INFORMATIONAL HEARING OF
ASSEMBLY BUDGET SUBCOMMITTEE
NUMBER ONE ON HEALTH AND HUMAN
SERVICES AND THE ASSEMBLY BUDGET
SUBCOMMITTEE NUMBER TWO ON
EDUCATION FINANCE.
THIS HEARING IS ABOUT THE STATE
OF THE STATE'S HEALTH CARE
WORKFORCE.
AND SPECIFICALLY TO LEARN FROM
THE FINDINGS AND RECOMMENDATIONS
INCLUDED IN THE FINAL REPORT OF
THE CALIFORNIA FUTURE HEALTH
WORKFORCE COMMISSION.
I WOULD LIKE TO THANK THE
SPEAKERS AND PANELISTS WHO AGREE
TO BE HERE ON FAIRLY SHORT
NOTICE.
AND I WOULD ALSO LIKE TO THANK
ASSEMBLY MEMBER MCCARTY WHO WILL
BE HERE SHORTLY -- WHOSE CHAIR
OF THE SUBCOMMITTEE NUMBER TWO
FOR JOINING US IN THIS IMPORTANT
ENDEAVOR.
I'D ALSO LIKE TO THANK ASSEMBLY
MEMBER -- WOODS WHO WAS A MEMBER
OF THE COMMISSION.
WHO PREPARED THIS FINAL REPORT --
ON THE CALIFORNIA FUTURE HEALTH
WERE FOR WORKFORCE COMMISSION.
AND WHEN MR MCCARTY WOULD
ASSEMBLY MEMBER MCCARTY ARRIVES
I WILL ASK HIM FOR BRIEF
COMMENTS IF HE WOULD LIKE.
I DO ANY OF THE OTHER MEMBERS
ALIKE WOULD ANY OF YOU LIKE TO
MAKE SOME OPENING REMARKS.
AFTERWARD DR WOOD THANK YOU
MADAM CHAIR AND THANK YOU -- FOR
AND ASSEMBLYMEMBER CARTY FOR
CONVENING THIS I THINK IT'S
CRITICAL COMPONENT OF OF THE ARE
ON GOING NO -- DESIRE TO FIND A
WAY TO PROVIDE HEALTHCARE FOR
ALL IN CALIFORNIA -- THE WORK
FORCE AND YOU'LL HEAR MORE ABOUT
IT AS WE GO ON OBVIOUSLY -- BUT
I REALLY FELT IT WAS OF VALUABLE
AND IMPORTANT FOR MEMBERS OF THE
OF THE LEGISLATURE TO HEAR
DIRECTLY FROM OF THE PEOPLE WHO
WORKED ON THE WORK FORCE --
COMMISSION TO TO I I'VE BEEN
TALKING ABOUT EVER SINCE REPORT
WAS RELEASED ON THE FOURTH OF
FEBRUARY AND I'M HAVE YOU HAVE
HAVE THAT AS THE REPORT AS A
BASIS FOR ONGOING WORK THAT I DO
I AM DOING NOW.
EVERYTHING'S I HOPE TO DO IN THE
FUTURE SO I'M VERY ANXIOUS TO
HEAR.
HAVE EVERYONE ELSE HERE -- THE
WORK AND AND HOW WE GOING
FORWARD AND I I I HOPE THAT --
HOPE THAT EVERYONE ELSE
APPRECIATES AND UNDERSTANDS --
MY PASSION FOR THIS AFTER
THEY'VE HEARD THE PRESENTATIONS
TODAY SO THANK YOU.
THANK YOU MISTER MEDINA.
THANK YOU MADAM CHAIR -- BEING
THE REPRESENTATIVE FROM THE
INLAND EMPIRE ONE OF THE
REPRESENTATIVES FROM THE INLAND
EMPIRE SPECIFICALLY RIVERSIDE.
OF WHERE WE HAVE THE FIRST
MEDICAL SCHOOL PUBLIC MEDICAL
SCHOOL -- SINCE NINETEEN SEVENTY
I BELIEVE THE FIRST A MEDICAL
SCHOOL OF PUBLIC MEDICAL SCHOOL
SINCE THE NINETEEN SEVENTIES I
VERY MUCH REALIZE THE SHORTAGE
OF DOCTORS IN THE IN A CENTRAL
INLAND CALIFORNIA.
AND SO I AM VERY HAPPY TO BE --
OFFERING A BILL TO EXPAND OUR
MEDICAL SCHOOL AT UC RIVERSIDE
TO GO FROM. ONE TO GO.
FROM FIFTY A DOCTORS THAT WE ARE
GRADUATING NOW EACH YEAR THAT WE
HAVE DONE FOR THE LAST FOUR
YEARS -- INTRODUCE A BILL TO GO --
TO ONE HUNDRED DOCTORS PER YEAR
AT THE UC OUR SCHOOL OF MEDICINE
LOOK FORWARD -- TO HEARING --
THE REPORTS IN THIS COMMITTEE.
THANK YOU MISTER MEDINA YOU'RE
RIGHT -- IT IT IT'S WONDERFUL
THAT IN FACT THAT'S ONE OF THE
AREAS THAT IS MENTIONED THE
INLAND EMPIRE AND WE HAVE THREE
INLAND EMPIRE LEGISLATORS IT IS
AN IMPORTANT SUBJECT.
THANK YOU SO MUCH -- I WOULD
LIKE TO ASK DOCTOR HERNANDEZ AND
THE FIRST PANEL TO PLEASE COME
TO THE TABLE SO THAT WE CAN
BEGIN.
AND JUST AS A SIDE OF MEMBERS IN
ORDER FOR US TO USE OUR TIME
EFFICIENTLY I WOULD LIKE TO HOLD
ALL QUESTION AND THE ANSWER
UNTIL THE END OF THE LAST PANEL
IF WE COULD.
AND WE WOULD LIKE TO THE FIRST
TWO PANELS.
FIRST TWO PANELS TO STAY. TWO
SIX STAY CLOSE BY IN CASE THERE
ARE SOME QUESTIONS.
THANK YOU VERY MUCH -- GOOD
AFTERNOON CHAIR RAISES AND
MEMBERS OF THE BUDGET
SUBCOMMITTEE FOR HEALTH AND
HUMAN SERVICES AND EDUCATION
FINANCE.
THANK YOU VERY MUCH FOR THE
INVITATION TO DISCUSS
CALIFORNIA'S SEVERE HEALTH
WORKFORCE SHORTAGES.
AND THE RECOMMENDATIONS OF THE
CALIFORNIA FUTURE HEALTH
WORKFORCE COMMISSION.
I ALSO WANT TO ACKNOWLEDGE AND
APPRECIATE A SOME WOMEN WOULD
WHO SERVED AS A VERY ACTIVE
MEMBER OF THE COMMISSION THANK
YOU -- HEALTH CARE OF COURSE IS
TOP OF MIND FOR CALIFORNIANS AND
WITH VERY GOOD REASON. TOO MANY
CALIFORNIANS TODAY STRUGGLE TO
AFFORD HEALTH CARE WE STILL HAVE
THREE MILLION OR MORE
CALIFORNIANS WHO REMAIN
UNINSURED.
AND EVEN WHEN CALIFORNIANS HAVE
HEALTH INSURANCE IT REMAINS TOO
DIFFICULT FOR TOO MANY. TO
ACCESS THE CARE THAT THEY NEED.
AS A STATE OUR ABILITY TO SOLVE
THESE ACCESS PROBLEMS DEPENDS
ENTIRELY.
ON WHETHER WE HAVE PEOPLE IN
PLACE TO PROVIDE NECESSARY CARE
[inaudible]
UNFORTUNATELY CALIFORNIA ALREADY
FACES A SERIOUS SHORTAGE IN
SEVERAL KEY AREAS OF OUR STATE
AND HEALTH WORKFORCE.
THESE SHORTAGES ARE PROJECTS TO
WORSEN OVER THE NEXT DECADE.
AS OUR POPULATION AGES.
AS IT BECOMES MORE DIVERSE AND
AS IT GROWS.
THERE'S OVERWHELMING CONSENSUS
THAT CALIFORNIA NEEDS TO SHIFT
MORE CARE. TO PRIMARY CARE AND
TO PREVENTION.
IN ORDER TO IMPROVE HEALTH BUT
ALSO TO REDUCE HEALTHCARE COSTS
IN THE LONG RUN.
IF CALIFORNIA'S STAYS ON THE
CURRENT PATH THE STATE WILL FACE
A SHORTFALL OF MORE THAN FOUR
THOUSAND PRIMARY CARE PHYSICIANS
IN THE NEAR FUTURE.
IN SOME PARTS OF THE STATE AS WE
HEARD A MOMENT AGO SHORTAGES ARE
ALREADY AT CRISIS LEVELS.
ABOUT SEVEN MILLION CALIFORNIANS
TODAY LIVE IN HEALTH
PROFESSIONAL SHORTAGE AREAS.
SAFETY NET PROVIDERS ACROSS THE
STATE AND PROVIDERS IN
PARTICULAR IN THE SAN JOAQUIN
VALLEY.
IN THE INLAND EMPIRE AND IN MOST
RURAL AREAS REPORT EXTREME
DIFFICULTY IN HIRING CLINICIANS
FOR ESSENTIAL ROLES.
BY TWENTY THIRTY ONE IN FIVE
CALIFORNIANS WILL BE OVER THE
AGE OF SIXTY FIVE THE NUMBER OF
OLDER ADULTS WHO WILL NEED HELP
WITH SELF CARE WILL DOUBLE IN
THAT TIME. TWO THIRDS OF
CALIFORNIA ADULTS WITH MENTAL
ILLNESS TO DAY DO NOT RECEIVE
ANY TREATMENT AT ALL.
AND ONLY TWO OF CALIFORNIA'S
FIFTY SIX COUNTY MENTAL HEALTH
PLANS MET TIME AND NETWORK
ACCESS REQUIREMENTS IN.
TWENTY SEVENTEEN TAKEN TOGETHER
THESE HEALTH WORK FOR SHORTAGES
MEANING THAT TOO MANY
CALIFORNIANS MUST VISIT
EMERGENCY ROOMS.
BECAUSE THEIR COMMUNITY HAS TOO
FEW PRIMARY CARE PROVIDERS. TOO
MANY GO WITHOUT MENTAL HEALTH
CARE BECAUSE THERE ARE NO
PSYCHIATRISTS OR MENTAL HEALTH
PROVIDERS.
AND TOO MANY MISS OUT ON THE
ABILITY TO HAVE THE SUPPORT OF
THEIR PHYSICIAN BECAUSE THEY
DON'T SPEAK ENGLISH OR
UNDERSTAND THEIR LANGUAGE OR
CULTURE.
AS A STATE WE CAN AND SHOULD DO
BETTER. ONE OF THE PRINCIPAL
REASONS THE CALIFORNIA ENDED UP
IN THE SITUATION.
IS BECAUSE THERE'S NO ONE ENTITY
THAT'S RESPONSIBLE FOR TAKING A
GLOBAL VIEW OF OUR HEALTHCARE
WORKFORCE.
THE RESPONSIBILITIES OF
EDUCATING TRAINING AND HIRING
HEALTH WORKER WORKERS ARE
FRAGMENTED. EIGHTEEN MONTHS AGO
THE CALIFORNIA FUTURE HEALTH
WORKFORCE COMMISSION LAUNCHED
WITH THE GOAL OF DEVISING A
COMPREHENSIVE PLAN. TO MEET
CALIFORNIA'S DEMAND FOR CARE.
SUPPORT CAME FROM MY
ORGANIZATION.
CALIFORNIA HEALTHCARE FOUNDATION
AS WELL AS THE BLUE SHIELD OF
CALIFORNIA FOUNDATION THE GORDON
AND BETTY MOORE FOUNDATION THE
CALIFORNIA ENDOWMENT AND THE
CALIFORNIA WELLNESS FOUNDATION.
TWENTY FOUR COMMISSIONERS WHO
WERE TOP LEADERS IN CALIFORNIA
HEALTHCARE HIGHER ED AND
BUSINESS PRINCE PARTICIPATED.
LAST MONTH THE COMMISSION
RELEASED ITS FINAL REPORT AND
RECOMMENDATIONS.
THE RECOMMENDATIONS AIM TO
ADDRESS A FEW KEY AREAS OF
HIGHEST NEED.
PRIMARY CARE AND PREVENTION
BEHAVIORAL HEALTH.
CARE FOR OUR AGING POPULATION.
DIVERSIFYING THE HEALTH
WORKFORCE.
AND REDUCING DISPARITIES IN
ACCESS.
BEFORE WE GO INTO THE SPECIFIC
RECOMMENDATIONS WHICH MY PANEL
HERE WILL DO.
I WANT TO ACKNOWLEDGE THE
COMMISSION'S CO CHAIRS.
UNIVERSITY OF PRESENT UNIVERSITY
OF CALIFORNIA PRESIDENT JANET
NAPOLITANO.
AND DIGNITY HEALTH CEO LLOYD D..
AS WELL AS ALL OF THE
COMMISSIONERS AND THE TECHNICAL
ADVISORY COMMITTEE MEMBERS WHO
INVESTED TIME PERSPECTIVE AND
EXPERTISE TO DEVELOP AND HOME
THESE RECOMMENDATIONS.
EVEN THOUGH ALL COMMISSIONERS
BROUGHT THEIR OWN UNIQUE
PERSPECTIVES TO THE TABLE.
THIS WAS VERY MUCH IN EVIDENCE
DRIVEN PROCESS.
THE COMMISSION'S ROOF
RECOMMENDATIONS REFLECT A SHARED
COMMITMENT TO IMPACT.
NOW WHAT I'D LIKE TO DO IS TO
INTRODUCE THE THREE
REPRESENTATIVES OF THE
COMMISSION THEMSELVES WHO WILL
GO INTO MORE DETAIL ABOUT THE
COMMISSION'S TOP RECOMMENDATIONS.
TO BUY RIGHT DOCTOR KATHY
FLORIDA'S IS DIRECTOR OF THE
UCSF FROZE MOST FRESNO LATINO
CENTER FOR MEDICAL EDUCATION AND
RESEARCH.
AND IS AN ASSOCIATE CLINICAL
PROFESSOR AT UCSF.
SHE WAS PART OF THE MANAGEMENT
TEAM FOR THE COMMISSION.
DANGER MONO IS THE CEO OF SHASTA
COMMUNITY HEALTH CENTER BASED IN
REDDING HE SERVED AS A
COMMISSIONER.
AND DR DAVID CARLISLE WHO IS THE
PRESIDENT AND CEO OF DREW
UNIVERSITY OF MEDICINE AND
SCIENCE IN LOS ANGELES.
DR CARLA CARLISLE ALSO SERVED AS
ELEVEN YEARS AS THE DIRECTOR OF
THE CALIFORNIA OFFICE OF
STATEWIDE HEALTH PLANNING AND
DEVELOPMENT AND DR CARLISLE
SERVED AS A COMMISSIONER.
IN ADDITION TO THESE PANELS WE
HAVE A NUMBER MEMBERS OF THE
COMMISSION TEAM ON HAND SHOULD
THERE BE ANY TECHNICAL QUESTIONS
SO WITH THAT I WILL GIVE IT OVER
TO DR FLORENCE.
THANK YOU DOCTOR NON THIS.
GOOD AFTERNOON I'D ALSO LIKE TO
MENTION THAT I AM A PRACTICING
FAMILY PHYSICIAN AND THE CENTRAL
VALLEY AND FRESNO SO I HAVE -- A
LOT OF EXPERIENCE WITH THE
PATIENTS IN OUR AREA AND THUS
THE NEED -- THAT I CAN SEE SO
THANKS FOR GIVING US THE
OPPORTUNITY -- TO SHARE WITH YOU
THE RECOMMENDATIONS IT'S BEEN
VERY ENCOURAGING TO BE A PART OF
THIS WORK AND TO SEE MANY
LEADERS ACROSS A VARIETY OF
SECTORS COME TOGETHER.
AND BE CLEAR THAT ADDRESSING THE
LOOMING HEALTH WORK FOR SHORTAGE
IS A PRIORITY.
AT THE UC SEVERAS NOTHING OF
CENTER FOR MEDICAL EDUCATION AND
RESEARCH WE HAVE LONG RECOGNIZED
THAT TO ADDRESS THE SERIOUS
SHORTAGES OF PHYSICIANS AND
OTHER HEALTH CARE PROFESSIONALS
IN THE SAN JOAQUIN VALLEY.
WE NEED TO DEVELOP AND SUPPORT
INDIVIDUALS.
WHO WILL RETURN TO THE VALLEY
AND PROVIDE CULTURALLY AND
LINGUISTICALLY COMPETENT HEALTH
CARE?
PARTICULARLY TO THOSE WHO --
CURRENTLY ARE NOT RECEIVING IT
WE PRIMARILY AT THE CENTER WORK
WITH DISADVANTAGED FIRST
GENERATION STUDENTS WHO HAVE NO
HIGHER EDUCATION LEGACY WE
STRIVE TO DEVELOP A COLLEGE
GOING CULTURE WITHIN THEMSELVES
AND THEIR FAMILIES.
BUT WE ALSO EDUCATE THEM ABOUT
THE NEEDS OF THEIR COMMUNITIES
AND HOW THEY NEED TO RETURN TO
THEIR COMMUNITIES TO MAKE A
DIFFERENCE.
IT MAY SEEM OBVIOUS BUT IT'S
WORTH BEING VERY CLEAR PROVIDING
COMPREHENSIVE LONGITUDINAL
ACADEMIC SUPPORT IN RICHMOND
HEALTH CAREER EXPOSURE AND
OPPORTUNITIES TO YOUNG PEOPLE SO
THAT THEY CAN BECOME THE NEXT
GENERATION AFTER DIVERSE HEALTH
CARE PROFESSIONALS.
IS A VITAL PIECE TO FILL IN
CALIFORNIA'S HEALTH WORKFORCE
GAPS.
OUR STUDENTS HAVE THE PASSION TO
PROVIDE THROUGH HEALTH CAREERS
THE DESIRE TO SERVE THEIR
COMMUNITIES AND THE CULTURAL AND
LINGUISTIC CAPABILITIES THAT WE
NEED.
WE HAVE PROVEN PROGRAMS
THROUGHOUT THE STATE THAT
SUPPORT THE SUCCESSES WHAT WE
NEED ARE INVESTMENTS FROM AN
ARRAY OF PARTNERS TO CONTINUE
THESE TYPE OF PROGRAMS.
AS DOCTOR NON THE STATED WE NEED
TO SUPPORT PROGRAMS THAT WERE
HELP THE STUDENTS AND THEIR
FAMILIES NAVIGATE THE
COMPLICATED EDUCATIONAL
TRAJECTORY REQUIRED FOR COLLEGE
ACCEPTANCE COLLEGE RETENTION.
AND HEALTH PROFESSIONALS SCHOOL
ENTRY WE THEN NEED TO HELP GUIDE
THEM BACK INTO THE COMMUNITIES
TO SERVE.
I'LL BE SHARING FOR THE
COMMISSION'S RECOMMENDATIONS
WITH THE FIRST THREE FOCUSED ON
STRENGTHENING PIPELINE PROGRAMS
THAT FEED HEALTH PROFESSIONALS
INTO COMMUNITIES WHERE WE NEED
THEM.
THERE IS A PARTICULAR EMPHASIS
ON INCREASING OPPORTUNITIES FOR
FIRST GENERATION LOW MIDDLE
INCOME AN UNDERREPRESENTED
STUDENTS TO COMPLETE THEIR
EDUCATION AND SUCCEED.
THE COMMISSION IS PROPOSING
NUMBER ONE FALTERING MODEL
HEALTH PIPELINE PROGRAMS THAT
PREPARE STUDENTS FROM
UNDERREPRESENTED IN LOW INCOME
BACKGROUNDS FOR HEALTH CAREERS
WITH MENTORSHIP ACADEMIC CAREER
AND CYCLE SOCIAL SUPPORT
EXCESSIVELY.
PURSUE HEALTH CAREERS
IMPLEMENTING THIS RECOMMENDATION
WOULD PREPARE APPROXIMATELY
SEVEN THOUSAND LOW INCOME AN
UNDERREPRESENTED MINORITY
STUDENTS INCREASING CALIFORNIA'S
HEALTH WORKFORCE BY OVER FIVE
THOUSAND OVER TEN YEARS AT A
COST OF ELEVEN THOUSAND PER
PERSON.
THE CALIFORNIA HEALTH
PROFESSIONS CONSORTIUM WHICH I
CO DIRECT INCLUDES MANY OF THESE
TYPES OF PROVEN PROGRAMS IN
PLACES LIKE THE CENTRAL VALLEY.
IN THE INLAND EMPIRE IN THE
COACHELLA VALLEY IN SAN DIEGO IN
THE THANK YOU WITH AN OAKLAND
THAT EFFECTIVELY SUPPORT YOUNG
PEOPLE TO PURSUE HEALTH CAREERS.
BUT THEY NEED FURTHER INVESTMENT
NOW TO BE SUSTAINED AND HAVE THE
LEVEL OF LARGE SCALE IMPACT
REQUIRED TO MEET SIGNIFICANT
WORKFORCE NEEDS. TO BE PROPOSED
TO DEVELOP THE HEALTH CAREER
OPPORTUNITY PROGRAMS ON AN
ACROSS TWENTY PUBLIC AND PRIVATE
COLLEGES. TO RECRUIT AND SUPPORT
COLLEGE STUDENTS INCLUDING
COMMUNITY COLLEGE STUDENTS FROM
UNDER REPRESENTS UNDER RESOURCE
REGIONS.
AND UNDER REPRESENTED IN
DISADVANTAGED BACKGROUNDS TO
PURSUE HEALTH CAREERS AND BECOME
COMPETITIVE CANDIDATES FOR
HEALTH PROFESSIONAL SCHOOLS I
NEEDED HEALTH JOBS.
IMPLEMENTING THIS RECOMMENDATION
WILL SUPPORT APPROXIMATELY FIFTY
ADDING AT LEAST TWENTY FIVE
THOUSAND NEW HEALTH CARE WORKERS
OVER THE TEN YEAR PERIOD THAT
WE'RE PROPOSING.
INCLUDING TWENTY TO TWENTY THREE
THOUSAND FROM UNDER REPRESENTED
MINORITY COMMUNITIES I WANT TO
NOTE THAT MANY OF THESE HEALTH
PROFESSIONALS IN CALIFORNIA ARE
PRODUCTS OF PREVIOUS STATE AND
FEDERAL AGE CUT PROGRAMS.
AT FRESNO STATE FOR INSTANCE ARE
H. COOPER FROM HAS HAD ABOUT
6270% SUCCESS RATE OF STUDENTS
ENTERING THE HEALTH FIELD WITH
MOST AT A MASTER'S OR DOCTORAL
LEVEL.
THIRD THE COMMISSION IS ALSO
PROPOSING TO INCREASE SUPPORT OF
SCHOLARSHIPS FOR QUALIFIED
STUDENTS -- PRIORITY HEALTH
PROFESSIONS AND COMMIT TO SERVE
AN UNDERSERVED COMMUNITIES.
