MY TO GO AHEAD AND CALL THE
MEETING TO ORDER.
I WANT TO ANNOUNCE THAT --
WE WILL HAVE A TO WITNESSES PER
SIDE WITH A TIME LIMIT OF THREE
MINUTES EACH.
ADDITIONAL WITNESSES WILL BE
ASKED TO STATE THEIR NAME AND
ORGANIZATION ONLY FOR THE RECORD
--
FOR THOSE WHO HAVE A POSITION
SOMEWHERE BETWEEN SUPPORT OR
OPPOSE FOR THOSE WHO HAVE NO
PISH AT A POSITION BECAUSE OF
THE LENGTH OF OUR AGENDA PLEASE
GIVE YOUR NAME ORGANIZATION AND
VERY VERY BRIEFLY.
EXPLAIN YOUR POSITION WE HAVE A
SOME BILLS PROPOSE FOR CONSENT.
TWENTY THREE OF THEM NOT JUST
KIDDING --
SIX BILLS FOR THE PROPOSED FOR
CONSENT.
NUMBER ONE ITEM NUMBER ONE ACR
TO THIRTY FOUR BY MS RUBIO.
ITEM NUMBER FIVE S. B. NINE
THIRTY ONE SENATOR HERTZBERG
ITEM NUMBER NINE S. B. TEN FORTY
ONE BY SENATOR LEYVA.
ITEM NUMBER TWELVE S. B. TWELVE
ELEVEN OO NINE EXCUSE ME BY
SENATOR BATES ITEM NUMBER
THIRTEEN S. B. ELEVEN TWENTY
FIVE BY SENATOR ATKINS.
AND ITEM NUMBER TWENTY TWO SP
FOURTEEN SIXTY FOUR BY SENATOR
WIENER SO IF YOU'RE EXPECTING --
TO TESTIFY ON THOSE BILLS TODAY
THERE THERE WON'T BE AN
OPPORTUNITY UNLESS SOMEONE
REMOVES US FROM THE CONSENT
CALENDAR.
WE DO NOT HAVE A QUORUM HOWEVER
WE COULD START THAT MEETING IF
WE HAD AUTHORS TO PRESENT BILLS
WHICH WE DON'T CURRENTLY HAVE.
SO WE WILL WAIT UNTIL WE HAVE
SOME AUTHORS PRESENT BILLS.
THANK YOU FOR YOUR PATIENCE
.
THANK YOU SENATOR THANKS FOR
JOINING OUR LITTLE PARTY.
THING RIGHT --
I'D LIKE TO BEGIN BY THANKING
YOU IN YOUR COMMITTEE STAFFER
WORKING DILIGENTLY --
WITH MY STAFF ON THIS IMPORTANT
ISSUE WE'D LIKE TO STATE FOR THE
RECORD THAT I'LL BE ACCEPTING
THE COMMITTEES AMENDMENTS THANK
YOU OUT TODAY I AM PRESENTING SP
TWO SEVEN FIVE WHICH
ESTABLISHES.
THE CHILDREN ADOLESCENTS AND
YOUNG ADULTS SUBSTANCE USE
DISORDER TREATMENT EARLY
INTERVENTION AND PREVENTION ACT
--
SP TWO SEVENTY FIVE REQUIRES
DEPARTMENT OF HEALTH CARE
SERVICES. TO CONVENE AN EXPERT
PANEL TO ADVISE D. H. C. S..
ON THE DEVELOPMENT OF YOUTH
SUBSTANCE DISORDER TREATMENT OUR
EARLY INTERVENTION AND
PREVENTION QUALITY STANDARDS THE
BILL ALSO DEFINES.
YOUTH -- ES
YOU DE TREATMENT SERVICES TO
INCLUDE ANY PUBLICLY FUNDED
DIRECT SERVICE INTENDED TO
ADDRESS OR TREAT S. YOU DIS FOR
INDIVIDUALS FROM BIRTH --
TO TWENTY SIX CALIFORNIA'S MADE
NUMEROUS ATTEMPTS TO ADDRESS.
THE COMPLEX NOT OF ISSUES
RELATED TO MENTAL HEALTH AND
SUBSTANCE ABUSE AND IN OUR
SYSTEM AND PROGRAMS DON'T SEEM
TO CARRY OUT OUR INTENTIONS.
WE SEE THE RESULTS AROUND US ON
THE STREETS IN OUR SCHOOLS AND
IN THE CRIMINAL JUSTICE SYSTEM
MULTIPLE STUDIES HAVE
ESTABLISHED THAT ADOLESCENTS ARE
MORE VULNERABLE THAN ADULTS TO
ALCOHOL CANNABIS TOBACCO AND
OTHER DRUG RELATED.
PROBLEMS SERVICES FOR YOUTH NEED
TO BE INTEGRATED AND WRAPAROUND
SERVICES ARE NECESSARY AYE THIS
BILL SEEKS TO ADDRESS ALL OF
THESE ISSUES TO THE DEVELOPMENT
OF A YOUTH INTERVENTION
PREVENTION AND TREATMENT
STANDARDS FOR CHILDREN.
TODAY I HAVE WITH ME AND NUMBER
FOLKS ONE SPEAKING IN SUPPORT.
WE DON'T HAVE A QUORUM
UNFORTUNATELY BUT I APPRECIATE
YOUR ENTHUSIASM.
I LOVE THAT SHOW IS READY --
TO WE HAVE TO WITNESSES --
THREE MINUTES EACH PLEASE.
THANK YOU --
MEMBERS ASSEMBLY HEALTH
COMMITTEE THANK YOU CHAIRMAN
WOULD -- MY
NAME IS DOCTOR DAVID CONN AND
THEN THE PRESIDENT OF THE
CALIFORNIA SOCIETY OF ADDICTION
MEDICINE.
I WANTED TO START WITH THE STORY
--
JACK FROM NORTHERN CALIFORNIA
WAS TWELVE YEARS OLD WHEN HE
BEGAN TO SMOKE CANNABIS DRINK
ALCOHOL REGULARLY.
HIS SUBSTANCE USE HELP MUFFLE
THE EMOTIONAL TURMOIL BECAUSE BY
DIFFICULT FAMILY LIFE YOU BEGIN
USING OXYCODONE.
AND SHORTLY THEREAFTER BY HIS
FRESHMAN YEAR IN HIGH SCHOOL HE
BEGAN INJECTING HEROIN.
IF YOU THINK YOU TO HELP WHERE
THE STORY IS HEADED YOU MIGHT BE
SURPRISED NOW IS TWENTIES AFTER
YEARS OF ADDICTION JACK IS NOT
ONLY IT STILL ALIVE HE'S
RECLAIMING ITS LIFE.
IN A PROCESS OF INCREDIBLE
DEDICATION AND COURAGE.
RECOVERY THROUGH MEDICAL
TREATMENT WHICH PROVIDES
BEHAVIORAL THERAPY SOCIAL
SUPPORT.
IN CRITICALLY MEDICINE TO MANAGE
ADDICTION.
JACK WAS LUCKY.
FINDING TREATMENT IS A CHALLENGE
BUT FINDING EFFECTIVE TREATMENT
EVEN MORE SO.
IS CALIFORNIA IS POISED TO
INVEST NEW MONIES INTO YOU
SUBSTANCE USE DISORDER.
PREVENTION EARLY INTERVENTION
TREATMENT WE NEED TO LOOK AT THE
SUCCESS OF JACK AND OTHER PEOPLE
TO GUIDE SOUND DECISION MAKING.
NEW SOURCE OF FUNDING PROMISE
AUGMENT YOU SUBSTANCE USE
DISORDER TREATMENT BY HUNDREDS
OF MILLIONS OF DOLLARS ANNUALLY.
THIS NEW SURGE OF FUNDING
ADDRESSES ONE OF TWO PROBLEMS WE
FACE IN CALIFORNIA THE FIRST
PROBLEM IS ACCESS TO TREATMENT.
NEARLY ONE HUNDRED AND FIFTY
THOUSAND CALIFORNIA YOUNG PEOPLE
BETWEEN THE AGES OF TWELVE AND
SEVENTEEN REPORTED THAT THEY
NEEDED.
BUT DID NOT GET AS YOU DE
TREATMENT.
IN TWENTY SIXTEEN FOUR HUNDRED
EIGHTY THOUSAND YOUNG
CALIFORNIANS BETWEEN THE AGE OF
TWELVE AND TWENTY FIVE MISUSED
OPIOIDS AND SYNTHETIC OPIOIDS
SUCH AS FENTANYL.
AND THOSE FENTANYL'S ARE ADDING
A TWIST IN A STORY IN THAT IT IS
DANGEROUS IT IS THAT.
OUR PEOPLE ARE DYING.
BUT THERE'S A SECOND FUNDAMENTAL
PROBLEM THAT WE NEED TO ADDRESS
ACCESS TO TREATMENT ALONE IS NOT
ENOUGH JACK FOR EXAMPLE CYCLE IN
AND OUT OF THE SYSTEM HALF DOES
WITH YOUR HALF DOZEN TREATMENT
PROGRAMS.
THAT DIDN'T USE EVIDENCE BASED
BACK BEST PRACTICES.
NON EVIDENCE BASED TREATMENTS
FAILED HIM THAT COULD HAVE COST
HIM HIS LIFE.
INSTEAD WE MUST PROVIDE ACCESS
TO EFFECTIVE RESULTS BASED
TREATMENT THAT IS APPROPRIATE
FOR YOUNG PEOPLE WHO ARE SPECIAL
AND DIFFERENT NEEDS PHYSICALLY.
EMOTIONALLY SOCIALLY AND
ACADEMICALLY.
DEVELOPMENTALLY A YOUNG PERSONS
BRAIN IS SIMPLY DIFFERENT YOUNG
BRAIN FINISHES DEVELOPING AT THE
AGE OF TWENTY FIVE ADDICTION
CHANGES THE BRAIN IN INTERRUPTS
DECISION MAKING PROCESSES.
NOT RELATED TO JUDGMENT GOOD
JUDGMENT AND DECISION MAKING.
IT HAVE ADDICTION HAMPER OCIAL
DEVELOPMENT AND DERAILS THE
CRUCIAL FINAL YEARS OF
MATURATION.
YOUNG PERSON WHO IS STRUGGLING
WITH ADDICTIONS ALSO PART OF THE
FAMILY AND THE ENTIRE FAMILY MAY
NEED HELP AS WELL.
FINALLY MUST WE MEET MUST BE THE
EVER WEAR THAT CHILDREN AND
TEENS ARE JUST HAVE NOT EXPOSE A
PROBLEM IN THE PAST BUT THEY
COULD BE EXPOSED TO TRAUMA
CURRENTLY SO WE NEED TO ADDRESS
THOSE ISSUES.
THAT IS WHY MY ORGANIZATION THE
CALIFORNIA SOCIETY OF ADDICTION
MEDICINE.
IS SPONSORING LEGISLATION S. B.
TWO SEVENTY FIVE TO CREATE CLEAR
STANDARDS FOR USE SUBSTANCE USE
DISORDER PREVENTION.
EARLY INTERVENTION AND
TREATMENT.
THE BILL WOULD INVOLVE
PEDIATRICIANS PSYCHIATRISTS
SOCIAL SERVICES EDUCATIONAL
EXPERTS AS WELL AS YOU THINK
PARENTS.
SO IN SUMMARY I APPRECIATE YOUR
SUPPORT FOR S. B. TWO SEVENTY
FIVE TO CREATE.
A TREATMENT SYSTEM THAT WORKS
THANK YOU.
VERY MUCH DOCTOR.
MISTER CHAIRMAN MEMBERS ROBERT
HARRIS ON BEHALF OF BESSIE AYE
YOU CALIFORNIA.
WE'VE BEEN WORKING WITH SEE SAM
TO DEVELOP THIS BILL FOR ALMOST
A YEAR IT TOOK A LONG TIME TO
FIGURE OUT.
WHAT'S THE BEST APPROACH BUT WE
KNOW WE ALL KNOW THAT THIS
SOMETHING MUST BE DONE BECAUSE
WE CAN'T LET CHILDREN SUFFER
WITH BAD TREATMENT WHEN WE
FINALLY HAVE MONEY TO GIVE THEM
GOOD TREATMENT.
SO STANDARDS ARE THE CRITICAL
THING THAT SPLIT THE BILLS HELPS
CREATE.
AND WE WOULD APPRECIATE YOUR
SUPPORT FOR THE BILL THANK YOU.
MISTER CHAIRMAN RANDALL HAGER
FOR THE CALIFORNIA PSYCHIATRIC
ASSOCIATION WERE VERY HAPPY TO
CO SPONSOR THIS BILL HERE TO
ANSWER ANY.
THANK YOU VERY MUCH OTHER
SUPPORT JUST YOUR NAME AND
ORGANIZATION PLEASE.
OF MARKET DATA BY HALF
SHATTERPROOF IN SUPPORT OF THE
BILL.
THANK YOU MISTER CHAIRMAN FIRST
MY CONSUMERS ON BEHALF OF
CALIFORNIA HEALTH PLUS ADVOCATES
IN THE THIRTEEN HUNDRED
COMMUNITY HEALTH CENTERS IN
CALIFORNIA AND SUPPORT THANK
YOU.
THAT'S YOUR ANSWER WITH THE
COUNTY HEALTH EXECUTIVES
ASSOCIATION IN SUPPORT
[inaudible]
Q..
KELLY BROKE SOME BEHALF OF THE
COUNTY WELFARE DIRECTORS
ASSOCIATION PLEASED APPEARANCE
PARTY GIVE.
TOM RENT FREE WITH THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION OF CALIFORNIA IN
SUPPORT.
FAIR MCDADE TING ON BEHALF OF
THE CALIFORNIA STATE ASSOCIATION
OF COUNTIES IN SUPPORT.
JERRY DAILY WITH THE CALIFORNIA
CONSORTIUM OF ADDICTION PROGRAMS
AND PROFESSIONALS IN SUPPORT
THANK YOU.
MISTER CHAIRMAN MEMBERS HOME A
HAVE WITH CALIFORNIA ASSOCIATION
OF ALCOHOL AND DRUG PROGRAM
EXECUTIVES CAT PEE.
ó WE GENERALLY ARE SUPPORTIVE
OF THE DIRECTION OF THIS BILL
BUT WE DO HAVE SOME CONCERNS AND
WE'VE --
DISCUSS THOSE WITH.
SIR AND WE LOOK FORWARD TO
CONTINUING TO WORK AS THIS BILL
MOVES THROUGH THE PROCESS THANK
YOU.
HELEN ROTH HADN'T HE JUST FOR
HEALTHY KIDS WERE FINE WITH THE
TREATMENT STANDARDS BUT WE HAVE
A A PROVINCE WITH THE EARLY
INTERVENTION AND PREVENTION.
THIS IS REALLY --
AWAY TOWARDS PROP SIXTY FOUR
IT'S BEEN A WHOLE STAKEHOLDERS
PROCESS THAT THIS IS BY PASSING.
IN WERE REALLY CONCERNED ABOUT
THAT ON BOTH THE PROP SIXTY FOUR
AND EARLY INTERVENTION AND
PREVENTION WE THINK ARE VERY
DIFFERENT THAN.
THE TREATMENT STANDARDS THAT
WOULD BE SET UP THAT'S FINE IT'S
JUST TOO BROAD THANK YOU.
GIVE.
MISTER CHAIR TONY TRIGGER ON THE
HAVE THE CALIFORNIA TEACHERS
ASSOCIATION WE APPRECIATE THE
WORK THAT THE COMMITTEE
CONSULTANT ON THE BILL WE HAVE
AN OPPOSING LESS AMENDED WE'LL
LOOK AT THE AMENDMENTS WHEN
THEY'RE IN PRINT AND WE'LL GO
FROM THERE.
THANK YOU APPRECIATE IT.
WE'RE GONNA PAUSE FOR A MINUTE
AND THEN.
WE HAVE TO GROW THINK WE MAY
HAVE A QUORUM.
WOULD HERE MAYES HERE AGAR
CURRY.
BIGELOW.
BONTA BURKE CARILLO FLORA
[inaudible]
LIMON MCCARTY.
THIS AREA RODRIGUEZ [inaudible]
SANTIAGO BERMAN [inaudible]
WALDRON.
WE HAVE A QUORUM LEVEL.
OKAY LIVE MOTION.
AND THE SECOND IS THEIR
OPPOSITION TO THE BILL.
WE HEARD FROM SUPPORT AND US A
COUPLE OF TWEENER SEPARATELY AND
ONE OPPOSITION ANYONE ELSE.
SEE NO ONE QUESTIONS OR COMMENTS
FROM THAT SCIENCE MR MCCARTY
THANK YOU I I JUST CAME IN SO I
MISSED THE FIRST PART OF THE
PRESENTATION BUT I SUPPORT THE
EFFORT WE'RE TRYING TO
ACCOMPLISH HERE JUST A FEW.
I QUESTIONS MAYBE CAN YOU CAN
HELP ME HERE SO I I KNOW FROM
THE PEOPLE IN BETWEEN THAT.
KIND OF A DEBATE AS FAR AS
TREATMENT AND PREVENTION AND WE
WANT TO DO THEM BOTH HERE IN
CALIFORNIA SO I JUST WANTED TO
ASK.
KIND OF YOUR VIEWS ON THAT AND
HOW YOU KIND OF SEE THIS PLAYING
OUT WITH.
POTENTIAL PROP SIXTY FOUR
REVENUES DOWN THE ROAD AND I
KNOW YOU MENTIONED PROP SIXTY
FOUR AND POTENTIALLY GENERAL
FUND.
BUT THAT WHAT'S YOUR WHAT'S YOUR
INTENT ON THAT.
HE'S GONNA GO FIRST [inaudible]
JUST ABOUT.
THROUGH THE CHAIR ARM.
SO THE BILL MANTON IS UP
PREVENTION AND EARLY
INTERVENTION AND IT ASKS.
THE COUNTY OFFICE EDUCATION TO
WORK CLOSELY WITH THE COUNTY
OFFICE THAT DOES TREATMENT TO
MAKE SURE THAT.
BECAUSE YOU CAN'T DO PREVENTION
WITHOUT.
HEMINGWAY TO TREATMENT FOR
PEOPLE WHO THEATER EARLY AND A
PASSION ARE FRENCH AND DOESN'T
WORK.
FOR THE SAME THING WHEN PEOPLE
DRIVE IN THE PEOPLE WHO.
IN THE TREATMENT COMMUNITY AND
THEY MIGHT NOT NEED.
THE DEPTH THE TREATMENT THEY
OFFER BUT THEY CAN GET THE EARLY
INTERVENTION THE SCHOOLS.
SO THAT'S WHY THE BILL SO THEY
SHOULD WORK TOGETHER. TO MAKE
SURE THAT WE DON'T HAVE STAND
THE LOANS LITTLE FILO.
THINGS THAT WE ACTUALLY WORKED
TOGETHER.
ACROSS THE BOARD WE DON'T SET
STANDARDS FOR EARLY
INTERVENTION.
WE SET STANDARDS FOR TREATMENT
WHICH IS A CRITICAL THING
BECAUSE IT'S TOTALLY MISSING
RIGHT NOW BECAUSE WE HAVE BEEN
DOING TREATMENT FOR KIDS.
OKAY SO IT IS THE IDEA THAT
THOUGH THIS WOULD BE THE THE
VESSEL TO HELP SHAPE PROP SIXTY
FOUR FUNDING.
WHERE WE WE OPENED TO THAT WOULD
BE LOOKING AT SENATOR?
I THINK THAT'S A CONVERSATION
THAT PASSED THE CONTINUE I THINK
THIS PRESENTS A FRAMEWORK TO
INTEGRATE AND SORT OF MAKE
EVERYTHING WORK MORE EFFICIENTLY
--
AND I THINK THAT'S THE
CONVERSATION YOU NEED TO GO ON I
THINK THAT THE WORKING GROUP
WITH ALL STAKEHOLDERS I THINK IS
A PRAGMATIC STEP TO TRY TO HELP
INTEGRATE ALL OF THE PROGRAMS
OUT THERE.
SO.
I DON'T SEE THIS AS A HIERARCHAL
THING I SEE IT AS AN INTEGRATED
THING.
FAIR ENOUGH HE KNOWS I KNOW IS A
VERY DIFFERENT BUT SIMILAR TO
OUR CAP AND TRADE PROGRAM.
POT OF MONEY SCARCE POT LOT A
GREAT IDEAS AND A LOT OF A
COMPETITIONS WAS TO MAKE SURE
THAT.
WE PLEASE BUT FOCUS ON ON THE
INTENT OF THE VOTERS AND SIXTY
FOUR I'M.
AND THEN LASTLY.
THIS THE THE APPOINTMENTS ON
HERE ARE PRETTY MUCH ALL WEEK ON
THE HEALTH SIDE WHICH ISN'T A
BAD THING REPORTS THE HEALTH
COMMITTEE.
BUT ON THE PREVENTION SIDE THERE
WASN'T A LOT OF EDUCATOR AND THE
I THINK THERE'S ONE OR TWO FROM
THE S. P. AYE.
AND THE MAJORITY ARE FROM.
THE THAT HEALTH SIDE IS THAT.
YOUR YOUR INTENT HAVE A MORE
FOCUSED ON THAT TREATMENT SIDE
BECAUSE IF YOU WANT TO TALK
ABOUT PREVENTION.
THE ENTITY THAT DOES PREVENTION.
IS THE PUBLIC EDUCATION.
A A VENUE MAINLY IN CALIFORNIA
AND THROUGH OUR PUBLIC SCHOOL
SYSTEM IN THROUGH OUR NOT.
EARLY EDUCATION AND SO FORTH.
SO I THINK IT'S A VALID POINT
AND WE CAN HAVE A FURTHER
CONVERSATION ON THAT --
BY THE THAT'S A GOOD POINT.
THAT'S A WILL LOOK AT THE MAKE
UP.
AND YOU AND I CAN TALK ABOUT IT.
IF THAT'S OKAY WITH THE CHAIR
[inaudible]
YOU KNOW.
I THINK YOU.
I RESPECTFULLY ASK FOR AN AYE
VOTE.
TOOK.
SO GOODNESS MISSING HER NOW I
JUST WANT TO COMMENT I REALLY
APPRECIATE BEING THIS FOR ONE OF
MY GOALS.
IS WHATEVER WE CAN DO FOR MENTAL
HEALTH HELP YOU ARE YOUNGSTERS
AND I WOULD BE HONORED IF I CAN
BE A CO AUTHOR [inaudible]
SO [inaudible]
ANYONE ELSE.
SEE NO ONE WOULD YOU LIKE CLOSER
RESPECTFULLY ASK FOR AN AYE
VOTE.
WELL THANK YOU VERY MUCH I
APPRECIATE.
VERY MUCH YOU BRING THIS THIS
FORWARD AND TACKLING A VERY VERY
DIFFICULT SUBJECT DOWN.
AS I UNDERSTAND THAT THIS IS MY
UNDERSTAND IS THIS THE SEXY SETS
THE STANDARDS AND THAT'S AND
THAT'S ABSOLUTELY CRITICAL --
ULTIMATELY HOW WE FUND THIS AND
IT WILL BE PLAYED OUT LATER
WHETHER IT'S PROP SIXTY FOUR
GENERAL FUND WHATEVER --
BUT THAT IS NOT.
THE SCOPE OF THIS BILL AT THIS
POINT IT IS ABOUT THE STANDARD
SO SO I APPRECIATE THAT THOUGH
THE BILL DOES ENJOY A DO PASS
RECOMMENDATION I THINK YOU FOR
THAT AND THEN THAT.
THE I THINK YOU FOR ACCEPTING
THE AMENDMENTS THAT MOTION IS TO
PASS AS AMENDED TO
APPROPRIATIONS A MOTION WAS MADE
BY MISTER MAYES AND SECONDED BY
SOMEBODY.
MISTER BIGELOW --
ALWAYS HERE ACTUALLY MUCH CAN.
SO THOSE THAT WE HAVE A MOTION
AND A SECOND MADAM SECRETARY
PLEASE CALL THE ROLL.
WHAT I WOULD AYE MAYES AYE MAYES
AYE AGAR CURRY?
ANGER CURRY I BIGELOW
[inaudible]
BUT I BIGELOW AYE BONTA
[inaudible]
BURKE CARILLO.
FLORA.
FLORA I LOW MOAN.
MCCARTY TYPE MCCARTY AYE THIS
AREA.
RODRIGUEZ.
RODRIGUEZ AYE.
SANTIAGO.
THURMOND.
WALDRON.
WALDRON AYE.
IT.
HAS GREAT EIGHT VOTES YOUR BILLS
OUT WILL LEAVE IT OPEN FOR OTHER
SAT ON THANK YOU VERY MUCH
SENATOR [inaudible]
I SEE [inaudible]
RIGHT.
THE CENTER HUESO ARE YOU ARE YOU
PRESENTING ON YOUR OWN OR WITH
CENTER LARA OR OKAY [inaudible]
PLEASE [inaudible]
THANK YOU.
PLEASE AS A ABOUT PERCENT.
BUT THIS IS A VERY IMPORTANT
BILL FOR MY DISTRICT THAT IT
EXPANDS ACCESSIBILITY TO QUALITY
AFFORDABLE HEALTH CARE. FOR
INDIVIDUALS WORKING.
IN THE SAN DIEGO AND IMPERIAL
COUNTIES THIS IS OUR OF IS
PARTICULARLY.
ABOUT THE BORDER REGION WHICH
HAS A VERY INTERESTING AND VERY
DIFFERENT DIE NAPA SOCIAL
DYNAMIC THAN THE OTHER PARTS OF
THE STATE.
WE HAVE -- A
VERY IMPORTANT PROGRAM THAT WAS
IMPLEMENTED ALONG THE BORDER
THAT ALLOWS --
PEOPLE ARE THAT LIVE IN THE
BORDER AREA TO ACCESS QUALITY
COULD MEDICAL HIT CARE THAT IT'S
LOCATED.
IN THAT RIGHT AT THE BORDER.
THE BORDER OF CALIFORNIA WITH
MEXICO.
YOU KNOW WE PRIDE OURSELVES IN
CALIFORNIA HAS BEEN A VERY
DIVERSE STATE.
AND THE STATE THAT --
CELEBRATES OUR DIVERSITY.
WE HAVE --
YOU KNOW TODAY IN IN THE BORDER
AREA WE'RE STRUGGLING WITH SOME.
ISSUES THAT --
MAKE.
ACCESS TO HEALTH CARE VERY VERY
DIFFICULT LONG BORDER --
THIS BILL HAS ARISEN FROM SOME
OF OUR WORK THAT WE'VE DONE
LOCALLY AT WITH OUR WITH OUR
SELECT COMMITTEE ON ON
COOPERATION WITH CALIFORNIA
MEXICO.
WE WE'VE WE DID --
A RECENT --
HEARING AT THE BORDER TO ADDRESS
HEALTH ISSUES AND WE FIND THAT.
SOME OF THE STATE'S MOST
PRESSING HEALTH ISSUES ARE FOUND
AT THE BORDER SIMPLY BECAUSE OF
THE OF THE OF THE THAT THE
DYNAMICS OF OTHER VERY FLUID AND
AND A VERY ACTIVE BORDER.
WE I HAD A BILL THAT --
WAS TRYING TO GET THAT THE
OFFICE OF BORDER BI NATIONAL
HELPED WORK ON A STRATEGY ON
IMPROVING HEALTH AT THE BORDER.
BUT THIS BILL IT IS MUCH BETTER
THIS BILL OF WHAT IT WOULD
EXPAND OF THE SCOPE OF OF BUT OF
ACCESS OF ELIGIBILITY FOR PEOPLE
LIVING LONG BORDER [inaudible]
TO TO QUALIFY. FOR A A
HEALTHCARE PROGRAM THAT IT WAS A
CREATED BY OUR STATE SEVERAL
YEARS BACK.
IN PARTICULAR THIS BILL
[inaudible]
WOULD OF THIS BILL WOULD YEAH.
HELP HER TO MAKE SURE THAT --
A PROGRAM CALLED SIMPSON WHICH
OFFERS HEALTH CARE AND BROKE
BORDER IS MADE MORE AVAILABLE TO
ANYBODY.
THAT WANTS TO ACCESS THAT
PROGRAM CURRENTLY.
THIS PROGRAM EXISTS IT'S ONLY
ACCESSIBLE TO PEOPLE THAT HAVE I
HAVE --
MEXICAN --
NATIONALITY OR MEXICAN --
OF OF MEXICAN ORIGIN LIVING IN
THE UNITED STATES WORKING IN THE
UNITED STATES --
AND THIS WOULD EXPAND IT BEYOND
THAT TO PEOPLE THAT ARE LIVE
ALONG THE BORDER REGION THAT ONE
APART TO SPEND PROGRAM. ONE OF
THE THINGS THAT MAKES THIS
EXCITING.
IS THAT SAMSUNG OFFERS A A VERY
--
WIDE ARRAY OF OF PROGRAMS
TREATMENTS.
I THOUGHT THAT OFTEN ARE NOT
AVAILABLE ON ON OUR SIDE OF THE
BORDER.
BUT THEY ALSO PROVIDE --
HIGH QUALITY SERVICE AT A VERY
AFFORDABLE RATE.
SO WE HAVE SOME TESTIMONY HERE
THAT ARE SPEAK --
TO WHY WHY THIS IS THIS BILLS
NECESSARY WHY IT'S IMPORTANT TO
OFFER IT TO THE PEOPLE OF OF
THOSE TWO COUNTIES ALONG THE
BORDER [inaudible]
AND WHY --
THIS WOULD BE A GOOD BILL TO
SUPPORT. FO THE BENEFIT OF
CALIFORNIANS --
THIS BILL SEEKS TO EXPAND HEALTH
CARE OPTIONS AND SEND YOU ON A
PER COUNTIES.
BY ALLOWING EMPLOYERS.
IN THOSE REGIONS TO PARTNER WITH
SIMPSON.
OF THE SIMPSON HEALTH PLAN FOR
THEIR EMPLOYER.
SPONSORED HEALTH GROUPS BEYOND
JUST MEXICAN NATIONALS AND THEIR
DEPENDENTS.
SOME SAYS ONE OF THE LEADING
HEALTH MAINTENANCE ORGANIZATIONS
IN NORTHERN MEXICO AND SINCE TWO
THOUSAND HAS PROVIDED OVER FORTY
SEVEN THOUSAND INDIVIDUALS WITH
AFFORDABLE QUALITY ALTERNATIVE.
TO THE TRADITIONAL HMO.
WE HAVE CHI MAK.
MARIAMA HE'S A LITTLE BIT TO
COUNSEL FIRST SIMPSON.
I JAMIE MARIAMA SORRY.
WE CALL THE I JUST CHANGE YOUR
YOUR GENDER THERE SORRY.
JAMIE I'M MEADOW YAMASKA LEGAL
COUNSEL WITH SOME SUCH IS HERE
TO ANSWER TECH TECHNICAL
QUESTIONS OF COMMITTEE MEMBERS
SHOULD HAVE ANY.
WE HAVE WILLIAM BECAUSE HE CAN'T
CAMPBELL WHO IS AND WHO IS
EMPLOYED AT A CAR DEALERSHIP IN
MY DISTRICT AND HE IS.
HERE TO SPEAK ON HIS EXPERIENCES
WITH SIMPSON.
AND WE ALSO HAVE A
REPRESENTATIVE FROM SINCE --
HERE OF TO ANSWER ANY QUESTIONS
IF ANY SHOULD HAPPEN IF --
LOW WHO DID YOU WANT US SURE BUT
A GOOD AFTERNOON TWO WITNESSES
THREE MINUTES EACH SO.
GOOD AFTERNOON MISTER CHAIRMAN
OF MIGHT AND COMMITTEE MEMBERS
MY NAME'S JAMIE MORIYAMA AND I'M
HERE ON BEHALF OF SINCE THE
HEALTH PLAN.
BUT IN A FEW MINUTES YOU'LL HEAR
FROM MR --
CAMPBELL AND THE REASON WHY WE
ARE SPONSORING THIS BILL.
OUR PLAN IS UNIQUE OUR NETWORK
IS IN MEXICO AND MEMBERS WHO
ELECT OUR PLAN ARE CHOOSING TO
RECEIVE PRIMARY CARE FROM
PROVIDERS IN MEXICO.
WHEN THIRTEEN FIFTY ONE POINT
TWO WAS FIRST PASS AND THAT'S
HOW WE'RE LICENSE IT WAS LIMITED
FOR THE BENEFIT OF MEXICAN
CITIZENS LEGALLY EMPLOYED IN
CALIFORNIA?
DUE TO THE IMMIGRATION LAWS
THOSE MEXICAN CITIZENS WERE
THREATENED WITH THE LOSS OF
COVERAGE.
UPON BECOMING A NATURALIZED U.
S. CITIZEN.
DUAL CITIZENSHIP WAS NOT ALLOWED
AT THE TIME HENCE THE CHANGE TO
MEXICAN NATIONAL WHERE WE'RE AT
TODAY.
WE ARE A UNIQUE PLAN AND WE'RE
NOT GONNA BE FOR EVERYONE
HOWEVER IF SOMEONE LIKE MR
CAMPBELL WHO WANTS AN AFFORDABLE
OPTION.
AND IS WILLING TO RECEIVE CARE
MEXICO WANTS TO JOIN THE PLAN WE
DO NOT WANT TO HAVE TO TURN HIM
AWAY DUE TO HIS NATIONALITY.
OUR CURRENT MEMBERSHIP TOTALS
APPROXIMATELY FORTY SEVEN
THOUSAND WHICH INCLUDES PRIMARY
SUBSCRIBERS AND THEIR
DEPENDENTS.
SHOULD SHOULD SIMPSON MEMBERSHIP
GROWTH DUE TO THE CHANGING
NATIONALITY REQUIREMENTS.
SINCE THE HOUSE ABILITY TO MEET
THAT NEED WE ARE NOT DECO TIMELY
ACCESS REQUIREMENTS HOWEVER WE
TRACK NETWORK ADEQUACY ON THEIR
OWN ACCORD.
WE DO THIS THROUGH OUR GRIEVANCE
DEPARTMENT IN MEXICO.
AND WE ALSO MONITOR UTILIZATION
ON A MONTHLY BASIS TO TRACK
POSITION APPOINTMENT USAGE AND
ENROLLMENT NUMBERS TO ANTICIPATE
NETWORK NEEDS WE LSO HAVE A
WAIT LIST OF POSITIONS WAITING
TO JOIN OUR NETWORK IN MEXICO.
I THINK HERE'S A MISCONCEPTION
ABOUT SENSA BECAUSE WE ARE
UNIQUE IN WE ARE A MEXICAN
HEALTHCARE PLAN THAT WE DO NOT
COMPLY WITH THE REGULATIONS AND
THE LAWS WHICH IS INCORRECT.
WE COMPLY WITH ALL KNOCKS KEEN
REQUIREMENTS IN A CA
REQUIREMENTS TO THE EXTENT THAT
WE CAN.
I'D LIKE TO GIVE AN EXAMPLE IT
MAY CLARIFY THE ISSUE --
WHEN THE A CA WAS IMPLEMENTED WE
MET WITH OUR ACTUARIES?
AND USE TO FEDERAL CALCULATOR TO
TRY TO CREATE SMALL GROUP
PRODUCTS THAT WOULD MEET THE
METAL LEVER LEVELS IN NEAR THE
STANDARD.
PRODUCTS.
DOING SO PROVED IMPOSSIBLE
WITHOUT THE IMPLEMENTATION OF
COPAYS THAT FAR EXCEEDED 50% OF
THE ACTUAL COST OF SERVICE TO
THE PLAN.
SO WE RECEIVED AN EXEMPTION AND
WE HAVE TO ALTERNATE PLANS FOR
SMALL GROUPS AND BOTH OF THEM
EXCEED 90% IN VALUE.
THEY'RE VERY RICH PLANS.
SO SIMPSON IS UNIQUE.
WE ARE NOT ANY BETTER OR ANY
WORSE THAN ANY CALIFORNIA BASED
HEALTH PLAN WERE JUST DIFFERENT.
SENATE BILL SIX FORTY ONE WILL
PROVIDE CONSUMERS WITH ANOTHER
OPTION FOR HEALTH CARE.
SINCE EXPRESSES ITS STRONG
SUPPORT FOR THIS BILL AND WE
RESPECTFULLY REQUEST THE SAME
FROM THIS COMMITTEE [inaudible]
THANK YOU [inaudible]
CAMPBELL.
GOOD AFTERNOON EVERYBODY MONIES
WHEN COFFEE CAMPBELL MOST SINGLE
FILE FROM SENEGAL CALIFORNIA OR
WORK FOR FRANK AUTO GROUP I'M
HERE ON BEHALF OF SOME SO HEALTH
PLAN AND CRISTINA CARRILLO.
WITH A GOOD CLIENT OF MINE
AMENDMENTS CRUEL BACK IN TWO
THOUSAND THIRTEEN OF OUR
PREVIOUS EMPLOYMENT.
AND SINCE THEN WE'VE BUILT A
RELATIONSHIP TO WHERE SHE HAS.
ALSO VEHICLES FROM ME.
SO WHEN KNOW CHRISTINA AND
FINDING OUT WHO SHE IS IN THE
LINE OF WORK SHE'S INVOLVED IN.
A LETTER NO I TO DENY HAVE
INSURANCE I WAS LOOKING FOR
INSURANCE BUT SHE EXPLAINED TO
ME.
THAT IT WASN'T AVAILABLE FOR ME
BECAUSE I WOULD HAVE TO BE OF
MIXED XIN CITIZENSHIP.
I'M NEVER AND AGAIN INSURANCE
FOR ME MY SON BECAUSE OF THE
COST WOULD JUST NOT AFFORDABLE.
I BELIEVE.
MONTH BOTH WOULD HAVE BEEN A
ROUGHLY AROUND FOUR DOLLARS.
I WITH COST OF LIVING AT ALL
TIME HIGH.
IT JUST DIDN'T MAKE ANY SENSE
FOR ME FINANCIALLY.
I WASN'T ABLE TO AFFORD
INSURANCE IT'LL MOVE
DEALERSHIPS.
I FOUND OUT THAT MY CURRENT
EMPLOYER PAYS HALF A MORE
PREMIUM.
SO WHEN IT CAME TIME TO CHOOSE
WHICH INSURANCE PLAN OR ONE OF
THE GOAL WITH.
I WANTED TO CHOOSE SENSIBLE ONCE
AGAIN.
IT WASN'T AVAILABLE FOR ME.
EVEN WITH MY EMPLOYER PAIN HAVE
SINCE OF STILL WOULD HAVE BEEN
CHEAPER TOOL.
FOR BEING A SINGLE PARENT LIVING
SENEGAL'S DEFTLY NOT EASY.
WHEN TIMES ARE HARD WE SCRAMBLE
IN THIS WORLD TO TRY TO SAVE A
BUCK OR?
TWO ALLOWING AMERICANS WHO WANT
TO CHOOSE AN AFFORDABLE HEALTH
PLAN AND GO OVER THE BORDER FOR
CARE IT JUST MAKES SENSE.
IT'S ARROGANT ACT AS THE THERE
ARE VIABLE SOLUTIONS OUT THERE
THAT BENEFIT AMERICAN CITIZENS.
MEDICAL TRAVEL TOURISM ISRAEL
AND FOR SOME WHO CAN'T AFFORD
HEALTHCARE.
HERE IN UNITED STATES IT COULD
BE A LIFESAVING NECESSITY
[inaudible]
THANK YOU.
TAKE YOUR PICK YOU VERY MUCH.
OTHERS IN SUPPORT TO OUR JUST
PUT YOUR NAME AND ORGANIZATION
PLEASE.
SOME OF THINGS HE DECIDED AND
OPERATE.
AND HERE TO ANSWER ANY QUESTIONS
THAT YOU MAY HAVE FOR ME.
SO ROBERT GOOD IN THIS ARE
REPRESENTING THE BOILERMAKERS
INTERNATIONAL UNION --
REPRESENTING THE THOUSANDS OF
WORKERS AT THE LARGER SHIPYARD
IN SAN DIEGO AND WERE IN SUPPORT
OF THE SEEMS A PLAN.
THE CHAIRMAN MEMBERS MIKE
MONTGOMERY CONGRESS OF
CALIFORNIA SENIORS WE SUPPORT
THE BILL [inaudible]
IF.
AFTER A MISTER CHAIR BEVERLY ON
BEHALF OF YOU W. ASKS ME LOCAL
THREE NINE THIRTY WE REPRESENT
ALMOST THIRTY THREE THOUSAND IN
HOME SUPPORT SERVICES PROVIDERS
AND IMPERIAL AND SAN DIEGO
COUNTIES.
IN THIS WAY INCREASE ACCESS TO
HEALTHCARE FOR THE THREE ONE IN
OPPOSITION.
GOOD AFTERNOON MISTER CHAIRMAN
AMBER'S MARRIAGES FORESTS ON
BEHALF OF HEALTHAXIS CALIFORNIA
THE STATE WIDE HEALTH CARE
CONSUMER ADVOCACY COALITION WE
ARE HERE TO OPPOSE UNLESS --
AMENDED S. B. --
SIX FOUR ONE UNLESS IT IS
AMENDED TO LIMIT THE EXEMPTIONS
FROM THE CONSUMER PROTECTIONS
THAT APPLY TO OTHER COVERAGE
REGULATED UNDER TO KNOCK SKEEN
ACT AND THE AFFORDABLE CARE ACT.
AS YOU KNOW THIS BILL WAS X.
EXTENSIVELY AND RECENTLY
AMENDMENT WE APPRECIATE THE
ONGOING CONVERSATIONS THAT WE'VE
HAD WITH YOUR OFFICE AS WELL AS
THE AUTHOR AND THE SPONSORS.
AND WE HAVE OFFERED AMENDMENTS.
IN THE LAST FEW DAYS WE HAVE
BEEN TROUBLE TO LEARN THAT THESE
PREPAID MEXICAN HOW PLANS.
HAVE BEEN ACCEPTED EXEMPTED FROM
VARIOUS CONSUMER PROTECTIONS AND
WE ARE EVEN MORE TROUBLE TO
LEARN THAT WE CAN'T TELL EXACTLY
WHAT PROTECTIONS APPLY AND WHAT
DO NOT. FOR EXAMPLE THIS
MONSTERS DID SHARE A DOCUMENT
WHAT DOES THAT MAKES IT APPEAR
THAT THIS PLAN.
IS EXEMPT FROM PROVIDING
GRIEVANCE AN APPEALS PROCEDURES
INCLUDING INDEPENDENT MEDICAL
REVIEW BUT WE CAN SEE ON THE D.
MHC WEBSITE THAT THERE ARE
GRIEVANCES IN APPEALS.
AND IN THE BED INDEPENDENT
MEDICAL REVIEW CASES WE
RECOGNIZE THAT THESE CROSS
BORDER PLANS ARE UNIQUE AND
UNUSUAL AND HAVE PLAYED A ROLE
IN BORDER COMMUNITIES IN
IMPERIAL AND SAN DIEGO CONNIE.
TO REMOVE OUR OPPOSITION WE ARE
ASKING FOR A SET OF AMENDMENTS
THAT TO THE FOLLOWING FIRST THAT
IT WOULD CREATE A PUBLIC PROCESS
FOR EXEMPTIONS FROM CONSUMER
PROTECTIONS.
SECOND APPLYING THE SAME FISCAL
SOLVENCY STANDARDS THAT ALL
OTHER HEALTH PLANS MEET CALL
TANGIBLE NET EQUITY.
AND LASTLY REQUIRING EMPLOYER
MUST OFFER A FULLY AC COMPLIANCE
PLAN.
AND KNOCKS CAN PLAN IF A PREPAID
HEALTH PLAN IS OFFERED FOR THESE
REASON WE ARE OPPOSE UP TO S. B.
SIX FOUR ONE UNLESS IT IS
AMENDED.
IF YOU ARE THERE OTHERS IN
OPPOSITION.
SEEING NONE PREFECT ARE YOU
ACCEPTING COMMITTEE AMENDMENT
SENATOR HUESO.
AND I WANNA I WANNA EXCEPT THE
SPIRIT OF THE MEN MINUTES BUT I
WANNA HAVE ALSO WORKED WITH YOU
MISTER CHAIR ON MAKING SURE THAT
WE CAN WORK.
WITH WITH THE THE STATE
DEPARTMENT.
THAT OVERSEES HIS PLAN TO MAKE
SURE I MEAN THE WE'VE SEEN THREE
SETS OF AMENDMENTS THAT --
ARE.
ARE NOT --
THAT THEY'RE ALL DIFFERENT.
BUT I THINK WE SHARE THE
CONCERNS THAT --
HEALTH THAT SHARES I DO MYSELF.
I WANT TO GET --
TO THAT POINT WHERE WE CAN --
SATISFY THOSE CONCERNS.
AND I'M GONNA ASK YOU MISTER
CHAIR IF WE CAN THINK OF THE
OPTION TO WORK TOGETHER JUST
WORK ON THE DETAILS OF THOSE.
SO WE CAN FULLY UNDERSTAND THE
THE THE AMENDMENTS AND GET TO
THE GOALS THAT WE'RE BOTH TRYING
TO ACHIEVE --
APPRECIATE APPRECIATE THAT --
THIS IS A GUT AND AMEND SO.
YEAH I HAD THIS GONE TO A NORMAL
PROCESS WE WOULD HAVE HAD MORE
TIME.
WE'VE WE HAVE BEEN SOMEWHAT
RUSHED TO DO THIS YEAH SO MY
OFFER IS ARE IF IF YOU ACCEPT MY
AMENDMENTS WE WILL HAVE A DO
PASS RECOMMENDATION.
IF YOU DO NOT IT WILL BE ENOUGH.
I'LL I'LL I'LL I'LL ACCEPT THEM
BUT ALSO WE MIGHT GET SOME.
SOME PUSH BACK FROM THE
DEPARTMENT IN TERMS OF WHETHER
THAT THAT THE SPIRIT OF THAT.
THE LANGUAGES OF THE PLANET
IMPLEMENTABLE SELF AND MY LOOK
SEMI DOORS ALWAYS OPEN I'M HAPPY
TO WORK WITH YOU GOING FORWARD
FANTASTIC THAT'S ALL I WANTED TO
HEAR MISTER CHAIR.
YEAH JUST BECAUSE THE THE THE
AUTHOR IS TAKE TAKING THOSE
AMENDMENTS ARE TO CONTINUE WORK
TOGETHER ALL OF THE BILL.
THANK YOU. THREE MOTION AND A
AND A SECOND OR ANY OTHER
QUESTIONS OR COMMENTS.
SOME RISK ON DISK A JUST
REITERATE --
SOME OF THE SOME OF THE CONCERNS
THAT WE HAVE --
AND THAT'S THAT WE GET WE NEED
TO MAKE SURE THAT EMPLOYEES HAVE
THE SAME CONSUMER PROTECTIONS
THAT ARE AFFORDED TO HEALTH PLAN
HIM AND RELEASE. TO THE EXTENT
THAT THERE ARE WAIVERS OF
EXISTING CONSUMER PROTECTIONS OR
ANY OTHER REQUIREMENTS ON HEALTH
PLANS WE NEED TO ENSURE THESE
TYPES OF DECISIONS ARE ANALYZE
IN THE BEST INTERESTS OF
ENROLLEES.
ALSO HE MAKES FOR EMPLOYERS ALSO
PROVIDE AN OPTION TO ITS
EMPLOYEES OF HEALTH PLAN OUR
FRIENDS.
THERE FULLY COMPLIANT WITH
CALIFORNIA LAW [inaudible]
SO.
I WILL ABSOLUTELY WORK WITH YOU
ARE GOING FOR ON THIS AND WITH
THOSE AMENDMENTS ARE I WILL
SUPPLY THE BILL TODAY.
MISS WALDRON ANSWERED.
JUST BRIEFLY ARM COMING FROM SAN
DIEGO.
I WAS VERY INTERESTED IN THIS
BILL AND JUST UNDERSTANDING
THAT.
YOU KNOW I COULD SEE AN EMPLOYER
WHO IS EMPLOYING FOLKS WHO COME
OVER EVERY DAY FROM MEXICO WHO
LIVE IN MEXICO WORK THERE GO
HOME.
AND THEN THEY HAVE OTHER PEOPLE
WHO WORK THERE WHO ARE CITIZENS
SO WHY CAN'T THIS EMPLOYER OFFER
THE SAME INSURANCE TO ALL
EMPLOYEES.
I MEAN SEEMS TO ME AWAY THAT
HELP EMPLOYERS AND I UNDERSTAND
TRIBAL GOVERNMENTS.
ALSO ARE PART OF THIS PLAN --
AS WE HEARD NASCO THE HIGH IT A
LOT OF DIFFERENT CORPORATION SO.
YOU KNOW BEING FROM A BORDER
TOWN I CAN TOTALLY UNDERSTAND
WHY.
SO THANK YOU FOR BRINGING IT.
THANK YOU TO ANYONE ELSE.
SO WOULD YO LIKE TO CLOSE ARE
YOU WILL WASN'T IT YEAH JUST
VERY BRIEFLY AND IN TERMS OF THE
SPIRIT OF THE OF WHAT WE'RE
TALKING ABOUT HERE.
RIGHT NOW THERE'S A CO OP
PROCESS THAT ALREADY EXIST OF
THE WAIVER PROCESS THAT EXIST
WAS ONLY INTENDED [inaudible]
CHU CHU. TO MAKE SURE THAT YOU
CAN -- YOU
KNOW THERE'S SOME REGULATIONS
AND AND MEXICO THERE DEFERRED
THE CALIFORNIA AND SO THE WAIVER
PROCESS.
IS IS ONLY --
CREATED TO CORRECT.
THOSE DIFFERENCES TO MAKE SURE
THAT THAT PROGRAM STILL
COMPLYING WITH ALL THE STATE
REGULATIONS THAT.
APPLY TO EVERY SINGLE OTHER HMO
SO THE PROTECTIONS ARE CURRENTLY
THERE.
AND THEY WILL CONTINUE TO BE
THERE UNDER THIS BILL.
MAN SO THAT'S WHY IT'S VERY
IMPORTANT THAT WE WE YOU ALLOW
US AT LEAST A LITTLE TINY
FLEXIBILITY TO WORK.
WITH THE STATE DEPARTMENT TO
ENSURE THAT THAT.
PROGRAM STAYS UP IN PLACE.
AND AND IT QUICKLY CONTINUES TO
SERVE ITS PURPOSE TO MAKE SURE.
THAT THEY'RE OPERATING UNDER ALL
THE CODES OF STATE LAW THAT.
ARE YOU SURE THAT ALL THE PEOPLE
THAT GO THERE THEY GET THE SAME
SERVICE AND SAY PROTECTIONS THAT
THE WHAT HAPPENED A CALIFORNIA
TOMORROW AND THAT'S THAT'S MY
INTENTION I THINK THAT'S ALL OF
OUR INTENTIONS.
AND WE WANT TO GET THERE IN THE
DEVIL'S ALWAYS IN THE DE AND I
APPRECIATE.
HOW HARD YOU'VE WORKED TO ENSURE
THAT WE HAVE THE RIGHT AMENDMENT
I THINK I THINK THE AMENDMENT
YOU APROPOS PROPOSED WILL GET US
THERE?
BUT JUST IN CASE THERE'S JOB OF
MINOR TWEAK I I WANNA MAKE SURE
THAT YOU CONTINUE TO STAY AT THE
TABLE.
AND THAT WE CONTINUE TO
COMMUNICATE BECAUSE WE'RE GOING
TO TRY TO GET THIS BILL.
SO THE GOVERNOR'S DESK THIS YEAR
WE NEED ALL YOUR HELP HAS A VERY
IMPORTANT TO HELP HELP LET'S
ACHIEVE THAT OUR GOALS OF
IMPROVING.
ACCESS TO HEALTH CARE.
THE BORDER REGION THANK YOU VERY
MUCH TO SHARE THANK YOU VERY
MUCH SENATOR HUESO AND YOU'RE
ALWAYS WELCOME AT MY TABLE.
AND THEN AND LIKE THAT --
WE WILL WE HAVE A MOTION BY
MISTER MISTER MAYES SECOND BY.
MISS WALDRON EXCUSE ME ON THE
MOTION IS TO PASS AS AMENDED TO
APPROPRIATIONS AND MADAM
SECRETARY PLEASE CALL THE ROLL.
WHAT I WHAT I MAY HIS MAYES AYE
AGUIAR-CURRY?
HACKER CURRY NOT VOTING
[inaudible]
BIGELOW [inaudible]
BIGELOW AYE [inaudible]
BONTA [inaudible]
BURKE [inaudible]
CARILLO [inaudible]
CARILLO I FLORA.
FLORA AYE AMONG.
MCCARTY MCCARTY AYE NAZARIAN.
RODRIGUEZ I'M SORRY NAZARIAN AYE
RODRIGUEZ AYE [inaudible]
SANTIAGO [inaudible]
THURMOND [inaudible]
WALDRON [inaudible]
WALDRON AYE.
THE BILL THE BILL HAS NINE VOTES
IT'S OUT WILL LEAVE IT ON FIVE
THANK SURE OTHERS THAT VERY HOW
AYE AYE SHE OPENED THE ROLE OF
EXCUSE ME [inaudible]
SENATOR HEALTH.
GOOD AFTERNOON.
MISTER CHAIR AND THAT COLLEAGUES
S. B..
EIGHT TWENTY THREE REQUIRES THE
DEPARTMENT OF HEALTH CARE
SERVICES TO ADOPT THE AMERICAN
SOCIETY.
AND I APPRECIATE YOUR SUPPORT
INTO.
REFRESHER AYE VOTE I HAVE
WITNESSES IN SUPPORT THANK YOU
--
MARK AGAIN ON BEHALF OF
SHATTERPROOF WERE NATIONWIDE --
OPIOID ADDICTION TREATMENT A
NONPROFIT --
THIS IS A BILL THAT WE THINK
PROVIDES CERTAINTY TO PATIENTS
OF FAMILIES AS WELL AS INSURERS
THAT WHAT HAPPENS INSIDE OF A
LICENSED CALIFORNIA TREATMENT
FACILITY IS EVIDENCE BASED
OUTCOMES BASED --
WE UNDERSTAND THAT MANY COUNTIES
WERE RE DOING THIS ARE WE
UNDERSTAND THAT A LOT OF GROUPS
HAVE MOVED TOWARDS THIS THIS
ACTUALLY.
