GO AHEAD AND GET STARTED WITH
OUR JOINT INFORMATIONAL
HEARING- OF THE ASSEMBLY HEALTH
COMMITTEE AND BUDGET SUB
COMMITTEE NUMBER ONE A SIMILAR
THANK YOU FOR BEING WITH US
TODAY. IN OUR OF OUR FINAL
HEARING OF THREE ON THE CAL AIM
INFORMATION- INFORMATIONAL-
THIS ACCOUNT AIM INFORMATIONAL
HEARING SORRY. SO DUE TO THE
CONTINUED- STATE HOME ORDER
WE'RE PRACTICING PHYSICAL
DISTANCE IN HERE IN THE HEARING
ROOM AND THROUGHOUT THE CAPITOL
BUILDING SO WE'RE ABLE ONLY
ABLE TO HAVE A LIMITED NUMBER
OF PEOPLE WATCH AND PARTICIPATE
AT THE HEARING IN PERSON.
REQUIRING THAT MASKS BE WORN IN
FISCAL DISTANCING BE MAINTAINED
BY ALL MEMBERS OF THE PUBLIC
TESTIFYING WEATHER HERE IN THE
ROOM OR AT ONE OF OUR VIDEO
CONFERENCING SITES IF YOU DO
NOT HAVE A MASK WE CAN PROVIDE
ONE FOR YOU- WHEN WE REACH THE
PUBLIC COMMENTS PORTION OF THE
AGENDA I WOULD ASK THAT ANY
MEMBERS OF THE PUBLIC TO
TESTIFY. EITHER IN THE STATE
CAPITAL OR WITNESS VIDEO ROOM
TO- PLEASE- MAINTAIN SIT SOCIAL
DISTANCE AS YOU JUST AS SOON AS
YOU MOVE AROUND THE ROOM. IN
ADDITION WE HAVE PANELISTS AND
OTHER MEMBERS OF THE PUBLIC
MAKING USE OF ONE OF OUR VIDEO
CONFERENCING ROOMS HERE IN THE
CAPITAL AND IN A FEW LOCATIONS
THROUGHOUT THE STATE. THOSE
WITNESSES WILL APPEAR ON THE
SCREEN SO MEMBERS CAN WATCH
THEIR TESTIMONY LIVE. FROM
OUTSIDE THE HEARING ROOM AND
ALSO ASK THEM QUESTIONS. WE'LL
ALSO BE USING A MODERATE
TELEPHONE SERVICE THROUGH WHICH
ANY MEMBER THE PUBLIC CAN
PROVIDE COMMENTARY WHEN WE GET
TO THAT POINT IN THE AGENDA.
PALACE HAVE BEEN PROVIDED A
CALLING NUMBER PRIOR TO THIS
HEARING. THE CALL IN NUMBER FOR
PUBLIC COMMENT FOR THIS HEARING
IS EIGHT SEVEN SEVEN. SIX NINE
TWO. EIGHT NINE FIVE SEVEN. AND
THE ACCESS CODE IS ONE THREE
ONE FIVE. FOUR TWO- OH TWO.
READ THAT AGAIN. EIGHT SEVEN
SEVEN SIX NINE TWO EIGHT NINE
FIVE SEVEN IS THE CALL IN
NUMBER. AND THE ACCESS CODE IS
ONE THREE. ONE FIVE. FOUR TWO
OH TWO. YOU CAN ALSO FIND THIS
NUMBER ON THE ASSEMBLY HEALTH
COMMITTEE'S WEBSITE AS WELL AS
ON YOUR TV SCREEN. THE OPERATOR
ON THE LINE WILL GIVE YOU
INSTRUCTIONS ON HOW TO BE
PLACED IN THE QUEUE. AND TO
PROVIDE YOUR PUBLIC COMMENT. IF
YOU'RE CALLING IN PLEASE
ELIMINATE ALL BACKGROUND NOISE
THIS INCLUDES MUTING YOUR LIVE
STREAM BROADCAST IN YOUR SMART
DEVICES TO REDUCE REDUCE THE
SOUND DISTORTION. WAS YOUR
PLACE IN THE CALL IN THE QUEUE.
YOU'LL ALSO NEED TO MEET
YOURSELF UNTIL YOU ARE CALLED
UPON TO SPEAK. REVENUE PROBLEMS
OF THE MODERATED TELEPHONE
SERVICE. YOU CAN CALL THE
COMMITTEE AT NINE ONE SIX.
THREE ONE NINE. TWO ZERO NINE
SEVEN AND MY STAFF WILL BE
THERE TO TRY TO HELP. I ALSO
WANT TO NOTE THAT WE ARE
ACCEPTING WRITTEN PUBLIC
COMMENT THROUGH THE HEALTH
COMMITTEES PUBLIC EMAIL. A. H.
E. A. DOT COMMITTEE. AT
ASSEMBLY DOT C. A. DOT G. O. V.
WHICH IT CAN ALSO BE FOUND ON
OUR WEBSITE. WE MAY NEED TO
LIMIT HOW LONG EACH PERSON HAS
TO PROVIDE PUBLIC COMMENT. AND
I WANT TO THANK YOU FOR YOUR
PATIENCE- I WANT TO THANK YOU.
THANK YOU TO OUR SPEAKERS FOR
ACCOMMODATING REQUESTS. TO
RESENT AT THIS HEARING DURING
THE PANDEMIC. THIS IS THE THIRD
AND LIKELY FINAL JOINT
INFORMATIONAL HEARING ON
CALAMP. TODAY'S HEARINGS FOCUS
ON THE PROPOSED MEDIC CAL. IN
C. A. Q. ACCREDITATION. MANAGED
CARE RATES. D. SNAP. THE
PROPOSAL AND COUNTY ELIGIBILITY
PROVISIONS. WE HAVE A COUPLE
NEW DH CS PREVENT PRESENTERS
WHO WILL- WE WILL ANNOUNCE AT
THE- AT THE AT EACH PANEL. ALSO
A LOT OF THE A LOT TO DISCUSS
WITH A VERY FELIZ. SO JUST SAY
I LOOK FORWARD TO HEARING THE
TESTIMONY. AND WE WILL TAKE ALL
PUBLIC COMMENT AT THE END OF
THE HEARING SOUTH- I'D LIKE TO
INVITE DOCTOR AMBULANCE- TO
MAKE ANY OPEN REMARKS. AND
STATUS LET US BEGIN THE HEARING
I DID WANT TO TAKE A MOMENT TO
THANK THE STAFF. WORK THAT IS
COMMON TO THE THREE.
INFORMATION HERE IS THAT WE GOT
TOGETHER. AS WELL AS TO THANK
YOU. FOR SHARING THIS WITH US
AND ALLOWING US TO DO A DEEP
DIVE. INTO. THE PROFILE TO SEE
IF WE CAN. WITH OUTLOOK BEGIN
THANK YOU- SO WITH WE HAVE NOT
PANEL- TO DISCUSS PROPOSED
CHANGES TODAY ALL THE PANELS
ARE USING WEBEX SO WE CAN SEE
THEM AS THEY SPEAK. OF THE
HEARING PAPER IS POSTED ON THE
ASSEMBLY WEBSITE UNDER THE
HEARINGS AND THEN INFO HEARINGS
TAB- DR RANDALL AND I WILL
ALTERNATE CHEERING EACH PANEL
AND AT THE END OF THE HEARING
WILL TAKE PUBLIC COMMENT. OUR
FIRST PANEL- AND JUST SO YOU
KNOW THE SOME OF THE- SOME OF
THE HARDER ONES ARE GOING TO BE
UP FRONT AND- WHILE NONE OF
THIS IS EASY. I THINK THE
LENGTHY IT MORE LENGTHY
DISCUSSIONS ARE GOING TO HAPPEN
ON ON INDIVIDUAL ITEMS AT THE
BEGINNING OF THIS HEARING. OUR
FIRST PANEL IS ON THE IS ON THE
REQUIREMENT FOR PLANS TO B. AND
C. Q. A ACCREDITED. AND THE
OPTION FOR THE DEPARTMENT OF
HEALTH CARE SERVICES TO DEEM
PLANSAS COMPLYING WITH STATE
AND FEDERAL STANDARDS IF THE
PLAN MEETS. NCQA STANDARDS
STANDARDS. THE PANELS ARE- WILL
LIGHT BURN THE DIRECTOR FOR A
HEALTH DEPARTMENT HEALTH CARE
SERVICES JC COOPER THE CHIEF
DEPUTY DIRECTOR. FOR HEALTH
PROGRAM HEALTH CARE PROGRAMS IN
THE STATE MEDICAID DIRECTOR.
DEPARTMENT OF HEALTH CARE
SERVICES BEN JOHNSON THE
PRINCIPAL IN FISCAL POLICY
ANALYST FOR THE L. A- CAPTAIN
BARRESI- ARE IN- THE DIRECTOR A
CHARACTER CCM. DIRECTOR CARE
COORDINATION. PARTNERSHIP
HEALTH PLAN OF CALIFORNIA. AND
MJ DIAZ AND GOVERNMENT
RELATIONS. ADVOCATE FOR SEIU
CALIFORNIA. THANKS IN ADVANCE-
AND- HELLO ALLOW THE-
ADMINISTRATION ERA TO BEGIN
THANK YOU. SHE. WELL PRESSING
ON SOME SPECIFIC BENEFIT AREAS
AS WELL AS ON. VERY VERY
SIGNIFICANT ISSUES- ON SHARING
TRANSPARENCY AND ACCOUNTABILITY
IN THE PROGRAM- FOR THE FIRST
TIME ALL OF OUR STATE MEDICAID
DIRECTOR J. C. COOPER WILL ALL
BE OUR LEAD PROJECT. BEFORE WE
START I JUST I THINK AND THANK
YOU DIRECTOR LIFE FOR ANYONE
APOLOGIZE THAT- THE TECHNICAL
CHALLENGES OF DOING ALL THESE
THINGS ARE NOT BEING IN THIS
ROOM AS OFTEN AS WE USED TO
ACTUALLY- DR RIDICULOUS
COMMENTS. PROBABLY DIDN'T COME
THROUGH BECAUSE I HAD HIS
MICROPHONE TURNED OFF I DIDN'T
MEAN TO DO THAT TOO I MIGHT
TREASURY WAS A COLLEAGUE SO.
BUT SHE'S. DO YOU WANT TO SAY
THANK NOW HE'S RIGHT WE'RE
READY TO GO NOW OKAY THANK YOU.
RIGHT GOOD MORNING EVERYONE I'M
STILL IN ALIGNMENT WITH- ONE OF
THE MAIN- CALLIN GUIDING
PRINCIPLES OF KIND
STANDARDIZING AND SIMPLIFYING
ACROSS MEDIC CAL DH CS IS
PROPOSING TO REQUIRE ALL
MEDICARE MANAGED CARE PLANS AND
THEIR HEALTH PLANS OF
CONTRACTORS TO BE NCQA
ACCREDITED BY TWENTY TWENTY SIX
I HIGHLIGHT THE ON THE HEALTH
PLAN A SUBCONTRACTORS PART
BECAUSE AT THIS TIME THE
DEPARTMENT ISN'T PROPOSING A TO
GO DOWN TO THE- IPA OR PROVIDER
OF LEVEL IN REGARDS TO THOSE
THAT TAKE RISK- SOMETHING FOR
US TO EXPLORE IN THE FUTURE BUT
AT THIS TIME OUR PROPOSALS.
FOCUSED AROUND HEALTH PLANS THE
CONTRACTORS. I'M IN ALTHOUGH
THEY WOULDN'T HAVE TO COME INTO
COMPLIANCE UNTIL TWENTY TWENTY
SIX DH CS DOES BELIEVE THAT THE
PROPOSAL COULD NOT BE DEFERRED
TO A LATER DATE IN ORDER TO
PROVIDE PLANS THE NECESSARY
TIME. I REALLY TO PREPARE FOR A
MEETING THE ACCREDITATION
REQUIREMENTS ADDITIONALLY I
NEED TO BE CLEAR IN OUR
UPCOMING AS CARE FOR KERR
PROCUREMENT GOING ON THIS YEAR-
THAT WE WOULD HAVE THIS
EXPECTATION IN CALIFORNIA SO
ANYONE. RESPONDING TO THAT
PROCUREMENT UNDERSTANDS THAT
THEY WOULD NEED TO BE NCQA
ACCREDITED IN CALIFORNIA WITHIN
MEDICAID- BY THAT TWENTY TWENTY
SIX TIME PERIOD. NCQA
ACCREDITATION PROVIDES AN
INDUSTRY ACCEPTED ACCREDITATION
STANDARD IN SIX MAIN AREAS-
THAT INCLUDES QUALITY
IMPROVEMENT POPULATION HEALTH
MANAGEMENT NETWORK MANAGEMENT
UTILIZATION MANAGEMENT
CREDENTIALING AND RE
CREDENTIALING- AND MEMBER
EXPERIENCE. I WOULD ALSO
HIGHLIGHT HERE MANY OF THE
COMPONENTS OF THE CALAIS
POPULATION HEALTH MANAGEMENT.
DIRECTLY ALIGNS WITH NCQA
REQUIREMENTS AND THEN OF COURSE
WITH OUR PROPOSAL IN CALENDAR
DOES GO ABOVE AND BEYOND SOME
OF THE REQUIREMENTS WITHIN NCQA
ACCREDITATION. BUT USES IT AS A
FOUNDATION AND BASE FOR MANY OF
THOSE COMPONENTS. NCQA
ACCREDITATION ALSO PROVIDES THE
BEST PLATFORM TO INCREASE
STANDARDIZATION ACROSS MEDICARE
MANAGED CARE PLANS AND AFFORD
ALL PLANS WITH A VERY
CONSISTENT FOUNDATION OF
QUALITY BEST PRACTICES. TWENTY
SIX OTHER STATES ARE CURRENTLY
REQUIRE NCQA ACCREDITATION OF
THEIR CONTRACTED MEDICAID
HEALTH PLANS- OUT OF THE TWENTY
FOUR FULL SCOPE MEDICAL HEALTH
PLANS IN A CALIFORNIA-
SEVENTEEN CURRENTLY HAVE NCQA
ACCREDITATION SO HUGE NUMBER OF
THEM ALREADY HAVE THIS
ACCREDITATION TODAY. HEALTH
PLANS THAT PROVIDE PRIVATE
COVERAGE THROUGH COVERED
CALIFORNIA ARE REQUIRED TO BE
ACCREDITED BY NCQA- OR OTHER
ACCREDITING ORGANIZATIONS AS
WELL SO REALLY LOOKING FOR
CONSISTENCY ACROSS ALL OF OUR-
OUR BEER YES AB. ADD ENTITIES
IN PAIRS. ABOUT REQUIRING NCQA
ACCREDITATION OF THE MANAGED
CARE PLANS- AND FOLLOWING THE
NCQA FRAMEWORK DH CS IS GOALS
TO REALLY TO INCREASE THAT
SANDERS ASIAN ACROSS THE STATE
TO REDUCE REDUNDANCIES. IN
VARIOUS PROCESS SEASON
ASSESSMENTS PARTICULAR LEE AND
REALLY- THE CARE COORDINATION
PIECES AS WELL AND BY BRIDGING
SOME OF THOSE BEST PRACTICES IN
NCQA. NCQA HAS ALSO BEEN A
NATIONAL LEADER RECENTLY IN
REGARDS TO REALLY FORGING
FORWARD IN REGARDS TO EQUITY
WORK AS WELL AS WORKING VERY
CLOSELY WITH CALIFORNIA ABOUT
HOW TO EVEN IMPROVE SOME OF THE
NCQA PIECES AROUND CARE
COORDINATION- COMPLEX CASE
MANAGEMENT AND OTHER PIECES
THAT REALLY ALIGNED WITH THE
WORK THAT WE'RE DOING HERE IN
CALIFORNIA AND SEE THEM AS THAT
IS A GOOD PARTNER MOVING
FORWARD. THE ACS DOES NOT
RECOMMEND ALLOWING
ACCREDITATION OR MONITORING BY
AN ALTERNATIVE SO NON NCQA
ENTITY IN OUR PROPOSAL- OF
COURSE UNLESS THE HEALTH PLAN
DOES NOT QUALIFY FOR THE NCQA
ACCREDITATION BASED ON SIZE OR
SCOPE. OF THE MEMBER POPULATION
BECAUSE NCQA IS AN INDUSTRY
STANDARD FOR HEALTH PLAN
ACCREDITATION WE DON'T
ANTICIPATE THAT THERE WOULD BE
MANY IN CALIFORNIA- THAT WOULD
NOT MEET THAT STANDARD BASED ON
THE SIZE OF MEDIC AL HOWEVER
JUST NOTING THAT- EXCEPTION
POTENTIALLY. WOULD HAVE TO BE
CONSIDERED IN THE FUTURE.
ADDITIONALLY THE CS- IS KERR
ASSESSING WHETHER WE WOULD
ALLOW CERTAIN APPLICABLE STATE
AND FEDERAL MEDICAID
REQUIREMENTS FROM. THE
DEPARTMENT ANNUAL MEDICAL
COMPLIANCE AUDIT TO BE
EVALUATED ON RESULTS OF NCQA
ACCREDITATION- THIS IS
TYPICALLY. SEEN AS DEEMING- OR
TALK ABOUT AS AS DEEMING- AS
YOU ARE PROBABLY VERY WHERE DH
YES CURRENTLY ALLOWS FOR NCQA
DEEMING AND CREDENTIALING ARE
TODAY- FOR THE- SERVICES FOR
THE PLAN TO OUR NCQA ACCREDITED
OF COURSE- HOWEVER. IN THE
FUTURE BEFORE DH YES WOULD
ALLOW FOR ANY DEEMING WITHIN
THE PROCESS WE WOULD ENGAGE
WITH STAKEHOLDERS INCLUDING THE
LEGISLATURE I TO BE VERY
TRANSPARENT AROUND WHAT WE WERE
IN OR NOT. I DEEMING IN REGARDS
NCQA. HOWEVER I WANT TO BE
CLEAR HERE THAT DH CS IS NOT
CONSIDERING REPLACING ANY OF
OUR OVERSIGHT REQUIREMENTS-
WITH NCQA ACCREDITATION. A LAW
DOES ALLOW FOR A STANDARD
ACROSS ALL MANAGED CARE PLANS.
OF THAT WE DO NOT SEE THAT
WOULD THAT WOULD CHANGE OUR
ROLE AND RESPONSIBILITY IN
REGARDS TO DEPARTMENT
OVERSIGHT. INCLUDING REVIEWING
ALL OUTCOMES NCQA
ACCREDITATION- AND REALLY WE
SEE IT AS AN ENHANCEMENT TO THE
DARK DEPARTMENTS CURRENT.
OVERSIGHT POLICIES AND
PROCEDURES. I SO REALLY STATED
A PREVIOUS THAT IS NOT
INTENDING TO KIND OF CBO
OVERSIGHT- AND LOOK FORWARD TO
ANSWERING ANY QUESTIONS AT THIS
COMMITTEE MAY HAVE. THANK YOU
VERY MUCH- WILL GO ON TO OUR
NEXT OUR NEXT WITNESS PLEASE.
GOOD MORNING NOW BEEN JOHNSON
FROM THE LEGISLATIVE ANALYST'S
OFFICE- JUST HAVE A FEW BRIEF
COMMENTS HERE TODAY FIRST JUST
WE WANT TO RECOGNIZE THE
BENEFITS OF NCQA ACCREDITATION-
AND POTENTIALLY REDEEMING THE
FINDINGS OF THE WAY THAT
STREAMLINE AND STANDARDIZE
OVERSIGHT OF. MEDICAL MANAGED
CARE- DO A ALLOWING FORTY MAYBE
COULD REDUCE REGULATORY BURDEN
ON MEDICARE MANAGED CARE PLANS
WHILE ALSO FREEING UP G. H. U.
S. WORKLOAD TO POCUS ON OTHER
ACTIVITIES- ONE- ONE ADDITIONAL
NOTE WELL- DIRECTOR COOPER
NOTED THAT- ABOUT ABOUT HALF OF
ALL STATES ARE REQUIRED TO Q.
EIGHT CREDIT ASIAN- WE LOOKED
INTO HOW MANY DO YOU CAN. DO
YOUR STREAMING AND IT WAS ABOUT
HALF OF THE STATES THAT
REQUIREMENTS HE CUTE A CREDIT
ATION- ALLEN DO YOU DEEM- TO
THE FINDINGS THAT DETERMINE
THAT THOSE ITEMS MANAGED CARE
PLANS ARE MEETING STATE AND
FEDERAL STANDARDS. JUST REYES
ARE SEVERAL ISSUES FOR
CONSIDERATION- FIRST ALBUM THE
PROPOSED TRAILER BILL WHICH
WOULD GIVE DHS AUTHORITY TO
DETERMINE WHICH IF ANY- STATE
AND FEDERAL STANDARDS- IT WOULD
P. HIM AND THAT'S UNCLEAR
EXACTLY WHAT THE ROLE WOULD BE
OF THE LEGISLATURE IN PROVIDING
OVERSIGHT OVER THOSE OVER SUCH
DECISIONS- SECOND. MINISTRATION
HASN'T PROVIDED- OF DETAIL ON
THE FISCAL IMPACTS OF REQUIRING
ACCREDITATION WHICH COULD
INCLUDE NEW COMPLIANCE COSTS UP
FOR MANAGED CARE PLANS THAT
ULTIMATELY COULD BE REFLECTED
IN THEIR CAPITATED RATES. AND
SIMILARLY THAT WE DON'T HAVE A
GOOD UNDERSTANDING OF WHAT KIND
OF RESOURCES EVEN COULD
POTENTIALLY BE SORT OF RE
DIRECTED- OR- FREED UP IF THAT
CERTAIN STANDARDS WERE TO BE
DEEMED TO NCQA- AND THEN BURKE
JUST HAVE OUT WE ONLY HAVE A
PRELIMINARY UNDERSTANDING STILL
OF- OF HOW. NCQA ACCREDITATION
STANDARDS THAT REALLY SORT OF
PRECISELY TO STATE'S. AND- SO
WHICH ON SURE IT UNCLEAR IF. SO
OF WHICH STATE AND FEDERAL
RULES BE OF A FACT DONE. TO THE
ACROSS BODY. I DON'T AND THEN
JUST LET WE JUST SORT OF PICK
IT IS CERTAINLY APPROPRIATE FOR
THE LEGISLATURE TO CONSIDER-
THE POLICY IMPLICATIONS OF
DELEGATING YOU KNOW THE
IMPORTANT STATE OVERSIGHT-
RESPONSIBILITIES OF MEDICAID
MANAGED CARE PLANS. TO AN
OUTSIDE CONTRACTOR THAN TODAY
THANK YOU AND HAPPY TO TAKE ANY
QUESTIONS. THANK YOU VERY MUCH
WILL GO AHEAD AND MOVE ON TO
OUR NEXT WITNESS. CHISORA
CATHERINE BARRESI. HI GOOD
MORNING EVERYONE- MY NAME IS
KEVIN BROPHY ON THE RECORD CARE
COORDINATION FOR PARTNERSHIP
HEALTH PLAN OF CALIFORNIA-
PARTICIPATE THE NONPROFIT
COMMUNITY BASED ORGANIZED HELP
AT THAT THEM NOT SERVE OUR
PRIMARILY FOURTEEN NORTHERN
CALIFORNIA COUNTIES AND REALLY
AIMED AT IMPROVING THE LIVES
AND THE QUALITY OF CARE THAT
OUR MEMBERS AND BENEFICIARIES
WITH THE- PARTNERSHIP WITH
ACTUALLY RECENTLY AWARDED NCQA
ACCREDITATION IN FEBRUARY OF
TWENTY TWENTY ONE- AND FOR
THOSE OF YOU WHO MIGHT NOT BE
FAMILIAR WITH THE NCQA ACRONYM
THAT STANDS FOR THE NATIONAL
COMMITTEE FOR QUALITY
ASSURANCE- IT'S A NONPROFIT
ORGANIZATION THAT'S BEEN
EVALUATING- HEALTH CARE AND-
EVIDENCE BASED APPROACHES FOR
OVER TWENTY FIVE YEARS
NATIONALLY- PARTNERSHIP DECIDED
TO PUT. TWO AND TWO C-
BECAUSE ITS MISSION AND VALUES
ARE VERY MUCH IN LINE WITH
PARTNERSHIP MISSIONS AND
VALUES- AND LOOKING AT A
CONFERENCE A FRAMEWORK TO
ASSIST US IN ACHIEVING OPTIMAL-
QUALITY FOR OUR MEMBERS AND
PROVIDERS- AS WELL AS
CONFUSING- EVALUATION AND
MEASUREMENT ACTIVITIES WITHIN
OUR OWN OPERATIONS- ANOTHER
FACTOR THAT PLAYED INTO
PARTNERSHIPS DECISION FOR
PURSUING ANTI Q. WAY- WITH THAT
WE OBVIOUSLY PARTICIPATE IN OUR
ANNUAL I SEE THIS COLLECTION
ACTIVITIES- AND BOTH THE CUTEST-
PROGRAMMATIC WORK WITH NCQA AND
THEIR ACCREDITATION PROCESS
REALLY DO GO HAND IN HAND- WITH
SUPPORTING- REALLY ALL AREAS OF
QUALITY WITHIN HEALTH CARE-
HEALTH CARE OPERATIONS
HEALTHCARE DELIVERY. AN ACTUAL
HEALTHCARE OUTCOMES THAT
PATIENTS. EXPERIENCE IN THEIR
LIVES- IT IS MORE MENTIONING
HOWEVER THAT FOR MEN CARE OR NO
YET AND YOUR CREDIT AND I.
COOPER NOTED THERE- ARE ABOUT-
SEVEN OR SO THE ARE NOT THERE
YET IN CALIFORNIA- THAT
CONSIDERABLE INVESTMENTS ARE
NEEDED- PREEMPTIVELY IN ORDER
TO PURSUE THAT THIS IS NOT
SOMETHING THAT A PLAN JUST
DECIDES TO DO OVERNIGHT AFTER
PARTNERSHIP IT WAS ACTUALLY A
FIVE YEAR PLANNING. PROCESS AND
A DEDICATED PROCESS THAT
EVERYBODY WITHIN OUR
ORGANISATION- HAD TO STAY
COMMITTED TO- WHAT I SPEAK TO
THAT BECAUSE CURRENTLY WITH AN
ANTI CURATORS ACTUALLY OVER
SIXTY SIX FACTORS- WITH SUB
ELEMENT BENEATH THAT THAT
PLANTS HAVE TO DEMONSTRATE
THESE KEY AREAS IN A PATH. UP
FULL OR PARTIAL PERFORMANCE IN
ORDER TO. ACHIEVE AND MAINTAIN
ACCREDITATION- WHAT'S
INTERESTING THOUGH IS IT'S NOT
JUST THE OPERATIONAL BENCHMARKS
AND DEMONSTRATION IT'S ACTUALLY
AN OVERALL ANALYSIS AND ONGOING
FRAMEWORK- PLAN CAPTAIN BACKED
THEM PREEMPTIVELY. OFFER. AND
IF YOU A PURPOSE AS- SO WHILE
PARTNERSHIP RECORD RECORD THE
CAN TO ACT AND HOW CARE AND
BASE X. THAT AND C ALL-
FOOTBALL COME. AND MEDICAID
NATIONALLY- WE WANT TO KIND OF
HIGHLIGHT FOR THE COMMITTEE IT
DIED- THE PROPOSAL WITH AND CAL
AIMS MIGHT BE A HARD LEFT- FOR
SOME OF THE MANAGED CARE PLANS
THAT ARE NOT YET AND VQA
ACCREDITED- THERE ALSO ANOTHER
KEY. AREA TO HIGHLIGHT FOR THIS
COMMITTEE IS THAT THERE'S
VARIOUS AREAS AND FACTORS
WITHIN AND FIFTY WAY TODAY THAT
ARE NOT IN ALIGNMENT WITH THE
ETF STANDARDS IN CONTRACT
LANGUAGE SUCH AS DELEGATION
DELEGATION OVERSIGHT. COMPLEX
CASE MANAGEMENT IN THE PROPOSED
ENHANCED CARE MANAGEMENT
BENEFITS AND POPULATION HELP
THEM IN THE QUEUE- IN ADDITION
TO THAT THE NCQA STANDARDS
CHANGE ANNUALLY- AND
ACCREDITATION PROPERTIES HOW
DISTINCTIVE LOOK BACK PERIOD-
IN ORDER FOR PLANS TO MEET.
THOSE BENCHMARKS SO THAT WOULD
CREATE AN ADDITIONAL PRIME ONE
STRUCTURE FOR BOTH PCS AND THE
MANAGED CARE PLANS TO-
ORCHESTRATE ACTIVITIES. AND-
REGULATIONS AROUND. LASTLY I
WOULD THE AFTER COUNTY PROPOSED
ITSELF- IF YOU MAYOR NOT AND
MAY NOT BE AWARE BUT THE-
REQUIREMENT HAVE AID SPECIAL
NEEDS PROGRAM. AND TWENTY
TWENTY FIVE FOLLOWED BY THE
NCQA REQUIREMENT IN TWENTY
TWENTY SIX LEAVE A ONE YEAR
WINDOW. AND FOR NCQA THERE ARE
CERTAIN- ACCREDITATION
STANDARDS FOR PLANS THAT HAVE A
DUAL SPECIAL NEEDS PROGRAM OR
MEDICARE ADVANTAGE FIND
ACTUALLY HAVE A TWO YEAR LOOK
BACK PERIOD SO. THAT MIGHT NOT
AFFORD PLANS I'M NOT TRYING TO
BE SUCCESSFUL- TO MEET. THE
REQUIREMENT IF ONLY GIVEN A
YEAR. I'M PRETTY THREE THEY'RE
SETTLED THEY'RE JUST- THEY HAVE
THE ABILITY TO DIRECTLY IN PART
IMPACT COST- PLAN OPERATIONS
AND PROVIDER NETWORKS. BUT
ULTIMATELY NEED TO SUPPORT THE
PLAN- AND THEY'RE SICK FACT ARE
WITHIN THE CALLIN PROPOSAL WE
HAVE WE REQUEST THAT THE
DEPARTMENT REALLY PARTNER WITH-
PLANT THAT ARE INSECURE
CREDITED AND PLANS THAT ARE
NOT- YOU UNDERSTAND THAT THE
KEY. DRIVERS LASTLY JUST TO
HIGHLIGHT OUT AS A POTENTIAL
OPTION IF- IN FORBEARANCE IS
NOT ON THE TABLE THAT PERHAPS
THE LANGUAGE WITHIN CALTRAIN BE
AT REVISED TO INSTEAD OF FULL
ACCREDITATION. THAT THE
DEPARTMENT LOOK TO THOSE
REMAINING PLANS TO SERVE AB
HAVE FOR SURVEY OR IN TRUMP
SURVEY EXCUSE ME ACCREDITATION.
THE INTERNET SURVEY
ACCREDITATION REALLY THIRDS OF
READINESS BENCHMARK FOR FORMAL
FULL ACCREDITATION AND COULD.
REALLY AFTER SCAFFOLDING TO
HELP THEM PLANNED- BUILD IN THE
IF NECESSARY AT LONG TERM-
INVESTMENT IN SUPPORT. I THE
COMMITTEE FOR THEIR AND WALK
ANYTHING AFTER. THANK YOU VERY-
WILL MOVE ON TO J. D. WITH THIS
YET THANK YOU GOOD MORNING.
GOOD MORNING THANK YOU DOCTOR
WOULD END UP ARAMBULA AND GDS
HERE ON BEHALF OF SEIU
CALIFORNIA TO SHARE
PERSPECTIVES ON REQUIRING MANY
COMMENTERS CAMPAIGNS TO BE NCQA
ACCREDITED AND ALSO DH CS
ABILITY TO DEAN PLANS
COMPLIANCE TO MEET STATE AND
FEDERAL REQUIREMENTS- MISS
COOPER MENTIONED THIS BUT JUST
REMIND US ALL THAT SEVENTEEN
OUT OF THE TWENTY FOUR MANAGED
CARE PLANS ARE ALREADY. AND CQS
ACCREDITED MOST OF WHICH ARE
COMMERCIAL PLANS AND MOST OF
WHICH HAVE STILL YET TO FULLY
DELIVER ON THE PROMISE OF
MANAGED CARE AND ENSURING
ACCESS TO QUALITY HEALTH CARE
TO OUR MEDICARE BENEFICIARIES-
SA BELIEVES NCQA IS A GOOD
MINIMUM THRESHOLD AND STANDARD
BUT IT IS A NATIONAL STANDARD
THAT MAY NOT BE SUFFICIENT TO
MEET OUR EXISTING ROBUST. AND-
THAT HAVE CONSUMER PROTECTIONS.
IN THIS LEAGUE IS BASED IN. TWO
COLORS LIKE THE KNOX KEEN ACT
TO HOLD MANAGED CARE PLANS
ACCOUNTABLE IN MEETING THE
HEALTHCARE NEEDS OF MEDICARE
BENEFICIARIES- A SECOND LEAD
THIS PROPOSAL LEAVES DISCRETION
TO DH CS TO DECIDE WHETHER. TO
DECIDE WHAT THEY CAN MONITOR-
BASED ON NCQA STANDARDS THAT
THE AGENCY HAS PROCESS WILL
BECOME A BLACK BOX WHERE THE
PUBLIC AND RELEVANT
STAKEHOLDERS WILL NOT KNOW WHAT
NCQA STANDARDS THE AGENCY AS
WELL OR WILL NOT MONITOR AND AT
WHAT MONITORING AND DECISION
MAKING PROCESS WILL BE H. C. AS
USE FOR DEEMING NCQA STANDARDS
TO MEET STATE PURPOSES. ARE WE
STRONGLY SUGGEST NCQA ACCREDITS
ACCREDITATION SHOULD BE
PUBLICLY POSTED ON THE H. C. S.
WE NEED PUBLIC DISCLOSURE SINCE
WE DO NOT KNOW HOW THIS FULLY
WORKS WHAT IF PLANS DON'T MEET
ALL STANDARDS IT'S UNCLEAR IF
THERE WILL BE A REQUIRED
CORRECTIVE ACTION OR
ENFORCEMENT ACTION IF ANY. ARE
WE STRONGLY SUGGEST DH CS
SPECIFY WHICH STAKEHOLDERS A
PLAN TO ENGAGE PER THE COW AND
TBL SO WE CAN DETERMINE THAT
THESE ARE APPROPRIATE AND
SUFFICIENT STAKEHOLDERS IT
SHOULD NOT JUST BE MANAGED CARE
PLANS THAT THE H. THE ASKING
FOR A WAIT THERE SHOULD BE
PATIENT CONSUMER ADVOCATES AS
EXCLUSIVE REPRESENTATIVES OF
MEDICAL PROVIDERS AND OTHERS
THAT HAVE WORKED TO HOLD
MANAGED CARE PLANS AND FRANKLY
DH CS ACCOUNTABLE. LASTLY
EXISTING LAW HAS REQUIREMENTS
ON DH CS TO HAVE PROPER PROCESS
FOR OVERSIGHT AND TRANSPARENCY
OVER TO THEIR DECISIONS WE
SUGGEST THE LEGISLATURE
CONSIDER ADDITIONAL TV ALL TO
FURTHER ESTABLISH A PROCESS TO
ENSURE THAT THE LEGISLATURE IS
ENGAGEMENT- IN ADDRESSING THIS
PROPOSAL AND WITH ALL OF THAT
SAID I'M HAPPY TO ANSWER ANY
QUESTIONS THANK YOU. THANK YOU
VERY MUCH AND MY APOLOGIES-
THAT I INADVERTENTLY LEFT OFF
KERRY SANDERS- WITH. THE- THE
SENIOR POLICY DIRECTOR WITH THE
K. DEPEND I THINK HELP HEALTH
THAT I HOPE SHE'S OUT THERE.
WAS AN ERROR ON MY PART AND- I
JUST JUMPED RIGHT OVER IT SOUTH.
TWICE I'M HERE GOOD THANK YOU.
THANK YOU- SO- GOOD MORNING
SHARON MEMBERS MY NAME IS KERRY
SANDERS AND THE SENIOR POLICY
DIRECTOR WITH THE CALIFORNIA
PAN ETHNIC HEALTH NETWORK-
DEPENDS THE STATEWIDE HEALTH
ADVOCACY ORGANIZATION DEDICATED
TO ELIMINATING HEALTH
DISPARITIES AND ACHIEVING.
PUBLICLY FOR CALIFORNIA'S
DIVERSE COMMUNITIES OF COLOR
I'D LIKE TO THANK THE ASSEMBLY-
COMMITTEE CHAIRED JOINTLY
HOLDING THIS IMPORTANT HEARING
AND THE STAFF AT DH CS- THEIR
HARD WORK IN ADVANCING- THIS
AMBITIOUS AT A PROPOSAL- WE
WERE ACTIVELY ENGAGED IN THE-
NCQA ACCREDITATION WORKGROUP-
AND HAVE COMMITTED SEVERAL
COMMENT LETTERS ON THE
COMPREHENSIVE THAT OUR
PROPOSALS- BEFORE YOU- WE
APPRECIATE THE DEPARTMENT'S
EFFORTS TO INCREASE
STANDARDIZATION AND REDUCE
VARIATION ACROSS MANAGED CARE
PLANS. IT'S KIND OF NOT OPPOSE
REQUIRING ALL MEN AND MANAGED
CARE PLAN TO GET ACCREDITATION
FROM THE NATIONAL COMMITTEE FOR
QUALITY ASSURANCE. CALIFORNIA
IS ONE OF JUST ELEVEN STATES
THAT DO NOT REQUIRE AN TO COOK
YOU A ACCREDITATION OF THEIR
MANAGED CARE PLANS WE RECOGNIZE
THAT SEVENTEEN OF CALIFORNIA
TWENTY SIX PLANS ARE ALREADY
AND GQ ACCREDITED OR ARE IN THE
PROCESS AND THIS REQUIREMENT
COULD HELP ACCELERATE ADOPTION
BY ALL PLAN- WELL AND SECURE
CREDIT ASIAN IS IMPORTANT
STRATEGY MANDATORY KNOCKS KEEN
LICENSURE SHOULD BE A HIGHER
PRIORITY. WE BELIEVE THAT
MANDATORY- NOT IN LICENSURE
WOULD BE A GREATER STEP TOWARD
STANDARDIZATION FOR THAT ALL
PLANTED HERE TO THE STATE AND
STATE LAW AND ALL MEDICAL
KNOWLEDGE HAVE ACCESS. TO THE
SAME CONSUMER PROTECTIONS. WE
OPPOSE GAMING. CALIFORNIA LAW
IS THAN FEDERAL. AND NOT
NUMEROUS. INCLUDE FOR LANGUAGE
JACK NOW ADDICT STAND AND MAY
OTHER. WASHINGTON OTHER STATES
REQUIRE AND TWO C
ACCREDITATION WITHOUT ALLOWING
DEEMING OTHER STATES ALLOW
DEEMING IN ONLY VERY NARROW AND
LIMITED CIRCUMSTANCES. IF ANY
IS ALLOWED IT SHOULD BE
CAREFULLY VETTED TO BE IN
INSTANCES WHERE THE REVIEWS AND
HIGHLY DUPLICATIVE BOTH IN THE
STANDARDS BEING TESTED THE
SPECIFICS OF THE STANDARDS AND
THE PROCESSES USED. DENOUNCES
PROVIDED TO THE WORKGROUP
INDICATED MANY METRICS THAT
WERE SUPPOSEDLY POTENTIALLY
DIMPLE HAD DIFFERENT STANDARDS.
