PANEL PLEASE COME JOIN US WE
ARE GOING TO GET STARTED IT'S
TWO O'CLOCK- OF OUR FIRST PANEL
CAN PLEASE JOIN AS THE OFFICE
OF AIDS STD CONTROL BRANDS. THE
DEPARTMENT OF HEALTH CARE
SERVICES AND SAW THE DEPARTMENT
OF CORRECTIONS AND
REHABILITATION IS PLEASE COME
AND JOIN US IN THE FRONT.
WHAT
I CALL THE SELECT COMMITTEE ON
INFECTIOUS DISEASES TO ORDER.
MY NAME IS MIKE GIPSON AYE
CHAIR THIS SELECT COMMITTEE ON
INFECTIOUS DISEASES- A
DISADVANTAGED COMMUNITIES WE
WANT TO WELCOME EACH AND
EVERYONE OF YOU FOR JOINING US
THIS AFTERNOON IN OUR STATE
CAPITOL THE PEOPLE'S HOUSE- I
WANT TO BEGIN TO SIMPLY SAY AND
WELCOME EACH AND EVERYONE OF
YOU- MY COLLEAGUES WILL BE
JOINING US THROUGHOUT- TODAY'S
HEARING. WE'RE HERE TODAY- FOR
A PANEL DISCUSSION ON THE HIV
H. C. VI N. S. T. D. EPIDEMIC
AND THE STATE OF CALIFORNIA. I
WANT TO THANK THE PANEL. FOR
MAKING THEMSELVES AVAILABLE-
AND ATTENDING TODAY'S HEARING
AND I WANT TO SAY HOW GRATEFUL
I AM WITH THE PLETHORA OF
INDIVIDUALS WHO ARE OFF TO OUR
OUR B. ARTICULATE AND
AUTHORITATIVE IN THIS SPACE. IN
TODAY'S HEARING WILL RECEIVE AN
OVERVIEW OF THE H. C. D. AND H.
C. VI AND STDS IN CALIFORNIA WE
WILL ALSO DISCUSS COMBATING-
RISING RATES- OF WITH A HEALTH-
QUAL LIMITS. WE WILL ALSO HEAR
FROM STRATEGISTS. INDIVIDUALS
WHO'S BEEN IN THE SPACE A LONG
TIME AGAIN WE WELCOME THEIR
COMMENT. AUDIENCE ARE S. A.
OPPORTUNITY TO DURING THE Q.
AND A TO ANSWER AND ASK
QUESTIONS- AT APPROPRIATE TIME
I'LL GIVE THE SIGNAL WHERE. ARE
YOU Q. UP FOR THAT IF SOME
BEING SPARKS YOUR ATTENTION YOU
NEED A DEBT. OF SOME CARDS. WE
HAVE PEOPLE WHO. BY QUESTION
DOUBT CAN HANDLE AS A WE EVER
pFACT TIME OUT. OF WHAT WE BE
ABLE DO IS WE WILL POST REQUEST.
ON MY WEB WITH THE ANSWER SO
THAT YOUR QUESTION WE NOT GO A
IF BE A MAY NOT BE IN THIS FORM
BUT WE WILL MAKE SURE. THAT
EVERY EFFORT IS MADE TO HAVE
YOUR QUESTIONS ANSWERED SO WITH
THAT BEING SAID I ALSO WANT TO
RECOGNIZE MY COLLEAGUES. IT
WALDRON WAS HERE AND I WANT TO
OFFER HER A FEW OPPORTUNITIES
TO MAKE COMMENTS AND REMARKS
MISS WALDRON. I DON'T THINK IT
WAS THE TURN IN THE STORE
EVERYONE WHO CAME OUT THIS IS A
VERY IMPORTANT ISSUE FOR THE AS
WELL AS NATION- WE'VE BEEN
SERVING ON THE SELECT COMMITTEE
NOW FOR A COUPLE OF YEARS- HAVE
BEEN GARNERING A LOT OF
INFORMATION WHICH IS VERY
HELPFUL TO US AS POLICY MAKERS.
SO IT'S GOING TO BRING PEOPLE
WHO ARE WORKING IN THE SPACE
PEOPLE WHO ARE RESEARCHERS TO
COME TOGETHER WITH POLICY
MAKERS SO THAT WE CAN. WORK ON
SOLUTIONS AND GETTING TO ZERO
WHICH IS GOING TO BE OUR
ULTIMATE GOAL SO THANK YOU.
THANK YOU VERY MUCH NEXT UP
WE'RE GOING TO GET RIGHT INTO
WE'RE GOING TO ASK OUR PANEL TO
SELF DUES- YET IN MINUTES TO BE
PARTNER PRESENTATION AND TAKE
AWAY. FIFTH ON THAT. HI MY NAME
IS MARITZA RAMOS I AM THE CHIEF
FOR THE OFFICE OF BATES OVER
ITS CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH. AND THANK YOU
FOR FIRST OF ALL FOR THE
INVITATION TO BE ABLE TO
PERCENT- AND I'M JUST GONNA GO
AHEAD AND JUMP RIGHT IN AND
GIVE. KIND OF BACKGROUND ON S.
T. D. H. I. V. N. EIGHT CV AND-
THE STATISTICS THAT BE PORTION
OF IT IT'S ALL START- SO THE
IMPACT OF HIV HEPATITIS C.
VIRUS AND SEXUALLY TRANSMITTED.
DISEASES IS FITTED CHAD JUST
STICK AFFECTING MANY OF THE
SAME VULNERABLE AND
DISADVANTAGED COMMUNITIES.
GRADE NEXUS BURDEN AND NEGATIVE
HEALTH OUT CUTS AND I'LL START
OUT WITH VESTED HE SPECIFICALLY
DOWN ALL THE STATISTICS THE
RATES ARE WITH HAPPENED IN
CALIFORNIA. AND THEN I'LL MOVE
OVER TO THE DIFFERENT OTHER
DIFFERENT DISEASES- THERE HAVE
BEEN INCREASES IN STDS
NATIONALLY BUT RATES IN
CALIFORNIA EXCEED THE NATIONAL
AVERAGE. CALIFORNIA STD DATA
FOR TWENTY EIGHTEEN CHAU
CONTINUE INCREASES AT ALL THREE
REPORTABLE BACTERIAL STDS.
COLUMBIA THERE'S TWO HUNDRED
THIRTY TWO THOUSAND ONE HUNDRED
EIGHTY ONE CASES REPORTED. 56%
INCREASE OVER THE TEN YEARS.
HIGHER RATE SINCE REPORT BEGAN
IN NINETEEN NINETY AND
GONORRHEA OTHER 790-003-0090
SEVEN CASES REPORTED WITH A TWO
HUNDRED ELEVEN IN PERCENT
INCREASE OVER THE TEN YEARS.
HIGHEST RATE SINCE NINETEEN
EIGHTY NINE FOR SYPHILIS
THERE'S 250-003-0040 FOUR CASES
ALL STAGES REPORTED 210065%
INCREASE OVER TEN YEARS HIGHEST
RATE SINCE NINETEEN EIGHTY
EIGHT. 80% ABOVE THE NATIONAL
AVERAGE. THE RICIN STDS IS
DRIVEN BY A COMPLEX SET OF
SOCIAL FACTORS THAT INCLUDE
SOCIAL MEDIA DRUG USE POVERTY
CONTRACEPTIVE TECHNOLOGY IN HIV
PREVENTION. AS A RESULT THERE
ARE IMPORTING HEALTH
DISPARITIES RELATED TO STDS BY
H. GEOGRAPHIC FROM. JOURNAL
GRAPHICS AN INDIVIDUAL
CHARACTERISTICS YOUNG PEOPLE
ARE PARTIAL ARE PARTICULARLY AT
RISK WITH 50% OF CASES A
COMEDIENNE 30% OF CASES OF
GONORRHEA DIAGNOSED AMONG
PEOPLE UNDER AGE TWENTY FIVE.
NEARLY 70% OF MALE EARLY
SYPHILIS CASES WERE DIAGNOSED
AMONG MEN WHO HAVE SEX WITH
MEN. AND A LITTLE OVER ONE
THIRD WERE HIV POSITIVE
SYPHILIS AS ALSO INCREASE AMONG
WOMEN OF CHILDBEARING AGE.
WHICH IS DRIVING IS DRAMATIC
INCREASING COULD GENERAL'S
FULLER. THERE ARE THREE HUNDRED
TWENTY INFO BORN WITH CAN.
SYPHILIS AND 889100% INCREASE
FROM TWENTY TWELVE. THE RATE OF
CONGENITAL SYPHILIS IN
CALIFORNIA IS DOUBLE THE
NATIONAL AVERAGE. WOMEN IN
CALIFORNIA INCREASINGLY AT RISK
FOR SYPHILIS AT NEW HCV
INFECTION. FROM TWENTY TWELVE
TO TWENTY SIXTEEN THE RATES OF
EARLY SYPHILIS AND HEPATITIS C.
INFECTIONS AMONG WOMEN OF
CHILD. BEARING AGES FIFTEEN TO
FORTY FOUR YEARS REPORTED TO
THE CALIFORNIA DEPARTMENT
PUBLIC HEALTH INCREASE FOUR
HUNDRED AND 50% AND A 148%
WRIST RESPECTIVELY. DURING
201220167% OF WOMEN AND WITH
EARLY SYPHILIS ALSO HAD NO
HEPATITIS C. COINFECTION. WOMEN
WITH SYPHILIS IN KNOWN
HEPATITIS C. CONFECTION WERE
MORE LIKELY TO REPORT INJECTION
DRUG USE EXCHANGING SEX FOR
DRUGS AND HAVING A SEX PARTNER
WHO USED INJECTION DRUGS
COMPARED TO WOMEN WITH SYPHILIS
ONLY. MOVING ON TO HIV AN
ESTIMATED A HUNDRED FIFTY THREE
THOUSAND PERSONS WERE LIVING
WITH HIV IN CALIFORNIA AT THE
END OF TWENTY EIGHTEEN OF WHOM
88% OR A HUNDRED THIRTY FIVE.
OF THOUSAND AND EIGHTY TWO HAD
BEEN DIAGNOSED AND REPORTED TO
THE OFFICE OF AIDS. BASERUNNERS
CDC ALL OF OUR GREAT THEM
TESTAMENT SAYS THE DISTRIBUTION
OF LIVING CASES WITH RESPECT TO
MOTIVATE JVMS EXPOSURE MOST
SIXTY SIX POINT 9% OF
CALIFORNIA IS A FINANCIAL
ESTIMATED LIVING HIV CASES ARE
TO. OUR DUE TO MALE TO MALE
SEXUAL TRANSMISSION 14% OF THE
LIVING CASES ARE DUE TO
HETEROSEXUAL TRANSMISSION FIVE
POINT 6% TO INJECTION DRUG USE
AND SIX POINT 3% TO MALE TO
MALE SEXUAL CONTACT. WITH AN
INJECTION DRUG USE. THERE WERE
APPROXIMATELY FOUR THOUSAND
FIVE HUNDRED NEW CASES REPORTED
TO OFFICE OF EIGHTEEN TWENTY
EIGHTEEN AT AROUND FOUR
THOUSAND EIGHT HUNDRED AND
TWENTY FIVE. ALTHOUGH HIV
DIAGNOSIS HAVE DECLINED OVERALL
JUST THIRTIES PLACED AMONG
RACIAL ETHNIC GROUPS GENDER AGE
AND CHANCE CATEGORY. IN TWENTY
SEVEN BUT AFRICAN AMERICAN MADE
UP APPROX. 6% OF CAL POP. YET
THEY ACCOUNTED 417% OF
CALIFORNIA'S HIV EPIDEMIC HIV
RATES AMONG NEARLY DIAGNOSE
BLACK AFRICAN AMERICAN MEN ARE
THREE POINT NINE TIMES HIGHER
THAN WHITE MEN. AMONG BLACK
AFRICAN WOMEN SIX POINT SIX
TIMES HIGHER THAN WHITE WOMEN.
LATIN ACTS MAKE UP THE LARGEST
RACIAL ETHNIC GROUP AMONG NEW
HIV DIAGNOSIS ACCOUNTING 4407%
OF ALL NEW HIV DIAGNOSIS AND
TWENTY SEVENTY. HIV RATES AMONG
NEARLY DIAGNOSE LET IN X. MEN
ARE ONE POINT SEVEN TIMES
HIGHER THAN WHITE MEN IN AMONG
LATE IN ACTS WOMEN ONE POINT
FOUR TIMES HIGHER THAN WHITE
WOMEN. THE LOWEST RATES OF FIRE
SUPPRESSION BY TRANSMISSION
CATEGORY ARE FOR PEOPLE WHO
INJECT DRUGS. REGARDLESS OF
GENDER OR RACE TRACK OF PEOPLE
WHO INJECT DRUGS HAVE LOWER
FIRE SUPPRESSION THAN ANY OTHER
TRANSMISSION GROUP OVERALL
LINKAGE TO CARE. AMONG PEOPLE
WHO INJECT DRUGS IS SIMILAR TO
THE STATEWIDE AVERAGE WHICH
SUGGESTS THAT RETENTION AND
CARE MAY BE AN AREA FOR
IMPROVEMENT CONTINUED SUPPORT
OF SYRINGE SYRUP SERVICES
PROGRAMS AND OTHER SUPPORT
SERVICES ARE NEEDED TO PREVENT
NEW HIV INFECTIONS AND IMPROVE
HIV VIRUS OPPRESSION AMONG.
PEOPLE WHO INJECT DRUGS. FOR
EIGHT SAVE HCV THE RATE OF
NEARLY REPORTED CHRONIC
HEPATITIS C. INFECTION
CALIFORNIA INCREASED 14%
BETWEEN TWENTY FOURTEEN AND
TWENTY SIXTEEN AND EIGHTY SIX
TO NINETY EIGHT PER HUNDRED
THOUSAND POPULATION. CHRONIC
HEPATITIS C. REMAIN ONE OF THE
MOST FREQUENTLY REPORTED
COMMUNICATE DISEASE IN
CALIFORNIA. ALTHOUGH PEOPLE
BORN DURING NINETEEN FORTY FIVE
TO NINETEEN SIXTY FIVE HAD THE
HIGHEST RATES OF NEWLY REPORTED
CHRONIC HEPATITIS C. INFECTION
IN TWENTY SIXTEEN AND MADE UP
ALMOST HALF OF NEWLY REPORTED
CASES. THERE HAS BEEN AN
INCREASING PROPORTION OF NEWLY
REPORTED CHRONIC HEPATITIS C.
CASES AMONG ADOLESCENTS AND
YOUNG ADULTS AT OVER THE LAST
TEN YEARS. GEOGRAPHICALLY THE
RATE OF NEARLY REPORTED CHRONIC
HCV INFECTIONS WITH HIGHS IN
THE NORTHERN AND CENTRAL
REGIONS OF CALIFORNIA. IN
201699% OF ALL NEARLY REPORTED
CRITICS HEPATITIS C. CASES IN
CALIFORNIA REPORTED FROM STATE
PRISONS. AND DISPARITIES IN THE
GENDER AGE RACE OR GEOGRAPHIC
DISTRIBUTION OF CHRONIC
HEPATITIS C. INFECTIONS PERSIST
WHITE AFRICAN AMERICAN BLACK
AND AMERICAN INDIAN ASKS
ALASKAN NATIVE PERSONS IN THE
GENERAL POPULATION REMAIN
DISPROPORTIONATELY AFFECTED BY
CHRONIC HEPATITIS C. IN TWENTY
SIXTEEN. AMONG ADOLESCENTS AND
YOUNG ADULTS EIGHTEEN AGES
FIFTEEN TO TWENTY NINE IN
CONCERT RATED IN STATE PRISONS
BETWEEN TWENTY FOURTEEN TWENTY
SIXTEEN THE RATE OF NEARLY
REPORTED CHRONIC HEPATITIS C.
INFECTION INCREASED BY TWENTY
TWO PERCENT. AND TWENTY SIXTEEN
LEADING NECKS AND WHITE PERSON
CONTINUE BE DISPROPORTIONATELY
AFFECTED BY. YOU SEE IN THE
PAPER. LEADING NEXT. 42% OF THE
POPULATION AND PROVIDE STATE
PRISONS THAT 50% OF REPORTED
HEPATITIS C. CASES WITH RACIAL
RACE ETHNICITY SPECIFIED AND
WHITE. REPRESENTED 222% OF THE
POPULATION STATE PRISONS BUT
37% OF REPORTED CHRONIC
HEPATITIS C. CASES WITH RACE
ETHNICITY SPECIFIED. SO HOW
COULD THE STATE ADDRESS THESE
HEALTH DISPARITIES AS
PREVIOUSLY STATED HIV STDS AN
ATV DISPROPORTIONATELY IMPACT
MANY OF THE SAME POPULATIONS IN
CALIFORNIA THESE POPULATIONS
EXPERIENCE A MULTITUDE OF ME
FROM UNSTABLE HOUSING FOOD AND
THIRTY INCREASED INTERACTION.
WITH THE POLICE AND THE
CRIMINAL JUSTICE SYSTEM ADVERSE
CHILDHOOD EVENTS POSTTRAUMATIC
STRESS DISCRIMINATION AND
STIGMA CD PHP ARE REALIZED IF
OF THESE EPIDEMICS CANNOT BE
OVERCOME WITHOUT A HOLISTIC
COMPREHENSIVE AND INTEGRATED
RESPONSE TO THE VARIETY OF
NEEDS IMPACTING THESE
POPULATION. SUCH AS MANY
INDIVIDUALS WOULD BENEFIT FROM
AN INTEGRATED HIV S. T. D. ANY
TV SERVICES AT LEAST HALF OF
THE OF. MALES WHO HAVE SEX WITH
MALES KNOWS WE RELEASE OF THE
CALIFORNIA WOULD BENEFIT FROM
HIV CARE OR PREVENTION
ACTIVITIES INCLUDING LINKAGE TO
HIV TESTING MEDICAL CARE NAY IV
PREP SERVICES. AMONG CALIFORNIA
READ BINS LIVING WITH HIV IN A
CV IMPACT IN TWENTY SIXTEEN.
83% WERE CURRENTLY IN CARE FOR
HIV COMPARED ONLY THE 2% IN
CARE FOR EIGHT BE HIGHLIGHTING
THE NEED TO RE ENGAGE BUT WITH
H. EIGHT V. CO. TWO THE V. CAN
TO THE SUCH QUESTION ABOUT IN.
IN RISK TO THESE ARE. THE
CALIFORNIA TO PUBLIC HOW IS AND
AN ORGANIZATIONAL INTEGRATION
OF THE OFFICE OF AIDS STD
CONTROL BRANCH AND THE OFFICE
OF VIRAL HEPATITIS PREVENTION
WHICH OVERSEES OUR HEPATITIS C.
PROGRAM INTO A UNIFIED DIVISION
THIS NEW DIVISION WILL
FACILITATE COLLABORATION
BETWEEN CD PH STAFF WITH
EXPERTISE IN HIV STDS AND
HEPATITIS C. AND WILL ENHANCE
THE COORDINATION OF DISEASES
MONITORING PREVENTION AND CARE
ACTIVITIES THIS COORDINATED
WE'RE RESTARTING MORE ADVANCE
INTEGRATION OF EFFORTS AT THE
LOCAL LEVEL AS WELL. CENTRAL TO
THIS NEW ORGANIZATION. WILL BE
THE DEVELOPMENT OF A NEW
CALIFORNIA INTEGRATED HIV
SURVEILLANCE PREVENTION AND
CARE CLASS. THE NEW CD PH PLAN
WILL INTEGRATE THE GOAL OF
LAYING THE FOUNDATION FOR
ELEMENT ELIMINATING HIV
INFECTION. WITH STRATEGIC GOALS
TO ADDRESS THAT BUT THE MAKE OF
STDS AND TO REDUCE NEW EIGHT CV
INFECTIONS IN CALIFORNIA.
INTEGRATING AND SURVEILLANCE
PREVENTION TESTING LINKAGE TO
CARE AND TREATMENT EFFORTS AT
C. P. H. AND DEVELOPING A
COMPREHENSIVE AND INTEGRATED C.
PH PLAN WILL MORE EFFECTIVELY
ADVANCE OUR PRO PROGRESS AT
ELIMINATING NEW HIV STD AND ATV
INFECTIONS. COMMUNITY ADVOCATES
AND PEOPLE LIVING WITH HIV OR
AIDS CV- FROM THROUGHOUT THE
STATE WILL BE PART OF THE TEAM
WRITING THIS PLAN. UPDATING
REVISING THE CD PHP. COINCIDES
WITH THE FEDERAL EFFORT OF
IMPLEMENTING THE NATIONAL PLAN
OF INDIAN THE HIV EPIDEMIC IN
THE U. S. THIS STATE HAS
RECEIVED FEDERAL FUNDING TO
COORDINATE EFFORTS TO CELEBRATE
PLANNING FOR A NEW INNOVATIVE
APPROACHES. TO REACH THOSE WHO
HAVE NOT BENEFITED FROM HIV
PREVENTION AND CARE EFFORTS
THUS FAR. THIS NEW INITIATIVE
OFFERS AN OPPORTUNITY TO EXPAND
COORDINATED STRATEGIES LED BY
CITY PH FOR THE PREVENTION AND
CARE OF HIV STDS HCV INFECTION
AMONG PERSONS WHO MAY BE AT
RISK FOR MORE THAN ONE FACTION.
EFFORTS A CRUSTY PH SUPPORT THE
DELIVERY INTEGRATES SERVICES
ARE IN LINE WITH THE GOALS OF
THE NATIONAL HIV SLASH AIDS
STRATEGY. THE US HEALTH AND
HUMAN SERVICES APPETITE IS
ACTION PLAN AND THE FORTHCOMING
NATIONAL STD PLANT THESE
NATIONAL PLAN SUPPORT
CALIFORNIA'S APPROACH OF
ADDRESSING THE CINDER MIX OF
HIV STDS AND HEPATITIS C. FOR
MY CLIENT CENTERED APPROACH.
STRATEGIES INCLUDE INSURING
PEOPLE WITH HIV ARE TESTED FOR
STDS ENSURING PEOPLE DIAGNOSED
WITH FIFTIES ARE LINKED TO HIV
CARE IF THEY'RE LIVING WITH HIV
AND OUT OF CARE OR ARE LINKED
TO HIV PREP IF THEY ARE HIV
NEGATIVE. ENSURING PEOPLE WITH
HIV AIDS CV IN CONFECTIONER
TREAT AND CURE OF HCV. CD PH
SUPPORTS THE **** GOALS BY
REVIEWS FEDERAL HIV PREVENTION
DOLLARS FOR EXAMPLE TO SUPPORT
RAPID TESTING FOR HIV AND AIDS
THE V. N. STUDIES OF SERVING
PEOPLE AT THE HIGHEST RATES FOR
INFECTION. SUCH AS PEOPLE WHO
INJECT DRUGS AND BY SUPPORTING
TRAINING AND TECHNICAL
ASSISTANCE FOR LOCAL HELP
JURISDICTIONS ON HOW TO
INTEGRATE STD SERVICES INTO HIV
SERVICES AND VICE A VERSA. IN
RESPONSE TO EPIDEMIC CITY PH
ALSO WORKS IN CLOSE
COLLABORATION WITH OTHER STATE
DEPARTMENTS SUCH AS THE
CALIFORNIA DEPARTMENT OF
CORRECTIONS AND REHABILITATION
INCLUDING PROVIDING ONGOING
TECHNICAL ASSISTANCE REGARDING
HIV S. T. D. AN ATV SCREENING.
AN OUTBREAK RESPONSE GUIDANCE
EXPLORING OPTIONS FOR
COLLABORATING ON DELIVERY OF
STD SCREENING AND TRAINING
SERVICES A MEDICATION
PURCHASING OPPORTUNITIES FOR
HEPATITIS C. PREVENTION. AND
OPPORTUNITIES TASTY PER. SEE
RECENT ESTABLISH A DANISH
AGREEMENT WITH CDC ARE WHICH
HELP SAYS AT ESTIMATE THE
BURDEN OF DISEASE AND LOCAL
HELP JURISDICTIONS THAT HAVE
LARGE PRISON POPULATIONS AS
WELL AS STATE PRISONS. THE
LIMITED FUNDING QUESTION GIVEN
THE DISPARITIES THAT WE SEE IN
CALIFORNIA WITH VULNERABLE.
POPULATIONS DISPROPORTIONATELY
AFFECTED BY HIV STDS AND
HEPATITIS C. CD PHS STRUCTURED
MANY OF ITS EFFORTS TO FOCUS ON
THE MOST VULNERABLE
POPULATIONS. SUCH AS THE H. A.
B. A CALIFORNIA PLANNING GROUP
HAS RESTRUCTURED ON THE UNDER
MEMBERS TO FOCUS ON KEY
POPULATIONS INCLUDING YOUTH
WOMEN AND PEOPLE WITH HIV WHO
ARE EIGHTEEN. STD CONTROL
BRANCH HAS PROUD OF GIVEN
PRIORITY FOCUSED ON PREVENTING
CONGENITAL SYPHILIS IN ITS
PARTNERING WITH MATERNAL CHILD
AND ADOLESCENT HEALTH. INJURY
PREVENTION AND OTHER PROGRAMS
ACROSS THE STATE TO BETTER
UNDERSTAND THE FACTORS
CONTRIBUTING TO PEOPLE WHO ARE
PREGNANT EXPERIENCING
HOMELESSNESS THERE'S SINCE USE.
NOT AFFECTING PRENATAL CARE THE
STD CO INTRO BRANCH HAS TAKEN
AN ALL HANDS ON DECK APPROACH
TO THIS ISSUE PULLING IN STAFF
FOCUSED ON DATA POLICY
COMMUNICATIONS AND LOCAL
CAPACITY BUILDING. GIVING RISE
SEEN GIVEN RISE RATE RISING
RATES OF HEPATITIS C. AMONG
YOUNG PEOPLE THE OFFICE OF
VIRAL. PREVENT BEEN HAS
POPULATION IN FOR MY- FOR
GRAPHICS THROWING THE CONNECTS
BE TO. OPIOID EPIDEMIC TYPHUS
AND IT'S TECHNICAL ASSISTANCE
TO LOW CULTURE. I'M PARTNER
COMMUNITY BASED OR- WITH FACTS.
SO PEOPLE WHO DRUGS TO PROVIDE
HEPATITIS C. TESTING LINKAGES
TO CARE AND TREATMENT TO
PREVENT REINFECTION. I'M TO
GIVE SOME EXAMPLES OF SOME OF
THAT HOW WE'VE DISTRIBUTED THE
FUNDING THAT WE RECEIVED LAST
YEAR- THIS FISCAL YEAR AWAY
RECEIVE FIFTEEN POINT TWO
MILLION. IN STATE GENERAL FUND
ALLOCATED- FOUR YEAR SUPPORTING
SARAN SERVICES PROGRAMS FUNDS
WILL BE USED TO PROVIDE MUCH
NEEDED STAFFING AND OTHER
INFRASTRUCTURE AT ANY AND ALL
OF THE ARE FIFTY FIVE SEVEN
SERVICES PROGRAMS ESTABLISHED
THROUGHOUT THE STATE. FUNDING
WILL PROMOTE EIGHT PROMOTE HIV
AIDS TV AN STD PREVENTION
TESTING AND TREATMENT IN HIGH
RISK COMMUNITIES AMONG PEOPLE
WHO USE DRUGS AND OTHER PEOPLE
WHO ACCESS SERVICES AT SYRINGE
EXCHANGE EXTRA INCHES. AND
STARTING THIS FISCAL YEAR ALSO
THE OFFICE OF A THREE C. FIVE
MILLION DOLLARS IN STATE
GENERAL FUND- FOR PREVENT HIV
PREVENTION AND CONTROL FUNDING
WILL SUPPORT COME COMPREHENSIVE
HIV PREVENTION SERVICES
SERVICES WILL BE SPECIFICALLY
TARGETED TO REDUCE NEW HIV
DIAGNOSIS AMONG THE MOST
VULNERABLE POPULATIONS
CALIFORNIA INCLUDING. PEOPLE OF
COLOR GAY AND BISEXUAL MEN
TRANSGENDER WOMEN AND PEOPLE
WHO USE DRUGS COMPREHENSIVE HIV
PREVENTION SERVICES MAKE
INCLUDE BUT ARE NOT LIMITED TO
EXPANDING STRATEGIC HIV AIDS CV
AN S. T. D. TESTING PROMOTING
PREP AND PEP AND IMPROVING
ACCESS TO KEEP POPULATIONS
IMPROVING LINKAGE AND RETENTION
TO CARE FOR PEOPLE LIVING FOR
H. I. V. INCREASING. HIV
PREVENTION SERVICES FOR PEOPLE
WHO USE DRUGS ALL STAR IN THIS
YEAR'S STD CONTROL BRANCH
RECEIVE FIVE MILLION STATE
GENERAL FUND FOR YOU PER YEAR
FOR OVER THE NEXT THREE YEARS
FOR STD PREVENTION AND CONTROL
ACTIVITIES FUNDING WILL SUPPORT
COMPREHENSIVE STD PREVENTION
SERVICES SUCH AS SYPHILIS
OUTBREAK EMBRACED.
INVESTIGATIONS PROVIDER
TRAININGS DISEASE INTERVENTION
SURVEILLANCE CLINICAL SUPPORT
AND HEALTH PROMOTION AND
EDUCATION. ALSO STARRING THIS
FITS YEAR THE OFFICE OF OUR TO
PUT HEPATITIS PREVENTION
RECERTIFY MILLION INTO. FUND
PER YEAR OVER THE NEXT THREE.
YEARS FOR H. HEPATITIS C.
PREVENTION AND CONTROL
ACTIVITIES FUNDING WILL SUPPORT
MONITORING PREVENTION TESTING
AND LINK IT TO A RETENTION AND
CARE ACTIVITIES FOR THE MOST
VULNERABLE AND OR SERVE.
INDIVIDUALS LIVING WITH WITH OR
AT HIGH RISK FOR HCV IMPACT
INFECTION. IN CONCLUSION SEIZE
CD PH LOOKS FORWARD TO WORKING
CLOSELY WITH ALL OF OUR LOCAL
HEALTH CHURCH ACTIONS THE
COMMUNITY PARTNERS TO SUPPORT
THE IMPLEMENTATION OF ALL THESE
IMPORTANT PROGRAMS. THANK YOU.
HELP ME THANK DR ROME FOR HER
REPORT PLEASE. IT WAS VERY VERY
THOROUGH SO AS A THANK YOU VERY
MUCH YOU PROVIDED A GREAT DEAL
OF INFORMATION WE'RE GOING TO
DO BECAUSE WE HAVE- ONE PERSON
IS NOT HERE IS GOING TO BE ON
THE PANEL WE HAD SCHEDULED TO
HAVE FIVE PEOPLE HERE SO WE
HAVE A LITTLE MORE TIME TO
FLICK IN A VERY FLEXIBLE SO WE
WANT TO DO BEFORE WE ASKING
QUESTIONS GO TO- MISS MARKS TO
INTRODUCE HERSELF AN AGENCY.
THE PARMA YOU WORK FOR AND
GOING TO YOUR TEN MINUTE
PRESENTATION SURE THANK YOU
GOOD AFTERNOON MY NAME IS
DOCTOR KAREN MARK ON THE
MEDICAL THE MICROPHONE CLOSE TO
YOU. HELLO THANK YOU HAVE THAT.
SO MY NAME IS DOCTOR KAREN. I
AM THE MEDICAL TO AT THE COW.
DEPARTMENT OF HEALTH CARE
SERVICES. ANIMALS ON INFECTIOUS
DISEASE PHYSICIAN WHO SPENT
MOST OF MY CAREER WORKING ON
HIV STDS AND HEPATITIS C. SO
I'M GONNA GO AHEAD AND SHARE
SOME OF THE WORK THAT OUR
DEPARTMENT IS DOING TO BROADLY
ADDRESS SOCIAL DETERMINANTS OF
HEALTH AND TO IMPROVE HEALTH
OUTCOMES AMONG ALL OF OUR
BENEFICIARIES. INCLUDING OF
CODE COURSE THOSE AFFECT HIV
STDS AND HEPATITIS C. AND THEN
THEN DISCUSS A LITTLE BIT MORE
IN DEPTH SOME OF OUR
COLLABORATIVE WORK WITH C. P.
AGENCY SEE OUR AND OTHERS- TO
MORE SPECIFICALLY- AT. TALK
ABOUT THE CARE AND TREATMENT OF
OUR MEMBERS- WITH HIV STDS AN-
APPETITE SEE. I'M SO ARE MEDI
CAL HELP YOUR CALIFORNIA FOR
ALL PROPOSAL. I'M INVOLVED
IMPROVE CARE COORDINATION
ACROSS PHYSICAL AND BEHAVIORAL
HEALTH. AND FOCUSES ON
ADDRESSING SOCIAL DETERMINANTS
OF HEALTH FOR ALL
BENEFICIARIES- INCLUDING THOSE
WITH HIV STDS AND HEPATITIS C.
