GOOD AFTERNOON. GOING TO GO
AHEAD AND START THE HEALTH
COMMITTEE HEARING HERE THIS
AFTERNOON. BUT BEFORE WE BEGIN,
I'D LIKE TO MAKE A STATEMENT ON
PROVIDING TESTIMONY AT THIS
HEARING. WE SEEK TO PROTECT THE
RIGHTS OF ALL WHO PARTICIPATE IN
THE LEGISLATIVE PROCESS SO THAT
WE CAN HAVE EFFECTIVE
DELIBERATION ON THE CRITICAL
ISSUES FACING CALIFORNIA. IN
ORDER TO FACILITATE THE GOAL OF
THIS HEARING. WE WILL NOT PERMIT
CONDUCT THAT DISRUPTS, DISTURBS
OR OTHERWISE IMPEDE THE ORDERLY
CONDUCT OF LEGISLATIVE
PROCEEDINGS. OUR WITNESSES WILL
BE TESTIFYING IN PERSON. WE
ALLOW TWO MAIN WITNESSES FROM
MAXIMUM OF THREE MINUTES EACH.
ADDITIONAL TRUST TESTIMONY WILL
ALSO BE IN PERSON AND WILL BE
COMBINED AND LIMITED TO NAME
POSITION AND ORGANIZATION. IF
YOU REPRESENT ONE ALL PUBLIC
COMMENT NEEDS TO FOCUS ON THE
BILL AT HAND. COMMENTS ON OTHER
ISSUES WILL BE RULED OUT OF
ORDER, AND YOUR TIME WILL EXPIRE
IMMEDIATELY. PLEASE BE AWARE
THAT VIOLATIONS OF THESE RULES
MAY SUBJECT YOU TO REMOVAL OR
OTHER ENFORCEMENT PROCESS. WE
APPRECIATE YOUR CAR COOPERATION
. WE HOPE AUTHORS AND
STAKEHOLDERS ARE RESPECTFUL OF
THE PROCESS. WE HAVE BILLS
PROPOSED FOR CONSENT TODAY. UM
THE MEMBERS OF THE COMMITTEE MAY
REMOVE ANY MEMBER OF THE
COMMITTEE MAY REMOVE A BILL FROM
CONSENT THAT IS PROPOSED FOR
CONSENT OR ITEM NUMBER TWO. SB
11 65 BY SENATOR BATES. ITEM
NUMBER FIVE. SB 13 94 BY SENATOR
EGGMAN I'M NUMBER EIGHT SP 9 88
BY SENATOR HUESO AN ITEM NUMBER
10 SP 9 66 BY SENATOR LIMÓN
TODAY. WE HAVE A SUBSTITUTE. UM
WE HAVE SUBSTITUTES. EXCUSE ME.
SUDDENLY MEMBER, AKILA WEBER
WILL REPLACE THE DEMOCRATIC
VACANCY AND ASSEMBLYMEMBER'S
OSHKOSH WILL REPLACE FREDDY
RODRIGUEZ FOR TODAY'S HEARING.
THAT WE WOULD GO AHEAD AND BEGIN
OUR FIRST. SENATOR BATES, OUR
FIRST AUTHOR, PLEASE COME ON UP
. HAPPY TO HAVE YOU PRESENT SP 4
73.
GOOD AFTERNOON, MR CHAIRMAN AND
MEMBERS. I'M HERE TO PRESENT
SENATE BILL FOR 73, WHICH WILL
PLACE A CAP ON CO PAYS
DEDUCTIBLES AND COINSURANCE OR
OTHER COST SHARING REQUIREMENT
ON AN INSULIN PRESCRIPTION OF
$35 PER MONTH PER EACH DOSAGE
FORM OF INSULIN PRODUCTS. FIRST
I WOULD LIKE TO RECOGNIZE THAT
THIS COMMITTEE HAS PASSED
SIMILAR LEGISLATION, SO I KNOW
THAT YOU UNDERSTAND THIS ISSUE.
I WOULD LIKE TO ACKNOWLEDGE THE
EFFORTS OF ASSEMBLYMEMBER'S
NAZARIAN, WHO HAS HAD SEVERAL
BILLS ON THE TOPIC IN THE PAST,
AND I APPRECIATE THAT HE HAS
BLAZED THE TRAIL ON THIS
PARTICULAR ISSUE. IT IS MY HOPE
THAT WE CAN FINALLY GET A BILL
ON THIS TOPIC ACROSS THE FINISH
LINE. PEOPLE WITH DIABETES SPAN
2.3 TIMES MORE ON HEALTH CARE
EXPENSES THAN A PERSON WITHOUT
DIABETES. THE AVERAGE LIST PRICE
OF BRAND NAME INSULIN NEARLY
TRIPLED BETWEEN 2000 AND SEVEN
AND 2018. THE RISING COSTS OF
INSULIN HAS AFFECTED PEOPLE WITH
THIS DISEASE FOR PEOPLE WHO NEED
LIFE SUSTAINING INSULIN AND
CANNOT AFFORD IT. THE CHOICES
ARE SCARY. THEY CAN FIND
THEMSELVES BETWEEN CHOOSING
INSULIN OR PUTTING FOOD ON THEIR
TABLES. THIS IS UNACCEPTABLE. NO
ONE SHOULD HAVE TO RATION THEIR
INSULIN DUE TO COST. SB 4 73
WILL GIVE PEOPLE WITH DIABETES
CERTAINTY ON THEIR MAXIMUM COST
SHARING FOR THEIR LIFE SAVING
INSULIN. WHICH WILL ALLOW THEM
TO FOCUS ON MANAGING THEIR
CHRONIC CONDITION. I RECOGNIZE
THIS REPRESENTS A SIGNIFICANT
CHANGE IN COST SHARING THAT THE
SIZE OF THE POPULATION SUFFERING
FROM DIABETES REQUIRES THAT WE
DO THIS. I DO HAVE AUTHORS
AMENDMENTS, WHICH YOUR EXCELLENT
COMMITTEE ANALYSIS DESCRIBES
PERFECTLY, AND THAT'S ON PAGE
EIGHT. BASICALLY THEY ARE
TECHNICALLY AND CLARIFYING
AMENDMENTS SUGGESTED BY THE
DEPARTMENT OF INSURANCE I HAVE
WITH ME TODAY WHEN WITNESS
CHRISTA JACOB FROM ORANGE
COUNTY. THANK YOU WHENEVER
YOU'RE READY. NEED TO PUSH THE
BUTTON THE BUTTON THERE THE
MIGHT THERE YOU GO. GOOD
AFTERNOON, CHAIR AND MEMBERS. MY
NAME IS CHRIS TO JACOB. I LIVE
IN IRVINE WITH MY HUSBAND AND
TWO DAUGHTERS. OUR OLDEST IS 12
. HER NAME IS PAGE AND SHE WAS
DIAGNOSED WITH TYPE ONE DIABETES
AT THE AGE OF SEVEN. SINCE HER
DIAGNOSIS. WE'VE BEEN INVOLVED
WITH SEVERAL DIFFERENT TYPES OF
DIABETES ORGANIZATIONS AND I
LEAD A SUPPORT GROUP FOR PARENTS
. SO I'M HERE TODAY AS A MOTHER
, MOTHER, BUT ALSO AS A MEMBER
OF OUR COMMUNITY. TYPE ONE
DIABETES IS AN AUTOIMMUNE
DISEASE THAT CANNOT BE PREVENTED
. IT DESTROYS THE BODY'S ABILITY
TO PRODUCE INSULIN, WHICH IS
REQUIRED FOR BLOOD GLUCOSE
CONTROL. AS A RESULT, THE
INDIVIDUAL IS RELIANT ON
MANUFACTURED INSULIN TO STAY
ALIVE. TYPE ONE DIABETES ALSO
COMES WITH CONSTANT MONITORING,
PLANNING, INTERRUPTIONS AND
STRESS. WHETHER OUR DAUGHTER
PAGE IS AT SCHOOL OR SOME
PRACTICE OR EVEN SLEEPING IN HER
BED AT NIGHT, WE CAN NEVER LET
HER GUARD DOWN FOR LIFE. OR OUR
GUARD DOWN HER LIFE LITERALLY
DEPENDS ON IT. WE'RE CONSTANTLY
BALANCING TWO EQUALLY IMPORTANT
GOALS. THE FIRST IS PREVENTING
DANGEROUSLY LOW AND HIGH BLOOD
SUGARS OR BLOOD GLUCOSE LEVELS,
EITHER OF WHICH COULD BE FATAL,
SOMETIMES IN A MATTER OF
MINUTES. THE SECOND IS KEEPING
HER BLOOD GLUCOSE RANGES IN THE
HEALTHY RANGE OVERALL TO SUPPORT
HER LONG TERM HEALTH OUTCOMES.
AS YOU CAN IMAGINE, THIS TAKES
QUITE A TOLL ON BOTH THE FAMILY
AND THE INDIVIDUAL. AND THERE'S
ALSO A FINANCIAL ASPECT TO
CONSIDER. IN OUR CASE WE SPENT
OVER $17,000 LAST YEAR ON HEALTH
INSURANCE PREMIUMS AND MEDICAL
EXPENSES, MOST OF WHICH WERE TO
CARE FOR PAGE AND SOME FAMILIES
I KNOW PAY AS MUCH AS 30 TO
$40,000 A YEAR. WE'RE FORTUNATE
THAT WE CAN AFFORD OUR
DAUGHTER'S MEDICAL EXPENSES. BUT
WE KNOW THIS IS NOT THE CASE FOR
ALL FAMILIES AND THE QUESTION OF
HOW SHE WILL ONE DAY AFFORD HER
OWN CARE CONSTANTLY WEIGHS ON
US. AT THE TOP OF OUR MINDS IS
INSULIN AFFORDABILITY. FATHER
HAVEN'T BEEN ANY NOTABLE CHANGES
TO INSULIN AND THE RECENT YEARS
THE PRICES HAVE SKYROCKETED. ONE
VIAL KEEPS OUR DAUGHTER ALIVE
FOR 15 DAYS AND HAS A LIST PRICE
OF $320. IT'S NO WONDER THAT WE
HEAR SO MANY HEARTBREAKING
STORIES IN THE DIABETES
COMMUNITY STORIES OF PARENTS WHO
FORGO BASIC NEEDS TO CARE FOR
THEIR CHILDREN. STORIES OF
INDIVIDUALS WHO RATION INSULIN,
THEREBY RISKING THEIR LIVES IN
SOME CASES. AFFORDABLE ACCESS TO
INSULIN IS A CRITICAL COMPONENT
OF DIABETES CARE AND LONG TERM
HEALTH OUTCOMES. SB 4 73 WOULD
HELP INDIVIDUALS AND FAMILIES
AFFORD THIS LIFE SUSTAINING
MEDICATION. THANK YOU FOR YOUR
TIME TODAY AND ON BEHALF OF MY
FAMILY AND THE GREATER DIABETES
COMMUNITY, I URGE YOU TO SUPPORT
SB 4 73. THANK YOU VERY MUCH.
UM, ARE THERE OTHERS IN SUPPORT?
PLEASE COME FORWARD TO THE
MICROPHONE AND THIS YEAR. NAME
AND ORGANIZATION IF YOU
REPRESENT. THANK YOU, MR
CHAIRMAN AND MEMBERS MOIRA TOP
ON BEHALF OF BIO COM CALIFORNIA
IN SUPPORT. VIDEO BORN
REPRESENTING AMERICAN ACADEMY OF
PEDIATRICS, CALIFORNIA DIVISION
AND SUPPORT THANK YOU. BRIAN
SPENCER. I'M HAPPY. THE AMERICAN
COLLEGE OF O B G Y N DISTRICT
NINE AND THE CALIFORNIA
PODIATRIC MEDICAL ASSOCIATION
BOTH IN SUPPORT. THANK YOU.
AFTERNOON I'M FRED. NO OR
REPRESENTING PHARMA IN SUPPORT.
THANK YOU VERY MUCH. MOVING ON.
DO WE HAVE ANY WITNESSES IN
OPPOSITION REGISTERED WITNESSES
AND OPPOSITION.
AFTERNOON MR CHAIR MEMBERS OF
THE COMMITTEE JET HAMPTON WITH
THE CALIFORNIA ASSOCIATION OF
HEALTH PLANS. REGRETTABLY HERE
IN OPPOSITION TO SB 4 73. FIRST
WE WANT TO MAKE CLEAR THAT WE
ABSOLUTELY UNDERSTAND AND
EMPATHIZE WITH THE PATIENTS WHO
ARE BURDENED WITH THE HIGH COST.
AND CONTINUALLY RISING COST OF
INSULIN. WE HAVE CONTINUALLY AND
VOCIFEROUSLY EXPRESSED IN
ADDRESSING THE HIGH COST OF
PRESCRIPTION DRUGS THAN OUR
HEALTHCARE SYSTEM IS CRITICAL TO
MAINTAINING AFFORDABILITY FOR
ENROLLEES. WE SHARE OUR
ENROLLEES, FRUSTRATIONS THAT THE
EXPONENTIAL RISE OF PRESCRIPTION
DRUG PRICES, INCLUDING INSULIN.
IS CONTINUING TO DRIVE UP COSTS
WITHIN OUR HEALTH CARE SYSTEM.
IN FACT, ONE STUDY SHOWED THAT
THE PRICE OF INSULIN INCREASED
BY MORE THAN 240% FROM 2000 AND
7 TO 2017. YET ANOTHER STUDY
FROM THE NONPARTISAN HEALTH CARE
COST INSTITUTE DOWN PRICES FOR
INSULIN NEARLY DOUBLED OVER A
FIVE YEAR PERIOD BETWEEN 2012
AND 2016. AS NOTED IN THE STUDY
BY THE HEALTH CARE COST
INSTITUTE. QUOTE THERE ARE FEW,
IF ANY SEGMENTS OF THE AMERICAN
ECONOMY, WHERE A MANUFACTURER
CAN RAISE PRICES BY 92% AND HAVE
PEOPLE CONSUME THE SAME QUANTITY
OF THAT PRODUCT. THIS POINT IS
ESPECIALLY SALIENT CONSIDERING
THE FACT THAT INSULIN PRODUCTS
HAVE BEEN ON THE MARKET FOR
ALMOST A CENTURY AT THE PRICE
FOR INSULIN CONTINUES TO RISE
WITHOUT ANY MAJOR MEDICAL
IMPROVEMENT TO THE DRUG.
AGGRESSIVE EFFORTS BY BRAND NAME
DRUG MANUFACTURERS TO BLOCK
COMPETITION FROM GENERIC AND
BIOSIMILAR DRUG ENTRY INTO THE
MARKET IS ONLY EXACERBATED THE
SKYROCKETING PRICE INCREASES FOR
THIS LIFE SAVING DRUG.
REGRETTABLY SB 4 73. THERE'S
NOTHING TO TEMPER THE EGREGIOUS
PRICE INCREASES IMPLEMENTED BY
THE MANUFACTURERS OF INSULIN. IN
ITS CURRENT FORM. AS BEFORE, 73
WOULD ESTABLISH A $35 COPAY
CAPRA INSULIN WITHOUT ADDRESSING
THE ROOT CAUSE OF THE THAI
PRICE, WHICH IS THE EVER
INCREASING PRICES THAT THE DRUG
MANUFACTURERS CHARGE FOR
INSULIN. CAPTAIN CO PAYS THAT
ADDRESSING THE ROOT CAUSE OF THE
PRICE INCREASES MEANS THAT
EVERYONE WILL PAY MORE FROM
PATIENTS, BUSINESSES AND
TAXPAYERS TO HOSPITALS, DOCTORS
AND PHARMACISTS WHETHER THAT'S
THROUGH HIGHER DRUG PRICES. OR
NON ADHERENCE TO CRITICAL
MEDICINES THAT ARE NEEDED TO
PREVENT EVEN WORSE, POTENTIALLY
AVOIDABLE HEALTH OUTCOMES.
SIMPLY PUT THE SHARP PRICE
INCREASES HARM PATIENTS WHO RELY
ON INSULIN AND REDUCE THE
AFFORDABILITY OF COVERAGE FOR
ALL CONSUMERS, WHICH IS
REFLECTED IN THE CALIFORNIA
HEALTH BENEFIT REVIEWS PROGRAMS
. ANALYSIS OF THE BILL, WHICH
INDICATES THAT PREMIUMS WILL
INCREASE FOR ALL INSURANCE BY
APPROXIMATELY $52 MILLION. IN
CLOSING HEALTH PLANS REMAIN
COMMITTED TO PROVIDING
COMPREHENSIVE COVERAGE THAT
HELPS OUR ENROLLEES, PREVENT,
DIAGNOSE AND MANAGE BOTH ACUTE
AND CHRONIC CONDITIONS THAT
PROMOTE HEALTH, WELLNESS AND
PREVENTION. FOR THESE REASONS.
WE RESPECTFULLY OPPOSED AS
BEFORE 73. WE LOOK FORWARD TO
CONTINUE TO WORK WITH THE AUTHOR
AND THE LEGISLATURE TO ENSURE
THAT CALIFORNIANS OF ACCES TO
INSULIN AT COMPETITIVE AND
TRANSPARENT PRICES. THANK YOU.
THANK YOU. MR CHAIR MEMBER,
STEPHANIE WATKINS ON BEHALF OF
THE ASSOCIATION OF CALIFORNIA
LIFE AND HEALTH INSURANCE
COMPANIES. FIRST I'D LIKE TO
THANK THE AUTHOR. I KNOW SHE'S
PASSIONATE ABOUT THIS ISSUE, AND
IT'S ALSO LOOKED AT THE FEDERAL
LEVEL TO INTEND TO CONFORM THE
BILL TO SOME ACTIVITY THAT WE'VE
SEEN. TO ADDRESS THE HIGH COST
OF INSULIN. UNFORTUNATELY AT
THIS POINT, WE ARE OPPOSED TO
THE BILL, AS MANY OF YOU KNOW.
CALIFORNIA LIMITS PATIENT COST
SHARING FOR ALL PRESCRIPTION
DRUGS TO 2 50 FOR 30 DAY SUPPLY.
THE CAMP WAS CAREFULLY AND
THOUGHTFULLY NEGOTIATED TO
PROTECT CONSUMERS FROM THE HIGH
COST OF SPECIALTY DRUGS,
ENSURING THAT THE COST OF
HEALTHCARE REMAINED AFFORDABLE.
THIS BILL DIRECTLY INTERFERES
WITH THAT GOAL AS IT INCREASES
THE COST OF PREMIUMS FOR ALL
INSURANCE AND ENROLLEES BY
TREATING INSULIN DRUGS
DIFFERENTLY. ARBITRARILY
REDUCING THE COST SHARING OF
INSULIN DRUGS. YOU'RE SOCIALIZED
THAT ADDITIONAL EXPENSE AGAINST
ALL RATEPAYERS. ULTIMATELY
CREATING WINNERS AND LOSERS
WITHIN OUR HEALTH CARE SYSTEM BY
TREATING INDIVIDUAL ENROLLEES
DIFFERENTLY BASED ON SPECIFIC
DISEASES AND ARE DRUGS THAT THEY
TAKE. WELL, WE UNDERSTAND THE
IMPORTANCE OF THIS DRUG AND HAVE
A GREAT DEAL OF EMPATHY FOR, UM
, THOSE THAT FIND THEMSELVES UM
HAVING. TO AFFORD THESE TYPE OF
DRUGS AND TO PROTECT THEIR
FAMILIES. I THINK THERE SHOULD
BE A BROADER DISCUSSION. WE KNOW
THAT'S HAPPENING AT THE FEDERAL
LEVEL, AND WE LOOK TO THEM FOR
GUIDANCE. WITH THAT IN MIND, WE
CONTINUE TO LOOK FORWARD TO
HAVING DISCUSSIONS WITH THE
AUTHOR, BUT UNFORTUNATELY TODAY
WE ARE OPPOSED TO THE BILL.
THANK YOU. OTHERS IN OPPOSITION.
JOHN WINGER ON BEHALF OF
AMERICA'S HEALTH INSURANCE PLANS
WOULD JUST ECHO THE COMMENTS OF
CAPTAIN ACTUALLY WERE OPPOSED.
THANK YOU VERY MUCH. BRING IT
SEEMED NO ONE ELSE WILL BRING
BACKTO THE COMMITTEE, WHICH I
WILL NOTE. WE DO NOT HAVE A
QUORUM. SO WE ARE OPERATING AS A
SUBCOMMITTEE. SO, UM, UH
QUESTIONS OR COMMENTS. I HAVE A
COUPLE OF COMMENTS AND FIRST OF
ALL, THANK YOU VERY MUCH.
SENATOR BATES FOR BRINGING THIS
BEFORE WORD. I WILL NOTE FROM
THE COMMITTEE ANALYSIS THAT THE
POTENTIAL CHANGE AND INCREASING
PREMIUMS HERE IS LIKE 0.13
POINT, 14. IT'S NOT. IT'S NOT A
SIGNIFICANT IT'S NOT A
SIGNIFICANT INCREASE. AND UM AND
WITH ALL DUE RESPECT TO THE
OPPOSITION, UH, WE DON'T ALWAYS
WAIT FOR THE FEDERAL GOVERNMENT
TO DO THINGS WE ACTUALLY
HONESTLY ACT FIRST, MANY TIMES
AND ODDLY ENOUGH, INTERESTING.
THE FEDERAL GOVERNMENT SOMETIMES
FOLLOWS WHAT WE DO HERE IN
CALIFORNIA, BUT IT TAKES A LONG
TIME FOR THEM TO DO THAT GOOD
EXAMPLE OF THAT WOULD BE
SURPRISED BILLING, WHICH WE
WHICH WE PASSED A BILL IN 2017,
AND IT WAS UNTIL WAS JUST UNTIL
THIS YEAR THAT THAT THAT THAT
WAS VERSION OF THAT WAS ENACTED
BY THE AND GONE INTO FORCE BY
THE FEDERAL GOVERNMENT. SO
REALITY IS AND WHAT? WHAT WE
CAN'T REALLY KNOW FOR SURE, BUT
WE DO KNOW UM, ANNEX ANECDOTALLY
. A LOT IS THAT PEOPLE WHO DON'T
KEEP UP ON THEIR INSULIN HAVE A
LOT OF OTHER HEALTH CONCERNS.
AND SO IT DOES SURPRISE ME. I
THINK, IN THE END THAT THAT
THERE'S GOING TO BE A NET
BENEFIT, UM AND POTENTIALLY LESS
UNEXPECTED MEDICAL EXPENSES THAT
MIGHT LEAD TO PREMIUM INCREASES
BY KEEPING PEOPLE ON THIS
MEDICATION THAT WE KNOW IS A
LIFELINE, ESPECIALLY FOR PEOPLE
WITH DIET. TYPE ONE DIABETES
LIKE THE DAUGHTER OF OUR WITNESS
HERE, SO THIS BILL DOES ENJOY DO
PASS RECOMMENDATION WHEN WE HAVE
WHEN WE HAVE THE OPPORTUNITY TO
HAVE A QUORUM, AND IF THE BILL
DOES PASS, I WOULD LIKE TO BE
CONSIDERED AS A CO AUTHOR, IF
YOU IF YOU'D HAVE ME, SENATOR
BATES, ABSOLUTELY. THANK YOU
VERY MUCH. WOOD AND MY CLOSING
IS JUST TO THANK ALL OF YOU.
THIS WAS BROUGHT TO MY ATTENTION
WHEN LOCAL RESIDENT WAS SHARING
WITH ME THE NEAR DEATH
EXPERIENCES SHE HAD WITH A HER
YOUNG SON, WHO CONTRACTED.
JUVENILE DIABETES AND THE COST.
THAT PARTICULAR YEAR WAS $30,000
FOR A YOUNG COUPLE OR JUST
STARTING OUT, SO I THINK IT BEGS
THAT THIS HAPPENS TO BE A DRUG
THAT WE REALLY DO HAVE TO TAKE A
LONG, HARD LOOK AT REDUCING THE
COST SO THAT WE DON'T HAVE THESE
YOUNG FOLKS. LIFE IS IN DANGER.
THREE MONTHS ON WELL, THANK YOU
VERY MUCH FOR THAT CONSIDERATION
AND LOOK FORWARD TO GETTING AN
AYE. VOTE WHEN YOU HAVE FORUMS.
THANK YOU. THANK YOU VERY MUCH.
SENATOR BATES. MOVE ON. TO
REMEMBER? PH. WHAT ARE YOU
DOING OUT THERE? HE RIPPED YOU
DOING SOMETHING FOR SOMEBODY.
YOU'RE DOING SOMETHING. YOU'RE
DOING SOMETHING FOR MR GLASER.
WHAT WOULD YOU LIKE TO DO IT
NOW, SINCE THERE'S NOBODY ELSE
HERE. THANK YOU, MR FONG. YOU'LL
BE PRESENTING. SP 14 75 ON
BEHALF OF SENATOR GLASER? YES.
GOOD AFTERNOON, MR CHAIR MEMBERS
. I'M HERE ON BEHALF OF SENATOR
GLACIER TO PRESENT SP 14 75,
WHICH I HAVE BEEN PROUD TO WORK
ON WITH HIM AS A PRINCIPAL CO
AUTHOR. FIRST WE'D LIKE TO THANK
THE CHAIR AND THE COMMITTEE
STAFF FOR ALL THEIR HARD WORK.
AND THIS ON THIS BILL AND ACCEPT
THE COMMITTEE AMENDMENTS. LAST
YEAR I AUTHORED LEGISLATION THAT
PASSED THIS COMMITTEE TO ALLOW
MOBILE BLOOD DRIVES TO OPERATE
WITHOUT A REGISTERED NURSE ON
SITE AND SENATOR GLACIER HAS
CONTINUED THIS EFFORT IN
PARTNERSHIP WITH THE AMERICAN
RED CROSS. THIS BILL AUTHORIZES
A REGISTERED NURSE WHO IS IN
CHARGE OF BLOOD COLLECTION AT A
MOBILE BLOOD BANK TO BE
PHYSICALLY PRESENT OR AVAILABLE
VIA TELEHEALTH BLOOD DONATIONS,
AS WE ALL KNOW, SAVE COUNTLESS
LIVES ACROSS THE STATE AND
NATION. ACCORDING TO THE BLOOD
CENTERS OF CALIFORNIA, SOMEONE
NEEDS A BLOOD TRANSFUSION EVERY
THREE SECONDS. DONATED BLOOD
PRODUCTS AREUSED TO TREAT
INJURIES AND DISEASES RANGING
FROM CANCER, HEART DISEASE,
ORGAN TRANSPLANTS TO SEVERE
TRAUMATIC INJURIES. IT GOES
WITHOUT SAYING THAT WE RELY ON
THE KINDNESS AND GENEROSITY OF
BLOOD DONORS TO HELP SAVE SICK
AND VENERABLE CALIFORNIANS
NATIONWIDE BLOOD CENTERS ARE
FACING A BLOOD CRISIS, THE WORST
BLOOD SHORTAGE IN OVER A DECADE
, DOCTORS HAVE BEEN FORCED TO
MAKE DIFFICULT DECISIONS ABOUT
WHO RECEIVES BLOOD TRANSFUSIONS.
