HEALTH COMMITTEE HEARING-
BEFORE WE BEGIN I'D LIKE TO
MAKE A STATEMENT ON PROVIDING
TESTIMONY AT THIS HEARING. ANY
WITNESS WHO DID NOT MAKE THE
REQUEST IN ADVANCE- AND ARE NOT
ON THE WITNESS LIST WILL BE
LIMITED TO NAME ORGANIZATION
AND POSITION ONLY NO EXCEPTIONS
WILL BE MADE. ADDITIONAL
TESTIMONY AFTER THE MAIN
WITNESS TESTIMONY WILL BE
LIMITED TO TWENTY MINUTES TOTAL
FOR EACH BILL. WE APPRECIATE
YOUR COOPERATION AND HOPE
AUTHORS MYSTICAL IS A
RESPECTFUL OF THIS PROCESS.
WELCOME TO THE ASSEMBLY HEALTH
COMMITTEE HEARING WE ARE
REQUIRING THAT MASS BE WORN BY
ALL MEMBERS OF THE PUBLIC
TESTIFYING WEATHER HERE IN THE
ROOM WHERE THE VIDEO
CONFERENCING SITE. WE DO NOT
HAVE A MASS WE CAN PROVIDE ONE
FOR YOU- TODAY IN THE ASSEMBLY
CHAMBERS I WOULD ASK THE PUBLIC
NOT TOUCH THE MICROPHONE- AND
YOU CAN EXIT THE HEARING ROOM
ONCE YOU HAVE ARE DONE
TESTIFYING TO RETURN TO YOUR
SEAT. TODAY'S AGENDA WILL BE
TAKEN UP IN FILE ORDER. AS
LISTED ON THE ON THE AGENDA IN
THE DAILY FILE. IN ADDITION TO
BEING ABLE TO TESTIFY FROM
INSIDE THE HEARING ROOM WE MAY
HAVE SOME WITNESSES YOU MAKING
USE OF OUR REMOTE TESTIMONY
STATION LOCATED IN OUR STEPS OF
THE CAPITOL GROUNDS. THESE%
WITNESSES WILL APPEAR ON THE
SCREEN SO MEMBERS CAN WATCH THE
TESTIMONY FROM LIVE FROM
OUTSIDE OF THE HEARING ROOM.
AND ALSO ASK THEM QUESTIONS. WE
WILL BE USING A MODERATED
TELEPHONE SERVICE THROUGH WHICH
ANY WITNESS CAN TESTIFY ON A
BILL. THE CALL IN NUMBER FOR
THIS HEARING IS EIGHT SEVEN
SEVEN SIX NINE TWO. EIGHT NINE
FIVE SEVEN AND THE ACCESS CODE
IS TWO FOUR TWO. SIX TWO THREE
SEVEN. YOU CAN FIND THIS NUMBER
ON THE ASSEMBLY HEALTH
COMMITTEE WEBSITE. IN THE DAILY
FILE AND ON YOUR TV SCREEN. IF
YOU'RE CALLING IN PLEASE PLAN
TO DO SO WELL BEFORE THE AUTHOR
OF THE BILL YOU'RE TESTIFYING
ON HIS BEGINNING THEIR
PRESENTATION. THE OPERATOR ON
THE LINE WILL GIVE INSTRUCTIONS
ON HOW TO BE PLACED IN THE
QUEUE. IF YOU'RE CALLING IN
PLEASE ELIMINATE ALL BACKGROUND
NOISE YOUR LIVE STREAM AND YOUR
SMART DEVICES TO REDUCE THE
SOUND DISTORTION. IN THIS
PROVIDING TESTIMONY FOR OR
AGAINST A BILL YOU WILL REMAIN
ON A LIFELINE. WE NEED TO MOVE
MEET YOURSELF UNTIL YOU'RE
CALLED UPON TO SPEAK. IF YOU
HAVE ANY PROBLEMS WITH THE
MODERATE PHONE SERVICE. PLEASE
CALL THE COMMITTEE AT NINE ONE
SIX TWO. THREE ONE NINE. TWO
ZERO NINE SEVEN AND MY STAFF
WILL BE THERE TO HELP. ME
REPEAT THAT NUMBER SINCE I.
STARTED ON IT. NINE ONE SIX.
THREE ONE NINE. TWO ZERO NINE
SEVEN. WE ARE ACCEPTING WRITTEN
TESTIMONY THROUGH THE POSITION
LETTER PORTAL WITH INSTRUCTIONS
ON THE COMMITTEE'S WEBSITE. AND
YOU CAN FIND THE EMAIL FOR THE
COMMITTEE THERE AS WELL. THANK
YOU FOR BEING WITH US AS WE
IMPLEMENT METHODS TO CONTINUE
TO SERVE THE PEOPLE OF
CALIFORNIA WHILE ALSO BEING
MINDFUL AND RESPECTFUL OF THE
PUBLIC HEALTH CONCERNS WE ALL
STILL FACE. IN FAIRNESS
EVERYONE WILL NEED TO BE STRICT
ON OUR TIME LIMITS TODAY WE
WILL HEAR FROM UP TO TWO
WITNESSES FOR THREE MINUTES
EACH FOR EACH SIDE. AFTER THE
TWO MAIN WITNESSES FOR EACH
SIDE TESTIFIED TESTIFY IF THERE
ARE ANY. WE WILL GO TO THE
PHONES- AND COMBINE THE
ADDITIONAL TESTIMONY FOR BOTH
SUPPORT AND OPPOSITION.
ADDITIONAL WITNESSES WILL BE
LIMITED TO THEIR NAME.
ORGANIZATION IF THEY REPRESENT
ONE. AND POSITION ON THE BILL
AND AS I SAID EARLIER WE WILL
LIMIT ADDITIONAL WITNESSES ON
ANY BILL TO TWENTY MINUTES. THE
FOLLOWING BILLS ARE PROPOSED
FOR CONSENT FOR TODAY'S HEARING
ANY MEMBER THE COMMITTEE MAY
REMOVE A BILL FROM CONSENT. I
REMEMBER THREE SB TWO FOUR
SEVEN BY SENATOR EGGMAN ITEM
NUMBER SIX S. B. FORTY BY
SENATOR HER TADO. AT NUMBER TEN
S. B. TWO EIGHTY BY CENTER TO
AMONG. I REMEMBER FOURTEEN SB
THREE THIRTY SIX BY THE
SENATOR- CHOI BOGUE. AND NUMBER
SEVENTEEN SB EIGHT TWENTY THREE
A HEALTH COMMITTEE BILL. WITH
THAT. I BELIEVE WE ARE READY TO
GO TO OUR FIRST AUTHOR AND THIS
WE HAVE TO HAVE A QUORUM THREE
FIVE. NUMBER SHORT. MAY NOT IN
STATURE BUT IN NUMBER SO- WILL
GO AHEAD AND TO OUR FIRST
WITNESS OUR FIRST A BILL EXCUSE
ME I SEE SENATOR CAFIERO HER
PLEASE GO AHEAD. THANK YOU MR
CHAIRMAN MEMBERS- I'M PLEASED
TO PRESENT. SB THREE SIXTY
FIVE. WHICH WOULD REQUIRE
MEDICAL TO REIMBURSE ALL
PARTICIPATING PRIMARY CARE
PROVIDERS INCLUDING THOSE WHO
OPERATE OUT OF A FEDERALLY
QUALIFIED HEALTH CLINICS FOR
RURAL HEALTH CLINIC. FOR ECON
SALT SERVICES. CONSUL SERVICES
ARE TRULY A PATIENT CENTERED
INNOVATION BALLAUGH ONE
PROVIDER USUALLY A PRIMARY CARE
PROVIDER. TO SEND ELECTRONIC
CONSOLE TO ANOTHER PROVIDER WHO
IS USUALLY A SPECIALIST WHEN A
PATIENT HAS A QUESTION-
CONDITION REQUIRING SPECIALTY
CARE. THE SPECIALTY THEN GIVE
THE RESPONSE TO THE PRIMARY
CARE PROVIDER AND IT COULD VERY
FROM WANTING TO SEE THE PATIENT
IN PERSON TO RECOMMENDING A
PRESCRIPTION OR A COURSE OF
CARE. HE COUNSELED OFFER TIMELY
RESOLUTIONS FOR PATIENTS WHO
MAY OTHERWISE WAIT WEEKS OR
MONTHS TO SEE A SPECIALIST FOR
SOMETHING THAT THEY MAY NOT.
THAT MAY NOT REQUIRED TO PUT IN
AN APPOINTMENT IN THE FIRST
PLACE. CURRENTLY EACH CONSOLE
SERVICES ARE REIMBURSABLE FOR
THE PROVIDERS AT THE DISTANCE
SITE. AND THESE ARE USUALLY THE
SPECIALIST HOWEVER THE PRIMARY
CARE PROVIDER AT THE
ORIGINATING SITE IT'S NOT ABLE
TO BILL FOR THE TELEHEALTH
SERVICE. BOTH PROVIDERS BRING
EXPERTISE IN INFORMATION TO THE
TABLE WHEN DISCUSSING THE
PATIENT'S CONDITION BUT ONLY
THE SPECIALIST IS REIMBURSED
FOR THEIR TIME. IN FACT IT
COULD BE ARGUED THAT THE
PRIMARY CARE PHYSICIAN IS GOING
ABOVE AND BEYOND BY EACH
COUNCIL CONSULTING WITH THE
SPECIALIST REGARDLESS OF
WHETHER THE PATIENT IS
EVENTUALLY REFERRED. THE
PATIENT IS REFERRED FOR AN
APPOINTMENT THE SPECIALIST NOW
HAS BACKGROUND INFORMATION ON
THE PATIENT'S CONDITION AND THE
VISIT WILL BE WELL SPENT ON
NEXT STEPS INSTEAD OF
INFORMATION GATHERING. AND IF
NO REFERRAL IS NEEDED THEN THE
PATIENT WILL HAVE THE QUESTIONS
ADDRESSED WITHIN DAYS THANKS TO
THIS FORM OF TELEHEALTH. EITHER
OF THESE OUTCOMES BENEFIT THE
PATIENT MORE THAN A SIMPLE
REFERRAL. THIS COMMUNICATION IS
A GREAT BENEFIT TO RURAL
RESIDENTS AS YOU KNOW WE'RE
ACCESS TO HEALTH CARE IN
GENERAL HAS BEEN A LONG
STANDING ISSUE. IN RURAL
DISTRICTS IT CAN BE DIFFICULT
TO GET AN APPOINTMENT WITH A
GENERAL PRACTITIONER LET ALONE
A SPECIALIST. WHO IS USUALLY
OUT OF TOWN ESPECIALLY SINCE
SPECIALLY. CARE IS STRESSED IN
ALL SECTORS OF OUR HEALTH CARE
INDUSTRY. USE OF AN ECON SALT
WOULD DETERMINE IF OF THIS IF A
PHYSICAL VISIT IS IN FACT
NEEDED. SAVING RURAL PATIENTS
TIME AND MONEY. IT ALSO GETS
THE PATIENT'S CONCERNS
ADDRESSED MORE QUICKLY. I THINK
THE DATA SHOWS VERY CLEARLY
THAT FOLLOW UP SPECIALTY VISITS
ARE. MORE LIKELY NOT TO HAPPEN
WHEN THE DISTANCE IS- IS
PROHIBITIVE. SB THREE SIXTY
FIVE IS A SMALL CHANGE TO THE
BILLABLE TELEHEALTH SERVICES IN
MEDICAL. AND I BELIEVE THIS
BILL WILL NOT ONLY CREATE
EQUITY FOR THE PRIMARY CARE
PROVIDER BUT MOST MOST
IMPORTANTLY WILL IMPROVE CARE
FOR THE PATIENTS THANK THANK
YOU AND I RESPECTFULLY ASK FOR
YOUR AYE BUT TODAY. THANK YOU
VERY MUCH SENATOR I BELIEVE WE
HAVE TO WITNESSES IN SUPPORT
MOLEST THE- TELEPHONE OPERATOR
TO OPEN THE LINE FOR THE
WITNESSES IN SUPPORT. THANK
YOU. PLEASE PRESS ONE ZERO AT
THIS TIME. AND WILL FIRST GO TO
Y. NINETY EIGHT YOUR LINE IS
OPEN. HE HAD ON BEHALF OF
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS REPORT. WHOOPS THOSE
ARE NOT PRIMARY THE WE HAVE TWO
PRIMARY WITNESSES IN SUPPORT.
AND YOU KNOW WHAT WHAT IT-NEARLY THEIR LIVES SHOULD BE
OPEN OKAY THANK YOU THAT THAT I
BELIEVE THAT WAS A ME TOO SO.
THE PLEASE PRIMARY WITNESSES IN
SUPPORT. HELLO THIS IS DANIELLE
ORRIN HELLO MISTER CHAIR AND
SENATORS. AND THANKS FOR
INVITING ME TO JOIN YOU TODAY
TO PRESENT ON SB THREE SIXTY
FIVE WHICH WOULD REQUIRE
MEDICARE TO REIMBURSE INVOLVED
PROVIDERS FOR ECON FULL
SERVICES. INCLUDING FQHCS. AND
RURAL HEALTH CENTERS MY NAME IS
DANIEL OREN AND I'M CHIEF
MEDICAL OFFICER OF RECORD
COMMUNITY HEALTH COALITION. WE
ARE A CONSORTIUM MADE UP OF
SEVENTEEN MEMBER COMMUNITY
HEALTH CENTERS AND NAPA MARIN
SONOMA. AND YOLO COUNTIES WE
SERVE ABOUT TWO HUNDRED AND
THIRTY TWO THOUSAND PATIENTS.
AND I AM ALSO A PRACTICING
FAMILY PHYSICIAN AT PETALUMA
HEALTH CENTER WHICH IS A
FEDERALLY QUALIFIED COMMUNITY
HEALTH CENTER AND SONOMA COUNTY.
OUR CLINICS CONTROL PROGRAM HAS
BEEN A LIFELINE FOR EXPANDING
ACCESS TO OUR CARE FOR OUR
PATIENTS OFTEN OUR PATIENTS
HAVE TO WAIT WEEKS TO MONTHS
FOR SPECIALTY APPOINTMENT. ECON
FOLKS HELP TO RELIEVE THE WAIT
TIMES FOR APPOINTMENTS BY
ENABLING MANY PRIMARY CARE
PROVIDERS TO BE ABLE TO MANAGE
THEIR PATIENTS CARE WITHOUT THE
NEED FOR AN IN PERSON SPECIAL
PIZZAS THAT. ARE IN OUR
CONSORTIUM OVER 50% OF THE
CASES WHERE PATIENTS RECEIVED
AN ECON SALT- IT RESULTED IN
AND AVOIDED REFERRAL DIAGNOSTIC
TEST OR PROCEDURE. ALLOWING FOR
BOTH THE TREATING PROVIDER A
PRIMARY CARE PROVIDER AND TO
CONSULT THE PROVIDER OR
SPECIALIST TO BILL FOR ECON
FOLKS WILL ENSURE THAT
PROVIDERS GET COMPENSATED FOR
THE TIME SPENT ON SERVICES
OUTSIDE. OF CLINIC VISITS
SHOULD MY COLLEAGUES AT MY
CLINICS IN OTHER APPS YOU
AGENCIES ACROSS THE STATE BE
ABLE TO BUILD FREE CONSOLE
SEPARATELY FROM THEIR CLINIC
VISITS. THE STATE WOULD BE
MAKING AN INVESTMENT IN
INNOVATIVE CARE PRACTICES AND
TECHNOLOGY ALREADY IN USE THAT
LARGER HEALTH SYSTEMS THAT
SERVE MANY CALIFORNIANS ON
COMMERCIAL PLANTS. IN A YEAR
WHERE PARITY AND EQUITY ARE OF
CONCERN TO STAKEHOLDERS AND
POLICYMAKERS ALIKE I URGE YOU
TO SUPPORT SB THREE SIXTY FIVE.
AND HE CONSOLE AS A CRITICAL
TOOL FOR SAFETY NET PROVIDERS
SERVING OUR MEDICARE
BENEFICIARIES THANK YOU. THANK
YOU VERY MUCH AND WE'LL. MOVE
ON TO OUR SECOND WITNESS PLEASE.
HI GOOD AFTERNOON SIR WHAT IN
THE AND OTHER ASSEMBLYMEMBERS
MY NAME'S BOBBY FRANCESCHINI
AND I AM I'M HERE TO ANSWER ANY
TECHNICAL QUESTIONS YOU MAY
HAVE ABOUT THE CONSUL TO
DEVELOP. OKAY VERY WELL THANK
YOU. BEFORE WE GO TO OTHER
WITNESSES IN SUPPORT OR
OPPOSITION WHAT TO BRING IT
BACK TO BE HONEST WITH YOU HAVE
A QUORUM SAID LIKE THE
SECRETARY TO PLEASE CALL THE
ROLL. WHENEVER YOU'RE READY
MADAM SECRETARY. WHAT I. HEAR
YEAH MAYES TO HEAR AGUIAR-CURRY
ARAMBULA BIGELOW. CALDERON
CARILLO. FLORA MAIENSCHEIN
MCCARTY NAZARIAN RIVAS.
RODRIGUEZ. SANTIAGO WALDRON. WE
HAVE A QUORUM THANK YOU AND I
WANT TO THANK- ASSEMBLY MEMBER
CALDERON FOR SITTING IN TODAY
ON BEHALF OF ASSEMBLY MEMBER
BURKE VERY MUCH APPRECIATED
THANK YOU. OKAY WE WILL GO.
BACK TO THE- PHONE LINE
ACTUALLY- FOR THE PHONE LINES
WE DO HAVE A WITNESS IN THE
GALLERY WHO WOULD LIKE THIS TO-
MAKE COMMENT PLEASE GO AHEAD.
YES MISTER CHAIRMAN CHRIS MCKAY
LEE ON BEHALF OF GOVERNOR FOR
CALIFORNIA IN SUPPORT OF THE
SENATORS BILL THANK YOU DOCTOR
WOULD THANK YOU. ANYONE ELSE IN
THE GALLERY SEEING NO ONE WILL
GO TO THE PHONE LINES A PLEASE
OPEN FOR PEOPLE WITNESSES IN
SUPPORT OR OPPOSITION JUST YOUR
NAME A POSITION ON THE BILL
AND- YOU ANY ORGANIZATION MIGHT
REPRESENT SO WHENEVER YOU'RE
READY MADAM OPERATOR. THANK YOU
AND I GET ONE AND THEN ZERO
WELL FIRST CAROLINUM SEVENTY
ONE PLEASE GO AHEAD. GOOD
AFTERNOON SHARON MEMBERS CALLS
FOR US WITH THE CALIFORNIA
PSYCHOLOGICAL ASSOCIATION IN
STRONG SUPPORT THANK YOU THANK
YOU NEXT CALLER PLEASE NEXT.
ONE LINE ONE CAN. THANK YOU
TERM MEMBER THEIR BRIDGE ON THE
TOP OF THE ASSOCIATION OF
CALIFORNIA HEALTHCARE DISTRICT
COURT. THANK YOU VERY MUCH NEXT
CALLER PLEASE. NINETY SEVEN.
SURE MEMBERS JOHN. PROBLEMS
FOR. THANK YOU NEXT CALLER
PLEASE. ONE FIFTEEN. CALORIE ON
BEHALF OF THE CALIFORNIA
MEDICAL ASSOCIATION IN STRONG
SUPPORT THANK YOU OKAY THANK
YOU NEXTCODE PLEASE. EIGHTY
SEVEN. HELLO THERE ARE A COUPLE
ON BEHALF OF THE UNIVERSITY OF
CALIFORNIA IN SUPPORT THANK YOU
THANK YOU NEXT CALLER PLEASE.
AT OUR LAST ONE HOURS ONLINE
SEVENTY FOUR. HI THIS IS ERIN
MINNELLI CALLING ON BEHALF OF
ARREST AND BEATING AND YOUR
PLEDGING HER SUPPORT FOR THE
BILL. THANK YOU. THANKS CALLER
PLEASE. NO FURTHER AT THIS TIME
OKAY THANK YOU VERY MUCH OF
BRING IT BACK TO THE COMMITTEE
ANY QUESTIONS OR COMMENTS FROM
THE COMMITTEE. THE GUY WAS A
SECOND WAS CORRECT OKAY THE
MOTION BY MISTER RODRIGUEZ A
SECOND BY MISS CARILLO- NO
COMMENTS OR QUESTIONS OF. THE
BILL DOES ENJOY DO PASS
RECOMMENDATION CENTER COPIER
WHICH LIKE CLOSE RESPECTFULLY
ASK FOR YOUR I. BOATS. THANK
YOU SENATOR THE MOTION IS DUE
PASSED TO APPROPRIATIONS OF
MOTION BY MISTER RODRIGUEZ
SECONDED BY MISS CARILLO. MADAM
SECRETARY PLEASE CALL THE ROLL
WHAT I WOULD AYE MAYES. MAYES
AYE AGUIAR-CURRY. AGUIAR-CURRY
AYE ARAMBULA. BIGELOW BIGELOW I
CALDERON. CALDERON I CARILLO
CARILLO HI FLORA. MAIENSCHEIN
MCCARTY NAZARIAN REVERSE.
RODRIGUEZ RODRIGUEZ I SANTIAGO
WALDRON WALDRON HIGH. EIGHT TWO
ZERO EIGHT ZERO YOUR BILL IS
OUT LEAVE THE ROLE OPEN FOR
OTHERS TO ADD ON THANK YOU
SENATOR THANK YOU VERY MUCH
MISTERCHEROKEE BEFORE WE MOVE
TO OUR NEXT- AUTHOR- WOULD LIKE
TO SEE IF THERE'S A MOTION ON
THE CONSENT CALENDAR. MOTION BY
MISS- MISS AGUIAR-CURRY SECOND
BY MISS WALDRON. OF THE ITEMS
ARE ITEM NUMBER THREE SB TWO
FORTY SEVEN BY SENATOR EGGMAN
ITEM NUMBER SIX SB FORTY BY
SENATOR HER TADO ITEM NUMBER
TEN S. B. TWO EIGHTY BY SENATOR
LIMóN. ITEM NUMBER FOURTEEN SB
THREE THIRTY SIX BY SENATOR-
CHOI BOGUE AND ITEM NUMBER
SEVENTEEN S. B. EIGHT TWENTY
THREE A SENATE HEALTH HEALTH
COMMITTEE BILL. OF THAT AMOUNT
OF SECRETARY PLEASE CALL THE
ROLL. WHAT I WOULD AYE MAYES
MAYES I AGUIAR-CURRY.
AGUIAR-CURRY AYE ARAMBULA.
BIGELOW BIGELOW AYE CALDERON
OVERALL I CARILLO. HI FLORA
MAIENSCHEIN. MCCARTY THIS AREA
RIVAS RODRIGUEZ RODRIGUEZ I
SANTIAGO WALDRON WALDRON HIGH.
EIGHT ZERO ZERO COULD SECOND
WONDERS OUT WILL BE THE ROLE
OPEN FOR OTHERS THAT ON- MOVING
TO SENATOR GLAZERS. THANK YOU
THANK YOU CHAIR WOULD- I WANT
TO START BY THANKING THE
CHAIRMAN AND THE COMMITTEE FOR
ALLOWING ME TO PRESENT. SEVEN
FORTY NINE AM BY ACCEPTING THE
PROPOSED COMMITTEE AMENDMENTS I
ALSO WANT TO ACKNOWLEDGE AND
THANK MY JOIN AUTHOR ON THIS
MEASURE CENTER EGGMAN. AND ALSO
TO ACKNOWLEDGE ASSEMBLY MEMBER-
ARAMBULA WHO IS HAD- IT HAS
WORKED IN THIS AREA AND SHOWN
GREAT LEADERSHIP IN THE SPACE
AND THEN LOOK FORWARD TO
PARTNERING WITH HIM. ON THIS
AND NINE OTHER OTHER MEASURES-
BUT THIS BILL IS A TRANSPARENCY
MEASURE THAT WILL PROVIDE
INSIGHT TO POLICY MAKERS AND
STAKEHOLDERS ACROSS THE STATE.
ABOUT HOW COUNTIES ARE USING
THEIR MENTAL HEALTH FUNDS AND
HOW THOSE FUNDS ARE SERVING.
OUR CONSTITUENTS. WE SPEND
BILLIONS OF DOLLARS EVERY YEAR
IN AN EFFORT TO HELP
CALIFORNIANS SUFFERING FROM
MENTAL ILLNESS BUT WE HAVE
PRECIOUS LITTLE DATA. TO HELP
US UNDERSTAND WHICH OF THE
PROGRAM FOR FUNDING OR THE MOSTEFFECTIVE. WHICH OF THEM ARE
ACTUALLY HELPING THE PEOPLE WHO
ARE DESPERATELY IN NEED OF THIS
ASSISTANCE. THIS IS NOT JUST MY
OPINION IT'S THE VIEW OF THE
CALIFORNIA STATE AUDITOR. LAST
SUMMER THE STATE AUDITOR
RELEASED A REPORT DETAILING THE
LACK OF TRANSPARENCY FOR HOW
MENTAL HEALTH SERVICES FUNDS
ARE BEING USED. AND THE
BENEFITS FOR THOSE SERVICES.
THIS BILL WOULD CHANGE THAT
BASED ON THOSE RECOMMENDATIONS
FROM THE AUDITOR IT WOULD
CREATE A STATE FRAMEWORK FOR
COLLECTING INFORMATION. ON
MENTAL HEALTH SPENDING AND
OUTCOMES THROUGH THE MENTAL
HEALTH SERVICE OVERSIGHT AND
ACCOUNTABILITY COMMISSION.
UNDER THIS BILL THE COMMISSION
WOULD BE REQUIRED TO
COLLABORATE WITH STATE AND
LOCAL MENTAL HEALTH AGENCIES.
TO CREATE A COMPREHENSIVE
TRACKING PROGRAM FOR COUNTY
SPENDING ON MENTAL HEALTH
PROGRAMS. AND THE OUTCOMES FROM
THAT SPENDING. COMMISSION WOULD
PROVIDE ASSESSMENTS. OF A
SPENDING AN OUTCOME PATTERNS BY
DEVELOPING CATEGORIES A MENTAL
HEALTH PROGRAMS AND SERVICES.
INCLUDING EMERGENCY SERVICES AN
INPATIENT SERVICES. CURRENTLY
REPORTING RELIES ON DISJOINTED.
AND INCOMPLETE TOOLS. A RESULT
OF MULTIPLE FUNDING SOURCES.
WITH DIFFERENT REQUIREMENTS AND
LEVELS OF TRANSPARENCY. THIS
BILL IS A STRAIGHTFORWARD
SOLUTION. TO ENSURE THAT
CALIFORNIANS WILL BE ABLE TO
UNDERSTAND HOW COUNTIES ARE
SPENDING FUNDS FOR MENTAL
HEALTH SERVICES. AND HOW THESE
FUNDS ARE BEING USED TO IMPROVE
CONSTITUENTS MENTAL HEALTH. I
WITH ME TODAY IS TOBY EWING FOR
THE MENTAL HEALTH SERVICE
OVERSIGHT AND ACCOUNTABILITY
COMMISSION TO TESTIFY WITHOUT A
RESPECTFULLY ASK YOUR SUPPORT
TODAY. THANK YOU VERY MUCH
SENATOR WILL OPEN THE PHONE
LINES FOR THE WITNESS IN
SUPPORT WHENEVER YOU'RE READY
MISTER EWING. THANK YOU MR
CHAIRMAN MEMBERS OPERATIVE THE
OPPORTUNITY TO TESTIFY IN
SUPPORT OF SB SEVEN FORTY NINE
I WANT TO THANK THE AUTHOR
FIRST LEADERSHIP ON THIS AS
WELL. THIS IS TOBY OWING ON
BEHALF OF THE MENTAL HEALTH
SERVICES OVERSIGHT AND
ACCOUNTABILITY COMMISSION. AS
YOU KNOW. AS YOU MAY KNOW
CALIFORNIA'S MENTAL HEALTH
SERVICES ACT CALLED FOR
ENHANCED COMMUNITY ENGAGEMENT
AND HOW WE ORGANIZE AND DELIVER
MENTAL HEALTH SERVICES. AND ONE
OF THE REASONS FOR THAT WAS TO
INCREASE AWARENESS OF WHAT'S
WORKING AND WHAT'S NOT WORKING
SO THAT WE CAN REALLY TAP INTO.
