WE'RE AWAITING ANOTHER MEMBER TO
BECOME PRESIDENT BEFORE WE BEGIN
TODAY'S MEETING BUT I WANTED TO
MAKE AN ANNOUNCEMENT THAT YOU
MAY NOTICE IN YOUR AGENDA THAT
THE DATE PAST A CERTAIN ISSUE IS
FROM LAST YEAR.
PLEASE ACCEPT OUR APOLOGIES FOR
THAT IT IS INTENDED TO BE MARCH
TWELFTH TWO THOUSAND EIGHTEEN
ALL DAY TODAY.
REGARDLESS OF WHAT'S ON THE TOP
OF THE AGENDA
THIS WILL BEGIN TODAY'S FOURTH
HEARING OF SUB ONE ON MARCH
TWELFTH TWENTY EIGHTEEN. IF I
CAN I'D LIKE TO ESTABLISH A
QUORUM.
ARAMBULA. HERE.
HARPER PRESENT.
MATHIS.
RUBIO HERE WOULD.
OUT OF DIFFERENCE TO THEM
MEMBERS WE ARE GOING TO TAKE A.
.
UP OUR ASSEMBLY MEMBER WHOSE
BIRTHDAY IT IS HERE TODAY FIRST
WHEN HE COMES.
FOLLOWED BY ISSUE ELEVEN SO WE
WILL TAKE ISSUE.
CORRECT ISSUE TEN ISSUE ELEVEN.
BUT UNTIL THAT POINT WE MAY AS
WELL BEGIN WITH ISSUE ONE.
WE HAVE THE FIRST PANEL COME
FORWARD PLEASE
.
I THINK GOOD AFTERNOON DOCTOR
CHAIRPERSON.
MEMBERS.
STAFF ON MY NAME IS JIM GREEN
DEPUTY DIRECTOR.
OF THE CENTER FOR HEALTH
STATISTICS INFORMATICS FOR THE
DEPARTMENT PUBLIC HEALTH.
I'M ALEX HOT OF FISCAL MANAGER
FOR THE CENTER FOR HEALTH
STATISTICS.
THE BACKGROUND ON THE CENTER.
THE CENTER FOR HEALTH STATISTICS
INFORMATICS IS RESPONSIBLE FOR
DEPARTMENT WIDE INITIATIVES TO
IMPROVE THE EFFECTIVENESS.
OF THE CALIFORNIA DEPARTMENT
PUBLIC HEALTH WORK THROUGH
BETTER HEALTH INFORMATION
SYSTEMS.
INCREASED APPLICATION.
OF EPIDEMIOLOGIC METHODS OF
ANALYSES
STRONG LIES OWNS WITH PUBLIC
HEALTH ORGANIZATIONS AND SCHOOLS
OF PUBLIC HEALTH.
AND EFFECTIVE PARTNERSHIPS WITH
LOCAL HEALTH AGENCIES AND
PROFESSIONALS.
THE CENTERS MADE UP OF THE
FOLLOWING FIVE BRANCHES.
THE VITAL RECORDS REGISTRATION
BRANCH.
WHICH ENSURES THE TIMELY ACT
REGISTRATION OF ALL VITAL EVENTS
OCCURRING IN CALIFORNIA.
ANNUALLY CALIFORNIA REGISTERS
APPROXIMATELY FIVE EARNED FORTY
THOUSAND PURSE.
PARTIALLY TORN FORTY THOUSAND
DEATHS MORE THAN TORRENT TEN
THOUSAND MARRIAGES.
AND MORE THAN FORTY THOUSAND
AMENDMENTS.
THE VITAL RECORDS REGISTRATION
BRANCHES WELL WORKED CLOSELY
WITH THE LOCAL REGISTRAR'S.
COUNTY CORKS RECORDERS HOSPITALS
FUNERAL HOMES.
AND CORNERS.
THE SECOND BRANCH IS THE VITAL
RECORDS ISSUANCE AND
PRESERVATION BRANCH WHICH WORKS
TO ENSURE TIMELY. AND ACCURATE
ISSUANCE OF VITAL EVENT RECORDS
REGISTERING CALIFORNIA.
IN ADDITION TO THE PRESERVATION
OF ALL VITAL RECORDS HELD SINCE
NINETEEN OH FIVE IN STATE.
THE PUBLIC HEALTH POLICY
RESEARCH BRANCH DEVELOPS IN
VALUE ITS POLICY TO SUPPORT
PUBLIC HEALTH PROGRAMS.
SUPPORT STATE REGISTRAR DATA
MANAGEMENT AND REPORTING
REQUIREMENTS.
AND ADMINISTERS.
THE CENTER FOR HEALTH STATISTICS
INFORMATICS LOCAL SERVICE
PROGRAMS.
THE PUBLIC HEALTH INFORMATICS
BRANCH.
DETERMINES REQUIREMENTS FOR
STATE REGISTRAR SYSTEMS AND
FUNCTIONS INCLUDING THE VITAL
RECORDS REGISTRATION.
SYSTEMS AND THE DATA MAINTENANCE
WHAT NEEDS OF PUBLIC HEALTH
POLICY AND RESEARCH BRANCH.
THE OPERATION BRANCH MEETS AND
SUPPORTS ALL THE CENTERS
BUSINESS FUNCTIONS WHO
PROVISIONAL ACCURATE.
AND TIMELY ADMINISTRATIVE
SERVICES.
MOVE ON TO THE PROPOSAL YES
PLEASE.
SO WE'RE CURRENTLY ON ISSUE ONE
DEPARTMENT OF FINANCE A LEO. ANY
COMMENTS ON ISSUE ONE. ANY
PUBLIC COMMENT ON ISSUE ONE.
SEEING NONE ALL BRING IT UP TO
THE DYESS FOR ANY COMMENTS WE
MAY HAVE.
SEEING NONE WE WILL HOLD THIS
ITEM OPEN AND MOVE ON THE ISSUE
TO.
THANK YOU.
THE CENTER FOR HEALTH STATISTICS
INFORMATICS REQUEST EXPENDITURE
AUTHORITY HAVE SEVEN OR NINETY
SIX THOUSAND FISCAL YEARS TWO
THOUSAND EIGHTEEN NINETEEN.
TWO THOUSAND NINETEEN TWENTY.
AND TWENTY TWENTY ONE TWENTY
TWENTY THREE TWENTY TWENTY ONE
FROM THE HEALTH STATISTICS
SPECIAL FUND.
TO MEET THE DEMAND FOR AN
INCREASED NUMBER OF BIRTH
CERTIFICATE REQUESTS DUE TO THE
REAL ID ACT.
ALSO KNOWS THE FEDERAL FEDERALLY
COMPLIANT DRIVER'S LICENSE
IDENTIFICATION CARD ACT.
SHE PICKED PROPOSES THREE DIRECT
FOR POSITIONS FOR THIS WORKLOAD.
CITY PITCH ALSO REQUEST BUDGET
BILL LANGUAGE AUTHORIZE UP TO
ONE POINT FIVE NINE MILLION.
FROM THE HEALTH STATISTICS
SPECIAL FUND IF NECESSARY.
TO SUPPORT POSSIBLE ADDITIONAL
WORKLOAD TEMPERAMENT THE ACT.
DEPARTMENT OF FINANCE ILIO
INCUMBENTS.
ANY PUBLIC COMMENTS ON ISSUE TO
AT THIS TIME.
SEEING NONE I BRING IT UP TO THE
DYESS FOR ANY COMMENTS WE MAY
HAVE.
SEEING NONE WE WILL HOLD ISSUE
TO OPEN AND MOVE ON TO ISSUE
THREE.
THANK YOU FOR YOUR PRESENTATION
THANK YOU THINK
.
HELLO.
I COUNTY MITCHELL AND THE DEPUTY
DIRECTOR OF THE CENTER FOR
FAMILY HEALTH AND A HAPPIER
TODAY LESLIE GAFFNEY WHO'S THE
ASSISTANT DEPUTY DIRECTOR. I%
WANTED HER TO BE HERE BECAUSE
SHE DOES OVERSEAS ALMOST ALL THE
FISCAL. AND ASSUMPTIONS
PREPARATIONS THAT YOU'VE BEEN
REVEALING BUT I WANTED TO BE
HERE INCOME THEY GIVE YOU A
LITTLE OVERVIEW. THEM ALL ROTATE
EACH OF MY DIVISION CHIEFS AND
HERE HOT TO GET MORE DETAILED
REPORTS.
SO I'D THIS THE CENTER FOR
FAMILY HEALTH HAS THREE MAJOR
DIVISIONS ON THE GENETICS OF THE
IT SCREENING PROGRAM. IS
ACTUALLY LOCATED IN RICHMOND.
FOR THE MOST PART THEY DELIVER
HEALTHCARE SERVICE THEY DO
MEDICAL BILLING FOR SERVICES FOR
PRENATAL SCREENING. AND THEN
THEY COLLECT FUNDS FROM
HOSPITALS WHO IN TURN BILL FOR
SERVICES RELATED TO NEWBORN
SCREENING.
THE DIVISION HAS I'VE I'VE.
ACTIVITIES OTHER RELATED TO PRAY
PROVIDING LOCAL SERVICES PARENT
EDUCATION AND COUNSELING
EFFORTS.
ON THE PROVIDE CONSIDERABLE
OVERSIGHT RESPONSIBILITY FOR
ENSURING HIGH QUALITY LAB
SERVICES AND THEY MAINTAIN A BY
A BANK OF SPECIMENS OF THE
RESOURCE TO. OFFER RESEARCH TO
BETTER UNDERSTAND GENETIC
DISEASES BOTH OLD AND NEW.
THE SECOND DIVISION BOTH HERE IN
SACRAMENTO THAT'S A MATERNAL
CHILD AND ADOLESCENT HEALTH
SERVICES. ARE A DIVISION OR
ADOLESCENT HEALTH DIVISION HERE
IN SACRAMENTO. HOT RELIES ON TWO
MAJOR FUNDING SOURCES TITLE FIVE
BLOCK GRANTS.
A TITLE FIVE BLOCK FEDERAL BLOCK
GRANTS SPECIFY THAT AT LEAST THE
THIRD OF THAT MONEY MUST BE USED
TO SUPPORT CASE MANAGEMENT OF
CHILDREN WITH SPECIAL HEALTHCARE
NEEDS.
A THIRD FOR CHILD ADOLESCENT
HEALTH AND A THIRD FOR MATERNAL
HEALTH.
AND THESE TITLES BY FUNDS HAVE
TO BE ALLOCATED EVERY FIVE YEARS
BASED UPON A FIVE YEAR NEEDS. A
FIVE YEAR ON NEEDS PLAN THAT IT
DIDN'T ASSESSMENT STATEWIDE
LISTEN TO THE. ON AND AND GATHER
EVIDENCE FROM OUR LOCAL HEALTH
AGENCIES ABOUT ONE OF THE ISSUES
THAT ARE IMPORTANT TO THEM. THAT
WE DEVELOP A FIVE YEAR PLAN AND
THE FIVE YEAR PLAN HOUSE TO
ALIGN WITH WHAT THEY CALL STATE
AND NATIONAL PRIORITY ME SIR SO
WHAT'S. VERY RESTRICTIVE HIGH
LEVELS OF ACCOUNTABILITY ARE
REQUIRED.
THE SECOND MAJOR FUNDING STREAM
IS ALSO FEDERAL MONIES TO
SUPPORT OUR HOME VISITING
PROGRAM. SO THAT THE MOST
VULNERABLE GET THE SUPPORT THEY
NEED TO BE THE KIND OF PARENT
THEY'VE ALWAYS DREAMED OF.
I WE FIND THAT OUR HOME BUSY
PARTICIPANTS ALL TALK OF THIS
DREAM OF BEING A GREAT PARENT
BUT THEY'RE SCARED OF REPEATING.
MISTAKES OF THE PAST SO WE HELP
THEM TO KNOW THAT EXPERIENCE IS
NOT HAVE TO BE THEIR SOLE
TEACHER. THERE IS ANOTHER WAY
AND THEY EMBRACE THIS
OPPORTUNITY.
THE THIRD DIVISION AS THOUGH
WOMEN INFANT CHILD NUTRITION
PROGRAM.
IT'S OUR BIGGEST DIVISION YOU
KNOW WHAT WILD WICKED THAT. ONE
POINT TWO BILLION DOLLAR FEDERAL
GRANT PROGRAM WITH ALMOST TWO
MILLION ELIGIBLE PARTICIPANTS
ESTIMATED BY THE YOU FTA.
SO THIS IS THE FINANCIALLY AT A
HUGE BUSINESS ENTERPRISE CHEN
CONNECT PARTICIPANTS TO THE
RESOURCES TO SUPPORT THEIR
NUTRITIONAL WELL BEING.
AND RICK
BOB ALSO SERVES THAT WOULD LIKE
TO POINT OUT IS THE SMALL
BUSINESS OWNERS IN THE LARGE
FOOD BUSINESS OWNERS THAT HELP
TO STOCK NUTRITIOUS WICK FOOD.
AND MEAT ALL BRICK REQUIREMENTS
SO WE CARE EQUALLY ABOUT EACH OF
THESE GROUPS.
ACCESS TO HEALTHY FOOD IS A
MAJOR ENVIRONMENTAL DETERMINANTS
OF HEALTH WHIPS GOAL IS TO
INSURE ACCESS TO HIGH QUALITY
NUTRITIOUS FOODS TO HELP GET
BABIES AND CHILDREN AFTER A
GREAT START.
SO MY JOB IS THE DEPUTY DIRECTOR
IS TO WEAVE THESE THREE
DIVISIONS A VERY VERY
DIFFERENTLY BOTH FISCALLY. AND
PROGRAMMATIC LEAD TO BELIEVE
THEM TO NOT ONLY SEE HOW WE CAN
MEET CURRENT NEEDS BUT
ANTICIPATE ON OTHER FAMILY
ISSUES AS THEY AND OTHER FAMILY
CHALLENGES AS THEY ARRIVE.
SO I DON'T WANT A REPEAT THE
SUMMARY THAT'S IN YOUR BINDER I
THINK IT WAS VERY GOOD ADVICE ON
A TO GIVE YOU KIND OF A BROAD
OVERVIEW OF HOW WE'RE ORGANIZED
AND AGAIN WE CAN GO INTO MORE
DETAIL. ON IN THE OTHER PARTS OF
THE PRESENTERS.
THERE WAS ONE QUESTION THAT WAS
DIRECTED SPECIFICALLY TO ME AND
THAT WAS HOW MUCH FEDERAL
FUNDING IS AVAILABLE TO BE
MATCHED WITH ADDITIONAL STATE
FUNDING. FOR FLP.
ACTUALLY ALL OVER FEDERAL
FUNDING THAT I THAT I'VE TALKED
ABOUT ISLAM ALREADY BEEN
ALLOCATED SO WE HAVE IN A DISH
WE DON'T.
WE HELPED TO MANAGE TITLE
NINETEEN SO WE HAVE TITLE FIVE
IN THAT'S ARGUMENT ALLOCATED AND
WE HAVE TITLE NINETEEN MONEY AND
THAT'S ALREADY HELP THAT
ALLOCATED. BUT WITH ADDITIONAL
STATE FUNDING THERE WOULD BE YET
ANOTHER ALL POTENTIAL TO ON.
I'M NOT STATE FEDERAL FUND
DOLLARS WITH TITLE NINETEEN
DOLLARS BUT WE'RE CURRENTLY HAVE
ALL APART MODEL FEDERAL FUNDS
ARE ALLOCATED.
DEPARTMENT OF FINANCE ELLIOTT.
PUBLIC COMMENT ON ISSUE THREE.
SEEING NONE OF BRING IT BACK TO
THE DYESS I WANTED TO DRILL DOWN
ON THE QUESTION IF I COULD IT
SEEMS LIKE DURING RECESSION WE
CUT STATE FUNDING.
AND THAT DECREASE THE AMOUNT OF
FEDERAL MATCHING FUNDING THAT WE
WERE RECEIVING.
MY QUESTION IS IF WE WERE TO
INCREASE STATE FUNDING TO HELP
WITH THE ADOLESCENT FAMILY.
PAT LIFE PROGRAM WOULD WE BE
ABLE TO DRAW DOWN FURTHER
FEDERAL FUNDS AND IF SO AT WHAT
RATE.
AYE THINK WHAT YOU'RE REFERRING
IN PARTICULAR TO IS THE TITLE
NINETEEN DOLLARS AND SUBTITLE
NINETEEN.
WILL MATCH STATE GENERAL FUNDS
OR LOCAL STATE OR LOCAL GENERAL
FUNDS ON IF THEY'RE AVAILABLE.
ARM.
SO IF WE HAD THAT MONEY AND WE
HAD THE LOCALS WILLING TO COMMIT
RESOURCES TIME THAT WOULD BE ON.
APPROPRIATE FOR TITLE NINETEEN
WE COULD THEN SEEK ADDITIONAL
FEDERAL FUNDING.
I'M I'M TRYING TO UNDERSTAND AS
THE LEGISLATURE IF WE WERE TO
INCLUDE INCREASED FUNDING TO
THIS PROGRAM.
WOULD WE GET DOLLAR FOR DOLLAR
MATCH FROM FEDERAL FUNDS OR IS
THERE. A SPECIFIC RATE.
IT WHAT'S TURKEY ABOUT AND NOT A
LET LESLIE ANSWER TO IS THAT WE
HAVE A TOTAL POT THAT WE CAN
ALLOCATE TO THE WHOLE STATE.
AND SO WE HAVE TO BALANCE THE
NEEDS OF THE LOCAL HEALTH
JURISDICTIONS AS WELL AS BALANCE
THE NEEDS OF AFL PIECE.
SO WE HAVE IN THE PAST BEEN ABLE
TO USE TITLE NINETEEN DOLLARS TO
ENHANCE A FLP STATE GENERAL
FUNDS.
WE COULD FEASIBLY DO THAT FOR
THE FUTURE TO AND THEN IT WOULD
DEPEND ON HOW THE LOCAL HEALTH
JURISDICTIONS DEEPAK.
DECIDE TO USE THOSE DOLLARS IF
THEY'RE USING THEM WITH A HIGH
LEVEL CLINICAL PERSON LIKE IN
NURSES A SEVENTY FIVE TWENTY
FIVE.
UP REIMBURSEMENT IF IT'S JUST A
REGULAR HEALTH COMMUNITY WORKER
IT'S A FIFTY.
UNDERSTAND.
THANK YOU FOR THAT ANY FURTHER
QUESTIONS.
SEEING NONE WE WILL HOLD THIS
ITEM OPEN.
AND IF BY MAY WE'RE GOING TO
SKIP TO ISSUES TEN AND ELEVEN
SEQUENTIALLY.
BECAUSE ONE OF OUR ASSEMBLY
MEMBERS HAS HIS BIRTHDAY TODAY
ALRIGHT. SO DON'T GO AWAY
THERE'S MORE ASSEMBLY MEMBER
CELLS.
THANK YOU MISTER CHAIRMAN
MEMBERS OF THE COMMITTEE BUT
THANK YOU FOR ALLOWING ME TO
PRESENT OBVIOUSLY IT'S A BUSY
DAY TODAY AND EVERYTHING.
THAT'S GOING ON SO IN ADDITION
TO IT BEING A VERY SPECIAL DAY.
I REALLY APPRECIATE THE
COMMITTEE'S TIME AS WE MOVE
FORWARD AND THANK YOU FOR
ALLOWING ME TO PRESENT ON A
NIGHT OF AND I DO HAVE A.
SUPPORT.
ON VALLEY FEVER AND I KNOW THIS
SHERMAN YOU'RE VERY KEENLY AWARE
OF THE ISSUES THAT THAT OCCURRED
NOT ONLY IN THE VALLEY AND I
THINK I'VE SPOKEN TO EVERY
MEMBER ON THE COMMITTEE ALREADY
ABOUT. THE SEVERITY THE VALLEY
FEVER HAS THROUGHOUT THE ENTIRE
STATE WE KNOW THAT THEIR
REPORTED CASES THAT FIFTY OUT OF
THE FIFTY EIGHT COUNTIES. WE
KNOW THAT.
CDC SAYS.
ACCORDING TO THEIR ESTIMATES
THAT THERE'S A HUNDRED AND FIFTY
THOUSAND CASES EVERY YEAR THAT
DON'T EVEN GO REPORTED. A
INDIVIDUALS THAT DO HAVE.
THE DO YOU HAVE VALLEY FEVER
THERE SIXTY PERCENT OF THOSE
THAT DON'T EVEN KNOW THAT THEY
HAVE IT.
AND SO.
MISTER CHAIRMAN AS WE GO
THROUGH THE BUDGET PROCESS ONE
OF THE THINGS THAT WE ARE ONLY
STRUCK WITH WAS HOW DO WE COMBAT
THIS ISSUE.
HOW DO WE MAKE A DIFFERENCE FOR
THESE FAMILIES THAT ARE
SUFFERING?
AND I WANNA THAT WEIGHS IS TO
NOT ONLY SHOW THAT NEED BUT ALSO
TO ADDRESS THAT WITH THE
RESOURCES TO HELP TACKLE.
THIS ISSUE AND SO I BEFORE YOU
WE HAVE A BUDGET. REQUEST TO
HELP DO THAT AND THAT'S DIVIDED
UP INTO SEVERAL AREAS ONE OF
THOSE AREAS IS AND RESEARCH.
BECAUSE WE KNOW THAT THERE IS
NO CURE AND THERE IS NO VACCINE
FOR VALLEY FEVER ARE CURRENTLY
AS IT STANDS TODAY THERE ARE
EFFORTS UNDERWAY TO HELP DO
THAT.
AND FACT OF THE UNIVERSITY OF
CALIFORNIA HAS TAKEN NAB SOME OF
THOSE RESEARCH EFFORTS ALREADY.
ARE WE'D LIKE TO HELP THEM
BECAUSE THAT FUNDING IS DRIED UP
NOW AS WELL. I'M AND ALSO PUBLIC
AWARENESS YOU KNOW WHEN WE'RE
TALKING TO EACH OF OUR COUNTIES
AND I'VE BEEN TALKING COUNTIES
UP AND DOWN THE ENTIRE STATE.
IT'S LETTING PEOPLE KNOW THAT IF
THEY COULD CATCH THIS EARLY IT
MEANS A WORLD OF DIFFERENCE FOR
THEIR HEALTH. MOVING FORWARD
THINK A CATCH IT EARLY YOU KNOW
MAYBE THEY DON'T SPEND THE REST
OF THEIR ADULT WORKING LIFE ON
DISABILITY.
RIGHT A LOT OF THE WORKERS AND
FAMILIES THAT I'VE TALKED TO
THAT HAVE BEEN AFFECTED. HAVE
SAID WE WANT TO WORK AND WE WANT
TO DO THINGS THAT WE WANT TO BE
PRODUCTIVE.
AND I WISH SOMEBODY WOULD HAVE
TOLD ME I WISH I WOULD HAVE
KNOWN TO BE TESTED EARLY SO THAT
HOPEFULLY WE COULD HAVE DONE
SOMETHING ABOUT THIS.
I AM I KNOW SPOKE AT EACH OF YOU
GUYS ALSO ABOUT.
AT SEVERAL MEMBERS OF THE
LEGISLATURE THAT HAVE BEEN
TOUCHED BY VALLEY FEVER ARE
DIRECTLY.
AND SO IT'S A IT'S
WANNA IT'S AT THE SILENT
EPIDEMIC WITH THE NUMBERS THAT
WE'VE SEEN INCREASING JUST LAST
YEAR.
AND SO.
WHAT THAT YOU KNOW I
RESPECTFULLY ASK FOR THE
RESOURCES TO COMBAT OF VALLEY
FEVER YOU KNOW DOWN AND?
KERN COUNTY WE AT KERN MEDICAL
CENTER AND THAT'S ONE OF THE
FOLKS THAT WILL TESTIFY AS WE
HAVE AN ADDITIONAL ASK MYSELF
SENATOR FULLER AND SOMEONE
MEMBER FONG. VAST FOR ADDITIONAL
RESOURCES
TO GO TOWARDS VALLEY FEVER
INSTITUTE AND I'LL LET THEM TALK
A LITTLE BIT MORE ABOUT THAT AS
WELL. ARM BUT AS WE MOVE FORWARD
IT WOULD REALLY BEHOOVE US TO DO
SOMETHING FOR THESE FAMILIES AND
I REALLY APPRECIATE EACH OF YOU
TAKING THE TIME. ADVERSELY TALK
ABOUT A SOME OF THOSE ISSUES AND
TALK ABOUT HOW THIS IS AFFECTED
SOME OF THOSE FAMILIES. AND I
ARE REALLY LOOKING FORWARD
AFFORD.
TO SOME SUPPORT AS WE CONTINUE
TO MOVE FORWARD WITH THIS BUDGET
ITEM.
THINK YOU'VE DO YOU HAVE ANY
SPECIFIC WITNESSES WHO'D LIKE TO
TESTIFY YES I HAVE THAT TIM
CURLEY ON BEHALF OF THE VALLEY
CHILDREN'S HEALTH CARE AND ALSO
RUSSELL GIANT ON BEHALF OF KERN
MEDICAL CENTER CREEK.
PLEASE COME FOR.
YOU CAN TAKE A SEAT IF IT LIKE.
DO YOU MIND FIFTH.
MISTER CHAIRMAN MEMBERS OF THE
COMMITTEE MY NAME IS RUSSELL
CHAD AND I'M THE CHIEF EXECUTIVE
OFFICER OF KERN MEDICAL.
WHICH IS THE SPONSORING
ORGANIZATION FOR THE VALLEY
FEVER INSTITUTE.
I.
THE SOUTHERN SAN JOAQUIN VALLEY
IS AT THE HEART OF VALLEY FEVER.
THE SPORES GROW IN THE SOIL A
THAT'S LOCATED THERE AND IT IS A
SPREAD SIGNIFICANTLY AROUND THE
COMMUNITY.
OF COURSE WE ARE VERY SUPPORTIVE
OF GETTING ANY FUNDING THAT WE
CAN SECURE TO TREAT THE PATIENTS
I AND THE COMMUNITY IN REGARDS
TO VALLEY FEVER.
BALLOT FEVERS NOT WELL KNOWN TO
THE STATE.
BED IN OUR COMMUNITY.
IT IS PROBABLY THE SINGLE MOST
SIGNIFICANT DISEASE THAT WE
FACE.
I WILL HAVE MORE PEOPLE DIE
ABOUT FEWER THAN THE FLU
EPIDEMIC THAT GOES TO THIS YEAR.
IT IS A SIGNIFICANT EVENT AT
THE KEY ELEMENT IS VALLEY FEVER
IS NOT ALWAYS. DIAGNOSED
IMMEDIATELY A MOST OFTEN IT
PRESENTS IS PNEUMONIA HAD
INDIVIDUAL BE ON ANTIBIOTICS FOR
THREE WEEKS BEFORE THEY FINALLY
SALE MAYBE IT. IS VALLEY FEVER
AND BY THAT TIME HAS BECOME A
SIGNIFICANT DISEASE.
SO WE'VE GOT A WONDERFUL
PHYSICIANS A LOT LOT OF PATIENTS
A GREAT NEED AND WOULD ENCOURAGE
THE FINDING OF A BOTH OF THESE
PROPOSALS WILL HAVE MORE TO SAY
ON ASSEMBLYMAN SONGS.
REQUEST OF FOR THIS VALLEY
FEVER THANK YOU THANK YOU SIR.
OKAY.
GOOD AFTERNOON MISTER CHAIRMAN
AND MEMBERS OF THE COMMITTEE MY
NAME IS TIM CURLEY AND I'M
DIRECTOR OF COMMUNITY AND
GOVERNMENT RELATIONS OF VALLEY
CHILDREN'S HEALTH CARE AND
MADERA.
WERE INCURRED BY THREE HUNDRED
THIRTY BED PEDIATRIC SPECIALLY
HOSPITAL IN MADERA BUT HOW THE
HOST OF PROGRAMS AND SERVICES
THROUGHOUT.
HOW THE CENTRAL VALLEY FROM
BAKERSFIELD NORTH TO?
ACTUALLY SACRAMENTO AND I
WANTED TO JUST SHARE WITH YOU
OUR EXPERIENCE WITH RESPECT TO
VALLEY FEVER AND KIDS.
OVER THE LAST NINE YEARS VALLEY
CHILDREN'S HAS SEEN A MARKED
INCREASE IN THE NUMBER OF
CHILDREN BEING TREATED BY.
FOR VALLEY FEVER.
IN TWO THOUSAND AND TEN WE
TREATED A HUNDRED AND THIRTY
FOUR CHILDREN DIAGNOSED WITH
THIS DISEASE.
AND TWO THOUSAND AND SEVENTEEN
THAT NUMBER MORE THAN DOUBLED
WITHOUT A CHILDREN'S TREATING
THREE HUNDRED NINE CHILDREN
DIAGNOSED WITH VALLEY FEVER.
WERE FIVE MONTHS AND OUR
CURRENT FISCAL YEAR TWO THOUSAND
AND EIGHTEEN WE HAVE A CURRENT
CASELOAD OF TWO HUNDRED NINETY
FIVE CHILDREN DIAGNOSED WITH
VALLEY FEVER. SO WE'RE GOING
EASILY SURPASSED NUMBER OF
CHILDREN REPEAT RETREATED INTO
SAU AND TWO THOUSAND AND
SEVENTEEN.