AND WHO WILL NEED TO WAIT. A
HOSPITAL IN LOS ANGELES EVEN HAD
TO CLOSE ITS TRAUMA CENTER FOR
TWO HOURS BECAUSE IT RAN OUT OF
BLOOD FOR PATIENTS. CALIFORNIA
IS THE ONLY STATE THAT MANDATES
AS A REGISTERED NURSE, BE
PHYSICALLY PRESENT. AT ALL SITES
WHENEVER BLOOD IS DONATED DURING
THE PANDEMIC, BLOOD BANKS WERE
ALLOWED TO DEVIATE FROM D. H C S
REGULATIONS BY USING TELEHEALTH
WHEN HE REGISTERED NURSE WAS NOT
AVAILABLE TO BE ON SITE. THIS
CRITICAL FLEXIBILITY ALLOWED FOR
MORE BLOOD DONATION AND DATA
SHOWS THAT DONOR SAFETY WAS NOT
IMPACTED DURING THESE DRIVES
THIS BILL ONE CHERYL ENSURE THAT
BLOOD IS COLLECTED SAFELY
INCREASE ACCESS IN RURAL
COUNTIES AND INCREASED BLOOD
DONATIONS DURING THIS CRITICAL
SHORTAGE WITH ME TODAY IS DARREN
GREENLEE, THE VICE PRESIDENT OF
DONOR SERVICES. OF THE AMERICAN
RED CROSS, AND DR HUGHES, THE
SENIOR MEDICAL OFFICER AT ADD
VITAL IN TO TESTIFY IN SUPPORT
OF THIS BILL. THANKS. PLEASE GO
AHEAD WHEN YOU'RE READY. THANK
YOU. CHAIRMAN WOULD AND
COMMITTEE MEMBERS. MY NAME IS
DARREN GREENLEE AND THE VICE
PRESIDENT. DONOR SERVICES FOR
THE AMERICAN RED CROSS PACIFIC
DIVISION. I SPENT 36 YEARS IN
THE BLOOD BANKING INDUSTRY. MOST
OF THAT WHICH HAS BEEN IN
CALIFORNIA. HOWEVER, I HAVE ALSO
WORKED AT BLOOD BANKS IN
NEBRASKA, IOWA, OREGON,
WASHINGTON AND ARIZONA. AND AS
ASSEMBLYMEMBER'S PHÊN MENTIONED
, CALIFORNIA IS THE ONLY STATE
WHICH REQUIRES PHYSICAL ARE IN
PRESENCE. AT ALL BLOOD DRIVE
OPERATIONS. THE PRIMARY
REGULATOR OF BLOOD BANKING IN
THE UNITED STATES IS THE FOOD
AND DRUG ADMINISTRATION. THE FDA
AND THEY HAVE NO REQUIREMENT FOR
RNS TO BE PHYSICALLY PRESIDENT.
BLOOD DRIVES A B B ALSO HAS NO
REQUIREMENT FOR OUR ENDS AND ALL
BLOOD DRIVES AND IT SHOULD BE
NOTED THAT CALIFORNIA ADOPTED A
BABY STANDARDS PUBLISHED IN 1989
AND ALL SUBSEQUENT AMENDMENTS AS
STATE LAW AND A BB SUPPORT
SENATE BILL 14 75. ON HER SAFETY
WILL NOT BE COMPROMISED UNDER
THIS BILL. IN FACT, OVER THE
LAST TWO YEARS WHILE OPERATING
UNDER TITLE 17 SECTION 1003 OF
THE CALIFORNIA CODE OF
REGULATIONS, WHICH ALLOWS
VARIANTS FROM TITLE 17 SECTION,
1002. CALIFORNIA BLOOD BANKS AND
THE DATA DEMONSTRATE THAT DONOR
SAFETY HAS IN NO WAY BEEN
COMPROMISED WHILE OPERATING
UNDER THE VARIANTS TO ALLOW RNS
TO PARTICIPATE VIA TELEHEALTH.
THOSE OPPOSING SENATE BILL 14
75. INDICATE THAT THIS
LEGISLATION PRESENTS PATIENT
SAFETY ISSUE. IN FACT, THE VERY
PURPOSE OF THE AMERICAN RED
CROSS IS BRINGING US FORWARD AND
OTHER BLOOD BANKS OPERATING IN
THE STATE OF CALIFORNIA AND THE
REASON WE'RE SUPPORTING THE
EDUCATION. LEGISLATION IS
BECAUSE IT IS A PATIENT SAFETY
ISSUE NOW. WE ARE ADVOCATING FOR
PATIENT SAFETY. UNDER CURRENT
REGULATION, THE SAFETY OF
CALIFORNIA PATIENTS WILL BE
COMPROMISED AS CALIFORNIA BLOOD
BANKS WILL BE UNABLE TO COLLECT
THE BLOOD THAT IS NEEDED. IF THE
LEGISLATION IS NOT PASSED. BLOOD
SHORTAGES HAVE EVEN RECENTLY
COMPROMISE PATIENT SAFETY AND IS
ASSEMBLYMEMBER'S PHÊN MENTIONED.
U C L, A CLOSED ITS TRAUMA
CENTER FOR SEVERAL HOURS BECAUSE
BLOOD WAS NOT READILY AVAILABLE
EARLIER THIS YEAR. YOU SHOULD BE
AWARE THAT 30% OF CALIFORNIA'S
BLOOD SUPPLY MUST BE IMPORTED
FROM OTHER STATES THAT HAVE NO
REQUIREMENT FOR RN PRESENCE AT
ALL BLOOD DRIVES, AND THAT
PERCENTAGE WILL ABSOLUTELY
INCREASE WITHOUT THE PASSAGE OF
SENATE BILL 14 75, AND THAT'S IF
THOSE STATES HAVE BLOOD
AVAILABLE THAT WE CAN IMPORT. ON
BEHALF OF THE AMERICAN RED
CROSS, ALL CALIFORNIA BLOOD
BANKS AND, MOST IMPORTANTLY, ON
BEHALF OF THE PATIENTS, RELYING
ON CALIFORNIA BLOOD SUPPLIED BY
CALIFORNIA BLOOD BANKS. I ASK
FOR YOUR SUPPORT OF SENATE BILL
14 75 WILL BE AVAILABLE TO
ANSWER ANY QUESTIONS YOU HAVE.
THANK YOU AGAIN. THANK YOU GO
AHEAD, AFTERNOON CHAIR AND
COMMITTEE MEMBERS. MY NAME IS DR
JONATHAN HUGHES. AND I AM THE
SENIOR CHIEF MEDICAL OFFICER FOR
THE WEST DIVISION OF A TALENT
TODAY I'M REPRESENTING BLOOD
CENTERS OF CALIFORNIA, A
COALITION OF 11 NONPROFIT BLOOD
CENTERS THAT OPERATE WITHIN THE
STATE AND PROVIDE THE MORE
MAJORITY OF BLOOD TO SUPPORT
CALIFORNIA HOSPITALS AND
PATIENTS. OUR TOP PRIORITY IS
THE SAFETY OF VOLUNTEER BLOOD
DONORS AND THE SAFETY OF
TRANSFUSED PATIENTS, WHICH
INCLUDES A SAFE AND AVAILABLE
SUPPLY OF BLOOD, WHICH CERTAINLY
HAS BEEN IMPACTED OVER THE LAST
SEVERAL YEARS WITH THE
AVAILABILITY OF THE BLOOD
SUPPLY. TO SUPPORT DONOR SAFETY
WITHIN OUR CENTERS. WE FOLLOW
STRICT DONOR ELIGIBILITY
SCREENING CRITERIA. COLLECT
BLOOD FROM HEALTHY VOLUNTEER
DONORS AND HAVE ROBUST TRAINING
AND COMPETENCY PROGRAMS,
LICENSED NURSE AND NON LICENSED
PHLEBOTOMIST STAFF RECEIVED THE
SAME EXACT TRAINING RELATED TO
THE SCREENING COLLECTION AND
CARIB DONORS AND HAVE THE SAME
EXPECTATIONS RELATED TO THE
SUPPORT OF THESE INDIVIDUALS.
ADVERSE REACTIONS ARE MANAGED
THE SAME REGARDLESS OF STAFF
LICENSE. SURE AND OUR STAFF,
ADDITIONALLY HAVE A MEDIA ACCESS
TO ON CALL PHYSICIAN SUPPORT AS
WELL AS TIMELY EMERGENCY MEDICAL
SUPPORT, ALSO AVAILABLE. THE
SAFETY AND EFFICACY OF THIS
APPROACH HAS BEEN BORNE OUT AND
DONOR HEMA VIGILANCE DATA WHICH
EVALUATES AND MONITORS BLOOD
DONOR SAFETY, THE TYPE OF
DONATION OPPORTUNITIES AND THE
TYPE OF DONORS THAT ARE
COLLECTED IN THE CALIFORNIA ARE
NO DIFFERENT FROM THE REST OF
THE NATION, WHICH DOES NOT
REQUIRE A NURSING PRESENCE TO BE
PHYSICALLY ON SITE DURING EACH
AND EVERY DONATION OPPORTUNITY.
FEMA VIGILANCE. DATA HAS SHOWN
NO DIFFERENCE IN THE TYPE OF
DONOR REACTIONS OR THE QUALITY
OF CARE WHEN COMPARING
CALIFORNIA OR TO THOSE STATES
THAT DO NOT HAVE AN ON SITE
PHYSICAL NURSING PRESENCE OVER
THE LAST TWO YEARS, BLOOD
COLLECTORS IN CALIFORNIA HAVE
DEMONSTRATED USING REAL LIFE
DATA AS WELL AS REAL LIFE
EXPERIENCE. THAT REMOTE NURSING
IS AN EFFECTIVE METHOD AND
SUPPORTING DONATIONS. SAFETY. AS
WELL AS AVAILABILITY OF BLOOD IN
THE STATE, EXPERIENCED ZERO
ISSUES AND ACCESSING TELEHEALTH
WITHIN THIS EXPERIENCE. WITHOUT
THIS OPTION DUE TO THE SEVERE
SHORTAGES OF REGISTERED NURSES
TO BE NEEDED TO SUPPORT ACUTE
PATIENT CARE. THOUSANDS OF UNITS
OF BLOOD WOULD NOT HAVE BEEN
COLLECTED AND AVAILABLE TO
CALIFORNIA PATIENTS. THE
AMERICAN RED CROSS REPORTED OVER
A TWO YEAR PERIOD USING REMOTE
NURSING TELEHEALTH, THEY WERE
ABLE TO SUPPORT 1600 BLOOD
DRIVES, EQUATING TO 35,000 WHOLE
BLOOD DONATIONS AND 6500
PLATELET DONATIONS. WITHIN VIæT
TALENT. WE HAVE USED CLOSE TO 40
TIMES PER MONTH REMOTE NURSING
TO SUPPORT BLOOD COLLECTIONS, SO
CERTAINLY BEEN ABLE TO SUPPORT
PATIENT NEED WITH THIS OPTION.
IF THE STATE DOES NOT ACT, THE
TELEHEALTH OPTION WILL NOT BE
AVAILABLE WHEN THE EMERGENCY IS
DECLARED OVER. AND PATIENTS WILL
BE AT RISK AS NURSING STAFFING
CHALLENGES WERE ONLY BE EXPECTED
TO CONTINUE, IF NOT WORSEN.
BLOOD CENTERS OF CALIFORNIA
STRONGLY SUPPORTS SB 14 75 AS IT
PROMOTES BLOOD AVAILABILITY TO
PATIENT CARE, THUS PROMOTING
PATIENT SAFETY. AND IT WILL
RETAIN THE HIGHEST LEVEL OF
DONOR SAFETY THAT HAS BEEN
ACHIEVED THROUGH THE LAST TWO
YEARS, AS WELL AS SHOWN THROUGH
OTHER STATES EXPERIENCE. THANK
YOU FOR YOUR TIME. THANK YOU
VERY MUCH OTHERS IN SUPPORT.
PLEASE COME FORWARD. JUST YOUR
NAME. POSITION OBVIOUSLY YOU'RE
IN SUPPORT AND ORGANIZATION IF
YOU REPRESENT ONE. CHRISTIE
WOODS, REPRESENTING THE AMERICAN
NURSING ASSOCIATION, THE
CALIFORNIA CHAPTER. THANK YOU.
VIDEO BORN REPRESENTING LET'S
CENTERS OF CALIFORNIA WERE IN
SUPPORT. THANK YOU. MR CHAIR AND
MEMBERS MADISON DWELLING ON
BEHALF OF THE AMERICAN RED CROSS
GOVERNMENT RELATIONS COMMITTEE
AND SUPPORT. GOOD AFTERNOON TURN
MEMBERS, VANESSA GONZALEZ WITH
THE CALIFORNIA HOSPITALS
ASSOCIATION AND SUPPORT THANK
YOU. AFTERNOON WILLIAMS PLUS OUR
COUNTY RESIDENT IN SUPPORT.
THANK YOU. THANK YOU. HMM WE
HAVE TO. WE HAVE WITNESSES IN
OPPOSITION. PLEASE COME FORWARD.
GOOD AFTERNOON, MR CHAIR AND
MEMBERS CURTIS LANGUAGE. THE
CALIFORNIA NURSES ASSOCIATION
REPRESENTING OVER 100,000
REGISTERED NURSES IN CALIFORNIA
. WE RESPECTFULLY OPPOSE SB 14
75. WHICH WOULD END THE
REQUIREMENT THAT BLOOD BANKS
HAVE A REGISTERED NURSE
PHYSICALLY PRESENT DURING BLOOD
DRAWS AND OTHER PROCEDURES, AND
INSTEAD IT WOULD ALLOW
REGISTERED NURSES TO MONITOR
PROCEDURES OF THE A
TELECONFERENCE. THE SUPERVISING
LICENSED PHYSICIAN DOESN'T HAVE
TO BE PRESENT ON THE BLOOD BANK
PREMISES. AND NOW THIS BILL
WANTS TO EVEN REMOVE THE RN
REPORTS OF THIS MEASURE HAVE
INDICATED THAT BY REMOVING THE
RESTRICTION TO HAVE NURSES
PHYSICALLY PRESENT AT A BLOOD
DRAW WOULD ALLOW FOR GREATER
INCREASES IN BLOOD DONATIONS.
YET ACCORDING TO A RECENT TUFTS
UNIVERSITY UNIVERSITY ARTICLE
THE BLOOD SUPPLY HAS BEEN UNDER
PRESSURE FOR THE PAST FIVE OR
SIX YEARS, WITH BLOOD CENTERS
HAVING TROUBLE WITH SHRINKING
PROFIT MARGINS AND OUR
RELUCTANCE AMONG INDIVIDUALS TO
KNOW DONATE BLOOD. ESPECIALLY
DURING THE COVID 19 RESTRICTIONS
. RESTRICTIONS DURING THE COVID
19 PANDEMIC RESULTED IN A
SIGNIFICANT DROP IN DONATIONS.
IN FACT, 62% DROP IN COLLEGE AND
HIGH SCHOOL BLOOD DRIVES WE'RE
SEEING DURING THIS PANDEMIC.
EVEN STATES THAT DO NOT REQUIRE-OUR ENDS ARE ALSO SEEING DROPS
IN DONATIONS IS NOT RELATED TO
DIFFICULTIES IN HIRING RNS. BOTH
THE SENATE AND ASSEMBLY HELP
ANALYSIS INDICATE THAT THE
RECENT BLOOD DONATION SHORTAGES
DUE TO CANCELATION OF BLOOD
DRIVES DURING THIS PANDEMIC. WE
BELIEVE THE BILL'S PROPONENTS
ARE TRYING TO EXPLOIT THE CD PH-RAGS THAT ALLOW FOR DEVIATION
FROM THE PROVISIONS REGULATING
BLOOD BLANKS IN THE EVENT THAT A
STATE OF EMERGENCY EMERGENCY IS
DECLARED IN THIS DEVIATION BING
THE USE OF TELEHEALTH. NURSES
ARE VERY CONCERNED THAT DONOR
SAFETY WILL BE PUT AT RISK BY
THIS CHANGE, AS IT HAS BECOME
PAINFULLY CLEAR OVER THE PAST
TWO YEARS. HELLO CONFERENCE
SERVICES ARE FREQUENTLY
UNRELIABLE. AND THIS RISK WOULD
BE EXASPERATED IN RURAL AREAS.
WITH LESS RELIABLE INTERNET OR
PHONE SERVICE, AND THESE RURAL
AREAS ALSO LIKELY INVOLVE LONGER
TRAVEL TIME. EMERGENCY CARE,
CREATING ADDITIONAL RISK TO
THOSE DONATING HEALTH CARE
WORKERS SIMPLY CANNOT INTERPRET
SOMEONE'S PHYSICAL REACTION TO
BLOOD BANK PROCEDURES OVER THE
PHONE, OR EVEN BY
VIDEOCONFERENCING AS WELL AS CAN
BE DONE IN PERSON. UNDER THIS
BILL AHRENS PROVIDING REMOTE
SUPERVISION COULD VERY WELL BE
MONITORING MULTIPLE SITES AT ONE
GIVEN TIME, AND IT SEEMS
LIMITLESS IN TERMS OF HOW MANY
PATIENTS OR IN THE CASE, BLOOD
BANKS IN THIS CASE, BLOOD BANKS
AND THEIR BLOOD DONORS IN RN,
MAYBE MONITORING AT ONE TIME.
THE COLLECTION OF WHOLE BLOOD
FROM HEALTHY DONORS. THERE'S
ONLY ONE PROCEDURE PERFORMED IN
BLOOD BANK SETTINGS, OTHER
PROCEDURES THAT INVOLVE A
POTENTIAL FOR GREATER RISK
INCLUDE APRIL REESE'S DURING
WHICH BLOOD PLASMA IS OBTAINED
FROM A DONOR SEPARATED OUT FOR
COLLECTION. AND THEN THE
REMAINING BLOOD IS RETURNED TO
THE DONOR AT THE END OF THE
PROCEDURE TO ENSURE SAFETY FOR
CALIFORNIANS. NURSES MUST BE ON
THE PREMISES FOR THIS AND OTHER
PROCEDURES. PROPONENTS HAVE
INDICATED THAT THE PRACTICE OF
TELE NURSING FOR EFFICIENT AND
SAFE POLITICAL ACTION THROUGH
THE STATE IS SAFE, NECESSARY AND
PRACTICAL. AGAIN RESTRICTIONS
DURING THE COVID PANDEMIC
RESULTED IN A 62% DROP IN
COLLEGE AND HIGH SCHOOL BLOOD
DRIVES. IT IS IMPORTANT TO NOTE
THAT THE TEENAGE BLOOD DONOR, UH
, DONORS COMPRISING LARGE,
DISPROPORTIONATELY POPULATION OF
BLOOD DONORS IN THE UNITED
STATES. ALTHOUGH BLOOD DONATION
IS GENERALLY A SAFE PROCEDURE,
ADVERSE REACTIONS AND INJURIES
HAVE BEEN REPORTED. AH MANY
STATES ALLOW UNLICENSED
PERSONNEL TO ADMINISTER
MEDICATION AND PROVIDE OTHER
TREATMENTS OUTSIDE OF THEIR
SCOPE OF PRACTICE. BUT THAT DOES
NOT MEAN THAT IT'S EITHER SAFE
OR ACCEPTABLE IN CALIFORNIA. FOR
THESE REASONS. WE RESPECTFULLY
ASK FOR YOUR NO VOTE TODAY ON
THE BILL. BASIC AHEAD. GREAT
THANK YOU, MR CHAIRMAN MEMBERS,
EDUARDO MARTINEZ WITH THE
CALIFORNIA LABOR FEDERATION IN
RESPECTFUL OPPOSITION TO S
BEFORE 14 75. WE APPRECIATE THE
AUTHOR, AND IN THIS CASE, THE
SEVEN MEMBER PH. MEETING WITH
US TO A HERE ARE CONCERNS.
HOWEVER WE REMAIN DEEPLY
TROUBLED BY THE ELIMINATION OF
THE REQUIREMENT THAT NURSES BE
PRESENT AT THE TIME OF BLOOD
DRAW. TO THE EXTENT OF THIS BILL
IS, UH, TRYING TO SOLVE BY A
WORKFORCE SHORTAGE. LABOR IS
ALWAYS WORKED WITH THE
LEGISLATURE AND SUPPORTED
INDUSTRIES TO LOOK AT WAYS TO
FIND SOLUTIONS TO ADDRESS
WORKFORCE SHORTAGES AND
WORKFORCE ISSUES. LAST YEAR, WE
FOUGHT FOR ADDITIONAL DOLLARS TO
INVEST IN THE PUBLIC HEALTH
WORKFORCE. WE WORKED WITH THE
GOVERNOR TO SUPPORT HIGH ROAD
TRAINING PARTNERSHIPS
INVESTMENTS TO ADDRESS THE
NURSING SHORTAGE IN THE STATE,
AND WE ARE CURRENTLY WORKING
WITH OUR BROTHERS AND SISTERS AT
ISSUE YOU CALIFORNIA ON A BILL
TO, UH PROVIDE ADDITIONAL
TRAINING DOLLARS AND INCREASED
PAPER FEDERALLY QUALIFIED HEALTH
CENTERS. HEALTH CENTER IN THE
HEALTHCARE SECTOR QUALITY IS
TYPICALLY ONE OF THE MOST
IMPORTANT COMPETITIVE FACTORS.
IT IS CRITICAL FOR BLOOD BANKS
TO ENSURE QUALITY AND THEN
PROVIDE LOW RISK. FOR PRODUCT
RELATED DISEASES OR INFECTION.
LET'S BE CLEAR THE INSTEAD OF
TAKING THE TIME TO UNDERSTAND
THE INDUSTRY AND HOW WE COULD
SUPPORT THE WORKFORCE NEEDED TO
SUPPORT A NECESSARY PART OF THE
HEALTH CARE SECTOR AND INDUSTRY.
UH THIS BILL IS BEFORE YOU TODAY
AND WE RESPECTFULLY REQUEST YOUR
NO VOTE. THANK YOU. ARE THERE
OTHERS IN THE ROOM IN
OPPOSITION, PLEASE? JUST YOUR
NAME ORGANIZATION POSITION. QUÊ
BETH NOT ASK YOU THAT YOU STATE
COUNCIL. WE HAVE 700,000 MEMBERS
. 150,000 HEALTHCARE WORKERS
RESPECTFULLY OPPOSING TODAY AND
ASKING FOR YOUR NO VOTE. THANK
YOU. CHRIS MEYERS, WITH THE
CALIFORNIA SCHOOL EMPLOYEES
ASSOCIATION. OPPOSING THE BILL.
THANK YOU GONNA STOP. WE HAVE A
QUORUM, SO MADAM SECRETARY,
PLEASE CALL THE ROLL. WOULD HEAR
WALDRON. I GET CURRY. ARAMBULA
BIGELOW. CARILLO. MHM.
MAIENSCHEIN MAZE. BACARDI. THIS
ARYAN LUZ RIVAS ALRIGHT.
SANTIAGO. WEBER. WE DO HAVE A
QUORUM. SO AT THIS POINT, WE'RE
BRINGING THE BILL BACK TO
COMMITTEE QUESTIONS OR COMMENTS
FROM THE COMMITTEE. DR WEBBER.
THANK YOU VERY MUCH FOR THE
PRESENTATION AND FOR PRESENTING
THIS BILL, I AM HAVE A QUESTION
FOR THE OPPOSITION BECAUSE WHAT
I'VE HEARD AND WHAT I'VE READ IS
THAT, UM, OVER THE LAST TWO
YEARS THAT THIS HAS BEEN
HAPPENING BECAUSE OF THE
EMERGENCY ORDINANCE. THERE HAS
NOT BEEN AN ISSUE WITH PATIENT
SAFETY. UM AND THIS IS SOMETHING
THAT IS ALSO HAPPENING ACROSSTHE COUNTRY, AND THERE'S NOT
BEEN AN ISSUE WITH PATIENT
SAFETY AND I CLARIFIED WITH
SENATOR GLASER TODAY THAT ALL
BLOOD BANKS WOULD STILL HAVE THE
REQUIREMENT OF BEING NO MORE
THAN 15 MINUTES AWAY FROM AN
EMERGENCY MEDICAL FACILITIES. SO
WHAT, UM PROOF. DO YOU HAVE THAT
THERE WOULD BE AN ISSUE SINCE
THE CURRENT EVIDENCE DOESN'T
SUGGEST THAT THERE WOULD BE MR.
CHAIR, PLEASE. THANK YOU FOR
THAT QUESTION. SIMPLY MEMBER. I
THINK ONE OF THE THINGS THAT WE
NEED TO KEEP AND KEEP IN MIND IS
THAT AS I MENTIONED 62% OF BLOOD
DRIVES WERE CANCELED AS A RESULT
OF THIS PANDEMIC. SO ANY DATA
THAT MIGHT BE AVAILABLE TO
REFLECT WHAT REACTIONS MAY OCCUR
HAVE OCCURRED AREN'T FULLY
REFLECTING WHAT WOULD OCCUR ONCE
THESE BLOOD DRIVES START TO
RESTART REMEMBERED TEENAGE BLOOD
IS THE TEENAGERS THAT COMPRISE
MOST OF THE POPULATION THAT
PROVIDES BLOOD DURING THE BLOOD
DRIVES, AND SO SINCE THOSE WERE
CANCELED OVER THE LAST TWO YEARS
, YOU'RE NOT GONNA HAVE DATA TO
REFLECT THOSE TEENAGERS AND
THEIR REACTION. UH THE
PROPONENTS DID PROVIDE SOME DATA
AROUND DONOR COMPLICATIONS. BACK
IN 2000 AND 17, WHICH I WOULD
INDICATE WHERE WHICH I WOULD
THINK WOULD BE MORE REFLECTIVE
OF, UM, WHAT WE MAY SEE AFTER
THE PANDEMIC IS OVER. RIGHT AND
SO BASED ON THAT DATA, IT LOOKS
LIKE CALIFORNIA HAS A HIGHER
COMPLICATION RATE THAN ANY OTHER
OTHER STATES. AND SO WITH THAT
IT'S IMPORTANT THAT I HAVE THE
DATA HERE THAT WAS SUPPLIED BY
THE PROPONENT, AND WITH THAT, IT
WOULD BE SEEMED TO INDICATE THAT
WE WOULD WANT TO HAVE A NURSE
AVAILABLE. TO BE SURE TO ADDRESS
THOSE ISSUES AS THE TEENAGERS
START TO THE BLOOD DRIVE START
TO PICK UP AND THE TEENAGERS
START TO DONATE MORE. THANK YOU.
SO YOU'RE STATING THAT
CALIFORNIA RESIDENTS HAVE A
HIGHER RATE OF UM, NEGATIVE
OUTCOMES THAN ANY OTHER STATE IN
THE UNITED STATES. THAT'S
CORRECT, MAN. I WAS SUPPLIED BY
THE PROPONENT. IS THEY WERE
SUPPLIED. BY WHO? THE PROPONENTS
OF THE BILL OKAY WITH THE
OPPONENTS, AND THEY PROVIDED THE
DATA, I HAVE IT HERE. DONOR
COMPLICATIONS DOCUMENTED ON A
DONOR COMPLICATION INJURY
RECORD. AND THUS IT SHOWS HERE
THAT THERE'S 35 PER 10,000
DONATIONS IN SOUTHERN CALIFORNIA
OR THE PER 10,000 DONATIONS IN
NORTHERN CALIFORNIA, WHICH WHEN
YOU COMBINE US TOGETHER, THAT'S
75, BUT THE TOTAL OF CALIFORNIA
TOTALITY OF CALIFORNIA WHICH IS
EXTREMELY HIGHER THAN ANY OTHER
STATE ON THIS DOCUMENT. THANK
YOU, DR WEBBER. MY RESPONSE TO
THAT WOULD BE THAT CLEARLY
DEMONSTRATES THAT PLATE OWNERS
ARE ACTUALLY NO SAFER IN
CALIFORNIA THAN THEY ARE OR ANY
ANY MORE DETRIMENT THAN ANYWHERE
ELSE IF THE INCIDENT OF REACTION
IS HIGHER IN THE STATE OF
CALIFORNIA WITH THE PRESENCE OF
OUR ENDS UM, THAT AND I'M NOT
EVEN SURE THAT THAT DATA
CORRELATES WITH THE PRESENCE OF
AN RN OR NOT, BUT I WOULD
SUGGEST THAT THAT DATA AND THE
DATA THAT WAS COLLECTED IN 2017
CLEARLY DEMONSTRATES THAT THERE
IS NO DIFFERENCE IN THE IN THE
REACTION RATE OF DONORS IN THE
STATE OF CALIFORNIA, WHERE AN
RNS PRESENT AND IN THOSE STATES
WERE IN RN IS NOT REQUIRED TO BE
PRESENT. WHAT WHAT I WOULD LIKE
IS TO SEE THE DATA BECAUSE I'M
SURE THIS BILL WILL COME TO THE
FLOOR BECAUSE, YOU KNOW, I WANT
TO MAKE SURE THAT I'M LOOKING AT
APPLES TO APPLES AND NOT APPLES
TO ORANGES. SO YOU KNOW WHEN
YOU'RE TALKING ABOUT OTHER
STATES FOR THESE HEALTHIER
INDIVIDUALS VERSUS THE ONES THAT
HAPPENED TO BE COLLECTED IN
CALIFORNIA. AND THAT JUST
HAPPENED. YOU KNOW THEY THE
OTHER STATES DIDN'T GIVE US
THEIR UNHEALTHY INDIVIDUALS, SO
I WANT TO MAKE SURE THAT IT'S
APPLES TO APPLES. SO I WOULD
LOVE TO SEE THAT DATA SO THAT I
CAN EVALUATED FULLY WHEN I GO TO
THE WHEN IT COMES WHEN IT COMES
TO THE FLOOR. UM, THANK YOU. MR
CHAIR IF I MAY, UM ACTUALLY.
