AHEAD AND GET STARTED THIS
AFTERNOON.
WELCOME TO THE COMMITTEE ON
HEALTH.
I HAVE A COUPLE OF ANNOUNCEMENTS
AND THEN WE'LL GO AHEAD WITH OUR
OUR BILLS.
A FIRST OF ALL -- JUST JUST FOR
WITNESSES -- WE WILL HEAR TWO
WITNESSES PER SIDE WITH A TIME
LIMIT OF THREE MINUTES EACH.
ADDITIONAL WITNESSES WILL BE
ASKED TO STATE ONLY THEIR NAME
AND THE ORGANIZATION AND YOUR
POSITION ON THE MEASURE.
OF FOR THOSE OF A YOU HAVE A
POSITION SOMEWHERE BETWEEN
SUPPORT AND OPPOSE OR THOSE WHO
HAVE NO POSITION.
BECAUSE OF THE LENGTH OF A JANET
WOULD PLEASE GIVE YOUR NAME
ORGANIZATION IN A VERY VERY
BRIEF EXPLANATION OF YOUR
POSITION -- CONSENT WE HAVE A
CONSENT CALENDAR ITEMS ITEMS
TODAY.
THE FOLLOWING THOSE ARE PROPOSED
FOR CONSENT.
ITEM NUMBER TWO AB TWO FOURTEEN
BY MR MULLIN.
ITEM NUMBER SEVEN AB SIX
NINETEEN BY MISTER CHIU.
ITEM NUMBER FOURTEEN AB SEVEN
EIGHTY ONE BY MR MAIENSCHEIN
WITH AMENDMENTS.
AB AND ITEM NUMBER SEVENTEEN AB
NINETY EIGHT NINETY NINE WOULD.
AND EIGHT ITEM NUMBER EIGHTEEN
A. B. NINE SIXTEEN MURATSUCHI.
ITEM NUMBER ONE AB FIFTY BY
MISTER KALRA HAS BEEN REMOVED
FROM TODAY'S CALENDAR --
ASSEMBLY MEMBER CHAO IS CHAIRING --
I'M SO THOSE OF THEIR MIND I'M
SORRY.
JUST SO EVERYBODY KNOWS AGAINST
MR CHAO WILL BE A LITTLE LATE
TODAY BUT HE'S HEARING ANOTHER
COME COMMITTEE SO -- HE'S
SUPPOSED TO BE OUR FIRST AUTHOR
UP.
SO THAT MEANS THAT.
WE HAVE MISTER TING THANK YOU
SIR PLEASE COME FORWARD.
ASSERTING YOUR PRESENT IN AB.
FIVE TWELVE THANK YOU MISTER
CHAIR JUST VERY QUICKLY AS YOU
KNOW THE AFFORDABLE CARE ACT
REQUIRES ALL HEALTH PLANS. TO
PROVIDE MENTAL HEALTH CARE FOR
THEIR MEMBERS.
WELL WE'VE HAD GREAT GAINS WE
UNFORTUNATELY.
HAVEN'T SEEN AS MUCH SUCCESS
WITH COMMUNITIES OF COLOR AND
OTHER MARGINALIZED COMMUNITIES.
THIS BILL EXPANDS INFORMATION
COLLECTED REPORTED AND THEN
UTILIZING CULTURAL CULTURAL
COMPETENCY PLANS FOR COUNTY
MENTAL HEALTH CARE PROGRAMS.
IN ADDITION TO CREATE A LOCAL
COUNTY COMMITTEE FOR COMMUNITIES
TO ENGAGE IN GIVE THEIR INPUT ON
HOW TO IMPROVE.
ACCESS.
I GOT. TWO WITNESSES WHO JUST
GIVE YOU A COUPLE OF EXAMPLES
ONE IS OUR AMANDA WALLER WHO
STRUCTURE THE LGBT Q. HEALTH AND
HUMAN SERVICES NETWORK.
AS WELL AS YA SHOWN WHOSE
DIRECTOR WAS THE ASSISTANT
DIRECTOR OF THE MANGA CULTURAL
CENTER OF BUTTE COUNTY AND THEY
CAN SHARE WITH YOU JUST A COUPLE
OF EXAMPLES -- TO AS TO WHY
WE'RE PUSHING THE BILL THANK YOU
THANK YOU PLEASE GO AHEAD.
HI THERE A GOOD AFTERNOON MY
NAME IS AMANDA MCALLISTER WONDER
AND THE DIRECTOR OF THE
CALIFORNIA LGBT Q. HEALTH AND
HUMAN SERVICES NETWORK.
AND THE CO DIRECTOR OF THE OUT
FOR MENTAL HEALTH PROJECT WHICH
IS -- I SEE WHERE PROJECT THAT
HAS MEDICAL SERVICES ACT FUNDING --
TO DO OUTREACH EDUCATION AND
ADVOCACY -- TO REDUCE LGBT Q.
MENTAL HEALTH DISPARITIES
THROUGHOUT THE STATE AND THROUGH
THAT PROJECT WE'VE HAD THE
OPPORTUNITY TO WORK WITH -- LGBT
Q. COMMUNITY BASED ORGANIZATIONS
AND MENTAL HEALTH CONSUMERS --
THROUGH THROUGHOUT CALIFORNIA IN
A NUMBER OF COUNTIES -- TO TRAIN
THEM ON HOW TO ENGAGE IN.
THEIR CULTURAL COMPETENCY
PLANNING PROCESS SEES -- AND HOW
TO ENGAGE AND MENTAL HEALTH
DECISION MAKING AT THE COUNTY
LEVEL AND WHAT WE REALIZED --
THROUGH THIS PROJECT IS THAT IS
HOW -- HOW LOW THE LEVEL OF
ENGAGEMENT FOR LGBTQ COMMUNITIES
WAS -- BEFORE WE STARTED WORKING
ON IT -- WE HEARD FROM WE'VE
HEARD FROM A NUMBER OF OUR
COMMUNITY MEMBERS AND PARTNERS --
YOU KNOW ABOUT PLANS THAT WERE
THAT THEY NEVER HEARD ABOUT
UNTIL THEY WERE BROUGHT TO THE
STATE LEVEL FOR APPROVAL --
WE'VE HEARD ABOUT AND COUNTIES
THAT WENT OUT AND BROUGHT --
FULLY FORMED PROPOSALS TO
COMMUNITY MEMBERS AND SAID DO
YOU LIKE THIS YES OKAY GREAT
WE'RE GOING TO DO THAT -- YOU
KNOW THEY'RE THERE WE'VE HEARD
OF JUST A NUMBER OF COUNTIES
WHERE THERE WASN'T -- MEANING
FULL ENGAGEMENT AND STAKEHOLDER
INVOLVEMENT FROM THE BEGINNING --
AND WERE THEY WEREN'T REALLY --
CALLING FROM THE COMMUNITY TO
GENERATE IDEAS TO IDENTIFY --
DISPARITIES AND MENTAL HEALTH
NEEDS -- IN A WAY THAT I THINK
WOULD REALLY THAT THIS BILL
WOULD REALLY ADDRESS AND MOVE
THE BALL FORWARD.
ON ON ADDRESSING MENTAL HEALTH
DISPARITIES.
AT THE COUNTY LEVEL -- IN ON
REALLY MEASURING HOW SUCCESSFUL
COUNTIES ARE AT AT MEETING THOSE
GOALS -- FOR FOR REDUCING AND
ELIMINATING MENTAL HEALTH
DISPARITIES I'M FOR COMMUNITIES
I WE KNOW THAT A NUMBER OF
COUNTIES ARE CURRENTLY DOING
THIS WHILE -- WE KNOW THERE ARE
MODELS OUT THERE -- IN LOS
ANGELES AND FRESNO IN SANTA
CLARA COUNTY WE KNOW THAT THIS
IS POSSIBLE AND WE BELIEVE THAT
AB -- FIVE TWELVE WILL TAKE A
BIG STEP IN THE RIGHT DIRECTION
TO SPREAD THOSE THOSE BEST
PRACTICES TO COUNTIES THROUGHOUT
THE STATE AND MAKE SURE THAT OUR
COMMUNITIES ARE ABLE -- TO TO
GET QUALITY -- AND AFFIRMING
MENTAL HEALTH CARE REGARDLESS OF
WHAT CALIFORNIA PART OF
CALIFORNIA THEY'RE LIVING IN.
THANK YOU.
YOUR NEXT NEXT WITNESS
[inaudible]
PLEASE.
I HAVE A GOOD AFTERNOON ASSEMBLY
MEMBER WOULDN'T OTHER
DISTINGUISHED MEMBERS OF THE
COMMITTEE I MEAN AS LONG --
TESTIFYING ON BEHALF OF THE MALL
CULTURE CENTER IF YOU COUNTY
IT'S THE CBC I'M HERE TODAY IN
SUPPORT OF ASSEMBLY BILL FIVE
TWELVE CULTURAL COMPETENCE IN
MENTAL HEALTH -- ACC BC SERVES
OVER.
FIVE THOUSAND INDIVIDUALS OF THE
SOUTHEAST ASIAN AMERICAN THE C.
COMMUNITY IN BIãU COUNTY --
THROUGH CULTURALLY RELEVANT
MATTEL SIR JUDGE SUCH **** OSHA
MONTAUK POINT AND FROM TAURUS
PROGRAMS THROUGH THE REDUCING.
THEIR THE CALIFORNIA REDUCING
DISPARITIES PROJECTS HERE D. P..
R. EIGHTY CBC HAS BEEN ABLE TO
TEST OUR COMMUNITY TO FIND
PRACTICES INTO EVIDENCE BASED
PRACTICES TAILOR TAILORED
ESPECIALLY FOR THEM ON COMMUNITY.
AS REFUGEES OF WAR THE C.
COMMUNITIES.
EXPERIENCE HIGH LEVELS OF MENTAL
HEALTH CONDITIONS A STUDY IN
TWENTY TO ENSURE THAT THE BALL
COMMUNITY IS THAT.
AS AT LEAST TWICE AS LIKELY TO
EXPERIENCE MAJOR.
DEPRESSION PTSD AND OTHER
ANXIETY DISORDERS -- MANY AMONG
OTHERS ARE STILL LIVING WITH THE
WAR THAT HAS NEVER ENDED IN
THEIR MINDS HOWEVER.
MANY OF THESE MENTAL CONDITIONS
REMAIN UNADDRESSED DUE TO LACK
OF CULTURALLY AND LINGUISTICALLY
COMPETENT MENTAL HEALTH SERVICES
AVAILABLE I EIGHTY CBC HAS
PARTICIPATED IN THE COUNTIES
CULTURAL COMPETENCE COMMITTEE
FOR MANY YEARS TO INCREASE
CULTURALLY COMPETENT.
AND RELEVANT TO HEALTH SERVICES
THROUGH DATA COLLECTION FOCUS
GROUPS AND SURVEYS UNFORTUNATELY
THESE ENGAGEMENTS HAVE YET TO
CREATE CONCRETE STRATEGIES TO
ADDRESS MENTAL HEALTH FOR THEM
ON COMMUNITY DUE TO THE LACK OF
OVERSIGHT THE CULTURE COMPASS
COMMITTEE HAS REGARDING.
THE COUNTIES CULTURAL COMPETENCE
PLAN ARMONK BUILDERS HAVE
EXPRESSED THEIR GRATITUDE OF
BEING A REGULAR PURCHASE MY
INITIAL SHARE PROGRAM MISSED HOW
A MONOLINGUAL.
OLDER ATTENDS OUR RECREATIONAL
GROUP QUICKLY BECAUSE WE ARE
ABLE TO SUPPORT HER WITH
CULTURALLY APPROPRIATE MENTAL
HEALTH COUNSELING REDUCE
ISOLATION AND INCREASE OUR
MENTAL WELLBEING.
SHE HAS TOLD US NUMEROUS TIMES
THAT WITHOUT A TO C. B. C. SHE
WOULD NOT.
BE THE PERSON SHE IS TODAY AND I
QUOTE I DO NOT KNOW HOW TO DRIVE
IN IT MAKES ME WORRIED THAT I
WILL NOT MAKE IT TO MY
APPOINTMENTS BECAUSE I HAVE NO
ONE TO TAKE ME.
I WAS SO WORRIED INTERESTS AND
SLEEPLESS.
BECAUSE I MEAN NOT BECOME A
CITIZEN I AM SO HAPPY THAT YOU
YOUNG LADIES HAVE HELPED ME
BECOME A CITIZEN NOW I AM VERY
THANKFUL FOR ALL THE HELP AND
SUPPORT AND QUOTE.
I THINK ABOUT WHAT WOULD HAPPEN
TO OUR COMMUNITY.
IF A CCBC WASN'T FUNDED BY
THIRTY P. AND HOW MANY OTHER
FONG AND SEE COMMUNITY ME AT MY
COMMUNITY MEMBERS REMAIN
UNDIAGNOSED UNTREATED AND
ENDANGERING THEIR LIVES LIVING
OF PTSD BECAUSE OF THE LACK OF
CULTURALLY AND LINGUISTICALLY
COMPETENT MENTAL HEALTH SERVICES --
AB FIVE TWELVE IMPROVES A
CULTURE CONTENTS OF COUNTY
MENTAL HEALTH PLANS MAKING
MENTAL HEALTH SERVICES MORE
ACCESSIBLE FOR THE MONTH
COMMUNITY TO ACCESS LIFESAVING
CARE AND FINALLY HEALTH AND THE
WARD THAT THEY LIVE THEY RELIVE
EVERY DAY THANK YOU FOR YOUR
ATTENTION TO THISIMPORTANT
ISSUE AND YOUR COMMITMENT. TO
THE MENTAL HEALTH OF ALL
CALIFORNIA RESIDENTS -- I URGE
YOUR SUPPORT AB.
FIVE TWELVE THANK YOU VERY MUCH
TWO OTHERS IN SUPPORT.
ON THE MEASURE.
AND I THINK HEALTH NETWORK THANK
YOU OTHERS IS FOR GOOD AFTERNOON
ADRIN SULTAN WITH THE STEINBERG
AND CITY ALSO APPROACH A PROUD
CO SPONSOR OF THIS MEASURE THANK
YOU.
THANK YOU.
HI WE NEED TO PUT A WALL FROM
EQUALITY CALIFORNIA WE SUPPORT
THIS BILL THANK YOU VERY MUCH.
STACY HERE A MODEL WITH RAM
CALLED THE RACIAL AND ETHNIC
MENTAL HEALTH DISPARITIES
COALITION WE REALLY WANT TO
THANK THE AUTHOR AND THE
SPONSORS WE DID A STUDY ON THE
COUNTY CULTURAL COMPETENCE PLAN
SEVERAL YEARS AGO AND THIS BILL
IS REALLY GOING TO HELP THE
PROCESS THANK YOU.
THANK YOU SO JUST NAME AN
ORGANIZATION PLEASE THANK YOU
REBECCA GONZALEZ NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER IN SUPPORT
THANK YOU.
GEN FLOOR ON BEHALF OF WESTERN
CENTER ON LAW AND POVERTY IN
SUPPORT THANK YOU.
ERIC HERS WITH DISABILITY RIGHTS
CALIFORNIANS SUPPORT THANK YOU.
AB HERE AMERICA'S WHITLEY LATINO
COALITION FOR A HEALTHY
CALIFORNIA ALSO A CO SPONSOR WE
STRONGLY SUPPORT THIS BILL THANK
YOU.
WHAT IS A YEAH LE DIRECTOR
MAKOTO CENTER WILL ALSO SUPPORT
THE BILL?
THANK YOU.
G. A. N. ALSO FROM ALL QUARTERS
CENTER -- WE SUPPORT BILL
SUPPORT.
THANK YOU VERY MUCH.
IS THERE ANYONE IN OPPOSITION.
SEE NOEL BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS FROM THE
COMMITTEE.
AND SO -- FIRST OFF THANK YOU
THANK YOU VERY MUCH -- FOR BRING
THE BILL FOR MR TANG -- THAT
DOES ENJOY DO PASS
RECOMMENDATION FORCING WE ARE
SHORT OF A QUORUM SO WE WILL
HAVE A QUORUM WILL BE ABLE TO
TAKE THAT ITEM UP THANK YOU TO
YOUR WITNESSES WOULD YOU LIKE TO
CLOSE.
A BY THE WAY HAVE USE ACCEPTED
OUR AMENDMENTS YES ABSOLUTELY
THANK FIFTY MINUTES AND JUST A
RESPECTFULLY ASK PRIVATE
THINKING MUCH.
THANK YOU VERY MUCH THANK YOU TO
EVERYONE THANKS.
THE NEXT STEP WOULD BE MISTER
MAIENSCHEIN.
ASSEMBLY BILL.
FIVE SIXTY FIVE THANK YOU VERY
MUCH -- MISTER CHAIR
[inaudible]
AND MEMBERS.
BEFORE I BEGIN I WILL BE
ACCEPTING THE AMENDMENTS
DESCRIBED IN THE ANALYSIS THE
SHORTAGE OF PSYCHIATRISTS IN THE
UNITED STATES HAS REACHED CRISIS
LEVELS.
AND CALIFORNIA'S SUFFERING THE
FALLOUT THE NATIONAL COUNCIL FOR
BAY POR EL HEALTH -- IN ITS
TWENTY SEVENTEEN REPORT
PROJECTED DEMAND FOR PSYCHIATRY
WOULD OUTSTRIP SERVICES BY 25%
AND TWENTY TWENTY FIVE AS IT NOW
STANDS 55% OF COUNTIES IN THE
UNITED STATES HAVE NO
PSYCHIATRISTS AND 77%.
HAVE A SEVERE SHORTAGE THE
SHORTAGE HAS CREATED CRITICAL
WEAKNESSES IN OUR PUBLIC MENTAL
HEALTH CARE DELIVERY SYSTEM THE
COUNTIES ARE STRUGGLING TO PATCH
BY EXPANDING THE ROLES OF OTHER
CATEGORIES OF WORKERS.
HOWEVER A LASTING SOLUTION
REQUIRES A MORE SUBSTANTIVE
FACTS THAT REVITALIZES THE FIELD
IT MUST INCLUDE A POWERFUL
INCENTIVE TO STEER PROMISING
STUDENTS INTO CAREERS AND
COMMUNITY PSYCHIATRY.
INSURING OUR MOST VULNERABLE
RESIDENTS HAVE ACCESS TO QUALITY
PSYCHIATRIC CARE.
AB FIVE SIXTY FIVE ADDRESSES THE
PSYCHIATRIC SHORTAGE BY TACKLING
THE HEAVY BURDEN OF DAT.
THAT SO MANY STUDENTS SHOULDER
AS THEY PURSUE AN ADVANCED
MEDICAL DEGREE IT'S NOT UNUSUAL
IN CALIFORNIA TO FIND
PSYCHIATRIC RESIDENTS IN
TRAINING WITH DEBT LOADS THAT
EXCEED TWO HUNDRED THOUSAND
DOLLARS.
THIS BILL EXPAND SUCH PROGRAMS
FOR PSYCHIATRIC RESIDENTS IN
CALIFORNIA WHO COMMIT TO WORKING
IN THE PUBLIC SECTOR.
WITH ME TO TESTIFY ON BEHALF OF
AB FIVE SIXTY FIVE R. ADRIAN
SHELDON FOR WITH THE STEINBERG
INSTITUTE AND RANDALL HAGER WITH
A CALIFORNIA PSYCHIATRIC
ASSOCIATION.
MR CHAIRMAN MEMBERS OF THE
COMMITTEE RANDALL HAGER FOR THE
CALIFORNIA PSYCHIATRIC
ASSOCIATION -- ASSEMBLY MEMBER
MAIENSCHEIN SUMMED UP I THINK
THAT THE NOT OF THE TYPE REALLY
NOT A PROBLEM -- IN
CONTEMPLATING A CAREER PATH.
EARLY IN MEDICAL SCHOOL MEDICAL
STUDENTS ARE THINKING AHEAD
ABOUT THE BURDEN THAT THEY WILL
INCUR.
IN THEIR EDUCATION.
AND IT'S REALLY IMPORTANT TO
PROVIDE THEM INCENTIVES SO THEY
CAN MOVE FORWARD THINKING ABOUT
SKYTREE PSYCHIATRY AS WITH
PRIMARY CARE IS NOT ONE OF THE
BEST REMUNERATED.
PROFESSIONS IN MEDICINE.
SO IT'S REALLY IMPORTANT WE HAVE
INCENTIVES LIKE THIS THE SECOND
THING ABOUT THIS BILL IS THAT IF
IF STUDENTS ARE DRAWN TO
PSYCHIATRY.
WE WANT TO FURTHER DRAW THEM
INTO PUBLIC PSYCHIATRY WE NEED
THEM IN OUR PUBLIC SKYTREE
SYSTEMS.
DEBT BURDEN -- ON A COUPLE OF
RESIDENTS THAT I KNOW OF WHO
WANT TO GO INTO PUBLIC
PSYCHIATRY HAS REACHED OVER THAT
TWO HUNDRED THOUSAND MARK IN.
ONE CASE EVEN -- AS HIGH AS
THREE HUNDRED THOUSAND SOMETIMES
THESE ARE INDIVIDUALS WHO HAVE
ARE VERY PUBLIC SERVICE ORIENTED.
THEY MAY ACTUALLY HAVE MASTERS
IN PUBLIC HEALTH OR M. B. A.'S
IN ADDITION TO THEIR EMPLOYEES
AND THEIR ADVANCED TRAINING IN
PSYCHIATRY AND OFTEN AND THE
TRAINING THAT'S REQUIRED IS.
IS REQUIRED FOR PUBLIC SERVICE
AND COMMUNITY SYSTEMS IS OFTEN
IN ADDITION TO AYE PSYCHIATRIC
RESIDENCY TRAINING PROGRAM WHICH
LASTS FOR YEARS SO.
I THINK YOU CAN SEE THAT THERE'S
A NUMBER OF STRUCTURAL
DIFFICULTIES IN GETTING
PSYCHIATRISTS INTO PUBLIC
SYSTEMS.
AND THIS BILL WILL CERTAINLY
HELP DRIVE MEDICAL STUDENTS IN
THE SKY TREE AND AND PSYCHIATRIC
RESIDENTS IN THE PUBLIC SERVICE
THANK YOU.
GOOD AFTERNOON MISTER TERRY
MEMBERS ADRIN CHILTON WITH THE
STEINBERG INSTITUTE ALSO A PROUD
CO SPONSOR OF THIS MEASURE.
JUST TO ADD A FEW STATISTICS
HERE ACCORDING TO THE CALIFORNIA
FUTURE HEALTH WORKFORCE
COMMISSION THE JUST COMPLETED
THEIR HEALTH WORKFORCE REPORTS
OVER 45% OF THE PSYCHIATRIST IN
CALIFORNIA.
ARE OVER THE AGE OF SIXTY WHICH
MEANS THAT OUR CURRENT WORKFORCE
SHORTAGES ARE ONLY PROJECTED TO
GET WORSE AS I INDIVIDUALS
RETIRED.
SO MUCH WE NEED TO BE MUCH MORE
PROACTIVE WHEN IT COMES TO
WORKFORCE DEVELOPMENT STRATEGIES
AND LOWER PAYMENT PROGRAMS ARE
REALLY A POWERFUL INCENTIVE TO
STEER INDIVIDUALS INTO THE
PUBLIC SECTOR.
SO WE ASK FOR YOUR SUPPORT TODAY
THANK YOU VERY MUCH.
THANK YOU.
OTHERS IN SUPPORT.
TIM MADDEN REPRESENT A
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS IN SUPPORT THANK YOU.
RIGHT SPENCER WITH AMERICAN
COLLEGE OBGYN IS JUST NINE IN
SUPPORT THANK YOU.
BRANDON MARGIE WITH THE
CALIFORNIA MEDICAL ASSOCIATION
ALSO IN SUPPORT [inaudible]
ANYONE ELSE. THREE ONE IN
OPPOSITION.
SEE NUMBER BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS OR COMMENTS
FROM THE COMMITTEE.
I SUPPOSE AS WAS A THANK YOU
MISTER MAY TEMPERING THIS BILL
FORWARD AND I COULDN'T AGREE
MORE WITH THE NEED FOR
PSYCHIATRISTS AND AND CERTAINLY
IN PUBLIC -- PUBLIC HOSPITALS WE
LEARN TO I THINK THERE'S ABOUT A
40% VACANCY RATE OUR STATE
PUBLIC COST IT'LL SO NECESSARILY
AT ALL PSYCHIATRISTS WOULD GO
THERE BUT WE HAVE HUGE WORKS
WORKFORCE ISSUES AND I KNOW THAT --
THE STAGGERING COST OF EDUCATION
IS A BIG COMPONENT AND SO SO I
ASKS I AM THANKFUL FOR YOU TO
BRING THIS BRING THIS BILL
FORWARD WE ARE SHORT OF A QUORUM
UNFORTUNATELY -- THE DOES ENJOY
DO PASS RECOMMENDATION DO YOU
HAVE -- WHICH I TO CLOSE AT
THANK YOU VERY MUCH MISTER CHAIR
MEMBERS RESPECTFULLY REQUEST AN
AYE VOTE THANK YOU VERY MUCH SO
WHEN WE GET A QUORUM OF WILL
BRING THIS AND OTHERS UP THANK
YOU SO MUCH [inaudible]
MISS EGGMAN.
THE SEVEN YOU HAVE.
AB.
SIX EIGHTY TWO I DO THANK YOU
MISTER CHAIR MEMBERS IN THIS
BILL MAY ALSO SEEM A LITTLE
STILL DEJA VU.
COMMITTEE FOR ME TO MY COME BACK
IT'S SOMETHING THAT WE'VE TALKED
ABOUT BEFORE -- SO AB SIXTY TWO
DIRECTS THE DEPARTMENT OF PUBLIC
HEALTH TO WORK WITH OTHER
AGENCIES AND STAKEHOLDERS TO
APPLY FOR FEDERAL FUNDS FOR
ESTABLISHING A REAL TIME WEB
BASED BAD REGISTRY -- AS WE DEAL
WITH OUR PSYCHIATRIC CRISIS THAT
IS EVERYWHERE -- THE THE CONCEPT
THAT WE NEED MORE BEDS AND MORE
RESOURCES IS WITHOUT QUESTION
BUT WHAT WE ALSO NEED SOMETIMES
IS A MORE DIRECT WAY TO BE ABLE
TO ASSESS WHAT BETTER OUT THERE
WHEN SOMEONE COMES IN CRISIS SO
WE CAN MORE QUICKLY.
I GET PEOPLE INTO TREATMENT.
SO A REGISTRY AGAIN WE'RE WE'RE
ASKING PEOPLE TO APPLY FOR THE
FUNDS TO CREATE ONE WOULD HAVE
EVERYBODY AT THE TABLE ALL
STAKEHOLDERS THAT MAY COME UP.
TO OBJECT TO THIS WOULD BE
INVITED IN TO SAY HOW DO WE BEST
MAKE THIS WORK -- AND REGISTRY
WOULD GIVE A BOOK SO NOBODY
COMES INTO -- TO MERGES YOU ROOM
THERE IN PSYCHIATRIC CRISIS
YOU'VE GOT TO FIND A BED FOR
THEM SOMEPLACE ELSE IF THEY ARE
DEEMED. TO THE THEY NEED
INPATIENT TREATMENT.
OFTENTIMES AS ON THE PHONE THAT
IS CALLING AT THE SAME TIME
SOMEBODY IS IN THE EMERGENCY
ROOM IN CRISIS TAKING A BED
SPACE FOR SOMEBODY ELSE WHEN A
MORE SUITABLE -- LEVEL OF CARE
WOULD BE INDICATED FOR THEM.
THE SOONER WE GET SOMEBODY AND
IN PATIENT CARE THE SOONER THEY
GET STABILIZED AND THEN WE ALSO
CLEAR OUT SPACE IN THE EMERGENCY
ROOM FOR ACTUAL.
CASES THAT NEED MORE MEDICAL
EMERGENCY TREATMENT OUT ANY TIME.
SO AN ONLINE BED REGISTRY WOULD
BE UPDATED IN REAL TIME AS WAYS
TO IDENTIFY POSSIBLE BUT IF YOU
NEED SOMETHING MORE SUB SUB USED
TO BE A LOCKED FACILITY AT
CHILDREN'S BAD UP FEMALE ONLY
ALL OF THESE THINGS COULD BE
UPDATED IN A REAL TIME ONLINE
DATA SYSTEM -- AGAIN THIS IS NOT
THE END ALL BE ALL BUT THIS IS A
BETTER WAY TO BE ABLE TO GET
PATIENTS TO THE APPROPRIATE
LEVEL OF CARE -- WITH AS LITTLE
TIME WASTED AS POSSIBLE -- WITH
ME HERE IS I HAVE MISSED RENTAL
HAGAR WHO YOU MAY HAVE HEARD
FROM BEFORE ON BEHALF THE
CALIFORNIA CALIFORNIA
PSYCHIATRIC ASSOCIATION.
HI I AM RENTAL HAGER FROM THE
CALIFORNIA PSYCHIATRIC SITUATION
THIS IS ANY QUESTION ABOUT THAT --
THIS IS SO THIS CONCEPT HERE IS --
I THINK.
IT IN IT IS A SIMPLE ONE AND IT
REALLY IS CAN CONNECTING A
CONSUMERS TO THE SERVICES THAT
THEY NEED WHEN THEY'RE AT THAT
LEVEL OF CARE WHERE THEY NEED AN
INPATIENT BAD.
OR MAYBE SOMETHING LIKE A
RESIDENTIAL BAD OR SOMETHING
LIKE THAT -- AND THE THE
INVESTIGATION THAT I'VE DONE TO
TELLS ME THAT THIS IS SIMPLE
TECHNOLOGY TO SET UP -- IF YOU
CAN SOME SOME IN AND UBER OR
LIFT CAR BY A COUPLE TOUCHES ON
YOUR IPHONE -- AND OR IF THE
HOSPITAL -- CAN UPLOAD DATA
ABOUT AN OPENING IN THEIR BED BY
COUPLE TOUCHES ON SIMILAR KINDS
OF TECHNOLOGY WHY CAN'T WE DO
THIS.
FOR THIS REALLY REALLY IMPORTANT
NEED WE KNOW THAT THERE ARE --
TOO FEW -- PSYCHIATRIC INPATIENT
BEDS -- SO IT'S CRITICAL NOT TO
GET ENGAGE AND EXERCISES WHERE
YOU GO THROUGH PAPERLESS OR
MAYBE.
A LIST OF OF THAT MIGHT BE
ONLINE BUT IT'S KIND OF A COLD
CALLING KIND OF PROCESS -- AND
AND HOPE THAT YOU CAN FIND A BED
QUICKLY BECAUSE OFTEN PEOPLE
WHEN THEY PRESENT IN EMERGENCY
DEPARTMENTS OR IN INPATIENT
UNITS --ARE AT A LEVEL WHERE WE
KNOW WHAT FIFTY ONE FIFTY MEANS
THEY MAY BE A DANGER TO
THEMSELVES OR DANGER TO OTHERS.
AND THEY REALLY NEED ACCESS TO A
BAD TO GET THAT IMMEDIATE
TREATMENT SO THAT THEY CAN BE
HELPED AND THEY CAN BE -- TAKEN
CARE OF AND THAT THREAT OR TO
THEMSELVES OR OTHERS IN.
CAN BE AMELIORATED SO THIS IS
OUR PROPOSAL TO DO THAT -- WE
THINK IT MAKES PERFECT SENSE AND
WE ASK FOR YOUR SUPPORT THANK
YOU.
THANK YOU VERY MUCH -- OTHERS IN
SUPPORT.
REBEKAH GONZALEZ NATIONALIZATION
OF SOCIAL WORKERS CALIFORNIA
CHAPTER IN SUPPORT THANK YOU.
CODY BOILS IN BEHALF THE
CALIFORNIA CONSORTIUM ADDICTION
PROGRAM TO PROFESSIONALS AND
SUPPORT.
THANK YOU.
GOOD AFTERNOON TO SHOW MUCH ARE
WE HAVE THE CALIFORNIA STATE
SHERIFFS ASSOCIATION SUPPORT.
THANK YOU. HUNDRED ALISON
SPEAKING ON BEHALF OF THE
CALIFORNIA CHAPTER OF THE
AMERICANCOLLEGE OF EMERGENCY
PHYSICIANS IN SUPPORT.
BRANDON MARCHING WITH THE
CALIFORNIA MEDICAL ASSOCIATION
AND SUPPORT.
ADRIN CHILDREN WITH THE
STEINBERG INSTITUTE IN SUPPORT.
THURMOND DATING ON BEHALF THE
CALIFORNIA STATE ASSOCIATION OF
COUNTIES IN SUPPORT [inaudible]
WHICH TO ANY TESTIMONY IN
OPPOSITION PLEASE COME.
FOR MISTER CHAIR MEMBERS ALEX
AUTHOR IN A CALIFORNIA HOSPITAL
ASSOCIATION WE DO HAVE AN OPPOSE
POSITION ON THIS BILL -- WE
NOTED OUR LETTER THAT THESE
MODELS HAVE BEEN TRIED IN OTHER
STATES ON SUCCESSFULLY -- AND WE
CAN SET THAT ASIDE AND SAY MAYBE
WE COULD MAKE SOMETHING WORKING
CALIFORNIA WILLING TO DO THAT --
THE THE PRIMARY CONCERN WE HAVE
WITH A BAD REGISTRY IS THE
FEASIBILITY OF KEEPING THAT
INFORMATION UP IN REAL TIME --
DEAD AVAILABILITY CHANGES
CONSTANTLY IT'S NOT JUST
NECESSARILY A MATTER OF FIFTH IF
THAT THAT IS OPEN OR NOT THERE'S
A LOT OF CLINICAL INFORMATION IT
HAS TO COME ALONG WITH THAT.
AND THAT REQUIRES A CONVERSATION
BETWEEN CLINICIANS -- SO JUST
KEEPING THAT TYPE OF INFORMATION
UP IN REAL TIME IS IS THE
BIGGEST CHALLENGE FOR MY MEMBERS.
IN A IN A BROADER SENSE WHEN WE
LOOK AT THIS ISSUE -- THE
ASSEMBLY MEMBER MENTIONED WE
HAVE A SHORTAGE OF PSYCHIATRIC
BEDS WHICH WE DO WE WOULD LOVE
TO BUILD MORE -- IN THE STATE
WHICH WE NEED TO DO THE CONCERN
WE HAVE I THINK MORE BROADLY IS
BILLS LIKE THIS MAY NOT CREATE
INCENTIVES. TO BUILD MORE BATS --
ACOSTA ABOUT A MILLION DOLLARS A
DEAD -- MEANT TO CONSTRUCT A
PSYCHIATRIC BEDS SO THOSE ARE
THE GENERAL CONCERNS WE SHARE
THE THE GOALS OF IT WITH THE
ASSEMBLY MEMBER AND THE SPONSORS
TO INCREASE ACCESS WE HOPE WE
CAN WORK ON THAT -- BUT WE ARE
OPPOSED TO IT TO THIS MODEL THIS
TIME [inaudible]
THANK YOU.
OTHER OTHERS IN [inaudible]
OPPOSITION.
SEE NO ONE STOP FOR A MINUTE
WE'RE GONNA TAKE WE HAVE A QUIRK
SO WE'RE GONNA TAKE ROLE.
ALLOW US TO DO SOME BUSINESS
HERE.
TRANSACTION PLEASE TAKE THE ROLE.
WHAT HERE MAYES HERE
AGUIAR-CURRY [inaudible]
BIGELOW.
BONTA.
BURKE.
CARILLO [inaudible]
FLORA [inaudible]
THE MOST [inaudible]
MCCARTY.
AARON.
RAMOS THERE.
RODRIGUEZ [inaudible]
SANTIAGO [inaudible]
WALDRON.
OKAY WE HAVE A QUORUM IT'S A
GOOD THING SO -- BACK -- TO
QUESTIONS FROM THE COMMITTEE.