LET'S LOOK AT THE FIFTY OR
OTHERWISE DID NOT HOLD THE PLAN
SIMILARLY ACCOUNTABLE. WE WOULD
ONE. ANY GAME STANDARDS TO BE
REVIEWED AND A PUBLIC PROCESS
AND BE ROUTED WE VISITED ON A
REGULAR BASIS. GIVEN THE NCQA
STANDARDS OFTEN AND EVOLVE AND
ARE NOT NECESSARILY IN
CALIFORNIA AND THE PUBLIC
INTEREST. IN PART BECAUSE THE
DIVERSITY OF OUR STATE OUR
SCALE IN OUR STRUCTURE
CALIFORNIA HAS REGULATIONS THAT
ARE STRONGER THAN FEDERAL LAW
INCLUDING WITH RESPECT TO AS I
MENTIONED LANGUAGE ACCESS
NETWORK ADEQUACY AND OTHER
CONSUMER PROTECTIONS. STANDARDS
RELATIONSHIP SHOULD TAKE TO
LEVEL UP TO EXPECTATIONS NOT
WATER THEM DOWN. WE ALSO
CONTINUE TO HAVE CONCERNS
AROUND DELEGATION BOTH IN TERMS
OF WEATHER AND PICTURESQUE
PROVIDE SUFFICIENT OVERSIGHT OF
DELEGATED ENTITIES. AND WHETHER
AND THE DEMON UP ANOTHER LAYER
OF DELEGATION IN TERMS OF
OVERSIGHT. DHS THE PROVIDE
CALLING PROPOSAL STATES THAT
ACCREDITATION ELEMENTS THAT ARE
SELECTED FOR POTENTIAL DEEMING
WILL BE VETTED WITH
STAKEHOLDERS BEFORE ANY FINAL
DECISIONS ARE MADE. BUT CURRENT
MANY MANAGED CARE PLAN CONTRACT
ALREADY ALLOW FOR DEEMING
UNCERTAIN SITUATIONS SUCH AS
PROVIDER ORGANIZATION
CREDENTIALING HEALTH PLAN
ACCREDITATION AND CREDENTIALING
OUTPATIENT MENTAL HEALTH
SERVICES- WITHOUT CONSUMER
STAKEHOLDER INPUT. WE REQUEST
THE LEGISLATURE STRIKE THE
DHS'S PROPOSED LANGUAGE
ALLOWING THE DEPARTMENT INDIAN
PLANS IN COMPLIANCE WITH STATE
AND FEDERAL MEDICAID
REQUIREMENTS. AGAIN WE
APPRECIATE THE INTENTION OF THE
ADMINISTRATION TO CONSULT WITH
AFFECTED STAKEHOLDERS- AS THEY
SAY TO THE EXTENT PRACTICABLE-
BUT WE YOU KNOW FILL THAT
STRONGER PROTECTIONS ARE NEEDED
AND WE HAVE. WE HAVE NOT SEEN
OUR STANDARDS IN PLACE AND WE
WANT TO MAKE SURE THAT PLANS
ARE FOLLOWING THEM. THANK YOU
FOR THE OPPORTUNITY TO TESTIFY
AND I LOOK FORWARD. TO
ANSWERING ANY ANY OF YOUR
QUESTIONS. THANK YOU VERY MUCH
AN AND WITH THAT WE WILL GO TO
FROM COMMITTEE A QUESTIONS. TO
DR EMIL. THANK YOU MISTER
CHAIR- I'M GOING TO HAVE TWO
QUESTIONS FOR THE DEPARTMENT
I'D LIKE TO FOLLOW UP IF I
COULD WITH WHERE SEE PAN AND S.
YEAH YOU WERE ASKING THE
QUESTIONS AND- I DO BELIEVE
THAT A GOAL OF CALLIE MISS
STANDARDIZATION AND SO MY
QUESTION FOR YOU IS WHY. AREN'T
WE STANDARDIZE AND CONSUMER
PROTECTIONS AND REGULATORY
OVERSIGHT BY REQUIRING KNOCKS
KEEN LICENSORS INSTEAD OF THE
NCQA ACCREDITATION. SO YEAH
HAPPY TO ANSWER THAT QUESTION I
THINK BOTH KNOCKS KEEN
REQUIREMENTS NCQA SERVE
DIFFERENT FUNCTIONS JUST TO BE
CLEAR SO ON THE DMH SEASIDE FOR
A REGULATORY POINT OF VIEW THAT
THERE IS VERY IMPORTANT I
REQUIREMENTS THAT ARE IN PLACE
THERE- IN IN MEDIC HOW. ABOUT
WE HAVE CO'S PLANS WHO ARE NOT
KNOCKS KEEN LICENSE WE DO HOLD
THEM- VIA THEIR CONTRACT TO ALL
OF THE NIGHT KNOCKING
REQUIREMENTS THAT WE HOLD OUR
KNOCKS KEEN. UP PLANS TO USE OF
THOSE REQUIREMENTS ARE EMBEDDED
INTO THEIR CONTRACTUAL
OBLIGATIONS- AND THAT'S
CURRENTLY HOW WE IN BED SOME OF
THOSE KNOCKS KEEN REQUIREMENTS
INTO. THE CO'S PLANS CONTRACT
WEBER NOTATING AS YOU
MENTIONED- THAT DOESN'T GIVE DO
YOU MAY SEE THE REGULATORY
AUTHORITY OVER THOSE PLANS
JUST. TO BE CLEAR ON THE NCQA
SIDE IT'S REALLY AROUND
STANDARDIZING IN THE AREAS THAT
I'VE- AND HIGHLIGHTED
SPECIFICALLY AROUND A QUALITY
UTILIZATION MANAGEMENT AS WELL
AS SOME OF THE OTHERCOMPONENTS
THERE AND CARE COORDINATION AND
THAT'S JUST A DIFFERENT
FUNCTION IN REGARDS TO THE
ROLE. THAT YOU MAY SEE PLAYS OF
THE REGULATORY BODY- IT'S ALSO
WHY THE DEPARTMENT STILL FEELS
WE NEED TO BE. IN THE ROLE OF
OVERSIGHT AT THE DMH C. R.
STARTED THE DH CS A PLAN THE
MEDICARE PLANS REALLY BECAUSE
THERE'S A LARGE DIFFERENCE IN
REGARDS TO WHAT WE DO FOR
OVERSIGHT MANAGEMENT OF OUR-
OUR MANAGED CARE PLANS. AND
JUST TO CLARIFY BASED ON THE
PREVIOUS CONVERSATIONS BY NO
MEANS WOULD WE NOT BE ENFORCING
THROUGH THE ACS IS OVERSIGHT
AND MONITORING SPOTS ABILITIES
ALL STATE AND FEDERAL LAWS IN
ANYWHERE WHERE THE STATE LAW
GOES ABOVE AND BEYOND FEDERAL
LAW OR AND SEE IF YOU A
REQUIREMENTS WE WOULD STILL BE
HOLDING THE MASK CARE PLANS TO
THOSE REQUIREMENTS. I'M THROUGH
OUR OWN MONITORING- OF SERVICES
AT THE DEPARTMENT SO JUST
WANTED TO CLARIFY THAT BASED ON
SOME OF THE PREVIOUS COMMENTS.
JUST MAKE SURE THAT WAS CLEAR
AS WELL. THANK YOU THAT
CLARIFICATION AND FOR THAT I AM
I'D LIKE TO DIG INTO FURTHER I
COULD ON. AS AS THE- KNOWS I'VE
AUTHORED BILLS THAT WOULD.
ESTABLISH A QUALITY ASSESSMENT
AND PERFORMANCE IMPROVEMENT
PROGRAMS TO HELP US TO IMPROVE
THE MEDICAL MANAGED CARE PLAN.
QUALITY AND FOR US TO REDUCE
HEALTH DISPARITIES. CONSIDERING
THE SIGNIFICANT INVESTMENT
THAT. WE ARE PUTTING INTO
CALTRAIN HOW DOES THIS PROPOSAL
DRIVE AND HOLD PLANS
ACCOUNTABLE. FOR QUALITY
IMPROVEMENT. SO WHAT I WOULD
SAY IS THAT WE'RE TRYING TO
TAKE A MULTI PRONGED APPROACH
TO HOW WE'RE ADDRESSING QUALITY
OF ONE ASPECT IS THE PROPOSAL
TO- HAVE. NCQA ACCREDITATION
WHICH WOULD ALLOW FOR. A SET OF
STANDARD RULES ACROSS ALL PLANS
IN REGARDS TO THE QUALITY
INFRASTRUCTURE THAT THEY HAVE
IN PLACE- BUT THAT IS JUST ONE
OF THE VARIOUS PIECES I WE ALSO
HAVE BEEN OF. INCREASING OUR
REQUIREMENTS IN REGARDS TO
BENCHMARKING HOW WE EVALUATE
OUR PROGRESS ALONG QUALITY OF
IT WILL BE LOOKING AT OTHER
WAYS IN WHICH WE CAN REALLY
ENGAGE WITH OUR MANAGED CARE
PLANS IN REGARDS TO YOU-
IMPROVEMENTS ON THE QUALITY
SPACE. I THINK WE ARE CLEARLY
ACKNOWLEDGE THAT WE NEED TO
THINK DIFFERENTLY AROUND HOW WE
WORK WITH OUR MANAGED CARE
PLANS ON QUALITY IMPROVEMENT UP
WHICH INCLUDES FOCUSING ON
THINGS LIKE DELIVERY SYSTEM
TRANSFORMATION AND NOT JUST THE
METRICS. I THINK IT'S WHY YOU
SEEN SOME OF THE REASON AND
INVESTMENTS AROUND THINGS LIKE
THE BEHAVIORAL HEALTH
INTEGRATION UP OF PROJECTS THAT
WE'RE DOING ACROSS THE STATE OF
CALIFORNIA IS WE KNOW IT'S
GOING TO BE A COMBINATION OF A
NUMBER OF THINGS THAT ARE GOING
TO HELP US MOVE THAT QUALITY
NEED L. THERE'S ALSO A PIECES
AROUND IMPROVING CONTACT- AND
DEMOGRAPHIC INFORMATION WHICH
WE WILL TALK ABOUT LATER IN
THIS. PRESENTATION ASSEMBLY
THAT'S REALLY IMPORTANT SO THAT
PLANTS ACTUALLY HAVE THE
ABILITY TO DO OUTRAGE AND
ENGAGE WITH BENEFICIARIES SO
THEY HAVE THE BEST INFORMATION
POSSIBLE TO DO THAT SO I THINK
WE'RE TRYING TO APPROACH
IMPROVING QUALITY. WITH OUR
PLANS IN A NUMBER OF WAYS ONE
OF WHICH IS THE NCQA. A
RECOMMENDATION FOR
ACCREDITATION. THANK YOU VERY
MUCH FOR THE- THANK YOU- AND I
DID MINE MORE OF A COMMENT AND
I THINK YOU FOR YOUR
PRESENTATION AND THAT IT THAT'S
WHAT MY COMING GOES AROUND-
THE- THAT YOU ARE HOLDING PLANS
YOU'LL BE HOLDING PLANS TO THE
KNOX KEEN STANDARDS AND ENFORCE
AND FORCING ON THAT AND I THINK
THAT'S- I APPRECIATE THAT THAT
CLARIFICATION I THINK IT'S
IMPORTANT- AND- THAT AND I L.
SAY THAT BECAUSE I KNOW THAT.
THE COST TO FOR A CO TO UNDERGO
THAT THE PROCESS TO BECOME A
KNOCKS KEEN PLAN IS AT LEAST IN
ONE CASE THAT I KNOW OF NORTH
OF A MILLION DOLLARS AND SO.
THAT MEANS THAT'S A MILLION
DOLLARS IT MAY NOT BE ABLE TO
GO TO PROPERLY TO PATIENT CARE
OR OR WHATEVER- AND IF YOU'RE
HOLDING THEM TO THE SAME
STANDARDS THEN. IF THAT WERE TO
EVER CHANGE OBVIOUSLY WE WOULD
WHAT I WOULD WANT TO KNOW ABOUT
THAT- BUT IT'S IMPORTANT THAT
WE KNOW THAT THEY ARE BEING
HELD THE SAME STANDARDS WHETHER
THEY ARE NOT KEEN PLAN OR NOT
SO THANK YOU FOR THAT FACT THAT
CLARIFICATION I APPRECIATE THAT.
I THINK WITH THAT- WILL GO
AHEAD AND MOVE ON TO OUR NEXT
PANEL. I WOULD LIKE TO THANK
VERY MUCH PANEL ONE WE WILL NOW
MOVE ON TO THE PANEL TO ON THE
PROPOSED AUTHORITY FOR DH CS TO
ESTABLISH MEDICAL. MANAGED CARE
PLANS ON A REGIONAL BASIS. WE
WILL HAVE FOUR PRESENTERS LINDY
HERRINGTON BEN JOHNSON. MAY
ALTMAN AND DOCTOR LARRY GET
HEALTHY. AND LET'S BEGIN WITH
CASEY COOPER PLEASE. SO I'M
GONNA TURN IT OVER TO LEND
HARRINGTON AND SHE'S GOING TO-
PRESENT ALL OF THE COMMENTS ON
BEHALF THE DEPARTMENT. MEMBERS
DEPUTY DIRECTOR FOR HEALTHCARE
FINANCE BEING I'M HERE AT THE
DEPARTMENT HEALTHCARE SERVICES.
ET AL THIRTY FIVE IMPLEMENT.
INFLATED ON THE AND WILL BE.
EASY TO CARE BY. OKAY FOR MODEL
AND POPULAR. THERE ARE PRIMARY
HE TRIED TO THROUGH REGIONAL
RATE. PRESS OF GREAT. I CORRECT
AND MEDICARE THIRTY PM. FIVE SO
LET'S SEE FEDERAL- BETTER
DETECT WE CAN KEEP YOU FOR BE
AT THE AND OF THE SAN. GOOD
EMPLOYMENT. IT'S HARD COUNTY
PER CALENDAR YEAR. TWENTY EIGHT
TWENTY TWENTY THREE AT ELEVEN
I'M AND THAT ONLY REGIONALES
EIGHT DOES QUALITY OF TWENTY
TWENTY. I READ RATE METHOD AND
CONSIDERING UTILITY THANKS THAT
CROP AND I CAN WHICH FORMED
ABOUT OF THREE OTHERS HE ON THE
BALLOT USING A THREE BASE THIS
IS NOT NEED A THE FINAL RATE HE
EACH PLAYER IN THE REGION WILL
BE I. BUT YOU NEED TO ENSURE
THAT THE OF THE- WHICH IS WHY
IN A PART IN OF NOT SPEAKING
OPPOSED REJECTED BECAUSE IN LAW.
YOU'RE A RETAIL RATE I DON'T
WANT CHANGES IN THE RATE BUT
THE CHANGES WILL BE RECESSED
AND OF. ALBUQUERQUE. OUR
COVERAGE REASONABLE OF AND
ACROSS PROJECTED I THINK THE
STATE I OUR CREDIT. IT
NECESSARY IN A- BUT HAD ENOUGH
AS APPLY A DEFINITE BACK SO
CALPERS BALLOT BILL IS LOCAL CA.
IN THE COMPETITION AND ALL
MEMBER AND OTHER. THIRTY ABOUT
MY THE MIGHT PUT BE ANYTHING TO
BE COMPARED ADVANTAGE OR
DISADVANTAGE PLANS I PRETTY.
I'M NOT A PART EXPLORE- OPTIONS
TO HELP WITH DIFFERENT QUALITY
OF CARE I. TO SUPPORT ONLINE
ABOUT NAPOLI BACK WITH A THE
FICTION BEING AND QUALITY. AS
EARLIER LOCAL. IF I THAT. AND
WE HAVE TO CONSIDER WHETHER
COOPERATE QUALITY METRIC MORE
FUN INTO THE PROCESS FOR
EXAMPLE. YOU ARE PERFECT. YEAH
GO TOWARD THE HIGH CALL. J.
YEAH BELIEVES THE VEHICLE OKAY
OUT OF IF THE WORK TO BE
COUNTERFEITED NOT PASS THE CAN
FOR QUITE ACCESS AND RESETTING.
HE. A DAY AFTER THAT AND. AT A
GREATER ACROSS AFRICA ACROSS
AND BENEFITS I OF FISH BE BUT
WHAT I'M GOING TO BE A APPLE
YEAH. THANK YOU DIRECTOR NEXT
WE WILL HEAR FROM BEN JOHNSON
WITH THE LEGISLATIVE ALL. GOOD
MORNING AGAIN- I IF THERE'S AN
IMPACT NOISE THE SOME WORK
GOING ON AN INMATE- BUT THAT WE
IN ANALYSIS OF REACH REGION
THREE RACE SETTING OR IN ENOUGH
THAT WE RELEASE ANALYZE.
FINANCIAL PRESENTED BY CALLAWAY.
AND SO- AND WE THAT THE WOULD
BRING OFF AND LIKE RIVERS IN
DIFFERENT WINNER AND LOSE THE
UNDER SYSTEM WHICH GENERAL SETS.
ON A COUNTY COUNTY OR PLANNED
BY B. FIRST WE RECOGNIZE AS
BEEN THAT REGIONAL SO COVERAGE
SAID COULD SEE. REDUCE
STATEMENT BURDEN OF CARE RATE
SETTING IN MY CAL AND THIS IN
TURN MAKE- FOR THERE TO SO OR-
EASIER TO. AND POTENTIAL
IMPROVE TIMELY OF FEDERAL
APPROVED OF THE STATE CAPITAL
RATE POTENTIALLY EVEN AND I-
THESE FLOW MORSE. ADDITIONALLY
REGION SITTING OUT AS- AS HARRY
NOTED COULD ENCOURAGE AND I'M
NOT OF THIS MEDICAID MANAGED
CARE PLANS- INCLUDING THE WHO
TO ARE CURRENTLY REALLY SOME TO
COST COMPETITION. TO OPERATE
MORE THE THEN AND IT IT WOULD
COME THIS BY. BUT CHEN NOT
REMEMBER PLANS FOR THE FOLKS OF
THIS THEY PAY FOR IF THOSE ARE
IF THOSE ARE COST- OUR
OPPONENTS GET REIMBURSED FOR
THE- COST OF THE PLANS WITHIN
THEIR OWN RE WHAT VERY
ADJUSTMENTS- AS MISS CAN- AND
SO HERE THE HIGHER. WERE
RECEIVE LESS THAN REIMBURSE
WHILE THE LOWER PLANS WOULD
RECEIVE A FINAL PLANNER- DUE TO
LEVEL- AS PREVIOUSLY- AS
PREVIOUSLY THOUGH THE DALLAS
THE POTENTIAL DOWNSIDE OF THIS
FOR IS THAT IT MY WOULD PRODUCE
DIFFERENT WINNERS AND LOSERS.
THEN UNDER TODAY'S- SIX- PERCH
THOSE. WHO NOT. THE SOUND
PUBLIC POLICY PROVIDED IMPROVED
EFFICIENCY WITHOUT COMPARING
THE BENEFICIARIES EXPERIENCE
SUCH AS BY REDUCING ACCESS OR
QUALITY OF CARE. TODAY WE DO
UNDERSTAND THAT THE STTE'S-HIGHER COST MEDICAL PLANS ARE
OFTEN DO PERFORM SOMEWHAT
BETTER THAN SOME OF THE LOWER
COST PLANS ON A RANGE OF
ACCESSING QUALITY MEASURES. AND
THIS RAISES QUESTIONS ABOUT
WHETHER THE TRANSITION TO
REGIONAL RATE SETTING WHAT
IMPROVING EFFICIENCY BUT AT THE
COST OF. ACCESSING QUALITY AND
SO WE'RE PLEASED TO HEAR-
COMMENTS FROM MS HARRINGTON
THAT THE DEPARTMENT IS
CONSIDERING. WAYS TO MORE
CLOSELY TIED MANAGED CARE PLAN
FUNDING. TO THE PERFORMANCE ON
ON ACCESS AND QUALITY STANDARDS
AND WOOD WELCOME YEAH WELL
WELCOME- SORT OF ANY AN OUTLINE
OF WHAT THAT PROPOSAL MIGHT
LOOK LIKE- AT THE APPROPRIATE
TIME THANK YOU. THANK YOU NEXT
WE WILL HEAR FROM MY OLD MAN-
CEO OF THE HEALTH PLAN OF SAN
MATTEO. GOOD MORNING- THANK YOU
FOR THE OPPORTUNITY TO PRESENT
THIS MORNING. MY MOM GOING TO
PRESENT THAT PERSPECTIVE OF THE
HOPE LOCAL HEALTH PLANS OF
CALIFORNIA WHICH IS THE
ASSOCIATION- OF LAW LOCAL
HEALTH PLANS. LIKE OURS I'M SO
THE KEY QUESTION WE HAVE IS
ABOUT REGIONAL RIGHT STATING IS
WE DON'T QUESTION THE VALUE OF
DOING IT BUT RATHER THE
QUESTION IS WILL IT BE DONE
PROPERLY AND FAIRLY. THERE IS
TREMENDOUS VARIATION ACROSS THE
LOCAL HEALTH CARE MARKETS EVEN
IF- PLANS HAVE STANDARDIZED
BENEFITS SO IN THE BAY AREA FOR
EXAMPLE- IN NOT HOSPITAL
MARKETS ARE BEARISH OUR REGION.
ON UCSF CONTRACTS WITH SAN
FRANCISCO HEALTH PLAN THE SAME
BASIS IS THAT CONTRACTS WITH
ANY OTHER HOSPITAL IN SCOTT
THAT'S CONTRACTED WITH WITH THE
HEALTH PLAN YES YOU SEE STAFF
DEMANDS A PERCENTAGE OF
CHARGES. I'M FROM THE HELP PLAN
A SAN MATTEO AND OUR MEMBERS
JUST LIVE A FEW MILES OUTSIDE
OF SAN FRANCISCO SO ONE
QUESTION THAT WE HAVE IS HOW
WILL DH D. H. U. S. ACCOUNT FOR
THE REAL ON HEALTH CARE COST
DIFFERENCES. AMONG COUNTIES
THAT MAY BE GROUPED INTO THE
SAME REGION WE HAVEN'T SEEN THE
DETAIL ON THAT YET- AS- DEPUTY
DIRECTOR HARRINGTON MENTIONED
RESEARCH JASMINE IS- IS A
PRIMARY METHOD USED FOR IS.
ASSESSING THE RISK OF SERVING
DIFFERENT POPULATIONS THAT IS
FOR COMPENSATING A PLAN THAT
HAS MEMBERS WITH MORE HEALTH
ISSUES AND THEREBY- WITH HIGHER
COSTS. AND SO WE UNDERSTAND
RISK IT JUST MEANS LIKELY TO BE
USED FOR STUDY RATES AMONG
PLANS IN OUR REGION- BUT I
THINK IT'S IMPORTANT TO NOTE
THAT RISK ADJUSTMENT IS A
PROBLEMATIC METHODOLOGY. IT IS
A CERTAIN ZERO SUM GAME SO
THERE WILL BE WINNERS AND
LOSERS AS HAS BEEN NOTED. ON
ITS USE NOW IN THE G. PLAN
COUNTIES AND THE RISKS ARE NOT
APPROPRIATELY CAPTURED
ACCORDING TO ANALYSES THAT
WE'VE DONE ON USING IT.
ACTUARIES HARD BY LH. PC EVEN
THE MAN ALL ONLY ACCOUNT FOR OF
THE- D. A. KERR APPROACH
EXPLAIN ABOUT PER OF THE REST.
AND THE PROPOSED FUTURE
APPROACH IS- BELONGINGS. LIKE
US HIGHER PERCENTAGE- HEALTH
PLAN TO STORE BUT- THE HIGHEST
RISK MEMBERS IF THE CURRENT
RISK ADJUSTMENT METHODOLOGY IS
CONSISTENTLY AND REPRESENTED.
THE COSTS OF THESE HIGH RISK
MEMBERS. OF STUDIES PRODUCED BY
THE SOCIETY OF ACTUARIES AND
CONCLUDED THAT NO RISK
ADJUSTMENT METHODOLOGY CAN
FULLY EXPLAIN RISK DIFFERENCES
IN THE PRESENCE OF SIGNIFICANT.
RISK VARIATION AMONG PLANTS.
EXPECTED RESULT AND WOULD BE%
UNDER FUNDING PLANS. WHICH
SERVE INDIVIDUALS WITH HIGHER
NEEDS. I ANY ON ON THE LINE
PROBLEMS WITH THIS JUST ME
MATTHEY WHICH IS METHODOLOGY
BUT ONLY COME. IN WHICH RIGHT.
I'M FINE WE DON'T HAVE DAY ON
THE AND ON CEILING PLANS PLANTS
BECAUSE THEY'VE NOT BEEN PART
OF ANY OF THE STATE RESIDUALS
AND EFFORTS TODAY SO THAT IS
SOMETHING THAT THAT WE'RE
CONCERNED ABOUT. WITH THE CODES
PLANTS. NOW TO STAND BY- SAYING
THAT THAT THAT STATE YOU REALLY
DECIDE ON ITS POLICY GOALS UP
FRONT- SO FOR EXAMPLE AND- THEN
JOHNSON POINTED OUT THE CLOSE
MODEL PLANS IT CONSISTENTLY
SCORED AMONG THE HIGHEST.
QUALITY SCORES- HOW WILL
QUALITY BE INCORPORATE THE
RIGHTS PROCESS AGAIN WHEN
COURAGE ONTO YOUR THAT THE-
DOES PLAN. TO REALLY AND CALL
IN THE RIGHT SETTING. HOW MUCH
DEEPLY THAN IT HAS TODAY- WILL
PROGRESS QUALITY INNOVATION
LOST PLANS ARE DRIVEN TO
FORWARD IT YOU COST
EFFICIENCIES. AND AND I THINK
ANOTHER REALLY IMPORTANT POINT
IS RISK ADJUSTMENT WILL NOT
ACCOUNT FOR HEALTH DISPARITY.
IF THE REGIONAL RATE SETTING
PROCESS DOES NOT ADEQUATELY
RECOGNIZED THAT YOU REDUCE
FIRST DISPARITIES ADEQUATE
FUNDING PERHAPS EVEN MORE
FUNDING NEEDS TO BE DIRECTED TO
COMMUNITIES AND PROVIDERS WERE
DISPARITIES ARE HIGHER. I'M TO
THE EXTENT REGENERATE SAID HE
DOES NOT PRIORITIZE QUALITY
ACCESS INNOVATION AND
COMMITMENT TO THE COMMUNITIES
BEING SIR THERE MAY BE
DISPROPORTIONATE IMPACTS ON
LOCAL HEALTH PLANTS. SO WE'VE
TO RECOMMENDATIONS ON FIRST-
AND WE YEAH WE UNDERSTAND THAT
THIS WILL BE THE CASE BUT
HEALTH PLANS NEED TO BE AT THE
TABLE HELPING DESIGN THE
STRUCTURE FOR REGIONAL RATE
SETTING. AND SECONDLY IT WAS A
HIGHLY TECHNICAL THIS WILL BE A
CRITICAL INITIATIVE AND THE
LEGISLATURE SHOULD BE INVOLVED
TO ENSURE THAT IT'S FAIR AND
HELPS ACHIEVE THE OVERALL STATE
POLICY GOALS IN THE MEDICARE
PROGRAM- THANK YOU. HAPPY TO
ANSWER ANY QUESTIONS. THANK YOU
VERY MUCH NOW WE WILL HEAR
DOCTOR. DATE COULD TOLD T. WHO
IS. CENTER PALO ALTO.
FOUNDATION IN SANTA CRUZ C.
THANK GOODNESS AND THANK YOU MY-
AND I KEPT TO I DRESSED LITTLE
FUN TODAY I AM WE ARE WE HAVE A
MASS VACCINATION CLINIC AND
I'VE COME IN FROM OUTSIDE-
DOING THAT WORK I HAVE A COUPLE
REFLECTIONS AT THE END OF MY-
TIME I LIKE TO SHARE. BUT FIRST
I LET THIS WORK LET ME JUST SAY
THIS WORK IS SO IMPORTANT AND I
APPRECIATE THE FOCUS THAT
YOU'RE MAKING BECAUSE THIS IS
TRANSFORMATIONAL IN A FIFTY
PLUS YEARS OF MEDICAID IN
CALIFORNIA I'VE BEEN LICENSE IN
IN CALIFORNIA FOR THIRTY NINE
YEARS THIS IS PROBABLY THE MOST
TRANSFORMATIONAL. SET OF
CHANGES I'VE SEEN IN SO FROM
THE PERSPECTIVE OF CALIFORNIA'S
PHYSICIANS CARING FOR OUR OUR
MEDIC CAL MEMBERS. IS AN
OPPORTUNITY TO IN IN IN BUILD
TRUST AND ONE OF THE WAYS THAT
WE CAN ENCOURAGE OR BUILD
TRUST- FOR THE- PHYSICIANS IN
CALIFORNIA IS MAKE THE WORK
TRANSPARENT MAKE THE FEE
SCHEDULE TRANSPARENT. AS BEST
AS POSSIBLE DON'T REINVENT THE
WHEEL AS WE MOVE- SO MANY OF
THESE DUAL BENEFICIARIES INTO
THE INTO THE MEDICARE PROGRAM A
LINE ARE. HOW WE VIEW AND RISK
ADJUST AND BUILD GEOGRAPHIES
ALIGNED WITH WHAT MEDICARE IS
DOING AND KEEP IN MIND THE
QUADRUPLE AIM WHICH WOULD BE-
IMPROVE PATIENT EXPERIENCE
IMPROVE PROVIDER EXPERIENCE.
IMPROVE CLINICAL QUALITY AND
LOWER THE TOTAL COST OF CARE
AND I THINK THERE'S AN
OPPORTUNITY TO DO ALL FOUR OF
THOSE. SO LET ME JUST BRIEFLY
TOUCH ON WHAT I MEAN BY ALLYING
WITH MEDICARE. FIRST OF ALL
WHAT OTHER GEOGRAPHIES HOW WE
DIVIDE TO FIFTY EIGHT COUNTIES
WELL WE USE ASSEMBLY DISTRICTS
WILL WE USE THAT THE NINETEEN
COVERED CALIFORNIA REGIONS- I
WOULD NOT I WOULD ADOPT WHAT.
WHAT CMS ADOPTED A WHICH ARE
VERY CAREFULLY THROUGH A
PROCESS A DERIVED BY THE OFFICE
OF. MANAGEMENT AND BUDGET IT
HAS TO VIED CAL INTO A PROXY
TWENTY TO CHARTER. BASED ON-
THE MEDICARE FEE SCHEDULE WE'RE
THE ONLY STATE WHERE THE PART A
FACILITY ARE. ICING STRUCTURE
AND THE PART B. PHYSICIAN AND
OUTPATIENT- GEOGRAPHIES ARE
ALIGNED I RECOMMEND THAT WE
ADOPT DOES GEOGRAPHY FOR
EXAMPLE SACRAMENTO GEOGRAPHY
CONSISTS OF YOLO EL DORADO
CLASSROOMS SACRAMENTO. AND
SONOMA CONSIST OF ITS OWN
GEOGRAPHY AND THE MEDICARE FEE
SCHEDULE PROGRAM SAN FRANCISCO
AND SAN MATTEO AND MY TALKED
ABOUT WHAT THAT MARKET AND HOW
SAN MATTEO RELIES ON SAN
FRANCISCO HOSPITALS THAT MARKET
IS ONE GEOGRAPHY. OF THE SECOND
THE POINT IS HOW DO WE SET
RATES BASED ON A COST INPUTS.
SAMSCLUB AREA HAS THE MOST
EXPENSIVE HEALTHCARE MARKET IN
THE COUNTRY- THE MEDICARE
PROGRAM ANNUALLY MEASURES THE
COST TO DELIVER CARE IN EACH OF
ITS FOUR HUNDRED GEOGRAPHIES
AROUND THE COUNTRY THE BAY AREA
IS THE HIGHEST ALMOST DOUBLE
WHAT THE AVERAGE COST TO
DELIVER A HOSPITAL SERVICE. FOR
AMERICA'S MEDICARE POPULATION
WITH THE STATE OF CALIFORNIA
SHOULD SHOULD FOLLOW AND
TRACKED AND ADOPT REGIONAL
RATES. BASED ON WHAT IT COSTS
TO CARE FOR PATIENTS THE SINGLE
BEST SOURCE OF THAT DATA IS THE
ANNUALLY PRODUCED MEDICARE
HOSPITAL WAGE INDEX AND I
RECOMMEND THAT WE USE THAT IN
THE RIGHT SETTING. RISK
ADJUSTMENT IS AS MYERS SAID
ANOMALY IMPORTANT I'M STRUCK BY
I'M A I'M A COMMISSIONER ON THE
CENTER CALL FOR AN ALLIANCE FOR
HEALTH WE HAVE. SANTA CRUZ
MONTEREY AND MERCED COUNTY I'M
STRUCK BY THE FACT THAT THE
HIGHEST OXIDATION RATES IN
THOSE THREE COUNTIES FOR CODE
ORANGE SANTA CRUZ COUNTY. BUT
THE CAT WHICH HAS THE LEAST
COVERT PENETRATION AND HAS HAD
THE GREATEST SUCCESS BECAUSE OF
THE DEMOGRAPHICS AS COMPARED TO
MERCED COUNTY WHICH HAS THE
LOWEST VACCINATION RATE AND HAS
THE GREATEST DISEASE BURDEN.
AND HOW DO WE RISK ADJUST WELL
RISK ADJUSTMENT IS WHAT IT IS
ALREADY USED FOR ALL OF THE 40%
OF CALIFORNIA'S MEDICARE
BENEFICIARIES THAT ARE MEDICARE
ADVANTAGE. THERE IS UP THE
PHYSICIANS ARE OR WELL ADAPTED
TO THE RISK ADJUSTMENT
METHODOLOGY USED IN AN MBA
PROGRAM IT IS THE SAME RISK
ADJUSTMENT METHODOLOGY WE USE
IN COVERED CALIFORNIA WHERE WE
A RISK ADJUSTER CROSSED THE
COMMERCIAL PLANS. THE CARE FOR
CERTAIN THE HETEROGENEOUS
POPULATION OF CALIFORNIA IN
FACT OVER BILLION DOLLARS MOVES
FROM OF A PLAN THAT CARES FOR
LESS SICK CALIFORNIANS TO
ANOTHER PLAN WHICH CARES FOR
THE SICK POPULATION. THE RISK
ADJUSTMENT TOOL IS BUILT FROM
THE PATIENT WE ACTUALLY MEASURE
RISK IS DEFINED BY THE
DIAGNOSIS CODES OF THE PATIENTS
IT'S ENTIRELY APPLICABLES TO
THE MEDICARE POPULATION. AND IT
AND IN FACT WE COULD ENHANCE IT
AND BUILD SOME OF THE SOCIAL
DETERMINANTS THAT MEYER A
MANSION MEDICARE PROGRAM IS
STARTING TO DO THAT. AND THE
ADVANTAGE OF USING PATIENT
DERIVED PATIENT CENTERED RISK
ADJUSTMENT METHODOLOGIES IS IT
IT ENCOURAGES PATIENTS TO HAVE
LONGITUDINAL RELATIONSHIPS WITH
THEIR PRIMARY CARE PHYSICIAN.
WHO WILL DO AN ANNUAL HEALTH
ASSESSMENTS AND APPROPRIATELY
CODE AND IDENTIFY THOSE A
CLINICAL CONDITIONS. THAT PUT
THE PATIENT AT RISK. LASTLY
CLINICAL QUAL. SHOULD BE AND-
AN INCENTIVE FOR ALL PLANS AND
PROVIDERS BUT IT SHOULD BE THE
SAME FOR ALL MEDICARE
BENEFICIARIES ALL DULY INSURED
BENEFICIARIES AND SHOULD BE
CONSISTENT WITH THE VERY
SUCCESSFUL MEDICARE ADVANTAGE
STARS PROGRAM. MEDICARE
ADVANTAGE PATIENTS IN
CALIFORNIA HAVE HIGHER QUALITY
THAN TRADITIONAL MEDICARE
PATIENTS AND I THINK WE CAN USE
THE LEARNINGS FROM MANAGED CARE
TO ENCOURAGE IT TO IMPROVE THE
QUALITY OF CARE. FOR OUR A
MEDIC CAL PATIENTS LASTLY MY
REFLECTION ON I JUST WANTED TO
SHARE I THOUGHT I HAD
VACCINATING PATIENTS TODAY AND
HOW THE PATIENT WAS OVER A
HUNDRED. AND I HAD A NINETEEN
YEAR OLD THAT I VACCINATED.
HELLO I'M COLFAX IN NATION IS
REALLY CHOICE FOR ALL OF US I
HAVE NEVER EXPERIENCED- IN MY
PROFESSIONAL CAREER MORE JOY
FROM PATIENTS AND NURSES AND
DOCTORS. AND THEN THERE ARE TWO
THINGS YOU WANTED TO REFLECT ON
WHY IT BESIDES THE OBVIOUS- A
RELIEF ACTIVITY FROM GETTING
THE VACCINE. THE PATIENTS
RECEIVE NO CHARGE IT IS THE
MOST IMPORTANT PREVENTIVE
SERVICE I'VE OFFERED TO
PATIENTS IN MY CAREER THE
PATIENTS GET THE CARE FREE OF
CHARGE. THE PATIENTS WILL NOT
AND WILL NOT RECEIVE A BILL FOR
THE FOR THE ADMINISTRATION OR
FOR THE VACCINATION ITSELF.
THAT IS LIBERATING FOR
PATIENTS. AND FOR PROVIDERS AND
THIS IS SUPER SUPER IMPORTANT
FOR YOU TO UNDERSTAND- SOME OF
THE PATIENTS HAVE ACCESS THEY
WERE MEDICARE BENEFICIARIES FOR
MEDICARE MEDICARE ADVANTAGE
SOMEWHERE KAISER MEMBERS SOME
HAVE NO INSURANCE SOMEWHERE
UNDOCUMENTED. AND EVERY PATIENT
I HAVE NO IDEA WHICH WHICH OF
THOSE HATERS WHETHER THE STATE
PAYS FOR THEIR CARE WHETHER
THEIR EMPLOYER WITH THE FEDERAL
GOVERNMENT PAYS FOR THEIR CARE.
LET'S TRY TO YEAH I IMAGINE A
SYSTEM WHERE WE CAN CARE FOR
CALIFORNIANS AND THE PHYSICIANS
DON'T HAVE TO ASK AND DETERMINE
WHETHER THE CARE WOULD BE
ADMINISTERED BASED ON WHO PAYS
FOR THE PATIENT'S CARE SO. I
WOULD THAT'S MY FINE ART AND I
REALLY APPRECIATE THE TIME SO
THANK YOU. THANK YOU DR AND-
HAVING BEEN OUT THERE
VACCINATING MYSELF I WOULD JUST
ECHO YOUR COMMENTS AND SAY A
MAN THANK YOU FOR YOUR SERVICE
AND CONTINUING TO BE ON THE
FRONT LINES HELPING TO TAKE
CARE OF ALL CALIFORNIANS. WITH
THAT I WILL NOW BRING IT UP TO
THE DíAS TO SEE IF ANY MEMBERS
HAVE QUESTIONS. C. NON I WILL
ASK MY QUESTION THEN OF THE
DEPARTMENT OF FIGHT COULD I.
THOUGHT BEN JOHNSON HIGHLIGHTED
WELL WHEN HE SAID WE NEED TO
HAVE AN OUTLINE FOR WHAT OUR
PLAN IS. WE HEARD FROM MY OLD
MAN ABOUT HOW THE LEGISLATURE
NEEDS TO PUT ITS POLICY GOALS
OUT FRONT. AND WILL JUST WEAR
ON MY SLEEVE HOW MUCH I'VE
TRIED TO HAVE US AS A
LEGISLATURE. PRIORITIZE AND
INCENTIVIZE PREVENTATIVE CARE
AND DRIVE TOWARDS QUALITY. THAT
I'D LIKE TO HEAR FROM THE
DEPARTMENT IF I COULD IF WE SET
ASIDE THE VARIATIONS OF. COST
OF LIVING THAT WE HAVE IN OUR
STATE. GENERALLY OUR OUR
MANAGED CARE RATES SET WITH AN
EYE TOWARDS INCENTIVIZING
PREVENTIVE CARE AND DRIVING FOR
QUALITY. THREE THREE THIRTEEN
AND EVEN THE HOCKLEY. FROM THE
PLANT ITSELF FOR THE SB. A
GREAT. FROM ACTOR CONFLICT
PLANT. PROVIDING AS I MENTIONED
WE HAVE- INCLUDED SAMPLES
BRACKET THANK. I'VE IS HE MAY
AND LOCAL RENT I'M I'M PROUD
QUALITY- AND IT REALLY WE ARE.
AT HOW IN MORE- I. IN ANY
CORPORATE- AND IN BED NO
QUALITY. ACT. IN ARE RIGHT
THANK YOU- MORE BROADLY YOU
THINK YOU CAN WORK A CLEAN
PARTNERS AT THE- IN THAT IT AND
I GOT- BUT A BIT YOU GET CAUGHT.