THROUGH HER IF SHE'D LIKE YOU,
IF YOU HAVE A QUESTION, IT'S UP
TO YOU. WOULD YOU LIKE TO? HE
HAS ANOTHER COMMENT. WOULD YOU
LIKE TO HEAR FROM HIM? THE
PROPONENT JUST INDICATED, SO.
THE PRESENCE OF THE NURSE
DOESN'T MEAN THAT ADVERSE
REACTIONS WON'T HAPPEN. THE
PRESENCE OF THE NERVES IS TO
ADDRESS REACTIONS WHEN THEY WANT
TO CLARIFY THAT. A NURSE. BEING
THERE DOESN'T MEAN THAT A PERSON
FOR POWERS. THEY'RE THERE TO
ADDRESS THEM. ONE. THANK YOU. GO
AHEAD. I'M SORRY, WHEN YOU WHEN
YOU WERE WHEN YOU RESPOND IF YOU
CAN TALK INTO THE MIX SO WE CAN
ALL HEAR WHEN THE YOUR YOU KEEP
TURNING AWAY. SO MY APOLOGIES. I
HAVE A BIG MOUTH SO I CAN BE
KIND OF LOUD SO I'M TRYING TO
ANY ANY RIGHT. I WAS JUST
WANTING TO INDICATE THAT THE
PRESENCE OF A NURSE DOES NOT
MEAN THAT ADVERSE REACTIONS
WON'T HAPPEN. THE PRESENCE OF
THE NURSE AND HEALTH CARE
PERSONNEL IS TO ADDRESS THEM.
WHEN THEY DO HAPPEN AND ENSURE
THAT THE DONORS GET THE CARE
THAT THEY NEED. CAN I ALSO ADD
THAT OUR HANDS ARE SELDOMLY
CONTACTED? UM AS BLOOD BAKING
STAFFORD TRAINED TO HANDLE
ROUTINE REACTIONS ASSOCIATED
WITH BLOOD DONATIONS, SO ANY
SEVERE REACTION FOR WHICH THE
STAFF NEEDS IMMEDIATE ADVICE
RESULTS IN A CALL TO THE MEDICAL
DIRECTOR TO PHYSICIAN BECAUSE
ALSO MADE TO THE R N AS A
NOTIFICATION THAT A SEVERE
REACTION HAS OCCURRED IN THAT
911 IS CALLED IF SOMETHING WERE
TO HAPPEN. BUT THIS PROCESS IS
THE SAME. UH, UNDER THIS UNDER
THIS PROPOSAL, AND THERE'S
NOTHING CHANGES WHEN IT COMES TO
THE PROCEDURES OF REACTING TO
ADVERSE REACTION. ANY OTHER
QUESTIONS OR COMMENTS. I DO HAVE
A COMMENT, AND SO, WITH ALL DUE
RESPECT, YOU DON'T JUST GET TO
TAKE 35 PER 100,000 AND 40 PER
100,000 AND ADD THEM TOGETHER
AND GET 8500 THAT'S NOT HOUSE TO
STATISTICS WORK. WE NEED TO KNOW
THE TOTAL NUMBER OF PEOPLE
INVOLVED IN NORTHERN CALIFORNIA
AND SOUTHERN CALIFORNIA AND THEN
AND THEN TAKE THE ADVERSE
REACTIONS FOR BOTH AND OUT AND
TOGETHER. SO JUST SAYING 35 IN
SOUTHERN CALIFORNIA 40. IT
DOESN'T WORK THAT WAY. SO I
DON'T KNOW WHAT YOUR WHAT YOUR
RAW NUMBERS ARE, BUT BUT THAT IS
NOT THE WAY THE WAY TO PRESENT
THAT AND JUST SO JUST SO YOU
UNDERSTAND SO UM, THE, UH, I
GUESS I GUESS WHAT I WILL GO
BACK TO AND I WANT TO SAY, MR
FONG, THE BILL DOES ENJOY THESE
PAST RECOMMENDATION. IT'S PRETTY
RARE THAT CALIFORNIA IS THE ONLY
STATE IN THE UNION. NOT DOING
SOMETHING, UM, LIKE THIS AND IF
IT'S I THERE IS THERE ARE HUGE
INCIDENCES OF. OF REACTIONS AND
UNINTENDED CONSEQUENCES. SURELY
THERE WOULD BE DATA IN 49 OTHER
STATES TO BE ABLE TO SUPPORT
THAT, AND WHAT I HAVE HEARD FROM
THE OPPOSITION IS NOT DATA THAT
SUPPORTS THAT. IT'S TALKING
ABOUT THE NUMBER OF PEOPLE WHO
AREN'T GOING TO DRIP BLOOD
DRIVES BECAUSE OF COVID AND SO
FORTH. SO, UM, SO I NO, I
HAVEN'T. I HAVEN'T SEEN THE DATA
THAT SUPPORTS THAT. THIS IS A
BAD IDEA. OTHERWISE MAYBE ONE OF
THOSE 49 STATES WOULD BE NOT
DOING IT ANYMORE AND GONE IN THE
OTHER DIRECTION. BUT CLEARLY,
THAT'S NOT NOT THE CASE. UM
STAFF SHORTING IS SHORTAGES ARE
AN ISSUE. I'VE BEEN TRYING TO
DONATE BLOOD AND IT'S HARD TO
GET IN QUITE FRANKLY, BECAUSE
THEY ARE STRUGGLING WITH
SHORTAGES, UM THROUGHOUT AND
THAT'S NOT JUST NURSING. IT'S
OTHERS THAT WORK IN THE
FACILITIES AND WE DO NEED BLOOD.
WE'VE NEEDED BLOOD FOR A LONG
TIME. COVID HAS EXACERBATED
THIS, OBVIOUSLY, UM RATHER
RATHER DRAMATICALLY. SO UH SO I
THE BILL DOES ENJOY DO PAST
RECOMMENDATION. MR. FONG, WOULD
YOU LIKE TO CLOSE? I MIGHT JUST
USE YOUR STATEMENT AS A CLOSE,
BUT I WILL ALSO SAY THAT YOU
KNOW THAT THERE IS WORKFORCE
ISSUES. UH YOU KNOW, YOU AND I
HAVE TALKED ABOUT THIS. WE NEED
MORE NURSES IN CALIFORNIA. SO
THIS ISN'T IT IS THIS IS NOT THE
EXCLUSIVE. TO THE NEED FOR MORE
NURSES, ESPECIALLY IN RURAL
AREAS. I REPRESENT A RURAL AREA
AS AS YOU DO AS AS AS YOU AS
WELL. SO YOU KNOW, WE WERE
CONCERNED ABOUT BLOOD DONATIONS
AND PLEDGE SHORTAGES IN RURAL
AREAS, AS WELL AS AN URBAN
AREAS, WHICH IN DISADVANTAGED
COMMUNITIES, YOU KNOW THEY NEED.
I MEAN, THEY HAVE MUCH SHORTAGES
AS WELL. SO I'LL JUST ADD THAT
THERE'S EMPIRICAL DATA WHERE THE
ONLY STATE THAT MANDATES UM,
PREVENTION NURSE BE PHYSICALLY
ON SITE. WE HAVE THE EMPIRICAL
DATA FROM THE LAST TWO YEARS.
UM, I APPLAUD THE WORK OF ALL
BLOOD BANKS ACROSS THE STATE.
ABOUT THE CONTINUED TO ADJUST
AND I RESPECTFULLY ASK FOR YOU.
THANK YOU VERY MUCH, MR FONG. SO
WE HAVE THE BILL. IS THERE A
HERE EMOTION? THE COMMOTION. UM
WELL MOTION BY MR FLORA. SECOND
BY MR BIGELOW. UM, MOTION WOULD
BE DO PASS AS AMENDED TO
BUSINESS AND PROFESSIONS. MADAM
SECRETARY, PLEASE CALL THE ROLL.
I WOULD I, WALDRON WALDRON, I
AGUIAR-CURRY ARAMBULA. BIGELOW.
BIGELOW. I CARILLO. FLORA. FLORA
I MAIENSCHEIN MAZE MCCARTHY
MISERY IN REVERSE. CHOLERA. I'LL
RUN THAT VOTING. SANTIAGO WEBER.
HOWEVER, I. 505 VOTES. THE BILL
WILL REMAIN ON CALL. THANK YOU.
THANKS SO MUCH. WE'VE GOT A LOT
OF MEMBERS MISSING RIGHT NOW.
OKAY UM, MOVING ON. LET'S SEE
SENATOR BECKER.
THANK YOU. GOOD AFTERNOON, MR
CHAIR MEMBERS. ONE OF THE MOST
SACROSANCT RELATIONS IN OUR
SOCIETIES BETWEEN A PATIENT AND
THEIR PHYSICIAN. IN SUCH A
RELATIONSHIP, PATIENTS CAN
CONSULT WITH THEIR PHYSICIAN ON
PRIVATE MATTERS ABOUT THEIR
HEALTH AND RECEIVE A FREE FLOW
OF INFORMATION. AND HIGH QUALITY
CARE TAILORED TO THEIR NEEDS.
OVER THE SHARING OF PATIENT
HEALTH INFORMATION WITHOUT
SUFFICIENT POSITION,
CONSULTATION AND PRIVACY
PROTECTIONS CAN HAVE A
JUDGMENTAL EFFECT. THIS CAN
HAPPEN ECAUSE FEDERAL
INFORMATION BLOCKING RULES
REQUIRE PHYSICIANS AND OTHER
PROVIDERS TO RELEASE PATIENT
DATA. AS SOON AS AVAILABLE.
THANKFULLY THE FEDERAL RULES
DEFER TO STATE LAWS ALLOWING
CALIFORNIA OPPORTUNITY TO
BALANCE THE GOAL, PROVIDING
PATIENT ACCESS TO INFORMATION
WHILE PROTECTING THE PRIVACY AND
ADHERING. TO THEIR WISHES. THIS
BILL ADDS NEW PATIENT
PROTECTIONS INTO CALIFORNIA LAW
TO ENSURE PATIENTS RECEIVE
CHALLENGING HEALTH INFORMATION
AND TIME AND MATTER THAT WORKS
BEST FOR THEM, BUT ALSO HAS NEW
PROTECTIONS FOR THE MOST
SENSITIVE DATA. THE PATIENT
PRIVACY IS MAINTAINED AT ALL
TIMES. TESTIFIED TO SUPPORT THIS
BILL IS DAVID FORD WITH THE
CALIFORNIA MEDICAL ASSOCIATION.
THANK YOU, SENATOR. THANK YOU,
MR CHAIRMAN AND MEMBERS AND THE
CENTER DID A FANTASTIC SUMMARY
OF THE ISSUE HERE. THE FEDERAL
INFORMATION BLOCKING RULES,
WHICH WERE RELEASED IN 2020 AND
TOOK EFFECT IN 2021. HAVE A VERY
LAUDABLE GOAL, WHICH IS MAKING
PATIENT DATA MORE AVAILABLE TO
THE PATIENTS THEMSELVES. UM THIS
ALLOWS PATIENTS TO BE MORE
ACTIVE PARTICIPANTS IN THEIR OWN
CARE. HOWEVER AS THE INFORMATION
BLOCKING RULES HAVE BEEN
IMPLEMENTED IN THE IN THE
HEALTHCARE MARKETPLACE. WE'VE
DISCOVERED SOME CHALLENGES IN
THE IMPLEMENTATION. UM THE
UNFETTERED ACCESS WITH BEFORE
THE TAKE. THE POSITION HAS A
CHANCE TO INTERPRET DATA.
SOMETIMES LEADS TO UNNECESSARY
CHALLENGES OR PATIENTS,
ESPECIALLY IF THEY GET
INFORMATIONTHAT'S NOT ACTUALLY
BAD, BUT LOOKS BAD TO, UM OF
LAYPERSON. UM. AND ALSO WE HAVE
SOME CHALLENGES IN THE LAW AND
THAT OPENING UP MEDICAL RECORDS
TO THE EXTENT OF THE FEDERAL
GOVERNMENT HAS POTENTIALLY
CHALLENGES PATIENTS RIGHT TO
PRIVACY OF THAT DATA.
THANKFULLY, WE HAVE SECTION OF
CALIFORNIA CODE THAT DEALS WITH
PATIENT ACCESS TO HEALTH
INFORMATION, BUT WE CAN MAKE
SOME REALLY MINOR AND CLARIFYING
CHANGES TO ALLOW US TO IMPLEMENT
THE LAW IN A WAY THAT MAKES
SENSE HERE IN CALIFORNIA. THANK
YOU VERY MUCH. THANK YOU. WE
HAVE OTHER WITNESSES IN THE
CHAMBER AND SUPPORT. PLEASE COME
FORWARD. JUST YOUR NAME AND
ORGANIZATION IF YOU REPRESENT
ONE. SEE NO ONE. DO WE HAVE
WITNESSES TO TESTIFY IN IN
OPPOSITION HERE?
THERE'S A BUTTON THERE FOR THE
MICROPHONE, AND WE'LL ASK YOU TO
CALLS FROM PEOPLE WHO AREN'T
ABLE TO HEAR US VERY WELL TODAY,
SO PLEASE SPEAK. SPEAK. SPEAK
UP, OKAY? GOOD AFTERNOON. MY
NAME IS TINA BERGEN. I'M HERE ON
BEHALF OF A VOICE FOR CHOICE
ADVOCACY WHILE WE AGREE WITH THE
OVERALL GOAL OF THIS BILL AND
BELIEVE PRIVACY OF MEDICAL
RECORDS CAN NEVER BE SECURE
ENOUGH. WE FEEL STRONGLY THAT
THE RECORDS OF MINORS CONSENTING
TO TREATMENT MUST BE ACCESSIBLE
, AT LEAST AT A HIGH LEVEL TO
THEIR PARENTS AND GUARDIANS SO
THEY CAN ASSIST WITH THEIR CARE.
THIS BILL WOULD COMPLETELY
REMOVE APPARENT OR GUARDIAN'S
ABILITY TO REVIEW MEDICAL
RECORDS FROM ANY SERVICE FOR
WHICH A MINOR CONSENTED WHILE WE
UNDERSTAND CALIFORNIA HAS MINOR
CONSENT LAWS. CURRENTLY ONLY
THOSE MEDICAL RECORDS RELATING
TO MENTAL HEALTH TREATMENT. MAY
BE RESTRICTED FROM PARENTS OR
GUARDIANS, AND THEN ONLY WHEN
THE HEALTHCARE PROVIDER
DETERMINES THAT ACCESS TO THE
RECORDS REQUESTED BY THE
REPRESENTATIVE WOULD HAVE A
DETRIMENTAL EFFECT ON THE
PROVIDER'S PROFESSIONAL
RELATIONSHIP WITH THE MINOR
PATIENT OR THE MINER'S SAFETY
AND WELL BEING. SB 14 19 WOULD
REMOVE THIS CAVEAT AND FULLY
RESTRICT A PARENT OR GUARDIAN
FROM BEING ABLE TO REVIEW ANY
MEDICAL ANY MENTAL HEALTH
RECORDS. IT WOULD ALSO FULLY
RESTRICT APPARENT OR GUARDIAN
FROM BEING ABLE TO REVIEW ANY
MEDICAL RECORDS OF ANY SENSITIVE
SERVICES, INCLUDING MENTAL
HEALTH TREATMENT OR COUNSELING,
DRUG OR ALCOHOL ISSUE RELATED
TREATMENT AND COUNSELING
PREVENTION OR TREATMENT OF
SEXUALLY TRANSMITTED DISEASES OF
A PREGNANCY, INCLUDING ABORTION
OR FOR AN HIV TEST, THE
DIAGNOSIS OR TREATMENT OF AN
INFECTIOUS, CONTAGIOUS
COMMUNICABLE, COMMUNICABLE
DISEASE TREATMENT DUE TO ALLEGED
RAPE OR SEXUAL ASSAULT. WE WANT
TO ENSURE CHILDREN ARE EMPOWERED
. HOWEVER WE ALSO WANT TO ENSURE
A STRONG RELATIONSHIP NOT ONLY
BETWEEN THEM AND THEIR HEALTH
CARE PROVIDERS, BUT ALSO BETWEEN
THEM AND THEIR PARENTS OR
GUARDIANS, WHO THEY WILL BE
RETURNING HOME TO AFTER
TREATMENT IS PROVIDED. INSTEAD,
SB 14 19 CREATES A STRUCTURE OF
DISTRUST BETWEEN THE PARENT
CHILD AND HEALTH PROVIDER. WHILE
WE UNDERSTAND SOME OF THE AREAS
MAY BE SENSITIVE, AND MINERS MAY
NOT WISH FOR THEIR PARENTS OR
GUARDIANS TO HAVE FULL ACCESS TO
THEIR MEDICAL RECORDS, THERE
SHOULD NOT BE A BLANKET BAN ON
PARENTS OR GUARDIANS. HAVING
ACCESS THERE MAY BE TIMES WHERE
A MINOR HAS AN ADVERSE REACTION
TO MEDICATIONS HAS POST
TREATMENT COMPLICATIONS OR, IN
RARE INSTANCES MAY DIE WHILE
UNDER A PHYSICIAN'S CARE. IN
THESE CASES, A PARENT WOULD NOT
BE ABLE TO ACCESS THEIR
CHILDREN'S MEDICAL RECORDS TO
UNDERSTAND THE BACKGROUND AND
HELP THEM. THEY ALSO WOULDN'T BE
ABLE TO GAIN ACCESS TO FILE A
LAWSUIT OR COMPENSATION CLAIM,
WHICH 12 PLUS YEAR OLD MINER
WOULD BE TOO YOUNG TO DO. A
VOICE FOR CHOICE, STRONGLY
OPPOSES THIS SECTION OF THE BILL
RELATING TO MINOR CONSENT LAWS.
WE ASKED THE AUTHOR AND THIS
COMMITTEE TO AMEND THE BILL TO
EITHER FULLY REMOVED THIS
SECTION OR AMENDED TO ALLOW FOR
THE MINERS REPRESENTATIVE TO
ACCESS PARTIAL MEDICAL RECORDS,
INCLUDING TREATMENT RECEIVED
MEDICATION, ADMINISTERED ADVERSE
EVENTS OR NOTABLE EVENTS
RECORDED AS WELL AS FULL MEDICAL
RECORDS IF THE CHILD HAS AN
ADVERSE REACTION OR DIES, WHILE
UNDER THE HEALTH CARE PROVIDERS
CARE, WE ASK YOU TO OPPOSE SB 14
19 AND NOT ALLOW IT. TO PASS
THROUGH THE ASSEMBLY HEALTH
COMMITTEE UNLESS IT IS AMENDED
AS SUCH. THANK YOU. THANK YOU.
PLEASE GO AHEAD. GOOD AFTERNOON
CHAIR WOOD AND MEMBERS OF THE
ASSEMBLY HEALTH COMMITTEE. CAN
YOU HEAR ME? YES. MY NAME IS
BONNIE GAIL AND I'M FIRST AND
FOREMOST A MOTHER TO FIVE.
EXCELLENT HUMANS. I'M ALSO A
SPECIAL EDUCATOR FROM AMADOR
COUNTY. AND A PASSIONATE
ADVOCATE FOR PARENTAL RIGHTS AND
SPECIAL EDUCATION. ADVOCACY I
HAVE A SON WITH EXCEPTIONAL
NEEDS. AS MENTIONED BY THE
PREVIOUS WITNESS. SB 1419 WOULD
PREVENT GUARDIANS AND PARENTS
FROM REVIEWING ALL MEDICAL
RECORDS RELATED TO MEDICAL CARE
CONSENTED TO BY A MINOR. THIS
CREATES POTENTIAL UNINTENDED
CONSEQUENCES, WHICH COULD LEAD
TO DELAYED A TREATMENT OF THESE
CHILDREN IF THEY HAVE SEVERE
SIDE EFFECTS FROM MEDICATION OR
TREATMENT. TODAY I WOULD LIKE TO
SHARE WITH YOU SOME REAL LIFE
SCENARIOS THAT COULD RESULT IF
THIS BILL IS PASSED WITHOUT
AMENDMENTS TO ADDRESS THIS
SECTION, THE FIRST SCENARIO A 16
YEAR OLD MINER IS AT HOME AND
STARTS HEMORRHAGING. THE PARENT
TAKES HER TO THE EMERGENCY ROOM,
AND THE YOUTH ADMITS THAT SHE
WENT TO PLANNED PARENTHOOD AND
GOT AN ABORTION THE DAY BEFORE.
UNDER THIS BILL, THE PARENT
WOULD NOT BE ABLE TO ACCESS THE
MEDICAL RECORDS FROM PLANNED
PARENTHOOD. THE DOCTOR WOULD NOT
BE ABLE TO GET THE RECORDS
TRANSFERRED BECAUSE THE MINOR
CHILD WOULD NOT BE ABLE TO GIVE
CONSENT. TO TRANSFER THE
RECORDS, AND NEITHER WOULD THE
PARENT DELAYED TREATMENT MAY
CAUSE A DOCTOR TO BE MORE
INVASIVE IN THEIR TESTS AND
EXAMS BECAUSE THEY ARE NOT AWARE
OF IF THERE WERE COMPLICATIONS
DURING THE PROCEDURE. OR WHAT
MEDICATIONS WERE ADMINISTERED A
SECOND SCENARIO A 14 YEAR OLD
BOY. WITH COMPLEX MEDICAL
HISTORY AND IS ON THE NUMBER OF
MEDICATIONS TO TREAT VARIOUS
ISSUES HE TREATS HE SEEKS
TREATMENT FOR THE PREVENTION OF
A STD, AND WHEN ASKED ABOUT HIS
MEDICAL HISTORY DOES NOT HAVE
ENOUGH KNOWLEDGE TO GIVE
ACCURATE INFORMATION ON WHAT HIS
CONDITION IS OR ALL THE
MEDICATIONS HE IS TAKING. ALL
RIGHT. HE UM, HOWEVER, HE IS
DESPERATE TO GET THE TREATMENT
AND SO JUST GIVES A DOCTOR A
PARTIAL, UH, INFORMATION NOT
KNOWING THAT THE TREATMENT IS
NOT RECOMMENDED. FOR PEOPLE
TAKING HIS MEDICATION. THE
PARENTS FIND HIM UNCONSCIOUS AND
TAKE HIM TO THE HOSPITAL WITH NO
KNOWLEDGE OF WHAT HE HAS TAKEN
BECAUSE THEY ARE THEY DO NOT
HAVE ACCESS NOR THE DOCTOR CAN
ACCESS HIS MEDICAL RECORDS. I
COULD GO ON WITH SEVERAL
SCENARIOS. BUT HOPEFULLY YOU
UNDERSTAND THAT THIS BILL AS
WRIST AND PUT SERIOUSLY HARMED
CHILDREN IF THEY HAVE POST
TREATMENT COMPLICATIONS OR DRUG
INTERACTIONS. IT WOULD ALSO NOT
ALLOW PARENTS TO ADVOCATE FOR
THEIR CHILDREN IN THE CASE OF AN
EMERGENCY FILE LAWSUITS OR
COMPLAINTS ON THEIR BEHALF.
THANK YOU FOR YOUR TIME. THANK
YOU. ARE THERE OTHERS IN THE
ROOM IN OPPOSITION TO THE BILL,
JUST YOUR NAME AND ORGANIZATION
IF YOU REPRESENT ONE MY NAME IS
SHANNON PRIMER. I'M A SPECIAL
EDUCATION PARALEGAL. AND I'M
HERE ON BEHALF OF MY CLIENTS AND
ESPECIALLY TASHA HAMBLETON, WHO
ASKED ME TO SAY THAT WE OPPOSE
THIS UNLESS THERE'S AMENDMENTS.
THANK YOU. CHRISTIE'S SUPPORT OF
MERCHANT OF EDUCATE ADVOCATE. WE
SERVE SPECIAL NEEDS FAMILIES
OPPOSED UNLESS AMENDED. THANK
YOU. MCKENNA EUROPE, SAINT JOHN
ON BEHALF OF THE CALIFORNIA
HEALTH COALITION ADVOCACY IN
OPPOSITION. HI MY NAME IS MERICA
COAL, AND I'M ON. I'M HERE ON
BEHALF OF THE CALIFORNIA HEALTH,
COALITION ADVOCACY AND MY SON
WHO IS AUTISTIC AND CONSERVE I
RESPECTFULLY OPPOSED THIS UNLESS
IT'S AMENDED. THANK YOU. GOOD
AFTERNOON, TERRY COBIAN ON
BEHALF OF ROCK CHART HARBOR
CHURCH OF CALIFORNIA CALORIE
TRIPLE VISALIA PARENTS
MAINTAIING AUTHORITY OVER
MINORS TO LARRY COALITION FOR
FREEDOM, BLESSINGS OF LIBERTY
AND UNMASKED HILLARY COUNTY. ALL
STANDING FOR PARENTS, THE
AUTHORITY RESPECTFULLY AND
STRONGLY STAND IN OPPOSITION OF
SB 14 19. THANK YOU. THANK YOU.
WILLIAMS SPEAKING ON BEHALF OF
PERK, WHICH IS PROTECTION OF
EDUCATIONAL RIGHTS OF KIDS IN
OPPOSITION. THANK YOU. ANYONE
ELSE? SAYING NO TO BRING IT BACK
TO THE COMMITTEE FOR QUESTIONS
OR COMMENTS, QUESTIONS OR
COMMENTS. MR MR NAZARIAN. EXCUSE
ME. THANK YOU, MR CHAIR. THANK
YOU TO THE AUTHOR. THANK YOU,
SENATOR FOR BRINGING THIS BILL
FORWARD AS WELL. BUT I HAVE TO
ADMIT TO YOU. I'M SOMEWHAT
CONFLICTED OVER THIS. UM, FIRST
OF ALL IN THE ANALYSIS A MINOR
WHO IS 12 YEARS OF AGE OR OLDER
CAN CONSENT TO MENTAL HEALTH
TREATMENT OR COUNSELING SERVICES
ON AN OUTPATIENT BASIS, IN THE
OPINION OF THE ATTENDING
PROFESSIONAL IS THAT A DOCK
POSITION OR IS IT AN M FT OR AN
MSW? UM DO WE KNOW FOR CERTAIN
WHO THE ATTENDING VISIT WHAT THE
ATTENDING PHYSICIAN IS ATTENDING
. PROFESSIONAL IS LET ME DEFER
TO THE WITNESSES. I'M SURE IT'S
BASICALLY A PROFESSIONAL
OPERATING WITHIN THEIR THEIR
SCOPE OF PRACTICE. UM SO IT UM,
WELL, IT'S IMPORTANT TO IT IT IT
COULD BE A PSYCHIATRIST. IT
COULD ALSO BE A PSYCHOLOGIST.
IT'S ALSO IMPORTANT TO NOTE THAT
THERE'S EXISTING LAW. BUT WE'RE
NOT. WE'RE NOT CHANGING THE
SCOPE OF PRACTICE. WE'RE NOT
CHANGING WHO THE ATTENDING
MEDICAL PROFESSIONAL COULD BE.
OKAY? AND WE'RE ALSO NOT
CHANGING THE MINOR CONSENT RULES
HERE. OKAY? OKAY THAT THAT
LEAVES ME A BIT MORE PUZZLED
THAN I WAS BEFORE BECAUSE I
THOUGHT I WASN'T SURE IF I EVEN
READ IT CORRECTLY. INITIALLY
WHEN I READ THE ANALYSIS OF
ATTENDING PROFESSIONAL, SO I
WOULD ASSUME THAT YOU WOULD WANT
THIS TO BE THE PHYSICIAN. AND
FOR THE PHYSICIAN TO HAVE A SAY
IN SOMETHING LIKE THIS,
ESPECIALLY IF WE'RE GONNA WE'RE
MAKING A DECISION. I
WHOLEHEARTEDLY SUPPORT ANYTIME
THERE'S AN INCIDENT OF RAPE,
SEXUAL TRAUMA, ANYTHING. OF THAT
NATURE. FOR THE CHILDREN TO BE
ABLE TO PROTECT THEMSELVES. UM
BUT TO BROADEN IT TO THIS LEVEL.
