AHEAD AND GET STARTED WITH OUR
HEALTH COMMITTEE HEARING THIS
AFTERNOON. SO WELCOME YOU TO
THE YOU WILL TAKE A MINUTE TO
GO THROUGH ALL THIS SO YOU'VE
GOT A GOT A COUPLE MINUTES OUR
GUYS IN THE BACK- SO WELCOME TO
THE HEALTH COMMITTEE ASSEMBLY
HEALTH COMMITTEE HEARING. DUE
TO THE CONTINUED STAY AT HOME
ORDER WE ARE PRACTICING
PHYSICAL DISTANCE IN HERE IN
THE CAPS IN THE IN THE HEARING
ROOM. AND THROUGHOUT THE
CAPITOL BUILDING SO WE'RE ONLY
ABLE TO HAVE A LIMITED NUMBER
OF PEOPLE WATCH AND PARTICIPATE
IN THE HEARING IN PERSON. ALSO
REQUIRING MAP THAT MASKS BE
WORN IN PHYSICAL DISTANCE IN BE
MAINTAINED BY ALL MEMBERS OF
THE PUBLIC TESTIFYING. WEATHER
HERE IN THE ROOM OR OR AT A
VIDEO CONFERENCING SITE. YOU DO
NOT HAVE A MASS WE CAN PROVIDE
ONE FOR YOU WE HAVE A FEW
DIFFERENT OPTIONS FOR WITNESS
TESTIMONY TODAY. THE PUBLIC IN
THE ROOM. TODAY IN THE ASSEMBLY
CHAMBERS WE CAN ONLY
ACCOMMODATE A MINIMAL
CONTINGENT OF STAFF. THE
LIMITED NUMBER OF PEOPLE AND
MEDIA SO WE CAN MAINTAIN
PHYSICAL SIX FEET OF PHYSICAL
DISTANCING. THERE ARE ALSO
STRICT. OF PHYSICAL DISTANCING
PROTOCOLS FOR THE PUBLIC TO
ENTER AND LEAVE THE CAPITAL.
AND FOR THOSE HERE IN THE ROOM.
IF ANY MEMBER OF THE PUBLIC IN
THE ROOM WOULD LIKE TO TESTIFY.
ON A BILL PLEASE RAISE YOUR
HAND I WILL ASK THAT YOU YOU TO
APPROACH THE MICROPHONE AT THE
APPROPRIATE TIME. I WOULD ASK
THEM A PUBLIC NOT TOUCH THE
MICROPHONE YOU CAN EXIT THE
HEARING ROOM ONCE YOU'RE DONE
TESTIFYING. OR RETURN TO YOUR
SEAT LEAPS. S. ME PLEASE BE
SURE TO OBSERVE PHYSICAL
DISTANCING UPON LEAVING THE
CAPITAL. INCLUDING LIMITING
ELEVATOR TO USED TO ONE PERSON
AT A TIME. TODAY'S AGENDA WILL
BE TAKEN UP IN THE ORDER LISTED
ON THE AGENDA- WITH ONE
EXCEPTION- MISTER GRAY- WILL BE
PRESENTING- ITEM NUMBER SEVEN
AB EIGHT EIGHTY TWO FIRST. AND
THEN WE WILL GO THEY WILL GO IN
ORDER AFTER THAT- FOR MEMBERS-
AND THEN FOR MEMBERS WHO ARE
NOT ON THE COMMITTEE FIRST. AND
THEN- MEMBERS ON THE COMMITTEE
WILL WILL PRESENT AFTER. OF NON
MEMBERS OF THE COMMITTEE. SO
OUR WITNESS VIDEO ROOM. OF
WITNESSES- IN ADDITION TO BEING
ABLE TO TESTIFY FROM INSIDE THE
HEARING ROOM WE HAVE SOME
WITNESSES MAKING USE OF OUR
WITNESS VIDEO CONFERENCING
ROOMS WHICH ARE LOCATED HERE IN
THE CAPITAL. IN A REMOTE
TESTIMONY STATION LOCATED ON
THE CAPITOL GROUNDS. THOSE
WITNESSES WILL APPEAR ON THE
SCREEN SO MEMBERS CAN WATCH
THEIR TESTIMONY LIVE FROM
OUTSIDE OF THE HEARING ROOM AND
ALSO ASK THEM QUESTIONS. UP
PEOPLE DIALING IN WE WILL BE
USING A MODERATED TELEPHONE
SERVICE THROUGH WHICH ANY
WITNESS CAN TESTIFY ON A BILL.
THE CALL IN NUMBER FOR THIS
HEARING IS EIGHT SEVEN SEVEN.
SIX NINE TWO. EIGHT NINE FIVE
SEVEN IN THE ACCESS CODE IS TWO
FOUR TWO. SIX TWO THREE SEVEN
WILL CALL THAT OUT AGAIN BEFORE
WE GET TO THAT POINT. YOU CAN
ALSO FIND THIS NUMBER ON THE
ASSEMBLY HEALTH COMMITTEE
WEBSITE AND IN THE DAILY FILE.
AS WELL AS ON YOUR TV SCREEN IF
YOU'RE CALLING IN PLEASE PLAN
TO DO SO AS THE AUTHOR OF THE
BILL YOU'RE TESTIFYING ON. HIS
BEGINNING THEIR PRESENTATION.
THE OPERATOR ON THE LINE WILL
GIVE YOU INSTRUCTIONS ON HOW TO
BE PLACED IN THE QUEUE. PLACED
ON. WHETHER YOU SUPPORT OR
OPPOSE THE BILL. RECALLING IN
PLACE ELIMINATE ALL BACK NOISE.
THIS INCLUDES MU YOUR LIFE
STREAM BROWN. IN YOUR SMART. TO
REDUCE THIS DOWN TO STORES.
PLEASE BE ADVISED YOUR MAIN
WITNESS PROVIDING TESTIMONY FOR
OR AGAINST A BILL YOU'LL REMAIN
ON A LIVE LINE YOU NEED TO MUTE
YOURSELF UNTIL YOU'RE CALLED
UPON TO SPEAK. YOU'RE HAVING
PROBLEMS WITH THE MODERATED
PHONE SERVICE YOU CAN KIND OF
CALL THE COMMITTEE AT NINE ONE
SIX THREE ONE NINE. TWO ZERO
NINE SEVEN AND MY STAFF WILL BE
THERE TO TRY TO HELP. I ALSO
WANT TO NOTE THAT WE ARE
ACCEPTING WRITTEN TESTIMONY TO
THE POSITION LETTER PORTAL WITH
INSTRUCTIONS ON THE COMMITTEE'S
WEBSITE. AND YOU CAN FIND THE
EMAIL FOR THE COMMITTEE THERE
AS WELL. THANK YOU FOR BEARING
WITH US AS WE IMPLEMENT METHODS
TO CONTINUE TO SERVE THE PEOPLE
OF CALIFORNIA. WHILE ALSO BEING
MINDFUL RESPECTFUL OF THE
PUBLIC HEALTH CONCERNS WE ALL
FACE- FOR- MEMBERS OF THE
COMMITTEE- LET'S GO. LET'S GET
THAT FOR A MOMENT- TIME LIMITS
IN FAIRNESS TO EVERYONE WE WILL
BE. ESPECIALLY SPECK STRICT ON
TIME LIMITS TODAY WE HEAR FROM
UP TO TWO WITNESSES FOR THREE
MINUTES EACH FOR EACH SIDE.
AFTER THE TWO MAIN WITNESSES
TESTIFY RECI TESTIFY IF THERE
ARE ANY WE WILL GO TO THE
PHONES- AND COMBINE THE
ADDITIONAL TESTIMONY FOR BOARDS
BOTH SUPPORT AND OPPOSITION. SO
ADDITION ADDITIONAL WITNESSES
WILL BE LIMITED TO THEIR NAME
ORGANIZATIONS THEY REPRESENT
ONE AND POSITION ON THE BILL-
WE HAVE FOUR BILLS PROPOSE FOR
CONSENT TODAY. ITEM NUMBER TEN
ASSEMBLY MEMBER. OF IT IS
SIMPLY BILL FIVE TWENTY ONE BY
MISTER MATHIS. THE SET- ITEM
NUMBER ELEVEN ASSEMBLY BILL
FOURTEEN SEVENTY ALSO BY MR
MATHIS WITH AMENDMENTS. I AM
NUMBER SEVENTEEN AB TWO FORTY
BY MR RODRIGUEZ AND ITEM NUMBER
EIGHTEEN BY AB FIVE THIRTY TWO
BY ASSEMBLY MEMBER WOULD. UP I
DIDN'T TODAY- ITEM NUMBER THREE
AB THIRTEEN FORTY FOUR HAS BEEN
PULLED FROM TODAY'S. HEARING BY
THE COMMITTEE. AND I WOULD JUST
NOTE ALSO THAT. WE WOULD ASK
THAT THERE BE NO PEOPLE WHO
MIGHT BE HERE PRESENT- IN
OBSERVING HERE WEWILL NOT BE
LOOKING KINDLY ON DISRUPTIONS-
AND- THE DESTRUCTION OF WILL
LIKELY VERY QUICKLY LEAD TO. AN
ESCORT OUT OF THE BUILDING OR
OUT OF THE CHAMBER ANYWAY SO
PLEASE BE RESPECTFUL IF YOU ARE
IN THE ATTENDING IN PERSON AND
WE WILL NOT BE- LOOKING KINDLY
ON DISRUPTION SO WITH THAT MR
GRAY HAS ASSEMBLY BILL EIGHT
EIGHTY TWO IF YOU'D LIKE TO
PRESENT THE BILL WILL NOT WE DO
NOT HAVE A QUORUM. BUT- PLEASE
GO AHEAD. THANK YOU. THE
MICROPHONE PLEASE. YEAH- SO WE
GOT TO THE PODIUM NHà. THANK
YOU MR CHAIRMAN MEMBERS. I'VE
SPENT A GREAT DEAL OF MY
LEGISLATIVE CAREER FIGHTING TO
IMPROVE ACCESS TO HEALTH CARE
IN UNDERSERVED COMMUNITIES. TOO
OFTEN OUR GOOD INTENTIONS IN
SACRAMENTO DO NOT TRANSLATE TO
IMPROVED HEALTHCARE OUTCOMES ON
THE GROUND. FOR EXAMPLE WHILE
THE AFFORDABLE CARE ACT
INVESTMENTS IN PUBLIC HEALTH
INSURANCE HAVE UNDOUBTEDLY
IMPROVED COVERAGE. THAT
COVERAGE IS NOT ALWAYS
TRANSLATE TO IMPROVE ACCESS TO
CARE. THE LONGSTANDING PROVIDER
SHORTAGE OF RURAL CALIFORNIA
MEANS THAT MY CONSTITUENTS
OFTEN GAIN HEALTH CARE COVERAGE
BUT THEN STRUGGLE TO FIND A
DOCTOR WHO IS ACCEPTING NEW
PATIENTS AND IS WILLING TO TAKE
THEIR INSURANCE. TO ADDRESS
THESE CHALLENGES THE STATE HAS
CREATED AND FUNDED SEVERAL
DIFFERENT HEALTHCARE PROVIDER
INCENTIVE PROGRAMS TO DRIVE
MORE PHYSICIANS DENTISTS AND
OTHERS TO PRACTICE MEDICINE. IN
THE MOST UNDERSERVED PARTS OF
THE STATE. MOST RECENTLY THE
LEGISLATURE IS UTILIZED SOME OF
THE PROP FIFTY SIX TOBACCO TAX
TO FUND A NEW LOAN REPAYMENT
PROGRAM TO IMPROVE ACCESS FOR
CALIFORNIANS MEDI CAL
BENEFICIARIES. THE STATE
AUDITOR RELEASED AN AUDIT OF
THIS LOAN REPAYMENT PROGRAM IN
JANUARY AND FOUND THAT THE
SCORING CRITERIA USED TO JUDGE
APPLICANTS DID NOT REQUIRE THEM
TO BE LOCATED IN AREAS. WITH A
SHORTAGE OF HEALTHCARE
PROVIDERS. AND S A RESULT OF
THAT ABOUT TWO THIRDS OF THE
PRIMARY CARE PHYSICIAN SELECTED
FOR LOAN FORGIVENESS WERE NOT
LOCATED IN A SHORTAGE AREA. THE
OTHER DETERMINE THAT THE
PROGRAM COULD BETTER ADDRESS
GEOGRAPHIC GEORGE'S BY
REQUIRING APPLICANTS TO
PRACTICE IN HEALTHCARE
PROFESSIONAL SHORTAGE AREAS.
AND RECOMMENDED THE PROGRAM
APPLICATION BE MODIFIED
ACCORDINGLY. THE DEPARTMENT OF
HEALTH CARE SERVICES WHICH
ADMINISTERS A LOAN FORGIVENESS
PROGRAM DECLINED TO MAKE THIS
REFORM. WHICH IS WHY I
INTRODUCED THE BILL BEFORE YOU
TODAY. AS A FORMER CHAIR OF THE
JOINT LEGISLATIVE AUDIT
COMMITTEE I HAVE DEEP RESPECT
FOR THE RECOMMENDATIONS MADE BY
THE AUDITOR'S OFFICE AND I
THINK THE CURRENT YEAR ASSEMBLY
MEMBER SALAS. FOR PARTNERING
WITH ME AS A JOINT AUTHOR ON
THIS BILL WHICH SIMPLY PROPOSED
TO CODIFY THE AUDIT'S
RECOMMENDATIONS. SINCE
INTRODUCTION I HAVE HAD A
NUMBER OF CONVERSATIONS WITH
STAKEHOLDERS IN THE HEALTH CARE
SPACE TO EXPRESS CONCERN ABOUT
USING HEALTH PROFESSIONAL
SHORTAGE AREAS. AS THE SOLE
METRIC TO JUDGE A PROVIDER
SHORTAGE. THEY HAVE REQUESTED A
SERIES OF AMENDMENTS ALLOW
OTHER VARIABLES TO DEMONSTRATE
PROVIDER SHORTAGES SO LONG AS
THE SOURCE OF INFORMATION
EMPIRICALLY QUANTIFIES THE NEED.
HEALTHCARE PROFESSIONALS
STORAGE AREAS ARE PRIMARILY
DESIGNED TO MEASURE SHORTAGES
OF PRIMARY CARE DENTAL MENTAL
HEALTH PROVIDERS. AND SO MAY
NOT TAKE INTO CONSIDERATION
CERTAIN SPECIALTIES WHICH ARE
BADLY NEEDED TO SERVE OUR
MEDICARE POPULATION. AS A
RESULT I HAVE AGREED TO
SIGNIFICANTLY EXPAND THE
METRICS BY WHICH AN APPLICANT
CAN DEMONSTRATE THEY ARE
IMPROVING ACCESS FOR
UNDERSERVED MEDICARE
POPULATIONS. INCLUDING CITING
NETWORK ADEQUACY STANDARDS
PROVIDER TO BENEFICIARY RATIOS
ALTERNATE ACCESS REQUESTS AND
OTHER QUANTIFIED DATA SETS. THE
GOAL OF THIS BILL HAS ALWAYS
BEEN TO ENSURE FUNDING FLOWS TO
PROVIDERS THAT ARE SERVING
THOSE WHO ARE MOST IN NEED AND
I BELIEVE THESE AMENDMENTS
MAINTAIN THAT GOAL WHILE
ACKNOWLEDGING NEED IS NOT A ONE
SIZE. FITS ALL METRIC.
CONVERSATIONS WITH STAKEHOLDERS
WILL CONTINUE AFTER TODAY'S
HEARINGS IS THERE REMAIN A
HANDFUL OF AMENDMENTS REQUEST
WE'VE NOT QUITE SETTLED ON.
THESE PRIMARILY RELATE TO
SMOOTH THE CONTINUED OPERATION
OF THE PROGRAM ONCE THIS BILL
GOES INTO LAW. IT IS CERTAINLY
MY GOAL TO MINIMIZE DISRUPTIONS
TO EXISTING OPERATIONS SO I'M
CONFIDENT WE CAN FIND A
SOLUTION. TO THESE FINAL FEW
ISSUES. ALL AND BY JUST
THANKING THE COMMITTEE FOR
FACILITATING A PRODUCTIVE
DISCUSSIONS WITH STAKEHOLDERS
AND RESPECTFULLY REQUEST YOUR
SUPPORT ON AB EIGHT EIGHT TWO
TODAY. I HAVE WITH ME SIR
BRIDGE WITH THE ASSOCIATION OF
CALIFORNIA HEALTHCARE
DISTRICTS- ON THE PHONE TODAY
IN SUPPORT OF THE BILL. THANK
YOU VERY MUCH MISTER GRAY- GO
TO OUR OPERATOR IN PLEASE-
ALLOW OUR WITNESS TO. TESTIFY
OR IF THEY'RE COMING ON THE
SCREEN I'M NOT REALLY SURE.
YEAH HI THERE I'M ON THE LINE
GREAT THANK YOU.OKAY GREAT AND
I THINK YOU AND GOOD AFTERNOON
SURE MEMBERS THEIR BRIDGE ON
BEHALF OF THE ASSOCIATION OF
CALIFORNIA HEALTHCARE DISTRICT.
ACROSS THE BORDERS OF ASSEMBLY
BILL ECH YOU HEALTHCARE
DISTRICT ESPECIALLY THOSE
LOCATED IN RURAL AND REMOTE
AREAS OF THE STATE HAVE EXTREME
DIFFICULTY RECRUITING AND
RETAINING PHYSICIANS. AND SERVE
LARGE PORTIONS OF THE STATE
MEDICAL POPULATIONS AT THE SAME
TIME CALIFORNIA'S CURRENT AND
FUTURE WORKFORCE SHORTAGES OF
PRIMARY CARE CLINICIANS. LOAN
REPAYMENT PROGRAMS SUCH AS A
TABLET PROPER FIFTY SIX SENATE.
POSITIONS UNDER SIR COMMUNITY
ARE ESSENTIAL TO DELIVER
PRIMARY CARE TO BE THERE.
HOWEVER EARLY TIS YEAR THE
STATE AUDITOR FOR THAT THE
COLLECTION IN THE MINISTRY OF
THE PROPERTY SIX BY. DID NOT
HAVE THE THING TO ENSURE THEY
WERE APPROPRIATE AWARDED TO
FINISH AND- LEVINE SHORT AREA.
EIGHTY EIGHT EIGHT TWO PLACE
MATHIS GUARD ON POSITION AND
THAT TOO ONE OR TWO PROGRAM AND
MINUTES THROUGH PROPOSITIONS
SIX FUND TO WE CLOSE THE
PROVIDE GOT IN THE MOST. WAY WE
LOOK FOR TO WORKING WITH A
LARGER COALITION TO ENSURE THAT
WORK. FOR SHORTAGES. MATHS I
YES I AM THANK YOU VERY MUCH SO
WE'LL BRING IT BACK TO
COMMITTEE CAN'T WE CAN'T MOVE
QUITE YET OF LOVE TO MOVE THE
BILL WE DON'T HAVE A QUORUM.
BUT BUT BEAR THAT MIND IN MIND
AS WE MOVE FORWARD THANK YOU.
BRING IT BACK TO THE COMMITTEE
FOR QUESTIONS OR COMMENTS OR
THEIR QUESTIONS OR COMMENTS
FROM THE COMMITTEE. C. NONE THE
BILL DOES ENJOY A DO PASS
RECOMMENDATION WHEN WE DO HAVE
A QUORUM TO BE ALE TO VOTE ON
THIS WOULD YOU LIKE TO CLOSE
MISTER GREG. WELL JUST CLOSE BY
SAYING- NUMBERS I'M NOT SURE
WE'RE ALL AWARE OF THE
SHORTAGES OF THOSE I LOOK
AROUND THIS ROOM AND- THIS IS
QUITE A GOOD HEALTH COMMITTEE
YOU PUT TOGETHER MISTER CHAIR
THERE'S A LOT OF GOOD ROLE
LEGISLATORS HERE DO I KNOW
UNDERSTAND THIS ISSUE AS WELL
AS I DO. BUT JUST TO PUT IT IN
VERY CLEAR TERMS. MERCED COUNTY
WHERE I LIVE HAS AROUND NINETY
DOCTORS. PER ONE HUNDRED
THOUSAND PEOPLE. SAN FRANCISCO
SITTING COUNTY HAS NEARLY FOUR
HUNDRED. PER ONE HUNDRED
THOUSAND PEOPLE APPLES TO
APPLES COMPARISON. AND THIS
pSHORTAGE THOSE RURAL
COMMUNITIES BY. PUTTING OUR
MONEY WHERE OUR MOUTH IS AND
ACTUALLY ENGAGING IN ACCESS TO
CARE FOR. ALL CALIFORNIANS
RURAL ORGANIZED RESPECTFULLY
ASK RIVAL THANK YOU FOR YOUR
TIME TODAY. HOLD TIGHT AND I
JUST WANNA SAY THANK YOU FOR
BRINGING THE BILL FORWARD YOU
KNOW I WE BOTH SHARE THE SAME
CHALLENGES OF REPRESENTING
RURAL AREAS AND UNDERSERVED
AREAS. AND HAS A LOOK AROUND
YOU KNOW THERE'S FOLKS ON THIS
COMMITTEE TO DO AS A SO I WAS
ONCE A APPRECIATE YOUR
CONTINUED EFFORTS TO HELP IN
THIS REGARD- YOU HAVE A LONG
HISTORY HERE AND- AS AS AS DO
SOME OF US AT SOME OF A SELF.
ALSO IN THE ROOM BUT I WANT TO
THANK YOU FOR BRINGING THIS
FORWARD AND THE SPIRIT IN WHICH
YOU'RE CONTINUE TO WORK WITH
EVERYONE. AND LOOK FORWARD TO
SEEING THIS BILL BE SUCCESSFUL
AND I WANT TO AT THIS POINT- WE
DO HAVE A QUORUM NOW I'M GOING
TO HAVE- OUR SECRETARY CALL THE
ROLL. AND THEN- WE HAVE BEEN
AND THEN THERE MIGHT BE A TIME
TO DO A MOTION AFTER THAT SO ON
THEM SECRETARY PLEASE CALL THE
ROLL WHAT HERE. MAYES.
AGUIAR-CURRY BIGELOW. BONTA
BURKE CARILLO FLORA MAIENSCHEIN
MCCARTY. NAZARIAN REVERSED
RODRIGUEZ SANTIAGO WALDRON. WE
HAVE A QUORUM OKAY WE HAVE A
QUORUM HAVE A MOTION- BY MISS
AGUIAR-CURRY A SECOND AYE MR
BIGELOW THE MOTION IS TO PASS
AS AMENDED TO APPROPRIATIONS
MINUTES SECRETARY CALL THE ROLL
PLEASE. WHAT I WHAT I MAYES.
MAYES NOT VOTING. AGUIAR-CURRY
AGUIAR-CURRY AYE BIGELOW.
BIGELOW I. BONTA. BURKE
CARRILLO CARILLO AYE FLORA
LAURA HI MAIENSCHEIN. MCCARTY.
MCCARTY AYE NAZARIAN NAZARIAN
AYE RIVAS RODRIGUEZ SANTIAGO
WALDRON. HAS SEVEN ZERO NEEDS
ONE MORE. SEVEN OR OKAY THANK
YOU SO WE'LL PUT THE BALL THE
BALL WILL PUT THE BILL ON CALL
THERE IS NO BALL OKAY THANK YOU
MISTER CHAIR THANK YOU MEMBERS
THANK YOU VERY MUCH MR GREAT.
AND WITH THAT. INTERESTING
START TO MY DOCUMENTARY HERE-
DR ARAMBULA YOU HAVE TO BILLS
BEFORE US- PLEASE START WITH AB
THREE FORTY SEVEN. THANK YOU
DOCTOR WOULD END MR CHAIRMAN
MEMBERS I WOULD LIKE TO START
BY THANKING THE COMMITTEE STAFF
FOR WORKING WITH MY OFFICE ON
THIS BILL. I'M HERE TODAY TO
PRESENT ON AB THREE FORTY SEVEN
REGARDING MUTILATION UTILIZED
STATION MANAGEMENT REFORM.
UTILIZATION MANAGEMENT
PROTOCOLS INCLUDE PRIOR
AUTHORIZATION AND STEP THERAPY.
PRIOR AUTHORIZATION IS A
PROCESS IN WHICH PHYSICIANS
MUST FILL OUT PAPERWORK
WHENEVER THEY PRESCRIBE A
SPECIALTY MEDICATION OR
TREATMENT THAT IS RESTRICTED.
STEP THERAPY IS THE PROCESS
WHEREBY PAYERS FREQUENTLY DENY
COVERAGE OF PROVEN AND
EFFECTIVE MEDICATIONS. THIS
PROCESS FORCES PATIENTS TO FAIL
FIRST ON ALTERNATIVE
MEDICATIONS BEFORE THEY ARE
PERMITTED TO OBTAIN THE
MEDICATION DEEMED APPROPRIATE
BY THE PRESCRIBING PROVIDER.
BOTH PRIOR AUTHORIZATION AND
STEP THERAPY ARE INTENDED TO
REDUCE HEALTHCARE COSTS. WHILE
REDUCING COSTS IS IMPORTANT
ACROSS THE HEALTH CARE SYSTEM
MAKING MEDICAL DECISIONS. BASED
SOLELY ON COST CAN LEAD TO AN
ERROR YEAR REVERSIBLE
DETERIORATION OF A PATIENT'S
CONDITION. PATIENTS AND
PROVIDERS OFTEN EXPERIENCE
CHALLENGES WITH THE STEP
THERAPY PROCESS SUCH AS DELAYS
IN A PATIENT'S ABILITY TO
OBTAIN MEDICATIONS.
SPECIFICALLY AB THREE FORTY
SEVEN EXPANDS PATIENT ACCESS
AND IMPROVES UTILIZATION
MANAGEMENT PROTOCOLS BY FIRST
CREATING STANDARD EXCEPTIONS TO
STEP THERAPY TO BE USED BY ALL
PAYERS. IT ALSO REQUIRES
CLINICAL PEER TO PEER REVIEW
APPEALS BY A HEALTHCARE
PROFESSIONAL IN THE SAME
PROFESSION OR SIMILAR SPECIALTY
AS THE DOCTOR WHO TYPICALLY
MANAGES THE MEDICAL CONDITION
PROCEDURES OR TREATMENT WHICH
IS UNDER REVIEW. IT ALSO
REQUIRES A PAIR TO SEND AN
APPROVAL OR DENIAL OF A STEP
THERAPY EXCEPTION REQUEST OR A
PRIOR AUTHORIZATION REQUEST
RATHER THAN JUST SUBMITTING A
RESPONSE. WITHIN SPECIFIED TIME
FRAMES. IT ALSO WILL
TRANSPARENCY BY REQUIRING
REQUIRING PLAYERS TO ANNUALLY
REPORT INFORMATION ON THE
NUMBER OF STEP THERAPY AND
PRIOR AUTHORIZATION REQUESTS
AND DENIALS TO THE DEPARTMENT
OF MANAGED HEALTH CARE AND THE
DEPARTMENT OF INSURANCE. THIS
BILL AIMS TO STRIKE A BALANCE
BETWEEN ALLOWING PLAYERS TO
CONTINUE TO UTILIZE STEP
THERAPY AND PRIOR AUTHORIZATION
WHILE ESTABLISHING GUARDRAILS
TO PROTECT PATIENTS IT DOES NOT
PROHIBIT PRIOR AUTHORIZATION OR
STEP THERAPY PROTOCOLS RATHER
IT ESTABLISHES A STANDARD AND
TRANSPARENT PROCESS. I HAVE TWO
WITNESSES TESTIFYING BY PHONE
WE HAVE CHLOE HUBBARD WHO IS AN
MS PATIENT FROM SOUTHERN
CALIFORNIA WITH THE ALLIANCE
FOR PATIENT ACCESS AS WELL AS
DR SAMI MATATUS RHEUMATOLOGIST
FROM SAN SOUTHERN CALIFORNIA
WHO IS THE PRESIDENT OF THE
CALIFORNIA RHEUMATOLOGY
ALLIANCE. THANK YOU VERY MUCH
MISS- TO OUR OPERATOR PLEASE GO
AHEAD AND OPEN THE PHONE LINES
FOR OUR- WITNESSES IN SUPPORT.
IN A CHLOE HUBBARD YOU ARE ON
THE LINE YOUR LINE IS OPEN
THESE MAKE SURE NOT I'M YOU.
THANK YOU. OKAY. WE HEARD YOU
CHLOE WE HEAR YOU PLEASE GO
AHEAD AT. OKAY I'VE- HI MY NAME
IS CHLOE HABERT ENACT RELAPSING
REMITTING MULTIPLE SCLEROSIS
WHICH IS AN AUTO IMMUNE DISEASE
THAT CAN BE VERY DEBILITATING
AND DIFFICULT TO CONTROL.
BLACKBEAR I WAS STRUGGLING WITH
THE SIDE EFFECTS OF THE
MEDICATION I WAS TAKING. I WAS
EXPERIENCING BURNING ITCHING
RASH REDNESS AT THE VERY CASH
AND CASH NO PROBLEM. THE JACK
WAS NOT WORKING AND I WOULD
MARKET TEETH IN NEED. WHICH
MADE IT REALLY DIFFICULT FOR ME
TO KIND OF WORK OR JUST GO
ABOUT MY EVERYDAY LIFE. THEN MY
DOCTOR PRESCRIBED ME A NEW
MEDICAID. THAT SHE SAID
HAPPENED OUTSIDE OF. BUT TODAY
FOUR MONTHS LATER THEIR
INSURANCE IS NOT A GOOD DAY. IT
WAS A LONG PROCESS I THANK
YOUNG INTERVIEWS THAT STARTED
AFTER I REPEAT THE FIRST NIGHT
OUT LAST DECEMBER WHEN I WAS
REQUIRED TO TRY. TO ALTERNATIVE
DRIVE AND BELFORD. I DO NOT
KNOW WHAT THEY OFFERED NEEDS TO
ENSURE THAT CELEBRATE THE
PATIENTS LIKE ME CAN BE
EXTREMELY DEVASTATING. SO MUCH
THAT I HAD THE TREATMENT
OUTSIDE OF MY INSURANCE WOULD
BE TO DRIVE I NEEDED. WHICH IS
WORKING WELL AND HAD NO SIDE
EFFECTS. MY DOCTOR SAID THE
DRIVE I WAS ASKED TO TRY WOULD
NOT WORK. IN A LETTER TO THE
INSURANCE STATED. THEY ARE
INFERIOR AND ADVOCACY AND THAT
THAT THAT THE PATIENT AT RISK
OF PERMANENT NEUROLOGIC DEFICIT
AND DISABILITY I HAVE A GREATER
SIDE EFFECT PROFILE INCLUDING
DEATH. I HAD TO WAIT TWO WEEKS
AFTER WE APPEALED THE FIRST
NILE AND THEY SAID THEY NEEDED
ANOTHER. FIFTEEN TO SEVENTEEN
TO DATE OR TIME. WE ASK FOR AN
EXPEDITED RUBIO AND GREAT
NIGHT. I WAS INTERVIEWED BY AN
EMPLOYEE AT THE INSURANCE
COMPANY NOT A DOCTOR WHO ASKED
ME IF I THOUGHT I WAS GOING TO
DIE IF I DIDN'T GET THE
MEDICATION. WE GOT THEIR FINAL
DECISION AND A LETTER ON MARCH
NINTH. AT THAT THEIR MEDICAL
DIRECTOR APPOINT CERTIFIED
OBSTETRICIAN I'D MADE THE
DETERMINATION THAT BOTH THE
DENIAL. MY DOCTOR AND
NEUROLOGIST SPECIALIZES IN
LOCAL RESIDENTS SHE KNOWS MY DE
BEERS AND HIRING BONDS THAT WE
HAVE WORKED TOGETHER FOR MANY
YEARS AND I TRUST HER. I WANT%
MY DOCTOR NOT INSURANCE COMPANY
MAKE DECISIONS ABOUT MY CARE.
ALSO IT CAN ME THAT INSURANCE
COMPANY HOW DID. OBSTETRICIAN
IN MY CASE THE MARK OF THAT
ATTITUDE SUPPORT AB TWO POINTS
THAT. THANK YOU VERY MUCH.
PLEASE OPEN THE LINE FOR OUR
NEXT WITNESS. THANK YOU. THANK
YOU CHAIR AND MEMBERS OF HEALTH
COMMITTEE MY NAME IS SENDING ME
TO AT A LITTLE MORE HUNDRED AND
SEVEN CALIFORNIA AND CURRENT
PROTECT CALIFORNIA BUDGET LINE.
THE GREATEST CHALLENGE WE HAVE
AS A RHEUMATOLOGIST THE FEELING
WAS BEAR WITH ME IN PRIOR
AUTHORIZATION TO START OUR
PATIENTS. ON EFFECTIVE
COMMUNICATION. IT CAN TAKE
WEEKS OR EVEN MONTHS TO GET THE
MEDICINE APPROVE MANY TIME DUE
TO BIGGEST LACK OF RESPONSE.
SOMETIMES WE MUST ACCEPT NON
EFFECTIVE MEDICATION OR EVEN
MEDICATIONS THAT'S NOT SUITABLE
TO THE BASIC CONDITION AND
FULFILLING THE STEPS SYRUPY
THAT THE BABY HAD MANDATED
FORTY CONDITION EVEN IF THE
PATIENT CRIED AND SCREAMED SEEM
MITIGATION. BEFORE WITH OTHER
INSURANCE. BOB THIS IS LYNN.
AND EXOTIC AND CAN TAKE YOUR MY
I'M OUR- GET THE RIGHT
TREATMENT BOTH CALLED IT A LOT
TIME FOR FOOD. TO WRITE EDU TO
ALSO. CAN BE SEEING. AND
MULTIPLE DIMPLED WE TO FILL OUT.
AND WHAT OF THE TIME WE HAVE TO
TALK TO ANDERSON. OR PHYSICIAN
ASSISTANT. TO GET APPROVED THE
MEDICINE. I WOULD LIKE TO BRING
ONE OF MY BE SAID MRS EIGHT
FIFTY THREE OLD WITH A HISTORY
STRIVE DISCOVERING 90% TO PUT
BUT HE- SAYS TWENTY SEVENTEEN.
PSORIATIC ARTHRITIS STATE
DELIVERED HIGH LIVER ENZYME
DEVELOPMENT DETECT THAT BASE TO
MUST TRY AND CREATE MITCHELL
TAKES IT FOR THREE MONTHS
BEFORE STARTING ANY BIOLOGIC.
pLIVER AND KIDNEY DISEASE LIVER
ENZYME BUT I HAD TO GIVE. I HAD
TO GIVE MISDIRECTED INCLUDE
THOSE TO FULFILL REQUIREMENTS
THAT NEED TO INCLUDE IS THE
LIVER ENZYME EVENTUALLY A HAD
TWO DEGREES IT WAS AND FINALLY
STOP. IT BECAUSE IT WAS LEGAL
CONDITION. THE PATIENT TRIED
AND FAILED TO LAND HUMANA
INJECTIONS FOR TWO YEARS. THE
SUFFERING OF SWOLLEN JOINT
BEING SLOW AT THE CRASH AND
FATIGUED SHE NEEDED. TO BE ABLE
TO HELP THEIR CONDITION. AND
NOT EXPECTED LIVE WHAT. AT WHAT
I INITIAL SUBMITTED FOR
STARTING CONSENT DICK'S WHICH
IS DIFFERENT BEGIN IS WITH
ACTION. IT WAS DENIED BECAUSE
OF REQUIREMENTS. OF THE
PRECINCT WILL CRY AND THREE
OTHER MEDICATION. SAM DAVIS
MEDICATIONS BEFORE START THE
CALL CENTER. THE PATIENT HAD
SUFFERED LIKE FOR A FEW MONTHS
SINCE TRYING GET NONE PARKS
MEDICATION WAS APPROVAL OF
EIGHTY THREE FORTY SEVEN.
PATIENTS TO BE QUALIFIED 4%
EXTRA BEGINNING AND THE LADY OF
THE TREATMENT WOULD BE AVOIDED.
THE CURRENT SITUATION IN EFFECT
ON HEALTHCARE IS VERY DIFFICULT
WE SHOULD WEEK WEEKS OR MONTHS
TO AND SUFFERED WITHOUT GETTING
SUFFICIENT TREATMENT. POSITION
TO SPEND HOURS SCROLLING FORTY
ONE INSURANCE COMPANY WRITING
LETTERS I'M HIGH OVERHEAD. AND
BAGELS WASTE MONEY TRYING TO
NINETY FIFTY THREE CAN. AND
BASICALLY DO AVOID THE WORLD
HOSTILITY FORTY CLICK. THANK
YOU FOR YOUR TIME AND I'M
AVAILABLE. FOR ANY QUESTIONS.
THANK YOU VERY MUCH. THIS POINT-
IN THE- HANG ON A SECOND HERE.
QUESTIONS FROM THE CA. C. NINE
I WILL GO AHEAD AND MOVED TO
THE- WE HAVE OPPOSITION- ON THE
PHONE COMING ON THE PHONE AS
WELL- MISTER- NICK LOUISE US IN
THE CALIFORNIA ASSOCIATION
HEALTH PLANS AND STEPHANIE
WATKINS ALSO- IN OPPOSITION SO-
STRUGGLING MAY OPEN THE LINE
FOR- WITNESSES IN OPPOSITION.
GREAT THANK YOU MR CHAIRMAN
MEMBERS NICCOLO USERS WOULD
CALIFORNIA'S ASSOCIATION OF
HEALTH PLANS- WE ABOUT
RESPECTFULLY TAKEN AN OPPOSE
UNLESS AMENDED POSITION ON AB
THREE FORTY SEVEN- WHICH
MANDATE THE NEW REPORTING
REQUIREMENTS ON HEALTH PLANS.
AND CREATING NEW STEP THERAPY
EXCEPTION PROCESS FOR
PRESCRIPTION DRUGS- DESPITE
EXISTING LAW AND REGULATIONS-
ADDRESSING THE ISSUE. NOW WE
DON'T HAVE A PARTICULAR
OBJECTIONS TO THE IDEA OF A
STEP THERAPY EXCEPTION PROCESS
INDEED- ONE ALREADY EXISTS-
RATHER WERE CONCERNED THAT THE
NEW LANGUAGE- IS SOMEWHAT VAGUE
AND SUBJECTIVE TO THE POINT
THAT THE PROCESS IMAGINED IN
THIS BILL- WOULD COMPEL PLANS
TO COVER NON PREFERRED.
EXPENSIVE BRAND NAME DRUGS EVEN
WHEN LOWER COST GENERICS OR
PREFERRED BRAND NAME
ALTERNATIVES ARE AVAILABLE AND
CLINICALLY APPROPRIATE- WE MUST
ACKNOWLEDGE HOWEVER THAT THE
AUTHORS TAKING AMENDMENTS TODAY
SOME OF WHICH WE HAVE SUGGESTED
IT- AND OTHER AMENDMENTS THAT
WILL HAVE TO ANALYZE- WE
APPRECIATE THE OPENNESS OF THE
AUTHOR AND THE SPONSOR TO
CONSIDER OUR ISSUES- FROM WHAT
WE CAN TELL- SOME OF OUR ISSUES
ARE BEING ADDRESSED- BUT AGAIN-
WORK REMAINS TO BE DONE AND SO
WE AINTAIN OUR OPPOSE POSITION
AT THIS TIME- ONE ISSUE THAT
I'D LIKE TO HIGHLIGHT.
