GOOD AFTERNOON AND
WELCOME THIS IS THE ASSEMBLY
BUDGET SUB COMMITTEE NUMBER ONE
ON HEALTH AND HUMAN SERVICES
TODAY WE WILL BE DISCUSSING
VARIOUS HEALTH RELATED PROPOSALS
INCLUDED IN THE GOVERNOR'S
JANUARY BUDGET. THE CIVIC LEASE
SINCE THIS IS THE FIRST SOMEONE
HEARING OF TWENTY TWENTY TWO WE
WILL FOCUS ON THE HIGHEST
PRIORITIES THIS YEAR ONE OF
THOSE WHICH IS HEALTH CARE
AFFORDABILITY. I'VE BEEN ASKED
TO READ SOME DIRECTIONS
REGARDING PUBLIC PARTICIPATION
IN TODAY'S HEARING TO HELP
ENSURE THE PUBLIC SAFETY OF
EVERYONE HERE TODAY WHILE
ALLOWING FULL PUBLIC
PARTICIPATION IN THE PROCESS.
FOR THE PANELIST TODAY WE'RE
HAVING A PHYSICALLY DISTANCE IN
PERSON HEARING AT THE STATE
CAPITOL IN ROOM FOUR FOUR SEVEN
. IN FOR PUBLIC COMMENT WE ARE
ACCEPTING PUBLIC COMMENT AT THE
BEGINNING OF THE HEARING BOTH IN
THE HEARING ROOM AND ON THE
PHONE. THE PHONE NUMBER TO
CONNECT IS ON THE COMMITTEE
WEBSITE AND SHOULD BE ON THE
SCREEN IF YOU ARE WATCHING OVER
THE INTERNET. THAT NUMBER IS
PUBLIC TOLL FREE. EIGHT EIGHT
SEVEN SIX NINE TWO EIGHT NINE
FIVE SEVEN. THE PUBLIC ACCESS
CODE IS. ONE THREE ONE FIVE FOUR
FOUR SEVEN. IF YOU ENCOUNTER ANY
PROBLEMS PLEASE CONTACT THE
ASSEMBLY BUDGET COMMITTEE AT.
916-319-2090 NINE AND A STAFF
MEMBER WILL ASSIST YOU. THOSE
WISHING TO TESTIFY IN PERSON MAY
DO SO BUT MUST WEAR A MASK AT
ALL TIMES AND FOLLOW ALL OTHER
POSTED GUIDANCE. WE WILL BEGIN
PUBLIC COMMENT AFTER ALL MEMBERS
HAVE CONCLUDED THEIR QUESTIONS
FOR THE PANEL. THERE WILL BE NO
VOTES TAKEN IN TODAY'S HEARING
AS THIS IS AN INFORMATIONAL
HEARING TO DISCUSS THE
GOVERNOR'S JANUARY BUDGET
PROPOSALS. I WANT TO NOTE THAT
WE ARE ACCEPTING WRITTEN
FEEDBACK THROUGH THE SUB ONE
EMAIL ACCOUNT AND THAT ADDRESS
IS BUDGET SUB ONE AT ASM DOT CA
DOT GOV. FINALLY BEFORE WE
INVITE OUR FIRST PANEL TO BEGIN
I'LL BE MAKING A FEW
INTRODUCTORY COMMENTS AND OPEN
UP TO MY COLLEAGUES IF THEY
WOULD LIKE TO DO THE SAME.
PLEASED TO BE BACK AT THE STATE
CAPITOL STARTING OUR FIRST
SUBCOMMITTEE HEARING HERE IN
TWENTY TWENTY TO. WE ARE ONLY
FIVE WEEKS AWAY FROM THE TWO
YEAR ANNIVERSARY OF THE COPA
NINETEEN PANDEMIC. WHICH
HIGHLIGHTS THE ABSOLUTE CRITICAL
NATURE OF THE WORK OF THE SUB
COMMITTEE. THE LIFE OR DEATH
VALUE OF BOTH PUBLIC HEALTH AND
UNIVERSAL ACCESS TO HIGH QUALITY
AFFORDABLE HEALTH CARE HAS NEVER
BEEN MORE UNIVERSALLY UNDERSTOOD
AND SUPPORTED. THE PRIMARY FOCUS
OF TODAY'S HEARING IS HEALTH
CARE AFFORDABILITY WITH A
PARTICULAR FOCUS ON THE PROPOSED
OFFICE OF HEALTH CARE
AFFORDABILITY AS WELL AS A
REVIEW OF THE OTHER PROPOSALS
AND OVERSIGHT ISSUES THAT RELATE
TO THE AFFORDABILITY OF HEALTH
CARE. HOWEVER FIRST GIVEN THE
TIMELINESS OF THE ISSUE WE WILL
BEGIN WITHAN OVERVIEW OF THE
DEPARTMENT OF PUBLIC HEALTH
COMPONENTS OF THE COVERT
RESPONSE EARLY ACTION PACKAGE.
THOUGH THIS PACKAGE OF PROPOSALS
WHICH WAS HEARD JUST THIS
MORNING AND FULL BUDGET
COMMITTEE. WE FELT IT WARRANTED
ANOTHER OPPORTUNITY FOR SOMEONE
TO DIG A LITTLE DEEPER ON THE
PUBLIC HEALTH PIECES SHOULD ANY
MEMBERS WISH TO DO SO. WITH THAT
I WILL SEE IF ANY OTHER MEMBERS
HAVE OPENING COMMENTS. SEEING
NONE LET'S BEGIN WITH PANEL ONE
ON THE COVERT RESPONSE EARLY
ACTION ITEMS WITHIN CD P. H. AND
THE DEPARTMENT OF HEALTH CARE
SERVICES FOR THOSE PANELISTS WHO
ARE PRISONERS PLEASE PRESENT IN
THE ORDER THAT YOUR NAME APPEARS
IN THE AGENDA. WE HAVE FOUR
PRESENTERS ON THE PLAN PANEL
INCLUDING DR THOMAS ARAGON
DIRECTOR OF THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH.
BRANDON NUNEZ CHIEF DEPUTY
DIRECTOR OF OPERATIONS FOR THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH. A SUSAN FANELLI CHIEF
DEPUTY DIRECTOR OF POLICY AND
PROGRAMS AT CDPH AND SONYA
PADDOCK WITH THE L. A. L. WE
WILL HOLD ALL MEMBERS QUESTIONS
UNTIL AFTER ALL OF OUR
PRESENTERS HAVE. CONCLUDED LET'S
BEGIN PLEASE WITH DR ERICA. GOOD
AFTERNOON THANK YOU VERY THANK
YOU VERY MUCH FOR- SENATE
PRESIDENT FOR THAT- FOR A PUT
THE PROPOSAL HERE- YOU KNOW THE
FINANCING FOR THE BOOK THE LOCAL
TIME FOR ALL OF US RIGHT NOW WE
ARE TURNING AROUND WITH A-
CONCERT. CALIFORNIA WE DOCTOR ON
I MEAN YOU JUST HOLD ON FOR A
SECOND AS WE ARE- WORKING ON
SOMETHING ON OUR SIDE. OKAY. CAN
YOU TRY AGAIN DOCTOR ARE GONE
OKAY- THANK YOU THANK YOU VERY
MUCH- GOOD AFTERNOON BOB WE ARE
THE THIS IS A RIP AN INCREDIBLY
DIFFICULT TIME DOCTOR ARE GONE
IS THERE ANY WAY THAT MIGHT CAN
BE MOVED CLOSER TO YOUR MOUTH
WE'RE HAVING A VERY DIFFICULT
TIME OKAY. LET ME TRY IT LOOKS
LIKE. INSPECTOR. I COULDN'T HEAR
THEIR- IS THAT BETTER. NO THE
HOUSE MEMBERS ARE HAVING A HARD
TIME HEARING YOU SIR OKAY I'M
GONNA GO AHEAD AND JUST LET THE-
BRENDA NUNEZ HE'S GOING TO
PRESENT THE BUDGET- I WAS JUST
GONNA MAKE OPENING COMMENTS
ANYWAY I'LL TURN IT OVER TO
PRINTED. THANK YOU. THANK YOU
RENDON HI MISTER JERRY MEMBERS
CAN YOU HEAR ME OK. YES SIR.
OKAY GREAT- SO ALL PRESENT OUR
DEPARTMENT'S BUDGET ON THE EARLY
ACTION ITEM THAT'S FIRST ON THE
AGENDA- FOR OUR DEPARTMENT- AS
PART OF THE TOTAL BUDGET BILL
JUNIOR REQUESTED ONE POINT NINE
BILLION OUR DEPARTMENT HE SAID
THAT ROUGHLY ONE POINT SIX
BILLION- FOR ONGOING COVERT
RESPONSE ACTIVITIES. AND THE
ASSUMPTION FOR COVERED RESPONSE
ACTIVITIES THAT WERE INCLUDED
INITIALLY IN THE TWENTY TWENTY
ONE BUDGET ACT ASSUME THAT
RESPONSE COSTS WOULD BE NEEDED
THROUGH DECEMBER TWENTY TWENTY
ONE. AND GIVEN THAT THE STATE IS
STILL IN THE MIDDLE OF ITS
COVERED RESPONSE PARTICULARLY
WITH THE EMERGENCE EMERGENCE
RATHER OF THE OMICRON VARIANT-
THIS REQUEST WILL NOW SUPPORT
RESPONSE ACTIVITIES THROUGH JUNE
TWENTY TWENTY TWO. AND SO I'LL
HIT SOME OF THE HIGHLIGHTS ON
THIS PROPOSAL AND THEN WE HAVE
MEMBERS FROM OUR TEAM ORDERS
TASK FORCE APPEARED TO BE ABLE
TO TAKE IN ANY QUESTIONS THAT
YOU WERE THE MEMBERS MAY HAVE-
BUT KIND OF IN THE- FIRST-
BUCKET IF YOU WILL OF RESPONSE
TIME CATEGORIES PRICES
VACCINATIONS. AND I WORK FULL
ONE POINT SIX BILLION DOLLAR
REQUEST ABOUT THREE HUNDRED AND
NINETY NINE MILLION DOLLARS THAT
IS RELATED TO BACK THE NATION'S
AND THAT GOES TO SUPPORT OUR
VARIOUS VACCINE AND BOOSTER.
OUTREACH PLANS. ASIA IN A POINT
IN THE SYSTEM CAMPAIGN THAT WE
HAVE- PROVIDE AND- MILLER. AND
MANAGE SERVER- OF OUR- SITES
THAT STRAIGHT TEAMS- AND THEN IT
SUPPORTS OUR BACKS MOBLIE. THAT
COULD GROW ACROSS COUNTY AND
LOCAL CULTURES. TO PROVIDE POP
UP PLANNING SERVICES- IN THE
TESTING CATEGORY THERE'S ROUGHLY
FIVE HUNDRED AND NINETY NINE
MILLION- BEING REQUESTED AS PART
OF THE EARLY ACTION- AND THIS
FUNDING GOES TOWARDS PROVIDING
SPECIMEN COLLECTION SERVICES
THROUGH VARIOUS MODALITIES
INCLUDING OUR OUR DRIVE THRU
SITES. MOBILE SITES ARE AT HOME-
TRAVELING TEAMS AND THEN IT GOES
TO SITE EXPANSION AS WELL AS
EXISTING SITES SUCH AS-
INCREASING LINES OF SERVICE-
HOURS AND DAYS OF OPERATIONS AS
WELL- AND THEN IT PROVIDES OF
COURSE DIAGNOSTIC TESTING
SERVICES CONTINUES TO SUPPORT
THE LOCAL AND STATE BRANCH LAB
THAT WOULD SET UP. EARLY IN
RESPONSE- ONE OF THE THINGS
SINCE I'M TALKING ABOUT TESTING
THAT I WOULD NOTE THAT NOT
NECESSARILY RELATED THIS REALLY
ACTION BUT IS IN YOUR AGENDA AS
WELL- THIS IS SOMETHING THAT
WE'VE BEEN WORKING WITH THE
DEPARTMENT HEALTHCARE SERVICES
ON IT'S BEEN AN EFFORT. TO
PURCHASE- THIRTY MILLION
ADDITIONAL ANTIGEN TEST KITS
USING APPROXIMATELY TWO HUNDRED
BILLION DOLLARS. GENERAL FUND
FORTY THAT'S WITHIN DH YES ITS
BUDGET I'M THEY'VE BEEN A GOOD
PARTNER WITH US TO BE ABLE TO
MAKE THIS PURCHASE OF WORKING
WITH. ALL TALIESIN FEMA ON THIS
PROJECT AS WELL. THE SPECIFIC
RECEIVINGFEMA REIMBURSEMENT FOR
THIS PURPOSE BUT THAT'S NOT PART
OF THE EARLY ACTION IS JUST ONE
OF THE AGENDA ITEM. BUT I KNOW
THAT WHILE WE'RE DISCUSSING THE
HEARING. TEST FOR ANOTHER OF OUR
- AT RISK REALLY TO CON TRACING
THEIR EIGHTEEN TWO. REAL TO THIS
REQUIRES. AND MUCH OF THE REPLY
HERE RELATED TO A STAFF. OUR
HEALTH PORTER THE DEPARTMENT-
THE RESERVE FOR IS GOING TO HELL
ASSIST- ART OF. WITH HER. BUT
HEALTH. AS WELL AS CAN CON REYES
CASE THE BEST A NUMBER RELATED.
SPECIFICALLY TO NINE. AND THE
RESERVE FORCE TO CONSISTENCY.
CONSIST OF PRIMARILY OR SOLELY
RATHER OF STATE EMPLOYEES- ON
TOUR FOR THE PROGRAM AND RECEIVE
THEIR DEPARTMENTS ARE THERE
AGENCIES APPROVAL TO PARTICIPATE. AS WELL. I AND PRODUCT. FOR
THE- IS A MEDICAL STAFFING
THERE'S ROUGHLY FOUR HUNDRED AND
EIGHTY SEVEN MILLION DOLLARS
BEING REQUESTED AS PART OF THE
EARLY ACTION FOR THAT. AND THAT
FUNDING IS GOING TO USED TO
DEPLOY REGISTERED NURSES.
CERTIFIED NURSING ASSISTANTS
CLINICAL TAX THERAPISTS AND
OTHER. HEALTHCARE PROFESSIONALS
TO BOTH RESPOND TO MEDICAL
EXPERTS NEEDS THAT ARE HAPPENING
IN THE HEALTH CARE FACILITIES AS
WELL AS- A MINISTER- THAT- IN AN
OPERATION SUPPORT CATEGORY THAT
PART OF EARLY ACTION WERE
FUSSING ROUGHLY FIFTY SEVEN
MILLION. AND THAT'S GOING TO
CONTINUE SUPPORT FOR THEREST OF
THE YEAR FOR OUR CALL CENTER
THAT'S BEEN ESTABLISHED- ARE
READ WEB CHAT RATHER FUNCTIONS
AND OUR TECH SUPPORT FUNCTIONS
OF ITSELF IS DURING THE
RESPONSE. AS WELL AS ADDITIONAL
STAFFING NEEDS TO SUPPORT THE
EMERGENCY PREPAREDNESS RESPONSE
IN GENERAL AND SOME OF OUR
RECOVERY TASKS. AND THEN FINALLY
IN THE INFORMATION TECHNOLOGY
AREA THERE'S SIXTY FIVE MILLION
DOLLARS BEING REQUESTED AS PART
OF ONGOING MAINTENANCE AND
OPERATIONS WITH A NUMBER OF
DIFFERENT- COVERED SYSTEMS THAT
HAVE HAD TO BE STOOD UP DURING
THE RESPONSE- THIS IS THE FIRST
YEAR COMPONENT A LITTLE LATER IN
HEARING THIS YEAR PROBABLY IN
YOUR MARCH HEARING. WE HAVE A
PCP RELATED THIS PROPOSAL THAT'S
GOING TO TAKE INTO ACCOUNT AND
DISCUSS THE- BUDGET YOU'RE AN
ONGOING IMPACTS RELATED TO THE
INFORMATION. TECHNOLOGY PEOPLE'S
- AND THEN FINALLY GET. EARLY
ACTION OUT. OF KOBE THERE'S A OF
AYE THAT I'VE RAISED. WE EITHER
A QUESTION OR A POSITIVE. OF
FINANCE TO ROUND OUT THIS PIECE
OF THE AGENDA BUT- THAT YOU
OUTSIDE OF- CODED ARE RELATED TO
OUR INDUSTRIAL HEMP PROGRAM- WE
HAVE ONE POINT SIX MILLION IN
THE EARLY ACTION PROPOSAL TO
IMPLEMENT THE INDUSTRIAL HEMP
PROGRAM THAT. AND IT WILL BE
CONSISTENT WITH THE REQUIREMENTS
OF AB FORTY FIVE SOME O YOU MAY
RECALL THAT AB FORTY FIVE HAD AN
URGENCY CLAUSE TO IT SO THE
DEPARTMENT NEEDS- THOSE
RESOURCES IN THE BILL TO BE ABLE
TO BEGIN IMPLEMENTING THE
PROGRAM RIGHT AWAY. AND SIMILAR
TO THE LAST ONE WE ALSO HAVE A
B. C. D. IN PLACE FOR THIS THAT
WILL BE DISCUSSING A LITTLE
LATER IN HEARINGS THIS YEAR
RELATED TO THE ONGOING. NEEDS
FOR THIS BUT THE ONE POINT. SIX
MILLION TO SPECIFIC TO THE
CURRENT. AND THEN FINALLY TO
SOME FOR HIS LANE RELATE TORQUE.
REDUCING THIS. ARE IMPACT- RAM-
THERE'S SOMEBODY BILL LANGUAGE
INCLUDED IN. JUNIOR TO- ACCEPT
THE PROGRAM FROM PUBLIC
CONTRACTS CODE- SO THAT WE CAN
CONTINUE THE EXISTING BASE TO
CONTRACTS THIS IS RELATED TO
SOME BUDGET AUTHORITY THAT WAS
PUT IN THE TWENTY ONE BUDGET
ACT- OUR CURRENT CONTRACTS
RELATED TO THIS FUNDING EXPIRES
IN APRIL. AND IT WOULDN'T BE
POSSIBLE TO CONTINUE THOSE
CONTRACTS WITHOUT. WITH THE
CURRENT PROJECT VENDORS WITHOUT
THIS EXEMPTION. THIS WAS
SOMETHING WITH AN APPARENTLY
LEFT OUT DURING- SOME OF THE.
TWENTY ONE BUDGET NEGOTIATIONS-
BUT THAT THAT'S KIND OF A HIGH
LEVEL OVERVIEW OF ARE PART OF
THE- THE EARLY ACTION PACKAGE
RELATED TO COPE IN A NON PROFIT
ITEMS. I'LL STOP THERE NEITHER
AS A TWO DEPARTMENT OF FINANCE
OR LIKE I MENTIONED WE HAVE SOME
OF OUR TEAM HERE AND ANSWER ANY
QUESTIONS. THANK YOU VERY MUCH
NEXT WE WILL HEAR FROM SUSAN
FANELLI. I'M HERE JUST TO ANSWER
QUESTIONS BRANDON PROVIDE AT
THAT OVER HERE SO I'M JUST HAPPY
TO ANSWER ANY QUESTIONS. THANK
YOU SONYA PADDOCK WITH THE L. L.
HEY DOCTOR EMILY THIS IS SONYA
PEDIG- YEAH DR IMPLY IN MEMBERS
THIS IS WHEN YOU PICK FROM THE
LEGISLATIVE ANALYST'S OFFICE. I
BELIEVE YOU THE PROPOSAL AND
HAVE HAD DISCUSSIONS WITH THE
ADMINISTRATION OF THE ESTIMATED
COSTS AND TYPES OF ACTIVITIES
THAT HAVE BEEN AND ARE CURRENTLY
BEING UNDERTAKEN BY THE
DEPARTMENT IN RESPONSE TO COVER
THE ENACTED- TO. TWENTY TWENTY
ONE BUDGET AS SOON THAT COKE IT
WOULD BE RAINING BY THE END OF
THE CALENDAR YEAR. AND THAT THE
QUOTE FROM VERY YOU CREATED
SIGNIFICANT CHALLENGES AND
UNPLANNED COSTS. ALSO PREDICTED
. FREEZING BUDGET PROCESS
REQUEST THESE EXPENDITURES AS
OPPOSED TO THE NOTIFICATION
PROCESS OF THE PAST IS THIS
INCREASES LEGISLATIVE OVERSIGHT
. AND WE DID RAISE ANY MAJOR
CONCERNS ABOUT FOR EARLY ACTION
REQUEST IN ADDITION I WOULD
MENTION THAT WE DO NOT HAVE
CONCERNS ABOUT THE OTHER ITEMS
IN THE DEPARTMENT OF PUBLIC
HEALTH BUDGET IN THE EARLY
ACTION REQUEST. THANK YOU VERY
MUCH. THANK YOU VERY MUCH- WITH
THAT I WILL BRING THAT BACK TO
THE DYESS AND SEE IF ANY MEMBERS
HAVE ANY QUESTIONS SAYING NON I
WILL KEEP IT HERE AT THE CHAIR-
FIRST ALL BEGIN WITH- DOCTOR
ERAGON- I KNOW THAT- SINCE THE
BEGINNING OF THE PANDEMIC THAT
YOU HAVE BEEN A STALWART
CHAMPION FOR. OUR STATE AND
ADVOCATING FOR PUBLIC HEALTH AND
WANTS TO MAKE SURE TO APPRECIATE
AND- UP LEFT MUCH OF THE WORK
THAT YOU'VE DONE- THROUGHOUT
THIS PASTYEAR BUT BUT I WOULD
LIKE TO BEGIN FOR US TO HAVE A
CONVERSATION AS WE ARE. NEARING
THE TWO YEAR ANNIVERSARY OF
DECLARING A STATE OF EMERGENCY
FOR CALIFORNIA FOR US TO HAVE A
CONVERSATION ABOUT WHAT THE
SCIENCE WOULD TELL US AND
DICTATE TOWARDS WHICH METRICS WE
WOULD LOOK AT TO WORK CONSIDER
AS CRITERIA FOR US IS THE STATE
TO LEAVE THE STATE OF EMERGENCY
AND I'M HOPING YOU CAN COMMENT
AS TO WHAT THE SCIENCE- WILL-
STATES FOR. US AS A STATE. YEAH
I'LL MAKE A FEW COMMENTS I WANNA
MAKE SURE CAN YOU HEAR ME. YES
SIR MUCH BETTER THANK YOU.
TRAFFIC OKAY THANK YOU SO MUCH
SO I YOU KNOW ALL OF US ALL OF
US HAVE LEARNED A TREMENDOUS
AMOUNT OF IT THERE THE- THE
FIRST COPY TO- THE AGENT THAT
CAUSES THAT THE COUPLE BECOMING
NINETEEN PANDEMIC KEPT REALLY
THROWING US SOME CURVEBALLS IF
WE REMEMBER. AFTER JUNE
FIFTEENTH WE ARE COMING OUT WE
THOUGHT WE WERE GOING TO DO
REALLY WELL THEN THE DELTA
VARIANCE CAME. WITH ALL
DIFFERENT WAS MORE VIRULENT AND
IT WAS MORE TRANSMISSIBLE. THEN
THE- MAKRAN VARYING CAME. ACROSS
VERY WAS DIFFERENT IT WAS LESS
RELIANT COSTLESS DISEASE BUT IT
HAD A MUNIS CAPE THAT MEANS
PEOPLE WHO ARE VACCINATED OR HAD
PRIOR INFECTION IS ABLE TO
OVERCOME OVERCOME THAT HAND IT
WAS. INCREDIBLY INFECTIOUS AND
ONE OF THE THINGS THAT WE'RE
LEARNING MOVING FORWARD IS.
BECAUSE MOST TRANSMISSION
HAPPENS. WHEN PEOPLE ARE A
SYMPTOMATIC. THE FOR THE VIRUS
THE THOUGHT HAVE AN EVOLUTIONARY
REASON FOR IT TO BECOME LESS
VIRULENT OVERTIME. WE HAVE SO
MUCH TRANSITION HAPPENING ALL
OVER THE WORLD THAT WE'RE GOING
TO BE FACING NEW VARIANTS SOME
OF THEM MAY HAVE SOME OF AND HOW
HOW THEY'RE VERY IT PRESENTS
ITSELF IT MAY BECOME MORE
VIRULENT MORE TALK MORE
TRANSMISSIBLE AND MAY HAVE
REPORTED MEAN ESCAPE. SO WE'RE
REALLY FOCUSING ON RIGHT NOW. MR
HALF COURT INFRASTRUCTURE SO
THAT WE HAVE GOOD SURVEILLANCE
AND TO RESPOND TO ANY ADDITIONAL
VARIANTS THAT COULD AFFECT THE
COMPANY HAD. BOB AND I WERE
HOPING THAT IN THE COMING IN THE
COMING WEEKS I HAVE A COUPLE OF
MONTHS WILL BE ABLE TO REALLY
GET A BETTER FEEL FOR HOW THIS
IS GOING TO PLAY OUT. IT IT'S SO
HARD TO PREDICT RIGHT NOW WITH
RESPECT TO THE- DICK DECLARATION
OF EMERGENCY YOU KNOW WHAT WE
HAVE TO GO BACK AND SPEAK TO-
ADMIT. THE MINISTRATION AND GET
GET MORE INPUT FROM THEM. I'M I
YOU FOR THAT DOCTOR ARE GONE AND
BELIEVE IT'S A NECESSARY
CONVERSATION FOR US TO HAVE AS-
AN INSTITUTION TO MAKE SURE THAT
WE ARE- PROTECTING IN DOING OUR
DUE DILIGENCE IN OVERSIGHT.
WHILE I'M VERY APPRECIATIVE OF
THE ADMINISTRATION RUNNING THIS
BILL THROUGH THE NORMAL. PROCESS
I BELIEVE THE STATE OF EMERGENCY
ALLOWED YOU AND GAVE YOU EXTRA
POWERS TO BE ABLE TO. RUN IT
THROUGH THE JAIL BC OR ANOTHER
PROCESS. AND SO I'D LIKE TO MAKE
SURE WE HAVE SPECIFIC CRITERIA
AND METRICS THAT WERE ANALYZING
TO DETERMINE WHEN. WE WILL. BE
ABLE TO LEAVE THE STATE OF
EMERGENCY. AS I BELIEVE THAT
WILL RESTORE AND CREATE THE
RIGHT BALANCE THAT WE NEED
BETWEEN OUR BRANCHES OF
GOVERNMENT. AND ALLOW US TO
PROVIDE THE NECESSARY OVERSIGHT
FOR THE ITEMS THAT WE ARE
SPEAKING ABOUT TODAY. BUT I'M
HAPPY TO- FOLLOW UP IN MORE
DISCUSSIONS. YES I'LL I'LL I
WILL I WILL ABSOLUTELY TAKE I'LL
ACTUALLY TAKE THAT BACK WE ARE
WORKING ON METRICS AND WE'LL TRY
TO MAKE SURE THAT'S CONNECTING
TO THE QUESTION THAT YOU'RE
ASKING. I'M I'M GONNA FOLLOW UP
WITH TO SPECIFIC QUESTIONS
WITHIN THE PROPOSAL'S AYE I WILL
START BY- APPRECIATING THE
ADMINISTRATION FOR- THE C. R. D.
P. FIXES THESE WERE- ITEMS THAT
DIDN'T NEED TO BE IMPROVED FROM
THE TWENTY ONE BUDGET AND I'M
VERY APPRECIATIVE OF THAT. BUT I
WANTED TO FOCUS MY QUESTIONS
TODAY ON SEARCH STAFFING AS WELL
AS THE APIO TV. AMBULANCE
PATIENT. OFFLOAD TIME. T. AND
I'M HOPING TO FIRST TALK ABOUT
THE SURGE STAFFING. SO FOUR
HUNDRED AND EIGHTY SIX MILLION
FOR THE STATE DOESN'T HELP US
WITH ANY CLARITY TOWARDS WHETHER
THERE'S ANY PATTERNS THAT WERE
NOTICING. WHETHER OR NOT WE CAN
IDENTIFY THAT THERE ARE CERTAIN
REGIONS OF OUR STATE THAT MAY BE
REQUIRING MORE SURGE STAFFING
AND AS WE ARE. MAKING FUTURE
DECISIONS AYE I BELIEVE IT'S
IMPORTANT FOR US TO UNDERSTAND
WHERE OUR CURRENT FUNDING IS
GOING TO SUPPORT THAT SURGE
STAFFING AND I'M HOPING THAT WE
CAN FOLLOW UP AND UNDERSTAND-
THAT AS WE ARE SPENDING
SIGNIFICANT RESOURCES AND WORK
FORCE THIS YEAR. WE BELIEVE IF
THERE'S A PATTERN THAT'S
IDENTIFIED THROUGH THE SEARCH
STAFFING AND THE PANDEMIC THAT
SHOULD HELP TO INFORM OUR FUTURE
FUNDING DECISIONS AND I'M HOPING
THAT YOU CAN PROVIDE SOME
CLARITY REGARDING SEARCH STAFF-
THIS PRESIDENT BENEFIT ACTING
DIRECT OF IN THE CENTER- IT'S
PER MAKES COMMENTS PERFECT.
THANK YOU SO MUCH ANGER- SO JUST
ANSWER QUESTION I THINK THAT'S A
THAT'S THAT'S EXCELLENT AND I
THINK AS WE FROM- FORD IN THIS
RESPONSE WE ARE STARTING NOW TO
TRY TO IDENTIFY SOME OF THESE
PATTERNS. FOR EXAMPLE NORMALLY
ONE REGION IN THE STATE AS
DEFINED BY PUBLIC HEALTH OFFICER
REGION NORMALLY SEE SOME
INCREASE IN SEARCH MAYBE IN
SOUTHERN CALIFORNIA VETERANS
COMMUNITY TRANSMISSION IS
ELEVATED WE SEE THAT-
TRANSMISSION OF KERR AND OTHER
PARTS OF THE STATE AND CONTINUE
TO SUPPORT. OUR AND END UP
SUPPORTING HOLISTICALLY
THROUGHOUT THE STATE I WILL SAY
THAT. CURRENTLY WHEN WE LOOK AT
OUR MEDICAL RESOURCES ACROSS THE
STATE THERE IS NOT NECESSARILY
ONE PARTICULAR REGION THAT IS
MORE HEAVILY SUPPORTED THAN
ANOTHER HOWEVER THE VERY FAR
PART OF NORTHERN CALIFORNIA DOES
SEEM TO SEAT AT SOMETIMES A LOT
OF SUPPORT AND THAT- THEIR
HOSPITALS MAY NOT BE AS
IMPACTED- OR OR- THEY MAY JUST
NEED THE LAST. HELP IN THIS AREA
BUT I THINK THAT'S ABSOLUTELY
SOMETHING TO TAKE BACK TO INFORM
FUTURE FUNDING DECISIONS SO THAT
WE CAN IDENTIFY THESE PATTERNS
AND TARGET INTERVENTIONS.