EXACTLY EXACTLY COSTS AND- THAT-
AT THE BY BY THE. B. FOR THE
INVESTMENTS THAT WE'RE MAKING
AND I WOULD JUST WANT TO MAKE
SURE THAT THAT WAS HEARD HERE
TODAY WITHOUT I WILL THANK VERY
MUCH PANEL TO AND WE WILL MOVE
ON TO PANIC THREE. THANK YOU
VERY MUCH DOCTOR REVIEW AND
THANK YOU TO OUR WITNESSES WILL
GO AHEAD AND MOVE ON TO PANEL
THREE- OKAY ARE WITNESSES FOR
THIS PANEL- AND ESTANCIA DOTS
IN THE ASSOCIATE DIRECTOR FOR
POLICY OR JC COOPER- SOMEONE
FROM THE PRIVATE HEALTH CARE
SERVICES I BELIEVE- NED RESTING
COUGH OF FISCAL POLICY ANALYST
FOR THE- LEGISLATIVE ANALYST'S
OFFICE. JACK DALY THE DIRECTOR
POLICY AND TRAINING AND
COORDINATOR. THE HEALTH
CONSUMER ALLIANCE AT THE AT
LEGAL AID SOCIETY OF SAN DIEGO
COUNTY. IT'S A LOT TO PUT ON A
BUSINESS CARD- MY ALTMAN- CHIEF
EXECUTIVE OFFICER OF THE HEALTH
PLAN OF SAN MATTEO. EVE GELB- A
SENIOR VICE PRESIDENT AND
MEMBER AND COMMUNITY HEALTH
SCAN HEALTH PLAN SO WE'LL. GO
AHEAD AND START WITH THE
ADMINISTRATION. I'M GONNA TURN
IT TO AND DOT WHO WILL BECAUSE
ON BEHALF OF THE- TODAY THANK
YOU. THE TOPIC HERE IS THE SON
SAID OF CASH MEDIC. AND
REQUIRED FOR A LINE. DUAL
ELIGIBLES NEEDS PLANS. OR D.
SNIPS. GOOD MORNING- THIS IS
ANASTASIA DOBSON THE CALIBER
DEPARTMENT OF HEALTH CARE. YES
HM WE HAVE A- VERY PLAY TO BE
WORKING ON THIS ASPECT OF THE
CAN ISSUE DO- THE TRANSITION OF
POOR NEED CARE INITIATIVE AND
CONNECT. WE HAVE A NUMBER
LESSONS LEARNED THROUGH THE
EIGHT INITIATIVES THAT ARE
WOVEN THROUGH THE MOSEL WE KNOW
THAT YOUR ELIGIBLE
BENEFICIARIES BENEFIT BENEFIT
FROM INTEGRATED ACCORDING CARE
IS WHY WE'RE TO EXTEND. UP
MEDICARE AND MEDI CAL A LOT
ROAD. TO ALL IN THE STATE
CURRENTLY AS YOU KNOW IN CC
ICRA CARE INITIATIVE THAT'S
WHERE WE HAVE- CALVET CONNECT
WITH TO EXPAND MODEL WHY TO
HAVE A LINE THE MOMENT- THE
RISK ASSESSMENT. HAS VERY
HELPFUL. LESSONS THAT WE ARE
GOING TO. IN CAL FOR THE
POPULATION HEALTH MAY STRATEGY
FOR CALLING THE RISK ASSESSMENT
PROCESS TO BUY LISTA FOR CALVIN
CONNECT. SIXTY NINE. IN C. C.
I. WE REALLY SAW THE VALUE OF.
MEDICARE MANAGED PLAN
ENGAGEMENT WITH PROVIDE.
COUNTIES AND- PARTNERS ON I HSS
THE NUMBER OF OTHER PROOF TO
COORDINATE THAT FOR OF. AND
REDUCE BEEN YEAR IT FAMILY CARE
GIVER COMPETE. IN CAL WE'RE
GOING TO BE COURT THOSE PART.
YOUR THROUGHOUT THE CARE MAY.
AND IN LIEU OF SERVICES BENEFIT.
ANOTHER ASPECT OF THE INCUMBENT
CONNECT WERE VERY OF IS THE
DEMENTIA CAL CAN PROJECT. WHICH
PROVIDES CONSUL TO HELP BRING
AND FOR MAN. AND FAMILY CARE
GIVER IN PARTNERSHIP THE ALSO
IS THE- EACH YEAR WILL BE IN
COURT THE SIX MY INTO. FOR BOTH
THE ALLOWED AND MEDICARE ONLY
BEEN. ALSO IN A CCA THE COR
CARE WITH THAT PLANS CAN REALLY
A KEY ROLE. IN SUPPORTING
BENEFITS TO. FROM IN CARE IN
THE CAN. OF COMEDY PLANS NOW
YOU LIKE. OF CARE PLAN. AND
FINANCIAL A LINE. OF MANY HOW
MEDICARE. INCOME ANY CONNECT TO
INVEST INC TRANSITION AND HELP
MEMBERS. FROM INSTITUTE CARE IN
THE CAN AND SUCCESSFULLY STATE.
THE COMMUNITY. THESE LESSONS
THAT WE LEARNED WERE REALLY
INTO IN HELP DIVERT TO DEVELOP
ENHANCED MANAGE. AND IN A- THE
POPPY. IN NEED GREATER CARE ME.
AND THE NUMBER OF THE IN LIEU
OF SERVICES INCLUDING COMMUNITY
TRANSITIONS AND HOME
MODIFICATIONS. OF CCI COMEDY
CONNECT HAS A LONG HISTORY NOW-
SO WE'RE DEFINITELY USING THOSE
LESSONS LEARNED. THE LESSONS
ARE ALSO HELP TO SUPPORT THE
STATE WIDE CARBON OF LONG TERM
CARE INTO MANAGED CARE SO. JUST
TO SHARE A COUPLE OF DATA
POINTS THE TWENTY EIGHTEEN
SCANNED FOUNDATION REPORT THAT
ASSESSED THE EXPERIENCES OF A
DUALLY ELIGIBLE BENEFICIARIES
IN COMEDY CONNECT. ON THAT 94%
OF COMEDY CONNECTED FEATURES
REPORTED THAT THEY WERE VERY OR
AT LEAST SOMEWHAT SATISFIED
WITH THEIR BENEFITS. AND THIS
WAS HIGHEST AMONG THE COMITY
CONNECT BENEFICIARIES COMPARED
TO THOSE WHO OPTED OUT OR THOSE
IN NINE C. C. A. COUNTY- THERE
IS BEEN A SIGNIFICANT RE. IN
EMERGENCY DEPARTMENT USE-
ACCORDING TO THAT SCAN REPORT-
AND IN 20001787% OF COMEDY
CONNECTED BENEFICIARIES. RATED
THEIR QUALITY OF CARE AS EITHER
EXCELLENT OR GOOD WHICH IS AN
INCREASE FROM 84% IN TWENTY
SIXTEEN. SO WE'RE PROUD OF THAT
AND- SO THE NEXT QUESTION
RELATED POINT WAS ABOUT- FOR
DUAL ELIGIBLE SPECIAL NEEDS
PLANS OR D. SNAPS ON THE
MEDICARE SIDE- JUST TO MAKE
SURE EVERYONE IS AWARE THAT
THE- VOLUNTARY OPT IN
ENROLLMENT. BY DUAL ELIGIBLE
BENEFICIARIES- SO THERE WILL
THERE WILL NOT BE PASSIVE
ENROLLMENT INTO DE SNAPS SO
THAT INDIVIDUALS WHO ARE
ENROLLED IN FEE FOR SERVICE AND
MOST MEDICARE ADVANTAGE
PRODUCTS THEY THEY WILL NOT
HAVE PASSIVE ENROLLMENT-
HOWEVER WE ARE AT THE END OF
TWENTY TWENTY TWO WHEN WE
TRANSITION. INDIVIDUALS WHO ARE
CURRENTLY ENROLLED IN COUNT
MANY CONNECT. INTO AN ALIGNED
D. SNAP AND- MEDICARE MANAGED
CARE PLAN WE WILL HAVE THE-
CROSSWALK IN ROMAN PROCESS AND
WE ARE DISCUSSING THIS FULLY
WITH STAKEHOLDERS. AT OF
STAKEHOLDER WORKGROUP SERIES
THAT WE'VE STARTED SO WE'RE
WORKING COLLABORATIVELY TO MAKE
SURE THAT TRANSITION GO
SMOOTHLY. I'M MY OTHER PIECE OF
PIECE BUT FOR THAT IS NOT RENEW
CONTRA FOR MANY AGAIN. DECENT
LOCAL PLAN THAT SERVE D°ûI
BUT DON'T OFTEN SAME DAY. SO
THERE BE A TRAIN PROCESS- FOR
THOSE MEMBER. INTO DECENT. WITH
SUBSEA SO FROM NETWORK SO WE
WILL HAVE A- SOME- JUST
TRANSITION OF CERTAIN BENEFITS.
INTO BETTER- MANAGED CARE
STRUCTURE. AND THEN WE- ONE OF
ANY MEDICAL ONLY BENEFICIARY SO
WHO IS NOT YET ELIGE FOR MEDI.
WHEN THEY GAIN BETTER L.
THROUGH EIGHT OR VISIT. THEN.
D. SNAP OF LYING TO BE THAT
OFFERED BY THE MEDIC CAL PLAN
THAT THEY'RE IN- WE- THAT PLAN
WILL TRIMS THAT INTO THE A LINE
DECENT. SO YEAH WE'RE GONNA BE
TALKING IN GREAT DETAIL STEAK
ABOUT ALL OF THESE PROCESS- IT
OVER THE COMING- EIGHTEEN OR SO
BEFORE THE TRANSITION OCCURS IN
TWENTY THREE. BUT IN ALL CASES-
DO WELL BIT AND ISSUES CONTINUE
TO HAVE THE TO CHOOSE MEDICARE
FEE SERVICE. OR MEDICARE GAME
PLAN THAT- A FUNDAMENTAL. IN
THERE WAS A QUESTION OF D. SNAP
UP BY A BILL EVEN IF THEY HAVE
LOW IN RAW IN CAN- THOSE PLANS
OFTEN. COVER MULTIPLE. SO I
THERE DECENT STOP IN THIRTY SIX
OF CAL FIFTY EIGHT. AND NOTHING
THAT MADE THE TO SAY TO. DISNEY
WITH YOUR THEN A THOUSAND MEN
AND COUNTY SO I IT IT IS VIABLE
AND WE'RE GLAD TO CONTINUE TO
HAVE. WITH PLANS IN AFRICA
ABOUT THE BUT. IT IS A VIABLE.
AND FOR SEVEN- THE DC ONLINE IN
ROMAN POLICY WOULD BE SO WOULD
THE SAME FOR THE MEDIGAP OR NOT
DELEGATE CLAIM SO WHAT THATIS
THAT IF THAT'S IN IN A DECENT
FOR MEDICARE- IF THAT THE SNAP
IS A DELEGATED PLAN. THEN THE-
MEDIC HOUSE WHERE THERE'S OF-
DELEGATED ON THE MEDICAL THAT
WE MATCH SO- WE WILL MAKE SURE
THAT- BENEFITS BENEFITS FROM
THE CORNER CARE FROM HAVING
THIS ORGAN. MANAGE THEIR MEDIC
AND MEDICARE BENEFITS AND- YEAH
WE'RE TALKING TO A LOT OF THE
IN OUR STAKEHOLDER WORKGROUP-
FINALLY THERE'S A QUESTION OR
IT CAN MANY CAN- BUT AND
ADDITIONAL FUNDING FOR HIKING.
WE WITHIN THE ADMINISTRATION
NEXT FALL AND THEN RELEASE THE
GOVERNOR'S BUDGET NEXT JANUARY
FOR TWENTY TWENTY TO TWENTY
THREE SO- WITH. RIGHT NOW WE'RE
JUST FOCUSED ON THAT- PIECES OF
CALLIE AND THAT- WE NEED TO
WORK ON THE STAKEHOLDERS AND
THE BUDGET PROCESS. FOR NEXT
YEAR WE WILL DO THAT IN DUE
TIME. SO I THINK THAT IS THE
EXTENT OF THE QUESTIONS. WELL
THANK YOU THANK YOU VERY MUCH I
THINK WE WILL HAVE SOME
ADDITIONAL QUESTIONS FOR YOU
BUT I GOTTA ASK THIS ONE
BECAUSE I'VE HEARD A LOT OF
TERMINOLOGY AND MY TIME AS
CHAIR HERE. BUT WHAT IS A
CROSSWALK ENROLLMENT PROCESS
I'VE NEVER HEARD THAT ONE. OKAY
SURE. SO WHAT WHAT WE WILL DO
IS- IN IT'S SORT OF AN
AUTOMATED WAY MAKE SURE THAT
IF- SOMEONE IS ENROLLED IN
KALMADI CONNECT FOR. A
PARTICULAR HEALTH PLAN RIGHT
NOW. THEN IN PREPARATION FOR
JANUARY TWENTY TWENTY THREE. WE
WILL DO- AND- WILL WORK WITH
THE HEALTH PLANS AND CMS. ON AN
AUTOMATED PROCESS SO THAT THE
STATE. IN THAT SAME HEALTH PLAN
BUT THEY WILL SPLIT. WITH FOR
THEIR MEDICARE BENEFITS THEY
WILL BE IN A DECENT AND FOR
THEIR MEDICARE BENEFITS. WE
WILL BE IN A MEDICARE MANAGED
CARE PLAN. BUT BOTH OF THE
DECENT AND THE MEDICARE PLAN
WILL BE OPERATED BY THE SAME
PARENT ORGANIZATION. AND SO BY
HAVING THAT SAME ORGANIZATION-
ADMINISTER. THE BENEFITS FOR
BOTH. OF PROGRAMS THEY CAN
SHARE DATA INTERNALLY. THEY CAN
HAVE OF THE SAME CARE
COORDINATOR. THEY CAN-
COORDINATE ACROSS PROVIDERS.
BUT THAT CROSSWALK ENROLLMENT
MAKES SURE THAT. BENEFICIARIES
DON'T NEED TO. MAKE AN
AFFIRMATIVE SELECTION THEY WILL
AUTOMATICALLY GO INTO- THE
MEDIC MEDIC COW AND A DECENT
PLAN THAT MATCHES THEIR
CURRENT. CAL MANY CONNECT CLAN.
OKAY GOOD WELL THANK YOU RIGHT
NOW I'VE GOT SOMETHING ELSE
FROM MY VOCABULARY THAT I
DIDN'T HAVE BEFORE SO MUCH
APPRECIATE IT WE'LL GO AHEAD
AND MOVE ON TO OUR NEXT-
WITNESSES- MR RESNICK COUGH-
FISCAL POLICY ANALYSTS ANALYSTS
FOR THE LEGISLATIVE ANALYST'S
OFFICE THANK YOU. GOOD MORNING
EVERYONE- THIS IS- NAY REZNIKOV
WITH L. A. O. BUT AS- WE
DESCRIBE IN OUR- REPORT- KELLY
PROPOSALS RELATED TO SENIORS
AND PERSONS WITH DISABILITIES.
ON THE CURRENT LANDSCAPE OF
CARE FOR SENIORS AND PERSONS
WITH DISABILITIES- STDS IS A
HIGHLY FRAGMENTED. AND THAT'S
THE CASE BOTH FOR THROUGH THE
LANDSCAPE- A PROGRAM SUCH AS- I
HSS AND- AT PACE AND SO ON BUT
ALSO FOR- FRAGMENTATION
BETWEEN. MEDIC HAL AND MEDICARE
SO. WE TO THINK THAT- THE
DECENT PROPOSAL COULD
POTENTIALLY IMPROVE
COORDINATION BETWEEN MEDICARE
AND MEDICARE FOR THE SENIOR
POPULATION AND THAT THE DUAL
ELIGIBLE POPULATION BUT THERE
ARE POTENTIAL TRADE OFFS
BETWEEN THE SCALABILITY OF THE
D. STEP MODEL AND THE LEVEL OF
COORDINATION AND INTEGRATION.
THAT DISTANCE WOULD OFFER AND
THERE'S ALSO- SOME QUESTIONS
REGARDING THE LEVEL OF
STANDARDISATION STATEWIDE THAT
WOULD BE POSSIBLE. NOW THAT THE
TRAILER BILL LANGUAGE FROM THE
ADMINISTRATION DOESN'T REALLY
SPECIFY WHAT SPECIFICALLY WOULD
BE REQUIRED OF THE STEPS AND
BECAUSE THE STATE IS GOING TO
BE SETTING UP A DECENT CONTRACT
TERMS UNDER CAL AIM- THIS COULD
BE A POSSIBILITY THIS COULD BE
AN OPPORTUNITY FOR THE
LEGISLATURE TO. THINK ABOUT-
WHAT SORT OF TERMS AND WHAT
REQUIREMENTS SHOULD BE IMPOSED
ON ANTI STEPS ONE MORE ONE MORE
COMMENT- WHICH IS- THAT. IT A
AND- HOW VIABLE IT IS TO TAKE
THE STEPS STATEWIDE INTO INTO
EVERY COUNTY AND WHAT SORT OF A
POLICY OR FISCAL INCENTIVES.
WOULD BE NEEDED FOR- PLANS TO
ACTUALLY MAKE SURE THAT THERE'S
FORTY STEP COVERAGE AND ALL IN
ALL AREAS OF THE STATE- SO
THAT'S JUST SOMETHING ELSE THAT
THE LEGISLATURE MIGHT WANT TO
CONSIDER. I THANK YOU AND HAPPY
TO TAKE ANY QUESTIONS. GREAT
THANK YOU VERY MUCH I
APPRECIATE APPRECIATE THAT WILL
UP WE MAY HAVE A QUESTION FOR
YOU- AS WE MOVE THROUGH THE
REST OF THE PANEL SO. WE'LL
MOVE ON TO JACK DALY THE
DIRECTOR POLICY AND TRAINING
AND COORDINATOR FOR THE HEALTH
CONSUMER ALLIANCE AT THE LEGAL
AID SOCIETY OF SAN DIEGO COUNTY.
THANK YOU VERY MUCH I. AGREE
THAT IS THE AMOUNT FOR. MY
BUSINESS CARD IS BUSIER AND
ACTUALLY LEFT OFF ONE OF MY
TOTAL SO- THAT'S WE HAVE A
BACKSIDE OF THE CARD SO EXACTLY
EXACTLY. SO THANK YOU FOR
HAVING US WE ARE THE LEAD
AGENCY- ON THE CAL MEDICAL
ACCOMPLISHMENT PROGRAM- AND
JUST FOR REFERENCE THE COMEDY
CARE ACT ABOUT SOME PROGRAM
PROVIDES LOCAL INDEPENDENT
ADVOCACY- TO CMC MEMBERS AND
SINCE THE L. DOUBLE DOUBLES IN
EACH OF THE SEVEN SIXTY I
COUNTY- WE APPRECIATE THE
OPPORTUNITY COME TO PROVIDE
FEEDBACK- YOU KNOW ALL OF OUR
PERSPECTIVES ARE REALLY
INFORMED BY YEARS OF HELPING
THE WORLD WILL CONSUMERS
MAINTAIN COVERAGE AND ACCESS.
NEEDED CARE AND SEE SEE I
COUNTIES AND SO- EIGHT IN IN
TERMS OF THE LESSONS LEARNED WE
CERTAINLY HAVE. BEEN HAPPY TO
OFFER PROVIDE THOSE THOSE
LESSONS AND INSIGHTS- WE
CERTAINLY APPLAUD AND SUPPORT
THE DEPARTMENT'S GOAL TO
PROVIDE THE WORLD WILL
CALIFORNIANS WITH INTEGRATED
PATIENT CENTERED COORDINATED
CARE. AND REALLY DO APPRECIATE
THEIR- EFFORTS TO ENGAGE
STAKEHOLDERS IN THE PLANNING
PROCESS AS ENVISIONED MADE
MENTION THAT THEY HAVE A
SPECIFIC TOOL INTEGRATION
ANALYST TO L. M. L. TSS
WORKGROUP WHICH WE'VE BEEN
INVOLVED ACTIVELY AND WE REALLY
DO APPRECIATE- THAT
OPPORTUNITY- THAT THE SCALE AND
THE SCOPE IN THE COMPLEXITY OF
THE PROPOSAL REALLY DOES HAVE
TO BE APPRECIATED- IN AND IN
PARTICULAR IN IN TERMS OF THE
POPULATIONS THAT WE'RE WE'RE
TALKING ABOUT- MOST IF NOT ALL
OF THE ONE POINT FOUR MILLION.
THE WORLD'S BOARDS IN
CALIFORNIA WILL BE IMPACTED IN
SOME WAY BY THIS PROPOSAL SO
REDUCE IT YES- ARE YOU KIND OF
LOOKING AT THIS POPULATION-
MORE CHARACTER FLEA.
POPULATIONS CULTURALLY AND
LINGUISTICALLY DIVERSE- AS A
VERY COMPLEX CARE NEEDS. OF
MULTIPLE CARE PROVIDERS-
SPECIALIST THEY'RE BUILT TWICE
AS LIKELY TO HAVE A BEHAVIORAL
HEALTH CONDITIONS- THE IN IN
THE CONTEXT OF. THE PUBLIC
HEALTH EMERGENCY DOOR OLD WILL
THE SPECIALLY THE FROM. LEFT
NEXT AND COMMUNITIES. ARE BEING
DIED HIGH. IN A DYING- DO TO
COPE WITH THAT THIS BEFORE
RATES THIS IS A- POPULAR- AND
SO THE CON. OF THE- TRANS. WE
REALLY EMPHASIZE THE VALUE
IMPORTANCE OF SETTING AS A
PRIORITY- MINIMIZING
DISRUPTIONS TO CARE FOR THE
WORLD PEOPLES- THAT THE PROCESS
OF GETTING TO WHERE WE WANT
THEM TO BE IN THE TEENS THE-
PLAN. IT IS FRAUGHT WITH WITH
RISKS AND CHALLENGES AND SO
WE'RE WE'RE CERTAINLY I'D BE
HAPPY TO BE ON BOARD AND
PARTNERING WITH THE CASE AT THE
STATE- FOR THE PLANNING PROCESS
OF THAT BUT- I WANT TO
HIGHLIGHT SOME OF THOSE THOSE
RISKS. IF. THIS IS A STATE
WIDE- TRANSITION. AND HUNDREDS
OF THOUSANDS OF DOLLARS WILL
NOW FIND THEMSELVES IN
MEDICAMENTO CARE FOR THE FIRST
TIME IT JUST BY COMPARISON
WOULD BE IMPLEMENTED CCI IN TWO
THOUSAND FOURTEEN- THAT
IMPLEMENT THAT IMPLEMENTATION
WILL MEAN A FRACTION OF THE
SCALE OF THIS. TRANSITION
PROPOSAL SO DURING THAT TWO
THOUSAND FOURTEEN
IMPLEMENTATION- YOU KNOW. WE
ARE BOTH IN OFFICE AND IN OTHER
ADVOCATES AND COMMUNITY
EXPERIENCE- A NORMA'S CONFUSION
AND FEAR AMONGST THE
DELIVERABLES THAT WE ARE
INTERACTING WITH. AS THEY WERE
INTERACTING WITH THIS PROCESS
AND ATTEMPTING TO ACCESS CARE-
THERE WERE THERE WERE DURING
THE TRANSITION PROCESS THERE
THE WORK WAS CONCERNED ABOUT-
COVERAGE AND DESTRUCTION THE
CARE- BACK IN IN MANY INSTANCES
LEAD TO THE DESTRUCTION OR A
LACK OF FIRED RATHER. TO TO THE
PART OF THE PROGRAM ULTIMATELY-
WE RECEIVED PUBLIC THOUSANDS OF
CALLS PER MONTH DURING THAT
FIRST YEAR FROM FRUSTRATED AND
CONFUSED PATIENTS MANY OF WHOM
COULD NOT ACCESS- SERVICES THAT
THEY THAT THEY NEEDED HADN'T
HAD. PROVIDERS CANCEL
APPOINTMENTS FOR THE AMBER OR
REFUSED TO SEE THEM DUE TO THE
CHANGE OF THEIR COVERAGE- SO
YOU KNOW WE DESPITE THE BEST OF
INTENTIONS WHEN THAT PROCESS
ROLLED OUT THERE'S JUST WERE
NUMBER OF SYSTEMIC CHALLENGES-
IT IMPACTS THE CONSUMERS AND WE
HELP CONSUMERS THAT HAD- THEIR-
COVERAGE DISRUPTED DURING
CANCER TREATMENTS WE HAD. WE
HELP FOLKS OUT. THERE WHO HAD
PRE APPROVED AUTHORIZED-
SURGERIES- ABOUT WERE CANCELED
DUE TO THE- YOU KNOW DAYS IN
ADVANCE OF THE SURGERY DO THE
CHANGE OF COVERAGE- AND FOLKS
FACING AT THIS IT DIFFICULT
ACCESSING NEEDED MEDICATIONS
SO. REALLY THE EFFORTS THAT THE
PLANNING GROUP IS MAKING
TOWARDS AVOIDING THOSE
DESCRIPTIONS IN THIS TRANSITION
PROCESS ARE A REALLY- OF UTMOST
IMPORTANCE. OF TRANSITION- YOU
KNOW WE REALLY- A RIGOROUS
OVERSIGHT ROLE FOR THE
DEPARTMENT AND- IT. ACCOUNT AND
EVALUATE OF THIS PER. THIS IS A
ANOTHER PRIMARY- OVERSIGHT. OF
PLANS DO USE THAT SHE INCLUDE
HIM DATA THAT THAT MEASURE
WHETHER MEDICARE ALLEN THESE
THAT PLANS ARE CONNECTING TOOLS
TO NEEDED LONG TERM SERVICES
AND SUPPORTS AND DOING SO
EQUITABLY. LTSS UTILIZATION IS
THAT JUST REFERENCE THIS- IS A
VERY COMPLEX AND- FRAGMENTED
SYSTEM AND SO THE COORDINATION
OF THAT LTSS UTILIZATION THE
REFERRALS. I'M EVEN
EXPENDITURES- INCLUDING
EXPENDITURES ON HOME AND
COMMUNITY BASED SERVICES REALLY
MUST BE MONITORED AND TRACKED
VERY CLOSELY- ADDITIONALLY
EARLIER REFERENCE TO YOU KNOW
BROAD BASED DEMOGRAPHICS DATA
COLLECTION AND I THINK THAT'S
REALLY IMPORTANT BUT I ONLY
JUST COLLECTING INFORMATION.
BUT SELECTING AND SYNTHESIZING
THAT INFORMATION WITH LOCATION
DATA- SO THAT WE CAN REALLY
TRACK THE INTERSECTION I'LL BE
BETWEEN- DISPARITIES. AB OF HOW
PEOPLE ACCESS CARE AND THEN
REALLY SAID AS BENCHMARKS- FOR
PLANS TO HELP REDUCE THOSE
REDUCE THOSE EFFORTS. RELATEDLY
THE PLANNING IMPLEMENTATION
PROCESS AS WELL AS THE- CARE TO
LIVE AS WELL AS THE CARE
DELIVERY- PROCESS MUST
PRIORITIZE REDUCING THESE
DISPARITIES- SB EQUITY CENTER-
DURING THE CCI DEMONSTRATION
PROCESS THE RED NUMBER OF
DISPARITIES THAT CAME TO BEAR-
AT IN TERMS OF WHO
PARTICIPATED. IN THE COMEDY
CONNECT PROGRAM WHO OPTED OUT.
AT YOU PART. THERE THERE WERE
EFFORTS TO ENGAGE. AND RELATE
TO NEW YORK I CAN OF AND L. E.
P. COMMUNITY. HOWEVER THAT THAT
WASN'T ALWAYS SUCCESSFUL AND SO
WE SAW HUGE- MASS OPT OUT OF
DISTINCT- EXCUSE OF COLOR IN
THE TO BE GOOD FOR FISHING
PATIENTS THAT REALLY COULD HAVE
BENEFITTED FROM THESE WONDERFUL
SERVICES. LANGUAGE ACCESS
BARRIERS AND LIMITATIONS OF
PROVIDERS AND SOME PLANTS BIRDS
AND SOME FURTHER CHALLENGES TO
LDP POPULATIONS. AND I THINK
WE'VE SEEN COVERED ON THE
EQUITIES SO WE REALLY WANT TO
PUT FORWARD EQUITY AS A
PRIORITY TO BE BUILT INTO EVERY
ASPECT OF THIS TRANSITION
PLANNING- AND WE- WANT TO
EMPHASIZE IT PROVIDING
SUFFICIENT TIME FOR CONSUMER
PROVIDER EDUCATION DO YOU THINK
THAT THAT WAS THE KEY ISSUE.
WITH THE PRIOR IMPLEMENTATION
NOTICED THE MATERIALS TESTING
THOSE IMPORTANT OF COURSE-
ESPECIALLY REACHING OUT TO.
SUCH A DIVERSE- POPULATION- AND
INCLUDING THE TERMS AND
CONDITIONS AND CONTRACT
PROVISIONS THAT ESTABLISH
BENCHMARKS AND TARGETS FOR
REDUCING DISPARITIES THAT THE
COMMISSION THAT PREVIOUSLY.
FINALLY YOU KNOW WE FILL OUR
ROLE IN THIS PROCESS IS THE
MOST IMPORTANT WE NEED TO
SUPPORT THE WORLD WILL HELP
THEM UNDERSTAND AND NAVIGATE
THESE TRANSITIONS. SO
CONTINUING OUR COMPREHENSIVE ON
BUTTON SERVICES PROGRAM WITH
BILLS ABSOLUTE CRITICAL NOT
ONLY THROUGH THE TRANSITION-
WHICH WHICH REALLY IS STARTING
IN IN TWENTY TWENTY THREE FOR
MANY MANY BILL SO ELIGIBLE. BY
TEARING THROUGH- THAT TO BE THE
END GOAL AND TWENTY TWENTY FIVE
BEYOND REQUIRED TO PROVIDE
SUPPORTS TO DO WELL DOUBLES.
THAT NEED ASSISTANCE TO ADDRESS
INDIVIDUAL BEARS AND INVENTHELP
EVENT WE CAN THEN TURN AROUND
AND FLAG THOSE FOR THE STATE TO
HELP ADDRESS- ADDRESS THOSE
BARRIERS SO I APPRECIATE THE
OPPORTUNITY PERCENT TODAY. IF
FIVE SEVEN QUESTIONS THAT. HAVE
TO DO TO ANSWER THOSE THANK YOU.
GREAT THANK YOU VERY MUCH PUSH
THAT AND WE MAY COME BACK TO A
QUESTION SO- OUR NEXT WITNESSES
MY ALL. THE CHIEF EXECUTIVE
OFFICER FOR THE HEALTH PLAN OF
SAN MATTEO. HELLO AGAIN THE
IT'S I'M GLAD I'M I'M FONG WITH
MR DALY'S TESTIMONY BECAUSE- I
THINK HE REALLY BROUGHT THINGS
FRONT AND CENTER PUT IN FRONT
AND CENTER AT THE ONE POINT
FOUR MILLION CALIFORNIANS WERE
ELIGIBLE FOR BOTH MEDICARE AND
MEDI CAL ON THESE FOLKS ARE
POORLY SERVED IN CURRENT
SYSTEMS AND THEY ARE AMONG THE
HIGHEST PAID POPULATIONS. ON
DATE THE LACK OF GOOD OPTIONS
IN GOOD CARE FOR DUAL ELIGIBLES
IS REALLY AN EQUITY ISSUE AS HE
EXPLAINED AND JUST TO PUT A PEN
AND SOME OF HIS CLIENTS ALL MY
THE COUPLE'S REALLY TELLING
STATISTICS- AS OF NOVEMBER
202040% OF THE MEDICARE
BENEFICIARIES THIS IS
NATIONWIDE- WHO DIED. OF COVERT
NINETEEN OR DAHLE. NATIONWIDE
THE RATE OF. DUE TO COLDER IS
THREE TIMES HIGHER FOR DAHLE
DOUBLES COMPARED TO THE GENERAL
MEDICARE POPULATION. YES HE
SAID THE OF DUELS ARE FORWARD
AND MORE LIKELY TO BE PEOPLE OF
COLOR. THEY HAVE MORE HEALTH
ISSUES AND CHALLENGES AND THEY
HAVE. THEY HAVE TO DEAL WITH
MORE SIZE PSYCHOSOCIAL NEEDS.
THE GENERAL MEDICARE POPULATION.
I'M I SERVED ON THE MASTER FOR
AGING STAKEHOLDERS COMMITTEE.
AND THE NEEDS OF DUAL ELIGIBLES
WAS A WAS A MAJOR FOCUS FOR US.
ONE OF OUR RECOMMENDATIONS WAS
CALLING FOR PLANS AND WE
RECOGNIZE THAT BUSINESS IT'S
GOING TO HAPPEN QUICKLY. REALLY
A LONG TERM PLAN TO GUARANTEE
THAT THERE WILL BE INTEGRATED
OPTIONS EVERY PART OF THE
STATE. OFFER DUAL ELIGIBLES
REACH COULD BE CASE PROGRAMS.
SOMETHING LIKE HOW MANY CONNECT
BUT BETTER WE'RE TRULY
INTEGRATED DUAL ELIGIBLE
SPECIAL NEEDS PLANTS. THIS
RECOMMENDATION ALSO SPEECH THAT
GEOGRAPHIC INEQUITIES IN THE
STATE MANY RURAL PARTS THE
STATE FARM HELP ABSOLUTE ALL
AVAILABLE IN TERMS OF OPTIONS
FOR- RANGES FROM LTSS OPTIONS
TWO OPTIONS FOR INTEGRATED CARE.
BUT EVEN IN URBAN AREAS THERE
ARE MAJOR PROBLEMS- AND- AND
THAT'S WHY IT'S REALLY CRITICAL
WHY. I SUPPORT THE STATE'S
REQUIREMENTS THAT THE DIS NEXT
REALLY BE ONLINE AS THEY CALL
IT- I DO ARGUE THAT THERE'S TOO
MUCH CHOICE ON THE MEDICARE
SIDE. I'M SIXTY FIVE AND I'VE
BEEN A BOMBARDED WITH MAIL
MAILINGS ABOUT MEDICARE
ADVANTAGE PLANS IN LOS ANGELES
I UNDERSTAND THERE ARE MORE
THAN NINETY MEDICARE ADVANTAGE
OPTIONS FOR PEOPLE ALL THESE
PLANS THESE MEDICARE ADVANTAGE
PLANS- INCLUDE TOOLS AND THEIR
MARKETING WHETHER INTENTIONALLY
OR NOT. AT TIMES IT'S VERY
MISSILE VERY MISLEADING AND
CONFUSING FOR DOOR MEMBERS
OFFER DAHLE BENEFICIARIES SO
WHAT WE REALLY NEED I THINK IS
A CURATED CHOICE AND LONG
DISTANCE WITH THE COLLEGE THAT.
AGAIN THERE MAY BE FEWER
CHOICES FOR DUAL ELIGIBLES BUT
IT WOULD BE REAL MEANS SO- DO A
LOT OF TROUBLES AND AGAIN UNDER
THIS PROPOSAL THEY CAN STAY IN
FEE FOR SERVICE THERE'S NO
PROPOSAL FOR PASSIVE ENROLLMENT
OR MAKING PEOPLE OF ROLE IN R.
D. STEPS AGAINST DAVIES FOR
SERVICE WORK ON THEY WOULD HAVE
AT LEAST ONE TRULY INTEGRATED
MEDICARE MEDICAID PLANS. ON. IF
THAT'S WHAT THE AND WHAT WE
WANT. I'M ANOTHER KEY. OF AND
OTHER OF TOUCH ON ON THIS IS
WHAT IS TRULY. TRUE INTEGRATION
GO BEYOND JUST INTEGRATE
MEDICARE MEDI CAL BENEFITS-
THAT IS CRITICALLY IMPORTANT.
IT MEANS INTEGRATING OR CLOSE
COORDINATION OF HEALTH WITH
LONG TERM SERVICES AND SUPPORTS
WITH BEHAVIOR HEALTH SERVICES.
AND OTHER CRITICAL SERVICES
SUCH AS HOUSING AND FOOD
AVAILABILITY. THE STATE SHOULD
ENSURE THAT THE ALIGNED YOU
STEPS ARE HIGHLY INTEGRATED AS
POSSIBLE. SO JUST ONE EXAMPLE
ON LONG TERM CARE IT'S A FAIRLY
VERYLEAST ANY ONLINE DO YOU
STEP ON PASSED TO TAKE
RESPONSIBILITY FOR BOTH
MEDICARE AND MEDICAID FUNDED
LONG TERM CARE. IS NOT THE
DISTANCE WILL HAVE NO INCENTIVE
TO HELP PEOPLE AVOID LONG TERM
NURSING HOME STATES. SO UNDER
FOR EXAMPLE UNDER CHAO MANY
CONNECT ON MY OUR PLAN HELP
HELP THAT ESTIMATES HAS HELPED
HUNDREDS OF PEOPLE HUNDREDS OF
OUR MEMBERS MOVE OUT OF NURSING
HOMES AND THAT'S ONLY POSSIBLE
BECAUSE WE ARE RESPONSIBILITY
FOR LONG TERM CARE- AND
FINALLY- SIMILAR TO THE- TO THE
DOCTOR THE LAST PANEL I WANTED
TO POINT OUT. ON THE GROUND NO
WE DON'T WORLD IMPACT AT THE
INTEGRATED MEDICARE MEDI CAL
CARE CAN HAVE. SO TODAY 55% H.
P. S. M.'S ELIGIBLE- CAL MANY
CONNECT TOOLS HAVE BEEN
VACCINATED- WE THINK THAT'S
GOOD PROGRESS BUT IT'S STILL
LOWER THAN THE 75% FRACTION
VACCINATION RATE FOR THE SIXTY
FIVE PLUS. GENERAL POPULATION
IN THE COUNTY OVERALL- AND IT
WE THINK IT'S GOOD PRICE
BECAUSE WE KNOW THAT ALL BUT
THE DOOR WILL DOUBLE SPACED IT.
ISSUE AGING BASED. ISSUES AND
OTHER CHALLENGES. AND THE
REASON WE CAN MAKE THIS KIND OF
PROGRESS IS BECAUSE THESE
MEMBERS ON ON YOU KNOW AND
TRUST OUR PLANT WE'VE ENGAGE
WITH THEM OVER MANY YEARS AND
WE KNOW HOW TO WORK WITH THEM.
SO ONE SPECIFIC EXAMPLE IS
EARLY ON WE IMMEDIATELY
ENGAGED- A TRUSTED ORGANIZATION
THAT WE SUBCONTRACT WITH. THAT
COMBAT SOCIAL ISOLATION AMONG
OUR GOALS ESPECIALLY DURING THE
PANDEMIC. WHEN THE VACCINES-
FIRST BECAME AVAILABLE THIS
ORGANIZATION CALLED Y. CIRCLE
WAS ABLE TO IMMEDIATELY ENGAGE
MORE THAN FIVE HUNDRED OF OUR
SPANISH SPEAKING. ARM ARM ARE
ONLY TOOLS AND ENSURE THEY GOT
TO VACCINATION OF POINTS WHICH
WAS NO EASY TASK. SO I YOU KNOW
INTEGRATED CARE WILL MAKE A
HUGE DIFFERENCE IN PEOPLE'S
LIVES ARE. YEAH I THANK YOU FOR
THE OPPORTUNITY TO TESTIFY IN
THE VEHICLE FOR ANY QUESTIONS.
THANK YOU VERY MUCH- WILL WILL-
WILL TAKE YOU UP ON THAT
PROBABLY AFTER THE AFTER THE
PANEL GOES THROUGH HERE SO
THANK YOU- OUR FINAL MEMBER OF
THE PANEL IS EVE GELB. SENIOR
VICE PRESIDENT MEMBER AND
COMMUNITY HEALTH. SCAN HEALTH
PLAN. AS THANK YOU FOR MUCH FOR
OPPORTUNITY TO PRESENT AND- I'M
GONNA FOLLOW UP RIGHT ON WHAT
MY SAID ABOUT FULLY INTEGRATED
MODELS BECAUSE THAT'S- EXACTLY
WHAT WE'VE BEEN ABLE TO PROVIDE
SO I AM- THE SENIOR VP OF
MEMBER AND COMMUNITY HEALTH
FORCE CAN HELP PLAN. AND
PERHAPS A NEW PIECE OF
VOCABULARY WE ARE WHAT IS
CALLED A FULLY INTEGRATED DUAL
ELIGIBLE SPECIAL NEEDS PLAN. SO
THANK YOU STEP OUT WE HAPPEN TO
BE THE ONLY ONE IN THE STATE OF
CALIFORNIA- BUT I FULLY AGREE
WITH WHAT MIKE WAS SAYING AND
WITH WHAT OTHERS WERE SAYING
ABOUT FULLY INTEGRATED OPTIONS
AND- OUT WE- WENT AROUND- LONG
BEACH CALIFORNIA IS WHERE WE
STARTED. OUT WE WERE FOUNDED BY
A DIVERSE GROUP OF SENIORS- WHO
THEIR REAL FOCUS WAS HOW TO
KEEP PEOPLE OUT OF NURSING
HOMES. AND THAT'S REALLY BEEN
THE FOUNDATION OF OUR
ORGANIZATION WE NOW SERVE ABOUT
TWO HUNDRED TWENTY THOUSAND
MEDICARE BENEFICIARIES AND
ELEVEN COUNTIES IN CALIFORNIA-
THEN. AS A MEDICARE ADVANTAGE
PLAN M. A. T. T. PLANNED- BUT
ABOUT FIFTEEN THOUSAND OF OUR
BENEFICIARIES ARE DULY ELIGIBLE
AND JULIE AND ROLLED IN OUR-
PSYCHE SNAPPED IN THIS FULLY
INTEGRATED MODEL. I'M AND IT
BRINGS TOGETHER THE BEST OF
BOTH WORLDS AS THE PHYSICIAN
EARLIER WE'RE SPEAKING TO. ALL
OF THE MEDICARE AND THE
MEDICAID. OUTSIDE YOU KNOW A
MULTI SET OF CALL MEASURES- WE
ARE AND A HALF. WE HAVE BEEN
MANY YEARS. I'M AT THAT IT YOU
KNOW ALL OF OUR CAL. GET
TREATED EQUITABLY HAVE CARE.