HIGHLIGHT IS THE NEW IN THE
NECESSARY AND ONGOING REPORTING
REQUIREMENT ON PLANS THAT WILL
BE AN ADMINISTRATIVE BURDEN NOT
JUST TO MY MEMBERS BUT TO OUR
DELEGATED A PROVIDER PARTNERS
AS WELL- THE INFORMATION
REQUIRED UNDER AB THREE FORTY
SEVEN. WILL BE DIFFICULT TO
ASSEMBLE- AND WON'T TRANSLATE
INTO HIGHER COSTS FOR CONSUMERS
FOR- AN ILL DEFINED OBJECTIVE-
A NUMBER OF THE PLANNED YOU THE
DELEGATED MODEL WHERE SERVICES
AND UTILIZATION MANAGEMENT OR
MANAGED BY THE PROVIDER GROUPS
ON A CONTRACTUAL BASIS. THAT'S
THE WHOLE POINT IS GOING TO
HAVE TO SURVEY THE PROVIDER
GROUPS FOR THE INFORMATION
REQUIRED BY THIS BILL IN THESE
DATA REQUESTS ARE NOT
PARTICULARLY POPULAR- BUYER
CONTRACTED FOR- PROVIDERS. AND
SO THE RESPONSIVENESS HAS BEEN
A PROBLEM IN THE PAST ON THESE
ISSUES AND WHEN THE WHEN THERE
IS LOW LEVEL OF RESPONSE IT
BECAME EVEN MORE
ADMINISTRATIVELY BURDENSOME TO
ENSURE ACCURACY. IF WE CAN SURE
AT ALL- IN ANY CASE WE DO LOOK
FORWARD. TO RESOLVING THIS AND
OTHER ISSUES WITH THE BILL IF
WE CAN WITH YA BUT TIME- WE
MUST MAINTAIN OUR OPPO UNLESS.
POSITION AND OUR ISSUE ARE
ADDRESS THANK YOU. THANK YOU
VERY MUCH OUR NEXT WITNESS IS
WALKEN'S. NUMBER THIRTY JOAQUIN
BUT THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES WE TO HAVE
AN OPPOSE UNLESS AMENDED
POSITION IN THE INTEREST OF
TIME IT'S LIKE TO ALIGN MYSELF
WITH MY COLLEAGUES COMMENTS-
AND JUST UNDERSCORE- AFTER P.
DOES. LANE AND ROLE IN THE
PROCESS ALSO WE UNDERSTAND THAT
THERE IS A NEED TO HAVE A
THOUGHTFUL AND EASY PROCESS
THAT EVERYONE BOTH PLANS
PRODUCT PROVIDERS. AND
CONSUMERS UNDERSTAND THE
PROCESS THE TO THAT DEGREE WE
LOOK FORWARD TO WORKING WITH
THE OPTIMA SPONSORS IF THE BILL
MOVES FORWARD TODAY AND TRY TO
FIND A PATHWAY FORWARD AND SO
THAT THERE'S A CLEAR. AND
CONCISE PROCESS THAT EVERYONE
CAN FOLLOW THE THIRD THOSE
REASONS WE LOOK FORWARD TO
WORKING WITH THE DOCTOR AND THE
REMAINING- I'M ACTUALLY OPPOSED
TO DEVELOP. CURRENTLY IN PRINT
THANK YOU. THANK YOU VERY MUCH-
WILL NOW MOVE TO OTHER
WITNESSES- IN SUPPORT OR
OPPOSITION IT'LL BE BLENDED SO-
PLEASE- YOU'LL BE STATING YOUR
NAME YOUR POSITION ON THE BILL
AND ANY ORGANIZATION YOU. YOU
REPRESENT BUT NO OTHER
TESTIMONY SO- WITH THAT MR
OPERATOR OR DO WE HAVE OTHER
WITNESSES IN OR OTHER OTHER
PEOPLE IN THE PUBLIC COMMENT
SECTION OF THIS WISHING TO MAKE
A- MAKE A STATEMENT. ABSOLUTELY
IN THOSE THAT ARE IN SUPPORT OF
AB THREE FOUR SEVEN PLEASE
PRESS ONE ZERO AT THIS TIME.
AGAIN ONE ZERO IF YOU ARE IN
SUPPORT. AND AS OF NOW DOES
LOOK LIKE WE HAVE ABOUT
EIGHTEEN IN THE QUEUE. PLEASE
GO AHEAD- WE'LL START WITH
NUMBER ONE FOURTEEN ONE ONE
FOUR PLEASE GO AHEAD. FOR ONE
ONE FOR YOUR LINE IS OPEN. WILL
MOVE ON TO NUMBER ONE OH TO ONE
OH TO PLEASE GO AHEAD. THE
TECHNICIAN CARE RYAN SPENCER ON
BEHALF OF THE CROHN'S AND
COLITIS FOUNDATION WE ARE CO
SPONSORS ON THAT MEASURE THEIR
SUPPORT I ALSO LIKE TO SPEAK IN
SUPPORT OF THE BILL ON BEHALF
OF THE AMERICAN COLLEGE OF
OBGYN STRYCHNINE. AND THE
CALIFORNIA COULD BE AFTER
MEDICAL ASSOCIATION THANK YOU
THANK YOU VERY MUCH. NEXT
CALLER PLEASE. NEXEO THE NUMBER
ONE THREE ONE PLEASE GO AHEAD.
GOOD AFTERNOON YES MEAN COLORED
WITH HEALTH ACCESS CALIFORNIA
IN SUPPORT THANK YOU VERY MUCH
NEXT CALLER PLEASE. I WILL NOW
GO TO NUMBER ONE NINETEEN
PLEASE GO AHEAD. GOOD AFTERNOON
REBEKAH GONZALEZ NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER IN SUPPORT
THANK YOU. NEXT CALLER PLEASE.
NEXT OF THE NUMBER ONE THIRTY
THREE PLEASE GO AHEAD. GOOD
AFTERNOON LINDA WAY WITH
WESTERN BEEN ON MON POVERTY IN
SUPPORT THANK YOU THANKS CALLER
PLEASE. NOW GOTTEN LINE ONE
THIRTY FOUR PLEASE GO AHEAD.
THIS IS YOUR AND MEMBERS
BRANDON MARCHING WITH THE
CALIFORNIA MEDICAL ASSOCIATION
ALSO IN SUPPORT THANK YOU NEXT
CALLER PLEASE. NEXT TO BE
NUMBER ONE THIRTY EIGHT PLEASE
GO AHEAD. MR CHAIRMAN MEMBERS
CHRIS ROSA ON BEHALF OF BIOGEN
IN SUPPORT OF THE BILL THANK
YOU. NEXT CALLER PLEASE. I'M
NOT A LINE ONE TWENTY PLEASE GO
AHEAD. GOOD AFTERNOON CITY LATE
NINETY HALF OF THE CHILDREN
SPECIALTY CARE COALITION IN
SUPPORT OF AB THREE FORTY SEVEN
THANK YOU. NEXT CALLER PLEASE.
NEXT OF THE LINE ONE THIRTY
FIVE PLEASE GO AHEAD. MR
CHAIRMAN MEMBERS STEVE HORN
INTERNATIONAL CANCER ADVOCACY
NETWORK WE ARE IN SUPPORT THANK
YOU. NEXT CALLER PLEASE. SIX OF
THE NUMBER EIGHTY TWO PLEASE GO
AHEAD. HI GOOD AFTERNOON MY
NAME IS REBECCA KING AND I AM
WITH THE MOST POKER OKAY SB
NATION AS AMERICA AND WE ARE IN
SUPPORT. THANK YOU THANK YOU
NEXT CALLER PLEASE. NEXT TO BE
NUMBER ONE THIRTY SIX PLEASE GO
AHEAD. THANK YOU THIS IS
KRISTIN THE FIRE WITH THE
NATIONAL PSORIASIS FOUNDATION
IN SUPPORT THANK YOU NEXT
CALLER PLEASE. I WILL NOW GO TO
LINE ONE FORTY SEVEN PLEASE GO
AHEAD. GOOD AFTERNOON MY NAME
IS STEPHANIE DANCE CURRENT
BOARD MEMBER HAVE ADVOCACY
CHAIR FOR THE HAEMOPHILIA
COUNCIL OF CALIFORNIA THE
SUPPORT FOR EIGHTY THREE FORTY
SEVEN. THANK YOU. NEXT CALLER
PLEASE. NEXT TO BE NUMBER ONE
THIRTY NINE PLEASE GO AHEAD.
MICHELLE WE INVEST BUT THE
CALIFORNIA PHARMACISTS
ASSOCIATION AND SUPPORT. THANK
YOU NEXT CALLER PLEASE. NEXT WE
NUMBER ONE FORTY TWO PLEASE GO
AHEAD. HI REBECCA BIRCH WITH
SUSAN G. KOMEN IN SUPPORT THANK
YOU NEXT CALL PLEASE. NEXT TO
BE NUMBER ONE THIRTY TWO PLEASE
GO AHEAD. THIS IS NOT YOUR
AVERAGE TIME FROM THE NATIONAL
MULTIPLE SCLEROSIS SOCIETY- WE
ARE IN SUPPORT OF THE BILL.
THANK YOU VERY MUCH NEXT CALLER
PLEASE. NEXT TO BE NUMBER ONE
EIGHTEEN PLEASE GO AHEAD. SHARE
GONZALEZ ON BEHALF OF THE
AMERICAN DIABETES ASSOCIATION
AND THAT THE CALIFORNIA CHRONIC
CARE COALITION AND STRONG-SUPPORT OF THE BILL THANK YOU.
NEXT CALLER PLEASE. SIX OF THE
NUMBER NINETY EIGHT PLEASE GO
AHEAD. UNDER SECRETARY ON
BEHALF OF THE CALIFORNIA LIFE
SCIENCES ASSOCIATION AND
SUPPORT. THANK YOU NEXT CALLER
PLEASE. NEXT TO BE NUMBER ONE
SIXTEEN PLEASE GO AHEAD. MISTER
KAREN MEMBERS JIM JACKSON
VIACOM CALIFORNIA IN SUPPORT
THANK YOU NEXT CALLER PLEASE.
AND AS A REMINDER IF YOU'RE IN-
SUPPORT OR OPPOSITION OF AB
THREE FORTY SEVEN PLEASE PRESS
ONE ZERO. THE NEXT TO WHERE
WHERE. HELLO MISTER MEMBERS-
STEVEN SCHULTZ- OUR PART OF A
NATION IN SUPPORT I WAS ON THE
WIND RESPONSES OPERATOR THANK
YOU. NEXT CALLER PLEASE. THE
NEXT TO WILL GO TO NUMBER ONE
TWENTY THREE PLEASE GO AHEAD.
THANK YOU MISTER CHAIRMAN
BUSINESSES PREGNANT WE'RE
REPRESENTING A PHARMACEUTICAL
RESEARCH AND MANUFACTURERS OF
AMERICA IN SUPPORT OF AB THREE
FOUR SEVEN THANK YOU. THANK YOU
FOR. CALLING PLEASE. NEXT WE
WILL GO TO NUMBER ONE FIFTY
PLEASE GO AHEAD. BUT SHORT ON
BEHALF THE ASSOCIATION OF
NORTHERN CALIFORNIA ONCOLOGY
STERN SUPPORT THANK YOU NEXT
CALLER PLEASE. NEXT TO BE
NUMBER ONE TWENTY EIGHT PLEASE
GO AHEAD. THIS IS YOUR MEMBERS
JOHN WHEN YOU'RE ON THE UP
AMERICA'S HEALTH INSURANCE
PLANS WOULD ECHO THE COMMENTS.
OF CAPEN APPLICABLES MOST
AMENDED AT THE MOMENT. THANK
YOU. NEXT CALLER PLEASE. AND
ONCE AGAIN IF YOU ARE IN
SUPPORT OR OPPOSITION PLEASE
PRESS. ONE ZERO. AT THIS TIME
WE HAVE NO FURTHER IN THE QUEUE
PLEASE CONTINUE MISTER CHAIR
THANK YOU VERY MUCH FOR BRING
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS OR
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. THE NO QUESTIONS OR
COMMENTS WE HAVE A MOTION BY
MISS AGUIAR-CURRY. THE SECOND
BY MR MCCARTY- ARE YOU
ACCEPTING THE AMENDMENTS SO
DOCTOR REGULAR. YES MISTER
CHAIR THANK YOU VERY MUCH- THE
MOTION IS DO YOU PASS AS
AMENDED TO APPROPRIATIONS.
AHMED SECRETARY PLEASE CALL THE
ROLL. WHAT I WOULD AYE MAYES.
MAYES I AGUIAR-CURRY.
AGUIAR-CURRY AYE BIGELOW. BONTA
BURKE BURKE I CARILLO CARILLO
AYE FLORA. FLORIDA VOTING
MAIENSCHEIN MCCARTY. MCCARTY
AYE NAZARIAN NAZARIAN I REQUEST.
RODRIGUEZ SANTIAGO WALDRON.
SEVEN EIGHT NEEDS ONE MORE
SEVEN ZERO SO WE WILL LEAVE
THAT BILL ON CALL AND- WE'RE
GONNA STOP FOR A SECOND BECAUSE
I MADE AN ERROR- EARLY ON IN MY
EXCITEMENT OVER THE FACT THAT
WE HAD A QUORUM SO EARLY IN THE
MEETING I NEGLECTED TO OPEN THE
LINES FOR PUBLIC COMMENT FOR MR
GRAY'S BILL EIGHT EIGHTY TWO SO
WE'RE GOING TO. GIVE THE
OPERATOR OF A MOMENT TO Q.
PEOPLE UP ANYBODY WHO WOULD
LIKE TO SPEAK IN EITHER SUPPORT
OR OPPOSITION PUBLIC COMMENT
FOR- AB EIGHT EIGHT TWO BY
MISTER GRAY. GIVE A MINUTE FOR
THE OPERATOR DO THAT AND MY
APOLOGIES I WAS SO EXCITED TO.
HAVE THAT HAPPEN SO EARLY IN
OUR MEETING. HANDLEY'S JIM IF
YOU'RE IN SUPPORT OR
OPPOSITION- PLEASE PRESS ONE
ZERO AT THIS TIME AGAIN ONE
ZERO FOUR SUPPORT OR OPPOSITION.
AND AT THIS TIME IT LOOKS LIKE
WE HAVE THREE IN THE QUEUE
PERFECT THANK YOU AND ONCE
AGAIN MY APOLOGIES TO WITNESSES
IN THE QUEUE. LET'S GO AHEAD
AND OPEN THE LINES MR OPERATOR.
WE WILL FIRST GO TO NUMBER
EIGHTY FIVE EIGHTY FIVE PLEASE
GO AHEAD. HI THIS IS A THIS
ASSEMBLY HILLARY FROM THE
CALIFORNIA MEDICAL ASSOCIATION-
OR NOT THINKING IN SUPPORT OR
OPPOSITION TO PERFECTLY JEFF
ONE Q- THANK THE AUTHOR AND THE
COMMITTEE STAFF FOR WORKING SO
HARD WITH US AND OUR OTHER
MEMBERS WHO WERE WORKING IN THE
SAME ISSUE ON THE SAME ISSUES
AND LOOK FORWARD TO WORKING
WITH THE COMMITTEE AND AUTHOR
STAFF AS WE GO FORWARD HE
GETTING THE LANGUAGE TO A POINT
THAT WE'RE ALL COMFORTABLE.
WITH THANK YOU SO MUCH OKAY
THANK YOU. NEXT CALLER. NEXT WE
ARE THE NUMBER ONE FORTY FOUR
PLEASE GO THAT. J. THANK YOU MR
CHAIRMAN MEMBERS THIS IS DORIAN
THE GROUP ON BEHALF OF THE
CALIFORNIA DENTAL ASSOCIATION
IN OPPOSITION- BUT WE ALIGN
OURSELVES WITH THE COMMENTS OF
THE PREVIOUS SPEAKER APPRECIATE
THE WORKS TOWARDS I DIDN'T
AGREEABLE SOLUTION I WAS NOT
ABLE TO REMOVE OPPOSITION AT
THIS TIME BUT I APPRECIATE THE
AUTHORS- COMMITMENT TO
CONTINUING CONVERSATION- THAT
AND BELIEVE THAT WE CAN GET
THERE. BEFORE THE NEXT
COMMITTEE THANK YOU. VERY GOOD
THANK YOU VERY MUCH NEXT
WITNESS PLEASE. OUR NEXT
SPEAKER NOW GO TO LINE ONE
TWENTY PLEASE GO AHEAD. MISTER
TERRY NUMBER CHELATE NOT BE
HAPPY THE CHILDREN SPECIALTY
CARE COALITION REPRESENTING
OVER TWENTY FIVE HUNDRED
PEDIATRIC SUBSPECIALISTS
THROUGHOUT CALIFORNIA NOT LOOK
AT REGIONAL TRIP HERE TO
CHILDREN'S HOSPITAL. AND
PROVIDE CARE FOR CHILDREN THAT
HAVE COMPLEX AND CHRONIC HEALTH
CARE NEEDS WE DO NOT HAVE AN
OFFICIAL POSITION ON THE BILL
BUT WHEN I THINK THE- FOR
WORKING WITH US AND OTHER
STAKEHOLDERS ON AMENDMENT. AT
THE LETTER CAME APART
PROTECTIVE A LIFELINE RICHARD.
YEAH APOSTLE. A HIGH OF MEDIC
HELPED. WORKING THE
CONVERSATION WHICH ARE THAT
THEY WOULD BE ELIGIBLE CREDIT
THEM OF THE PROGRAM THANK YOUNG.
THANK YOU VERY MUCH. ANY OTHER
CALL IN THE QUEUE MISTER- HAVE-
WILL GO TO NUMBER ONE FIFTEEN
PLEASE GO AHEAD. HI THIS IS A
AT THE APPLE WITH THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION- ALIGNING OURSELVES
WITH THE FIRST COUPLE OF
BECAUSE I'M HOPING TO GET TO
ARM AND THE AMENDMENTS AND
HELPING TO REMOVE OPPOSITION
THANK YOU. THANK YOU VERY MUCH.
ANY OTHER CALLERS. INSTRUCTOR
NOW ONCE AGAIN IF YOUARE IN
SUPPORT OR OPPOSITION PLEASE
PRESS. ONE ZERO. AT THIS TIME
THERE ARE NO FURTHER IN THE
QUEUE PLEASE CONTINUE MISTER
CHAIR OKAY THANK YOU VERY MUCH
AND ONCE AGAIN MY APOLOGIES FOR
THAT AND WE'LL BEFORE WE GO TO
DO IT WHEN YOU ONE OTHER THING
BEFORE WE GO DOCTOR AMBULANCE
WE'RE GOING TO ASK A MAN OF
SECRETARY TO CALL THE ROLL ON
THE CONSENT CALENDAR. WHICH IS-
NIGHT OF ITEMS NUMBER TEN
ELEVEN SEVENTEEN AND EIGHTEEN
AB FIVE TWENTY ONE EIGHTY
FOURTEEN SEVENTY AB TWO FORTY
AND AB FIVE THIRTY TWO. MINUTES
SECRETARY PLEASE CALL THE ROLL.
WHEN I WOULD AYE MAYES MAYES
AYE AGUIAR-CURRY AGUIAR-CURRY
AYE BIGELOW BONTA BURKE BURKE I
CARILLO. CARILLO AYE FLORA
FLORA I MAIENSCHEIN MCCARTY
MCCARTY AYE NAZARIAN. NAZARIAN
AYE RIVAS RODRIGUEZ SANTIAGO.
WALDRON WALDRON HIGH. MR
RODRIGUEZ RODRIGUEZ FIVE
RODRIGUEZ I. TEN ZERO VERY GOOD
THANK YOU CONSECUTIVE PASSES SO
WITH THAT WE'LL GO AHEAD AND
MOVE ON TO WILL LET YOU GO DR
AMBULANCE. THANK YOU THANK YOU
MR CHAIRMAN MEMBERS. AB FOUR
FIFTY ONE WILL REMOVE BARRIERS
AND CURRENT LAW TO ENSURE THAT
INDIVIDUAL SEEKING EMERGENCY
PSYCHIATRIC SERVICES HAVE
TIMELY ACCESS TO ADDITIONAL
CARE AND SERVICES. THAT MAY BE
NEEDED. LIKE MANY OTHER
INDIVIDUALS. WHO ARE IN A
MENTAL HEALTH CRISIS MAY SEEK
CARE AT THE NEAREST EMERGENCY
DEPARTMENT. AFTER EVALUATION BY
AN EMERGENCY PHYSICIAN SOME
INDIVIDUALS NEED ADDITIONAL
PSYCHIATRIC SERVICES AND
REQUIRE TRANSFERRED TO A
PSYCHIATRIC HOSPITAL. HOWEVER
EMERGENCY PHYSICIANS HAVE
EXPERIENCED TROUBLE
TRANSFERRING PATIENTS TO
PSYCHIATRIC FACILITIES THAT DO
NOT MAINTAIN AN EMERGENCY
DEPARTMENT. THERE IS A CONCERN
THAT SOME PSYCHIATRIC HOSPITALS
ARE USING LANGUAGE IN CURRENT
LAW WHICH ONLY APPLIES TO
CALIFORNIA HOSPITALS THAT
MAINTAIN AND OPERATE AN
EMERGENCY DEPARTMENT. AS A WAY
TO NOT ACCEPT ALL PATIENTS
OFTEN BASED ON THEIR PERCEIVED
INABILITY TO PAY. IF A
PSYCHIATRIC POSSIBLE AVOIDS
TAKING PATIENTS IT LIMITS
ACCESS TO CARE AND REDUCES
CAPACITY OF ALREADY SCARCE
MENTAL HEALTH RESOURCES. THERE
SHOULD BE ACCESSIBLE TO ALL
PATIENTS FACING AN EMERGENCY
MENTAL HEALTH CRISIS REGARDLESS
OF THE ABILITY TO PAY. AB FOUR
FIFTY ONE PROVIDES A CRITICAL
IMPROVEMENTS TO PATIENT ACCESS
TO PSYCHIATRIC TRANSFERS BY
REQUIRING ALL HOSPITALS TO
ACCEPT HIGHER LEVEL PSYCHIATRIC
TRANSFERS REGARDLESS OF A
PATIENT'S ABILITY TO PAY. I AM
JOINED TODAY BY WITNESSES TEN
MADDEN WAS THE LEGISLATIVE
ADVOCATE FOR THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF EMERGENCY PHYSICIANS AND
JULIE SNYDER GOVERNMENT AFFAIRS
DIRECTOR FOR THE STEINBERG
INSTITUTE. THANK YOU VERY MUCH-
INSTRUCTOR PLEASE OPEN THE
PHONE LINES FOR THE WITNESSES.
THANK YOU MR CHAIRMAN MEMBERS
TIBETAN REPRESENTING THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS WE ARE THE PROUD
SPONSOR THE QUANTITY ONE DOCTOR
ABLY DID AN EXCELLENT JOB IN
OUTLINING THE ISSUE EMERGENCY
POSITIONS ARE FACING AND TRYING
TO TRANSFER OUR PATIENTS WITH
EMERGENCY MEDICAL PSYCHIATRIC
CONDITION. A FEDERAL LAW THOSE.
A MERCY DEPARTMENTS TO TREAT
ANYONE WHO IS IN NEED OF CARE
FOR EMERGENCY MEDICAL CONDITION
REGARDLESS OF THEIR INSURANCE
STATUS OR ABILITY TO PAY.
EMERGENCY CONDITIONS HAVE BEEN
EXPERIENCING A GAP WHICH
REQUIREMENTS WHEN IT COMES TO
TRANSPLANT PATIENTS WITH
EMERGENCY MEDICAL PSYCHIATRIC
CONDITION. FOR MANY SETBACK
PSYCHIATRIC PATIENTS THE NURSES
SESSION IS ABLE TO STABILIZE
THE PATIENT. BUT THE PATIENT IS
STILL EXPERIENCING AN EMERGENCY
MEDICAL PSYCHIATRIC CONDITION
AND THE SITUATION. EMERGENCY
PHYSICIAN NEEDS TO TRANSFER THE
PATIENT TO A PSYCHIATRIC
FACILITY TO RECEIVE A HIGHER
LEVEL CARE TO TREAT THEIR STILL
EXISTING EMERGENCY. DOCTOR AND
BILL MENTIONED WE ARE
EXPERIENCING SOME PSYCHIATRIC
FACILITIES THAT WILL NOT TAKE
THESE PATIENTS WITH AN
EMERGENCY MEDICAL PSYCHIATRIC
PSYCHIATRIC CONDITION. DUE TO
THERE BEING UNINSURED OR
MEDICAID ROLLY. THIS BREAKDOWN
IN THE MERCY CARE SYSTEM NEEDS
TO PATIENTS LANGUISHING IN
EMERGENCY DEPARTMENTS FOR DAYS
GOING ON WEEKS TO RECEIVE CARE
TO THEIR MERCY. MEDICAL
PSYCHIATRIC CONDITION. AB FOUR
FIFTY ONE WOULD AND SHE-
PSYCHIATRIC YET FACILITY ARE
NOT ABLE TO. FOR CHERRY.
PATIENTS BASED ON THEIR STATUS
OR TO PAY. THIS BILL WILL
PROVIDE PATIENTS EXPERIENCING A
PSYCHIATRIC. EMERGENCY THE SAME
ACCESS TO EMERGENCY CARE AS ANY
PATIENT EXPERIENCING A NON
PSYCHIATRIC MEDICAL MERGING.
FOR THESE REASONS WE
RESPECTFULLY REQUEST TONIGHT.
THANK YOU. THANK YOU VERY MUCH
OUR OUR NEXT WITNESS PLEASE. I
HER AGAIN THOUGH EACH MAN AT
SEVEN IN FOR JULIE CAN YOU HEAR
ME YES ABSOLUTELY. OKAY
WONDERFUL- LIKE I SAID THIS WAS
HARD GAMBLE EASTMAN WITH THE
STEINBERG AND IF YOU WERE AN
INDEPENDENT NONPROFIT PUBLIC
POLICY IS IF YOU COULD FOCUS
THE TO ADVANCE SOUND PUBLIC
POLICY AND INSPIRED LEADERSHIP
ON THE ISSUE OF BRAIN HEALTH I
JUST LIKE TO BRIEFLY TALK I
THINK IN THE COMMITTEE FOR ITS
ONGOING COMMITMENT TO
ADDRESSING ISSUE OF BRAIN
HEALTH ANTI DR GRANT ELECT THE
BRING THE PARTS. POINTED OUT.
OUR THANK YOUNG TECH EMERGENCY
SYSTEM SALTED WOEFULLY SHORT OF
PROVIDING CARE TO THOSE IN NEED
AND FOR MANY CALIFORNIANS THE
EMERGENCY DEPARTMENT IS THE
ONLY PLACE THEY KNOW THEY CAN
ALWAYS BACKED UP CARE AND SO
OUR EMERGENCY DEPARTMENTS
REALLY SERVE AS THE ENTRY WAY
TO A MENTAL HEALTH SYSTEM WHERE
INDIVIDUALS CAN ACT THAT. THE
HIGHER LEVELS OF CARE THAT THEY
NEED AND DESERVE IN ORDER TO
RECEIVE THE CARE HOWEVER
PATIENTS NEED TO BE TRANSFERRED
FROM THE EMERGENCY DEPARTMENT
SHE WAS PSYCHIATRIC FACILITY
AND ADDS THAT BOTH KIM AND DR
RANDALL HAD MENTIONED RIGHT NOW
PATIENTS ARE LANGUISHING IN
EMERGENCY DEPARTMENT ESPECIALLY
MEDIC HELP PATIENT. BECAUSE
SOME PSYCHIATRIC DISABILITIES
ARE REFUSING PATIENTS THEY
FOUND THEREIN SHALL BATTLE.
PSYCHIATRIC PATIENTS SHOULD NOT
BE KEPT AWAY FROM THE NEEDED
PSYCHIATRIC SERVICES
APPLICABILITY HEY JUST BECAUSE
THEY ARE MODERN GOLLY I'M
INSURED NOT. IT IS EVERYBODY
ALL OF. COOL COOL- WHILE THREE
FOR A FOUR ONE RESPECT REFER
ABOUT BEING YOU. THANK YOU
THANK YOU VERY MUCH. THAT WILL
GO TO THE FROM LINES FOR A IN
SUPPORT FOR THOSE IN OFFICE AND
WE'LL JUST YOU TO NAME YOUR-
YOUR NAME OR IN ORDER. IF YOU
REPRESENT ONE IN YOUR POSITION
ON THE BILL. SO WHENEVER YOU'RE
READY MISTER OPERATOR. THEN
LATER GERMAN IF YOU'RE IN
SUPPORT OR OPPOSITION OF AB
FOUR FIVE ONE PLEASE PRESS ONE
ZERO. AGAIN SUPPORT OR
OPPOSITION PLEASE PRESS. ONE
ZERO- AT THIS TIME I'M SHOWING
WE HAVE TO IN THE QUEUE. GOOD
PLEASE GO AHEAD. WE'LL START
WITH LINE ONE THIRTY FOUR
PLEASE GO AHEAD. MISTER CHANG
MEMBERS BRANDON MARTINEZ THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT OF THE BILL THANK
YOU VERY MUCH NEXT CALLER
PLEASE. WILL NOW GO TO LINE ONE
FIFTEEN PLEASE GO AHEAD. HI ANY
ENTITLED COUNTY BEHAVIORAL
HEALTH DIRECTORS ASSOCIATION
AND RESPECTFUL OPPOSITION TO
THE BILL. OKAY THANK YOU VERY
MUCH. ANY OTHER CALLERS MISTER
UPGRADER. ONCE AGAIN IF YOU ARE
IN SUPPORT OR OPPOSITION- THE
AB FOUR FIFTY ONE PLEASE PRESS
ONE ZERO. AT THIS TIME WE HAVE
NO FURTHER IN THE QUEUE PLEASE
CONTINUE MISTER CHAIR THANK YOU
VERY MUCH BRING IT BACK TO THE
COMMITTEE QUESTIONS OR COMMENTS
TO THE AUTHOR. MR RODRIGUEZ
PLEASE. YES I JUST WANT TO
THANK GOD FOR BRINGING THIS
BILL FORWARD YOU KNOW JUST
HEARING SOME OF THIS-
SUPPORTERS TALKING ABOUT- WHAT
IS DONE THE IMPACT ARMORED SHE
ROOMS ACROSS CALIFORNIA I CAN
ATTEST TO THAT AS A ME WORKED
IN THE AS A FIRST RESPONDER
GOING TO MANY HOSPITALS IN
SOUTHERN CALIFORNIA ONE OF THE
BIGGEST ISSUES WERE THE MENTAL
HEALTH PATIENTS IN OUR
FACILITIES THAT WERE WORKING
FOR DAYS LITERALLY DAYS TO BE
TRANSFERRED TO OTHER FACILITIES
FOR PROPER CARE FOR SO. LOOK
FOR TO SUPPORT YOUR BILL THANKS
FOR BRINGING AFFORD- AND
REQUEST AN AYE VOTE. THANK YOU
VERY MUCH OTHER ANY OTHER
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. SEEING NONE WOULD
YOU LIKE TO CLOSE DOCTOR
AMBULANCE. I WILL TAKE MY
COLLEAGUES COMMONSENSE MICHAELS
VERY GOOD THANK YOU VERY MUCH
WE OF THE BILL DOESN'T JOY DO
PASS RECOMMENDATION FROM THE
CHAIR- THEM WE HAVE A MOTION BY
MISTER FLORA A SECOND BY MISTER
NAZARIAN THE MOTION IS TO PASS
TO APPROPRIATIONS BENNETT
SECRETARY PLEASE CALL THE ROLL.
WHAT I WOULD AYE MAYES. MAYES
AYE AGUIAR-CURRY. AGUIAR-CURRY
AYE BIGELOW. BIGELOW I. BONTA
BURKE BURKE I CARILLO. HI FLORA
FLORA I MAIENSCHEIN MCCARTY
MCCARTY AYE NAZARIAN. NAZARIAN
AYE RIVAS RODRIGUEZ RODRIGUEZ I
SANTIAGO WALDRON. WALDRON HI.
ELEVEN ZERO YOUR BILL IS ELEVEN
VOTES IT'S OUT WILL LEAVE THE
ROLE OPEN FOR OTHERS TO ADD ON
THANK YOU VERY MUCH DOCTOR
ARAMBULA. MISTER K. AND YOU
HAVE AB FOUR THIRTY NINE. THANK
YOU MR CHAIRMAN MEMBERS TODAY
I'M HERE TO PRESENT AB FOR
THIRTY NINE A SIMPLE YET
MEANINGFUL ADDITION OF ONE WORD
IN THE CODE THAT ADDS A NON
BINARY GENDER OPTION ON DEATH
CERTIFICATES. THE LGBTQ PLUS
COMMUNITY IN PARTICULAR THE
TRANS AND NON BINARY
INDIVIDUALS HAVE LONG FOUGHT
FOR RECOGNITION AND EQUALITY
UNDER THE LAW. AT THIS VERY
MOMENT THEIR RIGHTS ARE BEING
ATTACKED CROSS THE COUNTRY WITH
BANDS ON VITAL HEALTHCARE AND
SPORTS PARTICIPATION IN MANY
OTHER STATES. THIS CONSTANT
LEGAL AND SOCIAL RASCHER IS A
SOURCE OF PAIN. AND A VIOLATION
OF BASIC RIGHTS FOR TRANS AND
NON BINARY INDIVIDUALS. I AM SO
PROUD TO BE PART OF THIS
LEGISLATIVE BODY THAT HE'S MADE
CALIFORNIA A LEADER IN
PROTECTING LGBTQ PLUS PEOPLE.
AND THEIR RIGHT TO LIVE. AS
THEIR FULL SELVES PRO TEM
ATKINS HAS LONG LEAD DESPITE.
WITH AB FIFTEEN SEVENTY SEVEN
THEY GUARANTEED THAT SEX WOULD
REFLECT GENDER IDENTITY ON
DEATH CERTIFICATES AND AB ONE
SEVENTY NINE WHICH ALLOWED
INDIVIDUALS WHO IDENTIFY AS
MALE FEMALE OR NON BINARY OUR
BIRTH CERTIFICATES DRIVING
LICENCE IN COURT DOCUMENTS.
THIS MERELY EXTEND FAT TO DEATH
CERTIFICATE AS WELL- I WANT TO
THANK MY STAFF. KßT CATION TO
THIS MULTI AFTER SHE KNEW AN
INDIVIDUAL WHO IS DECEASED FOOD
WAS NOT ACKNOWLEDGED ON THE
DEATH CERTIFICATE AS THE PERSON
WHO THEY HAD LIVED AT. WITH ME
TO TESTIFY TODAY IN SUPPORT-
TAMMY MARTIN LEGISLATIVE
DIRECTOR FOR QUALITY CALIFORNIA
AND SAM BRITTON VICE PRESIDENT
ADVOCACY FOR THE TREVOR PROJECT.
THANK YOU VERY MUCH MR KAYHAN-
MR ARE GREATER PLEASE OPEN THE
LINES FOR THE WITNESSES.
SCHERING COMMITTEE NUMBER
CANYON MARTIN ON BEHALF OF
EQUALITY CALIFORNIA THE PROUD
TO CO SPONSOR EIGHTY FOUR
THIRTY NINE WHICH ARE THE
OPPOSITE CRIED BUILT ON THE
LEGISLATURE TO PREVIOUS WORK TO
ENSURE THAT ALL CALIFORNIANS
INCLUDING NON BINARY
CALIFORNIANS HAVE THE FREEDOM
TO LIVE. AND BE REMEMBERED AS
THEIR AUTHENTIC SELVES. THIS IS
A COMMON SENSE UPDATE THE CODE
THAT BUILDS UPON THE LEADERSHIP
OF ANNOUNCED SENATE PRO TEN
TWENTY ATKINS WHO AUTHORED THE
RESPECT AFTER DEATH ACT IN TWO
THOUSAND FOURTEEN. AND OF
COURSE IN TWO THOUSAND
SEVENTEEN ENSURE THAT NON
BINARY WOULD BE A GENDER MARKER
OPTION ON OTHER IDENTITY
DOCUMENTS. TO EIGHTY FOUR
THIRTY NINE WILL RELEASE SOME
MEASURE OF PAIN THAT PEOPLE
FEEL WHEN THEY'RE NON BINRY
LOVED ONE PASSED BY ENSURING
THAT THEIR OFFICIAL DOCUMENT
ARE. RESPECTFUL AND ACCURATE
THANK YOU. THANK YOU VERY MUCH.
OUR NEXT WITNESS PLEASE. YEAH
CAN YOU HEAR ME CAN I GET A OF
COURSE YEAH PLEASE GO AHEAD YEP
PERFECT HURT MAKE IT GREAT
THANK YOU SO MUCH MY NAME IS
SAM BRINTON MICRO NUMBER THEY
AND THEM I FAVOR THE VICE
PRESIDENT OF ADS YOU THINK I'M
GONNA PAYER FOR THE TREVOR
PROJECT THE LEADING NATIONAL
ORGANIZATION FOCUSED ON
PRACTICE AND WOULD LIKE TO
MENTION APPARATE AMONG HELP ME.
YOUTH WE ASK THAT YOU SUPPORT
AB FOUR THREE NINE FOR THE
LIFESAVING AFFIRMATION EVEN IN
DEATH THAT WILL PROVIDE NON
BINARY INDIVIDUALS REALLY
QUICKLY FROM DATA NON BINARY
VIEW WHO REPORT HAVING THEIR
PHONE UP WITH ACTED BY ALL OR
MOST PEOPLE IN THEIR LIVES AND
TO DO IT BUT AT HALF THE RATE
OF THOSE WHO DO NOT HAVE THEIR
PROBLEMS AFFECTED AND SADLY
LESS THAN ONE IN TEN NON BINARY
YOU REPORTED HAVING TO
PRONOUNCE AFFECTED BY ALL OR
MOST OF THE PEOPLE IN THEIR
LIVES.THAT'S ONE OF THE MANY
REASONS THAT HAVE OBTAINED THE
NON BINARY YOU HAVE SERIOUSLY
CONSIDERED SUICIDE AS NOTED IN
THE ANALYSIS OUR COVER PROJECT
RESEARCH FIND THAT NON BINARY
YOU REPORTED HIGHER RATE THAN
EVEN THE BIT PREMEDITATION GIVE
ME AN BEING PRESENT THREATENED
OR HARMED AT WHITE THE RATE AT
THE TENDER. PEER SO HOW WE
REDUCE THIS AND BROKE THE CAN
GET THEIR IT THEM ALL IT. AND
THAT IS WHAT THE FOURTH. NINE
BERMAN A NON BINDING PERSON
EVEN AFTER GAP. OPPOSED TO THE
VERY PER NOTE. WHEN I STARTED
MY REMARKS I KNOW THAT MY- ARE
THEY END UP AT NON BINARY PER
MICHAEL. I WONDER AND- OF WHAT
WILL AFTER MY DEATH I CAN WRITE
MY- PLAN AT THE- EVEN. MY IF
YOU. BUT I WILL NOT BE TO BE A
PRO PRO MARC AS NON BINARY INTO.
