNMENT AND THAT
ENDED UP SLOWING DOWN THE SYSTEM
AND SAID THAT TEMPORARY FIX WAS
REMOVED TO STABILIZE THE SYSTEM
AND THEN TO DUPLICATION PROCESS
WAS REINSTALLED IS ACTUALLY
YES YEAH RIGHT BACK TO WHERE IT
WAS ORIGINALLY AND THEN WE PULL
SOME OF THOSE DUPLICATE MESSAGES
OFF FROM BEING PROCESSED AND
I DO MAINLY PROCESS THEM AND
-- THAT DELAYED SOME OF THE
MESSAGES GETTING IN THE CAR
READY SO UNDERSTANDING NOW
THAT WE'RE ALL OPERATING ON
THE SAME LIKE SCENARIO WHAT
HAPPENED THEN I GUESS WHAT
WAS THEN TAKEN WHAT ACTIONS
WERE THEN TAKEN TO TO FIX THIS
BECAUSE IS IT IS IT IS THERE
A LIKELIHOOD THAT THIS WILL
HAPPEN AGAIN -- WHAT WHAT
VERY WHAT WAS DONE TO PREVENT
THIS FROM HAPPENING AGAIN SO A
NUMBER OF THINGS -- WE'RE DONE
-- TO PREVENT IT FROM HAPPENING
AGAIN AND -- WE STARTED THOSE
IN EARLY AUGUST LATE JULY
EARLY AUGUST AND WE STARTED
-- WE BROUGHT DEPARTMENT OF
TECHNOLOGY AND YOU HEARD RUN
ROBINETTE WE PUT -- -- TIGER
TEAMS TOGETHER TO WORK TWENTY
FOUR HOURS A DAY WE LOOKED AT
STABILIZING BOTH THE HIV GATEWAY
PROCESSING THE MESSAGES AND
IMPROVING THE THE RELIABILITY
OF THAT SYSTEM BY ADDING MORE
HARDWARE -- IMPROVING THE
PERFORMANCE BRINGING THE BAND
MORE VENDORS ON BOARD THAT
HAD MORE SKILLS AND WE HAD TO
ACTUALLY CONFIGURE THE SYSTEM
APPROPRIATELY -- -- TO HANDLE
THE ADDITIONAL WORKLOAD WHICH
WAS SIGNIFICANT FROM WHAT IT'S
BEEN OVER THE LAST YEARS OF
THAT HAD A DOWNSTREAM IMPACT
ON HOW READY IT MADE IT EASIER
FOR CARRIED A PROCESS REAL
MESSAGES BUT HE WITH THE
INCREASING VOLUME CAL READY
WAS STILL HAVING A BACKLOG IN
REAL MESSAGES WE SPENT A NUMBER
OF THE SAME TEAM FOCUSED ON
IMPROVEMENTS TO CAL READY --
AS RON ROBINETTE SAID FROM C.
T. WE FOUND SOME PERFORMANCE
ENHANCEMENTS IN THE SEQUEL
DATABASE WHICH INCREASE THE
PERFORMANCE ALMOST SIX TIMES
SO -- WE'VE IMPROVED THE
CHANGE MANAGEMENT PROCESS
WE'VE M. PROVED BRINGING MORE
SKILL SETS ON BALL FROM THE
VENDORS -- EAF --
WE'VE ADDED MORE SIGNIFICANT
-- HARDWARE AND -- -- UPGRADES
AND STUFF THIS HAS SIGNIFICANTLY
STABILIZE THE SYSTEM -- AS OF
WITHIN THE LAST PROBABLY SIX
WEEKS WE'VE HAD NO ONE PLANNED
DOWNTIME AND WE HAVE ZERO
BACKLOGS DAY IN AND DAY OUT ON
CAL READY -- WE HAVE OUR LEAD
MESSAGE DID JUST --
-- STATUS UP OF THE FIFTEEN
JEWS COMING IN THE CAR READY
NINETY NINE PERCENT OF THE
TIME THEY'RE ZERO AND WE ARE
PREFERRED FOR A PER PROCESSING
-- MORE MESSAGES IN CARRY THAN
WE EVER HAVE PROBABLY EIGHTY
THOUSAND AND THAT CONTINUES TO
GROW AS THE VOLUME GROWTH THE
FRONT IN HIV GATEWAY SYSTEM
HAS PROP -- WITH IMPROVEMENTS
WE'VE MADE TO THAT HAS --
AS SHE HAS SIGNIFICANTLY
-- AND ABLE TO PROCESS MORE
MESSAGES WE'VE EVEN HAD IN
THE RANGE OF TWO TO THREE
HUNDRED A DAY TWO OR THREE
HUNDRED THOUSAND AND WE'VE
HAD NO GLITCHES IN THE SYSTEM
SO ALL IMPROVEMENTS THAT
WE HAVE MADE ON THE CURRENT
ENVIRONMENT -- HAVE PROVED TO
BE VERY STABILIZING AND --
AND WE ARE CONTINUING TO
MONITOR AND STAY AHEAD OF THE
GAME AND AND YOU'D INDICATED
THAT THE THAT THE SYSTEM
IS TESTED EACH DAY OR DALY
WHAT WE DO EACH DAY IF
WE HAVE A SEPARATE -- --
-- REPORTING SYSTEM THAT LOOKS
AT ALL THE MESSAGES -- THIS
INDEPENDENT RUN BY THE PART
OF TECHNOLOGY AND GIVES US
THE TOTAL COUNTS OF MESSAGES
COMING IN AND THEN IN OUR IN
OUR SYSTEMS THE THE GATEWAY
COUNTS ALL THOSE MESSAGES AND
AND WE RELATE BACK TO THIS
INDEPENDENT ANALYSIS AND AS
THEY GO INTO CAL READY TO BE
PROCESS WE ALSO COMPARED NUMBERS
AND METRICS EVERY SINGLE DAY
WE ALSO COMPARE METRICS WITH
LA AND SAN DIEGO AND SO IF
THERE ARE ANY DISCREPANCIES
FOR ANY REASON WE IMMEDIATELY
IDENTIFY WHERE THEY ARE AND
WE'RE ABLE TO WORK ON VERY
QUICKLY TO RESOLVE THEM OKAY
AND AND THEN I GUESS MAYBE YOU
OR DOCTOR BANNER OUR DEMOCRACY
PH HOW DOES THAT SO I'VE I'VE
KIND OF HEARD THREE SYSTEMS AS
THE EXISTING CAR READY SYSTEM
THERE'S IS NAY C. C. R. S.
SYSTEM AND THEN THERE IS A
NEED FOR A A. B. A NEW CAR
READY SYSTEM IN THERE -- SO
HOW DO THEY ALL HAD AT LEAST
MY FIRST QUESTION IS HOW DOES
THE EXISTING COVERAGE SYSTEM
AND THIS NEW C. C. R. S. SYSTEM
HOW DO THEY INTERACT WITH EACH
OTHER YOU COULD HAVE
ORDERED THE OTHER TWO SYSTEMS
OR WIND JUST FOR CALL OF IT
AND THE OTHER ONES FOR TWELVE
AND PLUS EVERYTHING ELSE
NO THIS IS YOUR SYSTEM WAS
CREATED TO IMPROVE THE QUALITY
OF THE ELECTRONIC LAB RECORDS
COMING IN -- OFTEN HAS A LOT OF
SKILL AND KNOWLEDGE IN THIS AREA
SO ULTIMATELY THE NEW SYSTEMC
HARASSED WILL PROCESS ALL
THE INCOMING MESSAGES AND WE
EXPECT THEM TO GO TO THREE
OR FOUR HUNDRED THOUSAND A
DAY TO REMOVE THE DUPES
CHECK FOR QUALITY ENHANCE THE
QUALITY OF THE MESSAGE AND
AND THEN SEND THAT GOOD QUALITY
MESSAGES ON TO OUR HIV GATEWAY
AND THEN WE WILL ROUTE THEM
THROUGH OUT HOW READY LA AND
SAN DIEGO -- SO THAT OFFLOAD
SOME OF THE -- LAB PROCESSING
OFF OF OUR H. I. GATEWAY THE
SECOND SIGNIFICANT PART OF C.
C. R. S. IS THE COLBERT REPORT
THAT IS SPECIFIC TO COPE WITH
AND THAT IN ITSELF BUILDING
A REPORTING SYSTEM WILL ALLOW
THE DEPARTMENT PUBLIC HEALTH TO
DALY PROVIDE THE GOVERNORSHIP
-- METRICS FOR THE DASHBOARD
AND -- IN A MUCH SHORTER TIME
AND A MORE RELIABLE -- BEFORE
THEIR WORK THEY HAD TO CONSUME
EVERY DAY LOTS OF DATA -- THAT
WAS GROWING EVERY DAY THIS WILL
PUT IT ALL INTO ONE REPORTING
DATABASE AND THEY SHOULD BE MORE
EFFICIENT AT GENERATING THOSE
METRICS SO THEN THE THE WAY
THE PROCESS IS NOW OR AT LEAST
WE ARE NOT NOW BUT WHEN THIS
WEDNESDAY'S ARREST COMES ONLINE
IS THAT ALL THE DATA ALL THE
LAB DATA ALL THE LAB RESULTS AND
ALL THE RESULTS BEING COLLECTED
IN THE STATE THAT WOULD BE SENT
TO THE C. C. R. S. SYSTEM FIRST
AND THEN THAT WILL BE REVIEWED
AND THEN IT WOULD BE THEN SENT
TO THE CAL READY SYSTEM FOR THAT
TO BE UP LOADED -- FOR EVERYONE
TO ACCESS THAT THAT'S
CORRECT -- IT TOO WE HAVE OVER
FOUR HUNDRED LAPS THAT REPORT
DIRECTLY INTO THE CDPH GATEWAY
AND THOSE OVER TIME MONTHS
WILL SLOWLY BE MOVED ON TO THE
OPTIM SYSTEM TO SEE IF YOUR
SYSTEM AND THAT WILL OFF LOADED
AND IT WILL BE DIRECTLY HE TO
THEM NOW WITH WHAT THE NEW
CAR READY SYSTEM BE CREATED OFF
THE FOUNDATION OF THE CRS OR
IS IT OR THEY'RE GOING TO ARE
YOU GUYS GOING TO CREATE A BRAND
NEW CAR READY UP ON ITS OWN
SO -- -- SO IT'S MORE A DISEASE
SURVEILLANCE SYSTEM ANSWER
SURVEILLANCE AND -- WE WE
ARE WORKING WITH A CONTRACTOR
WHO'S LOOKING AT -- WHAT WHAT
THE FUTURE BE WHAT'S THE ROAD
MAP FOR A COUPLE YEARS OUT --
THERE ARE INTERVIEWING MANY
STAKEHOLDERS -- COUNTIES CDPH
AGENCY CDT TO SEE WHAT THEIR
VISIONS ARE THEY'RE LOOKING
AT NEWER TECHNOLOGIES THEY
ARE LOOKING AT OTHER STATES
AND WHAT THEY HAVE DONE AND
WHAT THEIR PLANS ARE FOR
THE FUTURE OF LOOKING AT --
CDC FOR ANY ANY IDEAS AND
SYSTEMS THEY HAVE SO WE'RE
JUST AT THE EARLY STAGES OF OF
-- OF LOOKING INTO THE FUTURE
AND WHAT TYPE OF SYSTEM WOULD
BE SIGNIFICANT FOR THE FUTURE
INCLUDING PROBABLY THE LOCAL
HEALTH DEPARTMENTS A LOT
BECAUSE THEY ARE OBVIOUSLY THE
FRONTLINE AND A LOT OF THIS
AND -- THEY HAVE THEIR OWN
-- SORT OF ON PREMISE SYSTEMS
THAT THEY HAVE TO SUPPORT --
AND WE WANT TO MAKE SURE THAT
WE ARE WORKING IN CONJUNCTION
WITH THEM OKAY BUT THE GOAL IS
COMPATIBILITY THOUGH RIGHT YOU
WOULDN'T WANT TO HAVE MULTIPLE
SYSTEMS THAT DON'T TALK TO
EACH OTHER NOW WE HAVE
TO INTER OPERABILITY IS EXACTLY
WHAT WE ARE TODAY EVERYTHING
WE BUILD TODAY THEY THE CONTACT
TRACING SYSTEM INTEROPERATES
WITH CAL READY AND IT WILL
INTEROPERATE WITH OTHER SYSTEMS
-- THAT REQUIRE THE CONTACT
TRACING DATA -- AND CAL
READY AS INTER OPERATING THAT
WAY ALSO THE NEW CCRI SYSTEM
INTEROPERATES WITH OUR GATEWAY
SO EVERYTHING THAT WE LOOK AT
TODAY IS REALLY CONNECTED IN
MY OR ANOTHER AND WE'RE USING
INTER OPERABILITY SOFTWARE TO
MAKE IT EASIER AND FASTER TO
DELIVER THOSE OKAY AND AFTER
JUST OUT OF CURIOSITY BIG I
KNOW THERE'S A LOT OF ATTENTION
ON CAL READY AND ON THIS NEWS
THE SEWER SYSTEM BUT HOW MANY
DATABASES DOES THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH HAVE
SHE WE HAVE OVER TWO
HUNDRED APPLICATIONS WE PROBABLY
HAVE -- YOU KNOW HUNDREDS
OF DATABASES FROM ACCESS TO
SEQUEL TO ORACLE -- WE HAVE
VERY LARGE DATABASES DRIVING
OUR LARGE SYSTEMS AND THEN
WE HAVE SMALLER DATABASES
FOR SOME OF THE PROGRAM AREAS
OKAY SO I GUESS I ME I JUST
HAVE A NUMBER BUT A FEW MORE
QUESTIONS AT LEAST ON THE
CALVET -- THE CAR READY SYSTEM
SO IT'S MY UNDERSTANDING THAT
THE HELP DESK WHICH THE USERS
AND PROVIDERS -- UTILIZE
-- THAT THE HELP DESK WAS SHUT
DOWN -- THEY SAID ON ITS PHONE
SERVICE AND MOVED TO AN EMAIL
ONLY SERVICE AND I I'VE HEARD
THIS FROM MY OWN DEPARTMENT
PUBLIC HEALTH BECAUSE OF THIS
RESPONSES TO TIME SENSITIVE
ISSUES ARE RELATIVELY SLOW
-- GOOD CD B. H. R. COULD YOU
COMMENT ON THAT AND ARE YOU
WORKING TO INCREASE RESPONSE
TIMES TO THE HELP DESK --
ESPECIALLY WHEN AS IT INDICATED
EARLIER WE NEED AS REAL TIME
AS POSSIBLE AND AS THE DATA
IS SO IMPORTANT -- KICKED THE
CAN YOU COULD YOU ADDRESS THAT
CHAU AYE I CAN'T ADDRESS THAT
I CAN CERTAINLY LOOK INTO IT
I DID NOT KNOW THAT THEY CARRY
PROGRAM IT'S PROBABLY THEIR
HELP DESK NOT AN I. T. HELP DESK
-- -- THAT THEY WERE MAKING NO
CHANGES BUT -- I CERTAINLY CAN
LOOK INTO IT AND SEE YOU KNOW
WHY THAT WAS HAPPENING OKAY AND
AS A FOLLOW UP THEM AND MAYBE
IT'S POSSIBLE TO GIVE LIMITED A
MINUTE AT ADMIN RIGHTS TO TO
THE COVERAGE SYSTEM TO SPECIFIC
INDIVIDUALS WITHIN THE COUNTY
LEVEL WITHIN CAL WITH WITH WITH
IN EACH DEPARTMENT OF PUBLIC
HEALTH AGENCIES COUNTY SO THAT
THERE'S SOME RESEARCH THAT SO
THAT THEY CAN HAVE SOME ACCESS
TO THEY CAN ACTUALLY UPLOAD
THE DATA QUICKER MAYBE THAT
SOMETHING THAT YOU CAN LOOK INTO
SIX YES AN ENHANCED PRIVILEGES
TO HAVE BETTER ACCESS TO DATA
WITHIN WITHIN THE CARRY DATA
WAREHOUSE SO WE HAVE A DATA
WAREHOUSE EVERY DAY THAT WE
POPULATE WITH THE CURRENT DATA
AND THAT IS AVAILABLE TO ALL THE
COUNTIES THROUGH ARE A WEB BASED
INTERFACE -- AND -- WE
ARE LOOKING AT MAKING HIM THAT
IMPROVEMENTS SO THAT THAT THAT
IS NOT JUST GO WITH THAT SCHOOL
THAT IN EVERYTHING SO I WILL
LOOK AT WHAT THAT REQUIRE SEE
SEE WHAT IT WHAT WHAT IT
WHAT ENHANCE PRIVILEGES WILL
OFFERS THE COUNTY SAN ACCESS
TO THAT THAT WOULD BE GREAT
AND THEN OF COURSE EVEN PRIOR
TO THE DATE A GLITCH CAL READY
PRESENTED AND STILL DOES PRESENT
SOME SIGNIFICANT ISSUES IN
TERMS OF I RECEIVED REPORTS OF
COUNTY PUBLIC HEALTH OFFICIALS
AND HEALTH CARE PROVIDERS
DEALING WITH SIGNIFICANT DELAYS
IN REGISTERING NEW USERS AND
PROVIDERS TO HAVE READY WITH
SOME PROVIDERS WAITING WEEKS TO
HAVE THEIR REGISTRATION APPROVED
-- WHICH IS CLEARLY PROBLEMATIC
AS AS AT ANY COULD BEFORE WE
DON'T WANT ANY DELAYS IN THE
DATA -- IS THERE A PLAN IN
PLACE TO MAKE THE REGISTRATION
PROCESS MORE EFFICIENT -- OR
SOMETHING THAT YOU CAN ADDRESS
I OTHER TEAM
AND SO WE'LL CONTINUE TO LOOK
AT THAT BUT WE WE HAVE TRIED
TO INCREASE THAT PROTECT THE
RESPONSE TIME AND SO WE DID
PUT A TEAM OF PEOPLE -- WHO ARE
WORKING ON THAT TO TRY TO GET
MORE TIMELY RESPONSES BACK TO
PEOPLE BUT WILL DOUBLE CHECK
ON THAT AND WE'LL ALSO LOOK AT
WHETHER WE CAN RESTORE ON THAT
PHONE LINE IN ADDITION TO THE
EMAIL ACCOUNT OKAY DEBBIE I
THINK THEY'LL BE VERY HELPFUL
ESPECIALLY AS WE NEED MORE
TIMELY INFORMATION -- AND THEN
OF COURSE SUCH A MEDIC
ALREADY USERS -- ARE FRUSTRATED
SOME OF THE SYSTEMS LESS THAN
USER FRIENDLY FEATURES --
DIFFICULT IS SURGING MORE THAN
ONE SINGLE DEMOGRAPHIC -- STOP
POSSIBLE SEARCH MULTIPLE FIELDS
OR TO QUICKLY FILTER A SEARCH BY
OTHER FIELDS -- AND OTHER
PARTS OF THE DATA DISTRIBUTION
PORTALS ARE IN TERMS OF THE
USE OF FLAT FILES MAKES DATA
PROCESSING MORE DIFFICULT --
ARE THOSE TEACHERS GOING TO BE
ADDRESSED -- MOVING FORWARD --
IS IS THAT SOMETHING THAT CAN
BE ADDRESSED IN THE C. SIERRA
SYSTEM OR WERE IN THE EXISTING
PROPERTY SYSTEM MANY OF
THOSE FEATURES WILL BE ADDRESSED
IN THE BUILDING OF THE NEW
SYSTEM ONE OF THE REASONS WHY
WE'RE DOING EXTENSIVE USER
OUTREACH IS TO GET OUT THOSE
ISSUES TO MAKE SURE THAT AS WE
BUILD THE SYSTEM OF THE FUTURE
THAT WE ADDRESS THOSE -- VERY
MEANINGFUL REQUEST FROM OUR
LOCAL PARTNERS AND PROVIDERS
OKAY BUT I GUESS IN TERMS OF
-- I GUESS IF YOU COULD ADDRESS
THE REGISTRATION PROCESS AS
WELL AS -- GIVING SOME LIMITED
ADMIN ACCESS THAT WOULD BE
EXTREMELY HELPFUL I THINK TO THE
LOCAL PUBLIC HEALTH DIRECTORS
TO THE I GUESS MAYBE THIS
QUESTIONS REGARD FOR DR PAN AM
I GUESS MOVING TO THE BLUEPRINT