ALL OF THE OPPORTUNITIES AND
IDEAS. AND PERSPECTIVES ACROSS
CALIFORNIA REALLY STRENGTHEN
OUR MENTAL HEALTH SYSTEM. THE
ACT ALSO CALLED FOR GREATER
OVERSIGHT AND ACCOUNTABILITY TO
MAKE SURE THAT WE ARE CREATING
THE LEVEL OF. A PUBLIC TRUST IN
THE SYSTEM THAT WE HAVE. IN
IDEALLY BUILDING THAT PUBLIC
ENGAGEMENT TO REALLY DRIVE
TRANSFORMATIONAL CHANGE. IT
IT'S FAR TOO DIFFICULT TODAY TO
REALLY UNDERSTAND HOW OUR
SYSTEM IS FUNDED HOW FUNDS ARE
BEING USED IN THE OUTCOMES THAT
ARE. THAT WERE CHEATING WITH
THOSE DOLLARS WERE MAKING GREAT
PROGRESS BUT THERE'S MORE WORK
TO DO AS IS CLEAR TO ANYBODY
WHO HAS HAD THE OPPORTUNITY. TO
WALK NEXT STEPS IN OUR URBAN
AREAS AND SEE THE KIND OF
CHALLENGES WE HAVE. THE STATE.
COMMISSIONS ROUTINELY ASKED BY
POLICY MAKERS BUT ALSO THE
PUBLIC ABOUT COST ABOUT
OUTCOMES. AND MOST IMPORTANTLY
ABOUT OPPORTUNITIES FOR
IMPROVEMENT- EQUALLY
SIGNIFICANTLY HERE FROM COUNTY
MENTAL HEALTH LEADERS AND
PROVIDERS WHO. ARE CONSISTENTLY
ASKING ABOUT WHAT OTHER
COUNTIES ARE DOING WHAT OTHER
STATES ARE DOING. BECAUSE THEY
WANT TO KNOW HOW WE CAN
IMPROVE. SB SEVEN FORTY NINE
LAYS OUT AN AMBITIOUS BUT A
VERY PRACTICAL AGENDA TO BRING
TOGETHER DISPARATE INFORMATION
TO ALLOW A COMPLETE
UNDERSTANDING OF OUR MENTAL
HEALTH SYSTEM. INCLUDING WHAT'S
WORKING WHERE CHANGE IS NEEDED
AND HOW WE CAN STRENGTHEN THE
WAY WE CARE FOR THE PEOPLE WHO
HAVE MENTAL HEALTH NEEDS ACROSS
THE STATE. SB SEVEN FORTY NINE
BETTER POSITIONS EVERYONE IS
IMPACTED BY MENTAL HEALTH TO
ENGAGE IN OPTIONS FOR
IMPROVEMENT FOR THAT REASON THE
COMMISSION SUPPORTS THE BILL.
AND WE'D BE HAPPY TO ANSWER ANY
QUESTIONS YOU MIGHT HAVE THANK
YOU. THANK YOU VERY MUCH MISTER
EWING WILL WE DO HAVE A WITNESS
IN OPPOSITION I WILL OPEN THE
PHONE LINES FOR THE WITNESS. IN
OPPOSITION PLEASE GO AHEAD WHEN
YOU'RE READY. THANK YOU SURE
WOULD ANY OTHER HAVE OVER THE
COUNTY. HEALTH DIRECTORS
ASSOCIATION ALTHOUGH WE
ABSOLUTELY AGREE WITH THE
PURPOSE OF. THIS BILL AS
OUTLINED IN THE ANALYSIS.
UNFORTUNATELY WE DO THE WITH
THE- BECAUSE IT'LL RESULT IN.
REPORTING FOR. AND ANNETTE.
ADDITION COSTS. THE BILL
CHARGES THE MENTAL HEALTH TO.
OVER IN ACCOUNTABILITY
COMMISSION WITH CREATING A
COMPREHENSIVE TRACKING PROGRAM
FOR COUNTY SPENDING ON MENTAL
AND BEHAVIORAL HEALTH PROGRAMS.
AND SERVICES INCLUDING FUNDING
SOURCES AND HOW COME DATA.
BECAUSE THE COMMISSION- WITH.
ALL OF THAT WE RESPECT THAT
DAY. A WORK OF THE COMMISSION
THEY DO NOT CURRENTLY HAVE A
ROLE IN THE DELIVERY OF
BEHAVIOR HEALTH SERVICES UNDER
MEDICARE I'LL- A SIGNIFICANT
AMOUNT OF THE DATA INVOKED. IN
SB SEVEN FORTY NINE WOULD BE
THE EXACT SAME DATA CURRENTLY
COLLECTED. BY THE DEPARTMENT OF
HEALTH CARE SERVICES.
SUBDIVISION C. OF SB SEVEN
FORTY NINE WOULD REQUIRE
COUNTIES TO REPORT. THIS
EXACTING DATA TO THE COMMISSION
RESULTING IN UNNECESSARY AND
DUPLICATIVE COSTS FOR COUNTIES
AND THE STATE. THE COMMISSION
STAFF WITH THEIR VERY
SIGNIFICANT EXPERTISE. FOCUSED
ON THE MENTAL HEALTH SERVICES
ACT AS EXPRESSED BY MISTER
EWING. UNFORTUNATELY DO NOT
HAVE THE SAME LEVEL OF
EXPERTISE HOW'S THAT THE ATF ON
THE MEDIC CAL BEHAVIORAL HEALTH
DELIVERY SYSTEM. INCLUDING
SUBSTANCE USE DISORDER SERVICES
WHICH ARE NOT CURRENTLY PART OF
THE MHSAA. THIS RAISES CONCERNS
WITH SB SEVEN FORTY NINE SHARKS
OF THE COMMISSION DEVELOP
PERFORMANCE MEASURES. AND
OUTCOMES IN THESE AREAS. SOME
OF WHICH ARE ALREADY PART OF
THE P. EIGHTY S. B. Q. R. O.
OR- EXTERNAL QUALITY REVIEW
ORGANIZATION REPORTING. AGAIN
CREATING UNNECESSARY
DUPLICATION. TBH P. A.
CONTINUES TO FIRMLY BELIEVES
THAT THE HEALTH AND HUMAN
SERVICES AGENCY IS A MORE
APPROPRIATE ENTITY TO REALIZE
WITH A VERY IMPORTANT. AND
MERITORIOUS PURPOSE THAT
OUTLINED IN SB SEVEN FORTY
NINE. HHF HAS THE AUTHORITY
OVER ALL BEHAVIORAL HEALTH
SERVICES. INCLUDING THOSE UNDER.
G. ACS AND MHSAA FUN BEING
UNDER HHS LEADERSHIP NEW
RECORDING. CAN BE RETRIEVED.
ALONGSIDE WITH IT ANY CURRENT
UNLESS. REPORTING QUITE A THEY
CAN REDUCE TO MAKE THE CALL. TO
THE SYSTEM OVER. WE BELIEVE IN
A FUTURE LED EFFORT WITH IN A
MORNING. WITH FRAMEWORK FOR
MANAGING CONFORM AND NOW AND-
PUBLIC BEHAVIOR HEALTH DELIVERY
SINCE. THEY CAN ITSELF NOTES
THE SICK COST THE THIRTY. WITH
A FORMAL RESPONSE S. B. C.
FORTY NINE TO WHICH WOULD
REQUIRE RESOURCES. FOR THE
COMMISSION TO PROCESS AND
ANALYZE COST REPORTS AND
SUBSTANCE USE DISORDER
EXPENDITURES EITHER AREAS
ALREADY EVALUATED BY THE ATS
AND THEREFORE CREATING ANOTHER
DUPLICATE THE PROCESS. BECAUSE
OF THE ADDED COST OF DUPLICATE
DUPLICATIVE REPORTING AND
EVALUATION EBITA RESPECTFULLY
OPPOSES SB. SEVEN FORTY NINE
AND URGES THE NUMBER THANK YOU.
THANK YOU VERY MUCH WE WILL
MOVE TO THE LINES IS THERE
ANYONE IN THE GALLERY WISHES TO
TESTIFY IN THIS BILL SEE NO ONE
WILL GO TO THE PHONE LINES. AND
WOULD JUST BE ASKING OUR
WITNESSES FOR THEIR POSITION ON
THE BILL- ANY RECORD
ORGANIZATION IN MY REPRESENT
AND NOTHING FURTHER SO PLEASE
GO AHEAD. THANK YOU AND AGAIN
AT ONE AND THEN GENERAL. IN ONE
MOMENT HERE.
BUT. AND WE CAN
OUTLINE OF ONE TWENTY TWO
PLEASE GO AHEAD. THANK YOU
MEMBERS MONNING THE CONNECTION
WHEN I'M UP AND RUNNING TWO
PHOTOS CALIFORNIA DEPARTMENT OF.
JUSTICE THANK YOU VERY MUCH.
NEXT CALL PLEASE. AND THEN
FURTHER AT THIS TIME. I'M SORRY
THERE'S NO NO NO FOR THE COLORS.
IT CORRECT CORRECT OKAY THANK
YOU VERY MUCH RINGBACK
COMMITTEE FOR QUESTIONS OR
COMMENTS FROM THE COMMITTEE.
NONE THE BILL DOES ENJOY A DO
PASS RECOMMENDATION THERE WAS A
MOTION BY- MISTER MAYES A
SECOND I BELIEVE IT WAS. MISS
WALDRON- AND- SO WOULD YOU
WOULD YOU LIKE TO CLOSE SENATOR.
THANK YOU FOR YOUR
CONSIDERATION THANKS FOR THE
PASSION THAT OUR MENTAL HEALTH-
DIRECTORS HALF OF- IN OUR STATE
WE LOVE THEM AND APPRECIATE ALL
THAT THEY DO- BUT AS I
MENTIONED EARLIER THAT. WE DO
HAVE THIS FUNCTION WE HAVE TO
CLEAN IT UP I THINK THIS BILL
IS GOING TO HELP MOVE IN THAT
DIRECTION SO THAT WE AS POLICY
MAKERS CAN UNDERSTAND WHAT'S
WORKING WHAT'S NOT. SO WE CAN
DO OUR BEST WORKING WITHOUT
RESPECTFULLY ASK FOR AN AYE
VOTE TODAY. THANK YOU VERY MUCH
SENATOR I SHARE YOUR PASSION
AND DESIRE TO- TO GET MORE DATA
ON A VARIETY OF THINGS SO- THIS
BILL. DOES ENJOY TO PASS
RECOMMENDATIONS OF THE MOTION.
BY MISTER MAYES THE SECOND BY
MISS WALDRON. I DO PASS AS
AMENDED TO APPROPRIATIONS AND
ALSO SECRETARY TO PLEASE CALL
THE ROLL. WHAT I WOULD AYE
MAYES. MAYES AYE AGUIAR-CURRY.
AGUIAR-CURRY AYE ARAMBULA
BIGELOW BIGELOW I CALDERON.
CARILLO FLORA MAIENSCHEIN
MCCARTY THIS AREA RIVAS
RODRIGUEZ. THIS IS SANTIAGO
WALDRON. FIVE ZERO FIVE ZERO OF
WILL LEAVE THE BILL WILL LEAVE
THE BILL ON CALL THANK YOU VERY
MUCH HAVE A VERY MUCH. GO AHEAD
ON TO OUR NEXT AUTHOR SENATOR
HUESO. WHENEVER YOU'RE READY
SIR. THANK YOU MR CHAIRMAN
MEMBERS PLEASURE TO BE HERE
GOOD AFTERNOON- I'M REALLY
PROUD TO PRESENT SB SIX EIGHTY
SEVEN THIS IS A BILL THAT WOULD
REQUIRE REQUIRE TRAUMA KITS. TO
BE PLACED IN CERTAIN PUBLIC AND
PRIVATE BUILT BUILDINGS IN
ORDER TO HELP TREAT INDIVIDUALS
AND THE EVENT THAT THE
REQUIREMENT EMERGENCY MEDICAL
CARE BEFORE MEDICAL
PROFESSIONALS CAN ARRIVE ON
SITE. IN TWENTY TWELVE IN
RESPONSE TO THE HORRIFIC
HORRIFIC MASS SHOOTING OF SANDY
HOOK ELEMENTARY SCHOOL. A GROUP
OF DOCTORS DECIDED TO CREATE
THE NATIONAL STOP THE BLEED
CAMPAIGN TO WEARS A RAISE
AWARENESS INCREASE TRAINING FOR
BYSTANDERS AND EMERGENCY
DRAMATIC EVENTS. STANDARD FIRST
AID KITS ARE VERY HELPFUL BUT
THEY DO NOT CONTAIN THE
ADEQUATE EQUIPMENT. NECESSARY
TO TREAT VICTIMS WERE DEALING
WITH HEAVY BLEEDING. SB SIX
EIGHTY SEVEN WOULD REQUIRE THE
TRAUMA KITS CONTAIN THE
NECESSARY. JUST TOURNIQUETS
THAT HAVE HAVE BEEN PROVEN TO
INCREASE THE CHANCE OF SURVIVAL
FOR TRAUMA VICTIMS. THIS BILL
IS I AM VERY NEEDED MUCH
OVERDUE WE'VE HAD SEVERAL OF
OTHER LEGISLATORS PUSHES BILL
PREVIOUS YEARS WORK AND- ONE OF
ONE OF THE MEMBERS IS HERE OF.
ASSEMBLY MEMBER RODRIGUEZ WE
ALSO HAD SOME OF THE MEMBER
STEINORTH THE TRIED OF. AND IT
IT JUST BEHOOVES ME I DON'T
KNOW WHY WE HAVEN'T DONE THIS
THIS IS SO IMPORTANT THIS COULD
HELP SAVE LIVES. I APPROVED A
BILL THAT WOULD WOULD PUT
EIGHTY DAYS IN IN BUILDINGS
ACROSS THE STATE AND- AND I CAN
NAME SEVERAL PEOPLE THAT I KNOW
PERSONAL WHOSE LIVES HAVE BEEN
SAVED. BY SIMPLY HAVING AN ADD
ONSITE THIS COULD DO THE EXACT
SAME FOR ABOUT A FOR A LOT LESS
COST. THESE TRAUMA KITS ARE
VERY INEXPENSIVE AND THEY COULD
MAKE THE DIFFERENCE AND HELP
SAVING LIVES. WHAT WHAT PRICE
DO WE PUT ON HUMAN LIFE THEN IT
IN THE STATE IF WE MAKE JUST A
VERY MINOR. EXPENSE IN HAVING
THESE SUCCESSFUL WE COULD HELP
SAVE NUMEROUS LIVES ACROSS THE
STATE. I RESPECTFULLY ASK FOR
YOUR SUPPORT I HAVE A- DR EMILY
PART THAT WOULD LIKE TO MAKE
SOME COMMENTS AT FIFTY WOULD
ALLOW. MISTER CHAIRMAN IN
SUPPORT OF THE BILL. ABSOLUTELY
MY PLEASURE- AND THANK YOU FOR
PRESENTING THE BILL WILL GO TO
THE PHONE LINES FOR THE WITNESS
IN SUPPORT- WHENEVER YOU'RE
READY DOCTOR LEAPER. GREAT
THANK YOU. MISTER CHAIRMAN- MY
NAME IS DR ANY LOOK FOR AND I
AM A TRAUMA SURGEON- AT UC SAN
DIEGO HEALTH TODAY I'M
REPRESENTING MYSELF. THE
AMERICAN COLLEGE OF SURGEONS
ALL THREE OF THE CALIFORNIA
CHAPTERS OF THE AMERICAN
COLLEGE OF SURGEONS AND THE
AMERICAN COLLEGE OF SURGEONS
COMMITTEE ON TRAUMA. I'M NOT
REALLY THINKING THE SUPPORT AND
STRONG SUPPORT OF THIS BILL I
ALSO WOULD LIKE TO ACKNOWLEDGE
AND THANK- MEMBER RODRIGUEZ FOR
HIS WORK PREVIOUSLY ON A
PORT MOVING THAT FORWARD- TODAY-
LIKE RUNNING. CAN HAPPEN
ANYWHERE AT HOME AT THE
WORKPLACE IN TRAFFIC ACCIDENTS
AND YES THE MATH CASUALTY
EVENT. THEY CAN BE ACCIDENTAL
INTENTIONAL OR THE RESULT OF A
NATURAL DISASTER INCLUDING
EARTHQUAKE. ADVANCES IN
BLEEDING CONTROL TECHNIQUES AND
PARTICULARLY THE USE OF
TOURNIQUETS HAVE EXPANDED IN
RECENT YEARS. UNDER MILITARY
FOR VIEW OF FAIR USE AND THE
COMBAT STUDIES AND HAVE LED TO
THE DEVELOPMENT OF BLEEDING
CONTROL- EDUCATIONAL COURSES
FOR THE PUBLIC. AND AN
UNTHINKABLE CRIME OF THE MASS
SHOOTING AT SANDY HOOK
ELEMENTARY SCHOOL. IT'S
SIMULATED A COLLEAGUE OF MINE
FROM A SURGEON DOCTORS
LANGWORTH ACOBS TO CONVENE A
NATIONAL PANEL TO ADDRESS
INJURY THAT HE WITNESSED FROM
THAT TERRIBLE OF- TO DETAIN THE
STOP THE BLEED PROGRAM. IS THAT
IT WAS DEVELOPED BY THE
AMERICAN COLLEGE OF SURGEONS
COMMITTEE ON TRAUMA AND ADOPTED
BY THE DEPARTMENT OF DEFENSE
AND SUPPORTED BY HOMELAND
SECURITY AND ENCOURAGE EACH OF
YOU TO LEARN MORE. AT STOP THE
BLEED DOT ORG WITH LOTS OF
EXCELLENT FORMATION AT YOUR
DISPOSAL. THE PROGRAM EVEN
MEMBERS OF THE GENERAL PUBLIC
TO FACE LIFE WITH MINIMAL AND
RELATIVELY INEXPENSIVE
EQUIPMENT THAT WILL BE IT THAT
ONE AVAILABLE WILL SAVE LIVES.
DISAPPOINTMENT INCLUDE SIMPLY
BECAUSE THE PROPER GLOVES
TOURNIQUETS CAN SIMPLE
INSTRUCTION. HELLO KIDDING
DIFFICULT NOW WITH EIGHTIES AND
PUBLIC BUILDINGS AT PATH REALLY
PREVIOUSLY IN TWO THOUSAND
FIFTEEN BY SB SIX FIFTY EIGHT
MAKE LOGICAL SENSE. IN THE TIME
OF LIFE THREATENING BLEEDING OF
THAT. WE ADDRESS THE EQUIPMENT
TO BE PER COULD BE. ACCESSIBLE%
BY SOURCES SUPPLY GOING TO BE
OUT OF REACH COST. AS A TRY
SURGEON HERE YOU SANTA HEALTH
I. T. EACH TIME THAT I AM ON
FALL AS I WAS THE PAST WEEKEND.
LIVE DAYS BY BLEEDING CONTROL
TECHNIQUES THAT ALLOW PATIENTS
THE OPPORTUNITY PRESENTED TO
THE HOSPITAL FOR DEFINITIVE
TREATMENT AND FOR OTHER TO
ARRIVE WITH MUCH LESS FLOOD
WATER. THAN OTHERWISE. A TRAUMA
VICTIM CAN BLEED TO DEATH
WITHIN FIVE MINUTES. AND FOR
MINIMAL COST IN MONETARY FUNDS
AS WELL AS EDUCATION LINE. CAN
AND WILL BE STATE. IS THE
OPPORTUNITY FOR CALIFORNIA TO
LEAD IN THIS IMPORTANT PUBLIC
HEALTH MEASURE YET COMBINED
LEADERSHIP AT EFFORTS WITH.
EMERGENCY MEDICAL SERVICES
TRAUMA SURGERY EMERGENCY
MEDICINE NURSING IN PARTNERSHIP
WITH BUILDING A PROPERTY
INDUSTRY. OTHER STATES SUCH AS
GEORGIA HAVE ALREADY PASSED
LEGISLATION BUT THIS WOULD
REALLY BE IMPORTANT FOR
CALIFORNIA. THIS WILL RESULT IN
LIFE STATE AND COULD BE YOURS
YOUR FAMILY MEMBERS YOUR
COLLEAGUE OR YOUR FRIEND'S
LIFE. TOGETHER WE CAN STOP THE
BLEEDING. THANK YOU. THANK YOU
THANK YOU VERY MUCH WE DO NOT
HAVE ANY WITNESSES REGISTERED
IN OPPOSITION SO WE'LL GO TO
THE PHONE LINES AND ASK THE
OPERATOR OPEN THE LINES FOR. A
WITNESSES IN SUPPORT OR
OPPOSITION JUST YOUR NAME
POSITION ON THE BILL AN
ORGANIZATION IF YOU REPRESENT
ONE SO PLEASE WHENEVER YOU'RE
READY. THANK YOU VERY MUCH AND
AGAIN IT IS ONE AND THEN ZERO.
PRESS ONE ZERO. GIVE ME A
MOMENT HERE. YEP OUR LINE HERE
WILL OPEN NINE ONE THIRTY FOUR.
ONE THIRTY FOUR YEAR LANCE OPEN.
MISTER CHAIR MEMBERS OF HIS
MATTHEW HARPER WITH THE
CALIFORNIA BUSINESS PROPERTIES
ASSOCIATION WE DID SUBMIT AN
OPPOSITION LAST WEEK THAT DOES
NOT SHOW UP IN THE ANALYSIS WE
DO OPPOSE THE BILL- AND
UNFORTUNATELY I CAN'T GET INTO
THOSE REASONS NOW BUT- IF YOU
WANNA GIVE ME A CHANCE I WOULD
LOVE TO EXPAND UPON THEM THANK
YOU. WILL MOVE ON TO OUR NEXT
CALLER PLEASE. A PARTY
CURRENTLY NINETY TWO AT THIS
TIME. THANK YOU VERY MUCH OR
BRINGING BACK TO THE COMMITTEE
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. MISTER RODRIGUEZ.
YES I WANT TO THANK THE SENATOR
FOR BRINGING THIS VERY
IMPORTANT BILL. FOR TODAY AS
YOU KNOW THE LAST TWO YEARS I
TRIED RITE OF SPRING BUT
SIMILAR TO LEGISLATION. BUT A
PORTION OF MEDICAID THEY WERE
ACROSS BUT FOR THE REASON
THAT'S BEEN TALKED ABOUT THESE
TRAUMA KITS WOULD DEFINITELY
SAVE LIVES. IT WOULD BE MY
VISION ONE DAY TO SEE A TRAUMA
KIT. LIKE THIS NEXT TO EVERY A
E. D. WE HAVE THROUGHOUT THE
STATE AND WE SEE THEM PRETTY
MUCH EVERYWHERE WE GO- STUDIES
TELL YOU TIME AND TIME AGAIN
THAT THEY DEFINITELY WILL SAVE
LIVES. SO I'D LIKE TO SUPPORT
THIS WANT TO THANK YOU FOR
BRINGING THIS BILL FORWARD. AND
I LIKE TO KNOW IF I COULD BE
ADDED AS A CO AUTHOR AS WELL.
THANK YOU. THANK YOU VERY MUCH.
OTHER QUESTIONS OR COMMENTS FOR
THE AUTHOR. THANK YOU. WE HAVE
A MOTION FROM MISTER RODRIGUEZ
A SECOND FROM MISS AGUILAR
CURRY. THE MOTION IS. DUE
PASSED TO JUDICIARY THE BILL
DOES ENJOY DO PASS
RECOMMENDATION WHICH LIKE THE
CLOSE SENATOR. I JUST SIMPLY
THIS BILL HAS RECEIVED
UNANIMOUS BIPARTISAN SUPPORT
THROUGHOUT THE PROCESS. THE
HAVE ALL OF YOUR SUPPORT FOR
THIS IMPORTANT MEASURE. THAT
WILL HELP TO SAVE LIVES SO
THANK YOU APPRECIATE YOUR
SUPPORT TODAY. THANK YOU
SENATOR- WITH THAT WILL HAVE
MADAM SECRETARY PLEASE CALL THE
ROLL. WHAT I WOULD AYE MAYES.
MAYES AYE AGUIAR-CURRY.
AGUIAR-CURRY AYE ARAMBULA.
BIGELOW BIGELOW NOT VOTING.
CALDERON CARILLO CARILLO AYE
FLORA. MAIENSCHEIN MCCARTY
NAZARIAN RIVAS. RODRIGUEZ
RODRIGUEZ ICE SANTIAGO. WALDRON.
FIVE ZERO FIVE ZERO WILL LEAVE
THE BILL ON THANK YOU VERY MUCH.
THAT WE ARE- MISS SENT WE HAVE
A WE A BILL FOR SENATOR WHO
WOULD TO COME IN PERCENT ON
THEIR BILLS.
AND HE. BY THE
SENATOR ALAN HI MARIA. HI THERE
MISTER CHAIR YOU KNOW SHE RAN
DOWN HERE BECAUSE ALL COMBINE
OUR ECONOMY. NO YOU DON'T WANT
TO DO THAT SHE HAS FOR BILLS.
THIS WILL BE QUICK I'M JUST
SAYING I'M JUST SAYING YEAH I.
THOMAS WILL MAKE THIS QUICK-
LET ME START BY ACCEPTING THE
COMMITTEE MEMBERS TO DETAIL ON
PAGE SEVEN. I THE HOSPICE
MOVEMENT AND ITS INTEGRATION
INTO WESTERN MEDICINE IS AN
UPLIFTING STORY ABOUT
COMPASSION. AND ABOUT THE BEST
INSTINCTS OF HUMANITY EMBRACING
THE MISSION OF PROVIDING
COMFORT AND SOLACE. TO THOSE
AMONG US WHO ARE DYING. HOWEVER
MEDIA REPORTS AND GOVERNMENT
SURVEY SUGGESTS THE LACK OF
OVERSIGHT HAS LED TO
UNSCRUPULOUS BUSINESSES
ENTERING THE FIELD FOCUS MORE
IN PROFIT AND PAIN MANAGEMENT.
CALIFORNIA HAS THE HIGHEST RATE
OF FOR PROFIT HOSPICES IN THE
NATION AT NINETY ONE POINT TWO.
PERCENT FOR PRIVATE HOSPICE
LICENSORS IN OUR STATE OF RISEN
DRAMATICALLY IN RECENT YEARS
ESPECIALLY THROUGHOUT LOS
ANGELES COUNTY. WHERE THERE ARE
EXPONENTIALLY MORE HOSPICE
PROVIDERS PER CAPITA THAN
ANYWHERE UNITED STATES. THERE
WAS A FASCINATING. AND VERY-
TROUBLING EXPOSE IN THE LOS
ANGELES TIMES AND IF YOU
HAVEN'T HAD A CHANCE TO READ IT
MEMBERS WE HAVE COPIES LOVE TO.
SHARE WITH YOU. AND THE EXPOSE
SUGGESTS THAT- THIS BOOM HAS
QUOTE SPAWNED A COTTAGE
INDUSTRY OF ILLEGAL PRACTICES.
ARE THERE WAS A SIMILAR
INVESTIGATION DONE BY THE
SACRAMENTO BEE WE CAN ALSO
PROVIDE YOU COPIES. AND IT
FOUND THE CALIFORNIA HOSPICES
THEM AT TO BE MARRED BY LAX
OVERSIGHT AND INABILITY OF
REGULATORS TO TAKE MEANINGFUL
ACTION AGAINST HOSPICES. THAT
MAY HAVE VIOLATED RULES AND
JEOPARDIZE THE HEALTH OF
PATIENTS. THE INSPECTOR GENERAL
FOUND THAT OVER NINETY PERCENT.
OF CALIFORNIA HOSPICES ARE
VIOLATING FEDERAL GUIDELINES.