THOUGH WILL SET THE STANDARD --
YET --
REQUIRES THAT EVERYTHING IN
BASED ON EVIDENCE BASED IN ORDER
TO OBTAIN A LICENSE --
AND IT REALLY SENDS A MESSAGE TO
THE REST OF THE NATION WE DO
KNOW THAT BACK IN --
WASHINGTON DC THERE'S A GROUP
WITH THE SURGEON GENERAL --
OUR ORGANIZATION SHATTERPROOF
SOME OF THE HEALTH CARE
FACILITIES AND MANY OF THE
TREATMENT GROUPS --
THERE ARE CURRENTLY OUT WORKING
TO UPDATE OF THE CURRENT AYE AYE
EVIDENCE BASED GUIDELINES TO
COME OUT WITH SOME OFFICIAL
ONES.
THERE ARE MANY --
INCLUDING THE A SAM REGULATION
OR CRITERIA THAT ARE OUT THERE
--
AND WE ASK FOR YOUR SUPPORT OF
THIS BILL.
THANK YOU VERY MUCH OF THE
OTERS IN SUPPORT. FOR CONSUMER
WATCHDOG IN THAT SUPPORT.
SHERRI DAILY WITH CALIFORNIA
CONSORTIUM OF ADDICTION PROGRAMS
AND PROFESSIONALS AND SUPPORT
THANK YOU.
MISTER CHAIRMAN MEMBERS HAULING
MEASURE BEHALF OF THE CALIFORNIA
ASSOCIATION OF ALCOHOL DRUG
PROGRAM EXECUTIVES.
WHICH GENERALLY SUPPORT THE
DIRECTION OF THIS BILL BUT WE DO
HAVE SOME CONCERNS ABOUT
LIMITING CAPACITY THROUGH THE OF
THE STATUTES THAT ARE THE
PROPOSALS AND I THIS IS
SOMETHING THAT --
WE HAVE SPENT SOME TIME TALKING
TO A THE SPONSORS AND THE AUTHOR
ABOUT MICKEY WE HOPE TO CONTINUE
TO WORK WITH BOTH AUTHOR IN THE
SPONSORS AS THIS BILL MOVES
THROUGH THE PROCESS THANK YOU.
PICKED HIM.
DOCTOR DAVID KAHN ON BEHALF OF
THE CALIFORNIA SOCIETY OF
ADDICTION MEDICINE IN SUPPORT OF
THE BILL.
YOU VERY MUCH CAN ALSO AND I'VE
BEEN ASKED ABOUT TO OFFER
SUPPORT FROM THE CALIFORNIA
CONSUMER ATTORNEYS.
IS THERE ANYONE IN OPPOSITION.
SEE KNOWN BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTION ANYONE
COMMITTEE.
THE NIGHT I I DON'T THINK YOU
SET A CENTER BUILT PERSON HILL
FOR BRINGING THIS.
FORWARD --
GIVING GIVEN OPPORTUNITY CLOSE
AS WELL BUT I APPRECIATE PRETTY
REFERENCE IN THIS IT'S VERY.
VERY NECESSARY BILL IN IT.
JOYS A TO PASS APARTMENT THANK
YOU VERY MUCH I APPRECIATE YOUR
SUPPORT RESPECTFULLY ASK FOR AYE
VOTES THANK YOU VERY MUCH.
SHARE AMEND TACTIC WE DO HAVE A
MOTION THE MASSIVE MOTION IS A
DO PASS AS AMENDED TO
PREPARATIONS A MOTION BY WAS MET
BY WAS WELL. FIVE WEST.
MR MAYES THE SECOND BY MR
MCCARTY.
HOME SECRETARY PLEASE CALL THE
ROLL.
WOULD I WOULD I MAYES.
EGGER CURRY.
AGAR CURRY I'M BIGELOW.%
BIGELOW AYE SHRINK BONTA
[inaudible]
BURKE [inaudible]
CARILLO.
RIO AYE FLORA.
FLORA I THE MOST [inaudible]
MCCARTY.
MCCARTY I NAZARIAN.
NAZARIAN AYE RODRIGUEZ.
RODRIGUEZ I SANTIAGO
[inaudible]
BERMAN.
WALDRON.
WALDRON AYE.
YOUR DOES NINE VOTES IS MORE
THANA FEW OUT COMMITTEE WILL
LEAVE IT OPEN FOR OTHERS THAT ON
THANK YOU SENATOR.
THIS POINT WE DON'T HAVE ANY
ADDITIONAL OFFERS BUT WE DO HAVE
A CONSECUTIVE SOMEONE WOULD LIKE
TO MOVE THAT CONCERN COUNTY.
THANK YOU SO MUCH THE AND THE
MOTION WAS BY MISTER BIGELOW THE
SECOND BY MR MCCARTY EMILY --
THEM THE CONSECUTIVE CONSISTS OF
ITEM NUMBER ONE ACR TO THIRTY
FOUR ITEM NUMBER FIVE S. B. NINE
THIRTY ONE ITEM NUMBER NINE S.
B.. TEN FORTY ONE ITEM NUMBER
TWELVE S. B. ELEVEN OH NINE ITEM
NUMBER THIRTEEN SP.
ELEVEN TWENTY FIVE AND NUMBER
ITEM NUMBER TWENTY TWO S. B.
FOURTEEN SIXTY FOUR AT A MOTION
BY MISTER BIGELOW SECOND AYE MR
MCCARTY BETTER SECRETARY PLEASE
CALL THE ROLL.
WHAT I WOULD AYE MAYES?
AGAR CURRY.
AGAR CURRY I BIGELOW.
BIGELOW AYE BONTA [inaudible]
BURKE CARILLO [inaudible]
CARILLO I FLORA.
FLORA AYE LOW MOAN [inaudible]
MCCARTY.
MCCARTY AYE THIS AREA.
MISSOURI AND I RODRIGUEZ.
RODRIGUEZ I SANTIAGO
[inaudible]
THURMOND.
WALDRON.
WALDRON AYE.
THAT HAS NINE VOTES OF THE
CONSENT CALENDAR IS OUT SO AT
THIS POINT WE'RE WAITING FOR
SOME SENATORS
.
WHENEVER HERE WITH EVERY LIKE
SENATOR.
ANYONE IN ORDERED AS A MATTER
WHICH ONE YOU PICK CAN YOU JUST
TELL ME WHERE YOU WANT TO GO --
I GOT TO TEN TWENTY THREE HAVE
TO HAVE THEM IN A NUMERICAL
ORDER PUT JUST WILL GO AND
NUMERICAL ORDER OF START WITH
WITH TEN TWENTY THREE PERFECT.
CAN'T THINK OF GOVERNMENT ORDER
TOOK.
OKAY WE'RE GONNA START OFF WITH
--
SP TEN TWENTY THREE PERFECT.
THANK YOU MISTER CHAIR AND
MEMBERS HIGH HORIA --
TELEHEALTH IS EXPANDING ITS A
VITAL PART OF OUR HEALTHCARE
SYSTEM.
THAT INCREASES ACCESS TO CARE.
TO AND LOWERS THE COST
ESPECIALLY RURAL UNDERSERVED
AREAS OF OUR STATE.
PLANO CALIFORNIA THERE AT LEAST
FIVE WEBSITES OR MOBILE APPS
THAT PATIENTS CAN USE REQUEST
HAS FOR CERTAIN STDS OR HORMONAL
BIRTH CONTROL WITHOUT AN OFFICE
VISIT.
WHOEVER THE SPONSOR OF THIS BILL
FOUND THAT IN SOME AREAS THE
STATE HEALTH INSURANCE
REIMBURSEMENTS FOR THESE TYPES
OF TELEHEALTH SERVICE IS
LIMITED.
THIS BILL CLARIFIES INSURANCE
COVERAGE IS AVAILABLE FOR
CERTAIN REPRODUCTIVE SERVICES
DELIVERED TO TELL HEALTH.
POLICY REQUIRES THAT OUR FAMILY
PACK PROGRAM TO COVER IT I WITH
THAT MEMBERS I RESPECTFULLY ASK
THAT I WOULD HAVE INTERVIEWS
HERE LIKE TO SPEAK IN SUPPORT
THE MEASURE [inaudible]
GO AHEAD.
GOOD AFTERNOON MISTER CHAIRMAN
AND MEMBERS OF THE COMMITTEE MY
NAME IS AMY MORE AND I'M VICE
PRESIDENT OF PUBLIC AFFAIRS AT
ESSENTIAL ACCESS HEALTH.
AND ESSENTIAL ACCESS IS PROUD TO
SPONSOR SB.
TEN TWENTY THREE THIS BILL I'M
AS THE SENATOR MENTIONED SEEKS
TO EXPAND ACCESS TO ESSENTIAL
SEXUAL AND REPRODUCTIVE HEALTH
SERVICES INCLUDING BIRTH CONTROL
AN STD TESTING PREVENTION AND
TREATMENT.
BY ENHANCING COVERAGE FOR THE
SERVICES PROVIDED TO MOBILE HOW
TECHNOLOGIES LIKE VIDEO PHONE
AND SMARTPHONE APPLICATIONS.
WE THANK SENATOR HERNANDEZ FOR
HIS LEADERSHIP ON THIS ISSUE AND
FOR BEING A CHAMPION FOR WOMEN'S
HEALTH ESPECIALLY DURING THESE
TIMES.
CALIFORNIA HAS SIGNIFICANTLY
REDUCED UNINTENDED PREGNANCY
RATES IN OUR STATE SINCE THE
NINETEEN NINETIES THANKS TO
POLICY AND PROGRAM INNOVATIONS.
THAT HAVE ADVANCE OR AT REDUCE
BARRIERS TO ACCESSING
REPRODUCTIVE HEALTH CARE BUT
DESPITE THIS PROGRESS.
IN CALIFORNIA DISPARITIES REMAIN
AND ARE UNINTENDED PREGNANCY
RATES REMAIN DOUBLE THOSE AND
OTHER DEVELOPED COUNTRIES AND
STD RATES ARE AT A HISTORIC
HIGH.
DISPROPORTIONATELY OF BONE.
RELATIONS IN OUR STATE
[inaudible]
AS A AREAS AND I'M LOW INCOME
COMMUNITIES STILL FACE BARRIERS
IN ACCESSING TIME SENSITIVE
SEXUAL AND REPRODUCTIVE HEALTH
CARE.
AND WE HAVE MANY SEXUAL
REPRODUCTIVE HEALTH CARE DESERT
REGIONS THAT EXPERIENCE THE
HIGHEST RATES OF UNINTENDED
PREGNANCY AND STDS.
AND ON WHAT WE NOW WIDESPREAD
SMARTPHONE USE OFFERS NEW
PATHWAYS FOR EXPANDING ACCESS TO
HEALTH CARE.
AND IN TURN AN OPPORTUNITY TO
IMPROVE PUBLIC HEALTH OUTCOMES
AND SAVE PUBLIC RESOURCES.
THIS BILL SEEKS TO ELIMINATE
BARRIERS AS THE SENATOR
MENTIONED BY ALLOWING OUT
EXPLICITLY PLANS TO COVER THESE
--
SERVICES DELIVERED TO MOBILE
TELEHEALTH AND ALSO REQUIRE
FAMILY PACK TO COVER THESE
SERVICES.
AND IN THESE DAYS --
WITH WOMEN'S AND REPRODUCTIVE
HEALTH UNDER ATTACK AT THE
FEDERAL LEVEL WE HAVE TO HEARING
CALIFORNIA DO EVERYTHING THAT WE
CANNOT ONLY TO HOLD THE LINE.
AND PROTECT THE ACCESS THAT
CALIFORNIANS HAVE NOW BUT TO
KEEP PUSHING FORWARD ALSO WITH
NEW POLICY INNOVATIONS IN NEW
PATHWAYS TO HEALTH.
SO FOR THESE REASONS WE ASK FOR
YOUR SUPPORT.
THANK YOU VERY MUCH.
SO GOOD AFTERNOON I'M DOCTOR
ALLEN HARSH WORDS I AM A BOARD
CERTIFIED INTERNIST A FELLOW OF
THE SOCIETY FAMILY PLANNING.
AND A TENURED PROFESSOR OF
MEDICINE AT THE UNIVERSITY OF
CALIFORNIA DAVIS.
I'M INTO TWO THOUSAND AND
SIXTEEN I WORK WITH OUR STATE
DEPARTMENT OF HEALTH CARE
SERVICES OFFICE OF FAMILY
PLANNING IS THERE SENIOR
MEDICAL.
CONSULTANT HOWEVER I'M SPEAKING
TODAY AS A PRIVATE CITIZEN NOT
AS A REPRESENTATIVE OF BY THE
UNIVERSITY OF CALIFORNIA AT THE
STATE DEPARTMENT OF HEALTH CARE
SERVICES.
I'M HERE TODAY TO URGE YOU TO
SUPPORT S. B..
TEN TWENTY THREE WHICH IS
DESIGNED TO EXPAND THE USE
TELEHEALTH FOR THE PROVISION OF
FAMILY PLANNING SERVICES.
I FIRST BECAME INVOLVED IN
TELEHEALTH OVER A DECADE AGO AS
FACULTY AT THE UNIVERSITY OF
PITTSBURGH MEDICAL CENTER IN
PENNSYLVANIA.
I WORKED WITH COLLEAGUES TO
DEVELOP A PROGRAM WE CALLED YOU
VISITS AND IS NOW A PROGRAM
CALLED ANYWHERE CARE.
THIS PROGRAM OFFERS PATIENTS
WITH NON EMERGENCY SYMPTOMS
QUALITY CARE ONLINE QUICKLY WITH
THE EXPLICIT GOAL OF NOT HAVING
TO WAIT.
IN AN EMERGENCY ROOM OR A
WAITING ROOM OR DEAL WITH
PARKING HASSLES.
SUCH CONVENIENCE IS REALLY
BECOMING THE STANDARD OF CARE
AND PRIVATE HEALTH CARE.
SUCH PROGRAMS ARE ESPECIALLY
IMPORTANT TO MAINTAINING THE
HEALTH PEOPLE LIVING IN RURAL
AREAS ESPECIALLY DURING SNOWY
WINTERS WHEN ROAD CONDITIONS CAN
BE HAZARDOUS.
OF PARTICULAR RELEVANCE TO
TODAY'S CONVERSATION I LED
UPMC'S LAUNCH OF A CONTRACEPTIVE
YOU VISIT WHICH ALLOWED WOMEN TO
REQUEST A PRESCRIPTION FOR
HORMONAL CONTRACEPTION.
AS WE PREVIOUSLY PUBLISHED IN
PEER REVIEW JOURNALS WOMEN WHO
USED A CONTRACEPTIVE
QUESTIONNAIRE TO SELF SCREEN FOR
CONTRAINDICATED INSTALL HARMONIC
CONTRACEPTION OR LESS LIKELY THE
WOMEN WHO SAW CLINICIAN DURING
THE REGULAR OFFICE VISIT. TO
RECEIVE INAPPROPRIATE
PRESCRIPTIONS MEANING USING
TELEHEALTH PROVIDE HORMONAL
CONTRACEPTION HAS BEEN PROVEN TO
BE BOTH SAFE AND EFFECTIVE.
MY CURRENT CLINICAL PRACTICE
HERE IN SACRAMENTO I GET TO SEE
FIRSTHAND THE WAYS ACCESS TO
TELEHEALTH IMPROVE MY PATIENTS
LIVES.
I TAKE CARE OF A GOOD NUMBER OF
PATIENTS WHO LIVE A COUPLE HOURS
NORTH OF SACRAMENTO. FOR THOSE
LIVING IN RURAL AREAS AND
PARTICULARLY THOSE WITHOUT GAS
MONEY TO DRIVE TO A CLINIC RIGHT
NOW.
THE OPTION OF TELEHEALTH IS A
GOD SO.
ESPECIALLY THOSE WHO WORK NIGHTS
OFTEN FIND IT HARD TO GET TO
CLINIC DURING USUAL BUSINESS
HOURS.
IN ALL OF THE SITUATIONS THE
OPTION OF USING TELE HEALTH TO
DISCUSS CONCERNS BUT ABOUT
POSSIBLE SIDE EFFECTS ROUTINE
REFILLS WHEN NEEDED CAN MEAN THE
DIFFERENCE BETWEEN.
DISEASE AND HEALTH FOR ALL THESE
REASONS I STRONGLY ENCOURAGE YOU
TO HELP THE STATE OF CALIFORNIA
EXPAND THEIR USE OF TELEHEALTH
TO EXPAND ACCESS TO PUBLICLY
FUNDED FAMILY PLANNING SERVICES.
THANKS VERY MUCH DOCTOR OTHER IS
IN SUPPORT.
THANK YOU MISTER CHAIRMAN FIRST
MEGAN SUPERS ON BEHALF OF
CALIFORNIA HEALTH PLUS ADVOCATES
IN SUPPORT THANK YOU.
RESIDENTS ARE ON BEHALF OF THE
CALIFORNIA ACADEMY DAMAGE
POSITIONS AND AMERICAN COLLEGE
OBGYN STRYCHNINE SUPPORT IF YOU.
RIGHT NEXT CALIFORNIA'S
DISABILITY RIGHTS CALIFORNIA
ALLIANCE RETIRED AMERICANS IN
STRONG SUPPORT.
YOU VERY MUCH.
SO ANYONE IN OPPOSITION.
SEEING NO ONE WILL BRING IT BACK
TO THE COMMITTEE FOR QUESTIONS
OR COMMENTS MISS AGUIAR-CURRY.
THANK YOUS THANK YOU THANK YOU
FOR BRINGING THIS BILL FOUR THIS
IS A REALLY GREAT BILL I
APPRECIATE I'VE BEEN WORKING ON
TRYING TO FIGURE OUT TELEHEALTH.
IN OUR RURAL AREAS DEMOCRACY WE
NEED TO GET SOME INTERNET OUT
THERE WHICH SHOULD BE HELPFUL.
BUT I FOUND OUT MY WHEN MY
COUNTIES IS NUMBER ONE WITH STD
RATES AND I CANNOT PUT UP
WITHOUT SO EVERITT DOES WE CAN
DO TO MOVE THIS FORWARD I AM I
REALLY APPRECIATE THE BALLOT
THANK YOU VERY MUCH.
I ALSO OR IF YOU HAVE A GOOD
VEHICLE AUTHOR --
THEM SO WE CAN MANY HERE IN THIS
COMMITTEE BUT YEAH.
BUT NOT TO EDITORS OR IF WE CAN
DO THAT APPARENTLY YEAH THANK
YOU APPRECIATE IT.
I DO KNOW WE HAVE THAT POWER
WELL MEANING SHE ASKING.
THANK YOU THANK YOU THANK YOU
VERY MUCH --
ANY OTHER COMMENTS OR QUESTIONS.
WOULD CENTER WHICH I TO GO ASK
FOR AN ITEM PLEASE TAKE THANK
YOU VERY MUCH REALLY PRETTY
BRING THIS FOR NOW ACTUALLY.
IF WELL RADICAL WE HAD ME IS
COOPER.
TO KNOW IT IT IS IT IS IT IS AN
ISSUE IT IS IT IS IT IS SERIOUS
ISSUE IN AN ESPECIALLY --
AND AND I WILL I WILL ALSO PUT
AN EXCLAMATION POINT ON ON THE
CHALLENGES WE HAVE WITH PEROT
BROADBAND TO TRULY MAKE THIS
THING WORK SO --
SO APPRECIATE PRETTY RING THE
BELL FORWARD AND IT DOES ENJOY
DO PASS RECOMMENDATION.
BUT WE NEED A MOTION.
OKAY AND WHERE MOST OF A MISSILE
YEAR CURRY AND A SECOND BY MISS
CARILLO MADAM SECRETARY PLEASE
CALL THE ROLL.
MOSHE'S DO PASSED APPROPRIATIONS
WOULD I WOULD I MAYES.
ACTOR CURRY.
ANCHOR CURRY I BIGELOW.
BIGELOW AYE BONTA.
BURKE.
CARILLO.
CARILLO AYE FLORA [inaudible]
LIMON [inaudible]
MCCARTY [inaudible]
NAZARIAN.
RODRIGUEZ SANTIAGO BERMAN
WALDRON.
HERE FOR WE NEED SOME MORE VOTES
YOU MISSED IT THERE WHERE WE HAD
ENOUGH VOTES HERE WHILE MY EYES
IS AMAZING SURE I'M SURE THEY
DON'T NAY BARRACKS CINNAMON.
SO ANYWAY YEARS YOUR NEXT BILL
SENATE YEAH SP ONE ONE ZERO
EIGHT PERFECT THINKING.
THINGS CHAIR MEMBERS IN JANUARY
AS WE KNOW THE FEDERAL
GOVERNMENT ANNOUNCED A DRAMATIC
CHANGE IN POLICY BY ALLOWING
STATES TO CONDITION.
MEDICAID COVERAGE AND WORK AND
COMMUTING GAUGE MEN FOR CERTAIN
BENEFICIARIES THE UNDERLYING
THEORY BEHIND REQUIREMENTS IS
THAT INDIVIDUALS WHO ARE NOT
WORKING CHOOSE NOT TO BE
EMPLOYED --
BUT THERE ARE MAJOR FLAWS IN
THIS STINKING FIRST OFF MEDICAID
BENEFICIARIES WHO CAN WORK.
DO WORK SECOND IMPOSING WORKERS
LAWSON COVERAGE FOR INDIVIDUALS
WHO WERE ACTUALLY IN NEED OF
COVERAGE TO WORK OR PEOPLE WHO
CAN'T WORK BECAUSE THERE.
HAVE FAMILY CAREGIVERS OR IN
FULL TIME STUDENTS FINALLY A
WORK REQUIREMENT WILL LEAD TO AN
OVERLY BURDENSOME PAPERWORK AND
RESULT IN HIGHER STATE AND
COUNTY ADMINISTRATIVE COSTS.
CALIFORNIA HAS BEEN A LEADER IN
IMPLEMENTATION INLAND TAMING THE
AFFORDABLE CARE ACT.
ENCOURAGING ENROLLMENT IN
COVERAGE MAKING MEDI CAL
CONTINGENT OUR WORK REQUIREMENTS
IS A STEP BACKWARDS MEMBERS.
THIS BILL PUTS CALIFORNIA RECORD
IS REJECTING MISGUIDED AND MEAN
SPIRITED ATTEMPTS TO MAKE TAKE
MEDICARE COVERAGE AWAY FROM
THOSE WHO NEED IT MOST.
AYE ASPIRIN AYE VOTE AND I HAVE
INDIVIDUALS HERE LIKE TO SPEAK
IN SUPPORT OF THE MEASURE MISTER
CHAIR MEMBERS.
GOOD AFTERNOON I'M CHEN FLOYD
FROM THE WESTERN CENTER ON LAW
AND POVERTY AND ARE PROUD TO
SPONSOR S. B. ELEVEN AWAY.
WHEN CONGRESS FAILED TO REPEAL
THE AFFORDABLE CARE ACT LAST
YEAR THE FEDERAL MEDICAID AGENCY
BEGAN ADVISING STATES ON CHANGES
THEY COULD MAKE TO REDUCE
ENROLLMENT IN THEIR STATE
MEDICAID PROGRAMS? FOUR STATES
ALREADY HAVE WAIVERS REAP
APPROVED WITH WORK REQUIREMENTS
FOR ADULTS WHO ARE NOT ELDERLY
OR DISABLED WELL EIGHT MORE HAVE
PENDING APPLICATIONS. THREE OF
THOSE APPROVED WAIVERS ALSO
INCLUDE A LOCK OUT PERIOD THAT
BARS AN INDIVIDUAL FROM
RECEIVING MEDICAID COVERAGE
SEVERAL MONTHS --
FOR FAILING TO TURN IN PAPERWORK
PAY PREMIUMS OR MEET THOSE WORK
REQUIREMENTS.
STATES ALSO OF A NUMBER OF OTHER
REQUESTS AND PENDING WAIVER
APPLICATIONS TO RESTRICT
ELIGIBILITY SUCH AS TOTAL
ENROLLMENT CAPS TIME LIMITS
LOWERING OF THE INCOME
ELIGIBILITY THRESHOLD AND
REINTRODUCTION OF THE ASSETS
TEST.
IT'S NOT YET KNOWN HOW MANY OF
THESE REQUESTS WILL BE APPROVED.
WE RECOGNIZE THESE ATTEMPTS FOR
WHAT THEY ARE A RETURN TO THE
IDEA THAT SO SOME LOW INCOME
PEOPLE ARE MORE DESERVING OF
HEALTH CARE THAN OTHERS.
PRIOR TO OUR MEDI CAL EXPANSION
MANY PEOPLE WHO NEEDED HEALTH
CARE OFTEN HAD TO WAIT UNTIL
THEIR HEALTH HAD DETERIORATED TO
THE POINT THAT THEY WOULD BECOME
ELIGIBLE FOR MEDICARE ALL.
ON THE BASIS OF A DISABILITY.
IN OTHER WORDS LOW INCOME PEOPLE
HAD TO BECOME MEDICALLY UNABLE
TO WORK IN ORDER TO GET THE
NEEDED HEALTH SERVICES.
THAT WOULD ALLOW THEM TO WORK
THIS IS NOT GOOD HEALTH POLICY.
FURTHERMORE WE HAVE LEARNED IN
CALIFORNIA THAT ANY PAPERWORK
REQUIREMENTS BECAUSE ELIGIBLE
PEOPLE TO LOSE COVERAGE.
AS A RESULT WE HAVE TAKEN THE
STEPS TO REDUCE SUCH
REQUIREMENTS IN OTHER WORDS WORK
REQUIREMENTS WILL CAUSE WORKING
PEOPLE TO LOSE COVERAGE FOR
FAILURE TO CERTIFY REGULARLY
THAT THEY ARE INDEED WORKING.
THE VAST MAJORITY OF MEDI CAL
BENEFICIARIES WHO ARE NOT HELD
EARLIER DISABLED ARE IN WORKING
FAMILIES AS A SENATOR MENTIONS.
THOSE WHO DO NOT WORK HAVE
LEGITIMATE REASONS CHRONIC
ILLNESS FAMILY CAREGIVING
RESPONSIBILITIES FULL TIME
SCHOOL OR WORK IS SIMPLY NOT
AVAILABLE TO THEM.
SIMILARLY RESTRICTIONS ON WHEN
AND HOW LONG A PERSON MAY ACCESS
MEDICAID DENIES IN HUMANITY OF
WITHHOLDING NEEDED HEALTH CARE
FOR BUREAUCRATIC PURPOSES.
WELL IT MAY BE THAT NO ONE IN
OUR CURRENT ADMINISTRATION
EXPECTS IMPOSE NEW RESTRICTIONS
ON ELIGIBILITY LEGISLATION MUST
BE CONSIDERED NOT ON BEST
INTENTIONS BUT I'M POTENTIAL
CONSEQUENCES.
SHOULD OUR ADMINISTRATION
CHANGES SHOULD THE FEDERAL
GOVERNMENT SEEK TO IMPOSE SUCH
REQUIREMENTS ON AN EXISTING
WAIVER APPLICATION WE WILL NEED
THE PROTECTION OF A STATE
STATUTE THAT REQUIRES
LEGISLATIVE OVERSIGHT.
PRIOR TO REDUCING ELIGIBILITY
FOR MEDICAL. FOR THESE REASONS
WE'RE PROUD TO SPONSOR SB ELEVEN
AWAIT WE THINK THE AUTHOR PURRS
LEADERSHIP AND RESPECTFULLY
REQUEST YOUR AYE VOTE AND NOW I
HAVE MY COLLEAGUE LIES ATTENTION
ON FROM LEGAL SERVICES IN
NORTHERN CALIFORNIA TO GIVE YOU
SOME.
EXAMPLES OF SOME MEDICARE
RECIPIENTS THAT WOULD BE HARMED
BY SUCH REQUIREMENTS MOVE THE
BILL.
GOOD AFTERNOON MISTER CHAIRMAN
THERE'S MY NAME IS LIES
ATTENTION ON A MANAGING ATTORNEY
AT LEGAL SERVICES OF NORTHERN
CALIFORNIA OUR OFFICE PROVIDES
DIRECT LEGAL SERVICES TO HELP
CONSUMERS IN THIRTY TWO NORTHERN
CALIFORNIA COUNTIES.
WE BELIEVE WORK REQUIREMENTS AS
A CONDITION OF MEDI CAL
ELIGIBILITY WOULD HAVE A VERY
DETRIMENTAL EFFECT ON OUR LOW
INCOME CLIENTS. FOR SO MANY OF
THEM ACCESS TO NECESSARY
HEALTHCARE SERVICES TO THE
MEDICARE PROGRAM IS ESSENTIAL TO
BEING ABLE TO EVENTUALLY
REJOINED THE WORK FORCE. ONE OF
OUR RECENT CLIENTS AS A FIFTY
SEVEN YEAR OLD MAN A FATHER OF
TWO HERE IN SACRAMENTO HE
USUALLY WORKS AS AN INDEPENDENT
CONTRACTOR BUT INJURED HIS BACK
THIS AS FAR AND SUBSEQUENTLY HAD
TWO HEART ATTACKS.
I HE WAS UNABLE TO WORK DURING
THIS TIME PERIOD IN COULD NOT
HAVE COMPLIED WITH WORK
REQUIREMENTS HOWEVER SINCE HE'S
HAD CONSISTENT ACCESS TO HEALTH
CARE SERVICES TO MEDI CAL HE'S
RECOVERING WELL AND GOING BACK
TO WORK.
ANOTHER CLIENT WE HAD WAS A
THIRTY SEVEN YEAR OLD SINGLE MOM
WITH THREE KIDS FROM SHASTA
COUNTY SHE WAS WORKING AS A
REGISTERED NURSE AND HER
THIRTEEN YEAR OLD DAUGHTER.
BEGIN HAVING SEIZURES DURING
WHICH SHE WOULD SOIL HERSELF
EXPERIENCE INTENSE PAIN IN ONE
SIDE.
HER DOCTOR SUSPECTED SHE MIGHT
HAVE A BRAIN TUMOR BEGAN SENDING
HER TO SPECIALIST APPOINTMENTS
HERE IN SACRAMENTO SOMETIMES UP
TO THREE TIMES A MONTH.
HIS MOM HAD TO QUIT HER NURSING
JOB TO CARE FOR HER DAUGHTER AND
TO ACCOMMODATE THE FREQUENT
TRIPS TO SACRAMENTO.
IF WORK REQUIREMENTS WE
IMPLEMENTED AS A CONDITION OF
MEDI CAL ELIGIBILITY THIS WOMAN
WOULD NOT HAVE BEEN ABLE TO
COMPLY IT WOULD HAVE BEEN
WITHOUT ACCESS TO HEALTH CARE
SERVICES HERSELF.
MANY THE PEOPLE IN THE MEDICAL
EXPANSION POPULATION ARE PEOPLE
WHO HAVE DISABILITIES AND CANNOT
WORK IN OUR AWAITING A
DISABILITY DETERMINATION IN THE
DAYS BEFORE THE AFFORDABLE CARE
ACT.
GETTING A PROPER DISABILITY
DETERMINATION TO GET ON TO MDI
CAL COULD TAKE MONTHS I HAD ONE
CLIENT COULD ADVANCE RECTAL
CANCER AS WELL AS MAJOR
DEPRESSION.
BUT HIS DISABILITY DETERMINATION
WAS STILL DENIED THAT DENIAL WAS
EVENTUALLY OVERTURNED IT TOOK US
SEVERAL MONTHS TO APPEAL AND
THAT MEANT UNFORTUNATELY WENT
WITH THE ACCESS TO MEDICAL
DURING THAT TIME.
WHILE MOST MEDICARE
BENEFICIARIES ARE IN WORKING
FAMILIES ARE ALSO MANY PEOPLE
WHO ARE UNABLE TO WORK DUE TO
MEDICAL CONDITIONS CAREGIVING
RESPONSIBILITIES OR DISABILITIES
THE IMPLEMENTATION OF WORK
REQUIREMENTS IN THE MEDICAL
PROGRAM.
WOULD LEAVE THESE GROUPS OF
PEOPLE WITHOUT NEEDED HELP FOR
THESE REASONS WE SUPPORT THE
BILL THANK YOU.
THANK YOU VERY MUCH OTHERS IN
SUPPORT JUST YOUR NAME AND
ORGANIZATION PLACE.
EMILY CHEN ON HALF THE
CALIFORNIA PAN ETHNIC HEALTH
THAT WE CAN SUPPORT.
MARY VALDEZ HEALTHAXIS
CALIFORNIANS SUPPORT.
DIFFERENT ON THE ON BEHALF OF
THE CALIFORNIA IMMIGRANT POLICY
CENTER IN SUPPORT.
SARAH FLUX CALIFORNIA LABOR
FEDERATION IN SUPPORT.
FINESCALE HIM ON BEHALF MANNERS
FAMILY PARTNERSHIP IN SUPPORT.
THE SET SHORT ON BEHALF OF THE
PRIVATE ESSENTIAL ACCESS
COMMUNITY HOSPITALS IN SUPPORT.
DIVIDENDS OF THE AMERICAN
DIABETES ASSOCIATION AS WELL AS
AMERICA'S POSITION GROUPS AND
SUPPORT.
WHEN EXPENSE OR THE CALIFORNIA
CADMIUM FAMILY PHYSICIANS SPORT?
MIKE MONTGOMERY CONGRESS OF
CALIFORNIA SENIORS WE SUPPORT
THE BILL THANK YOU.
VIDEO BORN AMERICAN ACADEMY OF
PEDIATRICS AND SUPPORT
[inaudible]
IF YOU.
ERICA SOME HAVE MORE TO DANCE IN
SUPPORT [inaudible]
IF YOU.
HIS READING OF ASIAN AMERICANS
ADVANCING JUSTICE CALIFORNIANS
ON SPORT.
THAT BROUGHT DISABILITY RIGHTS
CALIFORNIA SUPPORT.
BECAUSE UNDER RESTLESS AND A
FULL TIME GRADUATE STUDENT IN
SUPPORT.
DEFINITIONS WITH GROWING A
BEHALF THE CALIFORNIA CHRONIC
CARE COALITION IN SUPPORT.
YOU VERY MUCH [inaudible]
ANYONE ELSE.
ANYONE IN OPPOSITION.
C. KNOW WERE BRING BACK TO THE
COMMITTEE QUESTIONS OR COMMENTS.
IN THE SENATE WOULD LIKE TO
CLOSE.
THAT'S WHAT I'VE ALWAYS CHAIR
MEMBERS THANK YOU VERY MUCH
SENATOR OF FOR BRINGING THIS
FORWARD VERY IMPORTANT GO
FORWARD --
WE HAVE A MOTION BY
ASSEMBLYMEMBER CURRY I HAD YOUR
CURRY A SECOND BY A MISS CARILLO
MOTION IS TO PASS TO
APPROPRIATIONS MADAM SECRETARY
PLEASE KALRA.
WHAT FIVE WENT AYE MAYES?
AND YOUR GREAT.
AGUIAR-CURRY AYE.
BIGELOW.
BIGELOW AYE BONTA [inaudible]
BURKE CARILLO [inaudible]
FLORA.
FLOOR NOT VOTING [inaudible]
AMONG [inaudible]
MCCARTY [inaudible]
MCCARTY I NAZARIAN.
RODRIGUEZ SANTIAGO THURMOND
WALDRON.
BIGELOW I DUNNO.
IT'S A THREE ONE SO WILL WILL
LEFT LEAVE WHO LIVED ON COFFEE
THANK YOU MISTER CHAIRMAN
VERSONIX WHEN IS ESPY ONE ONE
FIVE TWO CORRECT.
CHAIR MEMBERS --
WE ARE ALL AWARE OF THE GROWING
HOMELESS CRISIS IN CALIFORNIA.
THIS BILL IS TRYING TO TACKLE
JUST ONE ASPECT OF THIS PROBLEM.
WHAT HAPPENS WHEN HOMELESS
INDIVIDUALS ARE DISCHARGED FROM
THE HOSPITAL?
I WANT TO BE CLEAR.
THAT HOSPITALS ARE NOT THE CAUSE
OF THE PROBLEM.
AND IN MANY CASES HAVE BEEN
DOING ALL THE BILL IS ASKING
THEM TO DO AND MORE.
BUT THERE HAVE BEEN A NUMBER OF
HIGH PROFILE CASES WHERE
PATIENTS HAVE BEEN DISCHARGED IN
AN UNSAFE MANNER.
FEEDBACK FROM HOMELESS SHELTERS
MAKES IT CLEAR THAT WE NEED
BETTER CAN COORDINATION BETWEEN
THE HOSPITALS AND THE HOMELESS
SERVICES PROVIDERS.
MY STAFF AND SPONSORS BEEN
WORKING CLOSELY WITH A HOT SPOT
COMMUNITY ADDRESS MANY OF THE
CONCERNS AS WE CAN.
WITH PRIOR AMENDMENTS EVERY MOVE
REQUIREMENTS TO KEEP PATIENTS IN
THE HOSPITAL UNTIL DAYLIGHT
HOURS OR DURING IN.
INCLEMENT WEATHER AND DELETED
CHANGES TO THE COMMUNITY BENEFIT
LAW AMONGST OTHER THINGS.
AS YOU ANALYSIS DESCRIBES I'M
OFFERING ADDITIONAL AMENDMENTS
TODAY AS WE CONTINUE WORK TO
ADDRESS THESE CONCERNS.
I MATT HAPPY TO ALSO TAKE
ADDITIONAL MEMBERS SUGGESTED IN
YOUR ANALYSIS IN COMMENT NUMBER.
SEVEN WITH THESE CHANGES I
BELIEVE WE'RE VERY MUCH CLOSER
TO POSITION WITH THE HOSPITAL
AND PHYSICIAN COMMUNITY ALTHOUGH
AS ALWAYS WE WILL CONTINUE
NEGOTIATE IN GOOD FAITH.
I WILL NOTE THAT THE HOSPITAL
COMMUNITY CONTINUES TO OBJECT TO
LANGUAGE THAT ENSURES THAT THIS
BILL DOES NOT PREEMPT LOCAL
ORDINANCE OR SETTLEMENTS.
ALL ALONG OR INTENT WITH THIS
BILL WAS TO SET A FLOOR AND NOT
INTERFERE IF LOCAL JURISDICTIONS
HAVE THEIR OWN LOCAL ORDINANCES.
CITY OF LOS ANGELES FOR EXAMPLE
HAS GROWN ANNA AND TAKE PATIENT
DUMPING BILL FOR A NUMBER OF
YEARS IN THE CITY ATTORNEY OF
LOS ANGELES.
REQUESTED A LANGUAGE THAT IS IN
THIS BILL ENSURE THAT IT DOES
NOT INTERFERE WITH OUR EFFORTS
IN LOS ANGELES.
THIS IS ONE AREA WHERE THE
HOSPITALS I WOULD GUESS WE'LL
HAVE TO AGREE TO DISAGREE BUT
MEMBERS WITH THAT I RESPECTFULLY
ASK WHEN I'M.
Q. WE HAVE TWO WITNESSES THREE
MINUTES EACH I SEE. FIVE PEOPLE
SO WHAT'S YOUR PLEASURE.
YOUR SIX YEAR OKAY OKAY SO TO
WITNESSES THREE MINUTES IT TOOK
PLACE.
A MY NAME IS STEVE WATERS ON THE
EXECUTIVE DIRECTOR OF FIRST UP
COMMUNITIES --
MY ORGANIZATIONAL RAN FOR THE
COUNTY OF SACRAMENTO THE WINNER
SANCTUARY EMERGENCY SHELTER
PROGRAM THE LAST FEW YEARS.
I'D LIKE TO SHARE SOME OF THOSE
EXPERIENCES FIRST THE PROGRAM IS
AN EMERGENCY SHELTER BUT MEANS
WE TAKE A HUNDRED PEOPLE PER
NIGHT.
I AND AND WE WE RUN NIGHTLY FROM
APRIL THROUGH NOVEMBER.
SO FOR ABOUT A HUNDRED AND
THIRTY FIVE NIGHTS STRAIGHT.
IT'S WE HAVE THREE AND TAKE
SITES PEOPLE ARE ALLOWED TO WALK
UP AND CHECK IN IN THE MID
AFTERNOON.
WE PROVIDE THEM DINNER SHELTER
FOR THE NIGHT.
AND THIS SURE WE'VE BROUGHT IN
MORE AND MORE HOW COLLABORATIVE
PARTNERSHIPS TO BRING IN MEDICAL
CARE HOUSING COUNSELING AND
OTHER SERVICES.
WE THEN TRANSPORT THEM TO A
HOSTING CHURCH FOR THE NIGHT.
YOU HAVE OVER FORTY CHURCHES IN
SACRAMENTO COUNTY THE
PARTICIPATED THIS YEAR.
THEY USUALLY SLEEP ON THE FLOOR
--
WE GIVE HIM SLEEPING BAGS.
WE ALLOW THEM TO BRING ALONG A A
BAG OF BELONGINGS [inaudible]
I HIM A FEW OF THE OUR CHURCHES
HAVE COTS BUT VERY FEW --
THE EXTRA SERVICES WE OUT WE'RE
WE WERE ABLE TO HOUSE OVER FIFTY
THIS YEAR SO IT'S EXPANDED THE
SCOPE OF THE EMERGENCY --
SHELTER.
IN TERMS OF THE UNSCHEDULED DROP
OFFS THAT WE SAW WE SAW MANY
MORE THIS YEAR THAN IN PREVIOUS
YEARS.
MUCH LARGER PROBLEM FOR SOME
REASON ALL SEASON LONG.
WE SAW SEVERAL PROF PER WEEK AND
IN SOME CASES EVERY DAY OF THE
WEEK.
REALLY RECEIVE PATIENTS FROM
HOSPITALS MENTAL HEALTH
FACILITIES AND OTHER AGENCIES
PRETTY MUCH IN THAT ORDER
HOSPITALS BEING THE ONES WE SEE
THE MOST FROM.
MY PLACE BECAME VERY SENSITIVE
TO ANY TAXI RIVER DRIVER.
PLEASE SIR OTHER OFFICIAL
VEHICLE DRIVING UP OUT FRONT
STARTING TO UNLOAD SOMEBODY
[inaudible]
ESPECIALLY TO SINCE WE VERY
SELDOM WERE CONTACTED AND
ADVANCE.
I HAVE SUPERVISORS OR REPLACE IT
SUPERVISE ALL NIGHT LONG BUT
THEY'RE NOT SKILLED HEALTH CARE
PROVIDERS --
OF THE SITUATION OF PEOPLE
COMING. TO US WITH MENTAL HEALTH
ISSUES AND OTHER PHYSICAL ISSUES
COULD BE VERY STRESSFUL NOT JUST
FROM MY STAFF.
BUT FOR THE OTHER PATIENTS OR
OTHER CLIENTS WHO WERE TAKING
CARE OF ALSO.
SEE I'M SHORT ON TIME WHEN YOU
SKIP DOWN.
WE ESTABLISHED A RELATIONSHIP
WITH SEVERAL HOSPITALS.
ESPECIALLY AFTER THIS --
TOPIC KEPT THAT THE MEDIA WORK
PRIMARILY WITH SUTTER AND KAISER
ON THIS UNDERTAKING LEAD.
WE ESTABLISHED A LINE OF
COMMUNICATION THAT SEEM TO MAKE
ALL THE DIFFERENCE IN THE WORLD
IN COORDINATING AND CONTROLLING
THE OUTCOME.
I'D IMPROVES THE CHANCES FOR THE
CLIENT TO SUCCEED IF THEY
UNDERSTAND WHAT OUR SYSTEM HAS
THE CAPABILITY OF PROVIDING IN
THE WAY OF CARE.
THEY ALSO WORK ARE CLOSELY WITH
KAISER IN SOME CASES BRINGING IN
CLIENTS THAT NEED OF SPECIAL
EQUIPMENT FOR OXYGEN.
FIRST A COMMUNITY SUPPORTS SP
ELEVEN FIFTY TWO WE BELIEVE THAT
HOSPITAL RELEASES SHOULD DROP
PATIENTS AT SHELTERS ONLY WITH
APPROPRIATE NOTICE IN
COORDINATION.
WE THINK THE PROTOCOL SHOULD BE
IN PLACE IN ADVANCE OF THE
PATIENTS ARRIVING.
IN CASES WHERE THE PATIENT HAS
NO PLACE TO SLEEP AND
SIGNIFICANT MENTAL OR CHRONIC
HEALTH ISSUES.
THEY MUST BE DIRECTED TO
APPROPRIATE CARE RATHER THAN AN
EMERGENCY SHELTER.
AGAIN NOW WE ARE IN SUPPORT OF
THIS AND WE THINK THAT WITH THE
RIGHT PROCESS SEASON PROTOCOLS
HE COULD BE MADE VERY
SUCCESSFUL.
MISTER CHAIRMAN MEMBERS MARK
WINDOWS WITH S. YEAH YOU
CALIFORNIA S. B. ELEVEN FIFTY
TWO TAKES A FAIR AND APPROPRIATE
APPROACH TO ENSURE HOMELESS
PATIENTS ARE DISCHARGED WITH
DIGNITY.
PROPER CARE AND DISCHARGE
PLANNING.
AS MENTIONED IN THE SENATE
COMMITTEE ON HEALTH OF SAN
FRANCISCO RESIDENT DOCTOR
TESTIFIED HOW HIS HOSPITAL
RECOMMENDED DISCHARGING A
HOMELESS PATIENT IN THE RAIN
WITH PLASTIC BAGS DESPITE THE
PATIENT HAVING SEVERE SKIN
INFECTIONS.
ALSO AFTER SERVING OUR OUR INS
IN HOSPITALS MEMBERS REPORTED
THAT MOST HOSPITALS DO NOT HAVE
A UNIFORM STANDARD IN PLACE.
EVEN WITHIN THE SAME HOSPITAL
SYSTEM. TO ENSURE HOMELESS
PATIENTS ARE DISCHARGED SAFELY
WITH RESPECT AND DIGNITY THE
BILL SIMPLY CREATES A MINIMUM
HUMANE STANDARD FOR HOSPITALS
DISCHARGING HOMELESS PATIENTS
AND AIMS TO FILL A GAP.
IN CURRENT LAW THAT DOES NOT
EXPLICITLY OUTLINED STANDARDS
WHEN TREATING THIS VULNERABLE
POPULATION.
THESE TYPES OF STANDARDS
PROPOSED ARE ALSO NOT
UNPRECEDENTED AS WE HAVE SEEN
SIMILAR POLICIES CREATED WITHIN
THE VA HOSPITAL SYSTEM.
AND THE WHOLE PERSON CARE
PILOTS.
IT IS IMPORTANT TO NOTE THAT
WHILE SOME HOSPITALS CURRENTLY
GO ABOVE THE PROPOSED STANDARDS
IN THIS BILL WHEN DISCHARGING
PATIENTS MANY IF NOT MOST DO
NOT.
THE BILL ALSO ENSURE AGAIN
ESTATE RIGHT STANDARD FOR ALL
HOSPITALS TO FOLLOW.
LASTLY SEIU REPRESENTS OVER TEN
THOUSAND SOCIAL WORKERS ALONG
WITH NUMEROUS ARE AND WHO ARE.
DOING THE DISCHARGE PLANNING FOR
THESE PATIENTS.
THIS MEASURE WOULD FURTHER
EMPOWER THEM TO DO WHAT THEY
NEED TO DO WHEN DISCHARGING
PATIENTS FROM THE HOSPITAL.
BOTH SEIU AND SEE PAN HAVE MADE
A GOOD FAITH EFFORT TO WORK WITH
OPPOSITION TO ADDRESS THEIR
CONCERNS.
NOTABLY WE TOOK THREE LARGELY
SUBSTANTIVE AMENDMENTS TO EASE
THE HOSPITAL'S ISSUES ON THE
SENATE FLOOR.
WE HOPE TO CONTINUE TO HAVE
PRODUCTIVE CONVERSATIONS WITH
THE HOSPITAL ASSOCIATION AND
CALLIE SAP.
AND ENSURE THAT THIS MOST
VULNERABLE POPULATION RECEIVES
THE HIGHEST QUALITY OF CARE AT
ALL TIMES THINK YOU.
KAREN SAVAGE CALIFORNIA PAN I
THINK HELP.
WHERE PROUD SPONSOR DISCOVERED
[inaudible]
THANK YOU LISTEN SUPPORT JUST
YOUR NAME AND ORGANIZATION
PLEASE.
RAIN X. CALIFORNIA DISABILITY
RIGHTS CALIFORNIA LINES RETIRED
AMERICANS IN STRONG SUPPORT.
MARY VALDEZ HEALTHAXIS
CALIFORNIANS SUPPORT.
GEN FLORI WESTERN CENTER ON LAW
AND POVERTY AND SUPPORT THANK
YOU.
J. CLIN WITH DECEMBER INSTITUTE
IN SUPPORT.
AND YOU READING OF ASIAN
AMERICANS ADVANCING JUSTICE
CALIFORNIA CHUNKS POINT.
HERE.
CHRISTINE BAUM BEHALF THE
CALIFORNIA PROFESSIONAL
FIREFIGHTERS IN SUPPORT.
CHRISTOPHER GO IN ON BEHALF OF
THE CALIFORNIA IMMIGRANT POLICY
CENTER IN SUPPORT.
GEBRACHT DISABILITY RIGHTS
CALIFORNIA SPORT.
STEVE SMITH CALIFORNIA
PARTNERSHIP TO A DOMESTIC
VIOLENCE IN SUPPORT.
MIKE MONTGOMERY CONGRESS OF
CALIFORNIA SENIORS IN SUPPORT.
TOM REILLY AMERICAN COLLEGE OF
PHYSICIANS CALIFORNIA IN
SUPPORT.
PAUL THE OTHER CITY SANTA MONICA
LA CITY ATTORNEY MIKE FUERAN
SPORT.
WE WERE HOUSE.
ANYONE IN OPPOSITION.
GOOD AFTERNOON CHAIRMAN MEMBERS.
MY NAME IS PEGGY BROUSSARD
WHEELER.
AND I SERVICE THE VICE PRESIDENT
FOR RURAL HEALTH CARE AND
GOVERNANCE AT THE CALIFORNIA
HOSPITAL ASSOCIATION.
AT C. H. A. I HAVE WORKED ON THE
ISSUES RELATED TO HOMELESS
PATIENT DISCHARGE FOR MANY
YEARS.
CH A REMAINS SOME LAST AMENDED
WE HAVE WORKED DILIGENTLY AS
YOU'VE HEARD WITH THE AUTHOR
STAFF IN THE BILL'S SPONSORS TO
NEGOTIATE REASONABLE
REQUIREMENTS IN THE BILL.
AND WE THANK THEM FOR THEIR
WILLINGNESS AND COMMITMENT IN
THAT PROCESS.
HAS THE AUTHOR HAS ACKNOWLEDGED
HOSPITAL'S DID NOT CREATE THE
HOMELESS CRISIS AND WITHOUT
ADEQUATE AND APPROPRIATE
COMMUNITY RESOURCE AS HOSPITAL'S
CANNOT SOLVE THE PROBLEM ALONE.
WE REMAIN OPPOSED PRIMARILY DUE
TO THE PREEMPTION LANGUAGE IN
THE BILL WE BELIEVE IT SETS A
CONDITION THAT HAS THE POTENTIAL
TO FRACTURE THE WORK WE HAVE
CAREFULLY NEGOTIATED.
ALLOWING LOCAL JURISDICTIONS TO
IMPOSE MORE BURDENSOME
REQUIREMENTS ON HOSPITALS THAN
IT'S REQUIRED UNDER STATE LAW.
WILL CREATE A PATCHWORK
REGULATORY SYSTEM.
ADDITIONALLY THE BILL IGNORES
THE RESPONSIBILITY OF OTHER
ORGANIZATIONS IN OUR COMMUNITIES
TO STEP UP AND PARTNER WITH
COMMUNITY HOSPITALS. TO
PROVIDE-THOSE SERVICES NEEDED BY
THIS
VULNERABLE POPULATION.
THE HOMELESS CRISIS IS A STATE
WIDE PROBLEM TO EFFECT REAL
CHANGE WE DO WHAT WE NEED A
COMMITMENT BY MANY INCLUDING THE
HOSPITAL'S I'D LIKE TO INTRODUCE
AMANDA WILKINSON.
HERE FROM AND LOW HOSPITAL IN
CHICO [inaudible]
NO.
HELLO GOOD AFTERNOON MISTER
CHAIRMAN MEMBERS --
THANK YOU FOR THE OPPORTUNITY.
TO PRESENT TO YOU TODAY AND
SENATE BILL.
ELEVEN FIFTY TWO MY NAME IS
AMANDA WILKINSON I AM A CASE
MANAGER AT AND LOW MEDICAL
CENTER.
I'VE SERVED IN THIS CAPACITY FOR
TWELVE YEARS AND I AM --
LCSW LICENSE GONNA CALL SOCIAL
WORKER BY TRAINING.
WE DO SUPPORT THE REQUIREMENT IN
SB ELEVEN FIFTY TWO TO HAVE A
WRITTEN PATIENT DISCHARGE
POLICY.
UP FOR HOMELESS PATIENTS AS A
HOSPITAL CASE MANAGER I AM
RESPONSIBLE FOR PUTTING TOGETHER
THE CARE PLAN OUR PATIENTS NEED
WHEN THEY LEAVE OUR HOSPITAL.
A WE WANNA DO EVERYTHING WE CAN
TO MAKE SURE THAT THE STEPS OUR
PATIENTS TAKE HELP THEM
TRANSITION TO HOME OR THE NEXT
LEVEL OF CARE AND BEGIN THE
HEALING PROCESS AFTER
HOSPITALIZATION.
WE ARE ACUTELY AWARE THAT NOT
EVERY PATIENT HAS A HOME TO
RETURN TO A IN LOW HAS NEARLY
FIVE THOUSAND HOMELESS PATIENT
ENCOUNTERS EVERY YEAR --
AT TEN HOMELESS PATIENTS IN THE
ER ON A DAILY BASIS AND IN ONE
PATIENT CASE --
OVER FORD --
FIFTY FIFTY VISITS TO THE IRAQI
ARE IN A THREE WEEK PERIOD.
SUPPORTING A PATIENT IN ENSURING
THE STAY HEALTHY ISN'T JUST
ABOUT HELPING THEM FOLLOW
MEDICAL ADVICE THAT WE
PRESCRIBE.
THERE'S SO MUCH MORE THAT'S
NEEDED ON THE ROAD TO RECOVERY
--
THE CHALLENGE THAT WE FACE IS
IDENTIFYING AND COORDINATING THE
APPROPRIATE RESOURCES FOR THESE
PEOPLE IN THE COMMUNITY --
IF WE CAN BETTER ADDRESS THESE
CHALLENGES WE HAVE MORE OF AN
OPPORTUNITY. TO MAKE A
DIFFERENCE IN PATIENTS LIVES WHO
ARE EXPERIENCING HOMELESSNESS.
