GOOD AFTERNOON LIKE TO GO AHEAD
AND CALL THE MEETING TO ORDER.
A COUPLE OF ANNOUNCEMENTS BEFORE
WE BEGIN.
WE WILL HEAR -- WE TWO WITNESSES
PER SIDE -- WITH A TIME LIMIT OF
THREE MINUTES EACH ADDITIONAL
WITNESSES WE ASK THE STATE THEIR
NAME AN ORGANIZATION ONLY AND
THEIR POSITION FOR THE RECORD --
WE HAVE BILLS KINDS OF PROPOSED
FOR CONSENT TO DAY.
OF THE BILLS -- BABY YEAH AB ANY
MEMBER OF THE COMMITTEE MAY
REMOVE A BILL FROM THE CONSENT
CALENDAR PROPOSED FOR CONSENT
TODAY ITEM NUMBER SIX AB FOR
FIVE THREE BY MR CHOW WITH
AMENDMENTS.
ITEM NUMBER THIRTEEN AB EIGHT
FIVE ONE BY MISTER COOPER.
AB TWO ONE THREE TWO SEVEN MS
PETRIE-NORRIS WITH AMENDMENTS.
AND AID BE ITEM TWENTY FOUR A.
B. FOURTEEN FORTY THREE MISTER
MAIENSCHEIN.
ALL FROM TODAY'S OR A CALENDAR
OF THE FOLLOWING THOSE WERE
PULLED.
NOW I REMEMBER FIVE AB THREE
SEVENTY SEVEN MR EDUARDO GARCIA
AND ITEM NUMBER -- EIGHTEEN AB
TEN EIGHTY FIVE BY MR MCCARTY.
WE WILL HAVE A SPECIAL ORDER
BUSINESS AND WE'LL HEAR THE
FOLLOWING BILLS STARTING.
VERY SHORTLY.
ITEMS AND AT THE END THEN WILL
RETURN OUR REGULAR ORDER OF
BUSINESS.
WELL HERE -- IN THIS ORDER ITEM
NUMBER ONE EIGHTY SIX EIGHTY
THREE BY MISS CARILLO.
ITEM NUMBER TO AB SEVEN FIFTEEN
BY ME MR WOULD -- ITEM NUMBER
THREE TEN FORTY TWO BY WOOD AND
ITEM NUMBER FOUR TEN EIGHTY
EIGHT BY WOOD SO WILL WHEN WE
FINISH CARILLO RICE WILL BEGIN
ARE A SPECIAL ORDER BUSINESS.
THANK YOU.
AB.
SIX EIGHTY THREE SO WE WILL BE
STARTING AS A SUB COMMITTEE WE
DO NOT HAVE A QUORUM SO.
WHEN WE HAVE A QUORUM WE WILL
TAKE ROLE AND WILL BE ABLE TO
PROCEED THAT WAY?
WHENEVER YOU'RE READY SIR. FOR
SURE.
THAT WHICH IS.
THIS ABOVE ALL THINGS TO PERFORM
SIMPLE.
GOOD DAY TO YOU.
TOO RED.
OKAY GREAT THANK YOU MISTER
CHAIR AND MEMBERS -- I'M HERE 2%
A. B..
SIX EIGHTY THREE A MUCH NEEDED
UPDATE TO THE ASSET LIMITS THAT
MUST BE MET BY SENIORS SEEKING
MEADOW CAL COVERAGE AB SIX
THIRTY THREE WILL ENCOURAGE SELF
SUFFICIENCY FOR OLDER ADULTS.
ON MEDICARE BY AMENDING THE
ASSETS TEST TO REFLECT THE SHIFT
AWAY FROM ACQUIRING LOW INCOME
INDIVIDUALS TO DEPLETE ALL OF
THE RESOURCES PRIOR TO RECEIVING
HIS SHIFT CAN BE IDENTIFIED BY
THE AFFORDABLE CARE ACT
ELIMINATING THE ASSETS TEST FOR
MORE. FOR MOST OF THE MEDI CAL
POPULATION INCLUDING CHILDREN
PARENTS AND CARE TAKER AND
CARETAKER RELATIVES.
AND MOST OTHER ADULTS UNDER THE
AGE OF SIXTY FIVE HOWEVER ONCE
AN ADULT TURNS AGE SIXTY FIVE OR
BECOMES MEDICARE MEDICARE
ELIGIBLE.
THEIR ELIGIBILITY IS DETERMINED.
UNDER A MORE RESTRICTIVE SET OF
RULES THAT REQUIRE THEM TO HAVE
A MINIMAL ASSETS TO RETAIN THEIR
MEDI CAL ELIGIBILITY.
AB SIX EIGHTY THREE WILL UPDATE
THE ASSETS LIMITS QUALIFICATIONS
FOR HEALTH COVERAGE BY ALLOWING
SENIORS. TO ACCUMULATE MORE
SAVINGS AND WEALTH WILL STILL
RECEIVING MEDI CAL SERVICES MY
BILL WILL ENSURE THOSE TO
RECEIVE SERVICES FROM MEDICAL
PROGRAMS CAN MAINTAIN
COMPREHENSIVE HEALTH COVERAGE.
WHILE MAINTAINING RESOURCES FOR
EMERGENCY EXPENSES RELATED TO
THEIR GENERAL WELL BEING. FOR
EVERY PERSON I'M SORRY EVERY
PERSON DESERVES THE OPPORTUNITY
TO SAVE FOR THEIR FUTURE.
AND THEIR PEACE OF MIND KNOWING
THAT THEY HAVE THE RESOURCES
THEY NEED IN THE EVENT OF AN
UNEXPECTED.
COSTLY EMERGENCY PARTICULARLY
OUR OLDER ADULTS WHO SHOULD NOT
HAVE TO WORRY ABOUT LOSING THEIR
MEDICAL COVERAGE.
BECAUSE THEY NO LONGER QUALIFY
SIMPLY BECAUSE THEY HAVE SAVINGS.
ADDITIONALLY THE CURRENT SYSTEM
DISPROPORTIONATELY PUNISHES
SENIORS OF COLOR BECAUSE THEY
ARE MORE LIKELY TO HAVE CASH
SAVINGS.
RATHER THAN A HOME THAT IS
EXEMPT FROM THE ASSETS TEST.
BY ENSURING OUR OLDER POPULATION
IN CALIFORNIA HAS THE RESOURCES
THEY NEED TO LIVE HEALTHY
COMFORTABLE LIVES WE CAN WORK
TOGETHER TO ACHIEVE AT ACCESS TO
ADEQUATE HEALTHCARE FOR ALL
CALIFORNIANS.
TODAY WE HAVE CHEN FLORIAN
BEHALF OF THE WESTERN CENTER ON
LAW AND POVERTY.
AND EVELYN A CHIANG.
AS WELL AND LEGAL AID SOCIETY OF
SAN MATTEO TO ATTEST TO THE
IMPORTANCE OF AB [inaudible]
SIX EIGHTY THREE AND CLEARLY.
AND CLEAR RAMSEY FOR TECHNICAL
ASSISTANCE THANK.
A GOOD AFTERNOON EVERYONE THANK
YOU FOR ALLOWING ME THE TIME TO
SPEAK -- MY NAME IS EVELYN I
CHIANG AND I AM A STAFF ATTORNEY
IN THE LEGALLY SOCIETY OF SAN
MATEO COUNTY SENIOR ADVOCATES
PROGRAM.
AND THE HEALTH CONSUMER CENTER.
IN OUR OFFICE WE ENCOUNTER
NUMERIC NUMEROUS SENIORS WITH
SERIOUS HEALTH CARE NEEDS WHO'S
COVERAGE HENGES ON MAINTAINING A
MINUSCULE AMOUNT OF ASSETS.
THEREFORE I SUPPORT AB SIX
EIGHTY THREE TO INCREASE THE
ASSET LIMITS FOR MEDI CAL
PROGRAM SERVING SENIORS AND
PERSONS WITH DISABILITIES.
THE CURRENT ASSET TEST UNFAIRLY
PUNISHES SENIORS WITH RETIREMENT
ACCOUNTS SHOULD SUCH SUCH AS
THOSE WHO HAVE NOT YET ELECTED
TO TAKE DISBURSEMENTS.
FROM THEIR INDIVIDUAL RETIREMENT
ACCOUNTS OR WORK RELATED PENSION
PLANS.
QUALIFY FOR MEDI CAL SHOULD NOT
COME AT THE EXPENSE OF
SACRIFICING RETIREMENT ACCOUNTS.
ERICA G. NOT HER REAL NAME.
WAS DIAGNOSED WITH CANCER AND
TWENTY TWELVE WHEN SHE WAS FIFTY
EIGHT YEARS OLD.
SINCE THEN SHE HAS UNDERGONE
MAJOR SURGERY AND MAY OF TWENTY
TWELVE WAS DIAGNOSED WITH A RARE
TUMOR IN FEBRUARY OF TWENTY
SIXTEEN AND SHE IS STILL GOING
THROUGH EXTENSIVE MEDICAL
TREATMENT.
SHE HAS LIMITED TREATMENT
OPTIONS AT THIS POINT.
AT THE TIME SHE WAS THANKFUL FOR
COVERAGE UNDER MATCH AYE MEDICO.
AND THOUGHT THAT SHE WOULD
CONTINUE TO HAVE AUTOMATIC MEDI
CAL COVERAGE WHEN SHE TURNED
SIXTY FIVE AND REGISTERED FOR
MEDICARE.
HOWEVER SHE WAS SUBSIDY
SUBSEQUENTLY TERMINATED UPON
TURNING SIXTY FIVE SAID SHE HAD
AN I. R. A..
BEING TERMINATED FOR MEDI CAL
WAS A BIG SHOCK TO ERICA.
IT WAS AS THOUGH SHE FELL OFF A
CLIFF SINCE THIS TERMINATION
CAME WITHOUT ANY WARNING --
CAMARO WITH MERELY HOPE TO HAVE
A SMALL NEST EGG FOR RETIREMENT.
AS SHE DOES HAVE A LOT AND
NEEDED TO MAKE IT LAST.
SHE NEVER THOUGHT THEY SHOULD BE
PET PENALIZED FOR HAVING AN IRA.
NOW ON TOP OF LIVING WITH CANCER
ERICA MUST FIND A WAY TO GET
BACK ON MEDI CAL ADDING AND DO
STRESS.
AB SIX EIGHTY THREE WILL EXPAND
AND SIMPLIFY THE LIST OF ITEMS
INCLUDING OUR ROADS AND OTHER
WORK RELATED PENSION PLANS. TO
BE EXCLUDED FROM THE ASSETS
TESTS FOR THOSE MEDI CAL PROGRAM
STILL SUBJECT TO THEM.
ON BEHALF OF ERICA AND ALL OTHER
SENIOR CENTER SITUATION.
WE RESPECTFULLY ASK FOR YOUR
SUPPORT OF THIS IMPORTANT
LEGISLATION TO PROVIDE EQUITY
AND STABILITY FOR LOW INCOME
SENIORS AND PERSONS WITH
DISABILITIES WHO HEALTHCARE
COVERAGE ARE SUBJECT TO THE
ASSETS TEST.
THANK YOU VERY MUCH.
THANK YOU.
GOOD AFTERNOON AT SHARON MEMBERS
CHEN FLORI ON BEHALF OF WESTERN
CENTER ON LAW AND POVERTY.
OVER THE PAST TWO YEARS
CALIFORNIA'S TAKEN A HARD LOOK
AT HOW IT'S PUBLIC PROGRAMS
ENABLE PEOPLE TO LIVE WITH
DIGNITY ARE NOT.
IN OUR CAO FRESH PROGRAM A
COUPLE YEARS AGO WE FUNCTIONALLY
ELIMINATED THE ASSETS TEST FOR
PEOPLE LIVING ON OR TWO AND A
PERCENT OF THE FEDERAL POVERTY
LEVEL.
IN MOST OF OUR MEDI CAL PROGRAM
WE ELIMINATED THE ACID TEST FOR
CHILDREN'S PARENTS AND ADULTS
UNDER AGE.
SIXTY FIVE HOWEVER FOR SENIORS
AND PERSONS WITH DISABILITIES WE
STILL SUBJECT THEM TO THE OLD
RULES.
MANY PEOPLE ARE NOW AGING INTO
THIS PART OF THE MEDICARE
PROGRAM. ONE OF OUR PARTNERS
REPORTED HELPING A WOMAN WHO
LOST HER MEDI CAL WHEN SHE
TURNED SIXTY FIVE BECAUSE SHE
HAD AMASSED A SMALL AMOUNT OF
SAVINGS TO PAY FOR HER
TERMINALLY ILL HUSBANDS FUNERAL
THAT SHE WAS UNWILLING TO GIVE
UP.
ANOTHER PARTNER REPORTS HELPING
AN ELDERLY INDIVIDUAL WHO IS THE
VICTIM OBTAIN A RELOCATION FEE
TO FIND A NEW APARTMENT BUT
BECAUSE HE WASN'T AT ABLE TO
IMMEDIATELY FIND A NEW PLACE HE
HAD TO SPEND DOWN THE RELOCATION
MONEY IN ORDER TO KEEP IS MEDI
CAL.
BECAUSE THE COST OF HEALTHCARE
SO HIGH AND LOW INCOME SENIORS
AND PERSONS WITH DISABILITIES
HAVE SO FEW ASSETS TO BEGIN WITH.
WHEN FACED WITH THE OUT DATED
MAY MEDI CAL ASSET RULES PEOPLE
SIMPLY SPEND DOWN THEIR ASSETS
USUALLY ON HEALTH CARE UNTIL
THEY'RE ELIGIBLE FOR MEDI CAL?
SO IT THIS WAY ASKING FOR THREE
THINGS THE FIRST IS TO INCREASE
THE OVERALL CAP ON ASSET SO
PEOPLE CAN SAVE MONEY FOR
EMERGENCIES.
THE SECOND IS TO SIMPLIFY THE
EXISTING ASSETS EXCLUSIONS TO
DECREASE THE ADMINISTRATIVE
BURDEN EVERY MOVE EVERY NEW IN
MEDI CAL EVERY YEAR.
MANY PEOPLE SUBJECT TO THE
ASSETS TEST HAVE TO GET
CONSIDERABLE HELP IN
INTERPRETING FINANCIAL DOCUMENTS
OR OBTAIN ASSESSMENTS ON LOW
VALUE PROPERTIES IN ORDER TO
KEEP THEIR MEDI CAL.
AND THEN FINALLY WERE ASKING TO
ELIMINATE THE ASSETS TEST FOR
THE MEDICARE SAVINGS PROGRAMS.
THESE ARE PROGRAM OR MEDI CAL
JUST PAYS FOR MEDICARE COSTS
RATHER THAN AND ROLLING
INDIVIDUAL MEDI CAL.
SEVERAL STATES HAVE GONE THIS
ROUTE AND IT WOULD BE AN
IMPORTANT TESTING GROUND FOR A
COST BENEFIT BENEFIT ANALYSIS AS
TO WHETHER AN ASSET TEST
CONTINUES TO MAKE SENSE AT ALL.
WE CANNOT AS A STATE
SIMULTANEOUSLY PROMOTE THE VALUE
OF SAVINGS WHILE PUNISHING THOSE
WHO ATTEMPT TO SAVE BY TAKING
AWAY THE ONLY HEALTH CARE THEY
CAN AFFORD.
WE THANK THE AUTHOR FOR HER
LEADERSHIP ON THIS ISSUE AND
RESPECTFULLY ASK FOR AYE VOTE.
THANK YOU VERY MUCH OTHERS IN
SUPPORT.
GOOD AFTERNOON MISTER CHAIR AND
MEMBERS CONNIE DELGADO ON BEHALF
OF THE COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION PLEASED TO
BE IN SUPPORT.
DEBORAH DISABILITY RIGHTS
CALIFORNIA VERY STRONG SUPPORT
THANK YOU.
JESSICA MORAN HOW TO ACCESS
CALIFORNIA IN SUPPORT THANK YOU.
REBEKAH COUSINS A VOLUNTEER WITH
ART AND ARCH SUPPORTS THIS BILL.
THANK YOU.
THEIR FLOCKS CALIFORNIA LABOR
FEDERATION IN SUPPORT THANK YOU.
VICTOR CHRISTY CALIFORNIA
HELPLESS ADVOCATES ADVOCATING ON
COMMITTEE HEALTH CENTERS IN
SUPPORT.
Q..
JOANNE CAMPBELL ON BEHALF VALLEY
KAREN SUPPORT THANK YOU.
RESIDENTS ALSO ME HALF OF
NATIONAL ASSOCIATION OF SOCIAL
WORKERS IN STRONG SUPPORT.
MICHELLE CABINET A WITH A CA YOU
CALIFORNIA IN SUPPORT THANK YOU.
KELLY BROOKS ON BEHALF OF THE
COUNTY WELFARE DIRECTORS
ASSOCIATION HERE IN SUPPORT.
THANK YOU.
LIZA COMMON REPRESENTING THE
CALIFORNIA LONG TERM CARE
OMBUDSMAN ASSOCIATION IN SUPPORT
THANK YOU.
BREANNA PITTMAN SPENCER WITH THE
CALIFORNIA DENTAL ASSOCIATION IN
SUPPORT THANK YOU.
KIM SELF ON WITH THAT SAID IT
LEGAL SERVICES IN SUPPORT THANK
YOU.
DEBBIE TELLS WITH CHOICE AN
AGING IN SUPPORT THANK YOU.
AND EVEN DOLLARS WITH AMERICA'S
VISION GROUPS IN SUPPORT.
THANK YOU VERY MUCH.
IS THERE ANYONE IN OPPOSITION
[inaudible]
I'M SORRY.
WITH JUSTICE AN AGING A CO
SPONSOR IN STRONG SUPPORT THANK
YOU SO MUCH IS THERE IS THERE
ANYONE IN OPPOSITION.
SEE KNOWN -- BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS.
OF THE WHOLE THAT FOR A SECOND
WE'RE GONNA STEPS A QUORUM SO --
MADAM SECRETARY PLEASE CALL THE
ROLL WOOD FIVE HERE.
MAYES [inaudible]
AGUIAR-CURRY.
BIGELOW PRESENT BONTA.
BURKE CARRILLO DISSENTING FLORA.
LIMóN [inaudible]
MCCARTY [inaudible]
THIS AREA [inaudible]
RAMOS [inaudible]
RODRIGUEZ [inaudible]
SANTIAGO [inaudible]
WALDRON HERE.
OKAY WE HAVE A QUORUM A MISS
WALDRON YOU HAVE A QUESTION
THANK YOU -- JUST BASICALLY A
COMMENT SO THE CURRENT ASSETS SO
TEST PREVENTS PERSONS WITH
DISABILITIES OR SENIORS -- FROM
HAVING ADEQUATE RESOURCES TO
WHETHER A CRISIS.
AND THAT'S A BIG CONCERN SO I AM
VERY HAPPY THAT YOU BROUGHT THIS
FORWARD FOR DISCUSSION BECAUSE
YOU KNOW WHEN THEY'RE THE MOST
VULNERABLE AND YOU WE KNOW
ALWAYS KNOW HOW ANYTHING CAN
HAPPEN.
SO -- SO WHERE TO PROTECT THEM
SO THAT THEY CAN.
IN A BE SELF SUFFICIENT THANK
YOU.
THANK YOU ANY ANYONE ELSE.
I SUPPOSE A THANK YOU FOR
BRINGING THIS BILL FORWARD WAS
CARILLO APPRECIATE THAT -- IT'S
LONG OVERDUE AND LOOK FORWARD TO
WORKING WITH YOU FURTHER ON THIS.
WOULD YOU LIKE TO CLOSE.
YES THANK YOU MISTER CHAIR WE
ARE AND I WANT TO THANK THE
COMMITTEE STUFF FOR WORKING.
WITH MY OFFICE AS WELL WE ARE
TAKING THE THE COMMITTEE --
RECOMMENDATION THANK YOU -- AND
AMENDMENTS -- AT THAT OUR
TECHNICAL IN NATURE I WOULD JUST
SAY THIS I KNOW PERSONALLY OF A
OF AN OLDER WOMAN WHO IS NINETY
TWO YEARS OF AGE WHO RECENTLY
WENT INTO.
IN HOPE AND HOME SUPPORT
SERVICES PROGRAM SHE HAD.
PAID FOR HER HOUSE IN EAST LA IN
MY DISTRICT.
AND IN ORDER FOR HER TO BE ABLE
TO QUALIFY FOR THIS SUPPORT SHE
LIVES ON HER OWN AT NINETY TWO
SHE HAD TO SELL HER HOUSE.
BECAUSE SHE COULDN'T -- SHE CAN
HAVE ANYTHING UNDER HER NAME.
AND I THINK THAT IS THAT IS WHAT
WE'RE TRYING TO CHANGE HERE AND
SO I RESPECTFULLY ASK FOR AND I
WILL.
THANK YOU VERY MUCH.
WE HAVE A MOTION.
THE MOTION BY MISTER RAMOS SAYS
SECOND BY MISS WALDRON.
THE MOTION IS TO PASS AS AMENDED
TO APPROPRIATIONS MADAM
SECRETARY PLEASE CALL THE ROLL.
WHAT I WHAT I MAYES [inaudible]
AGUIAR-CURRY [inaudible]
BIGELOW.
BIGELOW AYE BONTA [inaudible]
BURKE CARILLO.
CARILLO AYE FLORA FLOOR ISLAND.
HI LIMóN I MCCARTY.
MCCARTY AYE THIS AREA.
RAMOS.
ROTH IRA VEGAS RODRIGUEZ AYE
SANTIAGO.
WALDRON [inaudible]
WALDRON AYE.
MYSTERY OF THE BILL HAS TEN AND
TEN ZERO IT'S AND MOVES OUT AND
WILL LEAVE THE ROLE OPEN FOR
OTHERS TO ADD ON THANK YOU --
MISTER FLOORS CAN TAKE OVER WELL
LIKE PRESENT THE COUPLE BILLS
[inaudible]
AND PERFECT.
THANK YOU MISTER CHAIR.
SO HERE WE PRESENT A FILE ITEM
OR TO AB.
SEVEN FIFTEEN THANK YOU VERY
MUCH MISTER CHAIR.
HERE TODAY TO PRESENT AB.
SEVEN FIFTEEN THIS BILL WILL
RAISE THE INCOME LEVEL OF THE
AGED AND DISABLED MEDICARE
PROGRAM TO A HUNDRED AND 38% OF
THE FEDERAL POVERTY LEVEL
GRADING PARITY BETWEEN SENIORS
AND DISABLED MEDI CAL
BENEFICIARIES AND OTHER.
MEDICARE BENEFICIARIES.
SINCE THE PASSAGE OF THE ACA
MOST MELTS CONNECTICUT ALL FIVE
FOR MEDI CAL THING -- IF THEY
HAVE AN INCOME BELOW A HUNDRED
AND 38% OF THE FEDERAL PIE
POVERTY LEVEL WHICH IS JUST OVER
SEVENTEEN THOUSAND DOLLARS A
YEAR FOR AN INDIVIDUAL.
THE ACA HOWEVER DID NOT CHANGE
THE INCOME LEVEL FOR THE MEDI
CAL AGED AND DISABLED PROGRAM
WHICH IS EQUIVALENT TO A HUNDRED
AND 22%.
THE FEDERAL POVERTY LEVEL THIS
MEANS THAT A SIXTY FOUR YEAR OLD
DOT WITH WITH FREE MEDI CAL CAN
LOSE IT THE DAY THEY TURN.
SIXTY FIVE THE SENIOR WITHIN
INCOME DOT EVEN ONE DOLLAR OVER
A 122% OF THE THRESHOLD IS ONLY
ELIGIBLE FOR MEDI CAL WITH AN
EXPENSIVE SHARE COST.
THE ONLY A FOR SENIORS WITH
INCOMES ABOVE A 10422% OF THE
FEDERAL POVERTY LEVEL TO ACCESS
MEDI CAL BENEFITS.
IS BE HUNDREDS OF DOLLARS IN A
MONTHLY MEDI CAL SHARE COST OVER
SIX HUNDRED FIFTY DOLLARS A
MONTH WHICH MANY SENIOR SIMPLY
CANNOT AFFORD TO PAY.
THIS CREATES A SIGNIFICANT VERY
FOR SENIORS TO ACCESS AFFORDABLE
HEALTHCARE.
THEY ARE AS SO MANY OF THEM HAVE
SHARED WITH ME FORCED TO CHOOSE
BETWEEN PAYING FOR RENT AND FOOD
WHETHER MEDI CAL SHERIFF COST.
ALSO FORCES MANY SENIORS TO
FOREGO NEEDED MEDICAL SERVICES
OFTEN RESULTING IN THE MOVING
INTO SKILLED NURSING FACILITIES
AT A HIGHER COST TO THE STATE.
AND EVEN HIGHER PERSONAL COST TO
THEIR OWN INDEPENDENCE DIGNITY
AND WILL BE.
RAISING THE AGED AND DISABLED
INCOME LIMIT TWO HUNDRED AND 38%
OF THE FEDERAL POVERTY LEVEL IS
MOST APPROPRIATE AND COST
EFFECTIVE WAY TO ENSURE LOW
INCOME SENIORS HAVE ECHO ACCESS
TO AFFORDABLE HEALTH CARE.
AB SEVEN FIFTEEN WOULD ENSURE
THAT VULNERABLE.
RELATIONS LOW INCOME.
SENIORS ARE TREATED FAIRLY AND
HAVE ACCESS TO AFFORDABLE HAIR --
HEALTHCARE EXCUSE ME.
HERE TO TESTIFY IN SUPPORT THEN
THE WAY WITH WESTERN CENTER FOR
LAW AND POVERTY AND TRICIA
VINSON FROM THE LEGAL AID
SOCIETY OF SAN MATTEO.
THANK YOU.
THANK YOU MISTER CHAIR AND
ALLOWED TO WITNESSES THREE
MINUTES EACH THANK YOU.
MISTER CHAIR MEMBERS MY NAME IS
TRISH VINCENT AND I'M THE
DIRECTOR OF THE HEALTH CONSUMER
CENTER OF THE LEGAL AID SOCIETY
OF SAN MATEO COUNTY.
THANK YOU FOR THE OPPORTUNITY TO
ADDRESS YOU REGARDING THE
IMPORTANCE OF AB. SEVEN FIFTEEN
FOR THE PAST TEN YEARS I'VE
REPRESENTED LOW INCOME
INDIVIDUALS AND COUNTING
ENCOUNTERING BARRIERS TO THE
HEALTH CARE.
THIS PAST YEAR HUNDRED AND FIFTY
SEVEN SENIORS SOUGHT OUR HELP
BECAUSE OF AN UNAFFORDABLE MEDI
CAL SURE OF COST THAT REPRESENTS
OVER ONE THIRD OF OUR HEALTH
CASES.
WE ROUTINELY SEE SENIORS WHO DO
WITHOUT TREATMENT AND MEDICATION
THAT THEIR DOCTORS HAVE
PRESCRIBED IN ORDER TO PAY FOR
THEIR HOUSING AND FOOD.
BY FAILING TO TAKE CARE OF THEIR
HEALTH IS NEEDED THEIR MEDICAL
CONDITIONS OFTEN DETERIORATE.
RESULTING IN OF AVOIDABLE
HOSPITALIZATIONS AND
INSTITUTIONAL CARE.
THIS PAST WEEK ALONE SIX CLIENTS
CAME TO OUR OFFICE AS A RESULT
OF A NOTICE OF ACTION THAT THEY
WERE NO LONGER ELIGIBLE FOR FREE
MEDI CAL.
AND WOULD HAVE A SHARE OF THE
COST.
THE REASON FOR THIS DETRIMENTAL
CHANGE WAS THAT THEY RECEIVED A
COST OF LIVING ADJUSTMENT TO
THEIR SOCIAL SECURITY BENEFITS
THAT HAD THROWN THEM JUST OVER
THE LEVEL FOR FREE CARE.
I WANT TO TELL YOU ABOUT ONE OF
THE INDIVIDUALS THAT I SPOKE.
TO NOR A. B. WHICH IS NOT HER
REAL NAME IS EIGHTY YEARS OF AGE
WITH MULTIPLE CHRONIC HEALTH
CONDITIONS.
SHE'S DIABETIC AND HAS HIGH
BLOOD PRESSURE.
SHE HAS THREE STANCE AND NEEDS
TO VISIT HER CARDIOLOGISTS EVERY
THREE MONTHS.
SHE NEEDS REGULAR BLOOD TESTS TO
MONITOR HER DIABETES AND SHE
TAKES SEVEN MEDICATIONS EACH DAY.
IN JANUARY SHE RECEIVED A COST
OF LIVING ADJUSTMENT TO OUR
SOCIAL SECURITY BRINGING HER ONE
DOLLAR AND NINETY TWO CENTS OVER
THE LEVEL FOR FREE CARE.
AS A RESULT SHE RECEIVED A
NOTICE OF ACTION THAT SHE WOULD
NO LONGER HAVE THE FREE CARE BUT
WOULD HAVE A SHARE OF COST OF
SIX HUNDRED AND SEVENTY THREE
DOLLARS A MONTH.
NORA WAS PANICKED SHE WOULD NOT
BE ABLE TO AFFORD HER MEDICATION
OR CONTINUE TO RECEIVE
LIFESAVING TREATMENT FROM HER
CARDIOLOGISTS TENER HEALTH CARE
TEAM.
SHE KNOWS THE DISTRESS IS ONLY
EXACERBATING HER ALREADY HIGH
BLOOD PRESSURE.
BUT EIGHTY YEARS OF AGE SHE
FEELS HOPELESS TO DEAL WITH THE
ISSUE.
IT'S BOTH IRONIC AND UNFAIR THAT
NORTH HEALTHCARE COSTS BECAME
UNAFFORDABLE BY VIRTUE OF HER
BEING OVER SIXTY FIVE YEARS OF
AGE AND ELIGIBLE FOR MEDICARE.
A PROGRAM THAT WAS INTENDED TO
HELP VULNERABLE SENIORS RECEIVE
THE CARE THAT THEY NEED.
WE ASK YOU TO REMEDY THIS
INJUSTICE AND AN OCTAVE SEVEN
FIFTEEN THANK YOU.
THANK YOU VERY MUCH.
GOOD AFTERNOON CHAIR MEMBERS
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY PROUD CO
SPONSORS OF THIS IMPORTANT
MEASURE IT'S UNFAIR THAT SENIORS
AND PEOPLE WITH DISABILITY ARE
SUBJECT TO A LOWER INCOME
ELIGIBILITY THRESHOLD.
OF ABOUT A HUNDRED FIFTY DOLLARS
LESS A MONTH.
IN SAID THESE INDIVIDUALS
BECAUSE OF THEIR AGE OR
DISABILITY STATUS IF THEY HAVE
INCOMES ABOVE. TWELVE HUNDRED
FORTY TWO A MONTH ARE ONLY
ELIGIBLE FOR MEDICARE NOW WITH
THE SHERIFF COSTS THIS MEANS
THEY ARE EXPECTED TO LIVE OFF OF
SIX HUNDRED DOLLARS A MONTH FOR
AN INDIVIDUAL OR NINE HUNDRED
AND THIRTY FOUR DOLLARS FOR A
COUPLE.
THIS MAY HAVE MADE SENSE IN
NINETEEN EIGHTY NINE WHEN THAT
THE DOOR SHOWED WAS SET BUT
CERTAINLY DOESN'T MAKE SENSE NOW.
MANY OF OUR CLIENTS HAVE
DIFFICULTY LIVING OFF OF THEIR
CURRENT INCOME OF ABOUT THIRTEEN
HUNDRED A MONTH MUCH LESS HALF
OF THIS AMOUNT.
THIS FORCES THEM TO MAKE
DIFFICULT HEALTH DECISIONS BASED
ON THEIR FINANCIAL DECISIONS
INCLUDING RATIONING THEIR
PRESCRIPTIONS US FOR EXAMPLE
THEIR BLOOD PRESSURE MEDICINE
INSTEAD OF TAKING DALY MAYBE
TAKING ONCE A WEEK.
OR DELAYING A DOCTOR'S VISIT OR
FOR GOING CARE COMPLETELY.
NOW IS THE TIME TO PROVIDE MUCH
NEEDED PARITY AND RELIEF TO OUR
SENIORS AND PERSONS WITH
DISABILITIES AND URGE YOUR AYE
VOTE FOR THIS BIPARTISAN BILL
THANK YOU.
THANK YOU VERY MUCH ANYONE ELSE
IN SUPPORT NAME AN ORGANIZATION
PLEASE.
AND REBEKAH COUSINS I'M A
VOLUNTEER FOR OUR AND WE
STRONGLY SUPPORT AB SEVEN FIFTY
IN.
JUST COME RAN HOW TO ACCESS
CALIFORNIA IN SUPPORT.
GOOD AFTERNOON TIM VALDERRAMA
WITH THE WHITE A GROUP ON BEHALF
OF BLUE SHIELD OF CALIFORNIANS
SUPPORT.
JOINT CAMPBELL ON BEHALF LA CARE
AND SUPPORT.
THE TO CHRISTY CALIFORNIA HELP
WITH ADVOCATES IN SUPPORT.
RESIDENTS ALSO ON BEHALF OF
NATIONAL ASSOCIATION OF SOCIAL
WORKERS IN SUPPORT.
KELLY BROOKS ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA HEALTH
CARE DISTRICTS THE CALIFORNIA
ASSOCIATION OF PUBLIC HOSPITALS
AND HEALTH SYSTEMS IN THE COUNTY
WELL FULLER WELFARE DIRECTORS
ASSOCIATION HERE IN SUPPORT.
CONNIE DELGADO ON BEHALF OF THE
COUNTY WE HAVE A HEALTH
DIRECTORS ASSOCIATION IN SUPPORT.
MARK WINDOWS WITH A CA YOU
CALIFORNIA AND SUPPORT.
FRED MAY NOT BE HAVE CAL PACE
THE PROGRAMS FOR ALL IN COLUSA
OF CARE FOR THE ELDERLY IN
SUPPORT.
NICK LOUISA'S CALIFORNIA
ASSOCIATION OF HEALTH PLANS IN
SUPPORT.
ANGELA WILLIAMS CALIFORNIA BLACK
HEALTH NETWORK IN SUPPORT OF THE
BILL AND THE AUTHOR FOR
REPRESENTING AFRICAN AMERICAN
SENIORS.
MICHELLE GIVENS OF THE COUNTY
HEALTH EXECUTIVES ASSOCIATION
REPRESENTING LOCAL HEALTH
DEPARTMENTS IN SUPPORT.
LISA COLEMAN WITH CALIFORNIA
LONG TERM CARE OMBUDSMAN
ASSOCIATION IN VERY STRONG
SUPPORT.
SIR FLOCKS CALIFORNIA LABOR
FEDERATION IN SUPPORT.
CLEAR RAMSEY JUSTICE AN AGING
PROUD CO SPONSOR IN STRONG
SUPPORT.
HIMSELF ON ON BEHALF OF BETS
ATTIC LEGAL SERVICES IN SUPPORT --
DIPPING SAUCE WITH AMERICA'S
VISION GROUPS ALSO IN SUPPORT.
GEN HAMPTON LEADING H.
CALIFORNIA AND SUPPORT.
LINDA DINNER WITH WITH THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK IN SUPPORT.
DEBBIE TELLS WITH CHOICE AN
AGING STRONG SUPPORT.
GET BROUGHT DISABILITY RIGHTS
CALIFORNIA PROUD CO SPONSOR VERY
STRONG SUPPORT.
MARY HYATT FROM CALIFORNIA CIVIL
LIBERTIES WE SUPPORT THIS BILL.
THANK YOU VERY MUCH ANYONE
ELSE'S SUPPORT.
C. N. NINE OPPOSITION
[inaudible]
ANY OPPOSITION.
SEE AN NINE WILL BRING IT BACK
TO THE COMMITTEE FOR QUESTIONS.
THE QUESTIONS FROM THE COMMITTEE.
BUT WHAT WOULD YOU LIKE TO CLOSE.
I JUST RESPECTFULLY ASK YOUR AYE
VOTE IN THIS CASE TRULY DOLLAR
CAN MAKE A DIFFERENCE PRETTY
GOOD.
THANK YOU DOCTOR WOULD DO THAT
THE MOTION IS DUE PASSED
APPROPRIATIONS APPROPRIATIONS
AND SECTOR PLEASE CALL THE ROLL
WHAT.
WHAT I MAYES [inaudible]
AGUIAR-CURRY [inaudible]
HARPER.
AGUIAR-CURRY AYE BIGELOW.
BONTA.
BURKE CARRILLO.
CARILLO AYE FLORA FLORA AYE
LIMóN.
THE MODE I MCCARTY MCCARTY AYE
NAZARIAN.
RAMOS RAMOS I RODRIGUEZ
[inaudible]
SANTIAGO.
WALDRON.
WALDRON HIGH.
BILL IS ABLE TO TELL.
RIGHT DOCTOR WOULD LOOK LIKE A
FILE ITEM THREE AB.
TEN FORTY TWO THANK YOU VERY
MUCH MISTER CHAIR [inaudible]
AND MEMBERS. ONE THING MANY OF
US WOULD AGREE ON IS SENIOR
SHOULD BE ABLE TO RETURN TO FROM
A LONG.
TERM CARE FACILITY TO A HOME OR
APARTMENT IN THEIR COMMUNITY
WHEN THEY ARE ABLE.
RIGHT NOW WHAT'S THE SENIORS
DISCHARGE FROM A NURSING HOME
THEY OFTEN HAVE NO WHERE TO
RETURN TO BECAUSE AB THEIR LOST
THEIR HOME OR CAN'T FIND A PLACE
TO STAY BECAUSE THEY CAN'T
AFFORD.
FIRST AND LAST MONTH'S RENT.
AND THE UP FRONT COST REQUIRED
TO MOVE TO AN APARTMENT.
AB TEN FORTY TWO DOES TWO THINGS
TO ADDRESS THIS ISSUE FIRST IT
WOULD INCREASE WHAT'S KNOWN AS
THE HOME UPKEEP ALLOWANCE.
THIS ALLOWS US CURRENTLY TWO
HUNDRED AND NINE DOLLARS A MONTH
AND IT HAS IT'S BEEN THAT A
MONTH MATT AMOUNT FOR DECADES --
IN TWO THOUSAND NINETEEN THAT
AMOUNT IS WOEFULLY IN ADEQUATE
TO MAINTAIN A HOME IN CALIFORNIA.
SECOND IT WOULD ESTABLISH A NEW
TRANSITIONAL NEEDS FUNDS FOR
PICK PEOPLE WHO WANT TO LEAVE A
NURSING HOME BUT CAN'T MOVE OUT
BECAUSE THEY DON'T HAVE A PLACE
TO GO.
I RESPECTFULLY ASK FOR AN AYE
VOTE I DO HAVE WITNESSES HERE
FOR IN SUPPORT.
HI GOOD AFTERNOON CHAIR AND
MEMBERS I'M JIMMY FROM IN FROM
DISABILITY RIGHTS CALIFORNIA.
I THE COMMITTEE STAFF GNOSIS
DOESN'T EXCELLENT JOB LAYING OUT
THE IMPORTANT NEED FOR THIS BILL
IN THE KEY PIECES THAT WOULD
ASSIST MEDI CAL RECIPIENTS WHO
BOTH WANT TO AND SHOULD BE ABLE
TO LEAVE NURSING HOMES BUT FACE
THE BEARER OF NOT HAVING THE
RESOURCES TO EITHER MAINTAIN A
HOME.