AND -- CAN CAN CAN YOU
EXPLAIN TO ME WHY THE HOSPITAL
CAPACITY METRIC WAS REMOVED
FROM THE BLUEPRINT AND WHAT
WAS THE BASIS FOR THAT DECISION
SURE YEAH I KNOW IT'S A GREAT
QUESTION THANK YOU YET --
SO WE REALLY WANTED TO FOCUS
ON LEADING INDICATORS RIGHT
ESPECIALLY AS WE'RE THINKING
ABOUT THE FOCUS OF THE BOOK
WAS A SLOW INTERNET RE OPENING
-- BUT WE ARE ABSOLUTELY
STILL WATCHING ALL OF THE
HOSPITAL AFTER EXPECTING
AND THAT WAS WHY WE HAD A
A PRESS EVENT ON FRIDAY TO
REALLY TELL EVERYONE THAT WE
ARE SEEING THIS PLATEAUING
HOSPITALIZATIONS AND IN FACT IF
YOU REGION MAYBE A LITTLE BIT
AN UPTICK WE WATCH THE PERCENT
OF ICE YOU CLASSES EVERY DAY
WE ARE SO LONG AS CLOSELY AS
ARE THE LOCAL HEALTH DEPARTMENT
BUT WE REALLY FOR THE BLUEPRINT
WANTED TO TRY TO SIMPLIFY THINGS
A BIT MORE I THINK EVEN WITH
THAT I THINK WE THOUGHT OF THE
REALLY SIMPLE AND NOW YOU KNOW
IF THERE'S BEEN A LOT OF --
YOU KNOW A LOT OF EXPLANATION
OF EVERY RULE AND EVERY MOVEMENT
SO WE WANTED TO KIND OF GET IT
DOWN TO JUST THE BASICS WHICH
WAS CASE RATES TEST POSITIVE
IT'S AN EASY AND SORT OF SOME OF
THE NATIONAL RENDERERS ALTHOUGH
UNFORTUNATE NOT A NATIONAL
STANDARD FOR THE DIFFERENT TIERS
-- THAT THAT'S KIND OF THE BASIC
KIND OF DATA THAT WE LOOK AT
FOR DISEASE TRANSMISSION AS A
LEADING INDICATOR WE KNOW THAT
HOSPITALIZATIONS ARE -- AS FAR
AS THE DISEASE RELIGION ARE
LAGGING INDICATOR TYPICALLY
TAKES THREE WEEKS OR SO AFTER
YOUR CASE RATES GO UP THEIR
HOUSES AND GO TO THE ONE ON
TOP OF THAT CERTAINLY AS WE'RE
LOOKING AT AT LOOKING AT ALL
THESE THINGS AND IF THE CASE
RATE INCREASES QUICKLY -- OR
WERE CONCERNED AND AGAIN WE'RE
WATCHING ALL THIS HOSPITAL
METRICS VERY CLOSELY WE'RE
DOING PROJECTIONS WITH -- CAL
CAT WHICH YOU CAN ALSO GET AND
ONLINE AND THEN WE HIGHLIGHTED
THIS I'M OVER THE LAST FEW
DAYS THAT WE LOOK AT THIS
PROJECTIONS ABOUT HOW SUFFICIENT
AND WE COULD INTERVENE SOONER
WE HAVE SAID RIGHT NOW THAT
TO MOVE BACKWARDS -- I COUNTY
WOULD NEED TO KIND OF BE AND
NOT MORE RESTRICTIVE TEARS OF
THEIR READ THAT THEIR METRIC
START TO LOOK MORE PURPLE --
OVER TWO WEEKS -- THAT WE WOULD
LOOK AT BACKGROUND BUT WE'RE
ALSO REALLY AGAIN CLOSING MINUS
HOSPITAL METRICS WEALTH BURKE
AND EVERYTHING ELSE AND WHETHER
FLU SURVEILLANCE WILL BE ABLE TO
LOOK AT ALL OKAY WELL I MEAN
I I CERTAINLY UNDERSTAND THE
NEED FOR SIMPLIFICATION BUT ALSO
WE WE WANT WE WANT TO PRIVATIZE
ACCURACY TO ESPECIALLY THE FULL
PICTURE OF WHAT'S HAPPENING IN
DIFFERENT COUNTIES SO -- WELL
I KNOW YOU'RE MOVING TO ANY OF
THE BLUEPRINT IS SUPPOSED TO
BE MORE SIMPLE IT IS HI MIKE
MY FEAR MY CONCERN IS THAT
WE'RE NOT LOOKING AT THE FULL
PICTURE IN EACH COUNTY AND THAT
WERE MISSING THINGS BECAUSE THE
METRIC WAS REMOVED ESPECIALLY
SOMETHING AS IMPORTANT AS --
HOSPITALIZATIONS BECAUSE THAT
WAS KIND OF THE WHOLE PURPOSE OF
THE FIRST KIND OF STATE HOMELESS
TO INSURE THAT WE BENT THE CURVE
TO ENSURE HOSPITAL CAPACITY IS
THAT CORRECT THAT
IS RIGHT AND ALSO JUST TO REDUCE
OVERALL MORBIDITY AND MORTALITY
I THINK I'M OUR DASHBOARDS --
HOW STILL HAVE CONSULTATIONS
SO THE METRIC IN THE FRAMEWORK
IS LIKE THAT THE HIGHLY THAT
EVERYONE'S REALLY OF COURSE THE
MOST INTEREST BECAUSE IT DOES
IMPACT IT'S GOING TO OPEN OR
CLOSED BUT BOTH YOU ADAM AS
LEGISLATORS AND THE PUBLIC AND
WE I MEAN WE HAVE EVEN MORE DATA
BEHIND THE SCENES THAT WE'RE NOT
SHOWING EVERY SINGLE METRIC THAT
WE ARE HONORING THAT OF THAT OUR
PUBLIC DASHBOARDS AND THEY'RE
ABOUT TO GET UPDATED AGAIN
HOW HOSTAGE OUR THIRTY LOOK
AT NEW CONSTELLATIONS IS EVEN
MORE IMPORTANT TO CARE BECAUSE
HAS SEE A FLATTENING HOUSES
ASIANS BUT IT'S REALLY JUST
PULLING DISCHARGED OR THINGS
LIKE THAT SO ACTUALLY IN NEW
DATAPOINT WITHOUT IT OVER THE
LAST COUPLE MONTHS IS LOOKING
AT NEW HOSPITALIZATIONS AS WELL
SO WE HAVE THAT ON A SNAPSHOT
TOOL THAT WE LOOK AT EVERY DAY
-- VARIOUS EARLY AND THEN
AGAIN ON OUR PUBLIC DASHBOARD
RIGHT NOW THERE IS OVERALL
HOSPITALIZATIONS I SEE YOU
-- TEN PERCENT OF THOSE AND
AS WE INVOLVED WILL BE ADDING
MORE METRICS THAT THE PUBLIC
CAN FOLLOW ALONG AS WELL BUT
BUT THE HOSPITALIZATION METRIC
IS NOT USE FOR IN TERMS OF
MOVING COUNTIES UP AND DOWN
THE TEARS OR IN TERMS OF RE
OPENING WITH THAT IS SOMETHING
THAT'S GOING TO BE RE EVALUATED
IN THE FUTURE CORNELL'S HER
AND AGAIN I THINK THE THE THE
BECAUSE OF THIS FOR US IS TO
THINK ABOUT THE -- THE METRICS
ARE MOVING FORWARD AND --
THINK THAT OVERALL DISEASE
TRANSMISSION I THINK -- I THINK
WE HAVE SOME LANGUAGE IN THERE
AND WE CERTAINLY ANNA MORE --
BOTH METRIC AND QUALITATIVE --
LOOKING AT MOVING BACKWARDS OR
IF YOU NEED TO REALLY QUICKLY IF
YOU START TO SEE YOUR DOUBLING
TIME INCREASE YOUR ARE EFFECTIVE
INCREASE QUICKLY ENTER HOSTILE
SOLUTIONS WHICH AGAIN WOULD BE
LAGGING ACTUALLY AND THEN SO IT
IS IT'S SOMETHING THAT'S REALLY
IMPORTANT THAT WE'RE TRYING
TO BE MORE PREEMPTIVELY MORE
PREVENTIVE THAN LOOKING WE'RE
TRYING TO PREVENT THAT HOSPITALS
SHOULD SEARCH AND LOOK AT THE
MODELING SO WE'RE FOLLOWING UP
WILL BE BEHIND THE EIGHT BALL TO
WAIT FOR JUST SIX RIGHT
I'M NOT SAYING THAT WE RELY
SOLELY ON IT I'M JUST SAYING
THAT THAT IT'S IT'S AND IT'S
STILL IMPORTANT TO LOOK AT AND
SO IT'S IT MAYBE IT'S SOMETHING
TO DEMAND TO PUT BACK INTO
THE TO THE POINT IF YOU WANT
AN ACCURATE PICTURE OF WHAT'S
HAPPENING IN EACH COMMUNITY --
IN TERMS OF BE A JUST A CASE
WITH A LOT OF COUNTIES KALEEM
THE WHENEVER PRESENT -- CLEARLY
ARE -- AFFECTED BY THE
HSE CASE RATE VERSUS THE ACTUAL
CASE RIGHT CAN YOU EXPLAIN TO ME
WHY THAT ADJUSTMENT WAS PUT IN
SURE YEAH WE -- SPENT A LOT
OF TIME AND ENERGY AND ACTUALLY
CONSULTED WITH NATIONAL
EPIDEMIOLOGIST EXPERTS -- SOME
OF WHOM -- YOU KNOW THE
DINO BROWN SCHOOL PUBLIC HEALTH
AND WHATEVER THE ODDS THE WORKS
THE TIME FREEDOM THE FORMER
DIRECTOR OF CDC WE HAVE WORKED
WITH OTHERS TO LOOK AT STATE
AVERAGES ACROSS THE COUNTRY
AND WATER BENCHMARKS THAT WE
NEED TO DO FOR TESTIFIED TO DO
ADEQUATE CASE FINDING TICKETS
WILL THIS EPIDEMIC AND PANDEMIC
AND SO BY LOOKING AT THAT
AGAINST EIGHT HOURS OF TRYING
TO ASSESS WATER SORT OF VOLUME
TESTING VOLUME THEN TURNS TO
MAKE SURE WE'RE DOING ENOUGH
KEYS FINDINGS OR NOT AGAIN NOT
SEEING WHAT'S HAPPENING IN THE
COMMUNITIES BUT ALSO NOT --
SORT OF -- WE DIDN'T WANT TO
CLOSE QUOTE TONNAGE COUNTY IS
THAT WE'RE ABLE TO DO A LOT
OF TESTING INDICATES FUNDING
BUT FINDING MORE CASES AND
THEN HAVING TO HOLD BACK SO --
THROUGH A LOT OF ANALYSIS AGAIN
OF STATEWIDE DATA AND NATIONAL
DATA WE CAME UP WITH THE LINEAR
ADJUSTMENT SO THAT IF YOU'RE
TESTING ABOVE AND THERE'S A CAP
ON THAT BUT IF WE LOOK AT WHAT
IS THE STATE MEDIA WE PICKED
UP AND PARKS -- BASICALLY EVERY
FOUR WEEKS ABOUT EVERY MONTH
TO TO SAY WHAT'S THE MEDIA
AND AND IF YOU'RE ABOVE THAT
YOU CAN ACTUALLY REDUCE YOUR
ADJUSTED CASE THAT SAID IF
YOU'RE ACTIVELY TESTING FINDING
ISOLATING YOU'RE NOT GONNA GET
SORT OF -- YOU'RE NOT GONNA GET
HELP BEHIND FOR DOING THAT WORK
AND ON THE OTHER SIDE OF THINGS
IF YOU'RE NOT TESTING ENOUGH --
THE PORTION WHERE WHERE YOU'RE
MISSING CASES RATED NOTHING MANY
MISSING CASES SO THAT'S SORT OF
THE THEORY BEHIND IT AND THEN
AGAIN A LOT OF WORK ON DIFFERENT
WAYS TO LOOK AT THAT IT JUST
MIGHT AND AGAIN THERE'S A CAP AT
THE BOTTOM AND THE TOP OF THAT
AND THE MIDDLE IS CONVENIENT AND
THEN WORK BECAUSE WE HAD A LOT
OF ISSUES AS WELL WITH FIRES AND
AIR QUALITY SOME OF THE TESTING
STATES HAVE BEEN UNAVAILABLE
SO THAT'S THE OTHER IMPORTERS
AND HAVE THE MEDIA AND NOT JUST
A SOLID BENCH MARK THAT IS THE
SAME ALL THE TIME I GUESS IT
HAVE YOU HEARD THOUGH THAT FROM
THE THE NEED FROM FROM MY MY
EXPERIENCE IN KERN COUNTY AND
ANSWER OTHER MY LET MY OTHER
COLLEAGUES HAVE EXPERIENCE THE
SAME THING WHEN WE WENT FROM
ANYONE WHO WANTS TO TEST SHOULD
GET ONE TOO WHEN WE WERE
RUNNING SHORT OF AB TESTING KITS
THEN IT WAS ONLY SYMPTOMATIC
INDIVIDUALS -- WERE TO BE TESTED
AND NOW WE'RE ACTUALLY CREATING
A A BLUEPRINT OR A METRIC IN
WHICH IT'S TIED TO THE AMOUNT
OF TESTING YOU DO BUT NOW WE
WANT PEOPLE TO GET TESTED SO
THIS PING PONG AND -- IN THE
IN THE COMMUNITY AND AND IN
IN THE PUBLIC HAS CREATED IS
NOT NEW DIFFICULTY OF GETTING
INDIVIDUALS TO GET TESTED AND
NOW THAT'S A KEY COMPONENT FOR
ACTUALLY MOVING TO THE TEARS
SELL -- MAYBE EVEN ADD SOME
PERSPECTIVE IN TERMS OF HOW DO
YOU GET PEOPLE TO GET TESTED
IF WE WE'RE KINDA GETTING MIXED
MESSAGES SURE I MEAN
I GET ON IT KNOWLEDGE I THINK
AT ALL LEVELS AGAIN THAT THAT
KNOWLEDGE AND EVIDENCE ABOUT
WHY TO DO WELL AROUND THIS
PANDEMIC ARE CONSTANTLY EVOLVING
-- YOU'VE HEARD NATIONAL
CONGRESS IS WELL OVER WHO
SHOULD BE TESTED OR NOT AND A
LOT OF THAT IS REALLY BACK TO
WHAT'S YOUR CAPACITY SO WHEN
YOU HAVE LIMITED CAPACITY YOU
HAVE TO PRIORITIZE WHEN YOU
HAVE LIMITED CAPACITY WE REALLY
THOUGHT OKAY YOU ONLY WANNA
DOESN'T NOT PEOPLE THE OTHER
REASON THAT MESSAGE INVOLVED AS
WE'VE LEARNED SO MUCH OVER THE
LAST SEVERAL MONTHS ABOUT THIS
DISEASE AND WE DID NOT REALIZE
UNTIL IS ALWAYS HARD FOR ME OF
A TIME TO KEEP TRACK OF WHEN
WE LEARNED LET THAT YOU KNOW
WE KNOW THAT FORTY PERCENT OF
PEOPLE MIGHT HAVE NO SYMPTOMS
ALSO WE WILL MISS CASES IF WE'RE
ONLY TESTING SYSTEMATIC PEOPLE
BUT WE ALSO HAVE TO PRIORITIZE
SO AND WE JUST RECENTLY ALSO
IN THE LAST WEEK DID AS TO YOUR
POINT CHANGE THAT MESSAGE AGAIN
WE HAVE ENOUGH CAPACITY IN
THE STATE WERE UNDER UTILIZING
ALSO TO YOUR POINT SO WE WANT
PEOPLE TO REALIZE THAT IF YOU
ARE IN A HIGH RISK SETTING --
THAT YOU SHOULD GET TESTED SO
WE DEFINITELY CONTINUE TO WORK
ON IMPROVING OUR MESSAGING
AROUND THAT AND AGAIN THE THE
SCIENCE AROUND THIS INVOLVES
AND AND THAT IS WHY OF ALL
ISN'T AS WE GET MORE CAPACITY
AGAIN I THINK THERE'S MORE
AND MORE I'M INTERESTED IN
WATER HIKES VALENCE TESTING IN
CERTAIN SETTINGS YOU'VE PROBABLY
HEARD THIS AND SKILLED NURSING
FACILITIES BECAUSE IT'S SUCH A
HIGH RISK SITUATION BUT ON WHERE
YOU CAN GET DIZZY IS THE HIGH
RISK OF THE POPULATION OR VISIT
IN OPPOSITION THE DALLAS THAT
WE WANT THAT TEST SORT OF STAFF
THERE YOU KNOW PERIODICALLY
AND ACTUALLY WEEKLY IS WHAT'S
NEEDED SO THAT'S ANOTHER WAY AND
TARGET AUDIENCE TO BE STRATEGIC
AND I ALSO WANNA AGREE AND
ACKNOWLEDGE THAT WE WANT TO BE
STRATEGIC ABOUT OUR TESTING IS
NOT JUST THAT EVERYBODY SHOULD
GET TESTED THE PEOPLE WHO ARE IN
HIGH RISK SETTINGS OR CONTINUE
TO OF ALL THOSE PRIORITIES AS
WE MODIFIER CAPACITY AND THEN
THERE'S MORE TESTING TECHNOLOGY
THAT'S ON THE HORIZON THAT
WILL CONTINUE TO EVALUATE AND
PROVIDE GUIDANCE FOR RISE OF AS
BUT AS MORE AS YOU'RE PUSHING
MORE MEANS YOU'RE PUSHING
COUNTIES TO TEST MORE BECAUSE
THAT'S THE ONLY WAY THEY'RE
GOING TO BE ABLE TO MOVE TO THE
TEARS RIGHT I MEAN YOU HAVE A
SITUATION WHERE THEY HAD THE THE
UNADJUSTED CASE RATE IS LOWER
THAN THE ADDRESS IT BECAUSE
YOU'RE JUST COUNTIES UP AND
SO THE THE THE COULD IS THERE
ENOUGH SUPPLIES OF TEST KITS
AND REAGENTS MOVING FORWARD
TO ENSURE THAT AS COUNTIES
BEGIN TO RAMP UP TESTING THAT
THEY'RE NOT GOING TO RUN INTO
THE SITUATION THAT THEY DID
YOU KNOW MONTHS AGO WHERE
WE'RE RUNNING SHORT ON TESTS
SO CURRENTLY THANKFULLY RIGHT
NOW WE'RE NOT AWARE OF ANY
SUPPLIES AND SHORTAGES OF SUPPLY
OF TEST KITS OR REAGENTS AND
THINGS LIKE THAT A GUN MOVING
FORWARD THAT'S GOING TO BE A
PREDICT UNPREDICTABLE BUT THAT'S
THERE'S TWO THINGS I THINK TO
TO RESPOND TO THAT AGAIN THAT'S
WHY WE HAVE A MEDIAN OF THE
STATE WIDE BECAUSE IF THERE
ARE ISSUES THAT'S GOING TO
AFFECT EVERYBODY SO THE MEDIAN
IS ACTUALLY GONNA BE LOWER --
IF PEOPLE IF THERE IS A SUPPLY
ISSUE AND WE ACTUALLY HAVE A
DOUBLING OUR CAPACITY ONCE THE
PERKINELMER LAB OPENS -- AND
THEN I THINK AGAIN THE REALLY
THE PRINCIPLE IS BECAUSE IT'S
NOT JUST TO DO THE TESTING
AND SO THAT WE CAN FIND CASES
ISOLATE THEM CONTACTS QUARANTINE
RIGHT IT'S IT'S HOW SHE DID IT
CONTAIN THE DISEASE THAT'S THE
MITIGATION WITH IS CLOSING OF
SECTORS AND YOU KNOW THE MASSIVE
DOESN'T THINK THAT WE'RE GONNA
CONTIENEN IT HAS TO BE LAYERED
ON TOP OF THAT WITH THE TESTING
AND FINDING IT SURE AND AND AND
AND I WANT TO ACKNOWLEDGE THE
IMPORTANCE OF TESTING AND I'M
I'M OF COURSE MYSELF AND OTHER
OF MY COLLEAGUES ARE ENCOURAGING
EVERYONE TO GET TESTED AND
EACH OF THE COMMITTEES IF THEY
IF THEY'RE SYMPTOMATIC OR IF
THEY'VE IF THEY'VE BEEN EXPOSED
SO I'D I TOTALLY UNDERSTAND THAT
SINCE THE CIRCUMSTANCE I WILL I
APPRECIATE THE CHAIRS AND OLDER