AB PROVIDE RUN VERSION. WHO BY
THAT ARE- EACH EVERY DAY IT
WILL ALL. FEEL LIKE ERASURE
AFTER. I AM NEW TO THE EIGHTY
PRETTY FOR THREE NINE. BERMAN
ON BUYING FOLKS ME IN LIGHT AND
THEN THAT. THANK YOU. THANK YOU
VERY MUCH. WE WILL NOW GO TO
THE PHONE LINE FOR OTHER
WITNESS IN SUPPORT AND OFF IF
YOU'RE IN IF YOU'RE IN
SUPPORTER OPPOSITION WE WILL
JUST ASK THAT YOU NAME HAVE YOU
GIVE US YOUR NAME ANY
ORGANIZATION YOU MIGHT
REPRESENT AND YOUR POSITION ON
THE BILL ONLY- SO WHAT GO TO
THE OPERATOR WHENEVER YOU'RE
READY MISTER UPGRADER. ANALYSTS
GERMAN AND SUPPORTER OPPOSITION
OF AB FOUR THIRTY NINE PLEASE
PRESS ONE ZERO. AGAIN ONE ZERO
FOR SUPPORT OR OPPOSITION. AT
THIS TIME WE DO HAVE TO IN THE
QUEUE OKAY VERY GOOD PLEASE
WHENEVER YOU'RE READY MISS
REFERENCE. WE'LL FIRST GO TO
LINE OF ONE OH TWO PLEASE GO
AHEAD. RIGHT SPENT ON BEHALF OF
THE AMERICAN COLLEGE OF OBGYN
IS JUST AT NINE IN SPORT. THANK
YOU VERY MUCH NEXT CALLER
PLEASE. ABSOLUTELY IN OUR NEXT
CALLER- WE'LL GO TO LINE ONE
FIFTY SEVEN- LINE ONE FIFTY
SEVEN YOU ARE OPEN. A LINE ONE
FIFTY SEVEN YOUR LINE IS OPEN.
HELLO MY NAME IS SELECTED AND
CHAT AND THE DIRECTOR OF
ADVOCATES IN TRAINING FOR THE
SACRAMENTO LGBT CENTER AND WE
ARE IN SUPPORT OF THE BILL.
THANK YOU VERY MUCH. NEXT
CALLER PLEASE- AND NUMBER ONE
TWENTY SIX YOUR LINE IS OPEN. I
COULD AFTERNOON MISTER CHAIR
NUMBERS TO FIFTEEN NINETEEN
WITH THE ACLU CALIFORNIA ACTION
AND CRACKED THE PORT OF EIGHTY
FOUR THREE NINE. THANK YOU VERY
MUCH. NEXT CALLER PLEASE. CAN
FOR SUPPORT OR OPPOSITION OF AB
FOUR THIRTY NINE PLEASE PRESS
ONE ZERO. AT THIS TIME THERE
ARE NO FURTHER IN THE QUEUE
PLEASE CONTINUE MISTER CHAIR.
THANK YOU VERY MUCH FOR BRING
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS QUESTIONS
OR COMMENTS FROM COMMITTEE.
SEEN NONE- WE DO WE HAVE A
MOTION TO BE GOOD I APOLOGIZE.
I MISSED IT. IT WAS A MISTAKE.
MISSED BURKE WILL GIVE ITS BEST
BURKE WITH WITH THE SECOND BY
MISS AGUIAR-CURRY. THAT'S GREAT
THANK YOU VERY MUCH THE MOTION
IS TO PASS- MISS BURKE AND YOU
HAVE ANY CLOSING COMMENTS THANK
YOU MISTER CHAIR FACT ASPEN
EITHER. THANK YOU VERY MUCH
THIS BILL DOESN'T DO IT ENJOY
DO PASS RECOMMENDATION AND THE
MOTION IS DUE PASS SO WE'LL ASK
MADAM SECRETARY PLEASE- OPEN
THE ROLL CALL THE MEMBERS. WHAT
HI WHAT I MAYES MAYES AYE
AGUIAR-CURRY. AGUIAR-CURRY AYE
BIGELOW BIGELOW NO BONTA. BURKE
BURKE I CARILLO CARILLO AYE
FLORA FLORIDA VOTING
MAIENSCHEIN MCCARTY MCCARTY AYE
NAZARIAN NAZARIAN I REQUEST
RIVAS AYE RODRIGUEZ RODRIGUEZ I
SANTIAGO. WALDRON WALDRON HIGH.
TEN ONE THANK YOU VERY MUCH SO
YOUR BILL IS OUT WILL BE THE
ROLE OPEN FOR THERE'S OTHERS TO
ADD ON THANK YOU VERY MUCH.
NEXT UP. A. B. SIX NINE ONE
NINE EXCUSE ME- MISTER CALDERON.
GOOD AFTERNOON MR CHAIRMAN
MEMBERS AB SIX ONE NINE WOULD
ESTABLISH A COPD AWARENESS
CAMPAIGN AND WOULD REQUIRE
COUNTIES TO CREATE PLANS FOR
MANAGING THE EFFECTS OF
WILDFIRE SMOKE ON VULNERABLE
POPULATIONS. COPD REFERS TO A
GROUP OF LUNG DISEASES THAT CAN
BE TRIGGERED BY EXPOSURE TO AIR
POLLUTANTS AND CAN CAUSE AIR
FLOW BLOCKAGE FOR BREATHING
RELATED PROBLEMS. OUR STATE
CONTINUES TO EXPERIENCE
DEVASTATING WILDFIRES WHICH
HAVE HIGHLIGHTED THE THREAT OF
THE DANGEROUS AIR QUALITY TO
LONG HEALTH. THIS BILL WILL
PROMOTE THE DIAGNOSIS AND
TREATMENT OF THOSE WITH COPD IN
CALIFORNIA. AND MITIGATE THE
IMPACTS OF WILDFIRES ON LONG
HEALTH. WITH ME IN SUPPORT OF
AB SIX ONE NINE OUR MARC
CARROLL ON BEHALF OF BRIEF
SOUTHERN CALIFORNIA AND
EMPHYSEMA FOUNDATION AND BONY
EXTRA FUNNY A RESPIRATORY
THERAPIST FROM THE CALIFORNIA
SOCIETY FOR RESPIRATORY CARE.
THANK YOU VERY MUCH. MR
OPERATOR WILL GO AHEAD AND MOVE
TO THE WITNESSES WHEN EVER THEY
ARE AVAILABLE. GOOD AFTERNOON
MR CHAIRMAN MEMBERS OF THE
COMMITTEE MY NAME IS MARK CAROL
SERVICE PRESIDENT AND CEO BOTH
RESULT IN CALIFORNIA AND THE
IMPLEMENTATION OF AMERICA. TO
SPONSORS OF EIGHTY SIX ONE NINE
THE BILL SEEKS TO INCREASE
EARLY DIAGNOSIS AND TREATMENT
OF PATIENTS WITH COPD FIVE
TABLETS IN A PROGRAM AT THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH TO INCREASE AWARENESS OF
THE DISEASE AMONG PRIMARY CARE.
AND FAMILY CARE PHYSICIANS GPD
IF YOU DON'T KNOW IF THE FOURTH
LEADING CAUSE OF DEATH
NATIONALLY AND THE FIFTH
LEADING CAUSE OF DEATH IN
CALIFORNIA. DESPITE NEARLY ONE
HUNDRED FIFTY THOUSAND COPD
RELATED DEATHS EACH YEAR IT IS
NOT COMMONLY TESTED FOR. AND AS
A RESULT PATIENTS OFTEN ARE NOT
DIAGNOSED AND TREATED UNTIL
FIFTEEN YEARS AFTER THE SHOW
INITIAL SYMPTOMS. UNDER
DIAGNOSIS IS SO EXTREME THAT
WHILE FIFTEEN POINT SEVEN
MILLION AMERICANS HAVE BEEN
DIAGNOSED WITH COPD. IT'S
ESTIMATED ANOTHER. FIFTEEN
MILLION ARE UNDIAGNOSED.
CALIFORNIA ALONE HAS A FOR ONE
POINT FIVE MILLION ADULTS
DIAGNOSED WITH COPD AND AN
ESTIMATED ONE MILLION MORE
UNDIAGNOSED. INCREASING
AWARENESS OF EARLY TESTING FOR
COPD AMONG PRIMARY CARE
PROVIDERS WILL LEAD TO MORE
PEOPLE BEING DIAGNOSED AND
TREATED AT EARLIER STAGES OF
THE DISEASE RESULTING IN
IMPROVED OUTCOMES REDUCE STREET
AND COURT COSTS REDUCED ER
VISITS AND HOSPITAL STAYS. AND
ENHANCED HEALTH RELATED QUALITY
OF LIFE. EIGHTY SIX ONE NINE
ALSO ADDRESSES THE ISSUE OF
SEVERE WILDFIRE SMOKE THE
FREQUENCY AND INTENSITY
WILDFIRES HAS GROWN
DRAMATICALLY IN RECENT YEARS
KIND OF CALIFORNIA'S MOST
DESTRUCTIVE WILDFIRES HAVE
OCCURRED IN THE PAST FIVE
YEARS. AND TWENTY EIGHTEEN WAS
THE DEADLIEST AND MOST
DESTRUCTIVE WILDFIRE YEAR ON
RECORD WHILE FIRST RESPONDERS
REACTED IMMEDIATELY TO FIGHT
THE BLAZES AND SCHOOLS AND
BUSINESSES CLOSE TO THE SMOKE
LOCAL PUBLIC HEALTH OFFICIALS
WERE- OFTEN UNPREPARED AND ARE
REMAIN OF SOME PREPARE FOR THE
CRAPPIE THEIR POLLUTION EVENTS
IN THE DANGER THEY PRESENT TO
RESIDENTS. AND THEIR HEALTH THE
PUBLIC WANTS INFORMATION ON HOW
TO PROTECT THEMSELVES THIS BILL
WILL MAKE SURE THAT COUNTIES
HAVE A PLAN IN PLACE CAN
RESPOND WITH A MAJOR AIR
POLLUTION EVENT STRIKES- IF YOU
RECALL SOME OF THE WORK IN
SACRAMENTO DURING THOSE FIRES
IN TWENTY EIGHTEEN WHEN THE
COUNTY OF SACRAMENTO IN THE
CITY OF SACRAMENTO WE'RE
GETTING CONFLICTING INFORMATION
TO THE PUBLIC. ABOUT WHETHER TO
WEAR CERTAIN MAPS AND HOW TO
WEAR THEM SB SIX ONE NINE IS A
COMMON SENSE APPROACH TO
ADDRESSING RESPIRATORY HEALTH
AND TO MAKE SURE WE'RE DOING
WHAT WE CAN TO IMPROVE PUBLIC
HEALTH FOR ALL CALIFORNIANS. WE
ASK FOR YOUR VOTE THANK YOU
VERY MUCH. THANK YOU VERY MUCH.
MOVE ON TO OUR NEXT WITNESS
PLEASE. THANK YOU VERY FOR
HAVING ME NINETEEN IS MONIQUE
MONEY AND I HAVE BEEN AROUND
THE TRACK HER TRACTOR. FOR ON
GOING TWENTY YEARS NOW. THAT
WHAT WE SEE HERE THE PATIENT
WHAT THE EXPERIENCE. HERE
SHORTLY THE BACK ASSEMBLY
DURING PHYSICAL ACTIVITIES SUCH
AS NORMAL ACTIVITIES. OF DAILY
LIVING AT ME WHEN I TAKE FOR
GRANTED. WHEEZING CHEST THANK
MORE. FREQUENT RESPIRATORY
INFECTIONS THAT LEAD TO
FREQUENT HOSPITALIZATIONS. LACK
OF ENERGY. PEOPLE WITH COPD
OFTEN ARE. PROGRESSIVE WIENER
GRAPHICALLY DEALING WITH. THERE
STILL. IN SUFFERING ON A DAILY.
MANNER FIND HEALTHCARE
PROVIDERS WITHIN THE EARLIER.
HERE P. BUT BENEFIT PATIENTS BY
EMPOWERING PEOPLE WITH YOU.
THERE AND CAREGIVERS
RECOGNIZING THE YOU THE BURDEN
OF COPD IMPROVE THE PREVENT
DIAGNOSIS TREATMENT AND OF. BY
IMPROVING THE QUALITY OF CARE
DELIVERED ACROSS HEALTHCARE
TEACHING. IT WOULD ALSO COLLECT
NOW REPORT DECEMBER. THE RELAY
HOW HEALTH THAT DRIVE JEAN AND-
BARBARA. PATIENTS WITH COPD
NEED THAT SUPPORT AND GENERAL
OF AWARENESS IF YOU HAVE AMONG
HOLD WORKERS EARLY. OF EUROPEAN
AWAY ON THAT WE TO CALL. AND
BACK A PATIENT WHICH COULD BE.
HE OKAY THE TERM USED TO.
DESCRIBE BUT THAT VIEW THAT
INCLUDES I'M THIRTY CHRONIC
BROWN AND ALKALINE AND AS
MENTIONED EARLIER IT IS THE
FIFTH LEADING TO CAUSE OF DEATH
WILL CALIFORNIANS. TO BE THE
THIRD LEADING CAUSE OF DEATH
NATIONALLY. BY TWENTY THIRTY.
JEFF UNDER HALF A DEGREE CAL
WITH YOU B. ALONG TO MINOR POP.
WELL ONE THIRD BELOW. GRADE
BELOW THE HUNDRED THREE.
POVERTY LAW. ASSEMBLY BUILD SIX
ONE NINE. SOLVE THE PROBLEM BY
REQUIRE THE COW DEPARTMENT OF
PUBLIC HEALTH INCLUDES YOUR PDF
AWARENESS INFO IN THE CURRENT
OUTREACH TO HEALTHCARE
PROVIDERS IN ORDER TO INCREASE
EARLY DETECTION OF THE OPENING.
AB SIX ONE NINE ALSO REQUIRES
COUNTIES TO PROVIDE ONE HEALTH
RELATED INFORMATION AND
PREPARATION IN THEIR NEXT
EMERGENCY BY. EIGHTY SIX ONE
NINE COSPONSORED BY REPUBLIC
HEALTH POIGNANT THAN DIGGING
THE FOUNDATIONS AND CALIFORNIA
IT BY THE CURRENT TWENTY CARE
THE CALIFORNIA BY THE
RESPIRATORY CARE PROTECT YOUR
IPHONE. I'M AT SIX ONE NINE.
THANK YOU VERY MUCH. WELL NOW
MOVES TO THE PHONE LINES FOR
OTHER WITNESSES IN SUPPORT OR
OPPOSITION WILL ASK THEM TO
JUST STATE THEIR NAME-
ORGANIZATIONS THEY REPRESENT
ONE AND POSITION ON THE BILL.
SO WE'LL GO TO THE- HAVE-
WHENEVER YOU'RE READY MISTRUST
RAIDER. AND LATER JOHN IN
SUPPORT OR OPPOSITION OF AB SIX
ONE NINE PLEASE PRESS ONE ZERO.
AGAIN ONE ZERO FOR SUPPORT OR
OPPOSITION. AND AT THE TIME
LOOKS LIKE WE HAVE ONE IN THE
QUEUE VERY WELL PLEASE GO AHEAD.
AND WE'LL GO TO LINE ONE TWELVE
PLEASE GO AHEAD. GOOD AFTERNOON
MR CHAIRMAN MEMBERS CLIENTELE
COTTO ON BEHALF OF GRATEFUL.
THANK YOU VERY MUCH. SIR ANYONE
ELSE. BUT ONCE AGAIN IF YOU ARE
IN SUPPORT OR OPPOSITION PLEASE
PRESS ONE ZERO. WE HAVE NO
FURTHER IN THE QUEUE AT THIS
TIME PLEASE CONTINUE MISTER
CHAIR THANK YOU VERY MUCH- WILL
BRING BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS. MISTER
MISTER MASON. I JUST WANT TO
THANK THE AUTHOR FOR BRING THIS
FORD IT'S- VERY SIMILAR TO THE
ONE I HAD LAST YEAR AND IF IT'S
OKAY WITH YOU I'D LIKE TO BE
ADDED AS A CO AUTHOR. YES THANK
YOU AND MISTER MCCARTY. THANK
YOU MISTER CHAIR I ALSO- NOTE
THIS IS AN IMPORTANT ISSUE TWO
YEARS AGO WHEN WE HAD THE WILD
FIRES THE PARTICULAR MATTER IN
SACRAMENTO THAT DAY WAS THE
WORST AIR QUALITY IN THE WORLD.
IN THE WORLD RIGHT HERE IN THE
CAPITAL CITY OF SACRAMENTO AND
AS YOUR SPEAKER SPOKE FROM
THERE FROM- FROM LOS ANGELES
EARLIER THERE IS VERY
CONFLICTING MESSAGES ON WHAT TO
DO SOME SOME COUNTY PEOPLE SAID
WEAR A MASK SENSE AND NOT SOME
DISTRICTS HAD KIDS GO TO SCHOOL
CENTER NOT AUTHORED A BILL TWO
YEARS AGO WHICH AS AS A PILOT
REQUIRES MY AIR DISTRICT. TO
COME UP WITH PROTOCOLS AND
STANDARDS WHEN THIS HAPPENS
AGAIN BECAUSE WE KNOW WE WILL
HAVE MORE WILDFIRES
UNFORTUNATELY WITH CLIMATE
CHANGE BUT WE NEED TO DO MORE
THIS AND THIS IS APPROPRIATE
SO- THANK YOU AS WELL. THANK
YOU VERY MUCH MR MCCARTY MISTER
RODRIGUEZ. YES I ALSO WANT TO
THANK THE MEMBER FOR BRING THIS
BILL FORD. AS A PERSON WHO
SUFFERS FROMASTHMA AND WAS A
DOCTOR WHO WHO HAS A DAUGHTER
I'M SORRY WAS A RESPIRATORY
THERAPIST. WHO TREATS PATIENTS
WITH COPD WANT TO THANK YOU FOR
BRINGING THIS BILL FORWARD. AND
URGED A IPHONE THANK YOU THANK
YOU VERY MUCH MISS REAVIS- I'D
LIKE TO THANK THE AUTHOR FOR
BRINGING THIS IMPORTANT
MEASURE. AND I WOULD LIKE TO BE
ADDED AS A CO AUTHOR. THANK YOU
VERY MUCH MISS REAVIS- MISTER
NAZARIAN. THANK YOU MISTER
CHAIR OF KEEP IT SHORT SINCE
THERE'S A CHORUS ALREADY I'D
LOVE TO ADD MYSELF AS A CO
AUTHOR AND AS SOMEONE WITH
ADULT ONSET ASTHMA FIND IT
EXTREMELY IMPORTANT THAT YOU
BROUGHT THIS FORWARD THANK YOU.
THANK YOU VERY MUCH ANYONE ELSE.
SO ARE YOU YOU'RE ACCEPTING THE
AMENDMENTS THIS YES MISTER
CHAIR SO I WANT TO TELL YOU
WHAT THE AMENDMENTS ARE I DON'T
USUALLY DO THIS BUT- BUT IT IS
IMPORTANT- FROM MY PERSPECTIVE.
AND WE WERE DOING HERE WITH
THESE AMENDMENTS AS WERE ASKING
DEPARTMENT PUBLIC HEALTH TO
CONSULT WITH THE AIR RESOURCES
BOARD. AND TO UNDERTAKE
STATEWIDE PUBLIC EDUCATIONAL
CAMPAIGN REGARDING WILDFIRES
AND OTHER ENVIRONMENTAL HAZARDS
A RIGGERING ASTHMA COPD. AND
RESPIRATORY ILLNESS WHEN YOU
LOOK AT THE CHALLENGES WE FACED
LIKE MR MCCARTY- POINTED OUT
THE WORST AIR QUALITY IN THE
WORLD IN SACRAMENTO DURING ONE
WILDFIRE. IT SEEMS IMPORTANT
TO. HAVE WE HAVE THE EVAN OTHER
STATE ENTITY INVOLVED WITH AIR
QUALITY- TO BE PARTNERING WITH
THE DEPARTMENT OF PUBLIC HEALTH
HERE SO. SO I ASK FOR THOSE
AMENDMENTS AND- I'D ALSO ASK
THAT. THE AUTHOR CONSIDER
ADDING MUSIC AUTHOR TO THE BILL
AS WELL. YEAH YES- TERROR AND
WITH THAT WILL ALLOW YOU TO ASK
YOU TO CLOSE IF YOU LIKE. THANK
YOU MISTER CHAIR AND I'D LIKE
TO THANK THE MEMBERS OF THIS
COMMITTEE FOR YOUR COMMENTS AND
SUPPORT- HAPPY TO ADD YOU AS CO
AUTHORS THOSE THAT ASKED. AND I
RESPECTFULLY ASK FOR AN AYE
VOTE THANK YOU VERY MUCH. AND
WE HAVE A MOTION AND A SECOND.
MOTION BY MISTER MAYES A SECOND
BY MISS AGUIAR-CURRY- MADAM
SECRETARY PLEASE CALL THE ROLL.
MOTIONS TO PASS AS AN AMENDED
TO REGISTRY MANAGEMENT THANK
YOU WHAT I WOULD AYE MAYES.
MAYES I AGUIAR-CURRY.
AGUIAR-CURRY AYE BIGELOW.
BIGELOW I. BONTA BURKE BURKE I
CARILLO CARILLO HI FLORA FLORA
HI MAIENSCHEIN MAIENSCHEIN AYE
MCCARTY MCCARTY AYE NAZARIAN
NAZARIAN AYE RIVAS RIVERSIDE
RODRIGUEZ RODRIGUEZ I SANTIAGO
WALDRON. WALDRON HIGH. THIRTEEN
ZERO THIRTEEN ZERO YOUR BILLS
OUT OF COMMITTEE WILL ALLOW
OTHERS TO LEAVE THE ROLE
LOOKING FOR OTHERS TO ADD ON.
THANK YOU VERY MUCH FOR
SPEAKING WITH YOU TO. MR CHAN
MR CHAN YOU HAVE AB. THREE
FIFTY SIX. THANK YOU MISTER.
THANK YOU FOR MEMBERS FOR
ALLOWING ME TO PRESENT AB THREE
THREE SIX THIS BILL WOULD
RATHER POSITION SURGEONS AND
DOCTORS OF PODIATRIC MEDICINE
WE FOR AUSTIN PEAY IN OTHER
STATES IN A ONE TIME TEMPER
CERTIFICATION TO USE WASABI X.
RAY EQUIPMENT FOR THE SURGEON
CERTIFICATION DO YOU CROSSED
BEING IN CALIFORNIA THIS BILL
WOULD ENABLE THEM TO USE FOR US
TO BE IN PRACTICE FOR UP TO
TWELVE MONTHS. FROM DATE OF
ISSUE. CALIFORNIA'S PROCESS FOR
A PERMANENT CERTIFICATION AS
OUTDATED. TAKES ABOUT SIX TO
NINE MONTHS TO OBTAIN THROUGH
PHYSICAL APPLICATIONS USING
GENERAL MAIL- THAT TIME THE
SURGEON IS UNABLE TO PERFORM
FEROCITY X. RAY EQUIPMENT AND
SURGERY TO HELP THEIR PATIENTS.
AB THREE FIVE SIX WOULD
AUTHORIZE THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH
ISSUE A POSITION A SURGEON OR
DOCTOR THAT ACCIDENT MEDICINE A
ONE TIME NON RENEWABLE
TEMPORARY PERMIT. TO OPERATE
ROSS COPIC X. RAY EQUIPMENT
THEIR LICENSE IN CALIFORNIA
HAVE USED ROSCO P. IN ANOTHER
STATE HERE TO TESTIFY WITH ME
IS MISTER RYAN SPENCER THE
CALIFORNIA PODIATRIC MEDICAL
ASSOCIATION AND MISS KIM STONE
REPRESENTED CALIFORNIA
ORTHOPEDIC ASSOCIATION. THANK
YOU VERY MUCH. WE'LL HAVE THE
START OF ADVOCACY AND IN
SUPPORT AND I'M GONNA GIVE MY
TIME TO DR RUSSELL NORD AND BE
AVAILABLE IF THERE ARE ANY
QUESTIONS. THANK YOU. PLEASE GO
AHEAD THANK YOU THIS IS ROCK OR
HERE- GOOD AFTERNOON MR
CHAIRMAN AND MEMBERS OF THE
COMMITTEE I THANK YOU VERY MUCH
FOR THE OPPORTUNITY TO SPEAK
TODAY AS KIM MENTION MY NAME IS
RUSSELL NORTON I'M AN
ORTHOPEDIC SURGEON PRACTICING
IN FREMONT IT ALSO SERVES THE
LEGISLATIVE CHAIR FOR THE
CALIFORNIA ORTHOPEDIC
ASSOCIATION THE STATEWIDE
ORGANIZATION REPRESENTING OUR
COMPETING SEARCH. I DEFINITELY
WANT TO START BY THANKING THE
COMMITTEE STAFF FOR THE VERY
CLEAR AND COMPREHENSIVE REVIEW
OF THIS BILL. I DEFINITELY
HELPFUL INDEED THANK YOU. SO
THIS IS BACKGROUND TO START FOR
US COULD BE IS A CRITICAL AND
UNIVERSALLY ACCEPTED TOOL AN
ORTHOPEDIC SURGERY AND MEDICINE
IN GENERAL. IT'S A MODALITY
WHEREBY WIDE X. RAYS OR SEEN IN
REAL TIME AND SHOT BY A MOBILE
MACHINE FOR THE ANGLE OF THE
VIEW CAN BE CHANGED EFFICIENTLY.
WHAT COULD BE USED IN MANY
SETTINGS PERHAPS KNOWS MOST
NOTABLY IN THE OPERATING ROOM.
WHERE TIME IS CRITICAL AND THE
PATIENT IS RELATIVELY IMMOBILE.
DOES REQUIRING THE MACHINE TO
CHANGE POSITION RATHER THAN THE
PATIENT. ONE EXAMPLE ACROSS
COULD BE USED AS WITH THE
OPERATIVE FIXATION OF FRACTURES
USING THINGS LIKE PLATE SCREWS
RODS AND PAY. BOTH THE BOND AND
THE METAL HAVE TO BE POSITIONED
PERFECTLY SO AS TO ALLOW THE
PATIENT TO HEAL PROPERLY. IF
THIS ISN'T DONE WELL DONE CAN
FAIL TO HEAL CAN HE ON THE
WRONG ALIGNMENT OR HARDWARE CAN
BE PROMINENT AND REQUIRE
REMOVAL. THEN THE PATIENT BACK
TO THE OPERATING ROOM FOR
ADDITIONAL SEARCH. WHAT
CRITICAL PERON TO BE THE
ULTIMATE DANGEROUS AS IT
INVOLVES RADIATION. THAT'S WHY
DOCTOR SUCH AS WHAT THE X.
SURGEONS USED FOR US TO BE IN
THEIR PRACTICE. RECEIVE
EXTENSIVE TRAINING ON ITS USE
IN MEDICAL SCHOOL AND RESIDENCY.
WE NEED TO PROTECT OUR PATIENTS
AND WE ALSO WANT TO PROTECT
OURSELVES AND OUR CO WORKERS.
THAT'S WHY EVERYONE IS SPECIAL
TECHNIQUES TO MINIMIZE
RADIATION EXPOSURE TO ALL
PARTIES. SO HERE'S THE PROBLEM.
WHAT SURGEONS MOVED TO
CALIFORNIA FROM OTHER STATES.
OFTEN UNDERSERVED AND RURAL
AREAS. WHILE THE RECEIVER
CALIFORNIA MEDICAL LICENSE
THERE FOR US OULD BE
CERTIFICATION PROCESSING OFTEN
LACKED. IT PRECLUDES THE
SURGEON FROM TAKING EMERGENCY
ROOM CALL AND TREATING
PATIENTS. BECAUSE OF THE USE OF
FOR US COULD YOU BE REQUIRED
FOR THE SURGERY DID STEM FROM
THESE ACTIVITIES. MANY
ORTHOPEDIST HAVE USE FOR OFTEN
OTHER STATES FOR YEARS WITHOUT
NEEDING A SPECIAL
CERTIFICATION. YOU WHEN THEY
COME TO CALIFORNIA THEY'RE
OFTEN SURPRISED TO LEARN THAT
THEY MUST TAKE AND PASS THE
STATE MANDATED TESTS. BEFORE
THEY CAN USE THIS TECHNOLOGY.
ONLY ALASKA HAS A SIMILAR
REQUIREMENTS. THE CALIFORNIA
ORTHOPEDIC ASSOCIATION HAS
GOTTEN COMPLAINTS MARKETING
SURGEON THROUGHOUT THE STATE SO
THE PROCESS OF TAKING FOR THE
PROPERTY TAX. CAN BE CUMBERSOME
AND LENGTHY SEVERAL REPORTS ARE
THAT THE PROCESS CAN TAKE OVER
SIX MONTHS. THIS DELAY IN
ORTHOPEDIC SURGEONS ABILITY TO
TREAT ARE INJURED CALIFORNIANS
CAN CERTAINLY CREATE ACCESS TO
CARE ISSUES. ESPECIALLY IN MORE
RURAL AREAS WITH LOWER
GEOGRAPHIC DENSITY IS WORKING
EXCERPTED. AT THE HELP
COMMITTEE SUPPORTED THE
PREVIOUS VERSION OF THIS BILL
FOURTEEN TO NOTHING. AND WE NOW
HAVE THE SUPPORT OF
CALIFORNIA'S RADIOLOGIST. I
WOULD URGE SUPPORT FOR THIS
BILL TO ALLOW FOR A TEMPORARY
PERMIT FOURTH PEDIC'S SURGEONS
WHO WERE USING FOR US TO BE
SUCCESSFUL IN ANOTHER STATE. TO
CONTINUE USING THIS MODALITY IN
CALIFORNIA FOR TWELVE MONTHS
WELL THE CALIFORNIA
CERTIFICATION IS IN PROCESS.
BUT THE ALLOWING THEM TO CARE
FOR INJURED CALIFORNIA. YOU
VERY MUCH FOR YOUR TIME AND
ATTENTION AND IS GIVES DON'T
MENTION WE'RE BOTH HERE AND
HAPPY TO ANSWER ANY QUESTIONS.
THANK YOU VERY MUCH THANK YOU
VERY MUCH. SO WITH THAT WILL GO
TO OTHER WITNESSES IN SUPPORT
OR OPPOSITION ON THE PHONE. AND
ONCE AGAIN JUST YOUR NAME
ORGANIZATION YOU MIGHT
REPRESENT AND YOUR POSITION ON
THE BILL. SO WHENEVER YOU'RE
READY MISTER ROCK GREATER. AND
ONCE INSURANCE SUPPORT OR
OPPOSITION PLEASE PRESS ONE
ZERO AT THIS TIME AGAIN ONE
ZERO FOR SUPPORT OR OPPOSITION.
WE DO HAVE TO IN THE QUEUE VERY
GOOD THANK YOU WHENEVER YOU'RE
READY SIR. WE WILL START WITH
LINE ONE OH TWO ONE ONE OF TO
PLEASE GO AHEAD. BRENT SPENCE
ON BEHALF OF THE CALIFORNIA
KODIAK MEDICAL ASSOCIATION THEY
ARE THE OTHER CO SPONSORS ON
THE BILL IN SUPPORT THANK YOU.
THANK YOU VERY MUCH. NEXT
CALLER. ONCE AGAIN IF YOU ARE
IN SUPPORT OR OPPOSITION PLEASE
PRESS. ONE ZERO. BUT WE DO A
LOOK ONE MORE IN THE QUEUE WILL
GO NEXT TO LINE ONE SIXTY EIGHT.
BLIND ONE SIXTY EIGHT YOU ARE
OPEN. MISTER TURN MEMBERS BOB
BACK ON BEHALF OF THE
CALIFORNIA RELIGIOUS SOCIETY IN
SUPPORT THANK YOU THANK YOU
VERY MUCH. THERE ANY OTHER
CALLERS INSTRUCTOR. A YES WE DO
HAVE ONE MORE NEXT WE WILL GO
TO LINE ONE FIFTY ONE. ONE ONE
FIFTY ONE YOUR LINE IS OPEN.
GOOD AFTERNOON THIS IS BILL
BARCELONA WITH AMERICA'S
POSITION GROUPS AND SUPPORT.
THANK YOU VERY MUCH. ANY OTHER
CALLERS. AND AGAIN ONE ZERO IF
YOU ARE IN SUPPORT OR
OPPOSITION. THIS TIME WE HAVE
NO FURTHER IN THE QUEUE PLEASE
CONTINUE MISTER CHAIR THANK YOU
VERY MUCH MISS ROBERT OR BRING
IT BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS ANY
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. C. NINE WOULD YOU
LIKE TO CLOSE CONSTRUCTION. A
MISTRESS WONDER THANK YOU FOR
YOUR GUIDANCE AS WELL AS
ROUTINES- YOU AND YOUR TEAM
HAVE BEEN INCREDIBLY HELPFUL
WITH THAT I HUMBLY ASK FOR YOUR
AYE VOTE. THANK YOU VERY MUCH
THE BILL DOES ENJOY A DO PASS
RECOMMENDATION WE HAVE A MOTION
BY MISTER MAYES A SECOND BY
MISS WALDRON. US MADAM
SECRETARY PLEASE CALL THE ROLL.
MOTIONS TO PASS TO BUSINESS AND
PROFESSIONS. WHAT I WOULD AYE
MAYES. MAYES AYE AGUIAR-CURRY.
AGUIAR-CURRY AYE BIGELOW.
BIGELOW I. BONTA. BURKE BURKE I
CARILLO. HI FLORA FLORA HI
MAIENSCHEIN AS OUR HIGH MCCARTY
MCCARTY FIVE IN THIS AREA.
NAZARIAN I HAVE RIVAS. RIOS I
RODRIGUEZ RODRIGUEZ I SANTIAGO
WALDRON WALDRON HIGH. THIRTEEN
ZERO YOUR BILL IS OUT THIRTEEN
ZERO LEAVE THE ROLE OPEN FOR
OTHERS TO ADD ON THANK YOU
MEDICARE CHEN PROPITIATED. MR
GRAYSON YOU HAVE AB ELEVEN OH
FOUR. PLEASE WHENEVER YOU'RE
READY THANK YOU MISTER CHAIR
AND THANK YOU TO THE COMMITTEE
STAFF FOR THEIR WORK ON THIS
BILL I WILL BE ACCEPTING THE
COMMITTEE AMENDMENTS THANK YOU
WITH THE COMMITTEE AMENDMENTS
AB L. ELEVEN OH FOUR WILL
EXTEND THE SUNSET DATE OF A
MODEL BY EIGHTEEN MONTHS. AFTER
THAT IT'LL REQUIRE AIR
AMBULANCE RATES FOR- IN FEE FOR
SERVICES AND MEDICARE MANAGED
CARE TO BE REIMBURSED AT 80% OF
MEDICARE RATES. LAST SESSION
WHEN I PRESENTED A SIMILAR BILL
IN THIS COMMITTEE I STATED MY
INTENT TO FIND LONG TERM
FUNDING SOLUTIONS FOR AIR
AMBULANCE PROVIDERS AND WITH
THE HELP OF THE COMMITTEE WE
HAVE FOUND A LONG TERM SOLUTION
EMERGENCY AIR AMBULANCE
PROVIDERS ARNIE CENTRAL PART OF
THE STATEWIDE EMERGENCY MEDICAL
SERVICES EMS SYSTEM. THEY ALSO
PLAY A ROLE A KEY ROLE IN
HOMELAND SECURITY AND DISASTER
RESPONSE INCLUDING THE
EVACUATING HOSPITALS IN THE
PATH OF WILDFIRES AND
RESPONDING TO COVERT NINETEEN
CRISIS. EVERY YEAR THE
PROVISIONS OF ARMADA MUST BE
EXTENDED- WHICH CAUSES A GREAT
DEAL OF ECONOMIC UNCERTAINTY
FOR AIR AMBULANCE PROVIDERS SO
WITH THAT AB ELEVEN OH FOUR
WILL PROVIDE A TEMPORARY
EXTENSION OF AMADA TO ALLOW THE
AIR AMBULANCE PROVIDERS TO
CONTINUE TO PROVIDE LIFESAVING
SERVICES IN THE INTERIM WHILE
ALSO PROVIDING A LONG. OVERDUE
RATE INCREASE. THANK YOU VERY
MUCH MR GRAYSON- OF LEAVE YOUR
WITNESSES IN THE GALLERY.
FLYING HIGH ABOVE US. NOT IN A
HELICOPTER THOUGH THANK
GOODNESS NO PUN INTENDED SORRY
CAN HELP IT WALDRON. THANK YOU
MR CHAIRMAN MEMBERS OF THE
COMMITTEE- MY NAME'S KRISTEN
GELLER I'M THE PRESIDENT OF THE
CALIFORNIA ASSOCIATION OF AIR
MEDICAL SERVICES REPRESENTING
AMBULANCES THROUGHOUT THE STATE
AS WELL AS REACH AIR MEDICAL
SERVICES. WE'RE HERE TODAY IN
STRONG SUPPORT OF ELEVEN OH
FOUR AND- ONE OF SEVERAL CO
SPONSORS AMBULANCES AS YOU AS
MISTER GRAYSON INDICATOR FINAL
SERVICE OF PROVIDE LIFESAVING
EMERGENCY TRANSPORTATION FOR
THE MOST CRITICAL PATIENTS.
DIRECTLY TO TRAUMA CENTERS AND
TERTIARY CARE CENTERS
THROUGHOUT THE STATE. IN RURAL
AREAS WHERE EMERGENCY HAPPENED
FAR FROM TREATMENT CENTERS ARE
IN DIFFICULT TO REACH PLACES M.
JOBS ARE OFTEN OKAY PATIENTS
ONLY HOPE. TO REDUCE MORBIDITY
AND MORTALITY AND HAVE A PROVEN
TRACK RECORD OF DOING SO. IN
ADDITION RUNS HERE AMBULANCE
HELICOPTERS AND AMBULANCES
PROVIDE A CRITICAL LINK BETWEEN
RURAL AREAS AND URBAN TERTIARY
CARE CENTERS. AND AS MR GRAYSON
INDICATED ARE VITAL LINK WITHIN
THE HOMELAND SECURITY AND
AEROMEDICAL SERVICES SYSTEM
WITHOUT AN ADDITIONAL
COMMENSURATE SAFETY NET. THIS
BILL WILL CONTINUE TO PROVIDE
CRITICAL FUNDING TO THIS
ESSENTIAL LIFESAVING SERVICE
AND WE LOOK FORWARD TO FINDING
AN ONGOING SOLUTION AND
ESTABLISHING THOSE
CONVERSATIONS TO MAKE THIS
HAPPEN IN THE FUTURE. WOULD
LIKE TO THANK THE AUTHOR AND
THE CHAIR FOR YOUR ONGOING AND
CONTINUED SUPPORT AND
LEADERSHIP IN THIS ISSUE AND WE
RESPECTFULLY REQUEST AN AYE
VOTE THANK YOU. THANK YOU VERY
MUCH SIR MUCH APPRECIATED- WITH
THAT WE WILL GO TO THE PHONE
LINES AND ASK THE OPERATOR TO-
BRING UP ANY OF. TESTIMONY IN
SUPPORT OR OPPOSITION PLEASE
JUST YOUR NAME YOUR
ORGANIZATION AND YOUR POSITION
ON THE BILL. WHEN AND ONCE
AGAIN IF YOU ARE IN SUPPORT OR
OPPOSITION PLEASE PRESS ONE
ZERO AT THIS TIME. WE DO HAVE
TO IN THE QUEUE. ALL RIGHT
PLEASE GO AHEAD WHEN YOU'RE
READY SIR. WE WILL START WITH
LINE ONE SIXTY TWO PLEASE GO
AHEAD. MEDICARE AND MEMBERS
DOMINIC THE MARI HERE ON BEHALF
OF THEIR MESSAGE- THE OPERATOR
THAT OPERATES UNDER MERCY ERROR
IN CALIFORNIA- IN SUPPORT OF
THE BILL AND ALSO YOUR CORE CO
SPONSOR. THANK YOU THANK YOU
VERY MUCH. NEXT CALLER PLEASE.