THIS RODRIGUEZ AND THEN MISTER
BIGELOW.
IT'S ONLY THANK GOD THE FOR
BRING THIS UP BILL FORD I CAN
AGREE WITH THEIR ON WHAT WE NEED
TO DO.
TO IT'S FREE UP SOME THE OUR
SPACE THAT THE PROJECT WE'RE
GETTING THE FOLKS THE TREATMENT
THEY REALLY NEED -- JUST A
QUESTION REGARDING -- THE
OPPOSITION SEEMING WHAT WHAT IF
THIS ISN'T THE RIGHT APPROACH TO
A WHAT WOULD BE.
A DIFFERENT APPROACH -- VIRGIN
BECAUSE OBVIOUSLY WANT TO WORK
TOGETHER ON THIS AND ULTIMATELY
GET PATIENTS FOR THE NEED TO GO
AND BE THE MERGE ROOMS NOT WHERE
THEY NEED TO GO SO I'M.
LIKE TO ELABORATE A BIT MORE
WHAT YOU'RE TALKING ABOUT.
YEAH WE COULD WE COULD IT
COULDN'T AGREE MORE ASSEMBLY
MEMBER -- THE ISSUE IN THE
EMERGENCY ROOMS.
THAT WE HAVE IS A TOP PRIORITY
ISSUE FOR ASSOCIATION IN
RESOLVING THAT SITE BOARDING
TIMES -- THERE ARE SEVERAL
MEASURES UNDERWAY THIS YEAR TO
ADDRESS THAT -- WE SPONSOR THE
LAST YEAR WITH MISTER SANTIAGO --
THAT WOULD DIRECT THE STATE TO
APPLY FOR THE SAME POT OF MONEY
UNDER THIS BILL IS SEEKING WHICH
IS FEDERAL GRANT.
AND WHAT THAT WOULD DO IS SET UP
AN INVENTORY OR REGISTRY OF ALL
THE SERVICES AVAILABLE TO
CONSUMERS -- WE TEND TO FOCUS ON
IN PATIENT ACUTE PSYCH.
WITH THERE ARE DOZENS OF
DIFFERENT TYPES OF SERVICES THAT
ARE OFFERED TO CONSUMERS SO WE
WOULD LIKE TO LOOK AT A MORE
HOLISTIC APPROACH -- LOOK AT ALL
THE SERVICES IN THE COMMUNITY
NOT JUST FOCUS ON THE U. CUTE
EVEN THOUGH WE AGREE THERE'S A
NEED TO EXPAND THAT SERVICE --
WE WOULD LIKE TO SEE MORE MORE
HOLISTIC APPROACH TO INVENTORIES
AND HISTORIES AND THINGS OF THAT
NATURE.
THANKS AND I JUST LIKE.
TO I THOUGHT THE FROM THIS FOR
TELEPORTED SUPPORTED AND
HOPEFULLY WE CAN COME.
TO A BETTER WAY WE CAN ADDRESS
THE ISSUE WITH THANK YOU AND AND
I WILL BE SUPPORTING ABOUT
THANKS.
THANK YOU -- FOR THE AUTHOR.
WE HEARD THE OPPOSITION SPEAK
ABOUT BILLS NOT BEING.
THAT'S NOT NECESSARILY BEING
AVAILABLE WHEN WE THINK THAT
THEY'RE AVAILABLE COULD YOU
ADDRESS.
THAT CONCERN HOW YOUR BILL WOULD
REACT AND AND TREAT THOSE
SCENARIOS WHEREAS.
THE HOSPITAL DOES HAVE A BIG
IMPACT BUT TECHNICALLY IT'S NOT
AVAILABLE BECAUSE THE CONDITIONS
HAVEN'T.
PLANS TO OR ADDRESS THE ISSUES
RESPECTFUL OF THE BET.
CERTAINLY MISTER BIGELOW -- AND
IT'S IT'S I THINK A A GREAT
QUESTION -- BUT UNLIKE THE UBER
AND LIFT MODEL.
YOU STILL HAVE TO MAKE THAT CALL.
BUT YOU ARE MORE DIRECTED YOU
DON'T HAVE TO CALL A WHOLE SHEET
OF PLACES WHERE THERE COULD
POSSIBLY BE ABOUT OPEN.
YOU CALL THE ONE PLACE WHERE YOU
KNOW THERE IS BECAUSE YOU STILL
NEED TO HAVE A CLINICIAN TO
CLINICIAN TALK YOU STILL HAVE TO
HAVE SOMEONE.
THAT'S AND THAT'S PATIENT OVER
YOU HAVE TO HAVE SOMEONE EXCEPT
THAT PATIENT TO THE CONVERSATION
STILL HAS TO EXIST IT JUST EXIST
WITH MORE KNOWLEDGE THAT YOU'RE
ACTUALLY TALKING TO SOMEONE WHO
HAS A BED.
RATHER THAN CALLING TWENTY
PLACES AND MAYBE THERE'S ONE AND
MAYBE THERE'S NOT SO THE
CLINICIAN TO CLINICIAN TALK
WOULD STILL OCCUR NO MATTER WHAT.
THIS HOPEFULLY JUST REDUCE THE
AMOUNT OF TIME -- AND EFFICIENCY
WITH WHICH YOU CAN GET SOMEBODY
PLACED.
RIGHT AND AND FOR FOR THE
OPPOSITION HOW DO YOU SEE THAT
WITH RESPECT.
THAT EXPLANATION.
SO WHEN WE THINK ABOUT THIS
WE'VE LOOKED TO WHAT HAPPENED IN
VIRGINIA VIRGINIA DID A VERY
SIMILAR MODEL THEY HAD A
MANDATED REAL TIME THAT REGISTRY
FOR PSYCHIATRIC BATS.
AND BECAUSE KEEPING THAT
INFORMATION UP IN REAL TIME IS
SO DIFFICULT IF NOT IMPOSSIBLE.
IT WAS ACTUALLY TAKING LONGER TO
FIND A BET BECAUSE PEOPLE WERE
LOOKING AT A REGISTRY THAT
WASN'T ACCURATE BECAUSE IT IS SO
DIFFICULT TO KEEP IT ACCURATE --
SO WHEN WE AGAIN WE LOOK AT THIS
IT'S REALLY THE REAL TIME NATURE
OF THIS -- THAT WE THINK IS
GOING TO BE IN FEASIBLE FOR OUR
MEMBERS TO COMPLY WITH SO LET ME
ASK A DIRECT QUESTION IS THERE A
MECHANISM BY.
WHICH YOU CAN WORK WITH THE
AUTHOR AND THIS BILL. TO RESOLVE
IT YOU HAVE SEATED HERE BEFORE
YOU THREE OUT OF THREE OF THE
EMTS WHO ACTUALLY ARE ON THE
GROUND.
WORKING IN THIS SCENARIO QUIRK
BRINGING FORTH OF PATIENTS TO
THE HOSPITAL'S -- MR FLORA
MYSELF AND MR INCREASE HERE --
RECOGNIZE THAT WERE FILLING BEDS
IN THE E. OURS THAT DON'T NEED
TO BE FILLED WITH PATIENTS THAT
DON'T REALLY QUALIFY FOR MERCY
MEDICAL.
THERE'S A LOT OF OTHER FOLKS WHO
HAVE SERIOUS SERIOUS.
INJURIES OR OTHER ISSUES THAT
THEY'RE FACING.
WHERE WE CAN HANDLE THE TYPE OF
PATIENTS THAT WERE REFLECTING
HERE TODAY IN A IN A MUCH BETTER
WAY IN A MORE EFFICIENT WAY?
CAN YOU WORK WITH THE AUTHOR ON
FINDING A RESOLUTION FOR THIS.
ABSOLUTELY COMMITTED TO THAT --
ONE THING I WOULD KNOW AND I
APPRECIATE YOU YOU RAISING THAT
WE DID A STUDY IN ABOUT 70%.
OF THOSE IN EMERGENCY ROOMS WITH
THE BEHAVIORAL HEALTH CONDITION
DON'T NEED TO BE THERE THEY
DON'T HAVE AN EMERGENT CONDITION.
SO SOMETHING WE'RE LOOKING AT
THIS YEAR IS SPONSORING
LEGISLATION RUN ALTERNATE
DESTINATION GET THOSE
INDIVIDUALS TO THE APPROPRIATE
PLACE BEFORE THEY COME TO THE
EMERGENCY ROOM -- THAT'S ONE
APPROACH WORKING ON THIS YEAR
BUT YOU ACTUALLY HAVE THE
COMMITMENT OF OUR ASSOCIATION TO
WORK ON THIS AND THAT'S GOOD SO
TO THE AUTHOR MAYBE.
WHAT IT WILL TAKE A LOOK FOR
YOUR BILL TO CONTINUE MOVING
FORWARD WHICH I SUPPORT?
MAYBE THEY'LL TAKE A LITTLE TIME
FOR THEM TO PERFECT OR MAYBE
WORKING WITH YOUR OFFICE TO HELP
PERFECT.
HOW WE CAN DIRECT THIS IN A MORE
EFFICIENT WAY?
IF I COULD JUST ADD TO THIS
CONVERSATION JUST A LITTLE BIT
WE ALREADY HAVE A WORKING MODEL
IN CALIFORNIA IT'S ACTUALLY THE
LA COUNTY DEPARTMENT.
OF SUBSTANCE USE IS -- IN THE
INVENTORY AND IT IS AMAZING --
THAT IS A WILL NOT MY WORD BUT
IS THE WORD OF PSYCHIATRISTS WHO
WORK RIGHT NEXT DOOR IN THE
DEPARTMENT OF MENTAL HEALTH AND
I THINK WE COULD LOOK AT HOW
THEY ARE ABLE TO MAINTAIN THAT
AND AND HAVE DEVELOPED IT.
AND THAT WOULD BE A GOOD PLACE
FOR DISCUSSION.
THANK YOU FOR THAT.
THANK YOU MISTER SURE OF COURSE
OF ANYONE ELSE.
THE MOTION BY MISTER MESA SECOND
BY MISTER RODRIGUEZ I HAVE
COUPLE QUESTIONS SO -- SO.
HOW CURRENTLY IF YOU HAVE MADE
CONTACT WITH HOSPICES WITH HER
MISTER HOPPER?
YOU MAY CONTACT WITH A HOSPITAL
IN THE AUTHORS WELL OBVIOUSLY --
DO YOU KIND OF RESERVE THAT BAD
IN ADVANCE FOR EXAMPLE I HAVE
FOLKS UP AND DOWN ORDER HUMBOLDT
COUNTY MAY HAVE A FIVE HOUR
DRIVE.
IN AN AMBULANCE SO SO ONCE YOU
MAKE CONTACT.
AND AND THAT BAD IS RESERVE SO
TO SPEAK UNTIL PEOPLE UP I'M
JUST ASKING SO.
DOES ANYBODY KNOW THE ANSWER TO
THAT.
YEAH I THINK IT DIFFERS -- FROM
THE PROCESS OF RESERVING A ROOM
AT A HOTEL IN THAT THE MOMENT
YOU PUSH THE BUTTON THAN THAT
BUT THAT BAD SPACES SOLD
ESSENTIALLY -- AGAIN I THINK
IT'S A THERE IS A A DOCTOR IF
YOU WILL A DOCK TO DOCK
CONNECTION THAT THAT REALLY SAYS
TO BOTH PARTIES THIS IS
APPROPRIATE FOR THIS PATIENT YES
WE WILL TAKE THIS PATIENT YOU'VE
MADE THAT COMMITMENT.
SO I BELIEVE WHETHER OR NOT
YOU'RE COMING FROM YOUR RICA OR
JUST FROM YOLO COUNTY TO
SACRAMENTO THAT WOULD BE THE
ARRANGEMENT.
THAT IS THAT HAVE TO HELP PLACE
OUT.
YEAH IN IN THAT'S CORRECT IN
THAT THERE WOULD NEED TO BE A
DISCUSSION BETWEEN DOCTORS ABOUT
WHETHER OR NOT THAT THAT IS
APPROPRIATE AND GENERALLY
EMERGENCY ROOMS WILL HAVE.
A LIST THAT THEY OF OF
FACILITIES THAT THEY WOULD CALL
TO SEE IF THERE COULD BE AN
APPROPRIATE PLACEMENT -- THIS
THE HOSPITAL THEY'RE BEING
TRANSFERRED TO HAS TO HAVE THE
CAPACITY -- AND CAPABILITY TO
TREAT THE PATIENT -- AND THAT'S
PART OF THE DISCUSSION WOULD
HAPPEN WITH THE EMERGENCE FROM
CAN WE TAKE THE PATIENT DO WE
HAVE THE RIGHT.
PROVIDERS WE HAVE THE RIGHT
DOCTORS TO ACTUALLY TAKE THE
PATIENT WHAT'S THEIR NEED -- IT
DEPENDS ALSO ON HOW SICK THE
PERSON AS THEY WOULD GET
PRIORITY.
SO RECOGNIZING THAT -- THAT THE
IT DIDN'T THE ACUITY OF THE CASE
IS IS IMPORTANT AND HOW HOW
EVERYTHING GETS PUT PORK.
WOULD IT NOT BE A GOOD IDEA TO
HAVE SORT OF AN UPDATED REGISTRY
BECAUSE OTHERWISE.
DID YOU HAVE DOCTORS GOING
THROUGH THE TOP OF THE LIST
GOING DOWN TO THE BOTTOM LIST
EVERY SINGLE TIME THEY TRY TO
PLACE A PATIENT.
SO WOULDN'T IT BE NICE TO KNOW
I'M JUST I'M.
THAT GUESS WHAT IT'S THIS PLACES
FOR THIS PLACE IS FULL OR THEY
MAY HAVE BEEN THERE IS AT LEAST
HAVE A PLACE TO START.
SO THAT YOU TO SAVE TIME BECAUSE
I CAN IMAGINE AT SOME POINT USE
YOU RUN TO THE LIST THERE'S AN
AVAILABLE BED IT MAY NOT BE
AVAILABLE BY THE TIME YOU GET
CAUGHT UP IN THAT YOU KNOW.
DOES THAT.
SO THAT'S WHY I THINK THAT'S
WHAT YOU'RE HEARING A YOU KNOW
IT'S LIKE THERE OUGHT TO BE AWAY
HERE I MEAN FOR CRYING OUT LOUD
I CAN GO ON BOOKING DOT COM AND
BOOK A HOTEL ROOM.
THANK YOU KEEP TRACK OF THEY
KEEP TRACK OF HOW MANY ROOMS
THEY HAVE AVAILABLE -- AND I
KNOW THIS IS NOT THE SAME BUT I
JUST IN THE WORLD WE LIVE IN
WITH TECHNOLOGY I JUST.
KIND OF WONDER IF WE CAN'T AT
LEAST SAY OKAY THESE BEDS ARE
POTENTIALLY AVAILABLE.
NOT NECESSARILY COMPLETELY
AVAILABLE THERE POTENTIALLY
AVAILABLE SO THAT YOU HAVE A
WEIGHT PLACE TO START RATHER
THAN STARTING TO TOPPLE LISTING
GOING DOWN EACH TIME.
I JUST FEELS LIKE THERE OUGHT TO
BE AWAY.
SO ANYWAY WE WOULD AGREE -- SO --
WITH THAT IT IS THERE ANY OTHER
QUESTIONS OR COME MISTER BIG
MISTER BIGELOW.
I WAS JUST GONNA WIN ON YOUR
COMPONENT IT IT DOES GET A
LITTLE MORE A LITTLE MORE
COMPLICATED. FOR THE THREE OF US
WERE FOUND BY SCOPES AND
PRACTICES SURE -- AND LIKE YOU
ARE AS A DOCTOR WHAT WE CAN OF
WHAT ONE CAN DO AND IN OUR CASE
WE GET A A PERSON WITH MENTAL
HEALTH.
AND THAT PERSON TO PATIENT AND
WE'RE TRANSPORTED WE'RE GOING TO
WORK OUR INITIAL BASE HOSPITAL.
THE NEXT IF THAT'S NOT AVAILABLE
THEN IT GOES TO THE NEXT
AVAILABLE HOSPITAL.
AND SO IT BECOMES VERY
COMPLICATED FOR US BECAUSE THAT
HAS TO BE THAT REAL TIME
CONNECTION OF WHAT THAT LOCATION
HAS AVAILABLE.
SO THAT WE KNOW WHERE TO GO
BECAUSE EACH STEP GETS FARTHER
AWAY FROM THE PATIENT AND
TREATMENT.
AND SO THAT'S THE COMPLICATION
WORKING WITH THE HOSPITALS AND
THE I AM SEGMENTS BILL.
HOW TO BRING THAT TIMING
ALTOGETHER?
SO I KNOW THE AUTHOR IS WILLING
TO WORK ON IT.
I'M ENCOURAGED BY REPEAL SO.
AGAIN. FOR THOSE FORD OKAY WELL
THANK YOU AND AND IS THERE ANY
OTHER QUESTIONS.
NO WAS IT'S A THOUSAND EIGHT ONE
TIME AS WELL I WAS THE DOING THE
TYPE OF JOB WE DO AT THAT TIME I
MEAN.
IT SHOULD BE A SIMPLE FIX WITH
TECHNOLOGY WHERE WE JUST MAKE
THAT COMMUNICATION.
SMOOTH TRANSITION GET THAT PAGE
WHERE THEY REALLY NEED TO GO OF
COURSE THE END OF THE DAY.
THE MURDERS YOUR ROOMS ARE
REALLY OVER SUCH OR WITH THE
PATIENT THAT DON'T NEED TO BE
THERE AND JUST MAKE SURE YOU GET
ON WHERE THEY NEED TO GO.
BUT IT'S GOING TO TAKE EVERYBODY
WORKING TOGETHER SO COURAGE WITH
US HE MADE CONTINUE WORK WITH
AUTHOR ON THIS AND WE'LL FIND
THAT FIX EVENTUALLY THINKING.
ANY OTHER QUESTIONS SEEN NONE
WILL BRING IT BACK TO THE AUTHOR
QUESTION TO COME IS IT WITH THIS
ADDRESS A DO PASS RECOMMENDATION.
THANK YOU VERY MUCH.
THAT'S THAT'S OKAY ALL RIGHT WE
WITH THAT WE WILL -- GO AHEAD
AND CALL THE ROLL BUT A
SECRETARY PLEASE CALL THE ROLL.
WHAT I WOULD AYE MAYES AYE MAYES
AYE AGUIAR-CURRY?
AGUIAR-CURRY AYE BIGELOW BIGELOW
AYE BONTA.
BURKE BURKE I CARILLO CARILLO
AYE FLORA.
FLORA I LEVEL.
MCCARTY.
MCCARTY I IN THIS AREA.
RAMOS.
ROSS I RODRIGUEZ RODRIGUEZ I
SANTIAGO.
WALDRON.
WALDRON AYE.
YOUR VOTE IF YOUR YOUR BILL HAS
ELEVEN VOTES IS OUT COMMITTEE
BELIEVE IT THANK YOU VERY MUCH
FOR FOR OTHERS TO ADD ON TO
THANK YOU VERY MUCH [inaudible]
MISTER PATTERSON [inaudible]
THIS IS.
THIS RASI HAVE AB SEVEN YES WORK.
WE WILL WE WILL MAKE THIS QUICK.
AND YOU HAD AND YOU ENJOY DO
PASS REGULARLY GIVEN THE CHAIR
OUT AND WITH THAT I WOULD LIKE --
TO CLOSE MY REMARKS AND ASK FOR
YOUR VERY QUICKLY IS A SEVEN OH
FOUR WILL REQUIRE EMPLOYEES AT
LICENSE SUB OF SUBSTANCE USE
DISORDER TREATMENT FACILITIES.
TO UNDERGO A CRIMINAL BACKGROUND
CHECK PRIOR TO BEGINNING THEIR
EMPLOYMENT.
THE BACKGROUND CHECKS GOING TO
BE REVIEWED BY THE DEPARTMENT OF
HEALTH CARE SERVICES PRIOR TO AN
INDIVIDUAL BEGINNING EMPLOYMENT.
WITH A BACKGROUND CHECK ON
RECORD THE DEPARTMENT WILL ALSO
BE ABLE TO RECEIVE IN --
NOTIFICATIONS OF SUBSEQUENT
ARRESTS ETCETERA I IT IT REALLY
IS IMPORTANT THAT -- INDIVIDUALS
WHO SEEK TREATMENT FOR ALCOHOL
AND DRUG ABUSE THEIR VULNERABLE
AND SO -- REALLY IT'S TO ENSURE
THAT THEY ARE NOT TAKEN
ADVANTAGE OF AND APPRECIATE VERY
MUCH WORKING WITH THE COMMITTEE.
LOT OF LANGUAGE BACK AND FORTH
WAS VERY VERY HELPFUL WE'RE
GRATEFUL FOR THAT.
I WANT TO JUST A QUICKLY UP --
TURN -- TO JOE A BEAR WITH
COMPREHENSIVE ADDICTION PROGRAMS
HE HAS -- EXPERIENCE IN THIS AND
WANTS TO TELL HIS STORY I THINK
BE HELPFUL.
THANK YOU THANK YOU.
MY NAME IS JOE A BEAR I'M THE
EXECUTIVE DIRECTOR FOR THE
CONFERENCE OF ADDICTION PROGRAM
AFFECTIONATELY KNOWN AS CAP --
WE HAVE A HUNDRED AND SEVEN DEAD
FACILITY IN FRESNO -- WE TREAT
ROUGHLY TWO THOUSAND CLIENTS PER
YEAR -- THIS THIS BILL I
STRONGLY SUPPORT BECAUSE I
BELIEVE THAT -- OUR CLIENTS ARE
PROBABLY SOME OF THE MOST
VULNERABLE -- THAT THAT YOU'D
SEE PEOPLE GOING THROUGH
RECOVERY -- ARE EXTREMELY
EMOTIONAL AND AND VULNERABLE SO
IT'S A VERY IMPERATIVE THAT --
ALL ALL OF OUR EMPLOYEES HAVE
THE THE BACKGROUND NECESSARY
BACKGROUND CHECKS AND THAT THEY
BE BEYOND REPROACH -- RIGHT NOW
WE WE REQUIRE -- BACK RIGHT NOT
ONLY BACKGROUND CHECKS BUT ALSO --
DRUG TESTING -- TB TESTING AND I
ACTUALLY WAS VERY SURPRISED THAT
THIS WAS NOT A LAW BECAUSE WE'VE
ALWAYS BEEN DOING THIS AT OUR
FACILITY SO I WOULD THINK JUST
FOR THE SAKE OF CONSISTENCY AND
OUR CLIENT'S.
BEST INTERESTS I SUPPORT THIS
BILL.
THANK YOU VERY MUCH THERE ARE
OTHERS IN SUPPORT.
SEEING NO ONE IS THERE ANYONE IN
OPPOSITION TO THE BILL.
LIZZY BEGIN WITH THE ACLU I
APPRECIATE THE AUTHOR AND HIS
STAFF AND THE COMMITTEE FOR
WORKING WITH US TO ADDRESS OUR
CONCERNS AND WE'RE REMOVING OUR
OPPOSITION.
QUESTIONS FROM ANY OF ANYONE IN
OPPOSITION.
QUESTIONS FROM THE COMMITTEE.
MISS WALDRON JUST A QUICK
COMMENT -- THANK YOU SO MUCH I
HEARD FROM ONE OF MY CITIES IN
MY DISTRICT.
SUPPORTING THE BILL BECAUSE
WE'VE BEEN SEEING YOU KNOW MORE --
IN RESIDENTIAL NEIGHBORHOODS THE
CARE FACILITIES THAT ARE THERE
AND THEN IT HELPS THE NEIGHBORS
ALSO FEEL A LEVEL OF PROTECTION
AS WELL.
SO EVEN BEYOND THE FACILITIES SO
THEY WERE GRATEFUL FOR THAT
THANK YOU.
THANK YOU VERY MUCH THANK YOU
[inaudible]
ANYONE ELSE.
SEE NO ONE THE THE BUILD ENJOYS
A DO PASS RECOMMENDATION SIR
WOULD YOU LIKE TO CLOSE.
THAT'S MY CLOTHES THAT'S OKAY
VERY GOOD THIS THIS IS TO PASS
AS AMENDED TO APPROPRIATIONS
ABSOLUTELY OKAY.
SO ACCEPT OR AMENDMENTS THOUGH --
MATTER SECRETARY PLEASE CALL THE
ROLL WHAT HI WHEN I MADE THIS
AYE MAYES AYE AGUIAR-CURRY.
THANK YOU ARE CURRY I BIGELOW.
BIGELOW AYE BONTA [inaudible]
BURKE.
CARILLO HI CARILLO AYE FLORA
FLORA AYE LIMóN.
MCCARTY.
MCCARTY I NAZARIAN [inaudible]
RAMOS.
MOST AYE RODRIGUEZ RODRIGUEZ AYE
SANTIAGO.
WALDRON.
WALDRON AYE.
THAT IS TEN VOTES SITS OUT OF
COMMITTEE THANK YOU THE ROLE
OPEN FOR OTHERS TO ADD ON HERE
MISTER CHAIRMAN AND MEMBERS
THANK YOU THANK YOU MISTER
PATTERSON.
MISTER KALRA SCENE -- THE NEXT
AUTHOR IS NOT HERE PLEASE COME
ON I JUST FOR CLARIFICATION ON
MISS EGGMAN'S BILL WHICH WAS
ITEM NUMBER NINE AB SIXTY TWO
THAT MOTION THAT WAS DUE PASSED
TO APPROPRIATIONS SO.
JUST.
JUST JUST [inaudible]
FOR CLARITY [inaudible]
PLEASE.
THANK YOU MISS SURE MEMBERS
ASSEMBLY BILL SEVEN THIRTY ONE
EXPANDS RATE REVIEW PROCESS THE
LARGE GROUP MARKET AND ENHANCES
THE PROCESS BY CONSUMERS AND
REGULATORS A CLEAR PICTURE OF
HEALTH CARE COSTS.
CYNICALLY REQUIRES MAY REVIEW
DATED TO BE DISAGGREGATED BY
BENEFIT CATEGORY AND REGION
REQUIRES COMPARISON TO MEDICARE
PRICES.
THE REQUIRES HEALTH PLANS THAT
BUILD RAPPORT UNDER EXISTING LAW
TO REPORT RATES BASED ON
SPENDING AND USED BY TYPE OF
SERVICE.
THAT STRENGTHENS THE ABILITY TO
TO DETERMINE UNJUSTIFIED RATES.
IN CALIFORNIA OPINIONS FROM.
HEALTH INSURANCE PLANS OF RISEN
TUNER 49249% SINCE TWO THOUSAND
TO MORE THAN SIX TIMES THE
INCREASE IN THE STATE'S OVERALL
INFLATION.
THE SKYROCKETING COST OF
HEALTHCARE IS GOOD SHOOTING TO
WAGE STAGNATION AND FEELING
INCOME INEQUALITY IN THE STATE
BECAUSE WHAT WE PUT INTO OUR
HEALTHCARE SYSTEM.
ULTIMATELY COMPETES WITH WAGE
INCREASES AND HOUSEHOLD BUDGETS.
CALIFORNIA HAS HAD A RULE ROBUST
RATE REVIEW FOR THE INDIVIDUAL
AND SMALL GROUP MARKETS FOR
HEALTH INSURANCE IS.
TWO THOUSAND ELEVEN AND HAS
SAVED INDIVIDUALS AND SMALL
BUSINESSES TWO HUNDRED TWENTY
SIX MILLION DOLLARS SINCE THE
LAW WAS ENACTED.
AB SEVEN THIRTY ONE BILLS UPON
OUR STAYS PROVEN RATE REVIEW
POLICY.
SO THERE'S INCREASED SCRUTINY
AND PUBLIC ATTENTION ON
REASONABLE RATE INCREASES IN OUR
HEALTHCARE SYSTEM.
IN RESPONSE OPPOSITION COMMENTS
OF THE LARGE GROUP MARKET IS
HIGHLY TAILORED UNFIT FOR RATE
REVIEW I'D LIKE TO SUBMIT THAT
ONLY POINT 2% OF EMPLOYERS IN
THE STATE.
HAVE OVER FIVE HUNDRED EMPLOYEES
AND HAVE THE POWER TO BY TAYLOR
PLANS.
THE VAST MAJORITY OF EMPLOYER
EMPLOYERS BUY OFF THE SHELF
PRODUCTS WITH FEW OPTIONS AND
THEY SHOULD BE AFFORDED THE SAME
LEVEL REVIEW THAT PUTS A CHECK
ON ON REASONABLE RATES.
MOVING AND BUILDING UPON RATE
REVIEW WELL THE GREATER SCRUTINY
ON WHAT IS DRIVING WHAT IS
DRIVING RISING PREMIUMS AND
PROVIDE NECESSARY RELIEF FOR
MILLIONS OF CALIFORNIANS.
UNABLE TO AFFORD THEIR HEALTH
CARE.
WITH ME TO PROVIDE SUPPORTING
TESTIMONY IS BETH CAPELL
REPRESENTING HEALTH ACCESS YOU
KNOW HERE IN TEAMSTERS WALSER
FOX IN THE CALIFORNIA LABOR
FEDERATION.
THESE BETH EL ON BEHALF OF THREE
OF THE FIVE CO SPONSORS OF THIS
MEASURE HEALTH ACCESS TEAMSTERS
AND UNITED.
MEMBERS WE SPEND A LOT OF TIME
TALKING ABOUT HEALTH CARE COST
THE WE HAVE ACTUALLY DONE
SOMETHING IN CALIFORNIA TO
CONTROL HEALTHCARE COSTS.
IN TWO THOUSAND AND TEN WE
ENACTED LEGISLATION TO REQUIRE
RATE REVIEW FOR HEALTH INSURANCE
SOLD TO INDIVIDUALS AND SMALL
EMPLOYERS.
THAT HAS LITERALLY SAVED
CONSUMERS HUNDREDS OF MILLIONS
OF DOLLARS THE MEASURE THAT'S
BEFORE YOU TODAY WOULD EXTEND
THIS TO LARGE EMPLOYERS.
AND WOULD ASSURE THAT THEY HAVE
THIS THE BENEFIT OF THE SAME
KIND OF TRANSPARENCY IN THE SAME
KIND OF REVIEWS THAT SMALL
EMPLOYERS AND INDIVIDUALS NOW
BENEFIT FROM.
WE THINK THIS IS AN IMPORTANT
BILL YOU GET RICH AND SOMETHING
THAT IS ABOUT TRANSPARENCY IT IS
NOT RATE REGULATION YOU WILL
HEAR FROM THE OTHER SIDE THAT
THERE ARE HIGHLY CUSTOMIZED
PLANS.
BUT AS YOU JUST HEARD FROM
MISTER KALRA MOST EMPLOYERS HAVE
FEWER THAN FIVE HUNDRED
EMPLOYEES AND EMPLOYER WITH TWO
OR THREE HUNDRED EMPLOYEES DOES
NOT HAVE MUCH NEGOTIATING POWER.
UP AGAINST A HEALTH PLAN THAT
HAS EIGHT MILLION ENROLLEES OR
NINETY BILLION LIKE ANTHEM BLUE
CROSS.
SO WITH THAT WE ASSURE AYE VOTE
[inaudible]
THANK YOU.
MR TEAR MEMBERS THERE OF BLOCKS
FROM THE CALIFORNIA LABOR
FEDERATION.
AND LAST WEEK IN COMMITTEE --
THE COMMITTEE HEARD AB.
TWO NINETY AND COMMITTEE MEMBERS
ASKED.
HOW DO WE ENSURE THAT HEALTH
PLANS ARE GOING TO TAKE THE
SAVINGS FROM PROVIDERS AND PASS
IT ON TO CONSUMERS?
AND I SAT UP HERE ON THE DYESS
AND THOUGHT.
AB.
SEVEN THIRTY ONE THIS BILL IS
HOW WE START TO HOLD HEALTH
PLANS ACCOUNTABLE AND SAY WE
WANT TO KNOW EXACTLY WHAT IS
GOING INTO THOSE PREMIUMS WE
WANT TO KNOW THAT THOSE PREMIUM
INCREASES ARE JUSTIFIED IN THEIR
REASONABLE.
AND THAT ANY SAVINGS ARE GETTING
PASSED ON TO CONSUMERS AND TO
PURCHASERS SO WE CAN PUT IT IN
OUR MEMBERS POCKETS IN THE FORM
OF WAGES.
AND THIS IS A BILL THAT HAS A
PROVEN TRACK RECORD FOR THE
INDIVIDUAL AND AND SMALL
BUSINESSES IN TERMS OF RATE
REVIEW WE WANT TO EXTEND THAT TO
THE LARGE GROUP SO THAT.
PURCHASERS CAN BE ABLE TO SAY
HEY THE REGULATOR SAID THIS IS
UNJUSTIFIED.
LET'S NEGOTIATE NOW WE HAVE SOME
DATA SO WE CAN START TO TO LOOK
AT PREMIUM INCREASES BUT I ALSO
SEE THAT THIS BILL IS NOT JUST
ABOUT HEALTH PLANS.
BECAUSE PREMIUMS INCREASE
BECAUSE OF THE UNDERLYING PRICES
CHARGED BY HOSPITALS BY DOCTORS
AND BY DRUG MAKERS THAT IS PART
OF IT WHAT IS DRIVING UP THE
COST OF OUR HEALTH CARE.
THIS WILL INCREASE TRANSPARENCY
SO WE CAN SEE HOW MUCH ABOUT
MEDICARE IN OUR LABORATORY
SERVICES OR OUTPATIENT OR
PRESCRIPTION DRUGS.
AND HE'LL DO IT BY REGION SO WE
CAN SEE IN SAN JOSE WHICH IS ONE
OF THE MOST EXPENSIVE HEALTHCARE
MARKETS IN THE REGION ACTUALLY
IN THE NATION SORRY IN THE
NATION.
HOW DOES THAT COMPARE TO OTHER
AREAS OF OUR STATE IS
UTILIZATION IS A PRICE SO THIS
IS JUST VERY IMPORTANT DATA SAID
THAT NOT ONLY PURCHASER SHOULD
HAVE NOT I CONSUMERS BUT ALSO
POLICYMAKERS?
SO WE URGE YOUR I. BUT MISTER
CHAIR MEMBERS MICHELLE COVERED
IT UP WITH A CA YOU CALIFORNIA
WE ARE PROUD CO SPONSOR OF THIS
MEASURE AND JUST WANT TO SAY
WHAT'S GOOD FOR THE INDIVIDUAL
AND SMALL GROUP MARKETS ALSO IS
GOOD FOR THE LARGE GROUP MARKET.
NOT ONLY HAVE WE SAVED PEOPLE
HUNDREDS OF MILLIONS OF DOLLARS
AFTER WE STARTED SAVING INSURERS
WERE STILL CHARGING A REASONABLE
AND I JUSTIFIED RATES UNTIL WE
SENT NOTIFICATION. TO THOSE
INDIVIDUALS THAT THEY COULD THAT
THEY WERE GETTING A RAW DEAL AND
THEY COULD DO SOMETHING ABOUT IT
WE JUST WANT THE SAME THING ON
THE LARGE GROUP MARKET WE URGE
YOUR SUPPORT THANK YOU -- MUCH
OTHER SUPPORT.
REBEKAH GONZALEZ NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER IN SUPPORT
THANK YOU.
JACK RUBIN WITH UNITE HERE THE
HOTEL CASINO WORKERS UNION ONE
OF THE SPONSORS THE BILL AND WE
WOULD APPRECIATE A UNANIMOUS
VOTE ON THIS BILL.
MAP RIGHT HERE ON BEHALF OF THE
CALIFORNIA TEAMSTERS HERE CO
SPONSORS ON THE BILL ALSO THAT
MALCOLM MADE A TRANSIT UNION
MACHINE S. -- IB YOU ENGINEERS
AND SCIENTISTS OF CALIFORNIA.