THERE'S A FEW MORE QUESTIONS
IT IN KERN COUNTY AND IN THE
CENTER VALLEY WE'VE OBVIOUSLY
HAD THE BENEFIT OF HAVING
FEDERAL MOBILE TESTING SITES IN
WORKING WITH CONJUNCTION WITH
CALLAWAY YES BUT THERE'S BEEN
SITUATIONS WHERE THOUSANDS I
I THINK THE LACK OF THE LATEST
NUMBER HEARD WHEN THE PREVIOUSLY
WAS EIGHTY FIVE HUNDRED NEGATIVE
TESTS WERE NOT INCLUDED --
IN THE STATE DATABASE EVEN
THOUGH THE CURRENT AND MAYBE
THIS IS -- IN REFERENCE OF A
VISIT TO -- TO MY COLLEAGUES
IN THE MEMBER COOPER'S
RESPONSE THAT MET SOME OF
THAT WAS PAPER REPORTING VERSE
IS ELECTRONIC BUT IS IT THE
POSITION OF CV PH THAT ALL
TEST WHEN THEY'RE TAKEN ARE IT
SHOULD BE INCLUDED IN THE DATA
THAT'S PROVIDED IN CAR READY
YES AND WE KNOW THAT THAT
SPECIFIC SITUATION AND AS YOU
POINTED OUT AS A FEDERAL ASSET
THAT WAS DEPLOYED AND THEY
WHEN THEY DEPLOYED NOT REALLY
ON THAT THAT'S A MISSION TO
US SO WE ARE STILL WORKING ON
THAT DIRECT DATA FEED BUT IN
THE MEANTIME WE'RE RECEIVING
THAT DATA INDIRECTLY INCLUDING
INTO THE COUNTIES OKAY BECAUSE
MY CONCERN IS INCLUDED THAT
THAT WAS THAT RETROSPECTIVELY
BUT MOVING FORWARD WE'RE STILL
WE STILL ARE UTILIZING THE
MOBILE TESTING SITES AND I
BELIEVE THAT AS WE'RE TRYING
TO RAMP UP AND AS YOU INDICATED
IDENTIFY CERTAIN HOT SPOTS
IN THROUGHOUT THE COMMUNITY
THAT THE MOBILE TESTING SITES
WILL BE VERY VERY IMPORTANT
BECAUSE WE'RE GOING TO GO TO THE
POPULATIONS THAT ARE -- IN NEED
SO CLEARLY WE WANT TO ENSURE
THAT THERE'S A PROCESS IN PLACE
THAT AS THOSE TESTING SITES
CONTINUE TO TEST ESPECIALLY IN
AN INVALID YOU KNOW COMMUNITY
KERN COUNTY THAT THERE'S
ARE THOSE ARE COUNTED YES
ABSOLUTELY OKAY -- AND THEN
LASTLY I GUESS IS -- MAYBE
I THIS IS A BROADER QUESTION
BUT YOU CAN INDICATED IN THE
DARK CIRCUMVENTS THAT HAPPENED
THE WILDFIRES ARE CLEARLY ONE
OF THEM -- AS THE GUIDANCE IS
-- WHAT THE GUIDANCE IS BE OF
THAT REEVALUATED OR THEY RE
EVALUATE OVER TIME AS WE LOOK
AT THE DATA AS WE LOOK AT TRENDS
AS THINGS ARE IMPROVING WITH
THOSE GUIDANCES CHANGE OR
THEY'RE THEY'RE NOT THEY'RE NOT
STATIC I'M ASSUMING THAT THEIR
DYNAMIC BUT HOW OFTEN ARE THEY
REEVALUATED AND -- AND HOW CAN
WE IMPROVE THE COMMUNICATION
WITH THE LEGISLATURE IN TERMS
OF GETTING THE INFORMATION
OUT THERE WE'RE FINDING OUT
IN A PRESS CONFERENCE INSTEAD OF
MAYBE HAVING MORE COLLABORATIVE
PROCESS IN TERMS OF IT BECAUSE
WE'RE GETTING INPUT FROM
OUR CONSTITUENTS AND FROM
INDUSTRY LEADERS -- WE WOULD
LIKE TO HAVE SOME INPUT IN
TERMS OF HOW THESE ARE REALLY
AFFECTING REAL BUSINESS IS
REAL INDIVIDUALS WILL FAMILIES
SIR THANK YOU FOR THE BECAUSE
AS FAR AS HOW OFTEN THINGS ARE
ABOUT TO RE EVALUATE I WOULD
SAY CONSTANTLY -- AND IT'S
HARD TO PREDICT YOU KNOW WHEN
NEW TECHNOLOGY NEW GUIDANCE
FROM YOU KNOW THE WORLD HEALTH
ORGANIZATION OR THE CDC OR
OTHER ORGANIZATIONS OR DATA
WE'RE LOOKING AT IT WITHIN THE
STATE THAT FARMS ARE DECISIONS
SO WE'RE I'D SAY DALY LOOKING
AT REEVALUATING EVERYTHING ARE
TESTING GUIDANCE SPECIFICALLY
I'D SAY IT'S JUST CONSTANTLY
EVOLVING FOR DIFFERENT SETTINGS
DIFFERENT COMMUNITIES -- SO
THAT'S A CONSTANT AND I THINK
WE'LL TAKE THAT BACK AND YOU
KNOW REALLY THINK -- YOU KNOW
TAKE THAT BACK TO INTERNALLY
AND WITH ART WITHIN THE WHOLE
ADMINISTRATION ABOUT HOW TO
BETTER COMMUNICATE TO ALL OF
YOU OKAY I APPRECIATE THANK
YOU SO MUCH FOR YOUR TIME SIR
YEAH THANK YOU MISTER PRIME
HI GOOD MORNING I WANT TO
START WITH JUST A QUESTION FOR
DOCTOR PAN ABOUT THE --
THE COLOR TIER SYSTEM OUT
ONE SOURCE OF FRUSTRATION FOR
DIFFERENT AREAS OF THE STATE
HAS BEEN THAT THE COLORS APPLY
ON A COUNTY WIDE LEVEL --
WHICH IS REALLY YOU KNOW KIND
OF ARBITRARY LINES ON A MAP --
IT IS NOT CONNECTED TO SORT OF
THE REAL WORLD CIRCUMSTANCES OF
CONTIGUOUS COMMUNITIES -- SO THE
CITY OF FOLSOM WHICH I REPRESENT
AS VERY LOW CASE RATE AND IT'S
-- PHYSICALLY SITUATED -- RIGHT
NEXT EL DORADO HILLS -- WHICH IS
PART WHICH IS IN THE THE THIRD
LEVEL WHAT IS THAT I GUESS THE
ORANGE -- TEAR -- WHEREAS
FULSOME BECAUSE IT JUST HAPPENS
TO BE PART OF SACRAMENTO COUNTY
-- IS IN THE PURPLE HERE SO --
COMMUNITIES THAT ARE RIGHT NEXT
TO EACH OTHER THAT HAVE VERY
SIMILAR -- PROFILES AND IT COMES
TO -- THE PREVALENCE OF KOBE
NINETEEN IN THE COMMUNITY -- ARE
SUBJECTED TO VASTLY DIFFERENT
-- RESTRICTIONS WHEN IT COMES
TO BUSINESSES AND EVERYTHING
ELSE SO HAVE IS YOUR DEPARTMENT
LOOKED AT DOING THIS IN A WAY
THAT IS MORE FOCUSED
AT THE COMMUNITY LEVEL
SO IT'S A GREAT QUESTION AND
HAS COME UP A FEW TIMES AND I
THINK I THINK THERE ARE MANY
-- SORT OF CHALLENGES RELATED
TO LOOKING AT SOMETHING HAVING
WIDE VERSUS CITIES ARE OTHERS
AND DISEASE TRANSMISSION YOU
KNOW WE ALSO ACKNOWLEDGE IS NOT
NO SORT OF COUNTY BORDERS ARE
CITY BORDERS BUT WE DO HAVE TO
-- WE DO HAVE TO EVALUATE THESE
THINGS AND -- PROVIDE GOVERNANCE
IN THE STRUCTURES THAT WE HAVE
SO I THINK -- YOU KNOW AGAIN WE
KNOW THAT THAT'S -- THOSE ARE
CONSIDERATIONS AT THE COUNTY
LEVEL AS WELL PEOPLE HAVE
BEEN LOOKING AT I THINK OUR
APPROACH IS STILL THAT YOU KNOW
WE NEED TO YOU KNOW SIMILAR TO
ACTUALLY TOUCH ON -- WE WILL
LIKELY BE SAYING WHAT HONOR
HEALTH EQUITY METRIC THAT YOU
KNOW YOU REALLY WANT TO CLOSE
USING A LIST OF TRANSMISSION
ALISTAIR HE -- AND HAVE KIND
OF ALL GOVERNMENT ALL COMMUNITY
APPROACH TO REALLY GET YOU KNOW
FIND WHERE YOUR HIGHEST HOT
SPOTS ARE AND WHERE DISEASE
TRANSMISSION DOESN'T GET THOSE
DOWN AND THAT WILL HELP ALL
OF YOU MOVE FORWARD NANCY THAT
PRINCIPLE CAN APPLY DIFFERENT
WAYS WHETHER IT'S CERTAIN
COMMUNITIES CERTAIN GEOGRAPHY --
THAT WE WE HAVE HEARD INTEREST
IN THAT AND I WILL ACTUALLY
SPEAK AS A WHEN I WAS AT A LOCAL
COUNTY LEVEL THAT REQUEST CAME
TO ME AT A LOCAL KIND OF LEVEL
I ALSO DID NOT THINK THAT WE
COULD DO THAT JUST BECAUSE WE
NEED TO YOU KNOW GOVERN AND
THE STRUCTURES THAT WE HAVE
IN THE STRUCTURES WE HAVE
ZERO YOU MEAN THAT THAT COUNTY
GOVERNMENT IS THE STRUCTURALLY
HAPPENED SO THAT'S JUST KIND
OF WHERE YOU'RE PLACING THAT
-- YOU KNOW THE THE ASSIGNMENT
OF DIFFERENT CALLERS TO THE
COUNTY LEVEL BECAUSE THAT JUST
HAPPENS TO BE THE THE SYSTEM THE
GOVERNMENT SYSTEM THAT WE HAVE
IS THAT THE JUST WHAT YOU'RE
SAYING THERE PUBLIC HEALTH
DEPARTMENT SYSTEM IS LARGELY
COUNTY BASED THERE ARE CITY HALL
THREE CITY HEALTH DEPARTMENTS
AND AND ACTUALLY THOSE THREE
CITIES ALL AROUND THAT IT AND
TO COUNTIES AND THOSE CITIES
ARE ALSO HAVING TO FOLLOW ALONG
AND AND AND BE PART OF THE
COUNTY METRICS BECAUSE AGAIN
-- YOU KNOW ESPECIALLY YEAH
I KNOW YOU GREAT SOME POINTS
ABOUT PERIPHERAL VERSES WITH
THEN THAT THEY'RE ALL WITHIN
ONE ENTITY AND THEY THE CITY
HEALTH DEPARTMENT ACTUALLY
HAVE COMPLETE LOCAL HEALTH
AUTHORITY BUT THEY ACTUALLY
CANNOT CANNOT HAVE A DIFFERENT
RULE TO MOVE YOU KNOW WITHIN THE
TEARS OUTSIDE OF THEIR COUNTY
OKAY JUST DO THAT THAT DOESN'T
SEEM TO ME TO TO REALLY
GET TO THAT THE CONCERN AT
WHICH IS THAT YOU KNOW WERE --
CREATING RESTRICTIONS ON THE
BASIS OF PREVALENCE OF COVER
NINETEEN IN A GIVEN REGION --
BUT -- IT'S BEING DONE IN SUCH A
BROAD BRUSH THE WAY THAT YOU
HAVE -- COMMUNITIES THAT ARE
YOU KNOW CLOSER PHYSICALLY TO
-- AREAS THAT ARE IN THE WORST
YEAR THAN THEY ARE TO THE MORE
PROBLEMATIC AREAS OF THEIR OWN
COUNTY -- AND YET -- ARE BEING
FORCED INTO A TEAR THAT
CLEARLY IS NOT THE CORRECT
ONES FOR THEM SO WHAT WOULD YOU
TELL A CITY LIKE FOLSOM YOU KNOW
WHAT DO THEY NEED TO SHOW YOU IN
ORDER TO DEMONSTRATE THE SORT
OF INSTITUTIONAL CAPACITY
TO BE ABLE TO HAVE AN
ASSIGNMENT OF A TEAR THAT IS
NOT -- YOU KNOW SIMPLY AT THE
MERCY OF THE REST OF THE COUNTY
I MEAN AGAIN I THINK THE OTHER
REALLY IMPORTANT PRINCIPLES THAT
DISEASE TRANSMISSION YOU KNOW
IT THIS VIRUSES SPECIFICALLY
MOVES VERY QUICKLY WE'VE SEEN
HOW QUICKLY THINGS ESCALATED
THIS SUMMER IN CALIFORNIA AND
CERTAINLY IN CERTAIN REGIONS
SO JUST BECAUSE YOU ARE
GEOGRAPHICALLY PARTS NOT MEAN
PEOPLE CANNOT GO BACK AND FORTH
AND WE'RE CERTAINLY DISCOURAGING
PEOPLE FROM MIXING ACROSS
COMMUNITIES AS ONE OF THE KEY
PRINCIPLES AS I MENTIONED FOR
THE SECTORS BUT AGAIN I THINK
YOU KNOW SIGNED I JUST GOT
THAT THAT DOESN'T GET TO THE
QUESTION MANY PEOPLE CAN CROSS
COUNTY LINES AS WELL SO THAT'S
AN ARGUMENT AGAINST HAVING
DIFFERENT TIERS FOR DIFFERENT
COUNTIES I MEAN THE QUESTION
IS SPECIFICALLY -- ESPECIALLY
WHEN YOU HAVE CASES LIKE THE
CITY OF FOLSOM WHY CAN'T THE
STATE ESTABLISH A SET OF
CRITERIA TO ALLOW -- IN CASES
LIKE THAT A GREATER DEGREE
OF FLEXIBILITY IN THE COUNTY
BY COUNTY SYSTEM OFFERS
I THINK IT'S SIMILAR TO WHAT I
READ I MEAN WHEN WE HAVE COUNTY
BASED SORT OF -- ORDINANCES
OR RULES OR STATEWIDE THINGS
ARE COUNTY BASED THAT WE CAN'T
NECESSARILY CHANGE THOSE FOR
SPECIFIC -- SUBGROUPS WELL SURE
YOU CAN THE STATE'S CREATING
THE WHOLE SYSTEM I MEAN THIS
IS AN ENTIRELY NEW THING THAT
THE STATE'S PUT IN PLACE THAT
CAN DO IT HOWEVER WANTS RIGHT
WHITE WHY CAN'T THAT BE DONE
BUT IT'S BASED ON THE CRACKS OF
WORKING CLOSELY WITH OUR LOCAL
PUBLIC HEALTH DEPARTMENTS AS
WELL AND OUR LOCAL PUBLIC HEALTH
DEPARTMENTS ARE COUNTY THIS AND
THEIR RESPONSIBILITY FOR WORKING
ON COULD DISEASE TRANSMISSION
AND PREVENTION AND CONTROL ARE
IN COLLABORATION WITH THEIR
THEIR COMMUNITY AND THEY'RE
COUNTY -- AND OTHER CITIES
TO SEE THAT AT A COUNTY LEVEL
C. CERTIFIED SAY SACRAMENTO
COUNTY'S PUBLIC HEALTH
DEPARTMENT EXPRESSED A
WILLINGNESS TO WORK TO CREATE
A MORE FLEXIBLE A SET OF
CRITERIA FOR FULSOME AND
SAID THAT THAT WAS YOU
KNOW SOMEONE THAT THEY CAN
MANAGE WITH YOUR APARTMENT
BE OKAY SIGNING OFF ON THAT
WE WOULD STILL BE
ASSIGNING THE SAME TEARS
BASED ON THE COUNTY LEVEL
ALL RIGHT WELL I WOULD -- SIMPLY
ENCOURAGE THE ADMINISTRATION TO
TAKE A MORE WE ARE REAL WORLD
APPROACH I THINK THAT SIMPLY
SINGLE IT'S EASIER TO DO IT
BY COUNTY BECAUSE THAT'S WHERE
WE HAPPEN TO HAVE -- YOU KNOW
DIFFERENT UNITS OF GOVERNMENT
READY MADE IN EXISTING PUBLIC
HEALTH DEPARTMENTS I UNDERSTAND
THAT BUT YOU KNOW WE'RE TALKING
ABOUT PEOPLE'S LIVELIHOODS HERE
WE'RE TALKING ABOUT BUSINESSES
THAT ARE BEING FORCED TO CLOSE
PERMANENTLY YOU KNOW WE'RE
TALKING ABOUT COMMUNITIES
THAT MAY NEVER RECOVER IN SOME
WAYS AND JUST SAY WELL IT'S
IT'S JUST EASIER TO DO IT AT
THE COUNTY LEVEL THAT TO ME
IS NOT AN ACCEPTABLE ANSWER
MOVING ON TO THE THE DATA
GLITCH -- SO I --
RECEIVED A LETTER FROM ACTING
DIRECTOR SHE READ -- IN --
AUGUST AUGUST TWENTY EIGHTH
-- IN WHICH SHE NOTED THERE'S
BEEN THE DEPARTMENT IS BUILT
REDUNDANT PROCESSES TO VALIDATE
THE DATA REPORTS FOLLOWING
THE GLITCH AND INDEED WE'VE
HEARD A LITTLE BIT MORE
ABOUT THAT TODAY I'VE HEARD
FROM A COUPLE OF THE FOLKS
WHO HAVE TESTIFIED ABOUT
PARALLEL VALIDATION SYSTEMS
AN INDEPENDENT VERIFICATION
CHANNELS SO JUST TO CLARIFY
THESE ARE ALL REDUNDANCIES
THAT HAVE BEEN PUT IN PLACE
FOLLOWING THE DATA QUITS RIGHT
THAT'S CORRECT OKAY YES
WE WE WERE DOING SOME CHECKING
BUT I'M NOT AT THE EXTENT
THAT WAS REQUIRED WITH THE
VOLUME INCREASE AT THAT --
THE LEVELS THAT IT'S GONE UP
ARE THEY JUST MADE THERE WAS
MORE OPPORTUNITY FOR SOMETHING
TO HAPPEN SO THEY'VE THEY'VE
BEEN IMPLEMENTED STARTING
THE BEGINNING OF AUGUST AS
WE UNCOVER ALL THE ISSUES AND
DEVELOPS OF COUNTER BALANCES AND
-- ALTERNATE WAYS TO VALIDATE
EVERY SINGLE DAY THE METRICS
SEASON IS THE VOLUME INCREASE
THERE'S MORE OPPORTUNITY FOR
SOMETHING TO HAPPEN I GUESS
THAT'S WHAT I FIND A LITTLE
MYSTIFYING ABOUT THIS THIS WHOLE
INCIDENT IS THAT YOU KNOW I'VE
HEARD TIME AND AGAIN THE CAL
READY SYSTEM WAS NOT A SYSTEM
DESIGNED TO HANDLE THE SORT OF
ALL YOUR BILL IS NOT DESIGNED TO
HANDLE THE SORT OF ALL I AM --
AND YET IT TOOK AN INCIDENT LIKE
THIS FOR THE ADMINISTRATION
TO PUT IN PLACE THE SORT OF
REDUNDANCIES -- WHICH ARE
YOU KNOW SORT OF A STANDARD
FEATURE OF OF ENGINEERING WHEN
YOU HAVE A CRITICAL SYSTEM
-- IN ORDER TO MAKE SURE THE
SUNLIGHT DOESN'T HAPPEN TO WHITE
WHY WAS THAT NOT DONE SOONER
ESPECIALLY GIVEN HOW HEAVILY THE
STATE HAS RELIED ON THIS DATA
WELL -- SO THE RIVER
-- RELYING ON THE DATA OVER
THE PAST FEW YEARS IS IT WAS
SIGNIFICANT AND EVERYTHING
WAS IMPORTANT BUT WHEN COVERT
CAME THE DATA METRICS --
WERE LARGE LARGE AMOUNTS OF DATA
BUT THEY ALSO WERE NEEDED EVERY
SINGLE DAY IT AT SO THE
URGENCY OF UP YEAR LARGE COMING
INTO THE SYSTEM AND BEING
COUNTED THAT DAY WERE MUCH
MORE SIGNIFICANT THAN THEY
WERE YEAR TWO YEARS AGO SO WE
WATCH THE SYSTEMS -- WE WERE