THE PROPOSAL WILL ADDRESS MANY
OF THE COMPLEX CHALLENGES
FACING THE MOST VULNERABLE
CALIFORNIANS. BY TAKING A
PERSON CENTER APPROACH TO CARE
THAT CREATES SYSTEMS AND
PROCESSES USED TO IDENTIFY AND
MITIGATE SOCIAL DETERMINANTS OF
HEALTH. AND IMPROVE HEALTH
EQUITY WHICH IS OUR GOAL. THE
PROPOSAL WILL CLARIFY POLICIES
RELATED TO SUBSTANCE USE
DISORDER RECOVERY SERVICES SUCH
AS ESTABLISHING WHEN AND HOW
BENEFICIARIES CAN ACCESS THOSE
SERVICES. INCLUDING LANGUAGE TO
INCLUDE- TO ENCOURAGE THE USE
OF RECOVERY SERVICES FOR
JUSTICE INVOLVED THE VISUALS-
WHICH WILL ASSIST PEOPLE WITH.
HIV AND HEPATITIS C. WITH CO
EXISTING SUBSTANCE USE
DISORDERS- AS WELL AS OTHERS
WITH CO EXISTING SUBSTANCE USE
DISORDERS. THE PROPOSAL WILL
ALSO INCLUDE- THE
IMPLEMENTATION OF A NEW
ENHANCED CARE MANAGEMENT
BENEFIT AND A SET OF IN LIEU OF
SERVICES. WHICH ARE FLEXIBLE
WRAPAROUND SERVICES DESIGNED TO
FOCUS ON CREDIT POPULATION. SO
FOR EXAMPLE- AN EXAMPLE OF IN
LIEU OF SERVICES WOULD INCLUDE
MEDICALLY TAILORED MEALS- SO
PEOPLE WITH THAT. KIND OF
CONDITIONS SUCH AS HIV WOULD BE
ELIGIBLE RECEIVE MEDICALLY
TELL. MEALS THAT WOULD MAKE OUR
UNIQUE DIETARY NEEDS- OTHER
SERVICES INCLUDE ON PUT SOME
HOMELESSNESS AND HOUSING
SERVICES SERVICES SUCH AS
HOUSING DEPOSITS. SHORT TERM
POST HOSPITALIZATION HOUSING.
OF CARE FOR IN. TRACK AND DATA
HABIT PATIENT BROWN. THAT HELP.
LIVE WITH CHRONIC. HM THE.
THERE'S ALSO FOCUS. I JUST
ASSEMBLY. SO I'M THE IS TO
CREATE AN OP ABOUT ACCORDING
MEDICAL IN BEHAVIOR HEALTH AND
NINE SOCIAL. PRIOR TO UPON FOR
COUNTY. THESE EFFORTS WERE
SUPPORT KEEPING OF OUR MOST
PHONE NUMBER AND INDIVIDUALS
WITH SERIOUS MEDICAL OR
BEHAVIORAL HEALTH CONDITIONS
OUT OF JAIL AND PRISON AND LINK
THEM TO CARE WITHIN THE
COMMUNITY WE ALSO DO YOU SEE
HAS ALSO RELEASED A DRAFT
COMPREHENSIVE QUALITY STRATEGY.
FOR PUBLIC COMMENT IN NOVEMBER
OF TWO- TWENTY NINETEEN AND-
THAT INCLUDE OVER ARCHING GOALS
TO ADDRESS. I THAT ARE ACROSS
DELIVERY SYSTEMS- TO FOCUS ON
IMPROVING HEALTH OUTCOMES
HEALTH EQUITY AND ADDRESSING
SOCIAL DETERMINANTS OF HEALTH.
AND THE QUALITY STRATEGY ALSO
INCLUDED SPECIFIC QUALITY
IMPROVEMENT METRICS FOCUSED ON
HIV STDS AND SEVERAL PROGRAMS-
FOR EXAMPLE MANAGED CARE PLANS
MUST MEET A MINIMUM PERFORMANCE
LEVEL. I OR RECEIVE SANCTIONS
AROUND CERTAIN METRICS AND
THOSE THAT INCLUDES- COMMITTEES
CHLAMYDIA SCREENING AND WOMEN.
I'M WE ARE ALSO COLLABORATING
WITH THE DEPARTMENT PUBLIC
HEALTH- LOOKING AT HIV VIRAL
LOAD SUPPRESSION BY MANAGED
CARE PLAN AND PUBLISHING THAT
DATA AND PROVIDING TECHNICAL
ASSISTANCE TO PLANS TO IMPROVE
ARLIT SUPPRESSION. I'M GOING
THEIR BENEFICIARIES. WE ALSO
HAVE A QUALITY INCENTIVE
PROGRAM WHICH IS A PAY FOR
PERFORMANCE PROGRAM FOR
DESIGNATED PUBLIC HOSPITALS ARE
COUNTY HOSPITALS IN UC'S- AND-
THAT PROGRAM PROVIDES A
FINANCIAL INCENTIVES TO
DESIGNATE A PUBLIC HOSPITALS
FOR IMPROVING CHLAMYDIA
SCREENING AND WOMEN. AND FOR
IMPROVING VIOLETS PRESSURE HIV
VIRAL LOAD SUPPRESSION. OUR
FAMILY PLANNING ACCESS CARE AND
TREATMENT PROGRAM FOR THE
FAMILY PACK PROGRAM I'M ONE OF
THE MAIN PROGRAM I'D OBJECTIVES
IS TO IMPROVE CHLAMYDIA
SCREENING STRATEGIES. ON IN IN
THE FAMILY PLANNING PROGRAMS-
INCLUDING INCREASING THE
CHLAMYDIA SCREENING RATE AND
WOMEN TWENTY FOUR AND YOUNGER
IN ACCORDANCE WITH CURRENT
GUIDELINES. WE ALSO HAVE A
NUMBER OF ONGOING
COLLABORATIONS WITH CD PH AND
OTHER DEPARTMENTS AND THE
CREATION OF MEDI CAL BENEFITS
TO ADDRESS THE PREVENTION AND
TREATMENT OF HIV STDS AND
HEPATITIS C. SO FOR EXAMPLE
FULL COVERAGE OF MEDICATIONS TO
TREAT HIV WITHOUT ANY PRIOR
AUTHORIZATIONS. FULL COVERAGE
OF HIV PRE EXPOSURE PROPHYLAXIS
OR PROP AND POST EXPOSURE
PROPHYLAXIS OR PAP- WHICH ARE
MEDICATIONS TO PREVENT HIV
WITHOUT ANY PRIOR
AUTHORIZATIONS OUR OUR COVERAGE
FOR SCREENING AND TREATMENT OF
STDS. IS ALIGNED WITH ON
CURRENT CDC GUIDELINES AS WELL
AS HE PH STD TREATMENT
GUIDELINES SO THIS INCLUDES-
PROVIDING REIMBURSEMENT FOR
THREE AND A TOPICAL SITE
SCREENING FOR STDS AS WELL AS
CLARIFICATION THAT WHAT'S
ALLED EXPEDITED PARTNER
THERAPY OR PATIENT DELIVER
PARTNER THERAPY. FOR CHLAMYDIA
GONORRHEA INTERCONVERT
TRICHOMONIASIS ARE MEDICALLY
NECESSARY FOR A AND IT A
COVERED SERVICE FOR- BOTH MEDI
CAL AND FAMILY PACKED WERE ALSO
COLLABORATING WITH CD PHD
HOSPITALS AND A CITY SEE OUR-
OR- RATHER WE HAVE OVERTIME
COLLABORATED WITH THEM TO
RESULT AND THE EXPANSION OF THE
HEPATITIS C. TREATMENT
GUIDELINES- AND SPECIFICALLY
THE TREATMENT POLICY SO
EFFECTIVE JULY FIRST TWENTY
EIGHTEEN TO COVER TREATMENT OF
AL PERSONS INFECTED WITH
HEPATITIS C. REGARDLESS OF
DISEASE STAGE. WHICH IS IN
ALIGNMENT WITH THE ADSL TWO
GUIDELINES WHICH ARE THE
NATIONAL GUIDELINES ON
TREATMENT OF HEPATITIS C. WE
ALSO COOPERATE WITH C. PH TO
MISTER THE AIDS MEDI CAL WAIVER
PROGRAM- WHICH PROVIDE HOME AND
COMMUNITY BASED SERVICES AS AN
ALTERNATIVE TO NURSING HOME.
CARE FOR HOSPITALIZATION FOR
PEOPLE WHO NEED THOSE SERVICES.
AND THEN ADDITION- ARE MEDI CAL
MANAGED CARE PLANS ARE REQUIRED
TO COVER ALL MEDICALLY
NECESSARY COVERED SERVICES SO
THAT INCLUDES PREVENTIVE
SERVICES AN STD SERVICES
WITHOUT ANY PRIOR
AUTHORIZATION- FOR PREVENTIVE
SERVICES THE MANAGED CARE PLANS
ARE REQUIRED TO COVER ALL
AMERICAN ACADEMY OF PEDIATRICS
BRIGHT FUTURES RECOMMENDATIONS.
FOR CHILDREN UNDER THE AGE OF
TWENTY ONE AND ALL U. S.
PREVENTIVE HEALTH SERVICES TASK
FORCE GUIDE CREATE A AND B.
RECOMMENDATIONS FOR ADULTS. AND
NOT YOU KNOW IN IN THIS
PARTICULAR AREA THAT INCLUDES
CHLAMYDIA AND GONORRHEA.
GONORRHEA SCREENING CIVIL
SCREENING HEPATITIS C.
SCREENING HIV PRE EXPOSURE
PROPHYLAXIS FOR PERSONS AT RISK
FOR HIV ACQUISITION ROUTINE HIV
SCREENING- AS WELL AS SOME
OTHER THINGS. OUR PLANS MUST
ALSO PROVIDE STD IN HIV
SERVICES AND ACCORDANCE WITH
THE US PUBLIC HEALTH SERVICES
GUIDELINES AND OF COURSE STATE
AND FEDERAL LAWS. AND OUR
HEPATITIS C. TREATMENT- POLICY
IS- IT IN ACCORDANCE WITH THE
ASL THE GUIDELINES. I'M IN AND
OUT IN ADDITION WE HAVE SOME
COLLABORATIONS WITH CD PH TO
SUPPORT SOME OF THE HIV S. T.
D. AND HEPATITIS C.
SURVEILLANCE ACTIVITIES. THAT
WERE SERRANO SPOKE ABOUT- SO
THAT INCLUDES PROVIDING NINETY
TEN FUNDING FROM THE HIGH TECH
ACT TO SUPPORT- SOME OF THOSE
SURVEILLANCE ACTIVITIES OF
SPECIFICALLY THE CALIFORNIA
PORTABLE DISEASE INFORMATION
ARE CALIBRATED SURVEILLANCE
SYSTEM THAT'S OPERATED BY C.
PH- UP. TO IT- SUPPORTS THE
SUBMISSION OF LABORATORY
RESULTS FOR REPORTABLE
DISEASES- THROUGH THE-
ELECTRONIC LABORATORY REPORTING
SYSTEM AS WELL AS CONFIDENTIAL-
CASE REPORTING. AND THROUGH
THIS HIGH TECH FUNDING WE'VE%
BEEN ABLE TO SUPPORT
MODIFICATIONS THAT SUPPORT THE
SUBMISSION OF ELECTRONIC CASE
REPORTS FROM ELECTRONIC HEALTH
RECORDS- FOR EIGHTY REPORTABLE
CONDITIONS INCLUDING HIV
HEPATITIS C. N. STDS- AND WE'VE
ALSO BEEN ABLE TO USE SOME OF
THAT FUNDING TO SUPPORT ACROSS
PROGRAM WORKING GROUP-
INCLUDING DH CS AND CD PH
PROGRAMS TO ENSURE THAT SOME OF
THE LESSONS LEARNED THROUGH
THAT COLLABORATION OUR
EXPANDED. AND BROUGHT IN THE
COURSE ACROSS OTHER PUBLIC
HEALTH PROGRAMS. STOP WORKING
ON DESIGNING AND IMPLEMENTING A
COMMON APPROACH TO WORKING
WITH- STATEWIDE CROSS PROGRAM
PARTNERS SUCH AS ON MAJOR
ELECTRONIC HEALTH RECORDS
VENDORS HEALTH INFORMATION
EXCHANGES AND OTHER HEALTH
SYSTEMS. SO WE LOOK FORWARD TO
CONTINUING TO WORK WITH OUR
PARTNERS AT C. P. H. I. C. C.
R. AND OTHERS. TO IMPROVE
PREVENTION CARE AND TREATMENT
FOR OUR MEMBERS AT RISK FOR HIV
STDS AND HEPATITIS THANK YOU
DOCTOR MARK THANK YOU VERY MUCH
JUST GIVE DR- CAREMARK'S ROUND
OF APPLAUSE FOR HER REPORT.
THANK YOU VERY MUCH WE DO AN
EXCELLENT ON TIME SO NOW WILL
LIKE TO- TALK ABOUT OUR TO
PLEASE. INTRODUCE YOURSELF AND-
THANK YOU FOR TO PRESENT IT
THANK YOU SO MUCH. GOOD
AFTERNOON MY NAME IS HEIDI
BAUER- I'M THE LEAD PUBLIC
HEALTH PHYSICIAN FOR THE
CALIFORNIA CORRECTIONAL HEALTH
CARE SERVICES WHICH IS THE
MEDICAL PROVIDER FOR THE
CALIFORNIA DEPARTMENT OF
CORRECTIONS AND REHABILITATION.
WE HAVE THIRTY FIVE
INSTITUTIONS STATE WIDE AND
ABOUT A HUNDRED AND TWENTY
THOUSAND PATIENTS IN THAT
SYSTEM I AM VERY MUCH HONORED
TO BE HERE ON THIS PANEL AND
TESTIFYING TODAY- AND WE ARE
PARTICULARLY EXCITED ABOUT
PLAYING AN INTEGRAL ROLE IN THE
PARTNERSHIP TO- ELIMINATE IT
HAD SEE HIV AND STDS AND SO
THANK YOU VERY MUCH. I WANT TO
TALK A LITTLE BIT ABOUT SOME OF
THE PROGRAMS WE HAVE- FIRST ALL
SAY THAT I THINK YOU ALL KNOW
PEOPLE COMING INTO THE
CORRECTIONAL SETTINGS ARE
PARTICULARLY VULNERABLE TO ALL
THREE OF THESE TYPES OF
INFECTIONS FOR A VARIETY OF
REASONS. PRIOR TO THEIR
INCARCERATION THEY FACE POVERTY
HOMELESSNESS- MANY SOCIAL
CHALLENGES CHALLENGES ACCESSING
CARE. AND. SINCE AND SO WE
RECOGNIZE AND MANY HAVE
PARTICIPATED IN SURVIVAL SEX AS
WELL AS COMMERCIAL SEX AND SO
VERY VERY VULNERABLE POPULATION
AND I'LL GIVE YOU SOME NUMBERS
TO SUPPORT THAT AS WELL. WE
HAVE VERY ROBUST PROGRAMS FOR
SCREENING AND TREATMENT FOR ALL
OF THESE INFECTIONS- WE HAVE A
PROCESS WHERE WHEN FOLKS ARE
INCARCERATED IN THE PRISON
SYSTEM THEY COME THROUGH A
RECEPTION CENTER. AND IN THAT
RECEPTION CENTER THEY ARE
OFFERED TESTING FOR HIV.
HEPATITIS C. SYPHILIS GONORRHEA
AND CHLAMYDIA OVER 90% OF
PEOPLE ACCEPT THAT TESTING. AND
SO WE ARE ABLE TO LINK PEOPLE
TO CARE IMMEDIATELY WE HAVE
ABOUT TWO THOUSAND INDIVIDUALS
WHO ARE DIAGNOSED WITH SYPHILIS
GONORRHEA CHLAMYDIA EVERY YEAR.
AND THE VAST MAJORITY. ARE
TREATED FOR THOSE INFECTIONS
WITHIN FOURTEEN DAYS. WE HAVE
VERY FEW INCIDENT OR NEW
INFECTIONS WITH STDS WELL FOLKS
ARE INCARCERATED. WE DO
REGULARLY PARTNER WITH THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH AS WELL AS LOCAL HEALTH
JURISDICTIONS ON TREATMENT
VERIFICATION FOR CASES AS WELL
AS CONTACT INVESTIGATIONS AND
ALSO SHARING OUR EXPERTISE IN
THE FIELD. FOR H. I. V. WERE
ABLE TO LINK FOLKS DIAGNOSED
WITH HIV WHETHER THEIR NEWLY
DIAGNOSED OR THEY'RE KNOWN TO
HAVE HIV IMMEDIATELY IN THAT
RECEPTION CENTER PROCESS AND SO
AGAIN OVER 90% OF PEOPLE
EXCEPT. SCREENING ARIZONA FIDE
THEIR LINK TO CARE THROUGH A
SPECIALTY HIV PROVIDER NETWORK
THAT WE HAVE. AND GET INTO
CARE- IMMEDIATELY IN OUR
SYSTEM- WE HAVE ABOUT A
THOUSAND INDIVIDUALS AT ANY
GIVEN TIME WHO ARE IN CARE FOR
HIV- AND ARE VIRAL SUPPRESSION
RATE FOR THOSE INDIVIDUALS IS
ABOUT 94% AND THAT NUMBER
ACTUALLY INCLUDES FOLKS WHO
ARE- NEWLY WITH US HAVE BEEN
WITH US FOR A FAIRLY SHORT
PERIOD OF TIME- JUST COMING IN
IF WE LOOK AT PEOPLE WHO'VE.
BEEN WITH US FOR A YEAR THE
VIRAL SUPPRESSION RATE IS 98%
AND SO WE HAVE- DONE AND
AMAZING JOB OF ELIMINATING SOME
OF THE RACIAL ANOTHER
DISPARITIES THAT YOU SEE IN THE
HIV CRE CONTINUUM. WE HAVE A
NUMBER OF TOOLS THAT HELP US
WITH THAT TASK WE HAVE AN HIV
REGISTRY THAT ALLOWS PROVIDERS
AND CARE CARE GROUPS TO
IDENTIFY PATIENTS- IN NEED OF
SERVICES AND- HELPS. IDENTIFY
PREVENTIVE SERVICES AS WELL AS
A QUALITY METRICS ON A VARIETY
OF CARE OUTCOMES FOR HIV
POPULATION THE CONTINUITY OF
CARE IS GUIDED BY OUR COMPLETE
CARE MODEL AND WE HAVE
ELECTRONIC MEDICAL RECORD
SYSTEM THROUGHOUT THE STATE
THAT HELPS WITH COMMUNICATION
AND CONTINUITY AMONG THE
PROVIDERS. THE CHALLENGE WE
FACE WITH HIV IS UPON RELEASE
IN TWO THOUSAND SIXTEEN WE
PARTNERED WITH THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH TO
ASK THE QUESTION WHAT HAPPENS
TO FOLKS WITH HIV WHEN THEY'RE
RELEASED FROM PRISON. AND WHAT
WE LEARNED IN THAT DATA MATCH
IS THAT ONLY ABOUT A THIRD OF
INDIVIDUALS ARE LINKED TO CARE
WITHIN THIRTY DAYS AND IF WE
LOOK OUT TO A YEAR POST
INCARCERATION THE VIRAL
SUPPRESSION RATE IS ONLY 57%
AND SO THEY GO FROM. VIRAL
SUPPRESSION IN THE NINETIES
WITHIN OUR SYSTEM WITHIN CARE
TO BEING RELEASED AND FACING
REAL CHALLENGES THAT PATIENTS
FACE- GETTING LINKED TO CARE.
WE HAVE SOME NEW PROGRAMS THAT
WE HOPE WILL ADDRESS THAT ISSUE
AND I'LL TALK ABOUT THOSE A
LITTLE BIT- BUT THAT IS THAT IS
A CHALLENGE THAT WE RECOGNIZE.
MOVING ON TO HEPATITIS C. SINCE
WE HAVE VERY MUCH SCALED UP OUR
TREATMENT PROGRAM FOR HEPATITIS
C. SINCE JULY FIRST TWO
THOUSAND EIGHTEEN WE HAVE
TREATED NEARLY FOURTEEN
THOUSAND PEOPLE FOR HEPATITIS
C. WE HAVE. TWO THOUSAND
CURRENTLY ON TREATMENT AS OF
TODAY. GOING THROUGH THE
PROCESS OF GETTING TREATED AND
WE HAVE ABOUT SIX OR SEVEN
THOUSAND THAT ARE STILL- IN THE
PROCESS OF. PLANNING TO BE
TREATED WITHIN THE NEXT YEAR SO.
ONE CHALLENGE A NOTABLE
CHALLENGE THAT WE FACE WITH
HEPATITIS C. IS THAT THE RATES
OF HEPATITIS C. ARE STILL VERY
HIGH IN THE COMMUNITY. AND SO
AS THEY'RE COMING INTO OUR
RECEPTION CENTER WE'RE SEEING
ABOUT 13% OF PEOPLE AND THAT'S
ABOUT THIRTY FIVE THOUSAND
PEOPLE COMING INTO OUR
RECEPTION TESTING POSITIVE FOR
HEPATITIS C. R. IN NAY. MEANING
THEIR CHRONIC HEPATITIS C. AND
THEY NEED TO BE TREATED AND SO
THOSE ARE SIGNIFICANT NUMBERS
THAT CONTINUE TO COME INTO OUR
SYSTEM WE ARE VERY MUCH
DEDICATED TO MICRO LIMITATION
OF HEPATITIS C. WITHIN OUR
SYSTEM. IN HOPES THAT THAT WILL
DRIVE THE POTENTIAL FOR
EXPOSURE DOWN AND IN THE
COMMUNITY. WE ALSO HAVE-
FUNDING AS OF THIS FISCAL YEAR
FOR AN INTEGRATED SUBSTANCE USE
DISORDER TREATMENT PROGRAM AND
THAT IS ROLLING OUT THIS MONTH
WITH A NUMBER OF ASPECTS
INCLUDING SCREENING AT
RECEPTION CENTERS. AS WELL AS A
VERY ROBUST PLAN AROUND-
DISCHARGE AROUND RELEASED TO
THE COMMUNITY SO TWELVE TO
FIFTEEN MONTHS IN ADVANCE.
FOLKS ARE IDENTIFIED IT WILL BE
RELEASED A PAROLE OR TO
COMMUNITY SUPERVISION AND THESE
FOLKS ARE SCREENED FOR
SUBSTANCE USE DISORDER AND IF
THEY SCREEN POSITIVE AND THEY
ARE DIAGNOSED WITH THE
SUBSTANCE USE DISORDER. THEY
GET INTO ONE OF THE PROGRAMS.
AND AS PART OF THAT WE ARE VERY
DEDICATED TO MAKING SURE THAT
THEIR TRANSITION BACK INTO THE
COMMUNITY IS SUPPORTED BY US
AND BY THE BY THE COMMUNITY-
THIS PROGRAM IS CALLED WHOLE
PERSON CARE. AND THE INITIATIVE
ESSENTIALLY IS TO LOOK AT ALL
OF THE DIFFERENT NEEDS THAT
FOLKS HAVE WHETHER IT'S HOUSING
OR HEALTHCARE OR SUBSTANCE USE
DISORDER TREATMENT WHATEVER IT
IS AND MAKE SURE THAT WE HAVE
ENOUGH TIME TO PREPARE THEM FOR
RELEASED THE- I. NOW WILL SAVE
THE PART I'M TO BE SIX. THERE
NEEDS TO BE ABLE HAND ON THE
OTHER SIDE SO REAL WE'VE BEEN
WE AT PARTNERING WITH ALL FIFTY
EIGHT CAN. IN THE STATE OF
CALIFORNIA TO MAKE SURE THE-
HAVE BEEN IDENTIFIED AND THE
PROCESS- CAN BE PUT INTO PLACE
SO THAT FOLKS CAN BE
SUCCESSFULLY RE INTEGRATED HAVE
THEIR MEDICAL NEEDS MATT
INCLUDING. IF THEY NEED ONGOING
CARE FOR HIV AND OTHER CHRONIC
DISEASES. AND SO HAVE A LOT OF
THINGS IN THE WORK WORKS WE ARE
VERY HOW AND I CLUB. WHY CITY
PH AND THE OF HEALTH CARE
SERVICES DEPARTMENT HEALTHCARE
SERVICES HAS BEEN ESPECIALLY
SUPPORTIVE OF THE SUBSTANCE USE
DISORDER PROGRAM- AND THAT'S
BEEN A REALLY IMPORTANT
PARTNERSHIP FOR US SO THANK YOU
THANK YOU BOTH FOR BEING HERE
AND- THANK YOU FOR INVITING ME.
THANK YOU VERY MUCH CAN WE GIVE
OUR ARRIVAL PLAZA DR BAUER.
REPORT THANK YOU VERY MUCH I
WANT TO ASK THE PANEL A
QUESTION- AND THEY WILL OPEN UP
MY COLLEAGUES ALSO IT AND ASK
ANY QUESTIONS THAT SHE MAY
HAVE- OTHER AND TRY TO TAKE
SOME COPIOUS NOTES- A TRYING TO
NOW PUT IT ALL TOGETHER. AND
REGURGITATES YOU HOWEVER- MY
FIRST QUESTION IS HIV. USING
HIV- H. C. VI AND STDS ARE
AMONG THE MOST- SERIOUS PUBLIC
HEALTH ISSUES IN CALIFORNIA.
WHAT IS THE IMPACT OF THESE
EPIDEMICS IN CALIFORNIA'S
RESIDENTS PARTICULARLY IN THE
STATES THAT ARE MOST VULNERABLE
DISS TO DISADVANTAGED
COMMUNITIES. IT WAS A THE
QUESTION HERE IF YOU OKAY HERE
GOES. WITH HIV AND AIDS CV N.
S. D. ARE AMONG THEM SERIOUS
PUBLIC IS IN CALIFORNIA. WHAT
IS THE IMPACT OF THESE AB OF
THESE EPDEMICS ON CALIFORNIA'S
RESIDENTS PARTICULARLY- IN THE
COMMUNITIES THAT ARE MOST
VULNERABLE. SO WHAT IS THE
IMPACT. DOT THE CITY OF STICKS
BUT I'D HAVE TO HAVE SO THERE
ARE MOST- IMPACT THE IT
SPECIALLY FOR HIV AND STD IN
EIGHT CB BUT YOU COULD SEE THE
RATES ON H. I'LL START WITH
AIDS HIV FIRST. AT THE RATE OF
NEARLY DIAGNOSIS GOING DOWN BUT
IF YOU LOOK AT WHAT'S
HAPPENING- THE PEOPLE JUST
THERE'S HEALTH DISPARITIES
STILL SO A NOR TO. OF GET TO
ZERO ON HIV WE REALLY NEED TO
DO THAT LOOK AT WHAT'S GOING ON
WITH THAT POPULATION SO LIKE
FOR BLACK AFRICAN AMERICANS- 6%
OF THAT POPULATION- IS. OF THE
ACCOUNT IF SEVENTEEN PER OF THE
NEW COLOR EVEN THOUGH
CALIFORNIA'S OR SORRY BLACK
AFRICAN AMERICANS MADE UP
APPROXIMATELY 6% OF THE
POPULATION THERE ACCOUNTED 417%
OF THE CALIFORNIA'S OVERALL HIV
EPIDEMIC SO YOU COULD SEE
THERE'S A DISPERSION AT PAPA
AMERICA AFRICAN AMERICANS ARE
STILL AFFECTED BY HIV THE SAME
THING HAPPENS WITH FLAT AN AXE
YOU SEE THE RATES ARE- THE
POPULATION IS GROWING AND THE
NUMBERS OF LOUD NEXT WITH HIV
IS ALSO GROWING AT THE RATES
MIGHT NOT LOOK AS IT
DISPROPORTION BUT IF YOU LOOK
AT THE ACTUAL NUMBERS YOU COULD
SEE THE DISPERSION- OF
INDIVIDUALS ARE AFFECTED BY.
HIV AT THE SAME SAME YOU COULD
LOOK AT- WITH STD AND I DON'T
HAVE ALL THE INFORMATION- IN
FRONT TO ME THAT. WHAT DO YOU
NOW FOR THE IN. THAT YOU TALKED
ABOUT AROUND S. T. IS PLACE.
WHAT DO YOU CONSERVE THAT IN.
TO THAT COULD QUESTION I IT'S
PROBABLY THERE'S NOT. ANSWER TO
THAT BUT IT'S PUBLIC COMPLEXITY
IN A COULD BE A YOU KNOW OTHER
LIFESTYLE LIKE I SAID IT COULD
BE OF DRUG USE POVERTY SOME
KIND OF TRAUMA THAT OCCURRED-
IT IT'S HARD HOMELESSNESS IS A
BIG ORDEAL IN CALIFORNIA. SO
THERE'S NOT REALLY ONE AND
INCIDENT UNLESS. HEIDI THAT'S
ALL OF THOSE IT'S ALL THOSE
YEAH THERE'S NOT ONE ANSWERED
WE WISH THERE WES BUT THERE'S
NOT AN EASY ANSWER WITH WHAT'S
MAKING THE RICE ONE OF YOU
MENTIONED MADE MENTION A
REGARDING- BARRIERS TO CARE-
CAN TALK ABOUT THE PERCENTAGE
OF INDIVIDUALS. I'M STILL
HAVING AN ISSUE WITH- HAVING
ACCESS TO CARE. AND MEDICINE. I
MENTION THAT BUT IN OUR
POPULATION WE DON'T HAVE A LOT
OF BARRIERS TO CARE IN THE SAME
WAY THAT THE COMMUTE FOLKS IN
THE COMMUNITY FACE BARRIERS TO
CARE AND SO I'M NOT SURE I CAN
SPEAK FOR CDC ARE ON THAT TOPIC
BUT I THINK- YOU KNOW I'LL
MENTION I KNOW IF IT'S IN YOUR
TALKING POINTS BUT- WE USED TO
HAVE VERY ROBUST AS TO THE
CLINICS IN THE STATE. AND A LOT
OF THOSE HAD TO SHUT DOWN OR
SHUT DOWN BECAUSE RATES WERE
LOW IN BECAUSE IT WAS A
RECESSION AND COUNTIES HAVE
REALLY STRUGGLE TO PROVIDE
THOSE SERVICES AND I KNOW THAT
CREATED- SIGNIFICANT CHALLENGES
ACROSS THE STATE- IN THE IN THE
US TO THE WORLD- I THINK. WHAT
THE BARRIERS TO CARE FOR
HEPATITIS C. I'M SURE THERE'S-
YEAH. PRETTY SICK. IN THE
COMMUNITY STILL RIGHT. YEAH I
MEAN I THINK YOU KNOW I SPOKE A
LITTLE BIT ABOUT JUST THE
SOCIAL THE GERMANS OF HELP THAT
PEOPLE FACE AND THAT IF PEOPLE
ARE STRUGGLING WITH
HOMELESSNESS ARE ACCESS TO FOOD
YOU KNOW SOMETIMES GETTING IN
TO SEE THEIR DOCTORS AND THE
FIRST THING ON THE PRIORITY
LIST SO CERTAINLY WITHIN AS
PART MEDI CAL HEALTHIER
CALIFORNIA FOR ALL PROPOSAL.
WORST STARTED TO LOOK MORE
BROADLY AT HOW WE CAN SUPPORT
PEOPLE PARTICULARLY WITH
CHRONIC ILLNESSES WHO ARE
FACING SOME OF THESE CHALLENGES
TO- YOU KNOW TO HELP THEM GET
THE CARE THAT THEY NEED WE HAVE
A QUESTION FOR MISS WALDRON.
THIS IS THE A LOT OF A FOR. I
KNOW MISS RAMOS WHEN YOU FIRST
STARTED OFF YOU'RE TALKING
ABOUT ANY KIND OF. TOLD ME A
LITTLE BIT BECAUSE YOU MENTION
ABOUT. PEOPLE WHO INJECT DRUGS.
THAT ARE THEY'RE LESS LIKELY TO
REACH SUPPRESSION I MEAN IT'S
CLEARLY WHEN THEY'RE UNDERGOING
YOU KNOW IN THE IN THE- TAKING
DRUGS. AT THAT POINT AND IT'S
KIND OF MADE ME THINK ABOUT
BECAUSE I'VE WORKED- ON OP-
TASK FORCES SINCE GOING BACK.
THE EARLY TWO THOUSANDS WHEN I
WAS A LOCAL CITY COUNCIL MEMBER
AND YOU SEE THIS RISE AN OPIOID
ADDICTION AND HOW THAT LEADS
THEMINTO OTHER DRUGS LIKE
HEROIN. THAT WAS SEEING YOU
KNOW ON OUR STREETS NOW-
VISIBLY PEOPLE SHOOTING UP ON
THE STREETS YOU KNOW THE
EFFORTS IN HARM'S REDUCTION AND
THINGS LIKE THAT TO TRY TO
TACKLE IT. AND IT'S- YOU KNOW
ANNUAL THE HOMELESSNESS ALL OF
THESE THINGS THE HOLISTIC
RESPONSE OF FULL NECESSARY- AND
ALL THE TRAUMA SUPPORT. YOU
KNOW THE CHILD ABUSE AND- JUST
DOMESTIC VIOLENCE AT ALL THE
THINGS THAT CAN HOLD FEET IN
THAT- IT ALL COMES BACK TO.