ADDITIONALLY NOT ONLY ARE WE
TREATING MORE CHILDREN WERE
TREATING MORE CHILDREN FROM
ACROSS A MUCH BROADER GEOGRAPHIC
REGION.
WITH THE PATIENT POPULATION
TRADITIONALLY CENTERED IN A ROW
AND IN AROUND KERN KINGS AND
TULARE COUNTIES.
TODAY WERE SEEN AND GETTING
MORE AND MORE REFERRALS FROM
REGIONS OUTSIDE OF THAT AREA
EASILY NORTHERN SAN JOAQUIN
VALLEY FRESNO MADERA MERCED
STANISLAUS COUNTIES.
PAN OVER TO THE CENTRAL COAST SO
REALLY KIND OF NOTICING THAT
CREEP.
WELL BEYOND KIND OF THE
TRADITIONAL AREAS.
AT VALLEY CHILDREN'S OUR TEAM A
PEDIATRIC INFECTIOUS DISEASE
SPECIALISTS
A AND OTHER PROVIDERS ARE ON THE
FRONT LINES IN EFFORTS TO
PROMOTE EARLY DIAGNOSIS AND
TREATMENT A VALLEY FEVER IN
CHILDREN.
WE PROVIDE OUTPATIENT CARE
INCLUDING AT OUR BAKERSFIELD
PEDIATRIC OUTPATIENT SPECIALLY
CARE CENTER.
IN OTHER PIC A CARE CENTER IN
MADERA.
ALSO WHEN NECESSARY.
WE PROVIDE COMPREHENSIVE
INPATIENT CARE IN A HOSPITAL IN
MADERA.
IN TWO THOUSAND AND SEVENTEEN.
WE WE EXPERIENCED A TOTAL OF
ONE THOUSAND AND FORTY AND ONE
THOUSAND FOUR HUNDRED ONE
PATIENT VISITS FOR VALLEY FEVER
TREATMENT THAT INCLUDES
INPATIENT OUTPATIENT AND
EMERGENCY CARE.
IN TWO THOUSAND AND TEN THAT
NUMBER WAS FOUR HUNDRED NINETY
NINE SO IT'S ALMOST THREE TIMES.
OF WHAT WE SAW A IN TWO
THOUSAND TEN.
IN ADDITION TO THE TO THE
DIRECT%
CLINICAL CARE WE PROVIDE TO
PATIENTS WE HELP EDUCATE
COMMUNITY PROVIDERS REGARDING
HOW TO IDENTIFY SUSPECTED VALLEY
FEVER AS EARLY AS POSSIBLE.
AND WHEN AND HOW TO INITIATE
TREATMENT IN FACT
ONE OF OUR PEDIATRIC INFECTIOUS
DISEASE SPECIALIST IS GOING TO
BE CO PRESENTING WITH AN
EPIDEMIOLOGIST FROM THE KERN
COUNTY PUBLIC HEALTH DEPARTMENT.
IN EARLY APRIL TO A GROUP OF
LOCAL PEDIATRICIANS AND LOCAL
PROVIDERS TO MAKE SURE THAT
THEY'VE GOT. THE KNOWLEDGE THEY
NEED TO BE SURE TO A DIE
IDENTIFY DIAGNOSE AND GET
TREATMENT STARTED AS EARLY AS
POSSIBLE.
WE ALSO HAVE AND WILL CONTINUE
TO PARTICIPATE VALLEY FEVER
RESEARCH STUDIES.
INCLUDING A STUDY LOOKING AT.
OR ATTEMPTING TO INCREASE OUR
KNOWLEDGE AND UNDERSTANDING OF
THE CYCLE SOCIAL ISSUES THAT ARE
ASSOCIATED WITH VALLEY FEVER FOR
NOT ONLY THE CHILDREN BUT THEIR
FAMILY MEMBERS. A AND THEN ARE
ALSO LOOKING AT ANOTHER STUDY TO
IDENTIFY IN BETTER UNDERSTAND
ANY DIFFERENCES IN THE IMMUNE
SYSTEMS OF CHILDREN WITH VALLEY
FEVER. AS COMPARED TO THE IMMUNE
SYSTEMS OF CHILDREN WITHOUT A
WITHOUT VALLEY FEVER PERFECTLY
WHEN THERE'S MORE THAN ONE CHILD
IN THE HOUSE BUT ONLY ONE CHILD.
CONTRACTED VALLEY FEVER.
DESPITE OUR EFFORTS AND THE
EFFORTS OF SO MANY OTHERS A LOT
MORE NEEDS TO BE A NEEDS TO BE
DONE WE NEED TO REALLY DOUBLE
DOWN ON OUR EFFORTS TO DEVELOP A
VACCINE AND TO INVEST IN PUBLIC
EDUCATION. REGARDING SYMPTOMS
DIAGNOSIS AND EARLY TREATMENT
AND WE'RE HERE TO ASK FOR YOUR
SUPPORT FOR THE ONE MILLION
DOLLARS FOR THE PUBLIC A PATH
PUBLIC EDUCATION OUTREACH.
AND THANK YOU FOR YOUR TIME AND
I'M HAPPY TO ANSWER ANY
QUESTIONS IF THERE ARE ANY.
THANK YOU SIR
SUMMER FONG HAPPEN. INTO.
I THINK WE KILLED THAT.
SHE WAS ONE STONE I CERTAINLY OF
SUPPORTIVE OF MR UP SALAS HIS
REQUESTS FOR OUT MORE FUNDING
FOR.
.
FOR PUBLIC EDUCATION I WANT
SPECIFICALLY ADDRESS.
THE RESEARCH GRANT AT THE RIG
THAT REQUESTING A FOR THE
CURRENT AT FOR THE BIKE EVENTS%
TO OCCUR MEDICAL.
THIS IT OPPORTUNITY.
TO SEEK THREE MILLION DOLLARS
FOR RESEARCH GRANT AT THE KEY
THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH.
TO FIND OUT IF YOU WERE
TREATMENT RESEARCH AND OUTREACH
AT THE VALLEY FEVER INSTITUTE
OCCUR MEDICAL A NEW IF YOU LOOK
AT LOOK AT THE NUMBERS TWO
DECADES AGO CALIFORNIA.
AT SEVEN OR NINETEEN REPORTED
CASES ABOUT A KEEPER LOOK AT
NUMBERS TODAY THAT NUMBER HAS
SKYROCKETED RISING TO OVER FIFTY
THREE HUNDRED CASES IN TWENTY
SIXTEEN. OVER FORTY PERCENT
THOSE CASES WERE FROM KERN
COUNTY ALLOW. KERN MEDICAL HAS A
LONG HISTORY.
CARING FOR THOSE SUFFERING FROM
VALLEY FEVER AND HAS BEEN A
LEADER IN PROVIDING HIGH QUALITY
CARE FOR THOSE IMPACTED BY THIS
DISEASE. ITS DEDICATION TO
SERVING VALLEY PEOPLE PATIENTS
PROMPTED THE FOUNDING OF THE
BALLOT DIFFERENCE TO.
THE INSTITUTE IS UNIQUELY
POSITIONED PROVIDE HIGH QUALITY
CARE FOR THOSE AFFECTED BY THIS
DISEASE
IS THAT BY RENOWNED PHYSICIAN
SPECIALIZING ABOUT A FEVER
DOCTOR VOICE JOHNSON AND DOCTOR
ARE RUSSIA DIARY. HAVE DECADES
OF EXPERIENCE IN DIAGNOSING AND
TREATING VALLEY FEVER PATIENTS
THE INSTITUTE PROVIDES SEVERAL
TREATMENT OPTIONS NOT AVAILABLE
ANYWHERE ELSE IN THE WORLD AND
PATIENTS FROM ALL OVER THE STATE
AND NATION. HAVE COME TO THIS
INSTITUTE.
TO RECEIVE THE SPECIALIZED CARE
THE THREE MILLION DOLLAR FUNDING
REQUEST WILL HELP TO EXPAND THE
INSTITUTE SO THAT MORE PATIENTS
CAN ACCESS QUALITY CARE
CURRENTLY THERE ARE MORE THAN A
HUNDRED TWENTY FIVE PATIENTS
WAITING TO SEE EITHER DOCTOR
JOHNSON OR DOCTOR DARI.
THE ADDITIONAL FUNDING WILL
ALLOW THE INSTITUTE TO ESTABLISH
THE INFECTIOUS DISEASE
FELLOWSHIP PROGRAM VOTE A
REPOSITORY OF SPECIMENS THAT
WILL ENABLE ONGOING RESEARCH AND
DEVELOP EDUCATION PROGRAMS THAT
WILL RAISE AWARENESS AMONG
PHYSICIANS AND THE GENERAL
PUBLIC.
THERE WAS A GREAT NEED IN OUR
COMMUNITY AND THE STATE TO BRING
GREATER AWARENESS OF THIS
DISEASE
OTHER PEOPLE HAS AFFECTED OUR
REGION OUR FAMILIES OUR FRIENDS
HIS FORCE MADE RETIRE EARLY AND
STRANGER HEALTHCARE RESOURCES.
THIS FUNDING REQUEST WILL HELP
ALLEVIATE THE BURDEN THAT SO
MANY PATIENTS THEIR FAMILIES
FEEL WITH THE EFFECTS OF THE
STEPS LEADING DISEASE.
IT WILL HELP BUILD PARTNERSHIPS
BETWEEN STATE AND LOCAL
OFFICIALS AS WELL AS THE GREATER
MEDICAL COMMITTEE ESTATE BEFORE
THERE IS CURRENTLY NO CURE FOR
VALLEY FEVER. BUT TO HELP YOU
THROUGH OUR COLLECTIVE EFFORTS
AT WOLF WILL HELP OUR DOCTORS
RESEARCHERS AND LOCAL HEALTH
OFFICIALS A HELP AS MANY
FAMILIES AS POSSIBLE AS WE WORK
TO DEVELOP IF A VALLEY FEVER
CARE AND I KNOW THAT EVERYONE
HERE HAS BEEN A VERY VERY
FAMILIAR WITH THIS DISEASE. AND
THANK YOU FOR YOUR SUPPORT THINK
ASSEMBLY MEMBER NEXT WILL HAVE.
CEO RUSSEL JOHN
AND. THANK YOU AGAIN I'M RUSSELL
JED THE CEO KERN MEDICAL.
EXCUSE ME MISTER FUNK THAN A
GREAT JOB OUTLINING OF THE
SERVICES WE PROVIDE A POINT OUT
A COUPLEITEMS SO WE ARE THE
ONLY ACADEMIC INSTITUTE OF THAT
IS IN EXISTENCE FOCUSING SOLELY
ON BALLOT HUBER.
I IN THE WORLD A WE WORK VERY
CLOSELY WITH THE UNIVERSITY OF
ARIZONA IN TUCSON THERE IS A
QUADRANT DEVELOP FEVER THAT IS
FOUND. A IN THE DESERT OF
ARIZONA.
WE THEY'LL HAVE THE ONLY
INSTITUTO SPECIFICALLY DEDICATED
TO THIS OF THESE FUNDS WILL
EXPAND OF THOSE SERVICES.
IT WILL ALLOW US IS HE'S
MENTIONED TO INCREASE OUR
CLINICAL SPACE ALLOW PATIENTS AT
TO COME IN A MORE TIMELY BASIS.
A WEEK HAVE A MISSION THAT WE
DEFINE WITH SIX PIECE OF THAT GO
WITH OUR VALLEY FEVER INSTITUTE
THAT WE EDUCATE THE PUBLIC.
THAT WE EDUCATE OF COURSE OUR
PATIENTS AT AND THE PROVIDERS
A WE PROVIDE PATIENT CARE THAT
WE PROMOTE RESEARCH AND WE WANT
TO PREVENT A VALLEY FEVER.
OUR ARE INSTITUTE CARE FOR
PATIENTS FIRST AND FOREMOST OUR
SECOND MISSION IS TO PROMOTE
RESEARCH OF THIS GRANT WILL
ALLOW WAS TO DEVELOP A. VALLEY
FEVER REPOSITORY WHERE WE HAVE
THE MAJORITY OF THE PATIENTS
THOSE SAMPLES THAT ARE GATHERED
FROM THE PATIENTS WILL BE STORED
AT THAT REPOSITORY AND THEN
ALLOW TO BE USED AT RESEARCH.
WHERE EVER THAT RESEARCH WANTS
TO BE A PERFORMED A WE ARE
AFFILIATED WITH UCLA? A ALL OF
THE STUDIES THAT UCLA DOES THEY
GET THEIR PATIENT SAMPLES UP
FROM THE ABOUT FEWER INSTITUTE
AT AKRON MEDICAL.
EDUCATING PROVIDERS IS CRUCIAL.
EVEN WITH US IN THE HEART OF THE
VALLEY FEVER.
IT GETS MESSED PARA AT THE BIG
PRELIMINARY SIGNS
MOST OFTEN IT'S VIEWED AS
PNEUMONIA.
AND IT JUST GETS MISDIAGNOSED
WE WANT TO PROVIDE THAT
EDUCATION I TO OTHER HEALTHCARE
PROVIDERS.
I GET THE.
SOME DIAGNOSIS GET SOME
TREATMENT TO GET SOME EDUCATION
OUT OF SO PEOPLE DON'T ADVANCE A
IN THE DISEASE.
IT IS SIGNIFICANT KERN COUNTY A
WE WOULD.
DO WONDERFUL THINGS WE TAKE
CARE PATIENTS OUT WOULD INCREASE
THE OVERALL HEALTH OF OUR
COMMUNITY. AYE WITH ITS
ADDITIONAL FUNDING SO THANK YOU
FOR CONSIDERING A REQUEST LIKE
YOU VERY MUCH AND WITH THAT WE
WILL NOW TAKE PUBLIC COMMENT ON
ISSUES TEN AND ELEVEN.
SEEING NONE WILL BRING IT UP TO
THE DYESS WHEN IT COMES TO ME.
YES. IS MADE JUST A COMMENT.
AYE WHEN ASSEMBLY MEMBER SALAS
CAME TO ME AYE A I'M FROM
SOUTHERN CALIFORNIA SO LIKE
WHEAT WHY ARE YOU TALKING TO ME
ABOUT THAT I'D HAVE NO IDEA BUT
THEN WHEN HE SAW I SAW THE
STATISTICS THAT SEVEN HUNDRED
AND THIRTY EIGHT PEOPLE IN LA
COUNTY.
HAVE CONTACTED VALLEY FEVER
MANY BECAUSE THE BECOMES MORE
REAL I KNOW IT. FOR A COUNTY
LIKE LA IT'S US VERY SMALL
NUMBER BUT IF IT CAN BE
PREVENTED I THINK THAT IT'S
WORTH THE THE MONEY SO I AM IN
FULL SUPPORT OF OF YOUR REQUEST.
BUT AGAIN AND THANK YOU FOR
GIVING US THE INFORMATION I
THINK DATA SPEAKS FOR ITSELF AND
I THINK THAT'S THE APPROACH THAT
WE SHOULD TAKE AS DATA. DOES
SPEAK AND THAT'S WHAT CAUGHT MY
ATTENTION SO I'VE SIGNED ON TO
YOUR YOUR I REQUEST AS WELL BUT
I WANTED TO JUST.
ENCOURAGE. OTHER MEMBERS TO.
AGAIN WE DON'T THINK IT'S REAL
BECAUSE IF WE DON'T SEE IT IN
OUR AREA BUT WITH THE
INFORMATION GIVEN TO ME I IT
MADE IT MORE REAL SO THANK YOU.
THEM NOW AND I APPRECIATE THAT
WE KNOW IT'S A IT'S A SILENT
EPIDEMIC BECAUSE NOT EVERYBODY
KNOWS IT UNTIL YOU SEE POINT OUT
THOSE NUMBERS. AND SO REALLY DO
APPRECIATE YOUR UP YOUR SUPPORT
ESPECIALLY ON THE LEGISLATION
BUT ALSO THE BUDGET REQUEST
BECAUSE WE KNOW THIS IS AN
INVESTMENT IN CALIFORNIANS
WHETHER THEY'RE. IN YOUR
DISTRICT IN LOS ANGELES COUNTY
WHETHER THEY'RE IN THE VALLEY OR
WHETHER THEY'RE IN NORTHERN
CALIFORNIA THIS IS INVESTMENT
MAKING SURE THAT WE'RE TO DOING
EVERYTHING WE CAN. TO PROTECT
CALIFORNIANS.
SO THANK YOU.
ASSEMBLY MEMBER MATHIS.
VALLEY FEVER.
ITS JOB.
JONAS
AND WE'VE GOT TO TAKE THE STEPS
TO MOVE FORWARD AND DO THIS
RESEARCH.
.
ASSEMBLY MEMBER FONG
ASSEMBLYMEMBER SOLACE NAM.
HE HAS BEEN MY PARTNERS IN THIS.
ON THE ANY THE THREE OF US IN
THE VALLEY AND AS WELL AS DOCTOR
ARAMBULA CROWN THE DIETS.
I THINK THE FOUR OF US WE WE
ALL GET IT THE BEST.
BECAUSE WE ACTUALLY SEE IT ON A
DAY TO DAY.
HARD TO SEE OUR HOSPITALS GET
INVOLVED A SEE THE RESEARCH
GOING ON.
DOWN WITH KERN.
IT'S FANTASTIC TO SEE VALLEY
CHILDREN STEPPING UP IN THE US
ARE ALSO LOOK AT CLINICS IN VICE
CITY AS WELL.
WE'VE GOTTA DO MORE.
AND WE'VE GOT TO MAKE THE PUBLIC
AWARE.
.
YOU KNOW SO THIS MEASURE OF THIS
FUNDING.
A COUPLE MILLION DOLLARS TO DROP
IN THE BUCKET FOR THE STATE AND
IT'S A WORLD CHANGING.
SAYING NOT IS FOR THE PEOPLE IN
THE VALLEY BUT THE SIMPLE FACT
THAT THIS.
IS BASICALLY THE AT THE CENTER
OF THE ENTIRE WORLD FOR VALLEY
FEVER WE CAN FIGURE THIS OUT
HERE WE CAN STOP IT HERE.
SO THANK YOU FOR BRING IT
FORWARD IT'S GREAT TO PARTNER
WITH YOU ON IT. THAT'S GREAT TO
HAVE YOU AS PARTNERS OF WHATEVER
ABOUT THIS.
OBVIOUSLY YOU UNDERSTAND THE
DEVASTATION THAT IT REEKS
THROUGHOUT NOT ONLY OUR
COMMUNITY BUT THROUGHOUT THE
ENTIRE STATE.
YOU NOTE RESEARCH WILL GO A
LONG WAY ADDITIONAL FUNDS FOR
RESEARCH WILL WILL DO THAT. ITEM
THE OUTREACH WILL MAKE A
DIFFERENCE.
.
MR JUDD AT THE VALLEY FEVER
INSTITUTE IS IN A UNIQUE
POSITION TO OFFER A LOT OF
ASSISTANCE AND HELP AS WE CAN
CONTINUE TO COMBAT THIS. IS A
REALLY APPRECIATE YOUR SUPPORT
FOR THE BUDGET ASK.
THANK YOU.
I WILL CLOSE IF I MAY BY.
.
SAYING THAT THAT THIS HOUSE LAST
YEAR WAS HAPPY TO SUPPORT THE
BUDGET ASK AND WE MAY WANT TO
FOCUS OUR EFFORTS IF WE COULD ON
THE OTHER HOUSE TO MAKE SURE
THEY HAVE.
THE SAME AMOUNT OF APPRECIATION
THAT WE DO TO THE NECESSITY FOR
YOUR. REQUEST
FROM THE SECONDARY THING IF I
COULD IS THAT.
ANY YOU SEE RESEARCH STUDY WILL
ALSO NEED A BUDGET ASK WITHIN
SUB TO CUT AND SO WE WILL HANDLE
AND DEAL WITH THE ONE MILLION
ASK AS WELL AS ASSEMBLYMEMBER
FUNG'S ASK.
AND WE NEED TO MAKE SURE IT'S IN
THE.
WITH THAT WE WILL HOLD ISSUES
TEN AND ELEVEN OPEN FOR NOW AND
MOVE BACK TO ISSUE FOR THANK YOU
THANK YOU THANK BEEN MUCH
.
THANK YOU FOR YOUR INDULGENCE.
SO ISSUE FOR IS ARE WE PROGRAM
ESTIMATE AND CHRIS NELSON HEALTH
DIVISION CHIEF BOB WICKETS HERE
TO. PROVE THAT.
GOOD AFTERNOON.
SO THE WICK ESTIMATE WE
CONTINUE TO HAVE SUFFICIENT
FEDERAL FUNDING TO FOR A FULLY
SUPPORT THE PROGRAM THERE'S NO
IMPACT TO THE GENERAL FUND. AND
THERE ARE NO POLICY CHANGES IN
OUR ESTIMATE THAT IMPACT PROGRAM
SERVICES PUBLIC THROUGH A FEW
HIGHLIGHTS ABOUT THE NUMBERS.
THE PRIMARY FOCUS OF THE
ESTIMATE IS WHAT WE SPEND ON
FOOD DOLLAR SO OFF START THEIR
OWN WE RECEIVE FEDERAL FUNDS
FROM THE US DEPARTMENT OF
AGRICULTURE. AND REBATE FUNDS
FROM OUR CONTACTED INFANT
FORMULA MANUFACTURER WE MUST
SPEND THE REBATE FUNDS FIRST.
COST DRIVERS FOR THE PROGRAM ARM
COSTS ARE PROGRAM PARTICIPATION
AND FOOD COSTS PER PARTICIPANT.
IN THE BUDGET YEAR WE EXPECT TO
SPEND EIGHT HUNDRED NINETEEN
MILLION DOLLARS ON FOOD WHICH
INCLUDES FIVE HUNDRED EIGHTY
EIGHT MILLION DOLLARS OF FEDERAL
FUNDS AND TWO HUNDRED AND THIRTY
ONE MILLION DOLLARS FROM THE
INFANT FORMULA MANUFACTURER.
FOR A LOCAL ASSISTANCE AT TO
FIND THE LOCAL SERVICES THOSE
FUNDS ALL COME FROM THE US
DEPARTMENT AGRICULTURE AND WE
ARE ANNUAL ESTIMATE CONTINUES TO
BE THREE HUNDRED ONE MILLION
DOLLARS.
OUR STATE OPERATIONS AGAIN THIS
FEDERAL DOLLARS AND OF BUDGET
YEAR WE EXPECT TO SPEND SIXTY
FOUR MILLION DOLLARS.
THE TWO MOST SIGNIFICANT ISSUES
FACING THE PROGRAM. AND THAT WU
WILL BE OUR PRIMARY FOCUS IN THE
NEXT COUPLE OF YEARS ARE
DECLINING PARTICIPATION IN THE
PROGRAM AND TRANSITION TO E.
BITI THE ELECTRONIC BENEFITS
TRANSFER.
SO YOUR QUESTIONS IN THE AGENDA
WHERE SPOT OR SPOT ON THEIR.
I'M IS QUESTION NUMBER ONE WHICH
ELECTED JUST TO GO THROUGH EACH
OF THE QUESTIONS. YES PART OF.
BUT WHAT IS KNOWN AT THIS POINT
ABOUT DECREASING PARTICIPATION
SO AS WE'VE REPORTED IN THE PAST
A WICK PROGRAM PARTICIPATION HAS
BEEN DECLINING SINCE ABOUT TWO
THOUSAND TWELVE AND IT'S
DECLINING BOTH IN CALIFORNIA AND
NATIONALLY.
USDA REPORT OUT PRODUCES AN
ANNUAL REPORT WHERE THEY
ESTIMATE THE ELIGIBLE POPULATION
AND THEN COMPARE THAT TO WHAT A
DIFFERENT STATES HAVE SERVED TO
CREATE THE PROGRAM WHAT THEY
CALL PROGRAM REACH.
AND
JUST A COUPLE WEEKS AGO FEBRUARY
TWENTY EIGHTH THEIR LOAD LATEST
REPORT CAME OUT USING TWENTY
FIFTEEN DATA. AT THAT FOR USING
TWENTY FIFTEEN DATA THE NATIONAL
AVERAGE FOR PROGRAM REACH WAS
FIFTY TWO PERCENT AND
CALIFORNIA'S NUMBER IS SIXTY
FIVE PERCENT SO WE. OVER THE
PAST.
TEN FIFTEEN YEARS AT LEAST.
CALIFORNIA HAS TYPICALLY BEEN
ABOUT TWELVE TO FIFTEEN PERCENT.
PERCENTAGE POINTS ABOVE THE
NATIONAL AVERAGE AND WE CONTINUE
TO HAVE THE HIGHEST PROGRAM
REACH OF ALL STATES.
HOWEVER OUR PERCENTAGE HAS BEEN
DECLINING OVER THE PAST FEW
YEARS SO THAT WE KNOW WE DEFTLY
HAVE MORE WORK TO DO THERE.
THERE'D BEEN A NUMBER OF STUDIES
AND SURVEYS ASKING POTENTIAL
PARTICIPANTS OR PASSED
PARTICIPANTS Y. THEY DIDN'T COME
TO WECKER DIDN'T STAY IN WORK
AND SOME OF THOSE.
REASONS INCLUDE THEY DIDN'T
KNOW THAT THEY WERE THEY WOULD
QUALIFY SO ONE OF THE THINGS
THAT WE'RE DOING ON JUST A
LITTLE BIT MORE IS. REALLY
TAILORING OUR MESSAGE TO THE
SPECIFIC INDICATORS THAT COME UP
FROM THE SURVEYS
SO THEY DIDN'T THINK THEY WERE
QUALIFY MAYBE THERE ARE WORKING
FAMILY THAT THOUGHT THAT IF YOU
HAVE A JOB YOU DON'T QUALIFY FOR
THE WITH PROGRAM.
THEY DIDN'T THINK THEY NEEDED
THE PROGRAM SO THAT COMES UP
QUITE A BIT EVEN THOUGH
SOMETIMES THESE RESPONDENTS
INDICATE THAT THEY DO HAVE FOOD
INSECURITY ISSUES THEY STILL
DON'T THINK THAT THEY NEEDED THE
PROGRAM OR THEY WANT TO. MAKE
SURE THAT THE RESOURCES ARE
AVAILABLE FOR OTHER FAMILIES
THAT MIGHT BE MORE IN NEED THAN
THEY ARE.
SOMETIMES AND IT'S NOT IT'S NOT
AS HIGH. UP ON THE RESPONSE LIST
AS THEY DIDN'T KNOW ABOUTWORKS
I THINK A LOT OF PEOPLE KNOW
ABOUT WHICH IS THE SPECIFICS OF
WHERE TO GO ON WHO QUALIFIES
THAT SORT OF THING THAT WE NEED
TO. DO MORE WORK THERE. AND
THERE'S OTHER.
ACCESS ISSUES TRANSPORTATION TO
THE WORK SITE OR TIME
REQUIREMENTS ABOUT COMING TO AN
APPOINTMENT.
WE HAVE A NUMBER OF STRATEGIES
TO DO ADDRESS PROGRAM
PARTICIPATION AND WE'RE FOCUSED
ON THREE DIFFERENT.
.
GROUPS OF INDIVIDUALS ONE IS
RETAINING OUR ACTIVE.
OPPONENTS OF THOSE PEOPLE THAT
HAVE COME INTO THE WORK PROGRAM
THEY'RE CERTIFIED THEY'RE
ACTIVELY RECEIVING THEIR WHAT
CHECKS.
AND WE WANT TO MAKE SURE THAT
THEY STAY IN THE PROGRAM.
SECOND IS RE ENGAGING FAMILIES
THAT ARE CERTIFIED BUT NO LONGER
ACTIVELY COMING BACK TO RECEIVE
THEIR CHECKS.
AND THAT'S A PERCENTAGE THAT HAS
BEEN GROWING A LITTLE BIT OVER
THE PAST FEW YEARS.
AND THE THIRD GROUP IS
RECRUITING ELIGIBLE FAMILIES
THAT ARE NOT CERTIFIED AWAKE BUT
WE HAVE TO KEEP IN MIND AS WELL
THAT THIS LAST GROUP RECRUITING
NEW FAMILIES. THEY MAYHAVE BEEN
IN THE WITH PROGRAM IN THE PAST
SO IT MAY BE THAT THE BABY
WASN'T WAS ENROLLED AND WAKE
AND%
NOW THAT CHILD IS THREE OR FOUR
YEARS OLD. AND SO THEY'RE NOT
ACTIVELY THEY'RE NOT CERTIFIED
ANYMORE BUT THEY CERTAINLY ARE
WELL AWARE OF WAY BECAUSE THEY
WERE THERE COUPLE YEARS AGO OR
MAYBE WITH OF. AN EARLIER CHILD.
SO THINKING ABOUT THOSE THREE
DIFFERENT GROUPS OF FAMILIES
THAT ARE ELIGIBLE FOR THE
PROGRAM WE HAVE THREE DIFFERENT
KEY STRATEGY AREAS THE FIRST IS
UNDERSTANDING DATA AND RESEARCH.
AND ALL OF THEM SO WE ANALYZE
TRENDS WE CONDUCT STUDIES WE
UNDERSTAND A LOT OF STUDIES THAT
ARE HAPPENING IN AND THROUGHOUT
THE STATE AND NATIONAL. THERE'S
LOTS OF INTEREST IN DOING THESE
TYPES OF REVIEWS SO WE WERE
BEARING ABLE TO GET REPORTS FROM
OTHER GROUPS TO UNDERSTAND MORE
ABOUT WHAT PARTICIPATION
DECLINES.
