THIS WILL BEGIN OUR FIRST
SOMEONE HEARING THIS YEAR WE'RE
GOING TO START WITH THE
DEPARTMENT OVERVIEW OF THE
EMERGENCY MEDICAL SERVICE
AUTHORITY.
IF WE COULD HAVE THE FIRST PANEL
COME FOR
AUTHORITY.
WHICH I'LL REFER TO AS THE EMS
AUTHORITY THIS IS DANCE MY WAY
OUR CHIEF DEPUTY DIRECTOR AND
OUR DEPARTMENT OF FINANCE
ANALYSTS.
AND AS REQUESTED A PROVIDE A
BRIEF OVERVIEW THE DEPARTMENT
AND OUR BUDGET IN ACTIVITIES TO
SUPPORT THE RESPONSE TO LAST
YEAR'S CATASTROPHIC FIRES.
OR EMERGENCY MEDICAL SERVICES
SYSTEM IN CALIFORNIA WAS CREATED
IN NINETEEN EIGHTY ONE WITH EMS
AUTHORITY RESPONSIBLE FOR.
COORDINATION AND INTEGRATION OF
ALL STATE ACTIVITIES CONCERNING
EMERGENCY MEDICAL SERVICES. TO
ENSURE THE PROVISION OF
EFFECTIVE AND EFFICIENT
EMERGENCY MEDICAL CARE.
THE MS AUTHORITIES A SMALL
DEPARTMENT WITH RESPONSIBILITIES
IN THREE MAJOR CATEGORIES.
FIRST OUR PRE HOSPITAL EMERGENCY
SERVICES WHICH IS ONE PIECE OF
AN EMERGENCY CARE NETWORK.
INTEGRATED WITH HOSPITAL
EMERGENCY DEPARTMENTS AND OTHER
SERVICES.
NINE ONE ONE MEDICAL SERVICES
OR WIDELY SEEN BY THE PUBLIC AS
A GUARANTEED RESPONSE FOR ALL IN
ONE OF OUR MAJOR HEALTH CARE
SAFETY NETS.
IN CALIFORNIA THERE NOW MORE
THAN SIXTY TWO THOUSAND
CERTIFIED EMTS AND TWENTY TWO
THOUSAND LICENSE PARAMEDICS.
THE RESPOND TO NEARLY FOUR AND A
HALF MILLION NINE ONE ONE CALLS
FOR EMERGENCY SERVICE ANNUALLY.
WE'RE USING THREE THOUSAND SIX
HUNDRED GROUND AMBULANCES AND
ABOUT SEVENTY FOUR AIR
AMBULANCES. AND THEY TAKE THE
ILL OR INJURED TWO ONE OF THREE
HUNDRED TWENTY TWO CARE HOSPITAL
EMERGENCY DEPARTMENTS THAT ALSO.
MAY BE A DESIGNATED SPECIALTY
CARE CENTER.
SPECIFICALLY THAT YOU MUST
AUTHORITY IS RESPONSIBLE FOR
LICENSING PARAMEDICS AND
DISCIPLINING THE LICENSE WHEN
NEEDED.
SETTINGS GO FOR PRACTICE
TRAINING STANDARDS AND
REGULATIONS FOR VARIOUS LEVELS
OF UMASS INCLUDING PUBLIC SAFETY
FIRST AID.
AND THERE'S BEEN CONSIDERABLE
INTEREST IN THE LEGISLATURE OVER
THE PAST FEW YEARS CONCERNING
MEDICAL INTERVENTIONS FOR BOTH
THE PUBLIC. AND FOR PUBLIC
SAFETY PERSONNEL. THAT HAVE
PASSED ANSWER WITH IMPLEMENTING
TACTICAL MEDICAL CARE TRAINING
CURRICULUM.
AUTOMATED EXTERNAL
DEFIBRILLATORS.
TRAINING FOR USE OF EPINEPHRINE
FOR ALLERGIC REACTIONS AND THE
LOCKS ON FOR NARCOTIC OVERDOSE.
WE ALSO SET TRAINING STANDARDS
CERTIFIED TRAINING FOR LICENSED
CHILDCARE PROVIDERS. AND HELP
TRAIN THE PUBLIC IN CPR AND STOP
THE BLEEDING CAMPAIGNS.
ONE IMPORTANT ISSUE TO FROM YOU
MUST AUTHORITY REGARDING THE
ROLE OF PARAMEDICS IS APPROVED
HEALTH WORKFORCE PILOT PROJECT
THROUGH THE OFFICE OF STATEWIDE
HEALTH PLANNING AND DEVELOPMENT.
TO TEST AND EVALUATE THE USE OF
PARAMEDICS AND EXPANDED MOBILE
HEALTH CARE ROLLS OF FILM
IDENTIFIED GAPS.
IN LOCAL HEALTH CARE SYSTEMS AND
IMPROVE ACCESS TO AN INTEGRATION
OF CARE.
THE EVALUATION FOR THE FIRST
TWENTY FOUR MONTHS BY THE UC SAN
FRANCISCO CENTER FOR HEALTH
POLICY AND WORKFORCE.
DEMONSTRATE THE PARAMEDICS
PARAMEDICS CAN SAFELY AND
EFFECTIVELY WORK WITH PATIENTS
TO REDUCE REPEAT
HOSPITALIZATIONS.
TO DECREASE NINE ONE ONE
EMERGENCY USE.
PERFORM OUTREACH FOR HARD TO
REACH PATIENTS.
AND IDENTIFY PATIENTS A CAN BE
BETTER TREATED IN SETTINGS OTHER
THAN THE EMERGENCY DEPARTMENT.
ALL WITHOUT SUPPLANTING ANY
OTHER HEALTH CARE PROVIDERS OR
INCURRING ANY ADVERSE PATIENT
OUTCOMES.
SECOND OF THE YOU MUST AUTHORITY
DEVELOPS GUIDELINES IN A
PREVIOUS PLANS FOR EMERGENCY
MEDICAL SYSTEMS BETTER IMPLEMENT
AND OPERATED BY LOCAL UMASS
AGENCIES.
THERE ARE THIRTY THREE LOCAL
UMASS AGENCIES SEVEN MULTI
COUNTY AGENCIES THAT PRIMARILY
SERVE RURAL AREAS AND THAT
RECEIVE SOME SUPPORT FROM STATE
GENERAL FUNDS.
AND TWENTY SIX SINGLE COUNTY
AGENCIES.
DIRECT NINE ONE ONE AMBULANCE
SERVICES PROVIDED BY A MIXTURE
OF PUBLIC FIRE AGENCIES AND
PRIVATE PROVIDERS AND
VOLUNTEERS.
THE MS AUTHORITY DEVELOPS
REGULATIONS FOR DESIGN AND
QUALITY OF SPECIALTY CARE
SYSTEMS.
INCLUDING IN OUR TRAUMA SYSTEM
THAT CURRENTLY HAS EIGHTY ONE
DESIGNATED CENTERS.
PEDIATRIC EMERGENCY CARE THAT
CURRENTLY HAS A HUNDRED AND
ELEVEN CENTERS.
STROKES SYSTEM WITH A HUNDRED
AND FIFTY FOUR SET DESIGNATED
CENTERS A CARDIAC OR STEMI
SYSTEM WITH A HUNDRED AND FORTY
FIVE DESIGNATED CENTERS.
AND THE CALIFORNIA POISON
CONTROL SYSTEM THAT HANDLES
NEARLY THREE HUNDRED THOUSAND
POISON EXPOSURES EACH YEAR.
ONE OF OUR PRIORITY INITIATIVES
IS TO ASSESS EFFECTIVENESS OF
THE MC UMASS SYSTEM USING
IMPROVE THE LOCAL AND REGIONAL
DATA.
WITH A SUPPORT OF AB ELEVEN
TWENTY NINE WHICH WAS CHAPTER IN
TWENTY FIFTEEN. WE'RE CONVERTING
ALL OUR PROVIDERS TO ELECTRONIC
DOCUMENTATION TO PAY IS PATIENT
CARE THE CAN BE. AGGREGATED
ANALYZING USE FOR SYSTEM
EVALUATION PERFORMANCE
IMPROVEMENT.
WE HAVE FINISHED WORK ON A
NATIONAL GRANT TO EXCHANGE
CLINICAL DATA WITH HOSPITALS. SO
THE PARAMEDICS KANNAPOLIS XIN
INFORMATION IN THE FIELD AND
HOSPITALS TO RECEIVE PRE ARRIVAL
INFORMATION FROM ME A MASS.
THIS INITIAL LIVE WILL ALSO
IMPROVE CARE DURING THE DISASTER
BY MAKING CRITICAL PATIENT
INFORMATION AVAILABLE WHEN
PATIENTS ARE TREATED IN
DIFFERENT SYSTEMS.
S. B. NINETEEN CHAPTER IN TWENTY
FIFTEEN WILL FURTHER UTILIZE
THESE HEALTH INFORMATION
ADVANCES TO DESIGN AND TEST A
REGISTRY FOR END F LIFE
POSITION ORDERS KNOWN AS POST
FORMS.
THAT THE M. S. AUTHORITY
DEVELOPED AND UPDATES.
OUR THIRD MAJOR AREA OF
RESPONSIBILITY IS THE MEDICAL
RESPONSE TO DISASTER.
WE PARTNER WITH THE DEPARTMENT
OF PUBLIC HEALTH AND FEDERAL
LOCAL PARTNERS TO BUILD A PUBLIC
HEALTH. AND MEDICAL EMERGENCY
SUPPORT FUNCTION.
PLAN RESPOND TO THE MEDICAL
IMPACT IF ANY TYPE OF DISASTER
OR HEALTH EMERGENCY.
AND AS PART OF OUR PLANNING
EFFORTS INVEST AUTHORITY DEVELOP
THE HOSPITAL INCIDENT COMMAND
SYSTEM. WHICH HAS BECOME A
NATIONAL STANDARD IN AN
INTERNATIONAL MODEL.
TO PROVIDE EMERGENCY MEDICAL
RESPONSE IN THE FIELD THE EMS
AUTHORITIES DEVELOPED A TIERED
SYSTEM.
THERE FORTY TWO AMBULANCE STRIKE
TEAMS HOUSED IN LOCAL
JURISDICTIONS THAT CAN TRANSPORT
PATIENTS ARE ESTABLISH A FIELD
TRIAGE TREATMENT IN STAGING SITE
FOR MULTI CASUALTY INCIDENTS.
USUALLY WITHIN ONE TO TWO HOURS.
THESE ARE ROUTINELY USED BY
LOCAL JURISDICTIONS.
IN THE PAST YEAR THE AMBULANCE
STRIKE TEAMS WERE USED TO HELP
MOVE PATIENTS FROM HEALTH
FACILITIES DURING THE OROVILLE
DAM EVACUATION. AND BOTH
NORTHERN AND SOUTHERN CALIFORNIA
FIRES.
IN THE NORTHERN CALIFORNIA FIRES
THE MEDICAL AND HEALTH MUTUAL
AID SYSTEM THROUGH OUR REGIONAL
DISASTER MEDICAL HEALTH
COORDINATOR. AND THE LOCAL
MEDICAL ON HEALTH OPERATIONAL
AREA COORDINATOR THAT IS EITHER
A PUBLIC HEALTH OFFICER OR AN
EMS ADMINISTRATOR.
ORGANIZED EVACUATION OF TO
ACUTE CARE HOSPITALS AND MANY
MORE SKILLED NURSING AN
INTERMEDIATE CARE FACILITIES.
MOST NOTABLE WERE THE EVACUATION
OF SKILLED NURSING FACILITY
PATIENTS FROM YOUNTVILLE
VETERANS HOME. IN THE ENTIRE
CINEMA DEVELOPMENTAL CENTER.
LOCAL HIM S. AGENCIES USED THEM
NINETY TWO AMBULANCES INCLUDING
FOURTEEN OF OUR AMBIENCE STRIKE
TEAMS FROM FOUR DIFFERENT
REGIONS.
AND SIXTY PARATRANSIT VEHICLES
TO EVACUATE APPROXIMATELY NINE
HUNDRED PATIENTS FROM THE
NORTHERN CALIFORNIA FIRES.
THE SECOND TIER CONSISTS OF
CALIFORNIA MEDICAL ASSISTANCE
TEAM SECOND A BOY WITHIN TWELVE
HOURS BEGIN TO TREAT PATIENTS IN
ANY LOCATION.
THESE FLEXIBLE PATIENT CARE
ACCESS CAN BE DEPLOYED AS A
HEALTH CARE TEAM OF ANY SIZE AND
TAKE ON HEALTH CARE MISSIONS.
RANGING FROM ACUTE EMERGENCY
CARE TO MANAGEMENT AND EVACUATE
THE LONG TERM CARE PATIENTS.
FOR THE NORTHERN CALIFORNIA
FIRES INDIVIDUAL MEMBERS HELPED
WITH LOCAL NEEDS ASSESSMENTS.
IN ADDITION PERSONNEL CAN BE
PULLED FROM OUR DISASTER HEALTH
CARE VOLUNTEER REGISTRY.
THEY CURRENTLY CONTAINS OVER
TWENTY THREE THOUSAND LICENSE
PERSONNEL OF ALL TYPES INCLUDING
THE LOCALLY ORGANIZED MEDICAL
RESERVE CORES.
THIRTEEN MRC UNITS WITH THREE
HUNDRED AND SIXTY FOUR
INDIVIDUALS WERE DEPLOYED FOR
OUR NORTHERN CALIFORNIA FIRES
INCLUDING THREE VETERINARY TEAMS
WHICH WERE ROSTERED ON OUR
DISASTER MEDICAL VOLUNTEERS
SITE.
THE MOBILE FIELD HOSPITAL
PROGRAM AND WHICH WE'VE TALKED
ABOUT MANY YEARS INTO IN THE
PAST.
WAS RECONFIGURED INTO THE
MOBILE MEDICAL SHELTER PROGRAM
THAT'S AVAILABLE FOR MULTIPLE
USES. INCLUDING MEDICAL CARE A
COMMAND CENTER OR MEDICAL
SHELTERS.
ONE COMPLETE SHELTER WITH
DURABLE EQUIPMENT WAS
TRANSFERRED TO THE CALIFORNIA
NATIONAL GUARD.
THE SECOND WAS BROKEN INTO SIX
LOCAL JURISDICTIONS IN EACH OF
THE SIX MUTUAL AID REGION'S.
THE THIRD IS BEING KEPT BY THE
EMERGENCY MEDICAL SERVICES
AUTHORITY FOR FLEXIBLE
DEPLOYMENT.
TWELVE OF OUR SHELTERS WERE
RECENTLY USED DURING THE NOR CAL
FIRES. TO HOUSE MULTIPLE
ANCILLARY COMMAND SERVICES TO
SUPPORT THE EVACUATED CINEMA
DEVELOPMENTAL CENTER.
.
MAYBE ALL STOP THERE AND IF
THERE'S ANY QUESTIONS BEFORE I
MOVE ONTO OUR BUDGET AND TO
ISSUE TO.
I THINK AT THIS POINT IF YOU
DISCONTINUE THE BIGGER OKAY.
THE GOVERNOR'S PROPOSED BUDGET
FOR TWENTY EIGHTEEN NINETEEN
INCLUDES EXPENDITURE AUTHORITY
IN THE AMOUNT OF THIRTY SEVEN
POINT FOUR MILLION. AND SIXTY
NINE POINT NINE PERMANENT
POSITIONS.
OF THIS AMOUNT SIXTEEN POINT
FIVE MILLION OR FORTY FOUR
PERCENT IS DELEGATED FOR STATE
OPERATIONS. AND THE REMAINING
TWENTY POINT NINE MILLION IS
DELEGATED TO LOCAL ASSISTANCE.
THE DEPARTMENT ONLY HAS ONE NEW
WORKLOAD ADJUSTMENT UNDER
CONSIDERATION BY THE LEGISLATURE
WHICH IS ISSUE TO.
PM EST AUTHORITIES REQUESTING
ONE PERMANENT POSITION AND A
GENERAL FUND AUGMENTATION IN
FISCAL YEAR TWENTY EIGHTEEN
NINETEEN. TOTALING THREE HUNDRED
FIFTY SIX THOUSAND. WHICH
INCLUDES ONE TIME FUNDING OF A
HUNDRED AND NINETY SIX THOUSAND
FOR IT INFRASTRUCTURE
IMPROVEMENTS.
AN ONGOING FUNDING OF A HUNDRED
EIGHTY NINE THOUSAND TO
STRENGTHEN THE DEPARTMENTS.
IT INFRASTRUCTURE NEEDED TO
ENSURE COMPLIANCE WITH STATE
POLICY IN PROCEDURAL
REQUIREMENTS.
THE REQUEST RESULTS IN THE
FINDINGS OF AN INDEPENDENT
SECURITY ASSESSMENT BY THE
CALIFORNIA MILITARY DEPARTMENT
CYBER NETWORK DEFENSE TEAM IN
DECEMBER OF TWENTY SIXTEEN.
THIS COMPREHENSIVE REVIEW
DEMONSTRATED THAT THE M. S.
AUTHORITY LACKS SUFFICIENT IT
INFRASTRUCTURE. AND SUPPORT
STAFFING LEVELS TO KEEP UP WITH
STATE POLICY IN PROCEDURAL
REQUIREMENTS NECESSARY TO ENSURE
IT. INFRASTRUCTURE SECURITY
WEBSITE INFRASTRUCTURE IN
PARTICIPATION. IN STATE LEVEL AN
AGENCY WIDE IT INITIATIVES.
SO THE POSITION BEING REQUESTED
WILL INITIALLY REMEDIATE THE
SECURITY ASSESSMENT FINDINGS AND
MANAGED IN THIS AS THE NECESSARY
INFRASTRUCTURE UPGRADES.
ONGOING THE REQUESTED POSITION
WILL DEVELOP IMPLEMENT AND
MONITOR SECURITY PROGRAM FOR THE
DEVELOPMENT.
TO MEET THE REQUIREMENTS OF THE
STATE I SO.
I WANT TO THANK YOU FOR THE
OPPORTUNITY TO ADDRESS THE
SUBCOMMITTEE.
THANK YOU VERY MUCH DEPARTMENT
OF FINANCE LA WHEN IT COMES.
SEEING NONE.
WILL NOW HAVE PUBLIC COMMENT ON
ISSUE ONE AND ISSUE TO.
SEEING NONE ALL BRING IT TO THE
DYESS FOR ANY QUESTIONS YOU MAY
HAVE.
I JUST HAVE ONE IF I COULD I WAS
INTERESTED WHEN YOU TALKED ABOUT
POST.
IS THERE A CENTRALIZED LOCATION
WHERE WE CAN SEARCH AND
DETERMINE SOMEONE'S PREFERRED.
INTENSITY OF LIFESAVING
TECHNIQUES
AND IF NOT IS THERE AN
OPPORTUNITY FOR US AS A STATE TO
RECOGNIZE THE BENEFIT IN.
FOLLOWING PEOPLE'S
CHOICES FOR AND OF LIFE CARE.
YES HERB FOR THE BENEFIT OF THE
REMAINDER THE COMMITTEE WHO MAY
NOT BE AS FAMILIAR WITH ME
EXPLAIN THAT THE. SO CALLED THE
POST FORM THE IS A A PHYSICIAN'S
ORDERS FOR Y. SUSTAINING
TREATMENT AND IT IS ACTUALLY. A
SIGN THAT POSITION ORDER THAT
REPRESENTS THE PATIENT'S WISHES
AT THE END OF LIFE FOR THE
INTENSITY OF INTERVENTION.
IT IS SEPARATE FROM.
YOU'RE A A MORE GENERALIZED.
YOUR DISCUSSION.
OF.
OF YEAR END OF LIFE WISHES THAT
IS TO GUIDE.
YOUR TREATING PHYSICIAN IF YOU
HAVE NOT SIGNED ONE OF THESE
FORMS SO. YOU KNOW IT IT
ACTUALLY IS A PHYSICIAN'S ORDER
RIGHT NOW IT IS IT THERE IS NO
CENTRALIZED.
LOCATION THAT WHERE THESE ARE
STORED AND SO. YOU KNOW THE.
MERGING SEE SERVICES IN A MASS
AND OTHER.
YOUR EMERGENCY DEPARTMENTS WHEN
PATIENTS ARE BROUGHT IN OR
NURSING HOMES LITERALLY RELY ON.
FLUORESCENT PINK
SHEET OF PAPER THAT WERE HAS THE
PATIENT'S WISHES AND ASSIGNED
ORDER.
THE SP NINETEEN IN TWENTY
FIFTEEN.
DE YOU KNOW WAS A TEST TO TEST
AT OR TO PILOT. A AT THE IDEA OF
A POTENTIAL REGISTRY USING
HEALTH INFORMATION EXCHANGE FOR
THESE FORMS WHERE ARE YOU
PROVIDER YOU WHETHER IT'S IN THE
FIELD OR IN AN EMERGENCY
DEPARTMENT OR IN A HEALTH
FACILITY. COULD CALL AND RECEIVE
INFORMATION EVER FIND OUT WHAT
THE PATIENT'S WISHES WERE IF
THAT PAPER WAS NOT AVAILABLE
WITH THE PATIENT. THE TWO PILOT
SITES THAT WE WERE CHOSEN WERE
SAN DIEGO AND CONTRA COSTA. AND
THEY ARE.
THERE AFTER. SEVERAL DELAYS
THEY ARE FINALLY.
GETTING THERE ARE YOU KNOW IT
TAKES IT PUTTING INPUT.
INCLUDING THE FORMS INTO THEIR
REGISTRIES AND HAVE A MECHANISM
SET UP THEIR COMPLETELY
DIFFERENT.
.
USE IT OR TYPES OF SYSTEMS WHICH
IS WHAT WE WANT TO TEST BUT. THE
NEXT STEP TAKING THIS AND
EXPANDING IT STATEWIDE IT WILL
BE A TREMENDOUS CHALLENGE THAT
WILL TAKE NOT ONLY A. BETTER.
DESIGN OR BETTER. STATEWIDE
INFRASTRUCTURE OF HEALTH
INFORMATION EXCHANGE.
BUT.
ALSO A SIGNIFICANT AMOUNT OF
FUNDS THAT THIS IS A PILOT
PROJECT WAS FUNDED BY THE
CALIFORNIA HEALTHCARE FOUNDATION
HAS BEEN WORKING ON END OF LIFE
ISSUES FOR SOME TIME. AND WE
HOPE ONCE DE WE GET THESE
RESULTS
THERE WILL BE ENOUGH INTEREST
AND ADD DEMONSTRATE ENOUGH
SUCCESS THAT WHERE WE'LL BE ABLE
TO FIGURE OUT HOW TO FUND THE
NEXT STEPS.
THERE IS A LEGISLATIVE REPORT
THAT IS.
PART OF THIS LEGISLATION AND IT
IS IN REVIEW RIGHT NOW IN FACT
PENDING AS THOUGH IT SHOULD SHOW
UP BUT I'M NOT SURE WHICH
COMMITTEE IT'S GOING TO A.
IT SHOULD BE AVAILABLE SHORTLY.
WELL I WOULD LOVE TO SEE A COPY
OF THAT REPORT WHEN IT SHOULD
BECOMES AVAILABLE.
.
I'M REMINDED OF A PATIENT WHO
HAD THAT TATTOO DO NOT
RESUSCITATE ONTO THEIR CHEST.
AND KNOWING. THAT THE GREAT
STATE OF CALIFORNIA ALSO HOUSES
GOOGLE AND APPLE I HAVE TO
BELIEVE THAT THERE ARE. BETTER
OPPORTUNITIES FOR US TO MOVE
FORWARD IN THE TWENTY PERCENT
ABSOLUTELY AGREED. IF THERE ARE
NO FURTHER QUESTIONS STAFF HAS
RECOMMENDED NO ACTION ON ISSUE
ONE AND TWO AND WE WILL MOVE ON
TO ISSUE THREE.
THANK YOU SO MUCH
.
GEN.
AFTERNOON IT'S CHAIR MEMBERS MY
NAME IS BRANDON UNISOM THE CHIEF
DEPUTY DIRECTOR FOR OPERATIONS
OF THE DEPARTMENT OF PUBLIC
HEALTH.
GOOD AFTERNOON I'M SUSAN VALIUM
THE ASSISTANT DIRECTOR FOR THE
DEPARTMENT OF PUBLIC HEALTH.
SO THAT AFTERNOON WE'RE GONNA
GIVE YOU A QUICK OVERVIEW OF OUR
DEPARTMENT ANSWER IF YOU HAVE
QUESTIONS THAT YOU HAD IN THE
AGENDA. ONE DAY QUICKLY START UP
BY SAYING THAT DR SMITH SENDS
OUR APOLOGIES THAT SHE COULDN'T
BE HERE TODAY SHE'S OUT OF TOWN
ON ANOTHER ENGAGEMENT BUT SHE
HOPES TO JOIN US AT A FUTURE
HEARING.
YOUR STUFF THAT A REALLY GOOD
JOB OF PROVIDING AN OVERVIEW OF
ONE OF YOUR BUDGET ALL.
IT SOME OF THE HIGHLIGHTS AND
THEN WE'LL MOVE INTO SOME OF THE
THINGS THAT WE DON'T WORKING ON
OVER THE PAST YEAR.
SO OUR DEPARTMENT OPERATES ON A
BUDGET OF APPROXIMATELY THREE
POINT TWO BILLION FOR SEVENTEEN
EIGHTEEN.
THIS FUNDING SUPPORTS THIRTY
SIX HUNDRED STAFF WHOWORK IN
OVER TWO HUNDRED PROGRAMS WITHIN
OUR DEPARTMENT. THAT ARE
ADMINISTERED BY SIX CENTERS INTO
OFFICES WITHIN PARLIAMENT.
ARE PROPOSED BUDGET FOR
EIGHTEEN NINETEEN IS RELATIVELY
FLAT COMPARED TO SEVENTEEN
EIGHTEEN WERE SOVEREIGN AROUND
THAT THREE POINT TWO BILLION
MARK.
AND FOR THIS YEAR AND EIGHTEEN
NINETEEN WE'RE PROPOSING FUNDING
FROM.
THREE PRIMARY SOURCES FIRST
THEIR GENERAL FUND WHICH IS
ABOUT A HUNDRED AND THIRTY EIGHT
MILLION OR ROUGHLY ABOUT FOUR
PERCENT OF OUR DEPARTMENTS
OVERALL BUDGET. A LARGE
PROPORTION COMES TO US FROM
FEDERAL FUNDS ABOUT ONE POINT
SIX BILLION.
AND THEN THE REMAINDER COMES
FROM US FOR TO US FROM SPECIAL
FUNDS IN REIMBURSEMENTS THAT WE
HAVE ABOUT ANOTHER ONE AND A
HALF BILLION.
.
WE HAVE A A SLIGHT DECREASE
ABOUT THIRTY ONE MILLION
COMPARED TO LAST YEAR SEVENTEEN
EIGHTEEN THAT'S LESS THAN A ONE
PERCENT CHANGE FROM LAST YEAR'S
BUDGET.
AND THE CHANGES DRIVEN BY NINE
DIFFERENT BCP'S THAT YOU'LL BE
HEARING FROM US I'M OVER THE
COURSE OF THE SEASON.
WE HAVE FOR UPDATES TO
ESTIMATES THAT WE DO FAR AIDS
DRUG ASSISTANCE PROGRAM ARE WEEK
PROGRAM AYE GENETIC DISEASE
SCREENING PROGRAM IN OUR
LICENSING AND CERTIFICATION
PROGRAM. AND THEN WE HAVE SOME
ONE TIME ADJUSTMENTS RELATED TO
PROP FIFTY SIX I'M IN PARTICULAR
WE HAD SOME EXTRA FUNDING IN THE
SEVENTEEN EIGHTEEN YEAR THERE
WAS ONE TIME THAT'LL DROP OFF
AND EIGHTEEN NINETEEN THAT'S A
LARGE PROPORTION OF OUR
ADJUSTMENT BETWEEN THE TWO
FISCAL YEARS. AND THEN SOME
GENERAL BASELINE ADJUSTMENTS FOR
SALARY RETIREMENT COMPENSATION
AND THINGS OF THAT NATURE.
WE DO HAVE A COUPLE GENERAL
FUND ITEMS THAT YOU'LL BE
HEARING ABOUT TODAY WE HAVE OUR
GROUP FROM THE CENTER FOR
CHRONIC DISEASES THAT'LL BE
GOING OVER.
AND ALZHEIMER'S DISEASE
PROPOSAL.
ANY BEACH MONITORING SAFETY
MONITORING PROGRAM BETWEEN BOTH
THOSE PROPOSALS IT'S ABOUT A
THREE POINT FIVE MILLION GENERAL
FUND AUGMENTATION AND YOU'LL BE
HEARING FROM BOTH THOSE CENTERS
IN THOSE PROPOSALS TODAY.
AND AND WITHOUT OVER AGAIN OVER
THE COURSE OF THE SEASON WILL BE
HEARING.
FOR ABOUT FIVE OTHER PROPOSALS
WHEN THE OTHER CENTERS COME
BEFORE YOU AND WITH THAT THOUGH
ALL PASS THINGS OVER DOOR
ASSISTANT DIRECTOR WHO WILL.
GO THROUGH SOME OF THE THINGS
THAT WE'VE BEEN WORKING ON THE
PUBLIC HEALTH SIDE.
CLARENCE YOU TAKE A FEW MINUTES
TO SHARE SOME OF THE KEY ISSUES
AND ACCOMPLISHMENTS OF OUR
DEPARTMENT OVER THE PAST TWELVE
MONTHS. I'M AND I THINK I'LL
SHOW YOU THE BROTH OF THE TYPE
OF ACTIVITIES THAT WE ENGAGE IN
PUBLIC HEALTH.
A KEY FUNCTION OF PUBLIC HEALTH
IS TO PREVENT DETECT AND RESPOND
TO INFECTIOUS DISEASE OUTBREAKS
OVER THE PAST SEVERAL MONTHS THE
DEPARTMENT HAS RESPONDED TO
SEVERAL. INCLUDING.
HEPATITIS A ZECA AND INFLUENZA.
I'LL START WITH HEPATITIS AGES
TO PUT IT IN SOME CONTEXT IN TWO
THOUSAND SEVENTEEN THERE WERE A
TOTAL OF NINE HUNDRED AND
THIRTEEN TOTAL CASES WITH TWENTY
DEATHS. COMPARED TO ON AVERAGE
BETWEEN TWO THOUSAND THIRTEEN
AND SIXTEEN.
IN WHICH THE CASES RANGE FROM A
HUNDRED AND FORTY TWO TWO TWO
HUNDRED FIFTY FIVE WITH ZERO TO
TWO DEATHS PER YEAR.
AND THIS MOST RECENT OUTBREAK
Y. CHIMED HAS.
REALLY HAD SIX AND ARE NINETY
FOUR CASES ASSOCIATED WITH IT.
I'M AS OF FEBRUARY EIGHTH WITH
FIFTY FOUR HUNDRED FIFTY FOUR
HOSPITALS PENSIONS AND TWENTY
ONE DOUBTS THAT INCLUDED SOME
FROM THIS YEAR. OF THE MAJORITY
OF PEOPLE WITH A HIGH AND WHO
HAVE BEEN IMPACTED I'M HAVE BEEN
FROM.
HOMELESSNESS OR USING ILLICIT
DRUGS AND THAT SIMILAR TO WHAT
OTHER STATES ARE EXPERIENCING
WITH THOSE AT RISK POPULATION.
AND OUR ACTIVITIES INCLUDE
COORDINATING AND SUPPORTING HAVE
A OPERATE THROUGH AND THE
INCIDENT COMMAND STRUCTURE IN
OUR DEPARTMENT.
AND PUTTING A GOVERNOR'S
DECLARATION OF EMERGENCY I'M TO
SECURE AND PURCHASE VACCINE IN A
TIME OF VACCINE WRIST
CONSTRAINT.
I'M WE BEEN MONITORING THE
OUTBREAK IN PROVIDING ABBY
SUPPORT TO THE RESPONSE
INCLUDING MONITORING OF THE
CASES IMPLEMENTING F. STANDARD
CASE DEFINITION LABORATORY
TESTING AND PROVIDING TECHNICAL
ASSISTANCE TO OUR LOCAL HEALTH
JURISDICTIONS.
ITEM WE PROCURED AND DISTRIBUTE
IT HAPPEN A VACCINE.
WHICH ENABLED LH THESE ARE OUR
LOCAL HEALTH DEPARTMENTS TO GIVE
VACCINE TO THESE AT RISK
POPULATIONS TO DATE WE HAVE I'M
DISTURBIA HUNDRED TWENTY THREE
THOUSAND BACK SEEN DOSES.
FEDERALLY FUNDED WERE EIGHTY
FIVE THOUSAND AND STATE FUND AT
THIRTY EIGHT THOUSAND I'M WE
UNDER THE EXECUTIVE ORDER. HOME
THERE WAS FOUR MILLION SET ASIDE
FOR THE PURCHASE A VACCINE TO
DATE WE'VE SPENT ON ONE POINT
FOUR MILLION WE WILL DETERMINE
AND MARCH WHETHER WE NEED TO DO
ANOTHER ROUND OF VACCINE. I'M
PURCHASING I'M AND AGAIN THE
THE.
THE ABILITY TO GET THAT VACCINE
EARLY HAS LED TO A DOWNSLOPE AND
ARE ON STOPPING OF THE OUTBREAK
AND SO WE HOPE. THAT YOU HAVE
THAT TREND WILL CONTINUE AND WE
MAY NOT NEED TO PURCHASE THAT
MUCH MORE VACCINE.
I WE'VE STREAMLINED INTERNAL AND
EXTERNAL COMMUNICATIONS SO THAT
OUR PARTNERS THE MEDIA PUBLIC
I'M GET BEHIND UP TO DATE
INFORMATION AND TAKE CONTROL
MEASURES AND LAW. UNDERSTAND THE
RISKS AROUND.
HEPATITIS A.
SEVEN I NEXT ARE MOVED AND LENDS
OF THIS INFLUENZA SEASON STARTED
EARLY AND HAS BEEN MORE SEVERE
THAN THE IN RECENT YEARS. THERE
BEEN NEARLY DOUBLE THE NUMBER OF
DEATHS AND PEOPLE UNDER SIXTY
FIVE ON THIS YEAR HUNDRED AND
TEN COMPARED TO.
TO HONOR AND TO.
THIS YEAR.
SO HUNDRED TEN LAST YEAR AND TWO
HUNDRED TWO ALREADY THIS YEAR
SEE TO BE AGE RUNS RAN ABOUT
FIFTY PERCENT MORE CONFIRMATORY
TESTS THIS YEAR.
INCLUDING ANTI VIRAL RESISTANCE
TESTING AND I'M REALLY IS
LOOKING OUT THE PERCENTAGE OF
VISITS TO THE E. OUR ROOMS I'M
AT MUCH GREATER PERCENTAGE IS
ANOTHER ONE OF OUR INDICATORS
FOR. THE SEVERITY OF THE FLAT.
WE'VE ACTIVATED AGAIN OUR
MEDICAL AND HEALTH COORDINATION
CENTER AND TO SEND ALERTS IN
THIS YOUR COMMUNICATIONS ACROSS
GOVERNMENT. WE'VE CONDUCTED
ONGOING COMMUNICATIONS WITH
LOCAL HEALTH DEPARTMENTS HEALTH
CARE PROVIDERS AND THE PUBLIC
AND WE POST OUR WEEKLY UPDATES
ON OUR WEBSITE.
WE CONTINUE TO PROMOTE VACCINE
FOR ALL PERSONS SIX MONTHS OF
AGE AND OLDER.
AND WE AND ARE LOOKING OUT
ANTIVIRAL TREATMENTS AND MAKING
SURE THAT WHEN THERE ARE SPOT
SHORTAGES ACROSS THE STATE THAT
WE ADDRESS THEM.
WE CONTINUE TO.
OUR SURVEILLANCE ACTIVITIES BY
LOOKING AT IN A NUMBER OF KEY
INDICATORS AND WE HOPED THAT WE
ARE WORKING WITH OUR HEALTH CARE
INDUSTRY TO MITIGATE ANY HIM
IMPACTS ON THE HEALTHCARE
INDUSTRY.
NEXT I'LL TALK ABOUT ZECA
PRIMARILY SINCE.
BARBARA THAT WE CONTINUE TO
MONITOR OUR BIRTH DEFECTS AND
WOMEN I SINCE TWO THOUSAND AND
FIFTEEN CVH HAS BEEN MONITORING
SIX HUNDRED FORTY CASES OF ZICO
INCLUDING A HUNDRED AND SIXTY
TWO. AND PREGNANT WOMEN AT WITH
TWELVE CONGENITAL CASES.
WE HEAR CONTINUE TO WORK WITH
OUR PARTNERS.
AND ARE BACK NOT ONLY OUR LOCAL
HEALTH DEPARTMENTS BUT OUR
VECTOR CONTROL AGENCIES BECAUSE
AS YOU KNOW ON THE KEY TO
STOPPING SECA INSPECTOR CONTROL.
WE PUBLISH PLANS AND GUIDELINES
LA AND HONEST STATEWIDE ZICO
RESPONSE WE CONTINUE TO MONITOR
THAT.
CASES AND BIRTH DEFECTS AND
MOSQUITO FACTORS.
I'M WEEK CONTINUE PROVIDE
LABORATORY TESTING WE WERE THE
PRIMARY SOURCE OF TESTING FOR
SEEK AND CALIFORNIA FOR MANY
MONTHS AND WE REMAIN THE ONLY
SOURCE FOR CONFIRMATORY TESTING
IN CALIFORNIA. WE CONTINUE TO
PROVIDE PUBLIC INFORMATION AND
WE I'M YOU WE PASSED THROUGH
SOME OF THE FEDERAL DOLLARS TO
OUR LOCAL.
HEALTH DEPARTMENTS AND DOCTOR
CONTROL AGENCIES.
NEXT I WANT TO TURN TO OF THE
RESPONSE TO THE CALIFORNIA
WILDFIRES ORVILLE DAM INCIDENT
AND MUD SLIDES I KNOW HOWARD. A
BACKER HAS ALREADY DESCRIBED
SOME OF THE WORK THEY DID ON
DURING THESE EMERGENCIES WITH
THE.
AT ANY OF THAT MEDICAL
TRANSPORTATION AYE WE DO PARTNER
CLOSELY WITH THEM SO I HAD TO
SIR AS WE SERVE AS THE LEADS FOR
PUBLIC HEALTH AND MEDICAL ISSUES
AND DURING RESPONSE.
I'M AND FORCING THE PAGE OUR
RESPONSES INCLUDED ARE EMERGENCY
PREPAREDNESS OFFICE ARE CENTER
FOR HEALTH CARE QUALITY
INFECTIOUS DISEASES
ENVIRONMENTAL HEALTH IN OUR
DIVISION OF ENVIRONMENTAL AND
OCCUPATIONAL DISEASE CONTROL.
FOR EACH EVENT WE HAVE ACTIVATED
THE MEDICAL ON HEALTH
COORDINATION CENTER.
AS A COORDINATING BODY FOR ALL
OF THEM ON
DEPARTMENTS WITHIN THE FAA
EMERGENCY FUNCTION EIGHT.
I'M PRIMARILY THE ACTIVITIES
WITH THE FIRES WERE RELATED TO
OUR HEALTH CARE FACILITIES OF
LICENSING ANSWERED PICKET.
CERTIFICATION BRANCH THEY
MAINTAIN A DUTY OFFICER PROGRAM
THAT PROVIDES TO.
FACILITIES STATUS REPORTS DAILY
THEY CONDUCT WELFARE AND
MONITORING VISITS TO EVACUATE IT
PATIENTS THEY CONDUCT SITE
VISITS FOR REPOPULATION AM IN
COORDINATION WITH OUR SPREAD.