PROACTIVELY CONTINUE TO. THANK
YOU FOR MUCH I'M I WILL. OUT TO
THE P. O. T. AND- OF. I WILL SY
THAT- JUST AS A REMINDER I SPENT
TEN YEARS IN THE ER AND THE
ABILITY FOR OUR FIRST RESPONDERS
ARE PARAMEDICS HE AMASSED TO BE
ABLE TO OFFLOAD THE PATIENTS WHO
THEY PICK UP IN THE FIELD AND
TRANSFER RESPONSIBILITY TO THE
PERSONNEL WITHIN THE EMERGENCY
DEPARTMENT IS AN IMPORTANT
PROCESS AND SO I'M LOOKING AT
THE AGENDA ON PAGE THIRTEEN FROM
CALIFORNIA HOSPITAL ASSOCIATION
URGING THE LEGISLATURE TO. LOOK
TOWARDS DEPLOYING ADDITIONAL A
POT TEAMS OVER THE NEXT FEW
MONTHS. TO ENSURE THAT ALL
PATIENTS GET THE EMERGENCY CARE
THEY NEED AND I'M HOPING THAT
THE ADMINISTRATION CAN COMMENT.
ON WHETHER OR NOT THE STATE
SHOULD PROVIDE THESE ADDITIONAL
TEAMS OVER THE NEXT COUPLE
MONTHS. SORRY I WILL ALSO JUMP.
WELL I'M SO YOU KNOW CURRENTLY
WE HAVE A- SIGNIFICANT AMOUNT OF
ANTICIPATION OFFLOAD TEAMS
SUPPORTING FACILITIES ACROSS THE
STATE WE ARE GOING TO CONTINUE
TO IDENTIFY NEEDS AND HOSPITALS
THAT ARE STRUGGLING OR EMS
SYSTEMS THAT ARE STRUGGLING TO
OFFLOAD THE PATIENT AND DO THE
TRANSFER CARE WITH IN A TIMELY
MANNER TO CONTINUE TO SUPPORT
WITH EITHER AN AMBULANCE PATIENT
OFFLOAD TEAM AND OR SOME LEVEL-
THERE ARE MANY IN TLV IN SUPPORT
TO MAKE SURE THAT WE CAN RETURN
TO AMBULANCES. BACK TO THE NINE
ONE ONE SYSTEM TO RESPOND TO
CALLS. WHAT DO YOU LIKE. THE
WHAT DO YOU ANTICIPATE TO SEE
WITHIN THE EMERGENCY DEPARTMENTS
AND PATIENT ACCESS TO EMERGENCY
CARE IF WE WERE TO ADOPT THIS
REQUEST. I MEAN I THINK ANYTHING
THAT THAT WORDS CAN TAKE YOU TO
SUPPORT THE TRANSFER CARE FROM
THE AMBULANCE- SYSTEM A FOR ME
IN MY SYSTEM TO THE HOSPITAL ARE
ALL THINGS OF THAT THAT WE WANT
TO DO BUT I THINK LOOKING AT THE
CONTINUUM OF CARE HOLISTICALLY
AND- THE THROUGHPUT OF PATIENTS
THROUGH THE ENTIRE HOSPITAL
SYSTEM NOT ONLY UP TO THE FLOOR.
DISCHARGERS ON THROUGH THE OUT
OF THE BACK. DOOR OF THE
HOSPITAL ALL REMAIN IMPORTANT
ASPECT TO LOOK AT FOR THE
PATIENT. I'M A- I AGREE AND- DO
BELIEVE THE QUESTION WAS MEANT
TO- SHOW THE- BY ALL LOADING THE
PATIENTS IN ALLOWING R. E. M.
PERSONNEL TO GET. OUT INTO THE
FIELD TO. DO THEIR- TO DO THEIR
AS FIRST RESP. WOULD BETTER.
ACCESS FOR ALL CALIFORNIANS AND
IS A BETTER USE OF THEIR TIME
AND WOULD JUST ENCOURAGE US TO.
MAKE SURE WE'RE LOOKING AT-
THESE TEAMS AS THE NECESSARY
GREASE TO KEEP OUR SYSTEM
FLOWING AND- PATIENTS IN THE
RIGHT PLACE AND SO- I'LL LEAVE
IT THERE IS A- WOULD BE HAPPY TO
FOLLOW UP WITH MORE DETAILS AND-
TO HEAR FROM- THE HOSPITAL'S ON.
WHETHER OR NOT THIS IS
IMPROVING. BUT NO THAT IT
DRAMATICALLY AFFECTS RURAL AREAS
LIKE MINE IF HOSPITALS. ARE TIED
IN OR IF THE AMBULANCES ARE.
STATIONED AT HOSPITALS FOR HOURS
WHEN THEY COULD HAVE BEEN
OFFLOADING AND BACK OUT INTO THE
FIELD AND SO- WITH THAT I WILL
ASK MY FINAL QUESTION FOR THE
DEPARTMENT OF FINANCE- REGARDING
THE ONE POINT SIX BILLION IN
COVERT COSTS DO YOU ANTICIPATE
WHAT PORTION OF THIS WILL BE
REIMBURSED BY FEMA. SOME OF THE
TELL WITH THE DEPARTMENT OF
FINANCE I'M UP THIS TIME YOU
KNOW THAT'S SOMETHING WE CAN
TAKE BACK. RIGHT NOW I THINK THE
BIGGEST CHALLENGE IS EVEN THOUGH
WE UNDERSTAND THAT CERTAIN
ACTIVITIES ARE ELIGIBLE FOR FEMA
REIMBURSEMENT. UNTIL THE CLAIMS
ARE SUBMITTED AND PAYMENT
PROCESSES ARE CLAIMS AND
ACTUALLY PROVIDES
EMBARRASSMENTS. WE CANNOT THE-
FULLY UNDERSTANDING OF WHAT
EXACTLY WILL BE REIMBURSED BUT I
THINK THAT'S SOMETHING WE CAN
TAKE BACK. AND PROVIDE SOME HIGH
LEVEL DATA ABOUT WHAT HAS BEEN
SUBMITTED AND SORT OF WHAT WE
WERE THINKING AT THIS TIME MIGHT
BE REIMBURSED. THANK YOU VERY
MUCH WITHOUT IT WILL LOOK FOR
MEMBERS FOR ANY FINAL QUESTIONS
THE NON. I WILL THANK VERY MUCH
PANEL ONE AND WE'LL MOVE ON THE
PANEL TO ON THE OFFICE OF HEALTH
CARE AFFORDABILITY. WE WILL HAVE
THREE PRESENTERS ON THIS PANEL.
FIRST DIRECTOR ELIZABETH
LANDSBERG AND THE CHIEF COUNSEL
RYAN BUCKLEY WITH THE DEPARTMENT
OF HEALTH CARE ACCESS AND
INFORMATION. AND COREY HARSHA
WITH THE LEGISLATIVE ANALYST'S
OFFICE LET'S BEGIN WITH DIRECTOR
LANCE BURKE. GOOD AFTERNOON
MISTER CHAIR AND MEMBERS HELLO
FLANSBURGH I'M THE DIRECTOR OF
H. PRICE THE DEPARTMENT OF
HEALTH CARE ACCESS AND
INFORMATION FORMERLY OFFENSE.
THE OFFICE OF HEALTH CARE FOR IS
ONCE AGAIN INCLUDING THE
GOVERNOR'S BUDGET AND WE ARE
COMMITTED TO GETTING IT OVER THE
FINISH LINE THIS YEAR. WE PUBLIC
TO TRAILER BILL LANGUAGE LAST
WEEK AND I HAVE TO GO THROUGH
THE OVERVIEW OF THE POST OFFICE
WE I WILL REVIEW THAT MAJOR
CHANGES IN THE TRAILER BILL FROM
LAST YEAR TO THIS YEAR. AND THEN
WILL RESPOND TO QUESTIONS HAVE
BEEN ASKED. ONE OF KNOWLEDGE THE
DOCTOR WOULD HAS BEEN A CRITICAL
PARTNER. ON AND CHAMPION OF THE
OFFICE HEALTH CARE AFFORDABILITY
. SHE HAS WORKED CLOSELY WITH DR
WOULD AND HIS OFFICE ON THE
PROPOSAL AND ENGAGING WITH
STAKEHOLDERS. FEW WOULD DISAGREE
THAT HIGH HEALTHCARE COSTS ARE A
SIGNIFICANT PROBLEM IN
CALIFORNIA. WELL THE CALIFORNIA
HEALTH CARE FOUNDATION JUST TWO
WEEKS AGO RELEASED THEIR HEALTH
POLICY SURVEY IN WHICH 83% OF
CALIFORNIANS INTERVIEWED SAID IT
WAS EXTREMELY OR VERY IMPORTANT
FOR THE GOVERNOR AND LEGISLATURE
WORK ON MAKING HEALTHCARE MORE
AFFORDABLE. HEALTH OUR- AS NOTED
IN THE ENGINE OF NUMBER OF OTHER
FAITHS HAVE SIMILAR OFFICES- IN
CALIFORNIA'S TIME HAS COME I
THINK WE'VE ACTUALLY BEEN
ADVANTAGED BY THE FACT SOME
OTHER STATES HAVE ADOPTED.
SIMILAR OFFICES BUT WHAT WE'VE
DONE IN OUR PROPOSAL OUR
PROPOSED CALIFORNIA OFFICE OF
HEALTH CARE AFFORDABILITY IS TO
TAKE THE BAIT BEST ELEMENTS WITH
STATE OF ALL THE SECRETIVE
TAKING MEASURES AND PUT OUR
UNIQUE CALIFORNIA'S BEEN ON IT-
AND ALSO SCALED UP FIXING.
CALIFORNIA'S FIVE. THE FOR
OFFICE OF HEALTH FOR. WITH ANIL
THE HEALTH MARK FOR COST AND THE
DRIVERS OF. WOULD ENFORCE COSTS
SET BY AND YOU HEALTH OFF.
HEALTHCARE FOR. AND WOULD
MEASURE KEY INDICATE WHEN WE ARE
. HIGH SYSTEM RECORD THAN COST
VALUE SYSTEMS. THE OFFICE WOULD
FOR INCREASE PUBLIC. ON TOTAL
HEALTH CARE SPENDING IN THE
STATE. THE OFFICE WOULD REQUIRE
REPORTING OF TOTAL HEALTHCARE
EXPENDITURE DATA BROKEN DOWN BY
SERVICE CATEGORIES WE KNOW HOW
MUCH IT SPENT ON HEALTHCARE HOW
MUCH WAS SPENT ON SERVICES
RESTRICTIONS DRUGS THE LIFE. IT
WOULD BE SUPPLEMENTED WITH
FINANCIAL REPORTS FROM. GRANULAR
CLAIMS DATA FROM OUR HEALTH CARE
PAYMENT STATUS. THE OFFICE WITH
PUBLISHED IN IN YOUR FOR IN
CONJUNCTION WITH THE PUBLIC
MEETING ON HEALTHCARE SPENDING
TRENDS UNDERLYING FACTORS ALONG
WITH POLICY RECOMMENDATIONS TO
CONTROL COSTS AND IMPROVE THE
QUALITY AND EQUITY OF THE
HEALTHCARE SYSTEM FUNDS LAST.
THE LANGUAGE ESTABLISHES THE
HEALTHCARE AFFORDABILITY BOARD
WHICH WOULD SET AN OVERALL
STATEWIDE COST TARGET AS WELL
PACIFIC SECTOR TARGETS- AS WELL
AS REGIONAL TARGETS. I'LL TALK
MORE ABOUT THE SPECIFIC MAKEUP
OF THE BOARD AND THE ACTIVITIES
WHEN I GO THROUGH THE CHANGES
WITH THIS YEAR'S TRAILER BILL
LANGUAGE. THE OFFICE IMPORTANTLY
WILL ENFORCE COMPLIANCE WITH THE
COST TARGETS I'M TAKING A
PROGRESSIVE ENFORCEMENT APPROACH
WHICH I'LL TALK ABOUT A LITTLE
BIT MORE- UNDER THE QUESTIONS.
THE OFFICE BUT ALSO PROMOTE AND
BETTER QUALITY IN EQUITY THROUGH
PERFORMANCE FOR PARKING. WE WANT
TO BE SURE TO AVOID
UNANTICIPATED CONSEQUENCES THAT
COULD RESULT FROM FOCUSING ON
COST ALONE SO PERFORMANCE ON
QUALITY IN EQUITY MEASURES WILL
BE. YOUR TO GUARD AGAINST
NEGATIVE IMPACTS WE WANT TO MAKE
SURE TO BUILD ON THE WORK THAT'S
BEING DONE BY OUR SISTER
DEPARTMENTS SO WE WILL LEVERAGE
QUALITY IN EQUITY METRICS BEING
DEVELOPED RIGHT NOW BY THE
DEPARTMENT OF MANAGED HEALTH
CARE. AS WELL AS THOSE USED BY
THE DEPARTMENT HEALTHCARE
SERVICES AND COVERED CALIFORNIA
THE DECREASE ADVOCATION OF
HALFORDS. THE BOARD WILL SET A
STATEWIDE GOAL FOR ADOPTION OF
ALTERNATIVE PAYMENT MODELS TO
PROMOTE SHIFTING PAYMENTS AWAY
FROM FEE FOR SERVICE. PAYMENTS
THE PAYMENTS OF ALL OUR HIGH
QUALITY AND COST EFFICIENT CARE.
THE OFFICE WILL MEASURE PROGRESS
TOWARDS THE GOAL AND IT
STANDARDS FOR ALTERNATIVE
PAYMENT MODELS. OUR OFFICE WILL
ALSO MEASURE AND PROMOTED
SUSTAIN SYSTEM WIDE INVESTMENT
PRIMARY CARE AND BEHAVIORAL
HEALTH. INTEGRATE PRIMARY CARE
BEHAVIORAL HEALTH CARE SERVICES
HAVE BEEN SHOWN TO IMPROVE
ACCESS AND HEALTH HEALTH
OUTCOMES AS WELL AS REDUCING
COSTS. SO THE OFFICE OF HEALTH
CARE AFFORDABILITY WOULD MEASURE
THE PERCENTAGE OF TOTAL HEALTH
CARE EXPENDITURES SPENT ON
PRIMARY CARE BEHAVIORAL HEALTH-
AND WHAT IT SPENDING BENCHMARKS
AND MEASURES TOWARD THOSE
BENCHMARKS IN FUTURE YEARS. THE
OFFICE FULL MY AND ADDRESS
HEALTHCARE STABILITY COLLECTING
DATA AND ANALYZING CHANGES TO
THE HEALTHCARE WORKFORCE TO
AVOID HARMFUL REDUCTIONS TO THE
WORK FORCE FEED THE CALIFORNIA.
AND THEN FINALLY THE OFFICE
WOULD REVIEW THE PROPOSED
HEALTHCARE CONSOLIDATIONS GIVEN
THAT CAN BE A SIGNIFICANT DRIVER
OF COST. THE OFFICE FOR
INCREASED PUBLIC TRANSPARENCY.
TRANSACTION THAT MAY IMPACT
MARKET COMPETITION BY REVIEWING
MERGERS AND ACQUISITIONS NOT
CURRENTLY REVIEWED BY ANOTHER
GOVERNMENTAL ENTITY. THAT IT IS
THE IS THE HIGH LEVEL OVERVIEW
OF THE OFFENSE- AND THEN
QUESTION ONE ASKS ABOUT THE
SIGNIFICANT CHANGES BETWEEN THIS
YEAR'S AND LAST YEAR'S A
PROPOSED TRAILER BILL. THE
ADMINISTRATION HAS WORKED HAND
IN HAND WITH DOCTOR WOULD ALSO
HAD SIGNIFICANT CONVERSATIONS
WITH DR PANTS AS WELL AS BEEN
CONVERSATION WITH STAKEHOLDERS
ON THE LANGUAGE AND SO WE HAVE
TO MAKE SOME CHANGES IN THE
TRAILER BILL LANGUAGE- IN
RESPONSE TO THE THAT STAKEHOLDER
INPUT. THE WALKER THROUGH THE
MORE SIGNIFICANT CHANGES. FIRST
ON THE BOARD SO LAST YEAR'S
LANGUAGE WE HAD MORE OF AN
ADVISORY BOARD AND THIS YEAR
LANGUAGES DOUBLES AS A
HEALTHCARE AFFORDABILITY BOARD.
WHICH WILL SIT KEEP POLICIES
INCLUDING ESTABLISHING THE COST
TARGETS THEMSELVES. AS WELL AS
THE METHODOLOGY FOR SETTING
TARGETS AND FACTORS TO MODIFY
THOSE TARGETS WHEN APPROPRIATE.
IT WILL HELP SET TRACTORS FOR
ENFORCEMENT ACTIONS AND THE
SCOPE AND RANGE OF ANY
ADMINISTRATIVE PENALTIES. THE
BOARD WILL ALSO APPROVE THE
BENCHMARKS FOR PRIMARY CARE
BEHAVIORAL HEALTH SPEND. GOAL
WITH THE ADOPTION OF ALTERNATIVE
WORK PAYMENT MODELS AND
STANDARDS TO ADVANCE THE.
STABILITY OF THE HEALTH
WORKFORCE. THE YEAR'S LANGUAGE
HAS AN EIGHT MEMBER. WITH VOTING
MEMBERS SO THERE WOULD BE FAR
GOVERNOR'S APPOINTMENT SUBJECT
TO SENATE CONFIRMATION. ONE
APPOINTMENT EACH BY THE ASSEMBLY
SPEAKER AND THE SENATE RULES
COMMITTEE. HEALTH AND HUMAN
SERVICES SECRETARY OR THEIR
DESIGNEES WOULD BE A VOTING
MEMBER AND THEN THE CALPERS
CHIEF DEPUTY DIRECTOR OR THEY'RE
DEFINITELY WOULD WOULD SERVE AS
A NON VOTING MEMBER- I NEXT WANT
TO TALK ABOUT SOME OF THE
CHANGES THAT WE MADE IN TERMS OF
THE HEALTHCARE COSTS PARK IT.
THE TARGET FOR DEFINED AS THE
FIRST TARGET PERCENTAGE FOR
ANNUAL INCREASE IN PER CAPITA
TOTAL HEALTH CARE EXPENDITURES
SO FOR EXAMPLE TAKING A CONCRETE
EXAMPLE. OF MASSACHUSETTS AT
THEIR COST TARGET RATE AT THREE
POINT 6% FOR THE LAST FIVE
YEARS- IN THIS YEAR'S MODEL
WHICH COSTS FAR GETS CANNOT
REQUIRED DECREASING COSTS. ONLY
FOR A GROWTH RATE AND THAT WAS A
CHANGE FROM LAST YEAR IN
RESPONSE TO CONCERNS. RAISED
HOSPITALS. ANOTHER NEW
PREVENTION IN LANGUAGE ADDRESSES
THE IMPACT OF LABOR COSTS ON THE
TARGETS. THE NEW LANGUAGE COST
MARKETS CAN BE ADJUSTED FOR A
PROVIDER DELIVERY SYSTEM IF THEY
THAT NOT SUPERVISORY EMPLOYEE
LABOR COSTS ARE PROJECTED TO
GROW FASTER THAN THE RATE OF ANY
APPLICABLES COST TARGETS.
BECAUSE FORGET WILL ALSO BE
DEVELOPED BASED ONTHE
METHODOLOGYWHICH WILL BE
PUBLICLY AVAILABLE FROM BOTH
TECHNOLOGY OF THE HEALTHCARE
WORKFORCE AND MAINTAIN FEDERAL
FINANCIAL PARTICIPATION. NEXT
I'D LIKE TO HIGHLIGHT A FEW
CHANGES TO THE DEFINITION
SECTION- OF THE LANGUAGE. THE
DEFINITION OF HEALTH CARE
ENTITY- CHANGE FROM PAYER OR
PROVIDER TO INCLUDE FULLY
INTEGRATED DELIVERY SYSTEM AND-
WEHAVE FULLY- MORE FULLY
DEFINED THAT THE FULLY
INTEGRATED DELIVERY SYSTEM.
TOTAL HEALTH CARE EXPENDITURES
ARE ALSO FURTHER DEFINED IN UP
TO INCLUDE EXAMPLES OF NON
NAMESPACE PAYMENTS TO MAKE SURE
WE'RE TRULY GET AT TOTAL HEALTH
CARE COST. IT TERMS OF PHYSICIAN
ORGANIZATIONS WE DO HAVE A-
UPDATED DEFINITION OF SUCH
ORGANIZATIONS THEY STILL LOOK
GOOD OUR RISK BEARING
ORGANIZATIONS I- INDEPENDENT
PHYSICIAN ASSOCIATIONS. AND THEN
WE HAVE SET SOME NUMERIC- CUT
OFFS IN TERMS OF WITH PHYSICIAN
ORGANIZATIONS WOULD BE SUBJECT
TO THE COST TARGET AND BE
SUBJECT TO THE DATA SUBMISSION
REQUIREMENTS SO MEDICAL GROUPS
WITH SIXTY OR MORE PRIMARY CARE
PROVIDERS. FORTY OR MORE
SPECIALISTS OR FOR PRACTICES
THAT HAVE A COMBINED. SPECIALTY
AND PRIMARY CARE PRACTICE THAT
WOULD BE PROVIDED SO THOSE WOULD
BE THAT THE SOX CUT OFFS IN
TERMS OF WHICH GROUPS WOULD BE
SEPARATE COST TARGETS. IN TERMS
OF DATA COLLECTION AND REPORTING
THE OFFICE WILL NOT COLLECT DATA
FROM EXACT PROVIDERS INCLUDING
SMALL PROVIDER GROUPS. THE
OFFICE THERE THERE'S SEVERAL
PROVISIONS OF THE LANGUAGE-
ABOUT THE OFFICE COLLECTED FROM
OTHER STATE AGENCIES THROUGH
DATA SHARING AGREEMENTS AND WE
ANTICIPATE SIGNIFICANT DATA
SHARING PARTICULARLY WITH THE
DEPARTMENT OF HEALTH CARE
SERVICES AND THE DEPARTMENT OF
MANAGED HEALTHCARE. THERE WAS A
CONCERN. SINCERELY HAVE AUDITED
FINANCIAL STATEMENTS SO WE
VERIFIED THAT THOSE
ORGANIZATIONS THAT DON'T- HAVE I
DID FINANCIAL STATEMENTS MAY
SUBMIT A FINANCIAL STATEMENT
THAT INCLUDES- TALK ABOUT A NEW
WALK UP COSTS RECEIVE AND LYFT.
EITHER A FEW CHANGES WE NEED TO
MONITORING COMPLIANCE RENAMED
CORRECTIVE ACTION PLANS TO
PERFORMANCE IMPROVEMENT PLAN
WHICH I THINK IS A BETTER NAME
TO RELEASING FIVE THE
PROGRESSIVE AND COLLABORATIVE
APPROACH ON FORSMAN- AND AGAIN
I'LL TALK LITTLE BIT MORE ABOUT
THE ENFORCEMENT APPROACH. YOU
KNOW THAT SO THAT WAS THE END TO
QUESTION ONE STRIKE CONTINUES
THE REST OF THE QUESTIONS MISTER
CHAIR YES PLEASE DR. OKAY SO THE-NEXT QUESTION **** TO RESPOND TO
THE CONCERNS RAISED RAISED BY
HOSPITALS AND OTHER STAKEHOLDER
CONCERNS- THAT WE'RE AWARE OF SO
I WANTED TO START- WE HAVE
GOTTEN- CONCERNS RAISED BY THE
CALIFORNIA HOSPITAL ASSOCIATION
AND THE- CALIFORNIA CHILDREN'S
HOSPITAL ASSOCIATION- WE REVIEW
THE BED AND BUT OF COURSE. WE
WOULD NOTE THAT THESE CONCERNS
WERE BASED ON LAST YEAR'S
TRAILER BILL LANGUAGE- BEFORE WE
HAD POSTED THIS YEAR'S LANGUAGE
. WE BELIEVE OUR NEW TRAILER
BILL LANGUAGE REFLECTS CAREFUL
CONSIDERATION OF THE INPUT FROM
ALL STAKEHOLDERS- AND WE DO
THINK WE HAVE STE WE BELIEVE
WE'VE GOT A LANGUAGE STRIKES A
CAREFUL BALANCE. BETWEEN
ENSURING THAT WE'RE MEETING OUR
FUNCTIONS OF THE OFFICE AND
ADDRESSING THE ISSUES RAISED BY
STAKEHOLDERS. THE HOSPITAL
ASSOCIATIONS- URGE THAT NO
HEALTHCARE ENTITIES SHOULD BE
HEALTH OF A SPECIAL STANDARD OR
OR A DIFFERENT LEVEL OF
ACCOUNTABILITY. FOR THEIR PART
OF THE ASSOCIATION OF HEALTHCARE
DISTRICTS HAVE RAISED CONCERNS
ABOUT COST TARGETS THAT TAKE A
ONE SIZE FITS ALL APPROACH AND
MAY NOT BE ACHIEVABLE FOR SMALL
RURAL CRITICAL ACCESS FACILITIES
. H. KIND VERY MCH AGREES WITH
THE PRINCIPLE OF ALL AND AS WELL
AS THE NEED FOR SOME VERY
ABILITY AND INDIVIDUALIZED
DETERMINATIONS. I APOLOGIZE THAT
THE MAILBOX WAS HERE. ALL RIGHT-
SO THE OFFICE WILL ABSOLUTELY
START WITH AN ALL IN APPROACH IN
TERMS OF DATA COLLECTION AND THE
TOTAL COST OF CARE CALCULATION-
WILL INCLUDE DATA FROM ALL
SECTORS OF THE HEALTH CARE
ENOUGH. TO TRULY UNDERSTAND THE
FULL PICTURE OF HEALTHCARE COSTS
THIS ALL AND APPROACHES HE AND I
THINK THERE'S BROAD STAKEHOLDER
AGREEMENT ABOUT THAT. BUT THEN
THERE ARE ANUMBER OF PLACES
WHERE A MORE NUANCED APPROACH-
INDIVIDUALIZED APPROACH IS
WARRANTED. THE TRAILER BOAT
TRAILER BILL LANGUAGE REQUIRES
USE OF A RISK ADJUSTMENT
METHODOLOGY FOR THE COST MARKETS
THAT WE THINK ADDRESSES SOME OF
THE HEALTHCARE DISTRICTS WHOSE
ARMS. ARTICLE THREE OF THE BILL
SETS FORTH THE PROCESS AND
REQUIREMENTS FOR THE COST
TARGETS AND ALLOWS THE BOARD
SPECIFICALLY TO ADJUST COST
MARKETS WHEN WARRANTED. TO
ACCOUNT FOR THE BASELINE COST
ADDITIONALLY WHEN IT COMES TO
ADJUSTING TARGETS THE OFFICE
WILL SOMETIMES HAVE TO LOOK AT
INDIVIDUAL CIRCUMSTANCES AND
THERE IS A PROCESS FOR THAT. A
PARTICULAR ENTITY DOESN'T MEET
THE COST TARGET WOULD MEET WITH
THE OFFICE AND PROVIDE DATA
EXPLAINING THE COST OVERRUN SO
WE COULD ENVISION THAT BEING-
HIGHER RATES PAID DUE TO A
SCARCITY OF A PARTICULAR KIND OF
SPECIALIST. A SICKER PATIENT
POPULATION FOUR INVESTMENT IN A
CARE MANAGEMENT OR OR ELECTRONIC
HEALTH RECORD I. T. SYSTEM. THE
TRAILER BILL LANGUAGE REQUIRES
THE OFFICE IN EVALUATING WHETHER
AN ENTITY COMPLIED WITH THE COST
TARGET TO CONSIDER EACH ENTITY'S
CONTRIBUTION TO GROWTH TO COST
GROWTH IN EXCESS OF THE APPLE
PARK IT. ACTORS THE CONTRIBUTE
TO SPENDING IN EXCESS OF THE
TARGET AND THE EXTENT TO WHICH
EACH ENTITY HAS CONTROL OVER THE
COMPONENTS OF THE TARGET SO WE
REALLY THIS LANGUAGE WAS ALL
CRAFTED ON THE RESPONSE TO OUR
OUR CONVERSATIONS WITH
STAKEHOLDERS. WE THINK WE'VE
DEVELOPED AN INDIVIDUAL UP
APPROACH THAT ALLOWS FOR
INDIVIDUALIZED DETERMINATIONS-
TO BE USED AS NEEDED. THE
HEALTHCARE DISTRICTS ALSO OR
JUST THROW STAKEHOLDER. TO SET
THE COST TARGETS AND WE VERY
MUCH AGREE WITH THAT SO THE
LANGUAGE REQUIRES PUBLIC BOARD
MEETINGS THAT WOULD BE AN
IMPORTANT VENUE FOR STAKEHOLDER
ENGAGEMENT. AND THE BOARD WOULD
ACTUALLY BE REQUIRED TO HOLD A
BOARD MEETING TO DISCUSS
TARGETS- PUBLIC COMMENT WOULD OF
COURSE BE HEARD AND THEN- THE
TARGETS COULDN'T. COULDN'T BE
SAID AT THAT MEETING BUT THERE
WOULD HAVE TO BE A SUBSEQUENT
MEETING SO WE FELT THEN THE
OPPORTUNITY FOR ROBUST
STAKEHOLDER. ENGAGEMENT THE
HOSPITALS HAVE ALSO RAISED A
CONCERN ABOUT LOWER RATES PAID
BY MEDICAID AND MEDICARE AND
THAT THAT REQUIRES- OF THE
HIGHER COMMERCIAL RATES. AND SO
AGAIN WE'RE STARTING FROM- IF
THAT'S BUILT INTO THE SYSTEM
NOW- THEN THAT IS AN INPUT. AND
DATA FROM PUBLIC PAYERS WILL BE
INCLUDED IN TESTIMONY ON THIS
POINT WILL BE CONSIDERED. MOVING
ON TO ACCESS AND QUALITY THE
HOSPITAL ASSOCIATIONS URGED THE
COST MARKETS NOT BE BASED ON A
PER CAPITA BASIS AND ADDRESS
ONLY THE RATE OF GROWTH NOT- CUT
EXISTING HEALTHCARE SPENDING
LEVELS AND AGAIN- WE DID MODIFY
THE DEFINITION OF HEALTHCARE
COSTS FOR. IN RESPONSE TO THIS
CONCERT LAST YEAR. THE HOSPITALS
OF ALL OBJECT DEFECTOR PARKING
AND ARE THE- DIFFERENT TARGETS
AMONG. CAN RESULT IN HIGH RISK
PATIENTS GETTING SHUFFLED TO
PROVIDERS SEEKING TO AVOID.
TRIPPING THE COST GROWTH MARKETS
AS PREVIOUSLY IT'S CRITICAL TO
START WITH AN ALL IN APPROACH
AND THEN WE DO ALLOW SOME
INDIVIDUALIZED ANALYSIS IS
NEEDED IF A PARTICULAR SECTOR OR
ENTITY- THEY GO OVER THE COST
TARGET. GIVEN SOME SECTORS MAY
PLAY AN OUTSIZE ROLE IN
CONTRIBUTING TO THE INCREASING
COST OF CARE WE BELIEVE IT'S
IMPORTANT FOR THE BOARD TO BE
ABLE TO SET SECTOR MARKETS. WE
HAVE PROVISIONS THAT REQUIRE
SETTING OF SECTOR TARGETS BE
DONE IN A MANNER THAT MINIMIZES
FRAGMENTATION AND POTENTIAL
OPTION THING. AND THE COURAGE'S
CAUGHT COOPERATION AMONG THE
ENTITIES. THE NEXT WE ARE ASKED
TO ADDRESS- IS ABOUT THE
SPORTSMAN'S- SO HEALTH URGE THAT
THAT THE DEPARTMENT PROCESS BE
ALLOWED AND FOR THAT- AND THAT
THE OFF SHOULDN'T CELEBRATE
ENFORCEMENT ACTIONS BUT BUT
SHOULD ALLOW A LOT OF.