A WE'VE PREPARED DATA AND GEO
MAPPING TOOLSFOR OUR LOCAL
AGENCIES WE FUNDED LOCAL AGENCY
PROJECTS TO CONDUCT AND
EVALUATES INNOVATIVE PROJECTS.
OUR SECOND KEEFE STRATEGY IS RE
REVIEWING THE PROGRAM TO IMPROVE
THE SERVICES IMPROVE EFFICIENCY
AND REMOVE BARRIERS SAW TALK
LITTLE BIT MORE ABOUT THAT WITH
MODERN COMMUNICATION AND THE
APPLICATION PROCESS.
AND LASTLY I'M OUT REACHING
COMMUNICATIONS SO MAKING SURE
THAT WE TAILOR OUR MESSAGE TO
RESPOND TO THAT WHAT WE LEARNED
UNDER THE FIRST DATA AND.
RESEARCH AREA.
I'LL GIVE IT UPDATE ABOUT EBT SO
WE ARE ON TRACK TO IMPLEMENT EBT
AHEAD OF THE FEDERAL DEADLINE OF
OCTOBER TWENTY TWENTY.
FROM THERE IS SOME REPORTS THAT
COME OUT FROM DEPARTMENT OF
TECHNOLOGY AND OFFICIAL PROGRESS
HOME PROJECT REPORTS THAT I
THINK.
LA O. RECEIVES A COPY OF THAT
AND WE'RE ALL IT ALL GREEN SO
WE'RE VERY HAPPY TO REPORT THAT.
OF ONE OF THE KEY REQUIREMENTS
IN IMPLEMENTING EBT IS TO
REPLACE THE I. T. SYSTEM THAT WE
USE BOTH AT THE STATE AND LOCAL
AGENCIES IT'S ABOUT TWENTY THREE
YEARS OLD RIGHT NOW SO WE DO
HAVE TO REPLACE THAT. WE ARE NOT
DESIGNING A NEW SYSTEM WHERE
PROCURING A WE'RE WORKING WITH%
THE OFFICE OF SYSTEMS
INTEGRATION WHICH IS WITHIN OUR
AGENCY. AS THEY DID IN RFP LAST
YEAR AND WE HOPE TO ANNOUNCE THE
CONTRACT IN APRIL SO JUST IN A
COUPLE WEEKS WILL BE ABLE TO
ANNOUNCE WHAT SYSTEM THAT WE'RE
GETTING AND WHO THE CONTRACTOR
AS.
AND THIS WILL BE A SYSTEM THAT
IS BEEN USED IN. ANOTHER STATE
FOR WORK SO THAT'S ONE THE
REQUIREMENTS OF USDA'S NOT TO
BUILD A NEW SYSTEMS OR VERY
HAPPY JUST TO TRANSFER SOMETHING
WITH A CALIFORNIA. WE HAVE MIGHT
HAVE TO DO SOME ENHANCEMENTS TO
MEET THE NEEDS IN THE SCOPE OF
THE SIZE OF CALIFORNIA BUT.
WE'LL BE ANNOUNCING THAT I JUST
IN THE NEXT FEW WEEKS.
IN TWENTY EIGHTEEN OUR FOCUS IS
SITTING SETTING UP AT NEW
SYSTEMS INFRASTRUCTURE.
DEVELOPING TRAINING MATERIALS
AND PROCESSES BOTH FOR THE STATE
STAFF AND FOR THE LOCAL AGENCY
THERE'S ABOUT SIX HUNDRED LOCAL
AGENCY SITES THROUGHOUT
CALIFORNIA SO WE HAVE A LOT OF
WORK TO DO. TO ROLL OUT THE NEW
SYSTEM IN THOSE STATES AND TRAIN
STAFF AS WELL.
STARTING IN SUMMER TWENTY
NINETEEN WHERE WE'LL BE PILOTING
THE NEW SYSTEM AN EBT SERVICES
WILL START AND SOLANO COUNTY AND
DO THAT AGAIN SUMMER OF TWENTY
NINETEEN SO WERE. JUST A LITTLE
BIT OF A YEAR AWAY FROM ACTUALLY
HAVING EBT FOR WORKING
CALIFORNIA.
AND THEN AFTER THE PILOT WILL DO
A TIERED APPROACH ROLL OUT
THROUGHOUT THE STATE'S OR NOT
DOING EVERYBODY ALL AT ONCE WILL
STAGGER IT SO IT'S A MUCH.
BETTER FLOW AND LESSONS LEARNED
AS AS WE GO THROUGH THE PROCESS
AND WILL WE SHOULD COMPLETE THAT
BY SPRING OF TWENTY TWENTY.
OF IT THE COMMUNICATIONS WITH
STAKEHOLDERS AND FAMILIES IS
CRITICALLY IMPORTANT TO THE
SUCCESS OF THE PROGRAM.
WE'RE ENGAGING LOCAL AGENCIES
AND STORES ARE ARE AUTHORIZED
VENDORS.
BUT WE HAVE A A WORK GROUP THAT
WERE SETTING UP BOTH OF
STAKEHOLDER GROUP WITH THE
AUTHORIZED VENDORS TO THAT THEY
UNDERSTAND EVERYTHING THAT'S
COMING FOR THEM AS WELL AS THE
LOCAL AGENCIES. AND A
COMMUNICATION WITH THE FAMILIES
OF COURSE IS CRITICALLY
IMPORTANT.
AND WE HAVE OUR CONTACT FOR THE
EBT SERVICES PROVIDER TO THAT'S
THE BIKE THE BANKING PART THAT
HAPPENS AT THE STORE. AND THEY
ARE REQUIRED IN THEIR CONTRACT
TO OPERATE A TWENTY FOUR SEVEN
CUSTOMER CALL CENTER AND WEBSITE
FOR FAMILIES. THEY'RE DEVELOPING
YOUTUBE VIDEOS OF THAT COULD BE
SHOWN IN THE LOCAL SITES SO THAT
FAMILIES COME IN AND THEY COULD
SEE HOW DOES THE NEW CARD WORK
CAN TO I NEED TO SEPARATE THIS
FOOD OR. WHAT IF I HAVE A WHAT
CARD AND I CAL FRESH CARD NAY
USING BOTH AT THE SAME TIME YES
YOU CAN USE IN BOTH AT THE SAME
TIME? SO THERE'S A LOT OF WORK
THAT WE'RE DOING TO MAKE SURE
THAT THE FAMILIES ARE A REALLY
WELL INFORMED AND THOSE WRITTEN
IT TEARS WILL BE IN EIGHTEEN
DIFFERENT LANGUAGES SORT DOING
THE SAME PROCESS THAT COW
FRESHENED CAO WORKS IS DOING
THEIR ABOUT THE LANGUAGE.
I'M LAST THEY WILL HAVE AN APT
WHERE FAMILIES CAN SCAM FOODS IN
THE STORE TO SEE IF THEIR WORK
AUTHORIZED THE CAN CHECK RIGHT
THERE BEFORE THEY GET IN LINE TO
MAKE SURE THAT THEY'VE PICKED UP
THE RIGHT FIT.
I'M QUESTION NUMBER THREE WILL
TALK ABOUT MODERNIZING
COMMUNICATION WITH FAMILY SO
LAST YEAR I SHARED WITH YOU ARE
NEW WITH MOBILE WEBSITE. AND
WE'VE DONE SOME ENHANCEMENTS TO
THAT SINCE LAST YEAR WE'RE
ADDING A NEW BUTTON TO TALK OF
TO ADDRESS BREASTFEEDING SUPPORT
SO FAMILY AMONG MY MOM'S CAN
FIND MORE INFORMATION. AND THEN
WE ARE ABOUT TO ROLL OUT A NEW
BUTTON THAT WE'RE REALLY EXCITED
ABOUT SO LAST YEAR THERE WAS A
SEARCH FEATURE WHERE FAMILIES
COULD LOOK FOR WEARS AND WIKOFF
RACE STORE. AND NOW THERE'S A
NEW BUTTON LOOKED SO THEY CAN
SEARCH FOR WHERE'S THEIR WIKOFF
RIGHT FARMERS MARKET. THAT WAS
NOT IN THE SYSTEM LAST YEAR SO
WILL REALLY HAPPY THAT WERE
ROLLING OUT FOR THE SEASON
THERE.
WE CONTINUE TO DEVELOP MORE
ONLINE EDUCATION MODULES AND
TOOLS.
RC OUR OFFICE IS ALSO DEVELOPING
SOCIAL MEDIA MESSAGING EVERY
CORNER AND SENDING THAT OUT TO
LOCAL AGENCIES SOME OF OUR LOCAL
AGENCIES HAVE THAT CAPACITY
CAPACITY TO DEVELOP THEIR OWN
SOCIAL MEDIA MESSAGES BUT OTHERS
DON'T. OR WITHIN THEIR OWN
PARENT COMPANY THEY MIGHT NOT BE
ALLOWED TO SO WE'RE DOING THAT
FOR THEM AND SENDING THEM OUT
THEM EVERY QUARTER. WERE ALSO
DEVELOPING NEW YOU TO WHAT WE
CALL WEEK STORIES VIDEOS WHERE
IT MIGHT BE A PARTICIPANT OR A
FORMER PARTICIPANT IS TELLING
ABOUT THE IMPACT THAT WEEK MADE
FOR THEM AND WHY. IT'S A GREAT
PROGRAM.
WE ARE A CONTINUE TO EXPAND THE
USE OF TEXT MESSAGING SYSTEM FOR
OUR BREASTFEEDING PEER
COUNSELING PROGRAM. THAT HAD
BEEN KIND OF A A PILOT FOR
AWHILE IN THE LIMITED NUMBER OF
LOCAL AGENCIES AND WE'RE
EXPANDING AT THE SPRING TWO ADAM
ALL THE AGENCIES THAT HAVE THE
PRESSING PEER COUNSELING
PROGRAM.
WILL NOW HAVE ACCESS TO THAT
SYSTEM.
AND LET'S SEE LOCAL AGENCIES
ALSO USE TEXT MESSAGING FOR
APPOINTMENT REMINDERS AS AS WELL
AND ONE OF OUR LOCAL AGENCIES
ARE INNOVATION PROJECTS IS
PILOTING A TELEHEALTH PROGRAM TO
OFFER HIGH RISK NUTRITION
COUNSELLING VIA VIDEO CHAT.
QUESTION NUMBER FOUR HOW MANY
WHICH LANGUAGES ARE UTILIZED IN
OUR WITH OUTREACH SO LAST YEAR
REPORTED THAT WE WERE
CONSIDERING ADDING KOREAN AND WE
HAVE DONE THAT SO WE NOW HAVE TO
OUR CORE MATERIAL THERE IN TEN
LANGUAGES.
ENGLISH SPANISH
RUSSIAN ARABIC ARMENIAN CHINESE
MONK KOREAN RUSSIAN AND
VIETNAMESE.
AND THESE LANGUAGES ARE
DETERMINED BY THE DATA FROM OUR
OUR IT SYSTEMS SO THERE'S A
QUESTION AT THE WICK APPOINTMENT
THE LOCAL SITE WHAT LANGUAGE DO
YOU PREFER TO SPEAK AT HOME. SO
THAT'S WHERE WE WE IDENTIFY
THOSE LANGUAGES THERE.
OUR NEW SOCIAL MEDIA OUTREACH
MESSAGES ARE CURRENTLY ARE ONLY
IN ENGLISH AND SPANISH AT THIS
POINT.
A MANY LOCAL AGENCIES HAVE
DEVELOPED THEIR OWN OUTREACH
MATERIALS BASED ON THE LANGUAGE
IN THEIR SPECIFIC AREAS AND SO
THERE'S A FEW MORE THAT ARE HOW
THAT ARE USED IN DIFFERENT PARTS
OF THE STATE.
AND OF COURSE LOCAL AGENCIES
HIRE STAFF THAT SPEAK THE
LANGUAGE AND THAT FOR FAMILIES
IN THEIR PARTICULAR AREA.
QUESTION NUMBER FIVE IS ABOUT
THE FOODS AND CALIFORNIA GROWN
PRODUCE SO FEDERAL REGULATIONS
OF PROVIDE THE GUIDANCE THAT WE
USED FOR THE WITH FOOD PACKAGE
AND LAST YEAR THE NATIONAL.
ACADEMIES OF SCIENCE ENGINEERING
AND MEDICINE. AND I'M GONNA CALL
IT SCIENCE ENGINEERING AND MATH
ONE DAY.
THEY MADE RECOMMENDATIONS TO
THE U. STA FOR CHANGES TO THE
FOOD PACKAGING USDA NEEDS TO
ADOPT THOSE THROUGH A FEDERAL
REGULATIONS AND SO WHERE. I'M
ANTICIPATING HOPEFUL THAT SOME
OF THOSE CHANGES MIGHT BE COMING
FORWARD SOME OF THOSE CHANGES
INCLUDING INCREASES TO FRUITS
AND VEGETABLES AND OPTIONS TO
SUBSTITUTE FOR CHIU VEGETABLES
FOR JARRED INFANT FOR SOME
JARRED INFANT FITS.
I AM LAST YEAR I REPORTED TO YOU
THAT WE HAD ALSO BEEN TARGETING.
.
SPANNING THE FARMERS MARKET
PROGRAM WE WANTED TO ADD MORE
FARMERS MARKET THE PROGRAM LAST
YEAR REPORTED THAT WE HAD FOUR
HUNDRED AND FIFTY FARMERS I'VE
OR FARMERS MARKETS IN. TWENTY
EIGHT COUNTIES AND NOW WE ARE AT
SIX HUNDRED AND THIRTY IN THIRTY
SIX COUNTY SO WE'VE ITEM.
GROWN QUITE A BIT IN THE NUMBER
OF FARMERS AND FARMER'S MARKET
EXCEPT WICK.
VOUCHERS OR THE SPECIAL SUMMER
PROGRAM KEEP ON.
COUPON.
AND LASTLY I COULD STREAMLINING
THE WICK APPLICATION HELP WITH
PARTICIPATION RATES ONE OF
THINGS THAT IT'S IS DIFFERENT
ABOUT WAKE IS IT'S NOT JUST A
STRAIGHTFORWARD APPLICATION
PROCESS. THERE'S REQUIRED AND IN
PERSON CERTIFICATION UPON
APPOINTMENT.
SO WE HAVE.
THE FAMILY FAMILIES CAN MAKE AN
APPOINTMENT A COMMAND OR MANY
SITES ARE OPEN FOR AVAILABLE FOR
DROP IN THIS WHILE.
AND SOME LOCAL AGENCIES ARE
PILOTING OF WHAT THEY CALL A PRE
ELIGIBILITY A MODULE ON THEIR
WEBSITE SO IT DOES LOOK LIKE AN
ONLINE APPLICATION AND THERE AT
ABLE THEN TO COLLECT A LOT MORE
INFORMATION AHEAD OF TIME AND SO
WERE. SEEING HOW THAT GOES TO
THAT SPEED UP THE PROCESS I
THINK WITH MY CERTAINLY MAKE FOR
SHORTER CERTIFICATION
APPOINTMENT WHICH IS PROBABLY
DESIRABLE.
I'M A BUT WE HAVE BEEN WORKING
WITH LOCAL AGENCIES TO IMPROVE
THE PROPHECIES ABOUT FOR THAT
CERTIFICATION POINT.
APPOINTMENTS SO THAT THERE ARE
FEWER BARRIERS TYROLEAN AWAKENED
A HIGHLIGHT A FEW OF THOSE.
ONE IS ALLOWING GRANT AND
GRANDPARENTS AS CARETAKERS FROM
NOW.
USED TO BE THAT IF THERE IF THE
PARENT WAS ON THE PROGRAM THAT
MAYBE THE GRANDPARENT COULD BE
ALTERED THAT BUT NOW YOU COULD
HAVE BOTH AS. A OFFICIALLY
LISTED.
ANOTHER IS ADJUNCTIVE
ELIGIBILITY FOR MEDICAID BABIES.
SO WHEN A CHILD IS BORN IF MOM
WAS ON MEDI CAL. THAN THEIR OF
THEIR ALREADY COVERED BY
MEDICARE FOR AWHILE BUT THEY
MIGHT NOT HAVE THEIR MEDICAL
CARD RIGHT AWAY.
AND SO ON WITH WE NEEDED THEM TO
WAIT UNTIL THEY HAVE ABOUT MEDI
CAL CARD OR WE WOULD PUT HOLDS
ON THEIR BENEFITS AND THEY WOULD
JUST GET INCREMENTAL BENEFITS
AND NOW WE'RE SAYING. YEAR
COVERED BY THAT BY MOM'S
MEDICAID JUST AS MEDI CAL WHAT
FOR SERVICES AS WELL.
AND THAT CAME FROM LOCAL
AGENCIES THAT MADE THAT
SUGGESTION I THINK THEY'RE VERY
HAPPY THAT WE ARE ABLE TO DO
THAT.
TYPICALLY THE TRACKING NUMBERS
ARE ON THE SAME ON ALL THE CARDS
CORRECT.
LET'S SEE IT MOM GETS THE
MEDICAL CARD AND THEN THE KIDS
GET A CARD BUT THE THE NUMBERS
ARE THE SAME.
THAT I'M I'M SORRY I DON'T KNOW
ABOUT THAT ON THE MEDICARE PART
NO.
IT'S USUALLY MOST TO HEALTH
CARDS. THE.
THAT THE CODING NUMBERS ARE THE
SAME FOR THE PARENTS AS FOR THE
KIDS.
THAT SOMETHING IN THAT WAY IF IF
MOM'S CARD IS THE SAME NUMBERS
AS THE KIDS CARDS IN THE SYSTEM
THEY OUGHT TO BE ABLE TO PUNCH
IN THE NUMBERS AND LOOK IT UP
AND GO HERE'S HOW MANY CHILDREN.
FALL UNDERNEATH THIS PARENT.
THAT I'M I'M SORRY HAVE TO.
CHECK INTO THAT BUT IT BUT NOW
WE ARE SHOWING THAT.
ALLOWING THAT IF IF MOM HAS
MEDI CAL HAS THE BABY THEN
THAT'S FINE YES WILL GO AHEAD
EXCEPT THAT WOULD.
WERE OFFERING TO YOU WANT ONE
THAT WE CALL FEDERAL
REQUIREMENTS IS HEMOGLOBIN
SCREENING.
AND THAT'S NOT ALWAYS DONE AND A
REGULAR BASIS IN THE PEDIATRIC
OFFICE BUT IT STILL IS A FEDERAL
REQUIREMENT FOR THE WICK
PROGRAM.
SO WE'RE NOW OFFERING IN HOUSE
HE MICHAELMAS SCREAMING
SCREENING AND WE'RE ALSO
PROVIDING THE SERVICES FOR THREE
MONTHS SO WE USED TO BE WE'D SAY
YOU NEED TO GO TO THE DOCTOR AND
GET A HEMOGLOBIN SCREENING WE
CAN'T GIVE YOU BENEFITS I WOULD
MATT JUST GIVE YOU ONE MONTH. AT
A TIME NOW WILL GIVE THREE
MONTHS OF TIME.
WE HAVE EXPANDED MAILING OF THE
FOOD VOUCHERS TO PARTICIPANTS
THAT PER FOR ONLINE NUTRITION
EDUCATION SO NUTRITION EDUCATION
IS REQUIRED EVERY QUARTER. AND
MANY OF ARE YOU.
FAMILIES PREFER ON ONLINE
EDUCATION BUT THEN THEY STILL
HAVE TO COME INTO THE SITE TO
PICK UP THEIR CHECKS WHICH
COMETH.
MIGHT DEFEAT THE WHOLE PURPOSE
SO WE'VE PLAYED THAT CHANGE AS
WELL.
AND I'M WE'VE ADDED MORE
FLEXIBILITY AND BUT WE.
HOW TO BRING IN DIFFERENT
DOCUMENTATION IN THIS TYPE CUT
TIES BACK TO THE MODERN
COMMUNICATION?
SO MANY FAMILIES NOW THEY DON'T
GET A THEY DON'T GET THEIR BILL
A KNOW MAYBE THEIR ELECTRIC BILL
OR SOMETHING A HARD COPY THEY
DISCREDIT ELECTRONIC AND WE USED
TO SAY YOU HAVE TO BRING IN THE
BILL BUT IF THEY DON'T HAVE THE
BILL. NOW THEY JUST HAVE A COULD
SHOW US ON THEIR PHONE OR A
PICTURE OF THE PHONE THAT SORT
OF THING SO IS ANOTHER.
VERY RECENT CHANGE THAT WE'VE
MADE.
THANK YOU DEPARTMENT OF FINANCE
ALIONA COMMENTS ON ISSUE FOR.
PUBLIC COMMENT ON ISSUE FOR.
KAREN FARLEY WITH THE CALIFORNIA
WITH ASSOCIATION THE MEMBER
ASSOCIATION FOR THE EIGHTY THREE
AGENCIES.
WE'RE HERE IN SUPPORT OF THE
GREAT WORK THAT THE STATE AND
EIGHTY THREE AGENCIES ARE DOING.
CHRIS ONE UNDERSCORE THIS
CRITICAL PERIOD THAT WE KAZAN.
BECAUSE OF A CHRIS DESCRIBE THE
DECLINING PARTICIPATION WHICH IS
VERY WORRISOME IN CALIFORNIA HAS
A STELLAR REPUTATION ACROSS THE
NATION.
FOR BEST PRACTICES AND. WHAT
THAT MEANS IS KID FEWER KIDS ARE
IN THEIR FAMILIES ARE GETTING
FED BUT IT'S ALSO A THREAT TO?
OUR FEDERAL GRANT EVENTUALLY
PERHAPS AND THE HEALTH OUTCOMES
IT WHICH IS PLAYED SO MUCH ROOM
OVERALL IN PRETERM BIRTH. LOW
BIRTH WEIGHT ANEMIA
BREASTFEEDING CHILDHOOD OBESITY
I MEAN WICKS A STAR PROGRAM IT'S
A TREASURE.
SO THE LOCAL AGENCIES ARE VERY
CONCERNED AND WE SERVE ALL YOUNG
FAMILIES.
AND TRYING TO UNDERSTAND WHAT
THOSE YOUNG MOMS WANT TO BRING
THE MEN BECAUSE WE KNOW THAT
WAKE. HAS SUCH A LONG HISTORY OF
DOING SUCH A GOOD JOB HERE IN
CALIFORNIA ACROSS THE NATION SO.
I THINK WE ALL PLAY A ROLE IN IN
REALLY SUPPORTING OUR STAFF IN
THE LOCALS IN HOW TO REALLY.
KEEPER TREASURE ON GOING WELL
HERE IN CALIFORNIA.
THANK YOU.
SEEING NO FURTHER PUBLIC COMMENT
OF PRINTED UP THE DIES FOR ANY
MOMENTS WE MAY HAVE.
I'D ALSO LIKE TO EXTEND A BID OF
CONGRADULATIONS IF I CAN IT DOES
APPEAR THAT CALIFORNIA'S DOING A
VERY GOOD JOB FOR PARTICIPATION.
I WANT TO BETTER UNDERSTAND IF I
CAN HOW WE CAN HELP TO
STREAMLINE THE APPLICATION
PROCESS AND I THOUGHT YOU DID A
GOOD JOB OF ANSWERING IT.
BUT IS THERE ANYTHING
SPECIFICALLY THAT THE STATE
COULD DO TO HELP TO IMPROVE THE
APPLICATION PROCESS.
AS DELAYS AND RECEIVING WHAT
BENEFITS MAY. LEAD TO LOWER
PARTICIPATION ARE THERE THINGS
THAT WE COULD DO TO HELP WITH
THAT PARTICIPATION.
AT AT THIS POINT OUR OFFICE IS
CONTINUING TO REVIEW.
THE FEDERAL UP POLICIES I'M
OFTENTIMES THE. THE THE FEDERAL
REGULATION SAYS THE STATE SHALL
DO THIS OR IT MIGHT SAY THE
STATE SHALL.
FIND OUT OF THEM.
FIND A WAY TO DO THAT SO SOME OF
THEM ARE VERY PRESCRIPTIVE AND
SOME ARE NOT. SO OUR OFFICE GO
IS GOING THROUGH REALLY WITH A
FINE TOOTH COMB ALL OF THOSE
POLICY REGULAR.
THE STATE SPECIFIC LANGUAGE OF
THE FAT OF THE THE FEDERAL RULE
TO SEE WHAT WE CAN CONTINUE TO
DO SO WHERE THAT REALLY IS A KEY
FOCUS OF OUR OFFICE RIGHT NOW
I'M WORKING WITH.
THAT CALIFORNIA RICK
ASSOCIATION IN OUR LOCAL
PARTNERS AS WELL TO DO THAT.
AND I'LL JUST ADD MY TWO CENTS
IF I CAN COMING FROM AN
AGRICULTURAL AREA LIKE MINE. I'M
QUITE ENCOURAGED TO SEE THE
INCREASED PARTICIPATION OF THE
FARMERS MARKET. AS THAT WHICH
COMES FROM THE GROUND IS USUALLY
VERY GOOD FOR OUR BODIES AND.
QUITE HAPPY THAT YOUR SUPPORT
ABOUT THAT. WITH THAT WE WILL
HOPE A WE WILL HOLD ISSUE FOR
OPEN AND MOVE ON TO ISSUE FIVE.
AND COMING UP TO JOIN ME HERE IS
A LIGHTLY CALLALOO SKI I DON'T
THINK SHE HAD AN OPPORTUNITY TO
AND. GET YOU LAST TIME CITIES
ARE NEW DIVISION CHIEF YOUTH.
ACTUALLY BEEN HERE OVER A YEAR
BUT WE DID WANT TO EXPOSE IT TO
THE THREAT AWAY IN SCARECROW AT.
AND SO.
LESLIE CAME TO US FROM THE
MARCH OF DIMES LA WESTERN
REGIONAL DIRECTOR FOR MARCH TIME
SHE IS A LIFETIME COMMITMENT TO
THESE ISSUES WERE REALLY PLEASE
SUCH AS JOINED US AT THE
DIVISION CHIEF. ANCHOVY
ANSWERING YOUR QUESTIONS ABOUT
OUR HOBBIES THE KEY ON THAT HOME
VISITING PROGRAMS.
HELLO. AND I JUST WANNA JUST.
.
JUST POINT TO THE FACT THAT YOU
GOT A LOT OF BACKGROUND
INFORMATION IN THE IN THE IN THE
UPDATE AND WE'RE JUST REALLY
PROUD OF OUR HOME VISITING
PROGRAM. AS YOU MAY KNOW IT'S
IT'S FUNDED BY FEDERAL FUNDS WE
WE GET ABOUT TWENTY TWO MILLION
DOLLARS IN FUNDING FROM THE FEDS
TO TO FIND A PROGRAM. THAT IS IN
TWENTY THREE COUNTIES TODAY WE
HAVE CONDUCTED OVER A HUNDRED
AND FIFTY THOUSAND HOME VISITS
WERE REALLY PROUD OF THAT WE'VE
SERVED OVER EIGHT THOUSAND
FAMILIES. AND CURRENTLY WE CARRY
CASELOAD OF AROUND TWO THOUSAND
FAMILIES.
SO WE HAVE BEEN WHERE YOUR
QUESTION IS IS CAN YOU CAN
COMPARE CAN YOU COMPARE AND
CONTRAST THE DSS PROGRAM. AND WE
DEFERRED OF THEM TO TALK ABOUT
THEIR PROGRAM WE CAN GIVE YOU
DETAILS ABOUT OUR PROGRAM. AND
WE'RE PLEASED TO LET YOU KNOW
THAT WE CARRY OUT TO EVIDENCE
BASED MODELS FOR OUR HOME
VISITING PROGRAMS. AND WE KNOW
THAT THERE'S ABOUT ELEVEN HOME
VISITING PROGRAMS THAT ARE BASED
ON EVIDENCE ACCORDING TO THE TO
THE FEDS.
WE HAVE BEEN PROVIDING TECHNICAL
ASSISTANCE TO DSS WE'VE BEEN
WORKING ON AND WORKING WITH THEM
IN THEIR WORK GROUPS. AND WE
HAVE WE KNOW AND ANTICIPATE THAT
THERE WILL BE OPPORTUNITIES FOR
US TO LEARN FROM ONE ANOTHER AND
TO CONTINUE TO COLLABORATE ON
THE UPSTART OF THEIR PROGRAM.
WE HAVE A BASIC SET OF OUTCOME
DATA THAT THAT WE REPORT OUT TO
THE FEDS ON AND WE HAVE BEEN
SHARING THAT INFORMATION. WE
KNOW THAT OUR PROGRAMS ARE NOT A
DUPLICATION WE KNOW THAT THERE
ARE COMPLEMENTARY WITH SIMILAR
GOALS. BUT THEY HAVE DIFFERENT
STRATEGIES THE DSS PROGRAM IS
MORE FOCUSED AT THE LOCAL LEVEL
WITH OUR PROGRAM WE HAVE A LOT
OF STATE OVERSIGHT. AND WE HAVE
WE'VE GOT A LONGER PERIOD THAT
WE AND ROLL FAMILIES THEN.
SO THAT'S THAT'S JUST A SHORT A
SHORT UPDATE AND ANY ANY
QUESTIONS.
