AHEAD AND GET START WITH THIS
MEETING TODAY I APOLOGIZE FOR
BEING A LITTLE BIT LATE I GUESS
I WAS A BANG THE GAVEL THE HOUSE
WAS TO DO IT. I'VE DONE THIS
BEFORE ó I'M SORRY OKAY YOU
TURN THIS LIGHT OFF OVER HERE TO
IT'S LIKE IT'S LIKE MISSION
CONTROL APPEAR.
SO ANYWAY. WE HAVE A QUITE FEW
BILLS AHEAD OF US TO THIS
AFTERNOON.
WE DO HAVE SOME TIME LIMITS AND
I'D LIKE TO ANNOUNCE ON THESE
ARE THESE ARE VERY TYPICAL FOR A
MEANS IT'S NOT IT'S NOT
EXCEPTION.
WE WILL HEAR TWO WITNESSES PER
SIDE A WITH A TIME LIMIT OF
THREE MINUTES EACH.
AND WE'LL ASK ADDITIONAL
WITNESSES TO STATE ONLY THEIR
NAME AND ORGANIZATION AND THEIR.
THEIR POSITION FOR THE RECORD.
TRAINERS WE WE DO NOT WE WILL
NOT BE.
FOR THOSE WHO HAVE POSITION
THIS SOMEWHERE BETWEEN SUPPORT
AND OPPOSE OR THOSE WHO HAVE NO
POSITION BECAUSE OF THE LENGTH
OF OUR GEN AGENDA I'M NOT
ALLOWING EXTENSIVE TESTIMONY
PIECE TO MISS IT SUBMITTED A
LETTER TO THE COMMITTEE AND
AUTHOR.
VERY BRIEFLY EXPLAIN AND IF YOU
DID NOT SUBMIT A LOT.
IN AB TWO SIX ONE NINE MISTER
ALLEN.
WE HAVE.
SEVERAL BILLS PROPOSE FOR
CONSENT.
ITEM NUMBER SIX.
AB TWENTY ONE TO TWENTY TWO.
IS RAY YES WITH AMENDMENTS ITEM
NUMBER ELEVEN TWENTY FOUR TWENTY
EIGHT GONZALEZ FLETCHER. ITEM
NUMBER THIRTEEN AB TWENTY TWICE
FIVE TWENTY FOUR WOULD WITH
AMENDMENTS.
ITEM NUMBER SEVENTEEN AB TWENTY
FIVE NINETY THREE GRAYSON. ITEM
NUMBER TWENTY EIGHT TWENTY NINE
ALRIGHT AB TWENTY NINE OH FOR
MISS KOREA.
ITEM NUMBER THIRTY AB TWENTY
NINE SEVENTY SIX MISTER QUIRK
AND I'D NEVER THIRTY ONE IDA AB
TWENTY NINE EIGHTY THREE DOCTOR
ARAMBULA.
SO WITH THAT WE WILL GO AHEAD
AND BEGIN WITH OUR FIRST ITEM
AND THAT IS.
ASSEMBLY BILL.
AB SEVENTEEN NINETY FIVE MISTER
GIPSON.
WELL I'M SORRY.
YOU DO TWENTY DID YOU WANNA
TWENTY EIGHT FORTY SIX FIRST TWO
WOULD DO YOU WITH THE TWENTY
FORTY SIX FIRST.
WE HAVE A QUORUM SO WHILE WE'RE
GONNA HAVE MEADOW SECURE CALL
THE ROLL THAT'S A GOOD THING
MISTER GIPSON SO HANG ON WITH
US.
WOOD HERE MAYES HERE AGUILAR
CURRY BIGELOW.
BONTA.
BURKE
CARILLO.
FLORA.
LOW MOAN.
MCCARTY.
NAZARIAN.
RODRIGUEZ.
SANTIAGO.
THURMOND.
WALDRON.
WE HAVE A QUORUM MISTER GIBSON
PLEASE PROCEED.
GOOD AFTERNOON MISTER CHAIR AND
MEMBERS.
THANK YOU VERY MUCH I
RESPECTFULLY ASK WHEN I VOTE.
UNLESS YOU KNOW IT'S.
WHICH YOU YOU WHICH I CAN
WITNESSES SPS PLAYING OKAY WE
HAVE A REPRESENTATIVE FROM
CAROLINE ALSO FROM.
DONATE THE LIFE CALIFORNIA WHO
PROVIDES FOR TESTIMONY.
PLEASE CHRIS RESPONSIBLE TRAILER
THE COALITION FOR HUMANE
IMMIGRANT RIGHTS OP PRADA
SPONSOR THIS LEGISLATION WE SEE
THAT.
OVER THE YEARS WITH AB SIXTY
BEEN IMPLEMENTED AS LAWS ARE DOC
RECIPIENTS ABLE TO RECEIVE
DRIVERS LICENSE. THAT THE DONOR
REGISTRY HAS INCREASED BECAUSE
THOSE POPULATIONS UNFORTUNATELY
UNDOCUMENTED FAMILIES CONTINUE
TO BE LOCKED OUT OF THE SYSTEM
TO BE ABLE TO ATTAIN OUR ORGANS.
I'M NOT BECAUSE THEY'RE STATUS
BUT BECAUSE OF FINANCIAL
HARDSHIPS AND THEREFORE WE
BELIEVE THAT THIS BILL IDEA GOES
IN THE RIGHT DIRECTION TO ENSURE
THAT. OTHERS ARE WORKING GROUP
TO ENSURE THAT THIS PROBLEM NO
LONGER EXISTS NOT IN THE FUTURE
CALIFORNIA AGUIAR ABSOLUTELY OUR
DRIVER.
IF YOU VERY MUCH.
DEANNA SANTANA DON'T LIKE
CALIFORNIA BOARD MEMBER AND THE
PUBLIC EDUCATION RELATIONS
MANAGER FOR SIERRA DONNER
SERVICES ONE OF THE FOUR.
FEDERALLY AUTHORIZED ORGAN
PROCUREMENT ORGANIZATIONS IN
CALIFORNIA.
DIDN'T LIKE CALIFORNIA'S THE
STATE AUTHORIZED NONPROFIT ORGAN
AND TISSUE DONOR REGISTRY IN IS
PLEASED TO SUPPORT AB TWENTY
EIGHT FORTY SIX.
DON'T LIVE CALIFORNIA'S INCLUDED
IN THE WORK GROUP THIS BILL
CREATES AND WE WELCOME THE
OPPORTUNITY TO DISCUSS THE
INTRICACIES OF ORGAN DONATION
WITH OTHER MEMBERS. AND WE
RESPECTFULLY REQUEST YOUR GUEST
BOOK THANK YOU.
VERY MUCH AND YOU IF YOU'D LIKE
TO SPEAK ABOUT THE VOTE WE'RE
NOT WE DON'T NOT WANT TO CUT YOU
OFFICER GIPSON PLEASE FEEL FREE
TO. THE THANK THANK YOU VERY
MUCH.
I REALLY APPRECIATE THE
COMMITTEE MOVE EXPEDITIONS WE
KNOW THAT YOU HAVE A VERY A BIG
AGENDA AND I HAVE ANOTHER BILL
SO.
THIS IS A GOOD BILL AND
CERTAINLY FOR THE REASONS IN
WHICH.
THAT IS SPEAKERS HAVE ALREADY
INDICATED.
THIS IS THE RIGHT THING THIS
BILL PROVIDES A CONVENING OF
STAKEHOLDERS TO COME TOGETHER.
AND ALSO PUT FORTH MY DEALS TO
CREATE A POLICY BY TWENTY
TWENTY.
THAT WE CAN BRING FOR THE
LEGISLATURE TO ALLOW
INDIVIDUALS.
WHO WANTS TO BE ABLE TO DONATE
THEIR ORGANS TO BE ABLE TO DO
SO?
AND SO AGAIN ARTISTS
RESPECTFULLY ASK WHEN I VOTE.
YOU VERY MUCH AREN'T ALWAYS
APPRECIATE PEOPLE BRING US A
GOOD BILL.
THANK THIS INTO PRETTY NIGH
DEPRESSION VERY MUCH APPRECIATES
UP OTHERS AB WHO OTHERS WHO
WOULD LIKE TO SPEAK IN SUPPORT.
SEEING NO ONE IS THERE ANYONE IN
OPPOSITION TO THIS BILL.
SEEING NO ONE BRING BACK TO
COMMITTEE FOR QUESTIONS OR
COMMENTS.
MISTER MISTER BIGELOW.
TO THE AUTHOR YOU KNOW HAVING
BEEN APPROACHING FORTY FIVE
YEARS IS AN EMT SOMEONE WHO
DEALS WITH. THIS TYPE OF A
SITUATION WHERE WE'RE CONSTANTLY
PUTTING PATIENTS BROUGH.
THANK YOU I WAS TALKING ON THE
RUN BILL THANK YOU FOR THAT ONE.
ON THE NEXT ONE MISTER.
I LOOKED UP AND I'M GOING.
I'M IN TROUBLE WILL COME BACK TO
YOUR OTHER BILL.
IS THERE ANYONE ELSE HOW THE
DOESN'T OF A QUESTION OR
COMMENT.
SEE NO ONE.
WE DO HAVE A MOTION FROM.
MISTER MAYES A SECOND FROM
MISTER BIGELOW OR MOTION FOR
MISTER BIGELOW SAKE FOR MISTER
MAYES I'M REALLY NOT SURE.
IT WAS MR IT WAS MISTER MESS
OKAY. AS A MOTION A SECOND MADAM
SECRETARY PLEASE CALL THE ROLL.
MOTION IS.
DO PARENTS.
TWO OF. TWO APPROPRIATIONS.
OKAY.
WHAT I WOULD AYE MAYES MAYES AYE
ANGER CURRY ANCHOR CURRY AYE
BIGELOW? AYE BIGELOW AYE BONTA.
BURKE
CARILLO.
CARILLO AYE FLORA.
FLORA I AM LIMON.
MCCARTY.
MCCARTY I NAZARIAN.
NAZARIAN AYE RODRIGUEZ.
SANTIAGO THURMOND WALDRON.
WALDRON AYE.
SO THAT IS NINE ZERO YOUR VOTE
YOUR BILL IS OUT SO THANK YOU
VERY MUCH VERY MUCH I THANK YOU
TO TWO WITNESSES WATERSHED.
SO NOW.
AB SEVENTEEN NINETY FIVE
SEVENTEEN NINETY FIVE.
AS MY WITNESSES ARE COMING TO
TESTIFY I'LL GET STARTED. OUT
AGAIN GOOD AFTERNOON MISTER
CHAIR MEMBERS THANK YOU FOR
ALLOWING ME TO PRESENT ASSEMBLY
BILL SEVENTEEN THIRTY FIVE. I
LIKE TO START BY SAYING I ACCEPT
THE COMMITTEES AMENDMENTS WHICH
WOULD WHICH FURTHER INSURES
PATIENT SAFETY.
BY CLARIFYING OVERSIGHT AND
STAFFING STANDARDS AT SOBERING
CENTERS.
AND. I WANT TO THANK THE CHAIR
OF THE COMMITTEE FOR WORKING
EXPLICA THEY ARE.
EXCLUSIVELY AN EXTENSIVELY WITH
FAST TO PROVIDE A DIRECTION AND
TO MAKE THIS BILL BETTER.
MEMBERS WE HAVE A HEALTHCARE
CRISIS IN CALIFORNIA THE CRISIS
IS.
MOST EVIDENCE WERE PATIENTS WHO
NEED MEDICAL HEALTH.
CARE.
BUT ALSO FOR THOSE WHO SUFFER
FROM CHRONIC ALCOHOL
INTOXICATION.
MY SISTER AN EMERGENCY ROOM
NURSE SAW PATIENTS DAY AND AND
DAY OUT EVERY DAY SHE WORKED.
AND IT PAINS ME.
THANK YOU.
IT PAINS ME EVERYDAY WHEN I HEAR
STORIES THAT THESE PATIENTS WHO
CLEARLY HAVE A NEED BUT THIS
NEED WAS NOT WELL SERVED IN THE
EMERGENCY ROOM. MY SISTER WAS ON
THE PAPER ON THE FRONTLINE.
HAVING TO WATCH PEOPLE WITH
MENTAL HEALTH NEEDS.
OR THOSE WHO HAVE BEEN IN
ENUMERATED HAVING TO WAIT IN
EMERGENCY ROOM FOR HOURS AND
HOURS AT A TIME WAITING FOR SOME
TIME.
EVEN DAYS IN ORDER TO RECEIVE
THE KIND OF CARE THEY NEED.
WE HAVE TO KEEP IN MIND THAT
PEOPLE DON'T JUST NEED CARE.
BUT TIMELY AND APPROPRIATE CARE.
BUT THAT CARE NEVER ARRIVED
BECAUSE OVER FIFTY YEARS ABUSING
PARAMEDICS
AS A FIRST RESPONSE AS THE FIRST
RESPONSE.
WE DIDN'T THINK TO ASK OUR
PARAMEDICS SENDING PATIENTS
TO THE BEST PLACE POSSIBLE.
THE TRUTH IS THAT THERE THAT
THERE ARE CASES WHEN EMERGENCY
ROOMS IS NOT THE APPROPRIATE
SETTING FOR PATIENTS LET ME
REPEAT.
THERE ARE CASES WHEN EMERGE ZERO
IS NOT THE APPROPRIATE SETTING
FOR PATIENTS THIS BILL WILL GIVE
THE OPTIONS.
TWO LOCAL EMERGENCY MEDICAL
RESPONSE AGENCIES TO AUTHORIZE
THEIR PARAMEDICS TO TRANSPORT
PATIENTS TO BEHAVIOR HEALTH
FACILITIES OR SOBERING CENTERS.
THIS BILL REQUIRES PARAMEDICS TO
RECEIVE EXTENSIVE TRAINING
MODELED OFF THE EXISTING PILOT
PROGRAM WHICH HAS PROVEN TO BE
VERY EFFECTIVE.
THIS BILL MANDATES THAT THE
STATE TO CREATE A STANDARDIZED
TRIGGER AN ASSESSMENT. CRITERIA
FOR PARAMEDICS IN THIS FIELD AND
TO COLLECT THE DATA AND
EVALUATE.
IMP AND IMPROVE LOCAL EMERGENCY
RESPONSE PLANS AB SEVENTEEN
NINETY FIVE IS CRITICAL FOR
PATIENTS WHO HAVE NO UNDERLYING
MEDICAL ISSUES.
AND WHO COULD CARE FOR MORE
PATIENTS QUICKLY AND EFFECTIVELY
AT ALTERNATIVE DESTINATIONS
EXPRESSLY. WHEN A PATIENT IS
HAVING A PANIC ATTACK AND NEEDS
MENTAL HEALTH CARE AND CAN PROVE
BE PROVIDED IN A TIMELY FASHION
BY EIGHT BY PROVIDING. I'M BEING
HELPED BY.
BEHAVIOR HEALTH FACILITIES
RATHER THAN IN A NOISY
DISRUPTIVE EMERGENCY ROOM
DEPARTMENT OR WHEN A PERSON IS
HOMELESS EXPERIENCING CHRONIC.
ALCOHOL INTOXICATION AND VISIT
AN EMERGENCY ROOM EIGHT TIMES A
MONTH BECAUSE THERE IS ONLY ONE
OPTION.
FOR PARAMEDICS.
ALL WHILE THE PACERS SHOULD BE
SENT TO SOBERING CENTERS
RECEIVING THE RIGHT CARE. BE
CONNECTED TO SUPPORTIVE SERVICES
AND HOPEFULLY FIND LIGHT AT THE
END OF THE TUNNEL LET ME BE
CLEAR.
PATIENT SAFETY.
AND THE BETTER AND BETTER
OUTCOMES IS THE SOLE PURPOSE FOR
THIS POLICY TODAY THE EMERGENCY
ROAD DEPARTMENT IS A PRIMARY HAS
A PRIMARY RESPONSIBILITY. TO
SERVE AS A RAPID RESPONSE
EMERGENCY ROOM
RATHER THAN INDIVIDUAL A MEDICAL
CRISIS OR MASS OF DISASTERS.
ABOUT FOURTEEN POINT FIVE
MILLION PEOPLE VISIT THE
EMERGENCY ROOM EVERY YEAR.
MANY OF HOME COULD BE TREATED BY
MEDICAL PROFESSIONALS AT
BEHAVIOR HEALTH FACILITIES OR
SOBERING CENTERS PARAMEDICS ARE
ALREADY TRAINED. TO STABILIZE
OUR LOVED ONES WHEN THEY ARE
HAVING A HEART ATTACK A STROKE
OR SERIOUS ILLNESS THAT REQUIRES
A SPLIT DECISION TO BE MADE.
THIS BILL WILL SIMPLY ENSURE
COUNTIES HAVE THE FLEXIBILITY
TO ALLOW THEIR SPECIALIZED TRADE
PARAMEDICS TO HELP PATIENTS
WITHOUT EMERGING MEDICAL NEEDS
TO S. SS THE RIGHT CARE AT THE
RIGHT TIME AT THE RIGHT PLACE.
HERE WITH ME TO PROVIDE
SUPPORTING TESTIMONIES IS WE
HAVE.
DOCTOR CLAYTON BECAUSE OUT OF
THE LOS ANGELES. COUNTY FIRE
DEPARTMENT MEDICAL DIRECTOR AND
EMERGENCY ROOM POSITION. ALSO
SHANNON SMITH FORMER DEPUTY A
DIRECTOR OF SAN FRANCISCO'S I'M
SOBERING CENTER DOCTOR IN
TRAINING REGISTERED NURSE. IN
ADDITION TO KEVIN MACKEY
EMERGENCY ROOM POSITION WITH THE
WHO HAS CREATED THE FIRST MENTAL
HEALTH AND CARE PILOT AND
STANISLAUS COUNTY.
AS A MEMBER SOON MENTION CAN
THINK.
I'M BOTH A AN EMERGENCY
PHYSICIAN AND I'M THE MEDICAL
DIRECTOR OF THE LOS ANGELES
COUNTY FIRE DEPARTMENT.
AB SEVENTEEN NINETY FIVES ABOUT
TRYING TO GET BETTER OUTCOMES
FOR TWO OF OUR MOST VULNERABLE
PATIENT POPULATIONS.
BY ALLOWING OUR PERMITS TO
TRIAGE PATIENTS TO MENTAL HEALTH
AND SOBERING CENTERS.
SPECIALLY DESIGNED IN RESOURCE
TO CARE FOR THEM.
THE TO CRITICAL FUNCTIONS ARE
PERMITS PERFORM EACH DAY ARE TO
PROVIDE IMMEDIATE LIFESAVING
TREATMENT.
AND TO TRIAGE PATIENTS TO ENSURE
THAT THEIR BROUGHT THE
FACILITIES THAT ARE BEST
EQUIPPED TO TAKE CARE OF THEM.
OUR PARAMEDICS TUNICS
EXCEPTIONAL JOB OF GETTING
PATIENTS TO THE RIGHT PLACE.
BUT MENTAL HEALTH AND
INTOXICATED PATIENTS HAVE BEEN
LEFT OUT.
DESPITE THE FACT THAT THEIR
EXISTING MENTAL HEALTH AND
SOBERING CENTERS OR FIFTY YEAR
OLD PER MAKE STATUTE. REQUIRES
IN THE TRANSPORT ALL THESE
PATIENTS TO COMMUNITY E.*.
WITH ALL THESE CRISES THAT ARE
E. OURS FACE ON A DAILY BASIS
THESE PATIENTS WHO OFTEN REQUIRE
LITTLE OR NO MEDICAL
INTERVENTION AND UP LANGUISHING
FOR HOURS OR EVEN DAYS.
YEAH BECAUSE MOSTLY OURS HAVE
VERY LIMITED SERVICES TO OFFER
THEM.
I CAN UNDERSTAND HOW ANYONE CAN
ARGUE THAT CONTINUING OUR STATUS
QUO IS WHAT IS IN THESE PATIENTS
BEST INTERESTS.
IT'S NEAR IMPOSSIBLE FOR
COMMITTEE E. OURS TO PROVIDE THE
COMPREHENSIVE SERVICES THAT
THESE PATIENTS NEED. TO ACHIEVE
THE OUTCOMES THAT WE WANT AND
THE PATIENTS DESERVE.
FOR THESE PATIENTS THE BEST
CHANCE OF A GOOD OUTCOME IS TO
BE TRANSPORTED TO CENTERS.
THEY'RE PROPERLY EQUIPPED TO
MEET THEIR NEEDS.
WE LEARNED THAT LESSON WITH
TRAUMA CENTERS PEDIATRIC
RECEIVING CENTERS
STROKES CENTERS HEART ATTACKS
CENTERS AND ALL THE OTHER
SPECIALTY CENTERS THAT WE
TRANSPORTER PATIENTS TRUE TO.
AND IS EQUALLY TRUE FOR MENTAL
HEALTH AN INTOXICATED PATIENTS.
IT'S REALIZING A PATIENTS THE
CENTERS BY LAW ENFORCEMENT WITH
NO MEDICAL TRAINING HAS ALREADY
EXISTED FOR YEARS.
PASSING AB SEVENTEEN NINETY FIVE
WILL ENABLE PHYSICIAN MEDICAL
DIRECTORS LIKE ME. TO WORK WITH
STAKEHOLDERS TO DEVELOP TRIAGE
INSTRUMENTS.
ARE AN ADDITIONAL TRAINING FOR
PERMITS TO ENSURE THE SAFETY THE
PROGRAM JUST AS WE'VE DONE FOR
ALL OF OUR SPECIALTY CENTERS.
THIS WILL REPRESENT A VAST
IMPROVING ON THE STATUS QUO WILL
OFFER THE PATIENTS THEIR BEST
CHANCE.
FOR A GOOD OUTCOME SO I STRONGLY
URGE YOUR AYE VOTE ON AB
SEVENTEEN NINETY FIVE.
HELLO MY NAME.
MY NAME IS DENNIS MCCARTY THEN
I'M A REGISTERED NURSE AND A
PHD.
FOR THE LAST DECADE I HAVE
WORKED IN AND PUBLISHED RESEARCH
ON SUFFERING CENTERS AS AN
ALTERNATIVE TO THE EMERGENCY
DEPARTMENT.
HOW DOES A SOBERING CENTER WORK
MY CLIENT JAMES COMES TO MIND
HE'S A FIFTY YEAR OLD TENEMENT
SAN FRANCISCO? ON A TUESDAY HE'S
FOUND PASSED OUT ON THE SIDEWALK
NINE ONE ONE IS CALLED.
THE PARAMEDICS FOLLOW TRIAGE
PROTOCOLS AND DETERMINED THE
ONLY MEDICAL NEED THE JAMES HAS
IS THAT HE'S. INTOXICATED ON
ALCOHOL AND THEY BRING UP TO THE
SAN FRANCISCO SOBERING CENTER.
JAMES IN THE PARAMEDICS ABOUT
POINT AGREED TO BY A NURSE AND
THE SUPPORT STAFF WHO TAKE VITAL
SIGNS AND DO A QUICK PHYSICAL
ASSESSMENT.
WELL GIVEN JAMES A SHOWER AND
PROVIDING A BED TO SLEEP IN THEY
TALK TO HIM ABOUT WHAT IS
OPTIONS MAYBE IT DECIDES TO.
DECREASES DRINKING OR GO TO
DETOX REHAB.
WHILE HE'S RESTING THE SOCIAL
WORK AND SOBRE COACHES WILL
CHECK IN WITH JAMES. AND SEE IF
HE'S ELIGIBLE FOR SOCIAL
SECURITY OR HE'S READY TO FILL
OUT A HOUSING APPLICATION.
DURING THIS TIME THE NURSES
FOLLOWING PHYSICIAN AND NURSE
APPROVED PROTOCOLS WILL
CONTINUALLY MONITOR HIM TO
CONFIRM THAT HE HAS NO OTHER
MEDICAL NEED. THAT REQUIRES A
TRIP TO THE EMERGENCY
DEPARTMENT.
IN THE LAST FIFTEEN YEARS THIS
EVER CISCO SOBERING CENTER HAS
PROVIDED CARE TO OVER FIFTEEN
THOUSAND PATIENTS LIKE JAMES.
ALL REFERRED BY PARAMEDICS
DIRECTLY.
OF THESE FIFTEEN THOUSAND
ENCOUNTERS LESS THAN FIVE
PERCENT HAVE REQUIRED TRANSPORT
TO THE E. D. AT SOME POINT
DURING THEIR STAY.
THE VAST MAJORITY OF PATIENTS
OVER SAFELY AND WITHOUT
INCIDENT.
AND MANY OF THEM ARE CONNECTED
TO FURTHER CARE.
TREATMENT PROGRAMS LONG TERM
HOUSING PIECE MANAGEMENT.
THIS LEVEL OF COORDINATED CARE
AND TRAIN A SPECIALIZED
ATTENTION IS RARELY AVAILABLE TO
A PERSON LIKE JAMES WHEN HE SEEN
IN THE E. D..
MULTIPLE STUDIES HAVE DOCUMENTED
THE PARAMEDICS CAN TRAIN.
CAN BE TRAINED TO SAFELY TRIAGE
AND TRANSPORT PEOPLE WITH ACUTE
INTOXICATION.
YOUR SUPPORT OF AB SEVENTEEN
NINETY FIVE WILL OPEN THE DOORS
TO GIVING OUR MOST VULNERABLE
CLIENTS AND CITIZENS THE CARE
THEY NEED AND DESERVE.
THANK YOU.
SO ADDITIONAL WITNESSES ARE JUST
NAME AND POSITION ONLY.
MY NAME'S KEVIN MACKEY ON
EMERGENCY POSITION I'M IN MY MID
SUPPORT THANK YOU VERY MUCH
OTHERS.
GOOD AFTERNOON MISTER CHAIRMAN
MEMBERS COUNTY DELGADO WITH THE
CALIFORNIA HOSPITAL ASSOCIATION
ONE OF THE CO SPONSORS PLEASED
TO BE HERE IN SUPPORT.
DONNA SITES REPRESENTING THE LOS
ANGELES COUNTY BOARD OF
SUPERVISORS ONE OF THE CO
SPONSORS AND ARCHER AYE VOTE
THANK YOU.
SEAN OFTEN WITH THE CALIFORNIA
DISTRICT ATTORNEYS ASSOCIATION
SUPPORT.
MISTER CHAIRMAN MEMBERS STAND
FELIZ AUTO ON BEHALF OF THE LOS
ANGELES COUNTY DISTRICT
ATTORNEY'S OFFICE IN SUPPORT.
GIVE.
BRANDON UP REPRESENTING SHERIFF
JIM MCDONNELL US ANGELES COUNTY
IN SUPPORT.
NATASHA MINSKER ACLU OF
CALIFORNIANS SUPPORT.
RUSSELL NO ACT ON BEHALF THE
CALIFORNIA FIRE CHIEFS
ASSOCIATION THE FIRE DISTRICTS
ASSOCIATION OF CALIFORNIANS
SUPPORT.
AND HE'S.
WELL FRED KNOW WHERE
REPRESENTING ALLIANCE OF
CATHOLIC HEALTH CARE. ADVENTIST
HEALTH SYSTEM PRIVATE ESSENTIAL
ACCESS COMMUNITY HOSPITALS AND
STANFORD HEALTHCARE ON SUPPORT.
CADBURY TO HELP OFFICERS
ASSOCIATION OF CALIFORNIA IN
SUPPORT.
NEARLY VETERAN WITH MCCUE CUT AN
ASSOCIATES ON BEHALF OF THE
CALIFORNIA CHAMBER OF COMMERCE
IN SUPPORT.
IF YOU.
JOANNE CAMPBELL ON BEHALF LA
CARE AND SUPPORT.
THAT'S HE ARMSTRONG ON BEHALF OF
THE EMS ADMINISTRATORS
ASSOCIATION AND THE EMERGENCY
MEDICAL DIRECTORS ASSOCIATION
SUPPORT.
IF YOU.
KELLY BROKE SOME BEHALF OF THE
ASSOCIATION OF CALIFORNIA HEALTH
CARE DISTRICTS AND ON BEHALF OF
THE SANTA CLARA COUNTY BOARD OF
SUPERVISORS HERE IN SUPPORT.
KIM.
ROSANNA CARAVAGGIO ME HAVE
ALAMEDA COUNTY BOARD OF
SUPERVISORS ALSO IT'S PART.
GOOD AFTERNOON MARRIED THERE
WITH THE COUNTY BEHAVIORAL
HEALTH DIRECTORS HERE IN
SUPPORT.
JENNIFER CMOS OF THE MEDICAL
BOARD OF CALIFORNIA AT THE BOARD
SUPPORTS THE CONCEPT OF THE
LANGUAGE OF THE INTRODUCED
PERSON LET ME BRING IN THE.
CURRENT VERSION TOWARD MEETING
AND ON THURSDAY THANK YOU.
AARON TAYLOR ON BEHALF OF
MEMORIAL CARE HEALTH SYSTEM IN
SUPPORT.
MADISON Y. ON BEHALF OF THE
CEMETERY COUNTY BOARD OF
SUPERVISORS IN SUPPORT.
ERIN GILBERT ON BEHALF OF
SCRIPTS HEALTH AND SUPPORT.
DAVID JONES A MAP THE CITY OF
MARIETTA AND SUPPORT.
CATHERINE'S GOT GOT THE NIGHT
HOSPITAL ASSOCIATIONS POOR.
REBECCA GONZALEZ NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER IN SPORT.
FAIR MCDADE TING ON BEHALF THE
CALIFORNIA STATE ASSOCIATION OF
COUNTIES IN SUPPORT.
CUT THE MOST PROGRAM HAVE THE
LOCAL HEALTH PLANS CALIFORNIANS
SPORT.
WHAT'S AND MORE WITH CHAU YOUR
ENTRY ON BEHALF OF THE CITY AND
COUNTY OF SAN FRANCISCO THE CITY
OF SANTA MONICA. THE COUNTY
BOARD OF SUPERVISORS FOR
STANISLAUS SAN JOAQUIN AND
FRESNO AND LOS ANGELES MAYOR
ERIC GARCETTI IN SUPPORT. TAKE
YOU.
MICHAEL TO WITH PROMISING JUST
OF HEALTH IN SUPPORT.
OKAY.
.
XIN IS THERE ANYONE IN
OPPOSITION.
FORWARD.
ONE MORE MISTER CHAIR CHRIS
MCKINLEY ON BEHALF OF THE
CALIFORNIA AMBULANCE ASSOCIATION
ALSO IN SUPPORT. THINK SIR.
DR CHAIR MEMBERS TO MADDEN
REVERSING CALIFORNIA CHAPTER OF
THE AMERICAN COLLEGE OF
EMERGENCY PHYSICIANS
AND WE HAVE AN OPPOSING LESSEN
MANY POSITION ON THE BILL. WITH
ME I HAVE AMY MOULIN WHO IS AN
EMERGENCY PHYSICIAN AT UC DAVIS
ALSO RESIDENT OF CALIFORNIA
EXCEPT TO GO INTO THE DETAILS OF
OUR OPPOSITION.
THANK YOU.
I AM A PRACTICING EMERGENCY
PHYSICIAN AND ONE OF MY CORE
BELIEFS IS IN AND THE IN EMTALA
IN THE SPIRIT OF EMTALA THAT ALL
PATIENTS. ARE TREATED EQUALLY
REGARDLESS OF WHO THEY ARE AND
THEIR ABILITY TO PAY.
AND THIS BILL WOULD ALLOW
PATIENTS WHO ARE ACTIVELY BY THE
NINE ONE ONE SYSTEM. NOT TO LOSE
THEIR ARMS HOLLOW PROTECTIONS
AND WE FEEL THAT IS VERY
IMPORTANT THAT ALL PATIENTS BE
TREATED. EQUALLY.
SO WITH THIS SYSTEM IS A GRATES
AND IT IS SAFE FOR HOMELESS
ALCOHOLICS IT SHOULD ALSO BE
WONDERFUL AND SAFE.
FOR ME.
SO IF WE SHOULD TREAT ALL
PATIENTS EQUALLY THIS IS
PARTICULARLY IMPORTANT IF THE
DESTINATION WE ARE TAKING
PATIENTS TO. IS NOT LICENSED BY
THE STATE.
IT'S IMPORTANT THAT THESE
PROTECTIONS ARE IN PLACE BECAUSE
WE ARE TALKING ABOUT BONOBO
PATIENT POPULATIONS
SO. IF THIS BILL IS.
BUT STATE BILL.
IT SHOULD BE AVAILABLE TO ALL
PATIENTS ANDS THE FACILITIES
SHOULD BE LICENSED BY THE STATE
OF CALIFORNIA.
THANK YOU.
MISTER CHAIR AND MEMBERS OF MY
NAME IS STILL JACKSON I
REPRESENT THE CALIFORNIA NURSES
ASSOCIATION WHO ARE OPPOSED TO
AB SEVENTEEN NINETY FIVE.
AB SEVENTEEN NINETY FIVE
THREATENS PATIENT SAFETY BY
USING PARAMEDICS TO PROVIDE
HEALTH CARE CURRENTLY PROVIDED
BY POSITIONS REGISTERED NURSES
AND SOCIAL WORKERS.
TO EXPAND THE PILOT AND
DEFINITELY TO ALL FIFTY COUNTIES
AS WRITTEN IN THIS BILL IS A
DANGEROUS THREAT TO PATIENT
SAFETY.
PARAMEDICS ARE DEPENDENT
PRACTITIONERS WHOSE TRAINING
EQUIP SOME TO DELIVER LIMITED
CARE THAT IS IMMEDIATELY
NECESSARY TO SUPPORT AND
STABILIZE THE PATIENT UNTIL THEY
REACH THE EMERGENCY DEPARTMENT.
THEN CHARIS TURNED OVER TO THE
E. ARE TEAM WHICH INCLUDES OUR
ENDS IN POSITIONS.
THIS BILL WILL CREATE A TWO TIER
SYSTEM OF HEALTH CARE ESPECIALLY
FOR PATIENTS NEEDING MENTAL
HEALTH SERVICES.
NINETY NINE PERCENT OF THE
PATIENT'S DIVERTED FROM THE
LARGE PRIVATE HOSPITALS
PARTICIPATING IN THE BEHAVIORAL
HEALTH PILOT. WHERE MEDI CAL AND
UNINSURED PATIENTS
NONE OF THE PATIENTS WITH
PRIVATE INSURANCE WERE DIVERTED
FROM THE ER?
THE EFFECT HAS THUS BEEN TO
DIVERT PATIENTS WHO DO NOT HAVE
PRIVATE OR COMMERCIAL INSURANCE
FROM THE EMERGENCY DEPARTMENT
DECREASING THE NUMBER OF MEDI
CAL ON UNINSURED PATIENTS SEEN
IN THE EMERGENCY DEPARTMENT. AND
FREEING UP SITE BEDS IN THE
HOSPITAL FOR PRIVATELY INSURED
PATIENTS.
PATIENT SAFETY SHOULD BE
PARAMOUNT NOT COST SAVINGS
INEBRIATED PATIENTS PICKED UP BY
AMBULANCES ON NINE ONE ONE
CALLS.
ARE AT HIG RISK FOR TRAUMA
HYPOTHERMIA AND MULTI SUB DID
SUBSTANCE INTO DUST INGESTION
YET THE SOBERING CENTER PILOT
PROJECT PROTOCOLS. DID NOT
INCLUDE TAKING THE PATIENT'S
BODY TEMPERATURES.
ET SCREENINGS BEFORE A SOBERING
CENTER STAY IS THE SAFEST AND
MOST HUMANE WAY TO ASSURE
APPROPRIATE TRANSFERS.
THE PATIENT POPULATION ENROLLED
IN THE COMMUNITY PARAMEDIC SOME
PILOT PROJECTS DOES NOT REFLECT
CALIFORNIA'S DIVERSE POPULATION.
WITH THE EXCEPTION OF TWO
PROJECTS THE FIRST YEAR DATA
SHOW THE OVERWHELMING MAJORITY
OF PEOPLE ENROLLED IN THE PILOT
PROJECTS. WERE
DISPROPORTIONATELY ENGLISH
SPEAKING WHITE MALES.
LASTLY WE HAVE MADE SEVERAL
REQUESTS FOR ALL OF THE RAW DATA
AND MONTHLY REPORTS FROM THE
PILOT PROJECTS.
DESPITE THE FACT THAT THE HEALTH
AND SAFETY CODE MANDATES THE
RELEASE OF ALL DATA.
TO INTERESTED PARTIES UPON
REQUEST WE HAVE BEEN GIVEN THE
RUN AROUND.
THIS IS HEIGHTENED OUR CONCERN
OVER THE POSSIBILITY THAT
THERE'S INFORMATION IN THIS DATA
THAT AND SEND THE EVALUATOR DO
NOT WANT TO RELEASE FOR PUBLIC
REVIEW.
AB SEVENTEEN NINETY FIVE CREATES
A TWO TIER SYSTEM OF HEALTH CARE
WHERE ARE POOR HOMELESS AND
UNDOCUMENTED PATIENTS WILL
RECEIVE A LOWER STANDARD OF
CARE.
FOR ALL THESE REASONS HE IN A AS
OPPOSED AB SEVENTEEN NINETY FIVE
AND RESPECTFULLY ASK FOR YOUR
NOBEL.
YOU VERY MUCH OTHERS IN
OPPOSITION.
MISTER CHAIR MEMBERS STORE
TAUNTS ABOUT THE CALIFORNIA
MEDICAL ASSOCIATION WE'RE IN A
OPPOSE A LESS AMENDED POSITION.
TO MAKE CONCERNS ON THIS BILL IS
FIRST OF ALL WE BELIEVE THAT THE
CURRENT VERSION THE BILL HAS TOO
MUCH DELEGATION TO THE LENS
DOESN'T AND SIZE TO APPROVE
PROJECTS INCLUDING THE
ADDITIONAL SCOPE EXPANSION AND
TRAINING. AND SECONDLY WE'D LIKE
TO SEE THE SUFFERING CENTER IS A
LICENSED BY THE STATE OF
CALIFORNIA SO THERE'S MORE
OVERSIGHT BY HABIT OR WITH THE
AUTHOR FURTHER ON THESE
AMENDMENTS THANK YOU.
MISTER CHAIRMAN CHRISTMAS SHOCK
OF IT I WITH SEIU CALIFORNIA AND
WE HAVE A CONCERNS POSITION ON
THIS BILL.
WE ARE VERY PLEASED WITH THE
PROGRESS THAT'S BEEN MADE SO FAR
BY THE AUTHOR AND THE SPONSORS
IN TRYING TO ADDRESS.
THE CONCERNS THAT WE HAVE
AROUND ON VARIOUS TOPICS BUT WE
REMAIN CONCERNED ABOUT SCOPE OF
PRACTICE AS WELL AS.
THE LEVEL OF CARE THAT
INDIVIDUALS WILL BE RECEIVING IF
THEY ARE DIVERTED FROM THE
EMERGENCY ROOMS AND SO FOR THESE
REASONS WE ARE. IN A CONCERNS
POSITION BUT CONTINUE OUT TO
WANT TO WORK WITH THE AUTHOR AND
SPONSORS THANK YOU.
IF YOU VERY MUCH.
.
BRING BACK TO THE COMMITTEE FOR
QUESTION ANYONE ELSE
SMALL.
BRING BACK TO COMMITTEE FOR
QUESTIONS OR COMMENTS.
MISTER BIGELOW.
THANK YOU.
NOW THAT I'M ON TRACK IN.
CLEARLY FOCUSED ON THE RIGHT
BILL.
I WANT TO THANK YOU.
FOR THIS INTRODUCING THIS BILL
AND PRESENTING IT.
AS ANY EMPTY OF. NEARLY FORTY
FIVE YEARS I'VE HAD TO DEAL WITH
THIS PARTICULAR ISSUE.
WHETHER OVERCROWDING IN THE
HOSPITALS WHERE WE ARRIVE ON.
I AT THE DESTINATION. ANDERSON
NO PLACE
WORK WE WERE ABLE TO HANDLE THIS
IN A MORE EFFECTIVE WAY A MORE
HUMANE WAY.
WAY OF PROPERLY ADMINISTERING IT
WITH DIGNITY FOR THESE FOLKS.
THERE THEIR HOUSE TO BE A BETTER
WAY AND I THINK THIS IS.
OFFERING AS AN OPPORTUNITY TO
RECOGNIZE THAT IN HOW TO HANDLE
IT SO TODAY HAVE LIKE TO BE A CO
AUTHOR. ARE AT LEAST WHEN THE
OPTION COMES FOR YOU TO AMEND
AND ALLOW THAT TO OCCUR I WOULD
BE PLEASED TO STAND WITH YOU ON
THIS PARTICULAR BILL IS SOMEONE.
WHO'S FROM THAT FIELD I KNOW
THERE'S.
THREE OF US NOW THAT SERVE ON
THE FLOOR THERE FROM THE WORLD
OF BEING.
IN CONSTANT CONTACT WITH FOLKS
WHO ARE GOING THROUGH A LOT OF
DRAMA IN HER LIFE. AND.
WERE VERY SENSITIVE TO THIS
PARTICULAR ISSUE
SO THANK YOU VERY MUCH THANK YOU
VERY MUCH I CERTAINLY WELCOME
YOUR COOPERATION. THANK YOU
THANK YOU MISS WALDRON.
I DON'T THINK MISTER CHAIR JUST
REALLY BRIEFLY.
.
THERE'S BEEN A LOT OF DISCUSSION
AROUND THIS BILL SO I CAN COME
TO UNDERSTAND A LOT OF BOTH
SIDES.
THE CONCERNS THAT I SEE YOU
KNOW THAT HAVE PROMPTED HAVING A
BILL LIKE THIS ARE THE FACT THAT
THE EMERGENCY ROOMS IN THE SOME
OF THE FOLKS I'VE SPOKEN TO.
THEY'RE NOT STAFF TWENTY FOUR
SEVEN WHEN THE MENTAL HEALTH
PROVIDER OR YOU KNOW OTHER TYPES
OF.
PERSONNEL SO THAT'S AN ISSUE
PEOPLE ARE WAITING IN THE
ALREADY CROWDED EMERGENCY ROOMS
THEY IMPACT ON CROWDED YOURS.
.
ANOTHER CONCERN IS AN EMT MAKING
THE DIAGNOSTIC OR TREATMENT
DECISION THAT'S THAT WAS A
CONCERN OF MINE IN THE
BEGINNING.
ON A COMPLICATED PIG CASE OR A
PATIENT WHO. THEY'RE NOT
FAMILIAR WITH THEM.
I SEE THIS I WAS WONDERING WHERE
THIS CAME FROM IS THAT FROM.
OKAY. BECAUSE IT DOES DELINEATE
YOU KNOW WITH SOME OF THE.
THE THE FRAMEWORK OF HOW THE
DECISION IS MADE WHERE THE
PATIENT WOULD GO. ON.
WHAT WE FOUND IS YOU HAVE THE
SAME PEOPLE OVER AND OVER WAS A
GROUP OF PEOPLE ARE IN THE?
EMTS NO THEY ARE THE POLICE
NUMBER THEY ARE MY NAME THEY SEE
THEM.
ON REGULAR BASIS.
WHEN I WAS ON THE CITY COUNCIL
WE HAD A SOBRIETY CENTER.
WHERE OF THE POLICE ACTUALLY
WERE TRANSPORTING PEOPLE WHICH
YOU KNOW IN RETROSPECT NOW WHEN
WE HEAR A LOT OF THE ISSUES THAT
WAS MUCH MORE RISKY?
THING THERE'S A LOT MORE
PROTECTIONS OUR OBSCENE.
FOR THAT BUT ONE OF THE
BENEFITS OF HAVING THE SOBRIETY
CENTER OR IN YOUR CASE HAVING.
THE BEHAVIORAL HEALTH CENTER IS
THE ABILITY THEN TO OR HAVE CASE
MANAGEMENT AROUND THE PEOPLE
WHEN THEY COME IN.
SO YOU KNOW BEFORE IT WAS JUST.
IN THE BEGINNING IT'S NEW KIND
OF EVOLVE FROM A BED TO.
SLEEP IN AND GET OVER YOUR YOU
KNOW.
ALCOHOL. CONSUMPTION AND THEN IN
THE MORNING THEY WERE DEALT WITH
CERTAIN RATHER THAN TRANSPORTING
SOME TO JAIL. TO NOW THE ABILITY
TO ACTUALLY OPEN CASE MANAGEMENT
ON EVERYONE THAT COMES IN SO
THEN THERE FOLLOWED UP FROM THEN
ON. IN AN EFFORT TO TRY TO AVOID
THIS REPETITION OF BEING TAKEN
YOU KNOW EITHER TO THE EMERGENCY
ROOM OR TO THE.
THE BEHAVIORAL HEALTH CENTER.
.
SO THAT WAS.
BUT THE POINT I WANTED TO TAKE
AND I KNOW THIS DISCUSSION OF
AMENDMENTS.
I DON'T KNOW IF YOU'VE TAKEN ANY
AT THIS POINT BUT THERE SEEMS TO
BE.
IT'S THE AMENDMENTS AND THE
ANALYSIS OF THOSE THE.
YES I WE'VE ALREADY TAKEN SOME
AMENDMENTS AND SURLY.
THERE'S A WILLINGNESS ON MY
PART TO WORK WITH THOSE WHO HAVE
OPPOSITION TO THIS BILL TO TRY
TO HOPEFULLY MOVE INTO A PLACE
WHERE THEY CAN MOVE THE
OPPOSITION EVEN TO A NEUTRAL.
AND WE BELIEVE THIS IS A GOOD
SAU LEGISLATION OF THE COUNTY OF
LOS ANGELES BEEN DOING THIS FOR
FIFTY YEARS.
SUPERVISOR KINNEY HAN WHO'S A
FORMER SUPERVISOR BROUGHT THE
PARAMEDICS.
FIRST STARTED IN LOS ANGELES
COUNTY NEWS SPREAD IT TO OTHER
COUNTIES ARE BEST FIFTY YEARS
AGO.
IT'S TIME FOR A START UPDATING
LOOKING AT NEW WAYS TO TRY TO
ADDRESS SOME OF THE ISSUES THAT
EXISTS THAT CONFRONT US
ESPECIALLY THOSE WITH MENTAL
ILLNESSES AND ALSO THOSE WHO. IN
FACT.
WHO ARE?
INEBRIATED AND SO THEY WILL BE
TYING UP ARMORED SUIT ROPES AND
SO I LOOK FOR TO WORKING WITHOUT
ANYONE IS WILLING TO WORK WITH
ME ON CHINA STRAIGHT AND MAKE
THIS BILL THAT.
THANK YOU.
TO ANYONE ELSE.
SEE NO ONE.
.
I THINK IT'S IMPORTANT TO KNOW
THAT.
THE PILOT PROGRAM WAS DESIGNED
TO TEST MANY DIFFERENT.
CONCEPTS BASED ON THE NEEDS OF
EACH COMMUNITY.
I UNDERSTAND THE OPPOSITION'S
DESIRE FOR CLEAR STANDARDS AND
TRAINING HOWEVER I THINK THE
AUTHORS DID A GOOD JOB OF
ENSURING OVERSIGHT THREE OUNCES
ESTABLISHMENT GUIDELINES. AND
WITH THE ACCEPTANCE OF THE
AMENDMENTS WERE LOOKING THAT
LICENSING FACILITIES WHICH I
THINK WAS A CONCERN. OF YOUR
DOCTOR.
I ALSO THINK IT'S IMPORTANT
APPROPRIATE THAT THE BILL STILL
ALLOWS FOR SOME FLEXIBILITY ON
THE PART OF LOCAL AND STATE
AGENCIES. I KNOW THAT.
WHAT WORKS IN LOS ANGELES WON'T
NECESSARILY WORK IN MY COUNTIES?
AND AND AND I FLEXIBILITY IS IS
IS CRITICAL. TO ME AND AND MY
CONSTITUENTS SO WE'RE THANK YOU
ASSEMBLY MEMBER.
GIPSON FOR YOUR HARD WORK ON
THIS ISSUE THING I WANT TO GIVE
YOU THE OPPORTUNITY TO CLOSE.
THANK YOU.
I KNOW YOU HAVE A LOT OF BILLS
BEFORE YOU BUT I RESPECTFULLY
ASK FIVE VOTING THANK THOSE WHO.
AND MY WILLINGNESS TO WORK
AGAIN WITH ALL PARTIES THAT'S
INVOLVED IN ORDER TO STRENGTHEN
AND MAKE THIS BILL BETTER SO I
RESPECTFULLY ASK WHEN I DON'T.
THANK YOU MISTER GIPSON.
THIS DOESN'T CHOI DO PASS
RECOMMENDATION MADAM SECRETARY
THE OF THE BILL IS TO PASS AS
AMENDED TO APPROPRIATIONS THAT
MOTION WAS MADE BY MISTER
BIGELOW. SECOND BY MISTER FLORA
MEN OF SECRETARY PLEASE CALL THE
ROLL WOULD I FROM WHAT I MAYES
MAYES AYE AGAR CURRY. OCCUR
CURRY AYE BIGELOW. BIGELOW AYE
BONTA.
BURKE
BURKE I CARILLO.
FLORA. FLORA AYE LOW MOAN.
MCCARTY MCCARTY AYE NAZARIAN.
NAZARIAN AYE RODRIGUEZ.
SANTIAGO BERMAN.
WALDRON.
WALDRON AYE.
YOUR BILL IS NINE VOTES THAT
IT'S MORE THAN ENOUGH TO GET OUT
COMMITTEE THANK YOU MISTER
GIPSON THANK YOU TO THE
WITNESSES MUCH APPRECIATED.
MR HIS AREA AND.
MISTER AS ARIANNA WILL BE
PRESENTING A BE EIGHTEEN ONLY
ONE.
INITIALLY AND THEN DO YOU HAVE
THE MATERIALS FOR SECOND DOES
WELL PERFECT THING.
THANK YOU MISTER CHAIRMAN
COLLEAGUES AND THANKS FOR
ACCOMMODATING.
MANY OF THE PARENTS WHO HAVE
COME HERE FROM OTHER.
DIFFERENTREACHES OF THE STATE
TO BE WITH US TODAY.
SELECT MY.
IT'S ALL JUST START PRESENTING
PLEASE.
.
MISTER CHAIR MEMBERS I WILL BE
ACCEPTING THE SUGGESTED
AMENDMENTS LISTED IN THE
ANALYSIS AB EIGHTEEN NO ONE.
WOULD REQUIRE THE DEPARTMENT OF
HEALTH CARE SERVICES TO
ESTABLISH A COMMISSION WHICH
WOULD REVIEW AND PROVIDE
RECOMMENDATIONS TO ISSUE
SURROUNDING EXPOSURE TO.
CYTOMEGALOVIRUS OTHERWISE KNOWN
AS CMV.
CM VEHICLE MOST COMMON
INFECTIOUS BECAUSE OF BIRTH
DEFECTS IN THE U. S. IMPACTING
ONE IN TWO HUNDRED INFANTS EACH
YEAR. IT CAN LEAD TO HEARING
LOSS VISION LOSS JOHN THIS
SEIZURES DEVELOPMENTAL AND MOTOR
DELAY. AND OTHER LONG TERM
HEALTH PROBLEMS MOST INFANTS AT
RISK OF CMB GOING RECOGNIZED
BECAUSE THEY ARE SIMPLY NOT
BEING TESTED.
AS A.
BIG PROBLEM AS A CMV IS ONLY
NINE PERCENT OF THE POPULATION
EVEN KNOWS ABOUT IT.
WHAT WERE ULTIMATELY AFTER IS
TRYING TO UNDERSTAND THIS VIRUS
MORE CLEARLY AND OPPORTUNITIES
TO MITIGATE ITS HARMFUL AFFECTS
THROUGH THIS BILL? BY CREATING
THIS COMMISSION CALIFORNIA WILL
GATHER THE MOST CONTEMPORARY
EVIDENCE BASED AND DATA DRIVEN
INFORMATION WHICH CAN BE USED TO
MAKE THE APPROPRIATE POLICY
RECOMMENDATIONS. IN ORDER TO
COMBAT THE SERIOUS VIRUS AB
EIGHTEEN NO ONE REPRESENTS A
FIRST AN IMPORTANT STEP.
FOR CALIFORNIA.
TO JOIN THIS NATIONAL TREND A
WITH ME I HAVE JANELLE GREENLEE
A PARENT OF TWO CHILDREN
AFFLICTED WITH CMV AND FOUNDER
OF THE NATIONAL CMV FOUNDATION.
AND IRAN AHMED AND ASSISTANT
PROFESSOR OF. OTOLARYNGOLOGY
LEARNED GOLLY GEE AT STANFORD
UNIVERSITY MEDICAL CENTER.
GO AHEAD.