SO IT'S MY STRONG BELIEF THAT
WE NEED TO A THOROUGHLY EXAMINE
THESE ALLEGATIONS IN AN
EXPLORATION OF PATHWAYS FOR
POSSIBLE REFORM OF HOSPICE
LICENSURE AND OVERSIGHT
FRAMEWORK. I WITH THAT IN MIND
THE JOINT LIST OF AUDIT
COMMITTEE APPROVE MY AUDIT
REQUEST THAT PROPOSES AN
EXAMINATION OF THESE
ALLEGATIONS AN EXPLORATION OF
PATHWAYS FOR POSSIBLE REFORM
REFORM OF THE HOSPICE LICENSOR
IN OVERSIGHT FRAMEWORK- THIS
BILL. BASICALLY BECAUSE CALLS
FOR A PAUSE UNTIL. WE GET THE-
DATA AND RECOMMENDATIONS BACK
FROM THE AUDITOR. IT'S RECEIVED
BIPARTISAN SUPPORT IN THE
SENATE AS DID THE AUDIT
REQUEST. WE WORK VERY CLOSELY
WITH THE CALIFORNIA HOSPICE AND
PALLIATIVE CARE ASSOCIATION ON
THIS MEASURE IN THE AUDIT WE
APPRECIATE THEIR FEEDBACK AND
HELP AND- THEY REMAIN NEUTRAL
ON THE BILL- WITH ME TO TESTIFY
IN SUPPORT IS TONY TICKET TELL
FROM THE CALIFORNIA ASSOCIATION
FOR NURSING HOME REFORM. THANK
YOU VERY MUCH- WE WILL GO AHEAD
TO THE- PHONE LINES FOR A
WITNESS ARE PROPER WINDOWS IN
SUPPORT PLEASE WHENEVER YOU'RE
READY. YES GOOD AFTERNOON THANK
YOU TO THE COMMITTEE CHAIRED
STAFF MEMBERS MY NAME'S TONY
CHECK ITSELF I'M A STAFF
ATTORNEY WITH CALIFORNIA
BECAUSE FOR NURSING HOME REFORM.
THE HOSPICE MOVEMENT BEGAN IN
THE NINETEEN SEVENTIES REALLY
TO CAPTURE A PHILOSOPHY A KID
THAT WAS HIGHLY PATIENT DRIVEN.
WITH A SINGULAR FOCUS ON
PATIENT COMFORT- BUT ONCE THE
HOSPICE CARE WAS INTRODUCED AS
A MEDICARE BENEFIT IN NINETEEN
EIGHTY THREE AND- COMPOUNDED BY
DECADES OF MOSTLY REGULATORY
INDIFFERENCE THE HOSPICE
PHILOSOPHY HAS BEEN PRETTY
MANGLED. BY AN INCREASING
NUMBER OF HOSPICE PROVIDERS WHO
HAVE VERY LITTLE INTEREST IN
PATIENT COMFORT BUT ARE DRIVEN
INSTEAD BY EASY MONEY. AND ON
WAITING FAMILIES. AS SENATOR
ALAN REFERENCE THE RECENT LA
TIMES INVESTIGATION FOUND THAT
CALIFORNIA'S REALLY AN
EPICENTER FOR HOSPICE FRAUD AND
ABUSE. THE REPORT THAT INTENSE
COMPETITION FOR LUCRATIVE
MEDICARE PAYMENTS HISPANA
COTTAGE INDUSTRY OF ILLEGAL
PRACTICES AND ATTRACTED
OPERATORS WHO ARE ENGAGED AND-
AUDACIOUS AND WIDESPREAD FRAUD.
MOST ALARMINGLY THE TIMES FOUND
HUNDREDS OF INSTANCES IN WHICH
CALIFORNIA HOSPICE PATIENTS
WERE HARMED. NEGLECTED ARE PUT
AT SERIOUS RISK. THE
EXPONENTIAL BOOM IN PROVIDERS
HAS TRANSFORMED END OF LIFE
CARE THAT WAS ONCE THE REALM OF
CHARITIES AND RELIGIOUS GROUPS
INTO A MULTI BILLION DOLLAR
BUSINESS DOMINATED BY PRIVATE.
PROFIT DRIVEN OPERATORS. MANY
THE FOR PROFIT OPERATORS
RELENTLESSLY PURSUE PATIENTS
AND ENGAGE IN FRAUD KICKBACKS
AND WITHHOLDING OF CARE TO MEET
THE GOALS OF ADMINISTRATORS AND
INVESTORS. THERE ARE CERTAINLY
GOOD HOSPICE PROVIDERS OUT
THERE DOING AMAZING WORK IN
VERY DIFFICULT TIMES. THEY LIKE
MANY HOSPICE PATIENTS AND THEIR
FAMILIES ARE UPSET IN THE
WILDER BY THE PROLIFERATION OF
FLY BY NIGHT HOSPICE AGENCIES.
THE PROPOSED MORATORIUM IN SB
SIX SIX FOUR WILL GIVE A MUCH
NEEDED BREATHER TO THE STATE
ALLOWING POLICY MAKERS AND
ESPECIALLY THE STATE AUDITOR.
TO BETTER UNDERSTAND THE
ORIGINS OF THE HOSTAGE PROBLEMS
AND TO DEVISE SOLUTIONS.
CALIFORNIANS WHO ARE DYING
DESERVE FAR BETTER THAN TO BE
EXPLOITED BY CORRUPT HOSPICE
PROVIDERS. WE URGE YOU TO
SUPPORT THIS MORATORIUM THANK
YOU. THANK YOU VERY MUCH. THERE
ANYONE IN THE GALLERY TO SEE
TESTIFYING THIS. SEEING NO ONE
WILL GO TO THE PHONE LINES WILL
JUST BE ASKING FOR WITNESSES IN
SUPPORT OR OPPOSITION- JUST
YOUR NAME POSITION ON THE BILL
AN ORGANIZATION IF YOU
REPRESENT ONE WHENEVER YOU'RE
READY. AND PLEASE PRESS ONE
ZERO AT THIS TIME. CURRENTLY
NINE Q. THANK YOU VERY MUCH FOR
BRING BACK TO THE COMMITTEE
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. SEEING SEEING NONE.
HERE IS OUR MOTION OR. MISTER
REGUS. SECOND I HAVE A MOTION
BY MISTER RODRIGUEZ A SENT A
SECOND BY MR MAYES- THE BILL
DOESN'T JOIN THESE PASSED
RECOMMENDATION IT WOULD BE TO
PASS AS AMENDED TO
APPROPRIATIONS CENTER ALLEN YOU
WANT TO CLOSE. THE S. SUPPORT
IN THAT RESPECT HAS TRAVELED.
THANK YOU VERY MUCH MADAM
SECRETARY PLEASE CALL THE ROLL.
MOTIONS TO PASS AS AMENDED TO
APPROPRIATIONS WHAT I WOULD AYE
MAYES MAYES AYE AGUIAR-CURRY.
AGUIAR-CURRY AYE ARAMBULA
BIGELOW BIGELOW AYE CALDERON.
CARILLO FLORA. MAIENSCHEIN
MCCARTY NAZARIAN RIVAS
RODRIGUEZ RODRIGUEZ I SANTIAGO
WALDRON WALDRON HIGH. THANK YOU
MEMBER WHICH IS YOUR BILL HAS
SIX VOTES WILL BE THE WILL
LEAVE THE BILL ON CALL. THANK
YOU- SENATOR HER TADO. PLEASE
GO AHEAD GOOD AFTERNOON CHAIR
MEMBERS ARE THERE IS NO DOUBT
THAT THE CURRENT COVER NINETEEN
PANDEMIC HAS BEEN CHALLENGING
FOR EVERYONE ESPECIALLY WHEN IT
COMES TO MENTAL HEALTH EXPERTS
HAVE WARNED THAT THIS PANDEMIC
IS A TRAUMATIC STRESS STRAIN
THAT IT COULD LEAD TO A WHOLE
GENERATION OF CHILDREN WHO
SUFFER FROM TRAUMA OR DEVELOP
LONG TERM HEALTH ISSUES AS A
RESULT OF ADVERSE. CHILDHOOD
EXPERIENCES. HOW THEN HOW DO WE
ADDRESS THIS WAVE OF MENTAL AND
FUTURE PHYSICAL HEALTH IN. THE
CONTEXT OF THE TRAUMA THAT WERE
ALL EXPERIENCING TODAY. SB FOUR
TO EIGHT EXPENSE THE ABILITY OF
PROVIDERS TO SCREEN PATIENTS
FOR ASUS. IT REQUIRES A
COMMERCIAL INSURANCE TO
REIMBURSE PROVIDERS WHO PREFER
ASUS SCREENS ALLOWING EVERYONE
TO GET THIS VITAL SERVICE
REGARDLESS OF INSURANCE
COVERAGE. THE DEPARTMENT OF
HEALTH CARE SERVICES CURRENTLY
REIMBURSES POSITIONS WOULD TAKE
ACES TRAINING AND PROVIDES ASUS
SCREENS TO MEDICAL
BENEFICIARIES. THERE IS NO
REQUIREMENT FOR COMMERCIAL
PAYERS TO DO THE SAME. MY
EXPANDING COVERAGE OF ACES
GREENS FOR ALL REGARDLESS OF
INSURANCE COVERAGE DOCTORS CAN
HELP IDENTIFY FACTORS CAUSED BY
THE PANDEMIC AND OTHER EXPENSES
THAT MAY LEAD TO WORSE HEALTH
OUTCOMES IN THE FUTURE. I HAVE
TWO WITNESSES TODAY JOINING US
REMOTELY AS WELL AS TWO
INDIVIDUALS AVAILABLE FOR
TECHNICAL ASSISTANCE ALSO
JOINING US REMOTELY- AND I HAVE
WITNESSED DR. AB MARTY BOMB A
PETITION PERFORMS A SCREENINGS
AN ASSISTANT PROFESSOR AT LOMA
LINDA UNIVERSITY SCHOOL OF
MEDICINE. AND A DOCTOR JUST
MEAT BEANS A PHYSICIAN FROM
DIGNITY HEALTH FOUNDATION'S
MEDICAL GROUP. AND FOR
TECHNICAL ASSISTANCE I HAVE
ADRIN MUHAMMAD LEGISLATIVE
ADVOCATE FOR THE CALIFORNIA
ASSOCIATION ADD. LISTS ON
FRANCIS ASSOCIATE DIRECTOR FOR
CHILDREN NOW. CERVIA MOTION A
SECOND WILL GO TO THE FIRST
WITNESS IN SUPPORT OF THAT DR
MARTY MARTY BOMBS THAT HE SAID
YES. DR BOB. HELLO THIS IS DR
MARTY BAUMANN NINE SPEAKING AS
A BOARD OF TRUSTEES FOR THE
CALIFORNIA MEDICAL ASSOCIATION
I'M ALSO A PROFESSOR AT THE
SCHOOL OF MEDICINE AT LOMA
LINDA UNIVERSITY MEDICAL
DIRECTOR FOR COMMUNITY HEALTH
DEVELOPMENT AND INSTITUTE FOR
COMMUNITY PARTNERSHIPS AND MY
DIRECT CLINICAL RESPONSIBILITY
IS THAT SOCIAL ACTION COMMUNITY
HEALTH A FEDERALLY QUALIFIED
HEALTH CLINIC WHERE WE HAVE
OVER SIXTY RESIDENTS THAT ARE
TRAINED EVERY YEAR. AS A
PEDIATRICIAN I WILL SPEAK TO
THE IMPORTANCE OF SB FOUR
TWENTY EIGHT FOR CHILDREN AND
FAMILIES. AT THE PEDIATRICIAN
OF THIRTY YEARS I'VE BEEN
CONNECTING CHILDREN AND
FAMILIES TO RESOURCES AND
TEACHING THE SAME
RESPONSIBILITY TO NEW MEDICAL
STUDENTS AND RESIDENTS. WE ARE
NOT JUST SCREENING FOR
PNEUMONIA WHICH WILL REQUIRE A
SIMPLE TEN DAY ANTIBIOTIC
PRESCRIPTION FOR TREATMENT WE
ARE SCREENING FOR ARRESTED THAT
WILL HAVE A LIFETIME IMPACT AND
OUTCOME FOR THAT PERSON TO HELP.
SB FOUR TWENTY EIGHT IS AN
OPPORTUNITY FOR THE STATE OF
CALIFORNIA TO RECOGNIZE EARLY
RISK AND CHANGE TRAJECTORY. FOR
A CHILD AND THE SUBSEQUENT
GENERATION. THIRTY POINTS TO
MAKE AT THE POSITION. SCREENING
PATIENTS IS WHERE ALL THE
MEDICINE AND FINANCES MOVING AS
WE SEEK TO GET TREATMENT TO
PATIENTS. IF WE DO NOT KNOW WE
CANNOT REAT PHYSICIANS WANT TO
TAKE THE FIRST STEP TO SCREEN.
THE SECOND TREATMENT. ALL
TREATMENT WHETHER IT IS A
REFERRAL TO BEHAVIORAL HEALTH
CONNECTIONS SPECIAL EDUCATION
PATHWAY FOR MEDICATION GIVEN TO
AVOID. THE CONSEQUENCES OF THE
GENETIC RISK ALL THE TREATMENT
CHANGE OUT. OUR JOB IS TO PULL
PREVENTIVE CARE OR EARLY
INTERVENTION INTO THE CLINIC
ROOM. WITH OUR PATIENTS AND
FAMILIES THE TREATMENT IS
TAILORED TO IDENTIFY RISK.
PHYSICIANS ARE TRYING TO TAKE
THAT SECOND STEP WHICH IS TO
TREAT AND CONNECT RESOURCE.
THERE IS A MISCONCEPTION THAT
ONLY CHILDREN FROM POOR
COMMUNITIES NEED SCREENING
INTERVENTION EVERY PHYSICIAN
KNOWS THIS IS A FALSE SAFETY
CORNER. WERE. HEALTH INSURANCE
COMPANIES WANT TO CONGREGATE.
THE IS NOT A FAIR. I'M SON THE
THING AROUND ARGUMENT BE USED
FOR VACCINES NUTRITION PHYSICAL
ACTIVITY EARLY LITERACY
PROGRAMS AND THAT ONLY POOR
CHILDREN NEED THESE EXTRA
SERVICES ALL CHILDREN NEED RISK
EVALUATION FOR ADVERSE
CHILDHOOD EXPERIENCES WITH AN
EQUITY LENS ALL CHILDREN ARE AT
RISK OF CHILDREN ARE THE FINAL
UNSEEN POPULATION. AT WELL
CHILD EXAMS I GET A GLIMPSE
INTO HOME LIFE STRESSORS FOR
FAMILY THE NEIGHBORHOODS A
QUESTIONNAIRE SERVICES OF
THRESHOLDS FOR SCREENING RISK
FOR ALL FAMILIES. EVERY WEEK I
ENTERED EXAM ROOMS THERE'S A
CHILD WITH INCREASING FREQUENCY
WE HAVE TO DIED IN THE
EXPERIENCES OF MENTAL HEALTH.
THE PATIENT STORY OFTE
ENCOMPASS FOOD INSECURITY
MULTIPLE RELOCATIONS
DYSFUNCTIONAL RELATIONSHIP.
THAT ONE CHILD STORY BUT THERE
ARE OTHER CHILDREN IN THAT
FAMILY THAT HAVE THEIR OWN
STORIES OF TRAUMA. CENTER A
COMPLEXITY OF THE STORIES OF
THE PARENTS AND GRANDPARENTS
BEFORE I LEAVE THE ROOM
EVERYONE IN THE ROOM STATES
THAT THIS IS A MULTI
GENERATIONAL ISSUE. AND WE KNOW
THAT IT WILL REPEAT AGAIN IF
THERE'S NO INTERVENTION FORM MY.
PATIENT WHICH IS A CHILD.
PUBLIC HEALTH FINE RECORD THE
IMPORTANCE OF SOCIAL. OF HEALTH
AND EARLY NINETEEN EIGHTY FIVE
THE CDC. CARE SEMINAR TO BOMB
AND I HAVE YOUR AUTOGRAPH AND
ADOPTED RESPONSIBILITY. THANK
YOU VERY MUCH FOR LETTING ME
TESTIFIED FOR SB FOUR TWENTY
EIGHT. THANK YOU SO MUCH AFTER
BOMBS GREAT TO HEAR FROM
SOMEBODY FROM THE INLAND EMPIRE
AND WE'LL MOVE ON TO THE DOCTOR
JAZZ MAINTAINS THAT. THAT'S
CORRECT A DOCTOR BAINES. DR
BANDER YOU ON THE LINE. DR
BANDY THERE. ALL RIGHT WELL
LET'S MOVE WILL MOVE ON TO USER
ANY WITNESSES IN OPPOSITION. DO
YOU HAVE ANY WITNESSES IN
OPPOSITION. WE DON'T HAVE ANY
WITNESSES OPPOSITION WILL GO
TO- THE- THE ADELINE SO THERE
ANY WITH THE EDITION OF
WITNESSES IN SUPPORT. OR IN
OPPOSITION. MATT A MODERATOR.
THANK YOU TO GET I WANT TO GET
IT ONE OF THEM GENERAL WILL
FIRST GO TO ONE OF NINETY FOUR.
THANK YOU KATIEWRITTEN ON
BEHALF OF THE CHILDREN
SPECIALTY CARE COALITION AND
SUPPORT. THANK YOU. AND. NINETY
EIGHT. AND ON BEHALF THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS REPORT THANK YOU.
ONE THIRTY. RIGHT STEPS ON
BEHALF OF THE AMERICAN COLLEGE
OF OBGYN STRYCHNINE IN SUPPORT.
THANK YOU. ONE FORTY NINE.
NICOLE BORNEMANN ON BEHALF OF
THE CHILDREN'S PARTNERSHIP IN
SUPPORT. THANK YOU MMHM. ONE
THIRTY THREE. MISTER CHAIRMAN
AND MEMBERS PAUL EUROPE WE HAVE
THE CALIFORNIA STATE
ASSOCIATION PSYCHIATRISTS IN
SUPPORT. THANK YOU. ID. ONE OH
EIGHT. LINE ONE OH EIGHT. WE
WANT THE NEXT. ONE IN LINE. ONE
FORTY EIGHT. DIMITRIUS THE WORD
NATIONAL ASSOCIATION OPPOSE
WORKER CALIFORNIA CHAPTER IN
SUPPORT THANK YOU. THANK YOU.
IN THE LAST CHEN Q. HERE IS
LINE. EIGHTY FOUR. MANITO ON
BEHALF THE STANDARD INSECURE IN
SUPPORT THANK YOU. THANK YOU SO
MUCH ONE. HUNDRED ANYMORE. NOPE
THAT'S IT AT THIS TIME GREAT
THANK YOU WILL BRING IT BACK TO
COMMITTEE IN THE PAST BACK TO
DOCTOR WAS. YOUR QUESTIONS OR
COMMENTS- ASSEMBLY MEMBER
WALDRON. HI JUST EVERY TIME
THIS TOPIC COMES UP I ALWAYS
ONE TO SPEAK ON IT BECAUSE IT'S
REALLY AN IMPORTANT THING WE'RE
ONLY JUST. COMING TO LEARN
ABOUT. THE DAY AFTER THE EXTENT
OF ASUS ON PEOPLE'S LIVES AND
HOW IT AFFECTS THEM AND- YOU
KNOW. AS YOU ALL KNOW I WORK-
IN THE CRIMINAL JUSTICE FIELD A
LOT AND- WE FIND THAT WHEN YOU
LOOK AT WOMEN INCARCERATED OVER
86% OF THEM HAVE HAD TRAUMA. IN
THEIR LIFE WHEN THEY WERE YOUNG
WHETHER IT'S SEXUAL ASSAULT OR
OTHER THINGS. YOU KNOW ONE BOOK
IF WE CAN GET EARLY
INTERVENTION SERVICES TO HELP
IDENTIFY IT WILL GET PEOPLE
TALKING ABOUT IT. ESPECIALLY
YOUNG PEOPLE THEY DON'T EVEN
KNOW MAYBE WHAT'S HAPPENED TO
THEM. I THINK IT'S REALLY
IMPORTANT WILL GO A LONG WAY I
MEAN NOT ONLY IN THE COST OF
HEALTH CARE BUT ALSO. THE
SUCCESS OF PEOPLE'S FUTURE LIVE
SO I URGE A NO VOTE. THANK YOU
VERY MUCH ASSEMBLY MEMBER
WALDRON ANYONE ELSE. I JUST TO
CLARIFY- SORRY STEPPED OUT- ARE
YOU ACCEPTING THE AMENDMENTS-
THE CENTER YES THANK YOU THANK
YOU VERY MUCH. ANY OTHER
QUESTIONS OR COMMENTS WAS THERE
A MOTION OR SECOND ON THIS. A
MOTION BY MISS AGUIAR-CURRY
SECOND BY MISS WALDRON OF THE
MOTION WOULD BE TO PASS AS
AMENDED TO APPROPRIATIONS THE
BILL DOES ENJOY A DO PASS
RECOMMENDATION WHICH LIKE TO
CLOSE SENATOR. THANK YOU AND I
RESPECTFULLY ASK RIVAL THANK
YOU VERY MUCH BETTER SECRETARY
PLEASE CALL THE ROLL WHAT HI
WHAT I MAYES MAYES AYE
AGUIAR-CURRY. AGUIAR-CURRY AYE
ARAMBULA. BIGELOW BIGELOW AYE
CALDERON. CALDERON I CARILLO.
FLORA. MAIENSCHEIN MCCARTY.
MCCARTY I NAZARIAN. RIVAS
RODRIGUEZ RODRIGUEZ I SANTIAGO
WALDRON WALDRON I. IT'S EIGHT
ZERO THANK YOU CENTER YOUR BILL
HAS A BOAT SITS OUT WILL LEAVE
THE LEAVE THE ROLE OPEN FOR
OTHERS TO ADD ON. THANK YOU.
MISTER MON. THANK YOU CHAIR AND
MEMBERS. I HAVE A FEW TODAY THE-
STARTING WITH SB FORTY EIGHT S.
B. FORTY EIGHT HAVE THE PERFECT
THANK YOU THANK YOU THANK YOU
TURN COLLEAGUES I WANTED TO
START BY ACCEPTING THE
COMMITTEE AMENDMENTS TO RAISE
THE AGE TO SIXTY FIVE AND
THINKING THE CHAIR AND
COMMITTEE STAFF FOR THEIR HARD
WORK ON THIS IMPORTANT ISSUE.
SB FORTY CREATES AN INNOVATIVE
PROGRAM TO GIVE MEDICARE
PROVIDERS TRAINING VALIDATED
ASSESSMENT TOOLS AND PAYMENT
CENTERS FOR CONDUCTING
COGNITIVE HEALTH ASSESSMENTS IN
ORDER TO ACHIEVE THE STATE WIDE
GOAL OF IMPROVED ALZHEIMER'S
DETECTION AND DIAGNOSES
ACCORDING TO THE ALZHEIMER'S
ASSOCIATION LESS THAN HALF OF
INDIVIDUALS LIVING WITH
ALZHEIMER'S HAVE BEEN GIVEN A
DIAGNOSIS THE LACK OF DIAGNOSIS
LEADS TO A NUMBER OF CHALLENGES
RELATED TO PLANNING CARE COST
OF CARE AND ENGAGEMENT IN
CLINICAL TRIALS. R. C. HAS
MODELED HOW MUCH A PROGRAM
COULD BE SUCCESSFUL THROUGH THE
ADVERSE CHILDHOOD EXPERIENCES
PROGRAM ALSO KNOWN AS ASUS THE
PROGRAM PROVIDES FINANCIAL
INCENTIVES FOR PHYSICIANS
SERVING MEDICARE POPULATIONS TO
CONDUCT CASES SCREENINGS SB
FORTY EIGHT WOULD USE A MODEL
SIMILAR TO THIS FOR ALZHEIMER'S
AND DEMENTIA. THIS BILL IS AN
IMPORTANT STEP TO ENSURE
INDIVIDUALS RECEIVE A TIMELY
AND ACCURATE DIAGNOSES WHILE
GIVING PHYSICIANS THE TOOLS TO
EFFECTIVELY ASSESS A PATIENT'S
CHANCES OF- HAVING ALZHEIMER'S
DISEASE AND DEMENTIA. I ON THE
PHONE TODAY THERE ARE PATIENT
ADVOCATE CARLA PRAYER AND YOUR
IT AT YOUR RUSSO WITH
ALZHEIMER'S ASSOCIATION. THANK
YOU VERY MUCH- THANK YOU THANK
YOU SENATOR WE WILL NOW GO TO
THE PHONE LINES FOR OUR
WITNESSES IN SUPPORT WHENEVER
YOU'RE READY TO THE OPERATOR.
THANK YOU PLEASE PRESS ONE ZERO.
WELL FIRST LINE OF ONE OR TWO.
GOOD AFTERNOON MEMBERS UNDER
YOUR PARENTS ON BEHALF OF THE
CALIFORNIA LIFE SCIENCES
REPORT. THANK YOU NEXT CALLER
PLEASE. MY NINETY EIGHT HANG ON
HANG ON HANG ON A SECOND- WE
WERE LOOKING FOR OUR PRIMARY
WITNESSES IN SUPPORT. SO CARLA
PRAYER. AND JERRY G. RUSSO.
PLEASE GO AHEAD WHEN YOU'RE
READY. HI. GOOD MORNING CAN YOU
HEAR ME YES AND GOOD AFTERNOON
TO YOU. WHAT. GOOD AFTERNOON-
GOOD AFTERNOON SURE WOULD MY
NAME IS CARLA PRAYER AND I AM
THE SOLE CAREGIVER FOR MY
HUSBAND AND ADVOCATE AND
VOLUNTEER FOR THE- HUNDRED
ASSOCIATION. I WANT TO THANK.
THEM FOR OFFERING SB FORTY
EIGHT. ELLEN LEADING THE WAY IN
THE IDENTIFIES POLICY PROPOSALS
TO HELP THESE. DEMENTIA TODAY
I'M HERE TO SHARE OUR PERSONAL
EXPERIENCE BEGINNING A
DIAGNOSIS FOR MY HUSBAND
PATRICK WAS A VERY CARING
PERSON WHO BELIEVED IN LAUGHTER
WORKING HARD TAKING GREAT PRIDE
IN CARING FOR HIS FAMILY I
NOTICED MY HUSBAND'S MEMORY
STARTED CHANGING IN TWO
THOUSAND THIRTEEN IN FEBRUARY
NIGHT ON FEBRUARY NINETEENTH
TWO THOUSAND FOURTEEN PATRICK
CALLED ME AND ASKED ME TO MEET
HIM AT HIS DOCTOR'S OFFICE. I
WANT TO SEE HIM IN THE HALLWAY
HE LOOKED AT ME WITH TEARS IN
HIS EYES HE SAID. I GO BACK TO
WORK. I AGREE BECAUSE I FELT
THE STRESS. THAT HE WAS GOING
TO WAS GOING TO KILL HIM AFTER
A FEW MONTHS OF THE YEAR ALL
WORK AND GOING. TO THE
PSYCHIATRIST THE ANGER
MANAGEMENT CLASSES THE
STRESSING TO GET BETTER DESPITE
OF ALL THE LONG GRUELING
DOCTOR'S APPOINTMENT. BUT THEN
WHEN THEY SAID THEY WAS
RELEASING YOUNG TO GO BACK TO
WORK. THE PANIC STAR LOW
BREAKING. SO ON MAY. THIRTY
FIRST TWO THOUSAND FOURTEEN MY
HUSBAND RETIRED FROM THE IN THE
OPERATING ROOM NURSE. FOR OVER
THIRTY EIGHT YEARS AT ONLY AGE
FIFTY EIGHT. I HONESTLY THOUGHT
THIS IS THE ANSWER. AND THAT
THIS WOULD WE AND HE WILL
REGAIN HIS MEMORY. WHAT PATH TO
BE IN THE PRIMARY BREADWINNER
WE HAD TO SELL OUR HOME. WE HAD
TO MOVE INTO A TWO BEDROOM
APARTMENT AND SO ON. PATRICK
WAS GOOD. DISABILITY
COMPENSATION. A COUPLE OF TIMES
THE DOCTOR CONTINUE TO SAY THE
CONDITION IMPORTANT MILD
COGNITIVE IMPAIRMENT. FINALLY
FOUR YEARS LATER I WAS TIRED OF
THE RUN AROUND AND I TOOK
COMPLY OUTSIDE NETWORK.
STANFORD HOSPITAL. THEY DIDN'T
TESTING ON HIM THEY SAID IT WAS
CLEAR THAT THIS WAS THE NATURE.
I THINK STAFFERS REPORT BACK TO
HIS DOCTOR AND THEN I DECIDED
TO ORDER AND THEN THAT'S WHEN
THE DOCTOR DOCTOR HIS DOCTOR
DECIDE TO OR- A PET SCAN.
SHOWED LITELINE BODY DEMENTIA.