THIS COULD BE A PIVOTAL MOMENT
FOR THAT PATIENT TO MAKE A
CHANGE AND GET THE RESOURCES
THAT THEY NEED --
AND WE APPROACH EVERY DAY
WITHOUT PERSPECTIVE BELIEVING IN
THE IDEAL --
THAT WE CAN SUPPORT PATIENTS --
AND WE THANK YOU THE THANK YOU
FOR THE OPPORTUNITY FOR ME TO
TELL THIS --
STORY.
I AM GONNA DVM ALLOWED MR MAD TO
PRESENT.
WITHIN OUR SIX MINUTES SO PLEASE
MISTER CHAIR MEMBERS TO MADDEN
FOR OUR REPS AND CALTRAIN
CHAPTER IN AMERICAN BECAUSE
MERCY PETITIONS I APPRECIATE
YOUR INDULGENCE ALL KEEP MY
COMMENTS BRIEF.
I'M WE HAVE --
AND OPPOSE LISTS AMENDED
POSITION FIRST I'D LIKE TO THANK
THE AUTHOR HIS STAFF AND
SPONSORS FOR WORKING WITH
THOUGHTS WITH US ON SOME OF OUR
CONCERNS.
ON A NUMBER OF THEM ARE DRESSED
IN THE AMENDMENT IS THAT IF THE
SERVICES ARE GOING TO BE OFFERED
TO A PATIENT --
WE WOULD REQUEST THAT THEY BE
DONE IN A NON PATIENT CARE AREA
ONE OF OUR BIGGEST CHALLENGES IN
WORKING THE MERCY DEPARTMENT IS
THAT WHENEVER AT THE POINT.
OF HAVING FINISHED UP PROVIDING
MEDICAL TREATMENT TO A PATIENT
WERE READY TO DISCHARGE I
PATIENTS ON GET NEXT TO THE NEXT
PATIENT WHO'S WAITING TO GET
INTO THE MARIN CITY DEPARTMENTS.
I'M A WE LOOK AT THE LIST OF
SERVICES WHETHER IT BE PROVIDING
FOOD PROVIDING CLOTHING --
PROVIDING TRANSPORTATION ARE
COORDINATING FOLLOW UP CARE
WE'VE YOU THESE ARE SERVICES
THAT COULD BE PROVIDED OUTSIDE
THE MERCY DEPARTMENT OR OUTSIDE
OF AN IMPATIENT AREA AND WE
REQUESTED AMENDMENT THAT BE DONE
IN THAT FASHION THAT WAY WE CAN
--
GET PATIENT TO A DIFFERENT AREA
AND MOVE ON TO OTHER PATIENTS
WHO ARE WAITING TO GET INTO THE
MERCY DEPARTMENTS --
WE APPRECIATE CONVERSATIONS TO
DATE AND LOOK FORWARD TO
CONTINUING THE THANK YOU OTHERS
IN OPPOSITION.
CAPTION HOUSE IS COVERED IN A
DISTRICT HOSPITAL LEISURE
FOREMAN UNITED HOSPITAL
ASSOCIATION.
I'LL LIKE IN OUR COMMENTS WITH
THE THOUGHT OF CJ AND REMAIN
OPPOSED.
SHAWN FLANAGAN RESENT HOSPITAL
CORPORATION OF AMERICA OPPOSE.
MISTER CHAIRMAN MISTER THOMAS
ABOUT THE CALIFORNIA MEDICAL
ASSOCIATION LIKE THAT THINK THE
AUTHOR AND SPONSOR UP FOR
WORKING WITH US WE DO AGREE WITH
THE SPIRIT OF THIS BILL BUT LIKE
TO ASSOCIATE OUR COMMENTS WITH
WITH THE MATTER OF THE EMERGENCY
PHYSICIANS SICK IN THE SAME
MOMENT THANK YOU.
MISTER CHAIRMAN MEMBERS THE OUR
PASTOR WAS INTENDED ALTHOUGH.
SOME PROGRESS WAS MADE ON
AMENDMENTS WOULD LIKE TO THANK.
COMMITTEE STAFF AS WELL AS A
SPONSOR STATUS BUSINESS AS WELL
AS A MISS HERNANDEZ TO STAFF WE
STILL HAVE PROBLEMS.
THE PREEMPTION LANGUAGE A COUPLE
OF THE PROVISIONS OF THE BILL
THANK YOU.
YOU VERY MUCH --
ANYONE ELSE.
BRING BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS.
SHOWS ARE COMING FROM COMMITTEE
[inaudible]
MCCARTY.
YEAH I'D I AM VERY FAMILIAR WITH
THIS ISSUE THAT TRY TO DO
ORDINANCE HAS THAT COUNCIL
MEMBER TEN YEARS AGO.
AFTER A FEW HIGH PROFILE
INCIDENTS AND I I ADMIT IT'S NOT
THE HOSPITAL'S FAULT PER SE BUT
THINGS HAPPEN PEOPLE DROP PEOPLE
OFF MILLION NIGHT BUT THEY'RE
THERE.
TAXI DRIVERS OR SOCIAL SERVICE
ENTITIES BUT NOT HAVING SOLID
PLANS IS NOT GOOD FOR ANYBODY.
AND SO I I APPLIED YOU FOR FOR
WORKING ON THIS ON THIS ISSUE.
I I DIDN'T KNOW THEN THE
OPPOSITION I HEARD CHI TWO
ARGUMENTS ONE DOES FROM THAT.
IN THE MEDICAL COMMUNITY THAT
PERFECT PROVIDERS FARCE CAPACITY
AND WORKLOAD ONE AS FAR AS THAT.
THE PREEMPTION ISSUE SO I WANTED
TO ASK YOU IF YOU TRIP RESPONDED
THOSE TUITION SURE I'D BE MORE
THAN HAPPY FIRST LET ME JUST.
TELL YOU THAT I AGREE AND WHEN
YOU SAID TEN YEARS AGO WHEN YOU
DID IT WHEN YOU WERE A CITY
COUNCIL MEMBER.
I BELIEVE IS ROUGHLY AROUND TEN
YEARS ARE ELEVEN YEARS AGO WHEN
I WAS ELECTED TO THE STATE
ASSEMBLY ACTUALLY SAT IN THIS
COMMITTEE AND SENATOR STUDIO AT
THE TIME HAD ONE VERY SIMILAR TO
WHAT I THINK.
LA HAS RIGHT NOW TO THIS PROBLEM
HAS BEEN AROUND FOR AWHILE.
WITH REGARD TO THE PREEMPTION AS
I MENTION [inaudible]
FLOOR.
AND NOT THE CEILING.
AND LET'S SAY THAT WE AGREE TO
DISAGREE ON THIS BILL THAT
EITHER DOESN'T GET SIGNED OR IF
IT.
IT DOESN'T AFFORD AFTER THIS
COMMITTEE. THIRTY SET AT A
HIGHER LEVEL IN THE CITY OF LOS
ANGELES SO IT IS ALREADY THERE I
DON'T WANNA --
CHANGE WHAT IS ALREADY KIND OF
IN STATUTE.
WITH REGARD TO THE NOT PATIENT
CARE AREA I MEAN WE'RE MORE THAN
WILLING TO TALK TO YOU KNOW THE
E. OURS OF THE HOSPITALS BUT
PROMISED NOT EVERY HOSPITAL HAS.
NINE PATIENT CARE AREAS SO.
YES BY ALL MEANS ARE WILLING TO
CONTINUE THE CONVERSATION SO
THAT'S WHY WE HAVE BEEN ABLE TO
PUT THAT INTO THE BILL AT THIS
TIME [inaudible]
THANK YOU.
ANYONE ELSE YOUR MOTION.
THERE IS NO MOHAMMED ABOUT.
MOTION ON OF MY MR MCCARTY A
SECOND BY MATTEL YEAR CURRY --
I JUST A QUESTION OF THE
HOSPITAL ASSOCIATION --
DO YOU.
I'M FOR GOING TO PLUG THE AUTHOR
FOR BRINGING THIS FORWARD IS
OBVIOUSLY.
HEARING FROM MR MCCARTY NOW HE'S
WHERE HE DID TEN YEARS AGO THIS
THIS PROBLEMS GET ANY BETTER
ACTUALLY I WOULD ARGUE IS
ACTUALLY GETTING WORSE.
AND SO YOU FEW SAID WE NEED
RESOURCES WHATEVER.
BUT I DON'T HEAR SOLUTIONS ARE
ALTERNATIVES DO YOU HAVE AN
ALTERNATIVE FOR A SOLUTION THAT
YOU COULD OFFER HERE BECAUSE I'M
NOT ON THE HEARING THAT I'M JUST
HEARING.
WE CAN'T DO IT.
WELL WE THINK THAT WE HAVE
WORKED DILIGENTLY WITH THE
AUTHORS OFFICE AND THE BILL'S
SPONSORS TO TRY TO COME UP WITH
--
THE FAULT THE INTENT OF THE BILL
WHICH IS TO CREATE A HOMELESS
PATIENT DISCHARGE POLICY OUR
HOSPITALS WORK UNDER DISCHARGED
POLICIES AND WE HAVE AGREED.
THAT THIS IS A UNIQUE ENOUGH
PROBLEM THAT ISN'T GOING AWAY
THAT SEEMS TO BE GROWING THAT WE
NEED TO CREATE THAT HOMELESS.
PATIENT DISCHARGE POLICY I THINK
AMANDA CAN CAN SPEAK TO JUST HOW
GRAVE THE ISSUE HAS BECOME AND
SOME OF OUR HOSPITALS --
WHAT WHAT WE ARE SAYING IS THAT
IN ORDER FOR HOSPITALS TO
CONTINUE TO DO THE WORK THAT
THEY'RE DOING AND AMANDA DOES
THIS WORK EVERYDAY IN HER
HOSPITAL?
WE NEED MORE RESOURCES FUNDED
AND APPROPRIATE IN THE COMMUNITY
TO HELP US WHEN WE'RE READY TO
DISCHARGE THAT PERSON WHO NEEDS
RESPITE CARE OR TEMPORARY
SHELTER OR EVEN A PATHWAY TO
AFFORDABLE HOUSING.
THAT SOMETHING HOSPITALS ARE
WILLING AND ARE CURRENTLY TRYING
TO DO BUT WE NEED ADDITIONAL
RESOURCES IN THE COMMUNITY AND
WE THINK THAT THE BILL --
WOULD WOULD SHOULD CALL OUT THAT
MEET.
I ONE OF THE CHALLENGES THAT WE
SEE AS THE BEST JOB THAT WE
COULD POSSIBLY DO EVERYDAY IS TO
SET UP A GREAT RESOURCE LIST AND
GET SOME CONNECTIONS AND PROVIDE
A WARM HAND OFF TO AGENCIES.
WHERE WE THINK WE'RE
FACILITATING THE BEST CASE
SCENARIO PLAN FOR THE PATIENT
PROVIDING MADS PROVIDING
EQUIPMENT --
THE TRANSPORTATION.
THE CHALLENGES WHEN YOU HAVE A
PATIENT WHO MAY HAVE A HISTORY
OF TRAUMA OR
INSTITUTIONALIZATION.
AND WE RUN INTO --
PATIENTS THAT LEAVE BEFORE WE
CAN COMPLETE THE PLAN --
AND THOSE ARE THOSE ARE GREAT
CHALLENGE. TWO NAVY WHERE IF WE
HAD SOMEONE ON THE RECEIVING END
IN THE COMMUNITY WHERE WE CAN
PARTNER.
IN CENTRAL ISAM SUPPORT OUT IN
THE COMMUNITY WITH EITHER
SHELTER AGENCIES OR COUNTY
AGENCIES.
THERE THERE ARE --
MOMENTS THAT SOMETIMES WE JUST
SIMPLY CAN'T CAPTURE IN THE
HOSPITAL.
AND SO THAT IS THAT IS ONE OF
THE AREAS WHERE I COULD SEE A
SOLUTION HAPPENING IS HOSPITALS
COLLABORATING.
IN THE COMMUNITY.
AFTER THE DISCHARGED OR EVEN
ONCE A PATIENT YOU KNOW IF THEY
LEAVE IN THE MIDDLE OF A
DISCHARGE PLAN --
SO WE COULD FOSTER SOME SUCCESS.
I THINK THAT'S WHAT WE SEE AS A
BARRIER MOST OFTEN.
IT WASN'T THERE PROGRAM AT SOME
POINT WHERE HOSPITAL'S REXY
DOING CHARITY CARE AND
COMMUNITIES.
WELL I THINK THERE'S A LOT OF
VARIATIONS ON THAT THROUGHOUT
THE STATE AND AT CURRENT
CURRENTLY IN CHICO WE DON'T HAVE
ANY A PROGRAM LIKE THAT AND SO
BUT I THINK THERE ARE DIFFERENT.
HOSPITALS ARE DOING DIFFERENT
PROGRAMS THAT ARE MEETING
DIFFERENT NEEDS FOR HOUSING AND
STUFF LIKE THAT --
ANY OTHER QUESTIONS OR COMMENTS.
CNN WHICH I TO CLOSE TALK YES
I'M SURE I WOULD LIKE TO ARM YOU
KNOW.
SINCE I GOT ELECTED IN TWO
THOUSAND SIX UP UNTIL NOW.
WHEN I INTERACT WITH IT WAS IN
THE ASSEMBLY OR MY SENATE
DISTRICT?
THERE IS A INCREASE OF
HOMELESSNESS WITHIN OUR
COMMUNITIES WE SEE IT.
AND IT SPILLING OVER INTO OUR
HEALTHCARE SYSTEM HOSPITAL'S
EMERGENCY ROOMS ETCETERA.
LET ME JUST REITERATE LIKE A
SEMI OPEN STATEMENTS.
THE HOSPITALS ARE DOING AN
INCREDIBLE JOB AND THEY'RE DOING
EVERYTHING THEY CAN BUT THERE
ARE STILL INSTANCES WHERE YOU
HAVE SOMEBODY IT'S LEFT IN THE
STREET WITH THEIR HOSPITAL GOWN
AN IV IN THERE.
THIS IS NOT HUMANE THIS IS WEIRD
THIS IS NOT WHAT THIS COUNTRY'S
ABOUT WHAT CALIFORNIA'S ABOUT.
AND I KNOW WHEN I STARTED TO SIT
THERE WOULD BE SOME CONCERNS BUT
WE'VE SCALED US BACK WAY WAY
BACK TO WORK WITH THE OPPOSITION
I MEAN LET ME ALSO STATE OF WITH
REGARD TO WHAT.
THE THE COMMENT THAT THE DEMAND
THE OPPOSITION.
THAT YES THE AGREE WITH THE
DISCHARGE POLICY WHICH IS IN
THIS BILL WHICH WE ARE GOING TO
HAVE.
YES WE DO NEED MORE RESOURCE
AREN'T ENOUGH RESOURCES HERE'S
WHAT I DID DO IN THIS BILL.
OTHER ME REPHRASE THAT WHAT I
DIDN'T DO IN THIS BILL THAT WAS
IN THE STUDIO BILL WHEN I WAS IN
IN THE ASSEMBLY.
SEE IT'S A DEAL BILL HAD
EXTENSIVE PENALTIES.
IF THE HOSPITAL'S DIDN'T ABIDE.
AND I DON'T MEAN LIKE I RECALL I
DON'T THINK I VOTED FOR THE BILL
JUST BECAUSE I DON'T WANT TO PUT
A A PENALTY IN THE HOSPITAL SO
THIS.
BILL HAS NO PENALTIES WHATSOEVER
IT'S A BILL DESIGNED TO BE ABLE
TO WORK.
THE HOSPITAL'S.
WITH THE COMMUNITIES AND THE
AVAILABLE RESOURCES WE HAVE OUT
THERE AND I I REALLY BELIEVE WE
NEED TO DO SOMETHING TO THE
ABSOLUTE MORAL PATIENTS AND WITH
THAT MEMBERS ARE RESPECT LASSEN
I'VE.
THANK YOU VERY MUCH DOCTOR NAN
AS FOR BRINGING THIS FORWARD --
THE BILL HAS A DO PASS
RECOMMENDATION WE HAVE A MOTION
BY MISTER AGUILAR CURRY A SECOND
FIVE MR MCCARTY.
BLAST MEN SECRETARY CALL THE
ROLL THE WORLD THE MOTION IS TO
PASS AS AMENDED TO PREPARATIONS.
WHAT I WOULD AYE MAYES?
MAYES NO ANCHOR CURRY.
I CARE CURRY AYE BIGELOW.
BIGELOW NO.
BONTA [inaudible]
BURKE [inaudible]
CARILLO [inaudible]
FLORA [inaudible]
LIMON [inaudible]
MCCARTY.
MCCARTY I'M THIS AREA.
NAZARIAN AYE RODRIGUEZ.
RODRIGUEZ I SANTIAGO.
THURMOND WALTER.
THAT'S FIVE VOTES WILL HAVE
OTHER MEMBERS TO I DON'T BELIEVE
THAT ON CALL THANK YOU MISTER
CHAIRMAN DOES NOT EXPEL AS I SP
TWELVE FIFTY FIVE THAT'S OKAY
WITH YOU.
PRETTY.
AS YOU KNOW CALIFORNIA'S BEEN
VERY SUCCESSFUL AT IMPLEMENTING
THE AFFORDABLE CARE ACT WE HAVE
BROUGHT ARE UNINSURED RATE DOWN
TO SIX POINT 8%.
WITH UNCERTAINTIES CREATED IN
THIS CURRENT FEDERAL
ADMINISTRATION PREMIUMS ARE TO
SPEED IT GO UP BETWEEN TWELVE
AND 32%.
I HAVE AUTHOR OTHER BILLS
INTENDED TO KEEP CALIFORNIA'S
HEALTH INSURANCE MARKETS STABLE.
BUT I KNOW YOU AGREE THAT WE CAN
DO MORE TO MAKE INSURANCE MORE
AFFORDABLE IN CALIFORNIA BY
CREATING SUBSIDIES FOR THOSE WHO
CAN'T CURRENTLY.
OR ELIGIBLE FOR FEDERAL
ASSISTANCE AND HELP LOWER THE
INCOME.
OF PEOPLE WHO ARE ELIGIBLE FOR
FEDERAL SUBSIDIES FOR PROVIDING
MORE HELP THROUGH STATE
SUBSIDIES.
THERE ARE FIVE HUNDRED FIFTY
THOUSAND WHO DON'T QUALIFY FOR
THE FEDERAL COURT ARE --
ECA SUBSIDIES ARE ANOTHER --
CALIFORNIA'S WHO DO QUALIFY BUT
REMAIN UNSURE BECAUSE PREMIUMS
ARE STILL HIGH AND WITH THAT
MEMBERS I RESPECTFULLY ASK WHEN
I'M ON VERY MUCH [inaudible]
WITNESSES.
BEST PAL ON BEHALF OF HEALTH
ACCESS CALIFORNIA PLEASED TO BE
HERE IN SUPPORT OF THE MEMBERS
OF THIS COMMITTEE KNOW.
BILLIONS OF CALIFORNIANS HAVE
BENEFITTED FROM THE AFFORDABLE
CARE ACT BUT WE HAVE MORE TO DO
TO MAKE COVERAGE AFFORDABLE.
SP TWELVE FIFTY FIVE IS
COMPLIMENTS THE PACKAGE OF
ASSEMBLY BILLS THAT THIS
COMMITTEE VOTED FOR EARLIER THIS
YEAR.
WHETHER TO MARRIED COUPLE IN
THEIR EARLY SIXTIES IN YOUR
DISTRICT MISTER CHAREST PAYING
NINETEEN THOUSAND DOLLARS FOR
COVERAGE WITH THE SIX THOUSAND
DOLLAR DEDUCTIBLE.
AND HOW THEY AFFORD THAT ON
SIXTY FIVE OR SEVENTY THOUSAND
DOLLARS I HAVE NO IDEA.
OR SOMEBODY TRYING TO LIVE ON
EIGHTEEN OR TWENTY THOUSAND
DOLLARS BEING ASKED TO SPEND
THREE OR 4% OF THEIR INCOME FOR
PREMIUMS.
COVERAGE IS NOT AS AFFORDABLE
THE BILL WOULD MOVE US IN THAT
DIRECTION THANK YOU.
GOOD AFTERNOON CHEN FOR AN
BEHALF OF WESTERN CENTER ON LAW
AND POVERTY --
I DON'T SHE JUST LIKE TO POINT
TO ONE OF THE WITNESSES IN A
PREVIOUS BILL THAT YOU JUST
HEARD ON THE MEXICAN PREPAID
HEALTH PLANS.
THAT WHEN THIS WAS EXACTLY IS
EXACTLY THE PERSON THAT WE'RE
TALKING ABOUT HE SAID HIS FAMILY
WOULD HAVE TO PAY FOUR HUNDRED
DOLLARS A MONTH TO GET. TO GET
COVERED THROUGH THE EXISTING
COVERAGE AVAILABLE TO HIM AND
THAT'S JUST NOT AFFORDABLE TO
SOME PEOPLE AND MOST OF THE
STATE NOT ON THE BORDERS DOES
NOT HAVE THE OPTION TO GO TO
MEXICO TO GET THEIR HEALTH CARE.
WE SHOULD BE ABLE TO OFFER
AFFORDABLE HEALTH CARE HERE IN
CALIFORNIA AND THIS BILL WOULD
ADD ADDITIONAL PREMIUM HELP.
IT TO IN ORDER TO ENABLE US TO
DO THAT AS WELL AS ADDITIONAL
OUT OF POCKET EXPENSES.
OTHER WITNESSES --
NAME ORGANIZATIONALLY PLEASE.
TIM VALDERRAMA WITH THE WHITEMAN
GROUP ON BEHALF OF NEXT GEN
AMERICAN SUPPORT THANK YOU.
MAXINE MENTALITY HALF THE
NATIONAL MULTIPLE SCLEROSIS
SOCIETY IN SUPPORT MCCUE.
SARAH FLOCKS CALIFORNIA LABOR
FEDERATION IN SUPPORT.
MARK ROBERTS SMALL BUSINESS
MAJORITY IN SUPPORT THANK YOU.
RAN HICKS CALIFORNIA LINES
RETIRED AMERICANS CALIFORNIA
DISABILITY RIGHTS IN STRONG
SUPPORT.
KIMBERLY SHALL HAVE CALIFORNIA
BENEFIT BECAUSE THAT WORK IN
SPORT.
THERESA STARK HAS A PERMANENT IN
SUPPORT BECAME.
VIDEO BORN AMERICAN KENNARD
PEDIATRICS IN SUPPORT.
FIRST AMICORE BOTTOMING UP
ALAMEDA COUNTY BOARD OF
SUPERVISORS ALSO IN SUPPORT.
MIKE MONTGOMERY CONGRESS OF
CALIFORNIA SENIORS SUPPORT THE
BILL.
CHRISTOPHER GO AND ON BEHALF OF
THE CALIFORNIA IMMIGRANT POLICY
CENTER IN SUPPORT [inaudible]
ANYONE ELSE.
WE WENT IN OPPOSITE.
NO ONE BRING BACK TO MAYBE FOR
QUESTIONS.
BUT THANK YOU AGAIN FOR BRING
THIS FORWARD AT WE COMPLIMENTS
THE WORK WE'VE BEEN DOING HERE
IN -- WHICH
LIKE CLOSE DR ASPIRIN ITEMS
CHAIR MAKES MUCH OF A MOTION
MOTION IS TO PASS TO
APPROPRIATIONS MOTION BY MISS
AGUIAR-CURRY SECOND BY MISTER
HIS HEARING ABOUT OF SECRETARY
PLEASE CALL THE ROLL.
WOULD I WOULD I MAYES.
MAYES NO ANCHOR CURRY.
I CARE CURRY AYE BIGELOW.
BIGELOW NO BONTA [inaudible]
BURKE [inaudible]
CARILLO [inaudible]
FLORA [inaudible]
LIMON.
MCCARTY.
MCCARTY I'M THIS AREA.
NAZARIAN AYE RODRIGUEZ CRITICIZE
SANTIAGO BERMAN.
WALDRON.
I HAVE FIVE WILL LEAVE THAT ON
CALL THANK YOU VERY MUCH SIR.
EDU NO MAN WILL DO TWELVE EIGHTY
SEVEN RESEARCHER THANK YOU SIR
THANK YOU --
THIS MEASURE PUTS IN THE STATE
LAW EITHER CORRECT MEDICAL
NECESSITY STANDARD FOR CHILDREN
A ROMANTIC CAO.
CHILDREN MEDICARE RECEIVE
BENEFITS TO WHAT IS CALLED THE
EARLY CHILD AND PERIODIC
SCREENING DIAGNOSIS AND
TREATMENT SERVICES.
BENEFIT OR E. P. S. A LOT IF.
FOR MEDICALLY NECESSARY
NECESSITY IS NOT CONSISTENT WITH
FEDERAL MEDICAID LAW.
THE EPS TV MEDICAL NECESSITY
SANDERS COVERAGE WHICH IS
REQUIRED.
CORRECT AND AMELIORATE ILLNESS
AND MEDICAL CONDITIONS THAT
WOULD CODIFY IN STATE LAW THE
CREEK MEDICAL NECESSITY STANDARD
FOR CHILDREN'S HEALTH COVERAGE
AND WITH THAT I RESPECTFULLY ASK
WHENEVER.
GOOD AFTERNOON SHARE MEMBERS
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY PROUD CO
SPONSORS OF THIS IMPORTANT
MEASURE ALONG WITH THE NATIONAL
HEALTH LAW PROGRAM.
THE STATE DINNER PROBABLY
APPLIES AND NARROW MEDICAL
NECESSITY STANDARD WHEN
DETERMINING STE OUT ELIGIBILITY
FOR SERVICES SAVE FOR CHILDREN
ON MEDI CAL UNLESS I HEALTH
PROVIDER KNOWS. TO SPECIFICALLY
REQUEST THE MEDICAL NECESSITY
STANDARD FOR CHILDREN KNOWN AS
EARLY PERIODIC SCREENING
DIAGNOSIS AND TREATMENT EP STT.
SOME HEALTH PROVIDERS ARE AWARE
THAT THERE ARE DIFFERENT MEDICAL
NECESSITY STANDARDS FOR ADULTS
AND CHILDREN. FOR HEALTH
PROVIDERS WHO ARE WHO ARE
INFORMED MANY DO NOT KNOW THAT
THEY MUST EXPLICITLY REQUEST
THIS BROADER EPS DE T. STANDARD.
THROUGH THIS RESULTS IN MANY
CHILDREN AND YOUTH BEING DENIED
ACCESS TO HEALTH SERVICES THAT
THEY SHOULD BE RECEIVING.
AS SEEN IN THE CASE OF A SIXTEEN
YEAR OLD IN LA.
THE CHILD CRIES AND COMPLAINS OF
TOOTH PAIN EVERYDAY AND DO DID
THE CHILD VISIBLE NEED FOR MAJOR
DENTAL WORK SHE HAS BEEN
CONTINUALLY BULLIED AND
HUMILIATED BY HER PEERS.
THE CHILD'S DENTIST ADVISED
AGAINST REMOVING THE TEETH AND
TELL THEM UNTIL MEDI CAL
APPROVED THE CHILD'S RACES
WORRIED THAT ANY IMPROVEMENTS TO
THE CHILD'S CURRENT TEETH WOULD
LESSEN THE LIKELIHOOD.
OF APPROVAL FOR BRACES HOWEVER
THE PROBLEM WAS NOT THAT THE
CHILD'S TEETH WERE NOT BAD
ENOUGH.
RATHER IT WAS AT THE DENTIST
DIDN'T KNOW TO MAKE THE REQUEST
USING THE EP SDT STANDARD.
OUR LEGAL WAY PARTNERS REPORT A
NUMBER OF THE STORIES WERE CARE
WAS DENIED BECAUSE THE MAGIC
WORDS OF EP STT WAS NOT IN USE.
THEREFORE WE URGE YOUR AYE VOTE
ON THIS BILL THAT PASSED OUT OF
THE ASSEMBLY.
BY WITH BIPARTISAN SUPPORT
[inaudible]
UNANIMOUSLY SAFETY.
GOOD AFTERNOON MISTER CHAIRMAN
THERE'S OF THE COMMITTEE I'VE
GALIEN WITH CHILDREN NOW AND WE
RESPECTFULLY REQUEST YOUR
SUPPORT ON S. B..
TWELVE EIGHTY SEVEN MEDICARE
PROVIDES COMPREHENSIVE HEALTH
COVERAGE FOR OVER HALF OF ALL
CHILDREN CALIFORNIA IT IS
CRITICAL THAT MEDI CAL DELIVERS
THE HEALTH SERVICES AT CHILDREN
NEEDS.
S. B. TWELVE EIGHTY SEVEN WILL
HELP ENSURE THAT CHILDREN
MEDICAL COVERAGE ARE RECEIVING
THE SERVICES THEY ARE ENTITLED.
TO AS FAR OF THE FEDERAL EPA STT
BENEFIT WHICH IS BROADER AND
INCORPORATES MORE MEDICALLY
NECESSARY HEALTH SERVICES THAT
ARE STATES CURRENT DEFINITION OF
EP STT.
AS WE TALK EIGHTY SEVEN IS
NEEDED SO THAT CHILDREN ARE NOT
DENIED IMPORTANT SERVICES SUCH
AS DENTAL CARE AND MENTAL HEALTH
SERVICES.
THAT INCLUDED AS PART OF THE
ROBUST FEDERAL EPA STT STANDARD.
HE RESPECTFULLY REQUEST YOUR AYE
VOTE THINK YOU.
THANK YOU VERY MUCH OTHER
SUPPORT.
CAN RELIGION ON BEHALF THE
CALIFORNIA PAN ETHNIC HEALTH
ORGAN SUPPORT THANK YOU.
DEBORAH DISABILITY RIGHTS
CALIFORNIA IN SUPPORT.
MARY VALDEZ HEALTHAXIS
CALIFORNIANS SUPPORT SECURE.
MAYOR MARTIN ON BEHALF OF THE
CALIFORNIA CHILDREN'S HOSPITAL
ASSOCIATION IN SUPPORT.
KATIE LADEN ON BEHALF OF THE
CHILDREN SPECIALTY CARE
COALITION AND SUPPORT.
MELISSA CORTES ROTH ON BEHALF OF
AUTISM SPEAKS AND THE CENTER FOR
AUTISM AND RELATED DISORDERS IN
SUPPORT.
MANY EX CALIFORNIA DISABILITY
RIGHTS AND STRONG SUPPORT.
VIDEO PORN AMERICAN ACADEMY OF
PEDIATRICS AND AIR CARE SO THEY
HAVE A MARCH OF DIMES AND
SUPPORT.
MARRIED THERE WITH THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION IN SUPPORT.
BRAND OF HAPPENSTANCE ARE WITH
THE CALIFORNIA DENTAL
ASSOCIATION HERE IN SUPPORT.
MIKE MONTGOMERY --
CONGRESS OF CALIFORNIA C.
SENIORS WE SUPPORT THE BILL
THANK YOU.
I WEST SANDS UNITED WAYS OF
CALIFORNIA IN SUPPORT
[inaudible]
VERY MUCH. THREE ONE IN
OPPOSITION.
IT'S YOU KNOW ONE BRING BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS ANYONE FROM THE
COMMITTEE.
SEE NONE SENATOR WHICH OUGHT TO
CLOSE AS FURNITURE ITEMS TO
CHAIR MEMBERS THANK YOU VERY
MUCH -- WE
HAVE A MOTION BY MISTER BIGELOW
SECOND BYMISTER MAYES EMOTIONS
TO PASS TO APPROPRIATIONS.
THAT'S A TRICK PLEASE CALL THE
ROLL WOULD I WOULD I MAYES MAYES
I AM HERE AGAR CURRY.
I CARE CURRY AYE BIGELOW.
BIGELOW AYE.
BONTA.
BURKE CARILLO.
FLORA.
LIMON.
MCCARTY.
MCCARTY AYE.
NAZARIAN LIFE NAZARIAN AYE.
RODRIGUEZ RODRIGUEZ AYE SANTIAGO
[inaudible]
THURMAN [inaudible]
WALDRON.
IF SEVEN YOU GET CLOSER TO THE
MAGIC NUMBER.
THANK YOU.
WHAT GOT ONE MORE LEFT
[inaudible] ONE MORE.
WILL BE --
THIRTEEN SEVENTY FIVE MISTER
CHAIR.
NOW THE HEALTH.
I I'VE GOT ONE MORE HE HAS ONE
MORE YES I KNOW YOU KNOW ME
[inaudible]
WELL.
MISTER CHAIR MEMBERS THIS BILL
MAKES CALIFORNIA'S DEFINITION OF
EMPLOYER EMPLOYEE CONSISTENT.
FOR THE PURPOSE OF HEALTH
INSURANCE FINAL FEDERAL RULES
AND ASSOCIATION HEALTH PLANS
HAVE RECENTLY BEEN ISSUED AND
THEY MAKE IT CLEAR THAT STATES
ARE NOT PREEMPTED.
CALIFORNIA LAW ALREADY PREVENTS
--
ASSOCIATE HEALTH PLANS TO SPILL
JUST CLEANS UP OUR LAWS TO MAKE
IT CLEAR AND CONSISTENT WITH
THAT I RESPECTFULLY ASK
MONOGAMOUS CHAIR MEMBERS.
GOOD AFTERNOON MARRIAGES FORCE
ON BEHALF OF HEALTH ACCESS
CALIFORNIA WE ARE HERE IN
SUPPORT OF SB.
THIRTEEN SEVENTY FIVE AS
PERMITTED BY FEDERAL LAW AS THE
THIRTEENTH SEMIS BY WILL RETAIN
THE STATE'S AUTHORITIES TO
REGULATE ASSOCIATION HEALTH
PLANS AND WHO IS ELIGIBLE FOR
THEM.
BECAUSE OF THIS --
S. B. THIRTEEN SEMI FI WILL
ENSURE THAT ANY SMALL EMPLOYER
PLAN ISSUED EITHER THROUGH AN H.
P. OR ANY OTHER ARRANGEMENT.
ACTUALLY COMPLY WITH A CA MARKET
RULES FOR THESE REASON WE ASK
FOR YOUR AYE VOTE.
YOU VERY MUCH OTHERS IN SUPPORT.
ANYONE WITH THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES IN SUPPORT.
TERESA START WITH KAISER
PERMANENTE IN SUPPORT THANK YOU.
BECAUSE SUPPORT OF A BLUE SHIELD
OF CALIFORNIA IN SUPPORT.
MARK OF A SMALL BUSINESS
MAJORITY IN SUPPORT.
AS FOR CALLING ON BEHALF OF THE
CALIFORNIA IMMIGRANT POLICY
CENTER IN SUPPORT.
RIGHT NEXT CALIFORNIA LANCE
RETIRED AMERICANS SUPPORT.
MIKE MONTGOMERY CONGRESS OF
CALIFORNIA SENIORS SUPPORT
[inaudible]
ANYONE ELSE.
SO ANYONE IN OPPOSITION.
SEEN KNOWN OF BRINGING BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS IN IT FROM THE
COMMITTEE.
SEEING NONE BEFORE YOU CLOSE --
I SPECIFIC YOU --
I DON'T KNOW THAT WE'LL SEE YOU
IN FOR THIS COMMITTEE AGAIN I
THINK THAT'S IT IS MY LAST BILL.
AND I WANNA THANK YOU I THINK --
MILLIONS OF CALIFORNIANS OWE YOU
A DEBT OF GRATITUDE FOR THE WORK
YOU'VE DONE FOR THE A CIA
RECOVERED CALIFORNIA.
AS A CHAMPION FOR HEALTHCARE IN
CALIFORNIA AND I WANNA THANK YOU
VERY MUCH.
THANK YOU VERY MUCH MR CHAIR OF
YOU DON'T MIND I'D LIKE TO JUST
MAKE A COMMENT --
I WOULD LIKE TO THANK SOME VERY
VERY VERY SPECIAL PEOPLE
[inaudible]
MY STAFF.
I HAVE HAD THE ABSOLUTE MOST.
INCREDIBLE EXPERIENCE DEALING
WITH THE SENATE HEALTH STAFF I
KNOW YOU GUYS GOOD STAFF BUT
THESE GUYS ARE JUST [inaudible]
TOP.
SO I'D LIKE TO PERSONALLY THANK
ALL OF THEM P. BECAUSE THEY ARE
INCREDIBLE THEY MADE WHO I AM.
AND LEAST SUCCESSFUL BECAUSE OF
THEM THANK YOU GUYS.
AND WITH THAT I ASK FOR AN AYE
VOTE.
AND WE HAVE A MOTION BY MISTER
AS ARIANNA SECOND BY MISS
AGUIAR-CURRY MADAM SECRETARY
PLEASE CALL THE ROLL WOULD I
WOULD I MAYES.
REYES NOT VOTING ACKER CURRY.
AGAR CURRY I BIGELOW.
BIGELOW NOT VOTING BONTA.
BURKE CARILLO FLORA.
AMONG MCCARTY.
MCCARTY AYE THIS AREA.
NAZARIAN AYE RODRIGUEZ.
RODRIGUEZ I SANTIAGO THURMOND
WILDER. FIVE ZERO WE WERE STILL
LACKING A BUNCH OF PEOPLE HERE
BUT I WANT TO THANK YOU SO MUCH
SENATOR FOR FOR EVERYTHING ANTI
THANK YOU VERY MUCH MISTER
CHAIRMAN THERE'S IT'S BEEN AN
HONOR. TO HAVE A GREAT AFTERNOON
THINK.
IF YOU HAVE FIVE OR SIX MORE
BILL'S YOU'D LIKE TO PRESENT
THAT WOULD KEEP US BUSY I I YOU
KNOW [inaudible]
THE PRIEST.
YOU ON TO SOME OTHER BILLS
FOREST [inaudible]
SENATOR STONE.
WE'RE HAPPY TO HAPPY TO
ENTERTAIN YOU APPEAR
[inaudible]
PLEASE.
PRETTY CHAIR ON WILL MEMBERS.
I APPLAUD YOU FOR YOUR OF YOUR
YOUR INSURANCE TODAY.
AS I'M RUNNING UP AND DOWN THE
STAIRS TODAY PROCESS EARLY READY
TALKING ABOUT.
MISTER CHAIR FELLOW MEMBERS OF
THE COMMITTEE ON PRESENTING S.
B. TWELVE FIFTY FOUR WHICH
REQUIRE A PHARMACIST AT A
HOSPITAL PHARMACY TO CONFIRM.
AN ACCURATE PATIENT MEDICATION
PROFILE FOR EACH HIGH RISK
PATIENTS UPON ADMISSION.
OF THAT PATIENT.
I WOULD LIKE TO THANK THE CHAIR
AND THE COMMITTEE FOR WORKING
WITH US ON S. B. TWELVE FIFTY
FOUR AND I'M HAPPY TO BE TAKEN
THE COMMITTEE AMENDMENTS TODAY.
IT'S STARTLING COLLEAGUES AT UP
270% OF PATIENTS HAVE ERRORS.
ON THEIR MEDICATION LESS UPON
ADMISSION TO HOSPITAL NOT 259%.
OF THESE AREAS HAVE THE
POTENTIAL TO CAUSE MODERATE TO
SEVERE HARM.
THANK YOU SIR THERE IS CURRENTLY
A LACK.
OF OVERSIGHT FOR ENSURING SUCH
MEDICAL LISTS ARE ACCURATE A
PUNDIT HOSPITAL ADMISSION.
THIS LACK OF DEFINED
RESPONSIBILITY RESULTS AND
HERE'S IN THE LESS ANY ERRORS IN
THE MEDICATION ORDERS WHEN
PATIENTS ARE IN THE HOSPITAL AND
FACT WHEN THEIR DISCHARGE.
NOT ONLY DOES THIS LEAD TO
SIGNIFICANT HARM TO THE PATIENT
BUT STUDIES HAVE SHOWN.
THAT THIS PROBLEM ALSO COST
BILLIONS OF DOLLARS DUE TO
MEDICATION RELATED READMISSIONS.
AND ADVERSE DRUG EVENTS THIS
BILL WILL BETTER ENSURE THE
ACCURACY OF WHAT A PATIENT
MEDICATION PROFILE IS AN
ADMISSION.
THEREBY POTENTIALLY STOPPING ANY
ERRORS WHICH WILL ENHANCE
PATIENT SAFETY AND REDUCE
POSITION.
AND HOSPITAL LIABILITY INCLUDING
AFTER THE PATIENTS DISCHARGE I
WOULD LIKE TO INTRODUCE DOCTOR
RIEDERS CHANGING PHARMACY
OFFICER PROFESSOR OF MEDICINE.
FOR CEDAR SINAI AN ASSISTANT
DEAN OF CLINICAL PHARMACY AT
UCSF.
THEY APPEAR ON BOTH CENTER STONE
AND THANK YOU TO THAT --
TO THAT.
FAMILY COMMITTEE ON HEALTH --
COMMUNITY SHARE A PERSONAL STORY
AND AND AND FROM MY PROFESSIONAL
PERSPECTIVE HAVING BEEN.
A PHARMACIST FOR MANY MANY YEARS
AND DO IT VERY QUICKLY --
FROM A PERSONAL PERSPECTIVE
ABOUT TWENTY YEARS AGO ACTUALLY
LAST MONTH MY FATHER WAS
DIAGNOSED WITH A BRAIN TUMOR
FROM MY METASTATIC LUNG CANCER.
WHEN HE WAS DISCHARGED FROM HOT
ONE HAAS I NOTICED THAT THEY
DISCONTINUED ONE OF THE
MEDICATIONS THAT WAS TO REDUCE
THE SWELLING IN HIS BRAIN?
I AND SO I HAD TO MAKE SURE THAT
GOT TAKEN CARE WHEN HE WAS
READMITTED TO THE HOSPITAL OR
OTHER MEDICATIONS THAT WERE --
UNDEAD I SWEAR THEN THAT IT
WOULD MAKE IT MY HEART CAREER
GOAL TO TO FIX THIS SOMEHOW.
MORE RECENTLY MY NINETY YEAR OLD
HAND WAS HOSPITALIZED I WAS I
WAS TAKING CARE OF HER.
AND UPON ADMISSION --
THEY DISCONTINUED HER HER MATS
FOR HER BREAST CANCER THEY WERE
ALSO DISCONTINUED SUBSEQUENTLY
AND THEN SHE WAS.
START ON MULTIPLE --
BLOOD PRESSURE MEDS SHE WAS
NINETY POUNDS SHE WAS ADMITTED
FALLS AND I NEEDED TO CORRECT A
MEDALIST.
PERFECT PROFESSIONAL PERSPECTIVE
I'VE ALWAYS BELIEVED THAT THE
BEST CARE IS PROVIDED WHEN THE
HEALTH CARE TEAM WORKS TOGETHER.
PHYSICIANS AND NURSES ARE INTENT
ON STABILIZING THE PATIENT AT
THE TIME OF ADMISSION TO MAKE
SURE WHATEVER CONDITION ARE
BEING ADMITTED FOREST IS TAKEN
CARE OF PHARMACISTS ARE TRAINED
TO UNDERSTAND MEDICATIONS AND
HOW THEY'RE USED IN THAT EVERY
MEDICATION ORDER HOUSE TO BE A
COMPLETE SENTENCE JUST AS WE
SPEAK.
IN ENGLISH SO WE'VE CONDUCTED A
RESEARCH STUDY THAT WAS
PUBLISHED IN THE PEER REVIEWED
LITERATURE ALONG WITH MANY OTHER
ORGANIZATIONS IN OUR STUDY WE
FOUND THAT.
PHARMACY STAFF TO COMMIT THAT
TOOK A MEDICATION RISK.
LEST I RESULTED IN 80% REDUCTION
IN MEDICATION ERRORS HAD THOSE
THERE IS NOT BEEN CORRECTED TO
STUDY DEMONSTRATED THAT THERE
WOULD HAVE AN AVERAGE OF THREE
AREAS PER PATIENT.
OF WHICH ONE POINT TWO WOULD
HAVE IN YRIA SERIOUS OR LIFE
THREATENING THIS WAS DONE BY
PHYSICIAN PERRY VIEW OF THE OF
THE AREAS THEMSELVES TO
DEMONSTRATE THE POTENTIAL HARM.
THE ISSUE IS THE MEDICATION
LISTS ARE ARE OBTAINED BY RIGHT
OF INDIVIDUALS AND DIFFERENT
HEALTH CARE SETTINGS WHEN ONE
GOES TO A DOCTOR'S OFFICE IS
OFTEN A MEDICAL ASSISTANT.
GIVEN THE COMPLEXITY OF
MEDICATIONS THAT I'M GOING
RELEASE OF NEW MEDICATIONS THAT
ARE VERY VERY CHALLENGING TO
UNDERSTAND THE NUMBER OF
PATIENTS WITH CHRONIC DISEASES
AS WELL AS THE NUMBER OF
PHYSICIANS PATIENTS ARE OFTEN
SEEN.
THESE LISTS ARE PROBLEM PRONE IN
THE POTENTIAL FOR HARM IS REAL
FOR THE PURPOSE OF THIS BILL IS
TO ENSURE THAT A QUALITY
IMPROVEMENT PROCESS WITH
PHARMACISTS AND PHARMACY STAFF
WERE TRAINED IN THIS AREA.
ENSURE THE ACTRESS IN THE
MEDALIST WHEN OUR PATIENTS ARE.
THANK YOU FOR THE OPPORTUNITY TO
SHARE THIS WITH.
THANK YOU VERY MUCH OF THEIR
OTHER WITNESSES AND SUPPORT.
WE A PARADIGM MAP CALIFORNIA
LIFE SCIENCES ASSOCIATION IN
SUPPORT BECUZ.
CONNIE DELGADO WITH A CALIFORNIA
HOSPITAL ASSOCIATION IN SUPPORT.
IF YOU.
TIM VALDERRAMA WITH THE WHITEMAN
GROUP ON BEHALF OF THE
CALIFORNIA SOCIETY OF HEALTH
SYSTEM PHARMACISTS IN SUPPORT
[inaudible]
VERY MUCH.
SO ANYONE IN OPPOSITION.
MR MEMBERS TO MAD RIBS IN
CALIFORNIA CHAPTER THE MURDER
BECAUSE EMERGENCY PHYSICIANS ARE
WITH THE AMENDMENT --
IN THE ANALYSIS WE ARE REMOVING
OPPOSITION WE WANT TO THANK THE
SENATOR FOR ITS HELP IN THE
ASSISTANCE OF YOUR COMMITTEE
STAFF THANK YOU.
GOOD MORNING MISTER CHAIRMAN
MEMBERS PAT WHALEN ELLIS MOST
NAPA SEE HERE ON BEHALF OF
UNITED NURSES ASSOCIATION ALSO
REMOVING OUR OPPOSITION WE DO
STILL HAVE CONCERNS ABOUT THE
FACT THAT THE BILL ALLOWS --
THE GATHERING OF THE MEDICATION
PROFILE TO BE DELEGATED TO
PHARMACY TECHNICIANS AND WE'RE
NOT COMFORTABLE THAT THEY HAVE
THE EXPERIENCE --
TO TAKE ACCURATELY BECAUSE OTHER
MEDICAL PROFESSIONALS HAVE TO
RELY ON THAT DOWN THE LINE --
BUT WE ARE MOVING TO NEUTRAL
THANK YOU [inaudible]
ANYONE ELSE.
SEEING NO ONE WILL BRING IT BACK
TO THE COMMITTEE FOR QUESTIONS
OR COMMENTS THE WORKING
COMMITTEE --
IS WAS A OF THANK YOU FOR
BRINGING TO GO FORWARD.
THINK FOR WORKING ARE COMMITTEE
--
YOU JUST ENJOY DO PASS
RECOMMENDATION AND WHICH ELECT
CLOSE UNDER.
RESPECT LAST TRIBAL THANK YOU
MISTER CHAIRMAN FOR YOUR STAFF
THANK YOU I WE HAVE A MOTION BY
MISTER BIGELOW WAS SECOND BY MR
MCCARTY.
ARE THE MOTIONS TO PASS AS
AMENDED TO APPROPRIATIONS SPENT
SECRETARY PLEASE CALL THE ROLL
WOULD I WOULD I MAYES.
MAYES AYE AGUIAR-CURRY AGAR
KOREA.
BIGELOW AYE BONTA.
BURKE.
CARILLO.
CARILLO I FLORA.
LOW MOAN MCCARTY.
MCCARTY AYE NOSE AREA
[inaudible]
RODRIGUEZ.
SANTIAGO THURMAN WALTER
[inaudible]
WALDRON AYE. SEVENTY NEED ONE
MORE BUT YOU'LL SEE WERE LITTLE
SHY OF MEMBERS HERE SO WE'LL PUT
THAT ON CULTURE PARTICULARLY.
WHEN I ASK A A CENTER LABOR
WOULD YOU MIND IF WE ASK TALKED
OF MISTER ROTH TO TAKE HIS BILL
FORGET HIS WEEK SIGNIFICANTLY
SHORTER?
NO PROBLEM THANK YOU THANK YOU
SENATOR ROTH.
THANK YOU MISTER CHAIR OF HOPE
SPRINGS ETERNAL ON THE SHORTER
PIECE BUT THANK YOU.
I'M ALWAYS HOPEFUL SENATOR.
THANK YOU MISTER CHAIR FIRST LET
ME JUST TO THANK YOU PERSONALLY
AND YOUR STAFF FOR MEETING WITH
ME AND WITH MY STAFF ON THIS
BILL -- TO
ATTEMPT TO WORK OUT SOME OF THE
ISSUES.
OF THE BILL IS --
SIMPLY DESIGNED TO ENSURE THAT
PATIENTS HAVE THE RIGHT TO
RETRIEVE AND PRESERVE THEIR
MEDICAL RECORDS PURCHASE
DESTRUCTION IF THE PATIENTS
DECIDE TO DO SO.
OF THIS PARTICULAR BILL AT THIS
POINT IN TIME REQUIRES THAT
SPECIFIED HEALTH CARE PROVIDERS
SEND A SINGLE NOTICE.
VIA EMAIL OR POST.
MALE. TO THE PATIENTS LAST KNOWN
ADDRESS EMAIL OR POST NOTIFYING
THE PATIENT AND HIS OR HER
PERSONAL HEALTH CARE RECORD WILL
BE DESTROYED IF IT'S GOING TO BE
DESTROYED.
AND WHEN AND GIVES THE PATIENT
T. OPPORTUNITY TO REQUEST A
COPY.
BEFORE THE RECORDS ARE DESTROYED
--
I JUST WANT TO SAY I RECOGNIZE
IS THE ANALYSIS POINTS OUT THAT
MEDICAL RECORDS ARE NOT THE
PROPERTY OF THE PATIENT.
BUT MY PURPOSE IN MOVING THIS
BILL WAS TO ENSURE THAT PATIENTS
RECEIVE A CLEAR NOTIFICATION.
WHEN MEDICAL RECORDS ARE GOING
TO BE DESTROYED AND GIVEN AN
OPPORTUNITY TO PRESERVE THOSE
RECORDS IF THE PATIENT IS OURS
TO DO SO?
FUTURE OF AN OPPORTUNITY TO
REVIEW AT LEAST SOME MOCK UPPER
DRAFT AMENDMENTS THAT --
YOUR STAFF HAS PROVIDED TO ME --
THAT PROVIDE A NOTIFICATION.
TERM RECORD RETENTION PERIOD AT
THE BEGINNING OF THE A HEALTH
CARE PROVIDER PATIENT
RELATIONSHIP AND AS WE DISCUSSED
I HAVE SOME CONCERNS THE
PROVIDING.
PATIENTS WITH INFORMATION AT THE
BEGINNING OF THE DOCTOR PATIENT
RELATIONSHIP WHEN THE PATIENT IS
FOCUSED ON SECURING MEDICAL
TREATMENT OR PAIN RELIEF MAY NOT
BE THE MOST EFFECTIVE.
NOTIFICATION METHOD TO THE
PATIENT --
AS YOU KNOW AND WE DISCUSSED I'M
ALSO CONCERNED THAT PROVIDING
PATIENTS WITH THE MEDICAL
RETENTION PERIOD WHETHER IT'S
SEVEN YEARS OR FIVE YEARS.
MAY NOT ACTUALLY.
TELL THE PATIENT WHEN THOSE
RECORDS ARE GOING TO BE
DESTROYED AND TRIGGER IN THE
PATIENT'S MIND ASSUMING THEY
REMEMBER THAT NOTIFICATION.
THAT FAR DOWNSTREAM EXACTLY WHEN
THEY NEED TO PROVIDE.
THE NOTIFICATION TO THE OF
MEDICAL --
PROVIDERS OFFICE BUT I ALSO
RECOGNIZE THAT THERE CERTAINLY
ARE ARGUMENTS ON THE OTHER SIDE
--
AND POINTS TO BE MADE ON THE
OTHER SIDE OF THIS DISCUSSION.
AND SHOULD THIS BILL HAPPEN TO
MOVE FORWARD OF FROM THIS
COMMITTEE I HAVE PERSONALLY
COMMITTED TO WORK WITH YOU AND
WORK WITH YOUR STAFF TO TRY TO
COME UP WITH A WORKABLE
ALTERNATIVE --
ACCEPTABLE TO BOTH OF US --
AGAIN ASSUMING THE BILL HAPPENS
TO MOVE OUT OF THIS COMMITTEE
AND ASSUMING --
IF IT'S AN APPROPRIATION ISN'T
THAT IT SHOULD HAPPEN TO MOVE
OUT OF APPROPRIATIONS AND I
INTEND TO OF FULLY HONOR THAT
COMMITMENT AND AGAIN I WANT TO
EXPRESS MY APPRECIATION. TO YOU
FOR TAKING YOUR TIME IN THIS
BUSY WEEK TO MEET WITH ME ON THE
DETAIL OF THE BILL.
I HAVE A COUPLE OF FOLKS HERE
WHO MAY WANT TO BRIEFLY --
ADDRESS SOME ISSUES MISTER ALLEN
BONUS AND AND CHEN FLORI WAS I
CAN WESTERN CENTER THINK.
GOOD AFTERNOON CHAIR AND
COMMITTEE.
I'M ALAN POINT US PRIVATE
CITIZEN FROM LAGUNA BEACH
[inaudible]
IN SUPPORT.
I'VE BEEN WORKING ON RELATED
LEGISLATION FOR MORE THAN TWELVE
YEARS STEMMING FROM MY WIFE'S
PERSONAL BATTLES WITH BREAST
CANCER.
WE FACE SKINNER DEAL NOT JUST
WITH THE DISEASE BUT WITH AN
ARCANE SYSTEM OF LAWS THAT ARE
CONFUSING AT BEST.
SPEAK YOU ASLI BSENT WORST WHEN
IT COMES TO PROTECTING PATIENT
MEDICAL RECORDS FROM PREMATURE
DESTRUCTION.