THANK YOU ASSEMBLY MEMBER. I
CHAIRMAN WOULD VICE CHAIR MAYES
AND MEMBERS OF THE ASSEMBLY I
HEALTH COMMITTEE THANK YOU FOR
THE OPPORTUNITY TO TESTIFY
BEFORE YOU TODAY IN SUPPORT OF
AB ONE EIGHT OH ONE. MY NAME IS
JANELLE GREENLEE AND I'M CO
FOUNDER OF THE NATIONAL CMB
FOUNDATION I'D DURING MY YEARS
AS AN ADVOCATE ON THIS ISSUE OF
SEEM TO BE. I'VE MET WITH
COUNTLESS MEDICAL AGENCY AND
POLICY PROFESSIONALS NATIONWIDE
AND WORLDWIDE.
AND I'VE HEARD THE SAME THING
OVER AND OVER AGAIN. SOMETHING
NEEDS TO BE DONE ABOUT CMV.
I TODAY MY HOME STATE AB ONE
EIGHT OPINE IS THAT SOMETHING. I
AB ONE NATO ONE SEEKS TO ENGAGE
THE APPROPRIATE AND RELEVANT
PROFESSIONALS TOGETHER AS A
COMMISSION TO ADDRESS THE ISSUE
OF CMP. THIS COMMISSION WILL
EVALUATE THE BODY OF RESEARCH
WITH RESPECT TO CMP NEWBORN
SCREENING DIAGNOSIS I WILL ALSO
IDENTIFY HOW BEST TO EDUCATE
WOMEN OUR STATE ABOUT CMV.
AT THE STATE OF MAINE ALL THE
WAY ACROSS THE COUNTRY RECENTLY
CONVENED A SIMILAR COMMISSION TO
ADDRESS THE MD RECEIVING BROAD
SUPPORT OF FROM PEDIATRIC
ASSOCIATION'S AS WELL AS THEIR
STATES.
CENTERS FOR DISEASE CONTROL AND
PREVENTION AYE MEANS
COMMISSIONER I INCLUDING ARRAY
OF PROFESSIONAL SPECIFICALLY
EXPERIENCED IN THE ASSURE TEAM
BEAT WHICH RESULTED IN A VERY
THOUGHTFUL COMPREHENSIVE REPORT.
A REPORT BACK TO THEIR STATE
LEGISLATURE FOR RADIO. AYE
EDITION ONLY OTHER STATES
SEVERAL OTHER STATES HAVE
ALREADY ENACTED CMV EDUCATION
SCREENING POLICIES AND SEVERAL
MORE ARE WORKING TOWARDS AND
CREATING AN EXPANDING THEIR
EXISTING. SEEM BE INITIATIVES
AND PROGRAMS.
I THIS ATTENTION AND ENERGY
AROUND CMB IS ACCELERATING AS
THE BODY OF RESEARCH POINTS TO
ITS URGENCY.
REFINING THE CMB
DISPROPORTIONATELY AFFECTS BLACK
HISPANIC AND MULTI RACIAL
COMMUNITIES OR FINDING THAT THE
COST IMPACT OF CM VIENEN BURST
INTO THE BILLIONS OF DOLLARS.
AND UNFORTUNATELY WE'RE FINDING
OUT THAT SEEMED THE IS PROVING
TO BE A SIGNIFICANT CAUSE. OF
MISCARRIAGE AND STILLBIRTH.
AND STILL WE ALL AGREE HIT
WHERE I COME FROM THAT SOMETHING
NEEDS TO BE DONE ABOUT CMP.
I ADDITION TO MY ADVOCACY WORK
SORRY BROUGHT A PROP. THEM ALSO
MOTHER TO TWIN DAUGHTERS RILEY
AND RACHEL RILEY IS ONE OF THESE
LOVELY BLONDE GIRLS IN A
WHEELCHAIR BUT THE PAIN BY WE
TRIED TO IDENTIFY HER.
THEY WERE BOTH FORMA CMB BACK IN
TWO THOUSAND THREE AFTER RILEY
RACHEL WERE BORN UNDIAGNOSED MY
DOCTOR TOLD ME FIX HIM BE WAS
RARE HAVING NEVER HEARD OF IT
MYSELF I PRETTY MUCH BELIEVED
HER.
COVER THE CENTERS FOR DISEASE
CONTROL AND PREVENTION REPORTS
OF ONE HOUR TWO HUNDRED BABIES
ARE BORN WITH CMV SO THAT MEANS
ONE OF TWO HUNDRED BABIES WILL
LEAVE THE HOSPITAL IN ONE IN ONE
THOUSAND. WILL COME BACK AGAIN
AND AGAIN AND AGAIN BABIES LIKE
MY TWIN DAUGHTERS RIGHT LIAM
RACHEL WHO EACH HAVE PROFOUND
HEARING LOSS AND SEVERAL POLICY
ADDITIONALLY MY DAUGHTER RACHEL.
HOW PROFOUND VISION LOSS
BREATHING ISSUES SEIZURES AND A
FEEDING TUBE SHOE SEVERELY
MEDICALLY FRAGILE AND SHE
ULTIMATELY PASSED AWAY IN TWENTY
FOURTEEN? RALLIES HERE TODAY I'M
HERE TODAY THE PROBLEM ON
FAMILIES AND A LOT OF NOISY KIDS
TODAY I'M AND WE WANT TO ASK FOR
YOUR AYE VOTE FOR AB ONE EIGHT
OPEN BECAUSE INDEED SOMETHING
NEEDS TO BE DONE ABOUT CMV AND
LASTLY I WANT TO THANK ASSEMBLY
MEMBER NEEDS AREA. AND FOR
HELPING TO OFFSET THE SPELLING
BEE INTEGRATES PARKED WEST THINK
YOU MOVE THE BILL.
CHAIRMAN WOOD VICE CHAIR MAYES
AND MEMBERS OF THE ASSEMBLY
HEALTH COMMITTEE.
MY NAME IS YOUR MAMA AND I COME
BEFORE YOU TODAY TO TESTIFY IN
FAVOR OF ASSEMBLY BILL EIGHTEEN
NO ONE.
I'M AN ASSISTANT PROFESSOR OF
OTOLARYNGOLOGY ALSO KNOWN AS E.
N. T. AT STANFORD UNIVERSITY
NETWORK AND LUCILLE PACKARD
CHILDREN'S HOSPITAL.
I HAVE A PARTICULAR INTEREST IN
CMB BECAUSE I TREAT CHILDREN
WITH HEARING LOSS AND SEE A
MOVIE. IS THE MOST COMMON CAUSE
AND CAN GENERAL HEARING LOSS.
YET IT HAS THE LEAST AMOUNT OF
AWARENESS
AMONGST NOT ONLY MY PATIENTS BUT
ALSO MY COLLEAGUES.
WE ARE NOT ABLE TO IDENTIFY WHO
HAS CMV AS AN INFANT AND WE MISS
THIS VALUABLE WINDOW OF
OPPORTUNITY FOR DIAGNOSIS.
AS THE PEDIATRIC OTOLOGY LIST A
DOCTOR WHO TREATS CHILDREN WITH
HEARING LOSS AND DEAFNESS.
IT CONTINUOUSLY SHOCKS AND
SADDENS ME THAT WE ARE NOT
DIAGNOSING THIS CONDITION. THAT
CAUSES SUCH SEVERE SYMPTOMS SUCH
AS PROFOUND DEAFNESS.
WE ARE NOT BRINGING THE
NECESSARY ATTENTION TO CMB AND
INCREASING THE AWARENESS.
CMB.
NOW THE REASON THIS IS HAPPENING
IS BECAUSE THIS VIRUS
SHEDS EARLY IN THE IN THE EARLY
MONTHS OF LIFE DURING INFANCY.
AND IT CANNOT BE DETECTED LATER
ON.
THIS MEANS THAT A CHILD WHO
PRESENTS TO MY CLINIC WITH
HEARING LOSS AT THE AGE OF SIX
WHO IS PROFOUNDLY DEAF. THEY
WILL NEVER KNOW IF IT WAS FROM
CMB.
WE END UP WORKING UP THEIR
HEARING LOSS WITH GENETIC
TESTING MULTIPLE TO GENETIC
TESTS
CT SCANS AND MRIS.
ALL WHICH COME BACK NORMAL
HOWEVER WE WOULD THAT WE DO NOT
KNOW WHY THIS CHILD HAS PROFOUND
DEAFNESS.
THESE CHILDREN WOULD NOT NEED
THIS UNNECESSARY RADIATION. AND
CONTRAST UNNECESSARY TESTING.
IF THEIR CONDITION HAD BEEN
DIAGNOSED IN THE THAT TIME
APPROPRIATE FASHION.
THIS IS THE PROBLEM IN
IDENTIFYING THE INFECTION NOT
BECAUSE WE DON'T HAVE THE TOOLS
TO TEST FOR WE DO HAVE THE
TESTS.
IT'S BECAUSE WE ARE MISSING KEY
STEPS IN THE TIMELY DIAGNOSIS.
THE COMMISSION PROPOSED BUY
SIMPLY BELIEVES NO ONE IS AN
IMPORTANT STEP AT OUR STATE AND
ITS PROFESSIONALS BEGIN TO STUDY
AND CONFRONT THE ISSUE OF CMP.
IT'S THE MOST COMMON CAUSE OF
HAIR LOSS IN CHILDREN IT COSTS
ARE HEALTHCARE SYSTEM FUNDS BUT
IT ALSO COSTS SIGNIFICANT
BEHAVIORAL. EMOTIONAL AND
COGNITIVE IMPACT IN THE FUTURE
OF OUR CHILDREN I SUPPORT AB
EIGHTEEN NO ONE.
THANK YOU FOR YOUR TIME.
OTHERS IN SUPPORT
IT JUST YOUR NAME AND.
AND YOUR POSITION.
THANK YOU.
MICROPHONE PLEASE.
MY NAME AS MY SEMEN AND I'M FROM
SHERMAN OAKS I AM IN ASSEMBLY
MEMBER IN THIS AREA IS DISTRICT
B. EIGHTEEN NO ONE ON BEHALF OF
MY SON WHO WAS BORN WITH THE MP
THIS IS IMPORTANT A SHIELD
PLEASE DON'T LET OUR FAMILY'S
NIGHTMARE. BECOME ANOTHER
FAMILY'S REALITY THANK YOU SO
MUCH FOR YOUR CONSIDERATION OF
THIS BILL.
AND THANK YOU INCOMPLETIONS
CHURN NAME AND POSITION PLEASE.
HI I MEAN STUDY LAST AND I AM
FROM.
ASSEMBLYMAN WOULDST DISTRICT
AND.
I HAVE A THIRTY TWO YEAR OLD
SON WITH THE NBA AND I SUPPORT.
AB EIGHTEEN NO ONE.
HI I'M AMY FANTA FROM HAVE FROM
BAY CALIFORNIA AYE AS STRONGLY
SUPPORT THIS AND I ON BEHALF OF
MY SON WHO IS LIVING A NORMAL
LIFE DUE TO EARLY DIAGNOSIS AND
DETECTION OF CMP.
I MEAN GREENLEE AND I REALLY
APPRECIATE YOUR SUPPORT FOR THIS
BILL THANK YOU VERY MUCH.
CHRIS MANSE AUBURN CALIFORNIA
PLEASE SUPPORT A. B. EIGHTEEN NO
ONE.
BOB MANSELL AUBURN CALIFORNIA IN
SUPPORT OF ASSEMBLY BILL
EIGHTEEN A ONE.
SIR.
I'M PAT DEL MAJJHIMA PEDIATRIC
PHYSICAL THERAPIST FROM NAPA
CALIFORNIA AND I'M IN STRONG
SUPPORT OF THIS. UP BILL THANK
YOU.
PETER VARIOUS CMB RESEARCHER UC
DAVIS FOR THIRTY YEARS I
STRONGLY ENDORSE THIS BILL.
I'M LAURIN CHURCHILL IN HERE
WITH MY SON DYLAN WHO IS
AFFECTED BY CMB AND I STRONGLY
SUPPORT AB EIGHTEEN OUT ONE.
SPENCER CHURCHILL ALSO WITH MY
SON DONE WE ARE IN SUPPORT OF A
TO NO ONE.
KEEP OF.
JULIETTE SPENCER FROM SAN MATEO
I'M ALSO CMV RESEARCHER AT THE
UNIVERSITY OF SAN FRANCISCO AND
I STRONGLY SUPPORT THIS BILL.
APRIL ROUTE FROM NAPA CALIFORNIA
AND HERE WITH ME TO THE HALF
YEAR OLD SON WITH SEEM. INTO
PORTANTINO.
I AM AB EVEN MET BANG YOUR FROM
NAPA CALIFORNIA WITH MY DAUGHTER
KATIE USE PHARMACY AMBIEN AND
PARENTS PART.
NO TOWARDS FROM STOCK CALIFORNIA
AND ON BEHALF OF MY SISTER WHO
IS AFFECTED BY CMB I AM HERE IN
STRONG SUPPORT A BEACH NOAH.
SIR.
HIGH AND DOCTOR SEPARATE EQ
LINING I'M ASSOCIATE PROFESSOR
OF OTOLARYNGOLOGY AT UNIVERSITY
OF CALIFORNIA SAN DIEGO. AND I
STRONGLY SUPPORT THIS BILL
THINK.
DANIEL SILVINO ASSOCIATION OF
REGIONAL CENTER AGENCIES
REGIONAL CENTERS CONNECT
INDIVIDUALS OF PUBLIC
DISABILITIES TO STATE FUNDED
SERVICES AND SUPPORTS.
CMV CAN BE ON A QUALIFYING
CONDITIONS ARE VERY MUCH IN
SUPPORT OF THIS BILL.
WHAT GREEN?
THE FORTY SEVEN SPORTS.
MISTY DOT ON BEHALF OF THE
CALIFORNIA OPTOMETRIC
ASSOCIATION IN SUPPORT.
NICK BROKE ON BEHALF THE
CALIFORNIA ACADEMY OF IDEOLOGY
IN SUPPORT.
WHEN GAS FALLS IN CALIFORNIA IN
SUPPORT OF EIGHTEEN A ONE.
S. OR ANYONE ELSE.
IN OPPOSITION.
STEPHANIE WATKINS ON BEHALF OF
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES WOULD FIRST LIKE TO
THANK THE AUTHOR AND HIS STAFF
FOR WORKING WITH US IN WILL BE
REMOVING ARE OPPOSITE.
AND CHEN FRAWLEY WITH THE
CALIFORNIA ASSOCIATION HEALTH
PLANS WE'VE ALSO REMOVED OUR
OPPOSITION APPRECIATE HE OFFERS
OFFICE FOR WORKING CUTS.
JOHN WINGER ON DEATH AMERICA'S
HEALTH INSURANCE PLANS ALSO LIKE
TO THANK THE AUTHOR AND ALSO
REMOVE ENOUGH SUCH.
CHAIRMAN AND MEMBERS BARBARA
GLAZER WITH THE CALIFORNIA
HOSPITAL ASSOCIATION WE DO HAVE
AN OPPOSE POSITION LINE EIGHTEEN
NO ONE. OUR CONCERN IS THAT THE.
STATE WOULD BE DEVELOPING
STANDARDS THAT COULD POTENTIALLY
BE DIFFERENT THAN THE FEDERAL WE
THINK IT WOULD. BE BETTER IF I
NATIONALLY RECOGNIZED
ORGANIZATIONS SUCH AS THE
CENTERS FOR DISEASE CONTROL CAME
UP WITH THOSE STANDARDS SO THAT
WE WOULD HAVE STANDARDS
NATIONWIDE THANK YOU.
SO DO WE ARE YOU ARE YOU IN
OPPOSITION TO THE BILL.
I WILL COUNT THE OTHER ONE AND
THEN AS A WITNESS THEN SO
PLEASE.
HI I'M DOCTOR AND POTTER I'M THE
RESIDENT PEDIATRICIAN SPEAKING
ON BEHALF OF THE AMERICAN
ACADEMY OF PEDIATRICS OF
CALIFORNIA IN OPPOSITION OF AB
EIGHTEEN NO ONE. ON AS A RECIPE
ATTRITION AYE EVEN IN THE LAST
MONTH I'VE TREATED. I'VE FUTURE
INFANT WHO SEVERELY AFFECTED BY
SEEING THE AND I'VE SEEN MANY
FAMILIES. I AM DEVASTATED BY
THIS ILLNESS.
HOWEVER I AND AND WE APPLIED
THAT COMMITTEE FOR I'M BRINGING
THIS ALL THIS I AM DATA TO
LIGHT.
I HOWEVER RESEARCH.
ON TESTING FORESEEN V. IS STILL
IN ITS INFANCY FOR AND FENCE.
AYE AND TESTING ALL INFANTS AT.
FOR CMV. IS HAS BEEN SHOWN THAT
SENSITIVITIES CAN BE AS LOW AS
THIRTY PERCENT WHICH MEANS IT
WOULD STILL BE MISSING SEVENTY
FOR SENATE AND FENCE WHO WOULD
BE POSITIVE FOR CMV.
I HAD I HAD THE BILL AS IT'S
CURRENTLY WRITTEN SEEMS TO
HAPPEN.
A PORT LEGISLATIVE POLICY CHANGE
I HAVE TOWARDS UNIVERSAL
SCREENING AND FOR THAT REASON WE
ARE IN OPPOSITION TO THE BILL AS
IT'S CURRENTLY WRITTEN ALTHOUGH
WE ARE IN STRONG SUPPORT OF
COMMITTEES AND DRESSING.
AWARENESS AND EDUCATION TO FOR
CMV.
YEAH AND I AM DOCTOR DEEMED
LUMBER GONNA SPECIALIST WITH
PEDIATRIC INFECTIOUS DISEASES IN
HERE ALSO ON BEHALF OF THE
AMERICAN ACADEMY OF PEDIATRICS
IN CALIFORNIA REPRESENTING OVER
FIVE THOUSAND BOARD CERTIFIED.
PEDIATRICIANS WE APPRECIATE THAT
SOMEONE IN BRINGING THIS ISSUE
TO THE TABLE WE CLEARLY THINK
THAT THIS IS IMPORTANT I
PERSONALLY HAVE TREATED TO
CHILDREN THIS YEAR. WHO HAVE
BEEN AFFECTED BY CMB I KNOW THE
BENEFITS OF SCREENING I KNOW THE
BENEFITS OF TREATMENT BUT WE DO
BELIEVE THAT THE BILL? AS
WRITTEN IS.
SLANTED TOWARDS LEGISLATIVE AND
POLICY OUTCOMES AND WE'VE BEEN
TRYING TO WORK WITH THE AUTHORS
OFFICE.
TO.
ADDRESS THOSE ISSUES WE WOULD
LIKE TO SEE A SCIENTIFICALLY
EVIDENCE BASED APPROACH THAT IS
OPEN MINDED AND WE WOULD WE
WOULD LOVE TO WORK WITH THAT
SORT OF COMMISSION BUT WE'VE
BEEN FRUSTRATED WITH TRYING TO
GET THOSE CHANGES. AS A WRITTEN
SO WE URGE YOUR OPPOSITION
UNLESS AMENDED THANK YOU.
Q..
OTHERS IN OPPOSITION.
WHEN SPENCER WITH THE AMERICAN
COLLEGE WILL BE JOANNE'S WE LOOK
BUT I THINK THE AUTHOR FOR WORK
WITH US BUT A FORTUNE AS IT
STANDS NOW WE ARE POST.
MISTER CHAIR MEMBERS MAKE IT
ALRIGHT ON BEHALF OF THE
CALIFORNIA MEDICAL ASSOCIATION
WE APPRECIATE ALL THE WORK THAT
THE. COMMITTEE AND THE. AUTHOR
HAS AND THEY'RE OFF YOUR STAFF
HAS DONE WITH US ON THIS BILL
AND WE LOOK FORWARD TO ENGAGING
WITH YOU FURTHER IN THIS BUT AS
IT IS WRITTEN WE MUST PROSE
THINKING.
SO.
PLEASE JUST YOUR NAME AND
POSSESS.
I MEAN SACRIFICING BANG THEM A
LOS ANGELES PEDIATRICIAN ALSO AT
THE AMERICAN ACADEMY OF
PEDIATRICS IN CALIFORNIA AND I
STATED BY.
THE OPPOSITION I TO OPPOSE AB
EIGHTEEN AT ONE.
DOCTOR I'M A SOFT FROM
ELECTRONICS AFTER MY LOS
ANGELES.
ALSO ON BEHALF OF.
AMERICAN COMEY PEDIATRICS AND
RESPECTFULLY OPPOSE.
MY NAME IS DOCTOR LEE SHAUNA
DEBATE ALSO PEDIATRICIAN WITH
THE AMERICAN ACADEMY OF
PEDIATRICS BASED IN LOS ANGELES
THEY AGREE WITH THE OPPOSITION.
DOCTOR ABBEY FRED I'M
REPRESENTING THE AMERICAN
ACADEMY F PEDIATRICIANS AND I
AM OPPOSED.
I'M DOCTOR WENT FROM LOS ANGELES
AND A PART OF AMERICAN ACADEMY
OF PEDIATRICS AND I OPPOSE.
I AM DOCTOR OF NEED THE SHINY
ALSO FROM THE AMERICAN ACADEMY
OF PEDIATRICS I ALSO OPPOSE.
WORKS A LITTLE BIT A LOS ANGELES
WITH THE AMERICAN ACADEMY ALSO
OPPOSE.
DOCTOR JUST A GUY NOT ON BEHALF
OF THE AMERICAN ACADEMY OF
PEDIATRICS IN OPPOSITION.
DR DENIM Y. HOLES FROM LOS
ANGELES AND ALSO IN A POSITION.
MOST DOCTOR SHORTER PROMISES TO
THE COUNTY IN PEDIATRICS ON
PEDIATRICIAN BASED IN LOS
ANGELES. I ALSO POST.
THREE ONE ELSE IN OPPOSITION.
BUT INSTRUCTORS OR THE WHILE I
AM.%
PER PRISONER FROM THE AP AND AS
CURRENTLY WRITTEN.
OPPOSE THE BILL.
ANYONE ELSE.
SEEING NO ONE BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS.
SEEING NONE.
.
WE DO HAVE A.
PART WE GIVEN WHAT WE HAVE A
MOTION.
AND A MOTION BY MS SAGGY ARE
CURRY SECTOR. BY HAMAS AT AND
AND MY HAND AND A SECOND BY.
MISS WALDRON.
.
I WANT TO GIVE YOU AN
OPPORTUNITY CLOSE IF YOU LIKE
MISTER NAZARIAN.
THANK YOU MISTER CHAIRMAN AGAIN
THANK YOU FOR MAKING TO
ACCOMODATION FOR ALL THE PARENTS
THAT ARE HERE WITH THEIR
CHILDREN.
AND AND. THE COMMUNITY THAT'S
AROUND THIS.
THIS ISSUE.
.
I THINK WE'VE BEEN WORKING QUITE
OF BIT WITH THE OPPOSITION.
I'M GLAD TO SEE THAT SOME OF IT
WAS REMOVED.
AND.
I LOOK FORWARD TO CONTINUING
WORKING WITH THE OPPOSITION A I
THINK I THINK THE IMPORTANT
THING IS. TO PUT FORWARD A
COMMISSION WITH AT LEAST SOME
LEVEL OF EIGHT TARGETED GOAL OF
WHAT IT IS THAT WE EVEN WANT TO
STUDY. WHAT IS IT WE WANT TO
LOOK AT? WHAT POTENTIAL OUTCOMES
WE CAN GET? AND MAKE IT EVIDENCE
BASED
AND THE. OF IF WE NEED TO REFINE
THAT A LITTLE BIT MORE I'M HAPPY
TO WORK ON IT. AS SUCH I ASK FOR
AN AYE VOTE. THANK YOU. NO THANK
YOU MISTER NAZARIAN FOR WORKING
WITH OUR COMMITTEE AND THANK YOU
FOR ACCEPTING OUR AMENDMENTS AND
YOUR WILLINGNESS TO CONTINUE TO
WORK WITH THE OPPOSITION ON THIS
BILL. IT DOESN'T CHOI DO PASS
RECOMMENDATION FROM THE CHAIR
AND I'M AN* OF THE MOTION IS
TO PASS AS AMENDED TO
APPROPRIATIONS.
THE MOTION BY MISTAKE HERE
CURRENT SECOND I MISS WALDRON.
LAST MINUTE SECURITY CALL THE
ROLL.
WHAT I WOULD AYE MAYES? MAYES
NOT VOTING ANGER CURRY. AGAR
CURRY AYE BIGELOW.
BIGELOW AYE BONTA.
BURKE.
BURKE AYE KOREA.
FLORA. FLORA I LIVE ON.
MCCARTY. MCCARTY AYE THIS AREA
LIKE NAZARIAN AYE RODRIGUEZ
SANTIAGO THURMOND.
WALDRON.
WALDRON AYE.
YOUR YOUR BILL HAS EIGHT VOTES
HAS ENOUGH TO GET OUT OF
COMMITTEE.
THANK YOU MISTER VERY MUCH
MISTER HOSER THANK YOU AND I SAY
THANK YOU TO THE WITNESSES WHO
CAME I KNOW THAT YOU COME ALIVE
YOU COME LONG AND FAR. AND I
KNOW IT'S NOT ALWAYS EASY TO GET
AROUND THIS BUILDING AND I
APPRECIATE THAT.
APPRECIATE VERY MUCH YOUR
BRINGING.
BRINGING FAMILY MEMBERS HERE
AND THANK YOU FOR YOUR TESTIMONY
TODAY THANK YOU SO MUCH.
AND MR IS HEARING YOU HAVE AB
TWENTY EIGHT SIXTY THREE AS
WELL.
THANK YOU MISTER CHAIR.
AND AGAIN THANK YOU TO TO YOU
AND THE COMMITTEE FOR WORKING
WITH MY STAFF AND.
ON THE AMENDMENTS THAT I ACCEPT.
AB TWENTY EIGHT SIXTY THREE
AIMS TO CURTAIL PRESCRIPTION
DRUG OVERPAYMENTS BEING REMITTED
TO PHARMACY BENEFIT MANAGERS.
CONSUMERS ASSUME THAT THE
VARIOUS DISCOUNTS NEGOTIATED
BETWEEN.
DRUG COMPANIES INSURANCE AND P.
B. M.'S PROVIDE THE LOS
PRESCRIPTION COSTS UNFORTUNATELY
THAT'S NOT THE CASE AND THIS
BILL. IS HERE TO ADDRESS THAT
AND.
WITH THAT I WILL TURN OVER.
THIS THE MIKE TO. A MISS LEWIS
HOME PRESIDENT AND CEO AND
COFOUNDER OF THE CALIFORNIA.
CHRONIC CARE COALITION AS WELL
AS THE NET MENDELSSOHN SENIOR
ATTORNEY AT CONSUMERS UNION
THANK YOU.
FOR HOW MUCH.
BUT SOME.
REMEMBER IT IS THERE YOU CAN
HEAR ME.
CHAIRMAN WOOD HONORABLE MEMBERS
OF THE ASSEMBLY HEALTH COMMITTEE
MY NAME IS LIZ HOMES AND I
PRESIDENT CEO OF THE CONFERENCE
CHRONIC CARE COALITION. TODAY WE
ARE HERE IN SUPPORT OF AB TWENTY
EIGHT SIXTY THREE.
THANK YOU FOR PROVIDING THE
CALIFORNIA CHRONIC CARE
COALITION THE OPPORTUNITY TO
EXPRESS OUR VIEWS REGARDING PBM
PRACTICE OF CLAWBACK.
I ALSO LIKE TO THANK CHAIRMAN
WOULD ANY STAFF FOR WORKING WITH
US SO CLOSELY ON THIS.
THE FOUR SEASONS THE COALITION
MORE THAN THIRTY LEADING
STATEWIDE CONSUMER HEALTH
ORGANIZATION IN PROVIDER GROUPS
THAT PROMOTE THE COLLABORATIVE
WORK. OF POLICYMAKERS INDUSTRY
LEADERS PROVIDERS AND CONSUMERS
TO IMPROVE THE HEALTH OF
CALIFORNIANS WITH CHRONIC
CONDITIONS.
TOGETHER OUR ORGANIZATIONS
REPRESENT MORE THAN SIXTEEN
MILLION CALIFORNIANS LIVING WITH
ONE OR MORE CHRONIC CONDITIONS.
AB TWENTY EIGHT SIXTY THREE AIMS
TO CURTAIL PRESCRIPTION DRUG
OVERPAYMENT. AL ALSO KNOWN AS
CLAWBACK WHEN COMMERCIALLY
INSURED PATIENTS COPAYMENTS
EXCEED THE TOTAL COST OF THE
DRUG TO THEIR INSURANCE OR
PHARMACY BENEFIT MANAGER.
THE GENERAL PUBLIC IS ONLY NOW
BEGINNING TO LEARN THAT THIS
TYPE.
CONSUMER PRACTICE EXISTS WE
BELIEVE AB TWENTY EIGHT SIXTY
THREE HAS THE SOLUTION TO HELP
CONSUMERS.
ONE IT WOULD LIMIT THE AMOUNT OF
HEALTH CARRIER OR PBM MAY
REQUIRE A BENEFICIARY TO PAY AT
THE POINT OF SALE. FOR COVERED
PRESCRIPTION TO THE LOWEST
AVAILABLE COST WHETHER IT IS
APPLICABLE COST SHARING AMOUNT
OR THE RETAIL PRICE ENSURING
CONSUMERS ARE NOT OVER PAIN FOR
THEIR PRESCRIPTION MEDS.
IT WOULD ALSO ALLOW THE RETAIL
PRICE INSTEAD OF JUST A CO PAY
TO APPLY TOWARDS OUR DEDUCTIBLE
AND OUT OF POCKET MAXIMUM IF THE
BENEFICIARY OPS TO PAY THE CASH
PRICE.
IN A RECENT STUDY DONE BY U. S.
C. CENTER FOR HEALTH POLICY IN
ECONOMICS AND. IT ON MARCH
THIRTEENTH PUBLICATION FROM
KAISER HEALTH NEWS PATIENTS OVER
PAY FOR PRESCRIPTIONS TWENTY
THREE PERCENT OF THE TIME.
IT CONTINUES TO STATE THE STUDY
FOUND THAT TWENTY THREE PERCENT
OF FILL PRESCRIPTIONS INVOLVE
PATIENT CO PAY THAT EXCEEDED THE
AVERAGE REIMBURSEMENT PAID BY
THE ENSURE BY MORE THAN TWO
DOLLARS SPENDING AN OUT OF
POCKET COSTS.
IN FACT ONE PBM SHOWED REVENUE
OF A HUNDRED AND SEVENTY SEVEN
BILLION IN A PROFIT OF OVER FIVE
BILLION WHILE TAKING LITTLE OR
NO RISK WHEN THE REST OF THE
SUPPLY CHAIN PARRIS ALL THE
RISK.
IT'S QUITE A PHENOMENON.
OUR MISSION IS TO IMPROVE THE
HEALTH CARE SYSTEM ARE ALL
CALIFORNIANS CAN ACCESS
APPROPRIATE QUALITY HEALTHCARE.
AB TWENTY EIGHT SIXTY THREE WILL
HELP TO IMPROVE THE LIVES OF
CALIFORNIANS WITH CHRONIC
CONDITIONS THROUGH BETTER ACCESS
TO AFFORDABLE MEDICATIONS THEY
DESPERATELY NEED. CONSUMER
SHOULD ALWAYS POCKET ANY
AVAILABLE SAVINGS ON THE
PRESCRIPTION DRUGS.
WE STRONGLY URGE YOUR VOTE IN
FAVOR OF THIS IMPORTANT
LEGISLATION AND THANK YOU AGAIN
FOR ALLOWING THE CHRONIC CARE
COALITION TO EXPRESS OUR VIEWS
TODAY.
THE BLONDE.
IT IS.
THANK YOU FOR THE OPPORTUNITY TO
SPEAK TODAY MY NAME INCREMENTAL
CINEMA SENIOR ATTORNEY AT
CONSUMERS UNION THE ADVOCACY ARM
OF CONSUMER REPORTS.
FOR YEARS NOW CONSUMERS HAVE
EXPERIENCED EXPONENTIAL GROWTH
IN THE COSTS OF THEIR
PRESCRIPTION DRUGS.
INSURANCE COMPANIES
PHARMACEUTICAL MANUFACTURERS AND
PHARMACY BENEFIT MANAGERS. EACH
POINT THEIR FINGERS AT EACH
OTHER AND CERTAINLY THERE'S
ENOUGH BLAME TO GO AROUND.
WE BELIEVE THAT AB SIXTY THREE
WERE TAKEN IMPORTANT STEPS
TOWARD TAKEN THE CONSUMER OUT
FROM THE MIDDLE OF.
CONSUMER PARTS OF LONG REPORTED
ON HOW THE COST OF PRESCRIPTION
DRIVE IT'S AFFECTING CONSUMERS.
IN A RECENT SURVEY WE FOUND THE
CONSUMERS WHO FACED THE DRUG
PRICE HIKE IN THE PAST YEAR. HAD
MADE UNTENABLE CHOICES.
FOR EXAMPLE AFTER ONE METERED
INSULIN COVERAGE CHANGE THE
READER RATION HIS INSURANCE
SUPPLY.
A DRUG USED TO TREAT WHO TYPE
ONE DIABETES.
PENDING AN APPEAL ABOUT COVERAGE
DECISION.
EVEN AFTER A SUCCESSFUL APPEAL
HE STILL HAD TO BORROW THOUSANDS
OF DOLLARS FROM HIS FRIENDS AND
FAMILY. IN ORDER TO AFFORD HIS
CO PAY.
WITH CONSUMERS STRUGGLE IF NOT
HIS ALONE.
IN OUR SURVEY WE FOUND THAT
BECAUSE OF HIGH DRUG COSTS.
RESPONDED FOR TAKING EXPIRED
MEDICATION.
DELAYING RETIREMENT AND TAKING
SECOND JOBS.
TROUBLING WAY ADDITION TO
RATIONING THEIR OWN TREATMENT
SOME CONSUMERS IT SIMPLY JUST
CHOSE TO STOP PICKING THEIR
MEDICATION.
ON THE FLIP SIDE.
CONSUMERS OF CONSUMERS HAVE
FAITH THAT THE DRUG PRICE HIKE
IN THE PAST YEAR. ONE OUT OF
FIVE CONSUMER POST PHONE PAYING
OTHER BILLS.
IN A RECENT FEATURE ARTICLE
PUBLISHED IN THE MAY TWENTY
EIGHTEEN ISSUE OF CONSUMER
REPORTS.
WE GAVE CONSUMER PRACTICAL TIPS
ON HOW TO PAY LESS FOR THEIR
DRUGS.
SUCH AS ASKING FOR GENERIC OR
LOWER COST THERAPEUTIC
ALTERNATIVE.
AND ASKING FOR LOWEST PRICE ON
ANY GIVEN DRUGS.
THE SYSTEM IS BROKEN WHEN BIG
COMPANY PROFITS WHILE CONSUMERS
EVEN THOSE WITH INSURANCE.
ARE LEFT PAYING HIGH PRICES FOR
THE DRUG THAT THEY NEED.
CONSUMERS SHOULD NOT HAVE TO
KNOW THE MAGIC WORD IN ORDER TO
GET THE MOST AFFORDABLE
PRESCRIPTION DRUGS.
FURTHERMORE CONSUMER THAT DO
THEIR RESEARCH AND GET THE
LOWEST COST OPTION SHOULD NOT
WIND UP FURTHER AWAY FROM ME IN
THEIR DEDUCTIBLE AND OUT OF
POCKET WOMEN.
ESPECIALLY AFTER PAYING SO MUCH
TO BE INSURED IN THE FIRST
PLACE.
THAT'S WHY WE SUPPORT A BILL
LIKE AB TWENTY EIGHT FIFTY
THREE.
WHICH PROHIBIT GUY CLAUSES AND
CLAWBACK.
AND PROTECT CONSUMERS FROM
HAVING TO CHOOSE BETWEEN PAYING
THE LOWEST COST PRICE POSSIBLE
FOR PRESCRIPTION DRUG.
THIS MAY BE THE RETAIL PRICE
RATHER THAN THE COPAY. EXPANDING
TOWARD THEIR DEDUCTIBLE AND OUT
OF POCKET MAXIMUM.
I THINK ASSEMBLY MEMBER KNOW
DARIEN FOR AUTHORING THIS BILL.
AND INVITING ME TO SPEAK TODAY
THANK YOU TO THE COMMITTEE FOR
YOUR TIME.
AND I URGE YOU TO VOTE IN FAVOR.
OTHER SINCE SUPPORT.
GOOD AFTERNOON MY NAME IS JOAN
WHERE PLAN I AM CHAIR OF THE
CHRONIC CARE COALITION AND I AM
ALSO. VICE CHAIR OF CALIFORNIA
HEALTH COLLABORATIVE WE STRONGLY
SUPPORT THIS BILL.
JOHN WINGER ON BEHALF AMERICA'S
HEALTH INSURANCE PLANS APOLOGIZE
FOR LIKE AND HOUR LATER IN ON
TIME BUT WE AREN'T SUPPORT.
ALSO IT'S POOR IN SUPPORT.
ANTHEM BLUE CROSS.
TELL ME WHAT CAN.
STEPHANIE Y. KENTUCKY HAVE WITH
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
THE THOUSANDS OF.
LINDA CALVERT CALIFORNIA
HEPATITIS C. TASK FORCE WERE IN
SUPPORT PICK HIM.
NEXT THING AND TELL BEHALF THE
NATIONAL MULTIPLE SCLEROSIS
SOCIETY IN SUPPORT.
NANCY RENEE PATIENT ADVOCATE
FROM LOS ANGELES IN SUPPORT.
THANK YOU.
BRENT SPENCER WITH THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS IN SPORT.
SHARE GONZALEZ ON BEHALF OF THE
AMERICAN DIABETES ASSOCIATION
AND STRONG SUPPORT.
STEVEN SCHULTZ WITH ARTHRITIS
FOUNDATION IN SUPPORT.
TIM'S MISS THE ON BEHALF OF THE
OUR NATIONAL ITEM ASSOCIATION IN
SUPPORT.
NICK LOUISE'S CALIFORNIA
ASSOCIATION OF HEALTH PLANS WILL
BE ISSUING A SUPPORT LETTER AS
WELL.
RESTING HER LURKING WITH THE
CALIFORNIA RHEUMATOLOGY JOINS IN
SUPPORT.
SIR ANYONE IN OPPOSITION.
SEEING NO ONE WILL BRING BACK
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS OR COMMENTS
FROM THE COMMITTEE.
SEEING NONE.
.
WILL. LOS VETERAN FEATHER FOR
SECOND WHICH LIKE CLOSE WAS HIS
AREA. QUICKLY.
BUT AGAIN THANKS AGAIN FOR THE
WORK OF. WITH YOU AS WELL AS
WITH YOUR STAFF AND I
RESPECTFULLY ASK FOR AYE VOTE.
HE WAS HIS HEARING.
AYE WE DID THIS DOES ENJOY A DO
PASS RECOMMENDATION WE ACTUALLY
DID A.
OF THE AMENDMENTS THAT WEIRD
THAT YOU ACCEPT WERE ACTUALLY IN
PRINT PRIOR TO THIS OF THERE ARE
NO ADDITIONAL COMMITTEE
AMENDMENTS OF THE MOTION WE HAVE
BEFORE US WILL BE DO PASS. TO
BUSINESS AND PROFESSIONS
SO THE MOTION IS.
MADE BY MISTER MAYES A SECOND
BY MISS WALDRON AND I WOULD LIKE
TO BE ADDED AS A CO AUTHOR. AND
OUR CONTINUED SPIRIT WORKING
TOGETHER ON ISSUES RELATED TO
PHARMACY BENEFIT MANAGERS.
THANK MISTER AS IT WOULD BE
HONORED TO THINK IF YOU MISS.
MISS BURKE WOULD LIKE TO ADDRESS
WELL.
GREAT THANK YOU VERY MUCH SO WE
HAVE A MOTION AND A SECOND.
THEM SECRETARY PLEASE CALL THE
ROLL MOTION IS TO PASSED TO
BUSINESS AND PROFESSIONS.
WHAT I WOULD AYE MAYES? MAYES
AYE ANGER CURRY. BAKER CURRY I'M
PICCOLO.
BIGELOW AYE BONTA. BURKE
BURKE I CARILLO.
FLORA. FLORA AYE LAMONT.
MCCARTY.
MCCARTY AYE IS ARYAN.
I THIS AREA AYE RODRIGUEZ.
SANTIAGO THURMOND WALDRON.
WALDRON AYE.
NINE ZERO YOUR BILLS OUT THANK
YOU VERY MUCH MR HIS AREA.
MR MAIENSCHEIN.
CSUS MAIENSCHEIN HAVE A COUPLE
OF THOSE BEFORE US.
TAKE NINETEEN SIXTY FOUR FIRST
THAT'S OKAY.
VERY MUCH.
MISTER CHAIRMAN AND MEMBERS
BEFORE I BEGIN I WILL BE
ACCEPTING THE COMMITTEE I
PROPOSED AMENDMENTS AND I'D LIKE
TO THANK THE CHAIR ON HIS STAFF
OF FOR WORKING WITH ME ON THIS
BILL I'LL ALSO REALLY WANTED TO
GIVE A SPECIAL THANK YOU.
TO THE COMMITTEE CONSULTANT TO
PAULA.
VELASQUEZ FOR ALL THE WORK SHE
HAS DONE ON THIS BILL SO SO WELL
I WANTED RECOGNIZE THAT I LOOK
FOR TO CONTINUE WORKING WITH THE
OPPOSITION TO. ADDRESS ANY
REMAINING CONCERNS AB NINETEEN
SIXTY FOUR REVISES
THE DEFINITION OF ORGANIZED CAMP
TO INCLUDE BOTH ORGANIZED
RESIDENT CAMPS AN ORGANIZED DAY
CAMPS. TO ASSURE THE PUBLIC THAT
DAY CAMPS OPERATE UNDER THE
NECESSARY OVERSIGHT DAY CAMPS
TYPICALLY OPERATE DURING THE
SUMMER AND OTHER VACATION
PERIODS WHEN SCHOOL IS NOT
NORMALLY IN SESSION. AND PROVIDE
GROUP BASED RECREATION AND
EXPANDED LEARNING OPPORTUNITIES
FOR CHILDREN.
CONSIDERATIONS OF COST AGE OF
THE CHILD AND PARENTAL
PREFERENCE
ARE AMONG THE REASON SOME
PARENTS PREFER TO HAVE THEIR
CHILDREN ATTEND LOCAL DAY CAMPS
RATHER THAN REMOTE RESIDENT
CAMP.
ALTHOUGH MOST DAY CAMPS ATTEMPT
TO COMPLY WITH THE HIGHEST OF
SAFETY STANDARDS THERE IS VERY
LITTLE REGULATION OF THESE
ORGANIZATIONS
ADDITIONALLY SINCE THERE IS NO
REFERENCE TO DAY CAMPS AND
CURRENT LAW REGULATION. THERE'S
BEEN CONFUSION RELATED TO WHICH
GOVERNMENTAL AGENCY HAS
JURISDICTION OVER THEIR
OPERATION IF ANY AT ALL THIS
MEASURE WILL MAKE SURE THAT DAY
CAMPS MEET THE SAME APPLICABLE
STANDARDS APPLIED TO RESIDENT
CAMPS. AND ENSURE THE SAFETY OF
OUR CHILDREN HERE TO TESTIFY IN
SUPPORT OF AB NINETEEN SIXTY
FOUR.
ARE CATHARINE BURBANK IN THE
PUBLIC POLICY DIRECTOR WITH
CALIFORNIA COLLABORATION FOR USE
AND MICHELLE BRANCH BRAND CON
YEAH WITH AMERICAN CAMP
ASSOCIATION.
RIDLEY SCOTT THANK YOU MISTER
CHAIRMAN MEMBERS KATHY BURBANK
IN CALIFORNIA COLLABORATION FOR
YOUTH. I'M SURE YOU'VE OP YOU'RE
ALL FAMILIAR WITH RESIDENT CAMP
SHE PROBABLY GOT SHIPPED OFF TO
ONE WHEN YOU WERE YOUNG SO YOUR
PARENTS COULD HAVE A COUPLE
WEEKS OF VACATION. BUT YOU'RE
PROBABLY LESS FAMILIAR WITH WHAT
THE ASSEMBLYMAN WAS TALKING
ABOUT IN TERMS OF DAY CAMPS.
DAY CAMPS PROVIDE THE SAME KINDS
OF ACTIVITIES THAT A RESIDENT
CAMP HAS WITH THE ONLY
DIFFERENCE BEING THAT THE KIDS
DON'T SPEND THE NIGHT THEY GO
HOME.
I HAVE WITH ME MICHELLE RANK
NEAR FROM THE AMERICAN CAMP
ASSOCIATION SHE IS THE EXPERT
EXTRAORDINAIRE ON ACCREDITATION
STANDARDS FOR THE AMERICAN CAMP
ASSOCIATION. AND DOES A LOT OF
VISITS WITH THESE CAMPS ARE AND
MAKE SURE THAT THEY'RE IN
COMPLIANCE WITH STANDARDS AND
REGULATIONS AND SHE'S HERE TO
TELL YOU A LITTLE BIT ABOUT. DAY
CAMPS AND.
HER JOB.
GOOD AFTERNOON THANK YOU.
ON.
ASSEMBLY MEMBER.
MAYES I'M IN YOUR DISTRICT I
LOOKING TO CALIFORNIA SO. IT'S
NICE TO BE HERE.
I ASKED THREE TO SUPPORT THIS
BILL.
THE AMERICAN CAMP ASSOCIATION
DOES HAVE A VOLUNTARY
ACCREDITATION PROGRAM REQUIRES
DAY CAMPS TO ABIDE BY AS
PROVISION OF ACCREDITATION THEY
HAVE. A THEY ABIDE BY STATE
COUNTY AND LOCAL LAWS ON IN THIS
WORLD EXPAND THAT TO ALL CAMPS
DAY CAMPS ARE ASKING FOR
REGULATION THEY WANT TO ENSURE
THE HEALTH AND SAFETY OF THE
CAMPERS THAT THEY SERVE.
ON. WE'VE BEEN AT THIS FOR
AWHILE. AND AND WE REALLY DO
WANT TO ENSURE THAT EVERY CHILD
THAT GOES TO CAMP IS SAFE. WHILE
THEY'RE THERE.
I.
HUMBLY RESPECTFULLY ASK FOR YOUR
VOTE ON THIS.
THANK YOU VERY MUCH.
OTHERS IN SUPPORT.
GOOD AFTERNOON CHRIS SLEPT
WARMLY WITH A CALIFORNIA STATE
ALLIANCE OF YMCAS IN SUPPORT
THINK.
A MUCH.
ANYONE ELSE.
ANSWER ANYONE IN OPPOSITION
.
GOOD AFTERNOON MISTER CHAIRMAN
MEMBERS BUT YOU ARE STRONG ON
BEHALF OF THE COUNTY HEALTH
EXECUTIVES ASSOCIATION I WITH AN
OPPOSE UNLESS AMENDED POSITION
ON MAYBE NINETEEN SIXTY FOUR.
ALONG WITH OUR HEALTH OFFICER
COLLEAGUES AND ORGANIZATIONS
REPRESENTING THE COUNTY BOARD OF
SUPERVISORS. A. B. NINETEEN
SIXTY FOUR SEEKS TO EXPAND THE
EXISTING COUNTY REGULATORY
OVERSIGHT FOR RESIDENT CAMPS TO
NOW INCLUDE DAY CAMPS WHICH
WOULD REQUIRE A COUNTIES TO
OPERATE OUTSIDE OF OURS THEIR
SCOPE OF EXPERTISE.
BECAUSE OF THIS EXPANSION WE
SOUGHT AMENDMENTS TO LIMIT OUR
ROLE TO THE HEALTH AND
SANITATION ASPECTS OF A DAY CAMP
WE'D LIKE TO THANK THE
COMMITTEE.
AND THE AUTHOR FOR WORKING WITH
US.
ON THESE AMENDMENTS AND TO
BELIEVE THAT THEY ACCOMPLISH
THIS GOAL AYE WHY WE BELIEVE THE
BILL IS MOVING IN THE RIGHT
DIRECTION.
WE WOULD LIKE TO SEE THE TO A
COUPLE THINGS ADDRESSED BEFORE
WE CAN REMOVE OUR OPPOSITION.
FURTHER UP WE WOULD LIKE TO
FURTHER REFINE THE DEFINITION OF
A DAY CAMP TO PROVIDE CLARITY TO
OUR LOCAL ENFORCEMENT AGENCIES.
AND WE'D LIKE TO CLARIFY THE
ROLE OF LOCAL ENFORCEMENT IN THE
ABSENCE OF A DAY CAMP HAVING A
FACILITY OR A FIXED LOCATION.
WE'RE COMMITTED TO CONTINUING TO
WORK WITH THE AUTHOR TO RESOLVE
THESE OUTSTANDING ISSUES.
WITH ME HERE TODAY IS.
COUGH TO PROVIDE THE LOCAL
ENFORCEMENT PERSPECTIVE HIS CORE
ONE QUARTER PUBLIC ASSIST HEALTH
ASSISTANT DIRECTOR AND FORMER
ENVIRONMENTAL HEALTH DIRECTOR
FROM SAN BERNADINO CAM.
THANK YOU.
AS I STATED MY NAME IS CARMEN
PORTER ON THE PUBLIC HEALTH
ASSISTANT DIRECTOR IN PUBLIC AND
STAMINA DO YOU KNOW COUNTY AND A
MEMBER OF GEAC.
I WORKED IN THE FIELD OF PUBLIC
HEALTH FOR OVER TWENTY EIGHT
YEARS TWENTY SIX YEARS.
ABOUT TIME PERIOD WAS IN
ENVIRONMENTAL HEALTH AND WITHIN
THAT TIME PERIOD FIFTEEN OF
THOSE YEARS HAVE BEEN WORKING
WITH. CAMPS IN ONE CAPACITY OR
ANOTHER.
WE HAVE OVER SEVENTY ORGANIZE
RESIDENT CAMPS THAT WE PERMIT
AND INSPECT INSANITY YOU KNOW
COUNTY WHICH AS A NOTICE THE
MOST OF ANY JURISDICTION IN THE
STATE.
I WOULD FIRST LIKE TO EXPRESS
OUR APPRECIATION OF THE
COMMITTEE AMENDMENTS TO LIMIT
OUR LOCAL REGULATORY AUTHORITY
FOR DAY CAMPS TO HEALTH AND
SANITATION.
WITH THESE AMENDMENTS
ENVIRONMENTAL SPECIALISTS WHO
WILL ENFORCE THE PROVISIONS IN
THIS BILL. WHEN I'LL NOW ONLY BE
TASKED WITH ACTIVITIES WHICH
THEY ARE TRAINED AND REGISTER TO
DO. SUCH AS OVERSEEING FOOD
PROTECTION DRINKING WATER
QUALITY RECREATIONAL SWIMMING.
AND SOLID WASTE.
HOWEVER AB NINETEEN SIXTY FOUR
STILL DOES NOT CLEARLY DEFINE
WHAT IS A CAMPUS IN MAY AT
HUNDREDS OF NEW CAMPS UNDER OUR
OVERSIGHT.
YOU'LL RECALL A MOMENT AGO I
MENTIONED WE OVERSEE THE LARGEST
NUMBER OF ORGANIZE CAMPS.
pUNCLEAR WHETHER THIS BILL
INCLUDES SPORTS CAMPS.
ART AND CRAFT CAN'T STEM CAMPS
THEATRE CAMPS RECREATIONAL WATER
CAMPS AMONG MANY OTHER TYPES OF
DAY CAMP PROGRAMS OFFERED.
THIS FOR THE REST OF THE BURDEN
OF THE LOCAL ENFORCEMENT
AGENCIES TO FIGURE OUT WHAT IS
AND WHAT IS NOT A DAY CAMP AND
THE TO WHICH TEAR THEY WILL
FALL.
EVEN MORE DIFFICULT IS FIGURING
OUT HOW TO ENFORCE REQUIREMENTS
ON A DAY CAMP WITHOUT A FIXED
LOCATION.
OR THAT LACK OF PHYSICAL
FACILIIES SUCH AS A PARKER
BEACH.
THE NEW WORKLOAD.
PERMITTING AND FEE DEVELOPMENT
WILL BE BURDENSOME MORE NOTABLY
TO SMALLER JURISDICTIONS WITH
LIMITED RESOURCES.
THANK YOU FOR YOUR TIME.
THANK YOU VERY MUCH OTHERS IN
OPPOSITION PLEASE.
HELP CAN'T DIVERT HELP OFFICERS
ASSOCIATION CALIFORNIA IN
ALIGNMENT WITH MY COUNTY
COLLEAGUES.
FARMER DATING ON BEHALF OF THE
CALIFORNIA STATE ASSOCIATION OF
COUNTIES WE ESPECIALLY WHEN I
THINK THE AUTHOR AND COMMITTEE
WE ARE OPPOSE US AMENDED FOR
THOSE TWO DETAILS MENTIONED
THANK YOU.