WHAT WAS IN TROUBLING THAN THAT.
IN HIS RECORDS THEY SAID THAT
MY HUSBAND WAS BREAKING. ALL OF
THIS I HAD TO RELINQUISH. HAS
RELINQUISHED ALL MY-
RESPONSIBILITIES ALL IN A
BEAUTY SUPPLY ALL IN A BEAUTY
SALON- SO I CAN BETTER CARE FOR
MY HUSBAND THE ONE STRONG HAVE
BEEN FRIDAY MICHELLE TAKING
TAKE GREAT CARE OF HIS FAMILY.
I NOW CARE FOR HIM. HEY WE ASK
YOU TO SUPPORT. SB FORTY EIGHT.
THANK YOU THANK YOU VERY MUCH
MOVE ONTO OUR NEXT WITNESS. YES
THANK YOU COMMITTEE CHAIR WOULD
AND NUMBER MY NAME IS
CHARACTERISED THOUGH AND I'M
THE CALIFORNIA GOVERNMENT
AFFAIRS DIRECTOR FOR THE
ALZHEIMER'S ASSOCIATION WHEN I
THINK THAT ARE REALLY MOAN FOR
OFFERING UP TO FORTY EIGHT AND
FOR BEING AN UNRELENTING
CHAMPION FOR THOSE IMPACTED BY
ALZHEIMER'S ALTHOUGH I THINK
THE STAKEHOLDERS TO ENGAGE IN
THE PROCESS INVOLVED
LEGISLATIVE AND ADMINISTRATIVE
STAFF. WHO HAVE HELPED DEVELOP
THE PROPOSAL WE ESTIMATE THAT%
NEARLY SEVEN HUNDRED THOUSAND
PEOPLE ARE LIVING WITH
ALZHEIMER'S IN CALIFORNIA FOR
FAR TOO MANY THERE EITHER NEVER
GIVEN A DIAGNOSIS OR TAKE YEARS
TO RECEIVE ONE I CENTER THE
AMONG MENTIONED LESS THAN HALF
OF INDIVIDUALS LIVING WITH THE
DEAN AND THESE ARE GIVEN A
DIAGNOSIS. AT THE FORTY EIGHT
HEALTH REJECTED BY
INCENTIVIZING PUBLIC HEALTH
ASSESSMENTS FOR NON BILL
ELIGIBLE MEDICARE BENEFICIARY
FIFTY FIVE AND OVER POSITION
CHOOSING TO RECEIVE THE
THINKCENTRE WILL KEEP THE
COMPLETE IMAGE OF PACIFIC
TRAINING AS WELL WHILE THE
PROGRAM WOULD BE MODELED AFTER
THE WORKER IT HAS DONE RELATED
TO ADVERSE CHILDHOOD
EXPERIENCES OR EVEN. A PROGRAM
SOLELY FOCUSED ON DEMENTIA
WOULD BE THE FIRST OF ITS KIND
IN THE COUNTRY AND AN ADVANCE
OF THE CRUCIAL WORK OF LAST
YEAR AFTER CLAPPER EVENING AT
FAULT THE GOVERNOR ALZHEIMER'S
PREVENTION PREPAREDNESS TASK
FORCE. THIS PROPOSED PROGRAM
HAVE A FEW KEY BENEFITS FIRST
IT TELLS AN IMPORTANT GAP IN
OUR HEALTH CARE SYSTEM FOR
INDIVIDUAL A MEDIC CAL WITHOUT
ACCESS TO MEDICARE WHILE
MEDICARE OFFERS A SIMILAR
BENEFIT WITHIN THE ANNUAL
WELLNESS SAID THAT OVER A
HUNDRED EIGHTY THOUSAND
INDIVIDUALS OVER SIXTY FIVE DO
NOT CURRENTLY HAVE ACCESS TO
THAT BENEFIT. WITH THE PROGRAM
OUTLINED IN SB FORTY EIGHT WE
CAN FINALLY FILL THIS GAP
SECONDLY WHILE THE INCENTIVE
WILL ONLY BE AVAILABLE FOR
THOSE ON MEDI CAL WE BELIEVE
THE TRAINING THAT WILL BE
DEVELOPED COULD HAVE BROADER
BENEFITS TO NON MEDICARE
BENEFICIARY LASTLY ENSURING
MEDICAL BENEFITS VERY MYSTIQUE
COGNITIVE HEALTH DEPARTMENT
ENSURE THAT MAKE THEM MORE CAN
ACT THAT THE MEDICAID BENEFITS
THEY HAVE ACCESS TO THAT WOULD
HELP THEM THROUGHOUT THEIR
LIVES. AT THE HEART OF THIS
WORK IN THE SHOWING EVERYONE
THAT IN THE FALL MEMBERS OF
EQUITABLE ACCESS TO DIAGNOSTIC
SERVICES AND SUPPORT WE KNOW
THAT HEALTH DISPARITIES AND
HEALTH CARE DISPARITIES IN
FIFTH WITH RESPECT ALZHEIMER'S
AFRICAN AMERICANS ARE TWO TIMES
MORE LIKELY THAN WHITE
AMERICANS HAVE ALZHEIMER'S.
LATINO INDIVIDUALS ARE ONE IN
ONE HALF TIMES MORE LIKELY HAD
WELL. ADDITIONALLY TWENTY ONE
AND FIGURES SPECIALLY. ON THE-
50% OF BLACK AMERICAN. OVER 40%
OF NATIVE AND ONE THIRD OF EVEN.
AND NINETEEN. INDIVIDUAL FIXED.
FROM A NATION ONE THINK ACT
WITH HEALTH CARE. SB FORTY IF
FOCUS ON THE ACCOUNT ANSWERED
THAT THE BAND. OF THAT
INNOVATIVE PROGRAM WOULD BE
EXTENDED TO PEOPLE THE MOST
NEED. TIMELY BY. IS AN OPERA.
TO IT IMPROVE QUALITY LIFE THE
TICKET OF TARGET PROGRAM FOR
INDIVIDUAL AS WELL AS THEIR
CARE GIVERS. AND TO PARTICIPATE
IN CLINICAL TRIALS THAT WILL
ULTIMATELY FEEL. BETTER
TREATMENT AND A CHORE WE ASK
FOR YOUR. SUPPORT FOR SB FORTY
EIGHT THANK YOU. THANK YOU VERY
MUCH. WE WILL NOW MOVE TO THE
PHONE LINES FOR ADDITIONAL
SUPPORT- ADDITIONAL TESTIMONY
IN SUPPORT OR OPPOSITION WILL
BE JUST NAME. A POSITION ON THE
BILL AND ORGANIZATION IF YOU
REPRESENT ONE WHENEVER YOU'RE
READY OPERATOR. THANK YOU AGAIN
S. ONE AND THEN GENERAL WILL
RETURN ON JULY NINETY EIGHT
PLEASE GO AHEAD. I GUESS
THEY'VE TAKEN HIMSELF OUT WILL
GO TO ONE OH THREE PLEASE GO
AHEAD. GOOD AFTERNOON MY NAME
IS MARIE COLLINS I'M CALLING
BURYING MY FAMILY MEMBER HAD-
OF. THE MOB WHICH WOULD
DIAGNOSIS WITH EARLY ONSET
ALZHEIMER'S AND I'M CALLING TO
VOICE MY- STRONG STRONG SUPPORT
FOR GENERAL ALONE SB FORTY
EIGHT THANK YOU THANK YOU. NEXT
CALLER PLEASE. IT THANK YOU BYE
NINE ONE FORTY FOUR YEAR LINES
OPEN. MR CHAIRMAN MEMBERS
CRITICAL OF THE ON BEHALF OF
FIRE ENGINES IN STRONG SUPPORT
THANK YOU. NEXT CALLER PLEASE.
AND WHAT A LINE NUMBER NINETY
EIGHT PLEASE GO AHEAD. THE NEXT
DAY HE NINE TO HELP THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS WITH THE SUPPORT
AMENDED VERY MUCH APPRECIATE
THE WORK OF THE AUTHOR AND THE
SPONSOR. THANK YOU NEXT CALLER
PLEASE. YOU CURRENTLY NO
FURTHER CALLERS IN Q. OKAY
THANK YOU WE WILL BRING BACK
COMMITTEE QUESTIONS OR COMMENTS
FROM THE COMMITTEE. MISTER
RODRIGUEZ. THANK YOU JUST WANT
TO THANK THE CENTER FOR
BRINGING THIS VERY IMPORTANT
BILL FORD- I DID HAVE A MOTHER
AND FATHER WHO SUFFERED FROM
ALZHEIMER'S DEMENTIA UNTIL THE
PASSING. SORT OF THANK YOU FOR
THE HARD WORK YOU DO IN THIS
ARENA THE LOOK FOR
DISAPPOINTMENT THANK YOU. THANK
YOU. ANY OTHER COMMENTS OR
QUESTIONS CNN WILL BRING THEM-
WE HAVE- A MOTION BY MISS
AGUIAR-CURRY A SECOND BY MR
RODRIGUEZ AND MOTIONS TO PASS
AS AMENDED TO APPROPRIATIONS
BILL DOES ENJOY DO PASS
RECOMMENDATION WOULD LIKE TO
CLOSE CENTER I RESPECTFULLY ASK
FOR AN EVENT THANK YOU VERY
MUCH MADAM SECRETARY PLEASE
CALL THE ROLL. WHAT I WOULD AYE
MAYES. MAYES AYE AGUIAR-CURRY.
BAKER CURRY I ARAMBULA. BIGELOW
BIGELOW I CALDERON CALDERON I
CARILLO. FLORA MAIENSCHEIN
MCCARTY. NAZARIAN RIVAS
RODRIGUEZ RODRIGUEZ I SANTIAGO
WALDRON WALDRON I. SEVEN ZERO
SEVEN ZERO WILL LEAVE THE-
BELIEVE THE BILL ON CALL THANK
YOU AND WE DO HAVE A CENTER
LEYVA HERE WHO SAID SHE'S GONNA
BE VERY QUICK. VERY QUICK. TO
GET IT SINCE I HAVE A FEW. FAIR
ENOUGH. BY THE VERY QUICK
SENATOR LEYVA IS DASHING TO THE
MICROPHONE THANK YOU SENATOR
LIMóN I GREATLY APPRECIATE
THAT. BOB GOOD AFTERNOON MISTER
CHAIR AND MEMBERS I WAS FORGET
THAT THERE'S NO LITTLE PODIUM
HERE. I WOULD FIRST LIKE TO
THANK THE COMMITTEE STAFF FOR
WORKING WITH MYSELF ON THIS
BILL AND I WILL BE ACCEPTING
AMENDMENTS AS NOTED ON PAGE
THIRTEEN OF COMMITTEE ANALYSIS.
SB FIVE TWENTY THREE EXPANSIVE
MODERNIZES BIRTH CONTROL ACCESS
ENSURES GREATER CONTRACEPTIVE
EQUITY STATEWIDE. REGARDLESS OF
AN INDIVIDUAL'S GENDER
INSURANCE COVERAGE STATUS WHERE
THEY WORK OR WHERE THEY GO TO
SCHOOL. IN TWO THOUSAND FIFTEEN
CALIFORNIA METHODIST TEN FIFTY
THREE THE CONTRACEPTIVE
COVERAGE EQUITY ACT TO BUILD ON
EXISTING POLICY. AND CODIFY THE
AFFORDABLE CARE ACT'S
CONTRACEPTIVE COVERAGE MANDATE
INTO STATE LAW. MAJOR REQUIRED
MOST COMMERCIAL HEALTH PLANS TO
COVER ALL FDA APPROVED
CONTRACEPTIVE METHODS. WITHOUT
COPAYS COINSURANCE OR
RESTRICTIONS LIKE STEP THERAPY
OR PRIOR AUTHORIZATION.
ADDITIONALLY IN TWO THOUSAND
SIXTEEN JUST AFTER TEN THIRTY
THREE WAS ENACTED SB NINE NINE
NINE WAS IMPLEMENTED TO REQUIRE
MOST HEALTH INSURANCE PLANS. IN
CALIFORNIA TO COVER IS YEAR'S%
SUPPLY OF BIRTH CONTROL
DISPENSED AT ONE TIME. DESPITE
THE PROGRESS WE'VE MADE IN
CALIFORNA HEALTH DISPARITIES
AND REPRODUCTIVE HEALTH
OUTCOMES PERSIST AMONG BLACK
INDIGENOUS AND PEOPLE OF COLOR.
INCLUDING DISPROPORTIONATE
UNINTENDED PREGNANCY INFANT
NUMBER TEN MORE. PATERNAL
MORTALITY AND STD RATES IT'S
TIME FOR CALIFORNIA TO
MODERNIZE AND EXPAND ITS
CONTRACEPTIVE EQUITY LAWS. TO
REDUCE BARRIERS TO
CONTRACEPTIVE CARE IMPROVE
SEXUAL REPRODUCTIVE HEALTH
OUTCOMES AND CREATORS GREATER
HEALTH EQUITY. TO THAT END SB
FIVE TWENTY THREE ACCOMPLISHES
THE FOLLOWING. MAKES
CALIFORNIA'S CONTRACEPTIVE
EQUITY LAWS GENDER INCLUSIVE
REQUIRES COVERAGE OF OVER THE
COUNTER BIRTH CONTROL OPTIONS
TO INCREASE ACCESS TO TIME.
SENSITIVE CARE. EXPANSE ON SEPT
ACCOUNT RICH MILLIONS OF.
BREAKS EXPEND BENEFITS TO STATE
EMPLOYEES IN INDIVIDUAL AND IN
HEALTH PLANS. PROHIBITS
EMPLOYER DISCRIMINATION BASED
ON EMPLOYEES CONTRACEPTIVE
CHOICES HERE TO TESTIFY IN
SUPPORT REMOTELY ARLIS MACHAME
AND OF THE NATIONAL HEALTH LAW
PROGRAM AND DR JESSICA BEEMAN
ASSISTANT PROFESSOR OF MEDICINE
AT THE UNIVERSITY OF CALIFORNIA
SAN FRANCISCO. THANK YOU VERY
MUCH SAYS SENATOR- PLEASE WILL
OPEN THE PHONE LINES FOR OUR
WITNESSES IN SUPPORT. MR
CHAIRMAN AND COMMITTEE MEMBERS
MY NAME IS PLACEMENT CANON AND
I AM A SENIOR ATTORNEY WITH THE
NATIONAL HEALTH IN THE PROGRAM
AND HEALTH. WHICH IS THE PUBLIC
INTEREST LAW FIRM WITH OFFICES
IN LOS ANGELES. EASY AND CHAPEL
HILL. THANK OUR MISSION TO
PROTECT PROTECT AND ADVANCE THE
HEALTH RATES OF LOW INCOME AND
UNDERSERVED PEOPLE. WE ARE VERY
PROUD TO CO SPONSOR SB FIVE
TWENTY THREE AND WANT TO
EXPRESS OUR DEEP GRATITUDE TO
SENATOR LEYVA FOR BEING A
FAMILY PLANNING CHAMPIONSHIP
AND FOR HER LEADERSHIP ON THIS
IMPORTANT ISSUE. I ANOTHER
MENTION AND HELP ALSO- BONTA
CONTRACEPTIVE COVERAGE EQUITY
ACT IN TWENTY FIFTEEN. BUT
SINCE THEN. HAVE ENACTED A
PROVISION THAT GO ABOVE AND
BEYOND THE BIG BIRTH CONTROL
MANDATE TO CREATE GREATER
CONTRACEPTIVE EQUITY. I WILL
SEVEN STATES NOW REQUIRE HEALTH
PLANS TO COVER MALE
STERILIZATION FERRIS SAID WITH
NO COPAYS WELL INSURED MAN IN
CALIFORNIA HAVE TO PAY COST
SHARING FEES CORPORATE SECTOR
MEANS. ADDITIONALLY AT PENN
STATE'S MANDATE COVERAGE OF
OVER THE COUNTER BIRTH CONTROL
METHODS WITHOUT A PRESCRIPTION
AT NO COST TO THE PATIENT.
FINALLY SB FIVE TWENTY THREE
WHAT GUARANTEED UNIVERSITY
STUDENTS AND STATE EMPLOYEES
EQUITABLE ACCESS TO
COMPREHENSIVE CONTRACEPTIVE
CARE IN THEIR HEALTH PLANS.
AFTER FOUR YEARS OF ATTACKS ON
REPRODUCTIVE HEALTH CALIFORNIA
CAN AND MUST ADVANCE PROACTIVE
SOLUTION TO ENSURE THAT
CALIFORNIANS GET THE BIRTH
CONTROL THEY WANT WHEN THEY
NEED IT WITHOUT DELAY. THAT IS
WHY WE RESPECTFULLY REQUEST
YOUR AYE VOTE ON SB FIVE TWENTY
THREE TODAY THANK YOU. THANK
YOU VERY MUCH MOVE ON WILL MOVE
ON TO OUR NEXT WITNESS.
AFTERNOON AND THANK YOU
CHAIRMAN AND COMMITTEE MEMBERS
FOR THE OPPORTUNITY TO SPEAK MY
NAME IS DR CATHOLIC AT THE MAN
AND I AM AN ASSISTANT PROFESSOR
IN THE DEPARTMENT OF MEDICINE
AND THE DEPARTMENT OF
OBSTETRICS GYNECOLOGY AND
REPRODUCTIVE SCIENCES AT THE
UNIVERSITY OF CALIFORNIA SAN
FRANCISCO. AS A GENERAL
INTERNIST AND PRIMARY CARE
PROVIDER WITH EXPERTISE IN
FAMILY PLANNING AND
CONTRACEPTION I WITNESSED THE
IMPORTANCE OF ACCESS TO
CONTRACEPTION ON MY PATIENTS.
PATIENT SHARE WITH ME HOW
CONTRACEPTION HELPED THEM TO
PLAN THEIR LIVES AND ALLOWS
THEM TO DECIDE IF AND WHEN THEY
WILL HAVE CHILDREN. BY BEING
ABLE TO PROVIDE INFORMATION
ABOUT AND ACCESS TO
CONTRACEPTION IF IT IF DESIRED
I KNOW THAT I CAN HELP TO
ENSURE THAT MY PATIENT NOT ONLY
HAS BODILY AUTONOMY I CAN MAKE
DECISIONS THAT ARE BEST FOR
THEM JUST BECAUSE I WANT THEM
TO BE ABLE TO DO. ALL ASPECTS
OF THEIR HEALTHCARE. WE KNOW
FROM DECADES OF RESEARCH INTHE
FIELD THAT NOT EVERY
CONTRACEPTIVE. METHOD IS RIGHT
FOR EVERY PERSON. THE CHOICE
END OF. HOWEVER WE ALSO KNOW
THAT PEOPLE IN OUR STATE AND IN
OUR COUNTRY DO NOT HAVE ACCESS
TO ALL OF THE CONTRACEPTIVE
METHODS THAT THEY NEED A BUYER.
THE TYPICALLY PEOPLE THAT
BEACON EQUITIES WHEN ACCESSING
ANY HEALTHCARE INCLUDING BLACK
INDIGENOUS AND OTHER PEOPLE OF
COLOR. YOUNG AND ADOLESCENT
PATIENTS. PATIENT EXPERIENCING
HOMELESSNESS THOSE WITH LOW
INCOMES AND PEOPLE LIVING IN
RURAL RURAL COMMUNITIES.
EXPERIENCE VERY BARRIERS TO
GETTING THE CONTRACEPTIVE
METHODS THAT THEY DESIRE. SB
FIVE TWENTY THREE WOULD ENSURE
THAT PATIENTS ARE ABLE TO
ACCESS INTERCEPTED CARE WHICH
IS ESSENTIAL HEALTH CARE.
REGARDLESS OF WHERE THEY HAPPEN
TO LIVE HOW MUCH MONEY THEY
MAKE THEIR GENDER IDENTITY OR
RACE OR ETHNICITY. IT WOULD
EXPAND HEALTH CARE TO PROVIDE
CONTRACEPTIVE COVERAGE BENEFITS
TO MILLIONS OF PEOPLE IN OUR
STATE. THE FULL RANGE OF
CONTRACEPTIVE METHODS WOULD BE
COVERED AND OVER THE COUNTER
BIRTH CONTROL METHODS COULD BE
DISPENSED AT PHARMACIES
DIRECTLY TO PATIENTS. REDUCING
THE LIMITATIONS ON ACCESS AND
ENSURING THAT PATIENTS HAVE
TIMELY ACCESS TO ESSENTIAL
HEALTH CARE. BILL IS TIMELY AS
WE EMERGE FROM THE PANDEMIC
HAVING SEEN THE DISPARITIES
THAT WERE EXACERBATED DURING
THE COPA NINETEEN PUBLIC HEALTH
EMERGENCY. AND A REPORT WITH A
NATIONALLY REPRESENTATIVE
REPRESENTATIVE SAMPLE BY THE
GUTTMACHER INSTITUTE. 38% OF
BLACK WOMEN 45% OF LATINOS AND
36% OF LOWER INCOME WOMEN.
REPORTED EXPERIENCINGDELAYS
ARE BEING UNABLE TO GET
CONTRACEPTIVE CARE BECAUSE THE
PANDEMIC. CALIFORNIA HAS THE
OPPORTUNITY TO EXPAND OUR
CONTRACEPTIVE COVERAGE COVERAGE
IN A TIME WHEN PATIENTS WILL
NEED IT THE MOST. AS A PRIMARY
CARE PHYSICIAN I SEE EVERY DAY
THE IMPACT THAT BARRIERS TO AND
DELAYS IN CARE CAN HAVE ON
ONE'S LIFE. AND HEALTH
OUTCOMES. SB FIVE TWENTY THREE
WERE TAKEN IMPORTANT STEPS TO
ENSURE THAT CONTRACEPTIVE CARE
IN OUR STATE BECOMES MORE
EQUITABLE AND ACCESSIBLE. FOR
ALL THANK YOU FOR YOUR TIME.
THANK YOU VERY MUCH. OF THERE
ARE NO RED WITNESS ENOUGH. SO
WE WILL GO TO THE PHONE LINES.
ASKING FOR SUPPORT OR
OPPOSITION JUST YOUR NAME
POSITION ON THE BILL AN
ORGANIZATION WHO REPRESENT ONE.
PLEASE GO AHEAD WHEN YOU'RE
READY OPERATOR. THANK YOU AND
PLEASE REMEMBER AT ONE AND THEN
CHERYL. ALTHOUGH FIRST TO LINE
ONE OH THREE. ONE OF THREE
ALLIANCE OPEN. LEVINE TO LINE
UP NINETY EIGHT LET'S GO AHEAD.
THE TICKET ON BEHALF THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS AND SUPPORT. THANK
YOU NEXT CALL. NINETY ONE FIFTY
SIX. TWENTY ONE THIRTY. I'M
SORRY I COULDN'T HEAR YOU-
KATHY DOWN OFTEN REPRESENTING-
THE- OF THE AMERICAN
ASSOCIATION FOR UNIVERSITY
WOMEN CALIFORNIA IN STRONG
SUPPORT OF THE BILL THANK YOU
NEXT CALLER PLEASE. IN LINE.
ONE FOURTEEN. MR CHAIRMAN
MEMBERS THIS IS ERIN EVAN
CALLING ON BEHALF OF TO
SUPPORTING ORGANIZATION FIRST
NARAL PRO CHOICE CALIFORNIA IS
THE PRODUCT CO SPONSOR OF THE
MEASURE AND SECONDLY THE
CALIFORNIA NURSES MIDWIVES
ASSOCIATION STRONGLY SUPPORTS
THAT THIS WELL THANK YOU THANK
YOU NEXT CALLER PLEASE. AN.
EIGHTY SIX. CAROLINA FOOD ON
BEHALF OF ACLU CAL ACTION IN
SUPPORT THANK YOU NEXT CALLER
PLEASE. LINE ONE FORTY EIGHT.
IT MEASURES THE WORD NATIONAL
ASSOCIATION OF SOCIAL WORKER
CALIFORNIA CHAPTER IN SUPPORT
THANK YOU THANK YOU NEXT CALLER
PLEASE. LINE. ONE TWELVE. GOOD
AFTERNOON MR CHAIRMAN AND
COMMITTEE MEMBERS AND HIS
ASSOCIATE KATHY OVER THE FENCE
SO ACTIVE HEALTH CROWD CO
SPONSORS OF THE MEASURE IN
STRONG SUPPORT THANK YOU NEXT
CALLER PLEASE. LINE. ONE THIRTY
THREE. MR CHAIRMAN MEMBERS PAUL
YOU'RE A ME OUT THE CALIFORNIA
FACULTY ASSOCIATION IN SUPPORT
THANK YOU NEXT CALLER PLEASE.
THE LAST ONE IN Q. HERE IS LINE
ONE THIRTY. RIGHT CENTER ON
BEHALF OF THE AMERICAN COLLEGE
OF OBGYN STICKS AT NINE IN
SUPPORT. THANK YOU VERY MUCH
BRING BACK TO THE COMMITTEE
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. SEEING THAT WE DO
HAVE A MOTION BY MISS
AGUIAR-CURRY A SECOND BY MR
RODRIGUEZ SOME MOTION IS TO
PASS AS AMENDED TO
APPROPRIATIONS MADAM SENATOR
WHICH LIKE TO CLOSE
RESPECTFULLY ASK RIVAL. THANK
YOU VERY MUCH MADAM MADAM
SECRETARY PLEASE CALL THE ROLL
WHAT I WOULD AYE MAYES. MAYES
NOT VOTING AGUIAR-CURRY.
AGUIAR-CURRY AYE ARAMBULA.
ARAMBULA AYE BIGELOW. SORRY
BIGELOW NO. CALDERON CALDERON
AYE CARILLO. FLORA MAIENSCHEIN.
MCCARTY NAZARIAN RIVAS
RODRIGUEZ RODRIGUEZ I SANTIAGO.
WALDRON. FIVE TO ONE YOUR BILL
WILL REMAIN ON CALL THANK YOU
VERY MUCH THANK YOU MISTER
CHAIR THANK YOU MEMBERS THANK
YOU. SENATE ALONE ARE YOU. BACK
THERE SOMEWHERE. DID WE LOSE
CENTER DILEMMA. MEGAN WELCOME
BACK THANK YOU VERY MUCH. THE
NEXT BILL IS S. B. TWO NINE
THREE PERFECT THANK YOU THANK
YOU TURN MEMBERS OF THE EARLY
AND PERIODIC SCREENING
DIAGNOSTIC AND TREATMENT
PROGRAM IS A STATE ADMINISTERED
MEDICAID BENEFIT ENTITLED
ENTITLING LOW INCOME INFANTS
CHILDREN AND ADOLESCENTS UNDER
THE AGE OF TWENTY ONE ENROLLED
IN MEDICAID AS WELL AS FOSTER
USED TO A COMPREHENSIVE ARRAY
OF HEALTH CARE SERVICES.
COUNTIES CURRENTLY RECEIVE
LIMITED GUIDANCE FROM THE STATE
ON HOW TO COMPLY WITH
DOCUMENTATION REQUIREMENTS
RELATED TO THE PROGRAM AS A
RESULT PAPERWORK REQUIREMENTS
VARY WITH EACH OF THE FIFTY
EIGHT COUNTIES UNIT UTILIZING
DIFFERENT SETS OF PAPERWORK TO
ADMINISTRATE THE SAME TYPE OF
SERVICES SB TWO NINE THREE WILL
DIRECTLY INCREASE ACCESS TO
MENTAL HEALTH FOR CHILDREN IN
MEDIC HAL BY STANDARDIZING THE
FORMS COUNTIES REQUIRE.