AND THAT UTILITY WORKERS THANK
YOU THANK YOU.
I AM ONLY RASH ON BEHALF OF CAL
PERK IN STRONG SUPPORT THANK YOU.
THANK YOU MISTER CHAIRMAN BURRS
MEGAN SUPERS ON BEHALF OF THE
CALIFORNIA PROFESSIONAL
FIREFIGHTERS AND SUPPORT THANK
YOU.
WORK IS BECAUSE THE HOLD
CALIFORNIA PENALTY KILLS
NETWORKING SUPPORT.
THANK YOU.
GEN FLOOR ON BEHALF OF WESTERN
CENTER ON LAW AND POVERTY IN
SUPPORT THANK YOU.
IN A MEMO SENT ON BEHALF OF
CONSUMER REPORT IN SUPPORT.
THANK YOU.
ELENA CENTERING ON BEHALF
CONNECTION CALIFORNIANS SUPPORT
THANK YOU.
KEVIN'S GO FRIENDS COMMITTEE ON
LEGISLATION OF CALIFORNIANS
STRONG SUPPORT THANK YOU.
COVER WITH SMALL BUSINESS
MAJORITY IN SUPPORT THANK YOU.
IS THERE ANYONE OPPOSITION
.
THANK YOU MISTER CHAIR AND
MEMBERS -- NICK LOUISE US ON
BEHALF OF THE CALIFORNIA
ASSOCIATION OF HEALTH PLANS IN
OPPOSITION TO ASSEMBLY WILL --
SEVEN THIRTY ONE THIS BILL WOULD
SUBJECT THOUSANDS OF LARGE
EMPLOYER PRODUCTS TO A RATE.
REVIEW REGULATORY PROCESS THAT
WILL BE EXPENSIVE TO ADMINISTER
FOR BOTH THE STATE AND HEALTH
PLANS.
THE BILL ALSO ADD SIGNIFICANT
NEW REPORTING REQUIREMENTS ON
ALL HEALTH PLAN RATE FILINGS --
MEMBERS THIS IS A VERY IMPORTANT
YEAR WHERE WE CAN MAKE
SIGNIFICANT STRIDES IN REDUCING
THE NUMBER OF UNINSURED
INCREASING AFFORDABILITY TO
COVERAGE -- THE CALIFORNIA
ASSOCIATION HEALTH PLANS ARE CAP
IS ALWAYS WILLING TO ENGAGE IN
CONSTRUCTIVE DIALOGUE ABOUT
AFFORDABILITY AND COST
CONTAINMENT.
AS A PRIMARY PAYER OF HEALTH
SERVICES IN OUR SYSTEM WE ARE IN
A UNIQUE POSITION TO BE HELPFUL
IN THESE DISCUSSIONS --
UNFORTUNATELY EIGHTY SEVEN
THIRTY ONE IS NOT A PRODUCT OF
ANY STAKEHOLDER PROCESS NOR DOES
A NEW IDEA NOR NOR IS IT A NEW
IDEA EXCUSE ME.
VERSIONS OF THIS BILL HAVE BEEN
TRIED A NUMBER OF TIMES IN THE
PAST AND WE HAVE ALWAYS OPPOSED
THE IDEA.
OF SUBJECTING AGREEMENTS BETWEEN
LARGE EMPLOYERS AND HEALTH PLANS
TO REGULATORY REVIEW.
ON IT IT IS INAPPROPRIATE FROM
FROM OUR PERSPECTIVE FOR THE
STATE TO CHARACTERIZE DECISIONS
BETWEEN LARGE SOPHISTICATED
ACTORS IN OUR ECONOMY.
NO CAP DID REMOVE ITS OPPOSITION
TO THE BILL THAT -- HEALTHAXIS
REFERENCED -- FROM -- TWENTY TEN
IN ITS FINAL VERSION A WHICH
INITIATED RATE REVIEW IN THE
INDIVIDUAL AND SMALL EMPLOYER
MARKET -- WHILE WE DON'T
PARTICULARLY ENJOY THE RATE
REVIEW PROCESS AT LEAST IT CAN
BE IMPLEMENTED IN THOSE MARKETS
DUE TO THE FACT THAT THOSE
MARKETS ARE HIGHLY STANDARDIZED.
OF THEIR STANDARD PRODUCT
OFFERING STANDARD BENEFITS AND
BENEFIT DESIGNS IN THEIR
COMMUNITY RATED WHICH LIMITS THE
NUMBER OF FILINGS TO MANAGEABLE
LEVELS.
THAT IS NOT THE CASE IN THE
LARGE EMPLOYER MARKET.
LARGE GROUP IS A CUSTOMIZED IN
NEGOTIATED -- AND YOUR COMMITTEE
ANALYSIS A DEADLY POINTS OUT
THAT -- LARGE GROUP HEALTH
INSURANCE IS LARGELY UNDER
WRITTEN WITH RATES BASED ON
EMPLOYEE PARTICIPATION PRIOR
CLAIMS EXPERIENCE STORE
EXPERIENCE RATING.
THERE ARE LITERALLY THOUSANDS OF
LARGE EMPLOYER GROUP PRODUCTS IN
CALIFORNIA -- THE DEPARTMENT OF
MANAGED HEALTH CARE VERY
RECENTLY REPORTED THAT IN TWENTY
EIGHTEEN THERE WERE THIRTEEN
THOUSAND SIX HUNDRED RENEWING
LARGER PRODUCTS ON THE MARKET.
AND THAT'S JUST THE DEPARTMENT
OF MANAGED HEALTHCARE REGULATED
PRODUCTS -- WE CANNOT
EFFECTIVELY SUBMIT THOUSANDS OF
PRODUCTS RATE REVIEW AND WE
DON'T THINK THE STATE CAN
EFFECTIVELY REVIEW THEM --
CALIFORNIA'S HEALTH PLANS ARE
ALREADY SUBJECT TO A NUMBER OF
DATA REPORTING LAWS AND OTHER
TRANSPARENCY EFFORTS I WOULD I
WOULD.
THE EVEN GO AS FAR AS TO SAY
THAT'S PROBABLY ONE OF THE MOST
IF NOT THE MOST TRANSPARENT --
SECTORS OF THE HEALTH SYSTEM --
AND THAT INCLUDES THE SUBMISSION
OF AGGREGATED LARGE GROUP RATE
INFORMATION SO LARGE GROUP RATE
INFORMATION IS ALREADY GOING TO
THE STATE.
VIA SB FIVE FORTY SIX FROM A
NUMBER OF YEARS AGO -- CAP HAS
SUPPORTED MANY OF THESE
TRANSPARENCY EFFORTS WHERE THE
BENEFIT CONSUMERS AND THE MARKET.
HOWEVER WE BELIEVE POLICYMAKERS
SHOULD STRIKE A REASONABLE
BALANCE BETWEEN USEFUL
TRANSPARENCY AND LAWS A DRIVE UP
COSTS FOR LITTLE TO NO VALUE --
THE CAP ALONG WITH OTHER
STAKEHOLDERS HAS BEEN ASKED TO
PARTICIPATE IN THE HEALTH
PAYMENTS DATA REVIEW COMMITTEE
THAT WAS ESTABLISHED LAST YEAR
VIA AB.
I'M -- EIGHTEEN TEN WHICH WAS A
AUTHORED BY THE BUDGET COMMITTEE
OF LAST YEAR -- THE PURPOSE OF
THIS COMMITTEE IS TO ESTABLISH A
STATE WIDE CASA DATABASE TO BE
USED TO INFORM POLICY DECISIONS
REGARDING THE PROVISION QUALITY
OF HEALTHCARE.
REDUCING THE COST OF CARE IN
SUPPORTING GREATER HEALTH CARE
COSTS TRANSPARENCY -- OUR
ASSOCIATIONS BEEN APPOINTED TO
THE COMMITTEE ALONG WITH OTHERS
AND WE THINK -- THAT THAT IS A
BETTER PLACE TO DISCUSS NEW --
REPORTING REQUIREMENTS -- SO ON
TOP OF EVERYTHING THAT IS BEING
CURRENTLY DONE WE DON'T BELIEVE
THERE'S A COMPELLING REASON TO
NOW REQUIRE LARGE EMPLOYERS TO
BE SUBJECT TO RATE REVIEW.
ORDER REQUIRE PLANS TO SEND OF
VOLUMINOUS AMOUNTS OF NEW
PAPERWORK TO STATE REGULATORS AS
SUCH WE ASK YOU TO VOTE NO ON
ASSEMBLY BILL.
SEVEN THIRTY ONE THANK YOU THANK
YOU.
TELL ME WHY CAN SOME BEHALF OF
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES WE TO UNFORTUNATELY
HERE TODAY IN OPPOSITION TO THE
BILL.
I THINK THE UNFORTUNATE NATURE
OF THIS IS WE DO SEE OURSELVES
AS INSURERS AS PARTNERS WITH A
LARGE GROUP COMMUNITY TO COME UP
WITH PRODUCTS.
AND RATES THAT ARE AFFORDABLE
THAT MEET THEIR INDIVIDUAL NEEDS
I THINK MOST RECENTLY UNDER SB
FIVE FORTY SIX EDA ALSO HELD A
HEARING.
AND LOOKED AT THE AGGREGATE OF
LARGE GROUP RATE FILINGS I THINK
THEY ESTIMATED THIRTY TWO
HUNDRED INDIVIDUAL RATE FILINGS
THAT THEY RECEIVED AND LOOKED
OUT THE LION'S SHARE AT CD I AT
LEAST WERE EXPERIENCE RATED.
I THINK THAT'S SOMETHING THAT WE
NEED TO LOOK AT AS THE VOLUME IN
TOTALITY OF THESE UNIQUE --
INDIVIDUAL FILINGS WE ALSO SEE
OURSELVES AS A COLLABORATIVE
EFFORT WITH OUR LARGE EMPLOYERS
AND SPECIFICALLY SEVERAL YEARS
AGO WE REMOVED OPPOSITION TO SB
ELEVEN EIGHTY TWO WHICH WE
WORKED REALLY HARD WITH THEM TO
SEE. TO PROVIDE THE INFORMATION
THAT WE THOUGHT WAS REALLY
IMPORTANT FOR THEM TO BETTER
UNDERSTAND THE UNDERLYING COST
AND EXPERIENCE WITHIN THEIR
INSURED WORLD AND SO THAT THEY
COULD BETTER AND NEGOTIATE THOSE
RATES AND ALSO COME UP WITH
DIFFERENT PROGRAMS.
DEBT AND DIFFERENT WRITERS ON
THEIR INSURANCE POLICIES TO HELP
THEM MANAGE THE UNDERLYING
ISSUES AND HEALTH CARE CONCERNS
SO WE WE REALLY DO WANT TO WORK
TOGETHER AS A PARTNER AND AS MY
COLLEAGUE REFERENCED.
I THINK UNIVERSALLY MANY OF US
ARE SITTING ON THE REVIEW
COMMITTEE THE EIGHTEEN TEN
ESTABLISHED WITH OUR SPOT TO
TRYING TO COME UP WITH A
COLLABORATIVE WAY TO LOOK AT THE
UNDERLYING COST OF HEALTHCARE.
WE THINK THAT THAT CERTAINLY IS
A VERY VERY USEFUL WAY OF ALL OF
US TO COME TOGETHER IN A
COLLECTIVE WAY TO ANSWER THOSE
NAGGING QUESTIONS THAT EVERYONE
HAS IS WHAT ARE THE COST DRIVERS
IN THE SYSTEM.
AND I THINK OUR LAST CONCERN AND
AND JUST POINTED OUT I'M IN A
SEVERAL THE SECTIONS THEY DO
REMOVE SOME OF THE
CONFIDENTIALITY -- THAT EXISTED
IN STATUTES SINCE THE
ORIGINATION OF ELEVEN SIXTY
THREE THINK WE ARE CONCERNED
ABOUT WHAT THAT WOULD MEAN AND
ALSO THE CONFUSION FOR WHICH IF
YOU PUT OUT DIFFERENT RATES AND
CONTRACTED RATES -- THAT OTHER
INDIVIDUALS WOULDN'T UNDERSTAND
THE EXPERIENCE RATING NOR WHAT
WAS THE DRIVER OF THOSE
INDIVIDUALLY NEGOTIATED RATE SO
FOR THOSE REASONS WE RAIN OPPOSE
BUT LOOK FORWARD TO WORKING WITH
THE COMMITTEE.
AND OTHER STAKEHOLDERS AT THIS
BILL MOVES FOR TODAY.
THANK YOU VERY MUCH IS THERE ANY
OTHER OTHER OPPOSITION MISTER
CHAIR MEMBERS MARIN HIGGINS
REPRESENTING AMERICA'S HEALTH
INSURANCE PLANS ALSO IN
OPPOSITION.
KAREN SARKISIAN WITH THE
CALIFORNIA CHAMBER OF COMMERCE
IN OPPOSITION.
MUCH ANYONE ELSE. TO NUMBER
BRING BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS.
QUESTIONS THE COMMITTEE
[inaudible]
MISS WALDRON.
I GUESS I'LL NEED OFF -- OKAY SO.
I WAS LOOKING BACK ON THE
FEDERAL GOVERNMENT ENACTED THE
ACA -- THEY REQUIRED OF THAT A
WAIT REVIEW BASICALLY WOULD BE
DONE.
ON THE SMALLER INDIVIDUAL
CONTRACTS BUT NOT.
ON THE LARGER AND THAT WAS BASED
ON THAT EMPLOYERS GENERALLY HAVE
A GREATER NEGOTIATING.
ABILITY -- AND CHOICE IN THE
MARKETPLACE.
IN A AND I REMEMBER NEGOTIATING
A LOT OF THINGS WHEN I WAS ON
THE CITY COUNCIL YOU KNOW FOR
THE CITY OF MULTIPLE THOUSANDS
OF EMPLOYEES -- EVEN BACK THEN
THE DEPARTMENT OF HEALTH AND
HUMAN SERVICES INDICATED THAT --
THOSE PURCHASERS OF LARGE GROUP --
MARKETS HAVE GREATER LEVERAGE TO
AVOID ON RATE INCREASES.
SO MY QUESTION AND MAYBE I DON'T
KNOW START WITH THE OPPOSITION
IS.
YOU KNOW HOW MUCH WOULD IT
HEARINGS OF THIS COST BECAUSE
DEFINITELY THERE'S A COST IN
THAT WOULD SOMEHOW END UP IN A
RATES TO I WANT TO SAY.
OR DOESN'T WORK THAT WAY.
HOW DOES THIS?
HOW MUCH IMPACT [inaudible]
IS IT.
WELL THANK YOU FOR THE QUESTION
ASSEMBLY MEMBER ARE YOU KNOW
OBVIOUSLY WE HAVEN'T IN A
SPECIFIC FISCAL ON THIS
PARTICULAR BILL.
BUT TO THE EXTENT THAT THE BILL
WOULD REQUIRE -- YOU KNOW ARE
ALL LARGE GROUP RATE FILINGS TO
BE SUBMITTED -- TO THE STATE --
IT WOULD REQUIRE THE HIRING OF
NEW STAFF AT THE AT THE HEALTH
PLAN LEVEL IN OF COURSE.
WE KNOW THE POLICY MAKERS ARE --
VERY CONCERNED ABOUT THE LEVEL
OF ADMINISTRATION THAT CURRENTLY
EXISTS IN HEALTH CARE -- WE
WOULD SAY THAT -- YOU KNOW THE
STATE HAS ANALYZED -- YOU KNOW
SIMILAR BILLS IN THE PAST AND WE
CAN GO BACK AND CHECK THOSE
ANALYSES OUT -- BUT I THINK YOU
YOU YOU RAISE A REALLY GOOD
POINT THOUGH IN THAT -- IT ONE
OF THE REASONS THE ACA DIDN'T GO
IN THIS DIRECTION IS THAT -- YOU
KNOW THESE ARE LARGE
SOPHISTICATED ACTORS AND THEY
ARE PLANS COMPETE FOR THIS
BUSINESS AND YOU KNOW OBVIOUSLY
WE CAN'T GET INTO SPECIFICS YOU
KNOW BE IN BEING AT THE
ASSOCIATION LEVEL BUT WE HAVE
HEARD STORIES OF THEM TRYING TO
BEAT EACH OTHER OUT FOR THESE
CONTRACTS.
WITH THE EMPLOYERS HAVE A LOT OF
YOU KNOW THE LARGE EMPLOYERS DO
YOU HAVE A LOT OF LEVERAGE IN
THIS AREA WHICH IS WHY IT'S IT
HAS BEEN CONTEMPLATED A VERY
EXPENSIVE TO OPERATE.
PARTICULARLY IF IF -- THE STATE
HAD THIRTEEN THOUSAND RENEWALS
LAST YEAR SO THAT'S THAT'S A LOT.
OF RENEWALS -- SO THAT WOULD BE
A LOT OF WORK FOR OUR PLANS AND
FOR THE STATE'S REVIEW WE'RE NOT
SURE HOW THEY WOULD DO IT.
WHAT ONE OF THE ONLY THE OTHER
THING I WOULD POINT OUT -- TO
THE EXTENT THAT THE DEPARTMENT
HAVE TO HIRE NEW STAFF THAT'S AN
INCREASE TO THE COST OF THE
PLANS BECAUSE THE DEPARTMENT OF
MANAGED HEALTHCARE IS ENTIRELY
FUNDED THROUGH LICENSING FEES ON
HEALTH PLANS SO IT'S A DOUBLE
HIT.
WE WOULD HAVE TO HIRE INTERNALLY
OUR LICENSING FEES WOULD GO UP
FOR THE DEPARTMENT TO HIRE NEW
STAFF.
OKAY.
IT'S THE SAME FOR CDI THEY WOULD
EXPERIENCE THE SAME INFLUX AND
VOLUME THERE MMHM THEIR MARKET
SHARE IS A LITTLE SMALLER BUT
WITH THIRTY TWO HUNDRED
PRESUMABLY A LARGE GROUP FILINGS --
THEY WOULD CERTAINLY HAVE TO
HIRE ADDITIONAL STAFF AND THERE
HAVE BEEN SEVERAL BILLS WHAT IT
TALKED ABOUT THE ADDITIONAL
STOPPING THE MILLIONS SO IF YOU
CAN JUST THINK OF THIS SIZE AND
VOLUME FOR WHICH THAT THEY WOULD
HAVE TO HIRE AND BRING ON
EXPERTS IN ACTUARIES.
THAT'S CERTAINLY A CONCERNED AT
THIS WERE USER FUNDED
[inaudible]
THANK YOU -- FOR FIRST OF ALL TO
SUGGEST SOMEHOW THAT THEY DON'T
HAVE HAND HUNDRED DATA -- WILL
BE IN A SURPRISE TO ME BUT I
WILL JUST SAY THAT.
YOU KNOW THAT'S FIRST KEEP IN
MIND THAT DEPARTMENT MANAGED
HEALTHCARE.
WHICH I ACTUALLY DID SPEAK
BEFORE THEM -- JUST A COUPLE
WEEKS AGO AND THIS BILL WAS VERY
MUCH IN AND THIS IS JOSH WAS
VERY MUCH -- BROUGHT UP THERE
AND THERE WAS NO CONCERN RAISED
IN TERMS OF COST THEM TIME.
THEIR BUDGET IS EIGHTY SEVEN
MILLION DOLLARS OR SO UNDER
POINT 1% OF A HUNDRED BILLION.
DOLLAR PLUS A COMMERCIAL
PREMIUMS.
AND LET'S ALSO KEEP IN MIND THE
DEPARTMENT MANAGED HEALTHCARE
JUST ON THE INDIVIDUAL AND SMALL
pOVER TWO HUNDRED TWENTY SEVEN
MILLION DOLLARS.
THE DEPARTMENT OF INSURANCE TO
SAVE HUNDREDS OF MILLIONS MORE
SO.
THERE'S ABOUT A HALF A BILLION
DOLLARS IT'S ALREADY BEEN SAVED
BECAUSE OF THIS REVIEW PROCESS.
UP ADDITIONALLY LET'S ALSO KEEP
IN MIND THAT CURRENTLY THE
REVIEW OF INDIVIDUAL OR SMALL
GROUP PLANS REALLY APPLIES TWO
HUNDRED OR LESS -- IN TERMS OF
PLAYERS THAT ARE UNDER A LASSEN
THOSE ARE SMALL BUSINESSES.
AB HOWEVER.
LET'S FOR THE KEEP MY THE NINETY
NINE POINT 8% OF EMPLOYERS IN
CALIFORNIA HAVE FEWER THAN FIVE
HUNDRED EMPLOYEES.
SO WE'RE TALKING ABOUT TO WHAT.
THE COMPANIES WHICH ONE
EMPLOYEES HUNDRED FIFTY
EMPLOYEES FOUR HUNDRED EMPLOYEES.
NOT NOT EXACTLY THE KIND OF
WALES OF THE SYSTEM TO HAVE THE
ABILITY TO NEGOTIATE WITH THESE
MASSIVE PLANS -- THE PHARMACY
TORTILLA THEM -- OR REALLY.
THE CHOOSING AMONGST PLANS ARE
OFFERED TO THEM AND NOT.
HAVING THE ABILITY TO TAILOR A
PLAN OF A FOR THEIR OWN NEEDS
AND THE REALITY IS THIS LOOK
[inaudible]
THIS.
ISN'T A NEW IDEA IS AN IDEA THAT
WORKS.
AND AS HAS BEEN WORKING IT'S
BEEN WORKING WITH INDIVIDUALS
BEEN WORKING WITH SMALL PLANS
THIS IS THE OPPORTUNITY FOR US
TO EXPAND IT TO LARGER PLANS.
IF IT'S TRUE.
THAT THERE THAT THESE.
EMPLOYERS.
ARE ARE ACTUALLY TRUE PARTNERS.
THIS WILL GIVE THE ABILITY FOR
THE DEPARTMENT OF MANAGED
HEALTHCARE TO TO REVIEW THE
RATES DETERMINED THAT'S TRULY
THE CASE -- AND IN FACT WHAT WE
FIND IS THAT WHEN THERE IS RATE
REVIEW IN PLACE OF IT
INCENTIVIZE BOTH THE INSURERS
AND EMPLOYERS COME UP WITH PLANS
THAT WORK FOR EVERYONE AND
THAT'S REALLY WHAT IT COMES DOWN
TO IT'S IT'S ONCE A TRANSPARENCY
IS THERE.
AND AGAIN THE DEPARTMENT OF
MANAGED HEALTHCARE THEY THEY
WILL MAKE A STATEMENT AS TO
WHETHER THEY BELIEVE THE RATE
INCREASE AS BEING REQUESTED IS
JUSTIFIED.
AND IT'S JUST THAT ALONE THAT
THAT THAT PUBLIC --
PRONOUNCEMENT BY ITSELF CAUSES
ACTION IN THE MARKET AND THAT'S
WAS ALLOWED THEM THEY ARE THEY
OF SMALL INDIVIDUAL PLANS TO
SAVE TWO HUNDRED TWENTY SIX
MILLION DOLLARS IS BECAUSE THE
SUBSEQUENT ACTION.
AFTER THAT REPORT OUT IS DONE
BECAUSE A DOWNWARD TREND IN THE
INCREASE OF THOSE RATES SO IT'S
SO IT'S REALLY A WINNING
SITUATION NOT TO MENTION
SOMETHING I KNOW THAT.
THE CHAIR IS ON A GREAT JOB AND
FOCUSING ON HIS DATA THERE'S
ALSO A PART OF PROVIDE A LOT
MORE DATA FOR US AS WE GO
OF DETERMINING
POINTS.
AND PRICE PRESSURES ARE
HEALTHCARE SYSTEM.
THANK YOU I JUST I HAD THAT --
IF I CAN FIND IT.
JUST GOING BACK FOR TWENTY
SIXTEEN AND TWENTY SEVENTEEN THE
AVERAGE PREMIUM INCREASE -- AN
INDIVIDUAL AND SMALL GROUP
MARKETS WAS ABOUT TEN POINT 6%.
WHERE IS THE AVERAGE PREMIUM
INCREASE FOR THE THE SEVEN
LARGEST INSURERS IN LARGE GROUP
MARKETS WAS? FOUR POINT 8%.
SO.
THERE IS A VALUE TO THOSE THE
NEGOTIATIONS THAT'S GOING ON
WITH THE LARGER.
ABSOLUTELY I THINK THE FACT THAT
THEY ARE LARGER GIVES THEM A
BETTER ABILITY ABOUT BUT BECAUSE
OF THE VOLUME TO HAVE LOWER
RATES.
WE WOULD PRESUME THAT IT FOR THE
OTHER WAY AROUND.
THAT WOULD BE REALLY FISHING.
AND SO I THINK THAT THAT
PROBABLY THAT IS IN LINE WITH
HELD.
IS SUPPOSED TO WORK AND THIS IS
NOT A GOTCHA YEAH WE'RE NOT OUT
THROUGH THE THE THIS BILL IS NOT
OUT BE PUT OUT THERE TO TRY TO
GO AFTER.
THE INSURERS ARE TRYING AND
TRYING TO FIND OUT THE YOU KNOW
THE BAD ACTORS WE HOPE THAT.
THAT YOU KNOW THE RATE REVIEW
OCCURS AND EVERYTHING IS GREAT.
YOU KNOW BUT THE REALITY IS THAT
REPUBLICAN TO BE IT I'D BE ABLE
TO IDENTIFY SOME PRESSURE POINT
SOME PRICE POINTS SOME AREAS
WHERE WE CAN DO BETTER.
AND SO THAT'S WHY IT'S REALLY
IMPORTANT FOR US TO HAVE THIS
ADDITIONAL ABILITY TO BE ABLE
REVIEW THE RATES AMONGST A LARGE
GROUPS WHO COVER FAR MORE PEOPLE
THAN INDIVIDUAL SMALL GROUP
PLANS COLLECTIVELY.
THANK YOU THANK YOU [inaudible]
OTHER QUESTIONS.
SO I I DO I DO HAVE ONE AND SO
AND I'LL OPEN THIS TO BOTH SIDES
SO.
YOU YOU MENTIONED IN YOUR
COMMENTS -- THAT A LOT OF PEOPLE
TAKE AN OFF THE SHELF PLAN
[inaudible]
SO -- AND THEN WE'VE HEARD THAT
THERE WERE LIKE.
THIRTEEN THOUSAND REVIEWS IT
WOULD HAVE TO HAPPEN.
DO YOU HAVE A DO WE HAVE AN IDEA
OF WHAT THE HOW MANY BUT THE
PERCENTAGE OF PEOPLE THAT TAKE
THESE OFF THE SHELF PLANS.
A REVIEW IS EVERY YOU MEAN.
IF IT'S THE SAME PLAN DO WE HAVE
ANY IDEA.
WELL THAT WAS THAT.
IF I CAN DO IS TO FURTHER MY
WITNESS I THINK SHE MIGHT HAVE A
SUGGESTION.
THINK OF MISTER CHAIR MEMBERS
BEST FELL FOR HEALTH ACCESS AND
TEAMSTERS UNION RIGHT HERE.
I WANT TO POINT TO TWO THINGS
THE EXPERIENCE OF TRUST FUNDS
THAT NEGOTIATE IS THAT THERE
ISN'T IT IS.
RATHER LIKE BUYING A NEW CAR
THERE ARE VARIOUS OPTIONS IN
COLORS OFFERED BUT IT'S NOT AN
ENDLESS SET OF OPTIONS AND
COLOURS AND COLORS THAT ARE
AVAILABLE IN TERMS OF THE
PRODUCTS THAT ARE OFFERED.
I WOULD ALSO POINT TO THE RECENT
REPORT ON THE LARGE GROUP MARKET
THAT FIND 70% OF THE LARGE GROUP
MARKET JUST COMMUNITY RATED.
AND ANOTHER 20% IS A BLEND OF
EXPERIENCE RATED AND COMMUNITY
RATED.
IF SOMEONE IS ONLY 10% IS PURELY
EXPERIENCE RATED.
SOMEWHAT IN CONTRAST TO WHAT THE
OTHER SIDE SAID IN TWENTY ELEVEN
WHEN WE BEGAN RATE REVIEW IN
CALIFORNIA.
THERE WAS NO REQUIREMENT FOR
COMMUNITY RATING IN THE
INDIVIDUAL AND SMALL GROUP
MARKETS AND INDEED FOR THE FIRST
SEVERAL YEARS TO THE ACA WAS NOT
IN A FACT AND SO IF THE
INDIVIDUAL AND SMALL PLAYER
MARKETS WERE ALSO EXPERIENCE
RATED.
SO IT'S ENTIRELY POSSIBLE TO DO
THIS IN A MARKET THAT IS
EXPERIENCE RATED AND INDEED IN
MOST OF INSURANCE.
PROPERTY HOMEOWNERS AUTO IT'S
EXPERIENCE RATED AND YET THERE
IS.
RATE REGULATION WHICH THIS BILL
DOES NOT PROPOSE THIS BILL DOES
NOT SAY THAT THE REGULATOR CAN
SAY YES OR NO IT'S JUST
TRANSPARENCY.
AND SO WE THINK IT'S ENTIRELY
POSSIBLE TO DO THIS WE
UNDERSTAND.
THE OPPOSITION BECAUSE WE
UNDERSTAND THEY DON'T WANT
ANYBODY DOUBLE CHECKING THEIR
RATES.
BUT ONE THOSE OF US WHO ARE THE
PROPONENTS REPRESENT.
THE CONSUMERS THE TEN MILLION
CONSUMERS WHO WORK FOR LARGE
EMPLOYERS WHO ARE HAVING RATE
REVIEW ENVY BECAUSE THOSE WHO
HAVE INDIVIDUAL AND SMALL
BUSINESS COVERAGE CHAPTER RIGHT
CHECKED.
THIS TOO IS A SEA OF A SO THE
QUESTION WAS A QUESTION OF SCOPE.
OKAY -- YOU KNOW I KNOW THERE
WAS ONE PROVISION IN SB FIVE
FORTY SIX WHICH REQUIRE THE
PLANS I IF I'M REMEMBERING
CORRECTLY TO REPORT LIKE.
WHAT PERCENTAGE WAS -- COMMUNITY
RATED VERSUS EXPERIENCE RATED
BUT I MEAN EVEN IN LOOKING AT SO
LET'S SAY 30%.
OF THE MARKET IS A BLEND OF
EXPERIENCE RATING COMMUNITY
RATED IN 10% -- IS -- STRICTLY
EXPERIENCE RATED I MEAN 1010% OF
WE WE WHAT DID WE SAY ABOUT
SIXTEEN THOUSAND SEVENTEEN
THOUSAND PRODUCTS OUT THERE.
IS STILL A VERY I MEAN WE'RE
STILL TALKING IN THE THOUSANDS
OF PRODUCTS THAT COULD
POTENTIALLY BE SUBJECT. TO TO
RATE REVIEW UNDER THIS SO
THERE'S NO LIMITING FACTORS IN
THIS BILL AT ALL SO OUR
PRESUMPTION THEN OF COURSE HAS
TO BE THAT EVERY SINGLE RATE HAS
TO BE REVIEWED UNDER THIS BILL.
I'M TRYING TO CHANNEL THAT
RECENT SB FIVE FORTY SIX HEARING
BECAUSE THEY DID HAVE A NICE
LITTLE INFO GRAPHIC ON AND WHAT
WAS THE COMMUNITY RATED AND
BLENDED AND WHAT WAS EXPERIENCE
RATED I BELIEVE THAT THE LION'S
SHARE AT CDI AT LEAST WAS
EXPERIENCE RATED -- BUT WE CAN
CERTAINLY GET THAT INFORMATION
FOR YOU I DON'T WANNA MISS STATE
ACTUAL NUMBERS BUT I WOULD SAY
YOU'RE PROBABLY TALKING AT CD
GUY MAYBE AT LEAST A THOUSAND IF
NOT MORE INDIVIDUAL FILINGS BUT
I GUESS THAT I'D WANT TO MAKE
SURE THAT WE WERE CORRECT ON
THAT.
BEFORE THE GAME.
THANK YOU -- OTHER QUESTIONS OR
COMMENTS FROM ANYONE -- DOES
ENJOY DO PASS RECOMMENDATION
MISTER KALRA -- RECOGNIZING THAT
THERE STILL OBVIOUSLY WORK TO DO
HERE -- AND HOPE THAT BOTH
PARTIES WILL CONTINUE TO WORK
TOGETHER -- THIS IS A
CHALLENGING ISSUE AND AND YOU
KNOW.
WHY YOU MIGHT THE WHAT WE MIGHT
THINK THE DATA WOULD BE EASY TO
GET YOUR EASY TO COMBINE I WOULD
SAY THIS THIS YOUR NUMBERS MAKE
IT MAKE IT A CHALLENGE BUT I BUT
I?
ABSOLUTELY RECOGNIZE THAT THERE
IS VALUE IN THAT DATA SO -- SO
WITH THAT WOULD YOU LIKE TO
CLOSE.
THANK YOU MISTER CHAIR THANKS
FOR THE RECOMMENDATION FOR YOUR
INSIGHT -- BUT I THINK YOU'RE
YOU'RE.
IANS AND PASS ON THIS WILL BE
WELCOMED EVEN.
BEYOND THIS COMMITTEE HEARINGS
THANK YOU AND I WOULD SUGGEST --
IF YOU HAVEN'T HAD THE
OPPORTUNITY -- TO OTHER MEMBERS
THE DEPARTMENT OF MANAGED
HEALTHCARE TO AGREE PRESENTATION
ON LARGE GROUPS JUST A COUPLE
WEEKS BACK UP AND WE CAN
CERTAINLY MAKE THAT ABILITY I
THINK THAT JUST SERVING ON THIS
COMMITTEE IT MIGHT BE A HELPFUL
THING JUST. TO TO REVIEW BUT
WITH THAT I RESPECTFULLY ASK FOR
LIKE MY VERY MUCH.
WE HAVE A MOTION.
MR MCCARTY SECOND.
SECOND.
MR SANTIAGO SEVEN MOTION BY
MISTER MCCARTY A SECOND BY
MISTER SUN AT SANTIAGO.
THE MOTIONS TO PASS TWO PROBES --
SECRETARY PLEASE CALL THE ROLL
WHAT I WOULD AYE MAYES.
AGUIAR-CURRY AGUIAR-CURRY AYE
BIGELOW.
BONTA.
BURKE.
BURKE I CARILLO.
CARILLO AYE FLORA.
FLORA NO HELLO.
MCCARTY MCCARTY AYE THIS AREA.
RAMOS.
ROSS I RODRIGUEZ.
SANTIAGO.
SANTIAGO AYE WALDRON.
WALDRON NO [inaudible]
SEC.
GIVE SEVEN VOTES WE HAVE THE
MEMBERS MISSING WILL LEAVE THE
ROLE.
OR I SHOULD WILL LEAVE A CALL
EXCUSE ME SO -- SEE MISTER
MULLIN.
AB.
SEVEN THIRTEEN THANK YOU MISTER
CHAIRMAN.
AND MEMBERS PRESENTING AB SEVEN
THIRTEEN A FOLLOW UP TO LAST
YEAR'S AB THIRTEEN FIFTEEN THIS
BILL SEVEN THIRTEEN WOULD HELP
DELIVER.
MUCH NEEDED RESOURCES TO COUNTY
SO THAT THEY ARE BETTER EQUIPPED
TO PROVIDE EARLY PSYCHOSIS
DETECTION SERVICES.
IN TWENTY SEVENTEEN I AUTHORED
THIRTEEN FIFTEEN WHICH
ESTABLISHED THE EARLY PSYCHOSIS
DETECTION AND INTERVENTION FUN.
TO GRANT COUNTIES -- FUNDING TO
PROVIDE ESSENTIAL MENTAL HEALTH
SERVICES TO RESIDENTS ACROSS THE
STATE. SEVEN THIRTEEN SIMPLY
REMOVED THE ORIGINAL REQUIREMENT.