TO CHERISH JOINT OF OR SOMETHING
OF THE URBAN COUNTIES OF
CALIFORNIA ALSO HAVE OPPOSE MUST
AMENDED THAT VERY MUCH
APPRECIATE YOUR COMMENTS AND WE
BELIEVE THE BELLS FROM IN RIGHT
DIRECTION. AND HOPE IT CONTINUES
TO WORK ON AS AN FOR THANK YOU.
KELLY BRICKS ON BEHALF OF THE
RURAL COUNTY REPRESENTATIVES OF
CALIFORNIA.
SHARING THE SAME CONCERNS AS MY
COLLEAGUES AND THINKING AUTHOR
VERY MUCH FOR ALL THE WORK.
THANK YOU VERY MUCH.
TO MOTION A SECOND BRING YOU
BACK TO THE COMMITTEE QUESTIONS
OR COMMENTS MISTER MISTER MAYES.
WHO ARE GOOD TO SEE THANK YOU
COULD DECIDE TO?
SO IT'S BEEN BEEN A FEW YEARS
SINCE WE WORK TOGETHER.
BUT I REMEMBER LET ARE
CONVERSATIONS THAT YOU AND I
WOULD HAVE THAT COUNTY OFFICE WE
TALK ABOUT FEES.
WHAT THE IF THE SAME YOU COUNTY
WAS GOING TO A BEGIN TO TO
REGULATE AND GO OUT AND? AND
INSPECTS OF THESE DAY CAMPS WHAT
WHAT WHAT THE FEES LOOK LIKE IN
THAT WITH THE FEES BE SO HIGH
THAT THEY WOULDN'T THAT THEY'D
THE DAY CAMPS WOULDN'T WHAT
HAPPENED.
IT IS HARD TO PREDICT.
I WOULD ASSUME THAT WOULD BE
SIMILAR TO THE DAY CAPS THAT WE
CURRENTLY INSPECTORS A FEW YMCA
CAMPS THAT VOLUNTARILY COME
FORWARD AND ASK FOR INSPECTIONS.
SO WILL BE STRUCTURED BASED ON
THOSE AND THAT FEE WOULD BE
BASED ON THE TIME TO ACTUALLY DO
THAT INSPECTION.
SO.
IT'S HARD TO PREDICT WHAT THAT
DOLLAR AMOUNT WILL BE AT THIS
POINT BUT WILL DEFINITELY STUDY
THAT.
ANY OTHER QUESTIONS OR COMMENTS.
XENA BRING BACK TO YOU MR
MAIENSCHEIN WHICH OUGHT TO CLOSE
YEAH THANK YOU VERY MUCH MISTER
CHAIRMAN MEMBERS WE'VE BEEN WHAT
DO A LOT OF WORK WITH THAT.
PEOPLE ON WHO HAVE WHO'VE
EXPRESSED SOME CONCERNS WILL
CONTINUE TO DO THAT TEST SHOULD
THIS MOVE FORWARD.
WE'VE WORKED OUT A LOT OF THE
ISSUES I THINK WE'LL BE ABLE TO
CONTINUE TO DO SO BUT I DO THINK
THIS IS A REALLY IMPORTANT FELL.
FOR PEOPLE WHO FOR PARENTS TO DO
SEND THEIR KIDS TO CAMP THEY MAY
NOT FIT IN ALMOST SURELY DON'T
KNOW WHAT A BUREAUCRATIC
DEFINITION OF THESE CAMPS ARE.
BUT WHAT THEY DO KNOW IS THEY
WANT THEIR KIDS TO BE SAFE WHILE
THEY GO THERE AND THIS IS WHAT'S
PARTICULAR IMPORTANT THING BUT
THIS IS THE ENTRY INDUSTRY
ITSELF IS ASKING TO BE REGULATED
MAKE SURE THAT THEY'RE.
PROVIDING THE PROPER PROTECTION
FOR FOR OUR YOUNG PEOPLE.
AND WHEN WE ENTRUST OUR KIDS TO
THESE CAMPS I THINK WE ALL OF US
AS PARENTS WANT TO BELIEVE THAT
THAT BE SAFE THERE.
THANK YOU VERY MUCH ON THE
THEY'RE THE BILL HAS BEEN MOVED
AND SECONDED.
MOVE BY MISS WALDRON SECONDED
BY MISTAKE YOUR CURRY THE MOTION
IS DO PASS AS AMENDED TO
APPROPRIATIONS.
DOES ENJOY DO PASS
RECOMMENDATION BY THE CHAIR
MADAM SECRETARY PLEASE CALL THE
ROLL.
WHAT I WHAT I MAYES?
MAYES NOT VOTING AGAR CURRY. I
HEAR CURRY AYE BIGELOW.
BONTA.
BURKE.
CARILLO.
FLORA.
FLORA I MOANED.
MCCARTY MCCARTY AYE THIS AREA.
RODRIGUEZ SANTIAGO BERMAN
WALDRON.
WELL THEN I.
SO YOU HAVE FIVE VOTES WILL PUT
THE BILL ON CALL AND.
THANK YOU VERY MUCH YOUR
WITNESSES AND AND TO THE
OPPOSITION AS WELL STRANGE I'M
HAVE A SECOND BILL ONLY BE
TWENTY SEVEN NINETY EIGHT.
MISTER CHAIR AND MEMBERS I
BEFORE I BEGIN I WILL BE
ACCEPTING THE COMMITTEE PROPOSED
AMENDMENTS I WOULD LIKE TO THANK
THE CHAIRMAN A STAFFER WORKING
WITH ME ON THIS BILL. AB TWENTY
SEVEN NINETY EIGHT WILL IMPROVE
THE CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH APPLICATION
PROCESS REQUIREMENTS TO REDUCE
APPLICATION WAIT PERIODS FOR
HEALTH FACILITIES THAT WISH TO
EXPAND ADD AND CHANGE THE
LOCATION OF A SERVICE. OR MAKE
OTHER CHANGES DUE TO TO TO DUE
TO THE DELAYS RELATED TO D. PAHS
LICENSING AND CERTIFICATION
PROGRAM.
CONSOLIDATE ALL APPLICATIONS TO
THAT.
CENTRALIZED APPLICATIONS UNIT
WHICH APPEARS TO BE OVERWHELMED
AND UNDERSTAFFED HOSPITALS ARE
NOW EXPERIENCING EXTREMELY LONG
WAIT TIMES FOR APPLICATION
APPROVALS THE COMMITTEE ANALYSIS
QUOTES CDP H. HAS ESTIMATED THAT
CURRENTLY TAKE SIX TO NINE
MONTHS. FOR APPLICATIONS TO BE
ASSIGNED TO AN ANALYST.
AN ADDITIONAL FOUR OR FIVE
MONTHS TO APPROVE THE
APPLICATION IN THE COMPLETE AN
ON SITE INSPECTION IF NEEDED.
REGARDLESS OF THE EXACT TIME
FRAME WE CAN ALL AGREE IT IS
TAKING FAR TOO LONG THE BACKLOG
IT'S REACHED THE POINT OF
ENDANGERING THE HEALTH OF
CALIFORNIA CITIZENS. DELAYS IN
APPROVING THESE APPLICATIONS
MEANS THAT PATIENTS LACK ACCESS
TO CRITICAL AND SOMETIMES
LIFESAVING SERVICES.
FOR EXAMPLE ONE HOSPITAL WAITED
OVER SIX MONTHS TO EXPAND ITS
EXISTING CARDIAC CATHETERIZATION
LABORATORY. DURING THE WAY THE
TWO ADDITIONAL BATS REMAINED
EMPTY AND NINE ONE ONE
AMBULANCES HAD TO FIND ANOTHER
HOSPITAL WITH AN OPEN CARDIAC
CATHETERIZATION BAD. THAT'S
DELAYING THE TREATMENT OF THOSE
PATIENTS ANOTHER HOSPITAL IN
NORTHERN CALIFORNIA WAITED SIX
MONTHS FOR DPH APPROVE A NEW MRI
CENTER AND WAS FORCED TO
TRANSPORT ILL PATIENTS IN AN
AMBULANCE TO A DISTANT FACILITY.
SIMPLY BECAUSE DPH HAD NOT
COMPLETED ITS REVIEW TO APPROVE
A NEW MRI CENTER
WITH ME TO TESTIFY IN SUPPORT OF
AB TWENTY SEVEN NINETY EIGHT ARE
DAN GROSS EXECUTIVE VICE
PRESIDENT. OF HOSPITAL OFFERS
OPERATE OPERATIONS FOR SHARP
HEALTHCARE AND DEBBIE ROGERS
FROM CALIFORNIA HOSPITAL
ASSOCIATION MOVE THE BILL.
GIVE.
MISTER CHAIR AND MEMBERS W.
ROGERS ON BEHALF OF THE
CALIFORNIA HOSPITAL ASSOCIATION
I JUST WANT TO THANK COMMITTEE
AND THE STAFF FOR THEIR HARD
DILIGENT WORK ON THIS BILL. AND
I WOULD LIKE TO INTRODUCE DAN
GROSS.
FROM SHARP HEALTH CARE TO TALK
ABOUT THE REAL IMPACT OF THIS
DELAY.
THANK YOU.
HI GOOD AFTERNOON MISTER
CHAIRMAN AND COMMITTEE MEMBERS
THANK YOU FOR ALLOWING ME THE
OPPORTUNITY TODAY TO PROVIDE
INPUT AND PERSPECTIVE ON AB
TWENTY SEVEN NINETY EIGHT.
MY THOUGHTS ARE GROUNDED IN MORE
THAN FOUR DECADES OF HEALTH CARE
EXPERIENCE HERE IN CALIFORNIA.
AND NUMEROUS ARE A COLLEAGUE AND
PUT AS I TRAVEL THROUGHOUT THE
STATE AND LISTEN ACTRESS
INDIVIDUAL SPEAK ON THIS ISSUE.
FIRST I WILL BRIEFLY DESCRIBE
THE CHALLENGES AN UNFORTUNATE
CONSEQUENCES OF PROBLEMATIC
CENTRALIZE APPLICATIONS UNIT ALL
REFER TO IT AS CA YOU HERE I
AFTER. AT THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH.
IF YOU'RE NOT AWARE OF THE CA
YOU IT BEGAN IN TWENTY FIFTEEN.
AND YEAH HAD FULL IMPLEMENTATION
IN TWENTY SEVENTY.
THIS CA YOU ASSUMED MANY OF THE
STATE LICENSING IN FEDERAL
CERTIFICATION RESPONSIBILITIES
THAT WERE PREVIOUSLY
DECENTRALIZED THROUGHOUT THE
STATE INTO OUR VARIOUS
DISTRICTS.
THE GOAL OF THE CA YOU WISH TO
STANDARDIZE LICENSING PROCESS
FEES TO CREATE STANDARDIZATION
AND TO IMPROVE CONSISTENCY
INEFFICIENCIES THROUGHOUT THE
STATE.
TO SUPPORT HEALTH CARE DELIVERY
FOR ALL OF OUR CITIZENS WITHIN
OUR COMMUNITIES.
UNFORTUNATELY THE CA YOU HAS NOT
ACHIEVED ITS INTENDED GOALS.
INSTEAD IT HAS PRODUCED
UNREASONABLE CONSEQUENTIAL
DELAYS IN THE LICENSING OF VITAL
HEALTH CARE SERVICES.
THE END TIMELY LICENSING OF
HEALTH CARE SERVICES HAS
RESULTED IN DIMINISH CARE
DELIVERY TO PATIENTS.
CREATE A GREAT FRUSTRATION FOR
HEALTH CARE PROVIDERS BOARDS OF
DIRECTORS AND THE LOCAL CDP
EIGHT STAFF.
AND SADLY ENOUGH THE NEED TO ASK
YOU EIGHT MANY OF THESE ISSUES
TO ARE YOU IN THIS ROOM AS WELL
AS TOP EXECUTIVES IN THE HEALTH
AND HUMAN SERVICES DIVISION.
CURRENT LICENSING DELAYS IS NOT
OF LOCALIZED ISSUED OUR CONCERN
IT'S A STATEWIDE ISSUE AND
CONCERN.
PRESENTLY IS TAKING MONTHS OFTEN
UP TO A YEAR TO LICENSE NEW OR
SIMPLY EXPAND SERVICES WITHIN
OUR HEALTHCARE SYSTEMS.
IN ADDITION TO THE EXAMPLE THAT
ASSEMBLYMAN.
MAIENSCHEIN I DISCUSS I LIKE TO
SHARE WITH YOU A FEW MORE
EXAMPLES.
I WAS NOT GOING TO SHARE WITH
YOU US SOME OTHER STATE.
EXAMPLES THE SEEING THAT ONE
MINUTE SIGN I'LL GO TO SINCE
EXAMPLES CLOSE TO HOME IN TERMS
OF SAN DIEGO.
OBSTREPEROUS ONE HOSPITAL IN SAN
DIEGO HAS ONE OF THE BUSIEST
EMERGENCY ROOMS WITHIN OUR
COUNTY SING OVER A HUNDRED
THOUSAND. OP PATIENTS A YEAR WE
ALWAYS OUR FOCUS ON LIKE THE
STATE'S HOW TO INCREASE
THROUGHPUT THROUGH OUR
ORGANIZATIONS. IT UP RECENTLY
HAS TAKEN US I NINE MONTHS
AND WE'RE STILL COUNTING TO GET
A RADIOLOGY EXAM ROOM LICENSE.
WITHIN OUR COMMUNITY IS TAKING
EIGHT MONTHS TOGETHER I'M
URGENCY DEPARTMENT BLOOD DRAW
STATION. LA APPLICATION PROCESS
AND WE HAD THREE.
HOSPICE HOUSES THAT HAVE TAKEN
EIGHT TO ELEVEN MONTHS EACH TO
BE OUR AYE LICENSE THROUGH THE
APPLICATION PROCESS.
SO JUST WITH THOSE FEW EXAMPLES
WE HAVE GREAT ISSUES PROBABLY
ONE OF THE BIGGEST CONCERNS
RIGHT NOW FOR US IN OUR
COMMUNITY. IS THE CARE TELL NOW
LESSEN BEHAVIOR HOW PATIENTS
WILL HAVE SIXTY BEDS IN OUR
COMMUNITY. AND INDEED WE ARE
STILL AWAITING FOR THE LICENSING
OF FOR ALL JUST CLOSE BY SAYING
THAT THERE ARE FIVE ELEMENTS
WITHIN THIS LEGISLATION THAT WE
GREAT ASSISTANCE TO OUR
COMMUNITIES AND PROVIDING
HEALTHCARE THANK YOU VERY MUCH
FOR. TAKING TIME TO LISTEN TO
OUR PERSPECTIVE.
YOU VERY MUCH OTHERS IN SUPPORT.
CATARACTS DISCOVERED IN THE
DISTRICT HOSPITAL LEADERSHIP
FORUM.
SO THAT AS WE RAMP OR ELEVEN
FIFTEEN WAIVER ON SOME OF OUR
HOSPITALS HAVE. EXPERIENCING
DELAYS I MENTIONED PREVIOUSLY
SORTS PART OF THE BILL.
YOU THINK OTHER SUPPORT.
DAVID ARE DAHLIAS BOARD CHAIR.
AL ON BEHALF OF THE SOUTHERN
HUMBLE COMMUNITY HEALTH CARE
DISTRICT.
WE URGE.
YOUR APPROVAL AND WE SUPPORT
THAT AB TWENTY SEVEN NINETY
EIGHT.
MUCH SIR.
KELLY BROUGHT SOME BEHALF OF THE
ASSOCIATION OF CALIFORNIA HEALTH
CARE DISTRICTS AND ON BEHALF OF
THE BOARD OF SUPERVISORS OF
SANTA CLARA COUNTY HERE IN
SUPPORT.
Q..
MICHAEL TELL WITH PROMISING JUST
OF HEALTH IN SUPPORT.
SIR ANYONE ELSE ANY OPPOSITION.
SEEING NONE BRING BACK THE
COMMITTEE FOR QUESTIONS OR
COMMENTS.
WE HAVE A MOTION.
.
WE HAVE BUSH BY MISS WALDRON
THE SECOND BY MISTER FLORA ICE
WHEN IT THANK YOU FOR BRINGING
THIS BILL FORWARD THIS HAS BEEN
A. THIS IS A REAL FRUSTRATION
FOR ME PERSONALLY AND MY
DISTRICT AND I IMAGINE EVERY
MEMBER IN THIS BUILDING HAS
SOMETHING IN THEIR DISTRICT.
RELATED TO THIS ISSUE OF HOW
LONG IT'S TAKING TO GET THINGS
DONE NO ON THE FOLKS WHO ARE
HERE FROM HUMBLE COUNTY YOU'RE
TALKING ABOUT AN MRI.
AND.
WE'VE HEARD THIS WITH RELATION
TO LICENSING OF DIALYSIS
CENTERS.
AND I'M JUST APPALLED THAT WE'RE
TALKING ABOUT MONTHS AND MONTHS.
SURELY YOU HAVE MORE THAN ONE
BLOOD DROP STATION AND A
HOSPITAL.
TO ADD ADDITIONAL BLOOD DRAW
STATION I'D AND JUST BEFUDDLED
BY THAT QUITE FRANKLY.
I'M NOT SURE HOW WE.
COMPEL.
OF FASTER MOVEMENT BUT I FULLY
SUPPORT YOUR BILL MISTER
MAIENSCHEIN AND I THINK YOU MAKE
A RING AFFORD IF YOU'D LIKE TO
CLOSE PLEASE PLEASE GO AHEAD I
THINK THAT WAS A GREAT CLOSE
MISTER CHAIR THIS IS SOMETHING
THAT AFFECTS ALL OF US IN THIS.
FROM DISTRICT WANTED DISTRICT
EIGHTY FROM BIG CITIES TO SMALL
CITIES ALL OF THESE EXAMPLES I
THINK WE ALL SHARE SHARE
THEMSELVES THANK YOU FOR THAT.
THANK YOU VERY MUCH THE MOTION
IS TO PASS AS AMENDED TO
APPROPRIATIONS MOTION BY MISS
WALDRON THE SECOND BY MISTER
FLORA MEMSIC TREE PLEASE CALL
THE ROLL WOULD I WOULD I MAYES.
I MAYES AYE AGAR CURRY ANCHOR
CURRY AYE BIGELOW.
BONTA.
BURKE.
CARILLO.
FLORA.
FLORA I LOW MOAN.
MCCARTY.
MCCARTY AYE THIS AREA.
RODRIGUEZ
SANTIAGO THURMAN WILDER.
WALDRON AYE.
THEY LOOK.
BIGELOW AYE.
AT SEVEN STILL NEED ONE MORE.
WILL LEAP WILL LEAVE IT OPEN
FOR IT FOR OTHER MEMBERS THANK
YOU VERY MUCH THE WITNESSES WHEN
I ASK THE INDULGENCE OF OF
AUTHORS I KNOW YOU. ARE
ANXIOUSLY WAITING A MASS MISS
RUBIO TO COME FORWARD PLEASE AND
IF SHE HAS A WITNESS SAID HOUSE
TO CATCH A PLANE AND I'M.
APPRECIATE.
I'M SURE SHE APPRECIATES THIS.
I'M SURE I'M SURE SHE'LL THANK
YOU FOR THIS SO THANK YOU YES I
WILL BE SENDING OUR BREAD OVER
TO OUR OFFICES.
THANK YOU MISTER CHAIR FOR
INDULGING ME I DO HAVE WITNESSES
THAT HAVE TO FLY OUT SO
APPRECIATE THE. OPPORTUNITY TO
PRESENT.
THANK YOU I TODAY I AM HERE TO
PRESENT ASSEMBLY BILL THIRTY ONE
SEVENTY FIVE A BILL WHICH WOULD
REQUIRE THAT CERTIFIED CHILD
LIFE SPECIALIST BE INCLUDED IN
ALL PEDIATRIC AND ADOLESCENT
HOSPITAL UNITS. IN OUTPATIENT
SPECIALTY CLINICS.
CERTIFIED LIFE SPECIALISTS HELP
THOUGH IN ILL INJURED DYING
CHILDREN AND YOUTH AND THEIR
FAMILIES NAVIGATE CHALLENGING
AND LIFE ALTERING HEALTH HELLO
HEALTHCARE CRISIS.
MEDICAL TRAUMA THREATS TO LONG
TERM WELL BEING AND THE
POTENTIAL FOR DEATH AFFECTS A
SIGNIFICANT PORTION OF CHILDREN
AND FAMILIES IN CALIFORNIA. THE
MEDICAL TEAMS THAT SERVE THESE
CHILDREN AND FAMILIES RIGHTLY
FOCUS ON THE RESTORATION OF
PHYSICAL WELL BEING OF THE NO
CHILD. THE SOCIAL EMOTIONAL
DEVELOPMENT AND FAMILY WELL
BEING OF THESE CHILDREN
GENERALLY FALLS INTO THE SCOPE
OF SERVICES OF CHILD LIFE
SPECIALISTS.
THE SPECIALISTS ARE ALLIED
HEALTH CARE PROFESSIONALS THAT
SERVE CHILDREN AND THEIR
FAMILIES NAVIGATE NAVIGATING
HEALTHCARE CRISIS IS THAT HELP
IMPROVE THE QUALITY OF HEALTH
CARE AND WELL BEING. TO THEIR
PATIENTS.
CHILD LIFE SERVICES.
HAVE BEEN SHOWN TO REDUCE.
SEDATION RELATED COSTS USE OF
PAIN MEDICATION AND LENGTH OF
HOSPITALIZATIONS.
THEY ALSO HAVE BEEN SHOWN TO
INCREASE PATIENT AND FAMILY
CUSTOMER SATISFACTION WITH
HEALTH CARE SERVICES.
HEALTH GOOD HEALTH CARE INDUSTRY
STANDARDS ENDORSED THE VALUE OF
CHILD LIKE SERVICES BITE HAVE
FALLEN SHORT OF CONSSTENTLY
MANDATING DRIVE THEIR
AVAILABILITY. TO CHILDREN AND
FAMILIES BY PASSING THIS
LEGISLATION CALIFORNIA CAN LEAD
THE NATION IMPROVING THE SOCIAL
EMOTIONAL DEVELOPMENTALAND
FAMILY WELL BEING OF CHILDREN.
SUFFERING FROM SERIOUS MEDICAL
CONDITIONS.
SINCE THIS IS A NEW MANDATE I
ACCEPT THE COMMITTEES SUGGESTED
AMENDMENTS REMOVING THE STAFFING
RATIO IN THE BILL AS WELL. AS
THE TECHNICAL AMENDMENTS AND
SECTION ONE OF THE BILL.
WITH HERE.
HERE WITH ME TODAY. I HAVE
CHARITY BASKETS DIRECTOR OF THE
INVEST CHILD LIFE PROGRAM OF
THIS IS A PACIFIC UNIVERSITY AND
CAPTURING EKLUND AT DEPARTMENT
OF CYCLE OF. PSYCHOLOGY CHAIR AT
THIS IS ABSURD
MOVING.
MOTION.
YEAH.
CHAIR AND MEMBERS OF THE
COMMITTEE MY NAME IS CHARITY
FUSCUS.
AS A CERTIFIED HOLLOW
SPECIALISTS FOR MORE THAN
EIGHTEEN YEARS.
I AM HERE TO EXPRESS MY ARM
SUPPORT FOR THIS WHOLE
ESPECIALLY ILL A. B. THIRTY ONE
SEVENTY FIVE.
THROUGHOUT THE MEDICAL PUBLIC
POLICY SOCIAL SERVICES
EDUCATIONAL AND JUSTICE
COMMUNITIES THERE IS INCREASING
AWARENESS OF THE ROLE OF TRAUMA
AND ADVERSE EXPERIENCES IN
CHILDHOOD. IN SHAPING
ADOLESCENTS AND ADULTS OUTCOMES
ACROSS VIRTUALLY EVERY DOMAIN OF
LIFE FUNCTIONING.
THIS COLLECTIVE CONSENSUS WAS
REFLECTED IN THE PATH THIS ABOUT
OF ASSEMBLY BILL THREE FORTY
THIS PAST OCTOBER.
TRAUMATIC INJURIES AND SERIOUS
ILLNESSES IN PEDIATRIC PATIENTS
ARE SOCIO A SUBSTANTIALLY
INCREASED RATE OF PERSISTENT
POSTTRAUMATIC STRESS DISORDER AN
EVEN HIGHER RATES OF LINGERING
EMOTIONAL BEHAVIOR AND
DEVELOPMENTAL PROBLEMS.
CHILD LIFE SPECIALISTS LEAD THE
EFFORT TO PREVENT THESE OUTCOMES
BY CREATING A HEALTH CARE
ENVIRONMENT THAT IS SAFE. SECURE
AND COMPREHENSIBLE IN THE MIDST
OF WHAT IS OFTEN A PAINFUL
CHAOTIC AND TERRIFYING
EXPERIENCE.
PACIFIC EDUCATION A UNIQUE
TRAINING RECEIVED BY SALAS
SPECIALISTS ENABLES US TO
PROVIDE. PSYCHOSOCIAL
THERAPEUTIC AND DEVELOPMENTAL
SUPPORT INTERVENTIONS ARE NOT
DELIVERED IN THE SAME WAY BY ANY
OTHER MEMBER OF THE HEALTHCARE
TEAM.
RESEARCH CONTINUE TO SHOW
FINANCIAL BENEFIT OF FACILITIES
THAT EMPLOY TELL A SPECIALIST.
THE CURRENT EXISTING
REQUIREMENTS IN THE CALIFORNIA
TRIAL SERVICES PROGRAM TO OFFER
A CHILD LIFE'S SERVICES.
LIMIT CHILD LIFE SPECIALISTS
PRESIDENT'S TO PROVIDE VALUABLE
SERVICES AND EFFECTIVE
INTERVENTIONS WHICH CANNOT ONLY
EXACERBATE INCIDENTS OF
PSYCHOLOGICAL STRESS AND TRAUMA
BUT ALSO POTENTIALLY LENGTHY
HEALING AND. RECOVERY PROCESS
TO TANGIBLY IMPROVE HEALTH AND
WELL BEING OF THE NEXT
GENERATION IT IS IMPORTANT TO
MANDATE AND REVISED LEGISLATION.
TO EXPAND AND REQUIRE SERVICES
BY CALLASPO SHOELESS.
I HUMBLY AND RESPECTFULLY ASK
YOU TO SUPPORT ASSEMBLY BILL A.
B. THIRTY ONE SEVEN FIVE AND
HELP INFANT CHILDREN YOUTH AND
FAMILIES AFFECTED BY CRISIS
HOSPITALIZATION TERMINAL AND
CHRONIC ILLNESS OBTAIN. THE
SUPPORT AND GUIDANCE THE NEED TO
LIVE THEIR BEST AND MOST
FULFILLED LIFE THANK YOU FOR
YOUR TIME AND CONSERVING THIS
IMPORTANT ISSUE.
THANK YOU FOR YOUR TIME AND FOR
MOVING US UP SO WE CAN NOT MISS
OUR PLANE.
I MY NAME IS KATE DOCTOR
CATHERINE ECHLIN I'M A CLINICAL
PSYCHOLOGIST WHO SPECIALIZES IN
WORKING WITH CHILDREN AND
FAMILIES. ON I'M ALSO CLINICAL
EDUCATOR I'VE EDUCATED A CHILD
PSYCHIATRIST CHILD PSYCHOLOGISTS
ON SOCIAL WORKERS MF CHEESE AND
CHILD LIFE SPECIALISTS IN MY
ROLE IN ACADEMIA CLINICAL
ACADEMIA. I AM ALSO THE MOTHER
OF A CHILD WITH A CHRONIC
ILLNESS I'M HERE TO SUPPORT OF
LEGISLATION FOR A. B. THIRTY ONE
SEVENTY FIVE.
CHAU LIFE SERVICES PROVIDING
UNIQUE AREA OF EXPERTISE THAT
FILLS AN IMPORTANT GAP IN THE
MULTI DISCIPLINARY CHILD AND
FAMILY CENTER TEAM. WHILE
MEDICAL PROFESSIONALS ARE
TENDING TO THE PHYSICAL WELL
BEING OF A CHILD AND ALLIED
HEALTH SPECIALISTS IS SET SUCH
AS OCCUPATIONAL THERAPISTS
PHYSICAL THERAPISTS AND SPEECH
THERAPISTS. ARE TENDING TO THE
PHYSICAL AND ADAPTIVE NEEDS OF
THE CHILD CHILD LIFE SPECIALISTS
FUNCTION TO PROVIDE PREVENTIVE
AND EARLY INTERVENTION SERVICES
THAT FOCUS SPECIFICALLY ON
MAINTAINING. PSYCHOLOGICAL
EMOTIONAL DEVELOPMENTAL AND
INTER PERSONAL WELL BEING DURING
THE COURSE OF TREATMENT FOR
HEALTH CONDITIONS.
CHILD LIFE SPECIALIST
INTERVENTIONS INCLUDE
DEVELOPMENTALLY TARGETED CHILD
AND PARENT EDUCATION AND
PREPARATION FOR MEDICAL
PROCEDURES REAL TIME SUPPORT
DURING MEDICAL PROCEDURES AND
PROCESSING. AND IMMEDIATE POST
TRAUMA DEBRIEFING AND PROCESSING
WITH CHILDREN GOING THROUGH
MEDICAL ON THOMAS AS A CHILD
PSYCHOLOGIST WHO SPECIALIZES IN
WORKING WITH CHILDREN FAMILIES
HAVE EXPERIENCED A WIDE RANGE OF
TRAUMA. MY TRAINEE DID NOT
PREPARE ME TO PROVIDE THESE
IMMEDIATE REAL TIME.
HAD MEDICAL RELATED SERVICES ON
HOWEVER IN OUTPATIENT SETTINGS
OVER THE COURSE OF MY CAREER
I'VE SPENT SIGNIFICANT TIME WITH
CHILDREN FAMILIES. WHO SECONDARY
TO SUCCESSFUL TREATMENT FOR
SERIOUS ILLNESSES HAVE DEVELOPED
A VARIETY OF MENTAL HEALTH
CONDITIONS THAT AFFECTED
PSYCHOLOGICAL EMOTIONAL
RELATIONAL AND DEVELOPMENTAL
WELL BEING? WHEN I ENCOUNTER
FAMILIES THAT ARE STILL IN THE
PROCESS OF NAVIGATING HEALTH
CRISES OF THEIR CHILDREN I
ALWAYS RECOMMEND THEY REQUEST
CHILDLIKE SERVICES AND MORE
TIMES THAN NOT. CHUDLEIGH
SERVICES ARE NOT AVAILABLE IN
THE HEALTH CARE SETTINGS THAT
THEY ARE SERVED IN. THIS LACK OF
ACCESS TO TIMELY SERVICES
CONCERNING TO ME.
AS A CLINICAL PSYCHOLOGIST IT'S
ALWAYS OUR GOAL TO INCREASE THE
WELL BEING OF COMMUNING DE
MEMBERS SUCH TO MAKE OUR
SERVICES UNNECESSARY. I TRULY
BELIEVE THAT WITH THE PROVISION
OF CHILD LIFE SERVICES THE
NUMBER OF MENTAL HEALTH
REFERRALS FOR CHILDREN IMPACTED
BY HEALTH CONDITIONS TO
OUTPATIENT PSYCHOLOGICAL
SERVICES. TO ADDRESSED ECONDARY
ANXIETY BEHAVIORAL AND EMOTIONAL
DYSREGULATION AND DEVELOPMENT ON
SOCIAL DELAYS WILL DECLINE.
ADEN SO AB THAT I'M RUNNING
ATTEMPT AND A. B. THIRTY ONE
SEVENTY FIVE CAN INITIATE THE
PROCESS OF INCLUSION OF
CHILDLIKE SERVICES ISN'T ENOUGH
INTEGRAL HEALTH INTERVENTION FOR
FAMILIES AND CHILDREN.
CALIFORNIA WITH THE PASSAGE OF
AB THIRTY ONE SEVENTY FIVE WILL
SERVE AS A MODEL FOR A MOVEMENT
FROM ADVOCACY TOWARD ACTIVE
IMPLEMENTATION OF EARLY
INTERVENTION SERVICES. AND THE
PREVENTION OF LONG TERM DEFICITS
IN CHILDREN.
WELT CHILDREN CHILD WELL BEING
THAT CAN BE UNINTENDED
BYPRODUCTS OF CHILDHOOD
ILLNESSES.
THANK YOU FOR YOUR TIME AND
CONSIDERATION OF THIS BILL.
YOU VERY MUCH OTHERS TO SUPPORT.
SEEN NO ONE WILL.
IS THERE IS A OPPOSITION.
YOU COME UP IF YOU LIKE.
I THINK YOU MISTER CHAIR AND
MEMBERS WE ARE MORE EAR ON
BEHALF OF THE CALIFORNIA
CHILDREN'S HOSPITAL ASSOCIATION
REGRETFULLY IN OPPOSITION TO
THIS MEASURE.
MY EIGHT NONPROFIT FREESTANDING
CHILDREN'S HOSPITALS ARE STRONG
PROPONENTS OF CHILD LIFE
SERVICES I'M ALL OF OUR
HOSPITALS EMPLOY CHILD LIFE
SPECIALISTS.
AND ABSOLUTELY BUT AGREE WITH
EVERYTHING THE PROPONENTS SAID
ABOUT THE VALUE THAT THEY
PROVIDE TO THE CHILDREN THAT WE
SERVE.
HOWEVER THIS IS NOT A
REIMBURSABLE US THAT OUR WHOLE
OUR HOSPITALS PROVIDED SOMETHING
THAT THEY DO AT THEIR OWN
EXPENSE BECAUSE THEY SEE THAT
HAS A BENEFIT FOR CHILDREN AND
AS A RESULT. WE HAVE A LOT OF
CONCERNS ABOUT ATTEMPTING TO
MANDATE A SERVICE THAT IS NOT
CORRECT CARE. AREN'T ANY SERVICE
REALLY WHERE WE'RE TRYING TO
DICTATE THE PRIORITIES THAT
HOSPITAL FACES WHEN IT'S TRYING
TO FIGURE OUT HOW TO BEST MANAGE
ITS RESOURCES. I THINK WE ARE
VERY APPRECIATIVE OF THE
AMENDMENTS TAKEN TODAY TO.
ELIMINATE THE STAFFING RATIO
HOWEVER THE BILL IN KIND OF ALL
OF ITS ASPECTS STILL MANDATE
REQUIRING THAT YOU HAVE CHILD
LIFE SPECIALISTS IN ALL
SETTINGS.
OUR SPECIALTY CARE IS PROVIDED
AND ALL DAYS OF THE WEEK AGAIN
MANY OF OUR HOSPITALS PROVIDE
CHILD LIFE SPECIALISTS AND
CHILDLESS SERVICES IN SETTINGS
FAR BEYOND WHAT THEY'RE RQUIRED
TO DO NOW. BUT WE BELIEVE THAT
OF THE MANDATED APPROACH FOR AN
UNREIMBURSED SERVICE IS. IS
RISKY ESPECIALLY AT A TIME OVER
ASKING PROVIDERS TO BILLY FIGURE
OUT HOW TO MAKE OTHER SERVICES
MORE AFFORDABLE AND TO BE MORE
LEAN SO FOR THOSE REASONS WE
MUST OPPOSE. HOWEVER THE BILL
MOVES FORWARD TODAY WE DO A
COMMIT TO WORKING WITH THE
AUTHOR TO SEE IF WE CAN RESOLVE
SOME OF THESE CONCERNS.
THANK YOU.
ROBERT LAZAR WITH THE CALIFORNIA
HOSPITAL ASSOCIATION WHEAT WE
HAVE A NUMBER OF CONCERNS WITH
THE BILL THE SAME CONCERNS THAT
MISS MORTON MORTON POINTED OUT.
I'M HOWEVER WERE PLEASED TO SEE
THE AUTHOR HAS REMOVED THE
RATIOS THAT WAS PROBABLY OUR TOP
CONCERN AND WE LOOK FORWARD TO
CONTINUING TO WORK WITH THE
AUTHOR ON THIS BILL THANK YOU.
WELL
IS THERE ANYONE ELSE IN
OPPOSITION.
SEE NO PRE BACKED COMMITTEE FOR
QUESTIONS OR COMMENTS
THE ROOM COMMITTEE.
SEEING THEM WOULD YOU LIKE TO
CLOSE THIS RUBIO. THANK YOU YES
I AM A. B. THIRTY ONE SEVEN FIVE
IS AN IMPORTANT STEP FORWARD TO
ESTABLISHING CALIFORNIA THE
STANDARD BEARER. FOR THE HEALTH
AND WELFARE OF ITS CONSTITUENTS
BY M. OF HUNDRED PERCENT
COMMITTED OUGHT TO WORKING WITH
ALL STAKEHOLDERS ON FUNDING
ISSUES OF THE BILL MOVES THROUGH
THE APPROPRIATIONS COMMITTEE AND
WITH THAT I RESPECTFULLY ASK FOR
YOUR AYE VOTE.
VERY MUCH WE DO HAVE A MOTION.
FOR.
BY MISTAKE YEAR CURRY WERE
LOOKING FOR A SECOND.
THE SECOND BY MISTER MCCARTY.
HAD THIS DOES ENJOY DO PASS
RECOMMENDATION MADAM SECRETARY
DID THE MOTIONS TO PASS AS
AMENDED TO APPROPRIATIONS.
EXACTLY PLEASE CALL THE ROLL
WOULD I WOULD I MAYES. MAYES NO
ANGER CURRY ANCHOR CURRY AYE
BIGELOW.
BIGELOW NO.
BONTA AYE BONTA AYE BURKE.
CARILLO.
LARA.
THE MONK MCCARTY.
MCCARTY AYE THIS AREA.
RODRIGUEZ.
SANTIAGO THURMOND WALDRON.
GIVE FOUR VOTES WE HAVE VOTE AS
YOU SEE A FEW MEMBERS MISSING SO
I WILL LEAVE THE ROLE OPEN FOR
UP WITH WHAT. THE BILL BECAUSE
HIS FACE UP THANKS VERY MUCH FOR
THANK YOU AND THANK YOU FOR
ALLOWING ME TO MOVE UP IN THE.
DON'T MAKE ME THINK THEM SO
MANY.
MISTER PATTERSON.
PATTERSON HAS A. B. TWENTY TWO
HUNDRED
.
THANK YOU MISTER CHAIRMAN
APPRECIATE THE OPPORTUNITY
MEMBERS. ARE A. B. TWENTY TWO
HUNDRED WILL REQUIRE ALL
EMPLOYEES AT LICENSED.
SUBSTANCE USE DISORDER TREATMENT
FACILITIES TO UNDERGO A CRIMINAL
BACKGROUND CHECK.
THIS BACKGROUND CHECK WILL THEN
BE REVIEWED BY THE DEPARTMENT OF
HEALTH CARE SERVICES AND
APPLICATION FOR EMPLOYMENT THE
FACILITY. MAY BE APPROVED OR
DENIED BASED ON THE BACKGROUND
CHECK RESULTS.
ACQUIRING BACKGROUND CHECKS WILL
ALSO ALLOW FOR THE DEPARTMENT TO
RECEIVE NOTIFICATIONS OF
SUBSEQUENT ARRESTS AND
CONVICTIONS.
AS.
OUT PROMOTION IT IS OUT.
AS WE'VE SEEN MANY TIMES THE
NEWS EVEN A TWO REPORTS
PUBLISHED BY THE LEGISLATURE
THIS LAPSE IN OVERSIGHT BY THE
STATE HAS RESULTED IN NEGATIVE
OUTCOMES FOR PATIENTS AT THESE
FACILITIES.
I THINK IT'S IMPORTANT TO NOTE
EARLIER THIS YEAR THE SENATE
HEALTH COMMITTEE TOOK A LOOK AT
THESE PROBLEMS WITH INDUSTRY
PROPOSED. FIXES ONE OF THE
RECOMMENDATIONS THAT CERTAINLY
CAUGHT OUR EYE AS NECESSARY WAS
TO MANDATE BACKGROUND CHECKS FOR
ADDICTION. COUNSELORS THIS BILL
TAKES THAT RECOMMENDATION
APPLIES IT TO EMPLOYEES WORKING
AT RESIDENTIAL TREATMENT
FACILITIES HERE TO TESTIFY IN
SUPPORT US WHEN ANDERSON FOUNDER
AND PRESIDENT. PARENTS AND
ADDICTS IN NEED.
CHAIRMAN OF THE COMMITTEE FOR
ALLOWING ME TO TESTIFY THIS
AFTERNOON.
AS YOU SAID I AM I AM PRESIDENT
FOUNDER OF PAIN PARENTS GENETICS
IN NEED I'M ALSO RECOVERING DRUG
ADDICT OF SEVENTEEN YEARS. I GOT
CLEAN AND SOBER IN TWO THOUSAND
AND ONE AND STARTED MY
ORGANIZATION ABOUT SEVEN YEARS
AFTERWARDS.
I AM IN SUPPORT OF THIS BILL FOR
A LOT OF REASONS BUT I'LL JUST
GIVE YOU A GIVE ME A FEW HERE.
AYE I DO BELIEVE THAT THE
BACKGROUND CHECKS ARE CRITICAL
TO THE SAFETY OF OF NOT ONLY THE
CLIENTS THEMSELVES BUT.
TO THE TREATMENT FACILITY.
I BELIEVE IT'S GOING TO ENSURE
THE PROTECTION OF THAT TREATMENT
CENTER. AND IT'S ALSO GOING TO
PROTECT ITS OWNERS AND ALL ITS
EMPLOYEES.
YOU KNOW THERE'S THERE'S
THERE'S%
WE'VE HAD ENOUGH BAD PUBLICITY
GOING ON HERE IN THE LAST FEW
FEW YEARS.
WITH TREATMENT AND THIS IS IN
MY OPINION GOING TO SHOW THE
PUBLIC. THAT THAT WE MEAN
BUSINESS AND THAT WE DO NEED TO
CHANGE SOME POLICIES IN OUR IN
OUR TREATMENT CENTERS AND THAT'S
WHY I'M HERE THIS AFTERNOON
SUPPORT THE BILL. THANK YOU FOR
ALLOWING ME THE TIME.
IF YOU'RE MUCH SIR.
ANYWHERE AT THERE'S IN SUPPORT.
SEE NO ONE ANYONE IN OPPOSITION.
SEE NO ONE BRING BACK
COMMITTEES.
QUESTION FOR THE COMMITTEE.
I HAVE A NO QUESTION IT WAS LIKE
CLOSE MISTER FASHION.
RESPECTFULLY ASK YOUR AYE VOTE
THINK IS CHAIRMAN OF MEMBERS.
WE HAVE A MOTION BY.
.
STERN MAYES A SECOND BY MISTER
MCCARTY OF THEM SECRETARY THE
MOTION IS TO PASSED
APPROPRIATIONS MASSACRE TERRY
PLEASE CALL THE ROLL.
WOULD I WOULD I MAYES MAYES AYE
ANCHOR CURRY.
THANK YOU CURRY AYE BIGELOW.
BIGELOW AYE BONTA AYE BONTA AYE
BURKE.
CARILLO. FLORA. FLORA KILEY MON.
MCCARTY.
MCCARTY I IN THIS AREA.
RODRIGUEZ SANTIAGO. THURMOND
AND.
WALDRON.
AT SEVEN WE'VE WILL BELIEVE THE
BILL ON QUAKE VERY MUCH OF A
MESS WHICH APPRECIATE WHERE OUT
OF SILICON.
WE HAD DOCTOR ARAMBULA.
WEEK ABOUT THAT WE HAVE A
CONSECUTIVE OF THE FORESTS
THEIR.
SO MOVED BY.
WHO WHO WHO DID THAT WOULD? GIVE
US MCCARTY SECOND BY MISTER
MAYES IS THAT CONSENT COUNTY
RECRUITS ITEM NUMBER SIX AB
TWENTY ONE TO.
TWENTY TWO MISS REYES AT NUMBER
ELEVEN AB TWENTY FOUR TWENTY
EIGHT MISS GONZALEZ FLETCHER. A.
B.. ITEM NUMBER THIRTEEN AB
TWENTY FIVE TWENTY FOUR WOULD
WITH AMENDMENTS.
NUMBER SEVENTEEN AB TWENTY FIVE
NINETY THREE GRAYSON.
AB A EIGHT NUMBER TWENTY EIGHT
AB TWENTY NINE OH FOR MISS
CARILLO AND NUMBER THIRTY AB
TWENTY NINE SEVENTY SIX MISTER
QUIRK. AND ITEM NUMBER THIRTY
ONE AB TWENTY NINE EIGHTY THREE
DOCTOR ARAMBULA SO WE HAVE A
MOTION BY MISTER MAYES A SECOND
BY MISTER MCCARTY.
AND SECRETARY PLEASE CALL THE
ROLL.
WHAT I WOULD AYE MAYES AYE AYE
MAYES AYE ANCHOR CURRY? HERE
FREE AYE BIGELOW. PILLOW AYE
BONTA AYE.
BONTA AYE BURKE.
CARILLO.
FLORA. FLORA EILEMA.
MCCARTY. PARTY AYE NAZARIAN
RODRIGUEZ SANTIAGO. BERMAN.
WALDRON.
THAT'S SEVEN SO WE'RE SHY ON THE
CONSENT CALENDAR TOUGH I'M SURE
MEMBERS WILL RETURN.
DOCTOR ARAMBULA YOU HAVE THREE
THOSE BEFORE US AND YOU HAVE ONE
AND IT'S. ONE OF CONSENT.
I ACTUALLY BELIEVE I HAVE FOR MR
CHAIRMAN ONE ON CONSENT WHAT
PRINT I CAN'T COUNT VERY WELL SO
ANYWAY MORE THAN ONE ON CONSENT.
SO.
WE WILL START WITH.
AB TWENTY TWO SEVENTY FIVE ITEM
NUMBER EIGHT.
IF IT PLEASES THE CHAIR IS THERE
ANY OPPORTUNITY FOR ME TO
PRESENT AB TWENTY EIGHT NINETY
FIVE FIRST AS I HAVE SOMEONE
PRESENTING WAS A FLIGHT TO
CATCH.
YEAH I THINK WE CAN DO THAT.
THANK YOU MISTER CHAIR AND
MEMBERS.
AB TWENTY EIGHT NINETY FIVE
REQUIRES HEALTH PLANS TO REPORT
TOTAL PRIMARY CARE MEDICAL
EXPENDITURES.
INCLUDING THE PERCENTAGE OF
MEDICAL EXPENSES ALLOCATED TO
PRIMARY CARE. COMPARED TO
OVERALL MEDICAL EXPENDITURES.
AS WELL AS THE METHOD PLANS AND
INSURERS USED FINANCIALLY
SUPPORT PRIMARY CARE.
ONE OF THE BARRIERS TO ACCESSING
HEALTHCARE IS THE LACK OF
PRIMARY CARE HEALTH CARE
PROVIDERS AND THE HEAVY
DEPENDENCE ON SPECIALIST
SOMETHING THAT YOU YOURSELF
MISTER CHAIR OF FREQUENTLY SAID.
IS THAT IN THE UNITED STATES
APPROXIMATELY TWO THIRDS OF
PHYSICIANS ARE SPECIALISTS.
AND APPROXIMATELY ONE THIRD ARE
IN PRIMARY CARE.
THIS STATISTIC IS REFLECTED IN
CALIFORNIA AND OUR LACK OF THE
RULE BEST PRIMARY CARE WORK
FORCE.
IN ORDER TO IMPROVE ACCESS AND
CONTINUITY OF CARE THERE NEEDS
TO BE A STRATEGY TO ADDRESS THE
HEALTH CARE WORK FORCE AND ONE
OF THE FIRST STEPS IN DOING
THIS.
IS HAVING TRANSPARENCY IN THE
EXISTING PRIMARY CARE MEDICAL
EXPENDITURES.
REQUIRING HEALTH PLANS INSURERS
TO REPORT TOTAL PRIMARY CARE
MEDICAL EXPENDITURES WILL ALLOW
CONSUMERS AND CARRIERS TO BE
AWARE OF THE AMOUNT OF MONEY
SPENT ON PRIMARY CARE. AND TO BE
MOTIVATED TO INCREASE THEIR
SPENDING HAS SEEN IN OREGON
WHERE SIMILAR LEGISLATION HAS
BEEN PASSED.
IN ADDITION TO TRANSPARENCY THIS
BILL WILL CREATE A PRIMARY CARE
PAYMENTS REFORM COLLABORATIVE
WITH HEALTH CARE STAKEHOLDERS.
TO PROVIDE HEALTH PLANS AND
INSURERS WITH PROVEN STRATEGIES
TO SUPPORT PRIMARY CARE WHICH
WILL MAKE IT POSSIBLE TO ACHIEVE
A HIGH VALUE HEALTH SYSTEM THAT
ALL CALIFORNIANS HAVE A RIGHT
TO.
HERE TO TESTIFY IN SUPPORT OR DR
KARLA TUCKER TO ME AS WELL AS
JODY HEX FROM CALIFORNIA ACADEMY
OF.
OR RYAN SPENCER.
I'M OF THE.
MOVE THE BILL.
SECOND.
WHO HAVE MOTION A SECOND?
RYAN SPENCER WITH THE CALIFORNIA
ACADEMY OF FAMILY PHYSICIANS HAD
SPONSORED THE BILL OBVIOUSLY IN
SUPPORT A TO MY RIGHT IS DOCTOR
CARL THE COOK A TINY. KAKUTANI
SHE IS THE LEGISLATIVE CHAIR OF
THE ACADEMY AND SHOULD BE THE
ONE PROVIDING TESTIMONY.
IF YOU.
THANK YOU.
AMOS A DOCTOR CARL*
TANIYAMA FAMILY PHYSICIAN
PRACTICING IN A WINTERS
CALIFORNIA AND FULL DISCLOSURE I
DON'T HAVE A PLANE TO CATCH BUT
I HAVE A SIXTEEN YEAR OLDS
BIRTHDAY TODAY.
.
THE PORTION OF OUR HEALTHCARE
DOLLAR GOING TO PRIMARY CARE IS
NOT WELL KNOWN AND IT SHOULD BE.
WE NEED A BETTER UNDERSTANDING
OF PRIMARY CARE INVESTMENT IN
OUR STATE.
WE KNOW THAT A WELL FUNCTIONING
HEALTH CARE SYSTEM WITH THE
ROBUST PRIMARY CARE FOUNDATION
DELIVERS A HIGHER QUALITY.
HIGHER QUALITY CARE AT A LOWER
COST AND WE KNOW THAT THAT
PRIMERICA OUR FOUNDATION WITH
ADEQUATE RESOURCES. ALLOWS FOR
THE DELIVERY OF RIGHT CARE IN
THE RIGHT PLACE AT THE RIGHT
TIME.
WE ALSO KNOW THAT THE SHARE OF
SPENDING ON PRIMARY CARE IS A
CRITICAL MEASURE OF HOW STRONG
THAT PRIMARY CARE FOUNDATION IS.
BUT IN VIRTUALLY US HEALTHCARE
SYSTEM SEEMS TO BE GOING IN THE
OPPOSITE DIRECTION.
NATIONAL UTILIZATION OF PRIMARY
CARE. IS DECREASING AND
UTILIZATION ESPECIALLY SERVICES
CLIMBING AT AN ALARMING RATE.
IT DOESN'T SEEM LIKE A SMART WAY
TO RUN A HEALTHCARE SYSTEM BUT
WE CAN'T CHANGE WHAT WE.
WHAT WE DON'T MEASURE?
SO AB TWENTY NINETY FIVE ALLOWS
FOR THE GATHERING OF A DATE AND
IMPROVE TRANSPARENCY FOLLOWING
IN THE FOOTSTEPS OF OREGON IN
RHODE ISLAND THAT'S SHOWING US
HOW TO TACKLE THIS ISSUE.
OF THOSE STATES HAVE FOUND THAT
JUST HAVING THE DATA AVAILABLE
IS CHANGING HOW HEALTH PLANS
INSURANCE APPROACH THE PROBLEM.
THEY HAVE.
TACKLE THE TECHNICAL ISSUE OF
COLLECTING THE DATA IN VARIOUS
WAYS EITHER THROUGH HAVING A
REGULATOR OR STATE DEPARTMENT
COLLECT THE DATA AND ANALYZE IT
OR USING AN ALL PAYER CLAIMS
DATABASE. WE EXPECT THAT THE
COLLABORATIVE THAT SET UP IN
THIS BILL WILL GUIDE US TO A
FORMAT THAT WORKS BEST FOR
CALIFORNIA.
WE'VE DONE GREAT WORK TOGETHER
IN CALIFORNIA ON IMPROVING
ACCESS AND COVERAGE.
BUT NOW WE HAVE TO BEGIN THE
WORK OF RESHAPING HOW WE.
DELIVER THE CARE TO CREATE A
MORE SUSTAINABLE SYSTEM.
CALIFORNIA CAN ACHIEVE MORE
AFFORDABLE CARE WITH BETTER
OUTCOMES BY CONSISTENTLY
MEASURING AND SUSTAINING SYSTEM
WIDE INVESTMENT IN PRIMARY CARE.