NEXT WE WILL GO TO LINE ONE
TWENTY ONE PLEASE GO AHEAD.
BUSINESS NEAR MARTIN ON BEHALF
OF THE CALIFORNIA CHILDREN'S
HOSPITAL ASSOCIATION ALSO IN
SUPPORT THANK YOU THANK YOU
VERY MUCH. NEXT CALLER PLEASE.
THE NEXT WE WILL GO TO LINE ONE
SEVENTY FOUR PLEASE GO AHEAD.
SHARE MEMBERS OF OUR DATA BONTA
ON BEHALF OF P. H. I. HEALTH
AND STRONG SUPPORT THANK YOU
THANK YOU VERY MUCH NEXT CALLER
PLEASE. NEXT WE WILL GO TO LINE
ONE SEVENTY FIVE PLEASE GO
AHEAD. THANK YOU MISTER CHAIR
MEMBERS SHAUN HENSCHEL ON
BEHALF OF MOBILE MEDICAL
RESPONSE- OPERATING IN
CALIFORNIA'S CAL STAR AND REACH
AIR AMBULANCES- COSPONSORED IN
STRONG SUPPORT THANK YOU VERY
MUCH THANK YOU. THANK YOU VERY
MUCH NEXT CALLER PLEASE. AND AS
A REMINDER PLEASE PRESS ONE
ZERO IF YOU'RE IN SUPPORT OR
OPPOSITION. THIS TIME THERE ARE
NO FURTHER IN THE QUEUE PLEASE
CONTINUE MISTER CHAIR THANK YOU
VERY MUCH OF BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS OR COMMENTS
FROM. MR RODRIGUEZ. I WANT TO
THANK ALL THE FOR BRING THIS
VERY IMPORTANT BILL FOR. AS WE
ALL KNOW THE AIR AMBULANCE
SERVICE PROVIDES A VERY VITAL
LINK IN PROVIDING. CARE AND
SERVICE THOUGHT STATED
CALIFORNIA I'VE IN MY CAREER
WORKED CLOSELY IN HAND IN HAND
A LOT OF THESE. AIR AMBULANCE
PROVIDERS AND THEY- BRING A
VERY UNIQUE AND- SERVICES TO
THE STATE ESPECIALLY TO THOSE
IN NEED TO WANT TO THANK THE
MEMBER FOR BRING THIS. FORD'S
WE CONTINUE HAVEAN AIR MEDICAL
AILMENTS SERVICES PROVIDED
INSTEAD CALIFORNIA THANK YOU.
THANK YOU VERY MUCH MR I REGUS
ANYBODY ELSE. I JUST LIKE TO
ADD MY COMMENTS- PERSONAL THING
I WANNA THANK YOU FOR YOUR
CONSIDER CONTINUED WORK IN THIS
ARENA-MUCH APPRECIATED TO
SOMEONE REPRESENTS A VERY RURAL
AREA. WHERE WHERE WE AT THIS
TIME OF YEAR WELL ACTUALLY IF
IT HAD BEEN RAINING- WE LIKELY
HAVE MORE OF THIS BUT- WE OFTEN
HAVE ROAD CLOSURES BECAUSE OF-
MUD SLIDES- THAT'S THAT'S A
CHALLENGE FOR US AND SOMETIMES
EVEN IN MY DISTRICT. OF WHAT
LOOKS LIKE FIFTY MILES ON THE
MAP WHICH IS FIFTY MILES ON THE
MAP MIGHT TAKE A COUPLE OF
HOURS TO GET THERE SO. SO IN MY
DISTRICT TO REACH AND- AND CAL
STAR OUR OUR BIG IMPORTANT
PLAYERS AND I. ANNA AND WE WENT
WE DON'T NEED TO DO EVERYTHING
WE CAN TO MAINTAIN THEM SO- ONE
OF- THANK YOU FOR THAT. AND THE
BILL DOES ENJOYED YOU PASS AS
AMENDED- RECOMMENDATION TO
PREPARATIONS WOULD YOU LIKE TO
CLOSE. RICHARD THANK YOU VERY
MUCH ALONG WITH COMMITTEE STAFF
AND COMMITTEE MEMBERS I
RESPECTFULLY ASK RIVAL. THANK
YOU VERY MUCH MA'AM SECRETARY
PLEASE OPEN THE ROLE. AND CALL
THE MEMBERS. THE MOTION IS TO
PASS AS AMENDED APPROPRIATIONS
WHAT. I WOULD AYE MAYES. MAYES
AYE AGUIAR-CURRY. AGUIAR-CURRY
AYE BIGELOW BIGELOW I. BONTA.
BUT I BURKE BURKE I CARILLO.
FLORA FLORA I MAIENSCHEIN
MAIENSCHEIN HAI MCCARTY.
MCCARTY AYE NAZARIAN. NAZARIAN
AYE RIVAS. RODRIGUEZ RODRIGUEZ
I SANTIAGO. WALDRON WALDRON
HIGH. HAS TWELVE ZERO TWELVE
ZERO YOUR BILLS OUT AND I'D
LIKE TO BE ADDED AS A CO AUTHOR
IF YOU HAVE ANY MISTER GREAT
ABSOLUTELY THANK YOU. THANK YOU
VERY MUCH. NEXT UP. MR WYNN AB
THIRTEEN THIRTY ONE. THANK YOU
VERY MUCH- MISTER CHAIR AND
COMMITTEE MEMBERS AB THIRTEEN
THIRTY ONE WILL ESTABLISH A
FULL TIME STATEWIDE DIRECTOR OF
CRISIS SERVICES WITHIN THE
DEPARTMENT OF HEALTH CARE
SERVICES TO COORDINATE
BEHAVIORAL HEALTH PROGRAMS AND
SERVICES AONG VARIOUS
BEHAVIORAL HEALTH PROVIDERS
ACROSS CALIFORNIA. ONE IN SIX
CALIFORNIANS LIVE WITH A MENTAL
ILLNESS AND A COMPREHENSIVE
INTEGRATED CRISIS NETWORK IS
THE FIRST LINE OF DEFENSE IN
GETTING THESE CALIFORNIANS THE
HELP THEY NEED. THIS BILL WILL
CREATE LEADERSHIP ON A
STATEWIDE LEVEL TO DEVELOP AN
EFFECTIVE CRISIS CARE SYSTEM
THAT SAVES LIVES AND RESOURCES
I WANT TO THANK THE COMMITTEE
STAFF FOR CONTINUING TO WORK
WITH OUR OFFICE ON THIS VERY
IMPORTANT ISSUE. AND I DO
ACCEPT THE COMMITTEE AMENDMENTS
WITH ME IN SUPPORT OF THE BILL
IS ALEX HAWTHORN FOR ME THAT
CALIFORNIA HOSPITAL
ASSOCIATION. AND DANNY OFFER
FROM MOMMY CALIFORNIA. THANK
YOU VERY MUCH MISS IRWIN- WILL
GO TO THE PHONE AND- OF
MISTRUST WRITER PLEASE OPEN THE
PHONE LINES FOR THE WITNESSES
IN SUPPORT. MISTER CHAIR
MEMBERS DANNY OFFER WITH THE
NATIONAL ALLIANCE ON MENTAL
ILLNESS. ALSO NO THAT'S NOT A
CALIFORNIA. R. O. ARE OVER ONE
HUNDRED TEN THOUSAND MEMBERS
INCLUDE PEOPLE LIVING WITH
SERIOUS MENTAL ILLNESSES AS
WELL AS THEIR FAMILIES AND
SUPPORTERS. LAST FALL WE
SURVEYED OUR MEMBERS FOR THEIR
INPUT ON HOW THE LPS ACT IS
WORKING FOR THEM. WE RECEIVED
OVER THIRTEEN HUNDRED RESPONSES
THAT BY FAR THE LARGEST
RESPONSE ON ANY ISSUE I'VE SEEN
FROM OUR MEMBERS AND MY TIME
WAS NOT ME. AND WHILE SMALL
PORTION OF OUR RESPONDENTS FELT
THAT THERE CRISIS HERE WAS
HANDLED APPROPRIATELY. MANY
SHARED HORRIFIC EXPERIENCES AND
ACCESSING ADEQUATE SERVICES. SO
IN SHORT WHAT WE'RE ASKING FOR
IN THIS BILL IS TO PUT SOMEONE
IN A LEADERSHIP ROLE AT THE H.
C. S. WHO CAN POKE AS FULL TIME
ON OUR CRISIS SYSTEM. TO ENSURE
THAT THERE IS A CONSISTENT
APPLICATION CRISIS SERVICES AND
PATIENTS RIGHTS. THANKS VERY
MUCH. THANK YOU VERY MUCH. OUR
NEXT NEXT WITNESS PLEASE. GOOD
AFTERNOON CHAIR MEMBERS ALICE
HAWTHORNE CALIFORNIA HOSPITAL
ASSOCIATION CO SPONSORED THIS
MEASURE- TODAY BE ABLE HEALTH
CRISIS SERVICES ARE OFTEN
DELIVERED TOO LATE EITHER BY
LAW ENFORCEMENT OR HOSPITAL
EMERGENCY DEPARTMENTS. AND
URGENT DEVELOPMENT TOWARDS ROCK.
OPEN TO ANYONE IN NEED. THAT
ARE NOT TYPICALLY EQUIPPED WITH
THE RIGHT A COMMUNITY BASED
RESOURCES NEEDED TO SERVICE
POPULATION AND ENSURE THEY
RECEIVE NECESSARY LONG TERM
SUPPORT. A COMPREHENSIVE AND
INTEGRATED PRACTICE NETWORK OF
CARE THAT IS AVAILABLE
STATEWIDE. IT'S A GREAT FIRST
LINE OF DEFENSE IN PREVENTING
TRAGEDIES OF PUBLIC AND PATIENT
SAFETY SO THAT'S ACTIVE
CORRECTIVE CARE SAVE LIVES AND
DOLLARS BUT WE MUST INVEST. IN
A SYSTEMIC APPROACH ESTABLISH
LEADERSHIP AT THE STATE LEVEL.
THANK YOU THANK THE AUTHOR FOR
BRINGING MEASURE FORD AND THE
COMMITTEE FOR THEIR HARD WORK
ON AMENDMENTS WE RESPECTFULLY
ASK IN ABOUT. THANK YOU VERY
MUCH WITH THAT WE WILL GO TO
THE PHONE LINES AND MISTRUST
GREATER- CALL WILL OPEN THE
PHONE LINES WILL BE ASKING FOR
WITNESSES IN SUPPORT OR
OPPOSITION- JUST YOUR NAME
ORGANIZATION AND YOUR POSITION
ON THE BILL PLEASE SO. WHENEVER
YOU'RE READY MISTER OPERATIVE.
IN LATE YOU KNOW MIDCURRENT
SUPPORTER. PLEASE PRESS ONE
ZERO TO JOIN THE QUEUE. AGAIN
ONE ZERO YOU'RE IN SUPPORT OR
OPPOSITION. AT THIS TIME IT
LOOKS LIKE WE HAVE ABOUT FIVE
IN THE QUEUE. OKAY GO AHEAD
WHEN YOU'RE READY SIR. WE'LL
START WITH LINE ONE SEVENTY SIX
PLEASE GO AHEAD. GOOD AFTERNOON
CHAIRMAN LEADS AND MEMBERS OF
THE COMMITTEE THIS IS WHY THE
LANGUAGE WITH HATHAWAY
SYCAMORES WERE BASED IN LOS
ANGELES COUNTY AND WE ARE IN
SUPPORT OF AB THIRTEEN THIRTY
ONE THANK YOU THANK YOU VERY
MUCH NEXT CALLER PLEASE. NEXT
WILL BE LINE ONE SEVENTY ONE
PLEASE GO AHEAD. THANK YOU TERM
MEMBERS THEIR BRIDGE ON BEHALF
OF THE ASSOCIATION OF
CALIFORNIA HEALTHCARE DISTRICT
BOARD AB ONE THIRTEEN THIRTEEN
THIRTY ONE THANK YOU THANK YOU.
NEXT CALLER PLEASE. NEXT WILL
BE LINE ONE SEVENTY SEVEN
PLEASE GO AHEAD. GOOD AFTERNOON
MR CHAIRMAN MEMBERS ADRIN
SHELTON REPRESENTING THE
CALIFORNIA ALLIANCE OF CHILD
AND FAMILY SERVICES IN SUPPORT
OF AB THIRTEEN THIRTY ONE THANK
YOU THANK YOU NEXT CALLER
PLEASE. NEXT WE'LL GO TO LINE
ONE TWELVE ONE TWELVE THESE GO
AHEAD. GOOD AFTERNOON MR
CHAIRMAN MEMBERS CONTEL COTTO
ON BEHALF OF THE CALIFORNIA
LEGISLATURE'S DISASSOCIATION
WITH THE COURT THANK YOU NEXT
CALLER PLEASE. AND ONCE AGAIN
IF YOU ARE IN SUPPORT OR
OPPOSITION PLEASE PRESS ONE
ZERO. I WILL GO TO LINE ONE
FIFTEEN PLEASE GO AHEAD. HI
KELLY OKAY APPLE WITH THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION AND
RESPECTFUL OPPOSITION WE
HAVEN'T REVIEWED THE AMENDMENTS
HELP TO REFLECT ON THAT AND SEE
WHAT OUR POSITION IS AFTER
WE'VE TAKEN A LOOK THANK YOU.
THANK YOU. NEXT CALLER PLEASE.
BUT AGAIN IF YOU'RE IN SUPPORT
OR OPPOSITION PLEASE PRESS. ONE
ZERO. AT THIS TIME WE HAVE NO
FURTHER IN THE QUEUE PLEASE
CONTINUE MISTER CHAIR. THANK
YOU VERY MUCH WILL BRING IT
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS QUESTIONS
OR COMMENTS OF THE AUTHOR.
QUESTION BY MR BIGELOW PLEASE
GO AHEAD SIR. THANK YOU FOR THE
AUTHOR THE DEPARTMENT OF
HEALTH- RAISED AN ISSUE OF
CONCERN ABOUT SOME VAGUENESS
ABOUT THIS AND THEN THERE'S THE
COST AND BECAUSE OF THE
DUPLICATION OF EFFORTS COULD
YOU MAYBE ADDRESS THAT TO
THAT'S- JOKE IS ON A LITTLE
BIT. SURE THE B- AMENDMENTS
FIRMED UP THE- DEFINITION SO
THAT DEALT WITH THE VAGUENESS
ISSUE WHEN AND THE COSTS. NO WE
DON'T THINK THIS IS DUPLICATIVE.
I RECOGNIZE THAT- APPRECIATE IT
JUST WANT TO MAKE SURE WE GOT
THAT ADDRESSED- OUT OF RESPECT
FOR THE DEPARTMENT OF HEALTH
GREAT THANK YOU. YEAH THANK YOU
VERY MUCH MR BIGELOW ANYONE
ELSE QUESTIONS OR COMMENTS. C.
NUMBER BRING IT BACK TO- WOULD
LIKE TO CLOSE- MR WENT
RESPECTFULLY ASK HER ABOUT
THANK YOU VERY MUCH- YOU HAVE
ACCEPTED THE AMENDMENTS THE
MOTION THAT WE DO NOT HAVE A
MOTION YET- MOTION BY MISS
AGUIAR-CURRY. SECOND BY MISS
BURKE MOTION IS TO PASS AS
AMENDED TO APPROPRIATIONS THE
BILL DOES ENJOYED DO PASS
RECOMMENDATION BY THE CHAIR. SO
AMEND SECRETARY PLEASE CALL THE
ROLL WHAT I WOULD AYE MAYES.
MAYES AYE AGUIAR-CURRY.
AGUIAR-CURRY AYE BIGELOW.
BIGELOW I. BONTA. BONTA BURKE
BURKE AT. FIVE ZERO. LARA LARA
AYE MAIENSCHEIN MAIENSCHEIN AYE
MCCARTY. MCCARTY AYE NAZARIAN.
NAZARIAN AYE RIVAS. RODRIGUEZ
RODRIGUEZ I SANTIAGO. WALDRON.
WALDRON HIGH TOTAL ZERO TWELVE
ZERO YOUR BILL IS OUT WITH THE
ROLLING STONES THANK YOU. NEXT
UP A MISTER O'DONNELL AB. EIGHT
EIGHTY THREE. WHENEVER YOU'RE
READY SIR I AM READY- THANK YOU
MR CHAIRMAN MEMBERS I'M PLEASED
TO PRESENT AB EIGHT EIGHT THREE
WHICH WILL REQUIRE THAT
PROPOSITION SIXTY THREE MENTAL
HEALTH SERVICES ACT OR MHA IS
M. HSA FUNDS UNUSED BY COUNTIES
BE REALLOCATED TO SCHOOLS IN
THAT COUNTY TO PROVIDE MENTAL
HEALTH SERVICES. TO STUDENTS I
ACCEPT THE COMMITTEE'S PROPOSED
AMENDMENTS TO THANK THE
COMMITTEE STAFFER WORKING WITH
MY STAFF TO IMPROVE THE BILL WE
ARE FACING A MENTAL HEALTH
CRISIS AMONG OUR CHILDREN IN
THIS STATE AND IT IS ONLY
BECOME WORSE BECAUSE THE
PANDEMIC CAMPAIGN DEMOCRAT THIS
YOU KNOW. SCHOOLS ARE WELL
POSITIONED. TO RESPOND TO THE
MENTAL HEALTH NEEDS OF OUR
STUDENTS BUT NEED THE RESOURCES
TO BE ABLE TO DO SO
EFFECTIVELY. DAMAGE THE M. H.
S. A. GENERATES APPROXIMATELY
ONE POINT EIGHT BILLION DOLLARS
PER YEAR FOR MENTAL HEALTH
SERVICES AND THESE FUNDS ARE
ALLOCATED TO EACH COUNTY. IF
THE COUNTY DOES NOT UTILIZE
THEIR ALLOCATED FUNDS WITHIN
CERTAIN TIMELINES THEY
EVENTUALLY REVERT BACK TO THE
STATE. OR OVER TO THE STATE. WE
HEAR THAT TOO OFTEN SCHOOLS ARE
LEFT OUT OF THE COUNTIES M. H.
ESSAY PLANNING PROCESS THIS
BILL WOULD REQUIRE THAT IF A
COUNTY HAS UNSPENT FUNDS IN
THEIR REVERSION ACCOUNT. THEY
MUST WORK WITH LOCAL
EDUCATIONAL AGENCIES FOR THE
PROVISION OF MENTAL HEALTH
SERVICES FOR STUDENTS. SPEAKING
SUPPORT TODAY MISTER CHAIR OF
AB EIGHT EIGHTY THREE R. P.
ESTRADA WITH THE LOS ANGELES
UNIFIED SCHOOL DISTRICT AND
ALEX BRISCOE THE CALIFORNIA
CHILDREN'S TRUST. THANK YOU
VERY MUCH MR O'DONNELL. GO TO
THE PHONE LINES FOR WITNESSES
WHENEVER YOU'RE READY MISTER
OPERATORS. OUR IF YOU'RE ON THE
LINE UP IF YOU'RE WITNESSES ON
THE LINE PLEASE GO AHEAD. GOOD
AFTERNOON CAN YOU HEAR ME YES
YES MA'AM PLEASE GO AHEAD. OKAY
THANK YOU GOOD AFTERNOON CHAIR
WOULD IN MEMBERS MY NAME IS
SOPHIA AND- THAT'LL AND I
SERVICES PSYCHIATRIC SOCIAL
WORKER FOR THE LOS ANGELES
UNIFIED SCHOOL DISTRICT FOR THE
PAST THIRTY YEARS. TODAY I
TESTIFIED BEFORE YOU AS THE
EXECUTIVE DIRECTOR OF STUDENT
STUDENT HEALTH AND HUMAN
SERVICES I NEED OVER TWENTY
FIVE HUNDRED STAFF HEALTH AND
MENTAL HEALTH PROFESSIONALS.
FOR CRITICAL FOR TO STUDENT.
AND FAMILY IN OUR POOL. WE COME
UP WELL BEING COULD WELL AND
NEEDS OF THE WHOLE TRIAL TO
ENSURE EACH STUDENT CAN
SUCCESSFULLY- LEAD
ACADEMICALLY. FIVE ANGELES
UNIFIED IS A NATIONALLY
RECOGNIZED PIONEER AND LEADER
IN THE MENTAL HEALTH SERVICES
AND OTHER SPONSOR OF EIGHTY
EIGHT EIGHT THREE I AM HONORED
WITH TODAY'S OPPORTUNITY TO
TESTIFY. AND AMPLIFIED BEFORE
YOU IMPORTANCE OF THIS
LEGISLATIVE BILLS. EIGHTY EIGHT
EIGHTY THREE AND ALIGNED WITH
THE INITIAL INTENT OF THE
MENTAL HEALTH SERVICES ACT
WHICH WANTS TO TRANSFORM THE
MENTAL HEALTH SYSTEMS. ARE
PARTNERING WITH SCHOOL DISTRICT
BECAUSE WE ARE GROUND ZERO.
WHERE POINT TO PROVIDE
PREVENTION AND EARLY
INTERVENTION SERVICES EVERY DAY
IN OUR POOL. WE ARE WHERE THE
STUDENTS AND FAMILIES TURN TO
HOLD OUR FIRST TO HEAR WHEN
THERE'S A TRAGEDY OR LOSS IN
THE FAMILY. WHEN THERE'S A
CRISIS IN THE COMMUNITY WE'RE
ON THE FRONT LINES OF SPEAKING
WITH STUDENTS FOR EXPERIENCING
POSTNATAL IDEATION AND OTHER
CRIED DISEASE. SCHOOLS ARE THE
CENTER OF EVERY COMMUNITY AND
WE HAVE TO WAIT MATHIS AND
ACTIONS DURING THE PANDEMIC.
YES WHO'S OFTEN LACK THE
INTERNAL RESOURCES TO PROVIDE
SUCH SERVICES. THE LOCAL
STAKEHOLDER PROCESS FOR MENTAL
HEALTH SERVICES ACT
IMPLEMENTATION HAVE FAILED TO
CONSIDER. AT THE CENTRAL
ENTITIES FOR DRESSING MENTAL
HEALTH NEEDS. LEAVING PEOPLE TO
FEND FOR THEMSELVES. AB EIGHT
EIGHT THREE REQUIRES THAT
COUNTIES WORK WITH LOCAL
EDUCATION AGENCIES. TO DEVELOP
PLANS TO UTILIZE UNSPENT.
REVERTED MENTAL HEALTH SERVICES
FUNDS L. UNIFIED HAD BEEN BACK
IN OUR OWN LOCAL RESOURCES TO
ESTABLISH OVER FIFTY BASED
HEALTH CLINICS. AND FIFTY
WELLNESS CENTER WE HAVE A
PROXIMALLY THOUSAND MENTAL
HEALTH VISITS ANNUALLY. AS PART
OF THE PATH TO RECOVERY ONLY
UNIFIED IS INVESTING. OVER A
HUNDRED SEVENTY MILLION DOLLARS.
ONE TIME STATE AND FINE TO EACH
WITH. SOCIAL AT OTHER. SO HOW
STUDENTS AND THEIR TO WE- AND
TALK TO REDUCE. DURING THE
RETURN SCHOOL COMPACT FINE
STEVEN BATHROOM ARE JUST PART
OF OUR- TO MAKE SURE STUDENT
GETS SUPPORT THEY- AND THE BEST
POSSIBLE EDUCATE. AND STUDENT
NEEDS WE ONGOING SERVICE AB
EIGHT EIGHT THREE EIGHT
INCREASE A SUSTAINABLE. THE
FUNDS ARE TO STAY MENTAL HEALTH
WITH VERSION. COULD BE YOU THE
FACT TO PROVIDE MENTAL HEALTH
TO STUDENTS IN SCHOOL BASED
PROGRAM. AS WE RE OPEN ARE COOL
WE HAVE A BIG TASK AHEAD WE
HAVE TO ADDRESS THE TRAUMA AND
THE PAIN THAT HAS OCCURRED OVER
THE LAST YEAR. WE SIMPLY CANNOT
PICK UP WHERE WE LEFT OFF AND
WE CAN'T DO THIS ALONE. WE WILL
CONTINUE TO STRIVE FOR GROWTH
AREA FOR THE PREVENT STUDENTS
FROM LEARNING AND TO OPTIMIZE
HEALTH AND WELLNESS SO ALL
STUDENTS CAN THRIVE BUT WE
SPEAK YOUR SUPPORT. WE'RE
PLEASED TO SPONSOR EIGHTY EIGHT
EIGHT THREE AND RESPECTFULLY
REQUEST. YOUR IPHONE THANK YOU.
THANK YOU VERY. OUR WAS THAT
WITNESS PLEASE. HI GOOD
AFTERNOON SIR PERSON WOULDN'T
ELSE IS THEN TODAY- AT MY
PRIVILEGE MA'AM DOLLARS FISCAL
OF THE CALIFORNIA TERMS TRUCKS.
ACCOUNTED FOR BOTH- THE NEXT
SURFACED IN YOUR BEEN UNIFIED
SCHOOL DISTRICT AND ANSWER A
NUMBER OF YEARS AS THE DIRECTOR.
OF THE ON THE COUNTY HEALTHCARE
SERVICE AGENCY. WELL LOST OVER
TO OUR AND FORTY. AND INCLUDING
TO SEVEN SEVEN AUTONOMOUS. I
THINK IT'S A DIFFERENT SIDES
THE FIRST OF SOLUTION EMPLOYEE
FURNISH PERSPECTIVE OF ACCOUNT
ADMINISTRATOR WHO WAS
RESPONSIBLE FOR THE ROLLOUT AND
IMPLEMENTATION OF THE MENTAL
HEALTH SERVICES ACT. AND IT IS
MY PRIVILEGE TO SPEAK IN
SUPPORT AND THAT'S THE EIGHT
EIGHT THREE. IN HOPES THAT IT
CAN AND WILL LEAD TO GREATER
PARTNERSHIPS AND COLLABORATION
AMONG SCHOOL DISTRICTS AND
COUNTIES. THEY WILL ENSURE THAT
DOLLARS THAT ARE NOT SPENT.
WILL AT THE LOCAL LEVEL AND ARE
RISK AVERSION WILL BE
REPURPOSED TO CHOKE TO BENEFIT
CHILDREN AND FAMILIES IN THE
SCHOOLS AND COMMUNITIES THAT
THEY WERE INTENDED TO SERVE
WHEN WE ALL WORK SO HARD TO
PASS THIS EXTRAORDINARY ACTS IN
TWO THOUSAND FIVE. AT R. VERY
COMPELLING WHICH THAT SCHOOLS
ARE ESSENTIAL TO ANY RESPONSE
AT SCALE. SURE YOU FELT HEALTH
CRISIS THAT HAS LITERALLY SEEN
TWICE AS MANY OF OUR CHILDREN
TO TRY TO KILL THEMSELVES IN
THE DECADE BEFORE CALLED IT.
IMPACT OF CODE HAS BEEN
STRIKING. WITH MORE THAN 30%
INCREASES IN CRISIS SERVICES
AMHERST APARTMENTS. AND WE MUST
ACCEPT THE REALITY THAT 75% OF
MENTAL ILLNESS MANIFESTS IN
EARLY ADULTHOOD. AT A TIME WHEN
YOUNG PEOPLE USE OUR HEALTHCARE
SYSTEM AT THE LOWEST LEVELS.
CHILDREN AGED EIGHTEEN ACCESS
HEALTHCARE SERVICES AT THE
LOWEST RATE OF ANY DEMOGRAPHIC
GROUP IN THE MEDICAID PROGRAM.
SCHOOLS ARE NOT ONLY NEED A THE
SERVICES THE HEALTHCARE SYSTEM
MUST ENTER ITS RESPONSE TO THE
NEWS HOW QUICK MENTAL HEALTH
CRISIS IN SCHOOLS. THE REALITY
OF MENTAL HEALTH PLAN BUDGETING
AND OPERATIONS PUTS
EXTRAORDINARY PRESSURE ON AND
THIS IS A DOLLARS THE LOCAL
LEVEL AND THERE WILL
UNDOUBTEDLY BE ON SPENT HOURS.
BECAUSE OF THE RULES OF AN HSA
WHICH REQUIRE RESEARCHERS. BUT
ALSO BECAUSE THE BURDENSOME
ADMINISTRATIVE OBLIGATIONS THAT
MENTAL HEALTH PLANS FACE AS I
MENTIONED I THINK THE PRESSURE
FROM BOTH SIDES. THERE WILL
INEVITABLY BE RESERVES.
ACTUALLY BECAUSE OF THE BOOM
AND BUST CYCLE THAT COUNTY
MENTAL HEALTH PLANS MUST LIVE
AND THEY WOULD LIVE ON
REALIGNMENT DOLLARS WHICH ARE A
STAPLE JIM VEHICLE LIKE TO
SPEAK WITHOUT TAX. SO THINK NEW
CARS IN THE MALL WHEN YOU NEED
MONEY THE MOST IN A LOCAL
STATION THAT YOU LOSE THAT.
MENTAL HEALTH PLAN REVENUES
HAVE- RELIED ON IMAGES SAY I'VE
GOT SERVICE. SO WHEN YOU
DOLLARS ARE AT RISK OF
REVERSION IT'S NOT FAIR THAT
THEY BE REMOVED. AND REPRESENTS
A UNIQUE OPPORTUNITY FOR US TO
RETURN TO THIS CRITICAL. MASSES
OF HEALTH AND EDUCATION. IN
CONCLUSION THIS BILL ADDRESSES.
CHALLENGES IT PROMOTE AND
ENHANCE ENHANCES PARTNERSHIP
BETWEEN COUNTY NOT HELP MEN AND
SCHOOL DISTRICTS IT EXTENDS THE
REVERSION WINDOW AND ALLOWS FOR
DOLLARS AT RISK AVERSION TO BE
RE ALLOCATED IN SERVICE OF THE
CHILDREN AND FAMILIES THEY WERE
MEANT. TO SERVE. IT'S GOOD
PUBLIC POLICY IT'S GOOD FOR
CHILDREN AND FAMILIES. AND IT'S
GOOD FOR OUR COLLECTIVE
OBLIGATION TO PROMOTE
COLLABORATION AMONG AND BETWEEN
CHILD SERVING SYSTEMS THANK YOU.
THANK YOU VERY MUCH. NOW WILL
GO TO THE PHONE LINES FOR
WITNESSES AND- OTHER OTHER-
PUBLIC COMMENT. IN SUPPORT OR
OPPOSITION ONCE AGAIN JUST YOUR
NAME ANY ORGANIZATION YOU
REPRESENT IN YOUR POSITION ON
THE BILL. WHENEVER YOU'RE READY
MISTER OPERATOR. AND LEASES ON
AN INSURANCE SUPPORTER
OPPOSITION OF THE BILL PLEASE
PRESS ONE ZERO AT THIS TIME
AGAIN ONE ZERO FOR SUPPORT AND
OPPOSITION. AT THIS TIME WE
HAVE THREE IN THE QUEUE VERY
WELL WHENEVER YOU'RE READY SIR.
WE'LL START WITH LINE ONE TEN
PLEASE GO AHEAD. MISTER CHAIR
MEMBERS OF THE COMMITTEE TONY
CHECK THEIR- ON BEHALF OF THE
CALIFORNIA TEACHERS ASSOCIATION.
PORT AB EIGHT EIGHT THREE THANK
YOU THANK YOU VERY MUCH NEXT
CALLER PLEASE. NEXT WE'LL GO TO
LINE ONE THIRTY PLEASE GO AHEAD.
GOOD AFTERNOON CHRISTINA
MARCELLUS ON BEHALF OF THE SAN
FRANCISCO UNIFIED SCHOOL
DISTRICT AND THE CALIFORNIA
ASSOCIATION OF SCHOOL
COUNSELORS IN STRONG SUPPORT.
THANK YOU VERY MUCH NEXT CALLER
PLEASE. I WILL NOW GO TO LINE
ONE EIGHTY PLEASE GO AHEAD.
GOOD AFTERNOON MISTER CHAIR AND
MEMBER ADRIN SHELTON
REPRESENTING THE CALIFORNIA
ALLIANCE A CHILD A FAMILY
SERVICES IN SUPPORT OF AB EIGHT
EIGHT THREE WITH THE COMMITTEE
AMENDMENT THANK YOU. THANK YOU
VERY MUCH. NEXT CALLER PLEASE.
NEXT WE'LL GO TO LINE ONE
FIFTEEN PLEASE GO AHEAD. OKAY
APPLE WITH THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION IN SUPPORT WITH
APPRECIATION FOR THE AMENDMENTS
FROM THE COMMITTEE THANK YOU
NEXT CALLER PLEASE. AND IF
YOU'RE IN SUPPORT OR OPPOSITION
THE BILL PLEASE PRESS ONE ZERO.
AT THIS TIME THERE ARE NO
FURTHER IN THE QUEUE PLEASE
CONTINUE MISTER CHAIR OKAY
THANK YOU VERY MUCH FOR BRING
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS OF THE
AUTHOR. MR FLOOR. THANK YOU
VERY MUCH MISTER CHAIR- I AM A
SUPPORT THIS BILL I THINK IT'S
GREAT BUT I ACTUALLY FIND A
VERY FASCINATING. THAT IF WE
ACTUALLY CARE ABOUT THE MENTAL
HEALTH OF OUR KIDS. THE VERY
PEOPLE- KEEPING OUR KIDS OUT OF
SCHOOL RIGHT NOW ARE SUPPORTING
THIS MENTAL HEALTH BILL. I WILL
TELL YOU RIGHT NOW. WHAT ALSO
HELPS MENTAL HEALTH OF OUR
KIDS. IS GETTING THEM BACK IN
SCHOOL AND LEARNING IN THE
CLASSROOM. SO I FIND IT
INCREDIBLY FASTENING THE RIGHT
NOW WE'RE HAVING THIS
CONVERSATION. MEANWHILE THE
STATE HAS NOT OPENED UP OUR
SCHOOLS FOR OUR KIDS SO I WOULD
ENCOURAGE THE CTA. TO LET OUR
KIDS BE GET BACK IN SCHOOL
BECAUSE THAT IS INCREDIBLY
IMPORTANT TO THE MENTAL HEALTH
WORKERS THANK YOU. MR THANK YOU
VERY MUCH MR FOR. ANYONE ELSE.
K. C. NO ONE WILL BRING IT TO
YOU I'VE ANY WOULD YOU LIKE TO
CLOSE THE STORE I THANK YOU
MISTER CHAIR AND JUST QUICKLY I
DON'T KNOW ANYONE THAT DOESN'T
WANT OUR KIDS BACK IN SCHOOL
BUT TO THIS BILL ASK FOR AN AYE
VOTE. THANK YOU VERY MUCH THE
BILL HAS- A MOTION BY MISTER
MAYES. AND A SECOND BY MISS
AGUIAR-CURRY- THE MOTION IS TO
PASS AS AMENDED TO EDUCATION IT
ENJOYS A DO PASS RECOMMENDATION
FROM THE CHAIR MADAM SECRETARY
PLEASE CALL THE ROLL. WHEN I
WOULD AYE MAYES MAYES AYE
AGUIAR-CURRY AYE GREGORY AYE
BIGELOW BIGELOW I. BONTA. BONTA
AYE BURKE BURKE I CARILLO.
FLORA FLOOR I MAIENSCHEIN
MAIENSCHEIN AYE MCCARTY.
MCCARTY AYE NAZARIAN. NAZARIAN
I REQUEST. RODRIGUEZ RODRIGUEZ
I SANTIAGO. WALDRON WALDRON
HIGH. TWELVE ZERO THANK YOU
VERY MUCH OF BILLS OUT LEAVE
THE ROLE OPEN FOR OTHERS TO ADD
ONS TO THANK YOU MOVING NOW TO-
MISS QUICK SILVA. FOR EIGHTY
SIX THIRTY EIGHT. WHENEVER
THANK YOU MR SPEAKER AND
MEMBERS. I WANT TO THANK YOU
FOR THIS OPPORTUNITY TO PRESENT
AB SIX THIRTY EIGHT AS WE ARE
ALL AWARE MENTAL HEALTH
DISORDERS ARE AMONG THE MOST
COMMON HEALTH CONDITIONS FACED
BY CALIFORNIANS OVER THE PAST
YEAR WITH CLOVER NINETEEN
PANDEMIC WE HAVE SEEN HEALTH
PHYSICAL DISTANCING. AND
SENSATIONAL FROM OUR DAY TO DAY
LIVES CLOSURE OF SCHOOLS AND
WORKPLACES HAS CAUSED PEOPLE TO
FEEL STRESS ANXIETY FEAR AND
LONELINESS. ALL OF THESE
NATURAL RESPONSES HAVE
TRIGGERED MENTAL HEALTH ISSUES
ALONG WITH. SUBSTANCE USE
DISORDERS AND COULD HAVE A LONG
LASTING EFFECT ON PUBLIC HEALTH
CRISIS AFTER THE PANDEMIC IS
OVER. BUT THAT ALSO DOESN'T
ADDRESS THE ISSUES WE HAD
BEFORE THE PANDEMIC. AS A
CLASSROOM TEACHER I KNOW TOO
TOO OFTEN WE HAVE SEEN OUR
STUDENTS STRUGGLE IN ORANGE
COUNTY TRAPASSO IT'LL HAS
ACTUALLY HAD TO OPEN UP AN
ADOLESCENT USE. OF ADOLESCENT.
VISIBILITY AND THIS IS
SPECIFICALLY BECAUSE OF THE
SUICIDE ATTEMPTS MANY MANY SOME.
THEIR PATIENTS AS YOUNG AS
EIGHT. YOUNG GIRLS THAT ARE
CUTTING BULLETIN BULIMIA AND
OTHERS BUT THIS BILL ADDRESSES
ADDICTION. AND WHAT THEIR
MENTAL HEALTH DOG DOLLARS WE
KNOW THAT ALL TOO OFTEN
PATIENTS THAT HAVE MENTAL
HEALTH DISORDERS AND SUFFER
FROM ADDICTION OR OFTEN TRACKED
INTO TWO DIFFERENT SERVICE
AREAS AB SIX THIRTY SEVEN
ADDRESSES THE COMPLEX NEEDS AND
SERVICES OF THOSE. WITH CO.
