BUDGET SUBCOMMITTEE.
ONE ON HEALTH AND HUMAN SERVICES --
AS A YOU KNOW WHAT WE'D LIKE TO
DO SWEET WHEN WITH THE PANELISTS
COME UP WE DO ASK THE TO BE
SUCCINCT -- THE COMPLETE BUT BE
SUCCINCT IN YOUR PRESENTATIONS
WE ASK THAT YOU LIMIT YOUR
COMMENTS TO THREE MINUTES.
AND WE WILL THEN ELSE WILL DO
PUBLIC COMMENT THAT THEY BE
LIMITED TO ONE MINUTE.
OUT AT THIS IS ALSO VERY -- BUSY
TIME SO I WILL HAVE COMMITTEE
MEMBERS COMING IN AND OUT
INCLUDING MYSELF.
AND I APOLOGIZE -- BEFOREHAND
FOR MY ABSENCE -- BUT WE'D LIKE
TO BEGIN NOW WITH OUR FIRST
ISSUE AN ASSET THE PANELISTS
PLEASE COME.
DISASTER MEDICAL SERVICES BUDGET
CHANGE PROPOSAL.
I GERMAN REST MEMBERS OF THE
COMMITTEE MY NAME IS RICK
TRUSSELL CHIEF ADMINISTRATION OF
THE EMERGENCY MEDICAL SERVICES
AUTHORITY.
AND TO MY RIGHT IS CRAIG JOHNSON
CHIEF OF THE DISASTER MEDICAL
SERVICES DIVISION.
HAS REQUESTED WE WILL PROVIDE A
BRIEF OVERVIEW OF THE DEPARTMENT
SPRING FINANCE PROPOSAL WHICH IS
A PART OF THE ADMINISTRATION'S
LARGER DISASTER PREPAREDNESS
RESPONSE RECOVERY MAY REVISION --
THREE PITY OF THE EMS
AFFORDABILITY PROVIDE EMERGENCY
MEDICAL CARE TO DISASTER VICTIMS
IS CRITICAL THE DISASTER.
OR MAJOR EVENT WHILE THE EMUS OF
FORTY PLANS AND STANDS READY FOR
CALIFORNIA'S THREAT OF A MAJOR
EARTHQUAKE TSUNAMI FLOODING --
VOLCANO RECENT WILDFIRE RESPONSE
ACTIVITIES HAVE IDENTIFIED GAPS
IN OUR RESPONSE CAPABILITIES.
THE PROPOSAL UNDER CONSIDERATION
WILL PROVIDE YOU MISTER THIRTY
TWO POSITIONS AND NINE HUNDRED
SEVENTY NINE THOUSAND GENERAL
FUND IN.
NINETEEN TWENTY AND THREE
HUNDRED THREE THOUSAND GENERAL
FUND IN.
TWENTY TWENTY ONE AND ANNUALLY
THEREAFTER FOR INCREASED
DISASTER MEDICAL SERVICES
INCLUDING THE COORDINATION OF
MOBILE MEDICAL ASSETS.
AND MEDICAL VOLUNTEERS DURING
EMERGENCY RESPONSE EFFORTS.
THE REQUESTED RESOURCE IS ALSO
INCLUDE ONE TIME FUNDING OF
SEVEN HUNDRED TWENTY THREE
THOUSAND GENERAL FUND IN.
NINETEEN TWENTY FOR THE PURCHASE
OF REPLACEMENT EQUIPMENT IN
PREPARATION FOR DISASTER
RESPONSE AND FIFTY FOUR THOUSAND
GENERAL FUND ON GOING FOR
EQUIPMENT MAINTENANCE.
SO THE REQUESTED TWO POSITIONS
AND ONGOING FUNDING WILL SUPPORT
PREPAREDNESS RESPONSE AND
RECOVERY MEDICAL SERVICES
OPERATIONS INCLUDING BUT NOT
LIMITED TO THE FOLLOWING. FOR
DAY TO DAY ACTIVITIES DEVELOP
AND CONDUCT TRAINING AND
EXERCISES FOR MEDICAL TEAM
MEMBERS -- THIS INCLUDES A
CALIFORNIA CONSISTENT TEAM
MEMBERS HEALTH SYSTEM --
PROFESSIONAL STAFF REALLY HAVE
TO MEMBERS ALL OVER THE STATE
THAT WE WOULD BE TRAINING WITH
ALSO TO SUPPORT CASH INVENTORY
MANAGEMENT INCLUDING MAINTENANCE
AND ALL THE RESUPPLY THAT GOES
WITH THAT.
ON GOING COLLABORATION.
WITH MEDICAL HELP PARTNERS FOR
PLANNING AND INTEGRATION AGAIN
IS SOMETHING WE SAW A VERY
IMPORTANT IN THE RECENT
RESPONSES BEING ABLE TO
EFFECTIVELY INTEGRATE WITH THEIR
HEALTHCARE SYSTEMS IN OUR
MEDICAL TEAMS.
CONTINUED COMMENT PROGRAM
DEVELOPMENT THE CALIFORNIA
MEDICAL SYSTEM TEAM PROGRAM
DEVELOPMENT AND IMPROVEMENTS TO
THE RECRUITMENT.
AND DEPLOYMENT PROCESS SEES. FOR
RESPONSE ACTIVITIES INCLUDES
TECHNICAL STAFF. TO DEPLOY IN
SUPPORT TREATMENT SITES AND
MOBILE MEDICAL SHELTER
OPERATIONS IN THE FIELD.
PROVIDE JUST IN TIME TRAINING TO
DEPLOY IT MEDICAL TEAMS WHICH WE
HAVE FOUND TO BE OF SIGNIFICANT
IMPORTANCE -- DOING A RESPONSE --
OFTEN TIMES WE HAVE -- TEAM
MEMBERS THAT HAVE TRAIN WITH THE
TEAM BUT THEN WE HAVE NEW TEAM
MEMBERS THAT ARE DEPLOYED OUT
INTO THE FIELD AND THEN SOME
TEAM MEMBERS HAVE A DEPLOYED IN
A WHILE SO JUST IN TIME TRAINING
BECOMES CRITICAL.
ONSITE COMMUNICATIONS AND
INFORMATION SHARING WE WANT TO
BE ABLE TO PROVIDE INFORMATION --
QUICKLY TO THE DEPARTMENT
OPERATIONS CENTER MEDICAL HELP
CORONATION CENTER AS WELL AS THE
STATE OPERATION CENTERS AND
MAKING SURE THEY'RE ALL ON THE
SAME PAGE WE'RE ABLE TO IDENTIFY
THE NEEDS AND SUPPORT THE NEEDS.
THE ONETIME FUNDING BEING
REQUEST THERE WILL BE USED -- TO
FOR THE FOLLOWING.
REPLACEMENT OF OUTDATED BY
MEDICAL EQUIPMENT.
PURCHASE OF PERSONAL PROTECTIVE
EQUIPMENT FOR MEDICAL DEPLOYED
DEPLOYMENT TEAMS AND CRITICAL
INFRASTRUCTURE SUCH AS LIGHTING
AND SECURITY -- THIS IS FOR THE
BASE OF OPERATIONS.
PURCHASE OF VEHICLES TO ENHANCE
FLEET CAPABILITIES SUCH AS FLAT
BED -- TRUCK IN RECOGNIZE --
FORKLIFTS.
PURCHASE OF INFORMATION
TECHNOLOGY AND COMMUNICATIONS
EQUIPMENT SO AGAIN WE CAN
ENHANCE OUR OPERATIONS WHILE IN
THE FIELD.
AND THAT'S A QUICK SUMMARY -- SO
THANK YOU FOR THE OPPORTUNITY TO
PRESENT TODAY.
THANK YOU.
NEXT WITNESS PLEASE.
ANY PARTICULARLY -- WE'VE
REVIEWED THIS PROPOSAL AND DON'T
HAVE ANY CONCERNS AT THIS TIME.
THANK YOU.
WE ARE ALMOST FINANCED WITH INTO.
VERY GOOD THANK YOU LET'S OPEN
THIS UP TO PUBLIC COMMENT.
SEEING NONE LET'S BRING BACK TO
THE COMMITTEE QUESTIONS COMMENTS.
VERY GOOD THANK YOU SO MUCH FOR
YOUR PRESENTATION
.
RIGHT IF WE CAN ASK THE NEXT
PANEL.
TO COME FORWARD ON ISSUE NUMBER.
TWO AND ON ISSUE NUMBER ONE WE
ARE TAKING NO ACTION AT THIS
TIME TO ALLOW FOR ADDITIONAL
CONSIDERATION OF THE PROPOSAL.
ISSUE NUMBER.
TWO GOOD MORNING CHAIR MEMBERS
OF THE COMMITTEE MY NAME IS CJ
HOWARD AND THE DEPUTY DIRECTOR
OF THE HEALTHCARE WORKFORCE
DEVELOPMENT DIVISION AT THE
OFFICE OF STATEWIDE HEALTH
PLANNING AND DEVELOPMENT.
IN THE MAYOR VISION OFFERED IS
REQUESTING MULTI YEAR
APPROPRIATION AUTHORITY OF ONE
HUNDRED MILLION DOLLARS FROM THE
MENTAL HEALTH SERVICES FUND IN
FISCAL YEAR NINETEEN TWENTY TO
SUPPORT THE TWENTY TWENTY TWENTY
TWENTY FIVE WORKFORCE EDUCATION
AND TRAINING.
ALSO KNOWN AS WET FIVE YEAR PLAN.
ASA BUT IS ALSO REQUESTING
PROVISIONAL LANGUAGE TO TRANSFER
EXPENDITURE AUTHORITY TO STATE
OPERATIONS TO ADMINISTER THE
TWENTY TWENTY TWENTY TWENTY FIVE
WHAT FIVE YEAR PLAN.
THE WHAT FIVE YEAR PLAN AIMS TO
ADDRESS WORKFORCE SHORTAGES
WITHIN THE PUBLIC MENTAL HEALTH
SYSTEM THROUGH PIPELINE
RECRUITMENT ACTIVITIES
SCHOLARSHIPS AND STIPENDS AND
LOAN REPAYMENTS TO SUPPORT THE
RECRUITMENT AND RETENTION OF
INDIVIDUALS.
WITHIN THE PUBLIC MENTAL HEALTH
SYSTEM.
ADDITIONALLY THE WEB PLAN
SUPPORTS A SYSTEMS LEVEL
APPROACH TO ADDRESS IN WORKFORCE
NEEDS OF THE PUBLIC MENTAL
HEALTH SYSTEM THROUGH TRAINING
PEER PERSONNEL WITHIN THE SYSTEM.
SUPPORTING THE EXPANSION
PSYCHIATRIC TRAINING EDUCATION
PROVIDING TRAINING FOR PRIMARY
CARE PHYSICIANS TO PROVIDE A
PRIMARY CARE PSYCHIATRY AND
CONDUCTING RESEARCH EVALUATION
ON THE PUBLIC MENTAL HEALTH
SYSTEM AT WORK FORCE AND THE WEB
PLAN.
THANK YOU NEXT WITNESS.
BEN JOHNSON WITH LEGISLATIVE
ANALYST'S OFFICE -- LE ON SUNDAY
WE SENT OVER COMMENTS TO
LEGISLATIVE STAFF -- RESPONDING
TO THE GOVERNOR'S NEW PROPOSAL
AND WE IN THAT WE PROVIDE AN
ASSESSMENT SAYING THAT THERE'S
WE FOUND IN A REVIEW THAT WE
CONDUCTED EARLIER THIS YEAR ON
MENTAL HEALTH WORKFORCE THAT
THERE'S A MIXED EVIDENCE OF A
STATEWIDE -- WORKFORCE SHORTAGE --
THOUGH WE DO FIND STRONGER
EVIDENCE FOR CERTAIN PROFESSIONS
NAMELY -- PSYCHIATRISTS -- WE
ALSO FIND REGIONAL DISPARITIES --
DO EXIST HOWEVER IN TERMS OF
MENTAL HEALTH WORK FORCE
PARTICULARLY IN REGION WITH THE
Q. CHARGES FOR EXAMPLE AND
REGIONAL STATE LIKE THE INLAND
EMPIRE AND SAN JOAQUIN VALLEY.
WE ALSO FOUND THAT THERE IS
UNCERTAINTY AROUND THE
EFFECTIVENESS OF THE EXISTING --
PROGRAMS AND STRATEGIES NOTING
THAT WHERE IT BENEFITS WHERE
BENEFICIARIES THE PROGRAMS TEND
TO WORK AFTER THEY'VE COMPLETED
THEIR SERVICE OBLIGATIONS DON'T
ALWAYS MATCH UP TO THE AREAS
WITH THE HIGHEST NEED.
AND WE DO SO WE DO PROVIDE --
SOME OPTIONS FOR LEGISLATIVE
CONSIDERATION -- THE FIRST WOULD
BE THAT TAKE PAUSE AND IDENTIFY
THE STATE'S NEEDS IN THE MOST
COST EFFECTIVE STRATEGIES --
BEFORE PROVIDING FUNDING.
A SECOND WOULD BE TO SCALE BACK
FUNDING AND INSTEAD REQUIRE --
AND REQUIRE A LOCAL CONTRIBUTION
HISTORICALLY WET PROGRAMS ARE
FUNDED -- BY WHAT WE SORT OF
CONSIDER TO BE LOCAL -- MENTAL
HEALTH SERVICES ACT FUNDING SO
FUNDING THAT TODAY GOES -- TO
GOES DIRECTLY TO COUNTY -- UNDER
THE GOVERNOR'S PROPOSAL IT WOULD
BE EXCLUSIVELY SORT OF STATE AND
WHICH IS A FUNDING THAT WOULD --
FUND THIS INVESTMENT AND SO WE
DO THINK THAT IT COULD BE
APPROPRIATE -- TO HAVE LOCALS --
THAT CHIP IN FUNDING FOR THIS
PROGRAM AND THEN FINALLY WE DO --
GIVE OPTIONS OF ESTABLISHING
TIGHTER PARAMETERS O HOW THIS
FUNDING IS SPENT FOR EXAMPLE
REALLY DIRECTING IT TO THE
REGIONS OF THE STATE THAT -- WE
DO FIND ARE FACING -- THE MOST
ACUTE SHORTAGES.
AND OR FOCUSING ON THE
PROFESSIONS FOR WHICH THERE IS
GREATER EVIDENCE OF UNDERSUPPLY
SUCH AS FOR PSYCHIATRISTS AND
THE OTHER PRESCRIBING
PROFESSIONS SO HAPPY TO TAKE ANY
QUESTIONS [inaudible]
THANK YOU.
I'M IN FINANCE.
LORRAINE CHUNG DEPARTMENT OF
FINANCE I'M.
WILL DIFFER JOSH PAID FOR THE
OTHER POINTS -- THAT WILL ALLOW
OUR FOR THE OTHER POINTS AT THE
LA -- PRODUCT BUT FOR THE ON
OPTION TO SCALE BACK STATE
FUNDING AND HAVING THE COUNTIES
CONTRIBUTE MORE -- REJECTING THE
COUNTY ON MENTAL HEALTH SERVICES
FUND DOLLARS ON TO THE WEB PLAN.
HOW WOULD REQUIRE STATUTORY
LANGUAGE AND -- AT THIS TIME
WE'RE NOT PROPOSING.
TRAILER BILL LANGUAGE TO CHANGE
THE COUNTY ALLOCATIONS -- AND WE
WOULD NOTE THAT -- THE STATUE
THAT DIRECTED THE COUNTY MONEY
FOR THE FIRST TEN YEARS.
ON TO WHAT HAS SUNSET AND
COUNTIES ARE NOT EXPECTING.
TO BE ASKED TO MATCH NEED ANY
NEW FUNDING AND THEY HAVE NOT
BUDGETED FOR THIS COST -- SO
THEY MAY HAVE YOUR MARK THE
MONEY FOR OTHER PROGRAMS AND
REQUIRING A MATCH ME ON BECAUSE
DELAY TO IMPLEMENTATION -- AS
FAR AS THE OTHER POINTS THAT
WERE BROUGHT UP I WOULD DEFER.
TO THE DEPARTMENT TO ADDRESS --
YEAH IN TERMS OF I THINK WE
AGREE THAT THERE THE THERE'S A
MAIL DISTRIBUTION THE OR FOR
STATEWIDE -- AND THAT THERE ARE
CERTAINLY MORE ACUTE.
SHORTAGES IN CERTAIN PROFESSIONS
A PSYCHIATRIST.
WE ALSO JUST NOTE THAT THE THE
WEB PLAN AND THE RELATED
PROGRAMS -- HAVE BEEN DEVELOPED
THIS OF A BEST PRACTICES WITH
EXTENSIVE STAKEHOLDER ENGAGEMENT --
AND SUBJECT MATTER EXPERTS AND
USUALLY THE FUNDS WITHIN THE WEB
PLAN -- WILL BE ALLOCATED TO
REGIONAL PARTNERSHIPS BASED OFF
OF A LOCAL NEEDS ASSESSMENT SO
THEY WOULD PUT FORTH A NEEDS
ASSESSMENT TO DEMONSTRATE WHAT
THEIR NEEDS ARE BOTH WITHIN
WHICH PROGRAMS THEY WOULD FIND
IN TERMS OF WHETHER IT'S
SCHOLARSHIPS OR LOAN REPAYMENTS --
AS WELL AS WHICH PROFESSIONS
THEY WOULD TARGET TO MEET THEIR
LOCAL AND REGIONAL NEEDS
[inaudible]
THANK YOU.
LET'S OPEN IT UP TO PUBLIC
COMMENT.
GOOD MORNING CHAIR MEMBERS
SHERRY DAVIS CALIFORNIA
CONSORTIUM OF ADDICTION PROGRAMS
AND PROFESSIONALS WE SUPPORT
THIS ALLOCATION.
THE PRIOR ALLOCATIONS TO THE WEB
FUND WERE EXCLUSIVE TO PROP
SIXTY THREE FUNDING WHICH
EXCLUDED SUBSTANCE USE DISORDER
PROFESSIONALS.
FROM PARTICIPATING AND RECEIVING
THOSE STATEMENTS AND BENEFITS.
WITH THE NEW ALLOCATION
INCLUDING FIFTY MILLION DOLLARS
IN GENERAL FUND WE BELIEVE AT
THIS TIME IS APPROPRIATE TO OPEN
UP THAT FUNDING TWO SENTENCES
DISORDER.
PROFESSIONALS AS WELL THERE'S AN
EXTREME SHORTAGE OF COUNSELORS
AND IN THE MIDDLE OF AN OPIOID
EPIDEMIC AND NOW.
A WHITENING -- PSYCHOACTIVE AND
STIMULANT.
ABUSE SITUATION CALIFORNIA WE
CERTAINLY THOSE FUNDS TO BE
AVAILABLE.
TO A SUBSISTENCE ORDER
PROFESSIONALS WELL THANK YOU.
THANK YOU.
GOOD MORNING PAULA WILL HOME
REPRESENTING THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION OF CALIFORNIA.
AND WE SUPPORT THIS INVESTMENT
OF IMAGE AS A FUNDS IN STATEWIDE
WORKFORCE PROGRAMS IN PRIORITIES
AND WE KNOW THAT IT'S A CRITICAL
TIME FOR WORKFORCE INVESTMENT
AND WE AS COUNTIES RECOGNIZE THE
NEED TO IMPROVE OUR PENETRATION
RATES AND MEET THE NEEDS OF MORE
CALIFORNIANS WITH MENTAL HEALTH
CONDITIONS.
COUNTIES ARE WORKING TO BUILD
CONSISTENT HIGH QUALITY PROVIDER
NETWORKS -- TO MEET THE NETWORK
ADEQUACY STANDARDS UNDER THE
MEDICAID MANAGED CARE FINAL RULE
AND ADDRESSING THAT SPECIFIC --
SHORTAGES IN THE VARIOUS
PROFESSIONS AND IN SPECIFIC
GEOGRAPHIC AREAS IS KEY TO DOING
THIS -- AND WE WOULD AGREE THAT
IT'S IMPORTANT TO TARGET THE
FUNDING TO AREAS OF GREATEST
NEED AND PROFESSIONS WHERE --
SHORTAGES ARE MOST ACUTE AND WE
THINK THAT AWESOME HEADS PLAN TO
UTILIZE THE REGIONAL WET
COLLABORATIVE'S TO HELP DIRECT
AND TARGET FUNDING LOCALLY IS
ONE EFFECTIVE STRATEGY FOR DOING
THIS.
THANK YOU THANK YOU.
GOOD MORNING KELLY BROOKS I'M
HERE ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA
HEALTHCARE DISTRICTS AND ON
BEHALF OF THE RIVERSIDE COUNTY
BOARD OF SUPERVISORS -- I'M HERE
IN SUPPORT OF THIS FUNDING
PROPOSAL I WOULD JUST POINT OUT
THAT THE INLAND EMPIRE AND THE
SAN JOAQUIN VALLEY HAVE THE
LOWEST PROVIDER TO POPULATION
RATIOS IN THE STATE FOR ALMOST
EVERY SINGLE CATEGORY OF
BEHAVIORAL HEALTH PROVIDERS --
FUNDING FOR ADDITIONAL WORK
FORCE IS URGENTLY NEEDED
PARTICULARLY AS WE ARE HAVING
CONVERSATION STATEWIDE ABOUT
EXPANDING ACCESS IN THE STATE
YOU CAN EXPAND ACCESS IF YOU
DON'T HAVE THE PROVIDERS THANK
YOU.
THANK YOU.
THANK YOU FOR REPRESENTING THE
INLAND EMPIRE.
MADAM CHAIR MEMBERS ROBERT
HARRIS ON BEHALF OF THE
CALIFORNIA SOCIETY OF ADDICTION
MEDICINE.
WHO IS TOTALLY INVOLVED IN PROP
SIXTY THREE WE THINK THE WEB
FUNDING SHOULD BE FOR ALL
BEHAVIORAL HEALTH FIELDS? FOR
EXAMPLE THERE IS A PERSON RIGHT
I PERSONALLY KNOW WAS GETTING
WET LOAN REPAYMENT WHEN THEY
WERE WORKING HERE IN SACRAMENTO.
THEY DIDN'T HAVE ENOUGH
SUPERVISOR HOURS SO THEY CENTER
OVER TO ANOTHER FACILITY THAT
DOES SUBSTANCE ABUSE AND MENTAL
HEALTH AND THEN THEY TOLD HER
SHE COULDN'T GET HER LOAN REPAID
ANYMORE.
SO IT'S LIKE IT'S CRAZY THERE CO
MORBID SO MANY TIMES THAT IF IF
YOU DON'T ALLOW IT FOR BOTH
SIDES.
YOU AREN'T ACTUALLY DOING WHAT
WHAT THE INITIATIVE WAS INTENDED
TO ADDRESS WHICH IS WHY THERE IS
A SUBSTANCE USE DOCTOR ON THE
OVERSIGHT COMMISSION.
BECAUSE IT WAS INTENDED TO DEAL
WITH THE WHOLE COMPLEX ARRAY OF
MENTAL SUBS OUR BEHAVIORAL
HEALTH ISSUES THANK YOU.
THANK YOU.
THANK YOU MADAM CHAIR AND
MEMBERS FAIR IMITATING ON BEHALF
OF THE CALIFORNIA STATE
ASSOCIATION OF COUNTIES
REPRESENTING CALIFORNIA'S FIFTY
EIGHT COUNTIES WERE IN SUPPORT
OF THIS PROPOSAL -- COUNTIES ARE
DESPERATE FOR MENTAL HEALTH
PRACTITIONERS WE APPRECIATE IT
THANK YOU [inaudible]
THANK YOU.
ALL RIGHT LET'S BRING IT BACK TO
THE COMMITTEE.
YES MISTER FRAZIER THANK YOU
MADAM CHAIR SO WHEN WE TALK
ABOUT RESTRICTIONS ON IT AND
CLASSIFICATION OF OF WHAT
PROFESSION I GUESS.
WHEN WE LOOK AT THE ID
POPULATION ARE WE GOING IN AND
AND AND BEHAVIORAL HEALTH
BECAUSE OF THE ADVENT OF THE WAR
THE DUAL DIAGNOSIS IS NOW?
ARE WE GONNA HAVE A CATEGORY
THAT ACTUALLY.
HAS A PROFESSIONAL THAT CAN
ACTUALLY.
ADDRESS.
THE IDT COMPONENT PLUS THE
MENTAL HEALTH CHALLENGES I GO ON
HOW FOR FOR A TRAINING PROGRAM --
I'M NOT SURE I'D HAVE TO GET
BACK TO YOU.
I WOULD REALLY APPRECIATE
BECAUSE I THINK THAT.
WHEN WE START SEILING? ONE
SPECIFIC CHALLENGE THE WEEK
ALLEVIATE ANOTHER OPPORTUNITY.
THANK YOU MISTER FRAZIER
[inaudible]
I ONE OF THE THINGS IT SEEMS
LIKE A THEME THAT I KEEP SEEING
IN MANY OF THE ANALYSIS IS THAT --
THE INLAND EMPIRE SANJOAQUIN.
ARE -- BEHIND IN SO MANY WAYS.
AND I THINK THAT FOR ME I'VE
ALWAYS WHEN I'VE TAUGHT AT HOLLY
I ALWAYS TALKED ABOUT THE
CONCEPT OF EQUITY VERSUS
EQUALITY.
THE BEFORE WE CAN START BRINGING
EVERYBODY UP TO THE SITE TO
GIVING EVERYBODY THE SAME THING.
THOSE WHO ARE BEHIND HAVE TO BE
BROUGHT UP.