OR SAFE TO FIND ONE I CAN
CERTAINLY APPRECIATE A GOOD
COMMITTEE ANALYSIS.
THIS BARRIER KEEPS THOSE
RECIPIENTS IN NURSING FACILITIES
AND IN THEIR OWN HOMES IN THEIR
COMMUNITIES AT GREATER EXPENSE
JUST TO THE STATE.
ASSEMBLY BILL TEN FORTY TWO WILL
ALLOW NURSING HOME RESIDENTS WHO
ARE ELIGIBLE TO LEAVE NURSING
FACILITIES TO USE A CERTAIN
AMOUNT OF MONEY TO KEEP THEIR
HOME USING THE HOME UPKEEP
ALLOWANCE.
THE HOME UPKEEP ALLOWANCE ALLOWS
A RESIDENT OF A NURSING HOME WHO
MEETS A SPECIFIC CRITERIA THE
ABILITY TO SPEND MONEY ON THEIR
HOME.
THEY WOULD NORMALLY BE USED FOR
SHARE COST.
IMAGINE THE RESIDENT WHO IS
ELIGIBLE TO LIVE AT HOME BUT
CAN'T BECAUSE THEY LOST THEIR
HOUSE WHILE THEY WERE UNABLE TO
PAY FOR THE RENT TAXES
MAINTENANCE ETCETERA.
IF THE HOME UP KEEP ALLOWANCE
WAS AN AMOUNT ADEQUATE ENOUGH TO
KEEP THEIR HOUSE THEY WOULD BE
OUT OF THE NURSING FACILITY AND
THE STATE WOULD NOT BE PAYING
FOR THE HIGH COST.
OF THAT FACILITY AB TEN FORTY
TWO WILL ALLOW NURSING FACILITY
RESIDENTS WHO HAVE ALREADY LOST
THEIR HOMES. TO SAVE MONEY AND
TRANSITIONAL NEEDS FUND FOR SIX
MONTHS.
THE CONCEPT IS REALLY SIMPLE.
WHAT NURSING HOME RESIDENTS SAVE
SOME MONEY FOR A SIX MONTH
PERIOD TO GET BACK INTO THEIR
HOMES AND COMMUNITIES?
AND OUT OF A NURSING HOME WHEN
THE DOCTOR CERTIFIES THAT THEY
DO NOT NEED TO BE THERE -- THE
CURRENT HOME UPKEEP ALLOWANCES
TWO HUNDRED NINE DOLLARS IS AN
UNCHANGED AS THE NINETEEN
SEVENTIES.
IF THAT MOUNT HAD BEEN PEGGED TO
INFLATION IT WOULD BE NINE
HUNDRED NINETY EIGHT DOLLARS.
BUT INSTEAD IT HAS A CURRENT
BUYING POWER OF LESS THAN.
FORTY FIVE CONSIDERING THAT THE
ORIGINAL INTENT OF THESE
PROVISIONS WAS TO HELP MEDI CAL
RECIPIENTS RETURN TO THEIR HOMES
IT'S HARD TO IMAGINE FORTY FIVE
DOLLARS BE A SUFFICIENT
SPRINGBOARD TO DO SO.
THE TIME HAS COME TO MOVE
TOWARDS MAKING THE HOME UPKEEP
ALLOW IT'S AN IMPORTANT TOOL.
BUT IT WAS ALWAYS INTENDED TO BE
BUT HAS NOT YET BEEN REALIZED --
DISABILITY RIGHTS STRONGLY URGES
AND I'VE A GOOD AFTERNOON -- I'M
CHEN FLORIDA WESTERN CENTER ON
LAW AND POVERTY.
AS YOU CAN IMAGINE A HEALTH
CRISIS LANDING SOMEONE IN A
NURSING HOME CAN COMPLETELY WIPE
OUT SOMEONE'S FINANCES.
THE MEDICARE PROGRAM ALSO
REQUIRES PEOPLE TO PAY MOST OF
THEIR INCOME WHILE THEY'RE
RECEIVING NURSING HOME SERVICES.
AT THE SAME TIME FOR THE LAST
FEW YEARS OUR LOCAL LEGAL
SERVICES PARTNERS HAVE ASSISTED
MORE AND MORE PEOPLE BEING
RELEASED FROM NURSING HOMES WITH
LITERALLY NO WHERE TO GO.
OUR PARTNERS REPORT PEOPLE WHO
HAVE LEFT THEIR NURSING HOME AND
WERE RELEASED TO A MOTEL.
A SHELTER OR THE STREET.
LAST YEAR THE LEGISLATURE TOOK
IMPORTANT STEPS TO IMPROVE
HOSPITAL DISCHARGE POLICIES FOR
PEOPLE WITH NOWHERE TO GO.
AND MANY ADVOCATES TOLD ME THAT
WE NEEDED THE SAME PROTECTIONS
FOR PEOPLE LEAVING NURSING HOME
CARE.
WELL THE LARGER PROBLEM IS THE
LACK OF AFFORDABLE HOUSING FOR
LOW INCOME CALIFORNIANS AB TEN
FORTY TWO WILL PLAY AN IMPORTANT
ROLE IN PREVENTING HOMELESSNESS
AMONG SENIORS AND PERSONS WITH
DISABILITIES.
IN ADDITION TO INCREASING THE
AMOUNT THAT MEDICARE
BENEFICIARIES COULD SAVE TO
PROTECT THEIR EXISTING HOMES.
AB TEN FORTY TWO WOULD ALSO MAKE
AN IMPORTANT PROOF MAN ON THE
HOME UP KEEP ALLOW ITS PROGRAM
TO THE ESTABLISHMENT OF THE
TRANSITIONAL NEEDS FUND.
WHEN I ASKED OUR LOCAL LEGAL
SERVICES ADVOCATES IF THEY WERE
ABLE TO USE THE HOME ABOUT KEEP
ALLOWANCE PROGRAM TO HELP PEOPLE
LIVING NURSING HOMES EVERY
PRETTY HAVE REPEATED PROBLEM I
HEARD WAS?
THAT THIS PROGRAM REQUIRES
SOMEONE TO HAVE A HOME. TOO
OFTEN THE PEOPLE WE WANT TO HELP
HAVE ALREADY LOST THEIR HOME
EITHER BEFORE ENTERING THE
NURSING ARE OR AS A CONSEQUENCE
THEM IN THERE.
AB TEN FORTY TWO WILL NOT GET US
ALL THE WAY THERE AND ENSURING
THAT EVERYONE LEAVING A NURSING
HOME AS A HOME TO RETURN.
TO BUT IT DOES TAKE A VERY
IMPORTANT STEP.
BY ALLOWING PEOPLE TO DIVERT
SOME OF THEIR INCOME FROM THE
COST OF THEIR HEALTH CARE TO
SAVING FOR AN APARTMENT MORE
PEOPLE HAVE A HOME TO GO TO WHEN
THEY LEAVE.
THANK YOU VERY MUCH ANYONE ELSE
IN SUPPORT NAME AN ORGANIZATION
OF THE BILL.
HI TIM VALDERRAMA WITH THE
WEATHERMAN GROUP ON BEHALF OF
BLUE SHIELD OF CALIFORNIANS
SUPPORT.
THAT THE COUSINS ART OUR
VOLUNTEER WERE IN SUPPORT.
JOANNE CAMPBELL BEHALF LA CARE
AND SUPPORT.
ANGELA WILLIAMS CALIFORNIA'S
LIKE ALFA WORK IN SUPPORT --
YOUR ELBOWS BUT SHE LEGAL AID
SOCIETY OF SAME TALE COUNTY IN
STRONG SUPPORT.
LISA COLEMAN WITH CALCULUS ASIDE
FOR OUR FUNDING REQUEST THIS IS
OUR HIGHEST REQUEST AND ASK FOR
YOUR SUPPORT.
AMY BLOOMBERG ON BEHALF OF THE
CALIFORNIA ASSOCIATION OF HEALTH
FACILITIES REPRESENTING NINE
HUNDRED SKILLED NURSING
FACILITIES AND FORD AND FIFTY
INTERMEDIATE CARE FACILITIES AND
SUPPORT. TO BE TOLD AGAIN WITH
TRACE AN AGING STILL IN SUPPORT.
KELLY BROOKS ON BEHALF OF THE
COUNTY WELFARE DIRECTORS
ASSOCIATION HERE IN SUPPORT.
CLEAR RAMS WITH JUST AS AN AGING
IN STRONG SUPPORT.
HIMSELF ON ON BEHALF OF BET SEC
LEGAL SERVICES AND SUPPORT.
GEN HAMPTON LEADING H.
CALIFORNIA AND SUPPORT.
LINDA TO NARROW ITS CALIFORNIA
PEN I THINK HEALTH NETWORK IN
SUPPORT.
THANK YOU VERY MUCH ANYONE ELSE
IN SUPPORT.
SEE AN NINE ANY OPPOSITION
[inaudible]
ANY OPPOSITION.
SEEING NONE BRING IT BACK TO THE
COMMITTEE ANY QUESTIONS FROM THE
COMMITTEE.
SEE A NUN DOCTOR WOULD LIKE
CLOSE JUST RESPECTFULLY ASK YOUR
RIVAL.
THANK YOU VERY MUCH.
ENGINE -- THE MOTION IS DUE
PASSED APPROPRIATIONS PLEASE
CALL.
WHAT I WOULD AYE MAYES?
AGUIAR-CURRY AGAR CURRY I
BIGELOW [inaudible]
BONTA BURKE.
I CARILLO CARILLO AYE FLORA
FLOOR ISLA MOAN MOAN AYE MCCARTY
[inaudible]
THIS AREA [inaudible]
MOST.
RODRIGUEZ SANTIAGO WALDRON
[inaudible]
WALDRON HIGH.
MILOSEVIC WILL BE PLACED ON CALL.
BY DOCTOR WOULD AB TEN EIGHTY
EIGHT THANK YOU VERY MUCH MR
CHAIRMAN MEMBERS AB TEN EIGHTY
EIGHT WILL PREVENT LOW INCOME
SENIORS AND PEOPLE WITH
DISABILITIES WHO ARE THE BELT IN
BOTH.
MEDICARE AND MEDICARE ALL LOSING
THEIR MEDICARE COVERAGE WHEN THE
STATE BEGINS PAYING THEIR
MEDICARE PART B. PREMIUMS.
THIS ISSUE IS COMPLICATED BUT
IT'S IMPORTANT FOR THE PEOPLE
WHO ARE AFFECTED.
RIGHT NOW WHEN CERTAIN GROUPS OF
PEOPLE APPLY FOR MEDI CAL THEY
CAN DEDUCT.
THE AMOUNT THEY SPEND ON THEIR
MEDICARE PART B. PREMIUM FROM
THEIR MONTHLY INCOME IN TWO
THOUSAND AND NINETEEN THAT
AMOUNT IS AROUND A HUNDRED AND
THIRTY FIVE DOLLARS A MONTH FOR
AN INDIVIDUAL.
AND TWICE THAT FOR A COUPLE.
IF THERE EXISTS TO EX.
IF THEY HAVE SUCCESSFULLY
ENROLLED IN MEDICARE.
THE STATE BEGINS PAYING FOR THE
PART B. PREMIUM. FOR A SMALL
PEOPLE A GROUP OF PEOPLE CLOSE
TO THE MEDI CAL INCOME
ELIGIBILITY THRESHOLD.
THIS CAN PUSH THEIR INCOME UP
ABOVE THE LEVEL SO THEY ARE NO
LONGER ELIGIBLE FOR MEDICARE.
THIS MEANS THEY LOSE THE
COVERAGE THEY JUST SIGNED UP.
FOR PEOPLE REFER TO THIS AS
FLIPPING OR YO YO ING.
BUT IN ACTUALITY IT'S QUITE
SERIOUS.
WITH A LOW INCOME INDIVIDUAL OR
COUPLE LOSES ARE MEDI CAL THREE
THINGS HAPPEN FIRST IT MEANS
THEY NOW HAVE TO PAY MEDICARE
PREMIUMS AND DEDUCTIBLES.
SECOND THEY LOSE THE ADDITIONAL
LONG TERM SEPARATE SERVICES MEDI
CAL PROVIDES THAT MEDICARE DOES
NOT UNLESS THEY'RE ABLE TO PAY
OVER HALF OF THEIR INCOME.
ON HEALTH CARE COSTS AND THIRD
IT MEANS THEY LOSE THEIR
MEDICARE MANAGED CARE.
PLAN.
AB TEN EIGHTY EIGHT MAKE SURE
THIS WON'T HAPPEN BY BASICALLY
HOPE HOLDING PEOPLE IN THE SAME
PLACE THEY WERE WHEN THEY
APPLIED SO DON'T BOUNCE OFF OF
MEDICAL COVERAGE.
I'D LIKE TO ACCEPT THE AMENDMENT
NOTED IN COMMENT SEVEN IN THE
COMMITTEE ANALYSIS I WITNESSES
HERE IN SUPPORT I RESPECTFULLY
ASPIRIN I ABOUT.
THE DOCTOR WOULD FIRST WITH THIS
PLEASE.
GOOD AFTERNOON MISTER CHAIR AND
MEMBERS -- I APPRECIATE THE
OPPORTUNITY TO SPEAK ABOUT AB.
TEN EIGHTY EIGHT MY NAME IS KIM
SAW FUN AND I'M AN ADVOCATE AT
THAT SAID IT LEGAL SERVICES IN
LOS ANGELES.
I ASSIST LOW INCOME DISABLED AND
OLDER ADULTS ACCESS MEDI CAL
BENEFITS.
AB TEN EIGHTY EIGHT WILL
SIMPLIFY MEDI CAL ELIGIBILITY
AND CORRECTED MEDI CAL GLITCH
CALLED THE MEDI CAL YO YO.
INDIVIDUALS YO YO BETWEEN FREE
MEDI CAL AND SHARE OF COSTS MEDI
CAL EVERY FEW MONTHS
LET ME EXPLAIN HOW THE YO YO
WORKS AND HOW AB TEN EIGHTY
EIGHT WILL CORRECT THIS GLITCH.
MEET MY CLIENT EDDIE.
EDDIE IS DISABLED AND HE LIVES
IN LOS ANGELES.
HIS SOCIAL SECURITY INCOME IS
THIRTEEN ELEVEN A MONTH AND HE
HAS NO OTHER INCOME.
HE PAYS A HUNDRED AND THIRTY
FIVE DOLLARS A MONTH FOR HIS
MEDICARE BE PREMIUM.
THIS PREMIUM IS DEDUCTED FROM
HIS SOCIAL SECURITY BENEFITS.
AFTER DEDUCTIONS.
EDDIE'SCANNIBAL INCOMES.
ELEVEN SEVENTY THAT'S THE INCOME
LIMIT THE INCOME LIMIT FOR FREE
MEDI CAL IS. TWELVE SEVENTY ONE
TO HIS INCOMES BELOW THE INCOME
LIMIT AND HE'S APPROVED FOR FREE
MEDICARE.
AS AN ADDITIONAL BENEFIT TO HIM
THE STATE PAYS HIS MEDICARE BE
PREMIUM.
AT IS THRILLED HE NO LONGER
NEEDS TO PAY HIS MEDICARE BE
PREMIUM.
UNFORTUNATELY EDDIE WILL NOT BE
THRILLED FOR LONG.
HERE'S THE GLITCH.
WHEN HE STOPS PAYING HIS
MEDICARE BE PREMIUM?
HIS COUNTABLE INCOME INCREASES
TO THIRTEEN ELEVEN WHICH IS OVER
THE FREE MEDI CAL INCOME LIMIT
OF TWELVE SEVENTY ONE HE IS NOW
IN ELIGIBLE FOR THE FREE MEDI
CAL PROGRAM.
MEDI CAL TELLS HIM HE MUST PAY A
MONTHLY SHERIFF COST OF SIX
HUNDRED AND NINETY ONE DOLLARS.
THIS IS LIKE A MONTHLY
DEDUCTIBLE HE IS RESPONSIBLE FOR
PAYING SIX HUNDRED AND NINETY
ONE DOLLARS OF MEDICAL EXPENSES
EACH MONTH.
IN ANY CASE HE MUST PAY HIS AYE
HSS HOME CARE PROVIDER THE SIX
HUNDRED AND NINETY ONE DOLLAR
SHARE OF COST.
WHICH IS ALMOST HALF OF HIS
INCOME.
SINCE EDDIE LOST ELIGIBILITY FOR
FREE MEDICO MEDICO STOPS PAYING
HIS MEDICARE BE PREMIUM.
SOCIAL SECURITY WILL THEN START
CHARGING HIM A HUNDRED AND
THIRTY FIVE DOLLARS A MONTH FOR
MEDICARE BE WHICH AGAIN LOWERS
HIS INCOME TO UNDER.
ELEVEN SEVENTY AND HE NAY CAN
NOW GET FREE MEDICARE.
EVEN THOUGH HIS ACTUAL INCOME
NEVER CHANGES HE WILL YO YO
BETWEEN FREE MEDICO AND SHARE OF
THE COST MEDI CAL.
EVERY FEW MONTHS.
OKAY.
THE YOUR YOUR RULES ARE
OBVIOUSLY CONFUSING AND COMPLEX.
I REGULARLY COUNSEL PEOPLE STUCK
IN THE YO YO.
THOUSANDS OF OLDER AND DISABLED
ADULTS ARE CAUGHT IN THIS MEDI
CAL GLITCH STATEWIDE.
AB TEN EIGHTY EIGHT CREATES A
NEW LAW TO STOP THE MEDICAL YO
YO.
APPLICANTS WHO ARE ELIGIBLE FOR
FREE MEDI CAL WHEN THEY ENROLL
WILL STAY ELIGIBLE ONCE THE
STATE START PAYING THEIR
MEDICARE BE PREMIUM.
THAT SAID I RESPECTFULLY ASK YOU
TO VOTE I EIGHT II ON TEN EIGHTY
EIGHT AND CUT THE STRING OF THE
AREA THANK YOU.
THANK YOU MUCH NEXT WITNESS
PLEASE.
MEMBER CHAIR.
I'M CLEAR RAMSEY WITH JUSTICE IN
AGING AND I WANT TO SPEAK
SPECIFICALLY ABOUT THE IMPACTS
OF NOT PASSING THIS BILL VERSUS
THE IMPACTS OF PASSING THIS BILL.
AND FIRST I WANT TO START WITH A
COUPLE QUOTES FROM CLIENTS FIRST
WE HAD ONE CLIENT ASK.
THIS CAN'T BE HOW THIS WORKS
RIGHT AND UNFORTUNATELY AS
ATTORNEYS WE HAVE TO TELL THEM
ACTUALLY THIS IS RIGHT IT'S JUST
COMPLETELY NONSENSICAL.
WE HAVE MISS RAY IS NOT HER REAL
NAME WHO IS ABLE TO SHARE HER
THOUGHTS ABOUT HOW THIS YO YO
HAS AFFECTED HER.
SHE'S A SPANISH SPEAKING WOMAN
SEVENTY THREE AND LIVES IN
OAKLAND.
THIS IS HER DAUGHTER TRANSLATING
HER COMMENTS.
I CAN'T RELAX AND LOSE SLEEP
BECAUSE I DON'T KNOW IF I'M
GOING TO BE COVERED.
I GET WORRIED BECAUSE IT'S THE
MONEY I LIVE OFF OFIT EVEN
THOUGH MY SOCIAL SECURITY MIGHT
GO UP A LITTLE BIT MY BILLS KEEP
GOING UP TO AND THEY DON'T EVEN
LOOK AT THAT.
IT'S EXTRA FRUSTRATING BECAUSE
IT'S HARDER FOR ME TO UNDERSTAND
THE RULES AND COMMUNICATE WITH
MEDI CAL ABOUT HOW TO PROVIDE
PROOF THEY NEED.
I HAVE MEDICAL CONDITIONS
DIABETES AND HIGH BLOOD PRESSURE
AND I KNOW THE STRESS AFFECTS MY
HEALTH.
AND ALL THE STRESS ON THIS OLDER
ADULT IS SIMPLY BECAUSE OF A
COMPLICATED MEDI CAL RULE.
SO WHAT ARE THE IMPACTS OF NOT
PASSING THIS BILL WHAT HAS BEEN
HAPPENING CURRENTLY WELL PEOPLE
GET HIT WITH ON ON AFFORDABLE
SHERIFF COST.
THERE'S DISRUPTION TO THEIR
HEALTHCARE BOTH THEIR ONGOING
CARE AND THEIR LONG TERM
SERVICES AND SUPPORTS.
PEOPLE WILL LOSE COVERAGE WITHIN
THEIR MANAGED CARE PLAN FOR MEDI
CAL SO PEOPLE WILL BE DROPPED
OFF FOR THOSE MANAGED CARE PLANS.
BLESS YOU.
PEOPLE WILL HAVE TO START PAYING
THEIR PART B. PREMIUM AND THOSE
OFTEN COME OUT TWO TO THREE
MONTHS AT A TIME AND AN
UNEXPECTED MOMENT SO ALL OF A
SUDDEN SOMEONE WILL SEE THEIR
DEPOSIT.
AND IT WILL BE SEVERAL HUNDRED
DOLLARS LESS FOR THAT MONTH
OFTEN RISKING THEIR ABILITY TO
PAY FOR THEIR HOUSING AND OTHER
HEALTH CARE COST.
AND IT WILL CAUSE PEOPLE TO
RATION CARE AND THAT'S SIMPLY
BECAUSE PEOPLE WILL BOUNCE BACK
AND FORTH BETWEEN FREE AND
SHERIFF COST MEDI CAL.
HOWEVER THE EFFECTS OF PASSING
THIS BILL WILL BE TO ALLOW LOW
INCOME SENIORS TO KEEP THEIR
FREE MEDI CAL. TO INCREASE
ACCESS TO AFFORDABLE HEALTHCARE
FOR SENIORS AND PEOPLE WITH
DISABILITIES.
AND TO INCREASE THEIR FINANCIAL
STABILITY BECAUSE THEY WON'T BE
STRUGGLING BETWEEN PAYING AND
NOT PAYING THEIR MEDICARE PART
B. COST.
JUST AS AN AGING AND ALL THE CO
SPONSORS ASK FOR YOUR AYE VOTE.
THANK YOU.
THANK YOU VERY MUCH ANYONE ELSE
IN SUPPORT GEN FLORES WESTERN
CENTER ON LAW AND POVERTY JUST
HERE FOR TECHNICAL ASSISTANCE
AND A PROUD COSPONSORED.
THANK YOU VERY MUCH ANYONE
ELSE'S SUPPORT PLEASE NAME AN
ORGANIZATION PLEASE.
TEST CAM RANH WE HAVE TO BEHALF
TO HAVE ACCESS CALIFORNIA IN
SUPPORT.
CONNIE DELGADO ON BEHALF OF THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION THE
DISTRICT HOSPITAL LEADERSHIP
FORUM IN SUPPORT.
ANGELA WILLIAMS CALIFORNIA BLACK
OF MY WORK IN SUPPORT.
JOINT CAMPBELL ON BEHALF LA CARE
AND SUPPORT.
RESIDENTS ALSO ON BEHALF OF
NATIONAL ASSOCIATION OF SOCIAL
WORKERS IN SUPPORT.
REBECCA COUSINS ON BEHALF OF
HARPER IN SUPPORT.
TIM VALDERRAMA WITH THE WHITE A
GROUP ON BEHALF OF BLUE SHIELD
CALIFORNIA AND SUPPORT.
NATALIE COLOR ON BEHALF OF SAN
MATTEO LEGAL AID AND SUPPORT.
SHE HAD THREE ON BEHALF OF
CALIFORNIA STATE ASSOCIATION OF
COUNTIES IN SUPPORT.
KELLY BROKE SOME BEHALF OF THE
ASSOCIATION OF CALIFORNIA
HEALTHCARE DISTRICTS THAT
CALIFORNIA ASSOCIATION OF PUBLIC
HOSPITALS AND HEALTH SYSTEMS AND
THE COUNTY WELFARE DIRECTORS
ASSOCIATION HERE IN SUPPORT.
BARBARA GLAZER WITH THE
CALIFORNIA HOSPITAL ASSOCIATION
HERE TODAY IN SUPPORT.
MARK WINDOWS WITH US HERE YOU
CALIFORNIA AND SUPPORT.
PLEASE A COMMON CALIFORNIA LONG
TERM CARE OMBUDSMAN ASSOCIATION
IN SUPPORT.
MAKE IN OUR CALIFORNIA MEDICAL
ASSOCIATION IN SUPPORT.
DE VITO TRACE ANYTHING IN
SUPPORT.
SIR FLOCKS CALIFORNIA LABOR
FEDERATION IN SUPPORT.
THE DIVIDENDS ALL THE MAKERS
VISION GROUPS IN SUPPORT.
JEFF HANSON WITH LEADING EDGE
CALIFORNIA IN SUPPORT.
MICHELLE GIVEN TO THE COUNTY
HEALTH EXECUTIVES ASSOCIATION IN
SUPPORT.
LINDA DINNER WITH ON BEHALF OF
THE CALIFORNIA PAN ETHNIC HEALTH
NETWORK IN SUPPORT.
BREANNA PAYMENTS UNDER WITH THE
CALIFORNIA DENTAL ASSOCIATION IN
SUPPORT.
DEBORAH DISABILITY RIGHTS
CALIFORNIA PROUD SPONSOR AND
SUPPORT.
CALIFORNIA ASSOCIATION HEALTH
PLANS IN SUPPORT.
THANK YOU VERY MUCH ANYONE ELSE
IN SUPPORT.
SEE AN NINE ANY OPPOSITION.
CNN ANY QUESTIONS FROM THE
COMMITTEE.
SEE A NUN MISTER CHAIR WOULD YOU
LIKE TO CLOSE.
THANK YOU VERY MUCH THIS ONE
JUST COMES UNDER THAT CAN YOU
BELIEVE IT.
CATEGORY HONESTLY -- IN ITS
TOTALITY THAT THE BILLS I
PRESENTED HERE TODAY DON'T
REPRESENT A HUGE NUMBER THE
THIRTY NINE MILLION PEOPLE WHO
LIVE IN CALIFORNIA.
EVERYBODY REPRESENT A FAIRLY
SMALL NUMBER OF FOLKS THE MOST
VULNERABLE SENIORS WE HAVE.
WE DESERVED TO DO BETTER FOR A
BUYER SENIORS -- I RESPECTFULLY
ASK YOUR IPHONE THANK YOU THANK
YOU VERY MUCH AND TELL AND HE
KNOW THAT THIS MOTIONS TO DO
PASS AS AMENDED TO
APPROPRIATIONS MA'AM SECTOR
PLEASE CALL THE ROLL.
WHAT I WOULD AYE MAYES MAYES AYE
AGUIAR-CURRY?
AGUIAR-CURRY I TAKE A LOOK BONTA
BURKE.
BURKE I CARILLO.
I FLORA FLORA I LIVE ALONE.
LIMóN AYE MCCARTY [inaudible]
NAZARIAN.
RAMOS RODRIGUEZ SANTIAGO.
WALDRON.
WALDRON AYE.
THE BILL'S AUTHOR THANK YOU VERY
MUCH.
THANK YOU.
THANK YOU VERY MUCH -- AT THE
VOTE COUNT ON JUST AS A
CORRECTION HERE THE VOTE COUNT
ON EIGHTY SIX EIGHTY THREE WAS
NINE ZERO NOT TEN ZERO WAS
ANNOUNCED BUT WE'LL LEAVE THAT --
OPEN FOR OTHER MEMBERS TO ADD ON
TO SO WITH THAT WE'RE GOING TO
RETURN TO OUR REGULAR ORDER OF
BUSINESS -- THAT WOULD BE MOVING
TO ITEM NUMBER SEVEN AB FIVE OH
SIX MISTER KALRA
.
THANK YOU MISS SURE MEMBERS.
ASSEMBLY BILL FIVE OH SIX
UPDATES LONG TERM CARE FACILITY
CITATION COUNTIES IN ADVANCE.
FOR NOW THERE'S FOR NEGLIGENT
CARE. TO SAFEGUARD NURSING HOME
AND LONG TERM CARE FACILITY
RESIDENTS.
I WANT TO FIRST ACCEPT THE
COMMITTEE SUGGESTED AMENDMENTS
AS DESCRIBED IN THE ANALYSIS AND
ABOVE AND APPRECIATE THE THE
CHAIR AND THE COMMITTEE STAFF TO
WORKING WITH YOU TO ADDRESS.
ALL BUT ONE OF THE OPPOSITION
CONCERNS WITH THE BILL.
AS AMENDED THE BILL EFFECTUALLY
ITS RECENT STATE AUDIT
RECOMMENDATIONS TO INCREASE LONG
TERM CARE FACILITY CITATION
AMOUNTS WHICH HAVE NOT CHANGED
IN EIGHT YEARS FOR CLASS BE
CITATION.
AND NINETEEN YEARS FOR CLASS A.
AND DOUBLE A. CITATIONS.
IN THE AUTO RECOMMENDATIONS THAT
STATE CITATION COUNTY SHOULD BE
INCREASED ANNUALLY BY AT A
MINIMUM THE COST INFLATION.
MM INTRODUCED TO INCREASE TO
CLOSE REFLECT THE CONSUMER PRICE
INDEX AS REQUESTED BY THE
OPPOSITION.
I'M AGREEING TO MAKE THIS
INCREASE A ONE TIME -- INCREASE
BUT GRANT TO THE DEPARTMENT OF
PUBLIC HEALTH THE AUTHORITY TO
INDEX AMOUNTS BASED ON THE CPI.
ALSO AGREED TO MAKING THE
INCREASES THAT TO CITATION
PERSPECTIVE TO AFTER JANUARY
FIRST TWENTY TWENTY AND DELETING
LANGUAGE ALLOWING A SEPARATE
CITATION FOR A VIOLATION OF
PATIENTS RIGHTS.
AGAIN THESE A MEN'S ROOM FOR A
PROPOSED A BY THE OPPOSITION AND
ACCEPTED BY MYSELF AS WELL AS
AND CERTAINLY THE AB THE CHAIR
AND COMMITTEE STAFF.
LASTLY AS SUGGESTED BY THE
OPPOSITION THE COMEDIAN MEN'S
CREATE.
A CREATES A HIGHER PENALTY FOR
AN A CITATION THAT WAS REDUCED
TO FROM A DOUBLE A WHICH
RESULTED IN A RESIDENCE STAFF
THAT IS HALF THE AMOUNT OF A
CLASS OF DOUBLY CITATION.
THIS IS IMPORTANT BECAUSE
ACCORDING TO THE DEPARTMENT. TWO
HUNDRED NINETY SIX EE CITATIONS
WERE ISSUED AND CLOSE BETWEEN
200-022-00018. 74% REPEALED OF
THOSE 77% WERE REDUCE OR SIR A
PRETTY HIGH RATE.
WHERE RECRUIT CURRENTLY DIFFER --
WHERE I CURRENTLY DIFFER WITH
THE OPPOSITION IS OVER DIRECT
PROXIMATE CAUSE VERSES
SUBSTANTIAL FACTOR WHEN A PLAN
CLASS DOUBLY VIOLATION INVOLVING
THE DEATH OF A RESIDENT?
OVER TIME COURTS AND LEGAL
EXPERTS HAVE CONCLUDED THAT
DIRECT PROXIMATE CAUSE IS
CONFUSING.
AND SHOULD BE ELIMINATED AS THE
STANDARD FOR CAUSATION FOR JURY
INSTRUCTION.
CALIFORNIA HAS SINCE ADOPTED A
SUBSTANTIAL FACTOR DEFINITION IS
IN ITS JURY INSTRUCTIONS FOR
CAUSATION.
HOWEVER THE USE OF DIRECT
PROXIMATE CAUSE CONTINUES.
THIS IS A HINDER THE ABILITY THE
DEPARTMENT TO ASSIGN CLASS
DOUBLY BY LESIONS BECAUSE THE
PHRASE DIRECT PROXIMATE CAUSE
UNCLEAR AND RELAX RELIABLE LEGAL
PRECEDENT.
THE CHANGES PROPOSED UNDER AB
FIVE OR SIX IS CRITICALLY
IMPORTANT TO PROTECTING THE
HEALTH AND SAFETY OF RESIDENTS.
AND HOLDING ACCOUNTABLE THOSE
FOUND TO BE RESPONSIBLE FOR
RESIDENTS HARM OR DEATH.
WOULD BE TO PROVIDE SUPPORTING
TESTIMONY AS MARIA ABLE GARCIA
WHO LOST HER MOTHER DUE TO
NEGLIGENCE AND NURSING HOME CARE.
AND JIMMY FROM AGAIN FROM
DISABILITY RIGHTS CALIFORNIA.
PLEASE GOING TO SERVICE GOOD
AFTERNOON.
MY NAME IS MONEY I HAVE A GARCIA.
I STAND HERE TODAY NOT ONLY TO
TALK ABOUT AN AMAZING MEXICAN
WOMAN.
ME MAMA.
YEAH THE GUYS HERE.
BUT TO BE HER VOICE AND THE
VOICE FOR THOUSANDS OF DISABLED
RESIDENTS AND HUNDREDS WHO HAVE
LOST THEIR LIVES DUE TO LACK OF
PROPER CARE.
MY MOTHER WAS BORN IN MEXICO ON
APRIL TWENTY SIX NINETEEN THIRTY
SIX AND DIED ON SEPTEMBER FOURTH.
TWENTY SEVENTEEN SHE REPEATED TO
ME MANY TIMES NOT MAKE IT A
MOVIE.
I DON'T WANT TO DIE.
ON FEBRUARY TWENTY SEVENTEEN MY
BUDGET MY MOTHER SUFFERED A
MASSIVE STROKE THAT LEFT HER.
WITH BRAIN DAMAGE A WEEK LATER
THE DOCTOR CAME TO ME AND TOLD
ME.
YOUR MOTHER WOULD NOT RECOVER
MUCH MOVEMENT OF THE LEFT SIDE
OF HER BODY.
TERRIFIED.
MY RESPONSE WAS YOU MEAN SHE ONE
BE PARALYZED FOR THE REST OF HER
LIFE.
YES DR RESPONDED.
MY MOTHER WAS A STRONG
INDEPENDENT WOMAN WHO ALWAYS HAD
COFFEE READY WHICH SUGAR ADDED.
YOU COULD NOT SAY NO TO HER.
SCARED AND CONFUSED AFTER HER
MASSIVE STROKE SHE HAS SHE WAS
EXTREMELY DEVASTATED.
WORRIED SHE WOULD NO LONGER BE
ABLE TO BE THERE FOR HER
CHILDREN GRANDCHILDREN AND GREAT
GRANDCHILDREN.
SHE BECAME VERY DETERMINED TO
OVERCOME SHE REPEATED TO ME MANY
TIMES.
NO MAKE YET ON WHAT HE IS I DO
NOT WANT TO DIE.
IN MARCH OF TWENTY SEVENTEEN
AFTER LONG THOUGHT WE HER NINE
CHILDREN.
DECIDED TO ADMIT HER TO WHAT
WOULD SPRINGS HEALTH CARE
FACILITY.
A LONG TERM HEALTH CARE FACILITY
IN BY SALLY A WITH HOPES OF A
RECOVERY IN BRINGING HER HOME.
AFTER ADMITTING HER THE
CERTIFIED STAFF TOLD HER SHE
WOULD BE TAKEN CARE OF WITH THE
UTMOST RESPECT AND SHE WOULD
RECOVER FROM THIS.
AND GO ON TO LIVE MANY MORE
YEARS.
WEEKS PASSED AND WE CAME TO
UNDERSTAND THAT THE BRAIN DAMAGE
SHE HAD SUFFERED HAD VERY MUCH
DISABLED HER.
A STRONG PROUD WOMAN IN DIAPERS
AND IN A WHEELCHAIR.
ON AUGUST TWENTY NINTH TWENTY
SEVENTEEN A NURSE AT REDWOOD
SPRINGS ASSISTED MY MOTHER.
OUT OF HER WHEELCHAIR AND
LAUGHTER UNINTENDED.
ON A COMMODE CHAIR.
LEFT ALONE AND WITHOUT THE
ABILITY TO SUPPORT OR CONTROL
HER OWN BODY.
ME MY MOM FELL HEAD FIRST.
ONTO THE HARD TILE FLOOR.
WITHOUT ANYTHING TO BREAK HER
FALL.
SHE SUSTAINED MASSIVE HEAD
INJURIES.
RESULTING IN NUMEROUS STITCHES
AND GROSSING. SIX DAYS LATER.
THE WOMAN I'VE KNOWN ALL MY LIFE
TO BE A HARD WORKING LABOR.
DIED ON LABOR DAY.
TWENTY SEVENTEEN IT TOOK LARGE
AMOUNTS OF MAKE UP ON A
BEAUTIFUL WOMAN.
COULD NEVER WORE MAKEUP TO COVER
THE NINE STITCH WOUND AND MASS
OF BRUISES ON THE LEFT SIDE OF
HER FACE IN ORDER. TO GET MY
FAMILY AND I A CHANCE TO SAY
GOODBYE WITH AN OPEN CASKET
[inaudible]
SAD RIGHT.
TODAY YOU HAVE THE POWER.
THE POWER TO CHANGE THIS
CONFUSING LAW TODAY I AM BEGGING
YOU PLEASE VOTE YES.
I ON AB.
FIVE OH SIX ON BEHALF OF ME MAMA
IN THOUSANDS OF DISABLED
RESIDENTS WHO ARE AT RISK OF
HARM.
AT THE SALUTE IS THAT WOULD
RATHER PAY A FINE THEN PROVE THE
LAW.
LET'S CHANGE THIS LAW THAT HAS
CREATED CONFUSION FOR MANY YEARS.
AND MAKE A DIFFERENCE.
MY MOM DID NOT WANT TO DIE.
MY MOM DID NOT DESERVE TO DIE
THIS WAY.
HOW YOU STATUS STEVEN AND POOR
THEY HAVE THE KIND YET IS STUCK
ON **** ON TEXAS THE UPON WHICH
A SIGN YOU?
BUT FELIZ RAGEL CABLE THING SEE.
BUT I HAVE A SINGLE SET OF
CITIES CRISIS THANK YOU.
THANK YOU VERY MUCH.
GOOD AFTERNOON CHAIR MEMBERS MY
NAME IS JIMMY FROM YOU AND I'M
SENIOR LEGISLATIVE ADVOCATE FOR
DISABILITY RIGHTS CALIFORNIA.
ASSEMBLY BILL FIVE OH SIX
ESTABLISHES CONSISTENCY IN
CONFORMITY IN THE LAW BY
PROVIDING A MORE ACCURATE
UPDATED CAUSATION DEFINITION IN
DETERMINING IF ALONG IF A LONG
TERM HEALTH CARE FACILITY IS
RESPONSIBLE FOR RESIDENTS DEATH.
AND INCREASES THE PENALTY
AMOUNTS FOR FACILITY VIOLATIONS
BUILDING OFF RECOMMENDATIONS
FROM THE TWENTY EIGHTEEN STATE
AUDIT REPORT.
REQUESTED IN PART BY DOCTOR
WOULD.