WE WILL NOT SEE FUNDAMENTAL
IMPROVEMENTS IN OUR HEALTHCARE
SYSTEM UNTIL WE MAKE IT MORE
PRIMARY CARE ORIENTED AND WE CAN
START THIS PROCESS BY PASSING AB
TWENTY EIGHT NINETY FIVE. THANK
YOU FOR YOUR CONSIDERATION.
VERY MUCH.
HIS SUPPORTERS WERE.
MARRIAGE IMPLORES ON BEHALF OF
HEALTH ACCESS CALIFORNIANS
SUPPORT.
BUT IS IT SUPPORT.
SEEING NO ONE IS THERE ANYONE IN
OPPOSITION.
PLEASE COME FORWARD.
THANK YOU MISTER CHAIR AND
MEMBERS NICK LOUISE US ON BEHALF
THE CALIFORNIA ASSOCIATION
HEALTH PLANS IN OPPOSITION TO
TWENTY EIGHT NINETY FIVE.
BECAUSE IT WILL RESULT IN A NEW
ADMINISTRATIVE BURDEN ON HEALTH
PLANS FOR THE COLLECTION OF
DATA.
THAT WILL BE DIFFICULT TO
ASSEMBLE.
THESE NEW ADMINISTRATIVE COSTS.
HAS ALWAYS WILL TRANSLATE INTO
YOU I'M HIGHER COSTS FOR
CONSUMERS.
THERE WAS LAST WEEK WE DEBATED A
BILL.
BY SIMPLY MEMBER ARAMBULA THAT
WAS PREDICATED ON THE NOTION
THAT THERE IS TOO MUCH
ADMINISTRATIVE COST ON IN THE
HEALTHCARE SYSTEM. SPECIFICALLY
ON THE HEALTH SIDE PART OF THE
EQUATION.
PARADOXICALLY THIS WEEK WE ARE
DISCUSSING A BILL AB TWENTY
NINETY FIVE ADDS EVEN MORE
ADMINISTRATIVE REQUIREMENTS ON
MY MEMBER HEALTH PLANS.
BUT SETTING ASIDE THIS ISSUE OF
OVERALL POLICY DIRECTION A WE
FUNDAMENTALLY DISAGREE THAT THIS
BILL WILL PROVIDE ANY VALUABLE
INFORMATION.
REPORTING THAT HEALTH PLAN
EXPECT MORE LESS ON PRIMARY CARE
THAN HEALTH PLAN WHY. WILL NOT
PROVIDE CONSUMERS WITH WITH MUCH
USEFUL INFORMATION. AND THE
INFORMATION IF MY MEMBERS CAN
ASSEMBLY FROM THE PROVIDER
GROUPS.
WITH ANY ACCURACY I'M IS
QUALIFIED BY A VARIETY OF
FACTORS.
ON IS THAT DO YOU MAY SEE
LICENSE ENTITY BASED ON AN HMO
OR PPO CHASSIS.
CANYON ROWLY SULFUR FOR
THEMSELVES DIRECTLY TO A
SPECIALIST.
BOB DOES THE PLAN PAY ON A
CLAIMS BASIS ARE CAPITATED RATE.
WHAT IS THE HEALTH ACUITY OF
THE POPULATION THAT THE HEALTH
PLAN IS SERVING? ON AND OTHER
FACTORS THAT DRIVE A PRIMARY
CARE VERSUS SPECIALIST
CONSUMPTION.
BUT EVEN A. BIGGER
IMPLEMENTATION PROBLEM WITH THIS
BILL IS HE ISSUE OF HOW WE WILL
OBTAIN OR HOW MY MEMBERS WOULD A
TEENY INFORMATION. ON
CALIFORNIA'S HEALTH CARE MARKET
IS LARGELY BASED ON A CAPITATED
BASIS NOT FEE FOR SERVICE. SO
THIS MEANS THAT PLANS GENERALLY
DO NOT PAY ON A CLAIMS BY CLAIMS
BASIS ON THE PAPER PROVIDER
GROUPS ON A PER MEMBER PER MONTH
BASIS. IN THOSE GROUPS ARE
RESPONSIBLE FOR MANAGING PATIENT
CARE DIRECTLY. AND MANAGE
MANAGING THE CAPITATED PAYMENT
AS EFFICIENTLY AS POSSIBLE SO
MUCH OF THE INFORMATION ON
DIRECT HEALTHCARE EXPENDITURES
ON EXISTS AT THAT LEVEL.
THIS IN ORDER TO COMPLY WITH THE
BILL THE HEALTH PLANS MUST
SURVEY THEIR PROVIDER GROUPS FOR
THE INFORMATION.
AND THE RATE OF RESPONSE BY
PROVIDERS WILL DETERMINE WHETHER
THE HEALTH CLAIM CAN PERFORM
ACCURATE COMPLETE SURVEY OF
SERVICES PERFORMED IN PAID.
HEALTH ONE DATA REQUESTS ARE NOT
PARTICULARLY POPULAR AMONG A
CONTRACTED PROVIDERS.
THE DOCTORS GENERALLY DO NOT
WANT THE HMO IN THEIR OFFICE.
AS SUCH PROVIDER RESPONSIVENESS
HAS BEEN A PROBLEM THAT OUR
PLANS OF EXPERIENCE BUYER
MEMBERS WHEN ATTEMPTING TO
COMPLY WITH REPORTING MANDATES.
WEATHER IS COMPLYING WITH THE
PROVIDER DIRECTORY LAW TIMELY
ACCESS REQUIREMENTS ARE RELEVANT
MEDI CAL INFORMATION FOR RATE
DEVELOPMENT.
WHEN PROVIDERS ARE NON
RESPONSIVE IT BECOMES MORE
ADMINISTRATIVELY BURDENSOME ON
THE PLAN TO ENSURE ACCURACY
BECAUSE THE PLANS MOST
FREQUENTLY FOLLOW UP WITH THEIR
CONTRACT PROVIDER GROUPS.
SO IN RECOGNITION OF THIS
PROBLEM PRIOR LEGISLATION.
DOES A AND I'M THINKING
SPECIFICALLY OF THE PROVIDER
DIRECTORY LEGISLATION FROM A
NUMBER OF YEARS AGO. ACTUALLY
ALLOWS PLANS TO DELAY PAYMENT TO
PROVIDER PROVIDER GROUP IS IF
THERE IS A FAILURE TO PROVIDE
THE INFORMATION TO TO.
COMPLETE THE DIRECTORIES
THERE IS NO EQUIVALENT FEATURE
HERE. FINALLY THE BILL CREATES
AN ENTIRELY NEW GOVERNMENT
COLLABORATIVE TO GOVERN THE TYPE
OF PRIMARY CARRIED OUT OF THE
PLANS WOULD REPORT.
THIS COLLABORATIVE WOULD BE
AFTER THE REPORTING REQUIREMENTS
ON THE PLANS OF ALREADY KICKED
IN. WHICH MEANS THAT THE
STANDARDS COULD CHANGE DOWN THE
LINE
IF IN SHORT A WERE OPPOSED TO
THE BILL TAKE.
STEPHANIE WATKINS ON BEHALF OF
THIS VISION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANIES
WE TOO ARE OPPOSED TO THE BELL
I'M UNFORTUNATELY WHILE WE
APPRECIATE THE AUTHORS AND
INTEREST IN THIS AREA IT'S NOT
CLEAR TO US WHAT BENEFIT THIS
INFORMATION WOULD PROVIDE.
ESPECIALLY IN CONTEXT OF THE PPO
WHERE THE ENSURE THEMSELVES CAN
SELF REFER AND CHOOSE TO GO TO A
SPECIALIST DIRECTLY VERSUS GOING
TO A PRIMARY CARE PHYSICIAN. SO
OUR CONCERN IS IS THAT IF YOU
COLLECT THIS INFORMATION AND
PUBLISH IT WHAT REAL BENEFIT
pOTHER THAN ADDITIONAL COSTS
WOULD PROVIDE TO CONSUMER AND
COMPARING THAT. ESPECIALLY GIVEN
THE FLEXIBILITY THAT THEY HAVE
WITH THE PPO TO CHOOSE
THEMSELVES TO SEEK CARE THROUGH
A SPECIALIST EAT.
TO COMPARE PLAN TO PLAN IT WOULD
ALSO IF YOU'RE LOOKING AT
DIFFERENT CONTRACT RATES IT
WOULD BE DIFFICULT TO REALLY
GARNER AS A CONSUMER A LACK OF
INVESTMENT THAT THE PPL HAD IN
THEIR PRIMARY CARE PHYSICIANS.
BECAUSE DEPENDING ON WHERE WE
WHAT REGIONS THERE AND WHAT
CONTRACT RATES THEY PAY YOU
MIGHT SEE DISPROPORTIONATELY
DIFFERENCES BETWEEN WHAT THEY'RE
REPORTING WHICH HAS NOTHING TO
DO WITH ACTUALLY THE VALUE OF
WHAT THEY PUT THEIR. FOR THEIR
PRIMARY CARE PHYSICIANS.
SO WE ARE ADDITIONALLY WE ARE
CONCERNED ABOUT.
UNDER THE REGULATIONS YOU CAN
APPOINT YEAR OLD BE I'M AN
INTERNIST OTHER PROVIDERS THAT
ARE SPECIALIST AS YOUR PRIMARY
CARE PHYSICIAN. WE'RE NOT SURE
HOW THAT WOULD NECESSARILY BE
REPORTED BUT CERTAINLY IT CAN BE
DEBT ADDITIONALLY SKEW THOSE
NUMBERS THAT YOU MIGHT SEE IF
YOU HAVE A EXISTING RELATIONSHIP
WITH SENIOR OB. YOU CAN GET YOUR
FLU SHOT FROM THEM VERSUS YOUR
PRIMARY CARE AYE AND AND HOW
WOULD THAT RELATE INTO THE
INFORMATION WAS BEING REPORTED
AND HOW WOULD THAT BE. AVAILABLE
TO CONSUMERS IN A MEANINGFUL WAY
THAT THEY WOULD UNDERSTAND THE
DIFFERENCE BETWEEN THAT THE
INVESTMENT AND THE PROVIDER
NETWORK SO FOR THOSE REASONS
UNFORTUNATELY REMAIN OPPOSED TO
THEM.
TO ANYONE ELSE IN OPPOSITION.
SEEING NONE WILL BRING BACK TO
COMMITTEE QUESTIONS OR COMMENTS
FROM COMMITTEE.
SCENE NINE AND.
DOCTORATE. WE DO HAVE A MOTION
BY MISTAKE HERE CURRY A SECOND
BY MR MCCARTY THIS DOES ENJOY A
DO PASS RECOMMENDATION WHICH
LIKE CLOSE.
I RESPECTFULLY ASK FOR AND I.
THINK YOU IN NO TIME.
JOINT AREJOINT AUTHORED ON THIS
BILL COOPER ON THIS BILL I'M
HAPPY TO BE GIVEN DO PASS
RECOMMENDATION. THE MOTION IS TO
PASTOR APPROPRIATIONS MADAM
SECRETARY PLEASE CALL THE ROLL
WOULD I WOULD I MAYES.
EDGAR CURRY FIGURE CURRY AYE
BIGELOW.
BIGELOW NO BONTA BONTA AYE
BURKE.
CARILLO AYE CARILLO AYE FLORA.
FLORA NO LOW MOAN.
MCCARTY MCCARTY AYE IN THIS AREA
AND.
RODRIGUEZ SANTIAGO.
THURMOND AND WALDRON.
IF FIVE WE WILL NEED A FEW MORE
AND WE HAVE SOME PEOPLE MISSING
OBVIOUSLY THANK YOU VERY MUCH.
HAPPY BIRTHDAY TO YOUR SON.
MISTER DOCTOR VAN GOGH YOU HAVE
A NOW BEFORE IS AB TWENTY TO
SEVENTY FIVE THAT.
KRISTIN YES ARE. GOT IT RIGHT
THIS TIME GOOD THANK YOU.
MISTER CHAIR AND MEMBERS.
AB TWENTY TO SEVENTY FIVE
REQUIRES THE DEPARTMENT OF
HEALTH CARE SERVICES TO
ESTABLISH A QUALITY ASSESSMENT
AND AND. PERFORMANCE IMPROVEMENT
PROGRAM TO IMPROVE THE QUALITY
OF HEALTH CARE SERVICES PROVIDED
BY MANAGED CARE PLANS AND TO
REDUCE HEALTH DISPARITIES.
EXISTING QUALITY IMPROVEMENT
EFFORTS ARE NOT STANDARDIZED
ACROSS PLANS AND DO NOT REQUIRE
SPECIFIC IMPROVEMENTS.
PLANTS THAT FAILED TO MEET
MINIMUM STANDARDS FACE
RELATIVELY WEAK CONSEQUENCES.
BUT HAVE DETRIMENTAL IMPACTS FOR
THE INDIVIDUALS THAT ARE IN NEED
PROPER HEALTH CARE AND ARE
RELYING ON IT. WELL D. H. CS HAS
MADE EFFORTS TO IMPROVE THE
QUALITY OF SERVICES DELIVERED BY
SHOW THE PROGRESS ANTICIPATED
BY THE AFFORDABLE CARE ACT.
MEANWHILE THE HEALTH OUTCOMES OF
CALIFORNIANS RELYING ON MEDI CAL
FALLS FURTHER BEHIND TO THEIR
COUNTERPARTS IN THE COMMERCIAL
MARKET. AND WIDESPREAD
DISPARITIES IN RACE AND
ETHNICITY PROCESSED.
THIS BILL WILL ESTABLISH A NEW
MINIMUM PERFORMANCE LEVEL SET TO
THE BOTTOM QUARTILE OF MEDICAID
PLANS PERFORMANCE NATIONWIDE.
SPECIFIC STANDARDS WILL BE
DETERMINED BY A STAKEHOLDER
PROCESS THAT DRIVES QUALITY AND
REDUCES HEALTH DISPARITIES.
FURTHERMORE THIS BILL WILL
ESTABLISH FINANCIAL INCENTIVE
PROGRAM TO REWARD MANAGED CARE
PLANS THAT MEET PERFORMANCE
TARGETS THAT EXCEED THE NEW
MINIMUM PERFORMANCE LEVEL AND
ALSO INCLUDES A DEFINITION OF
HEALTH DISPARITIES.
AS PART OF ALL CONTRACTS WITH
MANAGED CARE PLANS THAT GOES
BEYOND GENDER RACE ETHNICITY AND
LANGUAGE PROFICIENCY TO OTHER
FACTORS FOR WHICH THERE IS PEER
REVIEWED EVIDENCE. OF HEALTH
DISPARITIES INCLUDING GEOGRAPHIC
REGIONS SUCH AS RURAL AREAS LIKE
MY OWN DISTRICT DISABILITY
STATUS SEXUAL ORIENTATION AND
GENDER IDENTITY.
WITH THE ESTABLISHMENT OF THIS
QUALITY ASSESSMENT AND
PERFORMANCE IMPROVEMENT PROGRAM
I HOPE WE CAN REDUCE THE HEALTH
DISPARITY. WITHIN COMMUNITIES
AND RAISE THE QUALITY OF OUR
HEALTHCARE IN ORDER TO BUILD
HEALTHIER COMMUNITIES
HERE TO TESTIFY IN SUPPORT IS
KIM CHAN WITH CALIFORNIA PAN
ETHNIC HEALTH NETWORK AS WELL AS
IT NOT JUST BAO. AN INDEPENDENT
HEALTH POLICY CONSULTANT.
MISTER CHAIRMAN FIRST KIMBERLY
CHANNEL THE CALIFORNIA PAN
ETHNIC HEALTH NETWORK PLEASED TO
BE HERE IS CO SPONSORED ASSEMBLY
BILL TWO TWO SEVEN.
CALIFORNIA HAS RIGHTLY INVEST IN
EXPANDING IN MEDI CAL NOW COVERS
ONE IN THREE A PEOPLE OUR STATE
INCLUDING HALF OF ALL CHILDREN
OF THOSE MEMBERS NEARLY EIGHTY
PERCENT ARE ENROLLED IN A
MEDICARE MANAGED CARE PLAN.
DEPARTMENT OF HEALTH CARE
SERVICES MEASURES AND MONITORS
THE QUALITY OF CARE PROVIDED
MEANT BY MANAGED CARE PLANS AND
WHILE UNDER EXISTING PRACTICES
MANAGED CARE PLAN. DON'T PERFORM
WELL CAN FACE CERTAIN.
CORRECTIVE ACTIONS AND FOR.
ENFORCEMENT ACTIONS WE KNOW
THAT BARRIERS TO BETTER HEALTH
STILL EXISTS WE KNOW THAT HEALTH
DISPARITIES PROCESS.
AND HEALTH OUTCOMES ARE
DIFFERENT BECAUSE OF YOUR ZIP
CODE YOUR RACE YOUR GENDER OR
WHAT LANGUAGE YOU SPEAK.
FOR INSTANCE AFRICAN AMERICAN
WOMEN WITH RECENT BIRTHS HAVE
HIGHER RISK FOR COMPLICATIONS
ENDANGERING THE HEALTH AFTER
BIRTH.
AND YET RECEIVE THE LOWEST.
POSTPARTUM THIS RATES
AND IN MEDI CAL THESE VISIT
THESE NUMBERS ARE GETTING WORSE
NOT BETTER THAT'S WHY WE'RE
PROUD TO BE WORKING WITH SOME
REMEMBER ARAMBULA AND WESTERN
CENTER ALONG PARTY TO SPONSOR
SOME THE BILL TWO TWO SEVEN. IT
WOULD RAISE THE EXPECTATIONS FOR
MEDI CAL PLANS THAT PROVIDE
HEALTH CARE SERVICES
ESTABLISHING A NEW MINIMUM
PERFORMANCE LEVEL CREATE AN
INCENTIVE TO EXCEED EXPECTATIONS
THROUGH A FINANCIAL CENTER
PROGRAM. ENSURE THAT WE HAVE THE
DATA TO MAKE EVIDENCE BASED
DECISIONS INVITES ALL
STAKEHOLDERS THE TABLE AND
SETTING THE SINCE EXPECTATIONS
AND UP FINALLY CLEARLY DEFINES
DISPARITIES REDUCTIONS AS A
PROGRAM ACTIVE.
COVER CALIFORNIA THE STATE'S
INSURANCE MARKETPLACES RT MOVED
IN THIS DIRECTION REQUIRING
HEALTH PLANS THERE TO SHOW
PROGRESS TOWARD REDUCING CHRONIC
DISEASES.
EVERYONE DESERVES QUALITY
HEALTHCARE AND THE OPPORTUNITY
TO LEAD HEALTHIER LIVES THIS
BILL BRINGS MEDICAID INTO THAT
EXPECTATION FOR THESE REASONS
THE PEN IS PROUD TO SUPPORT.
AB TWENTY TWO SEVEN FIVE
REQUESTS DRIVE.
THROUGH THE BILL.
Q..
MISTER CHAIR AND MEMBERS MY NAME
IS IGNATIUS BALLAM IN
INDEPENDENT HEALTH POLICY
CONSULTANT AND I'VE BEEN
PRIVILEGED TO WORK WITH NATIONAL
GROUPS. LIKE THE INSTITUTE OF
MEDICINE AND THE NATIONAL
QUALITY FORUM ON ISSUES OF
HEALTH CARE QUALITY AND HEALTH
CARE EQUITY ALSO SERVED.
FOR FIVE YEARS AS A MEMBER OF
THE CALIFORNIA DEPARTMENT OF
HEALTH SERVICES TASK FORCE ON
MULTICULTURAL HEALTH.
AS THIS COMMITTEE KNOWS THE
UNITED STATES IS MOVING AWAY
FROM A FEE FOR SERVICE.
PROGRAM IN IN WAYS THAT WE PAY
FOR HEALTHCARE IN THIS COUNTRY
TO MORE VALUE PAYMENTS AT PUT
EMPHASIS ON QUALITY AND COST.
UNFORTUNATELY MEDICAID FALLS
BEHIND IN THIS MOVEMENT TOWARDS
VALUE IN OUR HEALTHCARE SYSTEM.
AROUND THE COUNTRY AT LEAST A
DOZEN. OTHER MEDICAID PROGRAMS
AND OTHER STATES ARE MOVING
TOWARDS VALLEY BASED PAYMENTS
AND AN ADDITIONAL TEN STATES ARE
CONSIDERING OR PLANNING THAT
KIND OF MOVEMENT. I'VE BEEN
PRIVILEGED TO WORK WITH MEDICAID
PROGRAMS IN STATES LIKE OREGON
IN CONNECTICUT. IMPLEMENTING
BOTH QUALITY IMPROVEMENT AND
COST REDUCTION AS WELL AS
ADDRESSING HEALTH EQUITY.
THIS BILL AB TWENTY TO SEVENTY
FIVE WOULD MOVE CALIFORNIA'S
MEDICAID PROGRAM.
INTO THIS NATIONAL TREND.
EMPHSIZING QUALITY DISPARITIES
REDUCTION AND VALIDATES PAINS
RIGHT NOW MEDI CAL PLANTS IN
CALIFORNIA ARE ONLY HELD. TO
MEETING THE BOTTOM.
THE BOTTOM ONE QUARTER PER
PERCENTAGE OF WHERE THE NATIONAL
MEDICAID PLANS ARE.
WHAT THIS BILL WOULD DO IS SET
THAT AS A FLOOR AND ASK THOSE
MEDICAL PLANS TO INCREASE THEIR
PERFORMANCE TOWARDS AT LEAST THE
MEDIA? WHICH IS FIFTY PERCENT
AND EVEN HIGHER SO THAT IN
STATES LIKE OREGON WHICH
CURRENTLY SET PERFORMANCE LEVELS
OF SEVENTY FIVE TO NINETY
PERCENT OF THAT NATIONAL AVERAGE
WOULD BE THE PLACE THAT WE WANT
CALIFORNIA ULTIMATELY TO GO.
THIS IS RIGHT FOR AND REASONABLE
FOR OUR OUR PLANTS HERE IN
CALIFORNIA AND MORE IMPORTANTLY
IT'S THE RIGHT THING TO DO FOR
THE MEDI CAL BENEFICIARIES THAT
THOSE PLANTS SERVE.
THIS BILL WOULD ALSO ADDRESS
HEALTH EQUITY IN A WAY THAT WE.
POSITION CALIFORNIA AS A LEADER
IN TAKING CARE OF THE DIVERSE
MEDIC HELPING FISHERIES THAT ARE
SERVE PARAMEDIC HELP PLANTS.
BY COLLECTING DATA ABOUT THEIR
DIVERSE HEALTH CARE NEEDS IN
MAKING SURE THAT THESE QUALITY
IMPROVEMENTS APPLY ACROSS THE
BOARD TO ALL POPULATIONS.
INCLUDING THOSE POPULATIONS THAT
OFTEN EXPERIENCE LOCUSTS THOSE
DISPARITIES THE MOUSE.
AND FINALLY AS NOTED IT LEAVES A
LOT OF THE DETAILS OF WHICH
SPECIFIC MEASURES AND WHAT THOSE
PERFORMANCE LEVELS AND TARGETS
MIGHT BE TOO INCLUSIVE
STAKEHOLDER PROCESS WHICH IS
EMINENTLY REASONABLE. I URGE YOU
TO SUPPORT THIS BILL THANK.
THANK YOU VERY MUCH.
GOOD AFTERNOON CHAIR LINDA AWAY
WITH WESTERN CENTER ON LAW AND
POVERTY PROUD CO SPONSORS OF
THIS IMPORTANT MEASURE AND URGE
YOUR SUPPORT THANKS VERY MUCH.
OTHERS THE SUPPORT.
CAN'T DIVERT HELP OFFICERS
ASSOCIATION OF CALIFORNIANS FROM
SUPPORT PICK YOU.
ANGELINA WITH ASIAN AMERICANS
ADVANCING JUSTICE CALIFORNIA
CHUNKS PART.
KATIE ANDREW CHILDREN NOW IN
SUPPORT.
LET ME TELL YOU FROM DISTRICT
EIGHTEEN IN CHUNKS SUPPORT.
I MY LEYVA FROM DISTRICTS SIXTY
FIVE IN STRONG SUPPORT.
ON A HOUSE ABOUT WITH UNITED
WAYS AND ON BEHALF OF THE
CHILDREN'S DEFENSE FUND
CALIFORNIA CHILDREN'S
PARTNERSHIP AND UNITED WAYS IN
SUPPORT THE.
MY AND I GARCIA THAT WOMAN'S
FOUNDATION OF CALIFORNIA AND
SUPPORT.
BEEN A MENTAL THING CONSUMERS
UNION IN SUPPORT.
RAN SPENCER CALIFORNIA CABINET
FAMILY PHYSICIANS IN SPORT.
NAVNEET BEEN DAHLE AS THE AYE
YOU CALIFORNIA IN SUPPORT.
MARY VALDEZ HEALTHAXIS
CALIFORNIANS SUPPORT.
CHRIS GALIANO CALIFORNIA
IMMIGRANT POLICY CENTER IN
SUPPORT.
LEE LOW WHAT THE SOUTHEAST ASIA
RESOURCE ACTION CENTER AND STE
IN SUPPORT.
MICHELLE BARCODE THE CALIFORNIA
MEDICAL ASSOCIATION AND SUPPORT.
CHAU GIVENS AT THE COUNTY HEALTH
EXECUTIVES ASSOCIATION OF
CALIFORNIANS SUPPORT.
EGGERS ON BEHALF OF MARK DUNN'S
IN SUPPORT.
AS OUR PRESS REPRESENTING ABOUT
THE IN A COALITION FOR A HEALTHY
CALIFORNIA SUPPORT.
REBEKAH GONZALEZ MASTER NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER IN SUPPORT.
NO IT BOTTOM REPRESENTING
CALIFORNIA RURAL LEGAL
ASSISTANCE FOUNDATION. IN
SUPPORT AND ON BEHALF OF THE
HAVING HER ARE SAY COALITION IN
SUPPORT THANK YOU.
WHAT ELSE?
AND IN OPPOSITION
.
GOOD AFTERNOON MEMBERS OF THE
COMMITTEE AND JENNIFER RALLY
WITH THE CALIFORNIA ASSOCIATION
HEALTH PLANS.
WE REPRESENT A FORTY EIGHT
PUBLIC AND PRIVATE ORGANIZATIONS
ECLECTIC
COLLECTIVELY PROVIDE HEALTH CARE
COVERAGE TO TWENTY FIVE MILLION
CALIFORNIANS. AND WE
RESPECTFULLY OPPOSE AB TWO TWO
SEVEN FIVE.
WE FEEL THAT THIS IS AN
ADMINISTRATIVELY BURDENSOME AND
COSTLY BILL IS DUPLICATIVE OF
EXISTING MEDI CAL MANAGED CARE
QUALITY EFFORTS THAT ARE ENGAGED
WITH THE DEPARTMENT.
I'M THE DEPARTMENT HEALTH CARE
SERVICES HAS A. A MANAGE CARE
QUALITY AND. PROCESS THIS GROUP
MEETS AND INCLUDES A STATE CALL
A ROBUST STAKEHOLDER PROCESS TO.
IMPROVE AND MAKE CHANGES TO THE
QUALITY PROGRAM. I'M UNDER THE
CURRENT PROGRAM THE DEPARTMENT
COORDINATES A COMPREHENSIVE
REVIEW TO UPDATE THE EXISTING
QUALITY STRATUS STRATEGY
PROCESS.
THIS PROCESS ALLOWS FOR BUILDING
ON TO PRY YOUR STRATEGY. FOR YOU
EVALUATING MEDICARE MANAGED CARE
PERFORMANCE UPDATING PROGRESS
TOWARDS MEASURABLE OBJECTIVES
FOR HE AND INDICATORS.
ESTABLISHING NEW TARGETS FOR
IMPROVEMENT.
AND IF FUTURE AND INTRODUCING
FUTURE INTERVENTIONS IN
DESCRIBING CHANGES IN SERVICE
DELIVERY CONTRACTUAL STANDARDS
AND ENHANCING OVERSIGHT AND
MONITORING. OF THE MEDICARE
MANAGED CARE PLANS.
IN TWO THOUSAND SIXTEEN D. HTS
SUBMITTED OF MEDI CAL MANAGED
CARE STRIPPERS STRATEGY REPORTS
THE CENTER FOR MEDICAID MENTORS
MEDICAID SERVICES IS REQUIRED IN
THE FEDERAL MEDICAID RULE.
AND THEY RELEASED THEIR DRAFT
REPORT.
JUSTICE LAST MARCH OUT FOR
PUBLIC COMMENT. AGAIN WITH THEIR
STATE ROBUST STAKEHOLDER PROCESS
AND INDICATED THAT THEY WERE
COMMITTED TO HELPING ELIMINATE
DISPARITIES IN HEALTH CARE AND
ALIGN ITS QUALITY EFFORTS WITH.
THE CMS THE CENTERS FOR MEDICAID
AND MEDICARE SERVICES QUALITY
STRATEGY. AND THE US DEPARTMENT
OF HEALTH AND HUMAN SERVICES
ACTION PLAN TO REDUCE RACIAL AND
ETHNIC DISPARITIES.
AND SO IT'S NOT THAT MY MEMBERS
MY MEDI CAL MANAGED CARE MEMBERS
DISAGREE OF THAT THEIR NEED
IMPROVEMENTS IN THE QUALITY OF
MEDICARE OUT WE DO. MORE FULLY
COMMITTED TO MAKING THOSE
CHANGES
BUT WHEN WE LOOK AT AT AT THE
YOU KNOW NINETY FOUR PLUS YOU TO
SCORE MEASURES IN OTHER. I IN
THE CAPS SURVEY WHICH IS SET OUT
TO A YOU KNOW ENROLLEES TURF TO
MEASURE THEIR PROGRESS.
IT'S YOU KNOW IT'S AN EXISTING
PROGRAM QUARTERLY UPDATES OF OF
THAT DATA IS REPORTED ON D. H.
CSS WEBSITE. AND SO WE REALLY
AREN'T PROCESS AND WHAT WE'RE
LOOKING FORWARD TO WORKING WITH
THE AUTHOR OF THE SPONSORS ON
THIS. IS HOW TO IMPROVE WHAT'S
ALREADY THERE.
ON THE MEDI THE FINAL MEDICAID
THROUGH YOU KNOW RULE WAS
RESPONDED TO BY THE DEPARTMENT
AND. YOU KNOW PARTNERSHIP WITH
MY MEMBERS TO KIND OF ADDRESS
WHAT THE FEDERAL REQUIREMENTS
ARE.
AND SO WE'RE CONCERNED ABOUT
SOME OF THE ON.
CUTS OF THE DATA HAVE IF YOU
WILL THAT ARE REQUIRED IN THE
BILL AND AND HOW WILL THAT
INFORMATION BE PROVIDED. SOME OF
THE REQUIREMENTS ARE FOR
VOLUNTARY INFORMATION THAT
MEDICAID ENROLLEES PRESENT WHEN
THEY ENROLL FOR THE PROGRAM. AND
I'M NOT ALL THAT INFORMATION IS
TRANSLATED TO MY MEMBERS
SO WE'LL REQUIRED TO REPORT
EQUALITY SCORE BASED ON THAT.
HOW ARE WE SUPPOSED TO DO THAT I
MEAN THERE'S JUST SOME SERIOUS
CONCERNS ABOUT THE SPELL? PLAN
AND WE RESPECTFULLY ASK FOR NOW
ABOUT THANK YOU.
EROTIC YOU.
IS THERE ANYONE ELSE IN
OPPOSITION.
BRING IT BACK TO COMMITTEE FOR
QUESTIONS OR COMMENTS QUESTIONS
OR COMMENTS.
I I TRIED YOUR QUESTION BECAUSE
I I AM CONFUSED SOME BECAUSE WE
HAD ARE STAYING WAS.
THAT THERE ISN'T A ROBUST
STAKEHOLDER PROCESS.
GOING ON NOW IS THAT CORRECT.
BECAUSE WE'VE HEARD NOW THAT%
THERE IS SO ARE STANDING AT THE.
AT THE COMMITTEE IF THERE WAS
NOT IN A ROBUST TAKEOVER PROCESS
MISTER CHAIR THERE IS.
A FEEDBACK THAT THE DEPARTMENT
ELICITS FOR EIGHTY FIVE DOCUMENT
IT PURPORTS OUT ON THE THINGS TO
CONSIDER SINCE IN. QUALITY I
THINK THE PIECE THAT WE'RE.
HOPING TO CHANGE THAT THERE'S
NOT A CONCLUSION TO WHAT THOSE
EXPECT WHEN IN SETTING WHAT
THOSE.
GOALS ARE RIGHT SO THEY CAN
HAVE A DOCUMENTS A HEAR HEAR
THINGS THAT WE'RE LOOKING TO DO
THERE'S NOT CONVERSATION ABOUT
YOU KNOW SETTING WHAT THOSE
MINIMUM PERFORMANCE LEVELS ARE
WHICH ARE REALLY THE. THINGS
THAT HOLD PLANS ACCOUNTABLE TO
THEIR PERFORMANCE ARE NOT A A
ROBUST DISCUSSION ABOUT.
THE SELECTION OF PARTICULAR
MEASURES WE KNOW THAT COULD
CONSULT SOME STAKEHOLDERS BUT.
OFTENTIMES WE KNOW THAT A
CONSUMER STAKEHOLDERS OTHERS ARE
NOT IN THE ROOMS AND FOR THIS
CONVERSATION.
SO THERE IS STAKEHOLDER.
BUT IT'S NOT BECAUSE YOU KNOW WE
WOULD CONSIDER ROBUST YOU
CONSIDER ROBUST SO.
.
YOU HAVE AN ANSWER FOR THAT.
YOU KNOW I'M NOT AN EXPERT IN
THE D. H. CSS STAKEHOLDER
PROCESS I YOU KNOW DO
LEGISLATION CAP HAS REGULATORY
STAFF THAT PARTICIPATES IN THAT.
BUT IT'S MY UNDERSTANDING THAT
IF ANYBODY INCLUDING YOU KNOW
CAP OR ANY ORGANIZATION HAD A
QUESTION ABOUT THE PROCESS THE
DEPARTMENT WOULD HAVE TO TAKE A
PROBABLY REQUEST A MEETING WITH
THEM. THE STAKEHOLDER PROCESS IS
REQUIRED IT REAP REQUIRED THEIR
REPORT TO THE PUBLISHED IN MARCH
STATES THAT THEY HAVE ONE.
THAT'S I WOULD THINK THAT IF AN
ORGANIZATION AT QUESTIONS ON
WHAT THAT PROCESS WAS THAT THEY
WOULD ASK THE DEPARTMENT.
YOU HAVE A COMMENT.
I THINK THAT PERHAPS WE MAY HAVE
DIFFERENT PERSPECTIVES ON THAT.
HAVING ATTENDED SOME OF THOSE
STAKEHOLDER MEETINGS AND.
TALK TO SOME OF OUR COLLEAGUES
ABOUT THEM WE THINK THAT THERE
COULD BE IMPROVEMENT WE DO THINK
THAT FOR INSTANCE IN SELECT
SELECTING SOME OF THOSE HE JUST
MEASURES.
WE HEAR AFTER THE FACT THAT
DEPARTMENT HAS HAS DECIDED
HERE'S WHAT THEY ARE GOING TO
BE.
AND IT'S NOT LIKE THAT WE.
INHERENTLY OBJECT TO SOME OF
THE THE THE METRICS ARE CHOSEN
SOMETIMES THEY ARE THE
APPROPRIATE ONES BUT SOMETIMES.
FOR INSTANCE IN CONVERSATIONS
WITH.
OUR FRIENDS IN THE CHILDREN'S.
GROUPS.
IF THEY KNOW THAT THERE ARE
OTHER CHIP.
CHILD SPECIFIC METRICS THEY
WOULD LIKE TO BE CONSIDERED BUT
THEY'RE NOTIFIED AFTER THE FACT
YOU'RE THE ONES THAT WE'VE
CHOSEN.
SO THAT SO THAT'S WHERE THE
DISCONNECT IS HAPPENING IS
OFTENTIMES IT'S REPORTED OUT HIS
WILL BE CHOSEN
YES YOU'RE ENGAGING US BUT
YOU'RE NOT REALLY OFFERING US AN
OPPORTUNITY TO WEIGH IN ON
WHETHER. THESE MIGHT BE THE MOST
APPROPRIATE THINGS TO BE LOOKING
AT.
KIND OF.
IT AND JUST TO ADD TO THAT I
SPECIFICALLY THINKING ABOUT THE
EXTERNAL ACCOUNTABILITY SET THAT
WAS SIZE. SUBMITTED FOR COMMENT
AND AND THEN I HAVE
RECOMMENDATIONS WORK WORKS AT
DIFFERENT OF THOSE
RECOMMENDATIONS WORK DISCUSSES
PART OF THAT THE STAKEHOLDER
PROCESS AND SAID THAT
DEPARTMENT.
ON SPECIFIC TO MISS JONES POINT
ABOUT CERTAIN RECOMMENDATIONS
PARTICULARLY AROUND THE
CHILDREN'S AYE ADDING CERTAIN
METRICS WERE NOT INCLUDED AND
THERE WAS NO BUDGET. NOT A
ROBUST DISCUSSION AROUND THAT
AND SO THERE IS OPPORTUNITY TO
COMMENT BUT A WHETHER THOSE
COMMENTS ARE INCORPORATED IS A
DIFFERENT STORY.
GOOD.
IF YOU'RE A MUCH ME ANY OTHER
QUESTIONS.
OF DR EMIL WHICH OUGHT TO CLOSE
THANK YOU MISTER CHAIR.
THE STATUS QUO IS NOT ENOUGH TO
DRIVE COMPREHENSIVE QUALITY
IMPROVEMENTS AND DISPARITIES
REDUCTIONS.
AND MEANWHILE THE HEALTH OF
CALIFORNIANS RELYING ON MEDICAL
SUFFERS
AND WHY DISPARITIES IN RACE AND
ETHNICITY PROCESSED.
AB TWENTY TO SEVENTY FIVE
CLEARLY DEFINES DISPARITIES
REDUCTIONS AS A PROGRAM
OBJECTIVE AND ENSURES THAT WE
HAVE THE DATA TO MAKE EVIDENCE
BASED DECISIONS AND TO ADDRESS
THESE DISPARITIES.
I RESPECTFULLY ASK YOUR AYE
VOTE.
THANK YOU VERY MUCH.
HAD WE DO HAVE AMENDMENTS.
ARE YOU ACCEPTING OUR AMENDMENTS
YES MISTER THANK YOU VERY MUCH
SO WE HAVE A MOTION.
WE NEED A SECOND. WE HAVE A
MOTION BY MISTER OR MISS AGUILAR
KOREA'S SECOND BY MISTER BERMAN
THE MOTION IS TO PASS AS AMENDED
TO APPROPRIATIONS MADAM
SECRETARY PLEASE CALL THE ROLL.
WHAT I WOULD AYE MAYES SNOW
MAYES NO ANGER CURRY? HACKER
CURRY AYE BIGELOW. BIGELOW NO
BONTA.
BURKE.
BURKE AYE KOREA AYE CARILLO AYE
FLORA.
FLORA NO LIMON.
MCCARTY.
THIS AREA. RODRIGUEZ
SANTIAGO THURMOND. THURMOND AYE
WALDRON.
FIVE VOTES WILL PUT THAT ON CALL
AND THANK YOU VERY MUCH I WILL
GO AHEAD TO YOUR NEXT BILL. ITEM
NUMBER.
TWENTY NINE EIGHT BE NO WE DID
THAT.
NO WE DID NOT TRY AB TWENTY NINE
SIX NINE FIVE WE DID NOT DO YET.
THANK YOU.
PLEASE GO AHEAD.
I HAVE ALWAYS BELIEVED THAT
HEALTHCARE IS A HUMAN RIGHT.
IT IS BECAUSE OF THIS BELIEF
THAT I BECAME A DOCTOR.
SO THAT I COULD CARE FOR THE
RESIDENTS ALL OF THE RESIDENTS
OF MY COMMUNITY IN THE CENTRAL
SAN JOAQUIN.
VALLEY.
AS A DOCTOR I SAW THE CHALLENGES
FACING MANY CALIFORNIANS TRYING
TO GET GOOD MEDICAL CARE.
I ALSO SAW MANY OF THE
LIMITATIONS OF OUR CURRENT
HEALTHCARE SYSTEM.
PARTICULARLY THOSE MOST
VULNERABLE IN OUR COMMUNITIES.
WE KNOW THAT PEOPLE WITHOUT
INSURANCE ARE LESS LIKELY TO GET
THE MEDICAL CARE THAT THEY NEED.
THE FEDERAL INSTITUTE OF
MEDICINE PUT IT SUCCINCTLY.
UNINSURED PEOPLE ARE LESS ARE
MORE LIKELY TO RECEIVE TOO
LITTLE MEDICAL CARE AND TO
RECEIVE IT TOO LATE.
AS A RESULT.
THEY ARE SECKER AND DIE SOONER.
I HAVE SEEN THIS FIRST HAND.
I WAS ON THE FRONT LINES OF
HEALTH CARE AND FEEL THE URGENCY
TO FIX OUR CURRENT HEALTHCARE
CRISIS.
AB TWENTY NINE SIXTY FIVE SEEKS
TO EXPAND MEDICAL COVERAGE TO
INCOME ELIGIBLE UNDOCUMENTED
ADULTS.
SIMPLY PUT THIS BILL REMOVES A
BARRIER TO HELP ACCESS DUE TO
IMMIGRATION STATUS THAT THE
FEDERAL GOVERNMENT HAS UNJUSTLY
IMPOSED.
ABTWENTY NINE SIXTY FIVE WILL
BRING CALIFORNIA CLOSER TO
ENSURING THAT EVERY CALIFORNIAN
HAS COMPREHENSIVE AFFORDABLE AND
ACCESSIBLE HEALTH CARE.
IN ARE RECENTLY CONCLUDED SELECT
COMMITTEE ON HEALTH CARE
DELIVERY SYSTEMS AND UNIVERSAL
COVERAGE.
CHAIRMAN WOOD AND I CO CHAIRED
HEALTH CARE EXPERTS REITERATED
SEVERAL TIMES.
THAT THE SHORT TERM STEP TOWARD
UNIVERSAL COVERAGE IS TO WOR
WITHIN CALIFORNIANS CURRENT
FRAGMENTED FINANCING SYSTEM AND
IMPROVED COVERAGE TO EXPAND
MEDICAL COVERAGE TO THE
UNINSURED.
NEARLY SIXTY PERCENT OF
CALIFORNIANS REMAINING UNINSURED
POPULATION WHICH IS NEARLY THREE
MILLION CALIFORNIANS IS
UNDOCUMENTED.
ACCORDING TO THE UC REPORT
RELEASED AT THE END OF OUR
SELECT COMMITTEE HEARINGS.
SPENDING ELIGIBILITY FOR MEDICAL
TO THIS POPULATION
WOULD LIKELY MAKE SUBSTANTIAL
INROADS TOWARDS UNIVERSAL
COVERAGE.
OVER THE LAST YEAR WE HAD
WITNESSED THE BARRAGE OF ATTACKS
ON HEALTH CARE AT THE FEDERAL
LEVEL. INCLUDING MULTIPLE
EFFORTS TO REPEAL THE ACA AND
VARIOUS ADMINISTRATIVE ACTIONS
THAT UNDERMINE ACCESS TO CARE.
CALIFORNIA HAS WORKED TO SHIELD
OUR STATE FROM THESE ATTACKS TO
THE EXTENT POSSIBLE. AND WE MUST
CONTINUE TO CHAMPION AND LEAD
THE NATION IN BOLD AND INCLUSIVE
POLICIES THAT SUPPORT THE HEALTH
OF OUR COMMUNITIES.
DUE TO ARE UNDOCUMENTED
CALIFORNIANS BEING UNABLE TO
ACCESS HEALTH INSURANCE.
AND THE COMBATANT COMPOUNDING
FEARS AND CHILLING EFFECT
CREATED BY THE FEDERAL
GOVERNMENT.
THEIR QUALITY OF LIFE IS
NEGATIVELY IMPACTED AND
ADDITIONAL TRAUMAS ARE CREATING
AN URGENCY TO ENSURE THEY ARE
PROTECTED AND ENSURE.
INSTEAD OF BEING ABLE TO RECEIVE
CARE IN A TIMELY MANNER TO
PREVENT ILLNESSES FROM
DETERIORATING. MANY UNDOCUMENTED
CALIFORNIANS ONLY ACCESS HEALTH
CARE IN EMERGENCY ROOMS.
WHERE MANY TIMES POSITIONS LIKE
MYSELF ARE NO LONGER ABLE TO
HELP DUE TO THE EXACERBATION OF
THEIR ILLNESS?
I HAVE SEEN COUNTLESS CASES
IN MY EMERGENCY DEPARTMENT AND
THE CENTRAL VALLEY IN OUR
COUNTRY'S BREAD BASKET. WHERE
THE FARM WORKERS WHO HELPED TO
PRODUCE THE FRUITS AND
VEGETABLES THAT FILL OUR TABLES
AND FEED OUR FAMILIES ARE UNABLE
TO DO THE SAME? FOR THEIR OWN
FAMILIES DUE TO THEIR DIRE
HEALTH CIRCUMSTANCES.
NOT ONLY IS THIS CURRENT STATE
OF AFFAIRS DETRIMENTAL TO THESE
INDIVIDUALS. BUT ALSO INCREASES
THE DEMAND ON EMERGENCY ROOM
SERVICES AND INCREASES COST IN
OUR HEALTH CARE SYSTEM OVERALL
IN A MANNER THAT COULD BE
PREVENTED.
WE CAN DO BETTER.
THIS LEGISLATION BUILDS UPON THE
WORK OUR LEGISLATURE HAS DONE
WITH HEALTH FOR ALL KIDS WHICH
HAS CHECK WAS BEEN CHAMPIONED BY
SENATOR LOTT. WHO I AM PROUD TO
BE WORKING WITH THIS YEAR TO
EXPAND TO ALL LOW INCOME
UNDOCUMENTED ADULTS?
FELLOW MEMBERS.
WE INVEST IN THE HEALTH OF OUR
STATE WHEN WE INVEST IN HEALTH
COVERAGE FOR LOW INCOME
UNDOCUMENTED ADULTS.
WHO ARE A FUNDAMENTAL PART OF
OUR WORK FORCE AND OUR
COMMUNITIES
HERE TO TESTIFY IN SUPPORT IS
MARY VALDEZ WITH HEALTH ACCESS?
GLORIA CASILLAS WITH SACRAMENTO
ACT INCREASE GUY YOU KNOW WITH
THE CENTER FOR IMMIGRANT POLICY
CENTER.
WE DO HAVE TWO WITNESSES.
WHEN OF BAD OF A THING OPPOSITE
ANYTHING IMPRESSIVE COMEDIC. WE
NUMBER S. NORDIC I SEE YES
EITHER COMMONLY THOUGHT IT
BETTER THAN THE SEXY SYNCHRONOUS
A LOCAL SACRAMENTO OUT. INCLUDE
HIM AS A STINK WHEN THEY SAY
IT'S GOING TO US UNITS IT'S
GOING I THINK IT WAS BUT
UNANIMOUS. GOOD REPRESENTATIVE
SENT BY ME FROM THE NOTHING I'VE
GONE THOUGH THE SACRAMENTO.
MISTER LUCKY COMMODITY THAT THEY
SEE BECAUSE NO WAY AND USE THOSE
SIGN YOU'LL SEE AT THE MASSES IN
A BOILER PARTICULARLY I'VE IT
MEANS YOU NOTICE AND BY SINGLE
BLACK THAT THE SUBTLE BUT ALL
THE.
GOOD AFTERNOON MISTER CHAIRMAN
MEMBERS MY NAME IS LOW YES YES
COMMUNITY LEADER FOR SACRAMENTO
ACT WHOSE MEMBERS INCLUDE MORE
THAN FIFTY SIX CONGREGATIONS.
SCHOOLS NEIGHBORHOODS GROUPS
REPRESENTING SIXTY THOUSAND
FAMILIES IN SACRAMENTO COUNTY I
AM HERE AS A CALIFORNIA NOTHING
THE COMMENT
THAT'LL SEE NOT SINGLE RATTLES.
EVEN MUCH UNFAIR MOST WEIGHT IN
MICE WOMAN BUT CANNOT DENY
ACCESS OWN ACCORD THAT I THIS
AND WOULD INDICATE AT.
YOU WHAT THE NEATEST A LITTLE
MEDICAL AND THINGS IN MANASSAS
YET I THIS BOOK WHAT IS A.
BUT IT IS IMPORTANT I MEAN THE
LACK OF IT DIRECTED ME THAT THIS
AND THAT THE F. DISPOSED OF AT A
LOSS.
IT'S A REAL PROBLEM OF THE
FEDERAL.
BACK TO GET ON THE RECORD BLACK
AT THE ME NOW THE.
MAYBE SLOWLY GOT UP AND THE FOR
THAT THIS OF COURSE EUNICE
OPENLY THE GOTTA YUMMY SUMA ON
ICE BUT I'M SO THAT WOULD ADAM.
IT WOULD DO MCWETHY CBS AT THE
NEIL LOOKED OF.
UNDOCUMENTED AND UNSURE
UNINSURED CALIFORNIA'S LIVE
STICKER DIE YOUNGER BECAUSE THEY
DO NOT HAVE ACCESS TO
COMPREHENSIVE HEALTH COVERAGE.
I HAVEHAD MEDICAL INSURANCE
ONLY DURING MY PREGNANCIES.
I APPRECIATE THAT BUT
UNFORTUNATELY COVERAGE AND SIXTY
DAYS AFTER GIVING BIRTH. I HAVE
SUFFERED BASIC HEALTH PROBLEMS
WHEN MY MEDICAL COVERAGE IS
ENDED I HAVE BEEN FORCED ON
DIFFERENT OCCASIONS TO SELF
MEDICATE MYSELF WITH THE HOPE OF
BEING CURED.
ON ONE OCCASION I HAD AN
ALLERGIC REACTION I HAD HIGH
FEVER IN MY BODY WAS FULL THE
WELTS MY BABY WAS TWO MONTHS
BACK THEN. I FEEL HELPLESS
BECAUSE I COULD NOT TAKE CARE OF
MY BABY I TRIED TO SELF MEDICATE
MYSELF BUT SEEING THAT I
CONTINUED WITH THE SAME
SYMPTOMS.
I WAS FORCED TO ATTEND THE
EMERGENCY ROOM THIS WOULD BE
VERY DIFFERENT IF I HAD. IF I
HAD HAD A DOCTOR.
IT SIMPLY MEANS THAT THE MY BUT
GLOBAL FOR THE FIRST THAT I SEE
ON. BUT NOT AN INDIVIDUAL ARTIST
DINA OWN ACCOUNTS WITH THEM IN
THE CAR.
IF THE CAMPUS SO THEY WON'T JUST
GAVE US OUT.
YES THOUGH USE ANYTHING IN
PERSON IS MORE PROOF THAT THE ON
I WANT US BUT NO ONE ON THE
SMALL.
IT'S BEEN AT THOSE A BIG MACS
EMMY SMB INCOME BUT THE THE.
WE JUST A WHEN YOU GET UP AGAIN
YOU CAN BUT I THOUGH I WOULD
JUST THE THING HONEST CANCEL
FRIVOLOUS CONSEQUENCES ON THAT
THAT HE GOT. BUT NOTHING THAT
ALEXIS ALSO WITH MANY CA.
THE FEELING THAT DISTURBED ME
UP.
THE THING THAT DISTURBED ME WAS
FRUSTRATION OF NOT HAVING THE
RIGHT TO ATTEND A MEDICAL
CONSULTATION THAT THAT THE
OPPORTUNITY TO
RAISE MY CHILDREN WITH GOOD
VALUE SO THEY UNDERSTAND THAT
WHEN. ONE PERSON ASKED FOR
SOMETHING IT IS NOT JUST FOR ONE
PERSON IT'S FOR EVERYONE. THE
GOOD THAT DOES FOR ME IS THE
SHARE GOOD. MY TESTIMONY IS
SMALL COMPARED TO OTHER
TESTIMONIES THAT HAVE SUFFERED
THE CONSEQUENCES IN A TRAGIC WAY
FOR NOT HAVING ACCESS TO MEDICAL
HEALTH.
NO SESAME ASSISTANCE OF WINDOW
SETBACK IF IF THE SCHOOL CHEN
AND PUT AND DESPITE THIS PEOPLE
TO THE FOOT AND THIS PERSONA.
NO IT'S NOT GOING THAT THE NAVY
THEM EAST AFRICA WHAT GET
PERSONA.
AND I BELIEVE THAT CALIFORNIA'S
ANTI THE COMPACT UNIT THAT I WAS
JUST THAT IS REPRESENT THEM
THIS.