THEY CONDUCT.
.
CONDUCTED MANY OF THE ITEMS SITE
VISITS TO SHELTERS WHEN PEOPLE
WERE HAD TO BE EVACUATED VERY
QUICKLY AND HAD TO GO TO
SHELTERS BEFORE THEY COULD GO TO
ANOTHER FACILITY.
I'M IN THE OROVILLE DAM INCIDENT
A TOTAL OF ELEVEN FACILITIES
WERE EVACUATED WITH.
A TOTAL OF FOUR HUNDRED SEVENTY
THREE PATIENTS NORTHERN
CALIFORNIA FIRES WHICH INCLUDED
NOT POUNDS NUMBER COUNT COUNTIES
PRIMARILY.
IN WHICH TO HOSPITAL SUTTER AND
SAT AND KAISER SANTA ROSA WERE
EVACUATED WITH A TOTAL OF TWENTY
EIGHT FACILITIES ELEVEN HUNDRED
SIXTY PATIENTS.
AND AGAIN THIS WENT ON THROUGH
THE SOUTHERN CALIFORNIA.
FIRES AND THEN THROUGH THE
CALIFORNIA MUD SLIDE AS WELL.
SO OTHER ACTIVITIES WE DO DURING
RESPONSE IN IS TO MAP ALL OF THE
FACILITIES WE ARE USING GIS.
AND CAN CREATE A DASHBOARD THAT
SHOWS US THE STAFF THE CURRENT
STATUS OF EVERY FACILITY AND
SURROUNDING FACILITIES SO THAT
WE CAN BE MORE EFFECTIVE AND NOT
JUST THOSE FACILITIES THAT ARE
LICENSE FIRE DEPARTMENT. BUT ALL
OF THOSE FACILITIES FALLING
UNDER THE HEALTH AND HUMAN
SERVICES AGENCY.
WE CONTINUE TO SUPPORT OUR LOCAL
HEALTH DEPARTMENTS WITH GENERAL
POPULATION SHELTERS INCLUDING
EVEN I'M PROVIDING THEM WITH
SOME OF THE SUPPLIES FROM OUR
STOCKPILE. I'M AND PROVIDING
TECHNICAL ASSISTANCE ON
INFECTION CONTROL.
AND THAT INCLUDES IN THE
MITIGATION PHASE OF THEM OF
RECOVERY PHASE IT IN WHICH WE
ARE LOOKING AT ENVIRONMENTAL
CLEAN UP NEEDS.
AND PUBLIC SAFETY AROUND
ENVIRONMENTAL TOXINS AND
INFECTIOUS AGENTS.
NEXT I WANT TO SPEND A MINUTE ON
OUR OPIOID USE PRODUCTION
COLLABORATIVE WITH NEARLY TWO
THOUSAND OPIOID OVERDOSE DEATHS
PER YEAR ANOTHER APPROXIMATELY
EIGHT THOUSAND HOSPITAL IN EDIE
ADMISSIONS AND NEARLY TWENTY
FOUR MILLION PRESCRIPTION.
WRITTEN CALIFORNIA CONTINUES TO
FACE A SERIOUS PUBLIC HEALTH
CRISIS WE ARE LEVERAGING A MULTI
SECTOR STRATEGIC COLLABORATION
ABOUT THE STATE LOCAL LEVELS TO
BUILD A COMPREHENSIVE APPROACH
TO ADDRESS THE OPIOID EPIDEMIC.
AND THAT INCLUDES COORDINATION
OF EFFORTS THROUGH THIS MULTI
AGENCY WORKGROUP CHANGES IN
POLICIES A PUBLIC PAYER HEALTH
CARE SYSTEMS NEW LEGISLATING
MANDATE NEW LEGISLATION.
MANDATING THE USE OF PERSONAL.
PRESCRIPTION DRUG MONITORING
PROGRAM AND CREATING A ONE TIME
THE LOCKS ON DISTRIBUTION PROPS
PROJECT.
CHANGES TO REGULATIONS TO
INCREASE ACCESS TO NALOXONE
THROUGH PHARMACIES PHYSICIAN AND
PHARMACIST EDUCATION.
WE CONTINUE TO DEVELOP A PUBLIC
AWARENESS AND EDUCATION CAMPAIGN
FOR YOUTH AND HIGH BURDEN FOR
RURAL COUNTIES AND SUPPORT OF
TWENTY FIVE LOCAL OPIOID SAFETY
COALITIONS.
I THE FOUNDATION OF THIS A STAND
ABOVE APPROACH IS A COMMON
AGENDA WHICH SHARED MEASURES AND
MUTUALLY ALIGNED ACTIVITIES
ACTIVITIES TO ACHIEVE A COMMON
SET OF GOALS.
I'VE BEEN. OUT TICKET NEXT ABOUT
A COUPLE OF OTHER THINGS THAT
YOU WILL HAVE PROPOSALS ABOUT
I'M REALLY QUICKLY THE ORAL
HEALTH PROGRAM PROP FIFTY SIX
ALLOCATED THIRTY MILLION
ANNUALLY FOR THE STATE'S DENTAL
HEALTH PROGRAM. CD PAGE TO ISSUE
THE ORAL HEALTH PLAN EARLIER
THIS YEAR AS CONTACTED WITH
LOCAL HEALTH DEPARTMENTS TO
CONDUCT FIRST AND ASSESSMENT OF
THEIR DENTAL HEALTH NEEDS IN
THEIR JURISDICTION AND ONGOING
FUNDING TO BUILD THE ORAL HEALTH
PROGRAM.
OUR GENETIC DISEASE SCREENING
PROGRAM AND BEAR WITH ME AS I
TRY TO SAY THE NAMES OF MOVING
HIS DISEASES BUT I THE JACK
DISEASE SCREENING PROGRAM BEGAN
SCREENING FOR ADRENO
LEUKODYSTROPHY ES ALL THE IN
SEPTEMBER. AND HAS SCREENED AT
NINE HUNDRED FIFTY ONE THOUSAND
NEWBORNS SEVENTY BOYS AND
SEVENTY NINE GIRLS WERE
IDENTIFIED WHO HAD EITHER A
POPULAR JOHN THAT.
MUTATION OR A VARIANT OF UNKNOWN
SIGNIFICANCE AND REQUIRED
ADDITIONAL TESTING. OUR GENETIC
DISEASE PROGRAM IS PREPARING FOR
THE ADDITION OF POMPEII DISEASE
AND NICO POLYSACCHARIDE DOSIS.
TYPE ONE AND AND TO DISSIPATES
THE SCREENING WILL BEGIN IN LATE
SUMMER TWO THOUSAND EIGHTEEN IS
ARE ALL GENETIC METABOLISM.
METABOLIC ENZYME DISORDERS THAT
CAN HAVE SERIOUS CONSEQUENCES IF
WE DON'T PROTECT THEM EARLY.
I WILL END NEXT WITH A JUST A
LITTLE BIT ON OUR CANNABIS ON
EFFORTS AND THAT INCLUDES THE
LICENSEE GOT OF CANNABIS
MANUFACTURERS I'M WE HAVE OUR
CENTER FOR ENVIRONMENTAL HEALTH
HERE AND THEY. ARE ARE EXPERTS
IN THE PROVIDE YOU WITH MORE
DETAIL BUT WE AS YOU KNOW WE ARE
TASKED WITH REGULATING AND
LICENSING CANNABIS
MANUFACTURERS.
OUR HIGHEST PRIORITY IN
IMPLANTING THIS IS THE
PROTECTION OF THE PUBLIC HEALTH.
WE HAVE ISSUED OUR EMERGENCY
REGULATIONS AND HAVE BEGUN
ISSUING TEMPORARY LICENSE AS.
AS OF JANUARY FIRST SO AND
THEY'LL PROVIDE A LITTLE BIT
MORE AS WITH FAME DESCRIBE A
PROPOSAL BEFORE YOU TODAY.
WE HAVE ALSO EMBARKED ON AN
UNDER PROP SIXTY FOUR FIVE
MILLION DOLLARS WAS ALLOCATED TO
THE DEPARTMENT HEALTH CARE
SERVICES AND I HAD TO IMPLEMENT
THE PUBLIC EDUCATION COMING
CAMPAIGN. THEY ENTERED INTO. A
COUPLE OF DIFFERENT INTERAGENCY
AGREEMENTS BURST FOR A MILLION
DOLLARS WITH THE OFFICE OF
TRAFFIC SAFETY TO ADDRESS THE.
IMPACT ON DRIVING ASPECTS OF
I'M DRIVING UNDER THE INFLUENCE
OF CANNABIS.
AND WE ARE WORKING ON UP
CAMPAIGN TO EDUCATE THE PUBLIC
ABOUT THE NEW LAW WHAT WHAT
REALLY IS THE NEW LAW WHAT DOES
ENCOMPASS ASSOCIATED PENALTIES
AND RISK THAT SIDE OUT PROP
SIXTY FOUR. WE ARE ALSO LOOKING
AT THOSE RISKS OF CANNABIS USE
TO YOUTH AND PREGNANT
BREASTFEEDING WOMEN AND THOSE
MOST VULNERABLE POPULATIONS.
AT THE CENTER OF THE LET'S TALK
CANNABIS CAMPAIGN IS FORMATIVE
RESEARCH.
AND SO WE DO HAVE A WEBSITE UP
AND RUNNING NOW WE ARE
CONTINUING TO DO WORK ON THE
YOUTH AND THE PREGNANT AND
BREASTFEEDING WOMEN TO
UNDERSTAND CONSUMPTION PATTERNS
ATTITUDES AND BELIEFS. IN ORDER
TO GUIDE OUR PUBLIC EDUCATION
CAMPAIGN OF THIS CAMPAIGN
INCLUDES A WEBSITE TOOL KIT.
FOR OUR LOCAL PARTNERS THAT
MAYBE INTEREST IN USING THESE
MATERIALS DIGITAL RESOURCES
COMMITTEE BASED PROGRAMS AND
STATEWIDE ORGANIZATIONS ALL HAVE
ACCESS TO THOSE MATERIALS.
THE CAMPAIGN WILL FOCUS ON THE
LARGEST PRIORITY AUDIENCES I'M
PREGNANT BUSTING WOMEN AT RISK
YOUTH PARENTS AND MENTORS HEALTH
CARE PROVIDERS AND ADULT USERS.
OR POTENTIAL USERS.
OUR CREATIVE MATERIALS ARE OUT
THERE AND WE WILL BE DELIVERING
ADDITIONAL MATERIALS AS WE
CONDUCT AND FINALIZE OUR AND
FORMING UP RESEARCH ULTIMATELY
THE GOAL IS TO BROWN AND REDUCE
ANY UNINTENDED HARM. TO YOUTH
AND ADULTS ARISING FROM THE
COMMERCIAL AVAILABILITY OF
CANNABIS.
THANK YOU IN HERE WITH ME TODAY
ARE PROGRAM ACT SIR EXPERTS WHO
WILL BE ABLE TO PROVIDE YOU WITH
BACKGROUND ON THEIR PROGRAMS
ADDRESS YOUR SPECIFIC QUESTIONS
AND REVIEW. THE CURRENT
PROPOSALS BEFORE YOU.
THANK YOU DEPARTMENT OF FINANCE
L. L. ANYTHING'S.
PUBLIC COMMENTS ON ISSUE THREE
AT THIS TIME PLEASE COME
FORWARD.
SEEING NONE WILL BRING IT BACK
TO THE DYESS TO SEE IF THERE ARE
ANY QUESTIONS.
.
WELL YOU MENTIONED.
ROUGHLY TWO THOUSAND OPIOID
DEATHS ARE.
DO WE HAVE A MORE EXACT NUMBER
THAN THAT WE HAVE HAD AND HOW WE
HOW WE TRACKING THOSE I KNOW
THAT.
INDIVIDUAL MEDICAL EXAMINERS
CORONERS WHATEVER.
REAP YOU KNOW.
ACTUALLY YOU.
GATHER THIS DATA BUT IS IS THERE
A COMPREHENSIVE SYSTEM IN
CALIFORNIA TO ACTUALLY TRACKING
THIS.
SO WE RELY ON A SEVERAL DATA
SOURCES AND I I WOULD SAY THAT
THERE'S MORE WORK TO BE DONE BUT
WE IS VITAL RECORDS AND LOOK AT.
AND YOU WHAT'S REPORTED ON THE
DEATH RECORD WE ALSO HAVE A
DASHBOARD WE USE THE CURE'S
DATABASE AND.
I HAVE A DASHBOARD AVAILABLE
WITH A VARIETY OF INFORMATION
SOURCES WHERE WE TRIED TO GET
OUT THAT.
AND.
IF I COULD ADD TO IF YOU THE
SPECIFICS OF THE THE TWO
THOUSAND THAT THE SPECIFIC
NUMBER. EXACT NUMBER WAS ONE
THOUSAND NINE TWENTY FIVE AND I
WAS AS OF THE COUNTY YOUR TWENTY
SIXTEEN AND THE INFORMATION THAT
WERE POINT FROM A SUSAN WAS
MENTIONING WAS.
ARE OUR VITAL RECORDS
STATISTICS SO FROM THE DEATH
CERTIFICATES.
EMERGENCY DEPARTMENT VISITS AND
DISCHARGE DATA FOR THAT WE
RECEIVED FROM OUR SPED AND THEN
AS WELL AS.
INFORMATION ON PRESCRIPTION
DRUG DATA FROM THE CURE SYSTEM
THE DEPARTMENT OF JUSTICE
ADMINISTERS DEPENDED THOSE AREAS
OF OR AND AND THAT'S ALL UP ON
OUR DASHBOARD AS WELL IT'S GONNA
CONSOLIDATED. PICTURE.
SO DO YOU TRACK ALSO.
.
I SEE OVER OVERDOSE DEATHS WE
HAVE A NUMBER FOUR BUT THE
NUMBER OF OVERDOSES SET MAKE IT
INTO EMERGENCY ROOMS THAT
REPORTED ANYWHERE AND.
FOR THAT NUMBER SO ON THE
DASHBOARD AGAIN ISN'T IT ON THIS
A COUPLE OF OTHER THINGS SO FOR
THE EMERGENCY DEPARTMENT VISITS
RELATED OVERDOSE WAS THIRTY NINE
HUNDRED ROUGHLY. AND THEN.
OVER THE COURSE OF THE YEAR
JUST ANOTHER PIECE OF DATA THERE
WERE TWENTY FOUR MILLION
APPEARED PRESCRIPTIONS WRITTEN
THAT SAME TWENTY SIXTEEN
CALENDAR YEAR.
AND THAT'S AVAILABLE THERE AS
WELL GREAT THANK YOU.
THANK YOU.
YOU KNOW I KNOW WE'VE
COMMUNICATED OFFLINE BUT
SOMETIMES IT'S NICE TO ACTUALLY
SAY IT IN A HEARING SETTING AS
WELL SO I WOULD LIKE TO
FORMALIZE.
.
AN AGREEMENT IF I COULDN'T SEE
HOW WE COULD MOVE FORWARD.
I BELIEVE THAT WE AS A
LEGISLATURE NEED TO RECEIVE
REGULAR UP TO DATE INFORMATION
REGARDING PUBLIC HEALTH. AND
WOULD LIKE TO BE ABLE TO DISCUSS
HOW WE COULD CREATE A STATE OF
THE STATE'S PUBLIC HEALTH.
WITH SPECIFIC DATA PATTERNS
SO I'D LIKE TO WORK WITH YOU AND
THE DEPARTMENT SO THAT IT MAY
REVISE WE MAY HAVE A PLAN FOR
THIS UPCOMING YEAR. TO BE ABLE
TO GIVE US SPECIFIC DATA METRIC
POINTS THAT WE CAN FOLLOW. AND
TRACK ENTRANT.
SPECIFICALLY IF I COULD TOM I
DID WANT TO ASK BECAUSE I
BELIEVE IT'S TIMELY NOW.
HOW MANY SCHOOL SHOOTINGS HAVE
WE HAD IN CALIFORNIA WHEN HAVE
THEY BEEN? AND HOW MANY CHILDREN
HAVE DIED AT EACH.
SO UNFORTUNATELY WE DON'T
COLLECT SPECIFIC INFORMATION
RELATED TO SCHOOL SHOOTINGS WE
DO HAVE ONE OF YOUR OTHER
QUESTIONS IS RELATED TO FIREARM
DEATHS WE DO. IN OUR ANNUAL
REPORTS A COUNTY HEALTH STATUS
PROFILES REPORT IN IN THAT
REPORT EVERY APRIL WE DO.
REPORT OUT ON THE NUMBER OF
FIREARM RELATED DEATHS WHICH AND
BETWEEN THE TWENTY THIRTEEN
TWENTY FIFTEEN YEAR WAS ROUGHLY
THREE THOUSAND.
BUT RELATED TO SCHOOL SHOOTINGS
WE DON'T COLLECT THAT SPECIFIC
INFORMATION ANECDOTAL LEAVE THE
LAST ONE I RECALL WAS DOWN IN
SAN BERNADINO ON IN APRIL OF
LAST YEAR WHERE UNFORTUNATELY
TEACHER AND STUDENT WERE KILLED.
BY THE TEACHER'S HUSBAND.
BUT WE DON'T COLLECT THAT
INFORMATION WE HAVE REACHED OUT
TO OTHER DEPARTMENTS SUCH AS
EDUCATION DEPARTMENT JUST TO SEE
IF THERE'S INFORMATION OUT THERE
BUT AS FAR AS OUR DEPARTMENT WE
DON'T SPECIFICALLY. WHO WANT A
TRACK THAT INFORMATION?
FOLLOWING UP ON OUR QUESTION
THAT WE HAD ON OPIOIDS YOU HAD
MENTIONED THE NALOXONE PROJECT
WHERE. PHARMACISTS ARE ABLE TO
PRESCRIBE IT. OF NALOXONE TO
PATIENTS WHO ARE RECEIVING
OPIOIDS.
I WAS WONDERING IF YOU HAD
SPECIFIC DATA ON HOW THOSE
PATIENTS ARE DOING THEMSELVES.
IF THEY HAVE HIGHER OR LOWER
RATES OF OVERDOSES COMPARED WITH
THE GENERAL POPULATION. SO THAT
WE CAN ANALYSE THE PROJECT GOING
FORWARD.
I DON'T HAVE THAT ANSWER TODAY
BUT AND WE WILL ON ASK THE
PROGRAM TO GET THAT BACK TO YOU.
I APPRECIATE YOUR WILLINGNESS TO
WORK WITH US IT'S IMPERATIVE
THAT WE HAVE INFORMATION SO THAT
WE CAN MAKE DECISIONS AS WELL
AND LOOK FORWARD TO WORKING WITH
THE DEPARTMENT TO FIGURE OUT.
HOW THE SUBCOMMITTEE CAN GET THE
APPROPRIATE METRICS?
WITH THAT STAFF HAS RECOMMENDED
HOLDING THIS ITEM OPEN AND WE'LL
MOVE ON TO ISSUE FOR.
THINK
.
GOOD AFTERNOON. MY NAME IS MONA
COME AROUND THIS TIME THE DEPUTY
DIRECTOR FOR THE CENTER FOR
CHRONIC DISEASE PREVENTION AND
HEALTH PROMOTION.
I'LL START WITH AN OVERVIEW.
OF THE CENTER FOR CHRONIC
DISEASE PREVENTION AND HEALTH
PROMOTION IS ORGANIZED IN THREE
MAJOR COMPONENTS.
THE YOU NEVER CHRONIC DISEASE
AND INJURY CONTROL.
THE UNIT FOR ENVIRONMENTAL
OCCUPATIONAL DISEASE.
AND THE OFFICE OF PROBLEM
GAMBLING.
THE CENTER CURRENTLY HAS
APPROXIMATELY THIRTY PROGRAMS.
AND AN APPROXIMATE BUDGET OF
FOUR HUNDRED AND EIGHTY EIGHT
MILLION DOLLARS.
WE ALSO HAVE APPROXIMATELY FOUR
HUNDRED AND FIFTY STAFF.
OUR MAIN FOCUS IS ON PREVENTION
EFFORTS SPECIFICALLY ON
ACTIVITIES SUCH AS EVALUATION
POLICY ENVIRONMENTAL CHANGES.
SURVEILLANCE PROMOTION TECHNICAL
ASSISTANCE AND EDUCATION.
YOU WILL NOTE SPECIFIC
PROGRAMMATIC HIGHLIGHTS ON
TODAY'S AGENDA.
AT THIS POINT I'M HAPPY TO
ANSWER ANY QUESTIONS ABOUT THE
CENTER OR I'M HAPPY ALSO JUST
MOVE FORWARD IN ANSWERING THE
QUESTIONS THAT ARE PART OF
SECTION FOUR AROUND. BY A
MONITORING ALZHEIMER'S AND
PARKINSON'S REGISTRY.
THINK IF.
RIGHT BIOMONITORING. SO IN TERMS
OF THE TWO THOUSAND SIXTEEN
INCREASE.
.
AB ONE TO TO KIND OF START OFF A
LITTLE WOULD PROVIDE SOME
BACKGROUND ON THE CALIFORNIA
ENVIRONMENTAL CONTAMINANT BY
WATCHING PROGRAM WAS
ESTABLISHED.
BY LEGISLATION IN TWO THOUSAND
SIX.
BY MONITORING IS THE MEASUREMENT
OF CHEMICALS IN A PERSON'S BODY
FLUIDS AND TISSUE INCLUDING
BLOOD OR URINE. IT TELLS THEM ON
OF THE CHEMICAL THAT ACTUALLY
GETS INTO PEOPLE FROM ALL
SOURCES AIR SOIL WATER. OR
COMBINED.
BECAUSE IT THIS BY A MONITORING
CAN BE PRO PROVIDE HELPFUL
INFORMATION AND HOW MUCH
EXPOSURE TO TOXIC. CHEMICALS A
PERSON HAS.
THE BIO MARCHING CALIFORNIA
PROGRAM.
IS A COLLABORATION OF THE
DEPARTMENT TOXIC SUBSTANCE
CONTROL. IN A WE HAVE OFFICE OF
ENVIRONMENTAL HEALTH HAZARD
ASSESSMENT.
IN TERMS OF THE TWO THOUSAND
SIXTEEN INCREASE.
THERE ARE THREE COMPONENTS THAT
WERE USED TO WITH THOSE OF
FUNDING RESOURCES ONE WHAT'S
AROUND EDUCATION AND OUTREACH.
WERE WE GATHERED INFORMATION ON
ENVIRONMENTAL JUSTICE CONCERNS
ACROSS COMMUNITIES IN
CALIFORNIA.
WE ALSO EDUCATED COMMUNITIES AND
HOW BY HIM ON A TEAM WORKS
AND IDENTIFY WAYS IN WHICH BY
MONITORING CALIFORNIA CAN BE
RESPONSIVE TO ENVIRONMENTAL
ISSUES ACROSS THE STATE.
FINING WILL ALSO PRODUCED A
BIANNUAL NEW SLATER.
FURTHERMORE THE FUNDING
SUPPORTED ENVIRONMENT AND
BIOMONITORING FIELD WORK STUDY.
THE STUDY ASSESSED THE LEVELS OF
ENVIRONMENTAL CONTAMINANTS IN
THE VIETNAMESE POPULATION IN SAN
JOSE CALIFORNIA.
IT ALSO SUPPORTED LABORATORY
RESEARCH AND EQUIPMENT.
THAT ENHANCE OR WAS PART OF THE.
.
STUDIED THE BY ONE CAN STUDY.
CURRENTLY THE DATA IS BEING.
PRETTY MUCH ANALYZE AND
FINALIZE STE FROM THE VIETNAMESE
POPULATION STUDY IN SAN JOSE.
WE WILL FOLLOW UP PROVIDING
EDUCATION TO THE COMMUNITY. AND
PROVIDE INFORMATION ON UP
PREVENTION INFORMATION ON WHAT
WE LEARNT.
IF THERE ANY QUESTIONS
CAN MOVE FORWARD GREAT.
VETERANS OF THE ALZHEIMER'S
FUNDING.
LIBERTY BACKGROUND ON THE
ALZHEIMER'S DISEASE PROGRAM.
THIS IS A PARTNERSHIP WITH THE
TANK CALIFORNIA ELSE AMHERST
EASY CENTERS.
WE WORK TO REDUCE THE HUMAN
BURDEN ECONOMIC COSTS ASSOCIATED
WITH AL SAMAR'S. WE ALSO WORK TO
EDUCATE STAKEHOLDERS AND
COMMUNITY ABOUT THE AL SOMERS
DISEASE.
THE ONE TIME INCREASE IN GENERAL
FUND OF TWO POINT FIVE MILLION
DOLLARS WAS USED TO PROVIDE
PROFESSIONAL OUR REGION
EDUCATION AND AL SAMAR'S.
EVALUATE THE EDUCATIONAL
EFFECTIVENESS OF THESE EFFORTS.
AND ALSO WE PUT IN PLACE AND NOW
SUMMERS TOOLKIT.
THE TOOLKIT IS TO HELP
CLINICIANS IDENTIFY SITUATIONS
WHERE ELSE AMHERST IZZY'S IS NOT
STRAIGHTFORWARD.
SPECIFICALLY THE TOOK IT IS
INTENDED TO PROVIDE
PRACTITIONERS WITH METHODS TO
IDENTIFY SIGNIFICANT COGNITIVE
COMPLAINTS.
COMPLETED DETAILED ASSESSMENT.
AND INITIATE PROPER REFERRALS.
CDP H. WORK WITH THE ALZHEIMER'S
ON CENTERS
TO ACTUALLY CREATE THIS TOOLKIT
CURRENTLY IT IS IN DRAFT FORM.
AND WE IT'S EXPECTED TO.
WORKS BECKETT TO BEGIN PILOTS
AND.
THIS SUMMER.
MOVING ON UP THERE NO QUESTION
AS TO ITEM NUMBER TWO QUESTION A
TO EXCUSE ME.
RIGHT THE PARKINSON'S DISEASE
REGISTRY.
SO OVER THE PAST EIGHT MONTHS.
WE HAVE SPENT A LOT OF TIME
TRYING TO FIGURE OUT WHAT THE
BEST PATH IS TO MEET.
THE QUICKLY APPROACHING
DEADLINE OF THE REGISTRY.
THIS INCLUDES CONVENING WHAT
STAKEHOLDERS AT THE COMMUNITY
LEVEL TO GET A SENSE OF THE DATA
NEEDS THAT WE NEED IN THE STATE
REGARDING PARKINSON'S.
IN ADDITION WE'VE MET WITH OTHER
STATES SUCH AS YOU TALK TO LEARN
ABOUT THEIR OWN REGISTRY
PLATFORMS AND THAT TYPE OF THE
MEASUREMENTS THAT THEY'RE YOU
KNOW TRYING TO COLLECT.
IN ADDITION THE TEAM IS
CURRENTLY WORKING ON MEDIAN.
FOR EXAMPLE THERE IS OF THE
JANUARY TWO THOUSAND EIGHTEEN
REQUIREMENT TO START COLLECTING
INCIDENTS ON PARKINSON'S.
AND WE ALSO HAVE THE LEGISLATIVE
REQUIREMENT.
ON IT DUE APRIL FIRST TO START
POSTING INFORMATION ON THE
REQUIREMENT ON A WEB SITES OR
ACTIVELY WORKING ON THAT RIGHT
NOW.
IN TERMS OF A POTENTIAL DATA OF
REGISTRY. WE ARE CONCLUDING THAT
THE BEST PATH FOR S. CONSIDERING
HOW QUICKLY THIS IS APPROACHING
IS TO LOOK AT AN INTERNAL
SOLUTION.
WERE LITEON AND HAVE MET WITH
DIFFERENT PROGRAMS ACROSS OUR
DEPARTMENT.
TO IDENTIFY WHAT MIGHT WORK BEST
CONSIDERING THE BUDGET AND THE
TIMELINE IN WHAT WE ARE LOOKING
AT RIGHT NOW IS.
ATTENTION THE EXPLORING OF THE
MODEL THAT CAL RABIH USES FOR
COMMUNICABLE DISEASES.
SO.
MORE TO REPORT ON YOU ON AND
WHAT THAT'S GONNA LOOK LIKE TO.
AND THE FUTURE.
QUESTIONS.
THANK YOU.
ARE THERE IS ALSO A QUESTION
ABOUT THE COST ESTIMATE TO
ESTABLISH A FOR REG A FULL
PARKINSON'S REGISTRY.
AT THIS POINT AND I ANALYZE
SEEN A WHERE WE ARE WITH OF THE
PARKINSON'S REGISTRY WERE
ESTIMATING A COST OF ABOUT. TEN
TO FIFTEEN MILLION DOLLARS.
AND THE RANGE WOULD REALLY BE
ABOUT FOUR TO SIX MILLION OF ONE
TIME TO REALLY BUILD THE
AUTOMATED INFRASTRUCTURE.
ALL OF FOUR TO SIX MILLION AN
ONGOING.
TO MAINTAIN AND BUILD THE
INFRASTRUCTURE OF FOR HOSPITALS
TO REPORT
COMPLETE TIMELY IN CLEAN DATA.
AND ABOUT TWO TO THREE MILLION
DOLLARS ON GOING UP FOR
OVERSIGHT SURVEILLANCE.
DATA WHERE I'M HOUSE DESIGN.
AND NOT REPORTING.
ITEM NUMBER THREE.
NUTRITION EDUCATION OBESITY
PREVENTION PROGRAM ALSO KNOWN AS
NEON UP.
YUP SUPPORTS A COMPREHENSIVE
MORE TIGHT STRATEGY FOR OBESITY
PREVENTION BY FOCUSING ON POLICY
SYSTEMS AND ENVIRONMENTAL CHANGE
STRATEGIES.
THROUGH COMMUNITY ENGAGEMENT.
WE HAVE APPROXIMATELY HUNDRED
STAFF.
THE FUNDING PRIMARILY COMES
THROUGH OF INTER AGENCY
AGREEMENT WITH THE DEPARTMENT
OF-SOCIAL SERVICES.
THE FUNDING FROM THE DEPARTMENT
OF SOCIAL SERVICES COME SPRING
NINETY STATE'S DEPARTMENT OF
AGRICULTURE USDA.
AND IT'S ROUGHLY SEVEN SEVENTY
SEVEN MILLION DOLLARS ANNUALLY.
YUP ALSO HAS FUNDING FROM THE
SENATE FOR DISEASE CONTROL.
ABOUT A HUNDRED AND NINETY FOUR
THOUSAND DOLLARS ANNUALLY.
AND FUNDING FROM THE PREVENTIVE
HEALTH.
AND HEALTH SERVICES BLOCK GRANT
OF ABOUT THREE HUNDRED THOUSAND
DOLLARS ANNUALLY.
THE TOTAL PROGRAM BUDGET FROM
THE UP IS APPROXIMATELY SEVENTY
EIGHT POINT ONE MILLION DOLLARS.
ME UP HAS A UNIQUE.
APPROACH BECAUSE WE ACTUALLY
HAVE A WE OPERATE THROUGH A
LOCAL HEALTH DEPARTMENT MODEL.
SO WE FUND FIFTY FOUR MILLION
DOLLARS UP TO SIXTY A LOCAL
HEALTH JURISDICTIONS TO REALLY
UNDERGO AND DO A LOT OF THE
COMMUNITY WORKAROUND I SNAP AT
EDUCATION.
PRIMARILY WE FOCUS ON EDUCATION
SO.
WORKING WITH SCHOOLS AND
COMMUNITY SETTINGS ARE ON
DIETARY GUIDELINES.
WE ALSO AS YOU.
MIGHT KNOW WOULD DO A LOT OF
MEDIA AND MESSAGING CAMPAIGNS TO
PROMOTE HEALTHY EATING AND.
PHYSICAL ACTIVITY.
WE PROVIDE TECHNICAL ASSISTANCE
AND TRAINING TO COMMUNITY IN
STAKEHOLDERS.
AND WE DO A COMPREHENSIVE
EVALUATION DESIGNS BOTH ON OUR
MEDIA EFFORTS AND AND ALSO
CREATE INSTRUMENT TOOLS.
OF FOR OUR PROGRAMS AND THEN
STATEWIDE SURVEYS ON ON EATING
AND PHYSICAL ACTIVITY.
QUESTIONS.
AYE WORLD BUT AFTER. ARE YOU
DONE PRESENTING.
I'M PRESIDENT I'M DONE ISSUE FOR
IT LOOKS TO BERMAN A FINANCE
ILIO ANY COMMENTS ON ISSUE FOR.
SEEING NONE WILL TAKE PUBLIC
COMMENT ON THE ISSUE FOR.
WILL BRING BACK THE DYESS FOR
ANY QUESTIONS THAT YOU MAY HAVE.
BECAUSE HOPING TO TALK TO YOU A
LITTLE BIT ENDING IN MORE ON THE
NUTRITION EDUCATION AND OBESITY
PREVENTION BRANCH. CAN YOU GIVE
US A SENSE HOW WE'RE DOING.
AS A STATE. ARE WE MAKING
IMPROVEMENTS IS THE. INVESTMENT.
.
ARE WE GETTING A GOOD RETURN ON
INVESTMENT WITH.
THE CURRENT SPENDING.
THAT'S A GREAT QUESTION.
WHEAT WE KNOW THAT NATIONALLY
OUR SNAP EDUCATION PROGRAM IS
ACTUALLY WAS. WELL KNOWN WE
PRODUCE SOME OF WE HAVE AWARDS
FOR THE MEDIA CAMPAIGNS THAT WE
PRODUCE WERE ALSO VERY AWARE OF
CULTURAL COMPETENCY AND TRY TO
DO A LOT OF OUR. EDUCATION
AROUND YOU KNOW TARGETING
COMMUNITY SPECIFIC COMMUNITIES.
IN TERMS OF OUR EFFORTS IN
PHYSICAL ACTIVITY AND OBESITY
WERE KIND OF WATCHING A STAGNANT
APPROACH WHEN ON TERMS OF THE
DATA.
THAT IN GENERAL FOR US WE
CONSTANTLY GET RECOGNIZED BY THE
CENTERS FOR DISEASE CONTROL AND
OTHER STAKEHOLDERS NATIONALLY
FOR THE WORK THAT WE'RE DOING
HERE.
GREAT OF WITH THAT WILL MOVE ON
TO ISSUE FIVE AND GO FOR THE.
RIGHT. ISSUE FIVE THE TOBACCO
TAX POP NINETY NINE ABOUT FIFTY
SIX.
SO THE BUDGET ADJUSTMENTS TO THE
TOBACCO CONTROL PROGRAM OUR ARMY
SOLDIER PROP NINETY NINE REVENUE
CHANGES AND PROP FIFTY SIX
TECHNICAL ADJUSTMENTS.
SO I'M SPECIFICALLY FOR A
CHANGES HER PROPOSITION NINETY
NINE WE SAW A DECREASE AN
APPROPRIATION FOR AND THE HEALTH
EDUCATION ACCOUNT FOR YEAR
SEVENTEEN AND EIGHTEEN AND THEN
EIGHTEEN AND NINETEEN. THERE'S A
DECREASE IN APPROPRIATION AND
AMOUNTS OF ONE POINT SEVEN
MILLION DOLLARS AND SEVENTEEN
EIGHTEEN AND FIVE POINT SEVEN
MILLION IN EIGHTEEN NINETEEN.
THE REDUCTION ON IN EIGHTEEN
NINETEEN WILL IMPACT ACTIVITIES
PERTAINING TO MEDIA EVALUATION
AND LOCAL ASSISTANCE.
SPECIFICALLY FOR PROPOSITION
FIFTY SIX FIFTY SIX EXCUSE ME
IT'S A TECHNICAL ADJUSTMENT TO
DECREASE APPROPRIATION. DUE TO
FOUR QUARTERS OF UP REVENUE
AVAILABLE VERSUS FIVE QUARTERS
IN REVENUE AVAILABLE.
AS A RESULT THERE IS A DECREASE
IN APPROPRIATION AND THE AMOUNT
OF FIFTY FIVE MILLION DOLLARS
FOR THE TOBACCO PREVENTION AND
CONTROL ON ACCOUNT.
THIS WILL RESULT IN A DECREASE
IN APPROPRIATION FOR ACTIVITIES
PERTAINING TO MEDIA EVALUATION
AND LOCAL ASSISTANCE.
MON.
AND THERE'S A QUESTION ABOUT THE
INTERACTION BETWEEN THE TWO
FUNDING SOURCES.
AND YOU KNOW FOR US WHEN AND WE
LOOK AT PROPOSITION NINETY NINE
AND SOME OF THE SUPPORT AND
RESOURCES THAT THAT HAS REALLY
ENTAILED. HAS REALLY HELPED
BUILD THE FOUNDATION FOR THE
TOBACCO AND CAN.
PREVENTION CONTROL PROGRAM.
THERE IS KEY AYE AREAS OF FOCUS
FOR US THROUGH PROP NINETY NINE
THAT HAVE BEEN. ON IT SOLIDIFY
BECAUSE OF THE FINDING INCLUDING
MEDIA EVALUATION. PREVENTION
EFFORTS AT THE LOCAL AND
COMMUNITY LEVEL.
FOR WITH PROP FIFTY SIX FUNDING
HAS
HOW DO SIGNIFICANT IN CRITICAL
ROLE IN EXPANDING AND ALL THE
MEN TEAM THAT REALLY WHAT PROP
NINETY BACK HAS BUILT FOR US.
WHAT I MEAN SPECIFICALLY FROM
THAT IS THAT? YOU KNOW WITH PROP
NINETY NINE WE WERE ABLE TO
DEVELOP MEDIA CAMPAIGNS IN THE
PAST FOR EXAMPLE. THAT WERE
TRANSLATED INTO MULTIPLE
LANGUAGES WHAT PROP FIFTY SIX
WERE ABLE TO BUILD OFF OF THOSE
ACTIVITIES AND NOT ONLY CONTINUE
THE WORK AROUND. OTHER MEDIA
CAMPAIGNS IN TRANSLATING PAY
ACTUALLY TARGETING PRIORITY
POPULATIONS SUCH AS THE GAY
LESBIAN BISEXUAL COMMUNITY THE
ASIAN POPULATIONS. AND WERE ALSO
NOT REALLY ADDRESSED SEEN
EMERGING ON ISSUES IN TOBACCO
CONTROL LIKE ELECTRONIC
CIGARETTES.
SO WHAT WERE YOU USING AND THE
WAY WE THINK ABOUT OUR
APPROACHES LOOKING AT A WILL HAS
BEEN BUILT HISTORICALLY WITH
PROPER NINETY NINE AND REALLY
IDENTIFYING PRIORITY POPULATIONS
AND EMERGING ISSUES MOVING
FORWARD TO PROP FIFTY SIX. BOTH
COMBINED.
THANK YOU.
DEPARTMENT OF FINANCE LA JOH NA
COMMENTS ON ISSUE FIVE.
AND A PUBLIC COMMENT ON ISSUE
FIVE.
SAYING NONO BRING IT TO THE
DYESS FOR ANY QUESTIONS.
I JUST HAVE ONE IT'S.
FOR YOU DEPARTMENT OF FINANCE
ON PAGE TWENTY THREE OF OUR
HANDLE IT SAYS THAT.
WE HAVE FORTY MILLION INVESTED
IN PHYSICIAN TRAINING FOR THE
UNIVERSITY OF CALIFORNIA. FOR
PRIMARY CARE AND EMERGENCY
PHYSICIANS IN CALIFORNIA.
AND I WAS WONDERING. IS THAT A
TYPO OR DID THAT ACTUALLY
HAPPEN.
FOLLOW DEPARTMENT OF FINANCE
VIRTUALLY I DON'T HAVE THAT
DETAIL AFFRONT TO ME I WOULD
HAVE TO.
GO BACK AND TALK WITH MY PROP
THE SIX COME APART FROM THAT
BUTI CAN GET YOU THAT
INFORMATION.