OUR BILL ALLOWS DPH TO FULFILL
ITS MISSION OF PROPERLY IMPOSING
CITATIONS FOR TO US AND WE'LL
KEEP RESIDENTS SAFE.
ALDERSON FACILITIES ACCOUNTABLE
AND IT ACCURATELY INFORM THE
PUBLIC ABOUT QUALITY OF CARE.
AS YOU HEARD FROM MARIA THE
EXISTING STANDARDS FOR CITATION
ARE NOT SUFFICIENT TO PREVENT
NEGLIGENCE AND SOME FACILITIES.
OUR BILL DOES NOT REQUIRE THAT
THE SUBSTANTIAL FACTOR MUST BE
TIED TO A VIOLATION OF FACILITY
POLICY AND CAUSES OF DEATH.
INSTEAD INCLUDE SITUATIONS WHERE
FACILITY CONDUCT WAS SO
NEGLIGENT THAT A REASONABLE
PERSON WOULD CONSIDER IT LIKELY
TO RESULT IN DEATH.
IN ONE INSTANCE A RESIDENT WAS
VENTILATOR DEPENDENT.
REQUIRING IT TO BRIEF AND WHEN A
RESPIRATORY THERAPIST THREAT --
TURNED OFF THE VENTILATOR CLEAN
IT.
THEY FORGOT TO TURN IT BACK ON
IN THE INDIVIDUAL PASSED AWAY.
THE JUDGE ENDED UP DISMISSING
THE CLASS DOUBLE A VIOLATION
AGAINST THE FACILITY BECAUSE HE
FOUND THAT THE NURSING FACILITY
DID NOT HAVE A POLICY OR
PROCEDURE.
REQUIRING A VENTILATOR TO BE
TURNED BACK ON THE JUDGE SAID HE
COULDN'T FIND A VIOLATION AND
THEREFORE COULD NOT A PULL THE
CLASS DOUBLE A CITATION.
WOULD YOU TELL MANY MORE CASES
JUST LIKE THIS IN OUR TWENTY
SEVENTEEN INVESTIGATION KEEP
NURSING HOME RESIDENTS SAFE.
RESIDENTS AND THEIR FAMILIES BUT
TREMENDOUS TRUST IN NURSING
HOMES AND IT IS ESSENTIAL TO
HONOR THAT BY COMMITTING TO A
SYSTEM THAT EFFECTIVELY
REGULATES NURSING HOMES.
AND PROTECTS RESIDENTS.
DISABILITY RIGHTS CALIFORNIA
ALSO AGREES WITH THE CALIFORNIA
ASSOCIATION OF HEALTH FACILITIES
AND THE CALIFORNIA HOSPITAL
ASSOCIATION IN PART OF THEIR
OPPOSITION LETTER.
AND THAT WE DO NOT CONDONE BAD
ACTORS OR IMPROPER CARE EITHER.
THAT IS WHY THIS BILL WOULD ONLY
IMPACT FACILITIES THAT FAILED TO
LIVE UP TO THEIR PROMISE OF
EXEMPLARY CARE.
ADDITIONALLY IF THE FACILITY IS
NOT FEEL IT HAS BEEN A PROPERLY
CITED.
THERE IS AN APPEAL PROCESS THAT
ALLOWS FOR COVERAGE OF LEGAL
EXPENSES.
FINALLY THERE IS ALSO NO
EVIDENCE THIS BILL WOULD RESULT
IN THE CLOSURE OF NURSING HOMES
AND RURAL COMMUNITIES OR
ELSEWHERE.
IF SUCH A FACILITY WERE CLOSE IT
WOULD ONLY AFFECT THOSE WHO DID
NOT FOLLOW THE LAW AND THE
STANDARDS OF PATIENT CARE.
WE WORK CLOSELY WITH THE AUTHOR
AND COMMITTEE STAFF TO
ACCOMMODATE MANY OF THE CONCERNS
THAT ARE COVERED IN THE
OPPOSITION LETTER.
WHILE STILL MAINTAINING OUR CORE
MISSION OF PROTECTING RESIDENTS.
WE THANK MISTER KALRA FOR
BRINGING THIS IMPORTANT PIECE
LEGISLATION FORWARD. TO SERVE
NURSING HOME RESIDENTS AND OUR
STATE AND REQUEST YOUR AYE VOTE.
THANK.
THANK YOU VERY MUCH OTHERS IN
SUPPORT.
THE COMMON WITH THE CALIFORNIA
LONG TERM CARE OMBUDSMAN
ASSOCIATION IN STRONG SUPPORT.
MARY HYATT FROM CALIFORNIA CIVIL
LIBERTIES ADVOCACY AND AT HOME
KERR AID AND A CERTIFIED NURSING
ASSISTANT I SUPPORT THIS BILL
[inaudible]
EACH.
SO ANYONE IN OPPOSITION
.
GOOD AFTERNOON JENNIFER SNYDER
ON THE BEHALF OF THE CALIFORNIA
ASSOCIATION OF HEALTH FACILITIES
I WANT TO FIRST THANK AYE THE
COMMITTEE AND THE STAFF FOR THE
ATTENTION TO THIS BILL WE
GREATLY APPRECIATED.
AND AND THE AUTHOR IN THE
COMMITTEE BOTH -- TAKING
AMENDMENTS THAT WE THINK ARE
FAIR AND REASONABLE -- WE
DEFINITELY BELIEVE THAT -- IT IS
MAKES SENSE TO ROUTE TO RAISE
THE PENALTIES THEY HAVE NOT BEEN
RAISED IN A PERIOD OF TIME AND
AND WE DO.
BELIEVE THAT FACILITIES SHOULD
BE HELD RESPONSIBLE WHEN THERE
IS WRONGDOING -- AND SO ARE VERY
SUPPORTIVE OF THOSE ELEMENTS THE
BILL I'M ARE REMAINING CONCERNS
DO REVOLVE AROUND ON THAT.
THE PORTION OF THE BILL THAT
WOULD ALLOW A I GUESS CHANGE THE
ABILITY FOR THE DEPARTMENT.
I HAD TO ARE.
THE CAUSATION FACTOR FOR THE
DEPARTMENT TO MOVE A AND OF
FACILITY A DOUBLE A CITATION FOR
A FACILITY FROM PROXIMATE CAUSE
TO SUBSTANTIAL FACTOR.
AND WE HAVE A STRONG CONCERNS
ABOUT HOW THAT WILL IMPACT OUR
NURSING FACILITIES AND THEIR
ABILITY TO REMAIN OPEN AND ALSO
WITH THEIR ABILITY -- TO HAVE
PATIENT ACCESS -- I HAVE MARK
REAGAN WITH ME -- WHO IS LEGAL
COUNSEL FOR THE CALIFORNIA
ASSOCIATION HEALTH FACILITIES
AND HE CAN BETTER EXPLAIN ARE
CONCERNED SPECIFIC TO THAT BUT
I'D LIKE TO POINT OUT TO
IMPORTANT OVERALL -- THINGS
BEFORE WE BEFORE HEADED OVER TO
MARK REAGAN OF FIRST IS THAT --
THE DISABILITY RIGHTS REPORTS
THAT THEY MENTIONED THAT WAS THE
INSTIGATOR FOR THIS BILL -- HAS
A NUMBER OF ELEMENTS IN IT WHICH
WE THINK -- ARE VERY IMPORTANT
WE AGREE WITH -- THEY TALK ABOUT
TRANSPARENCY THEY TALK ABOUT --
THE DEPARTMENT BEING MORE
CONSISTENT IN THEIR APPLICATION
THE DEPARTMENT OF PUBLIC HEALTH
THE MORE CONSISTENT IN THEIR
APPLICATION A MORE TIMELY IN
THEIR APPLICATION.
OF THE USE OF THEIR ENFORCEMENT --
THERE IS NOTHING IN THAT REPORT
THAT EVEN MENTIONS THE
DIFFERENCE OR THE NEED TO CHANGE --
THE STANDARD BY WHICH THE
DEPARTMENT DETERMINES A DOUBLE A
CITATION -- IT MORE TALKS ABOUT
HOW WE NEED TO WORK WITH THE
DEPARTMENT FOR THEM I TO DO A
BETTER JOB -- IT'S ALSO
IMPORTANT FOR US TO REMEMBER
THAT THE ENFORCEMENT SYSTEM IS
MEANT TO BE REMEDIAL IT'S
SUPPOSED TO WORK WITH FACILITIES
TO MAKE SURE THAT THEY PROVIDE
BETTER CARE QUALITY CARE --
TIMELINESS IS IMPORTANT MANY
CITATIONS ARE NOT ISSUED FOR AT
LEAST A YEAR IF NOT FOUR TO SIX
YEARS BY THAT POINT IN TIME.
THE FACILITY HAS MOVED ON FROM
THAT EVENT -- AND WE'RE NOT
WE'RE NOT PUTTING OUR FACILITIES
IN A SITUATION WHERE THEY CAN
CORRECT AND WORK WITH THE
DEPARTMENT.
A TO MAKE SURE THAT THEY DO A
BETTER JOB AND LASTLY I THINK
IT'S ALSO IMPORTANT TO REMEMBER
THAT WEIRD WE HAVE A VERY
FRAGILE LONG TERM CARE SYSTEM.
IN CALIFORNIA -- MOST OF OUR
FACILITIES NURSING FACILITIES
RELY PRETTY HEAVILY ON MEDI CAL
FUNDING -- UPWARDS OF 65% FOR
SKILLED NURSING FACILITIES ARE
INTERMEDIATE CARE FACILITIES FOR
THE DEVELOPMENTALLY DISABLED
RELY A 100% ON MEDI CAL FUNDING.
AND WE HAVE A THOUSAND
INDIVIDUALS IN CALIFORNIA
ATTORNEY SIXTY FIVE EVERY YEAR --
WE HAVE MORE CUTE PATIENTS IN
OUR FACILITIES AND WE REALLY
NEED TO MAKE SURE THAT WHEN WE
DETERMINE POLICIES LIKE THIS
THAT WILL -- IN INCREASE
INCREDIBLY ENHANCE THE ABILITY
FOR OUR STATE DEPARTMENT TO
ISSUE EE CITATIONS WHICH COULD
PUT FACILITIES AT RISK OF
CLOSURE WE SHOULD MAKE SURE THAT
WE ARE LOOKING AT THAT ISSUE
VERY CLOSELY SO.
LIKE TO HAND IT OVER TO MARK
REAGAN TO MAKE A FEW MORE
COMMENTS THANK YOU THANK YOU.
THANK YOU.
I'VE BEEN PRACTICING IN THIS
AREA I'VE BEEN PRACTICING LAW
FOR OVER TWENTY FIVE YEARS AS
JENNIFER SAID I'VE BEEN
REPRESENTING THE STATE
ASSOCIATION.
THE OF THE ISSUE WE'RE TALKING
ABOUT A STRUCTURAL AND I WASN'T
INVOLVED I'VE TRIED MANY OF
THESE CASES I WASN'T INVOLVED IN
THE VENTILATOR CASE THAT THERE
WAS JUST SOME DISCUSSION ABOUT
BUT HEARING THE REPORT.
I DON'T THINK THAT THAT WAS A
FAILURE OF STRUCTURE BUT A
FAILURE BY THE TRIAL JUDGE. TO
DO THE RIGHT THING -- AND I
THINK IT'S IMPORTANT STAY THAT
SAY THAT RIGHT OUT FRONT.
WHAT'S IMPORTANT TO UNDERSTAND
ABOUT THE CHANGE THAT'S BEING
PROPOSED.
IS THAT THE NOTION OF PROXIMATE
CAUSE WHICH IS REALLY THE
UNDERLYING STANDARD THAT WE'RE
DISCUSSING IT STYLED AS DIRECT
PROXIMATE CAUSE WHAT RIGHT THAT
REALLY MEANS IS WHETHER THE
UNDERLYING INCIDENT.
WAS THE DIRECT CAUSE OF THE
RESIDENTS DEATH.
IS A LONG STANDING LEGAL
PRINCIPLE THAT IN NINETEEN
NINETY ONE AS WAS CORRECTLY
STATED.
THERE WAS A STATE SUPREME COURT
DECISION SAYING.
JURY INSTRUCTIONS ON THE FIRST
PRONG OF THAT TEST.
NEED TO BE CLEARER FOR JURIES.
BUT THERE'S TWO PARTS TO A
PROXIMATE CAUSE ANALYSIS HERE'S
THE PROBLEM THAT DEALS WITH
WHETHER OR NOT.
THE UNDERLYING CAUSE WAS A
SUBSTANTIAL FACTOR AND THEN
BEYOND THAT WHETHER OR NOT THAT
BECAUSE WAS FORESEEABLE.
WERE PRODUCED THE UNDERLYING
DEATH AT ISSUE.
IN NINETEEN NINETY NINE THERE
WAS A SUBSEQUENT CALIFORNIA
SUPREME COURT DECISION BY THE
NAME OF PPG INDUSTRIES VERSUS
TRANSAMERICA THAT REAFFIRM THE
PROXIMATE CAUSE IS THE TEST.
AND IN THE CITATION SYSTEM THAT
WE'RE TALKING ABOUT THERE ARE NO
INJURIES.
THESE ARE JUDGE TRIALS THEY'VE
ALWAYS BEEN JUDGE TRIALS AND
JUDGES CAN UNDERSTAND OR SHOULD
UNDERSTAND.
DESPITE THE LAST EXAMPLE WHAT
PROXIMATE CAUSES ABOUT.
IT'S ALSO TRUE THAT THE WAY THAT
THE REST OF THE CITATION SYSTEM
IS STRUCTURED.
HAS BURDENS THAT IF THIS
AMENDMENT WOULD BE A DROP DEAD
WOULD TRULY UNDERMINE THE WAY IN
WHICH THESE CASES GET TRIED AND
LET ME TRY TO EXPLAIN. ONE OF
THE PREREQUISITES FOR THIS LEVEL
OF CITATION A DOUBLE A CITATION.
IS THAT THERE BE A VIOLATION OF
THE REGULATIONS THAT RISES TO A
PARTICULAR LEVEL WHERE THERE IS
AN IMMINENT DANGER OR A
SUBSTANTIAL PROBABILITY OF DEATH
OR SERIOUS HARM.
WHEN YOU THINK ABOUT WHAT PROOF
THAT WOULD REQUIRE FIRST IT'S
IMPORTANT TO THINK ABOUT THE
NOTION THAT? TO PROVE THAT YOU
EVEN CAN PROCEED WITH A DOUBLE A
CITATION THAT YOU HAVE TO PROVE
VERY IMMINENT.
DANGER OF DEATH AND SO IF YOU
PROVE AN IMMINENT DANGER OF
DEATH.
BUT THEN YOU ONLY HAVE TO PROVE
THAT THAT THAT THAT BECAUSE WAS
HE A SUBSTANTIAL FACTOR.
YOU'VE NOT REALLY TAKEN ACTION
THAT'S CONSISTENT WITH THE
SYSTEM.
IT'S REALLY IMPORTANT TO
UNDERSTAND HERE THAT THE MOST
IMPORTANT CHARACTERISTIC TO MAKE
THE SYSTEM FAIR FOR ALL FOR BOTH
CONSUMERS AND BOTH FACILITY
OPERATORS.
IS THAT BOTH PROBLEMS OF
PROXIMATE CAUSE BE RETAINED.
THANK YOU.
WHO'S IN OPPOSITION.
CHAIR MEMBERS CHAD HAMPTON
ABUSING THE IS CALIFORNIA HERE
AT RADICALLY IN OPPOSITION TO
THE BILL I WANT TO THANK THE
CHAIR AND THE STAFF.
AND THE SPONSORS AND THE AUTHOR
STAFFER FOR WORKING ON ON THE
MINUTES TO THE BILL -- WE WOULD
REAFFIRM OUR CONCERNS -- WITH
THOSE MADE PREVIOUSLY BY THE
CALIFORNIA ASSOCIATION HEALTH
FACILITIES REGARDING TRUCK
PARKED ACOSTA.
BARBARA GLAZER ON BEHALF OF THE
CALIFORNIA HOSPITAL ASSOCIATION
WE TO HAVE AN OPPOSE UNLESS
AMENDED OUR CONCERNS ARE THE
SAME AS THE CALIFORNIA
ASSOCIATION OF HEALTH FACILITIES.
WE VERY MUCH APPRECIATE THE
AMENDMENTS PROPOSED BY THE
COMMITTEE AND LOOK FORWARD TO
CONTINUING WORKING ON THIS BILL.
Q..
TERM MEMBERS CUT THE MUSTARD
WITH THE DEVELOPMENT OF SERVICES
NECK NETWORK ECHO THE COMMENTS
OF MY COLLEAGUES AND APPRECIATE
THE WORK ON THE MINUTES.
THANK YOU.
A MUCH.
ANYONE ELSE IN OPPOSITION.
RING BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS MISTER
ROBERTS.
THANK YOU MISTER CHAIR AND AND
THE TO THE AUTHOR THANK YOU FOR
BRINGING THIS -- ISSUE TO THE
FOREFRONT.
HOWEVER WE WOULD CONTINUE TO
ENCOURAGE A DIALOGUE WITH
INDUSTRY IS FOR SOME OF THE
FINES AND THE ISSUES THAT HAVE
COME UP AND LOOKING FORWARD TO
THAT DIALOGUE AND KEEP ME
UPDATED ON THAT BUT I WILL
SUPPORT THIS BILL TODAY.
THANK YOU CENTER AND TO THE
CHARGE ON THAT POINT I I WOULD
DO WANT TO THANK THE OPPOSITION
AND WE'VE BEEN REALLY GOING TO
BE MAD.
EITHER BY MYSELF MY STAFF BUT
THE DEPARTMENT WITH THE
OPPOSITION.
NUMEROUS NUMEROUS NUMEROUS TIMES
SO THERE'S NO LACK OF DESIRE TO
TRY TO FIND A A COMMON GROUND
SOMETIMES THERE ARE THERE ARE
DIFFERENCES OF OPINION THAT
OCCUR.
I THINK THE A MAN'S INDICATE
THAT -- THERE'S A CLEAR DESIRE
THERE AND EVEN LAST YEAR -- EVEN
THOUGH THE DEPARTMENT OF WAS
SUPPORTIVE OF OF THIS CHANGE.
WE KEPT WE WE HELD A BILL IN THE
SENATE -- OUT OF RESPECT FOR THE
OPPOSITION TO GIVE US MORE TIME
TO TRY TO WORK ON AS MUCH AS WE
POSSIBLY COULD.
AND REINTRODUCE THE BILL THIS
YEAR INSTEAD OF PUSHING FOR LAST
YEAR HE PUT A GUN TO THE
GOVERNOR'S DESK WITH IT AND ALL
I COULD HAVE BEEN SIGNED -- BUT
WE RESPECTED THE OPPOSITION
ENOUGH TO MAKE SURE THAT WE GAVE
EVERY OPPORTUNITY TO FIND COMMON
GROUND.
WITH SO YOUR CURRENT AND MISTER
BOND.
I THANK YOU SOMEONE MEMBER KALRA
FOR WORKING ON THIS ISSUE YOU'VE
DONE IT FOR A COUPLE YEARS NOW --
THE SONORA DEVELOPMENTAL CENTER
CLOSURE MY DISTRICT REALLY
OPENED MY EYES TO THE CHALLENGES
THAT FACE MANY OF OUR PATIENTS
AND THE FACILITIES SPACE.
I APPRECIATE YOUR DEDICATION ON
THIS -- PROTECT THE HEALTH AND
SAFETY OF OUR OFTEN FRAGILE
RESIDENTS IN NURSING HOMES AND
LONG TERM CARE FACILITIES.
I WANT TO ACKNOWLEDGE ALL THE
MANY AMENDMENTS THAT YOU'VE
TAKEN SO FAR THAT YOU'VE AGREED
TO TAKE.
AND I THINK THIS STRENGTHENED
THE BILL SO FAR -- I CAN TELL
YOU THAT I CAN TELL YOU WORKING
REALLY HARD TO STAKEHOLDERS I
HOPE YOU'LL CONTINUE TO DO THAT
I THINK YOU CAN GET TO COMMON
GROUND I WOULD HOPE THAT THAT
WOULD HAPPEN -- ALL SUPPORT YOUR
BILL TODAY AND WE'LL SEE HOW WE
MOVES FORWARD SO THANK YOU VERY
MUCH FOR BRING IT FORTH THANK
YOU.
MR BONTA.
THANK YOU MISTER CHAIR.
THANK YOU FOR YOUR PRESENTATION --
THANK YOU FOR BRINGING THIS
ISSUE FOR MISTER KALRA I JUST
WANT TO ASK A COUPLE QUESTIONS
ABOUT THE THIS IS THE CHANGE IN
THE STANDARD COMPONENT OF THE
BILL OF NOT NOT NOT THE FINDS
PEACE BUT THE THE CHANGE IN THE
STANDARD.
IN YOUR VIEW IS THE SUBSTANTIAL
FACTOR STANDARD.
A LOWER STANDARD.
THAN THE DIRECT PROXIMATE CAUSE
STANDARD OR IS IN A A CLEARER
STANDARD OR IT OR HOW WOULD YOU
DESCRIBE IT.
AT THAT OUR STANDARD.
AND CERTAINLY MORE CLEAR DOES
PROVIDE MORE CLARITY -- BUT
CERTAINLY AND THAT'S PART OF THE
REASON WHY THE DEPARTMENT --
PREFERS IT AND AND IN SUPPORT OF
THIS CHANGE BECAUSE OF IT
PROVIDES GREATER CLARITY FOR
THEM AS WELL AND SO -- IT'S IT'S
ALSO.
A MORE COMMON PLACE USE STANDARD
AND BUT ONE THAT WILL CREATE
SOME CONSISTENCY WITH HOW THE
DEPARTMENT.
OF THE IN TERMS OF THE STANDARD
THE DEPARTMENT USES AS WELL AS
THE COURTS DEPARTMENTS RULINGS
APPEALED IT GOES THE COURTS%
USING THE SAME STANDARDS
CRITICAL IN THAT SENSE.
OKAY.
AND WHAT DO YOU MAKE OF THE
ARGUMENT MADE BY THE OPPOSITION
THAT THE SUBSTANTIAL FACTOR TEST
IS THAT IS MEANT TO BE A TWO
PART TEST.
AND THIS TAKES -- JUST THE FIRST
PART OF A TWO PART TEST IT.
ANY ANY REFLECTION MORE TALK ANA
WHAT WILL LET'S KEEP IN MIND
THAT THERE IS A THERE IS A WIDE
DISCRETION WITH THE DEPARTMENT
OF PUBLIC HEALTH AND I THINK
THAT.
pSTANDARD.
NARROWS THEIR DISCRETION IN
TERMS OF REALLY BE ABLE TO TAKE
INTO ACCOUNT ALL THE FACTS OF AN
INDIVIDUAL CASE AND THAT'S WHY
THERE'S SO MANY CASES THAT ARE
SUCCESSFUL APPEALS 77%.
ARE SAYS ONE APPEAL BECAUSE
THAT'S A VERY NARROW STANDARD
THIS IS DENTAL FACTOR STANDARD
IS A MORE COMMONLY USED AND
BECAUSE IT DOES ALLOW YOU TO
HAVE.
A GREATER ABILITY AND IN THIS
CASE FOR THE DEPARTMENT TO BE
ABLE TO HAVE MORE FLEXIBILITY IN
DETERMINING WHETHER A PARTICULAR
SET OF CIRCUMSTANCES FALLS INTO
THAT CATEGORY OR NOT.
AND AND AS SUGGESTED BY THE
OPPOSITION BY INCREASING THE
FINES AND FEES -- THE THE FINES
FOR THE THE CLASS A LEVEL IT
ALSO GIVES -- SOME SORT OF SELF
OF OF ASSURANCE SOME ASSURANCES
FROM THE DEPARTMENT THAT THEY DO
DROP IT DOWN AT THE PENALTIES
NOT SOON BE AS A KIND OF A SLAP
ON THE WRIST THAT IS ACTUALLY
COULD BE A MORE.
SUBSTANTIVE COUNTY SO I THINK
COMBINING BOTH USING A
SUBSTANTIAL FACTOR AND
INCREASING THE PENALTIES FOR
CLASS A. IN THESE TYPES OF CASES
REALLY PROVIDES KIND OF THE
TOOLS.
NECESSARY FOR THE DEPARTMENT --
TO BUT HAVE THE THE FEE OR THE
PENALTY FIT THE INCIDENT AT HAND
[inaudible]
MAC [inaudible]
I'M.
IF I UNDERSTAND THE MAGIC
ADDRESSES GONZALEZ CASE OUT
CORRECTLY THAT WAS ABOUT JURY
INSTRUCTIONS.
AND AND MAKING IT CLEAR FOR A
JURY YOU KNOW A POOL OF IN A
CROSS SECTION OF OUR COMMUNITY.
TO MAKE SURE THAT THE
INSTRUCTIONS CLEAR TO THEM
[inaudible]
BUT THE THE DETERMINAR THE FINAL
FACTOR THAT THAT THE THE PERSON
MAKES DECISIONS AND AND THE CASE
IS AT HAND IS IT OUR JUDGE.
RIGHT SO [inaudible]
IS IS.
IS IT LESS NECESSARY TO HAVE THE
YEAH THAT IS THE RATIONALE
BEHIND MITCHELL VERSUS GONZALEZ.
NOT AS PERSUASIVE IF WERE
TALKING ABOUT A JUDGE.
WHO UNDERSTANDS THE NUANCES
BETWEEN DIFFERENT STANDARDS
PROBABLY BETTER THAN A LAY
PERSON WITHOUT LEGAL TRAINING --
AND AND THEN MAKE IT LESS
NECESSARY TO HAVE A A
SUBSTANTIAL FACTOR TEST BECAUSE
IT SEEMS LIKE THAT THE WHOLE
RATIONALE BEHIND MITCHELL VERSES
GONZALEZ WAS CLARITY FOR
LAYPEOPLE WHEN RECEIVING A JURY
INSTRUCTION.
I DON'T I THINK IN EITHER CASE
ESSENTIAL FACTORS MORE
APPROPRIATE STANDARD IT ALLOWS.
IN EITHER CASE YOU KNOW THE
JUDGE AND THE JUDGE IS THE
ARBITER IN THAT CASE THEY'RE
GONNA BE ABLE TO APPLY IT IN A
WAY THAT MAKES SENSE BUT THE
DEPARTMENT WOULD LIKE.
IS TO HAVE A SIMILAR STANDARD
BECAUSE SUBSTANTIAL FACTOR FOR
THEM MAKES MORE SENSE AND IT'S
CONSISTENT WITH -- THE CASE LAW
AS WELL SO IT'S IT'S A KIND OF A
BOTH OF THE CONSISTENCY ARGUMENT
AS WELL AS A STAND THAT MAKES
MORE SENSE FOR THEM AND THAT'S
WHY THEY SUPPORT IT.
AND AND I THE WAY A JUDGE AGAIN
UP EVEN -- EVEN IF WHETHER IT'S
A COURT TRIAL OR A JURY TRIAL I
THE WAY THE STANDARD SHOULD BE
CLEAR AND CONSISTENT.
THANK YOU MISTER CARR THAT SUPER
HELPFUL AND ANSWERED ONE FINAL
QUESTION BECAUSE I KNOW THERE'S
BEEN SOME REFERENCE TO THE AUDIT.
AND I BELIEVE THE AUDIT MADE
SOME RECOMMENDATIONS THAT ARE
BEYOND WHAT YOUR BILL
CONTEMPLATES A THERE IS A REASON
THAT YOU DIDN'T THINK THAT THOSE.
ISSUES IN THE AUDIT WERE WORTH
PURSUING MAYBE YOU KNOW I KNOW
OF ONE BILL CAN DO EVERYTHING
BUT I JUST WANT TO ASK.
I'LL BUT MAYBE SOMEONE ELSE TO
PURSUE THEM WHAT DID YOU THINK
THAT THEY WEREN'T APPROPRIATE.
THIS IT IT'S INTERESTING BECAUSE
THIS ISSUE IS ONE THAT I WAS
WORKING ON WHEN THE AUDIT CAME
OUT -- KIND OF MID STREAM AND SO --
I CATERED THE BILL -- AND AND
DIRECTED THE BILL WORKING WITH
THE DEPARTMENT IN THE DIRECTION
OF THE AUDIT BASED UPON WHAT I
WAS ALREADY WORKING ON SO --
RATHER THAN ADDING EXTRA STUFF
TO IT WHICH I THINK IS NOT ONLY
INEFFICIENT BUT ALSO -- YOU KNOW
IT COULD BE CONSIDERED -- I I
THINK -- WEALTH IS NOT I I DON'T
THAT'S THE BEST WAY TO APPROACH
BILLS IS THAT NOT A COMES OUT
KIND OF MISTREATMENT US TO STORE
THE KITCHEN SINK IN THERE.
THERE ARE A LOT OF REALLY WERE
THE RECOMMENDATIONS THAT OUT
THAT IN THAT AUDIT I KNOW THAT
IT'S SOMETHING THAT THE CHAIR
AND MANY OTHERS ARE VERY
INTERESTED IN BECAUSE THEY CARE
ABOUT THE ISSUE OF WHAT'S
HAPPENING.
IN THE FACILITIES -- AND A MANY
THE AUTOMATIC RECOMMENDATIONS
THE OUR OUR OPPOSITION ALSO --
AND HAS TAKEN TO HEART AND IS
WORKING WITH THE DEPARTMENT AS
WELL SO IT'S NOT A SITUATION
WHERE WE HAVE ALL THESE
RECOMMENDATIONS AND ASSIST TO
TEN BILLS AND AND I THINK A LOT
OF THAT CAN BE DONE.
BUT THE DEPARTMENT WORKING
DIRECTLY WITH -- BUT THE
INDUSTRY ITSELF AND FOR THOSE
THAT CANNOT THAT I'M SURE
THEY'LL BE SUBSEQUENT LETS
LEGISLATION THAT WOULD.
NOT NESTLE FROM ME BUT THANK YOU
MISTER KALRA THANK YOU MISTER
CHAIR COURSE.
ANY OTHER QUESTIONS.
SEE NONE WILL BRING IT BACK TO
YOU FOR CLOSE MISTER BECAUSE OF
THIS SHOW ON ONCE AGAIN THANK
YOU -- AND YOUR STAFF FOR THE
INCREDIBLE WORK YOU'VE DONE I
SOUND LIKE A BROKEN RECORD SOME
I COME HERE BUT REALLY THE THE
IF YOU'RE COMMITTEE STOP AS ON A
TREMENDOUS JOB.
OF THESE ARE VERY CHALLENGING
ISSUES -- THIS.
THIS HAS BEEN A BILL THAT WE'VE
BEEN WORKING ON OF HOPE.
FOR FOR MANY MONTHS EIGHT GOING
INTO A YEARS NOW AND I THINK IT
IS SOMETHING THAT'LL BE REALLY
HELPFUL FOR THE DEPARTMENT AND
ULTIMATELY.
THE SAFETY OF OTHER PATIENTS SO
THANK YOU SO MUCH OF THAT
RESPECT THE ASPEN I BONE.
BUT ONE THANK YOU FOR BRING THIS
FORWARD AND OBVIOUSLY BEEN
WORKING ON THIS FOR A WHILE --
THIS DOES ENJOY -- DO PASS
RECOMMENDATION HELLO I I I WILL
SAY I AM SENSITIVE AND CONCERNED.
THIS IS A VERY FRAGILE NETWORK
AS WAS POINT HAS BEEN POINTED
OUT BY THE OPPOSITION -- AND IN
MY OWN DISTRICT I FACE THE
CLOSURE OF THREE OF THE FIVE
NURSING HOMES -- IN TWO THOUSAND
AND SIXTEEN I BELIEVE -- AND
FORGE FORTUNATE WAS ONLY -- ONE
BUT THE FRAGILITY OF THIS
NETWORK IS OF GREAT CONCERN.
AS IS THE SAFETY TO THE
RESIDENTS AND SO AS WE BALANCE
THESE THINGS -- THESE ARE THESE
ARE DIFFICULT ISSUES SO I
APPRECIATE THAT YOU WILL
CONTINUE TO WORK WITH THE
OPPOSITION AS YOU AS YOU HAVE --
AND I THANK YOU FOR THAT AND
WITH THAT I THINK ARE WITNESSES
TO AND I'M SORRY FOR YOUR LOSS
AND I THINK YOU FOR COMING FOR
WITH YOUR STORY -- THAT THAT'S
AT THIS POINT OF LIKE -- WE HAVE
A MOTION.
BUT WE DON'T HAVE A SECOND HERE
US I'M SORRY SECOND BY MUSLIM ON
A MOTION BY MISS CARILLO SECOND
BY MISS THE MON THE MOTION IS DO
PASS AS AMENDED TO
APPROPRIATIONS AND YOU'VE
ACCEPTED THE AMENDMENT SO --
MADAM SECRETARY PLEASE CALL THE
ROLL WHAT HI WHEN I MAYES NO
MAYES NO AGUIAR-CURRY
[inaudible]
BIGELOW.
BONTA.
BONTA AYE BURKE [inaudible]
CARILLO.
CARILLO I FLORA.
LIMON.
LEVINE AYE MCCARTY.
NAZARIAN FROM US.
ALSO I RODRIGUEZ SANTIAGO
WALDRON.
WALDRON NOT VOTING.
YOUR FIVE VOTES -- YOU MAY NEED
THREE A THREE MORE TO GET OUT WE
HAVE MANY MEMBERS MISSING I WILL
LEAVE THE ROLE -- BUT WAS IT
WILL BE THE BILL A CALL EXCUSE
ME SO THANK YOU VERY MUCH
[inaudible]
THANK YOU.
EXCEPT MISTER BRO.
ZEBRA WILL BE PRESENTING AB.
SIX FIFTEEN AS CHAIR OF THE SURF.
INCREASED PENALTIES FOR PATIENT
BROKERING IN TWENTY SIXTEEN OVER
NINETEEN HUNDRED CALIFORNIANS
DIED DUE TO OPIOIDS.
TRUCKING OPIATE OVERDOSE IS ARE
CURRENTLY IN THE TOP TWENTY
CAUSES OF DEATH IN CALIFORNIA.
TO BROKERS SEE THE EPIDEMIC AS
AN OPPORTUNITY TO TAKE ADVANTAGE
OF A VULNERABLE POPULATION.
OF PATIENT BROKEN KERR'S REHAB
CENTERS PAY PATIENTS TO STAY IN
THE FACILITIES REPAIR THIRD
PARTY FOR BRING PATIENTS THEIR
ESTABLISHMENT.
LAST YEAR THE LEGISLATURE
OUTLAWED THIS PRACTICE REQUIRE
THE DEPARTMENT HEALTH CARE
SERVICES TO INVESTIGATE
ALLEGATIONS ASSESSED PENALTIES
OR SUSPEND OR REVOKE A LICENSE.
THE LACK OF THE FIND PENALTIES
WILL NOT DETER PATIENT PROGRAM
STATES LIKE FLORIDA MAKE IT A
FENNEL TEA AND FINES UP TO FIFTY
THOUSAND DOLLARS -- WE HAVE MORE
THAN TWO THOUSAND LICENSED
FACILITIES AND MANY MORE ON
REGULATE HOMES IN OUR STATE 15%
OF THOSE FACILITIES ARE LOCATED
IN MY HOME COUNTY OF ORANGE --
WITH ME TODAY -- TO TEST FIND
SUPPORT IS THE CAL WORTMAN --
SCRUBS IN THE COUNTY OF ORANGE.
NICOLE ORNAMENT ON BEHALF OF THE
ORANGE COUNTY BOARD OF
SUPERVISORS AND SUPPORT.
AS ASSEMBLY MEMBER PEROT
MENTIONED THERE ARE 15% OF THESE
FACILITIES IN ORANGE COUNTY AND
INCREASINGLY THEY ARE
VICTIMIZING PEOPLE IN THEIR MOST
VULNERABLE STATES -- THE ORANGE
COUNTY BOARD OF SUPERVISORS
FIRMLY BELIEVES THAT INCREASING
THE PENALTIES FOR THIS CRIME.
WOULD.
WOULD MOVE US MORE TOWARD.
THE IT'S THE DECREASE AND
PATIENT BROKERING.
I ENCOURAGE AND I'VE VOTE THANK
YOU.
THANK YOU VERY MUCH OTHERS IN
SUPPORT.
SHARE MEMBERS TOM RENT FREE WITH
THE COUNTY BE ABLE HEALTH
DIRECTORS ASSOCIATION OF
CALIFORNIA IN SUPPORT THANK YOU
VERY MUCH.
ANYONE ELSE'S SUPPORT.
SIR ANYONE IN OPPOSITION.
SEEN KNOWN BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS FROM THE
COMMITTEE.
SEEING NONE WOULD LIKE TO CLOSE
MISTER BROOKS -- JUST RECYCLER
SHADOW THANKS FOR TIME.
THANK YOU VERY MUCH FOR BRING
THE BILL FORTY DOES ENJOY A DO
PASS RECOMMENDATION -- IS IT
WOULD BE TO PASS TO PUBLIC
SAFETY WE HAVE A MOTION BY
MISTER MAYES.
A SECOND BY MISS WALDRON AMOUNTS
SECTOR PLEASE CALL THE ROLL.
WHAT I WOULD AYE MAYES AYE MAYES
AYE AGUIAR-CURRY [inaudible]
BIGELOW.
BONTA AYE BONTA AYE BURKE.
CARILLO.
CARILLO I'D FLORA [inaudible]
MON.
I MCCARTY.
NAZARIAN.
RAMOS RAMOS I RODRIGUEZ.
SANTIAGO WALDRON.
WALDRON AYE.
SECOND.
GIVE SEVEN VOTES YOU NEED ONE
MORE WILL LEAVE THE BOOK BILL ON
CALL TECHNICIAN.
THANKS ROB.
WE DON'T HAVE OTHER OFFICERS
PRESENT.
RISK CARILLO WOULD YOU LIKE TO
PRESENT YOUR OTHER BILL.
IN A COUPLE OF THEM BUDGET GO
AHEAD. TO GET SIXTEEN TWENTY TWO
AND SEVENTEEN EIGHTY YOUR YOUR
SIXTEEN TWENTY TO BE GREAT.
WHAT IS SIXTEEN TWENTY TWO
PERFECT THANK YOU ARE THE CHAIRS
REQUEST? SIXTEEN TWENTY TWO COME
ON THE CALLING SIXTEEN TWENTY
TWO OKAY.
YOU CHOOSE IF YOU HAVE A PRETTY
YOU GET TO SEE CAN [inaudible]
TWENTY NOT SURE THEY'RE HERE.
SO REMEMBER SECURE 2% SEVENTEEN
EIGHTY TWO X. THAT'S A BILL THAT
WOULD EXPAND HEALTHCARE ACCESS
PROVIDED BY NONPROFIT LONG TERM
ACUTE CARE FACILITIES -- THIS
BILL IS NECESSARY TO CONFORM
CALIFORNIA STATUTE TO FEDERAL
STANDARDS.
THAT ALLOW LONG TERM ACUTE CARE
FACILITIES TO OPERATE SATELLITE
FACILITIES UP TO THIRTY FIVE
MILES AWAY FROM THE MAIN MEDICL
CENTER THERE BY ALLOWING. FOR
THE EXPANDED HEALTHCARE AXIS
LONG TERM ACUTE CARE HOSPITALS
SIR PATIENTS WITH COMPLEX
MEDICAL NEEDS WHO REQUIRE LONG
HOSPITAL STAYS.