DOING FIVE THOUSAND MESSAGES
A DAY IN OUR GATEWAY NOW WE'RE
DOING A HUNDRED AND FIFTY SO
UP THE SYSTEMS THEMSELVES ARE
ACTUALLY DESIGNED BUT THEY
ARE WORKING UNDER THE NEW LOW
BECAUSE WE'VE MADE SIGNIFICANT
IMPROVEMENTS BUT -- AT THE TIME
THEY WERE OPERATING AT A PACE
BASED ON THE MESSAGES THAT WERE
COMING INTO THE SYSTEM AND WE
FELT THAT WE HAD A REALLY GOOD
HANDLE ON ON ALL THE LABS ARE
REPORTING AND HOW OFTEN YOU'RE
REPORTING THAT THE NUMBERS
GOING UP MORE LAPSED MORE
CRITICALITY AND IF A BATCH
OF -- E. A LARGE DIDN'T GET
PROCESS FOR SOME REASON -- THE
COUNTY'S NEW THAT DAY AND WERE
TALKING TO US AND SO WE HAD
TO THEN IMPLEMENT A GREATER --
-- SORT OF VALIDATION ON EVERY
SINGLE DAY OF ALL THE MESSAGES
ARE COMING AND TO KEEP UP
TO ENSURE THAT THE COUNT
WAS ACCURATE FOR THAT DAY
SO WHEN THIS INCIDENT HAPPENED
I MEAN WAS IT A SURPRISE
WHY DID WHY DID IT HAPPEN
WHILE ARE WE READY FOR
THIS I GUESS IS MY QUESTION
SO ARM
I THINK WE KNEW THAT
THE LABORATORY TEST WE'RE
GOING TO INCREASE --
DID WE PLAN FOR THEM TO GO
UP TEN TIMES SO PROBABLY
NOT I THINK WHAT HAPPENED TO
CAUSE THIS IS THAT IT WAS A
COMBINATION OF A NUMBER OF
THINGS OR TWO OR THREE THINGS
THAT ACTUALLY HOSTAGE SITUATION
DE DUPLICATE MESSAGES THE
BACKLOG BECAUSE OF THEM THE
CHANGES WE MADE TO OUR GATEWAY
TO TRY TO CATER FOR THAT --
A SITUATION WHEN ON A NORMAL
WEEKEND WHERE THERE WAS A
PATCHING GOING ON -- THE SYSTEM
DIDN'T COME BACK UP TO THE
CONFIGURATION THERE A NUMBER
OF THINGS HAPPEN OVER THOSE TO
A THREE WEEK PERIOD IT CAUSED
ENORMOUS AMOUNT OF BACK LOCKED
AND AND THAT'S HOW WE'RE REACHED
AND WE RESPONDED TO THAT ALSO
KNOWING THAT THE NUMBER OF THE
LAB TESTS ARE GOING TO GO UP
SIGNIFICANTLY WE KNOW STARTING
NEXT MONTH SOME ADDITIONAL
-- TASK FROM PERKIN ELMER
COULD BE AS MUCH AS FORTY FIFTY
THOUSAND BY THE END OF THE YEAR
HUNDRED FIFTY THOUSAND MORE SO
WE HAVE JUST CONTINUE TO PUT
RESOURCES IN TIME TO ENSURE THE
QUALITY SCALABILITY RELIABILITY
IS BETTER TODAY THAN IT WAS LAST
YEAR THAT'S AND I APPRECIATE
THAT AND I THINK SOME OF THE
STEPS ARE ENCOURAGING BUT
WHEN YOU SAY THAT YOU DIDN'T
EXPECT THE TEN FOLD INCREASE
WHY NOT WHY WAS THAT SURPRISING
-- I HAD I'M NOT SURE I CAN'T
REALLY ANSWER IT I MEAN I THINK
YEAH IN HINDSIGHT IT'S IT WE
CAN GO BACK AS A YEAH WE SHOULD
HAVE BEEN ABLE TO SEE THAT THE
SISTERS WERE PERFORMING PRETTY
WELL AND WE FELT WE HAD TO
PASS CITY -- BUT YEAH
WE DID QUICKLY REALIZED THAT
I MEAN THE SAME SYSTEMS TODAY
ARE IN PLACE THAT WERE THERE TWO
MONTHS THREE MONTHS AGO WE'VE
JUST PUT SIGNIFICANT EFFORT IN
IMPROVING -- THE PERFORMANCES
OF SYSTEMS BY -- DOING
DEEP ANALYSIS AND BRINGING AND
SKILLS PARTIES I AND MANY
MORE STAFF TO WORK ON THAT
I KNOW THAT A LOT OF FOLKS HAVE
BEEN WORKING HARD TO MAKE THAT
HAPPEN SO THANK YOU VERY MUCH
I JUST -- YOU KNOW IT SEEMS
TO ME THAT WHEN YOU HAD THE
GOVERNOR IN MARCH SAYING THAT UP
TO TWENTY MILLION PEOPLE COULD
ULTIMATELY GET COBA NINETEEN
AND TELLING US ON A DAILY BASIS
THAT WE'RE MAKING DECISIONS
OF YOUR DAILY LIVES ON THE
BASIS OF THE DATA -- AND
WHEN EVERYONE IS ACKNOWLEDGING
THAT THE EXISTING SYSTEM WAS
NOT BUILT TO HANDLE THIS SORT
OF VOLUME THAT WOULD HAVE BEEN
AN URGENT PRIORITY TO MAKE SURE
THAT NO STONE IS LEFT UNTURNED
TO CREATE REDUNDANCIES WE WOULD
NEED TO ENSURE AN ACCURATE
FLOW OF DATA THAT WAS TO SERVE
AS THE BASIS OF THOSE DECISIONS
AND IT SEEMS THAT THAT DIDN'T
HAPPEN SO WELL I APPRECIATE
THE CORRECTIVE STEPS THAT ARE
BEING TAKEN YOU KNOW THAT'S
TO FIX THIS PARTICULAR PROBLEM
AND IT'S ESSENTIALLY A REACTIVE
POSTURE SO I WOULD SIMPLY
ENCOURAGE THE ADMINISTRATION
TO TRY TO TAKE A MORE FOR LIKE
THE THINKING APPROACH TO TRY
TO ANTICIPATE PROBLEMS THAT
MIGHT COME UP AND SURE THAT WE
HAVE AT THE SYSTEMS IN PLACE
THAT WE NEED AND THE LAST POINT
I JUST WANT TO RAISE IS ABOUT
THE COMMUNICATION OF THIS --
INFORMATION TO THE PUBLIC ACT
AS THE LA TIMES REPORTED THAT
-- THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH SAID COUNTY HEALTH
DEPARTMENT EMAIL ON JULY THIRTY
FIRST DESCRIBING AN ISSUE --
PROCESSING LAB RESULTS IN DELAYS
IN THE COW READY SYSTEM AND
THE EMAIL I. NOTES THAT LOCAL
OFFICIALS HAVE BEEN INFORMED OF
THE PROBLEM EVEN EARLIER --
AND YET THREE DAYS LATER -- THE
GOVERNOR HELD A PRESS CONFERENCE
AND TOUTED A DECLINE IN COVERT
CASES -- ON THE BASIS OF THAT
INACCURATE DATA SO WHY IS IT
THAT SOMETHING THAT THE PUBLIC
HEALTH DEPARTMENT KNEW ABOUT
AT LEAST THREE DAYS EARLIER
DIDN'T FIND ITS WAY TO THE
GOVERNOR AS HE -- CONVEYED
THIS PUBLIC HEALTH INFORMATION
SORRY THAT IS ONE OF THE
QUALITY CONTROL ISSUES WE HAVE
PUT BACK IN PLACE THAT THAT
INFORMATION DID NOT FLOW UP IT
DID NOT PULL UP TO THE DIRECTOR
IT DID NOT FLY UP TO AGENCY
OR TO THE GOVERNOR'S OFFICE
AND WE RECOGNIZE THAT THAT'S
A PROBLEM -- AND WE PUT IN A
LOT OF CONTROL MEASURES TO MAKE
SURE THAT DOESN'T HAPPEN AGAIN
OKAY AND CAN YOU BE A LOT MORE
SPECIFIC ABOUT EXACTLY WHY IT
WHAT WERE THE IMPEDIMENTS TO
THAT SORT OF A INFORMATION FLOW
AND WHAT THE QUALITY CONTROL
MEASURES ARE SO ONE QUALITY
CONTROL MEASURE IS THAT THE
MESSAGING GOING OUT TO OUR
LOCAL JURISDICTIONS IS NOW
REVIEWED UP THE CHAIN SAW THAT
MESSAGING THAT'S HAPPENING
BETWEEN STOCK OUR ANY AND OUR
LOCAL PARTNERS WORKING ON THE
GROUND IS ALSO INCLUDED WITH THE
DIRECTOR AND AND LEADERSHIP SO
THAT WE WOULD BE AWARE AS SOON
AS THOSE MESSAGES GO OUT THAT
SOMETHING MIGHT BE A PROBLEM
WE HAVE MULTIPLE NOTIFICATIONS
NOW PUT IN PLACE SO THAT ANY
ISSUES THAT COME UP ARE ARE
NOT ONLY GOING TO ONE PERSON
OR LINE MANAGER BUT GOING TO
MULTIPLE AND GOING UP THE CHAIN
HAS SOME OF THAT YOU KNOW MORE
QUICKLY THAT SOMETHING IS --
CHALLENGING OR A BARRIER TO
GETTING ACCURATE TIMELY DATA
ALL RIGHT THANK YOU I THINK
I YOU KNOW I JUST CANNOT HAVE
SIZE ENOUGH THE IMPORTANCE THAT
THE PUBLIC IS A SURE HEARD --
THAT THE INFORMATION IS BEING
COMMUNICATED TO IT IS ACCURATE
AND THAT THAT DIDN'T HAPPEN
HERE AND YOU KNOW TO MAKE
THINGS EVEN WORSE WE HAD THE
THE RESIGNATION OF THE PUBLIC
HEALTH DIRECTOR -- THAT CAME
AMIDST THIS WHOLE INCIDENT
AND THE GOVERNOR WOULDN'T
EVEN TELL US WHY HE WOULD SAY
THAT WAS A PRIVATE PERSONNEL
MATTER WHEN WE'RE TALKING
ABOUT THE RESIGNATION OF THE
CALIFORNIA -- DIRECTOR OF PUBLIC
HEALTH WHICH WAS OBVIOUSLY A
CONNECTED TO THE SITUATION SO --
I -- I I I WOULD JUST REITERATE
WHAT I SAID BEFORE THAT ON A
FORWARD GOING BASIS I HOPE THAT
THINGS ARE LOOKED AT IN A -- IN
A FORWARD LOOKING AND SYSTEMATIC
WAY SO THAT WE'RE NOT JUST
CONSTANTLY IN THIS REACTIVE
POSTURE THAT I THINK IS -- YOU
KNOW -- HAMSTRUNG OUR STATE'S
CODE RESPONSE IN MANY WAYS YEAH
WE WE HAVE LEARNED A LOT OF
LESSONS THROUGH THIS PROCESS
AND WE ARE LOOKING FORWARD AS
MUCH AS WE POSSIBLY CAN THANK
YOU VERY MUCH THANK YOU DOCTOR
REGULAR THANK YOU MISTER CHAIR
AND -- I WANT TO THANK MY
COLLEAGUES FOR THEIR LEVEL OF
QUESTIONS I THINK IT'S BEEN
QUITE INFORMATIVE AND REALLY
APPRECIATE IT SPECIFICALLY I WAS
GOING TO ASK ABOUT THE ADJUSTED
RATES -- WITHIN THE BLUEPRINT
AND SO I WILL HAVE MY FIRST
QUESTION TOWARDS DOCTOR PAN
IF I CAN HAVE HER COME TO THE
CHAIR BUT I BELIEVE
SPOKE ABOUT SCHOOLS REOPENING
WITH THE RED TIER AND AS
MANY OF US SEE THIS AS A
NATIONAL EMERGENCY FOR US TO
BE ABLE TO MAKE POSITIVE STEPS
FORWARD I WAS HOPING YOU COULD
SPEAK ABOUT -- THAT JUST SO
THAT WE CAN HAVE CLARIFICATION
SURE SO JUST WHAT THE RULES
ARE ABOUT IN SCHOOL STUDENTS
ABSOLUTELY SO TO REITERATE
AGAIN -- BASICALLY --
WAS ONCE A COUNTY HAS ENTERED
INTO THE RED HERE AND THERE IN
THAT READ HERE FOR TWO WEEKS
IF THE ACCOUNT REMAINS STABLE
IN THAT TWO WEEKS AND YOU KNOW
DOES NOT SEEM LIKE IT'S GONNA
RESTRICTION THAN THE SCHOOLS
COULD BEGIN TO RE OPEN AND AS
YOU'RE SEEING I THINK MANY OF
THOSE SCHOOL SYSTEMS SCHOOL
DISTRICTS AND COUNTIES ARE
STILL IF WITHIN THAT DECIDING TO
PHASE THAT RE OPENING OF THE
OTHER ISSUE I DIDN'T MENTION
EARLIER IS THAT -- IN THE PURPLE
TEAR THE WIDE FOR TRANSITION
TO HEAR AGAIN PRIORITIZING OUR
YOUNGEST CHILDREN WHO WOULD KNOW
-- YOU KNOW ARE HAVING THE
HARDEST TIME WITH DISTANCE
LEARNING -- THAT COUNTY
IS SCHOOL DISTRICTS IS GIVING
AND -- SCHOOL LEADERS CAN SUBMIT
A REQUEST FOR A WAIVER FOR
KINDERGARTEN TEACHER THREE SIX
GRADE THEY CAN SUBMIT A WAIVER
TO THEIR LOCAL HEALTH DEPARTMENT
AND THE OFFICER CAN WE GET THOSE
WAIVERS OFTEN SUSSING THE SCHOOL
SAFETY PLAN THE SCHOOLS ACTUALLY
NEED TO POST THAT SAFETY PLAN
PUBLICLY SO THAT THEIR COMMUNITY
CAN SEE THE SCHOOLS ALSO NEED
TO BE THERE THEIR TEACHER
IN THEIR OWN COMMUNITY AND SORT
OF MAKE SURE THAT THEIR SUPPORT
TO RE OPEN AND THEY APPLY THE
HEALTH DEPARTMENT'S ASSESSMENT
AND THEY ALSO CONSULT WITH US
AT THE STATE HEALTH DEPARTMENT
SO -- AS THE ACTING STATE HEALTH
OFFICER IT'S AN EPIDEMIOLOGIST
AYE YOU KNOW HOW WE KIND OF
TAKE A LOOK AT THOSE AS WELL AND
CONSULTED WE ANSWERED EXPRESSED
CONCERNS IF WE HAVE ANY ABOUT
THE SITUATION ABOUT WHETHER OR
NOT SCHOOLS SO AGAIN IT'S TWO
WEEKS IN THE RED HERE AFTER THE
TWO WEEKS SCHOOLS THREE OPEN
AND THEN SCHOOLS CAN APPLY FOR
A WAIVER IN THERE COUNTY --
K. TWO SIX -- AND THAT AND THEN
WITHIN THAT IS THERE HAVE BEEN
SITUATIONS ARE ACTUALLY JUST
HIGHLIGHT WHERE THERE'S A REALLY
HIGH DISEASE TRANSMISSION LEVEL
AND WE RECOMMEND THAT THAT --
IF THE DISEASE TRANSMISSION
IS OVER FOURTEEN PER CAPITA
FOURTEEN PER HUNDRED THOUSAND
CASES PER DAY IT'S ABOUT THAT
WE REALLY DON'T RECOMMEND
SCHOOLS RE OPENING AT THAT
POINT BUT ONCE YOU GET BELOW
THAT THAT THERE COULD BE AN
APPLICATION PROCESS FOR A WAIVER
AND I'M NOT ALLOWS THE LOCAL
HEALTH DEPARTMENT LOCAL HEALTH
OFFICER TO ASSESS THE SAFETY
PLANS OF THE SCHOOLS THANK
YOU AND YOU KNOW I I DO WANT TO
SAY -- THE THINGS ARE
CONSTANTLY EVOLVING IT WAS
BACK ON MARCH SECOND THAT I
HAD A DOCTOR ANGEL HERE PRESENT
AND WORSE ABLE TO ASK HER
SOME QUESTIONS AND WANTS TO
HIGHLIGHTS AND HER NAME WAS
BROUGHT UP EARLIER I BELIEVE HER
TO BE A CHAMPION FOR SOCIAL AND
RACIAL JUSTICE THAT TO REALLY
STOOD UP AND SPOKE FOR MUCH
OF OUR COMMUNITY AND HAS HELPED
US TO ADDRESS HEALTH EQUITY IN A
VERY MEANINGFUL WAY AND SO JUST
WANT TO HIGHLIGHT HER TIME HERE
AND HER SERVICE TO OUR STATE AS
SOMEONE WHO WAS LOOKING TOWARDS
THAT BUT IT'S IN THAT VEIN THAT
I FEEL LIKE I MUST ASK IF WE
ARE GOING TO BE TALKING ABOUT
SCHOOL RE OPENINGS SOME OF THE
DISCREPANCIES THAT WE'RE SEEING
IN THE HEALTH OUTCOMES AND SO
I'M HOPING YOU CAN SPEAK TO IF
YOU CAN BECAUSE I DON'T WANT
TO GET LOST IN THE MY NEW SHOW
OF THE MOMENT AND NOT SEE
WHICH PARTS OF OUR STATE
ARE BEING AFFECTED BY THIS
VIRUS THE MOST AND SO I'M
HOPING IF YOU CAN TO TALK ABOUT
SPECIFICALLY CHILDREN WHAT
ARE THE HEALTH OUTCOMES THAT
WE'RE SEEING WITH THE STATE AND
ARE THERE HEALTH DISPARITIES
SO AND I THINK THERE'S CERTAINLY
DIFFERENT ELEMENTS OF THAT
AND -- THIS IS AN AREA I ALSO
HAVE A A LOT OF INTEREST AND I
WOULD SAY WHAT IS ENCOURAGING
ABOUT CHILDREN AND PEDIATRIC
CASES IN THE STATE RIGHT NOW
IF WE'RE TALKING ABOUT COVER
NINETEEN AN IMPRACTICAL THE
NINETEEN IS THAT WE ARE SEEING
MORE CHILDREN TEST POSITIVE
BECAUSE MORE CHILDREN ARE --
HAVING YOU KNOW INDIVIDUAL
HAVING SYMPTOMS -- BUT IS STILL
A MUCH SMALLER PROPORTION OF
CASES THAN THE PROPORTION OF
KIDS IN THE POPULATION AND
AMOUNTS ARE HOSPITALIZATIONS I
BELIEVE IT IS STILL I WILL NEED
TO CONFIRM THIS BUT I BELIEVE IT
IS STILL LESS THAN ONE PERCENT
OF OUR CASES ARE HOSPITAL'S
CHILDREN'S SO OVERALL I THINK
AND -- DOCTRINA YOU MAY OR MAY
NOT OF HEARD AS WELL THERE'S
THERE'S SOMETHING AREAS AROUND
LIKE CHILDREN -- WHICH IS VERY
DIFFERENT AND SLEW AS FAR AS
RESTORATION IRISES THE CHILDREN
DO NOT SEEM TO BE ESPECIALLY
YOUNG CHILDREN SEEM TO BE
-- ABLE TO NOT HAVE A SEVERE
DISEASE NOT BE AFFECTED AS
OFTEN AND OFTEN -- ARE NOT
TRANSMITTING TO OTHERS SO I
THINK IT'S ACTUALLY SOMETHING
TO TO KEEP IN CONSIDERATION AS
WE THINK ABOUT THIS AND THEN
IT'S VERY DIFFERENT WITH FLU
AND FLU MODELING AND THE WHOLE
REASONS BEHIND SCHOOL CLOSURES
WITH FLU OR THEIR KIDS COULD
BE DRIVERS OF TRANSMISSION
AND OFTEN SPREADING TO OTHERS
-- AND WE'RE SEEING LESS OF
THAT YOUNG CHILDREN BUT AGAIN
THIS INFORMATION CHANGES EVERY
DAY THERE'S SOME THOUGHT THAT
KIDS HAVE -- A SMALLER LEVEL
THESE RECEPTORS THAT VIRUS
ENTERS YOUR BODY AND THAT'S
WHY THAT KIDS ARE NOT GETTING
SICK -- I'D SAY THE OTHER