COLLABORATION AND WE THINK THIS
IS EXACTLY THE ENFORCEMENT
APPROACH IN OUR LANGUAGE. THE
OFFICE WILL ENFORCE THE COST
TARGETS AND COLLABORATIVE AND
PRODUCTIVE WAIT- WE START WITH
TECHNICAL ASSISTANCE FOR
HEALTHCARE ACTIVITIES- WE WANT
IF WE NEEDED TO PERFORMANCE
IMPROVEMENT PLANS BASED ON THEIR
DATA- THAT WOULD ALSO INCLUDE
ESTABLISHED THAT'S ESTABLISH
DEADLINES- FOR UP. DATES TO MAKE
SURE THERE COULD. AND ALL OF
THAT WERE HAPPEN- IS AS PUBLIC
MEETINGS BEFORE ANY OF. PENALTY
ARE. SO WE DO A PROGRAM. I'M IN
FOR- MODEL. IN IN. AND FONG.
WITH ENTITIES. DAVID THE HOUSE-
URGED THE DISEASE BEING BY AND
NOT PREACH REQUIRED THAT POSE
EVERY GEOGRAPHIC BASED HARD- THE
DISTRICT ARE PARTICULARLY. WITH
THE OF COSTS AND GROWTH
RESTRICTIONS ABOUT AT DATA BUT
THIS IS REALLY JUST FOUNDER TO
THE OFFICE WE START VERY WITH
THE DATA. EIGHT HI FORMER OFF
THAT HAS LONG OF COLLECTING DATA
IN DISSEMINATING INFORMATION
ABOUT MANY COMPONENTS OF HEALTH
OF CALIFORNIA'S HEALTH CARE
SYSTEM. TO THE OFFICE'S DATA
COLLECTION AND ANALYSIS OF COST
RENDON DRIVERS OF SPENDING THE
BOARD WILL DEVELOP DATA INFORMED
ENGAGE AND METHODOLOGIES. TO SET
HEALTHCARE COSTS. THE OFFICE
WILL TAKE A COMPLIMENT APPROACH
TO DATA COLLECTION AND- FOR
MAKES DATA SOURCE. I WELL AS
DEVELOPING A IN ADDITIONAL- ALL
BE ABLE TO LEVERAGE. EMERGING
HEALTH CARE PAIN STATUS- AND AS
WELL AS DATA SHARING AGREEMENTS
THE H. YES IT MIGHT- AND
CALIFORNIA. OKAY I'M VERY
IMPORTANT WE'VE ASKED TO IT- HOW
WILL BE SURE THAT THE- COSTS
DON'T NEGATIVELY IMPACT. ACCESS
TO OUR QUALITY OF CARE. THIS IS
AGAIN JUST CRITICAL TO THE
OFFICE SO BOTH THE OFFICE AND
THE HEALTH CARE AFFORDABILITY
BOARD WILL UTILIZE COMPREHENSIVE
STRATEGY FOR HEALTH CARE COST
CONTAINMENT TO SET TARGETS FOR
AFFORDABILITY AND ACCOUNTABILITY
WELL ALL THESE MAINTAINING THE
FUNDAMENTAL PRIORITIES OF HEALTH
ACCESS QUALITY. WOULD BE. ARE
OFFICE AND THE BOARD WILL
UTILIZE THE MECHANISMS PROVIDED
IN THAT TRAILER BILL LANGUAGE AT
ALL THESE THE THROUGH A FEW.
FIRST IS TO SET HEALTHCARE COSTS
PARKING THERE IS A LIMIT ON
INCREASES IN HEALTHCARE SPENDING
NOT A REQUIREMENT TO REDUCE-
HEALTHCARE SPENDING SO WE TALKED
ABOUT THAT. WE WILL ALSO SET
COST TARGETS INFORMED BY DATA
COLLECTION AND- USING A
METHODOLOGY THAT IS EVIDENCE
BASED AND THAT ACCOUNT FOR THE
REALITIES OF HEALTHCARE SPENDING
FEEL BY THE DATA. THE PUBLISHING
REPORT. REPORTS INCLUDING OVER-
WHICH WILL RESULT IN GREATER OF
- AGAIN THE WE'LL HAVE A
POSITIVE EFFECT ON ACCESS.
EQUITY YEAH REPORTS WERE INCLUDE
HEALTHCARE SPENDING TRENDS- I'M
FLYING FACTORS AND POLICY
RECOMMENDATIONS AND WE'LL ALL
ALL THE WHILE- MEASURING QUALITY
AND EQUITY TO MAKE SURE THEY'RE
NOT NEGATIVELY IMPACTED. THE
OFFICE WILL ALSO PROMOTE THE
SHIP FROM PAYMENTS ARE BASED ON
FEE FOR SERVICE TO THOSE THAT
RECORD HIGH QUALITY- AND COST
EFFICIENT CARE AND SOAK AND I'VE
TALKED ABOUT THAT. WILL ALSO BE
MONITORING AND ASSISTING IN THE
EFFORTS OF HEALTHCARE ENTITIES
TO MEET THE COST TARGET SO THE
INTENT IS NOT TO TAKE A PUNITIVE
APPROACH. TO ONE FOURTH THE COST
TARGETS WHICH COULD HAVE
POTENTIALLY HARMFUL UNINTENDED
IMPACTS BUT EVEN IS TO ENCOURAGE
AND ASSIST HEALTHCARE ENTITIES.
TO ADOPT AN OVERALL COST
CONTAINMENT STRATEGIES TO BE
RETIRED. OUR SO IF I HELP ENTITY
WERE TO THE TARGET. THE OFFICE
WILL FOR OF OUT TO THE ENTITY
PROVIDE TECHNICAL REVIEW DATED-
TO WE DIDN'T MAKE IT ERROR AND
THREE TECHNICAL THIS IS AND FOR-
IMPROVEMENT PLANS AS NEEDED- YOU
KNOW WE WILL WORK TOGETHER IN A
COLLABORATIVE APPROACH. I ALSO
JUST WANT TO NOTE THAT
HEALTHCARE COSTS. IN AND OF
THEMSELVES A SIGNIFICANT DRIVER
OF INEQUITABLE LOWER QUALITY
CARE SO WHILE IT'S AND IT'S
CRITICAL THAT WE CRAP IN OFFICE
AND APPROACH IT DOESN'T
NEGATIVELY IMPACT QUALITY AND
CARE QUALITY QUALITY AND EQUITY
ARE ARE ARE BEING NEGATIVELY
IMPACTED TODAY BECAUSE COST. OF
THAT C. H. YEP CALIFORNIA
HEALTHCARE FOUNDATION SURVEY
THAT I CITED TO EARLIER. HALF OF
CALIFORNIANS. IF THEY'RE
POSTPONED SOME TYPE OF HEALTH
LAW TWELVE MONTHS. ALMOST HALF
OF THOSE HAVE WORSE HEALTH CARE
THERE THERE GOT WORSE OF. SO
WHILE WE MUST GUARD AGAIN REYES
THE BOTTOM WHERE THE COST CARE
ACT AT THE EXPENSE OF CALL
EQUITY. WELL IT'S THE TO IT.
CALIFORNIANS STRUGGLING TO PAY
FOR NEEDED CARE. BEFORE HELLO SO
WERE ARE MY RESPONSES TO THE
QUESTIONS I'M JOINED- BY THE
COUNCIL BUCKLEY AND MICHELLE
CONNIE FROM EVEN IF YOU HAVE ANY
QUESTIONS- I WAS HAPPY TO TAKE
ANY QUESTIONS THAT YOU MAY HAVE
TO STRUCTURE THANK YOU DIRECTOR
NEXT WE WILL HEAR FROM COREY HOW
SHE DONE WITH THE L. L. THANK
YOU DR ARAMBULA. HI COREY THIS
DATA WITH THE LEGISLATIVE
ANALYST'S OFFICE- REGARDING THE
OFFICE OF HEALTH CARE
AFFORDABILITY YOU KNOW WE WOULD
JUST FIRST FLAG THAT WE DO PLAN
TO RELEASED AN ANALYSIS IN THE
COMING WEEKS. FOCUSED ON VARIOUS
PROPOSALS FROM THE
ADMINISTRATION THAT FOCUS ON
ACCESS AND AFFORDABILITY ISSUES-
WHICH WOULD INCLUDE. AUTHOR
ALICE IS CIRCUITS YEAR'S OFFICE
OF HEALTH AFFORDABILITY
PROPOSAL- WE'VE ALSO HAD A
CHANCE TO INITIALLY REVIEW THE
TRAILER BILL PROPOSAL THE
ADMINISTRATION RELEASED LAST
WEEK AND ARE AWARE OF THE
CHANGES RELATIVE TO LAST YEAR'S
PROPOSAL THAT. THE
ADMINISTRATION JUST NOTED- JUST
TO REITERATE HIS WOULD INCLUDE
FOR EXAMPLE. HIS BROKE INTO THE
SCIENCE COMPOSITION AND SCOPE OF
THE PROPOSED BOARD WITHIN THE
OFFICE- SOME ADDITIONAL DETAIL
ON THE SIZE OF PHYSICIAN GROUPS
THAT WOULD BE SUBJECT TO CERTAIN
OF THE OFFICES REQUIREMENTS- AND
DEFINITIONS OF HEALTHCARE
TARGETS AND- ADDITIONAL
CONDITIONS. UNDER WHICH HEALTH
CARE COST TARGETS- COULD BE
ADJUSTED. WHILE FURTHER COMMENTS
ON THE RELATIVE MERITS OF THESE
CHANGES MAY BE FORTHCOMING FROM
US RIGHT NOW WE WOULD JUST NOTE
THAT THE LEGISLATURE MAY WISH TO
CONSIDER- TO WHAT AGREED TO WHAT
DEGREE- AGREES WITH THESE
REVISIONS TO THE PROPOSAL
RELATIVE TO LAST YEAR. AND TO
WHAT DEGREE IT FIND FURTHER
REFINEMENTS ON TO THE PROPOSED
LANGUAGE AND WARRANTED. AT AN
OVER ARCHING LEVEL WE GENERALLY
FIND THE CONCEPT OF THE
ESTABLISHMENT OF THIS OFFICE TO
BE A REASONABLE STEP TOWARD
ADDRESSING THE STATE'S
AFFORDABILITY ISSUES- BUT WHICH
IS NOW THAT CONTINUED MONITORING
OF THE IMPLEMENTATION OF THIS
OFFICE. I WILL BE CRITICAL TO
ENSURE THAT ITS ULTIMATELY
SUCCESSFUL AT CONTROLLING HEALTH
CARE COSTS- WE WILL ALSO JUST
MENTION THAT THE RE APPROPRIATED
FUNDS TO ESTABLISH THE OFFICE
STARRED- INTENDED TO ONLY COVER
THE FIRST COUPLE YEARS OF
IMPLEMENTATION OF FURTHER
FUNDING WOULD BE NEED TO BE
PROVIDED. FOR MULTI YEAR
IMPLEMENTATION INCLUDING FOR
ONGOING STAFFING COSTS RELATED
TO THE OFFICE OF THOSE ARE ALL
OF AMEND THAT THE NAME YOU KNOW
APPY TO PROVIDE BIRTH SYSTEMS.
WORK DID. THANK YOU OUR NEXT IT
WILL BRING IT UP TO THE DÍAS TO
SEE IF WE HAVE ANYCOMMENTS OR-
STATEMENTS WILL BEGIN WITH
DOCTOR WHAT. FIRST OF ALL THANK
YOU- TO THE ADMINISTRATION AND-
FOR- FOR THE FOR THIS- THE NEW
TRAILER BILL LANGUAGE AND-
OBVIOUS I KNOW THIS I KNOW THIS
ISSUE- PRETTY PRETTY WELL- THERE
WERE A COUPLE OF CHANGES- IN THE
TRAILER BILL. ONE OF WHICH IS
THE- COMPOSITION OF THE
COMMISSION- BOARD WHATEVER YOU
WANNA CALL IT AT THIS POINT- AND
WE'RE WE'RE STILL WE'RE STILL
CONSIDERING US CONSIDERING THAT-
I DO WANT TO POINT OUT THAT-
THAT ONE OF THE- KEY THINGS.
FROM MY PERSPECTIVE IS THAT THIS
IS OBVIOUSLY THIS IS NOT A NEW
IDEA- HERE WE'VE BEEN TALKING
ABOUT THIS THE THIRD YEAR WE'VE
BEEN TALKING ABOUT HERE IN
CALIFORNIA SO PEOPLE ARE
BECOMING FAMILIAR WITH IT. THIS
REALLY THE MASSACHUSETTS MODEL
HAS BEEN UP AND RUNNING FOR
SEVERAL YEARS NOW. THE KEY
DIFFERENCE HERE IS THE PROOF THE
POTENTIAL FOR- ENFORCEMENT- OF
THE- OF PENALTIES POTENTIALLY-
IF FOR NOT MEETING THE GOAL. AND
I JUST WANT TO REITERATE-
DIRECTOR LANCE BERRY'S COMMENTS.
THAT THIS IS NOT MEANT TO BE
PUNITIVE WHAT WE'RE TRYING TO DO
IS CHANGE BEHAVIOR. AND HOW
PEOPLE THINK ABOUT THIS- AND HOW
THE HOW THE- HOW HOW OF
CONTROLLERS ARE SPENT. SO THAT
WE CAN BENEFIT- THE MOST PEOPLE
ON AND GET THE HIGHEST QUALITY
CARE TO PEOPLE- IT IS IT IS
PRETTY WELL DOCUMENTED THAT-
THERE'S A IN IN HEALTH CARE- YOU
KNOW IT IS MUCH AS THIRTY PLUS
PERCENT. IS WASTE WASTED
SPENDING. AND MY CONTENTION HAS
BEEN FROM THE BEGINNING THAT IF
YOU COULD FIGURE OUT A WAY TO-
NOT WASTE SOME OF THE RESOURCES-
ACHIEVING SOME OF THESE GOALS
WOULD BE- WOULD BE- I'VE- THINK
IT WOULD BE THAT DEBT. QUITE
FRANKLY SOME OF THE DUPLICATION.
SOME OF IT IS- IS- HI HI HI
TREATMENT LOW OUT THE POSITIVE
OUTCOME. THERE'S SO IT'SJUST
GONNA TAKE SOME TIME. TO GET
SORT THROUGH THIS AND I USE THIS
EXAMPLE. OF A LOT BECAUSE IT
STICKS IT STUCK WITH ME I CAN'T
I CAN'T EXPLAIN WHY- WE KNOW
THAT- FROM STUDIES I BELIEVE IT
WAS THE CHC OF STUDY THAT
BROUGHT THIS UP A FEW YEARS AGO.
IN SAN DIEGO COUNTY FOR EXAMPLE-
THE COST OF HEALTHCARE IS
SIGNIFICANTLY LOWER THANIT IS
IN CHESTER COUNTY BY ABOUT 20%
AND ARGUABLY- AND AS ACTUALLY
ACTUALLY NOT ARGUABLY ITS IT'S-
FACT FACT FACTUALLY- THE
OUTCOMES AND THE QUALITY CARE IN
SAN DIEGO TEND TO BE BETTER SO
WHAT IS IT THAT MAKES SAN DIEGO
AND SO CALIFORNIA ABLE TO
PROVIDE HIGHER QUALITY CARE AT A
LOWER COST IS IT THE RURAL
NATURE OF SHASTA COUNTY IS IT IS
IT- IS IT HE PER THE A LARGE
NUMBER PROVIDERS POTENTIALLY
AVAILABLE IN SAN DIEGO COUNTY WE
DON'T KNOW- IN THE I BELIEVE IN
THE LONG RUN. THAT THAT AN
OFFICE LIKE THIS WILL HAVE GIVE
US OPPORTUNITY TO LOOK AT THIS
AND A MYRIAD OF OTHER ISSUES-
THAT- THAT ACCOUNT FOR WHAT
DRIVES THE COST OF COSTS OF
HEALTH CARE- WHAT IS IT WASN'T
SAID IS THAT THE- IN GENERAL IN
THE LAST SEVEN YEARS MY TIME IN
THE LEGISLATURE THE COST OF
HEALTH CARE HAS RISEN AT TWICE
THE RATE OF INFLATION. AND THAT
IS SIMPLY NOT SUSTAINABLE AND SO
THE IDEA IS HOW DO WE GET THIS
CLOSER TO INFLATION OR MAYBE
EVEN A TOUCH BELOW INFLATION IF
WE WERE TO BE REALLY OPTIMISTIC
HERE BUT BUT I DID IT IS REALLY
UNFATHOMABLE IT WE CANNOT GET
CLOSER TO THAT THE RATE OF
INFLATION- ME TO ROADS PEOPLE
SALARIES ERODES PEOPLE'S COST OF
LIVING- AND IN THE END- ARE WE
PROVIDING THE SERVICES REALLY
VALUABLE TO THEM- AS AS AS WE GO
FORWARD SO. SO I WANT TO JUST
HIT ONE ONE THING AND THEN WHEN
TURNED BACK TO THE CHAIR- AND
ONCE AGAIN JUST OF MY GRATITUDE
TOWARDS TO THE ADMINISTRATION
FOR CONTINUE TO WORK WITH US ON
THIS- WE DO HAVE A BILL AB
ELEVEN THIRTY- SINCE SENATE
HEALTH- THE LANGUAGE WILL BE.
IDENTICAL AT SOME POINT- TO
WHAT'S GOING ON HERE- AND WE'RE
HOPING THAT THE SENATE- ACTUALLY
WERE EXPECTING THE SENATE- TO BE
ABLE TO- HERE THIS EARLY- AND AS
WE MOVE FORWARD- THROUGH THE
PROCESS BUT ON THE QUESTION OF
ENFORCEMENT I JUST WANT TO SAY
YOU KNOW THIS IS THIS IS A THIS
IS THE ONE PIECE THAT I THINK IN
GENERAL HAS RAISED A LOT OF
CONCERN. AMONG PEOPLE AND IT
ISN'T MEANT TO BE UNITIVE-
THERE'S GONNA BE PLENTY OF A-
FOR. ACTIONS IT'S AN OPPORTUNITY
REVIEW. IF YOU'RE IF YOU'RE IF
YOU'VE GONE OVER YOUR TARGET
YOU'RE DOING THE RIGHT THING-
BECAUSE OF CERTAIN KINDS OF
INVESTMENTS THAT'S THAT'S A GOOD
THING- IF YOU'VE GONE OVER YOUR
TARGET BECAUSE YOUR- YOU HAVE
FOR OTHER REASONS. WE WANT TO
GIVE YOU TH OPPORTUNITY FOR
CORRECTION ACTION CORRECTIVE
ACTION. AND THERE WILL BE IT
THAT THE FINE IS POTENTIALLY BUT
THE LAST THING ON THE LIST SO.
SO MY HOPE IS THAT PEOPLE WOULD
JUST BEGIN TO CHANGE THEIR
BEHAVIOR. THINK ABOUT HOW THEIR
HOW THEIR PROCESS HOW THE
PROCESSING CARE OR PROCESSING
FEES AND THINGS FOR CARE- AND
RECOGNIZE THAT THERE ARE REAL
PEOPLE ON THE OTHER END OF THIS
THAT ARE. HAVING TO PAY- PAY
THESE BILLS AND- THEY'RE ANGRY
THEY'RE FRUSTRATED AND THEY'RE
SCARED BY THE RISING COST OF
HEALTHCARE. AS IS EVIDENCED BY
THE BY THE DIRECTOR LANSFORD
SPOKE ABOUT. THE NEED TO THE
EIGHTY THREE OR EIGHTY SIX
PERCENT. OF CALIFORNIANS
CONSIDER TO HEALTH CARE COSTS TO
BE- EXTREMELY OR VERY IMPORTANT
RIGHT NOW. THAT'S A STAGGERING
NUMBER AND WE NEED TO BE ABLE TO
RESPOND TO THAT SO. THANK YOU
MISTER CHAIRMAN AND THANK YOU TO
THE ADMINISTRATION FOR THEIR
EFFORTS. LOOK FOR TO WORKING
WITH YOU. THANK YOU DOCTOR
WOULD- I WILL TAKE A MOMENT AND-
REALLY DO WANNA. SPEND A LITTLE
TIME LOOKING AT SOME OF THE
TRAILER BILL LANGUAGE. I'M I'M
GONNA FOCUS ON ARTICLE FOUR
WHICH IS THE QUALITY AND EQUITY
PERFORMANCE WHICH- I WOULD JUST.
POINT OUT IS ONE PAGE OUT OF
FORTY. AND REALLY DO WANTS TO
ENGAGE WITH THE ADMINISTRATION
ON GOING AND HOW WE ENSURE THAT
WE ARE PROVIDING A QUALITY
PRODUCT AS WE ARE. LOOKING TO
SET COST TARGETS. AND SO WHAT
I'D REALLY LIKE. TO DIG INTO IS
THE TIMELY ACCESS STANDARDS THE-
TIME AND DISTANCE STANDARDS
WHICH ARE PART OF THE KNOX KEEN.
REQUIREMENTS AND I UNDERSTAND
THAT WE HAVE RECENTLY- PUT INTO
STATUTE OF REQUIREMENTS TO HAVE
SEVENTY. PERCENT PERFORMANCE ON
THOSE TIME. LEE ACCESS
STANDARDS. THAT I'M HOPEFUL AS
WERE FOLLOWING THIS THAT WE CAN
CONTINUE TO TRACK AND TREND AN
INSURER THAT. HAS WERE PROVIDING
UNIVERSAL ACCESS TO CARE THAT.
THOSE OF US WHO COME FROM
COMMUNITIES THAT STRUGGLE TO
HAVE THE SAME NUMBER OF
PROVIDERS. ARE ABLE TO ACCESS
THE SERVICES THE QUALITY
HEALTHCARE. THAT WE SO DESIRE.
AND SO WOULD WANT TO SIMPLY.
MAKE SURE AS WE ARE. GOING
FORWARD AND DEFINING WITHIN THE
TRAILER BILL HOW WE ARE GOING TO
LOOK AT THESE QUALITY METRICS.
THAT YOU INVOLVE THE LEGISLATURE
IN THAT PROCESS TO MAKE SURE
THAT WE- CAN PLAY A VITAL ROLE
IN. ENSURING THAT THE PRODUCT AT
THE END OF IT IS SOMETHING
THAT'S WORTHWHILE. FOR ALL
CALIFORNIANS AS WELL. NOW I WILL
AGREE WITH THE L. A. L. AS I
BELIEVE. THAT THIS IS A
REASONABLE STEP FOR US TO BE
TAKEN. THERE'S A REASON WHY WE
PRIORITIZE THAT AND PUT IT. IN
OUR FIRST HEARING WITHIN SUB ONE
HAS IT IS AN AREA FOR US TO
FOCUS ON. AS AN INSTITUTION AND
TO MAKE LIVES BETTER FOR
CALIFORNIANS. AND I'D LIKE TO
RECTOR LANDSBERG IF WE COULD TO
MAKE SURE THAT THIS IS SIMPLY AN
INTERNAL PROCESS BETWEEN OUR
BRANCHES OF GOVERNMENT. AS I
BELIEVE WE NEED TO MAKE SURE TO
GET THIS DONE RIGHT. I WILL
APPRECIATE MANY OF THE CHANGES
THAT HAVE OCCURRED BETWEEN THIS
VERSION AND PREVIOUS VERSION
SAYS I BELIEVE THIS IS A BETTER
PRODUCT THAT WE ARE. LOOKING AT
AND I'M HOPEFUL THAT THE
CONVERSATIONS THIS YEAR WILL BE
MUCH MORE PRODUCTIVE. AND
ULTIMATELY FRUITFUL BY THE END
OF THIS YEAR. WITH THAT I WILL-
ASKED TO FOLLOW UP WITH H. CHI
FOLLOWING THIS HEARING BUT-
WE'LL MOVE ON FROM THIS ISSUE
AND THANK THIS PANEL VERY MUCH.
WE WILL NOW MOVE ON TO PANEL
THREE WHICH IS ON THE P. C. P.
TO EMPLOYMENT AB TEN TWENTY FOUR
RELATED TO HOSPITAL EQUITY
REPORTING. WE HAVE ONE PRESENTER
ON THIS PANEL IT'S MICHAEL VIæT
THE DEPUTY DIRECTOR OF THE
CALIFORNIA DEPARTMENT OF EACH
CARD PLEASE BEGIN. THANK YOU
MISTER CHAIR AND- GOOD
AFTERNOON- CHAIR AND MEMBERS AB
TWELVE OH FOUR BUDGET CHANGE
PROPOSAL IS NUMBER THREE
ASSEMBLY BILL TWELVE OPAL
REQUIRES H. KITES EMPLOYMENT NEW
DATA REPORTING REQUIREMENTS FOR
HOSPITALS. OUR SCHOOLS ARE NOW
REQUIRED TO FILE AN ANNUAL
EQUITY REPORT WITH EACH GUY AND
ALSO THE POSTED. ON THEIR
INTERNET WEBSITE EQUITY REPORT
WILL INCLUDE MEASURES ON PATIENT
ACCESS QUALITY AND OUTCOMES BY
RACE ETHNICITY LANGUAGE
DISABILITY STATUS SEXUAL
ORIENTATION GENDER IDENTITY. AND
THE REPORT WILL ALSO INCLUDE AND
TO PRIORITIZE AND ADDRESS
DISPARITIES FOR MOBILE
POPULATIONS IDENTIFIED IN THE
DATA IN ADDITION TO THE NEW DATA
COLLECTION H. GUYS REQUIRED
CONVENE A PUBLIC HEALTH CARE
EQUITY MEASURES ADVISORY
COMMITTEE. WHICH PROVIDE
RECOMMENDATIONS ON THE DEVELOPED
MEASURES AS WELL AS PROVIDE
RECOMMENDATIONS ON THE
OBJECTIVES AND TIME PURPOSE FOR
HOSPITALS DEVELOP THEIR PLANS TO
PRIORITIZE AND ADDRESS
DISPARITIES OR BARB POPULATIONS
H. CHI WILL SUBSEQUENTLY
COMMENCED A PUBLIC. RULE MAKING
PROCESS TO SPECIFIED REPORTING
REQUIREMENTS FOR HOSPITALS THE
NEW WORKLOAD IMPLEMENTED FEES
PROVISION CANNOT BE ABSORBED
WITH CURRENT IT'S KIND OF
RESOURCES TO IMPLEMENT. THIS LAW
EIGHT GUYS REQUESTING PERSONNEL
TO ADMINISTER THE REPORT
SUBMISSION REVIEW AND EVALUATE
REPORTS WHICH PERFORM COMPLIANCE
ACTIVITIES AND ALSO TO STOP THE
ADVISORY COMMISSION. ONGOING H.
GUYS ALSO REQUESTING ONE TIME
INFORMATION TECHNOLOGY
CONSULTING TO ENHANCE THE
CAPACITY OF EXISTING H. I.
SYSTEMS INFRASTRUCTURE TO MEET
THE NEW REPORTING REQUIREMENTS.
THAT CONCLUDES MY PREPARED
REMARKS ON THE. ISSUE IN
PARTICULAR QUESTIONS. SINNOCK ON
THE TIME WILL THIS FOR THE
PRESENT. AND WE WILL ON PANEL
FOR. ON THE P. C. P. TO
IMPLEMENT AB TEN TWENTY RELATED
TO HEALTH CARE DEBT AND FAIR
BILLING DISCOUNT PAYMENT AND
CHARITY CARE POLICIES ENFORCED.
WE HAVE ONE PRESENTER ON THIS
PANEL IT'S RYAN BUCKLEY CHIEF
COUNSEL FOR THE DEPARTMENT OF
HEALTH CARE ACCESS AND
INFORMATION CAN YOU PLEASE PM.
GOOD AFTERNOON. AB TEN TWENTY
EXPANDED H. CAST
RESPONSIBILITIES FOR DATA
COLLECTION TO INCLUDE HOSPITAL
THAT COLLECTION POLICIES IN
ADDITION TO THE HOSPITAL
DISCOUNT PAYMENT AND CHARITY
CARE POLICIES CURRENTLY
COLLECTED. AND POSTED IS GUYS
WEBSITE. EIGHT CAPITAL REVIEW
ALL COLLECTED POLICIES FOR
STASHED RICK PLANTS MANSINGH IN
TWENTY TWENTY THREE.
ADDITIONALLY THE TEN TWENTY
CHARGES BASED QUE WITH A FORCE
MEANT OF THE HOSPITAL FAIR
PRICING POLICIES ARTICLE TO A
NEW PUBLIC COMPLAINT PROCESS IN
A POSITION OF ADMINISTRATIVE
PENALTIES OF UP TO FORTY
THOUSAND DOLLARS PER
INVESTIGATION. EIGHT GUYS OF
COURSE WILL COMMENCE IN TWENTY
TWENTY FOUR NOT THE
INVESTIGATIONS TASK WE HOUSE
WITHIN THE LEGAL OFFICE AND WILL
BE THE FIRST EIGHT CAP PROGRAM
TO PROVIDE SERVICES BROADLY TO
THE GENERAL PUBLIC. MOST H. I.
PROJECTED DATE WORK WITH
INSTITUTIONS BUSINESSES AND
CURRENT OR FUTURE HEALTH
PROFESSIONALS. TO IMPLEMENT THE
EXPANDED DATA COLLECTION OF THE
FORCE THE PROGRAM'S EIGHT K. SIX
SIXTEEN POSITIONS IN THE FIRST
BUDGET YOUR BUDGET YOU'RE-
EIGHTEEN POSITIONS THEREAFTER-
ESTIMATES FOR THE LIKELY. BEST
OCCASIONS AND PERSONAL WORKLOAD
WERE DEVELOPED BASED ON
EXPERIENCES SISTER PARK SISTER
DEPARTMENTS- WITH PROGRAMS
INTERFACING DIRECTLY WITH THE
PUBLIC ON CONTRACTUAL. AND LEGAL
COMPLIANCE MATTERS HI THIS
REQUEST ASSUMES THAT MATURITY A
YEARLY COMPLAINT VOLUME
APPROXIMATELY FOUR THOUSAND
INTERLINKS WITH FIVE THOUSAND
CASE FILES REQUIRED COMPLEX
ANALYSIS AND ENGAGEMENT
PROCEEDING TOWARDS A PENALTIES
OR SETTLEMENTS. IN THE
APPROXIMATELY TWO HUNDRED FIFTY
CASES RESULTING IN PENALTIES AND
OR APPEALS. BY THE PLANNING IT
WILL MAKE IT PROCESS FOR THE
EXPANDED POLICY COLLECTION OF
IMPOSED REQUIREMENT HAS ALREADY
COMMENCED IN THE COMPLETE BY THE
END OF THE YEAR. A RULE MAKING
FOR THE NEWER FORSMAN IN PUBLIC
COMPLAINT PROGRAMS WILL BE IN
PLACE FOR TWENTY TWENTY FOUR.