CONTRACTING PROVIDERS TO
COMPLETE UNDER THIS BENEFIT WE
WILL ALSO THIS BILL WILL ALSO
BE WORKING IN CONCERT WITH THE
CURRENT CAL AIM IMPLEMENTATION
ALTHOUGH WE BELIEVE SB TWO
NINETY WILL GO FURTHER BY
ENSURING FORM STANDARDIZATION
SB TWO NINE THREE IS AN
IMPORTANT STEP TO ENSURE THAT
OUR MOST VULNERABLE YOUNG
PEOPLE OBTAIN ACCESS TO LIFE
SAVING MENTAL HEALTH SERVICES
HERE ON THE PHONE TODAY WE
HAVEN'T NEED A MORE TEN
DIRECTOR OF GOVERNMENT
RELATIONS. THE CALIFORNIA
CHILDREN'S HOSPITAL ASSOCIATION
AND NANCY PFEFFER DIRECTOR OF
BEHAVIORAL HEALTH FROM LIKELY
GOT A LOT OF US A- THANK YOU
VERY MUCH WE WILL GO AHEAD AND
MOVE TO OUR WITNESSES IN
SUPPORT- OPERATOR PLEASE OPEN
THE LINE FOR WITNESSES AND
SUPPORT. YOU'RE A MARTIN WITH
THE CALIFORNIA CHILDREN'S
HOSPITAL ASSOCIATION A PROUD CO
SPONSOR AT THE TWO NINETY
THREE. LAWMAKERS RECENTLY
ALLOCATED OVER FOUR BILLION
DOLLARS IN THE STATE BUDGET TO
HELP EXPAND ACCESS TO
CHILDREN'S MENTAL HEALTH
SERVICES. BUT NONE OF THOSE
DOLLARS WILL RESULT IN
INCREASED ACCESS FOR CHILDREN
IN THE MEDICARE PROGRAM IN THE
NEAR TERM IF THERE AREN'T
ENOUGH PROVIDE YOU CAN ASSIST
THEM WITH THE BANDWIDTH TO
SERVE THEM. EDUCATING AND
TRAINING THE NEXT GENERATION OF
PROVIDERS WILL TAKE TIME TO
IMMEDIATELY CREATE ACCESS TO
THE SERVICES WE MUST FORGET THE
CAPACITY OF THE EXISTING
PROVIDERS. AS MY COLLEAGUE FROM
THE CLINICAL THERE LERATO WILL
EXPLAIN IN MORE DETAIL THE BEST
WAY TO DO THAT IS TO MAKE
AGGRESSIVE CHANGES TO THE
CURRENT COUNTY MENTAL HEALTH
DOCUMENTATION. REQUIREMENTS FOR
CHILDREN SERVICES. BOB
ADMINISTRATION IS TAKING
CONCERN. AND HAVE BECOME TO
TAKE OUT TO ADDRESS THE TROOPS.
WE BELIEVE THAT EFFORT NEEDS TO
GO MUCH FURTHER IF WE WANT TO
ENSURE CHILDREN WHO NEED.
URGENTLY CANNOT CUT THROUGH THE
CRACKS. CALLUNA FOCUSED ON
UNTANGLING WHAT DOCUMENTATION
SHOULD BE REQUIRED FOR
DETERMINING THE QUALITY OF CARE
PROVIDED VERSUS THE
REIMBURSEMENT. UPDATING STATE
AUDITING GUIDELINES AND
EDUCATING COUNTY FOR ABOUT WHAT
THE LAW REQUIRES. THERE IS NO
STATED INTENT REQUIRE COUNTY TO
LIMIT THEIR DOCUMENTATION THE
ONLY THE REQUIRED ELEMENTS.
SIMILARLY NO PLANETS AND SET
FORTH TO ADDRESS THE NEED TO
STREAMLINE INTAKE ASSESSMENT
AND TREATMENT PLAN
DOCUMENTATION REQUIREMENTS.
SOME OF THE MOST BURDENSOME.
PAPERWORK PROVIDER MUST
COMPLETE. SB THREE NINETY THREE
DIRECTLY ADMINISTRATION TO
ADDRESS THE SHORTCOMINGS BY
PACIFIC REQUIRING THE STATE TO
ADDRESS INTAKE ASSESSMENT AND
TREATMENT PLANNING
DOCUMENTATION. REQUIRING COUNTY
TO LIMIT THEIR PAPERWORK
REQUIREMENTS ONLY WHAT IS
NEEDED TO ENSURE THE QUALITY OF
CARE PROVIDED AND COMPLIANCE
WITH FEDERAL AND STATE LAW. AND
STANDARDIZING KEEP PEOPLE WORK
TO ENSURE THAT THE BURDEN OF
PROVIDERS AND MEANINGFULLY
REDUCE. WITHOUT THESE
ADDITIONAL REQUIREMENTS
CHILDREN WILL CONTINUE TO GO ON
FOR TWO OTHERWISE COULD BE FOR
WORK NOT FOR THE TIME IT TAKES
TO COMPLETE THE FORM. THE
COUNTY THEY HAVE A HOPE
DIRECTORS ASSERT THAT IF THIS
IS NECESSARY IT SHOULD BE
REQUIRED TO MANAGED CARE PLAN.
BUT WE BELIEVE THIS ARGUMENT AS
A DISTRACTION MANAGED CARE PLAN
COUNTY THEY'RE NOT RESPONSIBLE
FOR THE THINGS THAT BEHAVIORAL
HEALTH SERVICES FOR
STANDARDIZING THEIR FORMS WOULD
REQUIRE A COMPLETELY SEPARATE
EFFORT FROM THE FUNDS. IN
ADDITION MOST PROVIDERS WORK
WITH MANY MORE COUNTY SAN
MANAGED CARE PLANS TO THE
AMOUNT OF VARIATION AMONG
COUNTIES REPRESENTS A MUCH
GREATER BURDEN. FINALLY OUR
MEMBERS HAVE TOLD US CLEARLY
THAT THE PAPERWORK BURDEN AT
THE FEET OF THE COUNTY. COUNTY
CHILDREN'S BEHAVIOR HEALTH
SERVICES IS MUCH GREATER THAN
THE PAPERWORK OF FIFTEEN OF
WHICH WERE LATEST SERVICES
PROVIDED THROUGH MEDICAID
MANAGED CARE. FOR ALL THESE
REASONS WE SHOULD BE TACKLING
COUNTY. BEHAVIORAL PAPERWORK
FIRST AND FOREMOST. IN FACT TO
YOUR THE COUNTY ACTUALLY. OUR
TO THE- STANDARDIZATION OF THE
PAPER. BUT TODAY THEY WANTED TO
WAIT AND SEE IF TELLING WILL GO
FAR ENOUGH. OUR CHILDREN CAN'T
AFFORD TO WAIT NOR CAN I AFFORD
FOR US TO ONLY PARTIALLY
ADDRESSED THE PROBLEM. THAT WE
WANT TO TRULY FREE UP NOT
ACCOUNT CHILDREN'S MENTAL
HEALTH PROVIDERS TIME TO DO
WHAT THEY DO BEST. AND MAXIMIZE
ACTIVITIES INVALUABLE SERVICES
AT THIS CRITICAL TIME THE
EFFORT NEEDS TO GO MUCH FURTHER
THAN IT CURRENTLY BEING
PROPOSED AS PART OF TELLING FOR
THESE REASONS WE URGE YOU TO
SUPPORT SB TWO NINETY THREE.
THANK YOU. THANK YOU VERY MUCH
MOVE ONTO OUR NEXT WITNESS
PLEASE. GOOD AFTERNOON THIS IS
NANCY. URGENCY IN INCREASING
ACCESS TO MENTAL HEALTH CARE
FOR OUR LOW INCOME INFANTS
CHILDREN AND ADOLESCENTS AND
ARE FOSTER USE COVERED BY
MEDICAID. I'M THE DIRECTOR OF A
HAVE A HOLD. DEVATHA IN THE SAN
FRANCISCO BAY AREA. WE OPERATE
TWO. EPS T. T. PROGRAMS IN TWO
DIFFERENT COUNTIES. AND THEY'RE
IDENTICAL PROGRAMS BUT THE
DOCUMENTATION REQUIREMENTS
DIFFER SIGNIFICANTLY IN EACH
COUNTY. RESULTING IN THE NEED
TO RUN TWO PARALLEL DISTINCT
PROGRAMS WHICH IS OBVIOUSLY
INEFFICIENT DUPLICATE SCARCE
RESOURCES. MOST IMPORTANTLY
REDUCES AVAILABLE STAFFING
WHICH WE NEED FOR DIRECT
SERVICES PROVIDING TREATMENT TO
CHILDREN. AND ADOLESCENTS IN
ORDER TO PROGRAM SERVING THE
SAME CRIME POPULATIONS IS
COMPLETELY DIFFERENT.
SUPERVISORY STOPPING. LIMITING
THE STAFFING WHICH WOULD
OTHERWISE RESULT IN BETTER
ACCESS IF WE COULD STREAMLINE
ACROSS THE. COUNTIES RATHER
THAN DUPLICATE. OF COURSE THE
IMPACT OF THE PANDA. IS EVEN
BECAUSE AND DEMAND- AND THEN
EVER AND SYMPTOMS. SEVERITY
WHICH GROW. EACH DAY AND WE'RE
STRUGGLING TO MEET THE NEEDS
YET OUR THERAPISTS SPEND 3240%
OF THEIR TIME ON DOCUMENTATION
THIS BURDEN LOWER STAFF MORALE
INCREASES TURNOVER ENOUGH TO
PLEASE HER SCARCE CULTURALLY
AND LINGUISTICALLY COMPETENT
WORK FORCE. LIKELY TO GO ALONE
NOW HAS THIRTEEN THERAPIST
VACANCY POSITION VACANT
POSITIONS THIS ISN'T UNIQUE TO
US. EACH THEIR TEST WE LOOSEN
SPECIALTY MENTAL HEALTH IS A
SIGNIFICANT LOSS AND CAN TAKE
YEARS TO REPLACE REDUCTION IN
WORKFORCE RESULTS IN RESTRICTED
ACCESS TO CARE. FOR THE THIRD
DISTRICT STATE TIME HOUSTON
DOCUMENTATION THAT DOESN'T HAVE
QUALITY OR ACCOUNTABILITY
REDUCES ACCESS TO CARE IN IN IN
SOME VACANCIES TURNOVER
DUPLICATION DISPROPORTIONATE
TIME SPENT ON DOCUMENTATION ALL
REDUCES ACCESS AT A TIME WHEN.
THE DEMAND FOR CARE IS HIGHER
THAN EVER. MY PRESS LES
PRESSED. ADVOCATED FOR
DOCUMENTATION REDUCTION FOR A
DECADE SHE DIED ALMOST THREE
AND A HALF YEARS AGO WAITING
FOR THIS MOMENT. AS LESLIE
WOULD SAY LET'S PROVIDE CARE
FOR THE PATIENT NOT THE CHART.
AND NOW THE IMPACT OF THE
PANDEMIC IS TREMENDOUS WE'VE
NEVER SEEN ACUITY LIKE THIS
AMONG CHILDREN WE'VE NEVER HAD
AS MANY REFERRALS ACTION IS
NEEDED NOW STANDARDIZATION OF
DOCUMENTATION WOULD GO A VERY
LONG WAY. LET'S NOT WAIT ANY
LONGER TO IMPROVE ACCESS TO OUR
MOST VULNERABLE CHILDREN I
ASKED FOR HER AYE VOTE THANK
YOU. THANK YOU VERY MUCH WE DO
HAVE A WITNESS AND REGISTER
WITNESS IN OPPOSITION SO
PLEASE- GO AHEAD WHEN YOU'RE
READY. GOOD AFTERNOON SHERMAN
WAY THEN COMMITTEE MEMBERS A
SENSE HOLLOW WELL HOME AND I
APPRECIATE THE OPPORTUNITY TO
PROVIDE THIS PERSPECTIVE ON
BEHALF OF THE COUNTY BEHAVIORAL
HEALTH DIRECTOR AT THE
SITUATION. TODAY WE ARE SHARING
OUR CONCERNS WITHOUT SPEAKING
NINETY THREE WE HAVE CONTINUED
TO COMMUNICATE CONCERNS RATHER
THAN OPPOSE THE BILL BECAUSE WE
BELIEVE WE SHARE IMPORTANT OVER
ARCHING GOALS WITH THE AUTHOR
AND PROPONENT. ALONG WITH
BEHAVIORAL HEALTH PROVIDERS
COUNTY BEHAVIORAL HEALTH PLANS
HAVE CONSISTENTLY ADVOCATED
SIMPLIFY AND STREAMLINE
DOCUMENTATION REQUIREMENTS FOR
MEDICAL SPECIALTY MENTAL HEALTH
SERVICES. HOWEVER WE ARE UNABLE
TO SUPPORT THE BILL IN ITS
CURRENT FORM BECAUSE WE DO NOT
BELIEVE THE STANDARDIZED FORMS
PROPOSED IN SB TWO NINETY THREE
WILL BE NEEDED. ONE FOR STATE
HAS FULLY IMPLEMENTED THE
SIGNIFICANT DOCUMENTATION OR
FARMS PROPOSED IN THE
CALIFORNIA ADVANCING AND
INNOVATING MEDIC HOW INITIATIVE
ARE COUNTING. UNDER CALTRAIN
DHS PROPOSES TO WORK WITH
STAKEHOLDERS TO COMPLETELY
TRANSFORM THE WAY ESPECIALLY
MENTAL HEALTH SERVICES ARE
DOCUMENTED AND CLAIMS. CREDIT
PREVIOUS REFORMS SHOULD ALIGN
CLAIMING DOCUMENTATION AND
COMPLIANCE STANDARDS FOR
SPECIALTY MENTAL HEALTH
SERVICES WITH RULES THAT EXIST
ELSEWHERE IN MEDIC HOUSE AND AT
THE FEDERAL LEVEL FOR MEDICAID
AND MEDICARE. IN CONTRAST SB
TWO NINETY THREE WOULD CREATE A
NEW AND DIFFERENT STANDARDS
THAT WOULD BE APPLIED ONLY TO
SPECIALTY MENTAL HEALTH EPA-EFE
Q. SERVICES. THE BILL WOULD
REPLACE THE CURRENT APPROACH TO
SPECIALTY BEHAVIORAL HEALTH
DOCUMENTATION WHICH PROVIDERS
AND COUNTY ALIKE FIND OVERLY
PRESCRIPTIVE AND COMPLIANCE
ORIENTED. WITH EQUALLY
PRESCRIPTIVES AND UNIQUE
REQUIREMENTS FOR DH CS GROUP
FORMED. TO OUR KNOWLEDGE THIS
SORT OF REQUIREMENT DID NOT
EXIST ANYWHERE ELSE WITHIN
MEDICARE MANAGED CARE AT THIS
TIME. INSTEAD OF CREATING FORMS
SPECIFIC TO SPECIAL EMAIL
HEALTHY PFPT SERVICES WE
SUGGEST THEY WOULD BENEFIT
CLIENTS PROVIDERS AND PLANS-
LIKE TO ALIGN SPECIALTY LITTLE
HEALTHY PST T. REQUIREMENTS
WITH THOSE FOR OTHER BEHAVIORAL
HEALTH AND EAP PFPT SERVICES.
ELSEWHERE IN MEDIC CAL THE
STATE REQUIRES A SIMPLE SET OF
MINIMAL DATA ELEMENTS TO BE
DOCUMENTED IN REPORTING FOR
BILLING AND COMPLIANCE. BEYOND
IS ELEMENT SPEECH YES PERMITS
EACH CLIENT NEEDS AND EACH
PROVIDER'S EXPERTISE TO INFORM
AND SHAPE THE WAY. A CLINICAL
INTERACTION THAT DOCUMENTED.
FOR THE REASONS WE CAN K. TO
WRAP THAT IN THE VIEW OF THE-
PROPOSED IN TWO NINETY THREE.
BEHAVIORAL HEALTH STAKEHOLDERS
SHOULD FIRST FOCUS ON SHAPING
IN IMPLEMENTING THE
FUNDAMENTALLY REFORMS ALREADY
PROTESTING CALLIN. WE CAN
MANIFEST WHETHER TELLING HIS
HELP BALLPARK SYSTEMIC
DOCUMENTATION CHALLENGES AND
DECIDE IF ADDITIONAL CHANGES
ARE STILL NEED IT. I PRESCRIBED
IN AB ONE THIRTY THREE BUDGET
TRAILER BILL LANGUAGE EACH THE
AUTHORITY INITIATED THE
STAKEHOLDER PROCESS TO
COORDINATE IMPORTANT WORK ON
DOCUMENTATION REFORM. WE ARE
CONFIDENT THAT PROCESS CAN BE
USED TO DEVELOP A SINGLE SET OF
ATTRACTIVE AND STREAMLINED
STANDARDS FOR SPECIALTY
BEHAVIORAL HEALTH SERVICES. WE
SUGGEST THIS WILL BE THE MOST
EFFECTIVE PATH TO ALLEVIATE THE
EXCESSIVE DOCUMENTATION BURDEN
THAT WE ALL AGREE HAS HARM TECH.
WHAT RESISTANCE IN THE PAST. SO
I WILL PUT BY WE AND SPONSOR
FOR THE TWO. TODAY AND FOR
THEIR OF TO CONSENSUS ON THIS
IMPORTANT ISSUE AND HAPPY TO
ANSWER ANY QUESTIONS I CAN
ABOUT OUR CONCERNS. OKAY THANK
YOU VERY MUCH WILL NOW MOVE TO
THE PHONE LINES FOR WITNESSES
IN SUPPORT OR OPPOSITION JUST
YOUR NAME POSITION ON THE BILL
AND ANY. ORGANIZATION YOU MIGHT
REPRESENT- WHENEVER YOU'RE
READY OPERATOR. THANK YOU FOR
THROUGH A LINE ONE OR THREE.
GOOD AFTERNOON CAN YOU HEAR ME
YES PLEASE GO AHEAD WE CAN. HI
GOOD AFTERNOON THIS IS MARIA
CALLING FOR BEGINNING CONCEPT
IS A GOOD CENTERS FOR CHILDREN
AND FAMILIES AND I JUST WISH TO
EXPRESS THAT WE ARE PROUD. TO
EXPRESS OUR STRONG SUPPORT FOR.
SENATOR LIMóN. SB TWO NINE
THREE THANK YOU THANK YOU NEXT
CALLER PLEASE. LINE ONE FIFTY
ONE. HELLO THIS IS JACKIE WITH
TIGER WITH THE CALIFORNIA LINES
OF TOWN FAMILY SERVICES AND WE
ARE PROUD CO SPONSOR SB TWO
NINE THREE AND IN STRONG
SUPPORT THANK YOU THANK YOU
NEXT CALLER PLEASE. LINE. ONE
NINETEEN. HELLO THIS IS JANICE
LAURIE WITH WESTERN CENTER ON
LAW AND POVERTY IN SUPPORT
THANK YOU NEXT CALLER PLEASE.
CAN LINE WENT OUR QUEUES
REALIGN NINETY FOUR. GOOD
AFTERNOON KATIE LADEN ON BEHALF
OF THE CHILDREN SPECIALTY CARE
COALITION SUPPORT THANK YOU
NEXT CALLER PLEASE. LINE. ONE
TWENTY SEVEN. GOOD AFTERNOON
CHAIRMAN MEMBERS CALLS WORSE
WITH THE CALIFORNIA
PSYCHOLOGICAL ASSOCIATION IN
STRONG SUPPORT THANK YOU NEXT
CALLER PLEASE. ONE ONE FIFTY
EIGHT. GOOD AFTERNOON SHERMAN
WAY AND MEMBERS OF THE
COMMITTEE ADMITTED WENDY ****
REPRESENTING HATHAWAY SYCAMORES
IN STRONG SUPPORT OF SB. TWO
NINE THREE THANK YOU NEXT
CALLER PLEASE. NINE EIGHTY TWO.
MEDICARE MEMBERS ROB LANE WITH
THE CALIFORNIA COUNCIL OF
COMMUNITY BEHAVIORAL HEALTH
AGENCIES WE ARE PROUD SPONSOR
AND SUPPORTER- THANK YOU THANK
YOU NEXT CALLER PLEASE.
MOORLACH THANK YOU HERE IS LINE.
ONE OH FOUR. AFTERNOON EVERYONE
GORDON RICHARDSON FROM UPLIFT
FAMILY SERVICES AND A MEMBER OF
THE CALIFORNIA LINES AND IN
SUPPORT OF SB TWO NINE THREE
THANK YOU VERY MUCH. BRING BACK
TO THE COMMITTEE NOW FOR
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. AND THEN WE DO HAVE
A MOTION AND LOOKING FOR A
SECOND THE SECOND BY MISTER.
CALDERON WE HAVE A MOTION BY
MISS AGUIAR-CURRY A SECOND BY
MISS CALDERON MOTION IS DUE
PASSED TO APPROPRIATIONS. SB.
TWO NINETY THREE- THE BILL DOES
ENJOY THE PAST REGULATION SO-
WOULD YOU LIKE TO CLOSE CENTER
I RESPECTFULLY ASK FOR AN
ISLAND THANK YOU VERY MUCH A
MATTER OF SECRETARY PLEASE CALL
THE ROLL WHAT DR WHAT I MAYES
MAYES AYE AGUIAR-CURRY
AGUIAR-CURRY AYE ARAMBULA
ARAMBULA AYE BIGELOW. BIGELOW
AYE AYE CALDERON. CALDERON I
CARILLO. FLORA MAIENSCHEIN
MCCARTY MCCARTY I NAZARIAN.
RIVAS RODRIGUEZ RODRIGUEZ I
SANTIAGO. WALDRON. EIGHT ZERO
THANK YOU VERY MUCH YOUR BILL
IS OUT LEAVE THE ROLE OPEN FOR
OTHERS TO ADD ON PLEASE PROCEED
SB THREE SIXTY EIGHT THANK YOU
FILE ITEM AT TWELVE SB THREE
SIXTY EIGHT AT SB THREE SIXTY
REQUIRES ALL HEALTH PLANS AND
INSURERS TO SHARE HOW MUCH
CONSUMERS HAVE PAID TOWARDS OR
DEDUCTIBLES AND MAXIMUM OUT OF
POCKET LIMITS DURING ANY MONTH
BENEFITS FOR USE SB THREE SIXTY
WILL MANDATE HEALTH PLANS
COMMUNICATE FOR EVERY MONTH IN
WHICH BENEFITS WERE USED AND
UNTIL SUCH ACCRUAL BALANCE
EQUALS THE FULL DEDUCTIBLE
AMOUNT SB THREE SIXTY INSURES
THAT PEOPLE HAVE THE MOST
CURRENT INFORMATION ON THEIR
CURLS. AND ALSO ALLOWS FOR MORE
TRANSPARENCY FROM HEALTH PLANS
AND INSURERS AT WITH US TODAY
ON THE PHONE WE HAVE JANET
DOUGLAS FROM HEALTH ACCESS AND
JIM FLURRY FROM WESTERN LAW
CENTER ON LAW AND POVERTY TO
TESTIFY IN SUPPORT THANK YOU
VERY MUCH WE'RE GOOD OR
WITNESSES IN SUPPORT ON THE
PHONE. GOOD AFTERNOON MR
CHAIRMAN MEMBERS THE SPANISH
OUTLETS FOR HEALTH ACTIVE
CALIFORNIA THE STATEWIDE HEALTH
CARE CONSUMER ADVOCACY
COALITION. SPONSORSHIP OF SB
THREE SIXTY EIGHT. ALMOST TEN
MILLION CALIFORNIANS HAVE
DEDUCTIBLES MANY OF WHICH ARE
IN THE THOUSANDS OF DOLLARS ON
TOP OF THAT'S ALL CALIFORNIANS
WITH PRIVATE COVERAGE HAVE
MAXIMUM OUT OF POCKET LIMIT.
FOR FAMILIES THAT ARE
STRUGGLING TO MAKE ENDS MEET OR
FACING DIFFICULT EXPENSIVE
MEDICAL CONDITIONS. TRACKING OR
CRUEL TOWARD THESE AMOUNTS OF
THE CRUCIAL PART OF FINANCIAL
PLANNING AN ACT THE THING CARE.
SB THREE SIXTY EIGHT WILL PLACE
A BURDEN ON HEALTH PLAN TO
UPDATE RELEASED UNDER CRUEL
TOWARDS DEDUCTIBLES AND MAXIMUM
OUT OF POCKET LIMITS FOR ANY
MONTH. IN WHICH BENEFITS FOR
YOU. A NEW FEDERAL RULES WILL
REQUIRE PLAN SHARE THIS
INFORMATION WITH CONSUMERS BUT
FELL UNDER THE FEDERAL ROLE THE
CONSUMER WOULD HAVE TO REQUEST
THE INFORMATION. INSTEAD WE
PROPOSE SHIFTING THE BURDEN
FROM THE INDIVIDUAL TO THE
HEALTH PLAN FOR THAT CONSUMER
THINKING FACING SIGNIFICANT
HEALTH NEEDS AREN'T LEFT IN THE
DARK. THIS IS ALSO AN IMPORTANT
DISTINCTION FOR CALIFORNIANS
WITH LANGUAGE BARRIERS OR- LACK
FINANCIAL LITERACY. THE BURDEN
SHOULDN'T FALL ON THAT THEY
HAVE TO HUNT DOWN THE
INFORMATION. SOMEONE RELEASED
ALREADY RECEIVED YOUR FEES ARE
EVIDENCE OF BENEFIT PAYMENTS
WHICH INCLUDE THIS INFORMATION
AND WE ALREADY KNOW THAT IT'S
POSSIBLE BECAUSE MEDICARE
ADVANTAGE PLANS PROVIDE THE
UPDATE. WE APPRECIATE THE WORK
WITH THE DEPARTMENT OF HEALTH
PLANS ON AMENDMENTS WHICH
INCLUDE CLARIFYING. THE BILL'S
IMPLEMENTATION DELAYING
IMPLEMENTATION UNTIL JULY
TWENTY TWENTY TWO AND
CLARIFYING THAT AND RELEASE OF
OPTED INTO ELECTRONIC
NOTIFICATIONS ALREADY. WILL
ALSO RECEIVE THESE NOTICES
ELECTRONICALLY WE DO BELIEVE
THAT MALE NOTICES THAT THE
DEFAULT ARE CRUCIAL TO MITIGATE
EQUITY ISSUES FOR PEOPLE AND
COMMUNITIES THAT DON'T HAVE
HIGH SPEED INTERNET OR
SMARTPHONE ACCESS HOWEVER WE
APPRECIATE THE EASE OF
ELECTRONIC NOTICE. FOR THOSE
WHO OPTED TO NOT RECEIVE THE
HARD COPIES. SB THREE SIXTY
EIGHT WILL HELP CALIFORNIANS
TRACTOR CRUEL TOWARDS THE
DEDUCTIBLES AND OUT OF POCKET
NEXT MONTH SO THAT THEY CAN
BETTER MANAGE THEIR FAMILY
FINANCESAND KEEP TRACK OF
THEIR HELP FUNDING. FOR THESE
REASONS WE'RE PROUD TO SPONSOR
SB THREE SIXTY EIGHTRESPECTFULLY REQUEST YOUR AYE
THAT. THANK YOU THANK YOU. OUR
NEXT WITNESS PLEASE. THERE ARE.
POVERTY CAL. OLD AND LARGE
LEGAL. WITH CENTER AND MEMBER
OF THE YOU CAN RELY ON. CURRENT
CONSUMERS ARE REQUIRED TO KEEP
TRACK OF ALL THEIR HEALTHCARE
EXPENDITURES AND SELF CALCULATE
WHEN THEY REACH THEIR
DEDUCTIBLE OR OUT OF POCKET
MAXIMUM- CAN EXPLAIN ALL THE
COST SHARING REQUIRED WE CLICK
REQUIREMENTS OF THEIR PLANS.
WHEN CONSUMERS RECEIVE A BILL
FROM A PROVIDER AT MANY ASSUME
THEY- THE AMOUNT THEY'RE BUILT
FOR RATHER THAN ADEQUATE THEY
HAVE ALREADY ACCRUED TOWARD
THEIR DEDUCTIBLE OUT OF POCKET
MAXIMUM. THIS IS ASKING THOSE
WITH THE LEAST KNOWLEDGE OF
INDUSTRY PRACTICES AND
TERMINOLOGY TO BE ABLE TO
ADVOCATE FOR THEMSELVES.
FURTHER MORE CONSUMERS ARE MOST
LIKELY TO HIT THEIR DEDUCTIBLE
OUT OF POCKET MAXIMUM WHEN THEY
HAVE HAD A MAJOR HEALTH EVENTS.
SUCH AS AN ACCIDENT REQUIRING
EMERGENCY CARE OR A CANCER
DIAGNOSIS. IN THOSE STRESSFUL
TIMES KEEPING UP WITH ANY
FINANCIAL MATTER IS A CHALLENGE
THE ADDITIONAL BURDEN OF
UNDERSTANDING HEALTH PLAN OR
POLICY TERMS AND CONDITIONS IF
MORE THAN MANY CONSUMERS CAN
BEAR. IN ADDITION MANY LOW
INCOME CONSUMERS ARE VERY
CONCERNED ABOUT THEIR CREDIT AS
HAVING BAD CREDIT AND LIMITED
RESOURCES CAN MEAN LOSING OUT
ON HOUSING OPPORTUNITIES.