REALLY IMPORTANT PARAMETERS
THAT WE'RE JUST STARTING TO --
TO LOOK AT AND THINK ABOUT AND
I THINK MAYBE YOU'RE LEADING
TO THIS IS WHAT ARE THE IMPACTS
FOR KIDS NOT BEING IN SCHOOL AND
MENTAL HEALTH AND TAX -- YOU
KNOW WHAT A LEARNING IMPACTS OF
THOSE ARE OBVIOUSLY SOMETHING
WE TAKE VERY SERIOUSLY AS
WELL AND AGAIN CONTINUING LIKE
OTHER THINGS OF THIS AND I'M
NOT TRYING TO BALANCE AND I DO
WANNA ECHO THAT WE ABSOLUTELY
UNDERSTAND AND KNOW THAT THIS
IS VERY HARD AND EVERYONE IS
HEARTED BUSINESSES IS JUST AGAIN
S. AS UNITS AT AN UNPRECEDENTED
TIME A ONCE IN A CENTURY CITY
YOU ASIAN -- SO I THINK THERE
ARE DEFINITELY -- HEALTH
OUTCOMES FROM CHILDREN NOT BEING
IN SCHOOL BOTH DEVELOPMENTALLY
AND WITH THEIR PHYSICAL HEALTH
AS WELL AS THE RISK OF DISEASE
TRANSMISSION IN THE SETTINGS
AND WE'RE CONTINUALLY TRYING
TO BALANCE THAT AT ALL LEVELS
HI I WOULD HIGHLIGHT IF I
COULD -- THAT IF WE LOOK
AT OVERALL DATA WE SEE THAT
LATINO AND BLACK COMMUNITIES
ARE DISPROPORTIONATELY AFFECTED
BY COVERED NINETY EIGHT IF
WE'RE LOOKING AT KIDS WHO
ARE IN SCHOOL THE MAJORITY OF
THOSE KIDS ARE LATINO AND SO
BY CORRELATION WE COULD SAY THE
EFFECTS WILL BE BORNE BY THE
BY MOST THE LATINO POPULATION
AND SO I HAVE CONCERNS WHEN WE
ARE STILL LEARNING THINGS ABOUT
THIS DISEASE ABOUT THE LONG TERM
EFFECT THE LONG HAULERS IF YOU
WILL THOSE WHO CONTRACT THE
DISEASE BUT WE DON'T UNDERSTAND
THE MANIFESTATIONS DOWNSTREAM
THUS FAR AND I BELIEVE THAT
SOMETHING WE NEED TO LOOK AT
BUT IT'S THE SECOND TIME I'VE
HEARD YOU TALK OR OR -- --
SOMEONE WITHIN DEPARTMENT OF
PUBLIC HEALTH SPEAK ABOUT THE
HEALTHEQUITY METRIC AND WAS
HOPING YOU COULD ELABORATE
A LITTLE MORE ABOUT THAT
SO THAT WE COULD UNDERSTAND
HOW THAT COULD BE HELPFUL
SURE -- YEAH THANK YOU FOR
ASKING IT -- IT IS BIG BECAUSE
AS YOU SAID I THINK DOCTOR
ANGEL HERSELF IS A VERY LARGE
HAVING OF THIS AND THAT'S A
VERY IMPORTANT CORE VALUES OUR
ENTIRE HOPE TO BE THINKING ABOUT
HEALTH EQUITY AND AS YOU ALSO
MENTIONED -- VERY CONCERNED
ABOUT THE DISPERSION IMPACT ON
OUR LATINO POPULATION AND THEN
A HIGHER PROPORTION OF DUST
MORE AFRICAN AMERICAN POPULATION
SO THE HELD EQUITY METRIC
-- WE SPENT A LOT OF TIME
TALKING TO SORT OF LOCAL
HEALTH SLOWS LOCAL COUNTY
OFFICIALS OTHER STAKEHOLDERS
FROM -- YOU KNOW DIFFERENT PARTS
OF YOU KNOW DIFFERENT PREVIOUS
ORGANIZATION REALLY FOCUSING
PUBLICLY AND WHAT WE ARE
-- UNVEILING THIS WEEK WILL BE
AROUND LOOKING AT DIFFERENCES
AND -- SOMETHING CALLED THE
HEALTHY PLACES INDEX AND THIS
IS AN INDEX WE USE IN PUBLIC
HEALTH TO LOOK ABOUT ALL THE
FACTORS REYES SOCIOECONOMIC
STATUS OTHER ENVIRONMENTAL
FACTORS THAT IMPACT --
THE THE HEALTH OF PEOPLE'S LIVES
AND IT'S LOOKED AT BY CENSUS
TRACT SO WE'LL BE LOOKING AT
-- THE DIFFERENCES IN SORT OF
THE THE PEOPLE WHO ARE IN THE
LOW THE MOST ADVANCED CLOSE
QUARTILE DIFFERENT COUNTIES
AND MAKING SURE THAT THOSE
COUNTIES AND THOSE THE PEOPLE
IN THOSE QUARTILES OF THAT
ARE HAVING A TEST POSITIVITY
IN THE SAME RANGE AS AS THE
WHOLE COUNTY SO THAT THEY CAN
MOVE FORWARD -- SO THIS IS
ACTUALLY GONNA BE EFFECTIVE
LIKELY STARTING NEXT WEEK
AND AGAIN WILL BE KIND OF
ANNOUNCING MORE THE DETAILS
-- AS SOON AS LATER TODAY --
BUT WE ARE GOING TO BE LOOKING
AT -- AGAIN THIS LOOKING AT
MAKING SURE THAT THE THE MOST
JUST PARTIALLY IMPACTED THAT
YOU CANNOT MOVE TO THE RED HERE
FROM PURPLE AND THAT GROUP IS
ACTUALLY ALSO RIGHT HERE SO
THAT'S ONE OF THE KEY IMPACTS
AND THEN THERE WILL ALSO BE
SOMETHING WHERE IF YOU'RE
LOWEST QUARTILE THE HELP IF
THIS IS THE NEXT HAS A TEST
POSITIVE IT'S TWO TIERS BELOW
AND YOUR CASE RATE IS DECLINING
YOU MIGHT ALSO BE ABLE TO
LOOK FOR IT SO WE ARE TYING
FLOORED IN THE FRAMEWORK OF
TO HEALTH EQUITY METRIC IN
THE VERY NEAR FUTURE AND THEN
WE'RE ALSO PROVIDING TECHNICAL
ASSISTANCE TEAMS FOR COUNTIES
THAT -- ARE SEEING A LOT OF
THESE DISPROPORTIONATE IMPACTS
OF OUR WORKING WITHIN OUR
DEPARTMENT TO HAVE A TEAM AND
WITH -- SOME OF OUR ADVISORY
COMMITTEE MEMBERS AND OTHER
PARTNERS -- TO PROVIDE TECHNICAL
ASSISTANCE TO COUNTY SO THEY CAN
BE THINKING ABOUT WHAT ARE THE
RESOURCES THAT THEY NEED TO HELP
FIVE WHAT ARE SOME POLICIES THAT
AT COUNTY LEVEL CAN BE SUPPORTED
TO HELP WITH YOU KNOW ALL THE
KIND OF ISSUES THAT ARE WRAPPED
INTO A LOT OF THESE DEPRESSION
TAX WHETHER IT'S KIND OF HOUSING
-- CREDIT TRANSPORTATION -- WAGE
REPLACEMENT SICK LEAVE ALL OF
THOSE REALLY IMPORTANT THINGS
ARE REALLY AGAIN LEADING TO THE
INABILITY TO BE ABLE TO ISOLATE
-- CONCERNED ABOUT TESTING
-- AND THEN WE'RE ALSO REALLY
GOING TO BE LOOKING AT THAT
COMPLETENESS OF EVERY STEP
THE CITY DATA SO CURRENTLY WE
ESTIMATE ABOUT A THIRD OF THE
DATA IS MISSING STATEWIDE IS
DEFINITELY IMPROVED WE ACTUALLY
JUST RECENTLY UPDATED AND --
HIGHLIGHTED PUSHED OUT OUR
REGULATIONS THAT RAISE THAT
THE CITY DIDN'T NEED TO BE
REPORTED WITH OUR CASE DATA
-- IN EACH OTHER'S EYES THAT
LABORATORIES AND HEALTH CARE
SYSTEMS AS WELL SO WE'RE GOING
TO BE -- UPDATING OUR DASHBOARD
TO BE BUT IT COUNTY LEVEL RACES
ALL AND WORKING AT COUNTIES
IMPROVE THEIR DATA COLLECTION
FOR THAT AS WELL THANK YOU
DOCTOR PLAN FOR THAT AND I
LOOK FORWARD TO A LEVEL OF
DETAIL AND BEING ABLE TO ASK
QUESTIONS OFFLINE -- BUT DO WANT
TO APPRECIATE YOU HIGHLIGHTING
SOCIAL DETERMINANTS OF HEALTH
AS I BELIEVE WAGE REPLACEMENT
FAMILY LEAVE ARE IMPORTANT FOR
US TO MAKE SURE WE'RE USING
ALL TOOLS TO BE ABLE TO COMBAT
THIS VICIOUS VIRUS BUT WOULD
BE REMISS NOT TO HIGHLIGHT THAT
OFTENTIMES THE DISCREPANCIES WE
SEE ANY AND HEALTH CARE ARE A
REFLECTION OF THE DISPARITIES
WITHIN THE HEALTHCARE WORKFORCE
PROVIDERS AND THE COMMUNITIES
IN WHICH THEY SERVE THAT THERE
ARE CERTAIN LEVELS OF TRUST AND
JUST WENT CONTINUE TO ADVOCATE
FOR STATES TO LEAD ON THIS ISSUE
AND WILL AND MY COMMENTS IF I
CAN BUY -- SAYING THAT
AS AN EMERGENCY ROOM DOCTOR I
OFTENTIMES REALIZE THAT WE HAD
A CHAIN OF COMMAND WE HAD A
EACH HAVE A ROLE TO PLAY AND --
THAT EACH OF US HAD TO DO
WHAT WE DID WITH OUR RULES THAT
AT SOME POINT I WANTS TO NOW
MAKE SURE WE ARE APPRECIATING
OUR GOVERNOR RIGHT NOW WHO IS
ACTING IN UNPRECEDENTED TIMES
THAT THESE ARE TOUGH AND
CONSTANTLY EVOLVING MOMENTS BUT
I HAVE BEEN IMPRESSED WITH WHAT
I'VE SEEN OUT OF THE DEPARTMENT
OF PUBLIC HEALTH THAT IF IT
WERE NOT FOR THEM STEPPING UP
AND HELPING TO PROVIDE BEST
PRACTICES FOR MY COUNTY THROUGH
A STRIKE TEAM THAT WE WOULD
NOT SEE THE IMPROVEMENTS THAT
WE ARE WITHIN OUR DATA AND
I WANT TO MAKE SURE YOU FEEL
THAT APPRECIATION -- AND IT IS
A GLIMMER OF HOPE FOR MANY OF
US THAT WE ARE WORKING TOWARDS
AND WE HAVE A CHANCE TO TRYING
GET TO TOWARDS READ SO WE CAN
GET OUR SCHOOLS BACK OPEN SO WE
CAN GET BACK TO SOME LEVELS OF
NORMALCY BUT I WOULD NOT WANT
TO LET THE MOMENT PASS AND NOT
SAY THAT WE NEED TO HAVE FAITH
IN OUR LEADER OF THE STATE
AND THAT'S ONCE THE POLICIES
HE'S PASSING THIS BLUEPRINT
THESE TEARS ARE IMPORTANT FOR
OUR COUNTIES TO FOLLOW IS TO
LISTEN AND IT'S IMPORTANT FOR
US TO REMIND THOSE WHO ARE
LOCAL DECISION MAKERS ABOUT
THE EFFECTS OF THEIR DECISIONS
ON OUR LOCAL COMMUNITIES NOW I
WILL TELL YOU AS A STATE
LEGISLATOR I'VE BEEN SPENDING
MY TIME OVER THE LAST MONTH
READING THE FEDERALIST PAPERS
BECAUSE I'M TRYING TO UNDERSTAND
THE SEPARATION OF OUR POWERS
AND WHEN COUNTIES BECAME THAT
INTERMEDIARY IF YOU WILL TO
PROVIDING PUBLIC I THINK THERE
ARE SERIOUS QUESTIONS FOR US
TO ASK ABOUT WHETHER OR NOT YOU
NEED A CENTRALIZED SYSTEM TO
MAKE SURE WE ARE DEALING WITH
CRISIS LIKE TODAY THESE ARE
UNPRECEDENTED TIMES THIS IS THE
PANDEMIC OF THE CENTURY WE NEED
TO LEAN INTO OUR GOVERNOR AND
ALLOW HIM THE POWERS TO MAKE
SURE WE ARE DOING EVERYTHING WE
CAN TO COMBAT THIS VIRUS JUST
TO AND WITH DATA THUS FAR WE
PASSED A MILLION DEATHS IN THE
WORLD TWO HUNDRED THOUSAND PLUS
OF COME FROM AMERICA TWENTY
PERCENT OF THOSE DEATHS WE ARE
FOUR PERCENT OF THE POPULATION
THUS FAR OUR STATE HAS FIFTEEN
THOUSAND SIX HUNDRED INMATE
DEATHS WE ARE LESS THAN TEN
PERCENT OF OUR OVERALL COUNTRY
WE ARE DOING A GOOD JOB HERE IN
THE STATE OF CALIFORNIA WE HAVE
TO CONTINUE TO LISTEN TO OUR
PUBLIC HEALTH EXPERTS AND LISTEN
TO THE DATA SO THAT WE CAN MAKE
IMPROVEMENTS BUT I WOULD JUST
ASK THE ADMINISTRATION BECAUSE
THEY DO THINK YOU'RE HEARING
IT FROM A NUMBER OF US BETTER
COMMUNICATION AND ABILITY TO
ASK QUESTIONS SPECIFICALLY WERE
FINANCES ARE INVOLVED I THINK
WE ARE VERY CONNECTED TO OUR
COMMUNITIES WE ARE CONSTANTLY IN
THEM AND RESPONSIVE TO THE
NEEDS OF OUR COMMUNITIES AND I
WAS QUITE PROUD TO BE WITH HER
CHIEF SERVICE OFFICE YESTERDAY
AS WE WERE VOLUNTEERING AT A
FOOD BANK WHICH IS WHY I STARTED
MY COMMENTS THE WAY I DID BUT
NOW THAT THIS ADMINISTRATION
IS DOING QUITE A BIT TO HELP
COMMUNITIES LIKE MINE TO
MAKE IMPROVEMENTS JUST WANTED
TO MAKE SURE I SHARED THAT
APPRECIATION THANK YOU MISTER
THANK YOU DR REPLICA ONE QUICK
QUESTION MR FONG BECAUSE I
HAVEN'T GOTTEN MY QUESTIONS
AND I WAS UP BY ONE QUESTION
AND ACTUALLY MY -- MY COLLEAGUE
OF AS A KIND OF LIKE SET IT UP
FOR ME -- IN TERMS OF NEW
METRICS COMING OUT -- YOU'RE
DOT ORG YOU YOU I GUESS KIND
OF ANNOUNCED HERE THAT THERE'S
ANOTHER METRIC -- COMING --
AND I'LL HAVE THE COUNTIES AND
-- THE -- THEY WANT CERTAINTY
AND AS YOU INDICATED BEFORE
THE NEED FOR SIMPLIFICATION
TO MOVE THROUGH THE TEARS --
ARE THERE ARE NONE I GUESS HOW
MANY NEW METRICS ARE COMING OUT
AND WILL THIS DELAY COUNTIES ARE
MOVING UP AND DOWN OR IS ON
TOP OF EVERYTHING I THINK
THERE'S A I MEAN UNDERSTANDING
THE NEED FOR TO ADD TO
ADDRESS -- YOU KNOW THE HEALTH
DISPARITIES AT MY COLLEAGUE AND
I SHARE THE SENSE OF ALLEY BUT
HOW DOES THAT GET DETERMINED --
IN TERMS OF ADDING NEW METRICS
THAT NOW COUNTIES HAVE TO
PLAN FOR A JUST FOR YOU KNOW
THEY'RE THEY'RE TRYING TO GET
THEIR COMMUNITIES A REAL BAND
IN THEIR SCHOOLS REOPEN IN
CHURCHES AND BUSINESSES AND
THEN NOW YOU'RE WE'RE KIND OF
THROWING MORE ON TOP OF THEM
-- IS A THEIR NEW METRICS
COMING OUT ON TOP OF THIS
ONE NEW ONE AND -- I GUESS
WALK ME THROUGH THAT PROCESS
-- AND I ALSO JUST WANT TO
THANK THEIR CURRICULA FOR FREE
OF KNOWLEDGE MINT -- SO WE
ANNOUNCED ON AUGUST THIRTY FIRST
THAT THAT TEST POSITIVITY AND
CASE RATES WERE THE KEY METRICS
AND THAT WE WERE GOING TO HAVE
OUT SO WE KNOW THAT FROM THE
VERY BEGINNING -- WE ARE NOT
INTENDING TO ADD ANYTHING BEYOND
THAT THAT WE'VE BEEN WORKING
ON WHAT THAT METRIC IS SINCE
SINCE THAT WE'VE BEEN WORKING
FROM BEFORE THAT BUT WE'VE BEEN
WORKING REALLY CLOSE AGAIN WITH
OUR LOCAL HEALTH DEPARTMENTS
WITH OUR LOCAL COUNTY OFFICIALS
-- AND OTHER STAKEHOLDERS TO
-- TO WORK ON WHAT THAT LOOKS
LIKE -- YOU KNOW WHAT IS IT
GOING TO MEASURE BUT WE ANNOUNCE
THAT FROM THE VERY BEGINNING
IT'S BEEN IN WRITING IT WAS
IN OUR INITIAL ANNOUNCEMENT
SO IT IS NOT -- SOMETHING WE
HAVEN'T BEEN TALKING ABOUT
THE WHOLE TIME AND WE DON'T
INTEND TO ADD ANY ADDITIONAL
SO THE THE THE HEALTH EQUITY
METRIC WAS ALWAYS PLANTS ALWAYS
PLANNED TO BE BUT THEN IT WASN'T
ANNOUNCED AT THAT TIME IT WAS IS
AND IT'S GOING TO BE ANNOUNCED
LATER -- IT'S GONNA BE I
WAS WEAK RIGHT
WE HAD WE ANNOUNCED ON AUGUST
THIRTY FIRST THAT WHAT THE TEARS
WERE AND WHAT THE CASE RATES AND
THE TEST WAS TO THE THRESHOLD
WHERE AND THAT WE WERE WORKING
ON A HEALTH EQUITY METRIC THAT
THE ACTUAL MEASUREMENT OF WHAT
IT WOULD MEASURE WITH STILL
BEING WORKED ON AND WE'VE
BEEN ACTIVELY WORKING ON THAT
FOR THE LAST SEVERAL WEEKS
BUT THERE ARE NO ADDITIONAL
METRICS ON TOP THAT THERE ARE
NONE IN DISSIPATED RIGHT NOW
I MEAN AGAIN WE ARE ALWAYS
GONNA EVOLVING ON THE THRESHOLD
IN THE METRICS AS WE LEARN
MORE BUT THEY'RE NOT THAT I'M
AWARE OF THAT WE'RE JUST OKAY
THANK YOU THANK GOODNESS
FOR THAT DR PANDA'S
GOING BACK TO --
-- JUST CURIOUS DO YOU
HAVE A SENSE ON --
WHEN OR IF WE'RE GOING TO BE
ABLE TO HAVE A COLD IS AXING
SURE WE'RE VERY ACTIVELY WORKING
ON OUR -- PLANNING FOR THAT --
I THINK WE KNOW THAT THERE ARE
AT LEAST SIX THAT ARE FURTHER
ALONG IN TRIALS THAT COULD BE
AVAILABLE IN THE US I THINK --
YOU KNOW WHEN THOSE ARE ACTUALLY
GOING TO BE AVAILABLE AND THAT
HAVE BEEN SHOWN TO HAVE CLINICAL
SAFETY AND EFFICACY I THINK
ARE STILL UNKNOWN -- SO I THINK
YEAH BUT WE ARE ACTIVELY WORKING
THAT WE HAVE -- ACTUALLY WERE
JUST TALKING THIS MORNING WE
HAVE SEVERAL -- OF COURSE AND
A GREAT STATE LIKE OURS WE HAVE
SEVERAL LOCAL SORT OF EXPERTS