OCCURRING ISSUES BY AUTHORIZING
PREVENTION AND EARLY
INTERVENTION STRATEGIES THAT
ADDRESS MENTAL HEALTH NEEDS
SUBSTANCE USE OR MISUSE NEEDS
OR NEEDS RELATING TO CO
OCCURRING MENTAL HEALTH AND
SUBSTANCE USE SERVICES UNDER
THE MAP MENTAL HEALTH SERVICES
ACT. DRUG RELATED OVERDOSE
FATALITIES HAVE RISEN 50% SINCE
TWENTY SEVENTEEN AND IS ONE OF
THE TOP TEN LEADING CAUSES OF
DEATH IN OUR STATE. OVERDOSE
RELATED DEATHS ARE RISING
HIGHER IN CALIFORNIA THAN IN
ANY OTHER STATE IN THE UNITED
STATES AND THE TWELVE MONTHS
BETWEEN JUNE TWENTY NINETEENTH
AND JUNE TWENTY TWENTY THERE
WERE MORE THAN SEVEN THOUSAND
OVER DAY DOSE DEATHS WHICH
EQUALS APPROXIMATELY SEVENTEEN
OVERDOSE FATALITIES PER HUNDRED
THOUSAND RESIDENTS. BASICALLY
WE HAVE A CLEAR NEED AND I AM
HERE TO PRESENT THIS AND WE
HAVE TO WITNESSES TODAY WITH US
DR DONOVAN WHO IS CHAIR OF
PSYCHIATRY DEPARTMENT OF CEDAR
SINAI MEDICAL AND COMMISSIONER
OF THE MENTAL HEALTH SERVICES
OVERSIGHT AND ACCOUNTABILITY
COMMISSION. AND ALSO BY ELIA
VELARDO DIRECTOR OF THE
GOVERNMENT AFFAIRS FROM THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION OF
CALIFORNIA. THANK YOU SOME OF
OUR QUICK SILVA SOLE GO TO OF
THOSE WITNESSES NOW. THANK YOU
THANK YOU MR CHAIRMAN MEMBERS-
I APPRECIATE THE OPPORTUNITY TO
TESTIFY TODAY- MY NAME IS DE
TITANIC WHICH- I AM THE CHAIR
OF THE DEPARTMENT THE COUNTRY
AT CEDAR SINAI HOSPITAL. I'M
ALSO- BOARD MEMBER OF THE
AMERICAN SOCIETY OF ADDICTION
MEDICINE. PAST PRESIDENT OF THE
CALIFORNIA SOCIETY OF ADDICTION
MEDICINE AND AS YOU JUST HEARD
I SERVE ON THE MENTAL HEALTH
SERVICES OVERSIGHT AND
ACCOUNTABILITY COMMISSION. ON
BEHALF OFTHE COMMISSION I'M
HERE TO SPEAK IN SUPPORT OF AB
SIX THIRTY EIGHT. ONE THING
ASSEMBLY MEMBER CORK SILVA FOR
HER LEADERSHIP ON ADDRESSING
MENTAL HEALTH AND SUBSTANCE.
USE NEEDS AND FRAUD DURING THIS
BILL. SB SIX THIRTY EIGHT
AUTHORIZES THE USE OF AN HSA
FUNDING. TO SUPPORT PREVENTION
AND EARLY INTERVENTION
STRATEGIES TO ADDRESS SUBSTANCE
USE. AS WELL AS MENTAL HEALTH
WHO CO OCCURRING DISORDERS. I
THINK THAT LAWS NECESSARY FOR
THREE REASONS I DON'T TRY TO
PUT IT AS SIMPLY AS POSSIBLE-
FIRST. SUBSTANCE USE DISORDER
IS A MENTAL HEALTH CONDITION.
IN MY CLINICAL PRACTICE I
REGULARLY SEE THAT THESE
CONDITIONS ARE LINKED FOR THOSE
OF YOU THAT MAY HAVE FAMILY OR
FRIENDS WITH ADDICTION I'M SURE
YOU SEE THE SAME. THE
DISTINCTION BETWEEN SUBSTANCE
USE AND MENTAL HEALTH IN OUR
POLICIES IS REALLY A RELIC OF
AN OUTDATED UNDERSTANDING. THE
SCIENCE IS VERY CLEAR ON THIS
AND IT'S Y. CROSS THE FIELD IN
PSYCHIATRY. THERE IS AN
OPPORTUNITY INTEGRATE MENTAL
HEALTH AND SUBSTANCE USE
SERVICES TOGETHER WHICH IS ONE
OF THE THINGS THAT THIS- THAT
THE STOP- BILL DOES. AT SECOND
SUBSTANCE USE IS A MAJOR
COMPLICATING FACTOR FOR MOST
OTHER MENTAL HEALTH CONDITIONS-
SO ACROSS THE BOARD WITH EVERY
ABUSES ASSOCIATED WITH FORCE
RESPONSE TO TREATMENT MORE
HOSPITALIZATIONS PLUS RECOVERY
AND AS YOU MAY KNOW PEOPLE WITH
MENTAL ILLNESS PARTICULARLY
SERIOUS MENTAL ILLNESS DIE ON
AVERAGE TWENTY FIVE TWENTY FIVE
YEARS EARLIER THAN NORMAL. A
MAJOR CONTRIBUTOR TO THIS IS
TOBACCO USE ALCOHOL USE ILLICIT
DRUG USE HAVING SEPARATIST ARMS
AND- AND SEPARATE EARLY
INTERVENTION SYSTEMS JUST MEANS
PEOPLE SLIP THROUGH THE CRACKS.
AND THIRD I WOULD HIGHLIGHT
THAT USING SUBSTANCES EARLY IN
LIFE. INCREASES LIFETIME RISK
OF MENTAL HEALTH PROBLEMS. WHEN
IT COMES TO PREVENTION AND
PARTICULARLY FOR YOU. CHILDREN
IT MAKES NO SENSE TO SEPARATE
MENTAL HEALTH AND SUBSTANCE USE
PREVENTION IT'S REALLY ONE OF
THE SAME. I THINK AB SIX THIRTY
EIGHT WILL STRENGTHEN THE MHSAA
OKAY CONSUMERS PRACTITIONERS IN
OUR BROADER MENTAL HEALTH
SYSTEM IMPROVE TOOLS TO SUPPORT
THE PEOPLE WE SERVE. ON BEHALF
OF MYSELF IN THE COMMISSION I
ASK YOU TO SUPPORT SB SIX
THIRTY EIGHT I'D BE HAPPY TO
ANSWER ANY QUESTIONS YOU MIGHT
HAVE- WELL THANK YOU VERY MUCH.
WITH THAT WE'LL GO AHEAD AND
MOVE TO THE PHONE LINES. AND
ASK FOR- ANY CALLERS SUPPORT OR
OPPOSITION LESAGE YOU JUST
NAMED HER JUST GIVE YOUR NAME
ANY ORGANIZATION YOU REPRESENT
AND YOUR POSITION ON THE BILL.
SO WHENEVER YOU'RE READY MISTER
OPERATOR. AND LATER JOHN WITH
YOUR AND SUPPORTER OPPOSITION
THE BILL PLEASE PRESS ONE ZERO
AT THIS TIME. AGAIN ONE ZERO
FOR SUPPORT OR OPPOSITION. I'M
SORRY I DID BUT ON THE
ENVIRONMENT THE COUNTY
BEHAVIORAL DIRECTORS THE
PATIENT ACTUALLY THE SECOND
WITNESS YOU WANT ME TO WAIT
THAT LONG OR- STATE ARE HARD.
I'M SORRY KIND OF BROKE UP
INSIDE. YOUR IN SUPPORT CORRECT.
YOU WERE THE SECOND WITNESS AND
BEGIN AND BASICALLY
COMMISSIONER DON OF ITS EXPRESS
ALL OF THE SAME INTEREST THAT
WE HAVE BEEN WHY WE SUPPORT
THAT PIECE OF LEGISLATION
EXACTLY BIRDS THE SUPPORT ON.
THE COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION I'VE YEAH
OKAY MY APOLOGIES I DIDN'T
ALLOW. YOU TO DO THAT SO- THAT
WILL JUST ADD THAT TO THE OF
THING I'VE DONE TODAY MY- YOU
ONCE HAVE- GO AHEAD MR OPERATOR
AND LET'S SEE WHAT ELSE I CAN
COME UP WITH. WE'LL GO TO LINE
ONE EIGHTY SIX- LINE ONE A SIX
PLEASE GO AHEAD. AFTERNOON
MISTER CHAIR AND MEMBER ADRIN
SHELTON REPRESENTING THE
CALIFORNIA ALLIANCE A CHILD AND
FAMILY SERVICES IN SUPPORT OF
AB SIX THREE EIGHT THANK YOU.
THANK YOU VERY MUCH NEXT CALLER
PLEASE. NEXT WE'LL GO TO LINE
ONE SEVENTY SIX PLEASE GO AHEAD.
BY ONE SEVENTY SIX PLEASE MAKE
SURE NOT- YOU. AND ONCE
INSURANCE SUPPORT OR OPPOSITION
THE BILL PLEASE PRESS ONE ZERO.
MIDDLE. ONE SEVENTY SIX YOUR
LINE IS OPEN. PLEASE GO AHEAD.
AND AT THIS TIME WE HAVE NO
FURTHER IN THE QUEUE MISTER
CHAIR VERY WELL THANK YOU WILL
BRING THIS BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS OR COMMENTS.
FOR THE AUTHOR. SEEING NONE WE
WILL- WOULD YOU LIKE TO CLOSE-
ESCORTS SILVA- YES JUST- I
pWHO HAS. LOST A BROTHER- WITH
CO OCCURRING CONDITIONS THAT
THIS IS VITALLY NEEDED AND THAT
IT COULD MAKE A HUGE DIFFERENCE
FOR THOSE SUFFERING WITH CO
OCCURRING CONDITIONS AND I
RESPECTFULLY I ASK FOR AN AYE
VOTE. ARE YOU IF YOU'RE
ACCEPTING THE- YES THANK YOU
ARE AMENDMENTS THANK YOU VERY
MUCH. SO THIS BILL- ENJOYS A DO
PASS RECOMMENDATION THE MOTION
IS WOULD BE- WAITING FOR MOTION.
A MOTION BY MISS BURKE SECOND
BY MISS AGUIAR-CURRY THE MOTION
IS DUE PASSED APPROPRIATIONS
THE MATTER SECRETARY PLEASE
CALL THE ROLL. TO PASS AS
AMENDED TO APPROPRIATIONS WHAT
YES I WOULD I MAYES. AS I. PICK
AGUIAR-CURRY AGUIAR-CURRY AYE
BIGELOW. BIGELOW I. BONTA BONTA
AYE BURKE BURKE I CARRILLO.
LARA FLUORIDE MAIENSCHEIN
MAIENSCHEIN HI MCCARTY MCCARTY
AYE NAZARIAN NAZARIAN. RIVAS
RODRIGUEZ RODRIGUEZ I SANTIAGO.
WALDRON WALDRON HI TWELVE ZERO
TWO ZERO YOUR BILLS OUT LEAVE
THE ROLE OPEN FOR OTHERS TO ADD
ON THANK YOU MEMBERS THANK YOU
VERY MUCH MISS KIRK SILVA
MISTER SALAS YOU HAVE AB
SEVENTY. THANK A RESTAURANT.
AND THAT THEY CAN MEMBERS OF
THE COMMITTEE ON SERVICE SAYING%
I WILL ACCEPT THE- COMMITTEE OF
IMMENSELY THANK YOU MISTER
CHAIRMAN AND YOUR STAFF FOR
YOUR WORK ON- THIS MEASURE. YOU
KNOW I AM PLEASED TO PRESENT.
ASSEMBLY BILL SEVENTY TO THE
COMMITTEE TODAY WHICH WILL
ADDRESS MAJOR BIO SECURITY
CONCERNS WITH THE GENE
SYNTHESIS INDUSTRY. BY MAKING
CALIFORNIA THE FIRST STATE IN
THE NATION TO IMPLEMENT PUBLIC
SAFETY SCREENING GUIDELINES.
FOR GENE SYNTHESIS COMPANIES.
SCIENTISTS HAVE SHOWN THAT IT'S
POSSIBLE TO RECONSTRUCT VIRUSES
LIKE THE COVERT NINETEEN-
DISEASES LIKE EBOLA. AND BY
USING MAIL ORDER DNA THAT CAN
BE PURCHASED THROUGH THE
INTERNET FOR CERTAIN GENE
SYNTHESIS COMPANIES. AND I
RECEIVED A MOTION AND A SECOND
WITH THAT I DO HAVE- TESTIMONY
IN SUPPORT. CHAIRMAN AND SO
INDIFFERENCE TO THE COMMITTEES
TIME IF WE COULD MOVE TO-
TESTIMONY IN SUPPORT I HAVE
DOCTOR GIGI GROUNDBALL. A
SENIOR SCHOLAR AT THE JOHNS
HOPKINS CENTER FOR HEALTH
SECURITY. AND AN ASSOCIATE
PROFESSOR OF THE DEPARTMENT OF
ENVIRONMENTAL HEALTH AND%
ENGINEERING AT THE JOHNS
HOPKINS. BLOOMBERG SCHOOL OF
PUBLIC HEALTH. AND I ALSO HAVE-
ERIN SMITH SENIOR VICE
PRESIDENT OF GOVERNMENT AFFAIRS
AT TWIST BIOSCIENCE. A GENE
SYNTHESIS COMPANY OPERATING IN
SAN FRANCISCO. THANK YOU VERY
MUCH WILL OPEN THE HONE LINES
FOR OUR WITNESSES IN SUPPORT.
TO SPEAK UP WHEN YOU'RE ON THE
LINE USUALLY GROUND UP CAN YOU
HEAR ME YES MA'AM WELL. YEAH
OKAY SO WE'LL GO WITH THE
DOCTOR G. GREAT. DID YOU FIRST.
OKAY GREAT- THANK YOU VERY MUCH
FOR THE OPPORTUNITY TO SPEAK TO
YOU- IN SUPPORT OF THIS BILL-
M. G. GONZALEZ- ACTION I HAVE-
WRITTEN BOOKS AND ARTICLES
ABOUT BY A SECURITY AND
EMERGING BIOTECHNOLOGIES I
REMEMBER OF- FEDERAL ADVISORY
COMMITTEES AT THE DEPARTMENT OF
DEFENSE OR NATIONAL HEALTH
DEALING WITH THE MISUSE OF
BIOTECHNOLOGY. THE NATIONAL
ACADEMIES COMMITTEE- THAT
PRODUCERS FOR EXERCISE
DIFFERENCE IN AGE OF PROPHETIC
BIOLOGY- AND WE DETERMINED THAT
IT WAS- THE CONSTRUCTION-
VIRUSES- SUCH AS USING
SYNTHESIS PRODUCTS- FROM
SCRATCH THAT- WHAT POST ONE OF
THE MOST PRESSING BIODEFENSE
RISK THAT THE NATION FACES AT
THIS TIME SO THIS IS A GREAT
STEP FORWARD FOR BIO SECURITY
IT ADDRESSES BASIC BIOSECURITY
GAPS IN OUR CURRENT APPROACH TO
GENES THAT THAT THE SCREENING-
AS YOU NO JEANS TO THE TEST AND
OTHER- SYNTHETIC BIOLOGY TOOLS
ARE REALLY IMPORTANT FOR
ADVANCES IN BIOTECHNOLOGY AND
WE CERTAINLY ENJOYED. THE
FRUITS OF THAT- INCLUDING YOU
KNOW THE VACCINE DEVELOPMENT
BUT- BUT OUR CURRENT SYSTEMS
CAN BE TOO EASILY MISUSED FOR
CRIME SO THIS BILL PROMOTES
RESPONSIBLE BEHAVIOR OF
COMPANIES- IT- IT PROMOTES
RESPONSIBILITY IF YOU'RE TRYING
TO USE THEIR PRODUCTS. IT
MAKES- ATTENTION TO BY A
SECURITY ISSUES AT COMPETITIVE
FOR COMPANIES AS WELL SO THIS
IS A GREAT STEP FOR CALIFORNIA
I REALLY HOPE THAT IS EMULATED
BY OTHER STATES- BY THE FEDERAL
GOVERNMENT AND BY OTHER
NATIONS- BECAUSE THIS IS SORELY
NEEDED THANK YOU VERY MUCH FOR-
BREAKING. FOR YOUR ATTENTION.
VERY WELL THANK YOU- THE
WITNESS. GOOD AFTERNOON MASSIVE
MATHIS RIGHT PRESIDENT OF THE
AFFAIRS AND PUBLIC POLICY AT
TWIST BIOSCIENCE THANK YOU FOR
THE EARLIER INTRODUCTION WE ARE
PLEASED TO JOIN OUR COLLEAGUE
DR CON WELL AS WE'VE HEARD- HER
SHARING THE IMPORTANCE OF THAT
LEGISLATION WE ARE HERE IN
SUPPORT OF THE BILL AS WELL WE
HAVE BEEN HAPPY TO PARTNER
WITH- REPRESENTATIVE POLIQUIN
AND HIS- OFFICE. ON THIS BUDGET
BLAKE SHINN TWITTER IS A
COMPANY OUT OF SAN FRANCISCO-
AND JUST DESCRIBED EARLIER AND
WE NEED TO OUR CUSTOMERS TO
SUCCEED THEY'RE OFFERING HIGH
QUALITY SYNTHETIC DNA EVEN OUR
PROPRIETARY SILICON PLATFORM IF
IT'S SOMETHING THAT HAS REALLY
ALLOWED OUR PARTNERS- INCLUDED
IN OUR PARTNERSHIP THREE WITH
LESS. NOT ONLY THE
PHARMACEUTICAL AND BIOTECH
INDUSTRY BUT MOST RECENTLY WITH
THE COPAY NINETEEN PANDEMIC WE
WERE ONE OF THE FIRST COMPANIES
THAT THE FDA ALLOWED- SHOULD BE
PLACED ON OUR WEBSITE FOR
CREATING SYNTHETIC CONTROLS FOR
COOK NINETEEN WHICH ALLOWED
ULTIMATELY UP QUICKER ACCESS OR
CASTING WAY BACK IN THE
BEGINNING OF THE PANDEMIC WHEN
TESTING WAS NOT READILY.
AVAILABLE OR EVEN THE TECH.
CANNOT BE ON. EVEN THAT MORE
AND WE ARE TO HAVE THE OUTLOOK
TO TALK ABOUT THE BUDGET.
BECAUSE IT WHERE ONE OF THE
THINGS THAT WE DID WHEN THE
COMPANY FIRST. WITH RECOGNIZED
WITH THE INCREDIBLE TOOL IN
ADVANCEMENT FOR OUR PARTNERS
INCLUDING GOVERNMENT AGENCIES
AND RESEARCHERS. THAT COULD
ALSO BE USED FOR POTENTIALLY
DAMAGING- EFFORT. INTEL TWITTER
HAS TAKEN AN APPROACH THAT NOT
ONLY DO WE WANT TO LEAD IN THE
MARKET THERE ARE HIGH
THROUGHPUT TECHNOLOGY AN
INCREDIBLE PRECISION AT AN
AFFORDABLE PRICE AND QUICK
TURNAROUND. BUT THAT OUR
BIOSECURITY OUR PLATFORM SHOULD
NOT BE MUTUALLY EXCLUSIVE WITH
BEING SUCCESSFUL AND THERE WE
HAVE- I NUMBER OF AFRICA UNDER
WAY IT WENT. BUT WE WORK AT THE
INTERNATIONAL LEVEL WITH THE I.
G. S. B. THE INTERNATIONAL JEAN
BECKER CONSORTIUM WE SPEND A
LOT OF TIME WORKING WITH DOCTOR
BROWN BILL- AT THE JOHNS
HOPKINS CENTER FOR HEALTH
SECURITY- PARKING BOTH ON
PANELS AND PUBLICATIONS. I
REALLY ADVOCATING FOR THEIR-
YOU KNOW RATHER NEEDS IN
INDUSTRY YOU CAN HAVE A ROBUST
BIOSECURITY SCREENING PLATFORMS
AND BUILD REALLY BE
ENCOURAGING- INNOVATION
TECHNOLOGY. HELLO THIS BILL AND
THE RECOGNITION THAT IT IS A
VITAL FOR RESEARCH IN
CALIFORNIA WHILE UNDERSTANDING
THE IMPORTANCE OF HAVING
SCREENING GUIDELINES BE
AVAILABLE IF SOMETHING
IMPORTANT SO THAT COMPANIES
LIKE TWIST. WE'RE REALLY WHAT
WE'RE DEALING SHOULD BE THE
CORE THE REAL MINIMUM
REQUIREMENT FOR PEOPLE IN THIS
AREA VERSUS WHAT WE SEE NOW
WHICH IS PROBABLY ACTED
FEELING. AND WE HAVE WORKED
WITH FEDERAL GOVERNMENT-
COLLEAGUES. BOTH AGENCIES AND
THEN OUR DELEGATES IN
CALIFORNIA AROUND UPDATING THE
FEDERAL GUIDANCE- I THINK IT'S
NO SECRET THAT IT TAKES QITE A
BIT OF TIME AT THE FEDERAL
LEVEL TO MOVE THINGS ALONG ASK
FOR UPDATING. SO CERTAINLY
HAVING THE LEADERSHIP AT THE
STATE LEVEL AND VERY WELCOME
AND WE ARE HAPPY TO CONTINUE TO
SERVING AS A RESOURCE IN THIS
AREA I THANK YOU VERY MUCH. THE
REPRESENTATIVE IN THAT
COMMITTEE- MISTER CHAIRMAN FOR
HEARING NOT- AS A WITNESS ON.
THE TODAY. THANK VERY MUCH.
WITH THE WE WILL GO TO THE
PHONE LINE. FOR BOB COMMENT IF
YOU WANT TO PROVIDE PUBLIC
COMMON JUST YOUR- ORGANISER IN
YOUR ON BILL. WHENEVER YOU'RE
READY MISTER OPERATOR.
DOMINANTE WISH TO MAKE A PUBLIC
COMMENT YOU MAY PRESS ONE AND
ZERO AT THE TIME. HI THIS TIME
THERE'S NO ONE IN Q. THANK YOU
VERY MUCH WILL BRING IT BACK TO
THE COMMITTEE QUESTIONS OR
COMMENTS OF THE AUTHOR. SEEING
NONE WE HAVE A MOTION AND A
FROM MR FLORES SECOND FROM MR
MAYES MOTION IS TO PASS AS
AMENDED TO APPROPRIATIONS AND-
ENJOYS A DO PASS RECOMMENDATION
FROM THE CHAIR. JACK CLOSE MR
FOR THIS RESPECTFULLY ASK FOR
NINE. THANK THANK YOU VERY
MUCH- MADAM SECRETARY PLEASE
CALL THE ROLL. WHAT I WOULD AYE
MAYES MAYES AYE AGUIAR-CURRY.
AGUIAR-CURRY I BIG. BIGELOW AYE
BY. BONTA FIVE BURKE BURKE I
CARILLO. FLORA FLORA
MAIENSCHEIN MAIENSCHEIN AYE
MCCARTY. MCCARTY I NAZARIAN
NAZARIAN AYE RIVAS. RODRIGUEZ
RODRIGUEZ I SANTIAGO. WALDRON
WALDRON HI. TWELVE ZERO TWELVE
ZERO BILLS THAT PASSES I WILL
BE THE ROLE OPEN FOR OTHERS TO
ADD ON THANK YOU VERY MUCH I
DON'T SEE MISS CARILLO OUR NEXT
AUTHOR SO WE WILL MOVE ON TO
MISTER MAYES. THANK YOU WAS
CHAIRED MEMBERS- PROJECT
OPPORTUNITY TESTIFY BEFORE YOU
TODAY ON AB FOUR FOUR ONE- VERY
SIMPLY ARE LEGISLATION PICK UP
WHERE AB ELEVEN SIXTY ONE LEFT
OFF LAST SESSION. AFTER WAS
VETOED AFTER RECEIVING
UNANIMOUS SUPPORT THE
LEGISLATURE. IS EFFORT SEEKS TO
CREATE HEALTH AND SAFETY
STANDARDS APPLICABLE TO
DEDICATED SURFING WAVE BASINS
WHICH ARE NEW TO CALIFORNIA.
AND GENERATE REAL SEARCHABLE
WAVES AND A HUNDRED THOUSAND
SQUARE FOOT BODY OF WATER. THE
UNIQUE CHARACTERISTICS OF A MAN
MADE WAVE BASIN INCLUDING THE
VOLUMES OF WATER CHEMICAL
DISPERSION CAUSED BY WAVE
ACTION OCCUPANCY RATE AND SIZE
THE WEIGHT BASE IT MEANS THAT
THEY AN'T PROP PROPERLY
REGULATED. BY EXISTING
GUIDELINES FOR SWIMMING POOLS
OR TYPICAL WATER PARKWAY POOLS
WE RECENTLY TOOK A MOMENT TO
ADDRESS THE CONCERNS THE
DEPARTMENT OF PUBLIC HEALTH AND
JUST RELATIONS THAT LED TO THE
VETO LAST YEAR. AND ARE
AWAITING THEIR TECHNICAL
FEEDBACK ASSISTANT MOVES
FORWARD I LASTLY WANT TO LET
YOU KNOW THAT WE ACCEPT THE
SUGGESTED COMMITTEE MINUTES AND
OUR FRIEND AUTHORS AMENDMENT TO
DELETE UNNECESSARY PROVISION-
WITH THAT I'D LIKE TO INTRODUCE
MY WITNESSES- LEAVE PATTON.
CHOICE ON BEHALF OF THE WORLD
SURF LEAGUE. YEAH NEED MORE OR
GOOD AT. TO HAVE BEEN SHARE
COMMITTEE MET. MY NAME IS PAT
CHOICE AND I'M TO. IN SUPPORT
OF AB FOUR FORTY ONE ON BEHALF
OF THE BILL'S SPONSOR THE WORLD
SURF LEAGUE. CALIFORNIA HAS THE
OPPORTUNITY TO BECOME THE
LEADER IN WAY BASED ON
TECHNOLOGY AND TAKE PART IN ALL
THE ECONOMIC BENEFITS THAT COME
ALONG WITH IT. BEING HEARD THE
LEGISLATURE TO SUPPORT THE
GROWTH IN TECHNOLOGY BY PACKING.
EIGHTY FOUR FORTY ONE. A GOOD
CHANCE OF THE SECOND SIMILAR
BILL. AB ELEVEN SIXTY ONE BY
YOUR FORMER COLLEAGUE IAN
CALDERON WAS PASSED THAT IS
COMMITTEE ON A FIFTEEN- BILL.
LAST YEAR. THE BILL WAS VETOED
BY THE GOVERNOR OVER CONCERNS
FROM THE DEPARTMENT OF PUBLIC
HEALTH IN THE DIVISION OF
OCCUPATIONAL SAFETY AND HEALTH.
MOST RECENT MARCH TWENTY FOURTH%
AMENDMENTS ADDRESSED THESE
CONCERNS AND WE ARE AWAITING
FURTHER INPUT. AND TECHNICAL
ASSISTANCE FROM CITY PH AND
DOSH WELL WE'RE ENCOURAGE
BARRING GOING DISCUSSIONS WITH
THE DEPARTMENT DOSH IN THE
AUTHOR'S OFFICE. I REQUEST TO
CHAIR AND COMMITTEE MEMBERS
MOVED THE BILL FORWARD. NOT
STAKEHOLDERS TO CONTINUE TO
WORK ON REFINING THE VARIOUS
COMPONENTS OF THE BILL. WE
APPRECIATE THE AMENDMENT-
COMMITTEE PUT FORWARD AND I
RESPECTFULLY ASK YOUR EITHER
TODAY HAPPY ANSWER ANY
QUESTIONS THE COMMITTEE MIGHT
HAVE THANK YOU. THANK YOU VERY
MUCH- SEE THERE IT IS THERE ANY
OTHER ANOTHER WITNESS AND
SUPPORT. I DON'T BELIEVE WE
HAVE ANY OTHER WITH CASES VERY
WELL THEN WE WILL GO TO THE
PHONE LINES- MISTER OPERATOR
FOR. PUBLIC COMMENT THE PEOPLE
IN SUPPORT JUST YOUR NAME
ORGANIZATION POSITION ON THE
BILL WHENEVER YOU'RE READY
MISTER UP WRITER. YOU WISH TO
MAKE A PUBLIC COMMENT SUPPORT
YOU MAY PRESS ONE AND THERE AT
THE TIME. NO ONE IN Q. THEY'RE
ALL OUT SURFING THAT'S ONE SO-
WILL BRING IT BACK TO COMMITTEE
FOR QUESTIONS OR COMMENTS ANY
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. ZERO NINE WOULD YOU
LIKE TO CLOSE MISTER MAYNES.
BOB BOBBY HAPPY TO CLOSE- THE
CALIFORNIA- IS- IS A LEADER IN
A BAY IN INNOVATION- AND WE ARE
ALSO STATE THAT LOVES- SURFING.
AND THIS- THIS BILL- IS MUCH
NEEDED- IN MY DISTRICT THERE IS
A ONE PROJECT WITHIN THE
BOUNDARIES ANOTHER ONE VERY
CLOSE TO MY TO MY DISTRICT AS
WELL IT'S IMPORTANT THAT WE GET
THIS THING THROUGH ANALYSTS-
NOT QUITE RIGHT THE LAST TIME
BUT- WITH WITH THAT WOULD
RESPECTFULLY REQUEST AN AYE
VOTE. THANK YOU VERY MUCH MR
MAYS THE BILL DOESN'T DO IT
ENJOY IT A- JEFF RECOMMENDATION
YOU HAVE EXCEPT THE AMEND.
CORRECT YES SO THE MOTION IS
DUE PASS AS AMENDED TO
APPROPRIATIONS. MADAM SECRETARY
WE WILL SERVICE AND WE- WE
DON'T HAVE A MOST WE HAVE A
PROMOTION BUT WE DON'T HAVE A
SECOND WEEK SO WE HAVE OF A
SECOND BY MR BIGELOW SO- SO
MADAM SECRETARY MOTION BEING TO
PASS AS AMENDED TO PREPARATIONS
PLEASE OPEN THE ROLE. AND CALL
THE MEMBERS. WHAT I WOULD IF I
MAYES AYE MAYES AYE
AGUIAR-CURRY. AGUIAR-CURRY AYE
BIGELOW. BIGELOW I. BONTA BONTA
AYE BURKE BURKE I CARILLO. LARA
I MAIENSCHEIN. MAIENSCHEIN AYE
MCCARTY. NAZARIAN NAZARIAN HIGH
RIVAS. RODRIGUEZ RODRIGUEZ HI.
WALDRON WALDRON HIGH ELEVEN
ZERO THANK YOU VERY MUCH THE
BILL WAS OUT LEAVE THE ROLE
OPEN FOR OTHERS TO ADD ON. THAT
WAS TO WAITING FOR MISS CAREER
TO COME BACK SO. THAT WOULD
LEAVE ME RIGHT. REDOING THE
ITEM NINETEEN FIRST ELEVEN
THIRTY ELEVEN THIRTY SO MOVE
TO- THE- DOCTOR WOULD AB ELEVEN
THIRTY. THANK YOU VERY MUCH
MISTER CHAIR FIRST I'D LIKE TO
START OFF BY ACCEPTING THE
COMMITTEE AMENDMENTS. BURZUM
HERE TO DAY TO PRESENT AB
ELEVEN THIRTY WHICH CREATES THE
OFFICE OF HEALTH CARE
AFFORDABILITY. WITHIN THE
OFFICE OF STATEWIDE HEALTH
PLANNING AND DEVELOPMENT. I'D
LIKE TO BEGIN BY THANKING THE
ADMINISTRATION PARTICULARLY
STAFF IN AUST PAD WHO ARE MY
PARTNERS ON THIS INITIATIVE.
BUT ALSO LIKE THE MANY STILL
THINK THE MANY STAKEHOLDERS
HAVE BEEN WORKING WITH MY
OFFICE TO EXPRESS THEIR
CONCERNS I HOPE THEY WILL
CONTINUE TO WORK WITH ME ON
THIS PROPOSAL. HEALTHCARE COSTS
ARE A SIGNIFICANT CONCERN. AND
ONLY CONTINUES TO GROW. EIGHT
OUT OF TEN AMERICANS FOR NUNES.
SAY THAT MAKING HEALTH CARE
MORE AFFORDABLE MORE AFFORDABLE
IS AN EXTREMELY IMPORTANT OR
VERY IMPORTANT PRIORITY FOR THE
GOVERNOR AND THE LEGISLATURE.
YOU MAY RECALL THAT A COUPLE
YEARS AGO THERE WAS LEGISLATION
THAT WOULD REGULATED RATES
WITHIN THE HEALTH CARE SYSTEM.
LET ME BE CLEAR THIS PROPOSAL
DOES NOT DO THAT. AB ELEVEN
THIRTIES APPROACH IS BASED ON
DATA AND TRANSPARENCY BY
CREATING AN OFFICE RESPONSIBLE
FOR COLLECTING. AND ANALYZING
INFORMATION AND ESTABLISHING
COST TARGETS. IN RESPONSE TO
STAKEHOLDER FEEDBACK WE HAVE
MINIMIZE NEW DATA REQUIREMENTS
AND QUALITY MEASUREMENT
STANDARDS TO ASSURE
ADMINISTRATIVE BURDENS ARE
LESSENED. WE'VE ADJUSTED THE
TIMELINE SO THAT NO ENFORCEABLE
TARGET WILL BE IN PLACE UNTIL
AT LEAST TWENTY TWENTY SIX. TO
ALLOW THE FOUNDATIONAL WORK TO
OCCUR AND FOR HEALTH CARE
INTRODUCED TO BECOME
COMFORTABLE WITH THE PROCESS.
THE PROCESS OF HIS PROCESS OF
IMPORTANT FOR SMITH IS NOT
MEANT TO BE PUNITIVE ON THE
FRONT END IT'S NOT PUNITIVE ON
THE FRONT END. IT ALLOWS
ENTITIES TO WORK WITH THIS NEW
OFFICE TO DEVELOP A CORRECTIVE
ACTION PLAN. BEFORE ENFORCING
MISSED TARGETS WITH FINES. THE
CONCEPT OF A COMMISSION OR
OFFICE CHARGED WITH COST
CONTAINMENT IS NOT A NEW ONE.
THERE ARE SIX OTHER STATES THAT
HAVE SOMETHING IN PLACE ALREADY
AND THEY ARE SHOWING RESULTS.
YES YES YES THESE THESE OTHER
STATES ARE NOT AS LARGE AND
COMPLEX AS CALIFORNIA. WE CAN
NO LONGER WAIT. TO ADDRESS
GROWING HEALTH CARE COSTS.
THERE ARE STILL IMPORTANT
ISSUES WITH THE PROPOSAL THAT
HAVE YET TO BE RESOLVED
INCLUDING THE DEFINITION OF
WHICH PROVIDERS WILL BE IN.
RECESS EXEMPTED FROM THE BILL.
MY INTENT IS NOT TO CAPTURE
EVERY OFFICER ENTITY IN THE
STATE BUT RATHER FOCUS ON THOSE
GROUPS OR ENTITIES THEIR
DOMINANT OF DOMINO NOT IF IN AN
AREA. THAT THEY HAVE A
SIGNIFICANT IMPACT ON PRICING.
HAVING SAID THAT THE GOAL OF
THIS PROPOSAL IS TO INCLUDE
THOSE ENTITIES IN THE
HEALTHCARE SPACE THAT ARE
DRIVING COSTS. WHETHER BY THEIR
SIZE OR GEOGRAPHIC MARKET
INFLUENCE. WILL CONTINUE TO
WORK WITH STAKEHOLDERS ON THIS
ISSUE AS I DO WITH EVERYONE OF
MY BILLS TO CONSIDER ANY OTHER
REASONABLE CONCERNS. WITH ME
HERE IN SUPPORT TODAY. YASMEEN
POLET AND DEATH CAPELLE
REPRESENT REPRESENTING
HEALTHCARE ACCESS AND WILLIAM
KRAMER REPRESENTING THE PACIFIC
BUSINESS GROUP ON HEALTH
RESPECTFULLY ASK YOUR IBM.
LET'S MOVE TO THE TESTIMONY IN
SUPPORT. GOOD AFTERNOON CHAIR
AND MEMBERS YES MENTALITY WITH
HEALTH ACCESS CALIFORNIA THE
STATE WIDE HEALTH CARE CONSUMER
ADVOCACY COALITION WE ARE HERE
TODAY IN SUPPORT OF AB ELEVEN
THIRTY WHICH WOULD CREATE THE
OFFICE OF HEALTH CARE
AFFORDABILITY. EVERY CALIFORNIA
CONSUMER BUT PRIVATE HEALTH
INSURANCE IS BEING HIT BY THE
RISING COST OF HEALTHCARE
PAYING HIGHER PREMIUMS
DEDUCTIBLES AND COPAYS AND
FEELING THE IMPACT OF
STAGNATING WAGES. HEALTHCARE
COSTS ARE RISING FASTER THAN
GENERAL INFLATION AND BEACHES
AND MANY CONSUMERS FOR LOW CARE
BECAUSE THEY CANNOT AFFORD IT.
GETTING MEDICATIONS DOCTOR
VISITS LAB TESTS OR OTHER
NECESSARY CARE. THE OFFICE
WOULD HELP HEALTHCARE
AFFORDABILITY TAKES AIM TO TAKE
A HOLISTIC APPROACH TO
CONTAINING HEALTH CARE COSTS.
RESULTING FROM YEARS OF
NEGOTIATIONS AND ENGAGING
STAKEHOLDERS ABOUT WHAT CAN
WORK WELL WE APPRECIATE IT
PASSED COST CONTROL PROPOSAL
BUT HAVE TACKLED THE SUSPECT
MARKET. HEALTHCARE AFFORDABLE
WILL HAVE A CONCRETE VIEW OF
THE ENTIRE HEALTHCARE SYSTEM.
THE OFFICE WOULD SET AND
AFFORDABLE COST ER YEAR FOR
THE HEALTHCARE INDUSTRY AND
HAVE THE ABILITY TO LEVY
FINANCIAL PENALTIES OR OTHER
CORRECTIVE ACTION IF INTENSITY
EXCEEDS THE TARGET. THE TARGET
COULD BE SET BY SECTOR AND
WOULD TAKE INTO ACCOUNT
REGIONAL VARIATION RECOGNIZING
THE DIFFERENCES AND COMPLEXITY
THROUGHOUT CALIFORNIA'S HEALTH
CARE SYSTEM UNLIKE RATE SETTING
WHICH SAW THE DOCTOR VISIT IN A
CERTAIN AMOUNT OF DOLLARS OR
HOSPITAL STAY AT THE 150% OF
MEDICARE. THE TARGET SERVER THE
OVERALL GOAL THE INDUSTRY MUST
MEET BUT PROVIDES THE
FLEXIBILITY TO ACHIEVE IT IN A
WAY THAT WORKS WITHIN THE
CURRENT STRUCTURE. AND ALSO
GIVEN THE INDUSTRY THE TOOL TO
IMPROVE QUALITY AND EQUITY
WHILE REDUCING COSTS BY
EMPHASIZING PRIMARY AND
BEHAVIORAL CARE AND ALTERNATIVE
PAYMENT METHODS. LET'S OFFICE
DOES NOT SINGLE OUT ANY ONE
PART OF THE INDUSTRY BUT
INSTEAD RECOGNIZES THE ROLE
THAT HOSPITALS HEALTH PLANS
MEDICAL GROUPS AND OTHER PARTS
OF THE HEALTH SYSTEM PLAY
TOGETHER AND FINDING THE BEST
SOLUTION. TO PREVENTING HIGHER
COSTS. THE AMENDMENTS TODAY-
REMEMBER TO TODAY MAY PROGRESS
AND CLEAR. AND IMPROVING THE
BILL AND WE LOOK TO WORK WITH
THE ON DR ON A- AMENDMENTS.