TOM FORESHADOWING A BIT IF I
CAN.
MY UNDERSTANDING WAS THAT
FUNDING WAS NOT PRESENT IN LAST
YEAR'S BUDGET AND WOULD LIKE TO
MAKE SURE THAT.
WE AS A STATE ARE DOING
EVERYTHING WE CAN TO FUND
GRADUATE MEDICAL EDUCATION AS
THE VOTERS INTENDED FOR US.
TO DO AND WILL LOOK TO BE
WORKING WITH YOU.
TO ENSURE THAT GOING FORWARD.
YES.
WE KEEP ASKING FOR INFORMATION
AND I GUESS IF WE CAN MAKE IT I
GOT.
COMPACT IS TO FOR ALL OF US TO
RECEIVE IT BUT.
I KNOW WE'VE BEEN ASKING
QUESTIONS AND I DON'T SEEM TO BE
GETTING THE INFORMATION
THAT YOU REQUEST I KNOW WE
REQUESTED THAT MEETINGS BUT
I'VE.
IN DON'T SEEM TO BE GETTING IT'S
A WHATEVER INFORMATION YOU
PROVIDE TO DOCTOR ARAMBULA I
WOULD LOVE.
FOR THE WHOLE.
COMMITTEE TO TO HAVING.
THINK.
STAFFERS RECOMMENDED NO ACTION
ON ISSUE FIVE ME WITH THAT WE
WILL MOVE ON TO ISSUE SIX.
TO THE ALZHEIMER'S BUDGET AND
THE VCP EXCUSE ME AL SUMMERS BCP
IS REQUESTING AN EXPENDITURE
AUTHORITY INCREASE OF TWO POINT
SKINNY THREE POINT TWO MILLION
DOLLARS.
AND FISCAL YEAR EIGHTEEN AND
NINETEEN DERIVING FROM THE
GENERAL FUND FOR A TOTAL OF
THREE POINT ONE MILLION. AND THE
CALIFORNIA ALZHEIMER'S RESEARCH
FUND FOR A HUNDRED AND FOUR
THOUSAND DOLLARS.
ALSO IN I'M GOING TO CREATE AN
EXPENDITURE AUTHORITY IN STATE
OPERATIONS.
FROM THE CALIFORNIA ALZHEIMER'S
RESTRICT CAO CONSISTING OF A
HUNDRED AND THIRTY EIGHT
THOUSAND DOLLARS.
FINALLY THERE IS IN ADDITION. IN
AT THE BCP. REQUESTING AN
EXPONENTIAL INCREASE IN NINETEEN
TWENTY AN OUTGOING. OF THREE
POINT ONE MILLION DOLLARS FROM
THE GENERAL FUND.
THIS INCREASE IN EXPENDITURE
AUTHORITY WILL ALLOW CBP H. TO
FUND RESEARCH RELATING TO THE
STATE ALZHEIMER'S DISEASE.
I'M IN SOME RESEARCH PRIORITIES
INCLUDE CAREGIVING BIOMARKERS
INNER DETECTION RISK PREVENTIVE
FACTORS AND HEALTH DISPARITIES.
IF IT'S A KEY WITH THE CHAIR I I
FEEL LIKE I ANSWERED QUESTION.
RECORDING THE UPDATED BUDGET
FOR TWENTY SIXTEEN WE CAN MOVE
ON.
DEPARTMENT OF FINANCE ELIANA
COMMENTS ON ISSUE SIX.
ANY PUBLIC COMMENTS ON ISSUE SIX
AT THIS TIME.
SEEING NO QUESTIONS FROM THE DIE
OF STAFF HAS RECOMMENDED NO
ACTION AT THIS TIME WE'LL MOVE
ON TO ISSUE SEVEN.
THE CHILDHOOD LEAD PREVENTION.
PUT THINKS HE'S ME.
WHICH OTHER LED PREVENTION
PROGRAM HAS WORKED ON PREVENTION
AND REDUCING CHILDREN FROM
EXPOSURE OF LED. BY DEVELOPING
PROTOCOLS AND STANDARDS FOR
PREVENTION DEVELOPING REPORTING
PROCEDURES SURVEILLANCE CASE
MANAGING HOME VISITING.
EDUCATION IN OUR.
THIS VCP REQUEST EXPENDITURE
AUTHORITY OF TWO HUNDRED AND
SEVENTY SIX THOUSAND DOLLARS IN
STATE OPERATIONS FROM THE
CHILDHOOD LEAD POISONING
PREVENTION SPECIAL FINE.
I CARRY OUT NEW REGULATIONS PER
ASSEMBLY BILL THIRTEEN SIXTEEN.
SPECIFICALLY REQUESTING TO FTA
EASE
TO HELP WITH THE NEW OF
REGULATORY REQUIREMENTS AROUND
NEW REGULATIONS DATA ANALYSIS
REPORTING OF ADDITIONAL BLOOD
IN.
AND BLOOD DRUG TESTS.
DEPARTMENT OF FINANCE MILIONI
COMMENTS ON ISSUE SEVEN.
ANY PUBLIC COMMENT ON ISSUES
THAT.
GOOD AFTERNOON I'M SUSAN LITTLE
I'M WITH THE ENVIRONMENTAL
WORKING GROUP. AND THE BERMAN
WORKING THE DEPARTMENT'S
REQUEST.
AND WOULD LIKE TO THANK THEM
FOR PUTTING IT FORWARD AND WE
WOULD ALSO.
JUST LIKE TO.
.
PASS A SUBCOMMITTEE TO CERTAINLY
APPROVAL OF THE FUNDING I KNOW
THERE'S SOME DIFFERENT OPTIONS.
PUT FORWARD AND WE WOULD JUST
LIKE TO SEE THAT THE BILL IS
FULLY IMPLEMENTED.
FINALLY I'D JUST LIKE TO.
STATE THAT THE JUST RECENTLY AS
A MATTER OF COMMENT.
.
IN BURMA WORKING GROUP WORKED
WITH THE YES TEAM COMMITTEE TO
IDENTIFY THE.
BILLING RATES THAT DEPARTMENT
HEALTH CARE SERVICES HAS LIKE
HAS.
.
BOTH. TO IDENTIFY THE AMOUNT OF
LEAD TEST DEPARTMENT HEALTH CARE
SERVICES HAS BUILT OVER THE LAST
FEW YEARS FOR LET TESTING FOR
MEDI CAL KIDS WHO SHOULD BE
TESTED WHEN THEY'RE ONE AND TWO.
AND WHAT WE FOUND IS THAT.
EVEN WITH VARIOUS ADJUSTMENTS
SUCH A SLIGHTLY MORE THAN TWENTY
EIGHT PERCENT OF THOSE KIDS.
THEY SHOULD BE GETTING TESTED
ARE ACTUALLY GETTING TESTED AND
SO IT JUST ILLUSTRATES COME A
PROBLEM MORE HAVING RIGHT NOW
WITH LUCK WITH LEAD TEST RATES
AND. TRYING TO GET HOME FULL
COMPLIANCE AND TRYING TO
IDENTIFY ALL THE KIDS ARE AT
RISK.
SO AGAIN WE JUST SUPPORT THIS
MEASURE THIS SOME PROPOSAL AND
ALSO WAY AND ON BEHALF OF CLEAN
WATER ACTION. IN THEIR MARMOL
JUSTICE COALITION FOR WATERS
WILL IN SUPPORT THANK YOU THANK
YOU MA'AM.
ASSEMBLY MEMBER THANK YOU VERY
MUCH MY NAME IS STEPHANIE
MACKLIN I AM. A. RESEARCHER WITH
THE COALITION OF CALIFORNIA
WELFARE RIGHTS ORGANIZATIONS WE
ARE ALSO SPEAKING IN SUPPORT OF
THE BUDGET PROPOSAL.
OUR CONCERN IS THAT NGUYEN
TWENTY EIGHT PERCENT OF THE
NUMBER OF A ONE AND TWO YEAR
OLDS WHO SHOULD BE TESTED. ORBIT
AND IS AND THAT AMAZINGLY LOW
NUMBER IT MEANS THAT ALMOST FIVE
HUNDRED THOUSAND CHILDREN WHO
SHOULD BE TESTED ARE NOT BEING
TRUSTED. OR DEEPLY CONCERNED
THAT THOSE CHILDREN WILL PAY FOR
WITH THIS ALL FOR THE REST OF
THEIR LIVES IN TERMS OF POVERTY
AND LOST OPPORTUNITIES BECAUSE
BLOOD POISONING. SO DEEPLY
AFFECTS SO MANY THINGS IN THEIR
LIVES PARTICULARLY THEIR ABILITY
TO LEARN THANK YOU BEGIN.
I UNANSWERED URIAH BEHALF OF THE
BREAST CANCER PREVENTION
PARTNERS AND WE SPEAK IN SUPPORT
OF THIS.
PROPOSAL WELL IT IS LETTERS
PRIMARILY LOOKED AT AS A
NEUROTOXIN IT ALSO HAS.
HEAVY METALS HAVE SOME CONCERN
FOR BREAST CANCER CAUSATION AS
WELL SO WE'RE CONCERNED ABOUT
THIS AS WELL. THINKING UP.
YOU GET A CREDIT WITH AN ARCH
RESOURCES DEFENSE COUNCIL IN
SUPPORT OF THIS BUDGET REQUEST
ENERGIES HIS WORK WITH COMMUNITY
LEADERS IN FLINT MICHIGAN. OUGHT
TO RESPOND TO THE LEAD CRISIS
AND SECURE SAFE WATER TAUGHT US
MANY LESSONS ONE OF THEM WAS THE
IMPORTANT ROLE OF THE MEDICAL IN
THE PUBLIC HEALTH COMMUNITY. TO
OUTRIGHT LEAD EXPOSURES AND
SOUND THE ALARM WHEN ACTION IS
NEEDED WE SUPPORT THIS REQUEST
TO AMEND BELIEVE IT'S REALLY
VALUABLE FOR CALIFORNIA'S
CHILDREN TO BE PROPERLY TESTED
PHILIP EXPOSURES THINKING.
THANK YOU.
I THINK THERE WERE SOME FURTHER
QUESTIONS I HAD AND SO IF YOU
WANT I ANSWER THEM NOW THAT BE
GREAT IN THE WILL BRING IT BACK
TO US.
SO WE HAVE A QUESTION ABOUT THE
PERCENT OF MEDI CAL KIDS THAT
ARE BEING TESTED ON.
ARE AT THE DEPARTMENT OF PUBLIC
HEALTH DONE CHILDHOOD LEAD
POISONING PREVENTION BRANCH DOES
NOT HAVE DATA ON THE NUMBER OF
CHILDREN WHO ARE CONTINUE TO BE
INVOLVED IN MEDI CAL.
IN ACCORDANCE WITH THE
CALIFORNIA LAW CLIP RECEIVES
ELECTRONIC REPORTS DIRECTLY FROM
THAT THE TORIES PERFORMING THE
BLOOD LET TESS.
CLIP IS NOT RECEIVE INSURANCE
INFORMATION OR INCOME.
THE DEPARTMENT HEALTH CARE
SERVICES HAS THAT INFORMATION ON
THE NUMBER OF CHILDREN CONTINUE
TO BE INVOLVED IN MEDI CAL.
HOWEVER ON FEBRUARY THIRTEENTH
THE COMMITTEE FOR ENVIRONMENTAL
SAFETY AND TOXINS MATERIALS.
REQUESTED THE DEPARTMENT HELPED
HER SERVICES CONFIRM THE NUMBER
OF MEDI CAL CHILDREN BEING
TESTED.
THE DEPARTMENT OF PUBLIC HEALTH
IS WORKING WITH D. H. CS ON THE
STATE I'M ACTION WILL BE
REPORTING BACK THE RESULTS.
QUESTION NUMBER TWO.
I'M SINCE LAUREN THE CASE
DEFINITION BLOOD LEAD TEST
REPORTED TO CLIP.
AND BEING PROCESSED WENT FROM
SIX HUNDRED AND EIGHTY THOUSAND
DOLLARS. UNTIL THERE'S A HUNDRED
AND EIGHTY THOUSAND CASES.
TWO SEVEN HUNDRED AND TWENTY
FIVE ON THE FROM TWO THOUSAND
SIX TO TWO THOUSAND SEVENTEEN.
I'M SORRY EMIGRATE THAT FOR TWO
THOUSAND SIXTEEN TO TWO THOUSAND
SEVENTEEN.
FURTHERMORE THE NUMBER OF
CHILDREN IDENTIFY AS A CASE OF
LEAD POISONING HAS INCREASED
MORE THAN THREEFOLD. FROM TWO
HUNDRED TO OVER SIX HUNDRED AND
TWENTY CASES IDENTIFIED FROM
JULY TWENTY SIXTEEN. THROUGH
JUNE TWENTY SEVENTEEN.
TECHNICAL ASSISTANCE ENCOUNTERS
BY OUR STAFF TO LOCAL PROGRAMS
AND HOW PROVIDERS WENT FROM
SEVEN THOUSAND TWO HUNDRED AND
TWENTY FIFTEEN TO FIFTEEN
THOUSAND AND TWENTY SEVENTEEN.
SO AS YOU CAN SEE.
THERE'S BEEN.
AT DEFTLY AT INCREASE IN
WORKLOAD AND TECHNICAL
ASSISTANCE BEING PROVIDED AS A
RESULT OF THEIR LORENA AT THE
CASE DEFINITION.
NUMBER THREE.
CURRENTLY FORTY NINE LOCAL
JURISDICTIONS ARE ALLOCATED
TWENTY THREE MILLION DOLLARS IN
COMBINED CLIP IN FEDERAL
MEDICARE HOW FINDING.
THE COUNTY ALLOCATIONS ARE
DETERMINED BY TAKING INTO
ACCOUNT
THE NUMBER OF CHILDREN WITH
INCREASED SPELL LEVELS IN EACH
COUNTY.
THE NUMBER REPORTED MEDI CAL
CHILDREN UNDER AGE SIX.
AND THE NUMBER OF YOUNG CHILDREN
AND OLDER HOUSING.
THAT IS THE METHODOLOGY USED BY
THE PROGRAM.
FOR COUNTY ALLOCATIONS
LET ME JUMP IN FOR A SECOND
YOU'RE SAYING NUMBER NOT
PERCENTAGE.
SO WOULDN'T THAT INHERENTLY
FAVORED THE LARGER COUNTIES TO
RECEIVE.
MORE OF AN ALLOCATION. IS
PERCENTAGE A BETTER OPPORTUNITY
FOR US TO RECOGNIZE THE
PREVALENCE OF.
THIS DISEASE PROCESS.
THAT'S A GOOD QUESTION YOU'RE
BRING ENOUGH.
CURRENTLY I I DON'T HAVE
EXACTLY HOW THE FORMULAS BASED I
CAN FOLLOW UP AND MAKE SURE I
DON'T KNOW DOCTOR STAR THING IF
YOU RECALL ANYTHING ABOUT THAT.
NO SORRY FOR THE SUDDEN
APPEARANCE HERE I'M I'M LOCKED
MARK STAR DIPPY DIRECTOR FOR
RONALD HEALTH AND.
I WAS ACTING OVER THE CENTER YOU
MAY RECALL LAST YEAR SO I MEMBER
A FEW THINGS NOT TOO MUCH
ANYMORE.
BUT I THINK THE PROGRAM DOES
TARGET OF RESOURCES BASED ON. OF
THE NEED AND AS WELL AS
POPULATION SO THAT THEY LOOK AT
CENSUS DATA. THEY THE LOVE THE
TARGETING IS BASED ON LOWER
INCOME BECAUSE LOWER INCOME
HOUSEHOLDS TEND TO BE OLDER
HOUSEHOLDS.
AND YOU USE TOOLS LIKE THAT AS
WELL.
I'M.
THIS ONE HITS A LITTLE CLOSE TO
HOME IF IF I CAN I HAVE OBSERVED
CODE IN MY COMMUNITY WHERE WE
HAVE OVER TEN PERCENT OF KIDS
WHO. HAVE LEAD TOXICITY.
AND THAT I JUST WANTED TO MAKE
SURE WERE. DRIVING RESOURCES
TOWARDS THE COMMUNITIES THAT
NEED THE HELP THE MOST.
AND REALLY WILL BE FOLLOWING A.
B. THIRTEEN SIXTEEN TO FIGURE
OUT HOW WE CAN. BEST MAKE SURE
WE'RE DOING THAT.
WE REACHED OUT TO THE AUTHOR.
CHAIR OF THE STM HE HAS A FEW
QUESTIONS IF I MAY TO SUPPLEMENT
WHAT WE HAVE ASKED SO FAR.
IF YOU WANTED TO ASK
SPECIFICALLY IN RELATION TO HIS
BILL. CAN YOU EXPLAIN.
WHAT'S THE PLAN FOR REVISING THE
REGULATIONS WILL YOU BE ABLE TO
CONSULT WITH EXPERTS.
ARE YOU GOING TO CREATE A
WORKING GROUP OF EXPERTS TO ME
ONCE OR REGULARLY WHAT'S THE
PLAN GOING FORWARD.
A QUESTION ABSOLUTELY OF THIS
STATUTE DOES REQUIRE US TO
ACTUALLY CONVENE BUT
STAKEHOLDERS ME WHAT THE
CLINICAL SECTOR. AND IDENTIFY
WAYS WHERE WE CAN ACTUALLY
STANDARDS AS A COMPREHENSIVE
LIAM WITH INPUT FROM COMMUNITY
STAKEHOLDERS.
WHAT'S THE TIMING FOR THE
INITIATING OF THAT CONSULTATION
OF EXPERTS.
FOR US IDEALLY WE ACTUALLY ARE
TRYING TO SAY WERE PLANNING
ALREADY INTERNALLY OR USING
EXISTING.
NETWORKS THAT WE HAVE WERE
ACTUALLY VERY WELL CONNECTED TO
THE CLINICAL SECTOR IN COMMUNITY
STAKEHOLDERS SO. OUR GOAL IS TO.
CURRENY OUR TEAMS ALREADY
THINKING ABOUT HOW WE'RE GONNA
MOVE FORWARD A ONCE WE GET YOU
KNOW THE SUPPORT IN PLACE FROM
OUR STAFF WE'VE JUST A WILL BE
READY TO START. MEDIAN AND CUT
CONCEPTUALIZING MORE
INTENTIONALLY WITH FOLKS IN THE
COMMUNITY LEVEL CAN INDIVIDUALS
BE RECOMMENDED CAN INDIVIDUALS
APPLY TO THIS WORKING GROUP.
AND THAT'S A GREAT
RECOMMENDATION AND DEFTLY WE
CAN.
I KNOW THAT THERE IS EXISTING
STAKEHOLDER GROUPS ALREADY IN
PLACE WE WILL BE WORKING WITH
THEN SAID YOU KNOW THE COMMITTEE
HAS ANY RECOMMENDATIONS WILL
TAKE THOSE WELL I WOULD LIKE IF
YOU COULD TO WORK WITH MY OFFICE
AS WELL AS. A CHAIRMAN QUIRKS
OFFICE SO THAT WE CAN SEE IF WE
CAN MAKE RECOMMENDATIONS FOR
THIS WORKING GROUP GOING
FORWARD.
I'M TIRED JUST HAD A QUESTION.
IF I HEARD CORRECTLY FROM THAT
THAT TESTIMONY. I'VE A QUESTION
ABOUT WHY ONLY A TWENTY PERCENT
OF THE KIDS ARE BEING TESTED FOR
LEAD ITEM OF ITS.
BIZZARE.
A REAL SO LET ME LET ME BACK UP
THE THE QUESTION WAS ASKING OF
THE NUMBER OF MEDI CAL CHILDREN.
RIGHT INSTILL OUR DEPARTMENT.
DOZEN MANAGE THAT MEDICAL
CHILDREN THE DEPARTMENT OF
HEALTH CARE.
DE HTS DOES THAT WORK.
WEEK RECEIVER LABORATORY DAY
YEAH I'M BLACK BLOOD LEAD TESTS.
AND WE DO A LOT OF OUR
PREVENTION WORK A LOT OF OUR
EDUCATION WORK. WHEN WE GET KIDS
THAT ARE.
LEAD POISONED WE CASE MANAGE
THEM A WE PROVIDE OF FOR EXAMPLE
AND GO TO THEIR HOMES TO BE
PROVIDE ASSESSMENTS OF THEIR
ENVIRONMENTS.
A BIT IN TERMS OF SPECIFICALLY
THE MEDI CAL POPULATION.
YOU KNOW WE DON'T KNOW
SPECIFICALLY THE NUMBERS FOR
THAT POPULATION BECAUSE WE DON'T
COLLECT INSURANCE OR. INCOME ON
THAT LABORATORY DATA LIKE IT'S
LABORATORY DATA DOESN'T COME
WITH THAT INFORMATION RIGHT BUT
BUT I GUESS MY MY. NEXT QUESTION
WOULD BE IS IF ONLY TWENTY
PERCENT OF THE KIDS ARE BEING
TESTED SO WE JUST SAY OKAY IT'S
THERE BEATEN THEIR TONY TWENTY
PERCENT. I'M CONFUSED AS TO WHO
IS RESPONSIBLE FOR.
MAKING SURE THAT THE KIDS ARE
TESTED AND IF ONLY TWENTY
PERCENT OF THE KIDS ARE BEING
TESTED WHO DO WE.
INSISTS.
UPON. THEM TESTING THAT MORE
KIDS BECAUSE I'M ASSUMING THAT
WHEN YOU TEST KITS WERE PROVIDED
THE STATE IS PROVIDING MONEY FOR
THOSE TESTS.
AND IF THE MONEY IS NOT BEING
USED FOR TESTING THEN WHERE IS
THAT MONEY.
THIS IS WILL WE DO KNOW FROM OUR
DATA WHAT MIGHT HELP.
WE CURRENTLY PROCESSES.
FOUR HUNDRED AND NINE THOUSAND
LEAD TEST OF CHILDREN UNDER AGE
THREE. SO WE KNOW THAT WE HAVE
THAT DATA.
WE ALSO KNOW THAT THREE CENSUS
DATA APPROXIMATELY.
FIVE HUNDRED AND SEVENTY.
THOUSAND CHILDREN.
AGES ONE TO TWO ARE LIVING IN
HOUSEHOLDS BELOW TWO HUNDRED AND
FIFTY YOU KNOW A POVERTY LEVEL.
CIVIL FOR OUR DATE AND WHAT WE
HAVE BEEN ABLE TO ESTIMATE IS
THAT WERE REACHING ABOUT SEVENTY
TWO PERCENT.
OF CHILDREN.
WHO ARE LOW INCOME UNDER THREE
YEARS AND EACH?
SO I DON'T KNOW IF THAT HELPS
YOU I CAN'T SPEAK TO THE MEDICAL
DATA BUT I CAN SPEAK TO THE
LABORATORY DATA THAT WE HAVE NO.
SO YES THANK YOU FOR THE
INFORMATION THAT BUT I GUESS MY
QUESTION WOULD BE IN GENERAL WHO
DO I GO TO OR WHO DO WE GO TO
TO.
GET THAT DATA SINCE YOU CAN'T
PROVIDED AND WHO.
.
DO WE ENCOURAGE AYE IF YOU WELL
TO MAKE SURE THAT MARKETS ARE
TESTED. BECAUSE WHAT WHAT SOUNDS
LIKE IN.
THIS IS MY NOW MY SECOND YEAR
BUT WHAT I'M HEARING IS THAT YOU
ONLY HAVE.
CERTAIN POWERS YOU JUST.
GET THE DATA BUT SO WHO IF
SOMEONE CAN HELP ME COOL WE'VE
GOAL TO ENCOURAGE TO FOR.
MAKE SURE THAT THESE KIDS ARE
BEING TESTED AND AGAIN I'M
ASSUMING THAT WE'RE PROVIDING
THE FUNDING FOR THESE TESTS AND
IF THE TESTING IS NOT HAPPENING.
THEN WHERE IS THE MONEY FOR THAT
TESTING.
I IT'S BECAUSE IT JUST DOESN'T
MAKE SENSE.
AND SO AS OF FEBRUARY THIRTEENTH
JUST A COUPLE WEEKS AGO.
THE COMMITTEE FOR ENVIRONMENTAL
SAFETY AND TOXIC MATERIALS.
AND WE ACTUALLY HAD A HEARING
WITH THEM AND THEY WORK TWENTY
EIGHT CS TO ACTUALLY START
DURING THE MATCH WITH DEPARTMENT
PUBLIC HEALTH WHICH IS US.
SO WERE ACT WE GONNA START
MATCHING THE DATA TO TRY TO GET
THAT ANSWER IF THAT'S HELPFUL.
ALONG THOSE LINES THOUGH ARE
FIFTH IN QUESTION WAS THAT BY
STATUTE DPH IS TO PROVIDE BI
ANNUAL REPORTS TO THE
LEGISLATURE.
IS IS DPH IN COMPLIANCE WITH
THIS MANDATE.
I'M STILL A HEALTH AND SAFETY
CODE ONE OH FIVE TWO NINE FIVE
STATES THAT CLIP.
SHALL PROVIDE BI ANNUAL REPORTS
DESCRIBING THE EFFECTIVENESS OF
CASE MANAGEMENT EFFORTS.
AND MAKE THE REPORT AVAILABLE TO
THE LOCAL HEALTH DEPARTMENTS AND
THE PUBLIC.
AS SUCH ON OUR WEBSITE WE
CURRENTLY DO HAVE
REPORTS THAT OUTLINED BY
JURISDICTION. AGE AND BLOOD LEAD
ON CATEGORY.
SINCE TWO THOUSAND SEVEN
THROUGH TWO THOUSAND FOURTEEN SO
IT'S IT'S.
FOR CLARIFICATION THE STATUE
DOESN'T SAY.
IT'S A BIANNUAL LED LEGISLATIVE
REPORT IT STATES JUST A REPORT
AND IT'S ON OUR WEBSITE HOW
ACCURATE IS THAT DATA IF.
ON FEBRUARY OR TODAY WERE NOT
ABLE TO PROVIDE.
APPROPRIATE REAL TIME
INFORMATION AND.
WHAT WOULD NEED TO BE DONE TO
ENSURE THAT THE INFORMATION
PROVIDED ANSWERS THE QUESTIONS
WE HAVE?
SO THE INFORMATION THAT WE
PROPOSED IS.
DATA FROM OUR LABORATORY BLOOD
LEAD TASK.
SO IT AT A BREAK SADDAM BY EACH
OF CHILD IN JURISDICTIONS
SOMEWHERE THE COUNTY AND SO THAT
IS VERY ACCURATE. I WOULDN'T BE
ABLE TO PULL.
WHAT INSURANCE PLAN THE CHILDREN
ARE IN BECAUSE WE DON'T WE DON'T
GET THAT DATA?
RIGHT ANY OTHER QUESTIONS.
ACTUALLY JUST THE CAN I FOLLOW
UP AYE OF. IT.
AGAIN I'M.
TRYING TO FIGURE OUT HOW WE CAN
REINFORCE AND SONYA YOU CAN.
SHAKING HER HEAD AS IF YOU
UNDERSTOOD WHAT I WAS TRYING TO
ASK.
WHO? IS IT THAT I CAN SEPARATE
FROM YOU BUT WHO IS IT THAT WE
CAN GET THAT INFORMATION FROM AN
AND AND IS THERE ANYTHING THAT
WE CAN DO TO ENCOURAGE THESE TO.
WHOEVER IT IS TO MAKE SURE THAT
THE KIDS ARE BEING TESTED INCOME
CONCERNED WE WE JUST HAD A BILL
ON DEAD.
AND WATER FOR KIDS AND WE CAN
TEST BAD BUT BUT YET WE CAN
PROVE WE HAVE.
MY CONCERN IS THAT IF BUT THE
KIDS ALREADY HAVE LEAD
POISONING.
OR SOME KIND OF LEAD IN THEIR
SYSTEM AND WERE REQUIRING
SCHOOLS NOW TO TEST FOR LEAD
AND.
IT JUST SEEMS LIKE SOME OF THESE
KIDS ALREADY HAVE THE LEAD IN
THE SYSTEM. ANYWAY MY POINT IS
WHO I ASK AND WAIT WHERE CAN WE
GET THE INFORMATION.
I OF WHY.
THERE'S ONLY TWENTY PERCENT OF
THE KIDS BEING TESTED.
YEAH LET ME LET ME LOOK IN TO
THE SINK EFFECTIVE BECAUSE.
I WAS NODDING MY HEAD BECAUSE I
THINK WHAT YOU'RE TRYING TO FIND
OUT IS. WHY?
AS OPPOSED TO.
BREAKING THE DATA UP IN ALL
THESE DIFFERENT WAYS IS TO FIND
OUT WHY.
THESE CHILDREN ARE NOT GETTING
THE LEAD TESTING THAT THEY NEED.
SO I DON'T I PERSONALLY DON'T
KNOW THIS INFORMATION OFF HAND
BUT I'M HAPPY TO LOOK INTO THIS
ISSUE AND REPORT BACK TO YOU YES
PLEASE AND AND IF WE COULD.
BECAUSE.
IT GOES BACK TO THE
ACCOUNTABILITY PIECE SO WE HAVE
THIS MONEY OUT THERE THAT IS
SUPPOSED TO BE BEING USED FOR
THESE TESTS AND IT'S NOT BEING
USED AND IF WE'RE NOT USING THE
MONEY THAN WHAT IS HAPPENING TO
THAT MONEY. THAT'S NUMBER ONE
BUT BUT ACTUALLY NUMBER TWO
BECAUSE THE NUMBER ONE ISSUE
THAT I'M HAVING IS WIRED THESE
KIDS NOT BEING TESTED AND IF WE
CAN. AND LIKE I FORGET WHO THE
WITNESS ONCE SAID.
IF WE CAN HELP THEM HOW CAN WE
HELP THEM IF THEY DON'T KNOW
THAT THERE'S SOMETHING WRONG.
AND SO AGAIN ASIDE FROM YOUR IT
YOUR DEPARTMENT.
I NEED TO KNOW WHY AND IF WE CAN
PROVIDE THE INFORMATION IN THE.
YOU KNOW TIMELY FASHION SO THAT
WE CAN GET TO THE ROOT OF IT AND
WHO DO WE HOLD ACCOUNTABLE FOR
THIS LIKE IT'S.
I CAN JUST PROVIDE A COUPLE
COMMENTS ON THAT MAYBE COULD
HELP A LITTLE BUT.
THE TWENTY PERCENT IS OF MEDI
CAL CHILDREN AS EDU BECAUSE
YOU'VE HEARD. HERE IN THE POCKET
AND AND HER TESTIMONY.
PUBLIC COMMENT TODAY.
IT'S NOT ALL CHILDREN WE KNOW
FROM THE NUMBERS THAT MISS
MORALIS PRESENTED WE THINK THAT
WE'RE REACHING A SIGNIFICANT
MAJORITY OF THE LOW INCOME
CHILDREN IN CALIFORNIA. BUT.
AS YOU NOTED WHAT WE'RE GONNA
FOLLOW UP WITH DEPARTMENT OF
CARE SERVICES AND. TRY AND
FIGURE OUT. WHERE IT WAS ABOUT
THE TWENTY EIGHT PERCENT OF
MEDICAL KIDS AND AND WHAT THE
YOU KNOW WHAT THE SITUATION IS
WHAT THE WHY IS AS AS SONYA
MENTIONED?
AND ALSO AS I UNDERSTAND THAT
THE PAYMENT FOR THERE'S NOT A
BLOCK OF MONEY SET ASIDE FOR
THIS A MEDI CAL REIMBURSES FOR
SERVICES SO. IF THE PHYSICIAN
ISN'T.
REQUESTING THE TEST WHICH IT IS
PROBABLY THE REAL CHALLENGE HERE
IF THEY'RE IN WITH THE RATES
THAT LOW. THEN THERE IT'S NOT
GETTING REIMBURSED BECAUSE THE
TEST ISN'T BEING DONE. SO WE DO
HAVE OUR PROGRAM HAS WHAT'S
CALLED A TO SUPPORT IT.
THE TORY GUIDANCE THAT WE
PROVIDE TO HEALTHCARE PROVIDERS.
AND IT'S VERY MUCH GOES ALONG
WITH SOME OF THE INTENT OF AB
THIRTEEN SITE SIXTEEN TO REALLY
ENHANCE THAT GUIDANCE IN ORDER
TO. LOOK AT.
VARIOUS RISK FACTORS IN
CHILDREN AND MAKE IN THE
PROVIDER MAKING THE DECISION. OF
ASKING A PARENT TO GET THEIR
CHILD LEAD TESTING OR QUESTION
THAT BLOOD TESTS.
SO THE AND ALL THOSE FACTORS GO
INTO THIS AND.
YOU KNOW THAT DUCKTALES NICELY
WITH WHAT WE'VE BEEN DOING IN
THE PAST AS WELL AS WHAT IS
REQUESTED TO THIS LEGISLATION.
FINALLY IF I COULD A THE
GOVERNOR AND HIS BUDGET IN
JANUARY IS ESTABLISHING A HOME
VISITING PROGRAM TO START
JANUARY FIRST OF TWENTY
NINETEEN.
I WOULD LIKE TO BE ABLE TO WORK
WITH THE DEPARTMENT AND SEE IF
THERE'S OPPORTUNITIES TO HELP
EDUCATE. THE NURSES AND
PROVIDERS WHO WILL BE GOING INTO
PEOPLE'S HOMES.
TO IDENTIFY THE RISK FACTORS
FOR.
LEAD TOXICITY LEAD PAINT FLAKES.
TOYS OF TANTRA TOLD WANTS TO BE
ABLE TO WORK WITH YOU TO MAKE
SURE AS THIS HOME VISITING
PROGRAMS BEING ROLLED OUT THAT
THERE PROVIDED ALL OF THE
OPPORTUNITIES IN EDUCATION THAT
YOU CAN.
WITH THAT.
STAFFERS RECOMMENDED HOLDING
ISSUE SEVEN OPEN AT THIS TIME
AND WE'LL MOVE ON TO ISSUE A.
GONNA ASK IF WE CAN MAKE A
LITTLE SPACE FOR HOCEIMA HERE
THE.
PLEASE.
MISTER CHAIRMAN MEMBERS WAS SEMI
WITH LABOR STATE COUNCIL.
.
WE ARE PROVIDER WE ARE A TO OUR
PERMISSION FROM TRAINING
PROGRAMS WERE CURRY TRAINING IN
THE.
THE GENERAL CONSENSUS OF
HAZARDOUS WASTE MATERIALS WHAT
SPECIFICALLY THIS PARTICULAR
CASE THE LEAD ABATEMENT WHICH
NORMALLY. THE MOST CASES BEING
FOUND IN.
OLDER HOMES HOLDER PAINTS
IN SOME CASES IN THE DIE BEING
USED FOR HOMES THAT WERE BACKED
IN PLASTER IN PLACE.
IT'S VERY VERY DIRTY TYPE WORK
AND REQUIRES. A TRAINED
WORKFORCE THAT FOR THE MOST PART
IS VERY.
LOW PAID.
WE HAVE BEEN HAVING A PROBLEM
SINCE PROVIDER ONCE AGAIN THAT.
DUE TO THE AS WAS MENTIONED
EARLIER AND OTHER DISCUSSIONS.
ARE RECENT PARTISAN NORTH OF
COURSE NOW IN THE SELF.
WE ARE FINDING THAT THERE'S
SOME DELAYS OCCURRING.
I'M GETTING A CERTIFICATION
CARDS
THE PROCESS IS VERY SIMPLE.
WE TRAIN THE STATE THEN ISSUES
THE CARDS.
UP ON THE SUGGESTION ONCE WE
DEMONSTRATING GOOD FAITH IS
INDIVIDUALS ARE TRYING TO REFORM
THE WORK. OUR EMPLOYERS DO GOOD
GROUP OF EMPLOYERS ARE RECORDING
HAS SOME OF THESE PEOPLE IN
PLACE THAT HAD THE TRAINING IN
THE PAST.
AND IN MANY CASES THESE PEOPLE
THEY HAVE BEEN WORKING FOR THESE
EMPLOYERS HAVE TO RE UP.
AND THE DEPARTMENT DOES TAKE
PRIORITY FOR THOSE INDIVIDUALS
SO THAT THERE'S NO INTERRUPTION
WHATSOEVER.
WE RECOGNIZE IN MANY CASES YOU
HAVE SITUATIONS WHERE SOME AND
SOME THESE EMPLOYEES.
A WAY TO THE LAST TEN TEN DAYS
THE TWELVE DAY GRACE PERIOD.
IN IN WERE SCRAMBLING FOR IT.
WE RECOGNIZE THAT THERE'S A
TIMEFRAME ALSO BY THE DEPARTMENT
TO BE ABLE TO ISSUE THESE.
HE'S A CERTIFICATION CARDS
WE HAVE EXPERIENCING QUITE A BIT
OF A DELAY IN SOME CASES.
THREE FOUR FIVE SIX MONTHS.
OP WHICH SLOWS DOWN THE PROCESS.
AGAIN IF THEY'RE GOING TO GO
AHEAD AND. AN INNATE OR.
YOU KNOW GIVE THE ONCE WERE RE
UPPING ON TRAINING IT'S ONE
THING WE STILL HAVE A GROUP OF
FOLKS OUT THERE THE FOR THE MOST
PART. ARE BEING DELAYED AND
UNTIL THE CERTIFICATES ARE
RICHES INDIVIDUALS AND NOT ABLE
TO WOULD WORK THE EMPLOYERS
UNABLE TO HIRE.
IN INCREASED OUR WORK TO BE
ABLE TO FIX WITH A DEMAND.
AND WE'RE TRYING A FIVE FIGURE
OUT A POSSIBLE WAY TO BE ABLE TO
EXPEDITE THE PROCESS.
I'M VERY MUCH AWARE THE FACT
THAT THERE IS A PERIOD OF TIME
WHICH DEPARTMENT IS IS TO BE
DOING THIS BUT I'M NOT SURE
THERE'S A FEW IF THERE'S A
COMMUNICATION BETWEEN ALL SORTS
CHARGED WITH OVERSEEING. WHOSE
AFFAIRS TO THE ACTUAL PEOPLE
PERFORMING AND THE ISSUANCE OF
CARDS.
WE HAVE TO ANSWER THE QUESTIONS
THANK YOU UP IF WE GET OF THE
DEPARTMENT COMEBACK FORWARD AND.
WE HAD A FEW QUESTIONS ASKED. IN
THE ITINERARY AND WANDERING IF
YOU CAN TRUST US.
YEAH THERE IS QUESTIONS ABOUT
THE BACKGROUND OF THE PROGRAM ON
SALE DELAYED RELATED
CONSTRUCTION PROGRAM IS PRETTY
TWENTY FIVE YEARS AGO.
.
EXCUSE ME THE LRC IS AUTHORIZED
BY THE UNITED STATES
ENVIRONMENTAL PROTECTION AGENCY
USEPA. TO RUN SUCH A PROGRAM
SPECIFICALLY IT ACCREDITS
TRAINED PROVIDERS AND CERTIFIES
INDIVIDUALS CAN TO SAFELY
IDENTIFY AND CONDUCT EMBAYMENT
ACTIVITIES.
THE LRC PROGRAM CERTIFIES
APPROXIMATELY SEVEN THOUSAND
INDIVIDUALS EACH YEAR.
IN TERMS OF THE FUNDING.
SORRY I'M RECOVERING FROM A POT.
SO THE FEDERAL GRANT FOR.
IT'S TO FUNDING SOURCES ONE IS
UP THROUGH THE.
USEPA FOR APPROXIMATELY FIVE
HUNDRED AND TWENTY SIX THOUSAND
DOLLARS.