THAT ARE ON NATIONAL COMMITTEES
ARE EVALUATING THESE DIFFERENT
VACCINES VACCINE TRIALS AND WILL
BE WORKING WITH WOOD -- HAVING
THOSE EXPERTS THAT ARE WITHIN
OUR STATE ADVISING US OF THE
STATE HEALTH DEPARTMENT LEVEL AS
WELL AS WE ANTICIPATE AND NOT
ROLL UP AFFECTS THE DISTRIBUTION
GREAT THANK YOU -- INTO JUST
GOING BACK TO I THINK WE'VE
HAD A LOT OF DISCUSSION ABOUT
THE COMMUNICATION BETWEEN THE
STATE AND LOCAL GOVERNMENTS
IN PARTICULAR THE COUNTIES
-- ARE ARE YOU IN REGULAR
COMMUNICATION TO HAVE REGULAR
MEETINGS OR IS IT MORE JUST
TO COUNTIES -- REACH OUT
TO YOU OR YOU FOR BROADCAST
EMAIL MEANS HOW HOW'S THAT
COMMUNICATION WORKING BECAUSE
IT COULD IT IT APPEARS THAT
EVEN WITH THE THE THE
DATA FLAW -- THAT WAS IN THE
SYSTEM -- SEEM TO NEED MORE OF
A COMMUNICATION BREAKDOWN THAN
EVEN AT THE DATA BREAKDOWNS
BECAUSE IF THERE HAD BEEN
A REGULAR COMMUNICATIONS
PERHAPS THAT WHAT A SLACKED
-- LET'S JUST TALK AT A HIGH
LEVEL ABOUT OUR COMMUNICATION
THEIR LOCAL HEALTH DEPARTMENT IS
BASICALLY ALL THAT THAT THAT YOU
ASKED SO WE HAVE SENT DEFAULT
WEEKLY MEETINGS WITH OUR LOCAL
DEPARTMENT OF WE INVITE ALL
OF THE SIXTY ONE JURISDICTIONS
TO WE TYPICALLY HAVE ADHOC
ADDITIONAL CALLS WITH THEM
PROBABLY AN EXTRA TWO OR THREE
TIMES A WEEK -- I'D SAY AND I'VE
BEEN ON BOTH SIDES OF THAT AGAIN
AND -- HAVE YOU KNOW BEEN ABLE
TO RECEIVE THAT WE ALSO HAVE --
TO ACTUALLY THREE ORGANIZATIONS
THAT WE ALSO FORMALLY HAVE
MEETINGS AND RELATIONSHIPS WITH
THAT ARE ON THAT PUBLIC HEALTH
SIDE SO THERE'S THE COUNTY
HEALTH EXECUTIVES ASSOCIATION
CALIFORNIA THE CALIFORNIA
CAPITAL LOCAL OFFICERS AND
HEALTH OFFICERS ASSOCIATION
CALIFORNIA SO ALL THREE OF
THOSE ALSO HAVE STRUCTURES --
AND -- EXECUTIVE COMMITTEES
THAT WE ALSO REACH OUT THERE'S
CERTAIN INPUT -- WE HAVE LOTS
OF THE LAST EMAILS AND THEN
THERE'S A LOT OF STUFF KEEPS
HAPPENING WITH -- YOU KNOW WE
HAVE CD CONTROLLERS MEETINGS
ONCE A WEEK WITH SOME OF THAT
FROM MY END -- CRITICAL DISEASE
CONTROLLERS AND OUR FRONTLINE
STAFF WE HAVE -- CAL READY HELP
MEETINGS PERIODICALLY A LOT OF
DIFFERENCE OF ARAB CAL CONNECTOR
CONTACT TRACING GROUP HAS --
LOCAL HEALTH DEPARTMENT -- I
FORGET THEY'RE CALLING IN EITHER
TOWN HALLS ARE COMMUNITIES
LEARNING GROUPS AND SO WE HAVE
A LOT OF COMMUNICATION AND
THERE ARE AGAIN SIXTY ONE HEALTH
RESTRICTIONS -- SO -- YOU KNOW
I I FEEL IN EVERY EMERGENCY
YOU CAN NEVER COMMUNICATE
TOO MUCH OR TOO OFTEN SO WE
THAT WE DO A LOT OF OUR GREAT
CONFUSION AND ALSO I WOULD
SAY DEFINITELY LOCAL HEALTH
DEPARTMENT DIRECTORS AND HEALTH
OFFICERS CERTAINLY CALL SEASON
FINALE OF MYSELF FREQUENTLY
THEY EMAIL US DIRECTLY THE EMAIL
OUR STAFF TO CALL A SO WE HAVE
I'D SAY A LOT OF COMMUNICATION
GOING BACK AND FORTH AND I
KNOW OUR -- OUR HEALTH CARE
HEALTH HUMAN SERVICES AGENCY
HAS A VERY STRONG RELATIONSHIP
WITH THE COUNTY AND SEES ACT
COUNTY AND STATE -- ASSOCIATION
-- SO THAT IS ALSO AN ONGOING
DIALOGUE -- I THINK -- I
THINK YOU KNOW WE ALREADY
MENTIONED THERE WERE SOME
INTERNAL COMMUNICATIONS WHICH
IS AS WELL THAT WE HAVE A
REMEDY AND SO I THINK THAT
ACTUALLY MIGHT A LOT OF
WHAT WAS HAPPENING IN JULY
THANK YOU SINCE YOU FEEL LIKE
-- THAT WITH THE COMMUNICATION
BETWEEN THE SIXTY ONE
JURISDICTION OF THE STATE THAT
HOPEFULLY AT THE VERY LEAST
-- BASED ON THAT COMMUNICATION
-- THERE BE THE HOPE THAT
JURISDICTION WOULD RAISE ISSUES
THAT THEY BELIEVED TO HAVE
COME UP BECAUSE OBVIOUSLY THERE
WATCH THE DATA AS AS OFTEN
AS YOU'RE WATCHING THE DATA
YEAH AND I CAN SAY THAT EVERY
WEEK -- BOTH INFORMALLY AND
MORE FORMALLY AS WE FINALIZE
OUR EDUCATION CLASSES WE DO HERE
AND WE HAVE -- YOU KNOW SOME
OF THE SPECIFIC SITUATIONS WITH
THE FEDERAL TESTING SITE THAT
ISN'T OF ANY USE THAT WE HAVE
ARE OPTING OUT IS WORKING WITH
THAT -- LABS A MISSION AND LOCAL
HEALTH DEPARTMENTS DIRECTLY TO
GET THAT DATA SEPARATELY SO WE
CAN INCLUDED INTO OUR METRICS
-- WE HAVE YES PEOPLE POINT
OUT TO US ALL THE TIME WHEN
THERE ARE SITUATIONS AND THEN
OUR TEAMS KIND OF WORK WITH
EPIDEMIOLOGISTS AND AND THERE'S
A WHOLE LAYER OF ISSUES THAT
COULD BE HAPPENING IT COULD BE
THAT THE LAB IS NOT SUBMITTING
IT COULD BE THE WAY THEY'RE
CALCULATING THE DATA WE HAVE
JUST RECENTLY -- SET UP A HUB
SO THAT THAT EMAIL JUST OF THE
LOCAL HEALTH DEPARTMENTS CAN
ACCESS WE CALL THE CODE TO THE
DANCE IS EXACTLY THE SAME WAY
ARE AT THE DEAL JUST TO TAKE
CARE AND THAT'S I THINK REALLY
HELPED A LOT AS WELL WITH ANY
DISCREPANCIES AND I THINK NO
MATTER WHAT THERE'S ALWAYS
GOING TO BE A LITTLE BIT OF A
TIME LAG BECAUSE AGAIN HAVING
WORKED ON THE FRONT LINES OF
THE LOCAL LEVEL WE RECEIVE LOCAL
GOVERNMENTS RECEIVE THE DATA
FIRST -- IN SOME SITUATIONS
ESPECIALLY FROM CLINICIANS AND
THEN FROM LABS SOME OF THE LAST
COMPLETELY TO OUR SYSTEM AND
THEN GO TO THE LOCALS AND SOME
OF THE INTERESTING OF PERSON
I GET ATTACHED SO THEY'RE JUST
DIFFERENT WAYS OF THAT DATA IS
MOVING IN AGAIN THE SCOPE AND
MAGNITUDE OF THIS PANDEMIC HAS
JUST CREATED AND MOVED VERY
QUICKLY SO IT DEPENDS WHEN
YOU PULL THE DATA WHEN YOU
ANALYZE IT AND YOU'RE GOING TO
HAVE YOU KNOW THERE'S JUST NOT
ALWAYS GOING TO BE COMPLETELY
HONEST GREAT THANK YOU AND
-- THE THE READ THE REASON I
REPRESENT OFFICES BEIJING THAT
YOU COME FROM -- IT'S VERY
TYPICAL WHERE YOU HAVE PEOPLE
LIVING IN ONE COUNTY AND THEN
WORKING IN ANOTHER COUNTY SO
HOW DO YOU -- SURE THAT THERE'S
-- SURE FOR PROPER PROPER
BALANCE OF EXPECTATIONS BETWEEN
THOSE DIFFERENT COUNTIES --
SHOULD BECAUSE YOU KNOW IF
SOMEONE'S CATCHING KOPET THERE
GENERALLY BEING -- TALLIED
IN THE COUNTY THEY RESIDED
YES SO THE WAY IT WORKS -- WHEN
AND LOCAL HEALTH DEPARTMENTS ARE
INVESTIGATING CASES IS -- THERE
ARE KIND OF SOME JURISDICTIONAL
RULES ABOUT THAT SO I IN
THAT CASE IN THIS -- IS
COUNTED IN THE COUNTY WHERE THEY
RESIDE OR IF IT'S A CITY HEALTH
DEPARTMENT BUT IF THEY WORK
IN ANOTHER COUNTY AND THERE'S
NO EXPOSURES AT THAT WORK SITE
THAN ONE HEALTH DEPARTMENT
WILL COMMUNICATE TO THE OTHER
HEALTH DEPARTMENT -- MY CASE
HEY WORKED AT YOUR COMPANY BE
AT HERE'S WHAT WE KNOW ABOUT
THE DATES OF THAT PERSON WAS
THERE YOU CAN FOLLOW UP ON THE
CONTACT OF THIS OCCASION SO
THAT CAN HAPPEN ARE SIMILARLY IF
THAT THAT CASE ALSO HAS A CHILD
IS IN SCHOOL AND CHILD CARE
IN A DIFFERENT PLACE THERE'S
A NOTIFICATION IF THERE'S
AN EXPOSURE THERE SO THAT IS
HOW THAT WORKS AND THEN OFTEN
THAT THERE'S A LARGE OUTBREAK
THAT'S MULTI JURISDICTIONAL
THAT'S WHEN WE AT THE STATE
LEVEL OFTEN HELPLESS IN
COORDINATION AND CONSULTATION
I'M SO SO THAT UP IT'S A GREAT
IT'S A GREAT -- LEAD INTO MY
NEXT QUESTION WHICH IS REALLY
ROUND CONTACT TRACING FONG
YOU KNOW WHAT I THINK ONE OF
THE KEYS THAT WE'VE TALKED ABOUT
IS REALLY HAVING MORE ROBUST
CONTACT TRACING HOW DO YOU FEEL
THAT THAT'S HAPPENING WE'RE
GOING AT THE AT THE COUNTY LEVEL
DOESN'T SEEM THE STATE'S IN HERE
DOING ANYTHING SPECIFICALLY BUT
SOUNDS LIKE THE COUNTIES ARE
REALLY THE ONES IMPLEMENTING
THAT AND JUST TO GET A BETTER
SENSE OF HOW THAT -- CONTACT
RECENT ELEMENTS GOING YES I
KNOW THAT'S A GREAT QUESTION
WE ACTUALLY JUST RECENTLY DID
A SURVEY OF ALL OF OUR HEALTH
DEPARTMENTS AND I THINK THAT
IS SOMETHING THAT HAS BEEN A
GREAT PARTNERSHIP IT ABSOLUTELY
IS A LOCAL HEALTH DEPARTMENT
FRONTLINE ROLE THAT WE STOOD UP
ACTUALLY ANOTHER I. T. SYSTEM
WHICH WE ONLY TOUCHED ON TODAY
BUT CAL CONNECT WAS STOOD UP
VERY QUICKLY AND HAS BEEN VERY
SUCCESSFUL IN THIS HAD LOCAL
HEALTH DEPARTMENT INPUT FROM
THE VERY BEGINNING -- AND IT
CONTINUES TO EVOLVE BASED ON
THE USER NEEDS SO -- WE ARE
REALLY ENCOURAGED BY THE DATA
THAT WE'RE SEEING AS FAR AS THE
DEPARTMENT I THINK COLLECTIVELY
WE DO HAVE TEN THOUSAND PEOPLE
DOING CASE OR CONTACTED THE
STATION ACROSS THE STATE NO THAT
WAS A BIG GOAL EARLY ON -- WE'RE
SEEING BETTER BETTER DATA ABOUT
HOW MANY CASES ARE BEING EACH --
AND HOW MANY CONTACTS ARE BEING
MET SO -- I THINK THERE'S A HUGE
IMPROVEMENT IN THAT AND WE HAD
BEEN AIMING AS A STATE TWENTY
FIRST OF THAT UP TO BE AN ABOUT
THE LOVE WE ARE NOW TO BE ABLE
TO DO CASE CONTACT STATION IT IS
LOOKING LIKE WE ARE WE'RE HAVING
A GOOD BALANCE THERE OF -- OF
COUNTIES BE ABLE TO DO THAT I
WILL ACKNOWLEDGE WITH THINGS ARE
AT THEIR PEAK IN JULY I THINK
YOU KNOW AND AS YOU HEARD I'M
SURE FROM YOUR CONSTITUENTS ARE
HEALTH DEPARTMENT THEY WERE NOT
NECESSARILY ABLE TO TO DO ALL
THAT CONTACT RACING BUT I THINK
WE ARE NOT GETTING TO LEVELS
WHICH IS AGAIN WHAT WE ALL
WANT TO KEEP OUR GUARD UP AND
MAINTAIN WHAT WE ARE -- OR EVEN
APPROVED OF THAT I THINK WE'RE
IN A REALLY MUCH BETTER STATE AS
FAR AS CONTACT TRACING OUR STATE
GROUP IN IN DO LONG
ANTICIPATED AS WE GO INTO THE
FLU SEASON AFTER GOING TO THE
FALL IN THE WINTER THAT WE'LL
SEE ANOTHER WAVE JUST BECAUSE
OF THE -- OF THE WAY THE
DISEASE GETS SPREAD AND JUST
BASED ON THE WEATHER PATTERSON
YEAH THANKS I MEAN IT'S
OF COURSE A HUGE CONCERN
I THINK ONE ENCOURAGING
BUT I THINK WE HAVE TO MONITOR
WITH CAUTION IS THAT WE'VE
SEEN IN THE SOUTHERN HEMISPHERE
-- YOU KNOW WE TYPICALLY IN
GENERAL IS LOOK AT THE SOUTHERN
HEMISPHERE BECAUSE THEY HAVE
THEIR CLUES IS NUMBER FOUR YEAH
THAT -- AND THEY HAVE ACTUALLY
HAD A VERY VERY MILD FLU SEASON
AND OF COURSE THE THEORY IS
THAT EVERYONE'S WEARING MASKS
OR PHYSICALLY DISTANCE I
THINK THERE'S PROBABLY BETTER
COMPLIANCE OF THE COUNTRIES THAT
THAT WE'VE BEEN HEARING BACK
FROM OF BUT IT IS A GREAT MAYBE
IF ALL OF OUR INTERVENTIONS
CAN HELP US PREVENT FLU AND
COVER NINETEEN AND THEY ARE
TRANSMITTED A VERY SIMILAR WAYS
THAT WOULD MAKE SENSE -- AS
YOU MANY OF YOU HAVE MENTIONED
AS WELL IT'S TRUE THAT THERE'S
OFTEN YOU KNOW A SECOND OR
THIRD WAVE THAN A LOT OF THAT
DEPENDS ON AGAIN HOW MUCH PEOPLE
ARE INTERACTING AGAIN SO IT
KIND OF CIRCLE BACK TO IF WE
CAN MAINTAIN OUR -- YOU KNOW
SLOW KIND OF MEASURED RESPONSE
AND WATCH AFTER EVERY PHASE
AND NOT LET THINGS GET OUT OF
CONTROL WE MIGHT BE ABLE TO
TO MAKE IT BUT I THINK THAT
IS A CONCERN OF WHY WE ARE
WATCHING ALL THESE METRICS
INCLUDING HOSPITALIZATIONS
HOME AND SEEING WHERE WE ARE
AND AND RUNNING PROJECTIONS
YOU KNOW PERIODICALLY AS WELL
TO SEE WHAT THAT LOOKS LIKE --
BUT WE WON'T KNOW UNTIL IT ALL
HAPPENED BUT I CERTAINLY OF
COURSE CONCERNED ABOUT WE'RE
SEEING ON THE WORLD AS WELL OR
EVEN OTHER STATES AS FAR AS YOU
KNOW WE STARTED SINCE AGAIN AND
I THINK IT'S ALL ABOUT US AS A
COMMUNITY BEING ABLE TO MAINTAIN
-- AGAIN THESE REALLY KEY ASKING
THE SCHOOL DISTANCING ACTUALLY
WHILE I HAVE THE OPPORTUNITY
JUST MENTIONED THERE'S MORE DATA
TO MASKING NOT ONLY YOU KNOW
EARLY ON WE SET THEM ASKING WAS
ONLY PROTECTING THE OTHER PERSON
AND NOT YOURSELF THAT THERE'S
MORE AND MORE DATA THAT ACTUALLY
PROTECTS EVERYONE IT IT'S ALMOST
LIKE ANOTHER VACCINE AND THAT
THERE'S MORE DATA SAYING IT IF
PEOPLE ARE WEARING MASKS THEY
HAVE LESS SEVERE DISEASE TO
SO IT CAN DECREASE AND IT MAKES
SENSE -- DECREASED EXPOSURE
EVEN IF YOU GET A LITTLE EXPOSE
YOU MIGHT BE MORE LIKELY JUST
HAVE NO SYMPTOMS OR NOT SIR
SO IF WE CAN KEEP THIS UP AND
REALLY EXPANDED THE COMPLIANCE
WITH THE MEASURES THAT WE JUST
YOU KNOW KEEP SAYING -- I THINK
WE COULD WE COULD REALLY TRY TO
MITIGATE THIS AND NOT HAVE THAT
WEIGHT BUT I THINK WE WE WON'T
KNOW UNTIL WE SEE HOW THAT'S
ALL THANK THANK YOU WELL LET'S
LET'S LET'S HOPE THAT PEOPLE
ON SHORE FOLLOW INSTRUCTIONS
AND CONTINUE TO -- FOLLOW THE
GUIDELINES WILL HOPE FOR A
VERY MILD WINTER IN A MILD FLU
SEASON ON WHAT ONE OF THE
BIG BIGGEST ISSUES AND ALL
OF OUR COMMUNITIES AS SCHOOLS
RE OPENING YOU MENTIONED
THAT -- SCHOOLS MOVING INTO
-- RED THE RED TERROR COULD
REOPEN ARE THERE ARE OTHER
GUIDELINES OR PROTOCOLS THAT
YOUR GIVING ADVICE TO DISTRICTS
OBVIOUSLY THE CHALLENGES
SCHOOLS AS YOU DON'T HAVE
ONE JURISDICTION YOU HAVE
THOUSANDS OF INDIVIDUAL SCHOOL
DISTRICTS THAT ARE ALL IN
CHARGE OF THEIR INDIVIDUAL
SCHOOLS AND I'M SURE THEY ALL
HAVE A CERTAIN LIMITED CAPACITY
ABOUT EVEN UNDERSTANDING WHAT
THEY SHOULD BE DOING HOW THEY
SHOULD BE DOING IT IN SO --
DO YOU SORT OF -- DETERRED
APARTMENT SORT OF OFFER GUIDANCE
TO THOSE SCHOOL DISTRICTS OR
IS IT JUST THAT COUNTY PUBLIC
HEALTH OFFICERS THAT DOES THAT
OR IS IT REALLY ARE YOU WORKING
WITH THE SUPERINTENDENT JUST
TRYING TO GET UNDERSTANDING
OF LIKE WHAT WHAT WHAT CAN WE
DO TO REALLY HELP GIVE SCHOOLS
THE INFORMATION THEY NEED TO
PROPERLY AND SAFELY REOPEN
SURE -- I THINK IT REALLY IS