THAT NON STATE FUNDS BE
DEPOSITED INTO THE FUND BEFORE
THE PROGRAM IS IMPLEMENTED
ENSURING THAT THE COMMISSION CAN
BEGIN ALLOCATING RESOURCES FOR
THE PURPOSE OF EARLY PSYCHOSIS
DETECTION.
A. B. SEVEN THIRTEEN WILL GIVE
COUNTIES THE OPPORTUNITY TO
BEGIN PROVIDING PREVENTATIVE
CARE FOR MENTAL HEALTH
CONDITIONS SHIFTING AWAY FROM
THE STANDARD REACTIONARY CARE.
THAT MANY RECEIVE ONCE THEIR
CONDITIONS HAVE SEVERELY
PROGRESSED WITH ME TODAY IS
ADRIAN SHELTON WITH THE
STEINBERG INSTITUTE AS WELL AS
TOBY EWING WITH THE MENTAL
HEALTH SERVICES OVERSIGHT AND
ACCOUNTABILITY COMMISSION. TO
OFFER ADDITIONAL COMMENTS IN
SUPPORT.
GOOD AFTERNOON ADRIN CHILDREN
WITH THE STEINBERG INSTITUTE
ASKING FOR YOUR SUPPORT TODAY
ASSEMBLY BILL SEVEN THIRTEEN WE
WERE THE PROUD SPONSORS OF
ASSEMBLY BILL THIRTEEN FIFTEEN
THAT BACK IN TWENTY SEVENTEEN
AND HAVE BEEN WORKING.
IN PARTNERSHIP WITH THE
OVERSIGHT AND ACCOUNTABILITY
COMMISSION TO SET UP THE EARLY
PSYCHOSIS GRANT PROGRAM.
WE BELIEVE THIS GRANT PROGRAM IS
ABSOLUTELY CRITICAL TO THE
MENTAL HEALTH SERVICE DELIVERY
SYSTEM IN CALIFORNIA.
THERE ARE SIGNIFICANT --
ALARMING TRENDS AND ADOLESCENT
MENTAL HEALTH THAT SHOULD GIVE
ALL OF US REASON TO THINK MORE
ABOUT HOW WE PREVENT.
AND INTERVENE EARLIER IN A YOUNG
PERSON'S LIFE IN THE EARLY
COURSE OF THEIR ILLNESS -- THE
GOVERNOR HAS PROPOSED TWENTY
FIVE MILLION DOLLARS IN NEW
FUNDING TO SUPPORT AND SCALE UP
EARLY PSYCHOSIS PROGRAMS ACROSS
THE STATE.
AND WE ARE ACTUALLY SUPPORT THIS
PROPOSAL AND BELIEVE THAT IT
SHOULD BE ALIGNED WITH THE
FRAMEWORK THAT HAS BEEN
ESTABLISHED BY THE OVERSIGHT
COMMISSION THROUGH THE MANDATE
CONTAINED IN ASSEMBLY BILL.
THIRTEEN FIFTEEN SO FOR THOSE
REASONS WE ASK FOR YOUR SUPPORT
TODAY THANK YOU.
THANK YOU STREAMLINED
GOOD MARKET DEFINITION CHEN
MEMBERS MY NAME IS TOBY EWING
HIGH AND ACCEPTED DIRECTOR THE
KNOW HOW SERVICES OVERSIGHT AND
ACCOUNTABILITY COMMISSION --
THANK THE AUTHOR FOR HIS
LEADERSHIP ON THIS IN RESPONSE
TO THIRTEEN FIFTEEN THE
COMMISSION HAS BEEN WORKING TO
PUT IN PLACE THE STRATEGY TO
REALLY BUILD OUT A STATEWIDE
INITIATIVE TO SUPPORT EARLY
PSYCHOSIS.
CHALLENGES IN CALIFORNIA'S
HIGHLIGHTED IN THE ANALYSIS OF
THESE CAN BE SOME OF THE MOST
CRUCIAL PROGRAMS IN THE STATE
PARTICULARLY FOR YOUNG PEOPLE AS
THEY'RE EXPERIENCING A FIRST
PSYCHOSIS THAT CAN LEAD TO
CRIMINAL JUSTICE INVOLVEMENT
SUICIDE HOMELESSNESS.
THE CHALLENGES THAT HAVE BECOME
THE PUBLIC FACE OF OUR MENTAL
HEALTH SYSTEM IN CALIFORNIA.
WE SAID WE THINK THIS PROGRAM IS
ESSENTIAL TO TO REALLY IMPLEMENT
THE GOALS OF THE MENTAL HEALTH
SERVICES ACT WHICH ARE TO TO
PROVIDE A STRATEGY WHERE WE'RE
PURSUING PREVENTION EARLY
INTERVENTION.
WE'VE BEGUN TO WORK WITH THE
COUNTY IS WE'VE PUT IN PLACE A
STRUCTURE TO RECEIVE FUNDS WE'VE
PUT IN PLCE A STRATEGY TO
ENGAGE OUR RESEARCH EXPERTISE IN
UC DAVIS UC SAN DIEGO UC SAN
FRANCISCO AND ELSEWHERE WERE
WORKING WITH AND FEDERAL
AGENCIES.
THE THE BILL WOULD CHANGE THIS
RESTRICTION IN THAT THE REGIONAL
DRAFTING THIRTEEN FIFTEEN SO
THAT WE CAN BETTER ALIGN BURKE
OR ALREADY DOING WITH NEW
OPPORTUNITIES PARTICULARLY FOR
THOSE COUNTY SMALLER RURAL
COUNTIES THAT MAY NOT HAVE THE
LOCAL RESOURCES. TO MAKE THE
CONNECTIONS THAT THEY NEED TO
REALLY PUT IN PLACE EVIDENCE
BASED EFFECTIVE REALISTIC
BECAUSE THIS PROGRAMS.
WE VERY MUCH SUPPORT THIS THANK
YOU HAVE IDENTITY QUESTIONS YOU
MIGHT HAVE.
THANK YOU VERY MUCH OTHERS IN
SUPPORT.
SIR ANYONE IN OPPOSITION.
SEE KNOWN -- BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS [inaudible]
MISS WALDRON.
WELL THIS IS THE OBVIOUSLY A
PROGRAM THAT NEEDS TO GO THROUGH.
SO I SUPPORT IT AND AS YOU KNOW
WE'VE LEARNED.
HOW YOUNG PEOPLE YOU KNOW BY AGE
FOURTEEN AND BETWEEN FOURTEEN
AND TWENTY FOUR IS ONE A LOT OF
THE DIAGNOSIS OF COMING OUT --
GETTING YOUNG PEOPLE INTO CARE
EARLIER.
IS YOU KNOW THE WAY TO GO TO
REALLY MAKE SURE THAT THEY CAN.
YOU KNOW PROSPER IN THEIR LIVES
AS WELL AS IT WILL SAVE MONEY IN
THE LONG RUN SO [inaudible]
THANK YOU [inaudible]
ANYONE ELSE.
SEEING SEEING NO ONE OF THANK
YOU FOR BRINGING THE GO FORWARD --
DOES ENJOY DO PASS
RECOMMENDATION WE HAVE A MOTION
BY MISTER SANTIAGO A SECOND BY
MISTAKE YEAR CURRY.
WHICH I CLOSE THE MOBILE WE HAVE
AMENDMENTS I'M SORRY DO YOU JUST
I THANK MY COLLEAGUE FROM
ESCONDIDO FOR THE COMMENTS AND I
APPRECIATE THE CHURCH
RECOMMENDATION ASK FOR SUPPORT.
AND YOUR EXCEPT IN OUR
AMENDMENTS YES I AM OKAY SO THE
MOTION IS DO PASS AS AMENDED.
ACTUALLY WILL GO STRAIGHT TO THE
FLOOR -- SO MA'AM SECTOR PLEASE
CALL THE ROLL WHAT I WOULD AYE
MAYES.
AGUIAR-CURRY.
CURRY I BIGELOW [inaudible]
BONTA.
BURKE.
BURKE I CARILLO.
CARILLO AYE FLORA.
FLOOR I LEVEL.
MCCARTY MCCARTY I IN THIS AREA.
RAMOS RAMOS I RODRIGUEZ.
SANTIAGO SANTIAGO AYE WALDRON
[inaudible]
HI.
GIVE NINE VOTES OF THOSE OUT
WILL LEAVE WITHOUT ROLE OPEN FOR
OTHERS TO ADD ON THANK YOU VERY
MUCH.
THIS POINT -- WE DO HAVE ANOTHER
AUTHOR LOOKS LIKE PRESENT -- BUT
WE WELL I'D LIKE TO MOVE THE CAT
IS SEE IF SOMEONE'S WILLING TO
MOVE THE CONSENT CALENDAR.
SO WE HAVE -- THE OF THE MOTION
BY MISTAKE YEAR CURRY SECOND AYE
MR SANTIAGO THE CONSENT CALENDAR
HE INCLUDES ITEM NUMBER TWO AB
TWO FOURTEEN BY MR MULLIN.
ITEM NUMBER SEVEN AB SIX
NINETEEN BY MISTER.
TO ITEM NUMBER FOURTEEN EIGHTY
SEVEN EIGHTY ONE BY MR
MAIENSCHEIN WITH AMENDMENTS --
ITEM NUMBER -- SEVENTEEN AB
EIGHT NINETY NINE BY WOULD AND I
WOULD AND NUMBER -- EIGHTEEN AB
NINE SIXTEEN BY MURATSUCHI AND
SURGERY PLEASE CALL THE ROLL
WHEN I WOULD AYE MAYES.
AGUIAR-CURRY BAKER CURRY I
BIGELOW BONTA BURKE.
BURKE I CARILLO CARILLO AYE
FLORA FLORA LIMóN.
MCCARTY MCCARTY I IN THIS AREA.
RAMOS.
ROSS I RODRIGUEZ.
SANTIAGO.
SANTIAGO AYE WALDRON
[inaudible]
HI.
SO THE HAS NINE VOTES THE
CONSENT CALENDAR IS PASS AND
SEEN.
THIS PETRIE-NORRIS YOU A COME
FORWARD I DON'T SEE OTHER
AUTHORS SO.
I'M HERE TODAY TO ASK FOR YOUR
SUPPORT FOR A BI TEN SIXTY THREE
THE PURPOSE OF THIS SPELL IS TO
PROTECT CALIFORNIANS AGAINST ON
GOING FEDERAL ATTEMPTS TO
UNDERMINE THE AFFORDABLE CARE
ACT.
THIS BILL WOULD REQUIRE REQUIRE
LEGISLATIVE APPROVAL AND THE
STATE CHANGE IN STATUTE PRIOR TO
MAKING ANY CHANGES TO THE CAP
COVERED CALIFORNIA PROGRAM
THROUGH THE USE OF THIRTEEN
THIRTY TWO WAIVERS. THIRTEEN
THIRTY TWO WAIVERS ALLOW A STATE
TO WAIT EXTENSIVE PORTIONS OF
THE AFFORDABLE CARE ACT.
PROVISIONS OF THE ACA THAT CAN
BE WAIVED THROUGH THIS PROCESS
INCLUDE THE RULES REGARDING THE
REGULATION OF QUALIFIED HEALTH
PLANS COST SHARING REDUCTIONS
AND PREMIUM TAX CREDITS AND THE
INDIVIDUAL AND EMPLOYER MANDATES.
AS PART OF ITS STRATEGY TO
UNDERMINE THE AFFORDABLE CARE
ACT IN OCTOBER OF TWENTY
EIGHTEEN THE TRUMP
ADMINISTRATION ISSUED A NEW
FEDERAL GUIDANCE AND
REINTERPRETATION AT THIRTEEN
THIRTY TWO WAIVERS.
DRAMATICALLY RELAXING WAIVER
GUARDRAILS.
UNDER THE NEW TRUMP
ADMINISTRATION GUIDANCE SECTION
THIRTEEN THIRTY TWO WAIVERS GIVE
STATES THE ABILITY TO WAIT OUT
OF OFFERING COMPREHENSIVE
COVERAGE.
OR COVERING A COMPARABLE NUMBER
OF PEOPLE THIS ACTION EXPOSES
PEOPLE WITH PRE EXISTING
CONDITIONS TO HIGHER PREMIUMS OR
LACK OF COVERAGE. THREE
INTERPRETATION ALSO ALLOWS
STATES TO PURSUE THIRTEEN THIRTY
TWO WAIVERS WITHOUT THE NEED FOR
EXPLICIT STATE LEGISLATION.
INSTEAD WAIVERS CAN NOW BE
AUTHORIZED PER STATE REGULATION
OR EXECUTIVE ORDER.
IN CALIFORNIA THE LEGISLATURE
PLAYED A KEY ROLE IN THE
IMPLEMENTATION OF THE AFFORDABLE
CARE ACT HERE IN CALIFORNIA.
AND SHOULD CONTINUE TO WAY AND
SHOULD ANY MAJOR CHANGES
REQUIRING YOUR WAIVER OF FEDERAL
LAW BE CONTEMPLATED.
AND WHILE WE DO NOT ANTICIPATE
AT THIRTEEN THIRTY TWO WAY FOR
ISSUE ARISING AT THIS MOMENT.
WE DO KNOW THAT MOMENTS DO
CHANGE AND BELIEVE THAT IT IS
IMPORTANT TO FIRST TO SHORE UP
THE ACA IN CALIFORNIA TO
POTENTIAL THREATS.
SECOND TO CODIFY THE
LEGISLATURE'S ROLE IN MAKING
THESE SORTS OF SWEEPING POLICY
CHANGES TO THE ACA.
AND THIRD TO ENSURE AN EFFECTIVE
SYSTEM OF CHECKS AND BALANCES AB
TEN SIXTY THREE AT THE NECESSARY
LAYER OF PROTECTION TO THE ECA.
BY REQUIRING STATE LEGISLATIVE
APPROVAL FOR SECTION THIRTEEN
THIRTY TWO WAIVERS I
RESPECTFULLY REQUEST THE
COMMITTEE SUPPORT AND I AM
PLEASED TO INTRODUCE. TO
SUPPORTERS THAT ARE HERE TO
TESTIFY TODAY.
PLEASE GO AHEAD.
GOOD AFTERNOON MR TURN MEMBERS
ANY MISTRUST CAM RANH I'M HERE
ON BEHALF OF HEALTH ACCESS
CALIFORNIA THE STATE WIDE HEALTH
CARE CONSUMER ADVOCACY COALITION
AND WE ARE PROUD CO SPONSORS OF
AB TEN SIXTY THREE WHICH WOULD
REQUIRE EXPLICIT LEGISLATIVE
APPROVAL.
BEFORE APPLYING AND SUBMITTING
AT THIRTEEN THIRTY TWO WE EVER
TO THE FEDERAL GOVERNMENT.
AT THIRTEEN THIRTY TUESDAY
INNOVATION WAIVERS ALLOW STATE
TO PURSUE.
ALTERNATIVE THAT THAT'S A IN
PLENTY THAT YOU SEE IN THEIR
SEATS AS LONG AS THEY UPHOLD THE
ORIGINAL GOALS OF THE ACA.
WITH A THIRTEEN THIRTY TWO
WEAVER STATES ARE ABLE TO AND
RED COVERAGE AS LONG AS
COMPREHENSIVE AS THE EASY GAME
PROVIDE COVERAGE AND COST
SHARING PROTECTIONS AGAINST
EXCESSIVE OUT OF POCKET SPENDING
THAT ARE AT LEAST AS AFFORDABLE
AS THE ACA.
PROVIDE COVERAGE THE SEMEN
RESIDENTS THAT WOULD BE COVERED
UNDER THE ACA.
THEY ALSO NEED TO AND NOT
INCREASE THE FEDERAL DEFICIT AND
MAKE SURE THEY HAVE LEGISLATIVE
APPROVAL BEFORE DOING SO.
UNDER THE NEW TRUMPET
ADMINISTRATION GUIDELINE OF THE
THIRTEEN THIRTY TWO LEVERS THE
STRESS HOLDER REINTERPRETED AND
ULTIMATELY -- ALLOWS THE TO
SABOTAGE THE ECA WELL WE DON'T
EXPECT CALIFORNIA TO REVERSE ALL
OF THE GREAT WORK WE HAVE DONE
INTO MANY OF THE ACA WE WANT TO
MAKE SURE THE LEGISLATURE.
HAS -- AN ACTIVE ROLE IN ANY
PART OF ANY FUTURE THIRTEEN
THIRTY TWO CONSIDERATION THE
SAME WAY THAT THEY HAD -- A ROLE
IN INCLUDING THE ACA FOR THESE
REASONS WE ASK YOUR AYE ABOUT
THANK YOU.
GOOD AFTERNOON CHEN FLOOR WITH
WESTERN CENTER ON LAW AND
POVERTY -- JUST TO GIVE SOME
CONTEXT IN TWENTY SEVENTEEN THE
TRUMP ADMINISTRATION TRIED THAT
TRIED THIS WITH OUR MEDICAID
PROGRAM.
AND THEY BEGAN APPROVING WAIVERS
THAT WOULD ALLOW FOR WORK
REQUIREMENTS LOCKOUT PERIODS AND
ALL SORTS OF THINGS THAT -- PUT
PEOPLE'S COVERAGE AT RISK -- AS
A RESULT WE'VE SEEN A LOT OF
ONGOING LITIGATION FEDERALLY AND
IN STATES WHERE THEY HAVE
IMPLEMENTED SUCH WAIVERS PEOPLE
OF LOST COVERAGE.
IN ARKANSAS FOR EXAMPLE OVER
EIGHTEEN THOUSAND PEOPLE LOST
COVERAGE BY THE END OF LAST YEAR --
SO IN RESPONSE HERE IN
CALIFORNIA WE THAT THIS
LEGISLATURE PASSED SB ELEVEN OH
EIGHT TO SAFEGUARD OUR MEDI CAL
PROGRAM AND WE'RE REALLY SEEKING
TO DO THE SAME THING HERE FOR
COVER CALIFORNIA PROGRAM IN
RESPONSE TO THE SAME KIND OF
THREAT -- AND THEN YOU KNOW I
THINK MOST PEOPLE DO KNOW
SOMEBODY WHO'S BEEN HELD BY THE
AFFORDABLE CARE ACT AND
PARTICULARLY BY THE
COMPREHENSIVE -- REQUIREMENTS
THAT COVERAGE COVER EVERYTHING
AND NOT YOU KNOW BE SLIMMER
SKINNY INSURANCE PRODUCTS -- AND
THEN I DID WANT TO POINT OUT
THAT YOU KNOW WE'RE PROUD OF THE
WORK THAT WAS DONE HERE IN
CALIFORNIA TO IMPLEMENT THE ACA.
AND IT WAS A LEGISLATURE THAT
TOOK THE LEAD THROUGH THE
IMPLEMENTING LEGISLATION.
AB TEN SIXTY THREE DOESN'T
REQUIRE THE EVERY DETAIL OF A
THIRTEEN THIRTY TWO WAIVER BE
WORKED OUT THREE STATUTE.
IT MERELY KEEPS THE AUTHORITY TO
MAKE LAW WITHIN THE REALM OF THE
LEGISLATURE THIS MAINTAINING THE
STATUS QUO.
COVER CALIFORNIA IN THE
LEGISLATURE WORKED UNDER SUCH
PARTNERSHIP BEFORE WHETHER
THROUGH PREVIOUS WAIVER PROPOSAL
OR THROUGH THE MORE RECENT AB
EIGHTEEN TEN AFFORDABILITY
WORKGROUP WHERE THE LEGISLATURE
REQUIRED COVER CALIFORNIA AT TO
PRODUCE A REPORT ON OPTIONS. FOR
INCREASING AFFORDABILITY FOR
COVER CALIFORNIA AND COVER
CALIFORNIA THEN WORKS THROUGH
THE DETAILS AND PRODUCED ITS
REPORT WE WOULD EXPECT SUCH
PARTNERSHIP TO CONTINUE.
AND FOR THESE REASONS I THINK
THE AUTHOR FOR HER LEADERSHIP ON
THIS ISSUE AND I RESPECTFULLY
ASK DR.
THANK YOU VERY MUCH OTHER
SUPPORT.
MAXINE INTEL ON BEHALF OF THE
NATIONAL MULTIPLE SCLEROSIS
SOCIETY AND SUPPORT.
REBEKAH GONZALEZ NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER IN SUPPORT.
MARKETS BECAUSE THE HOLD
CALIFORNIA PENALTY KILL THEIR
WORK IN SUPPORT.
THANK YOU [inaudible]
ANYONE ELSE.
THERE ANYONE IN OPPOSITION.
SEEING NO ONE WILL BRING BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS.
SEEING NONE THIS DOES ENJOY DO
PASS RECOMMENDATION -- WOULD YOU
LIKE TO CLOSE.
THANK YOU FOR ADD THE COMMITTEES
ANALYSIS AND THANK YOU FOR YOUR
DO PASS RECOMMENDATION I
RESPECTFULLY ASK FOR YOUR I FELT
THANK YOU -- THE MOTION WILL BE
TO HAVE A MOTION -- PART THE
MOTION NOW BY MISS MISS KOREA.
THE SECOND BY MISTER RAMOS THE
MOTION IS DO PASS -- M.
SECRETARY PLEASE CALL THE ROLL
WHAT I WOULD AYE MAYES.
AGUIAR-CURRY.
THANK YOU ARE CURRY I BIGELOW
[inaudible]
BONTA.
BURKE.
BURKE AYE CARILLO [inaudible]
I FLORA [inaudible]
LIMON [inaudible]
MCCARTY [inaudible]
NAZARIAN.
RAMOS.
ROSS I RODRIGUEZ [inaudible]
SANTIAGO.
SANTIAGO AYE WALDRON
[inaudible]
WATER.
NINE GIVE SEVEN VOTES WE NEED
ONE MORE WE'RE MISSING THE FEW
MEMBERS SO -- LEAVE THE LEAVE
THE BILL ON CALL.
THANK YOU VERY MUCH THANK YOU
[inaudible]
MS RAMOS.
THANK YOU MISTER CHAIR AND
MEMBERS WHO WOULD LIKE TO BEGIN
BY THANKING THE CHAIR AND THE
COMMITTEE FOR WORKING WITH MY
OFFICE ON THIS BILL.
I ACCEPT AMENDMENT A LOCATED IN
THE AMENDMENT SECTION OF THE
ANALYSIS AND I ACCEPT A SIX YEAR
SUNSET ON THIS BILL'S PROVISIONS.
AS DISCUSSED WITH THE COMMITTEE
STAFF.
AB SEVEN SEVEN FOR THE DATA
COLLECTION BILL WHICH REQUIRES
THE OFFICE OF STATEWIDE HEALTH
PLANNING AND DEVELOPMENT TO
TRACK WAITING PERIODS FOR
PATIENTS AN EMERGENCY
DEPARTMENTS.
THAT ARE SEEKING TRANSFER TO A
PSYCHIATRIC FACILITY
[inaudible]
PSYCHIATRIC FACILITIES WHICH
PROVIDE A VARIETY OF MENTAL
HEALTH SERVICES INCLUDE BOTH
INPATIENT HOSPITAL UNITS AND
DISTINCT FACILITIES THE PROVIDE
PSYCHIATRIC CARE.
WHEN PATIENTS ARE IN NEED OF
MENTAL HEALTH SERVICES THEY
OFTEN SEEK CARE IN BY ACCESSING
THE NEAREST EMERGENCY DEPARTMENT?
IN MANY CASES ONCE YOU VALUE
WAITED PATIENTS MUST BE
TRANSFERRED TO A DEPARTMENT THAT
CAN BETTER MEET TO THEIR NEEDS.
ENSURING TRANSFERS OCCUR AS
EFFICIENTLY AS POSSIBLE IS
CRITICAL BECAUSE OF ITS IMPACT
ON THE PATIENTS HOSPITAL STAFF
AND OTHERS IN NEED OF CARE
PROVIDED IN EMERGENCY
DEPARTMENTS.
AB SEVEN SEVEN FOUR PROVIDES A
LEGISLATURE.
HOSPITAL'S PSYCHIATRIC
FACILITIES AND THE PUBLIC WITH
INFORMATION THAT WILL HELP
INFORM.
THE STEPS NECESSARY TO ADDRESS
THIS PROBLEM BY QUANTIFYING ITS
SCOPE.
THIS BILL PROVIDES A NECESSARY
FOUNDATION OF INFORMATION TO
ADDRESS A GROWING PROBLEM AND
BETTER ASSESS HOW WELL
CALIFORNIA'S PROVIDING KEY
MENTAL HEALTH SERVICES.
HERE TO TESTIFY ON BEHALF OF
THIS BILL IS TO MADDEN
REPRESENTED THE CALIFORNIA
CHAPTER OF THE AMERICAN COLLEGE
OF EMERGENCY PHYSICIANS.
TALK SHARE MEMBERS TO MADDEN
RIVERS IN THE CALIFORNIA CHAPTER
OF THE BEAR CALLS MERCY
PHYSICIANS AND I'M NOT SURE I
CAN REPEAT -- ANYTHING IT MORE
ELOQUENTLY THE MISS REYES STOOD
THIS INFORMATION THE VERY
VALUABLE NOT ONLY TO POLICY
MAKERS BUT ALSO TO STAKEHOLDERS
IF WE GET A BETTER HANDLE.
ON THE BOARDING TIMES NUMBERS TO
DEPARTMENTS THAT WE CAN MORE
SPECIFICALLY ADDRESS THAT
PROBLEM IN TRYING TO HELP
PATIENTS GET THE CARE THEY NEED --
I'M AVAILABLE FOR ANY QUESTIONS
OR RESPECTFULLY ASK YOUR I. BUT
EACH OTHER SUPPORT.
BRANDON MARCH YOU WITH THE
CALIFORNIA MEDICAL ASSOCIATION
STRONGLY SUPPORT [inaudible]
MUCH.
HUNTER PATTERSON SPEAKING ON
BEHALF OF THE CALIFORNIA
EMERGENCY MEDICINE RESIDENTS
ASSOCIATION IN SUPPORT THANK YOU
VERY MUCH. THIRTY ONE IN
OPPOSITION YES.
MISTER CHAIRMAN RESULTS AUTHOR
OF THE CALIFORNIA ASSOCIATION WE
DID ISSUE AN OPPOSE POSITION WE
HAD SOME CONCERNS AROUND THE
METHODOLOGY OF DATA COLLECTION.
THAT BEING SAID APPRECIATE THE
VERY PRODUCTIVE CONVERSATIONS
WITH THE AUTHORS OFFICE THE
SPONSORS AND LOOK FORWARD TO
FINDING A WAY TO MAKE IT WORK
[inaudible]
THANK YOU [inaudible]
ANYONE ELSE.
SEE NO ONE BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS.
SEEING NONE WOULD CHIU LIKE
CLOSE MYSTERIES.
I RESPECTFULLY REQUEST YOUR AYE
VOTE ON THIS VERY IMPORTANT BILL.
THANK YOU VERY MUCH THE BILL
DOES ENJOY A DO PASS
RECOMMENDATION -- WERE WAITING
FOR A MOTION AND A SECOND.
A MOTION BY MS BURKE SECOND BY
MISS CARILLO THANK YOU THANK YOU.
MADAM SECRETARY PLEASE CALL THE
ROLL THE MOTION IS DO PASS AS
AMENDED.
WHAT I WHAT I AM MAYES?
AGUIAR-CURRY.
HI AGUIAR-CURRY I BIGELOW.
BONTA BURKE.
BURKE I CARILLO.
CREEL AYE FLORA [inaudible]
THE MOST [inaudible]
MCCARTY.
NAZARIAN.
REBELS.
ASIDE RODRIGUEZ.
SANTIAGO.
SANTIAGO AYE WALDRON
[inaudible]
WALDRON AYE.
WE HAVE SEVEN WE ARE SORT OF
SHORT OF OUR NUMBERS HERE SO --
WILL LEAVE THE BILL ON CALL
THANK YOU VERY MUCH MISS REST
THANK YOU DOCTOR WOOD MISTER
CHAIR.
IN FIFTEEN MINUTES -- SANTIAGO
SEE NO OTHER AUTHORS PRESENT
WOULD YOU LIKE TO PRESENT YOUR
BILL. TO PRESENTING AB.
FOR FIFTY ONE WITH THIS YEAR
APPRECIATE BROTHERLY.
CHAIR ALWAYS APPRECIATES BREVITY.
IF IF THE COMMITTEES WILLING TO
HELP ALONG THOSE LINES.
OKAY NOW MAY I HAVE A MOMENT YOU
BY MISTAKE YOU'RE CARRYING A
SECULAR MISTER RAMOS HOUSE AFTER
BREVITY LEAVE THE ONE SENTENCE
EIGHTY FIVE FIFTY ONE WOULD
REMOVE BEARS AND CURRENT LAW SO
THAT A PERSON WITH MENTAL.
HEALTH CONDITIONS HAS TIMELY
ACCESS TO EMERGENCY CARE AND
SERVICES -- WITH ME UP ONE
WITNESS MISTER CHAIR OF THE
ASSEMBLY BILL FOR FIFTY ONE
FORTY ONE CRISIS HERE ALL RIGHT.
ABOUT I WANT TO PASS SOMEBODY
ELSE'S BILL.
THANK YOU NOT ON OUR WATCH.
THANK YOU MISTER ABOUT THE DUTCH
CHAIR TO MADDEN REP IN
CALIFORNIA CHAPTER THE AMERICAN
COLLEGE OF EMERGENCY PHYSICIANS
WITH THE SPONSOR OF THIS BILL --
WE RESPECTFULLY ASK DR.
OTHERS IN SUPPORT.
ADRIAN CHILDREN WITH THE
STEINBERG INSTITUTE IN SUPPORT
THANK YOU.
BRENT IN MARCH WITH THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT THANK YOU.
HI PATTERSON CALIFORNIA
EMERGENCY MEDICINE RESIDENTS
ASSOCIATION IN SUPPORT.
VERY MUCH.
REBEKAH GONZALEZ NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER IN SUPPORT.
THANK YOU VERY MUCH.
IS THERE ANYONE IN OPPOSITION.
SEE NO ONE BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS OR COMMENTS
FROM THE COMMITTEE.
SEEING NONE -- MISTER SANTIAGO
WHICH EXCLUDES I THINK IT'S
CHAIR SPEC LAST NIGHT.
THE BILL ENJOYS A DO PASS
RECOMMENDATION ISTO PASS TO
APPROPRIATIONS WE HAVE A MOTION
BY MISS -- BURKE A SECOND BY
MISS CARILLO.
NO SECTOR PLEASE CALL THE ROLL
WHAT I WOULD AYE MAYES.
I CARE CURRY.
AGUIAR-CURRY AYE BIGELOW.
BONTA BURKE.
I CAREER.
CARILLO AYE FLORA LIMóN MCCARTY.
NAZARIAN ALMOST.
SO I RODRIGUEZ RODRIGUEZ AYE
SANTIAGO.
AYE SANTIAGO AYE WALDRON.
WE HAVE EIGHT YOUR BILL IS OUT
THANK YOU LEAVE THE BILL ON I'M
NOT A CAR WILL BE ABLE TO OPEN
FOR OTHERS TO ADD ON THANK YOU
SIGNATURE MUCH [inaudible]
MISS REAVIS.
YEP ASSEMBLY BILL NINE TWENTY
NINE BEFORE US [inaudible]
OKAY.
OKAY THANK YOU CHAIR AND MEMBERS
I'M EXCITED TO PRESENT AB NINE
TWO NINE WHICH ENSURES COVERED
CALIFORNIA HAS THE AUTHORITY TO
COLLECT THE DATA IT NEEDS. TO
FULLY EVALUATE HOW HEALTH PLAN
IS DELIVERING CARE AND TO
PUBLISH THAT DATA BY HEALTH PLAN.
SPECIFICALLY COVERED CALIFORNIA
WILL BE ABLE TO SEE WHICH PLANS
ARE MAKING PROGRESS TOWARDS
LOWERING COSTS REDUCING HEALTH
DISPARITIES BILL.
AND IMPROVING OVERALL HEALTH
CARE QUALITY.
PUBLISHED IN THE STATE OF MY
HEALTH PLAN WILL EMPOWER
PATIENTS TO MAKE THE BEST
DECISIONS RELATED TO THEIR
HEALTH CARE NEEDS.
BY ALLOWING THEM TO CHOOSE THE
BEST HEALTH PLAN FOR THEM.
THE PROCESS TO LIMóN EIGHTEEN
HEALTH DISPARITIES INEQUITY IN
EQUITIES STARTS WITH HIGH
QUALITY DATA AND AB TWO NINE TWO
NINE IS THE FIRST STEP.
THANK YOU AND I'M HAPPY TO
ANSWER ANY QUESTIONS FROM THE
COMMITTEE [inaudible]
WITNESSES.
GOOD AFTERNOON MR CHEN MEMBERS
AND JDS ON BEHALF OF HEALTH
ACCESS CALIFORNIA PRACTICAL
SPONSOR EIGHTY NINE TWO NINE
WITH THE CALIFORNIA PAN ETHNIC
HEALTH NETWORK -- AS OF RIGHT
NOW COVER CALIFORNIA IS UNIQUELY
POSITIONED TO USE ITS AUTHORITY
AS AN ACTIVE PURCHASER. TO
NEGOTIATE WITH HEALTH PLANS TO
ADVANCE DELIVERY SYSTEMS REFORM
AND ALSO HEALTH EQUITY.
SINCE THE CREATION OF COVER
CALIFORNIA AS WELL AS ITS
ATTACHMENT SEVEN CONTRACT
PROVISION IN TWENTY THIRTEEN
PUBLIC REPORTING ON PLAN
SPECIFIC CONTRACT REQUIREMENTS
ON COST QUALITY.
AND HEALTH DISPARITY DATA HAS
BEEN THE STATED GOAL.
INSTEAD THE FIRST SET OF THE AD
THAT WAS MADE PUBLIC WAS IN THE
AGGREGATE AND DID NOT SHOW PLAN
SPECIFIC RESULTS.
THEREFORE THE DATA SHOWED
POSITIVE RESULTS AND FINDING BUT
BECAUSE THE DATA WAS IN THE
AGGREGATE AND NOT PLANT SPECIFIC
WE CANNOT KNOW WHICH PLAN
ACTUALLY MET THE REQUIREMENTS.
AND IF THE ELEVENTH PLAN IN
THESE FINDINGS ARE ALWAYS THE
SAME PLAN OR A DIFFERENT PLAN --
BECAUSE THE DATA IS INSUFFICIENT
AND DOES NOT ALLOW FOR PLAN BY
PLAN COMPARE SAN AB NINETY NINE
WOULD FIX THIS PROBLEM AND FOR
THESE REASONS WE ASK FOR YOUR
AYE SUPPORT THANK YOU.
VERY MUCH SIR.
THE TERM MEMBERS MARKETS CUSTER
ON THE CALIFORNIA SENATE NICK
HEALTH NETWORK ALSO PRO CO
SPONSORS THIS BILL -- STATED AS
THEIR MISSION -- COVER
CALIFORNIA'S COSTS INCREASE THE
NUMBER OF INSURED CALIFORNIANS
IMPROVE HEALTHCARE QUALITY --
LOWER COSTS AND REDUCE HEALTH
DISPARITIES -- IN ORDER TO
IMPROVE QUALITY AND REDUCE
DISPARITIES IN -- TWO THOUSAND
SIXTEEN WE WORKED WITH CAL
COVERED CALIFORNIA -- TO ADD
CONTRACT REQUIREMENTS THAT FOCUS
ON REPORTING AN IMPROVING HEALTH
OUTCOMES -- PARTICULARLY FOR
HISTORICALLY UNDERSERVED
COMMUNITIES AS FAR AS THE TWO
THOUSAND SEVENTEEN CONTRACT --
REQUIREMENTS HEALTH PLANS ARE
REQUIRED TO SHOW PROGRESS.