UNDER A NEW HIGHLY VISIBLE
EMERGING CALIFORNIA HEALTH
LEADERSHIP SCHOLARSHIP PROGRAM
SPECIFICALLY FOR LOAN CAN FIRST
GENERATION UNDER UNDER
REPRESENTED STUDENTS.
IMPLEMENTING THIS RECOMMENDATION
WILL PROVIDE FULL TUITION
SCHOLARSHIPS FOR OVER THREE
THOUSAND LOW INCOME STUDENTS.
OVER TEN YEARS AND FOR A VARIETY
OF HEALTH PROFESSIONS INCLUDING
ALLOPATHIC AND OSTEOPATHIC
PHYSICIANS NURSE PRACTITIONERS
PHYSICIAN ASSISTANTS PUBLIC
HEALTH PROFESSIONALS AND SOCIAL
WORKERS.
AND RETURN THE STUDENTS WILL
COMMIT TO A THREE YEAR SERVICE
COMMITMENT IN AN UNDERSERVED
COMMUNITY WE SHOULD ALL KNOW
THAT FINANCIAL SUPPORT HAS
BECOME A MAJOR FACTOR IN HOW
STUDENTS CHOOSE THEIR PROFESSION
PARTICULAR IN THE HEALTH FIELD.
IT'S A VERY EXPENSIVE PROCESS
AND THE PAY BACK IT TAKES A LONG
TIME SO THESE KINDS OF RESOURCES
ARE.
FINALLY WHEN WE HAVE THE
STUDENTS READY TO ENTER
RESIDENCY PROGRAM LET'S MAKE
SURE THAT THERE ARE ENOUGH
OPENINGS IN OUR OWN STATE -- FOR
THEM TO CONTINUE THEIR TRAINING
AND THAT WE DON'T LOSE STUDENTS
TO OTHER STATES.
THE COMMISSION IS RECOMMENDING
THE EXPANSION OF PRIMARY CARE IN
PSYCHIATRY RESIDENCIES WITH
SUPPORT GOING TO UNIVERSITIES
HOSPITALS AND CLINICS THAT
CURRENTLY DO NOT HAVE OPERATING
RESIDENCY PROGRAMS.
FUNDS WOULD ALSO BE USED TO
PROVIDE ONGOING SUPPORT FOR
RESIDENCY TRAINING AND
FACILITIES THAT ARE NOT ELIGIBLE
TO OBTAIN MEDICARE FUNDING FOR
GRADUATE MEDICAL EDUCATION.
EMPLOYMENT IMPLEMENTING THIS
RECOMMENDATION IS EXPECTED TO
ADD ALMOST TWO THOUSAND PRIMARY
CARE PHYSICIANS IN TWO THOUSAND
FIVE HIGH INTEREST OVER TEN
YEARS.
IN CLOSING I WANT TO CONVEY THAT
I KNOW FROM PERSONAL EXPERIENCE
WHETHER DIFFERENT MAKES WHEN
THERE'S INVESTMENT IN PIPELINE
PROGRAMS AND STUDENTS FROM
UNDERSERVED AREAS.
THIS EVIDENCE IS VERY CLEAR THAT
INCREASING THE DIVERSITY OF
HEALTH PROFESSIONAL.
HEALTH PROFESSIONALS IN THE WORK
FORCE WILL IMPROVE ACCESS AND
REDUCED HEALTH CARE DISPARITIES.
THANK YOU FOR YOUR TIME I WANT
TO THANK YOU FOR YOUR SERVICE TO
OUR STATE I KNOW IT'S NOT EASY
TO SIT HERE AND LISTEN TO ALL OF
THESE THINGS -- AND I KNOW THAT
MONEY IS LIMITED BUT JUST KNOW
THAT YOUR SUPPORT WILL HELP THE
HEALTH AND WELFARE OF ALL OF OUR
COMMUNITIES THANK YOU.
THANK YOU THANK YOU TO CARLISLE.
WELL THANK YOU DOT HERNANDEZ
THANK YOU DOCTOR FLOORS.
AND THANK YOU ARE COMMITTEE
MEMBERS FOR YOUR TIME TODAY
AGAIN I'M DOCTOR DAVID CARLISLE
PRESIDENT OF CHARLES R. DREW.
UNIVERSITY OF MEDICINE AND
SCIENCE AND I APPRECIATE THE
OPPORTUNITY TO GIVE THIS --
TESTIMONY TO YOU TODAY.
BUT BEING PART OF THIS
COMMISSION AND THIS WORK IS VERY
IMPORTANT TO CHARLES R. DREW
UNIVERSITY OF MEDICINE SCIENCE.
BECAUSE THIS WILL REALLY BOLSTER
WHAT WE'RE DOING EVERY DAY WITH
OUR STUDENTS AND OUR EMPHASIS IN
EDUCATING THE NEXT GENERATION OF
HEALTH WORKERS.
BUT FOR THOSE OF FOR THOSE YOU
MAY NOT KNOW VERY MUCH ABOUT OUR
UNIVERSITY WE SPENT MORE THAN
FIVE DECADES.
COMMITTED TO CULTIVATING DIVERSE
HEALTH PROFESSIONAL LEADERS FOR
DEDICATED TO SOCIAL JUSTICE AND
HEALTH EQUITY FOR UNDERSERVED
POPULATIONS THROUGHOUT STANDING
CLINICAL SERVICE AND COMMUNITY
ENGAGEMENT.
BUT WE RECOGNIZE OF COURSE THAT
WE CANNOT DO IT ALONE.
I'M HERE TO SHARE THREE MORE
RECOMMENDATIONS FROM OUR
COMMISSIONS TOP TEN THAT MUST BE
PART OF NEXT STEPS.
RECOMMENDATION TWO POINT ONE WE
WANT TO SUSTAIN AND EXPAND THE
PRIME PROGRAM THAT TRAINS HIGHLY
MOTIVATED SOCIALLY CONSCIOUS
GRADUATES FROM MEDICAL SCHOOLS
WILL THEN BECOME LICENSED
PHYSICIANS PRACTICING IN
UNDERSERVED COMMUNITIES.
CURRENTLY THE STATE FUNDS.
SUPPORT ONLY ABOUT A HUNDRED AND
TWENTY SIX OF THE THREE HUNDRED
FIFTY FOR MEDICAL STUDENTS
ENROLLED IN THE UC PRIME
PROGRAMS.
PERMANENT STATE FUNDING FOR THIS
PROGRAM.
WILL INCREASE LONG TERM
CONTINUITY AND SUSTAINABILITY OF
THESE PROGRAMS.
IMPLEMENTING THIS RECOMMENDATION
TWO POINT ONE WELL AT SIX
HUNDRED AND THIRTY GRADUATES-FROM UC MEDICAL SCHOOL PRIME
PROGRAMS OVER TEN YEARS.
COMMENDATION THREE POINT.
TWO THE COMMISSION SEES THE NEED
TO ESTABLISH AND SCALE A
UNIVERSAL HOME CARE WORKER.
FAMILY OF JOBS WITH CAREER
LADDERS AND ASSOCIATE TRAINING.
PROJECTIONS SHOW THAT WILL NEED
TO SIX HUNDRED THOUSAND HOME
CARE WORKERS BY.
TWENTY THIRTY WITH OVER FOUR
MILLION CALIFORNIANS WILL BE
ADDED TO THE SIXTY FIVE AND
OLDER AGE GROUP BY THAT YEAR AN
INCREASE OF 87% FROM TWO
THOUSAND TWELVE AND REPRESENTING
90% OF THE TOTAL POPULATION.
THIS CAN'T START SOON ENOUGH.
WE KNOW THE MOST OLDER ADULTS
PREFERRED TO REMAIN AT HOME.
IMPLEMENTED THIS HOME CARE
WORKER RECOMMENDATION WILL
INCREASE SUPPLY CAPACITY AND
RETENTION FOR THESE WORKERS OVER
FOUR YEARS AT COULD POTENTIALLY
REDUCE SPENDING.
ON UNNECESSARY EMERGENCY ROOM
VISITS AND HOSPITALIZATIONS BY
MORE THAN TWO POINT SEVEN
BILLION DOLLARS OVER TEN YEARS
DUE TO ENHANCED TRAINING AND
CARE.
RECOMMENDATION THREE POINT FOUR
ALONG WITH THAT THE COMMISSION
IS RECOMMENDING SCALING THE
ENGAGEMENT OF COMMUNITY HEALTH
WORKERS PROMO TORAS AND PURE
PROVIDERS THROUGH CERTIFICATION
TRAINING AND REIMBURSEMENT.
THESE SOME THE MOST TRUSTED
INDIVIDUALS IN A COMMUNITY AND
CAN BE INSTRUMENTAL IN
PREVENTIVE HEALTH WORKING
GETTING PEOPLE THE RIGHT CARE
THAT THEY NEED.
IMPLEMENTED THIS RECOMMENDATION
WILL STAB A CERTIFICATION FOR
EDUCATION PROGRAMS WILL
STERILIZE TRAINING.
WILL ADDRESS REIMBURSEMENT OVER
TEN YEARS RESULTING IN AN
INCREASED SUPPLY OF WORKERS
FOCUSED ON PREVENTION AND
BEHAVIORAL HEALTH.
IN CLOSING MY PORTION I WANT TO
LEAVE YOU WITH THIS.
AT A RESTITUTION WE BELIEVE
THERE IS A DIRECT RELATIONSHIP
BETWEEN ONE'S EDUCATIONAL
BACKGROUND AND HIS OR HER OWN
HEALTH STATUS.
EVERY TIME WE SUPPORTERS
STUDENTS OR HEALTH CARE WORKERS
EDUCATION AND CAREER PATH IN THE
HEALTH FIELD.
WE ARE NOT ONLY ENSURING THAT WE
CARE FOR MORE PATIENTS BUT FOR
THAT STUDENT AND THAT WORKER AS
A PATIENT ALSO.
I BELIEVE THE WORK THE
COMMISSION REFLEXIS OUTLOOK.
TWO THANK YOU VERY MUCH FOR YOUR
TIME AND CONSIDERATION OF HOW
THE STATE CAN PARTNER IN THESE
ENDEAVORS.
IF YOU'RE GONNA THANK YOU.
HI AM DANGER MONO AM HERE TO
TAKE YOU HOME.
LAST OF THE TEN RECOMMENDATIONS.
AS A AS MENTIONED I'M THE CEO
SHASTA COMMUNITY HEALTH CENTER
AND WE OVERSEE CARE FOR FORTY
THOUSAND AND DUPLICATED PATIENTS
AND SHASTA COUNTY OVER 92% LIVE
BELOW FEDERAL POVERTY THAT'S
ROUGHLY 25% OF THE POPULATION OF
MY COUNTY.
AND COMING FROM SHASTA COUNTY
AND STRUGGLING WITH HEALTH
WORKFORCE SHORTAGES IN RURAL
REGIONS I WANT TO STRESS THAT
THE RECOMMENDATIONS YOU'RE
LEARNING ABOUT FROM THE
COMMISSION ARE NOT ONE SIZE FITS
ALL.
AND THIS IS VERY IMPORTANT TO
KEEP IN MIND.
WE LOOK AT MANY WAYS TO CLOSE
THE WORK FORCE GAP IN WE WERE
THOUGHTFUL IN TRYING TO MAXIMIZE
FLEXIBILITY AND RECOGNIZING THAT
SHORTAGES ARE HEADING IN MANY
PLACES.
YES BUT HOW WE RECRUIT AND
RETAIN AND SHASTA MAY NOT WORK
IN LOS ANGELES WHERE MY
pTRAINING STUDENTS TO WORK IN
PRACTICE.
I'M GOING TO SHARE THE FINAL
THREE RECOMMENDATIONS THAT ROUND
OUT THE TOP TEN PRIORITIES.
FIRST IS A PROGRAM WE CALL THE
HOMETOWN SCHOLARS PROGRAM.
IT'S AN EFFORT THAT FOCUSES ON
RECRUITING AND RETAINING
STUDENTS FROM RURAL AREAS AND
UNDER AND OTHER UNDER RESOURCE
COMMUNITIES. TO PRACTICE IN
COMMUNITY HEALTH CENTERS IN
THEIR HOME REGIONS.
THIS HOME TOWN SCHOLAR PROGRAM
IF HAS REALLY FOUR COMPONENTS TO
IT.
THE FIRST SUPPORT A SPORTING A
PROGRAM UNDER WHICH LEADERS OF
COMMUNITY HEALTH CENTERS AND I'M
TALKING ABOUT [inaudible]
PHYSICIANS DENTISTS RIGHT UP
THROUGH TWO BOARD MEMBERS
NOMINATE HIGHLY QUALIFIED
STUDENTS TO MEDICAL NURSING
NURSE PRACTITIONER PHYSICIAN
ASSISTANT PROGRAMS DENTAL
PROGRAMS AND SO ON TO ESTABLISH
NEW COMMUNITY MEDICINE TRACKS AT
CALIFORNIA'S MEDICAL SCHOOLS.
MODELED AFTER THE UC PRIME
PROGRAM THAT YOU HEARD ABOUT.
THREE PROVIDE SCHOLARSHIPS TO
STUDENTS WHO AGREE TO PRACTICES
PRIMARY CARE PHYSICIANS
PSYCHIATRISTS GERIATRICIANS IN
UNDERSERVED AREAS OF CALIFORNIA
FOR AT LEAST FOUR YEARS. FOR
ESTABLISH A SAFETY NET
PROFESSIONS WORKFORCE INSTITUTE.
WHICH WOULD CREATE MORE CLINICAL
PLACEMENTS AND RESIDENCIES FOR
HEALTH PROFESSIONS STUDENTS
PARTICIPATING A COMMUNITY HEALTH
CENTERS BY REDUCING THE
ADMINISTRATIVE BURDEN ASSOCIATED
WITH TRAINING THE HEALTH
PROFESSIONS.
IN SUCH LOCATIONS.
AND AND THEN IN TERMS OF
IMPLEMENTING THE RECOMMENDATIONS
THIS WILL INCREASE MEDICAL
SCHOOL GRADUATES BETWEEN TWO
HUNDRED EIGHTY AND FIVE HUNDRED
AND SIXTY OVER TEN YEARS.
THE COMMISSION IS ALSO CALLING
ON MAXIMIZING THE ROLE OF NURSE
PRACTITIONERS AS PART OF THE
HEALTHCARE TEAM THE FILL THE
GAPS IN PRIMARY CARE.
UP IN THE NORTHERN REGION WHERE
I'M FROM THERE'S NO REGION
CALIFORNIA THE DEPENDS MORE ON
OUR NURSE PRACTITIONERS IN A
PHYSICIAN'S ASSISTANTS.
THEY'RE VERY IMPORTANT MEMBERS
OF OUR CLINICAL TEAM AND WE NEED
ALL HANDS ON DECK FOR THIS TO
WORK.
AS YOU'VE HEARD THE GAPS IN
PRIMARY CARE OUR SKIN ARE
SIGNIFICANT NOW WHEN ONLY GROW
WIDER OVER THE NEXT TEN YEARS.
WE NEED TO BE CREATIVE IN HOW WE
OVERCOME THE CHALLENGE AND AS WE
TAKE ON THIS ALL HANDS ON DECK
APPROACH.
THIS APPROACH SEEKS TO MAXIMIZE
NURSE PRACTITIONER EDUCATION TO
ONE INCREASE THE SUPPLY OF
PRIMARY CARE PROVIDERS AND
UNDERSERVED COMMUNITIES TO
MAXIMIZE FULL USE OF NURSE
PRACTITIONER SKILLS WITHIN THE
CURRENT SCOPE OF PRACTICE
REGULATIONS AND THREE REFORM THE
SCOPE OF PRACTICE RECORD AT
REGULATIONS TO GIVE NURSE
PRACTITIONERS.
FULL PRACTICE OF FORTY AFTER A
TRANSITIONAL PERIOD OF
COLLABORATION WITH PHYSICIANS OR
EXPERIENCE NURSE PRACTITIONERS.
IN MY ORGANIZATION WE'VE
ACTUALLY ESTABLISHED A POST
GRADUATE TRAINING PROGRAM FOR
NEW NURSE PRACTITIONERS IN PA
THE TWO YEAR ADDITIONAL TRAINING
TO GET THEM TO A PLACE WHERE
THEY'RE THEY'RE COMFORTABLE IN
PRACTICING PRACTICING AT THIS
LEVEL.
IMPLEMENTING THIS RECOMMENDATION
WILL AT SEVEN THOUSAND NURSE
PRACTITIONERS OF HOME FIFTY FIVE
HUNDRED WOULD PRACTICE IN
PRIMARY CARE.
THIS RECOMMENDATION WILL ALSO
INCREASE RURAL DISTRIBUTION AND
ACCESS TO SERVICES REDUCING ER
VISITS HOSPITALIZATIONS AND AND
REDUCE THE COST OF PRIMARY CARE.
FINALLY WANT TO SEE THE
DEVELOPMENT OF A PSYCHIATRIC
NURSE PRACTITIONER PROGRAM THAT
RECRUITS FROM IN TRAINS TO
PROVIDERS TO SERVE AN
UNDERSERVED RURAL AND URBAN
COMMUNITIES.
DOCTOR HERNANDEZ SHARED THE
DEMAND FOR MENTAL HEALTH
SERVICES IS EXTREMELY
SIGNIFICANT VERY.
WE'RE VERY SHORT OF THOSE
PROVIDERS IN OUR COMMUNITIES.
UNDER THIS PROPOSAL THREE YOU
SEE SCHOOLS OF NURSING UCSF UCLA
AND UC DAVIS.
WOULD PREPARE TOTAL OF THREE
HUNDRED NEW NURSE PRACTITIONERS
WITH POSTMASTERS TRAINING TO
PRACTICE AS PSYCHIATRIC MENTAL
HEALTH NURSE PRACTITIONERS.
USING AN ONLINE AND CLASSROOM
BASED PROGRAM ALONG WITH
SUPERVISED CLINICAL TRAINING IN
SPECIFIED SETTINGS.
IMPLEMENTING THIS RECOMMENDATION
WILL HELP ADDRESS ACCESS GAPS IN
BEHAVIORAL HEALTH BY ADDING
THREE HUNDRED PSYCHIATRIC MENTAL
HEALTH NURSE PRACTITIONERS WHICH
WE TREAT OVER. THREE HUNDRED AND
FIFTY THOUSAND PATIENTS OVER
FIVE YEARS.
BOTTOM LINE AS YOU TAKE THESE IN
THESE RECOMMENDATIONS I THINK.
AND THINK ABOUT THE NEXT STEPS
WE KNOW THAT WHAT WE DON'T HAVE
ARE THE RIGHT TYPES OF HEALTH
PROVIDERS IN THE RIGHT PLACES
AND THIS SIGNIFICANTLY IMPACTS
OUR COMMUNITIES.
THEIR HEALTH AND QUALITY OF
HEALTH CARE IS COMPROMISED THE
EXPERIENCE LONG WAITS NEW
PATIENTS ARE ABLE TO GET IN TO
SEE THEIR DOCTORS WHEN THEY
SHOULD.
PATIENTS ARE NOT ABLE TO RECEIVE
POST HOSPITAL CARE WHEN THEY
NEED IT.
UP IN THE NORTH STATE WE
STRUGGLE WITH THIS ALL THE TIME.
AND I'M SURE IT IN.
ALL THE REGIONS OF CALIFORNIA
EXPERIENCING SOME LEVEL OF THIS
STRESS.
BUT WE KNOW WE CAN START TO
CHANGE THIS FOR ALL CALIFORNIANS
BY MAKING STRATEGIC INVESTMENTS.
AND COMMISSION IS TAKING THE
FIRST STEPS TO OF LOAN OUTLINE A
BOLD VISION FOR HOW WE GET THERE.
THANK YOU [inaudible]
SURE MCCARTY.
THANK YOU -- FOR FOR CO CHAIRING
THIS AND WELCOME -- DOCTOR
LANDIS AND I'D JUST HAVE ONE
CLOSING MARKET FIND THEY AND
THEN WE HAVE TO TAKE ANY
QUESTIONS AS YOU MIGHT IMAGINE.
THE COMMISSION ALSO ESTIMATED
THE COST OF IMPLEMENTING THE
RECOMMENDATIONS.
THIS WAS DONE IN PARTNERSHIP
WITH RESEARCHERS AT HEALTH FOR
CENTER AND HEALTH MANAGEMENT
ASSOCIATES. TO PROVIDE OBJECTIVE
AND REALISTIC ASSESSMENT OF
THEIR IMPACT ON OUR WORK FORCE
NEEDS.
HERE ARE SOME OF THE KEY NUMBERS
THAT CAME OUT OF THAT ANALYSIS.
THE TOP TEN RECOMMENDATIONS THAT
YOU JUST HEARD WOULD COST
APPROXIMATELY THREE BILLION
DOLLARS OVER TEN YEARS.
KEEP IN MIND THAT THIS IS LESS
THAN 1% OF WHAT CALIFORNIANS ARE
PROJECTED TO SPEND ON HEALTH
CARE THIS YEAR ALONE. FOR THAT
MODEST INVESTMENT CALIFORNIA
WOULD SOLVE ITS PRIMARY CARE
PROVIDED SHORT PROVIDER SHORTAGE.
NEARLY ELIMINATE THE SERIES
SHORTFALL OF PSYCHIATRISTS.
AND DRAMATICALLY EXPAND THE
PIPELINE OF YOUNG PEOPLE FROM
UNDERSERVED BACKGROUNDS HEADED
FOR CAREERS IN THE HEALTH
PROFESSIONS.
THESE TEN RECOMMENDATIONS WOULD
YIELD FORTY SEVEN THOUSAND NEW
HEALTH WORKERS THIRTY THOUSAND
OF THEM FROM UNDER REPRESENTED
COMMUNITIES.
BEFORE THE COMMISSION CAME
TOGETHER.
WE DID NOT HAVE THE INFORMATION
LET ALONE THE BROAD AGREEMENT
NECESSARY TO TAKE BOLD ACTION.
THE COMMISSION HAS SOLVED THAT
PROBLEM AND NOW WE PASS THE
BATON TO ALL OF YOU THANK YOU
VERY MUCH FOR YOUR TIME AND
ATTENTION THIS AFTERNOON.
THANK YOU FOR THE TESTIMONY AND
APOLOGIZE FOR BEING LATE BUT
YOU'RE AT THE RIGHT COMMITTEE
THIS IS THE BUDGET COMMITTEE SO
WHEN YOU TALK ABOUT THE
RECOMMENDATIONS AND AND THREE
BILLION DOLLARS.
WE'RE AT THE RIGHT SPOT SO THIS
IS OF COURSE IS A JOINT HEARING.
WITH THE ASSEMBLY.
SUBCOMMITTEE BUDGET SUBCOMMITTEE
ON HEALTH AND HUMAN SERVICES AND
THE ASSEMBLY BUDGET SUBCOMMITTEE
ON EDUCATIONTRY CHAIR WHICH OF
COURSE HAS THE UC BUDGET SO I
UNDERSTAND THAT.
A LOT OF PROGRAMS HAVE BEEN
FUNDED HISTORICALLY.
A UNIVERSITY CALIFORNIA SO --
THIS IS IT IN MY WILL HOUSE LIKE
IT IS DOCTOR WOODS BUT I TRULY
UNDERSTAND THAT WE HAVE -- AND
ACCESS.