WHAT DEPARTMENT OF FINANCE
EARLIER WHEN HE COMES?
ANY PUBLIC COMMENT ON THE ISSUE
FIVE.
GOOD AFTERNOON MISTER CHAIR OF
ASKING ON BEHALF THE NURSE
FAMILY PARTNERSHIP PROUD TO BE
ONE OF THE EVIDENCE BASED
PROGRAMS INCLUDED IN THE
CALIFORNIA HOME VISITING
PROGRAM.
AND ARE JUST HAPPY TO HAVE THIS
CONVERSATION HAVING EVIDENCE
BASED HOME VISITING EXPANDED AS
MANY CHILDREN YOUNG CHILDREN AND
THEIR FAMILIES IN CALIFORNIA'S
POT IS POSSIBLE. TO IN THE MOST
POSITIVE THINGS THAT WE CAN DO
TO SUPPORT OUR LOW INCOME
FAMILIES WHO WE VERY MUCH
APPRECIATE YOUR SUPPORT.
ARGUMENT.
HIGHER IMPALA WILL HOME AND I'M
REPRESENTING THAT COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION AND WERE IN SUPPORT
OF THIS PROPOSAL FOR THE
CALIFORNIA HOME VISITING
PROGRAM.
THANK YOU THANK HIM.
SEEING NO FURTHER COMMENTS ON
BRING IT UP TO THE DIOCESE CAN.
.
YOU KNOW I I DON'T KNOW IF YOU
CUT SIXTY MINUTES THIS PAST WEEK
BUT WE HAD OPRAH TALKING ABOUT
SOMETHING I'M QUITE PASSIONATE
ABOUT AS WELL ADVERSE CHILDHOOD
EXPERIENCES. AND IN THE RIGHT
NOPE TO EXPLAIN HOW
SPECIFICALLY THIS PROGRAM IS
ATTEMPTING TO INCORPORATE ACES
ABSOLUTELY. SO HOME VISITING
HELPS PARENTS IN THE IDENTIFIED
AT RISK COMMUNITIES GIVE THEIR
CHILDREN A SOLID START IN LIFE
SO HELPING THE PARENTS HELP
THEIR CHILDREN HAVE A NURTURING
AND SUPPORTIVE. ENVIRONMENT IN
WHICH TO GROW UP. WE WE ALSO
KNOW THAT PARENTS
THAT ARE OFTEN IN HOME VISITING
SUFFER FROM OR HAD AN ADVERSE
CHILDHOOD EXPERIENCE AS OF THE
PROGRAM ALSO IDENTIFIES THEIR
NEEDS AND HOW TO HELP THEM WORK
THROUGH THOSE THOSE ADVERSE
CHILD. BUT EXPERIENCES. EVEN
THOUGH HOME VISITING IS NOT
SPECIFICALLY DESIGNED TO ADDRESS
A SAYS WE KNOW THAT MULTIPLE
STUDIES HAVE LINKED HOME
VISITING TO THE REDUCTION AND
SUPPORT OF OF A SAYS. SO WE KNOW
THAT ASUS CAN IMPROVE THE HEALTH
AND LIFE AND LIFE COURSE
OUTCOMES AND ACHIEVE THE THE
GOALS THAT WE ALL WANT FOR OUR
FAMILIES AND FOR IT AND FOR THE
CHILDREN IN CALIFORNIA.
WE KNOW THAT THE OUTCOMES
ADDRESS BY HOME VISITING INCLUDE
BECOMING A TEEN PARENT SMOKING
INTIMATE PARTNER VIOLENCE
ALCOHOL ABUSE ILLICIT DRUG USE
TOXIC STRESS SUICIDE AND
DEPRESSION.
SO WE KNOW THAT THERE'S A LINK
TO TO HELPING ADDRESS THE
ADVERSE
CHILDHOOD EXPERIENCES HIS IS THE
NURSE FAMILY PARTNERSHIP.
SCREENING BOTH THE PARENTS AND
THE CHILDREN FOR. CASE IS OR HOW
SPECIFICALLY DO THEY.
THAT START. UP.
THAT.
ACKNOWLEDGING AND FINDING THAT
WE HAVE US AND WE HAVE A SET OF
THERE'S THAT THERE'S A MODULE
THAT START THAT STARTS FROM DAY
ONE ADDRESSING THEIR AT THE
DIFFERENT. INDICATORS THAT THE
MODEL SETS OUT TO ACHIEVE AND
SOME OF THOSE FALL IN THE WHEEL
HOUSE OF OF ACES AND SOME OF
THEM ARE ARE BROADER.
I HAVE ONE LAST QUESTION I KNOW
YOU ANSWERED IT WELL ABOUT DSS
BUT HOW DO WE ENSURE THAT WERE
COMPLIMENTING. PROGRAMS AND NOT
DUPLICATING HOW CAN I. HAVE
CONFIDENCE THAT.
THE TWENTY.
THREE TO TWENTY THREE COUNTIES
THAT YOU'RE RAN. IT. HOW HOW DO
WE MAKE SURE THAT WE HAVE THE
BROADEST REACH POSSIBLE TO MAKE
SURE THAT?
BOTH OF THE HOME VISITING
PROGRAMS ARE HELPING OUR YOUNG
FAMILIES.
BUT NOW I RESPOND TO THAT
BECAUSE I ACTUALLY SIT ON THE
STATE INTERAGENCY TEAM ON YOUTH
AND CHILDREN AND THERE'S A WORK
GROUP ON HOME VISITING AND SO.
BOTH OUR DEPARTMENT OUR
DEPARTMENT AND DEPARTMENT SOCIAL
SERVICES ARE ON THAT BUT THAT
SPECIFIC.
GOAL OF COORDINATION.
MOM I THINK THAT CHALLENGES ARE
GOING TO REALLY BE.
.
AND THE INITIAL START UP PHASE
WITH OUR LOCAL AGENCIES BECAUSE
THEY WILL HAVE THE
RESPONSIBILITY OF TRYING TO.
IDENTIFY THE THE PAIR THE YOUNG
PARENTS THE PREGNANT AND
PARENTING WOMEN.
.
THEY'LL HAVE THE ABILITY TO
MAYBE TRIAGE THEM A LITTLE BIT
AND TO WHAT WOULD BE THE BEST
PROGRAM OUT WHERE MY BY WHERE MY
THINK ALL WORKS LEARNING HOW TO
DO SOME BRAIDED FUNDING WHERE
MAYBE WE CAN EXPAND. ON THE
UNIVERSE OF.
APPLICATIONS USING. FUNDING
STRATEGY SO.
I THINK WE'RE RIGHT IN THE MIDST
OF TRYING TO DO EXACTLY WHAT
YOU'RE SAYING AND I THINK THE
PRIMARY GOAL IS TO SUPPORT OUR
LOCAL AGENCIES.
TO BE ABLE TO USE THIS FUNDING
TO MAXIMISE ON THE ENROLLMENT OF
CLIENTS.
WELL I.
HOW AND WITH A COMMENT IF I CAN
I WAS QUITE PROUD THAT WE WERE
ABLE TO PASS AB THREE FORTY LAST
YEAR WHICH ALLOWED ACES TO BE
SCREENED UNDER EP STT?
AND WOULD HOPE THAT THE UPCOMING
GOVERNOR'S PROPOSAL FOR HOME
VISITING PROGRAM CAN ALSO FIND
WAYS TO USE THIS ASUS SCREENING.
I LIKE OPRAH OR MIGHT EXCITED
ABOUT THE REAL POTENTIAL THAT
ACES OFFER AS A KEY TO HELPING
TO.
DEAL WITH CHILDHOOD TRAUMA.
WE NEED TO TURN THE QUESTION
FROM. HOW DID OUR KIDS AND UP
LIKE THAT TO WHAT HAPPENS TO
THEM? AND I BELIEVE BASE IS
REALLY IS THAT TOOL AND HOPE WE
CONTINUE TO USE IT SOME. WITH
THAT'LL PASS INTO ASSEMBLY
MATHIS.
SO WELCOME THANK YOU HARM.
EVERYTHING HE SAID.
DID TO BREAK THIS DOWN A LITTLE
BIT SIMPLER WE ALWAYS TALK
ABOUT.
WHAT CAN WE DO TO BREAK THE
CYCLE?
THIS IS SAID A MINUTE ONE OF
THOSE BIG THANKS TO THE QUESTION
AS TO.
NO REDUNDANCIES WE WE ONLY HAVE
A FINITE AMOUNT RESOURCES AS WE
DO YOU HAVE TO WORKS ON.
VERY GLAD OF OF YOUR ANSWER.
.
SEEN WHAT WE'RE ABLE TO DO WITH
THESE KIDS TO TO GET THERE AND
TO GET. IN THE HOME THEY I THINK
IT'S ONE OF THE MOST IMPORTANT
FACTORS.
BECAUSE THAT'S REALLY YOU CAN
GET ONE STORY FROM PARENTS AND
CAN REACH OUT YOU CAN DO ALL OF
THAT UNTIL YOU STEP FOOT INTO
THAT ENVIRONMENT. AND I SAY AND
FIRE MEANT BECAUSE WHAT YOU GO
THROUGH THAT THRESHOLD OF THE
DOOR WAY. IT COULD BE A
COMPLETELY DIFFERENT WORLD. AND
SO THE WORK YOU GUYS ARE DOING
ITS EXTREMELY IMPORTANT.
WITH ACES AND EVERYTHING TO
REALLY LOOK AT THESE THINGS
BECAUSE IT THIS GIVES US THE
OPPORTUNITY TO TAKE THESE KIDS.
WHOSE PARENTS AND THEIR PARENTS
THEIR GRANDPARENTS AND SO ON AND
SO FORTH A LOT OF PEOPLE HAVE NO
IDEA WHAT THIS IS LIKE IN THIS
IS LIKE OWES THOSE PEOPLE. BUT
THIS IS HOW WE TAKE BILLS PEOPLE
ONLY BRING THE MEN. AND WOMEN
SHOULD THAT THAT NEXT GENERATION
IS A CONTINUING TO GO DOWN THAT
PATH AND WE DO BREAK THE CYCLE.
SO I LOOK FORWARD TO HOW THIS
COMES OUT MAY. GIVE.
WITH THAT I WILL HOLD ISSUE FIVE
OPEN AND HOPEFULLY WE WEREN'T
TOO PAINFUL.
THANK YOU. TO MOVE ON TO ISSUE
SIX.
DOCTOR RICHARD ALL NAY IS NOW
JOINING US IS THE DIVISION CHIEF
FOR GENETIC DISEASE SCREENING.
AND IF I MEAN FOR RICHMOND.
I THINK YOU HAVE HONOR. THANK
YOU.
SO FOR FISCAL YEAR TWENTY
EIGHTEEN NINETEEN THE GDS P.
ESTIMATE A LIST A TOTAL TEST
UNDER HUNDRED THIRTY THREE
MILLION DOLLARS.
AND AS DOCTOR MITCHELL MENTIONED
EARLIER THAT'S BE SUPPORTED
THROUGH THE GENETIC DISEASE
TESTING FUN.
THAT REPRESENTS AN INCREASE OF
ABOUT A HALF A MILLION OVER
SEVENTEEN EIGHTEEN ESTIMATE AND
AROUND ONE AND A HALF MILLION
OVER THE SEVENTEEN EIGHTEEN
BUDGET ACT.
THEY'VE ONLY BEEN SLIGHT CHANGES
IN OUR CASE LOAD THIS INCREASE
IN OUR BUDGET FOR EIGHTEEN
NINETEEN IS LARGELY DUE TO
EXPENDITURES REQUIRED.
TO COMPLY WITH A NEWBORN
SCREENING EXPANSION PROVISIONS
ENACTED IN TWENTY SIXTEEN
THROUGH SP TEN NINETY FIVE.
AND THAT WILL EFFECTIVELY AT TO
NEWTON TO NEW DISORDERS TO THE
CALIFORNIA NEWBORN SCREENING
PANEL AND TWENTY EIGHTEEN.
DUE TO THEIR RECENT ADDITION TO
THE FEDERAL RECOMMENDED UNIFORM
SCREENING PANEL.
AND THAT'S POMPEII DISEASE AN
AND PS ONE.
OTHER INCREASE IN EXPENDITURES
WILL BE REQUIRED FOR EXPANSIONS
AND TESTING IN OUR LAB IN
RICHMOND FOR THE NEW DISORDERS.
AND THAT'S REQUIRED TO BEGIN BY
AUGUST TWENTY EIGHTEEN.
ARE THESE ADDITIONAL COSTS WILL
REQUIRE A NEWBORN SCREENING FEE
INCREASE OF TWELVE DOLLARS PER
SPECIMEN FOR THE NEW DISORDERS.
AND THAT WILL BRING THE TOTAL
FEE UP TO A HUNDRED AND FORTY
TWO DOLLARS AND TWENTY FIVE
CENTS EFFECTIVE IN JULY.
THE FEW INCREASE WILL PRIMARILY
COVER THE COSTS OF ROUTINE
TESTING WITH OUR LABORATORY
DEVELOPED TESTS.
AND EVENTUALLY THE COSTS OF
PROCESSES INVOLVED WITH ROLLOUT
OF FDA APPROVED TEST KITS.
IT COULD BE USED IN OUR REGIONAL
LABORATORIES.
APPROVALS BY THE FBI ARE
PROJECTED TO OCCUR AROUND TWENTY
NINETEEN.
AND WE WOULD PLAN TO IMPLEMENT
SCREENING IN THE RITUAL LAPS
OVER TWO TO THREE YEARS.
SO THAT'S IT FOR.
THANK YOU
DEPARTMENT OF FINANCE ELIA.
ANY PUBLIC COMMENT ON ISSUE SIX.
SEEN NONO BRING IT TO THE DICE.
JUST I I KNOW A LOT OF PEOPLE.
NAY IN IT'S GOTTA BE SAID NAM.
THEY AS A FATHER WE WENT THROUGH
GENETIC SCREENING I'VE GOT SOME
THINGS IN IN THE FAMILY AND.
I I HAVE AN OLDER SON WITH.
.
SPECIAL NEEDS SO WHEN ME AND MY
WIFE HAD HER TWINS WE WENT
THROUGH THE PROCESS AND WE
CAUGHT MY SON'S.
SPINA DEFERRED OUT IN VERO.
AND
SO I AND A LOT OF PEOPLE CAN SAY
THIS BECAUSE ONE WAY OR ANOTHER.
BUT WHAT IT ALLOWED ARE MY
FAMILY NAY IT'S IMPORTANT TO
SHARE BECAUSE I KNOW.
ON REALLY GENETIC SCREENING.
.
PEOPLE THAT ARE NECESSARY FOR
DON'T NECESSARILY SEE IT THE WAY
I DO KNOW. IS THAT IT GIVES US
AN OPPORTUNITY TO PLAN WHAT THE
FUTURE'S GOING TO BE LIKE AND
FOR US TO PREPARE OUR FAMILY
THAT'S WHAT WE WERE ABLE TO
DEAL.
ALMOST AT THE HAVE THE
CONVERSATIONS WITH OUR FAMILY OF
HEY WE'RE GOING TO HAVE A CHILD
THAT IS GOING TO BE LIKE THIS.
AND IT ALLOWED US TO SAID.
KIND OF THE PATH FORWARD FOR
HEM.
AND SET UP THE CONVERSATIONS OF
WHAT KIND OF THERAPY IN THINGS
HE'S GONNA NEED AND HAS LIFE.
NOW HE'S AFTER FIVE SURGERIES
HE'S FULLY RUNNING AROUND AND
GET SOMEBODY ELSE RUN FOR THEIR
MONEY.
BUT I THINK IT'S IMPORTANT AND
HEALTH.
THANK YOU GUYS FOR WHAT YOU DO.
THANK YOU.
WITH THAT WE WILL HOLD ISSUE SIX
OPEN AND MOVE ON TO ISSUE SEVEN.
OKAY.
ISSUE SEVEN IS OUR NEWBORN
SCREENING BCP.
AND WE'VE LISTED AROUND A TWO
MILLION DOLLARS AND ONGOING
EXPENDITURE AUTHORITY FROM THE
GENETIC DISEASE TESTING FUN.
AND THIS INCLUDES FIFTEEN NEW
POSITIONS FOR PERSONNEL.
WHO WILL PERFORM ALL ASPECTS A
SCREENING IN OUR LABORATORY TO
COMPLY WITH THE UPDATED HEALTH
AND SAFETY CODE RELATED TO THE
NEW DISORDERS?
GSP IS MEETING EXPECTED
TIMELINES FOR IMPLEMENTATION SO
WE HAVE NO CONCERNS ABOUT THE
LAUNCH IN AUGUST TWENTY
EIGHTEEN.
ARE WE WILL NEED THE NEW
PERSONNEL AND THEY WILL BE
REQUIRED TO CARRY OUT THE
ONGOING PROCESS IS A SCREENING
FOR THE NEW DISORDERS IN OUR
RICHMOND LABORATORY.
ARE ALSO ON THE BCP WE'VE LISTED
OF FOUR HUNDRED SIXTY THOUSAND
DOLLARS AND STATE OPERATIONS
EXPENDITURE AUTHORITY.
AND THREE POSITIONS FOR ONGOING
SECOND TIER TESTING THIS IS
PERFORMING A SECOND SCREEN ON
THE SAME. NEWBORN PLOTS BUT
COLLECTED ORIGINALLY AND THAT'S
TO REDUCE FALSE POSITIVE
RESULTS.
ARE WE ALREADY DO SOME SECOND
YOU'RE TESTING FOR SOME
CONDITIONS SUCH AS ADRENAL
CATASTROPHE AND THE SOUL EXPAND
IT TO.
METABOLIC CONDITIONS.
AND AS DISPLAY IN THE ESTIMATE
THIS OF FOUR HUNDRED SIXTY
THOUSAND DOLLAR INCREASE WILL BE
OFFSET BY A DECREASE OF THE SAME
AMOUNT AND LOCAL ASSISTANCE
FUNDING.
A BY DECREASING OUR COSTS FOR
FOLLOW UP OF FALSE POSITIVES
SCREENS. AND FOR UNNECESSARY
CONFIRMATORY TESTING.
DEPARTMENT OF FINANCE LA A.
SEEING NONE ANY PUBLIC COMMENT
ON ISSUE SEVEN.
WITH THAT WE WILL HOLD ISSUE
SEVEN OPEN AND MOVE ON TO ISSUE
A.
THANK YOU
IF YOU THINK YOU
.
GOOD AFTERNOON DOCTOR ARAMBULA
AND MEMBERS OF THE COMMITTEE. A
PLEASURE TO BE HERE THOUGHT
BEFORE I BEGIN I WANT TO
RECOGNIZE THAT WITH ME I HAVE
DOCTOR KEN SMITH SHE IS OUR
STATE PUBLIC HEALTH OFFICER
DIRECTOR OF THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH.
I WILL PROVIDE AN OVERVIEW OF
THE CENTER FOR INFECTIOUS
DISEASES ADDRESS YOUR QUESTIONS
AROUND HEPATITIS.
HEY HOW AND DOCTOR SMITH THEN
WILL COVER IT YOUR QUESTIONS AND
ISSUES AROUND HONESTLY THE IN
CALIFORNIA THINK.
BOB.
SO I'M YOU HAVE IN YOUR AGENDA.
AN EXCELLENT DESCRIPTION OF THE
PROGRAM AREAS IN THE CENTER FOR
INFECTIOUS DISEASES.
SO I WILL NOT REPEAT THAT
INFORMATION.
BUT BRIEFLY WANTED TO TELL YOU
ABOUT SOME OF THE ACTIVITIES.
THAT THINK MUCH OF THE TIME OF
MY STUFF FROM. LATE TODAY.
AT THE CORE OF OUR DAILY
ACTIVITIES IS OUR BELIEF THAT WE
EXIST
TO PROTECT THE PEOPLE OF
CALIFORNIA. FROM THE THREAT OF
PREVENTABLE INFECTIOUS DISEASES
AND TO ASSIST THOSE LIVING.
WITH AN INFECTIOUS DISEASE IN
SECURING PROMPT AND APPROPRIATE
ACCESS TO HEALTHCARE.
MEDICATIONS AND ASSOCIATED
SUPPORT SERVICES.
ONE OF OUR KEY ACTIVITIES ENOUGH
FOUNDATION.
FOR ALL THAT WE DO.
TO COLLECT AND ANALYZE DATA FROM
LABORATORIES.
AND HEALTHCARE PROVIDERS ON MORE
THAN EIGHTY INFECTIOUS DISEASES
OF PUBLIC HEALTH SIGNIFICANCE.
THIS SURVEILLANCE FUNCTION IS
ESSENTIAL. IN OUR HEALTH
PROTECTION GOALS BY GIVING US
INTELLIGENCE FOR THE EARLY
DETECTION OF INFECTIOUS DISEASE
THREATS.
WE ROUTINELY PREPARE FOR AND
RESPOND TO RESPOND TO THE
SUSPECT CASES OF BIO TERRORISM.
AND OTHER EMERGING INFECTIOUS
DISEASE THREATS IN CALIFORNIA.
OVER THE PAST SEVERAL YEARS
WE HAVE INVESTIGATED.
M. BROUGHT UNDER CONTROL.
DOES SINCE BUTTONS OF INFECTIOUS
DISEASE OUTBREAKS.
WE HAVE DEALT WITH THREATS
COVERING A WIDE RANCHO A FEW
PICTURES THE THESIS.
SOME EXAMPLES INCLUDE
HEMORRHAGIC FEVERS
SUCH AS EBOLA.
MAXINE PREVENTABLE DISEASES SUCH
AS MEASLES MUMPS HEPATITIS.
MENINGITIS AND WHOOPING COUGH.
ACTOR BORNE DISEASES SUCH AS
HANTAVIRUS PLAGUE AND ZECA.
FOOD BORNE ILLNESSES INCLUDING
RECALL AYE LISTERIA AND
SALMONELLA.
RESPIRATORY AFFECTION SUCH AS
INFLUENZA TUBERCULOSIS
AND SEVERE RESPIRATORY SYMPTOMS.
AND SEXUALLY TRANSMITTED
INFECTIONS INCLUDING CONGENITAL
SYPHILIS.
THESE OUTBREAKS VARY IN SIZE
FROM A HANDFUL OF INDIVIDUALS.
HUNDREDS OF PEOPLE. IN VARIOUS
SEVERITY FROM MILD TO VERY
SEVERE. IN EVERY INSTANCE
SWIFT PUBLIC HEALTH ACTION.
PROVE TO BE VERY AND EXTREMELY
IMPORTANT IN EARLY CONTAINMENT
OF THE DECEASED.
WE HAVE TO THE STATE OF THE ART
NOT SHOWING A RECOGNIZED
INFECTIOUS DISEASE LABORATORIES.
THAT HAVE BEEN AT THE FOREFRONT
OF EVERYONE OF THESE PUBLIC
HEALTH RESPONSES.
OUR LABORATORIES PROVIDE TESTING
SEARCH CAPACITY IN SUPPORT OF
LOCAL HEALTH DEPARTMENTS.
DEVELOP NEW LABORATORY TEST FOR
NEW AND EMERGING INFECTIONS.
PROVIDE ESSENTIAL REFERENCE AND
COMPLEMENTARY TESTING.
AND MONEY TOWARDS TRAIN TYPING
AND NOT TIME MICROBIAL
RESISTANCE.
IN RECENT THREATS SUCH AS EBOLA
AND SIKA.
OUR LABORATORIES HAVE BEEN THE
VERY FIRST IN THE NATION TO THE
VILLA FESTING CAPACITY TO
PROTECT THE PEOPLE OF
CALIFORNIA.
WE PURCHASE AND DISTRIBUTE
PEDIATRIC VACCINES BY OF THE
FEDERAL VACCINES FOR CHILDREN
PROGRAM.
WE ALSO PURCHASE DISTRIBUTE AND
PROMOTE ADULT INFLUENCE OF
ACTING. FOR UNDER RISK GROUPS
WE PROVIDE GUIDANCE AND SUPPORT
TWENTY MINUTES HAS FROM PRACTICE
TEST THE LOCAL HEALTH
DEPARTMENTS.
NONPROFIT COMMUNITY HEALTH
CENTERS AND THE PRIVATE MEDICAL
COMMUNITY.
WE ASSESS THE MANY SOCIAL LEVELS
OF THE POPULATION AND DIRECT THE
ENFORCEMENT OF THE STATE SCHOOL
AND CHILD CARE IMMUNIZATION
REQUIREMENTS.
MOREOVER WE EDUCATE PROVIDERS
AND THE PUBLIC ON VACCINE
RECOMMENDATIONS.
WE WORK CLOSELY WITH HEALTH
OFFICIALS SIMBA CALIFORNIA
MEXICO TO PROTECT AND PROMOTE
THE HEALTH.
PEOPLE LIVING IN CALIFORNIA
BORDER COMMUNITIES. WE ALSO
FOSTER EDUCATION COMMUNICATION
AND HEALTH IMPROVEMENTS ALONG
THE US MEXICO BORDER.
WE SUPPORT THE PUBLIC HEALTH AND
MEDICAL NEEDS OF REFUGEES ON
THEIR GOING RESETTLEMENT IN
CALIFORNIA. AND ADMINISTER THE
REFUGEE HEALTH ASSESSMENT
PROGRAM FOR ELDERLY THAT
VACATION AND TREATMENT OF BOTH
INFECTIOUS AND CHRONIC HEALTH
CONDITIONS.
WE PROVIDE COUNSELING AND
TESTING FOR HIV. STV'S PP AND
HEPATITIS C. AND WORKING WITH
THIS EMBARRASSED FOR TESTING.
LASTLY AND VERY IMPORTANTLY WE
SECURE ACCESS TO LIFE SAVING
MEDICATIONS AND ASSOCIATED
SUPPORT SERVICES. FOR PEOPLE
LIVING WITH HIV AND HEPATITIS
INFECTION.
WE ADMINISTERED THE AIDS DRUG
ASSISTANCE PROGRAM AND MANY
OTHER IMPORTANT PUBLIC HEALTH
PROGRAMS.
I HOPE THESE BRIEF OVERVIEW HAS
BEEN HELPFUL FOR YOU.
A AND NOW WE CONTINUE TO ADDRESS
THE QUESTIONS THAT YOU HAD. OR
NOT RECENT RESPONSE TO THE
HEPATITIS A OUTBREAK.
YOUR FIRST QUESTION WAS HOW WAS
THE DEPARTMENT OF PUBLIC HEALTH.
CHEMICAL THAT HIS EMERGENCY
RESPONSE PROGRAMME UTILIZE.
IN THIS STATE RESPONSE TO THE
RECENT HEPATITIS A OUTBREAK.
WHAT MULTIPLE PROGRAMS WITH YOU
SEE THE P. H. PARTICIPATING IN
THE RESPONSE TO THE RECENT
HEPATITIS OUTBREAK?
PROGRAMS WITHIN THE SENATE FORTY
PICTURE THE FIFTH LEAD THE
RESPONSE BUT IT WOULD MEMBERS
FROM MANY OTHER CENTERS AND
OFFICES WITH YOU SEE THE PH ALSO
PARTICIPATED.
MORE IMPORTANTLY LOCAL HEALTH
AUTHORITIES IN EACH AND EVERYONE
OF THE EFFECT OF HEALTH
JURISDICTIONS.
WHERE ARE THE FOREFRONT OF THE
RESPONSE WORKING IN CLOSE
COLLABORATION WITH CVP AGE?
HOWEVER WITHIN OUR CENTER FOR
HELD UP WITH ENOUGH IN A FREE
PICTURE THIS HE SAID.
STOP THE VERY VERY CRITICAL WORK
THAT WAS CRITICAL IN CONTINUING
TO CONTAIN THE OUTBREAK.
WE WERE KEY IN IDENTIFYING THE
OUTBREAK IN MOUNTING ANOTHER
RESPONSE.
WE HAD THE NEPHRITE OUTBREAK
ASSOCIATED CASES TO SPECIALIZED
LABORATORY TESTING.
WE MONITOR THE INCIDENCE OF THE
CEASE AND PROVIDE A REGULAR
REPORTS ENSURING CONTROL
ENFORCEMENT PROPERTY TARGETED.
WE PROVIDE IT EXPERT GUIDANCE TO
LOCAL HEALTH DEPARTMENTS AND
OTHER PARTNERS.
WE WORK WITH THE GOVERNOR'S
OFFICE TO THE CURRENT STATE OF
EMERGENCY.
WE PROCURED DISTRIBUTED AND
MONEY TO OR OVER ONE HUNDRED AND
TWENTY THREE THOUSAND HEPATITIS
A VACCINE DOSES.
EIGHTY FIVE THOUSAND FEDERALLY
FUNDED AND THIRTY EIGHT THOUSAND
STATE FUNDED.
WE COORDINATED ENSURE TECHNICAL
AND EDUCATIONAL RESOURCES.
AND WE INSURE EFFECTIVE
COMMUNICATION BETWEEN LOCAL
STATE AND FEDERAL PARTNERS.
A QUESTION NUMBER TWO. WHAT WERE
THE LESSONS LEARNED RELATED TO
THAT CONTAINING OF HEPATITIS A
OUTBREAK?
WE LEARNED THE LACK.
OF ACCESS TO ADEQUATE HYGIENE
FACILITIES.