HI AND HIGHLY SPECIALIZED
CLINICAL CARE BARLOW RESPIRATORY
HOSPITAL IT'S A LONG TERM ACUTE
CARE HOSPITAL LOCATED IN MY
DISTRICT BY DODGER STADIUM
[inaudible]
FIGHTS INTERDISCIPLINARY MEDICAL
ATTENTION TO HELP PATIENTS
RECOVER AS QUICKLY AS POSSIBLE
SO THEY CAN RETURN TO A LOWER
LEVEL OF CARE OR RETURN TO THE
COMFORT OF THEIR OWN HOME --
BARLOW HOSPITAL IS THE ONLY NON
PROFIT LONG LONG TERM CARE
HOSPITAL IN THE ENTIRE STATE OF
CALIFORNIA.
AND PROVIDES AFFORDABLE MEDICAL
SERVICES TO A BROAD COMMUNITY OF
INDIVIDUALS WHO SUFFER FROM
SERIOUS CONDITIONS THAT REQUIRE
EXTENDED.
MEDICAL CARE DESPITE IT BEING --
IN LOS ANGELES PEOPLE FROM ALL
ACROSS THE STATE TRAVEL TO BAR
Là HOSPITAL TO RECEIVE CARE
OFTENTIMES STUCK IN.
LOVE TRAFFIC YOU KNOW COMING
FROM LONG LONG DISTANCES TO
RECEIVE CARE -- MOST IMPORTANTLY --
WE ARE THE PURPOSE OF THIS BILL
IS TO MAKE SURE THAT OF THE
STATE IS UP TO DATE WITH FEDERAL
FEDERAL REGULATIONS AND HERE
WITH ME TO TO HELP ADD ANY
ADDITIONAL COMMENTARY.
IS A MISTER KEEP DONE REPRESENTS
THE HOSPITAL.
THANK YOU MISTER CHAIRMAN KEEP
DONE HERE FOR BARLOW HOSPITAL.
THIS CRYSTAL VERY WELL I WOULD
JUST ASK FOR YOUR SUPPORT IF YOU
HAVE ANY QUESTIONS I'M HAPPY TO
ANSWER THEM.
THANK YOU VERY MUCH.
OTHER SUPPORT.
AND MARK IN THOSE WITH SEIU
CALIFORNIA IN STRONG SUPPORT --
AGAIN.
AS WE ARTICULATED IN OUR LETTER
THIS IS A VERY NARROW EXCEPTION
AND WE ARE SUPPORTIVE OF THAT
THANK YOU THANK YOU VERY MUCH.
ANYONE ELSE'S SUPPORT IS THERE
ANYONE IN OPPOSITION.
SONORA BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS.
SEEING NONE THE BILL DOES ENJOY
DO PASS RECOMMENDATION -- WHICH
I TO CLOSE JUST THINKING THERE'S
A CLASS FROM A VOTE THANK YOU
VERY MUCH.
SO WE HAVE A MOTION -- BY THE
MISTER MAYES A SECOND BY MISS
WELCOME TO MOTIONS TO PASS TO
APPROPRIATIONS.
MA'AM SECTOR PLEASE CALL THE
ROLL WHAT.
WOULD I MAYES MAYES AYE
AGUIAR-CURRY [inaudible]
BIGELOW [inaudible]
BONTA.
BURKE.
CARILLO.
I GREW AYE FLORA [inaudible]
MON.
LIMóN I MCCARTY [inaudible]
THIS AREA.
RAMOS.
RAMOS I'D RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO.
WALDRON.
WALDRON AYE.
SO YEAH SEVEN WHAT WILL BE THE
BILL ON CALL THANK YOU VERY MUCH.
FOR SERVICE MEMBERS THE OTHER.
ONE WE WOULD LIKE TO HELP YEAH
WE CAN DO IT I THINK YEAH.
I THINK MY FOLKS ARE HERE.
LOOKS LIKE -- YOU'RE GONNA
TESTIFY AND THE OTHER.
ONE TWO ALL RIGHT OKAY.
I AM PRESENTING -- AMAZING
ASSEMBLY BILL -- SIXTEEN TWENTY
TWO WHICH SEEKS TO PROTECT
PATIENT ACCESS AND BETTER
UTILIZE CALIFORNIA'S POSITION
NETWORK BY AMENDING STATUTORY
LANGUAGE TO MORE ACCURATELY
REFLECT THE TRAINING AND
EXPERTISE.
OF OUR FAMILY PHYSICIANS
SPECIFICALLY THIS BILL WILL
CORRECT SEVERAL CODE SECTIONS
THAT THE ABOUT THE IMPORTANT AND
EXPERIENCE VOICE OF FAMILY
POSITIONS ON MATTERS SUCH AS THE
STANDARD DEVELOPMENT OF
REPRODUCTIVE HEALTH IN MID LEVEL
PROVIDER EDUCATION SEXUAL HEALTH
EDUCATION PROGRAMS.
PEDIATRIC EXAMINATIONS FAMILY
MEDICINE POSITIONS RECEIVE
SPECIALIZED TRAINING A
PREVENTATIVE AND FAMILY CARE FOR
PEOPLE FROM BIRTH TO END OF LIFE.
WE WANT TO MAKE SURE THAT THESE
HIGHLY SPECIALIZED DOCTORS HAVE
AN OPPORTUNITY TO BE ABLE TO
CARE FOR THE HEALTH OF THE
FAMILY FROM THE TIME THAT
THEY'RE BORN.
UNTIL THEIR LATER YEARS I HERE
WITH ME TO HELP TESTIFY AND
PROVIDE ADDITIONAL -- SUPPORT IS
RYAN SPENCER WITH THE CALIFORNIA
ACADEMY OF FAMILY PHYSICIANS.
SPENCER.
RIGHT SPENCER WITH THE COMPANY
CAN MEET THEM STATIONS THEY ARE
THE SPONSORS OF THE BILL NOT
JUST SIMPLY LIKED ECHO THIS
WOMANS COMMENTS AND ASK FOR YOUR
SUPPORT THANK YOU.
THANK YOU VERY MUCH OTHERS IN
SUPPORT.
SEEING NONE IS THERE ANYONE IN
OPPOSITION.
WE HAVE A TWEENER OKAY.
THANK YOU MISTER CHAIR MEMBERS
MERE MORTON HERE ON BEHALF OF
THE CALIFORNIA CHILDREN'S
HOSPITAL ASSOCIATION WE HAVE NO
FORMAL POSITION I DID WANT TO
THANK THE AUTHOR.
OF FOR AMENDING THE BILL TO
REMOVE THE LANGUAGE RELATED CCS --
WE ARE LOOKING FORWARD TO
WORKING WITH HER AND WITH THE
FAMILY PHYSICIANS TO SEE IF WE
CAN RESOLVE THEIR CONCERNS AND
MAINTAIN THAT STRICT STANDARDS
FOR THE CCS PROGRAM SO WE LOOK
FORWARD TO WORKING WITH YOU
THANK YOU.
THANK YOU VERY MUCH.
GOOD AFTERNOON KATIE LATE NOT BE
HALF OF THE CHILDREN SPECIALTY
CARE COALITION REPRESENTING
PEDIATRIC SUBSPECIALTY
PHYSICIANS THROUGHOUT THE STATE --
ALSO NEUTRAL ON THE BILL AND
WOULD LIKE TO THINK THE AUTHOR
AND SPONSOR FOR REMOVING THE CCS
PROVISIONS AND DEFINITELY --
LOOK FORWARD TO CONTINUE
DIALOGUE [inaudible]
ANYONE ELSE.
SEE EVER WITNESSES.
IN C. C. TECHNICAL SUPPORT OR IN
SUPPORT WERE IN OPPOSITION THIS
SAYS THAT DOCTOR JUST MAINTAINS
WHO CAN SPEAK ON THE IMPORTANCE
OF THIS BILL IF NECESSARY.
ANY OTHER OPPOSITION.
ANY OTHER TWEETERS.
CASEY NONE WILL BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS [inaudible]
SEEING NONE.
THE CHU I CLOSE SURE THANK YOU.
THANK YOU MISTER CHAIR AND
MEMBERS I'D LIKE TO ALSO THANK
THE COMMITTEE STAFFER WORKING
WITH MY OFFICE ON THIS BILL AND
MAKING SURE THAT IT MOVES
FORWARD.
AB SIXTEEN TWENTY TWO WILL
REMEDY A PROBLEM BY FIXING AND
CONSISTS INCONSISTENCIES IN THE
LAW TO MORE ACCURATELY REFLECT
THE TRAINING AND EXPERTISE OF
FAMILY PHYSICIANS AND IMPROVE
PATIENT CARE.
RESPECTFULLY ASK FOR AN AYE VOTE.
THANK YOU SO YOU CAN YOU
ACCEPTED THE AMENDMENTS YES WE
ARE ACCEPTING THE AMOUNT THANK
YOU SO MUCH AND THANK YOU FOR
BRINGING BILL FOR IT DOESN'T
ENJOY DO PASS RECOMMENDATION --
MADAM SECRETARY -- THE DO PASSED
THE RECOMMENDATIONS TO PASS AS
AMENDED TO BUSINESS AND
PROFESSIONS.
I'M I'M SECRETARY PLEASE CALL
THE ROLL WHAT I WOULD AYE MAYES
MAYES AYE AGUIAR-CURRY
[inaudible]
BIGELOW [inaudible]
BONTA.
BURKE CARILLO HI CARILLO AYE
FLORA.
LIMON.
LEVINE AYE MCCARTY NAZARIAN
RAMOS.
RAMOS I RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO.
WALDRON WALDRON AYE.
YES SEVENTY NEED ONE MORE IT
SEEMS TO BE A POPULAR NUMBER
TODAY.
I LEAVE THE BILL ON CALL THANK
YOU VERY MUCH MISS KOREA MR
BLOOM.
WE HAVE S. EIGHT A. B..
SEVEN EIGHTY FIVE GOOD AFTERNOON
MISTER CHAIR MEMBERS AB SEVEN
EIGHTY FIVE UPDATES THE HEALTH
AND SAFETY BECAUSE THAT REGULATE
GAMETE BANKS GIMME BANKS ARE
TISSUE BANKS THE COLLECT PROCESS
OR STORE SPERM -- CIDER EXCELS
AND EMBRYOS THESE FACILITIES
ALSO PROVIDE PROFESSIONAL
REPRODUCTIVE SERVICES FOR PEOPLE
WISHING TO CREATE A FAMILY LAST
YEAR I AUTHORED AB TWENTY SIX
EIGHTY FOUR TO UPDATE THE
UNIFORM PARENTAGE ACT.
AND MAKE IT GENDER NEUTRAL AS
PART OF THE UPDATE WE CHANGE
CODES THAT REGULATE THE GAMETE
BANKS AN UPDATE CURRENT LAWS TO
PROVIDE FAMILIES WITH IMPORTANT
DONOR MEDICAL HISTORY.
THIS BILL IS A FOLLOW AT THIS
BILL THIS YEAR AS A FOLLOW UP TO
THOSE UPDATES AND TIES UP A FEW
LOOSE SOUNDS FROM LAST YEAR.
AB SEVENTY FIVE WILL BETTER
STREAMLINED THE TRANSFER OF
IMPORTANT DONOR MEDICAL HISTORY
INFORMATION FROM ONE BANK TO
ANOTHER AND THE LEGISLATION ALSO
ALIGNS THE EXISTING STATE CODES
TO HARMONIZE WITH THE FDA'S
REGULATIONS. FOR DONOR IDENTITY
REQUIREMENTS AND TISSUE
TRANSFERS.
AB SEVEN EIGHTY FIVE REQUIRES
BANKS THAT RECEIVED OWNER
GAMBITS TO MAINTAIN THE CONTACT
INFORMATION OF THE BANK FROM
WHICH THE SAMPLES WERE RECEIVED.
AND THE ORIGINATING BACK WILL
MAINTAIN MORE DETAIL DONOR
INFORMATION THIS IS TO ENSURE
THAT THE TRANSFER OF DAMAGE FROM
ONE BANK TO ANOTHER.
WILL NOT AFFECT THE FAMILY'S
ABILITY TO HAVE ACCESS TO PROPER
DONOR MEDICAL INFORMATION.
ADDITIONALLY THE LEGISLATION
UPDATES THE DEFINITION OF GAME
MEATS TO INCLUDE BOTH -- SITES
AND EMBRYOS TO BETTER ALIGN
STATE LAWS WITH FEDERAL LAW.
AND ULTIMATELY THESE UPDATES ARE
IMPORTANT IN COMPLYING WITH FDA
REGULATIONS. TO THE LEGISLATION
CONTINUES OUR EFFORTS TO BETTER
REGULATE GAMETE BANKS AND
PROVIDE ALL FAMILIES AND
CHILDREN CONCEIVED FROM DONOR
TISSUE.
WITH THE NECESSARY INFORMATION
TO MAKE INFORMED HEALTH
DECISIONS IN THE FUTURE. TO
SPEAK MORE IN THE TECHNICAL
CHANGES IN THE NEED FOR THE BILL
IF OF REPRESENTATIVES FROM THE
QUALITY CALIFORNIA.
AND THE AMERICAN SOCIETY FOR
REPRODUCTIVE MEDICINE.
THANK YOU MISTER CHAIR MEMBERS
ALICE KESSLER HERE ON BEHALF OF
A QUALITY CALIFORNIA WERE A CO
SPONSOR OF THE BILL.
OF MR BLOOM COVERED IT VERY WELL
THIS IS REALLY A TECHNICAL CLEAN
UP BILL -- BUT IT IS IMPORTANT
THAT WE CONTINUE TO HAVE
CALIFORNIA LAW A LINE WITH THE
UNIFORMED PARA DID.
UP AND MAKE THESE FIXES SO WE
CAN ENSURE THAT -- CHILDREN
CONCEIVED THROUGH A DONOR HAVE
ACCESS TO A VERY IMPORTANT
MEDICAL HISTORY -- SO WE WOULD --
DRIVE OUT.
THIS IS MY COLLEAGUES AT ALL
HERE REPRESENTING THE AMERICAN
SOCIETY FOR REPRODUCTIVE
MEDICINE GOOD AFTERNOON CHAIR
AND MEMBERS.
I'M I'M GONNA SENSUALLY ECHO
WHAT HAS ALREADY BEEN SAID AB
SEVENTY FIVE IS A TECHNICAL
CLEAN UP OF LAST YEAR'S BILL AB.
TWENTY SIX EIGHTY FOUR RELATIVE
TO GAMMA DONOR IDENTITY
INFORMATION FOR ASSISTED
REPRODUCTIVE TECHNOLOGIES -- THE
LET UNDERLYING BILL LAST YEAR
WAS AN ENORMOUS UNDERTAKING --
ESSENTIALLY MAKING THE UNIFORM
FRANTIC PERCENTAGE ACT GENDER
NEUTRAL HOWEVER SINCE SIGNING OF
THE BILL FEEDBACK FROM GAMETE
BEINGS WAS THAT THERE WERE
AB TWENTY SIX EIGHTY FOUR AND
THE FDA REQUIREMENTS SPECIFIC TO
DONOR DONOR IDENTITY FOR GAMBITS
OF DONORS.
I KNOWN TO THE PARTIES
ATTEMPTING TO ACHIEVE A
PREGNANCY.
SO THE CHANGES IN AB SEVEN
EIGHTY FIVE SHOULD BETTER
SYNCHRONIZE WITH FEDERAL READ
REQUIREMENTS RESPECTFULLY ASK
FOR YOUR AYE VOTE THANK YOU.
THANK YOU VERY MUCH -- OTHERS IN
SUPPORT.
IS THERE ANYONE IN OPPOSITION
[inaudible]
THE BILL.
SEE NO -- ONE BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS.
QUESTIONS OR COMMENTS.
SEEING NONE WE HAVE A MOTION AND
SECOND THAT ENJOYS A DO PASS
RECOMMENDATION MISTER BLOOM
WHICH I TO CLOSE I VERY
RESPECTFULLY ASK.
THANK YOU VERY MUCH MADAM
SECRETARY THE THE THE THE MOTION
IS TO PASS TO JUDICIARY MOTION
BY MISTER MAYES THE SECOND BY
MISTER RAMOS -- PLEASE CALL THE
ROLL.
WHAT I WOULD AYE MAYES MAYES I
HANG AGUIAR-CURRY?
BIGELOW BONTA BURKE.
CARILLO.
CARILLO AYE FLORA.
FLORA AYE LIMóN [inaudible]
I MCCARTY.
NAZARIAN.
BROTHERS.
RAMOS I RODRIGUEZ.
I REQUEST I SANTIAGO.
WALDRON WALDRON AYE.
YOU HAVE A BOAT YOUR BILL IS OUT
WILL LEAVE THAT WILL LEAVE THE
ROLL UP AND FOR OTHERS TO ADD ON
THANK YOU VERY MUCH CERVANTES.
CERVANTES YOU HAVE AB.
SEVEN NINETY EIGHT I HAVE A
MOTION A SECOND [inaudible]
EVERYTHING.
ASSEMBLY BILL SEVENTY NINE EIGHT
TODAY I WANT TO BEGIN BY
ACCEPTING THE COMMITTEE IT
SUGGESTED AMENDMENTS AS OUTLINED
IN PAGE FOUR OF THE ANALYSIS AND
WANT TO THANK THE STAFF FOR
THEIR SUPPORT.
AND ASSISTANCE ON THIS BILL WE
OFTEN CELEBRATE THE BIRTH OF
CHILDREN BUT THROUGH EACH
EXPERIENCE ALSO EMERGES THE
REBIRTH OF A WOMAN.
WHOSE STORY IS OFTEN FORGOTTEN.
MATERNAL MENTAL HEALTH DISORDERS
OF THE MOST COMMON COMPLICATIONS
OF PREGNANCY AND THE RISK
FACTORS ASSOCIATED WITH MATERNAL
MENTAL HEALTH STIGMA PERSIST.
DEPRESSION AND ANXIETY CAN
INCREASE A WOMAN'S FEELING OF
ISOLATION CONFUSION AND
AVOIDANCE WOMEN WHO EXPERIENCE
MATERNAL MENTAL HEALTH DISORDER
MAY NOT ASK FOR HELP AN
ADDITIONAL BURDEN SUCH AS A LACK
OF TRANSPORTATION OR POVERTY.
CAN CONTRIBUTE TO POOR DETECTION
AND TREATMENT RATES.
ACCORDING TO THE DEPARTMENT OF
HEALTH ONE IN FIVE CALIFORNIA
WOMEN WHO RECENTLY GAVE BIRTH
EXPERIENCE SYMPTOMS OF
DEPRESSION.
DURING OR AFTER PREGNANCY.
THIS MEANS THAT APPROXIMATELY
ONE HUNDRED THOUSAND WOMEN IN
CALIFORNIA EXPERIENCE THIS EVERY
SINGLE YEAR. ONE MAJOR OBSTACLE
TO ADDRESSING THIS CRISIS IS A
LOCK A MENTAL HEALTH CARE
PROVIDERS FOR INSTANCE THERE IS
ONLY ONE IDENTIFIED REPRODUCTIVE
PSYCHIATRISTS AND RIVERSIDE AND
VERY FEW COUNSELING AND SUPPORT
SERVICES FOR WOMEN.
IN THE DISTRICT THAT I REPRESENT
THIS IS VERY TRUE STATEWIDE.
THERE IS A MINIMAL SERVICES
AVAILABLE IN MANY RURAL AREAS OF
OUR STATE TO SUPPORT WOMEN
SUFFERING FROM POST PARTUM
MENTAL HEALTH DISORDERS.
THE ONGOING SHORTAGE OF MENTAL
HEALTH SPECIALISTS INCLUDE
INCLUDING PSYCHIATRISTS MAKE IT
DIFFICULT FOR WOMEN TO ACCESS
MENTAL HEALTH SERVICES LIKE
CANCER COUNSELING.
IN RIVERSIDE COUNTY RATES OF
PRENATAL DEPRESSIVE SYMPTOMS AND
POST PARTUM DEPRESSIVE SYMPTOMS
ARE BOTH HIGHER THAN THE STATE
AVERAGE.
AB SEVEN NINE EIGHT WILL CREATE
A PILOT PROGRAM BASED ON A MODEL
USED IN MASSACHUSETTS TO PROVIDE
PSYCHIATRY TELE CONSULTATION AND
VIRTUAL MENTORING SERVICES.
THIS PILOT PROGRAM WILL OPERATE
IN SEVERAL COUNTIES INCLUDING
RIVERSIDE TO INCREASE THE
CAPACITY OF HEALTH PROVIDER
SERVING PREGNANT AND POSTPARTUM
WOMEN WOMEN UP TO ONE YEAR AFTER
DELIVERY.
AB SEVEN NINE A WILL HELP MAKE
IMPORTANT PROGRESS TOWARD
ENSURING THAT WOMEN WITH
MATERNAL MENTAL HEALTH DISORDERS
CAN RECEIVE THE TREATMENT THAT
THEY RECEIVE THE TREATMENT THAT
THEY NEED AND DESERVE.
POST PARTUM SUPPORT DURING THIS
CRITICAL TRANSITION SETS THE
STAGE OF A WOMEN'S WELL BEING
FOR MANY YEARS TO COME WE MUST
NOT ALLOW WOMEN AND THEIR
FAMILIES TO CONTINUE SUFFERING
IN SILENCE.
WITH ME TO TESTIFY IN SUPPORT IS
EVA SWARTS.
HI MY NAME'S EVA SCHWARTZ -- I
AM A MOTHER WHO SUFFERED FROM
POSTPARTUM PSYCHOSIS IT'S KIND
OF POST PARTUM DEPRESSION ON
STEROIDS -- I THE MENTAL HEALTH
SERVICES AND MEDICATION SAVE MY
LIFE.
AND MY RELATIONSHIPS WITH MY
HUSBAND AND MY SON.
I WAS WHO I WAS DIAGNOSED WITH
POST PARTUM PSYCHOSIS NGUYEN --
MY SON WAS TEN DAYS OLD I WAS UP.
I WAS ADMITTED TO A MENTAL
HOSPITAL WHEN HE WAS TEN DAYS
OLD.
I SPENT A MONTH IN THE MENTAL
HOSPITAL -- I DON'T ACTUALLY
REMEMBER A LOT OF THE DETAILS
BECAUSE OF THE PSYCHOSIS -- MY
HUSBAND HAS TO TELL ME A LOT OF
WHAT HAPPENED.
BUT I AM ONE OF THE LUCKY.
I AM REALLY I AM ONE OF THE
LUCKY ONES.
THE PEOPLE.
IN THE MENTAL HOSPITAL I MAY I
MET PEOPLE WHO DID NOT GET
MEDICAL CARE.
MOST OF THEM TURNED TO DRUGS
INCLUDING HEROIN AND
METHAMPHETAMINES.
WITHOUT EASY ACCESS TO MEDICAL
CARE AND GOOD DOCTORS I WOULD
HAVE LOST MY FAMILY AND MY MIND.
POST PARTUM PSYCHOSIS IS
TREATABLE WITH PROFESSIONAL HELP.
AND THIS IS WHY ANY YEAH THIS
WHY WOMEN SUFFERING FROM ANY
FORM OF POST PARTUM INTO IT.
HEALTH DISORDERS MUST BE QUICKLY
ASSESSED AND TREATED AND
CAREFULLY MONITORED BY TRAINED.
HEALTHCARE PERINATAL MENTAL
HEALTH PROFESSIONALS. FOR THESE
REASONS AB SEVEN AND NINETY
EIGHT IS PART IS AT ABSOLUTELY
CRITICAL FIRED YOUR YES VOTE ON
AB SEVEN NINETY EIGHT THANK YOU.
THANK YOU VERY MUCH.
ANYONE OKAY I'M SORRY OKAY
ANYONE ELSE'S SUPPORT. TO NUMBER
BRING IT BACK UP SORRY ANYONE IN
OPPOSITION EXCUSE ME.
YOU KNOW BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS OR COMMENTS
FROM THE COMMITTEE.
CNN THE BILL DOES ENJOY DO PASS
RECOMMENDATION RESTAURANT IS TO
WHICH LIKE TO CLOSE I
RESPECTFULLY ASK FOR AYE VOTE
THANK YOU VERY MUCH -- YOU HAVE
ACCEPTED THE A A MAINTENANCE ON
THE MOTION WE HAVE A MOTION BY
MISTER RAMOS IN THE SECOND BY
MISS WALDRON.
THE MOTION IS TO PASS AS AMENDED
TO APPROPRIATIONS I'M SECRETARY
PLEASE CALL THE ROLL WHAT I
WOULD AYE MAYES AYE MAYES AYE
AYE GEAR CURRY.
BIGELOW [inaudible]
BONTA [inaudible]
BURKE [inaudible]
CARILLO.
I FLORA FLOOR AYE LIMóN.
LIMóN I AM THE CARTY.
NAZARIAN PROBLEMS.
RAMOS I RODRIGUEZ RODRIGUEZ AYE
SANTIAGO [inaudible]
WALDRON [inaudible]
MODERN I YOUR BILL IS EIGHT
VOTES -- WILL LEAVE THE ROLLOVER
BROTHERS ADAM I THINK YOU TO
THINK YES -- FOR COMING AND
SHARING YOUR STORY THANK YOU
VERY MUCH THANK YOU [inaudible]
MR GIPSON.
MR GIPSON YOU HAVE AB
[inaudible]
EIGHT TEN AS OUR GOOD AFTERNOON
MISTER SPEAKER MEMBERS.
THANK YOU FOR ALLOWING ME TO
PRESENT ASSEMBLY BILL EIGHT TEN
WHICH SEEKS TO CONVENE A WORK
GROUP TO EVALUATE WAYS TO
PROVIDE ORGAN -- TRANSPLANT TO
CALIFORNIA RESIDENTS WHO ARE
UNDOCUMENTED OR UNINSURED.
DONATE FOR LIFE CALIFORNIA IS A
STATE WIDE -- STATEWIDE
ORGANIZATION NONPROFIT
ORGANIZATION RESPONSIBLE FOR
MANAGING ORGAN AYE AYES TISSUE
DONORS REGISTRY.
THIS PARTNERSHIP WITH THE DMV
STREAMLINES THE PROCESS OF
INDIVIDUALS TO BECOME AN ORGAN
DONOR WHILE APPLYING FOR OR
REVIEWING THEIR DROUGHT GETTING
THEIR DRIVE LICENSE RENEWED.
IN TWO THOUSAND AND THIRTEEN AB
SIXTY PASS THIS BY THE
LEGISLATURE.
ALLOWING CALIFORNIA RESIDENTS
WHO ARE UNDOCUMENTED TO LEGALLY
OBTAIN A DRIVING LICENSE AND
ALSO OPT IN TO BECOMING AN ORGAN
DONOR.
SINCE THEN WITH OVER ONE MILLION
REGISTRANTS DRESSER DRIVERS
THROUGH AB SIXTY DONE DOCUMENT
COMMUNITY HAS CONTRIBUTE. TO BE
THE INCREASE IN THE NUMBER OF
AVAILABLE ORGANS WE HAVE TODAY.
HOWEVER.
AS A GROUP THEY ARE STILL -- I'M
NOT SIGNIFICANT -- TO RECEIVE --
DON'T -- ORGANS -- DUE TO AB.
SIXTY IF THE INDIVIDUAL CANNOT
AFFORD THIS LIFESAVING A
PROCEDURE OR OUR OF OUTPATIENT
CARE THEY WILL NOT RECEIVE.
A PARTICULAR ORGAN IF THE
INDIVIDUAL CANNOT AFFORD THIS
LIFESAVING PROCEDURE OR
OUTPATIENT CARE THEY WILL NOT
RECEIVE BE ABLE TO RECEIVE AND A
DONATION. TO HAVE AN ORGAN
ESPECIALLY IF THEY NEED IT MY
HOPE IS THROUGH THIS BILL WE CAN
BRING TOGETHER A DIVERSE WORKING
GROUP.
OF EXPERTS AND KEY STAKEHOLDERS
TO FIND A SOLUTION TO THIS
PROBLEM BY TWENTY TWENTY ONE
WITH ME TO PROVIDE SUPPORTING
TESTIMONIES A REPRESENTATIVE
FROM CHIRLA AND ALSO
REPRESENTATIVE ON BEHALF OF THE
DONATE FOR LIFE CALIFORNIA WHO
IS STILL PRODUCE.
THANK YOU GOOD AFTERNOON MY NAME
IS JOSEPH THE GENERAL DIRECTOR
POLICY ADVOCACY WHICH CHIRLA THE
COALITION FOR HUMANE IMMIGRANT
RIGHTS.
I'M HERE IN STRONG SUPPORTER A.
B. -- EIGHT EIGHT ONE ZERO
IMMIGRANTS ARE ONLY CONTRIBUTE
TO OUR ECONOMY THAT ALSO NOT
GOING TO BE IN AS AS BEING PART
OF IT ON YOUR SYSTEM -- BE ABLE
TO ONE ENTER INTO THAT SYSTEM
WHEN THEY GO AND APPLY FOR A
DRIVER LICENSE AND YET AS A SOME
NUMBER GIPSON OUTLINING THERE'S
KIDS RESTRICTIONS THAT THE NOT
ALLOWED THEM TO ACTUALLY ALSO BE
PART.
OF THE POOL OF INDIVIDUALS THAT
ACTUALLY HAVE ACCESS TO THAT DUE
TO IN OUR ORGAN IF THEY NEED.
TO DO TO KERN MISTER JUST IN
REGARDS TO ACCESS TO HEALTHCARE --
BUT ALSO FINANCIAL -- ISSUES
ABBAS SOME HOSPITALS ARE ABLE TO
PROVIDE SOME SORT OF A
ASSISTANCE FOR DAM HOWEVER DOES
OUR INDIVIDUAL BASIS AND IS THAT
A UNIFORM PRACTICE PERCENT.
AB ONCE I WON TEN IS THE FIRST
STEP THAT WILL REQUIRE THE
DEPARTMENT OF PUBLIC HEALTH TO
CONVENE A WORKING GROUP TO
EVALUATE WAYS IN WHICH WE BRING
IMMIGRANT COMMUNITIES INTO THIS
SYSTEM.
GIVEN THAT IS A LIFESAVING ISSUE
AND FOR THAT WE WERE REQUESTED
AND I SUPPORT FOR THIS
PARTICULAR BILL THANK YOU.
THANK YOU VERY MUCH. NINE JIM
MARTIN CEO TONY LIFE CALIFORNIA
AND WERE IN SUPPORT OF THIS BILL --
WE WOULD BE NAMED -- TO THE WORK
GROUP AS AN ACTIVE COMMITTEE
MEMBER AND WE'D BE HAPPY TO DO
SO DESPITE.
THANK YOU VERY MUCH OTHERS IN
SUPPORT.
IS THERE ANYONE IN OPPOSITION.
SEE NO WILL BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS OR COMMENTS
FROM THE COMMITTEE.
SEE NONE WHICH I'D CLOSE MISTER
GIBSON I WOULD THANK YOU VERY
MUCH I THINK THE COMMITTEE --
JUST WANT TO BRIEFLY MY MOTHER
WHO PASSED OF HEART DISEASE --
AFTER HER PASSING -- THAT NIGHT
I RECEIVED A PHONE CALL FROM THE
HOSPITAL -- AND ASKING -- IF WE
WOULD WANT TO SAU WHICH H
GANS Là WHICH WAS A NOT A
GOOD TIME FOR ME TO ANSWER THE
PHONE -- TO DO SO AND WAS
TOTALLY AGAINST THAT BUT AFTER
SEEING A MOVIE WITH WILL SMITH
COST SEVEN POUNDS IT CHANGED MY
ENTIRE LIFE MY WHOLE TIME
OUTLOOK WHEN IT COMES DOWN TO
ORGAN DONATION -- ON MY CARD MY
DRIVER LICENSE I WILL HAVE MY
ORGANS ARE SALVAGEABLE --
CERTAINLY DONATE THOSE ORGANS --
TO MAKE SURE THAT SOMEONE ELSE
LIVES ON AND I THINK IT'S THE
RIGHT THING TO DO AND KNOWING
THAT OUR LAWS HAVE THIS THIS IN
EQUITY.
INDIVIDUALS CAN DONATE THEIR
ORGANS BUT CAN'T RECEIVE IT WE
MUST DO EVERYTHING THAT WE CAN
BY ASSEMBLING EXPERTS I'M
STAKEHOLDERS TO ADDRESS THIS
PARTICULAR ISSUE AND BRING A A
COMPREHENSIVE -- POLICY BEFORE
THIS BODY FOR THIS BODY TO VOTE
ON AND SO THAT'S WHAT THIS AIM
IS TRYING TO DO IS BRINGING
EXPERT -- INDIVIDUALS TOGETHER
SO THAT WE CAN HAVE A VERY IN
DEPTH CONVERSATION A HOW TO FIX
WHAT IS BROKEN HERE IN
CALIFORNIA MAKING SURE THAT THE
PEOPLE WHO DONATE HAVE AN
OPPORTUNITY TO RECEIVE I
RESPECTFULLY ASK WHAT I BOTH THE
PROPER TIME.
THANK YOU VERY MUCH MISTER
GIBSON -- THIS BILL DOESN'T --
DOESN'T CHOI DO PASS
RECOMMENDATION I APPRECIATE VERY
MUCH HERE.
THANK IS FORWARD.
THE BILL IS TO PASS TO
APPROPRIATIONS -- BUT WILL NEED
A MOTION FIRST I'M SORRY
[inaudible]
MOTION.
BY MISS CARILLO SECOND BY MISTER
RAMOS -- MA'AM SECRETARY PLEASE
CALL THE ROLL.
WHAT I WOULD AYE MAYES?
MAYES NOT VOTING AGUIAR-CURRY
[inaudible]
BIGELOW.
BONTA BURKE CARRILLO.
CARILLO AYE FLORA.
FLORA NOT VOTING.
LIMON.
LEVINE AYE MCCARTY THIS AREA.
RAMOS.
RAMOS I RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO.
WALDRON. FIVE YOU HAVE FIVE
VOTES WILL NEED A FEW MORE OF
WILL LEAVE THE BILL ON CALL.%
WITH THANK YOU VERY MUCH THANK
YOU TEAR WITNESSES [inaudible]
MR O'DONNELL.
STRAW DONNA BRINGS BILL A. B..
TEN FOURTEEN THANK YOU MISTER
CHAIR AND COMMITTEE MEMBERS I AM
PLEASED TO PRESENT AB TEN
FOURTEEN WHICH REQUIRES
HOSPITALS.
AND HEALTH FACILITIES TO WRITE A
ONE HUNDRED EIGHTY DAY NOTICE TO
THE PUBLIC.
PRIOR TO DOWNGRADING CHANGING OR
CLOSING THEIR FACILITIES M.
REALLY THE SERVER IS SO
COMMUNITIES CAN PLAN FOR THE
IMPACT AND ALSO.
A POTENTIALLY FIND ANOTHER
OPERATOR SHOULD WANT SEEK TO
LEAVE.
HOSPITAL'S DECISION TO REDUCE OR
ELIMINATE SERVICES CREATE
SERIOUS CHALLENGES TO OUR
COMMUNITY.
IN RECOGNITION OF THESE
CHALLENGES CURRENT LAW REQUIRES
A NINETY DAY NOTICE TO THE
PUBLIC PRIOR TO REDUCING.
EMERGENCY SERVICES OR THIRTY DAY
NOTICE PRIOR TO CLOSING A HEALTH
FACILITY.
I CAN TELL YOU FROM EXPERIENCE
MY OWN EXPERIENCE IN LONG BEACH.
OF THAT THESE TIME FRAMES ARE
CERTAINLY.
NOT LONG ENOUGH.
IN MY DISTRICT JUST LAST YEAR
COMMUNITY HOSPITAL OF LONG BEACH
CLOSE ITS DOORS AFTER ABRUPTLY
DIVERTING EMERGENCY ROOM
PATIENTS TO OTHER HOSPITALS.
THIS WAS DONE WITH VERY LITTLE
NOTICE TO RESIDENTS AND VERY
LITTLE TIME TO ENGAGE THE
HOSPITAL.
PROVIDER ON ALTERNATIVE TO THE
CLOSURE IT WAS SIGNIFICANTLY
IMPACTFUL TO MY COMMUNITY.
AND REMAIN SO.
AS RESULTS PATIENTS IN MY
COMMUNITY NOW EXPERIENCE LONGER
WAIT TIMES. FOR SERVICES LONGER
AMBULANCE TRAVEL TIMES AND
OVERCROWDING AT OTHER HOSPITALS.
AND EMERGENCY ROOMS THIS IS IT
EXPERIENCE IS NOT UNIQUE TO
HAPPENING ALL OVER CALIFORNIA.
PATIENTS AND RESIDENTS DESERVE
ADEQUATE NOTICE TO REPAIR FOR
CLOSURE THANK YOU LEADERSHIP
BECAUSE THE SUFFICIENT TIME TO
WORK TOWARDS AN ALTERNATIVE.
IN MY DISTRICT A NEW PROVIDER
HAS NOW BEEN SECURED WE BELIEVE.
WE COULD HAVE AVOIDED ANY
DISRUPTION AN ESSENTIAL SERVICE.
CENTRAL SERVICES HAD MY
COMMUNITY AND GIVEN MORE NOTICE.
AB TEN FOURTEEN WILL PROVIDE
COMMUNITIES AND STAKEHOLDERS
WITH AN OPPORTUNITY TO FULLY
INVESTIGATE ALL OTHER OPTIONS
INCLUDING SECURING A NEW
PROVIDER. TO PREVENT A CLOSURE
OF A CRITICAL HOSPITAL.
AT THE VERY LEAST THIS BILL
ALLOWS PATIENTS A RESIDENTS TO
BETTER PREPARE FOR WHAT THEY
WILL DO IN THE NEXT EMERGENCY.
NOW THAT THE LOCAL HOSPITAL
MAYBE GONE.
HERE TO TESTIFY IN SUPPORT IS
TAYLOR JACKSON WITH THE
CALIFORNIA NURSES ASSOCIATION
AND SIR FLOCKS OF THE CALIFORNIA
LABOR FEDERATION MISTER CHAIR.
PLEASE GO AHEAD.
MISTER CHAIR AND MEMBERS TAYLOR
JACKSON WITH THE CALIFORNIA
NURSES ASSOCIATION WHERE THE
SPONSORS OF AB -- TEN FOURTEEN
AB TEN FOURTEEN OF A COMMONSENSE
PROPOSAL HOSPITALS ARE UNIQUE
CALIFORNIA BUSINESS AND A VITAL
PART OF THE PUBLIC INTEREST.
WHILE SOME MAY BE RUN BY A
CORPORATION THEY ARE IN THE
BUSINESS OF PUBLIC SERVICE
SAVING LIVES AND PROTECTING
PATIENTS HOSPITALS ARE WHERE
FAMILY MEMBERS ARE BORN THERE
WERE OUR NEIGHBORS GO WHEN THEY
GET SICK AND THEY ARE SAFE PLACE
WHEN A WILDFIRE OR OR EARTHQUAKE
STRIKES.