TO CARE CRISIS IN OUR STATE FOR
FOR HEALTH CARE A LOT OF THAT IS
BECAUSE WE HAVE AN ATM
HEALTHCARE PROVIDERS SHORTAGE
AND CRISIS UP AND DOWN THE STATE
ESPECIALLY IN.
CERTAIN AREAS.
AND REPRESENT AREAS RURAL AREAS --
LOW INCOME AREAS -- SO THANK YOU
FOR THE PRESENTATION AND BEFORE
WE GET TO NEXT PANEL I WANT TO
LOW ARE.
COMMITTEE MEMBERS TO ASK ANY
QUESTIONS SIR -- PROVIDE ANY
COMMENTARY DOCTOR WHAT MORE
COMMENTARY I GUESS THAN ANYTHING
BECAUSE I THINK EXHAUSTED MY
QUESTIONS DURING THE PROCESS OF
WORKING WITH THE COMMISSION BUT
I JUST WANT TO SAY.
A COUPLE A COUPLE OF THINGS --
THE SOME OF THE KINDS OF
PROGRAMS THAT ARE BEING PROPOSED
TO THAT THIS THE THE THE STEPS
THAT ARE BEING PROPOSED -- COULD
HAVE HUGE -- POSITIVE
REVOCATIONS NOT ONLY FOR THE
COMMUNITIES BUT FOR THOSE
INDIVIDUALS WHO WHO COULD AVAIL
THEMSELVES OF THESE -- THESE CUT
TYPES OF PROGRAMS.
I CAME FROM A LOW END LOW TO
MODERATE INCOME FAMILY I AM THE
FIRST IN MY FAMILY GO TO GO TO
COLLEGE.
I DON'T KNOW WHAT IT IS IT DREW
ME TO A SMALL RURAL COMMUNITY TO
PRACTICE DENTISTRY BUT SOMETHING
HAPPENED AND IT DID -- AND FOR
ME -- IT WAS A LIFE CHANGING
EXPERIENCE THE ABILITY TO
PRACTICE IN A PLACE WHERE I WAS
REALLY NEEDED -- AND PROVIDE
CARE TO PEOPLE AT ALL LEVELS OF
INCOME ESPECIALLY THE POOR --
CHANGED THE WAY I LOOK AT HEALTH
CARE -- AND AND HAS INSPIRED ME
THROUGHOUT MY ENTIRE CAREER --
TO KEEP BECOME INVOLVED IN
PUBLIC POLICY AT THE AT THE
LOCAL LEVEL AND NOW HERE AT THE
STATE LEVEL -- THE THE COST FOR
THIS IS AS A DOCTOR HERNANDEZ
SAID.
ALMOST ALMOST LIKE BUDGET DUST
IN MANY WAYS WHEN YOU THINK
ABOUT IT -- OVER TEN YEARS I
DON'T AND WHEN I AM I HAVE A
GOOD YOU HAVE A QUESTION ABOUT
THE DOUBT BUT WE SIMPLY ARE NOT
GOING TO INCREASE OUR PROVIDER
WORKFORCE BY DOING THE THINGS
THE SAME WAY WE'VE BEEN DOING
THEM FOR YEARS.
AND I THINK THAT IT IS TIME IS
PAST TIME TO THINK OUTSIDE THE
BOX.
IT IS PAST TIME TO UTILIZE AND
AND WORK WITH PEOPLE TO THE FULL
EXTENT OF THEIR EDUCATION -- AND
I KNOW THAT THERE IS TREMENDOUS
RESISTANCE TO SOME OF THE
PROPOSALS AND I PERSONALLY AM
ENCOUNTERING SOME OF THEM AS I
WORK ON ONE A BILL -- TO THAT --
BUT I THINK IT'S CLEAR.
THAT THAT WE CANNOT CAN WE CAN
EDUCATE PRIMARY CARE PHYSICIANS
AT THE RATE WE NEED.
TO ESPECIALLY SINCE WE HAVE AN
AGING -- AND RETIRING WORKFORCE.
IN ONE OF MY COUNTIES.
AND I SAY THIS ALL THE TIME AND
SO PEOPLE MIGHT GET TIRED OF
HEARING IT THE AVERAGE AGE OF A
PHYSICIAN IS.
SIXTY THREE THAT IS NOT A SIGN
OF A HEALTHY WORKFORCE.
MIGHT BE HEALTHY PHYSICIANS BUT
NOT NECESSARILY WHAT A HEALTHY
WORKFORCE IN ANOTHER CAN BE
ANOTHER COUNTY IT WAS.
SIXTY THREE UNTIL JUST RECENTLY.
THAT'S TO THE FIVE RURAL
COUNTIES THAT I REPRESENT.
THIS IS NOT JUST AN ISSUE FOR
RURAL COMMUNITIES AS WELL IT IS
AN ISSUE FOR UNDERSERVED URBAN
COMMUNITIES AS WELL.
I MET WITH THE C. E. O. FOR
MARTIN LUTHER KING HOSPITAL
RECENTLY -- MARTIN LUTHER KING
HOSPITAL AND WHAT'S IS ONE THE
MOST TECHNOLOGICALLY ADVANCED
HOSPITALS IN THE STATE.
AND I ASKED HER WHAT IS YOUR
BIGGEST PROBLEM [inaudible]
DOCTORS.
THE LACK OF DOCTORS [inaudible]
I SAID.
THIS IS WHAT I'M DOING.
HOW DO YOU FEEL ABOUT THAT?
LOOKING TO BROUGH BRING -- NURSE
PRACTITIONERS -- TO A TO A FULL
PRACTICE OF FORTY I LIKE THAT
IDEA HOW CAN I HELP YOU.
AND URBAN AREA AND UNDERSERVED
AREA THIS IS NOT JUST A RURAL
ISSUE THIS IS A CALIFORNIA ISSUE.
AND SO IF I IF I FEEL LIKE I'M A
LITTLE ON THE SOAPBOX HERE I AM
AND I WILL CONTINUE TO BE ON
THAT SOAPBOX BECAUSE IT MEANS SO
MUCH -- I WOULD HAVE LOVED TO
HAVE BEEN IN A POSITION TO TAKE
ADVANTAGE OF SOME THESE THINGS
BUT FOR ME I IF SOMETHING
HAPPENED AND I ENDED UP IN THE
RIGHT COMMUNITY AND IT CHANGED
MY LIFE.
AND AND AND IT I I HOPE IT
CHANGED THE LIFE FOR A LOT OF
PEOPLE THAT I SERVED OVER MANY
MANY YEARS SO -- WHAT THE
QUESTION THAT I WOULD LIKE TO
ASK IS BECAUSE IT IS A BUDGET
COMMITTEE -- AS WITH THIS IS NOT --
THREE BILLION DOLLARS -- THE IT
THIS IS THREE BILLION THREE
BILLION DOLLARS OVER TEN YEARS.
HOW DO YOU ENVISION THAT SCALING
UP OVER OVER TIME BECAUSE
OBVIOUSLY WE WOULDN'T BE
SPENDING THREE HUNDRED MILLION
DOLLARS A YEAR FOR TEN YEARS
WERE NOT ANYWHERE NEAR?
IN A POSITION TO BE ABLE TO DO
THAT SO -- HOW CAN YOU?
AND MAYBE THAT MAYBE THAT IS
IMMEDIATE ISN'T EVEN A FAIR
QUESTION OBVIOUSLY IS HOW MANY
THINGS GET IMPLEMENTED ALONG THE
WAY AND AND SO ON BUT I JUST
LIKE TO HAVE YOUR THOUGHTS ON
THAT -- WILL SIMPLY ME WOULD
THINK YOU FOR YOUR COMMENTS AND
WE CERTAINLY AS THE COMMISSION --
COMMISSIONERS I THINK WOULD ALL
AGREE THAT -- WE NEED TO
ELIMINATE THE PRIMARY KERR
CHARGES THAT WE HAVE THROUGHOUT
THE STATE AND USE ALL THE TOOLS
THAT WE HAVE AT OUR OUR HANDS.
OF REALLY THE WAY THAT THIS
WOULD GET PHASED IN OR STAGED OR
SCALED DEPENDS IN PART ON HOW
THE LEGISLATURE CHOOSES TO
PRIORITIZE EVEN AMONG THE TEN
PRIORITIES -- THESE ARE ALL
PIPELINE PROGRAMS THAT MOVE ONE
UPON THE OTHER -- IT IS QUITE
CLEAR THAT WE'VE NOT EXPANDED
RESIDENCY SLOTS AND SO WE'D
TRAIN MANY MANY TALENTED
STUDENTS IN CALIFORNIA AND THEN
BECAUSE THEY DON'T HAVE ANY
PLACE TO TRAIN WE SEND THEM TO
PRIVATE SCHOOLS AND OTHER PLACES.
AND THE EVIDENCE IS REALLY QUITE
CLEAR THAT WHERE YOU TRAIN IS
TYPICALLY WHERE YOU SET UP SHOP
AND START YOUR PRACTICE AND SO --
THAT CAP IS IS DISPLACING
TALENTED PEOPLE WHO WE'VE FOR
TRAINED IN THE STATE AND AND
THAT'S OBVIOUSLY A VERY VERY
IMPORTANT NEED -- BUT THE
COMMISSION DID NOT SORT OF SAY
HERE'S WHERE YOU'D SPEND THE
FIRST.
YOU KNOW HUNDRED MILLION OR THE
LIKE AS YOU KNOW -- AND I'D ASK
OF ANYBODY ON THE STAFF WOULD
WANT TO TAKE THAT QUESTION BUT
ESSENTIALLY WE ENVISION THIS
BEING -- THESE TEN PRIORITIES
AND AND I SHOULD SAY BECAUSE THE
EDUCATION -- OF FINANCE
COMMITTEE HERE IS IS HERE AS
WELL.
THE THE COMMUNITY COLLEGES IN
THE C. ISSUES AND YOU SEE WHO
YOU'RE GOING TO HEAR FROM FROM A
MOMENT DID ACTUALLY SIT DOWN AS
THE COURSE OF THIS WORK AND TALK
THROUGH THEIR PROGRAMS AND THEIR
PIPELINES AND YOU'RE GONNA HEAR
FROM THAT PANEL MOMENTARILY.
THANK YOU AND I I JUST LIKE THAT
I GUESS I'VE JUST COME TO THE
CHAIR OF THAT'S OKAY WERE
COMMENT -- JUST -- OFFICIAL
THANK YOU -- THANK YOU TO
EVERYONE WHO'S WHO PARTICIPATED
BUT RECOGNIZING THAT THERE IS
THERE IS NO.
AS AS WE SAY IN SILVER BULLET --
THIS GOING TO TAKE ALL OF THESE --
AT ONE LEVEL OR ANOTHER TO GET
US WHERE WE NEED TO GO AND AND
IT'S GONNA TAKE TIME -- BUT WE
LIKE I SAID BEFORE I DON'T
CLEARLY WE CAN'T CONTINUE GOING
THE WAY WE'RE GOING -- WE OWE IT
TO THE CAL THIS IS THE
CALIFORNIA TO TO DO MUCH MUCH
BETTER SO THANK YOU SO MUCH.
JUST ADD ONE THING ONE POINT --
THAT IS THAT WHAT'S THE COST OF
NOT DOING THIS.
AND I THINK THAT -- THIS IS --
HE PUT THAT IN IN IN THOSE TERMS --
IT BECOMES A DOABLE.
YOU KNOW BUDGET.
JOB HERE I THINK WE CAN GET THAT
WITH YOUR HELP AND I'M ALSO
THINKING THAT THERE MAY BE OTHER
PARTNERS OUT THERE TO HELP WITH
THIS AGENDA AS WELL THAT WE
SHOULD THINK ABOUT IT AND AND
BUT I I THINK THREE HUNDRED
MILLION DOLLARS A YEAR IS A IS.
A HEAVY LIFT BUT IF ANY STATE
CAN DO IT.
OUR STATE IN THE CAN AND AND
REALLY SHOULD BECAUSE AGAIN
WHAT'S THE PRICE OF BEING OF NOT
GETTING THIS DONE SO.
AND I'D LIKE TO JUST ALSO ADD
THAT I A APPRECIATE THAT YOU ALL
SENT OUT THIS AT THE JOINT.
BUDGET COMMITTEE BECAUSE AS A
PHYSICIAN EVERY TIME I GO OUT
LOOKING FOR MONEY FROM AT LEAST
FROM FEDERAL SOURCES FOR THE
PROGRAMS THAT I RUN.
I'M ALWAYS GOING TO THE HELP
HERSELF HEALTH RESOURCES AND
SERVICES ADMINISTRATION WHEN I
HIT EDUCATION THEY USUALLY DON'T
SEE THIS AND THEY'RE VALLEY
WHERE.
THE TRUTH IS IT IS IN MASH --
IT'S EDUCATION AND HEALTH AND
THEY DO GO TOGETHER SO THANK YOU
FOR BEING WILLING TO WORK
TOGETHER ON THIS -- AND ANYTHING
THAT WE CAN DO TO CONTINUE TO
HELP GIVE YOU MORE INFORMATION
TO HELP MAKE THE RIGHT DECISIONS
PLEASE LET US KNOW.
THANK YOU AND I WANT TO SAY HOW
PLEASED I AM WITH THIS REPORT --
IT WAS IT'S CLEARLY VERY WELL
THOUGHT OUT -- LOTS OF RESEARCH
WENT INTO THIS I'M SO GLAD MY
COLLEAGUE WAS PART OF THAT --
YOUR RECOMMENDATIONS ARE.
THEIR SPOT ON AS TO WHAT WE NEED
TO DO.
IT'S CLEAR WE ALL HAVE AN IDEA
THAT THERE'S A SHORTAGE AND
YOU'VE COME UP WITH A SOLUTION
ON HOW TO TAKE CARE THAT
SHORTAGE.
A IN THE LONG IN THE SHORT TERM
AND THE LONG TERM I SINCERELY
APPRECIATE THAT.
I DO.
WONDER FOR GOING TO HAVE THE
MEDICAL SCHOOLS THAT WOULD BE
ABLE TO TAKE IN THE STUDENTS OR
THE NURSING SCHOOLS I IS MY
COLLEAGUE -- ASSEMBLY MEMBER
MEDINA MENTIONED WE HAVE THE NEW
MEDICAL SCHOOL YOU SEE OUR IN
DECEMBER TO DO YOU KNOW THERE IS
A A NONPROFIT TO MEDICAL SCHOOL
THAT JUST OPENED RECENTLY.
WITH DOCTOR TO HAVE.
BUT WE NEED FACILITIES TO TRAIN.
THE THE VERY STUDENTS THAT WE
WANT. TO TAKE CARE OF THIS.
RIGHT.
SOMETHING THAT WE'VE GOT TO
FIGURE OUT RIGHT.
ALL RIGHT.
THANK YOU ANY OTHER QUESTIONS OR
COMMENTS THEN WE WILL LEAVE IT
FOR WITH THE SECOND PANEL WOULD
PLEASE COME UP.
THE IN A BULLARD.
ALISON NGUYEN AND GEOFFREY REZEK
DOCTOR JEFFREY REASON
.
SO GOOD AFTERNOON AND THANK YOU
TO THE COMMITTEE -- FOR YOUR
TIME TODAY AND I'M THANK YOU
VERY MUCH TO THE PANEL FOR AN
EXCELLENT OVERVIEW.
OF THE COMMISSIONS -- TOP TEN
PRIORITY RECOMMENDATIONS MY NAME
IS DINA BULLARD I AM THE SENIOR
ADVISER -- OF ACADEMIC PROGRAMS
AND SYSTEM WIDE INITIATIVES WITH
THE UNIVERSITY OF CALIFORNIA
OFFICE OF THE PRESIDENT.
AS MANY OF YOU KNOW THE
UNIVERSITY OF CALIFORNIA
OPERATES THE NATION'S LARGEST --
INSTRUCTIONAL HEALTH SCIENCES
INSTRUCTIONAL PROGRAM.
IN THE NATION AND IS A MAJOR
HEALTH DELIVERY SYSTEM SO
FOCUSING ON RECRUITING AND
TRAINING CALIFORNIANS FOR
CAREERS IN HEALTHCARE IS VERY
MUCH A PART OF OUR TEACHING
RESEARCH AND PUBLIC SERVICE
MISSION.
THIS IS ONE OF THE PRIMARY
REASONS WHY PRESIDENT JANET
NAPOLITANO AGREE TO SERVICE CO
CHAIR OF THE CALIFORNIA FUTURE
HEALTH WORKFORCE COMMISSION.
REALLY TO UNDERSCORE THE HIGH
PRIORITY AND ON THE IMPORTANCE --
THAT SHE AND THE UNIVERSITY
PLACES ON THE ISSUES RELATED TO
WORKFORCE DEVELOPMENT AND
INNOVATION.
NEARLY FIFTEEN THOUSAND STUDENTS
IN TRAINEES ARE ENROLLED IN OUR
EIGHTEEN HEALTH PROFESSIONAL
SCHOOLS AND THE SCHOOLS ARE
LOCATED ALL OVER THE STATE AND
AREN'T IMPORTANT.
ONGOING SOURCE OF FUTURE
GRADUATES FROM MEDICAL PRACTICES
HOSPITALS DENTAL AND BEHAVIORAL
HEALTH PRACTICES AND CARE
PROVIDED IN COMMUNITY SETTINGS.
AND HEALTHCARE HAS A HUGE IMPACT
ON THE QUALITY OF LIFE FOR ALL
PEOPLE AND YOU SEE IS IN THE
BUSINESS OF SOLVING THE BIG
CHALLENGES OUR SOCIETY FACES.
AND THIS IS ONE OF THE BIGGEST
CHALLENGES THAT CALIFORNIA FACES
RIGHT NOW AND SO WE ARE VERY
PLEASED TO BE PART OF THE
DELIBERATIONS -- OF THE
COMMISSION AND ARE AND ARE VERY
PLEASED WITH THE COMMISSION'S
COLLECTION AND COMPREHENSIVE
RECOMMENDATIONS THAT THEY ARE --
PUTTING FORWARD.
AN ALMOND THE COMMISSION'S
RECOMMENDATIONS THAT ARE --
CRITICAL IMPORTANT -- TO YOU SEE
AND OUR ABILITY TO MEET THE
WORKFORCE DEMANDS OF THE FUTURE
THE FIRST OF WHICH IS SECURING --
PERMIT ONGOING STATE FUNDING FOR
SUSTAINING ARE YOU SEE PROGRAMS
IN MEDICAL EDUCATION WHICH YOU
ALL HAVE.
HEARD ABOUT TODAY AND WE HAVE
THE REGENTS APPROVED BUDGET ITEM
OF EIGHT POINT EIGHT MILLION
DOLLARS -- BEFORE THE
LEGISLATURE THIS YEAR -- I HAVE
HAND OUTS HERE FOR THE COMMITTEE
MEMBERS IF.
SOMEONE WANTS.
TO SHARE THOSE -- JUST -- AS AN
INFORMATIONAL ITEM -- THERE ALSO --
OTHER RECOMMENDATIONS IN THE
REPORT THAT ARE VERY IMPORTANT
TO YOU SEE SPECIFICALLY THAT
WERE NOT MENTIONED IN THE TOP --
TEN AND THOSE INCLUDE EXPANDING
MEDICAL SCHOOL ENROLMENT THROUGH --
ARE UC RIVERSIDE SCHOOL OF
MEDICINE -- LAUNCHING A BRANCH
CAMPUS OF THE UCSF SCHOOL OF
MEDICINE AND FRESNO AND
EXPANDING XCELERATED THREE YEAR
MD PROGRAMS -- FOR THOSE WHO
PRACTICE IN PRIMARY CARE AND
RURAL AND UNDERSERVED AREAS --
IN ADDITION -- WE ARE -- AS YOU
KNOW SUPPORTIVE OF OF OUR POST
BACCALAUREATE PROGRAMS AND OTHER
PIPELINE PROGRAMS THAT HELP
RECRUIT AND PREPARE STUDENTS --
FIRM UNDERREPRESENTED
BACKGROUNDS FOR HEALTH CAREERS.
THESE ARE ALL INITIATIVES THAT
WE HOPE TO CONTINUE TO SPEAK
WITH YOU ABOUT IN THE FUTURE AS
WELL AS OUR BOARD OF REGENTS --
AND YEAH HAPPY TO TAKE ANY
QUESTIONS AFTER THE OTHER
SPEAKERS BOB.
GOOD AFTERNOON AND THANK YOU FOR
YOUR TIME TODAY I'M DOCTOR
ALLISON READ ASSISTANT VICE
CHANCELLOR FOR ACADEMIC PROGRAMS
FROM THE CSU OFFICE OF THE
CHANCELLOR.
AS YOU KNOW THE CSU IS AN ENGINE
OF SOCIAL MOBILITY EDUCATING
MANY STUDENTS FOR THE FIRST IN
THEIR FAMILY TO ATTEND COLLEGE.
WE DELIVER MORE JOB READY
GRADUATES INTO THE WORK FORCE
THAN ANY OTHER PUBLIC OR PRIVATE
UNIVERSITY IN THE STATE.
THIS INCLUDES THE FACT THAT 60%
OF NURSING DEGREES EARNED IN
CALIFORNIA ARE CSU DEGREES.
CALIFORNIA'S HEALTH WORKFORCE
WILL EXPAND AS THE STATE'S
POPULATION GROWS BY 15% IN THE
NEXT TWENTY YEARS WITH NEARLY
FOUR HUNDRED HEALTHCARE
PROFESSION RELATED DEGREE
PROGRAMS AND CONCENTRATIONS.
AND A DIVERSE STUDENT BODY THE
CSU IS A MAJOR CONTRIBUTOR TO
THE HEALTH WORKFORCE RESPONDING
DYNAMICALLY TO THE EVOLVING
HEALTH CARE INDUSTRY DEMAND FOR
UNIVERSITY EDUCATED
PROFESSIONALS.
IN THE COMING DECADE CAREERS IN
HEALTH CARE AND SOCIAL
ASSISTANCE WILL GROW FASTER THAN
ALL INDUSTRIES EXPANDING BY 33%.
CSU GRADUATES REPRESENT A
SUBSTANTIAL PORTION OF NEWLY
TRAINED WORKFORCE READY HEALTH
CARE PROFESSIONALS ADDITIONALLY.
MANY CSU STUDENTS ARE EARNING
HIGHLY VALUED BACCALAUREATE
DEGREES THE PREPARE THEM FOR
GRADUATE PROGRAMS AND HEALTHCARE
PROFESSIONS SUCH AS PHYSICAL
THERAPY.
AUDIOLOGY AND SOCIAL WORK.
THE CSU WAS FULLY ENGAGED WITH
THE WORK OF THE CALIFORNIA
FUTURE HEALTH WORKFORCE
COMMISSION.
CHANCELLOR TIMOTHY WHITE SERVED
AS A COMMISSIONER AND FULLY
ENDORSE THE RECOMMENDATIONS AND
PRIORITIES FROM THE REPORT.
ADDITIONALLY DOCTOR JOSEPH
CASTRO PRESIDENT OF FRESNO'S
CALIFORNIA STATE UNIVERSITY
FRESNO WAS A COMMISSIONER.