SO THAT WE DO HAVE EQUITY.
AT IN THERE'S A SERIOUS PROBLEM
AYE AYE I WOULD REQUEST VERY%
SPECIFICALLY.
THAT IF WE KNOW THAT THE INLAND
EMPIRE SAN JOAQUIN VALLEY.
ARE SO BEHIND AND THEY HAVE SUCH
A GREAT NEED THAT IS ALREADY
DOCUMENTED.
THEN I I WOULD ANTICIPATE THAT
THERE ISN'T GOING TO BE ANOTHER
STUDY TO DETERMINE.
HOW FAR BEHIND THE ARE WE
ALREADY KNOW THERE BEHIND -- BUT
I HEAR YOU LOUD AND CLEAR ABOUT
DOING A REGIONAL NEEDS
ASSESSMENT.
I HOPE THAT DOESN'T INCLUDE.
THIS ASPECT OF IT -- BECAUSE
IT'S ALREADY BEEN IDENTIFIED.
IS THAT SOMETHING THAT WE CAN
COUNT ON I WOULD BELIEVE THAT
THE THE NEEDS ASSESSMENT WHICH
YOU'VE CORROBORATE.
THAT THERE ARE SHORTAGES THERE
AND THEN THE FUNDING WOULD BE
TARGETED IN AREAS WHERE THERE IS
THE GREATEST NEED.
DO WE NEED ANOTHER NEEDS
ASSESSMENT.
THE WAY TO THE NEEDS DOESN'T
WORK IS THAT THE COUNTIES WOULD
PUT FORTH -- MORE LIKE PROPOSALS
ABOUT HOW THE FUNDING WOULD BE
ALLOCATED WITHIN THE WEB PLAN
AND WITHIN THE DIFFERENT
PROGRAMS -- AND AND HOW THEY
WOULD USE THE FUNDS TO AS I SAID.
I ALLOCATE BETWEEN PIPELINE A
RECRUITMENT ACTIVITIES
SCHOLARSHIPS LOAN REPAYMENT
BECAUSE ONE REGION MIGHT HAVE A
NEED FOR LOAN REPAYMENT TO
RETAIN THEIR EXISTING WORKFORCE
WHERE IS ANOTHER REGION MAY HAVE
A HIGHER NEED FOR SCHOLARSHIPS --
AND SO THAT WOULD START TO DRIVE
HOW THAT FUNDING WOULD WORK AND
THROUGH THIS NEEDS ASSESSMENT I
THINK WE WOULD SEE THE EXACT
SAME THINGS.
THIS IS A LITTLE MORE DETAILED
AND EXACTLY WHERE THE SHORTAGES
ARE ABOUT HOW THE REGION'S WOULD
ADDRESS THESE ISSUES THAT HAVE
BEEN DOCUMENTED -- AT THE THINK
ONE ISSUE THAT WE'RE WE'RE
BEGINNING TO EXPLORE IS THAT THE
OFTEN FOR TO GET FUNDING THROUGH
THE EXISTING STATE PROGRAMS --
YOU CAN QUALIFY UNDER A NUMBER
OF DIFFERENT CRITERIA SUCH AS
THE NUMBER OF MEDICAID LIVES OR
SORT OF A OTHER GENERAL CRITERIA
WHETHER OR NOT YOUR SAFETY NET
CLINIC AND SO FORTH.
AND WHILE -- SERVING THOSE
GROUPS OF PEOPLE WITH THE YOU
KNOW AND PROVIDING ADDITIONAL --
WORK FORCE FOR THOSE GROUPS IS
ABSOLUTELY LAUDABLE IT COULD
HAVE THE EFFECT OF NOT
NECESSARILY -- GOD DIRECTING THE
THE FUNDING TOWARDS SAY SPECIFIC
REGIONS AND SO FOR THE COULD
DILUTED A LITTLE BIT THROUGHOUT
THE STATE AND BE CREATING SOME
OF THAT MISMATCH BUT WE'RE
FINDING BETWEEN -- WHERE
BENEFICIARIES END UP WORKING
AFTER THEY'VE COMPLETED THERE'S --
OBLIGATIONS AND WHERE THE MOST
ACUTE NEEDS ARE.
IT ANOTHER CONCERN AND IT'S BEEN
BROUGHT UP IN THIS COMMITTEE AS
WELL AS OTHERS IS THAT
OFTENTIMES FUNDING GOES TO THOSE.
WHO ARE MOST ADEPT AT WRITING
GRANTS?
AND WRITE BEEN DESCRIBING THE
NEED AS OPPOSED TO THOSE WITH
THE GREATEST NEED -- THAT WAS
TRUE WHEN WE DISCUSS THE WILD
FIRES AND HOW THERE WAS GREAT
NEED IN SOME AREAS BUTTHEY
DIDN'T HAVE.
THE PERSONNEL TO PUT TOGETHER
THE GROUNDS AND SO.
RETHINKING HOW FUNDING IS
ALLOCATED SO THAT IT REALLY DOES
GO TO THOSE WITH THE GREATEST
NEED AND SOMETIMES THAT REQUIRES
MORE TECHNICAL ASSISTANCE. TO BE
SURE THAT AGAIN THAT WERE.
LOOKING AT EQUITY TO PROVIDE
THOSE WHO MOST NEED IT TO BRING
THEM UP. TO AN APPROPRIATE LEVEL --
EIGHT ANOTHER QUESTION I HAVE IS.
DOES THE WEB PLAN SEEK TO
LEVERAGE OTHER FUNDING. FOR THE
DEFERRED.
CHECK MY DEPARTMENT OF FINANCE
AT THIS POINT TIME OR SIMPLY
REQUESTING A HUNDRED MILLION
DOLLARS MENTAL HEALTH SERVICES
ACT FUNDING AND THERE'S NO
ADDITIONAL FUNDING BUILT INTO.
THIS REQUEST THAT WOULD HELP
FUND WHAT IMPLEMENTATION.
AT THE STATE LEVEL OR COUNTY
LEVEL.
THE LA AND IF I IF I MAY ADD A
IS THAT THE DEPARTMENT OF
FINANCE REYES DE GOOD POINTS ON
SORT OF WHAT THAT WHAT IT WOULD
TAKE TO SORT OF REQUIRE A LOCAL
LOCAL MATCH AND SO FORTH THE
ONLY THING I WOULD ADD HERE IS
THAT.
THE LOCALS DO GET -- A PORTION
OF THEIR IMAGES A FUNDING CAN BE
USED FOR WORKFORCE DEVELOPMENT
PROGRAMS UP 215% OF THEIR ANNUAL
ALLOCATIONS -- WHICH IS ABOUT
TWO BILLION DOLLARS ANNUALLY ONE
OPTION WOULD BE -- TO
POTENTIALLY BE TO SORT OF HAVE
THEM MATCH YOU KNOW STAY
CONTRIBUTIONS TO EITHER STATE OR
REGIONAL PROGRAMS OR HAVE THEM
FUND SORT OF THROUGH THE AND
CREATE THEIR OWN REGIONAL
ARRANGEMENTS WITH USING THEIR
OWN FUNDING TO TO SUPPORT SOME
OF THESE WORKFORCE ACTIVITIES.
WOULD YOU LIKE TO RESPOND.
AGAIN I THINK TO MAKE THAT
REQUIREMENT WOULD REQUIRED
TRAILER BILL STATUTORY CHANGES.
I ALSO NOTE THE CONCERNS THAT
YOU REYES RELATED -- TO
DIFFERENT REGIONS IN THE STATE
HAVING DIFFERENT CAPACITIES TO
PROVIDE THE SERVICES I THINK
REQUIRING A LOCAL MATCH FOR
THESE DOLLARS MAY EXACERBATE
THOSE ISSUES.
AS SOMETHING TO CONSIDER.
AND SOMETIMES IT'S IT SOMETIMES
WHAT'S NEEDED IS CAPACITY
BUILDING -- AT THE VERY LEAST
THAT THE VERY LEVEL THAT WE
WHERE IT'S MOST NEEDED -- WHAT
EVIDENCE IS THERE THAT THE LAST
WHAT PLAN WORKED -- SO WE'VE
CONDUCTED QUITE A BIT OF THE OF
ANALYSIS ON THE FIRST THREE
YEARS OF IMPLEMENTATION AND WE
FOUND THAT.
MOST OF THE RECIPIENTS INDICATED
THAT IT'S NOT THAT THE AWARDS
THEY RECEIVED STRONGLY
CONTRIBUTED TO THEIR DECISION TO
STAY WITHIN THE PUBLIC MENTAL
HEALTH SYSTEM.
RAISES SOME OF THE DATA THAT WE
HAVE WILL TAKE A LONGER TIME
FRAME TO COME UP WITH MORE
COMPELLING STATISTICS -- IN THAT.
SOMEBODY WHO RECEIVED AN AWARD
AND TWENTY SEVENTEEN HAS ONLY
BEEN ABLE TO STAY WITHIN THE
PUBLIC MENTAL HEALTH SYSTEM
TODAY FOR THREE YEARS SO WHEN WE
SAY THAT THE PEOPLE.
WHO RECEIVED AWARDS HAVE STAYED
WITHIN THE PUBLIC MENTAL HEALTH
SYSTEM ON AVERAGE A LITTLE OVER
TWO YEARS THAT'S BECAUSE?
ABOUT TWO AND A HALF OR THREE
YEARS HAVE PASSED SINCE WE WERE
ABLE TO DO THIS SURVEY -- SO WE
THINK THAT WITH LONGER TERM
STUDIES WILL BE ABLE TO COME UP
WITH A MORE COMPELLING STORY BUT
THE IMMEDIATE.
DATA THAT WE DO HAVE INDICATES
IT IS STRONGLY CONTRIBUTES TO
PEOPLE'S DECISION TO STAY WITHIN
THE PUBLIC MENTAL HEALTH SYSTEM.
THANK YOU. FOR THE QUESTIONS
COMMENTS.
MS REVIEW THANK YOU I'M JUST A
HEARING.
A LOT OF GIVE US THE MONEY AND
THEY WILL TELL YOU LATER.
BOB HOW HOW THIS WORKED SO MAYBE
IF YOU CAN PROVIDE US SOME DATA
ON THE SUCCESS OF THE PROGRAM OR
ON THE SUCCESS THAT YOU JUST
INDICATED I REALLY FEEL MORE
COMFORTABLE AND AUTHORIZING
ANOTHER HUNDRED MILLION DOLLARS
AYE.
I THINK -- YOU KNOW WE GET TO
THE POINT WHERE.
NOW THAT WE HAVE THE ME REVISE
AND EVERYBODY'S EXCITED ABOUT
HOW MUCH MONEY WE HAVE WHICH IS
KIND OF TELLING THEM THE MANY
OUT AND YOU KNOW MAYBE SOME
EVIDENCE.
TO THE SUCCESS AND ALSO TO THE
POINT AND I WANNA THANK YOU FOR
BRINGING THAT UP ABOUT THE
CAPACITY IS THERE ANY PLANS TO
HELP THOSE THAT DON'T HAVE THAT
CAPACITY OF SYSTEM.
THE TECHNICAL ASSISTANCE OR HAVE
WE EVEN PROVIDED TECHNICAL
ASSISTANCE TO THOSE FOLKS THAT
DIDN'T HAVE THE CAPACITY SO THAT
THEY CAN OBTAIN THIS MONEY.
I'M REALLY NOT SURE KIND OF WHAT
THE QUESTION I'M ASKING BUT IS
THERE A WAY TO IDENTIFY WHO HAS
GOTTEN I'M SURE YOU HAVE WHO HAD
GOTTEN IT WHAT REGION'S THEY ARE.
AND AND IF WE ARE TALKING ABOUT
CAPACITY I VENTURE TO SAY THAT
THOSE THAT SEMINAR DINO IN SOUTH
SAN JOAQUIN OR EVEN THE CENTRAL
VALLEY FOLKS.
HAVE NOT -- TAKING ADVANTAGE OF
THIS BECAUSE THEY DON'T HAVE THE
TECHNICAL CAPACITY TO OBTAIN
THOSE PLANS TO A WE CAN
CERTAINLY PROVIDE YOU WITH SOME
ADDITIONAL INFORMATION OR AROUND
THE OUTCOMES AND SOME SUMMARY
INFORMATION ABOUT THE OUTCOMES
THAT WE'VE PUBLISHED IN THE
TWENTY TWENTY TWENTY TWENTY FIVE
WHAT PLAN.
AND AND THEN WE CAN ALSO SHARE
WITH YOU SOME INFORMATION AROUND
WHERE THE FUNDING HAS BEEN
TARGETED WE HAD SOME PRETTY --
INFORMATIVE MAPS THAT SHOW SORT
OF FUNNY PER CAPITA AND WHERE IT
WAS MOST HEAVILY TARGETED -- I
WOULD KNOW THERE WAS QUITE A BIT
ON A PER CAPITA BASIS THAT WAS
FUNDED TOWARDS THE THE CENTRAL
VALLEY IN THE INLAND EMPIRE AS
WELL.
BUT SO WHAT WILL PROVIDE THAT
THANK YOU AND WHAT I ALSO WOULD
LIKE TO HEAR AND YOU KNOW WE WE
SIT HERE AND WE HEAR A LOT OF
YOU KNOW NUMBERS AND DATA AND I
ALSO WANT TO HEAR -- IN NOT
TODAY OBVIOUSLY BY I GUESS IN
THE FUTURE FOR WHAT I WOULD LIKE
TO HEAR IS YOU THINKING OUTSIDE
OF JUST THE MONEY AND ADDRESSING
ISSUES -- LIKE THE CHAIRWOMAN --
MENTIONED ABOUT HOW WE CAN
ASSIST THOSE LOWER.
A CAPACITY FOLKS I MEAN BECAUSE
I I UNDERSTAND YOUR JOB APPEARS
TO TELL US THIS IS WHAT WE NEED
THIS IS HOW WE'RE GOING TO DO IT
BUT AT SOME POINT.
YOU KNOW THERE'S GOT TO BE SOME --
I DON'T THINKING ABOUT HOW WE
SUPPORT THOSE COMMUNITIES THAT
DON'T HAVE THE ACCESS AND I'M
NOT HEARING THAT.
I'M HEARING YOU KNOW WE'RE GOING
TO GIVE YOU A HUNDRED MILLION
AND THIS IS WHAT WE WHAT YOU'RE
GONNA DO BY.
LOOKING FORWARD -- CAN WE
FORMULATE A PLAN OR MAYBE
SOMETHING IN WRITING TO HELP US.
HELP YOU HELP THOSE COMMUNITIES
THAT DON'T HAVE THE CAPACITY
SHOULD I THINK WE CAN ALSO
PROVIDES MORE DETAILED
INFORMATION ABOUT WITH THE STEPS
THAT WE HAVE TAKEN TO TRY TO
ENSURE THAT WE'RE WORKING WITH
PEOPLE ACROSS THE STATE AND NOT
JUST THOSE WHO HAVE THE MOST
CAPACITY.
TO PUT TOGETHER A GRANT PROPOSAL
ON HOW WE REALLY HAVE BEEN
TRYING TO ENGAGE PEOPLE --
ACROSS ALL REGIONS AND ACROSS
THE ENTIRETY OF THE STATE TO
ENSURE THAT EVERYBODY HAS --
EQUITABLE ACCESS TO THIS FUNDING
TO SUPPORT THEIR PUBLIC AND
HEALTH SYSTEM WORKFORCE NEEDS
THANK YOU AND I DO YOU KNOW WHEN
YOU CAN PROVIDE THAT INFORMATION
FOR ME.
OUR FOR US FOR THE COMMITTEE.
IT SHORTLY [inaudible]
CERTAINLY ANYTHING.
WE CAN TRY TO GET SOMETHING TO
YOU WITHIN THE NEXT WEEK OR SO
OKAY.
PERFECT THANK YOU.
THANK YOU PLEASE PROVIDED TO
STAFF -- IT WILL THEN BE
PROVIDED TO THE REST OF THE
MEMBERS [inaudible]
VERY GOOD.
THANK YOU SO MUCH LET'S MOVE ON
TO ISSUE NUMBER
[inaudible]
THREE DIRECTOR.
GOOD MORNING GO AHEAD.
GREAT SO GOOD MORNING JENNIFER
CAN AS DIRECTOR FOR THE
DEPARTMENT OF HEALTH CARE
SERVICES AND I'M JOINED BY -- G.
C. COOPER AS SENIOR ADVISER FOR
A PROGRAMS AND POLICY AND SHE'LL
TAKE US THROUGH THE FIRST COUPLE
ITEMS.
GOOD MORNING I'M SO I'LL PROVIDE
AN OVERVIEW OF THE DH CS BUDGET --
AS PROVIDED IN THE MAY REVISION
SO FOR FISCAL YEAR NINETEEN
TWENTY THE GOVERNOR'S NAY
REVISION INCLUDES A TOTAL OF A
HUNDRED SIX BILLION DOLLARS FOR
THE SUPPORT OF THE ACS PROGRAMS
AND SERVICES -- OF THAT ABOUT A
HUNDRED AND A STEP OR SORRY
EIGHT HUNDRED AND SEVENTY THREE
MILLION IS FOR STATE OPERATIONS --
I WOULD NOTE THAT IS INCLUDES AN
INCREASE OF ONE POINT FOUR
BILLION DOLLAR FUNDS FOR THE AND
A HUNDRED AND FORTY ONE GENERAL
FUND -- FROM THE GOVERNOR'S
BUDGET.
THIS PROPOSAL ALSO INCLUDES THE
ESTABLISHMENT OF EIGHTEEN
PERMANENT POSITIONS -- IN A
CONVERSION OF THIRTEEN EXISTING
LIMITED TORT LIMITED TERM
RESOURCES TO PERMANENT POSITIONS.
SO KEY ADJUSTMENTS FROM THE
JANUARY TO MAY -- REVISION
INCLUDE TIMING EVERY PAYMENTS OF
OF FEDERAL GOVERNMENT -- DUE
BACK IN SO MANY EARLY SEEING
ADJUSTMENT FROM CURRENT YEAR TO
BUDGET YEAR IN REGARDS THE
TIMING OF THOSE PAY BACKS.
YOU ALSO SEE AN INCREASE SAVINGS
FROM THE DRUG REBATES IN AND
JUST MEANT TO CASELOADS WE ARE
SEEING -- AN AVERAGE MONTHLY
CASELOAD OF SLIGHTLY OVER
THIRTEEN MILLION WHICH IS A
DECREASE FROM GOVERNOR'S BUDGET
SUGGESTS NOTING THAT -- OTHER
NEW.
DECREASE CORRECT.
OTHER NOTABLE PROGRAM CHANGES --
WHICH WE WILL GO OVER IN THE
HEARING TODAY -- INCLUDE
ADDITIONAL INVESTMENTS IN PROP
FIFTY SIX ADDITIONAL SUPPORT FOR
A WHOLE PERSON CARE LIKE
PROGRAMS.
YOUR RUN MENTAL HEALTH WARM LINE
PROP SIXTY FOUR PHARMACY BENEFIT
TRANSITIONS THE FEE FOR SERVICE
AND FULL SCOPE EXPANSION
IMPLEMENTATION SHIP TO JANUARY.
ONE TWENTY TWENTY SO SINCE WE
WILL DISCUSS THOSE ITEMS IN MORE
DETAIL ON THAT IS THE UPDATE
THAT WE HAVE FOR THE MAY
REVISION.
THANK YOU DEPARTMENT OF FINANCE.
NO COMMENT HELLO.
RIGHT WELL THE LEGISLATIVE
ANALYST'S OFFICE IN THE LAST
SEVERAL DAYS WE'VE DONE A
PRELIMINARY REVIEW OF THE
UPDATED MEDI CAL ESTIMATE.
AND DON'T HAVE ANY SIGNIFICANT
CONCERNS TO RAISE AT THIS TIME.
WE WILL HAVE COMMENTS ON SEVERAL
OF THE ITEMS THAT THE DEPARTMENT
MENTIONED.
AS THEY COME UP LATER IN THE
AGENDA TODAY.
BUT FROM A HIGH LEVEL WE'D LIKE
TO HIGHLIGHT THAT THE ESTIMATED
AMOUNT OF GENERAL FUND SPENDING
IN MEDICARE NOW.
IN TWENTY EIGHTEEN NINETEEN IS
NOW.
DOWN -- FROM THE ESTIMATE AT THE
TWENTY EIGHTEEN NINETEEN BUDGET
ACT BY THREE POINT THREE BILLION
DOLLARS.
THAT REPRESENTS -- 14%.
OF OF THE AMOUNT OF SPENDING
THAT WAS ESTIMATED AT THAT TIME --
SIGNIFICANT ADJUSTMENTS TO
ESTIMATED MEDI CAL SPENDING --
HAVE BECOME COMMON.
AND CONSIDERING THAT MEDI CAL IS
A MAJOR GENERAL FUND EXPENDITURE.
THESE UNANTICIPATED ADJUSTMENTS
CAN INTERFERE WITH THE
LEGISLATURE'S ABILITY TO
FORMULATE A PURSUE.
LONGER TERM FISCAL PLANS AND
COMPLEXITY -- IN THE MEDICAL
BUDGET ALSO CREATE CHALLENGES
FOR THE LEGISLATURE TO PROVIDE
OVERSIGHT OF THE PROGRAM.
IN JANUARY THE ADMINISTRATION
REQUESTED FUNDING FOR SOME NEW
POSITIONS.
THAT ARE INTENDED TO BETTER
ESTIMATE AND TRACK.
MEDI CAL EXPENDITURES THE
ADMINISTRATION HAS ALSO PROPOSED --
AS AS NOTED IN THE AGENDA TO
CREATE A SPECIAL FUND TO SMOOTH
THE IMPACT OF DRUG REBATES WHICH
IS AN AREA WHERE THERE IS I'M
PARTICULARLY -- LARGE
UNCERTAINTY -- WE CONTINUE TO
RECOMMEND THAT THE LEGISLATURE
APPROVE THOSE REQUESTED
POSITIONS.
AND TO CREATE THE DRUG REBATES
SPECIAL FUND INCLUDING THE
ALLOCATION OF A HUNDRED SEVENTY
TWO MILLION DOLLARS.
INTO THAT FUND -- AS INCLUDED IN
THE MAYOR VISION.
WE FURTHER RECOMMEND THAT THE
LEGISLATURE DIRECT.
THE DEPARTMENT OF HEALTH CARE
SERVICES TO SHARE KEY
INFORMATION WITH THE LEGISLATURE
THAT WOULD BE GAINED.
FROM THE POSITIONS THAT I'VE
BEEN REQUESTED -- FOR EXAMPLE AN
ADDITIONAL MADE YOUR UPDATES ON
CASH FLOWS IN KEY PROGRAM
COMPONENTS THAT ARE SUBJECT --
TO PARTICULAR UNCERTAINTY.
FINALLY RECOMMENDED THE
LEGISLATURE REQUIRE THE
DEPARTMENT TO PREPARE A PLAN
THAT WOULD BE PRESENTED TO THE
LEGISLATURE WITH LONGER TERM --
CHANGES TO IMPROVE MEDI CAL
ESTIMATES AND BUDGETING.
AND TO BEGIN THIS WITH -- AN
INCLUSIVE PROCESS THAT WOULD
INVOLVE -- STAFF FROM
LEGISLATIVE ANALYST'S OFFICE AND
OTHER LEGISLATIVE STAFF TO HELP
IDENTIFY KEY PRIORITIES FOR SUCH
LONGER TERM CHANGES.
THANK YOU PUBLIC COMMENT.
RUBBER WASTE UNIVERSITY OF
CALIFORNIA -- HEALTH LEAD
SERVICES -- CHAIR MEMBERS OF WE
HAVE A SIGNIFICANT.
PERCENTAGE WIENER WE HAVE
SIGNIFICANT CONCERNS BUT NOT
ENOUGH GRANULAR INFORMATION TO
ASSESS.
ACOSTA IN IMPLEMENTATION
PARTICULARLY THE PHARMACY
BENEFIT TO FEE FOR SERVICE.
TRANSITION UNDER CONSIDERATION.
THANK YOU THANK YOU.
THANK YOU MISTER CHAIR MEMBERS
MEGAN SUPERS ON BEHALF OF
CALIFORNIA HEALTH PLUS ADVOCATES
THE COMMUNITY HEALTH CENTERS AND
CLINICS IN CALIFORNIA --
INCLUDED IN THE MEDICAL ESTIMATE
AT AS YOU JUST HEARD WAS THE
PHARMACY BENEFIT TRANSITION TO
FEE FOR SERVICE.
I KNOW THAT MANY OF YOU HAVE
HEARD FROM US AND FROM OUR
HEALTH CENTERS ABOUT THE CONCERN.
OF THE IMPACT OF THIS PROPOSAL
ON THE THREE FORTY B. DRUG
DISCOUNT PROGRAM AND WHAT THAT
MIGHT MEAN FOR SERVICES THAT ARE
FUNDED WITH THE USE OF THOSE
SAVINGS -- I WOULD SUBMIT TO YOU
THAT WE ARE STILL A LITTLE BIT
UNCLEAR ABOUT WHERE THESE THREE
HUNDRED NINETY THREE MILLION
DOLLAR.
GENERAL STEP SAVINGS ARE COMING
FROM IF THEY'RE NOT COMING FROM
THE THREE FORTY B. PROGRAM WHICH
IS WHAT.
OUR CONCERN IS THAT THAT
TRANSITION FROM A MANAGED CARE
TO FEE FOR SERVICE ENVIRONMENTAL
DIRECTLY POOL DOLLARS FROM THE
THREE FORTY B. DRUG DISCOUNT
PROGRAM.