THERE WAS A FOSTER QUESTIONS
WRITTEN. ABOUT AN EXTENSION.
THANK YOU VERY MUCH FOR- WITH
THAT WE WILL HOLD THE ITEM. AND
THANK. YOU VERY MUCH FOR. WE
WILL NOW ON PANEL. ON ANOTHER C.
P. TO MENTAL S. SIX FIFTY
RELATED TO SKILLED NURSING
FACILITIES. THE ANNUAL
CONSOLIDATED FINANCIAL REPORT.
WE WILL HAVE ONE PRESENTER
MICHAEL FIRED THE DEPUTY
DIRECTOR OF THE- CALIFORNIA
DEPARTMENT OF HEALTH CARE ACCESS
AND INFORMATION. PLEASE BE ON.
THANK YOU AGAIN SB SIX FIFTY
BUDGET CHANGE PROPOSAL SB SIX
FIFTY EXPANDS FINANCIAL
DISCLOSURE REPORTING FOR SKILLED
NURSING FACILITIES ALSO CALLED
SNAPS. BY REQUIRING
ORGANIZATIONS THAT OPERATE A
SNACK TO PREPARE ANNUAL
CONSOLIDATED FINANCIAL
STATEMENTS AND RELATED ENTITIES
AND HAVE THE STATEMENTS REVIEWED
BY A CERTIFIED PUBLIC ACCOUNTANT
THOSE THOSE FINANCIAL STATEMENTS
ARE ALREADY AUDITED. STARTING
WITH THE PHILIP FISCAL YEARS
ENDING DECEMBER THIRTY FIRST TWO
THOUSAND TWENTY THREE HR WILL
COLLECT REVIEW AND PUBLISH THESE
CONSOLIDATED REPORTS TO ITS
WEBSITE. THE BILL ALSO REQUIRES
AGE GUIDE TO REVIEW THE
CONSOLIDATED REPORTS FOR
COMPLETENESS AND COMPLIANCE WITH
THEIR REPORTING STANDARDS AGE
COUPLE CONTINUE TO AUDIT THE
INDIVIDUAL SNAP FINANCIAL
STATEMENTS SUBMITTED. PURSUANT
TO CLARIFY AND POST THOSE ON ITS
WEBSITE REPUBLIC TRANSPARENCY. A
CONSULTANT REPORTS MONTHLY
FINANCIAL STATEMENTS FOR EACH
INDIVIDUAL OPERATING ENTITY
RELATED PARTY THAT SHARE 5%
COMMON OWNERSHIP AND THAT
PROVIDE SERVICES TO THE
FACILITY. REPORTS WILL ALSO
INCLUDE OTHER DISCLOSURES AS
WELL AS A VISUAL REPRESENTATION
OF THE ORGANIZATION STRUCTURE
AND RELATED ENTITIES. THAT'S
WHETHER THEY HAVE RELATED
PARTIES OR NOT BUT ALSO BE
REQUIRED TO DISCLOSE
ORGANIZATIONAL VISUAL
REPRESENTATION DOCUMENTS FOR
BOTH RELIGIOUS AND NON RELATED
ENTITIES. THE NEW WORKLOADS
IMPACT THESE PROVISIONS CANNOT
BE ABSORBED WITH CURRENT IT'S
GOT RESOURCES TO IMPLEMENT THIS
LAW REQUESTING PERSONNEL TO
ADMINISTER THE REPORT SUBMISSION
REVIEW AND EVALUATE REPORTS AND
PERFORM COMPLIANCE ACTIVITIES
THIS INCLUDES BELCHING.
ENFORCING FINANCIAL ACCOUNTING
AND AUDITING REQUIREMENTS
EXERCISE ALSO REQUESTING ONE
TIME INFORMATION TECHNOLOGY
CONSULTING TO ENHANCE THE
CAPACITY OF ITS DOING H. GUIDED
TECHNOLOGY SYSTEMS AND
INFRASTRUCTURE. TO MEET THE NEW
REPORTING REQUIREMENTS IN
RESPONSE TO COMMITTEE STOPS
COMMENT ON THIS PROPOSAL IT'S
PAST MANDATED NOR EXPLICITLY
AUTHORIZED NOW SEE IS FROM THE
STEP DATA. IT COLLECTS THE BCP
AND GOVERNOR'S BUDGET REFLECTS
ONLY THE RESOURCES NEEDED TO
IMPLEMENT THE SPECIFIED
REQUIREMENTS OF SB. SIX FIFTY
EIGHT GOD BY THE ANGEL
TRANSPARENCY PER ARE WITH.
AUDITING AND ACCOUNTING SO.
WHOSE RESPONSE. IT IS TO DEVELOP
FINANCIAL REPORT STANDARD
PERFORM DESTACADO FROM TURKEY
BILL STANDARDS. AND MAKE THE
DATA ACCESSIBLE. FOR YOU BECAUSE
THE H. CHI. FINANCIAL ARE ONE
HUNDRED. OPEN AND POP ANYWAY CAN
MAKE USE OF IT ANALYZE. THE
REPORTS IT IS AGE HAS GOAL TO
MAKE INFORMATION AS ACCESSIBLE
AS IT CAN'T BE AS COMMITTEE STOP
MENTIONING COMMENT. ACADEMIC
RESEARCHERS AND ADVOCATES BUT
ALSO MEDIA AND OTHER STATE
AGENCIES ROUTINELY TRAIN AND
ANALYZE THE H. CARE DATA. FOR
EXAMPLE A NEW WEBSITE WAS
RECENTLY RELEASED CALLED HOW
LONG TERM CARE COMPARE WHICH IS
ADMINISTERED BY ACADEMIC
PARTNERS AMONG. OTHER
STAKEHOLDERS TO CONTAINS H. CHI
DATA AS WELL AS DATA FROM OTHER
SOURCES AND PROVIDES QUALITY
RATINGS AND OTHER INFORMATION
ABOUT STEPS TO THE PUBLIC. H.
HELLO SUPPORT WORKING WITH ALL
STAKEHOLDERS INCLUDING.
COMMITTED STAFF AND ALL OTHERS
TO SUPPORT EFFECTIVE USE OF EACH
IDEA. IS MY PREPARED REMARKS. ON
THE ISSUE AND CAPITA QUESTIONS.
THANK YOU VERY MUCH FOR IN. I
WOULD LIKE TO DO AGAIN A LITTLE
ON WHY WE AREN'T ANALYZING. DATA
OURSELVES AS A STATE. TO GET A
BETTER UNDERSTANDING OF THE
PHYSICAL CONDITION OF THE SNAPS.
AND I'M WONDERING IF- THERE'S A
SEQUENTIAL NEXT STEP FOR US
AFTER WE DO THE REPORTING. OR IF
WE BELIEVE THE STATE DOES HAVE A
NEED FOR RESPONSIBILITY. TO
ANALYZE THE DATA I'M JUST HOPING
YOU COULD COMMENT ON THAT. THANK
YOU DR ARAMBULA AND DOCTOR WORK
SO I THINK- IT'S AN IMPORTANT
QUESTION AND ONE WE WOULD WE
WOULD WELCOME SOME GUIDANCE ON
WE SIMPLY NEED TO. REPRESENT
THAT THE REALITY WHICH IS THAT
WE HAVE STATUS STOPPING TO
COLLECT THE DATA AND TO BOTH THE
DATA AND MAKE IT AVAILABLE IT
WOULD JUST TAKE AN ADDITIONAL
LEVEL OF STAFFING IF THE STATE
DECIDES IT WANTS TO DIG IN AND
DO ADDITIONAL ANALYSIS. SO
REALLY IS A RESOURCE QUESTION.
THANK YOU DIRECTOR AND A DOCTOR
WOULD AND I BOTH HAVE AN
INTEREST IN ENSURING THAT THE
QUALITY FROM OUR SYNAPSES
IMPROVING WITH TIME AND- BELIEVE
THAT A BETTER UNDERSTANDING OF
THE FISCAL CONDITIONS OF THE
SKILLED NURSING FACILITIES WILL
BE BETTER INFORMED. POLICY AND
BUDGET DECISIONS THAT WE MAKE
GOING FORWARD AND SO ARE HAPPY
TO ENGAGE WITH YOU TO FIGURE OUT
HOW WE CAN ENSURE THAT YOU HAVE
THE STAFF AND TEAM TO DO THE
APPROPRIATE ANALYSIS. BUT FOR
COLLECTING THE INFORMATION AND
WE SHOULD BE ABLE TO ANALYZE IT
AND ALLOW IT. TO INFORM FUTURE
DECISIONS FOR US AND WOULD HOPE
THAT WE COULD PROVIDE YOU THE
STAFF THAT'S NECESSARY. TO BE
ABLE TO DO THAT NEXT STEP. AND
LOOK FORWARD TO THOSE ONGOING
CONVERSATIONS. BUT WITH THAT I
WILL THANK VERY MUCH PANEL FIVE
WE WILL MOVE ON THE PANEL SIX ON
THE AFFORDABILITY OPTIONS REPORT
. OVERSIGHT WE HAVE TWO
PRESENTERS FIRST WE HAVE K
REVELL DIRECTOR OF POLICY
ELIGIBILITY AND RESEARCH
DIVISION WITH COVERED
CALIFORNIA. AND LUKE COACH
MARROW SENIOR FISCAL AND POLICY
ANALYST WITH THE LEGISLATIVE
ANALYST'S OFFICE PLEASE BEGIN
DIRECTOR RAVEL. THANK YOU SO
MUCH FOR STATE CHERYL NUMBERS. I
DO HAVE A FEW FIGHTS FOR THE
PRESENTATION TODAY METROPOLIS IN
JUST A MOMENT AND THAT AS WE GET
GOING ON IT WOULD BE- LONG. LIVE
IT WOULD BE TO START WITH HE
SAID. FROM ABOUT COVERAGE. THE
AFFORDABLE ACT. A REFORM THE
BILL HEALTH INSURANCE MARKET.
I'M IN SOUTHWEST ARE HEALTHCARE
EXCHANGE WHERE CONSUMERS CAN BUY
A PRINCIPAL FUNDS WITH FINANCIAL
HELP I TO BASED ON INCOME TO
SUPPORT THEIR PREMIUMS AND OUT
OF POCKET COSTS AND THIS
COVERAGE IS AVAILABLE FOR PEOPLE
WHO DON'T HAVE EMPLOYER
SPONSORED COVERAGE MEDIC CAL FOR
MEDICARE OCTOBER CALIFORNIA IT
CALIFORNIA'S HEALTH INSURANCE
MARKETPLACE. ARE WE CONTRACT
WITH TWELVE HEALTH INSURANCE
CARRIERS THROUGHOUT THE STATE
OFFER COVERAGE. WHICH IS THE
PACKAGES AND- THE- BENEFITS
BETTER DEFINED A HIGHLY. IN THE
FOR CARE ACT FOR THEIR STUFF IN
THE STATE. OUR MEMBERS TO FROM
SO COVER OFF. THAT VERY IN THE
AMOUNT OF MONEY THEY PAY. THE
MONTHLY THROUGH PREEMIE FOR
THREE OUT OF FIVE COSTS WILL BIG
TO THAT MORE. AS OPPOSED THIS
FIVE. OF WE WILL TRY INTO TWELVE
TO AMPLE. A NEED LEADING CAL. TO
ADD A FEDERAL TO ADD STEEP
SUBSIDIES ON TOP OF THE FEDERAL
SUBSIDIES. AND WE'RE THE FIRST
STATE IN THE NATION TO DO THAT
WOULD PROVIDE A PREMIUM SUPPORT
TO MIDDLE INCOME CALIFORNIANS
WHO ARE ELIGIBLE FOR FEDERAL
FINANCIAL HELP. AND THEN LAST
YEAR. ON THE CALL THE NINETEEN.
AND THEN MAKING. RECESSION THE
AMERICAN RESCUE FROM
SIGNIFICANTLY EXPANDED FEDERAL
PREMIUM SUBSIDIES. IN
CALIFORNIA'S MODEL TO MIDDLE
INCOME CONSUMERS PREVIOUSLY
WEREN'T ELIGIBLE FOR FEDERAL
SUPPORT. AND IT'S SIGNIFICANTLY.
REDUCED PREMIUM CONTRIBUTIONS
FOR INDIVIDUALS UNDER 4100% OF
THE FEDERAL POVERTY LEVEL HIGHER
CUT OFF FOR FEDERAL SUPPORT. OF
THE SUBSIDIES ARE IN EFFECT
THROUGH TWENTY TWENTY TWO. AT
THIS YEAR- IN RESPONSE TO THIS
ACT SIGNIFICANT INCREASE IN
AFFORDABILITY ON THE PREMIUM
SIDE COVER CALIFORNIA HAS JUST
REPORTED RECORD HARLEM THAT FOR
US A ONE POINT EIGHT MILLION
SIGN UPS. ARE THAT WAS THE LEAD
INTO THE FINAL WEEK OF OPEN
ENROLLMENT WHICH THAT CLOSE FOR
US LAST YEAR- WHICH IS HAVE ONE
MORE AFFORDABILITY METRIC HERE
ON THE SLIDE WHICH IS NOW. A TWO
THIRDS OF OUR MEMBERS ARE
ELIGIBLE FOR COVERAGE THAT COST
LESS THAN TEN DOLLARS PER MONTH.
SO THAT'S THE NEWS ON THE
PREMIUM SIDE FOR US. SEVEN ON
THE TO THE NEXT. IN THE FEDERAL
SAID. I THAT WE SAW IN THEIR
REST PLAN WERE LIMITED TO PRE SO
I QUESTIONING SUPPORT STILL LIVE
UNDER THE AFFORD CARE. BLOODEDLY
ON THIS CHART WOULD I WOULD JUST
OUT ITS ASSURING SUPPORT IT'S
OUR LOWEST IN IN THE INDIVIDUAL
UNDER 2100% OF THE FEDERAL
POVERTY LEVEL AND LIKE MENTIONED
IT DOES ALLOW US TO REDUCE THEIR
DEDUCTIBLES AND MAXIMUM OUT OF
POCKET EXPOSURE THE HEARING
THERE COPAYS AND COINSURANCE
FOR- FOR CERTAIN SERVICES. SO
YOU CAN SEE ON THE SLIDE AS
INCOME RISES SO DO THOSE
DEDUCTIBLES FROM ON A SORT OF A
MODEST AMOUNT IN SEVENTY FIVE
DOLLARS FOR AN INDIVIDUAL
ALTHOUGH WITH THE ABSENCE OF
DOLLARS- AND COPAYS RISE AS
WELL. SO THAT- WE SEE THAT IN A
MOMENT AND IMPACTING THE CHOICES
THAT PEOPLE MAKE IN THEIR PLANS
APRENDIZ. FIVE WE HAVE FIGHT IN
. A LEVEL OF COVERAGE THAT
BEGINS CHIU SO. OUR CONSUMER AT
LOW IN WHO ARE L. FOR. A SICK
PREMIUM ASSISTANCE AND QUESTIONS
. YOU TEND TO JUST USE THOSE
PLANS THAT OFFER THEM THE BEST
FOR IT SO THOSE BARS THAT ARE
STILL PER THAT ARE SILVER LEVEL
OF COVERAGE WE OFFER A CAR
SHARING SUPPORT. AND THAT'S WHAT
THE MAJORITY OF THE- LOCAL
CONSUMERS CHOOSE. THOSE TO MAKE
THE CHOICE TO ADAM TO BUY MORE
GENEROUS COVERAGE FOR TO BUY
LESS GENEROUS COVERAGE WHICH HAS
A LOWER PREMIUM AND THAT'S
BOTTOM BAR THERE YOU SEE THAT
FOR BRONZE PLAN. WAS PREMIUMS
BUT ALSO THE HIGHEST OUT OF
POCKET COSTS FOR CONSUMERS AND
AS THEIR INCOME RISES YOU CAN
SEE A SIGNIFICANT INCREASE IN
CONSUMERS BUYING THAT BRONZE
PLAN. OPTED THAT LOWER MONTHLY
PREMIUM AND MORE OUT OF POCKET
IF THE CHIEFS CARE. AND THEN WE
HEARD DIRECTOR LANDSBERG TALK
ABOUT STATE NUMBERS BUT WE JUST
PUT. SOME OF OUR SURVEY DATA ON
HERE WHICH IS OUR ENROLLEES IN
BRONZE REPORT DELAYING CARE. AND
DUE TO COME GENERATED THREE TOP
HOMES ADAMS ARE IN ROLES WITHIN
OUR SILVER NINETY FOUR PLAN.
THAT FAR. NOT MORE BRANDED NAME
OUR SHARING AND TRY LOW INCOME
INVOLVED THAT COVERS MOST OF
THEIR- IN THE- OUR ARMS WE DO
SEE THAT. OUT PLANS. AND I THINK
THIS THE BACK. ALL ON WHICH THE
STATEMENTS AND US LAST YEAR THE
BUDGET. THAT ARE FOR. LOWER
INCOME ARE OF POCKET COSTS AND
THAT'S WHAT WE'VE THAT OUR
REPORT OKAY THAT'S CARE WITH THE
REACH. AND WHICH IS. ALSO WITH
THE IS BRIEF ATTEMPT DOG. ON
THAT WAS FOR BY OUR ACTUAL IT
MAY. AMP WITH OF THE THAT ARE
TOXIC ARE ALL THE OPTIONS THAT
ARE IN OUR- IN- WITHIN
DIFFERENCE IN HERE THAT ALLOW-
IT'S SORT OF PLAY WITH EVEN AN
OPTION THAT DIDN'T. MARC A
SIGNIFICANT OTHER OPTIONS ARE AT
AT AS I TURNED TO THE I WILL
THINK- HOURS. MUCH STAFF REPORT
IN OUR PER. AND IN THE REPORT.
PREMIUM SUBSIDIES THAT ARE
AVAILABLE UNDER THE AMERICAN
RESCUE PLAN- WHILE WE WERE IN
THE COURSE OF OUR WORK FOR THE
HOUSE ASK. THAT THEIR ACT. THAT
QUESTION OF THE POLICY. AND WHAT
EXTENDED MEREKA PASTI PLAN
PREMIUM SUBSIDIES THROUGH TWENTY
TWENTY FIVE SALUTE THOSE RICH
INDIAN SUBSIDIES IN PLACE FOR
SEVERAL MORE YEARS. I'M ALSO
GONNA STAB ESTABLISH
AFFORDABILITY FUNDS THAT WOULD
PROVIDE TEN BILLION DOLLARS PER
YEAR. BETWEEN TWENTY TWENTY
THREE AND TWENTY TWENTY FIVE FOR
MARKETPLACES LIKE COVERED
CALIFORNIA DID WITH THE STATE
LEGISLATURE ENVISIONED LAST YEAR
WHICH IS TO PROVIDE SOME
ADDITIONAL SUPPORT. THE LOGIN
ROWLEY'S COSTS INCLUDING THOSE
COPAYS AND DEDUCTIBLES. AND SO
THIS WAS OUR NEW NEWS FOR I
THINK HE DID INFORM THAT PHOTO
TOOK IN THE FOR OF STILL ON.
I'M GLAD OUT- OPTION THAT ARE IN
FOR. THAT ARE REALLY A LOT ST
POLICY SCENARIOS IN ALL WALKS
THROUGH. HERE SO IN THE FIRST. I
SIX ACTUALLY THE SCENARIO WHERE
WE LOSE THAT ENHANCE FEDERAL.
AND IN AMERICA SB CLAM PREMIUM
SUBSIDY. ARE INTENDED TO BILL
FACT THAT ARE WORTH- THAT HOLLIS
THE STATE WOULD THEN FACE
TRAITOR- OF USE MONEY FOR CAR
SHARING. FOR USING FOR STATE
PREEMIE OF SO WE ARE PROVIDE
SOME AND NUMBER. TO AND FROM
THAT. AND POLICY CHOICE BE. AT
THAT MOST OF EUROPE FOCUSES COST
SHARING. UNDER THAT FIRST
QUESTIONS. WE WOULD HAVE BETTER
FUNDING WE HAVE A VARIETY%
OPTIONS THAT MIGHT BE- MORE
APPROPRIATE FOR OUR FEDERAL
FUNDING. AND THEN THE THIRD
SCENARIO IS. THE ONE THAT THE
ANTICIPATED WHEN WE START ON OUR
WAY LAST FALL WHICH THAT FEDERAL
PREMIUM'S. TO CONTINUE AT THE
STATE FARM PROVIDES FUNDING AND
TECHNICAL THAT REDUCE YEAR.
COSTS WE DID MANAGE HERE AT THE
STATE OF. AND THAT WHICH IS IN
BUDGET LAST YEAR. OKAY LET'S
LOOK A LITTLE ARE. SYNEREO
AMERICAN WAS PLAN SUBSIDIES ARE
EXTENDED M. WE DO HAVE SOME
NATURAL HERE IF THAT TO HAPPEN
COVER CAL ENROLLEES WOULD LOSE
ON. ABOUT ONE HUNDRED DOLLARS
AND MISTER PER HOUSEHOLD PER
MONTH. WOULD BE LOSS TO THIS OF
THE ONE POINT SIX BILLION
DOLLARS IN IN PREMIUMS UP. SO
THAT'S AVAILABLE IN EUROPE OR
MORE GRAND DETAIL USE IN THIS-
THAT WE WOULD OFFER EXTRA
ASSISTANCE IT NEEDED- SHOULD THE
LARGEST TO THINK ABOUT RICH THAT
. PREMIUMS STEPS PROGRAM INSIDE
FORM FASHION. THOSE DETAILS ARE
IN THE- AND I'LL TURN NOW TO
SCENARIO TWO IS- WHICH IS FOR
SHARE OF THE KEY AND A VERY CHIU
THAT'S TRACKED EXHIBIT IN THE-
CERTAINLY WANNA HAVE WHAT
YOURSELF BY. BUT I WOULD USED.
ILLUSTRATES OF THE TRADE OFFS WE
LOOK AT AND- SOME OF THE WORK
THAT DID HE WILL NOT ROAD WHERE
YOU SEE. THE LEVELS OF THIS
OPTION USES. UP AT 6100% OF FPL
AT THE STATE NEEDS FOR ESTABLISH
A PREMIUMS. PROGRAM UP WITH
MAKES. INVESTMENTS REDUCE POSH
HEARING PEOPLE WHO ELIGIBLE
TODAY OF THE FEDERAL. AND WE
WILL SIX. ELIGIBILITY PEOPLE WHO
AREN'T ELIGIBLE FOR FEDERAL AND
CITY STAFF ON. WHERE YOU HAVE
THE NUMBERS INCREASE NINETY FIVE
EIGHT NINETY. DOES YOUR. OUR BUT
OF COVERAGE THAT MEANS THE WHOLE
FLAT ON A WOULD BE ABOUT 90% OF
THE COST. IN THE THAT'S WE'RE
ABLE TO OFFER PLAN THAT HAVE.
THREE DOLLARS G. KNOW DRUGS BY
THE PRIMARY CARE VISITS. AND ON
THE TOP AND CRITICAL THE OF THAT
OF THE STAFF. WE WILL DEDUCT UP
IN PLAN THAT OFFER BECAUSE
DURING ITS- WE CAN GAUGE LOT
WITH STICKER AND DEDUCTIBLES.
AND THE WE SET UP TO DATE- THEY
DON'T APPLY. IN THE FILM. UP TO
YOUR MOST THE ONLY A IN PATIENT
. AND SKILL NURSING. SO WE DO
THAT THAT WE TO THE IMPACT THOSE
TO. FOR MOST YOU GET K. FIRST
DOLLAR WHEN YOU **** AT THE TOP
AND IT JUST HOPE. AND THAT IS WE
ENGAGE A STATE THERE WERE A LOT
OF. ABOUT CONSUMERS NOT UNDER.
THAT NEW OF OUR THE AND COVER
ALL OF. AND PICKED NOT SIGNING
UP THROUGH A CONSTRUCTIVE HAVING
PRODUCTIVE. OR SOMETHING UP
BEING AT THE TO YOU THEIR- FOR
PRIMARY CARE. IT'S BECAUSE THEY
ASSUME THAT THAT IS A OF. FIVE
SEVEN. THAT'S SOMETHING THAT
BENEFITS DISCUSSION THAT WE ARE
. I'M IN BUSINESS OUR LIST. ALL
THE OPTIONS WITH MY HERE- WHERE
THE STATEMENT WILL PROVIDE
ENHANCED PRESSURE AVERAGE BE AT
LEAST AT THE LEVEL OF COVERAGE
WITH PLAN ABOUT EIGHTY PER OF X.
COST. AND I'LL JUST STAY A
LITTLE THAT DOLLAR THAT YOU SEE
IT ON THAT THERE. THIS REACHES
FOR HUNDRED SEVENTY FIVE MILLION
YEAR UP SIX MILLION. A YEAR THE
RANGE IS THERE HAVE TO DO WITH.
AND ALRIGHT. AND THAT THEY WOULD
MOVE FROM THE PLAN THERE
INDICADO FROM- ALL AND FIVE PLAN
. INTO THE FAR YEAR REDUCTION
PLANS TO THE EXTENT. THAT BE
ABLE TAKE IT OF THE CLASH THAT
FITS IN THE PRO COST UP. WE
LOOKED AT A COUPLE OF DIFFERENT
ENROLLMENTS AREAS THERE. AN
ADVOCATE TO WORK WITH THE- IN
THE LEAD. TO UP TO THESE NUMBERS
OFFICE UP TO THE CAR. BASE ON
THE ROLE WE HAVE FOR TWENTY TO
BASED OUR- INVOLVEMENT CLOSING
LAST. FOR NEXT WEEK OF OPTIONS
OUR LAST WEEK OF OPTIONS ARE FOR
STATE FUNDING. AND WE HAD THREE
HUNDRED AND THIRTY THREE MILLION
IN THE STATE AFFORDABILITY FUND
IN MIND WHEN WE LOOKED AT THESE
OPTIONS WOULD ALSO HAVE THE
DIRECTION FROM THE STATUTE-
PARTLY IN MIND. SO INTRODUCTION
THE MORE SET UP THE TABLE WE
PROVIDED OPTIONS WOULD. SIXTY
INTELLIGENCE. FOR UP TO FOUR THE
FIRST OF THE FEDERAL LEVEL- AND
PRIORITIZE YOU OPTIONS THAT
WOULD. PROVIDED POOL LEVEL OF
COVERAGE THAT THOSE INDIVIDUAL.
ON THE TOP WILL STEER MOST
GENEROUS OPTION THAT OPTION-
AGAIN WOULD EXPAND ELIGIBILITY
GET NEARLY ELIGIBLE AT THE GOLD
LEVEL COVERAGE BUT IT WOULD ALSO
SIGNIFICANTLY INCREASE THE CARD
SUPPORT PEOPLE WHO ARE ELIGIBLE
TO DEMAND THAT HE FEDERAL
PROGRAM MAKE THOSE- THOSE
COMPANIES ARE MORE AFFORDABLE
AND WOULD ELIMINATE DEDUCTIBLES.
AND THEN JUST FINAL OUR BOTTOM.
ROACHES BECAUSE OF THAT I THINK.
REPORT THIS ON TO STATUTE ON TO
THAT WITH I WHAT IT WOULD COST
JUST TO THE- OUR- ALAMEDA DID
THAT IN THE TEN OF MILLIONS
REYES MOST OF THE OP SO THAT WE
MODELED STATE. THAT SOME OF THE
HIGH MILLION TO FOUR BILLION PER
YEAR. SO I THANK COULD SPAWN
WITH. WE ALSO- AT THE OF THIS
LOOKS PRETTY OFFER ISSUES- WE
UNDERSTAND THAT THE DIRECTION
WOULD BE. READ BY TWENTY TWENTY
AT THE- LEGISLATURE
ADMINISTRATION FIVE IMPLEMENTED
PROGRAM SO DID QUITE A BIT OF
DETAILED WORK THERE I THINK. WE
ARE AT THE MOMENT RIGHT NOW EVEN
THOUGH THERE'S UNCERTAINTY ABOUT
THE FEDERAL FUNDING- WE DO HAVE
A CONTINGENCY PLANNING AND HUESO
THAT WE CAN DO WHAT WE CAN
ACHIEVE READY TO IMPLEMENT IF
SOMETHING IF FUNDING IS
AVAILABLE FOR THE TWENTY TWENTY
THREE PLAN YOUR- I WOULD JUST
CLOSE BY SAYING THAT WE WILL.
CONTINUE TO WORK CLOSELY WITH
THE ADMINISTRATION AND THE
LEGISLATURE TO MAKE DECISIONS
ABOUT DESIGN OF THE STATE
ADMINISTRATOR PROGRAM IT'S CLEAR
THE FEDERAL FUNDING. EMERGED
THOSE ARE THE- AT THE END OF MY
PREPARED. SEE IF I CAN TALK.
TWENTY FIVE. THANK YOU DIRECTOR
NEXT WE WILL HEAR FROM THE L. A.
L. GOOD AFTERNOON EVEN LUCAS
MORROW WITH THE LEGISLATIVE
ANALYST'S OFFICE. PUBLISH A MORE
IN DEPTH ANALYSIS AND IN THE
COMING WEEKS BUT ONE OF THE SHIP
YOU ISSUES FOR LEGISLATORS
CONSIDERATION. FOR FREEDOMS. NOT
CONTINUE UNLESS STATE DRUG MAY
WANT TO RE ESTABLISHING A STATE
PREMIUM. SUBSIDY PROGRAM. AND IF
I DON'T. SEE ARE GOING TO. THERE
ARE FEW ADDITIONAL WITH
LEGISLATURE TO CONSIDER.
INCLUDING WHAT'S AFFORDABILITY
SHOULD BE- ANY POSSIBLE- SPACE
GOALS CONCLUDED WE'RE GONNA FOR
CONSUMER WITH IN I OR BELOW 100%
OF THE FINAL. LEVEL WHICH IS
WHERE NOT IF I PREMIUM THANK
COST SHARING. REDUCTIONS ON IT
OR COULD EXPECT POSTURE DOT YOU
CAN OF THE 210050% OF. A POPULAR
OR NOT HELD PRODUCTS AT ALL COST
OPTION. ON GREAT THE FLOOR COULD
SOME APPROACH THAT COULD YOU IN
A MOMENT OR INTENT BY EXIST
ALWAYS. CAN WORK AND PLAN. ONE
OF THE TOP IN. YEAH BURKE HOW
MANY WELL. THE NEXT GENERATION
TINY UP FOR BOARD PROGRAM- AND
SPENDING PROVIDE SO IF THE
PROGRAM IF I DON'T KNOW WHY YEAR
TALKING EIGHT OR ON IN BASIS TOM
DO WE DON'T KNOW WHAT WE ARE
LIMITED TERM BASIS WHAT ACROSS
RESOURCE AND I PROGRAM BUT IT
THEN IT IN THE PROGRAM
COMMUNICATE THE PROGRAM ARTISTS
. WOULD BE SIMILAR AND A PROGRAM
REVERBERATION MAKING APPEALING
TO CONSUMER AND ALL PROVIDE WITH
A SHORT WINDOW TO TAKE IT OF
PROGRAM. IT'S NOT THE LEVEL FOR.