WHAT THEN IS THE ROLE OF THE CSU
AND IMPLEMENTING THE TEN
PRIORITY RECOMMENDATIONS?
THE REPORT CALLS FOR THE STATE
TO QUOTE OVER CALM THE GROWING
MISMATCH BETWEEN ITS EXISTING
WORK FORCE AND THE STATE'S
INCREASINGLY DIVERSE POPULATION.
PEOPLE OF COLOR REMAIN SEVERELY
UNDER REPRESENTED IN THE HEALTH
WORKFORCE.
THE DIVERSITY OF THE CSU WILL BE
KEY TO IMPLEMENTING THE
COMMISSION'S RECOMMENDATIONS.
THE CALIFORNIA STATE UNIVERSITY
IS ONE OF THE MOST ETHNICALLY
AND RACIALLY SEE RACIALLY
DIVERSE CAL UNIVERSITY SYSTEMS
IN THE UNITED STATES.
AND MORE THAN ONE THIRD OF THE
CS USER DURING FRESHMAN ARE
AMONG THE FIRST GENERATION OF
THEIR FAMILIES TO ATTEND COLLEGE.
THE CSU GRADUATE STUDENTS ACROSS
A WIDE VARIETY OF HEALTH
PROFESSIONS PROGRAMS WE HAVE
STUDENTS WHO ARE FOCUSED ON
BEHAVIORAL BEHAVIORAL HEALTH
PROGRAM SUCH AS PSYCHOLOGY.
OUR LARGEST UNDERGRADUATE MAJOR
AND GRADUATE PROGRAMS AND
COUNSELLING AND SOCIAL WORK.
WE HAVE STUDENTS PREPARING TO BE
HEALTH CARE PROVIDERS AS NURSES
NURSE PRACTITIONERS AND WE HAVE
A NEWLY ESTABLISHED PHYSICIAN
ASSISTANT PROGRAM.
AT CSU MONTEREY BAY.
WE ARE ALSO WORKING CLOSELY WITH
OUR COMMUNITY COLLEGE PARTNERS
TO PROVIDE A PATHWAY TO THESE
FOR YOUR DEGREE PROGRAMS THAT
SUPPORT THEIR STUDENTS INTERESTS.
FOR EXAMPLE OUR MOST POPULAR SO
SHE DEGREE FOR TRANSFER PATHWAY
IS IN PSYCHOLOGY.
AND RECENTLY WE ESTABLISHED A
PILOT ADN TO BSN.
PROGRAM WITH RIVERSIDE COMMUNITY
COLLEGE TO ALLOW FOR CONCURRENT
ENROLLMENT FOR TWO HOPE COHORTS
OF THEIR NURSING STUDENTS PER
YEAR.
WAS CSU FULLERTON AND TO THIS
USE INVERTED DINO.
WE ARE ALREADY MOVING FORWARD ON
SOME OF THE TOP TEN PRIORITIES
ADDRESSED IN THE REPORT. FOR
EXAMPLE PRIORITY ONE POINT TO
RECRUIT AND SUPPORT COLLEGE
STUDENTS FROM UNDERREPRESENTED
REGIONS AND BACKGROUNDS TO
PURSUE HEALTH CAREERS DISCUSSES
THE NEED TO EXPAND THE CAMPUS
BASED HEALTH CAREER OPPORTUNITY
PROGRAMS.
IN THE CSU WE HAVE PROGRAMS ON
NEARLY EVERY CAMPUS THAT ASSIST
STUDENTS WHO ARE INTERESTED IN
MEDICAL AND HEALTH RELATED
CAREERS.
AS DOCTOR FLORES MENTIONED
EARLIER FRESNO STATE HAS AN
EXTENT HEALTH CAREER OPPORTUNITY
PROGRAM THAT WORKS IN TANDEM
WITH THE UNIVERSITY OF
CALIFORNIA.
AS RESOURCES AND PARTNERSHIPS
BECOME AVAILABLE THE CSU WILL
WILL LOOK FOR OPPORTUNITIES TO
EXPAND OR ENHANCES PROGRAMS FOR
STUDENTS.
PRIORITY THREE POINT ONE
MAXIMIZE THE ROLE OF NET NURSE
PRACTITIONERS AS PART OF THE
CARE TEAM IS A PLACE WHERE THE
CSU CAN CONTINUE TO LEAD.
THESE WELL QUALIFIED HEALTH CARE
PROFESSIONALS ARE ALREADY
PRACTICING AT THE TOP OF THE
CURRENT LEGAL SCOPE OF PRACTICE
AND WE NEED TO PRODUCE MORE
NURSE PRACTITIONERS AND ENSURE.
THAT THEY ARE FULL PARTNERS ON
THE HEALTH CARE TEAM.
ADDITIONALLY THERE ARE
RECOMMENDATIONS OUTSIDE OF THE
TOP TEN THAT RESONATE FOR THE
CSU.
THESE INCLUDE RECOMMENDATION ONE
POINT EIGHT ASSESS STREET AND
IMPROVE COLLEGE STUDENT MENTAL
HEALTH AND PROMOTE BEHAVIORAL
HEALTH CAREERS WE'RE WORKING
CLOSELY WITH OUR CAMPUSES ON
ISSUES RELATED TO MENTALHEALTH.
STUDENT HEALTH AND WELL BEING IS
ONE OF THE SIX PILLARS OF
GRADUATION INITIATIVE.
TWENTY TWENTY FIVE AND WE
CONTINUE TO ADDRESS THE WELL
BEING OF ALL CO TWO STUDENTS OR
FOSTERING A STRONG SENSE OF
BELONGING THIS ON CAMPUS.
AND RECOMMENDATION TWO POINT
EIGHT BRING TOGETHER SCHOOLS AND
PROGRAMS OF PUBLIC HEALTH AND
LOCALHEALTH DEPARTMENTS TO
TRAIN THE NEXT GENERATION OF
PUBLIC HEALTH PROFESSIONALS AND
ADVANCE HEALTH EQUITY.
OF THE TWENTY THREE CSU CAMPUSES
SEVENTEEN OFFER UNDERGRADUATE
GRADUATE MAJORS AND PUBLIC
HEALTH HEALTH SCIENCES OR
RELATED DISCIPLINES.
AND TEN OFFERED MASTERS OF
PUBLIC HEALTH DEGREE PROGRAMS.
CSU FACULTY WOULD LIKE TO EXPAND
THE CONNECTIONS BETWEEN THE
PUBLIC HEALTH DEGREE PROGRAMS
AND THE LOCAL PUBLIC HEALTH
DEPARTMENTS.
LET ME CONCLUDE BY SAYING THERE
WILL BE SOME CHALLENGES WITH THE
WORK AHEAD.
WHAT WE CAN DO SOME OF THE WORK
WITHOUT ADDITIONAL FUNDING BY
BUILDING ON CURRENT STREETS AND
PROGRAMS AS MY COLLEAGUES HAVE
ALREADY ADDRESSED?
THERE WILL NEED TO BE
SUBSTANTIAL FUNDING IN THE
FUTURE TO GROW IN THE WAYS
DESCRIBED IN THE REPORT.
THE CSU STANDS READY TO SUPPORT
THE WORK TO BE DONE AS OUTLINED
IN THE COMMISSION REPORT WE LOOK
FORWARD TO WORKING WITH OUR
PARTNERS IN THE UNIVERSITY OF
CALIFORNIA AND THE CALIFORNIA
COMMUNITY COLLEGES. TO ENSURE
THAT CALIFORNIA HAS AN
EXCEPTIONALLY WELL TRAINED
HEALTH CARE WORKFORCE.
THAT REFLECTS THE DIVERSITY OF
ALL CALIFORNIANS THANK YOU AGAIN
FOR YOUR TIME AND YOUR ONGOING
SUPPORT OF THE CSU [inaudible]
THANK YOU.
A GOOD AFTERNOON THANK YOU FOR
THE OPPORTUNITY TO PRESENT HERE
TODAY AT THE BUDGET THAT THE
JOINT HEARING -- I'M HERE ON
BEHALF THE CALIFORNIA CAN CAUSE
CANCERS OFFICE AND I'D LIKE TO
TAKE A MOMENT AND GIVE YOU A
COUPLE -- KEY FOCUSES OF THE KEY
FOB SYSTEM AS A WHOLE THAT
PERFECTLY ALIGNED TO THE
COMMISSION TODAY.
AND OVERALL THAT'S KIND OF OUR
NORTH STAR WHICH IS THE VISION
OF SUCCESS WHICH IS REALLY
CALIFORNIA WE WE LOOK AT CUT ME
BECAUSE OF CALIFORNIA'S BROADER
SYSTEM OF HIGHER EDUCATION.
AND WE REALLY STAND TO FILL THE
WORKFORCE DEVELOPMENT NEEDS
BROADLY AS WE ARE ONE THE
LARGEST SYSTEMS OF HIGHER AT
POSSIBLY IN THE WORLD WE HAVE
OVER A HUNDRED FIFTEEN CAN YOU
COLLEGES SEVENTY TWO DISTRICTS.
AND WELL OVER TWO POINT ONE
MILLION STUDENTS.
AND SO OUR VISION FOR SUCCESS
PUTS OUT SOME SPECIFIC GOALS
THAT ARE -- SYSTEM IS LOOKING AT
IN TERMS OF INCREASING THE
NUMBER OF STUDENTS WHO --
ACQUIRE ASSOCIATES DEGREES
CREDENTIALS CERTIFICATES OR
SKILL SETS FOR IN DEMAND JOBS
MUCH LIKE THESE HEALTHCARE
CAREERS -- TO INCREASE 35% OF
THE NUMBER OF OUR STUDENTS OF
THE COMMUNITY COLLEGES
TRANSFERRING TO UC AND CSU TO
MEET THE NEEDS.
OF ITS HEALTHCARE CAREERS AND
ALSO TO DEGREE -- DECREASE --
THE AVERAGE NUMBER OF UNITS OF
STUDENTS ARE MOVING THROUGH THE
PIPELINE MOREQUICKLY AND
EFFICIENTLY TOWARDS THEIR
OUTCOMES.
I WOULD LIKE TO INCREASE THAT
NUMBER OF EXITING CAREER
TECHNICAL EDUCATION STUDENTS WHO
ARE ACTUALLY EMPLOYED THERE FEEL
TO NOT JUST ARE WE LOOKING TO
GET THEM THROUGH BUT REALLY HAVE
THEM FOCUSED ON THESE HEALTH
CAREERS TO MAKE SURE THAT THE
SELECT THAT CLEAR AND COMPLETE.
IN THAT INDUSTRY AS WELL AS
USING OUR SCALE SIZE AND IVERS
HIT ME PICK EQUITY GAPS IN THE
WORK FORCE AND REDUCE -- CIMA
GAS BY 40% WITH THE NEXT FIVE
YEARS.
AND THAT'S ALSO DON'T THAT
LOOKING AT REGIONAL LEVEL --
ACHIEVEMENT GAPS AS WELL MAKE
SURE THAT WE ARE BEING
REPRESENTED THE DIVERSE
DIVERSITY OF THE STATE.
THE OTHER MORE IMPORTANT.
ASPECT THAT HELPS WITH THIS
OUTCOME IS THE GUIDED PATHWAYS
MODEL -- WE'RE LOOKING AT HELP
MAKING STUDENTS ARE TAKING CLEAR
COURSE TAKING PATTERNS THAT LEAD
TO A BETTER IN ROME DECISIONS
AND STUDENT SUCCESS AND
INTEGRATING STUDENT SUPPORT
SERVICES THAT MAKE IT EASIER FOR
STUDENTS TO FIND.
AND GET THE SUPPORT THEY NEED TO
COMPLETE DURING THE COMMUNICABLE
EDGE SO THERE ARE FOUR PILLARS
TO THE GUIDED PATHWAYS ONE IS TO
CREATE A CURRICULAR PATHWAYS. TO
EMPLOYMENT FOR THE EDUCATION
WHICH DIRECTLY ALIGNS TO THE
WORK OF THIS COMMISSION -- TO
HELP STUDENTS CHOOSE ANOTHER
PATHWAY AND HEALTH -- TO HELP
STUDENTS STAY ON THE PATH OF
COURSE TO HAVE A HEALTH OUTCOME
AND ENSURE THAT LEARNING IS
HAPPENING INTENSELY OUTCOMES
MEET THE NEEDS OF THE TRANSFERS --
AND THEN SPECIFICALLY WE USE A
STRIKE SECTOR AND STRATEGIES IN
THE STATE WE HAVE A HEALTH
SECTOR STRATEGY FOR OUR STATE
WHICH IS INCREASED --
OPPORTUNITIES TO ADVANCE
HEALTHCARE CAREERS PROFESSIONS A
LINE IN EDUCATE EDUCATION
TRAINING PATHWAYS TO STOCK UP
ALL CREDENTIALS AND DEGREES
WHICH WE COORDINATE WITH BOTH UC
AND CSU TO DO.
AND ALSO STRENGTHEN THE CAPACITY
RETENTION AFFECTED AS OF
HEALTHCARE WORKERS -- AND
LIFELONG LEARNING OPPORTUNITIES --
NOT JUST YOUR TRADITIONAL
STUDENT.
SO IT'S IMPORTANT TO NOTE IN THE
RECENT LA -- REPORT IN TWO
THOUSAND NINETEEN THIS NEW ONE
CALIFORNIA'S EDUCATION SYSTEM IT
STATES THAT CALIFORNIA COLLEGE
ENROLLS NEARLY TWO THIRDS OF ALL
UNDERGRADUATES.
SO THERE'S YOUR SUPPLY THAT
YOU'RE LOOKING FOR IN TERMS OF
THE FUTURE WORKFORCE WE HAVE TO
MAKE SURE THAT WE'RE BEING
INTENTIONAL AS THEY MATURE THEIR
SKILL SETS AND ENTER -- DEGREES
AND PROGRAMS AND OCCUPATIONS
THAT REQUIRE HIGHER SKILL SETS
AND PROPS AND SO SHE ITS DEGREE --
SO HERE'S A COUPLE THINGS THAT
ARE DIRECTLY ALIGNED TO THE
CALIFORNIA FUTURE HEALTH CARE
WORKFORCE COMMISSION STRATEGIES
WHICH WERE. TO INCREASE
OPPORTUNITIES FOR ALL
CALIFORNIANS TO PASS THE HEALTH
CARE TO A LINE EXPAND EDUCATION
TRAINING AND TO STRENGTHEN THE
CAPACITY RETENTION AND
EFFECTIVENESS.
OF HEALTH WORKERS SO FOR
RECOMMENDATION ONE POINT ONE
OBVIOUSLY OUR SCALE THE SEVENTY
THREE DISTRICTS AND HUNDRED
FIFTEEN COLLEGES.
OVER TWO POINT ONE MILLION
STUDENTS REGISTERED AND
SEVENTEEN EIGHTEEN THEY
REPRESENT -- DEMOGRAPHIC OF 43%
HISPANIC 11% ASIAN AND 6% BLACK
OR AFRICAN AMERICAN WHICH
DEFINITELY CAN HELP IN TERMS OF
THE EQUITY GAPS.
IT'S VERY IMPORTANT ALSO FOR THE
SOCIAL DETERMINANTS OF HEALTH WE
KNOW THAT IF YOU ARE BEING
SERVED IN HEALTH CARE BY SOMEONE
WHO REPRESENTS YOU IN YOUR
COMMUNITY.
ACTUALLY HAS A BENEFIT TO YOUR
HEALTH OUTCOMES -- SOME OF THE
CHALLENGES THAT WE'RE FACING A
ONE POINT ONE IS HIGH SCHOOLS --
SCHOOL PROGRAMS ARE ALWAYS
PROVIDE CERTIFICATION FOR THE
PROGRAMS THAT THEY'RE DOING SO
IT'S NOT REQUIRED THAT THE
CERTIFICATE WHICH ALLOWS THEM TO
HAVE A STACKABLE INTO THE
COMMUNITY COLLEGE.
AND ALSO CITY PROGRAMS ARE NOT
ALWAYS ARTICULATED INTO THE HIGH
SCHOOL PROGRAM SO THEY MAY BE
HIGH SCHOOL PROGRAM TERMINATES
BUT YET DOES NOT ENTER THAT
LOCAL COMMUNITY COLLEGE SO THOSE
ARE AREAS WHERE WE CAN IMPROVE.
SOME NEEDS RESOURCES FOR
PIPELINE PROGRAMS TO FIND EARN
AND LEARN MODELS FOR
UNDERREPRESENTED LOW INCOME
STUDENTS TO EARN STACKABLE
DEGREES.
AS OUR LEARNING AND GAINING
ADDITIONAL SKILLS IN THE HEALTH
CARE ARE THEY ABLE -- TO EARN
AND LEARN AS THEY GO ALSO SEE T.
FACULTY AND TEACHERS ACT WILL
PAVE THE INDUSTRY IS ONE OF THE
PAIN POINTS -- IT'S MUCH MORE --
YOUR PAY IS HIGHER IN THE
INDUSTRY AND IS TO TEACH AND SO
IT MAKES IT DIFFICULT TO
SOMETIMES RECRUIT THE QUALITY
FACULTY THAT WE WOULD NEED TO
DELIVER CREE QUALITY PROGRAMMING --
FUNDING FOR APPRENTICESHIPS IS
ALSO AN AREA WHERE WE SEE A
GREAT OPPORTUNITY -- TO HELP OUT
AND THIS HEALTHCARE SHORTAGE --
ANOTHER RECOMMENDATION FOR ONE
POINT -- TWO WHICH IS TO RECRUIT
AND SUPPORT COLLEGE STUDENTS --
FUNDING ALLOCATED PROGRAM TO
SERVE STUDENTS FOR DIVERSE AND
LOW ECONOMIC -- HELP BILL THOSE
PIPELINE THAT'S THE ADVANTAGE
THAT WE OFFER I THINK ACROSS THE
BOARD -- AGAIN APPRENTICESHIP
PROGRAMS COULD BE -- MET HERE --
CURRENTLY THERE IS A AB TWENTY
ONE OH FIVE THAT'S BEING HEARD
IN ITS EXPLORING AND SUPPORTING
DEVELOPMENT OF APPRENTICESHIP
AND HEALTH CARE.
AND WITH KENYA COLLEGES THEY'RE
LOOKING FOR A TO FIND -- SOME
EARLY -- PILOTS OF
APPRENTICESHIPS IN THROUGH THAT
WORK AND ARE TRYING TO IDENTIFY
WITH THE BARRIERS ARE THAT KEEP
A PENSIONS FROM FORMING.
A RECOMMENDATION -- ONE ONE
POINT.
THREE HOW CAN YOU COLLEGES CAN
SUPPORT WITH ENTRY LEVEL PATHWAY
PROGRAMS CURRENTLY IN
DEVELOPMENT WE HAVE MENTAL AND
BEHAVIORAL HEALTH PIPELINE
PROJECTS WORKING WITH FACULTY
FROM HIGH SCHOOL COMMITTEE
COLLEGES AND CSU ARE A
CALIFORNIA.
STATE UNIVERSITY -- AN INDUSTRY
DRIVEN NEED FOR MORE INCUMBENT
WORKERS IN THE WORK FORCE THAT
IS IN THIS FIELD OF STUDY SO
AGAIN THAT'S WERE WORKING
AGAINST.
THE PROJECT AIMS TO DEVELOP
PACKAGE COURSE ISN'T STACKABLE
CERTIFICATES LEAVES AGREE
EMPLOYMENT.
AND WHILE MEETING THE NEEDS
INDUSTRY WHY IS STOCK OF
IMPORTANT -- SOMEONE THEY
HAVEN'T AND SITUATION THEIR LIFE
FOR THEY MAY HAVE TO EITHER.
IF YOU HAVE A STOCK OF WILL
CREDENTIAL FORMAT YOU CAN GO
INTO THE WORK FORCE AND IF YOUR
ECONOMIC SITUATION YOUR FAMILY
COMMUNITY CHANGES THEN YOU CAN
GO BACK TO SCHOOL AND NOT HAVE
TO START OVER -- OR YOU CAN
CONTINUE AS YOU'RE ALSO EMPLOYED
INCOME A WORKER SO THAT'S WHY WE
THINK STACKABLE -- CURRICULUM IS
IS IMPORTANT AT OUR LEVEL.
AN EXAMPLE FOR RECOMMENDATION
TWO POINT ONE IS THAT CAN YOU
CALL JUST CAN REPAIR PREPARATORY
COURSES AND PROGRAMS SUCH AS THE
HEALTH OCCUPATIONS PIPELINE.
EDUCATION OF THE WHOLE PROGRAM --
WHICH BUILDS THE FUTURE BY
INSPIRED GENERATIONS FOR HEALTH
CARE SO HOW DO WE GET STUDENTS
EVEN INTERESTED IN HEALTH CARE
TO THE BILL SELECT AND GO DOWN A
GUIDED PATHWAYS.
TOWARDS THE HEALTH CARE OUTCOME
IT PROVIDES EQUAL OPPORTUNITY
FOR ALL LOCAL HIGH SCHOOL
COMMITTEE COLLEGE AND UNIVERSITY
STUDENTS. TO TRAIN IN VARIOUS
ASPECTS OF HEALTH CARE WHILE
CREATING SUSTAINABLE PIPELINE
FOR FUTURE WORK FORCE.
OUR RECOMMENDATION TO POINT --
TO I THINK THERE'S A FEW NUMBER
FIVE NUMBER SEVEN NUMBER NINE
WHICH RECOMMENDATIONS THAT ARE
PRIDE THAT WE JUST KIND OF
PREPARE OF READY WORK FOR SECOND
TRANSFER I THINK WE HAVE TO WORK
IN.
TANDEM WITH CS YOU WHEN YOU SEE
TO BRING SOME OF THE SKILLS THAT
ARE A LITTLE BIT ABOVE THE
ASSOCIATE'S DEGREE READY MESS --
SO WE HAVE -- SOME DATA HERE
THAT SUGGESTS THAT 29% OF ALL
YOU SEE STUDENTS AND 51% OF ALL
CSU GRADUATES STARTED AT THE
COMMUNITY COLLEGE AND WILL
CONTINUE TO BE A PIPELINE FOR
READY STUDENTS FOR THOSE
PROGRAMS -- RECOMMENDATION TWO
POINT -- THREE WE'RE LOOKING
AGAIN FOR FUNDING ALLOCATED
PROGRAM TO SERVE STUDENTS.
ARE FROM DIVERSE IN LOWER SOCIAL
ECONOMIC TO DEVELOP PIPELINES
FIRST I EXAMPLE SUCH AS THE
WESTMINSTER FREE CLINIC.
THIS IS A PROGRAM OF THE
COLLABORATIVE PARTNERSHIP
BETWEEN WESTMINSTER FREE CLINIC
VENTURA COUNTY HIGH SCHOOL
DISTRICTS AND THE SOUTH CENTRAL
COAST REGIONAL CONSORTIA.
THE PROGRAM TRAINS ELEVEN
TWELFTH GRADE STUDENTS FROM
DIVERSE LOWER ECONOMIC PROGRAMS --
TO BECOME A MEDICAL ASSISTANT.