IN IN IN IN CREATING THIS SCHISM
. I'M JUST TRYING TO UNDERSTAND
WHY THERE IS A NEED FOR THIS
RIGHT NOW. I THINK WE'RE GONNA
DO FROM THE TECHNICAL DEFINITION
OF THE ATTENDING. BUT THE CORE
POINT THAT I THINK YOU THE WAY
THIS WAS TRYING TO GET ACROSS IS
THE FACT THAT THE BILL DOES NOT
ADD, UM OR CREATE ANY NEW LAW
PERTAINING TO SENSITIVE SERVICES
THAT WERE SIMPLY CLARIFYING THIS
LAW TO MAKE IT EXPLICITLY CLEAR
THAT CLINICAL NOTES FROM MINORS
12 YEARS OF AGE AND OLDER ARE
INCLUDED IN THIS SPACE. THIS
CLASSIFICATION. AS WE SAID, IT'S
NOT IT'S NOT TO UNDERMINE
PARENTAL INVOLVEMENT. UM
CERTAINLY I BELIEVE THAT'S TWO
TEENAGERS. I BELIEVE THAT
PARENTS ARE CRITICAL MAKING
HEALTH DECISIONS. UM SO IT'S
REALLY IT'S NOT ADDING OR
CREATING ANY NEW LAW PERTAINING
TO THOSE SERVICES IS CLARIFYING
THAT CLINICAL NOTES ARE
INCLUDED. AND YOU CAN ANSWER THE
OTHER PART, IF YOU'D LIKE. I WAS
JUST GONNA SAY THAT THERE'S AN
EXISTING DEFINITION IN THE CIVIL
CODE IN THE CONFIDENTIALITY OF
MEDICAL INFORMATION ACT OF
SENSITIVE INFORMATION. WE'RE
COPYING THAT IN THE HEALTH AND
SAFETY CODE. AND THE REASON IS
BECAUSE OF THEIRS. THERE IS A
CONFLICT THAT'S DEVELOPED
BECAUSE OF THE FEDERAL RULES.
THE FEDERAL RULES HAVE OPENED A
PARSON OF THE MEDICAL RECORD TO
INSPECTION THAT WASN'T OPEN
BEFORE CALLED CLINICAL NOTES.
IT'S THE FREEFORM NOTE. THAT
PHYSICIANS, UM THE PHYSICIANS
RIGHT IN THE MEDICAL RECORD. AND
BECAUSE TRADITIONALLY, THOSE
WEREN'T AVAILABLE TO PATIENTS
THAT'S OFTEN WERE VERY SENSITIVE
INFORMATION IS DISCUSSED. UM AND
OFTEN TIMES IT'S BECAUSE OF
REFERRALS THAT ARE PHYSICIAN
WILL WRITE THINGS IN THE
FREEFORM NOTES AS A
COMMUNICATION TO THE NEXT
POSITION WHO SEES THE PATIENT.
BUT NOW THAT THE FEDERAL RULES
HAVE OPENED THOSE UP TO
INSPECTION 22, PARENTS,
CAREGIVERS AND OTHERS. NOW WE
HAVE TO CREATE SORT OF A BOOT
AND SUSPENDERS PROTECTION FOR
THOSE TO MAKE SURE THAT WE
AREN'T INADVERTENTLY
COMPROMISING THE PATIENT'S
PRIVACY. BUT AS I SAY THIS IS
THIS PROTECTION IS ACTUALLY
ALREADY IN THE CIVIL CODE. WE'RE
COPYING IT OVER HERE FOR
CONSISTENCY OF THE CODE AND TO
MAKE SURE THAT THE PATIENT'S
PRIVACY IS PROTECTED. OKAY, I'M. I'M GOING TO WANT TO. IF YOU
DON'T MIND. I'M GONNA WANT TO
SEE THAT FOR MYSELF. AND I'M
GONNA ALSO WANT TO UNDERSTAND
WHY, UM WHAT. I'M I'LL. I'LL GET
MY OWN RESEARCH NOW ON THIS TO
READ UP ON IT, BUT I'M TRYING TO
THEN UNDERSTAND WHY. WHY DO WE
NEED TO CLARIFY THIS? SORRY I IF
IT'S ALREADY IN CODE IN THE
HEALTH SECTION IN THE I'M SORRY
IN THE CIVIL CODE SECTION WHY
DOES IT CREATE A
MISUNDERSTANDING IF THE FEDERAL
GUIDELINES HAVE SAID SOMETHING
IF IT'S THE SAME LANGUAGE SO
THERE'S THREE THINGS AT PLAY.
THE FEDERAL RULE. SAYS. BUT THE
PROVIDERS MUST RELEASE THE
CLINICAL NOTE. OKAY? BUT THEY
SAY. BASED ON STATE PRIVACY LAW.
RIGHT SO NOW WE HAVE TWO PARTS
OF STATE PRIVACY LAW, THE
CONFIDENTIALITY OF MEDICAL
INFORMATION ACT IN THE CIVIL
CODE AND PATIENT ACCESS TO
HEALTH INFORMATION, WHICH IS IN
THE HEALTH AND SAFETY CODE.
RIGHT? AND SO AS. YOU KNOW
PHYSICIANS, HOSPITALS, CLINICS
AND OTHER YOU KNOW, OTHER
PROVIDERS ARE TRYING TO
IMPLEMENT THIS LAW. AND
IMPLEMENT THE FEDERAL RULES. IT
BECOMES A MATTER OF CONSISTENCY
, THAT WE WANT TO MAKE SURE THAT
THE PATIENT ACCESS TO HEALTH
INFORMATION SECTION OF THE
HEALTH AND SAFETY CODE IMPORTS
WITH THE CONFIDENTIALITY OF
MEDICAL INFORMATION ACT AND
PROVIDES THAT PROTECTION TO
THOSE SENSITIVE INFORMATION AS
IS DEFINED ON THE OTHER SIDE. IF
YOU ACTUALLY LOOK AT THE
ORIGINAL VERSION OF THE BILL WE
ACTUALLY ORIGINALLY HAD, THIS IS
JUST A CROSS REFERENCE. AND UM,
ANOTHER COMMITTEE. THEY ASKED US
TO JUST COPY THAT SECTION INTO
THE HEALTH AND SAFETY CODES.
THAT'S A BILL AS IT NOW APPEARS
TO PROVIDE THAT PROTECTION FOR
REPRODUCTIVE HEALTH AND MENTAL
HEALTH. OTHER THINGS THAT WE
PROVIDE THIS PROTECTION FOREIGN
LAW. OKAY, I GUESS I NEED TO DO
MY OWN RESEARCH RIGHT NOW. BUT
FOR THE PURPOSES ALSO OF AT
LEAST STATING MY POSITION RIGHT
NOW, UNTIL OTHER QUESTIONS COME
UP. I DON'T KNOW IF I WANT TO
SUPPORT SOMETHING LIKE THIS. UM
WHEN. JUST JUST IN THE PAST TWO
YEARS, WE'VE TAKEN FURTHER STEPS
OF MAKING SURE THAT JUST
PHYSICIAN. FOR EXAMPLE, UH,
DECISIONS ARE BEING QUESTIONED
AT THE MEDICAL BOARD LEVEL IN
CERTAIN CASES. AND. NOW WE'RE
HAVING EVEN A NON PHYSICIAN
POTENTIALLY MAKE A DECISION THAT
BARS THE PARENTS FROM BEING
ENGAGED IN THAT CHILD'S UM
HEALTH AND WELFARE. SO I JUST
THAT CONCEPT ALSO ITSELF IS
SOMEWHAT JARRING TO ME. UM, BUT
THAT'S MAYBE JUST ME SOMEWHERE
IF I MAY. UM. WHAT WE'RE TRYING
TO PROTECT. HERE IS THE
PHYSICIAN PATIENT RELATIONSHIP.
RIGHT? THE PATIENT AT ANY
MOMENT. THE PATIENT ALWAYS HAS
THE ABILITY TO RELEASE THEIR OWN
INFORMATION. RIGHT AND SO WE'RE
TALKING ABOUT A 12 YEAR OLD,
RIGHT? YES IN THE IN THE IDEAL
SITUATION, RIGHT? I HAVE TWO
TEENAGE CHILDREN. AND THAT IDEAL
SITUATION. IF SOMETHING IS GOING
ON WITH THEM. THEY WERE INVOLVED
ME IN THAT IN THAT, UH, IN THEIR
DECISION MAKING WITH ALL DUE
RESPECT, THAT'S NOT THE
SITUATION FOR EVERY TEENAGER. I
AGREE. I AGREE. BUT THEN WHY?
WHY WHY NOT MAKE THE BILL
NARROWER SO THAT IT APPLIES TO
EVERY CASE THAT YOU AND I ARE
SENSITIVE ABOUT? BUT TO MAKE IT
THIS BROAD FOR AN AGE RANGE OF
INDIVIDUALS WHO ARE STILL VERY
INFLUENCED, THEN MALLEABLE. AND
HOW THEY APPROACH ISSUES. AYE. I
DON'T THINK THAT HELPS HELPS US
AND IN TIME WHERE WE'RE
CONSTANTLY TRYING TO, UM PROTECT
THE FAMILY UNITY. MAKE SURE THAT
WE'RE. UM PLACING OUR ELDERS IN
A PLACE OF CARE WITH THE
FAMILIES. YOU KNOW, WHEN WE WERE
TAKING ALL THESE STEPS TO MAKE
SURE THAT WE INVOLVE THE FAMILY.
HERE'S SOMETHING THAT'S ACTUALLY
AGAIN. SHIFTING AWAY FROM THAT,
SO I'M I'M JUST NOT
UNDERSTANDING WHY, IF THIS WAS
NARROWER, I WOULD SUPPORT IT.
BUT TO MAKE IT SO BROAD, I
QUESTION WHY. IN THE WITNESS CAN
CLARIFY, BUT I APPRECIATE IT. WE
CAN YOU KNOW, MAYBE COME BACK TO
IT THAT THE UM AGAIN THAT I
THINK THIS ALREADY EXISTS IN LAW
. SO ALL WE'RE DOING IS
CLARIFYING THE CLINICAL NOTES
PART WHICH HAVE NOW BECOME NEWLY
UM YOU KNOW, NEWLY ACCESSIBLE,
SO THIS IS REALLY JUST MAKING
EXPLICITLY CRYSTAL CLEAR ABOUT
THE CLINICAL NOTES ARE SORT OF
COVERED IN OUR AND WHAT IS
ALREADY UM, THE LAW ITSELF, SO I
DON'T THINK IT'S NOT GOING TO
DRAMATICALLY AFFECT THAT
RELATIONSHIP. I MEAN, I THINK
THE MAIN POINT WHEN WE REALLY
START WITH THE BILL, PART OF THE
BILL IS REALLY JUST ABOUT THAT,
MAKING SURE THAT PATIENTS GET
ACCESS TO THE INFORMATION THEY
CAN FORM A PLAN WITH THEIR
PHYSICIAN BECAUSE WE DON'T WANT
PEOPLE GET ACCESS TO DATA SCANS
RESULTS OF SCANS, WHICH NOW HAVE
TO BE AVAILABLE RIGHT AWAY, UM,
WITHOUT HAVING THE PHYSICIAN SAY
HEY, HEY, LET ME GIVE YOU THE
CONTEXT ON THIS. THIS MAY LOOK
BAD, BUT THIS IS NOT BAD, YOU
KNOW? DON'T FREAK OUT. YOU KNOW,
AS WE KNOW PEOPLE ARE VERY
SENSITIVE, YOU KNOW, I CERTAINLY
WOULD BE, UM SO THAT'S REALLY
THE POINT AND THEN WE'RE ALSO,
YOU KNOW, HAVING THIS
CLARIFICATION AROUND CLINICAL
NOTES, BUT I WOULD SAY, UM, YOU
KNOW, I THINK MY TEAM IN MY TEAM
DID HAVE A GOOD DISCUSSION
YESTERDAY WITH A VOICE FOR
CHOICE ADVOCACY AND SITTING DOWN
TOMORROW WITH THE CALIFORNIA
HEALTH COALITION ADVOCACY, SO I
DO APPRECIATE YOUR CONCERN AND
THEIR CONCERNS AND WE ARE
CONTINUING TO DISCUSS THEM.
THANK YOU. I THIS CONCERN IS
JUST ME. THIS IS COMING. I
HAVEN'T HAD A CHANCE TO EVEN
MEET WITH OPPOSITION OR ANYONE
ON THIS. SO THIS WAS JUST
SOMETHING THAT AH, I JUST FELT
IT'S BROUGHT. SO THAT'S IT.
THANK YOU, MR CHAIR FOR THE
OPPORTUNITY. OF COURSE, UH,
ANYONE ELSE ANY OTHER QUESTIONS
OR COMMENTS? I JUST, UM. GO
AHEAD. THANK YOU, MR CHAIR. UM I
DO WANT TO AGREE WITH MY
COLLEAGUE ABOUT THE ISSUES WITH
THAT ONE SECTION, PARAGRAPH
FLOOR LINES. 1 TO 6 IS WHERE THE
MOST EGREGIOUS PART OF THE BILL,
I THINK THE PART THAT WE'RE
HAVING THE MOST STRUGGLE WITH UM
, WHEN I GO TO THE DISTRICT, AND
I'VE ACTUALLY THOUGHT ABOUT WAYS
TO IMPROVE ACCESS TO PARENTS FOR
MORE INFORMATION, BECAUSE WHEN I
GO TO THE DISTRICT, AND IT'S
HAPPENED THE REAL FOUR TIMES,
AND IT DEALS WITH THE MENTAL
HEALTH. PART OF IT, UM, THEY
HAVE CHILDREN, CHILDREN AND EVEN
ADULTS. CHILDREN WHO GO INTO
SOME TYPE OF MENTAL HEALTH
TREATMENT. AND THE PARENTS ARE
NOT ALLOWED TO KNOW WHAT'S GOING
ON. THEY DON'T KNOW WHERE THEIR
CHILD IS. THEY CAN'T GET TO THEM
. THEY END UP IN THESE SPECIFIC
CASES. THESE PEOPLE CAME UP TO
ME AT DIFFERENT EVENTS. NOT EVEN
DEALING WITH MENTAL HEALTH. IT
WAS JUST THERE IN A EVENT OR THE
CHAMBER OF COMMERCE ONE TIME AND
THEY SAID, PLEASE DO SOMETHING.
MY CHILD DIED AND WE DIDN'T KNOW
WHERE THEY WERE. AND THERE'S NO
INFORMATION YET THE PARENTS ARE
RESPONSIBLE FOR THE CHILD.
THEY'RE RESPONSIBLE FOR THEIR
INSURANCE. THEY'RE RESPONSIBLE.
THEY'RE PAYING THE BILLS, AND
IT'S LIKE THEY CAN'T GET THE
INFORMATION. IT'S JUST NOT
RIGHT. AND I JUST I CAN'T
SUPPORT THE BILL WITH THAT PART
OF IT IN IT, AND I UNDERSTAND
WHAT YOU'RE TRYING TO DO ABOUT
ACCESS BETWEEN THE PHYSICIAN AND
THE PATIENT IS IMPORTANT. BUT WE
HAVE TO ALSO RESPECT, UH, AS WAS
SAID THE FAMILY AND THE PARENTAL
RIGHTS AS WELL. THANK YOU. ANY
OTHER COMMENTS. SEEN NONE. WOULD
YOU? WOULD YOU LIKE TO CLOSE
CENTER? SURE YES. ANYTHING
URGENTLY. YOU UNDERSTAND? UM
YEAH, AGAIN. I APPRECIATE THE
DISCUSSION AND, UM YOU KNOW, I
UNDERSTAND IS, YOU KNOW FOCUSSED
ON THAT THAT PIECE AND WE DO
BELIEVE THAT WORD, YOU KNOW,
TRYING TO CLEAR THAT WE'RE JUST
CLARIFYING THAT PIECE ABOUT
CLINICAL NOTES. UM BUT YOU
UNDERSTAND THIS ONGOING CONCERNS
AND WE ARE CONTINUING TO MEET
WITH FOLKS ON THAT ON THAT
PROVISION, AND WITH THAT, I
RESPECTFULLY ASK FOR MY VOTE.
THANK YOU, UM HAVE EMOTION.
MOVES THE BILL. I WILL. SECOND
THE BILL. UH, MADAM SECRETARY,
WE HAVE A MOTION AND A SECOND.
THE MOTION IS DUE PASSES AMENDED
TO JUDICIARY. UH PLEASE CALL THE
ROLL. WOULD WOULD I WALDRON.
WALTER. NO AGUIAR-CURRY EAGER
CURRY, I ARAMBULA. BIGELOW.
BIGELOW NÓ CARILLO. FLORA. FLORA
NO MAIENSCHEIN MAZE MCCARTHY.
NAZARIAN. LUZ RIVAS CHOLERA.
SANTIAGO WEBER. 2 TO 3. YEAH,
IT'S THE VOTERS 2 TO 3. WE HAVE
A LOT OF MEMBERS. THERE'S A LOT
OF COMMITTEES GOING ON ALL OVER
THE PLACE TODAY. SO WE, WE WILL
LEAVE THE BELONG COP. THANK YOU.
THANK YOU. AND IS THERE CAN WE
HAVE? SOME SERGEANTS WERE HAVING
A REALLY APPARENTLY PEOPLE
HAVING A REALLY HARD TIME
HEARING WITNESSES? UH FROM
SPEAKING IN TESTIMONY ARE THEIR
DIALS OR SOMETHING WE CAN DO IS
TO TURN THOSE THINGS UP. ARE
THERE ANY? WE'VE GOT DIALS UP
HERE, WHICH I THINK I CAN USE TO
TURN. I DON'T KNOW WHAT THE
STYLE DOES. IT DOESN'T DO
ANYTHING. APPARENTLY UM, BUT IT
FEELS GOOD TO TURN IT. SO COULD
YOU MAKE ME FEEL GOOD IN TURN
THOSE OTHER DIALS DOWN THERE OR
COULD WE FIGURE OUT A WAY SO
THAT PEOPLE CAN ACTUALLY HEAR
IT? OKAY. ALL RIGHT. THANKS. UM
SENATOR EDMUND WOULD YOU LIKE TO
COME UP SO WE CAN'T HEAR YOU TO
JUST ACTUALLY ASK YOU TO SPEAK.
SPEAK IN, YOU KNOW, SPEAK WELL
INTO THE MICROPHONE. I ALWAYS
TRY TO SPEAK WELL, SIR. GOD
BLESS YOU. THANK YOU. THANK YOU.
AND THANK YOU FOR THOSE OF YOU
HERE FOR HEARING THIS BUREAU
BILL TODAY. THIS IS A 10 35
CONTINUATION OF MY BILL PACKAGE.
UM HAT HAS TO DO WITH
MEDICATION COMPLIANCE FOR THOSE
ON OUTSIDE OUT PATIENT ASSISTED
TREATMENT PROGRAM KNOWN AS
LAURA'S LAW, OR A O T. UM IF
MEDICATION IS PRESCRIBED AS PART
OF THE TREATMENT PLAN AND THIS
BILL WOULD AUTHORIZE COURTS TO
CONDUCT STATUS HEARINGS JUST TO
MAKE SURE THEY GET AND WE'RE NOT
FORCING MEDICATION I BUT NOT
AGAINST ANYBODY'S WILL. BUT IF
MEDICATION IS PART OF YOUR
TREATMENT PLAN ORDER, THE JUDGE
MAY ASK YOU TO COME IN AND SEE
HOW THAT IS. THEN GOING UM, SO
WE JUST THINK THIS IS A GOOD
MOVE TO BE ABLE TO STANDARDIZE
THINGS ACROSS THE STATE. WE
UNDERSTAND PEOPLE DO THINGS
DIFFERENTLY. WE WANT TO PROVIDE
SOME CLARIFICATION FOR FOLKS. UM
AND APPROPRIATE TIME. I'D LIKE
TO ASK FOR YOUR VTE AND WITH ME
HERE TODAY IS RANDALL HAGAR, WHO
IS A LEGISLATIVE ADVOCATE WITH A
PSYCHIATRIC PHYSICIANS ALLIANCE.
IN CALIFORNIA. PLEASE GO AHEAD.
PUSH THE BUTTON UNTIL IT'S SORT
OF LIGHTS UP. THERE YOU GO, AND
THEN SPEAK INTO THE MICROPHONE
DIAL HERE, TURN IT AND MAKE IT
JUST TURN IT TO THE RIGHT. MAKE
ME FEEL GOOD. OKAY ALRIGHT, I
CAN GET IT. I'LL SPEAK LOUDLY AS
WELL. VERY GOOD. THANK YOU, MR
CHAIR. MEMBERS OF THE COMMITTEE
, RANDALL HAGER REPRESENTED THE
PSYCHIATRIC POSITIONS ALLIANCE
OF CALIFORNIA, PROUD CO SPONSORS
OF THIS BILL. I THINK THE IDEA
HERE IS TO DO WHAT JUDGE TOM
ANDERSON DOES IN THE VATICAN
COUNTY, ARGUABLY THE LONGEST
OPERATING ASSISTED OUTPATIENT
TREATMENT PROGRAM IN THE STATE,
ARGUABLY THE BEST JUDGE DOING
THAT WORK TODAY. AND IT IS HIS
PRACTICE WHEN PEOPLE FIRST ENTER
THE PROGRAM TO ENGAGE THEM ON A
WEEKLY BASIS. SO YOU'RE NEW.
YOU'RE YOU'VE GOT A COURT ORDER.
YOU'VE GOT A TREATMENT PLAN.
YOU'RE COMING TO COURT. EVERY
WEEK SO THAT THE JUDGE CAN
ACTUALLY TALK TO YOU AND THE
TREATMENT TEAM AND BUILD A
RELATIONSHIP AND ENCOURAGE TRUST
AND ENCOURAGE A COLLABORATIVE.
ATMOSPHERE IN THE COURT. AND
THAT'S THAT'S HIS PRACTICE, AND
IT WORKS REALLY WELL. ARGUABLY
HE HAS THE BEST OUTCOMES IN THE
STATE AND OTHER STATES THAT DO
THIS. THIS IS A REALLY IMPORTANT
PIECE. OF THE EFFECTIVENESS OF
ASSISTED OUTPATIENT TREATMENT.
AND SO REALLY, WHAT THE BILL
DOES IS TO ENCOURAGE THAT KIND
OF CONTACT WHERE THE JUDGE
BECOMES A SUPPORTER OF THE
PATIENT, A SOMEONE WHO'S
INTERESTED IN THEIR LIFE AND BY
ASKING ABOUT THE TREATMENT PLAN
BY ASKING ABOUT WHETHER YOU KNOW
WHAT THEIR ATTITUDE IS TOWARDS
MEDICATIONS. YOU START TO BUILD
THAT RELATIONSHIP, AND IF YOU
SUPPORT THE INDIVIDUAL FOR
TAKING THOSE MEDICATIONS AS THE
LPS, AUDITOR'S REPORT SAYS,
THAT'S ONE OF THE FACTORS THAT
KEEPS PEOPLE FROM HAVING. TO GO
TO HIGHER LEVELS OF CARE KEEPS
THEM OUT OF THE JAIL KEEPS THEM
OUT OF HOSPITALS. AND THAT'S
WHAT THIS BILL IS ABOUT. THANK
YOU. THANK YOU SO OTHERS IN
SUPPORT. JUST YOUR NAME AND
ORGANIZATION. IF YOU REPRESENT
ONE, PLEASE. THANK YOU, MR CHAIR
MEMBERS, ROSS BUCKLEY ABOUT
SACRAMENTO, DARRELL STEINBERG IN
SUPPORT. THANK YOU. SARAH GAMBA
EASTMAN WITH THE STEINBERG
INSTITUTE AND SUPPORT THANK YOU.
CHAIR MEMBERS ON BEHALF OF
ANOTHER CO SPONSOR, THE
CALIFORNIA STATE ASSOCIATION,
PSYCHIATRISTS AND ALSO THE CITY
AND COUNTY OF SAN FRANCISCO AND
MARYLAND. IN BREED AND SUPPORT.
THANK YOU. CALIFORNIA
PSYCHOLOGICAL ASSOCIATION AND
SUPPORT THANK YOU. WE HAVE
OPPOSITION WITNESS OR OPPOSITION
TESTIMONY TO THE BILL. MOVE THE
BILL. SEEN NONE ANY. ANYBODY IN
THE CHAMBER IN OPPOSITION TO THE
BILL. SEE NONE WILL BRING IT
BACK TO THE COMMITTEE. WE DO
HAVE A MOTION BY MISS A GEAR.
CURIOUS SECOND BY MR BIGELOW
EMOTIONALLY DO PASTOR JUDICIARY.
ANY QUESTIONS FOR THE. YEAH MISS
WALDRON'S YOUR QUESTION. THANK
YOU. UM I WANT TO THANK THE
AUTHOR FOR BRINGING THIS BILL. I
KNOW WE'VE DONE WORK ON THIS AND
YOU'VE BEEN A STRONG ADVOCATE IN
THIS FIELD AND, UM, VERY
SUPPORTIVE. IF UM, YOU DO AMEND
IT. I'D LIKE TO BE ADDED AS A CO
AUTHOR OF POSSIBLE THANK YOU.
ABSOLUTELY. THANK YOU. THANK YOU
VERY MUCH ANYONE ELSE? NO. ONE
AS I SAID, WE DO HAVE A WIT.
WHAT DO WE DO HAVE A WITNESS. WE
HAVE A MOTION AND A SECOND. AND
WOULD YOU LIKE TO CLOSE
DISRESPECTFULLY? ASK FOR YOUR
BOOK. THANK YOU VERY MUCH, SO
THE MOTION IS DUE PASS TO
JUDICIARY. MADAM SECRETARY.
PLEASE CALL THE ROLL. WOULD
WOULD I WALDRON? WALDRON, IAGAR
CURRY CURRY. I ARAMBULA. BIGELOW
BIGELOW. I CARILLO. LARA. FLORA.
I MAIENSCHEIN MAZE MCCARTY.
CAESARIAN NAZARIAN? AYE.
LUZ RIVAS CHOLERA. SANTIAGO
WEBER. 62060 WE WILL LEAVE THE
ROLE. WE ACTUALLY WILL LEAVE THE
BILL ON CALL. UM, THANK YOU
APPRECIATE SO WE DO HAVE. WE DO
HAVE A CONSENT CALENDAR IF
ANYBODY WOULD LIKE TO MOVE THE
CONSENT CALENDAR WEEK. MOTION BY
MISS WALDRON'S SECOND BY MR
BIGELOW. THE CONSENT CALENDAR
CONSISTS OF ITEM NUMBER TWO SB
11 65 BY SENATOR BATES. REMEMBER
FIVE SP 13 94 BY SENATOR EGGMAN
REMEMBER EIGHT SP 9 88 BY
SENATOR HUESO AND ITEM NUMBER 10
SP 9 66 BY MS LIMÓN. MADAM
SECRETARY, PLEASE CALL THE ROLL.
WOULD WOULD I, WALDRON, WALDER,
AND I AGUIAR-CURRY AGUIAR-CURRY.
AYE, ARAMBULA. BIGELOW. BIGELOW
I CARILLO FLORA. MAIENSCHEIN
MAZE, MCCARTY NAZARIAN. THIS
AREA AND I RIVAS ALL RUSSIA.
5050 WILL LEAVE THE CONSENT
CALENDAR ON CALL, AND WE WILL
NOW WAIT FOR SOME SENATORS. OH
THAT'S RIGHT. SOMEONE CAN
SOMEONE LIKE TO MOVE ITEM NUMBER
ONE. THAT'D BE GREAT. I DON'T
HAVE EMOTION FOR SB 4 73 WE HAVE
A 2ND. 2ND BY MR NAZARIAN MOTION
IS DUE PASS AS AMENDED TO
APPROPRIATIONS. MADAM SECRETARY,
PLEASE CALL THE ROLL. WOULD
WOULD I, WALDRON WALDRON, I'M
AGUIAR-CURRY AGUIAR-CURRY. AYE,
ARAMBULA. BIGELOW. BIGELOW. I
CARILLO. FLORA MAIENSCHEIN MAZE
MCCARTY MISERY IN MISERY AND I
GRIEVOUS CHOLERA. SANTIAGO WEBER. 50 WE HAVE THE SP 4 73 OUT OF
NUMBER 150 AND THAT THOSE ON
CALL NOW WE'LL WAIT FOR
SENATORS.