SENATOR LIVING ENVIRONMENT AND
HEPATITIS A VACCINE. RESULTED IN
HUNDREDS OF CASES OF HEPATITIS
A.
WITH ELIZABETH HOSPITALIZATIONS
AND MORE THAN TWENTY DEATHS.
THERE IS AN ONGOING RISK A FEW
PICTURE THIS IS SPREAD DUE TO
THE LIVING CONDITIONS FACED BY
HOMELESS PERSONS AND PERSONS WHO
USE DRUGS.
THESE CONDITIONS HAVE RECENTLY
CONTRIBUTED FOR THE TRANSMISSION
OF ALL THEIR THE HISSING
CALIFORNIA. INCLUDING SYPHILIS
AND TUBERCULOSIS.
INJECTION DRUG USE POST THIS
PARTICULAR THIS IS TRANSMISSION
RISK FOR HIV. HEPATITIS C. AND
SERIOUS BACTERIAL INFECTIONS.
THE RESPONSE TO THESE LARGE
OUTBREAK REQUIRED A COORDINATED
EFFORT BETWEEN LOCAL STATE AND
FEDERAL AGENCIES.
HEALTHCARE PROVIDERS AND PRIVATE
INDUSTRY PARTICULARLY VACCINE
MANUFACTURERS.
THE CORNELIA MANAGEMENT OF
LEAVING IT THIS IS CONTROL
RESOURCE US IN THIS CASE
VACCINE.
WAS A VERY VERY IMPORTANT IN
HELPING US CONTAIN THE EPIDEMIC.
THEY MAY POPULATION SUNDRESS FOR
HEPATITIS A IN THIS OUTBREAK
PERSONS EXPERIENCING
HOMELESSNESS AND OR ILLICIT DRUG
USE. IS A VERY CHALLENGING
POPULATION TO REACH.
THE CITY AND IS A GROUP MAY NOT
BE READILY IDENTIFIED.
DELIVER YOUR PREVENTIVE SERVICES
IS DIFFICULT AND COSTLY AND
OPTIONS FOR ISOLATION TO PREVENT
DISEASE TRANSMISSION A VERY
LIMITED.
FOR EXAMPLE THE MOST EFFECTIVE
APPROACH TO THE LIVER VACCINE
THIS OUTBREAK. WAS TAKING
VACCINE INTO HOMELESS
ENCAMPMENTS
THIS REQUIRED TEAMS OF THREE
PEOPLE WITH A NURSE TO PROVIDE
THE VACCINE. A PEACE OFFICER FOR
SAFETY IN A COMMUNITY WORKER TO
PROMOTE TRUST AND VEXING
ACCEPTANCE AMONG THE POPULATION.
THE GOVERNOR'S EMERGES FOR THE
CORRECTION WAS CRITICAL TO
PROCURE VACCINES.
ENSURE ADEQUATE SUPPLY OF
VACCINES AND FOR THE EFFECTIVE
DISTRIBUTION OF COMPLEX THINGS.
QUESTION NUMBER THREE.
HOW COULD THE STATE RICH
SUFFICIENT HEPATITIS
VACCINATION RATES TO ACCOMPLISH
HERD IMMUNITY?
HERD IMMUNITY IS ALREADY
INCREASING USED THE
INTERNATIONAL GUIDELINES THE
HAVE RECOMMENDED. THAT ALL
CHILDREN RECEIVE HEPATITIS A
VACCINE.
TRANSMISSION OF HEPATITIS A IN
CALIFORNIA HOUSE FALLING SHARPLY
SINCE NINETEEN NINETY NINE. WHEN
WE ARE NOT THAT I CHILDHOOD
VACCINATION REQUIREMENT.
THEREFORE DO THEY MOST CHILDREN
ANOTHER LISTEN CALIFORNIA ARE
PROTECTED AGAINST HEPATITIS A.
HOWEVER AS WE KNOW SOME GROUPS
REMAIN A TIGHT RACE FOR
HEPATITIS A TRANSMISSION
PARTICULARLY ADULTS WHO ARE AT
HIGH INTEREST OF EXPOSURE TO
HEPATITIS HAY.
THESE GROUPS INCLUDE HOMELESS
PERSONS.
PEOPLE USING ILLICIT DRUGS MEN
WHO HAVE SEX WITH MEN AND PEOPLE
WHO TRAVEL TO COUNTRIES WHERE
HEPATITIS A IS COMMON.
TO EXPAND HER IMMUNITY TARGETED
INEFFICIENT AIRPORT FOR HIGH
RISK ADULTS WOULD BE REQUIRED.
AND QUESTION NUMBER FOUR. WHAT
ARE THE PREDICTABLE RACING OFF
INCREASE HEPATITIS A INCIDENCE
RATES IN LIGHT OF THE STATE'S
INCREASING HOMELESS POPULATION?
HEPATITIS A OUTBREAK SOMEONE
HOMELESS PERSONS HAVE OCCURRED
IN THE PAST BUT THEY HAVE BEEN
UNCOMMON.
HOWEVER IN THE PAST TWO YEARS
ALONE THERE HAVE BEEN SEVERAL
HEPATITIS A OUTBREAK IN HOMELESS
PERSONS ACROSS THE COUNTRY.
HOUSE ALONG OF THAT ARE PERSONS
LIVING IN SITUATIONS WITH
INADEQUATE HEIGHT YOU
POSSIBILITIES AND SUNNY PATIENT.
AND LIMITED ACCESS TO
HEALTHCARE.
THERE WILL BE RISK OF HEPATITIS
OF HEPATITIS A TRANSMISSION. AS
WELL. AS TRANSMISSION OF ALL THE
DISEASES INCLUDING TUBERCULOSIS.
CONCOMITANT RACE FACTORS LIKE
DRUG USE INCREASE THE RISK OF
HEPATITIS A SPREAD. AIN'T TO
THIS RISK FOR OTHER THE SEASON
SUCH AS HIV.
INCREASING HEPATITIS A IMMUNITY
FROM COVERAGE
WOULD REDUCE THE RISK OF
HEPATITIS AND TRANSMISSION. BUT
WILL BE DIFFICULT AND WILL NOT
ADDRESS THE RISK UP ON THE DE
CSS.
ADDRESSING KEY UNDERLYING
FACTORS
SUCH AS ACCESS TO STABLE
HOUSING.
DRUG TREATMENT AND MENTAL
ILLNESS SERVICES RQ WAYS TO
DECREASE OVERALL RISK.
SO THAT CONCLUDES MY REMARKS ON
HEPATITIS A ALL YOU WANT TO
CONTINUE TO. FESTIVITIES HAD
ABOUT THE QUESTIONS ON HEPATITIS
FIRST
I THINK I'D LIKE TO ASK A FEW
FOLLOW UP QUESTIONS ON HEPATITIS
IF I COULD YOUR TIME. AND I
PROBABLY NEED TO BACK UP HALF A
SECOND AND TELL YOU PART OF THE
REASON WHY I'M SO INTERESTED AM
I WENT TO GO VISIT ONE OF THE
HOMELESS ENCAMPMENTS IN SAN
DIEGO. AFTER THE OUTBREAK AND.
BECAUSE OF WHAT I SAW AND.
EXPERIENCED FIRST HAND WHEN I
CAME BACK TO FRESNO.
I WANTED TO WORK WITH OUR LOCAL
HOMELESS ENCAMPMENTS TO GET
VACCINATIONS AND HELP TO
INCREASE AND SEE IF WE COULD GET
TO HER COMMUNITY.
ONE OF THE STRUGGLES WE FOUND IS
AN INABILITY TO ACCESS.
THE VACCINE BECAUSE OF THE NEED
TO USE IT AND SOUTHERN
CALIFORNIA. SO I WANTED TO
UNDERSTOOD AND IF I CAN WHEN YOU
TALKED ABOUT THE VACCINE
MANUFACTURERS.
HOW QUICK WAS THEIR RESPONSE TO
WHAT LEVEL SHOULD WE BE? I'M AT
STRIVING TO VACCINATE HOMELESS.
WOULD THE STATE OF CALIFORNIA
BENEFIT
FROM A PROGRAM TO PROACTIVELY.
CREATE HERD IMMUNITY WITHIN OUR
HOMELESS POPULATION BECAUSE OF
THE RATE OF INCIDENCE AND RECENT
SPREADS THAT WE'VE SEEN.
RIGHT.
SO GOING BACK TO THEIR EARLIER
STAGES OF THE OUTBREAK ARE AT
THE TIME WHEN WE HAD A DEL
BREAKING CALIFORNIA THERE WERE
OUTBREAKS OCCURRING IN OTHER
PARTS OF THE COUNTRY AS WELL.
AND THERE'S ONLY ONE MANUFACTURE
AT THE TIME THAT WAS PRODUCING
HEPATITIS A VACCINE.
SO WE WERE FACING A SITUATION
WHERE THERE WASN'T A NOVEL
SUPPLY OF HEPATITIS A VACCINE
NATIONALLY. ARE THE FEDERAL
GOVERNMENT HAD A SUPPLY THAT
THEY HAVE BEEN KILEY SHARING
WITH US BUT THEY WERE RUNNING
SHORT AS WELL.
SO ONE OF THE THINGS THAT WE DID
IN DECLARING THE YEAH EMERGENCY
IN CALIFORNIA IS THAT THEY GAVE
US ACCESS TO BOTH ADDITIONAL
HARM DOSES OF VACCINE THAT WE
COULD PURCHASE. BUT ALSO GAVE US
CONTROL IN TERMS OF WHERE
VACCINE DOSES WILL BE ALLOCATED.
THAT WAS VERY IMPORTANT BECAUSE
WHEN YOU HAVE ACTED OUTBREAKS
ENACTED TRANSMISSION OUR MAIN
GOAL WAS TO ACTUALLY BREAK THE
TRANSMISSION CYCLE FIRST BEFORE
WE COULD VACCINATE ANYONE ELSE.
SO OUR DOING THAT REALLY ALLOWED
US TO FOCUS ON THE COUNTIES
WHERE WE HAD ACTIVE ONGOING
TRANSMISSION WHICH WAS SAN
DIEGO.
LA SANTA CRUZ ARE PRIMARILY A TO
MAKE SURE THAT WE BROUGHT A
TRANSMISSION TO A TO A HALT.
I AND IN DOING SO YOU KNOW WE
PRIORITIZE BY COMMISSIONER THOSE
POPULATIONS.
HOWEVER WE KNEW THAT THERE WERE
ALL THE HYPE IS POPULATIONS IN
THE STATE AND SO WE. WANTED TO
MAKE VACCINE AVAILABLE FOR OUT
RISK COMMUNITIES IN DOES A
COMMUNITY IS A YOU KNOW TO THE
EXTENT THAT WE HAVE VACCINE
AVAILABLE.
BOB NOW THAT.
THE VACCINE SUPPLIES GETTING
BETTER ON WE UNDERSTAND THAT
MANUFACTURERS HUTS WRAPPED UP
AND THERE'S MORE VACCINE
AVAILABLE. I THINK WE CAN SAY
THAT I WEAR A POINT WHERE WE CAN
START FREEING UP MORE OF THE
VACCINE SUPPLY. SO THAT WE CAN I
GIVE IT TO OTHER POPULATIONS
THAT MAY NOT BE DIRECTLY
IMPACTED BY THE OUTBREAK. BUT
THAT ARE AT RISK FOR HOW ABOUT
LIKE TO SAY. I IN THIS CASE
GOING BACK TO YOUR QUESTION.
WHETHER OR NOT THE HOMELESS
INDIVIDUALS WILL BENEFIT FROM
CAPITALISM VACCINATION. ARE I
THINK THAT THEY WOULD AND IT'S
NOT NECESSARILY. BECAUSE THE CDC
CONSIDERS HOMELESS YET.
RISK FACTOR FOR BUT I THINK NO
ONE OF THE RECOMMENDED GROUPS OR
VACCINATION. BUTTING COLLEAGUE
CALIFORNIA WE KNOW FROM
EXPERIENCE THAT UNLESS WE CAN
INCREASE VACCINATION RATES IN
THE COMMUNITY. AYE IS GONNA BE A
CHALLENGE.
ANOTHER THING WE LEARNED DURING
THE OUTBREAK CONTROL IS THAT YOU
KNOW MOST HOMELESS INDIVIDUALS
ACTUALLY DO QUALIFY FOR MEDI
CAL.
SO IN WORKING WITH LOCAL HEALTH
AUTHORITIES WE WERE ABLE TO
ACTUALLY IN ROLE. MOST OF THE
HOMELESS INDIVIDUALS CAN OPERATE
ACTUALLY HE MADE THE COUNCIL THE
MEDICAL WOULD REIMBURSE. FOR THE
COST OF THE VACCINATION
SO THE REAL CHALLENGE IS TO
REACH TO THE POPULATIONS FINE
PEOPLE. AND GET HIM TO ACCEPT
AND AGREE TO BE VACCINATED BUT I
THINK WE HAVE THE INFRASTRUCTURE
TO THOUGH IT.
DO WE HAVE AN ESTIMATE OF NUMBER
OF.
POTENTIAL.
HOMELESS POPULATION THAT WOULD
NEED THE VACCINATION AND THE A
COST BOTH TO.
HELP WITH THE START UP BUT ALSO
ANY. PATIENTS WHO ARE NOT
COVERED BY MEDICARE ALL. IS
THERE A POSSIBILITY FOR US TO
WORK WITH YOUR DEPARTMENTS TO.
TRY TO COME UP WITH A FIGURE IN
LIGHT OF WHAT HAPPENED LAST
YEAR.
I THINK IT'S IMPERATIVE FOR US
TO TRY TO GET AHEAD OF.
THE BALL GOING FORWARD IS A
STATE AND WOULD WANT TO BE ABLE
TO WORK WITH YOUR DEPARTMENT
AFTERWARDS.
YEAH ESTIMATING THE NUMBER OF
HOMELESS PEOPLE IN CALIFORNIA
HAS PROVEN VERY VERY CHALLENGING
YOU KNOW WE'VE WE'VE HAD THE
SAME QUESTION AND WE WANTED TO
KNOW EVEN WITHIN THAT COUNTY
LIKE SAN DIEGO.
WHERE WE HAD?
ACTIVE OUTBREAK THERE WERE NOT
REALLY VERY GOOD ESTIMATES OF
HOW MANY PEOPLE ARE WHERE
HOMELESS.
SO SAN DIEGO COUNTY ACTUALLY HAD
TO DO VERY ACTIVE.
COUNTING THE PEOPLE WHO ARE
HOMELESS TO GET A BETTER
ESTIMATE BUT WHEN YOU WANT TO DO
THAT ACROSS THE STATE THERE'S
REALLY NOT A VERY GOOD PLACE
WHERE ONE CAN GO. BY AND SEE HOW
MANY PEOPLE ARE ARE ARE HOMELESS
OUT THERE.
THE HAVING SAID THAT I THINK
THAT IN MANY INSTANCES LOCAL
HEALTH DEPARTMENTS HAVE THE
ABILITY TO TRY TO QUANTIFY IN
THERE ON JURISDICTIONS. YOU KNOW
WHO IS HOMELESS ARE AND THEY
HAVE THE CAPABILITY OF HELPING
TO DISTRIBUTE VACCINE THE
VACCINE WAS TO BE MADE
AVAILABLE.
GREAT.
BOB WITH THAT IF I CAN WILL MOVE
ON TO THE STD QUESTIONS AND THEN
WILL INVOLVE PUBLIC COMMENT AND
DEPARTMENT OF FINANCE AND I'LL
HAVE TO THINK IT.
THANK YOU DOCTOR ARAMBULA
MEMBERS THANK YOU FOR THE
OPPORTUNITY TO SPEAK TO ON A.
TOPIC OF GREAT FOCUS FOR ME AND
THAT IS THE INCREASE IN SEXUALLY
TRANSMITTED INFECTIONS IN
CALIFORNIA.
UNLIKE GIL I'M NOT GONNA READ
YOUR QUESTIONS TO YOU BUT I'LL
ANSWER ALL OF YOUR QUESTIONS IN
THAT.
CONTEXT
TWO TWENTY SIXTEEN CENTERS FOR
DISEASE CONTROL AND PREVENTION
DATA SHOWS THAT CALIFORNIA HOW
THE HIGHEST NUMBER OF CASES OF
ALL THREE REPORTABLE BACTERIAL
SEXUALLY SEXUALLY TRANSMITTED
DISEASES.
CHLAMYDIA GONORRHEA AND SYPHILIS
INCLUDING THE HIGHEST NUMBERS OF
CONGENITAL SYPHILIS CASES. IN
OUR PRELIMINARY CALIFORNIA DATA
FOR TWENTY SEVENTEEN SHOWS
CONTINUED INCREASE IN EACH OF
THESE.
SPECIFICALLY IN TWENTY SEVENTEEN
THERE WERE THIRTEEN THOUSAND
FOUR HUNDRED AND FORTY SEVEN
EARLY SYPHILIS CASES REPORTED IN
THE STATE A TWENTY PERCENT
INCREASE OVER TWENTY SIXTEEN.
AND DOUBLE THE NUMBER FROM
TWENTY THIRTEEN.
EARLY SURPLUSES AS YOU KNOW THE
INFECTIOUS STAGE OF SYPHILIS AND
MOST DIRECTLY.
REFLECTS THE ONGOING SYPHILIS
TRANSMISSION IN COMMUNITIES.
THE CASES ARE PREDOMINANTLY MALE
AND MOST OF THEM ARE MEN WHO
HAVE SEX WITH MEN. OVER HALF ARE
ALSO HIV POSITIVE.
HOWEVER FEMALE CASES HAVE ALSO
INCREASED FOURFOLD SINCE TWENTY
THIRTEEN WITH A VERY CONCERNING
RISING CONGENITAL SYPHILIS.
THE NUMBER OF INFANTS BORN WITH
CONGENITAL SYPHILIS IN TWENTY
SEVENTEEN INCREASE FOR THE FIFTH
CONSECUTIVE YEAR. TWO HUNDRED
AND SEVENTY EIGHT CONGENITAL KIT
THAT SYPHILIS CASES WERE
REPORTED IN TWENTY SEVENTEEN
WHICH IS A THIRTY PERCENT
INCREASE OVER TWENTY SIXTEEN.
AND THERE WERE AN ADDITIONAL
THIRTY CONGENITAL SYPHILIS
ASSOCIATED STILLBIRTHS.
NEARLY THREE TIMES THE NUMBER
REPORTED IN THE PRECEDING YEAR.
WE'VE NOT SEEN THIS MANY
CONGENITAL SYPHILIS CASES IN
OVER TWENTY YEARS.
TWENTY SEVENTEEN ALSO SAW THE
HIGHEST NUMBER OF GONORRHEA
CASES SINCE NINETEEN EIGHTY
EIGHT.
SEVENTY FIVE THOUSAND FOUR
HUNDRED AND TWENTY THREE CASES
OF GONORRHEA WERE REPORTED AN
INCREASE OF SEVENTEEN PERCENT
OVER TWENTY SIXTEEN AND NEARLY
DOUBLE TWENTY THIRTEEN.
FINALLY AS ONE WOULD EXPECT THE
NUMBER OF CHLAMYDIA CASES HAS
ALSO INCREASED IN TWENTY
SEVENTEEN THE NUMBER WAS UP
ABOUT TEN PERCENT OVER TWENTY
SIXTEEN AND THIRTY PERCENT OVER
TWENTY SEVENTEEN.
AT TWO HUNDRED AND EIGHTEEN
THOUSAND FOUR HUNDRED AND FORTY
NINE REPORTED CHLAMYDIA CASES
THIS WAS THE UP IN TWENTY
SEVENTEEN THAT'S WAS THE HIGHEST
NUMBER SINCE REPORTING BEGAN IN
NINETEEN NINETY.
THE RATE OF CHLAMYDIA WAS AS
HAD HAS BEEN HIGHEST AMONG
ADOLESCENTS AND YOUNG WOMEN.
IMPORTANT DISPARITIES
PERSISTENT STDS WITH THE HIGHEST
RATES AMONG YOUNG PEOPLE AFRICAN
AMERICANS AND GAY BISEXUAL AND
OTHER MEN WHO HAVE SEX WITH MEN.
THESE POPULATIONS ARE AT HIGHER
RISK ALSO FOR OTHER SERIOUS
OUTCOMES INCLUDING HIV
INFECTION.
INFERTILITY SYPHILIS OF THE
NERVOUS SYSTEM AND MULTI DRUG
RESISTANT GONORRHEA.
IN LARGE PART THESE INCREASES IN
STDS ARE BEING DRIVEN BY BROAD
SOCIAL FACTORS.
INCLUDING INCREASED RATES OF
SUBSTANCE USE THE EXCHANGE OF
SEX FOR THINGS SUCH AS MONEY
HOUSING AND OTHER RESOURCES.
GREATER EASE AND MEETING SEX
PARTNERS THROUGH MOBILE
APPLICATIONS AND OTHER CHANGES
IN SEXUAL BEHAVIORS.
INTERVIEWS WITH MEN WHO HAVE SEX
WITH MEN DIAGNOSED WITH SYPHILIS
HAVE REVEALED INCREASES IN THE
USE OF INTERNET AND INTRANET
APPLICATIONS TO MEET FOR A
ANONYMOUS SEX PARTNERS.
AMONG WOMEN SYPHILIS IT.
HAS BEEN THERE'S BEEN A SHARP
INCREASE IN METHAMPHETAMINE USE.
IN FACT THE RISK PROFILE FOR STD
CASES AMONG HETEROSEXUALS
PARTICULARLY WOMEN.
CLOSELY MIRRORS WHAT WE USE TO
SEE DURING THE CRACK COCAINE
EPIDEMIC OF THE LATE NINETEEN
EIGHTIES AND NINETEEN NINETIES.
THE SAME SOCIAL FACTORS
OBVIOUSLY PRESENT SIGNIFICANT
NEW CHALLENGES TO STD CONTROL
EFFORTS.
AT THE SAME TIME THAT THE LOCAL
INFRASTRUCTURE FOR COMMUNICABLE
DISEASE CONTROL INCLUDING STD
CONTROL HAS ERODED.
CITY PH IN OUR LOCAL HEALTH
JURISDICTION PARTNERS ARE
PURSUING A NUMBER OF AVENUES TO
ADDRESS THE ISSUES.
CITY PITCH CONTINUES OUR
SURVEILLANCE FOR STDS STATEWIDE
AND PROVIDES DATA TO INFORM
DISEASE CONTROL ACTIVITIES AT
THE LOCAL LEVEL. WE ALSO PROMOTE
STD AWARENESS EDUCATION TESTING
TREATMENT AND OTHER STRATEGIES
TO PREVENT DISEASE. AND WE
PROVIDE GUIDANCE LEADERSHIP
TECHNICAL ASSISTANCE AND QUALITY
IMPROVEMENT ACTIVITIES TO ENGAGE
PARTNERS AND BUILD CAPACITY FOR
DISEASE CONTROL.
THE CITY PITCH DISTRIBUTES ONE
POINT SIX MILLION DOLLARS IN
STATE LOCAL ASSISTANCE FUNDS TO
THE TWENTY EIGHT LOCAL CULTURES
TO ACTIONS WITH THE GREATEST STD
BURDEN. THESE FUNDS
PROVIDE THE COURSE SUPPORT FOR
PREVENTION AND CONTROL
ACTIVITIES FOR OF SURVEILLANCE
DISEASE INTERVENTION HEALTH
PROMOTION AND POLICY
DEVELOPMENT.
AND AS YOU KNOW IN FISCAL YEAR
TWENTY FIFTEEN SIXTEEN AN
ADDITIONAL ONE TIME FIVE MILLION
DOLLAR ALLOCATION OF LOCAL
ASSISTANCE FUNDS. PRESTI DE
CONTROL OVER THREE YEARS WAS
MADE TO SEE P. H. WE'RE
DISTRIBUTING THESE FUNDS TO
FORTY LOCAL CULTURE STE ACTIONS
WITH THE GREATEST STD BURDEN
OVER ABOUT THREE YEAR TIME LINE.
AND THE REMAINING HEALTH TO
JURISDICTIONS CAN ALSO REQUEST
AND WILL RECEIVE SUPPLIES SUCH
AS TEST KITS LABORATORY REAGENTS
HEALTH EDUCATION MATERIALS AT
SAUDARA.
THE SPENDING'S BEEN VERY
VALUABLE TO LOCAL STD PREVENTION
AND CONTROL PROGRAMS BUT THE
GREATEST NEED EXPRESSED BY LOCAL
HEALTH JURISDICTION IS FOR
ONGOING STAFFING TO GET OUT
DISEASE MONITORING INTERVENTION.
INCLUDING CASE INTERVIEWS
CONTACT TRACING A PARTNER
SERVICES.
UNFORTUNATELY SOME JURISDICTIONS
WERE NOT ABLE TO CREATE
PERMANENT FOR.
POSITIONS USING ONE TIME
FUNDING.
IN CALIFORNIA AS YOU KNOW LOCAL
HEALTH JURISDICTIONS HAVE
PRIMARY RESPONSIBILITY FOR
IMPLEMENTATION OF A STD CONTROL
AND PREVENTION.
IN FACT IF ACTIVELY CONTROLLING
STDS REQUIRES A FLEXIBLE SKILLED
LOCAL PUBLIC HEALTH WORSE
WORKFORCE. WHICH ALSO PROVIDES
THE BACKBONE INFRASTRUCTURE FOR
OTHER COMMUNICABLE DISEASE
CONTROL INCLUDING ADDRESSING
EMERGING THREATS AND DISEASE
OUTBREAKS.
HOWEVER THROUGHOUT THE STATE AND
ESPECIALLY IN OUR SMALL RURAL
JURISDICTIONS.
LOCAL HEALTH DEPARTMENTS HAVE
INSUFFICIENT RESOURCES TO
ADDRESS THE ONGOING INCREASES IN
STDS.
MANY LOCAL HEALTH DEPARTMENTS
HAVE EXPERIENCE PERSISTENT
STOPPING LOSSES BEGINNING WITH
BUDGET DECREASES IN TWO THOUSAND
EIGHT DURING THE RECESSION.
DESPITE RAISING RISING CASELOADS
BY TWENTY THIRTEEN THE MAJORITY
OF HEALTH DEPARTMENT PROGRAMS
NOT JUST THE SMALLEST
JURISDICTIONS REPORTED FEWER
THAN THREE FULL TIME EQUIVALENT
STAFF DEVOTED TO SEXUALLY
TRANSMITTED. TRANSMISSIBLE
DISEASES CONTROL.
BY TWENTY SIXTEEN LOCAL
DEPARTMENT STOCK WERE EXPECTED
TO MANAGE OF SYPHILIS CASE RATE
THAT HAD DOUBLED.
IN THE PRECEDING FIVE YEARS
WITHOUT ANY ADDITIONAL STOCK.
BECAUSE OF THIS SOME LOCAL HAVE
JURISDICTIONS ARE CHALLENGED IN
COMPLETING THE MOST ESSENTIAL
DISEASE INVESTIGATION
ACTIVITIES.
WHICH FOR SYPHILIS FOR EXAMPLE
INCLUDE TREATMENT VERIFICATION
MAKING SURE THAT PEOPLE ARE
GETTING THE APPROPRIATE
TREATMENT.
PARTNER SERVICES LINKAGES TO HIV
TESTING AND LINKAGE TO HIV CARE
OR PRE EXPOSURE PROPHYLAXIS.
IN TWENTY SIXTEEN TWENTY SEVEN
PERCENT OF SYPHILIS CASES WITH
RECENT INFECTION AND THIRTY NINE
PERCENT WITH EARLY OF EARLY
LATENT CASES WERE NOT
INTERVIEWED FOR PARTNERSHIP MRS.
THE SERVICE THESE THIS MEANS
THAT OF THESE SERVICES ARE THE
MEANS BY WHICH WE IDENTIFY AND
TREAT ADDITIONAL CASES OF
SYPHILIS AND INTERRUPT IZZY'S
TRANSMISSION.
AND ALTHOUGH LOCAL HEALTH
JURISDICTIONS ALWAYS PRIORITIZE
FOLLOW UP OF PREGNANT FEMALES
WITH SYPHILIS.
OVER SEVENTY PREGNANT WOMEN WITH
SYPHILIS DID NOT RECEIVE PARTNER
SERVICES INTERVIEWS IN TWENTY
SIXTEEN.
ALSO IN TWENTY SIXTEEN AMONG
EARLY SO ALL EARLY SYPHILIS
CASES WHOSE HIV STATUS WAS
NEGATIVE ERA KNOWN. ONLY FIFTY
SEVEN PERCENT WERE DOCUMENTED TO
HAVE RECEIVED AN HIV TEST IN THE
THIRTY DAYS FOLLOWING SYPHILIS
DIAGNOSIS.
I MENTION THIS BECAUSE THESE ARE
MISSED OPPORTUNITIES TO
INTERRUPT YOUR DISEASE
TRANSMISSION NOT JUST FOR
SYPHILIS. AND CONGENITAL
SYPHILIS BUT ALSO FOR EACH AB.
IN RECENT YEARS AS THE MAJORITY
OF STD CLINICS HAVE CLOSE
SPECIALTY STD CLINICS
RESPONSIBILITY FOR TREATMENT.
HAS SHIFTED TO THE PRIVATE
SECTOR.
UNFORTUNATELY MOST CLINICIANS IN
THE PRIVATE SECTOR HAVE RECEIVED
LITTLE OR NO TRAINING IN THE
APPROPRIATE DIAGNOSIS AND
TREATMENT OF STDS.