AND MANY OF THE STUDENTS OF
COURSE TRANSFER FROM THE C. C.
TO BECOME PRE MED STUDENTS AND A
FOUR YEAR INSTITUTIONS FROM
THERE -- SO WHAT'S NEEDED THE
HELP THAT A FUNDING AGAIN NEEDED
TO DEVELOP APPRENTICESHIP
PROGRAMS AROUND THIS CAREER.
I'M CURRENTLY THERE'S NO
DEVELOPED -- PARTNERSHIP AND
HEALTH CARE COMMUNITY COLLEGES
FUNDING -- THOSE SPECIFICALLY TO
TO EMERGENCY MEDICAL TECHNICIANS
CNA MEDICAL IN THIS -- SO BEING
ABLE TO EXPAND INTO SOME NEW
CATEGORIES OF HEALTH CARE
OCCUPATIONS WOULD BE HELPFUL --
JUMPING TO RECOMMENDATION THREE
POINT TWO WE'RE LOOKING AT
ADDITIONAL SUPPORT WITH --
OCCUPATION SUCH AS PATIENT
NAVIGATOR.
A COMMUNITY HEALTH WORKER AND
THE COMMUNITY HEALTH ADVOCATE --
THERE'S A NEED -- FOR POLICY
AROUND REIMBURSEMENT FOR THE
LEVEL OF SERVICE FROM EMPLOYER
AND AGENCIES -- Là WITH THE
REIMBURSEMENT RATE IS FOR THAT
THAT OCCUPATION.
AND THAT CLASS WHAT I HAVE HERE
IS THREE POINT FOUR WHICH ALIGNS
TO THE TEN IT'S COMMUTER
COLLEGES OF COURSE -- CAN HELP
WITH HEALTHCARE WORKERS PATIENT
NAVIGATION -- COMMUNITY HEALTH
ADVOCATES PEER PROVIDERS AND
SPECIALISTS THAT WORKS BEING
DONE AT THE CITY COLLEGE OF SAN
FRANCISCO AND IT IS A PIPELINE
TO THE ASSOCIATE'S DEGREE INTO
THE HEALTH EDUCATOR HUMAN
SERVICES OR SOCIAL SERVICES.
OUTCOMES AND EASILY TO BACHELOR
AT BACHELOR'S DEGREES AND
MASTER'S DEGREES IN SOCIAL WORK
AND HUMAN SERVICES.
SOME OF THE CHALLENGES AGAIN ARE
A LOCAL CERTIFICATE COMPLETION --
WHETHER STUDENTS ACTUALLY
COMPLETE THE WORK THESE ARE
ENTRY LEVEL NON LIVABLE WAGE
JOBS OR VOLUNTEER POSITIONS SO
AGAIN IT'S ABOUT THE
REIMBURSEMENT RATES THAN WORKING
WITH EMPLOYERS. TO CREATE
LIVABLE WAGES FOR OCCUPATIONS
AND THEN TO THE LAST NEED THERE
IS AGAIN THIS IS ABOUT
REIMBURSEMENT FOR SERVICES AND
FOR PRODUCING.
INDUSTRY RECOGNIZED IT
RECOGNIZED CERTIFICATION TO
OVERSEE SUCH CERTIFICATIONS FOR
THESE OCCUPATIONS SPECIFICALLY.
AND THOSE ARE SOME OF A BRIEF
RECOMMENDATIONS OBVIOUSLY THE
COMMUNITY COLLEGE.
HAS -- OVER THREE THIRTY EIGHT
THOUSAND SIX HUNDRED AND SIXTY
THREE ASSOCIATES DEGREES FOR
TRANSFER SO THAT'S JUST THE TIP
OF THE ICEBERG.
BUT WE DO PREPARE YOUR FUTURE
WORK FORCE AND WE DO WORK
CLOSELY WITH OUR COUNTERPARTS
CSU.
AND YOU SEE -- AND WE WORK
TOGETHER -- ON A STEERING
COMMITTEE THERE'S AS THIS PIECE
OF THE LETTER OF THE COMMISSION
THAT SHOWS A LOT OF THE DAY THAT
WE WORK TOGETHER TO PUT THE DATE
AND THE PIPELINES TOGETHER AND
WE ARE COMMITTED -- TO SHORING
UP THE BOOKS THE NEED AND DEMAND
FOR FUTURE HEALTH CARE WORKERS
AND WELL AS BEING ABLE TO
PROVIDE OPPORTUNITY FOR US OUR
STUDENTS.
AND OUR CITIZENS FOR A LIVING
WAGES AND HERE IN CALIFORNIA.
THANK YOU THANK YOU TO THE THREE
OF YOU IT'S WHEN YOU WORK
TOGETHER AND REALIZE THAT THERE
IS A PLAN YOU WILL HAVE A GOAL
AND YOU WANT TO GET THERE WITH
THE START THE COMMUTE CULTURE.
STRAIGHT AT CSU OR YOU SEE.
WE NEED TO INCREASE OUR HEALTH
WORKFORCE WITHOUT A DOUBT.
THANK YOU FOR YOUR PRESENTATION.
I'D LIKE TO NOW CALL UP THE
LEGISLATIVE ANALYST'S OFFICE AND
JOHNSON AND JASON.
CUSTOM TAURUS
.
GOOD AFTERNOON MEMBERS JASON
CONCENTRATORS WITH ALLEGE
ANALYST'S OFFICE -- WE SHOULD
HAVE A HAND OUT IN FRONT OF YOU --
THAT'LL BE WORKING FROM.
THE FAST US -- TO CUT IT FINISH
YOUR HEARING TODAY WITH A BRIEF
OVERVIEW OF THE GOVERNOR'S
BUDGET PROPOSALS -- THAT RELATE
TO HEALTH CARE OF WORKFORCE
DEVELOPMENT.
MY PRESENTATION WILL START WITH
A BRIEF OVERVIEW OF OF THE KEY
PROGRAMS IN THE STATE THAT ARE
RELATED TO HEALTH CARE WORKFORCE
DEVELOPMENT.
AND THEN I'LL TOUCH ON THE
GOVERNOR SPECIFIC PROPOSALS.
FOR TWENTY NINETEEN TWENTY SO IF
YOU TURN THE PAGE TO PAGE ONE OF
THE HAND OUT.
YOU'LL SEE A TABLE THERE THAT
PROVIDES -- SOME KEY WORKFORCE
DEVELOPMENT PROGRAMS IN THE
STATE'S AND IT FOCUSES
SPECIFICALLY ON PUBLIC FUNDING
SO LOCAL STATE AND FEDERAL FUNDS.
WE THINK OF THESE PROGRAMS IS
KIND OF AN IN THREE KEY AREAS
AND THE FIRST AREA IS THE AREA
THAT YOU'VE HEARD A BIT ABOUT IN
THE PREVIOUS TWO PANELS AND
THAT'S HEALTH SCIENCE
INSTRUCTION.
A BASICALLY THE EDUCATION
INSTRUCTION THAT EACH HIGHER
EDUCATION SEGMENT -- PROVIDES AT
THE UNDERGRADUATE AND GRADUATE
LEVEL.
I'M AND YOU CAN SEE OTHER THE
MOUNTS VERY BY EACH SEGMENTS ON
THE SEGMENTS DIFFER SOMEWHAT IN
WHAT THEY FOCUSED ON SO AT THE
KEY.
THAT COMMUNITY COLLEGES AND CSU
TEND TO FOCUS SOMEWHAT MORE ON
UNDERGRADUATE LEVEL INSTRUCTION
IN NURSING WITH WITH ALSO SOME
GRADUAL OF INSTRUCTION OCCURRING
AT CSU.
THE UNIVERSITY CALIFORNIA TENDS
TO FOCUS MORE ON GRADUATE LEVEL
INSTRUCTION AND PARTICULARLY ON
MEDICINE AS BUT ALSO NURSING --
A PHARMACY AND I OPTOMETRY AND
OTHER KEY GRADUATE LEVEL OF
PROGRAMS.
ANOTHER THING TO NOTE ABOUT THIS
PART OF THE PORTION OF THE TABLE
THE FOCUS IS ON ON STATE
SPENDING -- WHICH IS REPRESENTS
PUBLIC SPENDING IN THE AREA
STUDENTS ALSO.
A CONTRIBUTE TO THE COST OF
THEIR INSTRUCTION THROUGH
TUITION.
AND THE UNIVERSITY CALIFORNIA
ALSO USES MANY OTHER FUN SOURCES
TO SUBSIDIZE INSTRUCTION SO FOR
EXAMPLE ONE KEY SOURCE THAT
MEDICAL SCHOOLS OFTEN USE IS
CLINICAL REVENUES THAT ARE
ASSOCIATED WITH.
OTHER FACULTY IN THE IN THE
MEDICAL SCHOOLS.
A MAN SO IF WE HAD INCLUDED
THOSE FUNDS JUST FOR SOME
CONTEXT THE THE UC LINE WOULD
WOULD INCREASE DRAMATICALLY TO
TWO POINT NINE BILLION DOLLARS.
SO YOU CAN SEE THAT THE STATE
PORTIONS JUST A SMALL SHARE OF
THAT TOTAL FUNDING.
THE CSU PORTION WOULD INCREASE
TO ABOUT THREE HUNDRED MILLION
READY REVIEW TO INCLUDE THAT
STUDENT TUITION DOLLARS.
THE SECOND AREA -- IN THIS TABLE
FOCUSES ON PHYSICIAN RESIDENCY
PROGRAMS IN EITHER OF STATE AND
FEDERAL PROGRAMS THAT HELP
SUPPORT THE POST GRADUATE
TRAINING.
OF THAT OCCURS AFTER STUDENT
GETS THEIR DEGREE LARGELY
FOCUSED ON PHYSICIANS WHEN
THEY'RE IN THE RESIDENCE YEARS
OR OR BEYOND THAT.
AND YOU CAN SEE THE LARGEST TO
PROGRAMS THERE ARE FEDERAL --
BOTH THE MEDICARE AND MEDICAID
PROGRAMS IN THE STATE PROVIDE
PAYMENTS TO HELP SUPPORT --
MEDICAL CENTERS AND AND TRAINING.
FOR THE OUR RESIDENTS.
IN ADDITION THERE ARE SOME
SMALLER STATE PROGRAMS THAT ALSO
SUPPORTS UP OF RESIDENTS. ONE OF
THEM IS AT THE OFFICE OF
DEVELOPMENTS ON IS A SONG BROWN
PROGRAM ANY OTHERS AT THE
UNIVERSITY OF CALIFORNIA.
BOTH FOCUSED PRIMARILY ON ON
PRIMARY CARE.
PHYSICIAN RESIDENCY PROGRAMS BUT
THERE THERE ARE SOME ADDITIONAL
THINGS THAT EACH PROGRAM ALSO
SUPPORTS AS WELL.
AND THEN THERE'S ALSO SOME ONE
TIME FUNDING THAT WAS PROVIDED
IN TWENTY EIGHTEEN NINETEEN THAT
YOU SEE SPECIFICALLY.
FOR A PSYCHIATRY PROGRAMS AT THE
INN AT UC RIVERSIDE.
AND THEN FINALLY THE THIRD
CATEGORY THERE WHICH YOU CAN
THINK OF IS KIND OTHER
DEVELOPMENT PROGRAMS THAT DON'T
FIT INTO THE FIRST TWO
CATEGORIES IN A LOT OF THESE
PROGRAMS ARE.
LIMITED TERM IN NATURE SO FOR
EXAMPLE THAT THE FOR THE LARGEST
ITEM THERE WHICH WAS WHICH WAS A
PROPOSITION FIFTY SIX FUNDS.
TO OF OF FOR LOAN REPAYMENT
PROGRAMS FOR MEDI CAL AND A DATA
PHYSICIANS AND DENTISTS.
ON THE THE FUNDS WERE PROVIDED
ON A ONE TIME BASIS SO THEY WILL
BE SPENT OVER MANY YEARS TO TO
FOR THOSE LOAN REPAYMENTS BUT
IT'S IT'S A ONE TIME
APPROPRIATION.
AND THERE ARE A VARIETY OF OTHER.
PROGRAMS IN THERE THAT ALL.
OF THE SKIN FOR NOW JUST FOR THE
SAKE OF TIME.
IF YOU TURN THE OF HEAD OUT TO
PAGE TWO WE PROVIDE A BRIEF
OVERVIEW OF THE GOVERNOR'S
PROPOSALS.
FOR TWENTY NINETEEN TWENTY I'M
AGAIN WEEK WE CATEGORIZE THESE
INTO THREE DIFFERENT AREAS THE
FIRST AREAS PHYSICIAN RESIDENCY
PROGRAMS.
AND YOU MIGHT RECALL I MENTION
THOSE TWO PROGRAMS WHEN IT YOU
SEE AND WHAT IT OFF PAD.
AND THE GOVERNOR'S PROPOSING
HERE TO MAKE SOME ONE TIME
FUNDING THAT WAS PRINT THAT'S
BEEN PROVIDED TO THOSE PROGRAMS
ON GOING.
THERE'S AN ACTUAL PROPOSAL FOR
FOR THE STATE AND AFTER THE
LEGISLATURE TO CONSIDER AND
TWENTY NINETEEN TWENTY THAT
WOULD MAKE THAT ON OF THE OXFORD
PROGRAM IS STILL USING ITS ONE
TIME FUNDS -- TO PROVIDE GRANTS
AND SO THE GOVERNOR IN THIS CASE
IS SIGNALING.
THAT THE FUNDS WILL BECOME ON
GOING IN A LATER YEAR.
THE SECOND AREA OF FOCUS THAT WE
WE KNOW HERE'S FOR MENTAL HEALTH
WORKFORCE DEVELOPMENT AND THE
LARGEST PROPOSAL HERE PROVIDES A
FIFTY MILLION DOLLARS ONE TIME
GENERAL FUND.
UP FOR VARIOUS -- MENTAL HEALTH
WORKFORCE PROGRAMS THAT --
OFSTED.
AND THEN THE FINAL TWO PROGRAMS
HERE ADDRESS A KIND OF A
DIFFERENT AREA THAT YOU HAVEN'T
HEARD YET IN THIS HEARING YOU'VE
HEARD A LOT ABOUT STATEWIDE AND
REGIONAL SHORTAGES.
BUT IN ADDITION A NUMBER OF
STATE AGENCIES ALSO.
HAVE DIFFICULTY -- MEETING
STAFFING GOALS AND IN SOME CASES
HAVE HIGH VACANCY RATES AND SO
THERE ARE SOME PROGRAMS AND ALSO
TRY TO ADDRESS THAT ONE AT THE
DEPARTMENT OF STATE HOSPITALS OF
BROADLY FOR BE A MENTAL HEALTH --
AND THEN ONE IN CORRECTIONS BOB --
FOR NURSE PRACTITIONER PROGRAMS.
THANK YOU I'M HAPPY TO ANSWER
ANY QUESTIONS THE COMMITTEE MAY
HAVE [inaudible]
THANK YOU.
I KNOW THAT NIGHT JASON -- HELD
ALL OUR REMARKS TODAY SO VERY
HERE TO ANSWER ANY QUESTIONS FOR
AND IS HERE TO ANSWER THE
QUESTION WELL ON THE HEALTH SIDE
AT LEAST.
ALL RIGHT.
ANY QUESTIONS OR COMMENTS.
FROM THE COMMITTEE.
MR MCCARTY OKAY.
WELL I'M USED TO SEEING YOU AT
CHASE IN OUR BUDGET SUBCOMMITTEE
SO -- YOU AGO OVER THE THE
NUMBERS IN THE EXCEL LIST FOR US
AS FAR AS HOW MUCH IT WOULD COST
AND SO.
THAT YOU KNOW THESE ARE ALL --
WORTHY ENDEAVORS AND I HAVE A
LOT OF RESPECT AS ASSEMBLYMEMBER
REYES THAT INTO THE GREAT WORK
AT THIS -- BODY -- FOR TOGETHER
ALONG WITH OUR COLLEAGUES.
A DOCTOR WOULD -- BUT A LOT OF
THESE OF COURSE.
COST MONEY WERE COMPETING WITH
OUR OTHER INTERESTS THAT'S YOU
KNOW FUNDING.
YOU SEE AN CSU AT THE FIRST
PLACE FUNDING ACCESS TO CARE AND
IN -- TO STIR OVER CALL OVERALL.
MEDI CAL PROGRAM AND SO FORTH SO
I WANTED TO TO ASK IF YOU COULD
MAYBE GO AND MORE BIT MORE
DETAIL ON THE ON THE KIND OF THE
FORTY THOUSAND FOOT LEVEL THEIR
RECOMMENDATIONS AS FAR AS THREE
BILLION DOLLARS OVER TEN YEARS
AND DO YOU THINK THAT THAT.
IS A IS AN AMOUNT THAT -- THAT
MAKES THE MOST SENSE AND AND HOW
WE DO IT OVER DOES NUMBER YEARS
AND ASSUMING THAT WE HAD -- TO
TO TO PHASE IT IN.
WHICH OF THE PIECES DO WE THINK
THAT WE SHOULD BE FOCUSING ON
FIRST.
RIGHT YOU KNOW -- WE WE NEED A
BIT MORE TIME TO SIFT THROUGH
THE RECOMMENDATIONS THAT WE BE
INTERESTED AND WE'D BE HAPPY TO
WORK WITH STAFF ON THAT IF
THAT'S OF INTEREST TO THE
COMMITTEE OR THE COMMITTEE WOULD
LIKE SOME MORE.
OF FOR THE REVIEW OF THESE
RECOMMENDATIONS TO HELP
PRIORITIZE -- I THINK IF YOU'RE
THINKING ABOUT THIS YOU KNOW
YOU'VE IDENTIFIED A KEY QUESTION
THAT'S BEFORE THE COMMITTEE
WHICH IS YOU FACE MANY BUDGET
PRIORITIES.
MANY WHICH ARE DISCUSSED IN IN
SUB TO AND I'M SURE MANY IN SUB
ONE THAT ARE TOP OF THE PRIOR IS
THAT YOU'RE THAT YOU'RE FACING
HERE AND SO QUITE WHAT SOME
QUESTION IS HOW DO YOU.
HOW DO YOU PRIORITIZE AMONG HIS
RECOMMENDATIONS IN THERE THERE
ARE A FEW APPROACHES YOU COULD
CONSIDER ONE IS TO THINK ABOUT
THE GOALS THAT WERE PRESENTED TO
USE YOU FOR A NUMBER OF GOALS
ABOUT ADDRESSING REGIONAL
SHORTAGES?
IMPROVING THE DIVERSITY OF
PHYSICIANS IN THE STATE IN ONE
APPROACH COULD BE THAT TO FOCUS
ON SOME OF THOSE GOALS
SPECIFICALLY SO FOR EXAMPLE
WHERE YOU TO FOCUS ON INCREASING
THE SUPPLY OR MAYBE ADDRESSING
REGIONAL SHORTAGES THAT MIGHT
LEAD YOU TO TO TARGETING
SPECIFIC PROGRAMS FIRST.
IF YOUR GOAL IS TO INSTEAD
IMPROVE THE DIVERSITY AND AND
HAVE A MORE REPRESENTATIVE.
A SUPPLY OF PHYSICIANS THAT
MIGHT.
TARGET FUNDS TOWARD THE SPECIFIC --
ARE DIFFERENT PROGRAMS THAT
THAT'S ONE WAY YOU COULD
PRIORITIZE.
YOU COULD ALSO THINK ABOUT WHICH
SPECIALTY AREAS -- I'VE HEARD A
LOT ABOUT PRIMARY CARE YOU'VE
HEARD A LOT ABOUT MENTAL HEALTH
RIGHT NOW AS YOU CAN SEE THE
STATE.
TENDS TO FOCUS ON GOING FUNDS
TOWARDS PRIMARY CARE THAT THAT'S
WHAT THE FOCUS IS OF THE SONG
BROWN PROGRAM IT'S LARGER THE
FOCUS OF THE UC PROGRAM AS WELL.
SO YOU COULD YOU COULD CONTINUE
THAT APPROACH AND FOCUS ON
PRIMARY CARE YOU COULD THINK
ABOUT MENTAL HEALTH -- YOU COULD
TRY TO FIND A DIFFERENT MIX OF
THAT SO THAT THAT'S ANOTHER WAY
TO PRIORITIZE SO YOU HAVE A FEW
OPTIONS DEPENDING ON WHAT YOUR
GOALS ARE.
I'M BUT TO COMMENT ON THE
SPECIFIC RECOMMENDATIONS I THINK
WE NEED A LITTLE BIT MORE TIME
TO SIFT THROUGH THEM AND AND
THINK A LITTLE MORE AND ALSO
KIND OF REVIEW HOW THE COST
ESTIMATES WERE DEVELOPED.
QUESTIONS LIKE THAT SURE AND I
GUESS WITH THAT YES I I WOULD
LIKE YOU TO DO THAT AND I WILL
NOTE THAT -- MAYBE NOT JUST --
BAD LUCK BUT BAD TIMING IS THAT
LAST YEAR OF COURSE WHO WERE
COMING OFF.
PROP FIFTY SIX THE RIGHT NUMBER
FIFTY SIX ARE WE HAD.
THE TOBACCO TAX REVENUE AND THE
ABILITY TO DO SOME THEY
SIGNIFICANT INVESTMENTS HANDS WE
WE HAD A BETTER.
REFLECTION OF ONGOING MONEY IN
THE BUDGET IN THIS YEAR IS IS IS%
A DIFFERENT SITUATION SO WE NEED
TO BE.
REALISTIC ABOUT THAT -- SO THAT
WOULD CERTAINLY BE HELPFUL IN
OUR DECISION MAKING PROCESS I
DID WANT TO ASK IS THAT -- YOU
KNOW BY NO MEANS OF MY FAMILIAR
WITH THESE PROGRAMS BUT YOU KNOW
I'VE I'VE HEARD OF THEM AND AND
SO DOES THE LA -- HAVE --
RECOMMENDATIONS ON WHICH ONES
ARE THE MOST.
LAST EFFECTIVE IN THE IN THE
PRIOR YEARS THE ONES ARE THE THE
UC FUNDED.
I KNOW THAT THE GATHERS THE
PRIME AND THERE'S THAT SONG
BROWN.
LOAN FORGIVENESS WHEN IT GETS A
STEEP THOMPSON.
SO THEY'RE ALL JUST PIECES I
DON'T HAVE EXPERTISE IN ANY OF
THEM BUT IS THERE ANY -- WORK
THAT WE HAVE DONE TO SEE WHICH
ONES -- GIVE US THE THE THE THE
BEST BANG FOR OUR BUCK.
AS FAR AS THE THE THE IN THE IN
THE SHORTAGE ISSUE RATE.
I EAT ALL THE ALL SPEAK TO SOME
OF THE UC ONES THAT I I THINK
THAT MIGHT HELP OUT ON SOME OF
THE OTHER AREAS OF HIS KNOWLEDGE
ON THEM.
IN TERMS OF THE UC ITEMS A
COUPLE OF THESE ARE ARE KINDA
NEW INITIATIVES AND SO IT'S JUST
TOO SOON IN SOME CASES FOR
EXAMPLE THE UC RIVERSIDE PROGRAM
IS FUNDED IN LAST YEAR'S BUDGET
AND YOU SEE STILL IMPLEMENTING
AND STILL DEVELOPING AN
EXPENDITURE PLANS SO.