THAT TO WHICH FUNDING IS
AVAILABLE. ON COULD BE AT HE DID
. AN ON IT IN. THREE HUNDRED
THIRTY. OR BILLION THAT SET
ASIDE FROM TWENTY ONE I FOR
PROGRAMS A BE. AN THE
LEGISLATURE ALSO YOU ADDITIONAL
ON REVENUE AT THE IS THAT
SOMETHING. YOU SEE THAT ON IT
WHAT TYPE CLUSTER COULD. THE
OFFER TO WORK OKAY THE MANDATING
YOU SEE THE DOCTOR. OR MOVIE
INTO MORE THAN MORE PLAN THAT.
THE COST THEY PAY FOR BOTH THE
BULLS AS OTHER OUT OF EXPENSE.
NOTHING ON OUR BUT A LOT
DIFFERENT DESIGN UP WITH IN WITH
THAT TO NO PER CALL. AND THAT
WOULD HELP. PART IN ORDER TO ARE
THE SO PENSION WE COULD NOT BE
FOUND IN DOUBLES FOR A LOT OF
SERVICES EVEN OUT EIGHT SHOULD
DISCUSSED- IN THE TESTIMONY- AND
SO THEN IT WILL WHAT MOSTLY.
WELL THE IMPACT THOSE CAN CAN
INPATIENT CARE WELL WHAT IT CAN
DO VERY EXPENSIVE FOR THOSE.
THAT YOU HAVE A PATIENT NEEDS.
AND ALSO DISCUSSED COMMUNITY TO
ENROLL IN OUR SEEKING FOR IT
OTHER PARTS. THEY ARE ALSO ALL
THE- BURKE ON THE ALSO LOOKING
DOCTOR- YOUR EXTEND BUT I'LL
KEEP THAT NOT GET OUT- AND THE
LEADING THE DOCTOR ARE BENEFIT
TEAM THAT COULD SEVERAL INTO AND
I MY DELAY THE IMPLEMENTATION.
TO THE TWENTY TWO THREE YOUR.
THE PLAN ALL ALSO THANK UPGRADE
PLANS OUT OF THE DEDUCTIBLES.
WHICH STILL. PROVIDED ONE OF-OPTIONS IN THE RIVER- THIS OP
WHAT SILVA CAN UPGRADES MORE
GENEROUS THAT REDUCE THE COST
INCLUDE WE CAN DEDUCTIBLE EVEN
THOUGH THEY WOULD BE FORTY. THIS
BE LESS OFTEN IMPLEMENT ALSO
COULD BE IN THAT. AFTER HE GOT
IT WOULDN'T ON THE BALLOT DESIGN
. ARE WE COULD RESULT IN HIGHER
COSTS AND SOME- JUGGLES WILL NOT
BE AT. AN EDISON- DIRECTOR IT OF
BACK UP ON THE DOCTOR. THAT
WOULD NOT BE ADDRESSED FROM
APPROACH DOESN'T KNOW. THE
DEDUCTIBLES. THANK YOU. YEAH.
THANK YOU VERY MUCH BEFORE A OF
IT TO MEMBERS QUESTION I'M GONNA
THAT WE THAT WAS. ME TOO WILL
PLEASE. HARAMBEE YOUR MATHIS
PATTERSON RAMOS BROUGH WHAT. YOU
CAN. DR WOULD. A PERSONAL THANK
YOU TO THE ALEJO'S OFFICE AND MS
REBEL FOR THE PRESENTATION JUST
A OKAY YOU COVERED TO THE
SEVERAL OF MY QUESTIONS THERE
BUT- THAT I HAD BUT TWO
QUESTIONS IN PARTICULAR FOR MISS
REVELL- JUST DO YOU HAVE I KNOW
IT'S EARLY IN THE IN THE PROCESS
BUT DO YOU HAVE ANY- IDEA OR AN
EX TO THE EXTENT THAT THE
DEDUCTIBLES COPAYS MY- ARE
EXPECTED TO CONTINUE RISING IN
TWENTY TWENTY THREE AND BEYOND
SO I MEAN I'M LOOKING FOR YOU
KNOW BROADER TRENDS- NOT NOT
GRANULAR DETAIL AT THIS POINT.
LET ME TAKE THAT ONE WE AND WE
ALWAYS START WITH- THE FEDERAL
GOVERNMENT THEY SORT OF PROVIDE
A FLOOR FOR US TO CREATE OUR
BENEFIT DESIGNS FOR THE
SUBSEQUENT YEAR. WE'RE IN THE
PROCESS OF CREATING THOSE
BENEFIT DESIGNS FOR TO PLAN YOUR
TWENTY TWENTY THREE. AND A DEBT
GENERALLY AGAIN NOW THAT THE
GRANULAR LEVEL GENERALLY LIKE
CONSUMER COST SHARING. A
DEDUCTIBLES AND CO PAYS MAY HAVE
TO RISE THIS YEAR. BASED ON THIS
FEDERAL GRANDMOTHERS. AB RIGHT
OKAY THANK YOU SO AND THEN JUST
OF A FOR A KIND OF A QUSTION
ANOTHER QUESTION SO WE'VE GOT
NOW ELIGIBILITY FOR- PREMIUM
SUBSIDIES FOR PEOPLE BETWEEN THE
FOUR HUNDRED. 8100% OF THE
FEDERAL POVERTY LEVEL- AND I'M
JUST CURIOUS HOW MUCH IS THAT
TRANSLATED THAT THAT THAT
SUBSIDY NOW TRANSLATING TO
PEOPLE. ACTUALLY YOU KNOW
INSTEAD OF BUYING THE BRONZE
PLAN BUYING THE SILVER PLAN
WHICH IS A MUCH BETTER PLAN. AND
THAT'S A CUROUS IS WHAT YOU'RE
SEEING THERE IN IN THIS IN THIS-
ENROLLMENT PERIOD. AND THEN- AND
THEN I MIGHT HAVE A FOLLOW UP
DEPENDING WHAT YOUR ANSWER IS.
AB WE ARE LOOKING AT OUR OPEN
ENROLLMENT DATA TO SEE EXACTLY
THAT ARE CONSUMERS. BUYING
DIFFERENT- PLANS MAKING
DIFFERENT CHOICES- THAN THEY
WERE BEFORE THE AMERICAN RESCUE
PLAN SUBSIDIES. WE DID SEE SOME
THAT MAYBE MODERATE EVIDENCE
WHEN WE STARTED WHEN WE
IMPLEMENTED CAN RESCUE PLAN LAST
SPRING AND THAT CONSUMERS. WERE
CHOOSING- THE STOVER PLANTED A
SLIGHTLY HIGHER RTE THAT WE DO
WANNA. TAKE A FULL LOOK AT THE
OPEN ENROLLMENT DATA AND THEN
GET BACK TO YOU ON THAT. OKAY
GREAT THANK YOU VERY MUCH. THANK
YOU DOCTOR WOULDN'T- DIRECTOR OF
L. I. ONE OF THE FIRST
APPRECIATE ALL THE WORK THAT
WE'VE BEEN ABLE TO DO BETWEEN
THE LEGISLATURE AND THE
ADMINISTRATION TO. BE NATION
LEADING AND HELPING TO PROVIDE
PREMIUM SUPPORT FOR MIDDLE
INCOME CALIFORNIANS AND I AM
VERY APPRECIATIVE OF WHAT
OCCURRED WITHIN THE AMERICAN
RESCUE PLAN TO- BACK FILL MUCH
OF THE RESOURCES THAT WE HAVE
PUT WITHIN THOSE SUBSIDIES
CREATING A- INCOME THRESHOLD OF
EIGHT AND A HALF PERCENT WHICH
WAS MUCH LOWER THAN WE WERE ABLE
TO ACHIEVE WITHIN. THE STATE BUT
REALLY WANTED TO MAKE SURE WE
UNDERSTOOD THE SCOPE OF THE
PROBLEM WE'RE FACING IF THE
BUILD BACK BETTER ACT IS NOT
PASSED AT THE FEDERAL LEVEL. AND
CURRENTLY MY UNDERSTANDING IS
THAT WERE LOOKING TO ESTABLISH
THE HEALTHCARE AFFORDABILITY
RESERVE FUND AT THREE HUNDRED
AND THIRTY THREE POINT FOUR
MILLION THAT'S APPROXIMATELY
WHAT WE- COLLECTED LAST YEAR IN
THE INDIVIDUAL MANDATE. BUT THE
YEARLY ANNUAL PREMIUM ASSISTANCE
WE'RE GETTING FROM THE FEDERAL
GOVERNMENT RIGHT NOW IS ONE
POINT SIX BILLION. AND SO JUST
TO PUT IT IN THE CONTEXT ABOUT
THE WHOLE WE'RE GOING TO BE AND
IF THE B. B. B. IS NOT. LAST AND
WANTS TO MAKE SURE WE ARE DOING
OUR DUE DILIGENCE IN EVALUATING
ALL OF THE OPTIONS AND SO- I
APPRECIATE THE- NATURE OF THIS
CONVERSATION BUT I BELIEVE THAT
IT'S IMPORTANT TO GET THAT
CLARITY ABOUT THE FEDERAL
FUNDING. AS WE ARE GOING FORWARD
THIS YEAR AND LOOK FORWARD TO
THAT CONTINUED CONVERSATION.
WITH THAT I WILL THANKS VERY
MUCH PANEL SIX WILL MOVE ON TO
THE PANEL SEVEN WHICH IS OUR
FINAL PANEL FOR TODAY. WHICH IS
ON CAL ARE EX AND MEDIC CAL R.
X. WE WILL HAVE THREE PRESENTERS
ON THIS PANEL. FIRST VISHAL
PARDON ME ASSISTANT SECRETARY OF
THE CALIFORNIA HEALTH AND HUMAN
SERVICES AGENCY. MICHELLE BOSS
THE DIRECTOR OF THE DEPARTMENT
OF HEALTH CARE SERVICES. IN JC
COOPER THE STATEWIDE MEDICAID
DIRECTOR AND CHIEF DEPUTY
DIRECTOR AT THE HEALTH CARE
PROGRAMS WITH THE DEPARTMENT OF
HEALTH CARE SERVICES. PLEASE
BEGIN AGAIN ASSISTANT SECRETARY. THANK YOU MISTER CHAIR MEMBERS
OF THE BUDGET SUB COMMITTEE- HEY
LOOK TODAY I'LL PROVIDE A STATUS
UPDATE ON CALAR EKSEMPEL
MAGICIAN. AS A RETAIL CAL OR X.
INITIALLY BEGAN AS THE
GOVERNOR'S BUDGET PROPOSAL. OUR
SYSTEM ALIGNMENT WITH THE
LEGISLATURE ON ON THIS CONCEPT
AND COUNTERACTS WITH LATER
CODIFIED INTO LAW VIA SENATE
BILL EIGHT FIVE ZERO AUTHORED BY
SENATOR PAM. THE LEGISLATION
REQUIRES TALENT HHS CENTER INTO
PARTNERSHIPS TO PRODUCE OR
DISTRIBUTE GENERIC PRESCRIPTION
DRUGS. AND AT LEAST ONE FORMER
DENZEL AND- BONTA NOTIFIABLE
TOPPLING FOR MANUFACTURING I'M
MORE AFFORDABLE INSULIN.
EXPRESSED SURPRISE THAT RESULTS
IN SAVINGS. SB FIVE TWO
PARTNERSHIPS ARE BROADLY DEFINED
AND INCLUDE BUT ARE NOT LIMITED
TO. AGREEMENTS FOR THE
PROCUREMENT OF GENERIC
PRESCRIPTION DRUGS BY WAY
CONTRACTS OR PURCHASING BY A
PAIR STATE AGENCY GROUP
PURCHASING ORGANIZATION
NONPROFIT ORGANIZATION OR OTHER
ENTITY. SO FAR I. CHANCE OF THE
PROTEST OUR NEXT WOMAN TENSION.
AND YOUR POLICY DESIGN AND
STRATEGY. AT THE FIRST STOP WE
OBTAINED PROJECT PARTNERS AT
JOHNS HOPKINS UNIVERSITY. THE UC
CASING CENTER FOR INNOVATION.
ALARIC'S DEVELOPED A MEMORANDUM
OF UNDERSTANDING. ONCE THE
RELATIONSHIP AND ARRANGEMENTS
FOR DATA SHARING RESEARCH AND
CONSULTATION AND- WHEN THE
PROJECT WORKERS. WE TEND SURVEYS
STAKEHOLDERS STUDY THE BROADER
LANDSCAPE OF GENERIC
MANUFACTURING. IT CHECK H.
CENTRAL PARTNERS TO ADVANCE THE
STATE'S GOALS FOR A HEALTHY
CALIFORNIA FOR ALL. WHERE
ASCENTIAL MEDICINES ARE
AFFORDABLE FOR ALL THOSE
PROPERTIES THAT- SO I'M GETTING
DESCRIBE THE PROCESS WE USED TO
DEVELOP PRACTICAL- SURVEY AND
SOME OF OUR FINDINGS. SO AND THE
DETENTION OF THE SURVEY WAS TO
DEVELOP A SELECTION FRAMEWORK
FOR UP FOR TARGET DRUGS. FOR
CHOLERA. SOMETHING CONSISTENT
WITH THE REQUIREMENTS OF SB FIVE
TO. CAL HHS. CONDUCTED A BROAD
SURVEY OF RELEVANT STAKEHOLDERS
TO PRIORITIZE THE RELATIVE
IMPORTANCE OF. NOT CERTAIN
CRITERIA- AND PUBLIC FOLDER AND
ECONOMIC CRITERIA. THIS ALLOW
INPUT FROM A BROAD ARRAY OF
STAKEHOLDERS- HAS A POST CAL
HHS- YOU KNOW OPENING OUR OWN-
OPINIONS ON THE TABLE. COMES UP-
DECIDING WHICH CRITERIA WORK
WERE MOST IMPORTANT. SO WHAT WE
DID IS ENGAGE A BROAD ARRAY OF
STATE POLICY EXPERTS CONSUMER
AND WEBER OUT GETS. OUR PUBLIC
AND PRIVATE PLANS AND PROVIDERS
- AND THAT THE MAJORITY OF THEM
ARE CALIFORNIA BASED-
APPROXIMATELY 20% OUT BASE
OUTSIDE OF- OUTSIDE OF THAT
CALIFORNIA. NO WE ARE SUPPORTERS
STAKEHOLDERS BRING ORDER-
DEVELOPING AREA THE MARKING
CRITERIA ESSENTIALLY FOUNDED TWO
BUCKETS- FIRST WITH ECONOMIC
IMPACT FACTORS- JUST TO GIVE YOU
A FLAVOR OF WHAT WHAT WHAT TYPES
OF FACTORS WE ASKED-
STAKEHOLDERS TO RECORDER. IS
INCLUDED ACOSTA PAYER HI
CONSUMER OUT OF POCKET SPENDING
HIGH PRICE INCREASES- SOBRE KIND
OF MORE ALONG THE LINES OF
ECONOMIC IMPACTS. AND THE SECOND
CATEGORY WE HAVE- ON TO THE
BUCKET OF PUBLIC HELD DOCTORS-
INCLUDED. I TRY THAT TARGETED A
LARGE TARGETPOPULATION AND- A
DRUG THAT TARGETED VULNERABLE
POPULATIONS HAMANEH TRIBECA
TREATS- HI MORBIDITY OR
MORTALITY CONDITIONS. OPEN WE
ARE STONE SURVEY RESPONDENTS TO
ORDER ALL RANK- FROM FROM ONE TO
ONE BEING THE HIGHEST RANKED
RANK ELEVEN BIGELOW EST- THE
RECORDER THAT THE ELEVEN- AREA.
WE DID AFTER GETTING THE
RESPONSES AND- WE USED AN
ALGORITHM TO IDENTIFY- HOW MUCH
WEIGHT SHOULD BE KEPT CHANGE
PARTS PERHAPS- SO WHAT WE FOUND
WAS THAT- ESSENTIALLY- ALL THE-
AMERICAN FEDERATION BECAUSE- THE
SPREAD WAS FAIRLY NARROW. THE
LOWEST. TARGET WEIGHT- WHAT
SEVEN POINT 2% ON THE HIGHEST
WAS TEN POINT 9% SO BECAUSE OF
THAT NARAL SPREAD- WHAT THIS
TOLD US IS THAT ARE ARE NONE OF
OUR CRITERIA WERE OUT OF LEFT
FIELD. WERE OFF THE MARK THEY'RE
ALL ESSENTIALLY BAR AND IT'S
JUST THAT SOME MIGHT BE A LOT
MORE THAN OTHERS- OUR FINDINGS
THE- THAT- CALAR ACTS SHOULD
TARGET DRUGS THAT AFFECT A
LARGE. POPULATION SESSION ONE
TARGET AT THAT. A LARGE
POPULATION- DRUGS THAT HAVE A
LARGE ABSOLUTE TOTAL COSTS. SO
THAT'S KIND OF A LIVING CREATURE
AND MENTIONED THE THREE THAT
ROSE TO THE TOP WORK- ONE LARGE
TARGET POPULATION TO CARE COST
THREE CONSUMER OUT OF POCKET
COSTS. IF WE CAN PROVIDE YOU
KNOW THE- THE RESULTS AND TOOK
UP. TO TWO YEARS- THE BOTTOM
FEAR ACTORS. WERE WERE MORE
RELATIVE FACTORS. USE RELATIVE
INCLUDE HIGH PRICE INCREASES-
PATRICK SHORTAGE RESCUES
EXTRATERRESTRIALS ARE KIND OF
MORE YOU KNOW RELATIVE NON
FACTOR WHEN COMPARED IT TO THE
TOP THREE FACTORS I MENTIONED
WHICH- HAD MORE TO DO WITH
ABSOLUTE TOTAL IMPACTS.
CONSTRUCTS A FROM THE SECRETARY
WERE ABLE TO IDENTIFY A LIST OF
PRETTY WOMEN EVERY TARGET TRUCKS
. ARE WE APPLIED THIS TO
UTILIZATION DATA FOR MEDIC CAL
COVER CALIFORNIA CALPERS. AND
WHAT WE'RE GONNA DO AS OUR NEXT
STEP IS. THAT'S WHAT WE CALL
POLICY AND REGULATORY FACTORS
ASSOCIATED WITH THESE DRUGS-
THEY CAN SHOP ON OUR LIST BUT IT
MAY NOT BE TECHNICALLY FEASIBLE-
TO MAKE THEM BECAUSE OF YOU KNOW
THE MANUFACTURING PROCESS SO
THERE MIGHT BE- AND ISSUES ARE
REGULATORY FACTORS WE NEED TO
TEST US COMMENTS IF THERE'S. A
WORKAROUND OR SOLUTION. AS MANY
OF YOU KNOW- INTELLECTUAL
PROPERTY LAWS THAT IS A COMPLEX
AREAS SO WE'RE GONNA BE RELYING
ON SOME OF OUR PARTNERS-
TRANSIENT TO HELP US- THERE ARE
NOW ABOUT THAT TARGET REQUESTTO
VIEW WHICH ONES ARE FEASIBLE TO
MANUFACTURE. NOW I WANTED TO
TURN TO THE HOW OF GETTING DRUGS
TO CONSUMERS. THE BEST FANS- A
FEW DIFFERENT BUCKETS- WHICH
INCLUDE STRATEGIC OPERATIONAL
MARKET ISSUES- HOW WALLER
UNIVERSITY PARTNERS- THANK US
FOR PROJECT IDENTIFYING TARGET
DRUGS- WE ALSO NEED EXPERTISE-
FOR HOW TO GET THE CARDS TO
PATIENTS. SO INTERNALLY WE'VE
LOOKED AT DISTRIBUTION MODELS
SOME OF THESE. I'M NOT A- DOCTOR
PARTNERS- DISTRIBUTION- IN THEIR
STRATEGY WHILE OTHERS DO NOT- SO
WHEN WE THINK OF DISTRIBUTION WE
ALSO KEEP IN MIND EQUITY. GIVEN
THAT- NOT ALL SIMMERS YOU
PROTECT OUR DELIVERY MODELS-
ESPECIALLY NEWER ONES LIKE MAIL
ORDER PHARMACY- WE'RE ACTIVELY
EXPLORING EXISTING CHANNELS
WHICH INCLUDE HEALTH PLANS PBMS.
WHOLESALERS AND PHARMACIES WHERE
WHERE CONSUMERS ARE USED TO
GOING TO GET THEIR DRUGS NUMBER
ALSO LOOKING AT YOUR MODELS-
WHICH ARE DIRECT TO CONSUMER. SO
THIS TYPICALLY INVOLVES THIRD
PARTY MAIL ORDER SERVICE- OFFERS
OUR- CAPABILITIES TO BE ABLE TO
DELIVER DRUGS TO PATIENTS- GIVEN
THAT THIS IS THAT THIS IS A
PARTICULARLY NUANCED AREA WE'RE
GOING TO BE ENGAGING A
CONSULTANT WITH INDUSTRY
EXPERIENCE TO HELP WITH. THESE
ISSUES I'M IN WITH TO GET THAT
CONSULTANT IN PLACE BY EARLY
SUMMER- SO NOW WILL DISCUSS
PROGRESS AND NEXT STEPS WITH
REGARD PARTNERSHIPS. ARE THE
FIRST ONE AT THE PENTAGON MANY
OF YOU THOUGHT THAT BUDGET EIGHT
PAGES- HARPER. THE PROPOSAL THAT
WILL BE COMING LATER IN THE
SPRING- YEAH THE REDUCING THE
COST OF INSULIN. SO CURRENTLY
THE MAJORITY OF CALORIE AXES
ATTENTION IS FOCUSED ON
EXPLORING PARTNERSHIPS AROUND TO
BRING AN INTERCHANGEABLE LOW
CONFIDENCE ONE PRODUCTS TO
MARKET. WITH THE OUR ACTS OF THE
CALIFORNIA RECALL RELATED PLAY
BALL- SO YOU KNOW WE'RE WE'RE
EXPLORING AND MAKING PLANS IN
THIS AREA AND WE HOPE TO SHARE
MORE DETAILS IN THE SPRING. AS
FAR AS FUTURE OPPORTUNITIES AND
CHALLENGES WHAT'S NEXT STEPS-
WE- WE THINK YOU KNOW. OVER SIX
PLUS WE HAVE A PARTNERSHIP ON
INSTALL AND WILL REALLY LAID THE
GROUNDWORK FOR- DRUG THAT WE
WANT TO TARGET THE FUTURE PENCIL
IN AS A AS A BIOSIMILARS IS MORE
COMPLICATED. COMPLEX WE THINK
THIS BILL WILL MAKE IT EASIER.
TO DO OTHER DRUGS SUCH A SMALL
MOLECULE DRUGS EXCEPT HER PAIN
POINT MEDICATIONS. ARE SO HARD.
WHAT TARGET OTHER SMALL KILL
DRUGS- BETTER ACTRESS FOR
SHORTAGE OR THEIR HIGH PRICE OR
SPECIAL. GENERICS ARE HIGH COST
. AND THEN WHAT WE ALSO CONTINUE
TO EXPLORE THE GENERIC
MANUFACTURING SPACE BAR HOPPING
INFORMATIONAL MEETINGS WITH.
SMALL PHARMACEUTICAL COMPANIES
ARE NONPROFIT AND THEN START UPS
BETTER- ARE TAKING ADVANTAGE OF
NEWER TECHNOLOGY TO REDUCE COSTS
. THAT CONCLUDES MY- REMARKS AND
I'M HAPPY TO TAKE ANY QUESTIONS
. THANK YOU NEXT WE'LL HEAR FROM
DIRECTOR BOSS. GOOD AFTERNOON
CHAIR AND MEMBERS I'M I'M HERE
TO SPEAK ABOUT THAT THE MEDICARE
PROGRAM I JANUARY FOR THE
CHARACTER LAUNCHED WE
TRANSITIONED ALL MEDICAL
PHARMACY SERVICES FOR MANAGED
CARE TO KEEP OUR SERVICE. WITH
MEDIC HELL OUR EXIT WE ARE
STANDARDIZING THE MEDICAL
PHARMACY BENEFITS UNDER ONE
STATEWIDE DELIVERY SYSTEM THIS
MEANS THAT NO MATTER WHAT COUNTY
YOUR FIRST LEFT AND THAT THE
SAME ACCESS TO THEIR
PRESCRIPTIONS IF POSSIBLE.
IMPROVING ACCESS TO PHARMACY
SERVICES WITH THE PHARMACY
NETWORK THAT INCLUDES THE VAST
MAJORITY OF THE STATE'S PHARMACY
. CENTRALIZING PHARMACY POLICY
TRANSACTION THE REIMBURSEMENTS
ULTIMATELY LEADING TO GREATER
EFFICIENCY FOR PHARMACIES
PRESCRIBERS AND THE MEDICAL
PROGRAM. AND STRENGTHENING
CALIFORNIA'S ABILITY TO
NEGOTIATE STATE SUPPLEMENTAL
DRUG REBATES FROM PHARMACEUTICAL
MANUFACTURERS. IN ADDITION
BETTER CHARACTERS EXPECTED TO
RESULT IN ONGOING ANNUAL SAVINGS
OF EIGHT HUNDRED TWENTY SEVEN
MILLION TOTAL FUNDS APPLE
IMPLEMENTATION THIS IS JUST LIKE
THE REDUCTION IN OVERALL
PHARMACY SPENDING IN
ADMINISTRATIVE COSTS AND
INCREASES IN OUR SUPPLEMENTAL
AND OTHER REBATES. WHAT THE
TRANSITION OF THE MEDICAL
PHARMACY BENEFIT OF MORE THAN
FOURTEEN MILLION MEDICAL MEMBERS
TO A SINGLE DELIVERY SYSTEM WE
ARE AWARE SOME ADDITIONAL
SIGNIFICANT IMPLEMENTATION
CHALLENGES AND CONCERNS AND WE
ARE ACTIVELY WORKING TO ADDRESS
. SOME OF THESE CHALLENGES
INCLUDE EXCESSIVE CALL CENTER
WAIT TIMES DELAYS AND PRIOR
AUTHORIZATION PROCESSING AND
SOME IMPROPER CLAIMS DENIALS.
AND CHALLENGES WITH MAGELLAN'S
DATA AND REPORTING. THE EX YES
WORKING DILIGENTLY WITH MAGELLAN
TO ADDRESS THESE ISSUES. OVER
THE WEEKEND CHANGES WERE MADE
THAT REDUCE THE PRIOR
AUTHORIZATION BACKLOG BY ABOUT
FIFTY PERCENT. AND ARE EXPECTED
TO REDUCE THE INCOMING PRIOR
AUTHORIZATION REQUESTS BY 80% WE
WILL KNOW MORE IN THE NEXT FEW
DAYS ON THE INCOMING PEACE.
REDUCE THE POINT OF SALE CLAIM
REJECT FROM ABOUT 20% LAST WEEK
TO ABOUT 8% THIS MORNING.
ADDITIONALLY WE EXPECT THESE
CHANGES TO DECREASE CALL CENTER
VOLUMES ABOUT 70% FOR CALL
CENTER INCREASE ARE RELATED TO
PRIOR AUTHORIZATION.
TRANSFORMATIONAL POLICY AND
IMPLEMENT IMPLEMENTATION BRING
SIGNIFICANT CHANGES THAT ARE
EXPECTED TO RESULT IN SOME
DISRUPTION. ART MEANT AND OUR
CONTRACTOR MAGELLAN REMAIN
COMMITTED TO SERVING OUR
MEDICARE BENEFICIARIES THAT THE
UP MOST IMPORTANCE ALSO
DEFECTIVE INEFFICIENT OPERATIONS
INCLUDING ROBUST COMMUNICATION
OUR PARTNERS AND BENEFICIARIES.
I WILL NOW TURN IT OVER TO CASEY
KUMAR STATE MEDICAID DIRECTOR TO
OUTLINE IN MORE DETAIL SOME OF
THE ACTIONS THE STATE TAKING AND
TO ADDRESS THESE CHALLENGES AND
YOUR QUESTIONS IN THE AGENDA.
GOOD AFTERNOON SO AS A DIRECTOR
BOB OUTLINED IMPLEMENTATION THE
MEDICAL OR ACT INCLUDES A NEW
FORMULARY NEW UTILIZATION
MANAGEMENT PROTOCOLS NEW
REIMBURSEMENT METHODOLOGIES AND
A NEW SYSTEM FOR FOURTEEN
MILLION MEMBERS AND TENS OF
THOUSANDS OF PROVIDERS
PHARMACISTS AND HOSPITALS STATE
WIDE I THINK IT'S FAIR TO SAY
THIS ALONE IS A MASSIVE CHANGE
HOWEVER DURING A PUBLIC HEALTH
EMERGENCY IT BRINGS TO BEAR EVEN
LARGER IMPACT. AND WHILE WE'RE
CONFIDENT MANY CALORIE ACTS WILL
YIELD THE BENEFITS DISCUSSED BUT
WE ARE AWARE OF THE MADWOMAN
TEACHING CHALLENGES AND I WILL
WALK THROUGH WHAT WE ARE DOING
TO RESOLVE THOSE WALLS OF WHAT
THOSE CHALLENGES ARE. HELLO
OTHER. FOURTH MEDIC CALORIE HAS
PAID OVER ELEVEN MILLION CLAIMS.
TOTALING APPROXIMATELY ONE POINT
THREE BILLION DOLLARS THE FIRST
CHECK RIGHT OF WAS INITIATED
SUCCESS WE ARE WITH PAYMENTS
GOING TO ALL PHARMACIES ON
JANUARY TWENTY EIGHTH AS PLANS.
YET AS WE SIT HERE ARE CLEARLY
FIVE WEEKS INTO OPERATIONS
MAGELLAN ARE MANY CALORIES
BENDER I'M HAS REALLY STRUGGLED
WITH THE OFFER SERVICE
OPERATIONS. INCLUDING THE LONG
HOLD WAIT TIMES. AND DELAYED
PRIOR AUTHORIZATION TURNAROUND
TIMES. THE DEPARTMENT HAD PUT IN
PLACE DAILY MEETINGS TO DISCUSS
ISSUE MANAGEMENT HIRING
TRAINING- AS WELL AS THE OVERALL
SYSTEM DESIGN EDITS NEEDED. TO
MITIGATE THE CURRENT SITUATION
THAT WE ARE AT. REGARDING LONG
HOLD TIMES AT THE CUSTOMER
SERVICE CENTER AS OF FEBRUARY
FIRST MAGELLAN HAS ANSWERED OVER
EIGHTY ONE THOUSAND CALLS. 60%
OF THOSE CALLS ARE FOR
BENEFICIARIES AND 40% OF OUR
PROVIDERS. MAJORITY OF CALLERS
ARE OPTING FOR A VIRTUAL HOLD
CALL BACK. MAGELLAN FORECASTED-
CALL CENTER VOLUMES TO BE AROUND
FORTY THOUSAND CALLS THE WEEK OF
WHICH EQUATED TO AROUND TWO
HUNDRED AND TWENTY F. T. JANUARY
FIRST MAGELLAN HAD TWO HUNDRED
THIRTY FIVE F. T. E.'S AVAILABLE
FOR CALLS. DURING WEEK ONE
ACTUAL CALL VOLUMES CAME IN ONLY
11% HIGHER THAN PROJECTIONS.