AND HAVE FOR TO HAVE STAR
QUALITY PLAN AVAILABLE TO THEM
AND TO THE POINT THAT THE
POSITION WAS MAKING EARLIER ONE
OF THE REASONS IS BECAUSE- OF
OUR STRONG PROVIDER NETWORK SO
PROVIDERS JUST NEED TO PROVIDE
CARE. WE DO ALL THE REST IN THE
FACT HE'S NEVER WHICH IS THE
WRAPAROUND SERVICES. INCLUDING
THE INTEGRATED LONG TERM
SERVICES AND SUPPORTS AND WHAT
THAT'S BEEN ABLE TO DELIVER IT
IS LESS THAN 1% OF OUR DUAL
ELIGIBLE BENEFICIARIES ARE.
ENROLLED IN A LONG TERM CARE
FACILITY AND THOSE NUMBERS THAT
MIGHT WAS MENTIONING BE ADAMANT
RELATED TO CODE BUT A LOT OF
THAT HAS TO DO WITH FOLKS WHO
WERE LIVING IN LONG TERM CARE
FACILITIES. AND OUR- YOU KNOW
OUR- RIGHT AFTER I READ FOR
BEING IS TO KEEP SENIORS LIVING
HEALTHY AND INDEPENDENTLY IN
THE COMMUNITY. AND YOU HAVE TO
DO THAT BY. FULLY INTEGRATING.
THEIR WHOLE PERSON NEEDS WHICH
IS WHY I LOVE THE WHOLE PERSON
MODEL I LOVE WITH THE STATE IS
DOING WITH COUNTING- WHAT DH CS
IS TRYING TO DO AND THE MANY
STAKEHOLDERS THAT THEY'RE
BRINGING TOGETHER. I'M STILL
ONE LESSON WE DID LEARN FROM
THE COORDINATED CARE INITIATIVE
WAS THAT PROVIDERS ARE KEY
STAKEHOLDERS AND THEY INFLUENCE
BENEFICIARY CHOICE. AND SO WE
HAVE TO WORK WITH A PRODUCT
THAT HAS STRONG PARTNERSHIP
WITH THOSE PROVIDERS- AND
ENABLES THEM TO YOU AS THE
DOCTOR SAID DELIVER CARE
REGARDLESS OF THE BENEFICIARIES
COVERAGE THEY JUST KNOW. THAT.
THEY NEED TO PROVIDE HIGH
QUALITY CARE. I KNOW LESSON WE
LEARNED IS THAT BENEFITS
CHOICES IMPORTANT SO I'M TO THE
POINT AT THAT THE LEGAL AID
SOCIETY WAS MAKING. THERE WAS A
LOT OF. BENEFITS RETURNED WHERE
FOLKS WERE DISTANT ROLLING FROM
THEIR ASSIGNED PLANS- WE SAW.
AMAZING STABILITY IN OUR
MEMBERSHIP THROUGH THIS-
TRANSITION BECAUSE WE ARE FULLY
INTEGRATED BECAUSE WE PROVIDE
GOOD SERVICES BUT ALSO BECAUSE
OF THE BENEFITS FREE CHOICE
WHEN THEY WHEN THEY HAD.
INTEGRATED OPTION- THAT MY IT
WAS TALKING ABOUT IN THE
COUNTIES WE SERVE I'M IN THIS
IS A GREAT OPTION ISN'T
RIVERSIDE SAMBAR DINO AND LOS
ANGELES COUNTIES. I'M WITH
RESPECT TO THE LTSS OF
DELEGATION- THAT ANASTASIA WAS
TALKING ABOUT SO OUR MODEL HAS
BEEN FULLY INTEGRATED- AND NOT
ONLY HASN'T ALLOWED US TO
ACHIEVE THOSE LOW
INSTITUTIONALIZATION RATES THAT
I TALKED ABOUT THAT LESS THAN
ONE PERCENT. BUT WE'VE ALSO
BEEN ABLE TO DEMONSTRATE LOWER
ACUTE UTILIZATION LOWER
READMISSION AND SO WHAT THIS
MODEL DOES IT CREATE SAVINGS
FOR BOTH MEDIC HOW AS WELL AS
MEDICARE. I'M SO NOT ONLY IS IT
YOU KNOW MODEL THAT PRODUCES
HIGH QUALITY OUTCOMES IT. ALSO
REDUCES COST. SO ENSURE AT KNOW
ARM. FOR CAROLINE IS GIVEN THAT
THE FIGHTING SNAPPED- IS- A
MODEL THAT REALLY ENABLES
POPULATION HEALTH APPROACH
WHOLE PERSON MODEL THAT ALLOWS
US TO LOOK AT- OUR POPULATION
THE SEGMENTS IN OUR POPULATION.
REYES THE LINGUISTIC AT THE
SOCHI NEEDS OF OUR POPULATION
AND DELIVER CARE THAT'S GOING
TO REDUCE INEQUITIES. IT IS
ALSO FULLY INTEGRATED WITH
RESPECT TO ALL OF THE NEEDS AND
NOT JUST THE MEDICAL NEEDS BUT
THE SOCIAL NEEDS THE SOCIAL
SUPPORTS INCLUDING OUR
MINISTRIES EXPERIENCING
HOMELESSNESS. I'M AND I THINK
THAT THEM THAT A MODEL LIKE
THIS WHICH HAS BOTH CMS AND
TEACH THE S. OVERSIGHT.
PROVIDES THE GREAT LEVEL OF
DENTISTRY PROTECTION. SO WE
WOULD ENCOURAGE OTHER
DEPARTMENT TO. ALLOW THE GROWTH
OF FIGHTING NAPS- AND TO ALLOW
FIVE EAST NEXT TO FULLY
PARTICIPATE. IT'S A MODEL THAT
SERVES YOU KNOW ABOUT A HUNDRED
FIFTY THOUSAND BENEFICIARIES
ACROSS THE COUNTRY- BUT IN
CALIFORNIA ONLY FIFTEEN
THOUSAND SO I DON'T REALLY AN
OPPORTUNITY TO GROW A MODEL
THAT HAS BEEN DOING IN HEALTH
CARE MANAGEMENT AND IN LIEU OF
SERVICES. THROUGHOUT OUR
HISTORY I'M AND SO WE'RE
ENCOURAGING THE GROWTH OF THAT
MODEL TO MY LAST POINT THE
GROWTH OF FULLY INTEGRATED
OPTIONS WHETHER THEY BE PEACE
VI SNAP OR SOMETHING ELSE
IN ALL COUNTIES- FOR THE
BENEFICIARIES OF THE STATE- AND
TO ALLOW THESE MODELS TO
FORMALLY OFFER AND PARTICIPATE.
IN IT LOOKS SERVICES- JUST YOU
KNOW CONSISTENT WITH THE RAP
BEST OF THE MEDICARE MANAGED
CARE PLANS. I THANK YOU FOR THE
OPPORTUNITY TO SPEAK AND BE
HAPPY TO TAKE QUESTIONS. THANK
YOU VERY MUCH- WILL BRING BACK
TO THE COMMITTEE FOR QUESTIONS
DOCTRINA. SO I THINK I HAVE A
COUPLE- FIRST ON THIS IS A
WE'RE GOING TO ASK FOR THE
ADMINISTRATION TO- AND
HOPEFULLY ANSWER FOR US- THIS
IS A COMPLEX AREA- MULTIPLE
PAYERS- MULTIPLE PROGRAMS- AND
MY READ OF THE PROPOSED TRAILER
BILL- IS THAT WE ARE NOW JUST
REQUIRING. IT INSTITUTIONAL
LONG TERM CARE TO BE A PART OF
THE BENEFIT PLAN AND WE'RE
REQUIRING IN A LINE D. SNAP AND
MEDICARE HOW A MANAGED CARE
PLAN- BUT WE'RE NOT TAKING
ACTION ON THE CURRENT HOME AND
COMMUNITY BASED SERVICES
PROGRAMS- AND- IS THAT CORRECT-
OR DISS PROPOSAL DO WITH HOME
AND COMMUNITY. BASED SERVICES
WAIVER PROGRAMS. SEVEN IS
COOPER- WHAT I WOULD SAY IS THE
PIECE THAT I THINK THE
OPPORTUNITY IS THE EXPANSION OF
THE IN LIEU OF SERVICES MANY OF
THE THINGS THAT WE HAVE SEEN-
DONE IN BOTH THE CCI FORMS THE
PLAN THAT'S REALLY AROUND THOSE
TRANSITIONAL SERVICES THINGS
LIKE PROVIDING MEDICALLY
TAILORED MEALS. HOME
MODIFICATIONS SERBIAN LOVE
SERVICES WOULD BE AVAILABLE FOR
ALL PARTIAL DUAL AND DUAL.
ELIGIBLE INDIVIDUALS AND THE D.
SNAP A PROPOSAL THAT IS BEFORE
YOU. UPPER CONSIDERATION UP AND
SO THEY WOULD HAVE ACCESS TO
GROWING- UP THOSE AREAS FROM
THE COMMUNITY BASED OR- LTSS
SERVICES IN THE MEDICARE
MANAGED CARE PLANS. AND THEN AS
WE GROW AND HAVE ADDITIONAL
CAPACITY STATEWIDE THE
DEPARTMENT WOULD CONSIDER A
WHAT WE OFFICIALLY CARBON IN
REGARDS TO BENEFITS- TO
EVENTUALLY GET TO LONG TERM
SERVICES AND SUPPORT BY TWENTY
TWENTY SEVEN IS THE GOAL. OF A
KIND OF BUILDING. AN
INFRASTRUCTURE OVER TIME. SO AS
AS- BEGIN TO FLESH THAT OUT.
THERE WOULD BE CONVERSATIONS
WITH. IT SO WE KINDA KNOW AS
WE'RE GOING ALONG RATHER THAN.
BOOM HERE IT IS. WE ARE BECAUSE
WE'RE GONNA NEED TO BUILD
CAPACITY AND IS ONE OF THE
BIGGEST OPPORTUNITIES RIGHT NOW
IN OUR OPINION IS AS WE'RE
BUILDING IN THE SYMBOL OF
SERVICES REALLY EXPANDING
ACCESS TO THESE HOME AND
COMMUNITY BASED SERVICES
TRANSITIONAL SERVICES- THAT WE
REALLY THINK WILL REALLY SERVE
OUR DAHLE POPULATIONS VERY
WELL- AND SO WHAT WE WHAT FULLY
ENGAGE IN REGARDS TO ANY
TRANSITIONS OF ADDING NEW
BENEFITS ADD. TO THE MEDIC CAL
A MANAGED CARE- RESPONSIBILITY-
AS WELL AS WHAT THAT MEANS FOR
NINETEEN FIFTEEN C. WAIVERS ARE
MOVING FORWARD AS WELL A VERY
CRITICAL A LOT OF THE PROVIDERS
WHO PROVIDE SERVICES IN OUR
NINETEENTH THE ACTIVITIES THE
RIVERS ARE THOSE ARE THE ONES
THAT WERE WORKING WITH VERY
CLOSELY TO FIGURE OUT BOTH THE
IN LIEU OF SERVICES ELIGIBILITY
CRITERIA LEARNINGS FROM THOSE
PROGRAMS AND CONNECTING THOSE
RESOURCES TO OUR MANAGED CARE
PLAN SO THEY CAN LEVERAGE THOSE
ADS IN LIEU OF SERVICES. TO GO
TO INCREASE THAT CAPACITY SO
YES THE DEPARTMENT FULLY
COMMITTED TO ENGAGING WITH THE
LEGISLATURE GARCIA THOSE
PROPOSED CHANGES IN THE FUTURE
OKAY- WHILE YOU'RE STILL THERE
SO THE L. A. R. HIS
RECOMMENDATION ABOUT MAKING A
SETTING ABOUT MAKING A SETTING
A MINIMUM STANDARD OF CARE FOR
INTEGRATION AND COORDINATION OF
THE SNAPS. WITH MEDICARE
MEDICARE PANS WHAT'S YOUR
REACTION. TO THIS.
RECOMMENDATION I'M- I WILL THIS
ONE UP TO NO SHE'S DOING A LOT
OF THINKING IN CONVERSATIONS
WITH MEMBERS ON THIS ONE AND SO
AND A STAGE OR DO YOU WANT TO
RESPOND TO THAT QUESTION SURE
YES YOU CAN HEAR ME- THERE'S
ACTUALLY ALREADY A MINIMUM SET
OF REQUIREMENTS IN THE CURRENT-
DECENT CONTRACT NOTICES SMACKED
ANOTHER WORD TODAY- SORRY.
ANYWAY SO BUT THERE THERE ARE
ALREADY MINIMUM STANDARDS AND
REQUIREMENTS FOR INTEGRATION
AND COORDINATION THAT WE EXPECT
THAT THESE NEXT TO COMPLY WITH.
AND THEN WE ARE ACTUALLY
WORKING RIGHT NOW. ON UPDATING
IMPROVING THOSE REQUIREMENTS
FOR TWENTY TWENTY TWO AND THEN
WE WILL HAVE A MUCH BIGGER
CONVERSATION IN OUR STAKEHOLDER
GROUP FOR TWENTY TWENTY THREE-
TO HAVE- STRONGER REQUIREMENTS
ADOPTING MANY OF THE
INTEGRATION PIECES THAT WE HAVE
FROM COMEDY CONNECT AND THEN-
IN. INCORPORATING ALL OF THE
ELEMENTS OF CALAIS IN THAT ARE
ALSO BEING WORKED ON ACROSS.
MANY AREAS TO THE SMACK
CONTRACT. GREAT THANK YOU- YOU
ALL HAVE A PART TO HAVE A
GLOSSARY FOR ALL THE- PHRASES
YOU HAVE SO I WILL TELL YOU IN
THIS IS A TRUE STORY- I HAVE.
FOR A WHILE THOUGHT THAT MR
MILLER WAS A REAL PERSON. UNTIL
I UNDERSTOOD WHAT MISTER MADE
REALLY MET A LONG TIME AGO SO-
JUST THROWING THAT OUT THERE
JUST. I WOULD I DIDN'T ASK AND
I JUST ASSUMED IT WAS A REAL
PERSON ANYWAY. THAT WAS BEFORE
I WAS IN THE LEGISLATURE. THANK
YOU APPRECIATE EVERYBODY ON
THIS PANEL WILL GO AHEAD AND
MOVE ON TO THE FOURTH PANEL DR
ABDULLAH. THANK YOU VERY MUCH
MISTER CHAIR. WE WILL NOW MOVE
ON THE PANEL FOR ON THE
PROPOSAL TO REQUIRE JAILS AND
COUNTY JUVENILE FACILITIES TO
PROCESS MEDICAL APPLICATIONS AT
THE TIME OF THEIR RELEASE. WE
WILL HAVE FIVE SPEAKERS ON THIS
PANEL INCLUDING JC COOPER NET
REZNIKOV KATHY CENTROLENE
MCDONALD'S DAVE PUTNAM AND
KATHERINE COHAN. IF WE CAN
PLEASE BEGIN WITH CHASING
COOPER. GET I'M AS I'M ROLLING
THIS UP- ONE THING I WOULD JUST
FLAG IS THAT WE ACTUALLY DO
HAVE AN ACRONYM BOOK AT DH CS
WHEN YOU START HERE AND IT IS
SIXTY FIVE PAGES LONG AND I
THINK GROWING SO- DEFINITELY
SOMETHING WE NEED TO WORK ON IT
PLEASE SEND US A COPY WE LOVE
TO HAVE A- THEREFORE IT GETS
UPDATED ABOUT- WITHIN A MONTH
BECAUSE OF HOW MANY NEW
ACRONYMS WE APPARENTLY DECIDED
TO ADD TO OUR- A BOOK EVERY DAY
SO. I JUST WANTED TO. TO MAKE
NOTE OF THAT- OKAY SO- ON ON
THIS PARTICULAR INITIATIVE. I'M
I'M GONNA HIGHLIGHT THAT A FEW-
INITIATIVES AROUND THE JUSTICE
INVOLVED POPULATION JUST
BECAUSE I WANNA MAKE SURE WE-
ARE LINKING A MALL HERE AND
THEN. SPECIFICALLY ANSWER THE
QUESTIONS THAT YOU HAVE SO-
THERE ARE MULTIPLE I'M JUST AS
INVOLVED INITIATIVE ALL WITH
THE A PROPOSED START DATE OF
JANUARY TWENTY TWENTY THREE.
THE ONE EXCEPTION TO THE TWENTY
TWENTY THREE TYPE HERE IT WOULD
BE. THE TRANSITION OF ANY OF
THE WHOLE PERSON CARE I'M
SERVICES THAT ARE BEING
PROVIDED TRANSITIONING OVER
ACTIVE JANUARY ONE OF TWENTY
TWO- BUT ESSENTIALLY- WE ARE
PROPOSING TO ENSURE THAT ALL-
INMATES. I RECEIVEDTIMELY
ACCESS TO MEDICAL SERVICES UPON
RELEASE FROM INCARCERATION- BY
PROPOSING TO MANDATE ALL
INMATES COMPLETED MEDICAL
APPLICATION PRIOR TO RELEASE-
BUT- OF FROM INCARCERATION. AS
WELL AS A MANDATE THAT JAILS
AND COUNTY JUVENILE FACILITIES
IMPLEMENT A PROCESS PERSON. IS
STILL TAKING REFERRALS- AND
LINKAGES FROM. INSTITUTIONS
UPON RELEASE AND THAT COULD BE
TO COUNTY SPECIALTY MENTAL
HEALTH THEY COULD BE TO DRUG
MEDI CAL. I'M DIAN CO DS OR THE
MEDICARE MANAGED CARE PLANS
DEPENDING ON WHAT TYPE OF
BEHAVIORAL HEALTH SERVICES THEY
WERE RECEIVING- WHILE THEY WERE
INCARCERATED- WE THINK IT'S A
CRITICAL. A COORDINATION POINT
THAT. REALLY NEEDS TO BE
IMPLEMENTED. ADDITIONALLY ONE
OF OUR CARE MAY- MANDATED
TARGET PA. IS INDIVIDUALS
TRANSITIONING FROM
INCARCERATION I'M WHO HAVE
SIGNIFICANT COMPLEX PHYSICAL OR
BEHAVIORAL HEALTH NEEDS
REQUIRING IMMEDIATE TRANSITION
SERVICES TO THE COMMUNITY I
POINT THAT OUT BECAUSE IT'S AN
IMPORTANT PART OF THE OTHER
MANDATES WITH IN. OTHER
PROPOSAL I KNOW WE HAD
MENTIONED THOSE IN PREVIOUS
HEARINGS. WE ALSO HAVE A
VARIETY OF THE ELIGIBILITY
CRITERIA WITH INDIA LIEU OF
SERVICES WE WHICH EXPLICITLY
CALLS OUT PEOPLE TRANSITIONING
FROM INCARCERATION I THINK IT'S
AN IMPORTANT LINK JUST TO MAKE
SURE THAT WE'RE THINKING
THROUGH THIS. BROADLY AND HOW
IMPORTANT CHALLENGES FOR THE
JUSTICE INVOLVED POPULATIONS IN
THE VARIOUS TOUCH POINTS IN
WHICH WE'RE TRYING TO THINK
ABOUT BOTH DIVERSION AS WELL AS
MOOD REENTRY INTO THE
COMMUNITY. I'M TO ENSURE THAT
PEOPLE CAN HAVE THE BEST HEALTH
OUTCOMES AND THE MOST SUCCESS
AS THEY RE ENGAGING THE
COMMUNITY. OF MANY OF THOSE IN
LIEU OF SERVICES ARE FOCUSED
AROUND THE HOUSING PIECES
RETRIBUTIVE CARE AND THE SHORT
TERM- POST HOSPITALISATION.
PIECES JUST APPLIED A FUME.
YEAH THING I WOULD NOTE ON IS
THAT WE DO PLAN ON REQUESTING
APPROVAL TO AUTHORIZE A FEDERAL
MEDICAID MATCHING FUNDS. FOR
MEDICAID SERVICES BEING
PROVIDED THIRTY DAYS PRIOR TO
RELEASE. OF FOR ELIGIBLE
JUSTICE INVOLVED POPULATIONS SO
THIS WOULD INCLUDE SERVICES
LIKE ENHANCE CARE MANAGEMENT
BEING ABLE TO START THIRTY DAYS
PRIOR TO RELEASE- THAT WILL
ALLOW FOR THAT COORDINATION OF
SERVICES THAT ARE NEEDED- IT
WOULD ALSO INCLUDE SOME LIMITED
COMMUNITY BASED CLINICAL
CONSULTATION OF SERVICES
PROVIDED VIA TELEHEALTH. OR EAT
CONSULTATION THAT COULD BE DONE
AS WELL AS A THIRTY DAY SUPPLY
OF MEDICATIONS FOR YOU ONCE
THEY ARE RELEASED FROM
INCARCERATION SO THAT THEY HAVE
THAT MEDICATION. UPON LEAVING-
THAT THE JAILER PRESENT. THIS
REQUESTED- IS UNDER THE
AUTHORITY PROVIDED VIA THE
SUPPORT ACT- AND WOULD ALLOW US
TO DRAW DOWN FEDERAL FUNDS FOR
THOSE SERVICES. ONE OF THE
PIECES THAT WE THINK IT'S JUST-
CRITICAL HERE IS ENSURING
CONTINUITY OF HEALTH COVERAGE
AND CARE FOR THE JUSTICE
INVOLVED POPULATIONS IS A REAL
HIGH PRIORITY FOR. US HERE AT
DH CS AND I DO KNOW I IN
CALIFORNIA BROADLY. THIS GROUP
OF LOW INCOME INTO AS ADULTS IS
JUST PROPORTIONALLY PEOPLE OF
COLOR WHO HAVE CONSIDERABLE
HEALTH. CARE NEEDS ARE BUT ALSO
OFTEN WHO ARE- WITHOUT CARE AND
NEED MEDICATIONS UPON RELEASE
I'M GONNA PROVIDE SOME SOME
INFORMATION AROUND STATISTICS.
ON SOME TWENTY EIGHT POINT 5%
OF MALE PRISONERS ARE BLACK AS
COMPARED TO FIVE POINT 6% OF
THE STATE'S ADULT MALE
RESIDENTS. FOR LATINO MEN THE
IMPRISONMENT RATE IS A ONE
THOUSAND AND SIXTEEN PER ONE
HUNDRED THOUSAND AS COMPARED TO
THE THREE HUNDRED FOURTEEN. OR
ONE HUNDRED THOUSAND MEN OF
OTHER RACES. INDIVIDUALS
LEAVING INCARCERATION ARE
PARTICULARLY AT HIGHER RISK OF
POOR HEALTH OUTCOMES JUST AS
THE BALD INDIVIDUALS
EXPERIENCE. HIGHER RATES OF
BOTH PHYSICAL AND BEHAVIORAL
HEALTH DIAGNOSES ENTERED A HIGH
RISK FOR. INJURY AND DEATH AS A
RESULT OF VIOLENCE OVERDOSE AND
SUICIDE I'M MORE THAN PEOPLE
WHO HAVE NEVER BEEN
INCARCERATED. INMATES YOU HAVE
A BEHAVIORAL HEALTH DISORDER
ARE MORE LIKELY. THAN THOSE
WITHOUT AND YOU HAVE A
DISORDER- OR HAD TO HAVE BEEN
HOMELESS IN THE YEAR PRIOR TO
INCARCERATION LESS LIKELY TO
HAVE BEEN EMPLOYED PRIOR TO
ARREST- AND MORE LIKELY TO
REPORT A HISTORY OF PHYSICAL OR
SEXUAL. ABUSE NEARLY 70% OF
INDIVIDUALS RE OFFENDED WITHIN
THREE YEARS AFTER RELEASE FROM
PRISON. WELL THE FACTORS
CONTRIBUTING TO RECIDIVISM ARE
COMPLEXITY WE GET ALL OF
KNOWLEDGE THAT. AFFECTED
TREATMENT FOR MENTAL HEALTH
CONDITIONS AND SUBSTANCE USE
DISORDERS CAN INTERRUPT THE
CYCLE OF RE OFFENDING- BY
WORKING TO ENSURE JUSTICE
INVOLVED POPULATIONS HAVE A
STABLE NETWORK OF HEALTH CARE
SERVICES AND SUPPORTS UPON
DISCHARGE- DH CS STRONGLY
BELIEVES. THAT IT WOULD BE ABLE
TO DEMONSTRATE A REDUCTION OF
EMERGENCY ROUTE- YOU START
SORRY EMERGENCY DEPARTMENT USE.
HOSPITALIZATIONS AND OTHER
MEDICAL EXPENSES ASSOCIATED
WITH RELAPSE AS WELL AS
IMPROVEMENTS IN HEALTH OUTCOMES
INCLUDING THE REDUCTION OF
OVERDOSE RATES AND DEATHS.
THERE ARE SIGNIFICANT RESEARCH
OUT THERE THAT SHOWS ON THE
NUMBER OF PEOPLE. AFTER BEING
RELEASED FROM JAIL DUE TO
EITHER NOT. CONTINUING
MEDICATIONS OUT OF WORK
EXPECTED OR THEIR HIGH NEEDS OF
MEDICAL SERVICES SHOP IN
EMERGENCY ROOMS AND OR ADMITTED
TO THE HOSPITAL WITHIN SIX
MONTHS OF BEING RELEASED INTO
YOUR- ARE THE COMMUNITY. IF WE
CAN INTERVENE EARLIER BY
ENSURING THEY HAVE ACCESS TO
MEDICAL UPON RELEASE. AND
MAKING SURE THERE ARE CLEAR
COORDINATION PIECES FOR THOSE
INDIVIDUALS WITH COMPLEX
PHYSICAL BEHAVIORAL HEALTH
CONDITIONS WE DO THINK THAT WE
CAN. GREATLY IMPROVE THE
OUTCOMES FOR THESE AND WELLS.
ARE IN ADDITION TO SOME THE
QUESTION AROUND PRE RELEASE OUT
THE PER. CURRENTLY THE MAJORITY
OF CHARAKA IS HAVING THREE
RELEASE APPLICATION PROCESS BUT
THE PROCESS IS NOT STANDARDIZED
AND IT IS VOLUNTARY AT THIS
TIME. I'M SO IT DOES VERY
COUNTY TO COUNTY. UNDER OUR
PROPOSAL- DH CS WILL
STANDARDIZE THE COUNTY INMATE
PRE RELEASE POLICY AND MANDATE
IT FOR ALL FIFTY EIGHT
COUNTIES- THIS WILL BE A
COORDINATED EFFORT WITH
PARTICIPATION FROM COUNTY STAFF
THE JAILS. IN OTHER COUNTY AND
STATE PARTNERS IN ORDER TO MAKE
THIS SUCCESSFUL I'M INCLUDING
OUR MANAGED CARE PLANS AS WELL.
IN COUNTY BEHAVIORAL HEALTH
DEPARTMENTS. IMPLEMENTING THE
PROCESS IN EACH COUNTY WILL
VARY DEPENDING ON THE
COOPERATION THE COUNTY HAS WITH
JUSTICE INVOLVED ENTITIES I'M
IN ASSOCIATED CONTRACTS. OF
FUNDING HAS NOT BEEN IDENTIFIED
FOR THIS COMPONENT WELL PART OF
CALAIS BECAUSE OF THE
IMPLEMENTATION IS PLANNED FOR
JANUARY ONE OF TWENTY TWENTY
THREE. DCS PLANS TO IDENTIFY
THE REQUIRED FUNDING
REQUIREMENTS IN THE TWENTY
THREE TWENTY THREE BUDGET
PROCESS HOWEVER- THE DEPARTMENT
IS ALSO REQUESTING A FROM CMS
TO BE ABLE TO DRAW DOWN FEDERAL
FUNDS FOR THE INFRASTRUCTURE
AND CAPACITY BUILDING. FOR THE
COUNTIES YOU KNOW UP IN FIFTEEN
WAIVER AS WE KNOW THIS BILL
WILL BE A LARGE LEFT STATEWIDE
BUT A VERY IMPORTANT AND
CRITICAL ONE AND SO SEEKING
THOSE FEDERAL DOLLARS. ARE FOR
THAT IS A CRITICAL COMPONENT OF
WHAT WE ARE MOVING FORWARD IN.
THE MANDATE- THE MAJORITY OF
MEDICARE APPLICATION PROCESS
SEIZE UPON RELEASE FROM JAIL- A
BURKE COUNTY JUVENILE
FACILITIES REALLY BUILDS ON A
LOT OF THE LESSONS LEARNED THAT
WE HAVE HAD IN THE VOLUNTARY-
APPLICATION PROCESS. AS WELL AS
OUR WHOLE PERSON CARE PILOTS-
WE HAD A NUMBER OF WHOLE PERSON
CARE PILOTS WHO REALLY YOU WORK
CLOSELY WITH OUR COUNTY
PARTNERS- THE SHERIFF
DEPARTMENT IMPLEMENTED. VERY
REALLY GOOD PROGRAMS ACROSS THE
STATE OF CALIFORNIA- SOME
EXAMPLES INCLUDE KERN JEANS LOS
ANGELES. MARIN MENDOCINO SAN
JOAQUIN JEAN SAMMET. AND SANTA
COUNTY. I'M INTO T. S. WITH THE
APPLE WITH VERY COUNTY AND- BY
COUNTY- AS IT CURRENTLY DOES
TODAY SOME COUNTIES WILL USE
COUNTY HIRED CARE COORDINATORS
OTHERS USE COUNTY ELIGIBILITY
STAFF TO ASSIST IN OTHERS HAVE
CAUGHT- CONTRACTED WITH
COMMUNITY BASED ORGANIZATIONS
ARE COORDINATORS WE REALLY WANT
TO ALLOW FOR THAT FLEXIBILITY
BECAUSE IT'S WORKED FOR
COUNTIES TODAY IN REGARDS TO
HOW THEY SET THIS UP- BUT LOOK
TO ENGAGE WITH PEOPLE ABOUT
WHAT THE BEST STANDARD IS
ACROSS WHERE OF THAT VARIATION
CAN EXIST. I'M IN NO THERE WILL
BE A MANY CONVERSATIONS ABOUT
THIS AS WE MOVE FORWARD- SO
LOOK FORWARD TO ANSWERING
QUESTIONS WHEN IS THE
APPROPRIATE TIME. THANK YOU
VERY MUCH NEXT WE WILL HEAR
FROM NED REZNIKOV WITH THE L.
A. L. HELLO THIS IS NOT
REZNIKOV WITH THE L. A- AGAIN I
JUST A COUPLE OF BRIEF COMMENTS
ABOUT THIS PROPOSAL- WE FEEL
THAT THE PROPOSAL DOES HAVE
MERIT AND DEATH THAT IT THAT
IT. LINKS BACK TO THE CORE
MISSION OF CALAIS AND THAT IT
WOULD THAT CONNECT A HIGH RISK
INDIVIDUALS WITH- WITH
NECESSARY SERVICES. HOWEVER
THERE IS SOME QUESTION OF
WHETHER IT COULD CREATE A STATE
MANDATED AND WHAT THE COST OF
THAT WOULD BE. WE'RE NOT
PREPARED TO SAY THAT IT WOULD
CREATE A STATE MANDATE BUT IT
IS SOMETHING TO POTENTIALLY
KEEP IN MIND THANK YOU. THANK
YOU VERY MUCH NEXT WE WILL HEAR
FROM KATHY CENTRALLY MCDONALD'S
EXECUTIVE DIRECTOR OF THE
COUNTY WELFARE DIRECTORS
ASSOCIATION. I THANK YOU
CHAIRMAN IT AND MEMBERS KATHY
SAID KNOWING THE FINAL WITH THE
COUNTY WELFARE DIRECTORS
ASSOCIATION FOR PURPOSES OF THE
PANEL I'M ALSO REPRESENTING
COUNT AT THE CALIFORNIA STATE
ASSOCIATION OF COUNTIES OR THE
FACT OF THEIR MCDADE TANGRAM
FEEDBACK AND I WORKED TOGETHER
ON THE TALKING POINTS. HOW DO
YOU STRONGLY SUPPORT POLICY
LINKING AND MATES OF BEHAVIORAL
HEALTH AND HEALTH CARE PLANS
UPON THEIR RELEASE. IT'S REALLY
THE NEXT LOGICAL STEP FOR THIS
HIGH RISK POPULATION I COULD
IMPROVE OUTCOMES FOR
INDIVIDUALS COUNTY SYSTEMS IN
OUR OVERALL COMMUNITIES. FOR
SAFETY REASONS THE SHERIFF MUST
BE ABLE TO RETAIN THE AUTHORITY
TO APPROVE OR DENY WHETHER AND
NINE SHERIFF ENTITY MAY
IMPLEMENT THIS POLICY AT THE
LOCAL LEVEL. AND WE ALSO ASK IN
DEVELOPING TRAILER BILL
LANGUAGE ON THE TOPIC HOW DO
YOU ARE BE GIVEN FLEXIBILITY IN
THE PROCESS OF THIS YEAR. AS
MANY COUNTIES HAVE ALREADY
VOLUNTARILY IMPLEMENTED MEDIC
HELPED ME RELEASE ELIGIBILITY
ACTIVITIES. SO IT'S NOT
NECESSARILY- A ONE SIZE FITS
ALL PROCESS. AND WE- CERTAINLY
THINK THAT THE PROCESS OF
VISITING TAKING ME ACTIVITIES
ONE STEP FURTHER AT THAT
COUNTIES ARE ALREADY DONE WITH
THAT WARM HAND OFF. OF ELIGIBLE
INMATES TO HEALTH AND
BEHAVIORAL HEALTH PLANS ON
RELEASED MAKE FANS AND LOOK
FORWARD TO WORKING IN
COORDINATION WITH THE
DEPARTMENT AND OTHER
STAKEHOLDERS. TO DEVELOP THAT
PROCESS. THEY'RE ALSO OPEN TO
BOTH IN NON CAN UNDER THE DOING
WORKING A PER OF THE SHARE. BUT
THE TRUTH AT THIS ENTITY MUST
BE REQUIRED INTERFACE CLOSELY
WITH COUNTY MENTAL HEALTH%
PLANS. TELL ME HUMAN SERVICES
ELIGIBILITY STAFF AND OTHER
COUNTY DEPARTMENTS AND SERVICES
AS APPROPRIATE AS WELL AS WITH
THE MANAGED HEALTH CARE PLAN.
HOW MANY LEVEL IMPLEMENTATION
EFFORTS MUST INCLUDE AT MINIMUM
PROPHECIES THE CEMENT
APPLICATION TO COUNTY HUMAN
SERVICES AGENCIES. FOR
ELIGIBILITY DETERMINATIONS. AS
WELL AS WELL AS COMMUNICATION
WITH COUNTY MENTAL HEALTH PLANS
TO ENSURE EFFICIENT LINKAGES.
TO THE CRITICAL COUNTY RUN
SERVICES THAT THAT RELEASED
INMATE AND BENEFIT FROM. YOU
DON'T NEED TO YEAH IT WILL BE
SIX SOME LANGUAGE TO ENSURE
THAT THE DUTIES ASSIGNED BY A
LOT OF COUNTY HUMAN SERVICES
AGENCIES. NAMELY CONDUCTING
INITIAL AND ONGOING ELIGIBILITY
DETERMINATIONS REMAIN CLEAR AND
ARE CLEARLY SEPARATED FROM THE
ACTIVITY OF SUPPORTING AN
INDIVIDUAL JUST TO EITHER FILL
OUT THE END OR SUBMIT A
COMPLETED APPLICATION. WHICH
MAY BE DONE BY OUTSIDE ENTITIES
SUCH AS CONTEMPLATED BY THE CAL
A PROPOSAL HERE. AND IN
ADDITION TO THE NECESSARY
FUNDING TO IMPLEMENT THESE NEW
REQUIREMENTS WHICH WE AGREED
WITH THAT INTERPRETATION THAT
THEY ARE MANDATE. COUNTIES ARE
SUPPORTIVE OF ADDITIONAL STATE
FUNDING TO MEASURE OUTCOMES
ASSOCIATED WITH THIS POLICY
PROPOSAL WHICH COULD INCLUDE
PERHAPS- INCREASE RECEIPT OF
SERVICE AS- PREVENTION OPPOSED
TO CARBURETION OVERDOSE STAFF.
OR OTHER OUTCOMES THAT WE WOULD
ALL WANT TO SEE REDUCED RISK
REDUCE RECIDIVISM AND OTHER
APPROPRIATE MEASURES THAT THE
STAKEHOLDERS MAY PROVIDE. I'D
BE HAPPY TO ANSWER ANY
QUESTIONS THAT CONCLUDES MY
FORMAL REMARKS THANK YOU. THANK
YOU NEXT WE WILL HEAR FROM DAVE
PUTNAM ASSISTANT. SHERIFF IN
KINGS COUNTY. WELL THANK YOU-
GOOD AFTERNOON COMMITTEE
MEMBERS I THINK IT IS WE HAVE
REACHED AFTERNOON YEAH I FIRST
WANT TO APOLOGIZE FOR NOT
HAVING WORKING VIDEO ON HIS
COMPUTER AND I HOPE YOU CAN
HEAR ME OKAY. YES SIR PLEASE
CONTINUE. THANK YOU JUST A
BRIEF INTRODUCTION- MY NAME'S
DAVE PUTNAM ON THE ASSISTANT
SHERIFF FOR THE KINGS COUNTY
SHERIFF'S OFFICE- I'VE BEEN
EMPLOYED WITH KINGS COUNTY FOR
ABOUT THIRTY ONE YEARS OF THE
LAST TEN YEARS AS THE SECOND IN
COMMAND F THE AGENCY- MY
PLEASURE TO GET TO SPEAK UP A
BRIEF OVERVIEW ONCE ON SOME OF
THE ISSUES- ON THE SHERIFF'S
THE- SHERIFF'S OFFICE AS WE
MOVE FORWARD. IN KINGS COUNTY
WE HAVE A MEDIUM SIZE JAIL WERE
LOCATED IN THE CENTRAL VALLEY
OF CALIFORNIA- RIGHT BELOW-
ASSEMBLY MEMBER ARAMBULA IS-
TERRITORY IN IN- HANFORD IS OUR
COUNTY SEAT ARE CURRENTLY
POPULAR- POPULATION CAPACITY IS
ABOUT SIX HUNDRED THIRTY SEVEN
INMATES- PRE COATED OUR
POPULATION WAS CONSISTENTLY
OVER SIX HUNDRED AND MANY TIMES
AS HIGH AS SIX HUNDRED FIFTY.
AND NOW IN THE MIDST OF CODE
PROTOCOLS WE'VE BEEN ABLE TO
KEEP OUR POPULATION TO AN
AVERAGE OF BETWEEN. FOUR
HUNDRED TWENTY FIVE TO FOUR
HUNDRED FIFTY. INMATES DALY. I
APPRECIATE THIS OP. TO TELL.
SOME POSITIVE OUTCOMES IN WHAT
I BELIEVE HAVE BEEN INEFFECTIVE
PROCESS WITHIN OUR FACILITY. WE
CAN SMALL COUNTY SUCH AS KINGS
WERE ABLE TO EFFECTIVELY KEEP
UP THE HUMAN SERVICES AGENCY
AND WE'VE DONE THAT AGAIN AND-
PRIOR TO CODE WE WERE ABLE TO
EMBED AN ELIGIBILITY WORKER.