ACCESS TO TREATMENT. YOU KNOW
GETTING PEOPLE INTO CARE
GETTING. THAT ONE STUMBLING
BLOCK THAT WE KEEP HITTING UP
AGAINST BECAUSE WE DON'T HAVE
ENOUGH PROVIDERS. I THINK
ANOTHER ISSUE THOUGH IT'S ALSO
STATE MANA- SPECIALLY WITH DRUG
USE USERS THERE IS SOME STATE
MUST STILL WHEN THEY DO GO TRY
TO SEEK ACCESS TO CARE- THAT
HAS TO BE OVERCOME AS WELL. BY
THIS WE DID IN TWENTY EIGHTEEN
AHEAD A BILL TO ENCOURAGE THE
MEDICAL BOARD. TO INCLUDE
CONTINUING EDUCATION ON PREP
AND PAP BECAUSE WE FOUND THAT
SO MANY PHYSICIANS EVEN. DON'T
KNOW WHAT TO SAY. THE PER THE
PATIENT IS IN FRONT OF THEM AND
THEY HAVE A STAKE MONTH THERE'S
JUST A LOT OF ISSUES WITH EVEN
JUST THE COMMUNICATION AT THAT
POINT. WHEN YOU COULD ACTUALLY.
IN A START TO TALK ABOUT THE
ISSUE. SO I DON'T KNOW YOU KNOW
HOW IF WE'VE SEEN ANYMORE
INCREASE IN PRIMARY CARE
PHYSICIANS EVEN BEING ABLE TO.
YOU KNOW UNDERSTAND WHEN THEY
CAN START TALKING ABOUT PREP
AND PAT. WELL IT DEPENDS ON THE
AREAS IN CALIFORNIA BUT WE HAVE
WE HAVE BEEN- GOING OUT AND
DOING A LOT OF TRAINING SCENES
TO THE MEDICAL BOARD ON THE USE
OF PREPPING PAP- WE ARE HELPING
THE BOARD OF PHARMACY RIGHT NOW
WITH SB ONE FIFTY NINE AND
PROVIDING TRAINING FOR THE
PHARMACISTS TO BE ABLE TO
DISPENSE PREPPING PAP- SO WE'RE
HOPING THAT THAT OUTRAGE. HELPS
OUT BUT THERE ARE YOU KNOW SOME
AREAS RIGHT NOW THAT ARE REALLY.
NEEDING THE ASSISTANCE AND WERE
TRYING TO REACH THAT. RIGHT NOW
I WANT TO ALSO CONGRATULATE MY
COLLEAGUES THAT BILL WAS SIGNED
BY GOVERNOR BROWN INTO LAW SO
THE DOCTORS WILL RECEIVE
CONTINUOUS EDUCATION- IN THE
SPACE OF THERE'S RESERVE
OCCASION- ON ON PREPPING PAP IN
THE WHOLE NINE YARDS SO WE'RE
GRATEFUL FOR LEADERSHIP IN THAT
SPACE SO WITH THAT BEING SAID I
WANT TO THANK THIS PANEL FOR
BEING HERE- AND WE'RE GOING TO
TRANSITION BUT LET'S GIVE THIS
PANEL. ARRIVAL FLAWS AND THANK
YOU FOR YOUR INFORMATION AND
THE TIME. WITH US. NECK WE
WANNA BY THE PATH TO DO TO
DISCUSS THE COMBAT RIDE RATES
WITH HEALTH C.
THERE.
COMING UP. YEAH. SO WELCOME WE
WANT TO THANK YOU FOR TAKING
TIME OUT YOUR BUSY SCHEDULE ME
PART OF THE SELECT COMMITTEE
HEARING- THIS PANEL'S
DISCUSSION WITH COMBATING- THE
RISING RATES IN HEALTH CARE-
INEQUALITY SO WITH THAT IF YOU
CAN. WHO WANTS TO START OFF.
PLEASE RIGHT AND I WILL START
OFF ON MY NAME ROBIN LEARN IT I
AM HERE REPRESENTING THE FIFTY
FIVE SYRINGE SERVICE PROGRAMS
IN THE STATE OF CALIFORNIA AND
THE HARM REDUCTION COALITION.
THE BIGGEST THING I WANT TO
TALK ABOUT IN THE ENDING THE
EPIDEMICS ASK IS THE- BUDGET
ASK FOR THE CLEARING HOUSE
ITSELF. JUST TO GIVE YOU A
LITTLE BACKGROUND IN TWENTY
FIFTEEN THE OFFICE OF AIDS
STARTED THE SYRINGE SERVICE
SYRINGE EXCHANGE SUPPLY
CLEARING HOUSE THE PROVIDES ALL
OF THE MATERIALS FOR SYRINGE
SERVICE PROGRAMS. THINGS LIKE
THE SYRINGES SHARPS CONTAINERS-
ALCOHOL ALL OF THAT STUFF COMES
FROM THE SYRINGE CLEARING
HOUSE. THAT BUDGET WAS SET AT
THREE MILLION DOLLARS IN TWENTY
FIFTEEN WHEN WE HAD THIRTY
SEVEN SYRINGE PROGRAMS. TODAY
WE HAVE FIFTY FIVE AND IT'S THE
SAME THREE MILLION DOLLAR
BUDGET. OKAY JUST TO GET THAT
OUT THERE FIRST OF ALL NOW IN
THE LAST THREE YEARS WE HAVE
EXPANDED TO TEN MORE COUNTIES.
OUR MOST OF THOSE PROGRAMS HAVE
EXPANDED WITHIN THE COUNTIES
AND WE HAVE ANOTHER SIX MORE
PROGRAMS COMING ONLINE THIS
YEAR. BRINGING FIVE ADDITIONAL
RURAL COUNTIES NEW SYRINGE
PROGRAMS. AND THAT BUDGET AGAIN
IS STILL THREE MILLION DOLLARS.
SO THE CLEARING HOUSE- JUST TO
LET YOU KNOW PROVIDES LIKE I
SAID SHARPS CONTAINERS IS
PROBABLY THE BIGGEST EXPENSE
COMING OUT OF OUR CATALOGS. AND
THAT THE DISPOSAL OF USED
SHARPS IT'S SOMETHING THAT WE
HAVE TO PAY FOR ALSO OUT OF
THAT BUDGET- THEN THERE'S THE
FACT NOT TEST STRIPS WHICH IS
SUCH A BIG THING TODAY BECAUSE
WE'RE SEEING FENTON ALL IN. ALL
OF THE DRUG SUPPLIES OKAY IT'S
NOT JUST OPIOIDS ANYMORE WE'RE
FINDING FACT NOW IN THE COCAINE
WERE FINDING FENTON ALL IN THE
MATH. SO HAVING THOSE TEST
STRIPS ON HAND IN ALL OF THE-
SYRINGE PROGRAMS. IS A HUGE
TOOL THAT PEOPLE CAN USE
THEMSELVES TO KEEP THEMSELVES
SAFE THEY ALSO PROVIDE THINGS
LIKE STERILE WATER AND OF
COURSE SYRINGES ALCOHOL AND
WOUND CARE KITS FOR FOLKS SO
THAT THEY CAN. MAYBE NOT HAVE
TO GO TO THE EMERGENCY ROOM TO
BE AS STIGMATIZED TO TAKE CARE
OF THEMSELVES. IN TWENTY
SIXTEEN AT THE CLEARING HOUSE
ALSO PROVIDED STARTED PROVIDING
THE LOCKS ON. NOW IN THE TIME
THAT WE HAVE BEEN PROVIDING THE
LOCKS ON IT. IT HAS BEEN SUCH A
HUGE IMPACT IN THE AMOUNT OF
OVERDOSE IS REVERSED. I JUST
FOR EXAMPLE IN IN THE SMALL
LITTLE SYRINGE EXCHANGE THAT I
WAS A PART OF HERE IN
SACRAMENTO WE STARTED
DISTRIBUTION IN JULY OF LAST
YEAR. WE GAVE OUT CLOSE A
LITTLE OVER SIX HUNDRED UNITS
OF NALOXONE BETWEEN JULY AND
DECEMBER THIRTY FIRST. AND OF
THOSE OVER THREE HUNDRED AND
FIFTY WERE SELF REPORTED
OVERDOSE REVERSALS. THAT'S
THREE HUNDRED FIFTY FAMILIES
THAT STILL HAVE A MEMBER ALIVE
TODAY. JUST HERE IN SACRAMENTO.
NOW THERE ARE MORE PROGRAMS
THAN WE'VE EVER HAD BEFORE AS A
DOCTOR RAMOS SAID WE HAVE NOW
THE- FIFTY FIVE PROGRAMS IN
CALIFORNIA WHICH IS THE MOST OF
ANY STATE. AND THAT'S STILL NOT
ENOUGH WE STILL HAVE PROBABLY
TWENTY COUNTIES THAT DON'T HAVE
ANY SYRINGE PROGRAMS. AND THOSE
PEOPLE NEED SYRINGES THEY'RE
DRIVING TO OTHER COUNTIES I WAS
SEEING FOLKS COMING FROM AS FAR
AWAY AS CHICO IN GRASS VALLEY
AND READING. COMING TO
SACRAMENTO TO PICK UP THEIR
SUPPLIES. FRESNO SEES THE SAME
THING ALL OF THE CENTRAL VALLEY
GOES TO FRESNO ON WEEKENDS TO
PICK UP THEIR SUPPLIES. THE
AVERAGE AMOUNT OF SYRINGES
DISTRIBUTED BY PROGRAMS BETWEEN
TWENTY FIFTEEN TO TWENTY
SEVENTEEN HAS INCREASED BY 53%
AND THAT'S STILL NOT EVEN
COMING CLOSE TO THE GOLD
STANDARD THE CDC RECOMMENDS OF
ONE NEW SYRINGE FOR EVERY TIME
SOMEBODY IN JACK'S. TO HONESTLY
DO THAT JUST IN SACRAMENTO
COUNTY WE WOULD HAVE TO BE
DISTRIBUTING SOMEWHERE IN THE
NEIGHBORHOOD OF FOUR MILLION
SYRINGES A YEAR. IN TWENTY
EIGHTEEN BSS PEAS WERE ASKED IF
THEY FELT LIKE THE DEMAND FOR
SYRINGES WAS HIGHER ABOUT THE
SAME OR LOWER COMPARED TO
TWENTY SEVENTEEN. OF THE THIRTY
TWO PROGRAMS THAT RESPONDED 88%
SAID THE DEMAND FOR WAS HIGHER.
NOW 15% REPORTED IT WAS ABOUT
THE SAME AND NO PROGRAM SAID
THAT IT WAS LESS. RIGHT THE
JUST TO GIVE YOU A LITTLE MORE
JUST GRASSROOTS KIND OF THING
IN TWENTY SIXTEEN THE AGENCY I
USED TO WORK AT- BEGAN SYRINGE
SERVICE PROGRAMMING AND WE THAT
FIRST YEAR DISTRIBUTED
SOMEWHERE IN THE NEIGHBORHOOD
OF FIFTY THOUSAND SYRINGES AND
FELT REALLY GOOD AT THAT. LAST
YEAR WAS OVER THREE HUNDRED
FIFTY THOUSAND. AND THAT'S
WITHOUT ANY KIND OF OUT REACH
OUR ADVERTISING OR ANYTHING
JUST PEOPLE WORD OF MOUTH
GETTING OUT THERE. SIX FOLD
INCREASE JUST IN A COUPLE OF
YEARS. IT GOT TO THE POINT
WHERE I HAD TO REALLY PUT A CAP
ON WHAT WE WERE LETTING GO OUT
THE DOOR BECAUSE I DIDN'T HAVE.
THE AMOUNT TO BACK UP TO GIVE
EVERYBODY. RIGHT. WHAT LIKE I
SAID A MINUTE AGO WE STARTED
SUPPLYING THE LOCKS ON LAST
YEAR NOW I KNOW FROM HARM
REDUCTION SERVICES HERE IN
SACRAMENTO IN THE FOUR YEARS
THEY'VE BEEN SUPPLYING THE
WALKS ON IT'S ALMOST TWO
THOUSAND PEOPLE THAT HAVE
REVERSED OVERDOSES HERE CAN YOU
EXPLAIN WILL LOCKS OWN NO LOCKS
ON IS A OPIOID ANTAGONIST IT IS
THE DRUG THAT WHEN ADMINISTERED.
DURING AN OVERDOSE WILL REVERSE
THE OVERDOSE. IT'S BASICALLY
BLOCKS THE RECEPTOR FOR ABOUT
AN HOUR OF THE OPIOID. THE COST
OF A SYRINGE IS ESTIMATED TO BE
AROUND SEVEN CENTS PER SYRINGE.
RIGHT THAT MAKES IT THE SINGLE
MOST COST EFFECTIVE HIV AND
HABSI PREVENTION TOOL AVAILABLE.
RIGHT IN TWENTY NINETEEN THERE
WAS A STUDY IN PHILADELPHIA THE
DOCUMENTED A TWO HUNDRED AND
FORTY MILLION DOLLAR PER YEAR
SAVINGS IN AVERTED HIV
TREATMENT COSTS. NOW THAT TWO
HUNDRED AND FORTY MILLION
DOESN'T EVEN TAKE INTO ACCOUNT
THE HABSI. TREATMENTS THAT WERE
AVERTED OR THE ANY OTHER
INFECTIOUS DISEASES THAT WAS
JUST LOOKING AT HIV ALONE AND
IT DIDN'T ACCOUNT FOR ANY OF
THE OVERDOSES ARE THE OVERDOSE
DEATHS THAT WERE AVERTED.
BECAUSE OF SYRINGE PROGRAMMING.
THE GROWTH IN DEMAND FOR
STERILE SYRINGES IS ALSO THE
MAIN DRIVER IN THE UPTAKE FOR
ALL OTHER VITAL SERVICES. FOR
EXAMPLE IN IN FROM TWENTY
SEVENTEEN TO TWENTY FIFTEEN
THERE'S BEEN- FROM FIFTEEN TO
SEVENTEEN SORRY THERE'S BEEN A
77% INCREASE IN THE NUMBER OF
ASSETS PEAS IN CALIFORNIA.
PROVIDING HIV RAPID TESTING.
THERE'S ALSO BEEN A TWO HUNDRED
AND 33% INCREASE IN THE AMOUNT
OF SYRINGE PROGRAMS PROVIDING
HABSI TESTING. LAST YEAR
FIFTEEN MILLION YEAH LAST YEAR
YOU GAVE OVER FIFTEEN MILLION
DOLLARS OVER FOUR YEARS- IN THE
BUDGET TO SUPPORT STAFFING AT
SS PIECE. WHICH IS AMAZING
BECAUSE MOST ASSETS PEAS AND I
THINK IT'S PROBABLY AROUND 60%
IN THE STATE. HAVE ALL
VOLUNTEER STAFF NOBODY GETS
PAID THEIR- RIGHT SO THAT THIS
IS A HUGE HUGE THING AND THANK
YOU FOR THAT THAT IT'S GOING TO
ALLOW ALL OF THEM TO HIRE
TREATMENT NAVIGATORS. SO THAT
WE CAN ACTUALLY LINK MORE
PEOPLE INTO CARE AND TREATMENT-
LINK THEMINTO HIV TREATMENT
HABSI TREATMENT. BUT THAT MONEY
CANNOT BE USED FOR SUPPLIES AT
ALL. SO WHILE WE'RE HERE WE'RE
ASKING THAT THE- INVESTMENT OF
FIVE MILLION DOLLARS A YEAR ON
GOING INTO THE CLEARING HOUS
IT'S A NECESSARY THING TO
ACTUALLY MAKE THAT FIFTEEN
MILLION DOLLAR INVESTMENT
YOU'VE ALREADY PUT AND MUCH
MORE EFFECTIVE. RIGHT THIS
THESE FUNDS TO HELP WITH
CRITICAL EXPANSION OF SERVICES
BUT WITHOUT THE INCREASED.
CLEARING HOUSE BUDGET THEY WILL
NOT BE ABLE TO PROVIDE THE FULL
RANGE OF SUPPLIES THAT PEOPLE
NEED. TOM THEY WILL NOT BE ABLE
TO PROVIDE A LOT OF THE OTHER.
SPECIALTY SUPPLIES LIKE IF
WE'RE TALKING ABOUT HARM
REDUCTION FOR FOLKS WERE
INJECTING DRUGS ONE OF THE
BIGGEST TOOLS WE TALK ABOUT IS.
NOT INJECTING MAYBE SMOKING.
THIS YEAR THE CLEARING HOUSE
ADDED SOME MORE SUPPLIES SO
THAT WE CAN GIVE FOLKS SAY FOR
SMOKING KITS- WHICH IS. IN THIS
AGE OF FAT NOW ACTUALLY A
REALLY BIG TO ALL TO HELP
PEOPLE SAVE LIVES. CELL I'M
JUST HERE TO ASK FOR THAT
INVESTMENT THAT FIVE MILLION
DOLLARS TO THE CLEARING HOUSE
ON GOING EVERY YEAR JUST TO
SHOW. THE EXPANSION THAT WE'VE
ALREADY SEEN IN THIS TATE AND
THAT THIS THIS IS THE BIGGEST
DRIVER ABOUT HOW WE'RE GOING TO
GET TO ZERO AN END TO THESE
EPIDEMICS. THANK YOU VERY MUCH
FOR SHARING YOUR TESTIMONY WITH
US- AND CERTAINLY WE KNOW THAT-
THERE'S A LOT OF PEOPLE IN THE
SPACE- THE ONE GETS ADDITIONAL
RESOURCES WE NEED TO MAKE SURE.
BECAUSE WE NEED TO FILL SOME
VERY SERIOUS GAPS IN FUNDING-
BASED ON THE DATA THE STRONG
SUGGEST THAT THERE NEEDS TO BE
SOME ADDITIONAL RESOURCES AND
SO. I THINK YOU HAVE A LOT OF
ADVOCATES WHO WILL BE
SUPPORTING A NUMBER OF BUDGET
REQUESTS- IN THAT REGARD THANK
YOU. WELCOME NEXT. MALDONADO
YES GOOD AFTERNOON. MY NAME IS
GABRIEL MALDONADO I SERVE AS
THE CHIEF EXECUTIVE OFFICER OF
A COMMUNITY BASED ORGANIZATION
SERVING RIVERSIDE AND SAN
BERNARDINO CULTURAL EVOLUTION-
BUT I'M ALSO SPEAKING ON THE-
BOARD OF TRUSTEES TO BORREGO
COMMUNITY HEALTH FOUNDATION. WE
ARE THE LARGEST FEDERALLY
QUALIFIED HEALTH CENTER IN THE
STATE OF CALIFORNIA WITH OVER
TWO HUNDRED THIRTY THOUSAND
PATIENTS. ONE POINT THREE
MILLION VISITS A YEAR- AND FOUR
THOUSAND PATIENTS LIVING WITH
HIV I'LL COME TO YOU AS A
PERSON LIVING WITH HIV. AND SO
MY LIVE NEXT. AND MUCH TIED IN
CONTEXTUALIZE SOME OF THIS TO.
BUT I JUST WANT OUTLINED FOR
YOU ON WHICH IT'S EQUITY IN THE
STATE CAL. BECAUSE IT OF.
POPULATION ARE SO MY READ
RIVERS STAMINA AS A- TWENTY
THOUSAND SQUARE MILE. SO WHERE
LARGER THAN FIVE STATES IN THE
U. S. AND WE'RE THE LARGEST HER
SAID JURISDICTION IN THE UNITED
STATES- WHAT IS HAPPENED OVER
THE LAST MANY YEARS DUE TO
GENTRIFICATION COST OF LIVING.
THE CHAMPIONS OF POT SHINS
TRYING TO SEE GAP COST LIVING.
ARE READ GROW SIGNET. IS THAT
ARE UNDERSTOOD. FULLER SO.
THERE'S BEEN A REAL ESTATE
INVESTOR FOR A SOME OF US JUST
HAVE HEALTHCARE FACILITIES WE
JUST DON'T HAVE MOBILE UNITS
JUST ISN'T IS A IN FIRST. FOR
US TO BE TO DO SO DELAY AND
BEEN EXACT SIGNET EVER THE A
WHERE THIS POPULATION OF P.
THAT ARE AVAILABLE TO RECEIVE
CARE AND SERVICE BUT STILL HAS
REALLY QUE UP WE THE RISING
AMOUNT OF PATIENTS THAT WE HAVE
TO SEE PARTICULARLY IN AREAS
THAT ARE NOW SEEN A LARGE IN.
OF NEW COMMUNITIES THAT ARE
COMING INTO OUR AREAS- WE HAVE
A SIGNIFICANT SIGNIFICANT
PROVIDER SHORTAGE THROUGHOUT
THE STATE OF CALIFORNIA-
PARTICULAR AROUND AS HIV
SPECIALTY- AS WE KNOW THE COST
OF STUDENT LOANS EXORBITANTLY
HIGH ESPECIALLY FOR THOSE OF US
IN THE ROOM WITH STUDENT LOANS-
AND THAT CAN CREATE A DISPARITY
IN PROVIDERS THAT ARE WANTING
TO. GO INTO HIV ISA SPECIALTY
WHICH MAY NOT NOT BE AS
ATTRACTIVE AS MAYBE BEING A
PLASTIC SURGEON OUR INTERNAL
MEDICINE- AND THAT IS NOT JUST
WITH OUR PROVIDERS AS RELATES
TO MEDICAL CARE A BIG ROLE OF
COMMUNITY BASED ORGANIZATIONS
IS THAT WE'RE ALL THE CHEVY
TESTERS AND THERE'S A VERY VERY
VERY VERY DIFFICULT. CHORE IN
BEING ABLE TO READ MEASURE
BURKE FORCIBLY TEST IS ON
AVERAGE WE ONLY STARTED COMING
TO OUR STATE ONCE A YEAR AND
USUALLY ALL FIVE PROVIDERS ARE
FOR THE FIFTEENTH THAT'S TAKING
UP OTHER. SO ON OUR CAN YOU
BASE ORGAN IS IN CAN MAYBE GET
ONE OR TWO TEST SIR TO. PER
YEAR AND CAN BE DIFFICULT WE
YOU'RE ONLY FOR ORGANIZATIONS
THAT ARE TRYING TO SERVE TWENTY
SEVEN THOUSAND SQUARE MILES SO
WORKFORCE. HIV TESTER SHORTAGE
AND MEDICAL STAFF WERE JUST
REAL CHALLENGE FOR US IS NOT
YEAH CAN WE YEAH PLEASE GO BACK
TO THE OKAY. SAYS. CAP BACK T.
ARTS. DIFFERENT PROCESS SEES
FOR HOW- TESTERS BECOME
CERTIFIED ON IN DIFFERENT
COUNTIES I THINK SOME OF THE
LARGER COUNTIES MIGHT BE ABLE
TO SPEAK TO THEIR CERTIFICATION
PROCESS I KNOW IN PLACES LIKE
RIVERSIDE AND SAN BERNARDINO WE
HAVE TO WAIT FOR A CERTIFIER TO
COME DOWN FROM THE STATE. AND
ON AVERAGE WHICH THAT HAPPENS
ONLY ONCE A YEAR. ON AND I'M
SURE THEY CAN SPEAK TO WHAT
THEY'RE CHALLENGES MAY BE AND
BEING ABLE TO YOU KNOW SEND OUT
SORT OF FIRES THROUGHOUT. THE
STATE- BUT- THE COURSE REQUIRES
THAT WE ONLY HAVE FIFTEEN
PARTICIPANTS THAT'S THAT'S THE
REQUIREMENT IS THAT THE CLASS
CAN ONLY HAVE ABOUT 50% IT
DEPENDS PER NUMBER OF TRAINERS
RIGHT IT'S LIKE A- STUDENT TO
TEACHER RATIO RIGHT- AND SO AS
A RESULT WHEN YOU HAVE FOUR TO
FIVE AGENCIES THAT ARE IN OUR-
TO COUNTY JURISDICTION. ALL
TRYING TO HAVE HIV TESTERS GET
CERTIFIED MANY TIMES WERE
BATTLING OVER ONE TO TWO SLOTS.
MANY TIMES MAYBE THREE BECAUSE
THE COUNTY THAT INCLUDES COUNTY
CERTIFICATION SO EVEN THE
COUNTY EMPLOYEES GET CERTIFIED
IN THE SAME CERTIFICATION
CLASS. THAT THE COMMUNITY BASED
ORGANIZATIONS AND THE CLINICS
AND THEIR TESTERS TO. SO YOU
GOT TO BE REAL TACTICAL AND YOU
KNOW GOD FOR BID A STAFF MEMBER
LEAVES IT GETS TRANSFERRED TO A
DIFFERENT APARTMENT OR WANT TO
GO TO A DIFFERENT AGENCY OR
JUST WANTS TO LEAVE HIV. YOU
HAVE TO WAIT AN ENTIRE YEAR
SOMETIMES BEFORE YOU CAN GET RE
CERTIFICATION SO. I'M WE HAD
FIVE TESTERS AS OF LAST YEAR I
ONLY HAVE TO THIS YEAR- AND
THAT COULD BE A REAL CHALLENGE
SO. THAT ANSWERS YOUR UESTION
IT DOES WIN WE'RE HERE TO TRY
TO- ADDRESSING CHALLENGES AND-
THEY WE HAVE NEVER PEOPLE IN
THE ROOM THAT REPRESENTS A
NUMBER OF AGENCIES THAT. WE
WANT TO TRY TO WORK THAT THING
OUT I THINK OKAY THIS TO HEAR.
THANK YOU AND THEN OBVIOUSLY
I'M SURE MANY OF MY COLLEAGUES
THERE FROM THE CENTRAL VALLEY
OR FROM PARTS OF NOR CAL CAN
YOU KNOW ECHO TRANSPORTATION AS
A REAL CHALLENGE- ON AVERAGE WE
SPEND FIFTY SEVEN DOLLARS ONE
WAY. FOR A CLIENT TO GET TO
THEIR MEDICAL POINT MA'AM
YOU'RE TALKING ABOUT TWENTY
SEVEN THOUSAND SQUARE MILES- I
DID A RESEARCH REPORT ONCE THAT
SHOW THAT CLIENTS ARE ABLE TO
GET. FROM THE FENWAY INSTITUTE
IN BOSTON. DOWN TO THE US
HELPING US FACILITY WHICH IS
LOCATED IN WASHINGTON DC.
FASTER THAN YOU CAN GET FROM
THE AIDS HEALTHCARE FOUNDATION
AND SMPOERNA DINO. TO THE
DESERT AIDS PROJECT IN PALM
SPRINGS WHICH IS THE TWO
OPPOSITE ENDS OF OUR
JURISDICTION SO REALLY SOMEONE
IN BOSTON CAN ACTUALLY GET
DOWN. DC FASTER THAN YOU CAN
GET. FROM ONE PART OF OUR
COUNTY TO THE OTHER AND ON
AVERAGE YOU CAN BE ABOUT A
SEVEN. AT NINE OUR ABOUT US ON
PRETTY GOOD BECAUSE THERE'S AN
INTRICATELY TRANSPORTATION SO
TRANSPORTATION IS A CHALLENGE.
I'M IN LASTLY CULTURAL SPACE.
ARE MY REP A COMMUNITY BASED
TORT WHERE MINORITY SERVING WE-
FOCUS ON THE AFRICAN AMERICAN
AND LATIN NEXT POPULATION- IN
IN THE LAST TWELVE YEARS THAT
TRUE EVOLUTION IS BANNED. A
PROVIDER IN THE AREA- I HAVE
SEEN TWO OTHER COMMUNITY BASED
ORGANIZATIONS CLOSE AND I'VE
SEEN NO OTHER COMMUNITY BASED
ORGANIZATION. BE FUNDED OR
CONTRACTED IN MY AREA SENSE.
THERE ARE TWO AGENCIES THAT ARE
WORTHY AND THAT ALREADY- BUT
THE BARRIERS TO ENTRY ARE QUITE
HIGH. TO BECOME A NONPROFIT-
SEXUALLY YOU TO BECOME A FOR
PROFIT THAN IT IS TO BE A
NONPROFIT YOU KNOW START UP
GRANTS AREN'T VERY. FOR OUR
FIELD ARE COMMON. I'M KIND OF
HAVE TO HAVE HISTORY- ALSO
COMMUNITY BASED ORGANIZATIONS
PLAY A ROLE IN RETENTION. AND
QUALITY OF LIFE- AND I THINK
WHAT I HAD A PRESENTATION DONE
ON THE HEALTHIER CALIFORNIA FOR
ALL. I HAD A PRETTY
PRESENTATION ONCE. ANY IN ITS
PROVEN THAT WHEN INDIVIDUALS
ARE ABLE TO ADDRESS OUR SOCIAL
DETERMINANTS WHEN PEOPLE CAN
OVERCOME THEIR- THINGS LIKE
CASE MANAGEMENT SERVICES ARE
PURE NAVIGATION OR
TRANSPORTATION OR- HOUSING CASE
MANAGEMENT. THAT IT INCREASES
THEIR OVERALL QUALITY OF LIFE
AND IT INCREASES MAXIMIZES.
HEALTH OUTCOMES WOULD ALSO CAN
DO THOUGH IT THE COST SAVER.
YOU KNOW BECAUSE IF INDIVIDUALS
ARE NOT GETTING INFECTED AND WE
DON'T HAVE TO CONTEND WITH THE
CUTE CASES. OF HIV WE CAN
REDUCE THE AMOUNT OF
COMORBIDITIES AND WE CAN ALSO
PREVENT HOSPITALIZATION WHICH I
KNOW IS A VERY BIG PRIORITY OF
OUR LOCAL MEDI CAL HEALTH PLAN.
I EACH BE THE INLAND EMPIRE
HEALTH PLAN. AND NOT PREVENTING
HOSPITALIZATION IS A VERY BIG
PRIORITY OF THEIR AREA. AND
CASE MANAGEMENT NAVIGATE IN
SERVICE PER. BY YOU BASED ARE.
A ROLE IN THAT. I IN MY LOOK
POINT CLOSE. IS THAT I'M ABOUT
BY TWO YEARS IN. IN THE FIELD
THAT HOW. IN IS. THE FORM. I WE
SPENT A- BEING. OUT AS AN CAT.
THE ANGRY. CARE FOR PEOPLE. I
WE TAKING A SAN IS NOT BECAUSE
IT WAS LOW THERE. BECAUSE I GOT.
HAPPENING THERE TOO. GO TO AN
EVENT NINE GOT STATE BUT ON
THAT I GO BACK TO RIVER WAY
I'VE BEEN RE READING MY CARE
FOR THE TWELVE YEARS BUT MY
DIAG. IT'S DIFFICULT FOR MY DAD
TO BEACH AS A PRIME. METHOD
PRODUCED. RESOURCE SO TO A FOR
ALL THE POPPY AT SOME IN PEOPLE
THAT ARE CA IN FROM DIEGO. LOS
ANGELES IN OUR COUNTY THE CLASS
OF LIVING IS TOO HIGH THEY'RE
COMING TO OUR AIR TO SEEK
AFFORDABLE HOUSING ON HOW DO WE
ACCOUNT FOR THIS GROWING
POPULATION THAT WE NOW HAVE TO
CARE FOR AND HOW DOES OUR
FUNDING PRIORITIES ALIGNED WITH
THE MOVEMENT OF CARE THROUGHOUT
THE STATE OF CALIFORNIA. THAT'S
MY FINAL MY FINAL POINT NINE I
THANK. THANK YOU VERY MUCH CAN
YOU HELP ME THANK OF ASHLEY ROW
HOUSE AND ALSO GABRIEL
MALDONADO. I'M SORRY. ROBIN
ROBIN SKEWS ABOUT APOLOGIZE
SHOULD HAD NAME PLATES OKAY
ROBERT THANK YOU VERY MUCH NEXT
PRESENTER HI HI MY NAME IS
ACTUALLY THE HOUSE OKAY. WELL
DO PLEASED THAT THE OKAY GOT
AND I AM THE EXECUTIVE DIRECTOR
OF FRIENDS NOBODY HAS A NEED US
IN FRESNO CALIFORNIA IN THE
CENTRAL VALLEY I'M I REALLY
APPRECIATE A LOT OF THE
COMMENTS THAT WERE MADE AND I
THINK I'M A LOT OF THE ISSUES
THAT WE WILL TALK ABOUT HIGHLY
THAT CENTRALLY HAVE BEEN
TOUCHED ON SO I WON'T USE TONS
OF TIME. I'M BUT I REALLY DO
ONE ECHO AND OR OR CENTER THE
NEEDS TO ADDRESS I AND- YES
COMMUNITY BASED ORGANIZATIONS
I'M AND WHEN WE DESIGN FUNDING
STREAMS A LOT OF THE COMMUNITY
BASED ORGANIZATION SERVING
REALLY SMALL. AND SPECIALIZED
POPULATIONS LIKE THE
UNDOCUMENTED IMMIGRANT
COMMUNITY I IT. I HAVE A HARD
TIME ACCESSING THE FUNDS THAT
WE MAKE AVAILABLE. AND BECAUSE
I THE WAY THAT THE STATE
REIMBURSEMENT- HAPPENS MEANS
THAT OFTEN WE HAVE TO PUT MONEY
UP FRONT TO ACCESS. THE
RESOURCES INITIALLY- WHICH SORT
OF SCREENS OUT A LOT OF SMALL
COMMUNITY BASED ORGANIZATIONS I
AM. BECAUSE YOU DON'T HAVE THE
CAPITAL TO PUT FORWARD. AND I
AM IS THAT BECAUSE OF THE
REIMBURSEMENT TAKES A LONG TIME
YEAH. HOW LONG DOES IT WAS A
NORMAL WAY TIME SO DEPENDING ON
THE THANK CHAIRMAN IT COULD BE
AND SIX MONTHS OR SO YOU CAN
OPT INTO WITH SOME CONNECTIONS
YOU CAN OPT INTO MONTHLY
REIMBURSEMENT SOME FUNDING
STREAMS YOU CAN OPT INTO
QUARTERLY- BUT THEN THE TIME
LINE FOR IT SORT OF. FROM WHEN
YOU SUBMIT YOUR DOCUMENTATION
TO YOU GET A CHECK CAN BE ABOUT
SIX TO TWELVE WEEKS I'M WHICH
IF YOU'RE TALKING ABOUT SAY US
AT. THAT IS ASK. FOR EIGHTY
CAME O THIRD YOU KNOW
SOMETHING TO THAT AMOUNT IT IT
REALLY IN THE LIMITS THE
OPPORTUNITY FOR SMALLER
ORGANIZATIONS THAT HAVE THE
RELATIONSHIPS WITH I AND SOME
OF OUR MOST MARGINALIZED
COMMUNITIES. TO RESOURCE
THEMSELVES SAYS BEEN OBVIOUSLY
ON A BAY AREA FOR NOT A LOT OF
SMALL CBO'S FROM GETTING IN
THIS SPACE AND GETTING INVOLVED
OR STAYING IN THIS SPACE
ABSOLUTELY I HAVE A FRIEND OF
MINE WHO'S EIGHTY OVER A SMALL.