THIS IS WHAT DRIVES ME TO THIS
DAY WHAT HAPPENS MY WIFE SHOULD
NOT HAPPEN TO ANYONE ELSE.
PEOPLE PAY DOCTORS FOR VITAL
SERVICE WHICH INCLUDES STORING
MEDICAL RECORDS.
WELL CURRENT LAW ALLOWS PATIENTS
TO ACCESS THEIR MEDICAL RECORDS
MOST WOULD BE SHOCKED TO LEARN.
DOCTORS ARE FREE TO SHRED
PATIENT RECORDS WITH NO
OBLIGATION TO INFORM THE
PATIENT.
IN THE CASE OF CANCER AND OTHER
DISEASE.
THAT GO INTO REMISSION FOR
PERHAPS DECADES TREATMENT PLANS
ARE DEPENDENT ON WHAT HAS
HAPPENED BEFORE.
MY WIFE SUFFERED FROM BREAST
CANCER TWICE OVER FOURTEEN YEAR
PERIOD.
WHEN SHE WAS STRICKEN THE SECOND
TIME I TRY TO RETRIEVE HER
ORIGINAL TUMOR SLIDES AND
RADIATION RECORDS TO LEARN
WHETHER HER CANCER WAS NEW OR
RECURRENT?
AND WHETHER SHE WAS A CANDIDATE
FOR MORE RADIATION.
BUT THE SLIDES HAD BEEN
DESTROYED AND THE RADIATION
RECORDS WERE MISSING.
IN THE MAD RUSH TO TREAT DOCTORS
RECOMMEND MY WIFE BE RADIATED
AGAIN.
BUT WITHOUT THE RADIATION
RECORDS THERE WAS NO WAY OF
KNOWING WHETHER SHE HAD REACHED
A LIFETIME MAXIMUM OF RADIATION
FROM HER FIRST BATTLES WITH
CANCER.
RADIATION TREATMENT CAN BE BOTH
THE QUEUE OR AND CURSE.
WITHOUT THE NOTIFICATION
REQUIREMENT IN THIS BILL
PATIENTS WILL CONTINUE TO BE IN
THE DARK.
NEVER KNOWING WHETHER THE DOCTOR
PATIENT RELATIONSHIP HAS ENDED.
OR WHETHER THEIR RECORDS EVEN
CONTINUE TO EXIST.
KNOWING ONE PATIENT MEDICAL
RECORDS MAY BE DESTROYED.
IT'S NOT THE SAME AS KNOWING
WHEN PATIENT RECORDS WILL BE
DESTROYED.
IT WAS PURE CHANCE THEN MY
WIFE'S TUMOR SLIDES WERE
DESTROYED AND RADIATION RECORDS
WERE EVENTUALLY FOUND.
THE CHANCE IS NOT HOW WE SHOULD
BE RUNNING HEALTH CARE IN THIS
STATE.
AND I HEARD YOUR SUPPORT THANK
YOU.
GOOD AFTERNOON CHEN FOR ON
BEHALF OF WESTERN CENTER ON LAW
AND POVERTY.
MANY OF THE LOW INCOME PEOPLE
THAT WESTERN CENTER AND OUR
PARTNERS SERVE HAVE COMPLICATED
MEDICAL HISTORIES WHEN MEDICAL
RECORDS ON AVAILABLE PROVIDERS
CAN MAKE APPROPRIATE TREATMENT
DECISIONS BASED ON WHAT'S BEEN
TRIED IN THE PAST.
ADDITIONALLY MANY PUBLIC
BENEFITS PROGRAMS RELY ON
MEDICAL RECORDS FOR PROGRAM
ELIGIBILITY DETERMINATION SUCH
AS ARE SSI PROGRAM MEDI CAL
PROGRAMS BASED ON DISABILITY AND
CERTAIN VETERANS BENEFITS.
OTHER PROGRAMS RELY ON MEDICAL
RECORDS TO DETERMINE WHETHER A
BENEFICIARY SHOULD BE SUBJECT TO
WORK REQUIREMENTS SUCH AS CAL
WORKS AND CAL FRESH NOT YET MEDI
CAL.
AS SUCH WE SPONSORED S. B. FIVE
SEVENTY FIVE LAST YEAR TO ENSURE
THAT PEOPLE WHO RELY ON THESE
RECORDS COULD ACCESS AND FOR
FREE WHEN NEEDED FOR VARIOUS
PROGRAM DETERMINATIONS.
HOWEVER WITHOUT THE PROTECTIONS.
A BIT OF PROTECTING THE
UNDERLYING MEDICAL RECORDS THE
PROTECTIONS IN S. B. FIVE
SEVENTY FIVE R. POINTLESS IT YOU
KNOW WE'VE WHEN I WAS IN LEGAL
SERVICES PREVIOUSLY I HELP MANY
PEOPLE WHO WERE TRYING TO PROVE
THEIR DISABILITY AND THEY COULD
NOT ACTUALLY GET THE RECORDS TO
PROVE THAT.
DISABILITY BECAUSE THE RECORDS
WERE GONE.
MEDICAL RECORDS ARE ALSO USED IN
A VARIETY OF LEGAL PROCEEDINGS
AND CAN HELP DETERMINE WHO HAS
CUSTODY OF A CHILD WHETHER
COMPANY IS LIABLE FOR HARM OR
WHETHER AN EMPLOYEE HAS A CLAIM
AGAINST AN EMPLOYER.
CONSUMERS MUST BE INFORMED WHEN
THEIR MEDICAL RECORDS ARE IN
JEOPARDY SO THEY CAN PRESERVE
THE DOCUMENTS THAT MAY DICTATE
THEIR RIGHTS IN THE FUTURE --
FINALLY IN OUR LOCAL LEGAL
SERVICES ADVOCATES SAY ALSO HELP
A LOT OF PEOPLE WITH MEDICAL TO
AT AND ALL TO SAY THAT MANY
PROVIDERS DO GO TO GREAT LENGTHS
TO FIND SOMEBODY ONE A BILL IS
OWED AND WE WOULD HOPE THAT THEY
WOULD GO TO AT LEAST THOSE.
SIMILAR LINKS TO FIND SOMEBODY
WHEN THEY'RE GOING TO DESTROY
THEIR MEDICAL RECORDS I
PERSONALLY FOUND OUT WHEN I WAS
APPLYING TO LAW SCHOOL AS A
YOUNG ADULT THAT ALL OF MY
PEDIATRIC RECORDS HAD BEEN
DESTROYED.
AND LATER IN LIFE IT WAS
ACTUALLY THE FACT THAT MY MOM
DID HAVE GOOD MEDICAL RECORDS
ABOUT HER BREAST CANCER THAT I
WAS ABLE TO MAKE DECISIONS ABOUT
MY CARE AND MY COUSIN WAS ABLE
TO MAKE DECISIONS ABOUT HER.
SO FOR THIS WE URGE YOUR AYE
VOTE AND WE URGE TO CONTINUE TO
WORK TOGETHER TO FIGURE OUT WHAT
THE BEST NOTIFICATION IS FOR
CONSUMERS.
THANK YOU VERY MUCH OTHERS IN
SUPPORT I JUST YOUR NAME AND
ORGANIZATION PLEASE.
MARY JANE FOR IS HEALTH ACCESS
CALIFORNIA IN SUPPORT.
THE MIKE MONTGOMERY CONGRESS OF
CALIFORNIA SENIORS WHO SUPPORT
THE BILL THANK YOU.
SARAH FLOCKS CALIFORNIA LABOR
FEDERATION IN SUPPORT THANK YOU.
TAYLOR DOT SOME OF THE
CALIFORNIA NURSES ASSOCIATION IN
STRONG SUPPORT.
JEFFERSON MOST OF THE MEDICAL
BOARDOF CALIFORNIA THE BOARD
SUPPORTS THE CONCEPT OF THIS
BILL EVEN WORKING WITH AUTHORS
OFFICE IN WILL BE BRINGING IT
BACK TO OUR BORN JULY THANK YOU.
PANCAKES CALIFORNIA ALLIANCE OF
TOUGH RETIRED AMERICANS STRONG
SUPPORT CALIFORNIA'S DISABILITY
RIGHTS IN STRONG SUPPORT.
IS ANYONE IN OPPOSITION.
THANK YOU MISTER CHAIR AND
MEMBERS AMY DUGGAR NOT THE
CALIFORNIA MEDICAL ASSOCIATION
SEEMAYER REMAINS OPPOSED TO S.
B. TWELVE THIRTY EIGHT AND MUST
AMENDED TO ADDRESS THE
PROBLEMATIC SECOND NOTICE
REQUIRED CURRENTLY UNDER THE
BELL.
WITHIN SIXTY DAYS OF DESTRUCTION
OF THE MEDICAL RECORDS TO THE
PATIENTS LAST KNOWN MAILING
ADDRESS AND EMAIL.
THE SECOND NOTICE ASSEMBLY AND
WORKABLE AS DRAFTED IN CREATES
NUMERO NUMEROUS OPERATIONAL ON
PRIVACY CONCERNS IT
FUNDAMENTALLY DOES REGARDS AWAY
THE HEALTHCARE SYSTEM CURRENTLY
WORKS AND THAT MANY HEALTH
FACILITIES AND HEALTH
INFORMATION EXCHANGES NOW GOVERN
RECORD MAINTENANCE ND
DESTRUCTION.
DEPENDING ON HOW THE HEALTH
SYSTEM IS INTEGRATED IN THE
ELECTRONIC HEALTH RECORD SYSTEM
USED THIS BILL AS WRITTEN DOES
NOT ACKNOWLEDGE THAT INSTEAD
PUTS A POSITION IN A POSITION OF
HAVING TO COMPLY WITH THE
DESTRUCTION NOTICED.
THAT THEY DO NOT CONTROL IN MANY
INSTANCES.
THERE FOR A RAISES OPERATIONAL
CONCERNS OF HOW THE NOTICE WOULD
WORK FOR PROVIDERS THAT MAY
PRACTICE IN MULTIPLE SETTINGS
GIVEN THE RECORDS ARE MAINTAINED
IN THOSE INTERNAL SYSTEMS AND DO
NOT FOLLOW THE PROVIDER.
THE HEALTHCARE SETTINGS ARE NOT
OBLIGATED UNDER THE BELL YET THE
PROVIDERS THAT THE CONTRACT WITH
ARE OBLIGATED UNDER THE BELT.
IN ADDITION MEDICAL PRIVACY LAWS
ENSURE THAT PATIENTS COME ACROSS
LIMITATIONS ON COMMUNICATIONS
NOW WHEN A PATIENT MAY HAVE BEEN
SEEN PERCENT OF MEDICAL SERVICES
FOR EXAMPLE DOMESTIC VIOLENCE
SERVICES ARE REPRODUCTIVE
ISSUES.
THE BILL WILL REQUIRE AN ACROSS
THE BOARD NOTICE TO BE CENTER
ADDRESS SHOWING THAT THEY
RECEIVE THE SERVICE AS A WITH NO
EXCEPTIONS EVEN IF THE PATIENT.
THEY ONLY BECAUSE AT A CERTAIN
NUMBER.
THEY INFORMATION IN THE NOTICE
IS CAPTURED AND THE LAWS MEDICAL
INFORMATION WHICH MEANS THAT
THERE MAY BE A PRIVACY BREACH OF
OPEN BY A DIFFERENT INDIVIDUAL.
FOR PATIENTS IN DECADES AGO IT
IS VERY LIKELY THAT THE CONTACT
INFORMATION ON FILE WILL NO
LONGER BE ACCURATE THERE FOR THE
MAJORITY OF THE NOTICES WILL NOT
REACHING THE WRONG INDIVIDUALS.
SO THE SECOND US IN THE BOW WE
THINK WILL ONLY CREATE CONFUSION
AND LITIGATION AND A MASSIVE
BURDEN ON MEDICAL PRACTICES THAT
YOU MAY HAVE OFFERED AMENDMENTS
THAT WE THINK WOULD ADDRESS
THESE CONCERNS AND QUESTIONS
WHILE ALSO ENSURING PATIENTS ARE
AWARE OF THE RETENTION RECORD
POLICY.
WHICH IS THE UNDERLYING ISSUE --
WE ALSO APPRECIATE THE CHAIR IN
THE COMMITTEE'S WORK ON THAT
BELL IN THEIR EFFORTS AND
WILLINGNESS TO WORK WITH THE OUT
THERE AND THE CONCERNS --
BUT WE REMAIN OPPOSED LAST
MINUTE AT THIS TIME WE LOOK
FORWARD TO CONTINUING
CONVERSATIONS --
BUT WILL BE CONTAINED US FOR NO
VOTE OF THESE ISSUES ARE
ADDRESSED IN THE FUTURE THANK
YOU.
MY NAME IS LIZ ALLAN AND I'M
HERE REPRESENTING THE CALIFORNIA
HEALTH INFORMATION ASSOCIATION.
I'D -- THIS
ASSOCIATION REPRESENTS --
NINE THOUSAND HEALTH INFORMATION
MANAGERS IN THE STATE OF
CALIFORNIA AND PRIMARILY WE ARE
THE PEOPLE WHO DEAL WITH THE
MEDICAL RECORDS WHEN PATIENTS
COME IN REQUEST FOR THEM OR WE
WORK WITH THE PRACTITIONERS WHO
OWN THE RECORDS AND AND MAKE
THEM AVAILABLE TO THE PATIENTS
--
WE STRONGLY SUPPORT PATIENT
ACCESS TO THEIR HEALTH
INFORMATION AND TO THEIR MEDICAL
RECORDS BUT WE CANNOT SUPPORT
THIS BILL.
ARE IN LESS AMENDMENTS ARE MADE
TO IT -- WE
SUPPORT THE FACT THAT PATIENTS
SHOULD BE INFORMED AT THE TIME
THEY ENCOUNTER THEIR PROVIDERS
THAT THE LENGTH OF TIME THE
PROVIDER WILL KEEP THEIR
RECORDS.
AND HOW THE PATIENT MAY OBTAIN
COPIES OF THOSE RECORDS.
BUT THE WAY THAT THIS --
THE BILL WORKS WITH THIS IS NOT
REALLY GOING TO WORK IN.
IN THE REAL WORLD --
ARE MAJOR CONCERNS ARE THE
POTENTIAL BREACHES OF PROTECTED
HEALTH INFORMATION BY SENDING
LETTERS OR EMAILS TO THE LAST
KNOWN ADDRESS OF PATIENTS WHO
YOU MAY HAVE NOT SEEN FOR FIVE
OR TEN OR FIFTEEN YEARS --
IT TOO AND MAYBE HUNDREDS OF
PATIENTS ARE THOUSANDS OF
PATIENTS --
THERE'S A LOT OF UNFORESEEN AND
POTENTIALLY EXTENSIVE BREACHES
OF UP PROTECTED HEALTH
INFORMATION.
IT'S IN A EXTENSIVE
ADMINISTRATIVE BURDEN
[inaudible] FOR PHYSICIANS AND
MEDICAL GROUPS WHO MAY ROUTINELY
DESTROY.
UP TO THIRTY THOUSAND RECORDS A
YEAR.
ARE OF PATIENTS THAT HAVE BEEN
--
DOT HAVE EXCEEDED THEIR
RETENTION POLICIES --
IT'S A LACK OF STANDARDIZED
MEDICAL RECORD RETENTION LAWS
THAT IS --
UNDERNEATH THAT UNDERLIES ALL
THIS.
HOSPITALS AND CLINICS MAY HAVE
TO OFFER MAY HAVE LAWS THAT.
SPECIFY HOW LONG THEY HAVE TO
KEEP THE RECORDS INDIVIDUAL
PHYSICIAN PRACTITIONERS DO NOT.
A HYBRID MEDICAL RECORDS AND
ELECTRONIC --
MEDICAL RECORDS AREN'T ISSUE FOR
EVERYBODY WERE IT IN ELECTRONIC
RECORDS BUT THERE ARE STILL A
LOT OF PAPER RECORDS REMAINING
SO WHAT IS THE ORIGINAL RECORD
THAT WOULD BE GIVEN TO THE
PATIENT.
SO UNLESS THERE ARE --
AMENDMENTS THAT ADDRESS THESE
ISSUES THAT CALIFORNIA HEALTH
INFORMATION ASSOCIATION STRONGLY
OPPOSES THE BILL.
OTHER WITNESSES IS JUST NAME AN
ORGANIZATION PLEASE.
AS THAT RECORD WITH THE
CALIFORNIA DALLAS ASSOCIATION
REPRESENTING TWENTY SEVEN
THOUSAND MEMBER DENNIS WE ARE
POSTED ON SOME ENDED.
MISTER CHAIR MEMBERS TO MATT
REPRESENT THE CALIFORNIA SOCIETY
OF PLASTIC SURGEONS IN
OPPOSITION [inaudible]
VERY MUCH ANYONE ELSE.
BRING BACK TO THE COMMITTEE
QUESTIONS OR COMMENTS.
WITH BIGGER YEAH THANK YOU
CENTER OFFERING THIS FOR AND
COMMITTEE TO WORK --
TO GET THE IMPLEMENTATION PIECE
DOWN THAT THE OPPOSITION DOESN'T
APPRECIATE AT THIS POINT.
ALL SUPPORT YOUR BILL TODAY AND
I LOOK FORWARD TO SEEING THE
AMENDMENTS IN THE CHANGES AND
HOPEFULLY I CAN VOTE FOR TO GET
ON THE FLOOR.
THINKING [inaudible]
ANYONE ELSE.
I DON'T THINK EVER THINK YOU I
THINK -- I
APPRECIATE OUR CONVERSATION THIS
MORNING AS WELL SENATOR I THINK
ONE OF THE THINGS THAT HAS --
BECOME GLARINGLY CLEAR TO ME IS
THAT THERE IS HUGE INCONSISTENCY
THROUGHOUT THE MEDICAL
PROFESSION AND HOW RECORDS ARE
RETAINED.
I'M REALLY OLD SCHOOL I KEPT
EVERY RECORD FROM EVERY PATIENT
EXCEPT THOSE WHO WHO I KNEW HAD
TO SEE WERE DECEASED --
IN A PERFECT WORLD I THINK
THAT'S THE WAY IT SHOULD BE DONE
--
AND DEATH YOU WOULDN'T HAVE WE
WOULDN'T HAVE THIS ISSUE WE'RE
ALSO MOVING INTO THE AGE OF
ELECTRONIC RECORDS SO STORAGE
WILL BE DIFFERENT AND UP
POTENTIALLY EASIER TO MAINTAIN.
AND IT COULD BE A POINT IN THE
NOT TOO DISTANT FUTURE WHERE WE
DON'T HAVE THIS ISSUE BECAUSE IT
IS ELECTRONIC AND IT'S IN THE
CLOUD WHERE THE HECK THAT IS --
BUT BUT YOU KNOW I MEAN JUST
JUST JUST LISTEN TO LISTEN TO
THE INCONSISTENCY HERE.
PROVIDERS TREATING MEDI CAL
PATIENTS ARE REQUIRED TO KEEP
THEIR RECORDS FOR A MINIMUM OF
TEN YEARS.
OPTOMETRISTS FOR SEVEN YEARS.
DEPARTMENT OF MANAGED HEALTHCARE
REQUIRES CONTRACTS BETWEEN
HEALTH PLANS AND PROVIDERS WHO
REGULARLY FURNISH SERVICES UNDER
THE PLANT --
TO REQUIRED PROVIDES RICK
MAINTAIN RECORDS FOR TWO YEARS.
HMO MEDICAL RECORDS MUST BE
RETAINED FOR TWO YEARS.
POSITIONS TO DISPENSE OF A
SCHEDULE ONE TWO AND FORD OR FOR
DRUGS A MUST KEEP RECORDS FOR
THREE YEARS.
WORKERS COMP GUY CASES PER FIVE
YEARS THERE IS HUGE
INCONSISTENCY HERE AND I WOULD
BET THE YOU COULD PROBABLY ASK.
HALF THE PHYSICIANS WOULD GET IT
WRONG THEY DON'T KNOW HOW LONG
THIS WAS TO KEEP RECORDS.
AND SO YOU YEAR THIS IS A MUCH
BIGGER ISSUE --
OUT THERE --
AND I APPRECIATE YOU BRINGING
THIS FORWARD I THINK WE'VE
ACCEPTED OUR FIRST AMENDMENT --
THERE AND I THINK WE'RE WHICH IS
THAT WERE CLARIFYING AND
TECHNICAL AMENDMENTS TO ALLOW
THE NOTIFICATION.
OTHER RETENTION --
APPEARED TO APPEAR IN ANOTHER
FORM RECEIVING GIVEN SO THAT'S
THE EARLY PART S. --
WE'RE STILL TRYING TO FIGURE OUT
HOW THIS THE SECOND THAT WHAT
HOW THE SECOND NOTIFICATION WORK
TONIGHT COMMITTED. TO TO WORK
WITH YOU THROUGH THAT --
IN AYE I AGREE --
I THINK MAINTAINING RECORDS IS
IS IMPORTANT ARE FOR PATIENTS
AND SO AND WE ALSO BUT NEED TO
FIND A WAY TO KEEP PATIENTS
INFORMED.
AT SOME POINT PATIENTS NEED TO
TAKE SOME RESPONSIBILITY --
AS WELL FOR THE THE THE
DISPOSITION OF OF THEIR RECORD
SO -- SO WE
WILL CONTINUE --
TO WORK I WORK WITH YOU ON THIS
--
AND I APPRECIATE THE SPIRIT
WHICH YOU COME FORWARD ON TRYING
TO SOLVE OF A REAL PROBLEM I
THINK I BELIEVE --
AND THAT THIS THIS DOES SO
SUPPORT ARE YOU TO HAVE A
SUPPORT RECOMMENDATION FOR ME
AND AT THIS POINT I WOULD YOU
LIKE TO CLOSE.
WELL LET ME JUST ASSURE THE LOOK
FIRST FOR MISTER CHAIR THANK YOU
VERY VERY MUCH FOR THOSE
COMMENTS AND FOR YOUR HELP
EARLIER.
LET ME JUST ASSURE THE COMMITTEE
THAT THERE IS NO INTENT HERE TO
VIOLATE ANYONE'S PRIVACY OR
DISCLOSE ANY MEDICAL
INFORMATION.
AND I I DON'T BELIEVE A A
NOTIFICATION IN A IN A EITHER A
SHORT LETTER OR AN EMAIL THAT
SIMPLY SAYS --
WE HAVE YOUR RECORDS WE'RE GOING
TO DESTROY THE MONEY MAY
NINETEEN TWO THOUSAND NINETEEN
IF YOU WANT THEM GIVE US A CALL
OR CONTACT US AT HACKS.
VIOLATES OUR DISCLOSES ANYONE'S
MEDICAL INFORMATION UNDER ANY
DEFINITION WHETHER IT'S THE
CONFIDENTIALITY OF MEDICAL
INFORMATION ACT THAT WE DEAL
WITH HERE IN CALIFORNIA.
OR OF FEDERAL HIPPA.
OF SECONDLY REPRODUCTIVE
SERVICES THERE'S NO INTENT HERE
TO DISCLOSE THAT SORT OF
INFORMATION AND IN FACT THE
CLINICS TO PROVIDE THOSE
SERVICES.
ARE EXEMPT UNDER THE BILL AND
OBVIOUSLY I THINK THE COMMITTEE
MEMBERS KNOW THAT IT'S THE
HEALTH CARE PROVIDER HIMSELF
HERSELF FOR ITSELF IN THE CASE
OF A GROUP.
THAT DECIDES WHETHER MEDICAL
RECORDS ARE DESTROYED AFTER THE
RETENTION RECORD RETENTION
PERIOD --
AND WHEN AND I DO RECOGNIZE THAT
THERE MAY BE SOME ADMINISTRATIVE
KOSTER INCONVENIENCE IT'S OCCUR
INCURRED HERE BY THE HEALTH CARE
PROVIDER OR THE GROUP DEPENDING
ON THE WAY THE PROVIDER DECIDES
TO IMPLEMENT THE PROVISIONS OF
THIS PARTICULAR BILL FRANKLY IF
THIS BILL PREVENTS AND ON
UNNECESSARY PROCEDURE PROVIDES.
FOR MORE EFFECTIVE TREATMENT FOR
A PATIENT OR IN.
AND HOPEFULLY THE RARE CASE
SAVES THE LIFE I THINK THOSE
ADMINISTRATIVE COSTS OF THAT
INCONVENIENCE CERTAINLY ARE WELL
WORTH IT.
AGAIN I THANK YOU MISTER CHAIR I
APPRECIATE THE COMMITTEE
COMMITTEE'S CONSIDERATION --
AND I WOULD CERTAINLY
RESPECTFULLY ASK FOR AN AYE
VOTE.
WE HAVE A MOTION [inaudible]
MOTION.
MUCH MR MCCARTY.
SECOND BY MISTER RODRIGUEZ PUT
THEM TO SLEEP.
I I'M SURE WILL BE AWAKE IN A
MOMENT.
A TO THE MOTION IS TO PASS AS
AMENDED TWO PROBES --
MEMSIC TRIP PLEASE CALL THE
ROLL.
WOULD I WOULD I MAYES.
IS NO AGUIAR-CURRY.
BIGGER CURRY AYE BIGELOW.
BIGELOW NO.
BONTA [inaudible]
BURKE [inaudible]
CARILLO [inaudible]
CARILLO I FLORA [inaudible]
THE MONK.
MCCARTY.
MCCARTY AYE NAZARIAN
[inaudible]
RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO.
THURMOND WALTER [inaudible]
WILDER KNOW.
YOU'RE FIVE VOTES --
WE HAVE SOME MEMBERS MISSING
WILL LEAVE THE ROLE WILL LEAVE
IT ALONE HALL THANK YOU MISTER
CHAIR THINK THINK CENTER
[inaudible]
SENATOR LEYVA
.
THANK YOU MISTER CHAIR.
GOOD AFTERNOON MEMBERS TO BEGIN
I WOULD LIKE TO THANK YOU AND
YOUR COMMITTEE STAFF BEFORE THE
TIME USE THAT WORKING WITH ME
AND MY STAFF ON THIS BILL.
I'M PLEASED TO ACCEPT THE
CHAIR'S RECOMMENDATION
RECOMMENDED AMENDMENTS THAT
SIMPLIFY THE ILL SIGNIFICANTLY.
AMONG OTHER THINGS THESE
AMENDMENTS REMOVE THE SIXTY DAY
NOTICE REQUIREMENT.
STIPULATE THAT FINANCIAL
ASSISTANT CAN ASSISTANCE CAN BE
DISCONTINUED IF A PATIENT DIES
OR OBTAINS OTHER HEALTH
INSURANCE COVERAGE.
PROHIBITS PROVIDERS FROM BALANCE
BILLING PATIENTS.
REMOVES COMPLICATED REVIEW
DETERMINATIONS.
IMPOSE ON REGULATORS AND
SPECIFIES THE PAYMENT RATE FOR
FINANCIALLY INTERESTED ENTITIES.
THIS BILL WILL PREVENT PROVIDERS
FROM GAMING THE SYSTEM AS A
MECHANISM TO ARTIFICIALLY
GENERATE THREE TO FOUR TIMES THE
MEDICARE REIMBURSEMENT RATE FOR
PROVIDING THE EXACT SAME CARE.
THIS GAMING OF THE SYSTEM IS
HARMFUL AND A COUPLE OF WAYS.
IT CAN EXPOSE THE PATIENT TO AN
INCREASED SHARE OF COSTS WITH
COPAYS AND DEDUCTIBLES AND A
COMMERCIAL PLAN.
IT PUTS PUTS PATIENTS AT RISK OF
LOSING COVERAGE IF THE PROVIDER
STOPS MAKING THEIR PAYMENTS.
IT DRIVES UP COSTS FOR EVERYONE
ELSE BY SHIFTING RISK TO FRAGILE
INDIVIDUAL MARKET.
S. B. ELEVEN FIFTY SIX PROTECTS
LEGITIMATE THIRD PARTY PAYMENT
MECHANISMS REMOVES THE INCENTIVE
FOR PROVIDERS TO GAME THE SYSTEM
AND ESTABLISHES SAFEGUARDS TO
HOLD PATIENTS.
WHO MAY HAVE INADVERTENTLY BEEN
CAUGHT UP IN ONE OF THESE
PAYMENT SCHEMES HARMLESS HERE IN
SUPPORT WITH ME TODAY?
AND YOU ONE FROM THE ASSOCIATION
OF CALIFORNIA HEALTH AND
INSURANCE COMPANIES ENGLAND
BACCHUS FROM DRUG POLICY
ALLIANCE.
THANK YOU MISTER CHAIRMAN AND
MEMBERS AND YOU ONE WITH THE
ASSOCIATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANIES
WERE STRONGLY IN SUPPORT OF SB
ELEVEN FIFTY SIX WE SEE THIS IS
A MODEST.
BUT IMPORTANT EFFORT TO ADDRESS
THE SITUATION THAT WE'VE SEEN
OCCUR IN JUST THE LAST FEW YEARS
SINCE THE PASSAGE OF THE ACA.
WHAT IS HAPPENING IS THAT SOME
PROVIDERS OF TAKING ADVANTAGE OF
THE GUARANTEED ISSUE ONCE
REQUIREMENTS OF THE ACA TO STEER
PATIENTS INTO COMMERCIAL HEALTH
INSURANCE MARKET?
BY OFFERING TO PAY FOR THE
PATIENTS PREMIUMS WHEN THE
PATIENT MAY BE ELIGIBLE FOR
MEDICARE ALLEN MEDICARE.
THEY DO THIS BECAUSE IT IS IN
THEIR FINANCIAL INTEREST TO DO
SO THEY KNOW THEY WILL MAKE MUCH
MORE FROM INSURANCE PAYMENTS TO
OUTWEIGH THE COST OF THE
PREMIUMS.
NOW MANY TIMES IS NOT IN THE
BEST INTEREST OF THE PATIENTS
AND CERTAINLY NOT IN THE BEST
INTEREST OF INDIVIDUALS AND
SMALL GROUPS STRUGGLING TO PAY
THEIR PREMIUMS.
IN THOSE MARKETS.
OTHER THAN A LOT OF PRESS
COVERAGE ABOUT AFINANCIALLY
INTERESTED OUT OF NETWORK
SUBSTANCE ABUSE DISORDER
TREATMENT FACILITIES.
AND HOW THEIR PRACTICES ARE
CAUSING HUGE BILLS FOR INSURERS
AND NOT PROVIDING SUBSTANTIVE
HELP FOR THE ADDICTED.
BUT I BELIEVE MY COLLEAGUE HERE
WILL PROVIDE MORE DETAIL ABOUT
THAT PRACTICE SO I WILL JUST
CONCENTRATE PERHAPS IN ANOTHER
AREA OF CONCERN.
WHICH IS WITH IN NETWORK
DIALYSIS CENTERS.
THE ISSUE THAT WE'RE SEEING
OCCURS WHEN THE DIALYSIS CLINIC
STAFF FIND PATIENTS WITHIN THEIR
CLINICS AND THEN STEER THEM INTO
COMMERCIAL COVERAGE WHEN THEY
WOULD OTHERWISE BE ABLE TO BE
ELIGIBLE FOR MEDICARE OUT WITH
NO SHARE OF KOSTER MEDICARE.
THE DIALYSIS PROVIDER THINK
CONNECTS THE PATIENT WITH THE
AMERICAN KIDNEY FUND WHICH IS
THE RECIPIENT OF CHARITABLE
CONTRIBUTIONS FROM THE PROVIDER
TO PAY FOR THE PATIENTS PREMIUM.
SO IT'S BASICALLY JUST A PASSED
THROUGH.
THE DIALYSIS PROVIDER THEN BILLS
INSURERS THREE TO FOUR TIMES THE
AMOUNTS THAT MEDICARE WOULD PAY.
FOR THREE TREATMENTS A WEEK FOR
MONTHS OR YEARS ON AND THE
FINANCIAL INCENTIVE IS OBVIOUS.
AND THIS IS NOT JUST A BILLING
DISPUTE BETWEEN HEALTH PLANS AND
PROVIDERS A CENTER LEYVA POINTED
OUT THERE ARE SOME REAL HARM TO
CONSUMERS.
SO WHAT DOES SQ ELEVEN FIFTY SIX
DO TO ADDRESS THE PROBLEM THE
BILL SIMPLY REQUIRES A FINANCIAL
INTERESTED THIRD PARTY PAYERS DO
THE RIGHT THING BY THEIR
PATIENTS BY KEEPING THEM ON
COVERAGE FOR A FULL YEAR.
RATHER THAN KICKING THEM OFF
WHEN HEALTH INSURANCE CAN NO
LONGER BE BUILT THEY MUST NOTIFY
PATIENTS OF THEIR OPTIONS AND
NOT STEER THEM INTO A PARTICULAR
PLAN.
AS WE CURRENTLY CHOIR OF OTHER
AGENTS AND BROKERS AND THEY MUST
LET HEALTH PLANS KNOW THAT THEY
ARE PAYING FOR THESE PREMIUMS
AND WHETHER THEY'D MET THESE
OBLIGATIONS.
NOW YOU MAY HAVE HEARD THAT THIS
BILL WILL FORCE PEOPLE INTO
MEDICARE TAKE AWAY THEIR
COMMERCIAL COVERAGE NOTHING IN
THIS BILL.
REQUIRES ANYONE TO BE ON
MEDICARE OR PROHIBITS A
FINANCIALLY INTERESTED PROVIDER
FROM PAYING THE PREMIUMS FOR
COMMERCIAL COVERAGE.
THE BILL SIMPLY TAKES THE
FINANCIAL INCENTIVE FOR DOING SO
WAY BY AUTHOR REYES NAY INSURED
TO PAY THE MEDICARE RATE WHERE
THE CONTRACT TREAT WHATEVER IS
LOWER.
WE AGREE WITH THIS COMMITTEE AND
MEMONS HE THINK MEET THEY
FURTHER STREAMLINE THIS PROCESS
AND MAKE IT MORE WORKABLE.
AND WE WOULD ASK YOUR AYE VOTE
ON THIS IMPORTANT MEASURE.
GOOD AFTERNOON MISTER CHAIRMAN
COMMITTEE GOING BACK IS FOR DRUG
POLICY ALLIANCE DRUG POLICY
ALLIANCE IS A NATIONAL ADVOCACY
ORGANIZATION.
WORKING TO END THE DRUG WAR AND
REPLACE IT WITH POLICIES THEIR
BALLOT BASED ON HEALTH PUBLIC
HEALTH COMPASSION AND HUMAN
RIGHTS.
OUR INTEREST IN THIS BILL GOES
TO THE ISSUE OF ALL THE WORK
THAT WE AND OTHER ADVOCATES DID
TO ENSURE THE SUBSIDY USE
DISORDER TREATMENT WAS IN THE A
CS.
WE DO NOT FORESEE HOWEVER
UNSCRUPULOUS PROVIDERS WOULD
SHOW UP IN CALIFORNIA AND TRYING
TO GET VANTAGE OF THE ACA BY
RECRUITING PATIENTS WITH
SUBSIDIES DISORDER FROM OUT OF
STATE.
MOVING TO CALIFORNIA AND THEN
ROLLING THEM IN THE HIGHEST
RETURN PAY PLAN THAT THEY COULD.
THIS WAS NOT MOTIVATED BY
CONCERN FOR THE PATIENT OR THE
FAMILY OF THE COMMUNITY BUT BY
GREED.
AND SO WE WANT TO SEE THAT.
PATIENTS ARE GUARANTEED.
IF THEY ARE RECRUITED INTO
TREATMENT THAT FIRST OFF THEIR
FULLY INFORMED OF THEIR OPTIONS
WHICH IS FAIR FOR EVERY PATIENT
INCLUDING A PERSON WITH THE
SUBSIDIES DISORDER AND THEIR
FAMILY.
THEY'RE GUARANTEED TO YEARS
COVERAGE IS OUR PRIMARY INTEREST
AS MANY OF YOU KNOW THERE WAS A
LOT OF COVERAGE OF THIS PICKED
OUT OF ORANGE COUNTY.
THAT PEOPLE RECRUITED FROM OUT
OF STATE BROUGHT TO CALIFORNIA.
THEY RAN THE INSURANCE PREMIUM
UP TO ITS MAXIMUM PAYMENT.
AND THEN THEY KICKED THEM TO THE
CURB QUITE LITERALLY TO THE CURB
WHERE THEY WERE THEN HOMELESS IN
ORANGE COUNTY.
THEY WERE PENDANT ON STREET
SERVICES E. OURS AND THEY HAD NO
WAY TO GET HOME WITH THAT HOME
WAS OHIO WHERE I WORK SOMEPLACE
ELSE. FOR THESE REASONS WE LIKE
TO MAKE SURE THAT FAMILIES OF
ADDICTED PERSONS PEOPLE
SUBSTANCE ABUSE DISORDERS.
ARE FULLY INFORMED AND HAVE
ACCESS TO THE HEALTH CARE
INSURANCE IS APPROPRIATE TO
THEIR NEED THANK YOU.
Q. OTHER WITNESSES IN SUPPORT
JUST YOUR NAME AND ORGANIZATION.
MISTER CHAIR MEMBERS TERAFLOPS
CALIFORNIA LABOR FEDERATION IN
SUPPORT THANK YOU.
GOOD AFTERNOON TIM VALDERRAMA
WITH THE WHITEMAN GROUP ON
BEHALF OF SEIU STATE COUNCIL IN
STRONG SUPPORT [inaudible]
IF YOU.
CARLA SUPPORTER BLUESHIELD OF
CALIFORNIA AND SUPPORT.
JENNIFER I CALIFORNIA
ASSOCIATION HEALTH PLANS IN
SUPPORT.
JOHN WINGER OF F. AMERICA'S
HEALTH INSURANCE PLANS AND
SPORT.
SHERRI DAILY CALIFORNIA
CONSORTIUM OF ADDICTION PROGRAMS
AND PROFESSIONS AND SUPPORT.
MARY THERE THE COUNTY BEHAVIORAL
HEALTH DIRECTORS ASSOCIATION IN
SUPPORT.
THERESA START WITH KAISER
PERMANENTE IN SUPPORT.
MENU GONZALEZ DIALS'S WORKER A
CARETAKER FOR MY FATHER WHO'S
BEEN ON DIALYSIS TWENTY ONE
YEARS IN STRONG SUPPORT.
IF YOU SEE WHAT DIFFICULT ROAD
WITH SUPPORT THE ELEVEN FIFTY
SIX LOW PROTEST DIALYSIS NURSE
FOR TWENTY FIVE YEARS IN
SUPPORT.
IT'S AND THE MAGICAL DAY HOUSES
WORKER IN STRONG SUPPORT.
THEN THE GUY NO PATIENT CARE
PROVIDER I SUPPORT.
YOLANDA VILLANUEVA.
MY FAMILY HAS DIED OF KIDNEY
DIALYSIS DUE TO ELUDE THE LACK
OF CARE.
I'M IN SUPPORT.
FRED LAKE DIALYSIS WORKER FOR
TWENTY YEARS [inaudible]
I SUPPORT.
SHERRY ACHES A DIALYSIS CHECK
FOR SEVENTEEN YEARS I SUPPORT.
PAUL MERCHANT BIOMEDICAL DOWSERS
WORKER AND SUPPORT.
SURE AMBER EXPLOIT COMMUNITY
TEAM LEADER.
SACRAMENTO SEIU HW AND I AM IN
SUPPORT.
AS OUR BOSSY AMADEUS'S WORKER
AND I AM SUPPORT.
MY NAME ITS A MAGELLAN HANFORD
DIALYSIS NURSE FOR SEVENTEEN
YEARS.
I JUST WANNA LET THIS COMMITTEE
KNOW THAT I'VE SEEN THIS SCHEME
IN FULL EFFECT FOR YEARS NOW
JUST AND I'M ROSE DEADLY AND
CLOSE SUPPORT.
REPIX CALIFORNIA DISABILITY
RIGHTS STRONG SUPPORT
[inaudible] ONE OUNCE.
THE KNOW WILL BRING IN A BRIEF
BACK -- IS
THERE ANYONE IN OPPOSITE
.
MISTER CHAIRMAN THE MEMBER SCOTT
WORSHIP HAVE TO CALIFORNIA STATE
ASSOCIATION OF ELECTRICAL
WORKERS TO CALIFORNIA STATE
PATRIOTS COUNCIL.
AND THE WESTERN STATES COUNCIL
SHEET METAL WORKERS.
THE ISSUE THAT MY HEALTH TRUST
FUNDS HAVE WITH THIS BILL IS ON
THE DIALYSIS SIDE NOT ON THE
DRUG TREATMENT SIDE.
EVEN WITH THE LAST THEIR
AMENDMENTS AS I UNDERSTAND WHICH
I THINK IMPROVES UPON THE BILL.
IT STILL IS BEYOND ME WHY
[inaudible]
THIS LEGISLATURE.
WE WANT TO TAKE WORKERS.
WHO HAVE FALLEN ON HARD TIMES?
WHO ARE GROSSLY ILL?
AND PUSH ALLOW EACH YOU MOST TO
PUSH THEM ON TO MEDICARE.
SO THAT THEIR FAMILY MEMBERS.
ARE THEN LEFT WITHOUT HEALTH
INSURANCE.
LET ME GIVE YOU AN EXAMPLE.
IT IS IN A UNION TRUST FUND
MULTI EMPLOYER TRUST FUND.
AND EMPLOYER PAYS A CERTAIN
AMOUNT PER HOUR TO A MEMBERS
HEALTH CARE ACCOUNT.
THEY DRAW DOWN THAT ACCOUNT ON A
MONTHLY BASIS.
WHEN THEY GET TOO IF THEY GET
UNEMPLOYED AS WE DO AND
CONSTRUCTION ON A REGULAR BASIS
MY MEMBERS WILL BE OUT OF WORK
SOMETIMES A YEAR OR TWO YEARS?
WHEN THEY RUN THEIR COUNT DOWN?
TO ZERO THEY GET COBRA.
MEANING THEY HAVE TO PAY OUT OF
THEIR POCKET. TO MAINTAIN THEIR
HEALTH INSURANCE NOT JUST FOR
THEM.
BUT FOR THEIR FAMILY.
I KNOW OF TWO INSTANCES WHERE
MEMBERS OF MINE HAVE RECEIVED
GRANTS THAT HAVE HELPED THEM
MAINTAIN THEIR HEALTH INSURANCE.
NOT FOR THEMSELVES BECAUSE THEY
COULD GOING TO MEDICARE.
BUT FOR THEIR FAMILY.
SO IT IS BEYOND ME WHY.
IT'S A DEMOCRATIC PRINCIPLE THAT
WE WANT TO FORCE WORKERS.
OUT OF THEIR HEALTH INSURANCE
FOR THEIR FAMILIES SO THAT.
H. YOU MODES CAN SAVE A FEW
MONTHS WORTH THE MONEY.
BECAUSE REMEMBER THERE ARE THE
CAPTIVE THIRTY MONTHS.
BEFORE SOMEBODY WITH ON DIALYSIS
GETS PUSHED.
I TO MEDICARE.
SO IS THAT REALLY WHAT WE WANT
TO DO.
TAKE HEALTHCARE AWAY FROM
FAMILIES KNOW THEY COULD GOING
TO MEDI CAL.
IF THE SPEND DOWN THEIR ASSETS
ALL THE WAY DOWN TO TWO THOUSAND
DOLLARS.
SO I DON'T WANT TO PUT MY MEMBER
IN A POSITION OF HAVING TO SAY
YOU HAVE TO SELL YOUR HOUSE.
AND SPENT EVERY PENNY OF IT.
ON HEALTH CARE.
SO YOUR FAMILY CAN GET ON MEDI
CAL WHEN YOU COULD JUST BE IN
OUR UNION TRUST FUND.
UP BLUE SHIELD OR A BLUE CROSS
THE HEALTH PLAN THROUGH THOSE
REASONS I THINK THIS BILL IS
FLAWED ON THE DIALYSIS.
THANK YOU.
BY BY EARLY AGREEMENT WE'D
AGREED FOR THREE WITNESSES A TWO
MINUTE SCENE SO.
SO YOU KNOW WHERE.
SO SO THAT EVERYBODY IN THE
AUDIENCE NOW SO YOU'VE GOT A
COUPLE MINUTES.
GOOD AFTERNOON CHAIRMAN WOOD AND
MEMBERS OF THE ASSEMBLY HEALTH.
I'M LEVINE BURDEN PRESIDENT AND
CEO OF THE AMERICAN KIDNEY FUND
LAST YEAR WE HELPED OVER FOUR
THOUSAND LOW INCOME
CALIFORNIANS.
OUGHT TO PAY FOR THEIR HEALTH
INSURANCE PREMIUMS.
I'M HERE TODAY IN OPPOSITION TO
SB ELEVEN FIFTY SIX DUE TO SOME
CHALLENGES THAT REMAIN IN THE
CURRENT VERSION.
WE ARE EXTREMELY GRATEFUL TO YOU
CHAIRMAN WOULD MD ASSEMBLY
HEALTH COMMITTEE FOR INTRODUCING
SIGNIFICANT AMENDMENTS TO THE
BILL.
THESE AMENDMENTS WILL ELIMINATE
MANY OF THE PROVISIONS THAT
WOULD HARM COVERAGE AND CARE FOR
CALIFORNIA DIALYSIS PATIENTS
THAT WOULD HAVE BEEN CAUSED BY
THE SENATE VERSION OF THE BILL.
WE THANK EACH MEMBER FOR
SPENDING THE TIME THAT YOU HAVE
WITH PATIENTS FROM YOUR
DISTRICTS OVER THE LAST SEVERAL
WEEKS.
WE THANK THE CHAIRMAN AND THE
COMMITTEE FOR PUTTING FORTH
AMENDMENTS TO ELIMINATE THE
REQUIREMENT THAT PATIENTS
RECEIVING CHARITABLE PREMIUM
ASSISTANCE.
MUST FIRST APPLY FOR MEDICARE
AND MEDICAID OBVIOUS AND WAIT
SIXTY DAYS BEFORE THEY COULD
RECEIVE ASSISTANCE.
WE BELIEVE THAT THE CHANGES THAT
HAVE BEEN ACTIVE GO A LONG WAY
IN IMPROVING THE BILL
[inaudible]
HOWEVER.
WE ARE UP WE REMAIN CONCERNED
ABOUT ISSUES THAT MAKE IT
DIFFICULT FOR US TO SUPPORT THIS
BILL IN ITS CURRENT FORM.
LET ME BE ABSOLUTELY CLEAR OUR
CONCERN IS NOT ABOUT
REIMBURSEMENT RATES WE ADAMANTLY
BELIEVE THAT RACE SHOULD BE
NEGOTIATED BETWEEN INSURERS AND
PROVIDERS.
OUR CONCERN IS ABOUT MAINTAINING
SUFFICIENT BALANCE IN THE SYSTEM
TO ENSURE ACCESS FOR PEOPLE WHO
ARE ON DIALYSIS.
WHILE WE THINK THAT IT WAS NOT
THE INTENTION OF THE COMMITTEE.
THE REWRITE POTENTIALLY CAUSES
NEW ISSUES FOR PATIENT ACCESS.
ESPECIALLY FOR THOSE PEOPLE WHO
LIVE IN INNER CITY AND RURAL
AREAS.
CHARITABLE PREMIUM ASSISTANCE
DOES NOT HAVE A VALUE OF
PATIENTS IN THESE AREAS CANNOT
FIND A PLACE TO RECEIVE THEIR
CARE.
OUR CONCERN IS THAT ELEVEN FIFTY
SIX SB ELEVEN FIFTY SIX AS
CURRENTLY WRITTEN.
COULD LEAD TO THE CLOSURE OF
DIALYSIS CENTERS AND THEY ARE
FIVE THREATEN PATIENT ACCESS.
IT IS CRITICALLY IMPORTANT THAT
THE COMMITTEE ANALYZE THIS ISSUE
BEFORE PASSING LEGISLATION THAT
HAS THE POTENTIAL TO DISRUPT THE
AVAILABILITY OF CARE FOR SOME OF
CALIFORNIA'S MOST MEDICALLY
VULNERABLE CITIZENS.
I PATIENTS CANNOT GET TO CARE
BECOME THE CLINIC IS CLOSE
THEY'RE HELPFUL SUFFERED GREATLY
AND THE COST OF CARE WILL
INCREASE AS THEY WILL BE
HOSPITALIZED MORE AND WILL SEEK.
ARE CURATIVE CARE AND OTHER
TREATMENTS.
WE CAN ALSO TELL YOU THAT THERE
IS A LONG HISTORY AND MEDICARE.
ABOUT ESTABLISHING A BALANCE
BETWEEN PUBLIC AND PRIVATE
REIMBURSEMENTS AND THAT IS
ABSOLUTELY ESSENTIAL TO MAKE THE
ENTIRE SYSTEM WORK.
OUR PROGRAM AT THE AMERICAN
KIDNEY FUND WAS ESTABLISHED
TWENTY ONE YEARS AGO UNDER
FEDERAL ADVISORY OPINION TO
ENSURE THAT WE WOULD BE ABLE TO
SUPPORT PATIENTS ABILITY. TO
CHOOSE THE INSURANCE THAT BEST
MEETS THEIR FINANCIAL NEEDS THIS
IS THE COMBINATION OF PUBLIC AND
PRIVATE.
PASSING LEGISLATION THAT SAYS
PROVIDERS WILL BE A REIMBURSED
AT THE MEDICARE RIGHT FOR
PATIENTS WHO RECEIVED CHARITABLE
ASSISTANCE SEEMS TO RUN CONTRARY
TO THREE DECADES A STATUTE AND
REGULATION.
AT THE FEDERAL LEVEL.
THIS WELL ESTABLISHED HISTORY
RECOGNIZES THE REALITY THAT
PUBLIC PROGRAMS AND PRIVATE
INSURERS MUCH SHARE THE BURDEN
OF COVERING THIS POPULATION.
I WOULD THEREFORE URGE THE
COMMITTEE TO CONSIDER THE
POTENTIAL BROADER IMPLICATIONS
OF THE PAVEMENT MEASURES OF THE
BILL.
IN ADDITION WE ARE ALSO
CONCERNED ABOUT ISSUES ARE
PROVISIONS IN THE BILL THAT
WOULD MAKE IT IMPOSSIBLE FOR US.
TO PROVIDE CHARITABLE ASSISTANCE
BASED UPON OUR MISSION AS IT
WOULD BE LIMITED ONLY TO
FINANCIAL NEED WE HAVE TO LOOK
AT THE FACT THAT THE AMERICAN
KIDNEY FUND FOR ALMOST HALF A
CENTURY.
HAS BEEN ESTABLISHED NOW TO
PROVIDE ASSISTANCE TO PEOPLE WHO
ARE HAVE TRANSPLANTS OR WHO ARE
ON DIALYSIS MAKING SURE THAT
THEY GET THE CARE THEY NEED.
I WOULD ALSO URGE YOU TO
REMEMBER THAT YOU CAN SAY IT AS
MANY TIMES AS YOU WISH BUT
AMERICA KIDNEY FUND NOT A
FINANCIALLY INTERESTED
ORGANIZATION WE URGE YOU TO TAKE
A LOOK AT THE IMPLICATIONS OF
THIS BILL BEFORE YOU PASS IT.
IF YOU WE HAVE NOW EXCEEDED
SEVEN MINUTES MIGHT BE GREEN IT
WAS THREE THREE WITNESSES TWO
MINUTES EACH SO I'M GONNA ASK.
FOR THE WITNESSES THEIR NAME AND
POSITION ON THE BILL ONLY HOUSE
ONE POINT OUT TO THE COMMITTEE
THAT THIS MOCKUP IS NOT
COMMITTEE MARKUP THIS IS A MOCK
UP.
FROM THE FROM THE CALIFORNIA
DIALYSIS COUNCIL SO IT LOOKS
VERY MUCH LIKE OUR MOCK UP AND
JUST WANT TO POINT OUT THAT
THERE IS A MARKET THAT IS.
FROM THEM WITH SUGGESTED
AMENDMENTS SO WITH THAT --
I APOLOGIZE WE WERE PRETTY CLEAR
ABOUT WHAT WE WERE WE WE WE ASK
--
WE WERE ASKED THREE WE WERE
GIVEN THREE WITNESSES TWO
MINUTES EACH WE WENT PAST THAT
WENT TO SEVEN MINUTES AND SO
JUST ASKING NOW.
FOR NAME AND POSITION ON THE
BILL PLEASE.
JAN THE WALL IS A PATIENT.
YES GOOD AFTERNOON CHAIRMAN
WOULD AND COMMITTEE MEMBERS.
YEAH I THINK YOU VERY MUCH FOR
THE OPPORTUNITY TO SPEAK TO YOU.
I'D LIKE TO SPEAK ADDITION.
PARDON YOU JUST YOUR NAME AND
POSITION ON THE PREVIOUS
WITNESSES TOOK YOUR TESTIMONY
TIME AND MY NAME IS JANET DEWALD
AND I AM A DIALYSIS PATIENT --
I AM A DIALYSIS PATIENT BECAUSE
EVER YEARS BUT I'M.
AGAIN AND I OPPOSE A THEY LET US
SENATE BILL [inaudible]
ELEVEN FIFTY SIX OTHERS.
YOUR NAME AND POSITION.
HI GOOD AFTERNOON SHANNON SMITH
CROWLEY REPRESENTING THE
CALIFORNIA COALITION.
OF ACCOUNT CALIFORNIA CHRONIC
CARE COALITION WITH IMPOSE LESS
AMENDED POSITION.
A MISTER CHAIR AND MEMBERS
MICHAEL ARNOLD REPRESENTING THE
CALIFORNIA DIALYSIS COUNCIL AND
WE DID PASS OUT THE AMENDMENTS
FOR YOU.
OUR PROBLEM WITH THE AMENDMENTS
PROPOSED BY THE COMMITTEE IS
SIMPLY THAT IT BECOMES A RATE
SETTING BILL.
THE SETTING MEDICARE AS THE RATE
THAT WOULD BE PAID AND WE THINK
THAT'S A VERY SLIPPERY SLOPE
THANK YOU.
NAY NAY HAD AFTER SURGERY TOSSED
OUT A LICENSED CLINICAL SOCIAL
WORKER TWENTY SIX YEARS AN
APOLOGY AND I OPPOSE THANK YOU.
CHRIS PROBABLY LICENSED CLINICAL
SOCIAL WORKER FOR THIRTY YEARS
AND I OPPOSE THINK --
MISTER CHAIR MEMBERS WANT TOM
CERTAIN CALIFORNIA MEDICAL
ASSOCIATION ON THE AMENDMENTS --
WELL I GUESS THERE'S NEW MEMBERS
SO WE HAVEN'T SEEN OF THE
MEMBERS THAT WE HAVE SEEN OUR WE
HAVE CONCERNS ABOUT LINKING
MEDICARE TO COMMERCIAL PRODUCTS.