ISN'T THE MENTALLY AT THE STATE
CAPITOL SEVEN BY THE SET OUT
AGAIN. BECAME BOYS THAT I MAY BE
ABSOLUTE.
ALSO FREEMAN.
I MEAN THE ADULT OR THE THOUGHT
OF.
IT'S ARE LOOKING TO SEE THOMAS
BUT I THINK THAT IT'S A FITTING
INTO THE AGAIN MONTHS. IT'S A
SCHOOL BUS YOUNG.
YES BUT IT'S A GOOD COUPLE YET
BUT IT DELAY I THINK YOU KNOW
THIS A SINGLE. THAT'S YES.
OUR FAMILIES ARE SUFFERING THE
ATTACKS REMEDY OR TO AVOID IT.
THAT IS WHAT WE NEED TO
UNDERSTAND THE SUFFERING OF
SOMEONE ELSE THAT IS COMPASSION.
THIS IS WHY I SUPPORT AB TWENTY
NINE SIXTY FIVE THANK YOU.
CHRISTOPHER GAGLIANO LEGISLATIVE
ADVOCATE FROM THE CALIFORNIA
MEAN THAT POLICY CENTER PROUD CO
SPONSOR.
THE STATE OF CALIFORNIA.
MUST GET THE JOB DONE AND MAKE
SURE THAT EVERYONE IN THE STATE
IS UNSURE.
MARY VALDEZ OF HEALTHAXIS
CALIFORNIA WE ARE.
WE ARE PROUD CO SPONSORS OF
HEALTH FOR ALL WHICH WILL BRING
CALIFORNIA ONE STEP CLOSER AT
UNIVERSAL COVERAGE AND WE CAN DO
THAT TODAY WITHOUT THE NEED FOR
FEDERAL APPROVAL. A TO COVER OUR
REMAINING AND SHIRT AND FOR
THESE REASONS WERE ALSO. IN
SUPPORT AND CO SPONSOR.
VICKI VERY MUCH.
OTHERS IN SUPPORT JUST TO NAME
AND.
HIS ORGANIZATION.
YOU SALES OF THE COUNCIL ON
ISLAMIC RELATIONS CALIFORNIANS
STRONG SUPPORT PICK YOU.
ANGELINA WITH ASIAN AMERICANS
ADVANCING JUSTICE CALIFORNIANS
CHUNKS PART.
NATASHA MINSKER ACLU OF
CALIFORNIANS STRONG SUPPORT.
CHRIS RESPONSES A CHAIR OF THE
COALITION FOR HUMANE IMMIGRANT
RIGHTS REPRESENTING DIRECTLY
IMPACTED FAMILIES IN STRONG
SUPPORT.
KATIE INJURED CHILDREN NOW IN
STRONG SUPPORT.
NAVNEET BEEN DAHLE SEIU
CALIFORNIA IN SUPPORT.
MY NAME IS BRIAN A HELLUVA THIS
EVER PRESENT TODAY TO LATINO
COALITION FOR HOW TO CALIFORNIA
WE BELIEVE WE ARE ALL
CALIFORNIANS REGARDLESS OF
STATUS IN STRONG SUPPORT.
Q..
HI MY NAME'S AS A PRESS I'M HERE
REPRESENTING THAT CHILDREN'S OF
IMMIGRANT PARENTS AND TOGETHER
WE ARE ALL REPRESENTING A
CALIFORNIA AND I SUPPORT.
IF YOU.
GENTLY BUT THEN ON BEHALF OF
MALTA AFTER MEXICAN AMERICAN
LEGAL DEFENSE AND EDUCATIONAL
FUND ALSO INSTRUCTS SUPPORT PICK
YOU.
CAN REALLY TELL THE CALIFORNIA
PAN ETHNIC HEALTH ORGANS FOR.
MICHELLE BLANCO THE CALIFORNIA
MEDICAL ASSOCIATION APOLOGIES TO
THE COMMITTEE FOR NOT GETTING
OUR LETTERING ON TIME BUT WE ARE
IN SUPPORT THANK YOU.
BUT I NEVER SEE ELEMENTS
FOUNDATION OF CALIFORNIA IN
SUPPORT.
ANGELIQUE YOUR QUICK NATIONAL
ASSOCIATION OF SOCIAL WORKERS IN
STRONG SUPPORT.
THAT HE SAID HE WAS ALSO FROM
HOMES FOUNDATION IN STRONG
SUPPORT.
I MAILLET REFERENCE AND THEN A
BUILDING HEALTHY COMMUNITIES AND
STRONG SUPPORT.
THERE'S ONLY YOU ARE WITH THE
CHILDREN'S PARTNERSHIP AS WELL
WITH THE CALIFORNIA HEALTH
COVERAGE COALITION WHICH
INCLUDES UNITED WAY A CDF.
.
C. CHI UMPTEEN CHILDREN AT.
THEY'RE GARRISONED AFTERMARKET
ON TO SUPPORT.
JENNIFER ALLEY WITH CALIFORNIA
ASSOCIATION HEALTH PLANS IN
SUPPORT.
CARE.
JOANNE CAMPBELL LA KAREN
SUPPORT.
KATIE I DON'T WITH HEALTH LENT
ITS SUPPORT. THINK.
I NEARLY GOT GONZALEZ WITH
KAISER PERMANENTE IN SUPPORT.
NO I BOTTOM REPRESENTING
CALIFORNIA RURAL LEGAL
ASSISTANCE FOUNDATION NON BEHALF
OF THE HAVING OUR SAY COALITION
STRONG SUPPORT.
LEE WHAT THE SOUTHEAST ASIA
RESOURCE ACTION CENTER IN STRONG
SUPPORT.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY IN STRONG
SUPPORT.
VIDEO BORN CALIFORNIA SCHOOL
NURSES AMERICAN CARRY PEDIATRICS
AND SUPPORT.
MICHELLE EVANS OF THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA REPRESENTING LOCAL
HEALTH DEPARTMENTS IN STRONG
SUPPORT THE QUEUE.
YEAH THE BLOMQUIST WITH SMALL
BUSINESS CHARITY IN SUPPORT.
A DAVID GONZALEZ WITH AMERICA'S
PHYSICIAN GROUPS IN SUPPORT.
KELLY BROKE SOME BEHALF OF THE
SANTA CLARA COUNTY BOARD OF
SUPERVISORS AND.
YOU MUST BECOME HELP OF
CALIFORNIA FOOD POLICY ADVOCATES
IN SPORTS.
RESIDENTS ARE CALIFORNIA CATNIP
DOWN WITH PHYSICIANS IN SUPPORT.
VERY MUCH.
ANYONE ELSE.
SO ANYONE IN OPPOSITION.
SEEING NO ONE.
IT'S A VERY GOOD SIGN DR ED.
GRAY BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS.
IT PASSES BEFORE I KNOW THIS IS
THE POLICY COMMITTEE BUT THIS IS
AN INCREDIBLE COST
DO YOU WHAT KIND OF IDEA. IS IT
WOULD BE FOR THE GENERAL FUND
SOME ASSUME IT'S TO BE GENERAL
FUND COST.
FOR THAT DID TO BE ABLE TO TO
RUN THIS PROGRAM. WELL MY
UNDERSTANDING WAS THAT STILL WAS
A POLICY COMMITTEE AND NOT THERE
FISCAL SIDE OF THINGS AND.
BUT I APPRECIATE THE QUESTION
SO. LAST YEAR WHEN WE WERE
LOOKING AT HEALTH FOR ALL YOUNG
ADULTS THE PRICE TAG FOR THAT
SECTION WAS ANYWHERE BETWEEN.
FIFTY FIVE AND NINETY MILLION
AND THAT WOULD HAVE INCREASED
THE AGE FROM EIGHTEEN UP TO
TWENTY SIX.
AND I CAN SAY WITHOUT GETTING
INTO SPECIFICS THAT IT'S LESS
THAN THE SIZE OF OUR SURPLUS.
AND SOMETHING THAT WILL HAVE TO
BE DEALT WITH AS WE GO THROUGH
BOTH APPROPRIATIONS AND
DISCUSSIONS WITHIN THE
LEGISLATURE.
AND IT IS SOMETHING THAT WE MUST
ADDRESS GOING FORWARD.
OTHER QUESTIONS BECOMES A MISS
KOREA.
I THINK HEAR TO THE AUTHOR OUT
IN THE VERY POWERFUL TESTIMONY I
JUST WANNA SAY THAT REGARDLESS
OF LEGAL STATUS OR LANGUAGE.
THIS IS STILL THE PEOPLE'S HOUSE
AND WILL CONTINUE TO BE THE
PEOPLE'S HOUSE. AND SO I JUST
WANT TO THANK YOU FOR BRINGING
THIS VERY IMPORTANT PIECE OF
LEGISLATION FORWARD AS A
FORMALLY UNDOCUMENTED PERSON
MYSELF.
I UNDERSTAND HOW IMPACTFUL THIS
IS TO FAMILIES WE ALREADY HAVE A
PROGRAM THAT ENSURES
UNDOCUMENTED YOUNG PEOPLE
MINERS.
OF OUR HAD ACCESS TO GO TO THE
DOCTOR AND HAVE HEALTH INSURANCE
MUST DO EVERYTHING WE CAN TO
ENSURE THAT THE ENTIRE
POPULATION OF CALIFORNIA
REGARDLESS OF LEGAL STATUS OR
INCOME.
HAS ACCESS TO SEE A DOCTOR SO
THAT THEY'RE GETTING
PREVENTATIVE CARE.
VERSUS THE CARE THAT THEY CAN IN
THE ER ONE SOMETIMES IT IS MUCH
TOO EARLY.
THANK YOU AND I WOULD LOVE TO BE
A CO AUTHOR IF YOU PERMIT.
THE GIFT.
MR THURMAN.
THANK YOU MISTER CHAIRMAN I
THANK THE AUTHOR FOR BRINGING
THIS FORWARD AND I GUESS I WOULD
ALSO ASK THE QUESTION.
WHAT'S THE COST TO NOT TAKE THIS
ACTION AND WE HAVE KNOWN FOR
DECADES THAT. WHEN ANY
INDIVIDUAL IN THE COMMUNITY DOES
NOT HAVE ACCESS TO HEALTH CARE
THAT THAT DRIVES UP OUR COST OF
EMERGENCY ROOM CARE IN OTHER.
WAYS AND THAT.
WE HAVE AN OPPORTUNITY TO
SUPPORT AND SO YOU KNOW AS
SOMEONE WHO WAS A CO AUTHOR OF
HEALTH CARE FOR ALL KIDS AND WHO
SUPPORTED THIS LEGISLATION. WITH
SENATOR LARRY JUST LIKES ME HOW
ODD IT WOULD BE THAT WE WOULD
SAY THAT FOR FAMILY OF ONE PARTY
YOUR FAMILY WOULD HAVE ACCESS TO
HEALTH CARE. A BUT THAT'S NOT
EXTENDED TO YOUR PARENTS OR TO
YOUR FAMILY OR TO SOMEONE ELSE
AND SO THIS IS THE OPPORTUNITY
FOR US TO BE BOLD. ARE THANK YOU
FOR BRINGING THIS LEGISLATION
FORWARD I WOULD BE HONORED IF
YOU'D HAVE ME AS A CO AUTHOR
AND.
I THINK THE QUESTION THAT WE
SHOULD BE ASKING IS WHAT IS THE
COST TO NOT ACT IN THIS WAY
THANK YOU FOR BRINGING A FULL.
ANYONE ELSE.
IBM IS A CO AUTHOR.
HAPPY TO.
A BIG THANK YOU THANK YOU FOR
BRING THIS FORWARD I AM A
COAUTHOR.
PROUDLY PROUD TO BE A CO AUTHOR
ON THIS BILL AND.
I WANT TO THANK YOUR WITNESSES.
FOR THEIR TESTIMONY TODAY WITH
EVERYONE WHO CAME OUT IN SUPPORT
OF THIS BILL.
WHICH LIKE CLOSED AFTER
AMBULANCE THANK YOU MISTER CHAIR
AND MEMBERS.
HEALTHCARE IS A HUMAN RIGHT. AND
AS SUCH I HOPE WE RECOGNIZE THAT
ARE UNDOCUMENTED CALIFORNIANS
SHOULD BE TREATED WITH THE SAME
DIGNITY AND GIVEN THIS RIGHT.
I RESPECTFULLY ASK FOR YOUR AYE.
SO WE HAVE A. WE ARE WAITING FOR
A MOTION.
WE DID DID I DID I APOLOGIZE I.
DID YOU.
WE HAVE A MOTION AND A SECOND A
MOTION BY MISS A YEAR CURRY IN A
IN A SECOND EIGHT TIMES BY MR
THURMAN. BETTER SECRETARY PLEASE
CALL THE ROLL THE MOTION IS TO
PASS TO APPROPRIATIONS
WOULD I WOULD I MAYES. MAYES NO
ANCHOR CURRY. AYE GREGORY AYE
BIGELOW.
BONTA.
BURKE.
BURKE I CARILLO AYE CARILLO AYE
FLORA.
FLORA NO LIMON.
MODE AYE. MCCARTY.
THIS AREA.
RODRIGUEZ RODRIGUEZ AYE
SANTIAGO.
THURMOND THURMOND AYE WALDRON.
IF SEVEN WILL LEAVE THE BILL
LONG CALL WE STILL HAVE QUITE A
FEW MEMBERS I'M CAPS IN AT THIS
MOMENT.
YOU HAVE ONE FINAL BILL DOCTOR
ARAMBULA DIFFERENT COUNTY
CORRECTLY THAT'S CORRECT OKAY
GOOD. THAT'S THAT'S COMFORTING.
.
THE FACT THAT A COUNTY CORRECTLY
NOW THAT YOU HAVE ONE MORE BILL.
ITEM NUMBER THIRTY TWO.
MAYBE THIRTY ONE FORTY EIGHT.
GOOD AFTERNOON MISTER CHAIRMAN
COMMITTEE MEMBERS. I'M HERE
TODAY TO PRESENT A. B. THIRTY
ONE FORTY EIGHT. MY BILL TO HELP
CONSUMERS AND COVERED CALIFORNIA
BETTER AFFORD THEIR COPAYS AND
DEDUCTIBLES.
UNDER COVERED CALIFORNIA TODAY
PEOPLE WHO MAKE LESS THAN TWO
HUNDRED PERCENT OF THE FEDERAL
POVERTY LEVEL. THAT IS ABOUT
TWENTY FIVE THOUSAND DOLLARS PER
YEAR FOR AN INDIVIDUAL. GET HELP
FOR PAYING FOR THEIR COPAYS AND
DEDUCTIBLES SO THAT THE CO PAY
FOR A DOCTOR'S VISIT IS FIVE
DOLLARS OR TEN DOLLARS. AND THE
CO PAY FOR GENERIC DRUG IS THREE
DOLLARS OR FIVE DOLLARS.
BUT CONSUMERS WHO MAKE MORE THAN
TWO HUNDRED PERCENT OF POVERTY
GET LITTLE OR NO HELP PAYING FOR
COPAYS AND DEDUCTIBLES.
LOTS OF THEM BY BRONZE PLANS
WHAT THE DEDUCTIBLE OF OVER SIX
THOUSAND DOLLARS.
AND WHAT DO THEY GET FOR THIS
BRONZE COVERAGE.
THREE DOCTOR VISITS AT SEVENTY
FIVE DOLLARS OR EIGHTY DOLLARS A
VISIT AND THEN THEY PAY CASH FOR
EVERY PRESCRIPTION.
EVERY LAB TEST EVERY XRAY IN
EVERY DOCTOR VISIT AFTER THE
FIRST THREE UNTIL THEY SPEND
SIXTY THREE HUNDRED DOLLARS OUT
OF THEIR OWN POCKET.
MEMBERS WE ALL KNOW THAT ALMOST
NO ONE LIVING ON TWENTY FIVE
THOUSAND OR THIRTY THOUSAND OR
EVEN FIFTY THOUSAND A YEAR. HAS
SIX THOUSAND IN THE BANK TO
COVER THEIR MEDICAL COSTS.
WHAT THE ACADEMIC LITERATURE
SHOWS IS THAT PEOPLE WHO FACE
SUCH HUGE DEDUCTIBLES SKIP
DOCTOR VISITS?
UP THEIR PILLS IN HALF DON'T GET
THE LAB TEST THAT THEIR DOCTOR
ORDERED.
AS AN EMERGENCY ROOM PHYSICIAN I
KNOW WHAT HAPPENS WHEN PEOPLE
DON'T GET THE CARE THEY NEED TO
MANAGE THEIR DIABETES.
OR ASTHMA OR HEART DISEASE.
THEY END UP IN MY EMERGENCY
DEPARTMENT WITH AN AVOIDABLE
HEALTHCARE COST.
IN CRISIS
THEY HAVE AN ASTHMA ATTACK A
COMPLICATION OF THEIR DIABETES
OR SOME OTHER HEALTH CRISIS.
AND THAT IS WHY MY BILL TODAY IS
ABOUT. MY BILL WOULD PROVIDE
HELP TO CALIFORNIANS WHO BUY
COVERAGE AS INDIVIDUALS AND WHO
MAKE BETWEEN TWENTY FIVE
THOUSAND AND FIFTY THOUSAND
DOLLARS A YEAR.
AB THIRTY ONE FORTY EIGHT WOULD
SAY THAT THOSE WHO MAKE BETWEEN
TWENTY FIVE THOUSAND AND THIRTY
SIX THOUSAND WOULD GET AS MUCH
HELP PAYING FOR COPAYS. AND
DEDUCTIBLES AS THOSE WHO MAKE
LESS THAN TWENTY FIVE THOUSAND.
SO THEY WOULD HAVE A TEN DOLLAR
DOCTOR VISIT AND FIVE DOLLAR CO
PAY FOR GENERIC DRUG.
AND WE WOULD PROVIDE HELP TO
THOSE WHO MAKE THIRTY SIX
THOUSAND TO FIFTY THOUSAND SO
THAT THEY WOULD HAVE A TWENTY
FIVE DOLLAR DOCTOR VISIT AND A
FIFTEEN DOLLAR CO PAY FOR
GENERIC DRUGS.
MEMBERS NOBODY WHO LIVES ON LESS
THAN FIFTY THOUSAND DOLLARS A
YEAR SHOULD BE EXPECTED TO HAVE
COVERAGE WITH THE DEDUCTIBLE
OVER SIX THOUSAND DOLLARS. THAT
IS JUST WRONG AND WE CAN FIX.
THE AFFORDABLE CARE ACT HAS
HELPED MILLIONS OF CALIFORNIANS
BUT WE STILL HAVE THREE MILLION
CALIFORNIANS WHO ARE UNINSURED
AND ONE POINT TWO MILLION OF
THEM ARE INDIVIDUAL CONSUMERS.
WHO DON'T GET COVERAGE FROM
THEIR EMPLOYER AND NEED MORE
HELP PAYING THE COVERAGE?
THE THREE BILLS YOUR HEARING
TODAY MY BILL MISTER CHOOSE AND
LATER MRS FRIEDMAN'S TAKEN
TOGETHER WITH MY BILL ON
EXPANDING MEDICAL TO THE
UNDOCUMENTED. WHICH YOU JUST
HEARD GIVES CALIFORNIA A PATH
FORWARD TOWARD UNIVERSAL
COVERAGE.
WE CAN GET TO UNIVERSAL COVERAGE
HERE IN CALIFORNIA AND WITH A.
B. THIRTY ONE FORTY EIGHT AND
THE THREE OTHER BILLS I
MENTIONED AND THE POLITICAL
WELL.
WE WILL BE CLOSER TO THAT GOAL.
I HAVE WITNESSES HERE WITH ME
TODAY IT'S BETH CAPELL FROM HELP
ACCESS AS WELL AS JIM FLORIO
FROM THE WESTERN CENTER OF LAWN
PARTY.
BEST PILL ON BEHALF OF HEALTH
TEXAS CALIFORNIA WE'RE PLEASED
TO SUPPORT AND SPONSOR THIS
MEASURE THAT WOULD HELP TO
IMPROVE AFFORDABILITY IN TERMS
OF COPAYS AND DEDUCTIBLES FOR
PEOPLE IN COVERED CALIFORNIA.
AS ADVOCATES WE HAVE WORK TO
COVERED CALIFORNIA YEAR AFTER
YEAR LOOKING UP THE COST SHARING
FOR THE STANDARD COVERED
CALIFORNIA PRODUCTS.
WE I PARTICIPATED IN A VERY
COLLABORATIVE PROCESS WITH
HEALTH PLANS AND COVERED
CALIFORNIA TO DESIGN. COST
SHARING THAT IS STANDARDIZED FOR
THE COVERED CALIFORNIA PRODUCTS
WE HAVE LEARNED THE HARD WAY
THAT WHAT BRUNCH COVERAGE MEANS
IS A DEDUCTIBLE OF SIX THOUSAND
THREE HUNDRED DOLLARS.
THAT'S WHAT IT MEANS WHEN YOU
HAVE CUT TO HAVE.
COVERAGE THAT COVERS ON AVERAGE
SIXTY PERCENT THE COST OF CARE
FOR AN AVERAGE POPULATION.
IN CONTRAST MOST OF YOU WHO GET
SURE COVERAGE THROUGH A LARGE
EMPLOYER WOULD HAVE COVERAGE THE
COST COVERS NINETY PERCENT OF
THE COST OF CARE.
IT IS REALLY OF HARD TO BELIEVE
THAT THE BEST CALIFORNIA CAN DO
IS TO GIVE CALIFORNIANS WHO MAKE
LESS THAN FIFTY THOUSAND DOLLARS
A YEAR. COVERAGE WITH
DEDUCTIBLES OF OVER SIX THOUSAND
DOLLARS
AB THIRTY ONE FORTY EIGHT
PROVIDES FINANCIAL HELP SO THAT
THOSE WHO MAKE TWENTY FIVE TO
FIFTY THOUSAND DOLLARS CAN GET.
CAN HAVE MORE AFFORDABLE COPAYS
AND DEDUCTIBLES.
ALMOST MEMBERS THIS IS PART OF
GETTING TO UNIVERSAL AS DOCTOR
ARAMBULA JUST SAID ALMOST FOUR
HUNDRED THOUSAND CALIFORNIANS
WHO ARE IN THIS INCOME RANGE
REMAIN UNINSURED WE THINK IN
PART BECAUSE THE IDEA OF PAYING
PREMIUMS FOR COVERAGE. WITH A
DEDUCTIBLE OF OVER SIX THOUSAND
DOLLARS DOES NOT SEEM LIKE A
VERY GOOD CHOICE IMPROVING
AFFORDABILITY WILL IT.
INCREASE THE NUMBER OF PEOPLE
WHO ARE UNINSURED AS WELL AS
IMPROVE AFFORDABILITY FOR THOSE
WHO ARE CURRENTLY COVERED
CALIFORNIA THANK YOU.
GOOD AFTERNOON I'M JAN FLOREY
FROM THE WESTERN CENTER ON LAW
AND POVERTY AND WE'RE PROUD TO
SUPPORT AB THIRTY ONE FORTY
EIGHT.
AB THIRTY ONE FORTY EIGHT LIKE
AB TWENTY FIVE SIXTY FIVE IN AB
TWENTY FIVE FORTY NINE WOULD
HELP SMOOTH OUT SOME OF THAT
CLIPS IN ASSISTANCE FROM THE
AFFORDABLE CARE ACT.
IN PARTICULAR A. B. THIRTY ONE
FORTY EIGHT WOULD ADDRESS THE
CLIFF THAT OCCURS WHEN
ASSISTANCE FOR OUT OF POCKET
EXPENSES ALL BUT DISAPPEARS FOR
THOSE EARNING JUST OVER TWO
HUNDRED PERCENT OF THE FEDERAL
POVERTY LEVEL.
IF WE TAKE A FAMILY OF FOUR AT
JUST ABOVE TO IN A PERCENT
EFFECTS OF THE POVERTY LEVEL
HERE IN SACRAMENTO. THAT
TRANSLATES TO JUST OVER FIFTY
THOUSAND A YEAR FOR THAT FAMILY
OF FOUR JUST OVER FORTY ONE
HUNDRED A MONTH.
THEY'RE TO KIDS ON MEDI CAL
THANKS TO THE CHIP
REAUTHORIZATION SO IT'S THIRTEEN
DOLLARS A MONTH FOR EACH OF
THEIR PREMIUMS.
BECAUSE OF THE AVAILABLE PREMIUM
ASSISTANCE THE PARENTS COULD BUY
A BRONZE PLAN FOR LESS THAN A
HUNDRED A MONTH BUT THAT WOULD
LEAVE THEM WITH THE
AFOREMENTIONED DEDUCTIBLE AT
SIXTY THREE HUNDRED DOLLARS.
IF THEY INSTEAD CHOOSE A SILVER
PLAN THEY'RE PAYING ANYWHERE
FROM TWO HUNDRED TO SIX HUNDRED
A MONTH BUT THEN THEY STILL FACE
A CONSIDERABLE DEDUCTIBLE AND CO
PAY WHAT'S WHEN USING CARE.
THE DIFFERENCE IN OUT OF POCKET
EXPENSES FOR A FAMILY EARNING
JUST OVER TWO HUNDRED PERCENT OF
THE POVERTY LEVEL AS COMPARED TO
A FAMILY EARNING JUST UNDER TWO
HUNDRED PERCENT OF THE FEDERAL
POVERTY LEVEL. IS TRIPLE.
THE DEDUCTIBLE GOES FROM STE AT
SIX HUNDRED AND FIFTY TO TWENTY
TWO HUNDRED REGULAR DOCTOR
VISITS GO FROM TEN DOLLARS TO
THIRTY DOLLARS AND GENERIC DRUGS
GO FROM FIVE TO FIFTEEN.
ONCE A FAMILY STARTS EARNING
JUST OVER TWO HUNDRED AND FIFTY
PERCENT OF THE FEDERAL POVERTY
LEVEL THERE'S NO ADDITIONAL
ASSISTANCE FOR OUT OF POCKET
EXPENSES.
AND THE DEDUCTIBLE FOR SOBRE
PLAN IS TWENTY FIVE HUNDRED.
IN ORDER TO MAKE COVERAGE
AFFORDABLE THROUGH THE
AFFORDABLE CARE ACT IT NEEDS TO
BE AFFORDABLE NOT JUST TO
PURCHASE BUT AFFORDABLE TO USE.
THE FEDERAL STANDARDS OF
AFFORDABILITY MIGHT BE
APPROPRIATE IN A STATE WITH A
MUCH LOWER COST OF LIVING WHERE
A FAMILY EARNING BETWEEN TWO
HUNDRED AND FOUR HUNDRED PERCENT
OF THE POVERTY LEVEL IS SOLIDLY
MIDDLE CLASS. BUT IN CALIFORNIA
WITH THE COST OF HOUSING A LOAN
SO EXCEEDINGLY EXPENSIVE PEOPLE
NEED MORE HELP.
WITHOUT THIS HELP THEY WILL
EITHER CHOOSE A BRONZE PLAN THAT
LEAVES HIM EXPOSED WHEN THEY
ACTUALLY NEED CARE GO WITHOUT
COVERAGE OR FORGO OTHER BASIC
NEEDS.
AB THIRTY ONE FORTY EIGHT BUILDS
ON THE SYSTEM WE DO HAVE TO PUT
COVERAGE WITHIN REACH HELPS
FAMILIES WHO PURCHASE COVERAGE
TO BE ABLE TO USE IT WHEN THEY
NEED IT.
I RESPECTFULLY ASK FOR YOUR AYE
VOTE AND WE THINK THE AUTHOR FOR
HIS LEADERSHIP ON THIS ISSUE.
YOU VERY MUCH OTHERS IN SUPPORT.
CAN REALLY TELL THE CALIFORNIA
PAN ETHNIC HEALTH ORGAN SUPPORT.
GIVE.
IN A MENACING CONCERT UNION IN
SUPPORT.
Q..
I ONE TIME SCOTT FOR MEDICAL
SOCIAIS XIN UP PLEASE ACCEPT.
MISTER CHAIR APOLOGIES RIGHT IN
OUR LETTER ON TIME HOWEVER ARE.
ASSOCIATION HAS ADOPTED A
SUPPORT POSITION WE ASK FOR YOUR
VOTE THANK YOU.
BRIAN LONGER ON BEHALF OF THE
NATIONAL ALLIANCE ON MENTAL
ILLNESS CALIFORNIANS SUPPORT.
Q..
NAVNEET BEEN DAHLE FROM FBI YOU
CALIFORNIA AND SUPPORT THANK
YOU.
WHEN THE GREATEST AMERICAN LUNG
ASSOCIATION CALIFORNIANS
SUPPORT.
THANK YOU VERY MUCH
THREE ONE IN OPPOSITION.
SEEN KNOWN BRING BACK THE
COMMITTEE FOR QUESTIONS OR
COMMENTS.
IN NONE OF.
THE MOTION.
UNTIL I HEARD A SECOND PRESENT
MISS RODRIGUEZ SO WE HAVE BUSH'S
SECOND.
MISTER DOCTOR ARAMBULA WHICH I
WOULD LIKE TO CLOSE HAS ROUGHLY
OUTSOURCING ARRIVAL THANK YOU
VERY MUCH. OF THE MOTION IS DUE
PASSED TO APPROPRIATIONS MOTION
BY MISTER YEAR CURRY SECOND BY
MISTER RODRIGUEZ. AND SECRETARY
PLEASE CALL THE ROLL WOULD I
WOULD I MAYES MAYES NO HACKER
CURRY. ACKER CURRY AYE BIGELOW.
BONTA.
BURKE.
BURKE AYE CARILLO AYE CARILLO
AYE FLORA. FLORA NO LIMON.
THE ONE I MCCARTY.
THIS AREA.
RODRIGUEZ.
RODRIGUEZ I SANTIAGO.
THURMOND.
WALDRON.
IF SIX WE NEED TO DO A COUPLE
MORE.
THE THAT ON COSTS.
THANK YOU MISTER CHAIRMAN
THERE'S.
THIS WEBER OUR WE HAVE WE HAVE
HOPE BEGINNING ON THIS BURKE HAS
A WITNESS WHO NEED SICK LEAVE.
WOULD YOU BE OKAY NO.
YEAH.
WHO QUE?
THANK YOU MISS WEBER.
YOU DO GET OUR ATTENTION.
SO MISS MISS BURKE THIS WILL BE
A BE TWENTY FIVE SEVENTY NINE
CLASS.
I THINK YOU AYE MISTER CHAIR DR
WEBER AND MEMBERS.
I CALIFORNIANS HAVE MADE
SIGNIFICANT PROGRESS INSURING
OUR CHILDREN ARE COVERED WITH
ADEQUATE HEALTH INSURANCE BUT
UNFORTUNATELY OVER TWO HUNDRED
THOUSAND STILL REMAIN UNINSURED.
OF THOSE STILL ENSURE NEARLY
HALF ARE ELIGIBLE BY MEDI CAL
BUT HAVE NOT ENROLLED IN THE
PROGRAM.
WIKI IS THE SUPPLEMENTAL
NUTRITION PROGRAM FOR WOMEN
INFANTS AND CHILDREN ACCORDING
TO RESCIND RESYNC CAO WAKE
ENROLLMENT EITHER SIDE. OVER
NINETY THOUSAND WEEK CHILDREN
ARE NOT WORLD INCOME MEDI CAL
DESPITE BEING ELIGIBLE AB TWENTY
AND FIVE SEVENTY NINE
ESTABLISHES AN EXPRESS LANE
ELIGIBILITY PATHWAY. FROM WEEK
TO MEDI CAL AND WOULD ALLOW
CHILDREN APPLYING TO THE WITH
PROGRAM TO SUBMIT A SINGLE
APPLICATION TO SIMULTANEOUSLY
ATTAIN EXPRESS LANE ELIGIBILITY
FOR THE MEDICARE PROGRAM.
ADDITIONALLY THERE ARE ROUGHLY
THIRTEEN THOUSAND PREGNANT WOMEN
WHO ARE ON WEEK BUT NOT WORLD IN
MEDI CAL DESPITE THEIR
ELIGIBILITY. AB TWENTY FIVE
SEVENTY NINE ENSURES THAT
PREGNANT WOMEN ENROLLED IN WHAT
COULD BE PRESUMPTIVELY ENROLLED
INTO MEDICARE WHICH WOULD
PROVIDE TEMPORARY BUT IMMEDIATE
COVERAGE WHILE THE COMPLETE THE
APPLICATION PROCESS.
STREAMLINING APPLICATION ROWAN
PROCESS FOR MEDI CAL AND WEEK
IT'S JUST CRITICAL STRATEGY FOR
INCREASING ENROLLMENT OF
UNINSURED AND ELIGIBLE CHILDREN
AND PREGNANT WOMEN INTO THESE
PROGRAMS.
I RESPECTFULLY REQUEST YOUR AYE
VOTE AND I HAVE WITNESSES HERE
FROM CHILDREN'S PARTNERSHIP. AND
CALIFORNIA WEAK ASSOCIATION.
ACUTE DYSENTERY SINCE
TO DO SUPPORT SUPPORT MOTION AND
SECOND SO.
GREAT GOOD AFTERNOON MY NAME IS
A WRESTLING OF OUR I'M WITH THE
CHILDREN'S PARTNERSHIP BUT ALSO
ON BEHALF OF THE CALIFORNIA
CHILDREN'S HEALTH COVERAGE
COALITION WHICH IS ALSO TRUE.
SPONSORING THIS BILL.
AGAIN AS NOTED WE'VE.
GAME NINETY SEVEN PERCENT OF
CHILDREN IN COVERAGE AND SO THIS
IS A GREAT OPPORTUNITY TO USE A
PROGRAM THAT HAS BEEN REALLY
EFFECTIVE. IN STREAMLINING.
COVERAGE FOR KIDS WHO ARE
ALREADY ELIGIBLE AND SO WE
REQUEST RISE VOTE.
GOOD AFTERNOON SAY IDEAS FROM
THE CALIFORNIA WITH ASSOCIATION.
AND THE MEMBER ASSOCIATION FOR
THE EIGHTY THREE LOCAL THE CAJUN
SEASONING BUT SERVE ABOUT ONE
POINT ONE MILLION WOMEN INFANTS
AND CHILDREN EACH MONTH. AND IN
THE EARLY TWO THOUSAND CW A
PARTICIPATED IN THE INITIAL
EFFORTS TO CREATE EXPRESS LANE
ENROLLMENT FROM WHAT TO MEDI CAL
AS MANY CHILDREN WHO ARE
UNINSURED. A LOT HAS CHANGED
SINCE THEN FOR HEALTH COVERAGE
AND MORE CHILDREN ARE INSURED
AND FOR WAKING CALIFORNIA
NATIONALLY THERE'S ALSO CHANGES
ONE OF WHICH IS A DECLINE IN
PARTICIPATION. AS A CONSEQUENCE
THERE'S VARIOUS EFFORTS TO
IMPROVE PARTICIPATION ONE BEING
LINKING ELECTRONICALLY IN THE
REFERRAL AND APPLICATION PROCESS
TO OTHER FEDERAL PROGRAMS.
IT'S IMPORTANT TO RECOGNIZE THAT
THE WICK PROGRAM IS IMPLEMENTING
A NEW MANAGEMENT INFORMATION
SYSTEM OVER THE NEXT FEW YEARS
THAT WORK IS JUST BEGINNING THE
FIRST GOAL WILL BE TO TRANSITION
FROM PAPER CHECKS THE EBT CARDS.
FOR SHOPPING FOR WEEK FOODS
THAT MY A SYSTEM WILL OF COURSE
BE EXPECTED TO EVENTUALLY
PROVIDE OTHER FUNCTIONS TO
SUPPORT THE WICK PROGRAM. WHILE
THE WICK AND MY SYSTEM IS BEING
ESTABLISHED OVER THE NEXT FEW
YEARS IS AN IDEAL TIME TO
UNDERSTAND WHAT IT WILL TAKE TO
ESTABLISH THE LINKAGES.
I WITH MEDI CAL AND BEGIN THE
PROCESS TO CREATE THE LINKAGES.
THIS PROPOSAL TO INCREASE
MEDICAL ENROLLMENT BY LINKING
WITH MORE CLOSELY.
SCORE SUPPORTING BECAUSE IT
WOULD PROVIDE INFORMED
INFORMATION AND TAKE IMPORTANT
STEPS FOR EVENTUALLY CREATING BI
DIRECTIONAL LINKAGES THAT COULD
ALSO SUPPORT WITH PARTICIPATION.
YOU VERY MUCH OTHERS IN SUPPORT.
ON THE HOUSE ABOUT WITH ME
UNITED WAYS OF CALIFORNIA ALSO
ON BEHALF OF CHILDREN NOW
CHILDREN'S DEFENSE FUND THE
CHILDREN'S PARTNERSHIP A PROD CO
SPONSORS OF THIS BILL THANK YOU.
JENNIFER HOLLYWOOD CALIFORNIA
ASSOCIATION HEALTH PLANS ALSO IN
SUPPORT.
GEN FLORES WESTERN CENTER ON LAW
AND POVERTY ALSO IN SUPPORT.
Q..
JOANNE CAMPBELL LA KAREN
SUPPORT.
KITTY ANDREW CHILDREN NOW A CO
SPONSOR IN SUPPORT THANK YOU.
BRENT SPENCER WITH THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS AND SPORT.
THE MENTAL THING CONSUMERS UNION
IN SUPPORT.
AARON TAYLOR ON BEHALF OF THE
CHILDREN SPECIALTY CARE
COALITION IN SUPPORT.
ERIC HEARS MARCHING BANDS IN
SUPPORT.
CAN REALLY CHEN CALIFORNIA PAN
ETHNIC HELP THAT WORK IN
SUPPORT.
KELLY BRICKS ON BEHALF OF THE
ASSOCIATION CALIFORNIA
HEALTHCARE DISTRICT
SUPPORT.
LYDIA BORN AMERICAN KENNY
PEDIATRICS AND SUPPORT.
MARY VALDEZ OF HEALTHAXIS
CALIFORNIANS SUPPORT.
YOU VERY MUCH.
IS THERE ANYONE IN OPPOSITION.
SEEING NO ONE BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS.
SEEING NONE TYPICALLY REQUEST
NATO.
THAT WAS BURKE.
WE HAVE A MOTION.
I CAN'T MEMBER TO THE MOTION AT
THIS POINT MR MAYES A SECOND BY
MISTER RODRIGUEZ MOTION IS TO
PASS TO APPROPRIATIONS. AND
SECRETARY PLEASE CALL THE ROLL
WOULD I WOULD AYE MAYES AYE
MAYES AYE ANGER CURRY. AND HER
CURRY AYE BIGELOW.
BONTA.
BURKE.
BURKE I. CARILLO. CARILLO I
FLORA. SLUR AYE LOW MOAN.
LEVINE I MCCARTY.
NAZARIAN RODRIGUEZ RODRIGUEZ AYE
SANTIAGO.
THURMOND.
WALDRON.
THAT'S EIGHT VOTES YOU BILLS OUT
MISS MISS BIRDS.
THANK YOU VERY MUCH SO WILL LET
YOU WILL GET YOU KNOW EACH OTHER
BILL LATER A DOCTOR WEBER PLEASE
COME UP AND THANK YOU VERY MUCH
DOCTOR WEBER.
YEAH I THINK.
SELECT FIRST.
A THAT THAT'S MY CUE OKAY.
AND TODAY I HAVE THE PLEASURE OF
VISITING AB TWENTY THREE THIRTY
ONE WHICH IMPROVE THE MEDICARE
OUT REVIEW TERMINATION PROCESS
FOR INDIVIDUALS WITH
DEVELOPMENTAL DISABILITIES.
THERE ARE OVER THREE HUNDRED AND
THIRTY THOUSAND DEVELOPMENTALLY
DISABLED INDIVIDUALS LIVING IN
CALIFORNIA WHO RECEIVE SERVICES
FROM REGIONAL CENTERS.
THEY SUFFER FROM DISEASES
RANGING FROM DOWN SYNDROME TO
CEREBRAL PALSY TO A VARIETY OF
GENETIC DISEASES.
THERE OFTEN DEPENDED ON THEIR
FAMILIES FOR SUPPORT BECAUSE
THEY HAVE LITTLE OR NO INCOME OR
ASSETS.
MANY OF THEM DEPEND ON MEDICARE
OFF A RELIABLE PRIMARY AND
SPECIALTY CARE. WITHOUT STABLE
HEALTH INSURANCE THESE
INDIVIDUALS CAN EASILY WIND UP
IN THE EMERGENCY ROOM OR EVEN
HOSPITALIZED.
EVERYONE MET ON MEDICARE ALL HAS
TO GO THROUGH AN ANNUAL
ELIGIBILITY REVIEW TERMINATION
PROCESS.
DEVELOPMENTALLY DISABLED FOLKS
ARE RARELY FOUND TO BE AN
ELIGIBLE.
IF THEY TURN IN THEIR FORMS LATE
OR IF THE COUNTY GETS BACKED UP
SOMETIMES DEFICIENCIES CAN WHO
VISCOUS MEAN BENEFICIARIES CAN
LOSE CUT COVERAGE OF FOR A
PERIOD OF TIME DOING THIS RE
DETERMINATION PERIOD.
THAT MEANS NO MEDICAL REVEALS.
UNKNOWN PRIMARY CARE SURGERIES
HAVE TO BE RESCHEDULED AND FOR
MANY AND FOR ANY PROBLEM THAT
INDIVIDUAL HAS NOWHERE TO GO BUT
THE EMERGENCY ROOM.
THIS PROCESS IS BURDENSOME FOR
FAMILIES AND ULTIMATELY CREATES
MORE WORK FOR THE COUNTY.
THIS BILL WILL ALLOW COUNTIES TO
USE INFORMATION FOR THE PAST
THIRTY SIX MONTHS IN ORDER TO
MAKE ANNUAL ELIGIBILITY
DETERMINATION FOR BETTER CALVET
OF FOR MEDI CAL FOR INDIVIDUALS
WITH DEVELOPMENTAL DISAIT
DISABILITIES.
THAT WAY THE COUNTY WILL ONLY
NEED TO CONTACT INDIVIDUALS WITH
DEVELOPMENTAL DISABILITIES EVERY
THREE YEARS TO UPDATE THEIR
INCOME INFORMATION INSTEAD OF
EVERY YEAR.
THE END RESULT WILL BE A
DECREASE BIRD ON PATIENTS AND
THEIR FAMILIES.
IT HAS THE SUPPORT OF THE
ASSOCIATION OF REGIONAL CENTER
AGENCIES THE WESTERN CENTER ON
LAW AND POVERTY AND DISABILITY
IN SOCIAL SERVICE AGENCY AT. AT
A GROUP ADVOCACY GROUPS AND
THERE IS NO OPPOSITION TO THIS
BILL.
Y. WITH WITH ME TODAY IS RYAN
SECORD THE CONSTITUENT IN MY
DISTRICT WHO BROUGHT THIS IDEA
FORWARD WORKS CLOSELY WITH
DEVELOPMENTALLY DISABLED ADULTS.
POR.
THANK YOU FOR CONCERNS REPORT
WITH PEOPLE DISABILITIES.
YEAH GOOD AFTERNOON MISTER
CHAIRMAN MEMBERS OF THE
COMMITTEE MY NAME IS BRYCE YOU
CORD I'M SPEAKING IN SUPPORT OF
AB TWENTY THREE THIRTY ONE. I
WORK WITH INDIVIDUALS WITH
DEVELOPMENTAL DISABILITIES FOR
OVER THIRTY YEARS FOR THE LAST
TWENTY ONE YEARS I'VE WORKED IN
SOUTHERN SAN DIEGO WITH
INDIVIDUALS WERE PROFOUNDLY
DISABLED.
MEDICALLY FRAGILE.
I DO YOU KNOW I'D BEEN A
STRAIGHT TO THREE I SEE FDD ENDS
IN A MINUTE CARE FACILITIES FOR
THE DEVELOPMENT OF DISABLED.
THEIR STATE LICENSED.
WE CAN ALL AGREE THAT THE.
SUBJECT OF HEALTH CARE CAN BE
VERY COMPLICATED THIS IS MADE
MORE COMPLEX WE FACTOR IN THE
SPECIAL NEEDS OF THE GROUP OF%
INDIVIDUALS WHO WOULD BE
AFFECTED BY THIS PARTICULAR
PIECE OF LEGISLATION.
I I WAS KIND OF HOPING THE YOUNG
LADY WITH THE UP TEMPO WOULD
STILL BE HERE.
THIS IS WHO I WORK WITH.
AT MOTHER DESCRIBED HER TWIN WE
HAVE VERY SIMILAR PEOPLE WITHOUT
MEDICAL MEDICALLY FRAGILE AND
HEADS SPECIAL NEEDS.
CURRENTLY WHEN YOU RECEIVE A
WRIST SUBMIT AN ANNUAL
RECERTIFICATION MEDICAL YOU MUST
REMAIN UNDER THE TWO THOUSAND
DOLLAR ASSET LIMIT.
MOON THAT'S WHAT CURRENTLY
REQUIRED BY LAW.
THE ASSET LIMIT FOR PEOPLE WITH
DEVELOPMENTAL DISABILITIES WILL
SOON BE CHANGING THANKS TO THE
BETTER LIFE EXPERIENCE ACT
SPECIFICALLY IN CALIFORNIA THE
SOON TO BE I HOPE.
TO FINALIZE CAL ABLE PROGRAM
THIS ESSENTIALLY ALLOW PEOPLE
WITH DEVELOPMENTAL DISABILITIES
TO SAVE UP TO ONE HUNDRED
THOUSAND DOLLARS RATHER THAN TWO
THOUSAND DOLLARS WITHOUT
JEOPARDIZING THEIR ELIGIBILITY.
AND ADDITIONAL FACTOR MADE A
DECISION MAKING WAS THE NUMBER
OF TIMES DURING READ
DETERMINATION PROCESS THAT SOME
INDIVIDUALS TEMPORARILY LOSE
THEIR COVERAGE FOR A VARIETY OF
REASONS.
DAVID TIME BUT NOT WITHOUT
COVERAGE FROM MONTH OR MORE AS
LONG AS SIX MONTHS WE CURRENTLY
HAVE ONE INDIVIDUAL WHO HAS BEEN
IN RE DETERMINATION FOR OVER
FOUR MONTHS INTO THIS YEAR.
DR.
SO WHAT SAID TAKING PEOPLE TO
THE PHYSICIAN'S OFFICE IF THEY
DON'T HAVE COVERAGE WOULD BE
LEFT WITH I'VE HEARD
SPOKEN ABOUT MANY TIMES TODAY
WOULD THEY GO TO THE EMERGENCY
ROOM.
THAT CAN BE VERY COSTLY AND IT'S
NOT EFFICIENT.
THERE IS THAT EVENTUALLY THEY
ALL. GET READ THROUGH READ A
TERMINATION AND. THEY HAVE TO
RETROACTIVELY PAY THESE.
ACUTE CARE FACILITIES FOR THE
CARE THAT THEY COULD HAVE
AVOIDED AT THE JUST
XENA A PRIMARY POSITION.
DOCTOR WEBER STATED ABOUT
THREADED TWENTY THOUSAND
INDIVIDUALS RECEIVE THE SERVICES
THE REGIONAL CENTER.
THIS WOULD NOT HAVE THIS
WOULDN'T CHANGE NOT ONLY CHANGE
FOR THE BENEFITS FOR THE
INDIVIDUALS WERE EXPLICITLY
COVERED BUT ANYONE ELSE WHO
COUNTS ON MEDICARE I'LL BE
MAKING THE SYSTEM MORE
EFFICIENT.
THE GENERAL TAXPAYERS WOULD
SAVE MONEY BECAUSE INSTEAD OF
GOING TO EMERGENCY CARE CRITICAL
CARE THEY CAN GET ROUTINE.
PREVENTIVE MEDICAL CARE.
UNDER TITLE FORTY TO STATE WHAT
STATE LICENSED FACILITIES.
SUCH AS THE ONE THAT I
ADMINISTRATE.
ARE REQUIRED TO PROVIDE IN A
CHAIN PREVENTIVE IN GENERAL
CARE.
DURING A RECENT DEPARTMENT OF
HEALTH AND HUMAN SERVICES
LICENSING RES FOR CERTIFICATION
THIS IS THE ONLY DEFICIENCY A
SITUATION WE HAD NO CONTROL
OVER.
TO SUM IT UP DUE TO TIME
LIMITATIONS AYE MONNING IT ONLY
ABLE TO GIVE YOU A CURSORY
BICU EST Y. BELIEVE THE
PASSAGE OF THIS LEGISLATION IS
CREDIBLE.
THE FEDERAL. LEVEL FOR ACHIEVING
A BETTER LIFE EXPERIENCE ACT NOW
WE HAD BIPARTISAN SPONSORSHIP
BUT IT PASSED OVERWHELMINGLY.
BASED.
BASED ON THE RESOURCE LIMITS
CHANGED MADE FOR THIS PARTICULAR
GROUP IN THE POTENTIAL COST
SAVINGS TO US ALL BY FORTY MORE
ACUTE CARE.
AND INTERVENTIONS INCREASING
OVERALL EFFICIENCY THE SYSTEM I
URGE YOU NOT ONLY TO MOVE
FORWARD UNANIMOUSLY BUT ADVOCATE
FOR FINAL PASSAGE WITH. YOUR
FELLOW MEMBERS.
WE DON'T ALWAYS FIND COMMON
GROUND THAT WE DO WE SHOULD ACT
THANK YOU VERY MUCH FOR YOUR
TIME AND ATTENTION.
OTHERS IN SUPPORT.
GEN FLORA BEHALF OF WESTERN
CENTER ON LAW AND POVERTY IN
SUPPORT.
DANIEL SILVINO ASSOCIATION OF
REGIONAL CENTER AGENCIES
REITERATE OUR SUPPORT.
THREE THING ANDERSON WITH ARKAN
UCP CALIFORNIA COLLABORATION AND
SUPPORT.
JENNIFER ALLEY WITH THE
CALIFORNIA ASSOCIATION HEALTH
PLANS ALSO IN SUPPORT.
KATHY WITH A LOCAL HEALTH PLANS
CALIFORNIANS SUPPORT.
ANGELIQUE YORK WITH NATIONAL
ASSOCIATION OF SOCIAL WORKERS
AND STRONG SUPPORT.
KELLY BROKE SOME EFFORT THE
COUNTY WELFARE DIRECTORS
ASSOCIATION WE HAVE A SUPPORT
AND CONCEPT POSITION WE'VE BEEN
IN CONTACT WITH THE AUTHOR STAFF
WITH AN OFFER OF TECHNICAL
ASSISTANCE I MEAN LOOK FORWARD
TO UMBEL CONTINUE TO WORK ON THE
BILL THANK YOU.
MUCH IS THERE ANYONE IN
OPPOSITION.
THE KNOW HONORING AFFECT THE
COMMITTEE FOR QUESTIONS OR
COMMENTS.
I JUST WANNA SAY DON'T WEAR THIS
JUST FEELS LIKE AN ABSOLUTE NO
BRAINER I CAN'T UNDERSTAND WHY
THIS DOESN'T EXIST NOW.
SO DISTANT Y. ONE ON CONSENT
WITH US OKAY.
THERE IS A NO BRAINER.
THAT WAS MY OPINION AND SO.
OR A COMPLETE CONTROL OVER THE
CONSENT CALENDAR
SO.
BUT I LIKE THE WAY YOU THINK.
SO.
SO WE DO HAVE A MOTION BY MISTER
MAYES A SECOND BY MISTAKE HERE
CURRY THE MOTION IS TO PASS TO
DO WHICH I TO CLOSE WHY NOT WHY
NOT TO KNOW THAT A LOT OF THIS
BUSH REALLY FORMALITY. DEAL FOR
MOUNTED A LEVERAGES SIMPLY THANK
THOSE WHO CAME DAY IN THE BANK
OF MY CONSTITUENTS FROM SAN
AND REALIZING HOW OF SOME THINGS
THAT WE THINK JUST MAKES SENSE
OF DON'T EVER MAKE IT TO
SACRAMENTO AND I HE BROUGHT IT
TO OUR ATTENTION.
SURELY THOSE WHO ARE VERY.
DISABLE.
DON'T NEED TO CURRENTLY
CERTIFIED RECERTIFY THEMSELVES
BECAUSE OF THE DISABLED ANTI
LIFE.
AND THEY PROBABLY WON'T COME
INTO MILLIONS OF DOLLARS MIL
CONSTANTLY NEED TO CONDUCT HERE
AND TOO OFTEN THEY FALL BETWEEN
THE CRACKS BECAUSE THEY CAN'T
GET THE APPLICATION IN ON TIME.
OR GET SANTA WE GOT A BACKLOG IN
THEY FIND THEMSELVES IN NEED OF
MEDICAL ASSISTANCE AND SO JUST
SEEING SOMETHING THAT'S
COMPLICATES OUR LIVES
UNNECESSARILY. AND SO I REALLY
RESPECTFULLY ASK OF FOR YOU I
BUILT FOR THIS A COMMON SENSE
MATTER THANK YOU.