AND SO TO THE EXTENT OF THE
LEGISLATURE IS ABLE -- TO ASK
FOR THINGS LIKE -- DETAILED
FISCAL ANALYSIS ABOUT WHERE THE
DOLLARS ARE COMING FROM A
CONVENING A STAKEHOLDER PROCESS
OF AUG A COVERED ENTITIES.
AND PLANS IN A LIKE STAKEHOLDERS
TO TO FIGURE OUT WHERE THE
SAVINGS ARE COMING FROM -- WE
WOULD APPRECIATE THAT AND I
THINK YOU.
AND IF KELLY BROOKS IS NOT
BEHIND ME SHE ASKED ME TO
EXPRESS A ME TOO ON BEHALF OF
THE PUBLIC HOSPITALS THANK YOU
[inaudible]
THANK YOU [inaudible]
THIS FRAZIER.
THANK YOU MISTER -- GOT THIS
SORT OF CONSTITUENTS JUST UP THE
MAY REVISE CAME OUT [inaudible]
SHOP RIGHT -- THAT IT SAYS THAT --
THIRD THE UNDERSTANDINGS THEY
HAVE LEARNED ABOUT A PROPOSED
CUT TO MEDI CAL PHARMACY
REIMBURSEMENT FOR BLOOD CAUGHT
BLOOD CLOTTING FACTORS.
BY THE DEPARTMENT OF HEALTH CARE
SERVICES.
OTHER CURRENT PROPOSAL REDUCES
ALL DRAMATIC CLASSROOM.
REIMBURSED SPECIALLY PHARMACIES
WHICH CREEK INDIVIDUALS OF HIM A
FEW FILIA.
CAN YOU.
OF COURSE I'M NOT SURE SO --
THAT'S NOT NECESSARILY PART OF
THE BUDGET THERE WERE -- FEDERAL
REQUIREMENTS THAT CAME OUT -- A
FEW YEARS AGO THEY LOOKED
NATIONALLY IT STATE MEDICAID
PROGRAMS AND THE WAY IN WHICH
STATE MEDICAID PROGRAMS
PURCHASED -- BLOOD FACTOR AND
OTHER DRUGS -- RELATED TO
HEMOPHILIA AND THEY ESSENTIALLY
REQUIRED STATE MEDICAID PROGRAMS
TO COME BACK AND BREAK UP WHAT
WAS A BUNDLED PAYMENT FOR SUCH
SERVICES -- IT WAS ESSENTIALLY
AVERAGE WHOLESALE PRICE.
MINUS 20% I THINK WAS HOW THE
PRICING WORKED AND SO WE SPENT A
LOT OF TIME WITH -- THE
STAKEHOLDERS WE GOT A LOT OF
DATA FROM LIKE THE METRIC
HEMOPHILIA TREATMENT CENTERS IN
WHICH WE WANTED TO UNDERSTAND
THE COSTS ASSOCIATED WITH BOTH
THE PRODUCT ITSELF AS WELL AS
THE SERVICES.
THAT KIND OF WENT ALONG WITH THE
MANAGEMENT AND THE CARE
COORDINATION FOR SUCH PATIENTS --
SO WE WORK BOTH WITH OUR
STAKEHOLDERS AS WELL AS THE
FEDERAL GOVERNMENT TO SAY DOES
THIS NEW -- REIMBURSEMENT
METHODOLOGY.
WORK AND SO IT WAS KIND OF LIKE
A BACK AND FORTH WITH THE
FEDERAL GOVERNMENT WHERE AND WE
FILED A DRAFT STATE PLAN
AMENDMENTS -- PROBABLY.
IT WAS IT WAS LAST YEAR BUT I
WOULD HAVE TO GIVE YOU THE DATE
IN WHICH WE SAID HERE'S THE NEW
METHODOLOGY FOR HOW WE WOULD
REIMBURSE AND WE ESSENTIALLY
BROKE.
THOSE THAT THAT ARE HEMOPHILIA
TREATMENT CENTERS THAT HAVE KIND
OF AN ACKNOWLEDGE LEVEL OF
STAFFING VERSUS SPECIALTY
PHARMACIES WHICH DO NOT AND
THERE'S A DIFFERENT PAYMENT
MECHANISM PER UNIT -- BASED ON
THAT AND SO IN SOME CASES IT HAS
REDUCED -- SOME PEOPLES --
PERCENTAGE BECAUSE IT WAS JUST A
MARK UP ON THE ACTUAL COST OF
THE DRUG BUT I'M HAPPY TO
PROVIDE YOU WITH THE STATE PLAN
AMENDMENT AND AND SOME OF THE
BACKUP DETAIL.
BUT I'D LOVE FOR YOU TO BE ABLE
TO COULD CONTACT THIS --
CONSTITUENTS WHO REACHED OUT
BECAUSE I DON'T WANT THEM
FALLING RACKS OKAY THEY WERE
HAPPY TO DO THAT IS A
MISINTERPRETATION OF WHAT WAS
YEAH IF YOU WANT TO JUST PROVIDE
ME THE NAME AFTER THE ABSENT
AFTER AGAIN HAPPY TO DO THAT.
PROMISES ASSISTANCE OTHER
COMMENTS OR QUESTIONS.
VERY GOOD THANK YOU.
ANALYSTS FROM ISSUE NUMBER.
THREE IT'S TO ISSUE NUMBER FOUR
PLEASE.
FAMILY HELP ESTIMATE UPDATES.
GOOD MORNING I'LL GIVE AQUICK
OVERVIEW OF THE FAMILY HEALTH
MAY REVISION -- UPDATES SO WE
ARE SEEING VERY LITTLE --
CHANGED EXPENDITURES FOR THE
FAMILY HEALTH ESTIMATES -- YEAR
OVER YEAR THERE IS A A NOTEDFOR
MILLION DOLLAR REDUCTION FROM
THEIR NOVEMBER TO MAY REVISED --
WE ARE SEEING A DECLINE IN CASE
LOAD FOR BOTH THE CCS AND G. H.
P. P. POPULATION MAINLY DUE --
TO IN ACTIVE CASES THAT HAVE
BEEN WORKED EITHER BY THE COUNTY
OR THE DEPARTMENT TO CLOSE --
OVER TIME -- WE WOULD KNOW AS
NOTED IN YOUR AGENDA ITEM -- THE
EVERY WOMAN'S COUNTS PROGRAM DID
SEE AN INCREASE TO GENERAL FUND
OF WE WOULD KNOW THAT WE ARE
SEEING A TRANSITION TO CHEN --
DIGITAL MAMMOGRAPHY SERVICES
WHICH WOULD HAVE A CORRESPONDING
INCREASE AS WELL AS PAYMENT
REDUCTION OR PAYMENT CORRECTIONS
THAT HAVE BEEN GOING THROUGH ON
THAT OUR ACCOUNTING FOR THAT
INCREASE AT THIS TIME.
AND THEN WE TAKE ANY QUESTIONS
[inaudible]
ALL.
YOU DID SAY INCREASE RIGHT.
THAT IS CORRECT OKAY.
I HEARD DECREASE -- I SORRY AND
I WAS CORRECTED KNOWN SHE SAID
TO INCREASE.
ALL RIGHT THANK YOU NEXT WITNESS
PLEASE -- BEN JOHNSON WITH THE
LA YEAH WE HAVE NO CONCERNS WITH
THE FAMILY ESTIMATES.
I'LL CONNECT APARTMENT FINANCE
WE HAVE NO FURTHER COMMENT.
VERY GOOD THANK YOU.
LET'S OPEN IT UP TO PUBLIC
COMMENT.
SEEING NONE BRING BACK TO THE
COMMITTEE QUESTIONS COMMENTS.
ALL RIGHT.
THANK YOU FOR YOUR PRESENTATION
ON ISSUE NUMBER.
FOUR WE WILL TAKE NO ACTION THIS
TIME TO ALLOW.
FOR FURTHER.
DEBATE AND DISCUSSION.
ALL RIGHT ISSUE NUMBER.
FIVE THE PROFIT SIX MEDI CAL
EXPENDITURE UPDATES [inaudible]
OKAY -- THE PROPERTY SIX CHANGES
INCLUDE FOR ADDITIONAL
INVESTMENTS THAT I WILL WALK
THROUGH AT THIS TIME -- THERE IS
A HUNDRED AND TWENTY MILLION
DOLLAR ADDITIONAL ONE TIME
FUNDING FOR THE LOAN REPAYMENT
PROGRAM -- WE WOULD KNOW THIS IS
FOR THE ELIGIBLE PHYSICIANS AND
DENTISTS AS IT WAS ALLOCATED
ADDITIONALLY LAST THEM IN THE
TWO THOUSAND EIGHTEEN BUDGET ACT.
SO THIS ONE TIME AMOUNT OF A
HUNDRED MILLION WILL GO TO
PHYSICIANS TWO HUNDRED OR TWENTY
MILLION I WILL GO TO DENNIS THAT
BRINGS THE TOTAL ALLOCATION FOR
THE LOAN REPAYMENT PROGRAM TO
THREE HUNDRED AND FORTY MILLION.
INCLUDING THE TWO HUNDRED TWENTY
MILLION FROM THE TWO THOUSAND
AND EIGHTEEN BUDGET ACT.
ADDITIONALLY THERE WAS A SEVENTY
MILLION DOLLAR ALLOCATION ODD TO
GO TOWARDS BEHAVIORAL HEALTH
INTEGRATION -- IT AND A PART OF
THE VALUE BASED PAYMENT PROGRAM.
THIS IS IN ADDITION TO THE
HUNDRED AND EIGHTY MILLION THAT
WAS PROPOSED TO THE GOVERNOR'S
JANUARY BUDGET BRINGING THE
TOTAL INVESTMENT TO THAT TWO
HUNDRED TWO HUNDRED FIFTY
MILLION.
THE DEPARTMENT SEEKS THIS IS A
VERY IMPORTANT INVESTMENT AS WE
CONTINUE TO LOOK AT BEHAVIORAL
HEALTH INTEGRATION ACROSS OUR
DELIVERY SYSTEMS -- TO ENSURE
THAT INDIVIDUALS WHO ARE
TRANSITIONING.
BETWEEN DELIVERY SYSTEMS HAVE
APPROPRIATE CARE COORDINATION
SERVICES TO RECEIVE THE
APPROPRIATE SERVICES.
AND TO MAKE SURE THAT PROVIDERS
OFFICES CAN MEET THE NEED FOR
MEDICARE BENEFICIARIES.
ADDITIONALLY THERE IS A ONE TIME
SIXTY MILLION DOLLAR ALLOCATION
OF FOR PROVIDING TRAINING AND
TECHNICAL ASSISTANCE SUPPORT FOR
THE GOVERNOR'S PROPOSAL -- FOR
PEDIATRIC AND ADULT TRAUMA
SCREENING -- THIS FUNDING IS
SPECIFICALLY TO BE ABLE TO TRAIN
PROVIDERS -- ON THE NEW TRAINING --
TRAUMA SCREENING A WE THINK THAT
IS VERY CRITICAL AND IMPORTANT
THE PROVIDERS KNOW HOW TO DO
THIS NEW TRINI A SCREENING --
AND THAT THEY HAVE BEEN TRAINED
AND THAT THEY CAN ATTEST THAT
TRAINING IN ORDER TO RECEIVE THE
TRAUMA SCREENING PAYMENTS AND SO
THIS IS A PART OF OUR PROPOSAL
WE THINK IT'S VERY IMPORTANT --
THE LAST ITEM IS ELEVEN POINT
THREE MILLION DOLLARS TO RESTORE
OPTICAL SERVICES FOR ADULT
BENEFICIARIES IN THE MEDICARE
PROGRAM -- AND WOULD KNOW THAT
THIS WOULD BE NO AFFECTED NO
SOONER THAN JANUARY ONE OF
TWENTY TWENTY THANK YOU NEXT
WITNESS.
WELCOME AND A GUEST DEPARTMENT
OF FINANCE SO WE DO WANT TO NOTE
THAT GIVEN THE LOWER THAT DOWN
PROJECTED GENERAL FUND.
REVENUES OVER THE FORECAST
PERIOD -- THE PROPOSITION FIFTY
SIX PACKAGE -- IS PROPOSED TO
SUNSET ON DECEMBER THIRTY FIRST
OF TWENTY TWENTY ONE NEXT
WITNESS PLEASE BEN JOHNSON WITH
THE LA JOH -- DESK FIRST HAVE
COMMENTS ON THE PROPOSED SUNSET --
WE WE DO THINK THAT -- WHILE
MAKING MOST PROPOSITION FIFTY
SIX PROVIDER PAYMENT INCREASES
LIMITED TERM ACTUALLY DOES HAVE
POLICY MERIT AS IT WOULD ALLOW
REEVALUATION OF THE PAYMENTS --
IN LIGHT OF HOW WELL THEY ARE
DOING TO IMPROVE ACCESS TO
QUALITY CARE IN THE PROGRAM WE
DO HAVE CONCERNS ABOUT -- THE
FISCAL SORT RATIONALE FOR SUN
SETTING THESE PAYMENTS -- IN --
TWENTY TWENTY ONE TWENTY TWO IN
OUR INITIAL COMMENTS IN THE MAY
REVISION -- WE WE WE RAISE THESE
CONCERNS AND AT AT FOR ONE WE
FIND THAT THEY ACTUALLY
UNDERSTATE THE OF POTENTIAL
ONGOING COSTS OF OF WHAT COULD
BE ON GOING -- POLICY
COMMITMENTS SO SO IF THEY IF WE
DID DO AN EVALUATION FOUND THESE
PAYMENTS TO BE EFFECTIVE.
BUT THEN STILL SUNSET THEM
ANYWAY THAT WOULD -- THAT WOULD
THAT PROBABLY WOULDN'T
NECESSARILY BE THE THE THE MOST
PART PRUDENT SORT OF POLICY --
DECISION THERE AND IT AND THEN
ALSO JUST THAT IT SETS -- IT
SETS US UP -- FOR POTENTIAL --
FISCAL ISSUES IF THOSE DO IF WE
DO NOT SUNSET THEM -- TO WE DO
ALSO HAVE SOME OUTSTANDING
QUESTIONS ABOUT THE COST
EFFECTIVENESS OF THE VALUE BASED
PAYMENT PROPOSALS -- WILL HEAR
AN ITEM LATER TODAY ABOUT
IMPROVED -- OVERSIGHT -- OF MEDI
CAL MANAGED CARE PLANS AND AND
AND WE FIND THAT A LOT OF THE
WAYS IN WHICH THE STATE IS
INTENDING TO REALLY INCREASE ITS
OVERSIGHT.
OVER THOSE PLANS COINCIDE QUITE
CLOSELY WITH THE VALUE BASED
PAYMENTS AND SO WE DO HAVE
QUESTIONS ABOUT THE COST
EFFECTIVENESS BOTH PAYING
SUPPLEMENTAL PAYMENTS THROUGH
PROPOSITION.
FIFTY SIX AND REQUIRING IMPROVE
PERFORMANCE AND ALSO PAYING FOR
IMPROVED PERFORMANCE SEPARATELY
THROUGH THE CAPITATED RATES SO
HAPPY TO TAKE ANY QUESTIONS
[inaudible]
THANK YOU.
LET'S OPEN IT UP TO PUBLIC
COMMENT.
THANK YOU MADAM CHAIR MEMBERS
MAY CONSUMERS ON BEHALF OF
CALIFORNIA HEALTH PLUS ADVOCATES
A COMMUNITY HEALTH CENTERS -- WE
ARE EXCITED AND HAPPY TO SEE THE
ADDITIONAL DOLLARS -- DIRECTED
TO THE VALUE BASED PAYMENTS
PROGRAM PARTICULARLY FOR
BEHAVIORAL HEALTH INTEGRATION AS
MANY MORE WERE HEALTH CENTERS
ARE STARTING -- TO INTEGRATE
BEHAVIORAL HEALTH INTO THEIR
PRIMARY CARE SERVICES WE DO AND
HAVE SUBMITTED TO THE COMMITTEE
PREVIOUSLY ADJUSTMENTS TO THE
TRAILER BUT TRAILER BILL
LANGUAGE TO MAKE CLEAR THAT.
ALL QUALIFIED MEDICAL PROVIDERS --
WHICH WOULD INCLUDE COMMUNITY
HEALTH CENTERS WOULD BE ELIGIBLE
FOR THE PROGRAM WE THINK THAT'S
IMPORTANT AS WE PROVIDE CARE TO
ONE THIRD OF THE MEDI CAL
POPULATION.
AND ASK FOR YOUR SUPPORT GOING
FORWARD THANK YOU.
THANK YOU.
GOOD MORNING KELLY BE MY BEHALF
THE CALIFORNIA MEDICAL
ASSOCIATION AND WE'RE IN SUPPORT
OF THE INCREASE INVESTMENTS
USING THE ONE TIME PROP FIFTY
SIX FUNDING OF TWO HUNDRED SIXTY
THREE MILLION.
INCLUDING -- THE PHYSICIAN A
DENTIST LOAN REPAYMENT BY BEES
PAYMENTS FOR BEHAVIORAL HEALTH
INTEGRATION AND PROVIDER
TRAINING HOWEVER WE BELIEVE
OTHER FUNDING STREAMS SUCH AS
THE M. C. O. TAX -- OR OTHER
REVENUE -- OTHER THAN ONE TIME
FUNDS WOULD BE BEST SUITED TO
FUND THE RESTORATION OF OPTICAL
BENEFITS AND ALSO THE OTHER
BENEFITS THAT WERE CUT DURING
THE RECESSION. FIFTY SIX IS
PASSED BY THE VOTERS WAS
INTENDED TO INCREASE ACCESS VIA
PAYMENTS TO PROVIDERS RATHER
THAN THE BENEFITS COVERED.
OR INCREASING THE NUMBER OF
BENEFICIARIES COVERED BY
MEDICARE. FOR THE SAME REASONS
HIM AS OPPOSED TO THE USE OF
PROPERTY SIX TO FUND GROWTH IN
THE MEDICARE PROGRAM AFTER THE
GOVERNOR'S PROPOSED SUNSET OF
PROP FIFTY SIX INVESTMENTS ON
DECEMBER THIRTY FIRST.
TWENTY TWENTY ONE INSTEAD WE
REQUEST THE SUBCOMMITTEE TAKE
ACTION REGARDING THE DEPARTMENT
AB OR DIRECTING THE DEPARTMENT.
TO SUBMIT FOR A THREE YEAR STATE
PLAN AMENDMENT TO PROVE PROP
FIFTY SIX INVESTMENTS -- AS
PROPOSES SHARE AND CREATE MORE
CERTAINTY WITHIN THE MEDICAL
SYSTEM.
WE LOOK FORWARD TO WORKING WITH
THE SUBCOMMITTEE THE LEGISLATURE
AND THE DEPARTMENT AND
ADMINISTRATION -- ON HOW TO BEST
IMPROVE ACCESS FOR BENEFICIARIES
MEDI CAL [inaudible]
THANK YOU.
MORNING TO MADDEN REPRESENT THE
CALIFORNIA CHAPTER OF THE
AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS AND QUICKLY RESPOND
AS STATE OR OPPOSITION. TO THE
SUN SAID OF THE SUPPLEMENTAL
PAYMENTS AS OUTLINED IN OUR
REASONS ARE SIMILAR WITH CMA'S
MENTIONED THAT WE BELIEVE THE
INTENT OF PROPERTY SIX IS.
TO IMPROVE PATIENT ACCESS TO
CARE NOT A SO JUST TO FIND THE
MEDICAL PROGRAM OVERALL THANK
YOU.
THANK YOU.
A GOOD MORNING BRAND OF HIM AND
SPENCER WITH THE CALIFORNIA
DENTAL ASSOCIATION I JUST WANT
TO SAY WE APPRECIATE THE
ADDITIONAL FUNDING FOR THE
STUDENT LOAN -- PAYMENTS AND WE
DO HAVE SOME SORT QUESTIONS
ABOUT LOOKING FOR MORE CLARITY
ON WHERE THE ONE TIME FUND OF
RECONCILIATION IS COMING FROM
THAT TWO HUNDRED AND SIXTY THREE
MILLION -- AND AGAIN WE WOULD
ALSO WANT TO EXPRESS OUR CONCERN
IN OPPOSITION ALONG WITH THE
MEDICAL ASSOCIATION AND OTHER
PROVIDERS ABOUT SUN SETTING --
THAT PROVIDER RATES I THINK THAT
WE HAVE BEEN LOOKING FOR
CONTINUITY THAT'S WHAT THE
VOTERS VOTED FOR AND PROPOSITION
FIFTY SIX AND TWENTY SIXTEEN
THAT YOU KNOW.
WE UNDERSTAND THAT THE STATE
BUDGET IS IS THE WAY IT IS AND
THAT SOMETIMES IT GROWS AND
SOMETIMES IT SHRINKS BUT WE
REALLY NEED CONTINUITY FOR
PROVIDERS.
THEY ARE -- EXCITED WE'RE
STARTING TO SEE GROWTH MORE
DINOSAUR ENROLLING INTENTA CAL
THEY'RE SERVING MORE PATIENTS
AND WE DON'T WANT TO SEE THOSE
GAINS -- BACK REVERSED AND WE
DEFINITELY DON'T WANT TO SERVE
UNDERMINE THE TRUST THAT OUR
PROVIDERS ARE STARTING TO HAVE
BUILDING WITH THE SYSTEM BECAUSE
OF THESE NEW RATES.
THANK YOU THANK YOU.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY WE DO APPRECIATE
THE OF RESTORATION OR TEMPORARY
RESTORATION OF OPTICAL.
GLASSES AND EYEWEAR AS WELL AS I
VALUE BASED PAYMENT AND UP.
GOD PROVIDER TRAINING FOR TRAUMA
DO YOU HAVE CONCERNS REGARDING
THE TEMPORARY NATURE A WE'VE
HEARD OFTEN -- THE
ADMINISTRATION STATE THAT THEY
DON'T WANT TO GIVE A BENEFIT
JUST TO TAKE IT AWAY AND SO FAR
I WEAR AN EYE GLASSES THAT IT
WOULD BE A TWO YEAR BENEFIT --
SIMILARLY -- WE DO THINK THAT
THE END AT THE INTENT OF
PROPOSITION FIFTY SIX WAS TO
INCREASE ACCESS FOR MEDI CAL AND
THAT.
IS NOT SPECIFIC TO A PROVIDER
RATE THAT CAN INCLUDE -- OPTICAL
OTHER SERVICES AS WELL AS
EXPANSION OF ELIGIBILITY SO DO
HAVE SOME CONCERNS REGARDING THE
TEMPORARY NATURE OF THAT THANK
YOU.
THANK YOU.
GOOD MORNING WELCOME HERE ON
BEHALF OF HEALTH ACCESS
CALIFORNIA WE CERTAINLY ARE VERY
SUPPORTIVE OF THE ADDITIONAL
INVESTMENTS -- FOR THE OPTICAL
BENEFITS AGO ALSO ARE VERY
CONCERNED ABOUT THE TEMPORARY
NATURE OF THIS RESTORATION --
BUT WE ARE ALSO -- ME IN --
STRONG SUPPORT OF THE ADDITIONAL
VEST INVESTMENTS FOR THE VALUE
BASED PAYMENT PROGRAM
PARTICULARLY FOR THE MANAGEMENT
OF CHRONIC DISEASES AND ALSO
BEHAVIORAL HEALTH INTEGRATION
SUPPORT OF HOUSING.
AND OTHER -- SUPPORTS FOR
INDIVIDUALS INCLUDING WHOLE
PERSON CARE -- CERTAINLY -- WE
LOOK FORWARD TO CONTINUING TO
WORK WITH YOU ALL AS THIS GETS
WORKED OUT OVER THE NEXT COUPLE
OF WEEKS THANK YOU.
THANK YOU.
TURN MEMBERS KATHY MOSSBERG
REPRESENTING BOTH THE
DEVELOPMENTAL SERVICES NETWORK
THE INTERMEDIATE CARE FACILITY
SERVING THOSE WITH DEVELOPMENTAL
DISABILITIES IN YOUR COMMUNITIES.
AS WELL AS THE STANDALONE
PEDIATRIC SUBACUTE FOUR OF THEM
AROUND THE STATE SERVING KIDS IN
DIRE NEED.
THESE ARE ENTITIES AND WE HAVE
PROPOSALS BEFORE YOU THEY HAVE
BEEN FROZEN THEIR RATES HAVE
BEEN FROZEN SINCE TWO THOUSAND
EIGHT OR NINE WE HAVE CONTINUE
TO RELY ON STATE SUPPLEMENTAL
PROP FIFTY SIX PAYMENTS IN ORDER
TO KEEP US GOING TO KEEP US.
GOING BOUGHT YOU KNOW CAN A
CONTINUING WE HAVE GREAT CONCERN
THAT THE IDEA THAT THESE WOULD
SUNSET CERTAINLY BEFORE WE REACH
SOME RESOLUTION AROUND GETTING
BEYOND THE FREEZE AND GETTING
OUR OUR RATES BACK TO NOT BACK
TO WHERE THEY SHOULD BE.
SO PUSHY -- TIME TODAY AND IT
WOULD URGE YOUR SUPPORT FOR
THOSE PROPOSALS THANK YOU.
THANK YOU.