INSIDE OUR FACILITY AND THIS
WORKER WITH THE HUMAN SERVICES
AGENCY THE ELIGIBILITY WORKER
WAS PROVIDED WITH ON A DAILY
BASIS WITH THE PENDING RELEASE
REPORT. BOTH THIRTY DAYS OR
SIXTY DAYS OUT ND- THIS
PROCESS ALLOWED THE ELIGIBILITY
WORKER TO REVIEW PENDING
RELEASES AND DETERMINE WHICH
INMATES MAY BE ABLE TO RE
INITIATE OR INITIATE BENEFITS
UPON. RELEASE AND IT WAS SUPER
EFFECTIVE. THERE AUDITING OF
THIS PROCESS WE DID MISS THAT
TOO MANY INMATES ELIGIBLE SO
NOW WITH CODE WHICH HAD TO
TRANSITION TO A PROCESS OF A
VIDEO BASED. PROCESS WHICH
ELIGIBILITY WORKER CAN YOU CAN
COMMUNICATE WITH THE- ATTENTION
WE ELIGIBLE INMATES AND INMATES
ARE PROVIDED WITH THE TABLET
AND CAN COMMUNICATE WITH THE
ELIGIBILITY WORKER THAT WAY TO
REVIEW AND THIS OLD BUILDING
WORKER IS STILL PROVIDED WITH
RELEASE REPORTS AND THE ABILITY
TO COMMUNICATE WITH THE-
INMATES PENDING RELEASE AND TO.
RIDE THEM WITH AN APPLICATION
AND ASSIST THEM WITH APPLYING
FOR BENEFITS. AND I JUST WANTED
TO ARTICULATE SOME CONCERNS
GOING FORWARD AS WE CONTINUE TO
ADVOCATE FOR A CONSISTENT
STREAMLINED PROCESS AND IT'S
BEEN A GOOD SYSTEM WORKING WITH
CLOSELY WITH OUR- COUNTY HUMAN
SERVICES AGENCY. BUT THE
CONCERN FROM A SHERIFF'S OFFICE
STANDPOINT I THINK IS THAT WE
MISS SOME INMATES HER IF THE
PROCESS ISN'T SMOOTH AND
STREAMLINED INCONSISTENT THAT-
SOME ELIGIBLE ELIGIBLE INMATES
UPON RELEASE MAY FALL THROUGH
THE CRACKS AND THAT THAT'S
THAT'S THE BIGGEST CONCERN IS
THAT THERE'S ALWAYS- A FLOCK.
OF A POPULATION- SO I JUST
WANTED TO EXPRESS THAT CONCERN
AND I'D BE HAPPY TO. ANSWER ANY
QUESTIONS THAT HAVE TO DO WITH
THE KINGS COUNTY SHERIFF'S
OFFICE THANK YOU FOR YOUR TIME.
THANK YOU SIR AND I'M FAMILIAR
WITH HANFORD I USED TO WORK AT
THE ADVENTIST EMERGENCY
DEPARTMENT THAT'S THER AND
HANFORD. NEXT WE'LL HEAR
CATHERINE COHEN WHO IS THE
STAFF ATTORNEY AT THE NATIONAL
HEALTH LAW PROGRAM. PLEASE
BEGIN. HELLO THANK YOU GOOD
AFTERNOON AND THANK YOU FOR THE
OPPORTUNITY TO TESTIFY TODAY MY
NAME IS KATHERINE COLEMAN AND
I'M AN ATTORNEY WITH THE
NATIONAL HEALTH LAW PROGRAM.
WHICH ADVOCATES EDUCATES AND
LITIGATE TO PROTECT AN ADVANCE
THE HEALTH AND CIVIL RIGHTS OF
LOW INCOME AND UNDERSERVED
POPULATIONS. WE'RE GLAD TO SEE
THAT DH CS IS TAKING EFFORTS TO
ENSURE THAT INDIVIDUALS LEAVING
INCARCERATION ARE CONNECTED
WITH LOW COST HEALTH COVERAGE
AND SERVICES IN A TIMELY
MANNER. JUSTICE INVOLVED
POPULATIONS HAVE HIGH HEALTH
NEEDS AS HAS BEEN MENTIONED
PARTICULARLY BEHAVIORAL HEALTH
AND SUBSTANCE USE DISORDER
NEEDS AND MEDICAL COVERAGE IS
ESSENTIAL TO ACHIEVING
CONTINUITY OF CARE BETTER POST
RELEASE HEALTH OUTCOMES AND
REDUCE RECIDIVISM. AND HELP
SUPPORTS THE CALIBER PROPOSAL
TO REQUIRE A MANDATORY MEDICAL
APPLICATION PROCESS FOR
INDIVIDUALS BEING RELEASED FROM
JAILS AND PRISONS AND JUVENILE
FACILITIES HOWEVER WE MAKE THE
FOLLOWING RECOMMENDATIONS TO
ENSURE THAT THE GOALS OF THIS
PROPOSAL ARE REALIZED. FIRST
THE STATE MUST ADOPT A MEDIC
CAL SUSPENSION RATHER THAN
TERMINATION POLICY FOR ALL
INCARCERATED INDIVIDUALS
REGARDLESS OF HOW LONG IT THEIR
CARS RIGHT. CURRENTLY
CALIFORNIA LAW REQUIRES MEDIKAL
TO BE TERMINATED AFTER ONE YEAR
AT IN MEET STATUS AND THIS
WOMAN ON SUSPENSION REMAINS
INTACT IN THE CURRENT TRAILER
BILL LANGUAGE. AND HELP
RECOMMENDS THAT SUSPENSION IT
NOT BE TIME LIMITED AND INSTEAD
THAT MEDICAL REMAIN SUSPENDED
FOR THE ENTIRE PERIOD OF
INCARCERATION FOR ALL
INDIVIDUALS. CMS HAS BEEN CLEAR
THAT STATES CAN AND SHOULD
SUSPEND RATHER THAN TERMINATE
MEDICAID FOR INCARCERATED
INDIVIDUALS AND HAS NOTED. THAT
SUSPENSION PROVIDES FOR
CONTINUITY OF CARE. IN ADDITION
THE TWO THOUSAND AND EIGHTEEN
SUPPORT ACT WHICH HAS BEEN
DISCUSSED TODAY RT REQUIRE
SUSPENSION FOR JUVENILES IN
DETENTION FACILITIES AND FORMER
FOSTER YOUTH UP TO AGE TWENTY
SIX. THE ACT ALSO REQUIRES THAT
STATES CONDUCT A RE DETERMINE
ELIGIBILITY PRIOR TO RELEASE
WITHOUT REQUIRING A NEW
MEDICAID APPLICATION. WELL THE
KALYAN PROPOSAL. MENTIONS THE
DESIRE TO LEVERAGE THIS OF OR
ACT IT BILLS TO STATE IN FOR.
DO YOU SEE AS IS MEETING THESE
KERN ABA UNDER FEDERAL. WE
RECOMMEND THAT THE STATE
IMPLEMENTED OPEN ENDED
SUSPENSION FOR ALL INDIVIDUALS
WHO ARE INCARCERATED INCLUDING
THOSE IN STATE PRISONS. THIS
WILL REDUCE CONFUSION CREATE
CONSISTENT POLICIES AND MAKE
THE SYSTEM EASIER TO IMPLEMENT.
OTHERWISE COUNTIES AND
FACILITIES WILL BE REQUIRED TO
DETERMINE FOR EACH INDIVIDUAL
IF THEY ARE COVERED BY THE
SUPPORT ACT AND PROCESS PEOPLE
THROUGH TWO DIFFERENT SETS OF
RULES. SUCH AN APPROACH IS
BURDENSOME AND IS NOT SOUND
POLICY. SECOND WE ENDORSE DH CS
IS PROPOSAL TO HELP
INCARCERATED INDIVIDUALS ENROLL
IN MEDIKAL PRIOR TO THE RELEASE
AND RECOMMEND THAT THIS BE DONE
FOR ANYONE NOT ENROLLED PRIOR
TO INCARCERATION. THIS WILL
REQUIRE COLLABORATION BETWEEN
THE COUNTY CORRECTIONAL
FACILITIES AND THE COUNTY
AGENCIES MAKING DETERMINATIONS
OF ELIGIBILITY. THE PROPOSAL
CURRENTLY LEAVES THESE UPWARDS
OF TWO COUNTIES TO FIGURE OUT
WITHOUT CLEAR STATE GUIDANCE OR
OVERSIGHT AND WE RECOMMEND THAT
THE PROPOSALS REQUIRE CLEAR AND
CONSISTENT POLICIES AND
PRACTICES. AND AT DESIGNATED
AND TRAINED STAFF OR SIGN IN TO
CARRY OUT SPECIFIC OBLIGATIONS.
IN ADDITION IT DEFEATS THE US
WANTS TO CONNECTING CARS RATED
INDIVIDUALS WITH MANAGED CARE
PLANS CLEAR PROCESSES AND
RESPONSIBILITIES MUST BE PUT IN
PLACE FOR THE SELECTION OF A
MEDICAL PLAN PRIOR TO RELEASE.
WE APPRECIATE THE DESIRE TO
COORDINATE PRIOR TO RELEASE TO
CONTINUE BEHAVIORAL HEALTH
TREATMENT BUT MORE DETAILS
ABOUT HOW THIS PROCESS WILL
WORK IS NEEDED AS CURRENTLY
MEDICAL ENROLLMENT AND THEN
PLAN CHOICE IS A TWO STEP
PROCESS. GIVEN THE FORTY FIVE
DAY LEGAL LIMIT FOR AN
APPLICATION TO BE PROCESSED
THIS WOULD NEED TO START WELL
BEFORE RELEASE IN ORDER TO
ENSURE THAT PEOPLE ARE ENROLLED
ON MEDIKAL WHEN THEY LEAVE JAIL
OR PRISON. AND IF THE GOAL IS
TO ENROLL PEOPLE IN A HEALTH.
PLAN THE PROCESS COULD TAKE
EVEN LONGER. THIRD WE RECOMMEND
THAT THERE BE CLEAR POLICY HOW
CONTINUITY OF CARE WILL OCCUR
BETWEEN SERVICES PROVIDED IN
THE FACILITY AND IN THE
COMMUNITY POST RELEASE.
SPECIFICALLY INDIVIDUAL SHOULD
BE CONNECTED WITH SERVICES AND
ORGANIZATIONS IN THE LOCATIONS
THEY WILL BE LIVING POST
RELEASE. AND IN ORDER FOR THIS
TO HAPPEN SOME AGENCY OR PLAN
WILL NEED TO ENSURE THAT
INDIVIDUAL IS ENROLLED IN
MEDICARE IN A MEDICAL PLAN
PRIOR TO RELEASE. OR MAKE AN
APPOINTMENT WITH AN APPROPRIATE
FEE FOR SERVICE PROVIDER IN THE
TIME IMMEDIATELY POST RELEASE.
ONCE AGAIN CLEAR GUIDELINES
ABOUT WHO IS RESPONSIBLE FOR
MAKING THESE CONNECTIONS AN
APPOINTMENT IS NEEDED. THANK
YOU VERY MUCH FOR THE
OPPORTUNITY TO TESTIFY I'M
HAPPY TO ANSWER ANY QUESTIONS
YOU MAY HAVE. THANK YOU VERY
MUCH THAT CONCLUDES THIS PANEL
OF BRING IT UP TO THE DíAS AND
SEE IF WE HAVE ANY MEMBER
QUESTIONS. DOCTOR WHAT. NO I
MCKNIGHT I'M I'M FINE THANK YOU.
THANK YOU I WILL TAKE A CHANCE
IF I CAN THE ECHO IN ELEVATE
SOME OF THE COMMENTS FROM CASEY
COOPER I THOUGHT SHE SAID IT
QUITE WELL THAT THIS SPECIFIC
POPULATION HAS HIGHER RATES OF
PHYSICAL. AND BEHAVIORAL HEALTH
NEEDS AND FOR US TO HAVE
EFFECTIVE MENTAL HEALTH AND
BEHAVIORAL HEALTH TREATMENT
WE'RE GOING TO NEED TO
INTERVENE EARLIER SAID MAY HELP
TO PREVENT RECIDIVISM
DECREASING YOUR USAGE AND
DECREASE HOSPITALIZATIONS. BUT
I'D LIKE TO DO AGAIN WITH THE
DEPARTMENT A LITTLE BIT IF I
COULD ABOUT THIS LAST COMMENT
FROM AND HELP ABOUT MEDIC MEDIC
CAL SUSPENSION VERSUS
TERMINATION AND ASK THEM THEIR
LOGIC FOR WHY IT IS TIME TO
LOOK. SO I THINK ONE OF THE
THINGS I WOULD SAY IS THAT WE
ARE CURRENTLY EVALUATING THE
POLICY AROUND SUSPENSION VERSUS
TERMINATION I KNOW THAT WE'VE
HAD MANY CONVERSATIONS WITH AND
HELP REGARDING. THAT PARTICULAR
PIECE I THINK THERE ARE SOME-
CONSIDERATIONS WERE MAKING IN
REGARDS TO A FEDERAL OR FEDERAL
PIECES THAT WE NEED TO EVALUATE
CLOSELY- BUT I WOULD JUST SAY
THE DEPARTMENT IS CURRENTLY
LOOKING AT THAT PROPOSAL AT
THIS TIME. ALSO BUT JUST KNOW
THAT IT VARIES ACROSS THIS THE
U. S. IN REGARDS TO HOW STATES
HAVE DONE THIS WHETHER THEY-
SUSPEND OR TERMINATE AT THE
SUSPENSION TIME PERIODS WHETHER
IT'S ONE YEAR WHETHER IT'S ON
GOING OR WHETHER IT'S A LONGER
PERIOD OF TIME. IT DOES VERY
STATE. TO SO JUST INFORM OUR
THINKING AS WE CONTINUE TO
EVALUATE- THIS MOVING FORWARD.
THANK YOU FOR THAT- WAS HOPING
IF YOU COULD COMMENT ON THE L.
A. L.'S QUESTION REGARDING
STATE MANDATES AND- WHERE THIS
PROPOSAL SETS. I'M SO CURRENTLY
ARE AS IN THE TRAILER BILL WE
ARE MANDATING THAT THIS BE A
REQUIREMENT TATEWIDE- FOR
RELEASE FROM FROM JAIL- AND
LOOK FORWARD TO WORKING WITH A
SHERIFFS AND COUNTIES TO BE
SUCCESSFUL IN THE
IMPLEMENTATION. THANK YOU FOR
THAT WITH THAT WE WILL THANK
THIS PANEL VERY MUCH AND MOVE
ON TO ISSUE FIVE ON INCREASING
OVERSIGHT AND MONITORING OF THE
COUNTY MEDICAL ELIGIBILITY
DETERMINATION PROCESS. WE WILL
HAVE FOUR PANELISTS WE WILL
BEGIN WITH THE DEPARTMENT
MOVEON TED NED RESNICK COUGH
WITH THE L. A. L. KATHY
SANDERLING MCDONALD WITH C. W.
DLA AND FINALLY DAVID CAIN WITH
THE WESTERN CENTER ON LAW AND
POVERTY. IF WE CAN PLEASE BEGIN
WITH THE DEPARTMENT. MISTER
WELL LIGHT BORN DIRECTOR
DEPARTMENT HEALTH CARE SERVICES
I'M GOING TO TAKE THIS ITEM- I
WAS STRUCK. DR THE COLLEAGUES
ONE OF SPOKE CAL WAS. SORT OF
THE MOST FUNDAMENTAL
TRANSFORMATION OF THE PUBLIC
HEALTH CARE SYSTEM BUT THAT HE
HAS SEEN- AND IT.
UNSURPRISINGLY TOUCHES ALL OF
THE SYSTEM. IN TERMS OF-
INCREASING. EFFECTIVENESS AND-
OVERSIGHT AND ACCOUNTABILITY-
SO SAY THIS WITH A GREAT DEAL
OF RESPECT. ALL MY BEEN OF
PROBABLY EVERY SIDE OF EVERY
TABLE. IN THE COURSE OF ON MY.
CAREER AND- AT THE TIME THAT WE
MET A SIN ARE ONE OF THE PEOPLE
WHO WAS VERY IN THE ON MEDICARE
ELIGIBILITY NEEDED TO REMAIN
RESPONSIBILITY ALL. COUNTY
DEPARTMENTS. ELIGIBILITY
FUNCTION THERE. WELL SINCE ACA
IMPLEMENTATION WE HAVE HAVE A
NUMBER OF. WHAT FROM STATE
LEVEL PARTNER LEVEL SEVERAL OF
THAT HAVE SORT OF OBSERVED-
ACCURACY ISSUES AND TIMELINESS
ISSUES. MANY OF THOSE ARE
FACTORED IN THE RESULT OF
SYSTEM- PROBLEMS WITH THE
AUTOMATION SYSTEM SO HERE'S
SEVERAL CALAVERAS INTERFACE
WITH SWORDS SO THOSE HAVE BEEN
WORKED ON OVER. ALL THESE MANY
YEARS READ MORE ABOUT. STANDING
WORK GROUPS- DASHBOARD SO AS
PART OF THE- SUPPLEMENTAL
REPORT LANGUAGE THAT WE'RE
WORKING THROUGH WITH COVERED
CALIFORNIA AND CAL HERE'S STFU
BA- WHAT WE'RE PROPOSING TO DO-
THIS IT DOES NOT CREATE NEW
ACCOUNTABILITY STANDARDS
BROUGHT HOME. REALLY TO BUILD
SOME PROCESSING GROUPS OF THE
ACCOUNTABILITY SYSTEM AND
RESUME OF THE MEASURING THE
PERFORMANCE STANDARDS. WELL
I'LL SPEAK WITH HIM OVER TO THE
TIMING OF WHEN WE FORESEE DOING
ABOUT ALL B. WHAT WE REALLY
WANT TO DO WITH THIS PROPOSAL
WHAT OUR COLONEL BILL. LANGUAGE
DOES IS. BLUECROSS PROGRAM. IT
THERE ARE DETERMINED TO BE OF
ISSUES TIMELY OR ACROSS TO MOVE
ON ADEQUATE PROCESS OF WORKS.
ALL DEFINER PROCESS OF ENGAGED
BETWEEN DEPARTMENT AND THE
COUNTY THAT MAY BE INVOLVED ALL
THE DEVELOP SORT OF BALK
CORRECTIVE ACTION OF SYSTEMS
AND PROTOCOLS- AND THEN IT
MAKES BERMAN HE- A PROCESS BY
WHICH ON THE SCHOOL PENALTIES
ON COULD BE ON. A POST- BUT
ALSO THE PROCESS BY WHICH WOULD
BE ONE IMPOSED ONE CORRECTIONS
WAS. AND THEN IN KEEPING WITH
THE SORT OF THE OVERALL
CALIFORNIA PRINCIPLES OF
TRANSPARENCY HAVING A SUITABLE
CAL GRANT COUNTY DASHBOARD THAT
WOULD BE. ON THE AGENCY OR
WEBSITE- ALONG WITH ALL OF THE
OTHER. PARTICIPANTS IN THE
MEDICAID SYSTEM SO ALL OUR PLAN
OUTCOMES ARE DISPARITY OUTCOMES
ON EQUITY SUCCESSES. AND THEN
ALSO TIME- APPROVING
APPLICATIONS RENEWALS WORKING
ALERTS ON YOUR FARM WE
DEFINITELY YOU KNOW JUST WHAT
THE SIZE THAT WE SEE OURSELVES
AS BEING ON CLOSE PARTNERSHIP
WITH OUR COUNTIES AND US AND
OUR GOAL IS TO. PEOPLE ALL SIX
OF US WE'RE CLOSE THE SYSTEM.
THERE IS A DEGREE OF- HOME
URGENCY IN SOME WAYS BECAUSE
WHILE WE HAVE WELL SEE A MOUSE
MOST READ IT WE HAVE THE ALL
ABILITY TO RECOUP ALL OVERPAID
STORED ON THE NETWORK PAYMENTS
YEAH. IT WAS CONDITIONAL ON ST
OR LOCAL ERROR RATE EXCEEDING
3% BECAUSE THEY WERE. QUESTIONS
ABOUT JOSE ISCALCULATING
YOU'RE RIGHT THEY REALLY DIDN'T
HAVE A PATH. THEY HAVE NOW-
SETTLED ALONG THEIR PROCESS AND
STARTING IN TWENTY FOUR TRUE-
THEY I'M BEGINNING TO ASSESS-
RECRUITMENT OF FARMING SO WE
NEED TO BE SURE OF OR-
CORRECTIVE ACTION PROCESS
WORKABILITY. PROCESS IN PLACE-
IN TERMS OF TIMING- WHAT WE ARE.
DOING IS WE RECOGNIZE THAT HOME
OF THE EXECUTIVE ORDER TAPPED.
ON PUBLIC HEALTH EMERGENCY- WE
HAVE NOT BEEN DOING
REDETERMINATION REQUEST WILL
TELL THESE NOT TO BRIDGE
PROMOTIONS- AND SO. A CRUCIAL
ALL OF THE PREDICTIONS WHAT WE
ANTICIPATE. MOVES- WHAT WHAT
OVER A YEAR OR TWO GEN DO. THE
SORT OF THE BACKLOG RETURN. ON
AND BE ABLE SORT OF RESTORE
NORMAL BUSINESS PRACTICES AND
SO NOT ACTUALLY BEGINNING THIS-
IMPLEMENTABLE OF THE PROCESS-
UNTIL. WE ARE A YEAR PAST THE
END OF THE PHD BUT ALSO- HAS
BEEN ADVANTAGE OF COINCIDING
WITH THE COMPLETION OF THE-
SOURCE MIGRATION- SINGLE SYSTEM
SO OBVIOUSLY WE WANT TO BE ABLE
TO BE SURE THAT THAT HAS BEEN
SUCCESSFULLY ACCOMPLISHED- SO
LET ME STOP THEIR PARTICULAR
QUESTIONS MMHM. DAHLE YEAH
RIGHT. GET DIRECTOR LIGHT FORM
NEXT WE'LL HEAR FROM NED
REZNIKOV WITH THE LEGISLATIVE
ANALYST'S OFFICE. HELLO AGAIN
SO- COUNTIES HAVE HISTORICALLY
STRUGGLED WITH- GETTING
PERFORMANCE GOALS AND SO WE DO
FEEL THAT SOME INCREASED
OVERSIGHT AND TRANSPARENCY IS
WARRANTED. BUT I DO WANT TO
HIGHLIGHT A FEW QUESTIONS THAT
WE RAISED LAST YEAR WITH THIS
PROPOSAL ORIGINALLY CAME OUT.
FOR LEGISLATIVE CONSIDERATION
THE FIRST QUESTION IS- JUST
WHAT ARE THE RIGHT PERFORMANCE
MEASURES- TO REQUIRE COUNTIES
TO MEET- THE ORIGINAL
PERFORMANCE MEASURES WERE
IMPLEMENTED PRIOR TO THE
AFFORDABLE CARE ACT SO THE
LEGISLATURE COULD CONSIDER
WHETHER THEY'RE THEY'RE STILL
THE MOST APPROPRIATE MEASURES
TO PURSUE- ADDITIONALLY-
ANOTHER QUESTION WOULD BE. WHAT
ARE THE STATE'S- MAIN
PRIORITIES FOR IMPROVING COUNTY
PERFORMANCE AT THE LEGISLATURE
COULD CONSIDER IS ESTABLISHING
SOME SOME KEY PRIORITIES-
ESPECIALLY BECAUSE SOME
COUNTIES MAY STRUGGLE TO-
ACHIEVE ALL OF THE- THE
MEASURES THAT. THEY ARE
CURRENTLY LACKING IN. THE LAST
TWO QUESTIONS THE FIRST ONE IS-
WHETHER COUNTIES HAVE AN
APPROPRIATE LEVEL OF RESOURCES
RELATIVE TO THE STATE'S
EXPECTATIONS AND CONVERSELY-
DOES DH CS HAVE AN APPROPRIATE
LEVEL OF RESOURCES RELATIVE TO
THE- STATES EXPECTATIONS- THE
LEGISLATURE- COULD CONSIDER
REVIEWING AND OTHER RESOURCES
THAT THE ADMINISTRATION
PROPOSES TO DEDICATE TO THESE
NEW OVERSIGHT MEASURES. THANK
YOU AND I AM HAPPY TO TAKE ANY
QUESTIONS. THANK YOU VERY MUCH
NEXT WE'LL HEAR FROM KATHY
CENTRAL IN MCDONALD EXECUTIVE
DIRECTOR WITH CWDM. RIGHT THANK
YOU AGAIN- MISTER CHAIRS AND
MEMBERS KATHY SANDERLING
WITHOUT ALL THE THICK WELFARE
DIRECTORS ASSOCIATION. AS NOTED
IN THE BACKGROUND PAPER THERE
IS EXISTING STATURE ON COUNTY
OVERSIGHT AND MONITORING
PROCESS THESE WHICH WE
NEGOTIATED ABOUT FIFTEEN YEARS
AGO WITH THE PRIOR
ADMINISTRATION. TRANSACTION
INCLUDES IMPORTANT PROVISIONS
TO ENSURE THAT COUNTIES ARE NOT
PENALIZED FOR THINGS BEYOND OUR
CONTROL SUCH AS INCOMPLETENESS
OF APPLICATIONS ARE
REDETERMINATION MATERIALS THAT
ARE SUBMITTED BY OUR CLIENTS OR
TIED THAT'S TAKEN BY OTHER
ENTITIES SUCH AS THE DEPARTMENT
OF SOCIAL SERVICES WHICH IN
TERMS DISABILITY FOR PURPOSES.
OF APPLICATIONS FOR THOSE
PROGRAMS THAT ARE BASED ON A
DISABILITY DETERMINATION. AS
NOTED IN THE ANALYSIS THE
PERFORMANCE OVERSIGHT PROCESS
WHAT'S PUT ON HOLD FOR THE PAST
SEVERAL YEARS FOR REASONS THAT
THAT BACK BACKGROUND PAPER
NOTED I DO WANNA KNOW THAT
ALTHOUGH THE OFFICE ITSELF WAS
PART OF. THE REQUIREMENT
COUNTIES OBSERVE AND WORK
TOWARDS MEETING THE OUTCOME
MEASURES WITH NOT AND THIS IS
ACTUALLY SOMETHING THAT THE TO
BE A WORK LIFE THAT ON BEHALF
OF OUR MEMBERS WHO APPRECIATE
HAVING THOSE OUTCOME MEASURES
OUT THERE TO BE ABLE TO UTILIZE
WITH THEIR STAFF AND
SUPERVISORS TO HAVE GOALS. THAT
THEY CAN THAT THEY CAN STRIVE
FOR. PROUD OF THE WAY WE DO I
BEHALF OF STATE TO MAINTAIN
ELIGIBLE FOR MORE THIRTY
MILLION PEOPLE IN THE STATE.
WHICH IS ABOUT A THIRD OF
CALIFORNIANS AT ANY GIVEN TIME.
I THINK IT WOULD HAVE A
CONVERSATION LAST YEAR BEFORE
THE PANDEMIC OCCURRED WE WOULD
HAVE TALKED MORE AND I THINK
BUILDING A WHAT DIRECTOR LAKE
FOREST SAD. ABOUT NUMEROUS
METHODOLOGY CONCERNS WE HAD
WITH SOME OF THE FIRE AUDIT. AS
WELL AS THE SIGNIFICANT
RELIANCE ON AUTOMATED PROCESS
THESE THAT AT THE TIME OF THE
DATA THAT WERE REVIEWED IN SOME
OF THOSE AUDITS. WERE FLAWED
AND HAVE SINCE BEEN CORRECTED I
MERRILY ACCOUNT YOUR COMPUTER
SYSTEM. WE ALSO HAVE TO
DISAGREE WITH ALEJO'S COMMENTS
THAT COUNTIES HAVE LONG
STRUGGLED TO MEET PERFORMANCE
GOALS. WE BELIEVE THE PRIOR
PROCESS WORKED WELL AND HELPED
COUNTY HIGHLIGHT THOSE AREAS OF
NEED THAT THEY CAN FOCUS ON
TERM PRO. BONIVA ENTERED INTO
CORRECTIVE ACTION PLANS
TYPICALLY FOR NO MORE THAN ONE
OR TWO MEASURES OF THE TIME.
AND WERE ABLE TO IMPROVE THE
RESULTS TO THOSE PLANS AND
HEIGHTENED OVERSIGHT. AND
COMMUNICATION WITH THE STATE.OVERALL WE HAVE BROKEN A FREE.
OF REVIEW PROCESS. WE DO INTEND
TO PROPOSE SOME CHANGES IN THE
LANGUAGE AND ITS CURRENT FORM.
FIRST FOR GET REGARDING TIMING
I REALLY APPRECIATE THE
COMMENTS ABOUT FROM DIRECTOR MY
BORN ON THE TINY. AND AGREED
THAT COUNTY SO NOT BE PUBLIC
PROCESSING REQUIREMENTS FOR THE
CURRENT CASELOAD. GIVEN THE- P.
EIGHTY FIVE. OR THE TIME WHEN
WE STARTED BIG OUT AFTER THAT
BOB HOPE EMERGENCY IS LIFTED.
AND ALSO APPRECIATE THE
CONSIDERATION OF HOW TO WORK
WITH. THAT UPCOMING CHALFONT
MIGRATION WHICH OF COURSE IS
FEDERALLY REQUIRED. AND WILL
RESULT IN SOME OFF WALKS OF
CASES LATELY AS WE SORT OF MOVE
BETWEEN THE SYSTEM. OF COURSE
WE ILL ATTEMPT AND ALWAYS. O
MINIMIZE THAT TO THE GREATEST
EXTENT POSSIBLE. WE HAVE ASKED
FOR A INFORMATION FROM OTHER.
OF IT THINKING REGARDING THE
PUBLIC POSTING OF COUNTY
PERFORMANCE DETAILS. ITSELF MAY
NOT JUST BE MOST LIMITED TO THE
EXISTING MEASURES BUT WE'RE NOT
CLEAR ON WHAT ELSE MIGHT BE
INCLUDED. I THINK IT'S
IMPORTANT TO GET CLARITY ON
THAT BEFORE ANY SUCH CHANGES
THAT HAPPENED ON THAT SHOOT.
ATTORNEYS UNDERSTAND WHAT WILL
BE EXPECTED ABOUT. THAT I WILL
ALSO SEND A PRIOR SYSTEM WAS
CREATED QUITE AWHILE AGO AND
BEFORE SUCH A SIGNIFICANT
AMOUNT OF DATA WAS ACTUALLY ON
THE INTERNET AND AVAILABLE. SO
UNDERSTANDING HOW THAT MIGHT BE
SHOWN AND HOW OFTEN. THAT MIGHT
BE UPDATED IS ALSO VERY
IMPORTANT. I ALSO LIKE TO
FURTHER HIGHLIGHT THE NEED FOR
TECHNICAL ASSISTANCE OR PHD AT.
THE MEDICAL PROGRAM HAS
UNDERGONE SIGNIFICANT PROGRAM
CHANGES ESPECIALLY WITH THE
ACA. I THINK- AS I AS WAS NOTED
THAT CAL AIM PROPOSAL WILL
CREATE A VERY SIGNIFICANT. PART
OF CHANGES TO OUR MEDIC HEALTH
SYSTEM. BUT I WOULD SAY THAT IN
TWENTY YEARS IN THIS JOB. THE
AFFORDABLE CARE ACT ON
ELIGIBILITY. HAD THE BIGGEST
IMPACT WE HAVE JUST SEEN SO
MANY CHANGES. AND I WILL
MENTION THAT WE'VE NOT HAD AN
UPDATED REGULATIONS PACKAGE OF
MORE THAN TWENTY YEARS AND
ELIGIBILITY. SO WHAT WE HAVE IS
A CONTINUUM OF LETTERS THAT
COUNTY THE FEDERAL LAND OF
THAT. IT CAN BE VERY DIFFICULT
FOR STAFF TO THREAD THE NEEDLE
BETWEEN MULTIPLE I'LL COUNTY
LETTERS. WHEN CONFRONTED WITH A
PARTICULAR SITUATION. AND THIS
CAN LEAD TO CONFUSION AND
UNINTENDED DELAYS IN
ELIGIBILITY OR OTHER ERRORS
THAT WOULD BE AFFORDABLE FOR
CLARITY. SO WOULD LIKE TO ASK
THAT THE STATE WORK WITH
COUNTIES TO ADDRESS. BOTH
COMMON ISSUES THAT WE THREE I'M
TRYING TO IMPROVE THE
COHESIVENESS OF OUR
INSTRUCTIONS TO COUNTIES WHICH
IS REALLY CRITICAL. AND FINALLY
I JUST LIKE TO NOTE THAT
EXISTING STATUTE OF THE
LANGUAGE AND CAL EVEN WITH
CORRECTIVE ACTION PLANS. AS
WELL AS THE POTENTIAL FOR
COUNTY PENALTIES. WITH THE
BENEFIT OF TIME WE HAVE THE
STATE AMERICAN AFRICA COUNTY
WHEN PROGRAMS LIKE HELL WORK.
AND CHILD WELFARE THE FOCUS UP
ON PENALTIES AND MORE IN
CONTINUOUS QUALITY IMPROVEMENT.
WE HAVE SEEN IMPROVEMENTS AND
HE MEASURES OVER TIME. WITH
SUCH PROPHECIES WHEN THEY ARE
COUPLED WITH THAT PUBLIC
ACCOUNTABILITY THAT IS ALSO
PART OF THIS PROPOSAL. WE
RECOMMEND THAT YOU WORK WITH US
AND WITH ADVOCATES TO CONSIDER
WHETHER I THINK YOU AYE
PROCESS. WOULD PERHAPS MAKE
MORE SENSE AS WE RESTART THE
PERFORMANCE MEASUREMENT
PROCESS. RATHER THAN THE
CURRENT PENALTY BASED
STRUCTURE. FOR ALL OF THOSE
REASONS I AM ALBEIT HAPPY TO-
MAKE FURTHER COMMENTS OR ANSWER
ANY QUESTIONS YOU MIGHT HAVE.
AND APPRECIATE THE OPPORTUNITY
TO COMMENT. THANK YOU VERY MUCH
NOT WE WILL HEAR DAVID KAY.
STAFF ATTORNEY WITH THE- CENTER
ON LAW AND- THANK YOU AND GOOD
AFTERNOON MEMBERS AND THANK YOU
CHAIR QUESTIONNAIRES AND DAVID
CHANGED TURNING WITH THE
WESTERN CENTER ON PROPERTY
WHERE MEMBERS OF THE HEALTH
CONSUMER ALLIANCE WHICH
DIRECTLY ASSISTS. MEDICAL
PATIENTS AND ALL FIFTY EIGHT
COUNTIES ACROSS OUR STATE WE
SUPPORT CAMPAIGNS PROPOSAL AT
THIS GOAL TO IN HOUSE ENHANCE
COUNTY ELIGIBILITY OVERSIGHT
MONITORING- AND THAT'S BECAUSE
AND MEDICARE ELIGIBILITY IS
DONE RIGHT. MILLIONS OF
CALIFORNIANS GET THE HEALTHCARE
THEY NEED AND ARE ELIGIBLE FOR.
AND WE APPRECIATE THAT THE
APARTMENT YELLING YELL AT THAT
COUNTIES RECOGNIZE THE
MONUMENTAL CHANGES IN THE
ACCOUNT OR CARD OVER THE PAST
DECADE I ADD TO THE LIST THAT
WE'VE ALREADY GONE THROUGH- CAR
WONDERFUL HEALTH FOR ALL
EXPANSIONS FORCE GOVERNMENT
ACCOUNT TO KIDS AND YOUNG
ADULTS REGARDLESS OF
IMMIGRATION STATUS. I ALSO WANT
TO NOTE THAT ARE CAL SUCH
TRANSITION IS NOT LIKELY TO BE
COMPLETE UNTIL MID TO LATE
TWENTY TWENTY THREE AND THEN-
YEAH PANDEMICS AND MUCH MORE
HAS CHANGED SINCE THESE
PERFORMANCE STANDARDS
ORIGINALLY ENACTED. AND SO NOW
WE WANT TO MAKE SURE THAT THIS
OVERSIGHT AND MONITORING
PROPOSAL. IS BROADER THAN
SIMPLY ADDRESSING WHAT WAS
DETERMINED TO BE THE PRIORITIES
IN YEARS PAST AND BROADER THAN
SIMPLY ADDRESSING PASSED AUDIT
FINDINGS AND THAT IT DOES NOT
FOCUS EXCLUSIVELY ON COUNTY
ACTIONS. HERE'S WHAT. MORMON
STANDARDS ASTOR AND THE BAND
ALERT MONITORING PRODUCT AS WE-
THAT OUR WAR. AFTER BUT THEY-
THOSE MY CHANGES TO MEDICAL.
AND THE ALSO FROM THE- PER. DO
NOT COMPREHENSIVELY MEASURE OR
MONITOR THE MOST COMMON DAY ARE
YOURS AND OBSTACLES THE
CALIFORNIANS FACE. ONE MEDIC
COUNTY IS A ROW ISLEY DID NIGHT
DISK. OR IT AND WORDS WHEN
PEOPLE LOSE THEIR HEALTHCARE IN
ERROR. SO LIKE THE LEGISLATURE
ASKED TODAY AT THE AGENDA WE
ARE INTERESTED IN SEEING THE
DEPARTMENT DEVELOPED WITH THE
LEGISLATURE COUNTIES ADVOCATES
AND OTHER STAKEHOLDERS
ADDITIONAL OVERSIGHT AND
MONITORING TO PROTECT AND
GUARANTEE ACCURATE AND TIMELY
MEDICAL ELIGIBILITY. CHECK THIS
ONE EXAMPLE AFTER THIS CALL THE
PUBLIC HEALTH EMERGENCY HANDS
MOST OF THE CURRENT THIRTEEN
MILLION PLUS MEDICARE
BENEFICIARIES WILL BE SUBJECT
AGAIN TO ANNUAL RENEWABLES.
THAT MEANS NEARLY A MILLION
DETERMINATIONS EVERY MONTH PLUS
NEW APPLICATIONS AND MAYBE
COMING AT AND UNDER THE CURRENT
PERFORMANCE STANDARDS 90% OF
RENEWALS MUST BE COMPLETED WHEN
INFORMATION IS SUSPENDED AND
NOTICES SENT APPROPRIATELY.
THIS MEANS THAT WOULD FIT IN A
WORST CASE SCENARIO EVERY MONTH
APPROXIMATELY A HUNDRED
THOUSAND CALIFORNIANS GOOD
AFTER MEDIC CALDERON EASILY CUT
OFF AND UNDER OUR EXISTING
PERFORMANCE STANDARDS ALL YOU
WOULD SEE. IS A PASSING SCORE.