AND THEN THERE'S A DELAY RELATED
CONSTRUCTION SPECIAL FIND WHICH
FINDS ABOUT SIX HUNDRED AND
NINETY THOUSAND DOLLARS.
THE LRC SPENT HER FINEST
GENERATED BY THE CERTIFICATION
APPLICATION FEE EVER US SEVENTY
FIVE DOLLARS PER APPLICATION.
THINK.
CURRENTLY THE APPLICATION TURN
AROUND TIME FOR US IS AVERAGES
ABOUT SIXTY DAYS.
PER STATUE WE HAVE A
HUNDRED AND TWENTY DAYS TO TURN
AROUND THERE.
.
FULL APPLICATION PROCESS.
CP RECOGNIZES DEPRECATION
PROCESS.
IS REALLY IN NEED OF
IMPROVEMENTS AND EXPLORATION AS
SUCH WE ARE MEETING ACTIVELY
WITH OUR TEAM AND OUR STAFF.
TO LOOK AT QUALITY PERMIT
EFFORTS AND INFORMATION
TECHNOLOGY SOLUTIONS TO IMPROVE
OUR EFFICIENCIES.
DEPARTMENT OF FINANCE ALLOW
INCOMES.
ANY PUBLIC COMMENTS ON ISSUE
EIGHT AT THIS TIME.
SINGING ON A BRING IT TO THE
DYESS OR POST THEM HERE YET.
CIRCULAR QUICKLY OB I JUST WANT
ME TO COMMENT.
I JUST FIND IT THAT WE SHOULD.
AS POLICY IN CALIFORNIA TO
CONSIDERATION.
IF WE TO BE DEPENDING ON GRANTS.
WITH DISCRIMINATES VERSION DC A
SOMEWHAT SCARY.
AND SO PLEASE SHERMAN PLEASE
CONSIDER THAT AS YOU MOVE
FORWARD NO DEPARTMENT REAP
STREAMLINED IN HIS QUEST FOR
NUMBER OF YEARS. OF THE HAVING
COMING IN. WAS ALWAYS OF THE
NUMBER AND I DO. BUT THAT'S OF
THE REALLY TING CONSIDERATION.
ACTUALLY A QUESTION I DIDN'T
DON'T THINK IT WAS COMPLETELY
ADDRESSED REGARDING MR HE HAS.
COMMENTS ABOUT SOMETIMES IS
APPLICATIONS ARE TAKING THREE TO
FIVE MONTHS SO THAT'S CLEARLY
FIVE MONTHS IS CLEARLY OUTSIDE
YOUR STATUTORY DEADLINES TO.
YOU HAVE THE SAID THE MOST THAT
WERE BE DONE WITHIN SIXTY DAYS
BUT YOU HAVE UP INTO A HUNDRED
AND TWENTY DAYS.
YOU DOING SEVEN THOUSAND HERE.
HE SAID.
THE SEVEN THOUSAND RENEWALS OR
SEVEN THOUSAND NEW ONES BECAUSE
I HE'S TALKING.
I THINK IT MISTER HERE DEMOCRAT
YOU'RE TRYING OUT THE NEW ONES
CORRECT NO IS AND THE REAL AND
AND THE RE UP SO SO HOW DOES IT
TAKE TO DO THE RE UPS.
BECAUSE THAT SHOULD BE PRETTY
SIMPLE. AND HOW LONG'S IT TAKING
TO DO THE NEW ONES.
SO WE PROCESS BOTH THREE NEW
LAWS AND NEW.
AND SAME FORMAT
THAT'S WHY CURRENTLY RIGHT NOW
WE'RE LOOKING AT OTHER METHODS
FOR WE CAN. MAYBE CONSIDER
HAVING A DIFFERENT METHODOLOGY
FOR RENEWALS FOR SINCE YOU YEAH
I'M JUST NEW APPLICATIONS.
SO IF ONE COMES INTO THE QUEUE
THERE'S NO DIFFERENTIATION
BETWEEN OF RENEWAL OR A NEW
APPLICATION SO THE APPLICATIONS
IDENTICAL FROM YEAR TO YEAR
WHETHER IT'S A NEW ONE A
RENEWAL.
FOR THE MOST PART YES YOU
THERE'S A SECTION WHERE YOU
SPECIFY IF IT'S A RENEWAL.
SO I'M JUST I'M JUST PUZZLED WHY
IT TAKES SO LONG.
YEAH WE WE UNDERSTAND AND WE.
ARE LOOKING INTERNET WENT OUT
TO TRY TO ALLEVIATE THE HOW LONG
IT'S TAKING THAT'S ONLY
RECOGNIZE THAT EVEN CURRENTLY
THE AVERAGE THIRTY DAY PROCESS.
IT'S SOMETHING THAT WE NEED TO
YOU KNOW THAT EXPLOIT SEES ME
SIXTY DAY PROCESS IS SOMETHING
WE NEED TO EXPLORE.
AND I GUESS I'M PUZZLED BECAUSE
I COOK I CAN GO ONLINE AND.
AND I WILL DO THAT IN THE NEXT
MONTH OR SO TO RENEW MY DENTAL
LICENSE.
AND IT WILL BE RENEWED VERY VERY
QUICKLY.
SO I'M REALLY PUZZLED WE'VE GOT
FOLKS THAT THAT WE GOT A NEED
FOR THESE FOLKS IN ESPECIALLY IN
THE FIRE AREAS.
AND AND AND WE GOT A NEED.
FOR THE FOR THEM TO BE OUT IN
THE WORKPLACE YET THEY MIGHT
HAVE TO WAIT THREE TO FIVE
MONTHS FOR THEIR CERTIFICATIONS.
I'M SORRY I JUST DON'T FIND THAT
TO BE TIMELY AND OR ACCEPTABLE.
BUT. IF I MAY YOU'RE NOT
ANSWERING THE QUESTION WHAT WHY
DOES IT TAKE SO LONG.
SO WITH A COUPLE OF FACTORS. AND
LOOKING. AT OUR DATA IS
SOMETIMES WHAT HAPPENS WITH
APPLICATIONS BECAUSE THEY'RE
STILL HAD A PROCESS STE.
ON PAPER SO THAT'S ONE OF THE
ISSUES THAT THEY'RE IT WE DON'T
HAVE AN ELECTRONIC PLATFORM
RIGHT.
SO THAT PROCESS ON PAPER.
UNFORTUNATE WHAT HAPPENS TO IS
WE HAVE TO FOLLOW UP IF THERE'S
INCONSISTENCIES OR INACCURACIES
IN THE APPLICATION. SO WE HAVE
TO THEN FOLLOW UP AND IT EXTENDS
SOME OF THE TIMELINE. ON FRIES
SO. WITH SOME OF THOSE UP FOR US
FOR EXPLORING DIFFERENT
AUTOMATION SOLUTIONS TO TRY TO.
MAKE SURE THAT FOLKS CAN
ACTUALLY DO THIS ONLINE FOR
EXAMPLE OR IN THAT WHEN I DO EAT
THAT IT'S A INFORMATION IS. NOT
PLEASE CORRECTLY THAT
APPLICATION WILL LET YOU MOVE
FORWARD AND BY THE TIME WE GET
IT IF IT'S VERY ACCURATE WE CAN
JUST MOVE FORWARD AND PROCESSES.
FROM OUR INTO.
BUT. WE'VE SEEN AN INCREASE IN
THESE APPLICATIONS OVER THE
YEARS AS WELL.
SO FOR EXAMPLE WE ARE PROCESS
SEEN ABOUT SIX THOUSAND IN TWO
THOUSAND MADE AND RIGHT NOW
WE'RE PROCESSING ABOUT SEVEN
THOUSAND THREE HUNDRED. ON AS IF
TWENTY SEVENTEEN SO THERE'S
DEFINITELY A DEMANDING. A DEMAND
AN INCREASE IN DEMAND WE HAVE
THE SAME ALSO ON WERE FULLY
STATS SEVEN F. T. E. SO THAT
HASN'T CHANGED FOR US IN QUITE
SOMETIME. WALL THEN MISS RADIO
AS THE TIME FRAME CHANGED IN THE
LAST FEW YEARS ARE IT'S ALWAYS
BEEN THREE TO SIX MONTHS.
WHY THINK IS WAS SERIOUSLY
CONSIDERED STEVE?
THE MORE ACTIVITIES BECOME OF
THE FORESTS KNOWLEDGE OF THAT HE
WAS SOUTHERN CALIFORNIA STILL
JUST YET. BUT I THINK IT'S I
THINK IT.
I DEMAND SOURCE SPEAK.
I JUST THAT AGAIN I THINK.
THE WAIT TIME HAS BEEN.
I MEAN A SLOW TIME AS MIGHT BE
ABLE TO GET IT DONE IN THREE
MONTHS.
AND SOME OTHER TIMES I MEAN
RECENTLY FOR THE LAST COUPLE
THREE YEARS HE'S BEEN PROMISING
ONE OFFER US WITH US FOR A LONG
TIME NOW. IN ITS ITS IT IT THAT
JUST KEEPS INCREASING IN TIME.
BIZARRE TWENTY DEFY Y..
IF WERE BUT I I CAN CERTAINLY
APPRECIATE ALL THE PROPOSAL
EITHER THOUGHT ABOUT TRYING TO
CHANGE THE FORMAT FOR ALL THOSE
ARE JUST UPPING THE. THE RENEWAL
PROCESS THAT WOULD BE SUCH A
CONSIDERATION BUT DIFFERENT AND
RENEWING YOUR DRIVERS LICENSE I
GUESS.
BUT I THINK THAT I JUST TRULY
BELIEVE SOMETHING IS TO BE DONE
TO EXPEDITE THE SYSTEM BILL MORE
CONSISTENT.
CUT CONFIRMABLE COULD HE SAID
YOU HAVE SEVEN FULL TIME
EQUIVALENTS TO DO THESE PROCESS
PROCESSES.
YES SO THAT'S ABOUT THAT'S ABOUT
A THOUSAND PER PERSON.
SURE WE'VE GOT YOU DIVIDE HAPPY
COUPLE HUNDRED WORK DAYS A YEAR
WE'RE TALKING ABOUT FIVE
APPLICATIONS PER PERSON. DAY.
AND WE CAN'T MOVE OUT OF ANY
FASTER.
RIGHT NOW AGAIN I'M JUST YOU
KNOW WERE AVERAGING ABOUT SO
LONG AS THE APPLICATION HOW MANY
PAGES IS APPLICATION.
ON YOU KNOW I'M FORTUNATE ALL
HAVE IT ON THE RIGHT NOW SO WE
CAN BE ABLE TO TELL YOU EXACTLY.
YEAH SURE YOU KNOW HOW LONG THIS
APPLICATION MISTER HERE.
A LOT OF IT'S THEMEDICAL
HISTORY PRIVATE TOLD THE JOKE
IS.
I THINK WHAT YOU'RE SENSING FROM
THE COMMITTEE SO FAR IS. WANTING
TO MAKE SURE THAT WE HAVE A MORE
STREAMLINED.
APPROACH.
AND WE WOULD LIKE BY ME REVISION
FOR YOU TO REPORT TO THE
SUBCOMMITTEE HOW WE CAN MAKE
SURE THAT WE ARE ON A MORE
STREAMLINED APPROACH.
AND IF I MAY I THINK SIXTY DAYS
TOO LONG IF WE CAN FIND A WAY TO
REALLY SHORTEN IT AT THAT WOULD
BE APPRECIATED.
THANK YOU WITH THAT WE WILL MOVE
ONTO ISSUE NOT
.
THANK YOU.
CHAIRMAN ARAMBULA AND
DISTINGUISH SUBCOMMITTEE MEMBERS
FOR INVITING ME HERE TODAY.
TO PRESENT A STAKEHOLDER
PROPOSAL TO INCREASE FUNDING AND
SUPPORT FOR THE CALIFORNIA SAFE
COSMETICS PROGRAM.
MY NAME IS JANET NOODLE MAN AND
I'M THE DIRECTOR OF PROGRAM AND
POLICY AT BREAST CANCER
PREVENTION PARTNERS AND CO
FOUNDER AND DIRECTOR OF OUR
CAMPAIGN FOR SAFE COSMETICS.
THE CPP IS THE ONLY NATIONAL
ORGANIZATION FOCUSED SOLELY ON
PREVENTING BREAST CANCER BY
IDENTIFYING AND ELIMINATING
CHEMICALS AND COMMERCE. IN OUR
COMMUNITIES AND IN CONSUMER
PRODUCTS THAT ARE LINKED TO AN
INCREASED RISK OF BREAST CANCER
AND OTHER DISEASES AND AT FIRST
HEALTH EFFECTS.
AS ONE OF THE ORIGINAL SPONSORS
OF SB FOUR EIGHTY FOR THE TWO
THOUSAND AND FIVE LEGISLATION
THAT CREATED THE SAFE COSMETICS
PROGRAM.
I AM HERE TODAY TO TELL YOU THAT
THIS IMPORTANT CONSUMER AND
WORKER RIGHT TO KNOW PROGRAM IS
MORE NEEDED AND MORE RELEVANT
THAN EVER. AND URGENTLY DESERVES
YOUR ATTENTION AND YOUR SUPPORT.
THE KIDS THE SAFE COSMETICS ACT
WAS SIGNED INTO LAW IN TWO
THOUSAND AND FIVE AND CREATED
THE CALIFORNIA SAFE COSMETICS
PROGRAM. WHICH REQUIRES
COMPANIES TO REPORT ANY COSMETIC
OR PERSONAL CARE PRODUCTS SOLD
IN THE STATE. THAT CONTAINS
CHEMICALS KNOWN TO THE STATE OF
CALIFORNIA TO CAUSE CANCER OR
BIRTH DEFECTS.
THIS INCLUDES CHEMICALS FOUND ON
THE PROP SIXTY FIVE LIST
OR ON ANY OF THE LISTS CREATED
BY SCIENTIFIC AUTHORITATIVE
BODIES THAT INFORMED PROPOSITION
SIXTY FIVE.
THE PROGRAM THEN MAKES THE
INFORMATION AVAILABLE THROUGH
PUBLICLY ACCESSIBLE DATABASE
WHICH IS UTILIZED BY CONSUMERS
SALON WORKERS SCIENTISTS AND
REGULATORS. FROM FROM THROUGHOUT
THE STATE AND THE COUNTRY.
ALTHOUGH A DOZEN YEARS HAVE
PASSED SINCE THIS BILL WAS
ENACTED THERE IS STILL NO
MEANINGFUL REGULATION OF THE
SAFETY OF THE OVER TEN THOUSAND
INGREDIENTS USED.
TO FORMULATE BEAUTY AND PERSONAL
CARE PRODUCTS EITHER HEARING
CALIFORNIA. OR FEDERALLY.
MOST PEOPLE ASSUME COSMETICS AND
PERSONAL CARE PRODUCTS ARE
TESTED FOR SAFETY BEFORE BEING
STOPPED ON STORE SHELVES.
IN TRUTH PERSONAL CARE PRODUCTS
ARE ONE OF THE LEAST REGULATED.
INDUSTRIES IN THE UNITED STATES
THE FEDERAL FOOD DRUG AND
COSMETICS ACT IS ONE HUNDRED AND
TWELVE PAGES LONG. AND HAS ONLY
TWO PAGES DEVOTED TO COSMETICS
SAFETY AND IS NOT BEEN AMENDED
SIGNIFICANTLY SINCE IT WAS
ENACTED EIGHTY YEARS AGO.
AS A RESULT A COSMETIC
MANUFACTURE MAY USE ESSENTIALLY
ANY RAW MATERIAL AS A COSMETIC
INGREDIENT. AND MARKET THAT
PRODUCT WITHOUT FTA PREMARKET
TESTING REVIEW OR APPROVAL.
TO MAKE MATTERS WORSE ALTHOUGH
THE FDA AND SEE PROHIBITS THE
MARKETING OF ADULTERATED AND
MISBRANDED COSMETICS IN
INTERSTATE COMMERCE. THE FDA
DOES NOT HAVE THE AUTHORITY TO
ORDER RECALLS OF MISBRANDED OR
ADULTERATED PRODUCTS
TO GET THEM OFF OF STORE
SHELVES.
THAT IS WHY MANY COMPANIES
CONTINUE TO TREAT THE ISSUE OF
COSMETIC SAFETY AS IF IT'S THE
WILD WEST.
COMPANIES CAN AND DO USE
CHEMICALS LINKED TO CANCER BIRTH
DEFECTS REPRODUCTIVE HARM.
INFERTILITY LEARNING
DISABILITIES ON HORMONE
DISRUPTION IN THE BEAUTY AND
PERSONAL CARE PRODUCTS THAT WE
USE EVERYDAY.
WHICH IS WHY IN THE ABSENCE OF
MEANINGFUL REGULATION OF THE
OVER TEN THOUSAND INGREDIENTS
USE TO FORMULATE THESE PRODUCTS.
PROP SIXTY FIVE INGREDIENT
DISCLOSURE PROVIDED BY THE SAFE
COSMETICS PROGRAM IS SO
DESPERATELY NEEDED.
AS OF NOVEMBER SIXTH OUR STATE'S
PUBLIC DATABASE DISCLOSED THE
SALE OF OVER SIXTY FIVE THOUSAND
COSMETIC PRODUCTS IN THE STATE
OF CALIFORNIA. CONTAINING ONE OF
EIGHTY EIGHT ONE OR MORE OF
EIGHTY EIGHT UNIQUE PROP SIXTY
FIVE CHEMICALS.
THE PRODUCTS SPAN EIGHTY SIX
CATEGORIES INCLUDING BEAUTY AND
PERSONAL CARE PRODUCTS MARKETED
TO MEN. WOMEN CHILDREN TEENS AND
SALON WORKERS
SUGGESTING EVERYONE IN
CALIFORNIA USING BEAUTY AND
PERSONAL CARE PRODUCTS IS AT
RISK OF EXPOSURE TO UNSAFE TOXIC
CHEMICALS.
GIVEN THE GROWING AWARENESS OF
UNSAFE CHEMICALS AND COSMETICS
IN THE GROWING DEMAND FOR SAFE
BEAUTY AND PERSONAL CARE
PRODUCTS.
THE SAFE COSMETICS PROGRAM IS
MORE RELEVANT THAN EVER BECAUSE
THE PUBLIC APPETITE FOR THIS
TYPE OF INFORMATION GENERATED BY
THE PROGRAM HAS GROWN
EXPONENTIALLY OVER THE PAST
DECADE.
AS MORE AND MORE SCIENTIFIC
EVIDENCE LINKS THE INCREASING
RATES OF BREAST CANCER ASTHMA
LEARNING DISABILITIES ANOTHER
DISEASES AND CONDITIONS. TO THE
AIR WE BREATHE THE FOOD WE EAT
THE WATER WE DRINK AND THE.
PERSONAL CARE PRODUCTS CLEANING
PRODUCTS AND OTHER CONSUMER
PRODUCTS WE COME IN CONTACT
WITH.
ON A DAILY BASIS CONSUMERS ARE
DESPERATE FOR INFORMATION TO
AVOID UNNECESSARY EXPOSURES TO
CHEMICALS LINKED ADVERSE HEALTH
EFFECTS.
YET SINCE ITS ENACTMENT STATE
FUNDING FOR THIS CRITICAL
PROGRAM. HAS DECREASED TWENTY
FIVE PERCENT FROM ITS INITIAL
APPROPRIATION OF FOUR HUNDRED
NINETY FIVE THOUSAND DOLLARS TO
ITS CURRENT FUNDING LEVEL OF
THREE HUNDRED AND SEVENTY
THOUSAND DOLLARS.
AS A RESULT OF CHRONIC
UNDERFUNDING THE PROGRAM DOES
NOT HAVE THE NECESSARY
RESOURCES.
TO ALLOW FOR FULL IMPLEMENTATION
OF ITS STATUTORY MANDATES NOR TO
ENSURE FULL COMPLIANCE WITH THE
PROGRAM. DESPITE EXISTING
ENFORCEMENT AUTHORITY WITHIN THE
SHERMAN FOOD AND DRUG ACT.
OUR PROPOSAL SEEKS APPROXIMATELY
ONE POINT FIVE MILLION AND
PROPOSE NEW FEE REVENUE TO BE
GENERATED BY A MODEST FEE.
LEVIED ON EACH PRODUCT REPORTED
TO THE SAFE COSMETICS PROGRAM.
PAID FOR ONLY BY THE COMPANY'S
MANUFACTURING THE PRODUCTS WITH
THE REPORTABLE CHEMICALS.
IT WOULD PROVIDE A DEDICATED
STREAM OF FUNDING TO THE SAFE
COSMETICS PROGRAM AND THIS FEE
WOULD BE DIRECTLY RELATED TO THE
SERVICES.
PROVIDED TO THE REPORTING
COMPANY BY THE SAFE COSMETICS
PROGRAM.
AN INCREASE IN FUNDING FOR THE
SAFE COSMETICS PROGRAM WOULD OUT
FIVE POSITIONS TO THE TWO
EXISTING PROGRAM STAFF.
THE ADDITIONAL STAFF WOULD
ENABLE THE PROGRAM TO CONDUCT
REGULAR AUDITS OF THE ACCURACY
AND COMPLETENESS OF THE PROGRAM.
THE DATA THAT'S REPORTED.
INVESTIGATE INACCURATE AND UNDER
REPORTING BY COMPANIES
INVESTIGATE THE SAFETY OF
INGREDIENTS AND PRODUCTS
INCLUDING CALLING IN SAFETY DATA
WHEN APPROPRIATE.
CONDUCT PUBLIC EDUCATION
ACTIVITIES TO RELATE TO REYES
SALON WORKER AND CONSUMER
AWARENESS AS WELL AS USE OF THE
PROGRAM.
INVESTIGATE THE INDUSTRY ABUSE
OF TRADE SECRET DESIGNATIONS.
INVESTIGATE UNSAFE SALON WORKER
EXPOSURES FOR POSSIBLE REFERRAL
TO CAL OSHA AND COLLABORATE WITH
OTHER RELEVANT STATE AND LOCAL
AGENCIES.
INCREASE FUNDING WOULD ALSO BE
USED TO SUPPORT EVERY DESIGN AN
OVERHAUL OF THE SAFE COSMETIC
PROGRAMS OUTDATED ELECTRONIC
REGISTRATION AND REPORTING
SYSTEM.
THINK I'M GONNA FINISH UP HERE.
THANK YOU FOR YOUR PATIENCE MORE
AND MORE COSMETIC COMPANIES ARE
MAKING BEAUTY AND PERSONAL CARE
PRODUCTS WITH OUT PROP SIXTY
FIVE CHEMICALS. JOINING A FOUR
BILLION DOLLAR AND GROWING
SECTOR OF THE EIGHTY FOUR
BILLION DOLLAR COSMETICS
INDUSTRY PROVING THAT SAFE
COSMETICS ARE NOT ONLY POSSIBLE
THEIR PROFITABLE.
IN CLOSING I HOPE THAT YOU AGREE
THAT THE SAFE COSMETICS PROGRAM
IS A MUCH NEEDED MODEL FOR THE
NATION THAT SHOULD BE
CELEBRATED.
AND ADEQUATELY SUPPORTED SO IT
CAN MEET ITS FULL STATUTORY
POTENTIAL.
THANK YOU FOR YOUR TIME AND
ATTENTION AND I'D LIKE TO
INTRODUCE DR GINA SOLOMON TO MY
RIGHT. WHO CAN HELP ANSWER
QUESTIONS REGARDING THE PROGRAM?
AND ITS DIFFERENCE.
WITH OTHER CALIFORNIA PROGRAMS
SHE IS THOUGH RECENTLY.
RETIRED DEPUTY DIRECTOR FOR
SCIENCE AND HEALTH AT CAL EPA.
SOLOMON IF YOU'D LIKE TO MAKE
COMMENTS.
GOOD AFTERNOON DOCTOR CHAIRMAN.
I'M VERY HAPPY TO BE HERE AND
I'M I'M JUST I CAME UP HERE
UNDER UP MY OWN. VOLITION AND.
MY OWN FUNDING I'M NOT A
REPRESENTING ANYONE AND ACTUALLY
I'M NOT REALLY SPEAKING.
ON BEHALF FOR AGAINST THIS
BUDGET ITEM BUT MORE HERE TO
CLARIFY BECAUSE I UNDERSTAND
THAT A NUMBER OF QUESTIONS CAME
UP.
AND I THINK THAT MY EXPERIENCE
WILL WILL HELP WITH ANSWERING
THEM JUST SO YOU KNOW WHO I AM.
UP UNTIL RECENTLY I WAS THE
DEPUTY SECRETARY FOR SCIENCE AND
HEALTH. AT CAL EPA.
IN THAT CAPACITY I WAS VERY
INVOLVED IN THE SEA FOR A
CONSUMER PRODUCTS PROGRAM ALSO
IN PROP SIXTY FIVE.
AND A NOW I AM A CLINICAL
PROFESSOR OF MEDICINE AT UCSF IN
THE DIVISION OF OCCUPATIONAL AND
ENVIRONMENTAL MEDICINE. I'M ALSO
A PRINCIPAL INVESTIGATOR AT THE
PUBLIC HEALTH INSTITUTE IN
OAKLAND.
.
AND THESE PROGRAMS THE.
IT SAFE COSMETICS PROGRAM IN
THE SAFER CONSUMER PRODUCTS
PROGRAM.
DO YOU TOUCH
BOTH ON AND PERSONAL CARE
PRODUCTS
BUT IN VERY VERY DIFFERENT WAYS.
SAVER CONSUMER PRODUCTS PROGRAM
WAS CREATED ABOUT A DECADE AGO
BY AT AB EIGHTEEN SEVENTY NINE
ASSEMBLY MEMBER FUEHRER'S A
BILL.
AND.
IT.
GIVES THE DEPARTMENT TOXIC
SUBSTANCES CONTROL THE AUTHORITY
TO IDENTIFY PRIORITY PRODUCTS
THAT CONTAIN CHEMICALS OF
CONCERN. KNOWS PRODUCT TO
USUALLY DEFINED QUITE NARROWLY.
AND THE PURPOSE OF THE PROGRAM
IS TO A ASKED TO.
ALLOW THE DEPARTMENT TO
PROMULGATE REGULATIONS THAT THEN
REQUIRED THE MANUFACTURERS OF
THOSE PRODUCTS TO CENTRALLY SHOW
WHETHER THAT CHEMICAL IS REALLY
NECESSARY IN THAT PRODUCT AND TO
EVALUATE THE FULL SUITE OF
ALTERNATIVES.
AND THEN AT THE END OF THAT
PROCESS A DTS HE DOES HAVE SOME
AUTHORITY TO.
MAKE REGULATORY DECISIONS.
BUT THERE IS A AYE ABSENCE OF
DATA COLIN AUTHORITY BUT IN THAT
LAW. AND IT'S ACTUALLY AN ISSUE.
THAT.
DTS HE HAS ADDRESSED BY CALLING
UPON. OTHER PROGRAMS OUT THERE
WHERE INFORMATION ACTUALLY IS
COLLECTED AND THEN MADE
AVAILABLE
I'M ONE OF THOSE BEING THE SAFE
COSMETICS PROGRAM WHERE IN THAT
SPACE THERE IS ACTUALLY QUITE A
BIT OF INFORMATION.
COLLECTED AS A RESULT OF THIS
PROGRAM ON CHEMICALS THAT ARE.
ON THE DTS SEE CANDIDATE
CHEMICALS LESS.
SO THIS IS THIS IS A PLACE
WHERE.
THAT THE DEPARTMENT OF TOXIC
SUBSTANCES CONTROL UP ALONG WITH
MANY CONSUMERS HOLES SO GO TO
LOOK FOR FOR INFORMATION AND
THEN. USE THAT INFORMATION TO TO
TRY TO SET LOGICAL RATIONAL
PRIORITIES FOR FOR.
UNIT ISSUES THAT MIGHT NEED TO
BE ADDRESSED
SO HOPE THAT'S HELPFUL AND I'M
HAPPY TO ANSWER ANY OTHER
QUESTIONS.
GREAT THANK YOU AT THAT TIME
WILL MOVE TO PUBLIC COMMENT ON
THE ISSUE NINE.
THANK YOU MISTER CHAIR AND
MEMBERS I AM HERE ON BEHALF THE
BLACK WHEN FOR WELLNESS THE
CALIFORNIA LEAVE CONSERVATION
VOTERS.
I WILL SEE TO THE EXPERTS BEHIND
ME BUT WE BELIEVE THAT THIS
BUDGET INCREASE ASK IS NECESSARY
TO PROVIDE THE DISCLOSURE AND
TRANSPARENCY NEEDED ON THIS
MULTIBILLION DOLLAR INDUSTRY
THANK YOU. THANK YOU.
I UNANSWERED YOU'RE MY ON BEHALF
OF THE CENTER FOR ENVIRONMENTAL
HEALTH CAL PERGA AND THE.
PRODUCTS CALIFORNIA PRODUCT
STEWARDSHIP COUNCIL. AS
ORGANIZATIONS THAT CARE ABOUT
CONSUMERS RIGHT NOW WE STRONGLY
SUPPORT THE STAKEHOLDER
PROPOSAL.
WITH THE MONEY IS NECESSARY TO
MAKE SURE THAT MANUFACTURERS ARE
COMPLYING WITH THIS PROGRAM. AND
THAT THE DATA IS.
OF HIGH QUALITY SO THAT IT'S
USABLE BY BOTH WORKERS AND
CONSUMERS SO WE RESPECTFULLY
REQUEST YOUR SUPPORT.
THANK YOU.
HELLO MY NAME IS CATHERINE
PORTER ON THE POLICY DIRECTOR
WITH CALIFORNIA HEALTHY NAIL
SALON COLLABORATIVE. I'M ALSO
HERE SPEAKING ON BEHALF OF
WOMEN'S VOICES FOR THE EARTH AND
SAN FRANCISCO BAY AREA
PHYSICIANS FOR SOCIAL
RESPONSIBILITY. WEARING MY
COLLABORATIVE HOT.
NAIL SALON WORKERS.
ARE A GROUP OF WOMEN
PREDOMINANTLY WOMEN A
PREDOMINANTLY IMMIGRANT AND
PREDOMINANTLY VIETNAMESE
SPEAKING.
THEY DESERVE AS DO OTHER SALON
WORKERS WERE EXPOSED TO
CHEMICALS ALL DAY THEY DESERVE
THE MOST WROTE ROBUST
INFORMATION THAT'S AVAILABLE THE
SAFE COSMETICS PROGRAM HAS DONE
A GREAT JOB ON A SHOESTRING
BUDGET FOR INSTANCE IT DEVELOPED
A GREAT.
DATABASE OF INFORMATION AND
IT'S ACTUALLY DONE SOME A GOOD
TRANSLATION OF MATERIALS INTO
LANGUAGES SUCH AS VIETNAMESE BUT
IT COULD DO AN EVEN MORE ROBUST
JOB. AND EVEN DO A BETTER JOB OF
PROTECTING CALIFORNIANS ARE FROM
THE COSMIC FROM THAT CHEMICAL
SOARING COSMETICS
SO ALL THREE OF THE
ORGANIZATIONS.
THAT WHOSE HOUSE I'M WEARING
TODAY ALL.
VIGOROUSLY SUPPORT MORE FUNDING
FOR THE SAFE COSMETICS PROGRAM
THANK YOU.
YOU.
GOOD AFTERNOON MY NAME IS LEE
SAID VAN FLEET AND I'M HERE ON
BEHALF OF THE INVESTOR
ENVIRONMENTAL HEALTH NETWORK.
WHICH IS A COLLABORATIVE PARCHIN
PARTNERSHIP THAT ENGAGES WITH
CORPORATIONS TO REDUCE FINANCIAL
AND PUBLIC HEALTH HEALTH RISKS.
ASSOCIATED WITH THE USE OF TOXIC
CHEMICALS.
THE MEMBERS OF THE INVESTOR
ENVIRONMENTAL HEALTH NETWORK
MANAGE OVER FIFTY FIVE BILLION
DOLLARS IN ASSETS.
AND.
THE NETWORK SUPPORTS THE
STAKEHOLDER PROPOSAL BECAUSE IT.
DISCLOSURE INCENTIVIZE IS
PERSONAL CARE AND COSMETIC
MANUFACTURERS TO MOVE TO SAFER
CHEMICALS FOR THEIR PRODUCTS WE
THEREFORE RESPECTFULLY REQUEST.
THAT THE COMMITTEE SUPPORTS THIS
STAKEHOLDER PROPOSAL TOO FULL.
TO ALLOW THE SAFER COSMETICS
PROGRAM TO FULFILL ITS MANDATE
UNDER THE MCNAUGHTON LAW THANK
YOU.
THANK YOU.
HELLO AGAIN I'M SUSAN LITTLE
WITH THE ENVIRONMENTAL WORKING
GROUP AGAIN SPEAKING IN SUPPORT
OF THIS PROPOSAL WHICH WE.
WE HOPE WILL ALLOW THE PROGRAM
TO FULLY ACTUALIZE ITS MISSION
THANK YOU.
YOU.
MY NAME IS KATHERINE BEACH ON
BEHALF OF BREAST CANCER ACTION
AND KEEP ABREAST ORGANIZATIONS
THAT CARE ABOUT VIA MENTAL
CAUSES OF BREAST CANCER WE
SUPPORT THE STAKEHOLDER
PROPOSAL.
WE RECOGNIZE THAT THERE'S A
GROWING. BODY OF EVIDENCE
LINKING TOXIC CHEMICALS TO
BREAST CANCER AND CONSUMERS HAVE
A RIGHT TO KNOW. ABOUT CHEMICALS
IN OUR DAILY PERSONAL CARE
PRODUCTS WE RESPECTFULLY URGE
THE. COMMITTEE TO APPROVE THIS
PURPOSE.
THANK YOU.
I AM DOCTOR LISA BAILEY ON MY
BREAST CANCER SURGEON AND.
ALSO THE PAST PRESIDENT OF THE
CANCER IN THE ENVIRONMENT TEAM
FOR THE AMERICAN CANCER IDEA I'M
SPEAKING ON BEHALF OF MYSELF
AND.
AND MY PATIENTS AND THEIR
FAMILIES.
I WANTED TO POINT OUT THAT
THERE WE SEE YOUNGER AND YOUNGER
WOMEN A YOUNGER YOUNGER GIRLS
MENSTRUATING AGE OF EIGHT EACH
OF NINE. THIS IS NOT NORMAL OF
SO MANY OF THESE COMPOUNDS
OCCURRING.
SOME OF THESE PERSONAL CARE
PRODUCTS TO CONTAIN.
CHEMICALS THAT CAN CAUSE
DISRUPTION OF THE HORMONE LEVELS
AND WE NEED TO KNOW MORE ABOUT
HOW THIS CAN BE RELATED TO SOME
THESE HEALTH OF HEALTH EFFECTS.
AS A PHYSICIAN WITH HIS WITH OUR
BREAST CANCER PATIENTS THEY WANT
TO KNOW WHY THEY DEVELOP BREAST
CANCER WE CAN'T TELL THEM
EXACTLY. HOW CAN THEY MAKE
THEMSELVES HEALTHIER?
TO REDUCE THE CHANCE OF THEIR
CANCER COULD RECUR.
AND THERE DESPERATE TO KNOW WHAT
ARE IN THOSE OF PERSONAL CARE
PRODUCTS AND OTHER.
ANYTHING ELSE IN THEIR LIFE
THAT THEY COULD POSSIBLY REDUCE
THEIR RISK FOR OF A FUTURE
CANCER.
OR OR ANYTHING.
UP OF ON HEALTH SEAT A
SIGNIFICANCE OF THEIR FAMILY SO
I'M IN STRONG SUPPORT OF THIS.
ON BOTH ON MY STE BUT SELF HELP
MYSELF AND ALL OF MY PATIENTS
SICK.
THANK YOU.
I GET EXTRA CREDIT WITH THE
NATURAL RESOURCES DEFENSE
COUNCIL OVER IN SUPPORT OF THIS
BUDGET PROPOSAL WE BELIEVE IT'S
IMPORTANT EMPOWER CONSUMERS
FAMILIES AND WORKERS ABOUT
INFORMATION ABOUT THE PRODUCTS
THEY USE IN THEIR DAILY LIVES SO
THEY CAN MAKE INFORMED
PURCHASING DECISIONS. AND UP
PARTICULARLY THESE PRODUCTS
CONTAIN CHEMICALS ARE KNOWN TO
CAUSE CANCER BIRTH DEFECTS AND
REPRODUCTIVE HARM SO WERE IN
SUPPORT OF THIS IMPORTANT
CONSUMER RIGHT TO KNOW PROGRAM
THANK YOU.
MISTER CHAIR MEMBERS MANY LIAM
BEHALF OF THE PERSONAL CARE
PRODUCTS COUNSEL REPRESENTING
OVER SIX HUNDRED. COMPANIES THAT
EITHER MANUFACTURER DISTRIBUTOR
SUPPLY COSMETICS IN THE UNITED
STATES.
WE OPPOSE THIS BUDGET REQUEST
THAT AUTHORIZES BROAD FEE
AUTHORITY ON THE BACKS OF
MANUFACTURERS IN ORDER TO FUND
AN INEFFECTIVE. AND NOW DATA
PROGRAM BY AN ALARMING FOREIGN
TO PERCENT.
CONSUMER SAFETY IS THE NUMBER
ONE PRIORITY FOR COSMETICS AND
PERSONAL CARE PRODUCTS COMPANIES
IN OUR INDUSTRY IS VERY STRONGLY
COMMITTED TO UPHOLDING THE US.
THE EARLIEST ASSERTION BY THE
SPONSORS OF THIS BUDGET PROPOSAL
THAT THE COSMETICS INDUSTRY IS
ONE OF THE LEAST REGULATED
INDUSTRIES.
I ONLY UNDERSCORES THEIR LACK OF
UNDERSTANDING FOR WHAT THE
COSMETIC INDUSTRY.
HOUSE TO INDOOR FOR EXAMPLE WE
ARE REGULATED BY ONLY HOW FOR
PURPOSES OF PROP SIXTY FIVE
REGULATED BY THE DEPARTMENT
TOXIC CONTROL SUBSTANCE
CONTROLS.
UNDER GREEN CHEMISTRY IN FACT
ARE R. PRODUCTS WERE NAMED IN
THE TWO THOUSAND EIGHTEEN TWO
THOUSAND TWENTY.
SCOPING SCOPING PLAN.
IT ADDITIONALLY UNDER DP H.
UNDER THIS EXISTING SAFE
COSMETICS PROGRAM CAR REGULATES
US UNDER FOR THE VOLATILE
ORGANIC COMPOUNDS FOUND IN SOME
FOR PRODUCTS.
AS WELL AS FTA SO THAT ONLY
SHOWS THE LAYERS AND LAYERS OF
REGULATION THAT OUR INDUSTRY.
AND PASSED TO COMPLY WITH.
THE PROPOSAL TO INCREASE FUNDING
BY FOREIGN TO PERCENT UNDER THIS
PROGRAM SERVICES SUSPEND.
RESOURCES ON AN OUTDATED
INEFFECTIVE AND DUPLICATIVE
PROGRAM.
AND WE URGE THE COMMITTEE TO
THINK CRITICALLY ABOUT THIS
REQUEST.
WHAT'S THE PROBLEM THAT WE'RE
SEEKING AFFECTS.
HOW DO OTHER EXISTING PROGRAMS
OVERLAP WITH AND POTENTIALLY
DUPLICATE?
AND WHY DO WE NEED TO MAKE THE
SAFE CONSUMER SAFE COSMETICS
PROGRAM MORE ROBUST IN TODAY'S
CONTEXT.
THE Y. AGAIN AS SOMEONE
MENTIONED EARLIER IN THE
SEPARATE PRESENTATION IS REALLY
CRITICAL AS WE CONSIDER FOREIGN
TO PERCENT INCREASE.