GOOD MORNING MADAM CHAIR MEMBERS
WHAT THE CARRERA PRISON THE LOS
ANGELES COUNTY BOARD OF
SUPERVISORS APOLOGIZE FOR BEING
OUT OF ORDER HERE -- WAS RUNNING
AROUND ANOTHER BUDGET COMMITTEE
HEARING BUT WANTED TO VOICE OUR
SUPPORT -- FOR ITEM NUMBER THREE
WHICH INCREASES ON PAGE --
SEVENTEEN THE PROPOSED TWO POINT
ONE BILLION WE'RE VERY
SUPPORTIVE OF THAT FUNDING
INCREASE FOR LOS ANGELES COUNTY
FOR MEDI CAL ESTIMATES THANK YOU
[inaudible]
THANK YOU.
LET'S BRING YOU BACK TO THE
COMMITTEE.
MISTER RAMOS THANK YOU MADAM
CHAIR AND DEALING WITH -- THE
MEDICALLY A FRAGILE CHILDREN
FRAGILE CHILDREN THE P. AT CHECK
A SUBACUTE WE TALK ABOUT THOSE
ISSUES ELEVEN YOUR FREEZE AND
TRYING TO GET THOSE PAYMENTS --
TO WHERE THEY NEED TO BE HAS
THERE BEEN ANY MORE DISCUSSION
OR IN THIS -- REVISED TO START
TO ADDRESS SOME OF THOSE THOSE
AREAS OF CONCERN -- I WOULD.
I WOULD SAY THE LEGISLATURE --
PROVIDED A ONE TIME AUGMENTATION
I'M LOOKING AT MY FINANCE
COLLEAGUES LAST YEAR ON THE FREE
STANDING PEDIATRIC SUB ACUTE --
THAT HAS NOT BEEN -- RE PROPOSED
IN THIS GOVERNOR'S MAY REVISION
OBVIOUSLY -- I THINK AS THE
LEGISLATURE IN THE
ADMINISTRATION WORK -- TO BECOME
YOU KNOW CLOSER IN TERMS OF WHAT
THE SPENDING -- PLAN IS OVER ALL
I THINK WE'RE STILL OBVIOUSLY
OPEN TO PROVIDING LIKE EITHER
DATE OUR TECHNICAL ASSISTANCE
BUT IT'S A CHANGE IN THOSE RATES
HAS NOT BEEN PROPOSED AS PART OF
THE GOVERNOR'S BUDGET.
THANK YOU AND AND DISCUSSION ON
THE ELEVEN YOU'RE A FREEZE ON
SOME OF THOSE RATES.
HAS THAT ALSO BEEN -- NOT
DISCUSSED IT WOULD BE MORE IN
THE LEGISLATURE IN THOSE
PROPOSALS COMING FOR BEFORE US
SO WE HAVE AS A DEPARTMENT WITH
PROVIDERS -- INCLUDING THE AYE
CFT DIS -- THERE HAVE BEEN
DISCUSSIONS WITH OTHER TYPES OF
SPECIALTY FACILITIES INCLUDING
THE PEDIATRIC SUBACUTE -- I
THINK THEY'VE PROVIDED -- SOME
DATA AN INPUT TO MY FINANCE SEEN
TEAM -- AND STAFF ABOUT -- IF WE
WERE GOING TO CHANGE A
METHODOLOGY AND A RATE
METHODOLOGY GOING FORWARD WHAT
WOULD THAT.
LOOK LIKE AND HOW COULD IT BE
CALCULATED I THINK THAT --
ANYTHING THAT WE AS AN
ADMINISTRATION WOULD PROPOSE
WOULD OBVIOUSLY BE YOU KNOW IN
CONCERT WITH THE DEPARTMENT OF
FINANCE AND THEN WOULD BE
REFLECTED MOST.
APPROPRIATELY AND LIKE A BUDGET --
YOU KNOW BY THE GOVERNOR EITHER
ON A JANUARY OR ME TYPE OF BASIS
BUT AT THIS POINT IN TIME WE
HAVEN'T -- PROPOSED ANYTHING
DIFFERENT BUT WE ARE ALWAYS OPEN
TO LOOKING AT METHODOLOGIES TO
SAY IS THERE SOMETHING THAT.
WE COULD DO DIFFERENTLY OR OR
CALCULATE IN A WAY THAT WOULD.
YOU KNOW BETTER REFLECT THE THE
COSTS INVOLVED.
THANK YOU THANK YOU FOR THAT TOO
AND IN OUR OFFICE IS OPEN TO SET
A MEETING TO REALLY TRY TO
UNDERSTAND THAT I THINK.
IN OUR AREA IN THE ASSEMBLY
FORTY TH DISTRICT INLAND EMPIRE
AREA.
WE HAVE A A LARGE NEED -- THAT'S
THERE AND I JUST WANNA MAKE SURE
THAT AS WE CONTINUE TO TALK IN
THE DIALOGUE WAS FORWARD WITH
THE MEDI CAL REIMBURSEMENT.
RATES AND ALL THAT WE DON'T
FORGET ABOUT THE MEDICALLY
FRAGILE CHILDREN ALSO THAT NEED
THOSE SERVICES DRASTICALLY.
IT MOVED OVER INTO -- PROP FIFTY
SIX FUNDS -- LAST YEAR I BELIEVE
BUT LET'S MAKE SURE THAT THAT
DIALOGUE AND THEIR VOICES STILL
BE HEARD IN ALL THESE DIFFERENT
DISCUSSIONS THAT ARE GOING ON
THANK YOU THANK YOU VENTURE.
THANK YOU MISTER HONEST DOCTOR
WOULD.
YES SIR THANK THANK YOU MADAM
CHAIR I'M AND MAKE SOME COMMENTS
OF SIMILAR TO WHAT I MADE LAST
NIGHT AND AND I'M.
I'M DISAPPOINTED BY THIS TREND
LAST NIGHT WE HEARD.
THAT -- SOME PROVIDER INCREASES
FOR OUR FOR FOR THE AYE DDS
COMMUNITY WOULD ALSO BE
POTENTIALLY SON SAID IT.
NOW WE'RE SO YOU'RE HEARING THE
PROP FIFTY SIX WILL BE PROVIDE
RATE INCREASES WILL BE
POTENTIALLY SUNSET AT THAT SENDS
A REALLY UNSETTLING MESSAGE TO
THE PRIVATE AT THE THE PROVIDER
COMMUNITY I THINK IT'S WRONG.
THE GOVERNOR HAS THE ABILITY OR
WE TO HAVE AN ABILITY THROUGH
THE BUDGET PROCESS TO SUSPEND
THOSE ADDED DATE SHOULD THE NEED
ARISE.
BUT TO HAVE TO GO BACK AND OVER
AND OVER AGAIN CLAW BACK FOR
THESE BENEFITS.
DOCTORS AND DENTISTS AND OTHER
PEOPLE WENT OUT.
SPEND A HUGE AMOUNT OF MONEY. TO
PUT THIS PROPOSITION ON THE
BALLOT AND GET IT PASSED BECAUSE
WE COULDN'T FIND ANOTHER
RESOURCE.
AND I UNDERSTAND THAT THE
GOVERNOR OF LAST GOVERNOR FELT
THAT THEY COULD TAKE SOME OF
THIS MONEY AND USE IT AND AND
THEY HAVE.
AND IT APPEARS THAT THIS IS
GOING TO HAPPEN WITH THIS NEW
ADMINISTRATION HERE AS WELL.
AND THERE'S NOT MUCH THERE'S NOT
MUCH WE CAN DO ABOUT THAT I
THINK WE ACCEPT THAT.
BUT I THINK THE MESSAGE THAT
SENT TO THE PROVIDER COMMUNITY
THAT SOMEHOW WE'RE GONNA HAVE TO
FIGHT FOR THIS OVER AND OVER AND
OVER AGAIN WHEN WE ALREADY KNOW
THAT THE BUDGET PROCESS WE CAN
MAKE THESE CUTS.
I THINK IS IS GROSSLY UNFAIR.
WE ARE TRYING TO GET MORE AND
MORE PEOPLE TO PARTICIPATE IN
THE MEDICARE PROGRAM AND YOU
CREATE THIS UNCERTAINTY OUT
THERE.
I'M SORRY THAT'S I DON'T SEE HOW
THAT'S PRODUCTIVE.
IT WE'RE GONNA BE EXPANDING
COVERAGE TO MORE AND MORE PEOPLE
WE NEED A PROVIDER BASE THAT
SOLID DEPENDABLE AND IS WILLING
TO BE THERE WITH US FOR THE LONG
RUN.
THEY DON'T NEED UNCERTAINTY.
AND THAT GOES FOR A LOT OF
OTHERS AS WELL SO -- I JUST.
I JUST FRUSTRATED BY THE BY THE
MESSAGE I GET THAT WE WE LOOK AT
PETITE FUTURE POTENTIAL.
FISCAL UNCERTAINTY WE ALL DO.
BUT THIS IS UNSETTLING THEY SAID
YESTERDAY WE ASKED WE WERE ASKED.
TO HIRING FOR FIFTEEN POSITIONS.
OF FOR STATE GOVERNMENT OF THOSE
FIFTEEN POSITIONS TOLD THAT YOUR
YOUR JOB MIGHT BE SUNSET IT I
DOUBT IT.
BUT WE'RE TELLING OUR PROVIDER
COMMUNITY THIS TAKING CARE SOME
OF OUR MOST VULNERABLE PEOPLE
OUT THERE THAT THEY COULD BE
SUNSET IT.
SO -- I I OBJECT TO THE THE WAY
THIS IS DONE AND I JUST I JUST
THINK IT'S UNFORTUNATE THAT THIS
IS SENDING THE WRONG MESSAGE IS.
THANK YOU DOCTOR WOULD FRAZIER.
TAKE I JUST WANT TO KIND OF IT.
ADD ON TO THAT WHY WOULD ANYBODY
WANT TO HELP ANYMORE WHY WOULD
THEY WANT TO DO TAKEN DO WHAT
YOU WANT WITH IT.
I MEAN THANK GOD WITH SB ONE
WEEK CONSTITUTIONALLY PROTECTED.
WITH -- ME SEE A FIVE AND PROP --
SIXTY NINE AND AGAIN MY MEANS.
IT WAS A CONCERTED EFFORT TO BE
PART OF THE SOLUTION.
AND WE TOOK [inaudible]
WE THE PROCESS TOOK ITS.
NORMAL TOLL ON WHAT THE WHEN
PEOPLE TRY TO HELP AND IT'S JUST
AGENTS NEEDS TO STOP.
OUR FINAL ON THE OTHER NOTE WHEN
YOU TALK ABOUT THE TEAM
INTERVENTION -- OF TRAINING.
DO WE KNOW OF ALL THE FIFTY
EIGHT COUNTIES.
EACH ACTUALLY EVEN HAVE CAPACITY
FOR PEDIATRIC ROUTINE CRISIS
BEDS.
AS I KNOW SEVERAL MY COUNTIES
DON'T.
AND SO YOU KNOW I THINK WE HAVE
TO IN PARALLEL FOR GONNA DO THE
TRAINING WE HAVE TO ACTUALLY
HAVE A A PLACE.
TO HELP THESE CHILDREN.
AND NOT PUTTING THEM IN SAVE.
THIRTY HOSPITAL THEN JUVENILE
HALL -- THAT'S ALL I HAVE IS ONE
COUNTY -- SO I'M THINKING THAT
YOU KNOW WAS GREAT HAVE AND I
APPRECIATE THE THOUGHTFULNESS
BUT IMPERIL WE NEED TO BE ABLE
TO MAKE SURE THAT HE CAN BE
EFFECTIVE.
AND ACTUALLY -- INSTEAD OF
THROWING MONEY GOOD MONEY AFTER
BAD.
THAT THAT THE COUNTIES ARE
ACTUALLY GOING TO BE ABLE TO
ACCOMPLISH.
I WILL -- WELL INTENTIONAL --
BUT I MEAN.
WHY WOULD WE WILL GO AHEAD AND
JUST START TRAINING PEOPLE AND
AND PUTTING THINGS IF WE CAN
ACTUALLY?
WE DON'T HAVE THE CAPACITY.
THANK YOU MISTER FRAZIER MR
MATHIS.
I'M GONNA GO THE SAME CONCERNS
AS MY COLLEAGUES HERE.
IN A HOME [inaudible]
WE HAVE.
A IN A SAID THIS LAST NIGHT.
TWENTY ONE POINT FIVE FIVE
BILLION DOLLAR SURPLUS.
NOT TO MENTION THAT THE TWENTY
BILLION PLUS SURPLUS FROM LAST
YEAR.
IN THE FACT THAT WE'RE TALKING
ABOUT SUNSETS.
I MEAN I I DON'T KNOW HOW YOU
ALL EXPECT TO RECRUIT PROVIDERS.
TO DO THAT.
BECAUSE IT'S YOUR TALENT -- MAY
SET UP A BUSINESS MODEL THAT'S
ONLY GONNA LAST FOR A FEW YEARS.
A WHO WANTS TO INVEST IN THAT.
AND THAT'S BEEN THE BIGGEST
PROBLEM WE HAVE.
THE LARGEST PROBLEM WE HAVE IN
CALIFORNIA'S ACCESS.
IN THAT MEANS ACCESS TO GET
PROVIDERS TO PROVIDE THE
SERVICES.
SO OUR FAMILIES ARE STUCK WITH
THESE HUGE WAIT TIMES ARE OR
LIKE SOME OF US AND AND RURAL
COUNTIES -- YOU KNOW.
IT'S HOURS LONG DRIVE STEVEN GET
IN IN YOUR YOUR HAVE A LONG TIME
TO WAIT JUST TO DO THAT.
IN ITS FAMILIES TAKING DAYS OFF
WORK KIDS OUT OF SCHOOL TO BE
ABLE TO DO THIS IN AND YOU WERE
THE WHOLE PURPOSE IS TO GET MORE
PROVIDERS TO INCREASE ACCESS
[inaudible]
SO.
WHAT KIND OF SUSTAINABILITY ARE
WE GONNA HAVE WITH THE SUNSETS
[inaudible]
AND AND AND I KNOW THE THE
OLIGARCHY WITHIN THE GOVERNOR'S
OFFICE IS ALREADY MADE THE
DETERMINATIONS ON THIS SIDE.
AND WE'VE SEEN THAT WITH THIS
REVISED I JUST HOPE THAT -- MY
COLLEAGUES AND I ALONG WITH OUR
COLLEAGUES IN THE SENATE COULD
PUT ENOUGH PRESSURE BACK ON THE
ADMINISTRATION TO GET REALLY
SUNSETS IS THIS TRAILER LANGUAGE
COMES UP NEXT WEEK.
BECAUSE THIS THIS ISN'T GOING TO
WORK WE ALL KNOW IT'S NOT GOING
TO WORK AND IT'S NOT GOING TO
PROVIDE THE SUSTAINABILITY THAT
WE NEED.
SO IF LA -- IF YOU GUYS HAVE THE
ABILITY TO GET US SOME TRAILER
LANGUAGE ACTUALLY FIX THAT OCCUR
THE SUNSET SO WE CAN ACTUALLY
PROVIDE CERTAINTY I'D LOVE TO
SEE [inaudible]
THANK YOU.
I THINK IT DOES BEG THE QUESTION.
WHY IS THERE A PROPOSED THREE
YEAR SUNSET GIVEN THAT THESE ARE
SPECIAL FUNDS? FOR THIS PURPOSE.
WELL ABOVE MEDICARE'S DEPARTMENT
OF FINANCE -- SO OVER THE MULTI
YEAR THE FIVE YEAR PERIOD WE ARE
PROJECTING A REVENUE DEFICIT --
IN THE OUT YEARS AND PROP FIFTY
SIX HAS BEEN USED TO FUND MEDI
CAL GROWTH -- IN THE PAST AND SO.
ARE OUR MULTI YEAR FORECAST
ASSUME THAT IN -- BUDGET BUT
DEAR TO HIM BUT DO YOUR THREE WE
WILL BE USING PROP FIFTY SIX
FUNDS TO FUND MEDI CAL PROGRAM
GROWTH.
AND SO THE YOU KNOW THE GOVERNOR --
HAS EXPRESSED -- DESIRE TO
PRESENT A BALANCED BUDGET --
WITHOUT -- IF THIS IS AN
APPROVED THERE WILL BE
REDUCTIONS ELSEWHERE IN THE
BUDGET AND SO IT'S ALL ABOUT
ABOUT A BALANCING ACT.
THE RESOURCES -- THAT WE TALK
TALK ABOUT IN THE OUT YEARS AND
YET LAST NIGHT.
WE'RE NOT GOING TO REPEAT ALL OF
OUR DISCUSSION FROM LAST NIGHT
IT WAS A VERY LONG MEETING
[inaudible]
BUT IF WE'RE TALKING ABOUT THE
FACT THAT IN THE OUT YEARS WE
MAY HAVE.
LESS RESOURCES WE KNOW THAT'S
ALWAYS A POSSIBILITY IS DOCTOR
WOULD IS IT HAS SAID WE HAVE THE
ABILITY TO THEN COME TOGETHER IN
THE BUDGET.
AND REDUCE OR OR ELIMINATE
WHATEVER NEEDS TO BE DONE.
BUT THE STABILITY THAT IS NEEDED
FOR THE PROVIDERS AND FOR THOSE
DATES THE SERVICE EXTREMELY
IMPORTANT.
AND I THINK THAT.
WE HOPE THAT THAT IS THE MESSAGE
THAT YOU ARE HEARING.
NOT JUST HERE BUT YET IT IS
EXTREMELY IMPORTANT WE DON'T SET
A PRECEDENT THAT DURING THE THE
THE YEARS WHEN WE DO HAVE A
SURPLUS.
THAT IN THOSE YEARS WE ARE STILL
NOT PROVIDING THE STABILITY THAT
THAT IS NEEDED IN A PROGRAM SUCH
AS THIS.
AND WE UNDER WE UNDERSTAND YOUR
CONCERNS -- AND DO WANT TO SAY
THAT THE ADMINISTRATION -- IS
COMMITTED -- TO LONG TERM --
CHANGES AND AND THE HEALTH --
UNIVERSE AND SO I DID DID ONE
EXPRESSED A COMMITMENT FROM THE
GOVERNOR SO THERE ARE SORT OF A
LONG TERM PLAN -- TO MAKE
CHANGES AND IN THE HEALTH SYSTEM
[inaudible]
THANK YOU.
YES DOCTOR WOULD.
ARE JUST JUST ANOTHER ANOTHER
COMMENT I THINK I THINK I'VE
MADE MY POINT THAT.
IT'S A MESSAGING THAT THAT THAT
BOTHERS ME AND AND AND AND IT
FEELS LIKE WE'RE NOT VALUING OUR
PROVIDERS WHEN WE TELL THEM THAT.
YOU KNOW YOU'RE YOU'RE UP FOR A
SUNSET YOU'RE GONNA HAVE TO
FIGHT THEM FOR THAT.
I WOULD SAY I WILL POINT OUT AND
I'M THIS ISN'T THE FIRST TIME I
POINTED OUT WE HAVE A A UPS
POTENTIAL BIG SOURCE OF REVENUE
THAT ISN'T CURRENTLY ON THE
TABLE RIGHT NOW THAT'S THE MCO
TAX.
WOULD WHICH WOULD BE BECAUSE OF
BETWEEN ONE POINT FIVE ONE POINT
EIGHT BILLION DOLLARS.
AND A BUNCH OF THAT IS FEDERAL
MONEY.
AND SO.
YOU WANT STABILITY OUT THERE --
I WOULD ENCOURAGE THE
ADMINISTRATION TO LOOK SERIOUSLY
GOING AND GOING AFTER THAT
RESOURCE A RENEWAL OF SOMETHING
THAT'S BEEN IN PLACE FOR FOR
SEVERAL YEARS NOW [inaudible]
VERY GOOD.
THANK YOU MEMBERS OF THANK YOU
TO THE PANELISTS.
ISSUE NUMBER SIX WILL BE DIVIDED
INTO TWO ISSUES ISSUE.
SIX EIGHTY WILL BE THE TOP
PORTION.%
OF PAGE.
TWENTY FIVE MEDI CAL ELIGIBILITY
EXPANSION UPDATES.
AND WITH.
ISSUE SIX BE WILL BE THE TRAILER
BILL LANGUAGE NOTED AT THE
BOTTOM OF THE PAGE [inaudible]
PLEASE BEGIN.
I'M SO GIVE A AN UPDATE ON THE
MEDICAID EXPANSION TO
UNDOCUMENTED YOUNG ADULTS
NINETEEN TO TWENTY FIVE AS
PRESENTED IN THE MAY REVIEW
REVISION.
THERE ARE TWO MAIN CHANGES THAT
YOU'LL SEE IN THIS PORTION THE
FIRST ONE BEING THE PROPOSED
IMPLEMENTATION DATE -- NOW BEING
PROPOSES JANUARY -- ONE TWENTY
TWENTY THE REASON WHY WE ARE PER
PROPOSING THIS REVISED
IMPLEMENTATION DAYS TO ENSURE
THAT OUR SYSTEMS ARE READY FOR
THE TRANSITION.
IF YOU HAVE PROPER COMMUNICATION
OUT TO THE BENEFICIARIES -- AND
TO ENSURE THAT EVERYBODY
INCLUDING OUR COUNTIES ARE READY
TO TRANSITION SUCCESSFULLY WE
DID LEARN FROM THE PREVIOUS
IMPLEMENTATION AND SO WE DO HAVE
SOME EXPERIENCE IN INFORMATION
ABOUT -- HOW LONG IT TAKES TO
PREPARE SYSTEMS -- AND TO
COMMUNICATE EFFECTIVELY TO
INDIVIDUALS ABOUT THE CHANGE --
SO THAT'S THE THE FIRST CHANGE
THE SECOND CHANGE IS GOING TO BE
THE REVISED ESTIMATE OF THE
COVERED BUYS WHICH YOU'LL SEE AN
ADJUSTMENT SLIGHTLY -- TO WHAT
WE ARE PROPOSING AS AN ESTIMATED
TO EXTEND FULL SO COVERAGE TO
NINETY THOUSAND INDIVIDUALS
SEVENTY FOR A 75% OF THOSE
INDIVIDUALS WOULD BE
TRANSITIONING FROM CURRENT
RESTRICTED SCOPE TO FULL SCOPE.
AND THE OTHERS WOULD TRANSITION
AS A PHASED IN -- OVER A TWELVE
MONTH PERIOD.
THAT IS ALL MY COMMENTS AT THIS
TIME.
THANK YOU NEXT WITNESS.
LORI L. AT DEPARTMENT OF FINANCE
AS MY COLLEAGUE FROM THE
DEPARTMENT OF HEALTH CARE
SERVICES STATED THE MAY REVISION
ASSUMES A SIX MONTH -- SHIFTED
IMPLEMENTATION AND ALSO -- ONE
HUNDRED TWENTY TWO MILLION
DECREASING COSTS AND 80% OF THE
DECREASING COSTS THAT IS
ATTRIBUTABLE TO THE SIX MONTH
SHIFT.
THE OTHER 20% IS ATTRIBUTABLE TO
THE DECREASE ENROLLMENT AND THE
DECREASE IN ROME IS BASED ON THE
LATEST AVAILABLE DATA -- ON
UNDOCUMENTED INDIVIDUALS IN THE
STATE AS YOU MAY RECALL
RESEARCHER FROM THE UC BERKELEY
LABOR CENTER PRESENTED.
A FEBRUARY TWENTY NINETEEN
REPORT WHICH STATES -- THAT THE
TRENDS OF UNDOCUMENTED
INDIVIDUALS IN THE STATE HAVE
BEEN -- DECREASING SINCE -- TWO
THOUSAND SEVEN AND THE REVISED
PROJECT ENROLLMENT OF NINETEEN
TO TWENTY FIVE YEAR OLDS IS A
HUNDRED AND FOUR THOUSAND THE
NINETY THOUSAND THAT MY
COLLEAGUES STATED.
IS -- PART OF THE PHASE IN IN
THE FIRST YEAR AND OF THE
REMAINING INDIVIDUALS WE WOULD
EXPECT WOULD PHASE IN OVER.
AND THE NEXT SIX MONTHS AND IN
THE IN BUDGET YEAR PLUS.
ONE THE ADDITIONALLY THE
DECREASE -- IS CONSISTENT THE
TREND OF DECREASING UNDOCUMENTED
UNINSURED INDIVIDUALS IN THE
STATE IS CONSISTENT WITH THE
DIFFERENT HEALTH CARE SERVICES
TWENTY EIGHTEEN DATA THAT LATELY
LATEST DATA USED IN.
THIS UPDATED ESTIMATE THAT SHOWS
THAT THE NUMBER OF RESTRICTED
SCOPE INDIVIDUALS ENROLLED IN
MEDICARE AL HAS BEEN DECREASING
SINCE SIXTEEN SEVENTEEN AS WELL
AS THE NUMBER OF CHILDREN IN
ROLL THROUGH SB.
SEVENTY FIVE THAT PEAK WAS -- IN
APRIL TWENTY SEVENTEEN AND IT
HAS BEEN INCREASING SINCE THEN
ADDITIONALLY THE TOTAL MEDI CAL
CASELOAD HAS BEEN DECREASING TO
SIXTEEN SEVENTEEN SO WE FEEL
THAT THE ALTHOUGH IT APPEARS TO
BE A SIGNIFICANT DECREASE IN
ELIGIBLE.
IS A REASONABLE AND CONSISTENT
WITH ALL THE RESEARCH THAT WERE
SAYING.