HOWEVER THE GERMANS FORECASTED
AVERAGE HANDLING TIME WAS
INACCURATE. WITH THE ACTUAL
COMING IN OFF EIGHTY FIVE TWO
HUNDRED AND 60% HIGHER. THAN
PROJECTED UP WHICH HAS
NEGATIVELY IMPACTED OUR ABILITY
TO HANDLE CALL VOLUMES WITH THE
CURRENT STAFFING RESULTING IN AN
AVERAGE 30% ABANDONMENT RATE.
AND OFTEN THREE TO FIVE HOUR
WAIT TIMES FOR THOSE CALLS. THIS
WAS FURTHER EXACERBATED WITH ON
A CONCERT RESULTING IN A VERY
HIGH ABSENTEEISM WITHIN THEIR
STAFF. ON ANY GIVEN DAY DURING
THE FIRST TWO WEEKS OF JANUARY
THE ACTUAL AVAILABLE STAFF TO
ANSWER CALLS WAS AROUND A
HUNDRED AND TWENTY F. T. E.'S.
OF THE ORIGINAL TWO HUNDRED
TWENTY HIRED ORDEAL ABILITY ON
THE CALL CENTER. BY MAGELLAN
ANTICIPATED LEARNING CURVE IN
SUPPLEMENTAL TRAININGS IN THEIR
FORECAST LARGE ABSENTEE
SIGNIFICANTLY IMPACTED THEIR
OPERATIONS. TO RESOLVE THESE
HOLD TIMES THE FOLLOWING ACTIONS
HAVE BEEN TAKEN AND COMMITMENTS
HAVE BEEN MADE BY THE GEL AND- A
DH CS IS ACTUALLY BROUGHT ONLINE
IT'S MEDICAL CALL CENTER TO
ASSIST WITH CALLS TO REDUCE THE
WHOLE TIMES. MAGELLAN HAS
COMMITTED TO ADDING A HUNDRED
TWENTY F. EASE BY THE END OF
FEBRUARY AN ADDITIONAL SEVENTY
BY THE END OF MARCH- WE ARE AT A
FOCUSING ON INCREASING TRAINING-
AT MAGELLAN IS WORKING TO
IMPROVE THE QUALITY. REALLY THE
SPEED A FACT TO BE HONEST WITH
YOU THE QUALITY OF CALLS ARE
ANSWERED HAVE BEEN PROVEN TO BE
PRETTY HIGH- BUT ADDITIONAL
TRAINING REALLY NEEDS TO BE
FOCUSED ON TO BRING THE
RESOLUTION FASTER DECREASING THE
OVERALL. YOU KNOW WAIT TIMES OF
THOSE CALLS COMING IN ARE WE
ALSO WORKING TO IMPLEMENT
POLICIES THAT STREAMLINED THE
EXPERIENCE FOR BENEFICIARIES AT
THE PHARMACY. TO DECREASE THE
CLAIM DENIALS IN THE PRIOR
AUTHORIZATION REQUIREMENTS IN
ORDER TO REDUCE THE IMPACT CALL
VOLUMES. REGARDING THE PRIOR
AUTHORIZATION TURNAROUND TIMES
AS OF FEBRUARY FIRST MAGELLAN
HAS RECEIVED OVER NINETY FIVE
THOUSAND PRIOR AUTHORIZATIONS.
OF MAGELLAN FORECASTED AROUND
SIX THOUSAND FIVE HUNDRED PER
DAY. AND YEAR ROUND A HUNDRED
AND SIXTY FOUR AFTER BASED ON
THEIR PROJECTIONS. HOWEVER I
JANUARY FIRST MAGELLAN HAD OVER
A HUNDRED SIXTY THREE YOU O
JUST ONE SHORT OF THEIR
PROJECTIONS- DURING THAT FIRST
WEEK THE CALL AT THE PA BARGAINS
RAFI SIGNIFICANTLY LOWER THAN.
FORECASTED COMING IN ON A
RATHER. AVERAGE ABOUT THREE
THOUSAND ONE HUNDRED. I'M
MOREOVER DO YOU CS THAT
IMPLEMENTED A HUNDRED AND EIGHTY
DAY GRANDFATHERED PRIOR
AUTHORIZATION PROCESS FOR
MEDICATIONS- WITH THE PRIOR
APPROVAL- OR DISPENSING RECORD
TO MITIGATE THE EXPECTED HIGH A
PRIOR AUTHORIZATION VOLUME WITH
THIS TYPE OF CHANGE. HOWEVER
PRIOR AUTHORIZATION TURNAROUND
TIME IS CURRENTLY GOING BEYOND
THE REQUIRED TWENTY FOUR HOURS
IT IS CURRENTLY TRENDING SEVENTY
EIGHT. OF AGING ARE WE COLLEGE
THIS IS UNACCEPTABLE. TO
INCREASE THAT TURN AROUND TIME
WITHIN TWENTY FOUR HOURS THE
FOLLOWING ACTIONS HAVE BEEN
TAKEN IN COMMITMENTS HAVE BEEN
MADE US SINCE- JANUARY ELEVENTH
VH THE AESTHETIC NEEDED I'M AN
ADDITIONAL THIRTY ONE DH CS FTZS
TO PROCESS PRIOR AUTHORIZATIONS.
OF MAGELLAN HAS COMMITTED TO
ADDING SEVENTY TWO EAST BY THE
END OF FEBRUARY FOR PRIOR OFF AN
ADDITIONAL FIFTY FIVE BY THE END
OF MARCH. ADDITIONALLY THERE WAS
DEVELOPMENT OF A SHORT TERM
PRIOR AUTHORIZATION MITIGATION
STRATEGY I TO ADJUST VARIOUS
EDITS- AND WAR. OF COURSE BUT
THE PRIMARY FOCUS ON REDUCED
MEMBER HARP AND SAFETY AS WELL
THE BALANCE OF PROGRAM
INTEGRITY. ARE THIS HAS RESULTED
AS OUR DOCTOR BOSS MENTIONED-
CORRECTOR. OF BOSS MENTIONED-
LOOKING AT 80% REDUCTION OF
INCOMING PRIOR AUTHORIZATION
VOLUME IN A 50% REDUCTION OF THE
BACKLOG AS OF THIS MORNING. I DA
CS. AN EXPANSION OF THE CURRENT
POLICY ON EMERGENCY FELL FROM
FIFTY TWO HOURS THE FOURTEENTH
DATE. ARMISTICE CAN EMERGENCY
BILL ANY MEDICATIONS AFTER
DISCRETION WITHOUT PRIOR
AUTHORIZATION IT WITH THE GEAR
THAT THE PHARMACIST WILL BE PAID
THIS WILL ENSURE THE ACCESS TO
CARE ISSUES ARE MITIGATED AND
START TERM ALLOWING TIME FOR
PRIOR AUTHORIZATION AND OR OTHER
CREDIT ALL AGES ARE JUST MEANT
TO BE NAY. WITH A BACKLOG OF
MAGELLAN HAS BEEN FOCUSING ON
THE FOCUS CASES THANK YOU FIRST
AND HAD PARKED OUT CLINICAL
STAFF TARGET REVIEW OF FIVE
SENSITIVE DRUG CLASS. LASTLY DO
YOU SEE S. THE NOGEN ARE
ACTIVELY ENGAGED IN ADDITIONAL
PLANNING AND SUPPORT EFFORTS
NEEDED FOR THE JULY FIRST AND
DATE OF THE HUNDRED EIGHTY DAY
TRANSITION POLICY. ULTIMATELY
THE DEPARTMENT MAGELLAN HAVE
BEEN WORKING TO RESOLVE REPORTED
ISSUES. AND HAVE SEEN A
REDUCTION IN THE POINT OF SALE
CLAIM REJECTS FROM ACROSS THE
20% LAST WEEK. TO ABOUT 8% THIS
MORNING. OTHER ITEMS ARE
RESULTING IN HIGH CALL VOLUMES
AND REPORTED IN FIRE EASE-
INCLUDE THINGS LIKE A LACK OF
HISTORICAL DATA FROM THE
MEDICAID MANAGED CARE PLANS AND
THEIR SUB DELEGATED FIFTIES.
NEGATIVELY IMPACTING THE
EFFECTIVENESS OF THE HUNDRED AND
EIGHTY DAY TRANSITION POLICY.
FOR EXAMPLE ONE OF OUR PLANS
ESTIMATED THEY DID NOT PROVIDE
THE H. THE S. THE TENSION THE
MILLIONS OF CLAIMS PRIOR TO WORK
GO LIVE. IN JANUARY ALONE
MISSING DATA FROM THE PLANTS HAS
IMPACTED ANYWHERE FROM FORTY TO
FIFTY THOUSAND THAT A CALPERS WE
ARE ACTIVELY WORKING WITH OUR
MANAGED CARE PLANS. TO COME TO A
RESOLUTION AND GET THAT DATA
INTO OUR SYSTEMS. CHIEF MOVING
EFFECTUATE WHAT WE'RE HOPING
WITH A FOUR HUNDRED EIGHTY EIGHT
TRANSITION POLICY. ADDITIONALLY
ARE COORDINATION OF BENEFITS
BURKE WHAT OTHER HEALTH COVERAGE
ARE YOU KNOW WE HAVE BEEN
ENFORCING THAT- MEDICAID AS THE
PAIR BLOCK RESORT WITHIN THE
SYSTEM- AND SO THAT HAS. CREATED
A NUMBER OF CALLS. A WE ALSO ARE
ARE IN THE PROCESS OF. THERE WAS
A CHANGE IN FORMULAR FOR SOME
PEOPLE FOR EXAMPLE A CHANGING
COVERED OVER THE COUNTER
MEDICATIONS AND PROVIDER
DIFFERENT COMING FOR MIGLIOR
WITH THE STATE'S CONTRACT DRUG
WITH ITS RESULT IN A NUMBER OF
CALLS IN ENQUIRING TO UNDERSTAND
HOW TO USE THE STATE'S CONTRACT.
WITH PROVIDERS THAT ARE NOT AS
FAMILIAR ARE THERE WAS ALSO
CHANGES IN REGARDS TO
REIMBURSEMENTS FROM WHAT THEY'RE
BEING PAID PREVIOUSLY UNDER
THEIR MANAGED CARE PLAN CONTRACT
TO THE FOR A FEE FOR SERVICE
CLAIMS REIMBURSEMENT ON
INCREASING CALLS ON THE PRIORIES
IN REGARDS TO THE BOTTOM WELL.
ADDITIONALLY THERE HAVE BEEN A
NEW SYSTEM THAT WAS ROLLED OUT
SO CLEARLY AS PROVIDERS OR
PHARMACIES ARE GETTING OUR
STANDARD WE GET CODES- OUR
SYSTEM DOES REQUIRE CERTAIN
THINGS TO BE TOUCHED BY A
PHARMACIST- IS THAT THERE HAS
BEEN SOME COMPLAINTS OF
ADMINISTRATIVE BURDEN AND WE
ARE- QUICKLY LOOKING INTO HOW WE
CAN MITIGATE- SOME OF THOSE OF
THOSE PIECES THAT THE SYSTEM. R.
AND LAST WEEK IN REGARDS TO YOU-
VIRUS COMING IN OF ONE OF THE
LARGEST PHARMACY CHAINS IN
CALIFORNIA DISCONTINUED THEIR
HOME DELIVERY SERVICE A JANUARY
FIRST I WHICH HAS IMPACTED US
SOME ACCESS TO MEDICATIONS FOR
THOSE NEEDING HOME. DELIVERY IN
CERTAIN PARTS OF THE STATE. WE
ARE. WORK TO IN THAT ALL
IMPLEMENT. ISSUES WITH MEDIC CAL
OUR ACTS ARE DRESSED. A RESULT-
REALLY GROUP BECAUSE IS BEING
ESTABLISHED OF MAGELLAN A MUST
BETTER- HAS PUT. A PLAN IN PLACE
TO ENSURE THAT SERVICE
OPERATIONS ARE PERFORMING AT THE
APPROPRIATE LEVEL. AND WE
MONITOR THAT ON A DAILY BASIS.
FURTHER WE HAVE REQUESTED
MAGELLAN SIGNIFICANTLY
STRENGTHEN OUR EDUCATION AND
OUTREACH ACTIVITIES ACROSS THE
ENTIRE STATE WITH ALL
STAKEHOLDERS. AND ENHANCE THEIR
DATA REPORTING TO THE DEPARTMENT
TO ENSURE THAT WE HAVE ALL THE
INFORMATION WE NEED TO HOLD THEM
ACCOUNTABLE AT THIS TIME R.
LASTLY DH YES WILL INSURE HER
MAGELLAN IS HELD ACCOUNTABLE FOR
ALL CONTRACTUAL PERFORMANCE
STANDARDS. ARE AND THEIR CURRENT
DEFICIENCIES. ARE THERE NOW IT
WILL TRANSITION INTO SOME OF THE
QUESTIONS REGARDING THE
SUPPLEMENTAL PAYMENT ALL. OF THE
DEPARTMENT- IS NOT PROPOSING TO
AUGMENT THE ANNUAL HUNDRED AND A
FIVE MILLION DOLLAR TOTAL FUND-
ADDS ORIGINALLY PROPOSED IN THE
SUPPLEMENTAL PAYMENT ALL. WE
HAVE SUBMITTED THE STATE PLAN-
TO YOU- CMS AND IT EXPLICITLY
INCLUDES- THE ANNUAL AMOUNT OF A
HUNDRED BILLION OTHER DEPARTMENT
ANTICIPATES APPROVAL OF STATE
PLAN AMENDMENT IN THE FIRST
QUARTER. OF THIS CALENDAR YEAR.
HE DID CAN BE IN A STAKEHOLDER
WORK GROUP TO ASSESS THE IMPACT
OF TO THESE CLINICS. THE
WORKGROUP TOPICS INCLUDED THE
ELIGIBILITY CRITERIA FOR RECEIPT
OF THE SUPPLEMENTAL PAYMENT. THE
AVERAGE AMOUNT OF FULL FUNDING
AVAILABLE FOR EACH FISCAL YEAR
OTHER CRITERIA FOR ALLOCATING
THE POOL OF FUNDING AMONG THE
QUALIFYING AND HOSPITALS REPORT.
UNITY CLINICS INCLUDING THE
TIMING FREQUENCY AND AMOUNT OF
THE RESULT SACRAMENTO PEMEX.
APPROXIMATELY FIVE HUNDRED AND
FIFTEEN NON HOSPITAL THREE FORTY
CLINICS I WOULD BE ELIGIBLE TO
PARTICIPATE IN THE SUPPLEMENTAL
PAYMENT FOR. I WOULD DOUBLE
ENTITIES MUST APPLY AND CERTIFY
THEIR ELIGIBILITY TO PARTICIPATE. IN THE PROGRAM TO THE
DEPARTMENT. IN SUPPLE PAYMENT.
OF WILL BE PAID A- OF PURPOSES
PROVIDED BY ELIGIBLE CLINICS
DURING THE PROGRAM PERIOD. THE
FIVE O'CLOCK NEWS THAT
SUPPLEMENTAL PAYMENTS WILL BE
CALCULATED BASED ON THE TOTAL
BILL AMOUNT IF I DID BY THE
NUMBER OF VISITS PROVIDED WITHIN
THE TECH THAT SERVICE. BASED ON
THIS WORK THE DEPARTMENT
BELIEVES THE HUNDRED FIVE
MILLION DOLLAR SUPPLEMENTAL
PAYMENT IS APPROPRIATE- HERE TO
CONTINUE UNDERSTANDING ANY
FISCAL IMPACT OF MEDICARE
CORRECT ON THE CLINICS AND OTHER
PROVIDERS. THE DEPARTMENT IS
MONITORING PPS COACHING REQUEST
FROM MATTHEW EXCEEDS THE
DETERMINE WHETHER CLINICS ARE
MODIFYING THE REIMBURSEMENT THEY
RECEIVE IN RESPONSE TO. THAT
TALLERES. THIS CONCLUDES OUR
COMMENTS AND HAPPY TO ANSWER ANY
QUESTIONS. THANK YOU VERY MUCH-
I WILL NOT BRING IT UP TO THE
DENTIST. TO SEE IF ANY MEMBERS
HAVE QUESTIONS. SEEING NONE OF.
THEM ASSEMBLY. BLANCA RUBIO THIS
IS MORE OF A COMMA RATHER THAN
QUESTION I JUST WANT TO SAY THAT
I REALLY APPRECIATE YOU BEING
FORTHCOMING ABOUT WHAT'S-
ACTUALLY HAPPENING I THINK THAT-
IT'S REALLY IMPORTANT THAT WE
ARE HONEST ABOUT WHAT'S GOING ON
SO THAT WE CAN HELP AND- YOU
KNOW I'VE HAD THESE
CONVERSATIONS AND- YOU KNOW
PRIOR- HOLD. HEARINGS WHERE YOU
KNOW WHEN WE ASK A QUESTION
SOMEBODY'S LIKE- EVERYTHING'S
FINE WILL WE KNOW IF IT'S NOT
FIND THAT THERE'S NOTHING THAT
THE COMMITTEE CAN DO TO ASSIST I
JUST WANT TO POINT THAT OUT THAT
I REALLY APPRECIATE YOU BEING
FORTHCOMING ABOUT WHAT'S
HAPPENING AND- LOOK FORWARD TO-
TO SEEING HOW WE CAN RESOLVE
THESE ISSUES AND IT YOU KNOW
WHAT WE CAN DO TO HELP- YOU
THROUGH THIS PROCESS AS WELL.
THANK YOU. THANK YOU I'M- I
WILL- SPEND A LITTLE TIME TRYING
TO. UNDERSTAND SOME OF THE
CONTRACTUAL PERFORMANCE
STANDARDS- THAT WE HAVE WITH.
MAGELLAN HI- KEPT NOTICING
DURING THE RIDE UP WITHIN THE
AGENDA THAT. OUR STATE STAFF
BOTH FOR THE PHARMACY BENEFIT
STAFF IN THE MEDICAL. CALL
CENTER WERE BEING LOANS TO
MAGELLAN DURING OUR ROLL OUT.
AND HAVE SOME. CONCERNS LOOKING
AT THE F. T. E. IS THAT THEY'RE
NEARLY DOUBLING THOSE LEFTIES
OVER THE NEXT TWO MONTHS. TO
JUST. ATTEMPT TO UNDERSTAND WHAT
THOSE CONTRACTUAL STANDARDS
WERE. IN ADVANCE. SO THAT WE CAN
ENSURE THEY ARE- MEETING THOSE
STANDARDS I'M HOPING YOU CAN.
SPEAK A LITTLE BIT ABOUT THOSE.
IF YOU CAN'T. MICHELLE DO YOU
WANT ME TO TAKE SOME OF THOSE.
SO I THINK THERE'S GOING TO BE-
A VARIETY OF STANDARDS I THINK
THE MOST CRITICAL ONE THAT WE
ARE FOCUSED ON BECAUSE I HAVE TO
DEAL WITH- INDIVIDUALS BEING
ABLE TO GET THEIR MEDICATIONS
TIMELY I'M IS REALLY THE
TURNAROUND OF PRIOR
AUTHORIZATION WITHIN TWENTY FOUR
HOURS- AND THAT IS IN A STATE
LAW THAT A REQUIREMENT IN STATE
LAW FOR THAT TWENTY FOUR HOUR
TURNAROUND. ON AND AS MENTIONED
THERE THERE CURRENTLY- GREATLY
EXCEEDING THAT WITH AROUND THE
SEVENTY EIGHT AGING OF THAT
PRIOR OFF. ON THERE ARE ALSO A
VARIETY OF THE- PERFORMANCE
IMPROVEMENTS AROUND THE CALL
CENTER- THINK BEING AT A HOLD
TIMES AND VARIOUS PIECES I'D BE
MORE THAN HAPPY TO GET YOU A
LIST OF THE CONTRACT FOR. YOU
KNOW- PERFORMANCE INDICATORS OF
THE THAT YOU ARE AWARE OF THOSE
AND HOW WE WILL BE TRACKING
THOSE OVER. THE COMING WEEKS IF
THAT WOULD BE HELPFUL- IT WOULD
I ALSO. PLEASE GO ORDER. SURE I
WOULD BAD- AS PART OF THEIR
INVOICE DID THIS. BASEBALL HAVE
TO LIST THEIR THE METRICS AS
THEY HAVE FOUND AT THE END OF
THE MONTH AND THAT'S WHAT WE
WILL GO THROUGH KIND OF. ODD
THAT THE DISCUSSION ON AND
HOLDING THEM ACCOUNTABLE FOR
THEIR THEIR PERFORMANCE
STANDARDS WE WILL BE RECEIVING
THAT AND THEN IN THE COMING
DAYS. I REALLY DO APPRECIATE
YOUR ATTENTION TO DETAIL AS WE
WERE IMPLEMENTING THIS AND-
IDENTIFYING TO BE ABLE TO
PROVIDE F. T. E. IN REAL TIME.
BUT I ALSO WANT TO MAKE SURE
THAT THE CONTRACTED THIRD PARTY
HOLD SOME RESPONSIBILITY TOWARDS
THOSE F. T. E.'S. THAT WE'VE
BEEN- SUPPLEMENTING- THROUGH
THIS. INITIAL IMPLEMENTATION AND
WANT TO MAKE SURE THAT THAT IS A
PART OF THE CONVERSATION GOING
FORWARD. EVEN IF THEY'RE GOING
TO INCREASE THEIR F. T. E.'S BY
NEARLY DOUBLE OVER THE NEXT TWO
MONTHS. WANT TO MAKE SURE THAT
THE STAFF WE WERE- PROVIDING OR-
ALLOWING THEM TO USE TO GET
THROUGH THESE GROWING PAINS. ARE
ARE. APPROPRIATELY- THE-
RESOURCE BY THE THIRD PARTY
VENDOR- AS THEY AS AS THAT'S
WHAT I BELIEVE OUR CONTRACT-
SHOULD HAVE STATED AND SO. I'M
HOPEFUL THAT I CAN FOLLOW UP ON
THAT AS I WOULD REALLY LIKE TO
BE ABLE TO GET AN UPDATE. AND
FOLLOW UP ON WHEN WE ARE ABLE TO
LOWER THOSE PRIOR AUTHORIZATIONS
BELOW TWENTY FOUR HOURS AGAIN
HI- AND- FLEXIBLE AND REASONABLE
TO GIVE SPACE TO WORK THROUGH
THESE GROWING PAINS BUT- ALSO
NOW WE HAVE CERTAIN STANDARDS TO
UPHOLD FOR. OUR PATIENTS AND
WOULD LIKE YOUR CONTINUED
ATTENTION- BUT- MAYBE I'LL JUST
BROADLY ASK HOW HOW SOON DO YOU
THINK. OR EXPECT THESE
CHALLENGES TO BE RESOLVED IT
SEEMS LIKE WE HAVE A TWO MONTH
PLAN HERE FOR FEBRUARY AND
MARCH. BUT CAN YOU GENERALLY-
COMMENT ON WHAT YOUR
EXPECTATIONS ARE FOR THE NEXT
TWO MONTHS. I WOULD SAY IN THE
IN THE NEXT. TWO DAYS WHEN WE
UNDERSTAND HOW THE CHANGES OVER
THE WEEKEND WILL REALLY IMPACT
OUR INCOMING PRIOR AUTHORIZATION
REQUESTS I THINK BY THAT- YOU
KNOW THE CONVENE WEEKS OR SO A
WEEK OR SO WE SHOULD KNOW MORE
ABOUT HOW. THE CHANGES WE
IMPLEMENTED THIS THIS WEEKEND
REALLY IMPACT THE KIND OF THE ON
GOING WORK WELL AS WE THINK
THROUGH THE LONG TERM PLAN AND I
WILL SAY. WE ARE DEFINITELY I
HAVE MADE IT CLEAR TO OUR
CONTRACTOR THAT AS PART OF THEIR
WORK PLAN DEVELOPMENT THEY NEED
TO ACCOUNT FOR KIND OF BUT- THE
DHS STAFF REALLY NOT BEING PART
OF THAT KIND OF THEIR ON GOING
SOLUTION AND SO WE ARE. I'M
GONNA MONITOR THAT VERY CLOSELY.
YEAH THING I WOULD ADD IS WE'VE
ALSO MADE IT VERY CLEAR TO YOUR-
APPOINT THAT THEREWILL BE- YOU
KNOW POTENTIAL WITHHOLDS FROM
THE- INVOICE TO ACCOUNT FOR THE
CLASS. THAT THE DEPARTMENT HAS.
ON HAD TO BEAR. A LOT FOR THE
ACT HE'S AS WELL AS UP FOR BOTH
ON THE CUSTOMER SERVICE SIDE AS
WELL AS THE PRIDE ROCKSLIDES. I
JUST WANTED TO BE REALLY CLEAR.
AND REGARD THAT IF WE WERE
BEFORE THEY GOT. YOU ON OUR
EXPECTATIONS WITHOUT FIRST
INVOICE COMING IN FROM THE
JALAN. THANK YOU VERY MUCH I'M
FINE FINAL QUESTION. OF IT IT'S-
YOU STATED THAT THE HAND WHEN
TIMES WERE LONGER BY EIGHTY FIVE
TO A HUNDRED. PERCENT THAT'S
THAT'S NEARLY TWICE AS LONG AND
I'M WONDERING IF THERE WAS
ANYTHING. SYSTEMATICALLY THAT
LED TOWARDS THOSE LONGER
HANDLING TIMES OR WHY THAT- ONE.
PARTICULAR DATA POINTS WAS- NOT
CONSISTENT. THROUGH
IMPLEMENTATION. YEAH I THINK
WHAT WE'RE SEEING MOSTLY IS
JUST- THAT LARGE NUMBER OF STAFF
COMING ON IN THE TRAINING NEEDED
I'M MAKING SURE THAT THEY'RE
EASIER TOOL KITS ARE FOR THEM-
CRITERIA. OF WHAT WE'VE DONE AS
WE CONTINUE TO DO AGAIN IS THE
DECISION TO OR ARE WITHIN THE
PRIOR AUTHORIZATION IS PROBABLY
OVER ENGINEERED IN THE LITTLE
TOO COMPLICATED- SO WE ARE
WORKING TO STREAMLINE THAT. OF
WHICH WE ARE HOPING- THAT THAT.
OUR MAGELLAN IS WORKING
STREAMLINED THAT I SHOULD SAY-
AND WE'RE HOPING THAT THAT WILL
RESULT IN YOUR REVIEWS- AND THEY
HAVE ON THE JOHN HAS BROUGHT ON.
A LOT OF ADDITIONAL RESOURCES TO
ENSURE THAT IN FACT WITHIN JUST
A WEEK OF THE THROUGH PUT- A
SIGNIFICANT INCREASE FROM WHAT
WAS BEING SEEN AS AROUND. EIGHT
HUNDRED TO NEARLY THREE THOUSAND
OFFER YOU PUT ON THOSE PRIOR OFF
THE WERE HOPING AT THESE
TOOLKITS. ACTIVISION ADJUSTABLE
ACHIEVEMENTS ARE MADE IT WILL
ALLOW FOR A HIGHER THROUGHPUT
THAN WHAT WE ARE SEEING IN THE
EARLIER WEEKS WHICH REALLY
ATTRIBUTED TO THE SIGNIFICANT
BACKLOG WE'VE BEEN TRYING TO DIG
OUT OF. A COLLECTIVELY- AND SO
WE'RE HOPEFUL THAT WE WILL BE
ABLE. TO SEE IMPROVEMENTS AS
BEING A PART. I THANK YOU VERY
MUCH FOR ALL OF THAT AND I- LOOK
FORWARD TO THE UPDATES ON THE
CHANGES THAT WERE MADE THIS PAST
WEEKEND THE- BETTER UNDERSTAND.
HOW THE IMPLEMENTATION WILL ROLL
OUT OVER THE NEXT. COUPLE MONTHS
AND- WOULD LIKE TO THANK ALL OF
OUR PANELISTS FROM TODAY. AND IF
THERE ARE NO ADDITIONAL MEMBERS
COMMENTS OR QUESTIONS WE WILL
NOW BEGIN PUBLIC COMMENT. AS A
REMINDER WE WELCOME PUBLIC
COMMENT ON ANY ISSUE ON THE
AGENDA. WE HAVE ASUBSTANTIAL
NUMBER OF PEOPLE WHO WOULD LIKE
TO PROVIDE PUBLIC COMMENT. AND
THEREFORE I WANT TO URGE YOU TO
KEEP YOUR COMMENTS BRIEF SO WE
CAN HEAR FROM EVERYONE. WE WILL
START WITH ANY. PERSON ANY IN
PERSON PUBLIC COMMENT IN THE
HEARING ROOM. PLEASE COME
FORWARD TO THE MICROPHONE IF YOU
WOULD LIKE TO MAKE A COMMENT.
SEEING NONE WE WILL NOW GO TO
THE PHONE LINE FOR PUBLIC
COMMENT. AND AS A REMINDER THE
PHONE NUMBER TO CONNECT IS ON
THE COMMITTEE WEBSITE. AND
SHOULD BE ON THE SCREEN IF YOU
ARE WATCHING OVER THE INTERNET.
THAT PUBLIC ACCESS TOLL FREE
NUMBER. IS. ONE EIGHT EIGHT
SEVEN SIX NINE TWO EIGHT NINE
FIVE SEVEN. PUBLIC ACCESS CODE.
IS. ONE THREE ONE FIVE FOUR FOUR
SEVEN. IF AND JUST TO CORRECTIVE
THE TOLL FREE NUMBER AGAIN IS
EIGHT EIGHT SEVEN SEVEN. SEES ME
877-692-8957. IF YOU ENCOUNTER
ANY PROBLEMS YOU CAN CALL OUR
ASSEMBLY BUDGET COMMITTEE AT.