I'M GRASSROOTS COMMUNITY BASED
ON THAT SERVICE I'M
UNDOCUMENTED I AM MY GREAT
FOLKS FROM CENTRAL AMERICA IT
SERVING FOLKS FOUR DIFFERENT
INDIGENOUS LANGUAGES AND THEY A
HARD TIME ACCESS THE FOR. AND
NOT ONLY THREE. PROCESS ALSO OF
THAN I AM OFTENTIMES A MANDATE
FOR EVIDENCE BASED PRACTICES I
AM THAT THEN ALSO. YOU KNOW THE
EVIDENCE BASED PRACTICE PROF.
REQUIRES AN ACADEMIC
INSTITUTION TO REVIEW YOUR
MODEL IT'S NOT ONLY PRICEY BUT
OFTEN THROUGH THE LENS. OF
FOLKS NOT FROM YOUR COMMUNITY
I. AM SO. NO RATING ELEVENTH
PROP FOR INDIGENOUS COMMUNITIES
IS. W. TOWN MEANING WHEN THEY
WERE TO TALK ABOUT THEIR MY AND
HOW THEIR EFFECT. I'M AGAIN
THEIRSCREEN OUT OF AN
OPPORTUNITY TO APPLY TO
RESOURCES IF THEY CAN EVEN
GUARDED THE CAPITAL I'M TO FIND
THEMSELVES WAITING FOR WHILE
WAITING FOR REIMBURSEMENTS. I'M
SUCH A SORT OF ONE OF THOSE
GAPS THAT I'M- JUST
AUTOMATICALLY SCREENS A LOT OF
FOLKS OUT. I'M. I WON IT ALSO
TALK ABOUT AND I AM SO GRATEFUL
TO SEE IN COMMITMENTS TO
CONTINUE FUNDING AS HE
PREVENTION- FRESNO COUNTY IN
PARTICULAR IS A HAS THE HIGHEST
RATE OF CONGENITAL SYPHILIS IN
OUR STATE I'M WHICH IMPACTS I
AM PREGNANT WOMEN AND THEN
THEIR CHILDREN AT BIRTH I'M-
AND. WHAT WE LOOK AT IS WHY
AREN'T THESE FOLKS ACCESSING
CARE RIGHT AND IT'S OFTEN I'M
THAT THEN WHEN THEY DO ACCESS
CARE AGAIN THE MET WITH SHAME
AND STIGMA I'M- AND SO WE WANT
TO REALLY REITERATE THAT IN THE
NEED FOR ONGOING PROVIDER
EDUCATION AND NOT JUST.
CLINICIANS ARE LICENSED
PROVIDERS BUT THE FOLKS WHO ARE
MANAGING THE FRONT OF THE
OFFICE AND THAT THE WAY IN
WHICH FOLKS ARE RECEIVED INTO
CARE MATTERS SIGNIFICANTLY. I
AM. WE SINCE TWENTY SIXTEEN
CALIFORNIA HEALTH EFFECT
MANDATES COMPREHENSIVE SEXUAL
EDUCATION ACROSS OUR PUBLIC
HIGH SCHOOLS I'M IN TWENTY
EIGHTEEN INCLUDED MIDDLE
SCHOOLS AND CHARTER SCHOOLS I'M
BUT WITH OUT THAT SORT OF
SYSTEM WIDE EDUCATION AND WE'RE
SEEING YOUNG PEOPLE WILL
RECEIVE INFORMATION BUT THEN
THERE ARE THE MECHANISMS IN
PLACE TO- LEAD TO ACCESS TO
CARE I'M OR THEIR THEN SAT WITH
SORT OF AGAIN A MESSAGE WITH
THE OPPOSITE THAT REINFORCES
SHAME AND STIGMA I'M ESPECIALLY
AROUND GENDER GENDER IDENTITY
I'M THAT. PUSHES KIDS AGAIN
AWAY FROM CARE I AM WHAT WE
WANT FOR FOLKS WHO KNOWS THE
LINK AGAIN AND THE IMPORTANCE
OF INTEGRATED CARE MODELS THAT
ARE CENTERING THE WHOLE PERSON
WE HAD WE HAD A LOT FOR
BEHAVIORAL HEALTH I'M AND
PRIMARY CARE VITAL MEDICAL
INTERVENTIONS TO BE I'M MORE
DEEPLY MARRIED I'M ESPECIALLY
FOR OUR YOUNG PEOPLE WERE MOST
OF THE REFERRALS COMING I'M
FOLLOWING SAY COMPARED SEXUAL
EDUCATION OUR BEHAVIORAL HEALTH
REFERRALS I'M AND WHEN
PROVIDERS AREN'T AWARE OF THE
MARRIAGE BETWEEN THESE TWO
ISSUES- WE MISS A LOT OF
OPPORTUNITIES TO CALL YOUNG
PEOPLE INTO INTO CARE EARLY ON.
I THINK ALL OF STUFF THERE.
THANK YOU VERY MUCH THIS GIVE-
ASHLEY ROSS AROUND APPLAUSE
THANK YOU. NICK'S A LITTLE.
OKAY HI MY NAME IS MACHE I USE
A THEM OR SHE HER PRONOUNCE I'M
THE MANAGER OF POLICY WITH THE
TRANSLATE THE NOT COALITION FOR
A NATIONAL ADVOCACY
ORGANIZATION AND A DIRECT
SERVICE PROVIDER FOR
TRANSGENDER NONCONFORMING FOLKS
IN LOS ANGELES. SO THE LAST
LIKE BIGGEST THIRTY IN
CALIFORNIA CONDUCTED BY THE
WILLIAMS IS TO CONTACT A LITTLE
UNDER TWO HUNDRED TWENTY
THOUSAND TRANS FOLKS I'M IN
CALIFORNIA BUT A LOT OF THE
TIME. AND STATE WHAT
CONVERSATIONS TRANS PEOPLE ARE
LEFT OUT ESPECIALLY AS IT
RELATES TO HIV AND STDS AND ALL
OF THE OTHER THINGS WE'VE BEEN
TALKING ABOUT TODAY. AND A LOT
OF THIS IS ATTRIBUTED TO THE
STIGMA PLACE AGAINST TRANS IN
GENERAL CONFORMING FOLKS
TRANSPORTS WESTERLY TRANS WOMEN
OF COLOR- ARGUED BY SOCIETY AS
UNEMPLOYABLE AS AND
PROFESSIONAL AND HOUSE A BULL.
BUT A TIME CALLED IMPOSTER IS
ONLY AS SEX WORKERS- AND IN
RELATION TO THIS HEARING AS A
THREAT AND THE LIABILITY IS
SEXUAL HEALTH. AND SO IS
STARKLY THE ONLY WAYS IN WHICH
TRANSIT GENERAL COMPLAINING
FOLKS HAPPENING KNOWLEDGE IN
REGARDS TO SOCIETY AND THE
SYSTEM. HAS BEEN IT'S BEEN
ADDRESSING OUR SEXUAL HEALTH.
BUT EVEN THEN TRANSPOSED WITHIN
THESE BIG POTS OF HIV FUNDING
OR THESE STD FUNDING. ARE
CONSIDERED MEN WHO HAVE SEX
WITH MEN WITH WHICH FURTHER
CONTRIBUTES TO THE STIGMA AND
DISCRIMINATION THAT WE ARE
CONSTANTLY FACING. ON THE COME
THIS CONFLATION AND HAVING
FOLKS TRANSPORTADORA FIGHT AS
MEN WHO HAVE SEX WITH MEN ONLY
HAVE SPURRED OUR PROGRESS AND-
AND ARE LEAVING US WHERE WE ARE
TODAY IN TERMS OF OUR SOCIAL
POSITION OUT IN THE WORLD. SO
ONLY TO THE STATE YOU SEE
POUNDS FOLKS LIVING VISIBLY AND
SAFELY THAN WE EVER HAVE IN THE
PAST BUT EVEN THEN WE STILL ARE
VERY LIMITED LIMITED AN
OCCUPATION OCCUPATIONS THAT WE
CAN HAVE. AS A TWENTY THREE
YEAR OLD TRANS PERSON I SEE THE
FRUITS THE LABOR THAT PASTA
NARRATIONS OF TRANS FOLKS. HAVE
DONE IN THE REALM OF HIV AND IN
BEING ABLE TO GIVE FOLKS LIKE
ME A VOICE IN THE SOCIETY AND
BEING ABLE TO EVEN BE HERE AND
BE LISTEN TO TODAY. BUT THERE'S
STILL SO MUCH THAT NEEDS TO BE
DONE SO AS TI IS HABSI. HJV ARE
ALL LIKE UNDOUBTEDLY REALLY
HUGE ISSUES IN OUR COMMUNITY.
AND A LOT OF THE TIME THE ROOT
CAUSES ARE VERY APPARENT AND AS
MANY PEOPLE AS THAT THE DAY
ARE. REALLY ADDRESSED THE
SOCIAL DETERMINANTS OF HEALTH.
SO A LACK OF RESOURCES LIKE
HOUSING EMPLOYMENT I'M ANOTHER
THESE THINGS THAT- CREATE
BARRIERS TO FOLKS GETTING
FINANCIAL STABILITY. AND
REACHING A LEVEL OF STABILITY
JUST IN GENERAL- LEADS TO
THINGS LIKE DRUG GROUP DRUG USE
RISKY SEXUAL BEHAVIOR FOLKS
BEING PUT IN POSITIONS. WHERE
MAYBE. WE'RE NOT MAKING THE
SMARTEST DECISIONS WHEN IT
COMES TO OUR SEXUAL HEALTH- AND
A LOT OF THE TIME THAT LEADS TO
US CONTRACTING A LOT OF THINGS
THAT WE TALKED ABOUT TODAY.
SEOUL CONDOMS AND LOW LEVEL
OUTREACH PROGRAMS WHICH A LOT
OF THE TIME OR WHAT'S AVAILABLE
TO TRANS FOLKS THOSE THINGS
AREN'T SAVING OUR LIVES BUT
IT'S WHAT WE HAVE AVAILABLE AND
SO THEY'RE HELPING BUT THEY'RE
NOT NECESSARILY ADDRESSING THE
ROOT CAUSES LIKE I MENTIONED
EARLIER THINGS LIKE HOUSING
WELL A LONG TERM STABLE INCOME
AND EMPLOYMENT WELL AND TING
POLICING INCARCERATION AND
ATTENTION WELL. HEALTH CARE
WELL BANNING DISCRIMINATION
CULTURAL TRANSFORMATION WELL
BUT THEIR EARLY EFFORTS AND
INITIATIVES ADDRESSING THOSE
THINGS THAT I JUST MENTIONED
HAVING TRANSPOSES ABOUT CONDOMS
LEAVING THEM WITH CRAP BUT
THEY'RE STILL HOMELESS SAID AS
WELL AS TRANSPHOBIC THIS IS WHY
S. TRANSOXANIA AT THE HANDS OF
THE SYSTEM WHERE WE'RE TAKING
BACK OUR POWER AND TRANSIT THE
A COALITION AND ANNA QUESTION
OF TRANSIT INNOVATIONS ACOSTA
THEY ARE REALLY. TRYING TO
DEMAND THE REASON IS THE WE
HAVE STE HEAD START DESERVE
FROM THE STAY AND SOCIETY. AND
SO WE'VE CREATED A STATEWIDE
BUDGET PROPOSAL ON FOR THE
CREATION OF THE TRANSGENDER
WELLNESS IN EQUITY FUND ACROSS
SEVERAL DIFFERENT STATE
DEPARTMENTS AND AGENCIES- WHICH
WOULD CREATE THIS FIND IN FIVE
DIFFERENT DEPARTMENTS WHICH HAD
FUN THINGS LIKE- NEEDS
ASSESSMENTS DATA COLLECTION AND
CULTURAL TRANSFORMATION
CHANNING'S. IT WOULD FIND IN
INVESTMENT IN MEDICAL OR MENTAL
HEALTH BUT ADEQUATE FOR OUR
PEOPLE PATHWAYS TO EMPLOYMENT
AND ENFORCEMENT OF THE LABOR
LAWS THAT WE DO HAVE IN
CALIFORNIA THAT BECAUSE WE HAVE
LIKE ACTUALLY REALLY STRONG
PROTECTIONS FOR TRANS FOLKS IN
CALIFORNIA BUT NONE OF THAT IS
ACTUALLY BEING RESPECTED AND
IMPLEMENTATION. FAIR INCLUSIVE
UNSTABLE HOUSING AND THEN A
BIG. GAP IN A BIG POPULATION OF
OUR FOLKS THAT ARE OFTEN
FORGOTTEN- FOLKS THAT ARE
COMING OUT OF PRISON AND PEOPLE
THAT ARE COMING OUT OF
IMMIGRATION INTENTION. AND SO
IT'S CHANGES INVESTMENTS LIKE
THESE THAT WILL REALLY LIKE
ADDRESS A LOT OF THE ROOT
CAUSES THAT ARE CAUSING US TO
CONTRACT. I'M A LOT OF THINGS
THAT WE'RE TALKING ABOUT TODAY.
AND SO WE REALLY NEED TO LOOK
INTO THE SPECIFIC AND HOLISTIC
NEEDS OF TRANS WOMEN- NOT ONLY
TRANS WOMEN THOUGH TRANS MAN ON
BINARY PEOPLE INTERSEX PEOPLE-
AND OTHER SEXUAL AND GENDER
VERY AND I TEND TO USE
ESPECIALLY THOSE WHO HAVE BEEN
INCARCERATED THOSE AROUND
DOCUMENTED. I'M AND OTHER
BARRIERS TO CARE. AND SO
FEDERAL GOVERNMENTS HAVE ALWAYS
ACKNOWLEDGE TRANS FOLKS IN THE
ROOM WITH SEXUAL HEALTH AND
KNOW THE PROBLEMS BUT RATHER
RARELY EVER TO MAKE BIG
FINANCIAL INVESTMENTS. INTO
FUNDING THINGS LIKE HOUSING AND
THINGS THAT WILL ACTUALLY HELP
FOLKS GET OFF THE STREETS AND-
AND LESSEN THE CHANCES OF
CONTRACTING ARMY TAVY SEE AND
ALL THESE OTHER THINGS. BUT BUT
THAT'S NOT HAPPENING AND SO
TODAY LIKE AS I MENTIONED WE'RE
REALLY DOING THIS BIG STATEWIDE
EFFORT TO HAVE CALIFORNIA BE A
LEADER IN THE NATION AND OF
BEING ABLE TO FUND PROGRAMS
THAT ARE ACTUALLY GOING TO SAVE
OUR LIVES AND SET THE STANDARD
FOR WHAT IT LOOKS LIKE TO
INVEST IN TRANS HEALTH AND
TRANS- BEING AND LIVELIHOOD- SO
I HOPE WITH THIS PROVIDE SOME
CONTEXT AS TO- A MUCH NEEDED
GAP WHEN IT COMES LIKE TO THE
CONVERSATION TODAY BUT JUST THE
CONVERSATION IN GENERAL- AROUND
TRANSGENDER NONCONFORMING FOLKS
SO. THANK YOU FOR LISTENING TO.
THANK YOU VERY MUCH MARSEILLE
LEGAL. MACHE MACHE AS GIVE A
ROUND OF APPLAUSE THANK YOU
VERY MUCH. FOR YOUR VOTE FOR
YOUR VOICE AND REPRESENTING THE
TRANS COMMUNITY- IS CERTAINLY-
WELCOME HERE IN THIS SPACE SO
THANK YOU VERY MUCH. NEXT MS
HERNANDEZ. YES SIR GET
AFTERNOON- IT IS AN HONOR TO BE
ON A PANEL WITH ALL OF YOU I
JUST WANT TO SAY THAT- BEFORE I
STARTED THANK YOU FOR THE
OPPORTUNITY FOR BEING- FOR
BEING HERE MY NAME IS KIMBERLY
HERNANDEZ. I AM THEASSISTANT
DIVISION DIRECTOR OF HEALTH
SERVICES AT THE KERN COUNTY
PUBLIC HEALTH DEPARTMENT- SO
I'M HERE TO SPEAK SORT OF FROM
THE LOCAL HEALTH DEPARTMENT
PERSPECTIVE OF WHAT WE'RE
SEEING- IN PARTICULAR-
AFFECTING PREGNANT WOMEN WITH
THE GENERAL CEPHALUS. AT CIVIL
SAID YOU KNOW THE SEXUALLY
TRANSMITTED DISEASE AND CAN
GENERAL CEPHALUS IS WHEN THIS
INFECTION IS PASSED FROM MOTHER
TO CHILD- CAN GENERAL SYPHILIS.
THEN UP 240% OF INFANTS
AFFECTED WITH CONGENITAL
SYPHILIS. IT CAUSES FETAL
DEMISE STILL BIRTH AND
PERINATAL DEATH- AND THAT'S AN
SIGNIFICANTLY HIGHER MORTALITY
RATE FOR A BACTERIAL INFECTION
THAT CAN BE CURED WITH
ANTIBIOTICS- IT IS THE MOST
COMMON CAUSE OF STILL WORK
AFTER TWENTY WEEKS GESTATION.
AND SURVIVING INFANTS MAY
SUFFER FROM SEIZURES BONE
DEFORMITIES BLINDNESS AND
DEAFNESS AND HAVE DEVELOPMENTAL
DELAYS- BUT CAN GENERAL
SYPHILIS IS NINETY EIGHT
PERCENT. PERCENT PREVENTABLE IF
THE MOTHER IS TREATED WITH
ANTIBIOTICS IN A TIMELY MANNER-
AND SO AS ACT DURING MOST
MENTIONED EARLIER IN THE STATE
OF CALIFORNIA IN TWO THOUSAND.
AND EIGHTEEN THERE WERE THREE
HUNDRED AND TWENTY NINE INFANTS
DIAGNOSED WITH CONGENITAL
SYPHILIS. AND THE PRELIMINARY
DATA FROM TWO THOUSAND NINETEEN
IS NOT PROMISING- IT IS. VERY
LIKELY TO BE SIGNIFICANTLY
HIGHER- SO WE ARE VERY
CONCERNED BY THE- AMOUNT OF
CONTENT ALL SUPPOSE WE ARE
SEEING IN THE STATE OF
CALIFORNIA. IN TWO THOUSAND
EIGHTEEN. CALIFORNIA BE WAS
ACCOUNTED 425% OF ALL THE CAN
DENTAL SUPPLIES CASES IN THE
NATION. I IN CURRENT IN MY
COMMUNITY HISTORICALLY GENTLE
SYPHILIS CASES WERE IDENTIFIED
EVERY COUPLE OF YEARS THERE ARE
MANY YEARS IN THE PAST TWENTY
YEARS WE HAD NO CASES OF
CONGENITAL SYPHILIS AND THEN IN
TWO THOUSAND AND TWELVE THERE
ARE FOUR CASES I'M AN
EPIDEMIOLOGIST BY TRAINING THAT
TIME. RUNNING AS TO THE NUMBERS
AND WE LOOKED AT THAT AND WE
SAID HEY WE'VE NEVER SEEN FOUR
CASES OF MALE CIRCLES IN A
SINGLE YEAR. BUT WE THOUGHT
WELL MAYBE THIS IS JUST ONE OF
THOSE ANOMALIES WERE IT JUST
HAPPENS AN ACTUAL BACK TO ZERO
OR MAYBE ONE- UNFORTUNATELY
THAT DIDN'T HAPPEN IN TWO
THOUSAND THIRTEEN WITH ANOTHER
FOR. AND WE SAT AROUND THE
TABLE AGAIN WE SAID HEY WE'VE
NEVER HAD TWO YEARS IN A ROW
WITH FOUR CASES EACH. BUT WE
SAID WELL LAST YEAR WAS FOUR
CASES THIS YEAR'S FOUR CASES
MAYBE THIS IS THE NEW NORMAL
THAT WE'RE SEEING. AND THEN WE
HIT TWO THOUSAND AND FOURTEEN
WE HAD EIGHTEEN. AND AT THAT
TIME WE SAID UNTIL WE SAID.
WE'RE IN TROUBLE- YOU KNOW WE-
AT THAT POINT WE KNEW WE HAD A
PROBLEM. AND THAT WE HAD TO
WORK VERY QUICKLY TO TRY TO
ADDRESS IT. THE FOLLOWING YEAR
IS IDENTIFIED TWENTY SEVEN
THIRTY THREE AND FIFTY SIX
CASES- KERN COUNTY HAS THE
UNFORTUNATE DISTINCTION OF
HAVING ONE OF THE HIGHEST RATES
OF CATTLE SURPLUS. OF FRESNO IS
ANOTHER ONE AND- JAIL SURPLUS
IN PARTICULAR HAS IMPACTED THE
CENTRAL VALLEY- MORE THAN.
OTHER COMMUNITIES IN CALIFORNIA.
I'M OFTEN ASKED AS AN
EPIDEMIOLOGIST WILL WHAT
HAPPENED WHAT BECAUSE CAN
DENTAL SUPPOSED TO GO FROM
ALMOST NOTHING- YOU KNOW TO.
109% HIGHER THAN IT WAS BEFORE
AND THE INTELLECTUAL REALLY
SIMPLE. IF YOU LOOK AT RATES OF
THE FOURTH AMONG WOMEN THEY
STARTED GOING UP RUN TWO
THOUSAND ELEVEN. AND AS THOSE
RATES- SKYROCKETED WE SELL
CONTENT ALSO FELIZ POP UP- SO
IT'S A VERY SIMPLE ANSWER- TO
VERY COMPLICATED QUESTION IS
THAT AS LONG AS THERE ARE.
WOMEN WITH THE FULLEST THEY
WILL BE BABIES WITH SYPHILIS
AND AS THAT ROUTE RATE
CONTINUES TO INCREASE ACROSS
THE CITY CALIFORNIA WE EXPECT
TO SEE MORE BABIES BORN WITH
CONGENITAL SYPHILIS. THEN KERN
COUNTY- WE'VE IDENTIFIED A
NUMBER OF THINGS AMONG WOMEN
WHO HAVE GIVEN BIRTH TO INFANTS
DIAGNOSED WITH MENTAL SYPHILIS.
MEDI CAL IS A PAIR OF NEARLY
ALL OF THE THIS IS. ALL THE
DELIVERIES IN KERN COUNTY. AND
WITH THAT WE EXPECTED THAT
MEDIC HOW WILL BE THE PAYER FOR
ANY OF THE ASSOCIATED
COMPLICATIONS THAT THESE
INFANTS FACE. THE VAST MAJORITY
OF MOTHER SHOW NO SIGNS OF
SURPLUS AT DELIVERY AND MANY OF
THEM DON'T KNOW THAT THEY WERE
INFECTED AT SOME POINT IN THEIR
LIVES. AND THAT THAT INFECTION
FROM YEARS AGO COULD AFFECT
THEIR PREGNANCY AND THEIR BABY.
MANY OF THE MOTHERS ARE
ENTERING INTO PRENATAL CARE
EITHER LATE IN THEIR IN THEIR
PREGNANCY OR NOT AT ALL WE HAVE
A NUMBER OF WOMEN WHO SHOW UP
AT THE HOSPITAL. AND DELIVER
WITH NO PRENATAL CARE. FANCIFUL
IS SOMETHING THAT IS REQUIRED
BY LAW TO BE TESTED AT YOUR
FIRST PRENATAL VISIT AND SO WE
KNOW A LOT OF THESE MOTHERS. IF
THEY WOULD ENTER INTO PRENATAL
CARE EARLIER WOULD BE TESTED
AND HOPEFULLY HAVE TIME TO BE
TREATED BEFORE- THIS INFECTION
AFFECT AFFECTED THEIR BABY. A
LARGE PROPORTION OF MOTHERS
HAVE A HISTORY OF DRUG USE-
MANY OF THEM ARE CURRENT DRUG
USERS WHEN THEY DELIVER. MORE
AND MORE OF THEM ARE BEING
AFFECTED BY HOMELESSNESS. AND A
LOT OF THESE INFANTS ARE ENDING
UP IN FOSTER CARE. THAT'S WHAT
WE SEE JUSTIN KERN COUNTY- AND
I IMAGINE IT'S VERY SIMILAR
ACROSS THE STATE. IN CURRENT
COUNTY WE HAVE BEEN DEDICATING
RESOURCES SPECIFICALLY.
SPECIFICALLY TO SUPPOSING
DENTAL SUPPLIES FOR THE BETTER
PART OF FOUR YEARS I HAD THE
PRIVILEGE OF WORKING WITH
INCREDIBLE PEOPLE WHO GO ABOVE
AND BEYOND TO SUPPORT PREGNANT
WOMEN. AND THEIR BABIES. IN A
TIME WHEN MANY HEALTH
DEPARTMENTS HAVE BEEN FORCED TO
CLOSE THEIR CLINICS ARE
CLINICIANS. WILL DO ALMOST
ANYTHING TO MAKE SURE THAT A
PREGNANT WOMAN WITH THE FELIZ
CAN BE SEEN RIGHT AWAY. SKIP
LUNCH THEY STAY LATE- THEY WORK
EXTRA HARD BECAUSE WE KNOW THAT
THESE WOMEN- WHEN THEY PRESENT
TO US NEED TO BE SEEN NOW
BECAUSE THEY MAY NOT COME BACK
I ALSO WORK WITH. AN AMAZING
TEAM OF MEDICAL INVESTIGATORS
WHO LITERALLY CLIMB OVER FENCES
TO FIND PEOPLE. AND TO HELP
THAT GET THEM TO TREATMENT. WE
HAVE PUBLIC HEALTH NURSES WHO
FOLLOW WOMEN THROUGHOUT THEIR
PREGNANCY AND BEYONDTO MAKE
SURE THAT THEY HAVE THE
HEALTHIEST OUTCOME THAT THEY
CAN. AND WE HAVE AMAZING
COMMUNITY PARTNERS WHO ENSURE
THAT MOMS AND BABIES I'M
RECEIVE APPROPRIATE TREATMENT.
IN CURRENT COUNTY WE ALSO HAVE
SOME SPECIAL RESOURCES THAT FEW
OTHER COUNTIES HAVE- WE ARE
FORTUNATE THAT E HAVE- SEE
PEEKS DISEASE INTERVENTION
SPECIALIST WHO SPECIALIZE IN
SYPHILIS. IN OUR BUILDING THEY
WERE THE BACKBONE OF CREATING
OUR PROGRAM TODAY AND MENTORING
AND TEACHING- OUR STAFF TO BE
ABLE TO FIND AND- INITIATE
CONTACT AND GET PEOPLE TO
TREATMENT. AND THEY CONTINUE
THE STATE HELP US FIND THOSE
PATIENTS AND GET THEM IN A
TREATMENT. WE ALSO HAVE OUR THE
RECIPIENT- OF SHORT TERM
FUNDING THAT'S DEDICATED TO
ADDRESSING GENERAL CEPHALUS-
AND WITH THAT COMES ENORMOUS
SUPPORT FROM OUR COLLEAGUES OF
THE CALIFORNIA PART OF PUBLIC
HEALTH. AND YET EVEN WITH ALL
OF THAT. WE ARE ONLY STILL
REACTING TO THE CAN DENTAL
SURPLUS IN OUR COMMUNITY. IN
ORDER TO ADDRESS THE EPIDEMIC
OF CANALS OF LISTEN KERN COUNTY
IN THE STATE OF CALIFORNIA WE
WILL HAVE TO AND THE LARGE
EPIDEMIC OF SYPHILIS. WE KNOW
THAT THESE BABIES ARE GETTING
IT FROM THEIR MOMS THEIR MOMS
ARE GETTING FROM THEIR PARTNERS
AND AS LONG AS SUPPOSED
CONTINUE TO CIRCULATE MY
COMMUNITY WE'LL HAVE BABIES
BORN WITH IT. AS WE SEE THE
RATES OF HIV AND HEPATITIS C.
AMONG WOMEN OF CHILDBEARING AGE
INCREASE. ON A DOCTOR MUST
MENTIONED EARLIER. WE'RE
WATCHING YOU KNOW HOLDING OUR
BREATH REALLY TO SEE. WHEN WE
START GETTING INFANTS BORN WITH
HIV AGAIN. WHEN WE START
GETTING INFANTS BORN WITH
HEPATITIS C. AGAIN- IT HAPPENED
IN THE PAST AND- WE ARE HOPEFUL
WE WILL BE ABLE TO STAVE IT OFF
BUT WE KNOW THE REALITY IS. AS
THESE ARE. RATES INCREASING IN
WOMEN OF CHILDBEARING AGE AND
IN PARTICULAR IN PREGNANT WOMEN
WE'RE GOING TO SEE INFANTS
AFFECTED. ACROSS THE STATE THE
PUBLIC HEALTH DEPARTMENTS ARE
WORKING AS HARD AS THEY CAN
WITH THE LIMITED RESOURCES THAT
THEY HAVE. INFECTIOUS DISEASES
HAVE NEVER STOPPED I COUNTY
BORDERS AND WE KNOW WE WILL ALL
HAVE TO WORK TOGETHER IN ORDER
TO. PROTECT OUR MOST NOTABLE
POPULATIONS. THANK YOU FOR YOUR
TIME THANK YOU ALL ON THE PANEL
FOR EVERYTHING YOU GUYS DO.
THANK YOU VERY MUCH CAN GIVE MS
HERNANDEZ AROUND APPLAUSE. I
DON'T KNOW WHERE TO BEGIN AS
YOU YOU ALL BROUGHT SO MUCH
INFORMATION TO BEAR I REALLY
APPRECIATE THAT AND DR NHà AND
DR ANDERS. OKAY MS HERNANDEZ
TALKED ABOUT YOU KNOW THE-
INFANTS BORING- WITH- SURPLUS
AND THINGS OF THAT NATURE- I
DON'T THINK PEOPLE UNDERSTAND
SO THE REASON WHY I'M IN THIS
SPACE AND I THINK IT'S- GOING
TO PUT IN SOME CONTEXTS. MY GOD
SON- WHO- MOTHER FATHER BOTH
DIED OF AIDS. WE GREW U IN THE
CHURCH TOGETHER. AND THAT THEY
CONNECTED AND THAT THEY BROUGHT
A CHILD INTO THIS WORLD- HE
LOST BOTH MOTHER FATHER AT SIX
YEARS OLD. LOS MOM AND DAD AT
SIX YEARS AGO. AND THE
BIOLOGICAL GRANDPARENTS NEVER
GOT HIM THE TROUT THE HELP THAT
HE NEEDED TO THE TRAUMA LOSING
BOTH PARENTS AND SO MY CHILD IS
NOW IN CRYSTAL METH AND HE'S
HOMELESS. AND YOU KNOW FOR ME-
YOU KNOW WHEN I FLY BACK TO LOS
ANGELES ONLY DO I TAKE CARE OF
MY CONSTITUENTS- SO HE WAS HE
WAS DIAGNOSED AFTER BEING
TREATED- PERIODICALLY TO MAKE
SURE HE WAS NOT HIV POSITIVE-
THAT ARE GOING TO CRACK HOUSES.