OTHER NOW WE THINK TO MAKE THEM
SO WE HAVE SEEN MOVE IN THE
RIGHT DIRECTION AND WE LOOK
FORWARD TO CONTINUE
CONVERSATION.
YOU'RE A TWEENER.
MISTER CHAIRMAN RESULT SOUTH OF
THE CALIFORNIA ASSOCIATION AND
WE APPRECIATE THE AUTHOR'S WORK
ON WITH THE COMMITMENTS WE
REMAIN IN OPPOSITION LOOK FOR
CONTINUING.
KEVIN BEAT MEN OPPOSED.
CASSANDRA ARMY DIALYSIS WORKER
AND I OPPOSE.
I'M ANGELA CHáVEZ SEVENTEEN
YEARS IN A FRAWLEY GI POST
ACUTE.
JOHN ON OPPOSED.
THINK HERE.
CHRISTY CASEY OPPOSED.
I CAN'T JOHNSON OPPOSED.
NGUYEN SINCE OUTSIDE OF DALLAS
IS NOT FIVE BOOKS.
SIGN ESCOBAR PATIENT CARE FOR
EIGHTEEN YEARS OPPOSE. FOR
DARIUS --
REGISTERED NURSE FOR ABOUT TEN
YEARS NOW AND OPPOSE THIS BILL.
MARYLAND THESE SIGNS DIALYSIS
ARE AND FOR EIGHTEEN YEARS AND I
OPPOSE THINK YOU.
BERNADETTE RALLY I OPPOSE CLICK
HERE.
SHEILA SIMON PCT I OPPOSE.
AARON LEVI FOR SATELLITE
HEALTHCARE BECAUSE JOSEPHINE
COMMONERS FOR FIFTEEN YEARS FROM
YOUR POST.
GARY FOR CHEAP PERSON IS KIDNEY
CARE I OPPOSE.
STACY MARTIN DIALYSIS ARE AND
FOR NINE YEARS AND I OPPOSE.
AND KNOW BONTA THIRTY YEAR
DIALYSIS NURSE AND I OPPOSE.
I DON'T KNOW SEEING FIFTEEN
YEARS OF DOZENS TECHNICIAN
APPLES.
BILL MAHER NET DIABLES.
VERONICA FLORES MCGREAL CSW --
AND AYE OPPOSED.
AND MAKE HELL LCSW AND I OPPOSE.
ANGELIC UP WHEN THEY'RE
REGISTERED NURSE [inaudible]
I OPPOSE.
ANGELA RETALIATED TWENTY THREE
YEARS ARE REGISTERED NURSE
DIALYSIS --
I POSE.
CEREMONIES STYLES HIS SOCIAL
WORKER AND I OPPOSE.
HEARING HAMMER LICENSED CLINICAL
SOCIAL WORKER AND I OPPOSE
[inaudible]
SORRY.
ANDREA GOMEZ DIALYSIS
TECHNICIANS LASH ADMINISTRATIVE
ASSISTANT AND DAUGHTER OF A TEN
YEARS DIALYSIS PATIENT.
AND I OPPOSE.
CAROLINE MEMBACA WHEN LCSW FOR
THE PAST EIGHTEEN YEARS AND
DIALYSIS AND I OPPOSE.
KENDER BLANCHETTE I'M A
REGISTERED DIETITIAN FOR TWENTY
FIVE YEARS AND I'LL ASSIST CARE
GIVER AND I OPPOSE.
DATA MICHELLE REGISTERED NURSE I
OPPOSE.
ASHLEY SLOAN I OPPOSE.
WILBUR OUR AYE OPPOSE.
DINI SIMPSON LICENSED CLINICAL
SOCIAL WORKER AND I OPPOSE.
TINA CRITICAL PATIENT CARE
TECHNICIAN I STRONGLY OPPOSE.
KIM MOLOT FORTY YEAR CARE
PROVIDER I OPPOSE.
MARIO AVIVA'S AND I STRONGLY
OPPOSE.
SHARON JONES EIGHTEEN YEAR
DIALYSIS PATIENT AND I OPPOSE.
KIMBERLY BAILEY THIRTY YEAR OLD
DIALYSIS NURSE INNER CITY I
STRONGLY OPPOSE.
HOW ACTION AND IT'S REGISTERED
NURSE I OPPOSE [inaudible]
YOU.
SHEILA NOW DIALYSIS DIETITIAN
AND I OPPOSE.
MARIN HER ADHA DIALYSIS SOCIAL
WORKER AND I OPPOSE Q..
SETH MILLER I OPPOSE.
TELL HER I'LL POST.
JORDAN GERSHMAN I OPPOSE.
ERIK MENENDEZ I OPPOSE.
DANIELLE LEWIS I OPPOSE.
RUSSELL DESMOND CURRENT DIALYSIS
PATIENT AND I POST.
JACKSONMALINOWSKI I OPPOSE.
TIES ATTORNEY CAN NOW POST.
BELIEVE ME POINTERS ON BEHALF OF
THE PERCENT IS MEDICAL CARE --
IN OPPOSITION UNLESS THE
CALIFORNIA DIALYSIS COUNCIL
AMENDMENTS WERE ADOPTED.
YES ECONOMY BASS --
PATIENT CARE TECHNICIAN FOR
SEVENTEEN YEARS AND FAMILY
MEMBER OF THREE DIALYSIS PATIENT
I OPPOSE.
GREAT COME UNDONE AYE OPPOSED TO
BE [inaudible]
ANYONE ELSE.
SEE KNOWINGLY BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS
COMMENTS [inaudible]
DETERMINE.
CAUSE ARE MISSING HERE CURRY.
HARVEST CARILLO QUICK DEBATING
WAS GONNA GO FIRST.
OKAY MISS KOREA THANK YOU.
THANK YOU SENATOR FOR BRINGING
THIS TO OR ATTENTION AND THANK
YOU TO ALL THE WITNESSES THAT
HAVE.
TESTIFIED TODAY BOTH IN SUPPORT
AND OFFICES.
I'VE HAD THE GREAT OPPORTUNITY
TO ACTUALLY MEET WITH SEVERAL
FOLKS THAT ARE IN SUPPORT AND
OPPOSITION AND TRYING TO
UNDERSTAND.
THE PURPOSE OF YOUR BILL.
AND I UNDERSTAND THAT THERE ARE
REAL ISSUES OF MANIPULATIONS
WITH SOME SUBSTANCE ABUSE
PROVIDERS ESPECIALLY THOSE THAT
IMPORT.
PEOPLE THAT NEED REAL CARE TO
OUR STATE UNFORTUNATELY LEFT
BEHIND AND I THINK THAT'S A REAL
CONCERN.
THIS ACTUALLY HITS REALLY CLOSE
TO HOME FOR ME MY AUNT IS A
RECIPIENT OF DIALYSIS CARE.
AND I'M TRYING TO UNDERSTAND
WHAT SHE GOES THROUGH EVERY DAY
AS I TRY TO UNDERSTAND WHAT THE
WORKERS GO THROUGH PAIN TERMS OF
ENSURING THAT THERE ARE STAFF TO
PATIENT RATIOS THAT ARE.
GOOD FOR ALL THE ENVIRONMENT AND
THOSE INVOLVED.
LET ME --
GIVE SOME PAUSE AS TO SOME OF MY
CONCERNS --
I'M CONCERNED HOW THIS
LEGISLATION WHAT IMPACT SOME ARE
OUR MOST VULNERABLE COMMUNITIES
TERMS OF THE POOR.
AND THE UNDOCUMENTED WHO DON'T
HAVE ACCESS TO MEDICARE.
AND MEDICAID FOR THAT REASON.
ADDITIONALLY IMAX IMAX THE
CONCERNED THAT THE HOUSE OF
LABOR HASN'T COME TOGETHER TO
FIGURE OUT HOW WE'RE GONNA HAVE
OR HOW UGLY PURSE GONNA WORK
TOGETHER TO ENSURE THAT ALL
WORKERS --
HAVE ACCESS TO HEALTHCARE AND IN
THE TESTIMONY TODAY.
BY THE REPRESENTATIVE FOR THE
CALIFORNIA STATE ASSOCIATION OF
ELECTRICAL WORKERS THE
CALIFORNIA STATE PRIDE PATRIOTS
COUNCIL IN THE WESTERN STATE
COUNCILS OF SHEET METAL WORKERS
I AM HOPING THAT THERE'S AN
OPPORTUNITY TO COME TO THE TABLE
AND ACTUALLY RESOLVE SOME OF THE
CONCERNS.
HOW MUCH LIKE THE TERRIBLE
FOUNDATIONS AND THE AMERICAN
KIDNEY FUND WHICH TESTIFIED
TODAY?
SEVERAL UNIONS HAVE HEALTH CARE
TRUST THAT ACTUALLY ENABLE THE
WORKERS AND THEIR FAMILIES TO
CONTINUE TO HAVE HEALTHCARE AND
THIS IS ESPECIALLY IMPORTANT FOR
CONSTRUCTION WORKERS.
WHOSE WORK IS OFTEN IN FLUX AND
I WORRY THAT IF A WORKER GOES ON
MEDICARE THEIR FAMILIES ALSO
LOSE HOT.
SO I LIKE TO ADDRESS SOME OF
THOSE CONCERNS AS WELL --
I LOOK FORWARD TO WORKING WITH
HIM ON A QUALIFY MAY VOTE TODAY
AND HOPEFULLY WERE ABLE TO
FACILITATE A CONVERSATION TO
BRING EVERYONE INVOLVED TO
RESOLVE SOME.
THANK YOU SUMA MEMBER DO ALREADY
ANSWERED OUR IN MY CLOTHES WOULD
IF YOU'RE COMFORTABLE WITH OKAY
VERY GOOD THANK YOU VERY MUCH
FOR YOUR QUESTIONS IT IS A
CONFUSING BILL OR CAN BE OF
COMPUTING BILL.
BOMB I JUST WANT TO BE VERY
CLEAR THAT NO ONE WOULD LOSE
ACCESS TO DIALYSIS BECAUSE OF
THIS BILL THIS IS SIMPLY ABOUT
MAKING SURE NO ONE IS PROFITING.
OFF OF SOMEONE ELSE'S MISERY SO
TO SPEAK --
MISTER WET SHOE CAME IN AND KIND
OF DROPPED HIS BOMB AND THEN
LEFT HAS NEVER MET WITH ME --
I ASKED TO MEET WITH HIM AND HE
NEVER MET WITH ME SO I HEARD HIS
CONCERNS FOR THE VERY FIRST TIME
TODAY.
I SAT ON A LABOR TRUST FUND FOR
TWELVE VERY AWARE OF HOW THAT
WORKS.
IF THE MEMBER HE IS TALKING
ABOUT NEEDED THE DIALYSIS THEY
WOULD NOT BE DENIED DEL DIALYSIS
CARE.
THIS BILL WOULD NOT IN ANY WAY
SHAPE OR FORM HELP OR HURT HIS
FOR THE FAMILY MEMBER BUT THE
DIALYSIS WORKER IF THEY WERE ON
COBRA OR NOT AND COOPER WOULD
STILL HAVE ACCESS.
THIRD PARTY PAYERS CAN STILL BE
A PART OF THIS AND PAY WE JUST
DON'T WANT THEM TO BE ABLE TO
PROFIT FROM IT --
THAT ANSWER ALL OF YOUR
QUESTIONS.
OKAY COME ON UP HERE MISTER
WHICH AND ALSO MISTER CHAIR I AM
SIR FLOCKS FROM THE CALIFORNIA
LABOR FEDERATION CAN ALSO SHARE
LAVERS VIEWPOINT [inaudible]
A A SIMILAR CREEL I I I DON'T
DISAGREE WITH THE SENATOR'S
CONTENTION.
THAT ONE OF MY MEMBERS WHO NEEDS
DIALYSIS WOULDN'T CONTINUE TO
GET DIALYSIS [inaudible]
BUT EVERY TRUST FUND WOULD SOME
BECOMES ELIGIBLE FOR MEDICARE
BECAUSE OF AGE OR BECAUSE OF
SOME OTHER QUALIFYING FACTOR.
IN THEY ARE THE IN ROLE WE AND
THEY GOING TO MEDICARE.
THEIR FAMILY IS THEN DROPPED
FROM COVERAGE BECAUSE THERE ARE
NO LONGER AN ACTIVE PARTICIPANT
IN THE TRUST.
THERE ARE NO LONGER RECEIVING
THEIR HEALTHCARE THROUGH THE
TRUST SO THEN THE FAMILY MEMBERS
ARE GOING TO BE LEFT.
IN YOU AT THIS IS AN ISSUE JUST
FOR MY MEMBERS ANY WORKER YOU
CARE ABOUT OTHER WORKERS.
IF ANY IF IF THE OF A WORKER
WHOSE OBTAINING PRIVATE HEALTH
INSURANCE EITHER THROUGH THEIR
AMP THROUGH THEIR EMPLOYER.
IS FORCED ON A MEDICARE.
THEY LOSE COVERAGE FOR THEIR FOR
FOR THEIR WIVES THEIR BABIES AND
THEY AND THEY THEN HAVE TO GO ON
MEDI CAL BUT YOU DON'T QUALIFY.
ON MEDI CAL INTO YOU HAVE ASSETS
OF NO MORE THAN TWO THOUSAND
DOLLARS SO YOU'RE FORCING THAT
WORKER TO HAVE TO SPEND DOWN
THEIR ASSETS SO THEY QUALIFY FOR
MEDICAID.
AND THAT'S WHAT I OBJECT IT IF I
MAY MISTER CHAIR WHAT YOU SAID
INITIALLY IS WHEN ONE OF YOUR
MEMBERS WHO ARE MANY TIMES OUT
OF WORK FOR MANY MONTHS AT A
TIME.
AND HOUSE TO GOING COBRAR THEN
LOOSES COBRA WOULD LOSE THEIR
COVERAGE SO WHAT I WAS
RESPONDING TO WAS YOUR INITIAL
ASSERTION THAT YOUR MEMBER WOULD
LOSE COVERAGE WHAT YOU JUST SAID
ABOUT MEDICARE.
IS CORRECT BUT THAT WAS NOT YOUR
FIRST ASSERTION.
I APOLOGIZE MY LETTER TO THE
COMMITTEE WAS CLEAR I THOUGHT MY
TESTIMONY WAS CLEAR I'M NOT
DISPUTING THE FACT THAT THE THAT
THE WORKER WILL GO ON MEDICARE
AND WILL GET IS DIALYSIS.
I'M WORRIED ABOUT THE FAMILY
MEMBERS WHO HAVE TO LOSE THEIR
HEALTHCARE SO NAY CHAMO CAN SAVE
A LITTLE BIT OF MONEY.
IT'S ACTUALLY NOT WHAT THE BILL
DOES BUT WE APPRECIATE YOUR
OPINION.
PLEASE NO NO [inaudible]
WHO WIENER [inaudible]
OTHER.
I SUB COUPLE COMES SO --
THANK YOU SENATOR LIVE FOR BRAIN
FOREIGN AS YOU KNOW THE COST OF
HEALTHCARE IS CONTINUALLY GO UP.
AND THE TYPES OF PAYMENTS SINCE
RELATIONSHIPS PLAY A PART OF
THAT -- AYE
I REALLY APPRECIATE YOU GONNA DO
SOME AMENDMENTS IT TAKES MORE
TIME ON THIS.
I'M CONCERNED ABOUT MY RURAL
PEOPLE I'M CONCERNED CONSUMERS
THE MAY SUFFER UNINTENDED
CONSEQUENCES AS A RESULT OF THIS
--
SO I DON'T WANT THE NEW LANGUAGE
TO BE ANY WIDER IMPACT ON
PATIENTS AND PROVIDERS THAT ARE
GOOD ACTORS BECAUSE THERE ARE
SOME GOOD ONES THAT ARE OUT
THERE.
AND TRULY PROVIDING NECESSARY
ASSISTANCE SO ALSO PUT YOUR BILL
TODAY --
HOWEVER I HOPE TO SEE IT
CHANGING IT ONLY BETTER BY THE
TIME IT COMES TO THE FLOOR.
I APPRECIATE THAT ASSEMBLY
MEMBER WE ARE ALWAYS LOOKING FOR
OUR BILLS TO GET BETTER AND IF
YOU HAVE ANY SPECIFIC --
ISSUES OR IDEAS PLEASE LET ME
KNOW.
AND AND I WOULD JUST SAY THAT --
KF THAT THIS BILL COULD CAUSE
THE CLOSURE OF DIALYSIS CLINICS
WHICH I THINK MIGHT GO TO TO
YOUR CONCERN ABOUT YOUR RURAL
FOLKS.
BEFORE EVER INTRODUCED THIS BILL
I HAD AN OPPORTUNITY TO MEET
WITH TO THE BIGGEST --
PROVIDE DIALYSIS PROVIDERS AND
ONE OF THEM LET ME KNOW THAT
THEY WERE GOING TO CONTINUE TO
OPEN DIALYSIS --
CLINICS BECAUSE THEY WERE SO
PROFITABLE SO I DON'T KNOW THAT
WE NEED TO WORRY ABOUT THIS IN
THIS BILL [inaudible]
THANK YOU.
IT'S MY RATIOS I ALWAYS HAVE TO
WORRY ABOUT IT.
FAIR ENOUGH.
MAY WAS CHAIR OF IN JUST A FEW
QUESTIONS THAT I THINK THERE ARE
COMPLEXITIES THIS BILL OF
REGARDLESS OF WHERE PERSON.
YOU KNOW LANDS ON IT CAN TURN TO
THEIR OPINION.
TODAY WE HEARD FROM PATIENTS
SOME WHO SAID THEY SUPPORT AND
SOME SAY THEY OPPOSE AND I THINK
THAT WE OWE IT. TO THE PUBLIC
HEALTH TO HAVE A ROBUST
CONVERSATION ABOUT WHAT IS TRUE
AND WHAT IS NOT --
SO THAT WE GET ALL --
YOU KNOW MAKE A VOTE TODAY WITH
CONFIDENCE THAT WHAT WE'RE DOING
IS IN THE BEST INTEREST OF THE
PUBLIC HEALTH AND I KNOW THAT'S
YOUR ATTENTION SENATOR NIGHT
RESHAPE THAT.
YOU AND YOUR STAFF TO MAKE
YOURSELF AVAILABLE TO MEDIAN
OTHERS OF THE MEMBERS OF THIS
COMMITTEE AND I APPRECIATE THAT
--
THAT SIDE I DON'T KNOW WHAT'S
GOING ON IN THIS.
YEAH -- IN
SO YOU KNOW IF YOU USE WITH THE
CHAIR SUPPORT UNLIKE DOES*
WE MAKE IT PLAIN AND WE JUST
SAY.
WHY WE'RE DOING WHAT WE'RE
DOING?
AND WHY WE OPPOSE IT KNOW WHAT
WILL HAPPEN IF AND WHEN WE DO IT
RANK THIS BREAKDOWN RIGHT.
SO.
IF I HAD IT WRONG SISTANI BUT AS
I UNDERSTAND IT --
THAT THERE ARE SOME COMPANIES
THAT PROVIDE DIALYSIS THAT GET
UP BASICALLY [inaudible]
PROFIT.
BY USING THIRD PARTY PAYERS TEND
TO HELP.
THOSE WHO NEED DIALYSIS
TREATMENT AND THEY'RE ABLE TO
GET THERE BUT A BILL AT A MUCH
HIGHER RATE THAN THEY WOULD IF
THOSE INDIVIDUALS WERE SERVED BY
MEG CAO.
COME I DON'T HOW MUCH DOES SO
YOU'RE LEARN JUST RIGHT IRAQ I
GOTTA GO SLOW MY AND SO --
THIS BILL WOULD SAY THAT YOU
HAVE TO VERIFY THAT SOMEONE IS
ELIGIBLE FOR MEDICARE THAT IS
CORRECT AND DOES IT ALSO MEAN
THAT.
IF THAT PERSON IS ELIGIBLE THEY
CAN NO LONGER ACCEPT THAT THIRD
PARTY PAYMENT THAT DONATION BUT
THAT THEY MUST IN FACT.
BECOME A MEDIC CAO PATIENT NO
THE WOULD JUST BE THE A
REIMBURSEMENT RATE WOULD JUST BE
AT THE MEDI CAL RATE. FOR
MEDICARE RIGHT SO THEY CAN
CONTINUE TO RECEIVE THE DONATION
FROM THE CHARITABLE ENTITY YEAH
UP BUT THE PROVIDER WHO PROVIDES
THE DIALYSIS HAST ONLY BE
REIMBURSED AT THE RATE THAT THEY
WOULD IF THIS PERSON WAS ON MEDI
CAL.
THAT IS CORRECT GLAD THAT'S BEEN
CLARIFIED --
IN I WANT TO HEAR FROM THE
OPPOSITION IF ANYONE IF IF
ANYTHING THAT WE ARE SAYING.
IS DIFFERENT YES MA'AM.
THANK YOU VERY MUCH --
THANK YOU SO MUCH.
THAT THE ISSUE HERE.
IS THAT PROVIDED THE THE THE
SYSTEM.
THAT ALLOWS DIALYSIS SERVICES TO
BE PROVIDED HAS ALWAYS ASSUMED
FROM THE BEGINNING OF THE
PROGRAM.
THAT THEY ARE OUR PUBLIC
PROGRAMS THAT ARE AVAILABLE AND
MOST PEOPLE USE THOSE AND THEY
WORK WELL FOR MOST PEOPLE.
ECONOMIC ASSIST SYSTEM ALSO
ASSUMES AND THERE'S A WHOLE
HISTORY OF FEDERAL LEGISLATION
THAT THERE WOULD ALSO BE SOME
FOLKS WOULD USE PRIVATE
INSURANCE.
IT TAKES THE COMBINATION OF
THOSE THINGS TO MAKE THE SYSTEM
WORK WHEN THAT COMBINATION DOES
NOT WORK DIALYSIS CENTERS WILL
BEGIN TO CLOSE.
SOME OF THEM ALREADY LOSING
MONEY AND THE WHEN WHEN THAT
HAPPENS WHEN THOSE REIMBURSEMENT
RATES WHEN THAT BALANCE IS NOT
--
ESTABLISH MORE OF THEM WILL LOSE
AND SOME OF THEM WILL CLOSE THE
PROBLEM IS THE PEOPLE WHO ARE ON
DIALYSIS HAVE TO GO THREE TIMES
A WEEK THREE OF FOUR HOURS --
MY FRIEND HERE WHO HAS THE
DIALYSIS PATIENT UNDERSTANDS
THAT VERY WELL SHE NOW GOES TO
DIALYSIS CENTER THAT'S CLOSE TO
HER HOME.
IF CENTERS CLOSE THOSE DIALYSIS
CENTERS MAY INVOLVE A MUCH
LONGER DISTANCE OF TRAVEL WE'RE
TALKING ABOUT PEOPLE 75280% OF
WHOM ARE UNEMPLOYED BECAUSE OF
THE TREATMENT BECAUSE OF THE
DISEASE.
THEY DON'T HAVE THE MONEY.
THEY DON'T OFTEN DON'T HAVE
PRIVATE TRANSPORTATION CANNOT
AFFORD PUBLIC TRANSPORTATION DO
NOT HAVE SOMEBODY TO TAKE THEM
HOW WILL THEY GET TO THE CARE
THAT THEY NEED THAT IS THE
ACCESS ISSUE SO LET ME ASK YOU
THIS I AGREE.
I THINK WE AGREE.
AND TELL ME IF I'M WRONG I WANT
IT IS OPTIONS THAT MEDICARE
RATES ARE LOW.
AND THAT IT MAKES IT DIFFICULT
TO SERVE PEOPLE IN EVERY
SPECTRUM OF HEALTH CARE DELIVERY
BECAUSE OF THOSE RATES BEING LOW
IT MAKES A HARPER PROVIDERS. TO
SERVE EVERYONE I I THINK WE
AGREE ON THAT I THINK THAT'S A
MATTER THAT WE HAVE TO WORK ON
HOW TO INCREASE MEDICARE
REIMBURSEMENT RATES --
AND IT'S MEDICARE I STEERED YOU
WRONG BY SAYING MEDI CAL I
APOLOGIZE.
THAT OKAY --
BUT WHAT I HEARD IS THAT A
PERSON DOESN'T LOSE THE ABILITY
TO TAKE THE THIRD PARTY PAYMENTS
UNDER THIS BILL.
DO YOU DISAGREE WITH THAT DC I
YEAH YOU MISTER CHAIR DESTRUCTOR
MUCH.
AYE AYE MISS WHAT I DO HAVE SOME
QUESTIONS FOR YOU THE US LET
THEM.
GIVE PERSON WILL NOT LOSE THE
MEDICARE WILL NOT LOSE THE THIRD
PARTY REIMBURSEMENT BUT THE
THIRD PARTY REIMBURSEMENT IS OF
NO USE IF YOU DON'T HAVE A
CENTER WHERE YOU CAN GO TO GET
DIE OUT UNDERSTOOD.
UNDERSTOOD THAT AND SO I THINK
AT LEAST FOR NOW FEELS LIKE THIS
CLARITY ABOUT THAT PART OF THE
BILL.
IN ITS COMPLEXITIES THE SECOND
PART IS THE PART THAT HAS TO DO
WITH THOSE --
FOLKS WHO WORK IN LABOR WHO
SOMETIMES HAVE SEASONAL WORK AND
SOMETIMES --
HAVE TO GO --
ON COBRA AND YOU KNOW I I WAS
CONCERNED HEAR THAT SOMEONE
WOULD BASICALLY HAVE TO GIVE UP
THEIR INSURANCE OR FOR THEIR
DEPENDENTS.
IN ORDER TO RECEIVE BENEFITS
BECAUSE REQUIREMENTS OF THIS
BILL.
THAT IS THAT IS NOT WHAT WOULD
HAPPEN IF SOMEONE HIT THE THAT
MEMBER.
YOU KNOW BETTER THAN I MISTER
WHICH PLEASE ANSWER [inaudible]
MISTER CHAIRMAN --
IT WOULD WHEN YOU ARE CO BRED.
AND YOU ARE PAYING AND YOU CAN'T
AFFORD TO PAY THAT ANY LONGER.
AND YOU FALL OUT OF YOUR HEALTH
CARE YOU GOING TO MEDICARE --
YOUR FAMILY MEMBERS DON'T FOLLOW
WITH YOU OKAY MEDICARE'S GOING
TO BE FOR THE FOR THE PERSON
WITH THE REAL DISEASE THEY'RE
GONNA GO ON MEDICARE THEIR
FAMILY WHICH WAS GETTING THEIR
EMPLOYER HEALTH CARE.
ARE GONNA BE DROPPED RIGHT.
THAT'S IN IT IN.
I'M STILL TRYING LOOK AT THE
AMENDMENTS WERE TAKEN AT THE
BACK BUT MY UNDERSTANDING PLEASE
CORRECT ME IF I'M WRONG.
IS THAT THE BILL IS STILL
PERMISSIVE FOR THE HEALTH PLAN
TO ACCEPT THE GRANTS THAT HAS
NOT CHANGED TO YOUR FIRST
QUESTION.
MEANING IF YOU VOTE FOR THIS
BILL YOU'RE GIVING THE
FLEXIBILITY TO THE HMO TO SAY NO
WE'RE NOT GONNA TAKE THE GRANTS
AND THAT'S THAT'S IT MUST BE
AMENDMENTS THAT WERE TAKEN
EARLIER.
CHANGE THAT THE BILL AS WRITTEN
IS STILL MAY.
OKAY SO WE'RE GONNA GO TO THAT
BUT BEFORE WE DO I LIKE TO ASK
YOU MISTER WHICH AND THEN THE
AUTHOR.
I I I I FAMILIAR WITH COBRA.
AND I'M FAMILIAR WITH SOME OF
THE WORK THAT YOU MEMBERS DO AND
THAT IT CAN BE SEASONAL.
AND IT WOULD BE A CONCERN TO ME
IF SOMEONE WAS ESSENTIALLY
FORCED TO GIVE UP THEIR
INSURANCE FOR THEIR FAMILY
MEMBERS FOR THEIR DEPENDENTS.
I WANT TO ASK THE AUTHOR HOW THE
BILL SPEAKS TO THAT BECAUSE I
UNDERSTAND THAT THE BILL WAS STE
WHO AT LEAST ATTEMPTING TO
CREATE.
SOME WORKAROUNDS --
FOR FOLKS WHO FALL IN A UNIQUE
SITUATION LIKE THOSE THAT YOU
READ
BUT BEFORE BEFORE YES APPRECIATE
I APPRECIATE THE QUESTION THE
OFFER SOMETHING THAT MAYBE THAT
TERRIFIES AND MAYBE DOES AND I'M
NOT TRYING TO MUDDY THE WATER
WHICH IS ALREADY REALLY.
WHY NOT LET'S PUT SOME MORE
MONEY?
LOOK MY AMENDMENTS WERE INTENDED
TO AVOID DISRUPTION FOR
PATIENTS.
BUT ELIMINATE THE FINANCIAL
INCENTIVES.
THAT WAS MY INTENTION NOTHING IN
THE BILL WILL TO PROHIBIT THE
COMPANIES FROM CONTINUING TO
DONATE TO FOUNDATION SET UP TO
HELP PATIENTS.
BUT THIS WILL TEST WHETHER
COMPANIES ARE MAKING THE
DONATIONS TO TRULY HELP PEOPLE
OR JUST TO AUGMENT THEIR BOTTOM
LINE.
SO SYMPATHETIC AS PEOPLE --
ARE HERE YOU KNOW ABOUT I MEAN I
CAN APPRECIATE WHERE YOU'RE
COMING FROM --
MISTER WET WE ALL HAVE TO DEAL
WITH THAT IT WITH COBRA AT SOME
POINT YES IT IT IS A IT IS IT IS
IT IS AN ISSUE SO.
I DON'T KNOW IF I MADE IT CLEAR
ARE MADE HERE NO NO I THINK
MISTER CHAIR YOUR YOUR RE
STATEMENT ABOUT THE AMENDMENTS
IS HELPFUL.
I THINK WE HAVE ESTABLISHED THAT
--
EVEN IF THIS BILL PASSES THAT --
A THIRD PARTY CAN STILL MAKE A
DONATION.
AND AND OF THE REPRESENTATIVE
FROM THE AMERICAN CAN FUN ALSO
AGREED THAT THAT IS STILL THE
CASE THAT NOW THEY HAVE A
DIFFERENT ARGUMENT.
THEIR THEIR ARGUMENT IS THAT.
THEY'LL BE LESS REVENUE OVERALL
TO SUPPORT THE INFRASTRUCTURE
NEEDED TO SUPPORT EVERYBODY WHO
NEED SERVICE THAT'S A DIFFERENT
QUESTION BUT AT LEAST ON THIS I
THINK WE HAVE AGREEMENT AND YOUR
AMENDMENTS.
REALLY POINT THAT OUT CLEARLY
THAT NOTHING ABOUT THIS BILL
SAYS THAT THIRD PARTIES CANNOT
CONTINUE TO CONTRIBUTE TO
SUPPORT THE HEALTH CARE NEEDS A
SOMEWHAT DIALYSIS.
I THINK WHAT WE ARE IN THE
MOMENT --
DEALING WITH SOME --
NEED FOR MORE CLARITY I'LL SAY
IT THAT WAY IS ON THIS ISSUE OF
THOSE WHO --
ARE REPRESENTED BY THE TRUSTS
WHO COULD BE SEASONALLY Y.
WORKING AND WOULD THEY BE FORCED
TO GIVE UP THEIR ASSETS. TO
ESSENTIALLY BECOME ELIGIBLE--
FOR MEDICARE --
IT IF I MAY MISTER CHARITIES I'D
LIKE TO ASK JOHN FROM SEIU TO
RESPOND.
THANK YOU JOHN ALLEN SEIU UNITED
HEALTHCARE WORKERS ALSO HERE
WITH LABOR IN STRONG SUPPORT OF
THIS BILL SPEAKING DIRECTLY TO
THE COBRA ISSUE.
TO A A SEASONAL WORKER WHO WOULD
SOMETIMES BE ON COBRA AND
SOMETIMES BE COVERED BY --
BY A TRUSTS HEALTH INSURER NO
DIFFERENT.
ANY OTHER PATIENT AND AS THE
CHAIR SAID --
THERE IS NOTHING IN THE BILL
THAT PROHIBITS A THIRD PARTY
FROM MAKING THOSE PAYMENTS TO
PROVIDE HEALTH INSURANCE
COVERAGE TO PAY THAT COBRA
PREMIUM. FOR EXACTLY THE THE
WORKER THAT WAS DESCRIBED
NOTHING IN THE BILL PROHIBITS
THAT COBRA PAYMENT.
ALL THAT WOULD HAPPEN IS THAT IF
IT IS A FINANCIALLY INTERESTED
PAVEMENT BY FINANCIALLY
INTERESTED CITY.
THEN IT WOULD TRIGGER THAT MEDIC
ABOUT LOWER OF THE MEDICARE
RATES OR THE CONTRACTED RATE.
SO THERE IS.
NO REASON WHY A PERSON WOULD BE
FORCED OFF OF COBRA.
AND ON TO MEDICARE [inaudible]
IN LESS.
THE THIRD PARTY ENTITY IS
CHOOSING TO TO NO LONGER MAKE
THOSE PAYMENTS BECAUSE THE
PROVIDER WOULD RECEIVE A LOWER
REIMBURSEMENT RATE SO THE
MESSAGE I THINK I FOLLOWED THAT
AND I THINK WHAT I HEARD YOU
SAY.
IS THAT -- A
THIRD PARTY ENTITY COULD MAKE A
CONTRIBUTION TO HELP SOMEONE WHO
IS A CORPORATE STYLE HEALTH
INSURANCE THEY CAN CONTINUE ON
THAT FORM OF HEALTH INSURANCE
AND CONTINUE TO GET.
TREATMENT DO.
THE ASSURANCE THAT THEY HAVE THE
COOPER THAT IS CORRECT IN SO OF
MR WHICH JUST SO I'M CLEAR.
ARE THERE SCENARIOS WHERE.
HAVE WE MISSED ANYTHING TO THE
ASSERTION THAT THE THIRD PARTY
SURE THIS BILL DOES NOT PROHIBIT
THE THIRD PARTY INSURERS.
FROM PAYING FOR SAY WHEN YOU'RE
MEMBERS WHO HAS CORPORATE TO
CONTINUE IN THAT SAME LINE OF
INSURANCE WE MISS ANYTHING ON
THAT NOW I NEED TO LOOK AT THE
AMENDMENTS AS ARE TAKEN THEY
WERE REFLECTED IN THE ANALYSIS
SELECT AFTER LOOKING OKAY SENT
BACK TO OUR LAWYERS THE TRUCK.
ITEMS AND SEE IF THERE'S A
IMPACT GOT A QUESTION TO THE
AUTHOR INTO THE PROPONENTS ARE
IT -- MAY BE
OPPONENTS IS THERE NYTHING
ABOUT THIS BILL THAT SAYS IF
TWENTY THREE MINUTES A MEMBER.
OF ONE OF THESE GROUPS AND IS
ALL CORPORA --
THAT HE HAS TO GIVE ME.
THAT SOMEONE WHO IS --
A SEASONAL WORKER AND CORPORATE
WOULD NOT QUALIFY.
FROM MEDICARE --
IN THEIR CURRENT FINANCIAL
SITUATION AND THAT OF THE THIRD
PARTY GROUP WAS GOING TO
CONTINUE TO SUPPORT THEIR CARE
THAT THERE WOULD BE NO REASON
UNDER THIS BILL FOR THAT TO
CHANGE BUT I DON'T MAKE ANY
ASSUMPTIONS.
THAT IS CORRECT THE I THINK THE
ONLY REASON THAT SOMEONE WOULD
NOT NO LONGER BE A COBRA IS IF
THEIR TIME RAN OUT MOST THE TIME
YOU'RE ONLY ENTITLED TO BE ON
COVER FOR EIGHTEEN MONTHS
[inaudible]
GOT IT --
ANYHOW THIS ASK FROM THOSE OF
FROM AMERICA KIDNEY FUND OR
OTHERS.
IS THERE ANYTHING THAT YOU SEE
DIFFERENTLY THAT THIS BILL SAYS
THAT A PERSON'S OWN COBRA WHO
WANT TO STAY ON COBRA WHO REALLY
DOESN'T QUALIFY FOR MEDICARE.
IN ALL LIKELIHOOD --
WOULD IT BE ABLE TO CONTINUE
RECEIVING THEIR CARE THROUGH
THEIR CORPORATE ARRANGEMENT WITH
THE SUPPORT OF A THIRD PARTY.
IS THERE ANYTHING THAT WE'VE
MISSED.
SO LONG AS WE HAD RESOURCES WE
COULD HELP THAT PERSON ARE
CONCERNED AS I MENTIONED BEFORE
IS THAT.
THE IN IN LOOKING AT THIS
LEGISLATION AS REVISED ALTHOUGH
THERE ARE A LOT OF IMPROVEMENTS
IN IT WE'RE CONCERNED THAT THERE
ARE GRAVE IMPLICATIONS FOR THE
AVAILABILITY OF DIALYSIS CARE
THAT HAVE NOT BEEN LOOK THAT
HAVE NOT BEEN CONSIDERED.
AND WE THINK THAT IN THE
INTEREST OF PATIENTS IN THE CITY
AND IN THIS CUT IN THE STATE
THAT IT IS REALLY IMPORTANT TO
UNDERSTAND ALL THE IMPLICATIONS
FOR ACCESS BEFORE THIS BILL IS
ACTED ON AYE I THINK YOU'RE
RIGHT THAT WE HAVE TO HAVE A
COMPETITION BUT THE LONG.
TERM --
ABILITY OF OUR STATE AND NATION
TO SERVE A DIALYSIS PATIENTS IN
PATIENTS WITH OTHER OTHER
CONDITIONS I AM IN TERMS OF
WHAT'S RIGHT IN FRONT OF US
TODAY.
AND IT SEEMS TO ME THAT IN THIS
CONVERSATION WITH BEEN LIFTED UP
HIS AT THIS BILL DOES NOT FOR
SOMEONE TO GIVE UP THEIR COOPER
ARRANGEMENT.
ARM AND AND IT DOESN'T A THIRD
PARTY.
PORTER TO SUPPORT SOMEONE SCARE
--
WHICH SEEM TO HAVE BEEN THE TWO
MAJOR ISSUES I AT HIM I I WOULD
SAY THAT THAT IS TRUE BUT WHAT I
WOULD WHAT I WOULD RESPECTFULLY
DISAGREE WITH IS THAT THIS
REALLY IS NOT A LONG TERM ISSUE
IT REALLY IS AN IMMEDIATE
IMPACT.
AND THAT IS THE CONCERN I YOU
KNOW WHAT I STAND CORRECTED
YOU'RE RIGHT HE HAS SHORT TERM
URGENCY AND I THINK WE HAVE TO
FIGURE OUT HUESO ADDRESS.
THANK YOU THANK YOU I THINK I
THINK THAT'S IT FOR MY QUESTIONS
MISTER THANK YOU FOR THE
LATITUDE COURSE.
THANK YOU VERY MUCH THINK --
ESTIMATES.
NOTHING WAS CHAIR --
IT'S INTERESTING LISTEN TO THE
CONVERSATION HERE AND I'VE ONLY
BEEN A LEGISLATURE FOR FOUR
YEARS BUT I CAN TELL YOU THAT
THERE'S A LOT OF DECISIONS THAT
ARE.
MADE HERE BASED UPON YOUR INNATE
BIASES --
SOMETIMES --
YOU MAY HAVE YOU KNOW
CONFIRMATION BIAS WHERE IT'S
LIKE WELL IF IT'S THIS PERSON'S
THEN I'M ADAMANTLY OPPOSE OF ITS
US PERSONS AYE MADLY AYE I'M I'M
IN SUPPORT OF TO BE FAIR OUT TO
THE AUTHOR.
I WHEN I FIRST SAW YOUR NAME I
WAS LIKE I'M GONNA BE OPPOSED.
YEAH I WEAR THAT AS A BADGE OF
HONOR THE WELL.
SO DO I SO DO I BUT GOT GREAT
REGARD FOR YOU AND WE DO
REPRESENT THE SAME THE SAME
COUNTIES.
SURE THERE ARE SOME THINGS THAT
WILL BE ABLE TO TO WORK ON BUT
I'LL TELL YOU WHEN I FIRST SAW
THIS -- MODE
LIKE OF COURSE I'M.
I'M I'M OPPOSED.
WHEN I HEARD THAT --
WE'RE GOING TO BAN NON NON
PROFITS FROM BEING ABLE TO GIVE
PREVIOUS PREMIUM ASSISTANCE.
I JUST SOME OF MY COMMUNITY I
WAS LIKE NO ABSOLUTELY NOT
THERE'S NOTHING WRONG WITH NON
PROFITS.
THAT BEING ABLE TO THAT TO GET
PREMIUM ASSISTANCE ABOUT FOLKS
IN MY HOMETOWN THAT ARE BARELY
ABLE TO MAKE ENDS MEET MOM AND
WE'VE GOT --
DIALYSIS FACILITY IN MY HOME
[inaudible]
TO LAST A COUPLE OF YEARS AND I
WANNA MAKE SURE THOSE FOLKS I'M
STILL HAVE SERVICE AND I KNOW
THAT ALL OF US IN OUR I'M
OFFICES OF HAD FOLKS IS SHOWING
UP.
NAM AND SAYING YOU KNOW WE'RE
NOT GOING TO BE ABLE TO HAVE THE
SERVICE.
IGNORANCE CAN BE BLISS SOMETIMES
--
AND FOR ME IT WAS AND HOW I
STARTED TO DIG INTO THIS MORE
AND MORE AND MORE.
AND THE THING THAT I BEGAN TO
REALIZE WAS.
MY GOODNESS THEIR GAME IN THE
SYSTEM HERE.
THERE WAS ONE PARTICULAR --
TERM I'M WHEN I ASKED THE
QUESTION OF WHAT WOULD HAPPEN --
IF FOLKS STOPPING IN THIS YOU
KNOW WE WENT BILL TO PROVIDE
THAT SERVICE ANYMORE.
NOW SO COUPLE QUESTIONS JUST TO
MAKE SURE THAT I'M THAT BACK TO
MR THURMAN'S --
QUESTIONS ON TO MAKE SURE WE GET
THIS -- THIS
CORRECT.
IF MY MOM IF I WAS ON A FIVE
THAT IF A RELATIVE --
WANTED TO PAY FOR PREMIUM
ASSISTANCE.
WOULD ANYTHING CHANGE IF THEY
CONTINUE TO KEEP PAYMENT
PREMIUMS PREMIUM ASSISTANCE NO.
SO IT'S ONLY FOR THOSE PEOPLE
WHO A FINANCIAL INCENTIVE --
THAT'S THE ONLY THE ONLY
DIFFERENCES CORRECT.
SO THERE'S A QUESTION THAT THEN
POPS UP.
IS WHY WHY DO WE DO THIS
ARBITRAGE THAT'S WHAT IT LOOKS
LIKE TO ME WE HAVE AYE NONPROFIT
THAT'S OUT HERE THAT FOLKS ARE.
BY WRITING CONTRIBUTIONS TO TO
BE ABLE TO PROP UP THOSE.
OF THIS PREMIUM PAYMENTS BECAUSE
MY GUESS IS IS THAT THE PRIVATE
PAYERS PAY SIGNIFICANTLY HIGHER
THAN WHAT MEDICARE A CITIES ON
THE GROUND.
SO LIKE TO MAYBE DIG INTO THAT
QUESTION.
A LITTLE BIT WHAT'S THE
DIFFERENCE SO IF I'M BECAUSE I
DON'T KNOW FOR WHAT WE'RE
TALKING ABOUT DIALYSIS.
SO IF I GO ON MONDAY WEDNESDAY
FRIDAY WHAT IS MEDICARE PAY FOR
THAT ONE PARTICULAR SERVICE ON
ON A MONDAY WHAT'S WHAT IS
MEDICARE PAY.
I LOWER MY EXPERTS ANSWER --
MEDICARE PAYS BETWEEN TWO
HUNDRED FIFTY AND THREE HUNDRED
DOLLARS PER TREATMENT MCKENNA.
AND COMMERCIAL RATES FOR THE
LARGE FOR PROFIT DIALYSIS
CENTERS ARE GENERALLY AROUND A
THOUSAND DOLLARS PER TREATMENT.
AND YOU HAVE TO HOW MANY TIMES A
DAY OR A WEEK SOMETIMES A WEEK.
HUNDRED AND FIFTY TREATMENTS PER
YEAR SO WE'RE TALKING ABOUT
WHAT'S THE DIFFERENCE THEN NOT
SO.
YOU'RE LOOKING AT EASILY A
HUNDRED THOUSAND DOLLARS IN
DIFFERENCE BETWEEN.
COMMERCIAL AND MEDICARE RIGHT
AND HOW MUCH WITH THE PREMIUM
PAYMENT BE THE PREMIUM
ASSISTANCE ARE BEING PAID.
A BY THE NONPROFIT FOR THAT YEAR
HOW MUCH.
IT WOULD THOUSAND FIFTEEN
HUNDRED SO MAYBE FIFTEEN
THOUSAND SO DO PRETTY WELL WE
WERE TALKING ABOUT A SIGNIFICANT
AMOUNT OF MONEY. SEVENTY FIVE
EIGHTY EIGHTY THOUSAND DOLLARS
MY GOODNESS THAT'S THAT'S SMART
BUSINESS.
THE PROBLEM IS.
IS THAT IN OUR HEALTHCARE SYSTEM
IS ONE THING THAT I'VE LEARNED
IS THAT WERE GAME IN EVERYBODY'S
GAME EVERYBODY.
AND WE HERE HAVE THESE THESE
COMMITTEE HEARINGS AND YOU GOT
THE DOCKS TRYING TO GAME THE
HOSPITAL'S TRYING TO GAME THE
PROVIDERS.
AND THE REASON THAT OUR
HEALTHCARE COSTS CONTINUE TO
KEEP ESCALATING IS BECAUSE
EVERYBODY'S GAME AND EVERYBODY.
AT SOME POINT IN TIME THAT HOUSE
TO STOP NOW.
AS THE VICE CHAIR I MET WITH
LOTS OF DIFFERENT FOLKS SAYING
LOOK WE GOTTA FIGURE OUT A WAY.
TO BE ABLE TO COME UP WITH --
MAYBE IN THE MIDDLE OF THE ROAD
AND WE WORKED WITH THAT THE
CHAIR TO TRY TO COME UP WITH
THAT.
AND THEY WANT TO FIND OUT THE
AMENDMENT WAS IS JUST APPLY THAT
THE MEDICARE RIGHT I THOUGHT
WELL.
I REMEMBER EFFECTS I MEMBER THIS
DISCUSSION JUST A FEW WEEKS AGO
180% OF THOSE TELL ME IF I'M
WRONG BUT 80% OF OUR PATIENTS
ARE ALREADY ON MEDICARE IS
ALREADY PAINT.
TO SO IT'S ONLY THE EXTRA 20% OF
PATIENTS AND THAT ARE THAT ARE
BUT THAT THAT THE THAT THE
PRIVATE PROVIDERS ARE ARE PAYING
THAT INCREASED THAT INCREASED
AMOUNT WHAT'S WRONG WITH.
SAYING LOOK YOU CAN STILL GIVE
TO AMERICA KIDNEY FUND YOU CAN
GIVE TO A NONPROFIT.
BUT IF THERE'S STUFF BUT
ELIMINATE THE FINANCIAL
INCENTIVE YOU JUST ARE GOING TO
HAVE TO PAY THE MEDICARE RATE.
I THINK THAT TAKES MOST OF ALL
THE ARGUMENTS.
OFF THE TABLE AND SO I THINK
WHEN I SAW THOSE AMENDS BETWEEN
THECHAIR OF THE COMMITTEE IN
THE THE AUTHOR I'M NOT QUITE
SURE MORE OF WHAT WE CAN DEAL.
NOW I CAN CHOOSE --
BECAUSE I'VE HAD THOSE PATIENTS
IN MY ARE IN MY OFFICE AND I'VE
HAD THOSE PHONE CALLS INTO MY
DISTRICT OFFICE IN. TO THE
CAPITOL OFFICE I CAN CHOOSE TO
TO TURN A BLIND EYE. TO THAT BUT
THE FACT IS FOLKS ARE GAME IN
THE SYSTEM.
WE GOTTA DO SOMETHING ABOUT
THAT.
SO I'LL BE SUPPORTING THIS
TODAY.
THANK YOU SO WHENEVER.
ANY OTHER QUESTIONS OR COMMENTS
WAS WELCOME.
IT'S TOUGH IT'S HARD WHEN WE
HAVE SO MANY PEOPLE ON BOTH
SIDES IN THE SO MANY ISSUES.
AND NOT YOU KNOW I JUST WANT
TALK A LITTLE BIT ABOUT THE
SUBSTANCE USE.
ISSUE BECAUSE I'M VERY CONCERNED
ABOUT THAT [inaudible]
ALSO PALM.
SOME TRYING TO FIGURE OUT HOW
THE RATES COULD EVEN BE.
AFFECTED OR CHANGED.
BECAUSE WHEN WE LOOKED AT
SUBSTANCE USE DISORDER.
RAISING REIMBURSEMENT RATES TO
HER TO HELP FOR TREATMENT.
WE WERE TOLD BY THE DEPARTMENT
OF HEALTH CARE SERVICES ON THE
RECORD AND I HAVE THE TRANSCRIPT
OF COURSE I DON'T HAVE WITH ME
BUT THAT THAT.
THAT THEY DON'T SET RATES.
SENATE STONE THROUGH ODS AND THE
WAIVERS ON THAT THE COUNTIES OF
SENDING THE RATES FOR THOSE
TREATMENTS SO IF WE COULDN'T.
REYES THE REIMBURSEMENT RATES
HOW WOULD YOU BE ABLE TO LOWER
THEM.
WITHOUT GOING COUNTY BY COUNTY
BY COUNTY.
A SIMILAR BERMAN ASK AND RESPOND
ABOUT.
YES THANK YOU.
I THINK WHAT WE'RE SEEING THIS
OCCUR AN IS THAT --
COMMERCIAL HEALTH INSURANCE
MARKET.
SO WHAT THIS BILL DOES IS
ADDRESS JUST THE COMMERCIAL
MARKET AND WHAT WE'VE SEEN IN
THE SUBSTANCE ABUSE SPACE IS
THAT IT'S GENERALLY OUT OF
NETWORK SUCH A SUPERUSER
TREATMENT CENTERS THEIR ADAM
NETWORK.
SO YOU DON'T HAVE A CONTRACT
WITH THEM FOR A PARTICULAR RATE.
WHAT THEIR THEN I'M NOT
PAINTBRUSH IN ALL OF THEM THIS
IS JUST SOME OF THE BAD ACTORS
BUT WHAT THEY'LL DO IS THEY'LL
GO AND GET PEOPLE TO COME IN BY
USING A BODY WHAT THEY CALL BY
THE BROKERS WE'VE HEARD?
THOSE BILLS IN THIS COMMITTEE
AND AND THEY'LL GO AND GET
PEOPLE TO JOIN GIVING THEM
INCENTIVES LIKE WE'RE GOING TO
GIVE YOU A SCHOLARSHIP ALLIANCE
PEOPLE DON'T EVEN KNOW THEY'RE
BEING SIGNED UP FOR HEALTH
INSURANCE THEY'RE ADDICTED
PEOPLE.
AND VULNERABLE THEY BRING THEM
INTO THESE TREATMENT CENTERS.
AND THEN THEY SIGN HIM UP FOR
HEALTH INSURANCE BECAUSE THEY
KNOW THAT THEY CAN BUILD THE
HEALTH INSURANCE FOR FAR MORE
THAN THEY'RE GOING TO PAY IN
PREMIUM PAYMENTS.
THEN AFTER THE NINETY DAY
TREATMENT PLAN IS OVER AND THEY
KNOW THEY'RE GOING TO BE
QUESTIONED ABOUT WHY THIS PERSON
STILL.
TERRIBLY ADDICTED THE DAILY AS
MY COLLEAGUE SAID THEY LITERALLY
KICKING TO THE CURB.
WHERE THINGS THAT THIS BILL DOES
IS IT REQUIRES A THIRD PARTY --
PAYER WHOSE FINANCIALLY
INTERESTED IN PAYING FOR A FULL
YEAR OF OF PREMIUMS INSTEAD OF
THIS KICKING HIM TO THE CURB
WHEN YOU CAN'T BILL HEALTH
INSURERS ANYMORE.
DURING THAT TIME CARRY BECAUSE
THEY'RE OUT OF NETWORK THEIR
BILL CHARGES ARE EX IS PART.
THOUSANDS UPON THOUSANDS UPON
THOUSANDS OF DOLLARS.
AND SO YOU CAN TRY AND NEGOTIATE
THAT WITH THEM BUT YOU'RE PAYING
FAR MORE IN ADDED NETWORK
COVERAGE IN YOUR PAIN IN NETWORK
WITH THE CONTRACTED PROVIDER.
AND OF COURSE IT'S IN THE
PATIENT'S BEST INTEREST TO GO TO
CREDENTIAL PROVIDERS WITHIN A
NETWORK.
AND SO THIS BILL DOES NOT SAY
YOU CANNOT CONTINUE TO PAY THOSE
PREMIUMS BUT YOU'RE GONNA HAVE
TO DO SOME --
SOME THINGS TO MAKE SURE THAT
THAT PATIENTS PROTECTED DURING
HAVE TO LET THEM KNOW WHAT THEIR
OPTIONS ARE.
AND IF YOU CONTINUE TO PAY THOSE
PREMIUMS FOR THEM.
YOU'RE GONNA HAVE TO MEET THOSE
STANDARDS LIKE PAYING FOR A FULL
YEAR LEADING THE HEALTH LAN
KNOW THAT THAT YOU ARE PAYING
THESE THIRD PARTY PAYMENTS.
AND THEN AS YOU SAID THEY TAKE
THE FINANCIAL INCENTIVE AWAY.
BY MAKING SURE THAT THEY'RE
GONNA PAY THE MEDICARE RATE.
NOT MEDI CAL MEDICARE.
SO THAT'S ON THE SUBSTANCE ABUSE
SPACE THAT'S THAT THE ANSWER
THAT QUESTION WHERE WERE NOT
PROHIBITING IT IN FACT THE FIRST
SENTENCE OF THIS BILL SAYS YOU
HAVE TO ACCEPT THOSE PAYMENTS
HEALTH PLANS HEALTH INSURERS.
BUT THE FINANCIAL INCENTIVE TO
DO THE WRONG THING IS TAKEN AWAY
IN THAT AND THEY REQUIRED TO DO
THE RIGHT THING BY THE PATIENT
IS IS SET OUT IN THE BILL.