WHEN A CLOSURES ANNOUNCED NURSES
ELECTED OFFICIALS AND MEMBERS OF
THE COMMUNITY ARE SOMETIMES ABLE
TO GALVANIZE A CITY AND KEEP THE
HOSPITAL OPEN OR FIND ANOTHER
WORKABLE SOLUTION?
UNFORTUNATELY SOMETIMES WE ARE
NOT ABLE TO KEEP FACILITIES OPEN
AND THEY CLOSE LEAVING
NEIGHBORHOODS IN A HEALTH CARE
DESERT.
INCREASE NOTICE TIMELINES MEAN
BETTER OUTCOMES FOR YOUR CITY
AND MORE TIME FOR YOUR
CONSTITUENTS TO FIGURE OUT WHERE
THEY WILL RECEIVE HEALTH CARE.
FOR WHERE THEIR NEXT JOB WILL BE.
AT THE BARE MINIMUM CALIFORNIANS
ARE ENTITLED TO ADEQUATE NOTICE
OF A HOSPITAL CLOSING.
CNA IS GRATEFUL TO OUR THREE
JOINT AUTHORS WHO'VE ALL
EXPERIENCED AND ANNOUNCED
HOSPITAL CLOSURE IN THEIR
DISTRICT.
AND UNDERSTAND THE URGENCY OF
THIS ISSUE NURSES ARCHER SUPPORT
ON AB.
TEN FOURTEEN VERY MUCH BEFORE
YOU BEFORE I LET YOU GO LET
MISTER BRO ONE OF THE JOINT
AUTHORS TESTIFY AND I I
APOLOGIZE MISTER CHAIR I WASN'T
GIVEN NOTICE.
ON THE BILL THIS EXTRA GIVING
NOTICE THE MISTER ROSE GOING TO
SHOW.
THAT I AM HAVING THAT THERE IS
NO NOTICE BUT YOU WILL NOTICE
THAT ARE NOTICING AUTHOR YOU'RE
READING OF MY TWO MINUTES -- NO
I'M I'M JUST HERE I'M PROUD TO
BE A JOINT AUTHORS I JUST WANTED
TO SHARE THE STORY OF WHAT
HAPPENED MY FIRST YEAR IN THE
CITY OF SAN CLEMENTE.
MY DISTRICT HAD THREE EMERGENCY
ROOMS HAVE MISSION HOSPITAL
WHICH IS OUR REGIONAL TRAUMA
CENTER.
AND TO HOSPITALS IN LAGUNA HILLS
IN SAN CLEMENTE SO THE PROVIDER --
DECIDED TO CLOSE THE FACILITY WE
ATTEMPTED RUN LEGISLATION IT WAS
UNSUCCESSFUL BUT THE THING THAT
REALLY GOT ME ENGAGED IS THAT
ALL THEY HAD TO DO WAS WRITE A
LETTER TO THE COUNTY.
ANNOUNCING A CLOSURE AND
RESIDENTS CONSTITUENTS ELECTED
OFFICIALS WILL REALLY HELP US WE
COULDN'T DO ANYTHING.
NOW I UNDERSTAND THAT --
EMERGENCY ROOMS OF THE MOST
EXPENSIVE -- FORM OF HEALTH CARE
BUT WE DO NEED MORE NOTICE AND
THE OTHER THING THAT REALLY GOT
ME FROM MY SITUATION.
WAS THAT THE PROVIDER WAS A NOT
FOR PROFIT ENTITY.
AND THEY GET THAT NONPROFIT
STATUS BY PROVIDING A COMMUNITY
BENEFIT THAT THEY NO LONGER WERE
PROVIDING IN THE CITY OF SAN
CLEMENTE WHICH IS MY SECOND
LARGEST CITY.
MILLIONS OF PEOPLE VISIT THE
COAST.
AND YOU KNOW JUST LIKE THAT TWO
MONTHS LETTER TO THE COUNTY --
THEY ANNOUNCED THE CLOSURE SO.
THERE NEEDS TO BE MORE -- DONE
TO DISCUSS IT FIND OTHER OPTIONS
MR O'DONNELL CITY IS.
THEY'RE NOT LUCKY FOR HOSPITAL
CLOSING BUT AT LEAST THE CITY ON
THE LAND IN MY SITUATION THE
OPERATOR ON THE HOSPITAL AND THE
LAND.
SO NOW IT'S JUST A FENCED OFF
CLOSE HOSPITAL THANK YOU MISTER
CHAIR.
THANK YOU VERY MUCH MR PEROT
MISS MISS BLOCKS.
MISTER CHAIR MEMBER SERAPH LOCKS
CALIFORNIA LABOR FEDERATION AS
WE'VE SEEN HOSPITALS ARE REALLY
THE BACKBONE OF MANY COMMUNITIES
THEY PROVIDE HEALTHCARE SERVICES
BUT ALSO COMMUNITY BENEFITS
CHARITY CARE.
HEALTH EDUCATION HEALTH BEARS --
AND ALSO ARE OFTEN THE LARGEST
EMPLOYER IN A LOT OF COMMUNITIES
SO THERE'S A REAL IMPACT WHEN
THEY CLOSE -- SUE THIS JUST
GIVES ENOUGH NOTICE FOR A
COMMUNITY TO TO PREPARE FOR A
CLOSER OR FOR A DOWNGRADE IN
SERVICES I DID WANT TO ADDRESS --
THE OPPOSE UNLESS AMENDED TO
ARGUMENTS IN THE OPPOSITION OR
IN THAT -- ANALYSIS THEY DID SAY
THAT.
OPPOSE UNLESS AMENDED IF THEY
HAD CONFORMITY WITH THE WARN ACT --
WHICH IS SIXTY DAYS.
WE'RE NOT TALKING ABOUT A
WALMART CLOSING WE'RE NOT EVEN
TALKING ABOUT A FACTORY CLOSING
WE ARE TALKING ABOUT HEALTHCARE
PROVIDERS THAT PLAY AND WARMUS
ROLES IN COMMUNITIES IT TAKES
MORE THAN SIXTY DAYS.
TO PREPARE FOR THAT KIND OF
CHANGE IN A COMMUNITY AND THE
IMPACT ON PEOPLE'S LIVES TO
DEPEND ON THIS -- AND EVEN WITH
THE WARN ACT OTHER STATES HAVE
DIFFERENT TIMELINES BECAUSE THEY
HAVE DECIDED THAT SIXTY DAYS
ISN'T ENOUGH -- AND THE WARN ACT
WAS DESIGNED AROUND A VERY
PARTICULAR TIE AND KIND OF
CLOSURE SO I WOULD SAY.
A HOSPITAL IS VERY VERY
DIFFERENT IT'S NOT JUST AN
EMPLOYER AND A HUNDRED EIGHTY
DAY TIMELINE MAKES A LOT OF
SENSE THANK YOU.
THANK YOU VERY MUCH OTHERS IN
SUPPORT MISTER CHAIR MEMBERS AMY
BROWN ON BEHALF OF THE CITY OF
LONG BEACH TO WANT TO THANK
ASSEMBLY MEMBER O'DONNELL FOR
CARRYING THE BILL OR YOUR
SUPPORT THANK YOU.
ANYONE ELSE'S SUPPORT.
ANYONE IN OPPOSITION.
PLEASE COME ON UP YEAH.
CATHERINE ALSO SCARRING THE
CALIFORNIA HOSPITAL ASSOCIATION
I'M WE ARE OPPOSE UNLESS AMENDED
AND WE ARE TRYING TO FIND A
BALANCE IN OUR OPPOSITION -- AS
YOU CAN APPRECIATE HOSPITALS DO
CLOSE FOR MARRIED OF REASONS --
SOME FINANCIAL SOME BECAUSE OF A
SERVICE GOING DOWN TO A LEVEL
WHERE -- WE MAY NEED TO RETHINK
THE USE OF THAT HOSPITAL TO
ANOTHER SERVICE -- BECAUSE THOSE
HOSPITAL SERVICES AREN'T USED AS
FREQUENTLY SO SAFETY BECOMES AN
ISSUE -- SO WE ARE WE WERE UP WE
ARE OPPOSE UNLESS AMENDED TO
ADJUST TO THE NINETY DAY TIME
FRAME FOR A CHANGE IN SERVICE WE
MAY CHANGE OUR SERVICE AGAIN FOR
MERRY REASONS YOU MAY HAVE A
DOCTOR LEAVE.
A BURN UNIT AND YOU NO LONGER
HAVE A DOCTOR TO MANAGE THE BURN
PATIENTS YOU MAY HAVE A KEY
MEDICAL STAFF LEAVE I'M FOR
VARIOUS REASONS AND A HUNDRED
AND EIGHTY DAYS WON'T ALLOW FOR
THAT CHANGE IN SERVICE THAT THEN
COULD CREATE PATIENT SAFETY
ISSUES.
OR CRATE BACKLOGS IN OTHER AREAS --
AND THEN WE DO OFFER THE SIXTY
DAYS BECAUSE WHEN A HOSPITAL HAS
TO CLOSE ONCE THEY ANNOUNCE --
YOU CAN ALL APPRECIATE WHEN YOUR
EMPLOYER TELLS YOU THAT THEY'RE
GOING TO CLOSE THE FIRST THING
YOU'RE GOING TO DO IS START
LOOKING FOR ANOTHER JOB.
AND FRANKLY FOR A SYSTEMS THEY
TRY AND FIND THEIR NURSES
DOCTORS.
OR DOCTORS BUT THERE NURSES.
I DON'T APPLY THEM -- AND THEIR
OTHER EMPLOYEES THEY TRYING TO
FIND THEM OTHER POSITIONS AND
OTHER FACILITIES TO BECOME OPEN
AND I MEAN PART OF THE SYSTEM
HUNDRED EIGHTY DAYS.
CREATES WHAT WE CAN'T WHAT WHAT
WE'RE CONCERNED ABOUT IS AN
IMBALANCE IN I'M BEING ABLE TO
RETAIN OUR EMPLOYEES AND
MAINTAIN THE SAFETY IN THE
SYSTEM SO.
UNFORTUNATELY WE ARE OPPOSED TO
THAT TIME FRAME AND HAVE OFFERED
UP OTHER TIME FRAMES WE BELIEVE
PROVIDE THAT BALANCE.
THANK YOU THANK YOU VERY MUCH
OTHER OTHERS IN OPPOSITION.
SEE NUMBER BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS.
QUESTION MISTER MISS RODRIGUEZ
WANT TO THANK THE AUTHORS FOR
BRING THIS VERY IMPORTANT BILL
FORD AS YOU KNOW THE PAST
WORKING IN THAT YOU MASS
INDUSTRY.
IT'S VERY IMPORTANT THAT WE HAVE
OUR FACILITIES OPEN PROVIDING
SERVICE.
AND THE MORE TIME WE HAVE WHEN
THEY DO LOOK TO CLOSE THE BETTER
TO PREPARE OURSELVES AS WERE TO
TRANSPORT PATIENTS BECAUSE AS WE
KNOW.
MINUTES ARE CRUCIAL IN SAVING
PEOPLE'S LIVES AND BY THAT DELAY
GOING TO OUR FOR THE HOSPITAL.
EVEN -- INCREASES THEIR CHANCES
OF MAYBE NOT SURVIVING SAUNA
THANK OF THE AUTHOR FOR BRING
THIS -- VERY IMPORTANT BEFORE I
THINK TALKING WITH OPPOSITION
TALKING ABOUT -- MAYBE TOO MUCH
TIME IT SHOULD BE SHORTER BUT
THEN WE ARE GOING TO LOOK AT AS
WERE LOOKING TO GET THESE
EMPLOYEES OTHER JOBS IN OTHER
AREAS WE NEED TO TAKE IN
CONSIDERATION THEY MAY HAVE TO
MOVE RIGHT AND THAT'S GOING TO
BE TIME AND COST. TO FIND IN
YOUR HOUSE APARTMENT OR WHATNOT --
SO I THINK THE MORE TIME THE
BETTER SO JUST THINK OF BRINGS A
VERY IMPORTANT BEFORE THANK YOU.
LOOK FOR THE SUPPORTED AS WELL.
THANK YOU VERY MUCH OTHER ANY
OTHER QUESTIONS OR COMMENTS.
SO -- FIRST ONE WITH AND ONE
THANK YOU FOR BRING THE BILL
FORWARD I KNOW WHAT A DIFFICULT
TIME YOU WENT THROUGH IN IN YOUR
DISTRICT LAST YEAR -- RELATED TO
THE CLOSURE OF THE HOSPITAL --
AND DIE THIS BILL DOES ENJOY DO
PASS RECOMMENDATION WOULD YOU
LIKE TO CLOSE THE STREET ON S.
RIVAL THANK YOU SO MUCH.
WE HAVE A MOTION.
AND A SECOND MOTION BY MISTER
RODRIGUEZ A SECOND BY MISTER
RAMOS.
THE MOTION IS DUE PASSED TO
APPROPRIATIONS MADAM SECRETARY
PLEASE CALL THE ROLL WHAT I
WOULD AYE MAYES.
MAYES NOT VOTING OCCUR CURRY.
AGUIAR-CURRY AYE BIGELOW.
BONTA.
BURKE I AM BURKE I CARILLO.
CARILLO I'D FLORA. FOR NOT
VOTING LIMóN.
MON I MCCARTY.
THIS AREA.
RAMOS.
ROSS I RODRIGUEZ RODRIGUEZ AYE
SANTIAGO.
WALDRON.
YOUR BILL HAS -- SEVEN SEVEN
VOTES WILL LEAVE THE BILL ON
CALL.
THANK YOU VERY MUCH [inaudible]
MR QUIRK.
YEAH AB
.
ELEVEN SEVENTY EIGHT IT'S A
PLEASURE TO BE HERE.
THANK YOU CHAIR AND MEMBERS --
THANK YOU TO THE COMMITTEE STAFF
WHO WORK SO HARD ON THIS BILL
WITH US.
AND ALSO THANKS -- TO MY STAFF
MEMBER HERE PUTTING EVERYTHING
TOGETHER -- AB ELEVEN SEVENTY
EIGHT REQUIRES PRO BIOTIC
MANUFACTURERS TO LABEL THEIR
PRODUCT WITH THE GENUS SPECIES
AND STRAIN OF MICRO ORGANISMS.
IN DIETARY SUPPLEMENTS AS WELL
AS A TOTAL ESTIMATED COUNT OF
LIFE MICRO ORGANISMS.
CURRENT FEDERAL LAW REQUIRES
MANUFACTURERS TO LIST AND
QUALIFY INGREDIENTS IN DIETARY
SUPPLEMENTS.
TRADITIONAL DIETARY INGREDIENTS
LIKE CALCIUM LISTING THE COMMON
NAME AND QUAN I FIND BY WEIGHT
MAKES INTUITIVE SENSE. FOR LIVE
MICRO ORI ORGANISMS IT'S
IMPORTANT TO USE A METRIC THAT
ACTUALLY AFFECTS HOW MANY ARE
LIVE.
IS ALSO CRITICAL TO IDENTIFY
THEM AT THE STRAIN LEVEL HERE TO
TESTIFY IN SUPPORT OF THIS
MEASURE IS.
FIRST ERIC LEVY WHO'S A PHD
STUDENT STUDYING INFECTIOUS
DISEASES AT UC BERKELEY AND WHO
SUGGESTED THIS BELL.
AND THEN SACK ABBOTT WHO'S A PHD
SCIENTIST IN THE C. E. O. Z.
BIOTICS.
LOW CHAIR AND MEMBERS OF THE
ASSEMBLY HEALTH COMMITTEE
[inaudible]
THANK YOU.
THANK YOU FOR THE OPPORTUNITY TO
SPEAK TODAY ABOUT AB.
ELEVEN SEVENTY EIGHT MY NAME IS
ERIC LEE AND I'M A PHD STUDENT
STUDYING MICROBIOLOGY AT UC
BERKELEY.
I'M HERE TODAY BECAUSE I
PARTICIPATED IN A COMPETITION
HOSTED BY THE UC CENTER OF
SACRAMENTO.
THIS COMPETITION ASKED GRADUATE
STUDENTS IN SCIENCE TECHNOLOGY
ENGINEERING AND MATH FIELDS. TO
DRAW FROM OUR EXPERTISE AND
PROPOSE NEW POLICY IDEAS.
MY PROPOSAL WAS SELECTED AS THE
WINNING PROPOSAL AND IS THE IDEA
BEHIND AB.
ELEVEN SEVENTY EIGHT AS A
RESEARCHER WHO STUDIES BACTERIA
FRIENDS AND FAMILY HAVE OFTEN
ASKED ME WHETHER THEY SHOULD
TAKE OVER THE COUNTER PROBIOTICS
OR DIETARY SUPPLEMENTS THAT
CONTAIN LIKE LIVE MICRO
ORGANISMS TO TREAT HEALTH
PROBLEMS.
I'M USUALLY HESITANT TO ANSWER
THAT QUESTION BECAUSE EVERY
PERSON HAS A UNIQUE MIXTURE OF
TRILLIONS OF BACTERIA IN THEIR
GUT.
WHICH CAN CHANGE PROBIOTICS
EFFECTIVENESS FROM PERSON TO
PERSON.
FURTHERMORE EVEN IF A CURE ALL
BACTERIA EXISTED I WOULDN'T BE
ABLE TO PICK IT OFF THE SHELF OF
MY LOCAL GROCERY STORE BECAUSE
MOST SUPPLEMENT LABELS DON'T
HAVE ENOUGH DETAIL FOR ME TO
FIND A THAT BACTERIA.
MOST LABELS INCLUDE BACTERIA
SPECIES.
BUT SCIENTISTS PREFER TO USE AN
ADDITIONAL LABEL LAYER OF
SPECIFICITY WHICH IS CALLED THE
STRAIN.
YOU CAN THINK OF BACTERIAL
STRAINS LIKE BREEDS OF DOGS.
ALL DOGS ARE THE SAME SPECIES
BUT IF YOU IMAGINE THE DOCKS IN
AS A POLICE CANINE YOU CAN
UNDERSTAND WHY SPECIFICITY
PASSED THE SPECIES LEVEL IS
IMPORTANT.
SIMILARLY A BACTERIA STRAIN CAN
IMPACT ITS FUNCTION.
SOME STRAINS OF E. COLI OUR FOOD
CONTAMINANTS CAUSING DIARRHEA
KIDNEY FAILURE OR DEATH.
OTHER E. COLI CAN HELP TREAT
INFLAMMATORY BOWEL DISEASE.
DESPITE THE IMPORTANCE OF THE
BACTERIA STRAIN THAT INFORMATION
IS NOT REQUIRED TO BE LISTED ON
A MANUFACTURED.
MANUFACTURER LABEL UNDER CURRENT
FEDERAL LAW.
CURRENTLY ABEL'S ALSO LIST
PROBIOTIC INGREDIENTS BY WEIGHT
WHICH COUNTS BOTH LIVE AND DEAD
ORGANISMS. TO FIND THE NUMBER OF
VIABLE MICRO ORGANISMS WILL
CONTRIBUTE ADDITIONALLY TO
TRANSPARENCY AND PRODUCT
INTEGRITY.
THE US PROBIOTIC MARKET IS
PROJECTED TO REACH SIX AND A
HALF BILLION DOLLARS IN THE NEXT
FOUR YEARS.
THE COST ALONE SHOULD BE AN
INCENTIVE TO IMPROVE LABELING
PRACTICES SO CONSUMERS CAN KNOW
EXACTLY WHAT'S IN THEIR
SUPPLEMENTS.
MORE DETAILED STREAM LEVEL
LABELING WILL ALLOW CONSUMERS TO
COMPARE PRODUCTS BETWEEN
MANUFACTURERS AND ENSURE THAT
THIS CRUCIAL INFORMATION IS
READILY AVAILABLE TO ALL.
THANK YOU.
YOU VERY MUCH.
AB.
MANNER.
YEAH.
THANK YOU TO THE CHAIR -- AND
COMMITTEE FOR LETTING ME SPEAK
TODAY ON BEHALF OF THE BILL.
MY NAME IS ZACH ABIT -- AND I AM
CEO OF HIM JUST GO BASED
PROBIOTICS COMPANY CALLED THE
BIOTICS.
AS YOU MAY KNOW PROBIOTICS ARE
LIVE ORGANISMS THAT ARE CONSUMED
FOR THE VARIOUS BENEFITS THAT
THEY MAKE HIM.
FOR THIS ISSUE OUT HIS ME THE
ISSUE IS THAT NOT ALL PROBIOTICS
ARE THE SAME AS WE JUST HEARD ON
AND NOT ALL COME FOR THE SAME
BENEFITS TO THE SAME PEOPLE.
ARE THE FIRST PROVISION OF THIS
BILL REQUIRES THAT THE GENUS
SPECIES AND STRAINED BE
SPECIFIED ON THE LABEL THIS IS
CRITICAL FOR MULTIPLE REASONS.
FIRST DIFFERENT STRAINS OF
BACTERIA EVEN WITHIN THE SAME
SPECIES VERY WIDELY.
THE DISTINCTION ABOUT WHAT
STRAIN SPECIFICALLY IS IN THE
PRODUCT IS INCREDIBLY IMPORTANT
FOR PROBIOTICS BUSINESSES LIKE
MINE. ONE STRAIN WITHIN A
SPECIES MAY HAVE A BENEFICIAL
FUNCTION ACTIVITY ANOTHER STRAIN
DOES NOT HAVE. FOR INSTANCE WE
SPENT THE LAST THREE YEARS ARE
DEVELOPING AND TESTING ARE
SPECIFIC STRAIN OF A PROBIOTIC
CALL BE SETTLES.
OUR STRAIN B. SUBTLEST ZB.
ONE EIGHTY THREE IT HAS A UNIQUE
FUNCTION THAT ALLOWS IT TO
ELIMINATE A SPECIFIC TOXIN FROM
YOUR GOT.
OTHER STRAINS OF BE SUBTLEST DO
NOT HAVE THIS FUNCTION.
AND WITHOUT A REQUIREMENT FOR
MANDATORY STRAIN LABELING
BUSINESSES DO NOT HAVE THE
RESPONSIBILITY TO KNOW OR LABEL
WHETHER OR NOT -- THEY HAVE A
FUNCTIONAL OR USEFUL STREAM.
BUSINESSES SUCH AS MINE ARE
PREDICATED ON THE FACT THAT ONE
STRAIN IS NOT THE SAME AS
ANOTHER.
AND THERE'S A VERY AND THERE'S
VERY SOUND SCIENCE TO SUPPORT
THAT.
WE GO THROUGH A GREAT DEAL OF
SCIENTIFIC AFRICAN RIGOR TO
ISOLATE DEVELOPING CHARACTER AYE
STRAINS AND FILE PATENTS TO
PROTECT THE STRAINS FOR THE
PURPOSES OF EXCLUSIVE USE.
WITHOUT MANDATORY STRAIN
LABELING THIS EFFORT IS UNDER
CUT AND MADE USELESS I SINCE
CURRENTLY THERE IS NO
REQUIREMENT THAT THE SPECIFIC
STRAIN BE IDENTIFIED.
I SUCH IN THE INTEREST OF
TRANSPARENCY AND ALLOWING
CONSUMERS TO MAKE INFORMED
PURCHASING DECISIONS AS MORE
INFORMATION BECOMES KNOWN ABOUT
PROBIOTICS WE STRONGLY SUPPORT
THE MANDATORY LABELING OF THE
GENUS SPECIES AND STRAIN FOR ALL
PROBIOTICS.
IN ADDITION BECAUSE TRAINS ARE
SO DIFFERENT HOW SUCH DIFFERENT
PROPERTIES MANUFACTURERS OF
PROBIOTICS SHOULD KNOW WHAT
SPECIFIC SHRINK THEY'RE PUTTING
INTO THEIR PRODUCTS WITHOUT
REQUIREMENT TO LABEL THE
SPECIFIC STRAIN.
THERE'S ALSO NO REQUIREMENT TO
KNOW WHAT STRANGERS IN THE
BOTTLE THIS IS NOT THE BEST
INTEREST OF THE PUBLIC OR THE
PRODUCT AND SHE THANK.
THANK YOU VERY MUCH.
OTHERS IN SUPPORT.
BRANDON MARCH WITH A CALIFORNIA
MEDICAL ASSOCIATION IN SUPPORT.
YOU VERY MUCH IS THERE ANYONE IN
OPPOSITION
.
GOOD AFTERNOON MISTER CHAIR AND
MEMBERS ANTHONY SAMPSON WITH
ARNOLD AND PORTER ON BEHALF OF
THE COUNCIL FOR RESPONSIBLE
NUTRITION IN THE AMERICAN HERBAL
PRODUCTS ASSOCIATION.
TRADED SEARCHES AND TRADE
ASSOCIATIONS WHICH COMPRISE OF
THE SIGNIFICANT.
AMOUNT OF MANUFACTURERS THAT
WOULD BE SUBJECT TO THIS BILL.
WE ARE ACTUALLY A SUPPORTIVE OF
WHAT -- INSTANTLY MEMBER QUIRK
IS IS TRYING TO DO.
OUR FUNDAMENTAL OBJECTIONS IS
THE CONFLICT RIGHT NOW WITH WITH
THIS BILL SEEKS TO DO.
AND WITH FEDERAL LAW AT A TIME
WHEN THE FDA IS ACTUALLY MOVING
IN THE RIGHT DIRECTION -- ON
THIS ISSUE.
AND FOR THAT REASON WHAT WHAT
I'VE TALKED ABOUT WITH THE
ASSEMBLY MEMBER A BIT.
IS THE IDEA OF MOVING A
RESOLUTION TO ENCOURAGE THE FTA
TO MOVE FORWARD WITH REGULATIONS --
TO AMEND ITS REGULATIONS -- TO
DO EXACTLY WHAT THIS BILL IS
SEEKING TO DO AND LET ME JUST
EXPLAIN.
WITH THE CURRENT REGULATIONS SAY
THAT LIVE MICROBIAL DIETARY
INGREDIENTS MUST BE QUANTIFIED --
BY WEIGHT ON THE SUPPLEMENT
FACTS LABEL.
AND BUT COLONY FORMING UNITS IN
ANY OTHER METRIC FOR THAT MATTER
ARE NOT AN OFFICIAL MEASUREMENT.
ALLOWED TO APPEAR ON THE
SUPPLEMENT FACTS LABEL WE
DISAGREE WITH THAT.
AND THAT'S WHY -- C. R. AND AND
AMERICAN HERBAL PRODUCTS
ASSOCIATION SUPPORTED -- A
PETITION BY THE INTERNATIONAL
PROBIOTICS ASSOCIATION -- TO
REQUIRE -- LABELS TO INCLUDE CF
USE AS METRICS FOR LIVE
MICROBIAL INGREDIENTS.
AND THE FDA RESPONDED WITH DRAFT
GUIDANCE -- ALLOWING BOTH -- THE
THE COLONY FORMING UNITS TO BE
EXPRESSED -- FOR PURPOSES OF
CHARACTERIZING LIVE MARK
MICROBIAL INGREDIENTS AS WELL AS
THE WEIGHT AND SO WE HAD AN
ISSUE WITH THAT.
WE THINK THAT THEY'RE GOING IN
THE RIGHT DIRECTION AND AGAIN WE
WOULD ENCOURAGE THE FDA TO AMEND
ITS REGULATION TO SIMPLY SAY THE
COLONY FORMING UNITS AT THE
APPROPRIATE MEASURES. TO
DETERMINE -- THE AMOUNT OF LYE
MICRO PEELS. FOR PURPOSES OF THE
BEST OTHER PROVISION IDENTIFYING
GENUS SPECIES AND STRAIN WERE
ALSOVERY SUPPORTIVE OF OF WHAT
THE ASSEMBLY MEMBER IS TRYING TO
DO.
ON THIS IN FACT THE COUNCIL FOR
RESPONSIBLE NUTRITION AND THE
INTERNATIONAL PROBIOTICS
ASSOCIATIONS GUIDELINES.
OUR STATE THAT THE LABEL SHOULD
IDENTIFY THE GENUS SPECIES AND
STRAIN FOR EACH MICRO ORGANISM
IN THE PRODUCT AND THAT'S IN
FACT -- CURRENT PRACTICE -- FOR
THEIR MEMBERS -- AND THEN IN TWO
THOUSAND SIXTEEN THE FDA ISSUED
GUIDANCE FOR NEW DIETARY
SUPPLEMENT INGREDIENTS.
SPECIFYING WHAT NEEDS TO BE
INCLUDING THOSE NEW
NOTIFICATIONS WHICH INCLUDES A
COMPLETE DESCRIPTION OF THE
ORGANISM.
INCLUDING THE STRAIN SO AGAIN ON
BOTH IF ISSUES WE SEE THE FTA
GOING IN THE RIGHT DIRECTION
WHAT WE WOULD PREFER IS TO SEE
THE FTA.
GO THAT DIRECTION THE DOCTOR
QUIRK IS SEEKING TO GO.
AND ESTABLISH A UNIFORM LABELING
REQUIREMENT FOR THESE PRODUCTS
THAT CAN BE USED -- THROUGHOUT
THE THROUGHOUT THE COUNTRY
WITHOUT SEPARATE STATE LEVEL
REQUIREMENTS SO WITH THAT THANK
YOU FOR YOUR TIME [inaudible]
SIR.
HELLO MY NAME IS CARLOS COULD
HERE IS I'M WITH THE CONSUMER
HEALTHCARE PRODUCTS ASSOCIATION
WITH A TRADE ASSOCIATION OF
WASHINGTON DC.
THE REPRESENT OVER THE COUNTER
MEDICINES AND DIETARY
SUPPLEMENTS.
THE ANTHONY DID A REALLY GOOD
JOB OF LAYING OUT OUR OR SIMILAR
CONCERNS ARE WE'RE NOT OPPOSED
TO WHAT'S IN THE BILL --
CERTAINLY APPRECIATE THE INTENT
ARE OPPOSITION LIES MOSTLY IN
THE FACT THAT IT DOES NOT A LINE
CURRENTLY WITH FTA.
AND WE ALSO HAVE -- PETITIONED
FTA TO MOVE IN THIS DIRECTION --
AS RECENTLY AS NOVEMBER OF THIS
LAST YEAR -- THEY ARE DUE TO
COME OUT WITH THE RULES ON THIS
ISSUE.
HOPEFULLY SOONER BETTER THAN
LATER AND AGAIN WE HAVE BEEN
SUPPORTIVE OF THIS WE APPRECIATE
YOU BRING IT TO THE FOREFRONT --
OR OPPOSITION JUST LIES IN THE
FACT THAT IT'S CURRENTLY NOT
ALIGNED WITH FTA.
THANK YOU VERY MUCH IS THERE
ANYONE ELSE IN OPPOSITION.
THE BILL SECOND. ONE QUESTIONS
MISTER MISTER MAYES [inaudible]
SO -- THIS IS FASCINATING -- A
COUPLE OF WELL THE DOCTOR IN A
COUPLE OF WANT TO BE DOCTORS
SAID THAT ARE HERE -- I DID NOT
STUDY -- SCIENCE I STUDIED
POLITICAL SCIENCE WITH SOME
WOULD ARGUE.
IS NOT A SCIENCE AT ALL -- BUT
MY MY QUESTION FOR THE
OPPOSITION IS -- I DO UNDERSTAND --
THE ROLE OF THE OF US GOVERNMENT --
AND I'M SOMEBODY WHO DEEPLY
BELIEVES IN THIS IDEA OF
FEDERALISM.
AND OFTEN TIMES -- WE HAVE --
FOLKS THAT COME DOESN'T SAY --
WE DON'T WANT CALIFORNIA TO SET
THEIR OWN -- STANDARDS OUR OWN
RULES WE WANT THEM CONGRESS TO
DO IT WE WANT WASHINGTON DC TO
DO IT RIGHT NOW THEY'RE NOT
DOING MUCH OF OF ANYTHING AND I
KNOW THAT YOU'RE.
HOPING THAT THE FDA WHICH IS ONE
OF THE AGENCIES WILL WILL COME
UP WITH -- WILL COME UP WITH
SOMETHING BUT WHY CAN'T
CALIFORNIA HAVE ITS OWN RULES
AND IF YOU AGREE THAT -- THAT
DOCTOR COURTS BILL -- IS MOVING
IN THE RIGHT DIRECTION WHY CAN'T
WE HAVE A CALIFORNIA STANDARD
THE THAT AND WRITE IT HERE THAT
THE FDA CAN USE IT AS A AS A
GUIDELINE.
YEAH I MEAN IT'S A GOOD QUESTION
WEEK KNOWLEDGE THE CALIFORNIA
CAN DO.
WHAT IT WANTS AND IT AND IT'S
AND IT'S DOING THAT RIGHT NOW I
THINK THAT THE ISSUES THAT
TYPICALLY WHEN WE SEE NEW
LABELING MANDATES AND DISCLOSURE
REQUIREMENTS?
WHAT WE'RE TYPICALLY SEEING IS
THE FEDERAL GOVERNMENT GOING THE
OPPOSITE DIRECTION OR TAKING NO
ACTION AT ALL THAT'S NOT WHAT'S
HAPPENING HERE WE JUST SAW FTA
TAKE ACTION?
ON THIS ISSUE AS WELL.
AS EARLY AS LATE LAST YEAR AND
WE EXPECT THEM TO CONTINUE TO
MOVE FORWARD WE'RE HOPEFUL THAT
THEY DO AND THE FACT THAT FTA IS
GOING IN THEIR DIRECTION.
THAT WE WANT THEM TO GO IN
CONSISTENT WITH THIS BILL OUR
POSITION IS THAT IT WOULD BE
NICE TO JUST HAVE A UNIFORM
FEDERAL STANDARDS.
THAT CALIFORNIA CAN BE GET
BEHIND IT THAT WE CAN ALL
SUPPORT.
IF FTA WAS NOT MOVING ON THIS
AND THEY WERE GOING THE OPPOSITE
DIRECTION SAYING CALLING FORMING
UNITS.
COUNTY FORMING UNITS IS NOT
APPROPRIATE METRICS.
DIFFICULT FOR ME TO GOT UP HERE
AND AND AND JUSTIFY THAT WHEN
WHEN CALIFORNIA SEEKING TO GO IN
THE OPPOSITE DIRECTION.
THIS IS CONSISTENT WITH A FIFTY
DOESN'T MOVE WHAT IF THEY DON'T
ACT WOULD BE IMPROPER FOR
CALIFORNIA TO ACT WOULD YOU
STILL BE WOULD BE SUPPORT
SUPPORTED THAT THE FDA IF YOU
KNEW THE FDA WASN'T I'M GOING TO
ACT WOULD YOU STILL WANT TO BE
SUPPORTIVE.
I THINK WE LIKE TO SEE AFTER
GIVE FTA THE CHANCE GIVEN THAT
THEY'RE GETTING.
LOS WE THINK ALLOW THAT TO TAKE
ITS COURSE AND IF THEY DON'T
TAKE ACTION.
THAT WE MAY FIND OURSELVES HERE
AGAIN NEXT YEAR AND AND GO FROM
THERE COULD BE AMENDED THE BILL
AMEND LANGUAGE IN THE BILL THAT
WOULD SAY THAT IF THE FDA DID
ACT -- THAN -- THAT WOULD SORT
SUPER CEDAR -- BUT WOULD YOU BE
SUPPORTIVE OF OF OF THAT SO IN
IN LIGHT OF THE FACT MAYBE THE
FDA WON'T.
ACT WE STILL HAVE THE CALIFORNIA
RULE.
I'M JUST CONCERNED ABOUT HAVING
WE DON'T KNOW EXACTLY THE FDA'S
GOING IN THIS GENERAL DIRECTION
AND THEY COULD HAVE A PROVISION
THAT'S DIFFERENT.
AND AND IT MIGHT NOT BE
OBJECTIONABLE BUT IT WOULD BE
ONE THAT COULD POTENTIALLY
CREATE CONFLICTING REQUIREMENTS.
AND SO I'D RATHER SEE THE LETTER
THE FDA PROCESS TAKE ITS COURSE.
SEE WHAT HAPPENS THERE AND AGAIN
IF THEY DON'T MOVE IN THEY DON'T
GO IN THAT DIRECTION AND TO THE
EXTENT.
CALIFORNIA WHICH IS TO DO A
RESOLUTION URGING THE FDA TO DO
THAT ESPECIALLY WITH THE
PRESENCE OF DIETARY SUPPLEMENT.
COMPANIES IN THIS STATE AND THEY
DON'T GO THAT DIRECTION.
THAT'S THEIR DECISION WE HOPE
THAT THEY WOULD AND IF THEY
DIDN'T WE AGAIN LIKE I SAID CAN
FIND OURSELVES BACK HERE AND
HAVE THE DISCUSSION YEAH.
OKAY [inaudible]
OTHER QUESTIONS.
I I HAVE TO FIND THIS A
FASCINATING DISCUSSION -- THE
SUBJECT MATTER ANOTHER DOCTOR
THE LACK OF SCIENCE OVER HERE --
I THINK THAT I I I I APPRECIATE
WITH THE OPPOSITION IS IS IS
COMING FROM BUT I ALSO HAVE TO
RAISE THE SAME CONCERNS THAT
MIGHT CULTURE DID -- OR MY
MOISTURE DID AND THAT'S FREE
WITH REGARDS TO WHAT IF THE FDA
DOESN'T ACT -- WE IN THE
LEGISLATURE HERE WE'RE DEALING --
WAITING FOR THE FDA TO ACT ON E.
CIGARETTES -- AND COMING OUT
WITH CONCLUSIONS ABOUT E.
CIGARETTES AND WE WAITED AND
NOTHING HAPPENED AND WE ALSO
REALLY TOOK ACTION HERE IN THE
STATE LEGISLATURE AND THEN THE
FDA DID ULTIMATELY.
MAKE SOME CONCLUSIONS THERE -- I
KNOW MR QUIRK IS A SCIENTIST --
AND I KNOW THAT MR QUIRK
APPRECIATES THE VALUE OF OF DATA
AND AND AND DOCTOR QUIRK EXCUSE
ME I'M SORRY I'VE BEEN CORRECTED.
DR COURT.
IS A IS A SCIENTIST -- AND I
PRETTY AND I KNOW HE APPRECIATES
FOR STATES THAT -- MY HOPE IS
THAT -- THIS IF THE BILL MOVES
FORWARD THAT -- HE'LL BE MINDFUL
OF WHAT'S HAPPENING WITH THE FDA
AND THAT IF THERE IS A CONFLICT
THAT THAT COULD BE POTENTIALLY
RESOLVED BUT I SEE AN
OVERWHELMING CONSIDERATION FOR
THE VALUE OF THE INFORMATION TO
THE CONSUMER.
AND I DON'T QUITE FRANKLY HAVE A
LOT OF FAITH THAT THE FTA.
WAS GOING TO ACT ANYTIME SOON --
IF THEY DO -- THAT I APOLOGIZE
FOR THAT MIS CHARACTERIZATION
BUT THE TRACK RECORD IS IS NOT
THAT THEY ARE.
PARTICULARLY EXPEDIA AND IN
RESOLVING A LOT OF THESE ISSUES
SO -- SO WITH THAT I WAS KIND OF
A LONG.
THANK YOU FOR MY CLOTHES OKAY.
OF THE BILL DOES -- ENJOYED DO
PASS RECOMMENDATION DOCTOR QUIRK
WOULD YOU LIKE TO CLOSE.
AS FOR YOUR AYE VOTE.
OKAY THANK YOU.