THANK YOU HELLO -- BEN JOHNSON
WITH THE LA -- WE DON'T HAVE ANY
CONCERNS WITH THE SHIFT IN THE
IMPLEMENTATION DATE -- TO HALF
YEAR JUST NOTING THAT THERE ARE --
PROCESS SEES THAT THE DEPARTMENT
DOES HAVE TO UNDERTAKE TO AFFECT
THAT TRANSITION -- AND THEN ON
CASELOAD -- WE ARE WORKING AND
CONTINUE TO WORK WITH THE
ADMINISTRATION HAVE BEEN REALLY
PROACTIVE IN PROVIDING US REALLY
GOOD INFORMATION TO JUST
UNDERSTAND A LITTLE BIT MORE
ABOUT -- THE CASELOAD DECLINE
WILL CONTINUE TO WORK WITH THEM
OVER THE COMING DAYS BUT DON'T
HAVE ANY REAL CONCERNS THERE --
JUST GUESS I'D NOTE THAT THAT
ACCORDING TO OUR ESTIMATES THAT
DOES -- THAT WOULD REDUCE OUR
PROJECTIONS OF ON GOING GENERAL
FUND COSTS BY ABOUT EIGHTY
MILLION COMPARED TO WHAT WE HAD
IN JANUARY [inaudible]
THANK YOU.
LET'S OPEN IT UP TO PUBLIC
COMMENT.
GOOD MORNING TURN MEMBERS DEEPLY
ACNE SHOW WITH THE CALIFORNIA
IMMIGRANT POLICY CENTER -- WE
ARE IN SUPPORT OF ITEMS SI
EIGHT THE GOVERNOR'S PROPOSING --
AN INITIAL LIKE EXPANSION THAT
WE ARE APPRECIATIVE OF ON OUR
PATHWAY TO GET TO UNIVERSAL
COVERAGE HOWEVER -- WE WOULD ASK
THAT THE COMMITTEE CONTINUES TO
CONSIDER HOW TO ACHIEVE -- A
FULL EXPANSION OF THE
UNDOCUMENTED POPULATION ARMED
AND ESPECIALLY FOR THIS YEAR OUR
COMMUNITY IS I REALLY INVESTED
IN ENSURING THAT SENIORS ARE
COVERED BECAUSE OUR SENIOR
CENTER COMMUNITY.
ARE FACING SOME OF THE WORST
HEALTH OUTCOMES I'M FOR SIXTY
FIVE AND OVER AND SO I WILL BE
OUR SUPPORT IF YOU WOULD ASK FOR
AN ADDITIONAL INVESTMENT THANK
YOU SO MUCH.
THANK YOU.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY VERY
APPRECIATIVE OF THE SAP PROPOSAL
I DO AGREE WITH THE DELAY IN
TIMELINE BASED ON A PREVIOUS
IMPLEMENTATION EFFORTS AND SO
IT'S YOU KNOW ISSUE THERE.
ARE SIMILARLY CONSIDERING THE
THE DECLINES IN REVENUES WOULD
URGE THE LEGISLATURE CONSIDER --
EXPANDING BEYOND A YOUNG ADULTS --
AND AS OF THE CALIFORNIA
IMMIGRANT POLICY CENTER HAS
STATED I THE COMMUNITY HAS
PRIORITIZED SENIORS INDIVIDUAL
SIXTY FIVE AND OLDER SO DO YOU
AGREE WITH THAT THANK YOU.
THANK YOU.
GOOD MORNING RANDALL COMING HERE
BEHALF OF HEALTH ACCESS
CALIFORNIA CERTAINLY HERE IN
STRONG SUPPORT OF THE GOVERNOR'S
PROPOSAL TO EXPAND MEDICARE OUT
TO YOUNG ADULTS IN THE
UNDOCUMENTED COMMUNITY CERTAINLY
WE DO THINK THAT THIS IS THE
YEAR FOR THE LEGISLATURE TO TAKE
IT A STEP FURTHER -- BUT WE DO
BELIEVE AT THIS TIME BASED ON
WHAT WE'VE HEARD FROM THE
COMMUNITY THAT WE SHOULD BE
FOCUSING ON THE SENIORS
POPULATION IT IS ABOUT THIRTY
THOUSAND PEOPLE 2% OF THE ENTIRE
UNDOCUMENTED POPULATION.
IT IS A NINETY FOUR MILLION BASE
BECAUSE IN THE MEDI CAL PROGRAM
AND WE ARE READY -- PAYING FOR
THE COST OF THESE INDIVIDUALS
AND LONG TERM CARE AND NURSING
HOME SO WE DO THINK THAT IT
SHOULD BE A PRIORITY THIS YEAR
TO BUILD ON THE GOVERNOR'S YOUNG
ADULT PROPOSAL AND INCLUDE
SENIORS AS BOOKENDS OF LIFE.
AND ALSO -- WORK TOWARDS A
COMMITMENT TO PHASE IN THE
POPULATION OVER THE NEXT COUPLE
OF YEARS TO GET TO ALL WE
CERTAINLY AGREE WITH THE
GOVERNOR ON LOOKING AT WAYS --
TO HAVE AN INCREMENTAL STRATEGY
TO GET TO UNIVERSAL HEALTH CARE
AND WE DO BELIEVE THAT THIS YEAR
WE CAN MOVE YOUNG ADULTS AND WE
CAN BUILD -- WITH SENIORS AND
GET BACK COMMITMENT TO ALL TO
PHASE IN THE POPULATION THANK
YOU.
THANK YOU.
THANK YOU MADAM CHAIR MEMBERS
KATHY SETTLING FOR THE COUNTY
WELFARE DIRECTORS ASSOCIATION WE
ALSO SUPPORT THE EXPANSION AND
ITEM SIX A AND ONE ASSOCIATE OUR
COMMENTS WITH OUR COLLEAGUES
THAT WE SUPPORT A BROADER
EXPANSIONIST WHILE.
COUNTIES WE'RE VERY PROUD OF THE
ROLE WE PLAYED IN THE CHILD
EXPANSION A FEW YEARS AGO WE
FELT LIKE WE WERE ABLE TO GET
THE CHILDREN ENROLLED VERY
QUICKLY.
AND WE THERE IS ALWAYS A MANUAL
WORK ASSOCIATED WITH THAT SO WE
DO ALSO APPRECIATE THE EXTENSION
OF TIME PRIOR TO IMPLEMENTATION
TO ENSURE IS AUTOMATED AS
POSSIBLE.
AND THAT ARE COUNTY STAFFERS
TRAINED AS POSSIBLE THANK YOU
THANK YOU.
HELLO BRANAGH PITTMAN SPENCER
WITH THE CALIFORNIA DENTAL
ASSOCIATION I'M CDA IS --
CONTINUES TO BE IN SUPPORT OF
THE GOVERNOR'S PROPOSAL TO
EXPAND MEDI CAL ELIGIBILITY TO
YOUNG UNDOCUMENTED.
ADULTS I THINK THIS THROWS INTO
STRONGER RELIEF THE CONCERNS
THAT I I'M EXPRESSED IN THE LAST
ISSUE ABOUT PROVIDER RATES -- WE
CONTINUE TO EXPAND MEDIC HAL AND
CITY HAS BEEN SUPPORTIVE AND
THINK THAT WAS THE RIGHT THING
TO DO WE CAN'T DO THAT WITHOUT
CONTINUING -- A COMMITMENT TO
OUR PROVIDERS TO ENSURE THAT WE
HAVE THE WORK FORCE TO SERVE
THOSE I'M PATIENTS AND
ESPECIALLY ENDEMIC HOW WHICH IS
PREDOMINATELY FEE FOR SERVICE --
WE YOU KNOW WE DON'T NEGOTIATE
WITH THE PLANS FAR RATES AND SO
WE ARE REALLY DEPENDENT ON THE
STATE SETTING THOSE RATES AT A
LEVEL THAT IS -- FEASIBLE FOR
PROVIDER TED DENNIS TO CONTINUE
TO SEE THEIR PATIENTS THANK YOU.
THANK YOU.
GOOD MORNING KELLY BEAM ABOUT
HALF THE CALIFORNIA MEDICAL
ASSOCIATION WE ARE SUPPORTIVE OF
THE GOVERNOR'S PROPOSAL TO COVER --
YOU KNOW EXPANDING MEDICAID
ELIGIBILITY -- BUT OF COURSE WE
WANT TO MAKE SURE THAT THOSE
NETWORKS ARE STRONG ENOUGH IN
YOUR PROVIDING MEANINGFUL ACCESS
FOR THOSE FOLKS THANK YOU.
THANK YOU.
GOOD MORNING JENNIFER ALLEY WITH
CALIFORNIA ASSOCIATION HEALTH
PLANS AND WE SUPPORT THE
GOVERNOR'S PROPOSAL TO EXPAND
THANK YOU.
KELLY BROOKS HERE ON BEHALF OF
THE CALIFORNIA ASSOCIATION OF
PUBLIC HOSPITALS AND HEALTH
SYSTEMS THE ASSOCIATION OF
CALIFORNIA HEALTHCARE DISTRICTS
AND THE COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA ALL IN
SUPPORT OF EXPANDING HEALTH CARE --
TO UNDOCUMENTED ADULTS THANK YOU.
THANK YOU.
YOUR MEMBERS HAPPY MUSTER WITH
THE LOCAL HEALTH PLANS ALSO IN
SUPPORT OF EXPANSION -- TO ON
DOCKS FOR MEDICAL.
THANK YOU [inaudible]
HI.
HELLO CIVIC CASTEEL REPRESENTING
ESSENTIAL ACCESS HEALTH AND
WE'RE IN SUPPORT OF THE PROPOSAL
THANK YOU.
BARBARA GLAZER WITH THE
CALIFORNIA HOSPITAL ASSOCIATION
ALSO HERE IN SUPPORT OF THE
GOVERNOR'S PROPOSAL TO EXPAND
THE UNDOCUMENTED.
YOUNG ADULTS.
THANK YOU.
LET'S BRING IT BACK TO THE
COMMITTEE QUESTIONS COMMENTS.
YES DOCTOR WOULD.
JUST WANNA SAY I'M SUPPORT
SUPPORT THE GOVERNOR'S PROPOSAL --
HI I WOULD LIKE TO SAY THAT I
ALSO CONTINUE TO BE CONCERNED
ABOUT OUR PROVIDER NETWORK AS
WEAK AS WE EXPAND COVERAGE.
IT'S IMPORTANT WE HAVE A STABLE
PROVIDER NETWORK AND GOES BACK
TO THE COMMENT SOME ON THE PRE
FROM THE PREVIOUS ITEM THERE --
AND WOULD LOVE TO SEE THIS
EXTENDED TO SENIORS -- AS WELL.
I WILL POINT OUT THOUGH -- JUST
IN GENERAL -- WITH THE OVERALL
SENIOR POPULATION THAT THE
BUDGET -- DIDN'T REALLY INVEST
IN THE SENIORS --AND THAT'S A
SIGNIFICANT CONCERN TO ME.
I'M NOT SEEN SEEN SEEN HERE WE
HEARD UP A QUITE A FEW REQUESTS.
OF FROM -- AGENCIES -- PROGRAMS
THAT HAVEN'T HAD THE THE
RECESSION CUTS RESTORED.
SO MY FEAR IS AS WE AS WE EXPAND
TO A LARGER AND LARGER
POPULATION ARE WE EXPANDING --
CARE WERE WE ACTUALLY EXPANDING
A CARD THAT SAYS YOU HAVE
COVERAGE BECAUSE WE HAVE ALL
THESE PROGRAMS THAT ARE
STRUGGLING -- TO PROVIDE
SERVICES YET WE'RE GOING TO
CONTINUE TO ADD ON TO THAT.
NOW GO BACK TO ONCE AGAIN --
THERE IS A POTENTIAL SOURCE OF
REVENUE OUT THERE THAT COULD
HELP US WITH THAT.
AND I HOPE THAT HOPE THAT THAT'S
MORE THAT SERIOUSLY EXPLORED.
THANK YOU DOCTOR WOULD STE
MATHIS.
HELLO MISTER WAS I THINK WE'RE
ON THE SAME PAGE ON A LOT OF
THIS -- YEAH MY MY DISTRICT IS A
HIGHLY.
VERY LARGE IMMIGRANT POPULATION
OF MY DISTRICT AND I I WANNA SEE
EVERYBODY GET COVERED A REALLY
DETAILED.
BUT AT THE SAME TIME.
AS WERE DEALING WITH BUDGET
PRIORITIES I I'VE GOT TO ASK.
YOU KNOW LAST NIGHT WE SPENT
TIME TALKING ABOUT YOU KNOW WE
CAN'T GO TO THE 8%.
THE RATE STUDY FOR THE DISABLED
POPULATION AND NOT GETTING THE
FULLY FUND AND THERE.
WERE NOT GOOD ENOUGH FULLY
FUNDING FOR OUR YOUTH FOR DENTAL
AND OPTOMETRY.
AS DR WHICH IS STATED WERE NOT
DOING ENOUGH TO INCREASE OUR
PROVIDERS WHICH IS THE TRUE
PROBLEM.
WITH ACCESS AND WE'RE NOT DOING
ENOUGH FOR OUR ELDERLY.
AND NOW WE'RE GOING TO BRING IN
UNDOCUMENTED POPULATION INTO
THAT.
IN THE HIGHER DEMAND
[inaudible]
WITH OUT.
ACTUALLY DOING WHAT WE ALL KNOW
NEEDS TO HAPPEN IN INCREASE OUR
PROVIDER SITUATION.
BECAUSE I ALREADY HAVE A
SITUATION.
IN MY DISTRICT WHERE IT TAKES
THREE TO FOUR WEEKS TO SEE A
PROVIDER. THREE TO FOUR WEEKS.
AND THIS IS ANYONE TALKING
SPECIALTIES SPECIALTIES ARE ARE
MONTHS OUT.
IN ANY AREA REFERRED.
SOMEWHERE THAT'S A THREE FOUR
HOUR DRIVE AWAY [inaudible]
SHELL.
I I'VE GAS.
YOU KNOW WE HAVE THIS IDEA IN IN
IN THE TALKING POINTS ARE GREAT
IT'S FANTASTIC TO SAY HEY
EVERYBODY'S GOING TO GET A
HEALTH CARE INSURANCE CARD
[inaudible]
IT'S GREAT.
THE IT IT'S LIKE GIVING
EVERYBODY A DRIVER'S LICENSE AND
DRIVER'S INSURANCE BUT NOT A CAR.
WE NEED THE PROVIDERS.
WE WE NEED TO STOP BOGGING DOWN
OUR SYSTEM.
THE INSANE IN THE HIGHER
EVERYBODY'S GONNA GET AN
INSURANCE CARD.
pIT'S LIKE THE GOVERNOR THINKS
HE'S OPRAH OR SOMETHING AND IT'S
YOU GET CARDED A CARDIO GET
INSURANCE AND EVERYTHING'S GONNA
BE GREAT.
WE DON'T HAVE THE DOCTORS.
WE DON'T HAVE THE CLINICS THE
IT'S NOT THERE.
AND WE CAN KEEP THROWING ALL THE
MONEY AWAY.
BUT I MEAN WE SEE HERE WITH THIS
CRAZY HUGE SURPLUS IN A GOOD
YEAR.
AND THE WE SIT HERE LISTENING TO
THE SAME ARGUMENTS.
THAT WE TALKED ABOUT YEARS AGO
WITH PROP FIFTY SIX THAT WAS
DESIGNED FOR MORE PROVIDERS.
BUT YET.
YOU KNOW JUST BECAUSE GOVERNOR
BROWN SIR PLANTED THE FUNDING TO
FILL THE HOLES.
SO WE'RE GOING TO DO IT AGAIN
AND WE'RE GONNA KEEP DOING THAT
AND IS THE THE DOCTOR WOODS.
MENTION YOU KNOW WE FOUGHT
REALLY HARD ON THE MCO.
A FEW YEARS AGO.
AND THERE'S NO MENTION OF THAT.
SO REALLY WHAT WHAT ARE WE DOING.
BECAUSE THESE ARE THE QUESTIONS
ALL OF US MEMBERS OF YOUR ON THE
DICE ARE GONNA GET ASKED WHEN WE
GO BACK HOME.
AND OUR PARENTS CAN'T GET IN TO
SEE THEIR DOCTORS NORMALLY GET
SENT SOMEWHERE ELSE.
THE QUESTIONS I GET ASKED EVERY
DAY.
WELL HOW HOW COME WE'RE TALKING
ABOUT UNDOCK SUCK WERE TALKING
ABOUT THIS WHEN I CAN'T EVEN GET
IN TO SEE A DOCTOR.
SO SO HOW DO YOU EXPECT US TO
ANSWER THAT TO OUR FOLKS BACK
HOME.
BECAUSE I I MEAN I I WANT TO SEE
EVERYBODY BE ABLE TO HAVE ACCESS
I WANNA SEE EVERYBODY WHETHER A
DOCUMENT OR NOT.
BE ABLE TO MAKE SURE THEIR
FAMILIES HEALTHY AND DOING WELL.
BUT WE'VE GOT AN ANSWER BACK TO
OUR PUBLIC.
AND RIGHT NOW IT'S A FANTASY OF
EVERYBODY'S GONNA GET COVERED
HEALTH CARE FOR ALL.
WITH THE ZERO ACCESS.
BECAUSE NOBODY HAS THE ABILITY
TO GET IN.
SO HOW ARE WE GONNA FIX THAT.
QUESTION OR MADAM CHAIR I'D LOVE
AN ANSWER BUT I'M NOT SEEN IT IN
HIS BUDGET.
ALL RIGHT WILSON WITH A
RHETORICAL QUESTION.
THANK YOU MADAM CHAIR FOR THE
OPPORTUNITY TO SPEAK ON THIS
ITEM.
OF THAT IS OF GREAT IMPERSONAL
IMPORTANCE TO ME AS MANY OF YOU
WATCHING YOUR TODAY I KNOW THAT
MY SIBLINGS AND I WERE
UNDOCUMENTED AT ONE POINT IN OUR
LIVES -- WE DIDN'T HAVE HEALTH
INSURANCE WHEN WE CAME TO THIS
COUNTRY AND I KNOW FIRST HAND
WHAT ARE UNDOCUMENTED
COMMUNITIES GOING THROUGH.
I WOULD LIKE TO APPLY GOVERNOR
NEW SOME FOR THIS ITEM IN MAKING
AND TAKING CARE OF OUR YOUNG
ADULTS UP TO AGE.
TWENTY SIX HOWEVER I WOULD ALSO
LIKE TO SPEAK UP AND PUT FORWARD
THAT THIS CAN COMMITTEE AND THE
ADMINISTRATION CONSIDER LOOKING
AT THE SENIORS.
IN THE UNDOCUMENTED COMMUNITY
AGE -- SIXTY FIVE AND UP
SPECIFIC SPECIFICALLY WHEN IT
BECAUSE COMES TO MEDI CAL AND
ARE YOU TAKE I. H. S. S..
ELIGIBILITY AS WE KNOW LATER IN
LIFE IS WHEN A LOT OF THE HEALTH
ISSUES BEGAN AND THAT'S WHERE
THE GREATEST SIX I THINK -- ARE
A LOT OF OUR SENIORS ARE GOING
TO THE URGENT CARE EMERGENCY
ROOMS AND WE'RE PAYING FOR THOSE
ANYWAY AND I THINK THE OLDER
POPULATION I NEEDS.
HELP RIGHT NOW AND I'M HOPING
THAT THE GOVERNOR AND THE
COMMITTEE CAN HAVE A
CONVERSATION ABOUT THAT.
THANK YOU.
THANK YOU MS REVIEW THANK YOU
FOR SHARING YOUR PERSONAL STORY.
MR FRAZIER THANK YOU MADAM CHAIR
CAN SOMEBODY ON THE PANEL TALK
TO ME ABOUT SEE AN SP.
AND THE TO THE NEXT ISSUE IS IT
YES OKAY FOCUS WAS PART OF THIS
ALSO.
IT IT'S WE'VE WE'VE DIVIDED IT
OKAY.
A WAY TO LIVE.
UNLESS SOMEBODY FROM THE PANEL
WANTS TO TALK ABOUT HERE.
YEAH BUT I I WANTED TO JUST SAY
REALLY QUICKLY ON THE WORK FORCE
I KNOW THAT -- YOU HEARD IT ON
THE OFFICE PEGGED -- ITEM
PREVIOUS TO THIS AS WELL AS THE
ADDITIONAL FUNDING THAT'S
INCLUDED IN THE GOVERNOR'S MAY
REVISION AROUND.
THE CAL HEALTH CARE'S WHICH IS
OUR LOAN REPAYMENT THAT WHERE
YOU'RE USING THE PROPOSITION
FIFTY SIX FUNDS -- FOR I THINK
THAT THIS IS A REALLY.
EXCITING TIME AN AREA FOR US ON
THE APPLICATIONS -- FOR THOSE AS
IN -- INDIVIDUALS CLOSED A
COUPLE OF WEEKS AGO -- WE
RECEIVED OVER TWELVE HUNDRED
APPLICATIONS FROM BOTH
PHYSICIANS AND DENTISTS
APPROXIMATELY NINE HUNDRED
APPLICATIONS FOR PHYSICIANS
APPROXIMATELY TWO HUNDRED FOR A
DENTIST -- IN EXCHANGE FOR US --
PAIN FOR UP TO THREE HUNDRED
THOUSAND DOLLARS AN EDUCATIONAL
DEBT -- THEY WILL COMMIT TO A
FIVE YEAR -- TERM OF SERVICE IN
THE MEDICAL PROGRAM THEY WILL
SEE AT LEAST A THIRD OF THEIR
PATIENT CASE LOAD WILL BE AND
MEDI CAL -- I THINK WHAT WE WERE
TRYING VERY MUCH TO DO IS --
CERTAINLY NEED SOME OF YOUR
INTEREST IN THIS AREA WE ARE --
PROVIDER AGNOSTIC IN TERMS OF
WHERE THEY WORK WE ARE LOCATION
AGNOSTIC IN TERMS OF WHERE THEY
ARE -- I THINK WHAT WE ALSO
INDICATED AS WE WANTED TO GIVE
ADDITIONAL CONSIDERATION TO
PROVIDERS THAT TOOK A GREATER
PERCENTAGE OF MEDI CAL -- AS
PART OF THEIR PATIENT CASELOAD
AND CERTAINLY -- FOR SPEAKING
ADDITIONAL LANGUAGES AND OR
BEING A SPECIALTY THAT IS
PARTICULARLY HARD FOR US TO
RECRUIT IN THE MEDICAL PROGRAM
SUCH AS CHILD PSYCHIATRY --
WHICH IS MY PERSONAL -- ONE THAT
I MIGHT IF I CAN FIND A CHILD
PSYCHIATRIST I WILL.
WHEREVER THEY ARE WE WILL WE
WILL FIND THEM -- SO I JUST I
WANT TO SAY THAT WE'RE REALLY
EXCITED ABOUT THE RESPONSE --
FROM THE PROVIDER COMMUNITY FOR
THE APPLICATION OF THOSE FUNDS
AS WELL AS WE INTEND TO BE
AWARDING THAT FIRST.
ROUND OF GRANTS TO PROVIDERS AT
THE END OF THIS FISCAL YEAR --
SO MORE ON THAT BUT CERTAINLY --
APPRECIATING AND WANTING -- TO
EMPATHIZE ABOUT THE NEED TO
CONTINUE TO GROW THE WORK FIRST
AND KEEP THOSE MEDICAL STUDENTS --
IN THE STATE OF CALIFORNIA
RATHER THAN GOING ELSEWHERE TO
PRACTICE.
YES DOCTOR WOULD.
I'M JUST CURIOUS IF HAVE YOU
WITH THE GARCIA REPORT TO BE
CONSIDERED -- THOSE SAME KINDS
OF PROGRAMS FORCING NURSE
PRACTITIONERS PHYSICIAN'S
ASSISTANTS.
NURSES BECAUSE YOU OBVIOUSLY WE
NEED THE DENTISTS AND WE NEED
THE POSITIONS BUT WE ALSO NEED
THOSE AS WELL AND WE NEED THEM
IN AREAS WHERE WE HAVE SHORTAGE
AREAS MY ENTIRE DISTRICT IS A IS
A IS A HEALTH MANPOWER SHORTAGE.
AND SO I I THAT'S THE WORLD THAT
THAT THA I LIVE IN BUT HAS HAD
CONSIDERED GOING BEYOND THAT
BECAUSE HE HAD DOCTORS DON'T
WORK WELL WITHOUT NURSES AND AND
AND ALL THESE OTHERS AND AND
WHILE WE'RE MAKING THAT
INVESTMENT.
CAN WE MAKE THE INVESTMENT ON A
BROADER ON A LITTLE BROADER
BASIS YEAH I THINK THAT PART OF
THE CONSIDERATION AND CERTAINLY
THAT HAS BEEN RECESSED ABOUT
USING THE LOAN -- FUNDS FOR
DIFFERENT TYPES OF PROVIDERS I
THINK JUST EVEN BASED ON THE
OVERWHELMING.
RESPONSE FROM THOSE TWO PROVIDER
TYPES -- IT WOULD BE IN SOME
CASES -- A DIFFERENT DISCUSSION
TO TALK ABOUT YOU KNOW IF YOU
WANT TO COVER MORE PEOPLE OR
DIFFERENT TO PROVIDER TYPES YOU
LOWER THE DOLLAR AMOUNT SO THAT
YOU CAN TRY TO INCREASE YOU KNOW
THERE'S THERE'S ALWAYS THAT
BALANCE I THINK THE OTHER THING
THAT I THINK ABOUT.