IT'S A VERY SIMPLE BUILT THAT
WAY.
THAT HANS I GUESS BUT THE FUNNY
IS THAT I DO HAVE IS ABOUT THE
RACE SENDING PART OF IT --
HE IT I UNDERSTAND YOU KNOW THE
BUSINESS PAR VERSUS THE YOU KNOW
A MORE GOVERNMENT RUN
[inaudible]
THE MIDDLE COMPARING ONE TYPE OF
PLAN TO ANOTHER.
AND I JUST I'M JUST CONCERNED
ABOUT.
AND MAYBE SOMEONE CAN RESPOND TO
THAT THAT.
YOU KNOW WE'RE TALKING IT IF
THERE'S A LOT OF PROBLEMS WITH
IN A DUMPY PEOPLE ON THE CURB.
SHORT TERM YOU KNOW PEOPLE
SIGNED UP THINK IN THE GETTING
YEAR THEY GET THREE MONTHS OR
WHATEVER.
AND I'M LOOKING AT THESE
AMENDMENTS ON THESE OR WHAT
PART.
THESE PUT HE HOOKED IT SAYING IN
HERE THAT THEY ARE COMMITTING TO
PROVIDE PREMIUM ASSISTANCE.
FOR A FULL YEAR'S. FOR THE
REMAINDER ASSEMBLY MEMBER THOSE
ARE PASSED OUT BY THE OPPOSITION
I BELIEVE.
THOSE ARE NOT THE AMENDMENTS
THAT THE COMMITTEE TOOK.
SO THAT'S THAT'S WHERE I'M
HAVING UNSETTLING.
RIGHT NOW WITH THE THE WEIGHT
REDUCTION.
THINK YOU.
IT DID YOU I'M GETTING QUITE WAS
YOUR QUESTION.
WELL IT'S JUST I MEAN THERE'S A
LOT OF THINGS GOING ON THAT ARE
WRONG.
AND I'M THINKING THERE MIGHT BE
OTHER WAYS TO LOOK AT IT AS WELL
BESIDES JUST LOOKING AT THAT
RATE ISSUE [inaudible]
TOM.
FEAR ME SUGGESTIONS WERE ALWAYS
OPEN TO SUGGESTIONS BUT MAY I
MISTER CHAIRMAN MAY I RESPOND.
ACTUALLY NOT LISTA UNLESS THE
UNLESS THE WITNESS.
DO YOU HAVE.
YEAH ANY RESPONSE REGARDING
THAT.
YEAH UP THANKS VERY MUCH AND
I'LL BE VERY BRIEF UP THERE ARE
WAYS TO CONTROL THESE ISSUES AND
THOSE WAYS HAVE A LOT TO DO WITH
THEIR NUMBER GUARDRAILS THAT WE
HAVE SUGGESTED THAT OTHERS WORTH
ETHIC.
SUGGESTED AND THAT HAVE BEEN AND
IN VARIOUS BROUGH VERSIONS OF
THE BILL ALTHOUGH THE GUARDRAIL
THAT WE DO IN FACT FOLLOW WE
ALSO OPERATE OUR PROGRAM UNDER
THE ADVISORY OPINION.
FROM THE HHS INSPECTOR GENERAL
WHICH WE HAVE DONE FOR THE LAST
COUPLE OF DECADES SO THERE ARE
THINGS TO TO CONTROL THOSE AND
TO MAKE SURE THAT THE
ORGANIZATION PROVIDING THE THIRD
PARTY IS A ASSISTANCE.
IS A YACHT AND INDEPENDENT
CHARITY WITH AN INDEPENDENT
BOARD WITH NO INTEREST
WHATSOEVER IN NAY IN A PROVIDER
TO ASSURE THAT CARE IS NOT
PROVIDED.
US SUPPORT IS NOT PROVIDED ON A
SHORT TERM BASIS BUT IT'S
PROVIDED ON A FULL PREMIUM YOUR
BASIS ALL OF THOSE THINGS TO
SHOULD ENSURE THAT THERE IS NOT
COST DURING THOSE ARE THINGS
THAT WE STRONGLY BELIEVE IN.
THAT WE STRONGLY SUPPORT AND WE
BELIEVE WOULD ADDRESS MANY OF
THE ISSUES HERE WE HAVE BEEN
PROMOTING THOSE THINGS
THROUGHOUT THE COUNTRY --
IN MANY STATES IN SUGGESTING
THAT.
SOME OF THE THINGS THAT WE HAVE
ALWAYS FOLLOW [inaudible]
THE QUESTIONS.
SENATE I KIND OF FROM LIVING
YOUR BILL SINCE BEFORE YOU GOT
OUT OF OUR COMMITTEE --
ALL YEARS MATTER FACT --
BUT YOU KNOW THIS BILLS ABOUT
PREMIUM ASSISTANCE OF FOR
FINANCIALLY FROM FINANCIALLY
INTERESTED ENTITIES.
STEERING PATIENTS IN THE
COVERAGE.
THAT HAVE POTENTIAL REIMBURSING
AT A HIGHER RATE.
WE UNDERSTAND THIS PRACTICE
EXISTS.
AND THIS BILL ATTEMPTS TO SET
SOME PARAMETERS FOR THE
PRACTICE.
AS IMPORTANT THAT IN DOING SO WE
DON'T PLACE A BURDEN ON PATIENTS
DISRUPT THEIR CARE.
A RESULT IN LAPSING COVERAGES.
WITH THESE AMENDMENTS WE REMOVE
THE FINANCIAL INCENTIVE TO
ENGAGE IN BEHAVIOR THAT TAKES
ADVANTAGE OF THE SYSTEM THAT'S
THE CORE OF THE AMENDMENTS.
I BELIEVE THE AMENDMENT
STREAMLINED THE PROCESS WILL NOT
PLACE A BURDEN ON PATIENTS PLANS
OR REGULATORS.
THE AMENDMENTS ALLOW ASSISTANCE
TO CONTINUE TO PROVIDE BE
PROVIDED BY THOSE CHARITIES.
THAT HAVE THE PATIENT'S
INTERESTS AT HEART.
AND ALLOW THESE PATIENTS
CONTINUE WITH THEIR COMMERCIAL
COVERAGE EVEN THOUGH THEY MAY
QUALIFY UNDER MEDI CAL OR
MEDICARE.
NOTHING PROHIBITS THAT --
AND THAT IS THAT IS THE HEART
THAT IS THE HEART OF THE BILL.
THE BILL.
ENJOYS A DO PASS RECOMMENDATION.
YOU'VE ALSO HEARD FROM PEOPLE
THAT THEY WANT TO CONTINUE TO
WORK ON THAT I WOULD ENCOURAGE
THAT -- THIS
OF THE DEBATE HAS BEEN VERY
ROBUST YOU CAN ONLY IMAGINE HOW
IT WILL ROBUST IT WILL BE WHEN
HE GETS TO OUR FLOOR.
IF.
ON THIS PARTICULAR ISSUE --
WITH THAT I WITH BUT WE DO HAVE
WE DO NOT HAVE MOTION.
WE DO NOT HAVE A PROMOTION.
THE SECOND BY MISTER MAYES
WITHOUT WOULD LIKE TO CLOSE
SENATOR LET ME THINK RESEARCHER.
AND I REALLY DO APPRECIATE ALL
OF THE HELP THAT YOU AND YOUR
COMMITTEE STAFF GAVE US ON THIS
BILL.
AND I THINK YOU SAID IT BETTER
THAN I COULD BUT I WOULD JUST
END WITH THIS MOST OF YOU DIDN'T
KNOW ME BEFORE I CAME HERE TO
THE LEGISLATURE.
I SPENT TWENTY YEARS WORKING ON
HEALTH CARE FOR YOUR AVERAGE
WORKER MAKING SURE THAT THEY HAD
ACCESS AND THAT THEY HAD ACCESS
AND IT WAS AFFORDABLE.
I WOULD NEVER EVER AFTER A BILL
THAT WOULD HARM SOMEONE'S ACCESS
TO HEALTH CARE BUT WHAT WE
ALWAYS RAN UP AGAINST WHEN WE'RE
NEGOTIATING THOSE BENEFITS WAR
WERE PEOPLE WHO WANT TO MAKE A
PROFIT AND THEY WERE MORE
WORRIED ABOUT THE PROFIT.
THAN THEY WERE ABOUT THE CARE
THAT THE WORKER OR THE MEMBER
WAS GOING TO GET SO WITH THAT I
RESPECTFULLY ASK FOR AN AYE
VOTE.
SO WE HAVE A MOTION AND A SECOND
THE MOTION IS TO PASS AS AMENDED
TO APPROPRIATIONS MADAM
SECRETARY PLEASE CALL THE ROLL
WOULD I WOULD I HAVE MAYES.
MAYES AYE AGUIAR-CURRY.
AGUIAR-CURRY AYE BIGELOW.
BIGELOW NO BONTA [inaudible]
BURKE [inaudible]
BURKE I CARILLO.
CARILLO AYE FLORA [inaudible]
FLORA NO [inaudible]
LIMON [inaudible]
MCCARTY [inaudible]
NAZARIAN [inaudible]
RODRIGUEZ [inaudible]
SANTIAGO THURMAN.
THURMOND AYE WALDRON
[inaudible]
MULDER NO.
HE OF SIX VOTES WE HAVE A BUNCH
OF MISSING MEMBERS --
BELIEF THE BILL ON COSTS VERY
GOOD THANK YOU MISTER CHAIR
THANK YOU MEMBERS
[inaudible]
THIS
[inaudible]
SENATOR.
YOU'RE WELCOME PLEASE
[inaudible]
ONCE A
DOGS COME
[inaudible]
RAINY
[inaudible]
YEAH
[inaudible]
CENTER BRADFORD.
GOT A BILL --
S. B. [inaudible]
TWELVE SIXTY EIGHT THE BILL
[inaudible]
THANK YOU.
I LIKE THAT AND I RESPECT THAT'S
RIGHT VOTE.
WILL NOT TO US.
OF THANK YOU MEMBERS MISS CHAIR
I'M HERE TO PRESENT --
TWELVE SIXTY A WHICH WILL
PROHIBIT PATIENT FOR BRAIN AND
ALCOHOL AND DRUG ADDICTION
TREATMENT SAID SYSTEMS.
PACIFIC LEE SP TWELVE SIXTY
EIGHT WOULD MAKE IT --
MISDEMEANOR PUNISHABLE BY TWENTY
FIVE HUNDRED DOLLAR FINE.
THE PACER BURKE GREEN AS YOU
KNOW -- IS
ALSO KNOWN AS BODY BROKERING
OCCURS WHEN A PERSON ADDS PAID
COMPENSATION FOR REFERRING A AT
PATIENT TO ALCOHOL TREATMENT
CENTER.
OF THIS IS ST FORT MEASURE WE
KNOW ABOUT ALL THE UNETHICAL A
PRACTICE THAT ARE HAPPENING
THROUGHOUT THE STATE OF
CALIFORNIA ACROSS THE COUNTRY
SPACE IN THIS OPIOID EPIDEMIC
CRISIS THAT WE FIND OURSELVES
IN.
HERE WITH ME THE DAY AS DANIEL
FORUMS WERE STOPPED DIRECTOR OF
REALIZATION REVIEW AND RISK
MANAGEMENT REPRESENTING SOBER
LIVING BY THE SEA AND SHERRY
DALY SENIOR GOVERNMENTAL AFFAIRS
DIRECTOR FOR THE CALIFORNIA
CONSORTIUM ON ADDICTION
PROGRAMS.
AND PROFESSIONALISM AND AND WE
RESPECT LESS RIVAL SO MY WOODS
ISSUES.
SO SENATOR FUND THE COURSE WITH
THAT WITH WITNESSES.
I CAN ONCE PEOPLE ARE COMING UP
HERE THAT MEANS THAT THEY WANNA
MOVE ALONG AT HIS SUPPORT
SUPPORT SO WELL QUICK A QUICK
COMMENTS AGREEMENTS.
LAST YEAR I DON'T THINK YOU.
ON BEHALF OF THE TWENTY THOUSAND
PRACTITIONERS WHO REPRESENT AND
THE FIVE HUNDRED PROGRAMS AND SO
RELEASE WE ASK YOUR SUPPORT
THANK YOU.
NICELY DONE ANY OTHER WITNESSES
IN SUPPORT SHAWN FLANAGAN ABOUT
HALF OF A SEEDS OR THANK YOU.
DOCTOR DAVID KAHN WITH THE
CALIFORNIA SOCIETY OF ADDICTION
MEDICINE STRONGLY SUPPORT THANK
YOU.
JAMES JACK ON BEHALF OF AMERICAN
ADDICTION CENTERS IN SUPPORT
[inaudible]
DO YOU.
PAULA LEON BEHALF OF KATIE
CALIFORNIA ASSOCIATION OF
ALCOHOL AND DRUG EDUCATORS IN
SUPPORT.
THANK YOU AND THEN MOVING ON TO
OPPOSITION ARE THERE ANY ANY
WITNESSES IN OPPOSITION
[inaudible]
LAST CALL [inaudible]
ANY.
ANYBODY WANT TO ADD NOPE.
ARE IT WILL BRING BACK TO THE
COMMITTEE ON ANY QUESTIONS OR
COMMENTS.
SEEING NONE SENATOR WOULD YOU
LIKE TO CLOSE I RESPECTFULLY ASK
JAGO.
THANK YOU IT'S PLEASE CALL THE
ROLL.
OTHERS THE MOTION IS DO YOU PASS
A TO APPROPRIATIONS I GUESS WE
NEED A MOTION KNOWING WE ARE DO
WE HAVE IT WITH HAS BEEN WILL
THAT'S RIGHT NAY THAT WE MOVE
AREA.
GOT THAT SO WE'RE GONNA WE'RE
GOOD TO GO [inaudible]
WOULD.
MAYES YES MAYES AYE AGAR CURRY.
BIGELOW.
BIGELOW AYE BONTA.
BURKE.
BURKE I CARILLO.
CREEL AYE FLORA.
FLOOR I LIMON [inaudible]
MCCARTY [inaudible]
NAZARIAN [inaudible]
RODRIGUEZ [inaudible]
SANTIAGO THURMAN.
WALDRON WALDRON AYE.
YOU'VE GOT SIX VOTES YOU NEED TO
MORE CIVIL WILL KEEP ON CALL I
APPRECIATE MISTER MEMBERS THANK
YOU THANK YOU SO MUCH SENATOR
[inaudible]
DOCTOR PAN.
THIS IS S. B. FOURTEEN NINETY
FIVE YES SIR THANK YOU MISTER
CHAIR MEMBERS THAT THIS IS THE
ANNUAL SENATE HEALTH COMMITTEE
OMNIBUS BILL WHICH MAKES NON
CONTROVERSIAL CHANGES TO VARIOUS
PROVISIONS OF HEALTH LAW
INCLUDING REVISING THE REPORTING
STRUCTURE OF LAW ENFORCEMENT
PERSONALITY HOSPITALS.
REVISING MENTAL HEALTH SERVICE
PERFORMANCE CONTRACT
REQUIREMENTS AND MAKING CLEAN UP
CHANGES TO TO RECENTLY ENACTED
BILLS RECENT AMENDMENTS ADDED
LANGUAGE AT THE REQUEST OF THE
PART OF A PUBLIC HEALTH TO GIVE
THEM THE BELIEVE ISSUE HOSPICE
PROVIDER LICENSE BASED ON AN
APPLICANT BEING ACCREDITED BY
ESTIMATES APPROVED.
NATIONAL CREATING ORGANIZATION
THE PART PUBLIC HEALTH REQUESTED
THIS LANGUAGE BASED ON A GROWING
BACKLOG OF HOSPICE PROVIDER
LICENSE APPLICATIONS AND HAS
RECENTLY IMPLEMENTED SIMILAR
PROGRAM FOR HOME HEALTH
AGENCIES.
AS ALWAYS AS A COMMITTEE BILL
ITEMS MUST REMAIN NON
CONTROVERSIAL AND THIS LANGUAGE
WAS VETTED WITH HOSPICE PROVIDER
ORGANIZATIONS OF ANY ENTITY
OPPOSES ANYTHING IN THIS BILL
THAT CANNOT BE ADDRESSED WITH
AMENDMENTS.
THAT PROVISION BE REMOVED OR
EXPECT WE ASK FOR A KNIFE IT.
THANK YOU DOCTOR PAN ANY
WITNESSES IN SUPPORT BETSEY
ARMSTRONG ON BEHALF OF THE
COUNTY HEALTH EXECUTIVES
ASSOCIATION IN SUPPORT OF THE
SPECIFIC PROVISIONS EXTENDING
PUBLIC HEALTH EMERGENCY
[inaudible]
THANK YOU.
MELISSA CORTES ROTH ON BEHALF OF
MY MEDICS IN SUPPORT OF THE STEM
CELL THERAPY PROVISIONS.
CHILDREN SCHOOL DEPARTMENT OF
PUBLIC HEALTH IN SUPPORT OF THE
HOSPICE PROVISIONS.
ANY FURTHER WITNESSES IN
SUPPORT.
MOVING TO OPPOSITION ARE THERE
ANY WITNESSES IN OPPOSITION.
SEE NINE BACK TO A QUESTION TO
COMMENTS FROM THE COMMITTEE.
THIS BIG WELL THANK YOU AND THE
DOCTOR AND THAT YOU CAN HELP US
--
THERE'S GONNA CONCERN RAISED
ABOUT PROVISIONS IN THIS BILL
APPEAR TO BE SUBSTANTIAL AND IN
THEIR SUBSTANTIATED.
IN THE POLICY CHANGE ON THEY'RE
NOT JUST THE NORMAL TECHNICAL --
TYPE OF NON CONTROVERSIAL
CHANGES.
SHOULDN'T THIS.
HAD BEEN ADDRESSED IN A MORE.
APPROPRIATE WAY GOING THROUGH
THE POLICY COMMITTEE OF PROCESS.
MAYBE YOU COULD ADDRESS THAT
FOREST'S.
SO I GUESS I'LL BE HELPFUL IF
YOU COULD INDICATE WHICH PORTION
THE BILL YOU FEEL A SUBSTANTIVE
OKAY SO IS BEING RELEASED
SPECIFIC THE HOSPICE CARE OKAY.
IF YOU COULD ADDRESS THAT ON HOW
DOES THE DP H. INTEND TO ENSURE
QUALITY COMPASSIONATE CARE FOR
PEOPLE FACING LIFE.
LIMITING ILLNESS AND INJURY
INCLUDING EXPERT MEDICAL CARE
PAIN MANAGEMENT EMOTIONAL AND
SPIRITUAL SUPPORT EXPRESSLY
TAILORED. TO THE PATIENT'S NEEDS
AND WISHES.
THIS SEEMS TO BE A CHANGE IN
DEVIATION.
FROM THE NORMAL PROCESS BY
ADDING SUCH A IN DEPTH OKAY.
OKAY SO ACTUALLY --
THAT I KNOW THAT I WILL TALK.
I DON'T KNOW THAT THEY AYE I'VE
--
MAY HAVE ACTUALLY --
WE HAVE TO FUND PUBLIC HEALTH
ADDRESS ADDRESS THAT TO THE
POLICE TO CHANGE [inaudible]
PLEASE DO [inaudible]
OKAY UP TILL SUGGEST BOTH
DEPARTMENT OF PUBLIC HEALTH --
I MAY HAVE MISSED A PART OF YOUR
QUESTION SO I DON'T ANSWER FULLY
THAT'S WHEN I LET ME KNOW
[inaudible]
AND THE DEPARTMENT OF BELIEVES
THAT THE SAFETY PROTECTIONS ARE
STILL INTACT BECAUSE THE
ORGANIZATIONS THAT WILL BE
PERFORMING THE INITIAL LICENSING
A SURVEY.
ARE APPROVED BY THE CENTER FOR
MEDICARE AND MEDICAID.
AND THE CENTER FOR MATTER
MEDICARE MEDICAID ONLY APPROVES
THOSE.
ACCREDITING ORGANIZATIONS THAT
STANDARDS MEET THE FEDERAL
REQUIREMENTS OR EXCEED THOSE
REQUIREMENTS.
IN ADDITION THE DEPARTMENT
INTENDS TO FULLY WORK WITH THE
ACCREDITING ORGANIZATIONS TO
ENSURE THAT ANY STATE SPECIFIC
REQUIREMENTS WE HAVE FOR HOSPICE
PROVIDERS [inaudible]
ARE ADDRESSED BY THE
ACCREDITATION STANDARDS AND IF
NOT WE WILL WORK WITH THOSE
ACCREDITING ORGANIZATIONS TO
MAKE SURE OF THAT.
THE FACILITIES MEET THOSE
REQUIREMENTS SO HELP US TO
UNDERSTAND BECAUSE THE ASSEMBLY
HEALTH COMMITTEE ANNOUNCES
STATED THAT.
AS OF OCTOBER TWENTY FIFTH
TWENTY SEVENTEEN THERE WERE
SEVENTY TWO HOSPICE APPLICANTS
AWAITING INITIAL LICENSE SURVEYS
AND IT DEVIATES STATES THAT.
IN FACT THEY STATED ON JUNE
TWENTIETH SUPPORT A SUPPORT
LETTER THAT THE DEVIATES
ANTICIPATES THAT THE CONTINUAL
GROWTH IN THE NEW OPERATING
HOSPICES WILL FURTHER DELAY.
WAIT TIMES SO HOW WE HOW DO WE
JUSTIFY THIS IN THIS OMNIBUS
BILL.
AND RECOGNIZE MAYBE.
YOU COULD HELP ME UNDERSTAND
THAT.
SO I IT'S WHY CLARIFY SO THE
ISSUE IS IS THAT THE DEFINITIONS
INCREASING THE BACKLOG. ONE YES.
BY CREATING THE DEFINITION ARE
WHERE INCREASING.
A NUMBER OF BACKLOGS FOR THE
DEPARTMENT OF HEALTH TO TO NOT
BE ABLE.
TO FACILITATE MEETING THE NEEDS
STILL.
SO IN RESPECT TO THE SERVICE.
IT'S REALLY ABOUT THE SURVEYS.
OKAY SO DAMNED IF I MAY --
THE I KNOW IS NORMALLY THE SHE
REAL SIMPLE BILL WE ALL YOU KNOW
GATHER AROUND A LOT BUT THIS HAD
A SUBSTANTIAL.
CHANGES AND SO ON THAT'S WHEN
TRYING TO GET TO THE BOTTOM OF
IT SO THE APPLICANTS WILL STILL
GO THROUGH THE REGULAR PAPER
APPLICATION PROCESS WHERE
THEY'RE REVIEWED BY OUR
CENTRALIZED APPLICATIONS UNIT.
AND THEN THE PROVIDER HAS THE
OPTION TO GO TO ONE OF THESE
ACCREDITING BODIES TO RECEIVE A
SURVEY.
THOSE ACCREDITING BODIES MAY
HAVE THE ABILITY.
TO AND CONDUCT THE SURVEY AHEAD
OF THE SCHEDULE WHERE THE
DEPARTMENT NORMALLY WOULD WHERE
THEY WOULD BE WAITING IN LINE
POTENTIALLY.
FOR A COUPLE OF MONTHS TO GET A
SURVEY.
AND SO WE THINK THAT HAVING THIS
OPTION MAY IMPROVE THEIR ABILITY
TO BECOME LICENSE.
SO ESSENTIALLY WHAT'S GOING TO
HAPPEN AS THEIR HANDS ARE GOING.
TO GET FULL AND ARE NOT GONNA
BUILD WHAT DO THERE'D THIS
SURVEY [inaudible]
POTENTIALLY.
I AM NOT SURE THIS IS YOUR
QUESTION CAME QUE REPEAT THE
QUESTION AGAIN SORRY PRICE IT.
SO FROM FROM FROM APPEARANCE
THINKS IT LOOKS LIKE THE
DEPARTMENT OF HEALTH.
WILL PROBABLY HAVE THEIR HANDS
FULL AND WON'T BE ABLE.
TO REALLY GO OUT AND DO ALL OF
THE SURVEYS BECAUSE THERE.
THERE'S NOT ENOUGH TO GO AROUND
FOR THEM. TO MAKE IT HAPPEN ON A
FUNDING NOT ENOUGH ACT.
SUPPORT THIS IS SO WHAT WE'RE
TRYING TO DO IS ACTUALLY A
LITTLE --
DECREASE THE BACKLOG I
UNDERSTAND YEAH [inaudible]
SO -- BUT IT
DOESN'T APPEAR THAT THAT'S THE
WAY IT'S GONNA HAPPEN.
MAYBE HAVE FRAMED THE QUESTION
WRONG I AND I APOLOGIZE KNOCKED
HIM BUT I IT'S A REAL CONCERN
THAT THAT THAT'S THAT'S BEING
RAISED SO.
OKAY WELL AS AS AS I INDICATED
BEFORE MY TESTIMONY --
IF THE YEAH THERE ISN'T OUT AS A
COMMITTEE BILL IF THERE IS A
PORTION THAT IS --
THAT'S A STICKING POINT WE WILL
REMOVE THAT FROM THE BILL --
SO -- SO WE
CAN'T TRY TO ADDRESS YOUR
CONCERNS ADAM AND THEN --
WILL THEN IF WE WILL LOOK TO
REMOVE THAT PROVISION FROM THE
BILL I I GUESS WHAT I WOULD SAY
IS THAT.
WE'RE TRYING TO LIVE REMOVES THE
BACKLOG BY GIVING THEM SO WHAT
THAT MEANT WHAT THE BILL DOES
INCLUDE.
IS IS THAT --
THERE IS AN AMEND THEIR BASIC IS
LANGUAGE GIVING THE PART PUBLIC
HEALTH THE ABILITY TO ISSUE A
HOSPICE PROVIDER LICENSE.
BASED ON THE FACT THAT BEING
CREDITED BY CMS APPROVED
NATIONAL TRADING ORGANIZATION
THEREFORE THAT THE PART PUBLIC
HEALTH --
WOULD BE ABLE TO MORE RAPIDLY --
APPROVE IT BECAUSE THEY CAN THEN
THE FOR TO THE CREDITING AGENCY
WHICH AGAIN IS A CMS APPROVED
ACCREDITING ORGANIZATION AND
THAT WOULD --
THEREFORE ALLOW THEM --
TO APPROVED THE MORE QUICKLY
WITHOUT HAVING TO SEND THEIR OWN
PEOPLE BASICALLY BECAUSE
ACCREDITING BODY HAS READY --
ACCREDITED THAT ENTITY.
OKAY SO THAT VERY WELL MAY BE
THE CRUX OF THE ENTIRE.
ISSUE RIGHT THERE.
THE DEPARTMENT OF HEALTH --
INTENDING TO TRANSFER THEIR
RESPONSIBILITIES OVER TO A
NATIONAL ACCREDITED ORGANISE
OKAY AND THAT VERY WELL MAY BE
THE ISSUE.
OBJECT AT HEART HERE IS THAT
WERE ACTUALLY PASSING THAT OFF
FROM THE STATE TO A NATIONAL
ORGANIZATION.
WHICH IS I BELIEVE WE'RE ALL
GONNA PROBABLY KNOW MORE ABOUT.
OKAY SO --
SO AGAIN IF I'D THAT REMAINS IN
ISSUE SAID IT THIS IT THESE ARE
CMS APPROVED NATIONAL GRADING
BUYS HOWEVER IF THAT IS --
CONTINUES IS THAT IS AN ISSUE
FOR FOR YOU AND OTHERS THAT AND
WE WILL REMOVE THAT PROVISION
FROM THE BILL.
OKAY GOTTA HOPEFULLY WE CAN WORK
IT OUT.
THEY BEAT THAT BUT BEGAN IF IN
THE END YOU STILL THE SIDE
THAT'S A PROBLEM SO WE MOVED
BILL.
CRUCIATE THANK YOU.
I JUST WANNA MAKE SURE WE GET
THIS RIGHT DOUGLASS DR BEN YOUR
DOCTOR PAN YOU ARE --
ACTING AS THE AUTHOR ON THIS --
ON THIS YET COMMITTEE ON BILL
WE'RE TALKING ABOUT THEM
REMOVING LANGUAGE ON THIS
BIGELOW AYE ARE YOU OR ARE YOU
COMFORTABLE WITH THAT AS IT
CURRENTLY SITS ARE YOU
SUGGESTING THAT HE'S BEEN
LANGUAGE.
REMOVED RIGHT NOW WORD OR IS
THIS AFTER THIS COMMITTEES DOWN
WE CAN CONTINUE TO WORK ON AT
THIS POINT.
AT THIS POINT I JUST WANTED A
CLARIFICATION OKAY I THINK WE
WALKED INTO.
YOU KNOW A LONG WAY AROUND THE
TREE BUT WE GOT TO THE THE P.
H..
INTENDING TO TRANSFER TO THE
NATIONAL ORGANIZATION I JUST
WANT TO MAKE SURE THAT'S ON THE
RECORD WHAT WE'RE DOING HERE
GETS.
ADDED AND SO BUT THAT'S A
SUBSTANTIAL CHANGE FROM OUTSIDE
THE NORM OF WHAT WE'VE DONE IN
THE PAST WELL WE'VE WE'VE DONE
SIMILAR THINGS LIKE THIS FOR
OTHER PROGRAMS LIKE HOME HEALTH
AGENCIES SO THIS IS NOT THE
FIRST TIME WE'VE.
DONE RIGHT HERE WHERE LONELY
SOUND POLICY PRIOR OKAY THAT'S
WHAT I'M.
TALKING ABOUT IS ONLY THROUGH
THE POLICY COMMITTEE OKAY NOT
THROUGH THE HONEST.
ALRIGHT WELL --
I WILL DEFER TO YOU WHETHER YOU
FEEL THAT WE SHOULD REMOVE IT BY
THE TIME IT HITS THE FLOOR ARE
IF YOU WILL BE COMFORTABLE NOW
OF THE DISCUSSION WITH THAT PART
OF THE CULT THAT THIS
INAPPROPRIATE PEOPLE.
SO PLEASE GIVE ME DIRECTIONS TO
GET.
I I I IF I CAN MR.
I'M GOOD WITH THAT WITH A
RESPONSE I BELIEVE ANSWER THE
QUESTION FOR CLARITY PURPOSES.
ALRIGHT SO YOU LEAVE IT IN THERE
LOS ANGELES HOUSE AS AN
OBJECTION BY APPRECIATE THE
QUESTION THANK YOU.
THANK YOU DOCTOR PAN --
ANY FURTHER QUESTIONS OR
COMMENTS --
MISS WALDRON JUST A COMMENT --
THE WORLD COUNTY REPRESENTATIVES
ARE SUPPORT OF THE BILL AND I
HAVE.
QUITE A LARGE WORLD AREA MY
COUNTY SO I APPRECIATE THAT AND
BY EXTENDING.
THE EMERGENCY REVIEW FROM
FOURTEEN DAYS AT THIRTY IS
CERTAINLY HELPFUL.
OKAY WELL THANK YOU THINGS IN
OUR WATER.
I WOULD THINK ZERO THAT AIM
THERE'S IS NOT NEW TO DO ITEM --
MEANT A MOTION BY A SWIMMER CREO
AND SECOND BY WALDRON.
AND WITH THAT PLEASE CALL THE
REPUBLIC THE MOTION IS TO PASS
APPROPRIATIONS FISCAL
[inaudible]
WOULD.
MAYES I MAYES AYE AGUIAR-CURRY.
BIGELOW.
BIGELOW AYE BONTA.
BURKE [inaudible]
CARILLO.
CARILLO AYE FLORA.
FLORA AYE LOW MOAN.
MCCARTY NAZARIAN RODRIGUEZ.
RODRIGUEZ I SANTIAGO
[inaudible]
THURMOND [inaudible]
WALDRON [inaudible]
MODERN HIGH.
SAID SIX VOTES WILL KEEP ON CALL
OKAY THANK YOU THINK ERECTION
ACCELERATES THANK YOU
[inaudible]
NO [inaudible]
SKIP [inaudible]
YEAH [inaudible]
HERTZBERG.
WE SKINNER AND WIENER
.
WE'RE JUST GONNA OPEN UP REAL
QUICK THOSE TO ADD ON FOR ON THE
CONSENT AGENDA [inaudible]
THE COUGH ABSENT MEMBERS
[inaudible]
MAYES.
BY MAYES AYE [inaudible]
BONTA BURKE [inaudible]
LOW MOAN [inaudible]
SANTIAGO THURMOND
AND SINCE WE
HAVE A COUPLE MORE MEMBERS HERE
WERE STILL AWAITING WORK GOING
TO GO THROUGH AND DO SOME I'M
ADD ONS SO WE ARE GOING TO START
THEM WILL.
OPEN BACK UP THAT THE CONSENT
[inaudible]
NAM.
AGENDA ITEMS THAT SPIDERS ONE
FIVE NINE TWELVE THIRTEEN AND
TWENTY TWO UNIT CALLED ABSENT
MEMBERS [inaudible]
BONTA [inaudible]
BURKE.
LIMON.
LIMON I SANTIAGO THURMAN.
RATHER IT MOVE ON TO ITEM NUMBER
CHIU SP.
TWO SEVEN FIVE BONTA BURKE
CARILLO.
CARILLO AYE FLOOR FROM SORRY LOW
MOAN.
LIMON AYE NAZARIAN SANTIAGO
THURMOND [inaudible]
I NEVER.
IT'S THAT STANDS AT TEN NINE TEN
VOTES.
WE HAD ITEM NUMBER.
THREE SB [inaudible]
SIX FORTY ONE BONTA [inaudible]
BURKE LOW MOAN AYE LAWN AYE
[inaudible]
SANTIAGO THURMAN [inaudible] TEN
VOTES --
ITEM NUMBER. FOR THAT MAKE IT ON
THE CAN.
THIS ITEM NUMBER FOUR OKAY.
MAYES HIGH MAYES AYE BONTA
[inaudible]
BURKE [inaudible]
LOW MOAN.
THE MOTOR AYE SANTIAGO THURMAN.
IT'S ZERO ITEM NUMBER SIX S. B..
NINE FORTY FOUR I'M SORRY TO
DUMP MAXIM.
MOVING ON ITEM NUMBER. SIX EIGHT
YEARS WHEREAS.
THAT'S ON EX ON COLLEGE
INITIATIVE THROUGH.
SO THIS LEPRECHAUN ITEM NUMBER
[inaudible]
EIGHT MAYES [inaudible]
OPPOSED NO [inaudible]
MAKES NO [inaudible]
BONTA [inaudible]
BURKE [inaudible]
FLORA.
WE'RE NOT VOTING.
AMONG.
THE MODE AYE MCCARTY.
MCCARTY I NAZARIAN.
RODRIGUEZ SANTIAGO THURMAN
WALDRON [inaudible]
SO.
WELL FOR NOT VOTING.
STOLEN SO SO SIX ONE WILL BE
THAT ON CALL [inaudible]
THIS -- TO
ITEM NUMBER ELEVEN SP ELEVEN
KNOWING.
I LEFT THE CALL [inaudible]
MAYES.
NO MAYES NO [inaudible]
BONTA BURKE [inaudible]
CARILLO.
CARILLO I FLORA I'M SORRY FLORA
HAVE IS NOT VOTING [inaudible]
LOW MOAN [inaudible]
LIMON I NAZARIAN.
RODRIGUEZ SANTIAGO THURMAN
WALDRON [inaudible]
WALTER NO.
IT'S FIVE THREE WILL.
WE'LL KEEP THE CALM THAT OF CALM
AND THEN.
OR IF.
FOURTEEN OF FOURTEEN I ASK
ELEVEN FIFTY TWO HERNANDEZ
[inaudible]
BONTA BURKE CARILLO.
CARILLO AYE FLORA.
FLORA NO LIMON.
LIMON AYE.
SANTIAGO THURMOND.
WALDRON.
WALDRON AYE.
SO EIGHTY THREE THE BILL AS IS
OUT LEAVING ON CALL.
COM FOR MEMBERS THAT ON I DON'T
[inaudible] EIGHTEEN SPONSOR A
TING.
SO ITEM NUMBER --
FIFTEEN LEVITY SIX LEYVA.
BONTA.
LET ALONE.
THE MOMENT I MCCARTY.
I MCCARTY AYE NAZARIAN
[inaudible]
RODRIGUEZ SANTIAGO [inaudible]
EIGHT THREE LET'S EIGHT THREE
IT'S PASSABLE LEAVE IT OPEN
FORUM.
PLEASE LEAVE ON CALL FOR ABSENT
MEMBERS [inaudible]
KNOWN.
TO ITEM NUMBER SIXTEEN ROTH S.
B..
TWELVE THIRTY EIGHT I LEFT THE
CALL [inaudible]
BONTA BURKE [inaudible]
FLORA.
FLORA NO LOW MOAN [inaudible]
LARA I NAZARIAN [inaudible]
SANTIAGO THURMAN.
IT'S FOR WILL OF EFFECT ON CALL
AND THAT WE ARE [inaudible]
SEVENTEEN STONE.
TWELVE FIFTY FOUR L. LIFT THE
CALL [inaudible]
BONTA [inaudible]
BURKE FLORA.
FLORA I LIVE MON.
LIMON I NAZARIAN.
RODRIGUEZ [inaudible]
SANTIAGO THURMAN.
THAT'S NINE ZEROS THAT BUILDS UP
IT WILL --
EVEN UNCALLED FOR ADAMS.
AND EIGHTEEN S. B..
TWELVE FIFTY FIVE LIFT THE CALL.
BONTA.
BURKE CARILLO.
STUDY EIGHTEEN S. B..
TWELVE FIFTY FIVE CARILLO I'VE
LARA.
FLORA I LOW MOANS.
LIMON I SANTIAGO THURMAN WALDRON
[inaudible]
WALDRON AYE.
RIGHT HERE ON THIS.
SO THAT IS A NINE TO THAT BILL
IS I'LL --
BUT WILL STILL I'M OF THE CALL
AND LEAVE IT OPEN.
AND THEN --
NINETEEN S. B. TWELVE SIXTY
EIGHT BRADFORD [inaudible]
WOULD.
ARE YOUR CURRY.
ACTOR CURRY I BONTA.
LOW MOAN.
LIMON AYE MCCARTY.
I MCCARTY AYE NOSE AREA
RODRIGUEZ SANTIAGO THURMAN.
SO THAT IS NICE THAT BILL IS OUT
BELIEVE THAT LEAVE IT OPEN FOR
ADD ONS.
AND I'D ITEM TWENTY SP.
TWELVE EIGHTY SEVEN AND LEFT THE
CALL [inaudible]
BONTA FIRST [inaudible]
CARILLO.
CARILLO AYE FLORA.
FLORA I LOW MOAN [inaudible]
LAMONT I SANTIAGO THURMOND
WALDRON.
WALDRON AYE [inaudible]
LIVE.
SO LET ME KNOW THAT BILLS OUT
BUT WE'LL LEAVE IT OPEN AS WELL
FRAT ARMS --
ITEM TWENTY ONE SP.
THIRTEEN SEVENTY FIVE I LEFT THE
CALL.
BONTA BURKE CARILLO.
CARILLO AYE FLORA [inaudible]
FLORIDA VOTING [inaudible]
LOW MOAN.
LEVINE I SANTIAGO THURMAN
WALDRON [inaudible]
WALDRON THOUGH.
SO IT SEVEN ONE SO LOVE WILL
LEAVE THAT OPEN.
AND WILL PLACE A BACK ON CALL.
AND THEN ITEM NUMBER TWENTY
THREE SB. FOURTEEN NINETY FIVE
LIFT THE CALL [inaudible]
WOULD.
EGGER CURRY.
FIGURE CURRY I BONTA
[inaudible]
BURKE [inaudible]
LOW MOAN.
THE MOMENT I MCCARTY.
MCCARTY I KNOW THIS AREA
[inaudible]
SANTIAGO THURMAN.
THAT IS NINE ZERO THAT'S OUT BUT
WE'LL LEAVE THAT OPEN I'M FOR AN
OUNCE OF
SWITCH WASN'T.
SO YOU WANNA VOTE YOU HAD NOT
VOTING BEHIND.
YEAH GO AHEAD.
SERENA BACK TO ITEM OR THREE SB
SIX IT'S FORTY ONE AGUIAR-CURRY
NOT VOTING TIME I SO ELEVEN
ELEVEN ZERO ON THAT LEAVE IT
OPEN
.
SO WE ARE MOVING ALONG DUH
SENATOR SKINNER IS --
IS HERE SO WE'RE GONNA MOVE
ALONG TO S. B..
THAT -- ONE
ZERO ZERO EIGHT THE BILL.
I GOOD AFTERNOON BREAD OF HEAVEN
SPENCER WITH THE CALIFORNIA
DALLAS ASSOCIATION HERE --
AS THE SPONSOR OF THE BILL VERY
PLEASED TO WORK WITH THE SENATOR
ON THIS.
TIME THIS IS BILLED BUILD OFF OF
AN EFFORT THAT WE HAVE A
PREVIOUS LEGISLATION WE RAN IN
TWENTY FOURTEEN TO INCREASE
DENTAL PLAN TRANSPARENCY IN
VALUE.
I'M ONE OF THE THINGS ARE
MEMBERS HERE FROM THEIR PATIENTS
IS THAT THEY DON'T REALLY
UNDERSTAND THEIR PLAN BENEFITS
AND THAT ALSO I'M WHEN THEY'RE
IN THE MIDDLE TREATMENT THEY
OFTEN DON'T UNDERSTAND WHAT THE
PLAN IS GOING TO COVER.
AND THEN SOMETIMES AFTER THE
FACT WHAT THEY'LL BE ON THE HOOK
FOR SO WHERE THIS TO PROVISIONS
IN THE BILL ONE IS CREATING A
STANDARDIZED MATRIX THAT WOULD
ALLOW PATIENTS TO BETTER
UNDERSTAND THEIR PLAN BENEFITS.
AND THE SECOND IS REQUIRING
PLANS TO MORE FULLY COMMUNICATE
WITH OUT OF NETWORK PROVIDERS SO
THAT THEY CAN EDUCATE THEIR
PATIENTS ABOUT THE TRUE COST AND
WE REALLY APPRECIATE THE
WILLINGNESS OF THE DENTAL PLANS
TO WORK WITH US WE KNOW IT'S
BEEN A LONG PROCESS --
WE ARE TAKING SOME AMENDMENTS I
BELIEVE IN COMMITTEE TODAY THAT
WOULD REMOVE I'M ONE OF THAT ONE
OF THEIR PIECES OF OPPOSITION
AND WE'RE GONNA BE WORKING WITH
THEM.
IN THE FALL ON FURTHER
DISCUSSIONS AROUND.
THE GOAL OF CDA AND WE THINK
THAT THERE'S A POTENTIAL
REASONABLE DEAL I THAT WE CAN
GET YOU AND ARE HOPEFUL THAT WE
CAN HAVE SOME DISCUSSIONS
ALTHOUGH DEATHLY NO COMMITMENT
THERE -- SO
WITH THAT I WOULD JUST URGE YOUR
AYE VOTE THANK YOU.
SWEAR TO MAKE SURE THAT YOUR
EXCEPT I COMMITTEE RIGHT.
I WAS GOING TO REFERENCE THE
AMENDMENTS AND IN MY CLOTHES BUT
I AM HAPPY TO NOW YES WE ARE
TAKING THE AMENDMENTS OUTLINED
IN THE COMMITTEE ANALYSIS.
THAT AND WE ARE ALSO TAKING THE
ADDITIONAL AMENDMENT THAT THE
SPONSOR JUST MENTION TO REMOVE
DISCLOSURE OF DENTAL LOSS RATIO
FROM THE SUMMARY.
GREAT THANK YOU ANY NAM OTHER
WITNESSES IN SUPPORT.
MARRIAGES ARE IS ON BEHALF OF
HEALTH ACCESS CALIFORNIA WE ARE
PIECES SUPPORT S. B. TEN NO WAIT
AS PROPOSED TO BE AMENDED.
AYE YOU FOR IT UNIFORMITY IN
SUMMARY OF BENEFITS AND COVERAGE
WILL MAKE IT EASIER FOR
CONSUMERS TO COMPARE ACROSS
DIFFERENT DENTAL PLANS AND
ACROSS DIFFERENT MARKETS. FOR
THIS REASON WE ARE IN SUPPORT
THANK YOU.
GREAT ANY DISTURBANCES SUPPORT.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY IN SUPPORT.
KIMBERLY TIME HAVE TO CALIFORNIA
PAN ETHNIC HEALTH NETWORK IN
SUPPORT [inaudible]
THANK YOU.
MAKE IT ALRIGHT ON BEHALF OF THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT [inaudible]
YOU.
ANYMORE WITNESSES IN SUPPORT.
IT'S MOVED TO WITNESSES IN
OPPOSITION.
GOOD EVENING CHRISTY WE SAW
BEHALF OF THE CALIFORNIA
ASSOCIATION OF DENTAL PLANS WE
DO HAVE BEEN OPPOSED POSITION --
WE WANT TO ACKNOWLEDGE AND THANK
SENATOR SKINNER'S COMMITMENT TO
REMOVE THE PROVISION IN THE BILL
THAT WOULD REQUIRE THE LOSS
RATIO TO BE INCLUDED ON THE THE
MATRIX AT THE BILL CREATES
THAT'S OF TO SIGNIFICANT ISSUE
FOR US AND WE HAVE BEEN IN
DISCUSSIONS WITH THE AUTHOR.
HERSELF IN THE SPONSOR AND SO
THE REMOVAL.
OF THAT PROVISION WILL GO A LONG
WAY TOWARD HELPING US.
GET TO A PLACE WHERE WE CAN WORK
THROUGH THE REMAINING ISSUES
THERE IN THE BILL --
THE DENTAL PLANS OBVIOUSLY SHARE
THE INTEREST OF THE DENTISTS TO
MAKE SURE THAT CONSUMERS
UNDERSTAND HOW THEIR COVERAGE
WORKS AND SO WE THINK WITH SOME
ADDITIONAL DISCUSSIONS WE CAN
GET THERE AND RESOLVE OR
REMEDIATE ISSUES.
IN THE BILL THAT WE ARE ON
RECORD.
AS OPPOSED TODAY BUT WERE
OPPOSED TO GETTING THERE.
GREAT ANYMORE WITNESSES IN
OPPOSITION.
AND ANYONE WITH THE ASSOCIATION
OF CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES WE HAVE AN
OPPOSING LESS AMENDED AIRLINER
COMMENTS WITH MISS WHEEZE.
THANK YOU MISTER CHAIRMAN MARINO
HERE REPRESENTING DELTA DENTAL
OF CALIFORNIA WE ALSO HAVE AN
OPPOSE LESS AMENDED POSITION BUT
AGAIN THANK THE AUTHOR.
HAS PURSUE WE SAID WE'RE
COMMITTED TO SITTING DOWN WITH A
DENTAL PLANS FALL VERY COMMITTED
TO WORKING SOMETHING OUT --
IN THE MEANTIME ON THE BILL
THANKS VERY MUCH.
JOHN WINGER ON BEHALF AMERICA'S
HEALTH INSURANCE PLANS WOULD
ALSO LINER COMMENTS WAS CAP
THINGS [inaudible]
Q..
JENNIFER I WITH CALIFORNIA
ASSOCIATION OF HEALTH PLANS ALSO
ALIGNING OUR OUR COMMENTS WITH
THIS WEEK [inaudible]
THANK YOU.
JERRY MCKEE REPRESENT CALIFORNIA
CHAMBER OF COMMERCE WE TO ALIGN
OUR COMMENTS WITH MY COLLEAGUES
THANK YOU.
THANK YOU COME BACK TO KNOW THE
COMMITTEE ANY QUESTIONS OR
COMMENTS.
SEEING NONE I DO BELIEVE THAT WE
HAVE A MOTION --
BY MR MCCARTY AND THEN SEC.
WAS OUR SECOND WAS THAT I QUIRK
CURRY --
SENATOR WOULD YOU LIKE TO CLOSE
AS I ALREADY OUTLINED THE
AMENDMENTS AND AS YOU HAVE A
MOTION BEFORE YOU I WILL
RESPECTFULLY ASK FOR YOUR AYE
VOTE.
GREAT WILL THEN --
THE MOTION IS TO PASS AS AMENDED
INTO APPROPRIATIONS PLEASE CALL
THE ROLL [inaudible]
WOULD.
MAYES I MAYES AYE AGAR CURRY.
ACTOR CURRY I BIGELOW.
I'VE BIGELOW AYE.
BONTA [inaudible]
BURKE [inaudible]
CARILLO.
FLORA.
FLORA I LOVE BOTH.
LIMON I MCCARTY.
MCCARTY I IN THIS AREA.
RODRIGUEZ [inaudible]
SANTIAGO.
SANTIAGO AYE THURMAN
[inaudible]
WALDRON [inaudible]
WALDRON AYE.
SCOTT EIGHT VOTES SO THAT BILL
IS OUT WE'RE GONNA LEAVE IT OPEN
FOR A FRAT ONS THANK THANK YOU.
AND THEN EYES DID YOU SEE.
SENATOR WIENER HERE SO WE'RE
GOING TO MOVE --
TO S. B..
TEN FORTY FIVE LEE THAT'S ITEM
NUMBER [inaudible] TEN BILL.
WITH NO AMENDMENTS [inaudible]
NNOVA.
THIS IS LIKE THE THIRD TIME
TODAY WE HAD THIS DOG AND PONY
SHOW GOING ON SENATOR THE FLOOR
IS YOURS.
OKAY THANK YOU --
MISTER VICE CHAIR.
LIKE COLLEAGUES I'M PRESENTING A
SPEED TEN FORTY FIVE TODAY --
WHICH IS --
A CONSERVATORSHIP DEL --
TO HELP US SOME OF THE MOST ARE
DEBILITATED AND OUR PEOPLE ON
OUR STREETS --
TO TO MENTAL ILLNESS AND
SUBSTANCE ABUSE DISORDER ARE
GOING TO START BY THANKING THE
THAT CHAIR DOES NOT HERE AND
AUDIT COMMITTEE STAFF ARE FOR
WORKING WITH US --
AS WELL AS WITH THE JUDICIARY
COMMITTEE WE ALL WORK TOGETHER
ON AMENDMENTS --
AND I DO ACCEPT THOSE AMENDMENTS
ON I BELIEVE WILL BE ADOPTING
THEM IN THE JUDICIARY COMMITTEE.
OF LATER THIS WEEK --
SO THANK YOU FOR THAT.
ON THIS BILL --
IS IS REALLY ABOUT A SMALL US
SUBSET OF OUR HOMELESS
POPULATION NO ON OUR STREETS NOT
JUST IN SAN FRANCISCO --
BUT IN LOS ANGELES AND FRANKLY
IN OTHER PARTS OF THE STATE
ALTHOUGH THIS BILL IS LIMITED --
TO SAN FRANCISCO AND LOS ANGELES
IS A PILOT PROGRAM WHO ARE
UNRAVELLING AND AND UNFORTUNATE
DYING.
PEOPLE HER SEVERELY DRUG
ADDICTED --
SEVERELY MENTALLY ILL ARE IN SO
ALTHOUGH WE ALL WANT TO SEE MORE
ON SERVICES OFFERED HOUSING.
TREATMENT --
TOTALLY IN FAVOR OF THAT --
YOU THESE ARE PEOPLE YOU CAN'T
REACH SIMPLY BY OFFERING
SERVICES AYE AND RIGHT NOW.
NOW THE TOOLS THAT ARE COUNTIES
HAVE --
UNDER THE LPS ARE AYE
INSUFFICIENT TO REGION'S
POPULATION IN FOR TYPICALLY. FOR
PEOPLE WHO ARE --
ADDICTED --
THEY GOT HELD IN A SEVENTY TWO
HOUR HOLD AND BY THE END OF THE
SEVENTY TWO HOURS WHEN THEY GO
BEFORE A JUDGE --
THEY SEEM SOBER AND NORMAL AND
THE JUDGE SAYS WELL THERE'S NO
BASIS TO HOLD THIS PERSON SEEMS
FINE TO ME --
AND NEVER MIND THAT THEY'VE BEEN
FIFTY ONE FIFTY FIVE OR SIX OR
SEVEN TIMES IN THE LAST YEAR.
AND SO WHAT ENDS UP HAPPENING
THESE PEOPLE ARE THEY DO END UP
GETTING CONSERVE.
BUT IT'S CALLED IT'S A DIFFERENT
KIND OF CONSERVATORSHIP CALLED
JAIL BECAUSE THEY END UP CYCLING
THROUGH THE CRIMINAL JUSTICE
SYSTEM.
OTHER FIRST THEIR MAIN
INTERACTIONS WITH POLICE
OFFICERS NOTS NOT.
WHAT WE WANT TO HAVE HAPPEN
PEOPLE CONSTANTLY INTERACTING
WITH POLICE OFFICERS?
GOING TO JAIL GETTING THEIR
TREATMENT IN JAIL WE WANT TO
GIVE PEOPLE A DIFFERENT CITING.
AND THIS TOOL OF WHICH WILL
ALLOW.
PLACE PEOPLE INTO A
CONSERVATORSHIP UNDER VERY
NARROW CIRCUMSTANCES IN TERMS OF
LOOKING AT THEIR TRACK RECORD
HOW MANY TIMES HAVE THEY BEEN.
FIFTY ONE FIFTY EIGHT OF FOR
EXAMPLE --
THEIR DIAGNOSIS THEIR INABILITY
CARE FOR THEMSELVES.
I'D THE BILL RETAINS ALL OF THE
STRONG DUE PROCESS PROTECTIONS
ARE CURRENTLY IN OUR
CONSERVATIVE SHIP LAWS YOU I
HAVE TO GO BEFORE A JUDGE.
UNION TRIAL BY JURY --
YOU GOT A RIGHT TO AN ATTORNEY
IN SAN FRANCISCO WE PROVIDE A
FULL PUBLIC DEFENDER --
AND YOU GET PERIODIC A REVIEW
EYES YOU KNOW THERE'S AN
ESCALATION IN TERMS OF THE PEER
TIME IT NEVER IS MORE.
ABOUT IN ONE YEAR BY THE BILL
HAS BEEN --
AMENDED OVERTIME AS HAS
ASSEMBLYMAN AYE SANTIAGO'S WERE
--
WE'RE BOTH ON THIS PARALLEL
TRACK AND LOTS OF AMENDMENTS TO
MAKE SURE THAT WE ARE REALLY
PROVIDING WRAPAROUND SERVICES --
WHETHER WE WANT TO USE I LEAST
RESTRICT --
WE HAVE PEOPLE WHO ARE CONSERVE
TO LIVING IN SUPPORT OF HOUSING
IS NOT JUST ABOUT PUTTING
EVERYONE.