IF YOU VERY MUCH FOR BRINGING
THIS FORWARD THINKING SO MUCH
MA'AM SECRETARY POLICE CALL THE
ROLL WOULD I WOULD I MAYES.
MAYES I ACTOR CURRY AND YOUR
CURRY AYE BIGELOW.
BONTA.
BURKE.
BURKE I CARILLO.
CARILLO AYE FLORA.
FLORA AYE LAMONT AYE LIMON AYE
MCCARTY. MCCARTY I'M THIS AREA.
RODRIGUEZ RODRIGUEZ AYE
SANTIAGO.
THURMOND.
WALDRON.
WALDRON AYE.
TWO ZERO YOUR BILLS OUT THANK
YOU THANK YOU BUT I DON'T
REMEMBER THANK YOU FOR THINK
LIMITLESS FOR. THANK YOU
THANKS TO WITNESSES AS WELL.
THIS FRIEDMAN.
S. PREVIEW HAVE ITEM NUMBER
TWELVE AB TWENTY FOUR FIFTY
NINE.
AND ITEM NUMBER THIRTY THREE AB
THIRTY ONE SIXTY TWO.
THANK YOU MISTER CHAIR AND
MEMBERS.
OVER THE PAST YEAR ALONE THIS
COMMITTEE HAS DONE AN AMAZING
DEAL OF WORK TO EXAMINE IT
BECAUSE IT ADDRESS GAPS IN
HEALTHCARE COVERAGE FOR
CALIFORNIANS.
AS YOU KNOW ALL TOO WELL ONE OF
THE BIGGEST BARRIERS FOR
INDIVIDUALS AND FAMILIES SEEKING
TO OBTAIN AND MAINTAIN HEALTH
CARE COVERAGE IS AFFORDABILITY.
TO COVER CALIFORNIA WE HAVE TAX
CREDITS IN PLACE TO HELP COVER
THE COST OF PREMIUMS FOR THOSE
MAKING LESS THAN FOUR HUNDRED
PERCENT OF THE FEDERAL POVERTY
LEVEL LIMIT. FOR FPL HOWEVER FOR
INDIVIDUALS AND FAMILIES WHO
INCOMES
SEAT FOUR HUNDRED PERCENT OF THE
FPL THERE ON THEIR OWN.
KEEP IN MIND FOUR HUNDRED
PERCENT OF THE FPL IS FIFTY
THOUSAND DOLLARS FOR AN
INDIVIDUAL.
AB TWENTY FOUR FIFTY NINE
CREATES A REFUNDABLE TAX CREDIT
FOR THOSE OVER THE FOUR HUNDRED
PERCENT FPL TO HELP PAY THE
PREMIUM FOR BRONZE LEVEL PLAN.
AT THE BRONZE LEVEL PLAN LEVEL
IF THEY WANNA IT MORE EXPENSIVE
PLAN THEY PAY THE GAP IN
COVERAGE.
THE CREDIT IS EQUAL TO THE COST
OF HEALTH INSURANCE PREMIUMS FOR
THE LOWEST COST BROADS PLAN FOR
THE INDIVIDUAL BUT IT AT THAT
EXCEEDS EIGHT PERCENT OF THEIR
MODIFIED ADJUSTED GROSS INCOME.
ESSENTIALLY THE BILL ENSURES
THAT NO CALIFORNIANS SPENDS MORE
THAN A PERCENT OF THEIR INCOME.
FOR BASIC HEALTH CARE COVERAGE.
TOO ANY OF OUR CONSTITUENTS ARE
FACING THE IMPOSSIBLE CHOICE A
PAPER HOUSING TRANSPORTATION
GROCERIES UTILITIES OR BUYING
HEALTH INSURANCE.
THE RESEARCH IS CLEAR IMPROVING
AFFORDABILITY WILL INCREASE
ENROLLMENT AND MOVE US CLOSER TO
UNIVERSAL COVERAGE.
AB TWENTY FOUR FIFTY NINE HAS A
BROAD COALITION OF SUPPORT THERE
WAS NO OPPOSITION AND REQUEST
RELIEF REQUEST AN AYE VOTE.
THANK YOU.
BETH CAPELL ON BEHALF HEALTH
TAXES CALIFORNIA WE'RE PLEASED
TO SPONSOR AND SUPPORT THIS
MEASURE. WHICH BUILDS ON THE
AFFORDABLE CARE ACT BY CAPPING
PREMIUMS AT EIGHT PERCENT OF
INCOME FOR THOSE OVER FOUR
HUNDRED PERCENT OF POVERTY.
TODAY IN EVERY REGION IN
CALIFORNIA SOMEONE IN THEIR
FORTIES ORFIFTIES WHO BUYS
THEIR OWN COVERAGE MAKES JUST
OVER FIFTY THOUSAND DOLLARS WILL
SPEND MORE THAN EIGHT PERCENT OF
THEIR INCOME ON PREMIUMS.
A MARRIED COUPLE IN THEIR
TWENTIES.
WHAT WHO MAKES OVER SIXTY FIVE
THOUSAND DOLLARS WOULD SPEND
OVER EIGHT PERCENT OF THEIR
INCOME ON PREMIUMS
FOR THAT REASON WE'RE PLEASED TO
SPORT SUPPORT THIS BILL INTO
SPONSOR AND APPRECIATE THE?
UP BY PERSON MOTION THANK YOU.
Q. AND THE WITNESSES.
MARK COVER WITH A SMALL BUSINESS
MAJORITY AT THE FAIR OPPORTUNITY
TO TESTIFY WE ARE A NATIONAL
SMALL BUSINESS EDUCATION AND
ADVOCACY ORGANIZATION. AND WE
REALLY BELIEVE THAT
ENTREPRENEURS AND SMALL
EMPLOYERS ARE CENTRAL TO HEALTHY
THRIVING LOCAL COMMUNITIES. OVER
THE PAST SIX YEARS THE ACA HAS
PROVIDED HEALTH CARE TO MILLIONS
MANY OF WHOM WORK FOR SMALL
EMPLOYERS OR ARE THEMSELVES
SMALL BUSINESS OWNERS OR SELF
EMPLOYED. PART A CA SMALL
BUSINESSES AND THEIR EMPLOYEES
COMPRISE A DISPROPORTIONATE
SHARE OF THE WORKING ON AND
SHARE IN THE AC HAS BEEN
PARTICULARLY IMPORTANT. FOR
CALIFORNIA SELF EMPLOYED
ENTREPRENEURS ROUGHLY THREE
HUNDRED AND SEVENTY THOUSAND
SELF EMPLOYED ENTREPRENEURS GET
THEIR INSURANCE THROUGH THE
COVER CALIFORNIA INDIVIDUAL
MARKETPLACE. AND ACCORDING TO
THE U. S. SMALL BUSINESS
ADMINISTRATION THE MEDIAN
INCOME.
IN CALIFORNIA FOR SELF EMPLOYED
INDIVIDUAL WITH AN INCORPORATED
BUSINESS WAS FIFTY SIX THOUSAND
DOLLARS HERE WHICH WOULD LIKELY
PUT THEM JUST ABOVE THAT CUT OFF
A TO RECEIVE INSURANCE I
INSURANCE PREMIUM ASSISTANCE.
SO AFFORDABILITY CONTINUES TO BE
AN ISSUE FOR SMALL EMPLOYERS AND
FOR ENTREPRENEURS AND AB TWENTY
FIVE TO TWENTY FOUR FIFTY NINE
WOULD ALSO PROMOTE MORE ROBUST
SMALL BUSINESS ECONOMY BY
REDUCING JOB LOCK. ALLOWING
WORKERS WHO PREVIOUSLY FELT TIED
TO THEIR JOB BY A LARGE EMPLOYER
BENEFITS PACKAGE TO STRIKE OUT
ON THEIR OWN OPERA NO PATH OR
JOIN A THRIVING SMALL BUSINESS.
WELL JOB LUCK HAS BEEN REDUCED
UNDER THE ACA THERE REMAINS A
CRITICAL ISSUE IT IS INSURANCE
IS STILL ON AFFORDABLE. WITH
MORE INCREASING AFFORDABILITY
WILL MAKE SMALL BUSINESSES MORE
COMPETITIVE WHEN THEY'RE SEEKING
TO HIRE TALENT.
ROUGHLY HALF OF CALIFORNIA'S
PRIVATE SECTOR EMPLOYEES WORK
FOR SMALL BUSINESSES
AND SMALL BUSINESSES HAVE
CREATED ROUGHLY TWO THIRDS OF
ALL THE NEW JOBS SINCE THE GREAT
RECESSION. AND THE SMALLEST
BUSINESSES THE ONE THAT HAVE
BETWEEN ONE AND FOUR EMPLOYEES
HERE IN CALIFORNIA ARE FROM OUR
CREATING MOST OF THOSE NEW JOBS.
SO IS THE SMALL FIRMS THAT ARE
MOST LIKELY TO BE UNABLE TO
AFFORD OR OFFER EMPLOYER
SPONSORED HEALTH INSURANCE SO BY
EXPLAINING AFFORDABILITY IN OF
MARKETPLACE COVERAGE. WE CAN
SHARE MORE WORKERS OF THE
SMALLEST FIRMS CAN GAIN ACCESS
TO AFFORDABLE COVERAGE IN
ADDITION TO ENSURING THAT THOSE.
THE EMPLOYERS THEMSELVES CAN
ALSO AFFORD.
AFFORD A INSURANCE TO
CALIFORNIA SMALL BUSINESSES LOOK
FORWARD TO THE DAY WHEN ONE'S
EMPLOYMENT AND INCOME STATUS A
DOESN'T THE GOVERNOR ACCESS TO
QUALITY AFFORDABLE CARE TO
CONTINUE THE PROGRESS UNDER THE
ACA WE URGE YOU TO SUPPORT
TWENTY FOUR FIFTY NINE TO MAKE
HEALTH CARE EVEN MORE
AFFORDABLE.
GREAT THANK YOU SO MUCH.
PARDEE A MOTION AND A SECOND
BUT.
ANY OTHER ADDITIONS ADDITIONAL
WITNESSES IN SUPPORT.
WHEN THE GREATEST AMERICAN LUNG
ASSOCIATION CALIFORNIANS
SUPPORT.
CHRIS KILEY ON OPEN THE
CALIFORNIA IMMIGRANT POLICY
CENTER IN SUPPORT.
IN A MENACING CONSUMERS UNION IN
SUPPORT.
BUT SHALL BACO AT THE CALIFORNIA
MEDICAL ASSOCIATION APOLOGIES
AGAIN FOR MISSING THE LETTER
DEADLINE WE ARE IN SUPPORT.
ANGELIQUE ARE WITH NATIONAL
ASSOCIATION OF SOCIAL WORKERS
AND SUPPORT.
A FURTHER WITNESSES IN SUPPORT.
ALRIGHT ANY. WITNESSES IN
OPPOSITION.
SAYING NOW COME BACK TO MEMBER
QUESTIONS YES
SOME OF THE RIVER WATER THINK
MRS CHAIR.
.
JUST QUICKLY.
WILL WE BE SUBSIDIZING SOMEONE
WHO WANTS TO PURCHASE A PLATINUM
LEVEL. PLAN WITH THE CREDIT THE
WAY IT WOULD WORK IS THAT THEY
WOULDN'T HAVE TO PAY MORE THAN
EIGHT PERCENT OF WHAT THE BRONZE
LEVEL WOULD BE IF THEY WANT TO
PURCHASE ADDITIONAL INSURANCE
AND PAY MORE TO GET THE PLATINUM
LEVEL FOR THEIR FAMILY. WE
SHOULD ENCOURAGE THEM TO DO
THAT.
SO FOR SOME PEOPLE IT THERE.
WANT TO BE ABLE TO USE MORE
COVERAGE THAT WOULD BE AN OPTION
FOR THEM THAT WE WOULD MAKE
SENSE OKAY.
AND THEN I I HAD BEEN WONDERING
ABOUT THE SMALL BUSINESS OF
MAJORITY THE SMALL BUSINESSES
BEING IMPACTED BUT WHEN YOU
SPOKE IT TOTALLY MAKES SENSE
BECAUSE. I'M ON THE SMALL
BUSINESS FOR TWENTY FIVE YEARS
AND THAT'S ALWAYS BEEN AN ISSUE
I MEAN IF I DIDN'T HAVE ANOTHER
JOB OR YOU KNOW MY HUSBAND AT
SOME POINT.
I DON'T SEE HOW WE COULD HAVE
AFFORDED IT.
SO THAT ANSWERS THAT QUESTION
AND I COMMEND THEY ALSO FOR
BRINGING THIS FORWARD BECAUSE.
YOU KNOW HAVING SERVED ON THE
UNIVERSAL CARE A SELECT
COMMITTEE.
ONE OF THE ISSUES WAS WHEN YOU
LOOK AT THE FOLKS WHO ARE NOT
INSURED Y. AND SOME OF THEM
ACTUALLY MAKE ENOUGH WITH ME. TO
MEET THEIR ABOVE THE LIMITS BUT
ONCE AGAIN IT'S STILL MUCH MORE
PERCENT OF THEIR INCOME THAT
THEY WOULD HAVE TO SPEND SO THEY
OPT NOT TO BE INSURED. AND THIS.
THIS DIRECTLY GOES TO SOME OF
THAT ISSUE WHICH HELPS WITH SOME
IMPROVING COVERAGE RATES SO.
THANK YOU.
THE MOTION IS TO PASS REVENUE
THAT ROBIN TAXES ANY FOR THE
QUESTIONS OR COMMENTS.
SEEING NONE WE HAVE A MOTION TO
RECALL PLEASE.
IF YOU WANT TO CLOSE KNOW NNOVA
CHINA MOVES ALONG AND. THAT'S A
CLOSE THANK YOU VERY MUCH.
WOULD.
MAYES I MAYES I AGREE AND YOUR
CURRY AYE BIGELOW.
BIGELOW AYE BONTA.
BURKE
BURKE I CARILLO.
BURKE NOT VOTING.
CARILLO.
CARILLO AYE FLORA.
FLORA I LOW MOAN. LIMON AYE
MCCARTY. MCCARTY AYE NAZARIAN.
RODRIGUEZ RODRIGUEZ AYE
SANTIAGO.
THEREIN. THEREIN I WALDRON.
WALDRON AYE.
THANK YOU.
UP NEXT THE.
FILE THIRTY THREE ASSEMBLY BILL
THIRTY ONE SIXTY TWO IT WAS TEN
ZERO.
THANK YOU SHIFTING GEARS A
LITTLE CHAIR COMMITTEE MEMBERS
I'D LIKE TO ACCEPT THE PROPOSED
COMMITTEE AMENDMENTS REGARDING
THE OVER CONCENTRATION AND
PENALTIES ON PAGE EIGHT AND NINE
OF THE ANALYSIS AS AN AUTHOR'S
MOMENTS.
I WANT TO THANK THE COMMITTEE
STOP WORKING WITH MY OFFICE.
AB THIRTY ONE SIXTY TWO IS A
TECHNICAL CLEAN UP BILL TO HELP
THE DEPARTMENT OF HEALTH CARE
SERVICES MORE EFFECTIVELY
ADMINISTER AND MANAGE THE STATE
ISSUANCE OF LICENSES FOR
RESIDENTIAL ALCOHOL AND DRUG
TREATMENT FACILITIES. WITH THE
CAPACITY OF SIXTY LESS PERSONS.
EXISTING LAW YOU WANT ME TO GIVE
YOU THE SHORT VERSION YES PLEASE
OKAY THANK YOU. OF THE SORT
SHORT VERSION IS THAT THE SEEKS
TO BETTER LICENSE THOSE
FACILITIES IT OUT ADDRESSES SOME
OVER CONCENTRATION ISSUES WHERE
THERE ARE LOOPHOLES IN THE LAW
THAT ALLOW FOR. THESE FACILITIES
TO INSTEAD OF OPERATING AS
RESIDENTIAL FACILITIES TO
BASICALLY BECOME COMPOUNDS ARE
MANY HOSPITALS IN THE MIDDLE OF
RESIDENTIAL NEIGHBORHOODS.
SO WE ARE TRYING TO A.
MAKE SURE THAT DOESN'T DOESN'T
HAPPEN ANYMORE AND I WILL
INTRODUCE ARE MY WITNESSES HERE.
FORMER PRESIDENT OF CONTRACT
CITIES AND COUNCILMEMBER LULA
MANTE FROM THE CITY OF MALIBU
AND HELEN MEASURE WITH
CALIFORNIA ASSOCIATION OF
ALCOHOL AND DRUG PROGRAM
EXECUTIVES.
IN LIGHT OF THE LATE HOUR AS
WELL VERY QUICKLY CAN BE VERY
BRIEF AND OTHER SOME OPPOSITION
TO THIS BUT.
WILL COME BACK FOR MEMBERS
COMMENTS OR QUESTIONS.
NOW FOR.
HOUSE. THANK YOU. ARE MY NAME IS
LAMONT I AM A COUNCIL MEMBER OF
THE CITY IN MALIBU AND THE
IMMEDIATE PAST PRESIDENT
CALIFORNIA CONTRACTS CITIES.
REPRESENT EIGHTY CITIES
THROUGHOUT CALIFORNIA. AND
ADDITION TO THE ASSOCIATION OF
ORANGE OF A CALIFORNIA CITIES
ORANGE COUNTY ANOTHER THIRTY
CITIES AND THE ALMOST FIVE
HUNDRED CITIES OF THE LEAGUE OF
CALIFORNIA CITIES.
JUST AS PART OF THE STRONG
SUPPORT FOR A BI THREE ONE SIX
TWO.
THE STATE LICENSE RESIDENTIAL
ALCOHOL AND DRUG ABUSE TREATMENT
FACILITIES WITH CAPACITIES OF
SIX OR LESS PERSONS. ARE
IMPORTANT TREATMENT MODEL THAT
ENABLES PATIENT TO BE INTEGRATED
INTO COMMUNITIES THROUGHOUT THE
STATE.
THE INTENT OF THE SIX BUT
LICENSE VILLAGE PROVIDING
RESIDENTIAL THERAPEUTIC
ENVIRONMENT FOR SOCIAL
INTEGRATION.
TO BENEFIT PEOPLE WITH
DISABILITIES.
A REHABILITATION FACILITY WITH
SIX BETTER TO SINGLE FAMILY HOME
IS WELCOME IN ANY COMMUNITY.
IT'S GOOD FOR THE NEIGHBORHOOD
IT'S GOOD FOR THE COMMUNITY IT'S
GOOD FOR MORE THAN ANYTHING ELSE
THE PATIENTS THAT ARE TRYING SO
HARD TO RECOVER.
AND AS ASSEMBLY MEMBER FRIEDMAN
STATED UNDER EXISTING
REGULATIONS RESIDENTIAL
LICENSES.
DO NOT REQUIRE THAT SERVICES
PERMITTED UNDER THE RESIDENTIAL
LICENSE ARE PROVIDED SOLELY AT
THE LOCATION WHERE THE STATE
LICENSES ISSUED.
SOME OPERATORS HAVE EXPLOITED
THIS LEUPOLD DEVELOPING MULTI
STRUCTURE CAMPUS LIKE FACILITIES
THAT OVERWHELM THE
INFRASTRUCTURE OF NEIGHBORHOODS.
AND HINDER THE ABILITY FOR
PATIENTS TO EXPERIENCE THE.
NEIGHBORHOOD ENVIRONMENT NEEDED
TO SUCCESSFULLY REINTEGRATE INTO
COMMUNITIES.
AB THREE ONE SIX TO REFORM SHE'S
OUTDATED REGULATIONS FOR THE
LICENSING OF RESIDENTIAL DRUG
AND ALCOHOL TREATMENT
FACILITIES.
TO ENABLE THE DEPARTMENT OF
HEALTH CARE SERVICES TO DO THEIR
JOB.
THIS A TECHNICAL CLEAN UP BILL
TO HELP THE DEPARTMENT TO THEIR
JOB AND TO EFFECTIVELY
ADMINISTER AND MANAGE THE STATE
ISSUANCE OF LICENSES.
THIS BILL IS THE RIGHT THING TO
DO FOR ALL THE COMMUNITIES THAT
WE ALL REPRESENT AND MORE
IMPORTANTLY FOR THE PATIENTS
THAT ARE TRYING TO RECOVER.
SO MUCH
MISTER CHAIRMAN MEMBERS HAULING
MEASURE BE UP TO THE CALIFORNIA
ASSOCIATION OF ALCOHOL DRUG
PROGRAM EXECUTIVES WE ARE THE
STATEWIDE ASSOCIATION OF
COMMUNITY BASED FREESTANDING US
SUBSTANCE USE TREATMENT PROGRAMS
THROUGHOUT THE STATE. I'VE WHO
WE HAVE.
WE SUPPORT A. B..
THIRTY ONE SIXTY TWO AND WE
HAVE LONG ADVOCATED FOR HIGHER
STANDARDS AND QUALITY SERVICE A.
B. THIRTY ONE SIXTY TWO DOES
THIS.
WE SUPPORT THE BILL BECAUSE OF
ITS IT UP
PORTANTINO WORK OF WORKING
TOWARD A LONG STANDING SOLUTION.
OUR SOLUTION TO A LONG STANDING
DISAGREEMENT SAT THAT HAVE BEEN.
OUT THERE AND.
WE.
.
LOOK FORWARD TO THIS BILL TO.
AGAIN.
HELP US WITH.
OF A STRONGER OVERSIGHT FROM
THE DEPARTMENT AND.
TO OF BALANCE OUT OF THE NEEDS
OF.
SUBSTANCE USE TREATMENT
PROVIDERS AS WELL AS COMMUNITIES
FOR UP FOR EVERYBODY TO BE GOOD
NEIGHBORS THANK YOU GREAT THANK
YOU SO MUCH ADDITIONAL WITNESSES
IN SUPPORT MISTER CHAIRMAN DAVID
JOHNSON BEHALF THE CITY OF SAN
MARCOS. HAVE ALSO BEEN ASKED TO.
OF REITERATE THE SUPPORT THE
LEAD CALIFORNIA CITIES BECAUSE
THEY'RE TIED UP ACROSS THE LAKE
GREAT THANK YOU.
AMY BROWN IN BEHALF OF THE CITY
OF RIVERSIDE IN SUPPORT. GREAT
THANK YOU.
ANY FURTHER.
ARE ANY WITNESSES IN OPPOSITION.
I TOM RENT FREE WITH THE COUNTY
BE ABLE HEALTH DIRECTORS
ASSOCIATION WE HADN'T OPPOSE ON
THE BILL A BECAUSE OF THE.
LANGUAGE.
DENYING THAT LICENSE BASED ON
OVER CONCENTRATION BUT IT SOUNDS
LIKE THE AMENDMENTS MAY HAVE
TAKEN CARE ABOUT PROBLEMS SO. AS
THAT'S THE CASE WE WE WOULD NO
LONGER BE A POST
A GREAT ANY FURTHER. WITNESSES
IN OPPOSITION MISTER CHAIRMAN
WAS TO MADDEN REPS N THE
CALIFORNIA CHAPTER THE AMERICAN
COLLEGE OF EMERGENCY PHYSICIANS
WERE IN THE SAME POSITION WHERE
OPPOSE LOS MANDATE WITH THE
AMENDMENTS WE ARE REMOVING
OPPOSITION. THANK YOU GREAT
FANTASTIC NOT SEEN ANY ANY
MEMBER QUESTIONS OR COMMENTS.
SO WE DO HAVE A MOTION AND A
SECOND. TO SECOND. SECOND AND.
MISS FRIEDMAN WOULD YOU LIKE TO
CLOSER TO CLARIFY THE AMENDMENTS
DID I ACTUALLY DO AS THEY SAID
AND SO WE WILL TAKE THEIR
TESTIMONY AS A SUPPORT POSITION.
THANK YOU SO MUCH SO THE MOTION
IS A DO PASS AS AMENDED TO
APPROPRIATIONS.
PLEASE CALL THE ROLL.
WOULD.
MAYES AYE MAYES AYE AGAR CURRY.
BIGELOW.
BIGELOW AYE BONTA.
BURKE. BURKE AYE CARILLO.
CARILLO AYE FLORA.
FLORA I LOW MOAN. MOAN I
MCCARTY.
MCCARTY AYE THIS AREA.
RODRIGUEZ RODRIGUEZ AYE
SANTIAGO.
THURMAN. THURMOND AYE WALDRON
WALDRON AYE.
TEN ZERO TWO BILLS OUT THANK YOU
WALTER.
THIS ISSUE YOUR.
SO IS THIS A.
ITEM.
.
SO AB TWENTY FIVE SIXTY FIVE
THAT CORRECT THAT IS CORRECT.
YEAH.
GIVEN THE ARE THE DAY THE THIRTY
FOR BILLS YOU HAVE THIS AS A
GREAT BILL FOR THE HEALTH OF
CALIFORNIANS I RESPECTFULLY ASK
YOUR AYE SUPPORT.
AB TWENTY FIVE SIXTY FIVE WOULD
IMPROVE AFFORDABILITY FOR LOW TO
MODERATE INCOME CALIFORNIANS
PURCHASING HEALTH INSURANCE
THROUGH COVER CALIFORNIA.
WHILE THE ACA HAS MADE GREAT
STRIDES IN HELPING CONSUMERS.
THANK YOU OF EXTREMELY BRIEF.
CURRENTLY ONE POINT TWO MILLION
CALIFORNIANS GET AFFORDABILITY
HEALTH WITH THEIR MONTHLY
PREMIUMS. YET OVER SEVEN HUNDRED
THOUSAND CALIFORNIANS UNDER FOUR
HUNDRED PERCENT OF THE FEDERAL
POVERTY LEVEL REMAIN.
UNDER IN UNINSURED DESPITE
EXTENSIVE OUTREACH BY COVER
CALIFORNIA.
FOR EXAMPLE AN INDIVIDUAL WHO
MAKES THREE THOUSAND DOLLARS A
MONTH IS EXPECTED TO SPEND THREE
HUNDRED DOLLARS A MONTH ON
PREMIUMS.
WE KNOW THAT APPROVING
AFFORDABILITY WILL INCREASE TAKE
UP OF COVERAGE SAID THIS BILL
CAPS WHAT PEOPLE WOULD PAY
ACROSS THE INCOME SCALE OF A
HUNDRED AND THIRTY EIGHT
PERCENT.
A FOUR HUNDRED PERCENT OF THE
FEDERAL POVERTY LEVEL SO THAT
CONSUMERS WOULD PAY NO MORE THAN
EIGHT PERCENT OF THEIR INCOME ON
THEIR MONTHLY PREMIUMS. WITH
THAT I WILL TURN TO HEALTH
ACCESS AND WESTERN.
DR SPOCK THINKING THAT YOU AND
IN LIGHT OF THE LATE HOUR AND I
SEE LOTS OF WORDS ON YOUR PAGES
UNDER PAPER THERE WOULD JUST
KEEP IT A LITTLE BIT THE LOOK
LITTLE QUICKER IF YOU CAN'T.
THE LETTER TO MISTER CHAIR BETH
CAPELL ON BEHALF OF HEALTHAXIS
CALIFORNIA PLEASED TO BE HERE IN
SUPPORT AS A SPONSOR OF THE
MEASURE. THIS WOULD LOWER
PREMIUMS COVERED CALIFORNIA
TODAY THEY ARE RANGE FROM TWO
PERCENT TO ALMOST TEN PERCENT OF
INCOME IT WOULD LOWER THEM FOR
THE. FOR THOSE AT THE LOWEST END
OF THE INCOME SALE TWO ZERO
PERCENT OF INCOME JUST AS WE
HAVE IN MEDI CAL UP TO EIGHT
PERCENT AS MR CHIU SATIN WITH
THAT WE'RE PLEASED TO BE IN
SUPPORT.
GOOD AFTERNOON OR EVENING JAN
FOURTH WESTERN CENTER ON LAW AND
POVERTY.
AB TWENTY FIVE SIXTY FIVE IT
ALLOWS FOR ADDITIONAL PREMIUM
ASSISTANCE THERE'S TWO MAIN
GROUPS OF PEOPLE THAT THIS IS
HELPING.
ONE PEOPLE ARE SOMETIMES
SURPRISED TO HEAR THAT THERE ARE
PEOPLE BELOW ONE HUNDRED AND
THIRTY EIGHT PERCENT OF THE
FEDERAL POVERTY LEVEL WHICH IS
THE MEDI CAL CUT OFF. ON COVERED
CALIFORNIA THERE'S ABOUT THIRTY
FIVE THOUSAND OF THEM THESE ARE
PEOPLE WHO ARE EITHER THERE
LAWFULLY PRESENT IMMIGRANTS BUT
BECAUSE OF A TECHNICALITY THEY
CAN'T GET ON MEDI CAL BUT THEY
CAN'T PURCHASE COVER CALIFORNIA
COVERAGE. AND ANOTHER GROUP OF
PEOPLE IS PEOPLE WHO ARE OVER
AGE SIXTY FIVE BUT THEY'RE NOT
ELIGIBLE FOR MEDICARE BECAUSE
THEY DON'T HAVE THEIR FORTY
QUARTERS AND THEY'RE NOT
ELIGIBLE FOR MEDICARE BECAUSE
THEY DON'T MEET. THEY GO OVER
THE ASSETS TEST
SO THEY'RE STUCK WITH NOTHING.
THE ACID TEST IS JUST TWO
THOUSAND DOLLARS SO AND AT THAT
AGE AT AGE SIXTY FIVE YOU CAN'T
REASONABLY PURCHASE UP COVERAGE
ON YOUR OWN SO THOSE PEOPLE ARE
ALSO UNCOVERED CALIFORNIA. THE
OTHER GROUP OF PEOPLE THAT THIS
HELPS PEOPLE WHO ARE ALREADY
ELIGIBLE FOR COVERAGE CALIFORNIA
BUT THEY NEED A BIT OF
ASSISTANCE.
TO KEEP PURCHASING COVER
CALIFORNIA WHEN YOU MOVE FROM
MEDICAID OUT TO COVER CALIFORNIA
YOU GO FROM FREE CARE.
AT YOU KNOW WHETHER THERE'S NO
MONTHLY PREMIUM ARE FREE AT THE
POINT THAT YOU PURCHASE IT.
YOU GO TO COVER CALIFORNIA BOTH
A PREMIUM IN OUT OF POCKET COSTS
SO THIS PUTS AND CARE WITHIN
REACH OF THOSE PEOPLE.
WE THINK THE AUTHOR AND WE
RESPECTFULLY ASK ME I. THINK IN
SO MUCH ANY ADDITIONAL WITNESSES
IN SUPPORT.
CAN REALLY CHEN ON ON THE ON
BEHALF THE CALIFORNIA PAN
ETHICAL THAT WORK IN SUPPORT.
THANK YOU.
WHEN THE GREATEST AMERICAN LUNG
ASSOCIATION AND SUPPORT THANK
YOU.
CHRIS KELANA FROM THE CALIFORNIA
GOOD POLICY CENTER IN SUPPORT.
WHATEVER SMALL BUSINESS MAJORITY
IN SUPPORT.
THE MENTAL THING CONSUMERS UNION
IN SUPPORT.
Q. ANY WITNESSES OPPOSITION.
SAYING NAM WELCOME BACK TO
MEMBERS QUESTIONS OR COMMENTS.
SEEING ANY MISSED YOU JOY TO
CLOSE THANK YOU FOR SPUR YOUR
SUPPORT HOPE TO GET DONE
QUICKLY.
TWO OF THEM
GIVE THEM A MOTION AND A SECOND
THE MOTION
YOU PASSED APPROPRIATIONS.
PLEASE CALL THE ROLL.
WOULD.
MAYES
I MAYES AYE ACKER CURRY.
BIGELOW.
BIGELOW AYE BONTA.
BIGELOW NO.
BONTA.
BURKE.
BURKE I CARILLO HIGH CARILLO AYE
FLORA. FLORA KILEY MON. LIMON
AYE MCCARTY.
MCCARTY I NAZARIAN.
RODRIGUEZ LAW RODRIGUEZ AYE
SANTIAGO.
THURMOND. THURMOND AYE WALDRON.
WALDRON AYE.
THANKS HIKES.
NINE ZERO YOUR BILL US OUT. I
DID SEE.
THIS ROAD DONALD HERE.
.
COME ON UP HERE NEXT UP THE ITEM
SIXTEEN TWENTY FIVE NINETY ONE.
TWENTY SIX.
THERE'S.
PLEASE GOOD AFTERNOON MISTER
CHAIR AND MEMBERS.
I AM PLEASED TO PRESENT AB
TWENTY SIX SEVENTY NINE YEARS TO
REQUIRE THE DEPARTMENT OF PUBLIC
HEALTH.
THE A A TO UPDATE THEIR
REGULATIONS ON THE PROCESSING OF
MEDICAL LIMON A VERY EXCITING
BILL BUT ACTUALLY A VERY
NECESSARY. BILL.
THE DEPARTMENT OF PUBLIC HEALTH
IS RESPONSIBLE FOR REGULATING
HEALTH FACILITY OPERATIONS WITH
THE GOAL OF ENSURING HEALTH AND
SAFETY. OF PATIENTS IN AND TO
THE GENERAL PUBLIC.
AS PART OF THIS STUDY THE
DEPARTMENT MUST DEVELOP
REGULATIONS SPECIFYING HOW
HOSPITAL LINENS SHOULD BE CLEAN
PRIOR TO RE YEARS.
THE LAST TIME THE DEPARTMENT
UPDATED THESE REGULATIONS WAS IN
NINETEEN EIGHTY FIVE A LONG TIME
AGO.
IN THE THIRTY THREE YEARS SINCE
THROUGH THESE REGULATIONS TOOK
EFFECT NEW TECHNOLOGIES AND
CLEAN METHODS HAVE LED TO MORE
ENERGY EFFICIENT OPERATIONS.
AND OTHER STATES.
CALIFORNIA MEDICAL ON RECOVERIES
HAVE NOT REALIZE HE'S
EFFICIENCIES DUE TO OUR WOEFULLY
OUT OF DATE.
REGULATIONS OVER THIRTY THREE
YEARS OLD.
AB TWENTY SIX SEVENTY NINE
SIMPLY DIRECTS THE DEPARTMENT TO
REVIEW THESE REGULATIONS IN
LIGHT OF THREE DECADES OF
CHANGES IN THE INDUSTRY.
HAS GONE THROUGH AND UPDATE THEM
THROUGHOUT THEIR EXISTING
REGULATORY PROCESS WE HAVE NEW
TECHNOLOGY WE CAN MAKE THEM EVEN
CLEANER TODAY.
WITH ME HERE TODAY TO TESTIFY
IN SUPPORT IS RJ SETTLEMENT
CERVANTES ON BEHALF OF THE
TEXTILE RENTAL SERVICES
ASSOCIATION AND NOEL. A
RICHARDSON CEO OF SHASTA LINEN
SUPPLY.
RICHARD.
CHAIR MEMBERS THAT ARE JUST A
MONTH ASSEMBLY HALF THE TEXTILE
RENTAL SERVICES ASSOCIATION AS
MR O'DONNELL. NOTED THESE
REGULATIONS ARE ON THE THE.
HEALTH AND HUMAN SERVICES
AGENCY.
HAS EVEN ACKNOWLEDGE PUBLICLY
IN A LETTER TO HOSPITALS THAT
THERE IS A NEED.
TO ADOPT A NEW REGULATIONS TO TO
GET UP TO A MORE MODERN
STANDARD.
HOWEVER THAT THAT ALL FACILITIES
LETTER THAT THEY SENT OUT WAS
FOUND TO BE AN UNDERGROUND
REGULATION AND SO NOW THAT THERE
IS A NEED TO UPDATE THESE
REGULATIONS SO WE STAND STRONG
SUPPORT OF OF THIS BILL THANK
YOU.
GOOD AFTERNOON MISTER CHAIR AND
MEMBERS MY NAME IS NOELLE
RICHARDS AND I'M THE FOURTH
GENERATION OPERATOR SHASTA LET
AND SUPPLY. THE SACRAMENT BASED
COMPANY THAT TRACES ITS HISTORY
OVER NINETY FIVE YEARS.
WE EMPLOY SEVENTY PEOPLE AND OUR
AVERAGE EMPLOYEE HAS BEEN WITH
US WORK FOR WELL OVER FIFTEEN
YEARS.
WE SERVICES SACRAMENTO AND SAN
JOAQUIN VALLEY AND MANY OF OUR
CUSTOMERS HAVE BEEN WITH US FOR
FORTY OR FIFTY YEARS.
WE STRIVE TO OFFER THEM THE BEST
SERVICE POSSIBLE. WELL MADE
WHILE MEDIAN THEIR UNIQUE
DEMANDS IN AN EVER CHANGING
BUSINESS ENVIRONMENT.
WHEN PHENOMENA THAT CONTINUES TO
GROW IN THE MINDS OF THE
BUSINESSES WE SERVE. IS HOW
SUSTAINABLE THEIR VENDORS ARE
AND SHASTA LIMBS SUPPLY IS NO
DIFFERENT.
WE HAVE IS WE HAVE STRIVED AS A
BUSINESS AND AS AN INDUSTRY. TO
BECOME MORE EFFICIENT WITH OUR
WATER USE WHILE ALSO REDUCING
OUR EMISSIONS FOOTPRINT IN THE
PROCESS.
WE HAVE MADE SIGNIFICANT
INVESTMENTS IN DEVELOPING COLD
WATER DETERGENT FORMULAS.
WASTEWATER TREATMENT AND WATER
RECLAMATION USED TO MEET THIS
CHALLENGE.
AS WE STRIVE TO MAKE MORE
SUSTAINABLE BUSINESS CHOICES WE
NEED A PARTNER IN GOVERNMENT
THAT ALLOWS US TO DO SO.
THAT'S WHY FINALLY UPDATING
TITLE TWENTY TWO REGULATIONS ON
MEDICAL AND LAUNDRY MAKE SOME.
WE CAN CUT DOWN ON OUR WATER USE
WE CAN GET DOWN ON OUR ENERGY
USE WHILE STILL SAFELY
LAUNDERING MEDICAL LINENS.
THIS IS A WIN WIN FOR MY
BUSINESS.
FOR THE GOOD FOR THE ENVIRONMENT
AND THE STATE OF CALIFORNIA.
CALIFORNIA AND I URGE YOUR
IPHONE WE GET.
OTHER WITNESSES IN SUPPORT.
TIFFANY VAN ON BEHALF EAGLE
AUDIT SUPPORT.
OR ANYONE IN OUR.
NO ONE BRING IT BACK TO THE
COMMITTEE QUIRK.
COMMENTS.
THEN WE HAVE A MOTION AND A
SECOND MOTION IS.
BY MISTER MESA SECOND FIVE MISS
WALDRON. MOTION IS TO PASS
APPROPRIATIONS IT'S AND DISTANT
ENJOYS A DO PASS RECOMMENDATION
FROM THE CHAIR WHEN SECRETARY
PLEASE CALL THE ROLL.
WITH I WOULD AYE MAYES. BY MAYES
AYE GALLAGHER CURRY. AND HER
CREW AYE BIGELOW.
BIGELOW AYE BONTA.
BURKE.
BERKELEY HIGH CARILLO TIMES
CARILLO AYE FLORA. FLORA
HEILEMAN. LIMOS AYE MCCARTY.
MCCARTY AYE NAZARIAN. RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO.
THURMOND. THURMOND AYE WALDRON.
WALDRON AYE.
IT DOES OUT THE LAUNDRIES.
WE GET DONE. DATACENTER.
.
SO MISTER O'DONNELL.
BEFORE YOU PROCEED HERE AND.
YOU HAVE HAD SEVERAL
CONVERSATION ABOUT YOUR BILL.
WHICH IS.
A. SIX TWENTY FIVE NINETY ONE.
NICE EH AND. MAKE SOME COMMENTS
BEFORE YOU GO OFF YOUR FURY QUE
OKAY WITH THAT YES I CONSIDER
THANK YOU. SO.
.
I I SHARE YOUR CONCERN THAT.
MUCH NEEDED EMERGENCY ROOM IS
CLOSING IN YOUR DISTRICT AND
THAT THIS MAY NEGATIVELY IMPACT
EMERGENCY HEALTH CARE IN THE
GREATER LONG BEACH AREA.
THE COMMITTEE HAS A
LONGSTANDING RECORD ONLY GRANT
TEEN SEISMIC EXTENSIONS TO
HOSPITALS THAT HAVE SEISMIC COME
UP COMPLIANCE PLANS IN PLACE.
LONG BEACH COMMUNITY HOSPITAL
HAS NO SUCH PLAN.
HOSPITALS THROUGHOUT THE STATE
OF BEEN PLANNING FOR UPCOMING
SEISMIC DEADLINES FOR YEARS NOW.
IS SORT APPEARS IT UNIT YOU NOT
ONLY HAVE A SEISMIC PROBLEM BUT
A PLANNING PROBLEM AS WELL.
NOT TO MENTION YOU YOU HAD DO
NOT HAVE AN OPERATOR FOR THE
HOSPITAL WHEN THE CURRENT
PROVIDER MOVES ON.
WELL I'M SYMPATHETIC TO THE
OFFER EFFORTS TO SAVE THE
HOSPITAL I'M VERY UNCOMFORTABLE
GRANTING AN EXTENSION TO A
HOSPITAL LOCATED ON AN ACTIVE
FAULT LINE. WITHOUT KNOWING HOW
OR WHEN THE FACILITY WILL EVER
MEET COMPLIANCE.
YOUR CITY NEEDS TO COME UP WITH
A PLAN.
I'M GONNA LET YOU PRESENT YOUR
BILL TODAY.
BUT I WOULD LIKE TO HOLD THE
BILL IN COMMITTEE UNTIL SUCH
TIME AS THE CITY OF LONG BEACH
HAS A PLAN. DEMONSTRATING HOW
THE HOSPITAL CAN ME SEISMIC
COMPLIANCE.
ARE YOU OKAY WITH THAT MISTER
O'DONNELL FIVE YES I AM MISTER
CHAIRMAN THANK YOU AND THANK YOU
OUT TO YOUR COMMITTEE STAFF TO.
THE BEST OF THE BEST FOR SURE
AND NOW WE ARE A TOUGH SPOT.
ABOUT THE CITY IS WORKING HARD
ON DEVELOPING THAT PLAN SO WE
CAN MOVE FORWARD.
AND IF I COULD JUST DO ONE RIVER
OTHERS ALLOW PLACE TO. PLEASE
TAKE YOUR. SO GOOD THANK YOU
MISTER CHAIR AND COMMITTEE
MEMBERS AND AGAIN I UNDERSTAND
YOUR COME CONCERNS APPRECIATE
THE OPPORTUNITY.
TO EDUCATE THE COMMITTEE.
ABOUT THE UNIQUE CIRCUMSTANCES
SURROUNDING THE CLOSURE OF A
HOSPITAL IN MY DISTRICT.
I DESPERATELY NEEDED HOSPITAL.
THE COMMUNITY HOSPITAL LONG
BEACH IS A LICENSED A CUTE AND
PSYCHIATRIC CARE HOSPITAL
LOCATED IN THE CITY OF LONG
BEACH.
IT IS THE ONLY FULL SERVICE
EMERGENCY ROOM LOCATED ON THE
EAST SIDE OF LONG BEACH
S. SERVE THE SURROUNDING DENSE
RESIDENTIAL COMMUNITY.
FOR OVER NINETY YEARS.
THE CITY OF LONG BEACH OWNS THE
LAND AT COMMUNITY HOSPITAL WHILE
MEMORIAL CARE HEALTH CARE SYSTEM
PROVIDES DAY TODAY. HOSPITAL
SERVICES.
LAST NOVEMBER WHEN OIL CARE
SUDDENLY ANNOUNCED THEIR INTENT
TO CEASE OPERATIONS.
BY JUNE TWENTY NINETEEN
CITING THEIR INABILITY TO MEET
TWENTY TWENTY SEISMIC SAFETY
STANDARDS REQUIRED UNDER LAW.
FOLLOWING THIS ANNOUNCEMENT I
INTRODUCED AB TWENTY FIVE NINETY
ONE TO EXTEND SEISMIC
COMPLIANCE.
MY HOPE WAS TO GIVE THE CITY AND
STAKEHOLDERS AN OPPORTUNITY TO
FULLY INVESTIGATE. ALL OTHER
OPTIONS INCLUDING SECURING
ANOTHER PROVIDER TO PREVENT THE
CLOSURE OF THIS CRITICAL
HOSPITAL.
UNFORTUNATELY.
MEMORIAL CARE HAS RADICALLY
ACCELERATED THEIR CLOSURE
TIMELINE.
THIS MAKES IT ALL THE MORE
DIFFICULT FOR THE CITY TO SECURE
AND OTHER PROVIDER.
MEMORIAL CARE COULD HAVE AND
SHOULD HAVE HAD AN OPEN DIALOGUE
WITH THE COMMUNITY AND
STAKEHOLDERS WHEN THEY FIRST
BEGAN TO HAVE CONCERNS ABOUT
THEIR ABILITY. TO OPERATE
COMMUNITY HOSPITAL.
THIS WOULD ALLOW THE CITY TO
PREPARE FOR THEIR DEPARTURE
YEARS BEFORE THE TWENTY TWENTY
SEISMIC COMPLIANCE DEADLINE.
IT IS MY UNDERSTANDING THAT
OTHER COMMUNITIES ACROSS
CALIFORNIA ARE FACING THE SAME
SEISMIC DEADLINE HOWEVER THESE
HOSPITALS BEGAN EXTENSIVE
PLANNING SOMETIME AGO.
WITH MEMORIAL CARE DECIDING TO
WALK AWAY MY COMMUNITY IS LEFT
HANGING IN THE BALANCE.
THE CLOSURE OF COMMUNITY
HOSPITAL RESULT IN A DIMINISHED
CAPACITY OF ESSENTIAL HEALTHCARE
SERVICES TO MY COMMUNITY.
IT WILL ALSO SIGNIFICANTLY
IMPACT A GREATER REGION'S TRAUMA
CARE SYSTEM AND FURTHER STRAIN
THE HEALTH CARE.
SAFETY NET.
I UNDERSTAND THAT THE CHAIR IS
NOT COMFORTABLE WITH EXTENDING
THE DEADLINE FOR SEISMIC
COMPLIANCE UNTIL THE CITY OF
LONG BEACH COMPLETES A PLAN
DEMONSTRATING HOW AND WHEN THEY
WILL MEET THE TWENTY TWENTY.
STANDARDS
IT IS MY UNDERSTANDING THAT THE
CITY IS IN THE PROCESS OF
WORKING ON THAT NECESSARY PLAN
NOW. IN FACT IN AN EXPEDITED
FASHION.
I WILL CONTINUE TO WORK WITH THE
CITY AND THE COMMUNITY ON THE
DEVELOPMENT OF THIS PLAN AND I'M
COMMITTED TO FINDING ANY AND ALL
SOLUTIONS.
KEEP THIS VERY UNNECESSARY
HOSPITAL OPEN.
I LOOK FOR TO BRING THIS BACK TO
THE COMMITTEE WANTS THE CITY HAS
A PLAN AND I KNOW THEY'RE
WORKING ON THAT PLAN.
WITH ME ARE TO TESTIFY HERE
TODAY.
ON THE IMPORTANCE OF YOUR
HOSPITAL IS THE CITY OF LONG
BEACH DIANA TANK. AND THE
CALIFORNIA NURSES ASSOCIATION
THANK YOU MISTER CHAIR.
THE MORNING CHAIR WHAT AND
MEMBERS OF THE COMMITTEE THANK
YOU FOR TAKING THIS TIME TO HEAR
THIS ITEM ON COMMUNITY HOSPITAL
OF LONG BEACH ON BEHALF OF THE
MAYOR AND THE LONG BEACH CITY
COUNCIL I'M HERE REQUESTING THE
COMMITTEE TO. AYE AT THE FUTURE
DATE CONSIDER PROVIDING THE CITY
WITH ADDITIONAL TIME TO MEET
STATES LIVES MAKE REQUIREMENTS
OUT COMMUNITIES WILL ONE WHICH
WE DO TRULY UNDERSTAND THE
IMPORTANCE OF HAVING THE SIZE A
COMPLIANCE PLAN IN PLACE.
AS WELL AS WORKING WITH THE
PROVIDER THROUGH THE PROCESS.
AS AS THE ASSEMBLY MEMBER
MENTIONED THE CITY OF LONG BEACH
OWNS THE LAND WE'RE NOT.
TOOK A TYPICAL HOSPITAL
PROVIDER I AND AT THE TIME WE
SIGNED THE LEASE AGREEMENT WITH
MEMORIAL HOSPITAL IN TWO
THOUSAND ELEVEN BOTH PARTIES DID
KNOW THERE WAS AN EARTHQUAKE
FAULT ON IN THE HOSPITAL. BUT
FOR THE CITY IT WAS NOT UNTIL
TWO MONTHS AGO THAT WE WERE ABLE
TO CONFIRM THE EXTENT OF THE
EARTHQUAKE FAULTS. ó I BELIEVE
MEMORIAL ABOUT TWO YEARS AGO
BEGAN THEIR SEISMIC STUDIES BY
IN NOVEMBER OF LAST YEAR WAS
WHEN THEY ACTUALLY SHARE THAT
INFORMATION WITH US. AND UPON
RECEIVING INFORMATION FROM THE
MORAL. AND THEIR DETERMINATION
THAT THEY WOULD NOT BE ABLE TO
MEET STATE SEISMIC REQUIREMENTS
AT COMMITTEE HOSPITAL THE CITY
OF ONE MEET JUMPED IN.
AND STARTED TO DO OUR OWN DUE
DILIGENCE AT THE SITE.
SO SO DURING THIS THIS TIME
PERIOD WE WENT BELIEVES THAT
MEMORIAL HADDA AN EXTENSION FROM
US BUT THROUGH JUNE THIRTIETH
TWO THOUSAND NINETEEN WE THOUGHT
WE HAD ABOUT A YEAR AND A HALF.
IT WAS A SHOCK TO US WHEN
MEMORIAL ISSUED THEIR HUNDRED
AND TWENTY DAY LEAST TERMINATION
NOTICE IN MARCH OF THIS YEAR
EFFECTIVELY TERMINATING SERVICES
BY JULY THIRD TWO THOUSAND
EIGHTEEN.
AGAIN FURTHER COMPOUNDED BY THE
LENSES DECISION TO DIVER ALS
AMBULANCES FROM THE HOSPITAL.
THE CITY OF HASN'T SEVERAL
LETTERS TO MEMORIAL CARE SINCE
IT'S TIME TO TRY AND STABILIZE
THE SITUATION MOST IMPORTANTLY
WE RECOGNIZE THAT THE HOSPITAL
LICENSE AT COMMUNITY HOSPITAL
EXPIRES ON APRIL TWENTY EIGHTH
IN JUST ELEVEN DAYS.
WE'VE NOTICED THAT THE
COMMITTEE ANALYSIS NOTES LET
LICENSE WAS NOT. RENEWED AND I
WE HAVE TWICE REQUESTED THAT
MEMORIAL CONFIRM THAT THEY WILL
INDEED RENEW THEIR LICENSE AND
IT APPEARS THAT ON APRIL TWELFTH
CITY PEACH.
CDP TO CENTRALIZE APPLICATION
UNIT DID CONFIRM THAT THEY DO
HAVE A COPY OF THE LICENSE
APPLICATION ON FILE. AND THEY
ARE WAITING TO RECEIVE PAYMENT
CLEARANCE FROM THE MORAL BEFORE
FINALIZING THE ISSUANCE OF THAT
LICENSE.
I CAN CURRENTLY AGAIN THE CITY
IS MOVING AHEAD ON TELEPATHS TO
ONE SECURE PLANNED TO MEET STATE
SEISMIC REQUIREMENTS AND TO
SECURE AN IMPOSSIBLE PROVIDER.
WITH RESPECT TO NEED OUT
COMMITTEE HOSPITAL I CANNOT
STRESS ENOUGH.
THE NEED FOR Q. AND PSYCHIATRIC
HEALTH SERVICES TO CONTINUE WITH
IN THE EAST SIDE OF ONE BEACH
THE ONE WHICH FIRE DEPARTMENT
REPORTS THAT TRANSPORT PLANES
ARE ALREADY BEING IMPACTED AND
WE DO EXPECT THAT TO CONTINUE.
PRIOR TO THE DIVERSION OF
ADVANCED LIFE SUPPORT AMBULANCES
ARE AVERAGE TRANSPORT TIME TO
COMMITTEE HOSPITAL FROM THE EAST
SIDE WAS SEVEN AND A HALF
MINUTES. SINCE THE CLOSURE OF A
LAST.
SINCE THE CLOSURE TO A LOST
PATIENCE THE NEW AVERAGE
TRANSPORT TIME HAS JUMPED TO
ALMOST NINE MINUTES.
THE US TRANSPORT PLANES HAVE NOT
YET BEEN AFFECTED BUT WE ARE
SEEING A CHANGE IN CALLING THE
CALLS FOR BEYONCE PATIENTS HAVE
NON NOW GONE UP BY OVER SIX
MINUTES.