A DIFFICULT TO COMMENT ON SOME
OF THE NEWER ONES -- I THINK ON
ON SOME OF THEM MORE
LONGSTANDING ONES LIKE THE SONG
BROWN PROGRAM FOR EXAMPLE.
ALL RIGHT THERE ARE SOME ISSUES
TO CONSIDER THEIR AS YOUR AS
YOU'RE THINKING ABOUT HOW TO
SUPPORT PRIMARY CARE ONE THING
THAT THE LEGISLATURE'S BEEN
CONSIDERING BOTH RESPOND BROWN
AND PROPOSITION FIFTY SIX THAT
YOU SEE.
IS THAT YOU HAVE TWO DIFFERENT
PROGRAMS THAT SUPPORT PRIMARY
CARE YOU'VE WON IT YOU SEE AND
AND ONE FOR US PAD.
AND IT YOU KNOW THEY THEY THERE
ARE SOME DIFFERENCES BUT THERE'S
A LOT OF CROSSOVER OF THOSE
PROGRAMS TO AND BY HAVING TWO
DIFFERENT PROGRAMS YOU HAVE IN
IT WITH THEIR OWN KIND OF
ADMINISTRATIVE STRUCTURES ARE
SOME QUESTION AS TO IS THAT THE
MOST EFFECTIVE WAY. TO TO DOLE
OUT GRANTS FOR FOR PRIMARY CARE --
I THINK ANOTHER WEAKNESS BEHIND
THE SONG BROWN PROGRAM IS THAT --
BECAUSE THE FUNDS ARE A REALLY
REIMBURSING COSTS THAT THE THAT
RESIDENCY PROGRAMS HAVE ALREADY
SPENT THERE'S SOME QUESTION AS
TO WHETHER CHANGING THINGS ON
THE GROUND OR REIMBURSING THEM
FOR FOR COSTLY ALREADY SPENCER
THERE ARE.
POTENTIAL WAYS THAT THE
LEGISLATURE COULD CONSIDER
RESTRUCTURING THAT PROGRAM THAT
THAT MAYBE HAVE A BETTER
INFLUENCE ON THINGS ON THE
GROUND -- I THINK IN TERMS OF
PRIME THAT'S SOMETHING WE HAVE
TO REVIEW A LITTLE MORE
CAREFULLY IN TERMS OF ITS
SUCCESS SO I KNOW IT'S BEEN A
LONG STANDING PROGRAM -- STATE
HASN'T FUNDED IT FOR SEVERAL
YEARS DIRECTLY -- AND SO WE HAVE
TO WORK WITH THE SEGMENTS TO
REVIEW THAT DATA AND AND PROVIDE
YOU A LITTLE MORE INSIGHT AS TO
WHAT IT'S TRYING TO ACCOMPLISH
AND IS IT A IS IT EFFECTIVE IN
ACCOMPLISHING THOSE GOALS.
AND IF YOU HAVE THEM I'M THE THE
ONLY THING I THAT IS THAT A LOT
OF THESE.
DIFFERENT SOLUTIONS REALLY SORT
OF TARGET DIFFERENT AREAS --
WHERE THERE CAN BE PROBLEMS SO
FOR EXAMPLE RESIDENCY PROGRAMS
ARE MORE -- FUNDING FOR
UNDERGRADUATE EDUCATION SO FORTH
COULD BE HELPFUL IN IN REALLY
INCREASING THE OVER SUPPLY ARE
THE SUPPLY OF THE NUMBER OF
PRACTITIONERS IN THE FIELD
WHEREAS OTHER SOLUTIONS SUCH AS
LOAN REPAYMENT PROGRAMS SUCH AS
SIMPLY -- YOU KNOW MAYBE --
TARGETING CERTAIN RATE INCREASES
IN THE MEDI CAL PROGRAM JUST FOR
EXAMPLE WOULD WOULD REALLY MAYBE
SHIFT TO THE EXISTING SUPPLY TO
POTENTIALLY WHERE THERE ARE MORE
NEEDS.
SO THERE ARE VARIETY OF
CONSIDERATIONS IN DECIDING THE
EFFECTIVENESS OF VARIOUS
INTERVENTIONS TO IMPROVING --
THE DISTRIBUTION AND OVERALL
SUPPLY OF OF PHYSICIANS AND
OTHER HEALTH CARE WORKERS AND
AND WE HAVE WE HAVE NOT
COMPLETED -- COMPREHENSIVE
ANALYSIS -- AT THIS TIME TO
REALLY BE ABLE TO MAKE TARGETED
RECOMMENDATIONS BUT WE ARE
DEFINITELY HAPPY TO LOOK INTO
THIS -- AS REQUESTED BY ON A
ANNIE MEMBERS HERE.
IT WAS OUR AND IT WAS REQUESTED
BY ASSEMBLYMEMBER MCCARTY.
STROBE OR NOT.
THANK YOU MADAM CHAIR I'D LIKE.
TO AMPLIFY WHAT A SOLOMON
MCCARTY JUST A REQUESTED BECAUSE
I THINK IT'S VERY IMPORTANT.
FOR THE LA -- TO TAKE KIND OF A
HOLISTIC OUT OF THE BOX APPROACH
TO SOLVING THE REALLY BIG
SYSTEMIC PROBLEMS THAT FACE THE
STATE.
SOMETIMES A MAN WE ALL VOTE ON
THREE THOUSAND SOME ODD BILLS A
YEAR IT'S REALLY HARD FOR US TO
GET OUT OF OUR HEADS DOWN MODE
AND TO TAKE YOU KNOW AN OVERALL.
THIRTY THOUSAND FOOT VIEW OF
THESE ISSUES SO ARE I'M REALLY
EXCITED THAT -- WITH THE GABRIEL
AND AND YOU KNOW YOU YOU'RE
YOU'RE KIND OF NEW DIRECTION
THAT YOU MIGHT BE TKING A LOOK
AT THAT I REALLY LIKE TO COURAGE
YOU IN THIS SENSE. TO TAKE THE
OPPORTUNITY TO DO THAT BECAUSE
WHAT WE'VE BEEN HEARING THAT THE
PROPOSAL'S HERE THAT YOU
PRESENTED ARE KIND OF ON THE
SUPPLY SIDE.
AND AS YOU POINTED OUT AND I
WOULD REALLY BE INTERESTED TO TO
LEARN WHETHER OR NOT HE WOULD BE
MORE EFFECTIVE TO TARGET THE
DEMAND SIDE I CAN TELL YOU FROM
PERSONAL EXPERIENCE THAT I HAVE
MANY.
CONSTITUENTS WHO ALTHOUGH
TECHNICALLY THEY'RE COVERED BY
MEDICARE ALL THEIR UNABLE TO SEE
PRIMARY CARE PHYSICIANS WHEN
THEY'RE ILL BECAUSE
REIMBURSEMENT RATES ARE SO LOW.
AND SO YES SOMETIMES WE WONDER
WHY WE DON'T HAVE MORE STUDENTS
THAT ARE MOTIVATED TO PERVERT
PURSUE A CAREER AS A PRIMARY
CARE PHYSICIAN -- BUT I THINK
THAT THAT COULD ANSWER SOME OF
THE QUESTION IS HOW DIFFICULT IT
IS TO HAVE A PRACTICE THAT MEETS
THAT NEED.
SO.
WHAT WE'RE INTERESTED IN IS
OBVIOUSLY THE BEST BANG FOR
ABOUT BARK? FOR SPENDING PUBLIC
RESOURCES IN SOLVING THIS
PROBLEM AND IT WOULD BE REALLY
INTERESTING FOR AN ORGANIZATION
LIKE THE LA -- TO TAKE A
HOLISTIC LOOK AND FIGURE OUT
WHAT THE BANG FOR THE BUCK IS IF
WE INVEST ON THE SUPPLY SIDE.
CREATING MORE PRIMARY CARE
PHYSICIANS HOW MANY MORE DO WE
GET PER DOLLAR -- IF WE INVEST
ON THE DEMAND SIDE REASON
REIMBURSEMENT RATES OR CREATING
RURAL HEALTH CLINICS OR ONE OF
YOU KNOW I'M NOT SURE A HUNDRED
DIFFERENT THINGS THAT.
THAT YOU COULD LOOK INTO WHETHER
OR NOT THAT'S THE BEST BANG FOR
THE BUCK AND WHAT THE TRADE OFFS
ARE THAT'S SOMETHING THAT I HAVE
NOT SEEN IN MY FIVE YEARS HERE
AND I WOULD REALLY BE REALLY
INTERESTED TO LOOK AT THANK YOU
MISTER OBERNOLTE.
WOULD EITHER OF YOU LIKE TO
RESPOND TO THAT.
REGIS TAKING ABANDONED BUILDING
INSTRUCTIONS RIGHT SIR OR TAKING
IT AND I THINK WHAT WE WANT TO
WORK WITH STAFF TO TO HELP.
MAKE SURE WE'RE WE'RE STOPPING --
THE WHAT WHAT YOU'RE ALL ASKING
AND MAKE SURE WE'RE WE'RE SORT
OF MEETING THAT.
I HAD DIFFERENT GOALS THAT
YOU'VE MENTIONED SO WE'D BE
HAPPY TO WORK STAFF ON THAT
[inaudible]
MR GALLAGHER.
YES THANK YOU MADAM CHAIRMAN --
AND I ONE THING I WANTED A FOCUS
AND WAS YOU KNOW I THINK.
IN TRYING TO ADDRESS THE
PHYSICIAN SHORTAGE ESPECIALLY IN
A MORE RURAL PARTS OF THE STATE --
IT SEEMS TO ME THAT WE REALLY
NEED. TO TO YOU KNOW GROW OUR
OWN -- DOCTORS IN THE REGION AND
I'LL GIVE AN EXAMPLE -- ONE OF
OUR COLLEAGUES BRIAN DALLY --
HIS I BELIEVE IT'S HIS UNCLE WAS
A LONG TIME POSITION UP IN THE
LASSEN AND MODOC COUNTIES AREA.
HE GREW UP THERE.
WHEN BECAME A DOCTOR AND THERE
WAS A RECENT ARTICLE HE ACTUALLY
WON AN AWARD AS THE YOU KNOW?
FOR HIS LONG SERVICE.
TO RURAL UNDER SERVED AREAS.
YEAH BUT HE GREW UP THERE WENT
TO MEDICAL SCHOOL AND CAME BACK
TO THE REGION AND IT SEEMS TO ME
THAT.
MAYBE EVEN MORE THAN JUST
CREATING MORE RESIDENCY SLOTS --
WE NEED TO REALLY TRY AND
ACTIVELY SAY HEY WE WANT TO
CREATE A PATHWAY.
FOR PEOPLE IN THE RURAL AREAS
BECAUSE THE CHANCES THAT
SOMEONE'S GOING TO GO TO A RURAL
AREA.
OR TWO AND UNDERSERVED AREA THAT
THEY'VE NEVER LIVED IN AND HAVE
NO CONNECTION TO A PROBABLY
PUTTING THEM MINIMAL -- BUT IF
WE IF WE GO THERE AND WE SAY HEY
WE WANT TO TRAIN.
PEOPLE THAT LIVE IN THESE AREAS
ARE FROM THESE AREAS HAVE A
CONNECTION FAMILY.
YOU KNOW WHATEVER TO THE REGION
THOSE ARE PROBABLY MORE LIKELY
TO GET TO THOSE AREAS SO -- I
MEAN WOULD YOU.
WOULD YOU AGREE TENNIS SEEMS
LIKE THAT'S PART OF SOME OF THE
RECOMMENDATIONS THAT WERE MADE
BY THE THE COMMISSION -- THE
OTHER THERE IS ONE PROGRAM THAT
I THINK MIGHT GET AT WHAT YOU'RE.
REFERRING TO AND THAT -- THAT
YOU SEE PRIME -- PRIME IS A
PROGRAM THAT IT'S IMPLEMENTED
SOMEONE DIFFERENT ON EACH CAMPUS
AND SPEECH CAMPUS HAS ITS OWN.
TARGET POPULATION BUT THERE
THERE ARE SOME CAMPUSES THAT
FOCUS SPECIFICALLY ON RURAL.
AREAS OF THE STATE.
AND WHAT THEY DO IS THEY RECRUIT
STUDENTS WHO COME FROM RURAL
AREAS.
AND THEY GIVE THEM AN ENHANCED
EDUCATION HAVE THE SAME
EDUCATION THAT YOU'D GET GOING
THROUGH MEDICAL SCHOOL NORMALLY
BUT ON TOP OF THAT THEY HAVE
SOME ADDITIONAL CURRICULUM AND
CLINICAL ROTATIONS FOCUSED ON
RURAL COMMUNITIES AND THE
OBJECTIVE IS TO HAVE THEM THEN
GO BACK TO RURAL COMMUNITIES AND
AND AND WORK.
THERE SO THEY THERE ARE THERE
ARE SOME THAT'S THE MAIN PROGRAM
I'M AWARE OF THAT REALLY TARGET
SO.
THAT I THINK THE OTHER PROGRAM
THAT.
MAKE IT OUT TO WHAT YOU'RE WHAT
YOU'RE REFERENCING A IT FOCUSES
MORE ON IN INCREASING --
RESIDENCY SLOTS WITH WHICH I
KNOW YOU MAY BE THINKING MORE
OUTSIDE THE BOX UP BUT ON THE
SONG BROWN PROGRAM.
IS DESIGNED.
TO A PROVIDE GRANTS TO RESIDENCY
PROGRAMS THAT ARE AND AREAS OF
THE STATE THAT HAVE A LOT
SIGNIFICANT SHORTAGES AND SO A
LOT OF THOSE AREAS ARE.
RURAL NOT ALL THE MANY OF THEM
URBAN TO BUT A LOT OF THOSE ARE
RURAL SO THAT IS ALSO TARGETING
RESOURCES TOWARDS READ THAT
RELIES ON YOU DOING THE
RESIDENCY THERE AND THAT
HOPEFULLY YOU STAY THERE.
RIGHT.
BUT THEY DON'T HAVE TO THEY CAN
DO THE RESIDENTS EITHER AND THEN
GO SOMEWHERE ELSE RIGHT.
THAT'S CORRECT -- SYSTEM THAT
MAYBE TRIES TO GET MORE OF A
COMMITMENT I THINK IS.
SOMETHING THAT'S NEEDED AGAIN
AND IT SOUNDS TO ME LIKE YOU'RE
SAYING.
YOU REALLY DON'T KNOW AT THIS
TIME WHAT ARE THE MOST AFFECTED
PROGRAMS RIGHT YEAH AND VERY SO
AND AND TO ADDRESS THAT LATTER
POINT THERE ARE THE SAY THE
ALONE ASSUMPTION PROGRAMS OR IN
FACT -- MANY MET MEDI CAL
MANAGED CARE PLANS ACTUALLY
RESERVE.
DEVOTE SOME OF THEIR RESOURCES
TO STIPENDS TO RECRUIT
PHYSICIANS IN HARD TO RECRUIT
AREAS AND SO FORTH AND SO THERE
ARE A VARIETY OF EXISTING
PROGRAMS THAT.
ARE JUST RELYING ON HOPING THAT
SOMEONE MIGHT STAY AFTER
RESIDENCY PROGRAM BUT ATTRACTING
A CANDIDATE WITH -- YOU KNOW
FINANCIAL RESOURCES TO A HARD TO
SERVE AREA SO THERE ARE GROW A
LARGE VARIETY OF A OF POTENTIAL
INTERVENTIONS AND THAT
UNDERSTANDING THE EFFECTIVENESS
OF VARIOUS ONES FOR SPECIFIC
ISSUES IS JUST A A AN
INTERESTING BUT TOUGH PROBLEM --
TO BUT THAT WANT ONE THAT WE'RE
HAPPY TO WORK WITH STAFF TO
ANALYZE OKAY AS IN GALLAGHER CAN
WE INVITE -- DOCTOR HERNANDEZ
PERHAPS SHE WOULD LIKE TO ALSO
COMMENT VOTERS BECAUSE IF WE'RE
TALKING ABOUT.
A PLAN -- AFTER. SEVENTEEN
EIGHTEEN MONTHS OF PREPARING A
REPORT.
OF WE'RE TALKING ABOUT WHAT IT'S
GOING TO COST IN FINDING THE
PRIORITIES BUT PERHAPS TO HEAR
FROM DOCTOR HERNANDEZ ABSOLUTE
WHY IT IS THAT THEY ARE MAKING
THESE RECOMMENDATIONS.
THANK YOU CHAIRMAN REYES -- THE
SETTLEMENT -- BUT I THINK IT'S
IMPORTANT TO NOTE THAT THE
SPIRIT OF THIS COMMISSION'S
REPORT.
IS THAT EVEN WITH ALL OF THE
EXISTING PROGRAMS THAT WE HAVE
IN PLACE -- WE TO DAY ALREADY
HAVE ANY MEN SHORTAGE.
OF PRIMARY CARE OF PREVENTION
PROGRAMS -- AND IMPORTANTLY IN
BEHAVIORAL HEALTH IS AS YOU'VE
HEARD -- AND SO -- YOU KNOW THE
PRIME PROGRAMS FRANKLY ARE
DIFFERENT IN EVERY SCHOOL IN
LARGE PART BECAUSE THEY'RE
FUNDED IN VERY.
AD HOC WAYS IF YOU WILL THERE IS
NO SUSTAIN FUNDING FOR PRIME
THAT HAS THE SET OF OUTCOMES IN
GOALS THAT YOU'RE TRYING TO
ACHIEVE.
IN SPITE OF THE FACT THAT IT'S
TRAINING.
THE KIND OF WORK FORCE THAT WE
BELIEVE WILL ULTIMATELY ADDRESS
BOTH THE OUTCOMES WERE LOOKING.
FOR AND AND CREATING BETTER
EQUITY IN TERMS OF THE
DIVERSIFICATION OF THE WORK
FORCE.
SO -- I WOULD ALSO SAY IF I MAY
YOU KNOW.
THE THE VENDORS THAT ANALYZE THE
COST ASSUMPTIONS IN THESE
RECOMMENDATIONS.
BE HAPPY TO WORK WITH THE LA JOH
TO REALLY ANALYZE THE
METHODOLOGY BY WHICH THOSE COST
ESTIMATES WERE MADE.
AND TO BE ABLE TO GIVE THE%
COMMITTEES BOTH OF THEM A BETTER
SENSE OF WHAT THE RETURNS ARE ON
ANY GIVEN INVESTMENT BUT I I
WOULD SAY IN GENERAL AND AND WE
DO KNOW THE EVIDENCE IS QUITE
CLEAR.
WHERE YOU TRAIN?
DOES HAVE A GREAT DEAL OF OF THE
OF IMPACT AND WHERE YOU
ULTIMATELY STAY AND PRACTICE.
AND THUS TRYING TO RECRUIT
PEOPLE AS YOU SAY FROM RURAL
AREAS INTO RESIDENCY PROGRAMS
WHERE THEY CAN TRAIN IN RURAL
SETTINGS.
INCREASES SIGNIFICANTLY THEIR
LIKELIHOOD THAT THEY WILL STAY
AND SERVE IN RURAL AREAS BUT
AGAIN RESIDENCY PROGRAMS HAVE
BEEN CAPPED.
AND SO WE TOOK WE TRAIN A LOT OF
VERY TALENTED DIVERSE STUDENTS
LIKE.
DOCTOR CARLO REFERRED TO AND
THEN WE SEND THEM OUT OF STATE
TO TRAIN.
AND WHEREVER THEY GO TYPICALLY
IS WHERE THEY STAY.
I CAME TO YOU SEE THE SAID
DETAINING PRIMARY CARE YOU SEE A
SELF -- AS A BEEN A GRADUATING
MEDICAL STUDENT BY THE WAY THE
NUMBER OF LATINOS IN THE STATE
AGAINST OUR POPULATIONS NOT
CHANGED IN THIRTY PLUS YEARS
SINCE I GOT HERE AND SO THAT I
THINK IS.
AND I STAYED AND TRAINED AT SAM
CISCO GENERAL HOSPITAL LARGE
PUBLIC HOSPITAL IN PRIMARY CARE.
SO I I IN THE EVIDENCE SORT OF
BACK SET UP -- MORE
SYSTEMATICALLY.
AND THEN JUST YES LAST QUESTION
WHAT IS B. M. ONE OF THE
RECOMMENDATIONS IS A MAXIMIZE A
ROLE OF NURSE PRACTITIONERS --
AS PART OF THE CARE TEAM.
COULD YOU SPEAK AT ALL TO WOULD
IT HELP TO EXPAND THE SCOPE.
OF WHAT WHAT PRIMARY OF WHAT --
NURSE PRACTITIONERS CAN DO AND
BECAUSE LIKE YOU SAY RIGHT NOW
AS WE SIT HERE TODAY.
WE DON'T HAVE THE PHYSICIANS AND
MAYBE THAT'S ONE WAY TO HELP.
ADDRESS THAT ISSUE ASSEMBLYMAN
GALLAGHER WE HE SYSTEMATICALLY
REVIEWED THE EVIDENCE ON NURSING
PRACTICE -- UNDER SCOPE OF
PRACTICE.
UNDERS PRACTITIONERS.
THERE ARE TWENTY TWO STATES.
WHO HAVE EXPANDED SCOPE OF
PRACTICE FOR NURSE PRACTITIONERS?
ALL IN ALL OF THOSE STATES WE
HAVE SEEN THE EVIDENCE OF THAT A
THE QUALITY OF CARE IS
COMPARABLE TO OTHER PRIMARY CARE.
AND THEY HAVE SIGNIFICANTLY
IMPROVED THEIR PRIMARY CARE WORK
FORCE IN WAYS THAT STATES HAVE
NOT DONE IT HAVE NOT -- AND SO --
THIS IS SOMETHING THAT WAS AGAIN
THE PROCESS FOR THIS REPORT WAS
VERY EVIDENCE BASED WE TRY TO
REVIEW ALL THE LITERATURE WE
HAVE A YOU SEE FACULTY MEMBER
WOULD BE HAPPY TO TALK TO ABOUT
THAT EVENTS BUT I THINK IT'S
QUITE CLEAR.
THAT WE WILL NOT ACHIEVE THE
PRIMARY CARE CAPACITY WE NEED IN
THE STATE BY ONLY TRAINING
PRIMARY CARE PHYSICIANS.
THANK YOU.
THANK YOU MISTER GALLAGHER.
MISTER RAMOS.
THANK YOU MADAM CHAIR AND I'M
GETTING BACK TO THE IS ME JUST
ONE SECOND.
ARE YOU CO AUTHOR OF SUCH A BILL.
I'M GLAD TO HEAR THAT THANK YOU
I'M SORRY MR ROMANS.
ALL RIGHT WHAT'S THE BILL NUMBER.
OKAY WELL LOOK IT UP THANK YOU
NOW I KNOW I'M NOT THE ONLY ONE
THAT DOESN'T KNOW THE NUMBER
[inaudible]
YEAH.