IS THERE ARE OTHER LOAN
REPAYMENT PROGRAMS THAT WITH --
ADDITIONAL INDIVIDUALS BEING SO
YOU CAN'T BE ELIGIBLE FOR OUR
LOAN REPAYMENT AND ALSO GET LOAN
REPAYMENT FROM DIFFERENT PLACES
AND SOME IN SOME CASES WE WILL
BE RELIEVING.%
AND OR ALLOWING FOR GREATER
CAPACITY FOR OTHER PROVIDERS TO
BE ELIGIBLE FOR LOANS WHERE THEY
WERE COMPETING AGAINST OTHER
PROVIDERS AND I THINK IF THERE
ARE.
CHANGES THAT NEED TO BE MADE IN
OTHER TYPES OF LOAN REPAYMENT IN
CALIFORNIA THROUGH EITHER OFSHE
BETTER OTHERWISE -- TO INCREASE
THE ABILITY FOR PEOPLE TO
COMPETE I THINK WHAT WE WERE
TRYING TO DO IS CERTAINLY ALLOW
FOR AN A LARGER NUMBER OF
APPLICANTS ACROSS PROVIDER TYPES
TO HAVE MORE OPPORTUNITY TO HAVE
THAT KIND OF THAT.
INCENTIVE TO PROVIDE CARE.
THANK YOU MISTER FRAZIER.
THANK YOU I JUST THIS IS KIND OF
A COINCIDENCE I JUST RAN INTO A
YOUNG LADY WHO IS A CLINICAL
PSYCHOLOGIST GOING FOR SOCIETY.
AND SHE SHARED WITH ME HER LOANS.
RIGHT NOW TO DATE JUST TO HAVE A
MASTER SHE HAS 200-900-0300
TWENTY THREE THOUSAND IN
PRINCIPLE. TWENTY THOUSAND AND
FOURTEEN DOLLARS IN.
INTEREST AND THEN SHE HAD TWELVE
THOUSAND SIX HUNDRED AND TWENTY
FIVE DOLLARS AND PELL GRANTS.
AND SHE STILL HAS TO OFFER SO ID.
WHY WOULD SHE?
IF YOU CAN'T GET RELIEF.
CHRIS CAN MAKE THIS UP I MEAN
WITH THE COST OF LIVING AND
EVERYTHING LIKE THAT SO.
I MEAN.
WE'RE TRYING TO GIVE CRITICAL
CAREER PATHS -- TO BE HONEST
WITH YOU SHE ENTERED INTO THE
ARMY BECAUSE SHE CAN'T AFFORD TO
GET OUR SIDE YOU SHE JUST CAN'T
TAKE MORE DEBT.
WITHOUT A REAL BILL YOU TO KNOW
THAT THERE IS SOME KIND OF
RELIEF AND THAT SHE CAN ACTUALLY
APPLY HER CRAFT.
I THINK ARE MAKING IT VERY
ONEROUS FOR THESE INDIVIDUALS TO
BE ABLE TO TREAT THE INDIVIDUALS
THAT.
YOU'RE SUPPOSED TO TAKE CARE OF
I MEAN I THINK WE FEEL VERY
STRONGLY ABOUT THE LOAN
REPAYMENT THAT WE HAVE INITIATED --
FROM THE STANDPOINT THAT WE WILL
BE ESSENTIALLY WITH UP TO THREE
HUNDRED THOUSAND DOLLARS WHICH
IS A IS A REALLY -- EXTENSIVE
AMOUNT OF LOAN REPAYMENT FOR
PROVIDERS -- IN OUR THINKING IT
WAS TO CHANGE THE ECONOMIC
DECISION AROUND WHERE PROVIDERS.
PRACTICE WHEN THEY GRADUATE --
BECAUSE IF YOU ARE A GRADUATE
WITHOUT MUCH DEBT PLUS YOU'RE
TRYING TO BUY A HOUSE OR START A
FAMILY OR DO ALL THE OTHER
THINGS THAT SUCH A CHALLENGE
THAT YOU WOULD BE -- HARD
PRESSED TO TAKE A JOB IN EITHER
UNDERSERVED AREA OR IN A SAFETY
NET.
PROVIDER TYPE OF CAPACITY I
THINK WE'RE TRYING TO
FUNDAMENTALLY CHANGE THE
ECONOMIC DECISIONS THAT
INDIVIDUALS MAKE AND I THINK
THAT'S WHAT IS SO EXCITING ABOUT
THE ABOUT THE PROGRAM AND AND
REALLY LOOKING FORWARD TO THE
KIND OF LONG RANGE -- AND IN
VETTING OF PROVIDERS IN CERTAIN
PARTS OF THE STATE THAT THEY
OTHERWISE WOULD NOT HAVE BEEN
ABLE TO PRACTICE IT.
SO JUST OUT OF CURIOSITY.
WHAT WITH THEIR INCOME LEVEL BE
DIMINISHED BY TAKING THIS DEAL --
RATHER THAN IF THEY WENT INTO
THE PRIVATE SECTOR AND AND
STARTED OFF I MEAN.
I MEAN ARE THEY GOING TO BE ABLE
TO BUY A HOUSE OF THOSE FIVE
YEARS ARE THEY GOING TO BE ABLE
TO OR YOU KNOW.
WHAT'S THE DIFFERENTIAL.
I MEAN I WANT TO KNOW BECAUSE
YOU'RE OFFERING UP TO THREE
HUNDRED THOUSAND BUT ARE THEY
MAKING FIFTY THOUSAND DOLLARS
YEAR.
AS A CLINICIAN.
I DON'T.
KNOW BUT I DON'T KNOW THAT ANY
PHYSICIAN OR DENTIST IS MAKING
THAT.
LOW OF AN AMOUNT I THINK AND YOU
KNOW.
I'M LOOKING AT DOCTOR WOULD IN
SOME OF HIS AREA WHERE HE HAS --
NOT BECAUSE IF YOU PERSONALLY AS
A PROVIDER BUT BUT FROM A FROM A
LIKE A YOU KNOW A FEDERALLY
QUALIFIED HEALTH CENTER YOU KNOW
I I DON'T KNOW WHAT THE AVERAGE
PHYSICIAN SALARY IS OR WHAT AN
AVERAGE DENTIST AND PRACTICES
BUT THEY'RE CERTAINLY.
IF YOU DON'T HAVE TO PAY YOUR
DEBT AT ALL BECAUSE WE HAVE
ESSENTIALLY TAKING CARE OF IT
YOUR SENSUALLY YOU HAVE A SALARY
AS A PROFESSIONAL MEDICAL --
CLINICIAN THAT WILL CHANGE THE
NATURE OF WHAT YOU'RE ABLE TO DO
AS OPPOSED TO HAVING TO JUGGLE
YOUR PERSONAL OBLIGATIONS
PLEASURE DEBT WE JUST NOTICED
SOME INDIVIDUALS.
WILL NOT TAKE MEDI CAL BECAUSE
OF THE REIMBURSEMENT RATE IS SO
LOW.
IS WHAT I'M SAYING IS.
WHAT DEAL ARE THEY MAKING?
IF THEY'RE TAKING.
THIS TO GET THIS.
THAT'S WHAT I'M SAYING HOW DOES
IT I MEAN.
HEY HOW'S IT GOING.
YOU KNOW I WOULD HAVE TO I'VE I
AM I DON'T I NEVER I NEVER HAD
THREE THOUSAND DOLLARS WORTH OF
STUDENT DEBT BUT I CAN CERTAINLY
YOU KNOW WE CAN CERTAINLY CHECK
AND SAY WHAT IS.
DEBT REPAYMENT LOOK LIKE IN
TERMS OF WHAT DO YOU A EXPECTED
TO PAY BACK WHEN YOU HAVE THAT
MUCH.
STUDENT DEBT AND THAT JUST KIND
OF CALCULATES INTO WHAT YOUR
ANNUAL SALARY HAS TO BE IN ORDER
TO HELP MAKE YOUR BOTH DEBT
PAYMENTS AS WELL AS OTHER
PERSONAL OBLIGATIONS SUCH AS YOU
KNOW RENTER HOUSING OR THINGS
LIKE THAT.
THANK YOU MISTER FRAZIER JUST
ONE BRIEF COMMENT AT THESE A LOT
OF PEOPLE BE THRILLED TO HAVE
JUST THREE HUNDRED THOUSAND
DOLLARS IN DEBT BECAUSE THAT
NUMBER IS.
QUICKLY BECOMING A FLOOR IN A
LOT OF PROFESSIONS SO AND THAT'S
A PRETTY STAGGERING THAT'S A
PRETTY STAGGERING.
CHALLENGE OF PEOPLE ARE FACING.
I THINK IT'S ABUNDANTLY CLEAR
FROM COMMENTS FROM EVERYBODY
HERE THE DICE THAT.
THERE IS GREAT CONCERN FOR
ACCESS.
HELLO.
AND I I WOULD VENTURE TO SAY
THAT.
WE DON'T GET A LICENSE WE DO GET
A CARDS JUST WE'VE GOT TO GET
THE ROAD.
BUT WE DO GET A CAR.
SO WHAT WE DO HAVE THE ACCESS
THAT WE DO HAVE OUR COVERAGE BUT
WE DO HAVE TO BE SURE THAT THERE
IS ACCESS.
AND I APPRECIATE ALL OF THE
PROGRAMS THAT ARE BEING OFFERED
UP AND TO THE THE BUDGETARY
ITEMS THAT ARE BEING INCLUDED.
BUT WITHOUT A DOUBT IT STILL IS
A SERIOUS ISSUE AS YOU CAN NOTE
FROM ALL THE MEMBERS HERE.
MADAM CHAIR WE'RE STILL WORKING
ON THOSE ROADS WE'RE STILL
WORKING ON THOSE ROADS THAT'S
RIGHT.
THANK YOU SO MUCH.
THAT CONCLUDES ISSUE.
SIX EIGHTY LET'S GO TO SEE ISSUE
SIX BE.
THE TRAILER BILL LANGUAGE
--
CHAIRS GOING TO STEP OUT SHE
ASKED ME TO TAKE OVER -- WE'RE
GONNA GO UNTIL NOON AND THEN
WE'LL BREAK UNTIL.
ONE THIRTY SO.
PLEASE A ISSUE -- SEVEN OR SIX
FOUR SIX FOUR SIX PM SORRY. SIX
BE IT IS.
THE MORNING MEMBERS JENNY WHEN
DEPARTMENT OF FINANCE.
THE NEIGHBOR VISION A SEEMS
GENERAL FUND SAVINGS OF FORTY
THREE POINT THREE MILLION
DOLLARS IN THE COW WORKS PROGRAM.
AND MAKE SEVERAL CHANGES TO THE
MINISTRATIONS PROPOSAL FOR A BI.
EIGHTY FIVE FIRST NOTING
COUNTIES CONCERNS ON THE
DECREASE FUNDING FOR PUBLIC
HEALTH SERVICES.
THAT MAY REVISION WILL NO LONGER
pFOR THE FOR COUNTIES REALIGNMENT
ROBIN IS 275%.
SECOND THE NAY REVISION REFLECTS
YOLO COUNTY AT THE COUNTY
MEDICAL SERVICES PROGRAM COUNTY.
AND LASTLY THE THE NEIGHBOR
VISION PROPOSES TO WITHHOLD
REALIGNMENT REVENUES FROM THE
COUNTY MEDICAL SERVICES PROGRAM
BOARD.
UNTIL THE BOARD'S TOTAL RESERVES
REACH A REASONABLE LEVEL EQUAL
TO TWO YEARS WORTH OF TOTAL
EXPENDITURES.
AT THAT POINT THE BOARD'S
REDIRECTION WILL BEREFLECTED
THAT 75%.
NEXT RYAN WAS THE LEGISLATIVE
ANALYST'S OFFICE JUST A FEW
COMMENTS ON THIS WERE STILL
REVIEWING THESE CHANGES AND AND
I LOOK FORWARD TO REVIEWING THAT
THE REVISED LANGUAGE -- THE
FIRST THING I'D LIKE TO SAY IS
THAT -- WE NOTED EARLIER IN THIS
YEAR THAT IT'S POSSIBLE THAT.
SOME OF THE FOR COUNTIES OR
REFERENCE COULD HAVE SOME
SAVINGS FROM THE EXPANSION OF
MEDICARE ALL TO THE UNDOCUMENTED
YOUNG ADULT POPULATION.
GOVERNOR'S PROPOSAL AS SENSUALLY
A A POLICY CHOICE TO ALLOW THOSE
FUNDS TO REMAIN AT THE LOCAL
LEVEL FOR LOCAL PRIORITIES
THAT'S A REASONABLE PRIORITY --
BUT ONE THAT THE LEGISLATURE
SHOULD WEIGH AGAINST ITS OTHER
PRIORITIES IN THE BUDGET -- THE
NEXT THING IS IS THAT WE WE
CONTINUE TO BELIEVE THAT IT IS
REASONABLE -- FOR THE THE STATE.
TO AND THE STOP THE THE FLOW OF
REALIGNMENT REVENUES TO THE SEEM
AS P. BOARD UNTIL SUCH A TIME AS
THE RESERVES COME DOWN TO A
LOWER LEVEL.
AND THE REVISED TWO YEAR --
TARGET RESERVE AMOUNT DOES
APPEAR REASONABLE TO US --
HOWEVER WE WOULD NOTE THAT 75%
RE DIRECTION -- EFFECTIVELY
TODAY RE DIRECTS ALL OF THE THE
SAME AS P. BOARDS REVENUES AND
IT.
LIKELY WOULD CONTINUE TO RE
DIRECT ALL OF THOSE RESERVES HAD
SUCH A POINT AS THEIR RECAP
SORRY WOULD REDIRECT ALL THE
REVENUES AT SUCH A POINT IS
THERE IS THERE IS REACH THE THE
LOWER TARGET.
SO IN THAT SENSE75% MAY STILL
BE TOO HIGH.
BUT IN ANOTHER SENSE SINCE THIS
WOULD TAKE PLACE SEVERAL YEARS
OUT -- THE LEGISLATURE DOES NOT
NECESSARILY NEED TO SET THAT 75%
LEVEL TODAY -- INSTEAD THE
LEGISLATURE COULD DIRECT THAT NO
ADDITIONAL REVENUES WOULD BE
PROVIDED UNTIL THE RESERVES
REACH THAT LOWER LEVEL.
AND THEN DIRECT THE
ADMINISTRATION.
TO RE ESTIMATE WHAT AN
APPROPRIATE REDIRECTION AMOUNT
WOULD BE AT THAT TIME
[inaudible]
ORDER FINANCE -- WE NOTE THAT
THE BOARD IS SITTING ON A
SIGNIFICANT RESERVE OF NEARLY
FOUR HUNDRED MILLION DOLLARS AND
SOLD THIS I'M NOT WOULD ALLOW
THEM TO CONTINUE ITS OPERATIONS.
AND DELIVER HEALTHCARE SERVICES
IN PARTICIPATING COUNTIES.
ANYONE ELSE BEFORE WE GO TO
PUBLIC COMMENT AT THIS POINT
WE'LL GO AHEAD TAKE PUBLIC
COMMENT.
ON THIS ISSUE.
GOOD MORNING MR TURN MEMBERS
CAROLING UNDER THE COUNTY
MEDICAL SERVICES BOARD GOVERNING
BOARD WE ARE IN OPPOSITION TO
THE ME REVISION WE'RE ASKING FOR
THIS COMMITTEE.
TO REJECT ADMINISTRATION'S
PROPOSAL AND SUBSTITUTE AND WHAT
HAS ALREADY BEEN OFFERED TO THE
DEPARTMENT OF FINANCE.
THE I. BOARD MET WITH FINANCE IN
MARCH AND OFFERED -- ABOUT
TWENTY MILLION DOLLARS TO BE
REDIRECTED OUT OF THE FORTY FIVE
MILLION THAT THEY RECEIVE AND
THEY ALSO OFFERED A SCHEDULED
SPEND DOWN OF THE RESERVE.
THAT WOULD -- BOTH EXPAND
CERTAIN BENEFITS BUT ALSO
MAINTAIN A SOURCE OF REVENUE SO
THAT THE FAMOUS PEOPLE OR TO
CONTINUE TO INVEST IN THE THIRTY
FIVE COMMUNITIES.
INCLUDING ALMOST ALL OF YOUR
DESTRUCTIVE NOT EVERY EVERY
COUNTY OF YOUR TO START.
MISTER FRASIER'S DISTRACT --
THIS IS THIS IS A CRITICAL BOARD
IT'S NOT A NICE TO HAVE IT'S A
MUST HAVE BECAUSE OF OFFERED
INSTITUTIONS CODE REQUIRES.
THAT THERE BE SOME ENTITY THAT
PICKS UP FOR THE MEDICALLY
INDIGENT POPULATION WE
UNDERSTAND THE RESERVE IS AN
ISSUE.
BUT TAKING IT ALL THE WAY DOWN
TO ZERO OR CITING THAT SO THAT I
ASKED HIM IF HE CAN'T HAVE ANY
MONEY AND TELLER DOWN THE LAST
TWO YEARS.
MAKES IT HARD FOR THEM TO MAKE
INVESTMENTS IN THE KEY IN THE
COUNTIES THAT ARE SERVING SO WE
ARE IN STRONG OPPOSITION THAT
ALSO JUST WANTED TO AND I HAD A
FEW MORE NOTES.
ON A COUPLE OF PANELS AGO WE
TALKED ABOUT WORKFORCE
INVESTMENT I'M FAMOUS P. IS
ACTUALLY FUNDED OFSHE PAD
WORKFORCE DEVELOPMENT.
FUNDING FOR THE MEDICAL -- WORK
FORCE IN THE THIRTY FIVE
COUNTIES THEY PROVIDE.
MEDICAL BENEFITS TO UNDOCUMENTED
PERSONS NOW ALL THE WAY UP TO
AGE SIXTY FIVE IT'S NOT FULL
SCOPE BECAUSE THEY HAVE
EMERGENCY.
COVERAGE IN A DIFFERENT -- SET
OF BENEFITS BUT IF YOU ARE AN
UNDOCUMENTED PERSON LIVING IN
ONE OF THE THIRTY FIVE HE MUST
BE COUNTIES YOU HAVE ACCESS TO A
CLINIC SYSTEM WITH FORTY SEVEN
SEPARATE.
ADDRESSES THAT YOU CAN GO GET A
PRIMARY CARE BENEFIT YOU CAN GET
PRESCRIPTION MEDICATIONS AND YOU
DON'T HAVE COPAYS.
THEY'VE ALREADY DONE THAT ALL
THE WAY TO SIXTY FIVE NOT JUST
TO TWENTY SIX AND THEY ALSO HAVE
OFFERED TO THE ADMINISTRATION TO
GO BEYOND AND AGE SIXTY FIVE AS
PART OF THE OVERALL SPEND DOWN.
TO COVER UNDOCUMENTED PERSONS
OVER THE AGE OF SIXTY FIVE SO
THEY OFFERED A FULL MENU TO THE
ADMINISTRATION.
THAT IS VERY CONSISTENT WITH
WHAT THE GOVERNORS TRYING TO GET
TO WHAT OTHER PANELISTS HAVE
TALKED ABOUT AND WE WOULD ARGUE
TO REJECT ADMINISTRATIONS PUZZLE
AND ADOPTING THE CITIES THANK
YOU AND THE KID THE MINISTER
FROM SOME ISSUES HERE IF YOU'D
LIKE TO TALK ABOUT THE TECHNICAL.
ASPECTS OF THIS PROPOSAL THANK
YOU.
THANK YOU MISTER CHAIR AND
MEMBERS FARMING DATING ON BEHALF
OF THE CALIFORNIA STATE
ASSOCIATION OF COUNTIES
REPRESENTING ALL OF CALIFORNIA'S
FIFTY EIGHT COUNTIES ON THIS
PROPOSAL FIRST WE WANT TO THANK
THE GOVERNOR FOR HIS MAY
REVISION PROPOSAL -- TO HOLD THE
FOR WHAT WE CALL THE
INBETWEENERS ARTICLE THIRTEEN
COUNTIES HARMLESS SUCH A HUGE --
IMPORTANT THING FOR THEM AND WE
REALLY THINK DEPARTMENT FINANCE
AND THE GOVERNOR FOR SUGGESTING
THAT HOPE THAT THE LEGISLATURE
WILL CONFIRM IT'S A STAY IN THAT
PROPOSAL. FOR THE C. M. S. P.
COUNTIES ON ECHO SOME OF THE
COMMENTS OF THE PREVIOUS SPEAKER
WE UNDERSTAND THE CHANGING
LANDSCAPE OF HEALTHCARE IN
CALIFORNIA AND IT'S HARD TO TELL
WHAT THINGS WILL LOOK LIKE IN
SIX TO EIGHT TO TEN YEARS -- WE
I SPECIALLY WANT TO GIVE SOME
WEIGHT TO THE LA OWES COMMENTS
ABOUT THAT SEVENTY FIVE TWENTY
FIVE AT WHEN THEY'VE GONE DOWN
TO TWO YEARS RESERVES I THINK
THAT WE DON'T HAVE TO SET THAT
LEVEL RIGHT NOW.
AND AND I THINK IT DOES MAKE
SENSE OF BEHOOVE THIS
ORGANIZATION TO LOOK AT IT IN A
COUPLE YEARS -- AND WE'RE
WILLING TO WORK WITH THE
ADMINISTRATION ANDTHE
LEGISLATURE ON THIS AS WELL
THERE ARE SEE MUST BE COUNTIES
IT IS THE RURAL HEALTH CARE
SAFETY NET -- BUT AS WE THINK
THERE'S A WAY WITH THE CHANGING
LANDSCAPE IN CALIFORNIA THAT WE
CAN WORK THROUGH THIS.
THANK YOU.
CHAU GIVENS OF THE COUNTY HEALTH
EXECUTIVES ASSOCIATION
CALIFORNIA REPRESENTED
REPRESENTING LOCAL HEALTH
DEPARTMENTS AND WE APPRECIATE
THE ADMINISTRATION RESCINDING
THE PROPOSAL TO INCREASE THE
REDUCTION ABOUT FOR THOSE FOUR
COUNTIES WE BELIEVE THAT FUNDING
IS GOING TO REMAIN A VITAL
SOURCE OF FUNDING FOR PUBLIC
HEALTH ACTIVITIES AND FOR THOSE.
THAT ARE SERVING THE
UNDOCUMENTED POPULATIONS WOULD
ALLOW THEM TO CONTINUE TO DO SO
SO WE APPRECIATE THAT THANK YOU.
GOOD MORNING RENTAL COMING HERE
BEHALF OF HEALTH ACCESS
CALIFORNIA CERTAINLY A VERY
APPRECIATIVE OF THE CHANGE IN
THE GOVERNOR'S PROPOSAL FOR
THOSE FOR COUNTY CERTAINLY --
FOR THEM BEING ABLE TO CONTINUE
THEIR PUBLIC HEALTH PROGRAMS AND
ALSO A PARTICULARLY FOR
SACRAMENTO AND YOLO COUNTY --
CONTINUING THE SERVICES THEY
OFFER TO THE UNDOCUMENTED
COMMUNITY WE ARE HOWEVER VERY
CONCERNED ABOUT THE C. M. S. P.
PROPOSAL -- BUT WE DO KNOW THAT
IF THERE WAS MONEY THAT WOULD
CONTINUE TO BE REDIRECTED TO
THEM THAT THEY WOULD CERTAINLY
BE ABLE -- TO EXPAND THEIR
PATHWAY TO HEALTH PROGRAM THAT
YOU HEARD -- SOME DETAILS ABOUT
CERTAINLY WE HAVE APPRECIATED
THE PATHWAY TO HELP PROGRAM THAT
HAS -- THAT POTENTIALLY -- OR IT
WAS CREATED IN IN THE HAS THE
POTENTIAL CAPACITY FOR TWENTY
FIVE THOUSAND AND UNDOCUMENTED
INDIVIDUALS TODAY COULD BE
EXPANDED O POTENTIALLY FIFTY
THOUSAND INDIVIDUALS IN THE
FUTURE BUT THIS FUNDING THAT
THEY WOULD GET FROM THE STATE
WOULD CERTAINLY HELP THEM BE
ABLE TO CONTINUE IT INTO
PERPETUITY.
SO WE ASK THE LEGISLATURE -- TO
MAKE CONSIDERATIONS ABOUT -- THE
GOVERNOR'S PROPOSAL THAT CAN
HELP C. M. S. P. COUNTIES TO
CONTINUE TO DELIVER SERVICES TO
THAT POPULATION -- THAT MOVING
FORWARD INTO THE FUTURE THANK
YOU VERY MUCH THANK YOU.
pHI AM KERRY BROWN STEEN THEY
SEEM SB MINISTRY TO OFFICER ONE
ECHO -- KAREN LANGE'S COMMENTS
ALSO WANTED TO GO INTO A LITTLE
BIT MORE DETAIL FOR YOU ON THE
SEVENTY FIVE TWENTY FIVE WE HAVE%
DONE AN ANALYSIS UP TO TEN YEARS
AND WE SEE THAT THERE IS NO
REVENUE COMING AFTER OBSERVER
SPENT DOWN. TO TWO YEARS OF
OPERATING EXPENSES WHICH MAKES
RUNNING A PROGRAM A LITTLE BIT
DIFFICULT FOR NOT ABLE TO SEE A
SUSTAINABLE REVENUE COMING
THROUGH -- WE ALSO I'M HERE FOR
ANY QUESTIONS -- WE DO HAVE THE
NEW PATH TO HEALTH PROGRAM IT
DOES COVER THE UNDOCUMENTED.
AGES -- TWENTY ONE TO SIXTY FOUR
ONE OF OUR PROPOSED CONCEPTS
THAT WE PRESENTED TO YOU -- THE
ADMINISTRATION IS COVERING THOSE
SIXTY FIVE PLUS.