WE ARE ADDITIONALLY SEEING THE
PULL OF.
FIRE UNITS FROM THE EAST SIDE OF
THE CITY TO HOSPITALS ARE
LOCATED ON THE WEST SIDE
DISPLACING UNITS WHERE THEY HAD
PREVIOUSLY BEEN STATIONED
BEFORE.
WHILE WHILE UNITS ARE OUT OF
SERVICE TO TO RUN CALLS.
PATENT BEHAVIORAL HEALTH SIDE
THE HOPE THAT BEHAVIORAL HEALTH
OCCUPANCY RATE IN AREA HOSPITALS
IS INCREASING.
AND WITH THAT I DO REALIZE THAT
WE NEED TO CLOSE AND JUST.
WOULD LIKE TO CHAIR THE
COMMITTEE TO KNOW THAT THE CITY
HAS CONSULTED WITH PARKINSON
WELLS WE DO HAVE A NEW AND MORE
SEISMIC CONSULTANT AND ALL THAT
STEVIE AND ASSOCIATES ON BOARD
WE ARE WORKING WITH US PET AND
JUST HOW DO. A GREAT CALL
YESTERDAY AND ARE MOVING FORWARD
WITH SOME CONCEPTUAL PLANS THANK
YOU.
TAYLOR JACKSON WITH THE
CALIFORNIA NURSES ASSOCIATION
I'M JUST HERE TO INTRODUCE ALLEN
LOCKRIDGE WHO'S BEEN AN RN.
PRIMARILY A COMMUNITY HOSPITAL
FOR AROUND THIRTY FIVE YEARS.
HI.
SO MY NAME IS ALAN MARC RICH.
.
BUT LIKE TO THANK YOU FOR
ALLOWING ME TO SPEAK HERE TODAY
I HAVE BEEN.
A REGISTERED NURSE AT LONG
BEACH COMMUNITY HOSPITAL FOR
THIRTY FIVE YEARS.
I'VE SEEN A LOT OF CHANGES AND
THE WAY WE.
DO MEDICINE.
AND THE WAY WITH THAT WE TRAIN.
ALL OF OUR PATIENTS
I WANT TO SAY THAT.
AS FAR AS THE HOSPITAL GOES
LONG BEACH MEMORIAL REALLY DID
NOT GIVE US.
MUCH TIME TO TRY AND GET A PLAN
IN PLACE IT WAS PRETTY MUCH
THROWN AT THE CITY AND TO THE
EMPLOYEES THAT.
YOU GOT A HEART STOPPER JULY
THIRD FIGURE OUT WHAT YOU GONNA
DO BECAUSE WE'RE LEAVING.
OKAY.
THE ADDITIONAL TIME OBVIOUSLY
IS NEEDED BECAUSE WE.
SERVE A HUGE SERVICE
TO.
EAST LONG BEACH WHERE THE
HOSPITAL IS LOCATED.
AND IT WAS BUILT AND OPENED IN
NINETEEN TWENTY FOUR SO THE
SURROUNDING AREA IS AN OLDER
COMMUNITY. AND WE HAVE A LOT OF
SENIORS THERE. AND THEY DON'T
NEED.
TO BE.
SHUTTLED ACROSS TOWN OR ACROSS
COUNTY LINES TO OTHER HOSPITALS
WHEN THEY CAN USE THESE LONG
BEACH.
AND COMMUNITY HOSPITAL AND ALSO
THE LOW THE LARGEST POPULATION
OF THE HAAS OF. LONG BEACH IS IN
EAST LONG BEACH SO THEY'RE
TAKING AWAY THE ONLY EMERGENCY
ROOM AND ACUTE CARE FACILITY IN
EAST LONG BEACH.
ADDING TO THE PROBLEM IS
THE LONGER WAIT TIMES IN THE
EMERGENCY ROOMS OF THESE OTHER
HOSPITALS IN LONG BEACH.
.
BUT THE TYPICAL WAIT TIMES IN
OUR EMERGENCY ROOM IS A TWO TO
FOUR HOURS AND THAT'S IN THE
DOOR AND OUT THANK YOU.
.
Z. WAIT TIMES AT LONG BEACH
MEMORIAL WHERE THEY'RE DIVERTING
THE PATIENTS TO. IS ANYWHERE
FROM FOUR TO TWELVE HOURS.
DEPENDING ON HOW SERIOUS YOU
ARE.
THERE WAS A GENTLE MAN IN
JANUARY THAT WHEN THE END FOR
HEADACHES WAITED IN THE OUTER
WAITING ROOM FOR APPROXIMATELY
FOUR HOURS. GOT TRIAGE MOVED
INTO THE INNER WAITING ROOM AND
WHEN THEY WENT TO GO FIND THEM
FAMILY SAID HE WAS IN THE
BATHROOM HE HAD HUNG HIMSELF.
WHILE WAITING TO BE SEEN.
THEY FORTUNATE WERE ABLE TO
REVIVE HIM.
YOU SHOULD HAVE TO WAIT THAT
LONG. OBVIOUSLY THIS MAN HAD
OTHER PROBLEMS SO WHEN LONG
BEACH MEMORIAL SAYS THIS IS A
BUSINESS DECISION THIS IS MORE
THAN A BUSINESS DECISION THIS IS
A LIFE AND DEATH DECISION. THIS
INVOLVES THE COMMUNITY THIS
INVOLVES.
THE STAFF.
THIS IS HEART BREAKING TO
ALMOST EVERYBODY IN THESE LONG
BEACH AND WE COULD USE SOME MORE
TIME.
TO GET OUR PLAN IN PLACE THANK
YOU.
OTHERS IN SUPPORT.
DONNA SIGHED REPRESENTING THE
LOS ANGELES COUNTY BOARD OF
SUPERVISORS IN SUPPORT.
ANYONE ELSE.
.
SINCE WE'RE NOT REALLY TAKING A
VOTE ON THE BILL I'M THE SPRING
BACK TO THE COMMITTEE FOR
QUESTIONS AS ANYONE HAVE ANY
QUESTIONS.
COMMENTS.
THEY.
I JUST AND SAY YOU KNOW A
CERTAIN I'VE I APPRECIATE THE
DIFFICULT PREDICAMENT YOU AND
AND YOUR CITY OR AND I I DON'T
FEEL FOR THE CITIZENS OF LONG
BEACH.
WE.
WE DON'T HAVE A MECHANISM FOR
COMPELLING YOUR. OPERATOR TO
STAY OPEN WE DON'T HAVE THE
ABILITY TO DO THAT.
AND.
WE DON'T ALSO IF THEY DO NOT
EXTEND THEIR LICENSE WE DO NOT
HAVE THE ABILITY TO FORCE THEM
TO STAY OPEN EITHER.
SO.
SO AYE AYES AYE SAYS I SUFFER
THE BEGINNING COURAGE YOU TO
COME BACK WITH THE PLAN.
AT THAT POINT.
WE CAN WE CAN MOVE FORWARD BUT
WE WE DO NOT HAVE THE ABILITY TO
FORCE ANYONE TO DO ANYTHING.
AND SO I REALLY THINK
UNFORTUNATE. THE BALL WAS IN THE
CITY'S COURT.
THANK YOU.
THANK THANK YOU MISTER CHAIR
THANK YOU.
FOR OFFERING TO CONTINUE TO
WORK WITH US ABSOLUTELY DO AT
THREE AND HE'S UNDER CONTRACT TO
THE WORKING.
RAPIDLY
TO ADDRESS THIS ISSUE SAID THANK
YOU.
MISS BURKE.
THINK YOU I MISTER CHAIR
MEMBERS.
THANK YOU FOR LETTING ME
CUTTING.
AB TWENTY SEVEN FORTY ONE CENTS
A FIVE DAY LIMIT ON OAKLEY LA
PRESCRIPTIONS FOR ACUTE PAIN
MANAGEMENT FOR MINORS WITH THE
EXCEPTION FOR CHRONIC PAIN
MANAGEMENT HOSPICE CARE CANCER
PATIENTS. MINORS WHO ARE UNDER
TREATMENT FOR SUBSTANCE USE
DISORDERS AND IN CASE OF
EMERGENCIES.
AB TWENTY SEVEN FORTY ONE ALSO
REQUIRES A DOCTOR TO INFORM THE
MYERS PARENT OR LEGAL GUARDIAN
OF THE DANGERS AND RISKS
ASSOCIATED WITH OPIUM PRODUCTION
FOR PRESCRIPTION DRUG USE AND TO
RECEIVE CONSENT BEFORE
PRESCRIBING OPIOID MEDICATION.
ACCORDING TO TWO THOUSAND
EIGHTEEN STUDY BY THE AMERICAN
ACADEMY OF PEDIATRICS OPIOID
POISONING AND OVERDOSES OVER
CHOICES ARE SENDING INCREASED
NUMBER OF U. S. CHILDREN AND
TEENS TO HOSPITAL. PROPOSITIONS
WERE MOST COMMON AMONG KIDS AGED
TWELVE TO SEVENTEEN IN THOSE
EACH ONE TO FIVE.
IN TWO THOUSAND FIFTEEN THE
AMOUNT OF OPIOIDS PRESCRIBED
WITH ENOUGH FOR EVERY AMERICAN
TO BE MEDICATED AROUND THE CLOCK
FOR THREE WEEKS.
AT ABOUT SIXTY PERCENT OF
AMERICANS HAVE USE UNUSED
OPIATES IN THEIR HOME.
SEVERAL ORGANIZATIONS INCLUDING
THE U. S. FOOD AND DRUG
ADMINISTRATION AND CENTER FOR
DISEASE CONTROL ALL AGREE THAT
OVER PRESCRIBING OF OPIOIDS
MEDICATIONS HAS DIRECTLY
CONTRIBUTED TO THE ADDICTION
CRISIS.
ACCORDING TO THE NATIONAL
INSTITUTE ON DRUG ABUSE NEARLY
HALF OF THE YOUNG PEOPLE WHO
INJECT HEROIN. REPORTED ABUSING
OPPRESSION PRESCRIPTION OPIOIDS
BEFORE TURNING TO HEROIN. AB
TWENTY SEVEN FORTY ONE IS
EVIDENCE BASED AND DATA DRIVEN
I'VE ASKS THAT SERGEANTS TO
DISTRIBUTE THE EVIDENCE AND DATA
THAT SUPPORTS A FIVE DAY LIMIT
AS OUTLINED BY THE CDC.
ACCORDING TO THEIR MARCH TWO
THOUSAND SEVENTEEN STUDY LONG
TERM OPIOID USE OFTEN BEGINS
WITH TREATMENT OF ACUTE PAIN.
THE PROBABILITY OF LONG TOYED
LONG TERM OPIOID USE INCREASES
MORE SHARPLY IN THE FIRST FEW
DAYS OF THERAPY PARTICULARLY
AFTER FIVE DAYS.
IN JULY TWO THOUSAND SEVENTEEN
THE CDC RELEASE UPDATED
GUIDELINES RECOMMEND NO MORE
THAN THREE DAY PRESCRIPTION OF
FOR ACUTE PAIN MANAGEMENT. THE
MEDICAL BOARD OF CALIFORNIA
SPECIFICALLY RECOMMENDS OPIOIDS
FOR ACUTE MANAGEMENT WITH MINORS
ONLY AFTER NON OPIOID
ALTERNATIVES HAVE FAILED.
THIS EPIDEMIC IS RESPONSIBLE FOR
NINETY ONE DEATHS EACH DAY.
FORTY TWO FROM PRESCRIBED
OPIOIDS.
MEMBERS WE DO NOT HAVE THE
LUXURY OF WAITING THE TEN YEARS
IT CAN TAKE FOR NEW
RECOMMENDATION GUIDELINES FROM
THE BOARD TO BECOME COMMON
PRACTICE.
I LIKE TO INTRODUCE MY FIRST
WITNESS IN SUPPORT OF AB TWENTY
SEVEN FOR YOU WANNA SUSAN KING
WITH KING IS WITH PATHWAY TO
PREVENTION IS HERE REPRESENTING
A MOTHER WHO LOST HER CHILD TO
OPIOID ADDICTION.
BUT THE OPPORTUNITY TO SPEAK.
CHAIRMAN WHAT AN HONORABLE
COMMITTEE MEMBERS.
I APPRECIATE BEING ABLE TO
SPEAK IN SUPPORT OF AB TWENTY
SEVEN FORTY ONE.
I'M SPEAKING IN PLACE OF LINDA
CHAPMAN WHO LOST HER DAUGHTER
TIFFANY TO COMPLICATIONS OF
LIVER FAILURE. THE DIRECT RESULT
OF HER ADDICTION TO PRESCRIPTION
PAIN MEDICATIONS.
TIFFANY WAS JUST TWENTY SEVEN
YEARS OLD WHEN SHE DIED.
TIFFANY NOEL CHAPMAN WAS A
GOLDEN CHILD WITH A BRIGHT
FUTURE SHE HAD JUST BEEN VOTED
SENIOR HIGH SCHOOL CLASS
PRESIDENT. WHEN FIVE WEEKS INTO
THE START OF HERS SENIOR YEAR
SHE WAS REAR ENDED BY A
DISTRACTED DRIVER. TIFFANY
BROKER KNACK WAS PUT IN A HALO
DEVICE WITH SCREWS IN HER HEAD
AND WAS HOME SCHOOLED FOR THE
REST OF HER SCHOOL YEAR. YOU CAN
SEE THERE BEFORE AND THE AFTER
AS SHE BEGAN HER JOURNEY.
DOWN THE ROAD AS SUBSTANCE USE
DISORDER.
AS A RESULT OF HER CAR ACCIDENT
TIFFANY WAS PRESCRIBED.
OUTWEIGHED OPIOID MEDICATIONS
AND OTHER MEDICATIONS TO HELP
HER SLEEP AND HANDLE HER ANXIETY
SHE WAS JUST SEVENTEEN YEARS OLD
AT THE TIME.
HER MOTHER LINDA WROTE IN HER
JOURNAL I WAS NAIVE ABOUT PAIN
MEDICATIONS AND I HAD NO IDEA
THAT THEY COULD BECOME ADDICTIVE
PARTICULARLY TO A YOUNG BRAIN
THAT WAS STILL DEVELOPING.
TIFFANY WAS AND A LOT OF PAIN
AND I TRUSTED HER DOCTORS TO
MONITOR THE AMOUNT OF PILLS SHE
WAS TAKING.
SOMETIMES THOUGH SHE HAD A
BOTTLE OF NINETY PILLS FOR ONE.
DESCRIPTION AND HAVE ANOTHER
FROM A DIFFERENT DOCTOR VAI
COULD IN NORCO WITH THE NAMES OF
TWO OF HER MOST COMMON
PRESCRIPTIONS.
ONE TIME WE HAD TO TAKE TIFFANY
TO THE EMERGENCY ROOM SHE SEEMED
SO SECOND DISORIENTED THEY USE
THE WORD OVERDOSED A WORD I ONLY
ASSOCIATED WITH DEATH. THE TOLD
ME SHE WAS PROBABLY ADDICTED TO
HER PAIN PILLS
IN LESS THAN FIVE HOURS AFTER
SHE WAS STABLE THEY CENTER HOME.
I WAS IN SHOCK I THOUGHT THEY
WERE CHEAPER THERE UNTIL SHE GOT
WELL REALLY WELL I WANTED MORE
INFORMATION BUT THEY DIDN'T HAVE
ANY INFORMATION TO GIVE ME
EXCEPT THEY TOLD ME TO GO LOOK
ON THE INTERNET.
AT ANOTHER VISIT TO THE
EMERGENCY ROOM A DOCTOR TOLD US
TO TELL TIFFANY TO QUOTE FLESH
OUT THOSE PILLS DOWN THE TOILET
WHERE SHE WAS GOING TO END UP IN
A BODY BAG. UNQUOTE.
STILL NO INFORMATION WAS GIVEN
TO US SOMEWHERE WE COULD GO FOR
HELP.
IT SEEMS LIKE NO ONE CARED.
I WANTED TO HELP WERE BUT DIDN'T
KNOW HOW JUST TAKING THE PILLS
AWAY FROM HER DIDN'T SOLVE HER
ADDICTION PROBLEM.
LATER ON TIFFANY GOT A JOB AND
MOVED INTO HER OWN APARTMENT
PREDICTION BECAME WORSE NOW SHE
HAD MORE THAN ONE DOCTOR SHE WAS
DOCTOR SHOPPING AND SHE WAS
PHARMACY SHOPPING.
I KNEW DOCTOR STARTED HER ON
ANOTHER PAIN MEDICATION ONE THAT
REQUIRED FEWER PILLS AND IN ONE
DAY HE TOLD HER ABOUT IT
OXYCONTIN. HE SAID THAT NOW SHE
WOULD ONLY HAVE TO TAKE ONE PILL
IN THE MORNING AND ONE IN THE
EVENING. THIS LATER JUMPED TO
THREE OR FOUR IN THE MORNING
WITH THE SAME AMOUNT IN THE
EVENING. HER ADDICTION
EVENTUALLY LEAD TO MORE AND MORE
E. R. VISITS FIVE DETOX IS. TO
I'M COMPLETED TREATMENT PROGRAMS
A DIY LIVER FAILURE AND LASTLY
HER DEATH.
WHEN TIFFANY WAS SEEKING
TREATMENT ABOUT THROUGHOUT THE
COURSE OF ACTIVITIES OBJECTION
SHE DOCUMENTED HER STRUGGLES.
.
AND WE FOUND HER JOURNAL AFTER
SHE PASSED AWAY. WHEN OUSTED THE
RECOVERY CENTER WHAT IS YOUR
DRUG OF CHOICE SHE DIDN'T KNOW
WHAT TO SAY. HER DOCTORS DIDN'T
USE THE WORD DRUGS.
I WASN'T A DRUG ADDICT TO
ANSWER THE QUESTION DRUG OF
CHOICE I HAD NO ANSWER I DON'T
REMEMBER HAVING A CHOICE.
THINKING ABOUT THE COMMERCIALS
IN MY YOUNG TEEN YEARS IT SHOWED
A HOT SKILLET ON THE STOVE.
SAYING THIS IS YOUR BRAIN ON
DRUGS DID THAT COMMERCIAL APPLY
TO ME THIS IS YOUR BRAIN ON A
MEDICATION THAT HAS BEEN
PRESCRIBED TO YOU BY YOUR
TRUSTED DOCTOR TO HELP YOU. NOT
HARM YOU.
THE SEEDS OF ADDICTION WERE
PLANTED IN TIFFANY'S PLASTIC
DEVELOPING BRAIN WHEN DOCTORS
PRESCRIBE POWERFUL OPIATES TO
HER AS A YOUNG AS A YOUNG WOMAN.
SHE WAS JUST A SENIOR IN HIGH
SCHOOL WHEN THAT BEGAN HER
PARENTS WERE KEPT IN THE DARK
AND RENDERED HELPLESS.
AS DOCTORS PRESCRIBE MORE AND
MORE AND MORE OP RIGHTS TIFFANY
NOEL CHAPLAIN. CHAPMAN DIED AT
AGE TWENTY SEVEN AND IT COULD
HAVE BEEN PREVENTED.
THIS BILL IS IT GIVES US AN
OPPORTUNITY TO STOP ADDICTION
BEFORE IT STARTS.
THANK YOU.
THERE ARE OTHER.
OTHERS IN SUPPORT.
CHAIR AND MEMBERS NAMELY PETRON
WITH MAKE YOU CUT CAN ASSOCIATES
ON BEHALF OF THE CALIFORNIA
CHAMBER OF COMMERCE IN SUPPORT.
JOHN WINGER ON BEHALF OF
GATEKEEPER INDIVIDUAL SPORT.
SO ANYONE ELSE.
ANYONE IN OPPOSITION.
YOU HAVE PLAYED ALONG.
YEAH.
TURN IT.
THANK YOU MISTER CHAIR NUMBERS
MAKE IT ALRIGHT ON BEHALF OF THE
CALIFORNIA MEDICAL ASSOCIATION.
IN OPPOSITION TO AB TWENTY FOUR
SEVENTY ONE.
AND THE FIVE DAY CAP ON
PRESCRIPTIONS IN THIS BILL
REPRESENTS A LEGISLATIVE ATTEMPT
TO PRACTICE MEDICINE. AND ZMA
OPPOSES THESE PROVISIONS AS
POSITIONS ARE THE APPROPRIATE
ENTITY TO MAKE THESE DECISIONS
SPECIFIC TO THEIR PATIENTS.
THE MEDICAL BOARD AMERICAN PAIN
SOCIETY AND AMERICAN ACADEMY OF
PEDIATRICS ALL HAVE GUIDELINES
ON PRESCRIBING. AND NONE HAVE
LIMITS ON THE DAIS PRESCRIBES.
AS MORE THAN HALF OF YOUTH
INCIDENTS THAT IS OF MISUSE OF
OAK BY PRESCRIPTION OPIOIDS
OCCUR BY YOUTH OBTAINING
ETHIOPIA AIDS FROM FRIENDS.
PARENTSAND NON MEDICAL SOURCES
WE FEEL THAT APPROPRIATE
PERSONAL PRESCRIBING OF
PROTOCOLS ARE THE BEST DIRECTION
TO TAKE.
AND THIS WILL BE ADDRESSED IN
OTHER LEGISLATION THIS YEAR.
AS SUCH WE ASK YOUR OPPOSITION
TO AB TWENTY FOUR SEVENTY ONE.
THINKING.
YOU VERY MUCH IS THERE ANYONE
ELSE IN OPPOSITION.
RIGHT SPONSORED HALF THE
CALIFORNIA ACADEMY FAMILIES
ISSUE POSITIONS AND THE AMERICAN
COLLEGE OF OBGYN STRYCHNINE. AND
OPPOSITION.
VERY MUCH.
THE WINDS BRING BACK TO THE
COMMITTEE FOR QUESTIONS COULD
MISS WALDRON. THANK YOU MISTER
CHAIR.
.
ABOUT EIGHT EIGHTEEN YEARS AGO
TO SIXTEEN YEARS AGO I'VE SERVED
ON THE OXY TASK FORCE IN SAN
DIEGO. AND ONE OF THE THINGS
THAT CAME UP WAS AND IT'S STILL
TRUE TODAY BECAUSE WE HAVEN'T
DONE ENOUGH EDUCATION.
IS THE FACT THAT PEOPLE BELIEVE
BECAUSE IT'S PRESCRIPTION THAT
IT'S SAFE.
AND THAT'S BEEN AN ONGOING YOU
KNOW PROBLEM OF WHY. THESE
PRESCRIPTION DRUGS ARE BEING
USED THE WAY THEY ARE BECAUSE
PEOPLE THINK THEY'RE SAFE
ESPECIALLY YOUNG PEOPLE.
.
AND AS I MENTIONED IN THE LAST
HEALTH HEARING.
SERVING ON THE STANFORD.
INITIATIVE ON THE DRUG POLICY.
ONE OF THE THINGS THAT CAME UP
WAS THAT THERE'S THAT WINDOW OF
OPPORTUNITY BETWEEN AGE ELEVEN
AND TWENTY FIVE THAT KIDS ARE
MOST SUSCEPTIBLE. TO GETTING
ADDICTED TO UP A DRUG LIKE THIS
AND THAT IF WE'RE GONNA SPEND
ANY MONEY AND TIME WE NEED TO
FOCUS ON THIS RANGE OF OF TIME.
BECAUSE THAT'S WHERE WE'RE
GETTING.
YEAH EVEN THE AGE TWENTY SEVEN
I MEAN IT'S RIGHT THERE SO.
ALSO ANOTHER FACTOR IS NINETY
ONE PERCENT OF OVERDOSE PATIENTS
ARE LATER PRESCRIBE AN OPEN.
SO THAT. THAT'S SOMETHING ELSE
THAT WE NEED TO KEEP WORKING ON
ON.
I KNOW ITS.
.
IT'S NOT EASY TO DO SOMETHING
LIKE THIS BUT I AM SAYING YOU
HAVE EXEMPTIONS HOME ABILITY TO
PORT THE BILL TODAY BECAUSE. I
THINK ARE YOU KNOW IT'S CLEARLY
AIMED AT THAT AGE GROUP. AND
ALSO YOU DO HAVE THOSE EXEMPTION
FOR CANCER OR CHRONIC PAIN AND
THINGS LIKE THAT.
YOU KNOW.
AND THROUGH THE CHAIR WE HAVE
ADDITIONAL EXEMPTIONS IF IT'S
NECESSARY.
TO PRESCRIBE MORE THAN FIVE DAYS
A DOCTOR MAY DO SO THEY JUST
MONTHS NOTE THE FILE.
TO ANYONE ELSE HAS QUESTIONS OR
COMMENTS.
THE PROMOTION IT.
THURMOND SHOW
THERE'S A. MOTION AND A SECOND
BY MISTER.
MUCH BY MR MCCARTY SECOND BY
MISTER THURMAN.
WOULD LIKE TO CLOSE OFF MISTER
AND IN JULY AND IT WAS JULY OF
TWO THOUSAND SEVENTEEN OR MAYBE
MARCH OF TWO THOUSAND SEVENTEEN
AT CDC PUT OUT THEIR
RECOMMENDATION AND TODAY I DO
NOT SEE CMA HAVING ANY PROTOCOLS
AND PLACED. IT DOES TAKE
PROBABLY TEN YEARS TO PUT THOSE
OUR RECOMMENDATIONS FOR THEM TO
BECOME COMMON PRACTICE SO WHICH
IS WHY I THINK WE ARE AT A POINT
NOW WHERE IT IS TIME TO THAT. TO
THOUGHTFULLY LEGISLATING I THINK
THAT'S WHAT THIS IS.
AS OF JULY TWO THOUSAND
SEVENTEEN TWENTY THREE OTHER
STATES HAVE ENACTED LEGISLATION
WITH SOME TYPE OF LIMITS.
OR AYE GUIDANCE OUR REQUIREMENTS
RELATED TO PULL OPI
PRESCRIPTIONS SO THERE'S NO
REASON CALIFORNIA CAN DO THE
SAME WITHOUT RESPECTFULLY
REQUEST NAY VOTE.
THANK YOU VERY MUCH MISS BURKE
AT THANK YOU FOR BRINGING THIS
BILL FORWARD.
AND I BELIEVE THE CDC
GUIDELINES ARE THREE DAYS.
YES THEY ARE.
AND I APPRECIATE THAT THANK YOU
THANK YOU VERY MUCH.
THE MOTION IS TO PASS TO
APPROPRIATIONS.
MADAM SECRETARY PLEASE CALL THE
ROLL WOULD I WOULD I MAYES.
THEY IS NOT VOTING. EGGER CURRY
POWDER CURRY AYE BIGELOW.
BIGELOW NOT VOTING BONTA. BONTA
AYE BURKE. BURKE AYE CARILLO.
FLORA.
FLORA NOT VOTING LOW MOAN.
LEARN AYE MCCARTY MCCARTY AYE
NAZARIAN.
RODRIGUEZ.
THURMOND.
AARON I. I'M SORRY SANTIAGO.
SANTIAGO I'D THURMOND. THURMOND
AYE WALDRON. WALDRON AYE.
NINE ZERO YOU BILLS OUT I THINK
YOU CAN WHISPER.
MISTER KANSEN CHU.
YOU KANSEN CHU WILL BE PRESENT
TEEN AB TWENTY TWO NINETY NINE.
MISTER. DAVID CHIU.
HAS A BILL COMING UP. AS. HE DID
AWARENESS THAT I MY APOLOGIES.
.
AND THEN.
.
MISTER GLORIA AS IS STILL UP
THERE SO PLEASE PLEASE PROCEED
MISTER CHAIR.
THANK YOU VERY MUCH SHARON
MEMBERS AND I A WALL ALSO SANK
TO COMMITTEE STAFF FOR WORKING
WITH US.
ON THIS BILL I LIKE TO ATTEMPT
TO COMMIT. A TO COME MEDIA
MOMENTS TO GIVE TO DEPARTMENT OF
HEALTH CARE SERVICES FLEXIBILITY
TO UPDATE DOCUMENTS THAT HAVE
ALREADY GONE THROUGH COMMUNITY
REVIEW PROCESS.
AB TWENTY TO LIFE AND I CALLED
THE FIGHT TO SIXTH GRADE.
READING LEVEL REQUIREMENT FOR
MEDI CAL BENEFITS HOUSE
EDUCATION AND INFORMATION
DOCUMENTS IN ENGLISH.
IN ADDITION THERE WOULD EXTEND
THIS REQUIREMENT TO THE
THRESHOLD LANGUAGES TO ENSURE
THAT READABILITY OFF TO
COMMUNICATION TO MEDI CAL
BENEFICIARIES.
MOBILE ALSO INCORPORATE AND ONE
TIME COMMUNITY REVIEW PROCESS
FOR EXISTING AND NEW DOCUMENTS
TO GIVE COMMUNITY MEMBERS AND
ORGANIZATIONS A CHANCE TO REVEAL
AND PROVIDE FEEDBACK ON
DOCUMENTS. IN STRESSFUL
LANGUAGES
TO CONFIRM DEAR APPROPRIATIONS
THE APPROPRIATENESS AND
READABILITY.
WOULD DAHLE NATIVE SPEAKING.
LIVES SPEAKERS REVEAL OFF TO
DOCUMENT THERE'S NO WAY TO TELL
WHETHER OR NOT THE WRITING IS
REALLY S. SIX GREAT LEVEL. SO.
ES EL AS AN IMMIGRANT MYSELF I
UNDERSTAND THE LANGUAGE BARRIER
THAT EXIST FOR THOSE WHO FIRST
LANGUAGE IS NOT ENGLISH.
AND ENSURING THAT DOCUMENTS SENT
TO MEDI CAL BENEFICIARIES ARE
EASY TO READ AND UNDERSTAND IN
ENGLISH AND IN ALL THRESHOLD
LANGUAGES IS VERY IS A VERY
FIRST STEP TO ENSURING THAT
PEOPLE UNDERSTAND THE HEALTH
SERVICES. AVAILABLE TO DAN AND A
WHAT DO YOU NEED TO DO TO KEEP
THEMSELVES AND THEIR FAMILIES
HEALTHY.
AND TODAY HERE WITH ME TODAY TO
TESTIFY IN SUPPORT OF.
MARYANN MARYANNE THAT GARCIA
WAS A WOMAN'S FOUNDATION OF
CALIFORNIA. IN JIM FLORIO WAS
WESTERN CENTER ON LAW IMPROPER
PROPERTY AND CO SPONSOR OF THIS
BILL WE ALSO HAVE KIMBERLY CHEN.
WAS A CALIFORNIA PAN ETHIC HOUSE
NETWORK HERE TO ANSWER TECHNICAL
QUESTIONS.
GETTING VERY MUCH.
GOOD AFTERNOON MISTER CHAIRMAN
COMMITTEE MEMBERS MY NAME IS
MIKE AND I GARCIA OF THE HALF OF
THE WOMEN'S FOUNDATION OF
CALIFORNIA WE ARE PROUD TO
SPONSOR IN SUPPORT OF AB TWENTY
TWO NINETY NINE.
I'VE BEEN A HEALTH ADVOCATE IN
THE COUNTY OF LOS ANGELES FOR
OVER SEVEN YEARS AND HAVE LOTS
ALONG SIDE MEDI CAL ENROLLEES IN
MEMBERS. AS THEY NAVIGATE HEALTH
CARE SERVICES
AS AN ADVOCATE I BEEN WITNESS TO
MEDI CAL MEMBERS TIME AND TIME
AGAIN. BEING UNABLE TO ACCESS
CRUCIAL HEALTH CARE SERVICES AND
HAVING A DIFFICULT TIME
UNDERSTANDING INFORMING
MATERIALS.
TODAY I WANNA HIGHLIGHT THE
STORY OF LINDA A FIFTY YEAR OLD
MEDI CAL MEMBER WHOSE PRIMARY
LANGUAGE IS SPANISH.
LENDERS HEALTH HAS BEEN
NEGATIVELY IMPACTED BY NOT BEING
ABLE TO UNDERSTAND PLAN
MATERIALS.
LAST YEAR LINDA WAS ACCESS THE
MENTAL HEALTH SERVICES FOR A
MILD MENTAL HEALTH CONDITION AND
THE PROVIDER SHE SAW SPOKE
LIMITED SPANISH.
LINDA HAD A DIFFICULT TIME
COMMUNICATING WITH HIM AND
EXPERIENCE ADDITIONAL
FRUSTRATION A STRESSED THAT SHE
ALREADY HAD FILLING MINIMIZE
THOSE THE PATIENT AND NOT TAKING
SERIOUSLY.
LENT LINDA FELT STRONGLY ABOUT
FINACLE PLEA DO TO THE LACK OF
CARE AND THE DISRESPECT SHE
EXPERIENCED.
SHE HAD NO IDEA WHAT TO DO OR
WHERE TO START. SHE SPOKE TO THE
CLINIC WHO THEN REFER HER TO
SPEAK WITH THE PLAN.
WHEN SHE CALLED THE PLAN SHE
EXPLAINED WHAT WAS GOING ON AND
WAS TOLD THEY WOULD CENTER
DOCUMENTS TO FILE A GRIEVANCE.
WHEN THE MATERIALS CAME SHE WAS
VERY CONFUSED ON THE PROCESS AND
DIDN'T UNDERSTAND WHAT STEPS TO
TAKE.
LINDA ULTIMA ULTIMATELY DENY
FILED A GRIEVANCE AND IN
CONSEQUENCE HAS NOT. SOUGHT OUT
MENTAL SERVICES SINCE THEN.
AND LINDA IS NOT ALONE THESE ARE
COUNT THERE ARE COUNTLESS
EXAMPLES OF THE WAY IN WHICH
MEDI CAL MEMBERS HAVE A
DIFFICULT TIME. RECEIVING THE
CARE THEY NEED DID TO THE
INCONSISTENCIES OF PLAN
DOCUMENTS.
AB TWENTY TWO NINETY NINE WOULD
ENSURE THAT MEMBERS LIKE LINDA
HAVE THE OPPORTUNITY TO PROVIDE
MEANINGFUL FEEDBACK ON THE
READABILITY ENCLOSURE PROBE INTO
IT. OF CONSUMER MATERIALS
ESPECIALLY IN LANGUAGES OTHER
THAN ENGLISH.
AB TWENTY TWO NINETY NINE CAN
HELP ENSURE THAT OUR VIBRANT AND
DIVERSE MEDI CAL POPULATION KNOW
THEIR HEALTHCARE RIGHTS IN OUR
POWER TO MAKE INFORMED DECISIONS
ABOUT THEIR HEALTH CARE. FOR
THESE REASONS I RESPECTFULLY ASK
FOR YOUR AYE VOTE THANK YOU.
GOOD AFTERNOON JANICE FLORES
WESTERN CENTER ON LAW AND
POVERTY WERE PROUD TO CO SPONSOR
AB TWENTY TWO NINETY NINE.
AB TWENTY TWO NINETY NINE IS
BASED ON A SIMPLE PREMISE PEOPLE
ON MEDICAL SHOULD UNDERSTAND THE
MATERIAL SENT TO THEM BY MANAGED
CARE PLANS.
SOME OF THE PROBLEMS THAT WE'VE
SEEN AYE WITH OUR LEGAL SERVICES
PARTNERS ON MATERIALS THAT ARE
SENT TO PEOPLE INCLUDE THE
FOLLOWING.
SOME TRANSLATED MATERIALS ARE
ONLY PARTIALLY TRANSLATED WITH
ENTIRE PARAGRAPHS LEFT IN
ENGLISH.
THIS MIGHT BE DUE TO HOW THE
MATERIALS ARE POPULATED BUT A
COMMUNITY REVIEW WOULD HAVE
CAUGHT THIS.
SOME TRANSLATED MATERIAL SLEEP
CERTAIN TERMS IN ENGLISH USUALLY
PROPER NOUNS.
HOW A PERSON READERS OF SOME
LANGUAGE CANNOT READ THE LETTERS
USED IN THE ENGLISH ALPHABET SO
THIS JUST LEAVES A MORE
SENTENCES WITH INEXPLICABLE
SYMBOLS IN THE MIDDLE? READERS
OF OTHER LANGUAGES WOULD STILL
NEED AN EXPLANATION OF THE
UNTRANSLATED TERMS.
SOME TRANSLATED MATERIALS ARE
WRITTEN IN A DIALECT OF THE
LANGUAGE NOT SPOKEN BY THE LOCAL
COMMUNITY MEMBERS.
ARMENIAN FOR EXAMPLE HAS BOTH
THE WESTERN EASTERN DIALECT THE
DIALECT SHARE NOTHING COMMON
THAT MATERIALS CAN BE PRODUCED
THAT ARE UNDERSTANDABLE BY BOTH
BUT ONLY IF MEMBERS OF THE
COMMUNITY ACTUALLY REVIEW THESE
MATERIALS.
CONSUMERS REPORT RECEIVING
MATERIALS THAT ARE TOO FORMAL.
JUST AS READERS OF ENGLISH WOULD
NOT UNDERSTAND MATERIALS WRITTEN
IN LEGALESE ARE WITH LOTS OF
TECHNICAL HEALTH INDUSTRY
LANGUAGE READERS OF OTHER
LANGUAGES STONE AS WELL AND
SOMETIMES THIS IS ACTUALLY
BECAUSE THE TRANSLATOR IS VERY
EDUCATED AND THE RELY ON THE
TERMINOLOGY THAT THEY KNOW.
SOME TRANSLATIONS ARE LITERAL
BUT NOT UNDERSTANDABLE.
FOR EXAMPLE ONE HEALTH PLANS
LANGUAGE ACCESS SHE GIVES THE
PHONE NUMBER TO CALL IN EACH
LANGUAGE AND IT TELLS IN RELEASE
IF THEY SPEAK TRADITIONAL
CHINESE THEY CAN GET LANGUAGE
ASSISTANCE.
NOBODY ACTUALLY SPEAKS
TRADITIONAL CHINESE THEY SPEAK
MANDARIN OR CANTONESE AND SO IT
SEEMS THAT THE TRANSLATOR WAS
JUST TRANSLATING INSTRUCTION.
ALL OF THESE PROBLEMS WOULD
HAVE BEEN CAUGHT BY A COMMUNITY
REVIEW AND SO ALL MEDICARE
BENEFICIARIES WHETHER SPEAKERS
OF ENGLISH ANOTHER LANGUAGE
SHOULD BE ABLE TO UNDERSTAND
THOSE MATERIALS.
FOR THESE REASONS WE
RESPECTFULLY REQUEST YOUR AYE
THOSE.
VERY MUCH.
KIMBERLY CHIP KIMBERLY CHANNEL
THE CALIFORNIA PAN ETHNIC HEALTH
THAT WORK IN SUPPORT.
OTHERS IN SUPPORT.
LET THE CITY BUS I REPRESENTING
THE WOMEN'S FOUNDATION OF
CALIFORNIA AND IT IS A CO
SPONSOR WE ARE JUNK SUPPORT.
I MY LEYVA FROM SANTANA BUILDING
HEALTHY COMMUNITIES AND WE ARE
IN STRONG SUPPORT.
MARY VALDEZ WITH HEALTHAXIS
CALIFORNIANS SUPPORT.
Q..
IN THE MENDELSSOHN CONSUMER
UNION IN SUPPORT.
EDUCATED ASIAN AMERICANS
ADVANCING JUSTICE CALIFORNIANS
TRUNKS POINT.
KATIE INJURED CHILDREN DOWN
SUPPORT.
KELLY BROOK SOME BEHALF OF THE
COUNTY WELFARE DIRECTORS
ASSOCIATION HERE.
VERY MUCH.
THERE ANYONE IN OPPOSITION.
I COULD AFTER NAM JENNIFER ALLEY
WITH A CALIFORNIA ASSOCIATION
HEALTH PLANS AND WE ARE OPPOSED
TO THIS BILL. WE FEEL THAT IT
INCLUDES UNNECESSARY REPETITIVE
AND COSTLY ADMINISTRATIVE COSTS
FOR THE PLAN.
ESTABLISHMENT OF ONE TIME TARGET
COMMUNITY READ REVIEW OF HEALTH
PLAN MATERIALS.
IT INCLUDES A NATIVE SPEAKER OF
WEEKS EACH LANGUAGE WILL BE VERY
DIFFICULT AND EXPENSIVE. ON FOUR
MEMBER STATE HERE TO FOR
MATERIAL INFORMATIONAL MATERIALS
THAT HAVE ALREADY BEEN
TRANSLATED.
IN ADDITION THE BILL REQUIRES
THAT THE MEDI CAL MANAGED CARE
PLAN REPORT TO THE KEY.
TO THE DEPARTURE THEIR
REGULATOR REGARDING THE
COMMUNITY PROCESS
COMMUNITY REVIEW PROCESS AND WE
DON'T UNDERSTAND WHAT THE
PURPOSES OF THIS REPORT. HOW
WILL BE USED HOW FREQUENT HEALTH
PLANS BE REQUIRED TO FILE THAT
REPORT?
OVERALL THIS BILL A DAD ADDS
ADDITIONAL COSTS THAT WERE
REQUIRE ADDITIONAL STATE A
MANAGED CARE PLAN RESOURCES AND
OFFERS NO ASSURANCE THAT THE
COMMUNITY REVIEWED MATERIALS BE
MORE EFFECTIVE THAN THOSE.
MATERIALS US ARE CURRENTLY
TRANSLATED.
I'M AVAILABLE FOR ANY
ADDITIONAL QUESTIONS A MADE UP.
IS THERE ANYONE ELSE IN
OPPOSITION.
SEEING NO ONE BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS.
SEEING NONE.
.
IF YOU GIVE ACCEPTED THE
AMENDMENTS I RECALL HEARING
THAT'S GOOD THANK YOU OF.
THIS IS OUR MOTION S. RESEARCHER
WOULD YOU LIKE TO CLOSE TO KAREN
THANK YOU I DE AGAIN. THAT THIS
IS THAT AN IMPORTANT AFTER AN
IMMIGRANT THAT WOULD MAKE SURE I
HAVE REVEALED SEVERAL OF A DAY
TRANSLATE THE DOCUMENT. AND DID
IT IS I WOULD LOVE TO SEE THEM
BEING MORE.
READABLE AND CULTURALLY
APPROPRIATE.
TO TO TO TO
TO TO HAVE MY.
.
PEOPLE LIKE A A HOUSING ENGLISH
VARIAS HOW COME FROM THE.
THE TREE WAS WAS A DIFFERENT
CULTUREAND I RESPECTFULLY ASK
FOR YOUR RIVAL.
YOU VERY MUCH MISTER
CHIU.
WE DO HAVE A MOTION BY MISTAKE
HERE CURRY TO WE HAVE SECOND.
SECOND BY MISS CARILLO. OF THE
MOTION IS TO PASS AS AMENDED TO
APPROPRIATIONS MADAM SECRETARY
PLEASE CALL THE ROLL. WOULD I
WENT I MAYES. MAYES NO ANGER
CURRY. ACTOR CURRY AYE BIGELOW
PICCOLO NOW BONTA AYE BONTA AYE
BURKE.
CARILLO I'VE CARILLO AYE FLORA.
LAUREN KNOW LONG. LONG FIVE
MCCARTY MCCARTY AYE IN THIS
AREA.
RODRIGUEZ.
SANTIAGO. SANTIAGO AYE PARENT.
THURMOND AYE WALDRON. WILDER NO.
YOU YOUR BILL HAS EIGHT VOTES US
ENOUGH TO GET OUT THE COMMITTEE
I WILL LEAVE IT OPEN FOR OTHERS
THAT ON TAKE MISTER TO. MISTER
GLORIA.
CURRENTLY.
WE. HAVE WE HAVE.
MISTER GROUP PRESENTING AB TWO
EIGHT FOUR THREE WE HAVE A
MOTION AND A SECOND MISTER
GLORIA.
YOU KNOW I THINK.
TOPIC TO LOOK AT YOU SURE DID
HIS HE DID SO I'M PICKING UP
WHAT YOU'RE PUTTING DOWN OF THIS
IS A PROBLEM.
WE NEED TO FIX IT ALL OF US KNOW
THERE'S A HEALTH CRISIS IN THIS
STATE THE FACT THAT THERE ARE.
HUNDREDS OF MILLIONS OF DOLLARS
THEIR LINE ON UTILIZED ON IS A
SCANDAL THOSE IDENTIFIED BY OUR
STATE AUDITOR WITH THIS BILL WE
CAN TAKE SOME ACTION TO CREATE
LEVERAGE MAKE SURE THESE DOLLARS
ARE SPENT IN COMMUNITIES WHERE
THE NEED IS GREATEST. OUT YOU
AYE VOTE TODAY WE GET THIS BILL
GOING AND HOPEFULLY GET SOME
RELIEF TO COMMUNITIES ARE
DEALING WITH A SIGNIFICANT
HEALTH CRISIS I ASK FOR YOUR AYE
VOTE.
GLORIA THERE OTHERS IN SUPPORT
OF MR GLORIA'S BILL.
NOT AT THIS HOUR SIR.
IT'S EARLY MISTER CLEARY.
WAIT TILL NEXT WEEK FOR NIGHT
OWLS LIKE YOURSELF DOCTOR WITH.
IS THERE HE WON IN OPPOSITION.
GOOD EVENING CHAIRMAN AND
COMMITTEE MEMBERS MY NAME IS
MARY THERE WITH THE COUNTY
BEHAVIORAL HEALTH DIRECTORS AND
I'M MAKING COMMENTS ON BEHALF
OF.
THE ASSOCIATION AS WELL AS THE
CALIFORNIA STATE ASSOCIATION OF
COUNTIES. WE DO WANT TO RESPOND
TO THE ASSEMBLY MEMBERS
INDICATION ABOUT. IN MANY MANY
IN THE POLITICAL PRESS WILL SAY
FUNDS ARE SITTING AROUND.
FUNDS THERE AS A RECENT AUDIT.
THOSE ISSUES ARE BEING ADDRESSED
BOTH BY STATE LAW THAT WAS
ENACTED LAST YEAR AB ONE ONE
FOUR IN THE STATE BUDGET
PROCESS.
TO ADDRESS REVERSION AND
ADDRESSED WHERE THOSE FUNDS GO.
UP IF THEY HAVE SAT.
AROUND OR BEEN UNUSED IN THREE
YEARS.
SO I WANTED TO POINT OUT THAT
MANY MENTAL HEALTH SERVICES ACT
PROGRAMS ARE IN CLOSE
COLLABORATION WITH CITIES.
COUNTY AFFILIATES
SCHOOLS
SCHOOL DISTRICTS AND OTHER LOCAL
ENTITIES.
NOTHING IN CURRENT LAW PROHIBITS
SUCH COLLABORATION.
THERE ARE HUNDREDS OF MHSAA
PROGRAMS ALREADY OPERATING IN
COLLABORATION WITH PUBLIC
SCHOOLS CITY POLICE DEPARTMENTS
AND OTHER LOCAL PUBLIC ENTITIES.
IN ADDITION THE ACT REQUIRES
THAT EACH COUNTY CONSULT WITH
LOCAL STAKEHOLDERS DURING ITS
THREE YEAR PLANNING PROCESS IN
THIS IS A VERY INTENSE OF LOCAL
PROCESS.
WE'RE NUMEROUS STAKEHOLDERS
INCLUDING SCHOOLS LOCAL LAW
ENFORCEMENT CITIES AND ALL KINDS
OF OTHER STAKEHOLDERS ARE AND.
INVITED AND PARTICIPATE.
AB TWENTY EIGHT FORTY THREE SIDE
STEPS THE LEADERSHIP ROLE IT
LEGAL RESPONSIBILITY THAT
COUNTIES PLATE IN CALIFORNIA. IN
DELIVERING HEALTH AND HUMAN
SERVICES TO VULNERABLE
CALIFORNIANS.
I HAVE.
AND.
THIS BILL SHIPS FUNDS AWAY FROM
COUNTIES THAT WILL RESULT IN THE
DISRUPTION OF SERVICES TO
MILLIONS OF CALIFORNIANS
ENJOYING THE BENEFITS OF THE
MENTAL HEALTH SERVICES ACT.
AND WILL DISRUPT THE LOCAL
PRIORITIES THAT I EARLIER
MENTIONED THANK YOU FOR YOUR
TIME.
THE TERRORIST TO LOT OF OR
SOMETHING AFTER URBAN KAISER
CALIFORNIA ALSO IN OPPOSITION
FOR THE REASONS STATED BY CBJ
AND AND WILL KNOW THAT WE DO
WORKS WITH ALL OF THESE ENTITIES
AT THE LOCAL LEVEL AND WE HAVE.
REPORTING THAT WE HAVE TO DO WE
HAVE ALL THESE.
.
AUDITS AND THINGS GOING ON SO WE
JUST DON'T THINK IT'S
APPROPRIATE TIME TO START
DIVERTING TO OTHER ENTITIES WHO
DON'T HAVE THE SAME
RESPONSIBILITIES THAT WE DO
THANK YOU.
KELLY BUCKS ON BEHALF OF THE
RURAL COUNTY REPRESENTATIVES OF
CALIFORNIA WERE ALSO IN
OPPOSITE.
IS THERE ANYONE ELSE.
SEE NO ONE WILL BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS.
WHICH LIKE CLOSE MISTER CLARK I
WOULD JUST AS A MATTER OF
KEEPING THIS ON THE RECORD IS
THIS ISNOT A BILL THAT WAS
DEVELOPED BY THE POLITICAL PRICE
THIS IS A BILL THAT WAS
DEVELOPED BY OUR STATE AUDITOR.
WE HAVE TWO AND A HALF BILLION
DOLLARS THAT ARE SITTING IN FUND
BALANCES IN COUNTIES ALL ACROSS
THE STATE. ALAMEDA COUNTY
HUNDRED FOUR MILLION SACRAMENTO
COUNTY HUNDRED TWENTY FIVE
MILLION IN MY OWN COUNTY HUNDRED
EIGHTY FIVE MILLION IN MY COUNTY
LAST YEAR MISTER WOULD YOU KNOW
WE LOST TWENTY PEOPLE TO
HEPATITIS A. WE HAVE A MASSIVE
HOMELESSNESS CRISIS IN MY CITY
IN THE LAST EIGHT YEARS THE
NUMBER OF A NINE ONE ONE MENTAL
HEALTH IMAGE BECAUSE IT
INCREASED BY OVER ONE HUNDRED
PERCENT.
THE FACT THAT WE'RE SITTING ON
THIS KIND OF MONEY NOT EXPENDED
NOT ALLOCATED IS A SCANDAL WE AS
LEGISLATORS MUST DO SOMETHING TO
ADD. TO WORK ON THAT I'M WILLING
TO WORK WITH ALL OF THE COUNTIES
TO MAKE SURE WE HAVE A PROCESS
THAT THEY CAN LIVE WITH. BUT
ULTIMATELY THEY ARE NOT SPENDING
THE FUNDS THIS IS ON ALL OF OUR
CONSCIOUSNESS PEOPLE WITH MENTAL
HEALTH NEED RELIEF NOW I ASK FOR
YOUR AYE THOSE.
GLORIA.
PLEASE YES YOU CAN.
I APPRECIATE THIS BUILD GRAPH
HERE.
BECAUSE I'M NOTICING WHEN MY
COUNTIES LAKE COUNTY APPEARS
THAT IS NOT EVEN.
RENT. SINCE TWO THOUSAND ELEVEN.
LIMIT TWO THOUSAND AND EIGHTEEN.
AND SO I AND I JUST NEED TO
CONTINUING US GETTING PEOPLE.
WHY HAVEN'T THEY REPORTED TIMELY
AND THEY HAVE FUNDING THAT'S?
THANK YOU FOR WRITING THIS
INFORMATION.
THAT'S FOR THE STATE AUDITOR'S
OFFICE AND THANK YOU FOR SOME IN
THE BACK DR.
WAS THAT EMOTION YEAH BUT COULD
NO THERE THAT'S THE MOTION
THERE'S.
TO HAVE AM A MOTION BY MS SAGER
CURRY A SECOND BY MISTER
SANTIAGO THIS DOESN'T CHOI DO
PASS RECOMMENDATION.
THE MOTION IS TO PASSED
APPROPRIATIONS MADAM SECRETARY
PLEASE CALL THE ROLL WOULD I
WOULD I MAYES. MAYES NO ANCHOR
CURRY HACKER CURRY AYE BIGELOW.
BIGELOW NO BONTA AYE BONTA AYE
BURKE.
CARILLO AYE CARILLO AYE FLORA.
FLORA NO THE MOST.
I LIMON AYE. MCCARTY.
MCCARTY AYE THIS AREA.
RODRIGUEZ.
SANTIAGO.
SANTIAGO AYE THURMAN. THURMOND
AYE WALDRON. WILDER NO.
YOU'RE YOU'RE GOES OUT HERE OF A
HOAX THE CANISTER VERY MUCH OF A
SUPER.
I'M AGO MISTER THURMAN.
CAN'T WE CITY.