THAT THE ADVICE BOARD AND
DOMINATED BY THOSE THAT
ACTUALLY PAY FOR THE COST OF
HEALTHCARE. FOR THESE REASONS
WE ARE PLEASED TO SUPPORT THE
MEASURE AND WE RESPECTFULLY
REQUEST YOUR I THOUGHT. JUST
MOVED TO THE SECOND TEST MONEY.
GOOD AFTERNOON TO THE CHAIR
VICE CHAIR AND MEMBERS OF THE
COMMITTEE AND THANK YOU FOR THE
OPPORTUNITY TO OFFER COMMENTS
ON AB ELEVEN THIRTY I'M BILL
KRAMER EXECUTIVE DIRECTOR FOR
HEALTH POLICY AT THE PURCHASER
BUSINESS GROUP ON HEALTH. NOT
FORMALLY KNOWN AS THE PACIFIC
BUSINESS GROUP ON HEALTH CARE
NOT FOR PROFIT COALITION BASED
IN CALIFORNIA REPRESENTING
NEARLY FORTY LARGE PRIVATE
EMPLOYERS AND PUBLIC ENTITIES.
WE STRONGLY SUPPORT THE
PROPOSED OFFICE OF HEALTH CARE
AFFORDABILITY. ALL OF YOU KNOW
WHAT THE PROBLEM IS THAT
HEALTHCARE COSTS ARE TOO HIGH
GREETINGS NATURAL BARRIERS FOR
PATIENTS TO GET NECESSARY CARE.
IT ALSO PUTS A SEVERE FINANCIAL
BURDEN ON EMPLOYERS THAT
PROVIDE HEALTH BENEFITS TO
THEIR EMPLOYEES AND FAMILIES
THERE BY CROWDING OUT THE
DISINVESTMENT AND WORKERS WAGES.
WE KNOW THE HEALTHCARE COSTS
COULD BE LOWER MUCH LOWER WHILE
MAINTAINING THE QUALITY OF
CARE. NUMEROUS STUDIES HAVE
SHOWN THAT THE ABOUT
UNNECESSARY SPENDING IS 2230%
OF TOTAL SPENDING. WE ALSO KNOW
THAT SOME HOSPITALS AND
PHYSICIAN GROUPS ARE ABLE TO
PROVIDE HIGH QUALITY SERVICES.
AT MUCH LOWER COST THAN OTHER
PROVIDERS. THIS BILL PRESENTS A
GREAT OPPORTUNITY TO HOLD DOWN
THE COST OF CARE AND BENEFIT
ALL CALIFORNIANS. WE BELIEVE
THAT THE PROPOSED OFFICE OF
HEALTH CARE AFFORDABILITY WILL
BE AFFECTED BECAUSE ONE IN ITS
SCOPE IS BROAD TAKING INTO
ACCOUNT. QUALITY ACCESS AND
EQUITY IN ADDITION TO COST. TO
IT WILL SET APPROPRIATE COST
TARGETS BUT MEANINGFUL
INCENTIVES FOR MEETING THOSE
TARGETS. AND THREE IT WILL
PROVIDE TECHNICAL ASSISTANCE
AND SUPPORT TO PROVIDERS FOR
HELP IN MEETING THE TARGETS.
THERE IS ONE ELEMENT OF THE
BILL HOWEVER THAT WE BELIEVE
NEEDS TO BE STRENGTHENED. THE
ROLE OF THE ADVISORY BOARD IS
VERY IMPORTANT TO THE SUCCESS
OF THE OFFICE OF HEALTH CARE
AFFORDABILITY. AND IT IS
IMPORTANT THAT ITS MEMBERS ARE
ACTING IN THE INTERESTS OF THE
GENERAL PUBLIC HE SPECIFICALLY
THE PORTION ASSURING THE
INTERESTS OF PATIENTS CONSUMERS
AND PURCHASERS. THOSE WHO
RECEIVE HEALTH SERVICES AND PAY
FOR THEM OUR PRIMARY. I TOOK IS
PAID IN MANY ADVISORY GROUPS
AND BOARDS THAT ARE COMPOSED OF
PEOPLE WHO HAVE. EXPERTISE IN
THE HEALTHCARE INDUSTRY. BUT
UNFORTUNATELY IN THESE GROUPS
THE INTERESTS OF CONSUMERS AND
PURCHASERS ARE OFTEN
OVERWHELMED BY OTHER INTERESTS.
AS A RESULT WE ARE OFTEN
STYMIED IN OUR EFFORTS TO MAKE
PROGRESS TOWARD OUR GOALS LOWER
COSTS AND BETTER QUALITY ACCESS
AND EQUITY. I STRONGLY
RECOMMEND TO COMMITTEE CONSIDER
CHANGES TO ENSURE THAT THE
ADVISORY BOARD. IS ACTING ON
BEHALF OF THE GENERAL PULIC.
AND THE PUBLIC INTEREST BROAD
LIKE. THANK YOU FOR
CONSIDERATION BE COMMENTS AND
WE'LL BE HAPPY TO PROVIDE
ADDITIONAL INFORMATION AND
ASSISTANCE IT WOULD BE HELPFUL
THANK. THANK YOU VERY MUCH WE
ARE NOW GOING TO- JUST TO GO TO
THE- TESTIMONY IN OPPOSITION.
WHO'S UP FIRST FOR TESTIMONY IN
OPPOSITION. IT CANNELLA QUINLAN
HAPPY TO JUMP IN YES. GLAZER
VERY MUCH THANK YOU MISTER
CHAIR VICE CHAIR AND MEMBERS OF
THE COMMITTEE I AM CANNELLA
COIL AND I SERVICE PRESIDENT
AND CEO OF THE CALIFORNIA
HOSPITAL ASSOCIATION AND I'M
TESTIFYING TODAY BECAUSE THE
EFFECT OF THIS BILL ON THE
PEOPLE OF CALIFORNIA AND ON YOU
AS ELECTED LEADERS WILL BE
ENORMOUS. I'M ALSO HERE BECAUSE
I LEFT THE HOSPITAL ASSOCIATION
IN THE STATE OF MARYLAND FOR
NINE YEARS A STATE THAT SETS
HEALTHCARE SPENDING TARGETS
LIKE THOSE PROPOSED IN THIS
BILL. WE RECOGNIZE THE
IMPORTANCE OF ADDRESSING THE
PROBLEM OF HEALTH CARE
AFFORDABILITY. ON AB ELEVEN
THIRTY CALIFORNIA HOSPITALS ARE
OPPOSED UNLESS THE BILL IS
AMENDED BECAUSE IN DOING THIS
WE MUST BE SUCCESSFUL AND NOT
CREATE UNINTENDED CONSEQUENCES
THAT I BELIEVE WILL HAPPEN WITH
THE BILL WAS DRAFTED WE HAVE
OFFERED TO THE CANADIAN
ALTERNATIVE TO THIS BILL TO
MEET AFFORDABILITY OBJECTIVES.
WELL THERE ARE MANY ISSUES I
HOPE YOU'LL HEAR JUST. THREE
POINTS TODAY. IT CRITICALLY
IMPORTANT TO BECAUSE- ABOUT
WHAT PROBLEM WE'RE TRYING TO
SOLVE. IT HEALTHCARE COSTS IT
HEALTHCARE PRICES THIS BILL
DOES NOT ADDRESS HEALTH CARE
COSTS OR PRICES. IT HOW MUCH WE
SPEND ON HEALTH CARE IS IT HOW
MUCH WE SPEND PER PERSON ON
HEALTH CARE. IT SPENDING BY
CONSUMERS ARE SPENDING BY
EMPLOYERS THIS BILL AN EXAMPLE
DOES NOT TAKE INTO ACCOUNT THE
RATE OF INCREASE IN PREMIUMS
PAID BY EMPLOYERS. SO THE BILL
pCRITICAL ISSUE. CALIFORNIA
SPENDS LESS PER PERSON ON
HOSPITAL CARE FOR EXAMPLE THAN
THE NATIONAL AVERAGE DESPITE
HAVING THE THIRD HIGHEST COST
OF LIVING IN THE NATION. AND
LABOR COSTS IN CALIFORNIA THAT
ARE GROWING 10% FASTER THE
NATIONAL HEALTH CARE SPENDING.
CALIFORNIA'S THREE QUARTERS OF
WHAT STATE LIKE MASSACHUSETTS
SPEND PER CAPITA ON HEALTH CARE
IF YOU'RE DEFINING THE PROBLEM.
THAT WE'RE TRYING TO SOLVE COST
PRICE DECLINES IN SPENDING PER
CAPITA IS CRITICAL. CORRECT
AFFORDABILITY BE RESOLVED THE
BILL LIMITS TO INCREASE IN
HEALTH CARE SPENDING IN
CALIFORNIA. BUT HOW MUCH WE
SPEND ON HEALTH CARE IS A
COMBINATION OF BOTH THE COST OF
CARE AND HOW MUCH CARE WE
PROVIDE TO FORTY MILLION PEOPLE.
HOW DO WE SEPARATE AND KEEP THE
GOOD SPENDING FOR EXAMPLE MORE
FOR PRIMARY CARE MORE FOR AN
AGING POPULATION IN CALIFORNIA
AND WALDRON EATING BAD SPENDING
UNNECESSARY CARE INFLATED DRUG
PRICES. THIS PROPOSAL DOES NOT
DIFFERENTIATE BETWEEN THE TWO
SO DO WE PROVIDE LESS CARE TO
THOSE IN NEED IN ORDER TO MEET
THE SPENDING CAPS. THE BILL
WILL LIMIT HOW MUCH CALIFORNIA
SPENDS ON CARE BUT NOT
NECESSARILY MAKE CARE MORE
AFFORDABLE FOR A TYPICAL
CALIFORNIANS. AND FINALLY THE
UNINTENDED CONSEQUENCE OF THIS
PROPOSAL IS NOT AMENDED ARE
REAL AND SERIOUS. CAPPING
HEALTHCARE SPENDING SUGGESTS
THAT TDAY WE'RE SPENDING THE
RIGHT AMOUNT IN THE RIGHT
PLACES. AND I BELIEVE THAT'S
NOT THE CASE FOR COMMUNITIES
THAT ARE UNDER RESOURCED
SPENDING CAPS CAN LOCK IN THAT
INEQUITY. WE NEED TO SPEND MORE
ON COVERAGE AND CARE FOR
UNDOCUMENTED INDIVIDUALS WE
NEED TO SPEND MORE ON MENTAL
HEALTH AND SUBSTANCE ABUSE-
CARE FOR MILLIONS IN CALIFORNIA
ESPECIALLY AFTER THE PANDEMIC.
WHAT IS THE NEXT NEW TECHNOLOGY
AND WHEN MIGHT THE NEXT DEADLY
DISEASE ARE PANDEMIC ARRIVE.
AND HEALTH CARE SPENDING CAP IN
CALIFORNIA MEANS THAT WE ARE
ACCOUNTABLE FOR ANY HEALTH CARE
DECISIONS THAT ARE MADE IN
WASHINGTON DC NOT CALIFORNIA.
RELATED TO MEDICARE OR MEDICAID
OR SETTING A FEDERAL MINIMUM
WAGE DRUG PRICING POLICY OR
MORE. ANY OF THOSE FEDERAL
DECISIONS CAN AFFECT SPENDING.
AND TRIP THE CALIFORNIA CAP. I
TOLD CARL TURNER CREE TO COMMIT.
LIKE THE ONE IN THIS BILL JUST
LIKE DID TO INFORM THEM AND
MAKE POLICY RECOMMENDATIONS ON
THE FEDERAL MEDICARE PROGRAM.
THE DIFFERENCE IS THAT ARE
PROPOSAL ASKS THE COMMISSION
WITH DATA AND EXPERTISE TO
DETERMINE KEY COST DRIVERS WHAT
SHOULD BE MEASURED HOW IT
SHOULD BE MEASURED WHAT SHOULD
BE LIMITED AND WHAT
RECOMMENDATIONS FOR SPECIFIC
POLICY CHANGE SHOULD BE MADE.
TO MAKE CARE MORE AFFORDABLE
WITH THOSE RECOMMENDATIONS
GOING DIRECTLY TO THE%
LEGISLATURE. THOSE MATTERS WE
BELIEVE SHOULD NOT BE
DETERMINED IN ADVANCE WITHOUT
THE DATA AND CRITICAL ANALYSIS.
AS COULD BE DONE IN THIS BILL.
WE THANK THE COMMITTEE MEMBERS
FOR YOUR TIME AND WE DO VERY
MUCH LOOK FORWARD TO WORKING
WITH YOU ON THIS IMPORTANT
ISSUE THANK YOU. THANK YOU MRS
COYLE AND MOVING TO THE- SECOND
WITNESS AND OPPOSITION. AND
JUST A MAKING SURE TO I DIDN'T-
THE SET MY TIMER THERE BUT JUST
MAKING SURE TO BE BE GOOD ON
TIME. SECOND WITNESS I. THANK
YOU MISTER CHAIR I WILL BE
FREE- MR CHAIRMAN MEMBERS OF
THE COMMITTEE BRANDON MARCHING
WITH THE CALIFORNIA MEDICAL
ASSOCIATION- WE ARE CURRENTLY
OPPOSED TO AB ELEVEN THIRTY AM
LACK MATHIS- POSITIONS HAVE
BEEN ON THE FOREFRONT OF POLICY
WORK TO ADDRESS THE RISING
COSTS AND HEALTH CARE IN TWENTY
EIGHTEEN THE PROFESSION DEVELOP
POLICY PROPOSALS THAT WOULD
CREATE AN EFFICIENT AND
EFFECTIVE HEALTHCARE DELIVERY
SYSTEM THAT PRIORITIZES HEALTH
IMPROVE. QUALITY AND REDUCE
COSTS. WE ARE ENCOURAGED AB-
THIRTY CONTAINS SOME VERSION OF
SEVERAL OF THESE PROPOSALS SUCH
AS THE REDUCTION OF THE
MINISTRY OF BERGEN. THE
STREAMLINING OF QUALITY
REPORTING METRICS THE
ENCOURAGEMENT OF VALUE BASED
CARE ARRANGEMENTS AND INCREASED
INVESTMENT IN PRIMARY CARE. B.
SECTIONS OF THE BILL DOES STILL
IN NEED OF REFINEMENT WILL HELP
TO CREATE COST SAVINGS FOR
PATIENTS AND IMPROVE THE CARE
DELIVERY SYSTEM. HOWEVER AS
WRITTEN AT ELEVEN THIRTY IS TO
BROADEN SKILLED AND SALES TO
FOCUS ON THOSE ENTITIES THAT
ARE TRUE CONTRACTORS WITHIN THE
SYSTEM. AND STILL THE BILL
TREATS A SINGLE PHYSICIAN
PRACTICALLY NOTHING MORE
PENALTY DOLLAR INSURANCE
COMPANY OR HOSPITAL SYSTEM AND
DOES NOT TAKE INTO ACCOUNT HE
CORPORATE STRUCTURES.
OPERATIONAL DIFFERENCES OR THE
RELEVANCE OF MARKET SHARE WHICH
CREATES SIGNIFICANT VARIANCES
IN COST. WITHOUT MORE FOCUSED
DEFINITIONS IN THE BILL THAT
TAKE THESE FACTORS INTO ACCOUNT
THE OFFICE WILL BE BOGGED DOWN
BY MANUSIA AND ANALYSIS OF
ENTITIES THAT DO LITTLE TO
CONTRIBUTE TO THE BUILDING
CONCORD HEALTH CARE.
ADDITIONALLY IT IS UNCLEAR WHY
ON THE FINANCIALS CHEAT ARE
NEEDED FROM PROVIDERS
ESPECIALLY SINCE RELEVANT
PROVIDER FINANCIAL DATA IS
INCORPORATED EIGHT INCORPORATED
INTO HEALTH PLAN DISCLOSURES
THAT ALREADY. IT IS UNCLEAR WHY
THE OFFICE WOULD NEED THESE
REPORT OR HOW THEY WOULD BE
HELPFUL IN CARRYING. OUT ITS
RESPONSIBILITIES. AT THIS TIME
CMA URGES THAT AB ELEVEN PM TO
FOCUS THE NEW OFFICE COSTS.
WITH THE MARKET PLACE. ENSURE
TRENT. AND FOR THE PUBLIC AND
HEALTH CARE ENTITIES. PROPERLY
PROMOTE COMPETITION AND ENSURE
THAT PROPER INTENT ARE GIVEN TO
THE OFFICE REGULATED ENTITIES.
TO PROMOTE AND ADOPT
ADMINISTRATIVE EFFICIENCIES AND
OF OUR PATIENTS IN THE VALUE
BASED CARE SYSTEM. WE LOOK
FORWARD TO FUTURE CONVERSATIONS
ON AT ELEVEN THIRTY AND THE
MEDICAL PROFESSION CONTINUES TO
DO THEIR PART TO HELP CONTROL
THE COST OF HEALTHCARE AND
IMPROVE HEALTH CARE. OUTCOMES
FOR PATIENTS THANK YOU. THANK
YOU ARE GONNA NOW. MOVED TO THE
ADD ONS THIS IS BOTH IN
OPPOSITION AND A SUPPORT.
MODERATOR WE- PLEASE OPEN THE
LINES. IF YOU LIKE TO MAKE A
COMMENT YOU MAY PRESS ONE TO DO
AT THIS TIME. FIRST BILL TO
LINE. ONE NINETY ONE PLEASE GO
AHEAD. WHAT CALIFORNIA RURAL
LEGAL ASSISTANCE FOUNDATION IN
SUPPORT OF AB ELEVEN THIRTY
THANK YOU VERY MUCH THANK YOU.
MEXICO TO LINE ONE NINETEEN
PLEASE GO AHEAD. GOOD AFTERNOON
REBECCA GONZALEZ NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER IN SUPPORT
THANK YOU. LIKE TO GO TO LINE
TWO OH TWO PLEASE GO AHEAD.
GOOD AFTERNOON RONALD KOEMAN ON
BEHALF THE CALIFORNIA PAN
ETHNIC HEALTH NETWORKING STRONG
SUPPORT. THANK YOU. THE NEXT
NINE TWO OH THREE. GO AHEAD
THANK YOU THANK YOU MISTER
CHAIRMAN BIRTH MEGHAN KEEPERS
ON BEHALF OF THE WRITERS GUILD
OF AMERICA WEST IN SUPPORT.
THANK YOU. THE NEXT TO GO TO
LINE TWO OH FIVE PLEASE GO
AHEAD. HAPPY COMMITTEE MEMBERS
WHO SHALL GALA ON BEHALF OF
CALIFORNIA IMMIGRANT POLICY
CENTER IN STRONG SUPPORT THANK
YOU THANK YOU. THE NEXT TO GO
TO LINE TWO OH FOUR PLEASE GO
AHEAD. I THINK YOU INTERACTION
WITH THE ASSOCIATION OF
CALIFORNIA HEALTHCARE DISTRICTS
HERE WITH AN OPPOSE UNLESS
AMENDED POSITION AND WE WITH A
LINE ARE COMMENTS MADE BY THE
TOP OF THE PAGE THANK YOU.
THANK YOU. MISTER KLEIN TWO OH
EIGHT PLEASE GO AHEAD.
AFTERNOON JANICE LAURIE ON
BEHALF OF WESTERN CENTER ON LAW
AND POVERTY IN SUPPORT OF AB
ELEVEN THIRTY. THANK YOU. THE
NEXT TO GO TO LINE ONE SEVENTY
EIGHT PLEASE GO AHEAD. IT'S A
CHAIR MEMBERS JOHN LINGER ON
THE UP AT THE BLUE CROSS
APPRECIATE THE CONVERSATIONS
AND I THINK WE HAVE SOME
TECHNICAL CONCERNS BUT WE DO
SUPPORT THE CONCEPT THANK YOU.
THANK YOU. NICE TO GO TO LINE
ONE NINETY NINE PLEASE GO AHEAD.
GOOD AFTERNOON MR CHAIRMAN
MEMBERS MECOLE FRIEDMAN ON
BEHALF OF THE CHILDREN'S
PARTNERSHIP IN SUPPORT OF AB
ELEVEN THIRTY THANK YOU. YOUR
LINE TWO OH ONE PLEASE GO AHEAD.
GOOD AFTERNOON MR CHAIRMAN RICK
THAT THE COMMITTEE WILL WRITE
NON PAYCHECK ON BEHALF OF BLUE
SHIELD OF CALIFORNIA IN SUPPORT.
THANK YOU. ONE TWO HUNDRED
PLEASE GO AHEAD. GOOD AFTERNOON
THIS IS A SPONSORED WALK UP UP
WITH THE ALLIANCE OF
CALIFORNIANS FOR COMMUNITY
EMPOWERMENT CALLING IN SUPPORT.
THANK YOU. THANKS TO GO TO LINE
ONE FIFTY ONE PLEASE GO AHEAD.
THANK YOU MISTER CHAIR THIS IS
BILL BARCELONA WITH THE
PRESENTING AMERICA'S PHYSICIAN
GROUPS IN A SUPPORT AMENDED
POSITION. THANK YOU. THANKS TO
GO TO LINE TWO OH NINE PLEASE
GO AHEAD. GOOD AFTERNOON CREDIT
UNION FROM THE CALIFORNIA
CHAMBER OF COMMERCE HERE TODAY
AND THE SUPPORT THE MEN DID
CONVENTIONAL BORDER WORKING
WITH YOU ON THAT THANK YOU.
THANK YOU. TO GO TO LINE THE
ONE TWELVE PLEASE GO AHEAD.
GOOD AFTERNOON STRUCTURE%
MEMBERS CLIENTELE COTTO ON
BEHALF OF THE DISTRICT HOSPITAL
LEADERSHIP FORUM THERE WAS AN
OPPOSE UNLESS AMENDED A MINOR
COMMENT IF U. K. THANK YOU. ONE
ONE NINETY SEVEN PLEASE GO
AHEAD. RUBIO WILL SIGN ON THE
NATIONAL MULTIPLE SCLEROSIS
SOCIETY- IN SUPPORT. THANK YOU.
NEXT TO GO TO LINE ONE EIGHTY
NINE PLEASE GO AHEAD. NICK
LEWIS WITH THE CALIFORNIA
ASSOCIATION OF HEALTH PLANS- WE
DON'T HAVE AN OFFICIAL POSITION
AT THIS TIME TO WANT TO THANK
THE CHAIR FOR ACCEPTING OUR
INPUT AND WE APPRECIATE THE
PROSPECT FOR FURTHER FEEDBACK
OPPORTUNITIES THANK YOU. THANK
YOU. THANKS AGAIN TO LINE ONE
SIXTY ONE PLEASE GO AHEAD. GOOD
AFTERNOON SHARE MEMBERS MAKING
LOVE BROWN BEHALF OF THE UNITED
HOSPITAL ASSOCIATION WITH AN
OPPOSE UNLESS AMENDED POSITION
THANK YOU. THANK YOU. THE TO
LINE ONE OH ONE PLEASE GO AHEAD.
HI THIS IS JENNIFER
MALLEABILITY CALIFORNIA LABOR
FEDERATION WE ARE IN SUPPORT OF
CEMENTED AND WE LOOK FORWARD TO
WORKING WITH DOCTOR WITH OFFICE
IN ENSURING THAT HEALTHCARE
COPTER WILL NOT ADVERSELY
AFFECT OUR HEALTH CARE WORKERS
THANK YOU. THANK YOU. THE NEXT
TO GO TO LINE ONE TWENTY ONE.
PLEASE GO AHEAD. THIS IS MERRY
MARTIN ON BEHALF OF THE
CALIFORNIA CHILDREN'S HOSPITAL
ASSOCIATION ALSO OPPOSE UNLESS
AMENDED THANK YOU. THANK YOU.
LIKE TO GO TO LINE TWO TWELVE
PLEASE GO AHEAD. I'D SAY THE
INFLUX OF JUSTICE IN AGING IN
SUPPORT OF AB ELEVEN THIRTY
THANK YOU. THANK YOU. THE NEXT
TO GO TO LINE TWO OH SEVEN
PLEASE GO AHEAD. CAN YOU HEAR
ME. WE CAN HEAR YOU. BEYOND THE
BLANKETS WITH SMALL BUSINESS
MAJORITY REPLACE REGISTRAR
SUPPORT FOR AT ELEVEN THIRTY
THANK YOU THANK YOU THANK YOU
JUST AS A REMINDER FOR THE
THOSE THAT ARE JUST TUNING IN
WE'RE ON AB. ELEVEN THIRTY ONE
WOOD AND WE'RE TAKING- I'M
SORRY I'M LOOKING AT THE WRONG
THING YES- AND ELEVEN THIRTY
NINE ELEVEN THIRTY ONE- AND-
WE'RE TAKING. ON THOSE WHO
WOULD JUST REGISTER THE NAME OF
THE ORGANIZATION AND WHAT THEY
SUPPORT OR OPPOSE THE BILL.
MISTER MODERATOR. AT THE TIME
THERE ARE NO OTHER THAN Q. WELL
THAT WAS EASY ENOUGH OF NOW
WILL COME BACK- TO THE THAT TE
COMMITTEE AND I WANT TO
RECOGNIZE- MISTER MAIENSCHEIN.
I'M NOT SURE YOU KNOW YOU'RE ON.
OKAY THANK YOU I'M SURE I'M
SUPPORTIVE OF IT YOU KNOW I OF
I THINK THAT WHERE YOU'RE
TRYING TO HATTER THE CONCEPT
BEHIND THIS I DO HAVE A FEW
QUESTIONS SO- WHAT WOULD BE
YOUR RESPONSE. ON WHETHER THIS
TIES WOULD WOULD TIE THIS INTO
SORT OF A MOMENT IN TIME AND BY
THAT I MEAN TERMS OF LET'S SAY
REPORTING RIGHT WHERE WE'D BE
TIED INTO A SORT OF STANDARDS
THAT EXIST TODAY. VERSES IN
TERMS OF TECHNOLOGY OR OTHER
THINGS MIGHT EXIST TOMORROW AND
ON THAT NOTE TO. I JUST ASK YOU
TO RESPOND TO THE POINT RAISED
AND I HAVE A FIVE QUESTION BUT-
IF THEY START HERE- THE POINT
RAISED ABOUT. THE RELATIONSHIP
WITH THE FACT THAT THEY GET
STANDARDS THAT WOULD BE SET
DOWN BY THE FEDERAL GOVERNMENT
I THINK CURRENTLY OBVIOUSLY
WERE. IT TEND TO BE IN LINE
WITH. THE CURRENT FEDERAL
ADMINISTRATION. BUT THAT MIGHT
NOT YOU KNOW BASED ON PAST
EXPERIENCE AND WHAT WE COULD
ANTICIPATE POSSIBLY IN THE
FUTURE THAT MIGHT NOT ALWAYS BE
THE CASE I'D LIKE TO GET
RESPONSES. ON ON KIND OF THOSE
TWO RELATED POINTS. WELL TO
MAKE IT TO THIS ONE FIRST AND
THEN I KIND. OF LOST YOU ON THE
FIRST OKAY FIRST ONE BUT- SO ON
THE SECOND ONE- YOU KNOW IF
THERE ARE IF THERE ARE FEDERAL
RECOMMENDATIONS AND- IT OUT
THERE- THERE ISN'T ANYTHING IN
FEDERAL LAW AT THIS POINT SO.
YOU KNOW WE AS A STATE. YOU
KNOW THE FEDERAL LAW SOMETIMES
IS THE FLOOR NOT THE CEILING
AND SO. SO WE WOULD OBVIOUSLY
NEED IF WE- IF WE WERE IN
CONFLICT WE WOULD NEED TO.
RECTIFY THAT IF WE WERE TRYING
TO BE LESS ARE MORE LENIENT
THAN THE THAN THE FEDERAL
GOVERNMENT. SO THE IDEA THAT-
AND PART OF WHAT I HEARD. IN
THE OPPOSITION TESTIMONY WAS
WELL MAYBE WE SHOULD JUST HAVE
A COMMISSION IF YOU KNOW THAT
THAT MAKES ALL THESE
RECOMMENDATIONS AND- AND THEN
SEND THOSE TO THE LEGISLATURE.
I KIND WOULD ARGUE THAT'S
WHAT'S HAPPENING NOW. AND IT'S
EXTREMELY DIFFICULT TO MOVE
THESE POLICIES BECAUSE EVERY
TIME YOU YOU YOU MOVE A POLICY
THERE'S HUGE OPPOSITION FROM
WHATEVER ENTITY IS OUT THERE.
WHO WHO MIGHT BE AFFECTED BY
THAT. SO GOING TO YOUR FIRST
QUESTION AND I APOLOGIZE FOR IT
YEAH MAYBE I WAS. SO MAY I WAS
VAGUE ON THAT WHAT WHAT WOULD
YOU RESPOND S. C. H. A. AND I
THINK SEE A MALE SOME MENTION-
BRING AT LEAST A COUPLE OF
POINTS HAVING PROPOSED SOME
SORT OF ALTERNATIVES HAVE YOU
HAD A CHANCE TO REVIEW THOSE
AND WHAT ARE YOUR THOUGHTS ON
THAT AS IT MOVES FORWARD
THROUGH THE PROCESS. WELL YEAH
AND THE AND THE ALTERNATIVE
WHICH WAS PUT FOR VICE BY CJ.
IS EXACTLY WHAT I JUST
DESCRIBED. LET'S HAVE SOME THE
COMMISSION THAT ACTUALLY LOOKS
AT THESE ISSUES AND THEN MAKES
RECOMMENDATIONS TO THE
LEGISLATURE. WE DON'T HAVE A
COMMISSION THAT DOES THAT
INSTEAD WE HAVE. AN ALPHABET
SOUP GROUP OF. ADVOCATES OUT
THERE THAT DO THAT NOW PRESENT
US WITH IDEAS WE RUN WITH THEM.
AND YOU KNOW HERE WE ARE WITH
SKYROCKETING HEALTH CARE PRICES
SO. SO IT THAT SYSTEM ISN'T
WORKING AS WELL AS WE WOULD
LIKE TO SEE IT. AS FAR AS THE
U. U. S. ABOUT LIKE A SNAPSHOT
IN TIME. YOU KNOW WE HAVE WE'RE
SENSITIVE. TO THE FACT THAT
WE'RE IN THE MIDDLE OF A
PANDEMIC AND SO. SO WE
RECOGNIZE THAT WE COULDN'T SET
TARGETS OR OR GOALS. BASED ON
WHERE WE ARE NOW. BUT WE CAN
CERTAINLY GATHER DATA AND
INFORMATION ABOUT WHAT'S GOING
ON OUT THERE. AND THEN WHEN WE-
GOD WILLING OR IN A BETTER
SITUATION OUT THERE WILL HAVE A
WAY TO BEGIN TO KICK TO
TABULATE THE DATA. FUTURE DATA
AND THAT WE CAN WORK WITH- OUT
THERE AND- AND BASE THINGS ON
ON THAT. THE IDEA OF BEING
CREATING CREATING GOALS. OKAY
NEEDED RIGHT THAT I WAS
ACTUALLY RESPONSE TO WHAT HE
DID UNDERSTAND WHY SAMI BUT
SAID NO THAT'S WHAT I WAS KIND
OF GETTING OUT WAS. YOU KNOW
THAT PARTICULAR THIS YEAR
OBVIOUSLY WOULD BE AN
ABERRATION ON A WHOLE. HOST OF
LEVELS. THE WAY THE WAY THE WAY
THE BILL'S BEEN AMENDED IT'S
GONNA BE TWENTY TWENTY SIX.
YEAH I WON'T BE HERE. WELL I
MIGHT ADD ON. THE WAY OUT THE
DOOR IT DOESN'T HIT ME. NOW
OKAY THANK YOU I APPRECIATE
YOUR ON THIS AND YOU KNOW
CERTAINLY WILL WANT TO KEEP.
WORKING WITH YOU ASSESSMENT FOR
BUT THANK YOU FOR YOUR RESPONSE
HAS BEEN GREAT THANK YOU.
THEMES RANGE SIGN ANYBODY ELSE
SO QUESTIONS GONE- MISTER
NAZARIAN. THANK YOU MISTER
CHAIR. MISTER CHECK THANK YOU
SO MUCH FOR BRINGING THIS BILL
FORWARD I. WILL SUPPORT IT. AND
I'M LOOKING FORWARD TO SEEING
IT MOVE FORWARD- MY ONLY
CONCERN AND I BRIEFLY BROUGHT
THIS UP. TO YOU JUST TODAY WAS
ABOUT THE FACT THAT. THE HOW
THIS BILL. POTENTIALLY IMPACTS
SOME OF THE CHILDREN'S
HOSPITALS AROUND THE STATE
GIVEN THE ONE THE IMPORTANT
WORK THAT THEY DO GIVEN THE
SAFETY NET THAT THEY PROVIDE-
MY CONCERN WOULD BE THAT. I
THINK THE REGULAR HOSPITALS CAN
WORK THROUGH AND FIGURE IT OUT
BUT THE CHILDREN'S HOSPITALS
GIVEN THE SENSITIVE COMMUNITIES
THAT THE ADDRESS- THAT THAT'S
WHERE I HAD SOME CONCERNS AND
WOULD LOVE TO HEAR FROM YOU ON
THAT. THANK YOU WELL I THINK
THANKYOU FOR THAT QUESTION IS
MISTERS ERIN AND WHAT WE
ENVISION IS ACTUALLY SUB
SECTORS YOU KNOW HOSPITALS
WOULD BE A SECTOR AND
SUBSECTORS RECOGNIZING. THE
CRITICAL IMPORTANCE OF. OF
CHILDREN'S HOSPITALS CRITICAL
IMPORTANCE OF ARE YOU SEE
HOSPITALS OUR OUR OUR OUR OUR
OUR COMMUNITY HOSPITALS AS WELL
SO THAT THERE WOULD NOT BE A
ONE SIZE FITS ALL APPROACH TO
ALL HOSPITALS WANT TO
RECOGNIZE. THAT THERE ARE
SETTINGS LIKE CHILDREN'S
HOSPITALS AND TEACHING
HOSPITALS THAT HAVE HIGHER
COSTS IN THERE. THEY DID THEY
JUST TAKE MORE TO RUN AND WE
RECOGNIZE THAT AND SO WE WOULD
ENVISION THESE B. B.'S BEING IN
SUB SECTORS BUT WE DON'T
ENVISION AND EXEMPTING. BECAUSE
I STILL BELIEVE THAT THERE IS
POTENTIAL FOR SAVINGS THROUGH
EFFICIENCIES AND ELIMINATION OF
WASTE. LOOKS IS THE MISTER
NAZARIAN IS COMPLETED HIS.
COMMENTS ANY FURTHER QUESTIONS
OR COMMENTS- MISS BURKE. I AM I
MIGHT I JUST WANT TO BE ADDED
AS A CO AUTHOR AND JUST WANT TO
PUT THAT ON THE RECORD. THANK
YOU WE HAVE HAPPY TO HAVE YOU.
MISS AGUIAR-CURRY. DID SHE
WOULD BE OUT OF A CO AUTHOR AS
WELL. YEAH ANY ANY FURTHER
QUESTIONS OR COMMENTS I JUST
HAVE ONE WANTED TO. A TO ASK
YOU A DOCTOR WOULD IT WAS
BROUGHT UP ACTUALLY THE
OPPOSITION TALKING ABOUT NO THE
NAME OF THIS IS- THE OFFICE OF
HEALTH CARE AFFORDABILITY. AND
IT WAS- SAID THAT THIS WOULDN'T
LOOK AT ALL AT ANY LABOR COSTS
OR ANY OTHER COSTS- LIKE- THE
EARTHQUAKE PRIME INSTANT AND SO
FORTH. IS THIS LIMITED IN ANY
WAY AND TALKING ABOUT
AFFORDABILITY OR OR WHAT WILL
THIS OF THIS OFFICE TO BE ABLE
TO DIG INTO ANYTHING THAT IS
GOING TO CREATE COST. WE
ENVISION BROAD AUTHORITY AND WE
VISITED A ROBUST WORKING GROUP
OF ADVISORS THAT CAN LOOK AT
LOOK AT LOOK AT EVERYTHING. AND
RECOGNIZING YOU KNOW EARTHQUAKE
SEISMIC IS IT IS AN ISSUE AND
OTHER THINGS ARE ISSUE SO WE
EMBRACE ENVISIONED THIS AS IS
FAIRLY BROAD IN ITS IN ITS
APPROACH. GREAT ALL RIGHT BACK
ABOUT THE COMMITTEE. WE HAVE A
MOTION ON THIS BILL AND WITH A
COUPLE- SO BUT AMID MOTION BY
DURING THE SECOND BY MISS BURKE.
SORRY MISTER NAZARIAN MADE THE
MOTION THE SPARK A SECOND WITH
THAT CARD PLEASE- PLEASE CALL
THE ROLL THANK YOU I'M SORRY
WANNA CLOSE. WE DON'T MIND IT
LIKE THE KILLERS I LIKE TO
CLOSE BY READING SOMETHING AND
I FIRST WANT TO THANK THE
COMMITTEE FOR THEIR QUESTIONS
OR COMMENTS I WANT TO THANK THE
WITNESSES. FOR THEIR QUESTIONS
COMMENTS BUT I WANT TO READ TO
YOU THIS CAME OUT TODAY.
CALIFORNIA HEALTH CARE
FOUNDATION BLOG AND IT'S
ENTITLED ALIGNING HEALTH CARE
COSTS GROWTH WITH ECONOMIC
GROWTH WOULD SAVE CALIFORNIA
BILLIONS THAT'S BILLIONS WITH
A- B. SO I'M GONNA READ THIS
BECAUSE I THINK IT'S
SIGNIFICANT. FORTUNATELY THEY
FIND THE RIGHT. READ IF I CAN
FIND IT. IF CALIFORNIA SETS AND
ACHIEVES A COST GROWTH TARGET
LIKE THOSE WE'RE STARTING TO
SEE IN OTHER PARTS OF THE
COUNTRY. THERE IS A CHARGE
ASSOCIATED WITH HIS AND I'M
HAPPY TO ROVIDE YOU THE LINKS
AS CAT THE FOCUS- I CAN FIND IT
I APOLOGIZE. I REALLY HATE IT
WHEN THINGS ARE PRINTED ON BOTH
SIDES. OKAY HERE WE GO. HERE%
IS A CHART HERE BUT BUT THE
POINT OF THIS IS BETWEEN TWO
THOUSAND AND NINE TWO THOUSAND
AND NINE IN TWO THOUSAND
FOURTEEN PER CAPITA GROWTH IN
HEALTHCARE SPENDING IN
CALIFORNIA GREW AT A COMPOUNDED
COUNTED ANNUAL GROWTH RATE OF
4% EXCEEDING THE THREE POINT
SIX COMPOUNDED ANNUAL GROWTH
RATE IN THE STATE'S OVERALL
ECONOMY. THAT'S ONLY A POINT 4%
DIFFERENCE SINCE THEN WE KNOW
THAT THAT NUMBER IS ACTUALLY
MUCH BIGGER IN FROM TWO
THOUSAND AND FOURTEEN OUT. IT'S
GROWING AT MUCH HIGHER RATE
THAN POINT 4% BUT EVEN IF AT
THAT POINT 4% IF WE IF WE HAD
SOME TARGETS HERE HAD
CALIFORNIA CHIEF HEALTHCARE
COST GROWTH IN LINE WITH
ECONOMIC GROWTH IN LINE WITH
ECONOMIC GROWTH. CONSUMERS AND
TAX EIGHT PAIRS WOULD HAVE
SAVED NEARLY FIFTY SIX BILLION
DOLLARS. WITH FOUR POINT POINT
4% OR ALMOST 5% OF THE TOTAL
HEALTH CARE SPENDING IN THE
PERIOD. THIS REPRESENTS A
MEANINGFUL AND ACHIEVABLE
PORTION OF THE STAGGERING 2225%
OF WASTE. THE EXPERTS FOUND IN
THE SYSTEM SO I'M NOT TRYING TO
BE PUNITIVE HERE I'M TRYING TO
GET PEOPLE THE ACTS TO WORK
SMARTER BE MORE EFFICIENT.