916-319-2090 NINE AND A STAFF
MEMBER WILL ASSIST YOU. OPERATOR
WE ARE READY TO BEGIN PUBLIC
COMMENT. THANK YOU MISTER CHAIR
AND LADIES AND GENTLEMEN IF YOU
WISH TO COMMENT ON THE CALL
TODAY YOU MAY PRESS ONE AND THEN
ZERO ON YOUR PHONE AT THIS TIME
. LATER WILL PROVIDE YOUR LINE
NUMBER AND WHEN YOU'RE LINE
NUMBER IS CALLED PLEASE STATE
YOUR NAME AND AFFILIATION. MY
FIRST COMMENT COMES TODAY FROM
NINE THIRTY THREE YOUR LINE IS
OPEN PLEASE GO AHEAD. THANK YOU
MR CHAIRMAN MEMBERS DIANA
DOUGLAS OF HEALTHAXIS CALIFORNIA
GOING ON STRONG SUPPORT OF THE
CREATION OF THE OFFICE OF HEALTH
CARE AFFORDABILITY AND
SPONSORSHIP OF PROPOSAL TO FUND
COST SHARING AFFORDABILITY
ASSESSMENTS FOR COVERED
CALIFORNIA. BOTH OF THESE
PROPOSALS WILL MAKE MORE CARE
MORE AFFORDABLE FOR CALIFORNIANS
AT A TIME WHEN MILLIONS ARE
FORCED TO SKIPPER RATION CARE
DUE TO COST. AN OFFICE OF
HEALTHCARE PORTABILITY WOULD
KEEP UNDERLYING COSTS DOWN TO
PROVIDE ADDITIONAL
ACCOUNTABILITY TO THE HEALTHCARE
INDUSTRY WHICH CONTINUES TO
INCREASE. PRICES BEYOND
INFLATION AND WAGE GROWTH. IT
INCLUSION OF OFFICE AND
GOVERNOR'S BY IN OUR ALLEGE
LEGISLATURE THROUGH. MEANWHILE
WE MUST MAKE PROGRESS REDUCE OUT
OF POCKET COSTS COVERED
CLIFORNIA ENROLLEES WITH
INCOMES OF ONLY TWO THOUSAND A
MONTH HAVE ANNUAL DEDUCTIBLE
APPROACHING FOUR THOUSAND. WE
LOOK FORWARD TO PARTNERING TO
FOLLOW THROUGH ON THE BRINGING
CARE WITHIN REACH REPORT TO
UPGRADE COST SHARING HERE'S AN
ELIMINATE. FOR SUMMER PLANS IF
FEDERAL SUBSIDIES. ARE EXTENDED
THANK YOU VERY MUCH. THANK YOU
NEXT CALLER PLEASE. LINE THIRTY
FOUR YOUR LINE IS OPEN PLEASE GO
AHEAD. HELLO CHAIR MEMBERS
JENNIFER VALLEY OUT OF
REPRESENTING THE CALIFORNIA
LABOR FEDERATION AT AND WE TRULY
APPRECIATE THE ADMINISTRATION
AND DOCTOR WOULD AND ALL THE
OTHER STAKEHOLDERS INVOLVED IN
THE PROCESS OF- TREATING THE
OFFICE OF HEALTHCARE
AFFORDABILITY. AT AND WE TRULY
APPRECIATE- DIRECTOR LANCE BURKE
COMMENTS ABOUT HOW
AFFORDABILITY- IS REALLY AN
EQUITY ISSUE WHICH COULDN'T BE
ANY TRUER OUR MEMBERS. WHO MANY
OF WHO DURING PARKING IT IS WITH
SOME PLAYERS- THEY TEND TO SHIFT
THE RISING COST OF HEALTHCARE
AND TO WORKERS THE FORM OF
HIGHER SHARE PREMIUMS. AND
HIGHER DEDUCTIBLES AND COPAYS
ACCORDING TO THE UC BERKELEY
LABOR CENTER MANY CALIFORNIA
WORKERS WITH JOB BASED COVERAGE
WITH THE MEETING CALLED FOR THE
CREATION OF THE OFFICE. BY
IMPLEMENTING A MECHANISM THAT
WOULD CURTAIL THE RISING COST OF
CARE WE BELIEVE THE RESULTS AND
I'M THAT LOWERS COST TO
TAXPAYERS EMPLOYERS AND OUR
MEMBERS WHICH WOULD THEN LOWER
PREMIUMS AND OUT OF POCKET
COSTS. EIGHT HUNDRED BILLION
DOLLARS LOOK FOR TO CONTINUE OUR
WORK WITH THE COMMITTEE THE OP
THERE AND THE ADMINISTRATION
UNDER VERY IMPORTANT. PROPOSAL
THANK YOU SO MUCH. THANK YOU
NEXT CALLER PLEASE. MY THIRTY
NINE YOUR LINE IS OPEN PLEASE GO
AHEAD. GOOD AFTERNOON THANK YOU
CHAIR ARAMBULA THIS IS STACEY
HER A MODEL WITH RAMCO THE
RACIAL AND ETHNIC MENTAL HEALTH
DISPARITIES COALITION ALSO A
MEMBER OF THE CALIFORNIA
REDUCING DISPARITIES PROJECT ON
BEHALF OF A NUMBER OF SMALL
GRASSROOTS ORGANIZATIONS AROUND
THE STATE THAT ARE DEPENDENT ON
THE FUNDING FROM THE CALIFORNIA
REDUCING DISPARITIES PROJECT I
WANT TO THANK YOU AND ESPECIALLY
YOUR STAFF FOR ALL THE
ASSISTANCE TO. ENSURE THAT THE
APPROPRIATE LEGISLATIVE LANGUAGE
THAT WOULD ALLOW THE C. R. D. P.
UNDER THE DEPARTMENT OF PUBLIC
HEALTH TO CONTINUE AND COMPLETE
MORE EVALUATION ON THE PILOT
PROJECT THAT WAS INCLUDED IN THE
ADMINISTRATION'S EARLY ACTION
LEGISLATION WE HOPE NOW THAT
THERE IS NOTHING IN THE WAY OF
THE DEPARTMENT OF PUBLIC HEALTH
COMPLETING THE CONTRACT
EXTENSIONS BEFORE THE CURRENT
FUNDING RUNS OUT FOR THESE PILOT
PROJECTS A LOT OF GRASSROOTS
STAFF TOOK TIME TO PARTICIPATE
IN THE PUBLIC PROCESS REGARDING
THE BUDGET LAST YEAR. WE HOPE
THAT THEY WILL BE ABLE TO
CONTINUE THEIR WORK FOR
COMMUNITIES OF COLOR AND THE
LGBT COMMUNITY WITHOUT A BREAK
IN FUNDING. THANK YOU AGAIN FOR
ALL YOUR SUPPORT. THANK YOU NEXT
CALLER. NINE TWENTY SEVEN YOUR
LINE IS OPEN PLEASE GO AHEAD.
FEDERAL BOROUGH WITH THE
CALIFORNIA SCHOOL EMPLOYEES
ASSOCIATION WE SUPPORT THE
GOVERNOR'S REAPPROPRIATION OF
THIRTY MILLION TO CREATE THE
OFFICE OF HEALTHCARE
AFFORDABILITY WHICH TAKES OF
SHARED DATA DRIVEN APPROACH TO
SOLVING OUR HEALTHCARE CRISIS.
FOR YEARS RISING HEALTHCARE
COSTS OFTEN TO PASS ANY COLDER
MEMBERS RECEIVE AND WE CANNOT
ALLOW THE HEALTHCARE CRISIS TO
CONTINUE UNCHECKED WITH NO
ACCOUNTABILITY AND LITTLE
TRANSPARENCY AND INVESTMENT IN
THE OFFICE OF HEALTH CARE
AFFORDABILITY AS AN INVESTMENT
ALL THE BY. FOR ALL CALIFORNIANS
THANK YOU. THANK YOU NEXT CALLER
PLEASE. NINE FIFTY FOUR YOUR
LINE IS OPEN PLEASE GO AHEAD.
GOOD AFTERNOON MR CHAIRMAN
MEMBERS COUNTY DELGADO ON BEHALF
OF TWO DIFFERENT CLIENTS MAKING
COMMENTS TODAY. ARE WITH RESPECT
TO THE DISTRICT HOSPITAL
LEADERSHIP FORUM HERE TO READ
THE FULL FIFTY OFTEN HEALTHCARE
AFFORDABILITY WOULD LIKE TO
ALIGN OUR COMMENTS WITH THOSE OF
THE CALIFORNIA HOSPITAL
ASSOCIATION WITH OVER THE
CONVERSATION. ON THE ISSUE GOING
FORWARD. CALIFORNIA EMERGENCY
NURSES. WOULD LIKE TO- IT'S IN
HERE WITH A PIECE BECAUSE
RECOMMENDED FROM THE CALIFORNIA
HOSPITALS REGARDING APPLICATION
OFFLOAD DELAY IN CURRENT AND
HOPE TO BE PART OF THE
DISCUSSION AT THE FISHING
THROUGH THE PROCESS THANK YOU
VERY MUCH. THANK YOU NEXT CALLER
PLEASE. NINE FIFTY SIX YOUR LINE
IS OPEN PLEASE GO AHEAD. KELLY
BROOK'S COMMENTING ON BEHALF OF
THE CALIFORNIA ASSOCIATION OF
PUBLIC HOSPITALS AND HEALTH
HEALTH TIPS ON ON THE MEDIC HOW
ARE ACT ITEM. OVER THE LAST
MONTH OUR SYSTEM HAVE REPORTED A
NUMBER OF IMPLEMENTATION
CONCERNS ABOUT HOW IRAQ WE
REPEAT SOMETIMES A DHD
ACKNOWLEDGEMENT JOHN AND REMAIN
COMMITTED TO DOING EVERYTHING WE
CAN. TO GET THE DISHES REPUBLIC
QUICKLY. I'M CONCERNED INCLUDE.
THE END OF THE FOR. TO TIMELY
WORKING WITH MAGELLAN ONE
CHALLENGES ARISE THE SIMPSONS A
VERY LONG WAIT TIMES WITH THE
MAGELLAN. LINE WHICH WAS
REPORTED LAST WEEK ASKING FOR TO
FIX OUR FONG. CHALLENGES OF
PRIOR AUTHORIZATIONS INCLUDING
REJECTIONS WITH NO EXPLANATION
REQUIRING PROPER PRIOR
AUTHORIZATION FOR DRUGS THAT
SHOULD NEED ONE OR AT THAT ARE
TAKING MANY DAYS PROCESS
SOMETIME OVER A WEEK.
BELLINGER'S REIMBURSEMENT ISSUES
AND CRIME REDUCTION. CHALLENGES
BEHIND THE PATIENT THE MAGELLAN
OF THE SENATE THEIR NAME IS
DIFFERENT. BUT IT'S NOT THERE
MEDIKAL OR ID CARD. OVERALL OUR
MEMBERS ARE CONCERNED THAT THE
PATIENTS ARE NOT GETTING NEEDED
MEDICATION BURKE. IN A TIMELY
MANNER WE LOOK FORWARD TO
WORKING WITH THE LEGISLATURE THE
DEPARTMENT AND THE GALLON.
ANYWAY WE CAN'T TORTURE THESE.
ISSUES GET RESOLVED AT ALL.
THANK YOU NEXT CALLER. NINE
FIFTY SEVEN YOUR LINE IS OPEN
PLEASE GO AHEAD. GOOD AFTERNOON
CHAIR MEMBERS WENT AWAY WITH THE
WESTERN CENTER ON MOM AND
POVERTY WE SUPPORT THE
ESTABLISHMENT. LOW WAGE WORKERS
WHO ARE STILL EXPECTED TO
CONTRIBUTE MORE TO THEIR WAGES
TO HEALTH COVERAGE REINING IN
THE CASA CARE SB FINANCIAL TO
GETTING TO UNIVERSAL COVERAGE.
UNDER SHE FOR A SPONSORS OF AB
TEN TWENTY WE SUPPORT THE B. C.
P. TO IMPLEMENT THESE CHANGES.
IN UNDER ISSUE SIX WE SUPPORT
FUNDING FOR FUTURE COVER
CALIFORNIA AFFORDABILITY
PROGRAMS PARTICULARLY FOR LOW
INCOME CALIFORNIANS WELL WE HOPE
FEDERAL PREMIUM ASSISTANCE WILL
CONTINUE IF IT DOES NOT BEEN
STATE AFFORDABILITY ASSISTANCE
WILL BE EVEN MORE IMPORTANT. AND
FINALLY WE RECOGNIZE THE
SIGNIFICANT EFFORTS TO IMPLEMENT
MEDICARE ARE EX BUT ARE
CONCERNED WITH ACCESS ISSUES
THAT CONTINUE A MONTH POST
TRANSITION WE APPRECIATE RECENT
TAXES AND MOVING TOWARD ONE TO
ENSURE THE SUCCESS. PRIORITIZE
MINIMIZING BURDEN TO CONSUMERS
THE LION AUTOMATED CORRECTIONS
WERE POSSIBLE AND ARE
EFFECTIVELY COMMUNICATED WE
APPRECIATE THE OVERSIGHT HEARING
AND LOOK FORWARD TO GREATER
TRANSPARENCY IN DATA FROM THE
DEPARTMENT THANK YOU. THANK. YOU
NEXT CALLER PLEASE. NINE FOUR
SEVEN YOUR LINE IS OPEN PLEASE
GO AHEAD. IN FORTY SEVEN YOU MAY
BE ON MUTE PLEASE GO AHEAD YOUR
LINE IS OPEN. MOVE ON TO LINE
SIXTY TWO LINE SIXTY TWO YOUR
LINE IS OPEN PLEASE GO AHEAD.
GOOD AFTERNOON DOCTOR ON THE
LINE MEMBERS NO I THOUGHT OF ALL
REPRESENTING CALIFORNIA WILL
LEGALIZE DISTANCE FOUNDATION.
CHECK THE GOVERNOR'S INVESTMENT
PLAN COVER NINETEEN RESPONSE AND
THANK THE DEPARTMENT OF PUBLIC
HEALTH FOR THEIR WORK INSURING
THAT OUR RURAL ESSENTIAL
FARMWORKERS AND THEIR FAMILIES
NEEDS ARE MET S. CHALLENGES
CONTINUE WTH MISINFORMATION
TESTING. PP IT BACK NATION'S. WE
SUPPORT THE GOVERNOR AND THE
LEGISLATURE THE PROPOSAL TO
ESTABLISH AN OFFICE OF HEALTH
CARE AFFORDABILITY AND THE COST
SHARING ASSISTANCE FOR COVERED
CALIFORNIA TO BENEFIT OUR RURAL
FARMWORKERS DISADVANTAGED
COMMUNITIES. WE SUBMITTED
COMMENTS ON THESE TWO WE LOOK
FORWARD TO WORKING ON THESE
ISSUES IN THE FUTURE THANK YOU
VERY MUCH. THANK YOU NEXT CALLER
PLEASE. NINE SIXTY THREE YOUR
LINE IS OPEN PLEASE GO AHEAD.
THANK YOU MR CHAIRMAN MEMBERS
MEGHAN SUPERS ON BEHALF OF
CALIFORNIA HEALTH PLUS ADVOCATES
REPRESENTING THE COMMUNITY
CLINICS AND HEALTH CENTERS
REALLY APPRECIATE THE DISCUSSION
THIS AFTERNOON AROUND THE
IMPLEMENTATION OF THE MEDICAL
PHARMACY TRANSITION ANY UPDATE
FROM THE DEPARTMENT ON THE
IMPLEMENTATION CHALLENGES OF
HEALTH CENTERS. HAVE BEEN
REPORTING A NUMBER OF ISSUES
RELATED TO PRIOR AUTHORIZATION
AND CONCERNED ABOUT PATIENTS
THINK THAT MEXICAN DELAYS IN
ACCESSING THEIR MEDICATION SO WE
ECHO THE COMMENTS OF OUR
PARTNERS AT THE PUBLIC HOSPITALS
ON THIS POINT WE ALSO APPRECIATE
THE UPDATE ON THE STATUS OF THE
SUPPLEMENTAL PAYMENT POOL
HOWEVER SINCE THE PROGRAM TOOK
EFFECT ON JAN ONE HEALTH CENTERS
ARE LOSING CRITICAL FUNDING EACH
DAY. WE'RE GRATEFUL TO THE
LEGISLATURE ANY ADMINISTRATION
FOR ESTABLISHING THE FUNDING
TWENTY ONE TWENTY TWO BUT WE
KNOW THE POOL AMOUNT WAS BASED
ON DATA FROM TWENTY EIGHTEEN AND
THAT NOT ALL ELIGIBLE ENTITIES
WERE SURVEYED MUCH MORE RECENT
DATA HIGHLIGHTS OF THE LOSS OF
THREE FORTY B. SAVINGS WILL FAR
EXCEED THE AMOUNT AND THE FUNDS
THAT WE ARE RESPECTFULLY
REQUESTING. THAT THE LEGISLATURE
AND THE ADMINISTRATION INCLUDED
AN ADDITIONAL FIFTEEN MILLION
DOLLAR GENERAL FUND WHICH WILL
DRAW DOWN FEDERAL MATCH AND HELP
MITIGATE THE FINANCIAL HARM
CAUSED BY THE TRAFFIC TRANSITION
TO COMMUNITY HEALTH CENTERS AND
THE PATIENTS THEY SERVE THANK
YOU VERY MUCH. THANK YOU NEXT
CALLER PLEASE. MIND NINE. YOUR
LINE IS OPEN PLEASE GO AHEAD.
GOOD AFTERNOON CHAIR MEMBERS NOT
WHICH DATES FROM- SEIU
CALIFORNIA NOT SPEAK ABOUT
COUPLE ISSUES FIRST IN SUPPORT
OF THE CREATION OF THE
GOVERNOR'S PROPOSAL OFFICE OF
HEALTHCARE PORTABILITY OUR
WORKERS ARE DESPERATE SHOULDN'T-
FOR ACTION TO CONTROL HEALTHCARE
COSTS. WE DO APPRECIATE THAT PPL
AND THE DOCTORS COMECON SHARING
COST CONTROLS ARE NOT BACK ON
THE BACKS OF HEALTHCARE WORKERS
WILL ALSO ADDRESSING ISSUES OF
EQUITY QUALITY AND ACCESS TO
CARE- IN ADDITION WE WOULD LIKE
TO ENSURE THE ENTITIES ALL
ENTITIES ARE MAKING PUBLIC
THEIR- FINANCIAL INFORMATION SO
THAT COSTS CAN BE FULLY
UNDERSTOOD- WORKERS ONCE AGAIN
NEED YOUR URGENT ACTION TO
CONTROL HEALTHCARE COSTS IN THE
BOARD TO WORK WITH THE
LEGISLATURE ADMINISTRATION. ON
THIS PROPOSAL THROUGHOUT THE
PROCESS ALSO WOULD LIKE TO
DISCUSS SPEAK IN SUPPORT OF- AT
THE SPONSOR OF EIGHTY TWELVE UP
FOR LAST YEAR- AND JUST SPEAK IN
SUPPORT OF THE BCP PROPOSAL- BY
EACH GUY. THANK YOU. THANK YOU
NEXT CALLER PLEASE. MINDS TWO
YOUR LINE IS OPEN PLEASE GO
AHEAD. ENTRANCED SEVENTY TWO
POINT. ANDREA RIVERA WITH THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK WE APPRECIATE THE
DISCUSSIONS THAT TOOK PLACE ON
PROPOSALS THAT SEEK TO CLOSE
DISPARITIES IN HEALTH COVERAGE
AND ACTIVISTS AND EVEN IF
SUPPORTERS OF EFFORT TO
ESTABLISH THE HEALTHCARE
AFFORDABILITY AS WELL AS COVER
CALIFORNIA COST SHARING. AND
CALIFORNIANS ARE FACING
HEALTHCARE. CRISIS WITH MILLIONS
BEING FORCED. OR RATION CARE DUE
TO COST. AND WITHOUT OVERSIGHT
AND ACCOUNTABILITY THE HEALTH
INTERESTS THE HEALTH INDUSTRY
WILL KEEP INCREASING THEIR
PRICES AND THE STATE REALLY HAVE
AN OBLIGATION HERE TO ENSURE
THAT COST COULD NOT BECOME A
BURDEN FOR CALIFORNIANS WHO ARE
ATTEMPTING TO ACCESS OF
RECOVERY. THE OFFICE OF
HEALTHCARE AFFORDABILITY WILL
TAKE A COMPREHENSIVE LOOK AT THE
WHOLE OF THE WHOLE HEALTH
SYSTEM. AND REALLY ESTABLISH
SOME POTENTIAL TO ENSURE THAT
COST REFORMS. REACH HARDWORKING
CALIFORNIA. IN A- THE ASSISTANCE
THE BY DIDN'T MINISTRATION HAS
MADE COVERED CALIFORNIA PREMIUM.
MORE AFFORDABLE THAN EVER WHICH
HAS LED TO THE STORAGE
COMPARTMENT BUT AT THE SAME TIME
OUT OF POCKET COSTS STILL REMAIN
A CHALLENGE FOR MANY FAMILIES.
AND THEREFORE FORGO ACCESS TO
CARE. ALL THAT SAYS ECONOMIST
AGAIN SUPPORTIVE OF THE EFFORT
TO ESTABLISH THE ON HEALTHCARE
AFFORDABILITY AND EFFORTS TO
ENSURE THAT COVERED CALIFORNIA
COP WOULD NOT CONTINUE. TO GET
BURDEN THANK YOU. THANK YOU NOT
CALLER PLEASE. NINE SEVENTY
THREE YOUR LINE IS OPEN PLEASE
GO AHEAD. THANK YOU MR CHAIRMAN
MEMBERS THE AMBER CAME WITH
USURPATION OF CALIFORNIA
HEALTHCARE DISTRICT CALLING TO
COMMENT ON THE TOP OF THE POPS
CARE AFFORDABILITY WE APPRECIATE
THE WORK BEING DONE BY THE
ADMINISTRATION AND FORMER MEMBER
WIDE AND THE LEGISLATURE ON THE
OFFENSE HOWEVER AND JACKIE WE
ARE CONCERNED THAT THE CURRENT
PROPOSAL COULD CREATE.
UNINTENDED CONSEQUENCES
INCLUDING A ONE SIZE FITS ALL
APPROACH ESPECIALLY FOR OUR
SMALL RURAL HOSPITALS AND LOOK
FORWARD TO CONTINUING THE
CONVERSATIONS ON THE PROPOSAL
THANK YOU. THANK YOU. NEXT
CALLER PLEASE. THANKS SIXTY FIVE
YOUR LINE IS OPEN PLEASE GO
AHEAD. GOOD EVENING CONFERENCE
ABOUT THE CALIFORNIA HOSPITAL
ASSOCIATION ON TWO ISSUES FIRST
WE APPRECIATE THE
ADMINISTRATION'S PROPOSAL
RELATED TO ADDITIONAL COVERT
FUNDING AND ADDITIONALLY
APPRECIATE THE CHAIRS FOCUS ON
THE A POT A SUPPORT SUPPORTIVE.
OF FUNDING FOR THE YARD AND YOUR
SUPPORT AS WE HAVE NOTED WALL AT
THE STATE'S NUMBERS ARE GOING
DOWN HOSPITALS ARE STILL FACING
THE CO THE CRISIS PARTICULARLY
IN OUR EMERGENCY ROOMS AND
APPRECIATE THE ADDITIONAL
SUPPORT. WE ALSO WOULD LIKE TO
WE ALSO APPRECIATE THE ON GOING
ENGAGEMENT ON THE OFFICE
HEALTHCARE AFFORDABILITY AS THE
PROPOSAL WORKS TO ADDRESS THE
QUESTION RELATED TO IN THE WORK
TOWARDS MAKING HEALTH CARE MORE
AFFORDABLE. WE DO APPRECIATE THE
LANGUAGE REFLECTS OF THE HOURS
OF DISCUSSION WITH THE
ADMINISTRATION AND HE'S LIKE HE
LEGISLATIVE LEADERS. I'M TO
ADDRESS OUR CONCERNS WE ARE
CURRENTLY REVIEWING THE LANGUAGE
I'M TO ENSURE THAT THOSE
CONCERNS ARE ADDRESSED BUT MORE
IMPORTANTLY TO FOCUS ON.
ENSURING WE CONTINUE TO. AN
ADDRESS ACCESS AND AFFORDABILITY
THE ACCESS AND QUALITY. WE ARE
CONCERNED THAT THE FRAMEWORK
ADDRESSES HOW ARE HOSPITALS WILL
RECOVER FROM COBIT. BY TWO YEARS
OF. CONSTANTLY HELPING MANAGE
THE CRISIS HAS DRAINED OUR-
HOSPITAL'S ABILITY AND FINANCIAL
RESOURCES SO WE ARE CONCERNED
ABOUT ENSURING THAT AT THE MEET
THOSE TARGETS ARE HOSPITALS CAN
RECOVER FROM THE CODE CRISIS. IN
ADDITION AS WELL ADDRESS THE
CONCERNS AND ISSUES AROUND
AFFORDABILITY RELATED TO THE-
COST OF MEETING THE TWENTY
THIRTY SEISMIC CHALLENGE BUT A
HUNDRED BILLION DOLLARS AND COST
AS WE WORK TO MEET THAT
CHALLENGE AND WE CONTINUE TO BE
VERY CONCERNED OUR HOSPITALS
WILL NOT BE ABLE TO GET THERE.
THANKYOU I LOOK FORWARD TO
WORKING WITH THE ADMINISTRATION
AND THE LEGISLATIVE LEADERS
WILLING REPORT ON THESE ISSUES.
THANK YOU NEXT CALLER PLEASE.
NINE FIFTY NINE YOUR LINE IS
OPEN PLEASE GO AHEAD. HELLO
TERRY MEMBERS MANY OF THEM THAT
CENTENARIO WOULDN'T ACTION
POLICIES I'M THINKING ON TWO
ITEMS TODAY THE FIRST THING THE
OFFICE OF HEALTH CARE
AFFORDABILITY- NIXON PUBLIC
CALIFORNIA'S OF BEFORE OF THIS
ITEM WITHOUT OVERSIGHT AND
ACCOUNTABILITY THE HEALTH
INDUSTRY WILL CONTINUE TO
INCREASE THEIR PRICE WOULD BE ON
INFLATION AND WAGE GROWTH. AND
THE STATE HAS A ROLE TO PLAY IN
TERMS OF SETTING COST GROWTH- TO
PROTECT CONSUMERS AS WELL AS THE
OTHER ISSUE IN COVERED
CALIFORNIA- ONE. WHAT OTHER HAVE
MENTIONED AS WELL ND WE THINK.
TO INVESTMENTS TO ENSURE THAT-
THIS HEALTHCARE IS AFFORDABLE TO
CONSUMERS IS ESSENTIAL THANK YOU
SO MUCH FOR YOUR TIME. THANK YOU
NEXT CALLER PLEASE. NINE FIFTY
THREE YOUR LINE IS OPEN PLEASE
GO AHEAD. BLIND COMMITTEE.
HOWEVER THERE ARE DIFFERENT YES
YOU CAN PLEASE GO AHEAD-
EXCELLENT- TO START OFF BY
SAYING- JUST FROM A LAYPERSON'S
PERSPECTIVE THAT THIS HEARING
WAS NOT ACTUALLY ABOUT
HEALTHCARE IT WAS ABOUT THE
MEDICAL INDUSTRIAL COMPLEX.
CALIFORNIA IN THE US IN GENERAL
DOES NOT ACTUALLY HAVE A HEALTH
CARE INDUSTRY IT HAS THE DISEASE
CREATION INDUSTRY. THE USA IS 5%
OF THE WORLD'S POPULATION YET
CONSUMES THREE QUARTERS OF THE
PHARMACEUTICAL DRUGS IN THE
WORLD. NO WHERE IS THE FARM OF
BIAS MORE GLARINGLY OBVIOUS BEEN
WITH THESE FORMA FASHION MEDICAL
MANDATE. AND YET YOU STILL IN
THIS WE NEED A PROOF OF
VACCINATION TO EXIST. AND SO THE
LIGHTS PERSIST BUT SOME OF US
CAN TELL AND YOU BET WE WILL
RESIST. I HOPE YOU KNOW IT'S
PLAIN TO SEE THE PSEUDO SCIENCE
ISSUES AND ON THE TV AND ALL THE
POWER YOU ABUSE TO KEEP THE
PEOPLE CONFUSED AND AFRAID. HOW
IS THIS STILL GOING ON THIS
PROVIDES GONE ON FOR WAY TOO
LONG. EVEN IF YOU'RE BLIND YOU
CAN SEE THAT THIS IS WRONG. IT
HAS TO STOP. YOU'RE HURTING THE
CHILDREN. YOU HAVE BEEN IN TOTAL
ABEYANCE OF THE LEGISLATURE TO A
TYRANNICAL GOVERNOR FOR OVER
SEVEN HUNDRED DAYS. WE DON'T
WANT YOUR PRODUCTS WE DON'T WANT
YOUR SHOT. THAT'S THE WAY TO
CONCLUDE LET ME LEAVE YOU WITH
THIS. THE SIX BEST DOCTORS
ANYWHERE ENGINE NO ONE CAN DENY
IT OUR SUNSHINE WATER REST AND
AIR EXERCISE AND DIET. THESE SIX
WE'LL GLADLY YOU ATTEND IF ONLY
YOU ARE WILLING YOUR MIND
ABILITIES YOUR WILL THURMOND AND
CHARGE YOU NOT ONE SHILLING. YOU
LAWMAKERS SHOULD BE ASHAMED OF
YOURSELVES. THANK YOU MA'AM NEXT
CALLER PLEASE. NINE SEVENTY ONE
YOUR LINE IS OPEN PLEASE GO
AHEAD. GET ONE LIBERTY ARE YOU
CALIFORNIA-DRIVERS-PAY-UNDERFUNDED-STATE-PATROL-PENSION. DOMINATE ANALYZE THE FINANCIAL
DATA AND INFORMATION PROVIDED BY
SMART AND LOOK FORWARD TO
PARTNERING IN THE FUTURE TO
OBJECT AND OTHER RELATED ISSUE
OF COMPETITION FROM THANK YOU SO
MUCH. THANK YOU NEXT CALLER
PLEASE. MIND FOUR YOUR LINE IS
OPEN PLEASE GO AHEAD. SHARE
MEMBERS MY NAME IS TIED TO WHAT
I'M CALLING ON BEHALF OF THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS AND I NEARLY ELEVEN
THOUSAND MEMBERS WE HOPE TO
CONTINUE TO HAVE DISCUSSIONS ON
THE PRIMARY CARE AND YOUR YOUR
HEALTH WORKFORCE SHORTAGES IN
CALIFORNIA WE KNOW THAT THE FIVE
PRIMARY CARE PHYSICIANS WOULD
DECREASE BETWEEN EIGHT AND
TWENTY BACK WITH THAT. ONE MIGHT
SUGGEST THIS TO PROMOTE PRIMARY
CARE BY CHANGING THE WAY WE PAY
FOR PRIMARY CARE AND INCREASING
THE AMOUNT OF MEDICAL DATA OUR
RECORDS IT IN ADDITION WE ASK
THAT YOU PRIORITIZE INCREASING
INVESTMENT IN THE SONG BOB
PRIMERICA DIVISION TRAINING
PROGRAM. WHICH WILL EXPAND THE
PRIMARY CARE AND BEHAVIORAL
HEALTH WORKFORCE ASSEMBLY
POSITIONS RECEIVED TWO HUNDRED
PLUS HOURS OF TRAINING AND
BEHAVIOR HEALTH FINALLY WE
REQUEST THAT YOU MAKE A
TECHNICAL SIXTY THE THIRTY
MILLION ALLOCATION IN THE TWENTY
TWENTY ONE FROM TWENTY TWO
BUDGET A NEW PRIMARY CARE
RESIDENCY PROGRAM. THROUGH THE
PHONE BOB COBURN ABOUT BUT
BECAUSE OF THE SHIP WHETHER A
PORTION OF THE FIFTY MILLION NOT
ONLY OUT BE ALLOCATED TO NEW
PROGRAMS THAT THE FUNDS
ALLOCATED TO THE SINGLE GRANT
AND EXPENSE BOB. ABOUT LOOK
FORWARD TO FURTHER BECAUSE ON OF
THE PRIMARY CARE PHYSICIAN WHAT
WITH THANK YOU. THANK YOU NEXT
CALLER PLEASE. NINE TWO YOUR
LINE IS OPEN GO. GOOD AFTERNOON
CHOI AROUND AND CAN I'M BILL
CRAIG JACK DIRECTOR HEALTH
POLICY THE PURCHASE BUSINESS ON
HOW. WE ARE NOT IMPROPER
COALITION BASED IN CAL
REPRESENTING FOUR LARGE AND
PUBLIC ENTITIES WE APPRECIATE
THE OPPORTUNITY TO OFFER
COMMENTS ON ISSUE TO THE
PROPOSED BUDGET FOR THE OFFICE
OF HEALTH CARE AFFORDABILITY.