I WAS DAYDREAMING. MY APOLOGIES
SO YOU ARE. OKAY WELL, PLEASE
SPEAK INTO THE MICROPHONE. WE'RE
HAVING A HARD TIME THAT GOES FOR
EVERYBODY. OKAY HOW'S THAT? GO
AHEAD, SENATOR LABOR. THANK YOU,
SIR. VERY MUCH. MR. CHAIR. GOOD
AFTERNOON MEMBERS. SB 6 44 WILL
ALLOW THE CALIFORNIA EMPLOYMENT
DEPARTMENT DEVELOPMENT
DEPARTMENT E. D. D TO SHARE
INFORMATION WITH COVERED
CALIFORNIA FOR THE PURPOSE OF
OUTREACH ON HEALTH COVERAGE
OPTIONS. AS WE ALL KNOW, IN
AMERICA, JOBS AND HEALTH
INSURANCE ARE OFTENTIMES CLOSELY
LINKED. IF A PERSON LOSES THEIR
JOB, THEY OFTEN ALSO FACED
LOSING HEALTH COVERAGE FOR BOTH
THEMSELVES AND THEIR FAMILY.
COVID 19 PANDEMIC HAS LED TO
UNPRECEDENTED JOB LOSSES DROPS
IN INCOME. BUT DESPITE THOSE
LOSSES, BOTH MEDICAL AND COVERED
CALIFORNIA HAVE EXPERIENCED
LOWER THAN EXPECTED ENROLLMENT.
THE LATEST MEDICAL AND COVERED
CALIFORNIA. DATA SUGGESTS THAT
SOME CALIFORNIANS ARE CHOOSING
TO GO WITHOUT COVERAGE ARE NOT
GETTING CONNECTED WITH THE BEST
COVERAGE OPTIONS. IN SHORT, THIS
BILL WILL IMPROVE CALIFORNIA'S
ACCESS TO HEALTH INSURANCE. AS
WELL AS AVOID COSTLY AND
DANGEROUS GAPS IN THEIR CARE.
EVERYONE DESERVES ACCESS TO
QUALITY, AFFORDABLE HEALTHCARE
COVERAGE AND SP 6 44 WILL HELP
ENSURE THAT PEOPLE WILL BE ABLE
pREGARDLESS OF EMPLOYMENT STATUS
. THIS BILL HAS EARNED UNANIMOUS
BIPARTISAN SUPPORT AND HAS NO
KNOWN OPPOSITION. AT THE
APPROPRIATE TIME. I RESPECTFULLY
ASK FOR AN I VOTE HERE WITH ME.
TODAY ARE TWO OF THE BILL CO
SPONSORS ANDREA RIVERA WITH
CALIFORNIA PAN ETHNIC HEALTH
NETWORK AND JOSE CASILLAS WITH
HELP ACCESS. THANK YOU, MR
CHAIR. OKAY, PLEASE GO AHEAD.
GOOD AFTERNOON CHAIR AND MEMBERS
OF THE COMMITTEE. MY NAME IS
ANDREA RIVERA, AND I'M, THE
SENIOR LEGISLATIVE ADVOCATE WITH
THE CALIFORNIA PAN ETHNIC HEALTH
NETWORK. DEPENDENTS ARE PROUD.
CO SPONSOR OF SB 644, WHICH
WHICH WILL BEGIN TO CLOSE GAPS
IN HEALTH CARE COVERAGE AND
EMPLOYMENT STATUS IN CALIFORNIA.
THIS BILL WILL ENSURE THAT
CALIFORNIANS WHO RECEIVE
UNEMPLOYMENT BENEFITS THROUGH
THE EMPLOYMENT DEVELOPMENT
DEPARTMENT ARE CONTACTED BY
COVERED CALIFORNIA AND RECEIVE
INFORMATION ON THEIR HEALTH
COVERAGE OPTIONS. THE COVID 19
PANDEMIC HAS LED TO
UNPRECEDENTED JOB LOSS AND DROPS
IN INCOME. HOWEVER BOTH MEDICAL
AND COVER CALIFORNIA EXPERIENCED
SLOWER THAN EXPECTED ENROLLMENT
RATES, PARTICULARLY FOR
COMMUNITIES OF COLOR, WHO HAVE
BEEN DISPROPORTIONATELY IMPACTED
BY THE PANDEMIC. IN DECEMBER.
2021 COVERED CALIFORNIA
ESTIMATED THAT 1.1 MILLION
CALIFORNIANS WERE UNINSURED AND
ELIGIBLE FOR FINANCIAL
ASSISTANCE, YET THEY REMAINED
WITHOUT CARE. THE VAST MAJORITY
OF THESE COMMUNITY MEMBERS WERE
ALSO ELIGIBLE FOR COVERAGE THAT
WOULD HAVE BEEN NO COST TO THEM
THROUGH EITHER MEDICAL OR
COVERED CALIFORNIA. SP 644 WOULD
REQUIRE THE EXCHANGE TO REQUEST
THE NAME, ADDRESS AND CONTACT
INFORMATION OF APPLICANTS THAT
HAVE RECEIVED UNEMPLOYMENT
COMPENSATION OR DISABILITY
INSURANCE FROM BDD. THE BILL
WOULD REQUIRE THE EXCHANGE TO
REQUEST THE INFORMATION, AT
LEAST ON A MONTHLY BASIS FOR THE
PURPOSE OF CONDUCTING OUTREACH
AND ENROLLMENT EDUCATION EFFORTS
TO EVERYDAY CALIFORNIANS. AS WE
RECOVER FROM THE PUBLIC HEALTH
EMERGENCY. WE CANNOT AFFORD TO
REVERT TO THE SYSTEMS THAT
EXPOSED CRITICAL SO CRITICAL
GAPS IN OUR SOCIAL SAFETY NETS.
SB 644 IS A SIMPLE FIX THAT HAS
THE POTENTIAL TO SAVE MILLIONS
OF CALIFORNIANS. FROM THE RISKS
OF LACK OF CONTINUOUS HEALTHCARE
. WE URGENTLY I VOTE FROM THE
COMMITTEE ON SP 644. THANK YOU.
THANK YOU. GOOD AFTERNOON. GOOD
AFTERNOON, MR CHAIRMAN MEMBERS.
JOSE TORRES WITH HEALTH ACCESS
CALIFORNIA, THE STATEWIDE
HEALTHCARE CONSUMER ADVOCACY
COALITION HERE IS A CO SPONSOR
OF SB 6 44. WE HAVE MADE GREAT
PROGRESS WITH PROVIDING
HEALTHCARE COVERAGE IN
CALIFORNIA. AND DUE TO THE
AFFORDABLE CARE ACT, A PERSON
LOSING THEIR JOB NO LONGER MEANS
THAT THEY HAVE TO REMAIN
UNINSURED. CALIFORNIANS HAVE
ACCESS TO MEDICAL, OUR ROBUST
SAFETY NET HEALTH CARE SYSTEM
AND ALSO COVERED CALIFORNIA. OUR
HEALTH INSURANCE MARKETPLACE,
WHICH CONTINUES TO LEAD THE
NATION IN AFFORDABILITY. EVEN
WITH SUCH PROGRESS, ONE OF THE
BIGGEST HURDLES TO COVERAGE
OUTSIDE OF AFFORDABILITY IS LACK
OF AWARENESS OF THESE OPTIONS AS
PEOPLE EXPERIENCED VARIOUS
TRANSITIONS IN THEIR EMPLOYMENT
AND INCOME, THEY MAY BE UNAWARE
OF WHAT OPTIONS EVEN EXIST OR
WHERE DO YOU TURN FOR
ASSISTANCE? CURRENTLY PEOPLE WHO
RECEIVE UNEMPLOYMENT BENEFITS
FROM E D D RECEIVE WITH THEIR
CHECK A NOTICE FROM COVERED
CALIFORNIA ON THEIR INSURANCE
OPTIONS. THIS NOTICE, HOWEVER,
IS ONLY GIVEN TO PEOPLE
RECEIVING BENEFITS. ONLY WIN.
THEY ACTUALLY START RECEIVING
THE BENEFITS NOT BEFORE MANY
PEOPLE, MANY MORE PEOPLE DO
APPLY TO E D D BUT ARE DENIED
COVERAGE OR DON'T GO ON TO
RECEIVE UNEMPLOYMENT,
UNEMPLOYMENT BENEFITS SO THEY DO
NOT RECEIVE ANY OF THESE NOTICES
FROM COVERED CALIFORNIA. SOME OF
CALIFORNIA COVERED CALIFORNIA'S
GREATEST ACHIEVEMENTS ARE IT'S
EXCELLENT MARKETING CAPABILITIES
AND ENROLLMENT PROGRAMS.
UNFORTUNATELY RIGHT NOW IT IT IS
NOT ABLE TO SHARE APPLICANT
INFORMATION WITH COVERED
CALIFORNIA AS MENTIONED BY MY
COLLEAGUE HERE BY E. D D IS ABLE
TO SHARE APPLICANT INFORMATION
WITH OTHER DEPARTMENTS, BUT NOT
WITH COVERED CALIFORNIA AND THIS
IS WHY SB 6 44 WOULD DO SB 6 44
WILL ENSURE THAT COVERED
CALIFORNIA RECEIVES BASIC
INFORMATION FROM ALL APPLICANTS
TO E. D D PROGRAMS SO THAT THEY
CAN, UM, PERFORM OUTREACH TO
THEM. THIS WOULD ENABLE COVERED
CALIFORNIA TO REACH OUT TO THOSE
WHO ARE EXPERIENCING. EMPLOYMENT
TRANSITIONS TO MAKE THEM AWARE
OF ALL OF THEIR OPTIONS END
SINCE MATIC HOW IN COVERED
CALIFORNIA USED THE SAME
APPLICATION, IT WILL SERVE THE
DUAL PURPOSE OF ALSO CONNECTING
PEOPLE WITH MEDICAL SB 6 44 WILL
PREVENT DANGEROUS GAPS IN HEALTH
COVERAGE. BY MAKING SURE PEOPLE
ARE INFORMED OF THEIR OPTIONS
AND WHEN THEY ARE MOST
VULNERABLE FOR THESE REASONS, WE
ARE PROUD TO CO SPONSOR SB 6, 44
AND REQUESTS UM RESPECTFULLY
REQUESTED I VOTE. THANK YOU VERY
MUCH OTHERS IN SUPPORT. JUST
YOUR NAME AND ORGANIZATION. GOOD
AFTERNOON, LINDA WAY WITH
WESTERN CENTER ON LAW AND
POVERTY, PROUD CO SPONSOR AND
SUPPORTER. THANK YOU. NICOLE
WARD ULLMAN ON BEHALF OF THE
CHILDREN'S PARTNERSHIP AND
SUPPORT. THANK YOU. CHRIS MEYERS
WITH THE CALIFORNIA SCHOOL
EMPLOYEES ASSOCIATION AND
SUPPORT THANK YOU. REBECA
GONZALEZ NATIONAL ASSOCIATION OF
SOCIAL WORKERS. CALIFORNIA
CHAPTER AND SUPPORT. THANK YOU.
MORGAN ON BEHALF OF THE AMERICAN
HEART ASSOCIATION AND SUPPORT
THANK YOU. ANYONE ELSE? ARE
THERE ANY WITNESSES COMING
FORWARD TO TESTIFY? AN
OPPOSITION. GUESS NOT. BASED ON
WHAT THE AUTHOR HAD SAID, SO
ANYONE AT ALL IN OPPOSITION. SEE
NO ONE WILL BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS ANY QUESTIONS OR
COMMENTS FROM THE COMMITTEE. MR
BIGELOW SER. THANK YOU. I
APPRECIATE THE AUTHOR AND THE
WAY THERE'S BILLS LAID OUT, BUT
THE PROBLEM THAT I'M HAVING
ACTUALLY IS THE FACT THAT ALL OF
US OF OUR STAFF WORKING FOR
EDDIE NOW. THEY'RE TAKING CARE
OF THE GREAT SHORTFALLS AT EDDIE
HAS BEEN THRUST INTO THE
LIMELIGHT ABOUT SO TODAY. I JUST
DON'T FIND MYSELF COMPELLED TO
WANT TO SHARE. ACTUALLY IF THE
SUPPORT FOR THIS BILL BCAUSE
IT'S GOING TO PUT MORE BURDENS
ON E D D TO PERFORM AND DO
SOMETHING THAT THEY HAVE FAILED
AT DOING SO I JUST SHARE THAT
WITH YOU BECAUSE I RESPECT YOU.
AND I APPRECIATE WHAT YOU'RE
TRYING TO ACCOMPLISH. BUT I
APPRECIATE THAT. IF I MAY. I
WOULD JUST SAY THIS IS NOT
ADDING A NEW RESPONSIBILITY. THE
E D D. IT'S ADDING AN AGENCY
pTHAT WILL DO THE WORK, WHICH IS
COVERED CALIFORNIA. AND YOUR
CONCERNS ARE WELL PLACED. WE AS
YOU SAID, WE HAVE ALL HAD THOSE
ISSUES, BUT I WOULD HATE TO SEE
SOMEONE NOT HAVE ACCESS TO
HEALTH CARE WHEN THEY LOSE THEIR
JOB. BECAUSE WE HAVE LOST FAITH
IN E, D D AND ANOTHER ASPECT OF
WHAT THEY DO SO THIS WILL NOT
REQUIRE THEM TO DO MORE. AT
ANOTHER RESPONSIBILITY. IT WILL
JUST MAKE SURE THAT THE TWO CAN
WORK TOGETHER AND COVERED
CALIFORNIA, WHICH IS DOING A
HECK OF A GOOD JOB. WILL BE THE
ONES THAT ARE HANDLING IT. I
WOULD GIVE A LOT OF KUDOS TO THE
COVERED CALIFORNIA FOR THEIR
MARKETING AND THEIR EXPERTISE OF
WHAT THEY'VE BEEN DOING TO
REACHING OUT TO THE PEOPLE. AND
I WOULD GIVE FAR MORE TRUST TO
THEM, SINGULARLY THAT I WILL TDD
SO THANK YOU. THANK YOU, THOUGH
. I APPRECIATE IT. THANK YOU. MR
VOTE FOR THE BILL, THEN OH,
WELL, I GOTTA TRY ANYWAY. SO
ANYONE ELSE. NO ONE DO WE? UM,
WE HAVE A MOTION. MOTION BY MR
NAZARIAN SECOND BY MR CHOLERA,
MR. UH SENATOR LEVEL WOULD YOU
LIKE TO CLOSE? RESPECTFULLY ASK
FOR MY VOTE. THANK YOU VERY MUCH
. IT DOES ENJOY DO PASS
RECOMMENDATION. MADAM SECRETARY
. PLEASE CALL THE ROLL. THE BET
THE MOTION IS DUE PASS TO LABOR.
WOULD, WOULD I, WALDRON.
AGUIAR-CURRY ARAMBULA. BIGELOW
BIGELOW NÓ CARILLO. FLORA.
MAIENSCHEIN MAZE MCCARTHY
MCCARTHY, I NAZARIAN CARRION I
RIVAS CHOLERA. CHOLERA I
SANTIAGO WEBER. HOWEVER, I 5 TO
1. 51 WILL LEAVE THE BILL ON
CALL. THANK YOU, MR CHAIR. THANK
YOU MEMBERS. THANK YOU. EXT. UP,
SENATOR MELENDEZ.
YOU KNOW, I'LL ASK EVERYONE JUST
REALLY PLEASED. JUST HOVER OVER
THAT MICROPHONE AND SPEAK. WE'RE
HAVING A REALLY HARD TIME TODAY
WITH OUR FOR WHATEVER REASONS IN
THIS BRAND NEW BUILDING.
TECHNOLOGY BEING WHAT IT IS. WE
JUST CAN'T HEAR IT ONE ANOTHER
VERY WELL. MAYBE IT'S BETTER ON
THE SENATE SIDE. I DON'T KNOW
WHAT'S THAT MAYBE IT'S BETTER ON
THE SENATE SIDE. ACTUALLY IT IS
A LITTLE BETTER IN THE SENSE
THAT WASN'T THE ANSWER. I WAS
LOOKING FOR A NICE TRY THE
ACOUSTICS I DON'T KNOW ABOUT.
THE ACOUSTICS ARE BETTER OVER
THERE. OKAY, LET ME TRY. THIS IS
MICROPHONE IS OKAY. READY OKAY.
THANK YOU SO MUCH. MR CHAIRMAN
AND MEMBERS OF THE COMMITTEE. I
AM PLEASED TO PRESENT SENATE
BILL 8 64, ALSO KNOWN AS TYLER'S
LAW ON OCTOBER 21ST 2000 AND 18
TYLER SHEAMUS DIED IN THE
BATHROOM OF A SOBER LIVING HOME
AFTER HAVING INGESTED FENTANYL.
THE NIGHT BEFORE HIS DEATH. HE
WAS TREATED AT A LOCAL EMERGENCY
ROOM FOR A SUSPECTED OVERDOSE
AFTER COMPLAINING ABOUT AN UPSET
STOMACH AND WAS ADMINISTERED
TEST FOR OPIOIDS, WHICH WAS
THOUGHT TO PICK UP ANY SIGN OF
FENTANYL. UNFORTUNATELY THAT WAS
NOT THE CASE. IT WASN'T UNTIL
AFTER TYLER PASSED AWAY THAT THE
DOCTOR AND TYLER'S FAMILY WERE
INFORMED. THE STANDARD
TOXICOLOGY SCREEN DOES NOT PICK
UP SYNTHETIC FORMS OF FENTANYL.
64 IS ABOUT MAKING SURE
EMERGENCY ROOM DOCTORS CAN PLAY
SIGNIFICANT KEY ROLE AND
IDENTIFYING OVERDOSES AND
ULTIMATELY SAVING SOMEONE'S
LIFE. RAPID TESTING FOR FENTANYL
CURRENTLY EXISTS AND HAS BECOME
SO SUCCESSFUL THAT THE MAJORITY
OF HOSPITALS IN SAN DIEGO
INCLUDE FENTANYL TESTING ANYTIME
A URINE DRUG SCREEN IS ORDERED
THE FENTANYL EPIDEMIC
THREATENING OUR COMMUNITIES AND
HARMING THEIR CHILDREN HAS
EXPLODED AND WE MUST PASS
MEANINGFUL LEGISLATION WITH THE
HOPES OF SAVING MORE LIVES. SB 8
64 HAS RECEIVED NO NO VOTES AND
HAS NO REGISTERED OPPOSITION
HERE WITH ME TODAY ARE MR AND
MRS SHEAMUS, UM CHARLES AND
JULIA HERE, JULIE WILL BE
TESTIFYING AND ALSO DR RAINEY
LEV, THE DIRECTOR OF OPERATIONS
AT THE SCRIPPS MERCY EMERGENCY
DEPARTMENT IN SAN DIEGO. THANK
YOU SO MUCH. AND AT THE
APPROPRIATE TIME. I RESPECTFULLY
ASK FOR YOUR I VOTE. MOVES THE
BILL. THANK YOU. PLEASE GO
AHEAD. AND JUST LIKE I SAID,
PLEASE SPEAK INTO THE
MICROPHONE. OKAY? CAN YOU HEAR
ME? YES. MY NAME IS JULIE
SCHAMASCH AND SB 864. TYLER'S
LAW IS NAMED FOR MY SON ON
OCTOBER 21ST 2000 AND 18. MY
CLIENT AND BRILLIANT SON DIED
FROM INGESTING FENTANYL IN THE
BATHROOM OF HIS SOBER LIVING.
TYLER AND OUR WHOLE FAMILY
STRUGGLED WITH HIS ADDICTION FOR
THREE YEARS. THE NIGHT BEFORE HE
DIED. HE WAS TAKEN BY AMBULANCE
TO AN EMERGENCY ROOM FOR A
SUSPECTED OVERDOSE. HE CLAIMED
TO HAVE TAKEN TOO MUCH, UM ODIUM
FOR AN UPSET STOMACH. SINCE I
WAS WELL AWARE THAT DRUG USERS
OFTEN DON'T TELL THE TRUTH. I
ASKED THE TREATING DOCTOR THREE
TIMES IF HE HAD BEEN TESTED FOR
EVERYTHING, INCLUDING FENTANYL.
THREE TIMES. HE ASSURED ME THAT
THEIR TALKS SCREEN THAT TEST FOR
OPIOIDS WOULD PICK UP THE
FENTANYL. AFTER TYLER DIED. WE
FOUND OUT THAT THE DOCTOR WAS
MISINFORMED. THE STANDARD TOX
SCREEN DOES NOT TEST FOR
FENTANYL BECAUSE IT IS A
SYNTHETIC OPIOID. AND WE KNOW
THAT TYLER HAD FENTANYL IN HIS
SYSTEM. WE WOULD HAVE SENT HIM
TO A DETOX OR RESIDENTIAL
TREATMENT, BOTH OF WHICH OFFER A
HIGHER LEVEL OF CARE INSTEAD OF
BACK TO SOBER LIVING. TYLER
STORY IS JUST ONE EXAMPLE OF A
DOCTOR UNAWARE THAT A SEPARATE
FENTANYL SCREENING TEST IS
NECESSARY. A MONTH AGO, I WAS
SPEAKING WITH A FRIEND WHO IS AN
O B. HE HAS TO ORDER TOX SCREENS
FROM OTHERS HE SUSPECTS OF USING
DRUGS. LIKE THE ER DOCTOR WHO
TREATED TYLER. HE HAD NO IDEA
THAT THE STANDARD FIVE PANEL TOX
SCREEN DOES NOT TEST FOR
FENTANYL AND THAT HE NEEDED TO
ORDER A SEPARATE TEST. SB 864
WILL SAVE LIVES IN SITUATIONS
LIKE TYLER AS WELL IN THOSE
CASES WHERE SOMEONE IS TAKEN TO
AN ER BECAUSE OF AN OVERDOSE
FROM ONE SUBSTANCE BUT WHO HAS
UNKNOWINGLY CONSUMED FENTANYL
FROM A POISONED PRODUCT.
FENTANYL IS A BIPARTISAN ISSUE
THAT AFFECTS EVERYONE IF WE KNEW
HIS DRUG SCREEN WAS POSITIVE FOR
FENTANYL, TYLER MAY BE ALIVE
TODAY. PLEASE VOTE YES. ON SB
864. THANK YOU. THANK YOU. HE
PUSHED THE BUTTON THERE THAT
HOW'S THAT? PERFECT. THANK YOU.
I URGE YOU TO ACT TODAY TO SAVE
LIVES, MAKE HISTORY AND SET A
NATIONAL STANDARD ON THE TRAGIC
FENTANYL CRISIS. MY NAME IS DR
AN IT, LEV. I'M BOARD
CERTIFIED IN EMERGENCY MEDICINE
AND ADDICTION MEDICINE. I WORK
ON THE FRONT LINES OF THE
EMERGENCY DEPARTMENT AT SCRIPPS
MERCY HOSPITAL. SAN DIEGO. AND
HAD THE HONOR OF SERVING AS THE
FIRST CHIEF MEDICAL OFFICER AT
THE WHITE HOUSE OFFICE OF
NATIONAL DRUG CONTROL POLICY.
EVERY DAY I TREAT PATIENTS WERE
EXPOSED TO FENTANYL, AND, SADLY,
IT'S NOW HAPPENING MULTIPLE
TIMES A DAY. MY RECENT SHIFT. I
TREATED A MAN WHO WAS FOUND
UNCONSCIOUS, BARELY BREATHING,
AND THANKFULLY, HE WAS REVIVED
WITH NALOXONE. HE WAS
CELEBRATING HIS 21ST BIRTHDAY
AND THOUGHT HE WAS TAKING XANAX.
HE WAS SHOCKED TO FIND OUT THAT
HE HAD NO XANAX IN HIS SYSTEM,
BUT DID HAVE FENTANYL. THE
POSITIVE FENTANYL TEST LED ME TO
GIVE HIM A PRESCRIPTION FOR
NALOXONE AND REFER HIM TO
APPROPRIATE TREATMENT. THE
POSITIVE FENTANYL TEST LED HIM
TO THROW AWAY HIS FAKE STASH OF
PILLS AND WARN HIS FRIENDS. WHO
MAY HAVE BOUGHT THE SAME PRODUCT
. FENTANYL IS THE NUMBER ONE
CAUSE OF DEATH IN THE UNITED
STATES, AGE 18 TO 45 MORE THAN
COVID. THE NUMBER OF TEENS WHO
HAVE OVERDOSED FROM FEDERAL HAS
GONE UP THREE FOLDS. THE NUMBER
OF BLACK TEENS WHO OVERDOSE HAVE
GONE UP FIVEFOLD. AND IN
CALIFORNIA FENTANYL DEATHS HAVE
GONE UP FIVEFOLD IN THE PAST TWO
YEARS IN SAN DIEGO, OUR MEDICAL
EXAMINER IS DEALING WITH 2.5
DEATHS A DAY. FROM FENTANYL.
INCREASINGLY HOSPITALS AROUND
CALIFORNIA ARE INCLUDING
FENTANYL AS PART OF THE STANDARD
RAPID URINE DRUG SCREEN. THIS
BILL WILL PUSH THE REST OF
CALIFORNIA'S HOSPITALS TO DO THE
SAME. A RAPID URINE PANEL TEST
FOR COCAINE, AMPHETAMINE AND
OPIATES DERIVED FROM THE POPPY
PLANT, SUCH AS HEROIN AND
MORPHINE. THE TRADITIONAL OPIOID
DRUG TEST DOES NOT INCLUDE
FENTANYL, A SYNTHETIC DRUGS. TO
INCLUDE FENTANYL HOSPITALS NEED
TO PURCHASE A 75 CENT. UM, TEST
THAT CAN DETECT THAT. HOSPITALS
QUICKLY ADAPTED TO INCLUDE COVID
TESTING WITH THE PANDEMIC, AND
THEY CAN AND THEY SHOULD DO THE
SAME FOR FENTANYL. THIS BILL IS
NOT ABOUT MANDATED TESTING IT
ASKED FOR INCLUDING FENTANYL
WHEN TESTING FOR OTHER DRUGS AND
ANY HOSPITAL THAT IS HAVING
TROUBLE ADOPTING FENTANYL
TESTING INTO THEIR LAB. I OFFER
FREE TECHNICAL ASSISTANCE. BUT
ALL TESTING WILL NOT SOLVE THE
CRISIS, BUT IT WILL ENGAGE THE
MEDICAL COMMUNITY AND SOLUTIONS
THAT COULD SAVE LIVES. I URGE
YOU ALL TO UNITE AND LEADING
CALIFORNIA AND OUR NATION AND
SOLUTIONS ON FENTANYL. THANK YOU
VERY MUCH. OTHERS IN SUPPORT.
JUST YOUR NAME AND ORGANIZATION
. IF YOU REPRESENT ONE GOOD
AFTERNOON, MR CHAIR AND MEMBERS
CONNIE DELGADO ON BEHALF OF THE
CALIFORNIA EMERGENCY NURSES
ASSOCIATION IN SUPPORT. THANK
YOU. LEAH BARROWS ON BEHALF OF
CALIFORNIA HOSPITAL ASSOCIATION
. WE HAVE A SUPPORT IF AMENDED
POSITION. A COUPLE OF EXTRA
COMMENTS HERE IS THAT WE DO
APPRECIATE THE TIMELINESS AND
IMPORTANCE OF THIS BILL. HOWEVER
WE DO HAVE SOME CONCERNS WITH
OUR RURAL AND SMALLER HOSPITALS
BEING ABLE TO AFFORD BUYING NEW
EQUIPMENT AND CALIBRATING
EXISTING EQUIPMENT. WE HAVE BEEN
WORKING CLOSELY WITH THE
AUTHOR'S OFFICE AND WE LOOK
FORWARD TO CONTINUING THOSE
CONVERSATIONS. THANK YOU.
AFTERNOON CHAIR AND MEMBERS
SHERRY DAILY WITH CALIFORNIA
CONSORTIUM OF ADDICTION PROGRAMS
AND PROFESSIONALS AND SUPPORT
THANK YOU. THANK YOU. JONATHAN
CLAY ON BEHALF OF SCRIPTS,
HEALTH AND SUPPORT. THANK YOU.