TOWARDS HEALTH HEALTH
DISPARITIES REDUCTION BY RACE
ETHNICITY AND GENDER AND KEY
TARGET AREAS WERE DOCUMENTED
SEVERITIES EXIST INCLUDING
DIABETES HYPERTENSION AND ASTHMA
AND BEHAVIORAL HEALTH.
OF FOR SAID DATA COLLECTED FROM
THE PLANTS -- WAS DISCLOSED IN
JANUARY OF THIS YEAR I AS MY
COLLEAGUE MENTIONED -- THE DATA
WAS PRESENTED AND AN AGGREGATE
FASHION -- IN ITS STATED FINDING
SUCH AS THE BEST PERFORMING
HEALTH PLANS RIGHT ABOVE THE
NINETIETH PERCENTILE.
IN -- DIABETES CONTROL
NATIONWIDE WHILE THE LOWEST --
PERFORMING PLAN RANK AT THE
FIFTIETH PERCENTILE NOT BEING
ABLE TO DIFFERENTIATE BETWEEN
THE PLANS IN THEIR PERFORMANCES
CONCERNING BECAUSE OF THE
IMPORTANCE OF IMPROVING HEALTH
OUTCOMES FOR CALIFORNIANS.
OVER ELEVEN MILLION PEOPLE IN
CALIFORNIA REPORT HAVING ONE OR
MORE CHRONIC CONDITIONS ABOUT
THREE MILLION ADULTS REPORT
HAVING TWO OR MORE.
LOW INCOMING -- COMMUNITIES OF
COLOR EXPERIENCE DISPARITIES AT
A DISPROPORTIONATELY HIGHER RATE
ACROSS MANY CONDITIONS FOR
EXAMPLE IN CALIFORNIA LATINOS
AND AFRICAN AMERICANS -- OF
TWICE THE PREVALENCE OF TYPE TWO
DIABETES AND ARE TWICE AS LIKELY
TO DIE FROM THE DISEASE.
PLANS AND COVER CALIFORNIA RAISE
CONCERNS ABOUT THEIR AUTHORITY
TO RELEASE MORE SPECIFIC DATA --
BUT THE STATE AS NECESSARY TO
DRIVE IMPROVEMENT HOLE PLANS
ACCOUNTABLE FOR HEALTH OUTCOMES
FOR THEIR MEMBERS.
OF BREAKING THE DATA DOWN
FURTHER WOULD ALLOW US TO SEE
WHICH PLANS ARE ARE PERFORMING
WELL ON HOW TO IMPLEMENT THOSE
PRACTICE IS IN THE PLANS THAT
ARE LAGGING BEHIND.
THIS BILL SEEKS TO CLARIFY --
THAT PLANTS MUST REPORT AND
REALLY DATA -- TO COVER
CALIFORNIA COVER CALIFORNIA MUST
PUBLICLY REPORT THAT BY ON A
PLAN BY PLAN BASIS -- HEALTH
DISPARITIES IN INEQUITIES CAN
ONLY BE ELIMINATED IF THERE'S
HIGH QUALITY DATA AVAILABLE TO
IDENTIFY MINDER PROBLEMS WITHIN
THE HEALTHCARE DELIVERY SYSTEMS.
AND AB NINETY NINE WOULD ADDRESS
THIS AND FOR THAT REASON WE'RE
PROGRESS SPONSOR AND I REQUEST
ARRIVAL.
VERY MUCH.
OTHER SUPPORT.
MR CHAIRMAN MEMBERS MARK WINDOWS
WITH US HERE YOU CALIFORNIANS
STRONG SUPPORT.
CHEN FLORES WESTERN CENTER ON
LAW AND POVERTY IN SUPPORT.
SO ANYONE IN OPPOSITION.
SEE KNOWN TO BRING BACK TO THE
COMMITTEE QUESTIONS OR COMMENTS
FROM THE COMMITTEE.
SEEING NONE -- THE BILL WOULD
YOU LIKE WHAT FIRST FOR THE BILL
ENJOYS A DO PASS RECOMMENDATION.
WOULD YOU LIKE TO CLOSE THANK
YOU I RESPECTFULLY ASK FOR YOUR
IBM.
THANK YOU THE WE HAVE A MOTION
BY MISS CARILLO A SECOND BY
MISTER RAMOS MOTIONS DO PASSED
TO APPROPRIATIONS BUT OF
SECRETARY PLEASE CALL THE ROLL.
WHAT I WOULD AYE MAYES?
AGUIAR-CURRY BAKER CURRY I
BIGELOW.
BONTA BURKE.
BURKE I CARILLO CARILLO AYE
FLORA.
LIMóN.
MCCARTY THIS AREA RAMOS.
FROM US I RODRIGUEZ RODRIGUEZ
AYE SANTIAGO.
SANTIAGO AYE WALDRON.
WALDRON AYE.
YOUR BECAUSE EIGHT VOTES IS OUT
OF COMMITTEE WILL LEAVE THE ROLE
OPEN FOR OTHERS TO ADD ON THANK
YOU THANK YOU VERY MUCH THIS
REQUEST.
MR GRAY.
AB.
EIGHT FORTY EIGHT GOOD AFTERNOON.
MISTER CHAIRMAN MEMBERS.
YOU'RE GONNA FIND COMMITTEE
MISTER.
A CHORUS OF SECONDS THERE MR
GRAY WAS AMAZING -- NUMBERS
TODAY -- BEFORE YOU AGAIN WITH
AB EIGHT FORTY EIGHT MANDATING
THAT MEDI CAL.
I'D COVERAGE FOR CONTINUOUS
GLUCOSE MONITORS WHEN MEDICALLY
NECESSARY FOR THE MANAGEMENT AND
TREATMENT OF DIABETES.
SOME OF YOU MAY BE EXPERIENCING
DEJA VU.
AS THIS IS THE THIRD YEAR.
I HAVE BROUGHT THIS ISSUE TO THE
LEGISLATURE.
IN TWENTY SEVENTEEN WE PASSED A
BILL WOULD UNANIMOUS BIPARTISAN
SUPPORT IN BOTH CHAMBERS.
I IT WAS AWFULLY VETOED BY
GOVERNOR BROWN WITH INSTRUCTIONS
TO THE DEPARTMENT OF HEALTH CARE
SERVICES TO UTILIZE THEIR
EXISTING AUTHORITY TO RECTIFY
THE SITUATION.
FAST FORWARD AND SHOCKINGLY
ENOUGH THEY FAILED TO RECTIFY
THE SITUATION.
IN IN -- WE BROUGHT A BUNCH OF
HOLES FOR THE FOLLOWING YEAR --
IN WHICH WAS ADOPTED INTO THE
ASSEMBLY VERSION THE BUDGET --
BEFORE BEING STRIPPED OUT IN
CONFERENCE COMMITTEE AT THE
ADMINISTRATION'S REQUEST.
SO TODAY WITH A NEW LEGISLATIVE
SESSION AND A NEW GOVERNOR.
WE ARE BEFORE YOU AGAIN IN THE
THIRD ATTEMPT THIS BILL SIMPLY
REQUIRES MEDI CAL PROVIDE THE
SAME COVERAGE FOR CONTINUOUS
GLUCOSE MONITORS AS MEDICARE.
COVERED CALIFORNIA THE MEDICAID
PROGRAMS OF MORE THAN THIRTY
STATES 90% OF MANAGED CARE PLANS.
AND THE CALIFORNIA CHILDREN'S
SERVICES PROGRAM.
AB EIGHT FORTY IS SUPPORTED BY
THE AMERICAN DIABETES
ASSOCIATION THE WESTERN CENTER
ON LAW AND POVERTY IN THE
CALIFORNIA SCHOOL ASSOCIATION
AMONG MANY OTHERS.
THERE IS NO OPPOSITION.
I AM JOINED TODAY BY A RISING
STAR AND PROBABLY THE BEST ISSUE
ADVOCATE I HAVE ON ANY BILL
ALEXIS ERICSSON YOU GARCIA.
LEXUS'S TESTIFIED THE ASSEMBLY
AND THE SENATE IN SUPPORT OF
EVERY ITERATION OF THIS BILL.
AND IS GOING TO SEE THIS THING
THROUGH WITH ME TO THE END SO
ALEXIS [inaudible]
SORRY.
GOOD AFTERNOON MR CHAIRMAN
MEMBERS MY NAME IS ALEXIS
SECTION GARCIA AND AMERICAN
DIABETES ASSOCIATION PATIENT
ADVOCATE.
ENTER MISS TEEN SACRAMENTO
INTERNATIONAL.
TWENTY NINETEEN I'M HERE TODAY
TO ASK YOU TO VOTE I ON AB.
EIGHT FORTY EIGHT THIS BILL
WOULD MAKE CGM A COVERED BENEFIT
UNDER MEDICARE OUT BY MAKING CDM
AT MEDI CAL COVERED BENEFIT.
KIDS LIKE ME IN THE CCS PROGRAM
WILL KNOW THAT THEY CAN KEEP
THEIR CGM AS THEY MOVE INTO
DON'T MEDI CAL.
AND ALL PEOPLE WITH DIABETES A
MEDI CAL WILL BE ABLE TO HAVE
ACCESS TO THE LIFESAVING CGM
DEVICE THAT THE PHYSICIANS
PROVIDE.
I HAVE TYPE ONE DIABETES.
I WAS DIAGNOSED EIGHTEEN MONTHS
WITH THIS INCURABLE AUTOIMMUNE
DISEASE.
BEING NEARLY DIAGNOSE MEANT
HAVING TO USE CHEAP TYPES OF
INSULIN EVERY DAY TESTING OF
COURSE TO TWELVE TIMES A DAY AND
LOTS OF INJECTIONS.
SHORTLY AFTER I WAS DIAGNOSED I
WAS REMOVED FROM MY BIOLOGICAL
PARENTS IN PLACE IN THE
CALIFORNIA FOSTER CARE SYSTEM.
I WAS PLACE IN SEVERAL FOSTER
HOMES WHEN I WAS FOSTER WHEN I
WAS A FOSTER CARE.
LUCKILY ONE FOSTER PARENT HAD
TYPE ONE DIABETES SO MADE THE
TRANSITION A LITTLE EASIER.
IN TWO THOUSAND ELEVEN I WAS
PLACE WITH AND FINALLY ADOPTED
BY MY DAD'S.
I THINK GREW OLDER MY PHYSICIAN
AND PARENTS DECIDED NEW NEWER
TECHNOLOGIES INCLUDING THE
INSULIN PUMP AND CONTINUOUS
GLUCOSE MONITOR WOULD HELP.
WHAT BETTER HELP ME MANAGE MY
DIABETES?
THESE TECHNOLOGIES HAVE MADE AN
AMAZING CHANGE IN MY DIABETES
MANAGEMENT.
AND HAVE ALLOWED ME TO LIVE
HEALTHIER AND DO THINGS AND THAT
OTHERWISE I MAY HAVE NOT BEEN
ABLE.
TO I CAN BE SUCCESSFULLY IN
PAGEANTS I AM THE CHAMPION HORSE
RIDER OWNER AND BREEDER OF MY
NIGERIAN DWARF GOATS HEARD.
I'VE ALSO BEEN A MENTOR TO
FOSTER AND THE QUESTIONING
FACILITY.
THE TECHNOLOGY EVEN HELPS ME TO
DO SIMPLE THINGS LIKE OVER TO
FRIENDS HOUSES AND HAVE
SLEEPOVERS WITHOUT ANY WORRIES.
THAT'S BECAUSE MY CGM HELPS ME
BY ISSUING AN ALARM IN MY BLOOD
SUGAR IS DROPPING.
LOW SO ME AND OTHERS CAN
INITIATE QUICKLY.
AND PREVENT SEVERE HAVE
HYPOGLYCEMIA OR LOW BLOOD
GLUCOSE LEVELS WHICH CAN RESULT
IN MEMBERSHIP FEES AND EVEN
DEATH.
HOWEVER FOR A PERIOD OF A TIME
OBTAINING A CGM IS DIFFICULT FOR
ME AND MY FAMILY.
MY DAD SPENT HOURS WORKING WITH
MY MEDI CAL CASE MANAGER MY
DOCTOR'S OFFICE AND THE PHARMACY
SO THAT I COULD EVENTUALLY GET
THE TECHNOLOGY.
WHILE WAITING FOR THE CGM MY
BLOOD SUGAR WAS.
SOMETIMES UNCONTROLLABLE FOR A
NUMBER OF REASONS INCLUDING THE
FACT THAT I WAS GOING THROUGH A
GROWTH SPURT.
FORTUNATELY I WAS VERY LUCKY
INDEED GET MY SEJAM BUT I KNOW
OTHERS WHO RECEIVE THEIR CARE
FOR MEDI CAL ARE NOT SO LUCKY
AND I READ THAT WHEN I TURNED.
EIGHTEEN I WILL LOSE MY COVERAGE.
FOR THAT'S WHY I'M HERE TODAY.
I WANT TO TELL YOU DIED BIG
DREAMS HAVING ACCESS TO MEDI CAL
TECHNOLOGY IS HELPING YOU REACH
MY GOALS.
BECAUSE WITH GOOD HEALTH IT'S
POSSIBLE.
I'M WORKING TOWARDS MY GOALS AT
ATTENDING UC DAVIS TO BECOME A
LARGE ANIMAL VETERINARIAN.
AND BE LIKE MY DAD WHO IS ALSO A
NINETY I DREAM OF JOINING THE
HUNTER JUMPER QUESTIONING TEAM
AND REPRESENTING DAVIS AT
COMPETITIONS.
OTHER CALIFORNIANS WHO ARE ON
MEDICARE WANT TO BE HEALTHY
REACH THEIR GOALS.
TO AB EIGHT FORTY EIGHT IT'S
IMPORTANT FOR ALL OF US.
IT IS BECAUSE OF THIS I ASK THAT
YOU MISTER CHAIR MEMBERS.
WELL I ON AB EIGHT FORTY EIGHT
SO THAT I AND OTHERS COVERED BY
MEDICARE MAY CONTINUE TO PURSUE
OUR DREAMS WITHOUT INTERRUPTION.
THANK YOU FOR YOUR TIME
CONSIDERATION AND ALLOW ME TO
SHARE MY STORY.
THANK YOU VERY MUCH WELL THEN.
GOOD AFTERNOON MISTER CHAIR
SHARE GONZALEZ ON BEHALF OF THE
AMERICAN DIABETES ASSOCIATION I
CAN'T SAY ANYTHING THAT OUR
PATIENT ADVOCATE HAS BEEN
ALREADY SAID AND SHE SAYS THAT
SO MUCH BETTER THAN MYSELF.
WE ARE LEADING A COALITION TO
SUPPORT AB EIGHT FOUR EIGHT BY
ASSEMBLY MEMBER GRAY OUR
COALITION CONSISTS OF THE
AMERICAN ASSOCIATION OF CLINICAL
ENDOCRINOLOGIST.
THE AMERICAN ASSOCIATION OF
DIABETES EDUCATORS THE DIABETES
PATIENT ADVOCACY COALITION AND
MANY MANY MORE -- I WELCOME YOUR
QUESTIONS AND WE RESPECTFULLY
REQUEST YOUR IPHONE.
THANK YOU VERY MUCH AND OTHER
SUPPORT PLEASE.
MR CHAIRMAN MEMBERS GOOD
AFTERNOON ALL OVER OPERATE
CALIFORNIA LIFE SCIENCES
ASSOCIATION IN STRONG SUPPORT
THANK YOU.
RIGHT SPENCER WITH AMERICAN
COLLEGE OF OBG WHY INSTITUTE
NINE IN SUPPORT.
THANK YOU.
CHRIS TAPIO BOARD MEMBER THE
NORTHERN CALIFORNIA JDRF CHAPTER
AND PARENT OF A YOUNG MAN WITH
TYPE ONE DIABETES IN SUPPORT.
THANK YOU.
JIMMY JACKSON UP WITH BIO CON IN
STRONG SUPPORT THANK YOU.
FIELDING GRIEVES WITH ADVANCED
MEDICAL TECHNOLOGY ASSOCIATION
SUPPORT.
IN A PRESS THE CALIFORNIA
ASSOCIATION HEALTH SERVICES AT
HOME IN SUPPORT.
MY NAME IS SERRA BOYD I'M A
REGISTERED DIETITIAN AND
CERTIFIED DIABETES EDUCATOR MY
FIRST TIME AT THE CAPITOL AND I
SUPPORT -- PEOPLE LIKE ALEXIS I
SEE THEM EVERY DAY IN THE
HOSPITAL WHO ARE ALL TURNING
EIGHTEEN OR TWENTY ONE AND ARE
GOING TO GET KICKED OFF OF THESE
LIFESAVING DEVICES AND I REALLY.
BELIEVE THAT EVERYONE SHOULD
HAVE ACCESS TO THEM THANK.
KELLY BEAM A HALF THE CALIFORNIA
MEDICAL ASSOCIATION IN SUPPORT
THANK YOU.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY IN SUPPORT.
THANK YOU THOMAS ERICKSON FATHER
OF LEXUS IN SUPPORT.
SPENCER SAXON SUPPORT THANK YOU.
MILEY'S I HAD WITH CALIFORNIA
CHRONIC CARE COALITION IN STRONG
SUPPORT THANK YOU THANK YOU.
MICHELLE GIVENS OF THE COUNTY
HEALTH EXECUTIVES ASSOCIATION
REPRESENTING LOCAL HEALTH
DEPARTMENTS IN SUPPORT THANK YOU
VERY MUCH.
IS THERE ANYONE IN OPPOSITION.
QUESTIONS OR COMMENTS FROM THE
COMMITTEE -- THESE LOT THESE
LIFE SAVING DEVICES AND MY
BROTHER -- JUST RECENTLY MET ME
THROUGH FOR YEARS SO FINALLY GOT
ON THE PUMP AND IT CHANGED HIS
LIFE.
AND TO HAVE TO THINK THAT YOU
MAY NOT HAVE THE ACCESS TO THIS
WHEN YOU'RE EIGHTEEN OR TWENTY
ONE BREAKS MY HEART.
I WILL BE AN AYE VOTE FOR YOU
TODAY.
MISTER RODRIGUEZ I JUST HAD TO
SAY SOMETHING YOU KNOW I WANT TO
THANK THE MEMBER FOR BRINGING
THIS A FORD IT'S A GREAT IDEA
AND I LOOK FORWARD.
TO THIS -- GET SIGNED BY THE
GOVERNOR BECAUSE IT'S A BIG CAL
FOR PATIENTS SUFFERING FROM
DIABETES OFFICER FOR FIRST
RESPONDERS AS WELL.
CAN HELP -- GET YOU THAT REALLY%
INFORMATION IN THE TREATMENT YOU
NEED VERSUS GOING TO THE MERGER
ROOMS AND DEALING WITH ALL OF
THAT SO REALLY WANT TO THANK THE
AUTHOR AND EVERYTHING YOU'RE
DOING FOR THIS.
SOMEONE FOR SPORT THANK YOU
[inaudible]
ANYONE ELSE.
I JUST AS WAS A NUMBER ONE THANK
YOU FOR YOUR PERSISTENCE MISTER
GRAY -- AND I SENT AND SPECIAL
THANK YOU TO YOUR WITNESS -- FOR
FOR COMING FORWARD WITH YOUR
YOUR INCREDIBLE STORY -- I IT'S
IT'S OBVIOUS THAT THIS IS NOT A
DEVICE IS NECESSARY FOR EVERY
PERSON BUT FOR THOSE PEOPLE THAT
IS NECESSARY FOR IT IS AN
IMPORTANT -- DEVICE THAT CAN
HELP THEM LEAD A NORMAL LIFE AND
AND PROTECT THEIR SAFETY SO THAT
WE HAVE THE OPPORTUNITY SEE HER
BECOME.
A MEMBER THE UC DAVIS HUNTER
JUMPER TEAM AT SOME POINT SO --
SO THE THE BILL DOES ENJOY A DO
PASS RECOMMENDATION -- THE
RECOMMENDATION IS TO PASS TO
APPROPRIATIONS THE MOTION BY WAS
MISTER WAS BY MISTER FLOOR THERE
WAS A CHORUS OF SECONDS BUT I'LL
GIVE IT TO MISTER SANTIAGO -- I
WOULD LOVE TO BE A IF THE BILL
PASSES OUT IT WOULD LOOK VIçT
IS A CO AUTHOR I THINK YOU FOR
YOUR PERSISTENCE -- LET'S GET
THIS CROSS THE LINE.
MA'AM SECTOR PLEASE CALL THE
ROLL.
WHAT I WOULD AYE MAYES AYE MAYES
AYE AGUIAR-CURRY?
AGUIAR-CURRY I BIGELOW.
BONTA.
BURKE BURKE I CARILLO.
CARILLO AYE FLORA.
FLOOR I LEVEL.
THE LOAN I MCCARTY.
THIS AREA.
NAZARIAN AYE RAMOS ROSS AYE
RODRIGUEZ.
RODRIGUEZ I SANTIAGO SANTIAGO
AYE WALDRON.
THE BILL HAS ELEVEN VOTES SITS
OUT BELIEVE THE ROLE OF THE
BROTHERS THAT ON TIMES CHAIR
THANK YOU MEMBERS THANK YOU VERY
MUCH [inaudible]
MR CHAPTER.
JANET IN THE BILL.
SECOND.
BY MISTER SANTIAGO SECOND BY
MISTER NAZARIAN GRAY THANK YOU
VERY MUCH HOUSE RECOMMENDATION
BY THE CHAIR ALRIGHT WONDERFUL
THANK YOU I'LL JUST TO KEEP IT
BRIEF IF I COULD -- THANK YOU
AGAIN MISTER CHAIR AND MEMBERS --
EIGHTY THREE EIGHTY FOUR WOULD
IMPLEMENT REASONABLE REGULATIONS
FOR THE USE OF DIGITAL HEALTH.
FEEDBACK SYSTEMS INCLUDING ITEMS
KNOWN AS DIGITAL PILLS.
WHAT TECHNOLOGY STANDS TO
IMPROVE HOW HEALTHCARE IS
DELIVERED THESE ADVANCEMENTS TO
NOT COME WITH THE RISK?
HEALTH AND MEDICAL INFORMATION
IS BY ITS VERY NATURE DEEPLY
PERSONAL AND SENSITIVE.
NEW MEDICAL TECHNOLOGY MAKES
MEDICAL INFORMATION EASILY AND
QUICKLY ACCESSIBLE OF THE
APPLICATIONS AND WEBSITES AND
CALIFORNIA HAS ENSURE THAT
MEDICAL INFORMATION HELD BY
MOBILE DEVICES.
IS PROTECTED UNDER ALL PRIVACY
LAWS.
HOWEVER IN ORDER TO BE
CONSIDERED MEDICAL INFORMATION
DISTANCE INFORMATION GENERALLY
NEEDS TO BE.
GENERATED BY -- THE HEALTH CARE
PROVIDER INFORMATION THAT IS
GENERATED BY DIGITAL HEALTH
FEEDBACK SYSTEM MEANING AT THE
PATIENT LEVEL IN OUTSIDE.
OF A MEDICAL FACILITY WILL NOT
NECESSARILY BE CAPTURE UNDER THE
EXISTING DEFINITION OF MEDICAL
INFORMATION -- THE BILL IS
IDENTICAL TO AB TWENTY ONE SIXTY
SEVEN WHICH DYSKINESIA
UNANIMOUSLY PASSED LAST YEAR --
AND WITHOUT I RESPECTFULLY ASK
FOR RIVAL.
THANK YOU VERY MUCH -- DO YOU
HAVE OTHER SINCE IT PEOPLE
SUPPORT.
IN A SPORTSCASTER OKAY THANK YOU
VERY MUCH OPPOSITION.
CHAIRMAN MEMBERS GOOD AFTERNOON
ALL OF ROCK ROY CALIFORNIA LIFE
SCIENCES ASSOCIATION. ONE OF THE
MANY COST DRIVERS AND HEALTHCARE
IS KNOWN IT HERE IT'S TO
MEDICATION OR SIMPLY PUT.
THE CONSEQUENCES OF ORDINARY
PEOPLE EITHER NOT TAKING OR
IMPROPERLY TAKING THEIR
PRESCRIBED MEDICATION.
IT IS ESTIMATED THAT WE SPEND
UPWARDS OF THREE HUNDRED BILLION
DOLLARS PER YEAR CARING FOR
PATIENTS.
WHO HAVE CALLS HIMSELF HARM BY
NOT FOLLOWING DOCTOR'S ORDERS?
ALMOST 10% OF HOSPITAL VISITS
AND A HUNDRED FIFTY THOUSAND
DEATHS PER YEAR.
CAN BE ATTRIBUTED TO MEDICATION
ON IT HERE IT'S SOME OF THE MOST
COMMON CLASSES OF DRUGS NOT
TAKEN.
OR CANCER.
PARKINSON'S HYPERTENSION HEART
DISEASE AND HIGH CHOLESTEROL.
THE MEDICAL DEVICE BEFORE ME
TODAY.
COULD HELP SIGNIFICANTLY DRIVE
DOWN SOME OF THESE COSTS AND
HELP PATIENTS TO BETTER HERE TO
THE MEDICATIONS.
PRESCRIBED TO THEM.
AND IT JUST DOUBLE SENSOR AS IT
IS CALLED IS AN FDA REGULATED
AND APPROVED MEDICAL DEVICE.
THAT IS PRESCRIBED TO A PATIENT
AS PART OF THE MEDICATION IF.
AND ONLY IF THE PATIENT AND HIS
OR HER MEDICAL PROVIDER.
DEMAND TO BE MEDICALLY NECESSARY.
AND THE PATIENT AGREES.
THE TOOL IS DESIGNED TO HELP
PATIENTS TAKE BETTER CONTROL OF
THEIR OWN HEALTH BY SERVING AS A
VIRTUAL NURSE AND PROVIDING A
FEEDBACK LOOP THAT CAN HELP A
DOCTOR OR LOVED.
ONE WITH THE PATIENT'S CONSENT
TRACK AND HEARINGS TO MEDICATION.
THE SYSTEM WORKS WHEN A SMALL
SENSOR.
MADE OF NATURAL INGREDIENTS THAT
ARE DIGESTED THROUGH THE STOMACH
EMITS A SMALL PULSE SHORTLY
AFTER BEING SWALLOWED AND
DIGESTED.
THIS VERY WEAK SIGNAL WHICH IS
INVISIBLE AND AN AUDIBLE IS
PICKED UP BY THIS PATCH.
WORN ON THE ABDOMEN IN
TRANSMITTED VIA ENCRYPTED SIGNAL
TO A MEDICALLY REGULATED
APPLICATION ON A SMART DEVICE.
THE RECORDED MEDICAL INFORMATION
SUCH AS THE TIME OF INGESTION
AND OTHER BIOMETRIC FACTORS SUCH
AS HEART RATE.
AND TEMPERATURE ARE TREATED AS
PERSONAL HEALTH RECORDS IN THE
SAME WAY AS A PAPER JOURNAL OR
MANUAL LOCK.
THE SYSTEM IS HAVE A COMPLAINT
MEETS OR EXCEEDS MISSED
CYBERSECURITY ENCRYPTION
STANDARDS AND IS BACKED BY
CLINICAL TRIALS DATA.
IT IS IMPORTANT TO NOTE THAT
THIS IS AN EMERGING FIELD OF
HEALTH INFORMATION TECHNOLOGY
AND THAT THERE IS ONLY ONE
COMPANY.
THAT HAS ACHIEVED THE RIGOROUS
STANDARDS SET BY THE FOOD AND
DRUG ADMINISTRATION FEDERAL
TRADE COMMISSION AND OTHER
REGULATORY BODIES TO RECEIVE
APPROVAL FOR LIMITED ROLL OUT.
SINCE RECEIVING THE INITIAL
CLEARANCE IN.
TWO THOUSAND TWELVE THIS
TECHNOLOGY PROVIDES A TOOL FOR
PATIENTS AND DOCTORS THAT CAN
HELP IMPROVE.
TREATMENT OUTCOMES AND RESULTS
FOR SERIOUS MEDICAL CONDITIONS
IT IS A CALIFORNIA SUCCESS STORY.
THE COMPANY IS HEADQUARTERED IN
REDWOOD CITY WITH MANUFACTURING
AND HAD WILL PAY IN HAYWARD BUT
VERY MUCH STILL A SMALL COMPANY.
IMPOSING ADDITIONAL BARRIERS
COULD THREATEN INVESTMENT DELAY
NECESSARY PARTNERSHIPS WITH
PHARMACEUTICAL COMPANIES LOOKING
TO PROVIDE VALUE BASED
PERFORMANCE METRICS.
AND JEOPARDIZE AN IMPORTANT
ADVANCEMENT IN PATIENT CARE AND
COST CONTAINMENT FOR HEALTHCARE
DELIVERY SYSTEM.
THE BILL IN PRINT TODAY
THREATENS THIS AND SIMILAR
INNOVATION AND WE MUST THEREFORE
OPPOSE THE MEASURE THE WE ARE
COMMITTED TO WORKING WITH THE
AUTHORS OFFICE AND HIS STAFF TO
FIND AMENDMENTS THAT ACHIEVE THE
STATED GOALS.
THANK YOU FOR YOUR TIME AND
ATTENTION.
I THANK LEGISLATION -- FIRST
LIKE TO ASSOCIATE MYSELF WITH --
COMMENTS IN CALIFORNIA LIFE
SCIENCES ASSOCIATION -- AND ALL
GO PRETTY QUICKLY CENTER WE'RE
GETTING CLOSE TO THE END HERE --
I THINK YOU COVERED A LOT OF THE
THE REGULATORY ISSUES THAT WE
THINK WE HAVE THE BILL -- FIRST
THE TECHNOLOGY IS HELD.
TO A STANDARD ALREADY -- THE
FEDERAL TRADE COMMISSION A
SECTION FIVE UNFAIR AND
DECEPTIVE BUSINESS PRACTICES
ENFORCEMENT AUTHORITY IS FAIRLY
BROAD.
AND WITH RESPECT TO THE WAY THAT
THE TECHNOLOGIES HELD OUT TO
CONSUMERS -- IS IS REGULATED
WITH RESPECT PRIVACY ALREADY IN
THIS MANNER -- ALSO THE FDA'S
CENTER FOR DEVICES AND
RADIOLOGICAL HEALTH --
EXTENSIVELY REGULATES CYBER
SECURITY -- SO WE THINK THERE'S
THERE'S AMPLE REGULATION -- IN
THIS AREA ALREADY ADDITIONALLY
WITH RESPECT SOME OF THE
PROVISIONS BILL DOING THE CYBER
SECURITY WE WE READ RECENT
AGREEMENT WITH.
ASSEMBLYMEMBERS IRWIN AND
SENATOR JACKSON LAST YEAR WITH
A. B. NINETEEN SIX SB -- THREE
TWENTY SEVEN TO ADDRESS FDA'S
ROLE IN PLAYING AT CYBERSECURITY
REGULATE -- DEALING WITH
CYBERSECURITY REGULATIONS SO --
WITH THAT I JUST WANT TO LET ME
KNOW THAT WE ARE WORKING WITH
THE AUTHOR -- AND AND STAFF TO
TRY AND WORK ON A WAY FOR WITH
THIS WE REALLY APPRECIATE.
ALL OF THE SOMEONE BUT CHAO'S --
EFFORTS TO WORK WITH US IN SPEND
TIME WITH US LEARNING ABOUT THE
TECHNOLOGY AND THANK HIM FOR HIS
TIME.
THANK YOU.
THANK YOU OTHER OTHERS IN
OPPOSITION.
SEE NO ONE QUESTIONS OR COMMENTS.
WE COULD MISTER MISTER.
MY FIRST MEETING ACTUALLY TO
HEAR ABOUT THIS TECHNOLOGY IS
ACTUALLY -- WITH -- WITH DOCTOR
WOULD AND THIS TECHNOLOGY -- WAS
ON A BUSINESS CARD LITTLE CLEAR
OF LITTLE TINY LITTLE AND THAT
WAS I THINK DOING A GOES IN A
PILL.
WELL AFTER YOU TAKE THE PILL
GOES IN YOUR BODY.
AND IT FEEDS BACK INFORMATION IT
WAS BLOWN AWAY BY THE THOUGHT
THAT I COULD EVEN HAPPEN -- AND
SO WE WE WANT TO MAKE SURE AND I
I THINK YOU'D AGREE SOME OF A
CHILD THAT -- THIS TECHNOLOGY
HAS THE CAPACITY TO BE ABLE TO
REDUCE HEALTHCARE COSTS -- AND
PROVIDE VALUABLE INFORMATION AT
TO BE ABLE TO SECURE -- MANY
ILLS AND SO JUST MAKING SURE YOU
UNDERSTAND -- THAT AND THAT YOU
ARE GOING TO WORK WITH FOLKS TO
MAKE SURE THAT -- WHATEVER
REGULATION THAT WE'RE DOING
ISN'T GONNA ISN'T GOING TO HARM
THEM AS ACT IS A TO HARM
INDUSTRY IN THINKING THAT
THERE'S THIS NEW TECHNOLOGY
THAT'S GOING TO BE THERE THAT'S
NOT GONNA -- CAN GET TO DO MORE
DAMAGE THAN GOOD ABSOLUTELY I
THANK YOU VERY MUCH FOR YOUR
TIME IS IN FCT A LAWSUIT WEEK I
HAD A CHANCE -- TO GO TO
ACTUALLY PROTEUS AND HE WORKED
ALONG WITH MY TEAM MEMBERS TO
BASICALLY OBSERVE.
WHAT WHAT THEY DO IN FACT WHEN
THE MANUFACTURE THE TRACK AND
WAS JUST AMAZING SO?
THE BOTTOM LINE CONCLUSION THAT
I MADE IS I WANT THEM TO SUCCEED
ALSO I WANT THEM TO SUCCEED
BECAUSE IF THEY SUCCEED ON
CALIFORNIA SUCCEED.
SO HAVING THAT HAVING SAID THAT
I THINK IT'S A POINT TO POINT
OUT THE FACT THAT WE ARE HERE.
TO ALL PROTECT ALSO THE PATIENTS
INFORMATION JUST THE I DON'T
WANT TO BELABOR THE POINT BUT
IT'S I THINK IT'S IMPORTANT FOR
ME TO A JUST TO REITERATE WHAT I
JUST STATED AT THE GET GO.
AND THAT IS ONE STEP PILL IS
INGESTED INTO THE BODY THAT
TRIGGERS IN AB OPPOSE IT TO THE
PATCH THAT WE USE HAS SAW
EARLIER.
AND THAT WAS START GENERATING
ALL KINDS OF INFORMATION WHETHER
IT'S BODY TEMPERATURE OR TIME
THE BILL WAS TAKEN A SOURCE OF A
HEART RATE AND ALSO ALL.
THE ALL THAT INFORMATION OUGHT
TO BE CONSIDERED AS PATIENT
INFORMATION AND THAT SHE OUGHT
TO BE PRIVATE.
AND UNFORTUNATELY ON THE CURRENT
LAW THAT INFORMATION IS NOT
COVER UNDER HIPAA OR CMI AA.
BECAUSE THE INFORMATION ONLY
INFORMATION THAT'S GENERATED AT
THE PHYSICIAN'S OFFICE OR WHEN
IT REACHES THE DOCTOR'S OFFICE
WOULD BE CONSIDERED A MEDICAL
INFORMATION UNDER C. M. I. A. O.
HIPPA.
BUT WHEN THAT INFORMATION IS
GENERATED BY THESE DEVICES THEN
THERE'S THERE'S NO PROTECTION
WHATSOEVER BEFORE IT REACHES THE
DOCTOR'S OFFICE.
SUIT THAT'S VERY THAT IS THE
VERY NEAR ALL OF THE TIME PERIOD --
ACTUALLY PASSED ON FROM TRYING
TO PROTECT I THINK.