PAYING HIGHER INTEREST ONLY
HAVING ACCESS TO SOME SUBPRIME
PRODUCTS LIKE PAYDAY LOANS.
IT'S NOT UNUSUAL FOR CONSUMERS
TO PAY A BILL FOR PROVIDER EVEN
IF THEY'RE NOT CERTAIN I THINK
A LOT BILL BECAUSE THEY FEAR
WHAT WILL HAPPEN TO THEIR
CREDIT. FOR LOW INCOME
CONSUMERS EVEN IF THE OVER
PAYMENT IS RETURNED BY THE
PROVIDER WHICH CAN BE A REAL
CHALLENGE BECAUSE PROVIDER
OFFICES ARE NOT SET UP TO PAY
PEOPLE. MONEY THAT IS TIED UP
IN HEALT CARE BILLS MEAN OTHER
BILLS ARE NOT PAID OR THEY
FOREGO NEEDED SERVICES
INCLUDING FUTURE MEDICAL CARE.
FINALLY FOR CONSUMERS WHO HAVE
MET THEIR DEDUCTIBLE OUT OF
POCKET MAXIMUMS HERE IS LIKELY
TO BE SIGNIFICANTLY CHEAPER FOR
THEM FOR THE REMAINDER OF THE
YEAR. IN THE CASE OF HITTING
THEIR OUT OF POCKET MAXIMUM THE
REST OF THE CARE THEY RECEIVE
THAT YEARS FREE. HOWEVER
WITHOUT THIS BEING COMMUNICATED
THE CONSUMER MAY AVOID CARE
ALTOGETHER PRECISELY THE TIME
WHEN THEY MOST NEED IT AND WHEN
HE DID FINALLY AFFORDABLE. SHE
EVER INCREASING DEDUCTIBLES AND
OUT OF POCKET MAXIMUMS TRAIN
CONSUMERS NOT TO GET CARE WHEN
THEY NEED IT. THEY SHOULD BE
INFORMED WHEN IT IS MOST
ADVANTAGEOUS FOR THEM TO GET
CARE. BECAUSE THE HEALTH
PLANNERS SURE WOULD RECEIVE
INFORMATION FROM ALL OF THE
PROVIDERS AND CONSUMERS SEE
THEY'RE IN THE BEST POSITION TO
TRACK HOW MUCH OF A DEDUCTIBLE
OR AN OUT OF POCKET MAXIMUM.
THAT A CONSUMER HAS ACCRUED.
THEY ALSO BETTER UNDERSTAND
WHAT SERVICES CAN BE APPLIED TO
NEEDED IN RELIEF THE DUCK
DOUBLE. I LIKE TO THANK THE
AUTHOR FOR CARRYING TO SELL.
AND WE RESPECTFULLY ASK FOR
YOUR I. BOATS. THE YOU VERY
MUCH. WE WILL NOW MOVE TO WE
HAVE TWO WITNESSES REGISTERED
IN OPPOSITION- WILL MOVE TO THE
WITNESSES IN OPPOSITION ON THE
PHONE LINE PLEASE. WITNESSES IN
OPPOSITION. PLEASE GO AHEAD
MISTER CHAIR MEMBERS NICK YEAH
MISTER CHAIR MEMBERS NICKEL
WITH THOSE WITH A CALIFORNIA
ASSOCIATION OF HEALTH PLANS- A
SORRY ABOUT THE TECHNICAL
DIFFICULTY THERE- WE JUST
WANTED TO THANK THE AUTHORED
HER STAFF AND THE SPONSORS OF
THIS BILL- BEFORE THE OPEN DOOR
POLICY AND CONSTRUCTIVE
DISCUSSIONS AROUND THE BILL- IN
THE PAST WE'VE- BEEN AL RIGHT
OPPOSED. TO THIS PARTICULAR
POLICY BUT WITH THE AMENDMENTS
TO CONDUCT TODAY TO GIVE MY
MEMBER PLANNED THE TIME TO
OPERATIONALIZE THE BILL AND
OTHER CLARIFICATIONS AROUND
PAPERMILL REQUIREMENTS. WELL
WE'RE IN A GOOD PLACE AND
CONCEPTUALLY WE DO NOT OPPOSE
THE BILL- MAYBE LONGER- WE DID
HOWEVER RECEIVE THE AMENDMENTS
CLOSE ENOUGH TO THE HOLIDAY
WEEKEND OF SUMMER MEMBERS ARE
STILL SITTING WITH SOME OF THE
NEWER LANGUAGE- PARTICULARLY
LANGUAGE THAT WAS REQUESTED BY
THE REGULATORS. ALSO WILL BE
OPERATED OPEN TO ANY QUESTIONS
THAT MIGHT COME UP ON THE
PRECISE LANGUAGE- THAT- YOU
KNOW WE'RE WE ARE NOT OPPOSED
TO THE BILL CONCEPTUALLY ANY
LONGER THANK YOU. THANK YOU
VERY MUCH- OUR NEXT- WITNESS
PLEASE. MISTER CHAIRMAN. SEVEN
WATKINS ON BEHALF OF THE
ASSOCIATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANIES.
I JUST LIKE TO LINE MY COMMENTS
WITH MY COLLEAGUES- FROM CAP.
WE'RE VERY GRATEFUL FOR THE
OPPORTUNITY TO HAVE. AN OPEN
DIALOGUE WITH BOTH THE DOCTOR
AND THE SPONSOR IT'S BEEN A
VERY PRODUCTIVE PROCESS WE LOOK
FORWARD TO AND ANY ADDITIONAL
FEEDBACK FROM OUR MEMBERS ON
THE MOST RECENT SET OF
AMENDMENTS. BUT LOOK FORWARD TO
THE OPPORTUNITY TO REMOVE OUR
OPPOSITION ONCE THAT'S
HAPPENED. THANK YOU GREAT THANK
YOU VERY THANK YOU VERY MUCH.
WE WILL NOW GO TO THE GALLERIES
OR ANYONE IN THE GALLERY WHO
HAS. WHAT LIKE THIS TEST. IN
SUPPORTER OPPOSITION SCENE NO
ONE WILL GO TO THE PHONE LINES
FOR SUPPORT OR OPPOSITION. JUST
YOUR NAME POSITION ON THE BILL
AN ORGANIZATION IF YOU
REPRESENT ONE WHENEVER YOU'RE
READY OPERATOR. THANK YOU IT IS
ONE ZERO FIRST WE'LL GO TO LINE
UP ONE FIFTY FOUR. GOOD
AFTERNOON MR CHAIRMAN MEMBERS
BRANDON MARCHING WITH THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT OF THE BILL. THANK
YOU NEXT CALLER PLEASE. ONE
SIXTY FIVE. ONE SIXTY FIVE YOUR
LINE IS OPEN. MR CHAIRMAN
MEMBERS CHRIS ROSA ON BEHALF OF
BIOGEN IN SUPPORT OF THE BILL
THANK YOU NEXT CALLER PLEASE.
NINE ONE SIX SIXTY SIX. I THANK
YOU MISTER CHAIRMAN THIS IS
SPREAD KNOW WHERE REPRESENTING
THE PHARMACEUTICAL RESEARCH AND
MANUFACTURERS OF AMERICA IN
SUPPORT OF SENATE BILL THREE
SIXTY EIGHT THANK YOU. THANK
YOU NEXT CALLER PLEASE. LINE.
ONE FIFTY FIVE. YEAH HELLO
CHAIR MEMBERS JENNIFER MALEY
WITH THE CALIFORNIA LABOR
FEDERATION IN COURT THANK YOU
NEXT CALLER PLEASE. MOORLACH
THANK YOU HERE IS LINE NINETY
SEVEN. MISTER CHAIRMAN JOHN
LINGER ON BEHALF OF AMERICA'S
HEALTH INSURANCE PLANS WE WOULD
JUST ECHO THE COMMENTS OF
CAPTAIN ACTUALLY THANK YOU
THANK YOU. BRING BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS MISTER MAYES. THEY
MISS CHERRY ADDED. THIS IS ONE
OF THOSE I'M A SUPPORT THIS
BILL TODAY SO THANK YOU FOR
BRINGING FORWARD- SENATOR. THIS
IS ONE OF THOSE THINGS THAT I
WHEN YOU READ IT SORT OF ON ITS
FACE YOU THINK YOURSELF WHY IN
THE WORLD DO WE HAVE TO HAVE A
BILL- FOR THIS- WELL I'M I'M
VERY THANKFUL THE HEALTH PLANS
REMOVE THEIR THEIR OPPOSITION-
THIS IS ONE OF THOSE THINGS
THAT I WOULD THINK THIS WOULD
BE GOOD BUSINESS- FOR- FOR
THOSE THAT ARE CARRYING BECAUSE
IT'S A PROVIDING- PERTINENT
INFORMATION THAT TO THOSE. WHO
WHO HAVE HAD THESE HEALTH PLANS
AND I KNOW THERE'S A LOT OF
FOLKS THAT ARE ALWAYS VERY
CONFUSED ABOUT IT SO. I'M GONNA
SUPPORT THIS TODAY ALTHOUGH
THIS IS ONE OF THOSE THINGS I
JUST WONDER WHAT IN THE WORLD
DO WE HAVE TO HAVE A- BILL FOR
SO I'LL BE SUPPORTING IT
THINKING SUBJECT. THANK YOU
VERY MUCH OF OTHER QUESTIONS OR
COMMENTS. I WOULD JUST I JUST
LIKE TO SAY- PRETTY MUCH ECHO
THE COMMENTS OF- MISTER MAYES
AYE. I KNOW THAT THERE'S A LOT
OF FOLKS OUT THERE WHO GET A
BILL NAY DILIGENTLY PAY THAT
BILL. WHEN THEY MAY NOT OWE
THAT MUCH MONEY THEY'RE JUST
THEY JUST. DON'T WANT THAT
HANGING OVER THEIR HEAD. AND I
WILL SAY- I'M HAVING DEALT WITH
THE FAMILY MEMBERS WHO. WHO'VE
DONE THAT- IN THE PAST IT'S
OFTEN REALLY DIFFICULT TO GET
THAT MONEY BACK. THAT'S BEEN
OVERPAID. AND THAT'S A THAT'S A
HUGE CHALLENGE FOR PEOPLE AND-
SO. SO BEING ABLE TO ACCURATELY
ACCESS ACCESS WHERE YOU ARE IN
YOUR DEDUCTIBLE COULD BE A HUGE
BENEFIT FOR PEOPLE- AND I
APPRECIATE YOUR WORK ON THIS
THANK YOU- WAS THERE. DID I
MISS WAS ARM MOTION ON THIS OR-
THERE WILL BE- WE GET IS OKAY
NOW THAT WE GOT SO MANY I'M
CONFUSED SO GOODNESS
AGUIAR-CURRY AND LOOK LIKE I
SAW MR MCCARTY WAVING HIS ARM
AROUND SO I THINK WE'LL CALL
THAT A SECOND- THE MOTION YEAH
HAVE YOU ACCEPTED YOU ACCEPT
THE AMENDMENT IDEA EXCEPT THE
COMING YEAR. THANK YOU SO THE
MOTION WOULD BE BY A MISS
AGUIAR-CURRY A SECOND BY MR
MCCARTY TO AS DO PASS AS
AMENDED TO APPROPRIATIONS-
MADAM SECRETARY PLEASE CALL THE
ROLL. WHAT I WOULD AYE MAYES
MAYES AYE AGUIAR-CURRY.
AGUIAR-CURRY AYE ARAMBULA.
ARAMBULA I BIGELOW. BIGELOW AYE
CALDERON. CALDERON I CARILLO
CARILLO I LARA MAIENSCHEIN
MCCARTY MCCARTY I THIS AREA.
NAZARIAN I'D RIVAS RODRIGUEZ
RODRIGUEZ I SANTIAGO WALDRON
WALDRON HIGH. ELEVEN ZERO THANK
YOU VERY MUCH WILL NOW MOVE ON
TO WITH THE BILL- THE ROLE OPEN
FOR OTHERS THAT ON THANK YOU
WILL MOVE TO YOUR FINAL BILL S.
B. FIVE THIRTY THREE THIRTY
FIVE EXCUSE ME THANK YOU SB
FIVE THIRTY FIVE ELIMINATES
PRIOR AUTHORIZATION AND
STREAMLINED THE BIOMARKER
TESTING PROCESS BY PROHIBITING
PRIOR AUTHORIZATION FOR BY
MAKER TODD TESTING IN PATIENTS
WITH ADVANCED OR METASTATIC
STAGE OF THREE AND FOUR CANCER.
SB FIVE THIRTY FIVE AIMS TO
IMPROVE ACCESS TO CARE AND
OVERALL REDUCES HEALTH CARE
COSTS FROM FEWER OUTPATIENT
DOCTOR VISITS HOSPITALIZATIONS
AND HOSPICE CARE PRIOR
AUTHORIZATION CAN CAUSE DELAYS
ANYWHERE FROM A FEW DAYS TWO
WEEKS WHICH IS A MISSED
OPPORTUNITY TO TREAT PATIENTS
WITH THE APPROPRIATE TARGETED
THERAPY FOR THEIR SPECIFIC
BIOMARKER TESTING THAT WOULD
ALLOW THEM TO TREAT THEIR
DISEASE SLOW RE OCCURRENCE OR
PROGRESSION AND LEAD TO BETTER
QUALITY OF LIFE. AT TESTIFYING
IN SUPPORT OF THE BILL AS DR
STEPHEN LANG FROM THE UCLA
HEALTH SYSTEMS AFFILIATE AND
KRISTEN SANTIAGO FROM LONDON
TIVITY. THANK YOU VERY MUCH
WILL OPEN THE PHONE LINES FOR
THE OUR WITNESSES IN SUPPORT.
OKAY CAN YOU HEAR ME OK YES
PLEASE GO AHEAD. HELLO OKAY
VERY GOOD THANK YOU DID HONOR
ROLL ASSEMBLY CHAIR WOULD AND
ON BOTH EVENTUALLY MONNING
COMMITTEE MEMBERS THANK YOU
VERY MUCH FOR ALLOWING ME TO
SHARE IMPORTANT VIEWPOINT
ASPECTS OF THIS IMPORTANT
HEALTH BILL SB FIVE THREE FIVE.
MY NAME IS DOCTOR STEPHEN LONG
I'M INDEPENDENT USUALLY TRAINED
ONCOLOGIST AND FORMER ASSOCIATE
PROFESSOR OF MEDICINE AND- G.
AT UCLA WHO CO AUTHORED AND
PUBLISHED IN MAJOR DISCOMFORT
BREAST CANCER.HER TWO ONCOGENE
WHICH IDENTIFIED A VERY
AGGRESSIVE DISEASE
IDENTIFICATION OF THIS CHAIN
HAS EVOLVED INTO A VERY
IMPORTANT BIOMARKER I CURRENTLY
WORK IN SEVERAL ONCOLOGY
PRACTICE IN THE SOUTHERN
CALIFORNIA AREA. SB FIVE THREE
FIVE ADDRESSES IMPORTANT ISSUE
IN ONCOLOGY CARE AND THAT IS
THE DELAY IN OPTIMAL TREATMENT
SELECTION CONCEPT PRIOR
AUTHORIZATION FOR BIOMARKER
TESTING. WE HAVE LEARNED THAT
THE HER TWO GENE ALTERATIONS AS
WELL AS MANY OTHER BIOMARKERS
IN MANY CANCERS MUST BE
IDENTIFIED FOR MOST OPTIMAL
MANAGEMENT RESULTING IN
IMPROVED PATIENT HEALTH AND
SURVIVAL THERE'S NOW A PLETHORA
BONTA BIOMARKERS NECESSARY FOR
OPTIMAL MANAGER FOR THE BEST
OUTCOMES IN CANCER. AS A
PRACTICING ONCOLOGIST I
PERSONALLY HAVE EXPERIENCED
DELAYS TIME AND TIME AGAIN AND
GET IN THE BOND MARKET TEST
APPROVED FOR PATIENTS DUE TO
HELP PLAN PRIOR AUTHORIZATION
REQUIREMENTS. THIS AMERICAN
VERY FROM AS MUCH IN COURT
PLEADINGS TO FEELING SOMETHING
LONGER AT TIMES COUPLE MONTHS
DEPENDING ON THE PATIENT'S
HEALTH INSURANCE IN SOME CASES
THE PATIENT NEVER SEEMS ABOUT
MARKETERS BECAUSE THE POSITION
DOESN'T HAVE THE STAFF.
RESOURCES OUR MOTIVATION TO
DEAL WITH THE PROCESS OF
DEALING WITH THE PRIORITIZATION
AND SOMETIMES A BAND IN THE
PROCESSIT'S CLEARLY SUPPORT
CARE. WE'LL HAVE BEEN TEMPLES
INCLUDE MULTIPLE PATIENTS WITH
LUNG CANCER BEING DIAGNOSED
WITH HOSTILE ARTS AND BY THE
TIME THEY COME TO THE
OUTPATIENT ONCOLOGY CLINIC
PRINCES MCCORMICK AND ALL
HAMBRE. YOU KNOW TO DEVELOP A
TREATMENT STRATEGY I DON'T HAVE
THOSE THAT TESTING COMPLETED
YOU KNOW SUCH AS THE EGYPT ARE
LG RUSSIAN MET A THERE'S A
NUMBER OF LUNG CANCER SPECIFIC
GENES. AS WELL AS- OTHER NON
SPECIFIC- GENES THAT WE TEST
FOR PL ONE PM. TO SIGN INTO
YOUR QUE IN THEN. THEY CAN MAKE
AUTHENTICATION IS DIFFERENT AND-
TREATMENT FOR NOW. INTO HER TO
CUTS OFTEN GET TO LAKE WOULD
MIGHT BE ALMOST. ON KNOWING
THESE BY. STATUS IS CRITICAL TO
THE MOST OPTIMAL CHIU PLANNING.
FOR ANY CANCER PAY. BUT A- ONE
WHO HAS STAGE THE REPORT DANCER
METASTATIC CANCER. THESE
GETTING MARKET. APPROVED
INSTALLATION STAR APPROACH
TREATMENT. THE ARGUMENT COSTA
BE X. IS OUT BY THE- TECHNICIAN
TO THE MOST APPROPRIATE. IT'S
MOST ACOSTA EFFECTIVE THERAPY
THE SECOND ACCIDENT PUBLISHED
IN NUMEROUS PUBLICATIONS. I
HAVE SEEN CANCER PATIENTS
ADVANCED METASTATIC CANCER
START INAPPROPRIATE THERAPY
BECAUSE THEY CAN'T GET THE BOND
MARKET TEST APPROVED IN TIME.
LEADING TO SUBOPTIMAL CARE FOR
THE PATIENTS. AND POTENTIALLY
REDUCE OVERALL PICTURE RESPONSE
AND SURVIVAL. IT'S GOING
COLLEGES WE WANT TO PROVIDE OUR
PATIENTS WITH THE BEST
TREATMENT POSSIBLE ELIMINATING
THE NEED FOR PRIOR
AUTHORIZATION FOR BIOMARKER
TESTING FOR PATIENTS WITH.
ADVANCED CANCER STAGE THREE AND
STAGE FOUR CANCER ONE PRACTICAL
INVALUABLE STEP FORWARD. I WANT
TO THANK YOU TO THE CHAIR OF
THE CANADIAN CENTRE LIMóN.
COMPLAIN THAT TOGETHER I URGE
YOU TO SUPPORT THIS
LEGISLATION. THANK YOU VERY
MUCH. THANK YOU VERY MUCH I
WILL MOVE ON TO OUR NEXT. THE
WITNESS IN SUPPORT. YOU HEAR ME
YES MA'AM PLEASE GO AHEAD. I
THANK YOU MISTER TERM AND
MEMBERS OF THE COMMITTEE AND
YOU CENTER LAMENTS INTRODUCING
INTRODUCING THE LITTLE
LITERALLY LIFESAVING
LEGISLATION I'M I'M PREGNANT
SANTIAGO AND THEY WORK FOR THE
LUNGEVITY FOUNDATION WHICH IS A
LONG CANCER PATIENT ADVOCACY
AND RESEARCH FOUNDATION
LONGEVITY HAS MADE A COMMENT ON
FILE THAT DOCUMENT WITH DATA
WIFI MARKET TESTING IS SO
CRITICAL FOR CANCER PATIENTS.
IN ADDITION TO MY ROLE WITH
LONGEVITY I AM ALSO A NEED TO
AN ARMED. WHO IS ALIVE AND
LIVING WELL TODAY BECAUSE SHE
HAD TIMELY ACCESS BIOMARKER
TESTING AT DIAGNOSIS AND
PROGRESSION. BACKTESTING
IDENTIFIED HER AS HAVING EJF
ARE POSITIVE ONE CANCER AND
FROM THERE SHE WAS PUT ON THE
MOST APPROPRIATE AND EFFECTIVE
TREATMENT. AND OUR FAMILY ARE
LUCKY THAT SHE HAD WAS KINDLY
ASK THAT THE BIOMARKER TESTING
WITHOUT DELAYS. DUE TO PRIOR
AUTHORIZATION BACK IN THE LIGHT
CARE. UNFORTUNATELY
UNFORTUNATELY WE KNOW THAT NOT
EVERYONE IS SO LUCKY AND THAT
IS WHY THE LEGISLATION THAT
SOME IMPORTANT. ALL PATIENTS
SHOULD HAVE ACCESS TO TIMELY
GUIDELINE BASED BIOMARKER
TESTING REGARDLESS OF WHERE
THEY LIVE OR WHETHER THEY
RECEIVE THEIR CARE AND A LARGE
ACADEMIC MEDICAL CENTRE OR IN
THE SMALLER COMMUNITY SETTING.
BIOMARKER TESTING IS STANDARD
OF CARE FOR MANY TYPES OF
CANCER AND IT SAVES LIVES. THIS
BILL WILL HELP PEOPLE WHO ARE
VERY FAST AND DO NOT HAVE THE
LUXURY TO WAIT FOR PRIOR
AUTHORIZATION TO BE COMPLETED
BEFORE. THEY RECEIVE BIOMARKER
TESTING. BUT CALL GUIDELINE TO
RECKON BY CAP THINGS LIKE. A
TREATMENT OPTIONS. ANY THAT
DELAYED BY MARKET. WILL WHEN A
PERSON CONCERT THEIR
INDIVIDUALIZED TREATMENT. I
AUTHORIZATION FOR BIOMARKER
TESTING HAS THE POTENTIAL TO
CAUSE HARMFUL DELAYS FOR
PATIENTS. WHEN HEALTHCARE PLANS
REQUIRE PRIOR AUTHORIZATION FOR
BIOMARKER TESTING FOR STANDARD
OF CARE I THANK BATES REQUESTS-
PATIENT CAN EXPERIENCE
INEXCUSABLE INEXCUSABLE KEEPING
DELAYS AND SOMETIMES A DENIAL A
DENIAL OF THE LIFE SAVING
DIAGNOSTIC THAT WILL DIRECT
THEM TO TIMELY ACCESS IS
CRITICAL THERAPIES. THIS BILL
HELPS PATIENTS WITH LATE STAGE
CANCERS WHO ALREADY HAVE
COVERAGE AND IT HELPS THEM
ACCESS BIOMARKER TESTING MORE
QUICKLY I WILL ALSO ACKNOWLEDGE
THAT THERE ARE STILL GAPS IN
THE COVERAGE OF I AM PROTECTING
SOME PATIENTS AND HOPEFULLY
THAT'S SMETHING THAT. WE CAN
EXPECT IN THE FUTURE BUT RIGHT
NOW WE HAVE SOMETHING OUT THERE
THAT CAN HELP PATIENTS TODAY
YOU ARE IN NEED- ABOUT HOPING
BY MARKER TYPE THING. THANK YOU
FOR YOUR TIME AND I HOPE THAT
YOU WILL SUPPORT SB FIVE FORTY
FIVE. THANK YOU VERY MUCH- I'M
WHEN IT WILL GO ON TO OUR WE
HAVE TWO WITNESSES IN
OPPOSITION WHENEVER YOU'RE
READY PLEASE. I THANK YOU MR
CHAIRMAN MEMBERS- NICOLINO
SUMMING UP THE CALIFORNIA
ASSOCIATION OF HEALTH PLANS-
AGAIN WOULD LIKE TO THANK THE
AUTHOR AND HER STAFF- FOR- THE
GREAT DISCUSSION THAT WE HAD
AROUND THIS BILL. IN THE
SENATE- AMENDMENTS WERE TAKEN-
THAT RECOGNIZE THE NEED TO
MAINTAIN REASONABLE CHECKS AND
BALANCES OF THE HEALTHCARE
DELIVERY SYSTEM PARTICULARLY ON
A SENSITIVE SERVICE OBSESSION
BIOMARKER TESTING- WE- IT WOULD
LIKE A DELAY IN THE EFFECTIVE
DATE OF THE BILL- IF THAT'S
TAKEN TO THE BILL WE WILL BE
REMOVING. OUR OPPOSITION- THANK
YOU. THANK YOU VERY MUCH NEXT
WITNESS PLEASE. MISTER KAREN
MEMBERS AT THE WATKINS ON
BEHALF OF THE ASSOCIATION OF
CALIFORNIA LIFE AND HEALTH
INSURANCE COMPANIES- WE TOO
WOULD LIKE TO THANK THE AUTHOR
AND SPONSOR- THIS AGAIN IS BUT
ANOTHER COLLABORATIVE EFFORT WE
APPRECIATE THE AMENDMENTS THAT
WERE TAKEN IN THE SENATE SHOULD
NARROW THE BILL AND ENSURE THAT
THERE ARE THOSE CHECKS AND
BALANCES IN PLACE. AS MY
COLLEAGUE MENTIONED- WITH MANY
OF THESE BILLS THAT THE LATEST
FACTOR DATE IS CRITICAL TO
ENSURE THAT OUR MEMBERS HAVE AN
OPPORTUNITY TO IMPLEMENT THESE
NEW CHANGES AND THAT'S
THOUGHTFUL WAY- AND ENSURE THAT
ALL AND RELEASED. THE NOTIFIED
AND HAVE INFORMATION REGARDING
ALL THESE CHANGES SO IF THAT
DELAYED IMPLEMENTATION DATE IS
TAKEN TO THE BILL WE WOULD LIKE
TO MOVE FORWARD. REMOVING
OPPOSITION THANK YOU. THANK YOU
VERY MUCH I WOULD BRING THE
QUESTION ARE YOU ACCEPTING THE
AMENDMENTS THIS. YOU YES
ACCEPTING THE AMENDMENTS AND
ACCEPTING THE DEATH DELAYED
IMPLEMENTATION DATE TO JULY
FIRST OF TWENTY TWENTY TWO.
VERY WELL THANK YOU- WE WILL
NOW GO TO THE PHONE LINES FOR
WITNESSES IN SUPPORT OR
OPPOSITION JUST YOUR NAME-
POSITION AND ON THE BILL AN
ORGANIZATION IF YOU REPRESENT
ONE. NEGATIVE ONE AND THEN ZERO
WILL FIRST GO TO LINE UP. ONE
FIFTY FOUR. MR CHAIRMAN MEMBERS
BRANDON MARCHING WITH THE
CALIFORNIA MEDICAL ASSOCIATION
IN SUPPORT OF THE BILL THANK
YOU NEXT CALLER PLEASE. ONE
SIXTY THREE. THANK YOU MR
CHAIRMAN MEMBERS ALEX CALLING
ON BEHALF OF THE CALIFORNIA
CHRONIC CARE COALITION IN
STRONG SUPPORT THANK YOU NEXT
CALLER PLEASE. ONE SEVENTY.
GOOD AFTERNOON CREDIT UNION
FROM THE CALIFORNIA CHAMBER OF
COMMERCE HERE IN OPPOSITION TO
THE BILL THAT APPEARS IN PRINT
TODAY THANK YOU THANK YOU NEXT
CALLER PLEASE AND- ONE FIFTY
NINE. GOOD AFTERNOON MR
CHAIRMAN JOHN VALENCIA FOR
ASTRAZENECA PHARMACEUTICALS IN
STRONG SUPPORT OF THE SENATORS
SB FIVE THIRTY FIVE THANK YOU
THANK YOU NEXT CALLER PLEASE.