MY NAME IS AMERICA, COLON AND
SUPPORT OF THIS BILL. UM I HAVE
A SON THAT WAS ARTISTIC. HAD HE
BEEN TESTED HE WOULD BE ALIVE
TODAY, SO PLEASE SUPPORT THIS
BILL. THANK YOU. FANNY GALE IN
SUPPORT OF THIS, BILL. THANK
YOU. CHRISTIE SUPPOSED TO BIRGIT
AND SUPPORT THANK YOU. CNN
PRIMARY SPECIAL EDUCATION
PARALEGAL ON BEHALF OF MYSELF
AND MY CLIENT, TASHA HAMBLETON.
WE STRONGLY SUPPORT THIS BILL.
THANK YOU. WILLIAMS PLASTIC
COUNTY RESIDENT IN SUPPORT. WE
HAVE WITNESSES AND OPPOSITION TO
THE BILL. SEE NO ONE ANYBODY IN
THE AUDIENCE AT ALL IN
OPPOSITION WITNESSING? OKAY ALL
RIGHT. SO, YOU KNOW ONE. THANK%
YOU BRING IT BACK TO THE
COMMITTEE FOR QUESTIONS OR
COMMENTS, QUESTIONS OR CURRY.
I'M SORRY. I DIDN'T SEE I WAS A
COUNTY. I HAVE A HABIT OF
LOOKING TO MY RIGHT TO MY LEFT,
MR KALRA. THANK YOU. THANK YOU.
THANK YOU, MR CHAIR, AND THANK
YOU, SENATOR FOR BRINGING THIS
IMPORTANT LEGISLATION FORWARD.
UM AND I JUST WANT TO CONFIRM
BECAUSE I THINK THAT ONE OF THE
FIRST OF ALL THAT THE FAMILY
VERY COURAGEOUS TO BE HERE AND
TO SPEAK TO ADVOCATE AFTER SUCH
A LOSS. AND SO I COMMEND YOU FOR
THAT, UM, I WORKED IN A PRIOR
CAREER AS A PUBLIC DEFENDER FOR
11 YEARS. 5.5 THOSE YEARS WAS IN
DRUG TREATMENT COURT, SO NOT
MAYBE IN THE SAME WAY AS AS OUR
GOOD DOCTOR, BUT IN A DIFFERENT
WAY, HAD A FRONT ROW SEAT TO THE
TRAGEDY OF ADDICTION. UM AND HOW
DEVASTATING IT CAN BE. UM
ESPECIALLY FOR THE FAMILY, WHEN
THERE ARE OPPORTUNITIES FOR US
TO INTERVENE, AND WHEN IT
DOESN'T HAPPEN BY NO FAULT OF
THE ADDICTED OR THE FAMILY. I
THINK WE NEED TO TRY TO FIND
WAYS TO GET THAT INTERVENTION
EVERY OPPORTUNITY WE HAVE,
BECAUSE YOU NEVER KNOW WHEN THAT
ONE INTERVENTION WILL BE THE ONE
THAT WILL SAVE SOMEONE'S LIFE.
UM AND I JUST WANTED FOR THE
RECORD BECAUSE I DID ASK THE
QUESTION OF COMMITTEE STAFF, AND
I THINK THE AUTHORS OFFICE AS
WELL JUST TO CLARIFY THAT THIS
IS NOT BECAUSE OF THE HIPPO
RULES. IT IS NOT AH, TRIGGER ANY
MANDATORY REPORTING, AND SO I
JUST WANT TO CLARIFY THAT MAKE
THAT CLEAR FOR THE RECORD AND MY
CONCERN THAT OF COURSE, YOU
STILL WANT PEOPLE TO SEEK
TREATMENT, REGARDLESS,
ESPECIALLY IF, UM THEY THEY'VE
BEEN USING ILLEGAL SUBSTANCES
THAT WE KNOW THAT WE HAVE THE
OPPORTUNITY TO SAVE THE LIFE
LAST YOU WANTED TO PREVENT
PEOPLE FROM THAT FROM GOING TO
THE HOSPITAL, BUT JUST WIRED UP
ON THE RECORD CONFIRM, CONFIRMED
THAT AND THANK THE AUTHORS
OFFICE AS WELL AS THE COMMITTEE
STAFF FOR REAFFIRMING THAT WITH
ME AS WELL, SO IN ANY CASE WILL
BE SUPPORTING THE BILL AND AGAIN
WANT TO THANK THE FAMILY. THANK
YOU. YOU SAID YOUR CURRY. THANK
YOU, SENATOR FOR BRINGING THE
BILL FORWARD. AND UM I JUST WANT
TO MAKE A COMMENT IS THAT WHEN I
HEARD ONE OF THE SUPPORTERS HAD
WAS SUPPORTING UNLESS AMENDED
REGARDING RURAL COMMUNITIES THAT
JUST LED A BIG TRIGGER OFF FOR
ME, BECAUSE IT IS AN ISSUE IN
SOME OF OUR AREAS THAT YOU DON'T
NECESSARILY HAVE THE RIGHT
PEOPLE IN THE RIGHT PLACE AND
THE EQUIPMENT WE NEED, SO I HOPE
YOU'LL CONTINUE TO WORK AND TO
ASSURE THAT MY COMMUNITY AS WELL
IS COVERED UNDER YOUR BILL. SO
THANK YOU VERY MUCH FOR BRINGING
IT FORWARD AGAIN. THANK YOU TO
THE FAMILY FOR COMING FORWARD.
WE APPRECIATE WE REALLY
APPRECIATE IT. THANK YOU, MISS
HAGAR. CURRIE JUST QUESTION
DOCTOR OF THE DOCTOR. I'M SORRY,
MISS WEBBER. OKAY? SORRY ABOUT
THAT. THANK YOU SO MUCH FOR THIS
BILL. IT IS DEFINITELY
DEFINITELY NEED IT. THANK YOU SO
MUCH FOR COMING AND TESTIFYING
AND SHARING YOUR STORY WITH US
DO HAVE, UM, JUST A QUICK
QUESTION IS THE URINE TEST FOR
FENTANYL IS THAT AN FDA
APPROVED? TEST. THERE ARE THREE
FDA RE AGENTS THAT ARE FDA
CLEARED TO BE USED WITH ANY
CHEMICAL ANALYZER AND A CHEMICAL
ANALYZER IS AVAILABLE AT EVERY
HOSPITAL, INCLUDING INCLUDING
RURAL HOSPITALS. ALL RIGHT. AND
I ALSO WANT TO ECHO. WHAT UM, MY
COLLEAGUE SAID. I MEAN, WE ARE
VERY FORTUNATE IN SAN DIEGO THAT
WERE IN A MAJOR CITY, LARGE
HOSPITAL SYSTEMS, BUT I DO
UNDERSTAND THAT'S NOT THE CASE
IN ALL ASPECTS OF CALIFORNIA,
AND I JUST WANT TO MAKE SURE
THAT AS THIS PHIL ROLLS OUT,
BECAUSE MY ASSUMPTION IS THAT IT
WILL PASS AND BE SIGNED, UM THAT
WE DON'T SEE A DISPROPORTIONATE
IMPACT VERSUS LARGER CITIES ARE
ABLE TO DO IT AND RURAL AREAS
ARE NOT BECAUSE OF COST BARRIERS
, SO I'M NOT SURE IF THERE WAS
IF THERE'S A BUDGET ASK ALONG
WITH IT. UM BUT I DO THINK THAT
WE SHOULD TAKE THAT INTO
CONSIDERATION AS WELL. THANK
YOU. YOU KNOW THE ANSWER. I WELL. WANT TO. I'D LIKE TO HEAR FROM
THE DOCTOR MYSELF. SO YOU HEARD
I HEARD YOU SAY IT WAS A 75 CENT
TESTS. SO THE WAY THE TEST
WORKS. THERE'S THREE FDA CLEARED
FENTANYL RE AGENTS THAT ARE
AVAILABLE. WE CREATED A TOOLKIT
THAT'S AVAILABLE ON BOTH THE
CALIFORNIA ASAP WEBSITE AND THE
SAN DIEGO PRESCRIPTION DRUG
ABUSE WEBSITE ON HOW TO HOW TO
DO THAT. IN WE TESTED THIS MODEL
IN 24 DIFFERENT HOSPITALS IN SAN
DIEGO COUNTY THAT INCLUDE SMALL
RURAL HOSPITALS. AND WHAT THE
WAY A TEST WORKS AS YOU PUT THE
RE AGENT IN THE CHEMICAL
ANALYZER, THE CHEMICAL ANALYZERS
AND EXPENSIVE MACHINE THAT'S
AVAILABLE AT EVERY HOSPITAL,
INCLUDING RURAL HOSPITALS. THE
TEST ITSELF COSTS BETWEEN 75 TO
A DOLLAR. IT'S LESS IF YOU BUY
MORE. I MEAN, AND IT COSTS A
LITTLE MORE, YOU KNOW A SMALLER
PURCHASES, BUT THAT'S A MINOR
AMOUNT OF MONEY. AND THE RE
AGENTS AREN'T TYPICALLY AREN'T
TERRIBLY EXPENSIVE TO 75 CENTS
TO A DOLLAR FOR THE ENTIRE COST
OF THE TEST TEST. I DON'T THINK
THAT'S GOING TO BREAK ANY BACKS
IN RURAL COUNTIES. SO UH AND
WHEN I AND I WOULD JUST SAY
ANOTHER COMMENT, AND I'LL GO
BACK. I'LL COME BACK TO YOU, DR.
WEBBER. UM SOME OF THE RURAL
COUNTIES, ESPECIALLY SOME OF THE
ONES I REPRESENT HAVE HAD A
DISPROPORTIONATE NUMBER OF
FENTANYL OVERDOSES. AND SO, UM,
YOU KNOW, I JUST CONFOUNDED THAT
WE WOULD BE CONCERNED ABOUT
COSTS, ESPECIALLY WITH SOMETHING
SO LOW. I THINK THE COST OF
SOMEONE PASSING AWAY BECAUSE WE
DON'T DIAGNOSE THAT IS, UH
MEASURABLE, AND SO I THANK YOU,
AND WE HAVE TECHNICAL SUPPORT
OFFERED BY SOMEONE FROM SAN
DIEGO IS WILLING TO GO HELP. SO
THANK YOU VERY MUCH FOR THAT.
AND IT'S ALSO THANK YOU TO THE
FAMILY, MR. MR SEAMUS THAT
BECOMING HERE TODAY AND BEING A
PART OF OUR PROCEEDINGS HERE
TODAY. THANK YOU. DO YOU WANT TO
GO BACK TO DR WEBBER? THANK YOU
KNOW, I SAW THE REPRESENTATIVE
FROM THE CALIFORNIA HOSPITAL
ASSOCIATION. I JUST WANT TO MAKE
SURE THAT WE'RE ALL CLEAR ABOUT
POTENTIAL COSTS BECAUSE AGAIN
RURAL AREAS ARE BEING HIT WITH
THIS. JUST LIKE OUR CITIES ARE
AND, UM AND SO I JUST WANT TO
MAKE SURE THAT IT IS JUST 75
CENTS. PROTEST UM, BECAUSE THAT
DOESN'T SEEM LIKE A LOT. PLEASE
GO AHEAD AND RAISE THE LETTER
LETTER LETTER TESTIFY. THANK YOU
FOR THAT, DR WEBBER. SO IT'S MY
UNDERSTANDING THAT YES, THE
PROTEST IS THAT LOW. BUT IF THE
PLATFORM IS NOT COMPATIBLE THAN
THE HOSPITAL WILL HAVE TO GET A
NEW CHEMISTRY SYSTEM AND THAT
WILL COST UP TO ABOUT 150,000.
FOR THAT SYSTEM, AND THAT'S WHAT
WE'RE TRYING TO ADDRESS. UM I
THINK WE'VE GOT A DISPUTE HERE
BECAUSE WE JUST HAVE THE DOCTOR
SAY EVERY EVERY HOSPITAL IN
CALIFORNIA HAS THE CAPACITY TO
RUN TESTS WE'RE TALKING ABOUT
DIFFERENT RE AGENTS, UM. NOT NEW
MACHINERY. RIGHT AND I FROM WHAT
WE KNOW FROM OUR FROM WE GOT
WORD FROM TWO OF OUR HOSPITALS
THAT IF THE IF THE PLATFORM IS
NOT COMPATIBLE, THAT'S WHAT IT
WOULD COST AND WE CAN FOLLOW UP
AGAIN WITH SOME MORE INFORMATION
THAT WE SENT TO COMMITTEE AND WE
CAN RESEND THAT INFORMATION TO
YOUR OFFICE AS WELL, DOCTOR. UM
IF THOSE TWO HOSPITALS REACH ME,
I'LL HELP HIM OUT BECAUSE THERE
IS AN EDUCATIONAL GAP. THANK YOU
SHOULD NOT. I DO NOT WANT
HOSPITALS SPEND 100 $50,000.
YEAH I DON'T WANT HOSPITALS
SPEND 100 $50,000, EITHER. SO IF
THERE'S AN EDUCATIONAL GAP THERE
THAT MAKES MAYBE THERE'S A SALES
REPRESENTATIVE WHO WANTS TO SELL
A NEW MACHINE. UM THAT WOULDN'T
BE SURPRISING. SO QUITE FRANKLY
, SO, UM, SO WE'VE GOT SOMEONE
HERE WILLING TO HELP. WHO'S DONE
A DONE GREAT WORK IN SAN DIEGO,
AND SHE'S WILLING TO TRAVEL.
THANK YOU MUCH APPRECIATED, AND
WE HAVE HAD SOME GREAT
CONVERSATIONS WITH DR LOVE AS
WELL. SO WE DO APPRECIATE YOU
FOR ALL OF YOUR ADVOCACY ON
THIS. THANK YOU. AS SOMEONE WHO
REPRESENTS THREE OF THE FIVE TOP
FIVE COUNTIES WHO HAVE HAD
OVERDOSE DEATHS THAT THAT WAS A
STATISTIC MAYBE A COUPLE OF
YEARS AGO. UH THIS IS A BIG DEAL
FOR SOME OF OUR RURAL
COMMUNITIES, AND I HAVE ONE OF
THE MOST RURAL DISTRICTS IN THE
STATE THAT I REPRESENT. SO I
WANT TO THANK YOU, SENATOR
MELENDEZ FOR BRINGING THE BILL
FORWARD. UM AND I WOULD LOVE TO
BE A CO AUTHOR, IF YOU'D HAVE
HAVE ME ON THEIR, UH, IF THIS
BILL PASSES OUT OF COMMITTEE, UM
AND WOULD YOU LIKE TO CLOSE
CERTAINLY, THANK YOU, MR
CHAIRMAN. I WOULD LOVE TO HAVE
YOU AS A CO AUTHOR. UM AND I
THINK THOSE WHO CAME TO TESTIFY
AND SUPPORT TODAY. AS YOU KNOW,
IT'S VERY HARD FOR FAMILIES TO
COME FORWARD AND TALK ABOUT WHAT
HAS HAPPENED TO THEM, AND THE
SAME ISH FAMILY HAS BEEN HERE
ALL ALONG THROUGH EACH COMMITTEE
SHARING THEIR STORY, WHICH IS
VERY DIFFICULT, AND I'M SURE
THIS COMMITTEE HAS HEARD OTHER
BILLS RELATED TO FENTANYL, WHERE
YOU HAVE HAD A PARENT AFTER
PARENT FAMILY MEMBER OF THEIR
FAMILY MEMBER AND MANY OF THEM,
MAYBE IN YOUR DISTRICT BEING
THAT IT IS SO RURAL AND YOU KNOW
THE NUMBER OF FENTANYL DEATHS
THAT THAT WE HAVE SEEN TAKE
PLACE, SO I WILL JUST ADD THAT
YOU KNOW WHAT? THIS IS NOT A
BILL ABOUT INCREASING A
FINANCIAL BURDEN ON ANY
COMMUNITY, LET ALONE RURAL
COMMUNITIES. AND I THINK WE'VE
ESTABLISHED THAT WE CAN ADDRESS
THAT SUCCESSFULLY. UM BUT WE
HAVE A LOT OF LIVES AT STAKE
HERE AND THIS, YOU KNOW, A 75
CENT TEST. I MEAN, MY GOODNESS,
THAT'S PRICELESS. WHEN YOU'RE
TALKING ABOUT BEING ABLE TO SAVE
SOMEONE'S, UH, LIFE, SO WITH
RESPECT, I WOULD ASK FOR YOUR
VOTE. THANK YOU VERY MUCH. UM
MADAM SECRETARY. THE MOTION IS
WE HAD EMOTION. I BELIEVE IT WAS
BY MISTAKE. YOUR CURRIES
SECONDED BY MR BIGELOW. THE
MOTION IS DO PASS THROUGH
APPROPRIATIONS. PLEASE CALL THE
ROLL. WOULD, WOULD I, WALDRON.
AGUIAR-CURRY CURIAE ARAMBULA.
BIGELOW PICCOLO, I CARILLO. LARA
MAIENSCHEIN MAZE MCCARTHY
NAZARIAN. LUZ RIVAS PALABRAS.
FOR A I SANTIAGO WEBBER.
HOWEVER, I. THEY JUST SAY ALL
THE MEMBERS THE COMMITTEE
MEMBERS THAT ARE HERE ARE MY
FAVORITES. 50 THANK YOU. CHAIR
AND COMMITTEE MEMBERS. THANK
YOU. SENATOR WIENER.
AND OR YOU HAVE SB 9 64. ANIMALS
WHO ARE ARE EDMUND. OUR OUR OUR
REQUEST. PLEASE SPEAK INTO THE
MICROPHONE. THANK YOU. THANK
YOU. PUT THAT ON. OKAY IT IS,
BUT WE'RE HAVING DOWN THERE
SEEMS TO BE A PROBLEM. OKAY
THANK YOU, MR CHAIR. I WILL SAY
, UNLIKE IN THE SENATE, UH, THIS
IS ACTUALLY APPROPRIATE FOR A
TALL PERSON. ROOMS ARE ONLY IF
WE CAN HEAR YOU, SENATOR. LET'S
SPEAK UP. I WILL SPEAK UP. THERE
WE GO. HOLD IT UP LIKE THAT. UM
THANK YOU, MR CHAIR FIRST. I
WANT TO, UM, JUST THANK THE
COMMITTEE FOR WORKING WITH US,
AND WE'RE HAPPY TO ACCEPT THE
AMENDMENTS OUTLINED AND SECTION
EIGHT OF THE ANALYSIS AND WE'LL
BE TAKING THOSE AS AMENDMENTS
AND, UM AND THE NEXT COMMITTEE
AND ASSEMBLY HIGHER EDUCATION.
UM SO COLLEAGUES I'M PRESENTING
SP 9 64 A BILL WITH VARIOUS
ELEMENTS TO HELP RETAIN AND
EXPAND CALIFORNIA'S STRUGGLING
MENTAL HEALTH WORKFORCE. WHILE
THERE IS NO SILVER BULLET, THIS
BILL IS A STEP IN THE RIGHT
DIRECTION. JUST ONE THIRD OF
CALIFORNIANS LIVING WITH A
MENTAL HEALTH CONDITION RECEIVE
THE CARE THAT THEY NEED. ONE OF
THE LARGEST DRIVERS OF THIS
FAILURE IS THE SHORTAGE OF
BEHAVIORAL HEALTH CARE WORKERS
IN TODAY, 31 OUT OF OUR 58
COUNTIES ARE CLASSIFIED AS QUOTE
UNQUOTE HIGH NEED FOR MENTAL
HEALTH SERVICES. UM OR 31 OF THE
COUNTIES WITH THAT ARE HIGH NEED
FOR MENTAL HEALTH SERVICES
REPORT HAVING A WORKFORCE
SHORTAGE. THE PARTICULARLY
PEOPLE LIVING IN RURAL
LINGUISTICALLY AND ETHNICALLY
DIVERSE AND LGBTQ COMMUNITIES,
UM, ARE SEVERELY UNDERSERVED
WHEN IT COMES TO MENTAL HEALTH
ACCESS. AND OUR MOST VULNERABLE
SUFFERING FROM MENTAL HEALTH
CONDITIONS CONTINUE TO CYCLE
THROUGH HOSPITAL ERS JAILS AND,
OF COURSE, OUR CITY STREETS. THE
STATES TRAINED MENTAL HEALTH
SYSTEM IS ON THE VERGE OF
COLLAPSE IN SOME AREAS TO BE
FRANK, UH, AND WE NEED MORE
MENTAL HEALTH PROFESSIONALS UM
SP 9 64 WILL HELP TO SHORE UP
AND EXPAND OUR MENTAL HEALTH
WORKFORCE IN A NUMBER OF WAYS BY
ESTABLISHING A BEHAVIORAL HEALTH
WORKFORCE PRESERVATION AND
RESTORATION FUND. BY CREATING A
STATEMENT PROGRAM FOR STUDENTS
AND MASTER OF SOCIAL WORK
PROGRAMS WITH A SPECIALIZED
FOCUS ON PUB PUBLIC BEHAVIORAL
HEALTH DEVELOPED, THE BILL WILL
DEVELOP GRANTS AND STIPENDS FOR
MASTERS LEVEL AND DUAL MASTER'S
AND DOCTORAL LEVEL STUDENTS
TAKING DEGREES AND FIELDS
ASSOCIATING. THIS YEAR WITH
BEHAVIORAL HEALTH OTHER THAN
SOCIAL WORKERS, UM, EXPANDING
ACCESS TO CULTURALLY COMPETENT
CARE BY MAKING THE PEER SUPPORT
SPECIALIST A STATEWIDE MEDICAL
BENEFIT, NOT JUST AN OPT IN
DEVELOPING ACCELERATED SOCIAL
WORK PROGRAMS DEVELOPING AN
ACCELERATED PROGRAM. AH FROM
CERTIFICATION TO ASSOCIATES,
BACHELORS AND MASTERS PROGRAMS
REQUIRING A STUDY OF OUR
BEHAVIORAL HEALTH WORKFORCE
LICENSING REQUIREMENTS SO WE CAN
MAKE SURE PEOPLE ARE ABLE TO
PRACTICE TO THE FULL EXTENT OF
THEIR TRAINING. REQUIRING A
COMPREHENSIVE LANDSCAPE ANALYSIS
OF OUR BEHAVIORAL HEALTH
WORKFORCE. UM AND SO FORTH. I
WILL NOT KEEP GOING BECAUSE
THERE'S A LOT IN THE SPILL.
ACKNOWLEDGE THAT AND THE GOOD
THING COLLEAGUE. THIS IS LIKE
THIS IS, I THINK AN IMPORTANT
STEP TO SHORE UP THIS CRITICALLY
IMPORTANT AND INCREASINGLY
BURNED OUT WORKFORCE AND I
RESPECTFULLY ASK FOR AN I VOTE
WITH ME TODAY ARE TERROR GUMBO
EASTMAN FROM THE STEINBERG
INSTITUTE, AND SEVEN STEPHANIE
SOGA, THE EXECUTIVE DIRECTOR AT
TURNING POINT HOME IN SAN DIEGO.
THE BILL THANK YOU. MOTION BY
MISS AGGIE OR CURIOUS SECOND BY
MR BIGELOW AND PLEASE GO AHEAD.
HI. GOOD AFTERNOON CHAIR AND
MEMBERS TAR GAMBO EASTMAN WITH
THE STEINBERG INSTITUTE. WE'RE
AN INDEPENDENT, NONPROFIT PUBLIC
POLICY INSTITUTE DEDICATED TO
ADVANCING SOUND PUBLIC POLICY
AND INSPIRING LEADERSHIP ON
ISSUES OF BRAIN HEALTH AND ARE
THE VERY PROUD SPONSORS OF SP 9
64. THANK YOU SO MUCH FOR HAVING
ME TODAY AND A HUGE THANK YOU TO
THE COMMITTEE FOR YOUR WORK ON
THIS BILL. DEATHS FROM OPIOID
AND MATTHEWS ARE SKYROCKETING,
MORE THAN 50,000. INDIVIDUALS
EXPERIENCING HOMELESSNESS LIVE
WITH A SERIOUS MENTAL ILLNESS
AND RATES OF DEPRESSION AMONG
OUR YOUTH HAVE INCREASED BY MORE
THAN 50% OVER THE LAST DECADE.
CONTRIBUTING TO A DOUBLING IN
THE NUMBER OF ER VISITS BY
SUICIDAL CHILDREN AND TEENS ARE
FACING A DEVASTATING AND DEADLY
MENTAL HEALTH AND SUBSTANCE USE
DISORDER CRISIS. BUT RIGHT NOW
WE'RE ALMOST POWERLESS TO
PREVENT IT AND STOP IT BECAUSE
WE'RE FACING A SECOND CRISIS.
THE BEHAVIORAL HEALTH WORKFORCE
SHORTAGE MORE THAN HALF OF ALL
COUNTIES REPORT BOTH A HIGH NEED
FOR MENTAL HEALTH SERVICES AND
HAVING A WORKFORCE SHORTAGE.
WITHOUT ESSENTIAL WORKERS ACCESS
TO SERVICES IS DROPPING
FACILITIES ARE CLOSING AND THE
SICKEST AMONG US CYCLE BETWEEN
THE STREET JAIL AND EMERGENCY
ROOM. AND AS WE SINK DEEPER INTO
THIS CRISIS, THE STATE IS ON THE
VERGE OF MONUMENTAL AND
DESPERATELY NEEDED REFORMS IN
CALAIS NAME, THE YOUTH
BEHAVIORAL HEALTH INITIATIVE AND
THE 988 MENTAL HEALTH CRISIS
LINE, BUT WE'RE DOING THEM
WITHOUT THE WORKERS TO CARRY
THEM OUT. IF WE DON'T TAKE
IMMEDIATE ACTION TO STABILIZE
OUR WORKFORCE, THE NUMBER OF
PEOPLE ABLE TO ACCESS CARE WILL
CONTINUE TO DROP. PEOPLE WILL
FALL EVEN SICKER, AND IN THE
MOST TRAGIC OF CASES, PEOPLE
WILL DIE. THE FUTURE OF
CALIFORNIA WORKFORCE AND SURGEON
BEHAVIORAL HEALTH INITIATIVE, OR
FOCUS B. H S. B. 9 64 IS THE
CULMINATION OF MORE THAN A YEAR
OF RESEARCH CONDUCTED BY THE
INSTITUTE AND MONTHS OF
DISCUSSIONS BETWEEN DOZENS OF
STAKEHOLDERS. THIS INITIATIVE
AND SB 9 64 SET FORTH AMBITIOUS
GOALS AND REPRESENT THE BEST
THINKING OF THE COALITION ON
SOLVING THE MOST INTRACTABLE
PROBLEM IN BEHAVIORAL HEALTH.
ADDRESSING THE WORKFORCE
SHORTAGE, I RESPECTFULLY REQUEST
YOUR I VOTE AND HAPPY TO ASK
ANSWER ANY QUESTIONS? THANK YOU.
THANK YOU. GOOD AFTERNOON.
HONORABLE CHAIR AND MEMBERS. MY
NAME IS STEPHANIE SABGA, AND I
AM CURRENTLY THE EXECUTIVE
DIRECTOR OF THE TURNING POINT
HOME OF SAN DIEGO. WE ARE
LICENSED AND CERTIFIED BY THE
STATE OF CALIFORNIA OFFERING.
INTENSIVE RESIDENTIAL TREATMENT
SERVICES FOR WOMEN. WITH
SUBSTANCE USE DISORDERS. I ALSO
SERVED AS THE VICE CHAIR FOR THE
SAN DIEGO COUNCIL. UM EXCUSE ME
, DIEGO COUNTY ALCOHOL AND DRUG
SERVICE PROVIDERS ASSOCIATION. I
HAVE NEVER BEFORE EXPERIENCED A
WORKFORCE CRISIS LIKE THE ONE WE
ARE FACING. NOW WE ARE IN THE
MIDDLE OF AN EXPONENTIAL. WE ARE
IN THE MIDDLE OF AN
EXPONENTIALLY ESCALATING OPIOID
OVERDOSE OVERDOSE OVERDOSE
EPIDEMIC, YET WE SIMPLY CANNOT
FILL THE VACANCIES FOR NUMEROUS
POSITIONS IN OUR ORGANIZATION.