TWENTY SIXTEEN SURVEILLANCE DATA
PERSEPOLIS SHOWS THAT TWENTY TWO
PERCENT OF WOMEN OF REPRODUCTIVE
AGE WITH A NEW SYPHILIS
DIAGNOSIS DID NOT RECEIVE
TREATMENT CONSISTENT WITH THE
CDC'S STD TREATMENT GUIDELINES.
IT PUTS THESE WOMEN AT RISK OF
COMPLICATIONS FOR SYPHILIS
INCLUDING THE INCREASED RISK FOR
CONGENITAL SYPHILIS SHOULD THEY
BECOME PREGNANT WHILE INFECTED.
IN THE MIDST OF THE CONCERNING
HOWEVER THERE IS GOOD NEWS OUT
THERE ARE EVIDENCE BASED COST
EFFECTIVE INTERVENTIONS THAT WE
KNOW WILL REDUCE STDS AND THERE
HAVE BEEN SUCCESS STORIES FROM
UP ABOVE JURISDICTION.
LIKE TO SHARE SOME OF THOSE.
.
BECAUSE OF CONCERNS REGARDING
MISSING OR INADEQUATE TREATMENT
OF STDS IN TWENTY FIFTEEN THREE
LOCAL HEALTH JURISDICTIONS
UNDERTOOK A TARGETED EVALUATION
PRO PROJECT AIMED AT IMPROVING
GONORRHEA TREATMENT.
THESE LOCAL JURISDICTIONS
CONTACTED NINETY THREE
PROVIDERS.
PROVIDED EDUCATION AND
INFORMATION ABOUT GONORRHEA
REPORTING IN TREATMENT.
THE PROPORTIONATE PROVIDERS
ORDERING CDC RECOMMENDED
TREATMENT ROSE FROM FIFTY TWO
PERCENT IN TWENTY THIRTEEN TO
EIGHTY FOUR PERCENT IN TWENTY
SIXTEEN AS A RESULT OF THIS
INTERVENTION.
A SIMILAR PROVIDER BASED QUALITY
IMPROVEMENT PROJECT IS UNDER WAY
FOR TWENTY SIXTEEN TO ENHANCE
CIVIL A SCREENING ENTRANCE
TREATMENT OF PREGNANT WOMEN.
AND WHILE THESE TYPES OF
INTERVENTIONS ARE EFFECTIVE
LOCAL HEALTH JURISDICTIONS HAVE
ONLY BEEN ABLE TO IMPLEMENT THEM
A SUPPLEMENTAL RESOURCES HAVE
BEEN AVAILABLE.
I'LL ASSIST IMPLEMENTATION UP.
TARGETED SCREENING AT RISK PUT
BUMPER POPULATIONS IS EXTREMELY
IMPORTANT.
TWELVE COUNTIES ARE CURRENTLY
RECEIVING SUPPLEMENTAL FEDERAL
FUNDING FOR JUVENILE HALL
CHLAMYDIA AND GONORRHEA SO.
SCREENING PROGRAMS.
TWENTY SIXTEEN DATA FROM THESE
CORRECTIONAL SCREENING SITE SHOW
THAT TWELVE PERCENT OF PERSONS
SCREAMED HAVE CREPT CHLAMYDIA
INFECTION. AND FOUR PERCENT HAVE
GONORRHEA WITH THIS HIGH LEVEL
OF INFECTION STD CASE BINDING IN
THESE VENUES IS HIGHLY
EFFICIENT.
SIMILAR INCREASES IN OFFICIAL IN
INEFFICIENT CASE FINDING HAVE
BEEN DEMONSTRATED WITH TARGETED
SYPHILIS SCREENING OF WOMEN IN
JAILS IN LOCAL HEALTH
JURISDICTIONS. WITH HIGH NUMBERS
OF FEMALE AND CONGENITAL
SYPHILIS CASES.
PARTNER SERVICES WHICH WE OF IN
OTHER DISEASES CALL.
CONTACT TRACING HAS BEEN A
STANDARD PRACTICE FOR
COMMUNICABLE DISEASE CONTROL
PROGRAMS NATIONWIDE AND ISRAEL
RECOMMENDED BY THE CDC. AS AN
EFFECTIVE PUBLIC HEALTH STRATEGY
TO REDUCE STD AND HIV
TRANSMISSION AND ASSOCIATED
MORBIDITY.
PARTNER NOTIFICATION IS AN
IMPORTANT COMPONENT OF PARTNER
SERVICES AND IS INTENDED TO
IDENTIFY LOCATE AND INFORM
PEOPLE OF THEIR POTENTIAL
EXPOSURE TO INFECTIONS. AND
REFER THEM INTO CARE THEREBY
PROVIDING TREATMENT AND BREAKING
THE CHAIN OF TRANSMISSION.
PARTNER SERVICES AND NOT ONLY
AFFECTED FOR SYPHILIS IT'S ALSO
A HIGHLY EFFECTIVE WAY TO
IDENTIFY PEOPLE WHO ARE UNAWARE
OF THEIR HIV STATUS CREATING AN
IMPORTANT OPPORTUNITY TO RESIST
REDUCE THE RESERVOIR UNDETECTED
HIV. BY PROVIDING ON OPPORTUNITY
FOR TESTING LINKING TO TREATMENT
LINKING UP AT RISK HIV NEGATIVE.
THE POSITIVE PERSONS TO TO
EXPERT TREATMENT.
TRIGGER PREVENTS THE SPREAD OF
STDS AND REDUCES THE ADVERSE
HEALTH OUTCOMES OF THEM.
BOB EXPEDITED PARTNER TREATMENT
OF SEX PARTNERS OF OF PATIENTS
DIAGNOSED WITH STDS.
IS A PROVISION OF TREATMENT TO
THE PATIENT TO PROVIDE TO THEIR
PARTNER WITHOUT THAT PARTNER
REQUIRING A HEALTH CARE IT
PROVIDER EXAMINATION BEFORE.
PARTNER.
EXAMINATION BY CLINICIAN IS
OFTEN NOT FEASIBLE FOR MANY
REASONS AND EXPEDITED PARTNER
TREATMENT OVERCOMES THOSE
BARRIERS TO PARTNER TREATMENT
AND REDUCES REINFECTION.
OF THE ORIGINAL PERSON AS WELL
AS DISEASE TRANSMISSION TO
OTHERS.
SOCIAL MARKETING SAVANNAH IS A
VITAL STRATEGY TO ADDRESS
BEHAVIORAL DISORDERS OF AS A
EXCUSE ME BEHAVIORAL DRIVERS OF
STD INCREASES.
SOCIAL MARKETING BOOSTS UPTAKE
OF SERVICES AND ESTABLISHES
SOCIAL NORMS THAT SUPPORT
HEALTHY BEHAVIORS.
WITH THE CURRENT ONE TIME
FUNDING THREE YEAR LOCAL
ASSISTANCE FUNDING INCREASED
LOCAL TO HELP JURISDICTIONS HAVE
BOOSTED THEIR HEALTH PROMOTION
ACTIVITIES BY PARTNERING WITH
MEDICAL PROVIDERS MATERNAL CHILD
HEALTH. PROGRAM PROVIDERS AND
OTHER COMMUNITY STAKEHOLDERS TO
INCREASE AWARENESS OF CONGENITAL
SYPHILIS AND TESTING ON PREGNANT
WOMEN.
THE OTHER ADDITIONAL EFFORTS TO
FURTHER INTEGRATE STD AND HIV
HEALTH COMMUNICATION MESSAGING
IS UNDER WAY WITH DEVELOPMENT OF
STAKEHOLDER INFORMED STD ITCH AB
MESSAGING FOR MEN WHO HAVE SEX
WITH MEN. AND INTEGRATED STD HIV
PROVIDER DETAILING IE DIRECT
COMMUNICATIONS WITH PROVIDERS TO
PROVIDE EDUCATION.
I'M TO ENHANCE THAT PROVIDER
AWARENESS OF SCREENING AND
TREATMENT GUIDELINES AND FOR HIV
PROP.
PROVIDERS ADDITIONALLY
IMPLEMENTATION OF TRAINING AND
TECHNICAL ASSISTANCE FOR SCHOOL
DISTRICTS AND SCHOOL BASED
PARTNERS.
SUPPORT CALIFORNIA HEALTHY YOUTH
ACT HAS BEEN A FOCUS OF A NUMBER
OF LOCAL CULTURES TO ACTIONS AS
ANOTHER WAY TO PREVENT STDS
AMONG YOUTH.
THERE ARE OPPORTUNITIES FOR
INNOVATION AS WELL I'M IT'S
IMPORTANT THAT WE ENSURE THAT
EVIDENCE BASED STD PRACTICES
LIKE RISK BASED TESTING
TREATMENT AND MORE USE AND
GREATER USE OF EXPEDITED PARTNER
THERAPY ARE CONSIDERATIONS IN
POLICY DECISIONS.
WHEN WE WERE.
MAKING POLICY RELATED TO THE
CONTINUING EVOLUTION OF THE
HEALTHCARE DELIVERY SYSTEM.
HOWEVER THE INCREASE IN STDS IS
PREDOMINANTLY BEING DRIVEN BY
SOCIAL TREND.
WHEN WE NEED TO INNOVATE WE NEED
INNOVATIVE STRATEGIES
TO FIGURE OUT HOW TO PROVIDE
EDUCATION AND DELIVER STD
SERVICES IN SETTINGS FREQUENTED
BY THE PEOPLE MOST AT RISK.
THIS SORT OF INNOVATION REQUIRES
COORDINATION BETWEEN MULTIPLE
PARTNERS AND.
PROGRAMS AND SEE BEACH IS
ACTIVELY WORKING TO IDENTIFY THE
MOST EFFECTIVE PARTNERSHIPS FOR
STD CONTROL AS WE MOVE. INTO THE
TWENTY FIRST CENTURY.
THIS CONCLUDES MY TESTIMONY NOT
BE HAPPY TO ANSWER ANY QUESTIONS
YOU MAY HAVE THANK YOU DOCTOR
SMITH.
BUT WE HAVE ONE FINAL QUESTION
FOR THE DEPARTMENT OF FINANCE
UNDER THE AGENDA.
I DON'T HAVE IT IN FRONT OF YOU
THOSE HOPING YOU COULD ADDRESS
THAT BEFORE. WE MOVE ON TO THE
LA.
FOLLOW DEPARTMENT OF FINANCE
AND.
YOU NO AS ALL PROPOSALS ARE
CONSIDERED.
WITHIN THE BROADER BUDGETARY
FRAMEWORK.
THEIR OFTEN DIFFICULT DECISIONS
WITH TO MAKE IT A LITTLE BIT A
GENERAL FUND RESOURCES.
WELL THE GOVERNOR'S BUDGET DOES
NOT INCLUDE ANY NEW PROPOSALS
FOR A CITY.
PREVENTION ACTIVITIES AND WE
WOULD NOTE THAT THERE ARE THERE
IS TWELVE MILLION AND WITHIN THE
PARK DEPART PUBLIC HEALTH TO
AND.
TO ADDRESS THE CITY PREVENTION
ACTIVITIES.
BUT IN LIGHT OF.
THE FACT THAT CALIFORNIA
SPENDING NEARLY A BILLION
DOLLARS IN TREATMENT OF STDS.
WOULDN'T IT A IMPROVE.
OUR ABILITY TO HELP TO PREVENT
DISEASE IF WE WOULD SPEND MORE
ON PREVENTION RATHER THAN
TREATMENT.
AND THOSE ARE SOME OF THE
DIFFICULT DECISIONS WE HAVE TO
ADDRESS AS WE'RE LOOKING AT THE
BROADER BUDGETARY FRAMEWORK.
KELLY O. ANY COMMENTS.
I WILL NOT TAKE PUBLIC COMMENT
ON ISSUE EIGHT.
YEAH MY NAME IS DAVID KILBURN
I'M EXECUTIVE DIRECTOR OF ACCESS
SUPPORT NETWORK OF SAN LUIS
OBISPO AND MONTEREY COUNTIES.
I'D LIKE TO JUST QUICKLY ADDRESS
QUICK'S.
SCENARIO OF HEPATITIS A
OUTBREAK.
.
WHILE MONTEREY COUNTY WAS NOT
ELIGIBLE FOR THE VACCINE TO
WHILE THE GOVERNOR HAD.
DIRECTED THOSE TYPE IMPACT
COUNTIES WE ACTUALLY ARE AIDS
SERVICE ORGANIZATION HEPATITIS
C. SERVICES.
PARTNERED WITH PUBLIC HEALTH AND
MONTEREY COUNTY AND PLANNED A
ACTION PLAN AROUND HOW WE WOULD.
BOB GET THOSE VACCINES OUT WE
HAVE A SYRINGE EXCHANGE PROGRAM
AND DO DIRECT OUTREACH TO THE
HOMES POPULATIONS WHAT WE DID IS
WE PLANNED.
A COURSE OF ACTION WIN THOSE
FUNDS WHEN THOSE VACCINES WOULD
EVER BECOME AVAILABLE. OF
MEDIATE LEE WHEN WE ARE CONTACT
IF THEY WERE AVAILABLE WE WERE
ABLE TO PARTNER. WITH PUBLIC
HEALTH GET THOSE VACCINES
DIRECTLY INTO THE FIELD
IMMEDIATELY SO I WOULD ENCOURAGE
THE STATE TO ENCOURAGE OUR
COUNTIES TO ENCOURAGE SYRINGE
EXCHANGE PROGRAMS IN THEIR
AREAS.
TO DO SIMILAR THINGS WE HAD THE
TRUST OF THE PARTICIPANTS AT
MOST RISK WE'RE ABLE TO BRING
NURSES IN FOR VACCINES ON SITE
IN OUR STRATEGIC CHANGE PROGRAM
AND GET. HUNDREDS OF PEOPLE
VACCINATED SOAP.
THANK YOU SIR.
SEEING NO FURTHER PUBLIC COMMENT
OF BRING IT BACK UP TO THE
DYESS.
I DID HAVE.
.
I WAS PARTICULARLY INTERESTED
WHEN YOU TALKED ABOUT THE PILOT
IN THE JUVENILE HALLS AND I'M
WONDERING IF THERE'S AN
OPPORTUNITY FOR US TO SINCE WE
OF RECOGNIZE THE BENEFIT.
TO SCALING THAT PROGRAM AND WAS
WONDERING IF YOU COULD COMMENT
ABOUT.
HOW WE CAN HELP TO PRIORITIZE
TESTING PRIOR TO DISCHARGE FROM
JUVENILE HALL SAYS IT SEEMS
THAT?
A FAIR AMOUNT ARE TRANSITORY HOW
CAN WE HELP TO INCREASE THE
AMOUNT OF TESTING THAT IS
OCCURRING IN OUR JUVENILE HALLS
SO THAT WE CAN HELP TO CATCH IT
SOONER.
YOU KNOW THAT'S AN EXCELLENT
QUESTION AND GOES BACK TO THE
VERY SAME ISSUE OF LOCAL
CAPACITY.
HIGH YOU KNOW OUR LOCAL HEALTH
OFFICERS AND WE MEET WITH THEM
REGULARLY KNOW THAT THAT THAT
WORKING WITH GILES REALLY WORKS
AND THEY WANT TO DO THIS ON IT
IS AN ISSUE OF THIS THEM NOT
HAVING ENOUGH CAPACITY AND THE
PERSONNEL. HOW TO WORK WITH THE
LOCAL JAILS IN SETTING UP
SCREENING PROGRAMS DOES NOT HAVE
DONE IT TOUGH ON THE TO BE VERY
EFFECTIVE? SO IS ONE OF THOSE
SORT OF LONG HANGING FRUITS THAT
WITHOUT SOME RESOURCES AT THE
LOCAL LEVEL COULD MAKE A BIG
DIFFERENCE. AND IT'S NOT LOST ON
ME THAT THE ONE TIME FUNDING DID
NOT CREATE THE ABILITY TO.
CREATE THOSE PERMANENT POSITIONS
AND LATER IN THIS AGENDAWE WILL
HEAR FROM ONGOING.
PROPOSAL THAT WILL PROVIDE A
SOURCE OF FUNDING THAT MAY ALLOW
US TO GET TO THAT PLACE.
BUT I DO FEEL THAT WE AS A STATE
HAVE AN OBLIGATION IN LIGHT OF
THE FACT THAT. CONGENITAL
SYPHILIS IS AT A TWENTY YEAR
HIGH THAT COMMITTEE AS THE MOST
SINCE NINETEEN NINETY. THAT NOW
IS THE TIME FOR US AS A STATE TO
BE APPROPRIATELY INVESTING. TO
ATTEMPT TO HELP TO PREVENT
DISEASE.
I'M HAVING BEEN ON THE FRONT
LINES HAVING WORKED IN AN AREA
THAT WAS QUITE A BIT OF A HOT
SPOT.
I HAVE SEEN THOSE CASES OF
CONGENITAL SYPHILIS AND.
THE. INFANT MORTALITY THAT COMES
WITH IT. AND REALLY DO BELIEVE
THAT WE SHOULD BE DOING AS MUCH
AS WE CAN TO TRY AND GET AHEAD
OF.
I HAD THIS PROBLEM FOR THE STATE
OF CALIFORNIA.
WITH THAT WE WILL HOLD ISSUE
EIGHT OPEN AND MOVE ON TO ISSUE
NINE THANK YOU DOCTOR SPENDING
FOR COME THANK YOU. ALSO DOCTOR
ARAMBULA I THINK ON THE AGENDA
THERE WAS A REQUEST THAT WE GIVE
YOU AN UPDATE ON WHAT WE HAVE
DONE WITH THE FUNDING YOU GAVE
US.
THROUGH STAKEHOLDER
AUGMENTATIONS THAT YOU WON TO
THOUGH THAT BEFORE WE PROCEED.
THAT IS UP TO YOU WE I HAVE A
DOCTOR HEIDI BAUER WHO IS OUR IS
TO THE CHIEF HERE WITH ME TO THE
WITH THAT ON THE IS TO THE
PROPOSAL CONDUCTOR MARK. ON THE
HIV PROPOSALS THE VALUE IF IT'S
OKAY MAYBE WILL HAVE A MEETING
AFTER THIS MARKET THAT IS
SOMETHING THAT I'M GOING TO
WANTS TO CONTINUE TO DIG INTO
AND.
BUT FOR THE SAKE OF THIS
MEETING IF WE MOVE ON TO SHORT
AND THAT BE CRAP THANK YOU VERY
MUCH THANK YOU.
BELIEVING.
GOOD AFTERNOON.
GOOD AFTERNOON I'M TIMOTHY BILL
I'M WITH THE ADMINISTRATION
DIVISION FOR THE CALIFORNIA
DEPARTMENT PUBLIC HEALTH. AND
BEFORE YOU IS A CAPITAL OUTLAY
BUDGET PROPOSAL. WHICH WILL
REVERT THREE POINT SEVEN NINE
NINE MILLION.
OF OUR EXISTING AUTHORITY AND A
REQUEST FOR FOUR POINT EIGHT SIX
SIX MILLION. FOR TO FUND THE
CONSTRUCTION PORTION OF THE
PUBLIC HEALTH BIO SAFETY LEVEL
THREE LABORATORY. THIS REQUEST
IS A NET INCREASE OF ONE POINT
ZERO SIX SEVEN MILLION DOLLARS.
THIS INCREASE APPROPRIATIONS
NECESSARY DUE TO THE DELAYS AND
INCREASED COSTS THAT WERE
BEYOND.
THAT DEPARTMENTS OR DEPARTMENT
GENERAL SERVICES CONTROL.
TO GIVE YOU A QUICK BACKGROUND
AND OVERVIEW OF THE PROJECT.
BE KEPT THE PUBLIC HEALTH
RICHMAN LABORATORY CAMPUS WAS
CONSTRUCTED IN TWO THOUSAND.
AND WITHIN THE LABORATORY CAMPUS
AS THE VIRAL RICK SILLIEST
DISEASE LABORATORY
APPROACH UP THAT UP BUT I JUST
QUALITY RTO.
THE VIDEO WAS A BSL THREE
CERTIFIED LABORATORY AND USE TO
SAMPLE A PATHOGENIC OF VIRUSES.
THIS LABORATORY UPGRADE PROJECT
STARTED TWO THOUSAND SIX WHEN
THE CENTER FOR DISEASE CONTROL
IN RESPONSE TO VARIOUS WHAT A
WAR HEALTH. ISSUES THAT ENHANCE
THE BE A SELF THREE
REQUIREMENTS.
IN FISCAL YEAR TWO THOUSAND
SEVEN TWO THOUSAND EIGHT WE
RECEIVED A FOUR HUNDRED EIGHTY
TWO THOUSAND DOLLAR
APPROPRIATION TO FUND THE
PRELIMINARY PLANS AND WORKING
TRYING PHASES OF THE PROJECT.
WE DIDN'T ENGAGE THE SERVICES OF
GENERAL SERVICES AND WHICH THEY
DEVELOP THE NATIVE PLANTS AND
THE WORKING TRUCKS.
IN FISCAL YEAR TWO THOUSAND
FIFTEEN SIXTEEN WE RECEIVED FOUR
POINT THREE THREE MILLION TO
FUND THE BED AND CONSTRUCTION
PHASE OF THE PROJECT.
THE.
THE SCHEDULE WAS TO.
DO THE.
OKAY BID PACKAGE IN TWO THOUSAND
SIXTEEN AND HE JUST COMPARE
PREPARED THEY ARE CONSTRUCTION
DRAWINGS AND BID PACKAGES.
HOWEVER DUE TO THE TWO THOUSAND
SIXTEEN CALIFORNIA WILDFIRES
THE STATE FIRE MARSHAL SUSPENDED
ALL THE PLAN REVIEWS BECAUSE
THEY HAD TO DIRECT ALL THE
RESOURCES TO COMBAT THE FIRE.
ONE.
DOES RESULT DIGESTED OUT WAS
UNABLE TO GET STUFF STATE
FARMERS APPROVAL AND A COMPLETE
THE PROJECT OUT THE BIT.
IN SIXTEEN SEVENTEEN WE CAME
BACK TO THE LEGISLATURE AND AND
ASK FOR REAPPROPRIATION OF THE
REMAINING THREE POINT SEVEN NINE
NINE.
FUNDS TO CONTINUE THE
CONSTRUCTION INTO THE NEXT
FISCAL YEAR.
FINALLY IN JUNE TWO THOUSAND
SEVENTEEN HE JUST FINALLY GOT
THE STATE FIRE MARSHAL APPROVAL.
BUT THE PLANS OUT THE BIT IN
AUGUST OUT TO THE ON SEVENTEEN.
AND THEN IN OCTOBER TWO THOUSAND
SEVENTEEN D. JUST RECEIVED ONLY
ONE BIT FOR THREE POINT FOUR
FOUR FIVE MILLION DOLLARS.
UNFORTUNATELY THIS WAS TWENTY
THREE PERCENT OR APPROXIMATELY
SIX HUNDRED FORTY THREE THOUSAND
ABOVE THE TWO POINT SEVEN NINE
SIX MILLION DOLLARS A
CONSTRUCTION BUDGET.
OKAY.
SO WE HAD THE JUST REVIEW THE
PROJECTS ESTIMATE AND THE BITS
THAT WERE RECEIVED. AND
DETERMINE THAT THAT ONE BECAUSE
IT'S A SPECIALTY TYPE OF SERVICE
SOUGHT AT THE LABORATORIES NOT
JUST STOP BUILDING CONSTRUCTION
NOW ELIMINATE THE COP THE
AVAILABLE CLOCK CONSTRUCTION
CONTRACTORS THAT COULD. FIT ON
THIS
THE SECOND WAS IF YOU LOOK AT
THE.
CONSTRUCTION MARKET RIGHT NOW
IT'S VERY VERY HEALTHY.
OF THEM IT'S VERY VERY STRONG IN
THE BAY AREA. AND US ALL THAT
LIMITED THE NUMBER OF FOLKS WHO
ARE INTERESTED IN GETTING SOME
FUND A PROJECT LIKE THIS.
THE PROJECT ALSO THE PROJECT
ORIGINAL ESTIMATE THAT
NECESSARILY GIVE A CALL REFLECT
THE CURRENT STRENGTH UP THE UC
CONSTRUCTION MARKET THEY USED A
THREE PERCENT OF. THE COST
INCREASE FACTOR AND IT'S GOT IN
THE CONSTRUCTION MARK WAS
GROWING AT TEN TO TWELVE
PERCENT.
SO THEN HE JUST LOOK AT THE BETS
AND ARE LOOKED AT THE ONE BIT
AND DETERMINED BASED ON WHAT
THEY SAW THAT IT IT. ADDED ACT
ACCURATELY REFLECTED BEYOND THE
CURRENT STRENGTH OF THE
CONSTRUCTION MARKET.
SO HERE WE ARE AGAIN.
THE CURRENT REQUEST INCLUDES
THE REVISED THE JUST COST
ESTIMATE WHICH WERE ACTUALLY
REFLECTS THE UP CURRENT STRENGTH
OF THE. OTHER CONSTRUCTION
MARKET AND THE SPECIALTY NATURE
OF THE UP PROJECT.
THE PROJECT REVISED SCHEDULE IS
THAT THE JETS ANTICIPATES WHAT
YOU APPROVAL WILL GO BACK UP THE
BED DOT SOMETIME IN SEPTEMBER.
WITH HOPEFULLY CONSTRUCTION TO
START IN JANUARY TWO THOUSAND
NINETEEN AND IT'S AS
CONSTRUCTION SCHEDULE BUT TWELVE
MONTHS AND SHOULD BE COMPLETE
AROUND THE FEBRUARY TWENTY
TWENTY. SO IN SUMMARY THE
PROJECT DELAYS WERE BEYOND
ANYBODY'S CONTROL. THE BSL THREE
ENHANCEMENTS ARE STILL WOULD
NEED IT SAUL WHO QUESTION
APPROVED FOR THIS PROPOSAL WE
COMPLETE THE PROJECT.
BECAUSE THE V. RTL LABORATORIES
A CRITICAL COMPONENT OF PUBLIC
HEALTH'S ABILITY TO MEET ITS
MISSION TO PROTECTING THE
HEALTH.
OF CAL ALL CALIFORNIANS THANK
YOU.
DEPARTMENT OF FINANCE EARLIER
WHEN IT COMES.
ANY PUBLIC COMMENTS ON ISSUE
NINE.
SEEING NONE OF WE WILL HOLD
ISSUE NINE OPEN AND MOVE ON TO
ISSUE TWELFTH PUBLIC THANK YOU
VERY MUCH
.
THANK YOU AND WELCOME.
CHAIR MEMBERS RANT MARTIN HERE
ON BEHALF OF AIDS HEALTHCARE
FOUNDATION AGAIN WITH OUR
PARTNERS AT ESSENTIAL HEALTH ON
ESSENTIAL ACCESS HEALTH WE ARE
HERE TO REQUEST OF A TEN MILLION
DOLLAR AUGMENTATION TO THEIR.
STD PREVENTION AND CONTROL
BRANCH SO DO MANY OF THE THINGS
THAT DOCTOR SMITH AND DOCTOR
CHAVEZ WERE SITTING UP HERE
TALKING ABOUT. I THINK OF THE
THE TENOR OF THE CONVERSATION IS
DIFFERENT THAN IT WAS WHEN WE
WERE BEFORE YOU A YEAR AGO.
WHICH I I FEEL LIKE YOU YOU HAD
TO TO PULL MORE INFORMATION OUT
OF THE DEPARTMENT THIS TIME THEY
WERE MUCH MORE WILLING TO. TO
PRESENT I THINK IT CHANGES ARE
CHANGES THE TENOR OF THIS
DISCUSSION WANT TO ADD.
ONE THING IN TERMS A CONTEXT
LIKE. WE LOOK AT WHAT'S HAPPENED
OVER THE LAST FEW YEARS WE'VE
BEEN OVER THE LAST TWENTY YEARS.
LOSE SIGHT OF THE FACT WHAT'S
HAPPENING CALIFORNIA THE LAST
HUNDRED YEARS
THIS IS WE ARE ANOTHER CYCLE
THAT WAS SIMILAR TO THE SIXTIES
AND SEVENTIES AND THOSE OF US
WHO GREW UP IN THE SIXTIES AND
SEVENTIES REMEMBER WHAT IT WAS
LIKE. AND HOW STD RATES WERE
OUTRAGEOUSLY.
I WASN'T ASKING FOR YOU TO HOOK
TO APPLY MISTER.
.
A.
SO IN THE IN NINETEEN SIXTY WE
SAW AT THE BEGINNING OF A RISE
ON AN STD RATES LOOKING AT
GONORRHEA AND PARTICULAR BECAUSE
THAT'S THE ONE THAT'S BEEN
TRACKED OVER.
THE LAST HUNDRED YEARS I'M TO
THE POINT WHERE WE GOT TO.
A RATE THAT IS WAS SO
OUTRAGEOUSLY HIGH IN SEVENTY
NINE ABOUT FIVE HUNDRED NINETY
FIVE CASES PER HUNDRED THOUSAND.
ON THAT THE STATE ACTUALLY
STEPPED UP.