FOR WE DO HAVE -- A MOTION -- BY
MISTER MISS AGUIAR-CURRY A
SECOND BY MISS BURKE THE MOTION
IS TO PASS TO APPROPRIATIONS.
MATT SECTOR PLEASE CALL THE ROLL
WHAT I WOULD AYE MAYES MAYES AYE
AGUIAR-CURRY.
AGUIAR-CURRY I BIGELOW BONTA.
BURKE BURKE I CARILLO.
GRILL I FLORA.
FLOOR AVAILABLE.
LIMóN AYE MCCARTY.
THIS AREA RAMOS.
RAMOS AYE RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO
[inaudible]
WALDRON [inaudible] NINETY YOUR
BILL HAS NINE VOTES I OUT OF
COMMITTEE THANK YOU VERY MUCH
BILLION TO ROLL OVER FOR OTHERS
TO ADD ON AND FOR THE RECORD
WILL COSTS OF POLITICAL SCIENCE
A SOCIAL SCIENCE.
SO -- MISS PARQUET HAND
.
NOT A SCIENTIST SINCE WE'RE
TAKING ROLE AND HE THE
SCIENTISTS AND COMMITTEE MEMBERS
I'M HERE TO PRESENT AN AB
THIRTEEN OH NINE WHICH WOULD
EXTEND CALIFORNIA'S ANNUAL
SPECIAL ENROLLMENT PERIOD.
IN THE INDIVIDUAL MARKET BY TWO
ADDITIONAL WEEKS ALLOWING MORE
CALIFORNIANS ACCESS TO HEALTH
COVERAGE THROUGH A BILL.
AB THIRTEEN OH NINE REMOVED THE
OPEN ENROLLMENT DEADLINE FROM
ITS CURRENT JANUARY FIFTEENTH TO
JANUARY THIRTY FIRST FOR PEOPLE
TO PURCHASE INDIVIDUAL INSURANCE
COVERAGE.
EITHER THROW STATE'S EXCHANGE
COVERED CALIFORNIA -- OFF
EXCHANGE.
AND IT HELPS CONTINUED ACCESS WE
HAVE NEARLY TWO AND A HALF
MILLION CONSUMERS THAT PURCHASE
IN THIS MARKET PLACE.
AND WE NEED TO GIVE PEOPLE TIME
TO DO SO AND GIVING THEM TIME
ONLY DURING THE HOLIDAYS WHEN
THEY'RE RUSHED ISN'T WORKING.
THIS YEAR WHEN WE HAD IT MOVED
TO JANUARY FIFTEENTH WE SAW A
24% DROP IN ENROLLMENT INTO
GIVING THESE EXTRA TWO WEEKS CAN
REALLY ENSURE THAT ADDITIONAL
CALIFORNIANS HAVE ACCESS. TO
COVERAGE IN A MEANINGFUL WAY.
WITH ME TODAY ARE M. J. DS FROM
HEALTH ACCESS CALIFORNIA AND
LINDA IT.
TENER RULE X. FELL BY OTHER
RIGHT AND GET MINE WRONG CENTER
AND GET RIGHT.
FROM THE CALIFORNIA PAN ETHNIC
HEALTH NETWORK TO SPEAK ON THE
BILL.
PLEASE GO AHEAD.
GOOD AFTERNOON MISTER CHAIR AND
MEMBERS AND JDS HERE ON BEHALF
OF HEALTH ACCESS CALIFORNIA THE
STATE WIDE HEALTH CARE CONSUMER
ADVOCACY COALITION.
PROUD TO SPONSOR AB THIRTEEN OH
NINE WHICH PROVIDE WOULD PROVIDE
CONSUMERS TO ADDITIONAL WEEKS TO
SIGN UP FOR COVERAGE IN THE
INDIVIDUAL MARKET. TWO YEARS AGO
YOUR COMMITTEE SUPPORTED
LEGISLATION THAT PRESERVE
CALIFORNIANS THREE MONTHLONG
OPEN ENROLLMENT PERIOD BUT
SHIFTED IT FROM THE MEMBER ONE
TO GENERATE THIRTY FIRST AND TO
OCTOBER FIFTEENTH TWO JERRY
FIFTEENTH.
THIS IS THE FIRST YEAR THAT THE
OPEN ENROLLMENT PERIOD ENDED ON
JANUARY FIFTEENTH AND AS
MENTIONED BY THE AUTHOR WE SAW
TWENTY FOUR PER 24% DROP IN YOU
ENROLLMENT WHICH FAR SURPASS THE
16% DROP IN ENROLLMENT.
AT THE FEDERAL MARKETPLACE IN
TWENTY EIGHTEEN COVER CALIFORNIA
DELAYED MARKETING AND
ADVERTISING UNTIL AFTER THE
ELECTIONS IN NOVEMBER TO AVOID
COMPETING WITH ELECTIONS
CAMPAIGNS ADD.
THIS EFFECTIVELY SHORTEN THE
OPEN ENROLLMENT PERIOD BY THREE
WEEKS AND EVERY YEAR COVER
CALIFORNIA HAS ALSO HAS TO
COMPETE WITH HOLIDAYS HE'S IN
CAMPAIGNING.
THIS BILL WOULD ENSURE
CALIFORNIANS HAVE PLENTY OF TIME
AFTER THE NEW YEAR BEGINS SO
THAT THEY CAN LEARN ABOUT
DIFFERENT CAUGHT COVERAGE
OPTIONS AND ACTUALLY BUY INTO.
A COVERAGE FOR THESE REASONS WE
ASK FOR YOUR I THINK YOU.
LINDA TO HEAR WHAT'S ON BEHALF
OF THE CALIFORNIA PAN ETHNIC
HEALTH NETWORK -- WE FIND THAT
THIS EXTENSION IS PARTICULARLY
IMPORTANT FOR COMMUNITIES OF
COLOR AS THIS IS TRULY AN ISSUE
OF ACCESSIBILITY -- RECENT COVER
CALIFORNIA DATA ON THEIR
ENROLLMENT NUMBERS IS ACTUALLY
REVEALED THAT THERE'S BEEN A
DECREASE IN SPANISH AND KOREAN
SPEAKING ENROLLEES SO THIS IS
REALLY CONCERNING AND IT'S
CRITICALLY IMPORTANT THAT WE
PROVIDE COMMUNITIES AND
ESPECIALLY COMMUNITIES WITH
LIMITED ENGLISH PROFICIENCY.
THE OPPORTUNITY TO FULLY LEARN
AND UNDERSTAND WHAT COVERAGE
OPTIONS ARE AVAILABLE TO THEM
AND THAT THEY CAN STAY AND
ENROLL IN COVERAGE EASILY.
THANK YOU VERY MUCH OTHERS IN
SUPPORT.
VIDEO ONE REPRESENTING AMERICAN
ACADEMY OF PEDIATRICS AND
SUPPORT THANK YOU.
ON A MOUNTAIN SMITH WITH THE
AMERICAN CANCER SOCIETY CANCER
ACTION NETWORK ALSO IN SUPPORT.
MARK MENDOZA WITH AS HE ARE YOU
CALIFORNIANS SUPPORT.
GEN FLORI FOR WESTERN CENTER ON
LAW AND POVERTY IN SUPPORT THANK
YOU.
RENDON MARCHING WITH THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT.
BREANNA THURMAN SPENCER WITH THE
DENTAL ASSOCIATION IN SUPPORT.
ON A HOUSE OF AYE WITH UNITED
WAYS OF CALIFORNIANS SUPPORT
THANK YOU.
ANTHONY GLASSER WITH THE GREEN
LINING INSTITUTE IN SUPPORT
THANK YOU VERY MUCH [inaudible]
ANYONE ELSE. THREE ONE IN
OPPOSITION.
WELL MISTER CHAIR NUMBERS NICK
LOUISE US ON BEHALF OF THE
CALIFORNIA ASSOCIATION HEALTH
PLANS WHICH I HAVE AN OPPOSE
UNLESS AMENDED POSITION ON THIS
BILL.
AND I'D LIKE TO THINK THE AUTHOR
STAFF IN THE SPONSOR FOR MEETING
WITH US THE OTHER DAY.
WE HAD A CONSTRUCTIVE
CONVERSATION AT LEAST ONE OPTION
WAS THROWN OUT THERE THAT WERE --
YOU KNOW TING BACKS WHERE
MEMBERS I THINK THE ISSUE FOR
THE HEALTH PLANS -- MISTER
MEMBERS IS THAT UNDER THIS BILL --
THOSE FOLKS THAT KIND OF HIT THE
ENROLLMENT DEADLINE -- PER PER
THE TENETS OF THIS BILL WOULDN'T
START THEIR COVERAGE UNTIL MARCH
FIRST AS OPPOSED TO THE CURRENT
A FEBRUARY FIRST START TIME.
AS YOU KNOW UNDER THE FEDERAL
RULES IF WE ADOPTED THEM HERE
THEY REVIEW JANUARY FIRST START
FOR COVERAGE THAT MEANS MORE
COVERAGE FOR CONSUMERS. FOR THE
HEALTH PLANS IN TERMS OF PREMIUM
DEVELOPMENT IT'S HELPFUL TO HAVE
A FULL YEAR OF OF OF RATES -- SO
THAT WE CAN -- YOU KNOW BASE --
YOU KNOW NEXT YEAR'S RATES ON
EXPERIENCE AND AND IN A FULL
YEAR PREMIUM SUPPORT.
SO -- THE GOOD THING ABOUT
HAVING A BILL IS PERHAPS WE CAN
SETTLE THIS AS YOU KNOW WE'VE
BEEN HAVING A BILL EVERY YEAR
AND IT'S KIND OUR OUR OUR OUR
PLANS LIKE PREDICTABILITY I WHEN
IT COMES TO COVER CALIFORNIA --
AND IMPLEMENTING THIS SCENE IN
THE INDIVIDUAL MARKET SO WE HOPE
TO COME TO TERMS YOU KNOW OUR
OUR OUR PRINCIPLE IS THAT
CONSUMERS SHOULD HAVE -- A FULL
YEAR OF COVERAGE OR CLOSE TO IT
AND FOR MARKET STABILITY IT'S
HELPFUL TO HAVE A FULL YEAR OF
PREMIUMS TO SUPPORT THE
INDIVIDUAL MARKET FINANCIALLY SO
HOPEFULLY WE CAN COME.
TO SOME SORT OF AGREEMENT ON
THIS BILL BUT WE'RE OPPOSE
UNLESS AMENDED AT THIS TIME
THANK YOU.
THANK YOU VERY MUCH IS THERE
ANYONE ELSE IN OPPOSITION.
SEE KNOWN BRING HIM BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS FROM THE
COMMITTEE.
SEEING NONE -- THE BILL DOES
ENJOY THE PAST RECOMMENDATIONS
FOR WE HAVE A MOTION BY MISTAKE
YEAR CURRY IN A SECOND BY MISS
BURKE WHICH LIKE TO CLOSE
RESPECT FASTER AND I PUT THANK
YOU VERY MUCH THANK YOU.
MADAM SECRETARY THE BILL -- THE
MOTION IS TO PASS TO
APPROPRIATIONS PLEASE CALL THE
ROLL.
WHEN I WHEN I MAYES?
MAYES NOT VOTING AGUIAR-CURRY
AGAR CURRY I BIGELOW.
BONTA.
BURKE BURKE I CARILLO.
CARILLO I'D FLORA. FOR NOT
VOTING LIMóN.
THE LOAN I MCCARTY [inaudible]
NAZARIAN.
RAMOS.
PROMISE I RODRIGUEZ.
RODRIGUEZ I SANTIAGO WALDRON.
SEVEN YES SEVEN SEEMS TO THE
MAGIC NUMBER WILL LEAVE THE BILL
ON CALL THANK YOU VERY MUCH
THANK YOU TANK MANY [inaudible]
MR BERMAN.
SERVING YOU HAVE AB [inaudible]
THIRTEEN TWENTY TWO WHAT WHAT.
THANK YOU MISTER CHAIRMAN
COLLEAGUES.
SCHOOL BASED HEALTH SERVICES
PLAY A KEY ROLE IN ENSURING THAT
CALIFORNIA STUDENTS ARE SAFE AND
READY TO LEARN WAS OUR SECOND.
WAS BIPARTISAN I'LL BE QUIET --
RESPECTFULLY ASK DR A AS AS YOU
WISH YEAH ARE THERE OTHERS IN
SUPPORT [inaudible]
PLEASE [inaudible]
ABBREVIATED.
ABOUT TWO MINUTES IS THAT RIGHT
GO FOR THAT SOUNDS GREAT GOOD
AFTERNOON EVERYONE MY NAME IS
TRACY MENDEZ AND THE EXECUTIVE
DIRECTOR FOR THE CALIFORNIA
SCHOOL BASED HEALTH ALLIANCE CSE
TODAY'S BEEN A CO SPONSOR OF AB.
THIRTEEN TWENTY TWO AND WE'VE
BEEN BRINGING TOGETHER HEALTH
AND EDUCATION STAKEHOLDERS ON
BEHALF OF CALIFORNIA CHILDREN
FOR THE PAST TWENTY YEARS.
WE KNOW THERE'S A CRITICAL AND
GROWING NEED I KNOW YOU KNOW IT
BECAUSE YOU'RE READY TO MOVE
FORWARD. FOR SCHOOL BASED HEALTH
CARE -- INTO MANY CASES --
SCHOOLS ARE THE ONLY PLACE WHERE
CHILDREN CAN OR AT LEAST DO
RECEIVE THE PRIMARY CARE NURSING
DENTAL VISION AND MENTAL HEALTH
SERVICES THEY NEED TO SUCCEED IN
SCHOOL.
WE'VE BEEN EXCITED BY THE
TREMENDOUS GROWTH IN BOTH THE
VOLUME AND VARIETY OF SCHOOL
BASED HEALTH SERVICES OFFERED IN
CALIFORNIA FOR NOW OVER THE LAST
SEVERAL YEARS.
BUT SCHOOL DISTRICTS THEMSELVES
AND ALSO BY THEIR LOCAL HEALTH
CARE PROVIDERS.
HOWEVER IT'S OFTEN DIFFICULT FOR
HEALTH AND EDUCATION -- PARTNERS
TO NAVIGATE THE COMPLEX TO REIGN
OF THESE TWO DIFFERENT SECTORS --
I WILL SHORTEN MY STATEMENTS
JUST TO SAY IT IS DIFFICULT AND
WE KNOW THAT MANY STATES HAVE --
KIND OF RESOLVE THIS TENSION BY
CREATING OFFICES OF SCHOOL
HEALTH IN THE DEPARTMENT OF
EDUCATION TO HELP NAVIGATE THE
TERRITORY.
AB THIRTEEN TWENTY TWO WOULD ADD
SIMILAR INFRASTRUCTURE THAT WE
THINK WOULD BE VERY SUPPORTIVE
TO SCHOOLS THEIR PARTNERS AND
YOUTH AND IN WORKING THROUGH
THESE DIFFICULT ISSUES -- I WILL
CLOSE BY JUST RESPECTFULLY
REQUESTING YOUR AYE VOTE WHICH
ALREADY GIVEN.
MR CHAIRED TONY TO BEAR ON THE
HAVE THE CALIFORNIA TEACHERS
ASSOCIATION I TO WILL TRYING AND
BRIEF YET MY COMMENTS.
THE SERGEANTS HANDING OUT A
DOCUMENT THAT THE JOINT
LEGISLATIVE AUDIT COMMITTEE JUST
PRODUCED -- LOOKING AT THE
DEPARTMENT OF HEALTH CARE
SERVICES AND CALIFORNIA RANKS
FORTY EIGHT OF THE FIFTY STATES
AND SERVICES AND WE BILL LESS
THAN 50%. FOR PREVENTATIVE CARE.
LAST YEAR'S SCHOOL DISTRICTS
WERE IDENTIFIED A HUNDRED AND
FORTY EIGHT MILLION DOLLARS IN
PROPOSITION NINETY EIGHT FUNDS
THAT THEY'RE GONNA HAVE TO PAY
BACK THIS YEAR.
BECAUSE OF A LACK OF TECHNICAL
ASSISTANCE PROVIDED TO THEM BY
THE DEPARTMENT OF HEALTH CARE
SERVICES LASTLY THE LEGISLATURE
PASSED IN THE GOVERNOR SIGNED A.
B..
THIRTY ONE NINETY TWO THE
CREATES A PROGRAM UP PROGRAM
GUIDE FOR DISTRICTS TO HOPEFULLY
GET TECHNICAL ASSISTANCE FROM
THE DEPARTMENT.
THAT'S WHAT WE'RE ASKING FOR
THAT'S WHAT STUDENTS STUDENTS
DEMAND WE ARE HOPEFUL THAT THIS
YEAR WE WILL.
REACH THE FINISH LINE TO GET A
GOVERNOR'S THAT SIGNATURE ON THE
CREATION OF AN OFFICE OF SCHOOL
BASED HEALTH WE ASK FOR YOUR AYE
VOTE.
THANK YOU.
VERY MUCH OTHERS TO SUPPORT. ONE
REPRESENTS ALL FOR YOU SCHOOL
NURSES WE ARE PROUD CO SPONSORS
OF AB. THIRTEEN TWENTY TWO S. WE
I'VE.
THANK YOU VERY MUCH.
HELEN ROSS THOUSAND TEACHERS FOR
HEALTHY KIDS IN FULL SUPPORT
WERE BECAUSE SPONSORS THANK YOU.
ON A HAS A BY THE UNITED WAYS OF
CALIFORNIA AS WELL AS ON BEHALF
OF CHILDREN'S DEFENSE FUND OF
CALIFORNIANS STRONG SUPPORT
THANK YOU.
MORE SECONDS ALSO ME HALF OF THE
NATIONAL ASSOCIATION OF SOCIAL
WORKERS IN STRONG SUPPORT.
THANK YOU VERY MUCH [inaudible]
ANYONE ELSE. THIRTY ONE IN
OPPOSITION.
SEE NUMBER BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS ANY QUESTIONS OR
COMMENTS.
MISS MISS AGUIAR-CURRY.
YOU KNOW THANK YOU VERY MUCH SO
MEMBER FOR BRINGING THIS FORWARD
AND THE REASON IT IS IRONIC THAT
I JUST SPENT SOME TIME WITH SOME
OF THE TEACHERS AND OF THE
ISSUES OF THAT ARE JUST --
SNOWBALLING IN OUR SCHOOLS AND
TO BE ABLE TO HELP SOME OF THESE
THE HOSE STUDENTS HAVE SOME SOME
KIND OF HEALTH CARE HEALTH
SERVICES.
I SHOULD LIKE YOU TO DRAG THE
PARENTS IN ON SOME OF THESE
BECAUSE THERE ARE CRISIS IN OUR
SCHOOLS AND OUR FAMILIES.
SO THANK YOU FOR BRING THIS FOR
THANK YOU.
SO THE THE BILL ENJOYS A DO PASS
RECOMMENDATION -- WE HAVE A
MOTION BY MISS -- CARILLO SECOND
BY MISTER -- SO MUCH BY MR FLORA
SECOND BY MISS CARILLO -- WHICH
I TO CLOSE MISTER BERMAN I DO
THANK YOU VERY MUCH MY
COLLEAGUES I COME I COME IT'S
INCREDIBLY SHORT BECAUSE OF THE
EARLY BIPARTISAN SUPPORT BUT
THIS IS A REALLY IMPORTANT BILL --
THAT WILL INCREASE ACCESS TO TO
HEALTH SERVICES FOR A LOT OF
STUDENTS AND DRAW DOWN FEDERAL
FUNDS TO DO THAT SO I JUST
REALLY APPRECIATE ALL YOUR ALL
SUPPORT -- FOR THIS BILL THANK
YOU WE APPRECIATE YOU VERY MUCH
BRING THE BILL FOR THINGS LIKE
THAT MA'AM SECRETARY THE MOTION
IS TO PASS.
OF PLEASE CALL THE ROLL.
WHAT I WOULD AYE MAYES?
MAYES AYE AGUIAR-CURRY.
I GET CREE AYE BIGELOW BONTA
BURKE.
BURKE I CARILLO CARILLO AYE
FLORA FLOOR I LEVEL.
LIMON AYE MCCARTY.
NAZARIAN.
NAZARIAN AYE RAMOS.
PROBLEMS I RODRIGUEZ -- YES AYE
SANTIAGO WALDRON.
YOU HAVE TEN VOTES SAYS OF THE
BILLS OUT WILL LEAVE THE ROLE
OPEN FOR OTHERS TO ADD ON THANK
YOU MISTER CHAIR THANK YOU
THANKS VERY MUCH.
SO OUR NEXT -- MISTER FLORA
.
ALL RIGHT THANK YOU MISTER CHAIR
MEMBERS.
WAS STARTUP ACCEPTING THE
COMMITTEES AMENDMENTS AND THANK
YOU FOR YOUR STAFF AND ALL OF
YOUR EFFORTS I'M HERE TO PRESENT
AB SIX SEVENTY EIGHT WHICH WILL
RESTORE.
BUT IT COVERAGE UNDER MEDICARE
AL.
AND MAKE AUTHORIZATIONS BILLING
POLICY CONSENT.
WITH THAT OF ANY POSITION
PERFORMING THE SAME SERVICES AS
YOU MAY KNOW BUDGET CUTS IN TWO
THOUSAND I AM ELIMINATED PUT IT
SERVICES UNDER MEDICARE.
BECAUSE OF THIS PODIATRISTS ARE
PROHIBITED FROM PREFER.
PROVIDING SERVICES TO PATIENTS
AUTOMATIC OUT UNLESS CERTAIN
CONDITIONS ARE MET.
LIMITATIONS OF NOT HAVE LED TO A
DELAY IN FOOT TREATMENT.
MOST OFTEN RESULTING IN PATIENTS
WAITING FOR WAIT UNTIL
COMPLICATIONS ARE SO BAD THEY
REQUIRES COSTLY ER VISITS.
THESE RESTRICTIONS HAVE WILL
WORSEN AN ALREADY CUTE ACCESS
PROBLEM FOR LOW INCOME.
THE DISABLED POPULATION STUDIES
SHOW THAT BY OFFERING COVERAGE
PROVIDERS CAN PREVENT
COMPLICATIONS FOR PATIENTS.
AND ACTUAL PROVIDE OVERALL
SAVINGS.
AB.
SIX SEVENTY FOUR EIGHT AS A STEP
IN THE RIGHT DIRECTION.
IT WOULD STREAMLINED POLICIES
PROVIDE BETTER HEALTH CARE
OUTCOMES FOR MOST VULNERABLE
POPULATIONS HERE TO TESTIFY IN
SUPPORT AND ANSWER ANY TECHNICAL
QUESTIONS.
AS DR JOHN GRISHAM.
GO AHEAD SIR CHAIRMAN WHAT
NUMBERS THAT MANY THANK YOU.
I'M JOHN CHISHOLM -- I'M JUST
PRESIDENT OF THE CALIFORNIA
POLICE AFTER MEDICAL ASSOCIATION.
I'M ALSO A PODIATRIST I'VE BEEN
IN PRIVATE PRACTICE IN CHULA
VISTA CALIFORNIA FOR OVER THIRTY
YEARS SERVING ONE OF THE MOST.
MOST ETHNICALLY DIVERSE AND
UNDERSERVED AREAS OF THE STATE
FOR MY ENTIRE CAREER.
THIS POPULATION RELIES HEAVILY
ON THE MEDICAL SYSTEM.
AND FOR THE LAST TEN YEARS HAVE
SUFFERED FROM A LACK OF ACCESS
TO QUALITY FOOT AND ANKLE CARE
THEIR TWO REASONS FOR THIS THE
FIRST IS THAT SERVICES VICE
PODIATRIST HAVE NOT YET BEEN
REINSTATED AND ALL HEALTH HEALTH
CARE SETTING SETTINGS.
AND SECOND PODIA TRICK SERVICES
ARE SUBJECT TO ONEROUS AND
UNNECESSARY AUTHORIZATION
BILLING AND SERVICE REQUIREMENTS
THAT FURTHER LIMIT ACCESS.
WHEN PRIDE FREE SERVICES WERE
LIMITED FOR MEDI CAL IN TWO
THOUSAND NINE THIS ELIMINATION
APPLY TO A TYPE OF PROVIDER BUT
I INTEREST?
BUT NOT THE SERVICES THEMSELVES.
IN OTHER WORDS PRIDE FIRST THE
SPECIALISTS AND PUT NICKEL CARE
ARE PREVENTED FROM PROVIDING THE
EXACT SAME SERVICES AS POSITIONS
FOR MEDICAL PATIENTS.
BUT POOL RESTORATION ALONE WILL
NOT SOLVE THE PROBLEM.
BUT ACCESS CURRENTLY SERVICES BY
PODIATRISTS ARE SUBJECT TO AN
ENTIRELY DIFFERENT SET OF
AUTHORIZATION BILLING AND
SERVICE REQUIREMENTS THAN
POSITIONS AS YOU CAN SEE IN THE
HANDOUT BEFORE YOU.
AS A MEDICAL PROVIDER FOR
PROVIDER FOR MY ENTIRE CAREER I
CAN ATTEST TO THE DIFFICULTY
INVOLVED IN TRYING TO MEET ALL
THESE REQUIREMENTS.
LET ME GIVE YOU AN EXAMPLE.
THERE'S AN EPIDEMIC OF DIABETES
AND DIET BECAUSE DIABETES
RELATED FOOT NICKEL DISEASE IN
CALIFORNIA MY OWN COMMUNITY IS
BEING PARTICULARLY DEVASTATED.
DIABETIC FOOT ULCERATIONS IN
TEMPTATIONS HAVE BEEN INCREASING
STEADILY SINCE PROVIDE FREE
SERVICES WERE ELIMINATED TEN
YEARS AGO.
THE PREVENTATIVE PUT CARE THAT
WOULD HAVE PREVENTED THESE
ALTERATIONS NOT A COVERED
BENEFIT.
AND TREATING THE AUTHORIZATION
LIKE ALL OF THE OPTIONAL
SERVICES IS LIMITED TO VISITS
PER MONTH I TREAT DIABETIC FOOT
WOUNDS ALL DAY EVERY DAY IT
TAKES MORE THAN ONE OR TWO
VISITS A MONTH TO HEAL A
DIABETIC FOOT INFECTION.
A DIABETIC FOOT WOUND AS AN
EMERGENCY LIFE THREATENING
CONDITION THE MEDICAL PROVIDER
MANUAL AGREES IN THIS PROCEDURE
DOES NOT REQUIRE PRIOR
AUTHORIZATION FOR A POSITION.
BUT PRIOR AUTHORIZATION IS
REQUIRED FOR ANY PROCEDURE OR
TREATMENT BY A PODIATRIST
REGARDLESS OF SEVERITY.
SO WHAT HAPPENS IS THE TREATMENT
OF THE INFECTION IS DELAYED OR
NOT TREATED ADEQUATELY IT
BECOMES LIFE THREATENING.
PATIENT LOSES THEIR LAKE.
THE SCENARIO I JUST PRESENTED IS
TYPICAL IT'S PREVENTABLE AND
IT'S WRONG.
WE NOW HAVE A CHANCE TO MAKE IT
RIGHT PLEASE VOTE IN SUPPORT OF
AB. SEVEN EIGHTY SIX SEVENTY
EIGHT THANK YOU.
THANK YOU VERY MUCH OTHERS IN
SUPPORT.
RENDON MARGIE WITH THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT.
THANK YOU.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY IN SUPPORT.
THANK YOU VERY MUCH OTHERS IN
SUPPORT. THREE ONE IN OPPOSITION.
SEE NO ONE WILL BRING YOU BACK
TO THE COMMITTEE FOR QUESTIONS
OR COMMENTS.
SEEING NONE WE HAVE A MOTION BY
MISTER MAYES SECOND BY MISS
CARILLO MOTION IS TO PASS AS
AMENDED TO A PROBES.
WHICH LIKE CLOSE MISTER FOR JUST
RESPECT LAST RIVAL THANK YOU I
JUST LIKE TO THANK YOU FOR
BRINGING THE BILL FORWARD -- AND
I WITH THANK YOU FOR YOUR WORK --
IN IN AND SERVING THE MEDICARE
POPULATION AND AND AND AND GREAT
IN GREAT NUMBERS A IT'S VERY
MUCH APPRECIATED -- I THANK YOU
FOR BRING TO GO FORWARD -- DOES
PASS ABBOTT DO PASS
RECOMMENDATION MA'AM SECRETARY
PLEASE CALL THE ROLL.
IT'S TO PASS AS AMENDED TO
APPROPRIATIONS WHAT.
I WHAT I MAYES MAYES AYE
AGUIAR-CURRY AGAR CURRY I
BIGELOW.
BIGELOW AYE BONTA [inaudible]
BURKE.
BURKE I CARILLO.
CARILLO AYE FLORA.
FLORA AYE LIMóN.
THE PHONE I MCCARTY.
NAZARIAN.
NAZARIAN AYE RAMOS.
FROM US I RODRIGUEZ RODRIGUEZ
AYE SANTIAGO [inaudible]
WALDRON. ELEVEN VOTES YOUR BILL
IS OUT SIR LEAVE THE ROLE OPEN
FOR OTHERS TO ADD ON THANK YOU
SO MUCH.
MISS BURKE.
AB -- NINE SIXTY TWO THANK YOU
MISTER CHAIR AND MEMBERS I'D
LIKE START A THINKING THE CHAIR
THE COMMITTEE FOR THEIR STAFF.
FOR THE WORK ON THE BILL AND I
WILL BE ACCEPTING THE AMENDMENTS.
AB NINE SIXTY TO OUR CARS
HOSPITALS WITH OVER TWENTY FIVE
MILLION IN OPERATING EXPENSES TO
ANNUALLY DISCLOSE.
IN A PUBLIC REPORT TO THE OFFICE
OF STATEWIDE HEALTH PLANNING AND
DEVELOPMENT THEIR GOALS AND
EFFORTS IN REGARDS TO THEIR
PROCUREMENT OF SUPPLIES.
FROM WOMEN MINORITIES.
WOMEN MINORITY LGBT A VETERAN
OWNED BUSINESSES EIGHTY NINE
SIXTY TWO ALSO REQUIRES A REPORT
TO INCLUDE INFORMATION ABOUT
WHICH PROCUREMENTS ARE MADE FROM
DIVERSE BUSINESSES. TO THE
EXTENT THAT THAT INFORMATION IS
AVAILABLE. EIGHTY NINE SIXTY TWO
DOES NOT REQUIRE QUOTAS FOR A
HOSPITAL'S PROCUREMENT POLICY IT
MERELY REQUIRES THE DISCLOSURE
OF THEIR PROCUREMENT PRACTICES.
OUR STATE IS ONE IS ONE THAT
TAKES PRIDE IN ITS DIVERSITY AND
IT IS FOR THAT REASON THAT WE
MUST CONTINUE TO PROMOTE
ECONOMIC OPPORTUNITY FOR ALL.
PARTICULARLY THOSE WHO HAVE
HISTORICALLY BEEN MARGINALIZED
DIVERSE BUSINESSES PROVIDE
NUMEROUS BENEFITS TO LOCAL
ECONOMIES ACCORDING THE U. S.
SMALL BUSINESS ADMINISTRATION
42% OF ALL BUSINESSES IN THE
STATE ARE.
MINORITY OWNED FOR THE MORE
DIVERSE BUSINESSES ARE MORE
LIKELY TO OPERATE AS SMALL
BUSINESS AND HIRE PEOPLE FROM
DIVERSE BACKGROUNDS PROVIDING A
PATHWAY TO FINANCIAL SECURITY
AND UPWARD MOBILITY FOR
HISTORICALLY UNDERSERVED
COMMUNITIES.
REQUIRING HOSPITALS TO BE
TRANSPARENT IN THEIR PROCUREMENT
EFFORTS AND PRACTICES AB NINE
SIXTY TO ENSURE THAT OUR WOMEN
MINORITY LGBT AND VETERAN OWNED
BUSINESSES HAVE ACCESS TO MORE
BUSINESS OPPORTUNITIES WITH THAT.
I REQUEST BY FLEA REQUEST AN
ANKLE.
GOOD AFTERNOON MISTER CHAIR AND
MEMBERS OF THE COMMITTEE AND
THANK YOU SO MEMBER BURKE FOR
YOUR LEADERSHIP ON THIS
IMPORTANT ISSUE.
MY NAME IS ANTHONY GLASS AND I'M
THE DIRECTOR OF HEALTH EQUITY AT
THE GREEN LINING INSTITUTE WHERE
STATEWIDE MULTIETHNIC POLICY
ORGANIZATION COMMITTED TO RACIAL
AND ECONOMIC JUSTICE.
WE ARE PROUD TO SUPPORT AB NINE
SIXTY TWO BECAUSE THIS BILL WILL
PROMOTE DIVERSITY EQUITY
INCLUSION BY REQUIRING HOSPITALS
TO ANNUALLY DISCLOSE THEIR
SUPPLIER DIVERSITY GOALS.
AND THE OVERALL PROCUREMENT OF
WITH THE BURST BUSINESSES OWNED
BY PEOPLE OF COLOR.
OUR STATE CURRENTLY LACKS THE
THE DATA ABOUT WHETHER OR HOW
HOSPITAL'S REFLECTING ENGAGE
DIVERSE BUSINESSES IN THEIR
PROCUREMENT PRACTICES.
WITHOUT THIS INFORMATION ALL WE
CAN DO THE SPECTER SPECULATE
ABOUT THE HEALTHCARE SECTORS
ENGAGEMENT WITH DIVERSE
BUSINESSES. EIGHTY NINE SIXTY TO
ALLOW HEALTHCARE BUSINESS AND
GOVERNMENT LEADERS TO ENGAGE IN
AN ON IT HONEST AND TRANSPARENT
DISCUSSION.
ABOUT LEVERAGING THE GROWTH OF
THE HEALTH SECTOR TO BENEFIT
DIVERSE BUSINESSES AND THE
COMMUNITIES THEY SERVE.
ACCORDING TO THE AMERICAN
HOSPITAL ASSOCIATION HOSPITALS
CONTRIBUTED OVER TWO HUNDRED
THIRTY BILLION DOLLARS INTO THE
STATE'S ECONOMY AND TWENTY
SIXTEEN FURTHERMORE.
NUMEROUS EXAMPLES SUGGEST THAT
SUPPLIER DIVERSITY EPORTING
REQUIREMENTS WILL LEAD TO
INCREASED OPPORTUNITIES IN
CAPITAL FOR DIVERSE BUSINESSES.
FOR EXAMPLE WHEN THE CPUC BEGAN
TRACKING SUPPLIER DIVERSITY
AMONG UTILITIES IN.
NINETEEN EIGHTY SIX DIVERSE
BUSINESSES ONLY RECEIVED WO
POINT SIX MILLION DOLLARS IN
CONTRACTS.
HOWEVER BY TWENTY SEVENTEEN
UTILITIES PROCURED OVER TEN
BILLION DOLLARS FROM DIVERSE
SUPPLIERS.
ADDITIONALLY WENT AFTER THE
DEPARTMENT OF INSURANCE BEGAN
TRACKING SUPPLIER DIVERSITY IN
TWENTY SIX AT TWENTY TWELVE
CONTRACTING BETWEEN LARGE
INSURERS AND DIVERSE BUSINESSES.
INCREASED BY 90% FROM NINE
HUNDRED THIRTY MILLION.
IN TWENTY TWELVE TO ONE POINT
EIGHT BILLION IN. TWENTY
SEVENTEEN HOSPITALS ARE UNIQUELY
POSITIONED TO BUILD
RELATIONSHIPS WITH THE
COMMUNITIES THEY SERVE MY
PARTNER IN CONTRACTING WITH
DIVERSE BUSINESSES.
AS A RESULT OF AB NINE SIXTY TWO
CALIFORNIA CAN LEVERAGE THE
EXPANSION OF THE STATE'S HEALTH
SECTOR TO BENEFIT SMALL
BUSINESSES THAT EMPLOY PEOPLE OF
COLOR WOMEN LGBT PEOPLE AND
VETERANS.
SIMILAR TO PREVIOUSLY ENACTED
SUPPLIER DIVERSITY LEGISLATION.
OUR STATE WILL BENEFIT FROM
GREATER TRANSPARENCY AND
INCREASED BUSINESS OPPORTUNITIES
FOR DIVERSE BUSINESSES ACROSS
THE STATE.
THANK YOU NOT RESPECTFULLY
REQUEST RIVAL.
VERY MUCH IS THERE ANYONE ELSE
IN SUPPORT.
NO ONE IS THERE ANY OPPOSITION.
CATHERINE ALSO GOT THE
CALIFORNIA HOSPITAL ASSOCIATION
WHERE IMPOSE UNLESS AMENDED --
POSITION [inaudible]
WE I HAVE BEEN TALKING WITH THE
AUTHORS OFFICE AND I THINK
THERE'S PLACES WHERE WE CAN
AGREE HOSPITALS DON'T HAVE
POLICIES RELATED TO SUPPLIER
DIVERSITY.
I THINK OUR STRUGGLE IS IS THAT
WHEN WE LOOKED AT WHAT OUR
SUPPLIERS WERE. 60% OF OUR
SUPPLIERS ARE LARGE
PHARMACEUTICAL COMPANIES LARGE
G. PO'S THAT MAN THAT WE WORK
WITH TO CREATE A LOWER PRICE ON
BRANDED DRUGS.
OF PHARMACEUTICALS AND OTHER
MACHINERY AND EXCEPT FOR THAT'S
IN OUR HOSPITALS AND ANOTHER 20%
IS ON OUR A REGULARLY UTILIZED
SUPPLIES LIKE TAPE EXCEPT FOR
THESE ARE MULTINATIONAL
COMPANIES THAT -- I THINK ONLY A
FEW [inaudible]
VERY FEW.
I'M TALKING MAYBE THE TWO
LARGEST SYSTEMS COULD HAVE AN
IMPACT IN CREATING MORE
DIVERSITY IN THAT SPACE SO WHEN
WE THINK ABOUT OUR DIVERSITY AND
HOW WE CAN MAKE AN IMPACT IN OUR
CHOICES WE'RE REALLY TALKING
ABOUT THOSE SMALLER BUSINESS
WHICH IS OUR UNFORTUNATELY AT A
VERY SMALL NUMBER.
SO I THINK WHERE WE'D LIKE TO
CONTINUE THE CONVERSATION WITH
THE AUTHOR IS HOW CAN WE HELP
LEVERAGE THOSE DOLLARS -- BUT AT
THE SAME TIME RECOGNIZE AND NOT
PENALIZE OUR HOSPITALS IN THEIR
REPORTING -- THAT THEY AREN'T
GOING TO DIVERSE COMPANIES
BECAUSE THEY'RE LOOKING FOR THE
PRICE RELATED TO THOSE GPO SO
AGAIN.
FOCUSED ON THAT HEALTH CARE
PRICE.
OTHERS IN OPPOSITION.
BIRTH CONNIE DELGADO ON BEHALF
OF THE DISTRICT HOSPITAL
LEADERSHIP FORUM I WOULD LIKE TO
ECHO THE COMMENTS OF THE
HOSPITAL ASSOCIATION.
WE DO YOU HAPPEN OPPOSE UNLESS
AMENDED POSITION THANK YOU.
WOULD YOU LIKE TO COME IN YES I
CAN JUST DO IN MY CLOTHES OKAY
THAT'S FINE -- INDIA ANYONE ELSE
IN OPPOSITION.