HAPPENING AT ALL LEVELS I'D SAY
ABSOLUTELY AT THE LOCAL HEALTH
LEVEL I THINK BECAUSE -- ARE ALL
HEALTH DEPARTMENTS ARE WORKING
VERY CLOSELY WITH THEIR LOCAL
SCHOOL DISTRICTS AND THEIR LOCAL
SCHOOLS -- MANY OF THEM I THINK
THEY'RE HAVING YOU KNOW WEEKLY
CALLS TO UPDATE THEIR SCHOOLS
ARE JUST THE LATEST ON WHAT'S
GOING ON AT THE PANDEMIC AND
ALSO ABOUT -- Q. AND A
AT THE STATE THREE OPENINGS AND
THEN AT THE STATE LEVEL WE'VE
BEEN OF THE MINISTRATION HAS
BEEN WORKING CLOSELY WITH CDA
-- CTA AT THE STATE BOARD OF
EDUCATION I THINK ANY TIME HAVE
ANY GUIDANCE IT HAS TO DO WITH
USE WE'RE WORKING CLOSELY WITH
THEM OF COURSE WITH WITHIN OUR
AGENCY EVEN THE CDS US WITH
WE'RE THINKING ABOUT CHILD CARE
AND SCHOOLS AND MAKING SURE
WERE YOU KNOW TAKING ALL THIS
INTO ACCOUNT SO IF IT'S REALLY
HAPPENING AT ALL LEVELS WE'VE
DONE SOME STATEWIDE WEBINARS
-- FROM THE STATE PUBLIC HEALTH
PERSPECTIVE BUT I THINK A LOT
OF THAT REALLY IMPORTANT WORK
IS HAPPENING AT THE LOCAL
LEVEL AGAIN -- YOU KNOW AND
TO HIGHLIGHT WHAT MANY OF YOU
WERE SAYING AS WELL I THINK
THERE'S SO MANY NUANCES AT
THE LOCAL LEVEL THEY NEED TO
BE TAKEN INTO ACCOUNT -- THAT
ARE IMPORTANT TO FACTOR AND IS
IT THINK ABOUT THE SAFETY OF
GREAT THANK YOU -- I WAS
HOPING ASK A COUPLE OF THE
-- FOR THE I. T. QUESTIONS TO
YOUR CHAU OKAY THANK
YOU VERY MUCH CHRISTIANS
HI HI THANK YOU THINK THANKS
AGAIN FOR PARTICIPATING SO SO
HERE WE HEARD EARLIER THAT --
THAT THE MANY ISSUES WITH THE
-- SYSTEM WERE ONE --
DUPLICATIONS FROM CERTAIN
COUNTIES AND THEN ALSO THE LACK
OF UPLOADING OF INFORMATION
FROM QUESTIONS ON CORRECT
AT THAT THAT IS CORRECT AT THEY
HAPPEN SIMULTANEOUSLY AT THE
ABOUT THE SAME TIME AND -- YES
AND AT THIS POINT YOU FEEL LIKE
YOU'VE WORKED OUT THE THE SYSTEM
TO TAKE CARE OF THE DUPLICATIONS
AS WELL AS -- AS WELL AS BE ABLE
TO UPLOAD INFORMATION FROM QUEST
ACTUALLY WE FIX THE QUESTION
ONE FAIRLY QUICKLY WITHIN A
FEW DAYS AFTER REALIZE THAT
BUT THAT WAS ANOTHER HUNDRED
THIRTY THOUSAND MESSAGES THAT
WOULD HAVE COME IN OVER A FEW
DAYS CAME IN ALL IN ONE DAY
-- AND SO THE THAT WAS FIXED
AND WE CERTAINLY KEEP TRACK
OF THE DIFFERENT -- THAT HAS
TO DO WITH SECURITY AS FAR
AS THE CONNECTION SO I'LL WE
HAVE MADE SURE THAT THAT'S
NOT GONNA HAPPEN AGAIN --
BUT -- YES AND YOU
KNOW I THINK AND IN GENERAL
THAT THE INCIDENT THAT
HAPPENED OBVIOUSLY WE BECAME
VERY CONCERNED AND WE KNEW
THAT FONG FOR GOING UP AND
WE STARTED TO SEE WHAT THE
RAMIFICATIONS WERE OF US NOT
MEETING -- WHAT WAS EXPECTED
OF US AND WE HAVE DOUBLED AND
TRIPLED THE WORK FORCE AND WE
HAVE MADE SIGNIFICANT CHANGES
AND WE FEEL VERY COMFORTABLE
GIVEN WHAT'S HAPPENED OVER THE
LAST MONTH AND A HALF THAT WERE
VERY WELL PREPARED WE OUGHT --
HAVE ACTUALLY STARTED TO DIGITAL
PROCESSES THE COVER THE SYSTEM
ITSELF IS PERFORMING VERY WELL
TODAY YOU HAVE UPGRADES TO THAT
SYSTEM A THAT PROVIDE A MORE
SCALABILITY AND MORE CAPACITY
MORE PERFORMANCE THAT WE'RE
WORKING CLOSELY WITH THE VENDOR
ON SAME WITH OUR H. I. GATEWAY
WE ARE LOOKING AT UPGRADES
TO THAT SYSTEM THAT PROVIDE
ENOUGH CAPACITY IS ABILITY
TO ENSURE THAT OVER THE NEXT
YEAR OR EVEN SIX MONTHS AT STAKE
WORKLOAD GOES UP SIGNIFICANTLY
WE'RE READY FOR THE THANK YOU
HE IN IN MORE CONCERNING WHAT
TO ME WAS THE DUPLICATIONS
COMING IN FOR THE COUNTIES SO
SO THAT HAS BEEN IRONED OUT
SHE YES YES WE EVERY DAY WE
KEEP TRACK OF THEM OUT OF
DUPLICATES THAT COME IN --
IN TWO SEPARATE PROCESSES AND
AND WHEN THEY -- EXCEED WHAT
WOULD BE NORMAL DUPLICATIONS
-- WE CONTACT THE COUNTY ISN'T
TRYING TO -- TO REMEDIATE THAT
ISSUE WHAT WAS THEIR REASON
TO COUNTY'S MISSED THAT TO
PETITION BECAUSE I MENTIONED
THE COUNTIES ARE TRACKING
THE DATA AND FOR SOME REASON
IF YOU DOUBLE COUNTED THE
THEIR DATA HOW IS IT THAT
BIG THEY MISSED IT AS WELL
I WAS JUST SO MUCH WE DOUBLE
COUNTED IT IT JUST TOOK A
PROCESSING TIME SHOW -- THEY
COME IN BATCHES FROM THE
COUNTIES AND BATCHES OF HUNDREDS
OF MESSAGES IS A CUME UP PUTTING
HIM BACK AND THEY SEND TO US --
IF AND SOME CASES IF THAT GETS
DUPLICATED FOR SOME REASON THAT
IS THE SAME SET OF MESSAGES
THAT WE HAVE TO PROCESS ON
THE FRONT END AND THAT'S WHAT
STARTED SOME OF THE PROBLEMS
WE WE CAN FIND DUPLICATE
MESSAGES OVER A TWENTY FOUR HOUR
PERIOD BUT WHEN THAT STARTED
TO GET FAIRLY SIGNIFICANT
DOWNSTREAM AND CAL READY
WE UP THAT NUMBER TO
A LOT LONGER WHICH COSTS AND
ADDITIONAL YOU KNOW PERFORMANCE
HIT ON OUR GATEWAY WHICH
STARTED THIS CHAIN OF EVENTS
-- GOT IT SO SO YOU'RE SAYING
THAT THE COUNTY JUST GIVES
YOU THE DATA THEY DON'T
DO A TALLY ON THEIR OWN TO
COMPLETELY RELYING ON THE
STATE TO TALLY THE DATA
SHE WELL THAT WHEN THE COUNTY
SET UP AND AND ACTUALLY THE
MESSAGES COMING FROM THE LACKS
SO ITSELF QUEST'S LAB IS THE
OTHER LAPSED EPIC THAT SENDS US
THE LABORATORY MESSAGE RIGHT THE
COUNTY SEE THOSE MESSAGES -- AS
A FLOW THROUGH INTO CAL READY
AND THEN THEY HAVE ACCESS TO
THEM IN THE CAR READY SYSTEM TO
-- TO MANAGE AND MONITOR THOSE
MESSAGES AND THEN -- THE COW
READY DATA WAREHOUSES WHERE THEY
HAVE DIRECT ACCESS ALSO TO DO
REPORTING AS OFTEN AS THEY WANT
ON EXTRACTING DATA FROM THAT
DEMAND THROUGH THE SYSTEM -- SO
-- THE COUNTY SEPT CELL SELDOM
THERE ARE SOME CASES WHERE THE
COUNTIES WILL GET INFORMATION
-- MAYBE A HOSPITAL OR OR
A OR A LAB DOESN'T HAVE THE
TECHNOLOGY SO THEY'LL FAX IT
TO THE COUNTY AND THE COUNTY
BUT WILL BE REQUIRED TO GET
INTO THE CAR IN THE SYSTEM
I GOT I GOT A SERVICE WITH
THE COUNTY SEE THE INFORMATION
JUST LIKE YOUR YOUR TEAM
MISSING THE INFORMATION IT'S
IT'S NOT IT'S THE SAME PLACE
RIGHT RIGHT THAT THE COUNTY TO
THE LAB TO DO THE TESTING AND
THEY SEND THEM TO US WE SAID
THE LAB REPORTS THROUGH THE
SYSTEM AND WE ROUTE THEM TO
THE APPROPRIATE PLACES -- ONE
OF THOSE HAS GOT READY ONE IS
LA ONE IS SAN DIEGO AND THEY
PROCESS THOSE INTO THEIR SYSTEMS
AND THEN THEY SEE POSITIVE AND
NEGATIVE RECORDS FOR CULVERT
WOULD BE THE POSITIVE CASES A
POSITIVE CASES WITHIN CAL READY
THEN END UP IN THE KHALKHIN ACT
WHICH IS A CONTACT TRACING AND
THEN THAT'S HOW THEY IDENTIFY
POSITIVE CASES AND START
WORKING ON IT SO HOW DO YOU
DETER HARD HOW DO YOU ENSURE
THE DE DUPING OF THE THE DATA
WELL -- WE HAVE A DEVELOPING
-- -- TECHNOLOGY WITHIN OUR
GATEWAY -- BUT PART OF
THAT ONE OF THE TWO MAJOR
REQUIREMENTS FOR -- THIS
-- CALIFORNIA OF CORPORATE
REPORTING SYSTEM IS YOUR
SYSTEM WHEN THE LABORATORY
START REPORTING DIRECTLY TO
THAT SYSTEM AND THAT'S RUN BY
OPTUM -- THEY WILL BE DOING
-- LIKE WE'RE DOING BUT IT HAS
A GREATER CAPACITY DE DUPING
FORMAT CHECKING AND AND I'M
I'M UP LISTING THE QUALITY
OF THE MESSAGES BEFORE BEFORE
THEY COME TO THE STATE AND THEN
THEY WILL BE SENDING UP TO THE
STATE WILL PROCESS HOW MUCH
CLEANER D. DO MESSAGE AT AND
THAT WILL GO TO THE SYSTEM SO
IT'S OFF LOADING SOME OF THAT
WORK ON THE NEW SYSTEM AND
IT'S ALSO HAVING A DEDICATED
RESOURCE TO LOOK AT THE QUALITY
OF THAT DATA HAVE BEEN A BETTER
METRICS AND ALSO HAVE MORE OUT
OF REACH BACK TO THE LABORATORY
WHEN THINGS ARE NOT QUITE
RIGHT WITH THE LADS EITHER
THEY'RE NOT SUBMITTING FOR
SOME REASON OR LAS DUPLICATES
OR OTHER REASONS THAT WE HAVE
THIS WHOLE OTHER RESOURCE --
OPTIM DEVOTING RESOURCES WITH
DASHBOARDS AND ALMOST LAB
SCORECARDS TRAFFIC THINGS IT
ENDED THE DE DUPING SOFTWARE
EXISTS TO BEFORE THE --
BEFORE THE ERROR WAS DETERMINED
YES YES YES SO
IT IT HAD HAPPENED OVER TIME BUT
NOT AT THE LEVEL THAT WE WERE
SEEN AND BECAUSE OF THE VOLUME
INCREASES IN REAL MESSAGES
HOW READY STARTED TO GET
BOGGED DOWN WITH THE ADDITIONAL
MESSAGES THAT WERE VALID BUT
THEY ALSO HAVE TO PROCESS THAT
THE -- DUPLICATE MESSAGES AND
THEY ALSO TAKE TIME AND SO THE
AMOUNT OF WORKLOAD WAS GOING
UP SIGNIFICANTLY AND THEN THE
BACKLOG STARTED TO KERN COUNTY
OKAY DOES NOT DONE THE
NONE OF THAT EXPLAINS WHY
YOU MISSED THE DUPLICATES
SAUGUS -- JUST ON UNDERSTANDING
THE DE DUPING SOFTWARE THAT
YOU USE NOW EXISTED BEFORE
WHAT CHANGES TO THE SOFTWARE
WERE MADE AND OR WHAT
JUST TO YOUR SYSTEMS WERE MADE
BECAUSE IT SOUNDS LIKE THE ONLY
CHANGE THAT WAS MADE IF YOU
HAVE A VENDOR THAT'S LOOKING
AT HIS DESK AT THAT THAT THEIR
DATA MORE CAREFULLY THAT'S LIKE
THE ONLY CHANGE THAT I FOR SO
PERHAPS THAT SO THAT'S THE NEWS
YOU SEE OUR SYSTEM THE CURRENT
SYSTEM IS HACKED THE DUPING
ALL FOR YEARS IT WAS INSTALLED
WITH THAT AND WE COULD IDENTIFY
DUPLICATE RECORD WITHIN TWENTY
FOUR HOURS AND SO NORMALLY
THAT WAS ADEQUATE AND HAVE SOME
RECORDS WERE OLDER THAN THAT
AND THEY GOT INTO THE CAR READY
SYSTEM COUNTY WAS ABLE TO HANDLE
THAT LOOK -- AS THE DUPLICATES
ONE UP AND THE VOLUME WENT UP
WE CHANGE THE H. ID GATEWAY
SOFTWARE TO TRY TO IDENTIFY
-- DUPLICATES OVER THREE MONTHS
WHICH WOULD HAVE CAUGHT ALL
THE DUPLICATES AND IT DID WORK
FOR ABOUT A WEEK OR SO BUT THAT
EXTRA WORK ON THE FRONT END
THAT H. ID WHITE COSTA GATEWAY
TO STE START TO HAPPEN FOR MUCH
PROBLEMS OKAY VOEPEL
THE BILL WHAT WOULD YOU SAY THE
ARBITRARY DEADLINE FOR THREE
MONTHS ONE NOT TO SAY A ONE YEAR
A ONE YEAR LOW BACK BECAUSE IT'S
A IT'S A PIECE OF SOFTWARE IT'S
NOT LIKE IT'S A HUMAN I AM STILL
TO TRY TO UNDERSTAND THIS IS
FILE FOR THIS NON HUMAN BEING
SO RIGHT IT IS THE KEY ISSUE
IS CHANGING A LOT OF CODE
YEAH RIGHT TO THE ISSUE BECAME
WITH THE VOLUME AND THAT AN
AMOUNT OF TIME IT TOOK TO
FIND IF WE'RE DOING A HUNDRED
THOUSAND MESSAGES A DAY AND
YOU'RE DOING IT FOR NINETY DAYS
AS THAT NINE MILLION RECORDS
THAT ARE SITTING IN A FILE
THAT EVERY SINGLE RECORD THAT
COMES IN YOU'RE TRYING TO MATCH
AGAINST AND SO THE PERFORMANCE
OF THE SYSTEM START TO SLOW
DOWN DUE TO THE SIZE OF
YOUR YARD DE DUPING SOFTWARE
THAT YOU'RE TRUMPCARE AND
DATABASE THAT YOU'RE TRYING
TO COMPARE TO GETS EITHER PASS
IT THROUGH THE SYSTEM OR OR
I DENY IT AS I DO BUT BECAUSE HE
WAS NOT A HARDWARE ISSUE THAT A
SOFTWARE ISSUE -- YEAH I GUESS
INTO HARDWARE AND SOFTWARE AND
AT THE TIME WE WERE AND HAND
SINGLE HARDWARE AND SOFT NOT
THE SOFTWARE BUT THE HARDWARE
BUT IT -- IT IN ITSELF JUST DID
NOT PROVE EFFECTIVE WAY TO DO
IT AND AND WE WERE SEEING MORE
DUPES THAN WE SHOULD NORMALLY
HAVE SEEN BUT BUT BUT THAT'S
WHAT I'M TO UNDERSTAND IS
LOOKING TO WIN OF A SOFTWARE
ISSUE THERE'S LINES INCLUDED
YOU GO CHANGE WHEN YOU'RE
TALKING ABOUT A BACK LOG IN
SPEED EITHER IT'S A LACK OF
FOR BECAUSE YOU HAVE PEOPLE WHO
ARE -- DE DUPING THINGS
BUT I NEVER HEARD YOU MENTION
ANY PEOPLE IN THIS PROCESS OR
IT'S A HARDWARE ISSUE BECAUSE
THE SYSTEM IS SLOW DOWN
AND THE PROCESSING SPEED
CANNOT HANDLE THE NUMBER OF
RECORDS SO I'M JUST TRYING TO
UNDERSTAND WHAT WAS THE PROBLEM
BECAUSE IT'S NOT IT DOESN'T
YOUR ANSWER DOESN'T SEEM LIKE
IT'S ALL THE PROBLEM SO WHAT
SO HOW DID THE PROBLEM GETS
SOLVED HOW IS THE PROBLEM
SOLVED OR THE PROBLEM NOT
SOLVED THE PROBLEM IS SOLVED
AT FIRST STARTED WITH A LOT
OF GUYS FROM ONE OF THE COUNTY
ONE OF THE LAPSED AND SO THAT'S
NOT HAPPENING AS OFTEN THERE
IS MORE HARDWARE CAPACITY THAT
WE PUT ON THE GATEWAY WHICH
IS DOING TO DO DEEPING DEEP
EUROPEAN PROCESS TODAY AND
WE'RE BACK TO THE TWENTY FOUR
HOURS AND THUS THE INCREASE
PERFORMANCE ON THE COW READY
SYSTEM WHICH WE EARLIER UP TO
SIX TIMES FASTER DUE TO THE
THE ENHANCEMENTS THAT WE MADE
TO THAT SYSTEM HARDWARE AND
CONFIGURATION CHANGES HAS ALSO
ALLOWED THE DOWNSTREAM SYSTEMS
TO HANDLE SOME MORE DUPLICATES
AT A MUCH FASTER RATE SO WE
WENT FROM ABOUT FOUR THOUSAND
MESSAGES PER HOUR AND CAR READY
TO TWENTY FIVE THOUSAND THAT
IN ITSELF HAS ALLOWED ZERO
BACKLOG AND THAT ARE SOME DUDE
TO COME THROUGH BUT THEY'RE THAT
THEY'RE MUCH EASIER TO ABLE TO
HAVE A GREAT IT STILL DOESN'T
FOR THEM AFTER THE HARDWARE
AND THE SOFTWARE ENHANCEMENTS
DO YOU NOW HAVE MORE INDIVIDUAL
PEOPLE WHO ARE GOING BACK AND
CHECKING AND VERIFYING THAT
DATA TO ENSURE THAT THE
SOFTWARE DID MISS SOMETHING
OR -- YOU KNOW THAT THE VENDOR
DIDN'T DIDN'T MISS SOMETHING
ABSOLUTELY WE HAVE TWO OR
THREE TIMES THE AMOUNT OF
STAFF WORKING AND WE HAVE MORE
VENDOR INVOLVEMENT -- THAT'S
FOR A LOT OF SKILLS JUST COME
FROM WE DEVELOP THAT DUPLICATE
METRIC SYSTEM THAT READS EVERY
SINGLE MESSAGE YOU KNOW THE
HUNDRED HUNDRED FIFTY THOUSAND
THE COMING TODAY THEY THEY
DO A SEPARATE -- METRICS AND
ANALYSIS OF ALL THE ALL THE LABS
ARE THE BILL BECAUSE FROM THE
LABS AND FORMAT FROM THE LAB
SO WE TAKE THOSE METRICS AND
WE COMPARE HIM TO THE METRICS
THAT WE HAVE IN OUR H. I.