AND STARTED DOING THINGS TO
BRING VALUE THE STD EPIDEMIC AT
THAT POINT UNDER CONTROL TO THE
POINT THE BY THE TIME WE GOT TO
THEM THAT NINETIES LATE NINETIES
WE WERE SEEING NUMBERS BACK TO
WHERE THEY WERE IN THE FIFTIES.
SOME OF THAT BECAUSE WHAT THE
STATE WAS DOING ON SOME OF IT
ALSO BECAUSE OF CULTURAL ISSUES
ON THE HIV EPIDEMIC.
HAD A LOT TO DO WITH THAT
BECAUSE PEOPLE CHANGE THEIR
THEIR.
THEIR PRACTICES
I'M BUT STILL WE MADE AN EFFORT
AND WE WERE ABLE TO PICK IT
UNDER CONTROL.
YOU LOOK AT THE LAST TEN YEARS
OR SO YOU'RE SAYING THAT.
THAT CLIMB BEGIN AGAIN ON WE
STARTED LOW AND WE'RE NOW BACK
UP INTO INTO THREE DIGIT NUMBERS
PER HUNDRED THOUSAND WITCHES.
AND AND CONTINUING TO GO OUT TO
GO OFTEN AND WE NEED TO DO
SOMETHING I'M DRAMATIC TO CHANGE
IT. WE APPRECIATE THIS COMMITTEE
ESPECIALLY TAKING A LEADERSHIP
ROLE BUT ALSO BY PUTTING FIVE
MILLION AND LAST YEAR
UNFORTUNATE DIDN'T SURVIVE. BUT
YOU WILL GET YOU UNDERSTAND AS
DOCTOR CHAVEZ SAID AND DOCTOR
SMITH SAID EVEN TODAY THAT THE
ISSUE WAS MANPOWER'S BITS PEOPLE
POWER WE NEED PEOPLE ON THE
GROUND WHETHER THEY WORK FOR
COUNTIES OR CBO'S. I'M TO
ACTUALLY DO THE WORK ON TO MAKE
SURE THAT THESE THINGS THAT
THINGS STICK. ON THAT WE'RE NOT
THROWING KITS AT THEM WHICH
IMPORTANT THEY NEED THOSE KITS.
FOR FOR TESTING PURPOSES BUT
YOU CAN'T STOP WITH THE TEST AND
NOT DO THE NEXT THINGS WHICH IS
MAKING SURE THAT THEY GET
TREATMENT THAT THEIR PARTNERS
GET NOTIFIED THAT THEIR PARTNERS
GET TREATMENT.
WHEN THEY NEED IT AMEND SO WE
DO REALLY INTERRUPT ON INTERRUPT
THE CYCLE AYE SO WE WOULD LAWYER
I STRONGLY ENCOURAGE YOU TO DO
AGAIN.
WHAT YOU DID LAST YEAR WE'RE
ASKING FOR TEN MILLION THIS YEAR
THE ISSUE GETS WORSE AND WORSE
URINE AND YOU'RE OUT?
AND WE REALLY NEED TO PUT A
SIZEABLE AMOUNT OF MONEY AT IT
ON TEN MILLION IS A SMALL AMOUNT
BUT IT'S CERTAINLY A A A BIG
START. GOING TO CLOSE WITH ONE
LAST POINT THAT THAT WE
SOMETIMES LOSE SIGHT OF THAT WE
LOOK AT ALL THE DATA. ON AND
THAT IS THAT MEDICALLY
CLINICALLY ON STDS ARE CHANGING.
ENDS I GONORRHEA ESPECIALLY HAS
GOT TO THE POINT WHERE WE ARE
DOWN TO ACCORDING THE CDC ONE.
TREATMENT THAT WORKS FOR
GONORRHEA EVERYTHING ELSE WE ARE
ARE SEEING DRUG RESISTANT.
STRAINS OF GONORRHEA THAT ARE
MAKING IT IMPOSSIBLE ARE NEARLY
IMPOSSIBLE TO US.
TO TREAT MOM SO WHERE WE'RE
CREATING A SITUATION WHERE THE
NUMBERS GO UP.
IN A DISEASE THAT IS BECOMING
INCREASINGLY UNTREATABLE WHICH
IF WE GET OVER THAT UNFORTUNATE
HUMP ON WILL FIND OURSELVES
REALLY AND I'M IN A WORLD OF
HURT. I'M NGUYEN COURAGE YOU TO
ADOPT THE TEMPLE IN DOLLARS
THINK IT.
I GOOD EVENING MISTER CHAIRMAN
AND.
MY NAME SLAVIC HESTIA I'M HERE
REPRESENTING ESSENTIAL ACCESS
HEALTH. OF WE CHAMPION AND
PROMOTE A QUALITY SECTION
REPRODUCTIVE HEALTH CARE FOR ALL
OUT WE ALSO ADMINISTER THE TITLE
TEN FEDERAL FAMILY PLANNING
PROGRAM. AND WE PARTNER WITH THE
STATE STD CONTROL BRANCH.
COUNTY HEALTH DEPARTMENT AND
PROVIDERS A TO IMPLEMENT BEST
PRACTICES AN STD PREVENTION AND
CASE MANAGEMENT.
.
YOU DON'T THIS IS NO LONGER AN
EPIC DEATH IT'S STD EPIDEMIC IF
THE PUBLIC HEALTH CRISIS IN BE
REACHED THAT CRISIS FOUR YEARS
AGO AND SO THIS THIS IS HOW LONG
WE'VE BEEN ASKING FOR THIS
FINDING.
TO THAT AND I WANT TO POINT OUT
THE HOT SPOTS INNER CITY AREAS
WITH THE HIGHEST STD NUMBERS ARE
FRESNO. MOVE HERNE BAY AREA
COUNTIES RIVERSIDE SAN DINO
ORANGE ALLEY MENTAL SCENE NOW
AND SACRAMENTO COUNTIES.
I'M TO THAT END OF BUT IT WAS
MENTIONED EARLIER THAT THE STATE
OF CALIFORNIA HAS TWELVE MILLION
DOLLARS ALLOCATED TO A CD
CONTROL BRANCH AND I WANTED TO
POINT OUT THAT A LITTLE OVER
FIVE MILLION OR CLOSE TO SIX
MILLION OF THAT. COME STRAIGHT
FROM THE CDC THROUGH FEDERAL
FUNDING AND THAT FUNDING IS ALSO
AT RISK RIGHT NOW WITH
EVERYTHING THAT HAPPENING IN
WASHINGTON DC. THIS LAST YEAR
ALONE THE REPUBLICAN LED HOUSE
OF REPRESENTATIVES VOTED IN
SUPPORT OF A FEDERAL BUDGET THAT
DRASTICALLY CUT THE CDC'S BUDGET
FOR STD PREVENTION. SO IF THAT
FEDERAL FUNDING IS SLASH
CALIFORNIA WILL SUFFER AND THAT
SO WE WERE JUST PLEASE URGING
YOU TO HEAR THE ALARM BELLS THAT
ADVOCATES HAVE BEEN SOUNDING FOR
A LONG TIME NOW. AND WE ASK FOR
ITS TEN MILLION DOLLAR INCREASE
THINKING.
REPUBLICAN MONTH ON ISSUE
TWELVE.
YEAH HI I'M ROBERT HOFFMAN FROM.
SERVICES GREAT FUNDACION
SYRINGE ACCESS SERVICES AND WERE
IN STRONG SUPPORT OF THIS ASK.
THANK YOU SIR.
ARENT FOX LOS ANGELES LGBT
CENTER ALSO IN SUPPORT
THANK YOU.
HELLO CREEK PULSE FROM THE HALF
OF THAT CALIFORNIA HIV ALLIANCE
A COALITION OF OVER A DOZEN HIV
SERVICE PROVIDERS IN CALIFORNIA
HERE IN STRONG SUPPORT.
AND ON THE ON BEHALF OF PROJECT
INFORM IN STRONG SUPPORT.
THE COMMITTEE.
WITH THAT I'LL BRING IT BACK UP
TO THE DYESS I THINK. YOU KNOW
HOW.
STRONGLY I FEEL ABOUT THIS
PROPOSAL AND.
LOOK TO MY OTHER MEMBERS IF THEY
WERE HERE TODAY. TO ATTEMPT TO
MOVE THIS TIME BUT LOOK FORWARD
TO CONTINUING TO ADVOCATE FOR
THIS PROPOSAL AS WELL SO THANK
YOU FOR YOUR PRESENTATION THAT
WITH THAT WE WILL HOLD ISSUE
TWELVE OPEN AND MOVE ON TO ISSUE
THIRTEEN
.
GETTING EATEN AND DEATH THANKS
FOR STAYING LATE TONIGHT.
MY NAME'S ANDREW REYNOLDS AND I
AM THE HEPATITIS C. EDUCATION
MANAGER FOR PROJECT INFORM. AND
THE ACTING DIRECTOR OF THE
CALIFORNIA APPETITE ITS
ALLIANCE.
TELL THAT IS MADE UP OF
APPROXIMATELY A HUNDRED
HEPATITIS B. HEPATITIS C.
ORGANIZATIONS.
CLINICS AND PROVIDERS AROUND THE
STATE OF CALIFORNIA.
THANK YOU FOR REVIEWING OUR
REQUEST TODAY.
CALIPERS REQUESTING A SIX POINT
SIX MILLION DOLLAR ONGOING
ANNUAL INVESTMENT AND HEPATITIS
C. PREVENTION. TESTING AND
LINKAGE TO CARE AND TREATMENT.
THIS REQUEST IS AN EXPANSION OF
THE TWO POINT TWO MILLION A YEAR
DEMONSTRATION PROGRAM. THAT WAS
FINANCED IN FISCAL YEAR TWENTY
FIFTEEN TWENTY SIXTEEN.
THIS FUNDING COVERS THE TESTING
OF PEOPLE WHO ARE A VERY HIGH
RISK OF ACQUIRING IN
TRANSMITTING HEPATITIS C.. AND
WHERE NEEDED SYSTEM NAVIGATION
TO HELP PEOPLE CONNECT TO
TREATMENT AND CARE. AS WELL AS
THE TRAINING OF PHYSICIANS TO
TREAT HEPATITIS C. IN THE
COMMUNITY.
THE DATA COLLECTED AND PUBLISHED
BY THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH SHOWS THAT THE
PILOT WAS SUCCESSFUL AND MERITS
EXPANSION.
BUT THE FUNDING FOR THAT PROGRAM
ENDS IN JUNE.
AND THE NEED IS URGENT.
ACCORDING TO THE CENTERS FOR
DISEASE CONTROL HEPATITIS C.
CAUSES MORE DEATHS THAN THE NEXT
SIXTY NINE INFECTIOUS DISEASES
COMBINED.
DISEASES THAT INCLUDE THE FLU
TUBERCULOSIS AND HIV.
HEPATITIS C. IS THE LEADING
CAUSE OF LIVER CANCER AND LIVER
TRANSPLANTS IN THE UNITED
STATES.
HERE IN CALIFORNIA WE HAVE OVER
FOUR HUNDRED THOUSAND PEOPLE
LIVING WITH HEPATITIS C.. AND
MOST PEOPLE DON'T KNOW IT.
THAT'S WHERE THE NEED FOR
TESTING AND CONNECTION TO
TREATMENT COMES AT.
WE HAVE OVER THIRTY THREE
THOUSAND NEW INFECTIONS PER YEAR
IN A TEN YEAR PERIOD FROM TWO
THOUSAND TO TWO THOUSAND ELEVEN.
WE HAD MORE THAN THREE HUNDRED
THOUSAND HOSPITALIZATIONS FOR
HIV RELATED LIVER DISEASE.
LIVER CANCER OR LIVER
TRANSPLANTS AS A RESULT OF
HEPATITIS C..
AND THIS COMES AT A COST
OF OVER TWENTY BILLION AND
HEALTH CARE COSTS.
ANYTHING ABOUT THIS IS ALL THE
SUFFERING THE DEATHS AND THE
RELATED COSTS ASSOCIATED WITH
HEPATITIS C. ARE ABSOLUTELY
AFFORDABLE.
WE HAVE A CURE.
THE CURE IS SAFE AND EFFECTIVE
DURING MORE THAN NINETY FIVE
PERCENT OF PEOPLE WITH VERY FEW
SIDE EFFECTS. IN AS LITTLE AS
EIGHT TO TWELVE WEEKS.
TREATING INCURRING HEPATITIS C.
IMPROVES A PERSON'S HEALTH AND
QUALITY OF LIFE.
IT'S COST EFFECTIVE. AND LEAST
OTHER LONG TERM BENEFITS SUCH AS
LESS HEALTHCARE UTILIZATION AND
RE ENTRY TO THE WORK FORCE FOR
THOSE WHO HAVE BEEN CURED.
AND IT'S ALSO IMPORTANT TO
REMEMBER THAT EACH CVS
COMMUNICABLE AND FOR EACH PERSON
WE CURE WE PREVENT OTHER PEOPLE
FROM EVER BEING INFECTED.
SIX POINT SIX MILLION IS A
LOGICAL INCREMENTAL EXPANSION OF
A SUCCESSFUL DEMONSTRATION
PROJECT.
IN ITS COMPLEMENTARY OF
INVESTMENTS BY HEALTH INSURERS
AND OTHER PROGRAMS.
THE FEDERAL GOVERNMENT HAS
PROVED INCAPABLE OF PRIORITIZING
THE ERADICATION OF THIS
COMMUNICABLE DISEASE THAT CAUSES
THE MOST DEATHS IN THE UNITED
STATES.
SO IT'S UP TO THE STATES TO
PROTECT THEIR COMMUNITIES.
THANK YOU TO THE COMMITTEE AND
TAKE THE.
AND TO THE COMMITTEE STAFF FOR
YOUR WORK ON THIS VERY IMPORTANT
ISSUE. THANK YOU SIR.
WITH THAT WE WILL TAKE PUBLIC
COMMENT ON ISSUE THIRTEEN.
I'M CUT AROUND FOR THAT SERVICE
TO ITS FOUNDATION AND I STRONGLY
SUPPORT THIS ASK.
MY NAME IS ROLANDO CHAVEZ I
REPRESENT DHEA. HIV EPS IN HARM
REDUCTION PROGRAMS TO TO GLIDE
FOUNDATION.
AND I'M ALSO HERE IN STRONG
SUPPORT OF THE SASK.
HI TYCO FROST HARM REDUCTION
COALITION STRONG SUPPORT OF THIS
ASK
WE CAME.
BRANDY WILSON FROM HUMBOLDT
COUNTY AND HUMBOLDT AREA CENTER
FOR HARM REDUCTION I AM STRONGLY
IN SUPPORT OF THIS THAT. MAKE
HIM.
AGAIN DAVID CHILDREN ACCESS
SUPPORT NETWORKS SAN LUIS OBISPO
MONTEREY COUNTIES AS A RECIPIENT
OF THE DAM ONE OF THE
DEMONSTRATION GRANTS ONE OF FIVE
THAT WERE AWARDED I CAN TELL YOU
THE IMPACT IT'S MADE IN OUR
COMMUNITY AND BUILDING AN
INFRASTRUCTURE TO GET PEOPLE IN
CARE. AND TREATED AND CURED IT'S
BEEN PHENOMENAL SO LIKE STRONGLY
ENCOURAGED.
YOU SUPPORT THIS PROPOSAL THINK
YOU'RE.
GOOD EVENING GOING BACK IS FOR
DRUG POLICY ALLIANCE IN SUPPORT.
AARON FOX LOS ANGELES LGBT
CENTER IN SUPPORT THANK YOU.
I PULSE FROM BEHALF OF THAT
CALIFORNIA HIV ALLIANCE HERE IN
STRONG SUPPORT THANK YOU.
SEEING NO FURTHER COMMENT. A
PUBLIC COMMENT I WILL.
HOLD THIS ITEM OPEN AND MOVE
ONTO ISSUE FOURTEEN.
THANKS
.
THANK YOU DOCTOR MARK.
GOOD AFTERNOON. AND THAT YOU CAN
MARK TO FOR THE F. CITY IT'S AT
THE CALIFORNIA DEPARTMENT OF
PUBLIC HOLLOW OUT MANY THANKS TO
THE ASSEMBLY STAFF FOR PREPARING
THIS WONDERFUL SUMMARY.
I'D LIKE TO START OUT BY
PROVIDING AN OVERVIEW OF
CALIFORNIANS LAYING A FOUNDATION
FOR GETTING TO ZERO PLAN AND
THEN OUT GO AHEAD AND PRESENT A
SUMMARY OF THE EIGHT UP
ESTIMATE.
THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH OFFICER BEADS
RELEASED THE TWO THOUSAND
SEVENTEEN TO TWO THOUSAND TWENTY
ONE LAYING A FOUNDATION FOR
GETTING TO ZERO PLAN IN
SEPTEMBER TWO THOUSAND SIXTEEN.
THE PLAN IS A JOINT EFFORT
BETWEEN STATE LOCAL AND
COMMUNITY PARTNERS ANCEPS FOURTH
CALIFORNIA'S COMMITMENTS A
COLLABORATION.
EFFICIENCY AND INNOVATION IN
ORDER TO MEET OR EXCEED NATIONAL
HIV AIDS STRATEGY PREVENTION
CARE AND TREATMENT GOALS.
THE PLAN PROVIDES A VISION AND
FOUNDATION FOR EVENTUALLY
GETTING TO ZERO IN CALIFORNIA
WHICH WE DEFINE ZERO NEW HIV
INFECTIONS ZERO AIDS RELATED
DEATHS.
AND ZERO STIGMA AND
DISCRIMINATION AGAINST PEOPLE
WITH HIV. AND DEVELOPING THE
PLAN WE TOOK AN OVERALL APPROACH
OF VISION AND POSSIBILITY.
WE SET OUT TO DEVELOP
CHALLENGING BUT POTENTIALLY
ACHIEVABLE OBJECTIVES.
OUR GOAL WAS TO DEVELOP BROAD
SUPPORT FOR THESE ACTIVITIES
THROUGHOUT THE ADMINISTRATION
INCLUDING ALLSTATE PARTNERS SUCH
AS THE DEPARTMENT OF HEALTH CARE
SERVICES. COVER CALIFORNIA
CALIFORNIA DEPARTMENT OF
CORRECTIONS AND REHABILITATION
AND THE CALIFORNIA DEPARTMENT OF
EDUCATION WHICH OVERSEES SEX
EDUCATION IN SCHOOLS. WE ALSO
WHEN IT'S DEVELOP BROAD SUPPORT
FOR THE PLAN FROM ALL LOCAL
PUBLIC CULT AND COMMUNITY
PARTNERS.
THE PLAN SETS OUT FOR GOALS TO
REDUCE NEW HIV INFECTIONS IN
CALIFORNIA INCREASE ACCESS TO
CARE AND IMPROVE HEALTH OUTCOMES
FOR PEOPLE LIVING WITH HIV.
PRODUCE HIV RELATED DISPARITIES
AND HEALTH INEQUITIES IN
CALIFORNIA AND TO ACHIEVE A MORE
COORDINATED STATE RIGHT RESPONSE
TO THE HIV EPIDEMIC.
A PLAN SET TWELVE OBJECTIVES TO
MONITOR CALIFORNIA'S PROGRESS
TOWARDS THESE GOALS SINCE THE
PLAN WAS RELEASED CALIFORNIA
SENATE SEEN IMPROVEMENT IN
SEVERAL OF THESE OBJECTIVES.
THE PROPORTION OF PEOPLE LIVING
WITH HIV WHO HAVE NO DETECTABLE
VIRUS IN THEIR BLOOD MEANING
THAT THEY WILL STAY HEALTHY AND
THAT THEY CAN'T TRANSMIT HIV TO
OTHERS.
INCREASED FROM FIFTY SEVEN
PERCENT TO SIXTY ONE PERCENT
WHICH IS ON TRACK TO MEET OUR
TWENTY TWENTY ONE GOAL OF EIGHTY
PERCENT.
ADDITIONALLY THE PROPORTION OF
EIGHT OUT CLIENTS WITH PUBLIC OR
PRIVATE HEALTH INSURANCE
INCREASE FROM FIFTY THREE
PERCENT TO FIFTY SEVEN PERCENT.
ON MAY THIRTIETH TWO THOUSAND
EIGHTEEN THE OFFICE OF AIDS WILL
CONVENE A STAKEHOLDER MEETING TO
PROVIDE UPDATES ON PROGRESS.
TOWARD PLAN GOALS AND TO SEEK
INPUT FROM COMMUNITY MEMBERS ON
AREAS IN WHICH WE'VE MADE LESS
PROGRESS.
IN CONJUNCTION WITH THIS MEETING
THE OFFICE OF AIDS WILL RELEASE
A BASELINE REPORT WHICH WILL
PROVIDE UPDATED BASELINE
MEASURES AND ANNUAL TARGETS FOR
EACH OBJECTIVE. AND WILL PROVIDE
A DESCRIPTION OF FORMATIVE
ACTIVITIES THAT TAKEN PLACE.
DURING HIS FORMATIVE PERIOD
WE'VE CONVENED INITIAL MEETINGS
WITH OTHER DEPARTMENTS INCLUDING
THE DEPARTMENT OF HEALTH CARE
SERVICES COVERED CALIFORNIA AND
THE DEPARTMENT OF EDUCATION.
ADDITIONALLY EACH BRANCH WITHIN
THE OFFICE OF AIDS AS BEGUN TO
MODIFY PROGRAM'S GUIDANCE AND
FUNDING TO ALIGN WITH THE GOALS
AND. OBJECTIVES
A PLAN AND TO COMMUNICATE THESE
MODIFICATIONS TO OUR CONTRACTORS
AND PARTNERS.
THE REPORT ALSO HAS A SUMMARY OF
NEXT STEPS
PLAN TO CONTINUE THE PROGRESS TO
ACHIEVE THE GOALS AND OBJECTIVES
STATED IN THE PLAN AND ORDERED
TO BRING US CLOSER TO GETTING TO
ZERO.
I AM I CAN NOW GO AHEAD AND GIVE
A BRIEF SUMMARY OF THE ADA
ESTIMATES.
THE TWO THOUSAND SEVENTEEN
BUDGET ACT INCLUDED EIGHT UP
LOCAL ASSISTANCE FUNDING OF
THREE HUNDRED NINETY FIVE POINT
SEVEN MILLION WITH NEW STATE
GENERAL FUND APPROPRIATION.
THE REVISED FISCAL YEAR
SEVENTEEN EIGHTEEN BUDGET IS
THREE HUNDRED NINETY EIGHT POINT
ONE MILLION AN INCREASE OF TWO
POINT FOUR MILLION MAINLY DUE TO
A ONE TIME NEED FOR SYSTEM
ENHANCEMENTS TO CD PEACHES.
INSURANCE AND MEDICAL BENEFITS
MANAGER PLATFORM TO IMPLEMENT
THE PURPOSES
PROGRAM AND TO ACCOMMODATE THE
EXPANSION OF INSURANCE.
A PREMIUM BENEFITS TO
INDIVIDUALS WITH EMPLOYER BASED
INSURANCE AND MEDICARE PART D..
IN ADDITION TO OTHER ELIGIBILITY
ENHANCEMENTS TO STREAMLINE
INSURANCE DATA TRANSFERS AND
MEDICAL OUT OF POCKET COSTS
CLAIM SUBMISSIONS.
AND FISCAL YEAR EIGHTEEN
NINETEEN.
WE PROPOSE A UP LOCAL STUDENTS
FUNDING THAT PROPOSED IT UP
LOCAL ASSISTANCE FUNDING IS FOUR
HUNDRED THIRTY FOUR POINT FOUR
MILLION. WE ESTIMATE THAT
EXPENDITURES WILL INCREASE BY
THIRTY EIGHT POINT SEVEN MILLION
WHEN COMPARED WITH THAT TWO
THOUSAND SEVENTEEN BUDGET ACT.
THIRTY SIX POINT THREE MILLION
INCREASE COMPARED WITH THE
REVISED FISCAL YEAR.
I CURRENT YEAR ESTIMATE.
WE EXPECTED THE OVERALL NUMBER
OF CLIENTS RECEIVING AID UP
SERVICES WILL CONTINUE TO
INCREASE EACH YEAR AT RATES
SIMILAR TO PRE ACA
IMPLEMENTATION. DUE TO PEOPLE
BECOMING NEWLY INFECTED WITH HIV
AND THEN ADDITIONALLY MEDICAL
MEDICATION PRICES INCREASE
ANNUALLY.
WE ALSO ESTIMATED DECREASE IN
MEDICATION ONLY CLIENTS DUE TO
THE IMPLEMENTATION OF EIGHT OUT
ACCESS ADHERENCE AND NAVIGATION
PROGRAM. AND THEREBY LOWERING
PROGRAM COSTS AS MEDICATION ONLY
CLIENTS TRANSITION TO PRIVATE
INSURANCE.
THERE IS ONE NEW EIGHT OUT
POLICY CHANGE INCLUDED IN THE
PROPOSED BUDGET THE NEW POLICY
CHANGE RELATES TO FUNDING FOR IT
UP ENROLLMENT SITES.
THE TWO THOUSAND SEVENTEEN
BUDGET ACT INCLUDED A ONE TIME
LEGISLATIVE AUGMENTATION FOR AN
ADDITIONAL FOUR MILLION FOR
PAYMENT TO ENROLLMENT SITES. FOR
A TOTAL OF EIGHT MILLION IN
FISCAL YEAR SEVENTEEN EIGHTEEN.
BECAUSE TASK PERFORMED BY EIGHT
UP ENROLLMENT WORKERS HAVE GROWN
IN BOTH SCOPE AND COMPLEXITY.
CITY PEACH PROPOSES STARTING IN
FISCAL YEAR EIGHTEEN NINETEEN
MOVING TO A MODEL IN WHICH THE
TOTAL AMOUNT OF FUNDS FOR A
HAPPEN ROMAN SERVICES
PERFORMANCE. IS ADJUSTED
ANNUALLY THROUGH THE ESTIMATES
PROCESS BASED ON CASELOAD AN
ESTIMATEDSERVICES TO BE
PERFORMED EACH FISCAL YEAR.
SO FOR FISCAL YEAR EIGHTEEN
NINETEEN.
WE PROJECT ENROLLMENT COSTS OF
SEVEN POINT NINE NINE MILLION.
IN ORDER TO ENSURE THAT THIS
ONGOING INCREASE IN FUNDING TO
EAT UP ENROLLMENT SITES RESULTS
IN IMPROVED CLIENT HEALTH
OUTCOMES AND COST NEUTRALITY. WE
PLAN TO INCLUDE PERFORMANCE
MEASURES AN EXISTING AID APPAN
MOMENTS AT CONTRACTS
TO ENSURE ENROLLMENT SITES USE
THE ADDITIONAL FUNDING TO
TRANSITION AN INCREASED NUMBER
OF MEDICATION ONLY CLIENTS TO
PRIVATE INSURANCE.
AND THE OFFICE OF AIDS HEALTH
INSURANCE PREMIUM PAYMENT
PROGRAM EONS TO MEET DEFINED
METRICS SUCH AS IMPROVEMENT AND
VIRAL SUPPRESSION RATES IN EACH
ENROLLMENT SITE. WHICH IS REALLY
CONSISTENT WITH OUR GETTING TO
ZERO PLAN.
AS ALWAYS THE NUMBERS AN
ESTIMATE WILL BE REVISED WITH
UPDATED INFORMATION DURING THE
MAY REVISION.
THANK YOU VERY MUCH DEPARTMENT
OF FINANCE LA ONLY COMMENTS.
ANY PUBLIC COMMENTS ON ISSUE
FOURTEEN.
SEEING NONE I WILL BRING IT BACK
UP THE DYESS AND HOLD THIS ISSUE
OPEN AND MOVE ON TO ISSUE FIFTY.
BANKS.
AND SO THAT IT UP ELIGIBILITY
ENROLLMENT BUDGET CHANGE
PROPOSAL REQUESTS TWO HUNDRED
FIFTY THOUSAND AND EIGHT APP
REBATE FUND EXPENDITURE
AUTHORITY TO SUPPORT TO
ADMINISTRATIVELY ESTABLISHED
POSITIONS. IN FISCAL YEAR
SEVENTEEN EIGHTEEN AND TWO POINT
SEVEN MILLION AND EAT UP REBATE
FUND EXPENDITURE AUTHORITY. AND
FIFTEEN PERMIT POSITIONS FOR
FISCAL YEAR EIGHTEEN NINETEEN AN
ON GOING TO MANAGE THE INCREASED
WORKLOAD INVOLVED IN
TRANSITIONING EIGHT APP
ELIGIBILITY ENROLLMENT SERVICES
TO THE CITY PEACH OFFICE OF
AIDS.
THESE POSITIONS WOULD INCLUDE
ELEVEN POSITIONS FOR THE IT UP
CALLING DATA PROCESSING CENTER
TWO POSITIONS TO PROVIDE
OVERSIGHT FOR ALL EAT AT DETER
RELATED ACTIVITIES.
ONE POSITION TO OVERSEE AND
MAINTAIN THE IT INFRASTRUCTURE
NEEDED FOR THE ENROLLMENT SYSTEM
AND ONE ADMINISTRATIVE POSITION.
WE BELIEVE THAT APPROVAL OF THE
SPECIES P. WILL ENABLE US TO
CONTINUE THE HIGH LEVEL OF
CUSTOMER SERVICE THAT WE HAVE
BEEN ABLE TO PROVIDE TO EAT AT
THE MOMENT WORKERS AND CLIENTS.