FROM THE PERSPECTIVE OF IT OUT
DATED IT'S IMPORTANT I THINK
ABOUT S. B. FORTY FOUR WHEN I
WAS PASSED IN TWO THOUSAND FIVE.
IT PREDATED A SIGNIFICANT
UPSURGE IN PROP SIXTY FIVE
ACTIONS THAT WE SEE TODAY IN
MANY INDUSTRIES NOT JUST US.
ADDITION.
THERE WAS MENTION THAT LANDMARK
LEGISLATION WAS PASSED BY THE
LEGISLATURE IN TWO THOUSAND AND
TEN ENACTING THE GREEN CHEMISTRY
LAW.
AND I ALREADY STATED MY EARLIER
COMMENTS SAID THE IMPACT ON OUR
PRODUCTS
TODAY.
BUT IF YOU LOOK BACK AT SB FORTY
FOUR MAKE THEN. EVEN AND
FINDINGS AND DECLARATIONS UNDER
LETTER I.
IT TALKS ABOUT THE ALTERNATIVES
TO SUBSTANCES THAT MAY BE
HARMFUL.
THAT'S PART AND PARCEL TO WHAT
THE GREEN CHEMISTRY INITIATIVE
IS ALL ABOUT.
AND. UNDER THE FINDINGS AND
DECLARATIONS UNDER FOR EIGHTY
FOUR LETTER F. IN G.. IT TALKS
ABOUT THE NEED FOR INGREDIENT
DISCLOSURE.
GIVEN THE POTENTIAL RISKS TO
SALON WORKERS.
IT'S WORTH NOTING IN THIS CITING
THAT PC PC ALONG WITH OTHER
INDUSTRY PARTNERS WORKED WITH
ASSEMBLYMAN KALRA WHO HAS. A
BILL THIS YEAR AND HAD A BILL
LAST YEAR THAT REQUIRES
INGREDIENT DISCLOSURE FOR
COSMETIC PRODUCTS THAT ARE USED
IN A PROPOSED PROFESSIONAL
SETTING.
I WANT TO UNDERSCORE THE
SIGNIFICANCE OF THE INDUSTRY
COMING TO THE TABLE. AND WORKING
OUT A DEAL.
ON INGREDIENT DISCLOSURE.
AND WE REMAIN COMMITTED TO
WORKING OUT A DEAL WITH MISTER
KALRA THIS YEAR AS HE ADVANCES
THAT EFFORT.
.
LASTLY.
I WANT TO TALK ABOUT THE THE
VALUE PROPOSITION AND AND IT'S
IMPORTANT TO THINK ABOUT VALUE
IN THE CONTEXT OF THE BUDGET AS
YOU GUYS ARE WELL AWARE.
THIS DATABASE PROVIDES
INFORMATION JUST FOR THE SAKE OF
INFORMATION WITHOUT REAL
CONTACTS FOR EXAMPLE.
TITANIUM DIOXIDE IS AN
INGREDIENT THAT IS REQUIRED TO
BE DISCLOSED UNDER THIS PROGRAM.
IT'S ALSO PROP SIXTY FIVE LISTED
CHEMICAL.
BUT IT'S ALSO FOUND IN OREOS
IT'S A FOOD ADDITIVE.
AND SO WITHOUT CONTEXT WHICH IS
PROGRAM DOESN'T PROVIDE WERE
ESSENTIALLY SAYING TO CONSUMERS
IT'S OKAY FOR YOU TO EAT THIS
PRODUCT BUT NOT OKAY FOR YOU TO
PLAY AT YOUR FACE.
SARGIS CLOSE WITH URGING THAT
COMMITTEE TO THINK CRITICALLY
ABOUT THIS REQUEST.
ESPECIALLY IN TODAY'S CONTEXT.
WITH THE LAYERS AND LAYERS OF
OF EXISTING PROGRAMS BEFORE WE
AUTHORIZED A SIGNIFICANT
INCREASE THANK YOU.
IF YOU.
GOOD AFTERNOON DOCTOR CHAIR.
MEMBERS ANTHONY SAMPSON WITH
ARNOLD PORTER ON BEHALF OF THE
CALIFORNIA CHAMBER OF COMMERCE.
.
I JUST WANT TO UNDERSCORE THE
FACT THAT OPPOSITION TO THIS A
BUDGET PROPOSAL ITEM IS NOT
OPPOSITION TO DISCLOSURE IN FACT
WE'VE SEEN. NOW LAST YEAR S. B.
TWO FIFTY EIGHT DISCLOSURE.
AND CLEANING PRODUCTS BY
SENATOR LARA INDUSTRY IS COMING
TO THE TABLE ON THESE ISSUES AS
YOU ALSO HEARD IN THE CONTEXT OF
PROFESSIONAL A SALONS.
BUT I WANT TO.
.
QUESTION WHETHER IN INCREASE
AGAIN IN FOUR HUNDRED PERCENT
FUNDING AND IN THIS PARTICULAR
PROGRAM IS APPROPRIATE.
I WANTED ADDRESSED TO COMMENTS
THEIR TWO ASSERTIONS RATHER
THAT.
THAT ARE INCLUDED IN THE
DOCUMENTS THAT ACCOMPANY YOUR
MATERIALS FOR THIS PROPOSAL.
OUT ONE OF WHICH IS THE
ASSERTION THAT THERE IS.
MISS RECORD UNDER REPORTING
AMONG COSMETIC MANUFACTURERS
UNDER THIS PROGRAM BECAUSE OF A
LACK OF FUNDING.
TO SUPPORT.
ENFORCEMENT.
I I HAVE NOT YET HEARD OF ANY
EXAMPLES OF SUCH UNDER
REPORTING.
OTHER THAN.
THE BRAZILIAN BLOWOUT EXAMPLE
IN TWO THOUSAND TEN WHICH AGAIN
IS INCLUDED IN THE MATERIALS.
BUT TO THE EXTENT THERE IS SUCH
UNDER REPORTING THERE ARE
ENFORCEMENT MECHANISMS IN PLACE
UNDER EXISTING LAW.
THAT WOULD ALLOW NOT ONLY
CONSUMERS.
BUT BUSINESSES AGAINST
BUSINESSES AND THE ATTORNEY
GENERAL UNDER BUSINESS AND
PROFESSIONS CODE SEVENTEEN TWO
HUNDRED.
CHIU ALLEGE UNFAIR BUSINESS
PRACTICES.
AND MISLABELING WE SEE THESE
CLAIMS BROUGHT. A VERY VERY
FREQUENTLY IN FACT IT'S A TOPIC
OF HOT DEBATE IN THIS
LEGISLATURE BECAUSE OF ITS BROAD
APPLICABILITY.
SO.
.
THEY A PROGRAM DOES NOT NEED TO
HAVE A GOVERNMENT ENTITIES.
ENFORCING AT IN ORDER FOR IT TO
BE EFFECTIVE LOOK NO FURTHER
THAN PROP SIXTY FIVE WHERE THE
OFFICE OF ENVIRONMENTAL HEALTH
HAZARD ASSESSMENT.
ADMINISTERS THE PROGRAM HAS NO
ENFORCEMENT AUTHORITY UNDER THAT
PROGRAM THERE'S A PRIVATE RIGHT
OF ACTION.
BUT EVEN WITHOUT ONE AGAIN
BUSINESS AND PROFESSIONS CODE
SEVENTY TWO HUNDRED.
IS SOMETHING THAT.
MANY ENTITIES USE.
AND ALSO AS A SECOND ASSERTION
THAT WAS MADE.
IS THAT.
BUSINESSES UNDER THIS ACT ARE
ABUSING A TRADE SECRET CLAIMS.
AGAIN THE MATERIALS DON'T
CONTAIN ANY EXAMPLES.
OF SUCH ABUSE.
BUT.
IT COULD NOT EXIST BECAUSE
TRAITS OCCUR CLAIMS THAT ARE
BEING CLAIMED UNDER THIS ACT ARE
BEING DONE SO PURSUANT TO LAW.
.
BOTH THE FEDERAL LAW AND ITS
STATE COUNTERPART WITH RESPECT
TO THIS PARTICULAR ISSUE.
PROTECT TRADE SECRET AND SO
MANUFACTURES ARE DOING WHAT THEY
ARE PERMITTED TO DO. AND
PROTECTING TRADE SECRET FOR FOR
FLAVORING AND FOR FRAGRANCES
THOSE TWO ISSUES ARE SPELLED OUT
AGAIN IN BOTH THE FEDERAL LAW
AND THE STATE LAW. SO ANY ABUSE
OF OF TRADE SECRET IS NOT ABUSE
BUT SIMPLY COMPLIANCE WITH THE
LAW.
AND FINALLY.
ASLEEP BEFORE ME TALKED A
LITTLE BIT ABOUT OTHER PROGRAMS.
THAT ARE THAT ARE IN PLACE YEAH
ONE OVERLAPPING PROGRAM WE TALK
A LITTLE BIT ABOUT. IS PROP
POSITION OF FOR ABOUT TWO AND A
HALF YEARS ON THIS.
DEVELOPMENT BUT.
IN RESPONSE TO A LOT OF
CRITICISM FOR PROP SIXTY FIVE
WARNINGS BEING TO UBIQUITOUS IN.
ARE NOT SPECIFYING ENOUGH
INFORMATION THOSE WARNINGS WERE
SUBSTANTIALLY MODIFIED BY THE
OFFICE OF ENVIRONMENTAL HEALTH
HAZARD ASSESSMENT THEY BECOME
EFFECTIVE ON AUGUST THIRTIETH OF
THE SHEER. AND THOSE WILL
REQUIRE WARNING SUSPECTS OF BY
THE CHEMICAL FOR WHICH THE
WARNING IS BEING PROVIDED
WHETHER FOR CARCINOGEN
REPRODUCTIVE TOXICANTS.
I'M OR BOTH. PROP SIXTY FIVE IS
THE MOST FAR REACHING RIGHT TO
KNOW ACT IN THE WORLD ARGUABLY
AND EVEN THEN.
IT PERTAINS TO EXPOSURES AT
CERTAIN LEVELS AND NOT MERELY
FOR THE CONTENTS.
FOR BEING MERELY PRESENT IN IN
IN THE UP PRODUCT.
SO.
WITH THAT AND I APPRECIATE THE
COMMITTEE'S CONSIDERATION AND.
AGAIN CALIFORNIA CHAMBER OF
COMMERCE IN OPPOSITION.
THANK YOU SIR.
THANK YOU MISTER CHAIRMAN SO A
NUMBER RUBIO TIM SHASTA CARE THE
AMERICAN CHEMISTRY COUNCIL I
WILL ASSOCIATE MY A COMMENTS.
WITH MISS LEE AND AND MISTER
SAMPSON I THINK THE I WOULD
CURSE A COMMITTEE TO LOOK
CRITICALLY AT SOME OF QUESTIONS
THAT WERE RAISED IN AND
MISLEADING TESTIMONY ABOUT THE
EVOLUTION OF OTHER PROGRAMS
REGULATORY. SCHEME SINCE HIS
ACTION OF THIS LOSS OF
PRODUCTION TO MAKE THE COMMENTS
THANK YOU THANK YOU SIR.
GOOD AFTERNOON A COOKING ON IS
HERE ON BEHALF OF THE
INTERNATIONAL FRAGRANCE
ASSOCIATION OF NORTH AMERICA AND
THE HOUSEHOLD AND COMMERCIAL
PRODUCTS ASSOCIATION.
I COULD HELP MYSELF BUT JUST
PUT ANOTHER LITTLE FINER POINT
ON THE TRADE SECRET.
AT CONCERNS THAT MR RAHMAN
BROKEN BROUGHT UP.
I JUST WANNA REMIND EVERYONE
THAT IF YOU ARE ON THIS DATABASE
SO OF THE SIXTY FIVE THOUSAND
PRODUCT THERE'S FOUR HUNDRED SIX
AS OF TODAY THAT HAVE A CLAIM OF
TRADE SECRET.
IF THEY HAVE CLAIMED IT ON THE
DATABASE THEY'RE SAYING THERE IS
A CARCINOGEN A REPRODUCTIVE
TOXICANTS IN MY PRODUCT I'M JUST
NOT TELLING YOU WHICH ONES I
JUST DON'T WANT TO COME ACROSS
THAT THEY'RE. SAYING HIDING
EVERYTHING AND.
YOU KNOW THERE IS USEFUL
INFORMATION TO CONSUMER IN THAT
RESPECT THAT IF THEY WANT TO
AVOID ANY OF THOSE INGREDIENTS
THEY CAN SEE.
WHAT PRODUCT HIGHS SOMETHING
AND?
MEKA INFORMED DECISION TO THINK
IT.
GIVE.
GOOD AFTERNOON MY NAME IS SHANE
A BROWN OF THE CALIFORNIA
MANUFACTURERS AND TECHNOLOGY
ASSOCIATION AND I WOULD LIKE TO
ASSOCIATE MAKE COMMENTS BUT
THOSE AHEAD OF ME WE ARE POSED
THE CURRENT BUDGET PROPOSAL. AND
I THINK THAT WE AGREE THAT THE
DATABASE IS OUTDATED AND I'M NOT
FUNCTIONING BUT WE DON'T AGREE
WITH THE PATHWAY PROPOSED MOVING
FORWARD. AND I THINK IT'S
IMPORTANT HIGHLIGHTS A COUPLE OF
OTHER AGENCIES THAT WE'RE
TALKING ABOUT WE HAN. DTS SEE
THESE ARE SORT OF BEYOND THE
SCOPE OF THIS COMMITTEE AND SO
WE JUST WANNA KIND OF PAINT THE
PICTURE OF THE BROADER LEDGE.
REGULATORY FRAMEWORK THAT AND
MANUFACTURERS ARE FACING.
HUMAN.
WHEN I BRING IT UP TO THE DYESS
FROM THE QUESTIONS.
SO I WAS HOPING IF YOU COULD.
BOTH DOCTORS OWN SOLOMON AND.
.
JANET NUDELMAN.
A PROBLEM MASSACRED THAT NOW IS
PERFECT.
CAN YOU COMMENT ABOUT GREEN
CHEMISTRY WHICH CAME TO
ORIGINATION AFTER THE.
MEET IN LAW AND
WHERE THERE'S OVERLAP DO YOU SEE
THESE AS.
COMPETING MEASURES OR
COMPLEMENTARY.
YESTERDAY NOT BROAD LEVEL AND
THEN YOU COULD PIGGYBACK.
SO. SO UNDER UNDER REALLY BROAD
LEVEL WHAT I'D LIKE TO SAY IS IS
THESE TWO PROGRAMS COMPLEMENT
EACH OTHER BUT BUT NEITHER AS A
REPLACEMENT FOR THE OTHER. AND
THEY ARE VERY VERY DIFFERENT OUR
RATE NOW THE THE SAFE COSMETICS
PROGRAM HAS AUTHORITY OVER.
THE DISCLOSURE OF PROP SIXTY
FIVE CHEMICALS SO THAT'S ONE
LESS PLUS THE THE AUTHORITATIVE
A LESS THAT INFORMED PROP SIXTY
FIVE.
THE THE GREEN CHEMISTRY PROGRAM
AS LOOKING AT TWENTY FOUR
DIFFERENT LISTS OF OF HAZARDOUS
CHEMICALS. SO THEY'RE THEY'RE
REALLY DIFFERENT IN TERMS OF
THEIR SCOPE WHEN THE GREEN
CHEMISTRY PROGRAM EXAMINES THE
THE SAFETY OF SPECIFIC CHEMICALS
AND PRODUCTS. THEY ARE LOOKING
AT CHEMICAL PRODUCT COMBINATIONS
THAT USUALLY SPAN. LIKE IN MAYBE
ONE OR TWO LIKE FOR EXAMPLE
THEY'VE ONLY SINCE THEIR
INCEPTION THE SAFER CONSUMER
PRODUCTS PROGRAM. HAS A EXAMINED
IN ISSUED REGULATIONS TO LOOK AT
THREE DIFFERENT CHEMICAL PRODUCT
COMBINATIONS
ONE LOOK DEBT TO FLAME
RETARDANTS IN CHILDREN'S.
SLEEPING PRODUCTS
THE SECOND LOOK DAD MUFFLING
CHLORIDE SO ONE CHEMICAL IN PETE
STRIPPER AND THE THIRD LOOKED
AT.
ONE CHEMICAL UNREACTED MD AYE IN
SPITE POLYURETHANE FOAM SO THE
POINT I'M TRYING TO MAKE IS THAT
THEY LOOK AT KIOSK A HANDFUL A
HANDFUL AS MIGHT EVEN BE AN
EXAGGERATION. OF CHEMICALS IN A
SPECIFIC
PRODUCT OR A FEW PRODUCTS IN A
PRODUCT CATEGORY.
THE SAFE COSMETICS PROGRAM LOOKS
AT. LOOKS FOR.
APPROXIMATELY NINE HUNDRED
CHEMICALS IN THE FULL SUITE OF
COSMETICS AND PERSONAL CARE
PRODUCTS THAT EXIST ON THE
MARKET TODAY.
THEY ARE SUBSTANTIALLY DIFFERENT
IN TERMS OF THE THE QUANTITY OF
CHEMICALS THAT THEY LOOK AT AND
THE PURPOSE BECAUSE. THE SAFE
COSMETICS PROGRAMS PURPOSES
DISCLOSURE OF THE INGREDIENT.
AND THE SAFER CONSUMER PRODUCTS
PROGRAM HAS REGULATORY AUTHORITY
TO REQUIRE ALTERNATIVES TO THE.
TO THE CHEMICALS THAT THEY
INVESTIGATE AND IF THEY DO FIND
THEM TO BE HAZARDOUS
WOULD I JUST WANNA MAKE SURE A
FOLLOW UP TO.
TONY BENNETT.
WOULD GREEN CHEMISTRY BE ABLE TO
DETERMINE IF THERE ARE TOXIC
CHEMICALS IN PRODUCTS AND HOW DO
WE AS CONSUMERS ENSURE THAT.
WHAT WERE PUTTING ON OUR BODY IS
SAFE TO USE?
I'M. THE THE GREEN CHEMISTRY
LAWS STADLER SH WHAT'S NOW
CALLED THE SAFER CONSUMER
PRODUCTS PROGRAM AT DTS SEE. AND
THAT PROGRAM HAS FROM ITS
INCEPTION FACED A BIT OF A CATCH
TWENTY TWO BECAUSE. THEY.
NEED TO SURPASS A CERTAIN
HURDLE IN ORDER TO MEET THE
THRESHOLD FOR IDENTIFYING A
PRIORITY. PRODUCT CHEMICAL
COMBINATION TO REGULATE.
AND THAT HURDLE INVOLVES YOU
SOME INFORMATION ABOUT TOXICITY
AND ALSO SOME.
INFORMATION ABOUT EXPOSURE
POTENTIAL HERE IN CALIFORNIA.
AND WHAT.
DTS SEE QUICKLY REALIZED IN
TRYING TO IMPLEMENT THIS
PROGRAM.
IS THAT IF THEY DON'T HAVE
INFORMATION ABOUT WHAT CHEMICALS
ARE IN A PRODUCT CATEGORY.
THEY DON'T THEY DON'T EVEN KNOW
WHERE TO START.
AND SO THEY ACTUALLY HAVE TO.
E. R. NOR TO FIGURE OUT A PATH
FORWARD THEY HAVE TO FIRST
FIGURE OUT OKAY WHAT.
CHEMICALS WERE IN THIS PRODUCT
CATEGORY THEN THEY LOOK AT
ISSUES LIKE THAT. CONCENTRATION
OF THOSE CHEMICALS AND.
HOW COMMON THEY ARE AND HOW
THAT PRODUCT IS USED IN WHAT
THEY THERE'S LIKELY TO BE
EXPOSURE TO? HUMANS EITHER
DIRECTLY OR MAYBE INDIRECTLY
THROUGH AYE GOING DOWN THE DRAIN
IN INTO WATER SUPPLIES SO FORTH.
SO THOSE.
THEY THEY ALMOST CAN'T PASS.
WITHOUT INFORMATION ABOUT WHAT'S
IN PRODUCTS AND SO THIS IS ONE
OF THOSE SORT OF PIECES ARE OR
PLACES THAT THAT WE GREEN
CHEMISTRY.
WE HAVE FOLKS ARE IMPLEMENTING
GREEN CHEMISTRY GO TO STE
FIND THAT IN STARTING PLACE.
FUNDING CAME UP IN THE
DISCUSSION AND I WAS HOPING YOU
COULD. EXTRAPOLATE A LITTLE BIT
ABOUT. THE NEED FOR FUNDING AND.
I HAVE TO TELL YOU EVERY TIME
WE TALK ABOUT INFORMATION
TECHNOLOGY I GET A LITTLE
CONCERNED BECAUSE IT DOES ALWAYS
SEEM LIKE. WE SPEND.
EXCESSIVE AMOUNTS OF MONEY TO
DEVELOP AND IMPLEMENT PROGRAMS.
SO SOMEONE ONE THING THAT I
FOUND VERY SURPRISING BY THE THE
OPPOSITION'S TESTIMONY IS THAT
MANY OF THEM WERE COMPLAINING
ABOUT THE IMPACT THAT THIS
PROPOSAL WOULD HAVE ON THE
BUDGET AND THERE WOULD BE NO
IMPACT ON THE BUDGET.
AND I WANNA MAKE A REALLY CLEAR
THAT'S THE WHOLE POINT OF
PROPOSING A NEW FEE MECHANISM.
THE THE IMPACT WOULD BE ON THE
COMPANIES REPORTING THE PRODUCTS
TO THE SAFE COSMETICS DATABASE.
AT OF FAIRY VERY NOMINAL LEVELS
ASSESSING A FEE OF THIRTY
DOLLARS PER PRODUCT.
THAT'S REPORTED TO THE DATABASE
WOULD WOULD NOT HAVE A
SIGNIFICANT IMPACT IN AND THAT
MY BELIEF ON ON ANY OF THE
COMPANIES THAT ARE REPORTING. OF
THESE PRODUCTS SO SO I JUST WANT
TO MAKE CLEAR THERE IS NO IMPACT
ON THE BUT BUDGET AND THAT'S WHY
WERE. WERE HERE TODAY.
IN IN TERMS OF WHAT THE SECOND
PART OF YOUR QUESTION IS WHAT
WITH A FUNDING PAY FOR.
EVEN OF THE THE PROBLEM WITH THE
DATABASE AND AYE I HEAR YOUR
CONCERN ABOUT THAT IS SINCE
AUGUST THE DEPARTMENT OF PUBLIC
HEALTH HAS INFORMED US THAT
THEY'VE RECEIVED. JUST SINCE
AUGUST THE LAST SIX MONTHS
NEARLY THREE HUNDRED.
USER ERROR SO THAT MEANS.
BUT THREE HUNDRED TIMES WHEN
WHEN A COMPANY WAS TRYING TO
INPUT DATA INTO THE DATABASE.
THEY RECEIVED AN ERROR AND
THAT'S A REAL PROBLEM BECAUSE
THAT MEANS THAT THE INFORMATION
IS NOT GETTING INTO THE DATABASE
EN.
A CLEAR AND CONSISTENT AND
USABLE MANNER SO THE DATABASE IS
MALFUNCTIONING I MEAN THAT IS
JUST A REALITY.
IT IT DOES NEED TO BE REPLACED
AND AND THAT IS PART OF OUR OF
OUR BUDGET PROPOSAL BUT IT'S IT
WOULD BE A ONE TIME FEE. TO
CONDUCT A THE OVERHAUL OF THE
DEBATE DATABASE ITSELF.
ONE MAKE SURE IF YOU HAVE ANY
QUESTIONS I WAS TO STOP
ATTACKING ALSO A LOT TRYING TO
FIGURE OUT THAT THE FUNDING
SOURCE AND.
.
SOLD JUST TO UNDERSTAND
CORRECTLY SO RIGHT NOW. I'M THE
STATE IS FUNDING THE PROGRAM AND
THAT YOUR PROPOSAL IS TO.
INCREASE SAID BUT TO CHARGE THE
COMPANIES FOR THAT FEE EXACTLY
SO THE CURRENT OF THIS THE
CURRENT ARM FUNDING FROM THE
GENERAL FUND IS THREE HUNDRED
AND SEVENTY THOUSAND DOLLARS.
AND WERE WE'RE PROPOSING TO TO
SUPPLEMENT THAT FUNDING WITH.
THE FEE.
WHICH WOULD BE ASSESSED ON THE
PRODUCTS REGISTERED WITH A
DATABASE.
AND THE FEE IS A ONE TIME FEE OR
AN ONGOING FEE ON IT WOULD BE IT
IT WOULD BE AN ANNUAL FEE THAT
WOULD BE ASSESSED ON THE
COMPANIES. BECAUSE THE THE
PRODUCTS THAT ARE ENTERED INTO
THE DATABASE CHANGE OVER TIME
COMPANIES ARE CONSTANTLY FOR
REFORMULATING. THEIR PRODUCTS SO
I AS COMPANY I MIGHT BE
REGISTERING A PRODUCT TODAY THAT
CONTAINED STYRENE.
AND PAY A THIRTY DOLLAR FEE
NEXT YEAR I'VE MIGHT REFORMULATE
STYRENE OUT OF THAT PRODUCT AND
THEN I HAVE NOTHING TO REPORT.
TO THE STATE SO IT WOULD BE
NECESSARY THAT THAT THE ANNUAL
ASSESSMENT OF THE FEE OR THE
ASSESSMENT OF THE FEE TAKE PLACE
ON AN ANNUAL BASIS.
BY NOT GIVING TO TECHNICALITIES
BUT WHAT IF A PRODUCT AS
MULTIPLE TWO THE IS IT JUST ONE
YEAH A THAT'S A REALLY GOOD
QUESTION THAT THE FEE WOULDN'T
CHANGE BASED ON THE NUMBER. OF
PROP SIXTY FIVE CHEMICALS IN THE
PRODUCTS AND I COULD SHARE WITH
YOU SOME SOME REALLY GOOD
ILLUSTRATIONS OF PRODUCTS THAT
CONTAIN MULTIPLE PROP SIXTY FIVE
CHEMICALS I MEAN ONE IN QUESTION
HAS SEVEN. DFFERENT.
CARCINOGENS REPRODUCTIVE
TOXICANTS BUT THAT COMPANY WOULD
JUST PAY THE THIRTY DOLLARS.
ONCE FOR THAT PRODUCT MEANT JUST
ONE MORE QUESTION.
SO.
WE DON'T THESE PRODUCTS AND
RENO'S BECAUSE I LOOK AT LABELS
ALL THE TIME. SO DON'T THESE
PRODUCTS HAVE THAT ON THE LOWER
THEIR LABELS THE INFORMATION ON
THE LABELS.
.
YES BEYOND FOOD DRUG AND
COSMETIC SAFETY ACT AS BEEN
AMENDED ONE SINCE NINETEEN
THIRTY EIGHT AND THAT WAS THIRTY
YEARS AGO TO. TO MANDATE
INGREDIENT DISCLOSURE ON THAT
PRODUCT LABELS OF PERSONAL CARE
AND COSMETIC PRODUCTS
SO ALL OF THE INGREDIENTS IN A
PRODUCT DO HAVE TO SHOW UP ON
THE LABEL EXCEPT FOR. FRAGRANCE
FLAVORINGS AND COLORANTS.
SO YES CONSUMERS DO OF THE
INFORMATION ON THE PRODUCT
LABELS BUT I DON'T KNOW.
IF YOU HAVE AS MUCH TROUBLE AS
I DO WITH MY.
MY OVER FORTY GUYS BUT I'M IT'S
REALLY HARD TO READ THE LABELS
IT'S HARD TO UNDERSTAND HER
DISTINGUISH. BETWEEN THE
CHEMICALS ON THE LABELS AND IT
FEELS LIKE A A REALLY LOGICAL.
AND UNFAIR FUNCTION OF THE
DEPARTMENT OF PUBLIC HEALTH
TO PULL OUT THE CHEMICALS LINKED
TO HARM.
AND M. PROVIDE THAT INFORMATION
TO CONSUMERS DIRECTLY.
WITHOUT DUB STAFFERS RECOMMENDED
NO ACTION AT THIS TIME WE WILL
HOLD THIS ITEM OPEN AND MOVE ON
TO ISSUE TO.
THANK YOU THANK YOU FOR YOUR
TIME
.
GERMAN RAMBLER.
ASSEMBLY WOMAN RUBIO. THANK YOU
FOR THE TIME TO SPEAK BEFORE
THIS COMMITTEE.
I'M HERE REPRESENTING AMERICAN
HEART AMERICAN CIRCUSES ZETIAN
I'M CURRENTLY THE PRESIDENT OF
THE BOARD OF DIRECTORS FOR THE
SACRAMENTO REGION.
I'M ALSO A BOARD CERTIFIED
NEUROLOGIST AND I PRACTICE HERE
IN THE SACRAMENTO COMMUNITY.
I'D SPENT THE LAST FIFTEEN
YEARS OF MY CAREER SAID
DEVELOPING CONFERENCE STROKES
SYSTEMS OF CARE TELEMEDICINE
SYSTEMS TAKING CARE OF PEOPLE IN
THERE. MOST ACUTE IN EMERGING
CRITICAL A TIME WHEN THEY'RE
HAVING STROKES.
I WANT TO SPEND THE NEXT TWO
DECADES OF MY CAREER OF
PREVENTING STROKE.
AND IN ORDER TO PREVENT STROKE
WE NEED TO MANAGE MODIFIABLE
RISK FACTORS.
OF RISK FACTORS SUCH AS
HYPERTENSION WHICH I'M HERE TO
SPEAK TO YOU ABOUT TODAY.
ATTENTION OR HIGH BLOOD PRESSURE
WHICH IS PRESSURE THAT AFFECTS
THE ARTERIAL WALLS OF OUR OF OUR
VESSELS IN THE.
CAN PUT US AT RISK FOR STROKE
AND HEART DISEASE.
WE WANT TO WITH OUR FUNDING
REQUEST EMPOWER PEOPLE WITH
KNOWLEDGE.
PROVIDE THEM WITH THE UPDATED
INFORMATION ABOUT WHAT
CONSTITUTES ELEVATED BLOOD
PRESSURE WHAT. CONSTITUTES
HYPERTENSION.
IN ORDER TO EMPOWER THEM WE NEED
TO EDUCATE WE NEED TO CREATE
AWARENESS.
WE ALSO WOULD LIKE TO GIVE THEM
TOOLS AND WE LIKE TO PROVIDE
THEM WITH TOOLS SUCH AS MUCH
MONITORING BLOOD PRESSURE CUFFS.
WHICH WILL ALLOW THEM TO.
PROVIDE SOME SELF CARE WILL ALSO
ALLOW CARE MEMBERS OF OUR
COMMUNITY TO GET OUT. AND TO
PROVIDE PEOPLE WITH OBJECTIVE
MEASURES OF THEIR BLOOD
PRESSURE.
SO THAT THEY CAN TAKE BETTER
CARE OF THEMSELVES WE CAN
PREVENT HEART DISEASE AND
STROKE.
.
I'M OPEN ANY QUESTIONS.
THERE'S A LOT OF DETAILED
INFORMATION HERE.
AND.
WE APPRECIATE THIS OPPORTUNITY.
THANK YOU.
I WILL TAKE PUBLIC COMMENT AT
THIS TIME.
DOCTOR CHAIR ASSEMBLY MEMBER
RUBIO TIM AND REPRESENT
CALIFORNIA CHAPTER THE AMERICAN
CULTURE CARDIOLOGY IN STRONG
SUPPORT OF THIS BUDGET REQUEST
ON THE HYPERTENSION PROGRAM.
IN OVER THE YEARS AND REPRESENT
CARDIOLOGY WHAT I'VE NOTICED.
WHEN LISTENING TO THEM AND
THEIR FRUSTRATIONS IS OVER
PATIENTS GIVING ADVICE TO
PATIENTS AND THEM NOT A SORRY
FOLLOWING IT. AND IT'S THEY WALK
OUT THE DOOR THEY TAKE
INFORMATION BUT THEY DON'T
ASSEMBLY DO ANYTHING WITH IT.
I'M UNFORTUNATELY I'M IS THE
DOCTRINE DESCRIBE WHEN COME
STROKE PATIENTS FOR PATIENTS WHO
SUFFER HEART ATTACKS THEY THEN
COME TO US. AND THEY THEY HAVE A
MUCH MORE SERIOUS CONVERSATION
AMPLE WHAT SHOULD I DO NOW MANY
TIMES THERE WERE FAR DOWN THE
ROAD FROM HEART DISEASE
PERSPECTIVE. WE CAN HELP THEM
BUT IF THEY WOULD HAVE LISTENED
TO THE ADVICE OR GIVEN EARLIER
AND YOU MAY HAVE HAD THIS
EXPERIENCE THE MERSEY DEPARTMENT
AS WELL. ON THINGS MIGHT HAVE
BEEN DIFFERENT SO WE WILL LOOK
AT A PROGRAM LIKE THIS WHERE
WE'RE TRYING TO GET AHEAD OF THE
GAME SOME IS SHOWING SIGNS OF
HYPERTENSION WE GIVEN SOME TOOLS
TO MONITOR THAT. AND ONE OF THE
ASPECTS THAT WE REALLY LIKED WAS
THE NOTION OF THE COMMUNITY
HEALTH WORKERS
SO IT'S A REALLY KIND OF AN
INTENSIVE WRAPAROUND APPROACH.
TO STAY CONNECTED TO THE
PATIENT.
HELP ME UNDERSTAND WHAT'S GOING
ON AND HOW THEY CAN IMPROVE
THEIR HEALTH TO STAY AHEAD OF
THIS HYPERTENSION WHICH IT
REALLY TRULY IS THE SILENT
KILLER AS WE NOW. SO FOR THESE
REASONS WERE STRONG SUPPORT.
THANK YOU SIR.
I GOOD AFTERNOON MY NAME IS
ADRIANA MORE I'M THE HEALTH
POLICY AVERAGE CORONER FOR THE
LATINO COALITION FOR HEALTHY
CALIFORNIA. WE'RE HERE TODAY TO
SHOW OUR SUPPORT FOR THIS
PROPOSAL AYE WE WORK WITH A LOT
OF COMMUNITY HEALTH WORKERS FROM
WITHOUT US THROUGHOUT THE STATE
AND A LOT OF WHAT WE HEAR IS
THAT.
A LOT OF THE MUSIC MEMBERS THAT
THEY WORK WITH THEY HAVE BLOOD
PRESSURE MONITORS BUT THE LOT OF
THEM DON'T KNOW HOW TO USE AND
SO FOR US. OF YOU KNOW HAVING
THESE CONVERSATIONS WITH HE
COMMITTEE MEMBERS AND THE FROM
WITH BUT AS WE SEE THAT THEY ARE
IN SCHICKEL PART OF THE
HEALTHCARE SYSTEM. AND THIS IS
ONE OF THE REASONS WHY WE
SUPPORT THIS AND WE HOPE THAT
YOU DID. THANK YOU
THANK YOU MA'AM.
WITH THAT WILL BRING INTO DIES
FOR ANY QUESTIONS.
I WANTED TO SAY HOW MUCH I
APPRECIATE THIS AND RECOGNIZE AS
WELL WORKING IN THE ER THAT WE
HAVE TO GET. UPSTREAM OF MANY OF
THESE PROBLEMS.
I WAS TROUBLED WHEN WE DID AN
ANALYSIS OF LOOKING AT OUR
DISCHARGE INSTRUCTIONS THAT OUR
PATIENTS.
DID NOT UNDERSTAND EIGHTY
PERCENT OF WHAT WE TOLD THEM.
AND KNOW THAT WE NEED BETTER OUR
REACH BETTER EDUCATION AND
OPPORTUNITIES TO HAVE THIS
CONTINUED DISCUSSION AND HOW
IMPERATIVE IT IS FOR OUR
COMMUNITY AND OUR STATE.
THANK YOU FOR BRINGING THIS
FORWARD AT THIS TIME STAFF
RECOMMENDS NO ACTION WILL HOLD
IT OPEN. AND THE BOND ISSUE
ELEVEN THANK YOU
GOOD AFTERNOON MISTER CHAIR.
AND THE MEMBER RUBIO.
I'M MARK STAR IF YOU TOOK HER
FROM ROMMEL HEALTHY PART OF
PUBLIC HEALTH AND WITH ME I HAVE
MY ASSISTANT DEPUTY. MAN KLEIN.
I WANNA THANK YOU FOR THE
OPPORTUNITY SHARE A LITTLE BIT
ABOUT OUR PROGRAM.
WILL GIVE YOU A QUICK CANNABIS
UPDATE AND THEN WE HAVE ONE
PROPOSAL BEFORE YOU.
SO THE CENTER FOR BERMAN HEALTH
INCLUDES PROGRAMS THAT FOCUS ON
PUBLIC HEALTH PROTECTION.
NO TO PREVENT DISEASE AND
INJURY.
SO ARE CENTER PROTECTION
IMPROVES THE HEALTH OF ALL
CALIFORNIA RESIDENTS.
BY WORKING TO ENSURE THE SAFETY
OF THINGS LIKE FOODS. DRUGS
MEDICAL DEVICES.
MANUFACTURED CANNABIS PRODUCTS
WHICH WE HEAR ABOUT MORE IN A
MOMENT.
WE ALSO CONDUCTED UNDER AGE TO
BACK ON FORSMAN OTHERWISE KNOWN
AS THE STATE PROGRAM.
WE DO ENVIRONMENTAL MANAGEMENT
PROGRAMS INCLUDE THINGS LIKE.
OVERSEEING MEDICAL WASTE
GENERATION AND DISPOSAL.
WELL I'LL ALSO NUCLEAR MERGER
RESPONSE PROGRAM. OF THE.
WORKING ON NUCLEAR POWER PLANTS
TO REVERT INCIDENT.
AND LASTLY WE OVERSEE THE USE OF
RADIATION AND ONE OF OUR LARGER
PROGRAMS RADIATION AND
RADIOACTIVE MATERIALS IN A
MEDICAL SETTING IS INDUSTRIAL
SETTINGS AND RESEARCH.
SETTINGS.
WILL CERTIFY OPERATORS OF THAT
OPERATE AT X. RAYS A CT SCANS
AND OF THERAPEUTIC. RADIATION
FOR.
CANCER THERAPY AND OTHER USES.
SO WE COVERS ALL THOSE THEIR
INVESTIGATION INSPECTION
LABORATORY TESTING TECHNICAL
ASSISTANCE.
MIRCHI RESPONSE AND OTHER
REGULATORY ACTIVITIES WHO ARE
MOSTLY A REGULATORY PROGRAM.
THE CENTER INCLUDES THE DIVISION
OF FOOD DRUG AND CANNABIS SAFETY
AND INCLUDES A DIVISION OF
RADIATION SAFETY AND
ENVIRONMENTAL MANAGEMENT.
SO ARE MANUFACTURED CANNABIS
SAFETY BRANCH HAS BEEN AMONG THE
BUSIEST OVER THE LAST COUPLE
YEARS AS YOU CAN WELL IMAGINE. A
SINCE THE PASSAGE OF THE MEDICAL
CANNABIS LAWS AND TWENTY
FIFTEEN.
AND THEN THE ADULT USE
PROPOSITION SIXTY FOUR AND
TWENTY SIXTEEN AND SUBSEQUENT
LEGISLATION AND TWENTY
SEVENTEEN.
OF THIS ALL END UP REQUIRING
LICENSING OF BOTH MEDICAL
MEDICINAL CANNABIS IS NOW THE
TERM WE USE. AN ADULT USE
COMMERCIAL CANNABIS BY JANUARY
OF TWENTY EIGHTEEN.
RENT CLIMB WILL.
STEP HAS STEPPED UP TO LEAVE THE
CITY PAGES PART IN REGULATION.
OF LIGHT SAME COMMERCIAL
CANNABIS AND.