OUR INABILITY TO RECRUIT TRAIN
AND RETAIN COUNSELORS IS
COMPROMISING OUR ABILITY TO
ADDRESS AN OVERWHELMING NEED FOR
SERVICES, LET ALONE INCREASED
CAPACITY TO MEET EVER GROWING
DEMAND. RECENTLY WE'VE HAD
MULTIPLE OPENINGS FOR FULL TIME
AND PRT TIME DIRECT SERVICE
STAFFS, AND THEY'VE REMAINED
UNFILLED FOR WELL OVER SIX
MONTHS. WE CANNOT OFFER SERVICES
WHILE LACKING THE QUALIFIED
STAFF NECESSARY TO SAFELY
DELIVER THE SERVICES. AS A
RESULT, WE HAVE SPENT MUCH OF
THE LAST TWO YEARS WITH A
LOWERED CENSUS, WHICH MEANS
THERE HAVE BEEN WOMEN WHO HAVE
REACHED OUT FOR HELP. AND WE
HAVE NOT BEEN ABLE TO MEET THEIR
NEEDS. MY FIRSTHAND EXAMPLES OF
THE WORKFORCE CRISIS ARE NOT
UNIQUE IN CALIFORNIA ALONE. IT
IS ESTIMATED THAT APPROXIMATELY
2.7 MILLION PEOPLE MEET THE
CRITERIA FOR A SUBSTANCE USE
DISORDER DIAGNOSIS. YET THERE
ARE LESS THAN 10,000 CERTIFIED
ALCOHOL AND DRUG COUNSELORS IN
THE STATE. AMIDST A MONUMENTAL
INCREASE IN DEMAND FOR SUBSTANCE
USE DISORDER SERVICES ONLY 282
NEW CERTIFIED COUNSELORS WERE
ADDED TO THE WORKFORCE SINCE
JANUARY 1ST OF THIS YEAR. THAT'S
ONLY AN AVERAGE OF 47 PER MONTH
WHEN COMPARING THE NUMBER OF
RESIDENTIAL INPATIENT TREATMENT
BEDS FROM MAY 21 TO MAY. 22
CALIFORNIA HAS LOST CLOSE TO 500
BEDS. WE SIMPLY MUST DO ALL THAT
WE CAN TO REVERSE THIS TREND.
PEOPLE'S LIVES DEPEND ON IT. SP
9 64 INCLUDES TARGETED RELIEF
FOR THE SUBSTANCE USE DISORDER
WORKFORCE IT ALLOWS FOR HIRING
AND RETENTION BONUSES. EDUCATION
SUPPORTS FOR VOCATIONAL SCHOOL.
FINANCIAL SUPPORT TO OVERCOME
WORKFORCE, ENTRY BARRIERS AND
LONG TERM INVESTMENTS THAT WILL
HELP OUR EDUCATIONAL
INSTITUTIONS CREATE BETTER ON
RAMPS FOR THIS PROFESSION. FOR
THESE REASONS, I RESPECTFULLY
REQUEST YOUR I VOTE. THANK YOU
VERY MUCH. THANK YOU. OTHERS IN
SUPPORT. HAS COME FORWARD. JUST
YOUR NAME AND ORGANIZATION IF
YOU REPRESENT ONE. GOOD
AFTERNOON CHAIR MEMBERS SHERRY
DAILY WITH CALIFORNIA CONSORTIUM
OF ADDICTION PROGRAMS AND
PROFESSIONALS AND SUPPORT ALSO
HERE AS A COURTESY TO THE
CALIFORNIA SOCIETY SOCIETY OF
ADDICTION MEDICINE WHO ARE ALSO
IN SUPPORT. THANK YOU. THANK
YOU. REBECA GONZALEZ NATIONAL
ASSOCIATION OF SOCIAL WORKERS,
CALIFORNIA CHAPTER. WE ARE IN A
SUPPORTIVE MENDED POSITION, BUT
WE'RE VERY CONFIDENT THAT WE
WILL BE ABLE TO MOVE INTO A FULL
SUPPORT POSITION. WE HAVE BEEN
WORKING ON AMENDMENTS TO ENSURE
THAT ANY NEW, ACCELERATED SOCIAL
WORK PROGRAMS WILL BE CONSISTENT
WITH ACCREDITATION STANDARDS
BECAUSE SOCIAL WORKERS NEED TO
GET DEGREES FROM AN ACCREDITED
SCHOOL IN ORDER TO BECOME AN L C
S W THANK YOU. THANK YOU. ANYONE
ELSE? SEE NO ONE WILL GO AHEAD
AND AS THEIR OPPOSITION
TESTIMONY, IT LOOKS LIKE THERE
IS.
GOOD AFTERNOON CHAIR AND MEMBERS
COLLINS, WHEREAS WITH THE
CALIFORNIA PSYCHOLOGICAL
ASSOCIATION, WE DO HAVE A
OPPOSING LESS AMENDED POSITION.
I DO WANT TO SPECIFY THOUGH THIS
IS SOMETHING THAT WE'VE BEEN
WORKING CLOSELY WITH THE AUTHOR
AND SPONSORS ON FOR MONTHS. A
LOT OF THE COMPONENTS OF THIS
LEGISLATION OR THINGS THAT WE
HAVE ACTIVELY WORKED ON. HOWEVER
THERE IS ONE ASPECT OF THE BILL
THAT IS INCREDIBLY PROBLEMATIC
AND IS DRIVING THE OPPOSED AND
THAT'S THE INCLUSION OF
RECOMMENDATION SECTION. ON THE
ANALYSIS OF SCOPE THAT IS TO BE
CONDUCTED BY THE U. C AS OUR
ORGANIZATION SEES IT, THE /C
HAS NOT PLAYED A ROLE AND
DISCUSSION ON SO THE /C DOES
NOT PROVIDE NEARLY A FRACTION OF
THE TRAINING, EDUCATION AND
DELIVERY OF MENTAL HEALTH
PROFESSIONALS. THEY HAVE NOT
TRADITIONALLY PLAYED A ROLE IN
SCOPE IN OUR PAST. AND OUR
CONCERNS ARE LESS ABOUT THE
STUDY BECAUSE THAT ANALYSIS IS
ALREADY LARGELY BEING DONE
THROUGH DATA COLLECTED THROUGH H
GUY. HOWEVER THE REAL
IMPLICATIONS OF A STUDY PAID FOR
BY THE LEGISLATURE AUTHORIZED BY
THIS ADMINISTRATION COULD BE ONE
THAT OPENS PANDORA'S BOX. FOR
THE SCOPES OF PRACTICE FOR OUR
PROFESSIONALS AND OTHERS IN THE
BEHAVIORAL HEALTH WORLD. IF
THERE IS TO BE A STUDY DONE, WE
DO ASK THAT THERE BE NO
RECOMMENDATIONS PROVIDED BY THE
/C. TO LIMIT THE BLOWBACK THAT
ALL OF OUR ORGANIZATIONS WILL BE
DEALING WITH FROM MULTIPLE
STAKEHOLDERS, IN ADDITION TO
SEEDING THE RESPONSIBILITIES OF
THE SUNSET REVIEW AT THE
BUSINESS AND PROFESSIONS
COMMITTEES OF BOTH HOUSES. THANK
YOU. AS CHAIRMAN OF MARY IN
MAYORS, MR CHAIRMAN, OTHER
MEMBERS PAUL YODER, ON BEHALF OF
THE CALIFORNIA STATE ASSOCIATION
OF PSYCHIATRISTS. UM, WE ARE
ALONG WITH THE PSYCHOLOGIST. WE
ARE OPPOSED TO ONE SMALL
PROVISION OF THIS OTHERWISE
FANTASTIC BILL, AND IT IS, AS
COLIN NOTED, SCOPE PART THIS
LEGISLATURE OVERWHELMINGLY,
HISTORICALLY HAS RESERVED THAT
DISCUSSION FOR ITSELF. THAT IS
WHERE THE DISCUSSION BELONGS.
THE UNIVERSITY OF CALIFORNIA.
WITH ALL DUE RESPECT HAS ITS OWN
BIASES. AS A LOT OF OTHER
ORGANIZATIONS TO WHOM YOU COULD
GIVE THAT POWER WOULD BUT TO BE
CLEAR. THE UNIVERSITY OF
CALIFORNIA DOES, IN FACT RIGHT
NOW HAVE BIASES ABOUT SCOPE OF
PRACTICE. SO YOU WILL, IN FACT.
IT'S A GIVEN GET RECOMMENDATIONS
BACK FROM THE YOU SEE THAT
INSTEAD OF THE DETENTE THAT THIS
LEGISLATURE AND OUR
ORGANIZATIONS CURRENTLY ENJOY.
INSTEAD OF THAT DETENTE. YOU
WILL HAVE CHAOS. NGUYEN AS THE
SPONSORS NOTE, MISS GAMBOA NOTED
, WE ARE TAKING ON ALL OF THESE
MAJOR MENTAL HEALTH VENTURES.
THAT ARE SO CRITICALLY NEEDED.
MENTAL HEALTH IS ONE OF THE FEW
REMAINING BIPARTISAN ISSUES AND
CONGRESS AND IN THIS
LEGISLATURE. WE'RE PROUD TO BE
PART OF THIS COALITION.99% OF
THIS BILL IS SOME OF THE BEST
STUFF I'VE EVER SEEN IN MY OVER
30 YEARS OF LOBBYING. BUT YOU
SHOULD NOT INVITE UNNECESSARILY
INVITE A SCOPE FIGHT WHERE ONE
DOESN'T EXIST CURRENTLY. THANK
YOU. THANK YOU. ARE THERE IS
ANYONE ELSE IN OPPOSITION IN THE
AUDIENCE? NO ONE WILL BRING IT
BACK TO THE COMMITTEE QUESTIONS
OR COMMENTS FROM THE COMMITTEE.
I'M SORRY. I JUST HAVE THIS
HABIT OF LOOKING TO THE RIGHT
FIRST. YOU KNOW, I DON'T KNOW
WHY. BUT BUT I APPRECIATE THE
COMMENT THAT IT'S 99.95 THERE.
SO I WILL SUPPORT THE BILL TODAY
BECAUSE I HAVE, UH I DO KNOW
THAT YOU WILL CONTINUE TO WORK
WITH THEM, AND I WOULD HOPE THAT
YOU WILL CONTINUE TO WORK ON
THEM ON THAT ONE PIECE ON THE
SCOPE. AND THE COMMENT FROM THE
STEINBERG OR ONE OF THE GROUPS
LIKE WE MUST DO ALL WE CAN DO
AND TO ME AS WE HAVE TO DO ALL
WE CAN DO PLUS MORE. I'M REALLY
CONCERNED ABOUT THE WORKFORCE.
WE SEE IT ALL THE TIME WE GET
COME COMMENTS INTO OUR OFFICES.%
ARE YOU GOING TO VISIT WITH
FRIENDS AND ALSO WHAT WE GONNA
DO ABOUT MENTAL HEALTH? SAID I.
WE DON'T HAVE THE WORKFORCE. HOW
ARE WE GOING TO FILL THAT UP? SO
I WANT TO SAY, APPRECIATE THIS
BILL. I THINK THAT WE HAVE TO
GET THIS PIECE GOING. WE CAN'T
FIX THE BACK END UNTIL WE GET
THIS FRONT END TAKEN CARE OF. SO
THANK YOU VERY MUCH FOR BRINGING
THE BILL FORWARD. THANK YOU, DR.
WEBBER. DID YOU HAVE A COMMENT?
I'M LOOKING TO THE LEFT NOW, SO
THANK YOU KNOW, I WOULD JUST
LIKE THE AUTHOR IF HE CAN TO
ADDRESS THE CONCERNS FROM THE
OPPOSITION AS REGARDS TO SCOPE.
YEAH AND IT'S ALL IT'S NOT
COMFORTABLE FOR ME TO BE
FIGHTING WITH THE PSYCHOLOGISTS
AND PSYCHIATRISTS BECAUSE WE
WORK TOGETHER. ON SO MANY OF THE
REST OF US PATIENTS CAN'T HEAR
YOU. SORRY. THAT'S BETTER. I
SAID. IT'S A LITTLE AWKWARD TO
BE FIGHTING WITH THE
PSYCHIATRIST AND PSYCHOLOGIST
BECAUSE WE WORKED TOGETHER ON SO
MANY THINGS, INCLUDING, LIKE
AGREEING ON THE VAST MAJORITY OF
THIS BILL. UM THERE, TOO, AND
WE'VE HAD VARIOUS CONVERSATIONS
THATTHERE ARE TWO POINTS THAT
THEY MAKE, UM ONE OF WHICH IS
EASILY ADDRESSABLE. WANNA IS NOT
, UM IN TERMS OF THE OBJECTION
THAT THE C IS THE WRONG ENTITY
TO CONDUCTOR WE'VE EXPRESSED AND
WE CAN ALL STATING AND TODAY IF
THERE'S A DIFFERENT ENTITY TO
CONDUCT THAT STUDY, THERE'S
NOTHING WE THOUGHT C MADE A
LOT OF SENSE FOR A VARIETY OF
REASONS. BUT IF THERE'S A
DIFFERENT, MORE AGREEABLE ENTITY
DO THE STUDY. WE DON'T HAVE A
PROBLEM WITH THAT. SO WE'RE VERY
OPEN TO CHANGING IT FROM /C TO
A DIFFERENT ENTITY AND WILL
EXPRESS THAT WE'VE SAID THAT
BEFORE, LET'S SAY IT AGAIN IF
THEY WANT TO LET US KNOW. YOU
KNOW, THREE OR FOUR DIFFERENT
ENTITIES OR WHATEVER TO DO IT.
THAT'S TOTALLY FINE. BUT BUT
THAT'S NOT THEIR ONLY OBJECTION
. SO IF WE CHANGE IT TO SOMEONE
WHO THEY BELIEVE WAS THE PERFECT
EVALUATOR. THEY WOULD STILL I
BELIEVE BE OPPOSED. UM BECAUSE
THEY THEY OBJECT FUNDAMENTALLY
EVEN EVEN EVALUATING. WHETHER
THAT SOME OF THE SCOPE AND
LICENSING ISSUES JUST TO BE
CLEAR THIS BILL DOES NOT CHANGE
SCOPE OF PRACTICE. IT DOESN'T
SAY WE WANT ONLY TO BE VIS A VIS
SOCIAL WORKERS VERSUS THERAPIST
OR PSYCHIATRIST. THEY ALL THE
BILL SAYS IS WE HAVE THIS SEVERE
SHORTAGE AND WE'RE GOING TO TRY
ALL THESE STRATEGIES TO EXPAND
IT. BUT LET'S LOOK AT OUR
EXISTING WORKFORCE AND ARE THERE
LICENSING BARRIERS? WHERE WE
COULD ACTUALLY GET MORE OUT OF
OUR EXISTING WORKFORCE BASED ON
THEIR TRAINING. LET'S JUST LOOK
AT THAT. MAYBE THERE'S NOT.
MAYBE IT'LL COME BACK AND SAY
NO, NO, YOU HAVE IT SET UP
GREAT, OR MAYBE THERE'S ONLY A
LITTLE BIT AROUND THE CORNER OR
MAYBE AROUND THE EDGES. OR MAYBE
THERE'S SOMETHING MORE
SIGNIFICANT. BUT THE IDEA THAT
WE WOULD SAY WE DON'T EVEN WANT
TO KNOW IS TO ME. I DON'T I
DON'T PERSONALLY THINK THAT'S A
TENABLE POSITION. I UNDERSTAND
THAT THEY PSYCHIATRISTS,
PSYCHOLOGISTS ARE CONCERNED THAT
THERE WILL THEN BE FIGHTING THE
LEGISLATURE AROUND SCOPE OF
PRACTICE AND ITS CHAIR KNOWS
VERY PERSONALLY. THOSE ARE NOT
THE EASIEST FIGHTS TO HAVE, UM
BUT I THINK HAVING THAT
INFORMATION IS GOOD AND FRANKLY,
IT'S BETTER THAN HAVING RANDOM
BILLS BE INTRODUCED AROUND
MENTAL HEALTH WORKFORCE IN THE
LEGISLATURE BECAUSE SOME ONE OF
THE PROFESSIONS SAYS. I WANT TO
EXPAND MY SCOPE. IT'S BETTER TO
HAVE THE HOLISTIC VIEW AND I
THINK THAT'S WHAT THIS DOES. SO
WE HAVE NO PROBLEM. SWITCHING
WHO DOES THE EVALUATION? WE'RE
HAPPY TO TALK ABOUT THE DETAILS
OF THE LANGUAGE. WE DON'T YOU
KNOW, THE LANGUAGE ITSELF IS NOT
BIBLICAL. UM BUT I THINK AS
WE'RE TAKING A BIG LOOK AT OUR
MENTAL HEALTH WORKFORCE, AT
LEAST HAVING THAT INFORMATION
STRIKES ME AS SIGNIFICANT. AND
THANK YOU, AND SO FROM THE
OPPOSITION SIDE, THE CONCERN IS
THAT SOME OF THE RECOMMENDATIONS
THAT COME FROM THIS WOULD THEN
TURN INTO SOMEONE TRYING TO, UM
, EXPAND THE SCOPE OF PRACTICE
OUTSIDE OF THE FIELD RIGHT NOW.
YEAH THANK YOU, DR WEBBER. UM
AND THAT, I THINK IS THE CRUX OF
THE CONCERN ISN'T NECESSARILY,
UH, THE MASTER'S AND DOCTORAL
LEVEL BEHAVIORAL HEALTH
PROFESSIONALS. THE LAST SEVERAL
YEARS WE'VE WORKED AS MR YODER
ALLUDED TO AT A LEVEL OF DATA
THAT IS NOT TYPICALLY SEEN
AMONGST LICENSING ORGANIZATIONS
. WE HAVE NOT ATTEMPTED TO TOUCH
EACH OTHER'S SCOPE OF PRACTICE.
WE'VE BEEN GOOD ABOUT TAKING
AMENDMENTS TO MAKE SURE THERE
ARE BRIGHT LINE DISTINCTIONS
DURING OUR SUNSET REVIEWS. WE'VE
ALL CONSULTED WITH EACH OTHER TO
MAKE SURE BUT THERE ARE THOSE
DISTINCTIONS. THE CONCERN ISN'T
NECESSARILY OUR ORGANIZATIONS.
THE CONCERN IS INDIVIDUALS,
PERHAPS WITHIN CALIFORNIA,
OUTSIDE OF CALIFORNIA, WHO SEES
CALIFORNIA'S GENEROUS BENEFITS
PRIVILEGES. IT'S TELE ACCESS THE
THINGS THAT WERE LEADING THE
COUNTRY ON AND SEES A TARGET OF
OPPORTUNITY TO GET A PAYDAY. AND
THOSE ARE THINGS THAT ARE
OUTSIDE OF ANY OF OUR
ORGANIZATIONS CONTROL. BUT COULD
BE KICKED OFF BY ANY
RECOMMENDATION, HOWEVER HONEST
OR BLUE SKY THINKING FROM AN
ORGANIZATION THAT DOES NOT HAVE
, UM A DEPTH OF UNDERSTANDING IN
THE CHALLENGES SURROUNDING SCOPE
OF PRACTICE. JEREMY I JUST HAD A
VERY QUICKLY WE ARE OKAY WITH IN
THE JUNE 6TH AMENDMENTS, THE
BROADENING THE EXAMINATION OF
ALL THE THINGS THAT VITALLY NEED
TO BE EXAMINED ABOUT THE
DIVERSITY OF THE WORKFORCE.
ETCETERA. WE ARE. WE ARE JUST
FULL THROATED SUPPORT. JUST LIKE
THE REST OF THE COALITION. IT IS
THAT ONE VERY SPECIFIC ITEM. UM
WE'RE JUST REQUEST WERE
POLITELY. TRYING TO ASK THAT IT
BE REMOVED FROM THE BILL. ANYONE
ELSE? DR. WEBBER? DO YOU HAVE A
FOLLOW UP OR ANYTHING? WELL,
THANK YOU ALL FOR THE ANSWER FOR
YOUR ANSWERS TO THESE QUESTIONS
, AND, UM, TODAY I WILL BE
SUPPORTING THE BILL. BUT I DO
HOPE THAT YOU CONTINUE TO WORK
WITH THEM, UM, AND THAT THIS IS
RESOLVED BEFORE IT COMES TO THE
FLOOR. THANK YOU. I WOULD SAY
THANK YOU VERY MUCH SENATOR
WAITING FOR BRINGING THIS BILL
FORWARD. AND, UM AH! HAVE TO
RESPECTFULLY DISAGREE WITH THE
OPPOSITION. UH TO SAY THAT WE
CAN DO A STUDY BUT BUT IF IT IF
IT IF THE STUDY COMES TO A
RESULT THAT SAYS MAYBE WE SHOULD
BE EXPANDING THE SCOPE OF
PRACTICE TO TAKE OTHER PEOPLE IN
THE FIELD, WHO MIGHT THE HAVE
THE CAPACITY TO PROVIDE SERVICES
AND NOT ALLOW THAT TO BE A PART
OF THE CONVERSATION. UM IT
DOESN'T MAKE ANY SENSE TO ME.
LOOK AND I LIVED THROUGH ONE OF
THE UGLIEST SCOPE BATTLES THIS
CAPITALIST SEEN IN THE LAST 20
YEARS. WHEN WE SOUGHT TO HAVE
NURSE PRACTITIONERS BE ABLE TO
WORK WITHOUT THE SUPERVISION OF
A PHYSICIAN LIKE IN 24 OTHER
STATES. AND WE PREVAILED. SO
FAR. BUT IT HASN'T STARTED YET.
I SAT ON THE WORKFORCE
COMMISSION THAT CALIFORNIA
HEALTHCARE FOUNDATION DID, BUT
IN 2017 2018 AND ONE OF THE
THINGS WE TALKED ABOUT
THROUGHOUT THAT DISCUSSION WAS
ABOUT ALTERING THE POTENTIAL
SCOPE. TO TAKE ADVANTAGE OF THE
SKILL SET AND TRAINING OF PEOPLE
WHO MAY NOT BE WHO MAY HAVE MORE
TO OFFER AND BE ABLE TO PRACTICE
AT A HIGHER LEVEL BUT ARE NOT
ALLOWED TO BUY THE CURRENT
STATUTE. UM AND. IF WE ARE JUST
GOING TO IGNORE THE SCOPE ISSUE
, WE ARE NEVER GOING TO GET TO A
POINT WHERE WE HAVE ENOUGH
PROVIDERS OUT THERE WITHOUT EVEN
EXPLORING IT. SO I THINK WHAT
YOU'RE ASKING FOR IS IT'S A TINY
PIECE. THAT GUTS THE INTENTION
OF THE SENATOR'S BILL. IN MY
OPINION, THAT'S HOW I SEE IT.
YOU MAY DISAGREE, BUT I THINK
IT'S A VITALLY IMPORTANT PIECE.
UM WE SHOULD BE EXPLORING
EVERYTHING AND NOT SAYING YOU
CAN TALK ABOUT ALL LITTLE
PIECES, BUT NOT THAT PIECE.
BECAUSE WE'VE GOT THIS DAYTIME.
UM, YOUR DETENTE. MAYBE PART OF
THE REASON THAT WE DON'T HAVE
ENOUGH PEOPLE IN THE FIELD. SO
UM, AND YOU MAY DISAGREE WITH ME
AND I, THAT'S FINE, BUT, UM, BUT
I BELIEVE WE OUGHT TO BE
EXPLORING THAT AND EVERYTHING
SHOULD BE ON THE TABLE. WE OUGHT
TO BE DOING EVERYTHING WE CAN TO
GET AS MANY PROVIDERS. TO TAKE
CARE OF PEOPLE WHO ACTUALLY NEED
THESE SERVICES, AND SOMETIMES IT
MEANS PUTTING ASIDE. UH
DIFFERENCES LIKE THIS IN THE
INTEREST OF THE PUBLIC HEALTH,
AND SO, UH, YOU KNOW WITH THAT
SENATOR WIENER. WOULD YOU LIKE
TO CLOSE? THANK YOU. VERY, THANK
YOU VERY MUCH, MR CHAIR. YOU
KNOW, IT'S INTERESTING IN THE
MIDDLE OF OUR DISCUSSION WITH
WITH OUR FRIENDS ARE WITH US
LIKE PSYCHOLOGISTS AND
PSYCHIATRISTS. A FRIEND OF MINE
, WHO LONGTIME SAN FRANCISCAN
WHO WENT TO PHILADELPHIA TO GET
HIS PHD IN PSYCHOLOGY HE
RECEIVED THAT HE GOT LICENSED IN
PENNSYLVANIA. AND THEN HE
DECIDED HE THOUGHT HE MIGHT WANT
TO COME BACK TO CALIFORNIA. HE
GAVE UP BECAUSE ACTUALLY GETTING
THAT LICENSE GETTING LICENSED IN
CALIFORNIA FROM ANOTHER STATE
WAS SO OVER THE TOP THAT HE
THOUGHT IT WASN'T WORTH IT. AND
SO IT'S NOT JUST SCOPE OF
PRACTICE. IT'S A LOT OF THESE
DIFFERENT POTENTIAL LICENSING
BARRIERS. AND ULTIMATELY I VERY
MUCH RESPECT THE DETENTE, SO TO
SPEAK, AND I GET THAT BUT
ULTIMATELY THERE IS IN THE BIG
PICTURE HERE ON THIS BILL, THERE
IS DRAMATICALLY MORE THAN ENOUGH
WORK FOR EVERYONE. BECAUSE RIGHT
NOW, I DON'T CARE IF YOU'RE
TRYING TO FIND A SOCIAL WORKER
OR A THERAPIST OR A PSYCHIATRIST
OR A PSYCHOLOGIST. THERE ARE NOT
ENOUGH OF ANY OF THESE
PROFESSIONS. AND SO EVEN IF YOU
HAVE MONEY AND RESOURCES AND YOU
WANT TO FIND THE THERAPIST, IT'S
STILL HARD AND IMAGINE IF YOU'RE
SIMPLY A MIDDLE CLASS OR LOWER
INCOME PERSON. UH AND WE KNOW
THAT EVEN AND WE SEE THIS WITH
OUR MENTAL HEALTH PARITY FIGHTS,
EVEN PEOPLE WHO HAVE GOOD
INSURANCE. STRUGGLE TO GET CARE
SO I WILL CONTINUE TO WORK WITH
THE OPPOSITION, BUT BIG PICTURE.
THIS BILL EMPLOYS A LOT OF GOOD
STRATEGIES TO HELP FIX THIS
PROBLEM, AND I RESPECTFULLY ASK
FOR AN IVO. THANK YOU. THANK
YOU, SENATOR. WIENER THE BILL
THAT WE HAVE A MOTION BY MS
AGUIAR-CURRY. I BELIEVE THE
SECOND BY MR BIGELOW. THE MOTION
IS DUE PAST HIGHER EDUCATION.
UM, MADAM SECRETARY, PLEASE CALL
THE ROLL. I WOULD, I WOULD I.
WALDRON. WILDER AND IAGAR CURRY
CURRY. I ARAMBULA ARAMBULA. AYE,
BIGELOW BIGELOW. I CARILLO.
FLORA MAIENSCHEIN MAZE MCCARTHY.
NAZARIAN. LUZ RIVAS CHOLERA.
COBRA I, SANTIAGO WEBER.
HOWEVER, I. HAVEN'T IS ZERO. 7
TO 0. YOU'RE CLOSER THAN ANYBODY
HAS BEEN ALL DAY TO A VOTE TO
GET A BILL OUT OF THIS
COMMITTEE, SO WE'LL LEAVE IT ON
CALL. THANK YOU, COLLEAGUES.
THANK YOU, SENATOR. SENATOR
WILK. I BELIEVE IT'S YOUR TURN.
IT IS BECAUSE YOU'RE THE ONLY
SENATOR SITTING OUT THERE.
PLEASE PULL THAT MICROPHONE DOWN
AND I'M NOT QUITE AS TALL
SENATOR WIENER. NOBODY IS. NOT
HERE ANYWAY. CAN YOU HEAR ME?
OKAY ABSOLUTELY GREAT. FIRST
TIME IN HERE. THIS IS BEAUTIFUL
IS WAY NICER THAN THAN THE
SENATE. DO YOU LIKE GREEN? I
COME FROM GREEN, SO YOU KNOW, I
DO ANYWAY. GOOD AFTERNOON, MR
CHAIRMAN AND MEMBERS BEFORE YOU
TODAY IS SP 10 89, A BILL THAT
WILL ENSURE THAT CALIFORNIA'S
MEDICAL BENEFICIARIES ARE ABLE
TO RECEIVE THE HIGHEST QUALITY.