ELIMINATE WASTE. AND REDUCE THE
GROWTH IN IN THE COST OF HEALTH
CARE. WITH THAT I RESPECTFULLY
ASK YOUR IBM. I THINK WE DO
HAVE A MOTION A SECOND CAR
PLEASE CALL THE ROLL. THE
MOTION IS. TO PASS AS AMENDED
TO APPROPRIATIONS WOULD. HI
WHAT I MAYES HI MAYES AYE
AGUIAR-CURRY. AGUIAR-CURRY AYE
BIGELOW. BIGELOW NONVOTING.
BONTA. BONTA AYE BURKE BURKE I
CARILLO. HI FLORA. FLORIDA
VOTING MAIENSCHEIN MAIENSCHEIN
AYE MCCARTY MCCARTY AYE
NAZARIAN NAZARIAN AYE RIVAS
RIVERSIDE RODRIGUEZ RODRIGUEZ I
SANTIAGO. WALDRON. ELEVEN ZERO
ELEVEN ZERO YOUR BILL IS OUT.
ARE MOVING ON TO- ITEM- THE
ITEM NUMBER I CAN SEE THE
NUMBER ITEM NUMBER TWENTY AB
ELEVEN THIRTY ONE A DOCTOR
WOULD. THANK YOU VERY MUCH
MISTER CHAIR. AB ELEVEN THIRTY
ONE ADDRESSES THE GAPS IN THE
EXISTING HEALTH INFORMATION
EXCHANGE INFRASTRUCTURE AND
INFRASTRUCTURE THAT IS
INCONSISTENT AND INCOMPLETE.
THERE ARE DIFFERENT ELECTRONIC
HEALTH RECORD SYSTEMS AND
ALMOST EVERY HOSPITAL AND
CLINIC HAS A SIT SLIGHTLY
DIFFERENT SYSTEM TAILORED TO
ITS OWN NEEDS. THE FUTURE OF
HEALTH INFORMATION EXCHANGES
CAN HELP VACCINE SCHEDULING BUT
IT CAN ALSO COLLECT IMPORTANT
DATA ON DEMOGRAPHICS TO MAKE
SURE THAT THE LIMITED VACCINE
SUPPLIES ACTUALLY REACHING THE
HARDEST HIT COMMUNITIES
EQUITABLY. YOU WILL HEAR THAT
THIS BILL IS UNNECESSARY
BECAUSE OF FEDERAL LAW EFFORTS.
AB ELEVEN THIRTY ONE WILL
LEVERAGE AND SUPPLEMENT FEDERAL
EFFORTS AND WILL PROVIDE THE
DATA INFRASTRUCTURE NEEDED TO
MEET CALIFORNIA'S HEALTH CARE
ACCESS. EQUITY AFFORDABILITY
PUBLIC HEALTH AND QUALITY GOALS
WITH ME IN SUPPORT TODAY ARE
ABNER MASON WHO WILL SPEAK. AS
TO HOW A STATEWIDE HEALTH
INFORMATION EXCHANGE WILL
SUPPORT CALIFORNIA'S EQUITY
EFFORTS IN IN IN IN ANNA RAMSEY
AN INDIVIDUAL WHO CAN I SPEAK
WHO CAN SPEAK TO HER PERSONAL
EXPERIENCE. MOVED TO THE FIRST-
TESTIMONY IN SUPPORT. A GOOD
AFTERNOON ADD TO THE CHAIR AND
COMMITTEE MEMBERS MY NAME IS
THAT MAKE THAT I FOUNDER AND
CEO COMPLAIN ABOUT- I THINK
HAVING GATE MET AND NAVIGATION
COMPANY HEADQUARTERED IN LOS
ANGELES. I'M NOT ON THE BORDER
THE CALIFORNIA BLACK HEALTH
NETWORK AND I'M A MEMBER OF THE
CONNECTING FOR BETTER HEALTH
COALITION WHICH REPRESENTS A
DIVERSE GROUP OF THE HEALTHCARE
LEADERS AND STAKEHOLDERS THAT
AIMS TO ADVANCE CALIFORNIA
HEALTH INFORMATION EXCHANGE THE
POLICY. I'M HERE TODAY TO SPEAK
IN FAVOR OF- OF AB ELEVEN
THIRTY ONE I CAN THINK OF
DONALD WORKS WITH PROVIDERS AND
HEALTH PLANS GOVERNMENT
PROGRAMS SUCH AS MEDICARE AND
MEDICAID SO EMPLOYERS OTHER
PARTNERS TO GIVE THEIR MEMBERS
THE NEW LEVEL OF LINGUISTICALLY
AND CULTURALLY TAILORED CARE.
BECAUSE WHAT FAR TOO MANY
PATIENTS- THEY'RE LEFT BEHIND
BECAUSE THE SYSTEM IS OVERLY
COMPLICATED AND PERSONAL NOW
HAVING DIFFERENT COMMUNITY
APPROACHES THE MEETING HEALTH
NEEDS OF NATURAL AND ACTUALLY
IT'S A BEAUTIFUL THING BUT OUR
COMMUNITIES HAVING DIFFERENT
HEALTH OUTCOMES IS NOT
ACCEPTABLE. THESE KINDS OF
RACIAL ETHNIC AND INCOME
RELATED HEALTH DISPARITIES. ARE
THE GAPS I WORK EVERY DAY TO
CLOSE. I NEED LOOK NO THAN
COVERED LIKE PANDA THIS. THIS
AT IN. THE ROOT CAUSE OF THE BY
THE RABBIT COMMUNITIES OF. A
COMMUNITY ABOUT THAT EMAIL IS A
BILL. AND TRACKING WHICH
PATIENT RECEIVED. ONE TO FOUR
FOUR ZERO THROUGH THE- THANK.
COME WHOLE PERSON CARE. WHICH
REQUIRE DATA. GOOD HEALTH DATA
WE CAN TRACK THE NEEDS OF A
LATINO MAN BETWEEN THE AGES OF
FORTY AND FIFTY FIVE LIVING IN
SOUTHERN CALIFORNIA AND FOR
EXAMPLE. HOW TO ADDRESS THE
SUSPICION THEY MAY HAVE ABOUT
THE KOBE NINETEEN BACK CLEAN.
BUT IN CALIFORNIA WE DO NOT
HAVE GOOD ACCESS TO HEALTH DATA.
THAT'S BECAUSE HEALTH DATA IF.
AND THE PATCHWORK OF INDIVIDUAL
HEALTH NETWORK HOSPITALS AND
PROVIDE. YOU DELIVER THE WHOLE
PERSON CARE WE BELIEVE IT'S
CRITICAL WE NEED A STATE BY THE
HEALTH INFORMATION NETWORK THAT
BREAK DOWN BARRIERS AND ALLOWS
US TO HAVE ALL THE NECESSARY
DATA AVAILABLE TO WORK. IN A
SECURE WAY. UNDER AB ELEVEN
THIRTY ONE THE STATE WIDE INTO
YOU NETWORK WITH HAVE RULE
MAKING AUTHORITY. CHILDREN
INNOVATIVE PROGRAMS ARE NOT
CAUGHT IN RED TAPE THAT THEY
ARE AND THEY ARE NOW WAITING ON
AUTHORIZATION FROM STATE
AGENCIES TO PROVIDE CORRECT
CRITICAL DATA. WE NEED TO
DELIVER EXCELLENT CARE.
ADDITIONALLY AB ELEVEN THIRTY
ONE UNDER THIS BILL THE STATE
WOULD WIDELY DELEGATE THE
ACTIVITY I TO AN OPERATING
ENTITY AN OPERATING ENTITY
WOULD HAVE MORE LATITUDE THAN
THE STATE TO NEGOTIATE- AND
MANAGE CONTRACTS WITH MULTIPLE
VENDORS. AND HAVE CRITICAL
INDUSTRY AT THE EXPERIENCE AND
EXPERTISE WITH WHICH THE THINK
THE NOT HAVE. THIS IS A PART OF
THE BILL IS INCREDIBLY
IMPORTANT AND WILL GREATLY
IMPROVE ITS EFFICACY. THERE HAD
NEVER BEEN A MORE CRITICAL
MOMENT FOR CALIFORNIA TO BUILD
A STATEWIDE HEALTH INFORMATION
NETWORK WHICH WILL EMPOWER
ORGANIZATIONS LIKE MINE. AND
THE MANY OTHERS WHO ARE TODAY-
UNABLE TO PARTICIPATE IN AND
MEANINGFUL DATA EXCHANGE THAT
ALLOW US TO FULLY SERVE THE
HEALTH NEEDS OF ERIC OF EVERY
CALIFORNIA. I URGE YOU TO VOTE
YET BUT MAYBE. ELEVEN THIRTY
ONE. THANK YOU. THANK YOU SO.
AND WILL MOVE TO THE SECOND
SECOND ONE IS TO PROVIDE
TESTIMONY SUPPORT. GOOD
AFTERNOON MY NAME IS ANNA I'M
TWENTY FOUR AND I LIVE IN LOS
ANGELES. I KNOW FROM PERSONAL
EXPERIENCE AS SOMEONE WITH A
RARE AUTOIMMUNE DISORDER HOW
URGENTLY WE NEED TO BUILD
TRUST. AND MEANINGFUL DATA
EXCHANGE THAT BENEFITS
PATIENTS. I HAVE JUVENILE
DERMATOMYOSITIS OR JDM FOR
CHILDREN AND YOUNG ADULTS LIKE
MYSELF WHO HAVE JDM SIMPLE
THINGS LIKE WALKING AND HANGING
OUT WITH FRIENDS IS EXHAUSTING.
BECAUSE OF JDM I DEVELOPED
ARTHRITIS IN MY KNEES AND HIPS.
MAKING EVERY STEP I TAKE
DIFFICULT I EVEN HAD TO GO ON
CHEMOTHERAPY DURING HIGH SCHOOL
AND AT THE BEGINNING OF
COLLEGE. THIS LEFT ME
CONSTANTLY FATIGUED AND IN PAIN
SIMPLY SETTING UP NEXT YEAR WAS
CHALLENGING LET ALONE GETTING
THROUGH A FULL DAY OF WORK OR
SCHOOL. ON TOP OF IT ALL I WAS
EXPECTED TO MANAGE MY MEDICAL
RECORDS WHEN I COULD BARELY
MANAGE GETTING OUT OF BED. AT
MY DISEASE PROGRESSED SO TOO
DID THE DOCTORS SAID THAT
TREATMENT AND MEDICATIONS I HAD
TO KEEP TRACK OF. ALL
COMMUNICATIONS BETWEEN MY
DOCTOR'S REMAIN STRAINED OR
NONEXISTENT. I ENDED UP WITH
HUGE BINDERS FULL OF MEDICAL
RECORDS BUT I STILL KEEP TO
THIS DAY. I NEED MY HEALTHCARE
PROVIDERS TO HELP ME HEAL NOT
ADD MORE TO MY PLATE. MY
BIGGEST CONCERN IS GETTING IN
SOME SORT OF ACCIDENT THAT
LEADS ME IN THE ER UNCONSCIOUS.
WITHOUT ACCESS TO MY RECORDS NO
ONE WOULD KNOW ABOUT MY
COMPLICATED HISTORY OR HOW TO
GET ME BACK TO HEALTH. ALL OF
THIS PRESSURE CAN'T BE ON
PATIENTS AND THEIR FAMILIES.
OUR FOCUS SHOULD BE ON HEALING.
WE THIS WONDERFUL IN FRONT OF
YOU YOUR AN AWKWARD. TO STAND
UP FOR THE MANY THOUSANDS OF
PATIENTS LIKE ME. WHO
UNFORTUNATELY HAVE A LIFE
ALTERING DISORDER BUT DON'T
WANT OUR ENTIRE LIVES TO BE
DEFINED BY IT. BUILDING A
HEALTH DATA HIGHWAY THAT IS
AUTHORIZED BY THE STATE WOULD
GIVE ME THE REASSURANCE AND
THEN THE MARGIN SEE A PROVIDER
CAN SAVE MY LIFE. RIGHT NOW I
DON'T HAVE THAT REASSURANCE. AT
ELEVEN THIRTY ONE IT'S HOW WE
GET THERE. AT THE SAME TIME IF
I NEED TO SEE DIFFERENT
PROVIDERS ACROSS MULTIPLE
NETWORKS TO GET NECESSARY CARE.
THE BURDEN OF RECORD KEEPING
FALLS ON ME AND MY CARE GIVERS.
BECAUSE NO MATTER HOW HARD I
TRY TO BE PROVIDERS WERE ABLE
TO CONSULT TOGETHER. THEY DON'T
SHARE ONE DATA NETWORK. MY
HEALTH INFORMATION IS NOT
REGULARLY SHARED OR MADE
READILY AVAILABLE TO ALL THOSE
WHO NEED IT. AB ELEVEN THIRTY
ONE WOULD ENSURE UNIVERSAL
PARTICIPATION. CLOSING THE GAP
BETWEEN NETWORK AND LIFTING THE
BURDEN OF COLLECTING
INTERPRETING AND SHARING DATA.
OFF OF MY SHOULDERS. I URGE YOU
TO VOTE YES ON AB ELEVEN THIRTY
ONE TODAY TO STAND UP FOR THE
HEALTH AND SAFETY. OF EVERY
CALIFORNIANS THANK YOU. THANK
YOU AND- NOW WILL MOVE- TO-
THOSE ARE GONNA PROVIDE
TESTIMONY IN OPPOSITION. GO TO
THE FIRST. ONE GOOD AFTERNOON
MISTER CHAIR NUMBERS MARIA
SPERBER ON BEHALF OF THE
CALIFORNIA HOSPITAL ASSOCIATION
AND AN OPPOSE UNLESS AMENDED
POSITION I WOULD LIKE TO THANK
YOU AND YOUR OFFICE FOR THE
ONGOING CONVERSATION AND
CONSIDERATION OF THE PUBLIC
HEALTH USE CASE ALTERNATIVE WE
SHARED LAST WEEK. THANK YOU WE
TO BELIEVE A STRONG SECURE
EXCHANGE OF HEALTH INFORMATION
DATA CAN BE A POWERFUL TOOL TO
IMPROVE HEALTH CARE OUTCOMES
REDUCE REDUNDANT TESTING AND
LOWER HEALTHCARE COSTS OVERALL
AND HOSPITALS RECOGNIZE THE
GREAT VALUE IN THIS DISCUSSION
IN FACT FEATURING SHARES THE
OVER ARCHING GOAL OF A BROAD.
RICH EXCHANGE OF HEALTH
INFORMATION HOWEVER THE SHARED
GOALS ARE BEST TO COME
ACCOMPLISHED BY LEVERAGING
CURRENT NETWORKS ALIGNING WITH
THE FEDERAL REGULATIONS AND
IMPROVING THE PUBLIC HEALTH
INFRASTRUCTURE AND WOULD BE ILL
SERVED BY BUILDING A NEW
CENTRALIZED STATEWIDE DATA
REPOSITORY. MANY HOSPITALS AND
SYSTEMS REGIONAL HEALTH
INFORMATION ORGANIZATION
PRIVATE VENDORS AND OTHERS IN
CALIFORNIA CURRENTLY EXCHANGE
HEALTH INFORMATION SECURELY AND
PRIVATELY THANKS TO SIGNIFICANT
INVESTMENTS MADE IN THE LAST
DECADE THAT ALLOW FOR THE
SHARING OF CLINICAL RECORDS
WITHIN THEIR OWN SYSTEM AND
WITH EACH OTHER. EFFORTS AT THE
STATE AND FEDERAL LEVEL TO
ENHANCE INFORMATION EXCHANGE
ARE UNDER WAY AND PROVIDE A
FORWARD LOOKING PATH FOR
CALIFORNIA BUT ONLY IF
STANDARDS ARE DEVELOPED THAT.
STANDARDS AND SAFEGUARDS SHOULD
GOVERN SHARING OF PATIENT
HEALTH INFORMATION STANDARDS
ARE NECESSARY TO ENSURE PARTY
CHANGING HEALTH INFORMATION CAN
EFFECTIVELY SEND AND RECEIVE
INFORMATION. TO THAT END THE
CALIFORNIA HOSPITAL ASSOCIATION
RECOMMENDS THAT CALIFORNIA
FOCUSED ON MODERNIZING THE
CURRENT PUBLIC HEALTH
INFORMATION TECHNOLOGY
INFRASTRUCTURE AND TO ENHANCE
THE EXISTING CAPABILITY TO
COLLECT ANALYZE AND DISSEMINATE
INFORMATION UP THE SCALE NEEDED
TO TALK ABOUT PUBLIC HEALTH AND
EQUITY CHALLENGES. WE LOOK
FORWARD TO WORKING WITH THE
COMMITTEE AS YOU WORK TO
ENHANCE PATIENT CARE AND
IMPROVE PUBLIC HEALTH IN EQUITY
WITHOUT SACRIFICING PATIENT
RIGHT AND PRIVATELY. WITH US
TODAY AND CHRIS MAHER CHIEF
INFORMATION OFFICER AND
ASSOCIATE CHIEF MEDICAL OFFICER
FOR QUALITY AND SAFETY AT THE
UNIVERSITY OF CALIFORNIA SAN
DIEGO TO GET MORE CONTACT IN A
COMPLICATED ISSUE. THANK YOU.
THANK YOU SO THAT SECOND NOW
WITNESSED PROVIDE OPPOSITION.
VERY MUCH MARIA I APPRECIATE
THE OPPORTUNITY TO SPEAK WITH
THE FIFTEEN DIFFERENT- MY NAME
IS DR LONGHURST I'M WITH THE
UNIVERSITY CALIFORNIA SAN DIEGO
HEALTH. ALSO HERE SUPPORTING
CALIFORNIA HOSPITAL ASSOCIATION
OPPOSITION UNLESS AMENDMENTS
THIS BILL- I WANT TO SHARE WITH
YOU A STORY OVER THE LAST
DECADE BECAUSEOF THE
PRACTICING PEDIATRICIAN I'VE
WITNESSED THIS FIRSTHAND AS
WELL TO HELP ADDRESS SOME OF
THESE ISSUES. IS AN INFORMATION
TECHNOLOGY PROFESSOR. IN TWO
THOUSAND TWO I ADMITTED HA-
CHILD LUCILLE PACKARD
CHILDREN'S HOSPITAL SHORTLY
AFTER WE SWITCHED ELECTRONIC
HEALTH RECORD VENDORS TO A NEW
INTEROPERABLE PLATFORM. THIS
CHILD WAS SIX MONTHS OLD AND-
PRESENTED WITH SEIZURES. AND
THE PARENTS WERE NOT MEDICAL
SKILLED WORK FROM NORTH
CAROLINA AND NEW ONLY THAT
THEIR CHILD HAD A HOLE IN THE
CAR. THEY DIDN'T KNOW WHAT
MEDICATION- NAMES THAT THE
CHILD SHOULD BE TAKEN DIDN'T
KNOW ANY OF THE RECENT EXAMS
ARE STUDIES- THE SWITCHING OF
OUR ELECTRONIC HEALTH RECORD
PLATFORM. IT WOULD HAVE TAKEN A
DAY OR TWO TO GET OUTSIDE
RECORDS AND WE WOULD HAVE
REPEATED A LOT OF THOSE- EXAMS.
BUT BECAUSE OF OUR RECENT
TRANSITION I WAS ABLE TO
DOWNLOAD FROM THE UNIVERSITY OF
NORTH CAROLINA. IN ABOUT TWENTY
SECONDS RECORDS OF THE LAST ACT
OF CARD AGREE ON PEDIATRIC
CARDIOLOGY DOES THAT. INSIDE OF
GENETIC STUDIES SENDING BOTH
UNNECESSARY- PEOPLE KEPT ASKING
AND ALSO PROVIDING BETTER CARE
THAN THOSE INDIVIDUAL. BUT WITH
THE EXCEPTION IN TWO THOUSAND
TWELVE BUT BY TWO THOUSAND
SIXTEEN I PUBLISHED A STUDY
WITH COLLEAGUES ACROSS NORTHERN
CALIFORNIA. SHOWING THAT WE
WERE EXCHANGING MILLIONS OF
RECORDS ACROSS TWELVE HEALTH
SYSTEMS IN NORTHERN CALIFORNIA
MANY OF WHICH COMPETED WITH
EACH OTHER LIKE SUTTER KAISER.
UC SAN FRANCISCO STANFORD
WASHINGTON HOSPITAL. UC DAVIS
AND OTHERS. IN TWO THOUSAND
NINETEEN YES HE SAID DIEGO TWO.
ALL OF THEIR STUDENT HOW
RECORDS. BE INTEROPERABLE. THAT
THE SYSTEM. AND 98% OF OUR-
STUDENT NOW OUT HELP
INFORMATION AVAILABLE TO THE
PROVIDERS CARING FOR THEM. SO
THE FEDERAL STANDARDS THAT HAVE
MADE THE CALL POSSIBLE ARE
WORKING AND THEY'RE WORKING
WELL AND THEN THEY CAN BOTH
PRIVACY AND SECURITY.
CENTRALIZING DATA IS NOT THE
SOLUTION IT IS AN INCREASE
CYBER STERN REST. WITHOUT MUCH
ADDED BENEFITS. I'VE BEEN AT
THE HEART OF THE CODE NINETEEN
VACCINATION EFFORTS THAT
ASSEMBLY SPEAKER DOCTOR WOULD
LOOK THINKING ABOUT. AND WE
HAVE A LOT OF DATA WE DON'T
HAVE THE NECESSARY
INFRASTRUCTURE THE PUBLIC HELP
LEVEL. FOR THE APPROPRIATE
ANALYSIS THERE BETTER WAYS TO
ADDRESS PERFECT FINALLY WANT TO
WRAP UP BY MENTIONING. THAT I
TREATED UNCONSCIOUS PATIENTS IN
THE EMERGENCY DEPARTMENT LIKE
THE YOUNG WOMAN TESTIFIED ABOUT
HER. JUVENILE DERMATOMYOSITIS.
AND INCREASINGLY THESE PATIENTS
HAVE OUTSIDE HELP INFORMATION
AVAILABLE BECAUSE OF THESE
FEDERAL STANDARDS. SO I REALLY
DON'T THINK THAT WE NEED TO
DUPLICATE THE EXISTING FEDERAL
INFRASTRUCTURE WHAT WE NEED TO
DO WITH THE MODERNIZE. THE
STATE INFRASTRUCTURE FOR PUBLIC
HEALTH. WHICH HAS BEEN WOEFULLY
LACKING AND THE DATA IS THERE
WE WILL NOW ASSESS THE
TECHNOLOGY- WILL SUPPORT IT BUT
WE NEED TO INVEST IN RESOURCES
AND SMART MINES TO ANALYZE. IT
THANK YOU FOR THIS OPPORTUNITY.
THANK YOU SO MUCH NUMBER TO
MOVE- TO ADAM ARE GONNA TO
THOSE WOULD BE- IN SOME. OR OUR-
BUT JUST YOUR NAME YOUR
ORGANIZATION AND YOUR POSITION.
MISTER MODERATOR. EMBLAZONED
GERMAN IF YOU'RE IN SUPPORT OR
OPPOSITION PLEASE PRESS ONE
ZERO AT THIS TIME. AGAIN ONE
ZERO FOR SUPPORT OR OPPOSITION.
AND AT THIS TIME IT LOOKS LIKE
WE HAVE ABOUT EIGHT IN Q. OKAY.
IT'S GOOD THE FIRST. WE'LL
START WITH LINE TWO OH TWO
PLEASE GO AHEAD. GOOD AFTERNOON
RONALD KOEMAN HERE ON BEHALF OF
THE CALIFORNIA PAN ETHNIC
HEALTH NETWORK HERE IN SUPPORT.
THANK YOU. NEXT WE'LL GO TO
LINE TWO SEVENTEEN PLEASE GO
AHEAD. GOOD AFTERNOON THAT WAS
A ON BEHALF AS THE ARE YOU
CALIFORNIA IN STRONG SUPPORT.
THANK YOU. NEXT GO TO LINE ONE
SEVENTY EIGHT PLEASE GO AHEAD.
ONE SEVENTY EIGHT YOUR LINE IS
OPEN. MOVE ON TO LINE TWO OH
ONE TWO OH ONE PLEASE GO AHEAD.
GOOD AFTERNOON MEDICARE MEMBERS
OF THE COMMITTEE LARA KNOWING
HE TOOK ON BEHALF OF BLUE
SHIELD OF CALIFORNIA IN STRONG
SUPPORT. THANK YOU. IT COULD BE
LINE ONE EIGHTY FIVE PLEASE GO
AHEAD. THANK YOU TREAT THE
START WITH KAISER PERMANENTE
HEY WE ARE CURRENTLY OPPOSED TO
THE MEASURE BUT WE LOOK FORWARD
TO CONTINUING OUR CONVERSATIONS
WITH YOU MISTER CHAIRMAN AS WE
DO SHARE MANY OF YOUR CALL
THANK YOU. THANK YOU. NEXT TO
THE LINE TO THIRTEEN PLEASE GO
AHEAD. CLICK HERE TERM MEMBER
SERVICE ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA
HEALTHCARE DISTRICT WITH AN
OPPOSE UNLESS AMENDED POSITION
THANK YOU. THANK YOU. X. WILL
BE ALIGNED TO TEN PLEASE GO
AHEAD. GOOD AFTERNOON THANK YOU
INSULIN PECTIN I'M CALLING ON
THE CARE GIVER UNDETECTED
SECONDED IN A BOARD DIRECTOR
FOR THE NONPROFIT FAMILY
CAREGIVER ALLIANCE I'M CALLING
TODAY THOUGH TO REGISTER MY
PERSONAL SUPPORT MAYBE ELEVEN
THIRTY ONE IN A RESPECTFULLY
REQUEST. YOUR RIVALS THANK YOU
THANK YOU. NEXT WILL BE LINE TO
SIXTEEN PLEASE GO AHEAD. HELLO
ON BEHALF OF UNITE HERE THE
HOTEL AND CASINO WORKERS UNION
IN SUPPORT OF THE MEASURE THANK
YOU. THANK YOU. THINK ABOUT
ACCOUNTABILITY LINE. GOODNESS
MATTER YES- YES NEXT TO BE
LINED- ONE FIFTY THREE PLEASE
GO AHEAD. CLAUDIA WILLIAMS FROM
MANIFEST NOT ACT AND I'M
CALLING IN SUPPORT. THANK YOU.
NEXT TO BE LINED ONE NINETY SIX
PLEASE GO AHEAD. KAREN MEMBERS
CATALINA SANCHEZ THE CORBIN AND
PASTOR ON BEHALF OF THE
ELECTRONIC FRONTIER FOUNDATION
ALTHOUGH OUR POSITION IS NOT
REFLECTED IN THE ANALYSIS WE
ARE ANY OPPOSE DOCUMENTED
POSITION IT IS NOT YET CLEAR
HOW PUBLIC HEALTH DATA IN
RESPONSE BECAUSE THE NINETEEN
PANDEMIC HAS BEEN SHARED WE
LOOK FORWARD TO WORKING WITH
THE AUTHOR AND STAKEHOLDERS. TO
CONSTRUCT THEIR GUIDELINES IS
THAT IT CHANGES SO MUCH AND I
THANK YOU SO MUCH JUST YOUR
NAME YOUR ORGANIZATION AND YOUR
POSITION THANK YOU. THE NEXT WE
WILL OUTLINE ONE SIXTY SEVEN
PLEASE GO AHEAD. AND HILLARY
WITH THE CALIFORNIA MEDICAL
ASSOCIATION WERE SORT OF IN THE
OTHER CATEGORIES WE DO STRONGLY
SUPPORT THE WHITE IN OUR
OPERABILITY OF HEALTH DATA BUT
WE'RE CONCERNED THAT THE
MEASURE FAILED TO PROVIDE
RESOURCES FOR SMALL PRACTICES
ARE AND YOU FACING GREAT I. P.
IN EQUITY COULD CONNECT. THANK
YOU THANK YOU. NEXT WE HAVE
LINE ONE OH ONE PLEASE GO AHEAD.
HI THIS IS JENNIFER MAY ONLY
WITH THE CALIFORNIA LABOR
FEDERATION IN COURT THANK YOU.
AND WE HAVE LINE ONE SEVENTY
EIGHT PLEASE GO AHEAD. HI ONE
SEVENTY EIGHT PLEASE MAKE SURE
NOT A MU. I'VE NEVER GIVEN IT.
IT'S THAT IS THAT IT. BUT
ANYBODY ELSE. ALL RIGHT HEARING
NONE WILL COME BACK TO THE
COMMITTEE IT LOOKS LIKE- MISTER
FLORA IS READY TO GO SOME MR
FOR THANK YOU MISTER CHAIR
MISTER CHAIR- JUST HAD A
MINERAL COUPLE QUESTIONS OF THE
ONE I THINK YOU CAN ADDRESS
BUT- HOW CAN WE ENSURE THAT
THERE IS LIKE A COMPETITIVE BID
PROCESS TO THIS NEW HIV. AND I
THINK- ONCE A CONTRACTOR HAS
BEEN CHOSEN. TO DO THIS- HOW IS
IT FUNDED AND WHO'S GOING TO
MAINTAIN THE COST OF THAT H.
ID. HOW THE FUNDED THROUGH THE
STATE. FIRST OF ALL WE DO
ENVISION- AND RFP PROCESS SO
THERE WOULD BE AN OPEN BID FOR
THIS. AND AS FAR AS HOW WE HOW
WE FUND THIS- WHERE. WE'RE
WORKING WE'RE WORKING ON THIS-
I WILL SAY THAT THAT IN
GENERAL- A LOT OF HEALTH
INFORMATION. ORGANIZATIONS AND
SUCH ARE GETTING SIGNIFICANT
FUND THAT HAVE GOTTEN
SIGNIFICANT FEDERAL RESERVE-
FEDERAL SUPPORT FOR THESE
INITIATIVES AND SO I. DO
ENVISION. THAT THERE WOULD BE
SIGNIFICANT FEDERAL FEDERAL
SUPPORT AS WELL. AND WE'RE
STILL LOOKING AT AT HOW HOW WE
FUND THIS- INITIALLY WHAT WE'RE
TRYING TO DO THIS THIS BILL IS
NOT ABOUT HOW WE FUND IT LONG
TERM. IT'S ABOUT HOW IS THE
CONCEPT OF BUILDING THIS THING-
AND THEN FROM THERE WE WILL WE
WILL LOOK TO DRAW DOWN
SIGNIFICANT FEDERAL FUNDING TO.
FOR THE OPERATIONS AND
CONSTRUCTION. AWESOME AND THEN
SINCE I MEAN THERE ARE SOME
CONCERNS THAT THIS IS CURRENTLY
PLAGUE OF THERE'S ALREADY A AN
H. ID OUT THERE- WHAT DO WE
HAVE SAY LIKE. I MEAN AS FAR AS
IS THERE ANY THINGS ONCE IT.
PUT IN PLACE. THAT WE CAN
PROTECT AGAINST OVERLAY AND
LIKE CONFLICTING DATA LIKE IS
EVERYTHING IN PLACE TO MAKE
SURE THAT WE HAVE ONE. HIV
THAT'S HANDLING ALL OF THIS IS
THAT OF A- A DUPLICATE OF
SYSTEM. WELL THAT'S THAT'S THE
GOAL IS TO GET HAVE SOMETHING
THAT ISN'T DUPLICATIVE- I WOULD
COUNTER THAT THE OPPOSITION
SAYING THAT YOU KNOW THAT THAT
WE GOT GOOD COVERAGE OUT THERE.
THE BAY AREA RIGHT NOW HAS A
SIGNIFICANT AMOUNT OF WHITE
SPACE WHICH MEANS. IN MY WHICH
MEANS. THAT THERE'S NO COVERAGE
AT ALL THERE- AND THE RELIANCE
ON FEDERAL NETWORKS DOESN'T
NECESSARILY SUPPORT. WHAT GOES
ON IN INDIVIDUAL COMMUNITIES.
SO I APPRECIATE LIKE DOCTOR
LONG HERS HAD A GREAT EXAMPLE
HOW HOW HE THEY WERE ABLE TO
TALK TO SOMEBODY IN NORTH
CAROLINA. WELL NOT. EVERY
SYSTEM AS ALLOWS ALLOWS FOR
THAT IF THAT WAS THE CASE. I
WOULDN'T BE HERE WITH THIS BILL
TODAY- THERE THERE ARE. A
WHOLE. MYRIAD OF DIFFERENT
DIFFERENT PROVIDERS OUT THERE.
IF WE CAN FIND A WAY TO GET
EVERYBODY FEEDING INFORMATION
TO THE SAME PLACE. AND BE ABLE
TO. BE ABLE TO DISSEMINATE THAT
INFORMATION IN A TIMELY. MANNER
THEN THEN THEN WE WHICH OUR
GOAL. I LOVE IT I THINK THAT A-
AN ARGUMENT ABOUT THE
IMPORTANCE OF AN OFFICE
BUILDING I MEAN WE NEED THAT
RIGHT NOW UP AND DOWN THE STATE
A LOT OF DIFFERENT WAYS AND SO
IF WE CAN GET THERE WITH THIS-
I'M EXCITED ABOUT THIS. I DO
THINK THERE ARE SOME CONCERNS
AND I LOOK FORWARD TO WORKING
WITH YOU THROUGH THIS AND I-
TRUSTED CHILDRESS'S CONCERTS
PROCEDURE. THANK YOU. HE WAS
FOR A- ANY OTHER QUESTIONS OR
COMMENTS. I THOUGHT THAT MISS
KOREA WAS JUST ABOUT TO JUMP IN
BUT MAYBE MAYBE MAYBE NOT. ALL
RIGHT WELL I JUST WANTED TO
SAY- JUST ONE QUICK THING I AM
ACTUALLY SENT OUT EARLY- WITH
THE CHAIR TO THE AUTHOR- THIS
THIS BILL NOT FULLY
UNDERSTANDING- TO BE FAIR WHAT
AT WHAT ALL WENT INTO A HEALTH
INFORMATION EXCHANGE. BUT IT
DOES SEEM TO ME THAT A STATE
LIKE CALIFORNIA THAT WE SHOULD
BE ABLE TO PUT. SOMETHING
TOGETHER WHERE ALL OF OUR
SYSTEMS ARE TALKING TO EACH
OTHER IN AN EFFICIENT EFFICIENT
WAY INITIALLY WHEN I WAS
EXPLAINING WHY SIGNED ONTO
RIGHT AWAY- I SAID YOU KNOW
JUST LIKE THE INTERNET
INTERSTATE. HIGHWAY SYSTEM WE
NEED TO MAKE SURE THAT THERE IS
THE ROLE OF GOVERNMENT THAT
HAVE ONE CITY IN ANOTHER CITY
OR NEXT TO EACH OTHER THAT WE
HAVE A ROAD THAT CONNECTS AND
THAT IT WORKS- WHEN IT WHEN
THEY WHEN THEY CONNECT. AND
SOMEBODY EXPLAIN TO ME WELL
THAT'S A GOOD ANALOGY BUT THE
PROBLEM IS WE HAVE THAT NETWORK
WHAT WE REALLY NEED IS WE NEED
CARS WE NEED PROVIDERS. AND
WHILE I BELIEVE THAT MIGHT BE
TRUE I WAS READING THROUGH SOME
OF THE OPPOSITION LETTERS AND I
NOTICED ONE OF THE OPPOSITION
LETTERS FROM A VERY VERY LARGE-
NETWORK- PRIDING THEMSELVES ON
COMMUNICATING WITH- WITH- JUST
A FEW THOUSAND OTHER FOLKS- AND
I THOUGHT TO MYSELF. WELL THERE
ARE A LOT MORE PROVIDERS- OVER
THE COURSE OF THE YEAR THE JUST
A FEW A FEW THOUSAND WHICH THAT
SAYS TO ME AS AN AWFUL LOT OF
WORK THAT NEEDS TO BE DONE. I
TO BE ABLE TO SHARE INFORMATION
WE'RE TALKING ABOUT SAVING
PEOPLE'S LIVES WERE WERE THEY
WERE THEY WERE TALKING ABOUT
HAVING A SYSTEM TO BUILD A
REDUCE HEALTHCARE COSTS- AND
FOR THAT REASON I KNOW THIS
WORK ISN'T YET DONE ARE STILL A
LOT MORE TO DO. AT THIS IS THE
FIRST- COMMITTEE HEARING- IT'S
GOT A LONG WAY TO GO TO GET TO
THE PROCESS AND I'M LOOKING
FORWARD. TO WORKING WITH- WITH
DOCTOR WOULD THE CHAIRMAN- AS
IT AS IT GOES THROUGH THE
LEGISLATIVE PROCESS TO MAKE
SURE THAT WE HAVE A GREAT GREAT
PRODUCT IT LOOKS LIKE-
MISCREANTS GOT INSPIRATION-
IT'S HOME GOING TO. TURN TO
MISS CARILLO THANK THANK YOU
MISTER CHAIR. AND APOLOGIES I
WAS PRESENTING AND ANOTHER ON A
OTHER BUILDING ANOTHER. WITHIN
QUITE SURE BILL THIS WAS BY-
YOU HAVE A THIRTY ONE- I'M
REALLY GRATEFUL TO YOU DOCTOR
WOULD FOR BRINGING THIS BILL
FORWARD- AS I MENTIONED TO YOU.
BEFORE IT'S IT SEEMS LIKE. WE
HAVE A BETTER WAY TO TRACK A
FED EX PACKAGE OR SOMETHING
THAT GETS DELIVERED. ACROSS THE
COUNTRY THEN WE DO AN IN
TRACKING THE HEALTH CARE NEEDS
OF. EVERYDAY PEOPLE WHO ARE
DESERVING OF HEALTH CARE IN OUR
STATE. SO I'M I'M HAPPY TO BE
SUPPORTIVE AND I WOULD LOVE TO
AUTHOR CO AUTHOR WITH YOU. WHEN
THE APPROPRIATE TIME- IS.
DURING THE APPROPRIATE TIME.
AND THANK YOU AGAIN FOR
BRINGING THIS MUCH NEEDED
ACCOUNTABILITY TRANSPARENCY-
EFFORT TO ENSURE THAT WHERE
EVER YOU LIVE IN THE STATE.