SO THE ISSUE THE IS THAT PER
STATE. THAT MEASURE IS ACTUALLY
HELPFUL TO GUIDE OPERATIONS AS
IT'S BEEN DISCUSSED ALREADY
TODAY. BUT IT FALLS SHORT OF
WHAT MILLIONS OF CALIFORNIANS
NEED TO SAMPLE WEIGHTS ALLOWS
HUNDREDS OF THOUSANDS OF PEOPLE
TO FALL THROUGH THE CRACKS AND
IT DOES NOT MEASURE WHEN YOUR
ELIGIBILITY IS ACTUALLY DONE
CORRECTLY OR RIGHT. THAT'S WHY
MOVING FORWARD CONSUMER
ADVOCATES ARE EXCITED TO
CONTINUE THIS CONVERSATION WITH
COUNTIES THE DEPARTMENT AND THE
LEGISLATURE ABOUT HOW TO BEST
DESIGN IS CALLING PROPOSAL ON
OVERSIGHT MONITOR. WE HAD IDEAS
ABOUT HOW EXISTING QUALITY
CONTROL EFFORTS CAN BE UPDATED
ABOUT HOW INVITATIONAL
MONITORING METRICS CAN BE ADDED
TO CONFIRM THE ACCURACY. OF
ELIGIBILITY DETERMINATIONS NOT
JUST THE TIMELINESS. ADDITIONAL
WAYS TO MONITOR ERROR RATES
WITHOUT PENALTIES FOR COUNTIES
BECAUSE WE THANK FROM THE
CONSUMER PERSPECTIVE PENALTIES
FOR COUNTIES ULTIMATELY CORRECT
APPLICATION. AND BENEFICIARIES
AND SENTENCE FOR COUNTIES WOULD
BE MUCH BETTER. WE ALSO HAE
IDEAS ABOUT HOW THESE MEN'S
ALERTS CAN BE CHANGED AND
UPDATED SO THAT THEY ACTUALLY
TRACK WHAT IMPACTS CONSUMERS
MOST SEVERELY WHEN THERE IS A
MENTAL ERRO. WE ALSO WANT TO
BE INVOLVED IN HOW THE
DEPARTMENT CAN BE TAKEN
ADDITIONAL STEPS TO SUPPORT
COUNTY OPERATIONS. AS KATHY WAS
DISCUSSING. SO THESE ARE CALM
AND CRITICALLY IMPORTANT ISSUES
FOR MEDICAL. APPLICANTS AND
BENEFICIARIES AND WE LOOK
FORWARD TO REFINE THEM FURTHER
IN A COLLABORATIVE WORK GROUP
WITH THE DEPARTMENT. AND I'D BE
HAPPY TO TAKE ANY QUESTIONS AND-
THANK YOU SIR- I WILL BRING IT
UP TO THE DíAS FOR QUESTIONS I
WILL BEGIN BY APPRECIATING
DIRECTOR LIGHT BORN- YOU
PROVIDING THAT TIME LINE FOR
WHAT OCCURS- POST OUR PUBLIC
HEALTH. EMERGENCY BUT I'D LIKE
TO BE ABLE TO ASK ONE QUESTION
OF THE DEPARTMENT AND IT'S A
FOLLOW UP OF WHAT. MISTER KANE
WAS JUST SAYING. AND BEYOND
WHAT WE'RE DOING WITH THE
PUBLIC FACING REPORT CARD OR
DASHBOARD HOW'S THE DEPARTMENT
PLANNING TO INVOLVE CONSUMER
IMPLEMENTATION. OF THE
INITIATIVES TO ENHANCE ITS
OVERSIGHT AND MONITORING. FIRST
I MEAN I THINK I WOULD. NEED TO
NOTE THAT WHEN THE CALLING
PROPOSALS IN ITS OWN ANA WELL
STAKEHOLDER DEVELOPMENT
PROCESS- ON THIS. YEAR JUST
PAST YOUR PRIME ALONG THESE
STAKEHOLDERS WORK WERE INVOLVED
IN- I THINK THAT THERE IS I
THINK KANE- CORRECTLY SUGGESTS
THAT WE SHOULD ALWAYS REMAIN-
OPEN TROOPS OR DARE MEASURES
THAT. BETTER CAPTURE YEP
PROBLEMS WE'RE WALKING AND WE
YOU KNOW I FULLY EXPECT THAT WE
WILL CONTINUE ALL IN DIALOGUE
WITH OUR COUNTY BOARD MEMBERS
AND WITH STAKEHOLDER GROUPS-
INCLUDING CONSUMERS- THROUGH
REFINE REFINE THOSE THEY HAVE
TO BE- ASSEMBLY WITHDRAWALS
COMMENT- THAT THEY NEED TO
BEING- I THINK YEAH IN THE
SPIRIT OF. CONTINUOUS QUALITY
IMPROVEMENT A POEM AND SO ARE I
THINK WE'RE COMMITTED TO
CONTINUING THE CONVERSATIONS WE
WORK THROUGH- ACTUALLY DEFINING
PROCESS OVER THE SUMMER AND
FALL. THANK YOU FOR THAT
ANSWERED DIRECTOR AND HAVE
ALWAYS APPRECIATED YOUR
TRANSPARENCY CANDOR AND PROCESS
AND WORKING THROUGH MANY OF
THESE COMPLICATED ISSUES. WITH
THAT WE WILL NOW MOVE ON TO
ISSUES SEX AND I WILL THANK
VERY MUCH PANEL FIVE. PANEL SIX
IS ON INCREASING DH CS
OVERSIGHT OVER THE CALIFORNIA
CHILDREN'S SERVICES AND THE
CHILD HEALTH AND DISABILITY
PREVENTION PROGRAM. WE WILL
HAVE THREE SPEAKERS ON THIS
PANEL WE WILL BEGIN WITH TRACY
COOPER. FOLLOWED BY MICHELLE
GIBBONS AND SKYLER ROSELLINI
CAN YOU BEGAN THIS COOPER. SO
WHEN WE WERE LOOKING ACROSS ALL
OF THE VARIOUS DELIVERY SYSTEMS
WHEN ARE LOOKING AT KILLING WE
WANTED TO ENSURE THAT WE WERE
ALSO LOOKING AT THE CALIFORNIA
CHILDREN'S SERVICES AND CHILD
HEALTH AND DISABILITY
PRVENTION PROGRAM. I'M TO
ENSURE THAT WE ARE PUTTING IN
STANDARD REQUIREMENTS ACROSS A
PROGRAMS THAT HAVE EXISTED FOR
A VERY LONG TIME AS YOU'RE
PROBABLY VERY WELL AWARE CCS IS
THE OLDEST PROGRAM AND MEDIC
CALLIN EXIST ACTUALLY BARBER.
BEFORE MEDIC CAL EVER WAS IN
PLACE- SO REALLY WHAT WE'RE
LOOKING HERE IS TO ENSURE THAT
BENEFICIARIES ARE BEST SERVED-
WHEN THEIR CARES KIND OF
DELIVERED IN A IN A STANDARD
WAY TO KIND OF CONSISTENT
ACROSS OF IT TO ME MEET ALL OF
THEIR NEEDS SO WE DO PLAN ON-
YOU KNOW. I GUESS I SHOULD STEP
BACK WE CURRENTLY DO CONDUCT
REGULAR MONITORING WITH OUR
COUNTY PLANS AND- THROUGH
WHAT'S CALLED A FISCAL A
GUIDELINE PROCESS- WE MEET WITH
THEM REGULARLY WE HAVE A CCS
ADVISORY COMMITTEE FOR EXAMPLE-
AND WE DO WORK TO KIND OF
ESTABLISH PROTOCOLS- INTO
CONDUCT SOME AUDITS. TODAY
HOWEVER WHAT WE'RE WANTING TO
DO IN THE FUTURE AND WHAT WE
INTEND TO DO WITH THIS CHANGES
REALLY ENHANCE THE MONITORING
AND OVERSIGHT ACROSS ALL FIFTY
EIGHT COUNTIES AND THREE
CITIES- TO PROVIDE- YOU KNOW
ESSENTIALLY A STANDARD OF
QUALITY OUTCOMES IF WE'RE
EXPECTING IN THE CCS PROGRAM-
ON THE FEE FOR SERVICE SIDE- WE
ALSO- WANTING TO MAKE SURE THAT
WE HAVE CONTRACTS IN PLACE.
WITH COUNTIES IN ORDER TO MAKE
SURE THAT THERE IS A CLEAR
UNDERSTANDING OF THE ROLES
RESPONSIBILITIES TIMELINES AND
EXPECTATIONS. FOR THE SERVICES
PROVIDED AND BOTH CCS IN C. H.
D. P. TO REALLY BE ABLE TO
ENSURE THAT WE'RE GETTING A
STANDARD OUTCOME ACROSS THE
ENTIRE STATE OF CALIFORNIA- WE
ALSO WILL BE DEVELOPING
AUDITING TOOLS TO USE. IN THAT
PROCESS WILL WORK. VERY
COOPERATIVELY WITH THE COUNTIES
AND THE THAT- OPERATING THOSE
AREAS TO AND- THIS PROCESS YOU
IT'S WHY THE- I AND CAL MS OVER
MULTIPLE. THAT WE CAN OF ENGAGE
IN THOSE CONVERSATIONS IDENTIFY
OF THE VARIOUS COMPLIANCE AREAS
WHAT WE WILL BE EVALUATING.I'M
AND WORK CLOSELY WITH OUR
COUNTY PARTNERS I THINK ONE
THING THAT WE HAVE- IF
KNOWLEDGE IS THAT THERE ARE
SOME DIFFERENCES IN REGARDS TO.
THE STANDARD- TURNAROUND TIME
FOR EXAMPLE FOR AUTHORIZATION
OF SERVICES SOMETIMES IN CCS
DEPENDING ON WHERE WE'RE
TALKING ABOUT THAT CAN TAKE-
MANY WEEKS IN ORDER TO GET
THOSE AUTHORIZATIONS IN PLACE.
HOWEVER IN OUR MANAGED CARE
PLANS FOR EXAMPLE WE HAVE CLEAR
REQUIREMENTS IN REGARDS TO TURN
AROUND TIMES WITHIN THREE DAYS
URGENT. REQUESTS AND FOURTEEN
DAYS FOR STANDARD REQUEST SO
WHILE WE MAY NOT BE THERE YET I
THINK WE WANT TO MAKE SURE THAT
WE HAVE THOSE STANDARDS AND
EXPECTATIONS WITHIN THESE VERY
CRITICAL PROGRAMS FOR SOME OF
CALIFORNIA'S. MOST VULNERABLE
CHILDREN AND JUST MAKING SURE
THAT WE HAVE THAT PROCESS IN
PLACE AND SO WE LOOK FORWARD TO
WORKING CLOSELY WITH OUR
COUNTIES AS WE DEVELOP WITH
THOSE STANDARDS ARE WHAT WE
WILL EVALUATE. AND THEN WORK
TOGETHER AS WE- IMPLEMENTED A
BOTH AUDITING AS WELL AS
POTENTIALLY FUTURE CORRECTIVE
ACTION PLANS- IN THOSE AREAS.
AND THAT IS THE END OF MY
COMMENTS AT THIS TIME AND HAPPY
ANSWER QUESTIONS WHEN
APPROPRIATE. I YOU VERY MUCH WE
WILL NOW MOVE ON TO MICHELLE
GIBBONS EXECUTIVE DIRECTOR OF
THE COUNTY HEALTH EXECUTIVES
ASSOCIATION. OF CALIFORNIA.
THANK YOUNG GOOD AFTERNOON
CHAIR MEMBERS MACHEL GIVENS AT
THE COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA
REPRESENTING LOCAL HEALTH
DEPARTMENT TO ADMINISTER BOTH
THE CCS OF THE CALIFORNIA
CHILDREN'S SERVICES AND CHILD
HEALTH AND DISABILITY
PREVENTION PROGRAM ON BEHALF OF
THE STATE. THE PROPOSAL WITHIN
CALLIN TO ENHANCE OVERSIGHT AND
MONITORING OF CCS IN C. H. T.
P. DON'T YET HAVE A LOT OF
DETAIL IN TERMS OF WHAT ENHANCE
OVERSIGHT AND MODERATE
MONITORING MEANS. IN ORDER TO
INSTITUTIONAL OVERSIGHT AND
MONITORING BOTH IN THE CCS IN
C. H. T. P. PROGRAMS- THE STAFF
AT THE COUNTY LEVEL AND THE
LOCAL HEALTH DEPARTMENT LEVEL
MUST FIRST HAVE A BASE LEVEL
UNDERSTANDING OF THE STATE'S
EXPECTATIONS FOR PERFORMANCE
MEASURES AND CLEAR DOCUMENTS
AND ADD POLICIES THAT GUIDE THE
ADMINISTRATION OF THESE
PROGRAMS. AS MISS COOPER
MENTIONED CCS IS THE OLDEST
PROGRAM UNDER DH CS IT'S IT IN
TO BE QUITE HONEST IT'S CLUNKY
AND REQUIRES LEAVING THROUGH A
HOST OF NUMBERS LETTERS AND
POLICIES THAT ARE SUPERSEDED BY
NEW POLICIES OVER TIME AND ARE
EXPERIENCIAS ADMINISTRATORS ARE
REALLY THEY'RE ABLE TO CROSS
WHAT THE DIFFERENT POLICIES.
BUT IT'S IMPORTANT THAT THE
STATE MAKE SURE THAT ALL THE
GUIDING POLICIES AND DOCUMENTS
ARE EASILY ACCESSIBLE AND THAT
THERE'S TRININGS TOOK TO LOCAL
HEALTH DEPARTMENT IN THESE
PROGRAMS STAFF TO IT AS UPDATES
ARE BEING MADE- I ALSO BELIEVE
THAT DH C. S. B. HAS ALREADY
BEGUN THE PROCESS OF REVIEWING
ALL OF THEIR KIND OF GUIDING
DOCUMENTS AND POLICIES. AND
THEN THEY HAVE ALLOWED
OPPORTUNITIES FOR- STAKEHOLDER
INPUT WHICH IS BEEN REALLY
HELPFUL AND HOWEVER THE ONE
THING I WOULD NOTICE THAT IT'S
NOT CLEAR LIKE THAT THE BREATH
OF ALL THE POLICIES THAT THEY
INTEND TO REVISIT IN THE
TIMELINE FOR WHEN EACH OF THOSE
THINGS WHAT HAPPENED SAID SO I
TIMELINE AND A PLAN OF THAT
WOULD BE HELPFUL. AND IT'S ALSO
IMPORTANT THAT WE CONTINUE TO
CONVENE OR THE STATE CONVENE
CCS IN C. H. T. P. PROGRAMS AS
WELL AS LOCAL HEALTH DEPARTMENT
DIRECTORS TO ENSURE THAT THE
STATE IS CAPTURING ALL OF THE
CRITICAL POLICIES AND THAT
THERE IS AN AGREEMENT ON HOW
THIS PROCESS WILL WORK. UNDER
CCS I JUST WOULD KNOW THAT
THERE'S ALSO THE WHOLE CHILD
MODEL THAT HAS BEEN IMPLEMENTED
IN TWENTY ONE JURISDICTIONS AND
SO IT'S CRITICAL THAT WE
UNDERSTAND WHAT THE WHOLE CHILD
MODEL OVERSIGHT LOOKS LIKE
VERSUS. THE CLASSICS ECS COUNTY
OVERSIGHT LOOKS LIKE- AND ALSO
THAT WE'RE- HELD STANDARDS OF
THINGS THAT ARE BEYOND OUR-
MISS COOPER ALSO MENTIONED THE
TIMELINESS OF AUTHORIZATION
SOME OF OUR JURISDICTIONS. RELY
ON THE STATE TO HELP. COMPLETE
AS AN END OF THAT AUTHORIZATION
SO WE WANT TO MAKE SURE THAT WE
ARE ONLY BEING HELD TO THE
PROCESSES THAT ARE WITHIN THE
COUNTY OR THE LOCAL HEALTH
JURISDICTIONS CONTROL. A WE
ALSO APPRECIATE THE STATE'S
COMMITMENT TO CONSULTING WITH
COUNTIES THROUGHOUT THE PROCESS
OF IMPLEMENTING THIS GREATER
OVERSIGHT AND MONITORING. I
CHECK WHICH STRESSED THAT ANY
NEW AUDIT TOOLS ARE KIND OF
BILITY MEASURES A NEW
DOCUMENTATION. REQUIREMENTS FOR
COUNTIES BE PROCEEDED WITH
THEIR- TRAINING AND SUFFICIENT
FUNDING TO ENSURE THAT WE HAVE
THE STAFFING TO MEET THESE
OVERSIGHT AND MONITORING
REQUIREMENTS- IT'S IMPORTANT
THAT AS WE LOOK AT. ADDING
RESPONSIBILITIES TO THE LOCAL
HEALTH DEPARTMENTS THAT WE ALSO
ENSURE THAT THEY'RE BEING
ADEQUATELY FUNDED. BECAUSE AS
YOU KNOW OUR LOCAL HEALTH
DEPARTMENTS- IS SPECIALLY
DURING THIS PANDEMIC ARE BEING
STRETCHED QUITE THIN. I WOULD
ALSO LIKE TO ENSURE THAT THERE
IS AN ADEQUATE HONORING ON RAMP
TO OVERSIGHT AND MONITORING
REQUIREMENTS. IT'S IMPORTANT TO
MAKE SURE THAT THERE'S AN
ABILITY TO BRING EACH
JURISDICTION INTO COMPLIANCE
WHATEVER THAT MEANS- BEFORE
THEY START BEFORE THE STATE
INSTITUTES FINES AND PENALTIES
FOR NON COMPLIANCE. AND SIMILAR
TO THE SPEAKERS ON THE PREVIOUS
PANEL WE WOULD FURTHER ASK THE
STATE TO CONSIDER QUALITY OF
QUALITY IMPROVEMENT PROCESS.
VERSUS A SHIFT TO FINES AND
PENALTIES I WE URGE THIS
PROCESS TO INCLUDE A REMEDY
AND- AN ABILITY TO REMEDY AND
CARE FINDINGS AND THE DH CS BE
ADEQUATELY STAFF TO. RESPOND TO
TECHNICAL ASSISTANCE QUESTIONS
SO THAT WE CAN MAKE SURE THAT
ALL OF OUR JURISDICTIONS ARE IN
COMPLIANCE. WE LOOK FORWARD TO
ADDITIONAL DETAILS BECOMING
AVAILABLE AND WE'D BE HAPPY TO
KEEP THE LEGISLATURE ABREAST
INFORMED AS THINGS PROGRESS. I
AND WE ALSO LOOK FORWARD TO
WORKING WITH THE DEPARTMENT TO
BETTER FLESH OUT THE DETAILS IN
THE PROCESS- AND SO THAT WE ALL
HAVE A BETTER UNDERSTANDING OF
WHAT. THE GREATER OVERSIGHT.
AND MONITORING MEANS THANK YOU.
THANK YOU NEXT WE WILL HEAR
FROM SKYLER ROSE A LEVY. SENIOR
ATTORNEY WITH THE NATIONAL
HEALTH LAW PROGRAM. GOOD
AFTERNOON A DOCTOR'S WEDDING
ARAMBULA AND MEMBERS OF THE
ASSEMBLY COMMITTEES THANK YOU
FOR THE OPPORTUNITY TO PROVIDE
TESTIMONY TODAY MY NAME IS
KILEY WRESTLING INTO A SENIOR
ATTORNEY WITH THE NATIONAL
HEALTH LAW PROGRAM. THAT'S MY
COLLEAGUES EARLIER AS STATED I
AND HELP PROTECTS AND BEYONCE'S
THE WHOLE CARE RIGHTS OF LOW
INCOME AND UNDERSERVED
INDIVIDUALS AND FAMILIES. I
KNOW THIS THIS THIS PROGRAM IS
A CRUCIAL SERVICES TO LOW
INCOME CHILDREN WITH SERIOUS
AND SEVERE PHYSICAL
DISABILITIES AND ILLNESSES IT
PROVIDES DIAGNOSTIC TREATMENT
SERVICES MEDICAL CASE
MANAGEMENT AND PHYSICAL AND
OCCUPATIONAL THERAPY SERVICES
TO CHILDREN UP TO AGE TWENTY
ONE WITH A QUALIFYING
CONDITION. UNFORTUNATELY SEES
JUST REMAINS A COMPLEX AND
CHALLENGING PROGRAM TO NAVIGATE
WELL AND HELP SUPPORTS THE KIND
PROPOSAL IN A COMPANY TRAILER
BILL LANGUAGE TO INCREASED
OVERSIGHT MONITORING AND MUST
GO FURTHER TO PROTECT CCS
ELIGIBLE CHILDREN. IT IS
ESTIMATED THAT APPROXIMATELY
90% OF CCS AND RALLIES ARE ON
MEDI CAL. ALTHOUGH MEDICAL
COVERS THESE DAYS HAVE SERVICES
THE VARYING STRUCTURE OF
SERVICE DELIVERY EACH COUNTY
CREATES EXTENSIVE COMPETITION
FOR CHILDREN AND FAMILIES. FOR
EXAMPLE IN TWENTY ONE COUNTY
ORGANIZED HEALTH SYSTEM
COUNTIES THE WHOLE CHILD MODEL
REPAIRS MEDICARE MANAGED CARE
PLANS TO ADMINISTER SINCE
YESTERDAY SINCE AND ALL STATES
HAS BEEN FISHERIES ARE BOLD.
AND THAT CAUSED ME. SINCE THE
HOTEL. ESTEEM RESPONSIBILITY
FOR TO LET OF C. WILL. AND NON
C. STEPS RELATED SERVICES. THE
POINT OF ACCOUNT. IS WITH THE
MEDIC HEALTH PLAN. HOWEVER IN
THE MAJORITY OF. ARE NINE CODES
IS RESPONSIBILITY ADMINISTERING
CCS INSTEAD OF REST WITH THE
COUNTY OR DTS. DEPENDING ON THE
POPULATION SIZE. CURRENTLY THE
TRAILER BILL LANGUAGE ONLY
MANDATES INCREASED OVERSIGHT
OVER COUNTY'S ADMINISTERING CCS
PROGRAM GIVEN THAT CCS IS IT
MINISTERED BY MEDICARE MANAGED
CARE PLANS AND TWENTY ONE WE'LL
TELL NOT COUNTING. THE LANGUAGE
MUST INCLUDE OVERSIGHT OF
MANAGED CARE PLANS FURTHERMORE
HOW WILL TEACH THIS MONITOR ITS
OWN CHILDREN'S MEDICAL SERVICES
WHICH IS STILL RESPONSIBLE AND
SMALL POPULATION COUNTS.
INCREASED OVERSIGHT OVER CCS
WEATHER BY COUNTY MANAGED CARE
PLANS FOR DCS IS NEEDED TO
ENSURE MARKETABILITY REGARDING
ACCESS QUALITY AND OVERALL
EFFECTIVENESS OF SERVICE
DELIVERY TO NECESSARY COVERED
SERVICES FOR CCS CHILDREN. MORE
TRANSPARENCY IN DATA COLLECTION
IS ALSO NEEDED TO EVALUATE THIS
PROGRAM. GIVEN THE COMPLEXITY
OF STEVE'S DEATH BETWEEN
COUNTIES IT IS IMPORTANT TO A
WIDE DOUBLES WITH MEDIC CAL TO
ENSURE COORDINATES QUALITY CARE
FOR CHILDREN BUT COMPLEX
CALLUSES AND DISABILITY. MANY
GAPS WITHIN STATES YES EXISTS
DUE TO THE LACK OF POLICY
GUIDANCE IN ADMINISTRATION AND
OVERSIGHT NINETY COS FOR
EXAMPLE ACCESSING DURABLE
MEDICAL EQUIPMENT OR SUPPLIES
IS COMPLEX BECAUSE IT MUST BE
PRESCRIBED BY CCS PANEL
PROVIDER. I SEE SAYS THE GROUP
IS STILL ANY. HOWEVER THE
REALITY IS A CCS ELIGIBLE CHILD
NEED FOR DME MAYBE IDENTIFIED
BY DIFFERENT PROVIDERS THE
AUTHORIZATION PROCESS DEPENDS
ON WHETHER THE CHILD IS
ENROLLED IN A FULL CHILD MODEL
OR NOT WE'LL TELL BONTA COUNTY.
CONFUSION BASED ON LACK OF
CLEAR GUIDANCE AND
ACCOUNTABILITY RESULTS IN
DENIALS OF NECESSARY DAMPING
AND OTHER SERVICES AND THE
FAILURE TO ADHERE TO MEDICAL
MOVES. EVEN WHEN THE CHILD HAS
MEDICARE. OTHER ISSUES. WITH
STATES YOU TO PROCESS RIGHT THE
CHILD THE RIGHT TO APPEAL AND
NEGATIVE ACTION. BY COUNTY
MODEL DELIVERY SYSTEM AND
WHETHER THE CHILD IS ON
MEDICARE OUR HAS ANOTHER SOURCE
OF HEALTH COVERAGE. SOME
BENEFICIARIES CAN APPEAL FOR
THE MANAGED CARE PLAN THAT'S
ALL THE STATE. AND NONE WILL
HELP MODEL COUNTIES. THERE'S A
SEPARATE APPEALS PROCESS LET'S
SEPARATE NOTICE REQUIREMENTS IN
SEPARATE REQUEST HIGHLIGHTS. OF
THE STATE'S CHILDREN ON MEDI
CAL AND MAGICALLY HAVE THE
RIGHT TO BOTH APPEALS PROCESS
IT'S CONFUSING. THERE IS NO
COORDINATION OF POLICY GUIDANCE
BETWEEN CCS AND MEDIC CAL THIS
LEADS THE POLICY CONTEXT AND
INCONSISTENCY. IT'S GAPS ARE
NOT SPECIFICALLY ADDRESSED BY
COUNTY ARE COUNTING TO
ACCOMPLISH ITS GOAL IS TO
REDUCE COMPLEXITY ABOUT THE
CONSISTENT AND SEAMLESS SYSTEM
DISTILLS MUST EVALUATE THE
ENTIRE SYSTEM OF ADMINISTERING
CCS BENEFITS AND HELP STRONG
SUPPORT THIS PROPOSAL FOR
INCREASED OVERSIGHT OF THE
STATE'S JUST PROGRAM. BUT MORE
NEEDS TO BE DONE TO ENSURE
STATES YES WORKS FOR ALL
ELIGIBLE CHILDREN REGARDLESS OF
WHERE WE LEFT. THANK YOU. THANK
YOU VERY MUCH THAT DOES
CONCLUDE THIS PANEL I WILL
BRING IT UP TO THE DíAS FOR A
QUESTION. I WOULD LIKE TO ASK
THE DEPARTMENT IF I COULD THAT
IN MARCH OF TWENTY NINETEEN THE
BUREAU OF STATE AUDITS RELEASED
AN AUDIT. ON DH CS WHICH WAS
TITLED MILLIONS OF CHILDREN
MEDIC CAL. ARE NOT RECEIVING
PREVENTATIVE HEALTH SERVICES. I
WAS HOPING YOU COULD COMMENT ON
WHAT LESSONS WERE LEARNED FROM
THIS AUDIT AND WHICH
RECOMMENDATIONS THE DEPARTMENT
HAS ADOPTED. I'M SORRY I DON'T
HAVE THE AUDIT REPORT DIRECTLY
IN FRONT OF ME BUT WHAT I WOULD
SAY IS THAT THE DEPARTMENT HAS.
IMPLEMENTED EXTENSIVE CHANGES
IN REGARDS TO PREVENTIVE
SERVICES FOR CHILDREN. WE HAVE
A GREATLY STRENGTHENED SOME OF
OUR CONTRACT LANGUAGE WE HAVE
MORE CHANGES COMING IN THE
FUTURE GARCIA ACCOUNTABILITY ON
THAT FRONT. WE ALSO ARE WORKING
VERY CLOSELY WITH OUR MANAGED
CARE PLANS IN REGARDS THE
REQUIREMENT TO DO DIRECT
OUTREACH TO BENEFICIARIES
REGARDING GAPS IN CARE. OF AS
WELL AS EVEN CALLING
INDIVIDUALS TO ENSURE THAT THEY
UNDERSTAND THEIR RIGHT TO THOSE
SERVICES- WE ARE HOPEFUL THAT
MANY OF THE CHANGES THAT THE
DEPARTMENT HAS PUT IN PLACE IN
REGARDS TO. EVEN CHANGES TO THE
HANDBOOK OR THE MANUAL THAT
INDIVIDUALS RECEIVE WHEN
THEY'RE ROLLED IN THE MANAGED
CARE PLAN MAKING SURE THEY
UNDERSTAND THEIR RIGHTS TO
THOSE SERVICE AS- UP FOR
EXAMPLE. AND EXTENSIVE CHANGES
ACROSS MULTIPLE DCS DOCUMENTS
WEBSITES- STATUTE EXAGGERATE
JUST ENSURING THAT PEOPLE
UNDERSTAND. THAT THEY HAVE
ACCESS TO PREVENTIVE SERVICES
WHAT ARE THOSE PREVENTIVE
SERVICES THAT THEY HAVE ACCESS
TO- SO WE'RE HOPEFUL ON THAT
WITH THESE CHANGES WILL SEE.
INCREASES IN THE FUTURE I WOULD
NOTE ONE OF OUR IMMEDIATE
THINGS THAT WE NOTICED DURING
THE PUBLIC HEALTH EMERGENCY
DURING HOPE IT WAS A REDUCTION
OF CHILD TWELVE IS IT- WELL
THIS VISITS. AS WELL AS
IMMUNIZATIONS AND WE RECOGNIZE
THIS IN MAY OF TWENTY TWENTY
IMMEDIATELY AND STARTED AS
INDICATING IN ALMOST EVERY
SINGLE MEETING PUBLICLY THAT WE
HAD AS THE DEPARTMENT TO PUT
PEOPLE. IN BECOME AWARE OF
THESE DECREASES. AS PEOPLE
START RE ENGAGING IN HEALTHCARE
WILL BE WATCHING VERY CLOSELY
IN REGARDS TO SEEN CHILDREN'S
CHILD WELLNESS VISIT A VISITS
INCREASE- IN IMMUNIZATION RATES
INCREASE WE STILL HAVE NOT
CAUGHT UP JUST TO BE CLEAR- AND
SO WE WILL. WE WILL BE WATCHING
IT VERY CLOSELY WE ARE
RECORDING THOSE METRICS ON A
VERY REGULAR BASIS NOW PUBLICLY
A SO THAT WE CAN COLLECTIVELY
GET CHILDREN AND FOR THOSE
NEEDED VISITS AND IMMUNIZATIONS
AND- LOOK FORWARD TO WORKING
WITH OTHERS AS WE CONTINUE TO-
CLOSE THE GAPS THAT WERE THERE-
BEFORE COULD. AND THEN THE
LARGE GAPS THAT WERE CREATED
THE POP HEALTH EMERGENCY IS.
THANK YOU OF FINAL A I WAS
HOPING YOU COULD COMMENT ON THE
NATIONAL HEALTH LAW PROGRAMS.
COMMENTER QUESTION REGARDING
OVERSIGHT OF THE MEDICARE
MANAGED CARE PLANS AND HOW THIS
PROPOSAL WILL BE AFFECTING THE
WAR IF YOU COULD COMMENT ON
THAT YOUR- SO IF WE IDENTIFY
ANY AREAS- THAT WOULD BE
CONSISTENT ACROSS THE WHOLE
CHILD MODEL AND CCS PROGRAM OF
COURSE WE WOULD. IMPLEMENT THAT
ONE THING I WOULD SAY BECAUSE
OF FEDERAL REGULATIONS IN
MANAGED CARE THERE ARE
SIGNIFICANTLY MORE PROTECTIONS
IN PLACE FOR CHILDREN- CCS
CHILDREN THAT ARE IN THE WHOLE
CHILD MODEL PROGRAM THEN- IN D.
AS STATE ONLY AND OR THAT THE
P. FOR SERVICE AS CCS PROGRAM
AND SO. SOME OF THIS INITIATIVE
IS ACTUALLY JUST ELEVATING TO
THE SAME LEVEL OF- GRIEVANCE
APPEAL NOTICE REQUIREMENTS THAT
ACTUALLY EXIST AND ARE REQUIRED
IN MANAGED CARE AND I THINK IT
BECAME VERY CLEAR TO US WITH
THE IMPLEMENTATION OF WHOLE
CHILD MODEL SOME OF THE
DIFFERENCES THAT HISTORICALLY
HAVE EXISTED FOR THE CCS
CHILDREN. THAT HAVE BEEN CARVED
OUT TO FEE FOR SERVICE- AND SO
I THINK THAT IS ONE OF THE
PIECES THAT WERE LOOKING TO
KIND OF CLOSE THAT GAP IN
REGARDS TO THOSE CHILDREN
STAYING WITHIN THE CCS PROGRAM-
AND- WE HAVE STARTED POSTING.
REPORTS FOR EXAMPLE ON WHOLE
CHILD MODEL OF AND WE WILL BE
GETTING SOME DASHBOARDS FOR CCS
UP AS WELL AND START LOOKING
ABOUT- THOSE THOSE REPORTING
REQUIREMENTS ACROSS ALL OF OUR
DELIVERY SYSTEMS NOT JUST. NOT
JUST FEE FOR SERVICE OR MANAGED
CARE BUT HOW WE'RE SEEING THOSE
METRICS PLAY OUT BOTH IN CCS
TRADITIONAL. AS WELL AS WHOLE
CHILD MODEL. THANK VERY MUCH
FOR THAT AND WITH THAT I'D LIKE
TO THANK THE ENTIRE. PANEL SIX.
AS WE MOVE ON TO ISSUE SEVEN
IMPROVING MEDIC CALBENEFICIARY
CONTACT. AND DEMOGRAPHIC
INFORMATION WE WILL BEGIN AGAIN
WITH YOU MISS COOPER. THANK
YOU. SO YOU KNOW WHEN I HAD THE
OPPORTUNITY TO GO ACROSS THE
STATE OF CALIFORNIA- AS WE WERE
DEVELOPING A CALENDAR AND TALK
TO OUR PLANS COUNTIES PROVIDERS
BENEFICIARIES I'M ONE OF THE
MOST CONSISTENT THINGS RAISED-
IN THOSE CONVERSATIONS- WAS THE
NEED TO IMPROVE CONTACT AND
DEMOGRAPHIC INFORMATION. OF
THAT WE PROVIDE THE DEPARTMENT
PROVIDES TO PLANS PROVIDERS-
AND COUNTIES IN ORDER FOR THEM
TO MEET THE EXPECTATIONS THAT
WE HAVE OF THEM IN REGARDS TO
OUR REACH AND ENGAGEMENT WITH
MEDICARE BENEFICIARIES- IT WAS.
EXTREMELY CONSISTENT IN REGARDS
TO HEARING THIS WHETHER IT WAS
IN NORTHERN CALIFORNIA CENTRAL
VALLEY OF SOUTHERN CALIFORNIA-
THE COAST- IT WAS A CLEAR
MESSAGE AND SO I IT'S WHY IT'S
A CRITICAL COMPONENT OF TALLY
MANY INTERWEAVES WITH SO MANY
OF THE PIECES THAT WE- ARE
DOING. I THINK ONE OF THE OTHER
DRIVING FACTORS BEHIND THIS-
HAS BECOME EVEN MORE. RELEVANT
TODAY AS WE'VE LEARNED SO MUCH
FROM THE IMPACT OF SYSTEMIC
RACISM WITHIN THE HEALTHCARE
SYSTEM AND AS WE REALLY WORK TO
CLOSE. EQUITY GAPS IN THE
FUTURE WE NEED TO ENSURE THAT
WE HAVE AND COLLECT THE BEST A
DEMOGRAPHIC INFORMATION THAT WE
CAN INCLUDING RACE ETHNICITY A
LANGUAGE ETCETERA A TO REALLY
ENSURE THAT WE HAVE ALL OF THE
INFORMATION WE CAN'T YOU- TO
LOOK AT AT THE AT METRICS VIA-
AN EQUITY LENS AND TO CLOSE
THOSE GAPS. I MEAN FEEL
COMFORTABLE AT THAT LEVEL OF
COURSE WE'RE STILL FORGING
AHEAD IN THAT WAY BECAUSE WE
ARE WE DO HAVE A SIGNIFICANT
AMOUNT BUT WE'D REALLY LIKE TO
CLOSE THE GAP IN REGARDS TO YOU
OF THAT INFORMATION NOT BEING
PROVIDED- AND SO THINKING
THROUGH A NUMBER OF WAYS WHICH
YOU CAN DO THAT BOTH THROUGH.
IMPROVING THE COLLECTION AND
UPDATING OF CONTACTED
GEOGRAPHIC DEMOGRAPHIC
INFORMATION BUT ALSO WHAT WE
CAN DO WITHIN THE MEDICAL
APPLICATION ITSELF TO IMPROVE
THE COLLECTION OF THAT THAT
DATA- IN IT IS JUST- CRITIC ALL
FOR EVERYTHING. THAT WE DO- AND
SO I THAT WE WILL CONTINUE TO
FOCUS ON THIS AREA- WE DO NEED
TO ENGAGE WITH A LARGE NUMBER
OF PEOPLE TO BE ABLE TO MAKE.
THIS HAPPEN THIS IS NOT ANY
EASY FEAT- TO ENSURE THAT WE
HAVE UPDATED INFORMATION. IN
OUR IN OUR ELIGIBILITY SYSTEMS-
SO I TO ENSURE THAT RELEVANT
ENTITIES INCLUDING PLANS AND
PROVIDERS- CAN MORE EASILY
SHARED OBTAIN UP TO DATE
BENEFITS YOUR INFORMATION. WE
DO INTEND TO CONVENE A WORK
GROUP OF- STAKEHOLDERS. TO
DEVELOP RECOMMENDATIONS FOR
ENSURING THAT THAT INFORMATION
IS UPDATED OR AS ACCURATE AS
POSSIBLE BOTH BUT AT THE UP
FRONT A COLLECTION OF THAT AND
THEN OF COURSE- AS WE CAN
UPDATE IT WITHIN AND ACROSS OUR
ELIGIBILITY ENROLLMENT SYSTEMS.
THE COMMITTEE HAD BEEN ASKED
WHETHER. THERE WERE ANY LEGAL
BARRIERS TO IMPLEMENTING THIS
EFFORT- THERE ARE NO LEGAL
BARRIERS- THERE IS A PROCESS IN
PLACE TODAY FOR EXAMPLE- IN
MEDICARE MANAGED CARE PLANS-
WHERE THEY CAN CONTACT THE
COUNTY OFFICES BY PHONE FAX OR
EMAIL. TO PROVIDE UPDATED
BENEFICIARY CONTACT INFORMATION
FOR THE PURPOSES OF AND ADDRESS
CHANGES NAME CHANGES AND
TELEPHONE NUMBER CHANGES.
MANAGED CARE PLANS ARE REQUIRED
TO PROVIDE THE INFORMATION TO
THE COUNTY PER STATE LAWS AND
REGULATIONS. I'M EVEN IF THE
BENEFICIARY HAS NOT- PROVIDED
CONSENT TO DO SO- AS A PART OF
THAT PROCESS THOUGH MANAGED
CARE PLANS INFORM THE COUNTY
WHETHER THE BENEFICIARY HAS
APPROVED THE SHARING OF THAT
UPDATED CONTACT INFORMATION.
AND WHEN APPROVED- AND WHEN
APPROVAL WAS OBTAINED. OF THE
MANAGED CARE PLAN INDICATES
THAT IT DOES NOT HAVE THE
BENEFICIARIES CAN SENSE-
INFORMATION AND THAT IT IS THE
RESPONSIBILITY OF THAT. COUNTY
ELIGIBILITY WORKER TO REACH OUT
TO THE BENEFICIARY VERIFY THAT
NEW INFORMATION ON BEFORE
MAKING THE CHANGES IN THE CASE
RECORD. AS YOU WOULD IMAGINE
THAT PROCESS IS PROBABLY NOT
THE MOST EFFICIENT IN REGARDS
TO ENSURING. THAT WE GET
UPDATED IT CONTACT ENDEAVOR.
AND MOST CAL HAVE ESTABLISH A
METHOD FOR TRANSMITTING THE
UPDATED BENEFICIARY.
INFORMATION WITH MANAGED CARE
PLANS OPERATING IN THEIR
COUNTY- HOWEVER WE DO FEEL LIKE
THERE COULD BE- SIGNIFICANT
IMPROVEMENTS IN REGARDS TO THIS
PROCESS- MOVING FORWARD- THERE
WAS ALSO A QUESTION IN REGARDS
TO ADMINISTRATIVE BARRIERS FOR
IMPLEMENTING THIS EFFORT- THE
STATEWIDE AUTOMATED WELFARE
SYSTEM ARE- SAWS- IT IS THE
CASE MANAGEMENT SYSTEM THAT
COUNTIES USED TO UPDATE AND
STORE BENEFICIARY CONTACT AND
DEMOGRAPHIC INFORMATION. WHEN
COUNTY'S INPUT INFORMATION
UPDATES INTO SAWS THE CHANGES
ARE TRANSMITTED TO DH CS IS A
MEDIC CAL ELIGIBILITY DATA
SYSTEM OR WHAT'S KNOWN AS MEDS-
AND THESE CHANGES ARE
SUBSEQUENTLY SHARED THROUGH
DATA TRANSACTIONS- FOR MEDS TO
HEALTH PLANS AND THEN
ULTIMATELY. YOU OTHER DELEGATED
ENTITIES AND PROVIDERS SO AS
YOU CAN SEE REALLY CRITICAL
THAT THE INFORMATION IS UPDATED
I'M IN THE INITIAL ROUND TABLE
DISCUSSIONS WHEN WE KICKED OFF
THE PROPOSAL. IN FEBRUARY OF
TWENTY TWO. THE DISCUSSIONS AT
LEAST THAT WE IT WOULD BE NO
THE PROPOSAL'S THREE RELEASED
BEFORE THAT. IT INCLUDED A
LARGE NUMBER OF PEOPLE COUNTY
WELFARE DIRECTORS ASSOCIATION
CONSUMER HEALTH ADVOCATES
PLANS- EXCEPT IRAQ- YOU OUTLINE
MANY OF THE CHALLENGES THAT
EXIST WITHIN THE PROCESS SEE
THAT WE HAVE IN PLACE TODAY.
MANUAL COUNTY WORKLOAD ON BOTH
ON BEHALF OF THE PLAN AND THE
COUNTY TO HAVE TO LOOK AT-
UPDATES ARE OFTEN ENTERED
MANUALLY BY THE COUNTY
POTENTIALLY EVEN ONE BY ONE
THAT'S A HUGE LIFT- VOLUME OF
CHANGES- AND SOMETIMES
DUPLICATIVE CHANGES- SO SOME
MANAGED CARE PLAN STATED THAT
THEY SPEND APPROXIMATELY FIVE
THOUSAND BENEFICIARY UPDATES.
ON IT A WEEKLY- ON A WEAK ON
THAT THE NOT THAT'S ON AVERAGE.