AND PULL THEM OUT. AND BRING
THEM HOME AND CLEAN HIM UP AND
THEN HE WANTS TO GO AND LEAVE
AGAIN ANY CHECKS ITSELF OUT OF
PROGRAMS SO I SEE A DIRECT
LINK. TO ALL OF THIS- IN A VERY
SYSTEMATIC WAY AND SO I'M IN
THIS SPACE- BECAUSE THE FIGHT
IS IN THIS SPACE. I'M IN THIS
SPACE TO MAKING SURE THAT
RESOURCES ARE GIVEN TO TRY TO
REDUCE THE NUMBER OF
INDIVIDUALS THAT ARE AFFECTED-
BY STDS HIV ANNEX OUT- SO
THAT'S WHY I'M IN THIS SPACE.
AND SO LET IT BE KNOWN THAT ALL
DOUBT BE CAST ASIDE. THAT'S MY
MOTIVATION FOR BEING IN THE
SPACE ONLY UNDER THAN WE CAN TO
REDUCE THE NUMBERS HERE IN
CALIFORNIA SO WE THANK YOU ALL
FOR YOUR TESTIMONY. ON THIS
GIVE THIS PANEL ONE MORE ROUND
OF APPLAUSE PLEASE. AS THEY
TRANSITION. WE'LL BE ASKING
QUESTIONS CELLS- SO BE CLOSE WE
WANT TO BRING UP THE NEXT PANEL
IF YOU WOULD PLEASE. WE WANT TO
BRING UP THE NEXT- KEY
STRATEGIES IN THE EPIDEMIC TO
PLEASE- THAT PARA PLEASE COME
UP AND- TAKE YOUR PLACES. IN
FRONT. WE'LL START OFF WITH
WAYNE STEWART CALIFORNIA HIV
AND AIDS POLICY RESEARCH CENTER.
AND THEN THE TRANSITION CLINIC
NETWORK WILL FOLLOW AND THE LOS
ANGELES COUNTY DIVISION ON HIV
AND STD PROGRAMS AND THE FAMILY
HEALTH CENTER OF SAN DIEGO. AND
THEN ESSENTIAL ACCESS TO HEALTH.
THANK YOU VERY MUCH WE
APPRECIATE EACH OF EACH OF YOU
COMING GIVEN EVER TIME ONCE
AGAIN- WE WILL OPEN UP
INTRODUCTIONS AND PRESENTATIONS
WE'RE WE'RE GOOD WITH BEING
VERY LIBERAL IN TERMS OF TIME
SO WEDNESDAY ABOUT TEN FIFTEEN
MINUTES IF YOU WOULD PLEASE AND
YOU'RE WELCOME RIGHT THANK YOU
SO I AM WHEN STEWART I'M A
PROFESSOR AT THE UCSF CENTER
FOR AIDS PREVENTION STUDIES.
AND AS YOU ALLUDED TO IN YOUR
REMARKS AS YOUR OPENING THIS I
AM ONE OF ONE OF SEVERAL
PRICIPAL INVESTIGATORS FOR THE
CALIFORNIA HIV POLICY RESEARCH
CENTERS WHICH IS FUNDED BY THE
CALIFORNIA HIV AIDS RESEARCH
PROGRAM IN THE UNIVERSITY OF
CALIFORNIA SYSTEM SO I'VE BEEN
LISTENING TO THE REMARKS AS
THEY'VE BEEN GOING AND I'VE
BEEN JOTTING DOWN THINGS AND
KIND OF RE SHUFFLING WHAT I
WANNA SAY WHICH MAY BE A LITTLE
DANGEROUS AN ACADEMIC OFF
SCRIPT BUT- BUT- IN LISTENING
TO HURT TO THE CONVERSATION AS
IT'S GONE THUS FAR THIS
AFTERNOON- I THINK THERE'S
REALLY. TO KIND OF COMPETING
FORCES THAT SHAPE. WE HAVE TO
THINK ABOUT WHEN WE'RE THINKING
ABOUT STRATEGIES TO RESPOND TO
ENDING THESE EPIDEMICS- ONE OF
THEM THAT IS DEFINITELY. BEEN
PREVALENT IN MANY OF THE
CONVERSATIONS IS THIS ISSUE OF
LAYERS OF VULNERABILITY. RIGHT
I MEAN YOU CAN THINK OF THEM AS
A VENN DIAGRAM OF OVERLAPPING
CIRCLES- BUT- WE AS A GENERAL
RULE WHEN YOU LOOK ACROSS THE
DIFFERENT CONDITIONS AND YOU
LOOK ACROSS WHAT DISPARITIES
LOOK LIKE YOU TRY TO SAY. THE
WHAT'S THE PATTERN AND HOW DO
WE EXPLAIN THE PATTERN. BUT WE
GENERALLY DO BETTER. WHEN WE
ARE TRYING TO HELP SOMEBODY WHO
HAS FEWER LAYERS OF
VULNERABILITY SO IF YOU'RE ONLY
ISSUE. IS THAT YOU ARE AT RISK
FOR HIV AND YOU REALLY DON'T
HAVE OTHER BIG ISSUES THAT YOU
HAVE TO DEAL WITH. WE'RE NOT
PERFECT AT IT BUT WE DO OKAY AT
HELPING THAT PERSON TO REDUCE
RISK BUT IF THAT IF THAT SAME
PERSON NOT ONLY IS AT RISK FOR
HIV BUT IS ALSO AT RISK FOR HCV
AN S. T. D.'S XANDER HOMELESS.
AND THEY MIGHT HAVE A MENTAL
HEALTH CONDITION AND THEY DON'T
KNOW WHERE THEY'RE GOING TO GET
THEIR NEXT MEAL. AND YOU KNOW
THEY HAD ABUSE OR THINGS LIKE
THAT WE- ARE FAR LESS LIKELY TO
BE SUCCESSFUL. RIGHT AND THAT'S
JUST BECAUSE YOU DO HAVE THIS
HIERARCHY OF NEEDS IN THIS KIND
OF THE LAYER. OF ISSUES THAT
THE PERSON HAS TO DEAL WITH.
THEM AND THE IMPLICATIONS OF
THAT WHEN YOU THINK ABOUT A
RESPONSE. IS THAT YOU HAVE TO
BREAK DOWN AND SORT OF CUT
ACROSS HAVE BEEN VERY TO. IN
TERMS OF THE WAY THAT WE STEP
UP OUR SYSTEM IS IN THE WAY
THAT IT'S SET UP SERVICE. RIGHT
SO THERE'S DIVISIONS BY DISEASE.
RIGHT AND PART OF WHAT BROUGHT
US HERE TODAY IS THIS IDEA THAT.
WE WOULD DO BETTER NOT TO JUST
THINK OF HIV AS H. A. B.
SERVICES AN H. C. B. OVER HERE
AND STDS OVER HERE. BUT TO
BRING THEM TOGETHER AND THINK
ABOUT AND- PLAN. BUT WE ALSO
HAVE TO. A HEALTH SERVE. AND
THEN THINGS ARE NOT TREATED
HELD SERVICE SO HOMELESSNESS.
IS A HUGE VULNERABILITY IT'S-
VERY DIFFICULT TO FIND SAN
FRANCISCO FOR EXAMPLE WHERE I
COME FROM RIGHT I MEAN. WE HAVE
ALL THE SUCCESSES SAN FRANCISCO
GETS HERALDED FOR IT'S GETTING
TWO ZERO PLAN AND IT'S ONE
HUNDRED AND NINETY SEVEN NEW
INFECTIONS WHATEVER ELSE AND
THEN YOU FLIP THROUGH THE
ANNUAL. EPIDEMIOLOGY REPORT AND
YOU LOOK AT THE STATISTICS FOR
HOMELESS INDIVIDUALS. AND IT'S
A FAR LESS ROSY PICTURE I MEAN
IT'S ACTUALLY QUITE BLEAK IN
TERMS OF HOW WELL WE'RE DOING.
SO YOU'RE NOT GOING TO SOLVE.
THE PROBLEM. OF YOU KNOW A
PERSON WHO'S HOMELESS IT IS IN
IN CARE YOU'RE NOT GONNA
STRICTLY SOLVE THE PROBLEM BY
THINKING WELL WE'LL JUS HAVE
MORE CARE. WE HAVE TO DEAL WITH
THE ISSUE OF HOMELESSNESS WHICH
IS NOT. IN THE REALM OF HEALTH
CARE SERVICES WE TRADITIONALLY
DEAL WITH THAT. SO WE HAVE TO
THINK ABOUT HOW WE CUT ACROSS
THOSE DIVISIONS AND- AND YOU
KNOW AS AS STAKEHOLDERS WHO
RECEIVE MONEY OF COURSE. WE CAN
TRY TO DO THAT BUT SOME OF THE
BARRIERS ALSO COME FROM FUNDING
STREAMS AND FROM THE WAY THAT.
THE PEOPLE IN YOUR POSITIONS
RIGHT. LONG SET THINGS UP FOR
VERY GOOD REASONS THE WAY WE
STRUCTURE TO THINGS- FROM LONG
AGO IN TERMS OF HOW WE THINK
ABOUT. WHO'S RESPONSIBLE ONE
WHAT SELECT COMMITTEE WHAT WHAT
WHAT FUNDING STREAM WHAT PART
OF THE BUDGET TO SOMETHING COME
THROUGH THESE ARE THESE ARE
ISSUES WE HAVE TO TACKLE TO TRY
TO. TO BREAK DOWN THOSE
BARRIERS. THE COMPETING FOR THE
IS ALSO GOING WE'RE TALKING
ABOUT LAYERS OF OWNER BILLY
SOME TALKING ABOUT LAYERS OF
VULNERABILITY AND ACTUALLY.
ASKING US TO EXPAND WHAT WE
WERE THINKING OF AS AS SERVICES
AND WHAT WE NEED TO DO. THE
COMPETING FORCE IS THIS ONE OF
CAPACITY- IN ITS ANOTHER THING
THAT HAS HAS BEEN REFLECTED IN
THE LOT OF THE COMMENTS THAT
I'VE BEEN LISTENING TO TODAY-
AND- IS THAT IS. IT'S NOT THAT
WE ARE NOT TRYING TO DO THINGS
FOR THE MOST VULNERABLE AND
INDIVIDUALS I DO A LOT OF
RESEARCH IN IN CLINICS- I'M NOT
A CLINICIAN MYSELF SO I COME IN
WITH THIS SORT OF. OUTSIDER
LANDS WHEN I WHEN I DO SO AND
WHENEVER I GO IN THERE IF I
MEAN IF I THINK AS A PROFESSOR
THAT I HAVE A LOT OF DEMANDS ON
MY TIME I LOOK AT WHAT'S
HAPPENING IN THE CLINICS AND
I'M LIKE. I DON'T REALLY HAVE A
LOT TO COMPLAIN ABOUT RIGHT I
MEAN THE SHEER NUMBER OF THINGS
THAT ARE CLINICS HAVE TO DEAL
WITH JUST TO ADMINISTER CARE TO
THE MOST VULNERABLE OF
INDIVIDUALS. IS REALLY QUITE
REMARKABLE I MEAN NOT ONLY ARE
THERE ALL THE ISSUES WITH
INSURANCE THAT YOU HAVE TO
STRAIGHTEN OUT BUT YOU'LL HAVE
THINGS LIKE YOU'RE TRYING TO
REFER PEOPLE TO ALL SORTS OF
SERVICES. THEY IT'S VERY COMMON
TO FIND THAT YOU'RE MOST
VULNERABLE POPULATIONS WILL
HAVE ISSUES OF SOCIAL ISOLATION
SO THEY'RE ACTUALLY LEANING ON
THEIR PROVIDERS TO BE THEIR
SOURCE OF SOCIAL SUPPORT WHICH
IS WELL OUTSIDE THE BOUNDS OF
WHAT WE WOULD TRADITIONALLY
THINK OF AS AS WHAT THE
PROVIDERS RESPONSIBILITY IS. IN
SO AGAINST THAT BACKDROP WERE
NOW SAYING WE'VE GOT ALL THESE
DISH ISSUES WE NEED TO DEAL
WITH AND SO. THERE'S THIS ROOM
OF HOW DO WE HOW DO WE MAKE IT
HAPPEN AND RECOGNIZE THAT WE
ALREADY. IMPOSE A LOT ON OUR
CLINICS. AND WE CAN'T JUST
SIMPLY ASK FOR MORE WITHOUT
THINKING ABOUT HOW DO WE EITHER
BOLSTER. THE HEALTH CARE SYSTEM
ITSELF FOR RESTRUCTURED IN SOME
WAY TO MAKE IT POSSIBLE TO
DELIVER THOSE EXTRA SERVICES SO
THERE'S A QUESTION. EARLIER AS
AN EXAMPLE OF THIS EIGHT THINK-
MEMBER WALDRON YOU ASKED ABOUT
CRAP. SO I'VE BEEN ON A STUDY
IN SAN FRANCISCO THAT'S TRYING
TO DO PREP AND IT'S IN THAT THE
COMMUNITY HEALTH CENTERS THERE
AND- WHAT WE FOUND IS THAT
PROVIDERS IT'S NOT THAT
THEY'RE- DON'T SUPPORT THE
GOAL. IT'S NOT THAT THEY ARE
AFRAID OF HAVING THE
CONVERSATION IT'S THAT THEY ARE
SO BUSY. THAT THEY ARE HAVING
TO DO THE CALCULUS OF IF I IF I
INTRODUCED PREP TO THE PATIENT
IN FRONT OF ME I KNOW HOW TO
FOLLOW UP WITH THAT PATIENT
EVERY FEW MONTHS I HAVE. THIS
ADDITIONAL RESPONSIBILITY THAT
GOES BEYOND KIND OF WHAT MY
NORMAL ROUTINE IS AND IT'S AN
EXTRA SOMETHING SO THE WAY
WE'VE EFFECTIVELY DEALT WITH IT
IS TO PUT PROP COORDINATORS IN
PLACE PEOPLE WHO. ARE OFF
LOADING- SOME OF THAT WORK FOR
THE PROVIDERS SAID THAT THEY'RE
NOT CONCERNED ABOUT ABOUT THESE
KINDS OF. PASSING THE ISSUES-
MORE GENERAL LATER ALSO
QUESTIONS THAT COME UP THEIR
SORT OF INCAPACITY THEY'RE
STILL QUESTIONS THAT COME UP.
CLINICS CONSTANTLY HAVE TO LOOK
AT IN ASK THEMSELVES THE
QUESTION OF WHO. IS PAYING FOR
WHAT. IN AS WE DIVERSIFY THE
KINDS OF SERVICES WERE THINKING
ABOUT NOT EVERY FUNDING STREAM
WILL NECESSARILY FIND. EVERY
KIND SIR AND SO YOU HAVE TO
THINK ABOUT. IS THERE A FIT.
THAT'S GOING TO ALLOW A CLINIC
TO PICK UP IN ADDRESS SOMETHING
LIKE A TYPE OF VULNERABILITY
THAT HASN'T BEEN DEALT WITH
BEFORE AND IS THERE GOING TO BE
A WAY TO PAY FOR IT AND IN THE-
IN THE QUESTION THE ANSWER TO
WHETHER OR NOT THERE WILL BE A
WAY TO PAY FOR IT. IS A TOTALLY
DISSATISFIED IT DEPENDS BECAUSE
IT ALL DEPENDS ON THE SERVICE
AND IT DEPENDS ON THE KINDS OF
A FUNDING STREAMS THAT
PARTICULAR FACILITY HAS
AVAILABLE. FROM ANOTHER ISSUE
BECOMES A WHO IS ABLE TO DO
WHAT- SO SOMETIMES YOU JUST
SIMPLY DON'T HAVE POSITIONS
THAT YOU NEED TO HAVE IN ORDER
TO EXPAND YOUR SERVICES AND
SOMETIMES. THEY'RE ISSUES
AROUND THINGS LIKE LICENSING-
THAT AFFECT WHAT A PERSON CAN
DO. AND THEN THE THIRD THING IN
THIS MAY BE MORE TRUE IN I'VE
SEEN THIS BE MORE TRUE AS A
CONCERN AT THE FEDERAL LEVEL
AND I HAVE HERE AT THE STATE
LEVEL. IS ONE OF TIMELINE SO IF
WE ARE TRYING TO SOLVE THESE
KIND OF. MOST WORK WITH THESE
MOST MOST VULNERABLE OF
PATIENTS. THESE ARE NOT. THE
INTERVENTIONS WERE GOING TO DO
FOR WITH INDIVIDUALS NOT GOING
TO BE ONES THAT ARE GOING TO
HAVE A RAPID TURNAROUND. RIGHT
AND SO AT THE FEDERAL LEVEL
I'VE SEEN THIS THURSDAY LET'S
EXPAND WHAT YOU'RE GONNA DO AND
WILL SHORTEN THE AMOUNT OF TIME
IN WHICH YOU'RE GOING TO DO IT
AND THOSE TRENDS JUST. IT
DOESN'T WORK RIGHT ONE HAS TO
RECOGNIZE THAT THERE IS A KIND
OF LONG RAMP UP PERIOD TO MAKE
THAT WORK. AND SO AS WERE
THINKING ABOUT STRATEGIES DAY
WE DO HAVE TO KEEP IN MIND THIS
TENSION BETWEEN. LAYERS OF
VULNERABILITY MEAN WE HAVE A
KIND OF BIGGER FOCUS ON WHAT WE
NEED TO DO BUT AT THE SAME
TIME. WE ALREADY AVE A VERY
TAXED HEALTHCARE SYSTEM. AND IF
ANYTHING IT'S- GETTING MORE
TAXED BY THE DAY- AND SO
BRINGING THOSE TWO TOGETHER AND
ADDRESSING THOSE TWENTY ISSUES
WHICH SOMETIMES. BUT HEADS. IS
GOING TO BE KEY TO BEING
SUCCESSFUL AND I'LL STOP THERE
SO I DON'T TAKE ALL THE TIME.
THANK YOU VERY MUCH MISTER
STUDENTS GIVE A ROUND APPLAUSE.
YOUR TESTIMONY. HI AFTERNOON MY
NAME IS SHE SHOULD BE I'M A
FAMILY YEAH I KNOW IT'S A
LITTLE HARD TO SAY YOUR SURVEYS
YOUR SHIP IF YOU COULD PUSH THE
MICROPHONE CLOSER TO USE MAKE
UP WITH THAT LETTER IT IS NOT
THANK YOU VERY MUCH. HI I'M
SURE SHOULD BE IT I'M A FAMILY
PHYSICIAN AND I'M A CLINICAL
PROFESSOR UCSF- AS WELL AS A
CLINICIAN AT SOUTHEAST HEALTH
CENTER AND I HAVE TO SAY I LOVE
MY PREP COORDINATOR ACTUALLY
WITH THE BENEFIT OF THAT
PROGRAM- BUT I'M HERE TO TALK
TO YOU TODAY ABOUT MY ROLE IS
THE EXECUTIVE DIRECTOR OF THE
TRANSITIONS CLINIC NETWORK
WHICH IS A NON PROFIT NETWORK
OF A FEDERALLY QUALIFIED HEALTH
CENTERS. ACROSS THE STATE AND
COUNTRY THAT PROVIDE HEALTH
SERVICES FOR PEOPLE WHO ARE
RETURNING FROM INCARCERATION.
SO I AS YOU ALL PROBABLY HAVE
HEARD EARLIER IN THE DAY-
INCARCERATIONS SIGNIFICANTLY
IMPACTS PEOPLE WHO ARE LIVING.
WITH HIV HEPATITIS C. AND
SEXUALLY TRANSMITTED INFECTIONS
I'M NOT GOING TO KIND OF DETAIL
IN YOU KNOW THE OUTLINE OF
COULD WHAT HAPPENS DURING
INCARCERATION I REALLY WANT TO
FOCUS MORE ON. THE TRANSITION.
FROM THE CRIMINAL JUSTICE
SYSTEM BACK TO THE COMMUNITY.
BUT WHAT WE DO KNOW IS THAT-
WHAT PEOPLE ARE INCARCERATED
THEIR IN A VERY HIGHLY
STRUCTURED ENVIRONMENT- IT'S-
OFTEN TIMES EASIER TO GET
THEIR- CHRONIC CONDITIONS UNDER
CONTROL H. A. B. IS A GOOD
EXAMPLE- WE OFTEN SEE PEOPLE.
HAVING REDUCE VIRAL LOADS IN
THE CABLE TO SEE SUSTAIN THOSE
IN THAT ENVIRONMENT. AND IT'S
THAT WHEN PEOPLE ARE THEN
RETURNED TO THE COMMUNITY THAT
OFTENTIMES VERY DIFFICULT TO
SUSTAIN THOSE GAINS THAT PEOPLE
MAY EXPERIENCE DURING
PERSPIRATION IN THE COMMUNITY-
ONE STUDY FOR INSTANCE SHOWED
THAT. OF PEOPLE COMING OUT OF
INCARCERATION- ONLY 30% OF THEM
PICKED UP THE PEOPLE WITH HIV
ONLY 30% OF THEM PICKED UP
THEIR- MEDICATIONS IN THE FIRST
SIXTY DAYS POST RELEASE. I'M IN
A BIG PART OF THIS IS THAT
THERE'S REALLY VERY LITTLE-
CONTINUITY OF CARE FROM THE
CRIMINAL JUSTICE SYSTEM TO THE
PRIMARY HEALTH. SYSTEM THE CROW
JUSTICE SYSTEM IS A PUNITIVE
ENTITY. INTEL RE. THERE WAS
ALMOST NO FUNDING IN PLACE TO
PROVIDE ANY SORT OF DISCHARGED.
SERVICES OF FOR PEOPLE ARE
RETURNING FROM CAR SERRATION
AND AS A RESULT OF WHAT WE SEE
IS THAT PEOPLE ARE. MORE LIKELY
TO DIE GET THE POSED PLEASE. NO
IN ADDITION TO THE CONDITIONS
OF SITTING THERE MORE LIKE TO
BE. SO WE KNOW THAT ONE IN
TWELVE P. THE HOSPITAL IN THE
FIRST NINE DAYS. PROBABLY OF
WHAT ALSO THAT PEOPLE TO. OVER
PARTY OF. DISEASE IS. AND
CONNECTIONS OF CARE FROM THE
INCARCERATED SETTING UP BACK TO
THE COMMUNITY. SO THE WORK THAT
WE DO IN THE TRANSITIONS CLICK
NETWORK IS REALLY- WORKING WITH
THE PRIMARY CARE SYSTEM TO
TRANSFORM WHAT CLINICS DUE TO
BETTER MEET THE NEEDS OF PEOPLE
COMING HOME AND REALLY TRY TO
CLOSE THAT GAP. AND PROVIDE
CONTINUITY OF CARE TO PEOPLE
WHO ARE COMING HOME FROM
INCARCERATION AND- IT'S
UNFORTUNATE THAT MEMBER GIPSON
STEPPED OUT BECAUSE WHAT I WAS
GONNA SAY IS ACTUALLY REALLY
APPRECIATE PEOPLE SHARING.
THEIR PERSONAL STORIES OF HOW
THIS EPIDEMIC HAS IMPACTED THEM
BECAUSE I THINK THAT'S REALLY
WHAT. MOTIVATES PEOPLE TO MAKE
CHANGE AND DO THE WORK AND THAT
WE'VE REALLY. IN OUR WORK WE
REALLY FOCUS ON PEOPLE WHO-
HAVE THAT SHARED EXPERIENCE
THAT LIVED EXPERIENCE OF
INCARCERATION WHO ARE THEN
REALLY MOTIVATED. TO HELP
OTHERS WHO ARE OMING HOME FROM
INCARCERATION WE ALWAYS SAY
THAT THOSE CLOSEST TO THE
PROBLEM ARE CLOSEST TO THE
SOLUTION AND SO. IN OUR MODEL
OF CARE WHEN WE ARE TRYING TO
ENGAGE PEOPLE WHO ARE COMING
OUT OF INCARCERATION. OF ALL OF
OUR CLINICS HIRE AND TRAIN AN
EMPLOYEE COMMUNITY HEALTH
WORKERS WHO HAVE LIVED.
EXPERIENCE OF INCARCERATION-
ONE OF THE THINGS THAT WE DO
WITH THE CLINICS IS THAT WE
WORK WITH THEM ALSO TO
TRANSFORM THEIR CARE TO BETTER
MEET NEEDS OF PEOPLE WHO ARE
COMING HOME SO. I'M I KNOW
YOU'VE HEARD A LOT ABOUT STIGMA
TODAY AND DISCRIMINATION FOR
PEOPLE WHO ARE LIVING. WITH HIV
HEPATITIS C. AND OTHER SEXUALLY
TRANSMITTED INFECTIONS. WHAT WE
KNOW IF THERE WAS ACTUALLY
PEOPLE WHO ARE COMING OUT OF
THE CRIMINAL JUSTICE SYSTEM
ALSO. THIS DISCRIMINATE THERE A
STUDY IN CANADA THAT SHOW P.
WHO HAD. OF AN PART. WERE HALF
LIKELY TO GET UP CARE. CLINIC
CANADA. OF UNIVERSE COVERAGE.
I'M SO THAT WE KNOW THAT IN
HANDS OF HOUSES. PEOPLE ARE
BEING DISCRIMINATED AND SO IT'S
NOT SURPRISING THAT INDIVIDUALS
MAY NOT WANT TO ENGAGE WITH THE
SYSTEM PEOPLE WHO HAVE BEEN
IMPACTED THE- JUSTICE IS.
REALLY TRUST ALSO. OFF BECAUSE
OF IT AFFECTS. THAT THEY HAD IN.
AS KNOW OUR- PRESENCE. ON FOR
FIRST TO OPEN ACTUALLY THE
PATIENT'S AGE IN THE OTHER DAY
YOU KNOW. YOU HAVEN'T. INSTEAD
OF AIMING THE SYSTEM DOES VALUE
YOU AND THEN IT'S VERY HARD TO
VALUE. AND SO WHEN PEOPLE ARE
COMING OUT THIS SORT OF HAVE A
LEARNS NEGATIVE EXPERIENCE
ABOUT ENGAGING WITH HEALTH
SERVICES WITH PRIMARY CARE
PROVIDERS. OF THAT REALLY THEN
COMES INTO PLAY AN ENGAGING AND
SERVICES SO IF WE REALLY WANT
TO. AND THE EPIDEMIC IN ENGAGE
PEOPLE TO CARE WE HAVE TO
TRANSFORM WHAT WE DO WITH THE
PRIMARY CARE SYSTEM. SORRY
CLINICS ALL HIRE AN EMPLOYEE
COMMUNITY HEALTH WORKERS WITH
HISTORIES OF INCARCERATION THEY
DO OUT REACH INTO THE CRIMINAL
JUSTICE SYSTEM TO MEET PEOPLE
PRIOR TO RELEASE- OR MEET THEM
IN THE COMMUNITY THAT GO TO
HOMELESS ENCAMPMENTS.
RESIDENTIAL DRUG TREATMENT
PROGRAMS PROBATION FOR A WEBER
YOU MIGHT FIND PEOPLE WHO ARE
RECENTLY RELEASED. I'M AND THEY
WORK TO BUILD TRUST WITH THOSE
INDIVIDUALS TO MAKE THEM FEEL
COMFORTABLE TO UTILIZE THE
PRIMARY CARE SYSTEM WE ALSO
WORK WITH THE CLINICS TO TRAIN
THEM HOW TO BETTER CARE FOR
PATIENTS TO REDUCE STIGMA. AND
UNDERSTAND THE NEEDS OF PEOPLE
WHO ARE COMING HOME. BUT WE
WERE TO TRANSFORM SYSTEMS I
THINK KIND OF TO YOUR POINT. I
MEAN IF YOU HAVE A FIFTEEN MOST
CLINICS HAVE A FIFTEEN MINUTE
LATE POLICY YOU KNOW YOU SHOW
UP FIFTEEN MINUTES LATE TO YOUR
VISIT AND YOU'RE NOT GOING TO
BE SEEN YOU KNOW YOUR PROVIDER
MAY EVEN HAVE OF. A POLICY LIKE
THAT- BECAUSE THEY'RE GETTING
PAID PER VISIT AND SO THEY
REALLY NEED TO MAXIMIZE THE
NUMBER OF VISITS THAT THEIR
BEINGS YOU KNOW THAT THEY'RE
SEEING. THEY HAVE TO KEEP ON
SCHEDULE- AND SO WHAT WE FIND
IS THAT YOU SHOW UP FOR THE
CLINIC BUT SO YOU'RE MAKE A BIG
EFFORT TO GET THEIR YOUR
RECENTLY RELEASED FROM PRISON
MAYBE DON'T KNOW HOW TO GET
AROUND THE COMMUNITY. OR YOU'RE
RUNNING THE BUSES RUNNING LATE
THEN YOU'RE NOT GOING TO BE
SEEN AND THAT. YOU KNOW THAT
ONE SHOT THAT THE CLINIC HAS TO
ENGAGE YOU REALLY KIND OF GOES
OUT THE WINDOW AND SO WE WORK
CLOSELY WITH THE SYSTEMS TO
UNDERSTAND WHAT THEY'RE DOING
IN IN VIRTUALLY. TO KEEP PEOPLE
FROM WANTING TO ENGAGE WITH
THOSE SYSTEMS. BUT WE ALSO WORK
WITH SYSTEMS TO HELP THEM
ADDRESS MORE BEHAVIORAL HEALTH
ISSUES AS WELL AS MEDICARE IS.
TREATMENT AND ALL THE OF TO TRY.
OF IT MIGHT TO. OKAY YEAH
PROCEEDS. OF THIS IS WHAT OKAY
I IN BED THAT OF FOR TWENTY
FIVE YEARS BUT WE DO APPAREL
DECORATING WHICH IS SCREEN
PRINTING AND MANY PEOPLE LEARN
SCREEN PRINTING IN PRISON SO
BASICALLY EVERYBODY THAT I
HIRED THROUGH ALL THOSE YEARS
WHO HAD EXPERIENCE HAD BEEN
PREVIOUSLY INCARCERATED SO I'VE
BEEN ABLE TO WORK REALLY
CLOSELY WITH THOSE FOLKS AND
TRY TO HELP THEM IN THEIR
TRANSITION BUT THERE'S A LOT OF
BARRIERS WHEN YOU'RE AN
EMPLOYER. TRYING TO HELP THE
PERSON OR GET INFORMATION THAT
YOU CAN POLLS KIND OF IN THE
BACK DOOR. YOU KIND OF SEE
WHAT'S GOING ON YOU CAN ASK
BECAUSE IT'S YOU WANT TO HELP
THEM BUT THERE'S NOT REALLY
AVENUES TO HELP THEM. SO MY
THOUGHT IS I MEAN. AS SOMEONE
WHO HAS SEEN MANY MANY PEOPLE
THROUGH THE YEARS WHO COME IN
REALLY WANTING TO TURN THEIR
LIVES AROUND AND THEN GO DOWN
THE SLIPPERY SLOPE TIME AND
TIME AGAIN BEING HELPLESS
BECAUSE I CAN ASK QUESTIONS I
DON'T KNOW WHO TO ASK OF THOSE
BARRIERS. HOW DO WE BREAK THOSE
BARRIERS SO THAT THIS CAN BE
SOME COMMUNICATION BUT WHO DO I
TALK TO ONE I KNOW THAT YOU
KNOW MY EMPLOYER IF MY EMPLOYEE
IS NOT SHOWING UP TODAY SOME
REASON OR- I MEAN THAT'S IT I
THINK YOU JUST MADE THE CASE
FOR WHY WE NEED COMMUNITY
HEALTH WORKERS WITH HISTORIES
ON CARTRIDGE IN THE CLINIC AND
WHY WE NEED THESE PROGRAMS
BECAUSE WERE TRAINING THE- HOW
DO YOU ASK THREE. NEWS OR PORT
HOW DO YOU PROBATION I'M A
PHYSICIAN NO ONE EVER TAUGHT ME
HOW DO I WORK WITH THE CRIMINAL
JUSTICE SYSTEM RIGHT SO ALL
THESE THINGS ARE THINGS THAT WE
HAVE A LOT. AND WE THE TO DO WE
DO HAVE PEOPLE ARE JUST OUT
PRISON GEORGE ALTHOUGH THAT WE
LOOK FOR PEOPLE WHO BEEN SICK
AS TERMS WHO CAN THAT BE MEN IN
LEAVE THE FOR OTHER OKAY THAT
PIECES SO THAT YOU'VE THE RIGHT
PERSON THAT'S ARE ROLE IS
LOOKING THE- THEY WERE REAL
BUILDING THESE. WITH THE CARE
RIGHT IN THIS BUT IS WHY OF THE
LARGEST GROWING AND- YOU PEOPLE
WERE HAD TO BUY THE CROWD UPPER.