REJECTIONS MEMBERS STRONGLY
SUPPORT THE PROPOSED TOPS OF
HEALTH CARE AFFORDABILITY. WE
KNOW WHAT THE PROBLEM IS
HEALTHCARE COSTS ARE TOO HIGH.
CREEK FINANCIAL BARRIERS FOR
PATIENTS TO GET NECESSARY CARE.
BUT HIGH COSTS ALSO PUT ASEVERE
FINANCIAL BURDEN ON EMPLOYERS
THAT PROVIDE HEALTH BENEFITS TO
THEIR EMPLOYEES AND FAMILIES.
THEREBY CROWDING OUT BUSINESS
INVESTMENT AND WORKERS WAGES.
THEY OFTEN HEALTHCARE
PORTABILITY PRESENTS A GREAT
OPPORTUNITY TO ENSURE THAT THE
COST OF CARE ARE MORE REASONABLE
AND AFFORDABLE FOR ALL
CALIFORNIANS. THANK YOU FOR YOUR
CONSIDERATION THESE COMMENTS
WE'VE ALSO SUBMITTED WRITTEN
TESTIMONY TO PROVIDE MORE DETAIL
IT WILL BE HAPPY TO PROVIDE
ADDITIONAL INFORMATION IT WOULD
BE HELPFUL THANK YOU. THANK YOU
SIR NEXT CALLER PLEASE. NINE TEN
YOUR LINE IS OPEN PLEASE GO
AHEAD. GOOD AFTERNOON MR
CHAIRMAN AND MEMBERS OF THE
COMMITTEE MY NAME IS SELDOM
OLYMPICS AND I'M CALLING TODAY
ON BEHALF OF ULTIMATE SERVICES
THE LARGEST INDEPENDENT.
FEDERALLY QUALIFIED HEALTH
CENTER IN CALIFORNIA OPERATING
STYLE CALIFORNIA FOR MORE THAN
FIFTY YEARS WE TURN OVER FOUR
HUNDRED THOUSAND PATIENTS. THANK
YOU FOR CREATING EARLY URGENT
OVERSIGHT ON THE MEDICARE L. R.
X. TRANSITION GIVEN THE
TRANSITION OCCURRING POINTER
TRIP FINANCIAL DAMAGES THAT
WOULD COME TO THIS- COMMUNITY
HEALTH CENTERS AND THEIR
PATIENTS. HOWEVER THE UNINTENDED
CONSEQUENCE IF THAT THE STATE
FINANCIAL BENEFIT COMES AT A LOT
TO COMMUNITY HEALTH CENTERS AND
THE COMMUNITY THEY SERVE. WE ARE
STRONG SUPPORT OF INCREASING THE
SUPPLEMENTAL PAYMENT BY FIFTY
MILLION FROM THE STATE GENERAL
FUND TO ENSURE VALUABLE PATIENT
SERVICES SUCH OF EXTENDED HOURS
OF OPERATION FOR BOTH PRIMARY
CARE SITES IN PARTNERSHIP REMAIN
IN PLACE. TO HELP INNER THANK
YOU ST JUDE ABOUT FOURTEEN TO
CORRECT IS CRITICAL MEDICARE ARE
EX OPERATION CHALLENGE AND
SUPPORTING THE FIFTY MILLION
BUDGET AUGMENTATION FROM THE
HOSPITAL CLINIC SUPPLEMENTAL
PAYMENT POOL WHICH WAS CREATED
TO HELP COMMUNITY HEALTH CENTERS
MEDICAID A LOT THAT'S BEEN
COVERED BY THE MEDI CAL R. X.
TRANSITION. THANK YOU. OKAY NEXT
PLEASE. LINES YOUR LINE IS OPEN
GO. GOOD AFTERNOON MR CHAIRMAN
AND MEMBERS THE COMMITTEE IS
RANDALL HAGER FOR- HERE FOR THE
SAIKIA POSITIONS ALIGN ACCOUNT.
WE APPRECIATE HOW HARD THE
DEPARTMENT IS WORKING ON THE
OVERSIGHT THAT THE COMMITTEE IS
BRINGING TO BEAR ON FIXES FOR
THE CALORIE ACTS SYSTEM HOWEVER
I WANTED TO BRING TO YOUR
ATTENTION- REVISED- PARTNER ALL
. ALL SEE THAT WAS INSTITUTED
YESTERDAY FEBRUARY SIXTH. IN
WHICH- PRIOR AUTHORIZATION
REQUIREMENTS ARE TEMPORARILY
WAIVE FOR SOME DRUGS. AND DINNER
A LIST OF DRUGS THAT ARE
EXCEPTIONS ON A AND 80% OF THOSE
FOR PSYCHOTROPIC MEDICATIONS IT
BEGS THE QUESTION. ABOUT THE
RATIONALE FOR TARGETING PEOPLE
WITH SEVERE MENTAL ILLNESS IN
THIS WAY AND I WOULD- EXTEND TO
YOU AN INVITATION TO LOOK INTO
THAT FURTHER THANK YOU. THANK
YOU NEXT CALLER PLEASE. NINE
SEVENTY FIVE YOUR LINE IS OPEN
PLEASE GO AHEAD. GOOD AFTERNOON
MR CHAIRMAN BUDGET COMMITTEE
LARA NANTI JIKA PASSED THE
HOPPER BLUESHIELD OF CALIFORNIA
CALLING IN TO COMMENT I INTO THE
OPPOSITE HEALTHCARE
AFFORDABILITY- WE'D LIKE TO
EXPRESS OUR APPRECIATION FOR THE
ADMINISTRATION AND THE
LEGISLATURE CONTINUING TO WORK
ON THIS INCREDIBLY IMPORTANT
ISSUE. WE'RE STILL REVIEWING THE
TRAILER BILL LANGUAGE BUT I'VE
BEEN VERY SUPPORTIVE OF THE
OFFICE AND THE POLICY SINCE IT
WAS FIRST INTRODUCED IN TWENTY
TWENTY- WE BELIEVE OFFICE WOULD
PUT CALIFORNIA AT THE FOREFRONT
OF TACKLING THE HIGH COST OF
HEALTH CARE AT ITS ROOTS AND
MAKING GREAT STRIDES. IN
ENSURING HEALTH CARE IF THE
SENATE BILLY AFFORDABLE FOR
EVERY CALIFORNIA THE OFFICE WILL
PROVIDE TRANSPARENCY ALL THE
ENTIRE DELIVERY SYSTEM
ACCOUNTABLE FOR COST GROWTH AND
ENSURE QUALITY OF CARE AND
PATIENT OUTCOMES WE LOOK FORWARD
TO WORKING WITH YOUR COMMITTEE
AND THE ADMINISTRATION ON THE
PROPOSAL AS IT MOVES FORWARD
THANK YOU. THANK YOU NEXT CALLER
PLEASE. MY SEVEN SIX YOUR LINE
IS OPEN PLEASE GO AHEAD. YEAH
THANK YOU GOOD AFTERNOON MR
CHAIRMAN AND MEMBERS OF THE
COMMITTEE HELLO MY NAME IS NEIL
RUBENSTEIN WITH THE NATIONAL
MULTIPLE SCLEROSIS SOCIETY. I'M
NOT COMING BACK TO THE ITEMS ON
YOUR AGENDA FONG. M. F. IS AN
EXTRAORDINARILY COSTLY DISEASE
AND ACROSS THE SITE IS ONE OF
THE KEY REASONS PEOPLE LIVING
WITH THE DISEASE. STOPPER
AUTHORS ARE DISEASE MODIFYING
THERAPY. SEPARATED AT THE DIRECT
INDIRECT COSTS OF LIVING WITH MS
REPORTED SEVENTY THOUSAND
DOLLARS PER YEAR PER PERSON. ARE
WE STRONGLY SUPPORT THE OFFICE
OF HEALTH CARE AFFORDABILITY
PROPOSAL. BECAUSE IF YOU LOOK AT
THE WHOLE ISSUE. YOUR CAR IN
CALIFORNIA. AND HOPEFULLY WE'LL
BE ABLE TO REDUCE SOME OF THOSE
COSTS WHICH WOULD BENEFIT PEOPLE
WITH AN ACCESS WHETHER AS WELL
AS OTHER PATIENTS. WE ALSO
SUPPORT. COULD COVER CALIFORNIA
ADDITIONAL COST SHARING
ASSISTANCE FOR PEOPLE LIVING
WITH CHRONIC DISEASES LIKE MS
BEGAN TO HELP WITH THE VERY HIGH
COST. OF DRUGS AND MEDICATION
FOR THOSE PEOPLE THANK YOU VERY
MUCH FOR YOUR CONSIDERATION.
THANK YOU NEXT CALLER PLEASE.
NINE SEVENTY SEVEN YOUR LINE IS
OPEN PLEASE GO AHEAD. MISTER
CHARM MEMBERS AMY BLOOMBERG WITH
THE CALIFORNIA CHILDREN'S
HOSPITAL ASSOCIATION WITH
COMMENTS ON THREE ITEMS. ISSUE
NUMBER ONE WE SUPPORT THE
ADMINISTRATION'S EARLY ACTION
ITEMS ON CALVET NINETEEN
RESPONSE INCLUDING VACCINATION
COSTING ANSWERED STAFFING. THE
TWO THE OFFICE OF HEALTH CARE
FOR THE BILL WOULD BE WE ALIGN
OUR COMMENTS WITH THOSE OF THE
CALIFORNIA HOSPITAL ASSOCIATION
AND ARE STILL REVEALING THAT
TRAILER BILL LANGUAGE. WE
APPRECIATE DIRECTOR LANCE BURKE
SPEAKING FOR SOME OF OUR
CONCERNS WITH THE OFFICE AND
WILL CONTINUE. TO ENGAGE IN THIS
DISCUSSION. AND AS YOU MEMBERS.
REGARD MEDIC HOW ARE ACTION WE
ECHO THE CONCERNS OF PUBLIC. AND
OTHER CALLERS ARE HOSPITALS HAVE
GETTING PEDIATRIC PATIENTS THEIR
MEDICINE THAT I'VE HAD PRIOR
AUTHORIZATION. WE APPRECIATE THE
ATF OF COMMENTS REGARDING THEIR
EFFORTS TO CORRECT PROBLEMS AND
THERE'S MUCH MORE WORK TO BE
DONE THANK YOU. THANK YOU NEXT
CALLER PLEASE. NINE SEVENTY NINE
YOUR LINE IS OPEN PLEASE GO
AHEAD. HELLO THIS IS KEVIN ENSCO
WITH THE FRIENDS COMMITTEE ON
LEGISLATION OF CALIFORNIA
CALLING IN SUPPORT OF AN OFFICE
OF HEALTH CARE AFFORDABILITY AND
IN SUPPORT OF ADDITIONAL COST
SHARING FOR COVERED CALIFORNIA
THANK YOU. THANK YOU NEXT CALLER
PLEASE. NINE EIGHTY YOUR LINE IS
OPEN PLEASE GO AHEAD. GOOD
EVENING CHAIR ARAMBULA AND
TWENTY MEMBERS MY NAME IS OFF
PERCENT OF ALL AND NOT BE
GOVERNMENT AFFAIRS SENIOR
MANAGER FOR THE LATINO COALITION
FOR HEALTHY CALIFORNIA ALSO
KNOWN AS OPC. I'M CALLING TO
VOICE OUR SUPPORT THE OFFICE OF
HEALTH CARE AFFORDABILITY
CALIFORNIANS ARE AND HAVE BEEN
TAKING A HEALTHCARE
AFFORDABILITY PRACTICE LONG
BEFORE THE COVER NINETEEN
PANDEMIC. LOOKS CORRECTLY
SUPPORTERS BILLIONS TO MAKE THE
DIFFICULT DECISION OF SKIPPING
OR RATIONING CARE DUE TO THE
COST. IT'S TRAGIC CIRCUMSTANCE
CANNOT CONTINUE WE NEED
DEDICATED PROFESSIONALS TO
ENSURE THE BENEFIT OF COST
REFORMS ACTUALLY REACHED. EVERY
CALIFORNIA. THANK YOU. THANK YOU
NEXT CALLER PLEASE. NINE EIGHTY
TWO YOUR LINE IS OPEN PLEASE GO
AHEAD. THANK YOU AND- HELLO MR
CHEN MEMBERS OF THE COMMITTEE.
MY NAME IS DAVID LEVINE AND I'M
WITH THE HEALTH ALLIANCE OF
NORTHERN CALIFORNIA AND THE
NORTH BECAUSE CLINICS NETWORK
TOGETHER OUR MEMBER COMMUNITY
HEALTH CENTERS FOR MORE THAN TWO
HUNDRED THOUSAND PATIENTS ACROSS
THE NORTH STATE- I'M CALLING
TODAY IN STRONG SUPPORT OF
INCREASING THE SUPPLEMENTAL
PAYMENT POLL BY FIFTY MILLION
DOLLARS FROM THE STATE GENERAL
FUND- SINCE LAST YEAR. AND BASED
ON THE DATA WE WITH OUR PARTNERS
AT THE CALIFORNIA PRIMARY CARE
ASSOCIATION AND CALIFORNIA BUT
THAT THE KIDS HAVE BEEN RAISING
CONCERNS ABOUT THE FINANCIAL
CONSEQUENCES TO OUR HEALTH
CENTERS FROM THE MEDICARE OUR
TRANSITION WITHOUT SUCH AN STP
AUGMENTATION. AND THE COMMUNITY
HEALTH CENTERS IN OUR REAL
REGION WHO ARE IN MANY CASES THE
ONLY PROVIDERS OF CARE IN THE
COMMUNITIES THAT DEPEND ON THESE
RESOURCES THAT QUESTION TO
PROVIDE NEEDED HELP PROGRAMS AND
SERVICES TO THEIR PATIENTS- AND
WITHOUT AN AUGMENTATION OF THE
FTP WE BELIEVE THESE PROGRAMS
AND SERVICES ARE AT RISK. SECOND
I'M I'M CALLING TODAY TO
RESPECTFULLY REQUEST THAT THE
SUPPLEMENTAL PAYMENT WILL BE
INCREASED BY FIFTY MILLION
DOLLARS FROM THE STATE GENERAL
FUND THANK YOU. THANK YOU NEXT
CALLER PLEASE. NINE EIGHTY FIVE
YOUR LINE IS OPEN PLEASE GO
AHEAD. MIKE EIGHTY YOU MAY ENTER
YOUR NAME AGAIN HELLO HELLO
MISTER CHAIR AND MEMBERS OF THE
COMMITTEE MY NAME BEYOND PROBLEM
QUICKTIME DIRECTOR OF POLICY FOR
SMALL BUSINESS MAJORITY I MIGHT
WERE CALLING IN TO- GET THE
PART- ITEMS HERE THE OFFICE OF
HEALTH CARE AFFORDABILITY AND I
THINK ITEM SIX SEVEN COST
SHARING. AND BOB IS NOT MAJORITY
THE NATIONAL SMALL BUSINESS
ORGANIZATION ARE WE EMPOWER
AMERICA'S- TAKE BIRTH
ENTREPRENEURS TO BUILD A
THRIVING AND EQUITABLE ECONOMY
WE ADVOCATE FOR PUBLIC POLICY
SOLUTION- TO DELIVER RESOURCES
ENTREPRENEURS ABOUT EQUITABLE
SMALL BUSINESS GROWTH AND A KEY
PART OF OUR WORK. INCREASE OUR
REACH TO SMALL BUSINESS OWNERS
ON THE IMPORTANCE OF HEALTH CARE
AND PROVIDING A QUALITY JOB IN
CALIFORNIA- ADDRESS PREVENTATIVE
AT THE OVER FOUR MILLION SMALL
BUSINESS IN THE STATE MY
BUSINESS MAJORITY STRONGLY FOR
QUITE QUITE A FEW OF THE OFFICE
HEALTHCARE AND PORTABILITY. THE
COLLECTION OF THIS DATA WILL
ALLOW THE STATE THAT TARGET FROM
SPENDING AND CONTROL COSTS MAKE
HEALTH CARE MORE AFFORDABLE TO
SMALL BUSINESS OWNERS THEIR
EMPLOYEES AND SELF EMPLOYED
ENTREPRENEURS. AND BACK 67% OF
SMALL BUSINESS OWNERS OFFER
HEALTH CARE TO THE WORKFORCE
WERE STRUGGLING TO AFFORD IT THE
DATA POINT COMES FROM BEFORE
THOUGH THAT NINETEEN BECAUSE I'M
SURE YOU CAN IMAGINE THAT- AN
EVEN GREATER STRUGGLE FOR THOSE
SMALL BUSINESSES PARTICIPATING.
IN THE SMALL GROUP MARKET PLACE
TODAY HI CALIFORNIA SMALL
BUSINESS OWNERS KNOW THAT
POLICYMAKERS NEED THE TOOLS TO
BETTER TRACK THE CHANGES IN THE
HEALTH INSURANCE MARKET MANAGED
BY RENT THE PORT OF THE OPPOSITE
HEALTHCARE AFFORDABILITY WERE
ALSO IN SUPPORT OF BE COVERED
CALIFORNIA COST SHARING
ASSISTANCE. BECAUSE THE FEDERAL
ASSISTANCE THAT THE
ADMINISTRATION AT THAT AND- IN
OUT OF POCKET COSTS OF CARE
REMAIN DIFFICULT FOR MANY
CALIFORNIANS TO AFFORD. SMALL
BUSINESS OWNERS ARE RELYING ON
YOU KNOW- TO KEEP BEES AT COSTS
UNDER CONTROL THANK YOU SO MUCH. THANK YOU NEXT CALLER PLEASE.
MINDSET FOUR YOUR LINE IS OPEN
GO. HI CINDY HILLARY ON BEHALF
OF THE K. MEDICAL. IN EUROPE
BACK THE LIMITED TIME FRAME HERE
TODAY IN MY WILL FILE WRITTEN
RESPONSE WITH THE FACT THAT
PROPOSAL BETTER CREDIT TO OUR-
ENSURING FALLEN OUT OF RELEVANCE
BILL. PRIOR TO COME. GEN CMA
SUPPORT OF THE HEALTH RELATED
PROPOSAL IN THE GOVERNOR'S
PROPOSED IN YOUR I CAN BUDGET
DISCUSSED TODAY OUR CONCERNS
REALLY LIE IN THE DETAILS UP
IMPLEMENTATION. EMAILS COMMITTED
TO CONTINUING OUR WORK TO
IMPROVE ACCESS TO AFFORDABLE
QUALITY HEALTHCARE WE WILL
CONTINUE TO WORK WITH BOTH
HOUSES OF THE LEGISLATURE IN THE
ADMINISTRATION ON AMENDMENTS TO
THE OPPOSITE HEALTHCARE
AFFORDABILITY FOOTBALL IN ORDER
TO BETTER FOCUS ON THE TRUE PROP
DRIVERS IN THE BALLOT IN A STATE
WITH HIGHLY CONCENTRATED HEALTH. INSURANCE AND CAPITAL MARKET.
DMI HAS CONCERNS FOR THE
EMPLOYMENT OF HOW AT SO FAR. AND
WE HAVE SHE SOME OF THE CONCERNS
IN WRITING WITH THE COMMITTEE
AND STAFF. WE ARE WORKING
CLOSELY WITH THE DEPARTMENT TO
TRY TO RESOLVE THE PROBLEMS AS
THEY ARISE AND STATE DEPARTMENT
HAVE TEAMED RESPONSE THAT.
AFFECT FIND POLLUTION.WE WILL
CONTINUE TO ENGAGE WITH THE
DEPARTMENT THROUGH THE
SIMPLIFICATION PROCESS TO ENSURE
THAT ALL MEDICAL HELP
BENEFICIARIES WHO RECEIVE THEIR
MEDICATION. THANK YOU SO MUCH
FOR THE OPPORTUNITY TO COMMENT
THANK. THANK YOU NEXT CALLER
PLEASE. NINE TWENTY ONE YOUR
LINE IS OPEN PLEASE GO AHEAD. HI
THIS IS LILLIAN GLANTON CONTACT
PROGRAM RESOURCES AND WE ARE AT%
THE TECHNICAL ASSISTANCE
PROVIDERS TO THE CALIFORNIA
REDUCING DISPARITIES PROJECT
AFRICAN AMERICAN- IMPLEMENTATION
HI THE CROSSWALK. I JUST WANNA I
THANK YOU ARE CHAIRMAN OF THE
COMMITTEE- FOR INCLUDING THE
TECHNICAL LANGUAGE TO- FOLLOW
THROUGH ON THE INTENTION FROM
LAST YEAR'S BUDGET- TO SUPPORT
THE EXTENSION FOR THE- PERFECT
FOR THE PROJECT- AND GOD THIS
TECHNICAL LANGUAGE THAT IS BEING
INCLUDED HERE WILL ALLOW THE
CONTRACT EXTENDED WITHOUT ANY
UNINTENDED. AND UNNECESSARY-
INTRODUCTION- IN THE CONTRACT
THAT WOULD RESULT IN THE LOSS OF
SERVICES AND THE LOSS OF
CONTINUED EVALUATION AND SO ON
AND SO FORTH ON TO THE PROJECT
AND COULD RESULT IN MANY OF THE
PROJECT HAVING TO- I GOT CO STAR
AND OTHER KINDS OF YOUR CLOSING
TO WORKING THAT SORT OF THING SO
THANK YOU SO MUCH AND I JUST
WANT TO SAY- FOR THE REGULAR
YOUR COST. PLEASE LEAVE US OUT
OF THE CONTENTS OF THE.
WONDERFUL HELPFUL TO THANK YOU
ALL- AND- THANK YOU. THANK YOU
THAT AND I AGREE. NEXT CALLER
PLAY. MY EIGHTY YOUR LINE IS A
PLEASE GO AHEAD. THANK YOU KAREN
GILLAN MEMBERS OF THE COMMITTEE
WILL BE TORN REPRESENTING THE
COMMUNITY CLINIC INVESTIGATION
OF LOS ANGELES COUNTY REPRESENTS
SIXTY FIVE NONPROFIT COMMUNITY
CLINICS AND HEALTH CENTERS
THROUGHOUT THE COUNTY I SERVING
AS MEDICAL HOME FOR MORE THAN
ONE POINT SEVEN MILLION PATIENTS
EACH YEAR REALLY APPRECIATE THE
URGENTLY NEEDED OVERSIGHT OF
MEDICAL OUR EXTRADITION- AND
TODAY BANG UP DIALOGUE ANY
UPDATES FROM THE ADMINISTRATION.
I'D LIKE BACK OF MY COLLEAGUES
FROM DE CALIFORNIA HEALTH
ADVOCATES- COALITION ABOUT
ULTIMATE HEALTH SERVICES IN THE
HEALTH ALLIANCE THE NORTHERN
CALIFORNIA CLINIC ARE FACING
SIGNIFICANT RISING OPERATION
COSTS AT THE PORT COMMISSION
PROGRAM SERVICES THAT HAVE BEEN
SUPPORTED BY THE SAVINGS- AND
THEY'RE FACING THE CHALLENGES AT
THE SAME TIME THEY'RE
CONFRONTING EXACERBATED
WORKFORCE EXACTLY CHALLENGES.
CHANGING BACKPACKING IN BOOSTER
MANDATE AND CONFRONTING THE
MAKAN AND INCREASED VACCINATION
BOOSTERS OUR COMMUNITIES WE'RE
GRATEFUL TO LEGISLATURE AND
ADMINISTRATION FOR THE ONE
HUNDRED FIVE MILLION
SUPPLEMENTAL PAYMENT CALL
MEDICAID HARM TO HEALTH CENTERS
HOWEVER NOT SUFFICIENT SO WE
STRONGLY SUPPORT A FIFTY MILLION
DOLLAR AUGMENTATION- FROM THE
GENERAL FUND FOR THE NON-
HOSPITAL CLINIC SUPPLEMENTAL
PAYMENT CALL. ON IN WITH THAT I
WILL YIELD THANK YOU SO MUCH.
THANK YOU NEXT CALLER PLEASE.
NINE EIGHTY. YOUR LINE IS OPEN
PLEASE GO AHEAD. LINE EIGHTY
THREE YOU MAY BE ON MUTE PLEASE
GO AHEAD YOUR LINE IS OPEN. NINE
TWENTY TWO YOUR LINE IS OPEN
PLEASE GO AHEAD. GOOD AFTERNOON
MISTER CHAIR AND MEMBERS OF THE
COMMITTEE MY NAME IS OUR RECORDS
WE ARE CALLING TODAY ON BEHALF
OF THE COALITION OF ORANGE
COUNTY COMMUNITY HEALTH CENTERS
AND OUR MEMBERSHIP ABOUT TWENTY
FIVE COMMUNITY HEALTH CENTERS
WITH OVER SIXTY HEALTH CENTER
LOCATIONS THROUGHOUT. ORANGE
COUNTY. MY COMMENT IS IN REGARD
TO THE MEDIC CALIFORNIA TO
TRANSITION THEM PORTANTINO.
SACRAMENTO PEMPEL. I THINK THE
STATE BEGAN TALKING ABOUT THE
PROPER THE PHARMACY TRANSITION
MANY OF US INCLUDING SOME OF THE
FOLKS I HAVE SPOKEN TO THE
INCLUDING. CALIFORNIA HEALTH
ADVOCATES- WE HAVE BEEN RETAINED
A SIGNIFICANT FINANCIAL DAMAGES
THAT WOULD RESULT IN A
TRANSITION FOR OUR- FOR OUR
COMMUNITY HEALTH CENTERS AND
THEIR PATIENTS. THE LAST OF
THREE FORTY BC MENTAL IMPACT.
PATIENT SERVICES BY REDUCING
HOURS OF OPERATION FOR BOTH
PRIMARY CARE SITES AND
PHARMACIES. WHICH WILL TRANSLATE
INTO LIMITING ACCESS TO
PHARMACEUTICAL. INCREASINGLY
TRYING FOR PATIENTS TO BE SEEN.
AND NEGATIVELY. IMPACTING
OVERALL PATIENT ACCESS. HE FOR
MANY DIFFERENT. COMMITTEE HOW
CENTERS A PARA TO MAKE SURE THAT
THE FORM ROOM AND- SO I'M NOT TO
COMPROMISE QUALITY OF CARE FOR
PATIENTS. BUT THAT'S SAD A
COALITION OF ORANGE COUNTY
COMMUNITY HEALTH CENTERS IS A
STRONG SPPORTER AND HE CAN AT
THE MOMENT OF PAYMENT FOR. MY
FIFTY MILLION FROM THE STATE
GENERAL FUND THE INCREASE OF THE
STP FUNDS WILL ENSURE THAT THE
QUALITY OF THE PROGRAM SUPPORTED
BY THIS THE NEW GENERATED
GENERATED. THE CALIFORNIA
PROGRAM ARE NOT JEOPARDIZED. ANY
FURTHER THANK YOU SO MUCH. THANK
YOU NEXT CALLER PLEASE. OUR
FINAL COMMENT IN Q. IS FROM LINE
FORTY YOUR LINE IS OPEN PLEASE
GO AHEAD. HELLO AND MISTER CHAIR
AND MEMBERS THIS IS SERRA FLOCK
AND I AM REPRESENTING THAT
CALIFORNIA I GOT TO COUNCIL
WHICH REPRESENTS FIFTY TWO
THOUSAND UNION FILM AND TV CREW
AND CRAFTSPEOPLE AND I JUST
WANTED TO SPEAK IN SUPPORT OF
THE OPPOSITE HEALTHCARE
AFFORDABILITY. AND THANK
EVERYONE FOR ALL THEIR DON'T
WORK ON SUNDAYS TO SPECIALLY
DOCTOR WOULD- EVERY DOLLAR THAT
IS SPENT ON HEATHCARE COMES OUT
OF OUR MEMBERS POCKET. AND THE
RISING COST OF HEALTHCARE IS
JUST SIMPLY UNSUSTAINABLE- IT IS
EATING UP OUR WAGES IT IS. JUST
DO. IT STILL OF ALL AND SO WE
LOOK FORWARD TO WORKING WITH YOU
ALL ON THIS PROPOSAL TO CONTAIN
THE COST OF HEALTHCARE IN
CALIFORNIA AND MAKE IT MORE
SUSTAINABLE. THANK YOU. ANY
FURTHER CALLERS OPERATOR. YES WE
DID HAVE ONE FURTHER NINE JOIN
THE QUEUE. ONE MOMENT WHILE
WE'RE PROVIDING B. LINE NUMBER.
ONE EIGHTY NINE YOUR LINE IS
OPEN PLEASE GO AHEAD. YOU MAY
HAVE BEEN LISTED AS NINE EIGHTY
SIX YEAH HI THIS AB TECH BUT THE
THIRTY WORK BECKY GONZALEZ
NATIONAL ASSOCIATION OF SOCIAL
WORKERS CALIFORNIA I WANT TO
SUPPORT THE MANY CALLERS WHO
CALLED IN SUPPORT OF THE OFFICE
OF HEALTH CARE AFFORDABILITY AND
ALSO COST SHARING ASSISTANCE
UNDER. COVER CALIFORNIA THANK
YOU. THANK YOU OPERATOR THERE
ARE NO FURTHER COMMENTS IN Q. DO
YOU MIND GIVING THE INSTRUCTIONS
ONE FINAL TIME TO SEE IF WE HAVE
ANY OTHER PUBLIC COMMENT BEFORE
WE CLOSE. ABSOLUTELY THANK YOU
MR. LADIES AND GENTLEMEN IF YOU
DO HAVE A COMMENT ON TODAY'S
CALL YOU MAY PRESS ONE AND THEN
ZERO AT THISTIME. ONCE AGAIN
YOU MAY PRESS ONE AND THEN ZERO
IF YOU HAVE A COMMENT ON TODAY'S
CALL. THERE ARE NO FURTHER
COMMENTS INTO AT THIS TIME.
THANK YOU OPERATOR AND WE'LL
TAKE THAT AS THE CLOSE OF PUBLIC
COMMENT I WILL TAKE A MOMENT AND
THANK ALL OF THE STAFF THE- TECH
THE SERGEANTS AND THE TEAM WHO
HELPED US TO. PUT ON THIS
HEARING TODAY WITH THAT WE WILL
ADJOURN THANK YOU VERY MUCH.