SEE NO QUESTIONS OR COMMENTS
FROM THE COMMITTEE.
WOULD YOU LIKE YES US SO TO THE
OPPOSITION YES WE ARE WORKING
WITH THEM HOWEVER I WOULD LIKE
TO STATE THAT HISTORY HAS SHOWN
WITH WITH BOTH THE PC AND OTHER
AND OTHER REGULATORS THAT THAT.
THIS SORT OF LEGISLATION DOES
HELP TO CREATE MORE DIVERSITY
AND WHETHER YOU AND THE BILL
DOES SAY FOR THOSE WHO DO HAVE
THE CAPACITY TO REPORT -- I
THINK IT'S IMPORTANT I THINK
THAT DIVERSITY IS IMPORTANT AND
I THINK WHATEVER PRESSURE WE PUT
ON THE SYSTEM TO CREATE THAT
KIND OF SUPPLIER DIVERSITY IS
THINK IT SHOULD BE IMPORTANT
THAT STATE AS THE CAN THE STATE
OF CALIFORNIA.
WITHOUT A RESPECTFULLY REQUEST I
WILL.
THANK YOU SO MUCH FOR BRING THE
BILL FORWARD IS DOES ENJOY DO
PASS RECOMMENDATION -- TO HAVE A
MOTION.
OF THE MOTION BY MISS CARILLO
SECOND BY MISTER NAZARIAN
ABILITY TO CORRECT. THIRTY I'M
SO WHO WAS THAT.
IT WAS MISTER RODRIGUEZ I'M
SORRY I'M HEARING THINGS I HAD
TO MISTER MISTER RODRIGUEZ THE
MOTION IS DOOMED PASS AS AMENDED
TO APPROPRIATIONS.
A MATTER.
DID YOU ACCEPT AMENDMENTS YES
YES I THANK YOU -- THAN SURGERY
PLEASE CALL THE ROLL WHAT I
WOULD AYE MAYES.
AGUIAR-CURRY AGAR CURRY I
BIGELOW.
BIGELOW NO BONTA.
BURKE.
BURKE I CARILLO CREEL AYE FLORA.
LIMON.
LOW MOAN AYE MCCARTY.
THIS.
NAZARIAN AYE RAMOS.
ROSS HI RODRIGUEZ.
RODRIGUEZ I SANTIAGO WALDRON.
YOU HAVE EIGHT VOTES WILL LEAVE
THE ROLE OPEN FOR OTHERS TO ADAM
THANK YOU. TWO MORE VOTE TO MORE
BILLS FOLKS AND THEN -- THREE MR
IS AREA I'M SORRY.
SMITH HEARING HAS A BILL BEFORE
US.
I THOUGHT HE DID A
THANK YOU
MISTER CHAIR AND MEMBERS.
AB [inaudible]
TWENTY THREE TWENTY EIGHT NO.
TEN THIRTY ONE YEAH PLEASE THAT
WOULD BE BETTER.
THANK YOU THE RIGHT.
ONE AB TEN THIRTY ONE WOULD
REQUIRE THE DEPARTMENT OF HEALTH
CARE SERVICES TO DEVELOP
REGULATIONS FOR A COMPREHENSIVE
CONTINUUM OF SUBSTANCE USE
DISORDER CARE FOR YOUTH.
UNDER AGE.
TWENTY ONE THE BILL WOULD ALSO
ENABLE COUNTY SAN PROVIDERS TO
PROPERLY CLAIM AND BILL FOR T.
P. S. T. D. ENTITLEMENT SERVICES
UNDER DRUG MEDIC HELP BY
REQUIRING THE DEPARTMENT.
OF ESTABLISH THE DEPARTMENT TO
ESTABLISH BILLING CODES FOR
COVERED A SUBSTANCE USE DISORDER
SERVICES UNDER THE E. P. S. THE
T. BENEFIT.
SINCE THERE'S A FEDERAL MATCH
FORTY P. S. T. T. THE ABILITY TO
BILL FOR THE SERVICES WOULD
DRIVE DOWN FEDERAL DOLLARS FOR
YOUTH TREATMENT. FOR CONTEXT UP
290% OF ADULTS WITH SUBSTANCE
USE DISORDER DEVELOPED A PATTERN
OF ALCOHOL OR DRUG DEPENDENCE
BEFORE THE AGE OF EIGHTEEN UNDER
THE FEDERAL EARLY AND PERIODIC
SCREENING AND TREATMENT BENEFIT.
MEDICAID AND ROLLED YOU ARE
ENTITLED TO AGE APPROPRIATE CARE
FOR ANY IDENTIFIED BEHAVIORAL
HEALTH CONDITIONS HOWEVER
MEDICAID SERVICE PAYMENTS ALONE
ARE INSUFFICIENT FOR THE CAPITAL
AND OVERHEAD COSTS NEEDED TO
BUILD.
NEW COMMUNITY BASED TREATMENT
PROGRAMS AND UNFORTUNATELY
CALIFORNIA HAS NOT CHOSEN TO
INVEST IN A ROBUST SYSTEM OF
SUBSTANCE USE DISORDER CARE FOR
UNINSURED AND MEDICAID ELIGIBLE
YOUTH.
WHILE COUNTIES MANAGE PUBLICLY
FUNDED TREATMENT PROGRAMS THEY
LACK SYSTEMATIC -- GUIDANCE AND
DEDICATED FINANCIAL RESOURCES TO
ESTABLISH A COMPREHENSIVE SET OF
SERVICES FOR THIS VULNERABLE
POPULATION.
ESTABLISHING STATEWIDE STANDARDS
WILL BE A VALUABLE TOOL FOR
YOUTH TREATMENT PROGRAMS WITH ME
AND SUPPORT OUR DOCTOR WILLIAM
ARROYO FROM THE CALIFORNIA
PSYCHIATRIC ASSOCIATION.
AND TOM RENT FREE FROM THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS.
THANK YOU MISTER CHAIRMAN WAS
TOM RUN FREE WITH THE COUNTY BE
ABLE HEALTH DIRECTORS
ASSOCIATION.
I THINK WE'RE ALL AWARE THAT
MANY YOUNG PEOPLE IN ADOLESCENCE
I STRUGGLE WITH SUBSTANCE USE
DISORDERS.
NEW DATAFROM THE CENTER FOR
DISEASE CONTROL INDICATE THAT
EVERY TWO DAYS A CALIFORNIA
YOUTH DIES FROM AN OPIOID
OVERDOSE.
AND THAT -- THAT MORE YOUTH ARE
BEING NOW TREATED IN EMERGENCY
DEPARTMENTS THAT ARE WHO ARE
DEPENDENT ON OPIOIDS THE NUMBERS
HAVE INCREASED OVER 50%.
IN THE LAST TEN YEARS.
UNFORTUNATELY AS AS THE AUTHOR
IS SAID CALIFORNIA HAS NOT
INVESTED IN A COMPREHENSIVE SET
OF S. U. D. TREATMENT SERVICES
FOR UNINSURED MEDICAID ELIGIBLE
YOUTH.
MOST EXISTING PUBLICLY FUNDED A
SUBSTANCE USE DISORDER PROGRAMS --
IN THE STATE WERE DESIGNED TO
SERVE THE ADULT POPULATION THE
PURPOSE OF THIS BILL IS TO
SUPPORT PROGRAMS THAT ADDRESS
THE UNIQUE NEEDS OF YOUTH WITH
SUBSTANCE USE DISORDERS IN AGE
SPECIFIC TREATMENT SETTINGS.
THAT OFFER A FULL CONTINUUM OF
CARE ARE WE THANK YOU FOR YOUR
CONSIDERATION WE URGE YOUR
SUPPORT.
THANK YOU VERY MUCH SIR.
GOOD AFTERNOON MY NAME IS --
DOCTOR WILLIAM ROY AND I'M
REPRESENTING THE CALIFORNIA
PSYCHIATRIC ASSOCIATION -- SKY
ACTORS WHO PRACTICES IN LOS
ANGELES AND HAVE BEEN WORKING
WITH KIDS JUST LIKE THIS -- FOR
AT LEAST TWENTY YEARS -- IN A
PROBATION FACILITY.
IN LOS ANGELES I WANT TO BEGIN
BY SHARING WITH YOU SOME DATA
FROM THE MOST RECENT STATE WIDE
CALIFORNIA'S STUDENT MENTAL
HEALTH SCORE CARD.
WHICH IS A SURVEY CONDUCTED BY
THE DEPARTMENT OF ED BY A STATE
LAW -- THE SAMPLED -- PROXIMALLY
THIRTY FIVE THOUSAND STUDENTS --
MOST OF WHICH WERE FROM A
REGULAR ADD AND THEN HAD A SMALL.
GROUP A SAMPLE FROM --
CONTINUATION HAD.
AND THE THE KEY ELEMENTS IN THE
SERVER THAT I WANT TO SAY TO YOU
INCLUDED.
THE PERCENTAGE OF ELEVENTH
GRADERS TO WIN DOORS THE ITEM
THAT THEY ENGAGEDIN BINGE
DRINKING FIVE OR MORE DRINKS IN
A ROW DURING THE MONTH PRIOR. TO
THIS SURVEY. 12% OF ALL ELEVENTH
GRADE STUDENTS ENDORSE THIS.
WITH RESPECT TO WAIT WEEKLY
MARIJUANA USAGE AND THAT IS FOR
THREE DAYS OUT OF EACH WEEK FOR
THAT MONTH PRIOR TO THE SURVEY.
9%.
OF ALL ELEVENTH GRADE STUDENTS --
ENDORSE THAT ITEM SO.
WE HAVE A MAJOR PROBLEM -- IN
OUR HANDS -- AS WE HAD ALREADY
BEEN STATED.
MOST SERVE BEER SUBSTANCE ABUSE
PROBLEMS AMONG ADULTS BEGINS
DURING THE TEEN YEARS.
WE HAVE HAD A FEDERAL
ENTITLEMENT.
BY THE NAME OF EPS TT PROGRAM.
IN THIS IS A IN EXISTENCE SINCE.
NINETEEN SIXTY SEVEN WE HAVE YET
TO ESTABLISH A CONTINUUM OF CARE.
WHICH WOULD RANGE FROM SUCH
THINGS AS PREVENTIVE SERVICES.
TO OUT PATIENT COUNSELING NOT
ONLY FOR THE INDIVIDUAL BUT FOR
THE FAMILY THAT'S IMPACTED -- I
SHOULD UNDER SCORED THE ADVERSE
IMPACT THAT THESE VARIOUS
SUBSTANCES HAVE ON BRAIN
DEVELOPMENT.
SO THAT THEY COMPROMISED ONLY
THE STUDENTS EDUCATION BUT THE
STUDENTS HEALTH AS AN ADULT.
AND FRANKLY MANY OF THESE YOUNG
PEOPLE SIMPLY ADD TO THE
INCREASED SEEN HOMELESS
POPULATION OF THE STATE.
AND SO WITH THAT I IMPLORED THE
COMMITTEE TO SUPPORT THIS BILL.
THANK YOU VERY MUCH OTHERS IN
SUPPORT.
BRANDON MARGIE WITH THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT THANK YOU.
QUESTION THREE REPRESENT
CALIFORNIA STATE ASSOCIATION OF
COUNTIES IN SUPPORT THANK YOU.
MICHELLE GIVENS WITH THE COUNTY
HEALTH EXECUTIVES ASSOCIATION
AND SUPPORT.
THANK YOU VERY MUCH.
IS THERE ANYONE IN OPPOSITION.
SEE KNOWN WILL BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS OR COMMENTS
FROM THE COMMITTEE.
MISTER IS THERE IN YOUR BILL
ENJOYS A DO PASS RECOMMENDATION
WE HAVE A MOTION BY MISTER
AGUILAR CURRY A SECOND BY MISTER
BURKE THE MOTIONS TO PASS TO
APPROPRIATIONS WHICH LIKE CLOSE.
I RESPECTFULLY ASK FOR AYE VOTE
THANK YOU THANK YOU VERY MUCH
MADAM SECRETARY PLEASE CALL THE
ROLL WHAT I WOULD AYE MAYES.
MAYES AYE AGUIAR-CURRY AGAR
CURRY I BIGELOW.
BIGELOW AYE BONTA.
BURKE BURKE I CARILLO.
CARILLO AYE FLORA FLOOR I LEVEL.
LIVE ON AYE MCCARTY.
MCCARTY I NAZARIAN.
NAZARIAN AYE RAMOS.
ALMOST AYE RODRIGUEZ
[inaudible]
SANTIAGO [inaudible]
WALDRON.
GIVE ELEVEN VOTES YOUR BILL IS
APPLE LEAVE THE ROLL UP AND FOR
OTHERS TO ADD ON THANK YOU VERY
MUCH IF TO MORE BILL SOMEONE
ASKED MR MAYES TO TAKE OVER.
THANK YOU [inaudible] FOURTEEN
NINETEEN I WOULD.
THANK YOU VERY MUCH IT'S MY
PLEASURE TO PRESENT AB.
NINE FIFTY FOUR THANK YOU BETTER
MISTER CHAIR AND MEMBERS.
NETWORK LEASING ARRANGEMENTS
PRESENT NUMEROUS PROBLEMS FOR
THE DENTIST AND THEIR PATIENTS
THIS BILL IS INTENDED TO FIX
THESE PROBLEMS DENTIST MAY HAVE
CONTRACTS WITH MORE THAN ONE
PLAN.
WHICH MEANS THEY MAY BE A
PROVIDER IN DIFFERENT NETWORKS.
CURRENTLY THE PLANS THAT LEASE
OR PURCHASE NETWORKS HAVE
LIMITED RESPONSIBILITY TO BE
TRANSPARENT AND SOME PORTANTINO
WHICH FEE SCHEDULES ARE IN
EFFECT FOR THEIR PATIENTS.
DENNIS ARE SENSITIVE TO THE
PRICE CONCERNS OUR PATIENTS HAVE
AND THEY NEED THEIR THIS
TRANSPARENCY TO BE ABLE TO
CLEARLY DISCUSS TREATMENT
OPTIONS AN OUT OF POCKET COSTS
WITH THEM.
THIS BILL WOULD ALLOW FOR
EXAMPLE DENTAL PLANS TO GRANT
THIRD PARTY ACCESS TO TO
PROVIDER NETWORK SO THE
PROVIDERS CLEARLY KNOW WHAT THAT
THE CON.
THAT THE CONTRACT GRANTS A THIRD
PARTY ACCESS TO THE PROVIDER
NETWORK.
AND THAT I AS A PROVIDER HAVE
THE RIGHT TO CHOOSE TO NOT
PARTICIPATE IN THIRD PARTY
ACCESS.
I RESPECTFULLY ASK YOUR RIVAL.
GIVE ME WITNESSES WITH YEAH I DO.
YEAH BUT WHEN WITH THE
CALIFORNIA DENTAL ASSOCIATION.
GOOD AFTERNOON MADAM CHAIR AND
MEMBERS HERE I WITH SEE THE
CALIFORNIA DON'T ASSOCIATION AS
A SPONSOR.
OF THIS BILL -- AND I THINK IS A
DOCTOR WOULD MENTION THAT
THERE'S OBSERVE A GROWING TREND
OF LEASING AND DENTAL PLANS AND
WHAT CAN BE MUTUALLY BENEFICIAL
FOR BOTH THE PLANS AND THE
DENNIS.
THERE ARE PROBLEMS THAT ARISE
WHEN THERE'S NOT TRANSPARENCY
THEY'RE OFTEN DENNIS TO DON'T
KNOW THAT THEY'VE BEEN LEASED OR
THEY DON'T KNOW WHAT PLANS
THEY'VE BEEN LEASED TO OR THEY
DON'T KNOW THE TERMS OF THOSE
CONTRACTS.
THIS CAN CAUSE PROBLEMS FOR
PATIENTS WHEN THE DENTIST --
CAN'T EXPLAIN TO A PATIENT WHAT
THEIR PLAN IS GOING TO COVER
SIMPLY BECAUSE THEY DON'T HAVE
THINGS LIKE -- THAT LIMITATIONS
ON SERVICES WAITING PERIODS EVEN
THINGS LIKE HOW I SERVICES
CLASSIFIED AS AN A MAJOR SERVICE
OR MINOR SERVICE CAN HAVE
SIGNIFICANT FINANCIAL
IMPLICATIONS FOR PATIENT WHICH
ARE IMPORTANT FOR THEM TO BE
TAKING INTO CONSIDERATION WHEN
THEIR TREATMENT PLANNING --
REALLY THIS BILL JUST ABOUT
TRANSPARENCY ENSURING THAT
DENTISTS AND KNOW WHAT PLANS ARE
IN THAT THEY KNOW THE TERMS OF
THOSE CONTRACTS AND THAT THEY
CAN OPT OUT IF THEY DON'T WANT
TO PARTICIPATE.
WE HAVE BEEN I'M PLEASED TO WORK
WITH THE CALIFORNIA ASSOCIATION
OF DENTAL PLANS ON SOME
TECHNICAL CONCERNS WE ARE AWARE
THAT THE HEALTH PLANS HAVE --
RAISE SOME CONCERNS AS WELL
THERE ISSUES SEEM TO BE --
DIFFERENT THAN THOSE OF THE
DENTAL PLANS AND SO WE ASK THEM
TO CONTINUE TO WORK WITH THE
DENTAL PLANS AND THEN -- WILL
OBVIOUSLY CONTINUE HAVING
CONVERSATIONS AS THE BILL MOVES
FORWARD -- DRIVER.
CHRISTY WE SOME PERHAPS THE
CALIFORNIA ASSOCIATION OF DENTAL
PLANS AS BRIANNA SAID WE'VE BEEN
IN.
DISCUSSIONS WITH THE AUTHOR IN
THE SPONSOR AND THE DENTAL PLAN
SUPPORT THE INTENTION OF THE
BILL AND AND CD IS GOAL TO
ENSURE THAT DENNIS FULLY
UNDERSTAND -- THE PARAMETERS OF
THE NETWORK CONTRACTS THAT
THEY'VE ENTERED INTO SO WE DO
HAVE A FEW MORE OUTSTANDING
ISSUES THAT WERE STILL WORKING
THROUGH BUT WE ARE MAKING GOOD
PROGRESS AND WE FEEL CONFIDENT
THAT WE'LL BE ABLE TO GET THERE.
THANK YOU.
CREATE ANY ADDITIONAL WITNESSES
AND SUPPORT A TURN MEMBERS
COUNTY MUST WORK WITH DELTA
DENTAL CALIFORNIA IN SUPPORT.
RENDON MARGIE WITH THE
CALIFORNIA MEDICAL ASSOCIATION
AND SUPPORT.
GOT A MOTION AND A SECOND SO
WE'LL MOVE ON TO WITNESSES IN
OPPOSITION. SEVENTY WALK INS ON
BEHALF OF THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES WE HAVE A
BIT OF A TWEENER WE HAVE
CONCERNS RIGHT NOW WE APPRECIATE
THE AUTHOR AND SPONSORING HAD A
REALLY GOOD MEETING WITH STAFF
ABOUT THE CONCERNS ABOUT THE OPT
OUT PROVISION AND POTENTIAL
IMPACTS.
ON TRANSPARENCY AND WANTING TO
LOOK FORWARD TO WORKING WITH THE
AUTHOR AND THE SPONSOR OF THE
BILL MOVES FOR IT TODAY.
AND I THINK WE'RE REALLY HOPEFUL
THAT WE CAN COME.
TO THAT EVERYBODY CAN LIVE WITH
THANK YOU THANK YOU.
LOUISE WAS CALIFORNIA
ASSOCIATION HEALTH PLANS IS TO
ALIGN OUR COMMENTS WITH A
REPRESENTATIVE FROM ACT LIKE
THANK YOU.
AND NOT SEEING ANY MORE
OPPOSITION IS THERE ANY MORE
OPPOSITION.
TO BRING IT BACK TO THE MEMBERS
OF THE COMMITTEE.
ANY QUESTIONS COMMENTS.
WE DO HAVE A MOTION A SECOND
DOCTOR WOULD LIKE TO CLOSE.
IT'S LIKE THE RESPECTFULLY ASK
YOUR AYE VOTE AND IT'S AND WE
HAVE THE WE HAVE THE ASSOCIATION
OF HEALTH PLANS HERE AT THE
TABLE WORKING TOGETHER.
I THINK THAT'S A GREAT THAT'S A
GREAT WAY TO GO GRAY LOOKS LIKE --
THERE'S STILL SOME WORK PEOPLE
TALK AND AND WITH THAT SECRETARY
GO CALL THE ROLL.
IF THE MOTION IS DO PAST
APPROPRIATIONS.
WHAT I WOULD AYE MAYES AYE MAYES
AYE AGUIAR-CURRY THANK THEIR
CURRY I BIGELOW?
BIGELOW NOT VOTING BONTA[inaudible]
BURKE.
I CARILLO.
CARILLO AYE FLORA.
FLOOR I LIVE ALONE [inaudible]
HI.
NUMBER ONE I MCCARTY.
MCCARTY I IN THIS AREA.
RAMOS RAMOS I RODRIGUEZ.
SANTIAGO WALDRON.
WALDRON AYE.
THE BILL PASSES THE VOTE OF TEN
TO ZERO THANK YOU MOVING ON TO
THE NEXT BILL THANK YOU.
MY PLEASURE PRESENT AB ELEVEN
SEVENTY FOUR MISTER CHAIR AND
MEMBERS.
IN TWO THOUSAND AND SIXTEEN WE
SUCCESSFULLY PASSED AB SEVENTY
TWO WAS WHICH RESULTED IN
PROTECTING CONSUMERS FROM
SURPRISE MEDICAL BILLS.
WHEN THEY RECEIVE CARE FROM A
FACILITY THAT WAS IN THEIR OWN
HEALTH CARE'S OF NET WILL HAVE
HEALTHCARE PLANS NETWORK?
AS ONE OF THE KEY NEGOTIATORS
THAT BILL WE MADE SOME TOUGH
CHOICES WITH POTENTIAL IMPACTS
FOR MANY STAKEHOLDERS. FOR
EXAMPLE WE PUT IN PLACE A RATE
FOR THE OUT OF NETWORK PROVIDER
WITH THE EXPECTATION THAT THIS
WOULD ENCOURAGE CONTRACTING WITH
THOSE PROVIDERS.
THEY PROMISED TO FOLLOW THE NEW
CLOSELY FOR AND I'VE AND I
PROMISED TO PAUL THE NEW LAW
CLOSELY FOR ANY UNINTENDED
CONSEQUENCES.
SINCE THEN ONE OF THE CLAIMS HAS
BEEN THAT THESE RATES HAVE
NEGATIVELY IMPACTED EXISTING
CONTRACTS AND HEALTH PLANS ARE
USING THEM TO GAIN AN UPPER HAND
IN CONTRACTING.
IT'S IMPORTANT DETAIL HEALTH
PLAN ENSURE THAT THERE IS AN
ADEQUATE NETWORK OF PROVIDERS
FOR THEIR ENROLLEES.
WE ALL KNOW THAT THE
RELATIONSHIPS BETWEEN FACILITY
BASED ANESTHESIOLOGISTS HEALTH
PLANS INSURERS HEALTH THE CITY'S
BASILIDES AND HEALTH PLAN
ENROLLEES ARE COMPLEX.
AND THIS BILL ELEVEN SEVENTY
FOUR ATTEMPTS TO ADDRESS SOME OF
THESE CONCERNS BY REQUIRING UPON
A TERMINATION OF IN
ANESTHESIOLOGY CONTRACT.
THAT HEALTH PLAN HAS A CONTRACT
IN PLACE TO ENSURE THAT
ENROLLEES AND INSURERS WILL HAVE
ACCESS TO THESE TYPES OF
PROVIDERS WHEN THEY RECEIVE CARE
A CONTRACTED FACILITIES.
WITH THAT I HAVE WITNESSES IN
SUPPORT [inaudible]
THANK YOU.
MISTER CHAIR MEMBERS PRICE
DOUGHERTY ON BEHALF OF
CALIFORNIA SOCIETY OF
ANESTHESIOLOGISTS THE PHYSICIAN
ANESTHESIOLOGISTS AND STATE.
WE'RE PROUD SPONSORS OF THE BILL --
WE ALL ARE AWARE OF AB SEVENTY
TWO IMPORTANCE OF GETTING
PATIENTS OUT OF THE MIDDLE OF
CONTRACT DISPUTES BETWEEN.
PROVIDERS AND HEALTH PLANS --
THOSE PROVISIONS OF AB SEVENTY
TWO WERE A LONG TIME COMING WHAT
WE'VE NOTICED WITH REGARDS TO
THAT BILL LITERALLY MONTHS AFTER.
A COUPLE MONTHS AFTER THE BILL
WAS SIGNED WE'VE NOTICED THAT A
LOT OF HEALTH PLANS WERE --
ISSUING TERMINATION NOTICES WITH
REGARDS TO ANASTASIA SERVICES --
IN ADDITION WHAT MR WOOD SAID
IT'S ALSO IMPORTANT TO KIND OF
INFORM THE COMMITTEE WHAT THE
BILL DOESN'T DO.
YOU MIGHT HAVE HEARD IN YOU MAY
HEAR THAT -- THE BILL IS
INCREASED COSTS THIS BILL DOES
NOT INCREASE COST.
THE BILL DOES NOT FORCE PLAYERS
INTO A SIGNING CONTRACTS BAD
CONTRAST WITHIN ITS TEACHER
PROVIDERS.
THE BILL.
DOES NOT APPLY TO PROVIDER
TERMINATED CONTRACTS USER THESE
ARE CONTRACTED OR TERMINATED BY
THE PAIR OR BY THEIR DELEGATED
ENTITY -- NUMEROUS EXAMPLES ALL
AROUND THE STATE FOR EXAMPLE
WE'VE GOT LARGE ANASTASIA GROUPS
IN ORANGE COUNTY. HUNDRED AND%
THIRTY PHYSICIAN GROUP COVERING
A HUNDRED SIXTY THOUSAND LIVES.
IN SIX HOSPITALS AND THIRTY ONE
SURGERY CENTERS WHO HAD LEGACY
CONTRACTS WITH PAYERS FOR THIRTY
PLUS YEARS.
AND ARE NOW RECEIVING
TERMINATION NOTICES -- IT IS A
VERY DIFFICULT COMPLEX
TRANSACTION ANASTASIA SERVICES
ARE UNIQUE -- IT IS A CRITICAL
POINT OF HAVING SURGERY -- AND
MANAGING YOUR PAIN -- SO AT THE
SAME TIME.
MEDICARE AS A METHODOLOGY
REIMBURSEMENT ONLY PAYS ABOUT
33% OF WHAT THE AVERAGE
CONTRACTED RATE FRAME THIS
TEACHER SERVICES IS IN
CALIFORNIA -- FOR THOSE REASONS
AND WITH ME TODAY I HAVE --
DOCTOR JEFFREY POGUE WHO IS A
PEDIATRIC ANESTHESIOLOGISTS AND
CHAIR OF THE LEGISLATIVE IMPACTS
AFFAIRS DIVISION. FOR THE
CALIFORNIA SOCIETY OF
ANESTHESIOLOGISTS THANK YOU.
BUT MISTER CHAIR MEMBERS BRANDON
MARGIE WITH THE CALIFORNIA
MEDICAL ASSOCIATION -- ACCORDING
TO A REPORT FROM THE US
GOVERNMENT ACCOUNTABILITY OFFICE
AND MEDICARE REIMBURSEMENT RATES
FOR ANESTHESIOLOGY ARE
PRACTICALLY 67% LOWER THAN
COMMERCIAL RATES.
AND DO THIS PRICE DIFFERENTIAL
ANESTHESIA PROVIDERS ARE
UNIQUELY IMPACTED BY THAT
PAYMENT STANDARD IN AB SEVENTY
TWO WHICH IS TIED.
IN PART TO A 125% OF THE
MEDICARE RIGHT.
IN THE WAKE OF AB SEVENTY TWOS
PASSAGE CMA RECEIVE NUMEROUS
REPORTS FROM ANESTHESIOLOGY
PRACTICES ABOUT PAYERS USING THE
DEFAULT PAYMENT STANDARD IN AB.
SEVENTY TWO AS A WEAPON. FOR
EXAMPLE TERMINATION NOTICES
ANTHRAX BY PAYERS TO TERMINATE
EXISTING CONTRACTS IF PHYSICIAN
GROUP IF THE PHYSICIAN GROUP
THEY'LL TO RENEGOTIATE
LONGSTANDING CONTRACTS AT
SIGNIFICANTLY LOWER RATES.
IN SOME CASES IN EXCESS OF 30%
LOWER.
AB ELEVEN SEVENTY FOUR AND IT IS
AN ATTEMPT TO PREVENT FURTHER
DETERIORATION OF EXISTING
PROVIDER NETWORKS.
IT DOES NOT REQUIRE REPAIRS TO
CONTRACT WITH NEW POSITIONS AND
IT DOES NOT CREATE.
AN OPPORTUNITY FOR PHYSICIANS TO
DEMAND HIGHER REIMBURSEMENT
RATES ON EXISTING CONTRACTS
BECAUSE IT IS NOT TRIGGERED WHEN
A PHYSICIAN INITIATES THE
TERMINATION.
THE BILL REQUIRES.
A PAIR TO DEMONSTRATE SOME
MINIMUM LEVEL OF PATIENT ACCESS
TO IN NETWORK ANESTHESIA
PROVIDERS AT IN NETWORK
FACILITIES IF THE PAIR INTENDS
TO TERMINATE AN EXISTING
CONTRACT.
AS AB ELEVEN SEVENTY FOUR WILL
BE VERY LIMITED IN ITS
APPLICATION IT REPRESENTS A
TARGETED SOLUTION TO A SPECIFIC
PROBLEM.
FACING ANESTHESIOLOGY PRACTICE
WHICH IS NOT ADDRESS WILL RESULT
IN REDUCE ACCESS TO HOSPITAL
BASIC ANESTHESIA SERVICES.
I RESPECTFULLY REQUEST YOUR ANY
ADDITIONAL WITNESSES IN SUPPORT.
FOLKS ARE.
IN -- CHAPO GOOD AGAIN IN
PEDIATRIC ANESTHESIOLOGIST IN
EAST BAY -- PART OF A GROUP OF A
HUNDRED AND FIFTY PHYSICIAN
ANESTHESIOLOGISTS AND WE
APPRECIATE YOUR SUPPORT ON ON
THIS BUILDING THIS THIS BILL IT.
DRESSES SEVERAL ISSUES OF
CRITICAL IMPORTANCE TO THE OVER
SIX THOUSAND ANESTHESIOLOGISTS.
PRACTICING IN THIS GREAT STATE.
AND WE APPRECIATE THE THE CHAIRS
LEADERSHIP ON THIS ISSUE ON THIS
ISSUE THANK YOU VERY MUCH.
GREAT NOW GOING TO ADDITIONAL
WITNESSES IN SUPPORT.
KAREN KIRK FROM CALIFORNIA
ASSOCIATION OF NURSE
ANESTHETISTS PRACTICE DIRECTOR
IN SUPPORT.
GREAT ANY MORE WITNESSES IN
SUPPORT SEEING NONE IT WILL MOVE
TO A WITNESSES IN OPPOSITION.
BETH EL ON BEHALF HEALTH ACCESS
CALIFORNIA WE'RE NOT OPPOSED IN
LESS AMENDED POSITION OR
CURRENTLY WORKING WITH THE
AUTHOR ON AMENDMENTS THANK YOU.
THANK YOU [inaudible]
GO AHEAD.
THANK YOU MISTER CHAIR AND
MEMBERS NICK LOUISE US ON BEHALF
THE CALIFORNIA ASSOCIATION OF
HEALTH PLANS -- WE RESPECTFULLY
OPPOSE ASSEMBLY BILL -- ELEVEN
SEVENTY FOUR FIRST WE WANT TO
SAY WE DID -- YOU KNOW HAVE A
GOOD MEETING WITH -- THE CHAIR
ON THIS BILL WE WERE ALLOWED TO
EXPRESS OUR CONCERNS -- AND
WE'RE ALWAYS.
WILLING TO STAND WITH THEM YOU
KNOW WHEN HE TAKES ON HI
HEALTHCARE COSTS AND AND
LEGISLATION -- TO FIX MARKET
MANIPULATION AND AND THE LIGHT.
YOU KNOW UNFORTUNATELY THOUGH WE
RESPECTFULLY DISAGREE WITH THE
PREMISE IN THE SOLUTION OF THIS
PARTICULAR BILL -- WE OPPOSE
THIS BILL BECAUSE IT DIRECTLY
INTERFERES WITH A CONTRACTUAL
RELATIONSHIP BETWEEN PLANS IN
ANESTHESIOLOGISTS.
THE PROVISIONS OF THIS BILL
WE'VE YOU -- AS BEING ONE SIDED
ON WORKABLE AND WILL ULTIMATELY
LEAD TO AN INCREASE IN THE COST
OF HEALTH CARE FOR CONSUMERS.
HEALTH PLANS ARE ALREADY SUBJECT
TO EXTENSIVE NETWORK ADEQUACY
REQUIREMENTS TO ENSURE ACCESS TO
NECESSARY SERVICES.
IT'S IMPORTANT TO NOTE THAT AB
SEVENTY TWO STATUES EXPRESSLY
OBLIGATE THAT PLAN SATISFY THEIR
NETWORK OUT OF WITH CITY
ADEQUACY OBLIGATIONS EXCUSE ME --
THERE FOR THE NEW STANDARDS
PROPOSED BY AB ELEVEN SEVENTY
FOUR AT LITTLE IF ANY VALUE.
AND INSTEAD ADD NEW REPORTING
REQUIREMENTS ON THE PLANS WITH
THE PRACTICAL EFFECT OF
MANDATING DIRECT CONTRACTS
BETWEEN TWO PARTIES -- AB --
ELEVEN SEVENTY FOUR NOT ONLY --
INTERFERES IN THOSE CONTRACT
NEGOTIATIONS BETWEEN THE PLANTS
AND HONESTY.
ANESTHESIOLOGISTS IT DOES SO IN
A WAY THAT FAVORS ONE PARTY --
OVER THE OTHER THE BILL'S
PROVISIONS APPLY WHEN HEALTH
PLANS INITIATE CONTRACT
TERMINATIONS WITH
ANESTHESIOLOGISTS.
NO PROVIDERS RENEGOTIATE THE
TERMS OF THEIR CONTRACTS AS WELL --
THEY CAN AND THEY DO DEMAND
HIGHER RATES FROM HEALTH PLANS --
BY WAY OF EXAMPLE SEVERAL
DOMINANT ANESTHESIOLOGIST GROUPS
HAVE RECENTLY TERMINATED THEIR
PROVIDER AGREEMENTS WITH MEDI
CAL MANAGED CARE PLANS.
IN OUR INSTEAD DEMANDING TO BE
PAID AT FULL.
OF FULL BILL CHARGES OR NEAR
THAT -- IN THE TAKING AT LEAST
ONE OF MY PLANS -- IF NOT MORE
OF THEM TO COURT OVER THIS ISSUE
I KNOW WHEN A MAN WAS TAKEN OUT
TO APPLY TO MEDI CAL MANAGED
CARE BUT I YOU KNOW I OFFER THAT
AS A AS AN EXAMPLE.
OF THE FACT THAT THE PROVIDER
SIDE IS QUITE CAPABLE OF IT
BEING GAUGING AN AGGRESSIVE
NEGOTIATING TACTICS HOWEVER THIS
BILL PLACES ZERO ACCOUNTABILITY
ON PROVIDERS IF AND WHEN THEY
ARE TERMINATING THEIR
CONTRACTUAL AGREEMENTS WITH
PLANS -- MEMBERS MANY HOSPITAL
BASED PROVIDERS SUCH AS
ANESTHESIOLOGISTS ARE WELL KNOWN
FOR NOT CONTRACTING WITH PLANS
AND SUCH BUT AND AND THEREFORE
BILLING PLANS IN CONSUMERS --
OUTRAGEOUS OUT OF NETWORK
CHARGES IN SURPRISE BILLS -- ONE
RECENT REPORT -- PLACE THOSE OUT
OF NETWORK CHARGES -- AS AS HIGH
AS 11100% OF MEDICARE -- THE
LEGISLATURE ARE OF COURSE HAS
BEEN WIDELY CRACKING DOWN ON
THAT -- WE UNFORTUNATELY VIEW
THIS IS A STEP BACKWARDS -- ONE
FINAL NOTE -- MEMBERS OF THIS
BILL SUBJECT MY MEMBERS TO FINES
AND PENALTIES EVEN WHEN IT'S THE
PLANS DELEGATED ENTITIES NOT THE
PLAN ITSELF THEY'RE IN VIOLATION
OF THE BILL'S PROVISIONS -- THE
BILL CREATES A SUB ACCOUNT
WITHIN THE MANAGED CARE
ADMINISTRATIVE FINES AND
PENALTIES FUND FOR USE BY THE
LEGISLATURE -- IT'S AN ENTIRELY
NEW SUB ACCOUNT -- IN THE
LEGISLATURE WOULD BE USING.
MONIES FROM THIS ACCOUNT FOR
PURPOSES THAT WE THAT THAT ARE
ILL DEFINED -- AT THIS TIME SO --
WE JUST RESPECTFULLY OPPOSE THE
BILL AND ASK YOU TO VOTE NO
THANK YOU.
STEPHANIE WATKINS ON BEHALF OF
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES TO HEAR TODAY IN
OPPOSITION WE WOULD LIKE TO
THANK THE AUTHOR FOR SITTING
DOWN WITH US AND HAVING A VERY.
ACTIVE CONVERSATION ABOUT OUR
CONCERNS THAT BEING SAID I WOULD
LIKE TO POINT OUT -- FOR THOSE
OF US WHO LIVED THROUGH FIRST AB
THIRTY FIVE THIRTY THREE IN AB
SEVENTY TWO KIND OF NEGOTIATIONS.
WHAT WE REALLY TRY TO DO IS
CRAFT SOMETHING THAT WAS BOTH
BALANCED WHERE PLANS AND
PROVIDERS BOTH HAD A MECHANISM
TO ENSURE THAT A FAIR AND
APPROPRIATE RATE OF
REIMBURSEMENT WAS ENTERED INTO?
WHILE KEEPING THOSE CONSUMERS
OUT OF THE MIDDLE AND
UNFORTUNATELY WE DO SEE THIS
BILL TODAY AS A WAY THAT SORT OF
PUSHES THAT PENDULUM AND THE
OTHER WAY TOWARDS THE PROVIDER
GROUP.
AND I WOULD LIKE TO POINT OUT ON
THE CD I SIDE WE DO HAVE ROBUST
NETWORK ADEQUACY REQUIREMENTS
WOULD DO MAKE US FILE EVERY TIME
THERE IS A IF THERE IS A
POTENTIAL TERMINATION OF A
CONTRACT TEN DAYS PRIOR.
TO WE HAVE TO DO A SPECIFIC
REPORT TO CDI ABOUT ANY MATERIAL
MODIFICATION BASED ON HOSPITAL
BASED POSITION SPECIFICALLY
ANESTHESIOLOGIST.