WORKS CLOSELY WITH THE OTHER
STATE ENTITIES THAT ARE INVOLVED
IN THIS EFFORT.
SHOULD PROVIDE AN UPDATE ON OUR
WORK WHICH IS TO REGULATE
CANNABIS MANUFACTURING.
GOOD AFTERNOON.
SO LET ME START BY JUST
PROVIDING A QUICK OVERVIEW OF
THIS THREE LICENSING DEPARTMENTS
THAT ARE RESPONSIBLE FOR
REGULATING CANNABIS.
SO WE HAVE THE DEPARTMENT OF
CONSUMER AFFAIRS THE BUREAU
CANNABIS CONTROL. IS THE LEAD
AGENCY AND THE IMPLEMENTATION OF
THE CANNABIS PROGRAM.
AND RESPONSIBLE FOR LICENSING
DISTRIBUTORSTRANSPORTERS
TESTING LABORATORIES MICRO
BUSINESSES AND RETAILERS.
THE DEPARTMENT OF FOOD AND
AGRICULTURE IS RESPONSIBLE FOR
LICENSING THE DIFFERENT TYPES OF
CULTIVATORS.
AND THE DEPARTMENT OF PUBLIC
HEALTH MANUFACTURER CAN OF A
SAFETY BRANCH.
IS RESPONSIBLE FOR LACI'S
LICENSING CANNABIS PRODUCT
MANUFACTURERS.
SO CITY P. H. IN COLLABORATION
WITH THE OTHER TWO LICENSE IN
THE PARLIAMENTS ADOPTED
EMERGENCY REGULATIONS AND
DECEMBER. SEVENTH TWO THOUSAND
SEVENTEEN.
THE PERMANENT REGULATION RULE
MAKING PROCESS WILL START IN THE
SPRING OF THIS YEAR.
THE DEPARTMENT CONTINUES TO WORK
CLOSELY IN PARTNERSHIP AND
COOPERATION WITH THE BUREAU AND
WITH CITY CDFA.
WE MEET REGULARLY AND TO
COORDINATE ON REGULATIONS.
AREAS OF OPERATIONAL
EFFICIENCIES COMMUNICATIONS AND
OUTREACH AND LICENSING.
THE THE PERMITS STARTED
ACCEPTING TEMPORARY LICENSE
APPLICATIONS IN MID DECEMBER.
AND CITY P. H. TO DATE HAS
RECEIVED A TOTAL OF EIGHT
HUNDRED AND SIXTEEN
APPLICATIONS.
I CANNABIS MANUFACTURERS.
WE HAVE ISSUED A FIVE HUNDRED
AND FOURTEEN TEMPORARY LICENSE
LICENSES.
A HUNDRED AND TWENTY NINE OF THE
ORIGINAL APPLICATIONS WITHDREW
THEIR APPLICATION.
A HUNDRED AND SIX WHO WERE NOT
AUTHORIZED BY THEIR LOCAL
JURISDICTIONS.
SO OUR CURRENT BACKLOG IS THIRTY
SEVEN APPLICATIONS.
THE DEPARTMENT ALSO IMPLEMENTED
THE MANUFACTURING CANNABIS
LICENSING SYSTEM.
WHICH IS AN ONLINE APPLICATION
PROCESSING SYSTEM.
THE SYSTEM LAUNCH IN EARLY
DECEMBER.
AND THE SYSTEM ALLOWS LICENSEES
TO SUMMIT MANUFACTURING LICENSE
APPLICATION.
CHECK THEIR LICENSE TAP
OBLIGATIONS STATUS. MAKE
PAYMENTS ONLINE AND RENEW THE
APPLICATIONS.
THE DEPARTMENT IS PARTNERING
WITH THE BUREAU CANNABIS
CONTROL.
TO COLLECT CASH PAYMENTS FOR
LICENSING FEES.
AT THE BR US SACRAMENTO
LOCATION.
IN ADDITION TO THAT ALL THREE
DEPARTMENTS ARE COORDINATING. TO
SET UP A CACHE LA CORP
COORDINATED ON A CACHE LOCATION
SITE FOR THE NORTH COAST.
OVER THE LAST FOUR MONTHS WE
HAVE PARTICIPATED IN OUR RICH
OFFENSE. AND DEVELOP A NUMBER OF
RESOURCES TO ASSIST THE INDUSTRY
AND THE TRANSITION TO THE
REGULATED MARKET.
SO THE DEPARTMENT CONDUCTED TEN
LICENSE IN WORKSHOPS.
THROUGHOUT THE STATE DURING THE
MONTHS OF NOVEMBER AND DECEMBER.
AND THIS WAS TO EDUCATE AND
ADDRESS QUESTIONS FROM CANNABIS
MANUFACTURERS.
THE INFORMATION SHARE INCLUDED
REGULATORY REQUIREMENTS AND THE
LICENSE APPLICATION PROCESS.
IN TOTAL WE HAD ABOUT SIX
HUNDRED ATTENDEES AT OUR SOCIAL.
IN ADDITION TO THAT THE
DEPARTMENT ALSO PARTICIPATED IN
THREE WORKSHOPS
HOSTED BY THE BUREAU CANNABIS
CONTROL IN OCTOBER TWENTY
SEVENTEEN.
AND FOR IN JANUARY AND FEBRUARY
OF THIS YEAR.
ALL OF THE PRESENTATION
MATERIALS ARE AVAILABLE ON OUR
DEPARTMENT'S WEBSITE.
WE HAVE ALSO BEEN RESPONDING TO
INQUIRE RESPOND INDUSTRY AND THE
PUBLIC.
AND WE HAVE MULTIPLE AVENUES FOR
PEOPLE TO CONTACT US.
WE HAVE A TOLL FREE NUMBER WE
HAVE AN EMAIL ADDRESS. AND WILL
ALSO HAVE AN ONLINE COMPLAINT
FORM.
OUR WEBSITE INCLUDES EXTENSIVE
INFORMATION FOR THE CANNABIS
INDUSTRY AND THE PUBLIC.
SUCH AS THE REGULATORY
INFORMATION. LICENSE
INSTRUCTIONS A LICENSE LOOKUP
TOOL ADVANCE RESOURCES AND
FREQUENTLY ASKED QUESTIONS.
AND WE CONTINUE TO DEVELOP
ADDITIONAL RESOURCES INCLUDING
HANDOUTS WEBINARS IN MORE. TO
ASSIST THE LICENSEES AND
SUCCESSFULLY COMPLETED THEIR
CATIA. AND UNDERSTANDING HOW TO
TRANSITION TO THE NEWLY
REGULATED MARKET.
PART OF THE REGULATORY PROGRAM
ALSO INCLUDES COMPLIANCE AND
ENFORCEMENT.
TO ENSURE PRODUCT SAFETY
REQUIREMENTS FOR COMMERCIAL
CANNABIS MANUFACTURING.
SO WE HAVE ESTABLISH FIVE
REGIONAL DISTRICT OFFICES
THROUGHOUT THE STATE. WHICH OR
STAFF BY ENVIRONMENTAL
SCIENTISTS
WHICH HAVE BEGUN COORDINATED
SITE FACILITIES OF OUR TEMPORARY
LICENSEES. BUT THE FOCUS ON
EDUCATING MANUFACTURERS ON HOW
TO MEET THE STATE REQUIREMENTS.
OUR COMPLIANCE TEAM IS
COORDINATING CLOSELY WITH THE
LOCAL JURISDICTIONS.
SO. WE'VE BEEN EXTREMELY BUSY I
KNOW IT'S QUITE A FULL LIST.
OF ACTIVITIES THANK YOU FOR THE
OPPORTUNITY TO SUB TO PROVIDE A
SUMMARY OF ALL OF OUR
ACCOMPLISHED.
THANK YOU.
DEPARTMENT OF FINANCE MILIONI
COMMENTS ON THE ISSUE ELEVEN.
SEEING NONE ANY PUBLIC COMMENT
ON ISSUE ELEVEN.
WE'LL BRING IT UP TO THE DYESS
FOR ANY QUESTIONS.
WITH THAT STAFF HAS RECOMMENDED
NO ACTION WILL HOLD THIS ITEM
OPEN IN THE BOND ISSUE TWELVE.
THANK YOU.
OKAY ISSUE TWELVE IS THE BUDGET
PROPOSAL FOR A CALL PUBLIC
BEACHES INSPECTION FOR
CONTAMINANTS MRS OF FOLLOW UP.
WORK.
UNDER S. B. THIRTEEN NINETY
FIVE.
IN TWENTY FOURTEEN.
THE GOVERNOR'S BUDGET REQUESTS
AN INCREASE OF THREE AND FIFTY
FOUR THOUSAND IN GENERAL FUND
EXPENDITURE AUTHORITY TO ENABLE
OUR DEPARTMENT TO FINALIZE THE
IMPLEMENTATION.
OF THE AMENDED PROVISIONS OF
THAT BILL.
AND WHICH IS REGARDING THE
APPROVAL OF THE USE OF NEW RAPID
TEST METHODS FOR BEACH WATER
TESTING.
YOU'RE DONE THE PACKET HAS AN
EXCELLENT RIGHT UP OF THIS
PROPOSAL SO I'LL JUST PROVIDE.
LITTLE OVERVIEW LITTLE CONTEXT.
A TO BE IN WITH A LOCAL HEALTH
DEPARTMENTS ARE THE ENTITY
RESPONSIBLE FOR BEACH WATER
SAFETY AND TESTING FOR
CONTAMINATION. OF THE ONES THAT
WOULD POST A BEACH WITH A
WARNING SIGN IF NECESSARY OR
EVEN CLOSE BEACH WHEN NECESSARY.
OUR DEPARTMENT DETERMINES.
THE TESTING METHODS AND THE
STANDARDS AND THAT ARE NECESSARY
TO ESTABLISH THE SAFETY OF BEACH
WATER. AND WE DO THAT TO
REGULATION.
THE CURRENT GOLD STANDARD FOR
DOCTOR LOGIC TESTING OF OF OCEAN
WATER.
IS CULTURE BASED AND THOSE YOU
THAT OF BEEN INVOLVED
MICROBIOLOGY PROBABLY KNOW THAT
CULTURE REQUIRES TIME FOR THE
ORGANISM TO GROW. THE AVERAGE
TURNAROUND TIME FOR THAT TESTS
IS ABOUT TWO DAYS.
SO THAT HAS POTENTIAL HEALTH AND
ECONOMIC CONSEQUENCES BY TAKING
SO MUCH TIME THE WATER COULDBE
CONTAMINATED FOR THOSE TWO DAYS
BEFORE THE TEST COMES BACK AND
PEOPLE ARE STILL SWIMMING AND
IT.
IS ALSO THE CONSEQUENCES OF WHEN
THE BEACHES
CLEAR AND ALLOWED TO REOPEN
THERE'S A TWO DAY DELAY IN THAT
AND THAT AFFECTS TOURISM AND
OTHER ECONOMIC IMPACTS.
SO THESE NEW RAPID METHODS HAVE
BECOME AVAILABLE IN RECENT YEARS
THEY'RE CALLED POLYMERIZED CHAIN
REACTION METHODS AND.
OF VERY QUICKLY.
THEY ARE A METHOD TO DETECT THE
DNA OF THE BACTERIAL ORGANISM AS
OPPOSED TO CULTURING FOR ALIVE
ORGANISM.
THEY HAVE ABOUT A FOR OUR
TURNAROUND TIME AND.
SO BECAUSE OF THAT S. B.
THIRTEEN NINETY FIVE.
CAME INTO LAW WHICH REQUIRES
THE STATE TO DEVELOP AND
VALIDATE THE NEW TEST METHODS.
FOR USE IN CALIFORNIA.
THIRTY COMPLEX IT SPECIFIC TO
EACH LOCATION EACH BEACH CAN
HAVE DIFFERENT INTERFERING
SUBSTANCE AS THE WATER. THERE'S
A LOT OF SIDE BY SIDE TESTING
AND THINGS LIKE THAT BUT
ULTIMATELY WE HAVE TO REPAIR
TESTING STANDARDS GUIDELINES.
AND CONDUCT TRAININGS AND REVISE
OUR REGULATIONS.
SO WE S. BEGAN WITH A BUDGET
PROPOSAL THREE YEARS AGO THAT
PROVIDE THE RESOURCES FOR THE
NATIONAL LAB WORK AND ONLY LAB
WORK.
OF THE WORK THAT'S BEEN
COMPLETED DATA AS WELL DESCRIBE
IN YOUR PACKET I WON'T REPEAT IT
HERE WE'VE.
BUT CLOBBERING QUITE CLOSE TO
THE STAKEHOLDERS.
AND ORDER TO ACCOMPLISH THAT.
THE KERN PROPOSAL THEN REQUESTS
THE RESOURCES NEEDED TO COMPLETE
THE LAB WORK AS WELL AS TO
REVISE THE CURRENT RATE REVISE
THE REGULATIONS.
INCLUDES A LARGE COLLABORATIVE
STUDY IN SOUTHERN CALIFORNIA
RECALL THE FORTY SIX BEACH
STUDY.
THE SOME OF THE SITE SPECIFIC
CRITERIA AND THERE'S ALSO A
NEWER PC ARE AVAILABLE BUT WON'T
GO INTO THE DETAILS BUT I IT'S
AN EVEN APPROVED RAPID TESTED
WERE INCORPORATING IN OUR
EVALUATION.
AND THE BEGINNING IN THE THIRD
YEAR WILL.
BEGIN DRAFTING THE REGULATIONS
WITH THE REVISED GUIDANCE FOR
LOCALS AS WELL AS PROVIDE
TECHNICAL ASSISTANCE TO THEM.
AND WE EXPECT TO BE COMPLETELY
DONE IN FIVE YEARS.
OPEN QUESTIONS OF COURSE
DEPARTMENT OF FINANCE LA OPENING
COMMENTS.
WE'LL TAKE PUBLIC COMMENT ON THE
ISSUE TWELVE AT THIS TIME.
SEEING NONE WILL BRING IT BACK
UP TO THE DYESS. HOME I WAS
HOPING YOU CAN JUST MAKE IT A
LITTLE REAL FOR ME I UNDERSTOOD
THAT THERE WAS RECENTLY A SPELL
IN MONTEREY.
HOW WOULD THIS HAVE PLAYED OUT
HOW WOULD THE PC ARE HAVE HELPED
TO? IDENTIFY THE ORGANISM
EARLIER OR OPEN UP THE BEACH
SOONER CAN YOU GIVE US THAT AS A
REAL WORLD EXAMPLE.
WELL SO I DON'T RECALL THIS BILL
MONTEREY BUT IF THERE'S A FACE
FOR EXAMPLE SEWAGE OUTFLOW OR
SOMETHING LIKE THAT.
TYPICALLY LOCAL HEALTH
DEPARTMENT WILL CLOSE THE BEACH
IMMEDIATELY BASED ON THAT
KNOWLEDGE OF SEWAGE OUTFLOW
BECAUSE OF THE KNOWN RISK HAZARD
OF THAT.
AND THERE'S A FLOOD FOR EXAMPLE
IN A SEWAGE TREATMENT PLANT CAN
OVERFLOW.
BUT THESE ARE MORE ACTUALLY
TESTS ARE MORE VALUABLE IN
SITUATIONS WE DON'T HAVE A KNOWN
HAZARD LIKE THAT.
AND SO IT MAY BE.
HEAVY USE OF THE BEACH AND
MAYBE SOMETHING RELATED TO A
SUITABLE THAT'S THAT'S NOT KNOWN
OR OTHER CAUSES OF SOME KIND OF
CONTAMINATION. BUT THE ADVANTAGE
OF THE RAPID TEST IS REALLY THAT
ONCE WE HAVE ALL THESE METHODS
IN PLACE AND HAVE VALIDATED AT
EVERY AT VARIOUS SPEECH
LOCATIONS.
WE'LL HAVE RESULTS A LOCAL
HEALTH DEPARTMENTS FIVE RESULTS
OF FROM THEIR BEACH WATER
SAMPLES WITHIN FOUR HOURS AS
OPPOSED TO TWO DAYS AND SO THEY
CAN MAKE THEIR DECISIONS ON
ADVISING THE PUBLIC ARE CLOSING
THE BEACH OR WHATEVER BASED ON
THAT.
WITHOUT STAFFERS RECOMMENDED NO
ACTION ON THIS ITEM WE WILL HOLD
ISSUE TWELVE OPEN AND MOVE ON TO
ISSUE THIRTEEN
.
DIDN'T
GOOD AFTERNOON MISTER CHAIRMAN
VERSE I'M JEANNE I SEE NO I'M
THE DEPUTY DIRECTOR OF THE
CENTER FOR HEALTH CARE QUALITY
THE CALIFORNIA DEPARTMENT OF
BOTH HELP. I HAVE WITH ME TODAY
CJ HOWARD WHO IS OUR CHIEF OF
POLICY AND PLANNING IN THE
CENTER. AND OUR ASSISTANT DEPUTY
DIRECTOR SCOTT THE PHONO.
I'M GONNA START OUT WITH.
PROVIDING THE REQUESTED
OVERVIEW OF THE CENTER FOR
HEALTH CARE QUALITY.
THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH CENTER FOR
HEALTHCARE QUALITY LICENSING
CERTIFICATION PROGRAM. IS
RESPONSIBLE FOR REGULATORY
OVERSIGHT OF LICENSED HEALTHCARE
FACILITIES AND HEALTH CARE
PROFESSIONALS. TO ENSURE SAFE
EFFECTIVE AND QUALITY HEALTHCARE
FOR ALL CALIFORNIANS.
WE FULFILL THIS ROLE BY
CONDUCTING PERIODIC INSPECTIONS
AND COMPLAIN INVESTIGATIONS OF
HEALTH CARE FACILITIES TO ENSURE
THAT THEY COMPLY WITH FEDERAL
AND STATE LAWS AND REGULATIONS.
CH C. Q. LICENSES AND CERTIFIES
OVER TEN THOUSAND HEALTH CARE
FACILITIES IN AGENCIES IN
CALIFORNIA. IN THIRTY DIFFERENT
LICENSURE AND CERTIFICATION
CATEGORIES.
WE OVERSEE THE CERTIFICATION OF
NURSE ASSISTANTS
HOME HEALTH AIDES HEMODIALYSIS
TECHNICIANS AND THE LICENSING OF
NURSING HOME ADMINISTRATORS.
IN ADDITION TO THE LICENSING AND
CERTIFICATION PROGRAM WE ALSO
HAVE WITHIN THE CENTER OF THE
HEALTHCARE ASSOCIATED INFECTIONS
PROGRAM.
S. PROGRAM WAS CREATED WITH A
MANDATE TO OVERSEE THE
PREVENTION SURVEILLANCE AND
REPORTING OF HEALTHCARE
ASSOCIATED INFECTIONS IN
CALIFORNIA'S GENERAL ACUTE CARE
HOSPITALS.
HEALTHCARE ASSOCIATED INFECTIONS
ARE THE MOST COMMON COMPLICATION
OF HOSPITAL CARE.
SINCE TWENTY TEN ARE HAI PROGRAM
HAS REDUCED ANNUAL PUBLIC
REPORTS OF HOSPITAL. HA A DATA.
TO HELP INFORM THE
CONSTITUENCIES OF HEALTH CARE
CONSUMERS AMP PROMPT PROVIDERS
TO TAKE ACTIONS TO PREVENT
INFECTIONS.
WE ACTIVELY ENGAGE IN HA I
PREVENTION BY PERFORMING SITE
VISITS TO HOSPITALS WITH HIGH
INFECTION RATES.
CONVENING REGIONAL HAI
PREVENTION COLLABORATIVE'S AND
PROVIDING INFECTION PREVENTION
EDUCATION TO PROVIDERS.
ALL OF THESE ACTIVITIES WITHIN
THE CENTER FUNDED BY THE STATE
DEPARTMENT OF PUBLIC HEALTH
LICENSING AND CERTIFICATION
PROGRAM FUND.
FEDERAL FUNDS.
REIMBURSEMENTS ASSOCIATED WITH
INTER AGENCY AGREEMENTS FOR THE
DEPARTMENT OF HEALTH CARE
SERVICES
AND A SMALL AMOUNT OF GENERAL
FUND TO SUPPORT OUR ACTIVITIES
IN STATE OWNED FACILITIES.
THERE WAS A REQUEST IN THE RIGHT
UP TO PROVIDE A SUMMARY OF SOME
OF THE IMPROVEMENTS THAT WE HAVE
MADE OVER THE YEARS.
THE COMMITTEE RIDER PREFERENCES
A TWENTY TWELVE LETTER FROM THE
CENTER FROM CENTERS FOR MEDICARE
AND MEDICAID SERVICES.
STATING THAT THE CENTER FOR
HEALTH CARE QUALITY NEEDED TO
IMPROVE ITS PERFORMANCES.
WE ARE PLEASED TO REPORT THAT
SINCE TWENTY TWELVE WE'VE MADE
CONTINUOUS AND STEADY PROGRESS.
IN COMPLYING WITH CMS
REGULATIONS.
IN TWO THOUSAND AND NINE THE
CENTER FOR HEALTH CARE QUALITY
MET ONLY FOUR OF SEVENTEEN CMS
PERFORMANCE STANDARDS IN TWENTY
SEVENTEEN WE HAVE MET FIFTEEN OF
EIGHTEEN SEE UP CMS PERFORMANCE
STANDARDS.
THE COMMITTEE RIGHT UP ALSO
REFERENCES THE HARPER REPORT
THAT WE COMMISSIONED AS A RESULT
OF THE LETTER FROM CMS.
WE HAVE BEEN WORKING STEADILY.
SINCE THE REPORT WAS ISSUED TO
IMPLEMENT THOSE RECOMMENDATIONS
AND SOME OF THE PERFORMANCE
IMPROVEMENTS PURSUANT TO THE
HARPER REPORT INCLUDE. A
COMPLETE REVAMP OF OUR WORK
FORCE ESTIMATE TOOL TO MORE
ACCURATELY PROJECT THE NUMBER OF
STAFF WE NEED TO COMPLETE OUR
MANDATED WORKLOAD.
IMPROVES TRANSPARENCY BY WAY OF
STAKEHOLDER ENGAGEMENT.
PUBLICATION OF DATA METRICS.
AND A REVAMP OF OUR WEB PAGE
DISPLAYING FACILITY INFORMATION.
WE ARE EMBRACING INNOVATIVE
SOLUTIONS TO CONDUCTING OUR
BUSINESS BY USING NON REGISTERED
NURSES TO COMPLETE OUR MEDICAL
BREACH INVESTIGATIONS. THUS
FREEING UP ARE REGISTERED NURSE
WORKFORCE TO FOCUS DIRECTLY ON
THOSE ACTIVITIES THAT REQUIRE
THEIR EXPERTISE.
WE'RE MAKING GREATER USE OF
TECHNOLOGY TO PROVIDE REAL TIME
TRAINING TO OUR WORKFORCE AND
EXPLORING WAYS TO USE MOBILE
TECHNOLOGIES. TO SUPPORT THE
CONSISTENT TIMELY INVESTIGATION
OF CONSUMER COMPLAINTS.
WE HAVE PROVIDED TABLETS TO
OLIVER SURVEYOR WORKFORCE.
TO ENHANCE THEIR ABILITY TO
COMPLETE THEIR WORK.
AND WE HAVE MADE SIGNIFICANT
IMPROVEMENT IN HIRING REDUCING
THE TIME IT TAKES US TO HIRE A
NEW NURSE BY OVER THIRTY TWO
PERCENT.
WE HAVE A ROOM ROBUST
RECRUITMENT RETENTION PLAN AND
OUR CURRENT HEALTH FACILITIES
EVALUATOR NURSE VACANCY RATE IS
APPROXIMATELY TEN PERCENT.
IN ADDITION WE ARE ROLLING OUT
LEADERSHIP IN STAFF DEVELOPMENT
TRAINING TORRENT TIRE WORKFORCE.
ALONG THE WAY WE HAVE ENGAGED IN
NUMEROUS QUALITY IMPROVEMENT
PROJECTS.
INCLUDING REVAMPING OUR APPROACH
TO INVESTIGATING COMPLAINTS IN
ISSUING CITATIONS.
THESE EFFORTS ARE PAYING OFF AS
DEMONSTRATED BY THE HIGH
PERCENTAGE OF NEW COMPLAIN
INVESTIGATIONS THE CITATIONS.
SURVEYORS ARE COMPLETING MORE
TIMELY.
WE'VE ALSO COMPLETED QUALITY
IMPROVEMENT PROJECTS TO IMPROVE
THE PERFORMANCE OF OUR
CENTRALIZED APPLICATIONS UNIT.
AND AND OUR INVESTIGATION
SECTION WITHIN THE PROFESSIONAL
CERTIFICATION BRANCH.
WITH THE ADDED RESOURCES THAT
WE.
RECEIVED IN TWENTY FOURTEEN
FIFTEEN FOR PROFESSIONAL
CERTIFICATION BRANCH THE
BRANCHES SUCCESSFULLY ADDRESSED
ITS LARGE BACKLOG OF COMPLAINTS
AGAINST CERTIFIED INDIVIDUALS.
AND INVESTIGATES MOST NEW
COMPLAINTS WITHIN NINETY DAYS.
THE HEALTH CARE ASSOCIATE
INFECTION PROGRAM HAS
REFORMATTED ITS SURVEILLANCE
DATA IT IS PARTNERING NOW WITH
LICENSING CERTIFICATION STAFF.
TO USE THEIR DATA TO HELP US
IDENTIFY HOSPITALS WITH
PERSISTENTLY HIGH HAI INFECTION
RATES. AND TO PRIORITIZE THOSE
FACILITIES FOR RELICENSING
SURVEYS WITH A FOCUS ON
INFECTION CONTROL PRACTICES.
IN TWO THOUSAND AND EIGHT
CALIFORNIA RANKED HIGHEST IN THE
NATION IN THE USE OF PHYSICAL
RESTRAINTS. IN TWENTY THIRTEEN
WE WERE THE LOWEST IN THE
NATION.
SIMILARLY IN TWENTY TWELVE
CALIFORNIA RANKED TWENTY FOURTH
IN THE NATION. IN THE
INAPPROPRIATE USE OF HANNAH
PSYCHOTICS TODAY WE RANK FOURTH
LOWEST IN THE NATION.
THESE ARE JUST A FEW OF THE
EXAMPLES OF THE ONGOING QUALITY
IMPROVEMENT MATH.
EFFORTS WITHIN OUR CENTER.
YOU TURN IT OVER TO SEE JAY
HOW'RE NOW TO TALK ABOUT OUR
BUDGET.
THANK YOU. GOOD AFTERNOON UP FOR
THE CURRENT YEAR TWENTY
SEVENTEEN EIGHTEEN THE TWENTY
SEVENTEEN BUDGET ACT
APPROPRIATED TWO HUNDRED AND
SIXTY FOUR POINT TWO MILLION.
CVC HERE PROJECTS ARE REVISED
FISCAL YEAR SEVENTEEN EIGHTEEN
EXPENDITURE AUTHORITY OF TWO
HUNDRED AND SEVENTY TWO POINT
FIVE MILLION WHICH IS AN
INCREASE OF EIGHT POINT FOUR
MILLION OR THREE POINT TWO
PERCENT COMPARED WITH BUDGET
ACT.
THIS INCREASE IS THE RESULT OF
VARIOUS BASELINE ADJUSTMENTS.
FOR FISCAL YEAR EIGHTEEN
NINETEEN SEAT SECURE ESTIMATES
EXPENDITURES WILL TOTAL TWO
HUNDRED AND SEVENTY SEVEN POINT
EIGHT MILLION WHICH IS AN
INCREASE OF THIRTEEN POINT SIX
MILLION. OR FIVE POINT TWO
PERCENT COMPARED WITH THE BUDGET
ACT THIS INCREASE INCLUDES
ELEVEN POINT SEVEN MILLION
DOLLARS IN VARIOUS BASELINE
ADJUSTMENTS AND ONE POINT NINE
MILLION FROM THE STATE
DEPARTMENT OF PUBLIC HEALTH
LICENSING AND CERTIFICATION
PROGRAM FUND. TO PROVIDE
ADDITIONAL RESOURCES TO SEE THE
PEACHES CONTRACT WITH LOS
ANGELES COUNTY.
AND WILL HAVE.
LONGER DISCUSSION ABOUT THE
BUDGET CHANGE PROPOSAL.
THIS PROPOSAL EXTEND THE
CURRENT CONTRACT BY ONE YEAR AND
UPDATE THE SALARIES INDIRECT
COSTS THREE AND EMPLOYEE
BENEFITS RATE.
THE ESTIMATE SHOWS THAT SEE PETE
HUNDRED AND FORTY SEVEN HAPPENS.
THOSE WITH HFE AND HEALTH
FACILITY EVALUATOR NURSES.
WHAT WHICH SHOULD THIRTY THREE
OF THEM WOULD BE FOR THE STATE
WORK AND A HUNDRED FOURTEEN TO
BE IN LA COUNTY?
WHILE CCQ CONTINUES TO HAVE A
HIGH VACANCY RATE IS MADE
SIGNIFICANT PROGRESS IN FILLING
EXISTING VACANCIES AS OF JANUARY
TWENTY IN THE OVERALL VACANCY
RATE IS APPROXIMATELY TEN
PERCENT. FOR THE HEALTH FACILITY
EVALUATOR NURSES SUITS ACCUSE
WORKING WITH RECRUITMENT
CONSULTANTS TO AGGRESSIVELY
RECRUIT AND FILL THESE
POSITIONS.
AND AS DECREASE THE VACANCY RATE
BY EIGHT PERCENT SINCE THE
SUMMER OF TWENTY SEVENTEEN.
FOR THESE REASONS TO SECURE IS
NOT REQUESTING ADDITIONAL
POSITIONS AT THIS TIME.
THE LA COUNTY.
BUDGET REQUESTS A SUMMARY OF
THE BUDGET REQUEST IS ONE POINT
NINE MILLION DOLLARS FROM THERE
FROM OUR PROGRAM FUND. THEY
INCREASE AUGMENT DISCUSSION ON
THE COUNTY UNTIL ISSUE FOURTEEN
IF THAT'S THAT'S I JUST. COME.
ANY OTHER COMMENTS ON ISSUE
THIRTEEN AT THIS TIME.
DEPARTMENT OF FINANCE LA JOH NA
COMMENT.
WE'LL TAKE PUBLIC COMMENT ON
ISSUE THIRTEEN AT THIS TIME.
THE DOCTOR CHAIR THANK YOU FOR
INVITING US TODAY MY NAME IS
CAROL HERMAN I'M THE PRESIDENT
AND FOUNDER. OF THE FOUNDATION
AID THE ELDERLY. WE WORK ON A
NATIONWIDE BASIS FOR OVER THIRTY
FIVE YEARS NOW ON THE PREVENTION
OF ELDER ABUSE SPECIFICALLY IN
LONG TERM CARE FACILITIES IN
ACUTE HOSPITALS.
OVER THE PAST THIRTY FIVE YEARS
WE'VE HELPED OVER SEVEN THOUSAND
FAMILIES THE MAJORITY IN
CALIFORNIA BECAUSE WERE
HEADQUARTERED HERE IN
SACRAMENTO.
WE A FILE OF THOUSANDS OF
COMPLAINTS AGAINST NURSING HOMES
FOR THEIR POOR CARE OF OUR MOST
VULNERABLE CITIZENS.
RIGHT.
MOST OF OUR CLIENTS SUFFER FROM
POOR KIERAN NEGLECTING
CALIFORNIA NURSING HOMES. WHO
COMPLAINS THAT WE FILE ALWAYS
INCLUDE INSUFFICIENT STAFFING?
FAYE ALSO FILED THE PUBLIC
INTEREST LAWSUIT IN TWO THOUSAND
AND THIRTEEN AGAINST THE
DEPARTMENT FOR ITS FAILURE TO
INVESTIGATE NURSING HOME ABUSE
CASES IN A TIMELY FASHION.
THAT INSTIGATED THE OF THE
AUDITOR GENERAL'S REPORT THAT
SHOWED ELEVEN THOUSAND
COMPLAINTS THAT HAD BEEN SITTING
STAGNANT IN THE DEPARTMENT FOR
QUITE SOMETIME.
INSUFFICIENT STAFFING IS A YOU
KNOW I MIGHT BE JUMPING AHEAD ON
THIS MAYBE I SHOULD COME LAST
THE NEXT ONE JUST SESSION. BUT.
AS I SAID THE MAJORITY OF OUR
COMPLAINTS INCLUDE INSUFFICIENT
STAFFING.
WHEN THE FACILITIES
UNDERSTAFFED.
THE PATIENT'S NEEDS CANNOT BE
MET SO IT'S AUTOMATIC NEGLECT.
INCREASED STAFFING IS TO MEET
THE NEEDS OF OUR MOST VULNERABLE
CITIZENS AND IS ABSOLUTE MESSES
IT'S AN ABSOLUTE NECESSARY. THAT
INCREASED STAFFING UNDER THIS
BILL. GOES FORWARD.
WHAT SUPPORT WHAT FATE SUPPORTS
IZZIE INCREASE IN THE NURSING
HOWARD HOURS WE DON'T SUPPORT IS
THE WAIVER THAT ALLOWS
FACILITIES NOT TO ADHERE TO THE
INCREASE NURSING?
THE WAIVER WOULD BE TO DO YOU
BEND DE WOULD BE DETRIMENTAL TO
THE PATIENTS AS IT COULD ALLOW A
FACILITY. TO BE UNDERSTAFFED.
AGAINST STATUTE.
FOR APPROXIMATELY THREE YEARS
WITHOUT ANY ACCOUNTABILITY OF
NOT STOPPING. TO MEET THE NEEDS
OF THE PATIENT.
DPH HAS NO PLANS ON WHAT TO DO
WHEN A FACILITY CONTINUES TO BE
UNDERSTAFFED.
THE WORK FORCE IS DEFICIENT.
AND THE WORKFORCE IS DEFICIENT
THEY'RE STATING THAT THE
WORKFORCE IS DEFICIENT AND
THEREFORE THEY CAN'T HIRE. SO
THEY'RE ALLOWING WAIVERS TO
FACILITIES THAT CAN PROVE THAT
THEY CAN'T HIRE ENOUGH YET THE
DEPARTMENT HAS FUNDS AVAILABLE
TO HELP THE FACILITIES TO HIRE
PEOPLE.
JUST LAST WEEK THE INDUSTRY
STATED.
THAT REGULATIONS HAVE BECOME
AFFECTED SO.
JULY FIRST OF EIGHTEEN. HAVE
APPROXIMATELY THIRTEEN HUNDRED
NURSING HOMES IN CALIFORNIA SIX
HUNDRED WILL BE FILING FOR
WAIVERS.
THAT SO THAT THEY DON'T HAVE TO
MEET THE NEW STAFFING
REGULATIONS.
I THINK THAT'S ABDOMINAL HIDE
THIS IS JUST TERRIBLE IT'S NOT
THE BEST INTERESTS OF THE
CALIFORNIA CONSUMERS AND
CERTAINLY IS.
.
PUTTING THE NURSING HOME
PATIENTS AT GREAT RISK FOR POOR
CARE AND A GLASS.
IT APPEARS THAT.
DE IT.
ALSO IN THIS THE PAPERS HERE
SAYS THAT THE STAKEHOLDERS.
UMPIRE ASKING TO POSTPONE ALL IS
THE STAKEHOLDERS I CONSIDER TO
BE NOT THE INDUSTRY.
THE INDUSTRY WANTS IS TO BE
POSTPONED NOT THE STAKEHOLDERS.
SO IT APPEARS THAT DPH HAS
IGNORED OUR REQUEST AS A
STAKEHOLDERS THAT REPRESENT THE
FAMILIES IN THE STATE.
THAT WAIVERS NOT BE ALLOWED.
IN THE WAIVERS THAT THEY HAVE
COME UP WITH. NOT BE IMPLEMENTED
BECAUSE IT LEAVES A AND A WHAT
WE HEARD FROM THE INDUSTRY WE'RE
ALL SHOCKED.
THIS IS JUST LAST THURSDAY THAT
SIX HUNDRED FACILITIES WILL BE
APPLYING FOR WAIVERS NOT JUST
NOT TO STAFF TO THE NEW
REGULATIONS.
SO I'M ASKING THAT THE COMMITTEE
RELOOK AT THIS ENTIRE PROCESS
AND IT'S IT'S NOT IN THE BEST
INTERESTS OF. THE CALIFORNIA
CONSUMERS WHO ARE MOST
VULNERABLE CITIZENS
THANK YOU THANK YOU MA'AM.
GOOD AFTERNOON MISTER CHAIRMAN
RISEN A SUBCOMMITTEE MARKETS
MCKINNEY LEGISLATIVE ADVOCATE
WITH THE CALIFORNIA NURSES
ASSOCIATION.
SEEN A HAS TAKEN PART IN
DISCUSSIONS WITH THE DEPARTMENT
REGARDING LAST YEAR'S TRAILER
BILL S. B..
NINETY SEVEN THAT INCREASED THE
REQUIRED STAFFING RATIOS AND
SKILLED NURSING FACILITIES. WE
SHARE A NUMBER OF THE CONCERNS
PREVIOUSLY EXPRESSED BY MS
HERMAN WITH THE FOUNDATION
AIDING THE ELDERLY ABOUT THE
DEPARTMENT'S DRAFT WORKFORCE
SHORTAGE WAIVER. IN ADDITION WE
WANT TO POINT OUT ON THAT THE
PREVIOUS JEFF OF THE WAIVER
REQUIRED.
.
THAT BASICALLY INCLUDED CRITICAL
PATIENT PROTECTIONS THAT SEEING
A BELIEVES TO BE IMPORTANT TO
SAFEGUARDING PATIENTS FOR
EXAMPLE THE DEPARTMENT HAVE
PROPOSED REQUIRING THAT
FACILITIES ALSO INCLUDE A
PATIENT ASSESSMENT FOR EACH
RESIDENT ALONG WITH THE
FACILITIES PLAN. TO ADDRESS
RESIDENT NEEDS AND ASSURE
QUALITY CARE.
DESPITE WHETHER OR NOT THERE'S A
WORKFORCE SHORTAGE SO SEEING A
STRONGLY SUPPORTED THIS
PROVISION WE WROTE THE
DEPARTMENT EDUCATING OUR
SUPPORT.
HOWEVER AND I JANUARY MEETINGS
WE HEARD FROMINDUSTRY. THAT
UNFORTUNATELY THEY THOUGHT IT
WOULD BE IMPOSSIBLE TO CONDUCT
PATIENT ASSESSMENTS FOR EACH
PERSON IN THE FACILITY.
THIS IS TROUBLESOME TO US
BECAUSE EXISTING LAW ESSENTIALLY
ARE READY REQUIRES THAT THESE
PATIENT ASSESSMENTS BE COMPLETED
FOR EVERY PATIENT UPON A
MISSION.
AND UPDATED QUARTERLY AND MORE
OFTEN IF THERE'S A CHANGE IN THE
PATIENT'S CONDITION. ARM AND
HONESTLY THE INDUSTRY'S
ASSERTION THAT IT CANNOT CONDUCT
PATIENT ASSESSMENTS FOR EVERY
PATIENT IN THE FACILITY. IS A
FRIGHTENING ADMISSION OF
INADEQUACIES IF THESE
REQUIREMENTS ARE NOT CURRENTLY
BEING MET.
SEEN A BELIEVES THAT A FACILITY
REQUESTING A WAIVER OF THE
MINIMUM STAFFING REQUIREMENTS
UNDER LAST YEAR'S TRAILER BILL
SHOULD INCLUDE A PATIENT
ASSESSMENT FOR EACH RESIDENT.
AND THE PLANT TO ADDRESS
RESIDENT NEEDS.