PATIENTS INTO PRIMARY CARE
SERVICES UTILIZING THE
COMMUNITY HEALTH WORKERS AND IN
THAT STUDY WE FOUND THAT
PATIENTS WHO RECEIVE CARE IN
OUR PROGRAMS HAD 51% FEWER
EMERGENCY DEPARTMENT VISITS IN
THE FIRST TWELVE MONTHS POST
RELEASE IN A SUBSEQUENT STUDY
WE FOUND THAT INDIVIDUALS WHO
RECEIVED CARE IN OUR PROGRAM AS
COMPARED TO A PROPENSITY MATCH
PROGRAM I'M IN ANOTHER
JURISDICTION- HAD FEWER
PREVENTABLE HOSPITALIZATION SO
IF YOU'RE A CHRONIC CONDITION
LIKE HIV IF YOU'RE TREATED IN
THE PRIMARY CARE SETTING YOU
CAN PREVENT THOSE
HOSPITALIZATIONS. OUR PROGRAM
WAS SHOWN TO DO THAT AS WELL AS
TO REDUCE CRIMINAL JUSTICE
OUTCOMES SO OUR PATIENTS HAVE
FEWER- OF PAROLE AND PROBATION
VIOLATIONS AND- IF THEY ARE RE
INCARCERATED THEY SPEND TWENTY
FIVE DAYS FEWER IN THE CRIMINAL
JUSTICE SYSTEM WHICH RESULTS AT
SIX THOUSAND DOLLARS PER
PEOPLE. I MEAN PER YEAR EXCUSE
ME PER PERSON PER YEAR AND SO
IF YOU HAVE NINETY PEOPLE IN
ONE CLINIC YOU CITY FIVE
HUNDRED THOUSAND DOLLARS FOR A
YEAR PERIOD OF TIME OTHER
STUDIES HAVE SHOWN YOU KNOW
THERE'S A OF A STUDY- RCTI OUT
OF LA THAT SHOWED THAT-
UTILIZING HEALTH WORKERS WITH
HISTORY YOU KNOW LIVED
EXPERIENCE WORKING WITH PEOPLE
WITH HISTORIES WHEN CHIN ALSO
ROBERT. SUSTAIN IMPROVED OF
VIRAL LOADS OVER THE TWELVE
MONTHS POST RELEASE SO IT'S NOT
JUST OP PROGRAM BUT I THINK IT
REALLY KIND AS I MAY THOSE
CLOSE PROP A THIS SHOULDN'T
CHANGE EXIST TO IT PEOPLE HAD
TO THIS IS A REALLY WHAT IN A
THIS UP I THINK ONE OTHER KEY
POINT IS THAT. WE DID SEE FROM
ONE OF PROGRAM IN COUNTRY
TWENTY SOARED DOWN TO WIN SITES
IN THIRTEEN COUNTIES A CUTS IS
SO IN I'M SORRY IN SANTA CLARA
COUNTY WHAT WE THOUGHT WAS THE
JAIL IS MAKING UP FOR PEOPLE IN
PRIMARY CARE REAL AND ONLY.
PERCENT GOING AND WHEN THE YOU
NEED HOW RECORDS WHEN THE GYM
AND END OF THAT RATE IN A TO OR
SO. THAT'S SO CAN OCCUR I WAS
VERY LOW THAT SHARE OF WAS SIFT
OUT ANY HELP AND BUT- TO BE
ABLE TO INTERFACE WITH PEOPLE.
OR TO RE. ACROSS THE IT'S VERY
THE IT. BRIDGE THE SYSTEMS AND
REALLY MAKE CHIANG ACROSS
SYSTEM WE NEED TO SEE SOME
CHANGES KIND OF MORE TOWARDS A
CONTINUITY OF CARE AND KIND OF
OPENNESS TO WORKING WITH
HEALTHCARE SYSTEMS ACROSS THE
BOARD AND SO WITH THAT THANK
YOU SO MUCH. SURE MISS WALDRON
JUST JUST- ONE OF THE THINGS IN
MY LOCAL JAIL. AROUND IN VISTA.
IN MY DISTRICT- THEY HAVE A
THEY WORK REALLY CLOSE WITH THE
VETERANS THEY HAVE A WHOLE
VETERANS ADMINISTRATION. WING
OF THE JAIL AND- WHAT THEY DO
WHEN THE PEOPLE OF RELEASED IS.
YOU KNOW IF THEY HAVE A
SUBSTANCE USE ISSUE- WHEN THEY
REPORT FOR THEIR PAROLE. VISIT
AT THAT TIME THEY'RE GETTING
THE RIVER TALL. SO ITS ALL TIME
TO SO IN A WAY TO HELP TO KEEP
THEM. ON THE SCHEDULE YEAH I
MEAN IT WORKS BEAUTIFULLY WHEN
THEY'RE ON PAROLE AND THEN WHEN
THEY'RE NOT I'M PAROLE. WHAT
HAPPENS I MEAN WE'RE REALLY
WE'RE IN PRIMARY CARE WERE IN
IT FOR THE LONG HAUL YOU'RE
TALKING ABOUT PEOPLE YOU LIKE
YOU SEE IN YOUR PROGRAM THAT
CYCLE IN AND OUT. YOU HAVE TO
CREATE SYSTEMS THAT. EIGHTEEN
THAT MEANS THAT REALLY BUILDING.
THERE WERE YOU KNOW TREATING
THEM LIKE HUMANS THE RESPECT
NOT FORCING THEM TO YOU KNOW
THAT'S ESSENTIALLY LIKE FORCING
THEM FOR THE TREATMENT SO. IT'S
GOOD FOR THE SHORT TERM BUT I
THINK LONG TERM WE'RE LOOKING
FOR- SOLUTIONS THAT ARE REALLY
GOING TO BE MORE SUSTAINABLE
AND EACH- CLIENTS SERVICES. DOC
SURVEY THANK YOU SO VERY MUCH
JUST GIVE A ROUND OF APPLAUSE
FOR. THANK YOU VERY MUCH. AND
THANK YOU FOR YOUR KIND WORDS I
WAS TOLD WHEN I WAS OUT THE
ROOM THAT JUST TALKED ABOUT MY
STORIES OF THANK YOU VERY MUCH.
BUT AGAIN IT'S IS EXAMPLE THAT
THIS IS NO RESPECT OF PERSON
MAKES NO DIFFERENCE ON WHAT
TITLE YOU MATRICULATED TO- THIS
IS ALL OF OUR FIGHT. AND WE'RE
IN IT TO WIN IT AND SO WITH
THAT- WE HAVE REPRESENTATIVE
MARIO PRESS. THANK YOU CHAIRMAN
GIPSON- GOOD AFTERNOON MY NAME
IS MARIO PETTUS ON THE DIRECTOR
OF THE DIVISION. OF ETERNITY
PROGRAMS FOR THE LA COUNTY
DEPARTMENT OF PUBLIC HEALTH.
IT'S A PLEASURE TO BE HERE WITH
ALL OF YOU- I WANTED TO START
BY SHARING- MY PERSPECTIVE ACT
I'M A PART OF THE SOUTH LA. A
AND I GREW UP DURING THE CRACK
EPIDEMICS IN THE EPIDEMIC THAT
AGAIN VIOLENCE. AND IN MANY
WAYS THAT- INFORM MY WORK-
AROUND HIV AND WAS ON A SOUTH
LA- PORCH THAT I READ- DOCTOR
COOPSMESSAGE TO AMERICA. ABOUT
THE HIV EPIDEMIC. SOMEONE TO
START- BY SHEREEN AT THE COUNTY
LEVEL WERE RESPONSIBLE FOR
TAKING. LOCAL STATE AND FEDERAL
RESOURCES AND PUTTING THEM TO
USE IN A MATTER THAT HAS THE
GREATEST IMPACT AND WE HAVE.
THE UNIQUE PERSPECTIVE OF
WORKING VERY CLOSELY WITH
COMMUNITY BASED ORGANIZATIONS
WHO HAVE BEEN AT- AT THE
FOREFRONT OF THE H. EVERY
RESPONSE- DOMESTICALLY. AND OF
THE LAST THIRTY YEARS AND THEN
WORKING WITHIN- THE
ESTABLISHMENTS AND STRUCTURES
THAT GOVERNMENT HAS PUT IN
PLACE. I THINK ALL THE SPEAKERS
TODAY. HAVE OFFERED- VERY
USEFUL FEEDBACK- ABOUT SOME OF
THOSE STRUCTURES AND SYSTEMS I
WANT TO SHED LIGHT ON SOME
THINGS WERE SEEN AT THE COUNTY
LEVEL. THE FIRST IS- LA COUNTY
IS HOME 226% OF CALIFORNIANS-
AS SOON WITH ME NOW. BUT WE
SHOULDER ABOUT A THIRD OF THE
STATE'S HIV AND STD EPIDEMICS-
CALIFORNIA OUR GEAR GOLDEN
STATE- HAS THE UNFLATTERING
DISTINCTION. OF NOW BEING A
LEADER- IN TERMS OF THE
ABSOLUTE- NUMBER OF CASES- WITH
RESPECT HIV AN INTERNMENT ONLY
WITH STDS. AND IT'S TROUBLING
THAT WE ARE LOSING PROGRESS TO
OTHER PARTS- OF- OTHER PUBLIC
HEALTH RESPONSE ACROSS THE
COUNTRY. AND IT'S SOBERING
THAT. VERY PROGRESS THROUGHOUT.
AND SO- THE FIRST. THE FIRST
OBSERVATION I WANT TO SHARE IS
THAT WE HAVE A SERIOUS CAPACITY
AND INFRASTRUCTURE ISSUE IN
CALIFORNIA WE CAN EXPECT TO
RECEIVE FEDERAL FUNDS TO
FURTHER ENHANCE OUR RESPONSE TO
HIV OVER THE NEXT SEVERAL YEARS
BASED ON THE NATIONAL ANY
EPIDEMIC INITIATIVE. BUT I FEAR
THAT WE DO NOT HAVE THE
INFRASTRUCTURE AND WORKFORCE-
NECESSARY TO MOBILIZE AND
MARSHALL RESOURCES IN A WAY
THAT HAVE THE GREATEST IMPACT
ON A MUCH MORE UP MOTHER FATHER
EARLIER SHED LIGHT ON ON THIS.
WE HAVE GOAL TO DIAGNOSE TREAT
AND PREVENT HIV- BUT WE STILL
HAVE VERY ON EVEN PERFORMANCE
IF YOU'RE PART OF THE RYAN
WHITE SYSTEM IN CALIFORNIA. YOU
HAVE SOME OF THE BEST HEALTH
OUTCOMES IF YOU ARE NOT PART
THE RYAN WHITE SYSTEM YOU HAVE
HEALTH OUTCOMES ARE POOR UP OR
DIAGNOSIS FOR RATES. REALLY
GETS TO CARE RATE. THIS
ENCOURAGED A DOCTOR CAREMARK'S
DOM REFERENCE TO CARE
COORDINATION AS PART OF THE
MEDICAID SYSTEM THAT IS BEEN A
STAPLE IN THE RYAN WHITE SYSTEM
FOR TWO DECADES AND SO I THINK
THAT THERE ARE SOME SOLUTIONS
THERE THAT WE NEED TO
EXTRAPOLATE FROM THE RYAN WHITE
SYSTEM ALL THE OTHER HEALTH
CARE DELIVERY COMES CALIFORNIA
I DARE SAY THAT WE NEED TO GO
THROUGH SOME SERIOUS HEALTH
FROM IN STATE. ARTISTS ARE TOO
MANY WELL WITH UNDIAGNOSED HIV
INFECTION IN CALIFORNIA KERN
AFTER POPULAR TWENTY THOU. IT
IS GETTING HER. PART DIAGNOSED
PEOPLE WITH HIV THERE ARE FAR
TOO MANY PEOPLE IN THE SHADOWS
AND MARGINS AND WE'RE GONNA
MEET STATE POLICY. TO HELP
CHANGE SYSTEMS OF HEALTH CARE
SO THAT WE ROUTE NICE HIV
TESTING. IT'LL HELP- NORMALIZE
IT AND I THINK THAT WILL BE
ABLE TO DIAGNOSE A BIG CHUNK OF
THE TWENTY THOUSAND
CALIFORNIANS LIVING WITH HIV OR
UNDIAGNOSED. AS LONG AS HE
COMPLIMENTED WITH THE STILL
VERY IMPORTANT TARGETED HIV
POSITIVE WOULD HAVE THROUGHOUT
CALIFORNIA. WE ABSOLUTELY NOT.
READY OURSELVES TO GET TO AN
HIV FINISH LINE WHILE WE HAVE
UNACCEPTABLY HIGH LEVELS OF
SYPHILIS AND YOU HEARD A LOT
ABOUT SYPHILIS TODAY. A STILL
ROBUST MATH EPIDEMIC.
HOMELESSNESS THE CONTINUES TO-
OUTPACE- ALL THE SYSTEMS THAT
WE HAVE IN PLACE AND
INCREASINGLY IT CAN'T JUST BE
ABOUT THE HIV EPIDEMIC THEIR
INTERSECTING EPIDEMICS- YOU'LL
HEAR FROM SOME MICHAEL PALACE
REFER TO SEND THAT MAKES THAT
TO BE PART OF THE PACKAGE OF
INTERVENTIONS THERE ARE WE'RE
PUTTING FOR- OTHERWISE WE'RE
NEVER GOING TO MEET THE HIV
WE'RE NOT GONNA GET TO THE- END
OF THE H. M. MAKE FINISH LINE
AND A- ALL THE THING. YES
COUPLE TO BUY PRATT WE HAVE A
AS MANY PEOPLE HAVE SAID ONCE
IN A GENERATION OPPORTUNITY TO
CRIPPLE HIV WE HAVE VERY VERY
UNEVEN PREP- AWARENESS
WILLINGNESS AND ENROLLMENT
PATTERNS THROUGHOUT CALIFORNIA
IF YOU ARE YOUNG LACKEY GAME
MAN IF YOU'RE BLACK LATINO IF
YOU'RE BLACK GAY MAN OR
TRANSGENDER WOMAN. GROUPS WHO
THE HIGHEST RATES OF HIV
SEROCONVERSION ARE AWARE. AND
ENROLLING AT RATES ARE THERE
ANY CONSISTENT WITH WHAT THEY
SHOULD BE AND SO WE NEED TO-
MARSHALL MORE RESOURCES TO
SUPPORT. WHAT I BELIEVE WOULD
BE AN IMPORTANT COMPLEMENT TO
THE PREFACE THIS IS PROBABLY
CALIFORNIA AND HATS OFF TO OUR
STATE LEADERS FOR MAKING CRAP
APP- A FABRIC OF OUR
HEALTHCARE. DELIVERY SYSTEM BUT
WE NEED PREP NAVIGATORS TO MAKE
SURE THAT CRAP ACT THIS HAPPENS.
INCREASINGLY IT'S HARD TO
UNDERSTAND NAVIGATE THE
HEALTHCARE DELIVERY SYSTEM IN
CALIFORNIA WE HAVE A LOT OF
OPTIONS BUT THE COMPLEXITIES
AND WE NEED FOLKS WHO CAN HELP-
SOMEONE GO FROM EIGHT A. B. AND
STAY ENGAGED AND SOME OF
LIFESAVING PREVENTION.
OPPORTUNITIES MISTER OF THAT S.
IF I MAKE THIS WARNING CHIME IN
AND I. I WANNA MAKE SURE
CAPTION SOMETHING HE SAID WHAT
I'M HEARING- AND MY COLLEAGUE
CAN TELL ME IF SHE'S. SAME
THING. WHO SCORED THIS COURT.
UP I DON'T SEE AN NOR DO I HEAR
A CONCERTED EFFORT IN TERMS OF
COORDINATION WITH ALL AGENCIES
EVERYONE IT SEEMS LIKE THEY'RE
DOING THEIR OWN THING IN OUR
OWN SILO BUT THERE'S NO ARCH UP
QUARTER NATION TAKING PLACE SO
THAT WE CAN ONE ADDRESSED THE
GAPS WHEN WE'RE ALL ON THE SAME
PAGE AND COORDINATING AND THIS
THING THAT WE CAN FILL THOSE
GAPS IF YOU POLICY AND OR
FORCES SO MIKE XIN. YOU CAN
ANSWER IT NOW OR WE CAN WALK TO
LATER IS THERE ARE THE NATIVE
EFFORT THAT SHE LED BY THIS IT
IN MY MIND. BRING ALL OF THESE
TO TALK ABOUT HOW DO WE AND I
DO BY ON THE DAY THESE HOLES OR
GAPS IN AREAS THAT SHOULD BE
FILLED- MISTER MALDONADO TALKED
ABOUT- WITH THE EXPERIENCE-
HE'S FACED WITH AND THOSE WHO
LIVE IN IT IN TERMS HAVING TO
TRAVEL SO ARE TO LOS ANGELES TO
RECEIVE THREE. BECAUSE THIS IS
A THEIR GLUTAMIC- OF FACILITY
IN THE AT ARMS SAMPLE DINNER
RIVERSIDE AREA AND SO I DON'T
HERE AND MAYBE I'M GOING DEAF I
NEED A DOCTOR IN A ROOM TO HELP
ME I DON'T HEAR THERE'S A CAN
OF COORDINATION TAKING. MY MIND
MAY. ALL THE BRIEFEST IN A
PANELISTS CHIME IN AND YOU HAVE
A FEW AND ROOM TODAY THEY MIGHT
BE ABLE TO HELP. I THINK THAT
THERE NEEDS TO BE A NO WRONG
DOOR APPROACH TO THE SEND THAT
MAKES THAT WERE SEEN ITSELF
SOMEONE IS MOTIVATED ENOUGH TO
STAY HIV NEGATIVE AND ACCESS
CRAP THAT PREPPING COUNTER TO
THE END OF IT TO MAKE SURE THAT
THERE'S OTHER- ISSUES OR
SERVICE MADE AVAILABLE IF THE
MEDICAID SYSTEM IS PROVIDING
CARE TO THE LARGEST NUMBER OF
HIV POSITIVE CALIFORNIANS
POSSIBLE AND THOSE IN. CAN THEN
MAKE SURE THAT THERE'S TAP SEAT
ARE GREEN AND TREATMENT
OPPORTUNITY AVAILABLE SO WE
COULD FIGURE OUT AS A AS AS
MULTIPLE HEALTHCARE SYSTEM SORT
OF HOW HOW THAT HAPPENS BUT I'M
GONNA I'M GONNA MAKE MY LAST
POINT AND THEN- I THINK THE
COMPOUND THIS WANT TO JUMP AND
FOR THAT. IT'S AN AROUND WHY
ARE SOME OF THESE THINGS
HAPPENING- TRANSPHOBIA
HOMOPHOBIA HIV STIGMA SHAME
MEDICAL MISTRUST ARE ARE ONLY
FIVE OF THE MYRIAD OF THINGS
THEY CONTINUE TO INFLUENCE HOW
PEOPLE ACCESS SYSTEM AND HEALTH
CARE SYSTEMS AND SO WE NEED TO
MAKE SURE THAT THERE'S PRO
CHOICE THAT ADDRESSES AND
CONSIDERS ALL THOSE THINGS I
THINK PREP NAVIGATE. CAN HELP
SOME OF THE THINGS WE NEED MORE
SORT OF NORMALIZATION ACROSS
SOME OF THESE BUT PARTICULARLY
AMONG YOUNG AFRICAN AMERICAN
MAN IN LA DONE WHAT THE YOU
KNOW MAN THOSE ARE STILL THINK
WE OFTEN OUT OF THE- MEDICAL
ENVIRONMENT. IS SIR PACKED THE-
HEALTH CARE AT RATES AMONG AT
THE ALEJO THERE'S NO OF
EXTERNAL FORCES THAT AWFUL
INFLUENCE AT WORK IT'S WHEN A
GROUP CALLED UP VERY QUICKLY
BACK IN A MINUTE THE FOR- TO
THEN SPEAKER. IN CALIFORNIA THE
TWENTY THOUSAND CALIFORNIANS.
IF WE HAVE A POLICY IN
CALIFORNIA THAT FOR THE NEXT
FIVE YEARS ONLY TIME LIMITED.
WE SAY IN THE FIFTEEN TO TWENTY
MOST IMPACTED COUNTIES IN
CALIFORNIA LET'S THAT THE LET'S
ADOPT MANDATORY ROUTINE OPT OUT
HIV TESTING. AND THE OR CARE
SETTINGS I THINK WE CAN GET A
BIG CHUNK OF CALIFORNIANS
DIAGNOSE WE HAVE A MODEL IS
THIRTY YEARS OLD IN THE STATE
WE HAVE ROUTINE OPT OUT HIV
TESTING FOR ALL PREGNANT WOMEN.
AND WE HAVE A WONDERFUL PART OF
SUCCESS BECAUSE THERE'S VERY
VERY FEW CALIFORNIA BABIES BORN
WITH HIV AND SO WE IT'S GONNA
BE COOL HIGHER PURSUIT POSSIBLE
POLICY. GONNA MAKE MORE
PROGRESS IN YEARS. THANK YOU
VERY MUCH I WANT TO FOLLOW UP
ON THAT QUESTION OFF LINE
BECAUSE I WANT TO FIND OUT WHAT
WE NEED TO DO IN ORDER TO BE
THAT BALL. THANK YOU FOR. LET'S
GIVE MR FOR AS A ROUND OF
APPLAUSE AND THANK HIM FOR HIS
TESTIMONY. ALL RIGHT THANK YOU
CHAIRMAN GIPSON AND MEMBER
WALDRON- MEN'S CHRISTIAN RUMORS
OF AN INFECTIOUS DISEASE DOCTOR
AND JUST ADDED- ADDICTION
MEDICINE TONIGHT. SIR BOARD
CERTIFICATION LAST WEEK
ACTUALLY JUST A TESTAMENT TO
THE FACT THAT THESE EPIDEMICS
INTERACT WITH EACH OTHER- I'M
GONNA SCRAMBLE MY COMMENT A
LITTLE BIT LIKE WAYNE. AT THE
RISK OF A COMING INTELLIGENT
BUT I FEEL YOU'VE HEARD OVER
AND OVER THIS AFTERNOON THAT WE
HAVE THIS GREAT SCHOOLS WE HAVE
RULES THAT ARE NEW. NO SEARCH
TOOLS LIKE RAP. DAY V. RULES
YOU. FOR HAVE SEE WE AMAZING TO
WE HAVE TREATMENT THAT IS SO
BETTER THAN IT WAS TO FIVE AGO.
I'M AND IF WE THESE INCREDIBLE
TOOLS WHY ARE WE SEEING THE
HIGHEST RATES OF THESE
DISEASES. THAT WE EVER SEEN Y.
WIRE STDS THE HIGHEST ARE IN
THIRTY YEARS WHY ARE YOUNG
PEOPLE. HAVE A TWO FOLD
INCREASE IN NEW HAVE C.
DIAGNOSES WHY NATIONALLY DO WE
HAVE A 4100% INCREASE IN
HEPATITIS C. INFECTIONS- AND
I'LL TELL YOU A LITTLE BIT
ABOUT. MY BACKGROUND BUT THE
THINK. YEAH SEE IT. HAVE BEEN
MEN. EPIDEMICS THAT WE FACED OF
THE GLOBAL COMMUNITY THAT WHEN
THERE IS A WELL COORDINATED AND
WELL FUNDED RESPONSE WE HAVE
VERY GOOD RESULTS THE RYAN
WHITE CARE MODEL IS ONE OF
THOSE IT'S A COMPREHENSIVE
MODEL WITH MENTAL HEALTH WITH
SUBSTANCE ABUSE WITH HOUSING
ISSUES WITH DRUG ASSISTANCE
WITH INSURANCE THAT DOES GIVE
INCREDIBLE OUTCOMES. PEPFAR
PROGRAM THREE IN AFTER THE
GLOBAL FUND TO FIGHT AIDS TB
AND MALARIA THE SMALL POX
NATION YOU HAVE A WELL
COORDINATED WELL FUNDED REPLY
WE CAN THINGS. THE QUESTION
WHERE IS. THE CO. AMONGST
UPDATE. SENATOR WIENERACTUALLY
JUST WROTE A BILLS SB EIGHT
FIFTY NINE WHICH ARTICULATES.
THIS COORDINATED RESPONSE THAT
I THINK WE NEED- IN IN OUR OUR
STATE. LET ME GIVE A LITTLE
MORE BACKGROUND ABOUT WHAT'S
GOING ON IN SAN DIEGO I COME
FROM TODD GLORIA TERRITORY-
DOWN IN SAN DIEGO AND- I WORK
AT A FQHC NETWORK CALLED THE
FOR THE FAMILY HEALTH CENTERS
OF SAN DIEGO. OF A CLINICAL
POINT MINUTE UC SAN DIEGO
SCHOOL AND ON THE CO CHAIR OF
THE AMERICAN CARRY BASS HEAVY
MEDICINE A CALIFORNIA CHAPTER
WHICH REPRESENTS OVER SIX
HUNDRED HIV PROVIDERS- WHO WE
HAVE MAJOR WORK WORKFORCE
ISSUES WITH HIV PROVIDRS IN
CALIFORNIA. AND THEN I HAVE A
GLOBAL HEALTH WORKSTREAM AS
WELL I WORK FOR THE CLINTON
HEALTH ACCESS INITIATIVE. ON%
HEPATITIS C. ELIMINATION-
PROGRAMS IN SEVEN COUNTRIES IN
ASIA AND AFRICA. MANY OF WHICH
HAVE MUCH LOWER SPENDING ON
HEPATITIS ELIMINATION AND YET
ARE DOING A MUCH BETTER JOB
THAN WE ARE BECAUSE THEY ARE
COORDINATED I WANT TO WALK
THROUGH- AND I ALSO COACH OR
THE- AND HAVE SEE SAN DIEGO
LIMITATION INITIATIVE IN OUR
COUNTY. TO TRY TO ELIMINATE-
HEPATITIS C. ONE WALK THROUGH
THE CASCADE OF HEPATITIS C.
CARE AND JUST TALK ABOUT SOME
SOLUTIONS I THINK TO BE PRETTY
PRETTY SIMPLE. AND THE CASKET
OF CARE FOR NOT FAMILIAR WITH
IT IS WALKING FROM. THE
ABSOLUTE NUMBER OF CASES THAT
WE THINK ARE THERE. TO THOSE
THAT HAVE BEEN DIAGNOSED TO
THOSE THAT HAVE BEEN LINKED TO
CARE TO THOSE HAVE BEEN OFFERED
TREATMENT TO THOSE THAT ARE
KEYBOARD IT'S A PRETTY SIMPLE.
AND STRAIGHT FORWARD. ATTACKS
THAT WE ALL HAVE. TURN TO THE
NUMBER OF HEPATITIS C. CASES
YOU'VE HEARD THAT WE HAVE
ALMOST A HALF A MILLION CASES
OF PEPSI. IN CALIFORNIA. AND
YOU KNOW IT'S I TREAT HIV I
TREAT STDS AS WELL AND IN HIV
WE KNOW THAT THERE'S PROBABLY
15% OF PEOPLE HIV THAT ARE NOT
DIAGNOSED WE HAVE HALF OF
PEOPLE HEPATITIS C. THEY'RE NOT
DIAGNOSED. WHY IS THAT WELL
IT'S BECAUSE PEOPLE HAVE SEE
DON'T ALWAYS PRESENT THEMSELVES
TO CARE AND SAY LIKE I ANT TO
ENGAGE IN CARE AND I WANT MY
HEPATITIS C. TEST. IT IT'S A
POPULATION THAT IT THAT TEND TO
BE MORE DIFFICULT TO ENGAGE
WHERE YOU HAVE TO GO OUT AND
REACH THEM PERHAPS AT A SYRINGE
EXCHANGE. PERHAPS AT A AT A
PRISON OR JAIL. PERHAPS IN A
METHADONE CLINIC- PERHAPS OUT
IN THE COMMUNITY. MY
ORGANIZATION WAS FORTUNATE TO
BE. A PART. AND FROM THE FROM
THE POINT A PART OF PUBLIC
HEALTH TO GO OUT AND ENGAGE
PEOPLE ACTIVELY INJECTING
DRUGS. AND TEST THEM PERHAPS
LEAD TO SEE AND LINK THEM TO
CARE AND GET THEM TREATED AND
THERE'S AN AMAZING THING THAT
HAPPENS WHEN YOU DO THAT. THESE
ARE PEOPLE THAT TYPICALLY
YOU'VE HEARD A LOT FROM THE
SPEAKERS TODAY TYPICALLY HAVE
NOT ENGAGED IN THE TRADITIONAL
HEALTHCARE SYSTEM. THEY SEE
SOME OF THE WHITE COAT LIKE
THIS AND THEY RUN AWAY. BECAUSE
THEY ACTUALLY OF TRAUMA FROM
INTERACTING WITH PEOPLE THAT
HAVE STIGMATIZE THEM. AND TALK
DOWN TO THEM AND NOT REALLY
TREATED THEM LIKE HUMAN BEINGS.
BUT IF YOU PUT YOUR HAND OUT
YOU SAY- YOU KNOW WE CAN GIVE
YOU INSURANCE IN THE STATE OF
CALIFORNIA. WE CAN GIVE YOU
MEDICAID. WE CAN DO IT HAVE SEE
TESTING WE CAN ACTUALLY. DO
SOMETHING ABOUT TAT IF YOU
JUST COME AND JOIN US. AND YOU
GAVE SOMEONE LIKE THAT AND LIKE
MARIO SAID IT'S- A NO WRONG
DOORS APPROACH YOU COME IN. AND
GET A H. AT HALFTIME SEAT.
THAT'S POSITIVE- YOUR ALSO
PUTTING HER ONE. LET'S GIVE YOU
THOSE SERVICES TO. AND I SEEN
TIME AND TIME AGAIN. OWN
PRACTICE OF. BEEN CURED OVER
FIFTEEN HUNDRED PEOPLE. OF
HEPATITIS C. IN OUR CLINIC.
THAT YOU BRING THEM IN THE DOOR
THROUGH A METHADONE CLINIC
THEY'RE NOT REACH PROGRAM
THROUGH SYRINGE EXCHANGE
THROUGH- PER. ENGAGING WITH
OFFICERS AND YOU GET PEPSI
TREATED AND CURED AND THEN THEY
ENGAGE IN PRIMARY CARE. AND
THEY WANT TO QUIT SMOKING. AND
I WANT TO TAKE CARE THE
HYPERTENSION. AND ONE TICKET
THAT I BUSINESS ISN'T THAT WHAT
THIS IS REALLY ALL ABOUT. IS
NOT PROVIDING SINGLE VERTICAL
EYES PROGRAM SO WE CAN. GOOD
NUMBERS UP FOR HIV PROGRAMMER
GOOD NUMBERS THAT PERHAPS THE
PROGRAM. WE WANT HAVE HEALTHIER
CALIFORNIANS ARE MORE ENGAGED
IN THEIR CARE. SO YOU MAY NOT
BE AWARE THAT THE CITIES IN THE
US PREVENTIVE SERVICES TASK
FORCE THE AMERICAN ASSOCIATION
FOR THE STUDY OF LIVER DISEASES
IN THE IDSA HAVE ALL NOW
ALIGNED. AND RECOMMENDED
UNIVERSAL OPT OUT ADULT
HEPATITIS C. TESTING. THERE
THERE WAS AN OPEN COMMENT
PERIOD FOR U. S. P. S. T. AFTER
GOTTA BE. RECOMMENDATION THE
DRAFT FORM- BUT SO WE NEED TO
BE TESTING A WHOLE LOT MORE AND
MAYBE THAT'LL HELP. WITH
GETTING THIS 50% OF PEOPLE THAT
ARE NOT DIAGNOSED IN THROUGH
THE DOOR- WE ALSO NEED TO TEST
ON AN ANNUAL BASIS FOR THAT THE
HIGHER RISK. AND WE NEED TO
TEST NONTRADITIONAL SETTINGS
NOT JUST IN CLINICS ARE NOT
GONNA WALK UP AND KNOCK ON
YOUR- DOOR. GOT TO GET OUT AT
THIS EXCHANGES. OUT THE-
IMPROVEMENTS. OUT IN THE STREET.
I'M THERE ARE TWO TO TEST WANT
ONE OF THE MOST ALL PLACES GO
AND TEST FOR HEPATITIS DRUG
ALCOHOL CENTER RIGHT MAKES
SENSE WE HAVE RAPID YOU JUST DO
A LITTLE FINGER **** OF BLOOD
TWENTY MINUTES YOU HAVE A
POSITIVE RESULT KILLING
SOMEBODY- THEIR REGULATIONS IN
PLACE TO DON'T REALLY ALLOW
TESTING AND SOME OF THE THINGS
BECAUSE IT'S A IT'S A BLOOD
TEST. INTERESTED LIPSTICK CARE.
WHAT WE'VE BEEN ABLE TO DO IN
OUR SETTING IS I HAVE A ARMY OF
ELEVEN PEOPLE THAT ARE TREATING
HAVE SEE IT'S NOT JUST ME. IT'S
NURSE PRACTITIONERS AND
PHYSICIAN ASSISTANTS AND FAMILY
PRACTITIONERS AND DO IS AN MD
IS. ABLE TO TREAT A WHOLE LOT
MORE THAN JUST ME MYSELF. AND
JUST WITH A LITTLE BIT OF
SUPPORT PRIMARY CARE FOLKS CAN
TREAT HEPATITIS C. PRIMARY CARE
FOLKS CAN DO PREP. PRIMARY CARE
FOLKS WITH A LITTLE MORE
SUPPORT CAN TO HIV CARE AND WE
NEED A LOT OF. EMPHASIS IN IN
WORKFORCE DEVELOPMENT. I SAW
THAT- JOHN LEWIS IN GEORGIA
INTRODUCED A OF FEDERAL BILL
OFFERING. HONOR PAYMENT. TO GO
OUT HIV OF. SOPHIE SURVIVE
WAITING. PEOPLE INTO HIV WHEN
THEY COME OUT OF MEDICAL SCHOOL
OF CRUSHING. STUDENT LOAN DEBT.