AND ANY CORRECTIVE PLAN RELATED
TO ANY TERMINATIONS ARE NETWORK
CONCERNS SO WE DO BELIEVE THAT
WITH RESPECT TO THE
REIMBURSEMENT RATE THERE'S AN
INDEPENDENT DISPUTE RESOLUTION
PROCESS THAT CAN BE SEEK.
TO BY THE PROVIDER IF THEY
BELIEVE THAT THE PLAN IS NOT
FAIRLY REIMBURSING THEM WE THINK
THAT THE DEPARTMENTS HAVE A
GREAT.
AMOUNT OF INFORMATION TO SHOW
WHEN THERE IS A CONCERN ABOUT
NETWORK ADEQUACY WE REALLY THINK
THAT THAT IS THE BETTER VENUE.
FOR THIS KIND OF DISPUTE BETWEEN
TWO LARGER PARTIES TO BE TAKEN
TO THE REGULATOR IF THERE IS A
CONCERN ABOUT THE ADEQUATE
NETWORK.
THE NOT SHOULD BE DEALT WITH
THROUGH THAT PROCESS AND NOT
NECESSARILY THROUGH THE
LEGISLATIVE PROCESS.
WE'D ALSO LIKE TO POINT OUT FOR
HOSPITAL BASED POSITIONS
OFTENTIMES THE INSURER HAS NO
CONTROLLER WHOSE ACTUALLY
ASSIGNED THE DAY I HAVE A
PROCEDURE.
THAT SOLELY BASED WITH THE
HOSPITAL AND SO OFTEN TIMES YOU
COULD HAVE AND A VERY WIDE
BREADTH OF THE NETWORK BUT YOU
COULD HAVE SOMEONE SHOW UP ONE
DAY HEY AND THE HOSPITAL ASSIGN
SOMEONE WHO HAPPENS TO NOT BE
THE SAME AS THAT INSURED POLICY.
AND THEREFORE YOU END UP WITH
SOMEBODY WHO'S DONE EVERYTHING
RIGHT THEY'VE GONE TO AN IN
NETWORK FACILITY HAD AN IN
NETWORK DOCTOR AND HAD A
SPECIALIST OR SOMEONE ELSE SHOW
UP A PATH BIOLOGIST RADIOLOGIST
THAT DAY.
THAT PERSON HAPPENS TO BE OUT OF
NETWORK THAT DOESN'T MEAN THAT
THE NETWORK ISN'T ADEQUATE IT
JUST MEANS THAT WE WE DON'T
NECESSARILY HAVE CONTROL BECAUSE
HOSPITALS CAN'T EMPLOYEE
POSITIONS. TO CONTROL WHO'S
ASSIGNED THE DATE OF TO A
PATIENT SO FOR THOSE REASONS WE
REMAIN OPPOSED TO THE BILL WE DO
LOOK FOR IT THOUGH TO CONTINUING
THE CONVERSATION AT THE BILL
DOES MOVE FORWARD TODAY.
THANK YOU.
GREAT MANY OF THE ADDITIONAL
WITNESSES IN OPPOSITION YEAH
JOHN WINGER ON THE OF AMERICA'S
HEALTH INSURANCE PLANS WITH ECHO
THE COMMENTS OF CAP AND ACT LIKE
AND THEN JUST.
ONE POINT OF CLARIFICATION ON
THE PROPONENTS TESTIMONY THEY
SAID THE BENCHMARK RATE IS A
125% OF MEDICARE IT'S UNDER 25%
OF MEDICARE FOR THE AVERAGE
CONTRACTED RATE WHICHEVER IS
HIGHER SO JUST WANT TO MAKE SURE
THOSE CLARIFIED.
SEE NO FURTHER A WIN IS AN
OPPOSITIONAL BRING BACK A TO
MEMBERS ANY QUESTIONS.
I GET CREE.
THANK YOU DOCTOR WOULD FOR FROM
BRING THIS FOR I'M SUPPORT OF
THE BILL I DO HAVE A CONCERN --
THAT THE BILL REQUIRES HEALTH
PLANS TO CONTRACT WITH
ANESTHESIOLOGY JUST REGARDLESS
OF THE COST.
SO -- AS WE WORK TOGETHER TO TRY
TO REDUCE OUR COSTS FOR HEALTH
CARE SYSTEM OVERALL BECAUSE ME A
LITTLE BIT OF A SO -- I AGREE
THAT IT IS WRONG FOR PLANS TO
UNFAIRLY AN INAPPROPRIATELY
TERMINATE EXISTING CONTRACTS BUT
I HESITATE TO SWING THE PENDULUM
TOO FAR.
THE OBVIOUS WAY -- I'LL BE
SUPPORTING YOUR BILL TODAY AND
I'M SURE YOU CAN STILL WORK WITH
EVERYBODY -- BUT THANK YOU VERY
MUCH FOR BRINGING FORWARD.
I APPRECIATE APPRECIATE CONCERN
AND I AND I I THINK WHAT WE'RE
TRYING TO ADDRESS HERE IS IS AN
UNINTENDED CONSEQUENCE -- I
THINK THAT -- I NEVER I NEVER
ENVISIONED -- I WORKED CLOSELY
WITH MR BONTA ON THIS BILL FOR
WELL OVER A YEAR AB SEVENTY TWO
WE NEVER ENVISIONED.
THAT -- AT THE EXISTING
CONTRACTS WOULD THEN BE SLASHED
TO TO MUCH MUCH LOWER LEVELS WE
ANTICIPATED -- FUTURE CONTRACTS
NOT RISING AS FAST TO TO TO
CURTAIL THE RISING COSTS WE
DIDN'T ANTICIPATE THAT THAT SOME
PLANTS NOT ALL BUT SOME PLANS
WOULD USE THIS AS AN OPPORTUNITY.
TO TO SLASH REIMBURSEMENT ON ON
IN MANY CASES -- CONTRACTS HAVE
BEEN IN PLACE FOR EVERGREEN
CONTACTS FOR DECADES.
SO -- SO I AM TRUST ME I AM AS
YOU KNOW VERY CONCERNED ABOUT
HEALTHCARE COSTS AND AND AND AND
PROVIDER NETWORKS AND SO I'M
MORE THAN HAPPY CONTINUE WORKING
WITH THE WITH THE OPPOSITION ON
THIS I RECOGNIZE THIS DIFFICULT.
IT'S A CLOCK IN THE PENDULUM
SWINGING BACK AND FORTH
EVENTUALLY WE'RE GOING TO GET IT
TO STOP IN THE RIGHT PLACE --
AND I THINK WE'RE GETTING CLOSER
THANK YOU THANK YOU.
ANY FURTHER QUESTIONS.
CITAT.
DOCTOR WOULD JUST LOOKING AT THE
ANALYSIS I'M HERE BUT THIS IS
FROM HEALTH ACCESS -- IT SAYS
THAT -- AB ELEVEN SEVENTY FOUR
DRIES UP HEALTH CARE COSTS BY
REQUIRING HEALTH PLANS A
AT ANY COST A RECENT NATIONAL
DATA SHOWS THAT SOME
ANESTHESIOLOGIST CHARGE MORE
THAN NINE AND A PERCENT OF
MEDICARE AND THE AVERAGE CHARGES
510050% OF MEDICARE.
THIS LEGISLATION WOULD ALLOW
ANESTHESIOLOGIST TO DEMAND TO BE
PAID A RATE IN EXCESS OF MATTER
PERCENT OF MEDICARE.
AND SO JUST WANT TO MAP WHEN
PEOPLE WRITE STUFF ALL THE TIME
BUT THE CONCERN I HAVE IS
ACTUALLY THE SAME IS -- MISS
AGUIAR-CURRY.
IN THAT.
IN HEALTH CARE.
IT IS NOT A COMPETITIVE IT IS
NOT A FREE MARKET SYSTEM WHERE
YOU HAVE A WILLING BUYER AND A
WILLING SO SELLER.
AND THEN YOU HAVE THE ROLE OF
PRICES THAT TO DECIDE WHAT'S
WHAT'S THERE THERE ARE THIRD
PARTY.
PAYERS AND YOU'VE GOT A PROVIDER
THAT IS DEMANDING A CERTAIN
LEVEL.
BUT YOU DON'T HAVE ANY BAD HOW
DO YOU MAKE SURE -- THAT -- ON
BOTH SIDES OF THAT EQUATION THAT
WERE NOT GET THE YOU KNOW WE'RE
WE'RE NOT INCREASING COSTS OF
WHAT IN THIS BILL ACTUALLY
ADDRESSES THAT.
WHAT'S IT'S A GOOD QUESTION AND
I THINK I THINK WE'RE STILL
WE'RE STILL HAVING SOME OF THOSE
DISCUSSIONS BUT AS I SAID
EARLIER THE INTENTION WAS NOT.
FOR PLAN TO SAY OKAY WE'RE WE'RE
GONNA DRIVE YOUR CONTRACT DOWN
45%.
AND THAT HAPPENED IN ONE CASE I
BELIEVE 45% YOU ANYMORE --
BECAUSE OF WOLF WILL FIND
ANOTHER WAY TO DO IT -- AND I
COULD YOU KNOW DOCTOR POPE MIGHT
BE ABLE TO OR OR MISTER DOCTOR
MIGHT BE ABLE TO TO ELABORATE ON
THAT.
BUT I RECOGNIZE THAT THAT
THEY'RE THERE LOOK MY INTENTION
IS NOT TO DRIVE THE COST CARE A
MY INTENTION WAS TO FLATTEN THE
COURAGE AND KEEP IT TO A LOWER.
BUT BUT I NEVER INTENDED BUT WE
NEVER I WAS NOT MY INTENT TO
DRIVE THE COST DOWN TO DRIVE
THESE EXISTING CONTRACTS DOWN
AND THAT'S ESSENTIALLY WHAT HAS
HAPPENED IN SOME OF THESE CASES --
WHICH IS MADE DIFFICULT FOR SOME
PROVIDERS SO I GUESS MAYBE I
MAKE IN YOU AND I'VE WE'VE HAD
LOTS OF THESE CONVERSATION WE
HAVE A LOT OF AND SO WHAT ABOUT
THIS BILL -- THE PROVIDES THAT
THAT THAT BALANCE MAYBE YOU CAN --
YOU CAN ADDRESS THAT YET I THANK
YOU MISTER MAYES PRESTAR GRAHAM
ON BEHALF OF CSA I THINK IT'S
IMPORTANT REMEMBER THAT.
AB SEVENTY TWO THE INTENT WAS
TWO FOLD ONE WAS TO TAKE THE
PATIENT ON A MIDDLE THESE
CONTRACT DISPUTES THAT HAVE BEEN
GOING ON FOR WAY TOO LONG.
THE SECOND PURPOSE OF AB SEVENTY
TWO BY SETTING UP AN INTERIM
PAYMENT RATE WHICH OPPOSITION IS
CORRECT IT THE INTERIM PAYMENT
RATE IF YOU CAN'T IF YOU HAVE TO
GO OUT OF NETWORK.
AND YOUR PROVIDING SERVICES AT A
CONTRACTED IN NETWORK FACILITY.
THE INTRA RATE IS UP THE HIGHER
110025% OF MEDICARE OR THE
AVERAGE CONTRACTED RATE GIVEN
THE THE FORMULA THAT WE HAVE FOR
MEDI CAL FOR ANASTASIA SERVICES.
UNDER 25% IS NEVER GOING TO WORK
IT'S ALWAYS GONNA BE PARLAYED TO
THE AVERAGE CONTRACTED RATE AND
AND MISTER BONTA WE'RE GLAD THAT
THOSE PROVISIONS WERE INCLUDED.
THE INTENT OF AB SEVENTY TWO WAS
NEVER.
TO DRIVE DOWN HEALTHCARE COSTS
PER SE ALL THIS BILL SIMPLY DOES
WE'RE NOT WE'RE WE INTENTIONALLY.
WENT AWAY FROM ANYTHING RELATED
TO RATES AND CONTRACTS AND
PERCENTAGES OF THIS ALL THIS
BILL BASICALLY SAYS.
IS THAT IF YOU'RE A HEALTH PLAN
ENSURE THEIR DELEGATED ENTITY
AND THERE IS A PLAN OR DELEGATED
ENTITY AND NISHIDA TERMINATION
OF THE CONTRACT.
YOU JUST HAVE TO PROVE TO YOUR
REGULATOR THAT YOU HAVE AN
ADEQUATE NETWORK OF ANASTASIA
SERVICES AT THAT CONTRACTED
FACILITY.
SO THIS DOES NOTHING TO FORCE A
HEALTH PLAN TO CONTRACT WITH THE
NAME IS DJ GROUP ALL IT
BASICALLY DOES IS TO SAY.
THAT THERE ARE CERTAIN PLACES IN
THIS IN THE STATE WHERE THERE
HAVE BEEN NO WAY AS DCL JUST ON
STAFF.
THE DEPARTMENT MANAGED
HEALTHCARE HAS QUESTION AND OPEN
UP ALLEGATIONS IN A CASE AGAINST --
ANTHEM BLUE CROSS IN THE
COUNTIES OF SAN DIEGO ORANGE
SANTA BARBARA COUNTIES BECAUSE
THERE WERE NO ANESTHESIA
ANESTHESIA PROVIDERS ON STAFF
BECAUSE THE TERMINATION OF
CONTRACTS SO WE INTENTIONALLY
AVOIDING THAT THE COST.
AND AND OUT OF THE MONETARY
POINTS ALL WE'RE SAYING IS YOU
JUST HAVE TO HAVE AN ADEQUATE
NUMBER OF ANESTHESIOLOGISTS
BECAUSE THERE'S A LOT OF
PROCEDURES THAT GET DONE.
IN A HOSPITAL DOCTOR POKING TALK
TO THAT BETTER THAN I THAT
REQUIRE HERE IN SD JUST SERVICES
IS KIND OF AN IMPORTANT PART OF
A HOW DO YOU GUARD AGAINST
MANIPULATION.
I'M SORRY HOW DO YOU GUARD
AGAINST MANIPULATION WITH THAT.
HOUSING THE REASON I BRING THIS
UP IS THERE'S ANOTHER INSTANCE
WHICH I WANT TO TALK ABOUT
REGARDS TO ANOTHER -- ANOTHER
ANOTHER TYPE OF PROVIDERS WHERE
THIS THE QUESTION HAD COME UP IN
PART OF THE REASON WHY THERE'S
BEEN MANIPULATION IS BECAUSE IT
REQUIRES THIS NUMBER OF PEOPLE
TO BE ABLE TO DO THAT PARTICULAR
WORK AND SO.
THIS DID DID THESE PROVIDERS
HAVE GAME THE SYSTEM AND SO HOW
DO YOU WITH WITH THIS BILL AND
HOW DO YOU AND YOU GUARD GETS
MANIPULATION BECAUSE IT WILL
HAPPEN I MEAN HUMAN NATURE TELLS
US THAT.
YEAH YOU YOU MANAGER TELLS US
WE'RE GONNA ACT OUR OWN BEST
INTEREST RIGHT SO I THINK I
THINK I COULDN'T SAY IT ANY
BETTER THAN DOCTOR WOULD WHICH
IS WE'RE TRYING TO FIND A
BALANCE AND THIS ISSUE ABOUT A
NETWORK SERVICES AND SURPRISE
BILLS HAS BEEN AN ISSUE IN.
THIS BUILDING FOR FORTY PLUS
YEARS AND WHEN WE WHEN WE DID AB
SEVENTY TWO WE REALIZED THAT WAS
A SOLUTION FOR A SNAPSHOT IN
TIME.
OKAY IT'S NOT ANY DIFFERENT THAN
WHEN WE STARTED INDEPENDENT
MEDICAL REVIEW OF THE DEPARTMENT
MANAGED HEALTHCARE.
THERE'S THERE IS AN EQUILIBRIUM
OVER TIME THE KIND OF HAPPENS
AND WHAT WE'RE SEEING IS --
SITUATIONS WHERE PATIENTS IN AND
CONTRACTED FACILITIES.
DO NOT AND POTENTIALLY WILL NOT
HAVE ACCESS TO ANASTASIA
SERVICES SO IT IS KIND OF A
BALANCING ACT THE PENDULUM
SWINGS BOTH WAYS BUT IN THESE
INSTANCES.
YOU KNOW MOMENTS AFTER THAT BILL
WAS SIGNED WE'VE STARTED TO SEE
TERMINATION NOTICES FOR
ANESTHESIA SERVICES AND JUSTIFY
SO YOUR HEAD SHAKING OF HEADS
ONE MAKE SURE THAT.
IF YOUR ADDRESS SOMETHING WELL I
I THINK IT NEEDS TO BE CLARIFIED
ANY I THINK THE TENANTS OF THE
LETTER THAT YOU.
READ OFFERED ARE LARGELY CRACKED --
THE BILL SPECIFICALLY STATES
THAT THE DEPARTMENT OF MANAGED
HEALTH CARE.
MUST TO MAKE A FINDING.
THAT THEY HEALTH PLAN HOUSE
DEMAND IS MANDATED BASICALLY --
TO IT TO DIRECT CONTRACTS.
IT'S UNCLEAR WITH OBSCENITIES
YELLED AS GROUPS ARE
ANESTHESIOLOGISTS INDIVIDUALS.
THE POINT IS IS THAT THESE
EUROPE YOU'RE REQUIRED TO
MAINTAIN THE CONTRACT -- EIGHT
THANK YOU ASPECTS OF FIVE BY THE
BILL BY LAW.
AND WE'RE TALKING ABOUT A
PROVIDER CLASS THAT IS IS PRETTY
NOTORIOUS FOR ASKING -- FOR BILL
CHARGERS THAT OUR WAY IN EXCESS
OF THE MEDICARE RATE -- AND SO
YOU KNOW IF IF AND WE HAVE
NETWORK ADEQUACY REQUIREMENTS ON
OUR BACK SO I MEAN YOU KNOW YOU
CAN ALL YOU CAN JUST ENVISION
THE SITUATION THEY'RE NOT GOING
TO BE ASKING FOR I MEAN YOU KNOW.
I'M NOT A PARTY'S CONTRACT
NEGOTIATIONS BUT I FIND IT HARD
TO BELIEVE THAT THEY'RE GOING TO
BE ASKING FOR ONE TWENTY FIVE
MEDICARE OR THE AVERAGE
CONTRACTED RATES WHEN WERE
COMPELLED TO MAINTAIN DIRECT
CONTRACTS WITH ANESTHESIOLOGISTS.
IN CERTAIN CIRCUMSTANCES SO I
JUST YOU KNOW WE'VE YOU THIS IS
A COST FOR EVER. ONE ONE CHANCE
RESPOND YOU KNOW SURE I THINK
WHEN IN DOUBT READ THE BILL
RIGHT SO THE PROVISIONS OF THE
BILL STATE THAT.
UPON RECEIVING NOTIFICATION.
THE DEPARTMENT RECEIVE
NOTIFICATION THE DEPARTMENT
SHALL ISSUE A FINDING THAT THE
EXPIRATION OR HELP.
THAT THE EXPIRATION OR HEALTH
CARE SERVICES PLAN INITIATED
TERMINATION OF THE CONTRACT WITH
THE HEALTHCARE SERVICE PLAN SO I
HAVE A IN PLACE.
CONTRACTS WITH INDIVIDUAL HEALTH
CARE PROFESSIONALS WHO ARE
LICENSED BY THE STATE TO LIVER
REFRESH ANASTASIA SERVICES SO
BOTH.
SO SERVICES CAN BE PROVIDED SO
IT IT DOESN'T DO IT DOES WHAT
THE WORD SAY IT DOES IT JUST
THEY HAVE TO MAKE A FINDING THAT
IF THEY'RE GOING TO TERMINATE A
CONTRACT.
THAT THERE ARE THERE IS AN
ADEQUATE NETWORK OF ANESTHESIA
PROVIDERS THE PROVIDE SERVICES
IN THAT CONTRACTED HOSPITAL.
WHAT THE BILL SAYS?
OKAY ANYTHING FURTHER FROM ANY
THE MEMBERS.
I'LL JUST SAY THAT I STILL HAVE
SOME CONCERNS ABOUT THIS HOUSE --
UNDERSTAND DOCTOR WOODS --
INTENT WITH THIS WE ACTUALLY
AGREE ON ON THE INTENT BUT I
HAVE SOME CONCERNS ABOUT
ACTUALLY HAVE BIG GETTING THEIR
HOUSE WILL BE -- NOT VOTING ON
THIS -- TODAY HOPEFULLY CONTINUE
TO KEEP WORKING -- WITH THAT IF
THERE'S NOTHING FURTHER -- THAN
OTHERS HAVE BEEN IN MOTION.
I WILL ENTERTAIN A MOTION.
I'M SORRY.
NO NO OF COURSE AT A MISTER
BONTA [inaudible]
M..
I WANT TO THANK DOCTOR WHAT FOR
FREE LEADERSHIP ON THIS AND AND
TRYING TO ADDRESS THE ISSUE -- I
THINK THERE IS.
A LOT OF CONSENSUS AND A LOT OF
DISCUSSION A LOT A LOT OF YOUR
LEADERSHIP HAS BEEN ON REDUCING
THE COSTS OF OF OF HEALTH CARE
SO -- I KNOW YOU'LL DO THIS BUT
I I JUST WANTED TO REINFORCE
BECAUSE I APPRECIATE YOUR
WILLINGNESS TO TALK TO FOLKS
LIKE HEALTH ACCESS IN THE PLANS
TO TRY.
TO KEEP COSTS DOWN AS WE MAKE
SURE THERE'S ACCESS TO
APPROPRIATE SERVICES FOR OUR
PATIENTS IN CALIFORNIA THANK YOU.
THE USER BONTA AND DO ON A TEN
MOTION -- MOTION BY BURKE SECOND
BY MCCARTY SECRETARY PLEASE CALL
THE ROLL.
AND I MOTIONS PASSED REYES I'M
SORRY.
I SKIPPED OVER THAT DOCTOR WOULD
YOU LIKE TO CLOSE.
YEAH.
I'M JUST LIKE SAY LOOK.
HEALTHCARE IS COMPLICATED -- IT
IS AND AND THE NEGOTIATIONS ON
AB SEVENTY TWO WERE WELL OVER A
YEAR -- AS A GOOD ESSENTIALLY
STARTED WHEN WHEN AB FIVE THIRTY
THREE DIDN'T PASSED IN TWO
THOUSAND AND FIFTEEN AND THE
PENDULUM LIKE I SAID DOES SWING
SWING BOTH WAYS -- THE THE GOAL
HERE IS IS TO CREATE SOME
STABILITY AND IN THE MARKET
PLACE AND THE GOAL IS NOT TO
HAVE.
PARTIES NOT WANT TO CONTRACT WE
WANT PEOPLE TO CONTRACT WHAT THE
ANESTHESIOLOGIST A CONTRACT AND
WHAT THE HEALTH PLANS A CONTRACT
WE WANT THEM BOTH TO DO IT
FAIRLY -- LOOK I PRACTICED
DENTISTRY FOR ALMOST THIRTY
YEARS -- HAD CONTRACTS WITH
DENTAL INSURANCE PLANS ONE IN
PARTICULAR I HAD FOR TEN YEARS.
I NEVER GOT AN INCREASE IN THE
RATE I CHARGED.
IN TEN YEARS.
IS THAT FAIR.
MY COSTS WENT UP.
THE COSTA BINA A SOFT DRINK WENT
UP THE COST OF BUYING BREAD WENT
OUT BUT MIKE I'VE I WAS NEVER
ABLE TO NEGOTIATE.
AN INCREASE FOR THAT WHILE WHILE
COSTS CONTINUE TO RISE IS THAT
FAIR.
THE ONLY OPTION I HAD WAS TO TO
NO LONGER CONTRACT WITH THAT
WITH THAT PLAN WHICH I
ULTIMATELY CHOSE NOT TO CHOSE TO
DO.
WHICH MEANT THE SOME MY PATIENTS
WERE ABLE TO GET CARE THROUGH
THAT PARTICULAR PLAN IT WAS NOT
A DECISION.
I ARRIVED AT LIGHTLY.
I AM VERY CONSCIOUS OF THE IDEA
THAT WE NEED TO CONTAIN COSTS I
ABSOLUTELY AM BUT I'M ALSO
CONSCIOUS THAT PEOPLE NEED THE
ABILITY TO MAINTAIN THEIR
PRACTICES.
AND PROVIDE SERVICES TO PEOPLE
AND WHEN THE YOU HAVE
ESSENTIALLY FLAT CONTRACTING FOR
THE THE PREMISES TO REDUCE THAT --
NOW YOU POTENTIALLY HAVE
ADDITIONAL ACCESS PROBLEMS AND
THAT'S A PROBLEM FOR ME.
I RESPECTFULLY ASK YOUR AB.
THANKS THANK YOU DOCTOR WITH
THAT WAS A GOOD CLOSE -- SECOND
IT IS COLOR ALL.
WHAT I WOULD I'D MAYES NOT PUT
MAYES NOT VOTING AGUIAR-CURRY?
THANK A CURRY I BIGELOW.
BIGELOW NOT VOTING BONTA BONTA
AYE BURKE.
BURKE I CARILLO.
CREEL AYE FLORA.
FLORIDA VOTING ALONE.
LIMóN AYE MCCARTY.
MCCARTY I IN THIS AREA.
FROM LOS RAMOS I RODRIGUEZ.
RODRIGUEZ AYE SANTIAGO SANTIAGO
AYE WALDRON.
WATER NOT VOTING [inaudible]
OUR DOCTOR WOULD YOU BILLS OUT
OF TEN ZERO OKAY MADAM SECRETARY.
WE HAVE SOME BILLS ON CALL.
I WE HAVE A CONSENT CALENDAR SO.
YOUR MOTION FOR THE CONSENT
CALENDAR.
SECOND PERFECT MOTION BY MS
CARILLO SECOND BY MISTER MAYES
THE CONSENT CALENDAR INCLUDES
ITEM NUMBER ONE A. B. SIX EIGHTY
THREE BY MISS KOREA.
I REMEMBER TO AB SEVEN FIFTEEN
WOULD ITEM NUMBER THREE AB TEN
FORTY TWO WOULD.
I'M SORRY THAT'S THAT THAT WAS
THE FIRST THAT WAS NEVER MIND
[inaudible]
YEAH.
CAN WE USE THE TERM REWIND CAM.
I ONE OF THOSE TO BE ON CONSENT
NO JUST KIDDING.
ALL RIGHT -- YOU GET SHE DID IN
FRENCH TOO SO OKAY ALL RIGHT ME
BACK UP I'M SORRY.
ITEMS.
FOR SIX THE REAL CONSENT
CALENDAR -- ITEM NUMBER SIX AB
FOR FIFTY THREE MR CHOW.
A PIECE OF EIGHT FIFTY ONE
MISTER COOPER.
AB THIRTEEN TWENTY SEVEN MISS
PETRIE-NORRIS AND AB FOURTEEN
FORTY THREE MISTER MAIENSCHEIN
SO I PROMOTION BY MISS CARILLO
WITH AN ENGLISH IT WAS IN FRENCH --
AND AND THE SECOND BY MISTER
MAYES.
AMANDA SECRETARY PLEASE CALL THE
ROLL ON THE CONSECUTIVE.
WHAT I WOULD AYE MAYES MAYES AYE
AGUIAR-CURRY BAKER CURRY I
BIGELOW?
HELLO I BONTA BONTA AYE BURKE
BURKE I CARILLO.
CARILLO AYE FLORA FLOOR I LEVEL.%
LIMON AYE MCCARTY MCCARTY AYE
NAZARIAN.
RAMOS FROST I RODRIGUEZ.
RODRIGUEZ I SANTIAGO.
SANTIAGO AYE WALDRON WATER HIGH.
AS FOURTEEN ZERO OKAY NOW WE
HAVE A BUNCH OF ITEMS ON CALL.
ITEM NUMBER ONE AB [inaudible]
SIX EIGHTY THREE MADAM SECRETARY.
THAT THAT THAT IS.
WHAT I DID PASS I'M SORRY?
I AM HAVING A ROUGH DAY.
THE WHAT DO THE WE CAN DO THE ON
KYLE ALL.
LIVE WITH THE START THE TOP OF
THE ORDER AND WE'LL CALL THEM AT
WHETHER THEY'RE ADD ONS OR OR
OPENING THE PEROT WITHIN THE
CALL.
SO ITEM NUMBER ONE AB -- SIX
EIGHTY THREE MISS CARILLO PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS MAYES BY MAYES AYE
AGUIAR-CURRY.
AGUIAR-CURRY I BONTA.
BONTA AYE BURKE.
BURKE HI THIS AREA.
NAZARIAN AYE SANTIAGO
[inaudible]
SANTIAGO BY [inaudible] FIFTY AS
FIFTEEN ZERO ITEM NUMBERTO AB --
SEVEN FIFTEEN WOULD PLEASE OPEN
THE ROLL CALL THE ABSENT MEMBERS
MAYES MAYES AYE BIGELOW.
BIGELOW AYE BONTA.
BONTA AYE BURKE BURKE HI IN THIS
AREA.
NAZARIAN AYE RODRIGUEZ.
RODRIGUEZ I SANTIAGO SANTIAGO I
THIS.
FIFTEEN ZERO ITEM NUMBER THREE
PLEASE AB EIGHT TEN FORTY TO
PLEASE LIFT THE CALL CALL THE
ABSENT MEMBERS.
MAYES MAYES AYE BIGELOW.
BIGELOW AYE BONTA AYE BONTA AYE
MCCARTY MCCARTY AYE NAZARIAN.
THIS AREA AND I RAMOS RAMOS I
RODRIGUEZ RODRIGUEZ AYE SANTIAGO.
SANTIAGO I ITEM NUMBER FOUR AB
TEN EIGHTY EIGHT WOULD PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS BIGELOW.
HELLO I BONTA BONTA AYE MCCARTY.
MCCARTY I NAZARIAN.
NAZARIAN AYE ROSS.
ROSS I RODRIGUEZ RODRIGUEZ AYE
SANTIAGO.
SANTIAGO I HAS FIFTEEN ZERO ITEM
NUMBER SEVEN PLEASE LIFT THE
CALL AND CALL THE ABSENT MEMBERS
AS AB FIVE OH SIX KALRA.
EGGER CURRY AGAR CURRY I BIGELOW.
BIGELOW NOT VOTING [inaudible]
BURKE.
BURKE I FLORA.
FLORA NOT VOTING.
MCCARTY.
MCCARTY I NAZARIAN.
IS THERE ENOUGH VOTING
[inaudible]
RODRIGUEZ.
RODRIGUEZ I SANTIAGO.
SUN. ZERO FIVE TEN SIX THAT IS
SOMEONE THAT IS TEN ONE THE BILL
WAS OUT -- ITEM NUMBER EIGHT AB
SIX FIFTEEN MISTER PEROT PLEASE
LIFT THE CALL CALL THE ABSENT
MEMBERS.
AGUIAR-CURRY.
I GET VERY AYE BIGELOW AYE
BIGELOW AYE BURKE.
BURKE I FLORA.
FLORA I MCCARTY.
MCCARTY I NAZARIAN [inaudible]
NAZARIAN I VEGAS.
RODRIGUEZ AYE SANTIAGO
[inaudible]
SANTIAGO.
IT'S FIFTEEN ZERO ITEM NUMBER
NINE EIGHTY SIX SEVENTY EIGHT
MISTER FLORA PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS
BONTA.
BONTA AYE SANTIAGO.
I'M SORRY MCCARTY. THIRTY AYE
SANTIAGO.
SANTIAGO AYE WALDRON WALDRON AYE
FIFTY AS FIFTEEN ZERO ITEM
NUMBER TEN EIGHTY SEVEN EIGHTY
FIVE PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS AGUIAR-CURRY.
BAKER CURRY I BIGELOW.
BIGELOW AYE BONTA AYE BONTA AYE
BURKE.
BURKE I MCCARTY.
MCCARTY AYE THOSE AREA.
NAZARIAN AYE SO TERRIBLE
[inaudible]
SANTIAGO I AS FIFTEEN ZERO ITEM
NUMBER ELEVEN A. B. SEVEN NINETY
EIGHT PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS AGUIAR-CURRY.
AGUIAR-CURRY AYE BIGELOW.
BIGELOW AYE BONTA.
BONTA AYE BURKE.
BURKE I MCCARTY.
MCCARTY I IN THIS AREA NAZARIAN
AYE SANTIAGO.
SANTIAGO AYE.
HAS FIFTEEN ZERO ITEM NUMBER
TWELVE SB SIX EIGHT EXCUSE ME
EIGHT TEN BY MR GIPSON PLAYS
LIFT THE CALL AND CALL THE
ABSENT MEMBERS AGUIAR-CURRY.
AGAR CURRY I BIGELOW.
BIGELOW NO.
BONTA.
BONTA AYE BURKE.
BURKE I MCCARTY.
MCCARTY AYE NAZARIAN.
NAZARIAN AYE SANTIAGO.
SANTIAGO AYE WALDRON
[inaudible]
WATER NOW.
THAT IS -- ELEVEN TO TWO A. B.
THAT NIGHT OF NUMBER FOURTEEN A.
B. NINE FIFTY FOUR WOULD PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS.
BONTA.
BONTA AYE.
NAZARIAN.
IS THERE AN AYE RODRIGUEZ.
RODRIGUEZ I SANTIAGO.
SANTIAGO AYE. FOURTEEN ZERO ITEM
NUMBER FIFTEEN AB NINE SIXTY TWO
MISS BURKE -- PLEASE LIFT THE
ROLL CALL THE UPSTART YET OPEN
THE ROLL CALL THE ABSENT MEMBERS
MAYES.
MAYES NOT ONLY [inaudible]
BONTA [inaudible]
BONTA I YOUR FLORIDA VOTING.
MCCARTY.
MCCARTY I SANTIAGO.
SANTIAGO AYE WALDRON.
WATER NOT VOTING [inaudible]
YES.
HELLO CAN ONE THAT'S ELEVEN TO
ONE ITEM NUMBER SIXTEEN AB TEN
FOURTEEN BY MR O'DONNELL PLEASE
LIFT THE KHôNG CALL THE ABSENT
MEMBERS BIGELOW.
BIGELOW NOT VOTING.
BONTA.
BONTA I MCCARTY [inaudible]
I NAZARIAN.
NAZARIAN AYE SANTIAGO SANTIAGO
AYE WALDRON.
WATER NOT VOTING.
THAT'S ELEVEN ZERO I NEVER
SEVENTEEN A. B. TEN THIRTY ONE
BY MISTRESS ERIN PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS
BONTA.
BONTA AYE RODRIGUEZ RODRIGUEZ
AYE SANTIAGO.
SANTIAGO AYE WALDRON.
WALDRON AYE.
FIFTY ITEM NUMBER NINETEEN A. B.
O. I'M SORRY THAT WAS. FIFTEEN
ZERO FIFTEEN ZERO ITEM NUMBER
NINETEEN B ELEVEN SEVENTY FOUR
WOULD PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS.
NAZARIAN.
HI IS THERE AND I ZERO ELEVEN
ZERO ITEM NUMBER TWENTY AB
ELEVEN SEVENTY EIGHT MISTER
QUIRK PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS BIGELOW.
BIGELOW AYE BONTA.
BONTA AYE MCCARTY.
MCCARTY I IN THIS AREA.
NAZARIAN EYEING SANTIAGO.
SANTIAGO AYE WALDRON
[inaudible]
OLDER NOW. FOURTEEN THAT'S
FOURTEEN TO ONE ITEM NUMBER
TWENTY ONE A. B. THIRTEEN OH
NINE WAS PARA QUE HAND PLEASE.
LIFT THE CALL AND CALL THE
ABSENT MEMBERS.
BIGELOW.
THERE WAS.
ONE ITEM NUMBER TWENTY ONE
RECEBER CAM.
NO.
BIGELOW NO BONTA [inaudible]
BONTA HI.
MCCARTY.
MCCARTY I THIS AREA.
NAZARIAN ICE SANTIAGO.
SANTIAGO AYE WALDRON
[inaudible]
WALDRON I 12-1 HAS TWELVE ONE
ITEM NUMBER TWENTY TWO A. B.
THIRTEEN TWENTY TWO BY MISTER
BERMAN PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS BIGELOW --
THE REGISTERED. TO EIGHT EIGHT
EIGHT ZERO FIVE FIVE AND THIS
SERVICES FOR SCHOOL CHILDREN.
I WANTED TO MAKE SURE IF YOU
JUST CALL ME A SQUISH.
BIGELOW NOT VOTING [inaudible]
BONTA [inaudible]
MR BONTA [inaudible]
HI [inaudible]
MCCARTY.
THE ICE SANTIAGO SANTIAGO AYE
WALDRON [inaudible]
WATER NO [inaudible]
SO NO. THIRTY SIX THIRTEEN OF
ONE THIRTEEN TO ONE ITEM NUMBER
TWENTY FIVE A. B. SIXTEEN TWENTY
TWO BY MISS CARILLO PLEASE --
LIFT THE CALL AND CALL THE
ABSENT MEMBERS AGUIAR-CURRY AGAR
CURRY I BIGELOW. TO SUPPORT THIS.
BIGELOW AYE BONTA.
BONTA AYE BONTA AYE BURKE.
BURKE I FLORA.
FLORA AYE MCCARTY.
MCCARTY AYE NAZARIAN.
NAZARIAN AYE SANTIAGO.
SANTIAGO I FIFTEEN FIFTEEN ZERO
I I'VE LAST NIGHT OF FOLKS.
ITEM NUMBER TWENTY SIX AB
SEVENTEEN EIGHTY PLEASE LIFT THE
CALL AND CALL THE ABSENT MEMBERS.
AGUIAR-CURRY.
AGUIAR-CURRY AYE BIGELOW.
BIGELOW AYE BONTA.
BONTA AYE BURKE [inaudible]
I I HAVE CARILLO SO I FLORA
[inaudible]
OR I MCCARTY.
MCCARTY I IN THIS AREA.
NAZARIAN EYES SANTIAGO.
THAT'S FIFTEEN ZERO THANK YOU
VERY MUCH AND YOU HAD A BUT
CHANGE ON ITEM NUMBER -- TWELVE
EIGHT MISS WALDRON WHAT'S IT
ABOUT CHANGE I REMEMBER TWELVE
AB.
EIGHT TEN NO TO NOT VOTING FOR
HIM BY MISS WALDRON.
MISS BURKE FOR A CHANGE ON I AM.
FROM WHAT FROM WHAT TONIGHT
RIGHT.
SO MISS -- MISS BURKE FROM A
NUMBER SEVEN EIGHTY FIVE OR SIX
I TO NOT VOTING. ONE FOR ME ON
IT I FIFTEENTH THAT WOULD BE
[inaudible]
YES.
SO AN EIGHTY NINE FIFTY SIXTY
TWO ITEM NUMBER FIFTEEN MISS
BURKE -- MISTER BIGELOW WAS FROM
NO TO NOT PUTTING.
SELECT A CELEB AND ZERO NO.
SO -- MISTER NAZARIAN ON THE
CONSENT CALENDAR.
NAZARIAN.
NAZARIAN AYE.
AS FIFTEEN ZERO YOU COULD.
YEAH THE OTHER THING YEAH
[inaudible]
WHICH ONE ONE SIXTY TWO SIXTY
ITEM NUMBER [inaudible] FIFTEEN
IS THERE HAS.
OKAY.
RIGHT THANKS EVERYONE THANK YOU.
THAT CONCLUDES OUR HEARING TODAY
THANK YOU