I IN THIS PRIMARY CARE BENEFIT
AS WELL AND WE ALSO HAVE OUR OUR
WORKFORCE DEVELOPMENT PROGRAM
THAT DOES COVER NURSE
PRACTITIONERS IN P. A.'S.
AND THE RURAL COUNTIES AND IF
YOU HAVE ANY OTHER QUESTIONS
PLEASE FEEL FREE TO REACH OUT TO
ME.
THANK YOU VERY MUCH SO
[inaudible]
ANYONE ELSE.
BRING BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS.
THANK YOU HAVE A QUESTION MISTER
FREEZE YEAH.
FIRST WHAT WE WANT TO THANK THE
DEPARTMENT PLAN IS I I'M
OFFENDED WITH ANY AGENCY SITS ON
THIS MUCH MONEY.
IT STAGNATES OF THE ABILITY TO
HELP PEOPLE.
I MEAN WE ALL HAVE AN
EXPECTATION THE WIND OUT MONIES
ALLOCATED GOES TO THE DIRECTION
THAT IS SUPPOSED TO BE UTILIZED.
AND I I DON'T KNOW HOW YOU COULD
ACTUALLY EVEN.
LOOK SOMEBODY IN THE FACE WITH
THIS MUCH MONEY NOT GOING OUT TO
THIS POPULATION IN A TIMELY
MANNER -- BUT I DO APPRECIATE
THE FACT THAT.
WE WANT TO BE ABLE TO UNDERSTAND
THAT HOWEVER THIS HAPPENED
[inaudible]
THAT.
THESE RESOURCES NEED TO BE
UTILIZED AND I THINK SEVENTY
FIVE TWENTY FIVE IS A LITTLE
ONEROUS.
GOING FORWARD I HOPE WE CAN GET
TO YES.
WAS US YOU MUST BE.
ON SOME KIND OF PROGRAM GOING.
FOR BUT OBVIOUSLY HAD THIS NOT
BEEN FOUND IT IS SITTING ON THIS
NEXT YEAR THE NEXT YEAR THE NEXT
YEAR.
AND POSSIBLY MAY EVEN MAKING
GROWING -- MAYBE IS THIS MUCH
MONEY SITTING THERE LOOKING AT
THEIR WORK FIRST DEVELOPMENT.
THAT WE MAKE A CONCERTED EFFORT
AND MAKE THIS MONEY BE EXPENDED
[inaudible]
ON PROVIDERS -- AND AND THERE'S
A RESOURCE ONE TIME FOR
OPPORTUNITY -- THAT NEED NEEDS
[inaudible]
ARE THERE.
SO I'M HOPING THAT WE CAN COME
TO A SOLUTION AND HOW TO GET T.
**** YOU KNOW BETWEEN FINANCE
AND AND THE CMS P..
BUT I'M I'M GONNA FALL IS
CLOSELY -- BECAUSE I THINK THAT --
IT'S ACTUALLY OFFENSIVE THAT
THIS MUCH MONEY WAS NOT RESOURCE
AND UTILIZE FOR THE INTENDED
POPULATIONS.
SEE NO A PRETTY COMMENTS MISTER
FRAZIER SAYING NO ADDITIONAL
COMMENTS WILL GO AHEAD AND MOVE
ON TO ISSUE NUMBER. SEVEN SURE
SO -- THE NEXT ITEM -- IS
ALLOCATING A ONE TIME A TWENTY
MILLION DOLLAR APPROPRIATION
FROM THE MENTAL HEALTH SERVICES
FUND. TO COUNTIES THAT DON'T
CURRENTLY PARTICIPATE IN OUR
WHOLE PERSON CARE PILOTS SO
UNDER OUR SECTION ELEVEN FIFTEEN
MEDICAID WAIVER THAT WAS --
NEGOTIATED BACK IN DECEMBER OF
TWENTY FIFTEEN COUNTIES WERE
ABLE TO APPLY TO US -- AND START
TO CREATE WHAT ARE KNOWN AS
WHOLE PERSON CARE PILOTS WE
CURRENTLY HAVE TWENTY FIVE IN
THE STATE AND WE HAVE LARGE
COUNTY SUCH AS LOS ANGELES WE
HAVE SMALL COUNTY SUCH AS
MARIPOSA AND PLASTER.
THAT -- THE IDEA BEHIND WHOLE
PERSON CARE WAS REALLY TO HAVE --
COUNTIES AS WELL AS NONPROFIT
ORGANIZATIONS MEDICAL MANAGED
CARE PLANS PROVIDER GROUPS --
PUBLIC SAFETY ENTITIES THAT
DON'T NORMALLY -- WORK IN
COLLABORATION WITH EACH OTHER TO
KNOCK DOWN SILOS AND
COLLECTIVELY TREAT INDIVIDUALS
THAT ARE USING A MULTITUDE OF
SERVICES ACROSS ALL OF THOSE
DIFFERENT ENTITIES AND THEY HAVE
BEEN -- IN MANY CASES REALLY --
EMBRACED BY THE COUNTIES THAT
HAVE BEEN USING THOSE -- FUNDS --
THROUGH THE WAIVER BUT WE ALSO
ARE HEARTENED BY THE FACT THAT
IT HAS DONE DRAMATIC -- THINGS
TO CHANGE THE TRAJECTORY OF
PEOPLE'S LIVES THAT HAVE BEEN IN
THESE PILOTS I KNOW THAT THERE'S
BEEN REALLY -- POSITIVE COVERAGE
IN THE LOCAL SACRAMENTO BEE
AROUND THE CITY OF SACRAMENTO
DOING HOPE PERSON CARE PILOTS AS
WELL AS UP IN.
PLASTER AND ELSEWHERE IN TERMS
OF HELPING INDIVIDUALS GET OFF
THE STREETS -- RECEIVE SUPPORT
OF SERVICES -- AND SO.
WE ARE LOOKING ALREADY TO THE
RENEWAL OF OUR ELEVEN FIFTEEN
WAIVER -- J. C. HAS BEEN --
DOING LOTS OF THINKING ON THAT
PARTICULAR AB PROJECT IN
PARTICULAR BUT REALLY THIS
TWENTY MILLION DOLLAR
AUGMENTATION IS FOR US TO WORK
WITH THE COUNTIES THAT HAVE NOT
BEEN PARTICIPATING IN WHOLE
PERSON CARE. TO HELP THEM START
TO DO THE PLANNING AND
INFRASTRUCTURE AND BUILDING --
FOR OUR INTENT WHICH IS TO MAKE
THIS CONSISTENT AND MORE OF A
STATEWIDE BENEFIT AVAILABLE
AFTER TWENTY TWENTY SO WE WOULD
BE DOING -- GRANTS TO COUNTIES
AND AWARDING THOSE FUNDS -- BY
MARCH OF NEXT YEAR -- SUCH THAT
THEY CAN START THE WORK AND OUR
WAIVER EXPIRES IN DECEMBER OF
TWENTY TWENTY AND SO THE IDEA IS
THIS TO HELP KIND OF BUILD.
SOME OF THAT -- PROGRAMMATIC AN
OPERATIONAL -- INFRASTRUCTURE
AND OBVIOUSLY THE COUNTIES TO
DATE HAVE CHOSEN POPULATIONS --
THAT ARE THE MOST EITHER -- WITH
A SIGNIFICANT NUMBER OF CHRONIC
DISEASES OR HAVE BEEN KNOWN TO
THE PUBLIC SAFETY SYSTEM OR
STRUGGLING WITH MENTAL ILLNESS
AND SO CERTAINLY THE USE OF
THESE FUNDS.
AND THE USE OF THE OTHER FUNDS
THAT WE HAVE BEEN PUTTING INTO A
WHOLE PERSON CARE SUCH AS THE
HUNDRED MILLION THAT WAS
ALLOCATED THE GOVERNOR'S JANUARY
BUDGET.
HAVE REALLY BEEN TARGETED
TOWARDS INDIVIDUALS WITH MENTAL
ILLNESS JUST BECAUSE OF THE
DUPLICATION OF OVERLAPPING
SERVICES THAT A LOT OF
INDIVIDUALS IN OUR PROGRAM HAVE
WITH MENTAL ILLNESS.
AND HAPPY TO TAKE QUESTIONS
[inaudible]
WHERE -- BEN JOHNSON LA I WE'RE
CONTINUING TO REVIEW THIS
PROPOSAL BUT HAVE NO CONCERNS AT
THIS TIME.
FINANCE.
NO I'M CONFIRMING OF FINANCE NO
FURTHERCOMMENTS BUT THE
QUESTION.
ANYONE ELSE SIR OKAY ALL RIGHT
THE PUBLIC COMMENT ON THIS ISSUE.
THANK YOU DOCTOR REDFORD
IMITATING ON BEHALF OF THE
CALIFORNIA STATE ASSOCIATION OF
COUNTIES WE CARE A LOT ABOUT THE
WHOLE PERSON CARE PROGRAM WE
FIRST WANT TO SAY GO ON RECORD
AGAIN IN THINKING THE GOVERNOR
AND THE LEGISLATURE FOR THE
PROPOSING A HUNDRED MILLION
DOLLARS FOR EXISTING WHOLE
PERSON.
CHARACTER PILOTS DH CS DID --
DEVELOPING ALLOCATION FOR THAT
HUNDRED MILLION IN APRIL --
WITHOUT OUTSIDE INPUT AND WE DID
WANT TO NOTE THAT THERE'S A
COUPLE OF MISMATCHES IN THE
ALLOCATION AND BETWEEN WHAT
COUNTIES DO DIRECTOR CAN ALSO
MENTIONED IT.
THE WHOLE PERSON CARE PILOTS
EACH COUNTY DEVELOP THEIR TARGET
POPULATION THAT TARGET
POPULATION MAY NOT BE EXACT LEE
MASH WITH THE HUNDRED MILLION
PROPOSAL OF GOING TO THOSE WITH
SEVERE MENTAL ILLNESS AND
HOMELESS OR AT RISK OF
HOMELESSNESS.
WE HAVE PEOPLE IN THE WHOLE
PERSON CARE PILOTS WHO DO NOT
HAVE SEVERE MENTAL ILLNESS BUT
MAYBE A CHRONIC HEALTH CARE
CONDITION.
SO WE'D LIKE THAT ALLOCATION OF
TO BE ABLE TO USE FOR THE TARGET
POPULATIONS OF EACH EXISTING
WHOLE PERSON CARE PILOT WE ALSO
THINK THAT -- WE NEED THE
FLEXIBILITY IN THAT HUNDRED
MILLION FUNDING IT'S GREAT
FUNDING -- BUT THE GOVERNOR'S
INDICATED THAT -- DOESN'T
NECESSARILY WANT TO USE IT ON
TENDENCY BASED SERVICES AND
THOSE ARE EXACTLY THE SERVICES
WE NEED -- TO GET THESE MOST
WONDERFUL PEOPLE INTO HOUSING --
AND SO WE CAN USE SOME MEDICAID
FUNDING THROUGH THE PILOT -- FOR
GETTING PEOPLE INTO HOUSING BUT
THE TENNESSEE BASED SERVICES WE
CAN'T USE THAT WE'D LIKE TO SEE
THE WHOLE HUNDRED MILLION BE
ABLE TO BE USED FOR THAT.
IT'S STATE ONLY MONEY SO IT'S
NOT SUBJECT TO THE MEDICAID
REGULATIONS OR THE WAIVER AND SO
WE THINK THERE'S A GREAT
OPPORTUNITY THERE WE HAVE A
LETTER WITH ALL OF THIS HOT OFF
THE PRESSES TO YOU.
LASTLY ON THE ALLOCATION AS
GIVEN THESE CONCERNS WERE HOPING
THAT DH CS WILL REVISED
ALLOCATION AND THAT THIS BODY
WOULD INCLUDE -- PERHAPS BUDGET
BILL LANGUAGE OR TRAILER BILL
LANGUAGE -- REQUIRING DH CS TO
CONSULT WITH THE COUNTIES AS
THEY DEVELOP THAT ALLOCATION
JUST TO MAKE THE MONEY WORK MOST
EFFICIENTLY AT THE LOCAL LEVEL
LASTLY ON THE TWENTY MINUTES
MILLION WE'RE VERY GRATEFUL AND
EXCITED ABOUT THAT.
WE DON'T KNOW A WHOLE PERSON
CARE WILL LOOK LIKE POST THE
TWENTY TWENTY WAIVER BUT WE'RE
REALLY EXCITED WE HAVE A LOT OF
COUNTIES MANY SMALL COUNTIES.
OR INTERESTED IN JUMPING ON
BOARD THEY'VE SEEN HOW THE
PILOTS HAVE BEEN WORKING SO FAR
IN OTHER COUNTIES.
SO WE REALLY WANT TO DO THAT AND
THAT BECAUSE THAT IS -- BASED
FOR MENTAL ILLNESS AND IT'S PRO
SUSPECTED OF WE THINK THAT WORKS
JUST FINE FOR THE TWENTY MILLION
BUT THE HUNDRED MILLION IT NEEDS
TO MATCH THE TARGET POPULATIONS
THANK YOU.
YOU [inaudible]
SIR.
DOCTOR TO MADDEN RIBS IN THE
CALIFORNIA CHAPTER THE AMERICAN
CALLS RUMORS EFFICIENCY MORE
SUPPORT OF THE ADDITIONAL TWENTY
MILLION DOLLARS IN JUST WANNA
SURE QUICK SUCCESS THAT WE'RE
SEEING HERE IN SACRAMENTO. TO
BUILD OFFER DIRECTOR KEN'S
COMMENTS AT UC DAVIS -- WE HAVE
A WE SEE THIS HIGH RISK
POPULATION ON A DAILY BASIS AND
ONE OF THE KEYS TO THE SUCCESS
FOR US AND CONNECTING THEM TO
THE WHOLE PERSON CARE PILOT.
IS TO HAVE A COUNSELOR IN THE
MERCY DEPARTMENT WHO'S ABLE TO
TALK TO THIS HIGH RISK
POPULATION AND REALLY SHOW THEM
THAT THERE ARE PROGRAMS OUT
THERE THAT CAN HELP.
WE FOUND ONE OF THE CHALLENGES
IS GETTING PEOPLE INTO THESE
PROGRAMS AT THE RIGHT TIME AND
WE SEE THAT OPPORTUNITY NUMBERS
TO DEPARTMENT.
NOW UC DAVIS'S UNIQUE HAVING
THIS RESOURCE NOT EVERY
EMERGENCY DEPARTMENT HAS A
COUNSELOR -- WITH THE MARINES
VISIONS ARE SPONSORING A BUDGET
REQUEST THAT WOULD PROVIDE A
GRANT PROGRAM TO PLACE
ADDITIONAL CANCERS NUMBERS
APARTMENT WHICH WE SEE AS A NICE
FIT.
INTO THIS -- WHOLE PERSON CARE
PILOT PROGRAM THANK YOU FOR YOUR
TIME.
CHAU GIVENS OF THE COUNTY HEALTH
EXECUTIVES ASSOCIATION
CALIFORNIA FIRST AND FOREMOST
AGAIN WHEN A AND JUST EXPRESS
OUR GRATITUDE FOR THE INCLUSION
OF THAT ADDITIONAL FUNDING FOR
WHOLE PERSON CARE PILOTS IN THE
EXPANSION THE FUNDING FOR
EXPANDING THE PILOTS AT TO OTHER
JURISDICTIONS.
I'D LIKE TO ECHO THE SENTIMENTS
OF MY COLLEAGUE FROM C. SACKED
THAT CAME BEFORE ME -- IN TERMS
OF JUST ALLOWING US TO USE THE
THE FUNDING MOST EFFECTIVELY AT
AND INSURING IT REALLY DOES --
SERVE ITS PURPOSE AND SO
ALLOWING THE TARGET POPULATIONS
TO ALIGN ALLOWING ADDITIONAL
FLEXIBILITY IS IN THE
UTILIZATION OF THOSE FINES AND
FURTHER ENGAGEMENT IN REFINING
THE APPLICATION THANK YOU.
LINDA WAY WITH WESTERN CENTER ON
LAW AND POVERTY WE SUPPORT THAT
PROPOSAL TO EXPAND.
THE WHOLE PERSON CARE BEYOND THE
PILOT COUNTIES WILL NOTE THAT.
THE A PROGRAM GOALS OF THE WHOLE
PERSON CARE ALIGNED WITH THE
HEALTH HOMES PROGRAM WHICH DOES
DRAWDOWN FEDERAL FUNDS AND SO
WOULD URGE AYE THE LEGISLATURE
TO CONSIDER.
I CONSIDERING ABOUT THE WHOLE
PERSON CARE -- IS A WAIVER
PROGRAM AT THAT IS -- THAT TO TO
IN THAT WE WE LOOK AT EXPANDING
PROGRAMS THAT ARE ABLE TO JOT
DOWN FEDERAL FUNDS SUCH AS THE
HEALTH HOMES PROGRAM THANK YOU.
SHERRI DAILY WITH CALIFORNIA
CONSORTIUM OF ADDICTION PROGRAMS
AND PROFESSIONALS IN SUPPORT OF
THE EXPANSION ALSO WANT ECHO MY
COLLEAGUES COMMENTS FROM C.
SECRETARY IN.
MAKING THE FLEXIBILITY OF THE
HOUSING MORE FLEXIBLE SO THAT
PEOPLE IN EARLY RECOVERY CAN GET
INTO RECOVERY RESIDENCES AND
CONTINUE THE RECOVERY THANK YOU.
IF YOU'RE.
KELLY BROOKS I'M HERE ON BEHALF
OF THE URBAN COUNTIES OF
CALIFORNIA THE RURAL COUNTY
REPRESENTATIVES OF CALIFORNIA
AND THE CAP CALIFORNIA
ASSOCIATION OF PUBLIC HOSPITALS
AND HEALTH SYSTEMS -- ALL OF
THESE ORGANIZATIONS ARE IN
SUPPORT OF THE HUNDRED MILLION
THAT WAS PROPOSED IN JANUARY AND
THE ADDITIONAL TWENTY MILLION
THAT WAS INCLUDED IN THE MAY
REVISION.
AND WE SHARE SOME OF THE SAME
CONCERNS RANGE REYES SPICY SACK
AND JACK THANK YOU.
GOOD MORNING PAULA WILL HOME
REPRESENTING THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION OF CALIFORNIA AND WE
WOULD ALSO ECHOES THE SAX
COMMENTS IN RELATION TO THE
ORIGINAL HUNDRED MILLION AND
FIVE TO EXPAND HOUSING SERVICES
IN THE WHOLE PERSON CARE PILOTS.
WANT TO SEE THAT BE USED
FLEXIBLY AND ALSO DIRECTED TO
THE EXISTING TARGET POPULATIONS
OF THOSE PILOTS.
WE ARE EXCITED AND GRATEFUL FOR
THAT NEW TWENTY MILLION
ALLOCATION TO BRING MORE
COUNTIES AND TWO WHOLE PERSON
CARE WE HAVE COUNTIES.
READY TO DEVELOP THESE PROGRAMS
AND COORDINATES -- COUNTY
SERVICES AND WE WOULD JUST ASK
THAT.
THE ALLOCATION METHODOLOGY FOR
THAT -- PROGRAM BE CONSIDERED
WITH ENGAGEMENT AND INPUT FROM
COUNTIES AS WELL THANK YOU.
THANK YOU MISTER CHAIRMAN FIRST
KATHY SAID KNOWING WHAT THE
COUNTY WELFARE DIRECTORS
ASSOCIATION WE ALSO STRONGLY
SUPPORT BOTH A HUNDRED MILLION
DOLLARS IN THE ORIGINAL BUDGET.
AS WELL AS A PROPOSED TWENTY
MILLION EXPANSION WE'RE EXCITED
ABOUT THE OPPORTUNITY THAT THIS
FUNDING PROVIDES AND I WOULD
ALSO ASSOCIATE MYSELF WITH THE
COMMENTS MADE BY.
MS NAY DATING FROM SEIZE ACT
THANK YOU [inaudible]
THE QUESTIONS.
OF WHAT THANK YOU THANK YOU FOR
THE PRESENTATION JUST A JUST A
QUESTION SO.
THE WE HAVE TWENTY FIVE COUNTIES.
ON BOARD NOW AND THE PROPOSAL OF
THE TWENTY MILLION DOLLARS IS TO
HELP.
THE A THE ADDITIONAL THIRTY
THREE COUNTIES BECOME A PART OF
THE PROJECT IS THAT IS THAT MY
UNDERSTANDING.
OR DID I MISS SOMETHING.
YES SO TO BE AS WE TRANSITION --
I'M IN LOVE LOOK AT MY LIFE
PLANET SITTING NEXT TO ME -- AS
WE TRANSITION OUT OF THE ELEVEN
FIFTEEN RIVER AT THE END OF
TWENTY TWENTY IT'S OUR INTEREST
AND ALLOWING FOR A LOT OF THE
ACTIVITIES THAT HAPPEN UNDER THE
ELEVEN FIFTEEN TO BE DONE
THROUGH DIFFERENT WAIVER
AUTHORITIES -- SUCH AS A YOU
KNOW NINETEEN FIFTEEN RIVER WHEN
WE MOVE OUR MANAGED CARE PROGRAM
INTO THAT AND SO -- AND THERE'S
DIFFERENT FEDERAL THINGS THAT
ALLOW FOR THAT TO OCCUR I THINK
WHAT WE WILL BE WORKING WITH THE
COUNTIES ON THAT ARE NOT
CURRENTLY PARTICIPATING WHOLE
PERSON CARE IS TECHNICAL
ASSISTANCE TO HELP THEM -- DO
LESSONS LEARNED FROM THE
COUNTIES THAT HAVE ALREADY COME
BEFORE THEM -- SO THE MONEY IN
SOME CASES IS INTENDED TO HELP
EITHER EXPEDITE OR DO SOME WORK
IN ADVANCE OF THAT CONVERSATION
I THINK THAT -- IT DOESN'T
PRECLUDE US COMING AND IN FUTURE --
DISCUSSIONS WITH THE LEGISLATURE
IN THE ADMINISTRATION ABOUT
WHETHER OR NOT COUNTIES WILL
NEED ADDITIONAL SUPPORT IN THIS
AREA TO EFFECTUATE THE WHOLE
PERSON CARE BUT I THINK JUST FOR
PURPOSES OF THE GOVERNOR'S MAY
REVISION -- THIS MONEY IS
INTENDED TO WORK WITH SOME OF
THE AREAS OF THE STATE THAT HAVE
NOT HAD A WHOLE PERSON CARE
PILOTS OF ALL RIGHT SO THE WHOLE
PERSON CARE PILOTS OF REALLY
TRADITIONALLY BEEN -- COVERING A
LOT OF THE MORE URBAN AREAS OF
THE STATE AND SO THIS IS REALLY
INTENDED TO TRY TO WORK WITH
COUNTIES THAT HAVE NOT HAD ANY
TRADITIONAL -- INVOLVED ARE
ELEVEN FIFTEEN WAIVERS.
OKAY WELL I APPRECIATE THAT I
THINK -- OFTENTIMES THE THE THE
RURAL COUNTIES THAT THE DON'T
PARTICIPATE ONE OF THE THINGS IS
LACKING OBVIOUSLY IS TECHNICAL
ASSISTANCE.
AND THAT MAKES IT REALLY HARD
FOR THEM TO TO TO PARTICIPATE
BUT ALSO I HOPE THAT DID THE
ADMINISTRATION IN GENERAL --
CONSIDERS THE THE PLEA FOR
FLEXIBILITY -- EVERY EVERY
COUNTY IS NOT CREATED EQUAL AND
THE CHALLENGES WITH INDIVIDUAL
COUNTIES ARE ARE A CAN BE
SIGNIFICANT.
AND THAT MAY BE INDEED ONE OF
THE REASONS THAT YOU'RE NOT SEEN
SOME THE PARTICIPATION.
OF BYE BYE BYE RURAL COUNTIES IS
A FEAR THAT THERE ISN'T THAT
GOING TO BE THAT FLEXIBILITY AND
WHAT'S BEING OFFERED MAY NOT MAY
NOT FIT WITH WITH WITH.
WITH THEIR COUNTIES OPERATE SO
RIGID THAT MEANING ONE OF OUR
TWO FAVORITE COUNTIES ARE.
THAT AND SAID BENITO ARE IN
WHOLE PERSON CARE TOGETHER --
EVEN THOUGH THEY'RE NOT
CONTIGUOUS TO EACH OTHER SO THEY
HAVE FIGURED IT OUT AND WE'RE
VERY PROUD OF THAT AND SO I
THINK WHAT WE'RE LOOKING TO DO
IS HELP SUPPORT OTHER COUNTIES.
THANK YOU THANK YOU VERY MUCH --
WITH THAT -- WILL GO AHEAD AND
MOVE ON TO ISSUE NUMBER.
EIGHT SURE SO THIS IS -- I KNOW
THAT -- THIS -- PROPOSAL WAS
HEARD BY THIS COMMITTEE AND
ELSEWHERE SO I WON'T -- SPEND A
TON OF TIME I THINK THAT IT'S
INCLUDED IN THE GOVERNOR'S MAY
REVISION -- FOR THE AMOUNT THAT
WAS PASSED.
BY THE STAKEHOLDERS IN PREVIOUS
TESTIMONY IN TERMS OF IT'LL BE A
THREE POINT SIX MILLION DOLLAR
APPROPRIATION FROM THE MENTAL
HEALTH SERVICES FUND.