THIS IS ALREADY A REQUIREMENT
FOR HE'S PACING AND DESCRIBING
HOW THESE NEEDS WILL BE MET WITH
STAFFING UNDER THE REQUEST A
WAIVER SHOULD NOT IMPOSE AN
UNREASONABLE BURDEN ON ANY
FACILITY.
YET THE DEPARTMENT'S MOST RECENT
DRAFT DELETED THIS REQUIREMENT
SO CNA OBJECTS THESE CHANGES DUE
TO THE FACT THAT ITS EXISTING
LAW. AND WE FEEL AS THOUGH
FACILITY SHOULD BE REQUIRED TO
SHOW THAT THEY CAN MEET THE
PATIENTS ON NEEDS DESPITE A
WORKFORCE SHORTAGE SO WE
APPRECIATE YOU GUYS CONSIDER OUR
COMMENTS
THANK YOU SIR.
CHAIRMAN AND MEMBERS BARBARA
GLAZER WITH THE CALIFORNIA
HOSPITAL ASSOCIATION
REPRESENTING NEARLY FOUR HUNDRED
HOSPITALS AND HEALTH SYSTEM
THROUGHOUT CALIFORNIA.
TODAY I'M GOING TO FOCUS ON THE
LICENSING FEES AND THE
CENTRALIZED APPLICATIONS UNIT.
ON WE ARE VERY CONCERNED OVER
THE CD PAGE PROPOSAL TO RAISE
HOSPITAL'S PEACE ONCE AGAIN.
CA CHAN ARE MEMBER HOSPITALS
CONTINUE TO BE PROSTRATA BY THE
LENGTHY DELAYS IN CTP H.
LICENSING AND CERTIFICATION
COMPLETION OF COMPLAINT. AND AND
EDDIE REPORTED EVENTS SURVEYS
AND WE ARE EXTREMELY CONCERNED
ABOUT THE CENTRALIZED
APPLICATION UNITS ABILITY TO
PROCESS APPLICATIONS IN A TIMELY
MANNER.
CDP AGE PROPOSES TO RAISE
HOSPITAL PIECE BY FIVE PERCENT
IN THE BUDGET YEAR.
HOSPITAL FEES HAVE INCREASED
MORE THAN ONE HUNDRED PERCENT IN
THE PAST FOUR YEARS.
IN IN THE TWO THOUSAND FOURTEEN
FIFTEEN YEAR THEY WERE TWO
HUNDRED AND SIXTY SIX DOLLARS
PER BETH.
THEY ARE PROPOSED TO BE RAISED
TO FIVE HUNDRED AND FORTY
DOLLARS IN THE BUDGET YEAR.
HOSPITALS CONTINUE TO EXPERIENCE
LONG WAIT TIMES PROCEED TO BE
CAGED TO COMPLETE AND APPROVED
APPLICATIONS. THAT ARE SUBMITTED
TO THE CENTRALIZED APPLICATIONS
UNIT.
THIS CA YOU PROCESSES
APPLICATIONS FOR MANY CHANGES
INCLUDING INITIAL APPLICATION
PER LICENSURE. CHANGE OF
OWNERSHIP CHANGE OF LOCATION
CHANGE OF NAME CHANGE OF
SERVICES.
CURRENTLY IT TAKES APPROXIMATELY
EIGHT TO TEN MONTHS FOR AN
APPLICATION TO REACH THE TOP OF
THE QUEUE. TO BE ASSIGNED TO IS
CA YOU ANALYST.
IT TAKES AN ADDITIONAL FOUR
POINT FIVE MONTHS AFTER THE
APPLICATION IS COMPLETE TO
RECEIVE APPROVAL FOR THE NEW OR
EXPANDED SERVICES.
TWO EXAMPLES OF THE KIND OF
SERVICES WERE TALKING ABOUT OUR
ONE HOSPITAL EXPERIENCED A SIX
MONTH WAIT FOR APPROVAL OF A NEW
MRI.
IN THE MEANTIME PATIENTS HAD TO
BE TRANSPORTED TO ANOTHER
LOCATION IN AN AMBULANCE FOR
THEIR MRO.
ANOTHER HOSPITAL REPORTED THAT
IT HAD TO WAIT NINE MONTHS
BECAUSE IT WAS ADDING TWO BEDS
TO AN EXISTING CARDIAC
CATHETERIZATION PROGRAM.
IN A SOME LIKEWISE PATIENTS
NEEDED BE TRANSPORT BY AMBULANCE
TO ANOTHER FACILITY THAT HAD AN
OPEN CARDIAC CATH THE.
SO THESE ARE REAL THESE ARE
SERVICES THAT REALLY MAKE A
DIFFERENCE TO PATIENTS.
WE DO NO THAT CD PAGE HAS
UNDERTAKEN A NUMBER OF
ACTIVITIES TO IMPROVE THE CA USE
EFFICIENCY RECRUITING HIRING
ADDITIONAL STAFF. BOTH TEMPORARY
STAFF AND TEMPORARY.
BUT DELAYS DO CONTINUE.
WE WOULD LIKE THE BUDGET
COMMITTEE TO CONSIDER MANDATING
PUBLIC METRICS ON THE WORKLOAD
AND TIMELINESS OF THE CA USE
ACROSSALL FACILITY TYPES.
IN INVOLVING ALL APPLICATIONS.
THANK YOU.
JENNIFER SIDE ARAMBULA AFTER THE
CALIFORNIA ASSOCIATION HEALTH
FACILITIES I'D LIKE TO REFLECT
ON THE COMMENTS THAT BARBARA
GLAZIER JUST SAID WITH THAT
COMPANY HOSPITAL ASSOCIATION
WITH. RESPECT OUR CONCERNS ABOUT
DELAYS WITH THEM RESPONSES TO A
SURVEYS AND OTHER THINGS WITH
RESPECT TO NURSING FACILITIES I
LIKE TO USE MY TIME JUST HAVE A
COMMENT ON THE.
A CONTENT IN THE. I CAN THEN THE
ANALYSIS AND ALSO.
RELATED TO ISSUE THIRTEEN THAT
DEALS WITH THE SKILLED NURSING
FACILITY THE NEW STAFFING
MANDATES THAT WILL BE IN PLACE.
AND AS OF JULY FIRST OF THIS
YEAR. I'M AS FOLKS NO ONE IS
REFLECTED IN THAT.
INDIAN.
COMMITTEE.
ANALYSIS THERE IS SOME. STRONG
CONCERNS AT LEAST BY.
THE SKILLED NURSING FACILITIES
THAT THEY'RE NOT GONNA BE ABLE
TO COMPLY WITH THAT.
REQUIREMENT IT'S GOING TO BE IN
PLACE AS OF JULY FIRST AND WE DO
KNOW THAT LAST YEAR WAS AND PUT
IN PLACE AT THE END OF THE.
BUDGET PROCESS ON THERE HAS BEEN
A VERY SHORT TIME FRAME FOR
FACILITIES TO BE ABLE TO FIND
THE NECESSARY STAFF. AND IS A
SUBCOMMITTEE KNOWS WE TESTIFIED
LAST YEAR AND THE YEAR BEFORE
THAT WITH RESPECT TO CONCERNS
ABOUT THE ABILITY FOR OUR
FACILITIES TO FIND THE WORK
FORCE NECESSARY TO STAFF THEIR
FACILITIES. AT THE LEVEL THAT
WAS REQUIRED PRIOR TO LAST
YEAR'S BUDGET.
WE CONTINUE TO HAVE FACILITIES
THAT ARE VERY VERY CONCERNED.
ABOUT BEING ABLE TO COMPLY WHEN
WE.
PROVIDED TESTIMONY OR PROVIDED.
OF.
COMMENTS AT THE UPCOMING
STAKEHOLDER PROCESS OF WHICH THE
DEPARTMENT HAS BEEN PUTTING
TOGETHER TO DEAL WITH THE WAIVER
PROCESS WE DID SAY THAT WE. WE
THOUGHT THERE COULD BE AT MOST
US SIX HUNDRED FACILITIES THAT
AT LEAST NOW ARE NOT IN
COMPLIANCE THAT ARE GOING TO
THREE MONTHS AND TO BE ABLE TO
COMPLY WITH THIS MANDATE.
I THINK EVERY FACILITY THAT I
KNOW OF EVERY FACILITY WITHIN
OUR MEMBERSHIP WHICH IS EIGHT
HUNDRED FACILITIES MORE THAN
EIGHT HUNDRED FACILITIES WANT TO
COMPLY WITH THIS NEW
REQUIREMENT.
AND THEY WANT TO BE ABILITY TO
HIRE NEW STAFF THEY CANNOT FIND
THEM. WHAT WE HAVE IS WE HAVE A
MANDATE THAT'S NOT BEING
SUPPORTED BY THE STATE TO HELP
THOSE FACILITIES FIND THAT WORK
FORCE? THEM BACK WHEN WE HAD IT
A STAFFING MANDY PUT IN PLACE
BACK IN THE YEAR TWO THOUSAND
THERE WAS A PHASE IN APPROACH
FOR THAT PERIOD OF TIME WE HAD
THE ABILITY TO TAKE THE TIME TO
ACTUALLY. COMPLY WITH THE
MANDATE THERE IS A CARE GATOR
INITIATIVE THIS ACTUALLY PUT
PLACE THAT SAME TIME AND THE
GOVERNOR PUT IN TEN MILLION
DOLLARS TO PUT MONEY INTO.
CERTIFIED NURSING ASSISTANT
TRAINING PROGRAMS NURSING AND
OTHER TYPES OF AB TRAINING
PROGRAMS WE DON'T HAVE THAT NOW
AND WE HAVE A MANDATE WITHOUT
ANY STATE SUPPORT TO MAKE SURE
THAT FACILITIES CAN STAFF UP TO
BE COMPLIANT.
THERE IS A WAIVER PROCESS IT'S
BEING DELIBERATED RIGHT NOW IS
CDP H..
WE HAVE APPRECIATED THAT THERE
IS A POSSIBILITY FOR FACILITIES
TO FIND A WAIVER THIS WAIVER IS
MEANT TO BE TEMPORARY. IT'S
MEANT TO LAST FOR A SHORT PERIOD
OF TIME SO FACILITIES CAN BECOME
COMPLIANT.
OUR CONCERN IS THE WAIVER
PROCESS SAYS IS WORKING IT WILL
NOT ACTUALLY ALLOW FOR ALL
FACILITIES TO HAVE THE ABILITY
TO APPLY FOR A WAIVER.
AND SO WE WANT TO MAKE SURE
THAT FACILITIES HAVE THAT
OPPORTUNITY WE WOULD RATHER
ACTUALLY SEE THE STATE ACTUALLY
PROVIDE SOME TYPE OF PHASE IN
APPROACH. FOR FACILITIES TO HAVE
THE ABILITY TO COMPLY.
LIKE WE DID BACK IN THE YEAR TWO
THOUSAND.
I'M AND WITHIN THAT PERIOD OF
TIME THE ONE TO TWO YEARS THAT
THEY CAN GET TO COMPLIANCE THEN
WE DON'T HAVE THE DEPARTMENT
HAVING TO DEAL WITH SIX HUNDRED
APPLICATIONS.
THAT MAY OR MAY NOT BE FOUND
THE ABILITY TO HAVE THEM
APPROVED BY JULY FIRST.
AGAIN WE DON'T HAVE THE
INFRASTRUCTURE WE ONLY HAVE
FORTY FACILITIES IN THE STATE
THAT HAVE TRAINING PROGRAMS.
CPA'S IS TAKING SOME HOURS UP
TO NINE TO TWELVE MONTHS TO
ACTUALLY APPROVED. TRAINING
PROGRAM CERTIFICATION PROGRAMS
TO GET STARTED WE HAVE DELAYS ON
C. N. A.'S HUMAN BEING
CERTIFIED.
WE JUST DON'T HAVE THE
INFRASTRUCTURE IN PLACE TO MAKE
SURE THAT FACILITIES HAVE THE
SUPPORT TO MAKE THIS HAPPEN.
WE WANT AND WE APPRECIATE THIS
NEW REQUIREMENT WE WANT TO
COMPLY WITH IT WE'RE NOT ASKING
FOR THIS COMMITTEE TO ACTUALLY.
CHANGE THAT NEW REQUIREMENT
ANYWAY BUT WE JUST WANT TO MAKE
SURE WE GIVE OUR FACILITIES THE
ABILITY TO TO BE COMPLIANT.
THANK YOU MA'AM.
MISTER CHAIRMAN BURST OF ANYWAY
NOW BEHALF OF THE SERVICE
EMPLOYEES INTERNATIONAL UNION
I'M WE THINK YOU GUYS FOR THE
PROCESS LAST YEAR AND AND AND.
PASSING S. B. NINETY SEVEN WE
HAVE A BIT OF CONCERNS THROUGH
THE STAKEHOLDER PROCESS WILL
HOWEVER WE APPRECIATE THAT THERE
IS A STAKEHOLDER PROCESS FOR ALL
OF THOSE.
WHO HAVE INPUT TO BE INVOLVED
INDUSTRY LABOR ADVOCATES
CONSUMERS?
BUT WE DEFINITELY ACKNOWLEDGE
THAT THERE'S GONNA BE SOME
FACILITIES THAT ARE GONNA ARE
NOT GONNA BE ABLE TO MEET THE
REQUIREMENT HENCE THE WORKFORCE
I'M SHORTAGE WAIVER WE THINK THE
STAKEHOLDER PROCESS IS THE
PERFECT. PLACE FOR US TO
CONTINUE TO HAVE THOSE
CONVERSATIONS THEY ARE ONGOING
CONVERSATIONS WE ARE BETTER
ALARMED ABOUT THE PATIENT ACUITY
WAIVER THAT HAS JUST BEEN
RECENTLY.
BROUGHT UP WITHIN THE LAST
MONTH WE CAN WE COMPLETELY THINK
THAT UNDERMINES THE ENTIRE
INTENT.
OF S. B. NINETY SEVEN WHICH YOU
GUYS NOTICE.
FOR PASSING LAST YEAR THE WHOLE
POINT OF S. B. NINETY SEVEN IT'S
PROVIDE QUALITY CARE QUALITY
STAFF INTO THOSE INDIVIDUALS
THAT ARE IN NURSING FACILITIES
AND AB PATIENT ACUITY WAIVER
DOES DEFINITELY UNDERMINES THAT.
WE APPRECIATE WORKING WITH THE
ADMINISTRATION.
LAST YEAR TO MAKE SURE THAT WE
HAVE DIFFERENT WAIVERS IN PLACE
FOR THOSE FACILITIES.
BUT AGAIN IT IT SHOULD BE
WORKED OUT THROUGH THE PROCESS
IT AS FAR AS MAKING SURE THAT WE
HAVE ENOUGH SEE AN AIDS IN ORDER
TO FULFILL THOSE THERE WAS MONEY
IN THE BUDGET FOR TRAINING I
THINK IT'S ALL ABOUT
RECRUITMENT.
AND MAKING SURE THAT WE HAVE
THOSE INDIVIDUALS TO PUT IN
THOSE SLOTS IN ORDER TO PROVIDE
THEM WITH THE TRAINING THAT THE
BUDGET.
HAS APPROPRIATED FUNDING FOR WE
ARE DEFINITELY COMMITTED THROUGH
THE STAKEHOLDERS WE'RE VERY HARD
VERY DILIGENTLY
WITH IN THE STAKEHOLDERS PROCESS
THAT WAS ESTABLISHED IN STATUTE
IN ORDER TO MEET OUR GOAL SO
WITH THAT. I'M I WOULD JUST ASK
THAT YOU GUYS WORK WITH THE P.
H. AND CONSIDER OUR COMMENTS
TODAY THANK YOU. HIM.
MISTER CHAIRMAN MEMBERS OF THE
COMMITTEE FRED MAIN ON BEHALF OF
CAL PACE THE. PROGRAM FOR THE
ALL INCLUSIVE CARE FOR THE
ELDERLY IN THE STATE. OF.
PACE IS.
TRYING TO EXPAND.
IN LIGHT OF THE LEGISLATURE IN
THE ADMINISTRATION'S PASSAGE OF
THE PACE MODERNIZATION ACT.
IN NOT TWO THOUSAND AND.
AT SIXTEEN A TRYING IS THE
OPERATIVE WORD THERE A ONE OF
THE CHALLENGES FOR PACE
ORGANIZATIONS IS THAT THEY NEED
TO. BE LICENSED BY THE
DEPARTMENT OF. A PUBLIC HEALTH
FOR A CLINIC AND EIGHTY EIGHT C.
SOMETIMES A HOME HEALTH AGENCY
LICENSE OR.
ACHIEVE.
APPLICATION FOR EXEMPTION.
WHICH YOU'RE ALMOST AS DIFFICULT
TO.
ACQUIRE SO AS A RESULT PACES
NOT BEING ABLE TO EXPAND. A AND.
ACTUALLY IMPLEMENT THE.
THE EXPANSION AUTHORIZATION.
RIGHT NOW CLINIC APPLICATIONS
ARE.
BEING.
.
ACTED OUT FROM APRIL OF TWENTY
SEVENTEEN AND SO THAT'S QUITE A
BACKLOG THAT'S IN ADDITION TO
THE EIGHTEEN MONTH PROCESS.
THAT IT TAKES JUST UNDER THE A
PERFECT ALIGNMENT OF.
APPLICATION SO IT THAT IS A
SIGNIFICANT ISSUE THAT DOESN'T
UP AND THAT.
APPLICATION BACKLOG THAT WERE
AWARE OF WE HAVE NOT BEEN ABLE
TO IDENTIFY. THE BACKLOG FOR THE
EITHER THE HOME HEALTH AGENCIES
OR THE EIGHTY EIGHT C. SO. IT'S
A BIG CONCERN.
IT'S COSTLY FOR THE PACE
ORGANIZATIONS.
IN THEIR ABILITY TO START UP.
OF WE DO.
HAVE SOME HOPE FOR THE
ELECTRONIC APPLICATION PROCESS
IN THIS CENTRALIZED.
STAFFING.
BUT WE THINK THEY NEED TO BE.
LINK TO REAL OUTCOMES DE A P.
H. WE BELIEVE SHOULD BE REQUIRED
TO MEET ESTABLISHED GUIDELINES.
FOR THE APPROVAL OF LICENSE
APPLICATIONS FOR ALL PROVIDER
TYPE SIMILAR TO THAT. HOSPITALS
AND THE DEPARTMENT SHOULD
PUBLISH PERIODIC UPDATES
ON THE BACKLOG FOR THE
LEGISLATURE TO AYE TRACK ITS
PROGRESS. THANK YOU FOR PAYING
ATTENTION TO OUR.
ISSUES TODAY.
THANK YOU SIR.
MISTER CHAIRMAN MEMBERS MICHELLE
CUT IT OUT WITH A CA YOU
CALIFORNIA.
HEALTH CARE DIVISION.
AS YOU KNOW WE REPRESENT THE
NEAREST PUBLIC HEALTH NURSES WHO
DO LICENSING AND CERTIFICATION
FOR THE STATE AND WE WORK
TOGETHER WITH THE LEGISLATURE
BACK IN TWENTY FOURTEEN TO
ENSURE GREATER INVESTMENT IN THE
PROGRAM AT THAT TIME. WE WERE IN
A VERY DIFFERENT PLACE.
THE THOUGH WAY THAT THAT STATE
WAS CALCULATING WORKFORCE NEEDS
AT THAT TIME WOULD HAVE
INDICATED THAT THE STATE NEEDED
FEWER WORKERS NOT MORE AND SO
WE'RE HAPPY TO HEAR THAT THE
STATE HAS REVAMPED ITS PROCESS
FOR HOW IT LOOKS AT WORKLOAD.
AND.
WOULD WELCOME AS OTHER
STAKEHOLDERS MENTIONED GETTING
ADDITIONAL INFORMATION ON ON
WHAT THOSE WORKLOAD PRETTY OUR
PROJECTIONS ARE BASED ON AND HOW
THEY. HOW THEY WORK TO DAY I
WILL NOTE THAT AT THAT TIME WE
ALSO?
MADE IT CLEAR TO THE
LEGISLATURE THAT THE UNDER
INVESTMENT IN THIS PROGRAM AND
THE PROBLEMS ASSOCIATED WITH
THAT WERE SO DEEP THAT IT WOULD
TAKE TIME TO TURN THIS PROGRAM
AROUND AND SO. WE UNDERSTOOD
THAT WE NEEDED TO HAVE PATIENTS
THAT BRINGING ONBOARD SO MANY
MORE STAFF WOULD TAKE TIME IT
WOULD PUT ADDITIONAL STRESS ON
THE EXISTING WORKFORCE WHO HAD
TO DO DOUBLE DUTY AND TRYING TO.
CLEAR BACKLOGS DEAL WITH THE
WITH THE EXISTING OVER WORK BUT
ALSO BRING NEW PEOPLE ONBOARD
AND TRAIN THEM. AND.
SO SO WE UNDERSTAND THE NEED TO
BALANCE OUT PATIENTS AND SORT OF
BRING THINGS TOGETHER.
OVERTIME WITH THAT SAID I WILL
SAY.
RETENTION IN THIS PROGRAM WILL
BE CHALLENGED BECAUSE THE
STATE'S P. STRUCTURE IS SO LOW
AND I UNDERSTAND THAT YOU DON'T
HAVE A PROPOSAL BEFORE YOU TODAY
TO SORT OF BRING UP. THE THE
PAIN BUT JUST TO KIND OF PUT IT
IN CONTEXT
THE STATE IS PAYING A MASTER'S
LEVEL PUBLIC HEALTH NURSE AROUND
SIXTY SIXTY FIVE THOUSAND A
YEAR.
STARTING AND AND THE INDUSTRY
WRIT LARGE IS PAYING MUCH HIGHER
THAN THAT PIECE GALLON SO.
IT'S EASY TO RECRUIT AWAY A
HIGHLY EDUCATED VERY WELL
TRAINED PUBLIC HEALTH'S HEALTH
NURSE WHO'S GONE THROUGH THE
PROCESS OF UNDERSTANDING ALL THE
STATE AND FEDERAL LAWS AND
REGULATIONS THAT APPLY. AND SO I
THINK THIS IS JUST A
CONVERSATION THAT WE'RE GOING TO
CONTINUE TO HAVE OVER THE YEARS
AND WILL CONTINUE TO WORK WITH
WITH THE STATE TO TRY TO ENSURE
THAT WE GET GREATER
TRANSPARENCY.
AND THAT WE MEET OUR COMMON GOAL
OF IMPROVING SERVICE TO THE
FACILITIES THAT ARE LICENSED AND
REGULATED BY THE STATE WHILE
ALSO ENSURING THAT THE PUBLIC IS
KEPT SAFE IN QUALITY FACILITIES
AND WE THANK YOU FOR YOUR
ATTENTION TO THIS ISSUE.
THANK YOU MA'AM.
WITH THAT WILL BRING IT UP TO
THE DYESS FRONT QUESTIONS THAT
PEOPLE MAY HAVE.
YOU CAN BE AFRAID THAT YOU LAST.
WELL I'M I'M REALLY CONCERNED I
WANT TO FIRST ACKNOWLEDGE THAT.
I ACT. WE CAN HAVE THIS
CONVERSATION OVER AND OVER AGAIN
AT THE END OF THE DAY THOUGH THE
CONSUMERS ARE. ARE THE ONES THAT
ARE GOING TO BE EFFECTIVE ARE
AFFECTED SPECIFICALLY ON TALK
ABOUT THE ELDERLY.
AND THE THE OTHER SKILLED
NURSING FACILITIES I'M I I WAS A
TEACHER FOR SIXTEEN YEARS AND
DURING MY TENURE WE HAD A
TEACHER SHORTAGE. AND THAT THERE
WAS A POINT WHERE WE COULDN'T
RECRUIT ENOUGH TEACHERS WE HAD
QUITE A STATE AND WE HAVE TO GO
OUT OF. THE COUNTRY TO RECRUITS
ON THESE FOLKS NOW MY CONCERN
HERE IS THAT YOU KNOW WHEN I
HEAR BOTH SIDES. YOU KNOW
OBVIOUSLY THAT THAT THE.
.
PATIENT IS OF CONCERN BUT ALSO
MY CONCERN IS WHERE WE CAN FIND
ALL OF THESE.
FOLKS TOO UP FILL THESE
POSITIONS AND WHAT IS THE
DEPARTMENT DOING YOU KNOW ASIDE
FROM PAYING MORE OUT WHAT ELSE
CAN WE DO. TO RECRUIT THESE
FOLKS BECAUSE I HAVE.
TWENTY FIVE SKILLED NURSING
FACILITIES IN MY IN MY AYE
DISTRICT AND ELEVEN OF THOSE ARE
GOING TO BE OUT OF COMPLIANCE.
JULY FIRST.
NOT BECAUSE THEY'RE NOT TRYING
I WENT TO VISIT A FEW OF THEM
AND THEY CAN'T RECRUIT FAST
ENOUGH I SEE SEVERAL PROBLEMS I
WAS ALSO A SCHOOL BOARD MEMBER
AND A LOT OF THE. THE ESPECIALLY
CME PROGRAMS AT LEAST THE BASIC
PART OF THAT SCENE A PROGRAMS
WERE ELIMINATED DURING THE
BUDGET CRISIS AND HAVE NOT BEEN
BROUGHT UP.
OUGHT TO FOLK FULL FULLY FUNDED
OR SOME OF THE SPECIFICALLY MY
AREA SOME OF THOSE.
UP PROGRAMS WERE ELIMINATED AND
HAVE NOT BEEN BROUGHT BACK AT
ALL AND SO.
HOW OLD ARE WE ASKING FOLKS TO
COMPLY ON JULY FIRST ONE WHERE
NOT EVEN PROVIDING?
I DID HEAR THAT THERE WAS SOME
ADDITIONAL MONEY FOR TRAINING
BUT WHERE THE PEOPLE COMING
FROM.
WE CAN HAVE ALL THE MONEY IN THE
WORLD BUT IF WE'RE NOT
RECRUITING ENOUGH FOLKS.
TO TO BE TRAINED THEN HOW ARE WE
EXPECTING THESE FACILITIES TO
COMPLY. WITH THE REQUIREMENTS OF
WE'RE NOT DOING ENOUGH TO.
TO ABOUT IT ONE NUMBER ONE
RECRUIT BUT NUMBER TWO. I'M
RETAIN BECAUSE I HEAR THAT.
WE ARE RECRUITING SOME BUT THEY
WERE NOT PAYING ENOUGH THERE'S
NOT ENOUGH.
BEATEN.
THERE IS NOT IN EVIDENCE
INCENTIVE FOR FOR THESE FOLKS TO
STAY IN THESE FACILITIES SO WHAT
IS THE DEPARTMENT DOING FOR.
OR TO HELP WITH THAT.
SO I I JUST WANT TO BE.
CLEAR THAT YOU WERE TALKING
ABOUT THE CERTIFIED NURSE
ASSISTANTS THAT WORK IN THE
FACILITIES AND OT THE NURSES
THAT WORK FORCE SEEPAGE.
THANK YOU OF FOR THAT
CLARIFICATION.
SO.
.
YOU ARE CORRECT THAT YOU MEET
WON'T BUT IT ALSO.
IF IF WE IF WE TALK ABOUT THE
THE.
THE PAY SCALE FOR THAT THE.
BUT RIGHT QUALIFIED ONE THAT IS
AN ISSUE AS WELL I AGREE WITH IT
SO.
.
IN TERMS OF PAY SCALES FOR
EITHER THE NURSES THAT THEY
CALIFORNIA PART OF PUBLIC HEALTH
FIRES OR FOR THE CERTIFIED NURSE
ASSISTANTS THAT THE FACILITIES
HIGHER WE WE CERTIFY THEM BUT WE
DON'T HIRE THEM.
WE DON'T WE WE DO NOT HAVE
CONTROL OVER SETTING THOSE WHICH
LEVELS YOU KNOW THE STATE'S
CIVIL SERVICE CATEGORIES ARE SET
AT THE BARGAINING TABLE. AND.
INDUSTRY.
THE DEMANDS OF INDUSTRY AND AND
WHAT THEY WILL PAY ITS IS WHAT
DRIVES THE SCENE A SALARY. WE DO
ACKNOWLEDGE THAT.
THERE IS THERE. IS
CLEARLY A NEED FOR MORE CNA
TRAINING PROGRAMS.
THE DEPARTMENT DOES NOT PROVIDE
CNA TRAINING WE APPROVE.
PROGRAMS THAT SEEK TO PROVIDE
THAT TRAINING. AND THERE HAVE
BEEN PROGRAMS THAT HAVE CLOSED
OVER THE YEARS WE.
ONE OF THE THINGS WE'RE TRYING
TO SET UP A STATEMENT WAS MADE
ALONG THE WAY.
THAT I'M NOT CLEAR ON AND I
JUST WANT TO MAKE CLEAR THAT
THERE WAS A MENTION THAT WE THE
DEPARTMENT HAVE MONEY. FOR CNA
TRAINING PROGRAMS AND THAT WAS
NOT A CORRECT STATEMENT.
BUT.
WE DID WE DO HAVE WE HAVE A
SORRY BUT CAN YOU CLARIFY THEN
WHAT IS THE CORRECT STATEMENT.
SO THAT THERE IS A UP THERE. WE
HAVE A CIVIL MONETARY PENALTY
COUNT THAT AS FEDERAL CITATION
MONEY. THAT CAN BE USED ONLY.
.
TWO FOR PROJECTS THAT IMPROVE
HEALTHCARE FACILITIES
WE DO HAVE A PROPOSAL BEFORE US
FROM THE CALIFORNIA ASSOCIATION
OF HEALTH FACILITIES.
FOR THEM TO WORK WITH TRAINING
PROGRAMS AND WITH FACILITIES TO
TRAIN MORE C. N. A.'S AND THEY
WANT TO USE SOME OF THAT FEDERAL
MONEY FOR THAT PROGRAM.
THE USE OF THE FEDERAL MONEY
FOR THAT PROGRAM HAS TO BE
APPROVED BY THE FEDERAL
GOVERNMENT BY THE CENTERS FOR
MEDICARE AND MEDICAID SERVICES.
WE ARE AN ACTIVE DIALOGUE WITH.
THE CALIFORNIA ASSOCIATION OF
HEALTH FACILITIES AND THE
CENTERS FOR MEDICAID MEDICARE
SERVICES.
TO. WORK ON THAT PROPOSAL SO
THAT IT MEETS CMS IS APPROVAL SO
THAT CMS WILL APPROVE THE USE OF
THAT FEDERAL MONEY. TO HELP WITH
THAT WHAT THEY'RE CALLING A
KICKSTARTER TRAINING PROGRAM FOR
CNN'S.
LET ME JUMP IN JUST FOR A SECOND
MY UNDERSTANDING IS THE GOVERNOR
AND HIS JANUARY BUDGET HAD
INSERTED BELIEVE IT WAS TWO AND
A HALF MILLION.
THAT'S GOING TO LOOK TOWARDS
THE.
.
EMPLOYMENT DEVELOPMENT
DEPARTMENT OR HIGHER ED THAT
WILL HELP IN TRAINING. IS THAT
CONSISTENT WITH WHAT YOU KNOW
AND IS THOSE ARE THOSE FUNDS
SUFFICIENT TO MEET THE NEED.
I APOLOGIZE THAT I'M NOT
FAMILIAR WITH ANY AUGMENTATION
FOR US OUTSIDE OF OUR BUDGET SO.
SOON.
AND I AM PRETTY SURE THAT IT'S
FOUR POINT FIVE MILLION ONE TIME
TO IN FOR COMMUNITY COLLEGES AND
TWO POINT FIVE FOUR IN THE U.
DD.
WHAT IF A GOING? ONE ON OUR END
AND ALONG THOSE LINES.
THE CONVERSATION WE'RE HAVING
RIGHT NOW YOU KEEP SAYING WE'RE
GOING TO WE'RE GOING TO WE'RE
GOING TO WHICH I APPRECIATE
HOWEVER THE. THE THE THE
COMPLIANCE IS JULY FIRST
AND SO YOU SEE WHERE THE
DISCONNECT IS WE'RE GOING TO
WE'RE GOING TO BUT YET THE
FACILITIES ARE. ARE EXPECTED TO
TO COMPLY BY JULY FIRST SO AT
WHAT POINT DOES THAT ARE WEAK.
YOU KNOW WE'RE GOING TO COME
TOGETHER WITH THE REALITY OF
THIS DEBT DOES.
DATE.
TO COMPLY SO.
TWO POINTS OF CLARIFICATION.
TO ANSWER YOUR QUESTION IN AND
CLARIFY SOME THINGS. THE
IMPLEMENTATION DEADLINE FOR THIS
NEW STAFFING RATIO.
IS IN THE LEGISLATION.
IT IS NOT SET BY THE DEPARTMENT
AND THEREFORE WE ARE ONLY YOU
KNOW WE ARE BOUND BY THE
TIMELINE THAT'S IN THE
LEGISLATION AND. THE OTHER PIECE
ON THE ON THE WAIVERS WE HEARD A
LOT OF TALK ABOUT YOU KNOW
PEOPLE WILL NEED WAIVERS IN THE
BEGINNING AND WHAT KIND OF
WAIVERS AND CONCERNS WITH THE
WAIVERS. AND I WOULD JUST I
REMIND.
THAT COMMITTEE AGAIN THAT.
THE WAIVER PROCESS THE
REQUIREMENTS
TO HAVE THESE TWO DIFFERENT
KINDS OF WAIVERS IS ALSO IN THE
LEGISLATION AND THE LEGISLATION.
MAKES IT INCUMBENT ON THE
DEPARTMENT TO DEVELOP A WAIVER
PROCESS SO IT'S NOT OUR CHOICE
WHETHER WE THINK THERE SHOULD BE
WAIVERS OR SHOULD NOT BE WAIVERS
THE LEGISLATION REQUIRES. THAT
WE DEVELOP PROCESSES FOR
GRANTING WAIVERS.
OKAY BUT IT SOLD SO THANK YOU
BYE UP THE QUESTION STILL
REMAINS WHERE WE CAN MAKE IT.
I GUESS THAT'S MY QUESTION WHAT
IS THE PLAN TO MAKE SURE THAT
THAT IF THESE WAIVERS ARE.
ISSUED THEN THEN WHAT WHAT
HAPPENS.
TO ENCOURAGE OUR INCENTIVIZE OF
THE WAIVERS BECAUSE THAT WHAT
WHAT IT SOUNDS LIKE TO ME IS
WE'RE GONNA GIVE WAIVERS RIGHT.
BUT THEN IF THERE'S NO PLAN TO
FILL THOSE POSITIONS THEN. AND
ANOTHER YOUR WORK AND ASKING FOR
ANOTHER WAIVER THAT'S NOT THE
PURPOSE OF THAT THE WAIVER THE
WAIVER IS. THIS IS THE PLAN THIS
IS WHAT WE'RE I MEAN I'M
ASSUMING RIGHT THAT IF YOU ISSUE
A WAIVER THEN THE PLAN YOU HAVE
TO HAVE A PLAN ON HOW YOU'RE
GOING TO COMPLY BY EX.
PICK A DATE.
SO THAT'S WHERE MY CONCERN IS
BECAUSE I KNOW I UNDERSTAND THAT
LEGISLATION WAS A IMPLEMENTED
BY.
YOUR.
IT'S IT'S HERE. SO YOU HAVE THE
SAME PRESSURE AS THE FACILITIES
TO TO TO TRY AND COME TOGETHER
SO THAT WE CAN FIND THE A
SOLUTION TO.
SO LET ME TURN IT OVER TO SEE
JAY HOWARD TO TALK TO YOU ABOUT
WHAT WE'VE DISCUSSED IN
STAKEHOLDER MEETINGS ABOUT WHAT
WE ENVISION THE WAIVER PROCESS
WOULD LOOK LIKE ABOUT WHO WE'LL
GET THEM. HOWLONG THEY WOULD
LAST THE CONDITIONS FOR GETTING
THEM?
IS THAT WOULD THAT BE.
PUPPET YOUR QUESTION.
SO THE LEGISLATION REQUIRES US
TO IMPLEMENT THREE POINT FIVE
AND TWO POINT FOUR SO WE'RE
INCREASING THE NURSING HOURS PER
PATIENT DAY FROM THREE POINT TO
TURN OVER ALL OF THREE POINT
FIVE AND TWO POINT FOUR OF THOSE
HOURS MUST BE PROVIDED BY
CERTIFIED NURSE ASSISTANTS.
THE LEGISLATION ALLOWS FOR TWO
WAIVERS TO THE REVISED STANDARD
SO ONE IS A WAIVER TO THE TWO
POINT FOUR CM A REQUIREMENT
BASED ON PATIENT ACUITY.
SORT OTHER WORDS OF FACILITY
WOULD STILL NEED TO MEET THREE
POINT FIVE BUT BASED OFF OF
THEIR PATIENT MIX FOR THE ACUITY
OF THEIR PATIENTS THEY MIGHT
HAVE MORE ARE ENDS IN LV ENDS
AND FEWER SEEN AS IF THEY'RE
STILL MADE IN THE THREE POINT
FIVE.
THE SECOND WAIVER.
ALLOWS OF FACILITY TO WAVE TO
POINT FOUR AND OR THREE POINT
FIVE PROVIDED THEY STILL ME AND
OVERALL STAFFING LEVELS THREE
POINT TO USE OF THE CURRENT OR
EXISTING STANDARD.
THE DEPARTMENTS HELD FOR PUBLIC
STAKEHOLDER MEETINGS TO
AGGREGATE AT THAT.
CONCERNS.
AND IDEAS ABOUT HOW WE SHOULD
GO ABOUT IMPLEMENTING THESE
WAIVERS.
THE MATERIALS FROM ALL THESE
ARE INTERNET AND WE WILL BE
RELEASING SO THE WAY THAT THIS
WHOLE ALL COME TOGETHER IS
THROUGH A COMBINATION OF
EMERGENCY REGULATIONS AND ALL
FACILITIES LETTERS. AND THAT'LL
BE RELEASED BY MARCH THIRTIETH.
.
SO ESSENTIALLY WHAT WE'RE ASKING
FOR IN THE WORKFORCE SHORTAGE
WAIVER IS FOR THE FACILITY TO
DEMONSTRATE THAT THERE A IS A
WORKFORCE SHORTAGE IN THEIR
REGION. AND BE THAT THEY HAVE
MADE. STRIDENT EFFORTS TO HIRE
SUFFICIENT NUMBERS OF STAFF AND
THEN THE IN SCRANTON THE WAIVERS
OF CURRENTLY OUTLINED THE NEED
TO SHOW US A SERIES OF STEPS
THAT THEY PLAN TO TAKE TO FULLY
STAFF AND TO BE FULLY STAFFED
AT.
TWO POINT FOUR AND THREE POINT
FIVE AND THEY CAN ONLY RENEW THE
WAIVER FOR AND A LIMITED NUMBER
OF YEARS.
SO THREE SO YOU GET A FEW
THERE'S A POTENTIAL FOR IT IN
THE CAR PROPOSAL AN INITIAL
WAIVER AND TWO RENEWALS AND
AFTER THREE YEARS YOU WOULD NOT
BE ABLE TO GET A WAIVER. AND
ANOTHER PIECE OF GRANTING THE
WAIVERS THAT THE FACILITY
REQUESTING A WAIVER ACOSTA HAS
TO DEMONSTRATE.
TO THE DEPARTMENT IT'S
YOU KNOW IT'S PLAN FOR ASSURING
THAT IT CAN PROVIDE. PROPER CARE
TO THE RESIDENTS AT THE LOWER
LEVEL.
JUMP IN FOR A SECOND IF I CAN.
FIRST I THINK IT'S IMPERATIVE
TO.
MAKE UP STATEMENT THAT WERE ON
BOARD WITH SUPPORTING THAT
STAKEHOLDER PROCESS AND WANTS TO
MAKE SURE THAT.