IN A LOCKED FACILITY THAT MAY BE
NECESSARY FOR SOME PEOPLE BUT
THE PREFERENCE THE STRONG
PREFERENCE I IS TO HAVE PEOPLE
IN.
MY SUPPORT OF HOUSING AND OF
COURSE THE ULTIMATE GOAL IS TO
GET PEOPLE HEALTHY AGAIN --
IT'S NOT HUMANE OR PROGRESSIVE.
TO HAVE PEOPLE DYING ON OUR
STREETS AND TO JUST WALK BY AND
SAY WELL IT WOULD BE GREAT IF WE
COULD DO SOMETHING ABOUT IT.
WERE TRYING TO DO SOMETHING
ABOUT IT --
SAN FRANCISCO AND LOS ANGELES
ARE BOTH COMING TO THIS
LEGISLATURE ASKING FOR THESE
TOOLS THERE OTHER COUNTIES
INTERESTED AS WELL.
AND THE ORIGINAL BILL DID
INCLUDE ALL FIFTY EIGHT COUNTIES
IT'S BEEN NARROWED TO TWO
COUNTIES IN THE PILOT PROGRAM.
AYE IT'S A GOOD BILL AND I
RESPECTFULLY ASK YOUR I DON'T.
WITH ME TODAY ARE KELLEHER MOTO
NAM WHO IS THE DIRECTOR OF
TRANSITIONS FROM SAN FRANCISCO
TO PART IN PUBLIC HEALTH.
AND JILL NELSON --
WHO IS THE DEPUTY DIRECTOR OF
PROGRAMS AFTER THE SAN FRANCISCO
DEPARTMENT OF AGING?
ADULT SERVICES THANK YOU
[inaudible]
THANK YOU.
WHEN IT'S IN SUPPORT?
I'M JOHN YELTSIN AND DEPUTY
DIRECTOR PROGRAMS THE DEPARTMENT
OF AGING ADULT SERVICE SAYS OUR
DEPARTMENT OPERATE SAN
FRANCISCO'S OFFICE OF THE PUBLIC
SENATOR WIENER FOR HIS
LEADERSHIP ON THIS REALLY
IMPORTANT ISSUE AND THANK ALL OF
YOU FOR YOUR TIME TODAY --
SAVVY AS YOU'VE HEARD SP TEN
FORTY FIVE WOULD CREATE AN
OPTIONAL NEW CONSERVATORSHIP TO
SERVE OUR MOST AT RISK RESIDENTS
THOSE EXPERIENCING MENTAL
ILLNESS AND SUBSTANCE USE
DISORDER.
LIMITING AND ADULTS CIVIL
LIBERTIES IS A SERIOUS MATTER
AND CONSERVATORSHIP IS
ABSOLUTELY CONSIDERED TO BE AN
INTERVENTION OF LAST RESORT.
BUT THE FACT REMAINS THAT THERE
IS A SMALL SUBSET OF OUR
POPULATION THAT FACE.
PROFOUND CHALLENGES OUT AND
THEY'RE NOT ABLE TO ENGAGE IN
SERVICES ON A VOLUNTARY BASIS.
WE SEE THEIR HEALTH DETERIORATE
WITH EACH CRISIS S. B. TEN FORTY
FIVE WOULD OFFER US A WAY TO
HELP BREAK THE CYCLE OF STREETS
HOSPITALS IN JAIL A CYCLE THAT
ABSOLUTELY DOES NOT.
FACILITATE OR PROMOTE THEIR
RECOVERY.
WE BELIEVE THAT THE PROVISIONS
IN SB TEN FORTY FIVE WOULD
PROVIDE US WITH A TOOL THAT CAN
HELP TO SAVE THE LIVES OF
PEOPLE.
THAT CANNOT ACCESS HELP TO OUR
CURRENT LAWS.
THE LPS ACTS IN LAURA'S LAW OR
ASSISTED OUTPATIENT TREATMENT
BOTH HAVE NARROW ELIGIBILITY
CRITERIA.
AND NEITHER CONSIDER SUBSTANCE
USE EXCEPT FOR ALCOHOL AS A
SPECIFIC CONTRIBUTOR TO GRAY
DISABILITY.
THE REALITY IS THOUGH THAT ON
THE STREETS TODAY.
METHAMPHETAMINES AND HARRY DRUGS
ARE RAVAGING OUR STREETS AS SUCH
WE HAVE INDIVIDUALS OR TWO ELDER
ACCEPT VOLUNTARY SERVICES UNDER
LAURA SAW.
BUT THEY DON'T PRESENT WITH THE
OVERWHELMING LEVEL OF DISABILITY
REQUIRED TO SATISFY THE LPS
INVOLUNTARY HOLDS ESPECIALLY
ONCE THEY'VE BEEN IN THE
HOSPITAL FOR A COUPLE OF DAYS.
BECAUSE SUBSTANCE USE A MENTAL
ILLNESS OR CHRONIC CONDITIONS
IT'S ACTUALLY POSSIBLE THAT THE
DIFFERENT POSSESS PROVISIONS.
IS LARA'S LAW LPS IN S. B. TEN
FORTY FIVE CONSERVATORSHIP COULD
SERVE THE SAME INDIVIDUAL BUT AT
DIFFERENT POINTS IN TIME.
WE THINK THAT S. B. TEN FORTY
FIVE WOULD HELP TO FILL A GAP.
AND WE SEE A REAL OPPORTUNITY TO
HELP STABILIZE PEOPLE WHO ARE IN
CRISIS AND HELP THEM TO ACCESS
SERVICES THAT THEY MAY NOT BE
AWARE THAT THEY ACTUALLY NEED.
AND WE STAND READY TO PROVIDE
THEM WITH SERVICE RICH HOUSING
IN PLACEMENT --
A WE DO DISAGREE WITH THE
SUGGESTION THAT S. B. TEN FORTY
FIVE WOULD GREATLY EXPAND.
THE POTENTIAL NUMBER OF
INDIVIDUALS WHO WOULD BE UNDER A
CONSERVATORSHIP WE FEEL THAT WE
WOULD BE --
USING THE VERY NARROW
ELIGIBILITY CRITERIA IN SP. TEN
FORTY FIVE TO REACH THE
INDIVIDUALS --
WHO WE ACTUALLY ALREADY KNOW
BECAUSE THEY ARE IN OUR
DEPARTMENT OF PUBLIC HEALTH
SYSTEMS AND OUR --
CRIMINAL JUSTICE SYSTEMS.
SO WE SUPPORT THE NARROW
ELIGIBILITY CRITERIA SP TEN
FORTY FIVE PROPOSES AND WE
REALLY APPRECIATE THE SAFEGUARDS
IN PROTECTIONS.
THAT WOULD SUPPORT AN
INDIVIDUAL'S RIGHT TO CONTEST
CONSERVATORSHIP WITH LEGAL
REPRESENTATION.
SOME HAPPY TO ANSWER ANY
QUESTIONS THAT YOU MIGHT HAVE
THANK YOU.
IN SHARING TRAIN MEMBERS MY NAME
IS KELLY HOW ABOUT ON I'M THE
DIRECTOR TRANSITIONS AT THE
SARASOTA PART OF PUBLIC HEALTH.
MY TEAM IS RESPONSIBLE FOR
PROVIDING APPROPRIATE PLACEMENT
FOR INDIVIDUALS WHO ARE PLACED
ON CONSERVATORSHIP SO WE DO NOT
HAVE A PLACE TO GO AFTER LEAVING
THE HOSPITAL.
AS YOU'VE HEARD S. B. TEN FORTY
FIVE IS INTENDED.
THESE INDIVIDUALS ARE NOW BUT A
SYSTEM OF CARE BUT ARE CURRENTLY
HARD TO REACH I'D LIKE TO OFFER
AN EXAMPLE OF WHO THAT MIGHT BE.
MR JOHNSON IS A FIFTY SIX YEAR
OLD MAN WITH A LONG HISTORY
WITHIN THE CITY SYSTEM OF CARE
BUT ONLY WITH CRISIS SERVICES
ARE JAIL.
IN THE PAST YEAR HE HAS BEEN
BROUGHT TO PS FIFTEEN TIMES HE
HAS HAD TEN ENCOUNTERS WITH THE
SAN FRANCISCO POLICE DEPARTMENT.
HE IS KNOWN TO BE HOMELESS HAS A
MAJOR DEPRESSION DIAGNOSIS IS
NOT ENGAGE IN ANY TREATMENT
SERVICES ARE BEING OFFERED ANY
CURRENT HOUSING OPPORTUNITIES
BECAUSE OF ITS ACT OF SUBSTANCE
ABUSE.
METHAMPHETAMINE USE IS OBSERVED
AS A PRIMARY ISSUE DURING HIS PS
VISITS IN AFTER A TWELVE HOUR
STAY HE TENDS TO CLEAR UP ENOUGH
TO NO LONGER MEET MEDICAL
NECESSITY IN ITS RELEASED.
HE RETURNS TO PS LATER THAT WEEK
HAVING THEN PICKED UP BY THE
POLICE FOR BEING UNDER THE
INFLUENCE ADDRESSING IN PUBLIC
IN EXITING AGGRESSIVE BEHAVIORS
TOWARDS OTHERS ON THE STREET.
HE ONCE AGAIN CLEARS AFTER AN
OVERNIGHT STAY IN IS RELEASED IN
THE MORNING BECAUSE HE NO LONGER
MEETS GAVE DISABILITY CRITERIA
SITTING YOU WILL GO TO SAINT
ANTHONY'S FOR LUNCH AND WE'LL GO
TO THE SHELTER AFTER THAT TO
WAIT FOR A BED.
WHEN HE IS DISCHARGED HE STARTS
OUT FOR SAINT AND SAINT
ANTHONY'S BUT ENDS UP LOOKING
FOR DRUGS ON THE WAY?
AND FORTUNATELY I COULD SHARE
MORE EXAMPLES LIKE THIS
INCLUDING ONES OF AGING
INDIVIDUALS WHO HAVE SERIOUS
MENTAL ILLNESS SUBSTANCE USE
DISORDER AND OTHER CONDITIONS
LIKE DIABETES OR HIV.
SERVICES GOES A LONG HISTORY OF
PROVIDING COMPASSIONATE CARE
FONG A COVER GRANTED MODEL.
RECENTLY WE STARTED AN INTER
AGENCY WORKING GROUP TO CREATE
CARE PLANS FOR THE FORTY TO
FIFTY OF OUR HIGHEST UTILIZE
YEARS OF MULTIPLE SYSTEMS.
SOME AMONG THIS GROUP HAVE BEEN
KNOWN TO THE CITY FOR YEARS AND
WE HAVE NOT BEEN ABLE TO HELP
THEM.
STABILIZE NOT BECAUSE WE HAVEN'T
TRIED THAT BECAUSE THEIR ABILITY
FOR SELF CARE IS DETERIORATED
OVER TIME AND VOLUNTARY SERVICES
ARE HARDER AND HARDER FOR THEM
TO ACCEPT. FOR THEM IT'S BECOME
FREE FIVE CAN BE A PATH TO
STABILITY HOUSING IN A VASTLY
IMPROVED QUALITY OF LIFE THANK
YOU AND HAPPY TO ANSWER ANY
QUESTIONS.
THANK YOU OTHERS AND SUPPORT.
MISTER CHAIRMAN WAS ALEX
HAWTHORN CALIFORNIA HOSPITAL
ASSOCIATION HERE IN SUPPORT.
MISTER CHAIRMAN THERE'S MORE
ASSEMBLE WHICH I OR ANTI ON
BEHALF OF MAYOR GARCETTI IN THE
CITY OF LOS ANGELES AND THE CITY
OF SANTA MONICA AND SPORT.
SECURE.
NICOLE WATERMAN ON BEHALF OF THE
ORANGE COUNTY BOARD OF
SUPERVISORS AND SUPPORT.
SO ANYONE IN OPPOSITION
.
MISTER CHAIR MEMBERS SUCKER
CHILD DISABILITY RIGHTS
CALIFORNIA I'M HERE ON BEHALF OF
A COALITION OF MENTAL HEALTH
ADVOCATES.
HEALTH ADVOCATES --
AND CIVIL RIGHTS ADVOCATES DO UP
UNFORTUNATELY IN REGRETFULLY
OPPOSE THIS BILL --
WITH THAT BEING SAID I WOULD I
WOULD LIKE TO SAY THAT.
THE A I THINK THE COMMITTEE
CONSULTANT OF THE COMMITTEE
ANALYSIS REALLY DRILL DOWN TO
WHAT ARE THE SIGNIFICANT ISSUES
THAT WE'VE HAD.
IN ARE CONCERNED WITH THIS BILL
OUR OPPOSITION REMAINS BECAUSE
INVOLUNTARY EXPANSION OF
INVOLUNTARY CARE IS GOING
DIRECTLY COUNTER TO WHERE WE'VE
BEEN FOR THE LAST TWENTY THIRTY
YEARS.
ON MOVING MORE DIRECTLY
INDIVIDUALS OUT OF INSTITUTIONS
AND INTO A COMMUNITY BASED
SETTINGS FROM COMMUNITY BASED
CARE WHEN WE START IMPOSING
AGAIN INVOLUNTARY CARE.
YEAH OF PROVISIONS WE END UP
GOING IN THE WRONG DIRECTION --
BUT I WOULD LIKE TO SAY THAT THE
AMENDMENT TO THAT HAVE BEEN
PROPOSED HERE NARROW I THINK THE
STANDARD AND THE REST THAT ARE
OPPOSE THAT YOU WILL PULL INTO
THOSE.
PERSONS WHO --
WOULD BE MORE BROADLY DEFINED
AND NOT NECESSARILY --
REQUIRED TO BE --
ENVELOPED IN HELD.
AND AT ADDITIONALLY WHAT IS
CENTRAL --
TO OUR POSITION IS THAT IF WE
ARE PULLING INDIVIDUALS AND ON
THE INVOLUNTARY HOLDS THAT THAT
HAS TO BE TIED DIRECTLY TO
SERVICES.
WE HAVE IN MANY MANY PLACES --
INCLUDING THIS A. B. A MENTAL
HEALTH SYSTEM THAT IS FAILING
INDIVIDUALS.
AND TO PUT MORE PEOPLE INTO THAT
SYSTEM IS THE WRONG DIRECTION WE
NEED TO BUILD THAT BACK AND FOR
INDIVIDUAL SO THAT THOSE
SERVICES ARE AVAILABLE --
FOR THEM AND WHEN I SAY SERVICES
THAT IS SUPPORTIVE HOUSING
LOCATED IN THE COMMUNITY --
IT WRAPAROUND SERVICES --
AVAILABLE FOR THOSE INDIVIDUALS
PHYSICAL CARE AND MENTAL HEALTH
AND BEHAVIORAL HEALTH CARE --
FOR FOR THEM IF THOSE ARE --
ASSURED TO THESE INDIVIDUALS WE
BELIEVE THAT THAT THEN BECOMES
PROGRESS IN TREATING THE THE
INDIVIDUALS THAT I THINK --
THE AUTHOR AND THE SPONSORS OF
THIS BILL ARE SEEKING --
TO PROVIDE FOR THANK YOU.
GOOD EVENING CHEN FLOYER IS
WESTERN CENTER ON LAW AND
POVERTY I TOO WOULD LIKE TO
ACKNOWLEDGE --
THE PROGRESS THAT HAS BEEN MADE
IN THE AMENDMENTS WERE
PARTICULARLY GRATEFUL TO SEE
WHAT WE THOUGHT OF OR INCENTIVES
TO CONTINUE ARRESTING PEOPLE
LIVING ON THE STREETS AND SOME
OF THE THINGS THAT WE FELT TAT
WORK.
THAT COULD HAVE.
UNINTENDED CONSEQUENCES THE
AMENDMENTS SEEM TO BE ADDRESSING
THOSE -- AND
WE ALSO DO APPRECIATE THE
ADDITIONAL DUE PROCESS
PROTECTIONS --
AND THE INTENT TO LINK PEOPLE
TOWARD SERVICES WE DO REMAIN
OPPOSED MAINLY BECAUSE WE JUST
YOU KNOW THE PROMISES OF DE
INSTITUTIONALIZATION TO PROVIDE
COMMUNITY BASED SERVICES AND THE
PROMISES OF THE MENTAL HEALTH
SERVICES ACT.
JUST HAVE NEVER BEEN FULLY
FULFILLED.
PLACE WERE STILL GOING TO BE
CREATING THE SITUATIONS BUT WE
WE ARE APPRECIATIVE OF THE
MOVEMENT THAT HAS HAPPENED WITH
THIS BILL.
THANK YOU VERY MUCH OTHERS IN
OPPOSITION.
PLAIN X. CALIFORNIA THE
DISABILITY RIGHTS CALIFORNIA
LINES RETIRED AMERICANS OF
STRONG UP CLOSE.
AND AS A CLIENT.
I OPPOSE.
HIGHLY STRUNG WITH THE
CALIFORNIA ASSOCIATION OF SOCIAL
REHABILITATION AGENCIES IN
OPPOSITION.
KIMBERLY CHANNEL BEHALF THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK WE DO HAVE A OPPOSE
UNLESS AMENDED --
POSITION RIGHT NOW WE LOOK
FORWARD TO REVIEWING THE
PROPOSED AMENDMENTS IN DETAIL
AND APPRECIATE THE CONVERSATIONS
THAT HAVE --
OCCURRED THIS FOR THANK YOU PICK
YOU.
JERRY BROWN AROUND BEHALF SEIU
CALIFORNIA --
IN.
YEAH OPPOSE WITH OUR ALLIES
THINK [inaudible]
ANYONE ELSE [inaudible]
AFFORDABLE.
CENTER APPRECIATE YOU BRINGING
THIS UP IT'S A IT'S TIME THAT WE
DO SOMETHING AND ONE OF OUR
COUNTIES AND IN THE CENTRAL
VALLEY STANISLAUS COUNTY IS
ACTUALLY.
BEEN VERY ACTIVE AND ADDRESSING
THIS HOMELESS POPULATIONS I
WOULD LOVE TO CONTINUE THE
CONVERSATION ON PROUD TO SUPPORT
THIS BILL TODAY AND TING TING IN
THE CONVERSATION.
TRYING YOU MAY BE RURAL
STANISLAUS COUNTY INVOLVED IN
THIS IS ALSO APPRECIATE VERY
MUCH.
I THANK YOU AND AND STANISLAUS
COUNTY BOARD OF SUPERVISORS THIS
ACTUALLY IDEA OF I THINK
ORIGINATED --
THEY WERE INVOLVED IN THEN WE
HAVE THAT ON MOVIE AND SAN
FRANCISCO --
THEY DID SEND A LETTER ASKING TO
BE INCLUDED THE BILL STARTED IS
IMMENSE WITH ALL FIFTY EIGHT
COUNTIES --
SENATOR JACKSON AYE ASSETS TO
NARROW ITS TO COUNTIES WE DID --
I THINK THAT THERE ARE AYE.
PERSONALLY I THINK ANY COUNTY
THAT ONCE OFTEN IF THEY'RE ABLE
TO OFFER THE SERVICES AND MAKE
CERTAIN SHOWINGS.
THEY SHOULD BE ABLE TO SO I'M
OPEN TO TRYING TO RESOLVE OUT BY
STANISLAUS COUNTY WILL NEED TO
GO.
BUY MORE ACTIVE THROUGH ITS
NUMBERS TO MAKE THOSE REQUESTS
[inaudible]
SUCH.
ALL I DON'T THINK THE AUTHOR
BECAUSE HE HE AND I HAVE BEEN
WORKING ON THIS ISSUE FROM FROM
DIFFERENT HOUSES FOR DEBATE AND
IT'S LIKE A LITTLE BIT DIFFERENT
BUT NOT REMIND.
THE COMMITTEE THAT WHEN WE'VE
SUPPORT OUR BILL HOW NOW MY
BILLS HAD THE SAME FATE ON THE
ON THE OP ON THE OTHER HOUSE
WHERE IT'S BEEN NARROWED TO ONE
COUNTY THIS AFTERNOON I
UNDERSTAND IT'S BEEN NEARLY DID
NOW TO COUNTIES --
SAN FRANCISCO LOS ANGELES BUT I
THINK IT'S A WORTHWHILE
CONVERSATION AND I'VE MET WITH
THE OPPOSITION --
BRIEFLY HOW MY WAY OUT FROM THE
LAST MEETING.
AND THERE IS AMERICA ARGUING
ABOUT PEOPLE HAVING SERVICES --
TODAY.
BUT IT MAY BE A STRETCH TO FIND
BETTER LANGUAGE WHEN A JUDGE OR
A COURT IS CONSIDERING.
A CONSERVATIVE BECAUSE EVERY
THERE'S EVERY EFFORT AND WHAT
WE'RE TRYING TO DO AND WHAT I
THINK I HEARD --
MISTER A WINNER PRESENT --
THERE'S EVERY EFFORT THAT THIS
PROCESS GET SOMEBODY TO A BETTER
LIFE.
AND THAT'S THE MORE HUMANE THING
TO DO I THINK THAT'S WHAT WE
CAN'T LOSE IN THIS PROCESS AND I
I I WON'T REPEAT THIS THOUGH THE
LONG SPEECH ENABLED WE TALKED
ABOUT A KAZOO IT'S IT'S
DIFFICULT. TO DIFFICULT SUBJECT
THAT THINK THAT YOU CAN PICK
SOMEBODY UP AGAINST THEIR OWN
WILL BUT IT BUT AT THE VERY END
OF THE DAY.
IT IS ABSOLUTELY THE MORE HUMANE
THING TO DO THAN TO WATCH --
SOMEBODY POTENTIALLY DIE ON THE
STREET --
.
THERE ARE LITERALLY PEOPLE ON
THE STREETS AND AND I I I I KNOW
YOU KNOW THIS BUT THEY WHO.
HAVE NO TOES.
OR FEET OR RAPED [inaudible]
AND YOU TO TURN A BLIND EYE AND
NOT CHALLENGE THE CURRENT LAWS.
IT IS ABSOLUTELY IN HUMANE ARM.
ALL BE OF STOP NOW GENERAL.
MAKING A LOT MEETING LONGER BUT
I CANNOT EMPHASIZE ENOUGH HOW
MUCH WE NEED TO CHALLENGE --
THE LAWS THAT WE HAVE TODAY
BECAUSE THEY'VE RESULTED IN SOME
PRETTY HORRIFIC --
OUTCOMES AND WHEN WE HAVE THE
LOS ANGELES COUNTY EIGHT HUNDRED
PEOPLE DIED AND I CAN'T GIVE YOU
THE EXACT NUMBER OF THE PEOPLE
WHO WANT TO BENEFIT FROM THIS
LAW.
BUT EIGHT HUNDRED PEOPLE DIED ON
THE STREETS LAST YEAR ALONE.
IN THE END I GUESS AND AND I GOT
IMAGINE THAT THERE ARE.
THERE ARE PLENTY OF EXAMPLES
THAT WE KNOW IN EACH OF OUR
DISTRICTS.
I WISH IT WERE STATEWIDE.
ARM AYE I WISH IT WAS MORE
AGGRESSIVE QUITE FRANKLY.
OF THE IN THE SENSE THAT THE IN
THE SENSE OF GETTING PEOPLE
TOWARDS A BETTER RECOVERY BUT
ALSO REMIND PEOPLE THAT.
THAT THERE'S NOTHING THAT STOPS
THIS FROM BE.
UP PROCESS WHERE THEY END UP IN
SOMEBODY'S HOME --
IF IT WAS YOUR CHILD.
IF IT WAS YOUR UNCLES YOUR
MOTHER.
WHEN YOU WANT TO FIGHT FOR THEM
AND BE ABLE TO PICK THEM OFF THE
STREET BRING AMEND YOUR HOME AND
DO EVERYTHING YOU POSSIBLY
COULD?
TIM.
SO THAT THEY HAVE A HEALTHY
HAPPY AND PRODUCTIVE LIFE.
AND I THINK THAT WHAT WE'RE
WAITING HERE AND IT'S A
CHALLENGE BUT WE'VE GOT TO DO
THIS.
FISA NOT SUPPORT YOUR EFFORTS.
I'LL MAKE IT QUICK AYE TO ISSUES
GOING STATEWIDE I'M WHO WE'VE
HAD NUMEROUS CONVERSATIONS WITH
FAMILIES AND THEY'RE JUST BEING
TORN APART AND NOT KNOWING WHAT
TO DO WITH A LOVED.
ONE AND THEY'VE TRIED EVERY
AVENUE FOR CONSERVATORSHIP SO
I'M HOPING WE CAN GET ON TRACK
WITH THIS HOPE THIS WORKS --
AND YOU KNOWIF YOU CAN OFTEN
OTHER COUNTIES OR LET THEM DO
THAT THAT BE GREAT.
THANK YOU.
THANK I WOULD SAY IS THERE IS.
TIME REMAINING OF MEMBERS
[inaudible]
ADVOCATE [inaudible]
YOU KNOW.
IT IF I IF IT'S JUST ME THEN.
IT'S IT'S HARDER BUT OF PEOPLE
FROM DIFFERENT PARTS OF THE
STATE GRAVITATING IT'S MORE
POWERFUL.
BUT THANK YOU FOR THAT.
THANK YOU MISTER CHAIRMAN --
YOU KNOW WAS AS MR SANTIAGO
SAYING AND IT'S ABOUT THE
DIGNITY.
AND THE MANATEE OF THESE PEOPLE
ON IT'S JUST SEEMS LIKE.
THERE'S MORE AND MORE AND I WAS
JUST IN SAN FRANCISCO.
ON FRIDAY AND YOU KNOW I HADN'T
BEEN THERE IN THE VERY LONG
TIME.
SHOCKED TO SEE.
THE FOLKS OUT ON THE STREET AND
YOU KNOW I SEE IT IN SAN DIEGO
BUT I'M NOT IN THE CITY'S AREA
MORE RURAL AREAS SO I DON'T GET.
TO SEE YOU KNOW AS MUCH BOMB.
WHAT YOU SAID ABOUT THESE?
YOU KNOW PEOPLE WHO ARE GOING
THROUGH THE CRIMINAL JUSTICE
SYSTEM TIME AND TIME AND TIME
AND TIME AND TIME AGAIN --
I WISH I HAD THE CHART I DIDN'T
KNOW THIS WOULD COME UP BUT I
HAVE A CHART THAT SHOWS HOW MUCH
ALL THE DIFFERENT TYPES OF
TREATMENTS AND HOUSING IN THINGS
BECAUSE VERSUS INCARCERATION
WITCHES [inaudible]
DOLLARS MORE [inaudible]
PATIENT.
AND THAT'S YOU KNOW THAT'S WHERE
WE'RE SPENDING MONEY WHEN WE
SHOULD BE HELPING PEOPLE GET
INTO HOUSING GET AND HAVE
SOMEONE WHO CAN ACTUALLY SPEAK
FOR THEM --
YOU KNOW WHICH IS WHAT YOUR BILL
DOES -- BUT
I DID HAVE SOME QUESTIONS FOR
CLARIFICATION IF I MIGHT PHAM.
SO HOW HOW DO YOU IDENTIFY
PEOPLE WHO WOULD QUALIFY FOR THE
CONSERVATORSHIP.
AND HOW ARE THEY MONITORED HOW
HAS THE DUE PROCESS PROTECTED WE
KNOW SAN FRANCISCO YOU KNOW DOES
A GOOD JOB WITH.
WITH CIVIL LIBERTIES AND YEAH
HOW WOULD THAT TRANSLATE INTO
HOW YOU ACTUALLY.
DEVELOP THE CONSERVATIVE SHIP
PROGRAM AND WHAT YOU LOOK.
FOR SO ARE MAYOR ELECT BONE
MARROW LOOKED BREED HAS ACTUALLY
SUBMITTED A A LOCAL ORDINANCE --
IT'S THE MENTAL HEALTH CARE
COORDINATION PILOT PROGRAM AND
THIS ORDINANCE WOULD ESSENTIALLY
ESTABLISH A MULTI DISCIPLINARY
TEAM -- IT
WOULD CODIFY A MULTI
DISCIPLINARY TEAM IS NOT TO SAY
THAT WE DON'T HAVE OTHER MULTI
DISCIPLINARY TEAMS ALREADY IN
EXISTENCE.
THROUGH THAT TEAM WE WOULD BE
WORKING --
THROUGH A MULTI DEPARTMENTAL AND
ALSO INCLUDING LAW ENFORCEMENT
AND LAUNCH THE PARK POLICE.
FOR A BAY AREA RAPID TRANSIT FOR
PEOPLE FAMILIAR WITH OUR
TRANSPORTATION SYSTEM --
THE POLICE THAT A LOT OF OUR
HOMELESS INDIVIDUALS THAT HAVE
ACUMINATE MAY ACTUALLY BE
RESIDING DOWN ON THE PART
[inaudible]
TUNNELS --
SO BRINGING THAT GROUP TOGETHER
SO THAT WE CAN IDENTIFY THOSE
INDIVIDUALS THAT ARE COMING INTO
OUR SYSTEMS THE DEPARTMENT OF
PUBLIC HEALTH BE THE PRIMARY
SYSTEM --
AND IN TRYING TO COORDINATE OURS
IS STRATEGIES AND INTERVENTIONS
--
IS SO THAT WE CAN MAKE SURE THAT
IF WE ARE MOVING TOWARDS
CONSERVATORSHIP.
THAT WE HAVE ATTEMPTED EVERY
OTHER INTERVENTION FIRST ON A
VOLUNTARY BASIS AND THAT WOULD
BE INCLUDING LOOKING AT ASSISTED
OUTPATIENT TREATMENT TO SEE THAT
THAT WOULD BE.
IF THAT'S APPROPRIATE --
AND SO THESE ARE GONNA O.
GENERALLY SPEAKING INDIVIDUALS
THAT WE KNOW BECAUSE WE ARE
TRACKING THEM AS ARE COMING INTO
OUR PSYCHIATRIC EMERGENCY ROOM.
INTO OUR AND A MERGER WELL
ISSUES WERE TRACKING THEM AS
THEY'RE COMING INTO OUR JAIL IN
THEIR BE TREATED BY JAIL
PSYCHIATRY --
ENDS IT WE ARE WORKING TO
COORDINATE OUR INFORMATION
SHARING TO TO BETTER.
BETTER INTERVENE EL
STRATEGICALLY AND IN A MORE
TIMELY MANNER SO IN TERMS THE
DUE PROCESS QUESTION --
EVERY ARE PROPOSED CONSERVANCY
--
WOULD HAVE A PUBLIC DEFENDER --
ASSIGNED TO THEM AND THEY HAVE
THE ABILITY TO REQUEST A JURY
TRIAL -- OUR
OFFICE THE OFFICE OF THE PUBLIC
CONSERVATIVE WOULD BE DOING IT
--
AND THOROUGH INVESTIGATION
REALLY NEED TO PRESENT TO THE
COURT.
ON THE ARRAY OF ISSUES THAT ARE
LISTED IN THE SP TEN FORTY FIVE
AND PART OF OUR BURDEN WOULD BE
TO DEMONSTRATE TO THE COURT THAT
WE HAVE EXHAUSTED EVERY OTHER
POSSIBLE ALTERNATIVE.
THAT COULD BE CONSIDERED ON A
VOLUNTARY BASIS [inaudible]
OKAY -- AND
WE KNOW YOU KNOW SOMETIMES LAWS
LAW ISN'T ENOUGH --
CAN YOU EXPLAIN WHY YOU KNOW THE
A OR T. PROCESS DOESN'T HELP THE
POPULATION WE'RE TRYING TO HELP.
SO LOWER IF YOU THINK ABOUT --
THESE THREE TYPES OF
CONSERVATORSHIP SERVICES ON A
SPECTRUM --
YOU CAN THINK OF THE LAURA'S LA
ASSISTED OUTPATIENT TREATMENT ON
THE BOARD VOLUNTARY SIDE OF THE
SPECTRUM.
SO ASSISTED OUTPATIENT TREATMENT
--
YOU SINCE SAN FRANCISCO
IMPLEMENTED IN TWO THOUSAND
FIFTEEN WE HAVE ASSISTED NINETY
FOUR INDIVIDUALS ONLY THIRTEEN
OF THOSE INDIVIDUALS ACTUALLY
REQUIRED IS TO GO TO COURT AND
GET PETITIONS FROM THE COURT.
THROUGH THAT PROCESS WE ARE
GENERALLY SPEAKING ENGAGING
INDIVIDUALS ON A VOLUNTARY
BASIS.
AND AGAIN THE LAURA'S LAW IS --
A LESS RESTRICTIVE FORM --
INSISTED OUTPATIENT TREATMENT IT
DOES NOT ALLOW US TO PROVIDE FOR
IT INPATIENT TREATMENT WHEN THAT
MIGHT BE REQUIRED.
AND SO WITH S. B..
TEN FORTY FIVE IF IMPATIENT --
PLACEMENT IS THE MOST
APPROPRIATE LEVEL OF PLACEMENT.
THEN WE WOULD HAVE THE ABILITY
TO TO DEMONSTRATE A REQUEST THAT
AUTHORITY FROM THE COURT WHERE
YOU DON'T HAVE THAT WITH THE
ASSISTED OUTPATIENT TREATMENT OR
LAURA'S LA.
WELL IT'S ACTUALLY NAM --
ENCOURAGING TO HEAR FROM.
REAL WORLD MORE REAL WORLD
PRACTITIONERS WHO ARE OUT ON THE
STREET.
YOU KNOW TRYING TO MAKE A
DIFFERENCE IN PEOPLE'S LIVES
WHO.
ARE.
JUST IN SUCH A OF THE
DEVASTATING PLACE --
YOU KNOW THAT YOU DEAL WITH
PEOPLE ON A DAILY BASIS.
AND KNOW WHAT KIND OF TREATMENT
THEY NEED ITEM WE WILL WINS AND
REALIZE HOW INVOLVED IT WAS SO.
THANK YOU [inaudible]
THE X.. TO ANYONE ELSE.
THERE IS ONE THANK YOU.
FOR TACKLING THIS THEN THIS
INCREDIBLY COMPLICATED TOPIC AND
AND YOUR YOUR DILIGENCE IN AND
TRYING TO MOVE A SOLUTION
FORWARD.
I THINK I THINK WE'VE MADE
TREMENDOUS PROGRESS NIGHT SOUNDS
LIKE THEY'RE STILL STILL SOME
OUTSTANDING ISSUES AND I
APPRECIATE YOU APPRECIATE THAT I
KNOW THAT YOU'LL CONTINUE
WORKING WORKING WITHOUT --
THE BILL DOES ENJOY DO PASS
RECOMMENDATION --
DON'T KNOW WHO WE DO HAVE A WE
DO HAVE A MOTION BY FROM MISTER
SANTIAGO A SECOND FROM MISTER
FLORA --
WHICH LIKE CLOTHES ARE.
THANK YOU VERY MUCH I PLAY
PRESHEAF THOUGHTFUL I DISCUSSION
ALSO SO I KNOW IT'S REALLY
AWKWARD IT'S BEEN OFFERED
THROUGHOUT THIS BILL IT IS NOW
OUR FOURTH OR FIFTH HEARING ON
THE BILL --
TO I'VE THE OPPOSITE THE
OPPONENTS OF THIS FOCUS THESE
ARE NORMALLY GROUPS THAT I'M A
VERY MUCH ALIVE WITH --
AND I AM --
SOMEONE WHO BOTH MY TIME AS A
COUNTY SUPERVISOR HERE ON A HUGE
BELIEVER AND EXPANDING ACCESS.
TO SERVICE SERVICES OF ALSO BUT
EVERYTHING I KNOW THAT WE SHARE
--
DIED -- THAT
GOAL -- BUT
THERE YOU KNOW FOR THIS SMALL
SUBSET OF THE POPULATION AYE
IT'S JUST NOT WORKING AND WHEN
YOU.
YOU KNOW THAT I I TOOK A WALK
THROUGH SKID ROW --
WAS LAST YEAR WHEN I WAS IN LA
IT'S NEXT TIME AND WALK THROUGH
AND ON MY OWN JUST.
TO LOOK AT IT I WALKED THROUGH
YOU KNOW IN THE TENDERLOIN A
PARTS OF SOUTH OF MARKET IN THE
MISSION --
AND WHAT MRS ON THE ALGO
DESCRIBE SOME WITH NO TOES.
ON WHAT THAT THE THINGS THAT.
WE SEE.
IN TERMS AND AND YOU JUST WONDER
HOW. ONE EARTH.
IS THIS HAPPENING.
HOW ON EARTH IS ANYONE ALLOWING
THIS TO HAPPEN AND FOR THIS
POPULATION?
SIMPLY OFFERING SERVICES
UNFORTUNATELY IS NOT ALWAYS
ENOUGH AND SO I'D APPRECIATE THE
WORK IN THE COLLABORATION I
RESPECTFULLY ASK FOR AN AYE
VOTE.
THANK YOU VERY MUCH SENATOR
MADAM SECRETARY WE HAVE A MOTION
THIS EMOTION IS TO PASSED YOU DO
JUDICIARY --
PLEASE CALL THE ROLL.
WOULD HIGH WITH I MAYES MAYES
AYE AYE YOUR CURRY.
* CURRY AREN'T PICCOLO.
BIGELOW AYE BONTA.
AYE BONTA AYE BURKE.
BURKE I CARILLO.
CREEL AYE FLORA.
FLORA ISLA MON.
MCCARTY.
MCCARTY AYE THIS AREA
[inaudible]
RODRIGUEZ.
SANTIAGO.
SANTIAGO AYE BERMAN [inaudible]
WALDRON [inaudible]
WALDRON AYE.
THANK YOU BECAUSE THANK YOU VERY
MUCH BILLS OUT SIR THANK YOU
[inaudible] TEN HERTZBERG.
I THINK WE'RE JUST GONNA CALL
RECESSED FOR THE NEXT HOUR WOULD
YOU THINK.
IT IS ASSN FUNDS ARE THAT WAS
DEBT THAT'S THE DOWNSTAIRS
COMMITTEE EXCUSE ME.
THE ONLY THINGS GOING ON TIME
ISN'T HEALING.
TOMORROW IMMEDIATE SUCCESSOR
MATHIS [inaudible]
SURVEYS MERE.
WHERE TO GO MUCH CHAIRMAN?
JESSE MARVIN UNRRA.
LET'S ADMIT HAPPEN THIS BILL
THEM.
SO THIS IS THE THIS IS THE
COMMITTEE PER MEDICINE ACT OF
TWO THOUSAND EIGHTEEN AND THEN
WE'LL TALK ABOUT AMENDMENTS TO
THE MINUTE BUT BASICALLY IN A
NUTSHELL MEMBERS.
WHAT WE'RE TALKING ABOUT HERE IS
THAT IN TWO THOUSAND AND TEN
RAND CORPORATION DID A STUDY?
THEY INDICATED HE FORTUNE 27% OF
ALL -- E. D.
VISITS WHERE NON URGENT CARE TO
TAKE PLACE IN DIFFERENT SETTINGS
SUBSEQUENT.
S. COMPRISE FOUR POINT 528% OF
ALL THE P. PATIENTS YET. 21228%
OF ALL VISITS WEREN'T NECESSARY.
IN OTHER WORDS WHAT WE'RE DOING
THANK YOU SIR.
WHAT WE'RE DOING IS WE'VE GOT
THIS CHALLENGE WILL WHICH WE'VE
GOT THIS EXTRA MENDER SIXPENCE?
IN HEALTH CARE DELIVERY AND HOW
DO WE APPROPRIATELY WITH THE
APPROPRIATE LEVEL OF AND HERE
HERE I CAN'T.
SIT IT'S NO SAID --
THE THEY SAW HIM GO EACH OTHER
FOR A LONG TIME SO IT TOOK ME A
SECOND.
BUT IN ANY OF AT HOW DO WE
PROVIDE THAT LEVEL OF SERVICE
AND SO WHAT WE'VE DONE HERE WITH
RESPECT TO THIS ACTING OR CUT TO
THE CHASE HERE.
IS TO COME UP WITH THIS
COMMITTEE PER MEDICINE THERE'S
BEEN SOME PILOT PROJECTS THERE'S
DIFFERENCE OF OPINIONS WITH
RESPECT TO IT.
OUT WE'VE COMMITTED TO TAKING
THE AMENDMENTS NOTED AND
SUGGESTION A IN THE ANALYSIS.
AND WE APPRECIATE THOSE SET
FORTH IN BE BUT WE ARE BUT
THERE'S CERTAIN OVERLAPPING
QUALIFICATIONS OF THIS MEASURES.
OVERSIGHT COMMISSION EXISTING
INVEST COMMISSIONS AND WE
CERTAINLY COMMIT TO WORK WITH
THE M. DOCTORS.
OUR NURSES AND OTHERS AND WE'D
HAVE BEEN TRYING TO FIGURE OUT
WHERE WE CAN FIND SOME SOME
COMMON GROUND IN THIS REGARD AND
SO.
OF TURNOVER URGE CHRISTY BALMA
BUT BUT WHAT WE'RE TRYING TO DO
IS TO BE SMART ABOUT THIS ISSUE
AND THERE ARE.
LEGITIMATE MITCHELL HERE FROM
THE OPPOSITION ISSUES WITH
RESPECT TO SCOPE OF PRACTICE
WITH RESPECT TO THE LEVEL OF
PATIENT CARE
THAT WE SPENT A LOT OF TIME
TRYING TO FIGURE OUT AND WE'RE
NOT DONE YET [inaudible]
BUT THAT [inaudible]
DUO.
MR CHAIRMAN MEMBERS THE
COMMITTEE CHRISTY MOMMY HAVE THE
CALIFORNIA FICTIONAL
FIREFIGHTERS THE THINK THE
COMMITTEE AND STAFF FOR THE
THIRD ANALYSIS IN THE
RECOMMENDATIONS.
OF THAT WE WILL ENDEAVOR TO
ACCOMPLISH IN OUR NEXT STOP THIS
BILL SIMPLY LEVERAGES THE
TRUSTED COMMUNITY RESOURCE.
CONNECTING UP PATIENTS TO THE
RIGHT SERVICES AT THE RIGHT TIME
AND THE OTHER FIREFIGHTERS AND
PARAMEDICS IN YOUR COMMUNITIES.
A THIS BILL BECAUSE THIS ISSUE
HAS COME TO THIS COMMITTEE
MULTIPLE TIMES SO I WOULD SAY
THAT THIS BILL SPECIFICALLY IS
DESIGNED TO BE VERY PATIENT
FORWARD.
TAPPING THE EXPERTISE.
FEEDBACK AND DIRECTION OF MENTAL
HEALTH.
BEHAVIORAL HEALTH AND MEDICAL
EXPERTS --
THE THE STUDIES THE PILOTS THAT
HAVE GONE ON HAVE BEEN.
EVALUATED BY AN INDEPENDENT
THIRD PARTY THESE YOU CASF
STUDIES MULTIPLE STUDIES
RELEASED IDENTIFYING THIS IS AN
EFFECTIVE PROGRAM WITH.
ZERO NEGATIVE OR ADVERSE PATIENT
OUTCOMES.
OF THIS BILL CONTAINS ROBUST
REPORTING REQUIREMENTS TO MAKE
SURE THAT WE CONTINUE TO MONITOR
EVALUATE THESE PROGRAMS AND ALSO
A SUNSET SO THAT WE HAVE A
CHANCE TO DEMONSTRATE
EFFECTIVENESS --
OVER THE COURSE OF ITS LIFETIME
--
I THINK THIS IS ONE SOLUTION ON
MANY AND I'VE EVEN HEARD ABOUT
AND COMMITTEE TODAY --
AND ON BEHALF OF MY FIREFIGHTERS
WHO FEEL LIKE THEY'RE IN CRISIS
MODE IN THE FIELD WITH THESE
PATIENTS THAT NEED SERVICES THEY
ARE NOT GETTING.
WE WILL STICK TO OUR GOALS OF
MAKING SURE THERE'S MORE SAFE
AND MORE COMFORTED.
AFTER WE'VE ARRIVED ON SCENE BUT
REALLY WE WE COULD GET THEM TO
THE SERVICES THEY NEED THIS BILL
MAKES THAT A POSSIBLE WE URGE
YOUR SUPPORT TODAY.
AS CHAIR MEMBERS TIM AND
REPRESENT THE CALIFORNIA CHAPTER
OF THE AMERICAN BECAUSE
EMERGENCY PHYSICIANS AND WE ARE
SUPPORT OF THIS BILL.
ON IT'S KIND OF A BIG MOMENT FOR
ORGANIZATION BECAUSE WE HAVE
BEEN OPPOSED TO THE IDEA OF
COMMUTE PARA MEDICINE GOING BACK
TO THE INTRODUCTION OF THE PILOT
PROGRAMS.
WE HAD EXPRESSED IN NUMBER
CONCERNS AROUND THE SAFETY OF
THE PROGRAMS ON THEIR WHETHER
PATIENTS WILL BE TREATED EQUALLY
AND THIS TYPE OF A SYSTEM.
IN WORKING WITH THE SPONSOR AND
THE AUTHOR WE HAVE --
COME UP WITH SOME LANGUAGE IN
ASKING NINE FORTY FORCE YOU SEE
TODAY WHICH GETS TO A SUPPORT
POSITION WE THINK ARE PROPER
PATIENT PROTECTIONS IN THERE.
ON THE DATA COLLECTION IS GOOD
AND ALONG WITH THE SUNSET THAT
IS TO MENTION LOUD SINCE THE
CHANCE TO CHECK IT.
IN THERE ARE SPLIT THEIR
SPECIFIC LANGUAGE ON THE
RELEASED FROM TALA WHICH ENSURES
THAT ALL PATIENTS ARE TREATED
EQUALLY AND FOR THESE REASONS
RENTS AFFORDABLE RESPECT LAST
DRIVER.
YOU VERY MUCH --
OTHERS IN SUPPORT JUST YOUR NAME
AND ORGANIZATION.
THANK YOU MISTER CHAIRMAN VERSE
--
THE REPRESENTATIVE FROM THE
BOARD OF SUPERVISORS FOR THE
COUNTY OF SANTA CLARA ASKED ME
TO CONVEY THAT COUNTY SPUR THANK
YOU THANK YOU.
CHAIR MEMBERS KEPT US FOR THE
LOCAL HEALTH PLANS CALIFORNIANS
SUPPORT.
MISTER CHAIRMAN MEMBERS DAVID
JONES ABOUT THE CITY MYRIAD ON
SPORT [inaudible]
VERY MUCH ANYONE ELSE.
SEEING NO ONE WE HAVE OPPOSITION
[inaudible]
THE CHAIR.
THE TWO WITNESSES THREE MINUTES.
MISTER CHAIRMAN MEMBERS OF THE
COMMITTEE STEPHANIE ROBERSON ON
BEHALF OF THE CALIFORNIA NURSES
ASSOCIATION IN OPPOSITION TO
THIS BILL --
MEMBERS WE BELIEVE THAT THIS
BILL IS BASED ON WHAT PILOTS WE
BELIEVE THAT FLOOD PILOTS WILL
LEAD TO FLAWED POLICY AND WILL
PUT PATIENTS IN HARM'S WAY.
AND WE ALSO BELIEVE THAT THE
JURY IS OUT ON THESE PILOTS.
THEY HAVE BEEN EXTENDED FOUR
TIMES AND THE DATA HAS NOT
CHANGED.
DELIVERING SERVICES IN THE AREA
OF POST DISCHARGE FOLLOW UP
WHICH IS MOST PROBLEMATIC TO US.
IN THE BIGGEST COHORT OF
PATIENTS 25% OF THEM --
NINE HUNDRED TWENTY TWO PATIENTS
25% OF THOSE ENROLLED IN THOSE
PILOTS RETURNED TO THE E. D. IN
THIRTY DAYS.
IN YEAR 231% OF A FOUR HUNDRED
EIGHTY TWO POST DISCHARGE FROM
RELEASE A TWO HUNDRED FORTY NINE
PATIENTS RETURN TO THE EATING IN
THIRTY DAYS.
AND AT THE POINT THIS POINT THE
PILOTS ARE TO DECREASE
ADMISSIONS THAT'S THE POINT OF
THE POST DISCHARGE PILOT.
THESE PILOTS OCCURRED IN LA AND
YOU COUNTIES IS IMPORTANT TO
KNOW THAT AN ADDITIONAL TWO
THOUSAND NINE HUNDRED SEVENTY
FIVE PEOPLE THAT WERE ELIGIBLE
FOR THE POST DISCHARGE PROUD OF
PROJECT.
DID NOT ENROLL EIGHT HUNDRED AND
TWENTY THREE PATIENTS DID NOT
CONSENT.
PEOPLE WHO WERE ELIGIBLE BUT NOT
ROLL OVER HISPANIC AFRICAN
AMERICAN IN PREFERRED TO RECEIVE
THE ANYWHERE INFORMATION IN A
LANGUAGE OTHER THAN ENGLISH.
THE MAJORITY WHERE I'M MEDI CAL
BENEFICIARIES IN OVERALL THIS
PILOT SERVE MOSTLY WHITE ENGLISH
SPEAKING MALES.
INDIA TRIAGE INFREQUENT EMS USER
CASE IN ALAMEDA AND SAN DIEGO.
A SMALL COHORT WITH LESS THAN
EIGHTY PATIENTS OVER FORTY FIVE
PATIENTS WERE ABANDONED AND
FOLLOWED UP BY ACTUAL LICENSE
PERSONNEL DOCTORS.
WHEN THE PARAMEDICS AND TRAINEES
WERE REMOVED FROM THE PILOT --
THEY WERE REMOVED FROM THE PILOT
TO MEET THEIR NINE ONE ONE NEEDS
--
FROM THE AMBULANCE PROVIDER. ONE
MORE INSTANCE ALTERNATE
DESTINATION MENTAL HEALTH I WANT
TO NOTE THAT 99% OF THOSE
PATIENTS WERE DIVERTED TO THE
PILOT BECAUSE THEY WERE MEDI CAL
RECIPIENTS. 1% OF THOSE PATIENTS
STATE IN THE E. D. BECAUSE OF
PATIENTS WERE PRIVATE PAY.
I'M GONNA MOVE TO SOME SOLUTIONS
AND I'M SENDING AROUND TO ALL OF
YOU AND I HAVE MANY MORE --
PATIENT --
STATS THAT I CAN SHARE WITH YOU
BUT THIS DOESN'T PAINT A PRETTY
PICTURE NINE FOUR FOUR IS BASED
ON FACT FAILED OUTCOMES CROSS
ALL CONCEPTS FORTY PRE 3% OR
MEDI CAL BENEFICIARIES. 20% MEDI
CAL 50% AN INCH THE GOAL IS TO
ALLEVIATE YOUR PRESSURE.
WITH PATIENTS WHO DO NOT NEED TO
BE IN THE E. R. DECREASE WALL
TIME AND MAKE SURE THAT PATIENTS
ARE SAFELY TRIAGE I PASSED
AROUND TO YOU SOMETHING THAT'S
ALREADY HAPPENING.
IN OUR CALIFORNIA SYSTEMS YOU
CAN HAVE A RAPID A VALUE ADD
VALUATION THAT COULD HAPPEN SORT
OF RAPID EMR.
AND WHAT HAPPENS IS A DOCTOR --
COMBINED WITH NURSES NURSE
PRACTITIONERS MPS RIGHT NOW IN
OUR SYSTEM OUR TRIAGE ING THOSE
LOW ACUITY PATIENTS SO WHEN A
PARAMEDIC CALLS INTO THE OUR
LIKE THEY DO RIGHT NOW THEY SAY
THEY HAVE A PATIENT.
THEY HAVE THESE RAPID EVALUATION
UNITS WHERE THESE.
COM COLD BLUE TEAMS COME TO THE
SITE COME TO WHERE THE PATIENT
IS AND DISCHARGES THEM OR THEY
CAN GO TO THE LOCAL PARAMEDIC
AND SAY YOU CAN TAKE THEM TO AN
ALTERNATE DESTINATION CENTER.
AND BASED ON SOME OF THOSE
PILOTS THE OF DECREASE WALL TIME
AND DECREASED --
TIME IN THE E. R. FOR EACH
PATIENT SO WE URGE THAT YOU LOOK
AT THESE OTHER ALTERNATIVES
MEMBERS THINK YOU.
PETER CALLISON ON BEHALF OF TO
CLIENTS ONE WOULD BE THE
CALIFORNIA ASSOCIATION FOR
HEALTH SERVICES AT HOME WHICH A
HOME HEALTH AGENCIES THEIR
OPPOSITION IS SIMILAR TO WHAT
WAS ARTICULATED BY THE NURSES
ASSOCIATION.
SECOND CLIENT HAS THE CALIFORNIA
HOSPICE AND PALLIATIVE CARE
ASSOCIATION I'D LIKE TO FOCUS MY
COMMENTS UPON THE IMPACT ON
HOSPICE.
WITH THIS --
WITH THIS LEGISLATION IT'S OUR
UNDERSTANDING THAT UNDER THE
PILOT PROGRAMS THAT THE ONLY
HOSPICE PARTICIPANT WAS IN
VENTURA COUNTY.
A GOOGLE SEARCH REVEALED THAT
THERE'S ABOUT ELEVEN HIGHER
HOSPICE PROGRAMS IN VENTURA
COUNTY IT'S OUR UNDERSTANDING
THAT ONE HOSPICE PROGRAM
PARTICIPATED IN THAT PILOT THAT
WOULD MEAN THAT. TEN OF THE
HOSPICES DECLINED TO PARTICIPATE
BECAUSE THEY DID NOT FIND THAT
TO BE USEFUL FOR THEIR PATIENTS
OR FOR THEIR PROGRAMS.
HAVING SAID THAT.
THE DILEMMA WITH HOSPICE IS THAT
THE IT'S FOR THE TERMINALLY ILL.
IT'S NOT --
THAT PAYMENT SYSTEM FOR HOSPICES
CAPITATED IT'S LIKE A MANAGED
CARE SYSTEM FOR THE TERMINALLY
ILL.
BECAUSE OF THAT IF A NON LICENSE
A NON HOSPICE LICENSE PERSONNEL
AS INSINUATED INTO THE CARE OR
PER FILE PERFECT PROVIDES CARE
OF SOME WAY SHAPE OR FORM.
THAN THAT IMPACTS HOW THE
HOSPICE IS REIMBURSED IT IMPACTS
HOW WHO PAYS FOR SHOULD A
PATIENT BE.
TRANSFERRED TO AN EMERGENCY ROOM
IS THE HOSPICE RESPONSIBLE FOR
THE PAYMENT OF FOR THE
REIMBURSEMENT IS THE FAMILY IS
THE FAMILY IS THE PATIENT IT'S
UNCERTAIN.