THANK YOU MADAM CHAIR AND WITH
THAT AND GET INTO THE DIFFERENT
RECOMMENDATIONS THAT WERE THERE
ONE OF THEM THAT CAME UP WAS --
ONE POINT ONE EXPANDING SCALE
PIPELINE PROGRAMS TO RECRUITING
PREPARED STUDENTS AND IT CAME UP
WITH THE COMMUNITY COLLEGES IN
THE STATE OF CALIFORNIA THAT'S
AN IDEAL PIPELINE YOU GUYS SO
MUCH OF THE POPULATION THERE.
AND THE THE DIVERSITY IS THERE
SO TALKING ABOUT THEN THE
FUNDING MECHANISM TO THAT ARE WE
ALIGNING THAT WITH THOSE
RECOMMENDATIONS THAT ARE THERE.
TO SEE HOW THAT CONTINUES TO
MOVE FORWARD WITH ALL THE WORK
THAT'S BEEN DONE TO IDENTIFY
THAT PIPELINE AT THE COMMUNITY
COLLEGE LEVEL AND MOVING FORWARD.
DR HERNANDEZ YOU DIDN'T HAVE TO
LEAVE YOU CAN STAY HERE.
AND THEN SINCE MISTER ROSS IS
ASKING ABOUT THE COMMUNITY
COLLEGE.
WHO WAS A REPRESENTATIVE FROM
THE COMMUNITY COLLEGE?
BECAUSE MR ALMOST MAY HAVE A
QUESTION YOU SECURING IT UP.
WITH THE THINK GORE NOW.
SO THE QUESTION -- AS FAR AS THE
PIPELINE IN SEEN THE THE FUNDING --
THAT'S THERE AND THE OVERVIEW --
TALKS ABOUT RESIDENCIES AND THE
MENTAL HEALTH WORKFORCE ANOTHER
PRIORITIES BUT WE HEARD IN YOUR
PRESENTATION THAT COMMUNICATES
LEDGES.
I BELIEVE ARE IN A PRIME
POSITION TO BRING THAT DIVERSITY
BASED TOGETHER AND TO BE THAT
PIPELINE AND THEN FURTHER IN THE
DIALOGUE WITH THE WITH THE CAL
STATE SYSTEM OF THE UC SYSTEM.
TO ENSURE THAT THOSE STUDENTS
ARE MOVING IN THAT DIRECTION SO
SOME OF THE THE THE FINANCIAL --
CAPABILITIES -- TO MEET THAT
REQUIREMENT IN THE STRATEGIC
PLAN THAT'S THEIR IN TERMS OF
FUNDING I I WOULD GO TO OUR
STRONG WORK FORCE PROGRAM.
WHICH THIS SPECIFICALLY DESIGNED
AROUND A REGIONAL APPROACH TO
EACH REGION CAN PRIORITIZE WHICH
INDUSTRIES ARE.
THEIR FOCUS HEALTH TENDS TO BE
ONE THAT RISES TO THE TYPE QUITE
OFTEN AND THAT'S WHERE DIFFERENT
COLLEGES CAN WORK WITH THE
CONSTITUENTS AND THE COMMUNITY
AND TO BE ABLE TO FIND OUT WHERE
THOSE WORKFORCE GAPS ARE.
IN IN THE WORK FORCE AND
ECONOMIC DEVELOPMENT DIVISION IN
GENERAL ANY OF THE FUNDING
STREAMS THAT WE OVERSEE AND WE
OVERSEE ABOUT ONE POINT TWO
BILLION AND LOCAL SYSTEMS THAT
GOES OUT TO OUR COMMUNITY
COLLEGES.
THERE HAS TO BE EVIDENCE THAT
THERE IS ACTUALLY A LABOR
SHORTAGE IN ANY GIVEN OCCUPATION
BEFORE IT WOULD BE FUNDED.
SO THOSE ARE SOME OF THE THE BUT
WE DO HAVE FEDERAL FUNDS PERKINS
MONEY WE HAVE STRONG WORK FORCE
WHICH ARE NEWER.
FOCUSED MONEY ON DEVELOPING
PROGRAMS OF BY REGIONAL APPROACH
AND THEN OUR STANDARD.
ECONOMIC AND WORKFORCE
DEVELOPMENT -- STATE DOLLARS AS
WELL.
SO IN IF A STUDENT MOVES FORWARD
AND AND COMMITTEE COLLEGE SYSTEM
TAKES ON THE HEALTH CARE AS AS
THEIR MAJOR.
WHERE ARE IS THERE NOW THE
CORRELATION BETWEEN THE UC
SYSTEM IN THE COMMUNITY COLLEGE
SYSTEM? TO PLAN THAT THAT NEXT
STEP UP TO GET THAT FOUR YEAR
DEGREE.
YOU SEE WELL THERE'S A THERE WAS
AN EXAMPLE EARLIER OF THE CSU
RIVERSIDE -- AS WELL THEY
CREATES A LOCAL RANGELANDS BUT
HAS NOT YOU STATEWIDE
ARRANGEMENTS WHERE.
THEY EAT THIS EACH OTHER SEVENTY
DISTRICTS THEY'RE ACTUALLY KIND
OF MORE OF A FEDERATION IS KIND
OF HOW WE ARE AND IT'S OUR
SYSTEM WE DON'T HAVE A DIRECTION
SAYS YOU SHALL MAKE.
THESE ARTICULATIONS SO THEY'LL
WORK WITH A LOCAL SEE ISSUES AND
AND THE K. TWELVE SYSTEMS TO BE
ABLE TO IDENTIFY THE STACKABLE
CAREER PATHWAYS DOWN AND BUILD
ARTICULATION AGREEMENTS BETWEEN
THEM WHERE THEY MAKE.
TRANSFER GREEN IT'S A MAKE SURE
THAT THE CURRICULUM ALIGNED
THERE'S A LOT OF STRUCTURAL --
CONNECTIONS IN THE FUNDING THAT
DRIVE US TO THOSE TYPES OF
PIPELINES TO MAKE SURE THAT OUR
STUDENTS HAVE SOMEWHERE TO GO
BUT THEY'RE NOT JUST COMPLETING
A A THAT DOESN'T TRANSFER TO CSU.
SO THERE ARE MORE MORE
INTENTIONAL ON EFFORTS TO MAKE
THOSE TYPES OF CONNECTIONS LIKE
YOU SEE IN RIVERSIDE BECAUSE
EARLY ON I REMEMBER -- SOMETIME
BACK AT THE COMMUNITY COLLEGE
YOU GET YOUR ASSOCIATES DEGREE --
IT WHETHER IT'S SCIENCE ON ARTS
AND THEN MAKING SURE THAT THOSE
GENERAL REQUIREMENTS MET THOSE
REQUIREMENTS AT THE CAL STATE
UNIVERSITY SYSTEM THERE HAD TO
BE.
DAHLE PIECE OF LEGISLATION THAT
MOVE FORWARD TO MAKE SURE THAT
THAT WAS IN COLLABORATION.
IF WE'RE LOOKING AT THE PIPELINE
MOVING FORWARD IN THIS INDUSTRY
BECAUSE IT'S BEEN IDENTIFIED.
IS THERE ANY WORK THAT NEEDS TO
BE DONE IN THAT ASPECT OF
SPECIFIC TO THIS FILM.
WHAT COMES TO MIND IS THE --
SOCIALES DEGREE FOR TRANSFER
WORK THAT'S BEEN DONE SO THAT
STUDENTS CAN TAKE AS A SET OF
COURSE WORK THAT STANDARD ACROSS
THE STATE THAT BASICALLY SAYS IF
YOU TAKE A SET OF COURSE WORK
YOU'RE GUARANTEED OR PROMISE TO
TRANSFER TO CSU.
AND SO THAT MIGHT BE ABLE TO BE
LOOKED AT AS CAN YOU MAYBE
INCENTIVIZE STUDENTS TO MOVE
TOWARDS -- AT DEGREES THAT
RELATE TO HEALTH CARE HEALTHCARE
OUTCOMES BUT IN GENERAL THE
ASSOCIATES TO REFER TRANSFER
WHERE YOU CAN HAVE A STANDARD
TRAC.
SAID OF COURSE WORK THAT ALLOWS
STUDENTS TO MOVE TO THE NEXT
SEGMENT.
IT'S NOT AS THE REQUIRED THAT
THE NEW HEALTH CARE BUT THAT
MIGHT BE A PLACE FOR YOU TO LOOK.
MANAGERS ASKING THE QUESTION TO
ENSURE THAT WE DO GET THAT
PIPELINE MOVIE IN.
THAT IT'S AS SEAMLESS AS
POSSIBLE AND IF THERE IS SOME
TYPE OF LEGISLATION NEEDS TO BE
DONE THERE MAYBE THERE'S SOME
WORK THAT CAN BE DONE TO BRING
THAT BACK TO US.
I THINK THAT AS MISTER RAMOS
MENTIONS THIS IT SHOULD BE NOTED
THAT HE WAS A TRUSTEE FOR THE
SAN BERNADINO COMMUTE COLLEGE
DISTRICT PREVIOUSLY.
SO HE HAS THAT EXPERIENCE AND HE
KNOWS OF WHAT HE SPEAKS.
SO I APPRECIATE THAT AND IF
THERE IS LEGISLATION.
YOU'VE GOT YOUR CHAMPION RIGHT
THERE.
YES MISTER BRAZIER THANK YOU MAY
ENTER SO WHEN WE LOOK AT THIS --
AUGMENTATION.
WORKFORCE -- IN THE HEALTH WORLD.
WHEN WE LOOK AT SOME OF THE ID
DEPOPULATION ALSO WITH THE DUAL
DIAGNOSIS IS?
I DON'T SEE ANYTHING IN PREPARE
A PROPOSED PREPARING -- THAT
SPECIAL THE KIND OF AS THE
INDIVIDUALS ID DO YOU ARE VERY
HARD. TO EXAMINE OF IS IT TAKES
A SPECIAL KIND OF INDIVIDUAL
UNDERSTANDS BEHAVIORAL.
ASPECTS OF OF THE INDIVIDUALS.
AND SO I SEE MENTAL HEALTH AND I
SEE SOME OTHER.
SOME OPPORTUNITIES BUT ONE OF
THE THINGS IN I DON'T THINK THIS
IS D. S. AS PER VIEW.
BUT I THINK THE ONE OF THE
THINGS THAT WE'RE NEGLECTING IS
IT WE HAVE THREE HUNDRED THIRTY
THOUSAND INDIVIDUALS WITH ID DE.
AND WE DON'T HAVE A MEDICAL
SPECIALTY SPECIALIST.
THERE WERE PREPARING IN THIS
PIPELINE.
AS A CAREER PATH -- POPULATIONS
GROW 25% IN THE LAST TEN YEARS.
AND IT TAKES A SPECIAL
INDIVIDUAL TO BE ABLE TO WANT TO
NUMBER.
ONE AND NUMBER TWO WILLING TO
TAKE THE ARDUOUS TASK OF
LEARNING HOW IN SEVERAL
DIFFERENT FACETS.
OF ATTENDING TO THESE
INDIVIDUALS SO I WOULD LOVE TO
SEE SOMETHING.
ADDED INTO THIS.
UNDERSTANDING THAT THERE IS A
CRITICAL NEED -- AND I WOULD
APPRECIATE SINCE HILL
[inaudible]
SOME OF WISDOM HERE.
I'M NOT THE ONLY THING I COULD
CHAIR IS NOT IT'S NOT SPECIFIC
LEE WORK FORCE BUT YOU KNOW.
I THINK THAT -- SOLUTIONS
PROTECT POTENTIALLY EXIST ON A
ON A SORT OF SPECTRUM BETWEEN
YOU KNOW SPECIFIC COURSE WORK
FORCE PROGRAM RESIDENCY PROGRAMS
AND SAY THE THE PAYMENT LEVELS
THAT WE PAY IN OUR PUBLIC
PROGRAMS SUCH AS AN MEDI CAL --
RECENTLY THERE WAS ADDITIONAL
FUNDING THAT WAS PROVIDED FROM
PROPOSITION FIFTY SIX IN MEDI
CAL WE'RE MANY INDIVIDUALS WITH
DEVELOPMENTAL THIS DISABILITIES
RECEIVE THEIR SERVICES.
AND THIS WAS SPECIFICALLY TO
ALLOW DENTISTS TO HAVE MORE TIME
WITH INDIVIDUALS WITH
DISABILITIES -- AND THAT WILL
WOULD HOPEFULLY INCENTIVIZE MORE
PROVIDERS -- TO PROVIDE THOSE
SERVICES GET THE TRAININGS
NECESSARY AND THE EXPERIENCE
NECESSARY TO SERVE THAT UNIQUE
COMMUNITY SO -- WHILE THERE
ISN'T ANYTHING SPECIFICALLY IN
THIS YEAR'S BUDGET THERE HAVE
BEEN SOME RELATED AUGMENTATIONS
IN RECENT YEARS THAT COULD GO
SOME WAY IN HELPING THIS.
AND I WOULD SAY THAT.
UNDER UNDERSTANDING TEND TO CAL
WAS WAS PICKED UP TO TO A DEGREE.
NOT SUFFICIENT I MIGHT ADD BUT
IT WAS IT WAS A YOU KNOW LOSS OF
SMALL COMPONENT.
WHEN WE LOOK AT?
THE ADDITIONAL TIME NEEDED IN
MEDI CAL FOR INDIVIDUAL
INDIVIDUALS LADY DI.
WE NEED TO BE ABLE TO BE
COGNIZANT.
THE THING IS I'M SAYING THIS IS
A SPECIALIZED TRAINING THAT WE
NEED TO CREATE WHEN YOU TALK
ABOUT HI PLAINS.
WE HAVE TO IDENTIFY A CAREER
PATH FOR THESE INDIVIDUALS AND
MAKE IT WORTH THEIR WHILE.
SORT OF LIKE WILL BE DONE IN THE
SUPPORT SYSTEM FOR THE ID
POPULATION WE'VE MINIMIZED.
THAT WORK FORCE TO MINIMUM WAGE
[inaudible]
WORKFORCE.
AND SO THAT'S WHAT I'M TRYING TO
SAY IS WE NEED TO LOOK AT THIS
PRO ACTIVELY FOR THE ID
POPULATION AND ALL THESE OTHERS
ARE ADJUSTERS RELATIVE BUT THERE
HAS BEEN A HUGE DISPARITY.
IN LEVEL OF CARE. FOR THE
INDIVIDUALS IDEA I WOULD HOPE
THAT WE LOOK AT THAT WORKFORCE
AUGMENTATION.
OF BECAUSE AS I SAID POPULATIONS
GROWING.
BUT WE'RE NOT DOING ANYTHING
ABOUT IT.
I THINK THAT'S A FAIR COMMENT I
THINK JUST AS MISTER GALLAGHER
SAYING EARLIER ABOUT.
THE RURAL COMMUNITIES ALSO THAT --
WE DON'T HAVE ENOUGH PHYSICIANS
THEIR PRIMARY CARE PHYSICIANS
SOBRE WE HAVE TO LOOK TO THE
INCENTIVES I'M SURE BECAUSE IT
ISN'T SOMETHING WE CAN REGULATE
WE CAN'T SAY WELL WE'RE GOING TO
GIVE YOU INCENTIVE BUT YOU GOT
TO PRACTICE IN THE RURAL
COMMUNITY.
OR YOU'VE GOT TO PRACTICE IN
THIS FIELD SO YOU'RE RIGHT IF IT
TAKES SOMEBODY WITH A PARTICULAR.
HEART DENNIS TO TO WANT TO
PRACTICE IN THAT FIELD -- I I I
DID HAVE A QUESTION FOR CSU.
REPRESENTATIVE.
ALISON NGUYEN I TO LOOK AT MY
LIST HERE.
ALISON -- OFTENTIMES WILL LOOK
TO ONE WE THINK THE THIRD ONE
WHICH WE HERE WE KNOW THERE'S A
SHORTAGE WOULD LOOK TO SEE WHERE
THE PIPELINE IS COMING FROM WE
TALKED ABOUT THE COMMUNITY
COLLEGE.
BUT I WAS LOOKING AT THE HANDOUT
YOU GAVE US.
AND INSIDE THAT WE KNOW THAT
MENTAL HEALTH IS A BIG PROBLEM.
I REALIZE IT'S DIFFERENT TO GET
A BACHELOR'S DEGREE IN
PSYCHOLOGY AND THEN TO BECOME A
CLINICIAN.
BUT WHEN I SEE 800-080-0401
RECEIVING THEIR BACHELOR'S
DEGREE IN PSYCHOLOGY.
JUST SEEMS AT THOSE ARE THE
PEOPLE WE SHOULD LOOK AT IS
THERE A PARTICULAR REASON WHY
THERE ARE ONLY FOUR HUNDRED AND
EIGHTY NINE GETTING A MASTER'S
OR OR BEYOND OR HAVE YOU
CONSIDERED.
AT THE CSU THAT MAYBE THIS IS A
GROUP THAT PERHAPS SHOULD BE
ADDRESSED TO ENCOURAGE THEM TO
GO INTO MENTAL HEALTH -- THE
YEAH THAT'S A GOOD POINT IS
PSYCHOLOGY IS A POPULAR DEGREE.
FOR A VARIETY OF REASONS
STUDENTS ARE.
LOOKING FOR A DEGREE IN THEY
TAKES LIKE ONE A ONE AND THEY
THEY GET EXCITED ABOUT IT.
ON END IT BUT WE DO HAVE A LOT
OF STUDENTS AND A LOT OF
PROGRAMS THAT DEVELOP --
ACTUALLY STRONG RESEARCHERS IN
PSYCHOLOGY -- CAL STATE
NORTHRIDGE HAS A STRONG RESEARCH
BASE PSYCHOLOGY PROGRAMS THAT
SENDS PEOPLE ON FOR PHD USED TO
DO PSYCHOLOGICAL RESEARCH.
BUT YOUR POINT IS WELL TAKEN
THAT WE NEED MORE OF PEOPLE TO
WORK IN THE CSU IN MENTAL HEALTH
AREAS AND THIS WOULD BE AN AREA
THAT'S RIGHT FOR BRING YOUR OWN
STUDENTS.
INTO THESE KINDS OF PROGRAMS SO
THAT'S A THAT'S A GREAT POINT
AND I WOULD IMAGINE MANY OF THEM
ARE THE MINORITY STUDENTS THE
ABSOLUTE OF COLOR.
WHO ARE TRYING TO FIND TO A
DEGREE AND?
IT JUST SEEMS THAT IT.
PROVIDES FOR WHAT WE NEED.
ANY OTHER COMMENTS.
MISTER DOCTOR WOULD AGAIN I
APOLOGIZE THAT I HAD TO STEP OUT
EARLIER BUT I I GUESS -- JUST AT
WORK JUST TO COMMENT WE TALK
ABOUT TALKING ABOUT WORKFORCE
AND I FEEL REALLY STRONGLY ABOUT
THE PIPELINES I THINK THAT'S
REALLY A CRITICAL COMPONENT --
TO THIS -- BUT I ALSO WOULD SAY
THAT THAT -- INCENTIVES -- TO
GET PEOPLE TO COMMUNITIES WHERE
THEY ARE -- NEEDED -- HAVE A
HAVE A HUGE POTENTIAL VALUE AS
WELL -- IT'S YOU CAN'T CAN'T
GUARANTEE THAT PERSON'S GOING TO
STAY -- HOWEVER -- YOU KNOW
BEYOND THE THREE TO FIVE YEARS
BUT I KNEW NO THAT IN -- OUR
EXPERIENCE WITH THE CALIFORNIA
DENTAL ASSOCIATION AND REPAYMENT
PROGRAMS.
THAT -- PEOPLE WHO HAVE GONE
INTO UNDERSERVED AREAS HAVE HAVE
HER STAYING -- WELL BEYOND THEIR
THEIR TIME THERE AND THOSE DOES
IT SO THOSE INCENTIVES DO MAKE A
DIFFERENCE -- YOU KNOW CERTAINLY
I WOULD HAVE LOVED TO HAVE HAD
INCENTIVE LIKE THAT I DIDN'T
HAVE ANY INCENTIVES I JUST FOR
SOMEHOW.
STUMBLED INTO A PLACE THAT
BECAME.
MY MY MY OWN AND I WAS I WAS I
WAS ABLE TO SERVE THAT THAT
COMMUNITY BUT IT WAS -- BUT I DO
BELIEVE THIS AND SAYS CAN MAKE
SUCH A DIFFERENCE IN THE COST OF
EDUCATION IS SO HIGH.
AND I DO BELIEVE THAT ONE OF THE
THINGS THAT -- DRIVES PEOPLE
AWAY FROM PRIMARY CARE IS THE
CAR IS THE COST OF THEIR LOANS
IN THE COST OF YOUR EDUCATION SO.
YOU GET A MUCH BETTER CHANCE OF
PAYING THAT BACK IF YOU'RE A
SPECIALIST -- AND IN THOSE
COUNTRIES THAT HAVE MANY
COUNTRIES HAVE BETTER HOW HEALTH
OUTCOMES THAN WE DO.
THEY HAVE TWICE TWO THIRDS OF
THEIR PARTY PRACTITIONERS ARE
PRIMARY CARE AND ONE THIRD
SPECIALISTS IN OUR COUNTRY WHERE
WHERE ARE LEVEL OF CARE ARE OUR
OUTCOMES ARE NOT NEARLY AS GOOD
I THINK WE'RE SEVENTEENTH IN THE
WORLD.
BUT THAT'S THE NUMBER IS CORRECT --
ROUGHLY IS OR WILL OR WORSE AS
AS SUCH AS DOCTOR HERNANDEZ
POINTING DOWN.
WE'RE JUST THE OPPOSITE TWO
THIRDS OF OUR DOCTOR ARE
PHYSICIANS ARE SPECIALISTS.
AND SO THE EXPANDING THE ABILITY
TO PROVE TO PROVIDE PRIMARY CARE
FOR ALL.
LEVELS OF NEED OUT THERE IS
ABSOLUTELY CRITICAL SO THANK YOU.
IN IT IN CLOSING I I JUST WANTED.
TO RE STATE -- THE FIRST
SENTENCE IN YOUR IN THE FINAL
REPORT.
AT THE STATE DOES NOT HAVE
ENOUGH OF THE RIGHT TYPE OF
HEALTH WORKERS WITH THE RIGHT
SKILLS IN THE RIGHT PLACES TO
MEET THE NEEDS OF OUR STATE TO
GROWING.
AND INCREASINGLY DIVERSE
POPULATION.
THE LAST SENTENCE ON THAT PAGE
OR ONE OF THE LAST SENTENCES.
BOLD ACTIONS ARE NEEDED NOW TO
ENSURE THE STATE'S HEALTH SYSTEM
HAS ENOUGH QUALIFIED WORKERS TO
SUPPORT AND PROVIDE THOSE
SERVICES AND TO BUILD THE HEALTH
WORKFORCE.
THAT ALL CALIFORNIANS NEED AND
DESERVE I SINCERELY APPRECIATE
ALL THE WORK THAT WAS PUT INTO
THIS I LOOK FORWARD TO THE LA
OWES REPORT BECAUSE IN THE END
WE KNOW THERE'S A NEED.