YOU KNOW I THINK TO PUT MORE
PROTECTION AND SECURITY BROUGH
PROVIDE TO THE TO THE PALE I
THINK IT WOULD MAKE IT A BETTER
PRODUCT AND YOU KNOW I THINK THE
THIS THE COMPANIES CAN BE MORE
SUCCESSFUL SO.
SO THERE IS A LANGUAGE THAT HAVE
BEEN KIND OF WORKING WILL
WORKING ON SOME LANGUAGE ALSO.
AND THE IT IN REGARDS TO I MEAN
PRIVACY IS SOMETHING THAT I
THINK IS IMPORTANT TO ALL OF US
REPUBLICANS AND DEMOCRATS -- AND
AT THE MORE AND MORE THEY WERE
DIGGING INTO IT THE MORE AND
MORE CONCERNING THAT AGES.
WHEN YOU THINK ABOUT SOMETHING
LIKE YOUR HEALTH INFORMATION --
IF THERE'S ANYTHING -- THAT
SHOULD BE PROTECTED IT WOULD BE
THAT OBVIOUSLY YOU GUYS
UNDERSTAND THAT.
WHAT'S THE THE GREAT FEAR WITH
THIS BILL OF THAT WOULD -- AT
THAT ARE ARE YOU PUT RIGHT MAYBE
I SHOULD ASK IT THIS WAY DO YOU
HAVE YOUR OWN -- I'M DO YOU
UNDERSTAND HOW IMPORTANT PRIVACY
IS AND HOW TO UNDERSTAND THE
NECESSITY OF TO HAVE SOME --
OVERSIGHT TO MAKE SURE THAT THAT
INFORMATION ISN'T BEING USED.
FOR WAYS IN THE FIRST WITH.
IF I MAY THROUGH THE CHAIR THANK
YOU MISTER MAYES FOR THAT
QUESTION -- I THINK THE COMPANY
IS IN QUESTION I CERTAINLY
UNDERSTAND THAT THEY ARE AT THE
PIONEER IN THIS FIELD THEY WERE
THE FIRST TO DEVELOP IT THEY
WERE THE FIRST AND ONLY. TO
RECEIVE APPROVAL BY THE FOOD AND
DRUG ADMINISTRATION TO LAUNCH
THIS TYPE OF PRODUCT -- THE
MODEL DOESN'T WORK UNLESS THEY
PROTECT PATIENT DATA THAT IS THE
CORNERSTONE OF THAT THERE IS THE
TECHNOLOGY SIDE OF THINGS AND
THEN THERE'S THE ABILITY TO
CONVINCE PEOPLE TO USE THAT
TECHNOLOGY.
AND WITHOUT THE MOST STRINGENT
COMMITMENT TO DATA PROTECTION.
IT WOULDN'T WORK AND THE FDA
PROBABLY WOULDN'T GRANTED THEM
THE APPROVAL THEY PROBABLY WOULD
NOT HAVE THE PARTNERSHIP THAT
THEY HAVE WITH THE ONE
PHARMACEUTICAL COMPANY THAT THAT
IS ENTERED IN THIS PARTNERSHIP
SO -- YEAH THE COMPANY IS.
CRYSTAL CLEAR ABOUT THEIR
OBLIGATIONS TO PROTECT PATIENT
DATA.
JUST JUST TO ADD ON TO THAT I
THINK THIS IS ONE OF THE FIRST
TECHNOLOGIES YOU SEE THAT'S OUT
THERE THAT TRULY PUTS THE
CONSUMER COMPLETELY IN THE
DRIVER'S SEAT IT'S A COMPLETELY
PATIENT CENTRIC MODEL.
YOU SEE SO MANY PRODUCTS OUT
THERE UNFORTUNATELY WHERE THE
CONSUMERS THE PRODUCT THIS IS
THE OPPOSITE OF THAT THIS IS A
COMPANY -- TECHNOLOGY THAT'S
REALLY PIONEERING AND PRIVACY SO
WE'RE VERY PROUD OF EVERYTHING
THAT THEY'RE DOING IN THE AREA.
FORGIVE ME I DIDN'T ANSWER THE
SECOND PART OF YOUR QUESTION --
THE THREAT.
WHEN YOU'RE THE FIRST AND YOU
ARE TRYING TO PROVE A CONCEPT --
ANY ADDITIONAL REGULATION ANY
CHANGES FROM WHAT THEY WERE
ALREADY COMPLYING WITH AT THE
FEDERAL LEVEL ANY ADDITIONAL
BARRIERS TO ENTRY SCARES AWAY
INVESTMENT -- THIS IS A EIGHT
PRIVATELY OWNED COMPANY THEY'RE
NOT PUBLICLY TRADED THEY NEED TO
GO OUT AND RAISE THE CAPITAL
THAT HELPS THEM TO DEVELOP THIS
TECHNOLOGY -- THEY'VE THEY'VE
RAISED A SIGNIFICANT AMOUNT OF
MONEY TODAY THEY NEED TO RAISE
MORE BECAUSE WHILE.
THEY HAVE ROLLED OUT THE SYSTEM
THEY'RE NOT ACTIVELY ON THE
MARKET YET -- AND SO YOU KNOW
DECISIONAL THREATS OF OR EVEN
JUST THE THE IMPLICATION THAT
THEY ARE SOMEHOW NOT PROTECTING
PATIENT DATA -- COULD THREATEN
SOME OF THAT INVESTMENT
[inaudible]
THANK YOU [inaudible]
OTHER QUESTIONS.
SEE NONE OF JUST A JUST A
COMMENT THAT THE BILL IS DOUBLE
REFERRED SO THAT TO PRIVACY AND
CONSUMER PROTECTION OBVIOUSLY.
HUGE CONCERN ABOUT THAT THIS IS
MORE AROUND THE POLICY OF THE
HEALTH THE HEALTH.
POLICY I AM NOT A CYBER SECURITY
EXPERT I HAVE A HARD TIME
REMEMBERING THE PAST FOR FOR MY
IPHONE.
SO -- BUT I AM VERY INTRIGUED BY
THE CONTEST OLOGY -- ALTHOUGH
I'M NOT SURE WHAT TO SEE WHAT
THE INSIDES OF MY BODY LOOKS
LIKE.
SO -- THE BILL -- DOES INTO IT
JOY DO PASS RECOMMENDATION HAVE
A MOTION AND A SECOND WOULD YOU
LIKE TO CLOSE STRETCH OUT I'LL
BE VERY HAPPY TO CONTINUE
WORKING WITH THE STAKEHOLDERS IN
FACT THESE TWO GERMAN WERE AT
THE SITE WHEN WE VISITED PROTEUS
AND HE WOULD LAST WEEK SO.
SO WHILE WE HOPE HOPEFULLY WILL
HOUSE OR SOME KIND OF COMMON
GROUND SOME COMMON LANGUAGE --
SHORTLY BEFORE OR SHORTLY AFTER
REACHING A PRIVACY COMMITTEE SO --
THANK YOU VERY MUCH I
RESPECTFULLY ASK FOR EITHER.
THANK YOU MISTER CHAIR WE HAVE A
MOTION BY MISTER NAZARIAN A
SECOND BY MISTER SANTIAGO THE
MOTION IS TO PASS TO PRIVACY AND
CONSUMER PROTECTION.
MIDDLE SECTOR PLEASE CALL THE
ROLL WHAT I WOULD AYE MAYES.
MAYES NOT VOTING.
AGUIAR-CURRY AGUIAR-CURRY AYE
BIGELOW.
BONTA.
BONTA AYE BURKE [inaudible]
CARILLO.
FLORA.
FLORA NO LONG.
LIMóN AYE MCCARTY.
IN THIS AREA.
THOMAS RAMOS.
VEGAS.
SANTIAGO SANTIAGO AYE WALDRON.
SIX OF SIX WE'LL NEED A COUPLE
MORE WE HAVE MEMBERS MISSING SO
WILL LEAVE THE BILL ON CALL
THANK YOU VERY MUCH MISTER CHAP.
SEEING NO OTHER AUTHORS THIS
POINT -- HONEST GUY MR MAYS TOOK
OVER AND I WILL PRESENT A BE A
TWENTY FOUR THANK YOU MISTER
CHAIR AND MEMBERS.
AB.
EIGHT I'LL BE PRESENTING AB.
EIGHT TWENTY FOUR I'VE BEEN
FIGHTING AGAINST THE HIGH COST
OF PRESCRIPTION DRUGS SINCE
BEING ELECTED.
WHETHER IT'S CREATING
TRANSPARENCY IN PRICE HIKES
REGULATING EXTREME PROFITS OF OF
PHARMACY BENEFIT MANAGERS OR
PROHIBITING THE USE OF MARKING
COUPONS A PRACTICE USED TO KEEP
PATIENTS ON HIGHER BRENT HIGH
PRICED.
BRAND NAMES WITH EQUALLY
EFFECTIVE LOWER COST GENERICS
WERE AVAILABLE I'VE BEEN THERE.
FIRST AND FOREMOST TO PROTECT
PATIENTS BUT ALSO FOR THOSE WHO
FEEL THE SQUEEZE OF EVER
INCREASING HEALTHCARE COSTS.
AB EIGHT TWENTY FOUR IS ONE MORE
EXAMPLE OF FIGHTING AGAINST HIGH
IN AND WARRANTED PHARMACEUTICAL
DRUG COSTS.
THIS BILL WILL STOP THE DRUG
COMPANIES PROFIT PROTECTING
PRACTICE OF PAY FOR DELAY.
WE'RE DRUG COMPANIES MAKE
ARRANGEMENTS WHICH IN ERIK
COMPANIES TO DELAY THE
PRODUCTION OF LESS EXPENSIVE
GENERIC DRUGS.
ONCE THE PATENT EXPIRES.
IT WILL DO THIS BY PROVIDING A
PRESUMPTION THAT THESE TYPES OF
AGREEMENTS BETWEEN BRAND NAME
AND GENERIC DRUG COMPANIES ARE
ANTI COMPETITIVE.
THIS PRACTICE IS COSTING
CONSUMERS IMPAIR SUCH AS
MEDICARE OUR MEDICARE AND
EMPLOYERS BILLIONS OF DOLLARS
EVERY YEAR.
LIKELY THE PHARMACEUTICAL
ENGINEER COMPANIES WILL
TESTIFIED TODAY THAT THEY LIKE
THE STATUS QUO.
THEIR PREFERENCE FOR THE
STANDARD THAT WAS SET BY THE U.
S. SUPREME COURT.
LET ME TELL YOU THEIR STATUS QUO
BECAUSE IT TILTS THE BALANCE IN
THEIR FAVOR.
WHAT IS THAT FAVOR?
BRAND NAME DRUG MANUFACTURERS
PRO LONG THEIR MONOPOLY WAY
BEYOND THEIR PATENTS MAKING
HUNDREDS OF MILLIONS MORE.
AND KEEP IN MIND THIS PRACTICE
RESULTS IN GENERIC MAKING --
HUNDREDS OF MILLIONS FOR DOING
ABSOLUTELY NOTHING.
AB EIGHT TWENTY FOUR WILL CHANGE
THAT IT RECOGNIZES THE LEGALLY
PROTECT -- PROTECTED RIGHT OF
DRUG MANUFACTURERS TO THEIR
PATENTS.
AND TIME RESTRICTED MONOPOLIES
BUT ONCE THOSE PATENTS END
CONSUMERS.
AND PAYERS SHOULD NOT SHOULDER
THE HIGH COST OF THESE DRUGS.
I WILL CONTINUE TO FIGHT FOR
AFFORDABILITY.
AND COST CONTAINMENT WHEREVER I
FIND THE OPPORTUNITY AND I HOPE
YOU AGREE THAT THESE PAY FOR
DELAY AGREEMENTS MUST END.
THIS BILL SPONSORED BY ATTORNEY
GENERAL HAVE YOUR Và SERAH I
ASK YOUR AYE VOTE I HAVE --
COUPLE WITNESSES TO AND TO
TESTIFYING SUPPORT -- LET THEM
GO AHEAD THANK YOU.
GOOD AFTERNOON RONALD COLMAN
HERE ON BEHALF OF HEALTH ACCESS
CALIFORNIANS STRONG SUPPORT OF
AB EIGHT TWENTY FOUR HEALTH
ACCESS IS THE STATE WIDE
CONSUMER HEALTH COALITION
COMMITTED TO QUALITY AND
AFFORDABLE HEALTHCARE WE BELIEVE
THAT WE ABSOLUTELY NEED A BE A
TWENTY FOUR TO CRACK DOWN ON
THESE AGREEMENTS BETWEEN.
DRUG MANUFACTURERS IN GENERIC
COMPANIES WHICH DELAY LOWER COST
DRUGS FROM ENTERING THE MARKET
SIMPLY TO DRIVE UP PROFITS.
THIS MEASURE WOULD ENHANCE
ENFORCEMENT TOOLS MAKING PAY FOR
DELAY PRESUMPTIVELY ILLEGAL
SHIFTING THE BURDEN OF PROOF IN
LITIGATION THUS REQUIRING THESE
DRUG COMPANIES TO PROVE THAT
THESE AGREEMENTS ARE NOT ANTI
COMPETITIVE.
ACCORDING TO NATIONAL HEALTH
EXPENDITURE DATA WE'RE SPENDING
THREE HUNDRED AND THIRTY THREE
BILLION DOLLARS ON PRESCRIPTION
DRUGS JUSTIN.
TWENTY SEVENTEEN SPENDING
INCREASES YEARLY AND IT'S CLEAR
TO US THAT PAY FOR DELAY IS A
PROBLEM IN HOW MUCH PRESCRIPTION
DRUGS COST HEALTH ACCESS HAS A
HISTORY OF WORKING ON MAKING
SURE PRESCRIPTION DRUGS OR SEX
SYMBOL AND AFFORDABLE.
WE KNOW THAT AB EIGHT TWENTY
FOUR WILL CERTAINLY HELP WITH
SOME OF THESE CALLS FROM SOARING
WE COSPONSORED SB TWENTY
SEVENTEEN AND WE NOW HAVE
INCREASED TRANSPARENCY AROUND
PRESCRIPTION DRUG PRICES.
CERTAINLY WHEN PRICES SPIKE 8% A
YEAR OR 16% IN TWO YEARS DRUG
COMPANIES HAVE TO EXPLAIN WHY A
COST IS SUDDENLY GOING UP.
HOWEVER I'LL TRANSPARENCY LAW
DOESN'T IMPACT DRUG PRICES THAT
ARE ARTIFICIALLY HIGH BECAUSE OF
A LACK OF A LOWER COST
ALTERNATIVE WHICH IS EXACTLY
WHAT HAPPENS WHEN THESE -- WHEN
WE HAVE THESE PURPOSEFUL DELAYS
OF DRUGS GOING ON TO THE MARKET
SIMPLY TO DRIVE OUT THESE COSTS
WE BELIEVE EVERYONE SHOULD A FOR
THEIR MEDICAL BILLS WITHOUT
GOING INTO BANKRUPTCY?
BUT WHEN THESE PHARMACEUTICAL
COMPANIES CONSPIRE TO KEEP DRUG
COSTS IS HIGH.
AND AND NOT ALLOW LOWER COST
DRUGS GOING TO THE MARKET REALLY
HARD WORKING CALIFORNIA FAMILIES
ARE SUFFERING AND FORCED TO PAY
EITHER OUT OF POCKET OR THROUGH
THEIR PREMIUMS. FOR THESE
REASONS WE ASK FOR YOUR AYE VOTE
AND WE THANK THE AUTHOR FOR HIS
LEADERSHIP IN INTRODUCING THIS
MEASURE -- GOOD AFTERNOON MISTER
CHAIR AND MEMBERS OF THE
COMMITTEE MY NAME IS RUNNING
COULD GEORGE I'M A LEGISLATIVE
ADVOCATE WITH THE OFFICE OF THE
ATTORNEY GENERAL.
ON BEHALF OF ATTORNEY GENERAL
THIS ERA I WOULD LIKE TO THINK
ASSEMBLY MEMBER MOVE WOULD FOR
OFFERING THIS IMPORTANT PIECE OF
LEGISLATION AND HIS LEADERSHIP
IN PROTECTING HARD WORKING
CALIFORNIANS.
FROM HIGH PRESCRIPTION DRUG
COSTS.
ATTORNEY GENERAL THIS THERE IS
PLEASED TO SPONSOR AB EIGHT
TWENTY FOUR WHICH AIMS TO REDUCE
PRESCRIPTION DRUG COSTS BY
INCREASING ENFORCEMENT.
AGAINST COLUSA PAPER DELAYED
AGREEMENTS.
THESE AGREEMENTS ALLOW DRUG
COMPANIES TO EXTEND ITS MONOPOLY
OVER BRAND NAME DRUGS DRUGS BY
KEEPING.
LOWER PRICE NERI DRUGS OUT OF
THE MARKET FOR CONSUMERS FOR
YEARS.
I'M DURING THIS DELAY CONSUMERS
ARE FORCED TO PAY HIGHER PRICES
WHILE THE THE PARTIES TO AGREE
THE AGREEMENT THE BRAND NAME.
PHARMACEUTICAL COMPANIES READ
READ HUNDREDS OF MILLIONS AND
EVEN SOMETIMES BILLIONS OF
DOLLARS IN PROFIT.
I'M JUST AN EXAMPLE FOR YOU LA
SEVERAL AN ANTIBIOTIC THAT IS
TREATED THAT IS OFTEN USED TO
TREAT NUMBER OF BACTERIAL
INFECTIONS.
PAID ITS COMPETITORS FOUR
HUNDRED MILLION DOLLARS TO STAY
OFF THE MARKET FOR SIX YEARS.
DURING THIS TIME SUFFERS
MANUFACTURER BEAR MADE OVER A
BILLION DOLLAR IN BILLION
DOLLARS IN SALES WHAT WAS THE
PRICE IMPACT TO CONSUMERS.
SUPER COST OVER FIVE DOLLARS A
TABLET BEFORE GENERIC ENTRY
AFTER GENETIC GENERIC ENTRY THE
PRICE DROP TO LESS THAN TWENTY
CENTS A TABLET.
SO WHEN DID THESE AGREEMENTS
HAPPENED TYPICALLY THEY HAPPEN --
WHEN THERE'S AFTER AT THE END OF
A PATENT TIME AFTER A PATENT
INFRINGEMENT LAWSUIT AND WHAT
MAKES THEM ODD IS THAT IN THAT
CASE THE PLAINTIFF IS PAYING THE
DEFENDANT -- AND IS SETTLING THE
LAWSUIT BY AGREEING TO TRANSFER
SOMETHING OF VALUE TO DELAY ITS
RIVAL SALES.
OF ITS COMPETING VERSION OF THE
BRAND NAME DRUGS THE VALUE THAT
THE BRAND TRANSFERS COMES IN
MANY FORMS BUT IT CAN INCLUDE --
TRANSFERS OF MONEY PROMISES NOT
TO COMPETE IN OTHER MARKETS
FORGIVENESS IS OF LIABILITY AND
OTHER SUITS ARE TRANSFERS ARE
PRODUCTS OF OF LICENSE RIGHT.
SO YOU CAN SEE THAT IT'S HARD
SOMETIMES TO REALLY SUSS OUT --
THAT THESE ARE PAY FOR DELAY
AGREEMENTS WHICH IS WHY IT'S
SHIFTING THE THE PRESUMPTION IS
SO KEY AND SO IMPORTANT -- THESE
AGREEMENTS HAVE HARMFUL
CONSEQUENCES FOR CONSUMERS AS
WE'VE DISCUSSED -- A COUPLE
OTHER REALLY QUICK FIGURES I'M A
TWO THOUSAND SEVENTEEN REPORT BY
MEDICARE PAID AT BY NET PACK
FOUND THE GENERIC ONES GENERIC
DRUGS ENTER.
THE MARKET PLACE DRUG COSTS GO
DOWN BY 7290%.
FURTHER A TWO THOUSAND TEN STUDY
BY THE FTC -- ESTIMATED THAT HE
FOR DELAY AND GREEN MEN'S COST
CONSUMERS THREE POINT FIVE
BILLION DOLLARS A YEAR AND I
WHAT I WANT TO HIGHLIGHT THE
FACT THAT THAT'S A TWO THOUSAND
AND TEN STUDY SO IT'S ALREADY
TEN YEARS THE DATA IS ALREADY
TEN YEARS OLD.
WE CAN ASSUME THAT THAT THAT
THAT PRICE IS PROBABLY CLOSER TO
TWENTY BILLION DOLLARS OF NOT.
THIRTY I'M IN THAT SAME TIME
PERIOD.
AND THIS IS TO GIVE YOU THE
SCOPE THERE WERE NINE HUNDRED
SETTLEMENT AGREEMENTS REPORTED
TO THE FTC OF THESE AGREEMENTS
THE FTC HAS ALREADY.
IDENTIFIED MORE THAN A HUNDRED
OF THEM TO BE POTENTIAL PAY FOR
DELAYED BASED ON A REVIEW OF THE
FACE OF THE AGREEMENT.
THE ENFORCED AT THE DIFFICULT
HERE THAT AND FORSMAN EFFORTS TO
GO AFTER THESE AGREEMENTS ARE
COMPLEX AND TILTED IN FAVOR OF
THE PHARMACEUTICAL INDUSTRY.
ALTHOUGH COURTS HAVE HELD THAT
THESE AGREEMENTS MAYBE
CHALLENGES ANTI COMPETITIVE AND
HARMFUL TO CONSUMERS IS
AGREEMENT OFTEN DO NOT RECEIVE
THE APPROPRIATE LEVEL OF
SCRUTINY FROM THE COURTS BECAUSE
THE LEGAL STANDARDS. FOR THESE
CHALLENGES ARE TOO COMPLEX PARTY
TO THE AGREEMENT HAVE USED THIS
COMPLEXITY AND UNCERTAINTY TO
THEIR ADVANTAGE TO DROP THE
LITIGATION ALL THE WHILE
RETAINING A MONOPOLY IN THE
MARKET PLACE.
THE ENACTMENT OF CLEARING
EXPRESSED LET LEGISLATION ON
PAPER DELAYED REMAINS WILL DETER
THE PROLIFERATION OF THESE
COLUSA AGREEMENTS AND ENCOURAGE
AND SUPPORT MORE ROBUST
ENFORCEMENT.
CALIFORNIA IS ALREADY A LEADER
AND BETTER THAT.
FERRETING OUT THESE AGREEMENTS
AND SHINING A LIGHT THROUGH THE
DOJ'S ANTI TRUST ACTION NOW
CALIFORNIA CAN BE A LEADER AND
STATE LEGISLATION TO DETER THIS
HARMFUL CONDUCT.
AB EIGHT TWENTY FOUR PROTECT
CALIFORNIANS BY MAKING IT HARDER
FOR DRUG COMPANIES TO ENGAGE IN
THIS ANTI COMPETITIVE BEHAVIOR
BY MAKING IT PRESUMPTIVELY
ILLEGAL TO DELAY. TO ALLOW FOR
INCREASED ENFORCEMENT AND
DETERRING MISCONDUCT THANK YOU
FOR YOUR TME AND CONSIDERATION
THANK YOU ASSEMBLY MEMBER WHAT
THE ATTORNEY GENERAL'S OFFICE
RESPECTFULLY ASKS FOR YOUR AYE
THOSE.
ANY ADDITIONAL WITNESSES IN
SUPPORT.
MR CHAIRMAN MEMBERS THERESA
START WITH KAISER PERMANENTE IN
STRONG SUPPORT.
MIXING AND TELL BEHALF THE
NATIONAL MULTIPLE SCLEROSIS
SOCIETY IN SUPPORT.
MEGAN ALL RIGHT ON BEHALF OF THE
CALIFORNIA MEDICAL ASSOCIATION
SUPPORT. TEN FLORA BEHALF OF
WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT.
SERRA FLOCKS CALIFORNIA LABOR
FEDERATION IN SUPPORT.
IN A MENACING CONSUMER REPORTS
IN SUPPORT.
NICK LOUISA'S CALIFORNIA
ASSOCIATION OF HEALTH PLANS IN
SUPPORT.
MARK WINDOWS WITH SCA YOU
CALIFORNIANS SUPPORT.
TED TOP AND FOR THE CALIFORNIA
STATE RETIREES IN THE
ASSOCIATION OF CALIFORNIA
SUPERVISORS AND SUPPORT.
ELENA CENTURY -- INACTION
CALIFORNIANS SUPPORT.
SEEING NO FURTHER WITNESSES IN
SUPPORT WILL MOVE -- TO
WITNESSES IN OPPOSITION.
PLEASE COME FORWARD [inaudible]
OKAY [inaudible]
YEAH.
GOOD AFTERNOON MISTER CHAIRMAN
MEMBERS PROMOTION WITH THE
ASSOCIATION FOR ACCESSIBLE
MEDICINES AM REPRESENTS THE
GENERIC AND BIOSIMILAR.
MANUFACTURERS.
AND WE ABSOLUTELY SUPPORT THE
AUTHOR IN WHERE HE'S TRYING TO
GO WITH THIS BECAUSE I THINK THE
DATA THAT YOU'VE HEARD SOME OF
THE OTHER -- ONE PROPONENTS TALK
ABOUT.
THE BEST WAY TO SAVE MONEY IN
THE DRUG SPACE IS WITH GENERICS.
IN FACT IN CALIFORNIA IN TWENTY
SEVENTEEN ALONE TO SAVE TWENTY
THREE BILLION DOLLARS THROUGH
THE USE OF GENERICS IN THE
UNITED STATES ITSELF. TWO
HUNDRED SIXTY FIVE BILLION
DOLLARS.
SB SEVENTEEN REPORTING.
GENERICS COMPRISED 90% OF ALL
DRUGS PRESCRIBED IN ONLY TOOK
23% OF THE REVENUE.
MOST EXPENSIVE GENERICS AGAIN
ACCORDING TO SB.
SEVENTEEN WERE ABOUT 25% OF ALL
PRESCRIPTIONS 8% OF THE TOTAL
DRUG SPEND AND LESS THAN 1% OF
HEALTHCARE PREMIUMS WE AGREE
WITH THE AUTHOR.
GENERIC COMPETITION IS WHAT WILL
BRING DRUGS SAVINGS [inaudible]
UNFORTUNATELY.
WE ARE FINDING AT THIS POINT
BECAUSE OF SOME THE ANTICS AND
AND SOME OF THE ON GOING WITH
THE PATENT HOLDERS THE BRAND
DRUG COMPANIES.
AND THE EVER GREENING OF PATENTS
AND PATENT TICKETS THAT HAS BEEN
CREATED.
SETTLEMENTS ARE OFTEN ONE OF THE
BEST WAYS TO GET A GENERIC TO
MARKET SOONER THAN THE PATENT
EXPIRATION DATE.
WE SUPPORT THE INNOVATIVE WORK
BEING DONE BY THE BY THE PATENT
DRUG COMPANIES WITHOUT THEM WE
WOULD NOT HAVE GENERICS.
BUT 78% OF ALL NEW PATENTS IN
THE ORANGE BOOK OR FOR EXISTING
DRUGS.
OF THE TOP ONE HUNDRED SELLING
DRUGS 70% OBTAINED A PATENT
EXTENDING THEIR EXCLUSIVITY
RIGHTS.
IN ONE STUDY THE TOP TWELVE
DRUGS BRAND DRUGS HOLD EIGHT
HUNDRED AND FORTY EIGHT PATENTS.
X. SHIELDING THEM FROM GENERIC
COMPETITION FOR THIRTY EIGHT
YEARS [inaudible]
GENERIC.
MANUFACTURERS SUPPORT LAWS THAT
STOP THIS TYPE OF PATTON ABUSE.
PAN SETTLEMENTS ARE ONE OF THE
MOST EFFECTIVE TOOLS GENERIC
MANUFACTURERS HAVE IN ENDING
THIS EVER GREENING.
PROCESS I'D LIKE -- TO JUST DO
REAL BRIEF OVERVIEW OF HOW MANY
OF THESE CASES COME ABOUT --
BECAUSE I THINK THERE'S OFTEN
MIS UNDERSTANDING.
TYPICALLY A GENERIC COMPANY WILL
FILE WITH THE FDA FOR APPROVAL --
TO BRING A DRUG TO MARKET.
THEY MUST SHOW THAT IT HAS THE
SAME ACTIVE INGREDIENT THAT IT
HAS BIOLOGICALLY QUICK ONCE IN
ORDER TO QUALIFY FOR WHAT'S
CALLED IN PREHEATED NEW DRUG.
APPLICATION IN THIS PROCESS THEY
HAVE TO CERTIFY.
THAT -- HOW THEY ARE GOING TO
DEAL WITH ANY POTENTIAL PATENTS
IN AND THERE'S A FEW DIFFERENT
WAYS OF DOING IT?
ONE THEY CAN SHOW THAT NO PAN
EXISTS.
PATENTS EXPIRED OR PATTON WILL
EXPIRE THE WAR OFTEN THE
SETTLEMENT SO WE'RE TALKING
ABOUT TODAY COME THROUGH WHAT'S
CALLED THE PARAGRAPH.
FOUR WHERE THEY HAVE TO SHOW
THAT THE PATENTS INVALID OR THEY
WILL NOT INFRINGE ON THE PATTERN
THAT EXISTS.
THE SETTLEMENTS ARE REALLY
WHAT'S THAT AGAIN THE FOCUS OF
AB EIGHT TWENTY FOUR AND EIGHT
AM IS PRIMARY CONCERN.
WITH THIS IS HOW THIS BILL SEEKS
TO PREVENT THE LARGE AN
UNEXPLAINED AND REFERS PAYMENTS
WHICH MAYBE NOT BE JUSTIFIED.
A. M. GREECE WITH THIS.
THIS PROCESS.
WE ARE CONCERNED THAT THE BILL
ACTUALLY CREATES A DISINCENTIVE
FOR GENERIC MANUFACTURERS FROM
AN AGGRESSIVELY ATTACKING THE
PATENT THICKET.
THE BILL CREATES A PRESUMPTION
THAT THE U. S. SUPREME COURT
EXPRESSLY REJECTED AGAIN AND
ACTIVISTS.
THEY MADE THE DETERMINATION THAT
THAT THIS TYPE OF PRESUMPTION
WAS NOT NECESSARY.
SINCE THE ACT OF THIS CASE MANY
OFTHE NUMBERS THAT -- I THINK
YOU HEARD FROM SOME OF THE
PROPONENTS OF ACTUALLY -- BEEN
REDUCED IN FACT FROM A HIGH OF
THIRTY THREES AND SETTLEMENTS
THAT -- THEY CLAIMED.
WERE -- RESULTED IN PROBLEMATIC
LANES.
IN TWENTY FIFTEEN ONLY FIVE OUT
OF ONE HUNDRED AND SEVENTY ONCE
YOU SUBTRACT THE IDEA OF THE
GENERIC MANUFACTURE BEING ABLE
TO COLLECT THEIR LEGAL COSTS --
THE THE PROOF IS REALLY SHOWN
THAT ACTIVISTS SINCE ACTIVISTS
THESE TYPES OF SUPPLEMENTS HAVE
GONE DOWN.
AB EIGHT TWENTY FOUR ELIMINATES
ONE OF THE MOST EFFECTIVE TOOLS
AGAINST PATENT THICKETS AGAIN IN
TYPICAL CASE IT IS THE BRAND
MANUFACTURER WHO IS BRINGING A
LAWSUIT AGAINST THE GENERIC
MANUFACTURE.
IF WITHOUT CLEAR GUIDELINES
GENERIC MANUFACTURERS ARE HIGHLY
UNLIKELY OR WILL HAVE A MUCH
MORE DIFFICULT TIME. TO ATTACK
THE PATENTS.
SETTLEMENTS HAVE SAVED BILLIONS
OF DOLLARS FOR PATIENTS IN
STATES.
I THINK.
IF I COULD I AND AND I WE HAVE
ABOUT TWO MINUTES LEFT I
APPRECIATE THAT -- FOR FOR YET.
WE SALUTE THE GO AHEAD.
YEAH DAHLE JUST KIND OF
SUMMARIZE WHAT REAL QUICK --
SOME OF THE THE SUITS THAT ARE
SOME HAVE ARGUED THAT SU SHOULD
BE ARGUED FINALITY BUT THERE'S
INHERENT RISK IN THAT AS WELL
SIXTY FOUR OUT OF EIGHTY NINE
CLAIMS THAT WENT TO TRIAL FOUND
PATENT INFRINGEMENTS.
THAT MEANS THAT 70% OF THE TIME
THE GENERIC MANUFACTURERS LOST A
COURT WHEN THEY LOSE THEY ARE
UNABLE TO COME TO MARKET SOONER.
IT WILL COUPLE OF FINAL POINTS
REALLY IN ALL TO IT VERY QUICKLY
AB EIGHT TWENTY FOUR ALSO
REQUIRES TROUBLE DAMAGES FOR ANY
VIOLATION THIS LOAN WILL CHILL
SETTLEMENTS AND INCREASED
LITIGATION COSTS.
THESE COSTS CAN ARE VERY
DIFFICULT THEY CAN RANGE FROM
THREE MILLION TO TEN MILLION
DOLLARS -- AND WHEN FACED WITH
THESE COSTS MORE DIFFICULT
SETTLEMENT PROCESS A LIKELIHOOD
OF LOSING MANUFACTURES MAY
SIMPLY CHOOSE NOT TO
AGGRESSIVELY PURSUE.
THESE -- PATENTS AND AND TRY TO
INVALIDATE THEM AGAIN IN FINAL
WRAP UP WITH THIS WE AGREE WITH
THE AUTHOR WE WANT TO GET TO THE
SAME PLACE.
UNFORTUNATELY CHURCH DON'T
BELIEVE THAT THE WAY THAT THIS
BILL IS DRAFTED IT'S GOING TO
RESULT IN A BETTER OPPORTUNITY
FOR GENERIC MANUFACTURERS TO
CHALLENGE.
PATENTS THE GREAT WITH THEY WERE
A LITTLE BIT OVER TIME MR
STARTED OUT TO DO THIS IN A
MINUTE A HALF DO YOU THINK.
THANK YOU THANK YOU MISTER
MEMBERS MY NAME IS FRED NO WE'RE
REPRESENTING FORMA.
INFORM HAS ADOPTED IN OPPOSE
UNLESS.
UNLESS AMENDED POSITION ON AB
EIGHT TWENTY FOUR AND A FOUR
STAR REMARKS I JUST WANT TO
THANK THE AUTHOR.
AND THE AUTHOR STAFF ATTORNEY
GENERAL'S OFFICE FOR MAKING
GENEROUS AMOUNTS OF THEIR TIME.
TO DISCUSS THIS BILL WITH US
BECAUSE WE WOULD LIKE TO FIND A
PLACE TO LAND WITH THIS BILL
ANTS ARE OPPOSE UNLESS AMENDED
POSITION.
BUT PATENT SETTLEMENT AGREEMENTS
ARE ALREADY REVIEWED BY THE FTC
AT THE FEDERAL LEVEL.
AND THEY REVIEW THESE
SETTLEMENTS TO SPECIFICALLY LOOK
FOR PROVISIONS THAT WOULD MAKE
THESE AGREEMENTS ANTI
COMPETITIVE.
THE FRAMEWORK FOR LEGAL REVIEW
WAS DEVELOPED BY THE UNITED
STATES SUPREME COURT AND THE
CALIFORNIA SUPREME COURT HAS A
SIMILAR FRAMEWORK.
IF THE STATE OR THE FTC BELIEVES
THERE ARE ANTI COMPETITIVE
PROVISIONS.
THEY CAN THEN CHALLENGE THE
AGREEMENT AND THEY HAVE BEEN
VERY ACTIVE IN THIS AREA.
THESE SETTLEMENT AGREEMENTS CAN
BRING GENERIC DRUGS AND
BIOSIMILAR. TO MARKET SOONER AND
DO NOT EXTEND THE LIFE OF THE
PATENT FOR THE BRAND DRUG OR THE
BIOLOGIC.