SO THAT WE BELIEVE THAT THE
TERMINALLY ILL SECTION OF THE
BILL SHOULD BE COMMENDED TO
EXCLUDE HOSPICE PARTICIPATION --
HAPPY TO TALK WITH THAT FURTHER
WITH THE SPONSORED OR WHAT THE
AUTHOR WE JUST DON'T THINK THAT
IT'S COMPATIBLE FOR HOW HOSPICES
STRUCTURED FOR THE PURPOSE
AUSPICES SERVED --
AND RESPECTFULLY REQUEST THAT
FROM FOR YOUR CONSIDERATION.
OTHERS IN OPPOSITION JUST YOUR
NAME AND ORGANIZATION.
I MISTER CHAIR CHRIS MCKAY LEON
WE HAVE THE CALIFORNIA AMBULANCE
ASSOCIATION WE ARE OPPOSE FOR
OTHER REASONS.
THAT'S YOU ARMSTRONG ON BEHALF
OF THE MS ADMINISTRATORS
ASSOCIATION AN EMERGENCY MEDICAL
DIRECTORS ASSOCIATION
REGRETFULLY A POST [inaudible]
YOU.
THE DEPARTMENT THE CALIFORNIA
HOSPITAL ASSOCIATION AND
OPPOSITION OF THE BILL
[inaudible]
ANYONE ELSE.
SEE KNOWN BRING BACK TO
COMMITTEE FOR QUESTIONS OR
COMMENTS COMMENTS QUESTIONS FROM
ME.
I'M SORRY MR.
YEAH MISTER BIG JUST TO TALK
ABOUT THE OF THE AMENDMENTS --
THAT SPECIFIC SPECIFICALLY BE
SEE YOUR GONNA TAKE THE A A BUT
NOT.
BE CORRECTED AND THEN THE
COMMITTEE ANALYSIS HERE IT'S IS
GIVEN THE OVERLAP THE TWO
ENTITIES THE OVERSIGHT
COMMITTEES HOUSE WAS BUILT PEERS
UNNECESSARY.
AND DUPLICATIVE.
DO YOU NOT BELIEVE THAT TO BE
TRUE.
WELL I THINK WE NEED TO CONSULT
WITH ALL THE VARIOUS FOLKS TO
FIND OUT I MEAN WE IS THIS
PROCESS WHO DO READ THE BILL
IT'S KIND OF AMAZING TO ME.
IT BASICALLY SETS FORTH LOCAL
ABOUT OUR AUTONOMY TO MAKE A
DETERMINATION AND SETS FORTH
WITH THAT FRAME LOOKS LIKE.
THEY GOT REQUIRES A BIT MORE
HOMEWORK TALK AND EVERYBODY TO
FIGURE OUT THOSE COMMITTEES LOOK
LIKE OR HAVE.
THEY SUGGESTED THAT WE'RE HAPPY
TO TAKE THE TIME TO DO THE PUT A
HUGE AMOUNT TIMES MEASURE SO FAR
AND COMMITTED TO KEEP WORKING ON
IT UNFORTUNATELY THAT'S ONE OF
THE CHALLENGES WITH THIS
LEGISLATIVE PROCESS HAS BEEN.
PERFORMED ABOUT THIRTY FIVE
YEARS AGO TED.
HAS THESE VEHICLES RUN THROUGH
COMMITTEES RATHER THAN AMENDING
IMAGE GO ALONG SO WHAT'S.
WE WILL WILL WORK WILL CONTINUE
WORK ON YOU THAT COMMITMENTS ARE
[inaudible]
I JERRY JUST WANTED. TO HAVE A
CONVERSATION WITH MY FIRE CHIEF
IN MY COUNTY TODAY I'M WHOSE.
PORTER OF OF THIS --
AND I'M GONNA SUPPORT THIS TODAY
ALTHOUGH I DO HAVE SOME CONCERNS
ON A NUMBER OF OF DIFFERENT
THINGS HELP TO BUILD A CONTINUE
WORKING ON IT BUT I AM I WILL --
I WILL REGRET IT WILL SUPPORT IT
AND I DO THINK THIS SORT OF
INNOVATIVE APPROACH AS WE
CONTINUE ON IS GOING TO BE VERY
HELPFUL --
ABOUT FOR THE FIRE SERVICE AND
FOR PREPARE MEDICINE MATURE NAM
GOING FOR IT IT'S HARD LOOK THE
THESE THINGS ARE CHALLENGING BUT
WE'VE GOT UNBELIEVABLE COST
PRESSURE.
ON YOU KNOW WITH THAT THAT THAT
SOMEBODY BECAUSE NINE ONE ONE IN
A FIRE.
DE OFFICIAL WHO DID SHOWS UP
COMES DIFFERENT COUNTIES A
DIFFERENT KIND OF EQUIPMENT.
AND SOMETIMES A PERSON IS CALLED
THIRTY FIVE BUT CERTAINLY YOU
NEED THE PROFESSIONS OF DOCTORS
AND NURSES AND MAKING SOME OF
THESE DETERMINATIONS.
BUT IT TOOK THESE ARE TOUGH
DECISIONS AND SO.
YOU KNOW WE MAKE GOVERNMENT WORK
BETTER IS TO DO THE HOMEWORK TO
FIGURE IT OUT THAT'S WILLING TO
DO.
MISTER CHARLES SECOND MOTION.
BIGELOW THANK YOU VERY MUCH BEE
BEE -- I'M
GLAD TO HEAR THAT YOU'RE A
ENTERTAINING THE AMENDMENT ON A
I APPRECIATE THAT AND I ALSO.
WAS WONDERING IF YOU COULD MAYBE
ADDRESS SOME OF THE CONCERNS
THAT WERE RAISED ABOUT THE
PRIVATE COMMENTS THAT WERE MADE
HERE A MOMENT AGO.
AND I HAVE ANOTHER QUESTION OF
WELL THE BIG ISSUE IS A BIG
ISSUE IF FACING.
A WITH RESPECT TO ON THIS ISSUE
IS THE IDEA THAT PUBLIC AGENCY
PREFER PREFERENCE IN OUR
JUDGMENT REALLY PRESERVES THE
RIGHT OF LOCAL GOVERNMENTS TO
MANAGE --
EMERGENCY RESPONSE SYSTEMS
INTEGRATE THOSE A CRITICAL
SERVICES GENDER EXISTING PLANTS
RIGHT IF YOU LOOK AT THE
FRAMEWORK OF THIS.
I THINK IN THE LARGER
ARCHITECTURE DE AND WILL LOOK TO
YOU WORK ON IT IT'S ALL ABOUT
TRYING TO SET A FRAMEWORK FOR
LOCAL OPTIONS RIGHT IF YOU READ
THIS IF A LOCAL AGENCY WITH THE
COUNTY ELECTS TO DEVELOP.
HERE'S HOW TO DO THIS AND GOES
THROUGH AND SETS FORTH THAT
PLANTS SO I THINK THERE IS
PARTICULARLY FLEXIBILITY CERTAIN
AND CERTAINLY.
THE GOVERNMENT SHOULD BE THE
FIRST RESPONDER IF YOU WILL IN
THOSE COUNTIES WHERE THEY DON'T
HAVE A I THINK GOVERNMENT WILL
HAVE THE ABILITY TO TO DO
WITHOUT A CAR APPROPRIATELY
[inaudible]
AND BEING SOMEONE WHO IS ON THE
FRONTLINE WHO DOES RESPOND ON A
REGULAR BASIS AS AN EMT --
I COULD SEE THE SAME PATIENT
OVER AND OVER.
OVER AND OVER RIGHT IT'S
GROUNDHOG DAY IN MANY CASES --
IN THAT THIS THE SCENARIO NEVER
CHANGES.
I CAN'T CITE ONE WHERE DID
CHANGE.
REALLY YEAH THE THIRD TIME THERE
YOU ASSUMED YOU WERE NOT GOING
TO STAGE OUTSIDE.
I WALKED IN AND IT'S ILLEGALLY
SHOT FIVE TIMES.
THAT WAS A TIME TO TAKE YOUR
SIGN AND LEAVE.
IT SO ANY DID HE DID DESTRUCTIVE
WEAPON --
DON'T THE REALITY THE REAL ISSUE
IS.
FIREMAN GET THEIR FIRST.
IN THE RURAL AREA RIGHT BUT THE
TRUTH IS.
WE DON'T HAVE PARAMEDICS IN A
FIRE SYSTEM IN RURAL AREAS FOR
THE VAST MAJORITY NOT IN ALL
AREAS BUT IF FOR THE VAST
MAJORITY AT LEAST THE DISTRICT
THAT I CAN SAY.
I REPRESENT.
IN MOST CASES IS THE LOCALEMS
AMBULANCE CARRIERS.
THERE THE FIRST PEOPLE THERE IN
MANY CASES THEY'RE NONPROFIT
ORGANIZATIONS [inaudible]
SO HOPEFULLY WE WON'T BE STE
TRADING [inaudible]
AND HARMING THOSE FOLKS WHO ARE
IN PRIVATE ENTERPRISE WILL BE
DOING OF VALUE JOB.
IN OUR COMMUNITIES AS WE MOVE
FORWARD ON BUT AT THE SAME TIME
WORKING IN RESPECTING --
WHAT WHAT THE LOCAL GOVERNMENTS
CAN AND CAN'T DO AND I THINK
THIS MEMO COVERS A GREAT DEAL OF
THAT?
PERSPECTIVE OF THEIR LIKE IT I
ENJOY TO SEE IF I COULD COULD IF
I COULD JUST ADD TO YOUR
THOUGHT.
WITH THE WHOLE THING SURE IT IN
SECTION SEVENTY NINE ONE SEVEN
NINE SEVEN POINT TO THE SEVEN
SEVEN TWO IT SAYS.
THAT THE REPORTER SUPERVISOR
ESTABLISH EMERGENCY MEDICAL CARE
COMMITTEE AND SO ALSO INCLUDE
THE FOLLOWING MEMBERS.
THAT ADVISE EMS AGENCY ON THE
DEVELOPMENT OF COMMITTEE
PARAMEDICS PROGRAMS SO THAT THE
WHOLE IDEA.
I THINK IN THE STATE IS BIGGEST
CALIFORNIA'S LONGER STILL OF ONE
CALIFORNIANS SET OF THREE OR SIX
WHATEVER.
THE NUMBERS THAT HAVE BEEN
PROPOSED OVER THE YEARS.
THE IDEA IS TO MARRY THE
PROFESSIONALISM BY REQUIRING TWO
REGISTERED NURSES RECORDING TO
E. R..
DOCKS REQUIRING A NUMBER OF
OTHER FOLKS IN THE PROCESS THAT
THAT THE STANDARDS BE SAD.
THE BOARD OF SUPERVISORS TO MAKE
THOSE DETERMINATIONS WITH THE
ADVICE.
BECAUSE NOT EVERY CA I SUSPECT
YOU KNOW ALPINE COUNTY AND THAT
WE CITIES --
OR TRINITY COUNTY WEAVERVILLE IT
WILL HAVE DIFFERENT STANDARDS IN
LOS ANGELES OR SAN DIEGO AND
THEY'LL MAKE THOSE
DETERMINATIONS WITH THE ADVICE
OF EXPERTS [inaudible]
ACTUALLY IT.
AS FAR AS THE MPS GO.
IT'S ONE STANDARD NATIONWIDE.
AND WERE ON A NATIONALIST AND
AND WE DO HAVE STATED CALIFORNIA
STANDARD ARE THAT WE ACT ON AND
THEN EACH BOARD OF SUPERVISORS
ADOPTS THE IN MANY CASES THOSE
FORTY SUPERVISORS.
TURN IT OVER TO A JOINT.
OPERATION LIKE THE FRESNO MADERA
MARIN MERCED AGENCY WHICH IS
BASED ON A FRESNO.
WE WORK UNDER THOSE STANDARDS
AND THE SCOPE OF PRACTICE THAT'S
PLACED HIM IN IN.
IN ACTION AND THAT HAPPENS
THROUGHOUT THIS MY DISTRICT.
LIKE COUNTIES COMBINED AND WORK
TOGETHER IN A MULTI AGENCY ARE A
WORLD SO IT BECOMES A LITTLE
MORE COMPLICATED IN THE CONTEXT
OF WHAT EVERYONE'S DOING.
ROSETTA POLLEN TWIRL A TO RURAL
FROM THAT URBANIZED THOUGHT
PROCESS THAT MAYBE YOU'RE
ACCLIMATED TO FOUR I'M MORE
RULE.
ACCLIMATED.
TO GIVEN THAT SAID I THINK I'M
IN A PLACE WHERE I UNDERSTAND
WHERE YOU'RE GOING.
AND THAT THIS IS SOMETHING THAT
WE CAN SUPPORT OUR TODAY BUT I
DO HAVE ONE FINAL CONCERT.
YOU TALKED ABOUT THE AGED --
COMMUNITY AND HOW WE CAN HANDLE
THAT.
BECAUSE IT IS IT'S DIFFERENT
SCOPE IN A DIFFERENT MECHANISM
--
FOR HANDLING OF PATIENTS.
MAYBE THAT CONVERSATION CAN
CONTINUE.
ULCER --
GREAT DEAL.
BECAUSE AS WE GO THAT'S JUST A
SEPARATE ENTITY THAT MOVES THE
PATIENT NOT ALWAYS IS THAT.
CALLED AN ADVANCED LIFE CALL.
ALRIGHT APPRECIATE IT THANK YOU
[inaudible]
ANYONE ELSE [inaudible]
BERMAN.
THANK YOU MISTER CHAIR --
DESPICABLE QUESTIONS SO --
I WOULD START WITH --
THE EMERGENCY ROOM PHYSICIANS
REPRESENTATIVE VALUE YOU
OUTLINED THAT PREVIOUS SEE.
THERE WAS OPPOSITION AND I DO
REMEMBER HEARING ON A SIMILAR
BILL.
HEARING A CONCERN ABOUT WHO
SHOULD ASSESS SOMEONE'S --
MEDICAL CONDITION AND I GUESS I
WOULD ASK THAT QUESTION TO YOU
IN.
AND I GUESS ON BEHALF OF YOUR
MEMBERS AND NURSES --
YOU KNOW BOMB Y. THE CHANGE --
I GUESS IN YOUR POSITION WHAT'S
DIFFERENT --
GIVEN THE CONCERN EXPRESSED
BEFORE ARM INTO AND WHY SHOULD
THIS.
WHY SHOULD WE BE CONCERNED IF --
THE ASSESSMENTS ARE HAPPENING --
BY A PHYSICIAN AND A NURSE IN IN
AN EMERGENCY ROOM SET.
I THINK YOUR SERMON.
ON BEHALF EMERGENCY PHYSICIANS
WE FEEL THAT AND ASKING NINE
FORTY FOUR THERE SOME GUARDRAILS
THEY'VE BEEN PUT IN PLACE TO
ENSURE THAT WHEN THE DEVELOPMENT
OF THE PROTOCOLS THAT WILL BE
USED BY THE PARAMEDICS IN THE
FIELD.
THEY'LL HAVE SOME ADDITIONAL
OVERSIGHTS YOU BOTH AT THE LOCAL
LEVEL AND AT THE STATE LEVEL AND
GETTING TO A KIND OF SENATE
AROUND THE AMENDMENT THAT WAS
DESCRIBED IN AND AND BE IN THE
ANALYSIS. ONE OF THE VALUES THAT
WE SEE IN THAT COMMITTEE IS THAT
IT WOULD BE COMPRISED OF PEOPLE
WHO ARE MORE FAMILIAR WITH
DEVELOPING PRODUCT BECAUSE FOR
IT ADDRESSING PATIENTS OF THAT.
KIND SO SOMEONE WHO IS A LOWER
CUTIE PATIENT TODAY M. SAYS MORE
GEARED TOWARDS TRUMPCARE.
IT'S MORE GEARED TOWARDS SETTING
UP SYSTEMS FOR ESTABLISHING
CRITERIA FOR A STROKES AND OR
STOP ME CENTERS ALSO A VERY
DIFFERENT TYPE OF THE PATIENT.
ARE CONCERNED WITH THE CURRENT
STRUCTURE OF THEM SAYS THAT IT
MAY NOT BE COMPRISED OF ENOUGH
EXPERTS. TO BEST EVALUATE
WHETHER THE PROTOCOLS BEING
DEVELOPED ARE APPROPRIATE FOR A
DIFFERENT TYPE OF THE PATIENT.
SO US WITH SENATOR HERTZBERG
TALKING ABOUT TRYING --
TO TO THROUGHOUT WHAT THE
COMPOSITION OF THAT IS SO WE
FELT THAT WAS ANOTHER IMPORTANT
PART OF S. B. NINE FORTY FOUR
THAT WE HAD NOT SEEN ANOTHER
LEGISLATION.
FOUND WE ALSO FELT IT WAS
IMPORTANT TO HAVE WHATEVER WE
PUT INTO LAW IS LARGELY BASED ON
THE PILOTS THAT HAVE BEEN TESTED
SO OUR PERSPECTIVE IS DIFFERENT
TEST SOMETHING.
WE FEEL THAT IT HAS SHOWN THAT
THAT THIS CAN BE DONE THAT WE
SHOULD MODEL LEGISLATION AROUND
THAT.
IN THE ONE THE MOST IMPORTANT
ONES IS THAT WE INCLUDE LANGUAGE
TO ENSURE THAT ALL PATIENTS ARE
TREATED EQUALLY.
SO WE WORRY THAT IF YOU SET UP A
SYSTEM WHERE POTENTIALLY ONLY
CERTAIN PATIENTS GO TO A
SOBERING CENTER SO MAYBE YOU'RE
HOMELESS PATIENTS --
ARE MORE LIKELY TO END UP IN
THAT SITUATION WHERE IT'S A
BETTER PAYING PAY SHOULD BE MORE
LIKELY THAN UP AT THE HOSPITAL.
AYE WE WANT TO MAKE SURE THAT.
THE SPIRIT OF PROVIDING
EMERGENCY MEDICAL SERVICES THAT
WE TREAT EVERYONE THE SAME
THAT'S EQUAL ACCESS SO THOSE
THINGS WERE INCLUDED WHICH GOT
OUR ORGANIZATION TO MORE.
COMFORTABLE LEVEL CLASSES
QUESTION --
TO THAT PROPONENTS AND OPPONENTS
YOU KNOW IS THIS IS ABOUT SCOPE
OF PRACTICE MEANING WE HAVE TWO
GROUPS SAID --
FROM MY EXPERIENCE SERVICE WELL
YOU KNOW I'VE BEEN SERVED WELL
BY PARAMEDICS HAD BEEN SERVED
WELL BY NURSES --
EXISTE CASE GORGEOUS SWAPPING
ONE GROUP FOR ANOTHER --
IS A CISCO POSITION CISCO
CONVERSATION.
STEPHANIE WITH THE STEPHANIE
ROBERSON WITH CALIFORNIA NURSES
ASSOCIATION WE FULLY BELIEVE
THAT THIS IS A SCOPE ISSUE WE
FELT THAT THIS ISSUE SHOULD WANT
TO BUSINESS AND PROFESSIONS
COMMITTEE.
WE BELIEVE AND AT AN
APPROPRIATELY TRAINED GREAT PRE
HOSPITAL CARE PARAMEDIC THOUGHTS
THE LANE THAT PARAMEDICS ARE IN
AND THEY DO THE HAND OFF --
TO OUR PHYSICIANS NURSES
AND AND OTHER LICENSE PERSONAL
--
YOU KNOW I WANT TO GO BACK A
LITTLE BIT TO THE TWO TIERED
ISSUE WE HAVEN'T SEEN THE
LANGUAGE BUT WE HAVE BEEN
RAILING ON THAT ISSUE SINCE THE
INCEPTION OF THIS BILL.
WHAT YOU HAVE --
IN IN IN BETTER THAN THIS BILL.
ARE --
AMBITION BASICALLY CONSORTIUMS
WITH HOSPITALS IN THE SO BRING
IN BEHAVIORAL HEALTH CENTERS
THAT ONLY TAKE MEDI CAL.
RECIPIENTS.
THAT BY DEFINITION IS EMBEDDED
IN THIS BILL THAT HAS NOT BEEN
FIXED WE DID NOT GET ANY
AMENDMENTS ON THAT ISSUE SO IF
YOU CARE ABOUT IF YOU CARE ABOUT
THE TWO TIRED STANDARD CARE.
HE WOULD WANT TO LOOK AT OUR
AMENDMENTS I BELIEVE ON PAGE
FIVE OR SIX OF OUR OPPOSE LETTER
I'M SORRY AND PASS IT OUT.
SO ABSOLUTELY WE DON'T FEEL THAT
THESE ARE GOOD MODELS IF I HAD
MORE TIME I WOULD LAY OUT ALL OF
THAT YOU KNOW ADVERSE EVENTS
THAT HAVE HAPPENED.
WITH THE PILOTS THERE'S DATA
THAT WE ACTUALLY CAN'T COMPARE
THAT.
UCSF IS HIDING FROM US THAT INSA
IS HIDING FROM US WE ARE ASKING
FOR THE RAW DATA TO COMPARE
THOSE NUMBERS THEY'RE NOT GIVING
IT TO US SO WHAT ARE THEY
HIDING.
SO NOT ONLY DO WE LEAVE THAT
THIS IS A SCHOOL FOR PROPOSITION
THAT PATIENTS HAVE BEEN DIVERTED
TO THE SOBERING CENTERS AND THEN
GO BACK TO THE E. R. BECAUSE THE
PARAMEDICS THAT ARE OUT IN THE
FIELD ARE ASSESSING THESE
PATIENTS --
ADEQUATELY.
WHEN YOU LOOK AT A A PATIENT WHO
IS IS YOU KNOW ON HOW THE
SOBERING ISSUE WHOSE INEBRIATED
OFTENTIMES YOU KNOW THAT DOESN'T
ALWAYS PRESENT AS SUCH?
THESE PATIENTS MAY HAVE FALLEN
WE'VE SEEN THOSE ISSUES AND
THERE ARE LAYERED ISSUES AND IN.
EMSA IN YOU SEE A STEPS ONLY
DATA.
TROUBLE IN THE FIELD.
UNDERSTANDING IF IT'S DRUGS
OPIATES AND ALCOHOL THOSE ARE
LAYERED ISSUES AND THOSE ARE
VERY COMPLEX SITUATIONS SO THAT
WAS ALSO CAPTURED IN THE DATA
THAT THE PROPONENTS ARE TALKING
ABOUT TODAY.
SLIGHTLY DIFFERENT ANSWER ON
BEHALF OF HOSPICE IN THAT THE
ISSUE FOR THE HOSPICE PROGRAMS
IS.
THE CONTINUITY OF CARE FOR THE
PATIENT A PLAN OF CARE FOR
HOSPICE PATIENTS THE AVERAGE
STATE LIKE OF STATE FOR HOSPICE.
SEVENTEEN DAYS SO THIS IS A
PATIENT POPULATION IN THE WANING
DAYS OF THEIR LIFE SO ENSURING
THAT THEIR CARE IS CONDUCTED AS
THEY HAVE ARRANGED WHEN DAVE'S
SECURED HOSPICE CARE --
TO ENSURE THAT IF THERE ARE --
ADVANCE DIRECTIVES THAT THERE
HONORED BUT THERE'S ALSO THE
ECONOMIC ELEMENT OF IN INCLUDING
INTO HOW THAT PATIENT IS TREATED
AND NON LICENSED HOSPICE
PERSONNEL ISSUE.
THAT COULD PUT THE HOSPICE
PROGRAM AT RISK FINANCIALLY OR
THE PATIENT'S FAMILY AT RISK
COULD YOU JUST TELL US WHAT THE
BASELINE IS FOR EMERGENCY --
SUPPORT FOR SOMEONE IN A HOSPICE
ENVIRONMENT JUST LIKE AND
UNDERSTAND WHAT IT IS NOW IN
WHAT WOULD BE UNDER THE PARA
MEDICINE PROGRAM THE REASON I I
AND I SHOULD KNOW THIS BUT
BECAUSE I WAS ALSO SOCIAL
WORKER.
AND I PROVIDED HOSPICE SOCIAL
WORK SERVICES IN.
IN HOMES. FOR PATIENTS BUT I
DON'T UNDERSTAND WHAT THE ROLE
IS FOR THAT IMPAIR MEDICINE --
IN THE HOSPICE SO WHAT WE TALK
ABOUT WHAT'S THE CONCERN THAT
MIGHT HAPPEN.
WELL I GOT A CONCERN --
ONE CONCERN IS FOR EXAMPLE --
IF A PATIENT DOES NEED TO
LEGITIMATELY A HOSPICE PATIENT
NEED TO BE TRANSFERRED TO AN
EMERGENCY ROOM.
WHICH GIVEN THAT HOSPICE CARE IS
CARE THAT IS PROVIDED FOR THOSE
WHO HAVE --
NO LONGER ARE SEEKING CURED OF
CARE AND THAT OFTEN.
BUT WHEN IT DOES IF A THE WAY IT
WORKS CURRENTLY IS IF A HOSPICE
PERSONNEL IS THE ONE WHO MAKES
THE CALL TO HAVE.
EMERGENCY MEDICAL TRANSPORT THEN
THAT IS DEALT WITH THROUGH THE
HOSPICES CAPITATED PAYMENT.
AND THE HOSPICE Y. --
WINDS UP IT BECOMES PART OF
THEIR REIMBURSEMENT BUT IF A NON
HOSPICE PERSONNEL MAKES THAT
CALL.
AND THE PATIENT IS TRANSFERRED
THEN EITHER THE HOSPICE PROGRAM
HAVE TO EAT THE COST OF THAT.
THEMSELVES.
OR THE PATIENT'S FAMILY MAYBE
WIND UP HAVING TO BEAR THE
BURDEN OF IT INTERFERE IT JUST
INTERFERES WITH THE FLOW OF CARE
FOR THE FOR THE PATIENT'S FAMILY
THE PATIENT.
AND ULTIMATELY FOR THE THE
ECONOMICS OF THE HOSPICE PROGRAM
ITSELF.
I THINK THE AUTHOR WANTED TO
ADDRESS THE SCOPE QUESTION.
BUT AS I HAVE AN ANSWER
[inaudible] TO ME.
O. WAY ORDER OR YOU WITNESSES
YOU KNOW I BASICALLY WHAT LOOK
WEEKLY WE DRESS THIS.
AND I'LL SHOW TWO SECTIONS IF
YOU LOOK AT PAGE TWELVE OF THE
MEASURE.
A SUB PARAGRAPH TWO IT SAYS.
MY TALKS ABOUT THE PROTOCOL IT'S
IS THE FACILITY NOT BE BASED
UPON ARE AFFECTED BY THE
PATIENTS AT THIS CITY
CITIZENSHIP AGE PRE EXISTING
MEDICAL ADDITIONS INSURANCE
STATUS.
ECONOMIC STATUS ABILITY TO PAY
MEDICAL SERVICES OR ANY OTHER
CHARACTERISTIC LISTS IS DEFINED
SECTION FIFTY ONE US OF A CALL
THAT'S GENERAL CIVIL RIGHTS ACT
PASSED.
NINETY FOUR I REMEMBER THAT.
AND IN ADDITION THE IF YOU LOOK
AT PAGE THIRTEEN REGIONAL
LANGUAGE WAS ANY AGREEMENT WITH
AN ALTERNATE DESTINATION
FACILITY.
HAS TO BE A PROVIDE THAT IF IT
FAILS TO PUT OPERATE RECORDS OF
SIX THIRTEEN SEVENTEEN THAT'S M.
TAUGHT WHICH IS THE BOTH FEDERAL
AND STATE EMERGENCY MEDICAL
TREATMENT LABOR I IT WILL RESULT
IN THE IMMEDIATE TERMINATION OF
THE USE THE FACILITIES FOR THE
COMMITTEE AMERICA.
PERMISSION PROFILE.
SO BOTH WITH RESPECT TO THE
FACILITY IN WITH RESPECT TO THE
TREATMENT.
BUT HE CRACKED WHEAT AND ONE
THAT WE HAD THE BILL IN THE
OTHER ONLY AT THE MAN.
I GUESS I SAY RACED US WE
THOUGHT IT WAS APPROPRIATE ON
HOW TO SENSE IT THIS WAY BECAUSE
YOU'RE IN SO FORTUNATE THERE TOO
IMPORTANT GROUPS BEFORE US --
WHO EACH PROVIDING INCREDIBLE
SERVICE TO OUR COMMUNITY SAID
ABSOLUTE WHAT I WANT TO BE A TO
BE A TO SAY IS ONE OF THE
TONIGHT'S ON SUPPORTING WHAT'S
IN THE INTERESTS OF THE BEST
PUBLIC HEALTH?
AND SO I GUESS I'M GONNA BOIL IT
DOWN TO THE PROPONENTS WILL SAY
WHY THIS IS IN THE BEST INTEREST
OF THE PUBLIC HEALTH.
IN THE OPPONENTS WILL SAY WHY
IT'S NOT BE AND YOU KNOW I I'M
NOT GOING TO GO TO SOME THAT'S A
SCOPE ISSUE BUT IT'S ABOUT.
PROMOTING THE PUBLIC HEALTH I'M
ABOUT IT WHY IS THIS IN THE BEST
OF PUBLIC HEALTH AND FOR THOSE
WHO DON'T AGREE WHY WHY WHAT
IMPACTS OR NEGATIVE IMPACTS.
DO YOU THINK YOU CAN OCCUR.
I CAN ANSWER MIGHT THE
LITERATURE.
HOW THROUGH THE CHAIR HE'S ONE
OF THE GROUPS BECAUSE THAT'S
WHAT HE WAS ARE THURMOND YOU'RE
RIGHT ON THE MONEY THIS IS ABOUT
--
THE BENEFIT TO PUBLIC HEALTH IS
NOT OF THE SCOPE FIGHT AND THE
LOCALLY MISS AGENCIES TALK ABOUT
LOCAL OPTIONAL SCOPES OF
PRACTICE THAT ARE AUTHORIZED NOW
FOR EMTS.
WANTS TO THE PARAMEDICS ABSENT
ANY LEGISLATIVE AUTHORIZATION
BECAUSE THEY'RE ALWAYS OPERATING
UNDER MEDICAL CONTROL OF MEDICAL
DIRECTOR IN THE COUNTIES --
BUT THIS IS A PROMOTION OF
PUBLIC HEALTH BECAUSE IT
WHAT WE'RE SUGGESTING IS THAT IF
WE CONTINUE TO RESPOND ON THE
SAME POPULATION OF FOLKS?
OF ORAL HOSPITALS ARE
DISCHARGING PATIENTS WHO END
RIGHT BACK UP IN THE ER BECAUSE
OF A FAILURE OF CONFORMANCE WITH
THEIR MEDICATIONS OR WHAT HAVE
YOU THE HOSPICE.
IS IS SIMPLY ABOUT.
MAKING SURE THAT [inaudible]
WE'RE NOT TRANSPORTING THEM
AGAINST THEIR WISHES THAT IS THE
WHOLE POINT OF THE HOSPICE A
PILOT PROJECT IN THE
AUTHORIZATION OF THIS BILL SO
THIS IS A PROMOTIONAL PUBLIC
HEALTH.
THIS IS THIS IS A SERVICE THAT
DOESN'T EXIST FOR PATIENTS WHICH
IS WHY THEY'RE FALLING THROUGH
THE CRACKS.
AND I ONE MORE THING I JUST
IDENTIFY BECAUSE IN THE CONTEXT
OF YOUR QUESTION.
IT WAS REVISITED MAYBE --
REPEATEDLY.
THESE PILOTS WERE VOLUNTARY SO
YOU GOT FACILITIES THAT
VOLUNTEERED TO PARTICIPATE IN
TESSA'S PROGRAM YOU CAN'T JUDGE
THE PROGRAM.
THAT HAD ALMOST EXCLUSIVELY MEDI
CAL PATIENTS BECAUSE THEIR
ACCOUNT OF HIS COUNTY FACILITY
AND THAT'S WHO THEY ACCEPTED IT
WASN'T BECAUSE THEY WERE MAKING
SOME SELECTION THE FIELD AND
DIVERTED THAT PATIENT POPULATION
SO THE DATA CAN TELL LOTS OF
STORIES.
BUT I CAN ASSURE YOU THAT.
THE THE INDEPENDENT EVALUATOR
HAS NO INTEREST IN THIS PROJECT
EXCEPT TO SUGGEST IS THIS THE
RIGHT THING FOR A COMMUNITY
HEALTH CENTER COMMUNITY BENEFIT.
AND THE FIREFIGHTERS BELIEVE IT
IS WHICH IS WHY WE ARE BEFORE
YOU.
AFTERNOON EVENING NIGHT.
I UNDERSTAND WHAT --
THIS MOMENT JUST SAID ABOUT YOU
KNOW THESE FACILITIES ONLY
ACCEPT MEDICAL PATIENTS BUT I
WOULD ARGUE THAT THAT IS DONE BY
DESIGN.
SO YOU HAVE IN YOU CAN TREAT
SYSTEM.
THAT BASICALLY ONLY ACCEPTS MEDI
CAL PATIENTS AND IF THAT'S NOT
THE CASE IN THIS WAS OPEN TO
EVERYONE WE LOOKED AT THE DATA
1% OF THAT POPULATION.
GOT A BIT THE ARE PRIVATE PAY.
EVERYBODY ELSE WOULD TO THESE
FACILITIES SO IT'S DONE BY
DESIGN WHETHER IT'S NOT THE
CHARGER THAT'S NOT THE INTENT IS
DONEBY DESIGNS WITH INHERENT IN
THE PROCESS THAT'S NOT RIGHT.
WE ALSO UNDERSTAND THAT THERE'S
A LOOPHOLE IN SECTION THIRTEEN
SEVENTEEN THAT NEEDS TO BE FIXED
WE HAVEN'T SEEN THE LANGUAGE
IT'S NOT A TOTAL FIX.
SO THIS DOES NOT PROMOTE PUBLIC
HEALTH WE BELIEVE WE BELIEVE
THAT YOU HAD WHOLESALE PATIENTS
DECIDING YOU KNOW BY THEIR OWN
VOLITION THAT THEY'D WANT TO
TAKE PART OF THESE PILOTS WHO
HAD HOLE SO COMMUNITIES.
PERMANENTLY FOLKS OF COLOR THAT
DECLINED THESE PILOTS IT'S NOT
REFER REFLECTIVE OF CALIFORNIA
AND I DON'T BELIEVE THAT WE
SHOULD MOVE PUBLIC POLICY IN A
FASHION THAT'S NOT REFLECTIVE OF
CALIFORNIA.
WE ALL KNOW ABOUT SOCIAL
DETERMINANTS OF HEALTH.
WE ALL KNOW THAT IF YOU ARE
AFRICAN AMERICAN YOU PRESENT
WITH SICKLE CELL AND OTHER
ISSUES SO FOR ABOUT PUBLIC
HEALTH WE NEED TO BE MOVING
POLICIES THAT BEST.
YOU KNOW SUIT THE PATIENT AND WE
JUST DON'T THE RIGHT WAY WE'VE
AGAIN SHOWED YOU SOME MODELS
THAT WORK.
OUR MEMBERS ARE DOING THIS THIS
THIS TRIAGE AND WE WOULD BE OUT
A RATIO SO IF WE CAN PUT A NURSE
ON THE TRUCK WE WOULD BUT WE
CAN'T.
THAT IS THAT IS SOMETHING THAT
IS A NON STARTER FOR US AND THAT
WOULD BE BAD FOR PATIENT SAFETY
WE CAN'T HAVE AN RN JUMP ON THE
TRUCK INTO THE ASSESSMENT BUT
WHAT WE HAVE SAID IS.
IN THE LOT OF THESE CASES IN
CALIFORNIA HOSPITALS TODAY THERE
ARE SYSTEMS THAT WORK THAT
REDUCE WAIT TIME THAT REDUCE
WALL TIME AND THEN YOU ALSO HAVE
THE APPROPRIATE PRACTITIONER
DOING THE ASSESSMENTS THAT TO
TRIPLE WHEN.
WE PASS THOSE THINGS AROUND THAT
JUST BECAUSE THE PROPONENTS AND
COME UP WITH IT DOESN'T MEAN
IT'S NOT A GOOD THING.
SO I THINK THAT'S SOMETHING THAT
WE SHOULD MODEL AND TESTED IN
SOME CASES COMBAT KAISER MARINO
VALLEY SIXTY SEVEN MINUTES TO
TWELVE MINUTES USING POSITION
ARE IN MODEL.
IN OTHER CASES FOUR TO SIXHOURS
WERE REDUCED TO ONE TO TO THAT.
DOOR TO PHYSICIAN AND OUT THE
DOOR I THINK I THINK THAT'S
SOMETHING WE OUGHT TO LOOK AT
THANKS TO THE PARTICIPANTS THANK
YOU MISTER CHAIR.
IF YOU VERY MUCH ANYONE ELSE.
SEEING NO.
ONE JUST TO CLOSE ALL WILL SAY
IN CLOSING IS THE TERROR.
BERMAN MADE A POINT ABOUT.
GROUPS THAT CARE DEEPLY ABOUT
THE PUBLIC HEALTH OF CALIFORNIA.
THIS HAS CAUSED ATTENTION.
WHICH I DON'T LIKE.
THE MEETING IN MY OFFICE.
THIS WEEK WAS AT LAST WEEK A
CAMERA PURSUANT.
AND TRYING TO GET AND LISTEN TO
THE POINTS THAT WERE MADE.
TRYING TO GET THE PARTIES TO
FIGURE IS A PLACE.
THEY'RE MUCH SMARTER ON THIS
ISSUE THAT I DON'T APPEAR BEFORE
HEALTH COMMITTEE OFTEN.
BUT I THOUGHT THAT WAS COMMON
SENSE IN THE NOTION OF TRYING TO
DO EVERYTHING POSSIBLE TO
PROMOTE COMMUNITY PARA MEDICINE.
AND AVOIDING THIS PROBLEM
BECAUSE IT WILL TIME OR WHATEVER
BUT JUST BASIC GOVERNMENT COST
WHERE WE CAN GET STUFF DONE IN A
MORE INTELLIGENT WAY.
I THOUGHT THAT THAT WAS
FLEXIBILITY IN THE PROPOSAL.
LOCALS CONTROL IN THE PROPOSAL
TO DO THAT CLEARLY THERE'S SOME
CERTAIN CHALLENGES WITH RESPECT
TO INTERPRETATION OF WHAT THAT
MEANS IS.
TO ARM THE PROPER LEVEL OF CARE
I'M NOT STOPPED WORKING ON THIS
BILL.
WHETHER THIS THING KEEPS PASSING
OR NOT I'M CONTINUING TO LISTEN
AND TO TRY TO LEARN AND TO TRY
TO MAKE IT BETTER. TO
INCORPORATE THE ISSUES THAT ARE.
LEGITIMATE WITH RESPECT TO THAT
INCLUDING THE ISSUES THAT WERE
JUST RAISED HERE TODAY IN THIS
COMMITTEE.
AND WITH THAT I WOULD ASK FOR
NIVEAU.
NO THANK YOU SENATOR HERTZBERG
--
THIS IS THE THIRD COMMUNITY PARA
MEDICINE FILL THIS COMMITTEE IS
CONSIDERED IN THE LAST TWO YEARS
AND I APPRECIATE ALL THE HARD
WORK THAT'S GONE INTO MOVING
THIS ISSUE FORWARD.
UNDERSTAND THE STAKEHOLDERS
CONCERN FOR PUBLIC PATIENT
SAFETY.
WHEN THEIR INNOVATIONS IN HOW
HEALTH CARE IS PROVIDED USUALLY
TAKES AWHILE FOR THE POLICY TO
CATCH UP WITH THE PRACTICE?
TERRIBLY THE PROCESS FOR
DEVELOPING PROGRAMS AT THE LOCAL
LEVEL WITH OVERSIGHT REGULATIONS
PRIDE PROVIDED BY EMSA ALLOWS
FOR SIGNIFICANT INPUT NO
OVERSIGHT.
WELL THANK YOU FOR ACCEPTING OUR
CLARIFYING AMENDMENT WHICH IS
PART A AS WELL AS AGREED TO WORK
ON LANGUAGE THAT WILL REMOVE THE
OVERSIGHT COMMISSION.
TRIBALLY DUPLICATES THE WORK OF
OF THE COMMISSION ON EM --
THAT DICK AND TO CHANGE THE
COMMISSION'S MEMBERSHIP TO
PROVIDE NECESSARY EXPERTISE TO
OVERSEE COMMUNITY PARA MEDICINE.
WITH THAT LIKE TAG MADAM
SECRETARY TO CALL THE ROLE WE
HAVE A MOTION BY MISTER FLORA
SECOND BY MISTER MAYES MOTION IS
TO PASS TO APPROPRIATIONS.
TAKE AMENDMENTS WILL BE TAKEN
APPROPRIATIONS.
WHAT I WOULD AYE MAYES PLAYS AYE
AGUIAR-CURRY HAGGAR CURRY I
BIGELOW?
BIGELOW AYE BONTA BONTA AYE
BURKE.
BURKE I CARILLO.
CARILLO AYE FLORA.
FLORA AYE LOW MOAN.
LIMON AYE MCCARTY MCCARTY AYE
NOSE AREA [inaudible]
RODRIGUEZ [inaudible]
SANTIAGO.
SANTIAGO AYE.
THURMAN.
BERMAN I WALDRON [inaudible]
WALDRON AYE. THIRTEEN ZERO THE
BILL IS OUT.
WE HAVE NOW.
I HEARD ALL THE BILL SO WE WILL
GO BACK THROUGH THE ROLE WE DO
HAVE SOME MEASURES ON CALL.
SO WE WILL --
S. MADAM SECRETARY AND WE STILL
HAVE MEMBERS THAT ARE MISSING SO
MANY OF THOSE MEMBERS BACK TO
VOTE.
ON ALLRECIPES MEASURES --
AND SO WILL GO THROUGH --
ITEM NUMBER. EIGHT S. B. TEN
TWENTY THREE HERNANDEZ.
LIFT THE CALL AND CALL THE
ABSENT MEMBERS [inaudible]
BONTA.
BONTA AYE BURKE BURKE I NAZARIAN
[inaudible]
RODRIGUEZ [inaudible]
SANTIAGO.
A NUMBER TEN TWENTY THREE
HERNANDEZ.
I NEVER A SANTIAGO AYE THURMAN.
THURMOND AYE WALDRON.
WALDRON AYE.
THAT IS ELEVEN TO ONE THAT BILL
WAS OUT --
ITEM NUMBER --
ELEVEN SP ELEVEN AWAY DOCTOR
HERNANDEZ MADAM SECRETARY WITH
THE CALL CALL THE ABSENT MEMBERS
BONTA.
BONTA AYE BURKE.
BURKE I'VE [inaudible]
THIS AREA [inaudible]
RODRIGUEZ [inaudible]
SANTIAGO.
SANTIAGO AYE THURMOND
[inaudible]
THURMOND I THAT HAS NINE VOTES
NINETY THREE THAT GOES OUT.
ITEM NUMBER SIX TEEN SP TWELVE
THIRTY EIGHT SENATOR ROTH WITH
THE CALL CALL THE ABSENT MEMBERS
PLEASE BONTA.
BONTA NOT VOTING.
BURKE.
BURKE NOT VOTING [inaudible]
SANTIAGO. TO VOTE SHORT.
SANTIAGO NOT VOTING THURMAN.
SANTIAGO I'VE TERMINATE CAN'T GO
AYE THURMOND AYE.
THAT IS OUT [inaudible]
EIGHT TO FOUR THANK YOU.
ITEM NUMBER. EIGHTEEN SP TWELVE
FIFTY FIVE HERNANDEZ.
ORDINANCE.
I'M SURE THAT'S AND THAT'S OUT
I'M SORRY ITEM NUMBER TWENTY ONE
SP THIRTEEN SEVENTY FIVE
HERNANDEZ.
LET THE CALL CALL THE ABSENT
MEMBERS PLEASE [inaudible]
BONTA.
BONTA I'VE BURKE [inaudible]
BURKE I SANTIAGO.
SANTIAGO AYE PARENT [inaudible]
THURMOND I POLITICAL ONES.
SO WE NOW HAVE NO BILLS ON CALL.
IT'S A REGULAR TOP THE ORDER AND
RUN THROUGH AN AD FOR AT ARMS.
JUST FOR THOSE THAT ARE
LISTENING OUT THERE WE WILL
AFTER THIS WE WILL WAIT. FIVE
MINUTES AND THEN WE'LL CLOSE THE
MEETING OKAY [inaudible]
IT TOOK.
SO WHAT'S SO THE CONSENT
CALENDAR WHICH IS CLOSE ITEMS
NUMBER [inaudible] ONE FIVE NINE
TWELVE THIRTEEN AND TWENTY TWO
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS [inaudible]
BONTA.
BONTA AYE BURKE.
BURKE I SANTIAGO.
SANTIAGO AYE THURMAN
[inaudible]
THURMOND I THAT'S FIFTEEN ZERO
ITEM NUMBER TWO S. B. SEVEN TO
SEVENTY FIVE PORTANTINO PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS [inaudible]
BONTA.
BONTA AYE BURKE.
BURKE I NAZARIAN [inaudible]
SANTIAGO.
SANTIAGO AYE THURMAN
[inaudible]
THURMOND I FOURTEEN ZERO ITEM
NUMBER THREE SB SIX FORTY ONE
LARA PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS BONTA.
BONTA AYE BURKE [inaudible]
BURKE I SANTIAGO.
SANTIAGO AYE THURMAN.
THURMOND AYE FIFTEEN FIFTEEN
ZERO ITEM NUMBER FOUR SP EIGHT
TWENTY THREE HILL PLEASE OPEN
THE ROLL CALL THE ABSENT
MEMBERS.
BONTA.
BONTA AYE BURKE [inaudible]
BURKE I SANTIAGO.
SANTIAGO AYE THURMOND
[inaudible]
THURMOND I FIFTEEN ZERO OFTEN
[inaudible] SIXTEEN QUIRK SILVA
BACK TO EVERYTHING.
ITEM NUMBER --
SIX SP.
NINE FORTY FOUR IT JUST RAN
THROUGH THAT BILL --
BUT I WILL UP THE ROLL CALL THE
ABSENT MEMBERS MISSED I THINK
THIS RODRIGUEZ WAS NOT NAZARIAN
RODRIGUEZ.
RODRIGUEZ HAPPENING STILL
EIGHTEEN STILL THIRTEEN ZERO
ITEM NUMBER SEVEN SP ONE ZERO
ZERO EIGHT SKINNER.
OPEN THE ROLL CALL THE ABSENT
MEMBERS WOULD.
I WENT I BONTA.
BONTA AYE BURKE BURKE HIGH
CARILLO [inaudible]
CARILLO I NAZARIAN [inaudible]
RODRIGUEZ.
RODRIGUEZ AYE THURMAN.
THURMOND AYE [inaudible]
NAZARIAN.
ITEM NUMBER EIGHT SP TEN TWENTY
THREE HERNANDEZ.
TENNIS IS ONE ZERO ZERO EIGHT
SCHEMES ARE.
ONE ZERO ZERO EIGHT NAM ARE IT
WAS ONE ZERO ZERO EIGHT SORRY.
MY BAD SKINNER.
OKAY SIR AND I NOW WILL YOU
AFTER FIFTEENTH THIS FIFTEEN
ZERO NOW WE'LL MOVE TO ITEM
NUMBER.
EIGHT S. B. TEN TWENTY THREE
HERNANDEZ OPEN THE ROLL CALL THE
ABSENT MEMBERS [inaudible]
NAZARIAN.
NO ANSWER.
YEAH NAZARIAN [inaudible]
CORRECT I'D NAZARIAN AYE
RODRIGUEZ [inaudible]
RODRIGUEZ I THIRTEEN ONE
THIRTEEN ONE ITEM NUMBER TEN SP
TEN FORTY FIVE WIENER OPEN THE
ROLL CALL THE ABSENT MEMBERS THE
MONTH.
THE MONEY I KNOWS AREA.
NAZARIAN AYE RODRIGUEZ RODRIGUEZ
AYE THURMOND [inaudible]
BERMAN I TEAM.
ZERO ITEM NUMBER. ELEVEN S. B.
ELEVEN AWAY HERNANDEZ OPEN THE
ROLL CALL THE ABSENT MEMBERS
PLEASE.
IN THIS AREA.
SILICON VALLEY ELEVEN AWAY.
NAZARIAN AYE RODRIGUEZ
[inaudible]
RODRIGUEZ I LEVINE ELEVEN TO
THREE ITEM NUMBER FOURTEEN S. B.
ELEVEN FIFTY TWO HERNANDEZ
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS.
BONTA.
BONTA AYE BURKE [inaudible]
BURKE I SANTIAGO [inaudible]
YES CORRECT.
SANTIAGO AYE BERMAN [inaudible]
THURMOND I TWELVE THREE ITEM
NUMBER. FIFTEEN S. B. ELEVEN
FIFTY SIX LEYVA OPEN THE ROLL
CALL THE ABSENT MEMBERS PLEASE
BONTA [inaudible]
BONTA AYE [inaudible]
THIS AREA.
RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO.
SO TERRIBLE I THIS AREA NOT
VOTING.
THAT VOTE IS.
ELEVEN TO THREE ITEM NUMBER
SIXTEEN S. B. TWELVE THIRTY A
MUST THE ROOM --
MISTER ROTH --
OPEN THE ROLL CALL THE ABSENT
MEMBERS.
NICE AREA.
I'D NAZARIAN AYE [inaudible]
STEAM [inaudible]
ITEMS.
SANTIAGO I'D TO NOT VOTING
[inaudible]
SELECT.
IT FOR THE MEASURE CHANGE DOES
NOT CHANGE.
MOM ITEM NUMBER SEVENTEEN SP
TWELVE FIFTY FOUR STONE OF
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS [inaudible]
BONTA.
BONTA AYE BURKE BURKE I
NAZARIAN.
NAZARIAN AYE RODRIGUEZ.
RODRIGUEZ I SANTIAGO
[inaudible]
CORRECT.
SANTIAGO I THURMOND.
THURMAN I TEAM.
ZERO ITEM NUMBER EIGHTEEN SP
TWELVE FIFTY FIVE HERNANDEZ
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS FOR HARD SORRY
BONTA.
BONTA AYE BURKE [inaudible]
BURKE I SANTIAGO.
SANTIAGO AYE THURMAN
[inaudible]
THURMOND I THIRTEEN TO TO ITEM
NUMBER NINETEEN MISTER BRADFORD
--
SP TWELVE SIXTY EIGHT PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS WOULD I WOULD I BONTA
[inaudible]
BONTA AYE [inaudible]
NAZARIAN.
NAZARIAN AYE RODRIGUEZ RODRIGUEZ
I SANTIAGO.
SANTIAGO AYE THURMOND.
THURMOND AYE.
TEEN ZERO ITEM NUMBER TWENTY S.
B. TWELVE EIGHTY SEVEN HERNANDEZ
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS.
BONTA BONTA AYE BURKE BURKE I
SANTIAGO.
SANTIAGO AYE THURMAN
[inaudible]
BERMAN I FIFTEEN ZERO ITEM
NUMBER TWENTY ONE SP THIRTEEN
SEVENTY FIVE PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS.
NO ABSENT MEMBERS OKAY THAT WAS
QUICK ITEM NUMBER TWENTY THREE
SB FOURTEEN NINETY FIVE THE
HEALTH SENATE HEALTH COMMITTEE
BILL PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS WOULD I WOULD
I BONTA AYE.
BONTA AYE BURKE.
BURKE AYE.
NAZARIAN.
NAZARIAN AYE SANTIAGO.
SANTIAGO AYE THURMAN
[inaudible]
THURMAN I TEAM [inaudible]
ZERO SO THAT.
DOES CONCLUDE ALTHOUGH WE HAVE
SOME YOU HAVE SOME OF THE ANY
TED ONTO.
YOU HAVE TO FOCUS WILL.
KILEY GO THROUGH IT WILL GO
THROUGH THESE AND SEE WHERE THEY
ARE.
SP TWO SEVENTY FIVE SP TWO
SEVENTY FIVE PLEASE OPEN THE
ROLE [inaudible]
THIS AREA.
ITEM NUMBER NAZARIAN AYE
[inaudible]
TEAM.
ZERO I WHAT IS PART A CASSETTE
COUNTER OF SO.
EVERYTHING DIDN'T HAVE MANY
THINK EVERYBODY'S VOTED ON
CONSENT BUT I THINK YOU COULD
YOU JUST KNOW YOU DID.
THEY DIVIDE.
UP. FIFTEEN FIVE YEARS TO LIFE.
YOU THINK YOU'RE MISSING OUT
THIS CARILLO PLEASE USE WITH
[inaudible]
OF THAT.
I FORTY FOUR NINE FORTY FOUR PM
SORRY.
I WASN'T HERE SO I'M NOT SURE
WHO WAS BEFORE CENTER WIENER WAS
AT SENATOR ANDERSON SO WHAT.
WAS THAT CENTER BRADFORD WHOSE
BEFORE CENTER WAITER WHO WAS
BEFORE [inaudible]
SKINNER [inaudible]
SKINNER. OH PLAY NOT ITEM NUMBER
SEVEN I DON'T HAVE TO STAND ON
MY FORTY FOUR OKAY ALRIGHT.
WITH SO MANY THINGS GOING ON
HERE -- NINE
AND I DON'T EVER.
SIX S. B..
NINE FORTY FOUR CONSIDER
HERTZBERG NOSE AREA.
WELL THAT TO ENSURE.
IT'S CONSENT OUT OF ALSO --
COMMUNITY PARA MEDICINE.
THE LAST ONE WE JUST HEARD AYE
AYE.
AS AARON I TEAMED.
FOURTEEN ZERO SKINNER AND
SKINNER IS ITEM NUMBER SEVEN ONE
ZERO ZERO ME.
MY HAPPINESS AND WE HAVE YEARS
AND I NOT OUT OF THE ARE YOU AND
I YOU ARE AND I HOPE
[inaudible]
BUT ITEM NUMBER --
EIGHT STERN IS HARRY WANTS TO
CHANGE HIS VOTE TO NOT VOTING.
I MEAN I'M SORRY ITEM NUMBER.
SIX TELL SIMPLE NONE AS NOON
NINE FORTY FOUR IN THIS AREA AND
I TO NOT NOTE I DO NOT VOTING.
THAT LOOKS AT THIRTEEN YES THERE
ARE --
EIGHTEEN THIRTEEN ZERO ZERO
THANK YOU.
AND CERTAINLY.
HAVING IT'S EVERYTHING STRANGER
EXACTLY --
EVERYWHERE EVERYBODY I CONSULT.
NUMBER [inaudible] ONE FIVE NINE
TWELVE THIRTEEN AND TWENTY TWO
PICK YOUR I THINK WHAT.
I THINK WORD OF GOD [inaudible]
FINISH YOUR