AND WE KNOW THAT WE DON'T WANT
PEOPLE TO SIMPLY GO TO THE
EMERGENCY ROOM BECAUSE THEY
CAN'T FIND A PRIMARY -- PRIMARY
CARE PHYSICIAN -- WE DON'T WANT
THEM TO GO TO THE EMERGENCY ROOM
JUST BECAUSE THEY CAN'T TALK TO
A MENTAL HEALTH PROFESSIONAL WE
NEED TO BE ABLE TO FILL THE
NEEDS.
SO THAT WE CAN.
IN THE END I THINK IT WAS MISTER
OBERNOLTE WHO HAD MENTIONED THAT
IF WE COMPARE THE COST OF TAKING
CARE OF THE NEEDS NOW WE'RE
TAKING CARE.
OF THE NEEDS IT IN THE IN THE
COSTS IN THE EMERGENCY ROOM.
WE'RE BETTER OFF TAKING CARE OF
THE NEED NOW SO THANK YOU FOR
THE TIME AND EFFORT THAT WAS PUT
INTO -- PREPARING THIS REPORT
THANK YOU DOCTOR WOULD FOR YOUR
INPUT AS WELL THANK YOU ALL
THANK THANK YOU.
AND NOW WE'LL GO TO PUBLIC
COMMENT.
I WOULD ASK THAT I WOULD ASK
THAT THOSE OF YOU PROVIDING
PUBLIC COMMENT LIMIT YOUR
COMMENTS TO ONE MINUTE.
PLEASE [inaudible]
THANK YOU. ONE MINUTE EACH.
WE'LL BE STOPPING YOU TEN
SECONDS OF YOU SEE TEN PEOPLE.
GOOD AFTERNOON MY NAME IS PAULA
WELL HOME I AM SPEAKING ON
BEHALF OF THE COUNTY BEHAVIORAL
HEALTH DIRECTORS ASSOCIATION OF
CALIFORNIA AND WE REPRESENT THE
PUBLICLY FUNDED MENTAL HEALTH
AND SUBSTANCE USE DISORDER
TREATMENT PROGRAMS MANAGED OUT
OF THE FIFTY EIGHT COUNTIES --
WE WERE HONORED TO BE PART OF
THE BEHAVIORAL HEALTH
SUBCOMMITTEE THAT ADVISED THE
LARGER COMMISSION ON THE
BEHAVIORAL HEALTH SPECIFIC
STRATEGIES THAT WERE
INCORPORATED INTO THIS REPORT.
WE'RE HERE TO EXPRESS OUR STRONG
SUPPORT -- FOR THIS REPORT IN
ITS FINAL FORM AND THE
BEHAVIORAL HEALTH
RECOMMENDATIONS THERE IN.
WE WERE -- REALLY EXCITED
BECAUSE AS WE'VE TOUCHED ON
TODAY THERE ARE POCKETS OF
BEHAVIORAL HEALTH WORKFORCE
DEVELOPMENT HAPPENING AROUND THE
STATE IN AUST PAD AND THROUGH
THE UNIVERSITIES AND IN OTHER
PLACES.
BUT THIS PLAN IS UNIQUE IN ITS
SCOPE OF LOOKING ACROSS --
DIFFERENT HEALTH CARE SECTORS
BEHAVIORAL HEALTH PRIMARY CARE
CONSIDERING THE ROLES OF MANY
DIFFERENT PARTNERS AND
STAKEHOLDERS -- AND INCLUDING
THIS VERY COMPREHENSIVE SET OF
TWENTY SEVEN RECOMMENDATIONS AND
STRATEGIES THAT ADDRESS MANY
DIFFERENT CHALLENGES FOR THE
BEHAVIORAL HEALTH WORKFORCE AN
INCLUDING RESIDENCY SLOTS FOR
PSYCHIATRISTS AS WELL AS PRIMARY
CARE OUR PSYCHE IN PEAS -- AND
BRINGING DIVERSE CITY INTO THE
BEHAVIORAL HEALTH WORK FORCE
THROUGH THE PIPELINE PROGRAMS
AND BE IT FINANCIAL INCENTIVES
WHICH ARE KEY TO GETTING --
PEOPLE INTO THE DOOR OF THESE
PROFESSIONS WHO CAN TRULY
REPRESENT THE POPULATION THERE
SERVING SO -- IN CLOSING WE
REALLY APPRECIATE YOUR ATTENTION
TO THIS ISSUE IN THE HEARING
TODAY -- WE HOPE THAT AS YOU
PRIORITIZE YOU WILL LOOK AT THAT
BEHAVIORAL HEALTH STRATEGIES
INCLUDED IN THIS REPORT AND WE
LOOK FORWARD TO CONTINUING TO BE
PART OF THE CONVERSATION THANK
YOU.
THANK YOU AND AS YOU CAN SEE OUR
VERY ABLE STUFF IS HOLDING UP A
LITTLE SIGN THAT SAYS TIME.
SO IF YOU SEE THAT THAT MEANS
IT'S BEEN ONE MINUTE AND RATHER
THAN HAVE ME SAY PLEASE WRAP IT
UP.
THANK YOU NEXT NOTED.
I GOOD AFTERNOON MADAM CHAIR
MEMBERS MEGAN ON ALL RIGHT ON
BEHALF OF THE CALIFORNIA MEDICAL
ASSOCIATION.
JUST WANTED TO KNOW THE WORKS
CITED THAT DH CS WAS ABLE TO
TURN AROUND THE ONE TIME HUNDRED
NINETY MILLION FUNDING SO
QUICKLY. FOR THE LOAN REPAYMENT
PROGRAM THAT'S GOING TO PROVIDE
CRITICAL RESOURCES TO
UNDERSERVED AREAS.
AND UNDERSERVED POPULATIONS AND
WHEN COMBINED WITH THE NEW
FUNDING GOING OUT TO PRIMARY
CARE RESIDENCY PROGRAMS.
THERE'S GONNA BE A SIGNIFICANT
ACT IMPACT.
IN PATIENT ACCESS TO PHYSICIANS
ESPECIALLY IN RURAL AND
UNDERSERVED AREAS AND WE
APPRECIATE ALL THE WORK YOU'RE
DOING [inaudible]
THANK YOU.
GOOD AFTERNOON ADRIN SULTAN WITH
THE STEINBERG INSTITUTE WANT TO
THANK BOTH COMMITTEES TODAY FOR
HOLDING SUCH AN IMPORTANT
HEARING.
ON THE STEINBERG INSTITUTE WAS
INVOLVED WITH THE WORKFORCE
COMMISSION SPECIFICALLY THE
TECHNICAL ASSISTANCE ADVISORY
COMMITTEE.
AND THE BEHAVIORAL HEALTH
WORKFORCE AND WE'RE SEEKING TO
ADVANCE THE NUMBER OF THE
RECOMMENDATIONS -- THE CAME FROM
THE COMMISSION INCLUDING PIER
PROVIDER CERTIFICATION
MAXIMIZING THE ROLE OF NURSE
PRACTITIONERS AND PSYCHIATRIC
WORKFORCE EXPANSION --
CONSIDERING HOW MANY
CALIFORNIANS ARE AFFECTED BY
MENTAL ILLNESS IT REALLY
UNDERSCORES THE NEED TO THINK
ABOUT THE CAPACITY THAT WE
HAVEN'T BEHAVIORAL HEALTH AND SO
THANK YOU AGAIN. FOR YOUR
ATTENTION TO THESE ISSUES
[inaudible]
THANK YOU.
BARBER GLAZER WITH THE
CALIFORNIA HOSPITAL ASSOCIATION
I WANT TO THANK THE
SUBCOMMITTEES FOR TAKING THE
TIME TO TELL HOLD THIS HEARING
TODAY.
CH A WAS ALSO FORTUNATE ENOUGH
TO BE PART OF THE TECHNICAL
ADVISORY COMMITTEE AND WE
SUPPORT ALL OF THESE
RECOMMENDATIONS THERE ARE TWO IN
PARTICULAR WE'D LIKE TO POINT
OUT.
AND THAT IS THE RECOMMENDATION
TO SUSTAIN AND EXPAND THE PRIME
PROGRAM AS WELL AS THE
RECOMMENDATION TO DEVELOP A
PSYCHIATRIC NURSE PRACTITIONER
PROGRAM THAT RECRUITS.
RECRUITS FROM TRAINS PROVIDERS
TO SERVE AN UNDERSERVED AREAS
BOTH OF THESE WILL PROVIDE MORE
PRACTITIONERS IN BEHAVIORAL
HEALTH WHICH IS SORELY NEEDED.
ALSO I'D LIKE TO POINT OUT THAT
PERHAPS PROP FIFTY FIVE COULD BE
A SOURCE OF FUNDING ON THIS MAY
BE A WAY TO GET SOMEONE TIME
FUNDING FOR SOME OF THESE
PROGRAMS THANK YOU SO MUCH
[inaudible]
THANK YOU.
GOOD AFTERNOON DANIEL MAILLET
WITH THE CALIFORNIA LINES OF
CHILD AND FAMILY SERVICES I
WANNA THANK YOU FOR YOUR TIME
THIS AFTERNOON OUR MEMBERS
PROVIDE COMMUNITY BASED MENTAL
HEALTH SERVICES TO CHILDREN
YOUTH AND THEIR FAMILIES.
OUR MEMBERS ARE STRUGGLING WITH
A CRITICAL SHORTAGE IN CHILD
PSYCHIATRIST SO WE STRONGLY
SUPPORT ON THE PIPELINE PROGRAMS
FOR PSYCHIATRIC PROGRAMS FOR UP
YOUR CERTIFICATION AS WELL AS
THE PSYCHIATRIC NURSE
PRACTITIONERS.
WE BELIEVE THAT IT'S CRITICAL TO
HAVE ALL THREE OF THOSE
DIFFERENT COMPONENTS IN ORDER TO
ADEQUATELY SERVE OUR COMMUNITIES
[inaudible]
THANK YOU.
HELEN ROTH DELTON SEIU LOCAL ONE
THOUSAND STATE WORKERS WE HAVE
DONE A SUCCESSFUL PROGRAM TO
TURN ALL THE INSTANT TO OUR ENDS.
THROUGH THE APPRENTICESHIP THE
INNOVATION APPRENTICESHIP GRANTS
WITH THE COMMUNITY COLLEGES AND
WE WOULD LIKE TO SEE THIS NOW
DONE WITH THE C. AS HE IS IN THE
UC'S.
AS WE MOVE UP AND WE NEED THE
SAME SORT OF FUN -- SUPPORT
WHERE IN THIS CASE WE TOOK LPNS
AND IN FACT ALMOST FIFTY OF THEM
AND STOCKTON.
THEY WENT FROM MAKING FORTY FIVE
THOUSAND DOLLARS A YEAR TO
NINETY THREE THOUSAND DOLLARS A
YEAR WE NOW HAVE ONLY ONE HASN'T
PASSED THE TEST WE HAVE ALMOST
FIFTEEN MILLION MEN THAT.
ARE ENDS ADDING OVER TWO POINT
TWO MILLION DOLLARS TO THE
STOCKTON ECONOMY AND MANY WOMEN
AND THESE ARE MAINLY WOMEN
MIORITIES NEW IMMIGRANTS WHO
HAVE COME AND WITH DIVERSE
SKILLS TO SERVE A DIVERSE
POPULATION.
WITH OUR PARTNERS THE DEPARTMENT
OF CORRECTIONS AND WE WOULD
SUGGEST THE SAME MODEL BE
REPLICATED PARTICULARLY WITH
MENTAL HEALTH.
OVER ON THE CSU WHERE YOU COULD
TAKE YOUR PSYCHOLOGY STUDENTS IN
OUR CASE WE HAVE A TWENTY TWENTY
PROGRAM WHERE THE STATE PAYS
FORTY HOURS OF WORK THEY GO TO
SCHOOL TWENTY HOURS.
AND THEN THEY WORK. TWENTY HOURS
AND IT'S BEEN VERY SUCCESSFUL
AND WE THINK THESE ARE THE SORT
OF UNLOCK LEARN PROGRAMS THAT WE
NEED TO MAKE ENSURE PARTICULARLY
OUR POPULATION THAT CAN'T AFFORD
TO GO TO SCHOOL FULL TIME.
WE COULD PARTICULARLY IN
PSYCHOLOGY IN THOSE AREAS WE WE
CAN TURN THEM INTO AND WE CAN
HAVE THEM WORKING.
HELP OUR WORK FORCE AND WE COULD
TURN THEM INTO NEW -- NEWLY
MINTED PSYCHOLOGY AND OTHER SORT
OF PROFESSIONS THANK YOU.
THANK YOU SO MUCH AND I I WOULD
LOOK AT BE SURE YOU PROVIDE THE
INFORMATION I WOULD LIKE FOR YOU
TO ALSO TAKE THAT SAME PROGRAM
DECEMBER TO DO YOU KNOW I THINK.
IF IT YOU HAVE BEEN THIS
SUCCESSFUL.
THERE WITHOUT A DOUBT YOU NEED
TO BE THROUGHOUT CALIFORNIA WE
JUST GOT ANOTHER GRANT TO DO ONE
WITH RIVERSIDE SO WE'RE GOING
INTERNET SITE I THINK I'M GONNA
DENY ONE HOUR AND LET YOU KNOW
AND WE'RE DOING KERN COUNTY.
AND THEN YOU BUT WILL TRY I WILL
TRY SAN BERNADINO FOR OUR NEXT
ONE I I WILL TELL YOU THAT
ASSEMBLY MEMBER WHO SOME OF THE
NOSE HERE EARLIER HE'LL BE VERY
HAPPY TO HEAR THAT BUT I'M NOT
HAPPY.
NEITHER IS MR OBERNOLTE NEW
THERE'S MISTER RAMOS
[inaudible]
THANK YOU.
ALL RIGHT THANK YOU.
AFTERNOON MY NAME IS MICHELLE
GIVEN THEM WITH THE COUNTY
HEALTH EXECUTIVES ASSOCIATION OF
CALIFORNIA WE REPRESENT LOCAL
HEALTH DEPARTMENTS THROUGHOUT
THE STATE PRIMARILY AROUND
PUBLIC HEALTH ISSUES AND SO WE
APPRECIATE THE COMMISSION'S
MENTION OF THE PUBLIC HEALTH
WORKFORCE.
I'M IN THE REPORT AND WE WOULD
JUST ENCOURAGE -- CONTINUED DOT
AND INVESTMENTS INTO THE PUBLIC
HEALTH WORKFORCE WE HAVE A
HIGHLY SPECIALIZED WORK FORCE
THAT OFTEN REQUIRES AN ADVANCED
LEVEL CERTIFICATE OR DEGREE AND
I'LL GIVE YOU AN EXAMPLE.
FOR PUBLIC HEALTH NURSES AT
THEIR REGISTERED NURSES THAT
HAVE TO GO ABOVE AND BEYOND AND
GET A CERTIFICATE BEYOND THAT
AND YET THEY WORK IN SETTINGS
WHERE THEY HAVE A LOWER LEVEL OF
PAY AND OFTEN ARE COMPETING WITH.
OTHER SETTING SUCH AS THE
HOSPITALS AND SO FORTH AND SO ON
IN ADDITION TO THE PUBLIC HEALTH
NURSES WE HAVE EPIDEMIOLOGIST
THESE INVESTIGATORS --
PROFESSIONAL PUBLIC HEALTH LAB
PROFESSIONALS WHO REALLY DO --
IDENTIFY AND TARGET DISEASE
OUTBREAKS AND KEEP OUR
COMMUNITIES HEALTHY AND STRONG
AND WE WOULD AGAIN JUST
ENCOURAGE AS SOME CONVERSATION
AROUND HOW WE CAN HAVE
INVESTMENTS INTO THAT WORK FORCE
TO MAKE SURE THAT OUR OUR
COMMUNITIES ARE PROTECTED.
THANK YOU [inaudible]
THANK YOU.
THANK YOU TEARS IN MEMBERS MY
NAME IS CHRISTINA HEX I'M WITH
THE CALIFORNIA PRIMARY CARE
ASSOCIATION WE REPRESENT THAT
THEIR OVER THIRTEEN HUNDRED
COMMUNITY CLINICS AND HEALTH
CENTERS ACROSS CALIFORNIA.
PROVIDING HIGH QUALITY CARE FOR
NEARLY SIX POINT NINE MILLION
LOW INCOME UNINSURED AND UNDER
SERVE CALIFORNIANS IN THE STATE.
THE RECOMMENDATIONS PUT FORTH BY
THE COMMISSION REFLECT THE
INTRICACIES SURROUNDING
CALIFORNIA'S WORKFORCE CRISIS
AND WE'RE PLEASED TO SEE THAT
MANY IDENTIFY COMMUNITY HEALTH
CENTERS AS AND TRICKLE PLAYERS
THAN THE PROPOSED WORKFORCE
SOLUTIONS.
GIVEN THE COMPLEXITY OF THE WORK
FORCE CRISIS WERE PARTICULARLY
PLEASED TO SEE TWO
RECOMMENDATIONS AROUND THE HOME
TOWN SCHOLARS PROGRAM SO AGAIN
GROWING OUR OWN.
AND EXPANDING NUMBER A PRIMARY
CARE PHYSICIAN RESIDENCIES IN
THE STATE.
WE WOULD LIKE TO THANK THE
CALIFORNIA AT THE FUTURE HEALTH
WORKFORCE COMMISSION FOR THEIR
TIRELESS WORK ON DEVELOPING
THESE RECOMMENDATIONS AND WE
THANK YOU FOR YOUR TIME TODAY.
AND TALKING ABOUT THESE
IMPORTANT ISSUES THANKS
[inaudible]
THANK YOU.
HELLO CURTIS THANK THE
CALIFORNIA NURSES ASSOCIATION
THANK YOU FOR THIS OPPORTUNITY
TO SPEAK ON BEHALF OF THE
HUNDRED THOUSAND NURSES ACROSS
THE STATE.
WE VERY MUCH APPRECIATE THE
OPPORTUNITY TO COMMENT ON THE
COMMISSION'S FINAL REPORT.
WE ALSO DONE.
HOWEVER WE DO HAVE CONCERNS
ABOUT RECOMMENDATION THREE POINT
TWO WHICH PROPOSES TO ESTABLISH --
IN A SCALE A UNIVERSAL HOME CARE
WORKER FAMILY OF JOBS WITH
CAREER LADDERS AN ASSOCIATE
TRAINING.
CNA IS CONCERNED THIS PROPOSAL
WILL INADVERTENTLY LOWERED THE
STANDARD CARE FOR THOSE CLIENTS
AND PATIENTS WHO ACTUALLY
REQUIRE ARE IN OVERSIGHT IN THE
HOME SETTING AND INCREASED COSTS
FOR THOSE WHO DO NOT REQUIRE.
THE PERMANENT PROFESSIONAL
SERVICES OF AN ARE IN.
OF SECONDS -- I WOULD ALSO LIKE
TO QUICKLY COMMENT ON A
RECOMMENDATION TWO POINT.
EIGHT WHICH CONTAINS A
RECOMMENDATION TO EXPLORE THE
NEED FOR AN OPTION FOR
INCREASING PRODUCTION A BACHELOR
OF SCIENCE IN NURSING PROGRAMS
ARE GRADUATES.
FIRST IT IS IMPORTANT TO NOTE
THAT RESEARCH HAS DEMONSTRATED
THAT VERY FEW EMPLOYERS ACTUALLY
REQUIRE -- NURSES TO BBS IN
TRAINED.
ARE ALSO SECOND WE SEE IN A
BELIEVE STRONGLY THE THAT THE A
PUBLIC ASSOCIATE DEGREE ADN
PROGRAM ARE CENTRAL TO MAINTAIN
IT I DIVERSE SANDRA A DIVERSE
ARE IN WORKFORCE.
THANK YOU.
THANK YOU AND I THINK THAT
THAT'S A VERY IMPORTANT POINT
THAT YOU MENTION.
ON POINT THREE POINT. TWO TO
CONSIDER OUR NURSES AND TO MAKE
SURE THAT THERE IS THAT BALANCE
SO WE'RE NOT -- STEPPING ON THE
TOES OF OUR NURSES WHO PROVIDE A
VERY IMPORTANT SERVICE TO THE TO
THE PATIENTS THANK YOU FOR
BRINGING THAT UP.
MADAM CHAIR MEMBERS OF THE
COMMITTEE HOLE IN MY SHOWER
BEHALF OF THE CALIFORNIA
ASSOCIATION OF ALCOHOL AND DRUG
PROGRAM EXECUTIVES.
WHERE THE STATE ASSOCIATION OF
OF COMMUNITY BASED -- NONPROFIT
SUBSTANCE USE TREATMENT PROGRAMS
ACROSS THE STATE THAT ACTUALLY
TREAT PEOPLE WHO ARE PUBLICLY
SUBSIDIZED TREATMENT PROGRAMS.
I'M WOULD ONE LIKE TO SUPPORT
THE RECOMMENDATION OF THE
COMMISSION REGARDING THE PEER
SUPPORT AND NAVIGATORS -- AN
IMPORTANT PART OF THE SUBSTANCE
USE TREATMENT.
OUT WORKFORCE.
HOWEVER WE DO WANT TO ALSO
ACKNOWLEDGE THE FACT THAT AND
BRING TO THE COMMITTEE'S
ATTENTION THE CRITICAL SHORTAGE
IN OUR THE WORKFORCE OF
SUBSTANCE USE DISORDER
PROFESSIONALS AND ARE.
WOULD ASK THE COMMITTEE TO ALSO
INCLUDE THAT IN THE BEHAVIORAL
HEALTH.
OF OF PROVISIONS AND THE THE
PLANNING THAT GOES ON THANK YOU
[inaudible]
THANK YOU.
MADAM CHAIR RENTAL HAGER FOR THE
CALIFORNIA PSYCHIATRIC
ASSOCIATION ONE OF THE THANK THE
COMMITTEE ON THE COMMISSION FOR
SHINING.
SUCH A BRIGHT LIGHT ON WHAT WE
KNOW ARE REALLY CRITICAL ISSUES
OUT THERE IN THE COMMUNITY WE
ARE WE JUST WANTED TO HIGHLIGHT
THE FACT THAT WE WILL BE -- YOU
WILL SOON SEE A PROPOSAL FROM US%
ABOUT TRAINING UP OUR PRIMARY
CARE -- COLLEAGUES -- OF SKY
ACTRESS A TRAINING PRIMARY CARE
PHYSICIANS AS WE SPEAK IN ONE
YEAR FELLOWSHIPS IN ANOTHER
SETTINGS AND WE BELIEVE THAT
THAT'S A PART OF A SOLUTION THAT
DOES ANY CONSIDERATION GOING
FORWARD THANK YOU.
THANK YOU WHAT I WANT TO THANK
ALL OF YOU FOR THE THE PANELISTS
WHO PRESENTED TESTIMONY MY
COLLEAGUES FOR THE VERY.
THOUGHTFUL QUESTIONS -- ADDED TO
THE PUBLIC THANK YOU FOR YOUR
COMMENTS.
THIS CONCLUDES THIS JOINT.
HEARING [inaudible]
RIGHT [inaudible]
YEAH.
I HAVE NO ONE TOLD ME THAT THERE.
WE WILL BE STARTING SUB ONE IN
FIVE MINUTES