EYEGLASSES AVAILABLE. CURRENT
LAW REQUIRES OPTOMETRIST ANOTHER
EYE CARE PROVIDERS TO OBTAIN
EYEGLASSES FROM A MEDICAL
MEDICAL BENEFICIARY FROM THE
CALIFORNIA PRISON IN INDUSTRY
AUTHORITY. THIS SYSTEM. HE'S HAD
A LOT OF CHALLENGES, FORCING
THESE PATIENTS TO SOMETIMES WAIT
MONTHS TO RECEIVE THE RIGHT
GLASSES. AND WHEN THEY DO
FINALLY GET THEM, THE GLASSES
ARE OFTEN NOT OF SUFFICIENT
QUALITY OR MADE WITH THE RIGHT
PRESCRIPTION. THE IMPACT OF THIS
, PARTICULARLY ON YOUNG STUDENTS
, WHO ARE MEDICARE
BENEFICIARIES. HAVING TO BE
FORCED TO WAIT MONTHS OFTENTIMES
PUTS THEM BACK ACADEMICALLY
WITHOUT THE ABILITY TO SEE
CLEARLY, UM, EVENTS OF THE PAST
FEW YEARS. HE MADE IT HARD
ENOUGH FOR YOUNG PEOPLE TO GET
AHEAD. AND AS A LEGISLATORS OUR
RESPONSIBILITY TO ELIMINATE
THESE HURDLES TO ACCESSING
QUALITY EYE CARE FOR
CALIFORNIANS. SO WHAT THIS BILL
DOES IS SIMPLY ALLOW PROVIDERS
TO OBTAIN THESE EYEGLASSES FROM
PRIVATE ENTITIES. IN ADDITION TO
THE PIA AND ENSURING THAT
MEDICARE BENEFICIARIES ARE ABLE
TO RECEIVE THEIR EYE CARE IN A
TIMELY MANNER WITH ME TODAY TO
PROVIDE, UH, EXPERT TESTIMONY,
AND I NOTICED HE ALSO GOT HIS
HAIRCUT IS MR TOÀN TERRY MCHALE
ON BEHALF OF THE CALIFORNIA
OPTOMETRIC ASSOCIATION. I WE
CAN'T HEAR YOU. SO WE CAN'T TELL
IF YOU GOT YOUR HAIRCUT OR NOT.
SO, YEAH, I CAN ASSURE YOU I
DIDN'T GET IT CUT JUST FOR THIS
COMMITTEE, MR CHAIRMAN, TERRY
MCHALE, WITH AARON REID AND
ASSOCIATES REPRESENTING THE
CALIFORNIA OPTIMA TRICK SOCIETY.
THIS BILL INDEED IS VERY DIRECT
. BUT IT WILL MAKE A PROFOUND
DIFFERENCE IN THE LIVES OF OUR
MOST VULNERABLE PATIENTS. THE
MEDICAL RECIPIENTS ARE FORCED TO
ENDURE UNFAIR WAITING TIME FOR A
PAIR OF GLASSES. THIS
LEGISLATION PASSED UNANIMOUSLY
OUT OF THE HEALTH AND PUBLIC
SAFETY COMMITTEES, THE
APPROPRIATIONS COMMITTEE AND OFF
THE SENATE FLOOR UNANIMOUS
SUPPORT FROM BOTH SIDES OF THE
AISLE. MR CHAIRMAN AND MEMBERS.
THERE HAVE BEEN GREAT VICTORIES
IN THE PRISON 75,000 PRISONERS
HAVE BEEN REMOVED FROM
INCARCERATION IN THE PAST COUPLE
OF YEARS, BUT THERE ARE ALSO
UNINTENDED CONSEQUENCES. IN OUR
FIRES. WE SEE 190 INMATE CREWS
REDUCED TO 45 R P I A PROGRAMS.
WE HAVE LOST INMATES THAT HAVE
HELD THESE INDUSTRIES TOGETHER.
WHEN IT COMES TO OPTOMETRIC
SERVICES, MR CHAIRMAN AND
MEMBERS OF THE COMMITTEE, THE
PIA HAS ALWAYS BEEN PROBLEMATIC.
IN FACT, THE TURNOVER WITHIN THE
PRISONS ITSELF HAS BEEN SUCH BUT
IN THE LAST 15 YEARS MORE THAN
2000 PRISONERS HAVE ROTATED LESS
THAN 300 JOBS. THE NUMBER ONE
COMPLAINT THAT OPTOMETRISTS
RECEIVE COME FROM MEDICAL
PATIENTS AND THE PARENTS OF
MEDICAL PATIENTS THAT IT TAKES
SO LONG TO GET THE GLASSES BACK.
AND THE GLASSES THEY RECEIVE ARE
SO OFTEN OF QUESTIONABLE
QUALITY. IN PREPARATION FOR THIS
COMMITTEE. WE DID A SURVEY OF
OPTOMETRISTS AND FOUND OUT THAT
38% SAY IT TAKES UP TO TWO
MONTHS TO RECEIVE THE GLASSES.
AVERAGE IS TWO WEEKS. OVER 50%
SAY IT TAKES TOO MUCH OVER TWO
MONTHS. WE HAVE ALSO HEARD
STEADY COMPLAINTS UP STANDARD
PRODUCT. IT IS INTERESTING WHEN
WE GAVE THESE NUMBERS TO THE P I
A APIA RESPONDED THAT THEY CAN
DO THE WORK THAT THEY DO THE
WORK IN 5 TO 9 DAYS. WE SAID
THAT THAT WAS NOT CONSISTENT
WITH OUR DATA, AND THEY TOLD US
THAT JUST BECAUSE THEY DID IT IN
5 TO 9 DAYS DOESN'T MEAN THAT IT
GETS BACK TO THE CUSTOMER OR TO
THE CLIENT THAT THEIR SECURITY
OVERSIGHT AND PRIORITIZATION
MEANS THAT THEY DO NOT HAVE ANY
DATA AND HOW LONG IT ACTUALLY
TAKES THE LENSES TO ARRIVE TO
THE CLIENTS. THIS. THE P I A HAS
OVER 7000 INMATES. PRODUCING
MORE THAN 1500 PRODUCTS. THIS
BILL WILL NOT DAMAGE THE P A.
HE'S MISSED, HE'S DISPLACED
INMATES WILL BE ABLE TO FIND
WORK IN OTHER FIELDS. IN THAT
REGARD. I WOULD SAY THAT WE HAVE
NEVER BEEN ABLE TO FIND WHERE A
PRISONER HAS GONE FROM WORKING
THE P A AND UP TO AND OPTICS TO
BE WORKING IN IT IN A
PROFESSIONAL LEVEL. FINALLY
SENATOR WILKES SAID, IF THE P I
A WERE TO PRODUCE IT IN 5 TO 9
DAYS AS THEY TALKED, AND THEY
WOULD BE COMPETITIVE AND WOULD
NOT BE IMPACTED. THIS BILL
ALLOWS OPTOMETRISTS TO BE ABLE
TO BE ABLE TO GO TO OTHER
PROVIDERS AND TAKE CARE OF THESE
VULNERABLE PATIENTS. I ASKED FOR
MY VOTE. THANK YOU. OTHERS AND
SUPPORT IN THE CHAMBER HERE OR
ROOM. NO ONE IS THERE ANYONE IN
OPPOSITION TO THE BILL? I MEAN,
NO ONE WILL BRING IT BACK TO THE
COMMITTEE QUESTIONS OR COMMENTS
FROM THE COMMITTEE. PRACTICALLY
SEEING NO ONE UP HERE, UM AH! WE
HAVE A MOTION BY DR ARAMBULA WHO
WAS HERE BUT ISN'T NOW YOU KNOW
HE'S STILL HERE. HERE HE IS.
OKAY. NEVER MIND AND THEN A
SECOND BY MS WALDRON, WOULD YOU
LIKE TO CLOSE SENATOR? WELCOME
REALLY APPRECIATE YOUR
CONSIDERATION. I KNOW I
REPRESENT ONE POINT 1,040,000
CONSTITUENTS AND OVER 500,000 OF
THOSE CONSTITUENTS ARE ON
MEDICAL. IT IS AN ISSUE
THROUGHOUT THE STATE AND MIRACLE
, A BENEFICIARY'S DESERVE THE
SAME LEVEL OF SERVICES.
EVERYBODY ELSE SO I AGAIN, UH,
ASKED FOR AND I VOTE. THANK YOU
FOR YOUR TIME. THANK YOU,
SENATOR WILK. THE BILL DOES
ENJOY DO PASS RECOMMENDATION.
THE MOTION IS DUE PASS TO PUBLIC
SAFETY. MADAM SECRETARY. PLEASE
CALL THE ROLL. WOULD WOULD I?
WALDRON WALDRON, IAGAR CURRY
CURRY. I ARAMBULA ARAMBULA. AYE,
BIGELOW BIGELOW. I CARILLO.
KOREA I FLORA MAIENSCHEIN
MAIENSCHEIN. I'M ACES. MCCARTY
CAESARIAN. LUZ RIVAS CALDERON.
SARAH I SANTIAGO. HOWEVER. 00
EUR THE FIRST BILL OUT TODAY.
CONGRATULATIONS SENATOR WILL
OPEN FOR OTHERS TO ADD ON. THANK
YOU. DR RAMBLER YOU PRESENT
YOU'RE GONNA PRESENT FOR SENATOR
HERNANDEZ. I'M SORRY. I WAS
STILL IN EYEGLASSES, SO FORMER
SENATE HEALTH CHAIR. ANYWAY,
WE'RE SENATOR HERTZBERG. THANK
YOU VERY MUCH. MEMBERS AND
COLLEAGUES IN CALIFORNIA WE DO
NOT TAKE HEALTHCARE COVERAGE FOR
GRANTED. THANKS TO THE ROBUST
IMPLEMENTATION OF THE A. WE LEAD
THE NATION AND PROVIDING
UNIVERSAL ACCESS TO HEALTH CARE
COVERAGE FOR CITIZENS. COVERED
CALIFORNIA'S OUTREACH WORK HAS
HELPED 2.9 MILLION PEOPLE FIND
HEALTH INSURANCE, OFTENTIMES AT
A DISCOUNT. THAT'S 2.9 MILLION
PEOPLE WHO NOW HOLD A GREATER
CHANCE OF IMPROVED OVERALL
HEALTH OUTCOMES SIMPLY BECAUSE
OF THEIR ACCESS TO HEALTHCARE.
YET DESPITE THE HARD WORK BEING
DONE BY COVERED CALIFORNIA
NEARLY ONE MILLION CALIFORNIANS
ARE STILL UNINSURED. OF THIS ONE
MILLION AROUND. 900,000 PEOPLE
ARE ACTUALLY ELIGIBLE FOR FREE
HEALTHCARE. THESE INDIVIDUALS
ARE LIKELY UNAWARE THAT THEY
EVEN QUALIFY FOR NO COST OR LOW
COST. INSURANCE BECAUSE THEY
DON'T HAVE ACCESS TO THIS
CRITICAL INFORMATION. SP 9 67
WORKS TO CONNECT THESE UNINSURED
CALIFORNIANS WITH VITAL
HEALTHCARE COVERAGE BY SIMPLY
REQUIRING THE FRANCHISE TAX
BOARD INCLUDED CHECKS. CHECK BOX
ON EACH INDIVIDUAL TAX INCOME
RETURN WHERE A TAXPAYER CAN
INDICATE THEIR INTEREST IN NO
COST OR LOW COST HEALTH CARE.
THIS WILL ALLOW COVERED
CALIFORNIA TO BOOST THEIR ANNUAL
OUTREACH AND ENROLLMENT EFFORTS
AND TARGET THOSE WITHOUT
COVERAGE WHO INDICATE THEIR
INTEREST. THIS COMMON SENSE
MEASURE WILL HELP BRING
CALIFORNIA ONE STEP CLOSER TO
OUR MISSION TO FINALLY CLOSING
THE HEALTHCARE GAP IN THIS STATE
FOR GOOD. HERE TO TESTIFY IN
SUPPORT IS JOSE TORRES CASILLAS
, LEGISLATIVE ADVOCATE WITH
HEALTH ACCESS CALIFORNIA MOVE
THE BILL. THANK YOU, DR ROBERT.
GOOD AFTERNOON, MR CHAIRMAN
MEMBERS JOSE TOURS ON BEHALF ON
BEHALF OF HEALTH ACCESS
CALIFORNIA, THE STATEWIDE
HEALTHCARE CONSUMER ADVOCACY
COALITION AND A CO SPONSOR. IN
SUPPORT OF SB 9 67. THIS BILL
WOULD CREATE A CHECKBOX ON STATE
INCOME TAX RETURN FORMS. CAN YOU
PULL THE MICROPHONE CLOSER TO
YOU? PLEASE? THANKS. YEAH. THIS
BILL WOULD CREATE A CHECKBOX ON
STATE INCOME TAX RETURN FORMS AS
DOCTOR DOCTOR ARAMBULA MENTIONED
AND BY HAVING PEOPLE FILL THE
FORM, UM BY HAVING PEOPLE MARKED
THE FORM. THAT THEY WOULD ALLOW
THE EXCUSE ME. SORRY. THIS BILL
WOULD CREATE A CHECKBOX ON STATE
INCOME TAX RETURN FORMS THAT
WOULD ALLOW PEOPLE TO MARK IF
THEY ARE INTERESTED IN RECEIVING
MORE INFORMATION ABOUT LOW COST
OR NO COST HEALTHCARE COVERAGE.
THIS WOULD NOT AUTOMATICALLY
ENROLL PEOPLE INTO COVERAGE, BUT
IT WOULD ALLOW THEM TO CHOOSE IF
THEY WERE IT WOULD ALLOW THEM TO
CHOOSE TO RECEIVE MORE
INFORMATION. HAVING HEALTH CARE
COVERAGE IMPROVES HEALTH
OUTCOMES, AND CALIFORNIA HAS
DONE GREAT WORK IN LEADING THE
WAY IN REDUCING THE UNINSURED
RATE IN THE STATE. THIS WOULD
BENEFIT THOSE WHO ARE UNDER
UNINSURED AND PROVIDE THEM WITH
INFORMATION ABOUT THE VARIOUS
HEALTHCARE COVERAGE OPTIONS THAT
MAY BE AVAILABLE TO THEM. SB 967
WOULD ALSO HELP CONNECT PEOPLE
WHO, MAYBE UNDERINSURED OR
SIMPLY NOT KNOW WHAT OPTIONS
EXIST FOR THEM. OVER CALIFORNIA
ALREADY DOES GREAT WORK IN THEIR
OUTREACH AS MENTIONED, AND THIS
IS A NEW AVENUE FOR THEM TO
REACH OUT TO HEALTHCARE
CONSUMERS, AND WE HOPE MEMBERS
TODAY CAN SUPPORT THIS BILL WITH
AN I VOTE. THANK YOU FOR YOUR
TIME AND NOW PASS IT OVER. YOU
KNOW, MY COLLEAGUES. NEXT. WE
HAVE JAMIE MORGUE UNWIN, THE
AMERICAN HEART ASSOCIATION. GOOD
AFTERNOON, MR CHAIR AND MEMBERS
NEED TO SPEAK UP REALLY SPEAK
INTO THAT. PLEASE OKAY. IS THIS
BETTER? LITTLE BIT A LITTLE BIT
, OKAY, A LOUD. YEAH PLEASE.
OKAY SPEAK ENTHUSIASTICALLY AND
VERY LOUD. MY NAME IS JAMIE MORE
GONAD. I'M WITH THE AMERICAN
HEART ASSOCIATION, AND WE'RE
PLEASED TO CO SPONSOR THIS BILL.
WE KNOW THE IMPORTANCE ACCESS TO
HEALTHCARE HAS ON INDIVIDUALS
AND THEIR FAMILIES, SUCH AS
IMPROVED HEALTH OUTCOMES.
GREATER ADHERENCE TO COMMON
PREVENTATIVE MEASURES. AND
LONGER TERM SURVIVAL. RATES FROM
CHRONIC DISEASES SUCH AS
CARDIOVASCULAR DISEASE. WE ALSO
KNOW THAT THOSE WHO ARE
UNDERINSURED OR DO NOT HAVE
HEALTH INSURANCE HAVE HIGHER
MORTALITY RATES AND POORER BLOOD
PRESSURE CONTROL THAN THEIR
INSURED COUNTERPARTS, AND OFTEN
, THIS IS MORE PREVALENT IN
COMMUNITIES OF COLOR. SP 9 67 IS
A COMMON SENSE MEASURE THAT
BUILDS ON EXISTING OUTREACH
EFFORTS TO THOSE WHO MAY BE AN
INSURED AND UNDERINSURED AND
INFORMS THEM OF LOW COST OR NO
COST HEALTHCARE COVERAGE
OPPORTUNITIES. ACCESS TO
HEALTHCARE COVERAGE IS ESSENTIAL
TO IMPROVING HEALTH EQUITY AND
WILL ADDRESS EXISTING HEALTH AND
SOCIO ECONOMIC DISPARITIES ARE
STATE CASES TODAY. THANK YOU FOR
YOUR TIME, AND WE URGE YOUR I
VOTE. THANK YOU VERY MUCH OTHERS
IN SUPPORT OF THE BILL, PLEASE
COME FORWARD. JUST YOUR NAME AND
ORGANIZATION, PLEASE. GOOD
AFTERNOON, LINDA WAY WITH
WESTERN CENTER ON LAW AND
POVERTY IN SUPPORT. THANK YOU.
REBECA GONZALEZ NATIONAL
ASSOCIATION OF SOCIAL WORKERS
CALIFORNIA CHAPTER AND SUPPORT.
KELLY BROOKS ON BEHALF OF THE
COUNTY HEALTH EXECUTIVES
ASSOCIATION OF CALIFORNIA AND
SUPPORT THANK YOU. IS THERE
OPPOSITION TO THE BILL? AND THEN
BRING IT BACK TO THE COMMITTEE
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. AND WE DO HAVE
EMOTION BY MS AGUIAR-CURRY IS
SECOND BY MS WALDRON. UH THE
MOTION IS DUE PASTOR, REV AND
TAX. WOULD YOU LIKE TO CLOSE
DOCTOR ARAMBULA? THANK YOU. I
RESPECTFULLY ASK FOR AN I VOTE.
THANK YOU VERY MUCH. MADAM
SECRETARY, PLEASE CALL THE ROLL.
WOULD, WOULD I, WALDRON. WALTER
AND I ARE CURRY CURRY. I
ARAMBULA ARAMBULA. AYE, BIGELOW
BIGELOW. I CARILLO CARILLO I
FLORA. MAIENSCHEIN MAIENSCHEIN
AYE, MAZE. MCCARTY NAZARIAN.
LUZ RIVAS CHOLERA. ALRIGHT I ON
TIAGO. HOWEVER. HOWEVER, I. 9200
THE BILL IS OUT WILL LEAVE THE
ROLE OPEN FOR OTHERS TO ADD ON.
SO ALL THE BILLS HAVE BEEN
PRESENTED. UM WE WILL GO TO THE
TOP OF THE ORDER MEMBERS ARE ALL
OVER THE PLACE HERE TODAY. BUT
THOSE OUT OF RESPECT FOR THOSE
WHO ARE HERE WILL GIVE THEM AN
OPPORTUITY TO VOTE ON THE
BILLS. WE'LL START AT THE TOP OF
THE ORDER WITH ITEM NUMBER ITEM
NUMBER ONE SB 4 73 ASKED MADAM
SECRETARY TO LIFT THE CALL AND
CALL THE ABSENT MEMBERS.
ARAMBULA. I'M NUMBER ONE.
ARAMBULA AYE, CARILLO CARILLO I
FLORA MAIENSCHEIN MAIENSCHEIN.
AYE MAZE MCCARTY. MCCARTHY I
GRIEVOUS KALRA. LARA I SANTIAGO.
WEBBER WEBBER? AYE. THIS AREA.
OH, I ALREADY HAVE EMBASSY.
WELL, AND I. IT'S 11 TO 0 THAT
IS 11 0 WILL LEAD THE ROLE OPEN
FOR OTHERS TO ADD ON THE
CONSENT. CALENDAR INCLUDES ITEM
NUMBER TWO SB 11 65 ITEM NUMBER
FIVE SP 13 94 OUT OF NUMBER
EIGHT SP 9 88. AND ITEM NUMBER
10 SB 9 66, PLEASE, PLEASE LIFT
THE CALL AND CALL THE ABSENT
MEMBERS. ARAMBULA ARAMBULA. AYE.
CARILLO. RIO I FLORA MAIENSCHEIN
MAIENSCHEIN. I MADE MCCARTHY
MCCARTHY, I RIVAS ALGEBRA.
CHOLERA I SANTIAGO WEBER.
WHOEVER I. AS A CONSENT
CALENDAR. 11 0, 11 0 AND THE
CONSENT CALENDAR ITEM NUMBER
THREE. SB 14 19 BY SENATOR
BECKER, PLEASE LIFT THE CALL.
CALL THE ABSENT MEMBERS.
ARAMBULA ARAMBULA. AYE. CARILLO.
CARILLO? AYE, MAIENSCHEIN.
MAIENSCHEIN I MAZES, MCCARTY
MCCARTHY I NAZARIAN NAZARIAN. I
RIVAS. CHOLERA. PAUL RELIES
SANTIAGO, HOWEVER. HOWEVER, I.
90. I'M SORRY. 93 VOTE IS 93.
ITEM NUMBER. FOUR SB 10 35 BY
SENATOR EGGMAN, PLEASE LIFT THE
CALL AND CALL THE ABSENT
MEMBERS. ARAMBULA ARAMBULA. AYE
CARILLO CARILLO. AYE,
MAIENSCHEIN. MAIENSCHEIN I MADE
MCCARTHY MCCARTHY I REBUS
CHOLERA. FOR A I. SANTIAGO.
WEBER. WEBER. AYE. UP TO 0 12 0.
ITEM NUMBER. UM. SIX UM SP 14 75
THESE. OPEN THAT LIFT THE CALL.
CALL THE ABSENT MEMBERS CURRY.
AGUIAR-CURRY AYE ARAMBULA
ARAMBULA, NOT VOTING CARILLO.
CARILLO, NOT VOTING MAIENSCHEIN.
MAIENSCHEIN NOT VOTING MAZE.
MCCARTHY. MCCARTHY NOT VOTING
NAZARIAN. IS THERE IS AREA NOT
VOTING, REBUS. SANTIAGO.
LUZ RIVAS. AYE. SANTIAGO. 7 TO
0. SEVEN VOTES, OKAY? ITEM
NUMBER SEVEN SP 9 67 HERZBERG,
PLEASE, UH, OPEN OPEN THE ROLE
CALLED THE ABSENT MEMBERS LARA.
MAZE. MCCARTY MCCARTHY, I
NAZARIAN? NAZARIAN I RIVAS RIVAS
I SANTIAGO 12 TO 0. 12 0 ITEM
NUMBER NINE SP 9 68 SP 6 44,
PLEASE LIFT THE CALL. CALL THE
ABSENT MEMBERS. WALDRON WALDRON.
I AGUIAR-CURRY AGUIAR-CURRY. AYE
ARAMBULA ARAMBULA I FOR YOU,
CARILLO I FLORA MAIENSCHEIN.
MAIENSCHEIN I MADE LUZ RIVAS
RIVAS ICE SANTIAGO. 11 TO 1 11
TO 1. THAT BILL IS OUT. ITEM
NUMBER 11 SB 8 64, PLEASE LIFT
THE CALL AND CALL THE ABSENT
MEMBERS. WALDRON. WALDRON I
ARAMBULA ARAMBULA. AYE, CARILLO.
CARILLO I FLORA MAIENSCHEIN
MAIENSCHEIN. I MADE MCCARTHY
MCCARTHY HIGHNESS ARIAN NAZARIAN
IVORY OF US, RIVAS I SANTIAGO.
12 0 12 0 IS OUT. ITEM NUMBER 12
SB 9 64, PLEASE OPEN THE LIFT
THE CALL CALL THE ABSENT MEMBERS
CARILLO. I'M SORRY THAT WAS
OPENED THE ROLE THAT WAS OUT,
WASN'T IT? IT'S NOT. IT'S NOT.
OKAY. LIFT THE CALL, PLEASE. I'M
SORRY. SP 9 64 ITEM NUMBER 12
CARILLO I FLORA MAIENSCHEIN
MAIENSCHEIN. I MADE MCCARTHY
MCCARTHY. I NAZARIAN. IN THIS
AREA AND I RIVAS RIVAS SANTIAGO.
2012 0 AND ITEM NUMBER 13 SB 10
89 BY SENATOR WILK, PLEASE. OPEN
THE ROLE AND CALL THE ABSENT
MEMBERS. FLORA AMAZE MCCARTY.
MCCARTHY. I NAZARIAN. CAESARIAN
I RIVAS RIVAS. AYE. SANTIAGO.
WEBER. HOWEVER, I. 12 TO 0 12 0.
UM. YES, WE GOT TO GO BACK, SO
WE GOTTA YEAH. SO I DON'T KNOW
WHERE YOU WERE CAME IN. MR
NAZARIAN, DO YOU. YOU MAY MISS
ONE. LET'S START AT THE TOP.
THEN, UM SO ITEM NUMBER ONE SP 4
73, PLEASE OPEN THE ROLL CALL
THE ABSENT MEMBERS. FLORA MAZE,
REBUS. SANTIAGO RIVAS I SANTIAGO
OF ZERO. 12 0 ITEMS, THE CONSENT
CALENDAR DECEMBER 258 AND 10,
PLEASE OPEN THE ROLL CALL THE
ABSENT MEMBERS LARA. MAZE. RIVAS
RIVAS I SANTIAGO. CONSENT
CALENDAR. SOMETHING I GO. I. 13
0 13 0. LET'S GO BACK TO THE TOP
TO GRAB MR SANTIAGO'S VOTES, SO
WE ONLY HAVE TO DO THIS ONE MORE
TIME. SO ITEM NUMBER ONE SB 4 73
BY SENATOR BATES, PLEASE OPEN
THE ROYAL CALLED THE ABSENT
MEMBERS. FLORA MAY SANTIAGO.
SANTIAGO I NIGHT UH, 13 0 13 0.
AND THEN YOU GOT THE CONSENT
CALENDAR. OKAY, GOOD. SO ITEM
NUMBER THREE. SB 14 19, SENATOR
BECKER, PLEASE OPEN THE ROLL
CALL THE ABSENT MEMBERS. SPACE.
RIVAS. RIVAS, NOT VOTING.
SANTIAGO SANTIAGO. AYE. AND THE
THREE AND A THREE ITEM NUMBER
FOUR. SB 10 35, SENATOR EDMUND
PLEASE OPEN THE ROLE CALLED THE
ABSENT MEMBERS MAZE GRIEVOUS.
RIVAS SANTIAGO SANTIAGO I 14 0
14 0 ITEM NUMBER. SIX SP 14 75
GLASER, PLEASE OPEN THE ROYAL
CALLED THE ABSENT MEMBERS MAZE
GRIEVOUS. I'M HAPPY TO SAY
SORRY. SANTIAGO SANTIAGO. AYE.
THAT'S 8 TO 080. ALL RIGHT.
PARDON? SO NAZARIAN, NOT VOTING
TÔI. OKAY? NOW THAT IS 90 NOW,
90. OKAY ITEM NUMBER SEVEN. SB 9
67 HERZBERG, PLEASE OPEN THE
ROLL. CALL THE ABSENT MEMBERS
FLORA. MAZE. SANTIAGO SANTIAGO.
I 13 0 ITEM NUMBER NINE SP 6 44
LEYVA. UM PLEASE OPEN THE ROLL.
CALL THE ABSENT MEMBERS FLORA
MAZE. SANTIAGO. SANTIAGO. I 12
12-1. AN ITEM NUMBER 11. SB 8 64
MELINDA'S, PLEASE OPEN THE ROLE
CALLED THE ABSENT MEMBERS. LARA
MAZE, SANTIAGO. SANTIAGO I 13 00
DON'T REMEMBER. 12 SP 9 64
PLEASE OPEN THE ROLL. CALL THE
ABSENT MEMBERS. LARA MAZE.
SANTIAGO SANTIAGO. I 13 0 AND
FINALLY, ITEM NUMBER 13 SP 10 89
WILK, PLEASE OPEN THE ROLL CALL
THE OPPOSITE MEMBERS. LARA MAY
SANTIAGO SANTIAGO. I 13 0. OKAY?
AND WITH THAT WE ARE ADJOURNED.