IMAGINE BEING ON THE COUNTY
SIDE TRYING TO KEEP UP WITH
THAT LEVEL OF UPDATES ON IT BUT
IT ALSO SHOWS HOW IMPORTANT IT
IS FOR US TO GET UPDATED
CONTACT INFORMATION FORCING
THAT LEVEL OF CHANGE. WE DO
KNOW THAT MEDICARE
BENEFICIARIES CAN BE SOMEWHAT
TRAINS YET AND WE NEED TO MAKE
SURE THAT WE CAN GET A HOLD OF
THEM GET THEM INFORMATION GET
THEM NOTICES FOR EXAMPLE OF FOR
SENDING A NOTICE OF ACTION.
MANY GOOD ADDRESS SO THAT THEY
UNDERSTAND THEIR RIGHTS TO BE
ABLE TO APPEAL THOSE BENEFITS
IF FOR SOME REASON SOMETHING
WAS DENIED OR MODIFIED THAT'S
IMPORTANT INFORMATION FOR US TO
HAVE TO MAKE SURE THAT WE ARE
GETTING INFORMATION TO OUR
BENEFICIARIES- SO WE KNOW THAT
THERE'S A NEED FOR IMPROVEMENT.
OF THIS PROPOSAL IS REALLY
LOOKING TO EXPLORE ELECTRONIC
OR AUTOMATED TRANSMISSIONS OF
THIS TYPE OF INFORMATION AS
WELL AS LIKE I MENTIONED
COLLECTING IN THINKING ABOUT
HOW WE CAN GET THAT INFORMATION
UP FRONT. EVEN BETTER FROM OUR
OUR APPLICATION PROCESS WHICH
CAN BE A CHALLENGE WE KNOW
THAT'S A HUGE LIFT BUT WE DO
THINK IT'S SO CRITICAL FOR US
TO DO BEFORE GOING TO BE ABLE
TO MOVE THE NEEDLE- EXPAND OUR
ABILITY TO GET DATA FOR EQUITY
CLOSURE. AS WELL AS CONTACT
THEIR BENEFICIARIES TO ENSURE
THEY UNDERSTAND THEIR RIGHT TO
SERVICES AND MEDICARE AND BE
INFORMED IN REGARDS TO THE
BENEFIT THAT WE PROVIDE. THIS
CONCLUDES THAT MY AT COMMENTED
THIS TIME AND- TO QUESTIONS.
THANK YOU NEXT WILL FROM NED
REST WITH THE L. L. THANK YOU
DISTURB BRIEFLY- WE FEEL THAT
THIS PROPOSAL MAKES SENSE AND
CONCEPT. THAT IMPROVING THE
ABILITY OF THE STATE TO
CONTACT- INDIVIDUALS WHO WOULD
BENEFIT FROM MEDICAL SERVICES-
CLEARLY IMPROVES THE ABILITY OF
THE STATE TO MAKE SURE THAT
THOSE INDIVIDUALS RECEIVE THOSE
SERVICES- I WOULD ALSO NOTE
THAT- ASSEMBLY WHOLE PERSON
CARE ADMINISTRATORS HAVE NOTED
THAT. AN IMPORTANT CHALLENGE
FOR THEM WAS JUST THE ABILITY
TO GET IN TOUCH WITH
BENEFICIARIES SO- THIS IS
CLEARLY BEEN AN ISSUE FOR SOME
TIME AND- WE FEEL THAT AGAIN
THAT- THE PROPOSAL MAKES SENSE
IN CONCEPT THANK YOU. THANK YOU
MAX WE WILL HEAR FROM KATHY
SANDERLING MCDONALD WITH CWD.
OR I CAN REMEMBER A TIME YEAH
OKAY I THANK YOU MISTER CHAIR
OF MEMBERS KATHY THUNDERWING
MCDONALD WITH THE COUNTY WALKER
DIRECTORS ASSOCIATION. WE DO
NOT HAVE ANY ISSUES WITH THE
PROPOSED WORKGROUP WE DO THINK
AS THE SKIPPER NOTED THAT THIS
IS MORE COMPLEX THAN I THINK.
MAYBE ARE REALIZED ON FIRST
BLUSH GIVEN THAT KEEPING
PEOPLE'S ADDRESSES UP TO DATE.
SOUNDS LIKE A RELATIVELY SIMPLE
PASSED. BUT IT ACTUALLY NOT AS
AS YOU MIGHT THINK I THINK-
AGAIN THE SKIPPER GOT A GREAT
JOB OF EXPLAINING THE STEPS
THAT COUNTIES HAVE TO FOLLOW.
THE MAIN. GOAL THOUGH IS TO
ENSURE THAT WE ARE VERIFYING
WITH AN INDIVIDUAL THAT THEY
HAVE INDEED CHANGED THEIR
ADDRESS OR OTHER CONTACT
INFORMATION. BEFORE WE ACTUALLY
EFFECTUATE THAT CHANGE IN OUR
COMPUTER SYSTEM WHICH IS THAT
NOT ONLY THE CASE MANAGEMENT
SYSTEM BUT IT'S ALSO THE SYSTEM
OF RECORD. FOR MEDICCAL IF WE
DO NOT HAVE THE RIGHT-
INFORMATION WE MAY LOSE CONTACT
WITH THEM AND SO WE CAN'T JUST
TAKE THE WORD OF SOMEONE IN A
HEALTH PLAN OR SOME OTHER
STORES. INTEL WE'VE HAD A
CHANCE TO DOUBLE CHECK WITH
THEM. THE OTHER REASON WHY IT'S
SO IMPORTANT TO DO THAT IS
BECAUSE IT'S CONSIDERED A
CHANGE OF CIRCUMSTANCE AND
SOMEONE MOVES. THEY ARE
SUPPOSED TO REPORT THAT TO US
WITHIN TEN DAS IF WE FIND OUT
EITHER DIRECTLY FROM THEM OR
THROUGH ANOTHER SOURCE SUCH AS
THE HEALTH PLAN REPORT. THAT
APPEARANCE THEIR ADDRESSES
CHANGED THE COUNTY HAS TO READ
THE TERMINOLOGY ABILITY BASED
ON THE CIRCUMSTANCES OF THE
TERM AND- YES THEY WERE MADE
ELIGIBLE OR NOT. AND SO TAKING
SOMEONE ELSES WORD FOR AN
ADDRESS CHANGE. ULTIMATELY LEAD
TO A SET OF- SORT OF SET UP FOR
OUR PROCEDURES THAT TAKE PLACE.
THAT COULD ULTIMATELY RESULT IN
A PERSON BE BEING MADE
INELIGIBLE FOR THE PROGRAM. AND
SO I THINK IT'S ONE REASON TO
TREAD CAREFULLY INTO THIS AREA.
TO ENSURE THAT WERE BOTH
ACCURATELY AND EFFICIENTLY
DOING THAT BUT ALSO THAT WE'RE
NOT TAKING NEGATIVE ACTIONS
THAT COULD. AFFECT THE- AND
INDIVIDUAL OUR FAMILIES
ELIGIBILITY- WITHOUT. BEING
VERY CAREFUL ABOUT THAT. OR
HEAD OF SITUATION THAT HAPPEN
WITHIN THE- AND WE DON'T THAT
AFTER- YOU KNOW DISCONTINUE
PEOPLE ELIGIBLE UNLESS WE
ABSOLUTELY. TO BECAUSE OF AN
ELIGIBILITY. SO WITH THAT- WE
THINK THAT THE WORKGROUP CAN
HELP TO SORT OUT THOSE. KIND OF
THORNY ISSUES AND IDEALLY PUT
IN PLACE SOME PROCESS FEES. AND
EXPECTATIONS FOR THE DIFFERENT
PARTIES THAT ARE ENGAGED AND
WHEN SOMETHING WOULD BE
REPORTED. HOW IT WOULD BE
REPORTED AND HOW THAT THAT
WOULD BE THAT ACTED UPON OR-
DISPOSITION. THANKS FUNNY HAPPY
TO ANSWER ANY QUESTIONS. THANK
YOU NEXT WE'LL HEAR FROM KERRY
SANDERS WITH THE CALIORNIA.
PAN ETHNIC HEALTH NETWORK. J.
AND HOPE YOU CAN HEAR ME-
COUPLE THOUGHT DEPEND STRONGLY
SUPPORT AND THANKS THE H. YEAH-
FOR THE CRITICAL PROPOSAL TO-
AND SHE CAN BE IN A WORKER TO
PROVIDE FEEDBACK AND
RECOMMENDATIONS ON WAYS TO. AND
WHICH BENEFICIARY CONTACT AND
DEMOGRAPHIC INFORMATION CAN BE
UPDATED BY OTHER ENTITIES- CAN
USE OF COLOR THE MAJORITY EVEN
REALLY THE MEDIC HOW MANAGED
CARE CONTINUE TO EXPERIENCE
DISCRIMINATION. AND HAVE POOR
OUTCOMES ON KEY HEALTH
INDICATORS INCLUDING ASTHMA
DIABETES AND MENTAL HEALTH.
YOU'RE JUST HEALTH DISPARITIES
MEDIKAL MANAGED CARE PLANS AND
PROVIDERS AND THE STATE MUST
EXPLICITLY DOCUMENT AND MEASURE
THE EXISTENCE OF DISPARITIES
AND TARGET RESOURCES TOWARDS
ELIMINATING THEM. AIMED AT THE
FINAL RULE REQUIRES THE STATE
TO IDENTIFY AND EVALUATE AND
REDUCE DISPARITIES BASED ON AGE
RACE ETHNICITY. FACTS PRIMARY
LANGUAGE AND DISABILITY STATUS.
AND UNDER THE FINAL RULE
CALIFORNIA'S ALREADY REQUIRED
TO IDENTIFY THE DEMOGRAPHIC
INFORMATION FOR EACH MEDICAID
ENROLLEE. AND PROVIDE IT TO THE
MANAGED CARE PLAN AT THE TIME
OF ENROLLMENT. IN TURN DHS
REQUIRES MANAGED CARE PLAN TO
PROVIDE A DEMOGRAPHIC
INFORMATION ABOUT THEIR
BENEFICIARIES. INCLUDING FOR
MEASURES AND THERE I HOPE
DISPARITIES ANALYSIS. I'M
WALDRON LP- I HAVE BEEN VERY
HELPFUL IT'S BECOME CLEAR TO US
AND WE- ARE AT THAT TIME. THAT
THERE'S STILL A WIDE VARIATION
IN DATA QUALITY AND
COMPREHENSIVENESS. WHICH
SERIOUSLY LIMITS THE GENERAL
GENERAL GENERALIZE ABILITY OF
THE RESULTS OF THE ANALYSIS.
AND YOU KNOW WHERE AND YOU KNOW
A SMALL SAMPLE SIZE IS. STILL
THE NORM FOR THE PLAN TO NEED
TO UNDERSTAND THEIR MEMBERSHIP
IT DOESN'T YIELD THE STATE YOU
KNOW NEAR THE LEVEL OF DATA
THAT WOULD BE NEEDED TO
IDENTIFY DISPARITIES. AND
TARGET THE NECESSARY.
INTERVENTIONS TO ADDRESS.
WIDESPREAD ADOPTION PATIENT
HEALTH RECORD. ALLOWS US THE
CREDIT AFTER IN TOWARD MARKET
DATA. WERE FOR ALL MET THAN.
ALLOWING DHS TO IMPROVE. YOU
THE UPDATED CONTACT AND
DEMOGRAPHIC INFORMATION WILL
ALLOW FOR MORE GRANULAR
DISAGGREGATION OF THE STATE AS-
A DEMOGRAPHIC DATA. AND THE
ABILITY OF THE EXTENT OF THAT
YOUR FOR YOUR TARGET TO IMPROVE
OU HEALTH DISPARITIES WHICH IS
ONE OF THE KEY GOAL OF AB
TWENTY TWO SEVENTY FIVE CENTER
BY ASSEMBLY MEMBER ARAMBULA.
AND ADDITIONALLY ADDITION WORK
TO IMPLEMENT CAL IN ACCURATE
DEMOGRAPHIC DATA COLLECTION
REPORTING WILL BE CRITICAL TO
ENSURING IMPLEMENTATION OF THE
NEW PAGE AND- POPULATION HEALTH
MANAGEMENT PROGRAM REQUIREMENTS
RESULT IN PROPER CARE
MANAGEMENT ALL RESPECT MEN. AND
MEDICARE BENEFICIARIES OF PLANS
WILL NOT BE REQUIRED TO SCREEN
THEIR MEMBERS THE HEALTH CARE
NEEDS INCLUDING SOCIAL
BEHAVIORAL RISK AS WELL AS THE
UNBIASED RESTAURANT THE KITCHEN
AND SEGMENTATION. I'M OF THE
MENTION OF MY PREVIOUS. THE
POPULATION OF MANSIONS REQUIRED
TO MANAGE IN THE FAST. PACED AT
RISK IN ORDER TO TARGET A
CORPORATE INTERVENTION. AND
WHILE PREDICTIVE ANALYSIS HOLD
MAY HOLD PROMISE. I'M MANY PH
AN ALGORITHM- FIRST TESTING
RISK ARE BIASED WHEN AND
FOCUSED PRIMARILY ON HEALTHCARE
COST AND UTILIZATION- WHEN
THERE ARE OTHER DISPARITIES IN
ACCESS TO CARE. THE PAGE AND
TRY TO DO WILL BE MORE
EFFECTIVE FOR DIVERSE MEDICARE
BENEFICIARIES AND IF THEY ARE
ABLE TO INCLUDE AN- ACCURATE
MORE ACCURATE DEMOGRAPHIC DATA
AS WELL DATA ON SOCIAL BEHAVIOR
WITH- WE SUPPORTED EXTENSIVE
GOALS AND ESTABLISHING THIS
WORKGROUP. I AND THE POINT THAT
KATHY SANDERLING REYES ABOUT
THE NUANCES THE STATE NEEDS TO
CONSIDER AND- YOU KNOW FIGURE
OUT THE RIGHT WAY TO EXCHANGE
THE DATA AYE WE RECOMMEND THE
DHS CONTINUE THE WORK GROUP AND-
INCLUDE AND CONTINUE TO INCLUDE
CONSUMER STAKEHOLDERS IN THIS.
IMPORTANT DISCUSSION.
ADDITIONALLY A PART OF THESE
EFFORTS WE OFFER THREE-
RECOMMENDATION- SPECIFIC YOU
KNOW WHETHER NOW OR IN FUTURE
SPECIFICALLY WE WOULD LIKE TO
SEE DHS THAT CONCRETE TARGETS
FOR THE COLLECTION AND
REPORTING OF ACCURATE
DEMOGRAPHIC DATA FOR ALL
MEDICARE BENEFICIARIES- AND FOR
FUN TO BE TIED TO SUCCESSFUL
COMPLETION OF THIS REQUIREMENT.
THIS IS SOMETHING THAT'S
ALREADY HAPPENING AND COVER
CALIFORNIA HEARING IN TWENTY
TWENTY TO COVER CALIFORNIA WILL
REQUIRE ALL OF ITS HEALTH PLAN
TO ACHIEVE EIGHTY PERCENT. SELF
IDENTIFICATION OF RACE
ETHNICITY. DATA FOR THEIR
ENROLLEES. I AND- ADDITIONALLY
COME CALIFORNIA TIME SEVEN
POINT 5% AT RISK. TO THE
ACHIEVEMENT OF THE GOAL. I
WOULD LOVE TO SEE THAT HAPPEN
ACROSS THE BOARD- SECOND I
WOULD LIKE TO SEE AN
INVESTMENT- AND WE KNOW THAT
THE STATE AS- PRIORITIZING THAT
AND I THINK. YOU KNOW IS- AND
BEGINNING TO INVEST IN THE AND
THE DATA INFRASTRUCTURE THAT
NEEDED THAT TO FACILITATE-
ADDITIONAL GRANULARITY AND THE
COLLECTION REPORTING AND
DEMOGRAPHIC DATA. INCLUDING
THROUGH MUCH NEEDED UPDATES TO
THE METRIC SYSTEM AND WE THINK
THE STATE FOR FOCUSING ON THAT.
LASTLY WE ENCOURAGED EACH YES
HEALTH PLANS HEALTH SYSTEMS AND
PROVIDERS TO ADOPT THE TWENTY
FIFTEEN OMG STANDARDS FOR THE
COLLECTION REPORTING A
DEMOGRAPHIC DATA- BE STANDARDS
INCLUDE DATA ON BEHAVIOR ON
SOCIAL RISK FACTORS WHICH WILL
FIFTY EIGHT YEAH. BOTH IN
SETTING YOUR OF YOUR TARGETS
FOR QUALITY IMPROVEMENT AND
DISPARITIES PRODUCTION- AND
ALSO ALLOWING FOR GREATER
OVERSIGHT OF MANAGED CARE PLANS
FOR ADDRESSING THE SOCIAL
DETERMINANTS OF HEALTH. UNDER
THE NEW POPULATION. I WILL NOW
BRING IT BACK TO THE DíAS FOR
ANY QUESTIONS THAT WE MAY HAVE
I WILL BEGIN- FIRST I WANT TO
THANK SEE PAM FOR THE WORK THAT
WE'VE DONE BEFORE AND- WORKING
TOWARDS GRANULAR LEAVE DIS
AGGREGATING THAT DATA. SO WE
CAN START WORKING TOWARDS
HEALTH EQUITY BUT WANTED TO ASK
THE DEPARTMENT IF I COULD- THE
WHAT ARE YOU PLANNING TO
COLLECT IN TERMS OF DATA THAT
YOU'RE NOT COLLECTING NOW. AND
WILL THIS DATA BE AVAILABLE AND
ACCESSIBLE TO THE PUBLIC. I
THINK WE'RE CURRENTLY LOOKING
AT OUR MEDICARE APPLICATION IN
REGARDS TO A FEW THINGS- AND IT
CAN BE A LITTLE COMPLICATED
WITH A MEDIC CAL APPLICATION
BECAUSE THAT'S ESSENTIALLY
WHERE WE GATHER. THE
INFORMATION THAT THAT WE GET OR
ON THE ELIGIBILITY SYSTEMS AND
THEN GOES HAVE PROVIDERS AND
PLANS ETCETERA- BECAUSE THERE
ARE MANY STMS RULES THAT WE
HAVE TO FOLLOW IN REGARDS TO
WHERE WE CAN MAKE SOMETHING
MANDATORY VERSUS OPTIONAL. I'M
ONE OF THE PIECES THAT WE'RE
LOOKING AT RIGHT NOW IS. WHERE
A CERTAIN DEMOGRAPHIC
INFORMATION IS EVEN BEING
REQUESTED ON THE APPLICATION-
AS DIRECTOR LIFE BORN WITH
POINT OUT TO YOU OUR TEAM- I
THINK IT'S SOMEWHERE CLOSE TO
ON PAGE TWENTY SIX OF THE WHOLE
APPLICATION IN REGARDS TO WHERE
WE'RE ASKING THOSE QUESTIONS
AND ANYONE. WHO'S FILLING OUT
AN APPLICATION OF THAT LENGTH
IS GOING TO BE QUITE TIRED BY
THAT TIME AS HE OFTEN POINTS
OUT TO US AND SO EVEN STEPPING
BACK AND THINKING ABOUT WHERE-
WE'RE ASKING CERTAIN QUESTIONS.
ON THE APPLICATION OF THOSE ARE
HARDER CHANGES TO MAKE AS WE
ALL KNOW BECAUSE OF THE SYSTEM
IMPACTS AND VARIOUS PIECES THAT
WILL REQUIRE CMS APPROVAL BUT I
THINK WHAT- I'M TRYING TO SAY
IS THAT WE'RE LOOKING ACROSS
THE BOARD IN REGARDS TO HOW WE
CAN ADDRESS THIS. NOT JUST HOW
WE GET THE UPDATED INFORMATION
FOR BENEFICIARIES IF THEY DON'T
PROVIDED UPON APPLICATION-
ORBIT CHANGES- IN HER SAID
CONTACT INFORMATION ABOUT
REALLY HOW WE CAN. ALSO LOOK AT
OUR MEDIC CALIFORNIA EACH AND
IN WAYS THAT OR STREAMLINED
APPLICATION OF WAYS OF REALLY
GETTING BETTER INFORMATION-
FROM THE BEGINNING. THANK YOU
VERY MUCH FOR THAT I WOULD. NOW
TAKE A MOMENT TO THANK THE
ENTIRE PANEL SEVEN AS WE MOVE
ON TO ISSUE EIGHT. AND WILL NOW
PASS IT OVER TO DR WHAT. THANK
YOU VERY MUCH DOCTOR ARAMBULA-
THIS IS THE- NEW- THE PANEL ON-
NEW DEBIT CAL BENEFITS- AND PAY
FOR PERFORMANCE SO WITNESSES IN
THIS PANEL WILL BE. A J. C.
COOPER A FAMILIAR FACE TO US
ALL NOW- BEN JOHNSON FROM THE
LA ALWAYS L. A. O.'S OFFICE
DARIA MCGREW SENIOR LEGISLATIVE
ADVOCATE FOR THE CALIFORNIA
DENTAL ASSOCIATION. AND KATIE
ANDREWS SENIOR SENIOR HEALTH
POLICY NOT REACH ASSOCIATE WITH
CHILDREN NOW. SO WE'LL START
WITH YOU I MISS COOPER. THANK
YOU WE DID TRY TO BRING
COLLEAGUES WITH US TODAY WILL
AND I TO. IT UP A LITTLE BIT
TODAY- BUT YES THANK YOU I'M SO
REALLY WITH THIS CALLIN
PROPOSAL WERE REALLY WANTED TO
BUILD ON MANY OF THE SUCCESSES
THAT WE SAW WITHIN THE DENTAL
TRANSFORMATION INITIATIVE OR
WHAT'S KNOWN AS IDTI. DCS IS
VERY COMMITTED- TO IMPROVING
ACCESSIBILITY OF MEDICAL DENTAL
SERVICES AN ORAL HEALTH
OUTCOMES FOR MEDICARE
BENEFICIARIES WELL WE'VE COME.
A LONG WAY WE STILL HAVE A LONG
WAY TO GO IN AND WE ACKNOWLEDGE
THAT I'M IN THE TO MAKE THOSE
IMPROVEMENTS ON THE CALENDAR
PUZZLES WILL ALLOW US TO
IMPLEMENT SOME OF THE EFFECTIVE
ELEMENTS THAT WE IDENTIFIED
WITHIN THE DTI PILOTS. I'M
IMPLIED THEN ACCORDINGLY TO
CHILDREN ADULTS ACROSS THE
ENTIRE STATE OF CALIFORNIA-
WITHOUT THE CALLIE PROPOSAL THE
SERVICES ARE PROVIDED THROUGH
THE DENTAL TRANSFORMATION
INITIATIVE I WOULD HAVE BEEN
SCHEDULED TO CONCLUDE OR WILL
BE SCHEDULED TO CONCLUDE IN
TWENTY TWENTY ONE. ALSO REALLY
LOOKING FORWARD TO
TRANSITIONING THOSE THOSE
PIECES FORWARD. SO THERE ARE.
FOUR MAIN PROPOSALS WITHIN CAL
AIM ON THE DENTAL FRONT-
ESSENTIALLY WE WOULD BE
IMPLEMENTING A STATE PLAN TO
ADD IT CARRIES RISK ASSESSMENT
BUNDLE FOR CHILDREN- THIS WOULD
AND COULD BE BILLED. TWO TO
FOUR TIMES PER YEAR DEPENDING
ON THE RISK LEVEL IT ALSO
INCLUDES LOW MEDIUM AND HIGH
RISK OF VISIT FREQUENCIES AS
WELL AS- NUTRITIONAL
COUNSELING. IN THAT BUNDLE AS
WELL. ARE ALSO PROPOSING A
SILVER DIAMINE FLUORIDE FOR
YOUNG CHILDREN AND SPECIFIED
HIGH RISK IN INSTITUTIONAL
POPULATIONS OF THIS BENEFIT
PROVIDES TWO VISITS PER MEMBER
PER YEAR UP FOR UP TO TEN
TEETH. AND A MAXIMUM OF FOUR
TREATMENTS PER TOOTH- AND THEN
LASTLY WE'RE LOOKING FORWARD TO
AREAS A TO EMPLOYMENT FOR PAPER
PERFORMANCE I'M IN THIS SPACE
THE FIRST ONE REPORTING
INCREASED USE OF PREVENTIVE
SERVICES. REALLY SEEN GREAT
STRIDES IN REGARDS TO THE GT I
WORKED THERE. AND THE SECOND
ONE BOARDING. ESTABLISHING AND
MAINTAINING CON NEW CHARACTER
DENTAL. WITH THE RATE AB. TO
PROVIDER. ON THAT- PROVIDE
CONNIE OF CARE FOR ANNUAL RE-
AND DENTAL EXAMINATIONS FOR TWO
OR MORE YEARS IN A ROW. I'M
REALLY BASED ON DATAFROM THE
DTI EVALUATION- THAT HAS TAKEN
PLACE WE HAVE MADE SIGNIFICANT
PROGRESS IN IMPROVING THE
OVERALL DENTAL HEALTH IN
CHILDREN ARE BY INCREASING THE
PREVENTATIVE SERVICES UTILIZE-
UP FOR BOTH TREATMENT AND EARLY
CHILDHOOD CARIES AND IN
ESTABLISHING DENTAL HOMES. I'M
WITH TWO TO FIVE YEARS OF
CONTINUITY OF CARE. AND THE
PREVENTIVE DENTAL SERVICES
UTILIZATION RATE FOR CHILDREN
AGES ONE THROUGH TWENTY
INCREASED BY A TEN POINT 58%
FROM BASELINE- TO PROGRAM YOUR
FOR SO I'M INCREASES THERE
STILL OF KNOWLEDGE IN WE WANT
TO SEE THOSE NUMBERS BECOME
EVEN HIGHER- AS WE MOVE FORWARD
WITH PROPOSING A STATEWIDE. ED
BENEFITS THROUGH THROUGH
CALLING. ON THE NUMBER OF
PEOPLE SERVICE AND DENTAL
MANAGED CARE PROVIDERS
RENDERING PREVENTIVE DENTAL
SERVICES- TO AT LEAST TEN
CHILDREN AGES ONE THROUGH
TWENTY INCREASED BY 8% FROM
BASELINE. AS WELL AND THERE WAS
A 109% INCREASE IN PREVENTIVE
DENTAL SERVICES FOR CHILDREN
AGES ZERO TO SIX WHO RECEIVED
KERR'S RISK ASSESSMENTS WHEN
COMPARED TO THE CONTROL GROUP.
SO REALLY LOOKING FOR- THOSE
ADMISSION IS TO MOVE FORWARD
AND TAKE CONTINUE. SEEING
GROWTH IN THOSE. THEN LASTLY UP
FROM BAY. HERE TO YOUR FOR BOTH
OF THOSE. INITIAL CAL. AND THE
SUBSEQUENT EXPANSION COUNTIES
THERE HAVE BEEN CONSISTENT
INCREASES IN CON AIR CARE FOR
CHILDREN AGES TWENTY AND UNDER
OF THAT WERE OVER THE
RESPECTIVE YEARS OF THAT
PROGRAM. SO REALLY I DH CS HAS
NOT ESTABLISHED A GOAL- FOR
ADULT UTILIZATION- BUT THIS IS
UNDER CONSIDERATION- HOWEVER IT
SHOULD BE NOTED THAT THERE IS
NOT A NATIONAL BENCHMARK HERE.
FOR US TO REALLY UTILIZE UNDER
US DEPARTMENT OF HEALTH AND
HUMAN SERVICES HEALTHY PEOPLE
INITIATIVES OF TWENTY TWENTY
AND TWENTY THIRTY ON THERE ARE
ESTABLISHED ORAL HEALTH GOALS
ON EVERY TEN YEARS FOR CHILDREN
AND ADULTS WITH THE GOALS
FOCUSED ON CERTAIN AGE GROUPS.
WITH CERTAIN HEALTH ISSUES SUCH
AS DIABETES AND SMOKING THE
QUE- USE OF EMERGENCY ROOM
EXCEPT. UNDER MEDICARE THE
CURRENT AVERAGE ANNUAL DENTAL
VISIT UTILIZATION FOR
INDIVIDUALS OVER THE AGE OF
TWENTY ONE IS ONLY 22% SO WE DO
UNDERSTAND THE QUESTION AND
UNDERSTAND THE NEED TO HAVE A
GOAL FOR DOLE UTILIZATION.
THERE ARE STILL CONDUCTING THAT
RESEARCH AS MENTIONED
PREVIOUSLY. ADDITIONALLY OF AN
INITIAL STEP DH CS- HAS BEEN
ENGAGING IN WILL ENGAGE IN THE
FUTURE WITH THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH-
AND THE STATE DENTAL DIRECTOR
TO LEVERAGE THE USE OF THE
CALIFORNIA ORAL HEALTH PLAN. TO
INFORM WHAT THAT ADULT DENTAL
UTILIZATION GOAL COULD BE- AND
THIS CONCLUDES MY COMMENTS
HAPPY OUT ANSWER ANY QUESTIONS
WHEN THE TIME IS RIGHT. GREAT
THANK YOU VERY MUCH- NEXT WILL
HAVE- BEEN JOHNSON. WITH THE L.
A. L. THANK. I COULD AFTER I'M
JUST A BRIEF OF CALM HERE- JUST
NOTE THAT- YOU KNOW WE DO HAVE
ANY SORT OF CONCERNS THAT- ALL
WITH. REGARD TO THIS PROPOSAL
BUILDS ON- THE DENTAL
TRANSFORMATION INITIATIVE AS
DIRECTOR COOPER- I NOTED- IT IS
WE JUST NOTED IS ONE OF THE-
MORE PROMINENT SORT OF FUNDING
ITEMS WITHIN THAT CALTRAIN
PROPOSAL- COMING IT AT FIFTY
SEVEN MILLION DOLLARS GENERAL
FUND ABOUT TWICE THAT TOTAL
FUNDS. FOR THE FIRST YEAR OF
IMPLEMENTATION DOWN A LITTLE
BIT OVER A HUNDRED MILLION
DOLLARS. THEREAFTER USING USING
GENERAL FUND AND YOU KNOW
ULTIMATELY WE FIND- THE
PROPOSAL TO USE GENERAL FUND
REASONABLE PREVIOUSLY OF DENTAL
TRANSFORMATION INITIATIVE HAD
USED A STRONGER DISTINCT STATE
FARM SOURCE THAT REALLY IS NO
LONGER AVAILABLE SO JUST WANTED
TO. COMMENT THAT THAT WE DO
THINK USING GENERAL FUND HERE
AND PLACE OF THE PRIOR FUND
SOURCE. DOES PROBABLY MAKE
SENSE THANK YOU. GREAT THANK
YOU VERY- MOVING ON TO DARIA MY
GROUP. WITH THE CAL DENTAL.
RIGHT HI- THANK YOU TEARS FOR
INVITING ME TO SPEAK TODAY. IT
IS STRONGLY SUPPORTS THE
OVERALL OBJECTIVES CONTAINED
WITHIN THE COWLING PROPOSAL AND
THE FOCUS ON DELIVERING
INTEGRATED COORDINATED SERVICES
TO MEDICARE BENEFICIARIES. WE
ARE ENORMOUSLY SUPPORTIVE OF
THE PROPOSAL TO MOVE SUCCESSFUL
COMPONENTS. OF THE DTI INTO THE
GENERAL DENTAL PROGRAM. AS
DENNIS OUR MEMBERS BELIEVE THAT
ORAL HEALTH IS INTEGRAL TO
PHYSICAL AND GENERALLY
THROUGHOUT THE PROPOSAL THE
FOCUS ON COMPLEX I NEED
POPULATIONS COULD BENEFIT. FROM
CLOSER PARTNERSHIP AND
COORDINATION WITH DENTAL
PROVIDERS IN ORDER TO ENSURE
THESE PATIENTS ARE SUPPORTED
AND THEIR ORAL HEALTH NEEDS
SUCCESSFULLY ADDRESSED. LOOKING
BACK SIX YEARS PRIOR TO THE DTI
DENTAL PROGRAM WAS IN A VERY
DIFFERENT PLACE. THERE WERE
SEVERAL CRITICAL AUDITS FROM
THE CALIFORNIA STATE AUDITOR
AND LITTLE HOOVER COMMISSION.
PEDIATRIC UTILIZATION WAS ONE
OF THE LOWEST IN THE COUNTRY.
THE ADULT DENTAL BENEFIT
ELIMINATED IN THE GREAT
RECESSION WAS ONLY PARTIALLY
RESTORED AND 10% PROVIDER RATE
REDUCTIONS WERE STILL IN
EFFECT. PROVIDER PARTICIPATION
WAS DISMALLY LOW AND THERE WERE
SIX THERE WAS SIGNIFICANT
DISSATISFACTION WITH BOTH THE
RATES AND IT MINISTRY TO
PROCESS ITS- FAST FORWARD TO
TWENTY TWENTY ONE. AND THE
DENTAL PROGRAM HAS SEEN STEADY
IMPROVEMENT A DEFINITE MOVEMENT
IN THE RIGHT DIRECTION. DURING
THAT TIME PERIOD THE DTI
PROVIDED A CRITICAL SOURCE OF
FUNDING THE FIRST RATE
INCREASES OVER A DECADE AND
KICKED OFF A SERIES OF POSITIVE
CHANGES. THE STATE WAS ABLE TO
REVERSE THE 10% PROVIDER RATE
REDUCTION- THERE WERE. CHANGES
IN THE DEPARTMENT TO IMPROVE
ADMINISTRATIVE BURDENS SUCH AS
PRIOR AUTHORIZATIONS PROVIDER
APPLICATIONS AND PATIENT
OUTREACH. THE PASSAGE OF
PROBLEMS PROPOSITION FIFTY SIX.
ADDED SIGNIFICANT SUPPLEMENTAL
PAYMENTS TO THE GENERATES.
FIFTY SIX FUNDS ALSO CREATED A
BRAND NEW STUDENT LOAN
REPAYMENT PROGRAM FOR NEARLY
GRADUATING DENTISTS TO
ENCOURAGE THEM TO BUILD A
CAREER THAT INCLUDES MEDICAL
PATIENTS. IN THE FIRST TWO
YEARS ALREADY EIGHTY DENTISTS
HAVE RECEIVED AWARDS IN
EXCHANGE FOR A FIVE YEAR
SERVICE COMMITMENT TO MEDICAL
AND MANY MORE THAN THAT HAVE
APPLIED IN THE HOPES OF
RECEIVING SUCH AWARDS. ALL OF
THESE INTERVENTIONS HAVE
COLLECTIVELY CHANGE THE MEDICAL
DENTAL PROGRAM AND IMPROVE THE
ORAL HEALTH OF CALIFORNIANS
AFTER TEN YEARS OF DECLINING
PARTICIPATION NEARLY TWO
THOUSAND DENTISTS HAVE NEWLY
ENROLLED AND THAT'S A 20%
INCREASE FROM WHERE WE WERE
JUST A FEW YEARS AGO. THE
BACKGROUND PAPER ALSO
HIGHLIGHTS AND DIRECTOR COOPER
HIGHLIGHTED SOME OF THE- WANT
TO TAKE OF SUCCESSES SEEN IN
THE DTI PILOTS SO I WON'T GO
ANY FURTHER INTO THOSE NUMBERS.
ADDITIONALLY I'D LIKE TO NOTE
THAT THE PILOT PROGRAMS TESTED
IN THE DTI WERE THE FIRST TIME
THAT OUR DENTAL PROGRAM
IMPLEMENTED PAY FOR PERFORMANCE
INCENTIVE INCENTIVES OTHER
HEALTHCARE PROVIDERS AND
SYSTEMS HAVE BEEN GOING IN THAT
DIRECTION FOR SEVERAL YEAR
SEVERAL YEARS BUT DENTISTRY IS
JUST STARTING ALONG THAT PATH
AND THIS WAS A VERY INNOVATIVE
PART OF THE DTI AND WILL BE
ROLLED INTO THE ACCOUNTING
PROPOSAL. THE DTI HAS RENEWED
THE PROGRAM'S FOCUS ON EARLY
PREVENTIVE TREATMENT ESPECIALLY
FOR A BURNISHED SILVER DIçN
IN FLORIDA AND OTHER LOW COST
INTERVENTIONS THAT WILL REDUCE
THE NEED FOR MORE EXPENSIVE
RESTORATIVE TREATMENT IN THE
FUTURE. HOLDING THESE BENEFITS
INTO THE GENERAL DENTAL PROGRAM
WILL EXPAND ON INITIAL SUCCESS
BILL PERFORMANCE INCENTIVES
INTO THE PROGRAM AND IMPROVE
PREVENTIVE CARE. WE ARE HOWEVER
CONCERNED THAT RECENT ACTION
FROM THE FEDERAL GOVERNMENT.
MENTIONED BY THE L. L. A. O.
WILL CREATE A LAPSE IN FUNDING
AS THE STATE TRANSITIONS TO THE
NEW BENEFIT STRUCTURE UNDER
CALLING HIM AND THAT COULD
DESTABILIZE THE PROGRESS SO
FAR. WE LOOK FORWARD TO WORKING
WITH THE DEPARTMENT TO ADDRESS
THAT GAP. LASTLY WE WOULD LIKE
TO COMMENT ON THE FULL.
PROPOSED THE PROPOSED FULL
INTEGRATION PILOT. WHILE WE ARE
SUPPORTIVE OF TESTING MODELS
FOR MEDICAL DENTAL INTEGRATION
WE WOULD STRONGLY OPPOSE
ALLOWING ANY FUTURE PLANNED. TO
SIMPLY SUBCONTRACTED WILL
BENEFIT OUT TO A SPECIALIZED
PLAN. WE ASK THAT THE THAT THE
FULL EXPANSION OF FULLY
INTEGRATED PLANS NOW TARGETED
FOR JANUARY TWENTY TWENTY SIX
TAKE INTO ACCOUNT THE LESSONS.
AND EXPERIENCE FROM THE
FORTHCOMING HEALTH PLAN OF SAN
MATTEO PILOT. CA HAS BEEN
WORKING IN CLOSE PARTNERSHIP
WITH THE HEALTH MINISTER MATTEO
TO CREATE A TRULY INTEGRATED
DENTAL BENEFITS WITHIN THE
MEDICARE MANAGED CARE PLANS.
AND THAT IS SET TO BEGIN IN
TWENTY TWENTY TWO WE WOULD ASK
THAT THE LEGISLATURE CONSIDER
ADDITIONAL REQUIREMENTS AROUND
THIS PARTICULAR ISSUE AS THE
STATE MOVES FORWARD IN ITS CAL
AND IMPLEMENTATION. THANK YOU.
THANK YOU VERY MUCH- WILL MOVE
ON TO KßT ANDREW A SENIOR.