THEY ALSO RESOLVED THE GREAT
UNCERTAINTY OR RISK FOR THE
BRAND AND GENERIC MANUFACTURERS
SETTLEMENTS BRING FINALITY AND
THE ALLOW GENERIC EQUIVALENTS TO
MOVE FORWARD.
WE ARE CONCERNED THAT PLACING
RESTRICTIONS ON SETTLEMENTS AS
THIS BILL DOES NOW MAY PREVENT
THESE AGREEMENTS FROM OCCURRING
AT ALL.
THIS MEANS THAT BRANDON GENERIC
COMPANIES WILL HAVE TO LITIGATE
THEIR DISPUTE TO THE END THERE
WOULD BE NO SETTLEMENT.
A RECENT STUDY THAT LOOKED AT
LITIGATION FOUND AN INNOVATOR
COMPANIES PREVAILED IN THE
MAJORITY OF CASES.
IF A GENERIC COMPANY LOSES
CHALLENGE IT WOULD IT WOULD
ENTER THE MARKET.
UPON PATENT EXPIRATION NOT
BEFORE.
THEREFORE THIS BILL MAY HAVE THE
UNINTENDED CONSEQUENCE OF
INCREASING AVERAGE EXCLUSIVITY
PERIOD FOR BRAND DRUGS NOT
SHORTENING.
WITH THAT SAID.
FORMER WANTS TO WORK WITH WE CAN
WRAP IT UP MR KNOWING OKAY THANK
YOU -- THOUGH I WANT TO TALK
ABOUT A LITTLE MORE TO WORK WITH
THE AUTHOR AND LIKE MANY OF THE
OTHER BILLS YOUR TODAY WE THINK
THERE'S MORE WORK TO DO THANK
YOU OKAY GREAT ARE THERE ANY
OTHER.
ADDITIONAL -- WITNESSES IN
OPPOSITION.
THAT IS SHOCKING TO ME ACTUALLY --
FIVE EXPECTING A FEW MORE --
WITH A WILL BRING IT BACK AT TO
THE COMMITTEE FOR ANY QUESTIONS.
OF MISTER ROSS.
THANK YOU MISTER CHAIR THANK YOU
CHAIRMAN FOR FOR THIS BILL IT IS
MY PLEASURE TO MOVE THIS BILL
FORWARD -- IN ALSO LOOK FOR TO
ANY UPDATE ON ANY -- FUTURE
DISCUSSIONS OVER THE PATIENTS
SETTLEMENT AGREEMENT IN THE
FUTURE OF AS A STYLUS CONTINUE
TO HAPPEN.
THANK YOU MISTER TRICK.
THAT'S WHAT IT'S ABOUT. FOR I
WANNA JUST FIRST THANK THE
AUTHOR FOR BRINGING THE FORD AND
FOR ALL OF EFFORTS THAT YOU.
HAVE BEEN WORKING ON TO LOWER
COST OF HEALTH CARE TO WE ALL
WANT AND WE NEED YOUR LEADERSHIP
AND I APPRECIATE LEADERSHIP.
JUST WANT TO ASK COUPLE
CLARIFYING QUESTIONS ON A COUPLE
PORTIONS OF OF THE BILL -- I
UNDERSTAND THAT THAT SORT OF
THAT THE BIGGEST.
CHANGES IS THE THAT THE
PRESUMPTION OF ANTI COMPETITIVE
EFFECTS RIGHT AND THAT'S THAT'S
REBUTTABLE CAN BE REBUTTED WITH
THAT STANDARD -- THAT'S NO
LONGER.
THAT PROPONENTS OF THE EVIDENCE
STANDARD BUT NOW THE THE CLEAR
AND CONVINCING STANDARD SOOKIE
TALK A LITTLE BIT ABOUT THAT THE
THINKING BEHIND.
THAT THE DESIRE TO USE THE CLEAR
AND CONVINCING STANDARD.
IT'S THE HEART OF THE BILL -- I
THINK WHAT THE CHALLENGES WE
HAVE WITH THESE WITH THE F. T.
C. -- AND HOW THESE SETTLEMENTS
ARE MADE IS THAT WE DON'T HAVE
THE ABILITY TO REALLY -- IS TO
PENETRATE TO UNDERSTAND THESE
STATEMENTS AND SO -- WHILE I'VE
HEARD FROM THE OPPOSITION THAT
THAT THAT THE SETTLEMENTS
ACTUALLY MIGHT HELP GENERICS TO
GET TO THE MARKET SOONER THAT'S
NOT WHAT WE'RE SEEING -- WERE
ACTUALLY SEEN -- SO FASCINATED
WE HAVE -- THE GENERICS HERE WHO
ARE GETTING MONEY FROM
SETTLEMENTS TO NOT PRODUCE DRUGS
AND THE DRUG COMPANIES HERE BOTH
IN OPPOSITION TO THAT THAT THAT
TO ME -- IS IS IT IS AN
INTERESTING MARRIAGE -- AND SO
IT IS VERY DIFFICULT TO
PENETRATE THESE DICK AGREEMENTS
TO FIND OUT EXACTLY WHAT IS
GOING ON SO WE'RE SIMPLY SAYING.
IF AS I WAS TOLD OF THAT THESE
THE SOME THESE AGREEMENTS ARE
PRO COMPETITIVE.
THAN JUST PROVE IT TO US IT'S A
SIMPLE AS THAT -- AND IF YOU YOU
KNOW AND THE BECAUSE IT
CERTAINLY DOESN'T LOOK THAT WAY
WHEN A PLAINTIFF SUES SOMEBODY.
AND THEN THE PLANE IT PAYS. FOUR
IN THE SETTLEMENT THAT DOESN'T
LOOK RIGHT AND THAT AND AT THE
END OF THE DAY WHAT WE KNOW IS
THAT THESE DRUGS ARE THESE
GENERIC DRUGS ARE DELAYED AND
ARE NOT GETTING THE MARKET.
AND CONSUMERS.
AND EMPLOYERS ARE PAYING THE
PRICE FOR THAT AND IT'S BEEN
GOING ON FOR A LONG LONG TIME.
SEVERAL OF MY OWN AND THEN I
WHERE CURRY.
THANK YOU I HAVE A QUESTION FOR
BOTH SIDES ON THIS.
AND THE OPPOSITION IT MENTIONED
IN THE STATEMENT THAT WE WANT TO
GET TO THE SAME PLACE WHAT IS
THAT SAME PLACE.
THANK YOU.
PROMOTION WITH A AM.
I THINK THE SAME PLACE IS WHERE
WE ARE ACTUALLY ENCOURAGING
CHANT A GENERIC MANUFACTURERS TO
COME TO MARKET AS SOON AS
POSSIBLE.
I WOULD SAY WE AGAIN WE AGREE
WITH THE AUTHOR THAT WE NEED TO
DEAL WITH AND GENERIC COMPANIES
ARE NOT IN SUPPORT AS FAR AS THE
ASSOCIATION I CAN'T SAY THAT
THERE AREN'T SOME OUTLYING CASES
BECAUSE THEY DO OCCUR.
BUT IF WE CAN TAKE CARE OF THE
CASES THAT HAVE LARGE AND
UNEXPLAINED MONETARY SETTLEMENTS
THAT ARE NOT JUSTIFIED.
THOSE CASES SHOULD BE TAKEN CARE
OF AND WE BELIEVE THAT SINCE
ACTIVISTS AS HAS BEEN.
IMPLEMENTED THROUGH THE U. S.
SUPREME COURT IN TWENTY THIRTEEN
WE HAVE SEEN A VERY SIGNIFICANT
DROP IN THE NUMBER OF THESE
QUESTIONABLE CASES WE'RE DOWN TO
FIVE OUT OF ONE HUNDRED AND THEN
SEVENTY CASES I BELIEVE THAT'S
ABOUT 3%.
WE DO NOT SIT HERE IN SUPPORT
THOSE TYPES OF ACTIVITIES THOSE
TYPES OF SUPPLEMENTS THAT THE
AUTHOR IS TALKING ABOUT AND SO.
TO ME THAT'S THERE THE COMMON
GROUND THAT WE NEED TO BE ABLE
TO REACH IS LET'S FIND A WAY TO
BETTER TAKE CARE OF WHETHER IT'S
INSTANT STATE LEGISLATION OR
WHETHER IT'S IN -- ON GOING
FEDERAL LEGISLATION WE SHOULD
TAKE CARE OF THOSE TYPES OF
OUTLYING CASES.
THANK YOU WE WOULD ALSO AGREE
WITH THAT THAT STATE AND I THINK --
THE CONCERN THAT WE HAVE IS THAT
WHILE THE INTENTION IS IS
LAUDABLE HERE IT'S IT'S MOVING
THE NEEDLE TOO FAR THE OTHER WAY.
THERE COULD BE A DISINCENTIVE TO
ARRANGE A SETTLEMENT AGREEMENTS.
THANK YOU AND FOR THE SUPPORT
I'M IN THE COMMENTS THAT WERE
MADE IT'S SAID THAT THERE WAS
CONCERN.
THAT THIS TILTED IT TOO MUCH IN
FAVOR OF THE THE CURRENT SYSTEM
TOLD THE TO MUCH IN FAVOR OF THE
PHARMACEUTICALS WHAT ARE WE
DOING TO ENSURE IT DOESN'T TILT
IN FAVOR OF ANY SIDE BUT WE KEEP
IT BALANCED.
I THANK YOU FOR YOUR QUESTION
ASSEMBLY MEMBER LIMB ON I YOU
KNOW I THINK RIGHT NOW PART OF
WHAT WHAT WE HAVE TO THINK ABOUT
IS THAT WE HAVE.
NOT ONLY WE HAVE A PRESUMPTION
SHIFT BUT IN ORDER -- FOR THESE
AGREEMENTS TO BE PRESUMED ACT
ANTI COMPETITIVE -- WE FIRST
HAVE TO SHOW THAT THERE WAS
SOMETHING OF VALUE TRANSFERRED
AND THEN WE HAVE TO SHOW THAT
THERE ARE -- THAT THAT IT
CREATED A DELAY IN -- THE ENTRY
OF THE MARKETPLACE FOR THE
GENERIC AND THEN IT'S FOR AND
THEN IT GOES BACK -- TO IT GOES
BACK TO THE PHARMACEUTICAL
COMPANIES I'M TO SHOW WHY HESE
AGREEMENTS ARE PRO COMPETITIVE --
WHY THEY SHOULD BE PRESUMED ANTI
COMPETITIVE SO I THINK WE DO
HAVE A GOOD BALANCE RIGHT NOW --
FOR THESE TYPES OF CASES GIVEN
THE RESOURCES INVOLVED AND THE
EXPENSE INVOLVED IN THE NUMBER
OF YEARS IT TAKES BECAUSE I'M
BECAUSE THEY'RE SO.
BECAUSE THE LITIGATION IS SO
DRAWN OUT -- WE BELIEVE THAT IT
IS NECESSARY TO TO SHIP THE
PRESUMPTION AS WE HAVE BECAUSE
IT'S SO FAR IN FAVOR OF THE
PHARMACEUTICAL COMPANIES RIGHT
NOW.
IN ORDER TO BE ABLE TO SEE --
MOVEMENT -- IN THIS TYPE OF
LITIGATION IN ORDER TO BE ABLE
TO SEE -- TO SEE.
GOVERNMENT LIKE THE OJ TO BRING
CASES SUCCESSFULLY IN AND AND
PREVAIL IN COURT.
THANK YOU I GUESS FROM MY
PERSPECTIVE YOU KNOW BOTTOM LINE
FOR ME IS I JUST WANNA MAKE SURE
THAT PEOPLE GET THE MEDICINE
THEY NEED AND THEY CAN AFFORD IT --
AND SO THE IDEA THAT IT'S STILL
TOO TOO MUCH ON ONE SIDE I JUST
WANT TO MAKE SURE THAT WHATEVER
SIDES THERE ARE THAT WE STAY AT
A PLACE WHERE WE CAN STILL
ACHIEVE THAT AND WE'RE WE'RE NOT
TAKING AWAY.
OUR PRODUCT AWAY FROM -- FROM
CONSTITUENTS THAT WE SERVE -- I
HAVE HEARD IT YOU KNOW THE
OPPOSITION SAY THAT THEY WOULD
LIKE TO GET TO A PLACE WHERE WE
CAN ME IN IN THE MIDDLE AND I
DON'T EVEN IF MIDDLES THE RIGHT
WORD WHERE WE CAN.
MAYBE MAYBE IT'S NOT THE RIGHT
WORD BUT WHERE WE COULD REACH
SOME CONSENSUS OR SOME AGREEMENT
AND I HOPE -- THAT WERE ARE WE
ARE ABLE TO DO THAT -- I THINK
THAT -- IT WOULD BE IF IF THERE
IS A WILLING INTEREST ON THE
OPPOSITION SIDE TO GET TO A
PLACE WHERE SOME OF THIS IS
MANAGEABLE -- NOT ALL OF IT OUT
BUT HE EIGHT THINK THAT THERE'S
REALLY VALUE IN TRYING TO
EXPLORE THAT -- FOR PURPOSES OF
IT AS MOVING FORWARD AT AND YOU
KNOW BOTTOM LINE FOR ME IS I
JUST WANT TO MAKE SURE THAT
CONSTITUENTS GET THE MEDICINE
THEY NEED -- AND AND THINK ABOUT
WHAT THE IMPLICATIONS THIS COULD
HAVE -- FURTHER DOWN THE LINE.
SENATOR CORY -- DODGE WITH THANK
YOU FOR INTRODUCING THIS BILL.
ARE QUITE FRANKLY I WASN'T
FAMILIAR WITH TO PAY FOR DELAY
AGREEMENTS BEFORE BUT TODAY YOU
KIND OF CLEARED IT UP FOR ME AND
I INTEGRITY THAT WE NEED TO
CRACK DOWN ON THESE CASES AND
ABUSES -- DO THESE CASES YOU CAN
REALLY SEE ONE OF THE REASONS
WHY ARE HEALTHCARE COSTS ARE SO
HIGH AND IS A MEMBER OF THE
HEALTH COMMITTEE I'M GOING TO
SUPPORT YOUR BILL TODAY.
MOVING FORWARD I HOPE YOU'LL
WORK WITH THE OPPOSITION TO
ADDRESS SOME OF THE CONCERNS
WHICH I FEEL ARE MORE UNDER THE
JURISDICTION OF THE JUDICIARY
COMMITTEE.
AND I KNOW IT'S GONNA TAKE TIME
THERE BUT FIVE ALL MEANS I
SUPPORT YOUR BILL ON THIS HEALTH
SIDE I KNOW YOU'RE GONNA HAVE A
LOT TO CLEAN UP ON THE OTHER END.
SO -- HOPE TO WORK WITH THEM.
A SIMILAR CARILLO AND THEN WE'RE
GONNA BACK TO BONTA.
THANK YOU MISTER CHAIR -- DOCTOR
WOULD AYE MR PRESENTATION CAN WE
START OVER.
IT'S A LITTLE BREVITY.
THANK YOU FOR THANK YOU FOR THIS
VERY IMPORTANT -- AND IMPACTFUL
LEGISLATION I TO WANT TO OCCUR
ICAL OUR COLLEAGUE.
IS NOT AWARE.
OF THE PAGE -- DELAY TO PAY.
AND WHEN WE TALK ABOUT THE
INCREASE OF COST.
WHEN WE LOOK AT HOW MANY
FAMILIES ARE GOING BANKRUPT
BECAUSE OF THEIR HEALTHCARE
NEEDS?
WE ARE IN A VERY SPECIAL AND
UNIQUE TIME TO TRY TO FIGURE
THIS OUT FOR CONSUMERS ACROSS
OUR STATE AND REALLY LEAD THE
NATION ON SOMETHING THAT IS SO
IMPORTANT SO PIVOTAL -- TO
PEOPLE.
I'M CURIOUS -- WITH A. B. EIGHT
TWENTY FOUR IF IT SIGNED INTO
LAW DO YOU THINK THAT.
WE WILL SEE LOWER DRUG PRICES.
THAT I'M SORRY FIVE IF YOU
ADDRESS THIS NOT NO NOT AT ALL
AND I THAT IS THAT IS THAT THAT
THAT IS ABSOLUTELY THE HOPE --
THE THE IDEA IS THAT IF THIS IS
THAT THAT'S AS AS PRACTICE --
DELAYS THE INTRODUCTION OF OF
GENERIC DRUGS.
IF WE CAN SPEED UP THE PIPELINE
ABSOLUTELY CONSUMERS WILL SEE A
DECREASE IN PRICES THAT IS THE
END GOAL HERE SO -- IF THAT'S
THE GOAL THAT WE ALL END UP IN
THAT SAME PLACE -- THEN THEN I
THINK WE'RE ALL ON THE RIGHT
TRACK -- THAT'S THAT'S THE GOAL.
I THINK THAT'S SOMETHING THAT WE
WOULD ALL LIKE TO SEE
[inaudible]
THANK YOU [inaudible]
I'M SMARTER.
THANK YOU -- DOCTOR WITH THIS IS
A SECTION OF THE BILLS THE
SECTION BE WHERE IT TALKS ABOUT
THE PARTIES TO THE AGREEMENT --
IN A IF IF THEY MET THEIR BURDEN
THAT THE FACT FINDER SO NOT
PRESUME ANY OF THE FOLLOWING IS
A LIST OF THINGS THAT THE FACT
FINDER CAN'T PRESUME.
LIKE THAT ENTRY INTO THE MARKET
PLACE COULD NOT HAVE OCCURRED
UNTIL THE EXPIRATION OF THE
RELEVANT PATENT EXCLUSIVITY THAT
ANY PATENTS ENFORCEABLE IN
FRENCH COUPLE OTHER THINGS
[inaudible]
DOES THAT.
IS THAT SOMETHING THAT'S
PRESUMED NOW AND THEN AND IT'S
BEEN CHANGED OR YOU JUST
CLARIFYING THAT -- THE FACT
FINDER SHOULDN'T ASSUME THESE
THINGS EVEN THOUGH THEY'RE NOT
ALREADY.
OR IT IS GOOD BECAUSE IT.
I'M READING IT THAT THE NUMBERS
HAVING IT ONE WAY OR THE OTHER.
IT'S JUST SORT OF A BLANK SLATE
AND THEY'RE GONNA WEIGH THE
EVIDENCE AND THEY'RE GONNA SEE
IF IT MEETS THE CLEAR AND
CONVINCING STANDARD BUT I WANNA
MAKE SURE I'M UNDERSTANDING THAT
PART RIGHT.
RIGHT NOW THESE CASES ARE ALL
HANDLED WITH THE FEDERAL TRADE
COMMISSION SO WHAT WE ARE TO
SIMPLE WE'RE SIMPLY DOING IS
CHANGING THE PRESUMPTION -- UP
FRONT -- NOW I'M I'M NOT AN
ATTORNEY -- THERE ARE OTHER
ATTORNEYS IN THE ROOM I DON'T IF
YOU NOTICE THAT.
BUT BUT I WOULD GUILTY ACTUALLY
ASKED THE ATTORNEY FROM -- THE
TRAIN GENERAL'S OFFICE TO ANSWER
THAT QUESTION.
THANK YOU.
SO -- WHAT WHAT THIS THAT THIS
PROVISION IN THE BILL DOES IS
THAT IT -- BASICALLY FOR BED
CERTAIN PERCEPTIONS WITHOUT
EVIDENCE -- BECAUSE RIGHT NOW
WHAT WE HAVE FOUND IN CASES IS
THAT -- FACT FINDERS WILL ASSUME
THAT IF THERE'S A PATENT THAT
IT'S VALID AND WE'RE IN THE
POSITION THEN OF PROVING THE
UNDER UNDERLYING PATENT
INFRINGEMENT CASE WHICH IS NOT
THE REASON THAT WHERE IN COURT
IN THE FIRST PLACE WE'RE DEALING
WITH THE ANTI COMPETITIVE
BEHAVIOR -- AND THAT'S JUST ONE
OF THE PRESUMPTIONS BUT
ESSENTIALLY IT DOES CREATE
SOMETHING OF A BLANK SLATE I
THINK THAT IT'S IT'S TILTED IN
FAVOR RIGHT NOW THIS TO MEAN
CERTAIN THINGS AND SO WE'RE
TELLING THE FACT FINDER.
DON'T PRESUME THAT WITHOUT
EVIDENCE.
THAT'S HELPFUL THANK YOU.
MR FOR DID YOU HAVE A QUESTION
AND WASN'T SURE IF NOT.
OKAY.
SURE IF YOU DON'T MIND IF I
COULD IF I COULD GIVE.
PERHAPS ONE EXAMPLE IT AT THIS
POINT I THINK IT MIGHT HELP
CLARIFY SOME OF THE REASONS WHY
JUNIOR COMPANIES SURE DO SUPPORT
THE ABILITY FOR THESE -- THESE
PATENTS IN FACT THE THIS CASE
ACTUALLY WASN'T -- JUDICATA BY A
TYPICALLY A GENERIC COMPANY BUT
WAS A BRAND COMPANIES WHO WAS
SUED BY A NOTHER BRAND COMPANY.
BECAUSE THEY WERE TRYING TO
BRING A BY A SLIM SIMILAR TO
MARKET.
THEY ENDED UP IN AN AGREEMENT
THAT ACTUALLY RESULTED IN ELEVEN
YEARS BEING REDUCED FROM THE
LENGTH OF THE PATENT.
THAT MEANS THAT A BIOSIMILAR FOR
THE IN THIS HAPPENS TO BE THE
TOP SELLING DRUG IN THE WORLD
THREE POINT THREE BILLION
DOLLARS SPENT BY MEDICARE AND
MEDICAID.
ALONE IN ONE YEAR THAT
BIOSIMILAR IS NOT GONNA BE ABLE
TO COME TO MARKET SOONER BECAUSE
OF A SETTLEMENT.
THOSE ARE PRO COMPETITIVE
SETTLEMENTS THAT WE ARE HERE TO
TRYING TO TRYING TO PROTECT AND
I BELIEVE IS THE GOAL OF THE
ASSEMBLY MEMBER ALSO OF OF
MISTER CHAIRMAN TO PROTECT THOSE
TYPES OF SUPPLEMENTS AS WELL.
OUR CONCERN IS THAT WE HAVE TO
GET THIS RIGHT IT'S A VERY
DIFFICULT VERY TECHNICAL SECTION
OF LAW.
IN IF WE GET IT WRONG AND WE
START TO DISINCENTIVE EYES THE
GENERIC MANUFACTURERS.
WHETHER THEY'RE A BRAND COMPANY
OR A GENERIC COMPANY -- FROM
BRINGING THESE PATENT CHALLENGES
WE WILL NOT HAVE MORE
COMPETITION IN THE DRUG SPACE
AND WE WILL NOT REDUCE COSTS AND
SO THAT'S OUR PRIMARY CONCERN.
SO I THINK MITCHELL I THINK MISS
LIMóN WAS TRYING TO GET AT THAT --
AND I WANT TO MAYBE.
ASK THAT QUESTION AGAIN MISTER
MICHELIN SO HOW DO WE DO THAT --
BECAUSE THE WHAT WHEN I HEAR --
PAY FOR DELAY -- I THINK THAT
YOU'VE GOT PRIVATE ACTORS THAT
ARE TRYING TO MANIPULATE THE
MARKET AS YOU KNOW IN IN THIS
COUNTRY BECAUSE OF THOSE PATENTS
WE GIVE PEOPLE A THAT MONOPOLY
RIGHT -- BECAUSE OF THE OF OF
ALL THE RESEARCH AND DEVELOPMENT
THAT GOES INTO IT AND KNOWING
THAT YOU'VE GOT TO GET A GOOD
RETURN ON INVESTMENT BUT IT IT.
IT THERE'S ONLY A PERIOD OF TIME
IN WHICH IT ENDS AND OF COURSE
IF YOU BEGIN TO MANIPULATE THE
MARKET TO YOUR OWN YOUR OWN --
AND THEN THAT'S WHEN GOVERNMENT
DOES HAVE TO STEP IN I DON'T
LIKE WHEN GOVERNMENT HAS TO STEP
IN BUT AT SOME POINT IF THERE'S
MARKET FAILURE THAT'S A ROLE FOR
GOVERNMENT TO COME IN THAT'S WHY
WE HAVE ANTI TRUST.
A RULES -- A FEDERAL ANTI TRUST
RULES SO THAT WE DON'T HAVE
MONOPOLIES ARE ANTI COMPETITIVE
SO HOW DO WE GET TO THAT AND HOW
DO WE FIX DO YOU GUYS HAVE A
PROPOSAL TO BE ABLE.
TO A TO GET THERE.
YEAH SO -- SURE LET'S TAKE WITH
FARM -- WE'VE BEEN -- MEETING
WITH THE ATTORNEY GENERAL'S
OFFICE AND AUTHORS OFFICE TO TRY
TO GET TO A MIDDLE GROUND HERE.
SO PART OF IT IS THAT THE BILL
CREATES A FRAMEWORK THAT
ACTUALLY DOES THREE THINGS ONE
IT'S THE PRESUMPTION THAT THESE
ARE ANTI COMPETITIVE. TWO EIGHT
RAISES THE EVIDENCE STANDARD TO
OVERCOME WHETHER THE AGREEMENT
IS NOT ANTI COMPETITIVE AND THEN
AS THE ATTORNEY GENERAL'S STAFF
JUST ALLUDED TO THERE'S A
PRESUMPTION SAID THEY JUDGE --
OR THE FACT FINDER IN THIS CASE
THERE'S A CERTAIN ASSUMPTIONS
THAT THEY HAVE TO MAKE OR CAN'T
MAKE AND IN THE BILL AND SO I
THINK THAT THERE'S A MIDDLE
GROUND SOMEWHERE BTWEEN THE
RULE OF REASON THAT'S THE
CURRENT FRAMEWORK ESTABLISHED
THREE SUPREME COURT AND THEN.
THE THREE THE THREE PIECES THAT
ARE CREE RATED BY THIS BILL THAT
PUT A HEAVY HAND ON DETERMINING
THAT THESE AGREEMENTS ARE ANTI
COMPETITIVE.
SO IT SOUNDS LIKE THERE ISN'T
ANY THERE'S NOT DISAGREEMENT THE
FACT THAT THERE IS A PROBLEM --
MY HEARING THAT CORRECTLY THAT
THERE ARE THERE ARE ACTORS THAT
ARE ACTUALLY BEHAVING
INAPPROPRIATELY AND THEY ARE
MANIPULATING THE MARKET IS THAT
IS THAT ACCURATE.
WHICH IS WHY WE'VE TAKEN AN
OPPOSING LESS AMENDED POSITION
INSTEAD OF AN OPPOSE POSITION
BECAUSE WE WANT TO GET TO A
MIDDLE GROUND ON THIS.
DOCTOR WHAT ARE JUST AS THE
FIRST I'VE HEARD THAT THEM ADMIT
THAT THERE ARE ACTORS ACTUALLY.
THIS BEHAVIOR SO THAT'S THAT'S A
STEP FORWARD I THINK THAT'S
PROGRESS REGARDING MR MICHELIN'S
COMMENTS THERE'S ACTUALLY
EXEMPTION THE BILL THAT
ADDRESSES THE ISSUE HE JUST HE
BROUGHT UP.
SO -- THE ITEM NUMBER SECTION
THAT IS BUT THAT I DO KNOW THAT
THERE IS AN EXEMPTION THERE.
WITH REGARDS -- TO IF YOU KEEP
HEARING THE QUESTIONS ABOUT AT
TVS AND AND THAT PARTICULAR BILL --
THIS BILL ESTABLISHES A
DIFFERENT -- STANDARD A REVIEW --
AND THE THAT IS THAT IS WHAT WE
ARE TRYING TO DO SO WE'RE NOT
TRYING TO CIRCUMVENT -- THAT
CASE WE'RE TO SIMPLY TRYING TO
ESTABLISH A DIFFERENT STANDARD
OF REVIEW -- IF THESE ARE IF
THESE AGREEMENTS TRULY ARE PRO
COMPETITIVE THEN IT SHOULDN'T BE
THAT DIFFICULT TO PROVE THEM --
AND SO IF THE PENDULUM IS
SWINGING THE OTHER WAY IT'S
BECAUSE THE MARKET OR THE THE
THE DRUG PRODUCERS WHETHER THERE%
AND THIS CASE.
WILL LOVE THE GENERICS IN THERE
AS WELL BECAUSE THEY'RE GETTING
THE SETTLEMENTS IN ONE FORM OR
ANOTHER.
IF THE THEY HAVE HAD THIS
PROTECTION FOR MANY MANY YEARS
AND AS YOU POINT OUT.
WE HAVE PATENT PROTECTIONS THIS
IS NOT ABOUT PATENTS AND YOU
HEARD A LOT OF TALK ABOUT PADS
THIS BILL IS NOT ABOUT PATENTS
IT'S ABOUT COMPETITIVE BEHAVIOR.
AND AND ONE ENTITY TRYING TO
STIFLE THE MARKET AND AND ****
AND COMPETITION THERE SO -- IT.
THAT REALLY IS I THINK GEN IT
GERMANE TO THE ISSUE WE'RE NOT
THIS BILL IS NOT ABOUT PATENTS
IS ABOUT THE BEHAVIOR.
AND WE'VE HAD ACTUALLY HEARD
FROM FORMER THAT ACTUALLY SAID
THAT THEY WERE THEY NOW
RECOGNIZE THAT THIS ACTUALLY
EXISTS IN THE MARKET SO I
BELIEVE THAT'S A STEP FORWARD I
THANK THEM FOR ADMITTING THAT.
BUT I'D I'D I STILL WHETHER IT'S
PAY FOR DELAY IN A CASH FOR OR
PAY FOR DELAY IN OTHER FORMS
THAT -- ARE DIFFICULT TO
CIRCUMVENT OR TO TO TO FERRET
OUT THAT'S WHAT WE'RE TRYING TO
FIND BECAUSE AS THERE HAVE BEEN
CRACKDOWNS ON THESE ON THESE
BEHAVIORS.
THE MARKET OR THE MARK OR THE
DRUG MANUFACTURERS HAVE CHANGED
THE WAY TEY STRUCTURE THESE
AGREEMENTS IT'S REALLY DIFFICULT
TO GET THE INFORMATION ABOUT
THESE AGREEMENTS WITHOUT A
SUBPOENA TO THE FTC.
AND SO WE DON'T KNOW FOR SURE SO
WE'RE JUST SAYING LOOK IT'S
REALLY STRANGE HOW ALL OF A
SUDDEN THIS DRUG WHICH WAS
SCHEDULED -- TO THE GENERIC WAS
SCHEDULED TO COME IN AND AND AND
PRODUCES DRUG HAS DELAYED FOR A
YEAR THAT SUSPICIOUS WHY DID
THEY DELAY THAT.
WE'RE ASKING IS THIS A IS THIS
AN ANTI COMPETITIVE BEHAVIOR AND
WHERE WE WANT TO BE ABLE TO GO
FORWARD AND ASKED US QUESTIONS
IT'S AS SIMPLE AS THAT -- AT THE
END OF THE DAY CONSUMERS
CONTINUE TO PAY HIGH PRICES AND
THAT'S WHAT DRIVES THIS ENTIRE
ISSUE.
I JUST WANNA MAKE SURE AND I'M
LOOKING AT MR KNOW WHERE COSTS --
YOU DID NOT WE WERE NOT ABLE TO
FINISH AND SO IF WE CAN BE QUICK.
THANK YOU REAL GROWTH RATE THAT
CREATE THE WORDS FROM THE CHAIR.
I THINK OUR FEELING IS WE NEED
TO CONTINUE TO HAVE SETTLEMENTS
AND HAVE.
HAVE NOT DISINCENTIVES. TO ENTER
INTO THEM BECAUSE WITH
SETTLEMENTS.
THERE'S AN AGREEMENT BEFORE THE
PATENT EXPIRES WHICH WOULD ALLOW
THE GENERIC TO START IN THE
MARKET SOONER.
AND WE THINK THE WAY THE BILL IS
CONSTRUCTED NOW IS VERY WORKABLE
WE THINK WE GET TO A POINT BUT
WE THINK IT IN IN ITS CURRENT
FORM TO DISCOURAGE SETTLEMENTS
[inaudible]
THANK YOU.
DOCTOR WOULD CHEN I'D I'D IF
THIS IF YOU'RE GOING TO HAVE A
DRUG A SETTLEMENT ALLOWS A DRUG
TO INTO THEM A GENERIC TO ENTER
MY THE MARKET SOONER.
I'M ALL FOR THAT THERE'S NOTHING
WRONG WITH THAT AND THAT WOULD
BE A THAT WOULD BE PRO
COMPETITIVE.
THAT'S WHAT WE LIKE TO ENCOURAGE
BUT THAT'S NOT WHAT'S HAPPENING.
THAT'S NOT WHAT'S HAPPENING NOW
I'VE ASKED FOR YOU HAVE IF YOU
HAVE EXAMPLES SHOW ME HOW THAT'S
WORKING BECAUSE WE'VE GOT
EXAMPLES OF HOW IT HASN'T AND A
LOT OF THEM.
ANY OTHER QUESTIONS AT ALL NONE.
MISTER RODRIGUEZ.
YES -- ONE THANK GOD FOR
BRINGING THIS BILL FORWARD I
WOULD OVERSEEING COURAGE AND
CONTINUE WORKING OF OPPOSITION
HOPE BECAUSE OF FUNDAMENTAL
GROUND -- SO I'LL BE LOOKING TO
SUPPORT THE BILL AS LONG AS WE
GET A MOVING FORWARD.
BUT ALSO RESERVE MY RIGHT TO
COME TO THE FORE WHETHER I
SUPPORT OR NOT DEPENDING ON THE
CHANGES COME ABOUT THE BILL SO
JUST WANT.
TO URGE YOU TO CONTINUE WORKING
OPPOSITION HOPING I CAN COME IN
A MIDDLE GROUND ON SO THANK YOU.
I JUST WANT ALSO SAY I'VE I'VE
GOT SOME CONCERNS ABOUT THE OF
THE DATING DISINCENTIVE EYES --
BUT I'M TO SUPPORT THE BILL AS
WLL TODAY I KNOW -- THE THAT
THE CHAIR UNDERSTANDS THIS ISSUE
CARES DEEPLY ABOUT COST
CONTAINMENT MAKING SURE THAT THE
THERE'S NOT ANTI COMPETITIVE --
ANTI COMPETITIVENESS -- IN THE
MARKET PLACE TO HELP DRIVE DOWN
THAT SEEMS THAT SOUNDS LIKE
MAYBE SOME WORK TO DO ON THE
BILL IT LOOKS LIKE TODAY --
THERE'S JUSTICE -- SOME FOLKS
THAT WANT TO WORK WITH YOU TO
MAKE THE BILL BETTER -- SO I'LL
BE SUPPORTING -- THE SUPPORTING
THE BILL -- SUPPORTING THE BILL
TODAY I WOULD LIKE TO CLOSE.
I WOULD JUST SAY THANK YOU I I
ASK FOR YOUR SUPPORT -- THE END
OF THE DAY I JUST ASSUME THAT
THIS BEHAVIOR AND WE WOULDN'T WE
WOULDN'T BE HERE IF -- IF OF THE
DRUG COMPANIES WOULD JUST
RESPECT THE PATENTS THAT THEY
HAVE IN PLACE ALLOW THE GENERICS
INTO THE MARKET AT THE
APPROPRIATE TIME SAVE TAXPAYERS
BILLIONS OF DOLLARS THANK YOU
VERY MUCH.
ALL RIGHT WITH THAT THE PLEASE
CALL THE ROLL -- AND THE MOTION
IS -- DO PASSED THE JUDICIARY.
WHAT I WOULD AYE MAYES AYE MAYES
AYE AGUIAR-CURRY?
AGUIAR-CURRY I BIGELOW.