THANK YOU HERE GOT LINE. ONE
SIXTY ONE. GOOD AFTERNOON THIS
IS CHRISTY BOY ON BEHALF OF THE
CALIFORNIA CLINICAL LABORATORY
ASSOCIATION IN STRONG SUPPORT
SB FIVE THIRTY FIVE THANK YOU
THANK YOU VERY MUCH BRING IT
BACK TO THE COMMITTEE FOR
QUESTIONS OR COMMENTS QUESTIONS
OR COMMENTS FROM THE COMMITTEE.
THE BILL A SAID THERE IS A
MOTION FROM- MISS AGUIAR-CURRY
A SECOND FROM DOCTOR REGULAR.
OF THE WE DO HAVE A DO PASS AS
AMENDED TO APPROPRIATIONS- DO
PASS RECOMMENDATION FROM THE
CHAIR WHICH I TO CLOSE I
RESPECTFULLY ASK PRIVATE. THANK
YOU VERY MUCH SENATOR MOMENTUM
SECRETARY PLEASE CALL THE ROLL.
THE MOTION IS TO PASS AS
AMENDED TO APPROPRIATIONS WHAT
HI WHAT I MAYES. MAYES AYE
AGUIAR-CURRY. AGUIAR-CURRY AYE
ARAMBULA. ARAMBULA I BIGELOW.
BIGELOW AYE CALDERON. CALDERON
AYE CARILLO. CARILLO II FLORA
LARA AYE MAIENSCHEIN. MCCARTY
MCCARTY AYE NAZARIAN. NAZARIAN
I REQUEST. RODRIGUEZ RODRIGUEZ
FIVE SANTIAGO. WALDRON. ELEVEN
ZERO ELEVEN ZERO YOUR BILL IS
NOT LEAVE THE ROLE OPEN FOR
OTHERS ADAM THANK YOU VERY MUCH
SENATOR. SENATOR UMBERG YOU
HAVE S. B. ITEM NUMBER FIFTEEN
ESPYS THREE FORTY NINE WHENEVER
YOU'RE READY SIR THANK YOU MR
CHAIRMAN MEMBERS I'M PLEASED TO
PRESENT THE CALIFORNIA ETHICAL
TREATMENT FOR PERSONS WITH
ADDICTION ACT I WANT TO THANK
THE CHAIR FOR YOUR PERSONAL
INTERVENTION IMPROVEMENT IN THE
BILL AS WELL AS- JUDY BABCOCK
FOR HER ASSISTANCE ON THE BILL-
WE HAVE MANY EXCELLENT
PROVIDERS FOR THOSE WITH
SUBSTANCE ABUSE DISORDERS IN
CALIFORNIA UNFORTUNATELY
THEY'RE NOT ALL PERFECT- IN
PARTICULAR NEAR THAT I
REPRESENT SOMETIMES REFERRED TO
AS THE REHAB RIVIERA WE HAVE
SOME. PROVIDERS THAT ARTID
HEARING TO ETHICAL STANDARDS
AND THUS THE BILL OF THE BILL
CONTAINS A BILL OF RIGHTS FOR
THOSE WHO ARE- IN TREATMENT IN
A ENTITLES THEM TO APPROPRIATE
EVIDENCE BASED TREATMENT OF
PROVIDED BY QUALIFIED IN
QUALITY CARE GIVERS IT ALSO
REQUIRES THAT IF THE PLAN
PROVIDES THAT THAT THEY DO
PROVIDE EDUCATION SUPPORT AND
TREATMENT TO A CLIENT'S FAMILY
MEMBERS AND IT ALSO REQUIRES
THAT PROVIDERS- THEY PROMULGATE
IN MARKETS COMPLETE ACCURATE
EASY UNDERSTAND. INFORMATION
THOSE WHO KNOWINGLY PROVIDE
FALSE OR MISLEADING INFORMATION
CAN FACE FINES UP TO TWENTY
THOUSAND DOLLARS PER VIOLATION
IN ADDITION TO THE FINES THEY
ALSO COULD HAVE THEIR PROGRAMS
DECERTIFIED- URGENT I BOUGHT I
HAVE TWO WITNESSES WHO WERE ON
THE PHONE- ONE MICHELLE WARBECK
FOR THE NATIONAL ALLIANCE FOR
MODEL STATE DRUG LAWS UPON
WHICH THIS THIS BILLIS UP
FASHION AND SHERRY DAILY WITH
THE CALIFORNIA CONSORTIUM OF
ADDICTION PROGRAMS AND
PROFESSIONALS. THANK THANK YOU
VERY MUCH SENATOR-AMBERG WE
WILL GO ON TO THE PHONE LINES
TO YOUR WITNESSES IN SUPPORT.
THANK YOU CHAIR LEADING
COMMITTEE MEMBERS I AM A
SOPHOMORE PRESIDENT OF THE
NATIONAL ALLIANCE THE MODEL
STATE DRUG LAWS ALSO KNOWN AS
THE INSTALL AND IT IS MY
PLEASURE TO HELP THE CLIENT
BEFORE THE SENATE BILL THREE
TWENTY NINE WHICH CREATES A
LEGAL RIGHT. TO ETHICAL
TREATMENT FOR SUBSTANCE USE
DISORDER AND PROVIDE PROTECTION
FROM PREDATORY PRACTICES BY
THREATEN ACCESS TO DESPITE
BEING AFFECTED TREATMENT. OUR
NATION CONTINUES TO FACE THE
GROWING YOUR SUPPORTER OF THE
DOWNEY SAID IT'S BEEN GREATLY
EXACERBATED BY THE COLD AND
NINETEEN PANDEMIC. ONE ONGOING
BARRIER TO ACCESSING QUALITY
TREATMENT IS THE PROLIFERATION
OF PREDATORY AND UNETHICAL
PRACTICES WHICH WE FOLLOW RAP
IN FLORIDA SEVERAL YEARS AGO.
IN TWENTY NINETEEN MANSELL
PARTNERED WITH ARNOLD VENTURE
THROUGH DRUG THIS CRISIS. WE
LEARNED THAT CLIENTS WILL LEARN
AND UNETHICAL BUSINESSES BY
FALSE STATEMENTS AND PROMISES
DISSEMINATED BY THE FACILITIES
THEMSELVES AND. THEIR BROKERS.
PROVIDE A LITTLE INDUSTRY. AND
ONE PAYMENT FOR DRIED UP IN FOR
LEAD TO RELAPSE AGAIN MORE.
NEEDS SO DEVELOPED A MODEL
PATIENT. AND TREAT I THINK AT
TO ADDRESS THE PRACTICAL ON.
SENATOR I'M FACT CRAP SENATE
BILL THREE POINT NINE ON
CORPORATIONS HE FORCED OF THAT
MY- I WOULD BE CLEAR THAT.
FORTUNATE MANY FOR THE DAY
TREAT BECAUSE- IN CALIFORNIA
ALSO HAVE WITH THE- IN PLACE
JENNIFER PREDATORY PRACTICE.
INCLUDING ROBOT MIGHT INJURY
CHOIR AND POTUS OF BACK FOR
REFERRAL. YEAH I JUST PLACED
ADVOCATE TREAT PHILIP. I ACCESS
TO TRIPLE. AND FOR ME.
INDIVIDUAL EVIDENCE BASED CARE
PLAN. SERVICES BY WAY. AND
CERTIFIED PRE. PROFESSIONAL I
FACE AND AFTER TREATMENT STUDY.
INTRADE FOR CO OCCURRING THE
HOW CONDITION WHICH CALM.
VIOLATIONS CAN NOW BE ADDRESSED
THE- UNFAIR COP ACTION BY
THE GENERAL OR VISIT. ELIT NEED
TO CREATE A LOT OF FIELD THAT
CAN I CAN IN THE TO PROGRAM AND
PER. DATING AND FOR HOW TO
TRADE ON AND- PRACTICES. FOR
THE THREE NOW FINALLY THE AND
BILL THREE NINE FOR THE CHARTER
AN PUNISH AND PREDATORY ACTORS
ACROSS THE STATE OF CALIFORNIA
THANK YOU. THANK YOU VERY MUCH
MOVE ON TO OUR NEXT WITNESS
PLEASE. A GOOD AFTERNOON ARE
WHEELCHAIR MEMBER SHERRY DAILY
WITH THE CALIFORNIA CONSORTIUM
OF ADDICTION PROGRAMS AND
PROFESSIONALS REPRESENTING
ADDICTION COUNSELOR ST PROGRAMS
RECOVERY RESIDENCES AND
THOUSANDS OF PEOPLE ARE KEPT
THROUGHOUT THE STATE. I'M HERE
TODAY TO VOICE SUPPORT FOR SB
THREE FORTY MINUTE FORTY NINE
AND CALL YOUR ATTENTION TO THE
DANGERS OF DESPICABLE PRACTICE
OF ADDICTION PATIENT BROKERING
THAT STILL PLAGUES OUR STATE
AND MUST BE ADDRESSED. ALTHOUGH
WE HAVE SPONSORED SEVERAL
SUCCESSFUL BILLS IN THIS AREA
SO CALLED ADDICTION TREATMENT
REGISTRIES ARE ONLINE SCAM
WEBSITES THAT REDIRECT
VULNERABLE CLIENTS AND FAMILY
MEMBERS TO UNSCRUPULOUS
MARKETERS TO THEMSELVES
PATIENTS THE HIGHEST BIDDER.
ARE STILL OPERATING WITH
IMPUNITY THEY REMAIN DIFFICULT
IF NOT IMPOSSIBLE TO ADDRESS
GIVEN OUR CURRENT STATUTE YOU
MAY ASK HOW DO I KNOW THAT
THESE ENTITIES ARE STILL
PRAYING UPON PEOPLE WITH
ADDICTION WELL ACTUALLY GLOBAL
DILIGENT PROGRAM I KNOW TO
BRIGHT PROVIDE EXCELLENT
SERVICE TO THE MODESTO
CALIFORNIA. AND THE FIRST HIT
ON MY GOOGLE SEARCH SHOWED A
BEAUTIFUL PICTURE OF THE
FACILITY ITS STAFF AND ITS
SERVICES BUT WHEN I CLICKED ON
IT I WAS SENT TO A WEB PAGE NOT
BELONGING TO THAT PROGRAM. I
FOUND MYSELF IMMEDIATELY
CONNECTED TO A PATIENT BROKER
WHO ENGAGE IN A HARD SELL
BEAUTY THAT INCLUDED THREATS AT
THE PRETEND YOUNG ADULT I WAS
CALLING ABOUT WOULD BE DEAD BY
SUNDAY IF IT DID NOT MORTGAGE
MY HOUSE AND DELIVER HIM TO A
TREATMENT PROGRAM IN MICHIGAN
BY FRIDAY. HE NEVER ONCE ASKED
ABOUT MY PRETENSE AND CONDITION
IF YOU WERE TO NEED A FEW TALKS
OCCASION WHAT SYMPTOMS WERE IF
HE MIGHT BE SUICIDAL. HE SIMPLY
WANTED TO KNOW. WHAT MY
INSURANCE WAS HIS AGE AND HIS
DRUG OF CHOICE SADLY WHEN I
DEMANDED TO BE CONNECTED TO
BETWEEN APARTMENT CALLED ABOUT
HE DISCREDITED AT AT OUR STATE
AND GENERAL OF THE HORRIBLE
OPTION FOR MY SON. AND THEN
REFUSED TO CONNECT ME TO THE
PROGRAM THIS BILL WILL EXPAND
THE ABILITY OF PRIVATE PARTIES
AND LOCAL LAW ENFORCEMENT
AGENCIES TO REMOVE ARE
LEGITIMATE PROVIDERS FROM THE
SCAMS AND TO SEEK DAMAGES WHEN
THEY'RE BOUND TO OCCUR. AT ALL
TO CREATE STATE FIRST EVER
PATIENTS BILL OF RIGHTS FOR
PEOPLE WITH ADDICTION. FOR
THESE REASONS WE ARE DRIVE
THANK YOU. THANK YOU VERY MUCH.
WE WILL NOW GO TO THE- WAS
THERE ANYONE IN THE AUDIENCE.
AND GALLERY WE TO SPEAK ON THIS
BILL. SENIOR ONE WE WILL NOW GO
THE- PHONE LINES FOR WITNESSES
IN SUPPORT OR OPPOSITION JUST
YOUR NAME. POSITION ON THE BILL
AN ORGANIZATION IF YOU
REPRESENT ONE PLEASE GO AHEAD
WHEN YOU'RE READY. THANK YOU
PLEASE PRESS ONE AND THEN ZERO.
FIRST QUARTER FINALS EIGHTY
THREE PLEASE GO AHEAD. PICTURE
MEMBERS CARNEY CALCOT ON BEHALF
OF THE COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION SUPPORT
THANK YOU NEXT CALLER PLEASE.
ONE MOMENT HERE THAT WE CAN
OPERATE HERE. AN EXTRA LINE.
ONE SIXTY NINE. THIS IS HOLLY
MAY SHOWER WITH THE CALIFORNIA
ASSOCIATION OF ALCOHOL AND DRUG
PROGRAM EXECUTIVES IS STATE
WIDE ASSOCIATION OF STATE
LICENSED AND CERTIFIED
SUBSTANCE USE TREATMENT PROGRAM
IS AN OPPOSITION. THANK YOU
NEXT CALL PLEASE. FURTHER AT
THIS TIME OKAY GREAT THANK YOU
RICH BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS QUESTIONS OR COMMENTS
FROM THE COMMITTEE. C. NINE I
JUST WANT TO SAY- THANK YOU FOR
BRINGING THIS BILL FORWARD IT
DOES ENJOY A DO PASS
RECOMMENDATION IT'S BEEN A
PLEASURE WORKING WITH YOU ON
THIS- THE WE DO HAVE A MOTION
FROM MR MAYES A SECOND FROM. A
MISS CALDERON MOTION IS TO PASS
APPROPRIATIONS WHICH LIKE
LOSE. THANK YOU MISTER CHAIR
AND MEMBERS ORIGINAL VOTE THANK
YOU VERY MUCH AND SECRETARY
PLEASE CALL THE ROLL. WHAT I
WOULD AYE MAYES MAYES AYE
AGUIAR-CURRY AGUIAR-CURRY AYE
ARAMBULA ARAMBULA AYE BIGELOW.
BIGELOW I'D CALDERON CALDERON I
CARILLO. CARILLO AYE FLORA
FLORA I MAIENSCHEIN. MCCARTY.
NAZARIAN NAZARIAN HIGH RIVAS.
RODRIGUEZ RODRIGUEZ I SANTIAGO
SANTIAGO HI WALDRON.
CELEBRITIES ZERO ELEVEN ZERO
YOUR BILLS OUT AND LEAVE THE
ROLE OPEN FOR OTHERS THAT ARE.
THANK YOU SENATOR WE'RE MOVING
ON TO OUR FINAL ITEM OF THE DAY
ITEM NUMBER SIXTEEN SB TWO TO
ONE BY SENATOR WIENER. WHENEVER
YOU'RE READY SIR. GREAT THANK
YOU VERY MUCH MR CHAIRMAN-
CALLING SENATE BILL TWO TO ONE
ESTABLISH A SERVICES CLEAR
TIMELY ACCESS STANDARDS FOR
FOLLOW UP CARE NEEDED BY
PATIENTS- IN ORDER TO MENTAL
HEALTH AND SUBSTANCE USE
DISORDERS- BY EXTENDING
EXISTING REQUIREMENTS TO THOSE-
TO PEOPLE WHO REQUIRE ON GOING
CARE. ACT CURRENT TIMELY ACCESS
REQUIREMENTS ADMINISTRATIVELY
SPECIFY THAT APPOINTMENTS FOR
MENTAL HEALTH OR SUBSTANCE USE
DISORDER PROVIDER MUST OCCUR
WITHIN TEN BUSINESS DAYS- BUT
THEY DID NOT EXPLICITLY STATE
THIS REQUIREMENT APPLIES BEYOND
INITIAL APPOINTMENTS- THIS
LEADS TO THE FRANKLY RIDICULOUS
SITUATION WHERE SOMEONE WHO IS
EXPERIENCING A MENTAL HEALTH.
OR SUBSTANCE USE DISORDER
PROBLEM IS ENTITLED TO A QUICK-
TEN BUSINESS DAY INITIAL
APPOINTMENT BUT THEN MAY HAVE
TO WAIT THREE MONTHS FOR THEIR
SECOND FOLLOW UP APPOINTMENT
AND SO ON AND SO FORTH- WE
KNOW. BECAUSE WE HAVE A CRISIS
IN TERMS OF MENTAL HEALTH AND
ADDICTION IN THE STATE WE KNOW
THAT YOU YOUR TREE AND YOUR
ADDRESSES CRISIS BY THE END OF
FOURTEEN PEOPLE ACCESS TO
TREATMENT AND MAKING SURE THAT
IT'S CONSISTENT AND TIMELY
TREATMENT AND WE KNOW FROM
PROVIDERS- THAT WHEN PEOPLE
NEED THAT ONGOING CARE IT'S NOT
OPTIONAL. LAST YEAR THIS
COMMITTEE THANK YOU PASSED
SENATE BILL EIGHT FIFTY FIVE TO
ENSURE PARITY FOR MENTAL HEALTH
TREATMENT THE BASIC NOTION THAT
MENTAL HEALTH IS NOT DIFFERENT
THAN PHYSICAL HEALTH- YEAH WE
CONTINUE TO TOLERATE- MENTAL
HEALTH BEING TREATED
DIFFERENTLY AND SOMEHOW NOT AS
IMPORTANT WE WOULD NOT TOLERATE
THESE KIND OF HUGE GAPS FOR
PHYSICAL HEALTH HEALTH AND YET
WE CONTINUE TO TOLERATE THEM.
FOR MENTAL HEALTH AND NO WONDER
WE HAVE A PROBLEM- I WANT TO
MAKE CLEAR THAT THIS BILL L.
DOT DOES NOT MANDATE THAT YOU
HAVE TO HAVE AN APPOINTMENT-
EVERY TEN BUSINESS DAYS IF YOUR
PROVIDER THINGS THAT LONGER. IS
THE APPROPRIATE COURSE OF THE
PROVIDER THINGS THAT ONCE A
MONTH IS OKAY FOR PARTICULAR
DIAGNOSIS- THEY'RE NOT MANDATED
TO DO IT EVERY TIME BUSINESS
DAYS. IN ADDITION IF A PATIENT
DOES NOT WANT TO COMMENT EVERY
TEN BUSINESS DAYS THE HEALTH
PLAN IS NOT GOING TO BE DOING.
OFFER THAT- BUT WE BUT THIS
DOES PROVIDE THE PRACTITIONERS
WHO ARE THE EXPERTS THE ABILITY
TO SET A SCHEDULE AND A
REASONABLE- SCHEDULE. TIME SO
ARE BECAUSE THIS IS A GOOD AN
OVERDUE BILL I MAKES
CLARIFICATIONS AND MAKES
ABUNDANTLY CLEAR IN LAW THE
TIMELY ACCESS TO MENTAL HEALTH
CARE INCLUDING FOLLOW UP.
APPOINTMENTS IS AN IMPORTANT
GOAL OF THE STATE AND I
RESPECTFULLY ASK FOR YOUR- I
VOTE WITH ME TODAY TO TESTIFY.
IF CHELSEA MARTINEZ A PATIENT
DIRECTLY IMPACTED BY THIS
LOOPHOLE AND SUSAN WHITNEY A
LICENSED MARRIAGE AND FAMILY
THERAPIST WITH KAISER THANK
YOU. THANK YOU VERY MUCH WILL
GO TO THE GALLERY FIRST. TO OUR
WITNESS WHO'S HERE IN PERSON.
HI MY NAME IS CHELSEA MARTINEZ
I'M FROM U. K. CALIFORNIA I MET
THIRTY SIX YEAR OLD WIFE MOTHER
OF TWO BOYS EIGHTEEN AND TUE
AND HAVE A BABY ON THE WAY. I
AM DIAGNOSED WITH MAJOR
DEPRESSIVE DISORDER
POSTTRAUMATIC STRESS DISORDER
AND BORDERLINE PERSONALITY
DISORDER. NOT TO MENTION ALL
THE THINGS THAT FALL UNDER THE
UMBRELLA OF THESE ILLNESSES.
SUCH AS ADHD ANXIETY AND PANIC
ATTACKS JUST TO NAME A FEW. I
WAS DIAGNOSED WITH THESE THINGS
WHEN I BECAME A PATIENT AT
KAISER WHEN I WAS AROUND ABOUT
TWENTY FOUR YEARS OLD. AT
KAISER FOR ONE ON ONE THERAPY I
WOULD TYPICALLY WAIT SIX TO
EIGHT WEEKS BETWEEN
APPOINTMENTS SOMETIMES LONGER.
WITH WEIGHTS THAT LONG I DID
NOT GET BETTER. IN FACT IT MADE
THINGS MUCH WORSE FOR ME.
WHENEVER I WOULD MEET WITH A
NEW THERAPIST AFTER SUCH A LONG
BREAK. I WOULD HAVE TO RE
INTRODUCE MYSELF AND MY STORY
I'D HAVE TO RE OPEN MY WOUNDS
EVERY TIME AND HAD NO GUIDANCE
ON HOW TO KILL THEM. THE FIRST
FORTY MINUTES WOULD BE TAKEN UP
BY RE INTRODUCING MYSELF. THEN
THERE WAS ALMOST NO TIME TO
ADDRESS WHAT WAS HAPPENING
CURRENTLY IN MY LIFE AND
CERTAINLY NOT ENOUGH TIME TO
HELP ME MANAGE ALL THE
EMOTIONS. THAT I HAD HAD. FROM
ALL THE TRAUMAS THAT I JUST
REVISITED. AFTER THOSE SESSIONS
MY FLASHBACKS BECAME MORE
SEVERE I WOULD HAVE
DISSOCIATIVE EPISODES LOSING
TIME SOMETIMES HOURS SOMETIMES
DAYS AT A TIME. DURING THIS
TIME I STARTED KOMPLETT
CONTEMPLATING SUICIDE AND I
EVEN ATTEMPTED A FEW TIMES. HOW
DO YOU SITE HOW DO YOU FIND THE
WORDS TO SAY GOODBYE TO YOUR
CHILD. WHEN I WAS THIRTY I
STARTED PAYING OUT OF POCKET TO
SEE A THERAPIST OUTSIDE OF
KAISER. THIS CREATED AN EXTREME
FINANCIAL HARDSHIP FOR ME AND
MY FAMILY. HOWEVER SINCE THEN I
HAVE BEEN ABLE TO MEET WITH HIM
AS OFTEN AS I NEED TO. IN THE
FIRST SIX WEEKS OF AT LEAST
WEEKLY THERAPY I IMPROVED MORE
THAN IN THE SIX YEARS THAT I
WAS AT KAISER. I HAVEN'T NEEDED
WEEKLY TREATMENTS FOR SOME TIME
BUT IF I EXPERIENCE ANY OF MY
TRAUMA COMING BACK I CAN EASILY
REACH OUT TO MY THERAPIST AND
GET THE KIND OF CARE THAT. I
NEED TO MOVE THROUGH IT. EVEN
KNOWING THAT I HAVE ACCESS TO
CARE WHEN I NEED IT MAKES ME
CAPABLE OF DEALING WITH
PROBLEMS THAT I OTHERWISE COULD
NOT. I FEEL LESS AFRAID AND
LESS HELPLESS. I AM EAGER AND
ABLE TO MOVE ON WITH WHO I AM
AND MORE COMPLICATE CONFIDENT
IN NAVIGATING MY OWN LIFE AND
THE LIVES OF MY CHILDREN. I AM
CURRENTLY AN ACTIVE MEMBER OF
MY COMMUNITY. I WORK HARD I
CARE FOR MYSELF AND MY FAMILY.
I'VE MADE STRONG HEALTHY AND
BEAUTIFUL RELATIONSHIPS WITH
PEOPLE THAT HAVE BECOME
PILLARS. IN MY SUPPORT. THIS IS
WHAT PROPER TREATMENT CAN DO
FOR PEOPLE. THIS IS WHAT IT CAN
LOOK LIKE. I THINK THAT PEOPLE
OFTEN THINK OF MENTAL ILLNESS
AS A SINGULAR INDIVIDUAL ISSUE
WHEN THAT'S SIMPLY NOT THE CASE.
MENTAL ILLNESS IS AN ISSUE THAT
AFFECTS OUR CHILDREN AND THE
TRAUMA THAT THEY MAY EXPERIENCE
AS A DIRECT RESULT OF OUR OWN.
IT AFFECTS OUR FAMILY UNITS OUR
RELATIONSHIPS OUR JOBS AND IN
TURN OUR COMMUNITY. AGAIN I
CANNOT STRESS THAT THIS IS WHAT
TRUMP PROPER TREATMENT CAN DO
FOR PEOPLE. IT'S WHAT IT SHOULD
DO FOR PEOPLE. WE DESERVE A
CHANCE AND AN OPPORTUNITY TO
THRIVE. WE ARE DESERVING OF
PROPER MENTAL HEALTH CARE IN
ANYTHING LESS THAN THAT IS
SIMPLY IN HUMANE. THANK YOU FOR
HEARING MY STORY AND WHY THIS
BILL MEANS SO MUCH TO ME AND
COUNTLESS OTHERS. THANK YOU
VERY MUCH AND ESPECIALLY THANK
YOU FOR BEING HERE IN PERSON TO
TELL YOUR STORY. WILL MOVE ON
TO OUR NEXT WITNESS PLEASE. I
BELIEVE SHE'S ON THE PHONE LINE.
PARDON I BELIEVE SHE'S ON THE
PHONE YES ON THE PHONE I'M
SORRY I WASN'T YEAH TO THE
OPERATOR PLEASE. GOOD AFTERNOON
CAN YOU HEAR ME YES MA'AM
PLEASE GO AHEAD. I'M STEVEN
WHITNEY A LICENSED MARRIAGE AND
FAMILY THERAPIST AT KAISER
BAKERSFIELD. I'VE WORKED FOR
OVER THIRTY YEARS IN SOCIAL
WORK IN IN TREATING PATIENTS
WITH MENTAL HEALTH NEEDS. OVER
MY CAREER MOST PATIENTS I
TREATED HAVE BEEN ENROLLED IN
COMMERCIAL HEALTH PLANS THAT
WOULD BE COVERED UNDER AT THE
TWO TO ONE. EXPERIENCE MISS
MARTINEZ JUST DESCRIBED IS
CONSISTENT WITH WHAT CLINICAL
STUDIES TELL US ABOUT
TREATMENT. OF MENTAL HEALTH AND
SUBSTANCE USE DISORDERS.
PROFESSIONAL PRACTICE
GUIDELINES IN RESEARCH IT'S
CLEAR. WHEN PATIENTS AREN'T
SEEN FREQUENTLY ENOUGH THEY
OFTEN DON'T GET BETTER. H. HAD
WATER IN THEIR ILLNESSES
SOMETIMES FOR YEARS. TOO OFTEN
THEY GET WORSE WITH INCREASED
MORBIDITY AND MORTALITY LONGER
RECOVERY TIMES MORE MERGENCY
ROOM TRIPS. MORE COSTLY CARE.
THAT'S WHY THE AMERICAN
PSYCHOLOGICAL ASSOCIATION'S
PRACTICE GUIDELINES RECOMMEND
WEEKLY THERAPY FOR MANY COMMON
DIAGNOSIS SUCH AS DEPRESSION
AND POSTTRAUMATIC STRESS
DISORDER ESPECIALLY AT THE
ONSET OF THE PATIENT'S CARE. HI
THE MENTALLY WHEN PEOPLE
RECEIVE TIMELY FOLLOW UP HERE
MANY MAKE PROGRESS IN
RELATIVELY SHORT TIME FRAME
STABILIZE AND GRADUATE TO
LESSEN TENSIONS TREATMENT.