ALL INTERESTS ARE PRESENT IN
ABLE TO BE HEARD AND THAT WE ARE
MOVING FORWARD IN A
CONSTRUCTIVE.
PATTERN.
I BELIEVE THE GOAL IS TO GET TO
THREE POINT FIVE AND REALLY WHAT
IT SEEMS LIKE WE'RE MISSING HAS
HOW.
AND WE'RE TRYING TO FIGURE OUT
IF THE FOREIGN A HALF MILLION
THAT WAS INSERTED IN THE
GOVERNOR'S BUDGET WILL BE
SUFFICIENT TO REACH THAT GOAL.
AND IF NOT IS THERE A NECESSITY
FOR THE STATE LEGISLATURE TO
STEP UP.
BECAUSE IT IS IMPERATIVE THAT WE
PROVIDE THE STAFFING RATIO TO
PROTECT
OUR COMMUNITY AND RESIDENTS OF
NURSING HOMES.
HAS JUST BEEN A BAD ONE EITHER.
.
POINT OF INTEREST WHICH IS THAT
MY.
MEDICAL COLLEAGUES HAVE TOLD ME
THAT IN THE GOVERNOR'S BUDGET
THERE'S AN ADDITIONAL
AUGMENTATION OF TWENTY ONE POINT
SIX MILLION GENERAL FUND.
FOR ADD ONS TO SNIFF MEDICAL
RATES FOR NON COMPLIANT%
FACILITIES THAT'S ANOTHER.
POSSIBLE PIECE OF THE PUZZLE.
CAN YOU KNOW. AT SOME POINT
THERE IS A CAPACITY TO THE
TRAINING OF SEEING EYES OF
SWELLED THE.
THEY HAVE A CERTAIN NUMBER THEY
CAN DO WENT OVER A CERTAIN
NUMBER OF WEEKS.
IT SEEMS AS IF IF I RECALL FROM
LAST YEAR WE NEED TO TEN
THOUSAND NEW SEE AND EYES TO
MEET THIS INCREASE REQUIREMENT.
DO WE HAVE A SENSE OF WHAT THE
CAPACITY IS FOR TRAINING OF
INDIVIDUALS NOW AND HOW LONG WE
WOULD.
ANTICIPATED TO BRING THAT MAN.
I'M TRYING TO AGAIN DRIVE
TOWARDS HOW DO WE HELP MAKE SURE
WE CAN MEET THE OBLIGATIONS WE
PUT IN STATUTE PASSED HERE.
I APPRECIATE YOUR QUESTION I'M I
DO NOT HAVE THAT INFORMATION
AVAILABLE.
BIG BECAUSE WE ONLY AYE WITHIN
THE DEPARTMENT CERTIFY THE
TRAINING PROGRAMS WE DON'T HAVE
AND I CERTAINLY DON'T HAVE TODAY
I'M GOOD DATA FOR YOU ON. WHAT
THE DIM YOU KNOW HOW MANY SEE IN
A IS FACILITIES WOULD NEED TO
MEET THE STAFFING RATIO?
VERSUS HOW MANY SEE AN AIDS
THERE ARE AVAILABLE WE DO HAVE
DATA.
FROM ET DE TELLING US HOW MANY
SEE AN AIDS BY COUNTY ARE IN THE
ARE IN THE WORK FORCE AND THAT'S
PART OF THAT WILL USE THAT DATA
IN EVALUATING EACH INDIVIDUAL
FACILITIES. WAIVER REQUEST OF
DEMONSTRATING IF THERE'S A
WORKFORCE SHORTAGE BUT.
AYE WHEAT WE DON'T REALLY HAVE
GOOD INFORMATION FOR YOU ON WHAT
THE WHAT THE NEED IS AND HOW
LONG IT WOULD TAKE TO FILL THAT
NEED.
CONTINUE TO MONITOR THE
STAKEHOLDER PROCESS AS THIS GOES
FORWARD AND WILL HAVE FUTURE
DISCUSSIONS ABOUT IT. WALTON
MORE THAN THAT THEM MONITORING
WELL IT.
I WOULD LIKE TO HEAR FROM YOU
DIRECTLY IF THERE'S ANY PROBLEMS
ARE FROM FOR THE STAKEHOLDERS IF
THERE'S ANY PROBLEMS IF YOU CAN
KEEP US POSTED AS WELL BECAUSE.
MEET YOUR YOU'RE ALL HAVING
THESE STAKEHOLDER MEETINGS AND.
I'M NOT SURE AT WHAT POINT YOU
INVOLVED I'VE I DON'T
NECESSARILY WANT TO BE INVOLVED
IN THE DAY TO DAY BUT I WOULD
LIKE SOME REGULAR UPDATES FROM
BOTH SIDES TO SEE WHERE WE ARE
IN THE PROCESS BECAUSE I. WHEN
THIS HAPPENS I DON'T WANT US TO
TO BE IN A HURRY AGAIN AND THEN.
THAT STAKEHOLDER PROCESS
DOESN'T BREAKS DOWN AT SOME
POINT AND I WANT TO MAKE SURE
THAT IN. WE PREVENT ANY KIND OF
BREAKDOWN AND YOU KEEP US IN THE
LOOP SO THAT WE CAN ASSIST YOU
IN ANY WAY THAT WE CAN. INSTEAD
OF YOU KNOW THE ELEVENTH HOUR
TRYING TO FIGURE OUT WHAT WE'RE
GOING TO DO WITH THIS WE CAN
ABSOLUTELY DO THAT WHAT I'LL DO.
WHEN WE RETURN IS ALL OF THE
INFORMATION ABOUT THE
STAKEHOLDER PROCESS TO DATE
INCLUDING MINUTES OF OUR
MEETINGS. LETTERS FROM THE
VARIOUS STAKEHOLDERS INDUSTRY
AND CONSUMER ADVOCATES ON THEIR
POSITIONS DRAFTS OF OUR
PROPOSALS AND.
POWERPOINT PRESENTATIONS FROM
OUR STAKEHOLDER MEETINGS ARE ALL
POSTED ON OUR WEBSITE SO MAKE
SURE THAT WE GET YOU A LINK TO
THAT WEBSITE.
.
DARE FIRST THING TOMORROW
MORNING KNOWING SOME OF THE
STAKEHOLDERS INVOLVED IN THIS
THEY'RE NOT THAT SHOT I AM SURE
WE'LL HEAR WHAT THEY WANT THEIR
ANOTHER.
YOU KNOW I WOULD LIKE TO MOVE ON
IF I COULD AND.
.
SORRY DOT WOULD. DIE PROJECTS IF
IF I MISS THIS DISCUSSION
EARLIER.
I'VE HEARD ABOUT CHALLENGES
WITH RESURFACING OF C. N. A.'S
AND AND HOW SLOW THAT PROCESS
IS.
CAN EXPLAIN WHY THAT PROCESS IS.
SO SLOW ARE THEY HAVING TO FILL
OUT PAPER APPLICATIONS FOR
RENEWAL AS WELL.
AND.
BECAUSE THAT IS THAT THAT MIGHT
BE OF WHICH I HAVE FROM PEOPLE
IN MY DISTRICT IS THAT THAT IS.
WITHOUT THE CERTIFICATES OR
WITHOUT THE RENEWAL THEY CAN'T
WORK.
AND YET.
THEY CAN'T GET THERE RENEWAL
BECAUSE THE DEPARTMENT IS TAKING
SO LONG TO GET INTO. SO LIKE I
SAID EARLIER YOU KNOW I'VE GOT
IT WHEN I RENEW MY DENTAL
LICENSE I CAN DO THAT ONLINE.
AND IT TAKES VERY LITTLE TIME
WILL HAVE WITHIN A COUPLE WEEKS
FROM THE PROCESS AND.
.
YET WE'RE HEARING ANECDOTALLY
THAT IS TAKING A LONG LONG TIME
TO GET RENEWALS FOR CNN SO.
CAN YOU EXPLAIN WHAT THE
BOTTLENECK GIVES AND.
HOW WE'RE GOING TO ALLEVIATE
THAT SO THAT WE CAN?
ACTUALLY HAVE THE WORKFORCE WE
HAVE BE ABLE TO WORK IN THE AND
FACILITIES WHERE THEY NEED TO BE
THERE TO HELP PROVIDE PATIENT
CARE.
AND MY COLLEAGUE ANSWER THAT
QUESTION FOR YOU. SO THE THE
CURRENT PROCESS IS A PAPER BASED
PROCESS ROUGHLY FOUR MONTHS
PRIOR TO THE C. N. A.'S
EXPIRATION WE SEND OUT A NOTICE
REMIND IN THE C. N. A THAT IT'S
TIME FOR THEM TO RENEW.
.
BACK IN THE SUMMER AND NOVEMBER
OUR PROCESSING TIME HAD BECOME
QUITE A FLAG PILLARS UPWARDS OF
THIRTY DAYS FOR US TO TURN
AROUND. TO TURN AROUND OF THE
REVIEW OF THE APPLICATION AYE
WE'VE SUBSEQUENTLY DRIVEN THAT
PROCESS DOWN TO TWO OR THREE
DAYS THE LAST REPORT THAT I GOT
TODAY WAS IT WEIRD NOW TURNING
THOSE AROUND AND THREE DAYS THAT
JUST MEANS OF THAT. THAT DOESN'T
MEAN THAT IT WAS APPROVED WITHIN
THREE DAYS IT COULD BE THAT
WE'VE GOT AN INCOMPLETE
APPLICATION BUT WILL LET BURDENS
HAVE A TURN AROUND TIME A VOLLEY
OF THIRTY FIVE DAYS IT'S NOW
DOWN TO TWO OR THREE. SO IT'S
MUCH MORE MANAGEABLE WE ARE
MOVING WITHIN THE NEXT YEAR OR
SO TO AN ONLINE APPLICATION
SYSTEM SO THAT WE CAN REDUCE THE
NUMBER OF TIMES THAT WE GET
APPLICATIONS AN ERROR OR
INCOMPLETE APPLICATIONS.
SO THAT HOPEFULLY WE CAN GET IT
IN THE FIRST TIME AND WE CAN BE
APPROVING THE SCENE A RENEWALS
IN A MATTER OF DAYS RATHER THAN
A MATTER OF MONTHS OR WEEKS.
I JUST WANT TO ADD THAT WE ARE
MONITORING HONOR ON A WEEKLY
BASIS THE TURN AROUND TIME OF
THOSE APPLICATION RENAULT SO
IT'S THIS IS A HIGH. PRIORITY ON
OUR RADAR SCREEN THAT WE ARE
MONITORING VERY CLOSELY.
OF JUST HOW HOW LENGTHY OF APPLE
AT HOW LINK THE IS THE
APPLICATION FOR RENEWAL.
ACTUALLY.
I DON'T HAVE IT I DON'T OFFICE
OF MY HEAD I DON'T KNOW I CAN I
CAN TELL YOU WHAT ONE OF THOSE
WHAT WE WHAT WE SEE IS ONE OF
THE COMMON PROBLEMS I APOLOGIZE
IT ON HOW LONG APPLICATION IS.
SIENESE HAVE TO HAVE A CERTAIN
NUMBER OF CONTINUING EDUCATION
UNITS SPREAD OVER A TWO YEAR
PERIOD. AND THERE ARE VERY
SPECIFIC REQUIREMENTS OVER HOW
MUCH CAN BE DONE IN ANY ONE
YEAR.
AND THIS WOULD BE ONE OF THE
AREAS WHERE THERE'S THE MOST.
DIFFICULTY IN RENEWAL
APPLICATIONS.
EITHER WITH.
APPLICANTS.
GOING BACK AND FORTH BETWEEN THE
DEPARTMENT APPLICANTS TO VERIFY.
THE LEGITIMACY OF THEIR.
EDUCATION CONTINUING EDUCATION
UNITS OR.
ENSURING THAT THEY WERE
DISTRIBUTED APPROPRIATELY OVER
THE TWO YEARS AND SOMETIMES
WHEN.
THEY ARE NOT THE INITIAL
APPLICATION DOES NOT MEET THE
REQUIREMENTS FOR CONTINUING
EDUCATION WE THEN HAVE TO GO
BACK TO THE APPLICANT.
WITH THE PROCESS FOR THEM TO
TEST IN BACK INTO A RENEWAL.
IS THERE A RHYME OR REASON
THOUGH WHY THE CONTINUING
MEDICAL EDUCATION NEEDS TO BE
SPLIT UP BETWEEN. THE ERRORS IT
STATURE ITS AND STATUTES THAT IS
THAT IS SOMETHING THAT NEEDS TO
BE RE LOOKED AT AS WERE STARTING
TO RECOGNIZE WORKFORCE SHORTAGES
AND.
NEED TO ENSURE THAT WE HAVE AS
MANY CAPABLE BODIES AS WE CAN.
I I DON'T THINK WE CAN COMMENT
ON YOUR PARTICULAR QUESTIONS AT
THE STATURE RESET TEN HOURS THE
TO BE DONE IN ONE YEAR AND TEN
HOURS THE SECOND YEAR SAYS
THERE'S A TWENTY ARE A
REQUIREMENT FOR THE CONTINUING
EDUCATION SPLIT OVER. TWO YEARS
SO WHETHER NOT THAT SHOULD BE
REVAMPED UP MY DON'T THINK WE
HAVE A A COMMENT ON THAT. FAIR
ENOUGH.
I WAS HOPING TO. ARE YOU. I WAS
HOPING TO.
TAKE A LOOK AT THE LICENSING
FEES I WAS MOVED BY.
WHAT CALIFORNIA HOSPITAL
ASSOCIATION AND AS WELL AS
KELPIE SAID? REGARDING THE LONG
WAIT TIMES PARTICULARLY AS WE'RE
LOOKING AT INCREASES AND FEES.
ARE WE DELIVERING ON. TIME.
TO ENSURE THAT OUR APPLICATIONS
ARE BEING PROCESSED IN A
REALISTIC TIME FRAME IT SEEMS AS
IF THAT'S A CONSISTENT THEME
THAT WE'VE HEARD TODAY. AND
HOPEFULLY BY MAY REVISE YOU CAN
PROVIDE US SOME INFORMATION
ABOUT WHAT IS TAKING SO LONG AND
PATHWAYS FORWARD TO HELP TO
STREAMLINE. THIS PROCESS I CAN
GIVE YOU.
A LOT OF INFORMATION KNOWING
CERTAINLY UPDATE YOU BY MAY
REVISE SO.
A LOT MORE THAN A YEAR AGO WE
UNDERTOOK A PROCESS.
TO.
CENTRALIZE ALL OF THESE
APPLICATIONS INTO HEADQUARTERS
THEY USED TO BE PROCESSED.
IN OUR FOURTEEN DISTRICT
OFFICES AND ONE OF THE.
ME DOWNSIDES OF THAT WAS
INCONSISTENCIES AND APPROVAL OF
APPLICATIONS AND AND PROVIDERS
THAT ARE STATEWIDE. FACING
INCONSISTENCIES AND WE WE KNEW.
.
ON OUR OWN IN AND AND FROM A
CONSULTANT'S RECOMMENDATION THAT
REALLY CENTRALIZING THAT PROCESS
WITHIN SACRAMENTO WAS THE WAY TO
GO.
IN THE PROCESS OF BEGINNING THAT
WE UNDER ESTIMATED THE WORKLOAD
THAT THAT WAS GOING TO REQUIRE
SO WEAK KNOWLEDGE THAT THERE'S
BEEN AND IS CURRENTLY AT THIS
MOMENT A SIGNIFICANT. BACKLOG IN
TURNING AROUND THESE
APPLICATIONS WE'VE TAKEN
UNDERTAKEN MANY STEPS TO IMPROVE
THIS PROCESS INCLUDING.
REORGANIZING THAT UNITS SO THAT
WE HAVE.
.
WORKERS THAT ARE TRAINED AND
SPECIALIZED IN EACH FACILITY
TYPE OF APPLICATION SO THEY CAN
PROCESS THE MORE EFFECTIVELYAND
EFFICIENTLY REPAIRED ADDITIONAL
SUPERVISORS WE'VE HIRED.
MANY ADDITIONAL STAFF INCLUDING
RIGHT NOW WE'RE IN THE PROCESS
OF FIRING THIRTY LIMITED TERM
STAFF TO TRY TO BRING THAT
BACKLOG DOWN. WE HAVE DEVELOPED
WE ARE IN THE PROCESS OF
DEVELOPING. AUTOMATED
APPLICATION PROCESS SEIZE RITUAL
UP HAVE GREAT BENEFIT OVER THE
LONG TERM AND WE'VE BEGUN WITH
SKILLED NURSING FACILITIES AND
OTHER FACILITIES THAT. FILL OUT
THE SAME FORMS AND THOSE FORMS.
WILL GO LIVE WE HOPE SOMETIME
IN THE NEXT MONTH SO THAT SHOULD
IMPROVE THE PROCESSING TIME AS
WELL THIS IS ANOTHER AREA
MISSION AS WITH THE PROFESSIONAL
CERTIFICATION BRANCH. WE MONITOR
OUR.
INPUT OUTPUT AND TRANSFER
WEEKLY AND THERE WERE SOME
COMMENTS ALONG THE WAY FROM
VARIOUS STAKEHOLDERS ABOUT.
WANTING TO SEE PERFORMANCE
METRICS IN THAT AREA WE ARE.
WE HAVE DEVELOPED PERFORMANCE
METRICS THAT ARE BROKEN DOWN YOU
CAN YOU THERE BE.
THEY'RE THEY'RE NOT LIFE YET
WE'RE STILL WORKING ON CLEANING
UP THE DATA THEYSHOULD BE LIVE
VERY SOON.
AND YOU WOULD BE ABLE TO PICK
BY ANY PER.
APPLICATION TYPE FACILITY TIBOR
APPLICATION WITH THERE'S A
CHANGE OF NAME A CHAIN OF
OWNERSHIP FOR GENERAL ACUTE CARE
HOSPITAL SKILLED NURSING
FACILITY.
ANY CONSUMER ANY INTERESTED
PERSON WOULD BE ABLE TO GO IN
REAL TIME CHECK THE BOXES WHAT
THEY'RE INTERESTED IN AND GET
DATA ON WHAT OUR PERFORMANCES SO
THAT THAT. ANYONE CAN MONITOR
OUR PERFORMANCE IMPROVEMENTS
THEIR MAPS QUITE ENCOURAGING I
BELIEVE IT'S GOOD GOVERNANCE TO
ENSURE THAT WERE BEING.
FIDUCIARY THE RESPONSIBLE TO
TAXPAYERS AND TO THE FACILITIES
THAT ARE CONTRIBUTING TO THAT
SO I JUST WANTED TO MAKE SURE
THAT BY ME REVISE WE'D HAVE A
PLAN IT LOOKING FORWARD.
WITH THAT ASSET WAS RECOMMENDED
NO ACTION ON THIS ITEM WILL HOLD
IT OPEN AND MOVE ON TO ISSUE
FORTY.
SINCE OUR ISSUE FOURTEEN OTHER
.
YUGOSLAV ARMY IF IT'S HIDDEN YOU
CAN.
MY.
THE STORE WITH THE DEPARTMENT OF
PUBLIC HEALTH IF WE MAY AND THEN
WE'LL PROCED.
THEY WANT TO PROVIDE A QUICK
SUMMARY OF THE LA COUNTY BUDGET
REQUESTING AN OVERVIEW OF THE
SUPPLEMENTAL FEE AND IF YOU'D
LIKE AT THAT TIME I CAN ADDRESS
SOME OF THE COMMITTEE QUESTIONS.
BUT HOW MUCH HOW MUCH I DO AT
THAT POINT.
SO FOR THE LA COUNTY BUDGET
REQUESTS WE ARE REQUESTING AN
ADDITIONAL ONE POINT NINE
MILLION DOLLARS FROM THE STATE.
OF THE STATE PART OF PUBLIC
HEALTH LICENSE IN CERTIFICATION
PROGRAM FUND.
THIS'LL ACTUALLY FUND A TWO
POINT SEVEN MILLION DOLLAR
INCREASE TO THE CONTRACTS BUDGET
BECAUSE THERE WAS AN EIGHT
HUNDRED THOUSAND DOLLAR BASELINE
ADJUSTMENT THAT WAS BUILT INTO
LAST YEAR'S PCP. THAT AND ALSO
INCREASED THE LA COUNTY CONTRACT
BUDGET LEAVE AT THAT POINT BY
ONE POINT ONE MILLION DOLLARS SO
THE OVERALL INCREASE YOUR YEAR
FOR LA COUNTY IS ACTUALLY TWO
POINT SEVEN WE'RE JUST ASKING
FOR THE ONE POINT NINE MILLION
DOLLARS IN ADDITIONAL AUTHORITY.
TO FUND CHANGES TO THE INDIRECT
COST RATE. SALARIES AND
BENEFITS.
ADDITIONALLY WE'RE PROPOSING A
SUPPLEMENTAL LICENSE FEE ON LA
COUNTY FACILITIES. AND
ESSENTIALLY WHAT THIS FEE IS TO
DO IS TO OFFSET THE HIGHER COSTS
ASSOCIATED WITH THE PERSONNEL
AND.
AND LA COUNTY IT'S THE
DIFFERENCE BETWEEN WHAT IT WOULD
HAVE COST THE STATE TO DO THE
WORK AT STATE SALARIES COMPARED
WITH WHAT IT DOES COST THE
STATE.
TO PAY FOR THE LA COUNTY
CONTRACT AND SO THIS IS SO THAT
FACILITIES OUTSIDE OF LA COUNTY
NO LONGER BEAR A PORTION OF THE
HIGHER PERSONNEL COSTS
ASSOCIATED WITH THE LA COUNTY
CONTRACT.
THANK YOU MISTER CHAIR AND.
MEMBERS OF THE COMMITTEE. MY
NAME IS ANGELO BOLOGNA I'M THE
DEPUTY DIRECTOR FOR HEALTH
PROTECTION FOR LA COUNTY.
DEPARTMENT OF PUBLIC HEALTH.
WITH ME HERE TODAY IS A MARK OR
ON A SEE WHO IS THE. DIVISION
HEAD FOR THE HEALTH FACILITIES
INSPECTION DIVISION IN LOS
ANGELES COUNTY.
I GOT A VERY BRIEF LESS THAN
THREE MINUTES STATEMENT I'M
GONNA READ.
THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH UNDER LICENSING
AND CERTIFICATION PROGRAM.
CONTRACTS WITH LA COUNTY TO
PERFORM FEDERAL CERTIFICATION OF
LOCAL HEALTH CARE FACILITIES.
AND TO INVESTIGATE COMPLAINTS
AND FACILITY REPORTED INCIDENTS
WE ARE CURRENTLY IN THE FINAL
YEAR OF A THREE YEAR CONTRACT.
THIS IS A THREE YEAR CONTRACT
THAT SORT OF ITS BEEN REPEATING
ITSELF FOR SEVERAL DECADES.
THAT THE LA COUNTY'S BEEN
INVOLVED IN THIS PROGRAM.
FIRST THE COUNTY DOES SUPPORT
AND THANK THE GOVERNOR FOR THE
PROPOSAL TO EXTEND THE CONTRACT
FOR AN ADDITIONAL YEAR.
THROUGH FY EIGHTEEN NINETEEN.
AND TO INCREASE OUR FUNDING BY
ONE POINT NINE MILLION.
HOWEVER THIS AMOUNT IS
INSUFFICIENT TO FULLY FUND THE
CONTRACT.
AND THE COUNTY IS REQUESTING AN
ADDITIONAL ONE POINT NINE
MILLION FOR YEAR FOR.
A CLOSE THE DEFICIT.
AND TO COVER THE COST OF
DELIVERING THESE CRUCIAL
SERVICES IN LOS ANGELES COUNTY.
AS THE SUBCOMMITTEE MAY RECALL
FOUR YEARS AGO THERE WERE A
SERIES OF NEWS REPORTS AND
AUDITS.
WHICH UNCOVERED POOR PERFORMANCE
BY LA COUNTY. AND QUITE FRANKLY
BY POOR PERFORMANCE AND
MISMANAGEMENT THE PROGRAM
THROUGHOUT THE STATE.
IN LA COUNTY WE DISCOVERED THAT
THE HEART OF THIS PROGRAM OR
THIS PROBLEM. WAS THE CHRONIC
UNDERFUNDING OF THE PROGRAM.
WHILE LA COUNTY WAS GIVEN THIRTY
THREE PERCENT OF THE STATE'S
WORKLOAD WE RECEIVED
APPROXIMATELY FIFTEEN PERCENT.
OF THE FUNDING.
THE UNDERFUNDING RESULTED IN A
BACKLOG OF PENDING COMPLAINTS
AND FACILITY REPORTED INCIDENTS
THAT REQUIRED RESOLUTION.
IN TWO THOUSAND FIFTEEN SIXTEEN
WE WORKED WITH THE
ADMINISTRATION AND THE
LEGISLATURE. AND IT ENTERED INTO
A NEW THREE YEAR CONTRACT THAT
INCREASED OUR FUNDING AND TIED
IT TO A DEFINED WORK PLAN.
FOR EACH YEAR OF THE CONTRACT.
LA COUNTY INCREASE THE NUMBER OF
POSITIONS IN THE PROGRAM FROM A
HUNDRED AND FIFTY ONE.
TO TWO HUNDRED AND TWENTY FOUR.
AND WE'RE VERY PROUD TO SAY THAT
THE ADDITIONAL INVESTMENT IN LA
COUNTY HAS PRODUCED VERY GOOD
RESULTS.
HELLO COUNTY MET IN IN SOME
CASES EXCEEDED OUR CONTRACTUAL
OBLIGATIONS IN YEARS ONE AND
TWO.
AND WE ARE ON TRACK TO DO THE
SAME IN YEAR THREE.
IN THE FIRST YEAR OF THE
CONTRACT WE RECRUITED AND HIRED
SEVENTY FIVE NEW STAFF.
WHICH THEN AS YOU KNOW
UNDERGOES PAY FOR BOTH FEDERAL
AND STATE OF TRAINING IN ORDER
TO BECOME PRODUCTIVE THIS
TRAINING TAKES APPROXIMATELY
TWELVE MONTHS TO COMPLETE.
THE COUNTIES VACANCY RATE IS
CURRENTLY NINE POINT FOUR
PERCENT.
AND OUR STAFF TURNOVER RATE IS
NINE POINT ONE PERCENT.
VERSES THE STATE'S TURNOVER RATE
OF NEARLY FIFTEEN PERCENT.
LA COUNTY HAS PERFORMED THIS
WORK ON BEHALF OF THE STATE
SINCE THE NINETEEN SIXTIES AND
FACT WE REMAIN THE ONLY COUNTY
IN THE UNITED STATES.
THE DOES THIS TYPE OF WORK IN
EVERY OTHER JURISDICTION OF THE
COUNTRY THE PROGRAM IS RUN
EXCLUSIVELY BY THE STATE.
LA COUNTY IS COMMITTED TO MAKING
THIS PROGRAM THE MOST EFFECTIVE
IN THE NATION.
AND THE STRENGTH OF OUR
COMMITMENT IS ALIGNED WITH
UNIQUE VULNERABILITY OF PATIENTS
AND RESIDENTS.
THAT ARE WITHIN THEIR OF HEALTH
CARE FACILITY SETTING.
EFFORTS TO ENSURE THEIR SAFETY
DEMAND SUFFICIENTLY STAFF TIMELY
AND EFFECTIVE INSPECTIONS.
WE ARE THEREFORE REQUESTING THIS
ADDITIONAL ONE POINT NINE
MILLION IN FY THE BUDGET YEAR.
TO ADEQUATELY FUND THE
CONTRACTED SERVICES THE PROTECT
THE POPULATION.
THANK YOU FOR YOUR CONSIDERATION
OF OUR REQUEST WE ARE HAPPY TO
ANSWER ANY QUESTIONS.
THANK YOU DEPARTMENT OF FINANCE
HELLO.
SONYA PARTICULARLY.
WE TOOK A LOOK AT THE DIFFERING
COST ESTIMATES FROM BOTH THE
DEPARTMENT AND LA COUNTY AND. IT
LOOKS LIKE THE DIFFERENCE THE
ONE POINT NINE MILLION
DIFFERENCE IS REALLY THE RESULT
OF TWO FACTORS TO SORT OF
TECHNICAL FACTORS ONE IS A
DIFFERENCE IN WHICH INDIRECT
COSTS TREAT THEIR EACH USING AND
ONE HAS TO DO WITH.
ASSUMPTIONS ABOUT STAFFING
VACANCIES AND THE ASSOCIATED
SALARIES.
WE WOULD NOTE THAT MOST OF THE
FACTORS THAT GO INTO.
COMING UP WITH THE LA COUNTY
ESTIMATE ARE REALLY BASED ON
FACTORS THAT ARE SPECIFIC TO LA
COUNTY SUCH AS EMPLOYEE
COMPENSATION DUE TO COLLECTIVE
BARGAINING I'M THE EMPLOYEE
BENEFITS RATE.
AND ALSO THE FUNCTIONAL HOURS.
PER FULL TIME POSITION.
WE ALSO NOTE THAT IN THE
PREVIOUS THREE YEARS OF THIS
CURRENT CONTRACT WHICH THEY HOPE
TO EXTEND.
THE.
DEPARTMENT OF PUBLIC HEALTH
USED THE INDIRECT COST STREET
THAT WAS APPROVED BY THE LA
COUNTY AUDITOR CONTROLLER.
SO FOR THESE REASONS WE WOULD
RECOMMEND GOING WITH THE LA
COUNTY AUDITOR CONTROLLER
APPROVED INDIRECT COST STREET
WHICH WOULD REQUIRE AN AN
ADDITIONAL AUGMENTATION OF NINE
HUNDRED THOUSAND ABOVE WHAT THE
DEPARTMENT HAS REQUESTED FOR THE
CONTRACT.
WE ALSO WOULD RECOMMEND.
APPROVAL OF THE SUPPLEMENTAL
LICENSE FEE IN LA COUNTY.
AND WE THINK THIS GUY IS BETTER
ALIGNS THE FUNDING WITH THE.
COSTS ESOS THE REGULATORY COSTS.
AND WITH THE THE FACILITIES
THAT ARE BENEFITING FROM THAT
REGULATION.
IF THE LEGISLATURE WERE TO ADOPT
OUR PROPOSAL.
IT MAY REQUIRE THE DEPARTMENT
TO.
TAKE A LOOK AT THE SUPPLEMENTAL
FEES THAT THEY'VE PROPOSED FOR
LA COUNTY TO SEE IF THERE WOULD
BE ANY ADJUSTMENT NEEDED.
THANK YOU VERY MUCH.
AT THIS TIME WILL TAKE PUBLIC
COMMENT ON ISSUE FORTY.
A GOOD EVENING. MY NAME IS TIED
JONES AND I'M HEALTH FACILITIES
EVALUATOR NURSE WITH LA COUNTY
AND ALSO AT SEIU LOCAL SEVEN TWO
AND NUMBER.
AND PRIOR TO BECOMING AN
EVALUATOR I PRACTICE AS A
REGISTERED NURSE. AND THAT
DIFFERENT HEALTH CARE SETTINGS
GERIATRICS IN PEDIATRICS.
AND.
DURING THAT EXPERIENCE I WAS
COMPELLED TO CALL TO ATTENTION
AREAS THAT NEED IMPROVEMENT.
WHERE DEFICIENT PRACTICES
EXISTED?
AND I SAW IT AS AN INJUSTICE TO
OUR PATIENTS AND THAT WE SERVED
BECAUSE OF THESE DEFICIENT
PRACTICES.
I'M SORRY CENTER TODAY ISN'T
EVALUATOR NURSE AND COMMITTED TO
PROVIDE CARE TO OUR PATIENTS AND
HEALTHCARE FACILITIES.
BY ENSURING THAT FACILITIES
MEET THE STANDARDS SET BY
FEDERAL LAW AND FEDERAL STATE
AND LOCAL GOVERNMENTS.
AND TO MEET THE INDIVIDUAL NEEDS
OF OUR PATIENTS.
AND IF IF FACILITIES PROVIDE
SUBSTANDARD CARE AND THEY PUT
PATIENTS LIVES AT RISK.
AND IT MAY CAUSE THEM
SIGNIFICANT HARM.
THIS TIME CAN BE THE RESULT OF A
FIST STILL EFFORT MILLER.
THE FACILITIES FAILURE TO
PROTECT OUR CLIENTELE FROM ABUSE
AND NEGLECT.
AS WELL AS FROM THE PROVISION OF
SOME SUB STANDARD QUALITY OF
CARE.
I HOPE FACILITIES ACCOUNTABLE BY
WRITING DEFICIENCIES AND
CITATIONS
SO WE MAY IMPROVE HOW THEY
DELIVER CARE TO AYE CLIENTELE.
AND ULTIMATELY PROVIDE SAFE
INCOMPETENT CARE TO THE PEOPLE
OF CALIFORNIA.
WE'VE MADE IMPROVEMENT
IMPROVEMENTS IN LACOUNTY OVER
THE LAST SEVERAL YEARS.
AND LEGISLATURE HAS TAKEN ACTION
TO ADDRESS HOW SEVERELY
UNDERFUNDED WE WERE.
WE HAVE MET OR EXCEEDED OUR
OUTCOMES IN OUR AREAS AND HAVE
BEEN CONTRACT THAT WE'VE BEEN
CONTRACTED TO PERFORM.
THAT WE BELIEVE THAT SUCCESS
WE'VE HAD IN RECRUITMENT
RETENTION AND PERFORMANCE
HAVE SERVED LA COUNTY RESIDENTS
TO MAINTAIN THE QUALITY OF THE
PROGRAM.
HOWEVER LOS ANGELES COUNTY IS
STILL NOT CONTRACTED BY THE
STATE TO PERFORM ALL THE WORK
AND I COUNTY.
AND IT BREAKS OUR HEARTS WHEN
THERE IS NOT A STATE PLAN TO
ADDRESS THE WORK THAT HAS NOT
BEEN PERFORMED.
WE KNOW LIVES ARE AT RISK.
THE PEOPLE OF CALIFORNIA AND
THEY HAVE THE RIGHT TO SAVE
INCOMPETENT OF CARE SERVICES AND
HEALTHCARE FACILITIES.
LET'S WORK TOGETHER TO FIND A
SOLUTION TO ADEQUATELY STAFFED
LICENSING AND CERTIFICATION
PROGRAM.
AND TO SHARE THE LESSONS LEARNED
THROUGH THE LAST FEW YEARS OF
INVESTMENT.
AS MORE CHANGES REQUIRED TO
BETTER SERVE AND PROTECT THE
PEOPLE IN OUR GREAT STATE.
I RESPECTFULLY ASK THE
LEGISLATURE AND ADMINISTRATION.
TO LOOK AT THE ROOT OF THE
PROBLEM. AND TO HELP GET US ON
THE RIGHT TRACK TO IMPROVE THE
PROGRAM THAT PROVIDES THE
CRUCIAL SERVICES REQUIRE.
TO ADVOCATE FOR THE MOST
VULNERABLE VULNERABLE MEMBERS I
COMMUNITIES ESPECIALLY THOSE.
WHO CAN SPEAK FOR THEMSELVES?
THANK YOU.
JENNIFER SENATOR MATH THE
CALIFORNIA ASSOCIATION HOPE
FACILITIES JUST WANT TO POINT
OUT IN THAT MEDIUM ACTUALLY
PROVIDED A CHART THAT'S IN THE
ANALYSIS.
.
IT JUST TO POINT OUT SINCE
TWENTY FOURTEEN LICENSE FEES
HAVE BEEN INCREASED THINK ALMOST
UPWARDS OF EIGHTY PERCENT FOR
FACILITIES SO.
TO AGAIN COME BACK THIS YEAR
AND ASK AGAIN FOR AN INCREASE IN
OUR LICENSING FEES. MEAN HAS AN
IMPACT ON THE REVENUE THAT A
FACILITY HAS IF THEY'RE
SPENDING.
YOU KNOW CONTINUING TO SPENDING
AN ARM EXERTED AMOUNT OF MONEY
ON ON LICENSING FEES WE WANT TO
SUPPORT THE DEPARTMENT. WE
GENERALLY IN THE PAST HAVE NOT
OPPOSED INCREASES IN LICENSING
FEES.
OBVIOUSLY WANT TO SUPPORT ONLY
COUNTIES EFFORTS I'M JUST I
THINK WE SHOULD NOT TAKE THIS
TYPE OF REQUEST LATELY.
WE NEED TO LOOK AT WHAT OF THE
PERFORMANCE MEASURES ATTACHED TO
THIS WATER THE.
OPTIONS AVAILABLE FOR THE STATE
TO ACTUALLY PROVIDE THEM RIGHT
FUNDING TO LA COUNTY AND.
AND MAYBE PUT LESS BURDEN ON
ADDITIONAL LICENSING FEES FOR
FACILITIES SO JUST WANT TO POINT
OUT HOW HOW MUCH THEY HAVE BEEN
INCREASED IN THE LAST YEAR'S
IT'S IT'S PRETTY.
PRETTY SIGNIFICANT.
Q..
BARBARA GLAZER WITH THE
CALIFORNIA HOSPITAL ASSOCIATION
MY COMMENTS ARE SIMILAR TO ON
JENNIFER'S FROM CALF.
ON BUT FOR HOSPITALS IT'S A
LITTLE BIT DIFFERENT FIRST OF
ALL IT'S NOT CLEAR TO US WHETHER
WE REALLY KNOW.
ON EXACTLY WHAT THIS YEAR'S
PROPOSAL WILL END UP BEING IT
SOUNDS LIKE THERE'S SOME
DIFFERENCES OF OPINION.
BUT FOR HOSPITALS ARE FEES ARE
BEING RAISED IN THE LA COUNTY
THE PROPOSAL'S TRACE THEM BY
FIFTY DOLLARS PER BED.
FOR THE HOSPITALS AND IT'S NOT
CLEAR TO US WHY THIS IS
NECESSARY BECAUSE SO MUCH WITH
THE WORKLOAD.
IS NOT DONE BY THE LA COUNTY IN
THE HOSPITAL'S MOST OF IT IS
DONE BY.
THE REGIONAL STAFF OF CTP H. SO
WE DO WANT TO BETTER UNDERSTAND
HOW THE INCREASED HOSPITALS WE
DO QUESTION IT. AND THEN WE ALSO
QUESTION ON.
HOW MUCH?
AND LOOK LOOK LOOKING DOWN A
YEAR OR TWO FROM NOW HOW MUCH
THE ENTIRE WORKLOAD WILL END UP
COSTING IN LA COUNTY BECAUSE
SURELY THAT WILL RAISE FEES
AGAIN. SO THANK YOU FOR
LISTENING.
THANK YOU.
WITH THAT WILL BRING IT BACK TO
THE DYESS TWENTY QUESTIONS WE
MAY HAVE.
IT SEEMS LIKE THIS BUDGET
PROPOSAL NEEDS A BIT MORE WORK
TO MAKE SURE WE GET A TOTALITY
AND A CLEAR PICTURE AND SO I
WOULD ASK THAT WE. WORK WITH OUR
STAFF TO GET A BETTER SENSE BY
MAY REVISE.
I.
AM SUPPORTIVE IN PRINCIPLE OF.
.
TRYING TO MAKE SURE THAT LA
COUNTY IS ADDRESSING THE ISSUE
BEFORE US BUT WANTS TO MAKE SURE
THAT WE'VE SEEN AROUND THIS
ISSUE THAT WE UNDERSTAND. WHAT
WILL HAPPEN OVER THE NEXT COMING
YEARS AND?
CAN PREPARE FOR THAT AS WELL.
SO WITH THAT WE WILL HOLD THAT
THIS ITEM OPEN AND THAT WILL
CONCLUDE TODAY'S HEARING.
THANK YOU