HEALTH POLICY NOT REACH
ASSOCIATE. ASSOCIATE WITH
CHILDREN NOW. THANK YOU TO
CHERISH DR WHETHER DOCTOR
ARAMBULA AND COMMITTEE MEMBERS
MY NAME IS KATIE AND I AM A
SENIOR HEALTH POLICY ASSOCIATE-
AND OUT REACHES AS THE EXCUSE
ME CHILDREN NOW- CHILDREN NOW
IS A NONPARTISAN WHOLE CHILD
RESEARCH POLICY DEVELOPMENT AND
ADVOCACY ORGANIZATION DEDICATED
TO PROMOTING CHILDREN'S HEALTH
EDUCATION AND WELL BEING IN
CALIFORNIA. I APPRECIATE THE
COMMITTEES JOINTLY HOLDING THIS
IMPORTANT HEARING TODAY AND FOR
THE OPPORTUNITY TO ADDRESS BOTH
COMMITTEES AND SPEAK TO THE
DENTAL COMPONENT OF THE CALLIN
PROPOSAL WITH THE CHILD FOCUS
LANDS. I WOULD ALSO LIKE TO
ACKNOWLEDGE THE HARD WORK AND
EFFORTS OF THE DEPARTMENT OF
HEALTH CARE SERVICES STAFF IN
DEVELOPING THE AMBITIOUS
CALIPERS TOOL. I WILL START
WITH A HIGH LEVEL COMMENTED ON
THE KALYAN PROPOSAL AND WHILE
IT OUTLINES AN INNOVATIVE
RESTRUCTURING OF THE MEDICAL
SYSTEM. IT FAILS TO CLEARLY
CENTER CHILDREN AND YOUTH AND
DOES NOT ARTICULATE HOW THE
STATE WILL ENSURE OVERSIGHT AND
ACCOUNTABILITY FOR PLANTS AND
CONTRACTORS. FOR THE DENTAL
PORTION OF THE CALLIN PROPOSAL
I WOULD FIRST LIKE TO ECHO CTAS
COMMENTS CHILDREN I WAS ALSO
CONCERNED ABOUT THE POTENTIAL
ABSENT BENEFITS AND POVIDER
PAYMENTS ALLOWED FOR UNDER THE
DTI ONE YEAR EXTENSION. PRIOR
TO THE IMPLEMENTATION OF THE
CALLIN DENTAL PROPOSAL IN
JANUARY TWENTY TWO TWENTY
TWENTY TWO. AND DUE TO CMS'S
SUNSETTING OF THE SPENDING
AUTHORITY THROUGH THE STATE'S
DESIGNATED STATE HEALTH
PROGRAMS. WE STRONGLY RECOMMEND
THE DEPARTMENT EXPLORE DRESSING
THIS GAP IN FUNDING VIA THE MAY
REVISE PROCESS AND BY BEGINNING
THE CALLIN DENTAL PROPOSAL
PRIOR TO THE PROPOSED DATE OF
JANUARY TWENTY TWENTY TWO. TO
AVOID DISRUPTION IN BENEFITS
AND PROVIDER PAYMENTS. SECOND
WE HAVE SOME CONCERN AROUND
MAINTAINING THE INVESTMENTS IN
KIDS ORAL HEALTH THAT WERE SEEN
THROUGH DTI WHILE EXPANDING
THESE BENEFITS THE ADULT
POPULATION WELL WE ARE
SUPPORTED WITH THE EXPANSION TO
ADULTS. WE WOULD CAUTION THE
DEPARTMENT IN DOING SO IF IT IS
AT ALL AT THE EXPENSE OF GAINS
MADE IN IMPROVING ACCESS TO
ORAL HEALTH CARE AND- THE ORAL
HEALTH STATUS OF CHILDREN IN
THE STATE. I WOULD ALSO LIKE TO
NOTE THE IMPORTANT ROLE OF CARE
COORDINATION WHILE IT IS
GUARANTEED THROUGH EPS DTA THE
STATUS FAILED TO ADEQUATELY
ENSURE THAT PLANS ARE
COORDINATING CHILDREN'S
PREVENTATIVE DENTAL CARE AND
AIDING IN ESTABLISHING A DENTAL
HOME. WE BELIEVE THAT CARE
COORDINATION IS ESSENTIAL TO
IMPROVING ACCESS TO CARE
ALTHOUGH AT THE LOCAL DENTAL
PILOT PROJECTS FUNDED THROUGH
DOMAIN FOR THE DTI DID NOT
CONTINUE. UNDER THE ONE YEAR
EXTENSION THERE'S PLENTY TO BE
GLEANED FROM THE CARE
COORDINATION STRATEGIES TESTED
THROUGH THESE PILOTS. IN A
BRIEF THAT CHILDREN ARE
PRODUCED IN NOVEMBER OF LAST
YEAR WE LOOKED AT THE CARE
COORDINATION EFFORTS ACROSS THE
LOCAL DENTAL PILOT PROJECTS AND
WHAT SURFACED FROM THAT
ANALYSIS. IS THAT ROBUST
COMMUNITY BASED CARE
COORDINATION DONE BY COMMUNITY
ROOTED AND TRUSTED SOURCES WAS
NOT ONLY EFFECTIVE IN
CONNECTING CHILDREN AND THEIR
FAMILIES TO DENTAL CARE. BUT
ALSO IMPROVED IN IMPROVING
PROVIDER SATISFACTION WITH THE
MEDICAL PROGRAM. WE BELIEVE
THAT THE POPULATION HEALTH
MANAGEMENT AND ENHANCE CARE
MANAGEMENT PROGRAMS WITHIN THE
KELLY PROPOSAL PROVIDE
OPPORTUNITIES TO COURSE CORRECT
IN ESTABLISH THESE ROBUST
COMMUNITY BASED COORDINATION
NETWORKS UP AND DOWN THE STATE.
ADDITIONALLY THE PROPOSED
POPULATION HEALTH MANAGEMENT
PROGRAM STATES THAT IT WILL
COORDINATE CARE ACROSS THE
CONTINUUM OF MEDIC MEDICAL
BEHAVIORAL HEALTH DEVELOPMENTAL
ORAL HEALTH. AND LONG TERM
SERVICES AND SUPPORTS INCLUDING
TRACKING REFERRALS AND OUTCOMES
OF REFERRALS WELL WE APPLIED
THE DEPARTMENT'S EFFORTS TO
ENSURE CARE IS COORDINATED
ACROSS DIFFERENT SERVICES AND
SUPPORTS. IT REMAINS UNCLEAR
WHAT THE MECHANISM IS FOR
COORDINATING CARE PARTICULARLY
ORAL HEALTH CARE ACROSS THE
DIFFERENT ENTITIES RESPONSIBLE
FOR DELIVERING THAT CARE. AND
HOW IT WILL E TRACKED AND
MEASURED. WE RECOMMEND THAT THE
DEPARTMENT ENSURE THAT
CONTRACTS RESULTING FROM THE
MANAGED CARE AND DENTAL
ADMINISTRATIVE SERVICES
ORGANIZATION PROCUREMENT
PROCESS THESE INCLUDE
REQUIREMENTS FOR THE PLANS AND
DENTAL SO TO USE A COMMON
SYSTEM TO TRACK REFERRALS THE
OUTCOME OF THOSE REFERRALS AND
RELATED CARE COORDINATION
ACTIVITIES. ADDITIONALLY
THROUGH THE MANAGED CARE AND
DENTAL SO CONTRACTS REQUIRE
PERIODIC REPORTING OF METRICS
SPECIFIC TO REFERRALS REFERRAL
TRACKING AND REFERRAL OUTCOMES
FOR SERVICES REQUIRED UNDER THE
E. P. S. D. T. MANDATE. LASTLY
THE CALIBER POSTAL ADDS NEW
LEVELS OF AND CRITERIA FOR CARE
COORDINATION BUT LACKS
SPECIFICITY ABOUT HOW CHILDREN
WILL BE INCORPORATED INTO
MONITORED IN AND SERVED BY THE
NEW ENHANCE CARE MANAGEMENT
BENEFIT WE RECOMMEND THAT IS
PART OF THE ENHANCED CARE
MANAGEMENT BENEFIT PROPOSAL.
THE DEPARTMENT REQUIRE MANAGED
CARE PLANS IDENTIFY CHILDREN
FOR ENHANCE CARE MANAGEMENT WHO
ARE DEEMED HIGH RISK VIA IT
CARRIES RISK ASSESSMENT
EMBEDDED WITH IN AND NATIONAL
HEALTH ASSESSMENTS REQUIRED OF
PLANS. AGAIN THANK YOU TO BOTH
COMMITTEES FOR PROVIDING THIS
OPPORTUNITY AND THAT CONCLUDES
MY COMMENTS THANK YOU. THANK
YOU VERY MUCH APPRECIATE THAT
BRING IT BACK TO THE COMMITTEE
ANY QUESTIONS AFTER AMBULANCE
OKAY I HAVE A I HAVE A COUPLE
QUESTIONS- AND THAT. ACTUALLY
GOES BACK TO THE
ADMINISTRATION- AND THAT'S- I
RECOGNIZE THAT- WE DON'T WE
DON'T YOU YOU SAID- MISS COOPER
THAT WE'RE NOT SETTING A GOAL
FOR ADULT YOU TO THE
UTILIZATION OF DATA CAO. BUT DO
WE HAVE DATA ON CURRENTLY ON
UTILIZATION DATA CAL VERSUS
WHAT'S GOING ON IN OTHER
STATES- AND IF WE DO- WOULD
THAT NOT BE IMPORTANT TO USE
THAT AS A GUIDING- AS GUIDING
DATA TO- MAKING IMPROVEMENTS
SELF. SO I DON'T KNOW OFF HAND
WHETHER WE HAVE DONE THE
COMPARISON OF THE UTILIZATION
CALIFORNIA DIRECTLY TO OTHER
STATES I WOULD IMAGINE THE TEAM
HAS LOOKED AT THAT BUT WE CAN
DEFINITELY TAKE THAT BACK AS
WORK I'M LOOKING AT WHAT GOAL
WE COULD SET IN THE ADULT
POPULATION LET ME JUST PAUSE
AND SEE WHERE NAY- MAILLOUX WHO
ARE A DEPUTY DIRECTOR OF
ELIGIBILITY AND BENEFITS AND
OVERSEES OUR DENTAL- SHE MAY
HAVE ADDITIONAL INFORMATION IN
REGARDS TO- INFORMATION HAPPEN
OTHER STATES. YES HI OF RENE
MALL- THANK YOU COMMITTEE
MEMBERS FOR THE OPPORTUNITY TO
SPEAK TODAY- IN TERMS OF
LOOKING AT ADULT DENTAL
SERVICES WE DON'T HAVE MUCH.
I'M IN THAT SPACE BECAUSE IT IS
AN OPTIONAL BENEFIT. I'M AND
NOT MANY STATE MEDICAID
PROGRAMS TO COVER AND DENTAL
SERVICES. SO IT'S NOT SOMETHING
THAT WE HAVE THAT'S READILY
AVAILABLE TO US BUT WE CAN GO
BACK TO SEE IF THERE ARE SOME-
INFORMATION THAT CAN HELP TO
INFORM ADULT DENTAL
UTILIZATION. OKAY WELL THANK
YOU. I GUESS I GUESS THE- THE
OTHER QUESTION THAT THAT CAME
UP ACTUALLY FROM I THINK IT WAS
FROM OUR LAST WITNESS WAS. THE
CONCERN ABOUT A LAPSE IN- IN IT
OUT ONCE. IT ONCE WE MAKE THE
TRANSITION THAT THERE MIGHT BE
A LAPSE AND- AND YOU KNOW AS AS
SOMEONE WHO'S BEEN A PROVIDER.
OF THE PROGRAM- ALTHOUGH IT'S
ALBEIT IT'S BEEN A IT'S BEEN A
WHILE NOW- YOU KNOW ONCE YOU
LOSE YOU THE PROVIDER NETWORK
IS FRAGILE- BECAUSE- IT. IS
ABOVE ALL HAS BEEN FRAGILE
BECAUSE OF A LOT OF THE
UNPREDICTABILITY SO. ONCE YOU
LOSE A PROVIDER- IT'S HARD TO
GET HIM BACK SO WHAT IS THE
ADMINISTRATION'S PLAN TO HELP
WITH A LAP SO THAT WE ENSURE
THAT. THAT PAYMENTS- DON'T THAT
THAT THAT THERE ISN'T A
DISRUPTION THAT POTENTIALLY.
SETS US BACK ON OUR PROVIDER
NETWORKS. FOR SO AS SOON AS THE
ABOUT AS AT ALTERNATELY DENIED
THE DISH BE WHICH WERE QUITE
FUNNY DTI WE QUICK- ROUNDED
INTERNALLY TO FIGURE OUT WHAT
WHAT OUR NEXT STEPS COULD BE IN
REGARDS TO OF THE ROLL OVER
FUNDS HOW LONG THAT COULD LAST
AS AS WELL AS SYSTEM CHANGES TO
QUICKLY PIVOT I'M SORT
CURRENTLY LOOKING AT THAT RIGHT
NOW WE DO THINK IT ANTICIPATE
THAT THE DISPUTE FUNDS THAT WE
CAN USE THROUGH THE ROLL OVER
AND WHAT WAS AUTHORIZED UPPER
GI CAN GET US THROUGH JUNE OF
THIS YEAR- AND SO WE ARE A
LOOKING AT THAT AND WOULD
IMAGINE THERE WOULD BE AN
UPDATE FROM THE DEPARTMENT
REGARD SO WHAT WE'RE PROPOSING
WITHIN THE MAYBE FIVE. OKAY
THANK YOU APPRECIATE THAT AND
JUSTICE THANK YOU TO THIS
ENTIRE PANEL FOR THE
INFORMATION- MUCH APPRECIATED
SUBJECT ACTUALLY KNOW SOMETHING
MORE ABOUT THAN THAT SOME OF
THE OTHERS- BUT WE'RE ALL
LEARNING WITH A LOT OF
INFORMATION HERE SO THANK YOU
VERY MUCH. WE'RE GOING TO MOVE
ON TO OUR OUR NINTH AND FINAL
PANEL BEFORE WE GO TO PUBLIC
COMMENT ON THIS IS REGARDING
THE EXTENSION OF HOSPITAL
QUALITY IMPROVEMENT PROGRAM TO
DISTRICT HOSPITALS AND
EXTENSION OF THE GOAL THE
GLOBAL- PAYMENT PROGRAM SIR
WITNESSES TODAY WE'RE GOING TO
BE LINDY HERRINGTON THE DEPUTY
DIRECTOR HEALTH CARE FINANCING
FROM THE PARTMINER HEALTHCARE
SERVICES SERRA HALF CUT HESKETH
OF SENIOR VICE PRESIDENT
EXTERNAL AFFAIRS FOR THE
CALIFORNIA ASSOCIATION OF
PUBLIC HOSPITALS AND HEALTH
SYSTEMS. AND SHARON ELAINE
SENIOR VICE PRESIDENT FINANCE
POLICY DISTRICT HOSPITAL.
LEADERSHIP FORUM SO. MISS
POLICE. GO AHEAD HELLO YES OKAY
GREAT- GLOBAL PAYMENT PROGRAM
OR IF THEY CALL IT. PILOT
PROGRAMS INCLUDED IN CALIFORNIA
TWENTY THREE DEMONSTRATION
WAIVER AND HE ESTABLISHED A
STATEWIDE FUNDING FOR
CALIFORNIA WILL NEED TO WORK I
PROVIDING A POTENT. FEDERAL HIT
SHARE HOSPITAL LAST NIGHT WITH
AVAILABLE THE- FUNDING NOTING
CALIFORNIA THE FOOL I UNDER THE
UCBCP. PUBLIC HEALTH CARE
REPEAT. BETTER TO HELP YOU WE
DO NEED TO ABOUT CAN BE QUITE I
IT QUITE SERVICES. HE PROPOSED
KICKED THE GLOBAL PROGRAM UNDER
KELLY YOU'LL OF THE MEDIKAL AND
SECOND. IMAGE TWENTY GBP OKAY.
WORKING OF THE-
DISPROPORTIONATE SHARE I'M
POCKET ADDITIONALLY INTEL TO
CONTAIN COME CAN YEAH THINKING
FOR AND WORKING WITH PUBLIC
ROCK ON IT IF YOU KNOW I COULD
SOME COOL FOR A IF THE VERY
WELL WHICH SAID. IN MY GDP
ABOUT WHICH WAS ME IN TWENTY
EIGHTEEN BRAND SAYING FOUND
THAT THE PEOPLE BEEN SUCCESSFUL
THAT THE OBJECT MORE EIGHT HOW.
WITH THE I MEAN SURE INCLUDING
A INFRASTRUCTURE. TOWARD HIGHER
CARE IN. THE MEAN FOR AND
PROGRESS WILL LET THE PUBLIC
NURSES I'M. THE PROGRAM OCTOBER
YOU A KEY. PUBLIC HOSPITALS
REDUCE IS EXPECTED TO COME
PROGRAM A FULL PRICE. AT A LOT
OF ONE TWENTY TWENTY ALLEN
CRYING WITHIN. PARASITOLOGY
THANK THEIR PROGRAM. A HOSPITAL
TO CONTINUE QUALITY IMPROVEMENT
EFFORTS GOD I KNOW CRIED I
COULD ACTUALLY. DR GRIFFITH
OKAY OKAY FOR VALUE BASED CARE
FROM BY BASED CARE IN AFTER TO
CARE BY THANK YOU BYE. IT
HOSPITAL BAND CONTRACTING A
COLLABORATIVE. AND COLLABORATE
MAY OUR MEDICARE AND IT WILL
REDUCE EIGHT SEVEN ACROSS
SYSTEMS I THINK I'M LYING OF
ALL AT. INVOLVING A REMIND ALL
MEASURE WITH THOSE WITH. I HAVE
BEEN. ARAMBULA HEALTHCARE
PRACTITIONERS INCOMING THAT
MATTER FOR AND OTHER NON DATE
AND DOOR MEASURE. THESE
MEASURES ONLINE WITH WITHOUT
THE- I AM CALLING FIFTY. AT OUT
ABOUT. FIFTY MANAGED CARE PLAN
GOAL THE NEW MEASURE PLEASE
REFER THE PRIORITIES CAL A AND
HOPE AND THE QUALITY OF CARE
THAT BENEFITS IS THAT. EIGHT
YOU FOR THE OPPORTUNITY PROVIDE.
THANK AN INCLUDE ALL OF THAT
COUNTY OWNED AND OPERATED AND
AFFILIATED AS WELL AS THE FIVE
UNIVERSITY OF CALIFORNIA
MEDICAL CENTERS. TOGETHER THEY
CRIED HIGH QUALITY PRIMARY
SPECIALTY INPATIENT TRAUMA. IN
REHAB SERVICES TO JUST ON THREE
PATIENTS EVERY YEAR THE
MAJORITY WHO OF WHO ARE YOU
THERE BY OUT UNDENGE. OR
INSURED SUPPORT OF STATE
PROPOSAL TO THE CAME PROGRAM.
AS WELL AS UALITY FOR BOTH OF
THE PROGRAMS ARE INTEGRAL TO
OUR AT TO CARE QUALITY IN OUR-
PERSONAL ME START WITH THE GO
TEAM PROGRAM. THIS IS AN EFFORT
AS ONE MENTIONED THIS TAYLOR TO
PROVIDE MORE CA. SERVICES TO
OUR ON PATIENTS PROGRAMS ARE IN
TWO AND FIFTEEN EMERGE TO.
FEDERAL FUND SOURCES THAT ARE
ARE TO PROVIDE CARE TO BE UNDER.
UNDER THE NEW STRUCTURE SYSTEMS
WERE KIND OF TO EXPAND. PRIMARY
NOW PATIENTS AND THEN THAT NOT.
CARE INCLUDES MOBILE NURSES
THAT OUTREACH FROM COMMUNITY
HEALTH. ARRESTED INTO FORTH. AT
MENTION IN THE MOST RECENT OF
THE BILL PAYMENT ARE. REPORTER
REALLY NOW ARE IN OUT- YOU
OUTPATIENT- AND DECREASING
INPATIENT AND NUMBER ROOM. A
FORTY TWO PER AND IN THE USE OF
NON SERVICES AND OVERALL SIX
PER INCREASE IN THE TOTAL OF
UNDER PAY THAT WERE SO OVER THE
FIRST YEARS AT THE PROGRAM. WE
VERY MUCH LOOK FORWARD CONTINUE
WITH THE- AROUND HOW CONSTRAIN
AND X. ON OUR PART. THE LAST
YOU BUT THE GLOBAL A GRAM. AND
NOW LET ME SHARE A LITTLE ON
THE QUALITY. PROGRAM Q. ID. AND
EFFORT THAT SPOKEN ON IMPROVING
IN HELP OUT FOR ABOUT CAL POLY.
THE PROGRAM STARTED IN TWENTY.
AND PREVIOUS. FUNDING WE HAVE
RECEIVED OUR MEDIC PRO AND MADE
IT CLEAR BY. FOR THE LAST YEAR
WE'VE BEEN WORKING WITH THE
DEPARTMENT AND OUR DISTRICT
HOSPITAL COLLEAGUES TO EXPAND
AND STRENGTHEN THIS EFFORT BY
MERGING THE QUALITY. IN KIND OF
PROI AM WITH WITH THE PAIN
PROGRAM THAT TAKES THAT WHEN
THE OUTLOOK. SOME OF THE KEY
FEATURE OF THE- OF. PRO OUR
CALL CENTER PROGRAM INCLUDE. A
MIGHT HELP PLANS ALL OF THE
QUAL PLAN MEASURES. THAT
REQUIRED PER. FROM HEALTH PLAN
ARE THE- OR IN. A THAT ARE.
ACCEPTED THERE'S MEASURES NOT
LIKE FOR THE- TO. ALL OF THE
FUNDING IS PERFORM BASED SYSTEM
DAMAGE THAT THEIR- ON A PART.
MATTER IN OR TO EARN FINE.
FUNDING FOR NEXT IN BASED ON.
YEAR THE CHEAPER. ASSISTANT TO
MAINTAIN PRIOR IMPROVE MY AND
ON THE OVER TO IN ORDER TO EARN.
FEDERAL DOLLARS. THERE'S ALSO
CONTINUE FOCUS ON EQUITY.
PUBLIC HOSPITALS ARE. TO WORK
ON. FOR COULD FOR. AMERICANS
AND LAST NOT POP. THIS YEAR AND
CAN I CHOOSE TO WORK ON
ADDITION ACCORDING. FURTHER
THEY ARE ON REPORTING. REYES
NAY NECESSITY DATA ON A NUMBER
OF MEASURES AND WE EXPECTED
THAT YOU CAN. AND TO EXPAND
OVER TIME WE CAN. I A
DISPARITIES AND DEVELOP ACTIONS
TOOK THEM. ASIAN POPULATION. IT
MEANS THAT SOME OF OUR MEDIC
HEALTH FUNDING IS NOW BASED ON
IMPROVING DIABETES CONTROL
CONTROLLING BLOOD PRESSURE
THANK YOU SIR PAYMENT PATIENTS
ARE GETTING THEIR SCHEDULED
MAMMOGRAMS BREAST CANCER
CERVICAL CANCER SCREENING.
REDUCING READMISSIONS IMPROVING
PRENATAL AND POSTPARTUM CARE
SCREENING FOR DEPRESSION AND
MANY OTHERS I REALLY WANT TO
THANK THE DEPARTMENT FOR THEIR
LEADERSHIP IN THIS WORK AND
REALLY LOOK FORWARD TO
CONTINUING ON WITH A SEPARATE
THANK YOU. GREAT THANK YOU VERY
MUCH AND WE'LL MOVE ON TO OUR
OUR FINAL WITNESS OF OUR FINAL
PANEL HERE TODAY. CHARETTE
ALAIN'S. GOOD AFTERNOON THANK
YOU FOR ALLOWING ME TO BE HERE
TODAY I AM WITH THE DISTRICT
HOSPITAL LEADERSHIP FORUM AND
WE REPRESENT THE THIRTY THREE
DISTRICT AND MUNICIPAL
HOSPITALS THROUGHOUT
CALIFORNIA. THIS IS A DIVERSE
GROUP OF HOSPITALS- TWO THIRDS
ARE AND RURAL CALIFORNIA MORE
THAN HALF OF A CRITICAL ACCESS
HOSPITAL DESIGNATION WHICH
MEANS THEY ARE THE SMALLEST AND
MOST REMOTE. THE ADDITIONAL OUR
DISTRICT HOSPITALS ARE MEDIUM
TO LARGE SOME VERY LARGE AND
ARE LOCATED IN SUBURBAN AND
URBAN AREAS THROUGHOUT
CALIFORNIA. ALL PROVIDE AS ALL
HOSPITALS DO NEEDED HOSPITAL
AND HEALTH SERVICES BASED ON
THE COMMUNITY'S NEEDS AS HAS
BEEN NOTED BETWEEN TWO THOUSAND
AND FIFTEEN AND TWO THOUSAND
AND TWENTY THESE HOSPITAL
SUCCESSFULLY PARTICIPATED IN
THE OUR PRIME PROGRAM AND ARE
PLEASED TO BE ABLE TO CONTINUE
THE WORK BEGAN. OUT AS AN ALSO
NOTED QUALITY IMPROVEMENT
EFFORTS PROMOTING VALUE BASED.
PURCHASING AND IMPROVING CARE
PROVIDED TO PATIENTS AND
COMMUNITIES BY TRANSITIONING TO
THE Q. I. P. PROGRAM ORANGE
STRONG SUPPORT OF THIS PROPOSAL
AS OUTLINED IN IN CALAIS. THE
INCENTIVE FUNDING- TIED TO THE
SUCCESSFUL OUTCOMES OR METRICS
AS THEIR A MENTION WILL ALLOW
THE DISTRICT HOSPITALS TO
CONTINUE TO FOCUS THEIR EFFORTS
ON THE GOLDEN AND PRIORITIES OF
KALANK WHICH OBVIOUSLY IN TURN
BENEFIT. THE COMMUNITIES AND
THE PATIENTS SERVED. THE TYPES
OF PRIDE THAT BEGUN IN FOR TO
PRY WAS THE FIRST DELIVERY
TRANSFORMATION PROGRAM FOR THE
DISTRICT MUNICIPAL HOSPITALS US
SO SOME EXAMPLES OF THE WORK
THAT WAS DONE. WAS A BRINGING
SERVICES TO COMMUNITIES THAT
DIDN'T EXIST BEFORE FOR EXAMPLE
EASTERN PLUMAS HEALTH CARE IN
PORTOLA CALIFORNIA WAS ABLE
ABLE TO PUT IN PLACE A BRAND
NEW BEHAVIORAL HEALTH PROGRAM
IN COORDINATION WITH THEIR
COUNTY. OF THAT MEANS THE
PATIENTS NO LONGER HAVE TO
DRIVE SIXTY MILES JR RECEIVE
SERVICES ARE SIMILARLY LOMPOC
VALLEY MEDICAL CENTER IN OUR
WORLD SANTA BARBARA COUNTY WAS
ABLE TO PARTNER AND BRING
ONCOLOGY AND OTHER SERVICES.
AGAIN ALLOWING PATIENTS TO
RECEIVE SERVICES CLOSE TO HOME-
OTHER HOSPITALS REPORT. AND YOU
KNOW SAVING LIVES BASED ON
CANCER SCREENINGS ARE SOUTHERN
HUMBOLDT HEALTHCARE DISTRICT
WAS ABLE TO ACTUALLY LEVERAGE
THE WORK THAT THEY WERE DOING
IN PRIME ON HEART DISEASE M.
WHEN THE PANDEMIC STROKE WERE
ABLE TO- BECAUSE THEY HAD IN
PLACE A GOOD SYSTEM FOR
COORDINATING CARE. AND
COMMUNICATING WITH OUR PATIENTS
THEY WERE ABLE TO USE THAT AND-
WORK WITH THE WORK WITH THE
INDIVIDUALS WHO MIGHT HAVE
NEEDS. BEYOND HEALTHCARE NEEDS
ARE GROCERY NEEDS ARE EXERCISE
NEEDS AT CETERA. FOR THE
INDIVIDUALS AND THEIR
COMMUNITIES. ALL DESTROY OUT IN
UNISON HAAS SIXTY SICK.
IMPROVEMENTS SIMILAR TO THESE
ARE FEW EXAMPLES THAT I HAVE
CITED AND THESE ARE THERE ARE
EAGER TO CONTINUE THE WORK AND
EXPAND UPON IT AS PART OF Q. I.
P. AND WORKING WITH T. H. C. S.
THE PROPOSED Q. I. P. FOR
DISTRICT HOSPITALS HAS BEEN
SCALED. AND OTHERWISE ADJUSTED
TAKING INTO ACCOUNT THE
UNIQUENESS AND THE DIFFERENT OF
UNIQUENESS OF DISTRICT
HOSPITALS AND SOME OF THE
DIFFERENCES BETWEEN OUR COUNTY
AND YOU SEE COLLEAGUES. AS YOU
CAN IMAGINE- COVE IT HAS
SIGNIFICANTLY IMPACTED THESE
HOSPITALS AND TEMPORARILY
DEVOTED HAD DIVERTED. QUALITY
EFFORTS BUT ALL ARE EAGER TO
GET BACK ON J. Q. I. P. BASED
ON A METRIC PLANNING AT DATA
RESEARCH ETCETERA. THE ONE
DOWNSIDE FOR DISTRICT HOSPITALS
TRANSITIONING BETWEEN THESE TWO
PROGRAMS IS A SIGNIFICANT CASH
FLOW DELAY OUR PRIME- WAS MORE
IN A FEW FOR SERVICE CONSTRUCT
Q. . P. AS NOTED AS PART OF
THE MEDICARE MANAGED CARE
DIRECTED PAYMENTS AND- BECAUSE
OF THIS THIS MEANS THAT THERE
WILL NOT BE ANY FUNDING
RECEIVED. IN CALENDAR YEAR
TWENTY TWENTY ONE OR TWENTY TWO
FOR THESE HOSPITALS FOR THIS
PROGRAM AND IF THEY HAD BEEN
ABLE TO CONTINUE AND PRIME THEY
WOULD HAVE RECEIVED ALPHONSE.
LIKE I SAID- BECAUSE OF KOBE
CASH FLOW IS DEFINITELY AT A
PREMIUM SO THIS IS DEFINITELY A
CHALLENGE WE'VE BEEN WORKING
WITH A NUMBER OF YOU TO
MITIGATE. THAT CASH FLOW VIA
SOME SHORT TERM LOANS ARE
PROVIDED IN CALENDAR YEAR
TWENTY ONE AND TWENTY TWO-
BEYOND THAT THOUGH LIKE I SAID
PROGRAMMATIC LEE THESE
HOSPITALS ARE VERY EAGER TO
CONTINUE BUILDING UPON THE
SUCCESSES. TO FURTHER BENEFIT
THE MEMBERS OF THEIR
COMMUNITIES AND WE LOOK FORWARD
TO CONTINUING OUR WORK WITH DH
CS ON THIS AND OTHER IMPORTANT
PROGRAMS. THANK YOU. THANK YOU
VERY MUCH- WILL MOVE TO
QUESTIONS NOW DOCTOR EVERYBODY
QUESTIONS. AND ACTUALLY AND I
DON'T HAVE ANY QUESTIONS EITHER
I JUST WANNA SAY THANK YOU VERY
MUCH TO THE PANELISTS FOR THE
INFORMATION AND- VERY MUCH
APPRECIATE THAT- BEFORE WE GO
TO OUR FINAL PART OF THIS
PROGRAM HERE TODAY OR THE OF
THE MEETING HERE TODAY. WHICH
IS PUBLIC COMMENT I'D LIKE TO
TAKE THE TIME TO THANK
DIRECTOR- LIGHT BORN. AND
DEPUTY DIRECTOR COOPER AND
THEIR STAFFS- FOR THE HOURS
DAYS MONTHS NOW YEARS. HE SPENT
ON THIS PROPOSAL AND THE
PROPOSAL- THE POTENTIAL THIS
PROPOSAL HAS FOR IMPROVING CARE
FOR MEDICARE BENEFICIARIES AND
THAT'S THE BOTTOM LINE AND FOR
THAT WE ARE GREATLY
APPRECIATIVE. A DEPUTY DIRECTOR
COOPER HAS A IMPRESSIVE
COMMANDED THE DETAILS AND SPENT
OVER TEN HOURS BEFORE US- SO I
WANT TO THANK THANK AND
ACKNOWLEDGE HER AND THANK HER
FOR HER TIME- WILL WE NOW GO TO
THE NEXT STEP AND DEBATING THE
LANGUAGE AND BUDGET PROPOSALS
THROUGH OUR PROCESS. WITH A
BETTER UNDERSTANDING AND WE HAD
A MONTH AGO. AND I JUST WANT TO
ALSO. DO A SHOUT OUT TO MY
STAFF PARTICULARLY- OUR
CONSULTANTS GOT DANE WHO HAS
SPENT. A HUGE AMOUNT OF TIME ON
THIS- AND- HELPED US PROCESS
TOGETHER- BECAUSE OF THE-
INCREDIBLE NATURE OF THIS
PROPOSAL- WE THOUGHT THAT WAS
REALLY IMPORTANT THAT WE HAVE
HEARINGS ON THIS AND GIVE.
STAKEHOLDERS AN OPPORTUNITY TO
EDUCATE US AND ALSO BRING UP
SOME OF THEIR CONCERNS SO- BIG
THANKS TO MY STAFF. AND AND I
THINK THAT I WOULD LIKE TURN
OVER TO THE DOCTOR REGULAR
BEFORE BEFORE WE GO TO PUBLIC
COMMENT. WELL IT SEEMS
APPROPRIATE SINCE WE MISSED MY
OPENING COMMENTS TO. SAY THAT
MY- OPENING COMMENTS WERE ALSO
TO THANK MY STAFF AS- WELL AS
THE BUDGET SUB COMMITTEE STAFF
AND- MARGOLIS IT IS. INCREDIBLY
IMPORTANT FOR US TO WORK ON
THIS- FOUNDATIONAL AND
TRANSFORMATIVE CHANGE I. AGREED
EARLIER WITH THE DOCTOR WHO HAD
COMMENTED ABOUT THE SCOPE OF
THIS WORK AND- REALLY DO
APPRECIATE- BEING ABLE TO COACH
SHARE THESE WITH YOU DOCTOR
WOULD- HAVE APPRECIATED BEING
EDUCATED AND MORE INFORMED
ABOUT KILLINGS WERE. WITH THAT
I'D- LIKE US NOW TO BEGIN
PUBLIC COMMENT AND HOPE THAT
YOU CAN GIVE US. OPTIONS THANK
YOU FOR MUCH SO WE WILL GO TO
PUBLIC COMMENT- WE'LL OPEN THE
LINES TO PUBLIC COMMENT I
REPEAT THE CALL IN NUMBER FOR
PUBLIC COMMENT. FOR THIS
HEARING WHICH IS EIGHT SEVEN
SEVEN. SIX NINE TWO. EIGHT NINE
FIVE SEVEN IN THE ACCESS CODE
IS ONE THREE ONE. FIVE FOUR TWO
ZERO TWO. READ THAT AGAIN.
EIGHT SEVEN SEVEN SIX NINE TWO
EIGHT NINE FIVE SEVEN. AND THE
ACCESS CODE IS ONE THREE ONE.
FIVE FOUR TWO. ZERO TWO WITH
THAT- WE ASK THAT MEMBERS OF
PUBLIC KEEP THEIR COMMENTS TO
TWO MINUTES IF PLEASE- AND
OPERATOR OF. THE OPEN THE LINE
IS THERE ANYONE WHO BY TO GET
PUBLIC COMMENT. THANK YOU FOR
THOSE CONNECTED TO THE PHONE IF
YOU'D LIKE TO GIVE. PUBLIC
COMMENT ME PRESS ONE THEN ZERO
ON YOUR TELEPHONE KEYPAD AGAIN
THAT COMMANDERS ONE FOLLOWED BY
ZERO. WE'LL FIRST TO LINE
SEVENTEEN ONE SEVEN YOUR LINE
IS OPEN. KELLY BEING WITH
HEALTH NET AND CALIFORNIA
HEALTH AND WELLNESS WITH THIRTY
ONE COUNTY AND OVER TWO MILLION
MEDICAL MEMBERS HELP NOT IN
CALIFORNIA HELP WHILE THEY ARE
UNDERTAKING COUNSELING
INITIATIVES ON THE LARGER SCALE
OF ALL MEDICARE PLANS. WE ARE
DEEPLY INVESTED IN THE GOLD OF
CALLIN AND YOUR PARTNERSHIP
WITH THE DEPARTMENT AND OUR
COMMUNITY IT'S CRITICAL TO OUR
SHARED THINK THAT. WE LOOK
FORWARD TO REALIZING PROMISE OF
CALLIE VERY AMBITIOUS GOALS.
AND THE IMPACT WILL MAKE IN THE
LIVES OF THE MOST VULNERABLE
MEMBERS OF OUR COMMUNITY. OKAY
WE ARE ALREADY ACTIVELY
ENGAGING WITH COUNTY PARTNERS
AND COMMUNITY BASED PROVIDERS
TO BUILD UPON OUR HEALTH HOME
AND WHOLE PERSON CARE
EXPERIENCE. OKAY WILL CONTINUE
TO PROVIDE FEEDBACK TO DCS AND
THE COMMITTEE ON SEVERAL
IMPLEMENTATION COMPARED. TO
ENSURE THE PROGRAM INSTEAD OF
SUCCESSFULLY AND ACHIEVE THE
GOALS OF IMPROVING HEALTH
OUTCOMES WHERE MEMBERS. THANK
YOU. THANK YOU VERY MUCH JUST
THE AYE SORRY NEXT NEXT COVER
PLEASE. MEXICO DOMINO'S LINE
NINETEEN ONE NINE YOUR LINE IS
OPEN. HELLO KTM ZERO CHILDREN
NOW I JUST QUICKLY WANTED THEIR
COMMENT REGARDING THE PHD
PROGRAM CHILDREN I WOULD LIKE
TO ECHO THE COMMENTS OF THE
SHALL GET THEM FROM THE COUNTY
HEALTH EXECUTIVES ASSOCIATION
OF CALIFORNIA- WE ARE ALSO
INTERESTED IN PLEDGING OUT THE
PROBLEM. RECOMMENDS THAT EACH
SHE ASKED OUTLINED HOW MANY
CALAVERAS CARE PLANS WORK WITH
C. H. U. P. PROGRAMS TO THE
BILL THAT YOU PSTG MANDATE.
ADDITIONALLY WE WOULD ALSO LIKE
TO COMMENT ON THE REGIONAL RATE
SETTING PORTION OF TODAY'S
AGENDA THE REQUESTED BCS MAKE
EXPLICIT HOW THE REGIONAL RATE
SETTING PROPOSAL WITH IN CALAIS
IMPROVED QUALITY OF CARE FOR
KIDS WHICH WE KNOW HAS BEEN
POOR AND IS WORSENING IN LIGHT
OF THE COOK AT NINETEEN. THANK
YOU. THANK YOU VERY MUCH. NEXT
CALL PLEASE. THANK YOU AS A
REMINDER TO THOSE ON THE PHONE
IN THE PRESS ONE MIN ZERO TO
ENTER THE QUEUE WE'LL GO NEXT
TO LINE TWENTY TWO ZERO YOUR
LINE IS OPEN. NINE TWENTY IS
YOUR PERSONAL DEVICE ON ME.
YOUR IT YOUR LINE IS OPEN YOU
MAY BEGIN. WELL I'M NOT SURE
IT'S MY TURN OF THIS OCCURRED
WHEN I HEARD MOLD OF WAIT
DISABLED. AND OUT WILL BE A DID
WAS SAY UNITED NATIONS
ASSOCIATION LOCAL CHAPTER AND I
HAVE BOTH. AN ACCIDENT LOCALLY
AND INSPIRE GLOBALLY IN THE WAY.
I IS CURRENTLY SO PARK- THE
BILL THANK HI WANT TO THANK A-
WHO HAS BEEN THERE FOR IN. THE
WORK OF MAKING THIS HAPPEN
BRAVO TO ALL OF YOU. AT ALL
THANK YOU VERY MUCH SIR. NEXT
CALLER PLEASE. TO HAVE AN
ADDITIONAL COMMENT IT'LL BE
JUST A MOMENT BEFORE WE ARE
ABLE TO OPEN THE LINE NO
PROBLEM THANK YOU. THEY COMMENT
DOES COME FROM LINE TWENTY TWO
TWO ZERO YOUR LINE IS OPEN. HI
GOOD AFTERNOON SHARES- WHAT AND
ARAMBULA MEMBERS OF THE
COMMITTEE CHAIRED HAMPTON
CALIFORNIA ASSOCIATION HEALTH
PLANS REPRESENTING FORTY FIVE
PUBLIC NONPROFIT AND FOR PROFIT
ORGANIZATIONS THAT COLLECTIVELY
DELIVER HEALTH COVERAGE TO
APPROXIMATELY TWENTY EIGHT
MILLION CALIFORNIANS. IT GOT TO
PROVIDE PUBLIC COMMENT ON
BEHALF OF BARK NUMBER NET NET
ACCOUNT CARE PLANS ARRANGE FOR
THE CARE OF NEARLY ELEVEN
MILLION MEDICAID MEMBERS
THROUGHOUT THE STATE. I CAN'T
REMEMBER AND REMEMBER MANAGED
CARE PLANS ARE COMMITTED TO
CONTINUING TO PARTNER WITH THE
GOVERNMENT HEALTHCARE SERVICES.
AND CRITICAL STAKEHOLDERS TO
ENSURE THE SUCCESSFUL
IMPLEMENTATION OF CALAMP AND
APPRECIATE ALL THE HARD WORK
THAT'S GONE BELT THING THIS
PROPOSAL TODAY. ANY INTERESTED
CON. WE WILL BE. A CALM BUT
COMMITTEES THE A FEW HI BUT THE
KEY RECKLESS. MERRY THE
CONSIDERATION THAT WOULD BE
WILL HELP ENSURE SMOOTHER
CALLIN PLANTATION. ON BEHALF OF
OUR STAPLES OF AMERICA MEMBERS.
WE LOOK FORWARD TO CONTINUING
OUR WORK THE ADMINISTRATION AND
LEGISLATURE TO ENSURE LONG TERM
SUCCESS KELLY. THANK YOU. THANK
YOU VERY MUCH. NEXT CALLER
PLEASE. YOU AT THIS TIME MISTER
CHAIR THERE NOW FOR THE LINES
IN Q. OKAY. THAT BEING THE CASE
WE WILL GO AHEAD AND CLOSE OUT
OUR THIRD HEARING ON CALAMP
AND- I THANK EVERYBODY FOR
THEIR PARTICIPATION ANY CLOSING
COMMENTS ACKERMAN. WITH THAT WE
STAND ADJOURNED THANK YOU VERY
MUCH.