WHATEVER TYPE OF HEALTH CARE
YOU HAVE THAT WE ARE CREATING
THE TYPE OF SYSTEM. THAT
ENSURES THAT. WE CAN FOLLOW THE
HEALTH CARE NEEDS OF EVERY
INDIVIDUAL ACROSS CALIFORNIA
THANK YOU. WELL SEEING IT NO
OTHER COMMITTEE MATTER WITH
THIS IS TO SPEAK OR TO ASK
QUESTIONS SO DOCTOR WOULD LIKE
TO CLOSE. THANK YOU I WOULD AND
I WANT TO THANK YOU MEMBERS FOR
YOUR QUESTIONS AND I WANT TO
THANK THE- SUPPORTERS AND THE
OPPOSITION FOR THEIR THEIR
COMMENTS AND I I'VE I VERY MUCH
APPRECIATED. THERE ARE INDEED A
LOT OF NETWORKS OUT THERE AND I
THINK THE BEST WAY TO DESCRIBE
WAS A GARB OR VICE CHAIR HERE
DESCRIBE IT IS THAT THEY JUST
THEY'RE OUT THERE BUT THEY'RE
NOT ALL COMMUNICATING WITH WELL
WITH ONE ANOTHER. I DIDN'T COME
TO THIS OVERNIGHT WE'VE HAD
HEARINGS ON THIS WE'VE ACTUALLY
HAD A COUPLE HEARINGS ON THIS.
END WHERE I FIRST GOT STARTED
THINKING ABOUT THIS IS ABOUT
THREE YEARS AGO I WAS MEETING
WITH SOME EMERGENCY ROOM
DOCTORS- HOSPITAL NOT FAR FROM
HERE. TWENTY FIVE MILES. IS
NEAR IS A MILE FROM ANOTHER
HOSPITAL. AND IF SOMEBODY GOES
FROM ONE HOSPITAL TO THE NEXT
HOSPITAL. THEY CAN'T
COMMUNICATE THEIR DATA SYSTEMS
.COM DON'T DON'T CONNECT. SO
HOW DO THEY COMMUNICATE WITH
THE TELEPHONE AND A FAX
MACHINE. I TALKED TO A LARGE
SYSTEM IN SOUTHERN CALIFORNIA
AND I SAID SO HOW DO YOU
COMMUNICATE THERE ARE SOME OF
THE BIG PLAYERS OUT THERE SO
WILL ONE OF THE PEOPLE WE
COMMUNICATE WITH. IS WITH THE
TELEPHONE AND A FAX MACHINE AND
AS I THINK I THOUGHT ABOUT THAT
WE CAN FOCUS IS REMINDS ME OF A
PRINCE SONG YOU KNOW FEEL LIKE
WE'RE GONNAPARTY LIKE IT'S
NINETEEN NINETY NINE HERE. IT'S
TWENTY TWENTY ONE FOR CRYING
OUT LOUD WE NEED TO MOVE
FORWARD ON THIS AND WE WITH
THERE IS OPPORTUNITY TO
LEVERAGE FEDERAL RESOURCES OUT
THERE. AND I'M I'M AT LEAST
HAPPY TO HEAR THAT THE
OPPOSITION. RECOGNIZES THE NEED
FOR PUBLIC HEALTH
INFRASTRUCTURE THAT'S A PART OF
IT BECAUSE WE NEED TO
UNDERSTAND WHAT'S GOING ON OUT
THERE SO WE CAN WE CAN DO WE
CAN WORK WITH EQUITIES WE CAN
GET THINGS TO COMMUNITIES THAT
ABSOLUTELY NEED TO. KNOW SOME
PLAYERS IN OUR HEALTH SYSTEM
YOU KNOW HAVE A PERSPECTIVE
THAT THE RECORDS ARE SOMEHOW
THEIR INFORMATION. THEY'RE NOT
THE RECORD IS THE PATIENTS
INFORMATION AND THE PROVIDER IS
THE CUSTODIAN OF THAT. IN THE
SOMETIMES I AND I KNOW THIS TO
BE THE CASE. THAT SOME OF THE
OPPOSITION. THE REASON THEY
HAVE HIS PERSPECTIVE. IS THAT
THIS SYSTEM THEY HAVE PROTECT
THEIR BUSINESS MODEL NOW WHAT
WE SHOULD BE ASKED WE SHOULD BE
ASKING IS WILL BE THE BEST
SYSTEM FOR THE PATIENT. EASING
COORDINATION OF TREATMENT AS WE
HEARD FROM THE WITNESS THE
PATIENT WITNESS. AS WELL AS UP
TO THE STATE INTO IN TERMS OF
CHEATING OR PUBLIC A PUBLIC
HEALTH OBJECTIVES. HAVING
PATIENTS INFORMATION IN REAL
TIME CAN HELP THE STATE BETTER
RESPOND TO EMERGENCY
SITUATIONS- LIKE COVE IT. LIKE
POTENTIALLY WILDFIRES. IN THE
PANDEMIC THAT WE'VE SEEN NOW SO
I RESPECTFULLY ASK YOUR ABOUT.
THANK YOU RIGHT. THANK YOU FOR
YOUR CLOTHES DR WORD- DO WE
HAVE A MOTION ON THIS. I DON'T
REMEMBER THAT WE DID- MISS
AGUIAR-CURRY AND MISS REAVIS
SECONDS- WITH THAT THE MAN
BURKE WOULD YOU A CALL THE ROLL.
THE MOTION IS THE PAST TWO
APPROPRIATIONS WHAT I WOULD AYE
MAYES HI MAYES AYE
AGUIAR-CURRY. THANK YOU VERY
AYE BIGELOW. BIGELOW NARROW
BONTA. BURKE. CARILLO CARILLO
AYE FLORA LAURA HI MAIENSCHEIN
MAIENSCHEIN AYE MCCARTY MCCARTY
AYE NAZARIAN NAZARIAN AYE RIVAS.
RIVERSIDE RODRIGUEZ RODRIGUEZ I
SANTIAGO SANTIAGO AYE WALDRON.
TWELVE ELEVEN ONE. THANK YOU
VERY MUCH BEFORE WE MOVE ON TO
OUR FINAL BILL I JUST WANT TO
AGAIN I HAVE TO GO BACK SUBMIT
AN ERROR EARLIER MENTIONED
THAT- SO I NEED TO CORRECT THE
MOTION ON A. B. SIX THIRTY
EIGHT AND THE MOTION THE MOTION
SHOULD HAVE BEEN DO PASS TO
APPROPRIATIONS INSTEAD OF DO
PASS AS AMENDED SO HOPE THE
RECORD CAN NOW REFLECT THE
CORRECT MOTION SIR WE'LL HAVE
THAT TO THE LIST OF THINGS I.
MADE A MISTAKE ON TODAY. SO
WITH THAT BEFORE I MAKE ANY
MORE MISTAKES- LIKE TO MOVE TO-
ASSEMBLY MEMBER CARILLO AB.
FOUR SEVENTY. THANK YOU MR
CHAIRMAN MEMBERS TIME
PREVENTING AB FOR SEVENTY WHICH
ALLOWS LOW INCOME SENIORS AND
PEOPLE WITH DISABILITIES WHO
ARE MOST AT RISK OF COVER
NINETEEN TO ACCESS HEALTH CARE
SERVICES WHILE MAINTAINING.
THEIR DIGNITY AND FINANCIAL
STABILITY BY ELIMINATING THE
OUTDATED MEDICAL ASSETS TEST
THANK YOU MEMBERS. AS WE ALL
KNOW THE CURRENT MEDICAL OFFICE
LIMITS WRONGFULLY PREVENT
SENIORS FROM HAVING ADEQUATE
RESOURCES TO WHETHER A CRISIS
SUCH AN EVICTION A LEAKING ROOF
FOR MAJOR. VEHICLE REPAIR ONCE
AN ADULT TURN SIXTY FIVE AND
BECOMES MEDICARE ELIGIBLE THEIR
MEDICAL ELIGIBILITY IS
DETERMINED BY THIS RESTRICTIVE.
SET OF RULES THAT REQUIRES THEM
TO HAVE MINIMAL ASSETS TO
REMAIN ELIGIBLE. THE UNINTENDED
RESULT IS THE PEOPLE WHO WANT
TO REMAIN MEDICAL ELIGIBLE TO.
DEPLETE ALL OF THE RESOURCES TO
CONTINUE RECEIVING BENEFITS I
WOULD LIKE TO SHARE THE STORY
OF AN OLDER ADULTS WHO HAVE AN
ANNUAL INCOME OF SEVEN THOUSAND
SIX HUNDRED WHICH IS UNDER THE
NON. AB MEDICAL CAL INCOME
LIMIT- NON MHDI. UNFORTUNATELY
THIS SEVENTY FIVE YEAR OLD
WOMAN IT'S UNABLE TO QUALIFY
FOR MEDICAL DURING THE PANDEMIC
BECAUSE SHE TOOK A REVERSE
MORTGAGE. ON HER HOME TO PAY
FOR BASIC NECESSITIES AND TO
MAKE. ESSENTIAL HOME REPAIRS
THIS REVERSE MORTGAGE COMBINED
WITH HER EXISTING ASSETS
TOTALED. TO ABOUT TWENTY TWO
THOUSAND DOLLARS. CONSECUTIVELY
TO SQUALLY HER DISQUALIFYING
HER FOR MEDICAL SERVICES UNDER
THE CURRENT ASSETS LIMIT AND
LEAVING HER WITH ONLY ONE
VIABLE OPTION. SPEND DOWN HER
MONEY TO TWO THOUSAND AS SOON
AS POSSIBLE. THIS IS JUST ONE
OF MANY STORIES INDIVIDUALS
FACING. SUCH CHALLENGES
ANTIQUATED POLICIES LIKE THE
MEDICAL AFTER TEST NOT ONLY
PUTS INDIVIDUALS IN SUCH
COMPROMISING POSITIONS BUT IT
ALSO EXACERBATES. INEQUITY. FOR
EXAMPLE MY PRIMARY RESIDENT IS
EXEMPT IS AN EXEMPT ASSET BUT
CASH SAVINGS IS COUNTED THIS
MAY SOUND LIKE A NEUTRAL POLICY
CHOICE BUT THERE ARE LARGE
DISPARITIES. IN RATES OF
HOMEOWNERSHIP MEANING THAT IT
IS MUCH HARDER FOR HISPANIC OR
LATINO OR BLACK CALIFORNIANS TO
ACCESS MEDICAL ADDITIONALLY THE
ACID TEST PREVENT. LOW INCOME
PEOPLE OF COLOR FROM AMASSING
ANY WHILE TO TRANSFER TO THEIR
CHILDREN THIS WIDENING THE
INTERGENERATIONAL WEALTH
TRANSFER AMONGST PEOPLE OF
COLOR. WE'RE LIVING DURING A
TIME OR OLDER ADULTS WITH
PERSONS AND PERSONS WITH
DISABILITIES ARE FACING HIGHER
RISK OF COVER NINETEEN
COMPLICATIONS. IT IS
PARTICULARLY IMPORTANT THE
MEDICAL PROGRAMS TO NOT IMPOSE
ADDITIONAL BARRIERS TO ENTRY I
WOULD LIKE TO THANK THE
COMMITTEE STAFF. FOR WORKING
WITH MY OFFICE ON THIS ISSUE.
AND LOOK FORWARD TO CONTINUING
TO WORK WITH ALL STAKEHOLDERS
AS THE BILL MOVES FORWARD
AVAILABLE TO TESTIFY ON THE
PHONE OR MISTER JOSEPH STILL
LEANING. AND MISS CLEAR AROUND
THING WITH JUSTICE IN AGING.
THANK YOU VERY MUCH MR OPERATOR
PLEASE OPEN THE PHONE LINES FOR
WITNESSES. INDIA LINES ARE OPEN
FOR THEM. HELLO YES PLEASE GO
AHEAD YES WE CAN HEAR YOU.
JOSEPH DELANEY. HI JOSEPH
GIULINI EIGHTY TWO I'M FROM LOS
ANGELES ONE DIALYSIS WAS DENIED
MEDICAL BECAUSE OF ASSETS. I'M
BELOW POVERTY LEVEL INCOME
MONTHLY I HAVE TO DIP INTO
SAVINGS MONTHLY TO MAKE ENDS
MEET I PAY ONE FORTY EIGHT
FIFTY A MONTH FOR MEDICARE PART
B. MEDI CAL WOULD PAY THAT. AND
CLEANING SERVICES. PROVIDE
DEPLETE MY SERVICES MY SAVINGS.
I WOULD HAVE TO ABANDON MY CAR
BECAUSE OF REPAIRS INSURANCE. I
WOULD LOSE MY INDEPENDENCE AND
REGRESSED TO A LESS THAN NORMAL
LIFE. WE'LL BE NEEDING A NEW
CAR SHORTLY. BUT DEPLETE MY
SAVINGS KEEP THE CAR I WOULD
LOSE MY APARTMENT AND BECOME
HOMELESS. BUT LOSE MY SAVINGS I
WOULD LOSE A NEST EGG FOR
NURSING HOME INCLUDES EMERGENCY
FUNDS. THIS COULD ALL BE
RESOLVED IF I HAD MEDICARE
HEALTH MEDICARE WOULD PAY THE
ONE FORTY EIGHT FIFTY A MONTH
FOR MEDICARE PART B. THANK YOU.
THANK YOU VERY MUCH WE'LL MOVE
ON TO OUR NEXT WITNESS PLEASE.
THANK YOU MISTER WARD DR WHAT
EXCUSE ME AND MEMBERS MY NAME
IS CLAIRE RAMSEY AND I'M A
SENIOR STAFF ATTORNEY WITH
JUSTICE IN AGING. WE'RE PROUD
CO SPONSOR ALONG WITH WESTERN
CENTER ON LAW AND POVERTY A
BABY FOR SEVENTY. I'M THANKFUL
THAT MR TRULY NEED TO SHARE
WITH YOU HOW THE MEDICAL ASPECT
AT DIRECTLY AND NEGATIVELY
AFFECTS THE FLIGHT. WHICH TO
EASY PRETTY COMPLICATED POLICY
THE BILL MARKETS AND PERSONAL.
BUT BY ELIMINATING AFTER
CONSULTING AND PEOPLE WITH
DISABILITIES CALIFORNIA CAN
TRULY A POSITIVELY IMPROVE
PEOPLE'S LIVES. ONLY BECAUSE
THAT IN FOUR MAJOR WAGE. FIRST
IT CREEK PARITY IN OUR MEDIC
HEALTH PROGRAM. THE VAST
MAJORITY OF MEDICARE
RECIPIENTS. TEN POINT FIVE
MILLION CALIFORNIANS DO NOT
HAVE TO MEET AN ACID TEST AT
ALL. HOWEVER EVERY ADULTS SIXTY
FIVE AND OVER AND MANY PEOPLE
WITH DISABILITIES ARE STILL
REQUIRED TO ENSURE THAT THEY
HAVE LEFT IN TWO THOUSAND
DOLLARS IN COUNTABLE ASSETS.
FIFTEEN SUGGESTED YOU REACH A
POINT IN YOUR LIFE FOR YOUR
INCOME MAY BECOME SIX. OVER YOU
MAY WANT TO HAVE TO STOP
WORKING YOU MUST REDUCE YOUR
ASSETS TO LEVELS THAT NINETEEN
EIGHTY NINE. AND THEN ENSURE
YOU NEVER PAID MORE THAN THAT.
BECAUSE IF YOU DO YOU WILL LOSE
MEDIC COW. SECOND THE BILL
ADVANCES RACIAL AT. SURPRISING
THE ROLE OF QUITE ALL ADULTS.
HOWEVER BECAUSE OF THE THREE
DIFFERENT THAT ACCERN ARE.
DEGREE A PER PRIMARY BUT IS
EXACTLY THE TO DOLLARS. A
RECENT SURVEY SHOWS RACIAL GAPS
IN HOMEOWNERSHIP IN
TEMPERATURES GO 61% OF WHITE
RESIDENTS ON HOME BUT ONLY 33%
OF BLACK RESIDENTS DO IN LA
IT'S 58% TO THIRTY THREE
PERCENT. MEANS A WHITE PERSON
WITH A LOW INCOME OF A MILLION
DOLLAR HOME WILL BE ELIGIBLE
FOR MEDICARE NOW AND A BLACK
PERSON AT THE SAME INCOME IN
TWO THOUSAND ONE DOLLARS IN THE
BANK WILL NOT. ELIMINATING THE
LIMIT THE STATE WOULD TAKE A
BIG STEP FORWARD TOWARD
RACIALLY. EQUITABLE ACCESS AND
THAT ACCOUNT. THIRD TWO
THOUSAND FIVE ADMINISTRATION OF
THE MEDICAID PROGRAM. RIGHT NOW
OLDER ADULTS AND PEOPLE WITH
DISABILITIES MUST DOCUMENT AND
PROVE THEIR ASSETS WHEN THEY
APPLIED AND EVERY YEAR AFTER TO
STAY INVOLVED IN THAT ACCOUNT.
WE WILL PREPARE BUSINESS
PROCESS ALL THIS PAPER AND
REVIEW EVERYTHING WILL PAY TO
ENSURE COMPLIANCE. THIS IS
BURDENS AND FOR EVERYONE. EVERY
ADMINISTRATIVE BURDEN AND
COMPLICATION IN OUR MEDICAL
PROGRAM DIRECTLY LEADS TO SOME
PEOPLE. BEING DENIED OR LOSING
THEIR MEDIC CAL. FOUR ONE. IT
ENHANCE FINANCE STABILITY
SENIORS AND PEOPLE WITH
DISABILITIES. FOR MANY PEOPLE
AFFORDABLE HEALTHCARE IS MORE
IMPORTANT THAN ALMOST ANYTHING
ELSE. PEOPLE ARE TOLD THEY CAN
ONLY HAVE TWO THOUSAND DOLLARS
IF THEY WANT TO QUALIFY FOR
MEDICAID BE RATIONALLY
SPEND DOWN. EVEN THOUGH THIS
MAY BE THE ONLY MONEY THEY
SAVED OVER THE WHOLE LIFETIME
IN A CACHE OF A LIFE INSURANCE
POLICY THEY PAID INTO FOR YEARS
AND YEARS. THEY MAY SELL THE
MUCH NEEDED HARD BECAUSE THEY
CAN'T AFFORD TO MAINTAIN IT
WITHOUT MARKETING. IN SHORT
THEY'RE FORCED TO MAKE BAD INTO
STABILIZE FINANCIAL DECISIONS
JUST SO THEY CAN HAVE
AFFORDABLE HEALTHCARE. BUT WE
LIMIT THE MEDICAL ASPECT HAS
BEEN PEOPLE CAN KEEP THEIR HARD
EARNED SAVINGS CAN STAY HOW CAN
FIX. THEIR CAR AND STILL HAVE
NOT ACCOUNT. FOR ALL THESE
REASONS I COULD YOU EITHER ON
EIGHTY FOUR SEVEN. THANK YOU
EVERYONE ELSE THINK ASSEMBLY
CLEO FOR HER PASSIONATE THE-
THIS. THANK YOU. THANK YOU VERY
MUCH- MR OF MODERATOR PLEASE
OPEN TE PHONE LINES WILL BE
TAKING A PUBLIC COMMENT- JUST
YOUR NAME POSITION AND ANY
ORGANIZATION YOU MIGHT BELONG
TO SO WHENEVER YOU'RE READY
MISTER MODERATOR. AND LINDEMANN
IF YOU'RE IN SUPPORT OR
OPPOSITION PLEASE PRESS ONE
ZERO AT THIS TIME. THE N. ONE
ZERO FOUR SUPPORT OR OPPOSITION.
AND AT THIS TIME IT LOOKS LIKE
WE HAVE ABOUT EIGHT IN Q. VERY
WELL GO AHEAD WHEN YOU'RE READY
SIR. ABSOLUTELY WE'LL START
WITH LINE ONE EIGHTY ONE PLEASE
GO AHEAD. MISTER CHAIR MEMBERS
TERAFLOPS ON BEHALF OF THAT
CALIFORNIA PAN ETHNIC HEALTH
MAY BACK NETWORK IN SUPPORT
THANK YOU VERY MUCH NEXT CALLER
PLEASE. NEXT WILL BE GOING TO
WIND TWO OH EIGHT PLEASE GO
AHEAD. GOOD EVENING JANET CORY
FROM WESTERN CENTER ON LAW AND
POVERTY PROUD CO SPONSORS IN
SUPPORT. THANK YOU VERY MUCH
NEXT CALLER PLEASE. NEXT WILL
BE LINE TO NINETEEN PLEASE GO
AHEAD. MISTER CHAIR MEMBERS OF
THE COMMITTEE PRESS MAY NOT BE
HAPPEN. OUTPACED THE PROGRAM
FOR ALL INCLUSIVE CARE FOR THE
ELDERLY IN SUPPORT OF AB FOUR
SEVENTY. THANK YOU NEXT CALLER
PLEASE. NEXT WILL BE ALIGNED TO
TWENTY PLEASE GO AHEAD. THANK
YOU MISTER CHAIR AND EIGHT AM
TO EIGHT PM ON BEHALF OF A DAY
YOU CALIFORNIA IN SUPPORT.
THANK YOU VERY MUCH NEXT CALLER
PLEASE. X. WILL BE ONE ONE
NINETY PLEASE GO AHEAD. KELLY
BROOK BOBBIE HALF OF THE COUNTY
WELFARE DIRECTORS ASSOCIATION
IN SUPPORT THANK YOU NEXT
CALLER PLEASE. NEXT WE'LL GO TO
LINE ONE A ONE PLEASE GO AHEAD.
HELLO JENNIFER MALLEY FOR THE
CALIFORNIA LABOR FEDERATION IN
SUPPORT. THANK YOU VERY MUCH
NEXT CALLER PLEASE. NEXT WILL
BE LINE ONE NINETY FOUR PLEASE
GO AHEAD. CORRECT YOU MISTER
COMMITTEE MEMBERS BECAUSE THEY
TORRENT ON BEHALF OF HEALTH
ACTIVE CALIFORNIA IN SUPPORT
THANK YOU VERY MUCH NEXT CALLER
PLEASE. EXELBY TWO TO ONE
PLEASE GO AHEAD. BY THE OVER
THE SPOT AND ON THE NATIONAL
MULTIPLE SCLEROSIS SOCIETY IN
SUPPORT. THANK YOU VERY MUCH
NEXT CALLER PLEASE. NEXT WILL
BE LINE TWO TWO TWO PLEASE GO
AHEAD. HI DURING THE GROUP ON
BEHALF OF THE CALIFORNIA DENTAL
ASSOCIATION IN SUPPORT THANK
YOU NEXT CALLER PLEASE. THANKS
TO BE ALIGNED ONE NINETY ONE
PLEASE GO AHEAD. ALL POLL
REPRESENTING CALIFORNIA RURAL
LEGAL ASSISTANCE FOUNDATION IN
SUPPORT. THANK YOU VERY MUCH
NEXT CALLER PLEASE. ONCE AGAIN
IF YOU'RE IN SUPPORT OR
OPPOSITION PLEASE PRESS ONE
ZERO AT THIS TIME. AT THIS TIME
WE HAVE NO FURTHER IN Q. PLEASE
CONTINUE MISTER CHAIR THANK YOU
VERY MUCH WILL BRING IT BACK TO
THE COMMITTEE- QUESTIONS OR
COMMENTS FROM THE COMMITTEE.
SEEING NONE WHICH I LIKE TO
CLOSE MISCREANT. THANK YOU
MISTER CHAIR THIS IS NOT THE
FIRST TIME THAT WE BRING UP
THIS BILL WE WILL CONTINUE TO
BRING UP THIS BILL UNTIL IT
GETS DONE THIS IS AN ISSUE
ABOUT PARITY AND EQUITY AND
ENSURING HEALTHCARE ACCESS TO
OUR MOST VULNERABLE COMMUNITY
MEMBERS INCLUDING. SENIORS
THIS'LL BE ELIMINATING THE
ASSETS LIMITS CREATES PARITY
BETWEEN MEDICAL PROGRAMS AND
ALLOWS LOW INCOME PEOPLE TO
QUALIFY FOR MEDI CAL WHILE
SIMULTANEOUSLY GIVING THEM THE
OPPORTUNITY TO SAVE MONEY TO
PAY THEIR BILLS TO DO HOME
REPAIRS TO SIMPLY BILL THEIR
EMERGENCY FUNDS IN PREPARATION
FOR ECONOMIC AND HEALTH CRISIS
IS THIS IS NOT. ROCKET SCIENCE
THIS IS AN OPPORTUNITY FOR US
TO BE ABLE TO DO WHAT IS RIGHT
WHAT IS JUST AND WHAT IS
NECESSARY FOR PEOPLE THAT
DESERVE A HEALTH CARE NO ONE
SHOULD BE FORCED TO CHOOSE
BETWEEN MEDICAL ELIGIBILITY AND
PAYING FOR EVERYDAY BASIC HUMAN
NEEDS AND I RESPECTFULLY
REQUEST AN AYE VOTE. THANK YOU
VERY MUCH YOU DID YOU DID
ACCEPT OUR AMENDMENTS OR WILL
YOU ACCEPT AMENDMENTS YES I
WILL ACCEPT YOUR MOMENT THANK
YOU THANK YOU. THANK YOU VERY
MUCH AND I WOULD JUST LIKE TO
SAY YOU KNOW THAT THE BILL DOES
ENJOY DO PASS RECOMMENDATION-
IF I AND I'VE ALREADY A CO
AUTHOR IF I CO AUTHORED AGAIN I
DO IT- YOU KNOW PEOPLE MY NAME
ON THERE TWICE GREAT. BUT I
THINK IT'S A VERY IMPORTANT
BILL AND I THINK IT'S HIGH
TIME. AND SO OBVIOUSLY WE HAVE
A DO PASS RECOMMENDATION. I
BELIEVE WE HAVE A MOTION BY
MISTER BIGELOW. NO NOT AND IT
WAS A DIFFERENT BILL A MISS
BURKE. DIRECT MAYBE IT WAS A
DIFFERENT BILL THAT I'M I WAS
AT AN OLD TEXT MESSAGE DOES ANY.
OKAY THE- THEY CAME FROM OVER
THE- ALL RIGHT RIGHT STOP
FIGHTING PLEASE IT'S LATE IN
THE DAY ALL RIGHT MS BURKE OF A
MUCH OF A MISS BURKE A SECOND
BY MISS AGUIAR-CURRY MOTION IS
DUE PASS AS AMENDED TO
APPROPRIATIONS- MADAM SECRETARY
PLEASE CALL THE ROLL. WOOD I
WOULD HI MAYES. AGUIAR-CURRY
AGUIAR-CURRY AYE BIGELOW
BIGELOW NOT VOTING. BONTA BURKE
HI CARILLO. HI FLORA.
MAIENSCHEIN MAIENSCHEIN HI RT
MCCARTY I'M NAZARIAN NAZARIAN I
REQUEST. RIVAS HI RODRIGUEZ
RODRIGUEZ I SANTIAGO. WALDRON.
NINE ZERO THANK YOU VERY MUCH
WE DO HAVE A COUPLE BILLS ON
CALL AND THEN WE'LL WE'LL RUN
THROUGH THE ENTIRE LIST SO- OF
THE WHAT AND LEAVE THE ROLL UP
IN FOR- AB FOUR SEVENTY SO AB
THREE FORTY SEVEN ARAMBULA
PLEASE OPEN THE ROLE AND CALL
THE ABSENT MEMBERS. BIGELOW
BIGELOW NOW WATER. MAIENSCHEIN.
I DON'T WANT AB THREE FORTY
SEVEN. MAIENSCHEIN I RIVAS.
RIVAS AYE RODRIGUEZ. RODRIGUEZ.
YES BY. RODRIGUEZ I SANTIAGO
WALDRON. TEN ONE. THANK YOU
VERY MUCH WE WILL LEAVE THAT
ROLE OPEN AT FOR OTHER MEMBERS
THE OTHER ITEM I CALL A. B.
EIGHT EIGHTY TWO BY MISTER GRAY
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS BONTA BURKE.
BURKE HI. MAIENSCHEIN
MAIENSCHEIN I RIVAS RIVERSIDE
RODRIGUEZ RODRIGUEZ I SANTIAGO
SANTIAGO AYE WALDRON. TWELVE
ZERO TWELVE ZERO OKAY THANK YOU
SO WE'RE GONNA START AT THE TOP
OF THE ORDER AND GO THROUGH
THESE AND- AND- WHAT DO ONCE IN
THE SUB THEIR MEMBERS ARE
MISSING THAT HAVE NOT VOTED-
PLEASE COME ON DOWN TO THE
FLOOR WOULD APPRECIATE THAT. SO
WE JUST WE JUST DID AB THREE
FORTY SEVEN ITEM NUMBER ONE SO
WE'LL MOVE ON TO ITEM NUMBER
TWO AB FOR FIFTY ONE ARAMBULA
PLEASE. OPEN THE ROLL CALL THE
ABSENT MEMBERS- MISTER SANTIAGO
IS MISSING ON ITEM ONE. I'M
SORRY I'M SORRY ITEM NUMBER ONE
EIGHTY THREE FORTY SEVEN. OPEN
THE ROLL CALL THE ABSENT
MEMBERS. BONTA. SANTIAGO.
SANTIAGO AYE WALDRON. ELEVEN
ONE ELEVEN ONE THANK YOU AND
ITEM NUMBER TWO A. B. FOUR
FIFTY ONE ARAMBULA PLEASE OPEN
THE ROLL CALL THE ABSENT
MEMBERS BONTA. MAIENSCHEIN
MAIENSCHEIN I RIVAS RIVERSIDE
SANTIAGO SANTIAGO HI. FOURTEEN
ZERO FOURTEEN ZERO ITEM NUMBER
THREE THIRTEEN FORTY FOUR WAS
PULLED BY THE COMMITTEE ITEM
NUMBER FOUR AB FOUR THIRTY NINE
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS BONTA.
MAIENSCHEIN MAIENSCHEIN AYE
SANTIAGO SANTIAGO I. TWELVE TO
ONE AS TWELVE ONE ITEM NUMBER
FIVE EIGHTY SIX ONE NINE FIVE
ASSEMBLY MEMBER CALDERON PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS. BONTA SANTIAGO.
SANTIAGO HI. FOURTEEN ZERO
FOURTEEN ZERO ITEM NUMBER SIX
AB THREE FIVE SIX BY MR CHAN
ASSEMBLY MEMBER CHEN PLEASE
CALL THE OPEN THE ROLL CALL THE
ABSENT MEMBERS BONTA. SANTIAGO
SANTIAGO HI FOURTEEN ZERO THANK
YOU AND THEN WE JUST DID- WELL
IT. A. B. EIGHT EIGHTY TWO
MISTER GRAY I DON'T PLEASE OPEN
THE ROLL CALL THE ABSENT
MEMBERS. BONTA. WALDRON.
WALDRON HIGH. THIRTEEN ZERO
THIRTEEN ZERO ITEM NUMBER EIGHT
A. B. ELEVEN OH FOUR BY
ASSEMBLYMEMBER GRAYSON PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS CARILLO. CARRILLO HIGH.
RIVAS RIVERSIDE SANTIAGO
SANTIAGO HI. FIFTEEN ZERO
FIFTEEN ZERO ITEM NUMBER NINE
AB THIRTEEN THIRTY ONE BY
ASSEMBLYMEMBER IRWIN PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS. CARILLO AREA II RIVAS
RIVAS AYE SANTIAGO. SANTIAGO I
FIFTEEN ZERO FIFTEEN ZERO ITEM
NUMBER TEN EIGHTY FIVE TWENTY
ONE BY MR MATHIS THEY MADE
NUMBER ELEVEN AB FOURTEEN
SEVENTY BY MISTER MATHIS ITEM
NUMBER SEVENTEEN A. B. TWO
FORTY BY MR MARC RODRIGUEZ AND
ITEM NUMBER EIGHTEEN AB FIVE
THIRTY TWO BY ASSEMBLYMEMBER
WOOD THOSE ARE ALL CONSENT
CALENDAR ITEMS OF MADAM
SECRETARY PLEASE COOK OPEN THE
ROLL CALL THE ABSENT MEMBERS.
BIGELOW BONTA. MAIENSCHEIN
MAIENSCHEIN AYE RIVAS. RIVAS
ICE SANTIAGO SANTIAGO BY.
THIRTEEN ZERO THIRTEEN ZERO
ITEM NUMBER TWELVE AB EIGHTY
THREE BY ASSEMBLYMEMBER
O'DONNELL PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS CARILLO.
CAREER HIGH RIVAS RIVERSIDE
SANTIAGO. SANTIAGO I. FIFTEEN
ZERO. THANK YOU VERY MUCH ITEM
NUMBER- THIRTEEN AB SIX THIRTY
BY MISS CLARK SILVA. OR DID I
JUST DO THAT. PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS.
CARRILLO CARILLO I. RIVAS
RIVERSIDE SANTIAGO SANTIAGO
FIVE FIFTEEN ZERO THANK YOU
VERY MUCH ITEM NUMBER FOURTEEN
AB SEVENTY BY MISTER SALAS
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS CARILLO. CARILLO
I'D RIVAS RIVERSIDE SANTIAGO
SANTIAGO I FIFTEEN ZERO THANK
YOU VERY MUCH ITEM NUMBER
FIFTEEN AB FOR SEVENTY BY MISS
CARILLO PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS. MAY
BONTA FLORA. SANTIAGO SANTIAGO
AYE WALDRON WALDRON. NINE
ELEVEN ZERO SEVEN ZERO ITEM
NUMBER SIXTEEN EIGHTY FOUR
FORTY ONE BY MR MAYES PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS. CARILLO CARILLO III
MCCARTY MCCARTY AYE RIVAS.
RIVAS ICE SANTIAGO. SANTIAGO
AYE FIFTEEN ZERO THANK YOU VERY
MUCH I DIDN'T NUMBER. NINETEEN
AB ELEVEN THIRTY BY WOOD PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS. SANTIAGO SANTIAGO AYE
WALDRON. WHAT ARE NOT VOTING.
TWELVE ZERO THANK YOU VERY MUCH
ITEM NUMBER. TWENTY AB ELEVEN
THIRTY WHILE ASSEMBLY MEMBER
WOULD PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS BONTA. BURKE
WALDRON WALDRON HIGH. TWELVE
THE ONE. THANK YOU AND THAT
DOES IT I BELIEVE- WE'RE GOING
THROUGH I THINK EVERYBODY'S
HERE GONNA HOLD THIS OPEN AND
OTHERS A MEMBER WHO HAS A
MEETING AND WILL BE BACK SO.
WE'LL LEAVE THIS OPEN FOR NOW.
BUT THE REST OF YOUR FREE TO GO
IF YOU WANT BUT OR NOT. THANK
YOU. PARDON- YEAH OF COURSE
WHICH ONE. I DON'T WANT. IDM
ONE WE'RE GONNA THIS HAVE A
MADAM SECRETARY PLEASE GO OPEN
THE ROLE IN TEM ONE A. B.
THREE FORTY SEVEN ARAMBULA.
BONTA. WALDRON WALDRON HIGH
TWELVE TO ONE TWELVE TO ONE
THANK YOU AND THEN WE'RE GONNA
OPEN THE CONSENT CALENDAR- CALL
THE ABSENT MEMBERS PLEASE.
BIGELOW BIGELOW HI BONTA.
FOURTEEN ZERO THANK YOU VERY
MUCH. AND WILL WAIT A FEW MORE
MINUTES HERE.
THEY ARE. MISSING
OKAY AND CONSENT THANK YOU.
I
THINK EVER HAS IN THE FUTURE
I'M GOOD HOW ARE YOU SIR SAY
SOMETHING WE'RE YESTERDAY WE
WILL NOT WORK FOR YOU THE
TWILIGHT- TWENTY THE OTHER
SITES AND THAT'S AWESOME DID
YEAH. IT'S AWESOME. IT'S AN
AWESOME PLACE. AND THEY'RE OPEN
AGAIN SIR WE RESERVE. CAN YOU
SANTA ROSA WHAT RIGHT FOR THE
WEARABLE NO I HAVE I HAVE
WINDSOR BUT LEVINE HAS SANTA
ROSA I'M ASSUMING LEVINE YEAH
LEVINE ETCETERA SO HE HAD THE
ORIGINAL YEAH STORE HAVE THAT.
AT THE NEW ONE OF THE NEW ONE
YEAH THAT'S FOR THE RECORD ON
THE IRONICALLY MY DISTRICT
OFFICE IS NOT. IN-
HELLO MR
CHERRY THERE THIS IS THE
OPERATOR. YES MISTRUSTING YOU
CAN LEAVE NOW I'M SORRY. OKAY
SORRY I WANTED TO CONFIRM OF
AFFORDABLE SO SORRY I'M SO
SORRY YOU'RE WELCOME TO STAY IF
YOU WANT OF IT BUT- YOU KNOW.
PLEASE PLEASE GO HOME AND HAVE
DINNER YEAH OKAY OKAY OKAY
HELLO THEN SIR- IF THERE IS
ANOTHER MEETING COMING IN
NUMBER WITH DEALERS WHERE IT
FOR THE DAY SO THANK. YOU SO
MUCH FOR YOUR HELP REALLY
APPRECIATE IT. YOU'RE WELCOME
HAVE A NICE EVENING YOU.
TOO
WE'RE SORRY YOUR CONFERENCE IS
ENDING NOW PLEASE HANG UP.
OKAY
THEN SECRETARY PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS ON
ITEM NUMBER ONE AB. THREE FOUR
SEVEN. BONTA HI BONTA HI.
THIRTEEN ONE THIRTY THE BILL
VOTERS THIRTEEN ONE. THANK YOU
ITEM NUMBER TWO A. B. FOUR FIVE
ONE ARAMBULA PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS.
BONTA BONTA HIGH FIFTEEN ONE.
THANK YOU ITEM NUMBER FOUR
PLEASE AB FOUR THIRTY NINE
RIVER ASSEMBLY MEMBER PARA QUE
HAN PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS BONTA. BONTA
HI. THIRTEEN A ONE THIRTEEN
ONE- ITEM NUMBER FIVE A. B. SIX
NINETEEN ASSEMBLY MEMBER
CALDERON PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS BONTA
BONTA AYE FIFTEEN ONE MEMBERS
ARE FIFTEEN ZERO FIFTEEN ZERO
SIX A WEEK REMEMBER. SO ITEM
NUMBER SIX AB THREE FIVE SIX-
PLEASE MR ASSEMBLY MEMBER CHAN
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS BONTA. BONTA HI
FIFTEEN ZERO FIFTEEN ZERO ITEM
NUMBER SEVEN AB EIGHT EIGHTY
TWO MISTER GRAY ASSEMBLY MEMBER
GRAY PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS BONTA. BONTA
HI I ITEM NUMBER FIFTEEN
ASSEMBLY BILL FOUR SEVENTY
ASSEMBLY MEMBER CARILLO PLANS
HAVE THEIR AUTHOR OF THE
FOURTEENTH- OKAY- ITEM NUMBER
FIFTEEN EIGHTY FOUR SEVENTY
ASSEMBLY MEMBER CARILLO PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS MAYES. BONTA BONTA AYE
FLORA. TWELVE TWO ZERO TWELVE
ZERO AND FINALLY THE CONSENT
CALENDAR- PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS. BONTA
ALL RIGHT BONTA AYE WAIT ONE
MORE WE GOT ONE MORE. SECOND
ELEVEN THIRTY NINE AND TWENTY
FILE ITEM TWENTY- OH NO YOU'RE
RIGHT. L. NUMBER TWENTY AB
ELEVEN THIRTY ONE ASSEMBLY
MEMBER WOULD PLACE UP IN THE
ROLL CALL THE ABSENT MEMBERS
BONTA. BONTA AYE BURKE.
THIRTEEN IS THERE ARE THIRTEEN
OF ONE GREAT THANK YOU. AND
WITH THAT. WE WILL END TO
CONCLUDE THE ASSEMBLY HEALTH
COMMITTEE HEARING FOR THE DAY
THANK YOU VERY MUCH.