MOVING ON TO TREATMENT THE
TREATMENT PART OF HEPATITIS C.
MARK IN THE MEDICAL PROGRAM HAS
GOTTEN A WHOLE LOT EASIER THAN
IT IS IN OTHER STATES. LAST
TIME I WAS IN SACRAMENTO WE
WERE FIGHTING. ABOUT THE RULES
TO GETHAVE SEE TREATMENT WHICH
REQUIRE THAT YOU BE SOBER FOR
SIX MONTHS. THAT YOU ONLY SEE A
SPECIALIST AND THAT YOU HAVE
NEAR SNEER SERVICES IN YOUR
LIVER. WE GOT THAT WAS REMOVED.
WE'RE ONE OF THE LEADERS. THANK
GOODNESS- TO THE MAP OUT
PROGRAM. THANK YOU KAREN KAREN
MARK BY THE WAY WAS MY
ATTENDING PHYSICIAN IN MY
FELLOWSHIP. AT THE UNIVERSITY
OF WASHINGTON SO IT'S GOOD TO
SEE YOU AGAIN. BUT I ALSO HEARD
HER SAY THAT IT. CITY HIV
MEDICINES DON'T HAVE PRIOR
AUTHORIZATIONS. YOU KNOW HOW
MUCH EASIER MY LIFE WOULD BE A
PEPSI MEDICINE TO NOT A PRIOR
AUTHORIZATIONS. I HAVE A FULL
TIME EMPLOYED NURSE IN MY
CLINIC THAT HER ONLY JOB IS TO
HANDLE PRIOR AUTHORIZATION. IT
IS AN INCREDIBLE BURDEN OF
PAPERWORK I JUST TO GET
SOMEBODY TREATED INVOLVES EXTRA
TIME EXTRA BLOOD TESTS THAT
AREN'T REALLY. NECESSARY WE
JUST NEED TO STREAMLINE THE
PROCESS IT'S NOT ROCKET SCIENCE
TO GET THESE PEOPLE TREATED. I
THOUGHT I SHOULD BRING THIS UP
NOW BECAUSE WITH THE
MEDICATIONS THE ISSUE OF COST
ALWAYS COMES UP. AND THAT'S
BECAUSE WHEN THEY FIRST CAME
OUT. THE MEDICINES WERE VERY
HIGHLY PRIZED. THEY WERE HIGHLY
PRIZED BECAUSE THE PRIOR
TREATMENT WAS A YEAR LONG.
REQUIRED OFTEN HOSPITALIZATIONS
BLOOD TEST AND ONLY AT A 40%
CURE RATE. AND NEARLY KILLED
SOME OF THE PEOPLE ARE TREATED
WITH THE OLD INTERFERON
TREATMENT SO THE INNOVATION TO
TAKE A PILL FOR JUST THREE
MONTHS. HAD A BIG PRICE TAG ON
IT. THERE WAS SOMETHING CALLED
THE INSTITUTE FOR CLINICAL AND
ECONOMIC REVIEW THAT WAS
CONVENED- AND THE CALIFORNIA
TECHNOLOGY ASSESSMENT FORM TOLD
STUDY THIS ISSUE AND SAY WHY
ARE THEY SO EXPENSIVE AND WHAT
IS THE COST EFFECTIVENESS
THRESHOLD. TO GET THESE HAVE
SEE TREATMENTS DOWN TO WHERE
IT'S REASONABLE. IN THE LINE
THAT THAT COMMISSION CAME UP
WITH A SPONSORED BY THE
INSURANCE INDUSTRY WAS FORTY
THOUSAND DOLLARS PER. DOOR TO
MAKE IT A QUOTE UNQUOTE HIGH
VALUE INTERVENTION FOR THE
HEALTH SYSTEMS. THESE
TREATMENTS ARE NOW FIFTEEN
THOUSAND DOLLARS. PER WAY UNDER
THE COST EFFECTIVENESS CURE IN
YET WE STILL HAVE SOME
RESTRICTIONS ON ACCESSING THESE
THERAPIES. IT IS A LOT MORE
EXPENSIVE TO DO A LIVER
TRANSPLANT. OR TO TAKE CARE OF
SOME WITH THE ROSES IS NOT
IT'LL FOUR FIVE TIMES A YEAR.
THEN IT IS TO DEBT TO TREAT
SOMEBODY BEFORE THEY GET THERE.
FINALLY I THINK WE'VE DONE A
GOOD JOB OF SIMPLIFYING. THE
TREATMENT ALGORITHMS FOR
SOMEBODY THAT DOESN'T HAVE
SEVERE LIVER DAMAGE IT'S REALLY
PRETTY STRAIGHT FORWARD TO GET
A MANY GIVEN PILLS FOR THREE
MONTHS THEY GET CURED AT A 95%
RATE. IN PRIMARY CARE FOLKS CAN
BE DOING THAT WE JUST. WE JUST
HAVE THE TOOLS WE JUST NEED TO
DO IT. I'M GONNA FINISH TALKING
ABOUT. PREVENTION OF PEPSI-
BECAUSE IN SAN DIEGO THIS IS
ACTUALLY IN OUR- AND HAVE SEE
SAN DIEGO ONE OF THE MAJOR.
BARRIERS I THINK TO REACHING
ELIMINATION OF HEPATITIS C. WE
ARE NOT GONNA BE ABLE TO I
COULD HAVE. THIRTY FORTY FIFTY
PEOPLE. TREATING HAVE SEE WE'RE
NOT GONNA AND THE EPIDEMIC
BECAUSE WE'RE NOT PREVENTING
NEW INFECTIONS. AND THERE'S A
SIMPLE. SCIENTIFICALLY PROVEN
EVIDENCE BASED INTERVENTION
CALLED SYRINGE EXCHANGE. THAT
CAN ACTUALLY ENGAGE PEOPLE NOT
ENGAGE IN HEALTH CARE CAN
PREVENT HIV AND HEPATITIS C.
TRANSMISSION AND CAN GIVE THEM
OF. MUCH NEEDED OFFRAMP. FROM
THE THROES OF ADDICTION THAT
THEY ARE. ENGAGED IN- I'M A
SUBOXONE PRESCRIBER I USED YOU
CAN OFTEN FOR PEOPLE TO PUT USE
DISORDER AND MOST OF MY
PATIENTS. THAT COME AND GET ON
THE PHONE OR BEEN REALLY DON'T
LIKE USING DRUGS. THE USE IT'S
JUST PREVENT THE FEELING THAT
THEY HAVE WHEN THEY'RE
WITHDRAWING LIKE THEY'RE GONNA
DIE. EVERY EIGHT TO TWELVE
HOURS. THEY DON'T GET ANY HIGH
OFTEN ANYMORE MAYBE THEY DID
WAY BACK. BEGINNING BUT THIS
IDEA SYRINGE EXCHANGES IS GOING
TO MAKE PEOPLE USE MORE DRUGS.
IT'S LIKE BIRTH CONTROL PILLS
TO MAKE PEOPLE HAPPY. SEC AND
I'M- PEOPLE SEARCH FOR SOME.
PLAN TO RE. DRUG USE. EVEN
POPULATIONS NEED TO BE. TO
OFFER. IN PLACES WHERE YOU'RE
KNOCKING TO REACH THOSE. AND
ANY OTHER WAYS- AND WE STILL
RUN INTO BARRIERS IN IN SAN
DIEGO COUNTY ACTUALLY WHERE
IT'S OFFICIALLY STILL LEGAL TO
YOU TO DO SIR INTERCHANGES.
IT'S A GREAT. SERVE NO WRONG
DOOR APPROACH WITH THE GATES
PEOPLE AT THE METHADONE CLINICS
AT THE SYRINGE EXCHANGES FOR
TESTING. GET THEM IN THE DOOR
AND WE CAN TAKE BETTER CARE OF
THEM. SO I'M JUST GONNA CLOSE
BY SAYING THAT- IT'S JUST LIKE
THE AGONY AND THE ECSTASY OF
THIS WHOLE AFTERNOON. IT'S
AGONIZING TO HEAR THESE NUMBERS
THAT- THAT THERE'S SO MANY NEW
INFECTIONS. AND YET IT MAKES ME
ECSTATIC TO THINK OF HOW CLOSE
WE ARE AND HOW MANY TOOLS WE
HAVE. TO END THE EPIDEMIC EIGHT
WHETHER BE HIV ARE CITIES OR
HEPATITIS C. I KIND OF MISSED
OUT ON THE WHOLE CHANGING IT
EVERY FROM A DEATH SENTENCE TO.
A COMMAND PRODUCT OF THESE I
WAS IN HIGH SCHOOL AT THE TIME.
BUT RIGHT NOW WE'RE AT THE
PLACE WERE IN ANDY CHEVY. WE
CAN TURN HEPATITIS C. TALKING
IF KILLING MORE PEOPLE ANY
OTHER INFECTIOUS DISEASE IN OUR
COUNTRY. TO SOMETHING THAT'S
MANAGEABLE EVEN HAVING THAT'S
ELIMINATED. SO GOT THIS
OPPORTUNITY RIVER FRONT OF US I
JUST HOPE WE TAKE ACTION THANK
YOU. THANK YOU VERY MUCH. NECKS
NAME HELLO MY NAME IS AMY MORAN
I AM CHIEF EXTERNAL AFFAIRS
OFFICER AT ESSENTIAL ACCESS
HEALTH AND WE CHAMPION AND
PROMOTE QUALITY SEXUAL AND
REPRODUCTIVE HEALTH CARE FOR
ALL IN CALIFORNIA AND BEYOND TO
A BROAD RANGE OF PROGRAMS AND
SERVICES BUT I'LL FOCUS TODAY
ON OUR WORK AROUND S. T. D.
PREVENTION WE HAVE AN STD
PREVENTION CENTER AND WE WORK
VERY CLOSELY WITH THE COW AND
DD TROWBRIDGE LA IT. THE PUBLIC
HEALTH CARE CAN BE IS PROVIDERS
AND- THE FRONT MIGHT EVERY DAY
TO AND THAT. OF A- H. C. VI N.
S. T. D.'S. AND SO HAVE THE- OF
BEING THE FINAL PANELIST AFTER
A VERY USEFUL AND INFORMATIVE
AFTERNOON. AND I HOPE THAT
TOGETHER WE HAVE PAINTED A
PRETTY COMPREHENSIVE PICTURE
THAT WE HAVE A SERIOUS PUBLIC
HEALTH CRISIS BUT WE ALSO. HAVE
SOLUTIONS AVAILABLE- AND SO I'D
GET THE FUN PART A LITTLE BIT
TO WRAP IT UP AND SHARE SOME
ADDITIONAL STRATEGIES OF WHAT I
THINK WE CAN DO AT THE STATE
LEVEL AND WHAT WE MUST DO TO
HELP AB IT. AND WE HOPE WE'VE
WAITED A SENSE OF. URGENCY FOR
YOU ALL TO CONTINUE OUR
LEADERSHIP AND INTEREST AND
ATTENTION ON THIS ISSUE AND I
WANNA I'M ALSO ECHO- THANKS TO
THE CHAIR FOR SHARING YOUR
PERSONAL COMMITMENT AND
CONNECTION TO THE H. SO THAT
YOU CAN HELP RATE IN AS ABOUT
THE NEED ACT. HEREAMONG YOUR
COLLEAGUES I'M- SO. I AM WILL
SHARE AS AN ADDITIONAL
STRATEGIES THAT- THE AND THE
EPIDEMICS COALITION HAS COME UP
WITH- THAT SHOWING THAT HOW
THROUGH SIGNIFICANT INVESTMENT
OF STATE RESOURCES AND
ENACTMENT OF SOUND PUBLIC
HEALTH POLICIES. WE CAN AND
MUST TO START MOVING THE NEEDLE
IN THE RIGHT DIRECTION AROUND
THESE EPIDEMICS. SO FIRST
AROUND BUDGET ALLOCATIONS- WE
HAVE AS A COALITION A PACKAGE
THAT- CALLS FOR AN INVESTMENT
OF AROUND FIFTY MILLION
DOLLARS. TO DO AND THAT
HAPPENED MIX AND TO BREAK IT
DOWN A LITTLE BIT SEE YOU CAN
SEE WHERE THE KIND OF HOW THE
NUMBERS ADD UP TO IMPACT. WE
ARE CALLING AND I'M THANK YOU
FOR THAT IT'S VERY NICE
SOFTBALL THAT YOU LAID OUT
EARLIER- CHURCH MEN- WE ARE
CALLING FOR A STATE MASTER PLAN
TO NAB DE MAKES BECAUSE- I'M I
DON'T KNOW IF I NEED TO GET MY
EARS TO. TO BUT I HAVEN'T HEARD
OF A MASTER COMPREHENSIVE PLAN
TO AND THAT THAT THAT MAKES ON
THE STATE LEVEL AND IT'S TIME
THAT WE DO THAT WE HAVE
WONDERFUL PROGRAMS AS WE'VE
HEARD THAT ARE WORKING
INDIVIDUALLY. WE HAVE WONDERFUL.
I'M OPPORTUNITY NOW WE JUST
HAVE TO ENSURE THAT ALL
TOGETHER RULES. CALLER DOLLARS
TO HELP. THE DAY. THAT PLAN.
AND MASS. ALSO CALLING FOR
FIFTEEN MILLION DOLLARS IN
SUPPORT FOR HIV PREVENTION
ACTIVITIES FIFTEEN MILLION FOR
H. C. V. PREVENTION ACTIVITIES-
AN ADDITIONAL THREE MILLION
DOLLARS TO SUPPORT LOCAL HEALTH
JURISDICTIONS TO BE ABLE TO-
INCREASE. LOCAL INFRASTRUCTURE
TO BE ABLE TO CONDUCT- AN- STD
PREVENTION ACTIVITIES AND WE'RE
ALSO CALLING TO KIND OF CLOSE
TO COVERAGE. DOUGHNUT HOLE
RIGHT NOW FOR AS TD SERVICES
FOR UNINSURED FOLKS WHO
CURRENTLY DON'T HAVE A PATHWAY
TO GET AS TV SERVICES- FOLKS
RIGHT NOW R NOT AT RISK FOR
CAUSING EXPERIENCING AN
UNINTENDED PREGNANCY. AND WHO
ARE LOW INCOME AN UNINSURED
CURRENTLY DON'T HAVE A DIRECT
GATE WITH BE GETTING. NO COST
STD SERVICE. BUT WE HAVE A
PROGRAM RIGHT NOW CALLED THE
FAMILY PACK PROGRAM THAT
PROVIDES FAILED PLANNING LATE
TO. IN A TO IS AS FOR WHEN ON
HEARD FOR. RIGHT NOW SERVICE
HAVE TO BE PROVIDED WITH AN
CONTACT TO THE FAMILY PLANNING
VISIT AND RATHER THAN WELL WE
WERE. NEXT AND ARE
COMPREHENSIVE ACCESS TO HEALTH
CARE THROUGH THE MEDICAL PROBE
FOR IT IT JUST MAKES TO CREATE
A WHOLE NEW. PROGRAM WE ALREADY
HAVE A PROVIDE NETWORK IN A PRO
IN PLACE WE WANT TO. EXIST
FAMILY PRO TO MOVE MORE IN CARE.
AND WE'RE CALLING FOR TO
DOLLARS TO HELP FUND TO THE
GENERAL FUND. THE PLAN. TO BE
ABLE TO MOVE THAT PH IN
ADDITION WE HAVE AND CONNECTED
TO THAT SB EIGHT EIGHT FIVE
AUTHORED BY SENATOR PAN WOULD
CALL FOR THAT EXPANSION OF THE
FAMILY PACK PROGRAM FOR A-
SHORT BOOKS TO ACCESS STDS
SERVICES. ALSO FIVE INDIVIDUALS
MEDI CAL MANAGED CARE PLANS GO
OUT OF NETWORK AND HAVE FREEDOM
OF CHOICE FROM A TRUCK PROVIDER
AS- SAYS. AND TO ENSURE THAT
THOSE ON. AND WILLING TO OBTAIN
SERVICES. DIRECTLY AT A HEALTH
CENTER CAN ACCESS AN EVIDENCE
BASED INTERVENTION CALLED
EXPEDITED PARTNER. SO IF
SOMEBODY COMES INTO A CLINIC
AND HAVE. OF A POSITIVE TEST
THE TASK IF THEY HAVE A THAT.
ON WILL BE AROUND ABLE TO GO TO
A CENTER FOR THEM SO. THEY
BRING HOME TO. TO WE WANT TO BE
ABLE TO INCREASE A DA
UTILIZATION OF EVIDENCE BASED.
SERVICE IN ADDITION A NINE SIX
FIVE AUTHORED BY ASSEMBLY ID
CURRY WILL REDUCE H. IN. AND
RISK FOR LIFE THE CAN. BY MARK
THE FAMILY PACK PROGRAM TO
COVER THE H. P. V. VACCINATION
WHICH IT CURRENTLY DOES NOT BUT
IT DOES HAVE OTHER STD
PREVENTION HPV TESTING SO IT'S
ALIGNED WITH THE PROGRAM'S
INTENT. IN ADDITION- AUTHORED
BY SENATOR WIENER IS SB NINE
THIRTY TWO WHICH WOULD ALLOW
COUNSELORS THAT ARE HIV COUNTS
TO ADMINISTER RAPPER AS T. BUT
AS TI TESTING. THESE COUNSELORS
ARE ALREADY RAP H. C. TAG AND
ADDING AS TV TO WITH THEM A ONE
STOP SHOP IN A- ACCESS. I'M I
ALSO WANT TO NOTE AND THAT THE
COUNTIES HAVE ALSO ASKED FOR
ADDITIONAL FUNDING TO HELP-
FIND NAVIGATORS TO HALT- AND
ADDRESS REINFECTION SO- WERE
SUPPORTIVE OF THAT AS WELL. SO
BY TAKING ACTION ON THESE
BUDGET AND POLICY PRIORITIES
AND SOME OF THE OTHER
STRATEGIES THAT WERE- MENTIONED
INCLUDING CREATING A STATE
MASTER PLAN THAT INTEGRATES THE
RESPONSE- TO ALL THREE
EPIDEMICS CALIFORNIA CAN GET
BACK ON THE RIGHT TRACK OF. OF
LEADING THE WAY AND YOU KNOW AS
WE'VE HEARD TODAY AND I THINK
WE'VE HOPEFULLY WE'VE- REALLY A
HIGHLIGHTED UNDERSCORE THE
MESSAGE THAT LAW OLD ACTION TO
ADDRESS THESE EPIDEMICS IS LONG
OVERDUE AND WE'RE LOOKING
FORWARD TO TOGETHER- MAKING
SURE THAT WE CAN AND THAT WE
WILL ADDRESS THESE EPIDEMICS
AND MAKE SURE THAT FOLKS GET
THE TREATMENT. AND INFORMATION
THEY NEED TO- TO IMPROVE HEALTH
FOR ALL IN CALIFORNIA. THANK
YOU VERY VERY MUCH LESS GIVE
MEMORIAL AROUND APPLAUSE AND
THANK HER. WHAT OF PROVIDING
GREAT INFORMATION SO AT THIS
POINT TIME I WOULD ASK MY
COLLEAGUES SHE HAS ANY
QUESTIONS TO ADDRESS TO THIS
PAD OR PREVIOUS PANELS WHO ARE
STILL WITH USIN THE AUDIENCE
AND THEN I WILL ASK A QUESTION
THEY WOULD OPEN UP A PUBLIC
COMMENTS SO AS YOU ARE THE
THING ABOUT YOUR- QUESTION. THE
GLAD YOU CAN PHONE IN THIS.
THIS BECAUSE ME AFTER WE FINISH
MAKE IT AND A ASKING OF THE
PANEL WITH THAT WAS WHAT
SOMETHING. THANK YOU IT'S BEEN
IN. AND WHAT PART OF MY JUST IS
IN THE A AND I WAS MENTION TO
THE CHIU. THAT A CUP YEARS AGO
I HAD A- THAT. SEND UP PRIOR
AUTHORIZATION FOR SEVERAL
DIFFERENT- THIS. ALL RIGHT IN
BECAUSE OF BECAUSE SO I WAS
JUST SAYING THAT I WAS LOOKING
AT- POSSIBLY REINTRODUCING THAT
AGAIN YOU KNOW IN LIGHT OF THE
NEW GOVERNOR AND OTHER THINGS
THAT MIGHT BE HELPFUL BUT-
THERE'S JUST SO MUCH THAT'S
IMPORTANT I THINK THE THING
THAT'S COME OUT CLEARLY IS THE
FACT THAT WE NEED TO WORK IN A
BIPARTISAN MANNER TO GET- THE
FUNDING AVAILABLE IN THE
COORDINATION WITH THE FRAMEWORK
PUT TOGETHER BECAUSE THE TOOLS
ARE THERE THE PEOPLE THERE THAT
YOU KNOW. WE HAVE A LOT MORE
KNOWLEDGE THAN WE DID YEARS AGO
BROTHER IS- ON THE H. I. V.
DOCTOR IN NEW YORK AND THE I
LEARNED A LONG WHEN HE WAS A
MEDICAL SCHOOL AND HIV WAS JUST
COVERED BACK THAT IN THE A-
ACTUALLY WASN'T WAS EIGHT OF
TIME EN HE WOULD ADVOCATE FOR
THE- AND I THINK PART OF ME TO
MY TRYING ADVOCATE XIN CONFIRMS
HIS WITH. IN. MISSION BERNIE TO
THE LA. AND THE HOSPITAL. IN
ABOUT. I DIDN'T KNOW. AND COME
TO THE SOLUTION WE LOOK FORWARD
TO FOR OUR PATIENTS SO THINKING.
THANK YOU- THE BILLS THAT YOU
HAD MADE MENTION OF- I WILL BE
SIGNING ON AS A CO AUTHOR OF
THOSE THOSE BILLS SO AGAIN- I'M
HERE BECAUSE THE FIGHT IS HERE.
AND WE'LL BE SUPPORTING MY
COLLEAGUES- ON THOSE PARTICULAR
LEVELS WITH THOSE BILLS MOVING
FOR THE LEGISLATIVE PROCESS
WITH THAT QUESTION FOR YOU WHAT
CAN NOW ONLY YOU KNOW THE-
SIGNING IN SCHOOL OFTEN IS
BILLS WHAT DO YOU THINK THAT
THE LEGISLATURE. I TO TRY TO
HELP IN THIS FIGHT SO I PUT
THAT TO OF THOSE WHO ARE HERE
THE BUT I WAY I WAS SO THAT WE
CAN MAKE THAT WE- DOCUMENTED SO
WE CAN START LOOKING AT THE
THOSE THESE WAYS I'M TRYING TO
IS- A RESULT FROM THESE ISSUES
YOU BROUGHT FORTH. TODAY SO
WHAT WE'RE NOT DOING AS A
LEGISLATURE THAT WE SHOULD BE
DOING. THAT'S THE QUESTION.
FEEL FREE NOR I SPEAK A ONE
TIME I'M JUST A DOCTOR BUT ALL.
I'LL SAY THAT WHAT WE'RE I'VE
SEEN AND LIFE TO IS THAT PUBLIC
HEALTH INFRASTRUCTURE HAS JUST
BEEN UNDER FUNDED. FOR THE LAST
TWENTY YEARS YOU KNOW MAYBE A
YEAR AGO- ALL THE SUDDEN
CHLAMYDIA BECAME A NON
REPORTABLE DISEASE BECAUSE
THERE'S JUST NOT RESOURCES TO
FOLLOW IT UP ANYMORE SO.
HEPATITIS C. AT THE COUNTY
LEVEL IS NOT TRACKED REALLY AT
ALL. FOR THE EXERCISE THAT WE
HAD IN THE END HAVE SEE SAN
DIEGO AT THE DEMOCRATS TO
ACTUALLY SO STOKED THE COUNTY
PEOPLE TO. EVEN PAY ATTENTION
TO THIS. THEY'RE JUST NOT
FUNDED- TO CONFRONT THESE
EPIDEMICS LIKE THEY NEED TO BE
IN SAN DIEGO THE- LARGE
POPULATED COUNTY IMAGINE PLACES
LIKE SISKIYOU COUNTY OR OTHER
COMPANIES WITH WITH LESS
INDIVIDUALS THAT ARE JUST AS
IMPACTED BY THE OPIOID
EPIDEMIC. SO PROPERLY FUNDING
OUR PUBLIC HEALTH OFFICIALS TO
DO WHAT THEY NEED TO DO I THINK
THIS IS A START LEGISLATURE
KNOW. GREAT. OUR DID BREATH I
THINK THAT THE YOU. YES THE
CRISIS PARTICULAR IS WOLF ON
FINANCE AND THE H. A. B.
RESPOND TO THE- HAS FOR THE
PART KEPT PACE. THE
APPROPRIATIONS AT THE FEDERAL
AND LEVEL WITH THE INCREASED
DEMAND FOR SERVICES AND
REGRETTABLY WE'VE GONE
BACKWARDS WITH STDS WE'VE LOST
40% OF THAT THE PURCHASING
POWER THE LAST DECADE AND A
HALF. AND THERE'S BEEN EROSION
OF STD CLINIC INFRASTRUCTURE I
THINK THAT WAS HIGHLIGHTED A
LITTLE BIT EARLIER AND WE HAVE-
US- HE THIS MEASURE FOR
CHLAMYDIA AND WE'RE STUCK AT
5455% SO I THINK WE HAVE TO
FIGURE OUT A NEW APPROACH OR
STRATEGY TO MAKE SURE THAT
HEALTH PLANS ARE ARE IN FACT
IT'S A PRIORITY- TO INCREASE
YOU KNOW SEXUAL HEALTH
PROGRAMMING. BOTH IN THE PUBLIC
SECTOR BUT ALSO THE COMMERCIAL
PLAN SECTOR- AND YOU KNOW THE
SURPLUS EPIDEMIC WE CAN'T. THIS
THE CA TIED THE CIVIL. IS
EXT. CHALLENGING AND THE
MANIFESTATIONS WE SEE IN WE
HEAR ABOUT YOU KNOW BABIES
EXPOSED TO SYPHILIS. BUT WE
ALSO NEED TO UNDERSTAND AS LONG
AS THERE'S A POOL OF INFECTIONS
REFERENCE BEFORE. OF SYPHILIS
AMMAN- WOMEN OF CHILDBEARING
AGE WE'RE GONNA SEE SURPLUS
AMMAN- NEWBORNS. BUT WE HAVE TO
GO ONE STEP FURTHER AS LONG AS
WE HAVE A SURPLUS EPIDEMIC IN
CALIFORNIA. AMONG MEN. THEIR
HEAD OF SEXUAL AND BI SEXUAL
THAT'S BURGEONING AND IT'S
MULTIPLE FOLD HIGHER THAN THE
EPIDEMIC AMONG WOMEN YOU CAN
HAVE AN EPIDEMIC AMONG WOMEN.
AND SO WE CAN'T JUST HAVE A ONE
PROPER APPROACH TO SYPHILIS IT
NEEDS TO BE MULTI PRONG. AND
CIVIL CONTROL AMONG MEN YES IT
WAS CONTROL AMONG WOMEN. AT THE
NEWBORNS NEEDS TO BE. ABOUT
GREAT THANK YOU. AND I WOULD
JUST ADD YOU KNOW YOU HAVE VERY
STRONG FROM WHERE YOU'RE PERCH
TO AN YOU'RE SAID AND I THINK
THAT WHILE THIS MIGHT WE REALLY
APPRECIATE THE TO SHARE THIS AT
THE TO. AND KIND OF BE THINKING
ABOUT HOW WE KEEP PUTTING WIND
BEHIND IT THIS SALE BECAUSE WE
NEED TO GET TO THE FINISH LINE
SO WHAT ARE SOME OF THE OTHER
WAYS THAT WE CAN INCREASE
AWARENESS. WITH AND AMONG THE
CAUGHT YOUR COLLEAGUES AND IN
THE PUBLIC TO GET A MOVE A
MOVEMENT YOU KNOW WE
UNFORTUNATELY HAVE HAD-
HISTORICALLY OVER TIME HAD TO
HAVE A MOVEMENT AND- BECAUSE IT
WAS A NOTE EPIDEMIC WAS. YOU
KNOW HOW A DEVON IMPACT WE HAVE
NOT A MOVEMENT OR CHAMPIONS FOR
AS TV OR EIGHT CV AND NOW NOT
THAT WE'RE FINALLY ALL COMING
TOGETHER AND SAYING THAT
THEY'RE ALL KIND OF LINKED I
THINK WE REALLY NEED TO BE MORE
VOCAL AND PRESENT AND UNITED
THAN EVER SO ARE THERE OTHER
HEARINGS WE'VE YOU KNOW BRING
TOGETHER OTHER COXES WERE
COMMITTEES THAT ARE HAVE
REPRESENTS CAN SIT THESE ARE. I
AM. IT I'M I. WALDRON AYE OF A
OP ED THAT YOU WOULD PUT OUT
AROUND AND ONE OF THE MEASURE
THAT YOURS SO KIND KEEPING THE
LEADERSHIP AND THE ATTHIS
ISSUE OUT AND CENTER I THINK
THROUGHOUT THE YEAR WOULD BE
SOMETHING WE WOULD REALLY I BE
HAPPY SUPPORT ANYWAY WE COULD
GROUP THANK YOUR MUCH. THERE
WAS ONE OF THE QUESTION- I
THINK MISTER- BUT HAS TALKED
ABOUT THE RYAN WHITE FIVE. AND
YOU OR SOMEONE ARTICULATED THE
POINT THAT THERE IS- IF YOU'RE
IN THE RYAN WHITE FUND. YOU
GOING TO DO WELL. AND THAT'S
WHAT I HEARD- AND SO IF YOU'RE
IN THIS FINE YOU DO WELL BUT
WHAT OF. BOB THE PEOPLE WHO ARE
NOT THERE. AND I ALSO HEARD
THAT THOSE ARE THE CHALLENGES.
THERE SO HOW DO WE BRIDGE THAT
GAP. SERVE THE SO THE RYAN
WHITE PROGRAM. WAS RATED
BECAUSE IT'S FUNDED AT THE
FEDERAL LEVEL AND RESPONDS I
MEAN IT IT BASICALLY WAS SET UP
TO SOLVE THE PROBLEM OF HOW DO
WE GET CARE TO PEOPLE WITH HIV
RIGHT IT WAS CREATED THAT THE
POINT THAT YOU KNOW WHICH
PERCENT RIGHT PUSHING YOUR
BROTHER LIKE HAVING TO PUSH.
PUSH THAT THE- JOURNEY INTO THE
HEART WAS SOME ELSE TRYING TO
IT OUT RIGHT THAT WAS THE KIND
OF ENVIRONMENT WHERE IT WAS
DONE. AND IT'S HAD IT IT FOR
WHATEVER. RIGHT I WAS. AS YOUNG
AT THE POINT AT START. NOW NOT
BUT RIGHT IT WAS SET UP WITH
WITH MORE FLEXIBILITY THEN YOU
SEE WITH A LOT OF UNDER FUNDING
STREAMS AND SO. YOU HAVE THE
ABILITY TO FIND A LARGE VARIETY
OF THANKS WITH THE RYAN WHITE
PROGRAM AND WHAT IT'S MEANT IS
THAT. IT IS REALLY CENTERED ON
THIS IDEA OF WE'VE GOT TO GET
THESE MEDICAL THESE HIV MEDICAL
SERVICES TO PEOPLE BUT IF WE
HAVE TO DEAL WITH
TRANSPORTATION WE HAVE TO DEAL
WITH. WITH MENTAL HEALTH ISSUES
AND WE HAVE TO DEAL WITH THESE
OTHER THINGS WHAT WE CAN DO
THAT BECAUSE DEALING WITH THOSE
THINGS WILL GET PEOPLE INTO.
THE H. A. B. R. THAT'S OUR OUR
REYES ON DEATH I WEEKS AND
THERE'S- NO. A LOT OF IF ANY
OTHER FOR. DREAM THAT I KNOW OF
THAT FOR. THAT WAY. I CAL.
PROGRAM THE. YOUR TYPICAL. ITS
PLAN FOR. THE ARE FUNDED WITH
THIRD THERE MAY. IS BORING SOME
DIFFERENTLY AND SO. THERE
THEY'RE ORIENTED A BOUND. LIE
THIS IS THIS. THE WE CAN FOR AN
EFFORT FOR OUT OF THIS BAR. WE
CAN PAY FOR AND- SOAP CLINIC.
STRONG WENT YOU KNOW WHEN WE-
MEDICAID AND STATE ONE OF THE
PERVERSE. FOR PEOPLE WITH HIV
WAS. THAT SOME OF THEM LEFT THE
RYAN WHITE SAYS. AND THEY WENT
INTO THE MEDIC SYSTEM AND ALL
THE SUN THERE WERE THESE KIND
OF LAYERS OF ADDITIONAL
PROBLEMS THAT THE- HADN'T.
BEFORE SO AN EXAM WAS. YOU KNOW
THE GUY ROLLED INTO MY- HOW
THEY WERE PUT IN AND- A MAN.