GATEWAY AND FROM THOSE METRICS
TO WERE ABLE TO DETERMINE HOW
MANY MESSAGES SHE'S GOING TO
CALL READY SO WE DO THIS EVERY
SINGLE DAY THEY HAD OUT THERE
THERE'S SOME MINOR DISCREPANCIES
WE LOOK AT WHAT HAPPENED I MEAN
WHEN YOU TAKE METRICS YOU KNOW
YOU'RE TRYING TO DO IT OVER
TWENTY FOUR HOUR PERIOD A BATCH
OF FIVE THOUSAND MIGHT HAVE
GOT IN OR OUT DUE TO THE TIMING
BUT WE WE BALANCE -- TWO
IS TO A VERY MUCH SMALL LEVEL
EVERY SINGLE DAY THANK YOU IN
THE END YOUR AVAILABLE ONE WE
REALLY APPRECIATE ALL THE HARD
WORK OF YOUR DEPARTMENT BUT
ALSO THE ENTIRE AGENCY THE AND
THE REASON THAT YOU ARE RASKIN
THESE QUESTIONS IN DEPTH
WAY AS AS MY COLLEAGUES HAVE
REITERATED -- THE DATA YOUR OF
THE DATA THAT YOU ARE IN CHARGE
OF DRIVES THE COLOR CODES AND
IT'S NOT THAT WE CARE THAT MUCH
ABOUT COLORS BUT BEHIND EVERY
COLOR IS A RESTAURANT IS A HAIR
SALON IS A SMALL BUSINESS
ON A MAIN STREET AND THAT
THEIR LIVES ARE FRANKLY IN
YOUR COMPUTER SYSTEMS HANDS SO
YOUR DATA WILL DRIVE
THE COLOR CODES WITHIN EACH
OF THOSE COUNTIES AND IT'S
SO INCREDIBLY IMPORTANT --
BECAUSE BASED ON BASED ON THAT
INFORMATION REALLY THEIR THEIR
FATES ARE SORT OF IN YOUR HANDS
WHICH IS WHY WE WANT TO HAVE
THIS HEARING BUT ALSO REALLY
UNDERSTAND ON THIS INFORMATION
AND -- EFFICACY IN THE ACCURACY
OF THE INFORMATION SO WE REALLY
WE REALLY DO APPRECIATE ALL
THE HARD WORK THAT YOU AND YOUR
TEAM HAVE DONE BUT I JUST
WANTED TO TAKE A SECOND TO
RE ITERATE HOW IMPORTANT YOUR
DATA IS THIS IS NOT A ACADEMIC
EXERCISE WE'RE NOT HERE -- IT
OF BECAUSE OF -- SOME PAPER
THAT GOT WRITTEN OR SOMETHING
THAT THE THESE ARE AGAIN HE'S
A PEOPLE'S LIVES THE LIVELIHOOD
-- ARE BEING SIGNIFICANTLY
IMPACTED BY THIS PANDEMIC AND
AGAIN IF IF WE CAN ENCOURAGE
THEM TO DO THE RIGHT THING
THE HOPE IS THAT WE CAN SLOWLY
MOVE TOWARDS -- OPENING UP
IN A SAFE IN A SAFE WAY AND
YOUR DATA IS REALLY THAT
THE LINCHPIN OF OF THAT OF
THAT -- MOVEMENT SO ON
ONE EIGHT THERE'S NOT A
PERSON ON MY STAFF THAT DOES
NOT UNDERSTAND THAT WE WE
TOTALLY AGREE WE WORK AROUND
THE CLOCK TO FIX THE SYSTEM AND
TO GIVE THEM UP AND WE ARE VERY
UNDERSTANDING AND AND I THINK
BECAUSE EACH ONE OF US WANT TO
GO TO RESTAURANTS HEATH ONCE
ONCE YOUR LOCAL COMMUNITY AND WE
SEE THAT THEY'RE NOT FUNCTIONING
AND WE KNOW THAT THE DATA COMING
OUT OF THESE TWO PRIMARY SYSTEMS
AND OTHERS AROUND IT AFFECT
THE COLOR CODING AND AFFECT
WHAT CAN OPEN WHAT CAN OPEN AND
WE ARE VERY SENSITIVE AND AND
-- I CAN ENSURE YOU THAT ALL THE
PEOPLE PEOPLE THAT WE HAVE ON
MY TEAM WE RELOCATE PEOPLE
ALL THE TIME WE BACKFILL AND
WE CONTINUE TO TRY TO TRAIN
PEOPLE TO ENSURE THAT THE
SYSTEMS ARE FUNCTIONING AT AT
THE HIGHEST CAPACITY POSSIBLE
THANK YOU AND MAY I PLEASE
THANK YOUR TEAM FOR US MR FONG
HAD ONE LAST QUESTION YOU KNOW
I'VE ONE APPRECIATE THE THE
CHAIRS INTELLIGENCE AND TO TO
TO THE REAL QUICK I UNDERSTAND
THAT WE'VE TALKED ABOUT THE
UPGRADE TO CAL READY -- D.
THEIR TIME LINE IN TERMS OF
A WIN THAT WOULD BE DONE AYE
AYE WELL I GUESS I I FORGOT
TO ASK THAT AND IN TERMS
OF THE TYPE OF UPGRADE WILL
THERE BE MEANINGFUL SHARING
INFORMATION WITH WITH HEALTH
INFORMATION ORGANIZATIONS AND
HOSPITALS IN MAY WELL ARE YOU
LOOKING TO EXPAND THE NUMBER OF
PARTICIPANTS IN THE CAR READY
SYSTEM THAT ENDED THE NEW CAR
READY SYSTEM YEAH IT IF WE'RE
LOOKING AT THE NEW CARRY SYSTEM
ABSOLUTELY WE HAVE -- AGAIN A
VENDOR ON BOARD HELPING US DO
VERY EXTENSIVE OUTREACH WITH
ALL STAKEHOLDERS AND NOT JUST
FOCUSING ON POSSIBLY YOU KNOW
THE CURRENT STAKEHOLDERS WHAT
WE'RE LOOKING AT A BROADER
LEVEL TO BE MORE INCLUSIVE
AND REALIZING MORE I THINK
THAT YOU KNOW THE STATE CAN
HAVE A CENTRAL SYSTEM BUT EVERY
COUNTY HAS THEIR OWN NEEDS AND
THEIR -- AND FIREMAN'S AND
WE NEED TO POTENTIALLY BE MORE
ENGAGED IN HELPING THEM DO
THEIR JOB BETTER AT THE SAME
TIME WE HAVE TO WE HAVE STATE
RESPONSIBILITY SO I MIGHT AS
OUR TIME LINE THAT YOU HAVE I
THINK WE'RE LOOKING IN -- --
I DON'T KNOW A COUPLE YEARS OUT
BY THE TIME WE ARE ABLE TO DO
ALL THE ANALYSIS AND -- LOOK
AT THE TYPE OF SYSTEM THAT WANT
TO PROCURE AND WORK THROUGH THAT
YOU KNOW PROJECT APPROVAL LIFE
CYCLE THAT WE ALL HAVE TO WORK
WITH DEPARTMENT TECHNOLOGY BUT
THEY'RE VERY INVOLVED WITH THIS
EVERY STEP OF THE WAY AND SO IS
AGENCY I I WANNA PRESIDENT'S
ALLIES WHEN ACTED WITH THE
CHAIR SAID THAT THERE ARE
REAL WORLD CONSEQUENCES TO
EVERYTHING THAT YOU'RE DOING
-- I KNOW MY COLLEAGUES AND I
ARE GETTING PHONE CALLS FROM
SMALL BUSINESS OWNERS FROM
WORKING PARENTS WHO WANT TO
SCHOOLS RE OPENED INDIVIDUALS
WERE UNEMPLOYMENT -- WHO WANT
TO GET BACK TO WORK THESE ARE
EMOTIONAL CONVERSATIONS AND THE
NUMBER OF SHARES THAT HAPPENED
SHE SAID ON THE CALL ON THE
PHONE WITH ME I MEAN THESE
ARE RAW AND EMOTIONAL STORIES
AND SO WE NEED TO GET THE DATA
CORRECT WE NEED TO ALLOW AND
AND WORK WITH THESE COUNTIES
TO GET THEM THROUGH THESE TEARS
AS QUICKLY AS POSSIBLE AND
AS SAFELY AS POSSIBLE SO THAT
WE CAN GET BACK TO RE OPENING
OUR SMALL SMALL BUSINESSES OUR
SCHOOLS OUR CHURCHES I JUST
OUR SOCIETY IN GENERAL BYE BYE
IT'S ONLY APPRECIATES -- YOU
-- YOU YOU TESTIFYING TODAY
THAT'S RIGHT THANK YOU VERY
MUCH APPRECIATED AND NOTHING
ANY MORE QUESTIONS FROM THE
COMMITTEE WE ARE GOING TO PUBLIC
COMMENT IS THERE ANY PUBLIC
COMMENT PLEASE COME FOR
MY UNDERSTANDING IS THERE
IS NO PUBLIC AT THE VARIOUS
STATIONS AROUND THE STATE
IS IT ON YES PLEASE GO AHEAD
OKAY KELLY BEAM ON BEHALF
OF THE CALIFORNIA MEDICAL
ASSOCIATION -- I'D LIKE TO
HIGHLIGHT AN ISSUE THAT WAS --
TALKED A LITTLE BIT ABOUT TODAY
THAT IS MADE IT CHALLENGING
FOR PRACTICING PHYSICIANS TO
PROVIDE COORDINATED CARE DURING
THE PANDEMIC UNDER EXISTING
LAWS WHEN A PATIENT RECEIVES A
POSITIVE TEST THAT INFORMATION
AS REPORTED ELECTRONICALLY
CAL READY HOW READY HOWEVER
IS NOT REPORTING TESTING DATA
IN CASE REPORTS BACK OUT TO
HEALTHCARE PROVIDERS AND HEALTH
INFORMATION ORGANIZATIONS THE
LACK OF AVAILABLE DATA FROM
CAL READY CREATES MULTIPLE
CHALLENGES FOR CALIFORNIA'S
RESPONSE TO THIS PANDEMIC FOR
EXAMPLE -- THERE IS TECHNOLOGY
AVAILABLE NOW THAT MANY SMALL
PRACTICE PHYSICIANS RELY ON EACH
IDEAS TO ALERT THEM WHEN ONE
OF THEIR PATIENTS IS DISCHARGED
FROM THE HOSPITAL SO THEY CAN
SCHEDULE APPROPRIATE FOLLOW UP
CARE FOR KOBE CASES PHYSICIANS
ONLY RECEIVE THIS INFORMATION
IF THE PATIENT CONTACTS THEM
AFTER THEY'RE DISCHARGED WE
UNDERSTAND THEIR PLATE PLANS
IN PLACE TO UPGRADE CAL READY
AND PART OF THAT UPGRADE
SHOULD INCLUDE ADDRESSING THE
CHALLENGES AND LIMITATIONS OF
THE CURRENT SYSTEM TO ALLOW
FOR BIDIRECTIONAL COMMUNICATION
BETWEEN PROVIDERS AND HOW READY
WE LOOK FORWARD TO WORKING
WITH THE ADMINISTRATION THE
LEGISLATURE TO RESOLVE THIS
ISSUE THANK YOU THANK YOU XP FOR
CHEN MEMBER SALLY HAD A GRAND
WITH WIDENING GROUP HERE
ON BEHALF OF S. C. A. YOU
BLUE SHIELD OF CALIFORNIA
AND MANIFEST MEDICS WELL
WE APPRECIATE THE FACT THAT
THIS ADMINISTRATION MOVED
QUICKLY TO RESPOND TO COVER
NINETEEN ONE OF THE THINGS
THIS PANDEMIC HAS DONE IS
REALLY SHINED A SPOTLIGHT
ON ISSUES IN OUR HEALTH CARE
SYSTEM THAT ARE FAILING ONE
OF THE BIGGEST EXAMPLES OF
THIS IS OUR INABILITY TO
MEANINGFULLY SHARE HEALTH
INFORMATION AND THE SIGNIFICANT
LIMITATIONS THAT EXIST IN THE
CALORIE SYSTEM INFORMATION
CAN PROVIDE DATA THAT SUPPORTS
VITAL PUBLIC HEALTH EFFORTS
INCLUDING MANAGING PATIENT
CARE AND PERFORMANCE SYNDROMIC
SURVEILLANCE AS ALL OF CONTACT
TRACING AND THESE OF CODE
NINETEEN HOWEVER WRITER IN
H. IDEAS HAVE BEEN UNABLE TO
PLAY THIS VITAL FUNCTION AND
THEY HAVE NOT BEEN ABLE TO
ACCESS TEST TESTING DATA FROM
CAL READY OR FROM FROM COUNTY
PUBLIC HEALTH DEPARTMENTS WE
INTEND WITH ADMINISTRATION IN
THE COMING YEAR TO PLACE THE
HIGHEST PRIORITY ON UPGRADING
THE STATE'S HEALTH INFORMATION
EXCHANGE EXCHANGE CAPABILITIES
WHOLESALE BUT IN THE SHORT TERM
THE OF CRITICAL READY SYSTEM
MUST BE ABLE TO TRACK WITH
HEALTH INFORMATION ORGANIZATIONS
TO ENABLE THE PUBLIC HEALTH
RESPONSE CALIFORNIANS DESERVE
WOULD ALSO LIKE TO SEE THE
SHARING OF CALIBRATING AT A
WITH A TASTE SO THEY CAN NOTIFY
PROVIDERS WHEN THEIR PATIENTS
TEST POSITIVE IS THERE ANY
POLICY OR TECHNICAL BARRIERS
TO THAT WOULD LIKE TO KNOW
WHAT THOSE ARE SO YOU CAN WORK
TOGETHER TO SOLVE THEM THANK YOU
THANK YOU ANY OTHER SPEAKERS IN
THE PUBLIC ANY OTHER
SPEAKERS FROM THE PUBLIC IN THE
DIFFERENT ROOMS ACROSS THE STATE
OKAY HEARING NONE
WE ARE GOING TO ENSURE THAT
THIS HEARING WILL BE BACK
AT ONE O'CLOCK WITH THE --
COMMITTEE ON ACCOUNTABILITY AND
ADMINISTRATIVE REVIEW TO DISCUSS
STATE EXPENDITURES THANK YOU