SINCE WE TOOK IT UP ELIGIBILITY
ENROLLMENT SERVICES AND HOUSE
ONE YEAR AGO.
THANK YOU DEPARTMENT OF FINANCE
LA ONLY COMES.
ANY PUBLIC COMMENTS ON ISSUE
FIFTEEN.
SINAN.
I'M.
SUPPORTIVE OF BRINGING IN AND
HOW SOME QUESTIONING HAS THERE
BEEN AN ANALYSIS. COMPARING. THE
DIFFERENCE AND.
THE ORIGINAL SINGULAR.
COMPANY THAT WAS DOING IT AND
HOW WE'VE BROKEN IT UP IN TERMS
OF IF WE'VE ACTUALLY HAD AN
OVERALL INCREASING COSTS.
BECAUSE OF. DIVERSIFYING IN
ADDING THREE DIFFERENT GROUPS TO
DO THE PARTS OF THE AT PROGRAM.
AND I'M JUST TRYING TO GET AN
ANALYSIS HAD TO SEE IF. I WERE
BEING COST EFFICIENT.
WE CAN CERTAINLY DO THAT.
IT'S A LITTLE BIT LIKE
COMPARING APPLES AND ORANGES
BECAUSE I'M ONE OF THE THINGS
THAT OCCURRED IS THAT WE
IMPLEMENTED THE PAYMENT OF
MEDICAL OUT OF POCKET COSTS FOR
OUR OFFICE NEEDS HEALTH
INSURANCE PREMIUM PAYMENT
PROGRAM CLIENTS. AND THAT
INVOLVED AND NECESSITY DOES
GETTING UP THIRD CONTRACTOR THE
EIGHT OUT MEDICAL AND INSURANCE
BENEFITS MANAGER AND THAT BOTH
APPEASE THE INSURANCE PREMIUMS
AND HAPPY AS A MEDICAL AYE
POCKET COSTS.
I'M SO THAT WAS NECESSITATED BY
BY TOM.
AUGMENTATIONS WE GOT THROUGH THE
LEGISLATURE TO TO MAKE THAT
SERVICE AVAILABLE TO OUR CLIENTS
I LOOK FORWARD TO THAT
INFORMATION INTO WITH THAT WE
WILL HOLD ISSUE FIFTEEN OPEN.
NO BOND ISSUE SIXTEEN.
THANK YOU
.
I COULD AFTERNOON CREEK PULSE
FOR FROM IT KILL A HEALTH AND
LOS ANGELES AND CO CHAIR OF THE
CALIFORNIA HIV ALLIANCE.
POP AND I AM QUITE A MULTI
PERSON I'M THE SENIOR DIRECTOR
OF POLICY AND STRATEGY FROM THE
SAN FRANCISCO AIDS FOUNDATION
AND THE OTHER CO CHAIR OF THIS.
ATV ALLIANCE
AND THAT BEFORE WE GET STARTED
ON THE COMMAND THE OFFICE OF
BATES FOR THE AMOUNT WORK
THEY'VE DONE IN THE LATE THE
FOUNDATION PLAN. AND WE
CERTAINLY RECOGNIZE THAT.
ALSO I MEAN I THINK AS
ADVOCATES WERE VERY CONCERNED
THAT'S CALIFORNIA'S FALLING
BEHIND OTHER STATES THAT HAVE
MADE SIGNIFICANT ADVANCEMENTS
AND SIGNIFICANT INVESTMENTS IN
HIV PROGRAM SO. NEW YORK STATE
FROM TWENTY ELEVEN TO TWENTY
FIFTEEN SIDE NEW HIV INFECTIONS
FALL BY. THIRTY TWO PERCENT
COMPARED CALIFORNIA FALLING BY
THREE PERCENT. OVER THAT SAME
TIME PERIOD SO WE BROUGHT FOR
THE NUMBER PROPOSALS TO HELP
MAKE SURE THAT CALIFORNIA
DOESN'T CONTINUE FALLING BEHIND.
I'M I'M GONNA PRESENT THREE
PROPOSAL SPECIFICALLY LOOKING AT
HOW TO INCREASE.
TAKE A PROP AND OTHER HIV
PREVENTION SERVICES AS YOU KNOW
PREPOSITIONED VERY EFFECTIVE HIV
PREVENTION INTERVENTION UP TO
NINETY NINE PERCENT EFFECTIVE.
AT PREVENTING ACQUISITION OF
HIV.
BUT CALIFORNIA HIV AIDS RESEARCH
PROGRAM RECENTLY PUT OUT SOME
DATA LOOKING AT PREP UPTAKE IN
THE STATE'S MEDI CAL PROGRAM.
AND FOUND THAT FROM TWENTY
TWELVE TO TWENTY SIXTEEN THAT
INCREASED FROM LESS THAN ONE
HUNDRED TO OVER THREE THOUSAND
PEOPLE.
PEOPLE WHO ARE TAKING PERHAPS SO
THAT'S CERTAINLY A VERY GOOD
IMPROVEMENT WE'RE HAPPY ABOUT
THAT BUT IT'S FAR BELOW THE
STATE'S GOAL OF HAVING SIXTY
THOUSAND PEOPLE. ON PREP BY
TWENTY TWENTY ONE.
AND SOMETHING ELSE I THINK THAT
WAS VERY CONCERNING ABOUT THAT
DATA WAS THE UPTAKE WAS LOWER
AMONG AFRICAN AMERICANS LATINOS
YOUTH AND WOMEN.
AS YOU KNOW
HIV DISPROPORTIONATELY IMPACTS
THOSE FOLKS OF HIV RATE AMONG
AFRICAN AMERICANS IS FOUR TIMES
THAT OF WHITES AND AMONG LATINOS
IS ONE HALF TIMES THAT OF WHITES
AND SO. WE ARE VERY CONCERNED
UNLESS WE MAKE ADDITIONAL
INVESTMENTS THAT THOSE
DISPARITIES ARE ONLY GOING TO BE
EXACERBATED.
SO THE FIRST PROPOSAL AS TEN
MILLION DOLLARS GENERAL FUND.
TO INCREASE THE CAPACITY OF
HEALTH DEPARTMENTS IN CBO'S TO
PROVIDE HIV PREVENTION SERVICES
INCLUDING PREP AND HIV TESTING.
I THINK SIGNIFICANTLY WE DON'T
HAVE A RELIABLE ADEQUATE FUNDING
SOURCE
ESPECIALLY FOR PREP PROGRAM SO
THE CDC. HAS BEEN FUNDING
SEVERAL LOCAL HEALTH
JURISDICTIONS FOR THE PAST THREE
YEARS AT ABOUT SEVEN POINT EIGHT
MILLION DOLLARS PER YEAR. THAT
FUNDING IS SET TO EXPIRE THIS
YEAR.
WE APPRECIATE THE COMMITTEE FOR
THE INVESTMENT UP TO MILLION
DOLLARS IN PREP NAVIGATION THAT
WAS MADE A COUPLE YEARS AGO.
UNFORTUNATE WERE SEEN AS THAT'S
NOT ENOUGH TO MEET STATEWIDE
DEMAND WHEN THOSE ARE OF PEAS
WHEN OUT THEY RECEIVED EIGHTEEN
MILLION DOLLARS IN APPLICATIONS
AND SO WE NEED WE KNOW THE NEED.
AS MUCH GREATER THAT'S CURRENTLY
BEING ALLOCATED.
I AM THE NEXT PROPOSALS AROUND
EDUCATING MEDICAL PROVIDERS
ABOUT ADVANCES IN HIV AND STI
PREVENTION. I KNOW THIS IS
SOMETHING THAT DOCTOR SMITH AND
OTHERS MENTIONED EARLIER IS THE
IMPORTANCE OF. PROVIDERS AND
THEIR ABILITY TO INTERVENE AND
PREVENT ACQUISITION OR TREATMENT
OF HIV AND OTHER STIS. SO WE'VE
SEEN THAT'S AFFECTED IN OTHER
JURISDICTIONS WHERE THEY DO
PUBLIC HEALTH DETAILING AN
EXPERT GOES AROUND AND MEETS
WITH PROVIDERS ONE ON ONE.
DETAILING INITIATIVE WAS SHOWN
TO SIGNIFICANTLY INCREASE FIRST
TIME PRESCRIBING A PROP.
AND SO WE'RE HOPING TO EXPAND
AND REPLICATE THOSE EFFORTS
WE'VE HEARD WE CONTINUE TO HEAR
FROM PATIENTS ACROSS THE STATE.
IN PLACES LIKE FRESNO ANOTHER
WORLD JURISDICTIONS.
WHERE PROVIDERS EITHER DON'T
KNOW ABOUT PERHAPS OR ARE
UNWILLING TO PRESCRIBE AND SO WE
BELIEVE THAT SAYS NO EFFECTIVE
WAY? TO INCREASE AT A
PRESCRIPTION.
AND THEN THE FINAL THAT I'M
GONNA PRESENTED JUST SOME
MODIFICATIONS TO THE STATE'S
PURPOSES AND PROGRAM.
THIS IT HAS WAS APPROVED
TWO YEARS AGO AND IT'S BEEN
IMPLEMENTED THIS YEAR.
THIS PROGRAM IS GONNA HELP
IMPROVE ACCESS TO PREP FOR LOW
INCOME FOLKS. AND WE'RE VERY
PLEASED TO SEE IT MOVING
FORWARD.
WE'VE IDENTIFIED A FEW GAPS IN
THAT PROGRAM THAT REALLY PREVENT
IT FROM PROVIDING FULL SAFETY
NET COVERAGE FOR A UNINSURED AND
UNDERINSURED FOLKS AND SO WE
PROPOSED.
SEVERAL MODIFICATIONS TO THAT
PROGRAM I WON'T GO INTO ALL OF
THEM NOW BUT HAPPY TO ANSWER ANY
QUESTIONS YOU MIGHT HAVE.
I'M IN JUST FOR THOSE WHO ARE
FOLLOWING ALONG ON LINE YOU MAY
WANT TO TRACK THAT WE JUST
DISCUSSED PROP.
PROPOSAL ONE FOUR AND FIVE A
BELIEVE NOW THERE COLLEGES GO
OUT OF ORDER.
OKAY BETRAYED THAT I THINK THAT
HOW BAY THAT THE US.
AND SO YES I AM AGAIN COURTNEY
FROM THE SENSE GOOD ITS
FOUNDATION I WANTED TO SPEAK TO
TO PROPOSALS THAT WE'RE MAKING
FOR DEMONSTRATION PROJECTS THAT
AIM TO.
IMPROVE SERVICES AT FOUR TWO
UNDERSERVED AND VULNERABLE
POPULATIONS BOTH OF THESE
PROPOSALS ARE GROWING OUT OF
EXISTING. AND AND SUCCESSFUL
MODELS THAT WE LIKE TO SEE
REPLICATED IN OTHER AREAS ACROSS
THE STATE.
SO THE FIRST IS TWO MILLION
DOLLARS IN ONE TIME FUNDING FOR
THREE YEAR DEMO PROJECTS.
TO IMPROVE LINKAGE AT TATE AB
CARE AND PREVENTION SERVICES AS
WELL AS ECONOMIC EMPOWERMENT
PROGRAMS FAR TRANSGENDER
INDIVIDUALS.
JUST TO HIGHLIGHT SOME
STATISTICS A ONE THIRD OF
TRANSGENDER POPULATION AS I HIV
POSITIVE. I'M IN FACT ONE STUDY
SHOWED THAT TRANSGENDER WOMEN
ARE AS MUCH AS FORTY NINE
PERCENT MORE LIKELY TO BE HIV
POSITIVE THAN THE GENERAL
POPULATION.
I'M IN ADDITION TRANSGENDER
FOLKS I HAVE.
BUT I'M THAT HAVE LOTS A JOB DID
A BIAS OR UNEMPLOYED ARE MORE
LIKELY TO DO BE HIV POSITIVE. ON
THEY CALIFORNIA HIV RESEARCH
PROJECT HOSTED I THINK.
THINK TANK WITH I'M TRANSGENDER
AND THOUGHT LEADERS FROM ACROSS
THE STATE LAST APRIL AND ON
ECONOMIC AND ISSUES AND
EMPLOYMENT ISSUES ARE IDENTIFIED
AS THE MAIN BARRIER TO ACCESSING
HIV KAREN PREVENTION FOR THE
POPULATION.
AND NINETY PERCENT OF A TRANS
INDIVIDUALS NATIONWIDE HAVE
REPORTED HARASSMENT MISTREATMENT
ARM DISCRIMINATION AT WORK.
AND SO WE'RE PROPOSING
DEMONSTRATION PROJECTS THAT
WOULD SEEK TO BOTH INCREASE.
AND IMPROVE LINKAGE TO
PREVENTION AND CARE SERVICES AS
WELL AS PROVIDING WORK SKILL
BUILDING AND REFERRALS TO
EMPLOYERS. WHO PROVIDE
CULTURALLY COMPETENT WORK
ENVIRONMENT AND UPLOAD STATE
NONDISCRIMINATION LAWS? AND
THESE PROJECTS WIT WE BELIEVE
THESE PROJECTS ARE IMPORTANT AND
INNOVATIVE PUBLIC HEALTH
INTERVENTION THAT ADDRESS.
.
THAT WILL HELP ADDRESS IMPROVED
HIV PREVENTION CARE SERVICES. AS
WELL AS ADDRESSING A KEY
STRUCTURAL BARRIER THAT WILL
IMPROVE THE HEALTH OUTCOMES FOR
TRANSGENDER AND.
CALIFORNIANS.
OUR SECOND PROPOSAL I'M A
DEMONSTRATION PROJECT PROPOSAL
IS THREE MILLION DOLLARS IN ONE
TIME FUNDING THAT WOULD SUPPORT.
THREE YEAR DEMONSTRATION
PROJECTS TO ADDRESS THE HEALTH
AM PSYCHOSOCIAL NEEDS OF OLDER
CALIFORNIANS LIVING WITH HIV.
SO BY TWENTY TWENTY ONE HALF OF
THE ONE POINT TWO MILLION PEOPLE
LIVING WITH HIV AND THE U. S.
WILL BE OVER THE AGE OF FIFTY.
ARMIN SAN FRANCISCO CURRENTLY
SIXTY THREE PERCENT OF PEOPLE
LIVING WITH HIV ARE OVER THE AGE
OF FIFTY SO CALIFORNIA WHICH
DIED EARLY. ON EPIDEMIC IS
SEEING THIS AND TRY AND SOONER.
AND WE KNOW THAT PEOPLE WITH HIV
FACE UNIQUE CLINIC ON PSYCHO
SOCIAL ISSUES AS THEY AGE SO HIV
AIDS SPEEDS THE AGING PROCESS.
CLIENTS ARE SEEING INCREASED
CARDIOVASCULAR ISSUES LIVER AND
KIDNEY PROBLEMS HIV RELATED
CANCERS. DECREASED BONE DENSITY
FROWN ES COGNITIVE DECLINE
DIMENSION DEPRESSION.
AND AND THEN ISOLATION DO A LOT
LOSS OF SOCIAL SYSTEMS.
AND FINANCIAL AND HOUSING STE.
DAD INSTABILITY DID A LONG TERM
DISABILITY CLAIMS FOR MANY OF
THESE CLIENTS.
AND THERE'S VERY FEW
COMPREHENSIVE PROGRAMS TO
ADDRESS THE UNIQUE NEEDS OF THIS
POPULATION AM AND THE MODEL AND
THAT THERE IS ONE MODEL
CURRENTLY OPERATING IN SAN
FRANCISCO CALLED THE GOLDEN
COMPASS PROGRAM. AND IT OFFERS A
A UNIQUE FOCUS SO IT LOOKS AT
HEARTENED MIND BONES AND
STRENGTH.
DENTAL HEARING AND VISION AND
NETWORKING AND NAVIGATION. AND
AND THEY FIND ALL OF THEIR NON
CLINICAL SERVICES THROUGH
PHILANTHROPIC FUNDS WHICH. ARE
IS GREAT BUT ALSO INCONSISTENT
AND WE WOULD LIKE TO I'M.
REQUEST FUNDING TE REPLICATE
THIS DEMO PROJECT ACROSS THE
SEATS THAT WERE ENVISIONING SORT
OF THE MEDICAL HOME MODEL. AND
TO EXPAND COURTNEY AND
STRENGTHEN THE MUCH NEEDED
SERVICES FOR THIS POPULATION WE
WOULD ALSO LIKE FOR THESE
SERVICES TO BE EVALUATED.
FOR IMPROVED HEALTH OUTCOMES
AND COST EFFICIENCIES THE
PROJECTS WILL ALSO DISSEMINATE
LESSONS LEARNED TO SPUR ONGOING
SERVICES WE SEE THAT THIS IS AN
AREA WHERE CALIFORNIA CAN REALLY
BE A LEADER I'M IN HIV AND
ADDRESSING THE NEEDS OF THESE.
VERY VULNERABLE POPULATIONS
THINKING HERE.
WITH THAT WE'LL TAKE PUBLIC
COMMENT ON ISSUE SIXTEEN.
TYCHO FROST OF HER REDUCTION
COALITION IN STRONG SUPPORT.
GIVE.
DANTE MORSE WITH A PILLOW HEALTH
AND I WOULD LIKE TO ADD THAT I
THINK IT'S EXTREMELY IMPORTANT
THAT WE MAKE SURE THAT MEDICAL
PROFESSIONALS ARE MADE AWARE
PREP. I'M A SPECIALLY THOUGH
THAT WORK WITH THE HIGH RISK
POPULATIONS I'M AS A STAND NOW
PAPERS REALLY ONLY MADE AWARE BY
THOSE WHO ARE HIV SPECIALIST AND
THEY WORK A PERSON LIVING WITH
HIV. ON THE FLIPSIDE HIGH RISK
INDIVIDUALS THE GOAL FOR GENERAL
CARE WHO ARE AT RISK ARE NOT
TOLD ABOUT PREP BECAUSE THEIR
PROVIDER IS NOT HIV SPECIALIST
AND IS NOT BEEN MADE ABREAST OF
THAT SO WE CAN MAKE SURE THE
PREP KNOWLEDGE AND INFORMATION
IS SPREAD FAIRLY ACROSS THE
BOARD. AND EVERYONE IS GETTING
THE SAME INFORMATION WILL
GREATLY CA INCREASE IN HIV.
IN THE LACK OF NEW HIV
INFECTIONS.
ARENT FOX LOS ANGELES LGBT
CENTER IN SUPPORT.
JOE MICHAEL FOR EQUALITY
CALIFORNIA IN STRONG SUPPORT
THINK.
ORLANDO CHAVEZ GLIDED UP SEE HIV
IN HARM REDUCTION PROGRAMS IN
STRONG SUPPORT.
INCREMENTAL TO PROJECT INFORMANT
SAN FRANCISCO AND STRONG
SUPPORT.
GOING BACK ITS DRUG POLICY
ALLIANCE IN STRONG SUPPORT.
DAVID CHILDREN ACCESS SUPPORT
NETWRK SAN LUIS OBISPO MONTEREY
COUNTY IN STRONG SUPPORT.
BRAND MARK NUMBER HEALTH AIDS
HEALTHCARE FOUNDATION WE
GENERALY SUPPORT ANY INCREASE
IN DOLLARS FOR THE HIV PROGRAM I
REALLY WANT TO CALL PARTICULAR
ATTENTION TO THE SECOND AND
THIRD PROPOSAL. ON THAT SFA HALF
BROUGHT UP.
RELATIVE TO TO UNSERVED
POPULATIONS THOSE ON WHO ARE
TRANSGENDER LIVING WITH HIV AND
THOSE WHO ARE OLDER. APPRECIATE
YOUR SUPPORT THANK YOU THANK
YOU.
PAPER MALDONADO TRIP LUCIEN
SABATINO I CAN RIVERSIDE COUNTY
WHERE IN STRONG SUPPORT.
WITH THAT.
WE WILL HOLD ISSUE SIXTEEN OPEN
THEM OF BOND ISSUE SEVENTEEN
THANK YOU VERY MUCH
.
GOOD EVENING DEBORAH MALDONADO
TRIP POLLUTION REPRESENTING THE
INLAND COALITION FOR AIDS
RESOURCES AND RURAL REGIONS FOR
THE INLAND EMPIRE.
SO THANK YOU TO THE CHAIR AND
THE ENTIRE COMMITTEE FOR GIVING
ME THIS MOMENT TO SHARE A FEW
BRIEF REMARKS. MY NAME IS
GABRIEL MALDONADO AND I'M THE
EXECUTIVE DIRECTOR AND CEO OF
TRUE VOLUTION. AND LGBT JUSTICE
IN HIV AIDS DIRECT SERVICE
ORGANIZATION SERVING THE REGION
OF SABATINO AND RIVERSIDE COUNTY
ALSO KNOWN AS THE INLAND EMPIRE.
I'M HERE ON BEHALF OF THE INLAND
COALITION FOR AIDS RESOURCES IN
RURAL REGIONS OF THE AND LET
EMPIRE. WHICH IS MADE UP OF A
GROUP OF FEDERALLY QUALIFIED
HEALTH CENTERS AIDS SERVICE
ORGANIZATIONS ACADEMIC
INSTITUTIONS LGBT AGENCIES AND
OTHER HEALTH RELATED. ENTITIES.
AS A YOUNG AFRO LATINO GAY MAN.
LIVING WITH HIV FOR THE LAST SIX
YEARS I REPRESENT NOT ONLY
MYSELF.
BUT OVER THE NINE THOUSAND
PEOPLE LIVING WITH HIV IN THE
INLAND EMPIRE.
THIRTY EIGHT OF WHO ARE
CURRENTLY. AN UNMET AN
ADDITIONAL FORTY ONE HUNDRED
CORE UNDERWEAR OR IN NET
MIGRATION WORK IN OUR
JURISDICTION RECEIVING CARE.
AND WITH THE BACKBONE OF
APPROXIMATELY SEVEN MILLION
DOLLARS FROM THE HEALTH
RESOURCES AND SERVICES
ADMINISTRATION AND RYAN WHITE
PART A FUNDS AND VARIABLE FUNDS
AND SUPPLEMENT OF THE RYAN WHITE
PART BE THROUGH THE STATE.
THESE RESOURCES DO NOT REFLECT
THE FULL RANGE OF INVESTMENTS
NEEDED TO ADEQUATELY OVERCOME
THE UNIQUE BARRIERS TO CARE AND
PREVENTION FOR THE NEARLY TWENTY
SEVEN THOUSAND FOUR HUNDRED
SQUARE MILES A GEOGRAPHIC
TERRITORY WE COVER.
THE INLAND EMPIRE IS LARGER THAN
NINE STATES WITHIN THE U. S.
INCLUDING NEW JERSEY. MARYLAND
AND MASSACHUSETTS.
ACCORDING TO PUB MED RISK
FACTORS LATE TO TAX PUBLISHED BY
UC RIVERSIDE'S SCHOOL OF
MEDICINE.
NEARLY THIRTY POINT FIVE PERCENT
OF ALL NEW DIAGNOSES IN THE
INLAND EMPIRE I REPEAT THAT'S
ONE THIRD OF ALL NEW DIAGNOSES.
FROM TWO THOUSAND AND NINE TO
TWO THOUSAND AND FOURTEEN WERE
LATE TO TEST AND RECEIVED AN
AIDS DIAGNOSIS WITHIN TWELVE
MONTHS OF A POSITIVE RESULT.
THE FINDINGS OF RESEARCH SHOWS A
DEFICIENCY IN AVAILABLE TESTING
AND CARE OPPORTUNITIES.
NOT LIMITED TO ACCESS TO
TRANSPORTATION MENTAL HEALTH
DISPARITY SUBSTANCE ABUSE
HOUSING AND THE REGION'S
EXPANSIVE GEOGRAPHY IS WHAT
RESULTS IN THESE EXACERBATED
HEALTH DISPARITIES.
WHEN IT IT'S PAST ON PUBLIC
TRANSPORTATION TO GO FROM THE
FENWAY INSTITUTE IN BOSTON TO US
HELPING US IN WASHINGTON DC THAN
IT IS FOR ONE OF MY CLIENTS TO
GO FROM SAN BERNARDINO COUNTY
DEPARTMENT OF PUBLIC HEALTH. TO
THE DESERT AIDS PROJECT IN PALM
SPRINGS
THAT JUST SHOWS YOU THE LACK OF
ACCESS AND THE BARRIERS TO CARE
THAT OUR REGION IS UNIQUELY
EXPERIENCING.
BUT WE RECOGNIZE THAT THEY NEED
THAT THE INLAND EMPIRE I MERELY
A REFLECTION OF THE EXPERIENCES
OF THE OVER ONE HUNDRED AND
TWENTY THOUSAND OF MY BROTHERS
AND SISTERS LIVING WITH HIV.
THROUGHOUT THE ENTIRE STATE OF
CALIFORNIA.
SO WE STAND IN SOLIDARITY WITH
OUR COLLEAGUES AT THE CALIFORNIA
HIV ALLIANCE AND FULLY SUPPORT
THEIR BUDGET ASK AND POLICY
INITIATIVES AS A NECESSITY TO
STATEWIDE EFFORTS AND THAT
INCLUDES ISSUES. TWELVE THIRTEEN
AND SIXTEEN.
THE CONVERSATION AROUND HIV.
IS NOT ONLY A QUESTION OF AN
EQUAL DISTRIBUTION OF RESOURCES
BUT AN EQUITABLE DISTRIBUTION OF
RESOURCES.
RECOGNIZING THAT WE MUST ALL TRY
AND BUILD A SOLID FOUNDATION TO
MEET THE NEEDS WITHIN OUR
INDIVIDUAL JURISDICTIONS AS WELL
AS AROUND THE ENTIRE STATE.
WHEN WE ANALYSE THE TOTAL UNMET
NEED OF APPROXIMATELY EIGHTY ONE
HUNDRED PERSONS AT A
CONSERVATIVELY ESTIMATED COST
PER PATIENT PER YEAR OF TWENTY
EIGHT HUNDRED DOLLARS. THIS IS
NOT FACTORING IN COST ASSOCIATED
WITH COMORBIDITIES EXACERBATED
SOCIAL DETERMINANTS OF HEALTH
AND SPECIALTY SERVICES OUR
REGION HOW THE RESOURCE GAP OF
TWENTY TWO MILLION SIX HUNDRED
AND NINETY ONE THOUSAND. AND TWO
HUNDRED DOLLARS AND WE ARE NOT
ONE OF THE RECIPIENTS OF THE
FEDERAL DIRECT FUNDS FROM THE
CDC.
WHICH IS WHY WE ARE ONLY
REQUESTING TEN MILLION AS
CAPACITY BUILDING AMOUNT. TO
EXPAND EXISTING SERVICES TO HELP
FILL THE GAPS
AND LOWER THE DEFICITS OF THOSE
WHO ARE UNAWARE ARE UNMET NEEDS
LIVING WITH HIV.
TREATING THOSE LIVING WITH HIV
ACHIEVING VIRAL SUPPRESSION
LOWERING TRANSMISSION RESTS AND
APPROVING OVERALL HEALTH
OUTCOMES IS A NET SAVINGS FOR
THE STATE OF CALIFORNIA IN THE
TREATMENT AS PREVENTION MODEL AS
YOU MENTIONED EARLIER.
AS A FORMER MEMBER OF THE
PRESIDENT'S ADVISORY COUNCIL ON
HIV AND AIDS APPOINTED UNDER
BARACK OBAMA AND CONTINUED
BRIEFLY UNDER THE TRUMP
ADMINISTRATION.
I ADVOCATED FOR UNDERSERVED RULE
REGION SUBURBAN REGIONS AND
UNIQUELY BURDENED REGIONS
THROUGHOUT THE ENTIRE UNITED
STATES.
AND AS WE NAVIGATE THROUGH THIS
ERA OF MENDACITY TO SAY THE
LEAST.
UNDER THE CURRENT ADMINISTRATION
WHERE WERE SEEN THE DE
HUMANIZATION AND MARGINALIZATION
OF THE LEAST AMONG US.
WE HERE IN THIS STATE LEGISLATOR
MUST ENSURE THAT WE ALSO CRAFT
OUR POLICIES
WITH MORE THAN JUST POLITICAL
CALCULUS
AND WE HUMANIZE THE LEAST AMONG
US IN THE UNIQUE JURISDICTIONS
AROUND THE STATE.
SO I THANK YOU FOR THIS
OPPORTUNITY AND OUT OPEN ANY
QUESTIONS IF YOU HAVE ANY CLICK
YOU.
WILL TAKE ANY PUBLIC COMMENT ON
ISSUE SEVENTEEN AT THIS TIME.
CREEK PULSE FOR FROM AP LA
HEALTH IN LOS ANGELES HERE IN
SUPPORT. THANK YOU.
COURTNEY MONA PERSON FROM THE
SAN FRANCISCO AIDS FOUNDATION IN
SUPPORT.
BRENT MARTEN AIDS HEALTHCARE
FOUNDATION SUPPORT.
THANK YOU.
UP WITH THAT WE'RE GOING TO HOLD
THE ISSUE OPEN BUT I JUST WANTED
TO SAY IT'S REALLY NICE TO HEAR
YOUR ADVOCACY AND TO HEAR YOU
BOTH REPRESENTING YOURSELF IN
YOUR COMMUNITY.
I THINK WITH THAT WE WILL CLOSE
TODAY SOMEONE HEARING THANK YOU