OVER THE NEXT THREE FISCAL YEARS
TO IMPLEMENT THE CALIFORNIA PEER
RUN WARM LINE IT'S OUR
UNDERSTANDING THAT THIS WAS A
FUNCTION THAT WAS PROVIDED ON A%
TWENTY FOUR SEVEN BASIS UNTIL
THERE WAS FUNDING REDUCED -- AND
SO THEY'VE BEEN OPERATE ON A
MORE LIMITED BASIS AND THIS
ALLOCATION WILL ALLOW THEM TO
OFFER -- TWENTY FOUR SEVEN
SERVICE THROUGHOUT THE STATE --%
AND SO THAT IS THE IN THAT HAS
BEEN INCLUDED IN THE GOVERNOR'S
MAY REVISIONS [inaudible]
FINANCE.
YOU FOR THE COMMENT AT THIS TIME --
BEN JOHNSON -- WITH THE LA --
WE'RE CONTINUING TO REVIEW THIS
AND THE NEXT ITEM AND WILL
PROVIDE ANY FEEDBACK THAT WE DO
HAVE -- AT A LATER TIME.
PUBLICADO PUBLIC COMMENT ON THIS
ISSUE.
HELLO WILL HOME REPRESENTING THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION OF
CALIFORNIA -- WOULD NOTE THAT WE
STRONGLY SUPPORT THE EXPANSION
OF PEER BASED BEHAVIORAL HEALTH
SERVICES IN GENERAL AND AGREE
THAT PROVIDING PEER SERVICES
THROUGH.
A WARM LINE CAN BE AN IMPORTANT
WAY TO REACH MORE CALIFORNIANS
EXPERIENCING MENTAL HEALTH
CRISES IN CONDITIONS.
WE HAVE SOME QUESTIONS ABOUT HOW
THIS PROPOSAL WILL BE
IMPLEMENTED -- FOR STRICKEN
CERTAIN THAT SOME ASPECTS OF THE
WARM LINE COULD BE DUPLICATIVE
WE DO HAVE CURRENT SYSTEMS OF
SUICIDE PREVENTION AND CRISIS
LINES.
OPERATED BY COUNTIES REGIONALLY
AND AT THE STATE LEVEL OF THOSE
LINES DO YOU INCLUDE PEERS --
AND PROVIDERS WITH LIVED
EXPERIENCES.
THERE'S ALSO A QUALITY I AM
CONCERNED AS PART OF COUNTIES
OPERATION.
OF CURRENT CRISIS LINES -- WE'VE
BEEN INVOLVED WITH RESEARCHERS
AND ENSURING ONGOING QUALITY
MONITORING AND ASSESSING
OUTCOMES FOR THOSE PREVENTION
PLATFORMS SO WE THINK THAT
SHOULD BE.
A COMPONENT OF ANY ADDITIONAL
WARM LINE PROPOSAL.
AND FINALLY WE WOULD WANT TO
ENSURE COORDINATION WITH
EXISTING SYSTEMS OF CARE SO THAT
PEOPLE THAT UTILIZE THE WARM
LINE -- ARE ABLE TO ACCESS
REFERRALS TO ON GOING CARE AND
SUPPORTS WITHIN THE PUBLICLY
FUNDED BEHAVIORAL HEALTH
TREATMENT SYSTEM SO VERY
SUPPORTIVE OF THE CONCEPT BUT
HOPE THE STATE WILL THINK QUIT
CRITICALLY ABOUT HOW TO
COORDINATE THIS STRATEGY WITH
EXISTING WARM LINE STRATEGIES
AND RESOURCES FOR BEHAVIORAL
HEALTH TREATMENT.
THANK YOU VERY MUCH SO.
REQUEST ANYONE ELSE [inaudible]
THE QUESTIONS.
SEEING NONE THANK YOU THANK YOU
VERY MUCH GO AHEAD MOVE ON TO
ISSUE NUMBER EIGHT NINE EXCUSE
ME.
OUR GREAT THANK YOU SO -- AS
THIS COMMITTEE HAS HEARD IN
PRIOR -- MEETINGS THERE ARE --
IS AT FUNDING THAT IS COMING TO
THE DEPARTMENT OF HEALTH CARE
SERVICES THROUGH.
THE PASSAGE OF PROPOSITION --
SIXTY FOUR IN THE MAY REVISION --
AND CONSISTENT WITH THE WAY THE
FUNDING FLOWS IN WE WILL BE --
EXECUTING INTERAGENCY AGREEMENTS
WITH THE DEPARTMENT OF PUBLIC
HEALTH THE DEPARTMENT OF
EDUCATION AND THE CALIFORNIA
NATURAL RESOURCES AGENCY FOR THE
ITEMS THAT ARE NOTED IN THE
AGENDA -- FOR THE FUNDING THAT
HAS BEEN -- DEDICATED TO THE
DEPARTMENT OF HEALTH CARE
SERVICES WHICH IS TWENTY ONE
POINT FIVE MILLION DOLLARS -- WE
WILL BE -- CONVENING A
STAKEHOLDER PROCESS AS IS --
REQUIRED THROUGH THE INITIATIVE --
AND THEN -- MAKING.
GRANTS.
AVAILABLE ON A COMPETITIVE BASIS
TO PROGRAMS THAT EMPHASIZE
PREVENTION EDUCATION AND EARLY
INTERVENTION FOR USE CONSISTENT
WITH THE PURPOSES OF THE ACT.
I THINK -- WE ARE EXCITED.
ABOUT THIS OPPORTUNITY BECAUSE
THERE'S OFTEN NOT A LOT OF
FUNDING MADE AVAILABLE FOR
PREVENTION -- EDUCATION EARLY
INTERVENTION SO I THINK THAT
THAT WILL BE -- THE FOCUS OF OUR
PARTICULAR -- POLICY AREA BUT
CERTAINLY WILL BE INFORMED BY
THE STAKEHOLDER PROCESS AS WELL
AND THEN WE'RE HAPPY -- TO KEEP
THE LEGISLATURE APPRISED OF THE
PROCESS AS IT AS IT ROLLS
FORWARD BUT IT'S A TWENTY ONE
AND A HALF MILLION DOLLAR.
APPROPRIATION TO US FOR
COMPETITIVE GRANTS FOR PURPOSES
OF YOUR AGENDA [inaudible]
THANK YOU -- FINANCE.
HELLO NOW.
A PUBLIC COMMENT ON THIS ISSUE.
MISTER CHAIRMAN MISTER CHAIR HI.
ROBERT HARRIS ON BEHALF HAS HE
ARE YOU CALIFORNIA.
WE HAVE NO OBJECTIONS WITH.
THE BASIC DIRECTION THE THE
DEPARTMENT'S GOING UNFORTUNATELY
THERE WASN'T A PLANNING PROCESS
THAT HAPPENED BEFORE THIS.
HELLO PEOPLE I'VE TALKED ABOUT
DOING IT AND SO WE'RE WORRIED
THAT WHAT IT AMOUNTS TO IS YOU
HAVE TWENTY AND A HALF MILLION
DOLLARS WHICH ISN'T.
A WHOLE LOT TO DO ANYTHING IN
THE STATE.
AND THAT MONEY WOULD PROBABLY BE
BETTER SPENT.
DOING AT A NEEDS ASSESSMENT
PLANNING PROCESS FIND OUT WHAT'S
OUT THERE AND NO ONE NO ONE
REALLY KNOWS FROM EARLY
INTERVENTION PREVENTION AND
TREATMENT.
NO ONE KNOWS WHAT'S OUT THERE
FOR KIDS AND YET WE'RE GONNA
PUSH MONEY OUT THE DOOR WHICH WE
UNDERSTAND HAS TO HAPPEN BECAUSE
OF THE WORD THE TERMS OF THE
INITIATIVE.
BUT GOING FORWARD WE'RE WE
BELIEVE.
THAT.
AN ASSESSMENT OF WHAT'S OUT
THERE.
AND THEN AND THEN HOW IT WILL
ALL WORK WE DON'T KNOW WHEN WE
SEND MONEY TO PREVENTION WE
DON'T KNOW WHAT.
THERE'S BEEN BLOCK GRANT MONEY
ONE OF PREVENTION FOR YEARS BUT
SEVENTY BLOCK GRANT MONEY THIS
MONEY.
THE GHOST WOULD PREVENTION
SHOULD BE COORDINATED WITH THAT
THE INITIATIVE CALLS OUT. FOR
NOT NOT SUB PLANNING RIGHT.
BUT ACTUALLY ABBOTT BEING
ADDITIVE [inaudible]
THANK YOU.
MR CHAIRMAN MEMBERS HOW
IMMEASURABLE HAVE THE CALIFORNIA
ASSOCIATION OF ALCOHOL AND DRUG
PROGRAM EXECUTIVES WERE
STATEWIDE ASSOCIATION PROVIDING
SUBSTANCE USE DISORDER TREATMENT.
OR IN OVER THREE HUNDRED SITES
AROUND THE STATE -- WE ARE VERY
CONCERNED AND ARE A DISAPPOINTED
IN THE DISTRIBUTION WHICH IS
ESSENTIALLY AN 8020%
DISTRIBUTION BETWEEN EDUCATION
AND TREATMENT AND WE WOULD LOOK
FOR A MORE EQUITABLE.
DISTRIBUTION -- ONE AND MAINLY
BECAUSE THERE ARE MANY CHILDREN
AND MANY KIDS.
WHO ARE NOT IN SCHOOL AND NOT IN
THE EDUCATION SYSTEM AND THEIR
NEEDS FOR RESOURCES -- TO ASSIST
THEM IS JUST AS GREAT AS A KID
IN SCHOOL.
SO -- WE WE WERE LOOKING -- FOR
SOME ADDITIONAL RESOURCES FOR
OUT OF SCHOOL CHILDREN -- IN
ADDITION.
WE ALSO SUPPORT AN ASSESSMENT
AND A VERY ROBUST BECAUSE HAS
MEANT THAT SHOULD BE PROVIDED
SHOULD BE DONE.
BEFORE ANY FUNDS ARE ALLOCATED
EVEN THIS DISTRIBUTION BETWEEN
EDUCATION AND AT AND TREATMENT.
THAT -- THE ROBUST -- ASSESSMENT
NEEDS TO BE -- TAKEN PLACE IN.
THE ASSESSMENT AS OUTLINED IN AB
TEN TWENTY TEN I'M SORRY -- TEN
NINETY EIGHT WHICH YOU AND
ASSEMBLYMAN -- O'DONNELL ARE
SUPPORTING IS SOMETHING THAT
WE'VE BEEN WORKING ON AND I
THINK THAT THAT KIND OF ROBUST
ASSESSMENT -- NEEDS TO TAKE
PLACE IN ORDER TO IDENTIFY THE
AREAS OF GREATEST NEED AND THE
GAPS IN SERVICE IN THE CURRENT
SERVICES.
AND IT THE THAT KIND OF
ASSESSMENT GO A LONG WAY TO
INFORM DECISIONS ABOUT
DISTRIBUTION OF THE FUNDS THANK
YOU.
HELLO WILL HOME REPRESENTING THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION AND AS YOU
KNOW COUNTIES ARE RESPONSIBLE
FOR ADMINISTERING PREVENTION
EARLY INTERVENTION AND TREATMENT
SERVICES FOR YOUTH WITH
SUBSTANCE USE DISORDERS.
WE WOULD NOTE THAT PROP SIXTY
FOUR PRESENTS A REALLY
UNPRECEDENTED OPPORTUNITY TO
INVEST IN A FULL CONTINUUM OF
SUBSTANCE USE DISORDER CARE FOR
YOUTH SO INCLUDING PREVENTION
EARLY INTERVENTION AND TREATMENT.
WE HAVE A COUPLE OF CONCERNS
WITH THE CURRENT PROPOSALS AND
THAT THEY DIRECT THE BULK OF THE
FUNDING TO PREVENTION AND EARLY
INTERVENTION -- WHICH DOES VERY
LITTLE TO HELP YOUTH WHO ARE
ALREADY STRUGGLING WITH
SUBSTANCE USE AND NEED TO M.
SERVICES FARTHER ON THE
TREATMENT SIDE OF THE CONTINUUM.
SIXTY FOUR AS APPROVED BY THE
VOTERS DOES SPECIFY THAT FUND
SHOULD BE USED FOR THAT FULL
SPECTRUM OF CARE -- WE WOULD
ALSO ECHO COMMENTS FROM C.
SALMON CAD P. AND RECOMMENDING
THAT BEFORE UNDERTAKING A
COMPETITIVE GRANT PROCESS -- TO
ALLOCATE THE TWENTY ONE POINT
FIVE MILLION THREE DH CS.
THE STATE SHOULD THINK ABOUT
UNDERTAKING A COMPREHENSIVE
NEEDS ASSESSMENT AND MORE OF A
STRATEGIC PLANNING PROCESS TO
REALLY IDENTIFY WHERE THE GAPS
ARE IN OUR CURRENT SYSTEM OF
CARE AND HOW THESE PROP SIXTY
FOUR RESOURCES CAN BE
COORDINATED AND YOU
STRATEGICALLY ALONG WITH
EXISTING RESOURCES.
TO BUILD OUT THE SERVICE AS
THANK YOU.
CAN LOS REPRESENTING THE
CALIFORNIA COALITION FOR YEARS
AND JUST WANTED TO HIGHLIGHT.
OUR DISAPPOINTMENT A LACK OF
ATTENTION TO YOUTH EXPERIENCING
HOMELESSNESS AND I'M IN THE USE
OF THE RESOURCES UNDER.
C. EIGHT SAID SPECIFICALLY AN
INITIATIVE THAT GRANTS TO
PROGRAMS FOR OUR REACH EDUCATION
AND TREATMENT FOR HOMELESS YOUTH
IN OUT OF SCHOOL YOUTH WITH
SUBSTANCE USE DISORDERS COULD
HAVE BEEN ONE OF THE USES OF
THESE FUNDS.
THE STATE HAS UNDER INVESTED IN
THIS POPULATION FOR YEARS WE
ONLY DEDICATE LESS THAN TWO
MILLION DOLLARS ON AN ONGOING
BASIS.
IN GENERAL FUND RESOURCES TO
SUPPORT YOUTH EXPERIENCING
HOMELESSNESS AND IT'S NO
SURPRISE TO ME THAT WE HAVE A
GROWING HOMELESS POPULATION AND
STATE -- THE NUMBER ONE
INDICATOR OF HOMELESSNESS IS A
LACK OF A GED -- FOR A LOT OF
STUDENTS SO THERE IS A BIG
CONNECTION THERE AND YOUTH ARE
USUALLY COPING WITH THE TRAUMA
OF BEING ON THE STREET OR REASON.
THAT THEY'RE ON THE STREET IS DO
YOU SUBSTANCE ABUSE ISSUES -- I
KNOW SOMEONE MEMBER RARE SENT TO
SOMEONE RUBIO HAVE BEEN STRONG
SUPPORTERS OF ADVOCATING FOR
PROPOSAL AROUND HOW DO WE
ADDRESS THE NEEDS OF THESE YEARS.
AND FROM A DEPARTMENT OF FINANCE
PERSPECTIVE OF NOT LIKING -- I'M
GOING TO HAVE FUN COMMITMENTS
THAT THIS IS A GOOD USE A
SPECIAL FUND RESOURCES THANK YOU.
SURE IT IS CALIFORNIA CONSORTIUM
OF ADDICTION PROGRAMS AND
PROFESSIONALS ALTHOUGH IN
EXPENDITURES ON FIGHTING
ADDICTION ARE GOOD.
DON'T HAVE ANY COMPLAINTS ABOUT
THEM -- AND ALTHOUGH CHILD CARE
IS A BIT OF A STRETCH IN
PREVENTION BUT FOR THIS YEAR I
GUESS WE CAN.
WE CAN LOOK FORWARD TO THAT WE
JUST HOPING THAT A ROBUST
PLANNING PROCESS DOES OCCUR SO
THAT IN THE FUTURE THESE FUNDS
ARE SPENT WISELY.
AND PARTICULAR NOT ONLY DO WE
NEED TO KNOW WHERE SERVICES ARE
AVAILABLE WE NEED TO KNOW WHAT
TYPE WE PARTICULAR NEED TO WHAT
WORK FORCE IS PROVIDING THOSE
SERVICES.
WHETHER THEY'RE QUALIFIED TO DO
SO BOTH IN THE EDUCATIONAL
SETTINGS AND IN THE TREATMENT
SETTINGS SO A LOT OF WORK TO DO --
TO MAKE THIS THING WORK AND
WE'VE GOT TIME TO DO THAT AND WE
APPRECIATE WORKING WITH YOU AND
WITH THAT IN THE FUTURE THANK
YOU [inaudible]
ANYONE ELSE.
SEE NO BRING IT BACK ANY
COMMENTS QUESTIONS.
IS THE CUP I JUST HAVE A COUPLE
COMMENTS -- WE APPRECIATE THE
ADDITIONAL MONEY OBVIOUSLY --
FOR PROGRAMMING -- I THINK
YOU'VE HEARD FROM MANY THE
ADVOCATES HERE THAT THEY WISH
THAT THERE WAS A PLANNING
PROCESS IN PLACE.
I KNOW THERE WERE LEGISLATIVE
PROPOSALS -- RECENTLY AS A YEAR
OR TWO AGO ASKING THAT WE
ACTUALLY PUT TOGETHER WORKING
GROUP'S TO ACTUALLY LOOK AT HOW
WE HOW THIS IS SPENT THOSE PROP
THOSE DIDN'T MAKE IT -- FOR
VARIETY OF FOR A VARIETY OF
REASONS SO -- YOU TALKED ABOUT
COMPETITIVE GRANTS -- SO HOW
DOES THAT WORK -- HOW DO YOU
ENVISION THAT WORKING ONCE AGAIN --
RURAL AREAS -- HAVE A HARD TIME
COMPETING WITH LARGER URBAN
AREAS AND I WOULD ARGUE -- BASED
ON JUST MY DISTRICT THOSE
COMMUNITIES THAT HAVE BEEN MOST
AFFECTED BY -- CANNABIS AND
CANNABIS CULTIVATION THROUGHOUT
NORTHERN CALIFORNIA CENTRAL
CALIFORNIA -- ARE.
I I THINK AT A HAVE HAVE A AT A
HIGHER RISK OF HAD HIGHER
PROBLEMS THERE.
SO HOW DO YOU ENVISION -- AWAY
THAT GIVES AN OPPORTUNITY FOR
SOME OF THOSE COMMUNITIES THAT
WERE MOST AFFECTED. TO ACTUALLY
BECAUSE IT IS IN IN THE CAR IN
THE WORLD COMPETITION --
OFTENTIMES THOSE COMMUNITIES CAN
UNITIES LOOSE AND THAT WAS I
DON'T BELIEVE THAT WAS THE
INTENT OF PROP.
SIXTY FOUR YEAH SO THOSE ARE
GREAT QUESTIONS I THINK YOU KNOW
A COUPLE OF RESPONSES -- THE
FIRST IS THAT THE THE GRANTS
NEED TO BE INFORMED BY THE
STAKEHOLDER PROCESS THAT THE
INITIATIVE CONTEMPLATES SO WILL
BE CONVENING THAT IN TERMS OF
PROVIDING INPUT TO US ON YOU
KNOW EITHER PRIORITY -- AREAS TO
FOCUS ON A PRIORITY ACTIVITIES
THE THE TEAM THAT WILL BE
LEADING THIS WORK WITHIN THE
DEPARTMENT ARE ALSO THE ONES
THAT HAVE BEEN WORKING
EXTENSIVELY ON THAT -- FEELING
GRANT -- ACTIVITIES AND I KNOW
THAT WE HAVE SPENT A LOT OF TIME --
IN CERTAIN PARTS OF YOUR
DISTRICT AS WELL AS OTHER PARTS
OF THE STATE IN WHICH THERE ARE
NOT.
THE SAME KIND OF RESOURCES AND
CAPACITY -- AND SO WE'VE SPENT A
FAIR AMOUNT OF FEDERAL MONEY ON
THE ON THE OPIOID SIDE IN
PARTICULAR ABOUT BUILDING
CAPACITY IN AREAS IN WHICH
THERE'S NOT NECESSARILY.
EITHER PROVIDERS ARE PROGRAMS I
THINK THE LAST THING I WOULD SAY
IS -- IT'S NOT OUR INTEREST TO
DO AN OVERLY -- BUREAUCRATIC
GRANT PROCESS JUST BECAUSE I'VE
CERTAINLY HEARD -- THROUGH THE
CHAFF AND OTHER TYPES OF GRANTS
WHERE PEOPLE WILL SAY I I'D LIKE
THE MONEY BUT I DON'T HAVE THE
INTERNAL CAPACITY TO ACTUALLY
WRITE THE GRANT AND I THINK THAT
THAT'S NOT OUR INTEREST IN.
IN THAT IT'S YOU KNOW.
IT'S A LIMITED AMOUNT OF MONEY
FOR THIS FIRST YEAR
APPROPRIATION AND SO I THINK WE
WANT -- TO MAKE IT AS EASY AS
POSSIBLE FOR APPLICANTS TO BOTH
APPLY AND USE THE MONEY IN A WAY
THAT IS YOU KNOW AGAIN AND FROM
BY THE STAKEHOLDER PROCESS SO.
I'M HOPING THAT THAT YOU KNOW
WHAT WE'RE WE'RE CERTAINLY --
WILLING TO HAVE -- INCLUSION OF
LEDGE STAFF AS APPROPRIATE OR
POLICY STAFF -- SIT THROUGH THE
SIT THROUGH THE STAKEHOLDER
PROCESS TO HELP ALSO INFORMS
THEM THAT DECISION MAKING
BECAUSE SOME OF THOSE DECISIONS
JUST HAVEN'T HAVEN'T BEEN MADE
YET.
SO WITH THE STAKEHOLDER PROCESS
HAPPEN BEFORE THE AWARDING OF
GRANTS YES YES.
OKAY -- THAT'S THAT'S THAT'S
ENCOURAGING -- AS WELL I GUESS I
I WORRY THAT -- TWENTY ONE POINT
FIVE MILLION DOLLARS IS NOT A
HUGE AMOUNT OF MONEY IT WOULD BE
EASY TO GIVE EVERYBODY A LITTLE.
AND ACCOMPLISH NOTHING AND SO IT
WOULD BE I WOULD HOPE THAT THERE
BE A FOCUS ON COMMUNITIES THAT --
HAVE BEEN MOST AFFECTED GIVE
THEM THE BEST OPPORTUNITY THERE
RECOGNIZING THAT OVER TIME WE'RE
GOING TO HAVE MORE AND MORE AND
MORE MONEY COMING HERE BUT I
THINK.
I WOULD HOPE THAT THAT WOULD BE
ONE OF ONE OF THE CONSIDERATIONS
AND ALSO JUST THE THE CHALLENGE
THAT.
YOU KNOW SOME COMMUNITIES JUST
HAVE A HARD TIME WITH THESE WITH
GRANT PROCESSES SO I'M
ENCOURAGED TO HEAR THAT THAT
YOU'RE NOT TRYING WE'RE NOT
TRYING.
THIS OVER THE OVER THE
BURDENSOME.
SO -- AND THEN ALSO THERE WAS IN
HERE AND AND THERE'S ALSO FIVE
POINT THREE MILLION DOLLARS A
CALIFORNIA NATURAL RESOURCES
AGENCY TO SUPPORT YOUTH
COMMUNITY ACCESS.
GRANTS INCREASE ACCESS TO
NATURAL CULTURAL RESOURCES. FOR
LOW INCOME YOUTH AND
DISADVANTAGED COMMUNITIES WHICH
I I APPLAUD -- DOES ANYBODY KNOW
HOW WEIRD HOW WE ARE IDENTIFYING
DISADVANTAGED COMMUNITIES.
IS THAT -- BASED ON THE STATE
AND VIRUS SCAN OR IS THAT BASED
ON OTHER CRITERIA.
RYAN MILLER DEPARTMENT OF
FINANCE -- THAT'S SOMETHING I
THINK WHAT TO GET BACK TO YOUR
STAFF ON SO WE OWE IT WE DON'T
OKAY I KNOW THAT WAS PROBABLY I
KNOW THAT WASN'T HIGHLIGHTED
HERE BUT I WHENEVER I SEE
DISADVANTAGED COMMUNITIES -- IT
IT RAISES THE HAIR ON THE BACK
OF MY NECK BECAUSE ON SOME
THINGS WE ARE DISADVANTAGED IN
IN IN COMMUNITIES AND OTHERS
WERE NOT BASED ON THE ENVIRO
SCANNED AND SO.
I WOULD REALLY LIKE TO GET THAT
INFORMATION BACK YEAH WE CAN
WORK WITH OUR NATURAL RESOURCES
YEAH WELL READ WILL WORK WITH
OUR FOR WITH OUR FOLKS AT
FINANCE TO WORK ON THE NATIONAL
RESOURCES ISSUES AND WE'LL GET
BACK TO YOU ON THAT.
GREAT THANK YOU OKAY.
OKAY -- IT IS NOW WE'RE GOING --
TO RECESS WILL THIS IS NOT IT
WE'RE NOT WE'RE NOT CLOSING THE
HEARING WE'RE GOING TO RECESS
FOR LUNCH WILL BE WE WILL --
RECONVENE AT ONE THIRTY SO THANK
YOU THANK YOU VERY MUCH
[inaudible]
CASTOR.
A LOT OF THE AS A MATTER
[inaudible]
YEAH [inaudible]
SO.
I MEAN IF YOU WANT TO DO THE
THREE I CAN BE DISPENSED
WHATEVER IS GOING TO TRY TO SAVE.
OF COMPLETELY [inaudible]
YEAH NO [inaudible]
OKAY