UNFORTUNATELY MANY PATIENTS DO
NOT RECEIVE FREQUENT ENOUGH
FOLLOW UP APPOINTMENT. IN MY
CLINIC PATIENTS WITH DIAGNOSES
LIKE DEPRESSION ANXIETY BI
POLAR DISORDER AND PTSD
TYPICALLY RATE FORTY EIGHT
WEEKS OR MORE BETWEEN
APPOINTMENTS. THIS IS TRUE
ACROSS THE STATE AT KAISER
CALIFORNIA'S LARGEST HMO. IT'S
ONLY WORSENING DUE TO THE
DRAMATIC INCREASE IN DEMAND
PRODUCED BY THE PANDEMIC AND
THAT. WE'VE HEARD A LOT ABOUT
TODAY WE'VE ALSO HEARD ABOUT
ADVERSE CHILDHOOD EXPERIENCES.
WE ARE THOSE TO TREAT THOSE WHO
NEED THE TREATMENT. PROTOCOL
THAT EXIST IN CURRENT
REGULATIONS AND DULY FOCUSES
HELPCENTER TENSION ON TIMELY
ACCESS TO INITIAL APPOINTMENT
BUT NOT TO FOLLOW UP
APPOINTMENT. HENCE THE
PREDICTABLE RESULT ALREADY
MENTIONED THAT HEALTH PLANS
LIKE KAISER DON'T PRIORITIZE
FOLLOW UP APPOINTMENTS. THAT'S
WHY I STRONGLY SUPPORT SB TWO
TO ONE. IF PASSED IT WILL HELP
FOCUS HEALTH PLANS ON THE
CRITICAL NEED FOR TIMELY FOLLOW
UP APPOINTMENTS. THIS IS
ESSENTIAL FOR INSURING THE
CALIFORNIANS RECEIVE THE CARE
THEY NEED. AND THE CARE THAT
THEY HAVE PAID RECEIPT. THANK
YOU VERY MUCH THANK YOU. WE
WILL NOW MOVE ON TO WE HAVE TO
REGISTERED- WITNESSES IN
OPPOSITION AN OVERLAP OPERATOR
PLEASE ALLOW THOSE WITNESSES TO
OPEN THEIR PHONE OR APPLE OPEN
THE PHONE LINES FOR THOSE
WITNESSES. INTERLINE SHOULD BE
OPEN. A GOOD AFTERNOON MR
CHAIRMAN MEMBERS OF THE
COMMITTEE A JACKHAMMER
CALIFORNIA ASSOCIATION HEALTH
PLANS REGRETTABLY WE ARE HERE
OPPOSITION AT B. TWO TWENTY ONE
I WOULD LIKE TO THANK THE
AUTHORED SPONSORS AND THE
COMMITTEE STAFFER ENGAGING WITH
UP ON THE CELL. I WANT TO START
BY SAYING THAT WE DO APPRECIATE
THE INTENT OF THE BILL AND
AGREE THAT INSURING ACT AT THE
TIME WHEN CLINICALLY
APPROPRIATE MENTAL HEALTH AND
SUBSTANCE USE DISORDER
TREATMENT CARE IS CRITICAL.
HOWEVER WE ARE CONCERNED THAT
THE P. TWENTY ONE TAKES A ONE
SIZE FITS ALL APPROACH TO
SCHEDULE AN APPOINTMENT WITHIN
TEN DAYS. AND DID NOT
ADEQUATELY CONSIDER THE MANY
CHALLENGES THAT THIS PROVISION
ENTAILS. ARE TYPICALLY THE BILL
DOES NOT ADEQUATELY CONSIDERED
THE REASONS WHY A PATIENT MIGHT
CHOOSE NOT TO HAVE A FOLLOW UP
VISIT DEPENDING TIME FRAME. FOR
EXAMPLE AN INDIVIDUAL MAY NOT
FEEL LIKE PROVIDER WHO
PERFORMED THE INITIAL
ASSESSMENT WITH A GOOD DAY. AND
WE PREFER AN APPOINTMENT WITH
ANOTHER PROVIDER. OR AN
INDIVIDUAL MAY INDICATE THAT
THEY ON THEIR OWN PER SCHEDULE.
BI WEEKLY OR MONTHLY SESSIONS
ARE ADEQUATE. I WE ARE ALSO
CONCERNED THAT THE MAY- COULD
UNDER UNINTENTIONALLY UNDERMINE
EXISTING PROVIDER NETWORK BY
REQUIRING PLANTS TO ARRANGE FOR
OUT OF NETWORK COVERAGE. IF THE
CONTACT THE PROVIDER CAN NOT
OPERATE CAN DAY FALL POINT
MEANT. HOW PLANS WERE
DILIGENTLY TO MAKE SURE THAT
THEY HAVE ROBUST NETWORK THAT
MEETS THE NEEDS FOR THE
MEMBERS. THE CONSIDERING IRMA'S
CHARGE AT THIS BILL PLACES ON
THE CONTRACT PROVIDERS GET
THOUGHT AND A FOLLOW UP
APPOINTMENT. THERE WOULD BE
LITTLE INCENTIVE FOR PROVIDERS
WHO CONTRACTED HEALTH PLANS IF
THEY COULD PROVIDE THE SERVICES
OUT OF NETWORK- LASTLY. AND
MOST IMPORTANT IS YOUR CARE AND
NUMBER WE LIVE AT THE TWENTY
ONE ADEQUATELY CONSIDER. THE
FUNDAMENTAL CHALLENGE OF A LACK
OF AVAILABLE WORKFORCE TO MEET
THE CURRENT DEMAND FOR MENTAL
HEALTH SERVICES. ALTHOUGH WE
ARE ENCOURAGED TO SEE THE
SIGNIFICANT INVESTMENT MADE IN
THIS YEAR'S BUDGET BY THE
LEGISLATURE IN THE
ADMINISTRATION. RELATED TO THE
DEVELOPMENT OF A STRONG
BEHAVIORAL WORKFORCE IN OUR
STATE. CALIFORNIA STILL
CURRENTLY FACING A MENTAL
HEALTH CARE. WHILE WORKFORCE
SHORTAGE ROUTE STATE. PRIOR TO
COMPANY AND THEN. A UNIVERSITY
OF. CAN BECAUSE FOUND OUT
WITHOUT IT CONCERTED EFFORT TO
RECRUIT RETAIN MENTAL HEALTH
PROFESSIONALS. CALIFORNIA HAS
50% YOUR PSYCHIATRIST AND YOU
KNOW 30% YOUR THERAPIST THAT WE
NEED TO MEET THE DEMAND
BEHAVIORAL HEALTH SERVICES BY
TWENTY TWENTY EIGHT. THE
COMPANY DEMICHELIS EXACERBATED
THIS REPORT SHORTAGE AT THE
NAMPA THESE SERVICES HAS.
SIGNIFICANTLY INCREASED.
ASSEMBLY PART OF MANDATING
INCREASED FREQUENCY OF
APARTMENTS THAT ADDRESS THE
UNDERLYING OR CORE SHORT WILL
NOT LEAD TO INCREASE QUALITY
CARE UT RATHER. LEASE
PROVIDERS HAVING TO MANSER THE
THING CASELOAD IN ORDER TO
ENSURE NOT POSSIBILITY TO
SCHEDULE ALL APPOINTMENTS. IN.
THE TEN DAY TIME FRAME COSTA
DEL. PLEASE RETURN. I BELIEVE
QUESTION OF HONESTY TWENTY ONE
THANK YOU THANK YOU- NEXT-
WITNESS PLEASE. HM NUMBER SEVEN
WHAT CAN FROM BEHALF OF THE
ASSOCIATION OF CALIFORNIA LIFE
AND HEALTH INSURANCE COMPANIES
I APPRECIATE THE OPPORTUNITY TO
SHARE WITH YOU SOME OF OUR
THOUGHTS AND CONCERNS WITH
RESPECT SB THREE TWO ONE. BUT
LIKE TO ECHO MANY OF MY
COLLEAGUES COMMENTS AND I'LL SO
HIGHLIGHTS FOR YOU OUR CONCERNS
WITH RESPECT TO THE BILL
SEEKING TO CODIFY A PORTION OF
THE TIMELY ACCESS STANDARDS.
BUT MANY OF YOU CAN APPRECIATE
REGULATIONS ARE REALLY INTENDED
TO GIVE LIFE THE STOCK STORY
STRUCTURE THAT THE LEGISLATURE
ENACT. THESE GUIDELINES ARE
MORE LIKE LIVING BREATHING
DOCUMENTS THAT. AS AN EXAMPLE
TEAMMATES THESE EVALUATING
RIGHT DURING THEIR CURRENT
STATUTORY AND TIMELY ACCESS
STANDARDS AS THE TV I SEVERAL
YEARS AGO BUT THEY JUST
INCORPORATE ADDITIONAL ACCESS
STANDARDS WHICH WENT ABOVE AND
BEYOND THE TRADITIONAL GEO
ACTIVE STANDARDS THAT EXISTED.
WE START TO CODIFY THE
STANDARDS INTO LAW IT LIMITS
THE OVERSIGHT FLEXIBILITY THAT
REGULATORS CURRENTLY USED TO
ADDRESS ISSUES AS THEY ARISE BY
SIGNIFICANTLY HINDERING THEIR
ABILITY TO BE NIMBLE AND
ADDRESS OVERSIGHT ISSUES
QUICKLY. AS THEY WOULD NOT BE
REQUIRED TO COME AS A WOULD NOT
BE REQUIRED TO COME BACK TO THE
LEGISLATURE TO MAKE ANY
MODIFICATIONS NO MATTER HOW
INSIGNIFICANT OUR TECHNICAL
THEY MIGHT BE. JUST TO GIVE YOU
AN EXAMPLE WE'VE SEEN OVER THE
LAST YEAR A GREAT DEAL OF
GROWTH IN THE TELL HEALTH
SECTOR. WITH GROWTH COMES THE
NEED FOR ADDITIONAL REGULATORY
OVERSIGHT THAT COULD BE
HAMPERED IF THESE REGULATIONS
WERE TO BE ADOPTED INTO
STATUTE. SURELY AT THE ARTICLES
TO ADD AND SPECIFIC STATUTORY
REQUIREMENTS WITH RESPECT TO
ACCESS TO MENTAL HEALTH
SERVICES AND FOLLOW UP
APPOINTMENTS THEY CAN
ACCOMPLISH THAT WITHOUT TYING
HIM TO BREAK THE LATEST BY AND
THIS. CODIFYING EXISTING ACCESS
STANDARD. OR THE THREE. AND ONE
PREVIOUSLY BY MY COLLEAGUE WE
ARE BURKE IN OPPOSITION OF THE
**** AT THIS TIME. OKAY THANK
YOU VERY MUCH. WE WILL NOW GO
TO THE FOR LINE. ABOUT WE WERE
ON A FOR THE OTHER WITNESS IN
SOME- UP. JUST YOUR NAY-
BECAUSE ON THE BILL IN OREGON
IF YOU REPRESENT ONE SO YOU'RE
READY OPERATOR. THANK YOU AND
PLEASE PRESS ONE ZERO. WELL
FIRST CAROLINA ONE NINETEEN IS
GO AHEAD. ONE NINETEEN YEAR
ALLIANCE OPEN. GOOD AFTERNOON
JANICE LAURIE ON BEHALF OF
WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT THANK YOU
NEXT CALLER PLEASE. LINE. ONE
SEVENTY THREE. GOOD AFTERNOON
DIANA DOUGLAS WITH HEALTH
ACCESS CALIFORNIA IN SUPPORT.
THANK YOU NEXT CALLER PLEASE.
NINE ONE THIRTY THREE. MR
CHAIRMAN MEMBERS PAUL YOUR ON
THE HALF OF THE CITY AND COUNTY
OF SAN FRANCISCO AND THE
CALIFORNIA STATE ASSOCIATION OF
PSYCHIATRISTS STRONG SUPPORTER
DR- THANK YOU THANK YOU NEXT
CALL APPLY ONE. SORRY WHAT.
NINE ONE SEVENTY FOUR. GOOD
AFTERNOON CHAIR NUMBERS CALLS
WORSE FOR THE CALIFORNIA
PSYCHOLOGICAL ASSOCIATION
STRONG SUPPORT AND THANK THE
AUTHOR FOR HIS WORK ON THIS.
THANK YOU NEXT CALLER PLEASE.
LINE ONE FORTY EIGHT. GOOD
AFTERNOON TO MEET YOU AT THE
WORD NATIONAL ASSOCIATION OF
SOCIAL WORKERS CALIFORNIA
CHAPTER IN SUPPORT THANK YOU
THANK YOU NEXT CALLER PLEASE.
LINE. NINETY THREE. YEAH
JENNIFER OUR WITH THE
CALIFORNIA ASSOCIATION OF
MARRIAGE AND FAMILY THERAPIST
IN SUPPORT THANK YOU NEXT
CALLER PLEASE. LINE. ONE TWENTY
TWO. GOOD AFTERNOON. MY NAME IS
KIND OF CHECK I'M REPRESENTING
DISABILITY RIGHT CALIFORNIA AND
NEW YORK SUPPORT OF THE- THANK
YOU. MEXICO PLEASE. LINE.
EIGHTY FOUR. A REMINDER ON
BEHALF OF THE STEINBERG AND HE
CAN'T AND THE KENNEDY FORMED
PART THANK YOU THANK YOU NEXT
CALLER PLEASE. ALEX CALLER IN
THE QUEUE IS LINE. ONE SIXTY
FOUR. THANK YOU MELISSA CORTES
REPRESENTING AUTISM SPEAKS AND
THE CENTER FOR AUTISM AND
RELATED DISORDERS AND SUPPORT.
THANK YOU. AND I'M SORRY THE
OPERATOR WAS THAT THAT WAS THE
LAST CAR. THAT WAS AT THE TIME
CORRECT OKAY GREAT THANK YOU.
WE WILL NOW BRING IT BACK TO
THE COMMITTEE FOR QUESTIONS OR
COMMENTS FROM THE COMMITTEE.
I'M SORRY DID YOU BOB SORRY BUT
A PLEASE GO AHEAD OF WHAT WE
HAVE ONE MORE WITNESS IN THE
GALLERY JUST YET. YEAH SORRY-
M. B. WATSON WITH NATIONAL
UNION OF HEALTH CARE WORKERS
HERE IN STRONG SUPPORT. THANK
YOU MY APOLOGIES TO ANYONE ELSE
UP THERE. OKAY SEE NO ONE WILL
NOW BRING IT BACK TO COMMITTEE
FOR QUESTIONS OR COMMENTS.
QUESTIONS OR COMMENTS. SECULAR
KERR. ONE TO MAKE A COMMENT TO
THANK THE- THE YOUNG WOMAN WHO
SPOKE TODAY THAT WE HERDER'S
STORY WE UNDERSTAND IN THE-
TAKES A LOT OF BRAVERY TO SHARE
YOUR STORY SO THANK YOU SO MUCH
AND THANK YOU SENATOR FOR
BRINGING THIS FOR. THE LONG
TIME COMING WHEN YOU'RE IN NEED
IN YOUR DESPERATE AND YOU'RE
HAVING SO MANY DIFFICULTIES IF
YOU NEED HELP RIGHT AWAY. NOT
IN THE FUTURE. WE HAVE A
NUMEROUS OF OUR FRIENDS HAVE
PASSED AWAY- FROM DEPRESSION
AND SUICIDE AND IF THEY COULD
HAVE BEEN HELP SOONER I THINK
IT'S STILL BE HERE WITH US
TODAY SO THANK YOU VERY MUCH.
THANK YOU VERY MUCH ANYONE ELSE.
I JUST LIKE TO SAY THANK YOU
VERY MUCH CENTER COVERING THIS
BILL FORWARD EIGHT I DID HEAR
FROM THE OPPOSITION THAT THIS
IS A ONE SIZE FITS ALL
APPROACH- I WOULD SADLY SAY
THAT RIGHT NOW THERE AREN'T ANY
SIZES THAT FIT- FOR A LOT OF
PEOPLE RIGHT NOW. AND YOU KNOW
WHEN YOU I KNOW I RECOGNIZE WE
DO HAVE WORKFORCE ISSUES- THAT
THERE'S NO CHALLENGES A LACK OF
PSYCHIATRISTS WE'VE ALSO YOU
KNOW I'VE WORKED ON BILLS THAT
ALLOWED FOR EXPANSION OF THE
UTILIZATION OF OUR WORK FORCE
TO BE ABLE TO ADEQUATELY. SERVE
AS MANY PEOPLE AS POSSIBLE FOR
EXAMPLE MARRIAGE AND FAMILY
THERAPIST NOW CAN DO THE WORK
THE SOCIAL WORKERS DO AT AND-
AND SO ON WE ALSO HAVE NURSE
PRACTITIONERS WHO WORK IN IN IN
THE BEHAVIORAL HEALTH SPACE AS
WELL SO THERE ARE THERE IS A
WORK FORCE OUT THERE- AND- I
CAN'T THINK OF ANYTHING MORE
DISCOURAGING THAN TO GET THAT
TIMELY ACCESS IN TEN DAYS AND
THEN BE TOLD GONNA WAIT SIX TO
EIGHT WEEKS FOR THE NEXT FOR
THE NEXT APPOINTMENT HOW
DISCOURAGES OUT FOR SOMEONE
WHO. HAS A SERIOUS PROBLEM THAT
THEY NEED TO HAVE A DRESS SO I
THANK YOU FOR BRINGING THIS GO
FORWARD- IS MUCH APPRECIATED-
LOOKING FOR A MOTION. JEFF
GORDON A MICHIGAN KARIMA MOVED
IT. SIX SEVEN BY MISTER FLOOR.
WHICH I CLOSE. I THANK YOU
MISTER CHAIRMAN YOU- YOU KNOW
ITS- IT'S INTERESTING WHEN THE
OPPOSITION TALKS ABOUT ONE SIZE
FITS ALL OF COURSE IT'S NOT
ACCURATE FOR THE REASONS I
STATED. EARLIER BECAUSE-
PRACTITIONER CAN CRAFT WHATEVER
PLAN THEY THINK APPROPRIATE
THIS FOR THE BASELINE STANDARD
IN PLACE AND I'LL BE HONEST I
WISH WE DIDN'T HAVE TO HAVE
BASELINE TIMELY ACCESS
STANDARDS WHICH WE ALREADY HAVE
BEEN AROUND PHYSICAL HEALTH AND
INITIAL MENTAL HEALTH
APPOINTMENTS I WISH WE NEED TO
DO THAT. BUT THE SAD STATE OF
AFFAIRS IS THAT WE HAVE TO WE
HAVE TO HAVE A RULE BECAUSE
IT'S NOT HAPPENING- WITH THE
PLANS. I AM IN TERMS OF THE
SHORTAGE- YOU KNOW I THINK- I
THINK THERE ARE SOME CHALLENGES
WITH THE WORK FORCE AND WE HAVE
TO PROACTIVELY PLAN FOR THE
FUTURE TO DRAW MORE PEOPLE AND
FOR THIS IMPORTANT SPACE. I DO
THINK THE OPPOSITION IS
OVERSTATED THE SCALE- OF THAT
OF THAT ISSUE AND THERE ARE
STUDIES THAT SUGGEST THAT IT'S
NOT AT THE LEVEL THAT THEY'RE
SAYING SO THIS BILL IS
IMPLEMENTABLE- WITH THERE'S A
WILL THERE'S A WAY- I THINK WE
NEED TO COMPARTE- SEND OUT WELL
OUT TO THE HEALTH PLANS- AND
THIS BILL WOULD DO THAT AND I
RESPECTFULLY ASK FOR AN AYE
VOTE. THANK YOU VERY MUCH
SENATOR WE DO HAVE A MOTION BY-
MISS AGUIAR-CURRY A SECOND BY
MR FLOOR THE MOTION IS DUE PASS
TO APPROPRIATIONS LAST MINUTE
SECTOR TO PLEASE CALL THE ROLL.
WHAT HI WHAT I MAYES MAYES AYE
AGUIAR-CURRY AGUIAR-CURRY I'VE
ARAMBULA. ARAMBULA AYE BIGELOW.
FIGURE II CAL. CALDERON AYE
CARILLO. CARILLO AYE FLORA
FLORA I MAIENSCHEIN MAIENSCHEIN
AYE MCCARTY MCCARTY I IN THIS
AREA NAZARIAN AYE RIVAS. RIVAS
I RODRIGUEZ RODRIGUEZ III
SANTIAGO. SANTIAGO HI WALDRON.
FOURTEEN ZERO FOURTEEN ZERO
YOUR BILL IS OUT LEAVE THE ROLE
OPEN FOR OTHERS THAT ARE THANK
YOU VERY MUCH SENATOR THANK YOU
MISTER JOE THANK YOU COLLEAGUES.
WE WILL NOW- MOVED TO THE-
MOVED TO GO THROUGH THE BILLS
THAT THAT IS THE LAST BILL TO
BE PRESENTED TODAY. SO WE WILL
STOP START AT ITEM NUMBER ONE.
AND SB SIX SIXTY FOUR- MADAM
SECRETARY PLEASE OPEN THE ROLE
AND- CALL THE ABSENT MEMBERS.
THIS WAS ON CALL I'M SORRY THIS
BILLS ON CALL OKAY A- LIFT THE
CALL AND OUT CALL THE ABSENT
MEMBERS THANK YOU. ARAMBULA
ARAMBULA HI CALDERON. CALDERON
AYE CARILLO AREA AYE FLORA. I
AM NUMBER FOUR ONE SIX SIX
FOUR. THE. FOR LARA NOT VOTING
MAIENSCHEIN MAIENSCHEIN AYE
MCCARTY MCCARTY I IN THIS AREA.
THIS AREAS HIGHER RIVAS REQUEST
HI SANTIAGO. SANTIAGO I.
FOURTEEN ZERO FOURTEEN ZERO
THANK YOU VERY MUCH ITEM
NUMBERS TO SB THREE SIXTY FIVE
BY SENATOR CAFIERO PLEASE OPEN
THE ROLL CALL THE ABSENT
MEMBERS. ARAMBULA ARAMBULA AYE
FLORA FLORA AYE MAIENSCHEIN.
MAIENSCHEIN HAI MCCARTY MCCARTY
AYE NAZARIAN THIS AREA HIGH
RIVAS. RIVAS HI SANTIAGO
SANTIAGO I FIFTEEN ZERO FIFTEEN
ZERO ITEM NUMBER. THREE SIX TEN
FOURTEEN AND SEVENTEEN ARE ALL
CONSENT CALENDAR ITEMS PLEASE
OPEN THE ROLL CALL THE ABSENT
MEMBERS ARAMBULA ARAMBULA AYE
FLORA- I MAIENSCHEIN. MEASURE
AND I MCCARTY MCCARTY AYE
NAZARIAN. NAZARIAN I RIVAS
RIVERSIDE SANTIAGO. SANTIAGO
FIVE FIFTEEN ZERO FIFTEEN ZERO
THANK YOU LET'S GO BACK
MOMENTARILY TO ITEM NUMBER ONE-
AND JUST OPEN THE ROLL CALL THE
ABSENT MEMBERS. THIRTY ABSENT
MEMBERS I'M SORRY I THOUGHT
THERE WAS SOME SORT OF MY ERROR
THAT. WE'LL CHECK THAT ONE ITEM
NUMBER GOOD ITEM NUMBER FOUR IN
PLEASE LIFT THE CALL THEM CALL
THE ABSENT MEMBERS. ARAMBULA
ARAMBULA I CALDERON FORTY NINE
CALDERON I CARILLO MARIA HI
FLORA. LARA AYE MAIENSCHEIN
MAIENSCHEIN HAI MCCARTY MCCARTY
HIGHNESS AREA. THIS AREA AND I
RIVAS. RIVAS I. SANTIAGO
SANTIAGO I WALDRON WALDRON HIGH
FIFTEEN ZERO FIFTEEN ZERO THANK
YOU PLEASE OF LIFT THE CALL ON
ITEM NUMBER FIVE SB SIX EIGHTY
SEVEN BY SENATOR HUESO.
ARAMBULA ARAMBULA I. CALDERON
CALDERON HI FLORA FLORA HI
MAIENSCHEIN MAIENSCHEIN HAI
MCCARTY. MCCARTY I NAZARIAN
NAZARIAN AYE RIVAS. RIVAS ICE
SANTIAGO SANTIAGO I WALDRON
WALDRON HIGH FOURTEEN ZERO
FOURTEEN ZERO THANK YOU I'M
MOVING ON TO ITEM NUMBER SEVEN
SB FOUR TWENTY EIGHT BY CENTER
HER TADO PLEASE LIST THE CALL
CALL THE ABSENT MEMBERS.
ARAMBULA ARAMBULA I CARILLO. HI
FLORA FLORA I MAIENSCHEIN MAYES
AND HIGH NAZARIAN NAZARIAN AYE
REVERSE RIVAS HI SANTIAGO.
SANTIAGO FIVE FIFTEEN ZERO
FIFTEEN ZERO THANK YOU UP ITEM
NUMBER EIGHT SB FIVE TWENTY
THREE PLEASE LIFT THE CALL CALL
THE ABSENT MEMBERS CARILLO. SB
FIVE TWENTY THREE SENATOR LEYVA.
CARILLO AYE FLORA. FLORIMO
MAIENSCHEIN MAIENSCHEIN HI
MCCARTY MCCARTY I IN THIS AREA.
THIS AREA OF HIGH RIVAS
RIVERSIDE SANTIAGO SANTIAGO AYE
WALDRON. WALDRON OF VOTING.
ELEVEN A TWO SEVEN TWO THANK
YOU ITEM NUMBER NINE PLEASE
LIFT THE CALL CALL THE ABSENT
MEMBERS AS SB FORTY EIGHT BY
SENATOR LAMAR ARAMBULA REGULAR
HIGH CARILLO. CARILLO HI FLORA
FLORA HIGH MAIENSCHEIN
MAIENSCHEIN HAI MCCARTY.
MCCARTY HIGHNESS AREA THIS AREA
AND I REQUEST. RIVERSIDE
SANTIAGO SANTIAGO HIGH FIFTEEN
ZERO THANK YOU- ITEM NUMBER
ELEVEN- IN MY NOTES WE NEED TO
LIFT THE CALL ON THAT NOW OKAY
WE DON'T THEN SO WE DO NEED TO
DO IS OPEN THE ROLE FOR THE
ABSENT MEMBERS PLEASE CALL THE
ABSENT MEMBERS. CARILLO AREA
AYE FLORA. THREE FLUORIDE
MAIENSCHEIN MAIENSCHEIN I IN
THIS AREA. NAZARIAN AYE RIVAS
RIVERSIDE SANTIAGO SANTIAGO I
WALDRON WALDRON AYE FIFTEEN
ZERO FIFTEEN ZERO ITEM NUMBER
TWELVE- SB THREE SIXTY EIGHT BY
CENTER TO AMOUNT PLEASE OPEN
THE ROLE AND CALL THE ABSENT
MEMBERS FLORA. FLOOR NO.
MAIENSCHEIN MAIENSCHEIN AYE
RIVAS RIVERSIDE SANTIAGO
SANTIAGO AYE FOURTEEN THE ONE.
IF A MISS WALDRON YES PLEASE.
AB I'M SICK ABOUT CHANGES.I AM
NUMBER TWELVE SB THREE SIXTY
EIGHT OF MY CENTER LIMóN MISS
WALDRON I TO KNOW. WALDRON ITEM
NOW OKAY. ITEM NUMBER THIRTEEN
S. B. THIRTEEN A TWO OKAY I'M
SORRY POACHERS SO THAT WAS
THIRTEEN THE TWO ITEM NUMBER
THIRTEEN SB FIVE THIRTY FIVE BY
SENATOR LIMóN PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS
MAIENSCHEIN. MAIENSCHEIN I
REVERSE RIVAS AYE SANTIAGO
SANTIAGO I WALDRON WALDRON AYE
FIFTEEN ZERO THANK YOU ITEM
NUMBER FIFTEEN PLEASE OPEN THE
ROLL CALL THE ABSENT MEMBERS
THIS IS SB THREE FORTY NINE BY
SENATOR- BURKE. MAIENSCHEIN
MAIENSCHEIN AYE MCCARTY MCCARTY
I'D REVERSE RIVAS AYE WALDRON
WALDRON AYE FIFTEEN ZERO
FIFTEEN ZERO THANK YOU AND ITEM
NUMBER SIXTEEN S. B. TWO ONE
EIGHT TO TWENTY ONE BY SENATOR
WIENER PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS.
WALDRON WALDRON AYE FIFTEEN
ZERO OKAY AND THAT IS A WRAP
THANK YOU VERY MUCH MEMBERS
THAT CONCLUDES THE ASSEMBLY
HEALTH COMMITTEE DURING FOR
THIS AFTERNOON.