THE BILL.
PLEASE GO AHEAD WHEN WIENER AYE
THANK YOU MISTER CHAIR COMMITTEE
MEMBERS SOME BEFORE YOU PERCENT
AB TWENTY EIGHT SEVENTY FOUR. I
THIS BILL DEALS WITH THE SUBJECT
OF HOSPITAL CLOSURES WE TALKED
ABOUT ONE TONIGHT. YOU KNOW THAT
THERE HAVE BEEN MANY THROUGHOUT
THE STATE. MY DISTRICT ALONG
WITH EXPERIENCE ONE OF THAT WAS
THERE YOU KNOW PRIMARY HOSPITAL
FOR OF MANY IN OUR COMMUNITY
OVER FACING THE POSSIBILITY OF A
CLOSURE NOW AYE AYE DECLARED
CLOSURE BY ALTA BATES HOSPITAL.
OF THIS UP MEASURE WOULD
LENGTHEN THE TIME LINES THAT
COMMUNITY MEMBERS SHOULD BE
GIVEN A. NOTICE ABOUT A CLOSURE
AS WELL AS THE ATTORNEY GENERAL
IN THE DEPARTMENT OF PUBLIC
HEALTH SPECIFICALLY IT SAYS
THAT.
INSTEAD OF IT BEING.
NINETY DAYS FOR THE PUBLIC
DEPARTMENT PUBLIC HEALTH WOULD
BE HUNDRED EIGHTY DAIS
IT SAYS THAT A FOR THE ATTORNEY
GENERAL MUST BE A HUNDRED EIGHTY
DAYS PRIOR TO THE CLOSING OR
ELIMINATING. OF ANY SUPPLEMENTAL
SERVICE.
AND IT A PROHIBITS THE HOSPITAL
FROM CLOSING PRIOR TO OBTAINING
WRITTEN CONSENT FROM THE
ATTORNEY GENERAL.
I WITH ME TODAY TO PROVIDE
ADDITIONAL EMPHASIS AND
TESTIMONY.
IS TAYLOR JACKSON AYE
REPRESENTING THE CALIFORNIA
NURSES ASSOCIATION I
RESPECTFULLY ASK YOUR AYE VOTE.
GRANT.
THANK YOU I MISS RETURN MEMBERS.
THANK YOU FOR YOUR
CONSIDERATION OF AB TWENTY EIGHT
SEVENTY FOUR ON AND THAT HOW
MANY NURSES ASSOCIATION OF THE
SPONSORS OF THIS LEGISLATION.
SO ACROSS CALIFORNIA MAJOR
PROVIDERS OF HEALTHCARE AND JOBS
CLOSE THEIR DOORS WITH LITTLE
NOTICE TO THE COMMUNITY.
HOSPITAL CLOSURES DECIMATE
NEIGHBORHOODS AND IN DANGER
CITIES PARTICULARLY WHEN
RESIDENTS ARE LEFT WITHOUT A
LOCAL EMERGENCY ROOM WITH IN A
SAFE DISTANCE OF THEIR HOMES AND
SCHOOLS. IN BERKELEY AS THE
ASSEMBLY MEMBER MENTIONED ALTA
BATES MEDICAL CENTER OWNED BY
SUTTER HEALTH HAS BEEN UNDER
THREAT OF CLOSURE WHICH WOULD
LEAVE THE CITY IN A HEALTH
DOESN'T WITH A SEVERE LACK OF
EMERGENCY SERVICES.
HOSPITAL'S ESCALATE THEIR
DECISION TO CLOSE THE FACILITY
BY TRYING TO SPEED UP THE
PROCESS IN ORDER TO AVOID PUBLIC
PUSH BACK.
THESE ARE DIVERSIONS ARE
OFTEN USED AS A CYNICAL TOOL TO
REDUCE THE VITAL SERVICES
FACILITIES OFFER. WHICH USUALLY
MAKES THE FINAL CLOSURE OF THE
HOSPITAL INEVITABLE.
INSTEAD OF HASTENING OF CLOSURE
THE POSES A THREAT TO THE
COMMUNITY HOSPITAL SHOULD BE
WORKING WITH COMMUNITY RESIDENTS
DOCTORS NURSES AND WORKERS TO
RECEIVE PUBLIC INPUT. AND RETAIN
ESSENTIAL HEALTH CARE SERVICES.
WE DID HAVE A NURSE WHO ISHERE
TO TESTIFY BUT SHE HAD TO CATCH
A FLIGHT.
SO I JUST WANTED TO EMPHASIZE
WHAT SHE WAS GOING TO SAY WHICH
SHE WORKED FOR COMMUNITY
HOSPITAL IN LONG BEACH AND THEY
CURRENTLY HAVE NINE OPERATORS
INTERESTED IN TAKING OVER THEIR
OPERATIONS. AND THAT BILLS THIS
TO THEM BECAUSE THE MORE TIME
ADVOCATES ARE GIVEN TO ORGANIZE
A PLAN WHEN A HOSPITAL SAYS
THEY'RE GOING TO CLOSE. THE MORE
LIKELY WE ARE TO HAVE A BETTER
OUTCOME.
THESE HOSPITALS ARE WHERE FAMILY
MEMBERS ARE BORN OUR NEIGHBORS
GO WHEN THEY GET SICK AND OUR
CITIES COUNT ON TO BE THERE WHEN
A WILDFIRE OR EMERGENCY STRIKES.
HOSPITALS ARE A VITAL PART OF
THE PUBLIC INTEREST IN
CALIFORNIANS ARE ENTITLED AT THE
BARE MINIMUM TO ADEQUATE NOTICE
OF THEIR CLOSURE.
SEEING A RESPECTFULLY ASK YOUR
AYE VOTE MAYBE TWENTY IT'S ONLY
FOR.
I SHOULD NOTE THAT YEAR THAT WE
ARE ACCEPTING AMENDMENTS OFFERED
BY THE COMMITTEE THANK YOU.
OTHERS IN SUPPORT.
MICHELLE CAPITA WITH SEIU
CALIFORNIA CHERRY MEMBERS WE ARE
PROUD TO SUPPORT THIS MEASURE.
THIS HITS CLOSE TO HOME NOT
JUST FOR OUR MEMBERS WHO WORK
AT.
ALTA BATES AS WELL BUT FOR MANY
OF THE DISTRICTS AND COMMUNITIES
YOU SERVE.
FROM SADDLEBACK MEMORIAL.
IN SAN CLEMENTE TO LONG BEACH
MEMORIAL.
THERE HAS BEEN A TREND OF
HOSPITALS PULLING THE RUG OUT
FROM UNDERNEATH COMMUNITIES.
AND IN THE ABSENCE OF A LARGER
STATEWIDE PLANNING PROCESS TO
ENSURE. THAT OUR COMMUNITIES
HAVE ACCESS TO NEEDED SERVICES
WE BELIEVE THAT A MEASURE LIKE
THIS IS APPROPRIATE AND WE'RE
PROUD TO SUPPORT IT THANK YOU.
MISTER CHAIR MEMBERS SARAH
FLOCKS CALIFORNIA LABOR
FEDERATION HAPPY TO BE IN
SUPPORT WITH CNN SEIU IN THIS ON
THE SPELL THANK YOU.
SIR ANYONE IN OPPOSITION.
PLEASE.
MISTER CHAIR COMMITTEE MEMBERS
BE DAY PARTISAN FROM THE
CALIFORNIA HOSPITAL ASSOCIATION
AND THE US CA CHANNEL MEMBERS
HAVE SEVERAL OF. A ISSUES WITH
THIS BILL. AT FIRST THE BILL'S
DUPLICATIVE THERE ARE ALREADY
EXISTING LAWS IN PLACE FOR
HOSPITALS TO NOTIFY CDP H.
COUNTY LOCAL GOVERNMENTS. AND
THE PUBLIC PRIOR CHECK CLOSING
REDUCING EMS SERVICES.
SECONDLY THE REQUIREMENT FOR AG
APPROVAL OF ELIMINATION OR
REDUCTION OF HEALTH CARE
SERVICES IS UNNECESSARY
INAPPROPRIATE.
THIS ADDITIONAL STATUTORY LAYER
PLACES THE OFFICE AND POSITION
OF DETERMINING LOCAL PUBLIC
HEALTH CARE NEEDS.
IT COULD ALSO BE FINANCIALLY
TROUBLED HOSPITALS UNABLE TO
SUSTAIN CONTINUED LOSSES FOR THE
HUNDRED EIGHTY DAYS AEGEUS
CONSIDERING REQUESTS.
AND FINALLY.
WITH THIS TIME EXTENSION THE
AUTHOR SUGGESTING THE BILL WILL
KEEP HOSPITALS AND EDIE'S OPEN.
HOWEVER AT THE EIGHTY DOES NOT
HAVE CONTROL OVER HOSPITAL
REIMBURSEMENT RATES PATIENT
VOLUME PATIENT MIX OR OTHER
FACTORS THAT AFFECT THE
HOSPITAL'S FINANCIAL VIABILITY.
AND THEREFORE IT IS NOT CLEAR
HOW THIS WOULD PER.
FOR THAT PERMIT HOSPITALS OR
EMS SERVICES.
FOR COMMUNITIES THANK YOU.
CALF MUSCLES GOT RESENTING H
ó CALIFORNIA HOSPITALIZATION
AND THE UNITED HOSPITAL
ASSOCIATION.
WOULD JUST ASSOCIATE MY
COMMENTS OF MY COLLEAGUE FROM
THE CALIFORNIA HOSPITAL
ASSOCIATION THERE'S NOTHING IN
THIS BILL. THAT GETS A HOSPITAL
WHERE THEY NEED TO GO.
WHEN THEY'RE CLOSING MEANING A
SEISMIC RETROFIT FUNDING FOR
THAT FUNDING TO KEEP THE OPERATE
THE HOSPITAL OPEN THERE'S
NOTHING THAT THE AG CAN PROVIDE.
TO KEEP THEM OPEN AND ASK THAT
TIMELINE LINK THINGS WERE STILL
LOSING STAFF.
STILL LOSING STUFF EVERYDAY AND
SO FOR US IT'S
IT WOULD WE FEEL LIKE IT IT IS A
TOUGH POSITION FOR THE COMMUNITY
BUT IT'S NOT A POSITION. IT'S
NOT A DECISION THE HOSPITAL
TAKES LIGHTLY. AND THE LAMP
LONGER THAT DECISION GOES THE
LAST STAFF WE HAVE THE MORE
DIFFICULT IT IS TO KEEP
OPERATIONS GOING.
MAYOR MARTIN ON BEHALF OF THE
CALIFORNIA CHILDREN'S HOSPITAL
ASSOCIATION ALSO IN OPPOSITION
FOR THE REASONS PREVIOUSLY
STATED.
ANYONE ELSE IN OPPOSITION.
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS.
ANY COMMENTS.
THE THE MOTION.
MISTER FLORA SECOND BY MR
MCCARTY.
I MISTER SANTIAGO EXCUSE ME BUT
AND THEN SECOND BY MR MCCARTY.
WHICH LIKE CLOTHES MISTER
CHAIRMAN.
THERE.
THINGS CHAIR I APPRECIATE THE
CONCERNS RAISED BY OPPOSITION
OUT TO SAY THAT.
WE ALL DO LONG RANGE PLANNING
INFO HOSPITALS IN A CLOSE REDUCE
SERVICES I THINK THAT'S
SOMETHING THAT COMMUNITY MEMBERS
HAVE A RIGHT TO DO. THIS BILL
EXTENDS THE TIME LINES TO MAKE
SURE THAT THE COMMUNITY HAS
INPUT THIS HOSPITAL IN MY
DISTRICT IS THE ONLY ACUTE
HOSPITAL IN THE CITY OF
BERKELEY.
THAT WOULD SERVE ALL THE
STUDENTS AS WELL AS THOSE WHO
COME FOR THINGS LIKE HAVING.
YOU KNOW THEIRCHILDREN BORN
THERE.
IF PEOPLE HAVE A RIGHT TO KNOW
AND MANY IN OUR COMMUNITY DID
NOT KNOW ABOUT THE CONCERNS OF
THIS HOSPITAL CLOSING. THIS BILL
CHANGES THAT PROCESS GIVES
COMMUNITY UPPER RIGHT TO BE
HEALTHY AND BE INFORMED I
RESPECTFULLY ASK YOUR AYE VOTE.
HE'S VERY MUCH MR THURMAN THE
MOTION IS TO PASS TO.
JUDICIARY DOESN'T ENJOY DO PASS
RECOMMENDATION FROM THE CHAIR
MADAM SECRETARY PLEASE CALL THE
ROLL. WHAT I WHAT I MEAN IS NOW
MAYES NO AGAR CURRY?
ANGER CURRY AYE BIGELOW. BIGELOW
NOW BONTA.
BURKE.
CARILLO AYE CARILLO AYE FLORA.
FLORA NO LIMON. LIMON AYE
MCCARTY. MCCARTY AYE NAZARIAN.
RODRIGUEZ. RODRIGUEZ AYE.
SANTIAGO.
SOME TERRIBLE AYE THURMAN AYE
AYE THURMOND AYE.
WALDRON.
WONDER NO.
HE DOES A VOTES IS OUT OF
COMMITTEE THANKS VERY MUCH MR
CHAIRMAN THANK YOU MISTER
RODRIGUEZ.
ARE YOU.
READY TO PRESENT YOUR BILL SIR.
AB NINETEEN NINETY EIGHT
.
GENTLY REMOVE.
THE MOTION AND A SECOND WAS THIS
RODRIGUEZ.
YOUR MEMBERS.
TWENTY SIXTEEN CALIFORNIA SAW
OVER TWO THOUSAND OPIOID
OVERDOSE DEATHS AND NEARLY FOUR
THOUSAND MERGING VISITS.
FOR OPEN HEART OVERDOSES
NINETEEN NINETY EIGHT REQUIRE
EVERY HEALTH CARE PRACTITIONER
AUTHORIZED PRESCRIBE OPIATES TO
ADOPT A SAFE.
ASCRIBING PROTOCOL WITH THE GOAL
OF REDUCING UNNECESSARY CLERK
PRESCRIPTIONS.
THE PROBABLY HELP WOULD UTILIZE
DATA FROM THE CHURCH DATABASE
AND TRUCK THE REDUCTIONS OF OVER
PRESCRIPTION THE TOW TWENTY
TWENTY TWO.
MEMBERS THE LANGUAGE OF PRINTING
BEFORE YOU TODAY IS NOT PERFECT
HOWEVER IT IS THE FIRST STEP
TOWARDS FINDING A MEANINGFUL
COMPROMISE WITH. THE MEDICAL
COMMUNITY THAT WILL ACHIEVE A
SIGNIFICANT REDUCTION APPEAR
PRESCRIBING.
THEY ARE STILL HERE IS A MUST BE
DEFINED AND NEGOTIATE AS THE
BILL MOVES FORWARD AND LOOK FOR
TO CONTINUE THOSE DISCUSSIONS.
WITH ME TODAY IS PROFESSIONAL
SHARE ACTING ASSISTANT PROFESSOR
AT USC'S.
TECH SCHOOL OF MEDICINE AND LEAD
RESEARCHER FOR A STUDY WHICH
REVEALS THAT A LARGE SHARE OF
OPENER PRESCRIPTIONS.
ORIGINATES FROM THE DOCTOR'S
OFFICE.
HI MY NAME IS SAXENA I'M
ASSISTANT PROFESSOR OF EMERGENCY
MEDICINE AT THE UNIVERSITY OF
SOUTHERN CALIFORNIA MY RESEARCH
FOCUSES ON THE IMPACT OF STATE
LOCAL POLICIES ON THE
PRESCRIPTION OPIOID EPIDEMIC IN
THE UNITED STATES.
A RECENT STUDY OF MINE COOPERATE
WITH COLLEAGUES AT THE KECK
SCHOOL OF MEDICINE FINDS THAT
FROM NINETEEN NINETY SIX TO TWO
THOUSAND TWELVE THERE WAS A FOUR
HUNDRED AND SEVENTY ONE PERCENT
INCREASE. IN THE TOTAL QUANTITY
OF OPIOIDS PRESCRIBED IN THE
UNITED STATES
THE SINGLE GREATEST DRIVER OF
THIS INCREASED WAS OPIOID
PRESCRIPTIONS ORIGINATING IN
OFFICE SPACE SETTINGS LIKE
PRIMARY CARE PRACTICES.
IN NINETEEN NINETY SIX SEVENTY
ONE PERCENT OF TOTAL OF YOU AIDS
CAN FROM OFFICE SPACE SETTINGS
THAT NUMBER GOOD EIGHTY THREE
PERCENT BY TWENTY TWELVE. THE
SHARES ATTRIBUTABLE TO OTHER
SOURCES LIKE E. OURS IN PATIENT
STAYS ACTUALLY DECLINED OVER
THAT PERIOD.
IN ADDITION TO BEING A LARGE
SHARE OF THE TOTAL THE AVERAGE
OFFICE SPACE PRESCRIPTION WAS
STRONGER AND LONGER THAN THOSE
FROM OTHER SITES OF CARE.
FURTHER MUCH OF THE GROWTH IN
PRESCRIBING BY OFFICE BASED
PHYSICIANS IS ATTRIBUTABLE TO
REPEATED OR REFILL PRESCRIPTIONS
RATHER THAN ONE TIME
PRESCRIPTION.
REVEALED OPIOID PRESCRIPTIONS
FROM OFFICE SPACE SETTINGS
THROUGH FOUR HUNDRED AND FORTY
SIX PERCENT OVER THE HOUSES
PERIOD.
FINALLY WE FIND THE FREQUENT
USERS OF OPIOIDS RECEIVE MORE
THAN EIGHTY PERCENT OF THEIR.
BICU IT'S FROM OFFICE SPACE
SETTINGS COMPARED TO THE AVERAGE
USER WHO RECEIVES FORTY FOUR
PERCENT FROM OFFICE BASED
SETTINGS.
BASED ON THESE RESULTS EFFORTS
TO REDUCE INAPPROPRIATE OPIOID
PRESCRIBING THAT ARE FOCUSED ON
OFFICE SPACE SETTINGS COULD BE A
VERY SUCCESSFUL TOOL IN
COMBATING THE CURRENT OPIOID
EPIDEMIC.
THANK YOU TO THE CHAIR OF THE
COMMITTEE FOR LISTINGS MY
COMMENTS AND THANK YOU TO
ASSEMBLY MEMBER RODRIGUEZ FOR
INVITING ME TO SHARE THE RESULTS
OF MY RESEARCH TODAY.
VERY MUCH OTHERS AND SUPPORT. A
GOOD AFTERNOON OUT MICROBES IN
HERE ON BEHALF OF QUEST
DIAGNOSTICS A WEEK WE HAD A
SUPPORT IF AMENDED POSITION ON
THE PREVIOUS VERSION OF THE BELL
AND. AND REALLY I EVEN WITH THIS
VERSION OF THE BILL WE I THINK
ARE AMENDMENT IDEA IS STILL
PERTINENT AND THAT JUST SHARE
REALLY QUICKLY. IS ON AND AND
AND REALLY QUESTS PERSONALLY
THIS BILL AND ALL THE OTHER
PRESCRIBER PRACTICES BILLS THAT
ARE THAT ARE MOVING THROUGH THE
LEGISLATURE. AND THAT THE CDC
GUIDELINES AS MISS BURKE ALREADY
POINTED OUT I'M.
.
HAVE RECOMMENDATIONS FOR
PHYSICIANS IN IN IN THE CDC AND
MEDICAL BOARD GUIDELINES
RECOMMENDATIONS INCLUDE A
BASELINE URINE TESTS FOR FOR FOR
PRESCRIPTIONS FOR OPIOIDS. AND
AND REALLY WE THINK THAT A.
THAT THAT COMPONENT OF THE CDC
GUIDELINES SHOULD BE SOMETHING
THAT IS IN ANY OF THE SAFE PROP
PRESCRIBER PRACTICES ARE
PROVIDER.
YOU KNOW BILLS AND THAT THE
BASELINE PASSED IT WILL
ULTIMATELY TO IT REALLY IS THE
ULTIMATE IN EVIDENCE BASED
MEDICINE.
FOR A PEOPLE WHO ARE GETTING
PRESCRIPTION OPIOIDS.
THE DOCTOR SHOULD KNOW WHAT
DRUGS THEY MAY ALREADY BE ON
WHETHER THEY'RE ALREADY ON
CERTAIN OP ó EIGHTS WHETHER
THEY'RE TAKING DRUGS THAT ARE.
YOU KNOW WHETHER THE GETTING
DRUGS FROM THEIR NEIGHBOR FROM
THE MEDICINE CABINET OR WHATEVER
THAT THERE'S THINGS THAT THE
CURE'S DATABASE JUSTICE IS GOING
TO SHOW A BLOOD TEST WILL SHOW
IN HAVE IN IT. AND IT WILL HELP
DOCTORS MAKE MORE INFORMED
DECISIONS ON WHAT THEY PRESCRIBE
HOW THEY PRESCRIBE IN SOON SO
WHICH ONE TO SHARE THAT. SAYS
BILL MOVES FORWARD ANY OF THE
OTHER PRESCRIBER PRACTICES BILLS
THAT ARE. COMING FOR LEGISLATURE
WOULD LIKE YOU TO CONSIDER THAT
THE CDC GUIDELINES AS IT
PERTAINS TO THE A BASELINE URINE
TESTING PERIODIC TESTING FROM
THERE THANK YOU.
THANK YOU MISTER MEMBERS OF THE
COMMITTEE DAVID GONZALEZ.
AMERICA'S PHYSICIAN GROUPS.
MARKED AS A PRACTICING OVER
THREE AND A MEDICAL GROUP SO I
THINK THE.
THE AUTHOR FOR HIS GOOD WORK ON
THIS BILL AS WAS YOUR COMMITTEE
STAFF FOR THE RECENT AMENDMENTS
WE INITIALLY HAD OPPOSE POSITION
ON THE BILL. WITH THE RECENT
MOMENTS WHEN OUR IN SUPPORT OF
THE MEASURE RECITING SOME
FEEDBACK FROM SOME OUR MEMBERS
WOULD LIKE TO CONTINUE WORKING
WITH THE WITH THE AUTHOR AS A
CAUSE FOR THE. THROUGH THE
LEGISLATIVE PROCESS BUT WE
APPRECIATE THE NEW DIRECTION OF
THE BILL AND THANK YOU FOR YOUR
WORK.
IF YOU'RE A MUCH.
IS THERE ANYONE IN OPPOSITION
TO THE BILL.
I THINK MISTER CHAIRMAN BIRDS
MAKE IT ALRIGHT ON BEHALF OF THE
CALIFORNIA MEDICAL ASSOCIATION
ARAFAT. REMAIN OPPOSED WITH THE
LANGUAGE AS IN PRINT BUT VERY
MUCH APPRECIATE ALL THE WORK
THAT THE AUTHORS OFFICES DONE.
WITH US ON THIS BILL AND WILL
CONTINUETO WORK MOVING FORWARD
ON LANGUAGE.
DR IT MEMBERS TO MADDEN REPS IN
THE CALIFORNIA CHAPTER THE
MIRACLE OF MERCY POSITIONS WE
ARE ALSO OPPOSED.
TO THE INTRODUCED VERSION OF THE
BILL AYE WE'RE LOOKING AT THE
AMENDMENTS NOW WE HAVE SOME
QUESTIONS HAVE BEEN WORKING WITH
THEIR MISTER RODRIGUEZ'S OFFICE
WE PROCEED AS TIME AND LOOK
FORWARD TO CONTINUE THE
CONVERSATION.
RIGHT SPEND SOME HAVE THE
CALIFORNIA ACADEMY DOWN THE
PHYSICIANS AND THE AMERICAN
COLLEGE OBGYN IS DISTRICT NINE
LIKE ECHO THIS DIEM.
TESTIMONY OF PREVIOUS SPEAKERS
AYE IN OPPOSITION.
KRISTIN HER LURKING CALIFORNIA
UTILITY LINES US MORE TO MY
COLLEAGUES AGUIAR OPPOSES RIGHT
NOW BUT WORKING WITH THE
COMMITTEES ARE WITH THE.
MEMBERS OFFICE AND.
HAVING THE QUESTIONS ANSWERED
BY OUR PHYSICIANS THANK YOU.
GOOD EVENING I GUESS I SHARON
SMITH CROWLEY REPRESENTING THE
CALIFORNIA CLINIC CARE
COALITION.
OF WE HAVE A NUMBER OF CHRONIC
CARE.
CONSTITUENCY GROUPS WITHIN THE
COALITION AND WE ARE OPPOSED OUT
OF CONCERN THAT PATIENTS THAT
NEED LEGITIMATE PAIN CONTROL
WILL BE LIMITED AND DOCTORS WILL
BE SCARED TO TAKE CARE OF THEM.
YOU VERY MUCH.
SO ANYONE ELSE IN OPPOSITION.
XENA WILL BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS
DETERMINE.
I THINK IT'S CHAIR AND THANK THE
AUTHOR I SUPPORT FOR YOUR BILL
IS GOING I JUST WANT TO ASK IF
YOU HAVE AWAY AS YOU GO FORWARD
TO.
WORK WITH THE FOLKS IN THE
SICKLE CELL.
TREATMENT COMMUNITY WHO I KNOW
HAS SOME CONCERNS IF THERE'S A
WAY THAT YOU CAN WORK WITH THEM.
I'M SORT OF THEIR WAYS FOR THEM
TO GET THEIR NEEDS MET AS THIS
BILL US YOU KNOW BECAUSE FOR.
YES BY ALL MEANS I'LL CONTINUE
TO WORK WITH WORKING WITH THEM I
KNOW.
THAT ISSUE COULD BE WITH SOME
OF THE PATIENTS ARE CUTER
CHRONIC. BUT BY ALL MEANS I
DON'T WANT THIS TO BE AN
OBSTACLE FOR THOSE INDIVIDUALS
THAT NEED THEM OCCASION.
TO CONTINUE TAKEN TO CARRY THEIR
OF THE ISSUES THAT CONCERN SO.
DEBRA CONTINUE WORK WITH THEM
AND MAKING SURE THE PATIENT THAT
NEED THE MEDICATION OPPOSITE
HAVE ACCESS.
THANK YOU SIR.
ANYONE ELSE.
SEEING NO ONE.
.
WE HAVE A MOTION BY MISS LOW
MOAN FROM SEREMOS MUCH WHAT MR
SANTIAGO. A. S. SECOND BY MISS
LIMON THE MOTION IS DUE PASSED
TO BUSINESS AND PROFESSIONS.
WHICH I CLOSE MISTER.
STRUCK WE ASK FOR LIVE UP
THINKING GRAY CLOTHES THINK SIR.
DO PASTOR BRING. MEDICARE
PLEASE CALL THE ROLL.
I WOULD I WOULD I MAYES.
MAYES NO AGAR CURRY.
I CARE CURRY AYE BIGELOW.
BIGELOW NOT VOTING. BONTA.
BURKE.
CARILLO.
CARILLO AYE FLORA.
LARA NOT VOTING. AMONG.
LIMON I MCCARTY MCCARTY AYE
NAZARIAN.
RODRIGUEZ AYE RODRIGUEZ AYE
SANTIAGO.
SANTIAGO AYE THURMAN.
THURMOND AYE WALDRON.
THE WATER NOT PUTTING.
TO LIVE IN A TWO ONE.
THANK YOU.
DOCTOR DOCTOR WOOD MISTER CHAIR
DOESN'T.
IT WHAT IS YOUR TREASURE.
I HAVE TWO BILLS BEFORE YOU
FIRST ONE AB NINETEEN FIFTY
THREE WHAT'S GOT THAT ONE.
PART YES WILL GO THAT WOULD GET
VERY GET THIS BILL SIMPLY
EXPANDS THE DISCLOSURE
REQUIREMENTS THAT APPLICANTS FOR
A SKILLED NURSING FACILITY
LICENSE MUST.
MAKE THE DEPARTMENT OF PUBLIC
HEALTH MUST AND MUST MAKE TO THE
PUBLIC DEPARTMENT PUBLIC HEALTH
TO INCLUDE WHETHER OR NOT THE
APPLICANT FOR THEIR PARTNER. HAS
AN OWNERSHIP OR CONTROL IN
CONTROLLING INTEREST OF FIVE
PERCENT OR MORE IN A BUSINESS
THAT PROVIDES ANY SERVICE TO A
SKILLED NURSING FACILITY.
SOME SKILLED NURSING FACILITIES
CONTRACT UP BASIC FUNCTIONS LIKE
MANAGEMENT OR RENT THEIR OWN
BUILDING FROM A SISTER
CORPORATION PRIVATE INTEREST IN
A COMPANY THAT DOES THEIR
LAUNDRY.
SAYING IT IS SIMPLY AN EFFICIENT
WAY TO RUN A GREAT RUNNING THEIR
BUSINESSES AND CAN HELP MINIMIZE
TAXES.
SKILLED NURSING OWNERS FOR A
SKILLED NURSING FACILITY OWNERS
THEN ESTABLISH HIGHLY FAVORABLE
CONTRACTS IN WHICH THERE NURSING
HOMES PAY MORE FOR SERVICES AND
THEY MIGHT IN A COMPETITIVE
MARKET. THIS ALLOWS AND DECIPHER
OFF HIGHER PROFITS WHICH ARE NOT
RECORD ON THE NURSING HOMES
ACCOUNTS.
THE PROBLEM IS THAT THE SNIFFS.
MEDICARE REIMBURSEMENT RATES
ARE BASED ON THEIR COSTS.
SO THEY'RE INFLATING THEIR COSTS
THEY ARE ALSO POTENTIALLY
RAISING THEIR REIMBURSEMENT
RATES COSTS IN THE STATE MONEY
OF THE BILL. AGAIN THIS BILL
SIMPLY ADDS MORE TRANSPARENCY TO
SCHOOL THEIR SURFACES FACILITY
BUSINESS PRACTICES ASPIRO.
GOOD ANY.
WITNESSES IN SUPPORT.
JOHN HUNTER WITH CARP WHICH
SPORT BILL.
ANY FURTHER WITNESSES IN
SUPPORT.
SEEING NONE ARE THERE ANY
WITNESSES IN OPPOSITION.
SING AND WILL COME BACK TO.
THE COMMITTEE MEMBERS FOR ANY
QUESTIONS OR COMMENTS.
I DO BELIEVE WE HAVE A MOTION
AND A SECOND.
DOCTOR WOULD LIKE TO CLOSE
RESPECTFULLY ASK YOUR I'VE.
IT'S CALLED THE CALL THE ROLL
WOULD I WOULD I MAYES.
NOBODY MAKES NOT VOTING. I CARE
CURRY AND HERE CURRY AYE
BIGELOW.
TAKE.
BIGELOW NO.
BONTA.
BURKE.
CARILLO AYE CARILLO AYE FLORA.
FLORIDA VOTING LIMON PIE LIMON
I.
MCCARTY.
MCCARTY I'M THE SYRIAN.
RODRIGUEZ RODRIGUEZ AYE SANTIAGO
SANTIAGO AYE BERMAN. THURMAN AYE
WALDRON.
WALDRON AYE BONTA AYE BONTA AYE.
TEND TO WANT YOUR BILL IS OUT
MOVING ON TO THE NEXT ONE.
TAKE VERY MUCH MISTER CHAIR
ASSEMBLY BILL TWENTY SEVEN SIXTY
IN THINK FOR THE OPPORTUNITY AT
FIRST LIKE TO. START BY
ACCEPTING THE PROPOSED
AMENDMENTS.
AS.
I THINK.
THANKS VERY MUCH AS YOU ARE WE
ALREADY HEARD TODAY THERE IS A
DRUG EPIDEMIC IN CALIFORNIA
PRIMARILY DRIVEN BY OPIOIDS. YOU
WE DON'T OVERDOSE DEATHS
SURROUNDING THIS EPIDEMIC ARE
STAGGERING. AB TWENTY SEVEN
SIXTY IS A THAT IS A BILL
DESIGNED TO STICK TO ONE THING.
SIMPLY SAVE LIVES.
ON THE LOCK SO HYDROCHLORIDE IS
AN OPIOID TO ANTAGONISE ATTACKS
IMMEDIATELY TO REVERSE THE
EFFECTS OF AN OPIATE OVERDOSE.
THE BILL AS PROPOSED WOULD
REQUIRE HEALTH CARE PRESCRIBERS
WHEN ISSUING AN OPEN OPIOID
PRESCRIPTION TO IT TOO AT RISK
PATIENTS OFTEN THE LOCKS ON
PRESCRIPTION OR OTHER OPIOID
ANTAGONISTIC ALSO REQUIRES
EDUCATION ON ITS PURPOSE. AND
HOW TO USE IT.
HOW TO USE IT TO BE PROVIDED TO
THE PATIENT AND OTHER
INDIVIDUALS DESIGNATE OR OTHER
IT AT VISUALS DESIGNATED BY THE
PATIENT?
SO OFTEN IT ISN'T OFTEN ONE HAS
THE PRIVILEGE OF BEING ABLE TO
QUOTE DIRECTLY FROM THE SURGEON
GENERAL OF THE UNITED STATES.
HOWEVER IN EARLY APRIL AND THE
FIRST NATIONAL ADVISORY ISSUED
BY A SURGEON GENERAL SINCE TWO
THOUSAND AND FIVE. YEARS GENERAL
THAT SURGEON GENERAL JEROME
ADAMS ISSUED AN ADVISORY
EMPHASIZING THE IMPORTANCE OF
THE OVERDOSE REVERSING A LOCKS
ON.
.
COULD GO ON I DO HAVE A MOTION
AND A SECOND.
YES YOU.
I WILL LET THROUGH TO SORT MY
WITNESS.
AND JUST KNOWING. WHERE TIMING
IS A SEAT ON A HUNDRED PAGES YOU
GOT THERE BUT NOW WE GOT SUPPORT
US ALSO I AM JUST GOING TO GET
TO THE HIGHLIGHTED?
SURE. I'M HIS CHAIR MEMBERS OF
THE COMMITTEE MARKUP PRAY I'M
HERE ON BEHALF OF OUR CLIENT
MCKESSON CORPORATION.
HAPPY TO SUPPORT THE MEASURE OF
LAST FALL.
WE AT MCKESSON ISSUED A WHITE
PAPER ON THE SUBJECT OF OPIOID
ADDICTION AND TREATMENT. AND OUR
RECOMMENDATIONS FOR ADDRESSING
THE ISSUE.
THE THE CONTENT OF THIS BILL
THAT CONTAINS ONE OF THOSE
RECOMMENDATIONS AND THEREFORE WE
ARE HAPPY TO SUPPORT THE MEASURE
AND URGE DRIVE VOTE.
ANY FURTHER WITNESSES IN SUPPORT
MICHELLE GIVENS AT THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA REPRESENTING LOCAL
HEALTH DEPARTMENTS IN SUPPORT.
LINDA AWAY WITH WESTERN CENTER
ON LAW AND POVERTY REGISTER
EARLY SUPPORT.
ANY FURTHER WITNESSES IN SUPPORT
ANY WITNESSES HERE IN
OPPOSITION.
READ SPENCER WITH THE CALVARY
ACADEMY OF FAMILY PHYSICIANS AND
AMERICAN COLLEGE OF OB JOINS
DISTRICT NINE WE DO HAVE A RED
SHIRT OPPOSED TO THIS FILM
HOWEVER GIVEN. THE AMENDMENTS
THAT THE AUTHOR JUST ACCEPTED
ELECT BRING US BACK TO THE BOTH
BOARDS PREVIEW EXAGGERATION.
LIKE
DO YOU.
THINK YOU MAKE AN ART ON BEHALF
OF THE CALIFORNIA MEDICAL
ASSOCIATION ALSO THE REGISTERED
OPPOSE BUT. I REALLY APPRECIATE
THE AMENDMENTS THAT MOVE THE
BILL IN A MUCH BETTER TRACTION
WILL BE CHECKING BACK TO OUR
COUNCIL FOR CONSIDERATION.
THANK YOU ANY FURTHER WITNESSES
IN THE OPPOSITION.
I SEE NO COME BACK TO THE.
.
MEMBERSHIP FOR QUESTIONS
COMMENTS.
YES MISTER BIGELOW.
THANK YOU TO THE AUTHORED JUST.
BILL I LIKE AYE I THINK IT GIVES
US AN OPPORTUNITY BUT I DO HAVE
ONE FEAR MAYBE YOU CAN ADDRESS
IT.
AS AS THIS MEDICINE IS GIVEN.
THE OPI. AND IT'S ALSO GOT A
MULTIPLE.
THE ONE THAT YOU'RE TALKING
ABOUT ACTUALLY PRESCRIBING HERE
IN ADDITION TO. TO COUNTERACT
THREATS TO WORK ON A LOT OF
OTHER DRUGS.
MY THEORY IS THAT IT COULD BE
MISUSED FOR SOME OF THE KIDS WHO
ARE YOUTH WHO TODAY. PURPOSELY.
OVERDOSE.
FOR THEIR ACTIONS.
AND MAY NOT BE ABLE TO RECOVER
BECAUSE IT WON'T HAVE THE
WHEREWITHAL.
AND MAY BE USED AS A FUND TOOL
INSTEAD OF A REAL DRAMATIC TOOL
FOR SAVING LIFE.
I JUST WORRY ABOUT THAT I'M I'M
OKAY WITH A PRESCRIPTION I'M
GOOD WITH IT THAT. I WORRY ABOUT
THAT.
WELL AND THAT I APPRECIATE YOUR
CONCERN AND THERE'S THERE'S
ACTUALLY NO INTENT TO CREATE A
FALSE SENSE OF SECURITY ALSO I
DON'T BELIEVE THE AUTHORS.
SPONSORS DO AT ALL I JUST WORRY
ABOUT THAT.
COMPONENT YOU KNOW WE ALSO THE
FLAT LINING.
CRAZE NOT TOO LONG AGO AND WE
CAN.
OBVIOUSLY WATCH THIS.
POTENTIALLY HAPPEN HERE.
THANK YOU.
THE SHIP THAT ANY FURTHER
QUESTIONS OR COMMENTS.
WE DO HAVE A MOTION AND A SECOND
THEN SO I'LL CALL THE ROLL.
OH TO I WOULD LIKE TO CLOSE. I
JUST RESPECT AFTER ABOUT.
WOULD I WOULD AYE MAYES AYE
MAYES I ANCHOR CURRY. AGAR CURRY
AYE BIGELOW AYE BIGELOW AYE
BONTA AYE AYE BONTA AYE BURKE.
CARILLO HIGH.
CARILLO AYE FLORA. FLORA AYE THE
MOVE.
LODI MCCARTY.
MCCARTY I NAZARIAN.
RODRIGUEZ. RODRIGUEZ AYE
SANTIAGO. SANTIAGO AYE THURMOND
THURMOND AYE WALDRON WALDRON
AYE.
SO THAT IS THIRTEEN ZERO SO THAT
BILL WAS OUT.
Y. WE'VE GONE THROUGH A FEW
BILLS TO THIS AFTERNOON.
WE NEED TO STOP START AT THE
TOP THE ORDER IF THERE ARE
AUTHORS OR THERE ARE AUTHORS
THEIR THEIR AUTHORS. IF THERE
ARE MEMBERS OUT THERE WHO HAVE
NOT VOTED AND I KNOW THERE ARE.
PLEASE COME TO THE.
HEARING HEARING ROOM AND.
HELPLESS.
FINISH UP SO THAT WE MIGHT
ACTUALLY HAVE DINNER TONIGHT.
.
SO WE HAVE A BUNCH OF BILLS THAT
DO NOT HAVE.
.
BUT WE GOT A BUNCH OF BILLS THAT
NEED TO THE MOVE MOTIONS ON SO.
THAT WE MIGHT NEVER THIS RIGHT
WE DON'T MEAN MOTIONS ON
ANYTHING.
PEOPLE.
OKAY WE HAVE A FEW BILLS ARE
CALLED WE START THE TOP OF THE
ORDER AND JUST GO THROUGH.
.
OKAY.
OKAY SO MISTER THE TOP OF THE
ORDER MADAM SECRETARY.
SO WITH THIS THIS BILL HAS
PASSED FOR ADDING HAVE OPEN THE
ROLE IN AT THE ABSENT RECALL THE
ABSENT MEMBERS THIS IS AB
SEVENTEEN NINETY FIVE. BONTA.
I AYE BONTA AYE CARILLO. CARILLO
AYE LOW MOAN.
THE OF RODRIGUEZ.
RODRIGUEZ NOT VOTING SANTIAGO.
SANTIAGO AYE THURMOND.
BERMAN NOT VOTING.
BOB THAT I DID NOT VOTING.
BONTA I'M NOT VOTING.
IT'S ABOUT THEIR.
SO THAT IS TWELVE ZERO.
ITEM NUMBER TWO EIGHTEEN
EIGHTEEN NO ONE HAS AREA PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS.
MAYES
I WAS VERY IMPRESSED NOT VOTING
BONTA.
I BONTA AYE CARILLO.
CARILLO AYE LOW MOAN.
LIMON AYE RODRIGUEZ AYE
PREDATORS AYE SANTIAGO.
SANTIAGO AYE THURMOND.
THURMOND I.
THAT IS FOURTEEN ZERO.
ITEM NUMBER THREE NIGHTS AB
NINETEEN FIFTY THREE I KNOW
COUPLE PEOPLE POPPED IN HERE
PLEASE OPEN THE ROLAND.
CAL THE ABSENT MEMBERS.
FIRST I BURKE I.
IN THIS AREA.
THIS AREA AND I.
OKAY.
BIGELOW KNOW TO NOT VOTING.
THAT MUST.
SO THAT IS TWELVE ZERO.
ITEM NUMBER FOUR A. B. NINETEEN
SIXTY FOUR MISTER MAIENSCHEIN.
.
LIFTING THE CALL PLEASE.
THE ABSENT MEMBERS.
BIGELOW.
BIGELOW NOT VOTING BONTA.
I WANT TO AYE BURKE. BURKE I
CARILLO.
CARILLO I LIMON. LEVINE AYE
NAZARIAN.
CORRECT.
THIS AREA AND I RODRIGUEZ.
RODRIGUEZ NOT VOTING SANTIAGO.
SANTIAGO AYE.
KAREN. THURMAN I.
THAT IS TWELVE ZERO ITEM NUMBER
FIVE.
A. B. NINETEEN NINETY EIGHT
MISTER RODRIGUEZ PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS
BONTA.
I HAVE BONTA I'VE BURKE.
HE.
BURKE NOT VOTING.
IN THIS AREA.
NAZARIAN AYE.
IT'S TEN TO ONE.
ITEM NUMBER SIX BEGINS THE
CONSENT CALENDAR SO WE'RE GONNA
OPEN THE ROLE ON THE
CONSECUTIVE.
I DON'T KNOW THAT WOULD BE ITEM
NUMBER SIX
ELEVEN THIRTEEN SEVENTEEN TWENTY
EIGHT. THIRTY AND THIRTY ONE
PLEASE CALL THE ABSENT MEMBERS
BURKE I HAD BURKE I CARILLO TIME
RIO I LIMON LOW LIMON I'M THIS
AREA AND. THIS AREA AND I
RODRIGUEZ. RODRIGUEZ AYE
SANTIAGO SANTIAGO AYE THURMAN.
THURMOND AYE WALDRON.
WELL TECH I.
ITEM NUMBER SEVEN.
PLEASE LIFT THE CALL AND CALL
THE ABSENT MEMBERS BURKE. BURKE
AYE CARILLO. FIVE CARILLO AYE
LIMON.
LIMON AYE NAZARIAN.
NAZARIAN AYE RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO.
SANTIAGO EYES THURMAN.
BERMAN I WALDRON.
WALDRON AYE FIFTEEN.
THAT IS FIFTEEN ZERO.
AMID A FACT UP FOR A SECOND TO
ITEM NUMBER. TWENTY FOUR.
ARE NOT THEIR OWN. INTEL'S.
OKAY NEVER GOTTEN AROUND HER
NECK BACKING UP AT ALL FOR IS
GOING TO CONTINUE GOING FORWARD.
.
THESE.
ON ITEM NUMBER EIGHT PLEASE
LIFT THE CALL OF THE ABSENT
MEMBERS.
BONTA AYE BONTA AYE.
THE BONES ACTIVA AYE MCCARTY.
MCCARTY AYE NAZARIAN.
LET'S NAZARIAN AYE RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO. SANTIAGO
AYE WALDRON.
11-3 HAS 11-3 OF GOODNESS JUMP
AHEAD OF DIFFERENCE TO MY VICE
CHAIR HE WENT LIKE THIS TO JUMP
TO ITEM NUMBER TWENTY FOUR.
OPEN THE ROLAND CALLED THE
ABSENT MEMBERS.
BONTA.
I BONTA AYE BURKE. BURKE I
ALMOST.
MON I RODRIGUEZ. RODRIGUEZ AYE
SANTIAGO. SO TERROR AYE BERMAN.
THURMOND AYE MAYES AYE TO NOT
LOADING.
MAYES I CANNOT VOTING.
I.
BIGELOW AYE TO KNOW.
IT'S HARD TO EIGHTEEN WHEN
THERE'S THIRTEEN TO ONE SO.
MOVING ON TO ITEM NUMBER NINE
PLEASE OPEN THE ROLAND CALLED
THE ABSENT MEMBERS.
BURKE.
I BURKE AYE. NAZARIAN. THIS AREA
AYE RODRIGUEZ AYE RODRIGUEZ AYE.
AS ELEVEN TO FOR.
ITEM NUMBER TEN AB TWENTY THREE
THIRTY ONE PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS BIGELOW.
ITEM NUMBER TEN.
BIGELOW AYE BONTA LIKE BONTA
AYE.
THIS AREA AND. THIS AREA AND I
SANTIAGO. SANTIAGO AYE THURMAN.
THURMOND AYE FIFTEENTH THERE.
AS FIFTEEN ZERO MOVING ON TO
ITEM NUMBER TWELVE.
AB TWENTY FOUR FIFTY NINE IS
FRIEDMAN PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS WOULD. I
WOULD I BONTA AYE BONTA AYE
BURKE.
I'M SORRY FOR NOT VOTING.
THIS ARYAN.
THIS AREA AYE SANTIAGO.
DOES WALL.
A.
SINCE THERE ARE FOURTEEN THERE.
IT IS FOURTEEN ZERO.
MOVING ON TO ITEM NUMBER
FOURTEEN.
AB TWENTY FIVE SIXTY FIVE
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS WOULD HIGH WOULD
I AM HERE CURRY. FIGURE CURRY
AYE BONTA AYE BONTA AYE.
THE SYRIAN.
I I THE SYRIAN AYE SANTIAGO.
SANTIAGO AYE.
PORTANTINO.
THAT IS FOURTEEN TO ONE ITEM
NUMBER FIFTEEN AB TWENTY FIVE
SEVENTY NINE MISS BURKE PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS BIGELOW.
I
THE GLOW AYE BONTA AYE BONTA
AYE.
MCCARTY. MCCARTY EYEING THIS
AREA.
THIS AREA AYE SANTIAGO.
UNTIL I BERMAN. THURMOND AYE
WALDRON. WALDRON AYE FIFTY.
AS FIFTEEN ZERO.
ITEM NUMBER SIXTEEN.
AB TWENTY FIVE NINETY ONE
MISTER O'DONNELL. WAS.
WAS HELP THAT'S RIGHT NEVER MIND
THERE'S NO VOTE ON THAT MY
APOLOGIES ITEM NUMBER SEVENTEEN
MR GRAYSON WAS.
ON THE CONSENT CALENDAR. ITEM
NUMBER EIGHTEEN WAS PULLED BY
THE AUTHOR. ITEM NUMBER
NINETEEN.
AB TWENTY SIX SEVENTY NINE
MISTER O'DONNELL PLEASE OPEN THE
ROLE. AND.
CALYPSO MEMBERS BONTA AYE BONTA
AYE.
THIS AREA IN. THIS AREA AND I
SANTIAGO.
SANTIAGO AYE.
THAT'S FIFTEEN ZERO.
ITEM NUMBER TWENTY.
THIS BURKE.
.
AB TWENTY SEVEN FORTY ONE PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS KOREA. CARILLO I.
NAZARIAN.
IN THIS AREA I RODRIGUEZ AYE
RODRIGUEZ AYE.
ZERO.
THAT HAS TWELVE ZERO.
ITEM NUMBER TWENTY ONE AB
TWENTY SEVEN SIXTY.
WOULD PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS BURKE.
I.
THIS AREA.
I'VE BEEN IS AARON I FIFTEEN.
THAT'S FIFTEEN ZERO ITEM NUMBER
TWENTY TWO PLEASE LIFT THE CALL
AND CALL THE ABSENT MEMBERS
BONTA AYE BONTA AYE BURKE.
BURKE I CARILLO. CARILLO AYE
LIMON. LOW MOAN AYE NAZARIAN.
WAS THERE AND I RODRIGUEZ
RODRIGUEZ AYE SANTIAGO. SANTIAGO
AYE THURMAN. THURMOND AYE.
THIS FIFTEENTH ZERO ITEM NUMBER
TWENTY THREE AB TWENTY EIGHT
FORTY THREE MISTER GLORIA PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS BURKE.
BURKE I.
NAZARIAN. THIS AREA AYE
RODRIGUEZ.
RODRIGUEZ I.
SO LIVE IN THE FOR ITEM NUMBER
TWENTY THE.
FOR.
MISTER GIBSON AB TWENTY ON A.
WE JUST AT THAT I'M SORRY.
I RIVER TWENTY FIVE AB TWENTY.
EIGHT SIXTY THREE MISTER
NAZARIAN PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS BONTA
AYE BONTA AYE CARILLO.
AND SO THIS WAS ITEM FOR TWENTY
FIVE.
I.
CARILLO AYE LOW MOAN. LIMON AYE
RODRIGUEZ AYE RODRIGUEZ AYE
SANTIAGO. SANTIAGO AYE THURMAN.
THURMOND AYE FIFTEEN TO.
FIFTEEN ZERO. ITEM NUMBER TWENTY
SIX.
RESTRICT THURMAN AB TWENTY
EIGHT SEVENTY FOUR PLEASE OPEN
THE ROLL CALL THE ABSENT MEMBERS
BONTA AYE BONTA AYE BURKE. BURKE
AYE. NAZARIAN.
I WAS VERY AND I. LIKE.
AS ELEVEN TO FOR.
ITEM NUMBER TWENTY SEVEN PLEASE
LIFT THE CALM CALLED THE ABSENT
MEMBERS.
MAYES.
BURKE BURKE I.
LOW MOAN.
LIMON AYE. NAZARIAN.
THERE IT AYE RODRIGUEZ RODRIGUEZ
AYE SANTIAGO.
SANTIAGO I'D THEREIN. THURMOND
AYE WALDRON. WALDRON NO.
THAT IS ELEVEN TO THREE ITEM
NUMBER TWENTY NINE.
ARAMBULA AB TWENTY NINE SIXTY
FIVE PLEASE LIFT THE CALL AND
CALL THE ABSENT MEMBERS BIGELOW.
BIGELOW NO BONTA AYE BONTA AYE.
MCCARTY. PARTY I NAZARIAN. THIS
AREA AYE SANTIAGO.
LET HIM GO AYE WALDRON. WALDRON
NO.
THE LIFE IN THE FOR.
AS ELEVEN TO FOUR.
.
ITEM NUMBER THIRTY TO ARAMBULA
PLEASE.
LIFT THE CALL CALL THE ABSENT
MEMBERS.
BIGELOW.
BIGELOW NO BONTA AYE.
BONTA AYE.
MCCARTY. MCCARTY I IN THIS AREA.
THE SYRIAN AYE SANTIAGO.
SANTIAGO AYE BERMAN.
THURMOND AYE WALDRON. WALDRON
AYE.
OKAY THEORY.
IT IS A TWELVE TO THREE.
ITEM NUMBER THIRTY THREE PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS.
WHAT? I WHEN I AM HERE CURRY.
AND YOUR CURRY AYE BONTA AYE
BONTA AYE.
THIS AREA. NAZARIAN AYE
SANTIAGO.
SANTIAGO AYE FIFTEEN.
DOES FIFTEEN ZERO AND ITEM
NUMBER THIRTY FOUR PLEASE LIFT
THE CALL AND CALL THE ABSENT
MEMBERS.
FOR.
CARILLO.
I CARILLO AYE FLORA.
THE MOST.
ABOUT AYE THIS AREA.
THIS AREA HIGH RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO SANTIAGO
AYE THURMAN.
THERE ARE WALDRON.
WATER NO.
THE THREE
THAT IS TEN TO THREE.
PART.
OKAY.
NUMBER EIGHT.
THIS A WALDRON.
NUMBER EIGHT TWO TWO SEVEN FIVE.
THAT AS I.
WALDRON AYE.
THE MIX AT TWELVE THREE.
I BELIEVE THAT IS A WRAP FOLKS.
THANK YOU VERY MUCH THIS MEETING
OF THE HEALTH COMMITTEE IS
ADJOURNED