BIGELOW NOT VOTING BONTA
[inaudible]
BURKE.
BURKE I CARILLO CARILLO AYE
FLORA.
FLORIDA VOTING Là MON.
Là MON I MCCARTY.
NAZARIAN AYE NAZARIAN AYE RAMOS.
ROSS I PREFER GUESTS.
RODRIGUEZ AYE SANTIAGO
[inaudible]
WALDRON.
NOW. TO GET NINE VOTES IT'S OUT
BUT WE WILL LIVE IT OPEN FOR
PEOPLE THAT ON AND THEN YOU'VE
GOT ONE MORE BILL.
IS IT ONE OF THEM THAT ARE LIKE
A SAD.
LET'S HEAR BACK DOES ABOUT HIM
ON THAT THANK YOU [inaudible]
MR [inaudible]
AS IN.
MISSION IS THERE IN WITHOUT ONE
MORE BILL
.
THANK YOU MISTER CHAIR AND
MEMBERS -- I'D LIKE TO START.
PLEASE BY BY ACCEPTING THE
COMMITTEE AMENDMENTS -- ABLE
SIGNAL [inaudible]
THANK YOU.
THANK YOU VERY MUCH.
I HAVE ABOUT FOUR PAGES.
I'LL KEEP IT TO ONLY.
TWO I JUST WANT TO GO OVER THE
BASIC TENANTS AND AND THEN ASK
FOR YOUR SUPPORT AND I'M HAPPY
TO HAVE A ROBUST CONVERSATION
OVER THIS. ONE THIS BILL --
ESTABLISHES CLEAR REQUIREMENTS
ON FARE COLLECTION AND USE OF
PERSONAL INFORMATION. TO
PROHIBITING INTENTIONAL
DISCRIMINATION IN WELLNESS
PROGRAMS.
I'M SORRY I SHOULD SAY THAT DID
AB SIX FORTY EIGHT I HAVEN'T
EVEN MENTIONED THE BILL'S NUMBER
WOULD EXPAND CONSUMER PRIVACY
PROTECTIONS AROUND WELLNESS
PROGRAMS.
BY DOING THE FOLLOWING. ONE
ESTABLISHING CLEAR REQUIREMENTS
ON FARE COLLECTION AND USE OF
PERSONAL INFORMATION. TO
PROHIBITING INTENTIONAL
DISCRIMINATION AND WELLNESS
PROGRAMS THREE REQUIRING
TRANSPARENCY IN WELLNESS
PROGRAMS INCLUDING DATA USAGE
AND IN ROWLEY RIGHTS.
UNDER STATE AND FEDERAL LAW AND
FOR GRANTING WELLNESS PROGRAM
ENROLLEES THE RIGHT TO REVIEW
AND CORRECT THE COMPLETENESS AND
ACCURACY OF RECORDS WELLNESS
PROGRAMS ARE PROMOTED AS A WAY.
TO SUPPORT HEALTHY BEHAVIORS AND
IMPROVE HEALTHY OUTCOMES FOR
PARTICIPANTS HOWEVER MANY OF
COME WITH UNSPOKEN TRADE OFFS.
OF WITH ME IS -- OF DINO
MENDELSON FROM CONSUMER REPORTS
AND MERRY JUNE FLORES FROM THE
HEALTH ACCESS -- I'M HAPPY TO
DISCUSS THE ISSUE FURTHER BUT
FOR THE SAKE OF BREVITY I'M
HAPPY TO KEEP MY COMMENTS SHORT
AND ALLOW ALLOW THEM -- MY
WITNESSES THE OPPORTUNITY TO
EXPAND ON THE BILL.
IT'S GREAT SOUNDS GREAT THANK
YOU.
GOOD AFTERNOON CHAIRMAN WAITED
MEMBERS OF THE COMMITTEE MY NAME
IS TINA MENDELSSOHN I'M SENIOR
POLICY COUNSEL FOR CONSUMER
REPORTS. FOR YEARS WE HAVE
WORKED ON THE FRONT LINES OF
CONSUMER ADVOCACY ADVANCING A
BROAD RANGE OF CONSUMER
PROTECTION INCLUDING PRIVACY
WE'RE PROUD TO SPONSOR.
EIGHTY SIX FORTY EIGHT
HEALTHCARE IS COMPLICATED AND SO
OUR WELLNESS PROGRAMS.
THERE ARE SEVERAL DIFFERENT
TYPES OF ON THE PROGRAMS AND
THEY CAN BE OPERATED BY SEVERAL
DIFFERENT TYPES OF ENTITIES.
AS A RESULT THE LAW THAT EXIST
ARE INADEQUATE AND ON UNIFORM.
CALIFORNIANS TO CONSIDER
ENROLLING IN WELLNESS PROGRAM OR
WHO ARE ALREADY ENROLLED IN
WELLNESS PROGRAM.
OFTEN HAVE LITTLE WAY TO KNOW
THE EXTENSION WITH THEIR DATA
WILL BE COLLECTED AND SHARED.
FURTHERMORE CONSUMER SHOULD NOT
ALWAYS BEAR THE BURDEN OF
ENSURING THAT THEIR DATA IT'S
NOT MISUSED.
INSTEAD WE ARE SPONSORING THIS
LAW SO THE BASELINE PRIVACY
PROTECTIONS OUR ROBOT FOR ALL
WHAT WELLNESS PROGRAM
PARTICIPANTS.
CONSUMERS HAVE REASON TO BE
CONCERNED ABOUT THE DATA
COLLECTED ON THEM AND HOW IT'S
USED.
WELL THE PROGRAM'S GIVE EMPLOYER
PERMISSION TO ASK PERSONAL
QUESTIONS THAT THEY WERE NEVER
ASK IN OTHER CONTEXTS.
THE JUST MEDICAL HISTORY
REPORTER STRESS INCLUDE PROBLEMS
AT WORK.
SEPARATION OR DIVORCE PLAN TO
BECOME PREGNANT.
BODY MASS INDEX AND EATING AND
EXERCISE HABITS.
THIS INFORMATION IS VERY
PERSONAL AND COULD HAVE REAL
WORLD CONSEQUENCES.
THIS IS THE START NOT ONLY THAT
FOR WEARABLE DEVICES ARE
SUPPLIED BY THE EMPLOYER THE
DATA COLLECTED BY THE WEARABLE
BELONG TO THE EMPLOYERS NOT BE
EMPLOYEE.
TURNING INTO A TYPE OF
SURVEILLANCE AS UNDULY INVASIVE
pPURPOSE FOR WITH THE DATA WAS
COLLECTED. TO PROMOTE INDIVIDUAL
HEALTH.
I TO SIMPLY MEMBER MENTIONED
DATA COLLECTED BY WHILE THE
PROGRAM CAN BE USED FOR PURPOSES
UNRELATED TO PROMOTING EMPLOYEE
WELLNESS.
INCLUDING SECONDARY USE AND SALE.
CONSUMERS WOULD ROLL AND RUN THE
PROGRAM DO SO TO IMPROVE THEIR
HEALTH.
NOT SO THEY CAN GET TARGETED
MARKETING.
HAVE THEIR ABILITY TO GET
INFORMATION THE INSURANCE ALTER
OR MAKE PERSONAL INFORMATION
ABOUT THEMSELVES KNOWN TO
EMPLOYERS POTENTIAL EMPLOYERS OR
LENDER THAT ACT OF BAD FAITH.
AB SIX FORTY EIGHT WILL LIMIT
THE COLLECTION AND USE OF
PERSONAL DATA A PART OF ALL THE
PROGRAM BY LIMITING DATA
COLLECTION.
I USED TO ONLY THAT WHICH IS DUE
TO OPERATE THE PROGRAM AND BY
CODIFY REGRET TRANSFERRED TO
STANDARD.
SEN REALLY TO ROLL DO SO WITH A
FAIR BALANCED INFORMATION WITH
CONSUMER PROTECTION ON HEIR
SIDE. FOR THIS REASON CONSUMER
REPORTS APPRECIATE DRIVE VOTE.
GOOD AFTERNOON MISTER CHAMBERS
AND JDS HERE ON BEHALF OF HEALTH
ACCESS CALIFORNIA IN SUPPORT OF
AB. SIX FORTY EIGHT ONE THIS
INCENTIVE PROGRAMS REWARD THOSE
WHO ENGAGE IN HEALTHY BEHAVIOR
ALREADY.
THE ACADEMIC LITERATURE
INDICATES THESE PROGRAMS DO NOT
ACTUALLY CHANGE BEHAVIORS OF
THOSE WHO NEED TO IMPROVE THE
MOST. ONE THIS PROGRAMS ARE
OFTEN PROBLEMATIC FOR THOSE WITH
DISABILITIES THOSE WHO LIVE IN
LOW INCOME AREAS WERE OUTSIDE
EXERCISE MAY BE UNSAFE OR
INACCESSIBLE ADVANTAGE OF OTHER
EXERCISE RELATED ACTIVITIES.
THE ALSO TEND TO BE COSTLY. ONE
IS INCENTIVES TEND TO WORK BEST
FOR THOSE WHO ARE ALREADY
HEALTHY AN AFFLUENT RATHER THAN
THOSE WHO HAVE SERIOUS CHRONIC
CONDITIONS OR WHO ARE LOW OR
MODERATE INCOME.
AND IN MANY INSTANCES INCENTIVE
PROGRAMS ACTUALLY WORSEN HEALTH
DISPARITIES RATHER THAN REDUCING
THEM WE SUPPORT EIGHTY SIX FORTY
EIGHT BECAUSE IT WOULD CREATE
NEW CONSUMER PROTECTIONS FOR
HEALTH PLANS AND EMPLOYERS.
WE IMPOSE WELLNESS PROGRAMS AND
AS YOU HAVE HEARD THESE
PROTECTIONS WOULD PROTECT THE
PRIVACY OF CONSUMERS PREVENT
RETALIATION BASED ON
DISCRIMINATION.
ON FAILURE TO PARTICIPATING IN
WELLNESS PROGRAMS AND FOR THESE
REASONS WE ASK FOR YOUR RIVAL
THANK YOU.
THANK YOU VERY MUCH ARE THERE
OTHERS IN SUPPORT [inaudible]
YEAH.
THANKS TAYLOR JACKSON WITH THE
CALIFORNIA NURSES ASSOCIATION
REPRESENTING A HUNDRED THOUSAND
REGISTERED NURSES STATEWIDE HERE
IN STRONG SUPPORT OF THE WORKER
PROTECTIONS AND PRIVACY
PROVISIONS IN AB.
SIX FORTY EIGHT THANK YOU VERY
MUCH.
GEN FLOOR ON BEHALF OF WESTERN
CENTER ON LAW AND POVERTY IN
SUPPORT OF THE WHOLE THING THANK
YOU.
OKAY BECAUSE THEY'RE ALL THE
CALIFORNIA SENATE THINK OUT
THERE WORKING SUPPORT THANK YOU
[inaudible]
ANYONE ELSE. THREE ONE IN
OPPOSITION.
HI GOOD AFTERNOON LARA CURTIS ON
BEHALF OF THE CALIFORNIA CHAMBER
OF COMMERCE THANK YOU SO MUCH
FOR THE OPPORTUNITY TO TESTIFY
HERE TODAY AND WE APPRECIATE
YOUR TIME.
THE CHAMBERS CONCERNS WITH THIS
BILL -- MOSTLY RELY WITHIN THE
EMPLOYEE -- PROTECTIONS AS WELL
AS THE REQUIREMENTS ON THE
EMPLOYER.
EMPLOYEE WELLNESS PROGRAMS ARE A
BENEFIT THAT ARE OFFERED TO THE
EMPLOYEE THERE OBVIOUSLY OFFERED
FOR HEALTH AND WELLNESS OF THE
EMPLOYEE AND ARE SUPPOSED TO BE
AN ADDED BENEFIT.
OFTENTIMES THE EMPLOYEE TAKES --
ADVANTAGE OF THE GYM MEMBERSHIP
DISCOUNTS THINGS LIKE THAT AND
WE ARE AWARE THAT THE AUTHOR HAS
AGREED TO TAKE THE COMMITTEES
RECOMMENDED AMENDMENTS.
I KNOW THAT THE PROVISION THAT
WAS REFERRED TO IN THE COMMITTEE
RECOMMENDED AMENDMENTS WERE
DEALING WITH THE HEALTH AND
SAFETY CODE -- AND SO I'M I'M
LOOKING FORWARD TO SEEING THE
AMENDMENTS IN PRINT AS FAR AS
THE LABOR CODE PROVISIONS.
AND BECAUSE OF THE DISINCENTIVE
VICE ATION OF THE EMPLOYEE
BENEFITS OF WELLNESS PROGRAMS WE
SEE THAT EMPLOYERS WILL JUST
ESSENTIALLY STOP OFFERING THESE
WELLNESS PROGRAMS.
AND BECAUSE NOT ONLY DOES IMPOSE
CIVIL LIABILITY THERE'S ALSO
CRIMINAL LIABILITY ATTACHED TO
THIS.
THERE IS A MISDEMEANOR
ATTACHMENT FOR ANY SORT OF
VIOLATION OF THIS PROVISION THAT
INCLUDES -- A MINOR MISSTEPS
SUCH AS NOT PROPERLY PROVIDING
WRITTEN EXPLANATION OF THE
WELLNESS PLAN.
SO YOU'RE LOOKING AT CIVIL
LIABILITY UNDER THE LABOR CODE
WHICH INCLUDES A PRIVATE
ATTORNEYS GENERAL ACT WHICH IS
KNOWN AS AN S. TO YOUR EMPLOYER
TYPE LITIGATION.
AS WELL AS CRIMINAL LIABILITY
AND WITH THOSE KIND OF THREATS
ESSENTIALLY -- FOR AN EMPLOYER
THAT WANTS TO PROVIDE SOMETHING
THAT THEY SEE AS AN ADDED
BENEFIT TO THE EMPLOYEE THERE
CENTURY GOING TO STOP DOING THAT
FOR THAT SIMPLE REASON THAT THEY
DON'T WANT TO ASK YOU A LETTER
TO BE EXPOSED THAT TYPE OF
LITIGATION.
AND SO BECAUSE WILL ONE THIS
PROGRAM INCENTIVIZE GOOD HEALTH
AND CONTRIBUTE TO HEALTHY
WORKFORCE AT A TIME WHEN OBESITY
AND CANCER ON THE RISING
HEALTHCARE COSTS ARE INCREASING
WE THINK THAT CALIFORNIA SHOULD
ENCOURAGE WELLNESS PROGRAMS
WHETHER THAN RATHER THAN TRYING
TO DIS INCENTIVIZE THEM THANKS
SO MUCH FOR THE OPPORTUNITY.
THANK YOU. TWO REASONS.
THANK YOU MISTER CHAIRMAN
VERSION INCLUDES US CALIFORNIA
ASSOCIATION OF HEALTH PLANS ARE
I'LL BE BRIEF -- BE A CHAMBER OF
COMMERCE COVERED ALL THE MAIN
POINTS.
OF COURSE HEALTH PLANS DO WORK
WITH EMPLOYERS TO DEVELOP THESE
WELLNESS PROGRAMS.
AND YOU KNOW THE RESEARCH HAS
SHOWN THAT -- INCENTIVIZING THE
USE OF THESE WELLNESS PROGRAMS
INCREASES OUR PARTICIPATION SO
WE SO WE WERE HAPPY TO SEE -- A
STEP IN THE RIGHT DIRECTION WITH
RESPECT TO THE REMOVAL OF THE
PROHIBITION ON INCENTIVES -- WE
STILL MAINTAIN OUR OPPOSE
POSITION HOWEVER -- YOU KNOW
WE'VE WE'VE SEEN THE LETTER AND
SOME OF THE CITY -- ARGUMENTS IN
SUPPORT -- BY THE SPONSORING
SUPPORTERS OF THE BILL WE AT
THIS POINT FEEL -- TO UNDERSTAND.
WHY -- THE NEW -- PRIVACY
REQUIREMENTS POTENTIAL -- FOR
FOR LEGAL ENTANGLEMENTS ETCETERA
NEW NOTIFICATION REQUIREMENTS
ARE NECESSARY IN LIGHT OF
EXISTING LAW -- IN OTHER ISSUES --
WHEELS HAVEN'T SEEN ANY EXAMPLES
OF OF THIS -- ANY PROBLEMS IN
THIS AREA SO I WOULD LIKE TO
LEARN MORE WE'VE GOT YOU AUTHORS
OFF SO WE CAN SIT DOWN WITH THE
SPONSOR IF THIS BILL MOVES
FORWARD TODAY -- AND TRY TO
LEARN MORE ABOUT WHY ALL THESE
NEW REGULATORY REQUIREMENTS ARE
NECESSARY ON WELLNESS PROGRAMS --
WE THINK WE COULD
UNINTENTIONALLY OR INHIBIT THE
USE OF THESE PROGRAMS WHICH WE
WOULD BELIEVE WOULD BE A BAD
OUTCOME BECAUSE THERE IS A LOT
OF EXPERIMENTATION IN THIS AREA
AND THE MORE THAT WE CAN DO IN
THIS AREA WE THINK WOULD BE
BETTER FOR HEALTH AND FOR COSTS.
SO AT THIS POINT WELL WE REMAIN
OPPOSED TO THE BILL THANK YOU.
THANK YOU VERY MUCH OTHERS IN
OPPOSITION.
STEPHANIE WALKING SOME WE HAVE
THE SITUATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANIES
WE TO DO YOU THINK THE AUTHOR
FOR THE MOST RECENT MINUTES
UNFORTUNATELY WE'RE STILL POSE
TO THE BILL THANK YOU.
THANK YOU VERY MUCH.
ANYONE ELSE IN OPPOSITION. THREE
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS
[inaudible]
MISS LIMóN.
THANK YOU SO.
HE PARTICIPATED IN OUR WELLNESS
PROGRAM WHEN I WORKED AT THE UC --
AND I LOVED.
AND I DID SO NEXT TO A CUSTODIAN
NEXT TO A LANDS A YOU KNOW
WORKER MAINTENANCE PERSON AND
THEY DIDN'T.
THERE WAS INCENTIVE AND THEN
SEND YOU KNOW AND I JUST I
THOUGHT IT WORKED -- I
ABSOLUTELY AGREE THAT THE
INFORMATION THAT IS ASKED WHEN
YOU DO THESE PROGRAMS -- IS
INFORMATION THAT IS PERSONAL AND
SHOULD BE KEPT CONFIDENTIAL --
BUT BUT I I I HOPE WILL CONSIDER
WHAT IT MEANS TO MOVE FORWARD
BECAUSE I DO THINK THESE
PROGRAMS WORK.
AND I FOUND THAT EVEN THOUGH I
WAS A MANAGER I WS
PARTICIPATING WITH VERY
DIFFERENT TYPES OF EMPLOYEES AT
THE UC -- I FOUND IT VERY
HELPFUL AND I LIKELY WOULD NOT
HAVE BEEN IN SOME OF THE
PROGRAMS.
YOU KNOW WE DID A UC WALK FOR
EXAMPLE WHERE EVERYONE GOES OUT
YOU GET FREE LUNCH THAT'S YOUR
INCENTIVE -- AND YOU WALK AROUND.
THE CAMPUS AND I KNOW IT'S KIND
OF LIKE THE STUDENTS RIGHT --
BUT YOU DO YOUR YOUR INCENTIVE
IN IT YOU KNOW THE FREELANCE YOU
WALK AROUND -- BUT AGAIN I MEAN
I JUST WANT TO SHARE THAT
PERSPECTIVE FROM IT THAT THESE
PROGRAMS I DO THINK WORKING -- I
ABSOLUTELY AM SUPPORTIVE OF
PROTECTING INFORMATION BECAUSE I
KNOW WHAT KINDS OF THE I MEAN
THE ASK YOU INFORMATION ABOUT
PATTERNS AND BEHAVIORS SO I
COMPLETELY GET THAT BUT I DON'T
WANT TO SEE THESE PROGRAMS GO
AWAY BECAUSE I KNOW THAT THEY
THEY DEFINITELY WORK IN SOME
CASES AND THEY'RE DONE.
MASS SCALE SO JUST WANTED TO
SHARE THAT ALTERNATIVE
PERSPECTIVE TO SOME OF THE
COMMENTS THAT I HEARD -- RELATED
TO WHO THE PROGRAM IS FOR AND
WHO IT FITS -- AND JUST SURE
THAT I HAVE HAD A BEARD WELL I
HAD AND I WISH WE HAD A PROGRAM
HERE TO BE HONEST WITH YOU -- I
HAD A VERY POSITIVE EXPERIENCE
WITH IT MISTER CHAIR.
PLEASE I THINK THAT COMMENT THAT
LAST COMMENT WAS FOR YOU MAYBE --
THE THAT AND MATH MISTER COOLEY.
I COMPLETELY AGREE I AND AND I
DON'T WANT TO SEE THESE PROGRAMS
GO AWAY BUT I THINK IT'S VERY
IMPORTANT FOR US TO ENSURE THAT
THE PROGRAMS ARE ALSO IN PLACE
FOR THE RIGHT REASONS.
SO IF THERE'S TRANSPARENCY AND
IF THERE IS -- THE ABILITY TO
REVIEW AND KNOW EXACTLY WHAT
INFORMATION YOU HAVE PLACE THERE --
THEN.
THEN DIDN'T IT DOESN'T REALLY
ENTER THE PROGRAM -- THE PROGRAM
CAN CONTINUE AND BECOME VERY
SUCCESSFUL WHILE AT THE SAME
TIME ENSURING THAT YOUR PERSONAL
INFORMATION IS PROTECTED.
SO THANK YOU.
I COMPLETELY AGREE. ONE OF THE
QUESTIONS.
SEEING NONE WILL BRING BACK TO
THE AUTHOR WOULD YOU LIKE TO
CLOSE.
THE BILL DOES ENJOY DO PASS
RECOMMENDATION WE HAVE A MOTION
BY A MISSILE MONA SECOND BY
MISTER RODRIGUEZ.
THANK YOU I DO LOOK FORWARD TO
WORKING WITH THE OPPOSITION.
AND AND AND SEEING IF THERE'S
ANY OTHER WAYS THAT I CAN
[inaudible]
REST [inaudible]
THERE -- CONCERNS SO I'M LOOKING
FORWARD TO THE ONGOING
CONVERSATIONS BUT I A I HAVE
APPRECIATE THE QUESTIONS I
APPRECIATE THE CONFIDENCE FROM
SO FOR WHAT I'M SEEING AN
RESPECTFULLY ASK FOR AN AYE VOTE.
THANK YOU THANK YOU VERY MUCH
MISTER NAZARIAN -- MOTION IS TO
PASS AS AMENDED TO LABOR --
MADAM SECRETARY PLEASE CALL THE
ROLL WHAT I WOULD AYE MAYES.
MAYES NOT VOTING AGUIAR-CURRY
[inaudible]
I BIGELOW.
HELLO NO BONTA [inaudible]
BURKE [inaudible]
CARILLO.
CARILLO I'D FLORA [inaudible]
LAMONT.
LIMON AYE MCCARTY MCCARTY AYE
NAZARIAN.
IS THERE AND I ALMOST.
RAMESSIDE RODRIGUEZ RODRIGUEZ
AYE SANTIAGO [inaudible]
WALDRON.
THANK.
YOU HAVE EIGHT VOTES YOUR BILL
IS OUT MISTER NAZARIAN.
THAT CONCLUDES HEARING OF ALL OF
THE BILLS WOULD ASK THE MEMBERS
WHO HAVE NOT VOTED WE STILL HAVE
SOME BILLS -- ON CALL.
WITH TO PLEASE RETURN TO THE
FORTY TWO OH TWO SO WE CAN --
TAKE THOSE VOTES. FOR NOW WILL
START GOING THROUGH THE THE THE
THE TO LIST HERE [inaudible]
OKAY [inaudible]
THANK YOU.
OKAY VERY GOOD.
OKAY SO WE HAVE -- A COUPLE OF
BILLS THAT HAVE NOT HAD MOTIONS
ON THEM ITEM NUMBER FIVE AB FIVE
TWELVE TO HEAR MOTION. FOR
MISTER TEAMS BILL.
THE MOTION BY MISTER MCCARTY A
SECOND BY MISTER RODRIGUEZ I
BELIEVE -- MOTION IS TO PASS AS
AMENDED TO APPROPRIATIONS MADAM
SECRETARY PLEASE CALL THE ROLL
WHEN I WOULD AYE MAYES AYE MAYES
AYE AGUIAR-CURRY.
I GET CURRY I BIGELOW.
BIGELOW AYE BONTA [inaudible]
BURKE.
CARILLO.
CARILLO AYE FLORA.
LIMON.
LOW MOAN AYE MCCARTY.
MCCARTY I NAZARIAN.
NAZARIAN AYE ROMMEL'S ROTH
RODRIGUEZ.
RODRIGUEZ I SANTIAGO
[inaudible]
WALDRON.
BURKE THIS THIS MISTER TEENS
BILL AB [inaudible]
FIVE TWELVE BURKE I AS TEN VOTES --
THAT IS OUT. ELEVEN VOTES EXCUSE
ME THAT'S OUR ITEM NUMBER SIX AB
FIVE SIXTY FIVE BY MISTER
MAIENSCHEIN.
LOOKING FOR A MOTION.
MOTION BY MISTER AGUILAR CURRY A
SECOND BY MISS BURKE THE MOTION
IS TO PASS AS AMENDED TO
APPROPRIATIONS.
AS SECRETARY PLEASE CALL THE
ROLL WHAT I WOULD AYE MAYES AYE
MAYES AYE AGUIAR-CURRY.
I BIGELOW BIGELOW AYE BONTA
[inaudible]
BURKE.
I CARILLO.
CARILLO AYE [inaudible]
FLORA [inaudible]
LIMON.
LOAN AYE MCCARTY.
MCCARTY AYE IN THIS AREA.
NAZARIAN AYE.
RAMOS.
ROTH IRA EVERY GUEST RODRIGUEZ
AYE SANTIAGO [inaudible]
WALDRON [inaudible]
CANCEL -- THAT'S YEAH MR MAJORS
BILL.
ARE NOT WHAT I FIVE THAT HAS
THIRTEEN OKAY.
CONCERT TWELVE TWELVE OKAY.
ALL RIGHT WE'RE GONNA GO TO THE
TOP OF THE LIST HERE AND AND AND
AND RUN TO THE BILL SO IT ASKS I
KNOW THERE'S STILL SOME MEMBERS
WHO ARE PRESENT WHO HAVEN'T
VOTED ON BILLS SO.
I DON'T WANT TO CALL YOU UP BY
NAME BUT I THINK YOU KNOW WHO WE
ARE -- SO -- CONSENT CALENDAR
ITEMS NUMBER TWO SEVEN FOURTEEN
SEVENTEEN EIGHTEEN OPEN THE ROLE
AND PLEASE CALL THE ABSENT
MEMBERS [inaudible]
MAYES [inaudible]
I BIGELOW.
BIGELOW AYE BONTA [inaudible]
LIMóN.
Là M NINE NAZARIAN.
NAZARIAN AYE RODRIGUEZ
[inaudible]
RODRIGUEZ AYE. FOURTEEN ZERO
THAT'S FOURTEEN ZERO THE CONSENT
CALENDAR MISTER BONTA
[inaudible]
I ALSO.
THAT'S FIFTEEN ZERO ALL RIGHT
THERE WE GO.
ITEM NUMBER THREE EIGHTY THREE
EIGHTY FOUR MISTER CHILD PLEASE
OPEN THE ROOM -- OPENED A LIFT
THE CALL CALL THE ABSENT MEMBERS.
BIGELOW.
MR CHOW AB [inaudible]
THREE EIGHTY FOUR BIGELOW NOW
[inaudible]
BURKE.
BURKE NOT VOTING CARILLO
[inaudible]
I MCCARTY.
MCCARTY I IN THIS AREA.
THE VERY AND I AM RODRIGUEZ.
RODRIGUEZ SIGNED WALDRON
[inaudible]
WALDRON NOW. TO THE THREE THAT
IS TEN TO THREE THAT GOES OUT
WILL LEAVE THE ROLE OPEN FOR
OTHERS TO ADD ON MR SANTIAGO'S
BILL AB FOR FIFTY ONE NUMBER
ITEM NUMBER FOUR PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS
[inaudible]
MAYES.
NUMBER FOUR OF AB.
FORTY FIFTY ONE MR SANTIAGO.
HI.
MAYES AYE BIGELOW AYE BIGELOW
AYE BONTA.
BONTA AYE FLORA [inaudible]
LEVEL.
LIMON ONLY MCCARTY MCCARTY AYE
NAZARIAN.
NAZARIAN AYE. FOURTEEN FOURTEEN
ZERO ITEM NUMBER LOWER.
LET'S LET'S GO BACK AND MR.
THIS IS EITHER OVER CHRISTMAS.
OKAY [inaudible]
YEAH.
SO WITH GO BACK TO ITEM NUMBER
THREE MISTER SANTIAGO -- MISTER
CHAO WILL OPEN THE ROLL CALL THE
UP SOME [inaudible]
MEMBERS.
BUT YOU ALREADY VOTED ON IT SO
NEVER MIND WHAT IT WILL DO THAT
ANYMORE.
ALRIGHT WE'LL GO TO NUMBER FIVE
AB FIVE TWELVE MISTER TEAM OVER
THE ROLL CALL THE ABSENT MEMBERS.
BONTA I BONTA AYE FLORA
[inaudible]
SANTIAGO.
SANTIAGO AYE WALDRON.
WALDRON AYE. FOURTEEN THAT'S
FOURTEEN ZERO ITEM NUMBER SIX AB
FIVE SIXTY FIVE MISTER
MAIENSCHEIN I THINK WE JUST.
THE ABSENT MEMBERS MISTER SUN --
WILL THE ROLL CALL THE ABSENT
MEMBERS BONTA [inaudible]
HI [inaudible]
FLORA.
SANTIAGO.
SANTIAGO I THIRTEEN THAT'S
FOURTEEN ZERO ITEM NUMBER EIGHT
AB SIX FORTY EIGHT MISTER
NAZARIAN PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS BONTA.
BONTA AYE BURKE [inaudible]
FLORA.
SANTIAGO SANTIAGO AYE WALDRON.
NO WATER NO.
THAT'S TEND.
TWO ITEM NUMBER -- NINE EIGHTY
SIX EIGHTY TO MISS EGGMAN PLEASE
GO FOR THE ROLL CALL THE ABSENT
MEMBERS BONTA.
BONSAI Là M.
LAURA HI THIS AREA.
NAZARIAN AYE SANTIAGO.
SANTIAGO FIVE FIFTEEN FIFTEEN
ZERO ITEM NUMBER TEN A. B. SEVEN
OH FOUR MISTER PATTERSON OPEN
THE ROLL CALL THE ABSENT MEMBERS
BONTA.
BONSAI BURKE.
LIMóN.
LIMON I'M [inaudible]
NAZARIAN.
IS THERE ENOUGH VOTING
[inaudible]
SANTIAGO [inaudible] TWENTY FIVE
THIRTEEN ZERO ITEM NUMBER ELEVEN
A. B. SEVEN THIRTEEN PLEASE OPEN
THE ROLL CALL THE ABSENT MEMBERS.
HE'S.
MESA HIGH BIGELOW.
BIGELOW AYE BONTA BONTA EIN Là
MOM.
Là M NINE IS ARIAN.
NAZARIAN AYE RODRIGUEZ RODRIGUEZ
ARE. FIFTEEN FIFTEEN ZERO FIVE
ITEM NUMBER TWELVE AB SEVEN
THIRTY ONE PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBER OF THIS
TO CALL AND CALL THE ABSENT
MEMBERS THINK MAYES.
NO MAYES NO.
BIGELOW.
BIGELOW NO BONTA BONTA I LIMóN.
LIMON HI NAZARIAN.
NEWS THERE AND I RODRIGUEZ.
RODRIGUEZ I FOUR THAT'S ELEVEN
TO FOUR ITEM NUMBER.
THIRTEEN EIGHTY SEVEN SEVENTY
FOUR PLEASE LIFT THE CALL CALL
THE ABSENT MEMBERS.
MAYES.
MAYES NOT VOTING RECORD.
BIGELOW.
BIGELOW NO BONTA.
BONTA I FLORA.
FLOOR NOT VOTING LIMóN.
THE LOAN I MCCARTY.
MCCARTY I NAZARIAN.
NAZARIAN AYE RODRIGUEZ.
RODRIGUEZ AYE.
THAT IS -- ELEVEN TO ONE AB
EIGHT TWENTY FOUR ITEM NUMBER
FIFTEEN PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS.
BONTA.
BONTA I MCCARTY [inaudible]
MCCARTY I SANTIAGO. ZERO AYE
WALDRON.
WATER NOT VOTING. FOUR ZERO
TWELVE ZERO ITEM NUMBERS SIXTEEN
AB EIGHT FORTY EIGHT MISTER GRAY
PLEASE.
OPEN THE WRONG CALL THE ABSENT
MEMBERS BIGELOW. EIGHT FORTY
EIGHT SUPPORT.
BIGELOW AYE BONTA.
BONTA AYE MCCARTY.
MCCARTY I WALDRON.
WALDRON AYE. FIFTEEN FIFTEEN
ZERO ITEM NUMBER -- NINETEEN
EIGHTY NINE TWENTY NINE PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS MAYES.
MAYES AYE BIGELOW.
BIGELOW AYE BONTA.
BONTA AYE FLORA.
FLORA I LIMON.
LEVINE AYE MCCARTY.
MCCARTY I WAS VERY.
NAZARIAN. FIFTEEN SIX FIFTEEN
ZERO I REMEMBER TWENTY AB TEN
SIXTY THREE PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS.
THAT WAS I'M SORRY LIFT THE CALL.
ALL THE ABSENT MEMBERS MAYES.
MAYES NOT VOTING.
BIGELOW.
YEAH BIGELOW NO BONTA.
BONTA HIGH.
FLORA.
FLORA NO LOW MOAN.
LE BON AYE MCCARTY.
MCCARTY AYE NAZARIAN NAZARIAN
AYE RODRIGUEZ.
RODRIGUEZ I TWELVE TO TWELVE TO
TWO OKAY I THINK THAT ACTUALLY
COVERS IT EXCEPT I THINK MR
FLOOR THERE A COUPLE OF ABOUT.
THREE DID NOT ARE OF I'M SORRY.
YEAH I WANT ON IT WILL TALK MORE.
I THINK YOU GOT EVERYTHING.
YES WE GET IT YEAH YOU'RE YOU'RE
GOOD I THINK THE ONLY ONE WHO
HASN'T AS MR FLORA SO.
THE FIRST NINE BILLS
[inaudible]
SO.
OPEN THE ROLL CALL THE ABSENT
MEMBER.
AB THREE EIGHTY FOUR ITEM NUMBER.
THREE HE'S AND HE'S ALWAYS KNOW
YOU ALREADY DID THAT I'M SORRY.
OR ITEM NUMBER FOUR AB FOR FIFTY
ONE PLEASE OPEN THE ROLL CALL
THE UPS A MEMBER FLORA.
FLORA I FIFTEEN ZERO FIFTEEN
ZERO ITEM NUMBER -- FIVE PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBER FLORA -- FLOOR I FIFTEEN
FIFTEEN ZERO ITEM NUMBER SIX AB
FIVE SIXTY FIVE PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS
FLORA.
FLORA HI.
FIFTEEN FIFTEEN ZERO ITEM NUMBER --
EIGHT A. B. -- SIX FORTY EIGHT
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS FLORA.
FLORA NOW. 1-031-03 ITEM NUMBER
NINE AB [inaudible]
SIX EIGHTY TWO THINK.
I THINK WE'RE COVERED.
RIGHT REGARD.
ALL RIGHT.
YEAH THANK YOU SIR -- BUT THAT.
WE WILL PERSONALLY CLOSE THE
MEETING TODAY THANK YOU VERY
MUCH