CARE IN MY CAL. BUT WE CARVE
OUT OF THOSE MEN CARE PLANS.
MENTAL HEALTH. AND SUBSTANCE
SERVICE SINCE SO YOU'D PEOPLE.
BEFORE GOT EVERYTHING IN ONE
CLINIC BUT BECAUSE OF THE
PARTICULAR. AREA THEY WERE IN
AND OUT THE WAY THINGS WERE SET
UP THEIR HEALTH PLAN. AT THIS
POINT- OVER HERE FOR THE
MEDICAL. THIS IS BUT THEN OVER
THAT PER. OVER THERE. MENTAL
ITS USE. YOU KNOW IF YOU'RE
SOMEBODY. BOUGHT A
VULNERABILITY. THERE'S THE
ACTUAL BUDGET. GET TO THIS. WE
WALK CLINIC EIGHT. B. AND SO.
IT'S THAT COMPREHENSIVENESS IN
THE- THAT IT. BRANCH OF. THIS
CALL WHEN IT'S SORT. WHAT DOES
IT TAKE TO MAKE IT WORK. THIS
PEDAL MORE TIME IF YOU WOULD
PLEASE. GOING TO TRANSITION
INTO PUBLIC COMMENTS YOU CAN
PLEASE STAY RIGHT THERE YOU
LIKE AS A MAYBE SOME COMMENTS-
DIRECTED TOWARDS YOU SO AT THIS
POINT IN TIME IF YOU WOULD LIKE
TO PROVIDE A PUBLIC COMMENTS ON
WHAT YOU'VE HEARD- THUS FAR
WOULD YOU PLEASE COME TO THE
MICROPHONE STATE YOUR NAME
ORGANIZATION REPRESENTS- WILL
HAVE ABOUT TWO MINUTES- BUT OF
OR MINUTE A HALF RATHER- TO BE
ABLE TO- US. WEIGH IN ON THIS
CONVERSATION. SO MY NAME IS
CARL GARDEN- I WORK MY COUSIN
YOU GUYS. I WAS GOING TO
MENTION THAT BUT I WORK WITH AN
ORGANIZATION CALLED MEN TOUGH
FOUNDATION OVERSEEING POLICY
NOW BECAUSE HE BUT I DON'T COME
WITH YOU WEARING THAT HAT- I'M
A BLACK GAY MAN LIVING IN LOS
ANGELES COUNTY WHO IS A
PROVIDER BUT ALSO A CONSUMER-
ON PRESS IN ONE OF THE THINGS
THAT I GET FROM. THE POSITION
THAT WE HAD TODAY AND BEING OUT
OF THE ORGANIZING COMMITTEE OF
THE INNING THAT BUT DE MAKES.
LAST I LET THE SOME OF THE
WHOLE BE GREATER THAN ANY
INDIVIDUAL PART IN IT SEEMS
LIKE WHAT WE'RE ASKING. IS ALL
THE SYSTEMS BEGIN TO WORK
TOGETHER. TO FIGHT A PUBLIC
HEALTH CRISIS. THAT IS AFFECTED
COMMUNITIES FAR. MORE HARDER
THAN SHOULD BE AFTER SYNERGY-
IS ALIGNMENT IT SEEMS LIKE WE
ALL NEED TO BE GOING ON THIS I
GOING. IN THE SAME DIRECTION
AND FOR ME A LOT OF THE STUFF
COMES SPIRITUAL- THE BIBLE SAYS
BE NOT EQUALLY YOKED MAKE SURE
YOU GUYS ARE GOING IN THE
RIGHT. DIRECTION WHEN TWO
PEOPLE COME TOGETHER IN A IN A
COMMON COUGH NOTHING IS
IMPOSSIBLE- AND THE LAST THING
I THINK. IS PROBABLY THE MOST
IMPORTANT IS WE NEED TO BECOME
PROACTIVE- IN FIGHTING THESE
ASKED ENDEMIC TO SEEMS LIKE
BEING A CONSUMER BEING A BLACK
GAY MAN IT SEEMS LIKE WE'RE
ALWAYS PLAYING CATCH UP- TO- A
LOT OF WHAT'S GOING ON IN
ASSURING THE EXPERIENCE I HAD
WITH YOU- TO GIVE YOU GUYS A
FULL SCOPE. OF HOW PEOPLE ARE
ENGAGED IN THEIR- I HAVE AN
ACCOUNT ON A áP CALL JACK IN
IT'S A SOCIAL SEXUAL NETWORKING
APP BUT I TELL PEOPLE IF YOU
HAVE QUESTIONS ABOUT PRESS.
PLEASE LET ME KNOW AND THE
YOUNG GENTLEMAN REACHED OUT TO
ME AND THIS IS WHAT HE SAID.
THANK. THREE REACHED OUT HE
SAID A FEW QUESTIONS ABOUT
PREGNANT WOMEN GO AHEAD HE SAID
I'M HPV POSITIVE ALONG WITH HIV
POSITIVE WOODS PREP STILL BE A
BENEFIT FOR ME AND I TOLD HIM
UNFORTUNATELY NOT PURPOSE ONLY
DESIGNED FOR PEOPLE WHO ARE HIV
NEGATIVE BUT I ASKED HIM IF
HE'S ON TREATMENT HE RESPONDED
I'M NOT AND I'M SCARED TO GET
ON TREATMENT AS A RESULT OF
DEATH I'M SO NERVOUS AND WHAT
COULD HAPPEN TO ME HOWEVER I'M
AWARE OF THE CONSEQUENCES IN
NOT BEING TREATED. SOME HELP
WITH THIS YOUNG MAN LEAVE THE
CLINIC NOT FULLY UNDERSTANDING
WHAT HIS TREATMENT OPTIONS WORK
AND THE THING THAT HURTS ME
MORE SO THAN ANY TITLE THAT I
HAVE IN ANY STATISTIC I'M A
NERD BY BY TRAINING I LESS THAT
THEY LET SB BUT TO SOME EXTENT
WHEN WE SEE HERE TALK ABOUT
THESE NUMBERS THESE REPRESENT
PEOPLE TO ME I HAVE FRIENDS
WERE NO LONGER HERE ON THIS
EARTH YOU GUYS HAVE. LAID OUT
IN STATISTICS. BUT WHO'S WHO
WHO'S WHO'S ADVOCATING FOR
THEM- SO THAT'S WHAT I MEAN WE
HAVE TO BE PROACTIVE. BECAUSE
PEOPLE ARE COUNTING ON US EVEN
IF WE KNOW ORDER NOT TO MAKE
THE RIGHT DECISIONS FOR THEIR
SEXUAL OUT THANK YOU. GOOD
AFTERNOON MY NAME IS SANCTIONED
BY THE END AND I WORK WITH AND
PACKED GLOBAL ACTION FOR GAY
MEN'S HEALTH AND HUMAN RIGHTS.
ARE IN A RUN THE IF YOU CAN'T
AB AND PROGRAM THE FECA TO BE A
PROGRAM. IS TRYING TO ADDRESS
THE HIV CRISIS AMONG LIVE NEXT
GAME BISEXUAL MEN. ARE
NATIONALLY. WE ALSO BELONG TO.
CALIFORNIA IN THE EPIDEMICS
COALITION. AND OUR REALLY.
AMAZED ABOUT- THE WONDERFUL
SYNERGY THAT'S HAPPENING-
WITHIN THAT COALITION. JUST
WANTED TO ADDRESS- LIVE NEXT
CAME MY SEXUAL MAN- BECAUSE- A
LOT OF TIMES. THEY ARE NOT
REPRESENTED AT THE TABLE OR
THEY'RE NOT INVITED AT THE
TABLE. OUR THEY'RE NOT MADE THE
RESOURCES ARE NOT MADE
AVAILABLE FOR THEM TO BE AT THE
TABLE- IN THE OFFICE OF A TO
SEE AN OFFICER WITH THE
CALIFORNIA STATE OFFICE OF AIDS
IN NOVEMBER OF. TWENTY
NINETEEN- RELEASED A REPORT
THAT REALLY ARE KIND OF
SOLIDIFIED WHAT WE WERE SEEING
THE TRACKS THAT WE WERE SEEN.
NATIONALLY AROUND AT NEW HIV
INFECTIONS- NEAR HALF OF NEW
PAYCHECK DIAGNOSIS ARE TRIBUTE
TO. THE NEXT GAME BISEXUAL MAN.
ANY 49% OF THE NEW- HIV
DIAGNOSIS. ARE AMONG THIS. OF
WE ARE. OVER REPRESENTED ASKED
ME OF COLOR. WITH OUR BLACK
AFRICAN AMERICAN GAME MAN AMONG
ASIAN MEN AMONG NATIVE AND
NATIVE GAY BISEXUAL MEN- EVEN
EVEN AMONG THOSE MEN OUT A LOT
OF A LOT IS UNKNOWN AND SO I
WANTED TO HIGHLIGHT THAT
THERE'S STILL A LOT OF WORK
THAT NEEDS TO BE DONE THAT-
ALTHOUGH WE'RE MAKING PROGRESS
AMONG WHITE GAY AND BISEXUAL
MEN AND GOOD FOR THEM BECAUSE
THEY'VE BEEN ORGAN NINETEEN AND
THEY'VE BEEN PUSHING FOURTH.
THAT IS NOT THE SAME CASE ARE
IN COMMUNITIES OF COLOR- IN SO
AND IT HAS TO BE- VERY WELL
THOUGHT OUT SO WE ARE MAKING
OURSELVES AVAILABLE WITH SOME
OF THE SUGGESTIONS THAT HAVE
COME FROM NATIONALS LISTENING
SESSIONS. FROM LENNIX GAME
BISEXUAL MEN WHO ARE IN THE
FOREFRONT WERE WORKING THE
COMMUNITIES AND WHO ARE HAVING.
WONDERFUL SUCCESSES IN
ADDRESSING SOME OF THE
DISPARITIES THEY'RE ASKING OUR
COMMUNITIES THANK YOU THANK YOU
VERY MUCH. I'M LARA THOMAS AND
THE DOCTOR FROM REDUCTION
POLICY THE SAN FRANCISCO AIDS
FOUNDATION AND THANK YOU. FOR
HOLDING THIS HEARING BUT I WANT
TO ADD ANOTHER POLICYOPTION
AND PIECE OF LEGISLATION INTO
THIS- ASSEMBLY BILL THREE SIX
TWO BY ASSEMBLYMEMBER- EGGMAN-
WOULD ALLOW THE SITTING COUNTY
OF SAN FRANCISCO TO OFFER
OVERDOSE PREVENTION SERVICES
ALSO KNOWN AS SUPERVISED
CONSUMPTION. SITES AND ONE OF
THE REASONS AMONG THE REASONS
THAT SAN FRANCISCO WANTS TO
OPEN THE IS BECAUSE OF THE ROLE
THAT THEY CAN PLAY IN
PREVENTING HIV TRANSMISSIONS
AND HEPATITIS C. TRANSMISSIONS
AMONG PEOPLE WHO USE DRUGS. AS
WELL AS CREATING OPPORTUNITY TO
LINK PEOPLE WHO USE DRUGS TO
ADDITIONAL SERVICES INCLUDING
SEXUAL HEALTH AND STI TESTING
THE- A STUDY IN SAN FRANCISCO
LOOKING AT THE COST
EFFECTIVENESS OF THESE PROGRAMS
FOUND THAT THE MAJORITY OF THE
COST EFFECTIVENESS OF HIM FOR
THE PROGRAMS IN SAN FRANCISCO
IN IT WOULD SAVE US MILLIONS OF
DOLLARS A YEAR. WHERE WE
ALLOWED TO OPEN THEM IS BECAUSE
OF THE ABILITY TO PREVENT BILL
HIV INFECTIONS AND PREVENT NEW
HEPATITIS C. INFECTIONS AS
WE'VE HEARD REPEATEDLY HERE
PEOPLE WHO USE DRUGS. ARE ARE
ARE AMONG THE FOLKS MOST
VULNERABLE TO- HIV TRANSMISSION
TO HEPATITIS C. TRANSMISSION AS
WELL AS TO SEXUALLY TRANSMITTED
INFECTIONS AND ONE OF THE
THINGS WE KNOW WE'VE TALKED A
LOT ABOUT SYPHILIS AND
CONGENITAL SERVE AS AT. IS
INFERENCE AND I KNOW PART OF
THIS MUCH OF THAT IS RELATED.
METHAMPHETAMINE USE ON THE PART
OF WOMEN AND SO BEING ABLE TO
PROVIDE THESE TYPES OF
SUPERVISED CONCEPTIONS ARE HAS
WHERE PEOPLE ARE WELCOME IN-
PROVIDED WITH NON JUDGMENTAL
CARE IN A LOW THRESHOLD HARMON.
OR IN AND- SEC PART OF WHY YOU
NOW. TO A BRAT I YOU. THE UP
MAYBE TEN AND HAVE IT IS
TRANSMISSION AND ACTUALLY AND
INFECTIONS AND SO I ENCOURAGE
AS WE THINK ABOUT. WHAT IS NEED
IN THE STATE OF. IN ORDER TO
FULLY GET TO ZERO AND FULLY AND
HEPATITIS C. AND ELIMINATE
THESE STI EPIDEMICS AS WELL
THAT WE MAKE SURE THAT
SUPERVISE CONSUMPTION SITES AN
OVERDOSE PREVENTION SERVICE
SAYS. SUCH AS ENVISIONED IN AB
THREE SIX TWO ARE ON THE TABLE
AS PART OF THE SOLUTION. THANK
YOU THANK YOU. HI GOOD
AFTERNOON MICHELLE GIVENS WITH
THE COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA WE
REPRESENT LOCAL HEALTH
DEPARTMENTS THROUGHOUT OUR
STATE AND AT FIRST AND FOREMOST
LET ME JUST THANK YOU ALL FOR A
FOR HOSTING THIS HEARING IT'S
GREAT TO BE IN A ROOM FULL OF
FOLKS AT ALL WANT TO. TACKLE
AND ADDRESS THIS ISSUE. AND
LOCAL HEALTH DEPARTMENTS ARE
REALLY A CRITICAL PARTNER AND
THAT AND WANT TO CONTINUE TO
JOIN IN THAT EFFORT. AND I
THINK IT TO YOUR POINT AROUND
WHAT CAN WE DO ACT IT'S NO THAT
TO THE STATEMENT THAT WAS MADE
EARLIER AROUND PUBLIC HEALTH
INFRASTRUCTURE. I DON'T KNOW
THAT FOLKS ACTUALLY UNDERSTAND
WHAT THAT MEANS BUT THERE ARE
SPECIALIZED CLASSIFICATIONS
TRAINING SKILL SETS OF THINGS
THAT NEED TO HAPPEN IN TERMS OF
STAFFING CAPACITY. SO
EPIDEMIOLOGIST THAT LOOK AT
DATA TO FIGURE OUT WHERE THE
HOT SPOTS ARE AND FIGURE OUT
HOW TO TARGET RESOURCES- IT
DISEASE INVESTIGATORS THAT NEED
TO KNOW HOW TO APPROACH
INDIVIDUALS AND HOW TO ASK FOR
THEIR HISTORY AND HOW TO
ADDRESS PARTNER SERVICES AND SO
FORTH. THERE ARE A LOT OF
PARTICULAR SKILL SETS THAT OUR
HOUSE WITHIN PUBLIC HEALTH
INFRASTRUCTURE AND YET WHEN WE
TALK ABOUT LIKE HEALTH CARE
LOAN FORGIVENESS PROGRAMS
PUBLIC IS NEVER A PART OF THAT
COVERS IN SAID. FIRST AND
FOREMOST FROM A INFRASTRUCTURE
THE POINT WOULD BE REALLY
HELPFUL THE OTHER THING THAT I
WOULD JUST MENTION IS JUST THAT
THE- OVER FOR AND FOR. ABOUT
DIFFERENT AN I'M WITH OFF. WITH
A LOT OUR COMMUNITY OR PATIENT
BUT WE ALSO HAVE TO HAVE THE-
TO RESPOND IT. THREATS A SLEIGH
AS H. I. OTHER THINGS UP ON IT.
I'LL SING THE RATES OF STDS AND
OTHER DISEASES INCREASE AND SO
THIS LETS US KNOW THAT THERE
NEEDS TO BE A GREATER
PARTNERSHIP AND SYNERGY AND WE
ALSO UNDERSTAND THAT THERE ARE
MORE PRESSING ISSUES AT HAND.
JUST AS YOU'VE HEARD TODAY A-
NICE AND HOUSE ABILITY. AT ALL
CONTRIBUTING CROESUS TV RATE.
WE ARE SUPPORT OF A LOT OF
THOSE THAT YOU'RE HEARD. FROM
AND THAT. I SHOULD WE ALSO AT
AS WAS MENTIONED ARE GONNA BE
PUTTING FORWARD ANOTHER
PROPOSAL TO COMPLEMENT THAT
WHICH WOULD BE. S. T. E.
NAVIGATOR THIS IS SO BEING ABLE
TO DO THAT HEALTH. ASSESSMENT
OF AN END OF WILL TO SAY OKAY.
I BE. SUPPORT TO MAKE THAT
CONNECTION YOU NEED TO HAVE
YOUR X. HOUSING IS DOUBLE IN
THIS IS AN IS OR IT'S HOW.
LET'S GO AHEAD AND ADDRESS THE
ARE YOU HAVE TO. ISSUES LET'S
SEE WHAT WE DO TO ADDRESS. A
GATOR. PROTEST IN A CUP OF THE-
S. AGE MAY GROUPS THAT. CS
OFFERING ONE OTHER THING THAT
I'VE YOU. CONSTANTLY AS EXAMPLE
IS ASKED D.'S. BECAUSE WE KNOW
THAT RATES ARE IN. AS YOU HEARD
COLLEAGUE GOT A KERN COUNTY THE
MEDIC HOW BIRTH. AND YOU WE'RE
TRYING TO FIGURE OUT WAYS TO.
COMPLEMENT THE MEDIC HEALTH.
BUT THERE'S NOT A LOT SYNERGY.
WHAT THESE BIG ISSUES ARE IN
PUBLIC HEALTH AND WHAT'S
HAPPENING IN THE MEDI CAL
SPACE. MEDICAL SERVES A THIRD
OF OUR POPULATION WE NEED TO
FIGURE OUT A WAY TO CONNECT
THOSE TWO. AND SO FROM MY
STANDPOINT ONE THING THAT WOULD
BE REALLY HELPFUL IS FOR SOME
ADDITIONAL SUPPORT. THEY HAVE
WHAT'S CALLED IT CAN'T CASE
MANAGEMENT. THIS IS GONNA BE
FOR THOSE WITH LIKE THAT THE
MOST CHRONIC CONDITIONS THOSE
THAT ARE CREATING
HOSPITALIZATIONS. BUT THERE
SHOULD ALSO BE A TARGETED
APPROACH FOR STDS BECAUSE WE
KNOW THAT THE RATES ARE SO ARE
CLIMBING SO RAPIDLY. AND SO
WHAT CAN WE DO TO ENSURE THAT
THAT IS A PIECE S. T. WAITED
ANGST ALL HEALTH. AS THE
EMPLOYMENT IS PROPOSED SO THESE.
A FEW STRATEGIES I BEFORE YOU
AND APPRECIATE YOUR TIME. THANK
YOU. INCHES IN SOME SOLUTIONS
THAT WE HAVE- I'M SORRY I'M AND
DONNELLY WITH THE SAN FRANCISCO
AIDS FOUNDATION ALSO AND THE
EPIDEMICS COALITION. WANT TO
BUILD A LITTLE BIT OF WHAT THE
SHELL BROUGHT UP ACTUALLY
BECAUSE I ALSO SIT IN- THE
POPULATION HEALTH MANAGEMENT
GROUP. OF HEALTH HERE WHAT IS
IT MEDI CAL HEALTHIER
CALIFORNIA FOR ALL NOW. AND I
THINK DOCTOR. MARK TALKED A
LITTLE BIT ABOUT SOME OF THIS
IN. ENHANCE CASE COORDINATION-
IN SOME OF THE OTHER
ASPIRATIONAL GOALS WHICH WE
FULL SUPPORT OF THIS PROCESS.
AND BECAUSE MEDI CAL DOES COVER
ONE THIRD OF OUR POPULATION
HERE IN CALIFORNIA THESE ARE
GOING TO BE REALLY BROUGHT AND
THEY'RE NOT. ACTUALLY GOING TO
BE TARGETED AT THIS POINT. TO
MOST OF THE FOLKS THAT WE'RE
TALKING ABOUT TODAY. SO
BUILDING ON WHAT MICHELLE SAID
WE HAVE BEEN SUGGESTING IS
COMMUNITY WOULD LOVE ANY
ENCOURAGEMENT THAT WE MIGHT BE
ABLE TO GET TO DH CS. TO
CONSIDER A FORMAL AND STRATEGIC
PARTNERSHIP WITH THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH.
THAT WOULD ACTUALLY FOCUS ON
THESE THE ENDEMIC THE- THREE
AT. MAKES IT REALLY. WAY WE
WILL FOR ME. OPPORTUNITY NOW.
SAM THE HOT SPOKE. THE IN ORDER
SERVER FOLKS WHO ARE USING DRUG
I'M IN THE PROJECT THERE IS
TEST FOR BOTH HIV AND H. SO
WE'RE ON AS TO HAPPENED WITH
LINKAGE TO AND RETENTION IN
CARE IN THIS PROGRAM SO WE'RE
WE HAVE OPPORTUNITIES THAT WE
CAN REALLY LEVERAGE IF WE
SIMPLY HAD A STRATEGIC APPROACH
AND WE HAD A COLLABORATION
PARTNERSHIP SO THANK YOU. I
DON'T THINK. PRISON I WANT TO
THANK YOU FOR YOUR QUICK
MINUTES AGO ABOUT WHAT THE
LEGISLATURE CAN DO- ROBIN
LEARNING AGAIN FROM. I'M
ACTUALLY FREE AGENT RIGHT NOW
SO I'M JUST HERE REPRESENTING
HARM REDUCTION. I WOULD LIKE TO
SEE OUR LEGISLATURE TAKE MORE
OF A LEAD IN ENCOURAGING.
COUNTIES IN THE STATE TO
SUPPORT LOCAL SYRINGE
EXCHANGES. THIS IS CALIFORNIA
THERE'S NO EXCUSE FOR COUNTIES
LIKE SAN DIEGO OR ORANGE TO
ACTIVELY FIGHT THE PROVEN
EFFECTIVE. INTERVENTION LIKE
SYRINGE SERVICES. THANK YOU
KNOW THANK YOU. GOOD AFTERNOON
CRIPPLES FOR FROM A KILL A
HEALTH AND LOS ANGELES AT RISK
OF BEING REPETITIVE JUST ONE
AGAIN THANK A TIMER GET CENTS
HOWEVER WALDRON ON THE SELECT
COMMITTEE FOR YOUR ON GOING
LEADERSHIP ON THIS ISSUE AND
ALL OF THE PANELISTS WHO ARE
HERE TODAY INCLUDING OUR STATE
PARTNERS WHO I THINK ARE DOING
A LOT OF REALLY LOT OF WILL
WORK WITH THE RESPONSES SO THEY
HAVE BY THEIR THE- YOU NEED
JUST ONE I THINK HER TODAY.
THANK FALLING BEHIND. DOZENS OF.
STATE THE COUNTRY ARE REALLY
DEVELOPING AGGRESSIVE
STRATEGIES TO ADDRESS THESE
EPIDEMICS. AND AS ADVOCATES WE
FREQUENTLY GET QUESTIONS ABOUT
WHERE IS CALIFORNIA WISE
CALIFORNIA NOT TAKING A
LEADERSHIP ROLE ON THIS. FIRST
STATE THE AS A LEADER ON SO
MANY ISSUES AND CONTINUES TO BE
A LEADER ON SO MANY ISSUES. WE
ARE DUMBFOUNDED AS TO WHY THE
STATE HAS NOT REALLY STEPPED UP
AND DEVELOPED AN AGGRESSIVE
STRATEGY TO ADDRESS. HIV
HEPATITIS AND ASKED HE IS SO
CERTAINLY APPRECIATE THE ON
GOING LEADERSHIP OF THE SELECT
COMMITTEE. BUT WE REALLY WANT
MAKE PROGRESS UNTIL WE HAVE THE
SUPPORT AND LEADERSHIP OF OUR
GOVERNOR AND THE REMAINDER OF
THE LEGISLATURE SO. LOOKING
FORWARD TO OUR CONTINUED
PARTNERSHIP CURRICULUM IS A
THANK YOU AN A. P. LA FOR
AWHILE- ONE HELPING ORGANIZE.
WITH EXPERTS WE HAVE IN A ROOM-
YOU GUYS HAVE DONE A YEOMAN'S
JOB THANK YOU VERY MUCH FOR
YOUR LEADERSHIP. NOT ONLY BACK
HOME BUT ALSO HERE IN
SACRAMENTO. YOU ARE HOUSEHOLD
NAMES. AT LEAST HERE IN
SACRAMENTO THANK IN TERMS OF
THE WORK THAT YOU DO. AND WE
NEVER WANT TO A MINUTE AS A
WORKER WE PLEDGE TO OUR- OF THE
IS A- THIS IS SOMETHING THAT
YOU BELIEVE AND- THANK YOU FOR
BEING A CONSCIOUS TO ALL OF US.
IN SPACE OF THE YOU MUCH THANK
YOU APPRECIATE THAT. I DIDN'T
SEE THEM BEHIND HIM AS- A LOT.
ONE OKAY HI MY NAME'S PETER A
WHILE I'M GONNA SELL LIKE A
LITTLE BIT OF A BROKEN RECORD
ON BEHALF OF EQUALITY
CALIFORNIA THE NATION'S LARGEST
LGBTQ PLUS CIVIL RIGHTS
ORGANIZATION WE WANTED TO ECHO
OUR GRATITUDE FOR ALL THE
SPECIALISTS ADVOCATES AND
MEMBERS INVOLVED IN PUTTING ON
THIS VERY IMPORTANT HEARING AND
WE JUST WANTED TO AGAIN
REITERATE THAT WE LOOK FORWARD
TO CONTINUING TO WORK WITH-
BOTH THE LEGISLATURE- IN THE
STAKEHOLDER. AS WELL AS THE
VERY DIVERSE COALITION TOWARDS.
EPIDEMICS IN CALIFORNIA THANKS
AGAIN THANK YOU. HI MY NAME IS
PRETTY MILLION PEARSON WITH THE
SAN FRANCISCO AIDS FOUNDATION I
JUST- THANK YOU FOR HOLDING
THIS HEARING AND THANKS TO ALL
OUR PANELISTS FOR SPEAKING SO
ELOQUENTLY ON WHAT WE'RE FACING
AND WHAT WE'RE ASKING FOR AND
WHY AND TO BUILD ON CRAIG'S
COMMENT ABOUT THE EYES OF THE
NATION AND THE WORLD I JUST
ALSO WANTED TO HIGHLIGHT THAT-
WE ARE AND BEAT FORTUNATE TO BE
HOSTING THE INTERNATIONAL AIDS
CONFERENCE FOR THE FIRST TIME
SINCE NINETEEN NINETY TWO I
BELIEVE- IN SAN FRANCISCO AND
OAKLAND THIS JULY'S SO WE
REALLY WILL HAVE. BUYS A HIDDEN
WORLD AND IT'S BE REALLY
EMBARRASSING- AS CALIFORNIA TO
BE HOSTING THIS CONFERENCE IF
WE HAPPEN MADE THIS COMMITMENT
SO WE JUST REALLY CONTINUE TO
COLIN I KNOW THAT WERE TO THE
CHOIR THIS BUT WE THANK YOU SO
MUCH LEADERS ANYTHING YOU CAN
DO TO TOP TO YOUR FELLOW
MEMBERS OF THE LEGISLATURE TO.
OFFER ANY YOU CAN GET WITHOUT
GETTING THE- NUMBER. SIX FOR
THAT. CONFERENCE WE WOULD
REALLY THANK YOU THANK YOU FOR
MUCH AS GIVER OUT THANK YOU
VERY. WE WANT TO MAKE SURE THAT
WE ARE IN A POSITION TO- TO BE
ABLE TO BE WHAT WORLD LEADERS-
DURING THAT CONFERENCE AND SO
THANK YOU VERY MUCH FOR
LIGHTNING US. OF THAT THAT
PARTICULAR FACT WE WANT TO MAKE
A FEW OBSERVATIONS AND BEFORE
WE ADJOURN I WON I WON I THINK
MY AMAZING VICE CHAIR ASSEMBLY
WOMAN- MARIE WALDRON FOR JUST
BEING HERE EVER SINCE I THINK
THE SPEAKER POINT TO ME AS
CHAIR OF THE SELECT COMMITTEE.
SHE HAS BEEN MY RIGHT HAND UP
AND MY LEFT IN SO MANY
DIFFERENT WAYS AND I WANT TO
HELP ME JUST PUT OUR HANDS
TOGETHER THANK SIMILAR MARIE
WALDRON. IT IS OUR DESIRE TO.
ONE STEP TO THE PLATE- LONG
BEACH SAID THEY WANT TO HOST
THE NEXT ONE IN SOUTHERN
CALIFORNIA IN THE CITY OF LONG
BEACH AND SO WE WILL BE WORKING
TO- HAVE A HEARING. IN THE CITY
OF LONG BEACH WHERE ARE
SENATOR- MISS GONZALEZ- WANTS
TO BE ONE OF THE HOST AND THE
SENATE WHO REPRESENTS LONG
BEACH AS WELL AS MYSELF. AND
SHE MADE AN OVERTURE AND
CERTAINLY WE HOPE THAT THE
MAYOR WILL. BE THERE AS WELL SO
STAY TUNED FOR OUR NEXT HEARING
A DATE TO BE ANNOUNCED- IN LONG
BEACH SECONDLY IF ALL THE
PRESENTERS AND WE KNOW THAT
SOME OF LAUGHTER WILL TRY TO
REACH OUT. IF YOU COULD PROVIDE
YOUR NOTES I THINK YOUR NOTES
ARE VERY IMPORTANT IF YOU CAN
TYPE UP OR SENTENCE TO MUST
ACQUIRE WHO WORKS IN MY TEAM WE
WOULD CERTAINLY LOVE WE DON'T
WANT WE WANT TO CAPTURE
EVERYTHING. THAT YOU ADDS TO
ARTICULATE OF HERE TODAY
BECAUSE I THINK IT'S VITALLY
IMPORTANT- THAT WE CAPTURE YOUR
SOLUTION YOU'RE ADULTS. ALSO
THE DATA THAT WE BEGAN TO.
AGAIN COOPER. THIS IN. AS WE
MOVE FORWARD ABOUT TWENTY
TWENTY YOU'RE TESTIMONY HAVE
BEEN MAYES IT AT YOUR WORDS
HAVE NOT FALLEN ON DEAF HERE WE
WILL BE A VOICE CONTINUOUSLY IN
THIS SPACE- OUR COMMITMENT IS
TO THE POINT WHERE WE CAN- TOUT
THIS TIME NEXT YEAR. THAT WE
HAVE- HAVE AN AGGRESSIVE PLAN-
GETTING TO ZERO AND THE RESULTS
WILL BE THAT WILL MAKE SURE
THAT WE HAVE- ZERO NEW
INFECTIOUS CASES IN CALIFORNIA.
IN ALL OF THESE PARTICULAR
AREAS BUT IT'S GOING TAKE ALL
OF US WORKING TOGETHER- THAT
YOU KNOW WE CAN'T DO IT BY
OURSELVES GOING TAKE ALL OF
OUR- COALITION PARTNERS. THOSE
WHO HAVE SOME SKIN IN THE GAME
TO MAKE THIS HAPPEN AND THOSE
WHO ARE LIVING WITH. THIS
DISEASE THANK YOU FOR YOUR
AMAZING- YOU KNOW TRANSIT COME
OUT AND TALK ABOUT THIS FROM
YOUR LANDS- WE WANT TO MAKE
SURE THAT WE CONTINUE TO HAVE
SERVICES. TO TEAR DOWN BARRIERS
AND ALSO- STIGMAS THAT EXISTS-
HERE SO WITH THAT OF. THIS
WALDRON ANY CLOSING COMMENTS OR
THOUGHTS. I THINK YOU SAID AT
ONE. LIKE THANK YOU ALL ENOUGH
FOR COMING I KNOW YOU KNOW
TRAVELING IS NOT. EXACTLY THE
MOST FUN TO GET HERE AND- BUT
THE INFORMATION YOU PROVIDED IS
SO AMAZING AND- WE WILL TAKE
THIS BACK I PROMISE. AND
CONTINUE TO WORK ON THIS AND
COME UP WITH THE- SOME POLICY
IDEAS AND CONTINUE TO SUPPORT.
YOU KNOW THE EFFORT SO THANK
YOU. AND AGAIN- TO HAVE YOU
KNOW BI PARTISAN LANDS IN
THIS SPACE GOES A LONG LONG
WAY. AND I- MISS WALDRON BRINGS
THAT- AND I'M VERY GRATEFUL SO
WITHOUT- WITH NOTHING ELSE
BEING SAID THANK YOU VERY MUCH
THIS MEETING IS ADJOURNED.